Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma: A CIBMTR analysis

Narendranath Epperla, Kwang W. Ahn, Carlos Litovich, Sairah Ahmed, Minoo Battiwalla, Jonathon B. Cohen, Parastoo Dahi, Nosha Farhadfar, Umar Farooq, Cesar O. Freytes, Nilanjan Ghosh, Bradley Haverkos, Alex Herrera, Mark Hertzberg, Gerhard Hildebrandt, David Inwards, Mohamed A. Kharfan-Dabaja, Farhad Khimani, Hillard Lazarus, Aleksandr Lazaryan & 13 others Lazaros Lekakis, Hemant Murthy, Sunita Nathan, Taiga Nishihori, Attaphol Pawarode, Tim Prestidge, Praveen Ramakrishnan, Andrew R. Rezvani, Rizwan Romee, Nirav N. Shah, Ana Sureda, Timothy S. Fenske, Mehdi Hamadani

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: There is a paucity of data on the role of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with angioimmunoblastic T-cell lymphoma (AITL). Using the CIBMTR registry, we report here the outcomes of AITL patients undergoing an allo-HCT. Methods: We evaluated 249 adult AITL patients who received their first allo-HCT during 2000-2016. Results: The median patient age was 56 years (range = 21-77). Majority of the patients were Caucasians (86%), with a male predominance (60%). Graft-versus-host disease (GVHD) prophylaxis was predominantly calcineurin inhibitor-based approaches while the most common graft source was peripheral blood (97%). Median follow-up of survivors was 49 months (range = 4-170 months). The cumulative incidence of grade 2-4 and grade 3-4 acute GVHD at day 180 were 36% (95% CI = 30-42) and 12 (95% CI = 8-17), respectively. The cumulative incidence of chronic GVHD at 1 year was 49% (95%CI 43-56). The 1-year non-relapse mortality (NRM) was 19% (95% CI = 14-24), while the 4-year relapse/progression, progression-free survival (PFS), and overall survival (OS) were 21% (95% CI = 16-27), 49% (95% CI = 42-56), and 56% (95% CI = 49-63), respectively. On multivariate analysis, chemoresistant status at the time of allo-HCT was associated with a significantly higher risk for therapy failure (inverse of PFS) (RR = 1.73 95% CI = 1.08-2.77), while KPS < 90% was associated with a significantly higher risk of mortality (inverse of OS) (RR = 3.46 95% CI = 1.75-6.87). Conclusion: Our analysis shows that allo-HCT provides durable disease control even in AITL patients who failed a prior auto-HCT and in those subjects with refractory disease at the time of allografting.

Original languageEnglish (US)
Article number6
JournalJournal of Hematology and Oncology
Volume12
Issue number1
DOIs
StatePublished - Jan 10 2019

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T-Cell Lymphoma
Cell Transplantation
Autografts
Graft vs Host Disease
Disease-Free Survival
Survival
Mortality
Incidence
Homologous Transplantation
Survivors
Registries
Multivariate Analysis
Transplants
Recurrence

Keywords

  • Allogeneic transplantation
  • Angioimmunoblastic T-cell lymphoma
  • GVL effects

ASJC Scopus subject areas

  • Hematology
  • Molecular Biology
  • Oncology
  • Cancer Research

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Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma : A CIBMTR analysis. / Epperla, Narendranath; Ahn, Kwang W.; Litovich, Carlos; Ahmed, Sairah; Battiwalla, Minoo; Cohen, Jonathon B.; Dahi, Parastoo; Farhadfar, Nosha; Farooq, Umar; Freytes, Cesar O.; Ghosh, Nilanjan; Haverkos, Bradley; Herrera, Alex; Hertzberg, Mark; Hildebrandt, Gerhard; Inwards, David; Kharfan-Dabaja, Mohamed A.; Khimani, Farhad; Lazarus, Hillard; Lazaryan, Aleksandr; Lekakis, Lazaros; Murthy, Hemant; Nathan, Sunita; Nishihori, Taiga; Pawarode, Attaphol; Prestidge, Tim; Ramakrishnan, Praveen; Rezvani, Andrew R.; Romee, Rizwan; Shah, Nirav N.; Sureda, Ana; Fenske, Timothy S.; Hamadani, Mehdi.

In: Journal of Hematology and Oncology, Vol. 12, No. 1, 6, 10.01.2019.

