TY - JOUR
T1 - High-dose therapy and autologous stem cell transplantation in marginal zone lymphomas
T2 - A retrospective study by the EBMT Lymphoma Working Party and FIL-GITMO
AU - Avivi, Irit
AU - Arcaini, Luca
AU - Ferretti, Virginia V.
AU - Boumendil, Ariane
AU - Finel, Hervé
AU - Milone, Giuseppe
AU - Zaja, Francesco
AU - Liliana, Devizzi
AU - Musso, Maurizio
AU - Didier, Blaise
AU - Bachy, Emmanuel
AU - Wattad, Mohammed
AU - Nicolas-Virelizier, Emmanuelle
AU - Gramatzki, Martin
AU - Bourhis, Jean Henri
AU - Caillot, Denis
AU - Haenel, Anette
AU - Held, Gerhard
AU - Thieblemont, Catherine
AU - Jindra, Pavel
AU - Pohlreich, David
AU - Guilhot, François
AU - Kroschinsky, Frank
AU - Wahlin, Björn
AU - Scheid, Christof
AU - Ifrah, Norbert
AU - Berthou, Christian
AU - Dreger, Peter
AU - Montoto, Silvia
AU - Conconi, Annarita
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - Autologous transplant
KW - Marginal zone lymphoma
KW - Mucosa-associated lymphoid tissue lymphoma
UR - http://www.scopus.com/inward/record.url?scp=85050602419&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85050602419&partnerID=8YFLogxK
U2 - 10.1111/bjh.15454
DO - 10.1111/bjh.15454
M3 - Article
AN - SCOPUS:85050602419
JO - British Journal of Haematology
JF - British Journal of Haematology
SN - 0007-1048
ER -