Autologous or Allogeneic Stem Cell Transplantation in Patients with Waldenstrom's Macroglobulinemia

Athanasios Anagnostopoulos, Parameswaran N. Hari, Waleska S. Pérez, Karen Ballen, Asad Bashey, Christopher N. Bredeson, César O. Freytes, Robert Peter Gale, Morie A. Gertz, John Gibson, Hartmut Goldschmidt, Hillard M. Lazarus, Philip L. McCarthy, Donna E. Reece, David H. Vesole, Sergio A. Giralt

Research output: Contribution to journalArticle

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Abstract

The role of hematopoietic stem cell transplantation (SCT) in Waldenstrom's macroglobulinemia (WM) has not been extensively studied. To determine the potential for long-term disease control using SCT in WM, we performed a retrospective review of 36 patients with WM who received autologous (n = 10) or allogeneic (n = 26) SCT and were reported to the Center for International Blood and Marrow Transplant Research between 1986 and 2002. The following outcomes were described: nonrelapse mortality (NRM), relapse, progression-free survival (PFS), and overall survival (OS). Median age at the time of SCT was 51 years (range, 30-76 years), and median time from initial treatment to SCT was 29 months (range, 2-198 months). A total of 78% of the patients had 2 or more previous chemotherapy regimens, and 52% had disease resistant to salvage chemotherapy. In the allogeneic SCT group, 58% of the patients received myeloablative conditioning regimens containing total body irradiation (TBI), and of the allograft recipients, 19% received nonmyeloablative/reduced-intensity conditioning. After a median follow-up of 65 months, 15 of the 36 patients (42%) are alive. Primary disease accounted for 29% of the deaths in the allogeneic SCT group and 25% of the deaths in the autologous SCT group. The relapse rate at 3 years was 29% (95% confidence interval [CI], 14%-48%) in the allogeneic group and 24% (95% CI, 4%-54%) in the autologous group. PFS at 3 years was 31% (95% CI, 14%-50%) in the allogeneic group and 65% (95% CI, 32%-91%) in the autologous group; OS was 46% (95% CI, 27%-65%) in the allogeneic group and 70% (95% CI, 40%-93%) in the autologous group. NRM at 3 years was 40% (95% CI, 23%-59%) in the allogeneic group and 11% (95% CI, 0-36%) in the autologous group. Autologous SCT is a safe and feasible treatment option for patients with WM, especially for those who present with adverse prognostic factors. Allogeneic SCT carries a much higher (40%) risk of NRM and should not be considered outside the context of a clinical trial.

Original languageEnglish (US)
Pages (from-to)845-854
Number of pages10
JournalBiology of Blood and Marrow Transplantation
Volume12
Issue number8
DOIs
StatePublished - Aug 2006

Fingerprint

Waldenstrom Macroglobulinemia
Stem Cell Transplantation
Confidence Intervals
Disease-Free Survival
Mortality
Recurrence
Drug Therapy
Survival
Whole-Body Irradiation
Hematopoietic Stem Cell Transplantation
Allografts
Bone Marrow
Clinical Trials
Transplants

Keywords

  • Allogeneic
  • Autologous
  • Stem cell transplantation
  • Waldenstrom's macroglobulinemia

ASJC Scopus subject areas

  • Transplantation

Cite this

Anagnostopoulos, A., Hari, P. N., Pérez, W. S., Ballen, K., Bashey, A., Bredeson, C. N., ... Giralt, S. A. (2006). Autologous or Allogeneic Stem Cell Transplantation in Patients with Waldenstrom's Macroglobulinemia. Biology of Blood and Marrow Transplantation, 12(8), 845-854. https://doi.org/10.1016/j.bbmt.2006.04.010

Autologous or Allogeneic Stem Cell Transplantation in Patients with Waldenstrom's Macroglobulinemia. / Anagnostopoulos, Athanasios; Hari, Parameswaran N.; Pérez, Waleska S.; Ballen, Karen; Bashey, Asad; Bredeson, Christopher N.; Freytes, César O.; Gale, Robert Peter; Gertz, Morie A.; Gibson, John; Goldschmidt, Hartmut; Lazarus, Hillard M.; McCarthy, Philip L.; Reece, Donna E.; Vesole, David H.; Giralt, Sergio A.

