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Outcome following reduced intensity allogeneic stem cell transplantation (RIC AlloSCT) for relapsed and refractory mantle-cell lymphoma (MCL): A study of the British Society for blood and marrow transplantation: a study of the British Society for Blood and Marrow Transplantation

Outcome following reduced intensity allogeneic stem cell transplantation (RIC AlloSCT) for relapsed and refractory mantle-cell lymphoma (MCL): A study of the British Society for blood and marrow transplantation: a study of the British Society for Blood and Marrow Transplantation
Outcome following reduced intensity allogeneic stem cell transplantation (RIC AlloSCT) for relapsed and refractory mantle-cell lymphoma (MCL): A study of the British Society for blood and marrow transplantation: a study of the British Society for Blood and Marrow Transplantation
Reduced intensity Allogeneic stem cell transplantation (RIC-AlloSCT) is being increasingly considered for patients with aggressive lymphoma but limited evidence exist in Mantle cell lymphoma (MCL).

Design and methods: We report a retrospective study of transplant outcomes of RIC-AlloSCT for MCL in 70 patients (median age 48 years, range 30-67), with 57 patients receiving an Alemtuzumab-containing regimen. 34% of patients had received a prior autologous stem cell transplant.

Results: The 1 & 5 year Non-relapse mortality (NRM) was 18% (95%CI 10-27) & 21% (95%CI12-31), respectively. The incidence of severe (grade III &IV) acute GVHD was 10% & the 5 year incidence of chronic GvHD was 61%. The cumulative relapse risk was 65% (95% CI 48-77) at 5 years, significantly affected by disease status at transplant (p=0.0495) specifically the presence of chemo-sensitive disease (p=0.0364). 15 of 18 relapsed patients received DLI (n=14) or a second RIC-AlloSCT (n=1) with 11 of 15 currently in CR. The 5 year OS & PFS were 37% (95% CI 25 - 56%) & 14% (95% CI 6-34%), respectively. Age at transplantation & having <2 prior lines of therapy influenced the OS where as having <2 prior lines of therapy was the only factor to influence PFS. The use of Alemtuzumab in the conditioning was associated with an improved OS at 3 years (p=0.0271).

Conclusion: RIC-AlloSCT is a potential treatment modality for aggressive MCL. For patients relapsing post-AlloSCT, the disease is salvageable with DLI. The timing of RIC-AlloSCT should be explored in prospective studies to establish the optimal role in the management of this aggressive lymphoma.
1083-8791
1419-27
Cook, Gordon
4fe17be9-5e4e-4a58-a09a-b76f07f410f4
Smith, Graeme M
0b95e409-dc5f-4c22-8bf7-9427ebfe81a3
Kirkland, Keiren
59daf404-2117-4c96-a7f8-314a057f65cf
Lee, Julia
2bc510c5-aa01-46e5-8581-0625e8a46b7e
Pearce, Rachel
e82b05e0-be1e-44da-a679-ded7fba792e8
Thomson, Kirsty
0e0a7332-417f-4b89-b918-a6fc16418ce7
Morris, Emma
734efa25-79be-4587-b3aa-411e9b99711a
Orchard, Kim
794654ab-d6cc-488a-ac11-c9217433c7a2
Rule, Simon
cc835ff1-f9a5-47a4-b815-76e516e157e7
Russell, Nigel
50041bba-1fd0-47a5-948b-cd8d3e40e426
Craddock, Charles
ec80de01-977b-4d16-8538-2ad72303bd7e
Marks, David I
7e83726c-7b1f-4451-ad6c-a5d67c425203
Clinical Trials Committee (CTC) of the British Society for Blood and Marrow Transplantation (BSBMT)
Cook, Gordon
4fe17be9-5e4e-4a58-a09a-b76f07f410f4
Smith, Graeme M
0b95e409-dc5f-4c22-8bf7-9427ebfe81a3
Kirkland, Keiren
59daf404-2117-4c96-a7f8-314a057f65cf
Lee, Julia
2bc510c5-aa01-46e5-8581-0625e8a46b7e
Pearce, Rachel
e82b05e0-be1e-44da-a679-ded7fba792e8
Thomson, Kirsty
0e0a7332-417f-4b89-b918-a6fc16418ce7
Morris, Emma
734efa25-79be-4587-b3aa-411e9b99711a
Orchard, Kim
794654ab-d6cc-488a-ac11-c9217433c7a2
Rule, Simon
cc835ff1-f9a5-47a4-b815-76e516e157e7
Russell, Nigel
50041bba-1fd0-47a5-948b-cd8d3e40e426
Craddock, Charles
ec80de01-977b-4d16-8538-2ad72303bd7e
Marks, David I
7e83726c-7b1f-4451-ad6c-a5d67c425203

