Autologous stem cell transplantation for primary mediastinal B-cell lymphoma: long-term outcome and role of post-transplant radiotherapy. A report of the European Society for Blood and Marrow Transplantation
Irit Avivi
(1)
,
Ariane Boumendil
(2, 3)
,
Hervé Finel
(3)
,
Arnon Nagler
(2, 4)
,
Aïda Botelho de Sousa
(5)
,
Josep Maria Ribera Santasusana
(6, 7)
,
Elizabeth Vandenberghe
(8)
,
Peter Afanasyev
(9)
,
Dominique Bordessoule
(10)
,
José Maria Moraleda
(11)
,
Eulogio Conde Garcia
(12)
,
David Pohlreich
(13)
,
Gonzalo Gutiérrez Garcia
(14)
,
Kirsty Thomson
(15)
,
Reuven Or
(16)
,
Dietrich Beelen
(17, 18)
,
Eliana Zuffa
(19)
,
Sebastian Giebel
(20)
,
Christian Berthou
(21)
,
Gilles Salles
(22)
,
Angela Melpignano
(23)
,
Silvia Montoto
(3, 24)
,
Peter Dreger
(25, 3)
,
Boris Afanasyev
(26)
1
Tel Aviv Sourasky Medical Center [Tel Aviv]
2 CHU Saint-Antoine [AP-HP]
3 EBMT - Lymphoma Working Party, Paris
4 The Chaim Sheba Medical Center [Tel Hashomer, Israel]
5 Hospital de St. António dos Capuchos
6 Jose Carreras Research Institute
7 Hospital Universitario Germans Trias I Pujol
8 St. Jame's Hospital
9 First Pavlov State Medical University of St. Petersburg [Russian Federation]
10 CHU Limoges
11 Hospital Clínico Universitario Virgen de la Arrixaca = University Hospital Virgen de la Arrixaca [Murcia]
12 Hospital Universitario Marqués de Valdecilla [Santander]
13 Charles University Hospital
14 Hospital Clinic [Barcelona, Spain]
15 UCL - University College of London [London]
16 Hadassah Hebrew University Medical Center [Jerusalem]
17 Dept. of Bone Marrow Transplantation
18 AöR - University Hospital Essen
19 Unita Operativa di Ematologia, Ravenna
20 Cancer Center Gliwice
21 CHU-Brest-Hemato - CHRU Brest - Service d'Hématologie
22 Service d’Hématologie [Centre Hospitalier Lyon Sud - HCL]
23 A. Perrino Hospital
24 St Bartholomew's and The London Hospital
25 Department of Medicine V
26 SPb State I. Pavlov
2 CHU Saint-Antoine [AP-HP]
3 EBMT - Lymphoma Working Party, Paris
4 The Chaim Sheba Medical Center [Tel Hashomer, Israel]
5 Hospital de St. António dos Capuchos
6 Jose Carreras Research Institute
7 Hospital Universitario Germans Trias I Pujol
8 St. Jame's Hospital
9 First Pavlov State Medical University of St. Petersburg [Russian Federation]
10 CHU Limoges
11 Hospital Clínico Universitario Virgen de la Arrixaca = University Hospital Virgen de la Arrixaca [Murcia]
12 Hospital Universitario Marqués de Valdecilla [Santander]
13 Charles University Hospital
14 Hospital Clinic [Barcelona, Spain]
15 UCL - University College of London [London]
16 Hadassah Hebrew University Medical Center [Jerusalem]
17 Dept. of Bone Marrow Transplantation
18 AöR - University Hospital Essen
19 Unita Operativa di Ematologia, Ravenna
20 Cancer Center Gliwice
21 CHU-Brest-Hemato - CHRU Brest - Service d'Hématologie
22 Service d’Hématologie [Centre Hospitalier Lyon Sud - HCL]
23 A. Perrino Hospital
24 St Bartholomew's and The London Hospital
25 Department of Medicine V
26 SPb State I. Pavlov
Ariane Boumendil
- Fonction : Auteur
- PersonId : 908804
Arnon Nagler
- Fonction : Auteur
- PersonId : 973523
Josep Maria Ribera Santasusana
- Fonction : Auteur
- PersonId : 973521
Gilles Salles
- Fonction : Auteur
- PersonId : 765692
- ORCID : 0000-0002-9541-8666
- IdRef : 067204236
Silvia Montoto
- Fonction : Auteur
- PersonId : 897371
Peter Dreger
- Fonction : Auteur
- PersonId : 762540
- ORCID : 0000-0002-7429-8570
Résumé
The purpose of this retrospective registry study was to investigate the outcome of autoSCT for primary mediastinal B-cell lymphoma (PMBCL) in the rituximab era, including the effects of eventual post-transplant radiotherapy (RT) consolidation. Patients with PMBCL aged between 18 and 70 years who were treated with a first autoSCT between 2000 and 2012 and registered with the EBMT were eligible. Eighty-six patients with confirmed PMBCL and the full data set required for this analysis were evaluable. Sixteen patients underwent autoSCT in remission after first-line therapy (CR/PR1), 44 patients were transplanted with chemosensitive relapsed or primary refractory disease (CR/PR >1), and 24 patients were chemorefractory at the time of autoSCT. With a median follow-up of 5 years, 3-year estimates of relapse incidence, progression-free survival, and overall survival were 6%, 94%, and 100% for CR/PR1; 31%, 64%, and 85% for CR/PR >1; and 52%, 39%, and 41% for REF, respectively. Whilst there was no significant benefit of post-transplant RT in the CR/PR >1 group, RT could completely prevent disease recurrence post d100 in the refractory group. In conclusion, autoSCT with or without consolidating RT is associated with excellent outcome in chemoimmunotherapy-sensitive PMBCL, whereas its benefits seem to be limited in chemoimmunotherapy-refractory disease.