Allogeneic hematopoietic stem cell transplantation allows long-term complete remission and curability in high-risk Waldenström’s macroglobulinemia. Results of a retrospective analysis of the Société Française de Greffe de Moelle et de Thérapie Cellulaire.

Abstract

BACKGROUND:

Patients with poor-risk Waldenström's macroglobulinemia have suboptimal response and early post-treatment relapse with conventional therapies. Hence, new therapeutic approaches such as allogeneic stem cell transplantation should be evaluated in these patients.

DESIGN AND METHODS:

We examined the long-term outcome of allogeneic stem cell transplantation in Waldenström's macroglobulinemia by studying the records of 24 patients reported in the SFGM-TC database and one transplanted in the bone marrow unit in Hamburg.

RESULTS:

Median age at the time of transplant was 48 years (range, 24-64). The patients had previously received a median of 3 lines of therapy (range, 1-6) and 44% of them had refractory disease at time of transplant. Allogeneic stem cell transplantation after myeloablative (n=12) or reduced-intensity (n=13) conditioning yielded an overall response rate of 92% and immunofixation-negative complete remission in 50% of evaluable patients. With a median follow-up of 64 months among survivors (range, 11-149 months), 5-year overall survival and progression-free survival rates were respectively, 67% (95% CI: 46-81) and 58% (95% CI: 38-75). The 5-year estimated risk of progression was 25% (95% CI: 10-36%), with only one relapse among the 12 patients who entered complete remission, versus 5 in the 12 patients who did not. Only one of the 6 relapses occurred more than three years post-transplant.

CONCLUSIONS:

Allogeneic stem cell transplantation yields a high rate of complete remissions and is potentially curative in poor-risk Waldenström's macroglobulinemia.

• Authors: Alice Garnier, Marie Robin, Fabrice Larosa, Jean-Louis Golmard, Steven Le Gouill, Valérie Coiteux, Reza Tabrizi, Claude-Eric Bulabois, Victoria Cacheux, Mathieu Kuentz, Brigitte Dreyfus, Peter Dreger, Bernard Rio, Marie-Pierre Moles-Moreau, Karin Bilger, Jacques-Olivier Bay, Véronique Leblond, Didier Blaise, Olivier Tournilhac, Nathalie Dhédin
• Journal: Haematologica (Haematologica) Vol. 95 Issue 6 Pg. 950-5 (Jun 2010) ISSN: 1592-8721 [Electronic] Italy
• PMID: 20081058 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Disease-Free Survival
• Female
• Follow-Up Studies
• France
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Male
• Middle Aged
• Remission Induction
• Retrospective Studies
• Risk Factors
• Societies, Medical
• Time Factors
• Transplantation, Homologous
• Treatment Outcome
• Waldenstrom Macroglobulinemia (mortality, pathology, surgery)
• Young Adult