Haematopoietic stem cell transplantation in adult soft-tissue sarcoma: an analysis from the European Society for Blood and Marrow Transplantation
Peter Dreger,
Paolo Pedrazzoli,
Salvatore Siena,
Christoph E Heilig,
Stefan Fröhling,
Massimo Di Nicola,
Manuela Badoglio,
Myriam Labopin,
Simona Secondino,
Jürgen Heinz,
Emmanuelle Nicolas-Virelizier,
Didier Blaise,
Clément Korenbaum,
Armando Santoro,
Mareike Verbeek,
William Krüger,
Jakob R Passweg,
Jose Rifón,
Ulrike Koehl,
Christian Chabannon
Affiliations
Peter Dreger
Department of Medicine V, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
Paolo Pedrazzoli
Internal Medicine and Medical Therapy, Università degli Studi di Pavia, Pavia, Lombardia, Italy
Salvatore Siena
Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
Christoph E Heilig
Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
Stefan Fröhling
Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
Massimo Di Nicola
Immunotherapy and Innovative Therapeutic Unit, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
Manuela Badoglio
EBMT Paris study office, Department of Haematology, Hospital Saint-Antoine, Paris, Île-de-France, France
Myriam Labopin
Saint Antoine Hospital, Université Pierre et Marie Curie, Paris, Île-de-France, France
Simona Secondino
Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, Pavia, Italy
Jürgen Heinz
Medicine I, University Medical Center Freiburg, Freiburg, Baden-Württemberg, Germany
Emmanuelle Nicolas-Virelizier
Hematology Department, Centre Léon Bérard, Lyon, Rhône-Alpes, France
Didier Blaise
Institut Paoli Calmettes, Departement D'Hematologie, Centre de Recherche en Cancerologie de Marseille, Marseille, Provence-Alpes-Côte d'Azu, France
Clément Korenbaum
Medical Oncology and Cellular Therapy, Hospital Tenon Medical Oncology, Paris, Île-de-France, France
Armando Santoro
Department of Oncology-Haematology, Humanitas Cancer Center, IRCCS, Milan, Italy
Mareike Verbeek
Internal Medicine III, Technical University of Munich, Munchen, Bayern, Germany
William Krüger
Haematology/Oncology, University Medicine Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
Jakob R Passweg
Division of Hematology, University Hospital Basel, Basel, BS, Switzerland
Jose Rifón
Hematology Service and Cell Therapy Area, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
Ulrike Koehl
Institute of Clinical Immunology, Fraunhofer Institute for Cell Therapy and Immunology IZI, Leipzig, Sachsen, Germany
Christian Chabannon
Centre de Thérapie Cellulaire, Département de Biologie du Cancer, Institut Paoli-Calmettes, Inserm CBT-1409, Marseille, Provence-Alpes-Côte d'Azu, France
Background The role of high-dose chemotherapy with autologous stem cell transplantation (ASCT) in the treatment of soft-tissue sarcoma (STS) remains an unsettled issue. Prospective clinical trials failed to prove a benefit of the procedure but were limited by small and heterogeneous patient cohorts. Thus, it is unknown if ASCT may be a valuable treatment option in specific patient subgroups.Methods The purpose of this study was to investigate the value of ASCT according to histological subtype in STS patients who were registered in the European Society for Blood and Marrow Transplantation database between 1996 and 2016.Results Median progression-free (PFS) and overall survival (OS) in the entire cohort of 338 patients were 8.3 and 19.8 months, respectively, and PFS and OS at 5 years were 13% and 25%, respectively. Analysis of outcomes in different subgroups showed that younger age, better remission status before transplantation and melphalan-based preparative regimen were predictive of benefit from ASCT, whereas histology and grading had no statistically significant impact.Conclusions Outcomes after ASCT compared favorably to those of recent trials on conventional chemotherapies and targeted therapies in STS, including histology-tailored approaches. ASCT, thus, should be reinvestigated in clinical trials focusing on defined patient subgroups.
