title: Mature results of the M. D. Anderson Cancer Center risk-adapted transplantation strategy in mantle cell lymphoma.
abstract: In this study, we analyzed the long-term outcome of a risk-adapted transplantation strategy for mantle cell lymphoma in 121 patients enrolled in sequential transplantation protocols. Notable developments over the 17-year study period were the addition of rituximab to chemotherapy and preparative regimens and the advent of nonmyeloablative allogeneic stem cell transplantation (NST). In the autologous transplantation group (n = 86), rituximab resulted in a marked improvement in progression-free survival for patients who received a transplant in their first remission (where a plateau emerged at 3-8 years) but did not change the outcomes for patients who received a transplant beyond their first remission. In the NST group, composed entirely of patients who received a transplant beyond their first remission, durable remissions also emerged in progression-free survival at 5 to 9 years. The major determinants of disease control after NST were the use of a peripheral blood stem cell graft and donor chimerism of at least 95%, whereas the major determinant of death was immunosuppression for chronic graft-versus-host disease. Our results show that long-term disease-free survival in mantle cell lymphoma is possible after rituximab-containing autologous transplantation for patients in first remission and after NST for patients with relapsed or refractory disease.
authors.affiliation: Department of Hematology, St Vincent's Hospital, Melbourne, Australia.
authors.forename: Constantine S
authors.initials: CS
authors.lastname: Tam
authors.forename: Roland
authors.initials: R
authors.lastname: Bassett
authors.forename: Celina
authors.initials: C
authors.lastname: Ledesma
authors.forename: Martin
authors.initials: M
authors.lastname: Korbling
authors.forename: Amin
authors.initials: A
authors.lastname: Alousi
authors.forename: Chitra
authors.initials: C
authors.lastname: Hosing
authors.forename: Partow
authors.initials: P
authors.lastname: Kebraei
authors.forename: Robyn
authors.initials: R
authors.lastname: Harrell
authors.forename: Gabriela
authors.initials: G
authors.lastname: Rondon
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Giralt
authors.forename: Paolo
authors.initials: P
authors.lastname: Anderlini
authors.forename: Uday
authors.initials: U
authors.lastname: Popat
authors.forename: Barbara
authors.initials: B
authors.lastname: Pro
authors.forename: Barry
authors.initials: B
authors.lastname: Samuels
authors.forename: Frederick
authors.initials: F
authors.lastname: Hagemeister
authors.forename: L Jeffrey
authors.initials: LJ
authors.lastname: Medeiros
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.forename: Issa F
authors.initials: IF
authors.lastname: Khouri
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006086:Graft vs Host Disease / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012307:Risk Factors; D000069283:Rituximab; D015996:Survival Rate; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab