Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2018 Apr 15;124(8):1733-1742.
doi: 10.1002/cncr.31264. Epub 2018 Feb 9.

Allogeneic hematopoietic stem cell transplantation for relapsed follicular lymphoma: A combined analysis on behalf of the Lymphoma Working Party of the EBMT and the Lymphoma Committee of the CIBMTR

Anna Sureda  1 , Mei-Jie Zhang  2   3 , Peter Dreger  4 , Jeanette Carreras  2 , Timothy Fenske  5 , Herve Finel  6 , Harry Schouten  7 , Silvia Montoto  8 , Stephen Robinson  9 , Sonali M Smith  10 , Ariane Boumedil  6 , Mehdi Hamadani  2 , Marcelo C Pasquini  2
Affiliations
Multicenter Study

Allogeneic hematopoietic stem cell transplantation for relapsed follicular lymphoma: A combined analysis on behalf of the Lymphoma Working Party of the EBMT and the Lymphoma Committee of the CIBMTR

Anna Sureda et al. Cancer. .

Abstract

Background: Allogeneic hematopoietic stem cell transplantation (allo-HCT) remains the only potentially curative treatment option for relapsed follicular lymphoma (FL), yet questions remain about the optimal timing. This study analyzed long-term outcomes and associated factors among recipients of allo-HCT with FL.

Methods: Patients with relapsed FL who underwent allo-HCT from 2001 to 2011 with a human leukocyte antigen (HLA)-matched donor were included. Outcome analyses for overall survival (OS), progression-free survival (PFS), transplant-related mortality (TRM), and disease relapse/progression were calculated. A multivariate analysis was performed to determine factors associated with outcomes, and a prognostic score for treatment failure was developed in a subset analysis of patients.

Results: In all, 1567 patients with relapsed FL were included; the median follow-up was 55 months. The 5-year probabilities of OS and PFS were 61% and 52%, respectively. The 5-year cumulative incidences of disease progression/relapse and TRM were 29% and 19%, respectively. Chemoresistant disease, older age, heavy pretreatment, poor performance status (PS), and myeloablative protocols were predictors for worse survival. The prognostic score, using age, lines of prior therapy, disease status, and PS, stratified patients into 3 groups-low, intermediate, and high risk-with 5-year PFS rates of 68%, 53%, and 46%, respectively, and 5-year OS rates of 80%, 62%, and 50%, respectively.

Conclusions: Allo-HCT should be considered for patients with relapsed FL and available HLA-matched donors. Outcomes are better in earlier phases of the disease, and reduced-intensity conditioning should be preferred. The prognostic score presented here can assist in counseling patients and determining the time to proceed to transplantation. Cancer 2018;124:1733-42. © 2018 American Cancer Society.

Keywords: allogeneic hematopoietic stem cell transplantation; follicular lymphoma; prognostic risk score; reduced-intensity conditioning protocols; unrelated donors.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors of the manuscript declare no conflicts of interest.

Figures

Figure 1
Figure 1
Probabilities for overall survival (A) and progression free survival (B) and cumulative incidences for transplant related mortality (C) and disease progression/relapse (D) for patients with FL who received an allogeneic hematopoietic cell transplantation from 2001-2011.
Figure 2
Figure 2
Probabilities for progression free survival (A) and overall survival (B), transplant related mortality (TRM) (C) and disease progression/relapse (D) according to prognostic score.
Figure 2
Figure 2
Probabilities for progression free survival (A) and overall survival (B), transplant related mortality (TRM) (C) and disease progression/relapse (D) according to prognostic score.
Figure 2
Figure 2
Probabilities for progression free survival (A) and overall survival (B), transplant related mortality (TRM) (C) and disease progression/relapse (D) according to prognostic score.
Figure 2
Figure 2
Probabilities for progression free survival (A) and overall survival (B), transplant related mortality (TRM) (C) and disease progression/relapse (D) according to prognostic score.
See this image and copyright information in PMC

Comment in

References

    1. van Besien K, Loberiza FR, Jr, Bajorunaite R, et al. Comparison of autologous and allogeneic hematopoietic stem cell transplantation for follicular lymphoma. Blood. 2003;102:3521–3529. - PubMed
    1. Robinson S, Canals C, Luang JJ, et al. The outcome of reduced intensity allogeneic stem cell transplantation and autologous stem cell transplantation when performed as a first transplant strategy in relapsed follicular lymphoma: an analysis from the Lymphoma Working Party of the EBMT. Bone Marrow Transplant. 2013;48:1409–1414. - PubMed
    1. Klyuchnikov E, Bacher U, Kreger NM, et al. Reduced-Intensity Allografting as First Transplantation Approach in Relapsed/Refractory Grades One and Two Follicular Lymphoma Provides Improved Outcomes in Long-Term Survivors. Biol Blood Marrow Transplant. 2015;21:2091–2099. - PMC - PubMed
    1. Klyuchnikov E, Bacher U, Ahn KW, et al. Long-term survival outcomes of reduced-intensity allogeneic or autologous transplantation in relapsed grade 3 follicular lymphoma. Bone Marrow Transplant. 2016;51:58–66. - PMC - PubMed
    1. Faulkner RD, Craddock C, Byrne JL, et al. BEAM-alemtuzumab reduced-intensity allogeneic stem cell transplantation for lymphoproliferative diseases: GVHD, toxicity, and survival in 65 patients. Blood. 2004;103:428–434. - PubMed

Publication types

MeSH terms

Substances