Autologous haematopoietic cell transplantation for non-Hodgkin lymphoma with secondary CNS involvement

Richard Maziarz, Zhiwei Wang, Mei Jie Zhang, Brian J. Bolwell, Andy Chen, Timothy S. Fenske, Cesar O. Freytes, Robert P. Gale, John Gibson, Brandon Hayes-Lattin, Leona Holmberg, David J. Inwards, Luis M. Isola, Hanna J. Khoury, Victor A. Lewis, Dipnarine Maharaj, Reinhold Munker, Gordon L. Phillips, David A. Rizzieri, Philip A. Rowlings & 9 others Wael Saber, Prakash Satwani, Edmund K. Waller, David G. Maloney, Silvia Montoto, Ginna G. Laport, Julie M. Vose, Hillard M. Lazarus, Parameswaran N. Hari

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Pre-existing central nervous system (CNS) involvement may influence referral for autologous haematopoietic cell transplantation (AHCT) for patients with non-Hodgkin lymphoma (NHL). The outcomes of 151 adult patients with NHL with prior secondary CNS involvement (CNS+) receiving an AHCT were compared to 4688 patients without prior CNS lymphoma (CNS-). There were significant baseline differences between the cohorts. CNS+ patients were more likely to be younger, have lower performance scores, higher age-adjusted international prognostic index scores, more advanced disease stage at diagnosis, more aggressive histology, more sites of extranodal disease, and a shorter interval between diagnosis and AHCT. However, no statistically significant differences were identified between the two groups by analysis of progression-free survival (PFS) and overall survival (OS) at 5 years. A matched pair comparison of the CNS+ group with a subset of CNS- patients matched on propensity score also showed no differences in outcomes. Patients with active CNS lymphoma at the time of AHCT (n = 55) had a higher relapse rate and diminished PFS and OS compared with patients whose CNS lymphoma was in remission (n = 96) at the time of AHCT. CNS+ patients can achieve excellent long-term outcomes with AHCT. Active CNS lymphoma at transplant confers a worse prognosis.

Original languageEnglish (US)
Pages (from-to)648-656
Number of pages9
JournalBritish Journal of Haematology
Volume162
Issue number5
DOIs
StatePublished - Sep 2013

Fingerprint

Cell Transplantation
Non-Hodgkin's Lymphoma
Central Nervous System
Lymphoma
Disease-Free Survival
Propensity Score
Survival
Histology
Referral and Consultation

Keywords

  • Autologous transplantation
  • Central nervous system involvement
  • Non-Hodgkin lymphoma
  • Outcomes

ASJC Scopus subject areas

  • Hematology

Cite this

Autologous haematopoietic cell transplantation for non-Hodgkin lymphoma with secondary CNS involvement. / Maziarz, Richard; Wang, Zhiwei; Zhang, Mei Jie; Bolwell, Brian J.; Chen, Andy; Fenske, Timothy S.; Freytes, Cesar O.; Gale, Robert P.; Gibson, John; Hayes-Lattin, Brandon; Holmberg, Leona; Inwards, David J.; Isola, Luis M.; Khoury, Hanna J.; Lewis, Victor A.; Maharaj, Dipnarine; Munker, Reinhold; Phillips, Gordon L.; Rizzieri, David A.; Rowlings, Philip A.; Saber, Wael; Satwani, Prakash; Waller, Edmund K.; Maloney, David G.; Montoto, Silvia; Laport, Ginna G.; Vose, Julie M.; Lazarus, Hillard M.; Hari, Parameswaran N.

In: British Journal of Haematology, Vol. 162, No. 5, 09.2013, p. 648-656.

