Association Of Graft Vs. Host Disease (GVHD) With a Lower Relapse/Progression Rate After Allogeneic Hemopoietic Stem Cell Transplantation (HSCT) With Reduced Intentsity Conditioning In Patients With Follicular and Mantle Cell Lymphoma: A Cibmtr Analysis

• Published in: Blood 2013-11, Vol.122 (21), p.2093-2093
• Main Authors: Urbano-Ispizua, Alvaro, Pavletic, Steven Z., Flowers, Mary E.D., Zhang, Mei-Jie, Carreras, Jeanette, Smith, Sonali M., Maloney, David G., Montoto, Silvia, Cutler, Corey S., Spellman, Stephen R, Arora, Mukta, Saber, Wael
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V122.21.2093.2093

Reduced intensity conditioning (RIC) transplantation is an established platform of immunotherapy for lymphoma due to the graft-vs.-lymphoma (GVLy) effect. The objective of this study was to determine if GVLy was associated with acute (aGVHD) or chronic GVHD (cGVHD) in B cell and T cell lymphomas, and to analyze whether this effect differs in myeloablative and RIC transplants. Inclusion criteria were patients older than 18 years undergoing HLA-identical sibling or unrelated donor HSCT between 1997 and 2009, with diagnosis of Hodgkin lymphoma (HL), diffuse large B cell lymphoma (DLBCL), follicular lymphoma (FL), peripheral T cell lymphoma (T-NHL), and mantle cell lymphoma (MCL). Twin transplants, cord blood, and ex vivo T-cell depletion cases were excluded. The effect of aGVHD and cGVHD on relapse/progression in each subtype of lymphoma, and by conditioning regimen (myeloablative vs RIC) was analyzed in a multivariate analysis. 2611 cases were included (HL, n=466; DLBCL, n=579; FL, n=871; T-NHL, n=195; MCL, n=500). 56% of transplants were from unrelated donors (37% matched and 18% partially matched/mismatched). RIC conditioning regimen was used in 63% (n=1641), and the graft source was peripheral blood stem cells (PB) in 77% (n=2002). Some characteristics of the patients and results of the univariate analysis of clinical outcomes are shown in Table 1. In multivariate analysis, aGVHD II-IV was associated with a lower risk of relapse/progression in FL (RR 0.51; 95% CI 0.27-0.94; p=0.031), and cGVHD was associated with a lower risk of relapse/progression in MCL (RR 0.33; 95% CI 0.18-0.61; p