TY - JOUR

T1 - Retrospective analysis of hematopoietic cell transplantation for blastic plasmacytoid dendritic cell neoplasm

T2 - conditioning intensity matters

AU - Bruch, Peter Martin

AU - Dietrich, Sascha

AU - Finel, Herve

AU - Boumendil, Ariane

AU - Greinix, Hildegard

AU - Heinicke, Thomas

AU - Bethge, Wolfgang

AU - Beelen, Dietrich

AU - Schmid, Christoph

AU - Martin, Hans

AU - Castagna, Luca

AU - Scheid, Christof

AU - Schäfer-Eckart, Kerstin

AU - Bittenbring, Jörg

AU - Finke, Jürgen

AU - Sengeloev, Henrik

AU - Heiblig, Mael

AU - Cornelissen, Jan

AU - Chevallier, Patrice

AU - Mohty, Mohamad

AU - Robinson, Stephen

AU - Montoto, Silvia

AU - Dreger, Peter

N1 - Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer Nature Limited.

PY - 2023

Y1 - 2023

N2 - Blastic plasmacytoid dendritic cell neoplasia (BPDCN) is a rare myeloid malignancy with a generally poor prognosis. Although preliminary evidence suggests that hematopoietic cell transplantation (HCT) could improve outcome in patients with BPDCN, the individual contributions of conditioning and graft-versus-tumor (GVT) effects to HCT success are undefined. We present a retrospective study of 162 adult patients who underwent a first HCT (allogeneic 146, autologous 16) between 2009 and 2017, and were registered with the EBMT. Median age was 57 (range 20–73) years, and disease status at HCT was first complete remission (CR1) in 78%. Among patients receiving allogeneic HCT (alloHCT), myeloablative conditioning (MAC), reduced intensity conditioning (RIC) and in-vivo T-cell depletion (TCD) were used in 54%, 46%, and 59% respectively. Total body irradiation (TBI) was the conditioning backbone in 61% of MAC and 26% of RIC transplants. One-year overall survival (OS) and progression-free survival (PFS) rates were comparable after alloHCT and autologous HCT (autoHCT). Among alloHCT recipients, MAC with TBI significantly improved OS and PFS, independently of CR1, age, Karnofsky index and TCD. Accordingly, MAC (ideally based on TBI) should be preferred for alloHCT recipients with BPDCN. In patients who are not elegible for MAC alloHCT, autoHCT could be considered.

AB - Blastic plasmacytoid dendritic cell neoplasia (BPDCN) is a rare myeloid malignancy with a generally poor prognosis. Although preliminary evidence suggests that hematopoietic cell transplantation (HCT) could improve outcome in patients with BPDCN, the individual contributions of conditioning and graft-versus-tumor (GVT) effects to HCT success are undefined. We present a retrospective study of 162 adult patients who underwent a first HCT (allogeneic 146, autologous 16) between 2009 and 2017, and were registered with the EBMT. Median age was 57 (range 20–73) years, and disease status at HCT was first complete remission (CR1) in 78%. Among patients receiving allogeneic HCT (alloHCT), myeloablative conditioning (MAC), reduced intensity conditioning (RIC) and in-vivo T-cell depletion (TCD) were used in 54%, 46%, and 59% respectively. Total body irradiation (TBI) was the conditioning backbone in 61% of MAC and 26% of RIC transplants. One-year overall survival (OS) and progression-free survival (PFS) rates were comparable after alloHCT and autologous HCT (autoHCT). Among alloHCT recipients, MAC with TBI significantly improved OS and PFS, independently of CR1, age, Karnofsky index and TCD. Accordingly, MAC (ideally based on TBI) should be preferred for alloHCT recipients with BPDCN. In patients who are not elegible for MAC alloHCT, autoHCT could be considered.

U2 - 10.1038/s41375-022-01782-z

DO - 10.1038/s41375-022-01782-z

M3 - Journal article

C2 - 36550212

AN - SCOPUS:85144538592

VL - 37

SP - 465

EP - 472

JO - Leukemia

JF - Leukemia

SN - 0887-6924

IS - 2

ER -