Allogeneic Hematopoietic Cell Transplantation for Blastic Plasmacytoid Dendritic Cell Neoplasm: a CIBMTR analysis

Hemant S Murthy; Mei-Jie Zhang; Karen Chen; Sairah Ahmed; Uday Deotare; Siddhartha Ganguly; Ankit Kansagra; Fotios V Michelis; Taiga Nishihori; Mrinal M Patnaik; Muhammad Bilal Abid; Mahmoud Aljurf; Yasuyuki Arai; Ulrike Bacher; Talha Badar; Sherif M Badawy; Karen Ballen; Minoo Battiwalla; Amer Beitinjaneh; Nelli Bejanyan; Vijaya R Bhatt; Valerie Inez Brown; Rodrigo Martino; Jean-Yves Cahn; Paul Castillo; Jan Cerny; Saurabh Chhabra; Edward A Copelan; Andrew Daly; Bhagirathbhai Dholaria; Miguel Angel Diaz; César O Freytes; Michael R Grunwald; Shahrukh Hashmi; Gerhard C Hildebrandt; Omer Jamy; Jacinth Joseph; Christopher G Kanakry; Nandita Khera; Maxwell M Krem; Yachiyo Kuwatsuka; Hillard M Lazarus; Lazaros J Lekakis; Hongtao Liu; Dipenkumar Modi; Pashna Munshi; Alberto Mussetti; Neil Palmisiano; Sagar S Patel; David A Rizzieri; Marjolein van der Poel; W. Saber; Et al.

doi:10.1182/bloodadvances.2023011308

Allogeneic Hematopoietic Cell Transplantation for Blastic Plasmacytoid Dendritic Cell Neoplasm: a CIBMTR analysis

Hemant S Murthy, Mei-Jie Zhang, Karen Chen, Sairah Ahmed, Uday Deotare, Siddhartha Ganguly, Ankit Kansagra, Fotios V Michelis, Taiga Nishihori, Mrinal M Patnaik, Muhammad Bilal Abid, Mahmoud Aljurf, Yasuyuki Arai, Ulrike Bacher, Talha Badar, Sherif M Badawy, Karen Ballen, Minoo Battiwalla, Amer Beitinjaneh, Nelli BejanyanVijaya R Bhatt, Valerie Inez Brown, Rodrigo Martino, Jean-Yves Cahn, Paul Castillo, Jan Cerny, Saurabh Chhabra, Edward A Copelan, Andrew Daly, Bhagirathbhai Dholaria, Miguel Angel Diaz, César O Freytes, Michael R Grunwald, Shahrukh Hashmi, Gerhard C Hildebrandt, Omer Jamy, Jacinth Joseph, Christopher G Kanakry, Nandita Khera, Maxwell M Krem, Yachiyo Kuwatsuka, Hillard M Lazarus, Lazaros J Lekakis, Hongtao Liu, Dipenkumar Modi, Pashna Munshi, Alberto Mussetti, Neil Palmisiano, Sagar S Patel, David A Rizzieri, Marjolein van der Poel, W. Saber^*, Et al.

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with a poor prognosis and considered incurable with standard conventional chemotherapy. Small observational studies have shown that allogeneic hematopoietic cell transplantation (allo-HCT) offers durable remissions in patients with BPDCN. We conducted an analysis of 164 patients with BPDCN from 78 centers who underwent allo-HCT between 2007-2018 using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Results: Median follow up of survivors was 49 months (range 6-121). 5-year overall survival (OS), disease-free survival (DFS), relapse, and non-relapse (NRM) rates were 51.2% (95% confidence interval [95%CI]: 42.5-59.8%), 44.4% (95%CI: 36.2-52.8%), 32.2% (95%CI: 24.7-40.3%), and 23.3% (95%CI: 16.9-30.4%), respectively. Disease relapse was the most common cause of death. On multivariate analyses, age =60 was predictive for inferior OS (hazard ratio [HR]= 2.16, 95% CI 1.35-3.46, p= 0.001), and higher NRM [HR= 2.19, 95% CI 1.13-4.22, p= 0.02]. Remission status at time of allo-HCT (CR2/PIF/Relapse vs CR1) was predictive of inferior OS [HR= 1.87, 95% CI 1.14-3.06, p= 0.01] and DFS [HR= 1.75, 95% CI 1.11-2.76, p= 0.02]. Use of myeloablative conditioning with total body irradiation (TBI) was predictive for improved DFS and reduced risk of relapse. Conclusion: Allo-HCT is effective in providing durable remissions and long-term survival in BPDCN. Younger age and allo-HCT in CR1 predicted for improved survival, while myeloablative conditioning with TBI predicted for less relapse and improved DFS. Novel strategies incorporating allo-HCT are needed to further improve outcomes.

