title: Autologous haematopoietic cell transplantation for non-Hodgkin lymphoma with secondary CNS involvement.
abstract: Pre-existing central nervous system (CNS) involvement may influence referral for autologous haematopoietic cell transplantation (AHCT) for patients with non-Hodgkin lymphoma (NHL). The outcomes of 151 adult patients with NHL with prior secondary CNS involvement (CNS(+) ) receiving an AHCT were compared to 4688 patients without prior CNS lymphoma (CNS(-) ). There were significant baseline differences between the cohorts. CNS(+) patients were more likely to be younger, have lower performance scores, higher age-adjusted international prognostic index scores, more advanced disease stage at diagnosis, more aggressive histology, more sites of extranodal disease, and a shorter interval between diagnosis and AHCT. However, no statistically significant differences were identified between the two groups by analysis of progression-free survival (PFS) and overall survival (OS) at 5 years. A matched pair comparison of the CNS(+) group with a subset of CNS(-) patients matched on propensity score also showed no differences in outcomes. Patients with active CNS lymphoma at the time of AHCT (n = 55) had a higher relapse rate and diminished PFS and OS compared with patients whose CNS lymphoma was in remission (n = 96) at the time of AHCT. CNS(+) patients can achieve excellent long-term outcomes with AHCT. Active CNS lymphoma at transplant confers a worse prognosis.
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Maziarz
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Wang
authors.forename: Mei-Jie
authors.initials: MJ
authors.lastname: Zhang
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Bolwell
authors.forename: Andy I
authors.initials: AI
authors.lastname: Chen
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Fenske
authors.forename: Cesar O
authors.initials: CO
authors.lastname: Freytes
authors.forename: Robert P
authors.initials: RP
authors.lastname: Gale
authors.forename: John
authors.initials: J
authors.lastname: Gibson
authors.forename: Brandon M
authors.initials: BM
authors.lastname: Hayes-Lattin
authors.forename: Leona
authors.initials: L
authors.lastname: Holmberg
authors.forename: David J
authors.initials: DJ
authors.lastname: Inwards
authors.forename: Luis M
authors.initials: LM
authors.lastname: Isola
authors.forename: Hanna J
authors.initials: HJ
authors.lastname: Khoury
authors.forename: Victor A
authors.initials: VA
authors.lastname: Lewis
authors.forename: Dipnarine
authors.initials: D
authors.lastname: Maharaj
authors.forename: Reinhold
authors.initials: R
authors.lastname: Munker
authors.forename: Gordon L
authors.initials: GL
authors.lastname: Phillips
authors.forename: David A
authors.initials: DA
authors.lastname: Rizzieri
authors.forename: Philip A
authors.initials: PA
authors.lastname: Rowlings
authors.forename: Wael
authors.initials: W
authors.lastname: Saber
authors.forename: Prakash
authors.initials: P
authors.lastname: Satwani
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Waller
authors.forename: David G
authors.initials: DG
authors.lastname: Maloney
authors.forename: Silvia
authors.initials: S
authors.lastname: Montoto
authors.forename: Ginna G
authors.initials: GG
authors.lastname: Laport
authors.forename: Julie M
authors.initials: JM
authors.lastname: Vose
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
authors.forename: Parameswaran N
authors.initials: PN
authors.lastname: Hari
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016543:Central Nervous System Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D017567:Karnofsky Performance Status; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: autologous transplantation; central nervous system involvement; non-Hodgkin lymphoma; outcomes