title: Allogeneic hematopoietic cell transplantation for chemotherapy-unresponsive mantle cell lymphoma: a cohort analysis from the center for international blood and marrow transplant research.
abstract: Patients with chemorefractory mantle cell lymphoma (MCL) have a poor prognosis. We used the Center for International Blood and Marrow Transplant Research database to study the outcome of 202 patients with refractory MCL who underwent allogeneic hematopoietic cell transplantation (allo-HCT) using either myeloablative (MA) or reduced-intensity/nonmyeloablative conditioning (RIC/NST), during 1998-2010. We analyzed nonrelapse mortality (NRM), progression/relapse, progression-free survival (PFS), and overall survival (OS). Seventy-four patients (median age, 54 years) received MA, and 128 patients (median age, 59 years) received RIC/NST. Median follow-up after allo-HCT was 35 months in the MA group and 43 months in the RIC/NST group. At 3 years post-transplantation, no significant between-group differences were seen in terms of NRM (47% in MA versus 43% in RIC/NST; P = .68), relapse/progression (33% versus 32%; P = .89), PFS (20% versus 25%; P = .53), or OS (25% versus 30%; P = .45). Multivariate analysis also revealed no significant between-group differences in NRM, relapse, PFS, or OS; however, receipt of a bone marrow or T cell-depleted allograft was associated with an increased risk of NRM and inferior PFS and OS. Our data suggest that despite a refractory disease state, approximately 25% of patients with MCL can attain durable remission after allo-HCT, and conditioning regimen intensity does not influence outcome of allo-HCT.
authors: Myeloma and Lymphoma Service, West Virginia University Hospitals, Morgantown, WV, USA.
authors: Mehdi
authors: M
authors: Hamadani
authors: Wael
authors: W
authors: Saber
authors: Kwang Woo
authors: KW
authors: Ahn
authors: Jeanette
authors: J
authors: Carreras
authors: Mitchell S
authors: MS
authors: Cairo
authors: Timothy S
authors: TS
authors: Fenske
authors: Robert Peter
authors: RP
authors: Gale
authors: John
authors: J
authors: Gibson
authors: Gregory A
authors: GA
authors: Hale
authors: Parameswaran N
authors: PN
authors: Hari
authors: Jack W
authors: JW
authors: Hsu
authors: David J
authors: DJ
authors: Inwards
authors: Rammurti T
authors: RT
authors: Kamble
authors: Anderas
authors: A
authors: Klein
authors: Dipnarine
authors: D
authors: Maharaj
authors: David I
authors: DI
authors: Marks
authors: David A
authors: DA
authors: Rizzieri
authors: Bipin N
authors: BN
authors: Savani
authors: Harry C
authors: HC
authors: Schouten
authors: Edmund K
authors: EK
authors: Waller
authors: Baldeep
authors: B
authors: Wirk
authors: Hillard M
authors: HM
authors: Lazarus
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007391:International Cooperation; D008137:Longitudinal Studies; D020522:Lymphoma, Mantle-Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous
chemical_list: D019653:Myeloablative Agonists