Original language	English
Pages (from-to)	7007–7016
Number of pages	10
Journal	Blood advances
Volume	7
Issue number	22
Early online date	4 Oct 2023
DOIs	https://doi.org/10.1182/bloodadvances.2023011308
Publication status	Published - 28 Nov 2023

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10.1182/bloodadvances.2023011308

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Murthy, H. S., Zhang, M.-J., Chen, K., Ahmed, S., Deotare, U., Ganguly, S., Kansagra, A., Michelis, F. V., Nishihori, T., Patnaik, M. M., Abid, M. B., Aljurf, M., Arai, Y., Bacher, U., Badar, T., Badawy, S. M., Ballen, K., Battiwalla, M., Beitinjaneh, A., ... Et al. (2023). Allogeneic Hematopoietic Cell Transplantation for Blastic Plasmacytoid Dendritic Cell Neoplasm: a CIBMTR analysis. Blood advances, 7(22), 7007–7016. https://doi.org/10.1182/bloodadvances.2023011308

@article{48b6a95f5dff449db24f7a90bc3ba8f5,

title = "Allogeneic Hematopoietic Cell Transplantation for Blastic Plasmacytoid Dendritic Cell Neoplasm: a CIBMTR analysis",

abstract = "Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with a poor prognosis and considered incurable with standard conventional chemotherapy. Small observational studies have shown that allogeneic hematopoietic cell transplantation (allo-HCT) offers durable remissions in patients with BPDCN. We conducted an analysis of 164 patients with BPDCN from 78 centers who underwent allo-HCT between 2007-2018 using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Results: Median follow up of survivors was 49 months (range 6-121). 5-year overall survival (OS), disease-free survival (DFS), relapse, and non-relapse (NRM) rates were 51.2% (95% confidence interval [95%CI]: 42.5-59.8%), 44.4% (95%CI: 36.2-52.8%), 32.2% (95%CI: 24.7-40.3%), and 23.3% (95%CI: 16.9-30.4%), respectively. Disease relapse was the most common cause of death. On multivariate analyses, age =60 was predictive for inferior OS (hazard ratio [HR]= 2.16, 95% CI 1.35-3.46, p= 0.001), and higher NRM [HR= 2.19, 95% CI 1.13-4.22, p= 0.02]. Remission status at time of allo-HCT (CR2/PIF/Relapse vs CR1) was predictive of inferior OS [HR= 1.87, 95% CI 1.14-3.06, p= 0.01] and DFS [HR= 1.75, 95% CI 1.11-2.76, p= 0.02]. Use of myeloablative conditioning with total body irradiation (TBI) was predictive for improved DFS and reduced risk of relapse. Conclusion: Allo-HCT is effective in providing durable remissions and long-term survival in BPDCN. Younger age and allo-HCT in CR1 predicted for improved survival, while myeloablative conditioning with TBI predicted for less relapse and improved DFS. Novel strategies incorporating allo-HCT are needed to further improve outcomes.",

