HAPLOTRANSPLANTS VERSUS HLA-IDENTICAL DONOR (HID) FOR ALLOGENEIC STEM-CELL TRANSPLANTATION (ALLOSCT) IN REFRACTORY NON-HODGKIN LYMPHOMA (NHL)
(Abstract release date: 05/19/16)
EHA Library. Huang H. 06/12/16; 135284; S790
Dr. Haiwen Huang
Contributions
Contributions
Abstract
Abstract: S790
Type: Oral Presentation
Presentation during EHA21: On Sunday, June 12, 2016 from 08:30 - 08:45
Location: Hall A1
Background
AlloSCT is an effective therapeutic option for patients with refractory lymphoma. However, the donor source is the biggest problem for alloSCT. The feasibility of haploSCT has dramatically expanded the donor pool, making allogeneic transplantation available for the vast majority of patients, especially for patients with rapidly progressing disease in whom unrelated donor search cannot be awaited.
Aims
In this study, we aim to compare outcome of haplotransplants with conventional related and matched unrelated donor transplants for refractory relapsed or high risk NHL.
Methods
Seventy-eight patients who had undergone alloSCT between January 2006 and October 2015 in our center were analyzed retrospectively. The median age was 30 years (range, 12 to 58 years). The histological subtypes included diffuse large B cell lymphoma (13), mantle cell lymphoma (3), Burkett’s lymphoma (1), B-cell lymphoblastic lymphoma (8), other type mature B cell lymphoma(10), T-cell lymphoblastic lymphoma (18), peripheral T cell lymphoma (18) and NK/T cell lymphoma (7). Bone marrow was involved in 65 patients, 9 patients had experienced treatment failure with prior autologous SCT. All of the patients received a myeloablative conditioning regimen which is TBI/Cy or Bu/Cy. 33 patients received Haplo Donors, 45 patients received HID, including sibling and matched unrelated donors. Before alloSCT, 49 patients were in CR, 12 patients were in PR, 18 patients were in NR. Primary refractory or progression was more common in the HAPLO group (p=0.001), other variables were balanced.
Results
Seventy-eight patients were engrafted successfully and all patients achieved full donor chimerism. There is no difference for hematopoietic recovery between two groups. In HAPLO group, the median time of neutrophils and platelets recovery were 12 days (range, 9d to 15d) and 17 days (range, 11d to 60d). In HID group, the median time of neutrophils and platelets recovery were 11 days (range, 9d to 16d) and 17days (range, 12d to 45d), respectively. After transplantation, 75 patients acquired complete response, another 3 patients acquired partial response. In HAPLO group, 6 patients had recurrent disease, and 5 patients died from transplantation-related (TRM) including infection and other organ failure at 1-year. In HID group, 6 patients had recurrent disease and 8 patients died of TRM. The median follow-up duration was 23 months (range, 2-139) in HAPLO group, 29 months (range, 2-139) in HID group. Among HAPLO and HID recipients, the 3-year progress free survival rate was 56.8% and 60.0% (P =0.45), respectively; overall survival rate was 58.9% and 62.1% (P = 0.48), respectively; the 3-year cumulative incidences of relapse were 48.4 % and 47.7 % (P =0.36), and those of the 2-year-non-relapse-mortality were 25.2 % and 27.8 % (P =0.86), respectively. The cumulative incidences of grade 3–4 acute GVHD were 28.4% (95% CI =7.2-28.1%) and 20.5% (95% CI =5.7–22.2%)(P =0.43), respectively. Univariate analysis showed that disease status before alloSCT may be a factor affecting OS and PFS (p=0.001).
Conclusion
This retrospective study showed haploSCT resulted in similar clinical efficacy compared to HID in patients with refractory/relapsed or high risk lymphoma. Importantly, TRM and acute GVHD were acceptable without obvious difference between two groups. HaploSCT provides a chance of long-term disease control even for patients without HID.
Session topic: Aggressive lymphoma with emphasis on novel agents
Keyword(s): Allogeneic hematopoietic stem cell transplant, Non-Hodgkin's lymphoma
Type: Oral Presentation
Presentation during EHA21: On Sunday, June 12, 2016 from 08:30 - 08:45
Location: Hall A1
Background
AlloSCT is an effective therapeutic option for patients with refractory lymphoma. However, the donor source is the biggest problem for alloSCT. The feasibility of haploSCT has dramatically expanded the donor pool, making allogeneic transplantation available for the vast majority of patients, especially for patients with rapidly progressing disease in whom unrelated donor search cannot be awaited.
Aims
In this study, we aim to compare outcome of haplotransplants with conventional related and matched unrelated donor transplants for refractory relapsed or high risk NHL.
