Long-term survival benefits from nonmyeloablative allogeneic hematopoietic cell transplantation (HCT) were observed in patients with relapsed mantle cell lymphoma (MCL), including refractory disease and multiple relapses, according to an article published online in the journal Cancer.
In this study, 70 patients with MCL were evaluated, including 33 patients from an initial study who had an extended follow-up (median, 10 years).
Results showed the 5-year incidence of nonrelapse mortality was 28%, while the relapse rate was 26%. The 5-year overall survival (OS) rate was 55% and the progression-free survival (PFS) rate was 46%. Furthermore, the 10-year OS rate was 44%, while the 10-year PFS rate was 41%.
The OS rates at 5 (51% vs. 58%) and 10 (43% vs. 45%) years were comparable among patients with relapsed or refractory disease and patients who underwent transplantation with partial or complete remission, despite the increased rate of relapse (HR, 2.94; P=0.05) associated with the presence of relapsed or refractory disease at the time of HCT.
At the time of last follow-up, 80% of patients who survived were off immunosuppression.
The authors revealed the only independent factor that predicted worse OS (HR, 2.32; P=0.02) was a high-risk cytomegalovirus (CMV) status. PFS (HR, 2.22; P =0.03) was predicted by the high-risk CMV status and low CD3 dose.
Vaughn, J. E., Sorror, M. L., Storer, B. E., Chauncey, T. R., Pulsipher, M. A., Maziarz, R. T., Maris, M. B., Hari, P., Laport, G. G., Franke, G. N., Agura, E. D., Langston, A. A., Rezvani, A. R., Storb, R., Sandmaier, B. M. and Maloney, D. G.