EBMT NEWSLETTER | November 2013 | Volume 38 - Issue 3

Important dates
CMV serostatus has still an important prognostic impact in de novo acute leukemia patients after allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT.
Schmidt-Hieber M, Labopin M, Beelen D, Volin L, Ehninger G, Finke J, Socié G, Schwerdtfeger R, Kröger N, Ganser A, Niederwieser D, Polge E, Blau IW, Mohty M.
Blood. 2013 Sep 13.

This retrospective analysis of the acute leukemia WP demonstrates that in patients with acute leukemia, cases of CMV seropositivity of the donor and/or the recipient show a significantly decreased 2-year leukemia-free survival and overall survival, and increased nonrelapse mortality. Both groups show a comparable relapse incidence and 2-year probability of graft-versus-host disease. The negative prognostic effects of CMV seropositivity of the donor and/or the recipient (vs CMV seronegativity of both) were significantly stronger for acute lymphoblastic leukemia than for acute myeloid leukemia, resulting in a markedly reduced 2-year overall survival.

Indications for hematopoietic stem cell transplantation in patients with follicular lymphoma: a consensus project of the EBMT-Lymphoma Working Party.
Montoto S, Corradini P, Dreyling M, Ghielmini M, Kimby E, López-Guillermo A, Mackinnon S, Marcus RE, Salles G, Schouten HC, Sureda A, Dreger P.
Haematologica. 2013 Jul

The aim of this project was to define indications for hematopoietic stem cell transplantation in follicular lymphoma in Europe. Consensus was reached that: 1) high-dose therapy with autologous stem cell rescue is not an appropriate option to consolidate first remission in patients responding to immuno-chemotherapy outside clinical trials; 2) in patients with first chemo-sensitive relapse, high-dose therapy with autologous stem cell rescue is an appropriate option to consolidate remission, especially in patients with a short response after immuno-chemotherapy or with high-risk FLIPI; 3) high-dose therapy with autologous stem cell rescue is also appropriate in second/subsequent chemo-sensitive relapses; 4) allotransplant (preferably a reduced intensity conditioning-allotransplant) should be considered at relapse after high-dose therapy with autologous stem cell rescue.

Hematopoietic SCT in Europe: data and trends in 2011.
Passweg JR, Baldomero H, Bregni M, Cesaro S, Dreger P, Duarte RF, Falkenburg JH, Kröger N, Farge-Bancel D, Bobby Gaspar H, Marsh J, Mohty M, Peters C, Sureda A, Velardi A, Ruiz de Elvira C, Madrigal A.
Bone Marrow Transplant. 2013 Sep

This EBMT survey indicates that 48 countries reported 35 660 hematopoietic stem cell transplantation in 32 075 patients (13 470 allogeneic (42%), 18 605 autologous (58%)) in 2011. Main indications were: leukemias; 10 113 (32%; 94% allogeneic); lymphoid neoplasias; 18 433 (57%; 12% allogeneic); solid tumours; 1573 (5%; 5% allogeneic); and non-malignant disorders; 1830 (6%; 92% allogeneic). There were more unrelated donors than HLA identical sibling donors (54% versus 39%); proportion of peripheral blood as stem cell source was 99% for autologous and 73% for allogeneic HSCT. Cord blood was only used in allogeneic transplants (6% of total). In spite of the introduction of new therapeutic modalities, in the past 10 years, the overall number of transplants had increased by 53%.

Improved PFS after autologous stem cell transplantion does not translate into better Quality of Life in CLL: lessons from the randomized EBMT-Intergroup study.
de Wreede LC, Watson M, van Os M, Milligan D, van Gelder M, Michallet M, Dreger P, Dearden CE, Homewood J, Dupuis J, Leporrier M, Karas M, Corront B, Baerlocher GM, Herr W, Choquet S, Niederwieser DW, Sutton L, Kröger N, de Witte TM, Schetelig J.
Am J Hematol. 2013 Oct 9

This randomized EBMT-Intergroup trial compared high-dose therapy and autologous stem cell transplantation to observation and demonstrated a substantial improvement of relapse free survival without showing improved overall survival for the transplant arm. In terms of quality of life information, autologous stem cell transplantation had an adverse impact on quality of life which was largest at 4 months and continued throughout the first year after randomization. There also was a sustained adverse impact of relapse on quality of life which worsened over time and despite better disease control by autologous stem cell transplant, this procedure was associated to an inferior quality of life in the first year and comparable quality of life in the following two years after randomization. The study emphasized the importance of information concerning quality of life when patients are counseled about treatments aimed at improving relapse free survival in the absence of a survival benefit.
Bookmark and Share