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.

Allo-SCT is a curative option for selected patients with relapsed/refractory (R/R) MCL, but with significant NRM. We present the long-term results of patients receiving allo-SCT in Spain from March 1995 to February 2020. The primary endpoints were EFS, OS, and cumulative incidence (CI) of NRM, relap...

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Detalles Bibliográficos
Autores: Gutierrez, A, Bento, L, Novelli, S, Martin, A, Gutierrez, G, Salas, MQ, Bastos-Oreiro, M, Perez, A, Hernani, R, Viguria, MC, Lopez-Godino, O, Montoro, J, Pinana, J, Ferra, C, Parody, R, Martin, C, Espanol, I, Yanez, L, Rodriguez, G, Zanabili, J, Herrera, P, Varela, M, Sampol, A, Solano, C, Caballero, D
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p16722
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/16722
Access Level:acceso abierto
Palabra clave:CAR-T cell therapy
acute graft-versus-host disease
allogeneic stem-cell transplantation
graft-versus-lymphoma effect
mantle cell lymphoma
non-relapse mortality
target therapy
Descripción
Sumario:Allo-SCT is a curative option for selected patients with relapsed/refractory (R/R) MCL, but with significant NRM. We present the long-term results of patients receiving allo-SCT in Spain from March 1995 to February 2020. The primary endpoints were EFS, OS, and cumulative incidence (CI) of NRM, relapse, and GVHD. We included 135 patients, most (85%) receiving RIC. After a median follow-up of 68 months, 5-year EFS and OS were 47 and 50%, respectively. Overall and CR rates were 86 and 80%. The CI of relapse at 1 and 3 years were 7 and 12%. NRM at day 100 and 1 year were 17 and 32%. Previous ASCT and Grade 3-4 aGVHD were associated with a higher NRM. Grade 3-4 aGVHD, donor type (mismatch non-related), and the time-period 2006-2020 were independently related to worse EFS. Patients from 1995-2005 were younger, most from HLA-identical sibling donors, and were pretreated less. Our data confirmed that allo-SCT may be a curative option in R/R MCL with low a CI of relapse, although NRM is still high, being mainly secondary to aGVHD. The arrival of new, highly effective and low toxic immunotherapeutic or targeted therapies inevitably will relegate allo-SCT to those fit patients who fail these therapies, far away from the optimal timing of treatment.

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