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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 01 10;12(1):6

Date

01/12/2019

Pubmed ID

30630534

Pubmed Central ID

PMC6329157

DOI

10.1186/s13045-018-0696-z

Scopus ID

2-s2.0-85059829766   10 Citations

Abstract

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 M

Authors

Kwang Woo Ahn PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
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
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

Adult
Aged
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
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0