Matched unrelated donor allogeneic transplantation provides comparable long-term outcome to HLA-identical sibling transplantation in relapsed diffuse large B-cell lymphoma.

Abstract

The objective of this retrospective analysis was to compare outcomes of patients with diffuse large B-cell lymphoma (DLBCL) who received either a matched sibling (sib) or an unrelated donor (URD) allogeneic hematopoietic cell transplantation (allo-HCT). Long-term outcome of 172 DLBCL patients receiving URD-HCT between 2000 and 2007 and reported to the European Group for Blood and Marrow Transplantation, was compared with that of 301 subjects, allografted from sib-HCT. With a median follow-up of 45 months, 3-year PFS approached 35% for both groups; overall survival (OS) was 42% for sib-HCT versus 37% for URD (NS). Multivariate analyses confirmed that donor type was not associated with differences in non-relapse mortality (NRM), relapse rate (RR), PFS or OS. Poor performance status (PS) and refractory disease adversely affected PFS and OS. Prior auto-SCT and multiple previous therapies predicted for shorter PFS. NRM was adversely affected by older age (⩾50 years), poor PS and refractory disease, and RR by time from diagnosis to allo-HCT of <36 months, prior auto-SCT, refractory disease, poor PS and in vivo T-cell depletion with alemtuzumab. This large study shows for the first time that URD-HCT is not inferior to sib-HCT, providing a reasonable therapeutic approach for DLBCL patients, having no HLA-identical sibling available.

• Authors: I Avivi, C Canals, J-P Vernant, G Wulf, A Nagler, O Hermine, E Petersen, I Yakoub-Agha, C Craddock, A Schattenberg, D Niederwieser, K Thomson, D Blaise, M Attal, M Pfreundschuh, J Passweg, N Russell, P Dreger, A Sureda, EBMT Lymphoma Working Party
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 49 Issue 5 Pg. 671-8 (May 2014) ISSN: 1476-5365 [Electronic] England
• PMID: 24510071 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Child
• Disease Progression
• Female
• Graft vs Host Disease (etiology, immunology, mortality)
• Hematopoietic Stem Cell Transplantation (adverse effects, methods, mortality)
• Histocompatibility
• Histocompatibility Testing
• Humans
• Lymphoma, Large B-Cell, Diffuse (immunology, mortality, therapy)
• Male
• Middle Aged
• Multivariate Analysis
• Recurrence
• Retrospective Studies
• Siblings
• Transplantation, Autologous
• Transplantation, Homologous
• Unrelated Donors
• Young Adult