Long‐term follow‐up demonstrates curative potential of autologous stem cell transplantation for relapsed follicular lymphoma

Abstract

Summary Although autologous stem cell transplantation (ASCT) can achieve durable responses in eligible patients with follicular lymphoma (FL), long‐term follow‐up is needed to determine if it has curative potential. This retrospective, multicenter study included 162 patients who received ASCT for relapsed FL in Alberta, Canada. With a median (range) follow‐up time of 12.5 years (0.1–27.9), the 12‐year time‐to‐progression (TTP) was 57% (95% confidence interval [CI] 49%–65%), time‐to‐next‐treatment was 61% (95% CI 52%–69%), progression‐free survival was 51% (95% CI 42%–59%) and overall survival was 69% (95% CI 60%–76%). A plateau emerged on the TTP curve at 57% starting 9 years after ASCT with no relapses occurring beyond this timepoint. Ten patients remained in remission 20 years or more after ASCT. Patients undergoing ASCT at first or second relapse had superior outcomes compared to third or later relapse (12‐year TTP 61% vs. 34%), as did patients without progression of disease within 24 months (POD24) of frontline treatment versus those with POD24 (12‐year TTP 67% vs. 50%). ASCT achieves high rates of durable remission in relapsed FL, with long‐term follow‐up revealing that more than 50% of transplanted patients may be functionally cured of their lymphoma. The optimal timing to consider ASCT is at first or second relapse, regardless of POD24 status.

Burden of Illness in Follicular Lymphoma with Multiple Lines of Treatment, Italian RWE Analysis

“…Regarding the relapsing rate after ASCT, our data referred to a limited time span, however, they could be contextualized within a very recent multicentre Canadian study on 162 ASCT recipients for relapsed follicular lymphoma that reported over 12 years a time to progression of 57%, time to next treatment of 61%, progression-free survival of 51%. Thus, only about half of transplanted patients were able to achieve durable responses [35].…”

Sculpting nursing resilience: Transforming lives, nurturing ethics in chimeric antigen receptor T‐cell therapy

“…Recent advancement includes a computational approach where tumour cells are targeted with peptide-centric CAR Tcell (a new class of engineered T cells that can recognize and eradicate), 5 synthetic gene circuits, 6 traffickings and infiltration of CAR T-cells into solid tumours by engineering them with chemokine receptors, integrins, or enzymes that can degrade the extracellular matrix 6 and for such complex treatment regimens a nurse who is well trained, knowledgeable and skilful has a crucial integral role in providing comprehensive nursing health service to patients. [7][8][9][10]…”

Fifteen-year remission in a patient with follicular lymphoma after high-dose chemotherapy with autologous stem cell transplantation as a first-line treatment

“…Long-term follow-up have showed that HDT with ASCT provides long-term 25-30-year remissions in patients with FL, and over 50% of FL patients can probably achieve a biological cure of the tumor [1][2][3].…”