Autologous and allogeneic hematopoietic cell transplantation for diffuse large B-cell lymphoma–type Richter syndrome
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Autologous and allogeneic hematopoietic cell transplantation for diffuse large B-cell lymphoma–type Richter syndrome. / Herrera, Alex F.; Ahn, Kwang Woo; Litovich, Carlos; Chen, Yue; Assal, Amer; Bashir, Qaiser; Bayer, Ruthee Lu; Coleman, Melanie; DeFilipp, Zachariah; Farhadfar, Nosha; Greenwood, Matthew; Hahn, Theresa; Horwitz, Mitchell; Jacobson, Caron; Jaglowski, Samantha; Lachance, Sylvie; Langston, Amelia; Mattar, Bassam; Maziarz, Richard T.; McGuirk, Joseph; Mian, Mohammad A.H.; Nathan, Sunita; Phillips, Adrienne; Rakszawski, Kevin; Sengeloev, Henrik; Shenoy, Shalini; Stuart, Robert; Sauter, Craig S.; Kharfan-Dabaja, Mohamed A.; Hamadani, Mehdi.
I: Blood advances, Bind 5, Nr. 18, 2021, s. 3528-3539.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Autologous and allogeneic hematopoietic cell transplantation for diffuse large B-cell lymphoma–type Richter syndrome
AU - Herrera, Alex F.
AU - Ahn, Kwang Woo
AU - Litovich, Carlos
AU - Chen, Yue
AU - Assal, Amer
AU - Bashir, Qaiser
AU - Bayer, Ruthee Lu
AU - Coleman, Melanie
AU - DeFilipp, Zachariah
AU - Farhadfar, Nosha
AU - Greenwood, Matthew
AU - Hahn, Theresa
AU - Horwitz, Mitchell
AU - Jacobson, Caron
AU - Jaglowski, Samantha
AU - Lachance, Sylvie
AU - Langston, Amelia
AU - Mattar, Bassam
AU - Maziarz, Richard T.
AU - McGuirk, Joseph
AU - Mian, Mohammad A.H.
AU - Nathan, Sunita
AU - Phillips, Adrienne
AU - Rakszawski, Kevin
AU - Sengeloev, Henrik
AU - Shenoy, Shalini
AU - Stuart, Robert
AU - Sauter, Craig S.
AU - Kharfan-Dabaja, Mohamed A.
AU - Hamadani, Mehdi
N1 - Publisher Copyright: © 2021 by The American Society of Hematology.
PY - 2021
Y1 - 2021
N2 - Richter syndrome (RS) represents a transformation from chronic lymphocytic leukemia/ small lymphocytic lymphoma (CLL/SLL) to aggressive lymphoma, most commonly diffuse large B-cell lymphoma (DLBCL), which is associated with a dismal prognosis. Patients with DLBCL-RS have poor outcomes with DLBCL-directed therapy; thus, consolidation with hematopoietic cell transplantation (HCT) has been used, with durable remissions observed. Studies reporting HCT outcomes in patients with DLBCL-RS have been small, have not evaluated the prognostic impact of cytogenetic risk factors, and were conducted prior to the era of novel targeted therapy of CLL/SLL. We performed a Center for International Blood and Transplant Research registry study evaluating outcomes after autologous HCT (auto-HCT; n 5 53) and allogeneic HCT (allo-HCT; n 5 118) in patients with DLBCL-RS treated in the modern era. More auto-HCT recipients were in complete response (CR) at HCT relative to allo-HCT recipients (66% vs 34%), whereas a higher proportion of allo-HCT recipients had 17p deletion (33% vs 7%) and had previously received novel agents (39% vs 10%). In the auto-HCT cohort, the 3-year relapse incidence, progression-free survival (PFS), and overall survival (OS) were 37%, 48%, and 57%, respectively. Among allo-HCT recipients, the 3-year relapse incidence, PFS, and OS were 30%, 43%, and 52%, respectively. In the allo-HCT cohort, deeper response at HCT was associated with outcomes (3-year PFS/OS, 66%/77% CR vs 43%/57% partial response vs 5%/15% resistant; P, .0001 for both), whereas cytogenetic abnormalities and prior novel therapy did not impact outcomes. In our study, HCT resulted in durable remissions in therapy-sensitive patients with DLBCL-RS treated in the era of targeted CLL/SLL therapy, including patients with high-risk features.
AB - Richter syndrome (RS) represents a transformation from chronic lymphocytic leukemia/ small lymphocytic lymphoma (CLL/SLL) to aggressive lymphoma, most commonly diffuse large B-cell lymphoma (DLBCL), which is associated with a dismal prognosis. Patients with DLBCL-RS have poor outcomes with DLBCL-directed therapy; thus, consolidation with hematopoietic cell transplantation (HCT) has been used, with durable remissions observed. Studies reporting HCT outcomes in patients with DLBCL-RS have been small, have not evaluated the prognostic impact of cytogenetic risk factors, and were conducted prior to the era of novel targeted therapy of CLL/SLL. We performed a Center for International Blood and Transplant Research registry study evaluating outcomes after autologous HCT (auto-HCT; n 5 53) and allogeneic HCT (allo-HCT; n 5 118) in patients with DLBCL-RS treated in the modern era. More auto-HCT recipients were in complete response (CR) at HCT relative to allo-HCT recipients (66% vs 34%), whereas a higher proportion of allo-HCT recipients had 17p deletion (33% vs 7%) and had previously received novel agents (39% vs 10%). In the auto-HCT cohort, the 3-year relapse incidence, progression-free survival (PFS), and overall survival (OS) were 37%, 48%, and 57%, respectively. Among allo-HCT recipients, the 3-year relapse incidence, PFS, and OS were 30%, 43%, and 52%, respectively. In the allo-HCT cohort, deeper response at HCT was associated with outcomes (3-year PFS/OS, 66%/77% CR vs 43%/57% partial response vs 5%/15% resistant; P, .0001 for both), whereas cytogenetic abnormalities and prior novel therapy did not impact outcomes. In our study, HCT resulted in durable remissions in therapy-sensitive patients with DLBCL-RS treated in the era of targeted CLL/SLL therapy, including patients with high-risk features.
U2 - 10.1182/bloodadvances.2021004865
DO - 10.1182/bloodadvances.2021004865
M3 - Journal article
C2 - 34496026
AN - SCOPUS:85116143497
VL - 5
SP - 3528
EP - 3539
JO - Blood advances
JF - Blood advances
SN - 2473-9529
IS - 18
ER -
ID: 303581362