TY - JOUR
T1 - Matched unrelated donor allogeneic transplantation provides comparable long-term outcome to HLA-identical sibling transplantation in relapsed diffuse large B-cell lymphoma
AU - Avivi, I.
AU - Canals, C.
AU - Vernant, J. P.
AU - Wulf, G.
AU - Nagler, A.
AU - Hermine, O.
AU - Petersen, E.
AU - Yakoub-Agha, I.
AU - Craddock, C.
AU - Schattenberg, A.
AU - Niederwieser, D.
AU - Thomson, K.
AU - Blaise, D.
AU - Attal, M.
AU - Pfreundschuh, M.
AU - Passweg, J.
AU - Russell, N.
AU - Dreger, P.
AU - Sureda, A.
PY - 2014/5
Y1 - 2014/5
N2 - 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.
AB - 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.
KW - HLA-identical sibling
KW - allo-SCT
KW - diffuse large B-cell lymphoma
KW - matched unrelated donor
UR - http://www.scopus.com/inward/record.url?scp=84900301455&partnerID=8YFLogxK
U2 - 10.1038/bmt.2014.4
DO - 10.1038/bmt.2014.4
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 24510071
AN - SCOPUS:84900301455
SN - 0268-3369
VL - 49
SP - 671
EP - 678
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 5
ER -