TY - JOUR
T1 - Low incidence of posttransplant lymphoproliferative disorder after allogeneic stem cell transplantation in patients with lymphoma treated with rituximab
AU - Complication Working Group of the Japan Society for Hematopoietic Cell Transplantation
AU - Fujimoto, Ayumi
AU - Hiramoto, Nobuhiro
AU - Yamasaki, Satoshi
AU - Inamoto, Yoshihiro
AU - Ogata, Masao
AU - Sugio, Yasuhiro
AU - Fukuda, Takahiro
AU - Uchida, Naoyuki
AU - Ikegame, Kazuhiro
AU - Matsuoka, Ken ichi
AU - Shiratori, Souichi
AU - Kondo, Tadakazu
AU - Miyamoto, Toshihiro
AU - Eto, Tetsuya
AU - Ichinohe, Tatsuo
AU - Kanda, Yoshinobu
AU - Atsuta, Yoshiko
AU - Suzuki, Ritsuro
N1 - Funding Information:
We thank all the physicians and data managers at the centers who contributed to gathering data on transplantation for the Transplant Registry Unified Management Program and all the members of the Data Management Committees of Japan Society for Hematopoietic Cell Transplantation. This work was supported in part by the Practical Research Project for Allergic Disease and Immunology (Research Technology of Medical Transplantation), Japan Agency for Medical Research and Development, AMED.
Funding Information:
N.H., S.Y., M.O., Y.S., T.F., K.I., K.M., S.S., T.K., and T.E. have no financial conflicts of interest to disclose. A.F. has received personal fees from Bristol‐Meyer Squib and Celgene, outside the submitted work. Y.I. has received personal fees from Astellas Pharma Inc., Kyowa Kirin Co., Ltd., Novartis Pharma, Sumitomo Dainippon Pharma Co., Ltd., and MSD K.K., a subsidiary of Merck & Co., Inc., as well as nonfinancial support from Astellas Pharma Inc., Kyowa Kirin Co., Ltd., Novartis pharma, Sumitomo Dainippon Pharma Co., Ltd., and MSD K.K. a subsidiary of Merck & Co., Inc., outside of the submitted work. N.U. has received personal fees from MSD K.K., Asahi Kasei Pharma Corporation, Astellas Pharma Inc., Abbott Japan Co., Alexion Pharma Co., Otsuka Pharmaceutical Co., Ono Pharmaceutical Co., Kyowa Kirin Co., Sawai Pharmaceutical Co., Sumitomo Dainippon Pharma Co., Takeda Pharmaceutical Co., Chugai Pharmaceutical Co., Novartis Pharma K.K., and Pfizer Inc., outside the submitted work. T.M. has received personal fees from MSD, Celgene, Abbvie, Takeda Pharmaceutical, Bristol‐Myers Squibb, Janssen, Novartis, Astellas, and Astellas Amgen, outside the submitted work. T.I. has received personal fees from Kyowa Hakko Kirin, Celgene, Bristol Myers Squibb, and Janssen, and also has received grants from Kyowa Hakko Kirin, Repertoire Genesis, FUJIFILM Wako Pure Chemical Corporation, Takara Bio Inc., Chugai, Nippon Shinyaku, Takeda, Ono, Zenyaku, and Pfizer, outside the submitted work. Y.K. has received personal fees from Astellas, Eisai, Otsuka, Sanofi, JB, Nippon Shinyaku, Pfizer, MSD, Janssen, Celgene, Novartis, BMS, Takeda, Alexion, Shire, Daiichi Sankyo, Nippon Kayaku, Ono, Mundi, Chugai, and Kyowa Kirin, and also has received grants from Astellas, Eisai, Otsuka, Sanofi, Shionogi, Taiho, JB, Nippon Shinyaku, Pfizer, Celgene, Takeda, Chugai, and Kyowa Kirin, outside the submitted work. Y.A. has received personal fees from Mochida Pharmaceutical, Meiji Seika, Chugai Pharmaceutical, Kyowa Kirin, Bristol‐Myers Squibb, Yakult Honsha, and Janssen Pharmaceutical, outside the submitted work. R.S. has received personal fees from Bristol‐Meyer Squib, Novartis, Kyowa‐Hakko Kirin, Chugai Pharmaceuticals, Shionogi, Takeda, Meiji Seika Pharma, MSD, Otsuka, Sawai, Celgene, Sumitomo Dainippon, Eisai Pharmaceuticals, Alexion Pharma, Sanofi, Gilead Sciences, Abbvie Inc., Mundi Pharma, Jazz Pharma, Ono Pharma, and Janssen Pharmaceuticals, outside the submitted work.
