Abstract
Previous data suggested that allo-SCT might be an effective therapy in the setting of chemo-refractory/relapsed diseases because of the potent long-term immune-mediated tumor control. This retrospective study aimed to analyze the outcome of adult patients who received allo-SCT in a chemo-refractory/relapsed status. The series included 840 patients with active or progressive disease at the time of transplant. Median age was 50 years. With a median follow-up of 40 months, 3-year OS, disease-free survival (DFS), and non-relapse mortality rates were 29±2, 23±2, and 30±2%, respectively. At the last follow-up, 252 patients (30%) were still alive (of whom 201 were in CR (24%). In a Cox multivariate analysis, the use of a reduced-intensity conditioning (RIC) before allo-SCT and use of an HLA-identical sibling donor remained independently associated with a better OS (hazard ratio (HR)=0.82; 95% confidence interval (CI), 0.69–0.98, P=0.03; and HR=0.79; 95% CI, 0.66–0.93, P=0.006, respectively). Also, a diagnosis of myelodysplastic syndrome/myeloproliferative disorder, Hodgkin lymphoma and non-Hodgkin lymphoma compared with acute leukemia had a favorable impact on OS (HR=0.55; 95% CI, 0.45–0.68, P<0.0001; HR=0.49; 95% CI, 0.31–0.75, P=0.001; and HR=0.47; 95% CI, 0.35–0.63, P<0.0001, respectively). In conclusion, this study suggests that allo-SCT may be of benefit in some subgroups of patients with active or progressive hematological malignancies at the time of allo-SCT.
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Acknowledgements
We thank all the data managers of each centre for data management and collection.
Author Contributions
PC conceived and designed the study, analyzed data, recruited patients, provided clinical care, performed bibliographic search and wrote the manuscript. MM conceived and designed the study, recruited patients, provided clinical care, analyzed data, performed bibliographic search and helped writing the manuscript. ML performed statistical analyses. NM, KB, GS, IY-A, MM, CEB, SM, YB, J-OB, DB, NM, GG, ED recruited patients, provided clinical care and commented on the manuscript. NR performed central data management and collection. All the authors approved the manuscript for publication purposes.
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This study was presented as an oral session during the 37th Annual Meeting of the European Group for Blood and Marrow Transplantation (Bone Marrow Transplant 2011; Vol 46 (Supp1): S47 (abstract 0290)).
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Chevallier, P., Labopin, M., Milpied, N. et al. Outcomes of adults with active or progressive hematological malignancies at the time of allo-SCT: a survey from the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC). Bone Marrow Transplant 49, 361–365 (2014). https://doi.org/10.1038/bmt.2013.186
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DOI: https://doi.org/10.1038/bmt.2013.186
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