NYMC Faculty Publications

Outcomes of Hematopoietic Cell Transplantation for Diffuse Large B Cell Lymphoma Transformed from Follicular Lymphoma

Author Type(s)

Faculty

DOI

10.1016/j.bbmt.2014.03.014

Journal Title

Biology of Blood and Marrow Transplantation

First Page

951

Last Page

959

Document Type

Article

Publication Date

7-1-2014

Department

Pediatrics

Keywords

Adult, Aged, Disease-Free Survival, Female, Hematopoietic Stem Cell Transplantation, Humans, Lymphoma, Follicular, Lymphoma, Large B-Cell, Diffuse, Male, Middle Aged, Proportional Hazards Models, Survival Analysis, Transplantation Conditioning, Transplantation, Homologous, Treatment Outcome, Young Adult

Disciplines

Medicine and Health Sciences

Abstract

There are limited data on the outcomes of autologous or allogeneic hematopoietic cell transplantation (HCT) in diffuse large B cell lymphoma transformed from follicular lymphoma. We analyzed transplantation outcomes in 141 subjects with biopsy-proven diffuse large B-cell lymphoma transformed from follicular lymphoma reported to the Center for International Blood and Marrow Transplant Research between 1990 and 2009. Two groups were identified: autologous HCT (auto-HCT; n = 108) and allogeneic HCT (allo-HCT; n = 33). Fewer auto-HCTs were done for transformed follicular lymphoma in 2003 to 2009, with a shift favoring allo-HCT. Auto-HCT was associated with a 1-year nonrelapse mortality (NRM) of 8% (95% confidence interval [CI], 4% to 14%), 5-year progression-free survival of 35% (95% CI, 26% to 45%), and 5-year overall survival of 50% (95% CI, 40% to 59%). In contrast, allo-HCT was associated with a 1-year NRM of 41% (95% CI, 23% to 58%), 5-year progression-free survival of 18% (95% CI, 6% to 35%), and 5-year overall survival of 22% (95% CI, 8% to 41%). Auto-HCT for transformed follicular lymphoma achieves sustained remission in a high proportion of subjects. The high NRM of allo-HCT offset any benefit that might be associated with this transplantation modality.

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