Allogeneic stem cell transplantation for mantle cell lymphoma—update of the prospective trials of the East German Study Group Hematology/Oncology (OSHO#60 and #74)
Mantle cell lymphoma (MCL) is a non-Hodgkin’s lymphoma with an often aggressive course, incurable by chemotherapy. Consolidation with high-dose therapy and autologous stem cell transplantation (autoSCT) has a low transplant-related mortality but does not lead to a survival plateau. Allogeneic stem c...
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| Veröffentlicht in: | Annals of hematology 2021-06, Vol.100 (6), p.1569-1577 |
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| creator | Krüger, William H. Hirt, Carsten Basara, Nadezda Sayer, Herbert G. Behre, Gerhard Fischer, Thomas Grobe, Norbert Maschmeyer, Georg Neumann, Thomas Schneidewind, Laila Niederwieser, Dietger Dölken, Gottfried Schmidt, Christian A. |
| description | Mantle cell lymphoma (MCL) is a non-Hodgkin’s lymphoma with an often aggressive course, incurable by chemotherapy. Consolidation with high-dose therapy and autologous stem cell transplantation (autoSCT) has a low transplant-related mortality but does not lead to a survival plateau. Allogeneic stem cell transplantation (alloSCT) is associated with a higher early mortality, but can cure MCL. To investigate alloSCT for therapy of MCL, we conducted two prospective trials for de novo MCL (OSHO#74) and for relapsed or refractory MCL (OSHO#60). Fifteen and 24 patients were recruited, respectively. Induction was mainly R-DHAP alternating with R-CHOP. Conditioning was either Busulfan/Cyclophosphamide or Treosulfan/Fludarabin. Either HLA-identical siblings or matched-unrelated donors with not more than one mismatch were allowed. ATG was mandatory in mismatched or unrelated transplantation. Progression-free survival (PFS) was 62% and overall survival (OS) was 68% after 16.5-year follow-up. Significant differences in PFS and OS between both trials were not observed. Patients below 56 years and patients after myeloablative conditioning had a better outcome compared to patients of the corresponding groups. Nine patients have died between day +8 and 5.9 years after SCT. Data from 7 long-term surviving patients showed an excellent Quality-of-life (QoL) after alloSCT. AlloSCT for MCL delivers excellent long-term survival data. The early mortality is higher than after autoSCT; however, the survival curves after alloSCT indicate the curative potential of this therapy. AlloSCT is a standard of care for all feasible patients with refractory or relapsed MCL and should offer to selected patients with de novo MCL and a poor risk profile. For defining the position of alloSCT in the therapeutic algorithm of MCL therapy, a randomized comparison of autoSCT and alloSCT is mandatory. |
| doi_str_mv | 10.1007/s00277-021-04506-y |
| format | Article |
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Consolidation with high-dose therapy and autologous stem cell transplantation (autoSCT) has a low transplant-related mortality but does not lead to a survival plateau. Allogeneic stem cell transplantation (alloSCT) is associated with a higher early mortality, but can cure MCL. To investigate alloSCT for therapy of MCL, we conducted two prospective trials for de novo MCL (OSHO#74) and for relapsed or refractory MCL (OSHO#60). Fifteen and 24 patients were recruited, respectively. Induction was mainly R-DHAP alternating with R-CHOP. Conditioning was either Busulfan/Cyclophosphamide or Treosulfan/Fludarabin. Either HLA-identical siblings or matched-unrelated donors with not more than one mismatch were allowed. ATG was mandatory in mismatched or unrelated transplantation. Progression-free survival (PFS) was 62% and overall survival (OS) was 68% after 16.5-year follow-up. Significant differences in PFS and OS between both trials were not observed. Patients below 56 years and patients after myeloablative conditioning had a better outcome compared to patients of the corresponding groups. Nine patients have died between day +8 and 5.9 years after SCT. Data from 7 long-term surviving patients showed an excellent Quality-of-life (QoL) after alloSCT. AlloSCT for MCL delivers excellent long-term survival data. The early mortality is higher than after autoSCT; however, the survival curves after alloSCT indicate the curative potential of this therapy. AlloSCT is a standard of care for all feasible patients with refractory or relapsed MCL and should offer to selected patients with de novo MCL and a poor risk profile. For defining the position of alloSCT in the therapeutic algorithm of MCL therapy, a randomized comparison of autoSCT and alloSCT is mandatory.