In: Biology of Blood and Marrow Transplantation, Vol. 12, No. 8, 08.2006, p. 845-854.

Research output: Contribution to journalArticle

Anagnostopoulos, A, Hari, PN, Pérez, WS, Ballen, K, Bashey, A, Bredeson, CN, Freytes, CO, Gale, RP, Gertz, MA, Gibson, J, Goldschmidt, H, Lazarus, HM, McCarthy, PL, Reece, DE, Vesole, DH & Giralt, SA 2006, 'Autologous or Allogeneic Stem Cell Transplantation in Patients with Waldenstrom's Macroglobulinemia', Biology of Blood and Marrow Transplantation, vol. 12, no. 8, pp. 845-854. https://doi.org/10.1016/j.bbmt.2006.04.010
Anagnostopoulos, Athanasios ; Hari, Parameswaran N. ; Pérez, Waleska S. ; Ballen, Karen ; Bashey, Asad ; Bredeson, Christopher N. ; Freytes, César O. ; Gale, Robert Peter ; Gertz, Morie A. ; Gibson, John ; Goldschmidt, Hartmut ; Lazarus, Hillard M. ; McCarthy, Philip L. ; Reece, Donna E. ; Vesole, David H. ; Giralt, Sergio A. / Autologous or Allogeneic Stem Cell Transplantation in Patients with Waldenstrom's Macroglobulinemia. In: Biology of Blood and Marrow Transplantation. 2006 ; Vol. 12, No. 8. pp. 845-854.
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abstract = "The role of hematopoietic stem cell transplantation (SCT) in Waldenstrom's macroglobulinemia (WM) has not been extensively studied. To determine the potential for long-term disease control using SCT in WM, we performed a retrospective review of 36 patients with WM who received autologous (n = 10) or allogeneic (n = 26) SCT and were reported to the Center for International Blood and Marrow Transplant Research between 1986 and 2002. The following outcomes were described: nonrelapse mortality (NRM), relapse, progression-free survival (PFS), and overall survival (OS). Median age at the time of SCT was 51 years (range, 30-76 years), and median time from initial treatment to SCT was 29 months (range, 2-198 months). A total of 78{\%} of the patients had 2 or more previous chemotherapy regimens, and 52{\%} had disease resistant to salvage chemotherapy. In the allogeneic SCT group, 58{\%} of the patients received myeloablative conditioning regimens containing total body irradiation (TBI), and of the allograft recipients, 19{\%} received nonmyeloablative/reduced-intensity conditioning. After a median follow-up of 65 months, 15 of the 36 patients (42{\%}) are alive. Primary disease accounted for 29{\%} of the deaths in the allogeneic SCT group and 25{\%} of the deaths in the autologous SCT group. The relapse rate at 3 years was 29{\%} (95{\%} confidence interval [CI], 14{\%}-48{\%}) in the allogeneic group and 24{\%} (95{\%} CI, 4{\%}-54{\%}) in the autologous group. PFS at 3 years was 31{\%} (95{\%} CI, 14{\%}-50{\%}) in the allogeneic group and 65{\%} (95{\%} CI, 32{\%}-91{\%}) in the autologous group; OS was 46{\%} (95{\%} CI, 27{\%}-65{\%}) in the allogeneic group and 70{\%} (95{\%} CI, 40{\%}-93{\%}) in the autologous group. NRM at 3 years was 40{\%} (95{\%} CI, 23{\%}-59{\%}) in the allogeneic group and 11{\%} (95{\%} CI, 0-36{\%}) in the autologous group. Autologous SCT is a safe and feasible treatment option for patients with WM, especially for those who present with adverse prognostic factors. Allogeneic SCT carries a much higher (40{\%}) risk of NRM and should not be considered outside the context of a clinical trial.",
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T1 - Autologous or Allogeneic Stem Cell Transplantation in Patients with Waldenstrom's Macroglobulinemia

AU - Anagnostopoulos, Athanasios

AU - Hari, Parameswaran N.

AU - Pérez, Waleska S.

AU - Ballen, Karen

AU - Bashey, Asad

AU - Bredeson, Christopher N.

AU - Freytes, César O.

AU - Gale, Robert Peter

AU - Gertz, Morie A.

