A Comparison of HLA-Identical Sibling Allogeneic versus Autologous Transplantation for Diffuse Large B Cell Lymphoma: A Report from the CIBMTR

Hillard M. Lazarus; Mei Jie Zhang; Jeanette Carreras; Brandon M. Hayes-Lattin; Asli Selmin Ataergin; Jacob D. Bitran; Brian J. Bolwell; César O. Freytes; Robert Peter Gale; Steven C. Goldstein; Gregory A. Hale; David J. Inwards; Thomas R. Klumpp; David I. Marks; Richard T. Maziarz; Philip L. McCarthy; Santiago Pavlovsky; J. Douglas Rizzo; Thomas C. Shea; Harry C. Schouten; Shimon Slavin; Jane N. Winter; Koen van Besien; Julie M. Vose; Parameswaran N. Hari

doi:10.1016/j.bbmt.2009.08.011

A Comparison of HLA-Identical Sibling Allogeneic versus Autologous Transplantation for Diffuse Large B Cell Lymphoma: A Report from the CIBMTR

Hillard M. Lazarus
, Mei Jie Zhang
, Jeanette Carreras
, Brandon M. Hayes-Lattin
, Asli Selmin Ataergin
, Jacob D. Bitran
, Brian J. Bolwell
, César O. Freytes
, Robert Peter Gale
, Steven C. Goldstein
, Gregory A. Hale
, David J. Inwards
, Thomas R. Klumpp
, David I. Marks
, Richard T. Maziarz
, Philip L. McCarthy
, Santiago Pavlovsky
, J. Douglas Rizzo
, Thomas C. Shea
, Harry C. Schouten

Shimon Slavin, Jane N. Winter, Koen van Besien, Julie M. Vose, Parameswaran N. Hari

Knight Cancer Institute

Research output: Contribution to journal › Article › peer-review

84 Scopus citations

Abstract

We compared outcomes of 916 diffuse large B cell lymphoma (DLBCL) patients aged ≥18 years undergoing first autologous (n = 837) or myeloablative (MA) allogeneic hematopoietic cell transplant (HCT) (n = 79) between 1995 and 2003 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Median follow-up was 81 months for allogeneic HCT versus 60 months for autologous HCT. Allogeneic HCT recipients were more likely to have high-risk disease features including higher stage, more prior chemotherapy regimens, and resistant disease. Allogeneic HCT was associated with a higher 1 year treatment-related mortality (TRM) (relative risk [RR] 4.88, 95% confidence interval [CI], 3.21-7.40, P < .001), treatment failure (RR 2.06, 95% CI, 1.54-2.75, P < .001), and mortality (RR 2.75, 95% CI, 2.03-3.72, P < .001). Risk of disease progression was similar in the 2 groups (RR 1.12, 95% CI, 0.73-1.72, P = .59). In fact, for 1-year survivors, no significant differences were observed for TRM, progression, progression-free (PFS) or overall survival (OS). Increased risks of TRM and mortality were associated with older age (>50 years), lower performance score, chemoresistance, and earlier year of transplant. In a cohort of mainly high-risk DLBCL patients, upfront MA allogeneic HCT, although associated with increased early mortality, was associated with a similar risk of disease progression compared to lower risk patients receiving autologous HCT.

Original language	English (US)
Pages (from-to)	35-45
Number of pages	11
Journal	Biology of Blood and Marrow Transplantation
Volume	16
Issue number	1
DOIs	https://doi.org/10.1016/j.bbmt.2009.08.011
State	Published - Jan 1 2010

