Long term follow-up of BEAM-autologous and BEAM-alemtuzumab allogeneic stem cell transplantation in relapsed advanced stage follicular lymphoma

Noriega, Víctor; Kaur, Harpreet; Devereux, Stephen; Byrne, J L; Marcus, Robert; Haynes, Andrew; Yallop, Deborah; McMillan, Andrew; Ingram, Wendy; Khan, Anjum; Kenyon, Michelle; Potter, Victoria; Russell, Nigel H.; Mufti, Ghulam J.; Pagliuca, Antonio

doi:10.1016/j.leukres.2014.03.005

Cited by 7 publications

(7 citation statements)

References 30 publications

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“…The same conditioning therapy was applied in patients with follicular lymphomas (FL) (Ingram et al 2008 ; Noriega et al 2014 ). In the first study, the authors compared BEAM-autologous HSCT versus alemtuzumab-BEAM allogeneic HSCT.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the relapse rate was significantly lower in the allogeneic arm (20 vs. 43 %; p = 0.01) (Ingram et al 2008 ). The same treatment approach was used in two other studies (Faulkner et al 2004 ; Noriega et al 2014 ). Again a high rate of responses as well as a low incidence of GvHD was reported.…”

Section: Discussionmentioning

confidence: 99%

“…The introduction of alemtuzumab was shown to result in a lower incidence of GvHD (7–17 %) compared with non-T cell-depleted regimens and has been investigated in patients with lymphoproliferative disorders and follicular lymphoma (Faulkner et al 2004 ; Noriega et al 2014 ).…”

Section: Introductionmentioning

confidence: 99%

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Alemtuzumab-BEAM as conditioning for allogeneic hematopoietic stem cell transplantation in relapsed/refractory Hodgkin lymphoma: a single-center analysis

Rabitsch

Bojić

Wohlfarth

et al. 2016

J Cancer Res Clin Oncol

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Purpose Treatment of refractory Hodgkin disease deserves specific considerations. Recently, alemtuzumab-BEAM has been introduced in allogeneic hematopoietic stem cell transplantation (HSCT) in these patients.MethodsWe retrospectively analyzed the outcome of 20 patients with relapsed/refractory Hodgkin’s lymphoma (HL) who received allogeneic HSCT following conditioning therapy with alemtuzumab-BEAM.ResultsTreatment-related toxicity was tolerable. Half of the patients (50 %) had infections. Of these, 50 % were found to have pneumonia or catheter-related infections. In 20 %, an oral mucositis was observed. Acute graft-versus-host disease (GvHD) (≥grade 2) was seen in three patients. Complete remission (CR) could be achieved in 17 patients (85 %), 2 patients had persistent Hodgkin disease, and 1 patient died from infection prior to CR evaluation. Median progression-free survival and overall survival were 17.9 and 67.5 months, respectively. From the 17 CR patients, 8 had a relapse after a median of 10 months. Notably, of the eight patients relapsing after HSCT, all patients received another salvage treatment and four patients are still alive, whereas the other four patients died due to further progress. Six out of the remaining nine patients are still in CR, whereas the other three died from chronic GvHD and multi-organ failure. Overall, seven patients experienced chronic GvHD.ConclusionIn summary, alemtuzumab-BEAM is a well-tolerated conditioning therapy for allogeneic HSCT with high response rates in refractory HL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Alemtuzumab-BEAM as conditioning for allogeneic hematopoietic stem cell transplantation in relapsed/refractory Hodgkin lymphoma: a single-center analysis

Rabitsch

Bojić

Wohlfarth

et al. 2016

J Cancer Res Clin Oncol

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“…One prospective and several retrospective comparison studies between auto-SCT and allo-SCT for relapsed FL have been reported. [28][29][30][31][32][33] These studies showed that allo-SCT could reduce the incidence of relapse and progression. However, there was no difference in OS between auto-SCT and allo-SCT because patients who underwent allo-SCT had an increased risk of NRM, so a decreased risk of NRM is a matter of utmost concern.…”

Section: Discussionmentioning

confidence: 99%

Favorable survival after allogeneic stem cell transplantation with reduced-intensity conditioning regimens for relapsed/refractory follicular lymphoma