Research output: Contribution to journalArticle

Epperla, N, Ahn, KW, Litovich, C, Ahmed, S, Battiwalla, M, Cohen, JB, Dahi, P, Farhadfar, N, Farooq, U, Freytes, CO, Ghosh, N, Haverkos, B, Herrera, A, Hertzberg, M, Hildebrandt, G, Inwards, D, Kharfan-Dabaja, MA, Khimani, F, Lazarus, H, Lazaryan, A, Lekakis, L, Murthy, H, Nathan, S, Nishihori, T, Pawarode, A, Prestidge, T, Ramakrishnan, P, Rezvani, AR, Romee, R, Shah, NN, Sureda, A, Fenske, TS & Hamadani, M 2019, 'Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma: A CIBMTR analysis' Journal of Hematology and Oncology, vol. 12, no. 1, 6. https://doi.org/10.1186/s13045-018-0696-z
Epperla, Narendranath ; Ahn, Kwang W. ; Litovich, Carlos ; Ahmed, Sairah ; Battiwalla, Minoo ; Cohen, Jonathon B. ; Dahi, Parastoo ; Farhadfar, Nosha ; Farooq, Umar ; Freytes, Cesar O. ; Ghosh, Nilanjan ; Haverkos, Bradley ; Herrera, Alex ; Hertzberg, Mark ; Hildebrandt, Gerhard ; Inwards, David ; Kharfan-Dabaja, Mohamed A. ; Khimani, Farhad ; Lazarus, Hillard ; Lazaryan, Aleksandr ; Lekakis, Lazaros ; Murthy, Hemant ; Nathan, Sunita ; Nishihori, Taiga ; Pawarode, Attaphol ; Prestidge, Tim ; Ramakrishnan, Praveen ; Rezvani, Andrew R. ; Romee, Rizwan ; Shah, Nirav N. ; Sureda, Ana ; Fenske, Timothy S. ; Hamadani, Mehdi. / Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma : A CIBMTR analysis. In: Journal of Hematology and Oncology. 2019 ; Vol. 12, No. 1.
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abstract = "Background: There is a paucity of data on the role of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with angioimmunoblastic T-cell lymphoma (AITL). Using the CIBMTR registry, we report here the outcomes of AITL patients undergoing an allo-HCT. Methods: We evaluated 249 adult AITL patients who received their first allo-HCT during 2000-2016. Results: The median patient age was 56 years (range = 21-77). Majority of the patients were Caucasians (86{\%}), with a male predominance (60{\%}). Graft-versus-host disease (GVHD) prophylaxis was predominantly calcineurin inhibitor-based approaches while the most common graft source was peripheral blood (97{\%}). Median follow-up of survivors was 49 months (range = 4-170 months). The cumulative incidence of grade 2-4 and grade 3-4 acute GVHD at day 180 were 36{\%} (95{\%} CI = 30-42) and 12 (95{\%} CI = 8-17), respectively. The cumulative incidence of chronic GVHD at 1 year was 49{\%} (95{\%}CI 43-56). The 1-year non-relapse mortality (NRM) was 19{\%} (95{\%} CI = 14-24), while the 4-year relapse/progression, progression-free survival (PFS), and overall survival (OS) were 21{\%} (95{\%} CI = 16-27), 49{\%} (95{\%} CI = 42-56), and 56{\%} (95{\%} CI = 49-63), respectively. On multivariate analysis, chemoresistant status at the time of allo-HCT was associated with a significantly higher risk for therapy failure (inverse of PFS) (RR = 1.73 95{\%} CI = 1.08-2.77), while KPS < 90{\%} was associated with a significantly higher risk of mortality (inverse of OS) (RR = 3.46 95{\%} CI = 1.75-6.87). Conclusion: Our analysis shows that allo-HCT provides durable disease control even in AITL patients who failed a prior auto-HCT and in those subjects with refractory disease at the time of allografting.",
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TY - JOUR

T1 - Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma

T2 - A CIBMTR analysis

AU - Epperla, Narendranath

AU - Ahn, Kwang W.

AU - Litovich, Carlos

AU - Ahmed, Sairah

AU - Battiwalla, Minoo

AU - Cohen, Jonathon B.

AU - Dahi, Parastoo

AU - Farhadfar, Nosha

AU - Farooq, Umar

AU - Freytes, Cesar O.

