Allogeneic Stem Cell Transplantation in Mantle Cell Lymphoma; Insights into Its Potential Role in the Era of New Immunotherapeutic and Targeted Therapies: The GETH/GELTAMO Experience
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AuthorGutierrez, Antonio; Bento, Leyre; Novelli, Silvana; Martin, Alejandro; Gutierrez, Gonzalo; Queralt Salas, Maria; Bastos-Oreiro, Mariana; Perez, Ariadna; Hernani, Rafael; Cruz Viguria, Maria; Lopez-Godino, Oriana; Montoro, Juan; Piñana, Jose Luis; Ferra, Christelle; Parody, Rocio; Martin, Carmen; Español, Ignacio; Yáñez San Segundo, Lucrecia; Rodriguez, Guillermo; [et al.]
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© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution(CC BY) license.
Cancers (Basel) . 2022 May 27;14(11):2673
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Mantle cell lymphoma
Allogeneic stem-cell transplantation
Acute graft-versus-host disease
CAR-T cell therapy
Allo-SCT is a curative option for selected patients with relapsed/refractory (R/R) MCL, but with significant NRM. We present the long-term results of patients receiving allo-SCT in Spain from March 1995 to February 2020. The primary endpoints were EFS, OS, and cumulative incidence (CI) of NRM, relapse, and GVHD. We included 135 patients, most (85%) receiving RIC. After a median follow-up of 68 months, 5-year EFS and OS were 47 and 50%, respectively. Overall and CR rates were 86 and 80%. The CI of relapse at 1 and 3 years were 7 and 12%. NRM at day 100 and 1 year were 17 and 32%. Previous ASCT and Grade 3-4 aGVHD were associated with a higher NRM. Grade 3-4 aGVHD, donor type (mismatch non-related), and the time-period 2006-2020 were independently related to worse EFS. Patients from 1995-2005 were younger, most from HLA-identical sibling donors, and were pretreated less. Our data confirmed that allo-SCT may be a curative option in R/R MCL with low a CI of relapse, although NRM is still high, being mainly secondary to aGVHD. The arrival of new, highly effective and low toxic immunotherapeutic or targeted therapies inevitably will relegate allo-SCT to those fit patients who fail these therapies, far away from the optimal timing of treatment.
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