Efficacy of High-Dose Therapy and Autologous Hematopoietic Cell Transplantation in Gray Zone Lymphoma

A US Multicenter Collaborative Study

Mohamed A. Kharfan-Dabaja*, Renju Raj, Liana Nikolaenko, Sairah Ahmed, Nishitha Reddy, Sunita Nathan, Mohamad Cherry, Najla El-Jurdi, Cynthia Obiozor, Timothy S. Fenske, Joo Song, Tariq Muzzafar, Ernesto Ayala, Bipin Savani, Mohamad Khawandanah, Paolo F. Caimi, Mehdi Hamadani, Stephen J. Forman, Mohamad Hussaini, Marcos de Lima & 6 others Horatiu Olteanu, Bijal Shah, Julio C. Chavez, Monzr Al Malki, Ambuj Kumar, Siddhartha Ganguly

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

High-dose therapy (HDT) and autologous hematopoietic cell transplantation (auto-HCT) has been anecdotally prescribed in gray zone lymphoma (GZL), showing encouraging efficacy. We conducted a multicenter retrospective study aimed at assessing outcomes after auto-HCT in 32 patients with GZL treated at 9 transplantation centers in the United States. The median age of patients at transplantation was 38 years (range, 18 to 70 years), and the majority were male (n = 21; 66%). The median number of lines of therapy before transplantation was 2 (range, 1 to 4). BEAM was the most commonly prescribed regimen (n = 23; 72%). The median duration of follow-up for surviving patients was 34 months (range, 1 to 106 months). Median overall survival (OS) was not reached. The 3-year progression-free survival (PFS) and OS for all patients were 69% and 78%, respectively. Three-year PFS and OS were 100% for patients who received only 1 line of therapy before auto-HCT versus 65% (PFS, P =.25) and 75% (OS, P =.39) for those receiving >1 line. The cumulative incidence of relapse/progression was 4% at 1 year post-transplantation and 31% at 3 years post-transplantation. The 3-year nonrelapse mortality was 0%. These findings suggest that HDT and auto-HCT is an effective treatment in patients with GZL. Our findings ideally require confirmation in a larger cohort of patients, preferably in the setting of large prospective multicenter randomized controlled trials. However, we acknowledge that such studies could be difficult to conduct in patients with GZL owing to the disease's rarity. Alternatively, a multicenter prospective study that includes tissue banking and a data registry is warranted to help better understand the biology and natural history of the disease.

Original languageEnglish (US)
Pages (from-to)486-493
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume24
Issue number3
DOIs
StatePublished - Mar 1 2018

Fingerprint

Cell Transplantation
Multicenter Studies
Lymphoma
Transplantation
Disease-Free Survival
Survival
Therapeutics
Tissue Banks
Registries
Randomized Controlled Trials
Retrospective Studies
Prospective Studies
Recurrence
Mortality
Incidence

Keywords

  • Autologous hematopoietic cell transplantation
  • Gray zone lymphoma
  • High-dose therapy

