Single-Institution Outcomes of 16 Years of Allogeneic HSCT for Lymphoma

By Dustin Samples - September 6, 2023

At the 11th Annual Meeting of the Society of Hematologic Oncology (SOHO), Houston, Texas, researchers from the Princess Margaret Hospital, Toronto, Canada, presented their single-institution results of 116 patients who underwent allogeneic hematopoietic stem-cell transplantation (HSCT) for lymphoma treatment from 2005-2021.

The median follow-up period was 29 months, and the median patient age was 48 years.

At the 2-year mark, overall survival (OS) was 55.5%, transplant-related mortality was observed in 28.1% of cases, and the cumulative incidence of relapse was 21.9%.

At 100 days post-transplant, 52.8% of patients experienced grade II-IV acute GVHD, and 23.7% had grade III-IV acute GVHD. At 2 years post-transplant, 21.8% of patients developed moderate to severe chronic GVHD.

When examining the impact of conditioning intensity on patient outcomes, myeloablative conditioning was associated with a higher risk of grade II-IV acute GVHD (68.2% vs 32.2%) and grade III-IV acute GVHD (31.8% vs 12.8%) compared to other conditioning regimens. However, the effect on grade III-IV acute GVHD was not confirmed when considering multiple factors in a multivariate analysis.

Post-transplant cyclophosphamide (PTCy) showed promise in reducing the risk of grade II-IV and III-IV acute GVHD. Specifically, PTCy was associated with a lower risk of grade II-IV acute GVHD (HR 0.24) and grade III-IV acute GVHD (HR 0.19). However, using PTCy did not have a significant effect on overall survival (OS) or GVHD relapse-free survival (GRFS).

These findings shed light on the complexities and factors affecting outcomes in patients undergoing stem cell transplantation and provide valuable insights for clinicians and researchers.

The authors concluded, “reduced intensity conditioning [is] the preferred conditioning regimen, as it does not compromise OS or GRFS while minimizing treatment-related toxicity. Additionally, PTCy-based GVHD prophylaxis provides excellent GVHD control but does not affect OS or GRFS.”

Reference

Altareb M, Sayyed A, Gerbitz A, et al. Outcomes of Allogeneic Hematopoietic Cell Transplantation (HCT) for Lymphoma Patients: Single-Institution Experience. Abstract CT-343. Presented at the 11th Annual Meeting of the Society of Hematologic Oncology; September 6-9, 2023; Houston, Texas.

Post Tags:SOHO 2023: GVHD
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