Methods
Seventy-eight patients who had undergone alloSCT between January 2006 and October 2015 in our center were analyzed retrospectively. The median age was 30 years (range, 12 to 58 years). The histological subtypes included diffuse large B cell lymphoma (13), mantle cell lymphoma (3), Burkett’s lymphoma (1), B-cell lymphoblastic lymphoma (8), other type mature B cell lymphoma(10), T-cell lymphoblastic lymphoma (18), peripheral T cell lymphoma (18) and NK/T cell lymphoma (7). Bone marrow was involved in 65 patients, 9 patients had experienced treatment failure with prior autologous SCT. All of the patients received a myeloablative conditioning regimen which is TBI/Cy or Bu/Cy. 33 patients received Haplo Donors, 45 patients received HID, including sibling and matched unrelated donors. Before alloSCT, 49 patients were in CR, 12 patients were in PR, 18 patients were in NR. Primary refractory or progression was more common in the HAPLO group (p=0.001), other variables were balanced.
Results
Seventy-eight patients were engrafted successfully and all patients achieved full donor chimerism. There is no difference for hematopoietic recovery between two groups. In HAPLO group, the median time of neutrophils and platelets recovery were 12 days (range, 9d to 15d) and 17 days (range, 11d to 60d). In HID group, the median time of neutrophils and platelets recovery were 11 days (range, 9d to 16d) and 17days (range, 12d to 45d), respectively. After transplantation, 75 patients acquired complete response, another 3 patients acquired partial response. In HAPLO group, 6 patients had recurrent disease, and 5 patients died from transplantation-related (TRM) including infection and other organ failure at 1-year. In HID group, 6 patients had recurrent disease and 8 patients died of TRM. The median follow-up duration was 23 months (range, 2-139) in HAPLO group, 29 months (range, 2-139) in HID group. Among HAPLO and HID recipients, the 3-year progress free survival rate was 56.8% and 60.0% (P =0.45), respectively; overall survival rate was 58.9% and 62.1% (P = 0.48), respectively; the 3-year cumulative incidences of relapse were 48.4 % and 47.7 % (P =0.36), and those of the 2-year-non-relapse-mortality were 25.2 % and 27.8 % (P =0.86), respectively. The cumulative incidences of grade 3–4 acute GVHD were 28.4% (95% CI =7.2-28.1%) and 20.5% (95% CI =5.7–22.2%)(P =0.43), respectively. Univariate analysis showed that disease status before alloSCT may be a factor affecting OS and PFS (p=0.001).
Conclusion
This retrospective study showed haploSCT resulted in similar clinical efficacy compared to HID in patients with refractory/relapsed or high risk lymphoma. Importantly, TRM and acute GVHD were acceptable without obvious difference between two groups. HaploSCT provides a chance of long-term disease control even for patients without HID.
Session topic: Aggressive lymphoma with emphasis on novel agents
Keyword(s): Allogeneic hematopoietic stem cell transplant, Non-Hodgkin's lymphoma
Abstract: S790
Type: Oral Presentation
Presentation during EHA21: On Sunday, June 12, 2016 from 08:30 - 08:45
Location: Hall A1
Background
AlloSCT is an effective therapeutic option for patients with refractory lymphoma. However, the donor source is the biggest problem for alloSCT. The feasibility of haploSCT has dramatically expanded the donor pool, making allogeneic transplantation available for the vast majority of patients, especially for patients with rapidly progressing disease in whom unrelated donor search cannot be awaited.
Aims
In this study, we aim to compare outcome of haplotransplants with conventional related and matched unrelated donor transplants for refractory relapsed or high risk NHL.
Methods
Seventy-eight patients who had undergone alloSCT between January 2006 and October 2015 in our center were analyzed retrospectively. The median age was 30 years (range, 12 to 58 years). The histological subtypes included diffuse large B cell lymphoma (13), mantle cell lymphoma (3), Burkett’s lymphoma (1), B-cell lymphoblastic lymphoma (8), other type mature B cell lymphoma(10), T-cell lymphoblastic lymphoma (18), peripheral T cell lymphoma (18) and NK/T cell lymphoma (7). Bone marrow was involved in 65 patients, 9 patients had experienced treatment failure with prior autologous SCT. All of the patients received a myeloablative conditioning regimen which is TBI/Cy or Bu/Cy. 33 patients received Haplo Donors, 45 patients received HID, including sibling and matched unrelated donors. Before alloSCT, 49 patients were in CR, 12 patients were in PR, 18 patients were in NR. Primary refractory or progression was more common in the HAPLO group (p=0.001), other variables were balanced.