</description><identifier>ISSN: 0939-5555</identifier><identifier>ISSN: 1432-0584</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-021-04506-y</identifier><identifier>PMID: 33829299</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Cyclophosphamide - therapeutic use ; Disease-Free Survival ; Doxorubicin - therapeutic use ; Female ; Germany - epidemiology ; Graft vs Host Disease - etiology ; Hematology ; Humans ; Lymphoma ; Lymphoma, Mantle-Cell - epidemiology ; Lymphoma, Mantle-Cell - therapy ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Oncology ; Original ; Original Article ; Prednisone - therapeutic use ; Progression-Free Survival ; Prospective Studies ; Quality of Life ; Rituximab - therapeutic use ; Stem cell transplantation ; Stem Cell Transplantation - adverse effects ; Stem Cell Transplantation - methods ; Stem cells ; Transplantation Conditioning - methods ; Transplantation, Homologous - adverse effects ; Transplantation, Homologous - methods ; Transplants & implants ; Vincristine - therapeutic use</subject><ispartof>Annals of hematology, 2021-06, Vol.100 (6), p.1569-1577</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-ed6333fb944f2a4d0b7bd5464a90b06430bd3a4369409a98cf509f34b4a908ef3</citedby><cites>FETCH-LOGICAL-c474t-ed6333fb944f2a4d0b7bd5464a90b06430bd3a4369409a98cf509f34b4a908ef3</cites><orcidid>0000-0003-3427-3632</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00277-021-04506-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00277-021-04506-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,778,782,883,27911,27912,41475,42544,51306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33829299$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Krüger, William H.</creatorcontrib><creatorcontrib>Hirt, Carsten</creatorcontrib><creatorcontrib>Basara, Nadezda</creatorcontrib><creatorcontrib>Sayer, Herbert G.</creatorcontrib><creatorcontrib>Behre, Gerhard</creatorcontrib><creatorcontrib>Fischer, Thomas</creatorcontrib><creatorcontrib>Grobe, Norbert</creatorcontrib><creatorcontrib>Maschmeyer, Georg</creatorcontrib><creatorcontrib>Neumann, Thomas</creatorcontrib><creatorcontrib>Schneidewind, Laila</creatorcontrib><creatorcontrib>Niederwieser, Dietger</creatorcontrib><creatorcontrib>Dölken, Gottfried</creatorcontrib><creatorcontrib>Schmidt, Christian A.</creatorcontrib><title>Allogeneic stem cell transplantation for mantle cell lymphoma—update of the prospective trials of the East German Study Group Hematology/Oncology (OSHO#60 and #74)</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><addtitle>Ann Hematol</addtitle><description>Mantle cell lymphoma (MCL) is a non-Hodgkin’s lymphoma with an often aggressive course, incurable by chemotherapy. Consolidation with high-dose therapy and autologous stem cell transplantation (autoSCT) has a low transplant-related mortality but does not lead to a survival plateau. Allogeneic stem cell transplantation (alloSCT) is associated with a higher early mortality, but can cure MCL. To investigate alloSCT for therapy of MCL, we conducted two prospective trials for de novo MCL (OSHO#74) and for relapsed or refractory MCL (OSHO#60). Fifteen and 24 patients were recruited, respectively. Induction was mainly R-DHAP alternating with R-CHOP. Conditioning was either Busulfan/Cyclophosphamide or Treosulfan/Fludarabin. Either HLA-identical siblings or matched-unrelated donors with not more than one mismatch were allowed. ATG was mandatory in mismatched or unrelated