Allogeneic stem cell transplantation for patients with mantle cell lymphoma who failed autologous stem cell transplantation: a national survey of the SFGM-TC.
Fiche publication
Date publication
septembre 2016
Journal
Bone marrow transplantation
Auteurs
Membres identifiés du Cancéropôle Est :
Dr DAGUINDAU Etienne
Tous les auteurs :
Tessoulin B, Ceballos P, Chevallier P, Blaise D, Tournilhac O, Gauthier J, Maillard N, Tabrizi R, Choquet S, Carras S, Ifrah N, Guillerm G, Mohty M, Tilly H, Socie G, Cornillon J, Hermine O, Daguindau É, Bachy E, Girault S, Marchand T, Oberic L, Reman O, Leux C, Le Gouill S
Lien Pubmed
Résumé
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.
Mots clés
Adult, Aged, Female, France, Graft vs Host Disease, etiology, Hematopoietic Stem Cell Transplantation, methods, Humans, Lymphoma, Mantle-Cell, complications, Male, Middle Aged, Salvage Therapy, methods, Surveys and Questionnaires, Survival Analysis, Transplantation Conditioning, methods, Transplantation, Autologous, adverse effects, Transplantation, Homologous, adverse effects
Référence
Bone Marrow Transplant.. 2016 Sep;51(9):1184-90