@article{8bef9b1ce3bd49ecb98090f613ba3e5e,
title = "The Impact of Graft-versus-Host Disease on the Relapse Rate in Patients with Lymphoma Depends on the Histological Subtype and the Intensity of the Conditioning Regimen",
abstract = "The purpose of this study was to analyze the impact of graft-versus-host disease (GVHD) on the relapse rate of different lymphoma subtypes after allogeneic hematopoietic cell transplantation (allo-HCT). Adult patients with a diagnosis of Hodgkin lymphoma, diffuse large B cell lymphoma, follicular lymphoma (FL), peripheral T cell lymphoma, or mantle cell lymphoma (MCL) undergoing HLA-identical sibling or unrelated donor hematopoietic cell transplantation between 1997 and 2009 were included. Two thousand six hundred eleven cases were included. A reduced-intensity conditioning (RIC) regimen was used in 62.8% of the transplantations. In a multivariate analysis of myeloablative cases (n = 970), neither acute (aGVHD) nor chronic GVHD (cGVHD) were significantly associated with a lower incidence of relapse/progression in any lymphoma subtype. In contrast, the analysis of RIC cases (n = 1641) showed that cGVHD was associated with a lower incidence of relapse/progression in FL (risk ratio [RR], .51; P = .049) and in MCL (RR, .41; P = .019). Patients with FL or MCL developing both aGVHD and cGVHD had the lowest risk of relapse (RR, .14; P = .007; and RR, .15; P = .0019, respectively). Of interest, the effect of GVHD on decreasing relapse was similar in patients with sensitive disease and chemoresistant disease. Unfortunately, both aGVHD and cGVHD had a deleterious effect on treatment-related mortality and overall survival (OS) in FL cases but did not affect treatment-related mortality, OS or PFS in MCL. This study reinforces the use of RIC allo-HCT as a platform for immunotherapy in FL and MCL patients.",
keywords = "Graft-versus-host disease, Lymphoma",
author = "Alvaro Urbano-Ispizua and Pavletic, {Steven Z.} and Flowers, {Mary E.} and Klein, {John P.} and Zhang, {Mei Jie} and Jeanette Carreras and Silvia Montoto and Perales, {Miguel Angel} and Aljurf, {Mahmoud D.} and G{\"o}rg{\"u}n Akpek and Bredeson, {Christopher N.} and Costa, {Luciano J.} and Christopher Dandoy and Freytes, {C{\'e}sar O.} and Fung, {Henry C.} and Gale, {Robert Peter} and John Gibson and Mehdi Hamadani and Hayashi, {Robert J.} and Yoshihiro Inamoto and Inwards, {David J.} and Lazarus, {Hillard M.} and Maloney, {David G.} and Rodrigo Martino and Reinhold Munker and Taiga Nishihori and Olsson, {Richard F.} and Rizzieri, {David A.} and Ran Reshef and Ayman Saad and Savani, {Bipin N.} and Schouten, {Harry C.} and Smith, {Sonali M.} and G{\'e}rard Soci{\'e} and Baldeep Wirk and Yu, {Lolie C.} and Wael Saber",
note = "Funding Information: The CIBMTR is supported by Public Health Service grant/cooperative agreement U24-CA076518 from the National Cancer Institute , the National Heart, Lung, and Blood Institute , and the National Institute of Allergy and Infectious Diseases ; grant/cooperative agreement 5U10HL069294 from the National Heart, Lung, and Blood Institute and National Cancer Institute ; contract HHSH250201200016C with Health Resources and Services Administration; 2 grants from the Office of Naval Research ( N00014-12-1-0142 and N00014-13-1-0039 ); and grants from * Actinium Pharmaceuticals ; Allos Therapeutics, Inc. ; * Amgen ; an anonymous donation to the Medical College of Wisconsin ; Ariad ; Be The Match Foundation ; * Blue Cross and Blue Shield Association ; * Celgene Corporation ; Chimerix, Inc. ; Fred Hutchinson Cancer Research Center ; Fresenius-Biotech North America, Inc. ; * Gamida Cell Teva Joint Venture Ltd. ; Genentech, Inc. ; * Gentium SpA ; Genzyme Corporation ; GlaxoSmithKline ; Health Research, Inc. ; Roswell Park Cancer Institute ; HistoGenetics ; Incyte Corporation ; Jeff Gordon Children's Foundation ; Kiadis Pharma ; The Leukemia & Lymphoma Society ; Medac GmbH ; The Medical College of Wisconsin ; Merck & Co., Inc. ; Millennium: The Takeda Oncology Co. ; * Milliman USA, Inc. ; * Miltenyi Biotec ; National Marrow Donor Program ; Onyx Pharmaceuticals ; Optum Healthcare Solutions, Inc. ; Osiris Therapeutics ; Otsuka America Pharmaceutical, Inc. ; Perkin Elmer, Inc. ; * Remedy Informatics ; * Sanofi US ; Seattle Genetics ; Sigma-Tau Pharmaceuticals ; Soligenix, Inc. ; St. Baldrick's Foundation ; StemCyte, A Global Cord Blood Therapeutics Co. ; Stemsoft Software, Inc. ; Swedish Orphan Biovitrum ; * Tarix Pharmaceuticals ; * Terumo BCT ; * Teva Neuroscience, Inc. ; * Therakos ; University of Minnesota ; University of Utah ; and * WellPoint . The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration, or any other agency of the US Government. Publisher Copyright: {\textcopyright} 2015 American Society for Blood and Marrow Transplantation.",
year = "2015",
month = oct,
day = "1",
doi = "10.1016/j.bbmt.2015.05.010",
language = "English",
volume = "21",
pages = "1746--1753",
journal = "Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation",
issn = "1083-8791",
number = "10",
}