Funding

Financial disclosure: CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID) ; a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI ; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS); 2 Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research ; and grants from AABB; Aetna; American Society for Blood and Marrow Transplantation; Amgen, Inc.; anonymous donation to the Medical College of Wisconsin; Association of Medical Microbiology and Infectious Disease Canada; Astellas Pharma US, Inc.; Baxter International, Inc.; Bayer HealthCare Pharmaceuticals; BloodCenter of Wisconsin; Blue Cross and Blue Shield Association; Bone Marrow Foundation; Canadian Blood and Marrow Transplant Group; Celgene Corporation; CellGenix, GmbH; Centers for Disease Control and Prevention; ClinImmune Labs; CTI Clinical Trial and Consulting Services; Cubist Pharmaceuticals; Cylex Inc.; CytoTherm; DOR BioPharma, Inc.; Dynal Biotech, an Invitrogen Company; Enzon Pharmaceuticals, Inc.; European Group for Blood and Marrow Transplantation; Gambro BCT, Inc.; Gamida Cell, Ltd.; Genzyme Corporation; Histogenetics, Inc.; HKS Medical Information Systems; Hospira, Inc.; Infectious Diseases Society of America; Kiadis Pharma; Kirin Brewery Co., Ltd.; Merck & Company; The Medical College of Wisconsin; MGI Pharma, Inc.; Michigan Community Blood Centers; Millennium Pharmaceuticals, Inc.; Miller Pharmacal Group; Milliman USA, Inc.; Miltenyi Biotec, Inc.; National Marrow Donor Program; Nature Publishing Group; New York Blood Center; Novartis Oncology; Oncology Nursing Society; Osiris Therapeutics, Inc.; Otsuka Pharmaceutical Development & Commercialization, Inc.; Pall Life Sciences; PDL BioPharma, Inc; Pfizer Inc; Pharmion Corporation; Saladax Biomedical, Inc.; Schering Plough Corporation; Society for Healthcare Epidemiology of America; StemCyte, Inc.; StemSoft Software, Inc.; Sysmex; Teva Pharmaceutical Industries; The Marrow Foundation; THERAKOS, Inc.; Vidacare Corporation; Vion Pharmaceuticals, Inc.; ViraCor Laboratories; ViroPharma, Inc.; and Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, or any other agency of the U.S. Government.

Funders	Funder number
Bone Marrow Foundation
CIBMTR	U24-CA76518
Cubist Pharmaceuticals
Cylex Inc.
European Group for Blood
Invitrogen Company
MGI Pharma, Inc.
Michigan Community Blood Centers
Nature Publishing Group, USA
Saladax Biomedical, Inc
Schering Plough Corporation
Society for Healthcare Epidemiology of America
Office of Naval Research
U.S. Department of Health and Human Services	N00014-06-1-0704, N00014-08-1-0058
National Institute of Health National Heart, Lung, and Blood Institute
National Institute of Health-National Cancer Institute	U24CA076518
National Institute of Allergy and Infectious Diseases	5U01HL069294, HHSH234200637015C
Health Resources and Services Administration
Amgen
Baxter International
Teva Pharmaceutical Industries Ltd.
AABB
Enzon Pharmaceuticals
American Society for Blood and Marrow Transplantation
Association of Medical Microbiology and Infectious Disease Canada
Bayer Healthcare
Astellas Pharma

Keywords

Allogeneic transplantation
Hodgkin lymphoma
Unrelated

ASJC Scopus subject areas

Hematology
Transplantation

Access to Document

10.1016/j.bbmt.2009.08.011

Cite this

Lazarus, H. M., Zhang, M. J., Carreras, J., Hayes-Lattin, B. M., Ataergin, A. S., Bitran, J. D., Bolwell, B. J., Freytes, C. O., Gale, R. P., Goldstein, S. C., Hale, G. A., Inwards, D. J., Klumpp, T. R., Marks, D. I., Maziarz, R. T., McCarthy, P. L., Pavlovsky, S., Rizzo, J. D., Shea, T. C., ... Hari, P. N. (2010). A Comparison of HLA-Identical Sibling Allogeneic versus Autologous Transplantation for Diffuse Large B Cell Lymphoma: A Report from the CIBMTR. Biology of Blood and Marrow Transplantation, 16(1), 35-45. https://doi.org/10.1016/j.bbmt.2009.08.011

