Outcomes of Rituximab-BEAM Versus BEAM Conditioning Regimen in Patients With Diffuse Large B Cell Lymphoma Undergoing Autologous Transplantation

Deepa Jagadeesh; Navneet S. Majhail; Yizeng He; Kwang W. Ahn; Carlos Litovich; Sairah Ahmed; Mahmoud Aljurf; Ulrike Bacher; Sherif M. Badawy; Nelli Bejanyan; Mitchell Cairo; Jan Cerny; Narendranath Epperla; Nosha Farhadfar; César O. Freytes; Robert Peter Gale; Bradley Haverkos; Nasheed Hossain; David Inwards; Rammurti T. Kamble; Vaishalee P. Kenkre; Hillard M. Lazarus; Aleksandr Lazaryan; Lazaros Lekakis; Matthew Mei; Hemant S. Murthy; Alberto Mussetti; Sunita Nathan; Taiga Nishihori; Richard F. Olsson; Praveen Ramakrishnan Geethakumari; Bipin N. Savani; Jean A. Yared; Timothy S. Fenske; Mohamed A. Kharfan-Dabaja; Anna Sureda; Mehdi Hamadani

doi:10.1002/cncr.32752

Outcomes of Rituximab-BEAM Versus BEAM Conditioning Regimen in Patients With Diffuse Large B Cell Lymphoma Undergoing Autologous Transplantation

Deepa Jagadeesh, Navneet S. Majhail, Yizeng He, Kwang W. Ahn, Carlos Litovich, Sairah Ahmed, Mahmoud Aljurf, Ulrike Bacher, Sherif M. Badawy, Nelli Bejanyan, Mitchell Cairo, Jan Cerny, Narendranath Epperla, Nosha Farhadfar, César O. Freytes, Robert Peter Gale, Bradley Haverkos, Nasheed Hossain, David Inwards, Rammurti T. KambleVaishalee P. Kenkre, Hillard M. Lazarus, Aleksandr Lazaryan, Lazaros Lekakis, Matthew Mei, Hemant S. Murthy, Alberto Mussetti, Sunita Nathan, Taiga Nishihori, Richard F. Olsson, Praveen Ramakrishnan Geethakumari, Bipin N. Savani, Jean A. Yared, Timothy S. Fenske, Mohamed A. Kharfan-Dabaja, Anna Sureda, Mehdi Hamadani

Research output: Contribution to journal › Article

Abstract

BACKGROUND: Although rituximab-based high-dose therapy is frequently used in diffuse large B cell lymphoma (DLBCL) patients undergoing autologous hematopoietic cell transplantation (auto-HCT), data supporting the benefits are not available. Herein, we report the impact of rituximab-based conditioning on auto-HCT outcomes in patients who have DLBCL. METHODS: Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, 862 adult DLBCL patients undergoing auto-HCT between 2003 and 2017 using BEAM (BCNU, etoposide, cytarabine, melphalan) conditioning regimen were included. All patients received frontline rituximab-containing chemoimmunotherapy and had chemosensitive disease pre-HCT. Early chemoimmunotherapy failure was defined as not achieving complete remission (CR) after frontline chemoimmunotherapy or relapse within 1 year of initial diagnosis. The primary outcome was overall survival (OS). RESULTS: The study cohort was divided into 2 groups: BEAM (n = 667) and R-BEAM (n = 195). On multivariate analysis, no significant difference was seen in OS (P =.83) or progression-free survival (PFS) (P =.61) across the 2 cohorts. No significant association between the use of rituximab and risk of relapse (P =.15) or nonrelapse mortality (P =.12) was observed. Variables independently associated with lower OS included older age at auto-HCT (P <.001), absence of CR at auto-HCT (P <.001) and early chemoimmunotherapy failure (P <.001). Older age (P <.0002) and non-CR pre-HCT (P <.0001) were also associated with inferior PFS. There was no significant difference in early infectious complications between the 2 cohorts. CONCLUSION: In this large registry analysis of DLBCL patients undergoing auto-HCT, the addition of rituximab to the BEAM conditioning regimen had no impact on transplantation outcomes. Older age, absence of CR pre auto-HCT, and early chemoimmunotherapy failure were associated with inferior survival.

