부산대학교 도서관

Grade 3 follicular lymphoma (FL) has aggressive clinical behavior. To evaluate the optimal first transplantation approach In relapsed/refractory grade 3 FL patients, we compared the long-term outcomes after allogeneic (allo-) vs autologous hematopoietic cell transplantation (auto-HCT) in the rituximab era. A total of 197 patients undergoing first reduced-intensity conditioning (RIC) allo-HCT or first auto-HCT during 2000-2012 were included. Rituximab-naive patients were excluded. Allo-HCT recipients were younger, more heavily pretreated and had a longer interval between diagnosis and HCT. The 5-year probabilities of non- relapse mortality (NRM), relapse/progression, PFS and overall survival (OS) for auto-HCT vs allo-HCT groups were 4% vs 27% (P < 0.001), 61% vs 20% (P < 0.001), 36% vs 51% (P = 0.07) and 59% vs 54% (P = 0.7), respectively. On multivariate analysis, auto- HCT was associated with reduced risk of NRM (relative risk (RR) = 0.20; P = 0.001). Within the first 11 months post HCT, auto- and allo-HCT had similar risks of relapse/progression and PFS. Beyond 11 months, auto-HCT was associated with higher risk of relapse/progression (RR = 21.3; P = 0.003) and inferior PFS (RR = 3.2; P = 0.005). In the first 24 months post HCT, auto-HCT was associated with improved OS (RR = 0.42; P = 0.005), but in long-time survivors (beyond 24 months) it was associated with inferior OS (RR = 3.6; P = 0.04). RIC allo-HCT as the first transplant approach can provide improved PFS and OS, in long-term survivors. Bone Marrow Transplantation (2016) 51, 58-66; doi: 10.1038/bmt.2015.223; published online 5 October 2015
INTRODUCTION Follicular lymphoma (FL) is the most common subtype of indolent non-Hodgkin's lymphoma, and accounts for 20-30% of all non-Hodgkin's lymphoma. The World Health Organization classification uses a three-grade system [...]