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RESEARCH PRODUCT
Allogeneic Stem Cell Transplantation in Mantle Cell Lymphoma; Insights into Its Potential Role in the Era of New Immunotherapeutic and Targeted Therapies : The GETH/GELTAMO Experience
Antonio GutiérrezLeyre BentoSilvana NovelliAlejandro MartinGonzalo GutierrezMaria Queralt SalasMariana Bastos-oreiroAriadna PerezRafael HernaniMaria Cruz ViguriaOriana Lopez-godinoJuan MontoroJosé Luis PiñanaChristelle FerráRocio ParodyCarmen MartinIgnacio EspañolLucrecia YañezGuillermo RodriguezJoud ZanabiliPilar HerreraMaria Rosario VarelaAntonia SampolCarlos SolanoDolores CaballeroUniversitat Autònoma De Barcelona. Departament De Medicinasubject
CAR-T cell therapyCancer ResearchLimfomesMantle cell lymphomaAcute graft-versus-host diseaseTransplantation of organstarget therapyacute graft-versus-host diseasemantle cell lymphomaTarget therapyTrasplantament d'òrgansgraft-versus-lymphoma effectnon-relapse mortalityOncologyNon-relapse mortalityimmune system diseaseshemic and lymphatic diseasesallogeneic stem-cell transplantationmantle cell lymphoma; allogeneic stem-cell transplantation; non-relapse mortality; acute graft-versus-host disease; graft-versus-lymphoma effect; target therapy; CAR-T cell therapyLymphomasAllogeneic stem-cell transplantationCàncerGraft-versus-lymphoma effectdescription
Simple Summary We present the long-term results of patients receiving allogeneic stem cell transplantation (allo-SCT) for relapsed/refractory mantle cell lymphoma (R/R MCL) in the last 25 years in Spain. We conclude that allo-SCT may be a curative option in R/R MCL with a low cumulative incidence (CI) of relapse, although non-relapse mortality (NRM) is still high, which is mainly secondary to acute graft-versus-host disease (aGVHD). Results are better for fit patients, using HLA-identical (related or unrelated) or haploidentical related donors and without previous ASCT. However, the arrival of new highly effective and low toxic immunotherapeutic or targeted therapies inevitably will relegate allo-SCT to those fit patients who fail these therapies, being administered far away from the optimal timing. Allo-SCT is a curative option for selected patients with relapsed/refractory (R/R) MCL, but with significant NRM. We present the long-term results of patients receiving allo-SCT in Spain from March 1995 to February 2020. The primary endpoints were EFS, OS, and cumulative incidence (CI) of NRM, relapse, and GVHD. We included 135 patients, most (85%) receiving RIC. After a median follow-up of 68 months, 5-year EFS and OS were 47 and 50%, respectively. Overall and CR rates were 86 and 80%. The CI of relapse at 1 and 3 years were 7 and 12%. NRM at day 100 and 1 year were 17 and 32%. Previous ASCT and Grade 3-4 aGVHD were associated with a higher NRM. Grade 3-4 aGVHD, donor type (mismatch non-related), and the time-period 2006-2020 were independently related to worse EFS. Patients from 1995-2005 were younger, most from HLA-identical sibling donors, and were pretreated less. Our data confirmed that allo-SCT may be a curative option in R/R MCL with low a CI of relapse, although NRM is still high, being mainly secondary to aGVHD. The arrival of new, highly effective and low toxic immunotherapeutic or targeted therapies inevitably will relegate allo-SCT to those fit patients who fail these therapies, far away from the optimal timing of treatment.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2022-05-27 |