Original language	English (US)
Journal	Cancer
DOIs	https://doi.org/10.1002/cncr.32752
State	Accepted/In press - 2020

Keywords

BEAM
autologous transplantation
chemoimmunotherapy
diffuse large B cell lymphoma
rituximab

ASJC Scopus subject areas

Oncology
Cancer Research

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Jagadeesh, D., Majhail, N. S., He, Y., Ahn, K. W., Litovich, C., Ahmed, S., Aljurf, M., Bacher, U., Badawy, S. M., Bejanyan, N., Cairo, M., Cerny, J., Epperla, N., Farhadfar, N., Freytes, C. O., Gale, R. P., Haverkos, B., Hossain, N., Inwards, D., ... Hamadani, M. (Accepted/In press). Outcomes of Rituximab-BEAM Versus BEAM Conditioning Regimen in Patients With Diffuse Large B Cell Lymphoma Undergoing Autologous Transplantation. Cancer. https://doi.org/10.1002/cncr.32752

Outcomes of Rituximab-BEAM Versus BEAM Conditioning Regimen in Patients With Diffuse Large B Cell Lymphoma Undergoing Autologous Transplantation. / Jagadeesh, Deepa; Majhail, Navneet S.; He, Yizeng; Ahn, Kwang W.; Litovich, Carlos; Ahmed, Sairah; Aljurf, Mahmoud; Bacher, Ulrike; Badawy, Sherif M.; Bejanyan, Nelli; Cairo, Mitchell; Cerny, Jan; Epperla, Narendranath; Farhadfar, Nosha; Freytes, César O.; Gale, Robert Peter; Haverkos, Bradley; Hossain, Nasheed; Inwards, David; Kamble, Rammurti T.; Kenkre, Vaishalee P.; Lazarus, Hillard M.; Lazaryan, Aleksandr; Lekakis, Lazaros; Mei, Matthew; Murthy, Hemant S.; Mussetti, Alberto; Nathan, Sunita; Nishihori, Taiga; Olsson, Richard F.; Ramakrishnan Geethakumari, Praveen; Savani, Bipin N.; Yared, Jean A.; Fenske, Timothy S.; Kharfan-Dabaja, Mohamed A.; Sureda, Anna; Hamadani, Mehdi.

In: Cancer, 2020.

Research output: Contribution to journal › Article

Jagadeesh, D, Majhail, NS, He, Y, Ahn, KW, Litovich, C, Ahmed, S, Aljurf, M, Bacher, U, Badawy, SM, Bejanyan, N, Cairo, M, Cerny, J, Epperla, N, Farhadfar, N, Freytes, CO, Gale, RP, Haverkos, B, Hossain, N, Inwards, D, Kamble, RT, Kenkre, VP, Lazarus, HM, Lazaryan, A, Lekakis, L, Mei, M, Murthy, HS, Mussetti, A, Nathan, S, Nishihori, T, Olsson, RF, Ramakrishnan Geethakumari, P, Savani, BN, Yared, JA, Fenske, TS, Kharfan-Dabaja, MA, Sureda, A & Hamadani, M 2020, 'Outcomes of Rituximab-BEAM Versus BEAM Conditioning Regimen in Patients With Diffuse Large B Cell Lymphoma Undergoing Autologous Transplantation', Cancer. https://doi.org/10.1002/cncr.32752

Jagadeesh, Deepa ; Majhail, Navneet S. ; He, Yizeng ; Ahn, Kwang W. ; Litovich, Carlos ; Ahmed, Sairah ; Aljurf, Mahmoud ; Bacher, Ulrike ; Badawy, Sherif M. ; Bejanyan, Nelli ; Cairo, Mitchell ; Cerny, Jan ; Epperla, Narendranath ; Farhadfar, Nosha ; Freytes, César O. ; Gale, Robert Peter ; Haverkos, Bradley ; Hossain, Nasheed ; Inwards, David ; Kamble, Rammurti T. ; Kenkre, Vaishalee P. ; Lazarus, Hillard M. ; Lazaryan, Aleksandr ; Lekakis, Lazaros ; Mei, Matthew ; Murthy, Hemant S. ; Mussetti, Alberto ; Nathan, Sunita ; Nishihori, Taiga ; Olsson, Richard F. ; Ramakrishnan Geethakumari, Praveen ; Savani, Bipin N. ; Yared, Jean A. ; Fenske, Timothy S. ; Kharfan-Dabaja, Mohamed A. ; Sureda, Anna ; Hamadani, Mehdi. / Outcomes of Rituximab-BEAM Versus BEAM Conditioning Regimen in Patients With Diffuse Large B Cell Lymphoma Undergoing Autologous Transplantation. In: Cancer. 2020.

