Hematopoietic cell transplantation utilization and outcomes for primary plasma cell leukemia in the current era

Binod Dhakal; Sagar Patel; Saulius Girnius; Lohith Bachegowda; Raphael Fraser; Omar Davila; Abraham S. Kanate; Amer Assal; Amr Hanbali; Asad Bashey; Attaphol Pawarode; César O. Freytes; Cindy Lee; David Vesole; Robert Frank Cornell; Gerhard C. Hildebrandt; Hemant S. Murthy; Hillard M. Lazarus; Jan Cerny; Jean A. Yared; Jeffrey Schriber; Jesus Berdeja; Keith Stockerl-Goldstein; Kenneth Meehan; Leona Holmberg; Melhem Solh; Miguel Angel Diaz; Mohamed A. Kharfan-Dabaja; Nosha Farhadfar; Qaiser Bashir; Reinhold Munker; Richard F. Olsson; Robert P. Gale; Ruthlee Lu Bayer; Sachiko Seo; Saurabh Chhabra; Shahrukh Hashmi; Sherif M. Badawy; Taiga Nishihori; Wilson Gonsalves; Yago Nieto; Yvonne Efebera; Shaji Kumar; Nina Shah; Muzaffar Qazilbash; Parameswaran Hari; Anita D’Souza

doi:10.1038/s41375-020-0830-0

Hematopoietic cell transplantation utilization and outcomes for primary plasma cell leukemia in the current era

Binod Dhakal, Sagar Patel, Saulius Girnius, Lohith Bachegowda, Raphael Fraser, Omar Davila, Abraham S. Kanate, Amer Assal, Amr Hanbali, Asad Bashey, Attaphol Pawarode, César O. Freytes, Cindy Lee, David Vesole, Robert Frank Cornell, Gerhard C. Hildebrandt, Hemant S. Murthy, Hillard M. Lazarus, Jan Cerny, Jean A. YaredJeffrey Schriber, Jesus Berdeja, Keith Stockerl-Goldstein, Kenneth Meehan, Leona Holmberg, Melhem Solh, Miguel Angel Diaz, Mohamed A. Kharfan-Dabaja, Nosha Farhadfar, Qaiser Bashir, Reinhold Munker, Richard F. Olsson, Robert P. Gale, Ruthlee Lu Bayer, Sachiko Seo, Saurabh Chhabra, Shahrukh Hashmi, Sherif M. Badawy, Taiga Nishihori, Wilson Gonsalves, Yago Nieto, Yvonne Efebera, Shaji Kumar, Nina Shah, Muzaffar Qazilbash, Parameswaran Hari, Anita D’Souza

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Abstract

The outcomes of patients with primary plasma cell leukemia (pPCL) after undergoing hematopoietic cell transplantation (HCT) in the novel agent era are unknown. We report outcomes of 348 patients with pPCL receiving autologous (auto-) HCT (n = 277) and allogeneic (allo-) HCT (n = 71) between 2008 and 2015. Median age was 60 years and 56 years for auto- and allo-HCT respectively. For auto-HCT, the 4-year outcomes were: non-relapse mortality (NRM) 7% (4–11%), relapse (REL) 76% (69–82%), progression-free survival (PFS) 17% (13–23%), and overall survival (OS) 28% (22–35%). Karnofsky performance status (KPS) > 90 and ≥very good partial response (VGPR) predicted superior OS in multi-variate analysis for auto-HCT. For allo-HCT, the 4-year outcomes were: NRM 12% (5–21%), REL 69% (56–81%), PFS 19% (10–31%), and OS 31% (19–44%). Compared with prior CIBMTR pPCL patients (1995–2006), inferior survival was noted in the current cohort (3-year OS, 39% vs. 38% in allo-HCT, and 62% vs. 35% in auto-HCT) respectively. However, we noted an increased HCT utilization, from 12% (7–21%) in 1995 to 46% (34–64%) in 2009 using SEER data (available till 2009). Despite modern induction translating to higher proportion receiving HCT, the outcomes remain poor in pPCL patients, mainly derived by high relapse rates post-HCT.

Original language	English
Pages (from-to)	3338-3347
Number of pages	10
Journal	Leukemia
Volume	34
Issue number	12
DOIs	https://doi.org/10.1038/s41375-020-0830-0
State	Published - Dec 2020

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Dhakal, B., Patel, S., Girnius, S., Bachegowda, L., Fraser, R., Davila, O., Kanate, A. S., Assal, A., Hanbali, A., Bashey, A., Pawarode, A., Freytes, C. O., Lee, C., Vesole, D., Cornell, R. F., Hildebrandt, G. C., Murthy, H. S., Lazarus, H. M., Cerny, J., ... D’Souza, A. (2020). Hematopoietic cell transplantation utilization and outcomes for primary plasma cell leukemia in the current era. Leukemia, 34(12), 3338-3347. https://doi.org/10.1038/s41375-020-0830-0

