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Allogeneic hematopoietic cell transplantation for mycosis fungoides and Sezary syndrome.

Lechowicz MJ, Lazarus HM, Carreras J, Laport GG, Cutler CS, Wiernik PH, Hale GA, Maharaj D, Gale RP, Rowlings PA, Freytes CO, Miller AM, Vose JM, Maziarz RT, Montoto S, Maloney DG, Hari PN - Bone Marrow Transplant. (2014)

Bottom Line: The majority (64%) received non-myeloablative conditioning (NST) or reduced intensity conditioning (RIC).NST/RIC recipients were older in age compared with myeloablative recipients (median age 51 vs 44 years, P=0.005) and transplanted in recent years.Allogeneic HCT in MF/SS results in 5-year survival in approximately one-third of patients and of those, half remain disease-free.

View Article: PubMed Central - PubMed

Affiliation: Emory University Hospital, Atlanta, GA, USA.

ABSTRACT
We describe outcomes after allogeneic hematopoietic cell transplantation (HCT) for mycosis fungoides and Sezary syndrome (MF/SS). Outcomes of 129 subjects with MF/SS reported to the Center for the International Blood and Marrow Transplant from 2000-2009. Median time from diagnosis to transplant was 30 (4-206) months and most subjects were with multiply relapsed/ refractory disease. The majority (64%) received non-myeloablative conditioning (NST) or reduced intensity conditioning (RIC). NST/RIC recipients were older in age compared with myeloablative recipients (median age 51 vs 44 years, P=0.005) and transplanted in recent years. Non-relapse mortality (NRM) at 1 and 5 years was 19% (95% confidence interval (CI) 12-27%) and 22% (95% CI 15-31%), respectively. Risk of disease progression was 50% (95% CI 41-60%) at 1 year and 61% (95% CI 50-71%) at 5 years. PFS at 1 and 5 years was 31% (95% CI 22-40%) and 17% (95% CI 9-26%), respectively. OS at 1 and 5 years was 54% (95% CI 45-63%) and 32% (95% CI 22-44%), respectively. Allogeneic HCT in MF/SS results in 5-year survival in approximately one-third of patients and of those, half remain disease-free.

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(A) Probability of OS difference between NST/RIC and MAC patients in the registered patients.(B) Probability of PFS difference between the NST/RIC and MAC in the registered patients(C) Cumulative incidence of NRM between NST/RIC and MAC in the registered patients.(D) Probability of PFS divided by time between diagnosis and transplant.(E) Probability of OS difference between year of transplant in the registered patients.
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Figure 1: (A) Probability of OS difference between NST/RIC and MAC patients in the registered patients.(B) Probability of PFS difference between the NST/RIC and MAC in the registered patients(C) Cumulative incidence of NRM between NST/RIC and MAC in the registered patients.(D) Probability of PFS divided by time between diagnosis and transplant.(E) Probability of OS difference between year of transplant in the registered patients.

Mentions: Irrespective of conditioning regimen intensity OS was similar at 56% (95% CI 45–67%) and 41% (95% CI 29–53%) at 1 and 3 years respectively for NST/RIC and 51% (95% CI 35–66%) and 31% (95% CI 16–49%) respectively for MAC (log Rank P-Value=0.277) shown in Figure 1A. NRM for registered patients at 1 y and 5y was 19% (95% CI 12–27%) and 22% (95%CI 15–31%). NRM did not differ significantly between the NST/RIC and MAC cohorts (Table 4). Progression/relapse was 50% (95% CI 41–60%) at 1 year and 61% (95% CI 50–71%) at 5 years. PFS at 1 year was 31% (95% CI 22–40%) and at 5 years 17% (95% CI 9–26%). There was no significant difference in PFS between the NST/RIC and MAC cohorts (P value=0.149; Figure 1B). There was no significant difference in the incidence of NRM with MAC vs. NST/RIC (Figure 1C). There was no significant difference in PFS based on interval of diagnosis to transplant (Figure 1D). Progressive disease was the primary cause of death and treatment failure in this cohort of patients with advanced disease. Other causes of death are summarized in Table 5.


