Autologous transplantation versus allogeneic transplantation in patients with follicular lymphoma experiencing early treatment failure.
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Smith Sonali M, Godfrey James, Ahn Kwang Woo, DiGilio Alyssa, Ahmed Sairah, Agrawal Vaibhav, Bachanova Veronika, Bacher Ulrike, Bashey Asad, Bolaños-Meade Javier, Cairo Mitchell, Chen Andy, Chhabra Saurabh, Copelan Edward, Dahi Parastoo B, Aljurf Mahmoud, Farooq Umar, Ganguly Siddhartha, Hertzberg Mark, Holmberg Leona, Inwards David, Kanate Abraham S, Karmali Reem, Kenkre Vaishalee P, Kharfan-Dabaja Mohamed A, Klein Andreas, Lazarus Hillard M, Mei Matthew, Mussetti Alberto, Nishihori Taiga, Ramakrishnan Geethakumari Praveen, Saad Ayman, Savani Bipin N, Schouten Harry C, Shah Nirav, Urbano-Ispizua Alvaro, Vij Ravi, Vose Julie, Sureda Anna, Hamadani Mehdi
Аннотация
METHODS: This study compared autologous hematopoietic stem cell transplantation (auto-HCT) with either matched sibling donor (MSD) or matched unrelated donor (MUD) allogeneic hematopoietic cell transplantation (allo-HCT) as the first transplantation approach for patients with ETF FL (age ≥ 18 years) undergoing auto-HCT or allo-HCT between 2002 and 2014. The primary endpoint was OS. The secondary endpoints were progression-free survival, relapse, and nonrelapse mortality (NRM).
RESULTS: Four hundred forty FL patients had ETF (auto-HCT, 240; MSD hematopoietic stem cell transplantation [HCT], 105; and MUD HCT, 95). With a median follow-up of 69 to 73 months, the adjusted probability of 5-year OS was significantly higher after auto-HCT (70%) or MSD HCT (73%) versus MUD HCT (49%; P = .0008). The 5-year adjusted probability of NRM was significantly lower for auto-HCT (5%) versus MSD (17%) or MUD HCT (33%; P < .0001). The 5-year adjusted probability of disease relapse was lower with MSD (31%) or MUD HCT (23%) versus auto-HCT (58%; P < .0001).
CONCLUSIONS: Patients with high-risk FL, as defined by ETF, undergoing auto-HCT for FL have low NRM and a promising 5-year OS rate (70%). MSD HCT has lower relapse rates than auto-HCT but similar OS. Cancer 2018;124:2541-51. © 2018 American Cancer Society.