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Clinical Lymphoma, Myeloma and Leukemia

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Presentation on theme: "Clinical Lymphoma, Myeloma and Leukemia"— Presentation transcript:

1 Clinical Lymphoma, Myeloma and Leukemia
Clinical Outcomes of Fludarabine and Melphalan With an 800 cGy Total Body Irradiation Conditioning Regimen in Patients With Refractory or Relapsed Aggressive Non-Hodgkin Lymphoma Undergoing Allogeneic Hematopoietic Stem Cell Transplantation  Young-Woo Jeon, Seugyun Yoon, Gi June Min, Sung-Soo Park, Silvia Park, Jae-Ho Yoon, Sung-Eun Lee, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Hee-Je Kim, Seok Lee, Chang-Ki Min, Jong Wook Lee, Seok-Goo Cho  Clinical Lymphoma, Myeloma and Leukemia  DOI: /j.clml Copyright © 2019 The Authors Terms and Conditions

2 Figure 1 Survival Outcomes After Allo-HSCT With the FMT Regimen as RIC. Clinical Transplant Outcomes After Allo-HSCT With the FMT Regimen in Refractory or Relapsed Non-Hodgkin Lymphoma: A, OS and DFS; B, CI of Relapse and NRM Abbreviations: allo-HSCT = allogeneic hematopoietic stem cell transplant; CI = cumulative incidence; DFS = disease-free survival; FMT = fludarabine plus melphalan plus total body irradiation; NRM = non-relapse mortality; OS = overall survival; RIC = reduced-intensity conditioning. Clinical Lymphoma, Myeloma and Leukemia DOI: ( /j.clml ) Copyright © 2019 The Authors Terms and Conditions

3 Figure 2 Incidence of Acute and Chronic GVHD After Allo-HSCT With the FMT Regimen. Incidence Rates of aGVHD (A) and cGVHD (B) in Patients With Relapsed or Refractory Non-Hodgkin Lymphoma in Our Cohort Abbreviations: aGVHD = acute GVHD; allo-HSCT = allogeneic hematopoietic stem cell transplant; cGVHD = chronic GVHD; CI = cumulative incidence; FMT = fludarabine plus melphalan plus total body irradiation; GVHD = graft-versus-host disease. Clinical Lymphoma, Myeloma and Leukemia DOI: ( /j.clml ) Copyright © 2019 The Authors Terms and Conditions

4 Figure 3 Survival Outcomes According to Overall Acute GVHD Grade. A, Overall Survival Rate According to GVHD Severity. Grade III to IV Acute GVHD Was Associated With Poor Overall Survival. B, Disease-free Survival Rate According to GVHD Severity. Patients With Grade III to IV Acute GVHD Had Significantly Worse Disease-free Survival Abbreviations: allo-HSCT = allogeneic hematopoietic stem cell transplant; GVHD = graft-versus-host disease; OG = overall grade. Clinical Lymphoma, Myeloma and Leukemia DOI: ( /j.clml ) Copyright © 2019 The Authors Terms and Conditions

5 Figure 4 Survival Outcomes According to Chronic GVHD Grade. Overall Survival (A) and Disease-free Survival (B) According to the Severity of cGVHD. Compared With Moderate or Severe cGVHD, Mild cGVHD After Allo-HSCT Was Associated With Better Survival Outcomes as in Both Overall Survival and Disease-free Survival Rates in Patients With Refractory or Relapsed Non-Hodgkin Lymphoma Abbreviations: allo-HSCT = allogeneic hematopoietic stem cell transplant; cGVHD = chronic GVHD; GVHD = graft-versus-host disease. Clinical Lymphoma, Myeloma and Leukemia DOI: ( /j.clml ) Copyright © 2019 The Authors Terms and Conditions

6 Supplemental Figure 1 Transplant Outcomes Depending on Clinical Characteristics of Non-Hodgkin Lymphoma. Overall Survival and Disease-free Survival According to Histopathologic Subtype (A), Number of Lines of Systemic CTx Before Allo-HSCT (B), and BM Involvement at Initial Diagnosis (C). No Differences Were Observed Between T-cell Type and B-cell Type Non-Hodgkin Lymphoma; Patients Treated With Fourth-line Chemotherapy or Less Before Allo-HSCT Had Better Survival Outcomes, and BM Involvement Did Not Affect Survival Outcome Abbreviations: allo-HSCT = allogeneic hematopoietic stem cell transplant; BM = bone marrow; CTx = chemotherapy. Clinical Lymphoma, Myeloma and Leukemia DOI: ( /j.clml ) Copyright © 2019 The Authors Terms and Conditions

7 Supplemental Figure 2 Survival Outcomes According to Clinical Characteristics Before Allo-HSCT. Overall Survival and Disease-free Survival According to the Relapse Interval After First-line Chemotherapy (A), and Auto-HSCT Before Allo-HSCT (B) Abbreviations: allo-HSCT = allogeneic hematopoietic stem cell transplant; auto-HSCT = autologous hematopoietic stem cell transplant; CTx = chemotherapy. Clinical Lymphoma, Myeloma and Leukemia DOI: ( /j.clml ) Copyright © 2019 The Authors Terms and Conditions

8 Supplemental Figure 3 Survival and Transplant Outcomes According to HLA Matching Status. Overall Survival (A) and Disease-free Survival (B) According to HLA Matching. No Significant Difference in Survival Outcomes Was Observed Between HLA-well Matched or 1 Allele MM and Haploidentical or 1 Antigen MM. The CI Rates of Acute GVHD (C) and Chronic GVHD (D) Based on HLA Matching Status Were Not Different Between HLA-well Matched or 1 Allele MM and Haploidentical or 1 Antigen MM Abbreviations: allo-HSCT = allogeneic hematopoietic stem cell transplant; CI = cumulative incidence; GVHD = graft-versus-host disease; HLA = human leukocyte antigen; MM = mismatched. Clinical Lymphoma, Myeloma and Leukemia DOI: ( /j.clml ) Copyright © 2019 The Authors Terms and Conditions

9 Supplemental Figure 4 CI of Relapse According to Chemosensitivity and BM Involvement. A, CI of Relapse After Allo-HSCT According to Chemosensitivity Before Transplant. The Relapse Rate After Transplant Was Significantly Higher in the Group With Chemorefractory Disease. B, Malignant Lymphoma Involving the BM at Initial Diagnosis Was Significantly Associated With an Increased Relapse Rate After allo-HSCT Abbreviations: allo-HSCT = allogeneic hematopoietic stem cell transplant; BM = bone marrow; CI = cumulative incidence. Clinical Lymphoma, Myeloma and Leukemia DOI: ( /j.clml ) Copyright © 2019 The Authors Terms and Conditions

10 Supplemental Figure 5 Survival Outcomes According to Disease Status Pre-HSCT. Overall Survival (A) and Disease-free Survival (B) According to Chemosensitivity. The Chemosensitive Group Was Associated With More Favorable Survival Outcomes Than the Chemorefractory Group. The CI of Acute GVHD (C) and Chronic GVHD (D) According to Chemosensitivity Revealed That Chemosensitivity Was Not Associated With Any GVHD Type Abbreviations: allo-HSCT = allogeneic hematopoietic stem cell transplant; CI = cumulative incidence; GVHD = graft-versus-host disease; HSCT = hematopoietic stem cell transplant. Clinical Lymphoma, Myeloma and Leukemia DOI: ( /j.clml ) Copyright © 2019 The Authors Terms and Conditions

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