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

I. Avivi, C. Canals, J. P. Vernant, G. Wulf, A. Nagler, O. Hermine, E. Petersen, I. Yakoub-Agha, C. Craddock, A. Schattenberg, D. Niederwieser, K. Thomson, D. Blaise, M. Attal, M. Pfreundschuh, J. Passweg, N. Russell, P. Dreger, A. Sureda

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)671-678
Number of pages8
JournalBone Marrow Transplantation
Volume49
Issue number5
DOIs
StatePublished - May 2014
Externally publishedYes

Keywords

  • allo-SCT
  • diffuse large B-cell lymphoma
  • HLA-identical sibling
  • matched unrelated donor

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