Allogeneic stem cell transplantation for patients with mantle cell lymphoma who failed autologous stem cell transplantation: a national survey of the SFGM-TC.
Poly-chemotherapy plus rituximab followed by autologous stem cell transplantation (auto-SCT) is standard care for untreated young patients with mantle cell lymphoma (MCL). Despite this intensive treatment, transplant patients remain highly susceptible to relapse over time. The French SFGM-TC performed a national survey on reduced-intensity conditioning allogeneic stem cell transplantation (RIC-allo-SCT) for fit relapsed/refractory patients who failed after auto-SCT (n=106). Median times of relapse after auto-SCT, and from auto-SCT to RIC-allo-SCT were 28 months and 3.6 years, respectively. Sixty per cent of patients received at least three lines of treatment before RIC-allo-SCT. Conditioning regimens for RIC-allo-SCT were heterogeneous. Twenty patients experienced grade III/IV aGvHD, extensive cGvHD was reported in 28 cases. Median follow-up after RIC-allo-SCT was 45 months. Median PFS after RIC-allo-SCT was 30.1 months and median overall survival was 62 months. Treatment-related mortality (TRM) at 1 year and 3 years were estimated at 28% and 32%, respectively. A total of 52 patients died; major causes of death were related to toxicity (n=34) and MCL (n=11). Patients in good response before RIC-allo-SCT experienced a better PFS and OS. Our work highlights the need for new RIC-allo-SCT MCL-tailored approaches to reduce TRM, and early and late relapse.
Department of Hematology, University Hospital, Nantes, France.|INSERM team 10 UMR 892, CRCNA, Nantes, France.
B
B
Tessoulin
Department of Hematology, University Hospital, Montpellier, France.
P
P
Ceballos
Department of Hematology, University Hospital, Nantes, France.
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P
Chevallier
Department of Hematology, Paoli Calmettes, Marseille, France.
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D
Blaise
Department of Hematology, University Hospital, Clermont-Ferrand, France.
O
O
Tournilhac
Department of Hematology, University Hospital, Lille, France.
J
J
Gauthier
Department of Hematology, University Hospital, Poitiers, France.
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N
Maillard
Department of Hematology, University Hospital, Bordeaux, France.
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R
Tabrizi
Department of Hematology, Pitie Salpetriere, Paris, France.
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S
Choquet
Department of Hematology, University Hospital, Grenoble, France.
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S
Carras
Department of Hematology, University Hospital, Angers, France.
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N
Ifrah
Department of Hematology, University Hospital, Brest, France.
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G
Guillerm
Department of Hematology, University Hospital-Saint Antoine, Paris, France.
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M
Mohty
Department of Hematology, Centre Henri-Becquerel, Rouen, France.
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H
Tilly
Department of Hematology, Saint Louis Hospital, Paris, France.
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G
Socie
Department of Hematology, Institut de Cancerologie de la Loire, Saint Etienne, France.
J
J
Cornillon
Department of Hematology, Necker Hospital, Paris, France.
O
O
Hermine
Department of Hematology, University Hospital, Besancon, France.
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É
Daguindau
Department of Hematology, University hospital, Lyon, France.
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E
Bachy
Department of Hematology, University Hospital, Limoges, France.
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S
Girault
Department of Hematology, University Hospital, Rennes, France.
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T
Marchand
University Cancer Institute, Toulouse, France.
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L
Oberic
Department of Hematology, University Hospital, Caen, France.
O
O
Reman
Department of Epidemiology, University Hospital of Nantes, Nantes, France.
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C
Leux
Department of Hematology, University Hospital, Nantes, France.|INSERM team 10 UMR 892, CRCNA, Nantes, France.|Centre d'Investigation Clinique en Cancérologie (CI2C), CHU de Nantes, Nantes, France.
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Le Gouill
D000328:Adult; D000368:Aged; D005260:Female; D005602:France; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000150:complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy / Q000379:methods* / Q000401:mortality; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous / Q000009:adverse effects / Q000401:mortality; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000379:methods / Q000401:mortality