Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma: A CIBMTR analysis

Narendranath Epperla; Kwang W. Ahn; Carlos Litovich; Sairah Ahmed; Minoo Battiwalla; Jonathon B. Cohen; Parastoo Dahi; Nosha Farhadfar; Umar Farooq; Cesar O. Freytes; Nilanjan Ghosh; Bradley Haverkos; Alex Herrera; Mark Hertzberg; Gerhard Hildebrandt; David Inwards; Mohamed A. Kharfan-Dabaja; Farhad Khimani; Hillard Lazarus; Aleksandr Lazaryan; Lazaros Lekakis; Hemant Murthy; Sunita Nathan; Taiga Nishihori; Attaphol Pawarode; Tim Prestidge; Praveen Ramakrishnan; Andrew R. Rezvani; Rizwan Romee; Nirav N. Shah; Ana Sureda; Timothy S. Fenske; Mehdi Hamadani

doi:10.1186/s13045-018-0696-z

Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma: A CIBMTR analysis

Narendranath Epperla
, Kwang W. Ahn
, Carlos Litovich
, Sairah Ahmed
, Minoo Battiwalla
, Jonathon B. Cohen
, Parastoo Dahi
, Nosha Farhadfar
, Umar Farooq
, Cesar O. Freytes
, Nilanjan Ghosh
, Bradley Haverkos
, Alex Herrera
, Mark Hertzberg
, Gerhard Hildebrandt
, David Inwards
, Mohamed A. Kharfan-Dabaja
, Farhad Khimani
, Hillard Lazarus
, Aleksandr Lazaryan

Lazaros Lekakis, Hemant Murthy, Sunita Nathan, Taiga Nishihori, Attaphol Pawarode, Tim Prestidge, Praveen Ramakrishnan, Andrew R. Rezvani, Rizwan Romee, Nirav N. Shah, Ana Sureda, Timothy S. Fenske, Mehdi Hamadani

Research output: Contribution to journal › Article › peer-review

39 Scopus citations

Abstract

Background: There is a paucity of data on the role of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with angioimmunoblastic T-cell lymphoma (AITL). Using the CIBMTR registry, we report here the outcomes of AITL patients undergoing an allo-HCT. Methods: We evaluated 249 adult AITL patients who received their first allo-HCT during 2000-2016. Results: The median patient age was 56 years (range = 21-77). Majority of the patients were Caucasians (86%), with a male predominance (60%). Graft-versus-host disease (GVHD) prophylaxis was predominantly calcineurin inhibitor-based approaches while the most common graft source was peripheral blood (97%). Median follow-up of survivors was 49 months (range = 4-170 months). The cumulative incidence of grade 2-4 and grade 3-4 acute GVHD at day 180 were 36% (95% CI = 30-42) and 12 (95% CI = 8-17), respectively. The cumulative incidence of chronic GVHD at 1 year was 49% (95%CI 43-56). The 1-year non-relapse mortality (NRM) was 19% (95% CI = 14-24), while the 4-year relapse/progression, progression-free survival (PFS), and overall survival (OS) were 21% (95% CI = 16-27), 49% (95% CI = 42-56), and 56% (95% CI = 49-63), respectively. On multivariate analysis, chemoresistant status at the time of allo-HCT was associated with a significantly higher risk for therapy failure (inverse of PFS) (RR = 1.73 95% CI = 1.08-2.77), while KPS < 90% was associated with a significantly higher risk of mortality (inverse of OS) (RR = 3.46 95% CI = 1.75-6.87). Conclusion: Our analysis shows that allo-HCT provides durable disease control even in AITL patients who failed a prior auto-HCT and in those subjects with refractory disease at the time of allografting.

Original language	English
Article number	6
Journal	Journal of Hematology and Oncology
Volume	12
Issue number	1
DOIs	https://doi.org/10.1186/s13045-018-0696-z
State	Published - Jan 10 2019

Bibliographical note

Publisher Copyright:
© 2019 The Author(s).