Lazarus, HM, Zhang, MJ, Carreras, J, Hayes-Lattin, BM, Ataergin, AS, Bitran, JD, Bolwell, BJ, Freytes, CO, Gale, RP, Goldstein, SC, Hale, GA, Inwards, DJ, Klumpp, TR, Marks, DI, Maziarz, RT, McCarthy, PL, Pavlovsky, S, Rizzo, JD, Shea, TC, Schouten, HC, Slavin, S, Winter, JN, van Besien, K, Vose, JM & Hari, PN 2010, 'A Comparison of HLA-Identical Sibling Allogeneic versus Autologous Transplantation for Diffuse Large B Cell Lymphoma: A Report from the CIBMTR', Biology of Blood and Marrow Transplantation, vol. 16, no. 1, pp. 35-45. https://doi.org/10.1016/j.bbmt.2009.08.011

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title = "A Comparison of HLA-Identical Sibling Allogeneic versus Autologous Transplantation for Diffuse Large B Cell Lymphoma: A Report from the CIBMTR",

abstract = "We compared outcomes of 916 diffuse large B cell lymphoma (DLBCL) patients aged ≥18 years undergoing first autologous (n = 837) or myeloablative (MA) allogeneic hematopoietic cell transplant (HCT) (n = 79) between 1995 and 2003 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Median follow-up was 81 months for allogeneic HCT versus 60 months for autologous HCT. Allogeneic HCT recipients were more likely to have high-risk disease features including higher stage, more prior chemotherapy regimens, and resistant disease. Allogeneic HCT was associated with a higher 1 year treatment-related mortality (TRM) (relative risk [RR] 4.88, 95\% confidence interval [CI], 3.21-7.40, P < .001), treatment failure (RR 2.06, 95\% CI, 1.54-2.75, P < .001), and mortality (RR 2.75, 95\% CI, 2.03-3.72, P < .001). Risk of disease progression was similar in the 2 groups (RR 1.12, 95\% CI, 0.73-1.72, P = .59). In fact, for 1-year survivors, no significant differences were observed for TRM, progression, progression-free (PFS) or overall survival (OS). Increased risks of TRM and mortality were associated with older age (>50 years), lower performance score, chemoresistance, and earlier year of transplant. In a cohort of mainly high-risk DLBCL patients, upfront MA allogeneic HCT, although associated with increased early mortality, was associated with a similar risk of disease progression compared to lower risk patients receiving autologous HCT.",

keywords = "Allogeneic transplantation, Hodgkin lymphoma, Unrelated",

author = "Lazarus, \{Hillard M.\} and Zhang, \{Mei Jie\} and Jeanette Carreras and Hayes-Lattin, \{Brandon M.\} and Ataergin, \{Asli Selmin\} and Bitran, \{Jacob D.\} and Bolwell, \{Brian J.\} and Freytes, \{C{\'e}sar O.\} and Gale, \{Robert Peter\} and Goldstein, \{Steven C.\} and Hale, \{Gregory A.\} and Inwards, \{David J.\} and Klumpp, \{Thomas R.\} and Marks, \{David I.\} and Maziarz, \{Richard T.\} and McCarthy, \{Philip L.\} and Santiago Pavlovsky and Rizzo, \{J. Douglas\} and Shea, \{Thomas C.\} and Schouten, \{Harry C.\} and Shimon Slavin and Winter, \{Jane N.\} and \{van Besien\}, Koen and Vose, \{Julie M.\} and Hari, \{Parameswaran N.\}",