Cook, Gordon, Smith, Graeme M, Kirkland, Keiren, Lee, Julia, Pearce, Rachel, Thomson, Kirsty, Morris, Emma, Orchard, Kim, Rule, Simon, Russell, Nigel, Craddock, Charles and Marks, David I , Clinical Trials Committee (CTC) of the British Society for Blood and Marrow Transplantation (BSBMT) (2010) Outcome following reduced intensity allogeneic stem cell transplantation (RIC AlloSCT) for relapsed and refractory mantle-cell lymphoma (MCL): A study of the British Society for blood and marrow transplantation: a study of the British Society for Blood and Marrow Transplantation. Biology of Blood and Marrow Transplantation, 16 (10), 1419-27. (doi:10.1016/j.bbmt.2010.04.006).

Record type: Article

Abstract

Reduced intensity Allogeneic stem cell transplantation (RIC-AlloSCT) is being increasingly considered for patients with aggressive lymphoma but limited evidence exist in Mantle cell lymphoma (MCL).

Design and methods: We report a retrospective study of transplant outcomes of RIC-AlloSCT for MCL in 70 patients (median age 48 years, range 30-67), with 57 patients receiving an Alemtuzumab-containing regimen. 34% of patients had received a prior autologous stem cell transplant.

Results: The 1 & 5 year Non-relapse mortality (NRM) was 18% (95%CI 10-27) & 21% (95%CI12-31), respectively. The incidence of severe (grade III &IV) acute GVHD was 10% & the 5 year incidence of chronic GvHD was 61%. The cumulative relapse risk was 65% (95% CI 48-77) at 5 years, significantly affected by disease status at transplant (p=0.0495) specifically the presence of chemo-sensitive disease (p=0.0364). 15 of 18 relapsed patients received DLI (n=14) or a second RIC-AlloSCT (n=1) with 11 of 15 currently in CR. The 5 year OS & PFS were 37% (95% CI 25 - 56%) & 14% (95% CI 6-34%), respectively. Age at transplantation & having <2 prior lines of therapy influenced the OS where as having <2 prior lines of therapy was the only factor to influence PFS. The use of Alemtuzumab in the conditioning was associated with an improved OS at 3 years (p=0.0271).

Conclusion: RIC-AlloSCT is a potential treatment modality for aggressive MCL. For patients relapsing post-AlloSCT, the disease is salvageable with DLI. The timing of RIC-AlloSCT should be explored in prospective studies to establish the optimal role in the management of this aggressive lymphoma.

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More information

Accepted/In Press date: 15 April 2010
Published date: October 2010
Organisations: Cancer Sciences, Social Sciences

Identifiers

Local EPrints ID: 152945
URI: http://eprints.soton.ac.uk/id/eprint/152945
ISSN: 1083-8791
PURE UUID: 561f6269-988d-486f-8125-ff44fca1b1d5
ORCID for Kim Orchard: ORCID iD orcid.org/0000-0003-2276-3925

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Date deposited: 17 May 2010 15:55
Last modified: 14 Mar 2024 02:47

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Contributors

Author: Gordon Cook
Author: Graeme M Smith
Author: Keiren Kirkland
Author: Julia Lee
Author: Rachel Pearce
Author: Kirsty Thomson
Author: Emma Morris
Author: Kim Orchard ORCID iD
Author: Simon Rule
Author: Nigel Russell
Author: Charles Craddock
Author: David I Marks
Corporate Author: Clinical Trials Committee (CTC) of the British Society for Blood and Marrow Transplantation (BSBMT)

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