Research output: Contribution to journalArticle

Maziarz, R, Wang, Z, Zhang, MJ, Bolwell, BJ, Chen, A, Fenske, TS, Freytes, CO, Gale, RP, Gibson, J, Hayes-Lattin, B, Holmberg, L, Inwards, DJ, Isola, LM, Khoury, HJ, Lewis, VA, Maharaj, D, Munker, R, Phillips, GL, Rizzieri, DA, Rowlings, PA, Saber, W, Satwani, P, Waller, EK, Maloney, DG, Montoto, S, Laport, GG, Vose, JM, Lazarus, HM & Hari, PN 2013, 'Autologous haematopoietic cell transplantation for non-Hodgkin lymphoma with secondary CNS involvement', British Journal of Haematology, vol. 162, no. 5, pp. 648-656. https://doi.org/10.1111/bjh.12451
Maziarz, Richard ; Wang, Zhiwei ; Zhang, Mei Jie ; Bolwell, Brian J. ; Chen, Andy ; Fenske, Timothy S. ; Freytes, Cesar O. ; Gale, Robert P. ; Gibson, John ; Hayes-Lattin, Brandon ; Holmberg, Leona ; Inwards, David J. ; Isola, Luis M. ; Khoury, Hanna J. ; Lewis, Victor A. ; Maharaj, Dipnarine ; Munker, Reinhold ; Phillips, Gordon L. ; Rizzieri, David A. ; Rowlings, Philip A. ; Saber, Wael ; Satwani, Prakash ; Waller, Edmund K. ; Maloney, David G. ; Montoto, Silvia ; Laport, Ginna G. ; Vose, Julie M. ; Lazarus, Hillard M. ; Hari, Parameswaran N. / Autologous haematopoietic cell transplantation for non-Hodgkin lymphoma with secondary CNS involvement. In: British Journal of Haematology. 2013 ; Vol. 162, No. 5. pp. 648-656.
@article{33c426d015c6408fb0b6415106f6e870,
title = "Autologous haematopoietic cell transplantation for non-Hodgkin lymphoma with secondary CNS involvement",
abstract = "Pre-existing central nervous system (CNS) involvement may influence referral for autologous haematopoietic cell transplantation (AHCT) for patients with non-Hodgkin lymphoma (NHL). The outcomes of 151 adult patients with NHL with prior secondary CNS involvement (CNS+) receiving an AHCT were compared to 4688 patients without prior CNS lymphoma (CNS-). There were significant baseline differences between the cohorts. CNS+ patients were more likely to be younger, have lower performance scores, higher age-adjusted international prognostic index scores, more advanced disease stage at diagnosis, more aggressive histology, more sites of extranodal disease, and a shorter interval between diagnosis and AHCT. However, no statistically significant differences were identified between the two groups by analysis of progression-free survival (PFS) and overall survival (OS) at 5 years. A matched pair comparison of the CNS+ group with a subset of CNS- patients matched on propensity score also showed no differences in outcomes. Patients with active CNS lymphoma at the time of AHCT (n = 55) had a higher relapse rate and diminished PFS and OS compared with patients whose CNS lymphoma was in remission (n = 96) at the time of AHCT. CNS+ patients can achieve excellent long-term outcomes with AHCT. Active CNS lymphoma at transplant confers a worse prognosis.",
keywords = "Autologous transplantation, Central nervous system involvement, Non-Hodgkin lymphoma, Outcomes",
author = "Richard Maziarz and Zhiwei Wang and Zhang, {Mei Jie} and Bolwell, {Brian J.} and Andy Chen and Fenske, {Timothy S.} and Freytes, {Cesar O.} and Gale, {Robert P.} and John Gibson and Brandon Hayes-Lattin and Leona Holmberg and Inwards, {David J.} and Isola, {Luis M.} and Khoury, {Hanna J.} and Lewis, {Victor A.} and Dipnarine Maharaj and Reinhold Munker and Phillips, {Gordon L.} and Rizzieri, {David A.} and Rowlings, {Philip A.} and Wael Saber and Prakash Satwani and Waller, {Edmund K.} and Maloney, {David G.} and Silvia Montoto and Laport, {Ginna G.} and Vose, {Julie M.} and Lazarus, {Hillard M.} and Hari, {Parameswaran N.}",
year = "2013",
month = "9",
doi = "10.1111/bjh.12451",
language = "English (US)",
volume = "162",
pages = "648--656",
journal = "British Journal of Haematology",
issn = "0007-1048",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Autologous haematopoietic cell transplantation for non-Hodgkin lymphoma with secondary CNS involvement

AU - Maziarz, Richard

AU - Wang, Zhiwei

AU - Zhang, Mei Jie

AU - Bolwell, Brian J.

