TY - JOUR
T1 - Allogeneic haematopoietic cell transplant in patients with relapsed/refractory anaplastic large cell lymphoma
AU - Furqan, Fateeha
AU - Ahn, Kwang W.
AU - Chen, Yue
AU - Kaur, Manmeet
AU - Abutalib, Syed A.
AU - Ahmed, Nausheen
AU - Ahmed, Sairah
AU - Kharfan-Dabaja, Mohamed A.
AU - Friedberg, Johnathan
AU - Gregory, Tara
AU - Hill, La Quisa
AU - Sterling, Cole
AU - Barta, Stephan K.
AU - Shadman, Mazyar
AU - Perales, Miguel Angel
AU - Zain, Jasmine
AU - Herrera, Alex F.
AU - Sauter, Craig
AU - Hamadani, Mehdi
N1 - Publisher Copyright:
© 2022 British Society for Haematology and John Wiley & Sons Ltd.
PY - 2023/1
Y1 - 2023/1
N2 - The prognosis of relapsed/refractory (R/R) anaplastic large cell lymphoma (ALCL) is poor. Large studies evaluating outcomes of allogeneic haematopoietic cell transplantation (allo-HCT) in systemic R/R ALCL are not available. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we evaluated outcomes of 182 adults (aged ≥18 years) with R/R ALCL undergoing allo-HCT between 2008 and 2019. Non-relapse mortality (NRM), disease relapse/progression (REL), progression-free survival (PFS), and overall survival (OS) were modelled using Cox proportional hazards models. The median (range) follow-up of survivors was 62 (3–148) months. The 1-year NRM was 18%. The 5-year REL, PFS and OS were 32%, 41% and 56% respectively. On multivariable regression analysis African American race (hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.6–4.8; p < 0.001) and refractory disease at allo-HCT (HR 3.2, 95% CI 1.6–6.2; p < 0.001) were predictive of inferior OS. Similarly, African-American race (HR 2.1, 95% CI 1.3–3.4; p = 0.003), other minority race (HR 2.5, 95% CI 1.2–5.3; p = 0.02) and refractory disease (HR 2.2, 95% CI 1.2–4.3; p = 0.01) were predictive of inferior PFS. These data, demonstrate that allo-HCT can result in durable disease control in a sizable proportion of patients with R/R ALCL. Refractory disease and racial minority status predicted inferior allo-HCT outcomes. Whether the inferior outcomes of racial minorities with R/R ALCL after allo-HCT are driven by differences in disease biology or disparities in post allo-HCT care, or both, requires further investigation.
AB - The prognosis of relapsed/refractory (R/R) anaplastic large cell lymphoma (ALCL) is poor. Large studies evaluating outcomes of allogeneic haematopoietic cell transplantation (allo-HCT) in systemic R/R ALCL are not available. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we evaluated outcomes of 182 adults (aged ≥18 years) with R/R ALCL undergoing allo-HCT between 2008 and 2019. Non-relapse mortality (NRM), disease relapse/progression (REL), progression-free survival (PFS), and overall survival (OS) were modelled using Cox proportional hazards models. The median (range) follow-up of survivors was 62 (3–148) months. The 1-year NRM was 18%. The 5-year REL, PFS and OS were 32%, 41% and 56% respectively. On multivariable regression analysis African American race (hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.6–4.8; p < 0.001) and refractory disease at allo-HCT (HR 3.2, 95% CI 1.6–6.2; p < 0.001) were predictive of inferior OS. Similarly, African-American race (HR 2.1, 95% CI 1.3–3.4; p = 0.003), other minority race (HR 2.5, 95% CI 1.2–5.3; p = 0.02) and refractory disease (HR 2.2, 95% CI 1.2–4.3; p = 0.01) were predictive of inferior PFS. These data, demonstrate that allo-HCT can result in durable disease control in a sizable proportion of patients with R/R ALCL. Refractory disease and racial minority status predicted inferior allo-HCT outcomes. Whether the inferior outcomes of racial minorities with R/R ALCL after allo-HCT are driven by differences in disease biology or disparities in post allo-HCT care, or both, requires further investigation.
KW - allogeneic transplantation
KW - anaplastic large cell lymphoma
KW - graft versus leukaemia
KW - graft-versus-host disease
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U2 - 10.1111/bjh.18467
DO - 10.1111/bjh.18467
M3 - Article
C2 - 36120837
AN - SCOPUS:85138249429
SN - 0007-1048
VL - 200
SP - 54
EP - 63
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 1
ER -