AUTOLOGOUS STEM CELL TRANSPLANTATION FOR INTRAVASCULAR LARGE B-CELL LYMPHOMA: A RETROSPECTIVE STUDY OF THE OF THE EUROPEAN SOCIETY FOR BLOOD AND MARROW TRANSPLANTATION LYMPHOMA WORKING PARTY
(Abstract release date: 05/19/16)
EHA Library. Meissner J. 06/09/16; 133084; E1535
Mrs. Julia Meissner
Contributions
Contributions
Abstract
Abstract: E1535
Type: Eposter Presentation
Background
Intravascular large B-cell lymphoma (IVLBCL) represents a rare lymphoma subtype characterized by the selective growth of malignant cells within the lumina of small vessels. The combination of rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is widely used as first-line therapy but with about half of the patients being progressive within 2 years, outcome is inferior to non-intravascular diffuse large B-cell lymphoma.
Aims
Since the value and timing of autologous stem cell transplantation (autoSCT) in the treatment of IVLBCL is undefined, the objective of this study was to analyze for the first time the efficacy of autoSCT for IVLBCL in a larger cohort of Western patients.
Methods
This is a registry-based retrospective multicentre study including patients aged 18 years or above with histologically verified IVLBCL who underwent autoSCT between 1 January 2002 and 31 December 2013 and were registered with the European Society for Blood and Marrow Transplantation (EBMT) database. Of 97 patients identified in the EBMT registry, a full data set could be obtained for 19 patients. After exclusion of patients with a histopathology report not confirmative for the diagnosis of IVLBCL, the final study cohort consisted of 11 patients.
Results
The median age of the 11 patients was 55 (range 34-68) years. All had stage IV disease with CNS involvement in 5 patients. First-line treatment was mainly based on R-CHOP or a CHOP-like regimen. The median time from diagnosis to transplant was 6 months. Six patients were autografted in first remission while 5 patients received more than one line of treatment prior to autoSCT. Disease status at autoSCT was complete remission in 8 patients and partial remission in 3 patients. After a median follow-up of surviving patients of 51 months (range 12-95), 8 patients were alive and free of progression. One patient (transplanted in first remission) died treatment-related whereas 2 patients relapsed 15 and 27 months post autoSCT, both with more than one previous treatment line. No relapse occurred in patients autografted in first remission. 4-year progression-free survival of all 11 patients was 71%.
Conclusion
The outcome of this to date largest patient cohort compares favorable to the outcome after standard R-CHOP and is in line with the outcome of autoSCT in small Asian case series. Furthermore our data suggest that the outcome of autoSCT performed in first remission may be superior to that of autoSCT performed after multiple lines of therapy. Consolidative autoSCT performed in first remission after R-CHOP-like therapy results in favorable long-term outcome for patients with IVLBCL and thus appears to be a valuable treatment option for fit patients up to an age of 65-70 years.
Session topic: E-poster
Keyword(s): Autologous hematopoietic stem cell transplantation, Diffuse large B cell lymphoma, Non-Hodgkin's lymphoma
Type: Eposter Presentation
Background
Intravascular large B-cell lymphoma (IVLBCL) represents a rare lymphoma subtype characterized by the selective growth of malignant cells within the lumina of small vessels. The combination of rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is widely used as first-line therapy but with about half of the patients being progressive within 2 years, outcome is inferior to non-intravascular diffuse large B-cell lymphoma.
Aims
Since the value and timing of autologous stem cell transplantation (autoSCT) in the treatment of IVLBCL is undefined, the objective of this study was to analyze for the first time the efficacy of autoSCT for IVLBCL in a larger cohort of Western patients.
Methods
This is a registry-based retrospective multicentre study including patients aged 18 years or above with histologically verified IVLBCL who underwent autoSCT between 1 January 2002 and 31 December 2013 and were registered with the European Society for Blood and Marrow Transplantation (EBMT) database. Of 97 patients identified in the EBMT registry, a full data set could be obtained for 19 patients. After exclusion of patients with a histopathology report not confirmative for the diagnosis of IVLBCL, the final study cohort consisted of 11 patients.
Results
The median age of the 11 patients was 55 (range 34-68) years. All had stage IV disease with CNS involvement in 5 patients. First-line treatment was mainly based on R-CHOP or a CHOP-like regimen. The median time from diagnosis to transplant was 6 months. Six patients were autografted in first remission while 5 patients received more than one line of treatment prior to autoSCT. Disease status at autoSCT was complete remission in 8 patients and partial remission in 3 patients. After a median follow-up of surviving patients of 51 months (range 12-95), 8 patients were alive and free of progression. One patient (transplanted in first remission) died treatment-related whereas 2 patients relapsed 15 and 27 months post autoSCT, both with more than one previous treatment line. No relapse occurred in patients autografted in first remission. 4-year progression-free survival of all 11 patients was 71%.
Conclusion
The outcome of this to date largest patient cohort compares favorable to the outcome after standard R-CHOP and is in line with the outcome of autoSCT in small Asian case series. Furthermore our data suggest that the outcome of autoSCT performed in first remission may be superior to that of autoSCT performed after multiple lines of therapy. Consolidative autoSCT performed in first remission after R-CHOP-like therapy results in favorable long-term outcome for patients with IVLBCL and thus appears to be a valuable treatment option for fit patients up to an age of 65-70 years.
