title: Long-term sustained disease control in patients with mantle cell lymphoma with or without active disease after treatment with allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning.
abstract: BACKGROUND
  Previously, early results were reported for allogeneic hematopoietic cell transplantation (HCT) after nonmyeloablative conditioning with 2 Gy of total body irradiation with or without fludarabine and/or rituximab in 33 patients with mantle cell lymphoma (MCL).
  
  
  METHODS
  This study examined the outcomes of 70 patients with MCL and included extended follow-up (median, 10 years) for the 33 initial patients. Grafts were obtained from human leukocyte antigen (HLA)-matched, related donors (47%), unrelated donors (41%), and HLA antigen-mismatched donors (11%).
  
  
  RESULTS
  The 5-year incidence of nonrelapse mortality was 28%. The relapse rate was 26%. The 5-year rates of overall survival (OS) and progression-free survival (PFS) were 55% and 46%, respectively. The 10-year rates of OS and PFS were 44% and 41%, respectively. Eighty percent of surviving patients were off immunosuppression at the last follow-up. The presence of relapsed or refractory disease at the time of HCT predicted a higher rate of relapse (hazard ratio [HR], 2.94; P = .05). Despite this, OS rates at 5 (51% vs 58%) and 10 years (43% vs 45%) were comparable between those with relapsed/refractory disease and those undergoing transplantation with partial or complete remission. A high-risk cytomegalovirus (CMV) status was the only independent predictor of worse OS (HR, 2.32; P = .02). A high-risk CMV status and a low CD3 dose predicted PFS (HR, 2.22; P = .03).
  
  
  CONCLUSIONS
  Nonmyeloablative allogeneic HCT provides a long-term survival benefit for patients with relapsed MCL, including those with refractory disease or multiple relapses.
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.|Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Vaughn
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.|Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Mohamed L
authors.initials: ML
authors.lastname: Sorror
authors.affiliation: Clinical Statistics Program, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.|Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington.
authors.forename: Barry E
authors.initials: BE
authors.lastname: Storer
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.|Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington.|Marrow Transplant Unit, VA Puget Sound Health Care System, Seattle, Washington.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Chauncey
authors.affiliation: Pediatric Blood and Marrow Transplant Program, Primary Children's Hospital, Salt Lake City, Utah.|Division of Hematology/Hematological Malignancies, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pulsipher
authors.affiliation: Center for Hematologic Malignancies, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Maziarz
authors.affiliation: Colorado Blood Cancer Institute, Denver, Colorado.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Maris
authors.affiliation: Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Parameswaran
authors.initials: P
authors.lastname: Hari
authors.affiliation: Division of Blood and Marrow Transplantation, Department of Medicine, Stanford School of Medicine, Stanford, California.
authors.forename: Ginna G
authors.initials: GG
authors.lastname: Laport
authors.affiliation: Division of Hematology, Oncology, and Hemostaseology, Department of Medicine, University of Leipzig, Leipzig, Germany.
authors.forename: Georg N
authors.initials: GN
authors.lastname: Franke
authors.affiliation: Hematopoietic Stem Cell Program, Baylor University School of Medicine, Dallas, Texas.
authors.forename: Edward D
authors.initials: ED
authors.lastname: Agura
authors.affiliation: Division of Hematology-Oncology, Emory University School of Medicine, Atlanta, Georgia.|Bone Marrow & Stem Cell Transplant Center, Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Amelia A
authors.initials: AA
authors.lastname: Langston
authors.affiliation: Division of Blood and Marrow Transplantation, Department of Medicine, Stanford School of Medicine, Stanford, California.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Rezvani
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.|Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Rainer
authors.initials: R
authors.lastname: Storb
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.|Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Sandmaier
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.|Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
authors.forename: David G
authors.initials: DG
authors.lastname: Maloney
mesh_terms: D000328:Adult; D000368:Aged; D004358:Drug Therapy / Q000379:methods; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014916:Whole-Body Irradiation / Q000379:methods
keywords: conditioning regimen; long-term follow-up; mantle cell lymphoma; nonmyeloablative conditioning; stem cell transplantation