OUTCOMES OF AUTOLOGOUS AND ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION FOR BPDCN
Author(s): ,
Muzaffar Qazilbash
Affiliations:
Stem Cell Transplantation and Cellular Therapy,MD Anderson Cancer Center,Houston,United States
,
Qaiser Bashir
Affiliations:
Stem Cell Transplantation and Cellular Therapy,MD Anderson Cancer Center,Houston,United States
,
Denai Milton
Affiliations:
Biostatistics,MD Anderson Cancer Center,Houston,United States
,
Romil Patel
Affiliations:
Stem Cell Transplantation and Cellular Therapy,MD Anderson Cancer Center,Houston,United States
,
Uday Popat
Affiliations:
Stem Cell Transplantation and Cellular Therapy,MD Anderson Cancer Center,Houston,United States
,
Chitra Hosing
Affiliations:
Stem Cell Transplantation and Cellular Therapy,MD Anderson Cancer Center,Houston,United States
,
Partow Kebriaei
Affiliations:
Stem Cell Transplantation and Cellular Therapy,MD Anderson Cancer Center,Houston,United States
,
Stefan Ciurea
Affiliations:
Stem Cell Transplantation and Cellular Therapy,MD Anderson Cancer Center,Houston,United States
,
Marina Konopleva
Affiliations:
Leukemia,MD Anderson Cancer Center,Houston,United States
,
Richard Champlin
Affiliations:
Stem Cell Transplantation and Cellular Therapy,MD Anderson Cancer Center,Houston,United States
Naveen Pammaraju
Affiliations:
Leukemia,MD Anderson Cancer Center,Houston,United States
EHA Library. Qazilbash M. Jun 15, 2019; 267158; PS1541
Dr. Muzaffar Qazilbash
Dr. Muzaffar Qazilbash
Contributions
Abstract

Abstract: PS1541

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, aggressive hematologic malignancy arising from plasmacytoid dendritic cells. It commonly presents as skin lesions with or without bone marrow and soft tissue involvement. Limited retrospective data have shown durable remissions after both autologous (auto) or allogeneic (allo) hematopoietic cell transplantation (HCT).

Aims
To evaluate progression-free survival (PFS) and overall survival (OS) after and auto or allo-HCT.

Methods
In this retrospective single-center analysis, we evaluated the outcomes of BPDCN patients who received either an auto- or allo-HCT between September 2000 and January 2019 at our institution. 

Results
We identified 24 consecutive patients who received an auto-HCT (n = 10) or allo-HCT (n = 14) for BPDCN. Skin involvement, with or without other organs, was seen in 16 (67%), BM involvement, with or without soft tissue, in 5 (21%), and other organs in 3 (13%) patients. Patient characteristics are summarized in the attached table. In general, we used auto-HCT for older patients and those with skin-only involvement. Median age at HCT was 52 (range: 18-79) years for all patients. Median (range) follow up in auto-HCT and allo-HCT patients was 6.2 (0.2-37.6) and 8.4 (1.1-76.1) months, respectively (p=0.52). One-hundred day and 1-year non-relapse mortality (NRM) in auto-HCT was 21% and 35%, and in allo-HCT was 7% and 32%, respectively (p=0.58). Two of the 14 (14%) allo patients and 2 of the 10 (20%) auto patients progressed after HCT (p=1.00). Two-year PFS was 28% (4%, 60%) and 47% (95% confidence interval = 17%, 73%) in auto and allo-HCT, respectively (p=0.34). Two-year OS was 26% (4%, 57%) and 56% (24%, 80%) in auto and allo-HCT, respectively (p=0.33). In patients transplanted < 2015 vs. ≥ 2015, 2-year PFS was 13% vs. 54% (p=0.009) and 2 year OS was 13% and 68% (p=0.017).  

Table

 

Auto-HCT (N=10)

Allo-HCT (N=14)

p-value

Age at transplant, median (range)

70 (45-79)

30 (18-67)

<0.001

Organs involved

  Skin only

  Systemic

 

3 (30%)

7 (70%)

 

1 (7%)

13 (93%)

 

0.27

Disease status at HCT

  CR1

  ≥ CR2

  Refractory or relapsed

 

6 (60%)

2 (20%)

2 (20%)

 

6 (43%)

2 (20%)

6 (43%)

 

0.54

Induction

HyperCVAD

Targeted therapy

Other

 

6 (57%)

4 (14%)

4 (29%)

 

3 (30%)

6 (60%)

1 (10%)

 

 

0.21

Prep Regimen

  BEAM

  FM

  FB

  Other

 

10 (100%)

0

0

0

 

0

6 (43%)

6 (43%)

2 (14%)

 

<0.001

Donor type

  Matched sibling

  Haplo-identical

  Matched unrelated

  Mismatched unrelated

 

 

4 (29%)

4 (29%)

3 (21%)

3 (21%)

 

Response to HCT

  CR

  ED/PD

 

8 (80%)

2 (20%)

 

12 (86%)

2 (14%)

 

1.00

 

 

Conclusion
These results demonstrate the efficacy of both auto and allo-HCT in BPDCN, with a significant improvement in the outcome since 2015. Prospective studies are needed to better define the role of HCT in BPDCN.

Session topic: 22. Stem cell transplantation - Clinical

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