Allogeneic stem cell transplantation for patients with mantle cell lymphoma who failed autologous stem cell transplantation: a national survey of the SFGM-TC

Bone Marrow Transplant. 2016 Sep;51(9):1184-90. doi: 10.1038/bmt.2016.102. Epub 2016 Apr 25.

Abstract

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.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Female
  • France
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hematopoietic Stem Cell Transplantation / mortality
  • Humans
  • Lymphoma, Mantle-Cell / complications
  • Lymphoma, Mantle-Cell / mortality
  • Lymphoma, Mantle-Cell / therapy*
  • Male
  • Middle Aged
  • Salvage Therapy / methods*
  • Salvage Therapy / mortality
  • Surveys and Questionnaires
  • Survival Analysis
  • Transplantation Conditioning / methods
  • Transplantation, Autologous / adverse effects
  • Transplantation, Autologous / mortality
  • Transplantation, Homologous* / adverse effects
  • Transplantation, Homologous* / methods
  • Transplantation, Homologous* / mortality