{"title":"Skeletal muscle index impacts the treatment outcome of elderly patients with diffuse large B cell lymphoma","authors":"Yui Niiyama-Uchibori, Haruya Okamoto, Akihiro Miyashita, Kentaro Mizuhara, Yuka Kanayama-Kawaji, Takahiro Fujino, Taku Tsukamoto, Shinsuke Mizutani, Yuji Shimura, Satoshi Teramukai, Junya Kuroda","doi":"10.1002/hon.3252","DOIUrl":"https://doi.org/10.1002/hon.3252","url":null,"abstract":"<p>Sarcopenia is a crucial factor in the physical fitness of elderly individuals. This study investigated the prognostic values of multiple parameters of sarcopenia in association with established prognostic factors in elderly Japanese patients with diffuse large B cell lymphoma (DLBCL). As candidate indicators for sarcopenia, the skeletal muscle index (SMI) (cm<sup>2</sup>/m<sup>2</sup>), the psoas muscle index, the erector spinae muscle index, the visceral fat index, the subcutaneous fat index, and the visceral to subcutaneous fat area ratio at the third lumbar level were assessed by computed tomography at their initial diagnosis in 102 patients with DLBCL over 75 years old those were diagnosed and treated in our institute from 2007 to 2020. The primary endpoint was overall survival (OS), and the secondary endpoint was progression-free survival (PFS). The median age of patients analyzed was 80 years at diagnosis. The sex-specific cut-offs for the indices adopted two approaches: (i) the historical cut-off values established in the previous study for healthy Japanese individuals (Hamaguchi Y. J Cachexia Sarcopenia Muscle. 2018), and (ii) each sex-specific lowest quartile in our cohort. As the results, SMI evaluated by the historical cut-off and sex-specific lowest quartile was identified as the most influential independent prognostic factor for both OS and PFS among various parameters for sarcopenia. Furthermore, we developed an elderly sarcopenia prognostic index (ESPI). ESPI, which combines SMI evaluated by the historical cut-off and LDH > ULN, demonstrated statistically significant prognostic impacts on OS and PFS. Moreover, compared to the R-IPI, ESPI showed the ability to identify intermediate-risk groups and indicated a trend toward improved predictive accuracy. Our study revealed that SMI is the most appropriate assessment method for evaluating sarcopenia and the critical prognostic factor in OS and PFS of elderly patients with DLBCL.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139550240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Enrica Antonia Martino, Francesca Romana Mauro, Gianluigi Reda, Luca Laurenti, Andrea Visentin, Annamaria Frustaci, Ernesto Vigna, Sara Pepe, Gioacchino Catania, Giacomo Loseto, Roberta Murru, Annalisa Chiarenza, Paolo Sportoletti, Maria Ilaria Del Principe, Roberta Laureana, Marta Coscia, Sara Galimberti, Eleonora Ferretti, Antonella Zucchetto, Riccardo Bomben, Jerry Polesel, Alessandra Tedeschi, Davide Rossi, Livio Trentin, Antonino Neri, Fortunato Morabito, Valter Gattei, Massimo Gentile
{"title":"Ibrutinib as first line therapy in chronic lymphocytic leukemia patients over 80 years old: A retrospective real-life multicenter Italian cohort","authors":"Enrica Antonia Martino, Francesca Romana Mauro, Gianluigi Reda, Luca Laurenti, Andrea Visentin, Annamaria Frustaci, Ernesto Vigna, Sara Pepe, Gioacchino Catania, Giacomo Loseto, Roberta Murru, Annalisa Chiarenza, Paolo Sportoletti, Maria Ilaria Del Principe, Roberta Laureana, Marta Coscia, Sara Galimberti, Eleonora Ferretti, Antonella Zucchetto, Riccardo Bomben, Jerry Polesel, Alessandra Tedeschi, Davide Rossi, Livio Trentin, Antonino Neri, Fortunato Morabito, Valter Gattei, Massimo Gentile","doi":"10.1002/hon.3249","DOIUrl":"https://doi.org/10.1002/hon.3249","url":null,"abstract":"<p>Although chronic lymphocytic leukemia (CLL) predominantly affects the elderly, limited data exists about the outcomes of over 80-year-old patients, usually underrepresented in clinical trials. We conducted a multicenter study enrolling 79 consecutive CLL patients ≥80 years at the time of frontline therapy, all treated with ibrutinib. Nearly 48% of cases exhibited unmutated <i>IGHV</i> genes, 