Allogeneic Transplantation for Relapsed Waldenström Macroglobulinemia and Lymphoplasmacytic Lymphoma

Robert F. Cornell, Veronika Bachanova, Anita D'Souza, Kwang Woo-Ahn, Michael Martens, Jiaxing Huang, A. Samer Al-Homsi, Saurabh Chhabra, Edward Copelan, Miguel Angel Diaz, Cesar O. Freytes, Robert Peter Gale, Siddhartha Ganguly, Mehdi Hamadani, Gerhard Hildebrandt, Rammurti T. Kamble, Mohamed Kharfan-Dabaja, Tamila Kindwall-Keller, Hillard M. Lazarus, David I. MarksTaiga Nishihori, Richard F. Olsson, Ayman Saad, Saad Usmani, David H. Vesole, Jean Yared, Tomer Mark, Yago Nieto, Parameswaran Hari

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Waldenström macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) is characterized by lymphoplasmacytic proliferation, lymph node and spleen enlargement, bone marrow involvement, and IgM production. Treatment varies based on the extent and biology of disease. In some patients, the use of allogeneic hematopoietic cell transplantation (alloHCT) may have curative potential. We evaluated long-term outcomes of 144 patients who received adult alloHCT for WM/LPL. Data were obtained from the Center for International Blood and Marrow Transplant Research database (2001 to 2013). Patients received myeloablative(n = 67) or reduced-intensity conditioning (RIC; n = 67). Median age at alloHCT was 53 years, and median time from diagnosis to transplantation was 41 months. Thirteen percent (n = 18) failed prior autologous HCT. About half (n = 82, 57%) had chemosensitive disease at the time of transplantation, whereas 22% had progressive disease. Rates of progression-free survival, overall survival, relapse, and nonrelapse mortality at 5 years were 46%, 52%, 24%, and 30%, respectively. Patients with chemosensitive disease and better pretransplant disease status experienced significantly superior overall survival. There were no significant differences in progression-free survival based on conditioning (myeloablative, 50%, versus RIC, 41%) or graft source. Conditioning intensity did not impact treatment-related mortality or relapse. The most common causes of death were primary disease and graft-versus-host disease (GVHD). AlloHCT yielded durable survival in select patients with WM/LPL. Strategies to reduce mortality from GVHD and post-transplant relapse are necessary to improve this approach.

Original languageEnglish (US)
Pages (from-to)60-66
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2017

Keywords

  • Allogeneic stem cell transplant
  • Relapsed lymphoma

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    Cornell, R. F., Bachanova, V., D'Souza, A., Woo-Ahn, K., Martens, M., Huang, J., Al-Homsi, A. S., Chhabra, S., Copelan, E., Diaz, M. A., Freytes, C. O., Gale, R. P., Ganguly, S., Hamadani, M., Hildebrandt, G., Kamble, R. T., Kharfan-Dabaja, M., Kindwall-Keller, T., Lazarus, H. M., ... Hari, P. (2017). Allogeneic Transplantation for Relapsed Waldenström Macroglobulinemia and Lymphoplasmacytic Lymphoma. Biology of Blood and Marrow Transplantation, 23(1), 60-66. https://doi.org/10.1016/j.bbmt.2016.10.010