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Autologous stem cell transplantation for primary mediastinal B-cell lymphoma: long-term outcome and role of post-transplant radiotherapy. A report of the European Society for Blood and Marrow Transplantation

Bone Marrow Transplantation volume 53, pages 1001–1009 (2018)Cite this article

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Abstract

The purpose of this retrospective registry study was to investigate the outcome of autoSCT for primary mediastinal B-cell lymphoma (PMBCL) in the rituximab era, including the effects of eventual post-transplant radiotherapy (RT) consolidation. Patients with PMBCL aged between 18 and 70 years who were treated with a first autoSCT between 2000 and 2012 and registered with the EBMT were eligible. Eighty-six patients with confirmed PMBCL and the full data set required for this analysis were evaluable. Sixteen patients underwent autoSCT in remission after first-line therapy (CR/PR1), 44 patients were transplanted with chemosensitive relapsed or primary refractory disease (CR/PR >1), and 24 patients were chemorefractory at the time of autoSCT. With a median follow-up of 5 years, 3-year estimates of relapse incidence, progression-free survival, and overall survival were 6%, 94%, and 100% for CR/PR1; 31%, 64%, and 85% for CR/PR >1; and 52%, 39%, and 41% for REF, respectively. Whilst there was no significant benefit of post-transplant RT in the CR/PR >1 group, RT could completely prevent disease recurrence post d100 in the refractory group. In conclusion, autoSCT with or without consolidating RT is associated with excellent outcome in chemoimmunotherapy-sensitive PMBCL, whereas its benefits seem to be limited in chemoimmunotherapy-refractory disease.

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Acknowledgements

We thank all EBMT centres that participated in this study. Presented in part in abstract form at the 56th Annual Meeting of the American Society of Hematology, San Francisco, USA, December 6, 2014; and at the 40th Annual Meeting of the European Society of Blood and Marrow Transplantation, Milan, Italy, April 2, 2014.

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Authors and Affiliations

  1. Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

    Irit Avivi

  2. EBMT Lymphoma Working Party, Paris, France

    Ariane Boumendil, Hervé Finel, Silvia Montoto & Peter Dreger

  3. Chaim Sheba Medical Center, Tel-Hashomer, Israel

    Arnon Nagler

  4. Hospital dos Capuchos, Lisboa, Portugal

    Aïda Botelho de Sousa

  5. Hospital Universitari Germans Trias i Pujol, Barcelona, Spain

    Josep Maria Ribera Santasusana

  6. St. James’s Hospital, Dublin, Ireland

    Elizabeth Vandenberghe

  7. State Medical Pavlov University, St. Petersburg, Russia

    Boris Afanasyev

  8. C.H.R.U., Limoges, France

    Dominique Bordessoule

  9. Hospital Universitario Virgen de la Arrixaca, Murcia, Spain

    José Maria Moraleda

  10. Hospital U. Marqués de Valdecilla, Santander, Spain

    Eulogio Conde Garcia

  11. Charles University Hospital, Prague, Czech Republic

    David Pohlreich

  12. Hospital Clinic, Barcelona, Spain

    Gonzalo Gutiérrez Garcia

  13. University College London Hospital, London, United Kingdom

    Kirsty Thomson

  14. Hadassah University Hospital, Jerusalem, Israel

    Reuven Or

  15. University Hospital, Essen, Germany

    Dietrich Beelen

  16. Unitá Operativa di Ematologia, Ravenna, Italy

    Eliana Zuffa

  17. Maria Sklodowska-Curie Memorial Cancer Canter and Institute of Oncology, Gliwice, Poland

    Sebastian Giebel

  18. C.H.R.U., Brest, France

    Christian Berthou

  19. Hospices Civils, Lyon, France

    Gilles Salles

  20. Perrino Hospital, Brindisi, Italy

    Angela Melpignano

  21. St. Bartholomew’s and The Royal London NHS Trust, London, United Kingdom

    Silvia Montoto

  22. Department of Medicine V, University of Heidelberg, Heidelberg, Germany

    Peter Dreger

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  1. Irit Avivi
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Correspondence to Irit Avivi.

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Avivi, I., Boumendil, A., Finel, H. et al. Autologous stem cell transplantation for primary mediastinal B-cell lymphoma: long-term outcome and role of post-transplant radiotherapy. A report of the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 53, 1001–1009 (2018). https://doi.org/10.1038/s41409-017-0063-7

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