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Attend this session at the
2017 ASCO Annual Meeting!


Session: Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Type: Oral Abstract Session

Time: Saturday June 3, 3:00 PM to 6:00 PM

Location: S100bc

Autologous (auto) versus matched sibling donor (MSD) or matched unrelated donor (MUD) allogeneic (allo) hematopoietic cell transplantation (HCT) in follicular lymphoma (FL) patients (pts) with early chemoimmunotherapy failure (ECF): A Center for International Blood and Marrow Transplant Research (CIBMTR) analysis.

Sub-category:
Autologous Stem Cell Transplantation for NHL, HD, or CLL

Category:
Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Meeting:
2017 ASCO Annual Meeting

Abstract No:
7508

Citation:
J Clin Oncol 35, 2017 (suppl; abstr 7508)

Author(s): James K. Godfrey, Sonali M. Smith, Kwang Woo Ahn, Alyssa Digilio, Timothy S Fenske, Anna M. Sureda, Mehdi Hamadani; University of Chicago, Chicago, IL; Division of Hematology and Oncology - Medical College of Wisconsin, Milwuakee, WI; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI; Medical College of Wisconsin, Milwaukee, WI; Servei d'Hematologia, Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain

Abstract Disclosures

Abstract:

Background: Contrary to most FL, high-risk FL pts with ECF (i.e. relapse within 2 yrs of frontline chemoimmunotherapy) have a 5 yr OS of only 50%. (Casulo, JCO 2015). We used the CIBMTR database to compare autoHCT versus either MSD or MUD alloHCT as the first transplant approach in FL pts with ECF. Methods: Adult FL pts (age ≥18) undergoing autoHCT or alloHCT between 2002-2014 and receiving first line rituximab-based chemoimmunotherapies with evidence of ECF (defined as disease relapse or progression within 2 yrs of treatment initiation) were included. The primary endpoint was OS; secondary endpoints were progression-free survival (PFS), relapse and non-relapse mortality (NRM). Results: 440 pts had ECF (auto = 240, MSD = 105, MUD = 95) (Table 1). The 5 yr adjusted probabilities (AjP) of NRM were significantly lower with autoHCT (5%), versus MSD (17%) or MUD (33%) HCT (p<0.0001). 5 yr AjP of relapse were significantly lower with MSD (31%) or MUD HCT (23%), versus autoHCT (58%; p<0.0001). AjP of 5 yr PFS following auto, MSD and MUD HCT were 38%, 52% and 43% (p=.006) respectively. The AjP of 5 yr OS was significantly higher following autoHCT (70%) or MSD HCT (73%) versus MUD HCT (49%; p=0.004). Conclusions: AutoHCT for FL pts with ECF has low NRM and 5 yr OS rates (70%) that are provocatively higher than historical data (~50%). MSD HCT had the lowest relapse rate with similar survival. A prospective trial confirming the role of HCT in ECF FL is warranted.

Auto
(N=240)
MSD
(N=105)
MUD
(N=95)
Med age (range)56 (23-79)52 (29-68)53 (21-74)
Med number of therapies before HCT (range)2 (1-6)3 (1-9)3 (1-8)
Med time from diagnosis to HCT (range), months24 (6-203)23 (3-128)27 (7-167)
AlloHCT conditioning intensity
Myeloablative-35 (33)27 (28)
Remission @HCT
CR86 (36)25 (24)19 (20)
PR92 (38)32 (30)34 (36)
Refractory55 (23)46 (44)40 (42)
Missing7 (3)2 (2)2 (2)
Med follow-up (range), months73 (3-142)69 (3-152)73 (12-121)

 
Other Abstracts in this Sub-Category:

 

1. Innovative approach to determine overall survival (OS) benefit for orphan diseases using case match control analyses (CMCA): The PROPEL experience of pralatrexate in patients with relapsed/refractory (R/R) peripheral T-cell lymphoma (PTCL).

Meeting: 2017 ASCO Annual Meeting Abstract No: 7521 First Author: Owen A. O'Connor
Category: Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia - Autologous Stem Cell Transplantation for NHL, HD, or CLL

 

2. Ironclad: A randomized phase III study of ibrutinib (Ibr) or no consolidation following autologous hematopoietic stem cell transplantation (AutoHCT) for relapsed/refractory activated-B-cell (ABC) subtype diffuse large B-cell lymphoma (DLBCL).

Meeting: 2017 ASCO Annual Meeting Abstract No: TPS7566 First Author: Charalambos Andreadis
Category: Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia - Autologous Stem Cell Transplantation for NHL, HD, or CLL

 

3. Differences in outcomes between patients whose relapse was diagnosed radiologically versus clinically after autologous transplantation for relapsed/refractory diffuse large B-cell lymphoma.

Meeting: 2017 ASCO Annual Meeting Abstract No: e19001 First Author: Ghulam Rehman Mohyuddin
Category: Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia - Autologous Stem Cell Transplantation for NHL, HD, or CLL

 

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