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Lymphoma

Matched unrelated donor allogeneic transplantation provides comparable long-term outcome to HLA-identical sibling transplantation in relapsed diffuse large B-cell lymphoma

Bone Marrow Transplantation volume 49, pages 671–678 (2014)Cite this article

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Abstract

The objective of this retrospective analysis was to compare outcomes of patients with diffuse large B-cell lymphoma (DLBCL) who received either a matched sibling (sib) or an unrelated donor (URD) allogeneic hematopoietic cell transplantation (allo-HCT). Long-term outcome of 172 DLBCL patients receiving URD-HCT between 2000 and 2007 and reported to the European Group for Blood and Marrow Transplantation, was compared with that of 301 subjects, allografted from sib-HCT. With a median follow-up of 45 months, 3-year PFS approached 35% for both groups; overall survival (OS) was 42% for sib-HCT versus 37% for URD (NS). Multivariate analyses confirmed that donor type was not associated with differences in non-relapse mortality (NRM), relapse rate (RR), PFS or OS. Poor performance status (PS) and refractory disease adversely affected PFS and OS. Prior auto-SCT and multiple previous therapies predicted for shorter PFS. NRM was adversely affected by older age (⩾50 years), poor PS and refractory disease, and RR by time from diagnosis to allo-HCT of <36 months, prior auto-SCT, refractory disease, poor PS and in vivo T-cell depletion with alemtuzumab. This large study shows for the first time that URD-HCT is not inferior to sib-HCT, providing a reasonable therapeutic approach for DLBCL patients, having no HLA-identical sibling available.

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Author information

Authors and Affiliations

  1. Department of Hematology & Bone Marrow Transplantation, Ramban Medical Center, Haifa, Israel

    I Avivi

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

    C Canals

  3. Clinical Hematology, Hopital Pitie Salpetriere, Paris, France

    J-P Vernant

  4. Abteilung Hematologie und Onkologie, Universitätsklinikum Göttingen, Gottingen, Germany

    G Wulf

  5. Department of Hematology & Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel

    A Nagler

  6. Service Hematologie Adulte, Hôpital Necker, Paris, France

    O Hermine

  7. Department of Haematology, University Medical Centre, Utrecht, The Netherlands

    E Petersen

  8. Service de Maladies du Sang, Hopital Claude Huriez, Lille, France

    I Yakoub-Agha

  9. Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK

    C Craddock

  10. Department of Hematology, Radboud University—Nijmegen Medical Centre, Nijmegen, The Netherlands

    A Schattenberg

  11. Division of Hematology, Oncology and Hemostasiology, University Hospital Leipzig, Leipzig, Germany

    D Niederwieser

  12. Department of Haematology, University College London Hospital, London, UK

    K Thomson

  13. Unit de Transplantation et de Therapie Cellulaire, Institut Paoli Calmettes, Marseille, France

    D Blaise

  14. CHU Dept. Hematologie, Hopital de Purpan, Toulouse, France

    M Attal

  15. Department of Internal Medicine, BMT Unit, University of Saarland, Saarbrucken, Germany

    M Pfreundschuh

  16. Department of Hematology, University Hospital, Basel, Switzerland

    J Passweg

  17. Department of Hematology, Nottingham City Hospital, Nottingham, UK

    N Russell

  18. Medizinische Klinik u. Poliklinik V, University of Heidelberg, Heidelberg, Germany

    P Dreger

  19. Department of Haematology, Addenbrookes Hospital, Cambridge University, Cambridge, UK

    A Sureda

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on behalf of the EBMT Lymphoma Working Party

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Correspondence to I Avivi.

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Author contributions

IA designed and performed the research, analyzed data, wrote the paper and approved the final version of the paper. CC analyzed the data and approved the final version of the paper. J-PV performed the research and approved the final version of the paper. GW performed the research and approved the final version of the paper. AN performed the research and approved the final version of the paper. OH performed the research and approved the final version of the paper. EP performed the research and approved the final version of the paper. IYA performed the research and approved the final version of the paper. CC performed the research and approved the final version of the paper. AS performed the research and approved the final version of the paper. DN performed the research and approved the final version of the paper. KT performed the research and approved the final version of the paper. DB performed the research and approved the final version of the paper. MA performed the research and approved the final version of the paper. MP performed the research and approved the final version of the paper. JP performed the research and approved the final version of the paper. NR performed the research and approved the final version of the paper. PD designed and performed the research, analyzed data, wrote the paper and approved the final version of the paper. AS designed and performed the research, analyzed data, wrote the paper and approved the final version of the paper.

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Avivi, I., Canals, C., Vernant, JP. et al. Matched unrelated donor allogeneic transplantation provides comparable long-term outcome to HLA-identical sibling transplantation in relapsed diffuse large B-cell lymphoma. Bone Marrow Transplant 49, 671–678 (2014). https://doi.org/10.1038/bmt.2014.4

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