Autologous transplantation versus allogeneic transplantation in patients with follicular lymphoma experiencing early treatment failure

Sonali M. Smith, James Godfrey, Kwang Woo Ahn, Alyssa DiGilio, Sairah Ahmed, Vaibhav Agrawal, Veronika Bachanova, Ulrike Bacher, Asad Bashey, Javier Bolaños-Meade, Mitchell Cairo, Andy Chen, Saurabh Chhabra, Edward Copelan, Parastoo B. Dahi, Mahmoud Aljurf, Umar Farooq, Siddhartha Ganguly, Mark Hertzberg, Leona HolmbergDavid Inwards, Abraham S. Kanate, Reem Karmali, Vaishalee P. Kenkre, Mohamed A. Kharfan-Dabaja, Andreas Klein, Hillard M. Lazarus, Matthew Mei, Alberto Mussetti, Taiga Nishihori, Praveen Ramakrishnan Geethakumari, Ayman Saad, Bipin N. Savani, Harry C. Schouten, Nirav Shah, Alvaro Urbano-Ispizua, Ravi Vij, Julie Vose, Anna Sureda, Mehdi Hamadani

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

BACKGROUND: Early treatment failure (ETF) in follicular lymphoma (FL), defined as relapse or progression within 2 years of frontline chemoimmunotherapy, is a newly recognized marker of poor survival and identifies a high-risk group of patients with an expected 5-year overall survival (OS) rate of approximately 50%. Transplantation is an established option for relapsed FL, but its efficacy in this specific ETF FL population has not been previously evaluated. METHODS: This study compared autologous hematopoietic stem cell transplantation (auto-HCT) with either matched sibling donor (MSD) or matched unrelated donor (MUD) allogeneic hematopoietic cell transplantation (allo-HCT) as the first transplantation approach for patients with ETF FL (age ≥ 18 years) undergoing auto-HCT or allo-HCT between 2002 and 2014. The primary endpoint was OS. The secondary endpoints were progression-free survival, relapse, and nonrelapse mortality (NRM). RESULTS: Four hundred forty FL patients had ETF (auto-HCT, 240; MSD hematopoietic stem cell transplantation [HCT], 105; and MUD HCT, 95). With a median follow-up of 69 to 73 months, the adjusted probability of 5-year OS was significantly higher after auto-HCT (70%) or MSD HCT (73%) versus MUD HCT (49%; P =.0008). The 5-year adjusted probability of NRM was significantly lower for auto-HCT (5%) versus MSD (17%) or MUD HCT (33%; P <.0001). The 5-year adjusted probability of disease relapse was lower with MSD (31%) or MUD HCT (23%) versus auto-HCT (58%; P <.0001). CONCLUSIONS: Patients with high-risk FL, as defined by ETF, undergoing auto-HCT for FL have low NRM and a promising 5-year OS rate (70%). MSD HCT has lower relapse rates than auto-HCT but similar OS. Cancer 2018;124:2541-51.

Original languageEnglish (US)
Pages (from-to)2541-2551
Number of pages11
JournalCancer
Volume124
Issue number12
DOIs
StatePublished - Jun 15 2018

