title: Matched unrelated donor allogeneic transplantation provides comparable long-term outcome to HLA-identical sibling transplantation in relapsed diffuse large B-cell lymphoma.
abstract: The objective of this retrospective analysis was to compare outcomes of patients with diffuse large B-cell lymphoma (DLBCL) who received either a matched sibling (sib) or an unrelated donor (URD) allogeneic hematopoietic cell transplantation (allo-HCT). Long-term outcome of 172 DLBCL patients receiving URD-HCT between 2000 and 2007 and reported to the European Group for Blood and Marrow Transplantation, was compared with that of 301 subjects, allografted from sib-HCT. With a median follow-up of 45 months, 3-year PFS approached 35% for both groups; overall survival (OS) was 42% for sib-HCT versus 37% for URD (NS). Multivariate analyses confirmed that donor type was not associated with differences in non-relapse mortality (NRM), relapse rate (RR), PFS or OS. Poor performance status (PS) and refractory disease adversely affected PFS and OS. Prior auto-SCT and multiple previous therapies predicted for shorter PFS. NRM was adversely affected by older age (⩾50 years), poor PS and refractory disease, and RR by time from diagnosis to allo-HCT of <36 months, prior auto-SCT, refractory disease, poor PS and in vivo T-cell depletion with alemtuzumab. This large study shows for the first time that URD-HCT is not inferior to sib-HCT, providing a reasonable therapeutic approach for DLBCL patients, having no HLA-identical sibling available.
authors: Department of Hematology & Bone Marrow Transplantation, Ramban Medical Center, Haifa, Israel.
authors: I
authors: I
authors: Avivi
authors: Clinical Hematology Division, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: C
authors: C
authors: Canals
authors: Clinical Hematology, Hopital Pitie Salpetriere, Paris, France.
authors: J-P
authors: JP
authors: Vernant
authors: Abteilung Hematologie und Onkologie, Universitätsklinikum Göttingen, Gottingen, Germany.
authors: G
authors: G
authors: Wulf
authors: Department of Hematology & Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
authors: A
authors: A
authors: Nagler
authors: Service Hematologie Adulte, Hôpital Necker, Paris, France.
authors: O
authors: O
authors: Hermine
authors: Department of Haematology, University Medical Centre, Utrecht, The Netherlands.
authors: E
authors: E
authors: Petersen
authors: Service de Maladies du Sang, Hopital Claude Huriez, Lille, France.
authors: I
authors: I
authors: Yakoub-Agha
authors: Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK.
authors: C
authors: C
authors: Craddock
authors: Department of Hematology, Radboud University-Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors: A
authors: A
authors: Schattenberg
authors: Division of Hematology, Oncology and Hemostasiology, University Hospital Leipzig, Leipzig, Germany.
authors: D
authors: D
authors: Niederwieser
authors: Department of Haematology, University College London Hospital, London, UK.
authors: K
authors: K
authors: Thomson
authors: Unit de Transplantation et de Therapie Cellulaire, Institut Paoli Calmettes, Marseille, France.
authors: D
authors: D
authors: Blaise
authors: CHU Dept. Hematologie, Hopital de Purpan, Toulouse, France.
authors: M
authors: M
authors: Attal
authors: BMT Unit, Department of Internal Medicine, University of Saarland, Saarbrucken, Germany.
authors: M
authors: M
authors: Pfreundschuh
authors: Department of Hematology, University Hospital, Basel, Switzerland.
authors: J
authors: J
authors: Passweg
authors: Department of Hematology, Nottingham City Hospital, Nottingham, UK.
authors: N
authors: N
authors: Russell
authors: Medizinische Klinik u. Poliklinik V, University of Heidelberg, Heidelberg, Germany.
authors: P
authors: P
authors: Dreger
authors: Department of Haematology, Addenbrookes Hospital, Cambridge University, Cambridge, UK.
authors: A
authors: A
authors: Sureda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018450:Disease Progression; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000276:immunology* / Q000401:mortality; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006648:Histocompatibility; D006650:Histocompatibility Testing; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000276:immunology* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012189:Retrospective Studies; D035781:Siblings; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D061349:Unrelated Donors; D055815:Young Adult