32% 17p deletion, and 39.2% <i>TP53</i> mutations; 63.3% displayed a cumulative illness rating scale (CIRS) > 6. The overall response rate on ibrutinib, computed in 74/79 patients (5 patients excluded for early withdrawal), was 89.9%. After a median follow-up of 28.9 months, the median progression-free survival (PFS) and overall survival (OS) were 42.5 and 51.8 months, respectively. CIRS>6 and temporary discontinuation of ibrutinib lasting for 7–30 days were the only parameters associated with a significantly shorter PFS and were both relevant in predicting a shorter PFS compared to patients with CIRS≤6 and therapy discontinuation ≤7 days. The most common grade≥3 adverse events were infections (25.5%), neutropenia (10.1%), and anemia (2.5%). Eighteen patients (22.8%) experienced a cardiovascular event, including grade-2 atrial fibrillation (<i>n</i> = 9; 11%), grade-2 hypertension (<i>n</i> = 5; 6%), heart failure (<i>n</i> = 3; 3%), and acute coronary syndrome (<i>n</i> = 1; 1%). Mild bleeding events were observed in 27 patients (34.2%). Ibrutinib was permanently discontinued in 26 patients due to progressive disease (<i>n</i> = 11, including 5 Richter's syndromes), secondary malignancies (<i>n</i> = 6), infections (<i>n</i> = 3), cardiac failure (<i>n</i> = 3), severe bleeding (<i>n</i> = 2), and sudden death (<i>n</i> = 1). In conclusion, our analyses confirmed the overall effectiveness and favorable safety profile of the ibrutinib-single agent therapeutic approach in CLL patients ≥80 years.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.3249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139550239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prognostic value of the second revision of the international staging system (R2-ISS) in patients with multiple myeloma undergoing autologous hematopoietic stem cell transplantation","authors":"Taku Kikuchi, Nobuhiro Tsukada, Kodai Kunisada, Moe Yogo, Yuki Oda, Kota Sato, Tomomi Takei, Mizuki Ogura, Yu Abe, Kenshi Suzuki, Tadao Ishida","doi":"10.1002/hon.3248","DOIUrl":"https://doi.org/10.1002/hon.3248","url":null,"abstract":"","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139435084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"ZNF384 fusion transcript levels for measurable residual disease monitoring in adult B-cell acute lymphoblastic leukemia","authors":"Zong-Yan Shi, Xu Wang, Wen-Min Chen, Ling-Di Li, Yue Hao, Jin-Ying Li, Kai Sun, Xiao-Su Zhao, Hao Jiang, Qian Jiang, Xiao-Jun Huang, Ya-Zhen Qin","doi":"10.1002/hon.3251","DOIUrl":"https://doi.org/10.1002/hon.3251","url":null,"abstract":"<p>Zinc finger protein 384 (<i>ZNF384</i>) rearrangement defined a novel subtype of B-cell acute lymphoblastic leukemia (B-ALL). The prognostic significance of <i>ZNF384</i> fusion transcript levels represented measurable residual disease remains to be explored. <i>ZNF384</i> fusions were screened out in 57 adult B-ALL patients at diagnosis by real-time quantitative polymerase chain reaction and their transcript levels were serially monitored during treatment. The reduction of <i>ZNF384</i> fusion transcript levels at the time of achieving complete remission had no significant impact on survival, whereas its ≥2.5-log reduction were significantly associated with higher relapse free survival (RFS) and overall survival (OS) rates after course 1 consolidation (<i>p</i> = 0.022 and = 0.0083) and course 2 consolidation (<i>p</i> = 0.0025 and = 0.0008). Compared with chemotherapy alone, allogeneic hematopoietic stem cell transplantation (allo-HSCT) significantly improved RFS and OS of patients with <2.5-log reduction after course 1 consolidation (<i>p</i> < 0.0001 and = 0.0002) and course 2 consolidation (<i>p</i> = 0.0003 and = 0.019), whereas exerted no significant effects in patients with ≥2.5-log reduction (all <i>p</i> > 0.05). <i>ZNF384</i> fusion transcript levels after course 1 and course 2 consolidation strongly predict relapse and survival and may guide whether receiving allo-HSCT in adult B-ALL.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139435083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zofia Gross, Richard Veyrat-Masson, Béatrice Grange, Sarah Huet, Aurélie Verney, Alexandra Traverse-Glehen, Philippe Ruminy, Lucile Baseggio
