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Allogeneic hematopoietic stem-cell transplantation for patients with Richter transformation: a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT

Management of Richter transformation (RT) is particularly challenging, with survival estimates <1 year. We report on outcomes of 66 RT patients undergoing allogeneic-HCT (allo-HCT) between 2008 and 2018 registered with the EBMT. Median age at allo-HCT was 56.2 years (interquartile range (IQR), 51...

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Main Authors: Guièze, Romain (Author) , Eikema, Diderik-Jan (Author) , Koster, Linda (Author) , Schetelig, Johannes (Author) , Sengeloev, Henrik (Author) , Passweg, Jakob R. (Author) , Finke, Jürgen (Author) , Arat, Mutlu (Author) , Broers, Annoek E. C. (Author) , Stölzel, Friedrich (Author) , Byrne, Jenny (Author) , Castilla-Llorente, Cristina (Author) , Dreger, Peter (Author) , Eder, Matthias (Author) , Gedde-Dahl, Tobias (Author) , Kröger, Nicolaus (Author) , Ribera Santasusana, Josep Maria (Author) , Richardson, Deborah (Author) , Rambaldi, Alessandro (Author) , Yañez, Lucrecia (Author) , Van Gelder, Michel (Author) , Drozd-Sokolowska, Joanna (Author) , Raj, Kavita (Author) , Yakoub-Agha, Ibrahim (Author) , Tournilhac, Olivier (Author) , McLornan, Donal (Author)
Format: Article (Journal)
Language:English
Published: 19 March 2024
In: Bone marrow transplantation
Year: 2024, Volume: 59, Issue: 7, Pages: 950-956
ISSN:1476-5365
DOI:10.1038/s41409-024-02256-9
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1038/s41409-024-02256-9
Verlag, lizenzpflichtig, Volltext: https://www.nature.com/articles/s41409-024-02256-9
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Author Notes:Romain Guièze, Diderik-Jan Eikema, Linda Koster, Johannes Schetelig, Henrik Sengeloev, Jakob Passweg, Jürgen Finke, Mutlu Arat, Annoek E.C. Broers, Friedrich Stölzel, Jenny Byrne, Cristina Castilla-Llorente, Peter Dreger, Matthias Eder, Tobias Gedde-Dahl, Nicolaus Kröger, Josep Maria Ribera Santasusana, Deborah Richardson, Alessandro Rambaldi, Lucrecia Yañez, Michel Van Gelder, Joanna Drozd-Sokolowska, Kavita Raj, Ibrahim Yakoub-Agha, Olivier Tournilhac and Donal P. McLornan
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Summary:Management of Richter transformation (RT) is particularly challenging, with survival estimates <1 year. We report on outcomes of 66 RT patients undergoing allogeneic-HCT (allo-HCT) between 2008 and 2018 registered with the EBMT. Median age at allo-HCT was 56.2 years (interquartile range (IQR), 51.3-63.1). Median time from RT to allo-HCT was 6.9 months (IQR, 4.9-11) and 28 (42.4%) were in complete remission (CR). The majority underwent reduced intensity conditioning (66.2%) using peripheral blood derived stem cells. Eighteen (27.3%) patients had a matched sibling donor, 24 (36.4%) a matched unrelated donor and the remaining were mismatched. Median follow-up was 6.6 years; 1- and 3- year overall and progression free survival (PFS) (95% CI) was 65% (54-77) and 39% (27-51) and 53% (41-65) and 29% (18-40), respectively. Patients in CR at time of allo-HCT had significantly better 3-year PFS (39% vs. 21%, p = 0.032). Cumulative incidences of grade II-IV acute graft versus host disease (GVHD) at day +100 was 41% (95% CI 29-53) and chronic GVHD at 3 years was 53% (95% CI 41-65). High rates of non-relapse mortality (NRM) were observed; 38% (95% CI, 26-50) at 3 years. Although potentially curative, approaches to reduce considerable NRM and chronic GVHD rates are required.
Item Description:Gesehen am 13.09.2024
Physical Description:Online Resource
ISSN:1476-5365
DOI:10.1038/s41409-024-02256-9

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