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A comparison of HLA-identical sibling allogeneic versus autologous transplantation for diffuse large B cell lymphoma: a report from the CIBMTR. Biol Blood Marrow Transplant 2010 Jan;16(1):35-45 PMID: 20053330 PMCID: PMC2929576

Pubmed ID

20053330

DOI

10.1016/j.bbmt.2009.08.011

Abstract

We compared outcomes of 916 diffuse large B cell lymphoma (DLBCL) patients aged >or=18 years undergoing first autologous (n = 837) or myeloablative (MA) allogeneic hematopoietic cell transplant (HCT) (n = 79) between 1995 and 2003 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Median follow-up was 81 months for allogeneic HCT versus 60 months for autologous HCT. Allogeneic HCT recipients were more likely to have high-risk disease features including higher stage, more prior chemotherapy regimens, and resistant disease. Allogeneic HCT was associated with a higher 1 year treatment-related mortality (TRM) (relative risk [RR] 4.88, 95% confidence interval [CI], 3.21-7.40, P < .001), treatment failure (RR 2.06, 95% CI, 1.54-2.75, P < .001), and mortality (RR 2.75, 95% CI, 2.03-3.72, P < .001). Risk of disease progression was similar in the 2 groups (RR 1.12, 95% CI, 0.73-1.72, P = .59). In fact, for 1-year survivors, no significant differences were observed for TRM, progression, progression-free (PFS) or overall survival (OS). Increased risks of TRM and mortality were associated with older age (>50 years), lower performance score, chemoresistance, and earlier year of transplant. In a cohort of mainly high-risk DLBCL patients, upfront MA allogeneic HCT, although associated with increased early mortality, was associated with a similar risk of disease progression compared to lower risk patients receiving autologous HCT.

Author List

Lazarus HM, Zhang MJ, Carreras J, Hayes-Lattin BM, Ataergin AS, Bitran JD, Bolwell BJ, Freytes CO, Gale RP, Goldstein SC, Hale GA, Inwards DJ, Klumpp TR, Marks DI, Maziarz RT, McCarthy PL, Pavlovsky S, Rizzo JD, Shea TC, Schouten HC, Slavin S, Winter JN, van Besien K, Vose JM, Hari PN

Authors

Parameswaran Hari MD Chief, Professor in the Medicine department at Medical College of Wisconsin
J. Douglas D. Rizzo MD, MS Director, Ctr Associate Director, Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-72649090031   54 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Disease Progression
Female
Follow-Up Studies
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans
Lymphoma, Large B-Cell, Diffuse
Male
Middle Aged
Registries
Retrospective Studies
Siblings
Statistics as Topic
Tissue Donors
Transplantation, Autologous
Transplantation, Homologous
Treatment Outcome
Young Adult
jenkins-FCD Prod-321 98992d628744e349846c2f62ac68f241d7e1ea70