Funding

CIBMTR Support List The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 5U10HL069294 from NHLBI and NCI; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-13-1-0039 and N00014-14-1-0028 from the Office of Naval Research; and grants from *Actinium Pharmaceuticals; Allos Therapeutics, Inc.; *Amgen, Inc.; Anonymous donation to the Medical College of Wisconsin; Ariad; Be the Match Foundation; *Blue Cross and Blue Shield Association; *Celgene Corporation; Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Fresenius-Biotech North America, Inc.; *Gamida Cell Teva Joint Venture Ltd.; Genentech, Inc.;*Gentium SpA; Genzyme Corporation; GlaxoSmithKline; Health Research, Inc. Roswell Park Cancer Institute; HistoGe-netics, Inc.; Incyte Corporation; Jeff Gordon Children’s Foundation; Kiadis Pharma; The Leukemia & Lymphoma Society; Medac GmbH; The Medical College of Wisconsin; Merck & Co, Inc.; Millennium: The Takeda Oncology Co.; *Milliman USA, Inc.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; Onyx Pharmaceuticals; Optum Healthcare Solutions, Inc.; Osiris Therapeutics, Inc.; Otsuka America Pharmaceutical, Inc.; Perkin Elmer, Inc.; *Remedy Informatics; *Sanofi US; Seattle Genetics; Sigma-Tau Pharmaceuticals; Soligenix, Inc.; St. Baldrick’s Foundation; StemCyte, A Global Cord Blood Therapeutics Co.; Stemsoft Software, Inc.; Swedish Orphan Biovitrum; *Tarix Pharmaceuticals; *TerumoBCT; *Teva Neuroscience, Inc.; *THERAKOS, Inc.; University of Minnesota; University of Utah; and *Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA), or any other agency of the U.S. Government. *Corporate Members. Morgan Geronime for administrative Support.

Funders	Funder number
Allos Therapeutics, Inc.
HRSA/DHHS	N00014-13-1-0039, N00014-14-1-0028
Office of Naval Research Naval Academy
National Heart, Lung, and Blood Institute (NHLBI)	U10HL069294
National Childhood Cancer Registry – National Cancer Institute
National Institute of Allergy and Infectious F32-AI286447 Cydney N. Johnson Diseases National Institute of Allergy and Infectious R01AI168214 Jason W. Rosch Diseases National Institute of Allergy and Infectious P30 Cydney N. Johnson Diseases National Institute of Allergy and Infectious R00-AI166116 Christopher D. Radka Diseases National Institute of Allergy and Infectious T32-AI106700 Cydney N. Johnson Diseases National Institute of Allergy and Infectious R01AI192221 Jason W. Rosch Diseases National Inst...	HHSH250201200016C
Health Resources and Services Administration
National Institute for Health Research Health Protection Research Unit
Actinium Pharmaceuticals Incorporated

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Allogeneic transplantation
Angioimmunoblastic T-cell lymphoma
GVL effects

ASJC Scopus subject areas

Hematology
Molecular Biology
Oncology
Cancer Research

Access to Document

10.1186/s13045-018-0696-z

Cite this

Epperla, N., Ahn, K. W., Litovich, C., Ahmed, S., Battiwalla, M., Cohen, J. B., Dahi, P., Farhadfar, N., Farooq, U., Freytes, C. O., Ghosh, N., Haverkos, B., Herrera, A., Hertzberg, M., Hildebrandt, G., Inwards, D., Kharfan-Dabaja, M. A., Khimani, F., Lazarus, H., ... Hamadani, M. (2019). Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma: A CIBMTR analysis. Journal of Hematology and Oncology, 12(1), Article 6. https://doi.org/10.1186/s13045-018-0696-z

@article{9ff585e50093470180d8a7a3ac71ef00,

title = "Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma: A CIBMTR analysis",

abstract = "Background: There is a paucity of data on the role of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with angioimmunoblastic T-cell lymphoma (AITL). Using the CIBMTR registry, we report here the outcomes of AITL patients undergoing an allo-HCT. Methods: We evaluated 249 adult AITL patients who received their first allo-HCT during 2000-2016. Results: The median patient age was 56 years (range = 21-77). Majority of the patients were Caucasians (86\%), with a male predominance (60\%). Graft-versus-host disease (GVHD) prophylaxis was predominantly calcineurin inhibitor-based approaches while the most common graft source was peripheral blood (97\%). Median follow-up of survivors was 49 months (range = 4-170 months). The cumulative incidence of grade 2-4 and grade 3-4 acute GVHD at day 180 were 36\% (95\% CI = 30-42) and 12 (95\% CI = 8-17), respectively. The cumulative incidence of chronic GVHD at 1 year was 49\% (95\%CI 43-56). The 1-year non-relapse mortality (NRM) was 19\% (95\% CI = 14-24), while the 4-year relapse/progression, progression-free survival (PFS), and overall survival (OS) were 21\% (95\% CI = 16-27), 49\% (95\% CI = 42-56), and 56\% (95\% CI = 49-63), respectively. On multivariate analysis, chemoresistant status at the time of allo-HCT was associated with a significantly higher risk for therapy failure (inverse of PFS) (RR = 1.73 95\% CI = 1.08-2.77), while KPS < 90\% was associated with a significantly higher risk of mortality (inverse of OS) (RR = 3.46 95\% CI = 1.75-6.87). Conclusion: Our analysis shows that allo-HCT provides durable disease control even in AITL patients who failed a prior auto-HCT and in those subjects with refractory disease at the time of allografting.",

