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02.03.2024 | Original Article

Allogeneic stem cell transplantation and CAR-T in B-cell Non-Hodgkin Lymphoma: a two-center experience and review of the literature

verfasst von: Santiago Mercadal, Alberto Mussetti, Catherine J. Lee, Carolina Arevalo, Silvina M. Odstrcil, Esteban Peña, Anna Sureda, Daniel R. Couriel

Erschienen in: Annals of Hematology | Ausgabe 5/2024

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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is still a potentially curative option for B-cell Non-Hodgkin Lymphoma (B-NHL) in the modern immunotherapy era. The objective of this study was to analyze long-term outcomes of patients with B-NHL who received allo-HSCT. We analyzed overall survival (OS), progression-free survival (PFS) and graft versus host disease (GVHD) relapse-free survival (GRFS) in 53 patients undergoing allo-HSCT from two institutions. The median follow-up of the study was 72 months (range 29–115 months). The median number of lines of therapy before allo-HSCT was 3 (range 1–6) and twenty-eight patients (53%) had received a previous autologous transplant. The 3-year PFS, OS and GRFS were 55%, 63%, and 55%, respectively. One-year non-relapse mortality was 26%. Karnofsky Performance Scale < 90 was associated with worse OS in multivariable analysis. A non-comparative analysis of a cohort of 44 patients with similar characteristics who received chimeric antigen receptor T-cell therapy was done, showing a 1-year PFS and OS were 60% and 66%, respectively. Our data shows that allo-HSCT is still a useful option for treating selected patients with R/R B-NHL. Our retrospective analysis and review of the literature demonstrate that allo-HSCT can provide durable remissions in a subset of patients with R/R B-NHL.

Epperla N, Hamadani M (2017) Hematopoietic cell transplantation for diffuse large B-cell and follicular lymphoma: Current controversies and advances. Hematol Oncol Stem Cell Ther 10(4):30040–30047. https://doi.org/10.1016/j.hemonc.2017.05.004CrossRef

Schuster SJ, Bishop MR, Tam CS, Waller EK, Borchmann P, McGuirk JP et al (2019) tisagenlecleucel in adult relapsed or refractory diffuse large B-cell lymphoma. N Engl J Med 380:45–56. https://doi.org/10.1056/NEJMoa1804980CrossRefPubMed

Neelapu SS, Locke FL, Bartlett NL, Lekakis LJ, Miklos DB, Jacobson CA et al (2017) Axicabtagene ciloleucel CAR T-cell therapy in refractory large B-cell lymphoma. N Engl J Med 377:2531–2544. https://doi.org/10.1056/NEJMoa1707447CrossRefPubMedPubMedCentral

Dreger P, Fenske TS, Montoto S, Pasquini MC, Sureda A, Hamadani M et al (2020) Cellular immunotherapy for refractory diffuse large B cell lymphoma in the chimeric antigen receptor-engineered T cell era: still a role for allogeneic transplantation? Biol Blood Marrow Transplant. https://doi.org/10.1016/j.bbmt.2019.12.771CrossRefPubMedPubMedCentral

Peniket AJ, Ruiz de Elvira MC, Taghipour G, Cordonnier C, Gluckman E, De Witte T et al (2003) An EBMT registry matched study of allogeneic stem cell transplants for lymphoma: allogeneic transplantation is associated with a lower relapse rate but a higher procedure-related mortality rate than autologous transplantation. Bone Marrow Transplant 31(8):667–678. https://doi.org/10.1038/sj.bmt.1703891CrossRefPubMed

Reddy NM, Oluwole O, Greer JP, Engelhardt BG, Jagasia MH, Savani BN et al (2014) Outcomes of autologous or allogeneic stem cell transplantation for non-Hodgkin lymphoma. Exp Hematol 42(1):39–45. https://doi.org/10.1016/j.exphem.2013.09.012CrossRefPubMed

Tomaszewska A, Jagasia M, Beohou E, van der Werf S, Blaise D, Kanfer E et al (2021) Addition of rituximab in reduced intensity conditioning regimens for B-cell malignancies does not influence transplant outcomes: EBMT registry analyses following allogeneic stem cell transplantation for B-cell malignancies. Front Immunol 2(11):613954. https://doi.org/10.3389/fimmu.2020.613954CrossRef