Session topic: E-poster
Keyword(s): Autologous hematopoietic stem cell transplantation, Diffuse large B cell lymphoma, Non-Hodgkin's lymphoma
Abstract: E1535
Type: Eposter Presentation
Background
Intravascular large B-cell lymphoma (IVLBCL) represents a rare lymphoma subtype characterized by the selective growth of malignant cells within the lumina of small vessels. The combination of rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is widely used as first-line therapy but with about half of the patients being progressive within 2 years, outcome is inferior to non-intravascular diffuse large B-cell lymphoma.
Aims
Since the value and timing of autologous stem cell transplantation (autoSCT) in the treatment of IVLBCL is undefined, the objective of this study was to analyze for the first time the efficacy of autoSCT for IVLBCL in a larger cohort of Western patients.
Methods
This is a registry-based retrospective multicentre study including patients aged 18 years or above with histologically verified IVLBCL who underwent autoSCT between 1 January 2002 and 31 December 2013 and were registered with the European Society for Blood and Marrow Transplantation (EBMT) database. Of 97 patients identified in the EBMT registry, a full data set could be obtained for 19 patients. After exclusion of patients with a histopathology report not confirmative for the diagnosis of IVLBCL, the final study cohort consisted of 11 patients.
Results
The median age of the 11 patients was 55 (range 34-68) years. All had stage IV disease with CNS involvement in 5 patients. First-line treatment was mainly based on R-CHOP or a CHOP-like regimen. The median time from diagnosis to transplant was 6 months. Six patients were autografted in first remission while 5 patients received more than one line of treatment prior to autoSCT. Disease status at autoSCT was complete remission in 8 patients and partial remission in 3 patients. After a median follow-up of surviving patients of 51 months (range 12-95), 8 patients were alive and free of progression. One patient (transplanted in first remission) died treatment-related whereas 2 patients relapsed 15 and 27 months post autoSCT, both with more than one previous treatment line. No relapse occurred in patients autografted in first remission. 4-year progression-free survival of all 11 patients was 71%.
Conclusion
The outcome of this to date largest patient cohort compares favorable to the outcome after standard R-CHOP and is in line with the outcome of autoSCT in small Asian case series. Furthermore our data suggest that the outcome of autoSCT performed in first remission may be superior to that of autoSCT performed after multiple lines of therapy. Consolidative autoSCT performed in first remission after R-CHOP-like therapy results in favorable long-term outcome for patients with IVLBCL and thus appears to be a valuable treatment option for fit patients up to an age of 65-70 years.
Session topic: E-poster
Keyword(s): Autologous hematopoietic stem cell transplantation, Diffuse large B cell lymphoma, Non-Hodgkin's lymphoma
Type: Eposter Presentation
Background
Intravascular large B-cell lymphoma (IVLBCL) represents a rare lymphoma subtype characterized by the selective growth of malignant cells within the lumina of small vessels. The combination of rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is widely used as first-line therapy but with about half of the patients being progressive within 2 years, outcome is inferior to non-intravascular diffuse large B-cell lymphoma.
Aims
Since the value and timing of autologous stem cell transplantation (autoSCT) in the treatment of IVLBCL is undefined, the objective of this study was to analyze for the first time the efficacy of autoSCT for IVLBCL in a larger cohort of Western patients.
Methods
This is a registry-based retrospective multicentre study including patients aged 18 years or above with histologically verified IVLBCL who underwent autoSCT between 1 January 2002 and 31 December 2013 and were registered with the European Society for Blood and Marrow Transplantation (EBMT) database. Of 97 patients identified in the EBMT registry, a full data set could be obtained for 19 patients. After exclusion of patients with a histopathology report not confirmative for the diagnosis of IVLBCL, the final study cohort consisted of 11 patients.
Results
The median age of the 11 patients was 55 (range 34-68) years. All had stage IV disease with CNS involvement in 5 patients. First-line treatment was mainly based on R-CHOP or a CHOP-like regimen. The median time from diagnosis to transplant was 6 months. Six patients were autografted in first remission while 5 patients received more than one line of treatment prior to autoSCT. Disease status at autoSCT was complete remission in 8 patients and partial remission in 3 patients. After a median follow-up of surviving patients of 51 months (range 12-95), 8 patients were alive and free of progression. One patient (transplanted in first remission) died treatment-related whereas 2 patients relapsed 15 and 27 months post autoSCT, both with more than one previous treatment line. No relapse occurred in patients autografted in first remission. 4-year progression-free survival of all 11 patients was 71%.
Conclusion
The outcome of this to date largest patient cohort compares favorable to the outcome after standard R-CHOP and is in line with the outcome of autoSCT in small Asian case series. Furthermore our data suggest that the outcome of autoSCT performed in first remission may be superior to that of autoSCT performed after multiple lines of therapy. Consolidative autoSCT performed in first remission after R-CHOP-like therapy results in favorable long-term outcome for patients with IVLBCL and thus appears to be a valuable treatment option for fit patients up to an age of 65-70 years.
Session topic: E-poster
Keyword(s): Autologous hematopoietic stem cell transplantation, Diffuse large B cell lymphoma, Non-Hodgkin's lymphoma
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