Outcomes after allogeneic hematopoietic stem cell transplantation for adults with primary mediastinal B cell lymphoma: a SFGM-TC and LYSA study. (2nd November 2022)

• Record Type: Journal Article
• Authors: Le Calvez, Baptiste; Tessoullin, Benoit; Renaud, Loïc; Botella-Garcia, Carmen; Srour, Micha; Le Gouill, Steven; Guillerm, Gaelle; Gressin, Rémy; Nguyen Quoc, Stéphanie; Furst, Sabine; Chauchet, Adrien; Sibon, David; Lewalle, Philippe; Poiré, Xavier; Maillard, Natacha; Villate, Alban; Loschi, Michael; Paillassa, Jérôme; Beguin, Yves; Dulery, Rémy; Tudesq, Jean-Jacques; Fayard, Amandine; Béné, Marie C.; Camus, Vincent; Chevallier, Patrice; Le Bourgeois, Amandine
• Is Part Of: Acta oncologica. Volume 61:Number 11(2022)
• Page Start: 1332
• Page End: 1338
• Publication Date: 2022-11-02
• Subjects: Allogeneic stem cell transplantation -- primary mediastinal B cell lymphoma -- non Hodgkin lymphoma -- lymphoma; Oncology -- Periodicals; Cancer -- Treatment -- Periodicals; 616.992
• DOI: 10.1080/0284186X.2022.2130709
• Languages: English
• ISSNs: 0284-186X

Abstract

Abstract: Background: Despite therapeutic progress, 10 to 30% of adult patients with primary mediastinal B cell lymphoma (PMBCL) are primary refractory or experience early relapse (R/R). Allogeneic stem cell transplantation (allo-HSCT) thus remains a potentially curative option in this setting. Material and Methods: In this multicenter retrospective study, the outcomes of 33 French and Belgian adult patients allo-transplanted for R/R PMBCL between January 1999 and December 2018, were examined. Results: At allo-HSCT time, patients had received a median of 3 treatment lines, 50% of them were in complete response, 40% in partial response and 10% had a progressive disease. Forty-two percent of the donors were siblings and 39% matched related. The median follow-up for alive patients was 78 months (3.5–157). Considering the whole cohort, 2-year overall survival (OS), progression free survival (PFS) and graft-versus-host disease-free/relapse-free survival (GRFS) were 48% (95%CI: 33–70), 47% (95%CI: 33–68) and 38.5% (95%CI: 25–60) respectively. Cumulative incidence of relapse and non-relapse mortality rates were respectively 34% (95%CI: 18–50) and 18% (95%CI: 7–34). Disease status at transplant was the only factor predicting survivals, patients with progressive disease showing significant lower 2-year PFS (HR: 6.12, 95%CI: 1.32–28.31, p = 0.02) and OS (HR: 7.04, 95%CI: 1.52–32.75, p = 0.013). A plateau was observed for OS and PFS after 4 years with 10 patients alive after this date, suggesting that almost one third of the patients effectively salvaged and undergoing allo-SCT could be cured. Conclusion: This study indicates that allo-HSCT is a valid therapeutic option for R/R PMBCL, providing durable remissions.