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Rituximab-containing reduced-intensity conditioning improves progression-free survival following allogeneic transplantation in B cell non-Hodgkin lymphoma.
Epperla, Narendranath; Ahn, Kwang Woo; Ahmed, Sairah; Jagasia, Madan; DiGilio, Alyssa; Devine, Steven M; Jaglowski, Samantha; Kennedy, Vanessa; Rezvani, Andrew R; Smith, Sonali M; Sureda, Anna; Fenske, Timothy S; Kharfan-Dabaja, Mohamed A; Armand, Phillipe; Hamadani, Mehdi.
Afiliación
  • Epperla N; Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Ahn KW; Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Ahmed S; Department of Stem Cell Transplantation, MD Anderson Cancer Center, Houston, TX, USA.
  • Jagasia M; Division of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA.
  • DiGilio A; Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Devine SM; Division of Hematology, The Ohio State University Medical Center, Columbus, OH, USA.
  • Jaglowski S; Division of Hematology, The Ohio State University Medical Center, Columbus, OH, USA.
  • Kennedy V; Division of Blood & Marrow Transplantation, Stanford University, Stanford, CA, USA.
  • Rezvani AR; Division of Blood & Marrow Transplantation, Stanford University, Stanford, CA, USA.
  • Smith SM; Section of Hematology/Oncology, The University of Chicago, Chicago, IL, USA.
  • Sureda A; Servei d'Hematologica, Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain.
  • Fenske TS; Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Kharfan-Dabaja MA; Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
  • Armand P; Department of Medical Oncology/Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA, USA.
  • Hamadani M; Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. mhamadani@mcw.edu.
J Hematol Oncol ; 10(1): 117, 2017 06 12.
Article en En | MEDLINE | ID: mdl-28606176
BACKGROUND: In B cell non-Hodgkin lymphoma (B-NHL), rituximab-containing reduced-intensity conditioning regimens (R-RIC) have been shown to provide favorable outcomes in single-arm studies; however, large multicenter studies comparing R-RIC and non-rituximab-containing reduced-intensity conditioning regimens (nonR-RIC) have not been performed. Using the CIBMTR database, we report the outcomes of R-RIC versus nonR-RIC regimens in B-NHL. METHODS: We evaluated 1401 adult B-NHL patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) who received nonR-RIC (n = 1022) or R-RIC (n = 379) regimens. Graft-versus-host disease (GVHD) prophylaxis was limited to calcineurin inhibitor-based approaches. RESULTS: Median follow-up of survivors in the R-RIC and nonR-RIC groups was 47 and 37 months, respectively. On multivariate analysis, no difference was seen between the R-RIC and nonR-RIC cohorts in terms of acute GVHD grade II-IV (RR = 1.14, 95%CI = 0.83-1.56, p = 0.43) or grade III-IV (RR = 1.16, 95%CI = 0.72-1.89, p = 0.54), chronic GVHD (RR = 1.15, 95%CI = 0.92-1.46, p = 0.22), non-relapse mortality (RR = 0.90; 95%CI = 0.67-1.22; p = 0.51), relapse/progression (RR = 0.79; 95%CI = 0.63-1.01; p = 0.055), and mortality (RR = 0.84, 95%CI = 0.69-1.02, p = 0.08) risk. However, R-RIC was associated with a significantly improved progression-free survival (RR = 0.76; 95%CI 0.62-0.92; p = 0.006). On subgroup analysis, mortality benefit was noted in the R-RIC group patients not receiving busulfan-based RIC (RR = 0.76; 95%CI = 0.60-0.96; p = 0.02) and with the use of a higher cumulative rituximab dose (RR = 0.43; 95%CI = 0.21-0.90; p = 0.02). CONCLUSION: Our analysis shows that inclusion of rituximab in RIC regimens improves progression-free survival in patients with B cell NHL. These data supports the use of R-RIC in B-NHL patients undergoing allo-HCT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Linfoma de Células B / Trasplante de Células Madre Hematopoyéticas / Acondicionamiento Pretrasplante / Rituximab / Antineoplásicos Inmunológicos Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Hematol Oncol Asunto de la revista: HEMATOLOGIA / NEOPLASIAS Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Linfoma de Células B / Trasplante de Células Madre Hematopoyéticas / Acondicionamiento Pretrasplante / Rituximab / Antineoplásicos Inmunológicos Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Hematol Oncol Asunto de la revista: HEMATOLOGIA / NEOPLASIAS Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido