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Bone Marrow Transplant. 2016 Sep;51(9):1184-90. doi: 10.1038/bmt.2016.102. Epub 2016 Apr 25.

Allogeneic stem cell transplantation for patients with mantle cell lymphoma who failed autologous stem cell transplantation: a national survey of the SFGM-TC.

Author information

1
Department of Hematology, University Hospital, Nantes, France.
2
INSERM team 10 UMR 892, CRCNA, Nantes, France.
3
Department of Hematology, University Hospital, Montpellier, France.
4
Department of Hematology, Paoli Calmettes, Marseille, France.
5
Department of Hematology, University Hospital, Clermont-Ferrand, France.
6
Department of Hematology, University Hospital, Lille, France.
7
Department of Hematology, University Hospital, Poitiers, France.
8
Department of Hematology, University Hospital, Bordeaux, France.
9
Department of Hematology, Pitie Salpetriere, Paris, France.
10
Department of Hematology, University Hospital, Grenoble, France.
11
Department of Hematology, University Hospital, Angers, France.
12
Department of Hematology, University Hospital, Brest, France.
13
Department of Hematology, University Hospital-Saint Antoine, Paris, France.
14
Department of Hematology, Centre Henri-Becquerel, Rouen, France.
15
Department of Hematology, Saint Louis Hospital, Paris, France.
16
Department of Hematology, Institut de Cancerologie de la Loire, Saint Etienne, France.
17
Department of Hematology, Necker Hospital, Paris, France.
18
Department of Hematology, University Hospital, Besancon, France.
19
Department of Hematology, University hospital, Lyon, France.
20
Department of Hematology, University Hospital, Limoges, France.
21
Department of Hematology, University Hospital, Rennes, France.
22
University Cancer Institute, Toulouse, France.
23
Department of Hematology, University Hospital, Caen, France.
24
Department of Epidemiology, University Hospital of Nantes, Nantes, France.
25
Centre d'Investigation Clinique en Cancérologie (CI2C), CHU de Nantes, Nantes, France.

Abstract

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.

PMID:
27111043
DOI:
10.1038/bmt.2016.102
[Indexed for MEDLINE]

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