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Heinzelmann F, Bethge W, Beelen DW, Stelljes M, Dreger P, Engelhard M, Finke J, Kröger N, Holler E, Bornhäuser M, Müller A, Haubitz I, Ottinger H. Allogeneic haematopoietic cell transplantation offers the chance of cure for patients with transformed follicular lymphoma. J Cancer Res Clin Oncol 2018; 144:1173-1183. [PMID: 29623467 DOI: 10.1007/s00432-018-2633-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 03/27/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE In patients with follicular lymphoma, secondary transformation to aggressive lymphoma (tFL) implies a poor prognosis. In principle, allogeneic haematopoietic cell transplantation (allo-HCT) offers a chance of cure for tFL but is rarely practiced. Aim of this retrospective multicenter study was to define the actual significance of allo-HCT in treatment of tFL. METHODS The database of the German Registry for Stem Cell Transplantation (DRST) was screened for patients who underwent allo-HCT for tFL 1998-2008. Confirmation of tFL-diagnosis by local and/or pathologists of the National NHL Board was mandatory for enrolment. Gaps in reported EBMT Minimum Essential Data datasets (MED-A) were filled by local DRST data managers. Relevant HCT outcome variables were evaluated by uni- and multivariate statistical analysis. RESULTS Median age of enrolled 33 patients was 51 years with a post allo-HCT median follow-up of 7.1 years of surviving patients. At time of HCT 24/33 patients had chemosensitive disease. In 24/33 patients reduced intensity conditioning (RIC) was used. Estimated 1, 2, 5-year overall survival (OS) and event-free survival rates were 49/39/33, and 33/30/24%. Cumulative 100 days non-relapse mortality was 25%. Chemosensitive disease, RIC, and limited chronic GvHD were identified as independent prognostic factors for OS. CONCLUSIONS Allo-HCT offers the chance of cure for tFL.
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Affiliation(s)
- Frank Heinzelmann
- Department of Radiation Oncology, University Hospital (UH) of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
| | - Wolfgang Bethge
- Department of Internal Medicine II, University Hospital of Tübingen, Tübingen, Germany
| | | | - Matthias Stelljes
- Department of Bone Marrow Transplantation, University Hospital of Münster, Münster, Germany
| | - Peter Dreger
- Department of Medicine V, University Hospital of Heidelberg, Heidelberg, Germany
| | - Marianne Engelhard
- Department of Radiotherapy, University Hospital of Essen, Essen, Germany
| | - Jürgen Finke
- Department of Hematology and Oncology, University Hospital of Freiburg, Freiburg, Germany
| | - Nikolaus Kröger
- Clinic for Stem Cell Transplantation, University Hospital of Hamburg (UKE), Hamburg, Germany
| | - Ernst Holler
- Department of Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - Martin Bornhäuser
- Department of Internal Medicine I, University Hospital of Dresden, Dresden, Germany
| | - Annerose Müller
- Department of Radiation Oncology, University Hospital (UH) of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Imme Haubitz
- Data Processing Center, University of Würzburg, Würzburg, Germany
| | - Hellmut Ottinger
- Department of Bone Marrow Transplantation, University Hospital of Essen, Essen, Germany
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