Allogeneic hematopoietic cell transplantation for blastic plasmacytoid dendritic cell neoplasm: a CIBMTR analysis

Hemant S. Murthy, Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL.
Mei-Jie Zhang, Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI.
Karen Chen, Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
Sairah Ahmed, Department of Lymphoma/Myeloma and Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX.
Uday Deotare, London Health Sciences Centre, Toronto, ON, Canada.
Siddhartha Ganguly, Houston Methodist Hospital and Neal Cancer Center, Houston, TX.
Ankit Kansagra, Blood and Marrow Transplant Program, UT Southwestern Medical Center, Dallas, TX.
Fotios V. Michelis, Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, Toronto, Canada.
Taiga Nishihori, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL.
Mrinal Patnaik, Mayo Clinic Rochester, Rochester, MN.
Muhammad Bilal Abid, Divisions of Hematology/Oncology & Infectious Diseases, Bone and Marrow Transplant & Cellular Therapy Program, Medical College of Wisconsin, Milwaukee, WI.Follow
Mahmoud Aljurf, Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia.
Yasuyuki Arai, Kyoto University Hospital, Kyoto University, Kyoto, Japan.
Ulrike Bacher, Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Talha Badar, Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL.Follow
Sherif M. Badawy, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.Follow
Karen Ballen, Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA.
Minoo Battiwalla, Sarah Cannon Blood Cancer Network, Nashville, TN.Follow
Amer Beitinjaneh, Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, FL.
Nelli Bejanyan, Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL.Follow
Vijaya Raj Bhatt, The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE.
Valerie I. Brown, Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, PA.Follow
Rodrigo Martino, Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Jean-Yves Cahn, Department of Hematology, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France.
Paul Castillo, UF Health Shands Children's Hospital, Gainesville, FL.
Jan Cerny, Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA.
Saurabh Chhabra, Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
Edward Copelan, Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC.
Andrew Daly, Tom Baker Cancer Center, Calgary, AB, Canada.
Bhagirathbhai Dholaria, Vanderbilt University Medical Center, Nashville, TN.
Miguel Angel Diaz Perez, Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.
César O. Freytes, University of Texas Health Science Center at San Antonio, San Antonio, TX.

Document Type

Article

Publication Title

Blood advances

Abstract

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with a poor prognosis and considered incurable with conventional chemotherapy. Small observational studies reported allogeneic hematopoietic cell transplantation (allo-HCT) offers durable remissions in patients with BPDCN. We report an analysis of patients with BPDCN who received an allo-HCT, using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). We identified 164 patients with BPDCN from 78 centers who underwent allo-HCT between 2007 and 2018. The 5-year overall survival (OS), disease-free survival (DFS), relapse, and nonrelapse mortality (NRM) rates were 51.2% (95% confidence interval [CI], 42.5-59.8), 44.4% (95% CI, 36.2-52.8), 32.2% (95% CI, 24.7-40.3), and 23.3% (95% CI, 16.9-30.4), respectively. Disease relapse was the most common cause of death. On multivariate analyses, age of ≥60 years was predictive for inferior OS (hazard ratio [HR], 2.16; 95% CI, 1.35-3.46; P = .001), and higher NRM (HR, 2.19; 95% CI, 1.13-4.22; P = .02). Remission status at time of allo-HCT (CR2/primary induction failure/relapse vs CR1) was predictive of inferior OS (HR, 1.87; 95% CI, 1.14-3.06; P = .01) and DFS (HR, 1.75; 95% CI, 1.11-2.76; P = .02). Use of myeloablative conditioning with total body irradiation (MAC-TBI) was predictive of improved DFS and reduced relapse risk. Allo-HCT is effective in providing durable remissions and long-term survival in BPDCN. Younger age and allo-HCT in CR1 predicted for improved survival, whereas MAC-TBI predicted for less relapse and improved DFS. Novel strategies incorporating allo-HCT are needed to further improve outcomes.

First Page

7007

Last Page

7016

DOI

10.1182/bloodadvances.2023011308

Publication Date

11-28-2023

Identifier

37792849 (pubmed); PMC10690553 (pmc); 10.1182/bloodadvances.2023011308 (doi); 498210 (pii)

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