A Comparison of HLA-Identical Sibling Allogeneic versus Autologous Transplantation for Diffuse Large B Cell Lymphoma: A Report from the CIBMTR

Hillard M. Lazarus, Mei Jie Zhang, Jeanette Carreras, Brandon M. Hayes-Lattin, Asli Selmin Ataergin, Jacob D. Bitran, Brian J. Bolwell, César O. Freytes, Robert Peter Gale, Steven C. Goldstein, Gregory A. Hale, David J. Inwards, Thomas R. Klumpp, David I. Marks, Richard T. Maziarz, Philip L. McCarthy, Santiago Pavlovsky, J. Douglas Rizzo, Thomas C. Shea, Harry C. SchoutenShimon Slavin, Jane N. Winter, Koen van Besien, Julie M. Vose, Parameswaran N. Hari

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Abstract

We compared outcomes of 916 diffuse large B cell lymphoma (DLBCL) patients aged ≥18 years undergoing first autologous (n = 837) or myeloablative (MA) allogeneic hematopoietic cell transplant (HCT) (n = 79) between 1995 and 2003 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Median follow-up was 81 months for allogeneic HCT versus 60 months for autologous HCT. Allogeneic HCT recipients were more likely to have high-risk disease features including higher stage, more prior chemotherapy regimens, and resistant disease. Allogeneic HCT was associated with a higher 1 year treatment-related mortality (TRM) (relative risk [RR] 4.88, 95% confidence interval [CI], 3.21-7.40, P < .001), treatment failure (RR 2.06, 95% CI, 1.54-2.75, P < .001), and mortality (RR 2.75, 95% CI, 2.03-3.72, P < .001). Risk of disease progression was similar in the 2 groups (RR 1.12, 95% CI, 0.73-1.72, P = .59). In fact, for 1-year survivors, no significant differences were observed for TRM, progression, progression-free (PFS) or overall survival (OS). Increased risks of TRM and mortality were associated with older age (>50 years), lower performance score, chemoresistance, and earlier year of transplant. In a cohort of mainly high-risk DLBCL patients, upfront MA allogeneic HCT, although associated with increased early mortality, was associated with a similar risk of disease progression compared to lower risk patients receiving autologous HCT.

Original languageEnglish (US)
Pages (from-to)35-45
Number of pages11
JournalBiology of Blood and Marrow Transplantation
Volume16
Issue number1
DOIs
StatePublished - Jan 1 2010

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Keywords

  • Allogeneic transplantation
  • Hodgkin lymphoma
  • Unrelated

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Lazarus, H. M., Zhang, M. J., Carreras, J., Hayes-Lattin, B. M., Ataergin, A. S., Bitran, J. D., Bolwell, B. J., Freytes, C. O., Gale, R. P., Goldstein, S. C., Hale, G. A., Inwards, D. J., Klumpp, T. R., Marks, D. I., Maziarz, R. T., McCarthy, P. L., Pavlovsky, S., Rizzo, J. D., Shea, T. C., ... Hari, P. N. (2010). A Comparison of HLA-Identical Sibling Allogeneic versus Autologous Transplantation for Diffuse Large B Cell Lymphoma: A Report from the CIBMTR. Biology of Blood and Marrow Transplantation, 16(1), 35-45. https://doi.org/10.1016/j.bbmt.2009.08.011