Journal
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 20, Issue 7, Pages 951-959Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2014.03.014
Keywords
Transformed follicular; lymphoma; Transplant
Categories
Funding
- Public Health Service Grant/Cooperative Agreement from the National Cancer Institute (NCI) [U24 CA076518]
- National Heart, Lung and Blood Institute (NHLBI)
- National Institute of Allergy and Infectious Diseases
- NHLBI and NCI [U10 HL069294]
- Health Resources and Services Administration [HHSH250201200016C]
- Office of Naval Research [N00014-12-1-0142, N00014-131-0039]
- Allos Therapeutics, Amgen
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There are limited data on the outcomes of autologous or allogeneic hematopoietic cell transplantation (HCT) in diffuse large B cell lymphoma transformed from follicular lymphoma. We analyzed transplantation outcomes in 141 subjects with biopsy-proven diffuse large B-cell lymphoma transformed from follicular lymphoma reported to the Center for International Blood and Marrow Transplant Research between 1990 and 2009. Two groups were identified: autologous HCT (auto-Ha; n = 108) and allogeneic HCT (allo-HCT; n = 33). Fewer auto-Has were done for transformed follicular lymphoma in 2003 to 2009, with a shift favoring allo-HCT. Auto-HCT was associated with a 1-year nonrelapse mortality (NRM) of 8% (95% confidence interval [CI], 4% to 14%), 5-year progression-free survival of 35% (95% CI, 26% to 45%), and 5-year overall survival of 50% (95% CI, 40% to 59%). In contrast, allo-HCT was associated with a 1-year NRM of 41% (95% CI, 23% to 58%), 5-year progression-free survival of 18% (95% CI, 6% to 35%), and 5-year overall survival of 22% (95% CI, 8% to 41%). Auto-HCT for transformed follicular lymphoma achieves sustained remission in a high proportion of subjects. The high NRM of allo-HCT offset any benefit that might be associated with this transplantation modality. (C) 2014 American Society for Blood and Marrow Transplantation.
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