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title = "Outcomes of Rituximab-BEAM Versus BEAM Conditioning Regimen in Patients With Diffuse Large B Cell Lymphoma Undergoing Autologous Transplantation",

abstract = "BACKGROUND: Although rituximab-based high-dose therapy is frequently used in diffuse large B cell lymphoma (DLBCL) patients undergoing autologous hematopoietic cell transplantation (auto-HCT), data supporting the benefits are not available. Herein, we report the impact of rituximab-based conditioning on auto-HCT outcomes in patients who have DLBCL. METHODS: Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, 862 adult DLBCL patients undergoing auto-HCT between 2003 and 2017 using BEAM (BCNU, etoposide, cytarabine, melphalan) conditioning regimen were included. All patients received frontline rituximab-containing chemoimmunotherapy and had chemosensitive disease pre-HCT. Early chemoimmunotherapy failure was defined as not achieving complete remission (CR) after frontline chemoimmunotherapy or relapse within 1 year of initial diagnosis. The primary outcome was overall survival (OS). RESULTS: The study cohort was divided into 2 groups: BEAM (n = 667) and R-BEAM (n = 195). On multivariate analysis, no significant difference was seen in OS (P =.83) or progression-free survival (PFS) (P =.61) across the 2 cohorts. No significant association between the use of rituximab and risk of relapse (P =.15) or nonrelapse mortality (P =.12) was observed. Variables independently associated with lower OS included older age at auto-HCT (P <.001), absence of CR at auto-HCT (P <.001) and early chemoimmunotherapy failure (P <.001). Older age (P <.0002) and non-CR pre-HCT (P <.0001) were also associated with inferior PFS. There was no significant difference in early infectious complications between the 2 cohorts. CONCLUSION: In this large registry analysis of DLBCL patients undergoing auto-HCT, the addition of rituximab to the BEAM conditioning regimen had no impact on transplantation outcomes. Older age, absence of CR pre auto-HCT, and early chemoimmunotherapy failure were associated with inferior survival.",

keywords = "BEAM, autologous transplantation, chemoimmunotherapy, diffuse large B cell lymphoma, rituximab",

author = "Deepa Jagadeesh and Majhail, {Navneet S.} and Yizeng He and Ahn, {Kwang W.} and Carlos Litovich and Sairah Ahmed and Mahmoud Aljurf and Ulrike Bacher and Badawy, {Sherif M.} and Nelli Bejanyan and Mitchell Cairo and Jan Cerny and Narendranath Epperla and Nosha Farhadfar and Freytes, {C{\'e}sar O.} and Gale, {Robert Peter} and Bradley Haverkos and Nasheed Hossain and David Inwards and Kamble, {Rammurti T.} and Kenkre, {Vaishalee P.} and Lazarus, {Hillard M.} and Aleksandr Lazaryan and Lazaros Lekakis and Matthew Mei and Murthy, {Hemant S.} and Alberto Mussetti and Sunita Nathan and Taiga Nishihori and Olsson, {Richard F.} and {Ramakrishnan Geethakumari}, Praveen and Savani, {Bipin N.} and Yared, {Jean A.} and Fenske, {Timothy S.} and Kharfan-Dabaja, {Mohamed A.} and Anna Sureda and Mehdi Hamadani",

year = "2020",

doi = "10.1002/cncr.32752",

language = "English (US)",

journal = "Cancer",

issn = "0008-543X",

publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - Outcomes of Rituximab-BEAM Versus BEAM Conditioning Regimen in Patients With Diffuse Large B Cell Lymphoma Undergoing Autologous Transplantation

AU - Jagadeesh, Deepa

AU - Majhail, Navneet S.

AU - He, Yizeng

AU - Ahn, Kwang W.

AU - Litovich, Carlos

AU - Ahmed, Sairah

AU - Aljurf, Mahmoud

AU - Bacher, Ulrike

AU - Badawy, Sherif M.

AU - Bejanyan, Nelli

AU - Cairo, Mitchell

AU - Cerny, Jan

AU - Epperla, Narendranath

AU - Farhadfar, Nosha

AU - Freytes, César O.

AU - Gale, Robert Peter

AU - Haverkos, Bradley

AU - Hossain, Nasheed

AU - Inwards, David

AU - Kamble, Rammurti T.

AU - Kenkre, Vaishalee P.

AU - Lazarus, Hillard M.

AU - Lazaryan, Aleksandr

AU - Lekakis, Lazaros

AU - Mei, Matthew

AU - Murthy, Hemant S.