transplantation. Progression-free survival (PFS) was 62% and overall survival (OS) was 68% after 16.5-year follow-up. Significant differences in PFS and OS between both trials were not observed. Patients below 56 years and patients after myeloablative conditioning had a better outcome compared to patients of the corresponding groups. Nine patients have died between day +8 and 5.9 years after SCT. Data from 7 long-term surviving patients showed an excellent Quality-of-life (QoL) after alloSCT. AlloSCT for MCL delivers excellent long-term survival data. The early mortality is higher than after autoSCT; however, the survival curves after alloSCT indicate the curative potential of this therapy. AlloSCT is a standard of care for all feasible patients with refractory or relapsed MCL and should offer to selected patients with de novo MCL and a poor risk profile. For defining the position of alloSCT in the therapeutic algorithm of MCL therapy, a randomized comparison of autoSCT and alloSCT is mandatory.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Cyclophosphamide - therapeutic use</subject><subject>Disease-Free Survival</subject><subject>Doxorubicin - therapeutic use</subject><subject>Female</subject><subject>Germany - epidemiology</subject><subject>Graft vs Host Disease - etiology</subject><subject>Hematology</subject><subject>Humans</subject><subject>Lymphoma</subject><subject>Lymphoma, Mantle-Cell - epidemiology</subject><subject>Lymphoma, Mantle-Cell - therapy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Prednisone - therapeutic use</subject><subject>Progression-Free Survival</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Rituximab - therapeutic use</subject><subject>Stem cell transplantation</subject><subject>Stem Cell Transplantation - adverse effects</subject><subject>Stem Cell Transplantation - methods</subject><subject>Stem cells</subject><subject>Transplantation Conditioning - methods</subject><subject>Transplantation, Homologous - adverse effects</subject><subject>Transplantation, Homologous - methods</subject><subject>Transplants & implants</subject><subject>Vincristine - therapeutic use</subject><issn>0939-5555</issn><issn>1432-0584</issn><issn>1432-0584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9ks1u1DAQxyMEokvhBTggS3tpD6ETfyTxBamq2l2kSnsonC0nmeymSuxgO5Vy60PwCrwYT4K325aPA77Y1v83f8-MJ0neZ_AxAyjOPAAtihRolgIXkKfzi2SRcUZTECV_mSxAMpmKuI6SN97fAmS05PR1csRYSSWVcpH8OO97u0WDXU18wIHU2PckOG382GsTdOisIa11ZIi3Hg96Pw_jzg765_33aWx0QGJbEnZIRmf9iHXo7jCadLr3T8ql9oGs0EUbchOmZiYrZ6eRrHHQwcYc5rONqR8O5GRzs94scyDaNGRZ8NO3yas2euG7x_04-Xp1-eVinV5vVp8vzq_Tmhc8pNjkjLG2kpy3VPMGqqJqBM-5llBBzhlUDdOc5ZKD1LKsWwGyZbzaAyW27Dj5dPAdp2rApkYTO9Gr0XWDdrOyulN_K6bbqa29U2WW5ZSW0eDk0cDZbxP6oIbO71umDdrJKyoyoJyDoBFd_oPe2smZWF6kqCilAFFEih6oOnbWO2yfk8lA7adAHaZAxSlQD1Og5hj04c8ynkOevj0C7AD4KJktut9v_8f2F16BwOI</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Krüger, William H.</creator><creator>Hirt, Carsten</creator><creator>Basara, Nadezda</creator><creator>Sayer, Herbert G.</creator><creator>Behre, Gerhard</creator><creator>Fischer, Thomas</creator><creator>Grobe, Norbert</creator><creator>Maschmeyer, Georg</creator><creator>Neumann, Thomas</creator><creator>Schneidewind, Laila</creator><creator>Niederwieser, Dietger</creator><creator>Dölken, Gottfried</creator><creator>Schmidt, Christian A.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3427-3632</orcidid></search><sort><creationdate>20210601</creationdate><title>Allogeneic stem cell transplantation for mantle cell lymphoma—update of the prospective trials of the East German Study Group Hematology/Oncology (OSHO#60 and #74)</title><author>Krüger, William H. ; Hirt, Carsten ; Basara, Nadezda ; Sayer, Herbert G. ; Behre, Gerhard ; Fischer, Thomas ; Grobe, Norbert ; Maschmeyer, Georg ; Neumann, Thomas ; Schneidewind, Laila ; Niederwieser, Dietger ; Dölken, Gottfried ; Schmidt, Christian A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-ed6333fb944f2a4d0b7bd5464a90b06430bd3a4369409a98cf509f34b4a908ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krüger, William H.