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Lazarus HM , Zhang MJ , Carreras J , Hayes-Lattin BM , Ataergin AS , Bitran JD , Bolwell BJ , Freytes CO , Gale RP , Goldstein SC , Hale GA , Inwards DJ , Klumpp TR , Marks DI , Maziarz RT , McCarthy PL , Pavlovsky S , Rizzo JD , Shea TC , Schouten HC , Slavin S , Winter JN , van Besien K , Vose JM , Hari PN
A Comparison of HLA-Identical Sibling Allogeneic versus Autologous Transplantation for Diffuse Large B Cell Lymphoma: A Report from the CIBMTR
Biology of Blood and Marrow Transplantation. 2010 Jan;16(1) :35-45
PMID: ISI:000276730600003    PMCID: PMC2929576   
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We compared outcomes of 916 diffuse large B cell lymphoma (DLBCL) patients aged >= 18 years undergoing first autologous (n = 837) or myeloablative (MA) allogeneic hematopoietic cell transplant (HCT) (n = 79) between 1995 and 2003 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Median follow-up was 81 months for allogeneic HCT versus 60 months for autologous HCT. Allogeneic HCT recipients were more likely to have high-risk disease features including higher stage, more prior chemotherapy regimens, and resistant disease. Allogeneic HCT was associated with a higher 1 year treatment-related mortality (TRM) (relative risk [RR] 4.88, 95% confidence interval [CI], 3.21-7.40, P < .001), treatment failure (RR 2.06, 95% CI, 1.54-2.75, P < .001), and mortality (RR 2.75, 95% CI, 2.03-3.72, P < .001). Risk of disease progression was similar in the 2 groups (RR 1.12, 95% CI, 0.73-1.72, P = .59). In fact, for 1-year survivors, no significant differences were observed for TRM, progression, progression-free (PFS) or overall survival (OS). Increased risks of TRM and mortality were associated with older age (>50 years), lower performance score, chemoresistance, and earlier year of transplant. In a cohort of mainly high-risk DLBCL patients, upfront MA allogeneic HCT, although associated with increased early mortality, was associated with a similar risk of disease progression compared to lower risk patients receiving autologous HCT. Biol Blood Marrow Transplant 16: 35-45 (2010) (C) 2010 Elsevier Inc.
Lazarus, Hillard M. Zhang, Mei-Jie Carreras, Jeanette Hayes-Lattin, Brandon M. Ataergin, Asli Selmin Bitran, Jacob D. Bolwell, Brian J. Freytes, Cesar O. Gale, Robert Peter Goldstein, Steven C. Hale, Gregory A. Inwards, David J. Klumpp, Thomas R. Marks, David I. Maziarz, Richard T. McCarthy, Philip L. Pavlovsky, Santiago Rizzo, J. Douglas Shea, Thomas C. Schouten, Harry C. Slavin, Shimon Winter, Jane N. van Besien, Koen Vose, Julie M. Hari, Parameswaran N. 47 Elsevier science inc; 360 park ave south, new york, ny 10010-1710 usa 584dm