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
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.
Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia
2017 ASCO Annual Meeting
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
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.
|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), months||24 (6-203)||23 (3-128)||27 (7-167)|
|AlloHCT conditioning intensity|
|Myeloablative||-||35 (33)||27 (28)|
|CR||86 (36)||25 (24)||19 (20)|
|PR||92 (38)||32 (30)||34 (36)|
|Refractory||55 (23)||46 (44)||40 (42)|
|Missing||7 (3)||2 (2)||2 (2)|
|Med follow-up (range), months||73 (3-142)||69 (3-152)||73 (12-121)|