{"title":"Diagnosis of chronic B-cell lymphoproliferative disease in peripheral blood = how machine learning may help to the interpretation of flow cytometry data","authors":"Zofia Gross, Richard Veyrat-Masson, Béatrice Grange, Sarah Huet, Aurélie Verney, Alexandra Traverse-Glehen, Philippe Ruminy, Lucile Baseggio","doi":"10.1002/hon.3245","DOIUrl":"https://doi.org/10.1002/hon.3245","url":null,"abstract":"<p>Flow cytometry (FCM) has become a method of choice for immunologic characterization of chronic lymphoproliferative disease (CLPD). To reduce the potential subjectivities of FCM data interpretation, we developed a machine learning random forest algorithm (RF) allowing unsupervised analysis. This assay relies on 16 parameters obtained from our FCM screening panel, routinely used in the exploration of peripheral blood (PB) samples (mean fluorescence intensity values (MFI) of CD19, CD45, CD5, CD20, CD200, CD23, HLA-DR, CD10 in CD19-gated B cells, ratio of kappa/Lambda, and different ratios of MFI B-cells/T-cells [CD20, CD200, CD23]). The RF algorithm was trained and validated on a large cohort of more than 300 annotated different CLPD cases (chronic B-cell leukemia, mantle cell lymphoma, marginal zone lymphoma, follicular lymphoma, splenic red pulp lymphoma, hairy cell leukemia) and non-tumoral selected from PB samples. The RF algorithm was able to differentiate tumoral from non-tumoral B-cells in all cases and to propose a correct CLPD classification in more than 90% of cases. In conclusion the RF algorithm could be proposed as an interesting help to FCM data interpretation allowing a first B-cells CLPD diagnostic hypothesis and/or to guide the management of complementary analysis (additional immunologic markers and genetic).</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139109831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antonio Pinto, Marco Ladetto, Maurizio Martelli, Carlo Visco, Francesco Zaja, Emanuele Guardalben, Pier Luigi Zinzani
{"title":"Unmet needs in relapsed/refractory mantle cell lymphoma after failure of covalent Bruton's tyrosine kinase inhibitors: An Italian scenario","authors":"Antonio Pinto, Marco Ladetto, Maurizio Martelli, Carlo Visco, Francesco Zaja, Emanuele Guardalben, Pier Luigi Zinzani","doi":"10.1002/hon.3246","DOIUrl":"https://doi.org/10.1002/hon.3246","url":null,"abstract":"","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139109832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Possible effects of plasminogen activator inhibitor-1 on promoting angiogenesis through matrix metalloproteinase 9 in advanced mycosis fungoides","authors":"Taku Fujimura, Kentaro Ohuchi, Tetsuya Ikawa, Yumi Kambayashi, Ryo Amagai, Sadanori Furudate, Yoshihide Asano","doi":"10.1002/hon.3244","DOIUrl":"https://doi.org/10.1002/hon.3244","url":null,"abstract":"<p>Mycosis fungoides (MF) progresses slowly before advancing to skin tumors followed by lymph node and visceral involvement. Among MF progression, stage IIB is an initial time point of tumor formation in MF. Since MF in tumor stage possess abundant blood vessels, it is important to evaluate the pro-angiogenic factors before and after MF in stage IIB. In this report, we investigated pro-angiogenic soluble factors in MF patients, as well as its pro-angiogenetic effects on tumor cells and stroma cells. We first evaluated the serum levels of pro-angiogenic factors in 9 MF patients without tumor formation and 8 MF patients with tumor formation. Among them, the serum MMP-9 and plasminogen activator inhibitors 1 (PAI-1) was significantly increased in MF with tumor formation compared in MF without tumor formation, leading to favorable formation of human dermal microvascular endothelial cells tube networks. Moreover, PAI-1 stimulation significantly increased the mRNA expression and protein production MMP-9 on monocytes derived M2 macrophages and HUT-78. Furthermore, since MMP-9 production from tumor cells as well as stromal cells is suppressed by bexarotene, we evaluate the baseline serum pro-angiogenic factors including MMP-9 in 16 patients with advanced cutaneous T cell lymphoma treated with bexarotene. The serum levels of MMP-2 and MMP-9 was significantly increased in bexarotene non-responded patients compared to responded patients. Our present study suggested the significance of MMP-9 and PAI-1 for the progression of MF stage toward to the tumor stage, and could be a therapeutic target in future.