AU - Ghosh, Nilanjan

AU - Haverkos, Bradley

AU - Herrera, Alex

AU - Hertzberg, Mark

AU - Hildebrandt, Gerhard

AU - Inwards, David

AU - Kharfan-Dabaja, Mohamed A.

AU - Khimani, Farhad

AU - Lazarus, Hillard

AU - Lazaryan, Aleksandr

AU - Lekakis, Lazaros

AU - Murthy, Hemant

AU - Nathan, Sunita

AU - Nishihori, Taiga

AU - Pawarode, Attaphol

AU - Prestidge, Tim

AU - Ramakrishnan, Praveen

AU - Rezvani, Andrew R.

AU - Romee, Rizwan

AU - Shah, Nirav N.

AU - Sureda, Ana

AU - Fenske, Timothy S.

AU - Hamadani, Mehdi

PY - 2019/1/10

Y1 - 2019/1/10

N2 - Background: There is a paucity of data on the role of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with angioimmunoblastic T-cell lymphoma (AITL). Using the CIBMTR registry, we report here the outcomes of AITL patients undergoing an allo-HCT. Methods: We evaluated 249 adult AITL patients who received their first allo-HCT during 2000-2016. Results: The median patient age was 56 years (range = 21-77). Majority of the patients were Caucasians (86%), with a male predominance (60%). Graft-versus-host disease (GVHD) prophylaxis was predominantly calcineurin inhibitor-based approaches while the most common graft source was peripheral blood (97%). Median follow-up of survivors was 49 months (range = 4-170 months). The cumulative incidence of grade 2-4 and grade 3-4 acute GVHD at day 180 were 36% (95% CI = 30-42) and 12 (95% CI = 8-17), respectively. The cumulative incidence of chronic GVHD at 1 year was 49% (95%CI 43-56). The 1-year non-relapse mortality (NRM) was 19% (95% CI = 14-24), while the 4-year relapse/progression, progression-free survival (PFS), and overall survival (OS) were 21% (95% CI = 16-27), 49% (95% CI = 42-56), and 56% (95% CI = 49-63), respectively. On multivariate analysis, chemoresistant status at the time of allo-HCT was associated with a significantly higher risk for therapy failure (inverse of PFS) (RR = 1.73 95% CI = 1.08-2.77), while KPS < 90% was associated with a significantly higher risk of mortality (inverse of OS) (RR = 3.46 95% CI = 1.75-6.87). Conclusion: Our analysis shows that allo-HCT provides durable disease control even in AITL patients who failed a prior auto-HCT and in those subjects with refractory disease at the time of allografting.

AB - Background: There is a paucity of data on the role of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with angioimmunoblastic T-cell lymphoma (AITL). Using the CIBMTR registry, we report here the outcomes of AITL patients undergoing an allo-HCT. Methods: We evaluated 249 adult AITL patients who received their first allo-HCT during 2000-2016. Results: The median patient age was 56 years (range = 21-77). Majority of the patients were Caucasians (86%), with a male predominance (60%). Graft-versus-host disease (GVHD) prophylaxis was predominantly calcineurin inhibitor-based approaches while the most common graft source was peripheral blood (97%). Median follow-up of survivors was 49 months (range = 4-170 months). The cumulative incidence of grade 2-4 and grade 3-4 acute GVHD at day 180 were 36% (95% CI = 30-42) and 12 (95% CI = 8-17), respectively. The cumulative incidence of chronic GVHD at 1 year was 49% (95%CI 43-56). The 1-year non-relapse mortality (NRM) was 19% (95% CI = 14-24), while the 4-year relapse/progression, progression-free survival (PFS), and overall survival (OS) were 21% (95% CI = 16-27), 49% (95% CI = 42-56), and 56% (95% CI = 49-63), respectively. On multivariate analysis, chemoresistant status at the time of allo-HCT was associated with a significantly higher risk for therapy failure (inverse of PFS) (RR = 1.73 95% CI = 1.08-2.77), while KPS < 90% was associated with a significantly higher risk of mortality (inverse of OS) (RR = 3.46 95% CI = 1.75-6.87). Conclusion: Our analysis shows that allo-HCT provides durable disease control even in AITL patients who failed a prior auto-HCT and in those subjects with refractory disease at the time of allografting.

KW - Allogeneic transplantation

KW - Angioimmunoblastic T-cell lymphoma

KW - GVL effects

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