McClune BL, Ahn KW, Wang HL, Antin JH, Artz AS, Cahn JY et al (2014) Allotransplantation for patients age ≥40 years with non-Hodgkin lymphoma: encouraging progression-free survival. Biol Blood Marrow Transplant 20(7):960–968. https://doi.org/10.1016/j.bbmt.2014.03.013CrossRefPubMedPubMedCentral

Dodero A, Patriarca F, Milone G, Sarina B, Miceli R, Lori A et al (2017) Allogeneic stem cell transplantation for relapsed/refractory B cell lymphomas: results of a multicenter phase II prospective trial including rituximab in the reduced-intensity conditioning regimen. Biol Blood Marrow Transplant 23(7):1102–1109. https://doi.org/10.1016/j.bbmt.2017.03.031CrossRefPubMed

10.

Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2014) STROBE initiative. Int J Surg 12(12):1495–1499. https://doi.org/10.1016/j.ijsu.2014.07.013CrossRef

11.

Fenske TS, Ahn KW, Graff TM, DiGilio A, Bashir Q et al (2016) Allogeneic transplantation provides durable remission in a subset of DLBCL patients relapsing after autologous transplantation. Br J Haematol 174(2):235–248. https://doi.org/10.1111/bjh.14046CrossRefPubMedPubMedCentral

12.

Lazarus HM, Zhang MJ, Carreras J, Lattin BM, Ataergin AS, Bitran JD et al (2010) A comparison of HLA-identical sibling allogeneic versus autologous transplantation for diffuse large B cell lymphoma: a report from the CIBMTR. Biol Blood Marrow Transplant 16(1):35–45. https://doi.org/10.1016/j.bbmt.2009.08.011CrossRefPubMed

13.

Bacher U, Klyuchnikov E, Le-Rademacher J, Carreras J, Armand P, Bishop MR et al (2012) Conditioning regimens for allotransplants for diffuse large B-cell lymphoma: myeloablative or reduced intensity? Blood 120(20):4256–4262. https://doi.org/10.1182/blood-2012-06-436725CrossRefPubMedPubMedCentral

14.

Hamadani M, Saber W, Ahn KW, Carreras J, Cairo MS, Fenske TS et al (2013) Impact of pre transplantation conditioning regimens on outcomes of allogeneic transplantation for chemotherapy-unresponsive diffuse large B cell lymphoma and grade III follicular lymphoma. Biol Blood Marrow Transplant 19(5):746–753. https://doi.org/10.1016/j.bbmt.2013.01.024CrossRefPubMedPubMedCentral

15.

Robinson SP, Boumendil A, Finel H, Blaise D, Poiré X, Nicolas-Virelizier E et al (2016) Autologous stem cell transplantation for relapsed/refractory diffuse large B-cell lymphoma: efficacy in the rituximab era and comparison to first allogeneic transplants. A report from the EBMT Lymphoma Working Party. Bone Marrow Transplant. 51(3):365–71. https://doi.org/10.1038/bmt.2015.286CrossRefPubMed

16.

Kampen RJ, Canals C, Schouten HS, Nagler A, Thomson KJ, Vernant JP et al (2011) Allogeneic stem-cell transplantation as salvage therapy for patients with diffuse large B-cell non-Hodgkin’s lymphoma relapsing after an autologous stem-cell transplantation: an analysis of the European Group for Blood and Marrow Transplantation Registry. J Clin Oncol 29(10):1342–1348. https://doi.org/10.1200/JCO.2010.30.2596CrossRefPubMed

17.

Rigacci L, Puccini B, Dodero A, Iacopino P, Castagna L, Bramanti S et al (2012) Allogeneic hematopoietic stem cell transplantation in patients with diffuse large B cell lymphoma relapsed after autologous stem cell transplantation: a GITMO study. Ann Hematol 91(6):931–939. https://doi.org/10.1007/s00277-011-1395-9CrossRefPubMed

18.

Bento L, Gutiérrez A, Novelli S, Montoro J, Piñana JL, López-Corral L et al (2021) 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(8):1919–1928. https://doi.org/10.1038/s41409-021-01264-3CrossRefPubMed

19.