note = "Funding Information: Financial disclosure: CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID) ; a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI ; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS); 2 Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research ; and grants from AABB; Aetna; American Society for Blood and Marrow Transplantation; Amgen, Inc.; anonymous donation to the Medical College of Wisconsin; Association of Medical Microbiology and Infectious Disease Canada; Astellas Pharma US, Inc.; Baxter International, Inc.; Bayer HealthCare Pharmaceuticals; BloodCenter of Wisconsin; Blue Cross and Blue Shield Association; Bone Marrow Foundation; Canadian Blood and Marrow Transplant Group; Celgene Corporation; CellGenix, GmbH; Centers for Disease Control and Prevention; ClinImmune Labs; CTI Clinical Trial and Consulting Services; Cubist Pharmaceuticals; Cylex Inc.; CytoTherm; DOR BioPharma, Inc.; Dynal Biotech, an Invitrogen Company; Enzon Pharmaceuticals, Inc.; European Group for Blood and Marrow Transplantation; Gambro BCT, Inc.; Gamida Cell, Ltd.; Genzyme Corporation; Histogenetics, Inc.; HKS Medical Information Systems; Hospira, Inc.; Infectious Diseases Society of America; Kiadis Pharma; Kirin Brewery Co., Ltd.; Merck \& Company; The Medical College of Wisconsin; MGI Pharma, Inc.; Michigan Community Blood Centers; Millennium Pharmaceuticals, Inc.; Miller Pharmacal Group; Milliman USA, Inc.; Miltenyi Biotec, Inc.; National Marrow Donor Program; Nature Publishing Group; New York Blood Center; Novartis Oncology; Oncology Nursing Society; Osiris Therapeutics, Inc.; Otsuka Pharmaceutical Development \& Commercialization, Inc.; Pall Life Sciences; PDL BioPharma, Inc; Pfizer Inc; Pharmion Corporation; Saladax Biomedical, Inc.; Schering Plough Corporation; Society for Healthcare Epidemiology of America; StemCyte, Inc.; StemSoft Software, Inc.; Sysmex; Teva Pharmaceutical Industries; The Marrow Foundation; THERAKOS, Inc.; Vidacare Corporation; Vion Pharmaceuticals, Inc.; ViraCor Laboratories; ViroPharma, Inc.; and Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, or any other agency of the U.S. Government. ",

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doi = "10.1016/j.bbmt.2009.08.011",

language = "English (US)",

volume = "16",

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journal = "Biology of Blood and Marrow Transplantation",

issn = "1083-8791",

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T1 - A Comparison of HLA-Identical Sibling Allogeneic versus Autologous Transplantation for Diffuse Large B Cell Lymphoma

T2 - A Report from the CIBMTR

AU - Lazarus, Hillard M.

AU - Zhang, Mei Jie

AU - Carreras, Jeanette

AU - Hayes-Lattin, Brandon M.

AU - Ataergin, Asli Selmin

AU - Bitran, Jacob D.

AU - Bolwell, Brian J.

AU - Freytes, César O.

AU - Gale, Robert Peter

AU - Goldstein, Steven C.

AU - Hale, Gregory A.

AU - Inwards, David J.

AU - Klumpp, Thomas R.

AU - Marks, David I.

AU - Maziarz, Richard T.

AU - McCarthy, Philip L.

AU - Pavlovsky, Santiago

AU - Rizzo, J. Douglas

AU - Shea, Thomas C.

AU - Schouten, Harry C.

AU - Slavin, Shimon

AU - Winter, Jane N.

AU - van Besien, Koen

AU - Vose, Julie M.

AU - Hari, Parameswaran N.

N1 - Funding Information: Financial disclosure: CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID) ; a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI ; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS); 2 Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research ; and grants from AABB; Aetna; American Society for Blood and Marrow Transplantation; Amgen, Inc.; anonymous donation to the Medical College of Wisconsin; Association of Medical Microbiology and Infectious Disease Canada; Astellas Pharma US, Inc.; Baxter International, Inc.; Bayer HealthCare Pharmaceuticals; BloodCenter of Wisconsin; Blue Cross and Blue Shield Association; Bone Marrow Foundation; Canadian Blood and Marrow Transplant Group; Celgene Corporation; CellGenix, GmbH; Centers for Disease Control and Prevention; ClinImmune Labs; CTI Clinical Trial and Consulting Services; Cubist Pharmaceuticals; Cylex Inc.; CytoTherm; DOR BioPharma, Inc.; Dynal Biotech, an Invitrogen Company; Enzon Pharmaceuticals, Inc.; European Group for Blood and Marrow Transplantation; Gambro BCT, Inc.; Gamida Cell, Ltd.; Genzyme Corporation; Histogenetics, Inc.; HKS Medical Information Systems; Hospira, Inc.; Infectious Diseases Society of America; Kiadis Pharma; Kirin Brewery Co., Ltd.; Merck & Company; The Medical College of Wisconsin; MGI Pharma, Inc.; Michigan Community Blood Centers; Millennium Pharmaceuticals, Inc.; Miller Pharmacal Group; Milliman USA, Inc.; Miltenyi Biotec, Inc.; National Marrow Donor Program; Nature Publishing Group; New York Blood Center; Novartis Oncology; Oncology Nursing Society; Osiris Therapeutics, Inc.; Otsuka Pharmaceutical Development & Commercialization, Inc.; Pall Life Sciences; PDL BioPharma, Inc; Pfizer Inc; Pharmion Corporation; Saladax Biomedical, Inc.; Schering Plough Corporation; Society for Healthcare Epidemiology of America; StemCyte, Inc.; StemSoft Software, Inc.; Sysmex; Teva Pharmaceutical Industries; The Marrow Foundation; THERAKOS, Inc.; Vidacare Corporation; Vion Pharmaceuticals, Inc.; ViraCor Laboratories; ViroPharma, Inc.; and Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, or any other agency of the U.S. Government.