@article{0137c3b1ea6340279c94684dddf430c2,

title = "Hematopoietic cell transplantation utilization and outcomes for primary plasma cell leukemia in the current era",

abstract = "The outcomes of patients with primary plasma cell leukemia (pPCL) after undergoing hematopoietic cell transplantation (HCT) in the novel agent era are unknown. We report outcomes of 348 patients with pPCL receiving autologous (auto-) HCT (n = 277) and allogeneic (allo-) HCT (n = 71) between 2008 and 2015. Median age was 60 years and 56 years for auto- and allo-HCT respectively. For auto-HCT, the 4-year outcomes were: non-relapse mortality (NRM) 7% (4–11%), relapse (REL) 76% (69–82%), progression-free survival (PFS) 17% (13–23%), and overall survival (OS) 28% (22–35%). Karnofsky performance status (KPS) > 90 and ≥very good partial response (VGPR) predicted superior OS in multi-variate analysis for auto-HCT. For allo-HCT, the 4-year outcomes were: NRM 12% (5–21%), REL 69% (56–81%), PFS 19% (10–31%), and OS 31% (19–44%). Compared with prior CIBMTR pPCL patients (1995–2006), inferior survival was noted in the current cohort (3-year OS, 39% vs. 38% in allo-HCT, and 62% vs. 35% in auto-HCT) respectively. However, we noted an increased HCT utilization, from 12% (7–21%) in 1995 to 46% (34–64%) in 2009 using SEER data (available till 2009). Despite modern induction translating to higher proportion receiving HCT, the outcomes remain poor in pPCL patients, mainly derived by high relapse rates post-HCT.",

author = "Binod Dhakal and Sagar Patel and Saulius Girnius and Lohith Bachegowda and Raphael Fraser and Omar Davila and Kanate, {Abraham S.} and Amer Assal and Amr Hanbali and Asad Bashey and Attaphol Pawarode and Freytes, {C{\'e}sar O.} and Cindy Lee and David Vesole and Cornell, {Robert Frank} and Hildebrandt, {Gerhard C.} and Murthy, {Hemant S.} and Lazarus, {Hillard M.} and Jan Cerny and Yared, {Jean A.} and Jeffrey Schriber and Jesus Berdeja and Keith Stockerl-Goldstein and Kenneth Meehan and Leona Holmberg and Melhem Solh and Diaz, {Miguel Angel} and Kharfan-Dabaja, {Mohamed A.} and Nosha Farhadfar and Qaiser Bashir and Reinhold Munker and Olsson, {Richard F.} and Gale, {Robert P.} and Bayer, {Ruthlee Lu} and Sachiko Seo and Saurabh Chhabra and Shahrukh Hashmi and Badawy, {Sherif M.} and Taiga Nishihori and Wilson Gonsalves and Yago Nieto and Yvonne Efebera and Shaji Kumar and Nina Shah and Muzaffar Qazilbash and Parameswaran Hari and Anita D{\textquoteright}Souza",

note = "Publisher Copyright: {\textcopyright} 2020, The Author(s), under exclusive licence to Springer Nature Limited.",

year = "2020",

month = dec,

doi = "10.1038/s41375-020-0830-0",

language = "English",

volume = "34",

pages = "3338--3347",

journal = "Leukemia",

issn = "0887-6924",

number = "12",

}

Dhakal, B, Patel, S, Girnius, S, Bachegowda, L, Fraser, R, Davila, O, Kanate, AS, Assal, A, Hanbali, A, Bashey, A, Pawarode, A, Freytes, CO, Lee, C, Vesole, D, Cornell, RF, Hildebrandt, GC, Murthy, HS, Lazarus, HM, Cerny, J, Yared, JA, Schriber, J, Berdeja, J, Stockerl-Goldstein, K, Meehan, K, Holmberg, L, Solh, M, Diaz, MA, Kharfan-Dabaja, MA, Farhadfar, N, Bashir, Q, Munker, R, Olsson, RF, Gale, RP, Bayer, RL, Seo, S, Chhabra, S, Hashmi, S, Badawy, SM, Nishihori, T, Gonsalves, W, Nieto, Y, Efebera, Y, Kumar, S, Shah, N, Qazilbash, M, Hari, P & D’Souza, A 2020, 'Hematopoietic cell transplantation utilization and outcomes for primary plasma cell leukemia in the current era', Leukemia, vol. 34, no. 12, pp. 3338-3347. https://doi.org/10.1038/s41375-020-0830-0

TY - JOUR

T1 - Hematopoietic cell transplantation utilization and outcomes for primary plasma cell leukemia in the current era

AU - Dhakal, Binod

AU - Patel, Sagar

AU - Girnius, Saulius

AU - Bachegowda, Lohith

AU - Fraser, Raphael

AU - Davila, Omar

AU - Kanate, Abraham S.