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139109833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Picardi, C. Giordano, N. Pugliese, M. Mascolo, S. Varricchio, G. Troncone, E. Vigliar, C. Bellavicine, M. Lamagna, D. Lisi, A. Vincenzi, F. Pane
{"title":"Liposomal-encapsulated doxorubicin supercharge-containing front-line treatment improves response rates in primary mediastinal large B-cell lymphoma and mediastinal gray zone lymphoma","authors":"M. Picardi, C. Giordano, N. Pugliese, M. Mascolo, S. Varricchio, G. Troncone, E. Vigliar, C. Bellavicine, M. Lamagna, D. Lisi, A. Vincenzi, F. Pane","doi":"10.1002/hon.3242","DOIUrl":"10.1002/hon.3242","url":null,"abstract":"<p>Tumor-infiltrating macrophages (TIMs) are constantly ≥5% staining at immunohistochemical analysis on biopsy specimens of tumor masses, in primary mediastinal large B-cell lymphoma (PMBL) and mediastinal gray zone lymphoma (MGZL).<span><sup>1-3</sup></span> The presence of many CD68-positive TIMs into lymph node microenvironment of both PMBL and MGZL is associated with shortened progression-free survival (PFS) following conventional anthracycline-based regimens.<span><sup>1-3</sup></span> Myocet™ is doxorubicin encapsulated in a non-pegylated liposomal membrane of phosphatidylcholine and cholesterol.<span><sup>4</sup></span> Increased dosages of non-pegylated liposomal-encapsulated doxorubicin (NPLD) may have some pharmacokinetic and pharmacodynamic advantages<span><sup>4, 5</sup></span> since it rapidly accumulates at high levels within macrophage cells of the microenvironment of malignant lymphadenopathies, acting as slow-release reservoir with prolonged powerful tumoricidal effects specifically inside the neoplastic tissue.<span><sup>6, 7</sup></span> These effects might be perceived as a great benefit in those patients with aggressive non-Hodgkin lymphoma with high tumor burden. For this reason, a dose intensified (DI) strategy with NPLD was used for untreated advanced-stage diffuse large B-cell lymphoma (DLBCL), instead of hydroxydaunorubicin in rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine and prednisone (R-CHOP), thus constituting a new regimen, so called R-COMP-DI.<span><sup>8</sup></span> The scheme resulted to have better activity profile compared to the historical R-CHOP data.<span><sup>8, 9</sup></span> Furthermore, a personal extrapolation from published data showed very low rate of discontinued treatment due to drug related adverse events following intensified version of R-COMP.<span><sup>8-10</sup></span> On the basis of these data, in our Institution a frontline approach with increased dosage of Myocet™ has been routinely employed in PMBL and MGZL for the last 6 years. We report a real-life experience on the efficacy and safety of a new scheme named R-COMP-DI<sup>x6</sup>, with a supercharge dose of NPLD for six cycles every 3 weeks, in patients with newly diagnosed PMBL and MGZL. The R-COMP-DI<sup>x6</sup> schedule consisted of 1-day outpatient intravenous infusions of Myocet™ at an escalated dose of 70 mg/m<sup>2</sup>, plus rituximab 375 mg/m<sup>2</sup>, cyclophosphamide 750 mg/m<sup>2</sup>, vincristine 1.4 mg/m<sup>2</sup> (up to a maximal dose of 2 mg) and prednisone 40 mg/m<sup>2</sup> per day for 5 days, at a 3-week interval for a total of six cycles. The cumulative dose of NPLD was 420 mg/m<sup>2</sup> for the entire scheme of 6 cycles giving an increased dose of 70 mg/m<sup>2</sup> per each cycle. The dose-intensity of NPLD in cycles one to six of R-COMP-DI<sup>x6</sup> was increased to 140% of standard dosage and was well within the ceiling dose of 785 mg/m<sup>2</sup> (the median lifetime dose report","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.3242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138823704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hazim S. Ababneh, Matthew J. Frigault, Andrea K. Ng, Chirayu G. Patel