AU - Chen, Andy

AU - Fenske, Timothy S.

AU - Freytes, Cesar O.

AU - Gale, Robert P.

AU - Gibson, John

AU - Hayes-Lattin, Brandon

AU - Holmberg, Leona

AU - Inwards, David J.

AU - Isola, Luis M.

AU - Khoury, Hanna J.

AU - Lewis, Victor A.

AU - Maharaj, Dipnarine

AU - Munker, Reinhold

AU - Phillips, Gordon L.

AU - Rizzieri, David A.

AU - Rowlings, Philip A.

AU - Saber, Wael

AU - Satwani, Prakash

AU - Waller, Edmund K.

AU - Maloney, David G.

AU - Montoto, Silvia

AU - Laport, Ginna G.

AU - Vose, Julie M.

AU - Lazarus, Hillard M.

AU - Hari, Parameswaran N.

PY - 2013/9

Y1 - 2013/9

N2 - Pre-existing central nervous system (CNS) involvement may influence referral for autologous haematopoietic cell transplantation (AHCT) for patients with non-Hodgkin lymphoma (NHL). The outcomes of 151 adult patients with NHL with prior secondary CNS involvement (CNS+) receiving an AHCT were compared to 4688 patients without prior CNS lymphoma (CNS-). There were significant baseline differences between the cohorts. CNS+ patients were more likely to be younger, have lower performance scores, higher age-adjusted international prognostic index scores, more advanced disease stage at diagnosis, more aggressive histology, more sites of extranodal disease, and a shorter interval between diagnosis and AHCT. However, no statistically significant differences were identified between the two groups by analysis of progression-free survival (PFS) and overall survival (OS) at 5 years. A matched pair comparison of the CNS+ group with a subset of CNS- patients matched on propensity score also showed no differences in outcomes. Patients with active CNS lymphoma at the time of AHCT (n = 55) had a higher relapse rate and diminished PFS and OS compared with patients whose CNS lymphoma was in remission (n = 96) at the time of AHCT. CNS+ patients can achieve excellent long-term outcomes with AHCT. Active CNS lymphoma at transplant confers a worse prognosis.

AB - Pre-existing central nervous system (CNS) involvement may influence referral for autologous haematopoietic cell transplantation (AHCT) for patients with non-Hodgkin lymphoma (NHL). The outcomes of 151 adult patients with NHL with prior secondary CNS involvement (CNS+) receiving an AHCT were compared to 4688 patients without prior CNS lymphoma (CNS-). There were significant baseline differences between the cohorts. CNS+ patients were more likely to be younger, have lower performance scores, higher age-adjusted international prognostic index scores, more advanced disease stage at diagnosis, more aggressive histology, more sites of extranodal disease, and a shorter interval between diagnosis and AHCT. However, no statistically significant differences were identified between the two groups by analysis of progression-free survival (PFS) and overall survival (OS) at 5 years. A matched pair comparison of the CNS+ group with a subset of CNS- patients matched on propensity score also showed no differences in outcomes. Patients with active CNS lymphoma at the time of AHCT (n = 55) had a higher relapse rate and diminished PFS and OS compared with patients whose CNS lymphoma was in remission (n = 96) at the time of AHCT. CNS+ patients can achieve excellent long-term outcomes with AHCT. Active CNS lymphoma at transplant confers a worse prognosis.

KW - Autologous transplantation

KW - Central nervous system involvement

KW - Non-Hodgkin lymphoma

KW - Outcomes

UR - http://www.scopus.com/inward/record.url?scp=84881661687&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881661687&partnerID=8YFLogxK

U2 - 10.1111/bjh.12451

DO - 10.1111/bjh.12451

M3 - Article

VL - 162

SP - 648

EP - 656

JO - British Journal of Haematology

JF - British Journal of Haematology

SN - 0007-1048

IS - 5

ER -