PY - 2010/1/1

Y1 - 2010/1/1

N2 - We compared outcomes of 916 diffuse large B cell lymphoma (DLBCL) patients aged ≥18 years undergoing first autologous (n = 837) or myeloablative (MA) allogeneic hematopoietic cell transplant (HCT) (n = 79) between 1995 and 2003 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Median follow-up was 81 months for allogeneic HCT versus 60 months for autologous HCT. Allogeneic HCT recipients were more likely to have high-risk disease features including higher stage, more prior chemotherapy regimens, and resistant disease. Allogeneic HCT was associated with a higher 1 year treatment-related mortality (TRM) (relative risk [RR] 4.88, 95% confidence interval [CI], 3.21-7.40, P < .001), treatment failure (RR 2.06, 95% CI, 1.54-2.75, P < .001), and mortality (RR 2.75, 95% CI, 2.03-3.72, P < .001). Risk of disease progression was similar in the 2 groups (RR 1.12, 95% CI, 0.73-1.72, P = .59). In fact, for 1-year survivors, no significant differences were observed for TRM, progression, progression-free (PFS) or overall survival (OS). Increased risks of TRM and mortality were associated with older age (>50 years), lower performance score, chemoresistance, and earlier year of transplant. In a cohort of mainly high-risk DLBCL patients, upfront MA allogeneic HCT, although associated with increased early mortality, was associated with a similar risk of disease progression compared to lower risk patients receiving autologous HCT.

AB - We compared outcomes of 916 diffuse large B cell lymphoma (DLBCL) patients aged ≥18 years undergoing first autologous (n = 837) or myeloablative (MA) allogeneic hematopoietic cell transplant (HCT) (n = 79) between 1995 and 2003 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Median follow-up was 81 months for allogeneic HCT versus 60 months for autologous HCT. Allogeneic HCT recipients were more likely to have high-risk disease features including higher stage, more prior chemotherapy regimens, and resistant disease. Allogeneic HCT was associated with a higher 1 year treatment-related mortality (TRM) (relative risk [RR] 4.88, 95% confidence interval [CI], 3.21-7.40, P < .001), treatment failure (RR 2.06, 95% CI, 1.54-2.75, P < .001), and mortality (RR 2.75, 95% CI, 2.03-3.72, P < .001). Risk of disease progression was similar in the 2 groups (RR 1.12, 95% CI, 0.73-1.72, P = .59). In fact, for 1-year survivors, no significant differences were observed for TRM, progression, progression-free (PFS) or overall survival (OS). Increased risks of TRM and mortality were associated with older age (>50 years), lower performance score, chemoresistance, and earlier year of transplant. In a cohort of mainly high-risk DLBCL patients, upfront MA allogeneic HCT, although associated with increased early mortality, was associated with a similar risk of disease progression compared to lower risk patients receiving autologous HCT.

KW - Allogeneic transplantation

KW - Hodgkin lymphoma

KW - Unrelated

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