Allogeneic hematopoietic cell transplantation for mycosis fungoides and Sezary syndrome.

Lechowicz MJ, Lazarus HM, Carreras J, Laport GG, Cutler CS, Wiernik PH, Hale GA, Maharaj D, Gale RP, Rowlings PA, Freytes CO, Miller AM, Vose JM, Maziarz RT, Montoto S, Maloney DG, Hari PN - Bone Marrow Transplant. (2014)

(A) Probability of OS difference between NST/RIC and MAC patients in the registered patients.(B) Probability of PFS difference between the NST/RIC and MAC in the registered patients(C) Cumulative incidence of NRM between NST/RIC and MAC in the registered patients.(D) Probability of PFS divided by time between diagnosis and transplant.(E) Probability of OS difference between year of transplant in the registered patients.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4221526&req=5

Figure 1: (A) Probability of OS difference between NST/RIC and MAC patients in the registered patients.(B) Probability of PFS difference between the NST/RIC and MAC in the registered patients(C) Cumulative incidence of NRM between NST/RIC and MAC in the registered patients.(D) Probability of PFS divided by time between diagnosis and transplant.(E) Probability of OS difference between year of transplant in the registered patients.
Mentions: Irrespective of conditioning regimen intensity OS was similar at 56% (95% CI 45–67%) and 41% (95% CI 29–53%) at 1 and 3 years respectively for NST/RIC and 51% (95% CI 35–66%) and 31% (95% CI 16–49%) respectively for MAC (log Rank P-Value=0.277) shown in Figure 1A. NRM for registered patients at 1 y and 5y was 19% (95% CI 12–27%) and 22% (95%CI 15–31%). NRM did not differ significantly between the NST/RIC and MAC cohorts (Table 4). Progression/relapse was 50% (95% CI 41–60%) at 1 year and 61% (95% CI 50–71%) at 5 years. PFS at 1 year was 31% (95% CI 22–40%) and at 5 years 17% (95% CI 9–26%). There was no significant difference in PFS between the NST/RIC and MAC cohorts (P value=0.149; Figure 1B). There was no significant difference in the incidence of NRM with MAC vs. NST/RIC (Figure 1C). There was no significant difference in PFS based on interval of diagnosis to transplant (Figure 1D). Progressive disease was the primary cause of death and treatment failure in this cohort of patients with advanced disease. Other causes of death are summarized in Table 5.

Bottom Line: The majority (64%) received non-myeloablative conditioning (NST) or reduced intensity conditioning (RIC).NST/RIC recipients were older in age compared with myeloablative recipients (median age 51 vs 44 years, P=0.005) and transplanted in recent years.Allogeneic HCT in MF/SS results in 5-year survival in approximately one-third of patients and of those, half remain disease-free.

View Article: PubMed Central - PubMed

Affiliation: Emory University Hospital, Atlanta, GA, USA.

ABSTRACT
We describe outcomes after allogeneic hematopoietic cell transplantation (HCT) for mycosis fungoides and Sezary syndrome (MF/SS). Outcomes of 129 subjects with MF/SS reported to the Center for the International Blood and Marrow Transplant from 2000-2009. Median time from diagnosis to transplant was 30 (4-206) months and most subjects were with multiply relapsed/ refractory disease. The majority (64%) received non-myeloablative conditioning (NST) or reduced intensity conditioning (RIC). NST/RIC recipients were older in age compared with myeloablative recipients (median age 51 vs 44 years, P=0.005) and transplanted in recent years. Non-relapse mortality (NRM) at 1 and 5 years was 19% (95% confidence interval (CI) 12-27%) and 22% (95% CI 15-31%), respectively. Risk of disease progression was 50% (95% CI 41-60%) at 1 year and 61% (95% CI 50-71%) at 5 years. PFS at 1 and 5 years was 31% (95% CI 22-40%) and 17% (95% CI 9-26%), respectively. OS at 1 and 5 years was 54% (95% CI 45-63%) and 32% (95% CI 22-44%), respectively. Allogeneic HCT in MF/SS results in 5-year survival in approximately one-third of patients and of those, half remain disease-free.

Show MeSH
Related in: MedlinePlus