Abstract
We performed a retrospective multicenter study including 140 patients with relapsed/refractory (R/R) diffuse large B cell lymphoma (DLBCL) who underwent allogeneic hematopoietic stem cell transplantation (allo-SCT) from March 1995 to November 2018. Our objective was to analyze long term outcomes. Seventy-four percent had received a previous auto-SCT (ASCT) and the median number of lines pre-allo-SCT was 3 (range 1–9). Three year-event free survival (EFS) and overall survival (OS) were 38% and 44%, respectively. Non-relapse mortality (NRM) at day 100 was 19%. Cumulative incidence of grade III–IV acute graft versus host disease (GVHD) at day 100 was 16% and moderate/severe chronic GVHD at 3 years 34%. Active disease at allo-SCT (HR 1.95, p = 0.039) (HR 2.19, p = 0.019), HCT-CI ≥ 2 (2.45, p = 0.002) (HR 2.33, p = 0.006) and donor age >37 years (HR 2.75, p = 0.014) (HR 1.98, p = 0.043) were the only independent variables both for PFS and OS, respectively. NRM was significantly modified by HCT-CI ≥ 2 (HR 4.8, p = 0.008), previous ASCT (HR 4.4, p = 0.048) and grade III–IV acute GVHD on day 100 (HR 6.13, p = 0.016). Our data confirmed that allo-SCT is a curative option for patients with R/R DLBCL, displaying adequate results for fit patients with chemosensitive disease receiving an allo-SCT from a young donor.
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We thank Ángel Cedillo for his contribution in obtaining the clinical data of the paper.
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LB and DC performed the research. LB, AG, SN, JM, JLP, LLC, MC, GG, MO, MB, ND, AP, RH, CF, ISO, IGC, PH, NR, GR, CM, LY, JZ, MRV, TZ, OLG, IH, IEM, CM, AS, JAPS, CS, AS, JS, AC and DC contributed to clinical data. LB, AG and DC contributed to the analysis and data interpretation. Statistical analysis was performed by AG. All authors contributed to review, provided their comments on this paper and approval the final version.
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Bento, L., Gutiérrez, A., Novelli, S. et al. Allogeneic stem cell transplantation as a curative option in relapse/refractory diffuse large B cell lymphoma: Spanish multicenter GETH/GELTAMO study. Bone Marrow Transplant 56, 1919–1928 (2021). https://doi.org/10.1038/s41409-021-01264-3
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DOI: https://doi.org/10.1038/s41409-021-01264-3
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