@article{dd51dc1c6b214e8589b7a4420c89d78e,
title = "Autologous stem cell transplantation for untreated transformed indolent B-cell lymphoma in first remission: an international, multi-centre propensity-score-matched study",
abstract = "High-dose chemotherapy (HDC) and autologous stem cell transplantation (ASCT) are used as consolidation in first remission (CR1) in some centres for untreated, transformed indolent B-cell lymphoma (Tr-iNHL) but the evidence base is weak. A total of 319 patients with untreated Tr-iNHL meeting prespecified transplant eligibility criteria [age <75, LVEF ≥45%, no severe lung disease, CR by positron emission tomography or computed tomography ≥3 months after at least standard cyclophosphamide, doxorubicin, vincristine and prednisolone with rituximab (R-CHOP) intensity front-line chemotherapy] were retrospectively identified. Non-diffuse large B-cell lymphoma transformations were excluded. About 283 (89%) patients had follicular lymphoma, 30 (9%) marginal-zone lymphoma and six (2%) other subtypes. Forty-nine patients underwent HDC/ASCT in CR1, and a 1:2 propensity-score-matched cohort of 98 patients based on age, stage and high-grade B-cell lymphoma with MYC, BCL2 and/or BCL6 rearrangements (HGBL-DH) was generated. After a median follow-up of 3·7 (range 0·1–18·3) years, ASCT was associated with significantly superior progression-free survival [hazard ratio (HR) 0·51, 0·27–0·98; P = 0·043] with a trend towards inferior overall survival (OS; HR 2·36;0·87–6·42; P = 0·1) due to more deaths from progressive disease (8% vs. 4%). Forty (41%) patients experienced relapse in the non-ASCT cohort — 15 underwent HDC/ASCT with seven (47%) ongoing complete remission (CR); 10 chimeric antigen receptor-modified T-cell (CAR-T) therapy with 6 (60%) ongoing CR; 3 allogeneic SCT with 2 (67%) ongoing CR. Although ASCT in CR1 improves initial duration of disease control in untreated Tr-iNHL, the impact on OS is less clear with effective salvage therapies in this era of CAR-T.",
keywords = "autologous stem cell transplantation, indolent lymphoma, non-Hodgkin lymphoma, transformed lymphoma",
author = "Chin, {C. K.} and Lim, {K. J.} and K. Lewis and P. Jain and Y. Qing and L. Feng and Cheah, {C. Y.} and Seymour, {J. F.} and D. Ritchie and K. Burbury and Tam, {C. S.} and Fowler, {N. H.} and Fayad, {L. E.} and Westin, {J. R.} and Neelapu, {S. S.} and Hagemeister, {F. B.} and F. Samaniego and Flowers, {C. R.} and Nastoupil, {L. J.} and Dickinson, {M. J.}",
note = "Funding Information: This work was supported in part by the Cancer Center Support Grant (CCSG) at UT MD Anderson Cancer Center. Funding Information: CKC, KJL, PJ, YQ, LF, KB, LEF, FS, LEF and FBH: no conflict of interest. KLL: has received honoraria from Roche; has received travel expenses from Janssen, Novartis. CYC: has received consulting/advisory/honoraria from Roche, Janssen, MSD, Gilead, Ascentage Pharma, Acerta, Loxo Oncology, TG Therapeutics; has received research funding from Celgene, Roche, AbbVie; has received travel expenses from Roche. JFS: has received research support from AbbVie, Celgene, Janssen and Roche; has served as consultant and advisory board member for AbbVie, Acerta Pharma, Janssen, Roche, Sunesis Pharmaceuticals and Takeda; Speaker{\textquoteright}s Bureau for AbbVie, Celgene and Roche; has received honoraria from AbbVie, Acerta Pharma, Janssen, Roche, Sunesis Pharmaceuticals and Takeda; has received travel expenses from AbbVie and Roche. DR: has received research support from Amgen, Bristol‐Myers Squibb, Takeda, Beigene and Imago; has served as consultant and advisory board member for Amgen and Pfizer; has received honoraria from Amgen, Novartis and Sanofi. CT: has received research support from Janssen‐Cilag and AbbVie; has served as consultant and advisory board member for Janssen, Loxo, Roche, BeiGene and AbbVie; has received honoraria from Janssen‐Cilag, AbbVie, Novartis, Beigene and Pharmacyclics. NF: has received research support from Celgene, Roche, Janssen, TG Therapeutics and AbbVie; has served as consultant and advisory board member for Celgene, Roche, Janssen, TG Therapeutics and AbbVie. JW: has received research support from Novartis, Celgene, Janssen, Kite/Gilead, Unum, Genentech, Curis and 47 Inc; has served as consultant and advisory board member for Novartis, Celgene, Juno, Janssen, Kite/Gilead, MorphoSys, Genentech and Curis. SSN: has received research support from Kite/Gilead, Cellectis, Poseida, Merck, Acerta, Karus, BMS, Unum Therapeutics, Allogene, and Precision Biosciences; has served as consultant and advisory board member for Kite/Gilead, Celgene, Novartis, Unum Therapeutics, Pfizer, Merck, Precision Biosciences, Cell Medica, Incyte, Allogene, Calibr, and Legend Biotech; has patents related to cell therapy. CF: has received research support from AbbVie, Acerta Pharma, Celgene, Gilead Sciences, Infinity Pharmaceuticals, Janssen Pharmaceuticals, Millennium/Takeda, National Institutes of Health, Onyx Pharmaceuticals, Pharmacyclics and Spectrum Pharmaceuticals; has served as consultant and advisory board member for Spectrum Pharmaceuticals, Celgene, Optum Rx, Seattle Genetics, Kite/Gilead and Bayer. LN: has received research support from TG Therapeutics, Janssen, Genentech and Celgene; has served as consultant and advisory board member for TG Therapeutics, Novartis, Janssen, Spectrum Pharmaceuticals, Kite/Gilead, Genentech, Bayer and Celgene. MD: has received research support from Celgene, GSK, Takeda and Novartis; has served as consultant or advisory board member for Roche, GSK, Janssen and Takeda. Celgene, Gilead Sciences and Novartis; has served as a speaker for Roche, Novartis, Janssen, Takeda and Gilead Sciences. Publisher Copyright: {\textcopyright} 2020 British Society for Haematology and John Wiley & Sons Ltd Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",
year = "2020",
month = dec,
doi = "10.1111/bjh.17072",
language = "English (US)",
volume = "191",
pages = "806--815",
journal = "British Journal of Haematology",
issn = "0007-1048",
publisher = "Wiley-Blackwell",
number = "5",
}