Internal medicine journal · 2026
Allogeneic stem cell transplantation for mantle cell lymphoma can achieve durable remission and myeloablative conditioning is associated with inferior survival: an Australian and New Zealand Transplant & Cellular Therapies registry study.
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McKeague Sean, Di Ciaccio Pietro R, Tran Steven, Minson Adrian, Richie David, Kennedy Glen, Milliken Sam, Purtill Duncan, Gottlieb David, Perera Travis, Yeung David T, Larsen Stephen R, Doocey Richard, Greenwood Matthew, Durrant Simon, Watson Anne-Marie, Butler Andrew, Khot Amit, Curley Cameron, Hamad Nada
Аннотация
BACKGROUND: Allogeneic stem cell transplantation (AlloSCT) has established curative potential in mantle cell lymphoma (MCL). As therapies for MCL evolve, outcomes with AlloSCT require reassessment.
AIM: This study aimed to report the outcomes of AlloSCT for MCL across Australia and New Zealand.
METHODS: Data were collected through the Australasian Bone Marrow Transplant Recipient Registry (ABMTRR) for all patients undergoing AlloSCT for MCL between January 2009 and December 2019.
RESULTS: Forty-six patients underwent AlloSCT for MCL between 2009 and 2014 and 40 between 2015 and 2019. The median patient age was 56 years (range 32-72), nine of 15 patients tested (60%) had TP53 mutation, and 14% of patients underwent myeloablative conditioning (MAC). A higher proportion of patients in the 2015-2019 period were BTKi-exposed (68% vs. 0%, P = 0.00). Non-relapse mortality (NRM) at 1 year and 5 years was 23% (95% confidence interval (95% CI) 14-32) and 31% (95% CI 21-42) respectively. The 100-day cumulative incidence of grade II to IV acute graft-versus-host disease (GVHD) was 21% (95% CI 13-30), and the 3-year cumulative incidence of chronic GVHD was 31% (95% CI 22-41). At 5 years, overall survival (OS) was 48% (95% CI 36-59) and progression free survival (PFS) was 38% (95% CI 27-50). The use of MAC was independently associated with inferior PFS (hazard ratio [HR] 2.33, 95% CI 1.05-5.17, P = 0.038) and OS (HR 3.11, 95% CI 1.39-7.00, P = 0.006). There was no difference in outcomes for patients transplanted between 2009 and 2014 versus 2015 and 2019.
CONCLUSION: AlloSCT can achieve durable remissions for MCL in the modern era, and the use of MAC is associated with inferior outcomes.
AIM: This study aimed to report the outcomes of AlloSCT for MCL across Australia and New Zealand.
METHODS: Data were collected through the Australasian Bone Marrow Transplant Recipient Registry (ABMTRR) for all patients undergoing AlloSCT for MCL between January 2009 and December 2019.
RESULTS: Forty-six patients underwent AlloSCT for MCL between 2009 and 2014 and 40 between 2015 and 2019. The median patient age was 56 years (range 32-72), nine of 15 patients tested (60%) had TP53 mutation, and 14% of patients underwent myeloablative conditioning (MAC). A higher proportion of patients in the 2015-2019 period were BTKi-exposed (68% vs. 0%, P = 0.00). Non-relapse mortality (NRM) at 1 year and 5 years was 23% (95% confidence interval (95% CI) 14-32) and 31% (95% CI 21-42) respectively. The 100-day cumulative incidence of grade II to IV acute graft-versus-host disease (GVHD) was 21% (95% CI 13-30), and the 3-year cumulative incidence of chronic GVHD was 31% (95% CI 22-41). At 5 years, overall survival (OS) was 48% (95% CI 36-59) and progression free survival (PFS) was 38% (95% CI 27-50). The use of MAC was independently associated with inferior PFS (hazard ratio [HR] 2.33, 95% CI 1.05-5.17, P = 0.038) and OS (HR 3.11, 95% CI 1.39-7.00, P = 0.006). There was no difference in outcomes for patients transplanted between 2009 and 2014 versus 2015 and 2019.
CONCLUSION: AlloSCT can achieve durable remissions for MCL in the modern era, and the use of MAC is associated with inferior outcomes.