Allogeneic hematopoietic cell transplantation for blastic plasmacytoid dendritic cell neoplasm: a CIBMTR analysis

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with a poor prognosis and considered incurable with conventional chemotherapy. Small observational studies reported allogeneic hematopoietic cell transplantation (allo-HCT) offers durable remissions in patients w...

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Detalles Bibliográficos
Autores principales: Murthy, Hemant S., Zhang, Mei-Jie, Chen, Karen, Ahmed, Sairah, Deotare, Uday, Ganguly, Siddhartha, Kansagra, Ankit, Michelis, Fotios V., Nishihori, Taiga, Patnaik, Mrinal, Abid, Muhammad Bilal, Aljurf, Mahmoud, Arai, Yasuyuki, Bacher, Ulrike, Badar, Talha, Badawy, Sherif M., Ballen, Karen, Battiwalla, Minoo, Beitinjaneh, Amer, Bejanyan, Nelli, Bhatt, Vijaya Raj, Brown, Valerie I., Martino, Rodrigo, Cahn, Jean-Yves, Castillo, Paul, Cerny, Jan, Chhabra, Saurabh, Copelan, Edward, Daly, Andrew, Dholaria, Bhagirathbhai, Diaz Perez, Miguel Angel, Freytes, César O., Grunwald, Michael R., Hashmi, Shahrukh, Hildebrandt, Gerhard C., Jamy, Omer, Joseph, Jacinth, Kanakry, Christopher G., Khera, Nandita, Krem, Maxwell M., Kuwatsuka, Yachiyo, Lazarus, Hillard M., Lekakis, Lazaros J., Liu, Hongtao, Modi, Dipenkumar, Munshi, Pashna N., Mussetti, Alberto, Palmisiano, Neil, Patel, Sagar S., Rizzieri, David A., Seo, Sachiko, Shah, Mithun Vinod, Sharma, Akshay, Sohl, Melhm, Solomon, Scott R., Ulrickson, Matthew, Ustun, Celalettin, van der Poel, Marjolein, Verdonck, Leo F., Wagner, John L., Wang, Trent, Wirk, Baldeep, Zeidan, Amer, Litzow, Mark, Kebriaei, Partow, Hourigan, Christopher S., Weisdorf, Daniel J., Saber, Wael, Kharfan-Dabaja, Mohamed A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The American Society of Hematology 2023
Materias:
Transplantation
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10690553/
https://www.ncbi.nlm.nih.gov/pubmed/37792849
http://dx.doi.org/10.1182/bloodadvances.2023011308
Descripción
Sumario:Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with a poor prognosis and considered incurable with conventional chemotherapy. Small observational studies reported allogeneic hematopoietic cell transplantation (allo-HCT) offers durable remissions in patients with BPDCN. We report an analysis of patients with BPDCN who received an allo-HCT, using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). We identified 164 patients with BPDCN from 78 centers who underwent allo-HCT between 2007 and 2018. The 5-year overall survival (OS), disease-free survival (DFS), relapse, and nonrelapse mortality (NRM) rates were 51.2% (95% confidence interval [CI], 42.5-59.8), 44.4% (95% CI, 36.2-52.8), 32.2% (95% CI, 24.7-40.3), and 23.3% (95% CI, 16.9-30.4), respectively. Disease relapse was the most common cause of death. On multivariate analyses, age of ≥60 years was predictive for inferior OS (hazard ratio [HR], 2.16; 95% CI, 1.35-3.46; P = .001), and higher NRM (HR, 2.19; 95% CI, 1.13-4.22; P = .02). Remission status at time of allo-HCT (CR2/primary induction failure/relapse vs CR1) was predictive of inferior OS (HR, 1.87; 95% CI, 1.14-3.06; P = .01) and DFS (HR, 1.75; 95% CI, 1.11-2.76; P = .02). Use of myeloablative conditioning with total body irradiation (MAC-TBI) was predictive of improved DFS and reduced relapse risk. Allo-HCT is effective in providing durable remissions and long-term survival in BPDCN. Younger age and allo-HCT in CR1 predicted for improved survival, whereas MAC-TBI predicted for less relapse and improved DFS. Novel strategies incorporating allo-HCT are needed to further improve outcomes.

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