keywords = "Allogeneic transplantation, Angioimmunoblastic T-cell lymphoma, GVL effects",

author = "Narendranath Epperla and Ahn, \{Kwang W.\} and Carlos Litovich and Sairah Ahmed and Minoo Battiwalla and Cohen, \{Jonathon B.\} and Parastoo Dahi and Nosha Farhadfar and Umar Farooq and Freytes, \{Cesar O.\} and Nilanjan Ghosh and Bradley Haverkos and Alex Herrera and Mark Hertzberg and Gerhard Hildebrandt and David Inwards and Kharfan-Dabaja, \{Mohamed A.\} and Farhad Khimani and Hillard Lazarus and Aleksandr Lazaryan and Lazaros Lekakis and Hemant Murthy and Sunita Nathan and Taiga Nishihori and Attaphol Pawarode and Tim Prestidge and Praveen Ramakrishnan and Rezvani, \{Andrew R.\} and Rizwan Romee and Shah, \{Nirav N.\} and Ana Sureda and Fenske, \{Timothy S.\} and Mehdi Hamadani",

note = "Publisher Copyright: {\textcopyright} 2019 The Author(s).",

year = "2019",

month = jan,

day = "10",

doi = "10.1186/s13045-018-0696-z",

language = "English",

volume = "12",

number = "1",

}

Epperla, N, Ahn, KW, Litovich, C, Ahmed, S, Battiwalla, M, Cohen, JB, Dahi, P, Farhadfar, N, Farooq, U, Freytes, CO, Ghosh, N, Haverkos, B, Herrera, A, Hertzberg, M, Hildebrandt, G, Inwards, D, Kharfan-Dabaja, MA, Khimani, F, Lazarus, H, Lazaryan, A, Lekakis, L, Murthy, H, Nathan, S, Nishihori, T, Pawarode, A, Prestidge, T, Ramakrishnan, P, Rezvani, AR, Romee, R, Shah, NN, Sureda, A, Fenske, TS & Hamadani, M 2019, 'Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma: A CIBMTR analysis', Journal of Hematology and Oncology, vol. 12, no. 1, 6. https://doi.org/10.1186/s13045-018-0696-z

Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma: A CIBMTR analysis. / Epperla, Narendranath; Ahn, Kwang W.; Litovich, Carlos et al.
In: Journal of Hematology and Oncology, Vol. 12, No. 1, 6, 10.01.2019.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma

T2 - A CIBMTR analysis

AU - Epperla, Narendranath

AU - Ahn, Kwang W.

AU - Litovich, Carlos

AU - Ahmed, Sairah

AU - Battiwalla, Minoo

AU - Cohen, Jonathon B.

AU - Dahi, Parastoo

AU - Farhadfar, Nosha

AU - Farooq, Umar

AU - Freytes, Cesar O.

AU - Ghosh, Nilanjan

AU - Haverkos, Bradley

AU - Herrera, Alex

AU - Hertzberg, Mark

AU - Hildebrandt, Gerhard

AU - Inwards, David

AU - Kharfan-Dabaja, Mohamed A.

AU - Khimani, Farhad

AU - Lazarus, Hillard

AU - Lazaryan, Aleksandr

AU - Lekakis, Lazaros

AU - Murthy, Hemant

AU - Nathan, Sunita

AU - Nishihori, Taiga

AU - Pawarode, Attaphol

AU - Prestidge, Tim

AU - Ramakrishnan, Praveen

AU - Rezvani, Andrew R.

AU - Romee, Rizwan

AU - Shah, Nirav N.

