Stem cell transplantation for follicular lymphoma relapsed/refractory after prior rituximab: A comprehensive analysis from the NCCN lymphoma outcomes project

BACKGROUND Stem cell transplant (SCT)-related outcomes and prognostication for relapsed/refractory follicular lymphoma (FL) are not well-defined in the post-rituximab era. METHODS Through the National Comprehensive Cancer Network (NCCN) lymphoma outcomes study, 184 patients with relapsed/refractory FL who underwent autologous SCT (autoSCT) or allogenic SCT (alloSCT) following disease relapse after prior rituximab-based therapy were examined. RESULTS Patients who underwent autoSCT (N = 136) were older compared with patients who underwent alloSCT (N = 48) (54 versus 51 years, respectively, P = .01) and more frequently had grade 3 FL (35% versus 8%, respectively, P = .006). Patients who underwent alloSCT received more prior therapies (4 versus 3, respectively, P   60 years and > 3 prior therapies as adverse factors. Furthermore, a survival model was created for the autoSCT cohort based on number of factors present (0, 1, 2); 3-year failure-free survival was 72%, 47%, and 20%, respectively (P = .0003), and 3-year overall survival was 96%, 82%, and 62%, respectively (P < .0001). CONCLUSIONS AutoSCT remains an effective therapy for patients with FL. For alloSCT, continued strategies to reduce NRM are needed. Cancer 2013;119:3662–3671. © 2013 American Cancer Society.