High-dose Therapy and Autologous Hematopoietic Cell Transplantation as Consolidation Treatment for Primary Effusion Lymphoma

Abu Sayeef Mirza, Bhagirathbhai R. Dholaria, Mohammad Hussaini, Sarah Mushtaq, Pedro Horna, Adharsh Ravindran, Ambuj Kumar, Ernesto Ayala, Mohamed A. Kharfan-Dabaja, Celeste Bello, Julio C. Chavez, Lubomir Sokol

Research output: Contribution to journalArticle

Abstract

Background: Primary effusion lymphoma (PEL) is a rare type of non-Hodgkin lymphoma. The limited disease-free survival after chemotherapy has resulted in a poor prognosis. The outcomes data for high-dose therapy followed by autologous hematopoietic cell transplantation (auto-HCT) for PEL are limited owing to the rarity of the disease. Patients and Methods: The present study included 9 patients with PEL from 2 major academic centers. Of these patients, 4 had received auto-HCT after high-dose therapy. Of the 9 patients, 8 (89%) had immunodeficiency (7 with human immunodeficiency virus seropositivity; 1, a solid organ transplant recipient) at the diagnosis. Human herpesvirus-8 by immunohistochemistry was positive in 8 patients. Anthracycline-based combination chemotherapy was used as first-line treatment in 7 patients; 4 underwent auto-HCT after attaining first complete remission. Results: The median follow-up of the surviving patients was 25 months (95% confidence interval [CI], 8%-29%). The 2-year progression-free and overall survival for the 8 patients who had received treatment was 58% (95% CI, 22%-95%) and 73% (95% CI, 41%-100%), respectively. The 2-year progression-free and overall survival for the patients who had received auto-HCT was 50% (95% CI, 1%-99%) and 75% (95% CI, 33%-100%), respectively. Of the 4 auto-HCT recipients, all had been in first complete remission at the time of autografting. The cumulative incidence of relapse was 50% (95% CI, 19%-100%). No deaths were attributable to auto-HCT at 2 years after autografting. Conclusion: Despite the small sample size, our data have shown that consolidative auto-HCT is safe and effective and should be considered for eligible patients with PEL after demonstration of an objective response to induction chemotherapy. However, the high relapse rate remains a concern and warrants the development of new strategies to mitigate post-transplantation relapse.

Original languageEnglish (US)
Pages (from-to)e513-e520
JournalClinical Lymphoma, Myeloma and Leukemia
Volume19
Issue number9
DOIs
StatePublished - Sep 2019

Keywords

  • Autologous hematopoietic cell transplantation
  • Chemotherapy
  • Immunodeficiency
  • Primary effusion lymphoma
  • Survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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  • Cite this

    Mirza, A. S., Dholaria, B. R., Hussaini, M., Mushtaq, S., Horna, P., Ravindran, A., Kumar, A., Ayala, E., Kharfan-Dabaja, M. A., Bello, C., Chavez, J. C., & Sokol, L. (2019). High-dose Therapy and Autologous Hematopoietic Cell Transplantation as Consolidation Treatment for Primary Effusion Lymphoma. Clinical Lymphoma, Myeloma and Leukemia, 19(9), e513-e520. https://doi.org/10.1016/j.clml.2019.03.021