High-dose therapy (HDT) and autologous hematopoietic cell transplantation (auto-HCT) has been anecdotally prescribed in gray zone lymphoma (GZL), showing encouraging efficacy. We conducted a multicenter retrospective study aimed at assessing outcomes after auto-HCT in 32 patients with GZL treated at 9 transplantation centers in the United States. The median age of patients at transplantation was 38 years (range, 18 to 70 years), and the majority were male (n = 21; 66%). The median number of lines of therapy before transplantation was 2 (range, 1 to 4). BEAM was the most commonly prescribed regimen (n = 23; 72%). The median duration of follow-up for surviving patients was 34 months (range, 1 to 106 months). Median overall survival (OS) was not reached. The 3-year progression-free survival (PFS) and OS for all patients were 69% and 78%, respectively. Three-year PFS and OS were 100% for patients who received only 1 line of therapy before auto-HCT versus 65% (PFS, P =.25) and 75% (OS, P =.39) for those receiving >1 line. The cumulative incidence of relapse/progression was 4% at 1 year post-transplantation and 31% at 3 years post-transplantation. The 3-year nonrelapse mortality was 0%. These findings suggest that HDT and auto-HCT is an effective treatment in patients with GZL. Our findings ideally require confirmation in a larger cohort of patients, preferably in the setting of large prospective multicenter randomized controlled trials. However, we acknowledge that such studies could be difficult to conduct in patients with GZL owing to the disease's rarity. Alternatively, a multicenter prospective study that includes tissue banking and a data registry is warranted to help better understand the biology and natural history of the disease.
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Conflict of interest statement: M.A.K.-D. serves on the speaker's bureau for Incyte Corp, Alexion Pharmaceuticals, and Seattle Genetics. M.C. has a consulting/advisory role for Pfizer and Takeda. P.F.C has a consulting/advisory role for Kite Pharma and serves on the speaker's bureau for Celgene. M. Hussaini has received an honorarium from Janssen Pharmaceuticals. M.d.L. has a consulting/advisory role for Celgene, Pfizer, and Amgen and has received research funding from Celgene. B.J. has a consulting/advisory role for Celgene, Bayer, Baxalta, Jazz pharmaceuticals, Pfizer, and Clonoseq; receives research support from Incyte and Rosetta Genomics; and serves on the speaker's bureau for Amgen. J.C.C. has a consulting/advisory role for Novartis, serves on the speaker's bureau for Janssen Pharmaceuticals, and has received research support from Merck. S.G. has a consulting/advisory role for Amgen, Millennium, and Seattle Genetics; has received research funding from Janssen; and serves on the speaker's bureau for Seattle Genetics.
© 2017 The American Society for Blood and Marrow Transplantation
- Autologous hematopoietic cell transplantation
- Gray zone lymphoma
- High-dose therapy