AU - Assal, Amer

AU - Hanbali, Amr

AU - Bashey, Asad

AU - Pawarode, Attaphol

AU - Freytes, César O.

AU - Lee, Cindy

AU - Vesole, David

AU - Cornell, Robert Frank

AU - Hildebrandt, Gerhard C.

AU - Murthy, Hemant S.

AU - Lazarus, Hillard M.

AU - Cerny, Jan

AU - Yared, Jean A.

AU - Schriber, Jeffrey

AU - Berdeja, Jesus

AU - Stockerl-Goldstein, Keith

AU - Meehan, Kenneth

AU - Holmberg, Leona

AU - Solh, Melhem

AU - Diaz, Miguel Angel

AU - Kharfan-Dabaja, Mohamed A.

AU - Farhadfar, Nosha

AU - Bashir, Qaiser

AU - Munker, Reinhold

AU - Olsson, Richard F.

AU - Gale, Robert P.

AU - Bayer, Ruthlee Lu

AU - Seo, Sachiko

AU - Chhabra, Saurabh

AU - Hashmi, Shahrukh

AU - Badawy, Sherif M.

AU - Nishihori, Taiga

AU - Gonsalves, Wilson

AU - Nieto, Yago

AU - Efebera, Yvonne

AU - Kumar, Shaji

AU - Shah, Nina

AU - Qazilbash, Muzaffar

AU - Hari, Parameswaran

AU - D’Souza, Anita

PY - 2020/12

Y1 - 2020/12

N2 - The outcomes of patients with primary plasma cell leukemia (pPCL) after undergoing hematopoietic cell transplantation (HCT) in the novel agent era are unknown. We report outcomes of 348 patients with pPCL receiving autologous (auto-) HCT (n = 277) and allogeneic (allo-) HCT (n = 71) between 2008 and 2015. Median age was 60 years and 56 years for auto- and allo-HCT respectively. For auto-HCT, the 4-year outcomes were: non-relapse mortality (NRM) 7% (4–11%), relapse (REL) 76% (69–82%), progression-free survival (PFS) 17% (13–23%), and overall survival (OS) 28% (22–35%). Karnofsky performance status (KPS) > 90 and ≥very good partial response (VGPR) predicted superior OS in multi-variate analysis for auto-HCT. For allo-HCT, the 4-year outcomes were: NRM 12% (5–21%), REL 69% (56–81%), PFS 19% (10–31%), and OS 31% (19–44%). Compared with prior CIBMTR pPCL patients (1995–2006), inferior survival was noted in the current cohort (3-year OS, 39% vs. 38% in allo-HCT, and 62% vs. 35% in auto-HCT) respectively. However, we noted an increased HCT utilization, from 12% (7–21%) in 1995 to 46% (34–64%) in 2009 using SEER data (available till 2009). Despite modern induction translating to higher proportion receiving HCT, the outcomes remain poor in pPCL patients, mainly derived by high relapse rates post-HCT.

AB - The outcomes of patients with primary plasma cell leukemia (pPCL) after undergoing hematopoietic cell transplantation (HCT) in the novel agent era are unknown. We report outcomes of 348 patients with pPCL receiving autologous (auto-) HCT (n = 277) and allogeneic (allo-) HCT (n = 71) between 2008 and 2015. Median age was 60 years and 56 years for auto- and allo-HCT respectively. For auto-HCT, the 4-year outcomes were: non-relapse mortality (NRM) 7% (4–11%), relapse (REL) 76% (69–82%), progression-free survival (PFS) 17% (13–23%), and overall survival (OS) 28% (22–35%). Karnofsky performance status (KPS) > 90 and ≥very good partial response (VGPR) predicted superior OS in multi-variate analysis for auto-HCT. For allo-HCT, the 4-year outcomes were: NRM 12% (5–21%), REL 69% (56–81%), PFS 19% (10–31%), and OS 31% (19–44%). Compared with prior CIBMTR pPCL patients (1995–2006), inferior survival was noted in the current cohort (3-year OS, 39% vs. 38% in allo-HCT, and 62% vs. 35% in auto-HCT) respectively. However, we noted an increased HCT utilization, from 12% (7–21%) in 1995 to 46% (34–64%) in 2009 using SEER data (available till 2009). Despite modern induction translating to higher proportion receiving HCT, the outcomes remain poor in pPCL patients, mainly derived by high relapse rates post-HCT.

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U2 - 10.1038/s41375-020-0830-0

DO - 10.1038/s41375-020-0830-0

M3 - Article

C2 - 32313109

AN - SCOPUS:85083712292

SN - 0887-6924

VL - 34

SP - 3338

EP - 3347

JO - Leukemia

JF - Leukemia

IS - 12

ER -

Hematopoietic cell transplantation utilization and outcomes for primary plasma cell leukemia in the current era

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