Haematopoietic stem cell transplantation in adult soft-tissue sarcoma: an analysis from the European Society for Blood and Marrow Transplantation
Christoph E Heilig 1 2 3 , Manuela Badoglio 4 , Myriam Labopin 5 , Stefan Fröhling 6 2 , Simona Secondino 7 , Jürgen Heinz 8 , Emmanuelle Nicolas-Virelizier 9 , Didier Blaise 10 , Clément Korenbaum 11 , Armando Santoro 12 , Mareike Verbeek 13 , William Krüger 14 , Salvatore Siena 15 16 , Jakob R Passweg 17 , Massimo Di Nicola 18 , Jose Rifón 19 , Peter Dreger 3 , Ulrike Koehl 20 21 , Christian Chabannon 22 , Paolo Pedrazzoli 23 , European Society for Blood and Marrow Transplantation (EBMT), Cellular Therapy & Immunobiology Working Party
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.