Results
Seventy-eight patients were engrafted successfully and all patients achieved full donor chimerism. There is no difference for hematopoietic recovery between two groups. In HAPLO group, the median time of neutrophils and platelets recovery were 12 days (range, 9d to 15d) and 17 days (range, 11d to 60d). In HID group, the median time of neutrophils and platelets recovery were 11 days (range, 9d to 16d) and 17days (range, 12d to 45d), respectively. After transplantation, 75 patients acquired complete response, another 3 patients acquired partial response. In HAPLO group, 6 patients had recurrent disease, and 5 patients died from transplantation-related (TRM) including infection and other organ failure at 1-year. In HID group, 6 patients had recurrent disease and 8 patients died of TRM. The median follow-up duration was 23 months (range, 2-139) in HAPLO group, 29 months (range, 2-139) in HID group. Among HAPLO and HID recipients, the 3-year progress free survival rate was 56.8% and 60.0% (P =0.45), respectively; overall survival rate was 58.9% and 62.1% (P = 0.48), respectively; the 3-year cumulative incidences of relapse were 48.4 % and 47.7 % (P =0.36), and those of the 2-year-non-relapse-mortality were 25.2 % and 27.8 % (P =0.86), respectively. The cumulative incidences of grade 3–4 acute GVHD were 28.4% (95% CI =7.2-28.1%) and 20.5% (95% CI =5.7–22.2%)(P =0.43), respectively. Univariate analysis showed that disease status before alloSCT may be a factor affecting OS and PFS (p=0.001).
Conclusion
This retrospective study showed haploSCT resulted in similar clinical efficacy compared to HID in patients with refractory/relapsed or high risk lymphoma. Importantly, TRM and acute GVHD were acceptable without obvious difference between two groups. HaploSCT provides a chance of long-term disease control even for patients without HID.
Session topic: Aggressive lymphoma with emphasis on novel agents
Keyword(s): Allogeneic hematopoietic stem cell transplant, Non-Hodgkin's lymphoma
Type: Oral Presentation
Presentation during EHA21: On Sunday, June 12, 2016 from 08:30 - 08:45
Location: Hall A1
Background
AlloSCT is an effective therapeutic option for patients with refractory lymphoma. However, the donor source is the biggest problem for alloSCT. The feasibility of haploSCT has dramatically expanded the donor pool, making allogeneic transplantation available for the vast majority of patients, especially for patients with rapidly progressing disease in whom unrelated donor search cannot be awaited.
Aims
In this study, we aim to compare outcome of haplotransplants with conventional related and matched unrelated donor transplants for refractory relapsed or high risk NHL.
Methods
Seventy-eight patients who had undergone alloSCT between January 2006 and October 2015 in our center were analyzed retrospectively. The median age was 30 years (range, 12 to 58 years). The histological subtypes included diffuse large B cell lymphoma (13), mantle cell lymphoma (3), Burkett’s lymphoma (1), B-cell lymphoblastic lymphoma (8), other type mature B cell lymphoma(10), T-cell lymphoblastic lymphoma (18), peripheral T cell lymphoma (18) and NK/T cell lymphoma (7). Bone marrow was involved in 65 patients, 9 patients had experienced treatment failure with prior autologous SCT. All of the patients received a myeloablative conditioning regimen which is TBI/Cy or Bu/Cy. 33 patients received Haplo Donors, 45 patients received HID, including sibling and matched unrelated donors. Before alloSCT, 49 patients were in CR, 12 patients were in PR, 18 patients were in NR. Primary refractory or progression was more common in the HAPLO group (p=0.001), other variables were balanced.
Results
Seventy-eight patients were engrafted successfully and all patients achieved full donor chimerism. There is no difference for hematopoietic recovery between two groups. In HAPLO group, the median time of neutrophils and platelets recovery were 12 days (range, 9d to 15d) and 17 days (range, 11d to 60d). In HID group, the median time of neutrophils and platelets recovery were 11 days (range, 9d to 16d) and 17days (range, 12d to 45d), respectively. After transplantation, 75 patients acquired complete response, another 3 patients acquired partial response. In HAPLO group, 6 patients had recurrent disease, and 5 patients died from transplantation-related (TRM) including infection and other organ failure at 1-year. In HID group, 6 patients had recurrent disease and 8 patients died of TRM. The median follow-up duration was 23 months (range, 2-139) in HAPLO group, 29 months (range, 2-139) in HID group. Among HAPLO and HID recipients, the 3-year progress free survival rate was 56.8% and 60.0% (P =0.45), respectively; overall survival rate was 58.9% and 62.1% (P = 0.48), respectively; the 3-year cumulative incidences of relapse were 48.4 % and 47.7 % (P =0.36), and those of the 2-year-non-relapse-mortality were 25.2 % and 27.8 % (P =0.86), respectively. The cumulative incidences of grade 3–4 acute GVHD were 28.4% (95% CI =7.2-28.1%) and 20.5% (95% CI =5.7–22.2%)(P =0.43), respectively. Univariate analysis showed that disease status before alloSCT may be a factor affecting OS and PFS (p=0.001).
Conclusion
This retrospective study showed haploSCT resulted in similar clinical efficacy compared to HID in patients with refractory/relapsed or high risk lymphoma. Importantly, TRM and acute GVHD were acceptable without obvious difference between two groups. HaploSCT provides a chance of long-term disease control even for patients without HID.
Session topic: Aggressive lymphoma with emphasis on novel agents
Keyword(s): Allogeneic hematopoietic stem cell transplant, Non-Hodgkin's lymphoma
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