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Kharfan-Dabaja, Mohamed A. ; Raj, Renju ; Nikolaenko, Liana ; Ahmed, Sairah ; Reddy, Nishitha ; Nathan, Sunita ; Cherry, Mohamad ; El-Jurdi, Najla ; Obiozor, Cynthia ; Fenske, Timothy S. ; Song, Joo ; Muzzafar, Tariq ; Ayala, Ernesto ; Savani, Bipin ; Khawandanah, Mohamad ; Caimi, Paolo F. ; Hamadani, Mehdi ; Forman, Stephen J. ; Hussaini, Mohamad ; de Lima, Marcos ; Olteanu, Horatiu ; Shah, Bijal ; Chavez, Julio C. ; Al Malki, Monzr ; Kumar, Ambuj ; Ganguly, Siddhartha. / Efficacy of High-Dose Therapy and Autologous Hematopoietic Cell Transplantation in Gray Zone Lymphoma : A US Multicenter Collaborative Study. In: Biology of Blood and Marrow Transplantation. 2018 ; Vol. 24, No. 3. pp. 486-493.
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abstract = "High-dose therapy (HDT) and autologous hematopoietic cell transplantation (auto-HCT) has been anecdotally prescribed in gray zone lymphoma (GZL), showing encouraging efficacy. We conducted a multicenter retrospective study aimed at assessing outcomes after auto-HCT in 32 patients with GZL treated at 9 transplantation centers in the United States. The median age of patients at transplantation was 38 years (range, 18 to 70 years), and the majority were male (n = 21; 66{\%}). The median number of lines of therapy before transplantation was 2 (range, 1 to 4). BEAM was the most commonly prescribed regimen (n = 23; 72{\%}). The median duration of follow-up for surviving patients was 34 months (range, 1 to 106 months). Median overall survival (OS) was not reached. The 3-year progression-free survival (PFS) and OS for all patients were 69{\%} and 78{\%}, respectively. Three-year PFS and OS were 100{\%} for patients who received only 1 line of therapy before auto-HCT versus 65{\%} (PFS, P =.25) and 75{\%} (OS, P =.39) for those receiving >1 line. The cumulative incidence of relapse/progression was 4{\%} at 1 year post-transplantation and 31{\%} at 3 years post-transplantation. The 3-year nonrelapse mortality was 0{\%}. These findings suggest that HDT and auto-HCT is an effective treatment in patients with GZL. Our findings ideally require confirmation in a larger cohort of patients, preferably in the setting of large prospective multicenter randomized controlled trials. However, we acknowledge that such studies could be difficult to conduct in patients with GZL owing to the disease's rarity. Alternatively, a multicenter prospective study that includes tissue banking and a data registry is warranted to help better understand the biology and natural history of the disease.",
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Kharfan-Dabaja, MA, Raj, R, Nikolaenko, L, Ahmed, S, Reddy, N, Nathan, S, Cherry, M, El-Jurdi, N, Obiozor, C, Fenske, TS, Song, J, Muzzafar, T, Ayala, E, Savani, B, Khawandanah, M, Caimi, PF, Hamadani, M, Forman, SJ, Hussaini, M, de Lima, M, Olteanu, H, Shah, B, Chavez, JC, Al Malki, M, Kumar, A & Ganguly, S 2018, 'Efficacy of High-Dose Therapy and Autologous Hematopoietic Cell Transplantation in Gray Zone Lymphoma: A US Multicenter Collaborative Study', Biology of Blood and Marrow Transplantation, vol. 24, no. 3, pp. 486-493. https://doi.org/10.1016/j.bbmt.2017.11.033

Efficacy of High-Dose Therapy and Autologous Hematopoietic Cell Transplantation in Gray Zone Lymphoma : A US Multicenter Collaborative Study. / Kharfan-Dabaja, Mohamed A.; Raj, Renju; Nikolaenko, Liana; Ahmed, Sairah; Reddy, Nishitha; Nathan, Sunita; Cherry, Mohamad; El-Jurdi, Najla; Obiozor, Cynthia; Fenske, Timothy S.; Song, Joo; Muzzafar, Tariq; Ayala, Ernesto; Savani, Bipin; Khawandanah, Mohamad; Caimi, Paolo F.; Hamadani, Mehdi; Forman, Stephen J.; Hussaini, Mohamad; de Lima, Marcos; Olteanu, Horatiu; Shah, Bijal; Chavez, Julio C.; Al Malki, Monzr; Kumar, Ambuj; Ganguly, Siddhartha.

In: Biology of Blood and Marrow Transplantation, Vol. 24, No. 3, 01.03.2018, p. 486-493.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Efficacy of High-Dose Therapy and Autologous Hematopoietic Cell Transplantation in Gray Zone Lymphoma

T2 - A US Multicenter Collaborative Study

AU - Kharfan-Dabaja, Mohamed A.