{"title":"Radiation therapy as bridging and salvage strategy among patients with secondary central nervous system lymphoma undergoing CD19-targeted chimeric antigen receptor T-cell therapy","authors":"Hazim S. Ababneh, Matthew J. Frigault, Andrea K. Ng, Chirayu G. Patel","doi":"10.1002/hon.3243","DOIUrl":"10.1002/hon.3243","url":null,"abstract":"","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jakob R. Passweg, Helen Baldomero, Marc Ansari, Caroline Arber, Yves Chalandon, Michael Daskalakis, Miriam Diepold, Tamara Diesch-Furlanetto, Michel A. Duchosal, Sabine Gerull, Tayfun Güngör, Dominik Heim, Felicitas Hitz, Andreas Holbro, Stavroula Masouridi-Levrat, Gayathri Nair, Urban Novak, Thomas Pabst, Christoph Renner, Georg Stussi, Dominik Schneidawind, Urs Schanz, Luciano Wannesson, Jörg P. Halter, for the Swiss Blood Stem Cell Transplantation Group (SBST)
{"title":"Hematopoietic cell transplantation and cellular therapies in Switzerland. Evolution over 25 years. A report from the stem cell transplantation and cellular therapies working groups of the SBST 1997–2021","authors":"Jakob R. Passweg, Helen Baldomero, Marc Ansari, Caroline Arber, Yves Chalandon, Michael Daskalakis, Miriam Diepold, Tamara Diesch-Furlanetto, Michel A. Duchosal, Sabine Gerull, Tayfun Güngör, Dominik Heim, Felicitas Hitz, Andreas Holbro, Stavroula Masouridi-Levrat, Gayathri Nair, Urban Novak, Thomas Pabst, Christoph Renner, Georg Stussi, Dominik Schneidawind, Urs Schanz, Luciano Wannesson, Jörg P. Halter, for the Swiss Blood Stem Cell Transplantation Group (SBST)","doi":"10.1002/hon.3241","DOIUrl":"10.1002/hon.3241","url":null,"abstract":"<p>The Swiss Blood Stem Cell Transplantation and Cellular Therapy Group (SBST) leads a mandatory national registry for all hematopoietic stem cell transplants (HCT) and cellular therapies. After 25 years, information was available for 11,226 patients receiving an HCT (4031 allogeneic and 7195 autologous), including 925 pediatric patients. We compared patient characteristics and outcome by quinquennia 1997–2001, 2002–2006, 2007–2011, 2012–2016, and 2017–2021. There were numerous changes over time. Allogeneic transplant recipients became older (median age 33.7 vs. 54.3) and had more frequently unrelated donors and reduced intensity conditioning in later quinquennia. Similarly, age increased for recipients of autologous HCT (median 48.3 vs. 59.9). We did not see a significant drop in transplant activity during the SARS-CoV-2 pandemic. Analysis of outcome showed overall survival (relative risk (RR) of death 0.664 (0.529–0.832) and progression free survival (RR 0.708 (0.577–0.870) being improved over time comparing the latest to the first quinquennium adjusting for risk factors. Non-relapse mortality decreased in recipients of allogeneic HCT (RR: 0.371 (0.270–0.509)) over time but relapse risks did not. Outcome of autologous HCT improved as well across quinquennia, this improvement was mainly due to decreased relapse risks (RR 0.681 (0.597–0.777)), possibly related to maintenance treatment or rescue treatment for relapse mainly in myeloma patients. Cellular therapies other than allogeneic or autologous HCT, particularly chimeric antigen receptor T-cells (CAR-T) treatment have started to increase after 2019, year of approval of the first commercial CAR-T product in Switzerland. Data on chimeric antigen receptor T-cell treatment are too early for comparative analyses. Detailed analyses of changes over time are presented. This study includes all HCTs, and cellular therapies, data useful for quality assurance programs, health care cost estimation and benchmarking. Between 50% and 60% of patients are long-term survivors after both types of HCT, indicating growing populations of surviving patients requiring long-term care.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138498186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}