Funding Information:
We thank all the physicians and data managers at the centers who contributed to gathering data on transplantation for the Transplant Registry Unified Management Program and all the members of the Data Management Committees of Japan Society for Hematopoietic Cell Transplantation. This work was supported in part by the Practical Research Project for Allergic Disease and Immunology (Research Technology of Medical Transplantation), Japan Agency for Medical Research and Development, AMED.
Publisher Copyright:
© 2020 John Wiley & Sons Ltd
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Posttransplant lymphoproliferative disorder (PTLD) is a serious complication after hematopoietic stem cell transplantation (HSCT). Several studies of risk factors for PTLD have been reported; however, the probability of, and risk factors for, PTLD in patients with lymphoma is unknown. Japanese nationwide transplant registry data from 5270 patients with lymphoma after allogeneic HSCT were analyzed. Mature B-cell, T/NK-cell, and T-cell lymphoblastic subtypes accounted for 49%, 26%, and 9.6% of lymphoma cases, respectively. Rituximab was used in 1678 lymphoma patients, most of whom (89%) received HSCT for mature B-cell lymphoma. Thirty-one patients with lymphoma developed PTLD, representing a probability of 0.77% at 2 years post-HSCT, which did not differ significantly from that in patients with other diseases (P =.98). Year of HSCT after 2010 (hazard ratio [HR] = 5.6, 95% confidence interval [CI], 1.48-21.3), antithymocyte globulin (ATG) use in the conditioning regimen (HR = 4.5, 95% CI, 1.61-12.5), and no rituximab use before HSCT (HR = 3.2, 95% CI, 1.26-7.90) were identified as risk factors for PTLD. Probabilities of PTLD at 1 year post-HSCT according to rituximab and ATG use were 0.23% (rituximab+, ATG−), 0.75% (rituximab−, ATG−), 1.25% (rituximab+, ATG+), and 3.53% (rituximab−, ATG+). Regarding lymphoma subtypes, patients with mature B-cell lymphoma had the lowest incidence of PTLD (0.35% at 2 years). Among high-risk patients receiving ATG, the mortality rate due to infection was elevated in those previously treated with rituximab (22%) relative to those without (14%); however, the difference was not significant (P =.10). Rituximab use before HSCT significantly reduces the risk of PTLD. Adding rituximab to the conditioning regimen is potentially a good strategy to prevent the development of PTLD in high-risk patients.
AB - Posttransplant lymphoproliferative disorder (PTLD) is a serious complication after hematopoietic stem cell transplantation (HSCT). Several studies of risk factors for PTLD have been reported; however, the probability of, and risk factors for, PTLD in patients with lymphoma is unknown. Japanese nationwide transplant registry data from 5270 patients with lymphoma after allogeneic HSCT were analyzed. Mature B-cell, T/NK-cell, and T-cell lymphoblastic subtypes accounted for 49%, 26%, and 9.6% of lymphoma cases, respectively. Rituximab was used in 1678 lymphoma patients, most of whom (89%) received HSCT for mature B-cell lymphoma. Thirty-one patients with lymphoma developed PTLD, representing a probability of 0.77% at 2 years post-HSCT, which did not differ significantly from that in patients with other diseases (P =.98). Year of HSCT after 2010 (hazard ratio [HR] = 5.6, 95% confidence interval [CI], 1.48-21.3), antithymocyte globulin (ATG) use in the conditioning regimen (HR = 4.5, 95% CI, 1.61-12.5), and no rituximab use before HSCT (HR = 3.2, 95% CI, 1.26-7.90) were identified as risk factors for PTLD. Probabilities of PTLD at 1 year post-HSCT according to rituximab and ATG use were 0.23% (rituximab+, ATG−), 0.75% (rituximab−, ATG−), 1.25% (rituximab+, ATG+), and 3.53% (rituximab−, ATG+). Regarding lymphoma subtypes, patients with mature B-cell lymphoma had the lowest incidence of PTLD (0.35% at 2 years). Among high-risk patients receiving ATG, the mortality rate due to infection was elevated in those previously treated with rituximab (22%) relative to those without (14%); however, the difference was not significant (P =.10). Rituximab use before HSCT significantly reduces the risk of PTLD. Adding rituximab to the conditioning regimen is potentially a good strategy to prevent the development of PTLD in high-risk patients.
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U2 - 10.1002/hon.2714
DO - 10.1002/hon.2714
M3 - Article
C2 - 31953867
AN - SCOPUS:85078819482
SN - 0278-0232
VL - 38
SP - 146
EP - 152
JO - Hematological Oncology
JF - Hematological Oncology
IS - 2
ER -