Yano¹,

Mori

Kanda

et al. 2015

Bone Marrow Transplant

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Allogeneic stem cell transplantation (allo-SCT) is a curative option for patients with relapsed follicular lymphoma (FL). Prospective studies of reduced-intensity conditioning (RIC) have revealed that chemosensitivity at allo-SCT is the most reliable predictor of outcome; however, limited data are available for progressive/refractory disease. We report here a retrospective analysis of RIC allo-SCT for patients with FL. The purpose of this study was to elucidate the role of allo-SCT for patients with relapsed/refractory FL. We analyzed 46 patients-11 (24%) transplanted in CR, 6 (13%) transplanted in PR and 29 (63%) with progressive/refractory disease. The estimated 5-year overall survival rate was 71.6% (95% confidence interval (CI), 51.5-84.5%). According to the disease status at transplantation, the 5-year survival rate was 80.7% (95% CI, 37.7-95.4%) in the patients with CR or PR and 66.1% (95% CI, 41.5-82.3%) in those with progressive/refractory disease (P=0.29). There were no differences in relapse/progression and non-relapse mortality between the patients with chemosensitive disease and progressive/refractory disease. Allo-SCT may be a valuable treatment option, even for patients with progressive/refractory FL.

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“…In a British study [63] comparing autologous versus allogeneic HSCT in patients with follicular lymphoma, 29% of patients transplanted in first complete remission (CR) in the allogeneic group received DLI, being 43% for mixed chimerism and the remaining, for relapse (accompanied by chemotherapy). In total, 14 out of 16 patients remained alive and in CR after DLI, suggesting good control of disease.…”

Section: • • Lymphomasmentioning

confidence: 99%

Donor Lymphocyte Infusion After Allogeneic Hematopoietic Stem Cell Transplantation

Pereira

Danby

Rocha

2015

Int. J. Hematol. Oncol.

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Donor lymphocyte infusion, a rescue therapy after hematopoietic stem cell transplantation, has been increasingly adopted, as modalities of stem cell transplantation have widened. First described as donor lymphocyte transfusion or cell therapy, it consists of infusion of donor lymphocytes, collected in steady state or after growth factor enhancement. As in literature the most used name is donor lymphocyte infusion, we'll adopt it here. Its most striking efficacy is observed in patients with chronic myelogenous leukemia, who relapsed after allogeneic stem cells transplantation. However, graft-versus-host disease, its main complication, may still hamper its feasibility. KEYWORDSAllogeneic hematopoietic stem cell transplantation (HSCT) has become an attractive approach for the treatment of many patients with hematological diseases, including malignant and nonmalignant disorders. Importantly, in the last 15 years, with the advent of reduced intensity conditioning (RIC) regimens, many older adult patients, initially excluded from this therapy approach, became eligible for HSCT. This approach decreased the transplant-related mortality, still maintaining T-cell immune response from the graft against the host tumor cells, also known as the graft-versus tumor or graft Practice points• Donor lymphocyte infusion (DLI) is an alternative strategy to reverse mixed chimerism, treat relapse and reconstitute immunity against infections after hematopoietic stem cell transplantation.• Responses to DLI are disease-dependent.• As main side effect, DLI can promote graft-versus-host disease (GVHD) in the range of 40-60% of patients.• The incidence of GVHD after unrelated DLI is similar to the incidence after related DLI, both presenting same pattern of presentation.• Although GVHD and graft versus leukemia (GVL) after DLI are highly correlated, some patients experience remission (GVL) without expressing GVHD.• Escalating doses for DLI is preferable, as it induces less GVHD. There is no clear association, yet confirmed, between T-cell dose and incidence of neither GVHD nor GVL after DLI.• The further DLI is made from transplantation, the better outcome.• Preadjuvant treatment before DLI is preferable as DLI effect is enhanced with low tumor burden.• Some strategies still under investigation are focused on separating GVHD and GVL, including graft engineering and gene therapy, to improve clinical outcome.For reprint orders, please contact: reprints@futuremedicine.com

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Long term follow-up of BEAM-autologous and BEAM-alemtuzumab allogeneic stem cell transplantation in relapsed advanced stage follicular lymphoma

Cited by 7 publications

References 30 publications

Alemtuzumab-BEAM as conditioning for allogeneic hematopoietic stem cell transplantation in relapsed/refractory Hodgkin lymphoma: a single-center analysis

Alemtuzumab-BEAM as conditioning for allogeneic hematopoietic stem cell transplantation in relapsed/refractory Hodgkin lymphoma: a single-center analysis

Favorable survival after allogeneic stem cell transplantation with reduced-intensity conditioning regimens for relapsed/refractory follicular lymphoma

Donor Lymphocyte Infusion After Allogeneic Hematopoietic Stem Cell Transplantation

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