AU - Gibson, John

AU - Goldschmidt, Hartmut

AU - Lazarus, Hillard M.

AU - McCarthy, Philip L.

AU - Reece, Donna E.

AU - Vesole, David H.

AU - Giralt, Sergio A.

PY - 2006/8

Y1 - 2006/8

N2 - The role of hematopoietic stem cell transplantation (SCT) in Waldenstrom's macroglobulinemia (WM) has not been extensively studied. To determine the potential for long-term disease control using SCT in WM, we performed a retrospective review of 36 patients with WM who received autologous (n = 10) or allogeneic (n = 26) SCT and were reported to the Center for International Blood and Marrow Transplant Research between 1986 and 2002. The following outcomes were described: nonrelapse mortality (NRM), relapse, progression-free survival (PFS), and overall survival (OS). Median age at the time of SCT was 51 years (range, 30-76 years), and median time from initial treatment to SCT was 29 months (range, 2-198 months). A total of 78% of the patients had 2 or more previous chemotherapy regimens, and 52% had disease resistant to salvage chemotherapy. In the allogeneic SCT group, 58% of the patients received myeloablative conditioning regimens containing total body irradiation (TBI), and of the allograft recipients, 19% received nonmyeloablative/reduced-intensity conditioning. After a median follow-up of 65 months, 15 of the 36 patients (42%) are alive. Primary disease accounted for 29% of the deaths in the allogeneic SCT group and 25% of the deaths in the autologous SCT group. The relapse rate at 3 years was 29% (95% confidence interval [CI], 14%-48%) in the allogeneic group and 24% (95% CI, 4%-54%) in the autologous group. PFS at 3 years was 31% (95% CI, 14%-50%) in the allogeneic group and 65% (95% CI, 32%-91%) in the autologous group; OS was 46% (95% CI, 27%-65%) in the allogeneic group and 70% (95% CI, 40%-93%) in the autologous group. NRM at 3 years was 40% (95% CI, 23%-59%) in the allogeneic group and 11% (95% CI, 0-36%) in the autologous group. Autologous SCT is a safe and feasible treatment option for patients with WM, especially for those who present with adverse prognostic factors. Allogeneic SCT carries a much higher (40%) risk of NRM and should not be considered outside the context of a clinical trial.

AB - The role of hematopoietic stem cell transplantation (SCT) in Waldenstrom's macroglobulinemia (WM) has not been extensively studied. To determine the potential for long-term disease control using SCT in WM, we performed a retrospective review of 36 patients with WM who received autologous (n = 10) or allogeneic (n = 26) SCT and were reported to the Center for International Blood and Marrow Transplant Research between 1986 and 2002. The following outcomes were described: nonrelapse mortality (NRM), relapse, progression-free survival (PFS), and overall survival (OS). Median age at the time of SCT was 51 years (range, 30-76 years), and median time from initial treatment to SCT was 29 months (range, 2-198 months). A total of 78% of the patients had 2 or more previous chemotherapy regimens, and 52% had disease resistant to salvage chemotherapy. In the allogeneic SCT group, 58% of the patients received myeloablative conditioning regimens containing total body irradiation (TBI), and of the allograft recipients, 19% received nonmyeloablative/reduced-intensity conditioning. After a median follow-up of 65 months, 15 of the 36 patients (42%) are alive. Primary disease accounted for 29% of the deaths in the allogeneic SCT group and 25% of the deaths in the autologous SCT group. The relapse rate at 3 years was 29% (95% confidence interval [CI], 14%-48%) in the allogeneic group and 24% (95% CI, 4%-54%) in the autologous group. PFS at 3 years was 31% (95% CI, 14%-50%) in the allogeneic group and 65% (95% CI, 32%-91%) in the autologous group; OS was 46% (95% CI, 27%-65%) in the allogeneic group and 70% (95% CI, 40%-93%) in the autologous group. NRM at 3 years was 40% (95% CI, 23%-59%) in the allogeneic group and 11% (95% CI, 0-36%) in the autologous group. Autologous SCT is a safe and feasible treatment option for patients with WM, especially for those who present with adverse prognostic factors. Allogeneic SCT carries a much higher (40%) risk of NRM and should not be considered outside the context of a clinical trial.

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KW - Autologous

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KW - Waldenstrom's macroglobulinemia

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