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Allogeneic stem cell transplantation as a curative option in relapse/refractory diffuse large B cell lymphoma: Spanish multicenter GETH/GELTAMO study

Bone Marrow Transplantation volume 56, pages 1919–1928 (2021)Cite this article

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Abstract

We performed a retrospective multicenter study including 140 patients with relapsed/refractory (R/R) diffuse large B cell lymphoma (DLBCL) who underwent allogeneic hematopoietic stem cell transplantation (allo-SCT) from March 1995 to November 2018. Our objective was to analyze long term outcomes. Seventy-four percent had received a previous auto-SCT (ASCT) and the median number of lines pre-allo-SCT was 3 (range 1–9). Three year-event free survival (EFS) and overall survival (OS) were 38% and 44%, respectively. Non-relapse mortality (NRM) at day 100 was 19%. Cumulative incidence of grade III–IV acute graft versus host disease (GVHD) at day 100 was 16% and moderate/severe chronic GVHD at 3 years 34%. Active disease at allo-SCT (HR 1.95, p = 0.039) (HR 2.19, p = 0.019), HCT-CI ≥ 2 (2.45, p = 0.002) (HR 2.33, p = 0.006) and donor age >37 years (HR 2.75, p = 0.014) (HR 1.98, p = 0.043) were the only independent variables both for PFS and OS, respectively. NRM was significantly modified by HCT-CI ≥ 2 (HR 4.8, p = 0.008), previous ASCT (HR 4.4, p = 0.048) and grade III–IV acute GVHD on day 100 (HR 6.13, p = 0.016). Our data confirmed that allo-SCT is a curative option for patients with R/R DLBCL, displaying adequate results for fit patients with chemosensitive disease receiving an allo-SCT from a young donor.

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Fig. 1: Survival analysis in total cohort.
Fig. 2: Survival analysis in total cohort.
Fig. 3: Survival analysis depending on prognostic score.

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Acknowledgements

We thank Ángel Cedillo for his contribution in obtaining the clinical data of the paper.

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Authors and Affiliations

  1. Son Espases University Hospital, IdISBa, Palma, Spain

    Leyre Bento, Antonio Gutiérrez & Antonia Sampol

  2. Hospital Sant Creu i Sant Pau, Barcelona, Spain

    Silvana Novelli, Irene García-Cadenas & Jordi Sierra

  3. Hospital La Fe, Valencia, Spain

    Juan Montoro & J. L. Piñana

  4. Hospital Universitario Salamanca, Salamanca, Spain

    Lucía López-Corral, Mónica Cabrero, Alejandro Martín-Sancho & Dolores Caballero

  5. Hospital Clinic, Barcelona, Spain

    Gonzalo Gutiérrez-García, Marcela Ortiz-Moscovich & Carmen Martínez

  6. Hospital General Universitario Gregorio Marañón, Madrid, Spain

    Mariana Bastos-Oreiro & Nieves Dorado

  7. Hospital Clínico Valencia, Valencia, Spain

    Ariadna Pérez, Rafael Hernani & Carlos Solano

  8. ICO-IJC-Hospital Germans Trias i Pujol, Badalona, Spain

    Christelle Ferrà

  9. Institut Català d’Oncologia (ICO), Hospitalet, Spain

    Rocío Parody & Anna Sureda

  10. Hospital Ramón y Cajal, Madrid, Spain

    Pilar Herrera

  11. Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC / CIBERONC), Universidad de Sevilla, Sevilla, Spain

    Guillermo Rodríguez, Nancy Rodríguez & José Antonio Pérez-Simón

  12. Hospital Reina Sofía, Córdoba, Spain

    Carmen Martín

  13. Hospital Valdecilla, Santander, Spain

    Lucrecia Yáñez

  14. Hospital Asturias, Oviedo, Spain

    Joud Zanabili

  15. Complejo Hospital Juan Canalejo, Coruña, Spain

    María Rosario Varela

  16. Hospital Morales Meseguer, Murcia, Spain

    Oriana López-Godino & Inmaculada Heras

  17. Hospital Universitario Virgen de Arrixaca, Murcia, Spain

    Ignacio Español

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  1. Leyre Bento
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on behalf of the Grupo Español de Trasplante Hematopoyético (GETH) and Grupo Español de Linfoma y Trasplante Autólogo (GELTAMO)

Contributions

LB and DC performed the research. LB, AG, SN, JM, JLP, LLC, MC, GG, MO, MB, ND, AP, RH, CF, ISO, IGC, PH, NR, GR, CM, LY, JZ, MRV, TZ, OLG, IH, IEM, CM, AS, JAPS, CS, AS, JS, AC and DC contributed to clinical data. LB, AG and DC contributed to the analysis and data interpretation. Statistical analysis was performed by AG. All authors contributed to review, provided their comments on this paper and approval the final version.

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Correspondence to Leyre Bento.

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Bento, L., Gutiérrez, A., Novelli, S. et al. Allogeneic stem cell transplantation as a curative option in relapse/refractory diffuse large B cell lymphoma: Spanish multicenter GETH/GELTAMO study. Bone Marrow Transplant 56, 1919–1928 (2021). https://doi.org/10.1038/s41409-021-01264-3

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