title: Outcomes of adults with active or progressive hematological malignancies at the time of allo-SCT: a survey from the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC).
abstract: Previous data suggested that allo-SCT might be an effective therapy in the setting of chemo-refractory/relapsed diseases because of the potent long-term immune-mediated tumor control. This retrospective study aimed to analyze the outcome of adult patients who received allo-SCT in a chemo-refractory/relapsed status. The series included 840 patients with active or progressive disease at the time of transplant. Median age was 50 years. With a median follow-up of 40 months, 3-year OS, disease-free survival (DFS), and non-relapse mortality rates were 29±2, 23±2, and 30±2%, respectively. At the last follow-up, 252 patients (30%) were still alive (of whom 201 were in CR (24%). In a Cox multivariate analysis, the use of a reduced-intensity conditioning (RIC) before allo-SCT and use of an HLA-identical sibling donor remained independently associated with a better OS (hazard ratio (HR)=0.82; 95% confidence interval (CI), 0.69-0.98, P=0.03; and HR=0.79; 95% CI, 0.66-0.93, P=0.006, respectively). Also, a diagnosis of myelodysplastic syndrome/myeloproliferative disorder, Hodgkin lymphoma and non-Hodgkin lymphoma compared with acute leukemia had a favorable impact on OS (HR=0.55; 95% CI, 0.45-0.68, P<0.0001; HR=0.49; 95% CI, 0.31-0.75, P=0.001; and HR=0.47; 95% CI, 0.35-0.63, P<0.0001, respectively). In conclusion, this study suggests that allo-SCT may be of benefit in some subgroups of patients with active or progressive hematological malignancies at the time of allo-SCT.
authors.affiliation: Centre Hospitalier et Universitaire (CHU) de Nantes, Hématologie Clinique, Centre d'Investigation Clinique en Cancérologie (CI2C), Université de Nantes and INSERM CRNCA UMR 892, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
authors.affiliation: 1] Hématologie Clinique et Thérapie Cellulaire, Hopital Saint-Antoine, APHP, Paris, France [2] EBMT, ALWP Office, Hopital Saint Antoine, Paris, France [3] Universite Pierre et Marie Curie (UPMC), Paris, France [4] INSERM UMRs 938, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.affiliation: Service d'hématologie, CHU et Université de Bordeaux 2 Victor Segalen, Bordeaux, France.
authors.forename: N
authors.initials: N
authors.lastname: Milpied
authors.affiliation: Department of Hematology, Hôpital Hautepierre, CHU, Strasbourg, France.
authors.forename: K
authors.initials: K
authors.lastname: Bilger
authors.affiliation: Department of Hematology-BMT, Hôpital Saint-Louis, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.affiliation: Service des Maladies du sang, CHU Hôpital Claude Hurriez, Lille, France.
authors.forename: I
authors.initials: I
authors.lastname: Yakoub-Agha
authors.affiliation: BMT Unit, Department of Hematology, Hôpital Henri Herriot, CHU, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Michallet
authors.affiliation: Department of Hematology, Hopital A. Michallon, CHU, Grenoble, France.
authors.forename: C-E
authors.initials: CE
authors.lastname: Bulabois
authors.affiliation: Department of Hematology, Hôpital Henri Mondor, CHU, AP-HP and Faculté de médecine UPEC, Créteil, France.
authors.forename: S
authors.initials: S
authors.lastname: Maury
authors.affiliation: Department of Hematology, University of Liege, CHU Sart-Tilman, Liege, Belgium.
authors.forename: Y
authors.initials: Y
authors.lastname: Beguin
authors.affiliation: Department of Hematology, CHU, Clermont-Ferrand, France.
authors.forename: J-O
authors.initials: JO
authors.lastname: Bay
authors.affiliation: Unité de Transplantation et de Thérapie cellulaire, Institut Paoli-Calmettes et INSERM UMR 891, Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Blaise
authors.affiliation: Department of Hematology, Hopital La Miletrie, CHU, Poitiers, France.
authors.forename: N
authors.initials: N
authors.lastname: Maillard
authors.affiliation: Department of Hematology, CHU, Brest, France.
authors.forename: G
authors.initials: G
authors.lastname: Guillerm
authors.affiliation: Department of Hematology, Hopital Jean Minjoz, CHU, Besancon, France.
authors.forename: E
authors.initials: E
authors.lastname: Daguindeau
authors.affiliation: SFGM-TC, Hôpital Henri Herriot, CHU, Lyon, France.
authors.forename: N
authors.initials: N
authors.lastname: Raus
authors.affiliation: 1] Hématologie Clinique et Thérapie Cellulaire, Hopital Saint-Antoine, APHP, Paris, France [2] EBMT, ALWP Office, Hopital Saint Antoine, Paris, France [3] Universite Pierre et Marie Curie (UPMC), Paris, France [4] INSERM UMRs 938, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006680:HLA Antigens / Q000737:chemistry; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000628:therapy*; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000628:therapy; D009196:Myeloproliferative Disorders / Q000401:mortality / Q000628:therapy; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012955:Societies, Medical; D033581:Stem Cell Transplantation; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006680:HLA Antigens