Abstract
BACKGROUND Previously, early results were reported for allogeneic hematopoietic cell transplantation (HCT) after nonmyeloablative conditioning with 2 Gy of total body irradiation with or without fludarabine and/or rituximab in 33 patients with mantle cell lymphoma (MCL). METHODS This study examined the outcomes of 70 patients with MCL and included extended follow-up (median, 10 years) for the 33 initial patients. Grafts were obtained from human leukocyte antigen (HLA)-matched, related donors (47%), unrelated donors (41%), and HLA antigen-mismatched donors (11%). RESULTS The 5-year incidence of nonrelapse mortality was 28%. The relapse rate was 26%. The 5-year rates of overall survival (OS) and progression-free survival (PFS) were 55% and 46%, respectively. The 10-year rates of OS and PFS were 44% and 41%, respectively. Eighty percent of surviving patients were off immunosuppression at the last follow-up. The presence of relapsed or refractory disease at the time of HCT predicted a higher rate of relapse (hazard ratio [HR], 2.94; P =.05). Despite this, OS rates at 5 (51% vs 58%) and 10 years (43% vs 45%) were comparable between those with relapsed/refractory disease and those undergoing transplantation with partial or complete remission. A high-risk cytomegalovirus (CMV) status was the only independent predictor of worse OS (HR, 2.32; P =.02). A high-risk CMV status and a low CD3 dose predicted PFS (HR, 2.22; P =.03). CONCLUSIONS Nonmyeloablative allogeneic HCT provides a long-term survival benefit for patients with relapsed MCL, including those with refractory disease or multiple relapses.
Original language | English (US) |
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Pages (from-to) | 3709-3716 |
Number of pages | 8 |
Journal | Cancer |
Volume | 121 |
Issue number | 20 |
DOIs | |
State | Published - Oct 15 2015 |
Keywords
- conditioning regimen
- long-term follow-up
- mantle cell lymphoma
- nonmyeloablative conditioning
- stem cell transplantation
ASJC Scopus subject areas
- Oncology
- Cancer Research