TY - JOUR
T1 - Efficacy of High-Dose Therapy and Autologous Hematopoietic Cell Transplantation in Gray Zone Lymphoma
T2 - A US Multicenter Collaborative Study
AU - Kharfan-Dabaja, Mohamed A.
AU - Raj, Renju
AU - Nikolaenko, Liana
AU - Ahmed, Sairah
AU - Reddy, Nishitha
AU - Nathan, Sunita
AU - Cherry, Mohamad
AU - El-Jurdi, Najla
AU - Obiozor, Cynthia
AU - Fenske, Timothy S.
AU - Song, Joo
AU - Muzzafar, Tariq
AU - Ayala, Ernesto
AU - Savani, Bipin
AU - Khawandanah, Mohamad
AU - Caimi, Paolo F.
AU - Hamadani, Mehdi
AU - Forman, Stephen J.
AU - Hussaini, Mohamad
AU - de Lima, Marcos
AU - Olteanu, Horatiu
AU - Shah, Bijal
AU - Chavez, Julio C.
AU - Al Malki, Monzr
AU - Kumar, Ambuj
AU - Ganguly, Siddhartha
N1 - Funding Information:
Conflict of interest statement: M.A.K.-D. serves on the speaker's bureau for Incyte Corp, Alexion Pharmaceuticals, and Seattle Genetics. M.C. has a consulting/advisory role for Pfizer and Takeda. P.F.C has a consulting/advisory role for Kite Pharma and serves on the speaker's bureau for Celgene. M. Hussaini has received an honorarium from Janssen Pharmaceuticals. M.d.L. has a consulting/advisory role for Celgene, Pfizer, and Amgen and has received research funding from Celgene. B.J. has a consulting/advisory role for Celgene, Bayer, Baxalta, Jazz pharmaceuticals, Pfizer, and Clonoseq; receives research support from Incyte and Rosetta Genomics; and serves on the speaker's bureau for Amgen. J.C.C. has a consulting/advisory role for Novartis, serves on the speaker's bureau for Janssen Pharmaceuticals, and has received research support from Merck. S.G. has a consulting/advisory role for Amgen, Millennium, and Seattle Genetics; has received research funding from Janssen; and serves on the speaker's bureau for Seattle Genetics.
Publisher Copyright:
© 2017 The American Society for Blood and Marrow Transplantation
PY - 2018/3
Y1 - 2018/3
N2 - High-dose therapy (HDT) and autologous hematopoietic cell transplantation (auto-HCT) has been anecdotally prescribed in gray zone lymphoma (GZL), showing encouraging efficacy. We conducted a multicenter retrospective study aimed at assessing outcomes after auto-HCT in 32 patients with GZL treated at 9 transplantation centers in the United States. The median age of patients at transplantation was 38 years (range, 18 to 70 years), and the majority were male (n = 21; 66%). The median number of lines of therapy before transplantation was 2 (range, 1 to 4). BEAM was the most commonly prescribed regimen (n = 23; 72%). The median duration of follow-up for surviving patients was 34 months (range, 1 to 106 months). Median overall survival (OS) was not reached. The 3-year progression-free survival (PFS) and OS for all patients were 69% and 78%, respectively. Three-year PFS and OS were 100% for patients who received only 1 line of therapy before auto-HCT versus 65% (PFS, P =.25) and 75% (OS, P =.39) for those receiving >1 line. The cumulative incidence of relapse/progression was 4% at 1 year post-transplantation and 31% at 3 years post-transplantation. The 3-year nonrelapse mortality was 0%. These findings suggest that HDT and auto-HCT is an effective treatment in patients with GZL. Our findings ideally require confirmation in a larger cohort of patients, preferably in the setting of large prospective multicenter randomized controlled trials. However, we acknowledge that such studies could be difficult to conduct in patients with GZL owing to the disease's rarity. Alternatively, a multicenter prospective study that includes tissue banking and a data registry is warranted to help better understand the biology and natural history of the disease.
AB - High-dose therapy (HDT) and autologous hematopoietic cell transplantation (auto-HCT) has been anecdotally prescribed in gray zone lymphoma (GZL), showing encouraging efficacy. We conducted a multicenter retrospective study aimed at assessing outcomes after auto-HCT in 32 patients with GZL treated at 9 transplantation centers in the United States. The median age of patients at transplantation was 38 years (range, 18 to 70 years), and the majority were male (n = 21; 66%). The median number of lines of therapy before transplantation was 2 (range, 1 to 4). BEAM was the most commonly prescribed regimen (n = 23; 72%). The median duration of follow-up for surviving patients was 34 months (range, 1 to 106 months). Median overall survival (OS) was not reached. The 3-year progression-free survival (PFS) and OS for all patients were 69% and 78%, respectively. Three-year PFS and OS were 100% for patients who received only 1 line of therapy before auto-HCT versus 65% (PFS, P =.25) and 75% (OS, P =.39) for those receiving >1 line. The cumulative incidence of relapse/progression was 4% at 1 year post-transplantation and 31% at 3 years post-transplantation. The 3-year nonrelapse mortality was 0%. These findings suggest that HDT and auto-HCT is an effective treatment in patients with GZL. Our findings ideally require confirmation in a larger cohort of patients, preferably in the setting of large prospective multicenter randomized controlled trials. However, we acknowledge that such studies could be difficult to conduct in patients with GZL owing to the disease's rarity. Alternatively, a multicenter prospective study that includes tissue banking and a data registry is warranted to help better understand the biology and natural history of the disease.
KW - Autologous hematopoietic cell transplantation
KW - Gray zone lymphoma
KW - High-dose therapy
UR - http://www.scopus.com/inward/record.url?scp=85044870952&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044870952&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2017.11.033
DO - 10.1016/j.bbmt.2017.11.033
M3 - Article
C2 - 29225164
AN - SCOPUS:85044870952
SN - 1083-8791
VL - 24
SP - 486
EP - 493
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 3
ER -