Is ASCT with TBI superior to ASCT without TBI in mantle cell lymphoma patients?
BACKGROUND
Impact of total-body irradiation (TBI) in conditioning regimen on outcome for patients with mantle cell lymphoma (MCL) remains unknown.


METHODS
Patients with MCL who underwent autologous stem-cell transplantation (ASCT) in our institution were eligible for the present study (n=73). We analyzed the impact of various biologic and clinical parameters, with and without TBI, on patient outcome.


RESULTS
All patients presented with chemosensitive disease at transplantation. Median follow-up from ASCT was 37.2 months. One- and three-year overall survival (OS) rates were 90.3% and 74.5%, progression-free survival (PFS) rates were 85% and 59%, respectively. Three-year OS and PFS rates in the non-TBI group versus TBI group were similar: 80% versus 72.5% and 60% versus 57%, respectively. In univariate analysis, the use of TBI did not modify OS or PFS (P=0.93 and P=0.48, respectively). This remains true for patients who underwent ASCT up front. According to multivariate analysis, OS tended to be shorter for patients presenting with high Mantle Cell Lymphoma International Prognostic Index or low hemoglobin level.


CONCLUSIONS
Absence of TBI in conditioning regimen modifies neither PFS nor OS. The present retrospective and monocentric analysis shows that transplant patients with MCL remain highly exposed to relapse.
Department of Haematology, CHU de Nantes, Nantes, France.
Pierre
P
Peterlin
Christophe
C
Leux
Thomas
T
Gastinne
Virginie
V
Roland
Béatrice
B
Mahé
Viviane
V
Dubruille
Jacques
J
Delaunay
Patrice
P
Chevallier
Thierry
T
Guillaume
Nicolas
N
Blin
Sameh
S
Ayari
Aline
A
Clavert
Mohamad
M
Mohty
Christelle
C
Dousset
Noel
N
Milpied
Jean Luc
JL
Harousseau
Philippe
P
Moreau
Soraya
S
Wuilleme
Anne
A
Moreau
Steven
S
Le Gouill
D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome; D014916:Whole-Body Irradiation / Q000379:methods*
D006454:Hemoglobins