Allogeneic haematopoietic cell transplantation offers the chance of cure for patients with transformed follicular lymphoma

  • Frank Heinzelmann
  • Wolfgang Bethge
  • Dietrich Wilhelm Beelen
  • Matthias Stelljes
  • Peter Dreger
  • Marianne Engelhard
  • Jürgen Finke
  • Nikolaus Kröger
  • Ernst Holler
  • Martin Bornhäuser
  • Annerose Müller
  • Imme Haubitz
  • Hellmut Ottinger
Original Article – Clinical Oncology
  • 45 Downloads

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.

Keywords

Allogeneic HCT Transformed follicular lymphoma Prognostic factors Cure 

Notes

Acknowledgements

The authors would like to thank Franziska Hanke, Helga Neidlinger, and Karin Fuchs, who are the data managers of the DRST, and to all local data managers of the participating transplant units. Last but not least, thanks to all local as well as reference pathologists for their valuable support of this study. The DRST is/has been supported by grants from the “Deutsche Krebshilfe e.V.”, “Deutsche Jose-Carreras Leukämie Stiftung e.V.”, “DKMS”, and “Alfred and Angelika Gutermuth-Stiftung”.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Frank Heinzelmann
    • 1
  • Wolfgang Bethge
    • 2
  • Dietrich Wilhelm Beelen
    • 3
  • Matthias Stelljes
    • 4
  • Peter Dreger
    • 5
  • Marianne Engelhard
    • 6
  • Jürgen Finke
    • 7
  • Nikolaus Kröger
    • 8
  • Ernst Holler
    • 9
  • Martin Bornhäuser
    • 10
  • Annerose Müller
    • 1
  • Imme Haubitz
    • 11
  • Hellmut Ottinger
    • 3
  1. 1.Department of Radiation OncologyUniversity Hospital (UH) of TübingenTübingenGermany
  2. 2.Department of Internal Medicine IIUniversity Hospital of TübingenTübingenGermany
  3. 3.Department of Bone Marrow TransplantationUniversity Hospital of EssenEssenGermany
  4. 4.Department of Bone Marrow TransplantationUniversity Hospital of MünsterMünsterGermany
  5. 5.Department of Medicine VUniversity Hospital of HeidelbergHeidelbergGermany
  6. 6.Department of RadiotherapyUniversity Hospital of EssenEssenGermany
  7. 7.Department of Hematology and OncologyUniversity Hospital of FreiburgFreiburgGermany
  8. 8.Clinic for Stem Cell TransplantationUniversity Hospital of Hamburg (UKE)HamburgGermany
  9. 9.Department of Hematology and OncologyUniversity Hospital of RegensburgRegensburgGermany
  10. 10.Department of Internal Medicine IUniversity Hospital of DresdenDresdenGermany
  11. 11.Data Processing CenterUniversity of WürzburgWürzburgGermany

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