author = "Murthy, {Hemant S} and Mei-Jie Zhang and Karen Chen and Sairah Ahmed and Uday Deotare and Siddhartha Ganguly and Ankit Kansagra and Michelis, {Fotios V} and Taiga Nishihori and Patnaik, {Mrinal M} and Abid, {Muhammad Bilal} and Mahmoud Aljurf and Yasuyuki Arai and Ulrike Bacher and Talha Badar and Badawy, {Sherif M} and Karen Ballen and Minoo Battiwalla and Amer Beitinjaneh and Nelli Bejanyan and Bhatt, {Vijaya R} and Brown, {Valerie Inez} and Rodrigo Martino and Jean-Yves Cahn and Paul Castillo and Jan Cerny and Saurabh Chhabra and Copelan, {Edward A} and Andrew Daly and Bhagirathbhai Dholaria and Diaz, {Miguel Angel} and Freytes, {C{\'e}sar O} and Grunwald, {Michael R} and Shahrukh Hashmi and Hildebrandt, {Gerhard C} and Omer Jamy and Jacinth Joseph and Kanakry, {Christopher G} and Nandita Khera and Krem, {Maxwell M} and Yachiyo Kuwatsuka and Lazarus, {Hillard M} and Lekakis, {Lazaros J} and Hongtao Liu and Dipenkumar Modi and Pashna Munshi and Alberto Mussetti and Neil Palmisiano and Patel, {Sagar S} and Rizzieri, {David A} and {van der Poel}, Marjolein and W. Saber and {Et al.}",

year = "2023",

month = nov,

day = "28",

doi = "10.1182/bloodadvances.2023011308",

language = "English",

volume = "7",

pages = "7007–7016",

journal = "Blood advances",

issn = "2473-9529",

publisher = "The American Society of Hematology",

number = "22",

}

Murthy, HS, Zhang, M-J, Chen, K, Ahmed, S, Deotare, U, Ganguly, S, Kansagra, A, Michelis, FV, Nishihori, T, Patnaik, MM, Abid, MB, Aljurf, M, Arai, Y, Bacher, U, Badar, T, Badawy, SM, Ballen, K, Battiwalla, M, Beitinjaneh, A, Bejanyan, N, Bhatt, VR, Brown, VI, Martino, R, Cahn, J-Y, Castillo, P, Cerny, J, Chhabra, S, Copelan, EA, Daly, A, Dholaria, B, Diaz, MA, Freytes, CO, Grunwald, MR, Hashmi, S, Hildebrandt, GC, Jamy, O, Joseph, J, Kanakry, CG, Khera, N, Krem, MM, Kuwatsuka, Y, Lazarus, HM, Lekakis, LJ, Liu, H, Modi, D, Munshi, P, Mussetti, A, Palmisiano, N, Patel, SS, Rizzieri, DA, van der Poel, M, Saber, W & Et al. 2023, 'Allogeneic Hematopoietic Cell Transplantation for Blastic Plasmacytoid Dendritic Cell Neoplasm: a CIBMTR analysis', Blood advances, vol. 7, no. 22, pp. 7007–7016. https://doi.org/10.1182/bloodadvances.2023011308

TY - JOUR

T1 - Allogeneic Hematopoietic Cell Transplantation for Blastic Plasmacytoid Dendritic Cell Neoplasm

T2 - a CIBMTR analysis

AU - Murthy, Hemant S

AU - Zhang, Mei-Jie

AU - Chen, Karen

AU - Ahmed, Sairah

AU - Deotare, Uday

AU - Ganguly, Siddhartha

AU - Kansagra, Ankit

AU - Michelis, Fotios V

AU - Nishihori, Taiga

AU - Patnaik, Mrinal M

AU - Abid, Muhammad Bilal

AU - Aljurf, Mahmoud

AU - Arai, Yasuyuki

AU - Bacher, Ulrike

AU - Badar, Talha

AU - Badawy, Sherif M

AU - Ballen, Karen

AU - Battiwalla, Minoo

AU - Beitinjaneh, Amer

AU - Bejanyan, Nelli

AU - Bhatt, Vijaya R

AU - Brown, Valerie Inez

AU - Martino, Rodrigo

AU - Cahn, Jean-Yves

AU - Castillo, Paul

AU - Cerny, Jan

AU - Chhabra, Saurabh

AU - Copelan, Edward A

AU - Daly, Andrew

AU - Dholaria, Bhagirathbhai

AU - Diaz, Miguel Angel

AU - Freytes, César O

AU - Grunwald, Michael R

AU - Hashmi, Shahrukh

AU - Hildebrandt, Gerhard C

AU - Jamy, Omer

AU - Joseph, Jacinth

AU - Kanakry, Christopher G

AU - Khera, Nandita

AU - Krem, Maxwell M

AU - Kuwatsuka, Yachiyo

AU - Lazarus, Hillard M

AU - Lekakis, Lazaros J

AU - Liu, Hongtao

AU - Modi, Dipenkumar

AU - Munshi, Pashna

AU - Mussetti, Alberto

AU - Palmisiano, Neil

AU - Patel, Sagar S

AU - Rizzieri, David A

AU - van der Poel, Marjolein

AU - Saber, W.