Sirvent A, Dhedin N, Michallet M, Mounier N, Faucher C, Yakoub-Agha I et al (2010) Low nonrelapse mortality and prolonged long-term survival after reduced-intensity allogeneic stem cell transplantation for relapsed or refractory diffuse large B cell lymphoma: report of the Société Française de Greffe de Moelle et de Thérapie Cellulaire. Biol Blood Marrow Transplant 16(1):78–85. https://doi.org/10.1016/j.bbmt.2009.09.002CrossRefPubMed

20.

Sureda A, Zhang MJ, Dreger P, Carreras J, Fenske T, Finel H et al (2018) Allogeneic hematopoietic stem cell transplantation for relapsed follicular lymphoma: A combined analysis on behalf of the Lymphoma Working Party of the EBMT and the Lymphoma Committee of the CIBMTR. Cancer 124(8):1733–1742. https://doi.org/10.1002/cncr.31264CrossRefPubMed

21.

Epperla N, Ahn KW, Armand P, Jaglowski S, Ahmed S, Kenkre VP et al (2018) Fludarabine and busulfan versus fludarabine, cyclophosphamide, and rituximab as reduced-intensity conditioning for transplantation in follicular lymphoma. Biol Blood Marrow Transplant 24(1):78–85. https://doi.org/10.1016/j.bbmt.2017.10.011CrossRefPubMed

22.

Laport GG, Wu J, Logan B, Bachanova V, Hosing C, Fenske T et al (2016) Reduced-intensity conditioning with fludarabine, cyclophosphamide, and high-dose rituximab for allogeneic hematopoietic cell transplantation for follicular lymphoma: a phase two multicenter trial from the blood and marrow transplant clinical trials network. Biol Blood Marrow Transplant 22(8):1440–1448. https://doi.org/10.1016/j.bbmt.2016.04.014CrossRefPubMedPubMedCentral

23.

Robinson SP, Canals C, Luang JJ, Tilly H, Crawley C, Cahn JY et al (2013) The outcome of reduced intensity allogeneic stem cell transplantation and autologous stem cell transplantation when performed as a first transplant strategy in relapsed follicular lymphoma: an analysis from the Lymphoma Working Party of the EBMT. Bone Marrow Transplant 48(11):1409–1414. https://doi.org/10.1038/bmt.2013.83CrossRefPubMed

24.

Evens A, Vanderplas A, LaCasce AS, Crosby AL, Nademanee AP, Kaminski MS et al (2014) Stem cell transplantation for follicular lymphoma relapsed/refractory after prior rituximab: a comprehensive analysis from the NCCN lymphoma outcomes project. Exp Hematol 42(1):39–45. https://doi.org/10.1016/j.exphem.2013.09.012CrossRef

25.

Klyuchnikov E, Bacher U, Kröger NM, Hari PN, Ahn KW, Carreras J et al (2015) Reduced intensity allografting as first transplantation approach in relapsed/refractory grades one and two follicular lymphoma provides improved outcomes in long-term survivors. Biol Blood Marrow Transplant 21(12):2091–2099. https://doi.org/10.1016/j.bbmt.2015.07.028CrossRefPubMedPubMedCentral

26.

Robinson SP, Boumendil A, Finel H, Peggs KS, Chevallier P, Sierra J et al (2018) Long-term outcome analysis of reduced-intensity allogeneic stem cell transplantation in patients with mantle cell lymphoma: a retrospective study from the EBMT Lymphoma Working Party. Bone Marrow Transplant 53(5):617–624. https://doi.org/10.1038/s41409-017-0067-3CrossRefPubMed

27.

Yamasaki S, Chihara D, Kim SW, Izutsu K, Iwato K, Fukuda T et al (2018) Impact of hematopoietic stem cell transplantation in patients with relapsed or refractory mantle cell lymphoma. Ann Hematol 97(8):1445–1452. https://doi.org/10.1007/s00277-018-3318-5CrossRefPubMed

28.

Arcari A, Morello L, Vallisa D, Marcheselli L, Tecchio C, Quaglia FM et al (2021) Allogeneic stem cell transplantation in patients with mantle cell lymphoma: results from the MANTLE-FIRST study on behalf of Fondazione Italiana Linfomi. Leuk Lymphoma 62(14):3474–3483. https://doi.org/10.1080/10428194.2021.1961238CrossRefPubMed

29.

