Faculty Collaboration Database

Efficacy of High-Dose Therapy and Autologous Hematopoietic Cell Transplantation in Gray Zone Lymphoma: A US Multicenter Collaborative Study. Biol Blood Marrow Transplant 2018 Mar;24(3):486-493

Date

12/12/2017

Pubmed ID

29225164

DOI

10.1016/j.bbmt.2017.11.033

Scopus ID

2-s2.0-85044870952 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

High-dose therapy (HDT) and autologous hematopoietic cell transplantation (auto-HCT) has been anecdotally prescribed in gray zone lymphoma (GZL), showing encouraging efficacy. We conducted a multicenter retrospective study aimed at assessing outcomes after auto-HCT in 32 patients with GZL treated at 9 transplantation centers in the United States. The median age of patients at transplantation was 38 years (range, 18 to 70 years), and the majority were male (n = 21; 66%). The median number of lines of therapy before transplantation was 2 (range, 1 to 4). BEAM was the most commonly prescribed regimen (n = 23; 72%). The median duration of follow-up for surviving patients was 34 months (range, 1 to 106 months). Median overall survival (OS) was not reached. The 3-year progression-free survival (PFS) and OS for all patients were 69% and 78%, respectively. Three-year PFS and OS were 100% for patients who received only 1 line of therapy before auto-HCT versus 65% (PFS, P = .25) and 75% (OS, P = .39) for those receiving >1 line. The cumulative incidence of relapse/progression was 4% at 1 year post-transplantation and 31% at 3 years post-transplantation. The 3-year nonrelapse mortality was 0%. These findings suggest that HDT and auto-HCT is an effective treatment in patients with GZL. Our findings ideally require confirmation in a larger cohort of patients, preferably in the setting of large prospective multicenter randomized controlled trials. However, we acknowledge that such studies could be difficult to conduct in patients with GZL owing to the disease's rarity. Alternatively, a multicenter prospective study that includes tissue banking and a data registry is warranted to help better understand the biology and natural history of the disease.

Author List

Kharfan-Dabaja MA, Raj R, Nikolaenko L, Ahmed S, Reddy N, Nathan S, Cherry M, El-Jurdi N, Obiozor C, Fenske TS, Song J, Muzzafar T, Ayala E, Savani B, Khawandanah M, Caimi PF, Hamadani M, Forman SJ, Hussaini M, de Lima M, Olteanu H, Shah B, Chavez JC, Al Malki M, Kumar A, Ganguly S

Authors

Timothy Fenske MD Professor in the Medicine department at Medical College of Wisconsin
Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin

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

Adolescent
Adult
Aged
Autografts
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma
Male
Middle Aged
Survival Rate