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Lymphoma

Long-term follow-up of high-dose treatment with autologous haematopoietic progenitor cell support in 693 patients with follicular lymphoma: an EBMT registry study

Leukemia volume 21, pages 2324–2331 (2007)Cite this article

Abstract

To evaluate the outcome of a large series of patients who received high-dose treatment (HDT) for follicular lymphoma (FL), 693 patients undergoing HDT (total-body irradiation (TBI)-containing regimen: 58%; autologous bone marrow (BM)/peripheral blood progenitor cells (PBPCs): 378/285 patients) were included in the study. A total of 375 patients (54%) developed recurrent lymphoma, 10-year progression-free survival (PFS) being 31%. On multivariate analysis, younger age (P=0.003) and HDT in first complete remission (CR1) (P<0.001) correlated with longer PFS. With a median follow-up of 10.3 years, 330 patients died. Ten-year overall survival (OS) from HDT was 52%. Shorter OS was associated on multivariate analysis with older age (P<0.001), chemoresistant disease (P<0.001), BM+PBPC as source of stem cells (P=0.007) and TBI-containing regimens (P=0.004). Thirty-nine patients developed secondary myelodysplastic syndrome/acute myeloid leukaemia (MDS/AML), in 34 cases having received TBI as the conditioning regimen. The 5-year non-relapse mortality (NRM) was 9%. On multivariate analysis, older age (P<0.001), refractory disease (P<0.001) and TBI (P=0.04) were associated with a higher NRM. This long follow-up study shows a plateau in the PFS curve, suggesting that a selected group of patients might be cured with HDT. On the downside, TBI-containing regimens are associated with a negative impact on survival.

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Acknowledgements

We are indebted to all transplantation centres, physicians, nurses and data managers for their continued help in EBMT studies. A list of the transplant centres and investigators of the European Blood and Marrow Transplantation Group appears in the ‘Appendix’. SM was kindly supported by a grant from Olivia Walduck's family.

Author information

Authors and Affiliations

  1. Cancer Research UK Medical Oncology Unit, Institute of Cancer, Centre for Medical Oncology, Barts and the London, Queen Mary's School of Medicine and Dentistry, London, UK

    S Montoto, A Z S Rohatiner & T A Lister

  2. Clinical Hematology Division, Hospital Santa Creu i Sant Pau, Barcelona, Spain

    C Canals & A Sureda

  3. EBMT Central Registry Office, London, UK

    G Taghipour

  4. Department of Hematology, AK St Georg, Hamburg, Germany

    N Schmitz

  5. Department of Hemato-oncology, Hôpital St Louis, Paris, France

    C Gisselbrecht

  6. Department of Hematology, Hôpital Saint Antoine, Paris, France

    L Fouillard

  7. Department of Hematology, Hotel Dieu, Nantes, France

    N Milpied

  8. Department of Hematology, Hôpital Henri Mondor, Creteil, France

    C Haioun

  9. Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel

    S Slavin

  10. Department of Hematology, Hospital de Valdecilla, Universidad de Cantabria, Santander, Spain

    E Conde

  11. Department of Hematology, Centre François Baclesse, Caen, France

    C Fruchart

  12. Department of Hematology, UCL, Cliniques Universitaires Saint-Luc, Brussels, Belgium

    A Ferrant

  13. Department of Hematology, Groupe Hospitalier Pitié Salpêtrière, Paris, France

    V Leblond

  14. Department of Hematology, Centre Henri Becquerel, Rouen, France

    H Tilly

  15. Department of Hematology, University College London Hospital, London, UK

    A H Goldstone

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  1. S Montoto
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  2. C Canals
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  3. A Z S Rohatiner
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  6. N Schmitz
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  7. C Gisselbrecht
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  8. L Fouillard
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  9. N Milpied
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  10. C Haioun
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  11. S Slavin
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  12. E Conde
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  15. V Leblond
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  18. A H Goldstone
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Consortia

for the EBMT Lymphoma Working Party

Corresponding author

Correspondence to S Montoto.

Additional information

Dedicated to the memory of Felix Reyes.

