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Title: | 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 |
Author: | Gutierrez, Antonio Bento, Leyre Novelli, Silvana Martin, Alejandro Gutierrez, Gonzalo Queralt Salas, Maria Bastos Oreiro, Mariana Perez, Ariadna Hernani, Rafael Cruz Viguria, Maria López Godino, Oriana Montoro, Juan Piñana, José Luis Ferra, Christelle Parody, Rocío Martin, Carmen Español, Ignacio Yañez, Lucrecia Rodriguez, Guillermo Zanabili, Joud Herrera, Pilar Varela, Maria Sampol, Antonia Solano, Carlos Caballero, Dolores On Behalf Of The Grupo Español De Trasplante De Progenitores Hematopoyéticos (geth) And Grupo Español De Linfoma Y Trasplante Autólogo (geltamo) |
Keywords: | Trasplantament d'òrgans Limfomes Transplantation of organs Lymphomas |
Issue Date: | 27-May-2022 |
Publisher: | MDPI |
Abstract: | 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. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/cancers14112673 |
It is part of: | Cancers, 2022, vol. 14, num. 11 |
URI: | https://hdl.handle.net/2445/187061 |
Related resource: | https://doi.org/10.3390/cancers14112673 |
ISSN: | 2072-6694 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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