Study Compares 5-Year Outcomes of Auto- vs. Allo-HCT in Patients with High-Risk FL

This study of high-risk patients with follicular lymphoma (FL) compared autologous hematopoietic cell transplantation (HCT) with allogeneic HCT, and demonstrated that auto-HCT patients can achieve a 5-year overall survival (OS) of 70%.

The researchers analyzed 440 adults with FL who experienced early treatment failure (ETF) ─ relapse or progression within 2 years of frontline chemoimmunotherapy. In patients undergoing allogeneic HCT, 105 had matched sibling donors (MSD) and 95 had matched unrelated donors (MUD); 240 patients underwent autologous HCT.

At a median follow‐up of 69 to 73 months, the adjusted probability of 5‐year OS was significantly higher after autologous HCT (70%) or MSD HCT (73%) vs. MUD HCT (49%) (p=0.0008). Additional outcomes are shown in the table below.

 Outcome Auto-HCT MSD HCT MUD HCT p-value
 5-year OS 70% 73% 49% 0.0008
 5-year NRM 5% 17% 33% <0.0001
 5-year relapse 58% 31% 23% <0.0001

NRM = non-relapse mortality

Findings on early auto-HCT performed within 1 year of ETF showed improved OS in comparison with conventional chemotherapy. These results were consistent with a recent National LymphoCare Study/Center for International Blood and Marrow Transplant Research analysis and the authors recommend that HCT be considered for high-risk patients with early relapse.

The researchers concluded that adult patients with high‐risk FL, as defined by early treatment failure, undergoing autologous HCT for FL have low NRM and a promising 5‐year OS (70%), and that MSD HCT has lower relapse rates than autologous HCT, but similar OS.

Smith SM, et al. Cancer

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