Autologous stem cell transplantation for post-transplant lymphoproliferative disorders after solid organ transplantation: a retrospective analysis from the Lymphoma Working Party of the EBMT

Journal article

Published data describing the efficacy and safety of autologous stem-cell transplantation (autoSCT) in post-transplant lymphoproliferative disorders (PTLD) is limited to case reports. This is a retrospective analysis of 21 patients reported to the EBMT registry who received an autoSCT for PTLD post solid organ transplant (SOT). Median age at autoSCT was 47 (range: 22–71) years. The commonest SOTs were kidney (48%) and liver (24%). Commonest histologies included DLBCL-type PTLD (14/21) and plasmacytoma-like PTLD (3/21). Patients received a median of two lines of therapy (range: 1–4) pre-autoSCT. ECOG performance status pre-autoSCT was 0 in 14% and 1 in 86%. Remission status pre-autoSCT was CR 47% and PR 38%. BEAM conditioning was used in 57% and high-dose melphalan in 10%. The median follow-up post-autoSCT was 64 months for alive patients. 3-year PFS was 62% [95% confidence interval (CI) 44–87%] and 3-year OS was 61% [95% CI:43–86]. There were 12 deaths, including four related to autoSCT. 100-day non-relapse-mortality (NRM) was 14% and 1-year NRM was 24%. This study suggests that autoSCT, although feasible and with potential therapeutic activity, is associated with a high NRM, primarily driven by infectious toxicity. A multi-disciplinary approach, expert microbiological input and stringent patient selection are required to optimise outcomes.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Authors: Eyre, TA; Caillard, S; Finel, H; Boumendil, A; Kothari, J

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer Nature [academic journals on nature.com]
• Journal: Bone Marrow Transplantation
• Volume: 56
• Issue: 9
• Pages: 2118-2124
• Publication date: 2021-04-16
• DOI: 10.1038/s41409-021-01270-5
• EISSN: 1476-5365
• ISSN: 0268-3369
• Language: English
• Keywords: Transplantation; Lymphoproliferative disorders; Medicine; Stem cell; Solid organ; Lymphoma; Cancer; Internal medicine; Immunology; Organ transplantation; Oncology; Solid tumor; Surgery