Outcomes of hematopoietic cell transplantation for diffuse large B cell lymphoma transformed from follicular lymphoma.
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-HCT; n = 108) and allogeneic HCT (allo-HCT; n = 33). Fewer auto-HCTs 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.
Wirk, B; Fenske, TS; Hamadani, M; Zhang, M-J; Hu, Z-H; Akpek, G; Aljurf, MD; Armand, P; Ayala, E; Bachanova, V; Bolwell, B; Cairo, MS; Cashen, A; Chen, Y-B; Costa, LJ; Farhan, S; Freytes, CO; Gajewski, JL; Gibson, J; Hale, GA; Holmberg, LA; Hsu, JW; Inwards, DJ; Kamble, RT; Maharaj, D; Maziarz, RT; Munker, R; Nath, R; Reddy, NM; Reeder, CB; Rizzieri, DA; Sauter, CS; Savani, BN; Schouten, HC; Sureda, A; Vose, JM; Waller, EK; Wiernik, PH; Gale, RP; Burns, LJ; Saber, W
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