Appendix

Appendix

Agnes Buzyn, Hôpital Necker, Paris, France [FR][160] 3; Roelof Willemze, Leiden University Hospital, Leiden, The Netherlands [NL][203] 7; Jane Apperley, Imperial College, Hammersmith Hospital, London, United Kingdom [GB][205] 5; Niels Jacobsen, Rigshospitalet, Copenhagen, Denmark [DK][206] 10; J Maertens, University Hospital Gasthuisberg, Leuven, Belgium [BE][209] 4; Norbert C Gorin, Hopital Saint Antoine, Paris, France [FR][213] 38; Stephen Mackinnon, Royal Free Hospital and School of Medicine, London, United Kingdom [GB][216] 1; Kurt Leibundgut, University Hospital Bern, Bern, Switzerland [CH][221] 1; Bernard Rio, Hotel Dieu, Paris, France [FR][222] 8; Antony H Goldstone, University College London Hospital, London, United Kingdom [GB][224] 5; John M Davies, Western General Hospital, Edinburgh, United Kingdom [GB][228] 1; Didier Blaise, Unité de transplantation et de thérapie cellulaire, Marseille, France [FR][230] 22; Roberto Foa, Univ. ‘La Sapienza’, Rome, Italy [IT][232] 6; Eric Deconinck, Hopital Jean Minjoz, Besancon, France [FR][233] 10; Augustin Ferrant, Cliniques Universitaires St Luc, Brussels, Belgium [BE][234] 13; A Schattenber, University Medical Center St Radboud, Nijmegen, The Netherlands [NL][237] 8; Leo F Verdonck, University Medical Centre, Utrecht, The Netherlands [NL][239] 3; Michele Baccarani, Bologna University, S Orsola-Malpighi, Bologna, Italy [IT][240] 5; Pierre Biron, Centre Leon Berard, Lyon, France [FR][241] 8; Arturo Iriondo, Hospital U Marqués de Valdecilla, Santander, Spain [ES][242] 15; H Van den Berg, Academisch Ziekenhuis bij de Universiteit, Amsterdam, The Netherlands [NL][247] 1; Oumedaly Reman, Centre Hospitalier Universitaire, Caen, France [FR][251] 1; Catherine Cordonnier, Hôpital Henri Mondor, Creteil, France [FR][252] 27; JL Harousseau, Hotel Dieu, Nantes, France [FR][253] 37; Shimon Slavin, Hadassah University Hospital, Jerusalem, Israel [IL][258] 19; Anna Sureda, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain [ES][ 260] 5; JP Vernant, Hopital Pitie-Salpetriere, Paris, France [FR][262] 12; F Guilhot, Hopital La Miletrie, Poitiers, France [FR][264] 2; Gunnar Oberg, University Hospital, Uppsala, Sweden [SE][266] 3; Noel Milpied, CHU Bordeaux, Pessac, France [FR][267] 37; P Colombat, Hopital Bretonneau, Tours, France [FR][272] 10; Jacques-Olivier Bay, Fédération de Greffe de Moelle et de Therapie Cellulaire, Clermont-Ferrand, France [FR][273] 3; GH Jackson, Royal Victoria Infirmary, Newcastle- upon-Tyne, United Kingdom [GB][276] 1; JP Jouet, Hopital Claude Huriez, Lille, France [FR][277] 7; Carlos Solano, Hospital Clínico Universitario, Valencia, Spain [ES][282] 1; DW Milligan, Birmingham Heartlands Hospital, Birmingham, United Kingdom [GB][284] 3; Ignazio Majolino, Ospedale S Camillo-Forlanini, Rome, Italy [IT][287] 1; Keith Wilson, University of Wales, Cardiff, United Kingdom [GB][303] 2; Alberto Bosi, Ospedale di Careggi, Firenze, Italy [IT][304] 9; Giuseppe Leone, Universita Cattolica S Cuore, Rome, Italy [IT][307] 3; Urs Hess, Kantonsspital St Gallen, St Gallen, Switzerland [CH][324] 1; Rainer Haas, Heinrich Heine Universität, Düsseldorf, Germany [DE][390] 1; Rosanna Scimè, Ospedale V Cervello, Palermo, Italy [IT][392] 4; Filomena Floristan, Hospital de Cruces, Barakaldo (Bilbao), Spain [ES][393] 1; Tapio Nousiainen, Kuopio University Hospital, Kuopio, Finland [FI][396] 1; Tapani Ruutu, Helsinki University Central Hospital, Helsinki, Finland [FI][515] 2; Martin Hildebrandt, Charité Universitätsmedizin Berlin, Berlin, Germany [DE][518] 1; Nicole Gratecos, Hôpital de l’ARCHET I, Nice, France [FR][523] 1; M Janvier, Centre Rene Huguenin, Saint Cloud, France [FR][551] 3; Harry Schouten, University Hospital Maastricht, Maastricht, The Netherlands [NL][ 565] 8; Bjarne Jensen, Herlev Hospital Anker, Herlev, Denmark [DK][568] 3; GJ Ossenkoppel, VU University Medical Centere, Amsterdam, The Netherlands [NL][588] 1; Axel A Fauser, Klinik für Knochenmarktransplantation, Idar -Oberstein, Germany [DE][592] 1; W Feremans, ULB—Hopital Erasme, Brussels, Belgium [BE][596] 2; Fabio Benedetti, Policlinico GB Rossi, Verona, Italy [IT][623] 3; R Schots, University Hospital VUB, Brussels, Belgium [BE][630] 1; Elli Koivunen, Tampere University Hospital, Tampere, Finland [FI][635] 1; Norbert Ifrah, CHRU, Angers, France [FR][650] 6; Tiziano Barbui, Ospedale Bergamo, Bergamo, Italy [IT][658] 2; Thierry de Revel, Hôpital Percy, Clamart, France [FR][665] 3; Jean HenriBourhis, Institut Gustave Roussy, Villejuif, France [FR][666] 3; Mauricette Michallet, Hopital E Herriot, Lyon, France [FR][671] 9; NH Russell, Nottingham City Hospital, Nottingham, United Kingdom [GB][717] 2; Vladimir Koza, Charles University Hospital, Pilsen, Czech Republic [CZ][718] 3; J Besalduch, Hospital Universitari Son Dureta, Palma de Mallorca, Spain [ES][722] 1; Dolores Caballero, Hospital Clínico, Salamanca, Spain [ES][727] 2; M Komarnicki, K Marcinkowski University of Medical Science, Poznan, Poland [PL][730] 1; Anders Wahlin, Umea University Hospital, Umea, Sweden [SE][731] 2; José M Moraleda Jimenez ,Hospital Morales Meseguer, Murcia, Spain [ES][735] 6; Elisabeth Koller, Hanuschkrankenhaus, Vienna, Austria [AT][743] 2; Marek Trneny, Charles University Hospital, Prague, Czech Republic [CZ][745] 3; Jean-Pierre Lotz, Hôpital Tenon, Paris, France[FR][747] 1; GJ Mufti, GKT School of Medicine, London, United Kingdom [GB][763] 1; John Gribben, St Bartholomew’s and The Royal London Hospital, London, United Kingdom [GB][768] 114; Joerg Schubert, University of Saarland, Homburg, Germany [DE][785] 1; Massimo F Martelli, University of Perugia, Perugia, Italy [IT][794] 21; Francesco Rodeghiero, S Bortolo Hospital, Vicenza, Italy [IT][797] 2; C Gisselbrecht, Hôpital St Louis, Paris, France [FR][805] 49; Jean Francois Rossi, CHU Lapeyronie, Montpellier, France [FR][926] 7; H Tilly, Centre Henri Becqueral, Rouen, France [FR][941] 11; Ghandi Damaj, University of Amiens: CHU Amiens, Amiens, France [FR][955] 1; Alain Delmer, Hôpital Robert Debre, Reims, France [FR][959] 6; Laurent Degos, Institut Universitaire d’Hématologie, Paris, France [FR][960] 2; Dominique Bordessoule, CHRU Limoges, Limoges, France [FR][977] 2.

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Montoto, S., Canals, C., Rohatiner, A. et al. Long-term follow-up of high-dose treatment with autologous haematopoietic progenitor cell support in 693 patients with follicular lymphoma: an EBMT registry study. Leukemia 21, 2324–2331 (2007). https://doi.org/10.1038/sj.leu.2404850

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