AU - Et al.

PY - 2023/11/28

Y1 - 2023/11/28

N2 - Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with a poor prognosis and considered incurable with standard conventional chemotherapy. Small observational studies have shown that allogeneic hematopoietic cell transplantation (allo-HCT) offers durable remissions in patients with BPDCN. We conducted an analysis of 164 patients with BPDCN from 78 centers who underwent allo-HCT between 2007-2018 using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Results: Median follow up of survivors was 49 months (range 6-121). 5-year overall survival (OS), disease-free survival (DFS), relapse, and non-relapse (NRM) rates were 51.2% (95% confidence interval [95%CI]: 42.5-59.8%), 44.4% (95%CI: 36.2-52.8%), 32.2% (95%CI: 24.7-40.3%), and 23.3% (95%CI: 16.9-30.4%), respectively. Disease relapse was the most common cause of death. On multivariate analyses, age =60 was predictive for inferior OS (hazard ratio [HR]= 2.16, 95% CI 1.35-3.46, p= 0.001), and higher NRM [HR= 2.19, 95% CI 1.13-4.22, p= 0.02]. Remission status at time of allo-HCT (CR2/PIF/Relapse vs CR1) was predictive of inferior OS [HR= 1.87, 95% CI 1.14-3.06, p= 0.01] and DFS [HR= 1.75, 95% CI 1.11-2.76, p= 0.02]. Use of myeloablative conditioning with total body irradiation (TBI) was predictive for improved DFS and reduced risk of relapse. Conclusion: Allo-HCT is effective in providing durable remissions and long-term survival in BPDCN. Younger age and allo-HCT in CR1 predicted for improved survival, while myeloablative conditioning with TBI predicted for less relapse and improved DFS. Novel strategies incorporating allo-HCT are needed to further improve outcomes.

AB - Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with a poor prognosis and considered incurable with standard conventional chemotherapy. Small observational studies have shown that allogeneic hematopoietic cell transplantation (allo-HCT) offers durable remissions in patients with BPDCN. We conducted an analysis of 164 patients with BPDCN from 78 centers who underwent allo-HCT between 2007-2018 using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Results: Median follow up of survivors was 49 months (range 6-121). 5-year overall survival (OS), disease-free survival (DFS), relapse, and non-relapse (NRM) rates were 51.2% (95% confidence interval [95%CI]: 42.5-59.8%), 44.4% (95%CI: 36.2-52.8%), 32.2% (95%CI: 24.7-40.3%), and 23.3% (95%CI: 16.9-30.4%), respectively. Disease relapse was the most common cause of death. On multivariate analyses, age =60 was predictive for inferior OS (hazard ratio [HR]= 2.16, 95% CI 1.35-3.46, p= 0.001), and higher NRM [HR= 2.19, 95% CI 1.13-4.22, p= 0.02]. Remission status at time of allo-HCT (CR2/PIF/Relapse vs CR1) was predictive of inferior OS [HR= 1.87, 95% CI 1.14-3.06, p= 0.01] and DFS [HR= 1.75, 95% CI 1.11-2.76, p= 0.02]. Use of myeloablative conditioning with total body irradiation (TBI) was predictive for improved DFS and reduced risk of relapse. Conclusion: Allo-HCT is effective in providing durable remissions and long-term survival in BPDCN. Younger age and allo-HCT in CR1 predicted for improved survival, while myeloablative conditioning with TBI predicted for less relapse and improved DFS. Novel strategies incorporating allo-HCT are needed to further improve outcomes.

U2 - 10.1182/bloodadvances.2023011308

DO - 10.1182/bloodadvances.2023011308

M3 - Article

SN - 2473-9529

VL - 7

SP - 7007

EP - 7016

JO - Blood advances

JF - Blood advances

IS - 22

ER -