AU - Sureda, Ana

AU - Fenske, Timothy S.

AU - Hamadani, Mehdi

PY - 2019/1/10

Y1 - 2019/1/10

N2 - Background: There is a paucity of data on the role of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with angioimmunoblastic T-cell lymphoma (AITL). Using the CIBMTR registry, we report here the outcomes of AITL patients undergoing an allo-HCT. Methods: We evaluated 249 adult AITL patients who received their first allo-HCT during 2000-2016. Results: The median patient age was 56 years (range = 21-77). Majority of the patients were Caucasians (86%), with a male predominance (60%). Graft-versus-host disease (GVHD) prophylaxis was predominantly calcineurin inhibitor-based approaches while the most common graft source was peripheral blood (97%). Median follow-up of survivors was 49 months (range = 4-170 months). The cumulative incidence of grade 2-4 and grade 3-4 acute GVHD at day 180 were 36% (95% CI = 30-42) and 12 (95% CI = 8-17), respectively. The cumulative incidence of chronic GVHD at 1 year was 49% (95%CI 43-56). The 1-year non-relapse mortality (NRM) was 19% (95% CI = 14-24), while the 4-year relapse/progression, progression-free survival (PFS), and overall survival (OS) were 21% (95% CI = 16-27), 49% (95% CI = 42-56), and 56% (95% CI = 49-63), respectively. On multivariate analysis, chemoresistant status at the time of allo-HCT was associated with a significantly higher risk for therapy failure (inverse of PFS) (RR = 1.73 95% CI = 1.08-2.77), while KPS < 90% was associated with a significantly higher risk of mortality (inverse of OS) (RR = 3.46 95% CI = 1.75-6.87). Conclusion: Our analysis shows that allo-HCT provides durable disease control even in AITL patients who failed a prior auto-HCT and in those subjects with refractory disease at the time of allografting.

AB - Background: There is a paucity of data on the role of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with angioimmunoblastic T-cell lymphoma (AITL). Using the CIBMTR registry, we report here the outcomes of AITL patients undergoing an allo-HCT. Methods: We evaluated 249 adult AITL patients who received their first allo-HCT during 2000-2016. Results: The median patient age was 56 years (range = 21-77). Majority of the patients were Caucasians (86%), with a male predominance (60%). Graft-versus-host disease (GVHD) prophylaxis was predominantly calcineurin inhibitor-based approaches while the most common graft source was peripheral blood (97%). Median follow-up of survivors was 49 months (range = 4-170 months). The cumulative incidence of grade 2-4 and grade 3-4 acute GVHD at day 180 were 36% (95% CI = 30-42) and 12 (95% CI = 8-17), respectively. The cumulative incidence of chronic GVHD at 1 year was 49% (95%CI 43-56). The 1-year non-relapse mortality (NRM) was 19% (95% CI = 14-24), while the 4-year relapse/progression, progression-free survival (PFS), and overall survival (OS) were 21% (95% CI = 16-27), 49% (95% CI = 42-56), and 56% (95% CI = 49-63), respectively. On multivariate analysis, chemoresistant status at the time of allo-HCT was associated with a significantly higher risk for therapy failure (inverse of PFS) (RR = 1.73 95% CI = 1.08-2.77), while KPS < 90% was associated with a significantly higher risk of mortality (inverse of OS) (RR = 3.46 95% CI = 1.75-6.87). Conclusion: Our analysis shows that allo-HCT provides durable disease control even in AITL patients who failed a prior auto-HCT and in those subjects with refractory disease at the time of allografting.

KW - Allogeneic transplantation

KW - Angioimmunoblastic T-cell lymphoma

KW - GVL effects

UR - https://www.scopus.com/pages/publications/85059829766

UR - https://www.scopus.com/pages/publications/85059829766#tab=citedBy

U2 - 10.1186/s13045-018-0696-z

DO - 10.1186/s13045-018-0696-z

M3 - Article

C2 - 30630534

AN - SCOPUS:85059829766

SN - 1756-8722

VL - 12

JO - Journal of Hematology and Oncology

JF - Journal of Hematology and Oncology

IS - 1

M1 - 6

ER -

Allogeneic hematopoietic cell transplantation provides effective salvage despite refractory disease or failed prior autologous transplant in angioimmunoblastic T-cell lymphoma: A CIBMTR analysis

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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