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Impact of pretransplantation conditioning regimens on outcomes of allogeneic transplantation for chemotherapy-unresponsive diffuse large B cell lymphoma and grade III follicular lymphoma.
Biol Blood Marrow Transplant. 2013 May; 19(5):746-53.BB

Abstract

Patients with chemorefractory non-Hodgkin lymphomas generally have a poor prognosis. We used the observational database of the Center for International Blood and Marrow Transplant Research to study the outcome of 533 patients with refractory diffuse large B cell lymphoma (DLBCL) or grade III follicular lymphoma (FL-III) who underwent allogeneic hematopoietic cell transplantation (allo-HCT) using either myeloablative (MA; n = 307) or reduced-intensity/nonmyeloablative conditioning (RIC/NST; n = 226) between 1998 and 2010. We analyzed nonrelapse mortality (NRM), relapse/progression, progression-free survival (PFS), and overall survival (OS). Only 45% of the patients at transplantation had a Karnofsky performance score of ≥90%. Median follow-up of surviving patients after MA and RIC/NST allo-HCT is 35 months and 30 months, respectively. At 3 years, MA allo-HCT was associated with a higher NRM compared with RIC/NST (53% versus 42%; P = .03), similar PFS (19% versus 23%; P = .40), and lower OS (19% versus 28%; P = .02), respectively. On multivariate analysis, FL-III histology was associated with lower NRM (relative risk [RR], .52), reduced risk of relapse/progression (RR, .42), and superior PFS (RR, .51) and OS (RR, .53), whereas MA conditioning was associated with reduced risk of relapse/progression (RR, .66). Despite a refractory state, a small subset of DLBCL and FL-III patients can attain durable remissions after allo-HCT. Conditioning regimen intensity was not associated with PFS and OS despite a higher risk of relapse/progression with RIC/NST allo-HCT.

Authors+Show Affiliations

Myeloma and Lymphoma Service, West Virginia University Hospitals, Morgantown, West Virginia, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

23380340

Citation

Hamadani, Mehdi, et al. "Impact of Pretransplantation Conditioning Regimens On Outcomes of Allogeneic Transplantation for Chemotherapy-unresponsive Diffuse Large B Cell Lymphoma and Grade III Follicular Lymphoma." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 19, no. 5, 2013, pp. 746-53.
Hamadani M, Saber W, Ahn KW, et al. Impact of pretransplantation conditioning regimens on outcomes of allogeneic transplantation for chemotherapy-unresponsive diffuse large B cell lymphoma and grade III follicular lymphoma. Biol Blood Marrow Transplant. 2013;19(5):746-53.
Hamadani, M., Saber, W., Ahn, K. W., Carreras, J., Cairo, M. S., Fenske, T. S., Gale, R. P., Gibson, J., Hale, G. A., Hari, P. N., Hsu, J. W., Inwards, D. J., Kamble, R. T., Klein, A., Maharaj, D., Marks, D. I., Rizzieri, D. A., Savani, B. N., Schouten, H. C., ... Lazarus, H. M. (2013). Impact of pretransplantation conditioning regimens on outcomes of allogeneic transplantation for chemotherapy-unresponsive diffuse large B cell lymphoma and grade III follicular lymphoma. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 19(5), 746-53. https://doi.org/10.1016/j.bbmt.2013.01.024
Hamadani M, et al. Impact of Pretransplantation Conditioning Regimens On Outcomes of Allogeneic Transplantation for Chemotherapy-unresponsive Diffuse Large B Cell Lymphoma and Grade III Follicular Lymphoma. Biol Blood Marrow Transplant. 2013;19(5):746-53. PubMed PMID: 23380340.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of pretransplantation conditioning regimens on outcomes of allogeneic transplantation for chemotherapy-unresponsive diffuse large B cell lymphoma and grade III follicular lymphoma. AU - Hamadani,Mehdi, AU - Saber,Wael, AU - Ahn,Kwang Woo, AU - Carreras,Jeanette, AU - Cairo,Mitchell S, AU - Fenske,Timothy S, AU - Gale,Robert Peter, AU - Gibson,John, AU - Hale,Gregory A, AU - Hari,Parameswaran N, AU - Hsu,Jack W, AU - Inwards,David J, AU - Kamble,Rammurti T, AU - Klein,Anderas, AU - Maharaj,Dipnarine, AU - Marks,David I, AU - Rizzieri,David A, AU - Savani,Bipin N, AU - Schouten,Harry C, AU - Waller,Edmund K, AU - Wirk,Baldeep, AU - Laport,Ginna G, AU - Montoto,Silvia, AU - Maloney,David G, AU - Lazarus,Hillard M, Y1 - 2013/02/01/ PY - 2012/10/26/received PY - 2013/01/26/accepted PY - 2013/2/6/entrez PY - 2013/2/6/pubmed PY - 2014/3/15/medline SP - 746 EP - 53 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol. Blood Marrow Transplant. VL - 19 IS - 5 N2 - Patients with chemorefractory non-Hodgkin lymphomas generally have a poor prognosis. We used the observational database of the Center for International Blood and Marrow Transplant Research to study the outcome of 533 patients with refractory diffuse large B cell lymphoma (DLBCL) or grade III follicular lymphoma (FL-III) who underwent allogeneic hematopoietic cell transplantation (allo-HCT) using either myeloablative (MA; n = 307) or reduced-intensity/nonmyeloablative conditioning (RIC/NST; n = 226) between 1998 and 2010. We analyzed nonrelapse mortality (NRM), relapse/progression, progression-free survival (PFS), and overall survival (OS). Only 45% of the patients at transplantation had a Karnofsky performance score of ≥90%. Median follow-up of surviving patients after MA and RIC/NST allo-HCT is 35 months and 30 months, respectively. At 3 years, MA allo-HCT was associated with a higher NRM compared with RIC/NST (53% versus 42%; P = .03), similar PFS (19% versus 23%; P = .40), and lower OS (19% versus 28%; P = .02), respectively. On multivariate analysis, FL-III histology was associated with lower NRM (relative risk [RR], .52), reduced risk of relapse/progression (RR, .42), and superior PFS (RR, .51) and OS (RR, .53), whereas MA conditioning was associated with reduced risk of relapse/progression (RR, .66). Despite a refractory state, a small subset of DLBCL and FL-III patients can attain durable remissions after allo-HCT. Conditioning regimen intensity was not associated with PFS and OS despite a higher risk of relapse/progression with RIC/NST allo-HCT. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/23380340/Impact_of_pretransplantation_conditioning_regimens_on_outcomes_of_allogeneic_transplantation_for_chemotherapy_unresponsive_diffuse_large_B_cell_lymphoma_and_grade_III_follicular_lymphoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(13)00060-8 DB - PRIME DP - Unbound Medicine ER -