</au><au>Hirt, Carsten</au><au>Basara, Nadezda</au><au>Sayer, Herbert G.</au><au>Behre, Gerhard</au><au>Fischer, Thomas</au><au>Grobe, Norbert</au><au>Maschmeyer, Georg</au><au>Neumann, Thomas</au><au>Schneidewind, Laila</au><au>Niederwieser, Dietger</au><au>Dölken, Gottfried</au><au>Schmidt, Christian A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Allogeneic stem cell transplantation for mantle cell lymphoma—update of the prospective trials of the East German Study Group Hematology/Oncology (OSHO#60 and #74)</atitle><jtitle>Annals of hematology</jtitle><stitle>Ann Hematol</stitle><addtitle>Ann Hematol</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>100</volume><issue>6</issue><spage>1569</spage><epage>1577</epage><pages>1569-1577</pages><issn>0939-5555</issn><issn>1432-0584</issn><eissn>1432-0584</eissn><abstract>Mantle cell lymphoma (MCL) is a non-Hodgkin’s lymphoma with an often aggressive course, incurable by chemotherapy. Consolidation with high-dose therapy and autologous stem cell transplantation (autoSCT) has a low transplant-related mortality but does not lead to a survival plateau. Allogeneic stem cell transplantation (alloSCT) is associated with a higher early mortality, but can cure MCL. To investigate alloSCT for therapy of MCL, we conducted two prospective trials for de novo MCL (OSHO#74) and for relapsed or refractory MCL (OSHO#60). Fifteen and 24 patients were recruited, respectively. Induction was mainly R-DHAP alternating with R-CHOP. Conditioning was either Busulfan/Cyclophosphamide or Treosulfan/Fludarabin. Either HLA-identical siblings or matched-unrelated donors with not more than one mismatch were allowed. ATG was mandatory in mismatched or unrelated transplantation. Progression-free survival (PFS) was 62% and overall survival (OS) was 68% after 16.5-year follow-up. Significant differences in PFS and OS between both trials were not observed. Patients below 56 years and patients after myeloablative conditioning had a better outcome compared to patients of the corresponding groups. Nine patients have died between day +8 and 5.9 years after SCT. Data from 7 long-term surviving patients showed an excellent Quality-of-life (QoL) after alloSCT. AlloSCT for MCL delivers excellent long-term survival data. The early mortality is higher than after autoSCT; however, the survival curves after alloSCT indicate the curative potential of this therapy. AlloSCT is a standard of care for all feasible patients with refractory or relapsed MCL and should offer to selected patients with de novo MCL and a poor risk profile. For defining the position of alloSCT in the therapeutic algorithm of MCL therapy, a randomized comparison of autoSCT and alloSCT is mandatory.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33829299</pmid><doi>10.1007/s00277-021-04506-y</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-3427-3632</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Annals of hematology, 2021-06, Vol.100 (6), p.1569-1577 |
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| subjects | Adult Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Cyclophosphamide - therapeutic use Disease-Free Survival Doxorubicin - therapeutic use Female Germany - epidemiology Graft vs Host Disease - etiology Hematology Humans Lymphoma Lymphoma, Mantle-Cell - epidemiology Lymphoma, Mantle-Cell - therapy Male Medicine Medicine & Public Health Middle Aged Mortality Oncology Original Original Article Prednisone - therapeutic use Progression-Free Survival Prospective Studies Quality of Life Rituximab - therapeutic use Stem cell transplantation Stem Cell Transplantation - adverse effects Stem Cell Transplantation - methods Stem cells Transplantation Conditioning - methods Transplantation, Homologous - adverse effects Transplantation, Homologous - methods Transplants & implants Vincristine - therapeutic use |
| title | Allogeneic stem cell transplantation for mantle cell lymphoma—update of the prospective trials of the East German Study Group Hematology/Oncology (OSHO#60 and #74) |
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