TY - JOUR
T1 - Allogeneic hematopoietic stem-cell transplantation for patients with Richter transformation
T2 - a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT
AU - Guièze, Romain
AU - Eikema, Diderik Jan
AU - Koster, Linda
AU - Schetelig, Johannes
AU - Sengeloev, Henrik
AU - Passweg, Jakob
AU - Finke, Jürgen
AU - Arat, Mutlu
AU - Broers, Annoek E.C.
AU - Stölzel, Friedrich
AU - Byrne, Jenny
AU - Castilla-Llorente, Cristina
AU - Dreger, Peter
AU - Eder, Matthias
AU - Gedde-Dahl, Tobias
AU - Kröger, Nicolaus
AU - Ribera Santasusana, Josep Maria
AU - Richardson, Deborah
AU - Rambaldi, Alessandro
AU - Yañez, Lucrecia
AU - Van Gelder, Michel
AU - Drozd-Sokolowska, Joanna
AU - Raj, Kavita
AU - Yakoub-Agha, Ibrahim
AU - Tournilhac, Olivier
AU - McLornan, Donal P.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature Limited 2024.
PY - 2024/7
Y1 - 2024/7
N2 - Management of Richter transformation (RT) is particularly challenging, with survival estimates <1 year. We report on outcomes of 66 RT patients undergoing allogeneic-HCT (allo-HCT) between 2008 and 2018 registered with the EBMT. Median age at allo-HCT was 56.2 years (interquartile range (IQR), 51.3–63.1). Median time from RT to allo-HCT was 6.9 months (IQR, 4.9–11) and 28 (42.4%) were in complete remission (CR). The majority underwent reduced intensity conditioning (66.2%) using peripheral blood derived stem cells. Eighteen (27.3%) patients had a matched sibling donor, 24 (36.4%) a matched unrelated donor and the remaining were mismatched. Median follow-up was 6.6 years; 1- and 3- year overall and progression free survival (PFS) (95% CI) was 65% (54–77) and 39% (27–51) and 53% (41–65) and 29% (18–40), respectively. Patients in CR at time of allo-HCT had significantly better 3-year PFS (39% vs. 21%, p = 0.032). Cumulative incidences of grade II–IV acute graft versus host disease (GVHD) at day +100 was 41% (95% CI 29–53) and chronic GVHD at 3 years was 53% (95% CI 41–65). High rates of non-relapse mortality (NRM) were observed; 38% (95% CI, 26–50) at 3 years. Although potentially curative, approaches to reduce considerable NRM and chronic GVHD rates are required.
AB - Management of Richter transformation (RT) is particularly challenging, with survival estimates <1 year. We report on outcomes of 66 RT patients undergoing allogeneic-HCT (allo-HCT) between 2008 and 2018 registered with the EBMT. Median age at allo-HCT was 56.2 years (interquartile range (IQR), 51.3–63.1). Median time from RT to allo-HCT was 6.9 months (IQR, 4.9–11) and 28 (42.4%) were in complete remission (CR). The majority underwent reduced intensity conditioning (66.2%) using peripheral blood derived stem cells. Eighteen (27.3%) patients had a matched sibling donor, 24 (36.4%) a matched unrelated donor and the remaining were mismatched. Median follow-up was 6.6 years; 1- and 3- year overall and progression free survival (PFS) (95% CI) was 65% (54–77) and 39% (27–51) and 53% (41–65) and 29% (18–40), respectively. Patients in CR at time of allo-HCT had significantly better 3-year PFS (39% vs. 21%, p = 0.032). Cumulative incidences of grade II–IV acute graft versus host disease (GVHD) at day +100 was 41% (95% CI 29–53) and chronic GVHD at 3 years was 53% (95% CI 41–65). High rates of non-relapse mortality (NRM) were observed; 38% (95% CI, 26–50) at 3 years. Although potentially curative, approaches to reduce considerable NRM and chronic GVHD rates are required.
U2 - 10.1038/s41409-024-02256-9
DO - 10.1038/s41409-024-02256-9
M3 - Article
SN - 0268-3369
VL - 59
SP - 950
EP - 956
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 7
ER -