AU - Mussetti, Alberto

AU - Nathan, Sunita

AU - Nishihori, Taiga

AU - Olsson, Richard F.

AU - Ramakrishnan Geethakumari, Praveen

AU - Savani, Bipin N.

AU - Yared, Jean A.

AU - Fenske, Timothy S.

AU - Kharfan-Dabaja, Mohamed A.

AU - Sureda, Anna

AU - Hamadani, Mehdi

PY - 2020

Y1 - 2020

N2 - BACKGROUND: Although rituximab-based high-dose therapy is frequently used in diffuse large B cell lymphoma (DLBCL) patients undergoing autologous hematopoietic cell transplantation (auto-HCT), data supporting the benefits are not available. Herein, we report the impact of rituximab-based conditioning on auto-HCT outcomes in patients who have DLBCL. METHODS: Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, 862 adult DLBCL patients undergoing auto-HCT between 2003 and 2017 using BEAM (BCNU, etoposide, cytarabine, melphalan) conditioning regimen were included. All patients received frontline rituximab-containing chemoimmunotherapy and had chemosensitive disease pre-HCT. Early chemoimmunotherapy failure was defined as not achieving complete remission (CR) after frontline chemoimmunotherapy or relapse within 1 year of initial diagnosis. The primary outcome was overall survival (OS). RESULTS: The study cohort was divided into 2 groups: BEAM (n = 667) and R-BEAM (n = 195). On multivariate analysis, no significant difference was seen in OS (P =.83) or progression-free survival (PFS) (P =.61) across the 2 cohorts. No significant association between the use of rituximab and risk of relapse (P =.15) or nonrelapse mortality (P =.12) was observed. Variables independently associated with lower OS included older age at auto-HCT (P <.001), absence of CR at auto-HCT (P <.001) and early chemoimmunotherapy failure (P <.001). Older age (P <.0002) and non-CR pre-HCT (P <.0001) were also associated with inferior PFS. There was no significant difference in early infectious complications between the 2 cohorts. CONCLUSION: In this large registry analysis of DLBCL patients undergoing auto-HCT, the addition of rituximab to the BEAM conditioning regimen had no impact on transplantation outcomes. Older age, absence of CR pre auto-HCT, and early chemoimmunotherapy failure were associated with inferior survival.

AB - BACKGROUND: Although rituximab-based high-dose therapy is frequently used in diffuse large B cell lymphoma (DLBCL) patients undergoing autologous hematopoietic cell transplantation (auto-HCT), data supporting the benefits are not available. Herein, we report the impact of rituximab-based conditioning on auto-HCT outcomes in patients who have DLBCL. METHODS: Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, 862 adult DLBCL patients undergoing auto-HCT between 2003 and 2017 using BEAM (BCNU, etoposide, cytarabine, melphalan) conditioning regimen were included. All patients received frontline rituximab-containing chemoimmunotherapy and had chemosensitive disease pre-HCT. Early chemoimmunotherapy failure was defined as not achieving complete remission (CR) after frontline chemoimmunotherapy or relapse within 1 year of initial diagnosis. The primary outcome was overall survival (OS). RESULTS: The study cohort was divided into 2 groups: BEAM (n = 667) and R-BEAM (n = 195). On multivariate analysis, no significant difference was seen in OS (P =.83) or progression-free survival (PFS) (P =.61) across the 2 cohorts. No significant association between the use of rituximab and risk of relapse (P =.15) or nonrelapse mortality (P =.12) was observed. Variables independently associated with lower OS included older age at auto-HCT (P <.001), absence of CR at auto-HCT (P <.001) and early chemoimmunotherapy failure (P <.001). Older age (P <.0002) and non-CR pre-HCT (P <.0001) were also associated with inferior PFS. There was no significant difference in early infectious complications between the 2 cohorts. CONCLUSION: In this large registry analysis of DLBCL patients undergoing auto-HCT, the addition of rituximab to the BEAM conditioning regimen had no impact on transplantation outcomes. Older age, absence of CR pre auto-HCT, and early chemoimmunotherapy failure were associated with inferior survival.

KW - BEAM

KW - autologous transplantation

KW - chemoimmunotherapy

KW - diffuse large B cell lymphoma

KW - rituximab

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U2 - 10.1002/cncr.32752

DO - 10.1002/cncr.32752

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AN - SCOPUS:85079369077

JO - Cancer

JF - Cancer

SN - 0008-543X

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