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

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Romain Guièze - , Clermont-Ferrand University Hospital (Author)
  • Diderik-Jan Eikema - , European Society for Blood and Marrow Transplantation (Author)
  • Linda Koster - , European Society for Blood and Marrow Transplantation (Author)
  • Johannes Schetelig - , Department of Internal Medicine I, University Hospital Carl Gustav Carus Dresden (Author)
  • Henrik Sengeloev - , Righospitalet (Author)
  • Jakob Passweg - , University Hospital Basel (Author)
  • Jürgen Finke - , University of Freiburg (Author)
  • Mutlu Arat - , İstanbul Florence Nightingale Hospital (Author)
  • Annoek E C Broers - , Erasmus University Medical Center (Author)
  • Friedrich Stölzel - , University Hospital Schleswig-Holstein Campus Kiel (Author)
  • Jenny Byrne - , University of Nottingham (Author)
  • Cristina Castilla-Llorente - , Institut Gustave Roussy (Author)
  • Peter Dreger - , Heidelberg University  (Author)
  • Matthias Eder - , Hannover Medical School (MHH) (Author)
  • Tobias Gedde-Dahl - , Oslo University Hospital Rikshospitalet (Author)
  • Nicolaus Kröger - , University Hospital Hamburg Eppendorf (Author)
  • Josep Maria Ribera Santasusana - , Hospital Germans Trias i Pujol (Author)
  • Deborah Richardson - , University Hospital Southampton NHS Foundation Trust (Author)
  • Alessandro Rambaldi - , ASST Papa Giovanni XXIII Hospital (Author)
  • Lucrecia Yañez - , Hospital Universitario Marques de Valdecilla (Author)
  • Michel Van Gelder - , Maastricht University Medical Centre (UMC+) (Author)
  • Joanna Drozd-Sokolowska - , Medical University of Warsaw (Author)
  • Kavita Raj - , University College London Hospitals NHS Foundation Trust (Author)
  • Ibrahim Yakoub-Agha - , University Hospital of Lille (Author)
  • Olivier Tournilhac - , Clermont-Ferrand University Hospital (Author)
  • Donal P McLornan - , University College London Hospitals NHS Foundation Trust (Author)

Abstract

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.

Details

Original languageEnglish
Pages (from-to)950-956
Number of pages7
JournalBone marrow transplantation
Volume59
Issue number7
Publication statusPublished - Jul 2024
Peer-reviewedYes

External IDs

Scopus 85188059146

Keywords

Keywords

  • Humans, Middle Aged, Hematopoietic Stem Cell Transplantation/methods, Retrospective Studies, Male, Female, Transplantation, Homologous/methods, Transplantation Conditioning/methods, Graft vs Host Disease/mortality, Adult, Allografts