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Br J Haematol. 2018 Sep;182(6):807-815. doi: 10.1111/bjh.15454. Epub 2018 Jul 9.

High-dose therapy and autologous stem cell transplantation in marginal zone lymphomas: a retrospective study by the EBMT Lymphoma Working Party and FIL-GITMO.

Author information

1
Tel Aviv Sourasky Medical Centre, Tel-Aviv, Israel.
2
Universita Di Pavia, IRCCS Fondazione San Matteo, Pavia, Italy.
3
IRCCS Fondazione Policlinico San Matteo, Pavia, Italy.
4
EBMT LWP Paris Office, Hôpital Saint-Antoine, Paris, France.
5
Institute of Hematology, University of Catania, Catania, Italy.
6
DRMM, University of Udine, Udine, Italy.
7
Division of Medical Oncology, Istituto Nazionale dei Tumori, Milan, Italy.
8
Oncoematologia e TMO, Palermo, Italy.
9
Département d'Onco-Hématologie, Institut Paoli-Calmettes, Marseille, France.
10
National Institutes of Health, National Cancer Institute, Bethesda, MD, USA.
11
Kliniken Essen Süd, Essen, Germany.
12
Centre Léon Bérard, Lyon, France.
13
University Hospital Schleswig-Holstein, Kiel, Germany.
14
University of Kiel, Kiel, Germany.
15
Institut Gustave Roussy, Villejuif, France.
16
CHU de Dijon - Hospital `Le Bocage`, Dijon, France.
17
Klinikum Chemnitz gGmbH, Chemnitz, Germany.
18
Department of Internal Medicine I, Saarland University Medical School, Homburg/Saar, Germany.
19
University Hospital of Saarland, Homburg, Germany.
20
APHP - INSERM U 728 - Institut Universitaire d'Hematologie, Hopital Saint-Louis, Paris, France.
21
University Hospital, Pilsen, Czech Republic.
22
Charles University Hospital, Prague, Czech Republic.
23
Inserm U935, CHU de Poitiers, Poitiers, France.
24
Midizinische Klinik und Poliklinik I, Universitaetsklinikum Dresden, Dresden, Germany.
25
Department of Medicine, Huddinge (MedH), H7, Unit for Hematology, M 54, Karolinska Universitetssjukhuset Huddinge, Stockholm, Sweden.
26
GMMG, Germany, Cologne, Germany.
27
CHU d'Angers, Angers, France.
28
Brest University Hospital, Brest, France.
29
University of Heidelberg, Heidelberg, Germany.
30
Department of Haemato-Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
31
Ospedale degli Infermi, Biella, Italy.

Abstract

The role of autologous stem cell transplantation (ASCT) in patients with marginal zone lymphoma (MZL) is debatable. This study investigated the outcome and prognostic factors affecting the outcome of patients undergoing ASCT for MZL. Eligible patients had non-transformed nodal, extra-nodal (MALT) or splenic MZL (SMZL), aged ≥18 years, who underwent a first ASCT between1994 and 2013 and were reported to the European Society for Blood and Marrow Transplantation, Fondazione Italiana Linfomi or Gruppo Italiano Trapianto Di Midollo Osseo registries. The study included 199 patients, [111 MALT lymphoma, 55 nodal MZL (NMZL) and 33 SMZL]. Median age at transplantation was 56 years. The median number of prior therapies was 2 (range 1-8), including rituximab in 71%. 95% had chemosensitive disease. 89% received a chemotherapy-based high-dose regimen. There were no significant differences in patient and transplant characteristics between the 3 histological subtypes except for a lower percentage of patients previously treated with rituximab in the MALT sub-group and more transplants performed in recent years in the other sub-groups. After a median follow-up of 5 years, 5-year cumulative incidence of relapse/progression and non-relapse mortality were 38% and 9%, respectively. Five-year event-free survival (EFS) and overall survival (OS) were 53% and 73%, respectively. Five-year cumulative incidence of second malignancies was 6%. Multivariate analysis revealed age ≥65 years was associated with a shorter EFS and OS. In addition, patients with SMZL had a shorter OS than those with MALT. ASCT may provide clinical benefit in MZL patients who have failed multiple lines of chemoimmunotherapy.

KEYWORDS:

autologous transplant; marginal zone lymphoma; mucosa-associated lymphoid tissue lymphoma

PMID:
29984825
DOI:
10.1111/bjh.15454

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