Gutierrez A, Bento L, Novelli S, Martin A, Gutierrez G, Salas MQ et al (2022) Allogeneic stem cell transplantation in mantle cell lymphoma; insights into its potential role in the era of new immunotherapeutic and targeted therapies: The GETH/GELTAMO experience. Cancers (Basel) 14(11):2673. https://doi.org/10.3390/cancers14112673CrossRefPubMed

30.

Le Gouill S, Kröger N, Dhedin N, Nagler A, Bouabdallah K, Yakoub-Agha I et al (2012) Reduced intensity conditioning allogeneic stem cell transplantation for relapsed/refractory mantle cell lymphoma: a multicenter experience. Ann Oncol 23(10):2695–2703. https://doi.org/10.1093/annonc/mds054CrossRefPubMed

31.

Hamadani M, Saber W, Woo Ahn K, Carreras J, Cairo MS, Fenske TS et al (2013) Allogeneic hematopoietic cell transplantation for chemotherapy-unresponsive mantle cell lymphoma: a cohort analysis from the center for international blood and marrow transplant research. Biol Blood Marrow Transplant 19(4):625–631. https://doi.org/10.1016/j.bbmt.2013.01.009CrossRefPubMedPubMedCentral

32.

Fenske TS, Zhang MJ, Carreras J, Ayala E, Burns LJ, Cashen A et al (2014) Autologous or reduced-intensity conditioning allogeneic hematopoietic cell transplantation for chemotherapy-sensitive mantle-cell lymphoma: analysis of transplantation timing and modality. J Clin Oncol. 32(4):273–81. https://doi.org/10.1200/JCO.2013.49.2454CrossRefPubMed

33.

Munshi PN, Hamadani M, Kumar A, Dreger P, Friedberg JW, Dreyling M et al (2021) ASTCT, CIBMTR, and EBMT clinical practice recommendations for transplant and cellular therapies in mantle cell lymphoma. Bone Marrow Transplant 56(12):2911–2921. https://doi.org/10.1038/s41409-021-01288-9CrossRefPubMedPubMedCentral

34.

Jain T, Bar M, Kansagra AJ, Chong EA, Hashmi SK, Neelapu SS et al (2019) Use of chimeric antigen receptor T cell therapy in clinical practice for relapsed/refractory aggressive B cell non-hodgkin lymphoma: an expert panel opinion from the american society for transplantation and cellular therapy. Biol Blood Marrow Transpl 25:2305–2321. https://doi.org/10.1016/j.bbmt.2019.08.015CrossRef

35.

Dreger P (2021) Allogeneic stem cell transplant in non-Hodgkin lymphomas: Still an indication? Hematol Oncol 39(Suppl 1):100–103. https://doi.org/10.1002/hon.2845CrossRefPubMed

36.

Zurko JC, Ramdial J, Shadman M, Ahmed S, Szabo A, Lovino L et al (2022) Allogeneic hematopoietic cell transplantation for relapsed/refractory large B-cell lymphoma after CAR T-cell therapy failure. Tandem Meetings 2022, Abstract 8

37.

Dholaria B, Savani BN, Huang XJ, Nagler A, Perales MA, Mohty M et al (2021) The evolving role of allogeneic haematopoietic cell transplantation in the era of chimaeric antigen receptor T-cell therapy. Br J Haematol 193(6):1060–1075. https://doi.org/10.1111/bjh.17460CrossRefPubMed

38.

Mussetti A, Bento L, Bastos-Oreiro M, Sansalvador BR, Albo C, Bailen R et al (2023) Role of allogeneic hematopoietic cell transplant for relapsed/refractory aggressive B-cell lymphomas in the CART era. Bone Marrow Transplant. https://doi.org/10.1038/s41409-023-01949-xCrossRefPubMed

Titel: Allogeneic stem cell transplantation and CAR-T in B-cell Non-Hodgkin Lymphoma: a two-center experience and review of the literature
verfasst von: Santiago Mercadal
Alberto Mussetti
Catherine J. Lee
Carolina Arevalo
Silvina M. Odstrcil
Esteban Peña
Anna Sureda
Daniel R. Couriel
Publikationsdatum: 02.03.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Annals of Hematology / Ausgabe 5/2024
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-024-05677-0

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