Bibliographical note

Funding Information:
The Center for International Blood and Marrow Transplant Research is supported by the following: the National Cancer Institute, the National Heart, Lung, and Blood Institute, and the National Institute of Allergy and Infectious Diseases (Public Health Service grant/cooperative agreement U24-CA076518); the National Cancer Institute and the National Heart, Lung, and Blood Institute (grant/cooperative agreement 5U10HL069294); the Health Resources and Services Administration (contract HHSH250201200016C); the Office of Naval Research (grants N00014-13-1-0039 and N00014-14-1-0028); Actinium Pharmaceuticals, Inc (corporate member); Allos Therapeutics, Inc; Amgen, Inc (corporate member); an anonymous donation to the Medical College of Wisconsin; Ariad; the Be the Match Foundation; the Blue Cross and Blue Shield Association (corporate member); Cel-gene Corporation (corporate member); Chimerix, Inc; the Fred Hutchinson Cancer Research Center; Fresenius-Biotech North America, Inc; Gamida Cell Teva Joint Venture, Ltd (corporate member); Genentech, Inc; Gentium SpA (corporate member); Genzyme Corporation; GlaxoSmithKline; the Roswell Park Cancer Institute (Health Research, Inc); HistoGenetics, Inc; Incyte Corporation; the Jeff Gordon Children’s Foundation; Kiadis Pharma; the Leukemia & Lymphoma Society; Medac GmbH; the Medical College of Wisconsin; Merck & Co, Inc; Millennium: The Takeda Oncology Co.; Milliman USA, Inc (corporate member); Miltenyi Biotec, Inc (corporate member); the National Marrow Donor Program; Onyx Pharmaceuticals; Optum Healthcare Solutions, Inc; Osiris Therapeutics, Inc; Otsuka America Pharmaceutical, Inc; Per-kinElmer, Inc; Remedy Informatics (corporate member); Sanofi US (corporate member); Seattle Genetics; Sigma-Tau Pharmaceuticals; Soligenix, Inc; St. Baldrick’s Foundation; StemCyte (a Global Cord Blood Therapeutics company); Stemsoft Software, Inc; Swedish Orphan Biovitrum; Tarix Pharmaceuticals (corporate member); Terumo BCT (corporate member); Teva Neuroscience, Inc (corporate member); Therakos, Inc (corporate member); the University of Minnesota; the University of Utah; and WellPoint, Inc (corporate member). The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, the Health Resources and Services Administration, or any other agency of the US Government.

Funding Information:
The Center for International Blood and Marrow Transplant Research is supported by the following: the National Cancer Institute, the National Heart, Lung, and Blood Institute, and the National Institute of Allergy and Infectious Diseases (Public Health Service grant/cooperative agreement U24-CA076518); the National Cancer Institute and the National Heart, Lung, and Blood Institute (grant/cooperative agreement 5U10HL069294); the Health Resources and Services Administration (contract HHSH250201200016C); the Office of Naval Research (grants N00014-13-1-0039 and N00014-14-1-0028); Actinium Pharmaceuticals, Inc (corporate member); Allos Therapeutics, Inc; Amgen, Inc (corporate member); an anonymous donation to the Medical College of Wisconsin; Ariad; the Be the Match Foundation; the Blue Cross and Blue Shield Association (corporate member); Celgene Corporation (corporate member); Chimerix, Inc; the Fred Hutchinson Cancer Research Center; Fresenius-Biotech North America, Inc; Gamida Cell Teva Joint Venture, Ltd (corporate member); Genentech, Inc; Gentium SpA (corporate member); Genzyme Corporation; GlaxoSmithKline; the Roswell Park Cancer Institute (Health Research, Inc); HistoGenetics, Inc; Incyte Corporation; the Jeff Gordon Children's Foundation; Kiadis Pharma; the Leukemia & Lymphoma Society; Medac GmbH; the Medical College of Wisconsin; Merck & Co, Inc; Millennium: The Takeda Oncology Co.; Milliman USA, Inc (corporate member); Miltenyi Biotec, Inc (corporate member); the National Marrow Donor Program; Onyx Pharmaceuticals; Optum Healthcare Solutions, Inc; Osiris Therapeutics, Inc; Otsuka America Pharmaceutical, Inc; PerkinElmer, Inc; Remedy Informatics (corporate member); Sanofi US (corporate member); Seattle Genetics; Sigma-Tau Pharmaceuticals; Soligenix, Inc; St. Baldrick's Foundation; StemCyte (a Global Cord Blood Therapeutics company); Stemsoft Software, Inc; Swedish Orphan Biovitrum; Tarix Pharmaceuticals (corporate member); Terumo BCT (corporate member); Teva Neuroscience, Inc (corporate member); Therakos, Inc (corporate member); the University of Minnesota; the University of Utah; and WellPoint, Inc (corporate member).

Keywords

  • allogeneic transplantation
  • autologous transplantation
  • chemoimmunotherapy
  • early treatment failure
  • follicular lymphoma
  • rituximab

Fingerprint Dive into the research topics of 'Autologous transplantation versus allogeneic transplantation in patients with follicular lymphoma experiencing early treatment failure'. Together they form a unique fingerprint.

Cite this