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Long-term outcome analysis of reduced-intensity allogeneic stem cell transplantation in patients with mantle cell lymphoma: a retrospective study from the EBMT Lymphoma Working Party

Bone Marrow Transplantationvolume 53pages617624 (2018) | Download Citation

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Abstract

Reduced-intensity allogeneic stem cell transplantation (RIST) is usually reserved for patients with mantle cell lymphoma who relapse after an autoSCT. However, the long-term efficacy of RIST and its curative potential have not been clearly demonstrated. We studied the long-term outcome of patients receiving a RIST for MCL as reported to the EBMT. A total of 324 patients, median age 57 years (range 31–70), underwent a RIST between 2000 and 2008; 43% of the patients had received >3 lines of prior therapy, including an autoSCT in 46%. Non-relapse mortality (NRM) was 10% at 100 days and 24% at 1 year and was lower for patients receiving anti-thymocyte globulin (ATG)/ALG (RR 0.59, p = 0.046). After a median follow-up of 72 months (range 3–159), 118 patients relapsed at a median of 8 months post RIST (range 1–117). The cumulative incidence of relapse was 25% and 40% at 1 and 5 years, respectively, and was associated with chemorefractory disease (HR 0.49, p = 0.01) and the use of CAMPATH (HR 2.59, p = 0.0002). The 4-year progression-free survival rate and overall survival rate was 31 and 40%, respectively. RIST results in long-term disease-free survival in about 30% of the patients, including those patients relapsing after a prior autoSCT.

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Affiliations

  1. University Hospitals Bristol, Bristol, UK

    • Stephen P. Robinson
  2. Lymphoma Working Party EBMT, Paris, France

    • Ariane Boumendil
    •  & Herve Finel
  3. University College London Hospital, London, UK

    • Karl S. Peggs
  4. CHU, Nantes, France

    • Patrice Chevallier
  5. Hospital Santa Creu i Sant Pau, Barcelona, Spain

    • Jorge Sierra
  6. University of Freiburg, Freiburg im Breisgau, Germany

    • Jürgen Finke
  7. Cliniques Universitaires St. Luc, Brussels, Belgium

    • Xavier Poiré
  8. Hôpital La Miletrie, Poitiers, France

    • Natacha Maillard
  9. CHU Bordeaux, Bordeaux, France

    • Noël Milpied
  10. Hôpital Huriez, Lille, France

    • Ibrahim Yakoub-Agha
  11. St. George’s Hospital, London, UK

    • Mickey Koh
  12. University Hospital Eppendorf, Hamburg, Germany

    • Nicolaus Kröger
  13. Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel

    • Arnon Nagler
  14. Medical Park Hospitals, Antalya, Turkey

    • Yener Koc
  15. University of Heidelberg, Heidelberg, Germany

    • Sascha Dietrich
    •  & Peter Dreger
  16. St. Bartholomew’s Hospital, Barts Health NHS Trust, London, UK

    • Silvia Montoto

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The authors declare that they have no conflict of interest.

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Correspondence to Stephen P. Robinson.

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DOI

https://doi.org/10.1038/s41409-017-0067-3