TY - JOUR
T1 - A Comparison of HLA-Identical Sibling Allogeneic versus Autologous Transplantation for Diffuse Large B Cell Lymphoma: A Report from the CIBMTR
AU - Lazarus, Hillard M.
AU - Zhang, Mei-Jie
AU - Carreras, Jeanette
AU - Hayes-Lattin, Brandon M.
AU - Ataergin, Asli Selmin
AU - Bitran, Jacob D.
AU - Bolwell, Brian J.
AU - Freytes, Cesar O.
AU - Gale, Robert Peter
AU - Goldstein, Steven C.
AU - Hale, Gregory A.
AU - Inwards, David J.
AU - Klumpp, Thomas R.
AU - Marks, David I.
AU - Maziarz, Richard T.
AU - McCarthy, Philip L.
AU - Pavlovsky, Santiago
AU - Rizzo, J. Douglas
AU - Shea, Thomas C.
AU - Schouten, Harry C.
AU - Slavin, Shimon
AU - Winter, Jane N.
AU - van Besien, Koen W.
AU - Vose, Julie M.
AU - Hari, Parameswaran N.
PY - 2010/1
Y1 - 2010/1
N2 - 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. American Society for Blood and Marrow Transplantation. All rights reserved.
AB - 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. American Society for Blood and Marrow Transplantation. All rights reserved.
KW - Unrelated
KW - Allogeneic transplantation
KW - Hodgkin lymphoma
U2 - 10.1016/j.bbmt.2009.08.011
DO - 10.1016/j.bbmt.2009.08.011
M3 - Article
SN - 1083-8791
VL - 16
SP - 35
EP - 45
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 1
ER -