Session
26
Oral presentations Nursing, Supportive & Palliative care, Rehabilitation & Survivorship
Nov. 20, 2024,
1:45 p.m. - 3:15 p.m.,
Lima
Abstract
4
Late effects of allogeneic stem cell transplantation for Non-Hodgkin lymphoma in Switzerland, 1997-2021, SBST register. Clinical analysis of ALLOHNS study cohort*.
A. von Werdt1, A. Künzi1, D. Schneidawind2, N. Wolfensberger2, J. Passweg3, Y. Chalandon4, S. Morin4, H. Baldomero3, A. Rovo1, E. Rebmann1, 5, Presenter: A. von Werdt1 (1Bern, 2Zurich, 3Basel, 4Geneva, 5Neuchâtel)
Objective
Allogeneic stem cell transplantation (allo‐HSCT) represents so far the only potentially curable treatment according to a longest follow in a setting of relapse/refractory NHL (rrNHL). However, it is performed in the majority of cases as a very last salvage ligne treatment and late effects in context of rrNHL are underexplored. We present here the first retrospective, multicentre, registry-based analysis (Swiss Blood Stem Cell Transplantation and Cellular Therapy, SBST) of late effects in patients underwent allo‐HSCT for rrNHL in Switzerland. This is a clinical analysis of patient’s cohort, analyzed for social and quality of life status (SQoL) in the ALLOHNS study.
* Krebsliga Swiss Cancer Research grant HSR-5223-11-2020, ALLOHNS SQoL, Abstract-ID 363.
Methods
We retrospectively analyzed data from 109 patients with all types of rrNHL who underwent allo-HSCT in 3 University Hospitals of Switzerland (Zurich, Basel and Geneva) between May 1997 and November 2021. The primary endpoint was the cumulative incidence (CI) of LE and secondary endpoint were overall survival (OS), relapse incidence (RI) and type of LE according to organ/systems involved. Final analysis is ongoing with more data possibly expected.
Results
Median of follow-up was 6.5 years. The mean age of patients at the time of allo-HSCT was 48 years. Patients who survived 2 years after allo-HSCT presented 5 and 10 years OS of 94% [95% CI 86.3 - 97.5] and 86% [95% CI 75 - 92.4] respectively (Figure). RI was 18.3% at 5 years and 34.4% at 10 years post allo-HSCT. Most frequent LE were secondary malignancies (21%), chronic kidney dysfunction (21%), osteoporosis (21%), cardiovascular disease (19%), and thyroid dysfunction (15%).
Conclusion
Our analysis of a mixed-type rrNHL cohort confirms the efficacy of allo-HSCT in heavily pretreated/refractory patients, showing excellent OS at 5 and 10 years for those who survived 2 years. Secondary malignancies, renal, bone and cardiovascular disease appear to be the most frequent types of LE, revealing accumulated toxicity in heavily pretreated patients with rrNHL. These results should be interpreted with caution due to the nature retrospective of the analysis, the long period analyzed, the heterogeneity of the conditioning regimen and the NHL cohort.