title: Outcomes of hematopoietic cell transplantation for diffuse large B cell lymphoma transformed from follicular lymphoma.
abstract: There are limited data on the outcomes of autologous or allogeneic hematopoietic cell transplantation (HCT) in diffuse large B cell lymphoma transformed from follicular lymphoma. We analyzed transplantation outcomes in 141 subjects with biopsy-proven diffuse large B-cell lymphoma transformed from follicular lymphoma reported to the Center for International Blood and Marrow Transplant Research between 1990 and 2009. Two groups were identified: autologous HCT (auto-HCT; n = 108) and allogeneic HCT (allo-HCT; n = 33). Fewer auto-HCTs were done for transformed follicular lymphoma in 2003 to 2009, with a shift favoring allo-HCT. Auto-HCT was associated with a 1-year nonrelapse mortality (NRM) of 8% (95% confidence interval [CI], 4% to 14%), 5-year progression-free survival of 35% (95% CI, 26% to 45%), and 5-year overall survival of 50% (95% CI, 40% to 59%). In contrast, allo-HCT was associated with a 1-year NRM of 41% (95% CI, 23% to 58%), 5-year progression-free survival of 18% (95% CI, 6% to 35%), and 5-year overall survival of 22% (95% CI, 8% to 41%). Auto-HCT for transformed follicular lymphoma achieves sustained remission in a high proportion of subjects. The high NRM of allo-HCT offset any benefit that might be associated with this transplantation modality.
authors.affiliation: Division of Hematology-Oncology, Stony Brook University Medical Center, Stony Brook, New York. Electronic address: bmwirk@gmail.com.
authors.forename: Baldeep
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authors.lastname: Wirk
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authors.forename: Mehdi
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authors.lastname: Hamadani
authors.affiliation: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Mei-Jie
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authors.lastname: Zhang
authors.affiliation: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Zhen-Huan
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authors.initials: MD
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authors.forename: Veronika
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authors.lastname: Bachanova
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authors.lastname: Bolwell
authors.affiliation: New York Medical College, New York Medical College, Valhalla, New York.
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authors.forename: Amanda
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authors.affiliation: Medical University of South Carolina, Charleston, South Carolina.
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authors.affiliation: South Texas Veterans Health Care System and University of Texas Health Science Center San Antonio, San Antonio, Texas.
authors.forename: César O
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authors.affiliation: Oregon Health and Science University, Portland, Oregon.
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authors.lastname: Gajewski
authors.affiliation: Royal Prince Alfred Hospital Institute of Haematology, Camperdown, Australia.
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authors.affiliation: All Children's Hospital, St Petersburg, Florida.
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authors.initials: GA
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authors.lastname: Holmberg
authors.affiliation: Shands HealthCare and University of Florida, Gainesville, Florida.
authors.forename: Jack W
authors.initials: JW
authors.lastname: Hsu
authors.affiliation: Mayo Clinic Rochester, Rochester, Minnesota.
authors.forename: David J
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authors.forename: Rummurti T
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authors.lastname: Maharaj
authors.affiliation: Oregon Health and Science University, Portland, Oregon.
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authors.forename: Reinhold
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authors.lastname: Munker
authors.affiliation: UMass Memorial Medical Center, Worcester, Massachusetts.
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authors.initials: CB
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authors.forename: David A
authors.initials: DA
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authors.forename: Craig S
authors.initials: CS
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authors.forename: Bipin N
authors.initials: BN
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authors.initials: HC
authors.lastname: Schouten
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authors.forename: Anna
authors.initials: A
authors.lastname: Sureda
authors.affiliation: The Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Julie M
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authors.initials: PH
authors.lastname: Wiernik
authors.affiliation: Imperial College, Section of Hematology, Division of Experimental Medicine, Department of Medicine, London, United Kingdom.
authors.forename: Robert Peter
authors.initials: RP
authors.lastname: Gale
authors.affiliation: University of Minnesota Medical Center, Minneapolis, Minnesota.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Burns
authors.affiliation: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Wael
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mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008224:Lymphoma, Follicular / Q000473:pathology / Q000628:therapy*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Transformed follicular lymphoma; Transplant