Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma: a CIBMTR analysis. J Hematol Oncol 2019 Jan 10;12(1):6
Date
01/12/2019Pubmed ID
30630534Pubmed Central ID
PMC6329157DOI
10.1186/s13045-018-0696-zScopus ID
2-s2.0-85059829766 (requires institutional sign-in at Scopus site) 28 CitationsAbstract
BACKGROUND: There is a paucity of data on the role of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with angioimmunoblastic T-cell lymphoma (AITL). Using the CIBMTR registry, we report here the outcomes of AITL patients undergoing an allo-HCT.
METHODS: We evaluated 249 adult AITL patients who received their first allo-HCT during 2000-2016.
RESULTS: The median patient age was 56 years (range = 21-77). Majority of the patients were Caucasians (86%), with a male predominance (60%). Graft-versus-host disease (GVHD) prophylaxis was predominantly calcineurin inhibitor-based approaches while the most common graft source was peripheral blood (97%). Median follow-up of survivors was 49 months (range = 4-170 months). The cumulative incidence of grade 2-4 and grade 3-4 acute GVHD at day 180 were 36% (95% CI = 30-42) and 12 (95% CI = 8-17), respectively. The cumulative incidence of chronic GVHD at 1 year was 49% (95%CI 43-56). The 1-year non-relapse mortality (NRM) was 19% (95% CI = 14-24), while the 4-year relapse/progression, progression-free survival (PFS), and overall survival (OS) were 21% (95% CI = 16-27), 49% (95% CI = 42-56), and 56% (95% CI = 49-63), respectively. On multivariate analysis, chemoresistant status at the time of allo-HCT was associated with a significantly higher risk for therapy failure (inverse of PFS) (RR = 1.73 95% CI = 1.08-2.77), while KPS < 90% was associated with a significantly higher risk of mortality (inverse of OS) (RR = 3.46 95% CI = 1.75-6.87).
CONCLUSION: Our analysis shows that allo-HCT provides durable disease control even in AITL patients who failed a prior auto-HCT and in those subjects with refractory disease at the time of allografting.
Author List
Epperla N, Ahn KW, Litovich C, Ahmed S, Battiwalla M, Cohen JB, Dahi P, Farhadfar N, Farooq U, Freytes CO, Ghosh N, Haverkos B, Herrera A, Hertzberg M, Hildebrandt G, Inwards D, Kharfan-Dabaja MA, Khimani F, Lazarus H, Lazaryan A, Lekakis L, Murthy H, Nathan S, Nishihori T, Pawarode A, Prestidge T, Ramakrishnan P, Rezvani AR, Romee R, Shah NN, Sureda A, Fenske TS, Hamadani MAuthors
Kwang Woo Ahn PhD Professor in the Institute for Health and Equity department at Medical College of WisconsinTimothy 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
Nirav N. Shah MD Associate Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Autografts
Drug Resistance, Neoplasm
Female
Follow-Up Studies
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma, T-Cell
Male
Middle Aged
Registries
Salvage Therapy
Transplantation Conditioning
Transplantation, Autologous
Transplantation, Homologous
Young Adult