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). Epub 2019 Jan 10.

Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Suite C5500, 8701 W. Watertown Plank Rd, Milwaukee, WI, 53226, USA.

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.

Download full-text PDF

Source
https://jhoonline.biomedcentral.com/articles/10.1186/s13045-
Publisher Site
http://dx.doi.org/10.1186/s13045-018-0696-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329157PMC
January 2019
48 Reads
4.812 Impact Factor

Publication Analysis

Top Keywords

cell transplantation
8
aitl patients
8
angioimmunoblastic t-cell
8
t-cell lymphoma
8
hematopoietic cell
8
allogeneic hematopoietic
8
cumulative incidence
8
95%
7
acute gvhd
4
3-4 acute
4
2-4 grade
4
incidence grade
4
gvhd day
4
grade 2-4
4
grade 3-4
4
180 36%
4
ci = 8-17 cumulative
4
incidence chronic
4
chronic gvhd
4
95% ci = 8-17
4

References

(Supplied by CrossRef)

C Gisselbrecht et al.
Blood 1998

N Mourad et al.
Blood 2008

M Federico et al.
J Clin Oncol 2013

W Siegert et al.
Ann Intern Med 1992

P Pautier et al.
Leuk Lymphoma 1999

N Schmitz et al.
Blood 2010

J Vose et al.
J Clin Oncol 2008

J Schetelig et al.
Haematologica 2003

J Rodriguez et al.
Eur J Haematol 2007

C Kyriakou et al.
J Clin Oncol 2008

S Gouill Le et al.
J Clin Oncol 2008

Similar Publications