AU - Raj, Renju

AU - Nikolaenko, Liana

AU - Ahmed, Sairah

AU - Reddy, Nishitha

AU - Nathan, Sunita

AU - Cherry, Mohamad

AU - El-Jurdi, Najla

AU - Obiozor, Cynthia

AU - Fenske, Timothy S.

AU - Song, Joo

AU - Muzzafar, Tariq

AU - Ayala, Ernesto

AU - Savani, Bipin

AU - Khawandanah, Mohamad

AU - Caimi, Paolo F.

AU - Hamadani, Mehdi

AU - Forman, Stephen J.

AU - Hussaini, Mohamad

AU - de Lima, Marcos

AU - Olteanu, Horatiu

AU - Shah, Bijal

AU - Chavez, Julio C.

AU - Al Malki, Monzr

AU - Kumar, Ambuj

AU - Ganguly, Siddhartha

PY - 2018/3/1

Y1 - 2018/3/1

N2 - High-dose therapy (HDT) and autologous hematopoietic cell transplantation (auto-HCT) has been anecdotally prescribed in gray zone lymphoma (GZL), showing encouraging efficacy. We conducted a multicenter retrospective study aimed at assessing outcomes after auto-HCT in 32 patients with GZL treated at 9 transplantation centers in the United States. The median age of patients at transplantation was 38 years (range, 18 to 70 years), and the majority were male (n = 21; 66%). The median number of lines of therapy before transplantation was 2 (range, 1 to 4). BEAM was the most commonly prescribed regimen (n = 23; 72%). The median duration of follow-up for surviving patients was 34 months (range, 1 to 106 months). Median overall survival (OS) was not reached. The 3-year progression-free survival (PFS) and OS for all patients were 69% and 78%, respectively. Three-year PFS and OS were 100% for patients who received only 1 line of therapy before auto-HCT versus 65% (PFS, P =.25) and 75% (OS, P =.39) for those receiving >1 line. The cumulative incidence of relapse/progression was 4% at 1 year post-transplantation and 31% at 3 years post-transplantation. The 3-year nonrelapse mortality was 0%. These findings suggest that HDT and auto-HCT is an effective treatment in patients with GZL. Our findings ideally require confirmation in a larger cohort of patients, preferably in the setting of large prospective multicenter randomized controlled trials. However, we acknowledge that such studies could be difficult to conduct in patients with GZL owing to the disease's rarity. Alternatively, a multicenter prospective study that includes tissue banking and a data registry is warranted to help better understand the biology and natural history of the disease.

AB - High-dose therapy (HDT) and autologous hematopoietic cell transplantation (auto-HCT) has been anecdotally prescribed in gray zone lymphoma (GZL), showing encouraging efficacy. We conducted a multicenter retrospective study aimed at assessing outcomes after auto-HCT in 32 patients with GZL treated at 9 transplantation centers in the United States. The median age of patients at transplantation was 38 years (range, 18 to 70 years), and the majority were male (n = 21; 66%). The median number of lines of therapy before transplantation was 2 (range, 1 to 4). BEAM was the most commonly prescribed regimen (n = 23; 72%). The median duration of follow-up for surviving patients was 34 months (range, 1 to 106 months). Median overall survival (OS) was not reached. The 3-year progression-free survival (PFS) and OS for all patients were 69% and 78%, respectively. Three-year PFS and OS were 100% for patients who received only 1 line of therapy before auto-HCT versus 65% (PFS, P =.25) and 75% (OS, P =.39) for those receiving >1 line. The cumulative incidence of relapse/progression was 4% at 1 year post-transplantation and 31% at 3 years post-transplantation. The 3-year nonrelapse mortality was 0%. These findings suggest that HDT and auto-HCT is an effective treatment in patients with GZL. Our findings ideally require confirmation in a larger cohort of patients, preferably in the setting of large prospective multicenter randomized controlled trials. However, we acknowledge that such studies could be difficult to conduct in patients with GZL owing to the disease's rarity. Alternatively, a multicenter prospective study that includes tissue banking and a data registry is warranted to help better understand the biology and natural history of the disease.

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