Cancer Institute A national cancer institute
designated cancer center

Ginna G. Laport

Publication Details

  • Conditioning regimens for allotransplants for diffuse large B-cell lymphoma: myeloablative or reduced intensity? BLOOD Bacher, U., Klyuchnikov, E., Le-Rademacher, J., Carreras, J., Armand, P., Bishop, M. R., Bredeson, C. N., Cairo, M. S., Fenske, T. S., Freytes, C. O., Gale, R. P., Gibson, J., Isola, L. M., Inwards, D. J., Laport, G. G., Lazarus, H. M., Maziarz, R. T., Wiernik, P. H., Schouten, H. C., Slavin, S., Smith, S. M., Vose, J. M., Waller, E. K., Hari, P. N. 2012; 120 (20): 4256-4262

    Abstract:

    The best conditioning regimen before allogeneic transplantation for high-risk diffuse large B-cell lymphoma (DLBCL) remains to be clarified. We analyzed data from 396 recipients of allotransplants for DLBCL receiving myeloablative (MAC; n = 165), reduced intensity (RIC; n = 143), or nonmyeloablative conditioning (NMAC; n = 88) regimens. Acute and chronic GVHD rates were similar across the groups. Five-year nonrelapse mortality (NRM) was higher in MAC than RIC and NMAC (56% vs 47% vs 36%; P = .007). Five-year relapse/progression was lower in MAC than in RIC/NMAC (26% vs 38% vs 40%; P = .031). Five-year progression-free survival (15%-25%) and overall survival (18%-26%) did not differ significantly between the cohorts. In multivariate analysis, NMAC and more recent transplant year were associated with lower NRM, whereas a lower Karnofsky performance score (< 90), prior relapse resistant to therapy, and use of unrelated donors were associated with higher NRM. NMAC transplants, no prior use of rituximab, and prior relapse resistant to therapy were associated with a greater risk of relapse/progression. In conclusion, allotransplantation with RIC or NMAC induces long-term progression-free survival in selected DLBCL patients with a lower risk of NRM but with higher risk of lymphoma progression or relapse.

    View details for DOI 10.1182/blood-2012-06-436725

    View details for Web of Science ID 000311637400022

    View details for PubMedID 23007405

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