Allogeneic transplantation for Hodgkin’s lymphoma

Corradini, Paolo; Sarina, Barbara; Farina, Lucia

doi:10.1111/j.1365-2141.2010.08492.x

Cited by 24 publications

(20 citation statements)

References 78 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The clinical response, observed after chemotherapy and donor lymphocyte infusions, together with a high number of patients who remain in CR with a 63% disease-free survival at 4 years, would suggest the existence of a graft-versus-Hodgkin's lymphoma effect, operating in the setting of haplo-transplants and PT-CY. 24,25 An additional comment should be made on our experience with DLI: the lack of GvHD following several DLI, as well as the very low overall rate of GvHD, would point to allogeneic tolerance, actively maintained by regulatory T cells, without counteracting GvL.…”

Section: Discussionmentioning

confidence: 99%

Unmanipulated haploidentical BMT following non-myeloablative conditioning and post-transplantation CY for advanced Hodgkin’s lymphoma

Raiola

Dominietto

Varaldo

et al. 2013

Bone Marrow Transplant

141

View full text Add to dashboard Cite

Twenty-six patients with advanced Hodgkin's disease received a related HLA haploidentical unmanipulated BMT, following a nonmyeloablative conditioning with low-dose TBI, proposed by the Baltimore group; GvHD prophylaxis consisted of high-dose posttransplantation CY (PT-CY), mycophenolate and a calcineurin inhibitor. All patients had received a previous autograft, and 65% had active disease at the time of BMT. Sustained engraftment of donor cells occurred in 25 patients (96%), with a median time to neutrophil recovery (40.5 Â 10 9 /L) and platelet recovery (420 Â 10 9 /L) of þ 18 and þ 23 days from BMT. The incidence of grade II-IV acute GVHD and of chronic GVHD was 24% and 8%, respectively. With a median follow-up of 24 months (range 18-44) 21 patients are alive, 20 disease free. The cumulative incidence of TRM and relapse was 4% and 31%, respectively. The actuarial 3-year survival is 77%, the actuarial 3-year PFS is 63%. In conclusion, we confirm that high-dose PT-CY is effective as prophylaxis of GVHD after HLA haploidentical BMT, can prevent rejection and does not appear to eliminate the allogeneic graft versus lymphoma effect.

show abstract

Section: Discussionmentioning

confidence: 99%

Unmanipulated haploidentical BMT following non-myeloablative conditioning and post-transplantation CY for advanced Hodgkin’s lymphoma

Raiola

Dominietto

Varaldo

et al. 2013

Bone Marrow Transplant

141

View full text Add to dashboard Cite

show abstract

“…Demonstrated responses to donor lymphocyte infusion (DLI) and a trend toward a lower relapse rate after allogeneic SCT than after ASCT, especially when chronic graft-versus-host disease (GVHD) occurs, are direct and indirect arguments for a GVHL effect. [37][38][39] Because of the negative aspect of treatment-related mortality (TRM) of myeloablative conditioning regimens, reduced intensity conditioning (RIC) regimens have emerged as a potential option with acceptable TRM and long-term response. 40,41 Importantly, several studies have shown that chemosensitivity at transplantation remains a major predictor of outcome of RIC allogeneic SCT (RIC-allo).…”

Section: Allogeneic Stem-cell Transplantationmentioning

confidence: 99%

“…40,41 Importantly, several studies have shown that chemosensitivity at transplantation remains a major predictor of outcome of RIC allogeneic SCT (RIC-allo). 38,41,42 The expert panel acknowledges that RIC-allo may have a role in HL. For patients with primary refractory disease, and for those relapsing after first-line standard-dose chemotherapy, RIC-allo without previous ASCT is not recommended.…”

Section: Allogeneic Stem-cell Transplantationmentioning

confidence: 99%

Classical Hodgkin's lymphoma: the Lymphoma Study Association guidelines for relapsed and refractory adult patients eligible for transplant

et al. 2013

View full text Add to dashboard Cite

Key pre-salvage treatment risk factors that were almost consistently found to independently prognosticate outcome in Classical Hodgkin's lymphoma: the Lymphoma Study Association guidelines for relapsed and refractory adult patients eligible for transplant open-access paper. doi:10.3324/haematol.2012.072090 Manuscript received on January 15, 2013. Manuscript accepted on May 6, 2013 .beThe Hodgkin's Lymphoma Committee of the Lymphoma Study Association (LYSA) gathered in 2012 to prepare guidelines on the management of transplant-eligible patients with relapsing or refractory Hodgkin's lymphoma. The working group is made up of a multidisciplinary panel of experts with a significant background in Hodgkin's lymphoma. Each member of the panel of experts provided an interpretation of the evidence and a systematic approach to obtain consensus was used. Grades of recommendation were not required since levels of evidence are mainly based on phase II trials or standard practice. Data arising from randomized trials are emphasized. The final version was endorsed by the scientific council of the LYSA. The expert panel recommends a risk-adapted strategy (conventional treatment, or single/double transplantation and/or radiotherapy) based on three risk factors at progression (primary refractory disease, remission duration < 1 year, stage III/IV), and an early evaluation of salvage chemosensitivity, including 18 fluorodeoxy glucose-positron emission tomography interpreted according to the Deauville scoring system. Most relapsed or refractory Hodgkin's lymphoma patients chemosensitive to salvage should receive high-dose therapy and autologous stem-cell transplantation as standard. Efforts should be made to increase the proportion of chemosensitive patients by alternating non-cross-resistant chemotherapy lines or exploring the role of novel drugs. ABSTRACT © F e r r a t a S t o r t i F o u n d a t i o nN o c o m m e r c i a l u s e relapsing and refractory HL are primary refractoriness, short time to HL relapse, and advanced clinical stage at relapse. 2,12,13 The expert panel recommends using these robust prognostic factors to stratify patients into three risk groups (Table 1). There have been inconsistent reports of other predictive risk factors, sometimes with independent value, such as anemia, poor performance status (PS), presence of B symptoms, extranodal relapse, relapse in previous radiation field, age, or bulky disease, but the latter were not retained by the expert panel to serve in the risk group definition. 2,14,15 Primary refractoriness is defined either by progression at any time during chemotherapy or radiotherapy (RT) and up to three months after the end of treatment, and/or by persistence of a PET positive residual mass, using the quantitative 5-point scale Deauville score (DS) for PET interpretation. Using these criteria, a positive FDG-PET (i.e. DS 4 or 5) after 3-4 cycles of ABVD for supra-diaphragmatic HL, and after four cycles of BEACOP Pesc or ABVD for advanced HL, is considered as primary refractory disease...

show abstract

“…[16][17][18] Following the failure of allo-SCT, treatment options are limited and the prognosis for patients at this stage is extremely poor. 19 There is therefore a need for new therapeutic options for HL patients with relapsed/refractory disease. sALCL is a rare type of non-HL (NHL), and represents a group of large cell lymphomas, distinguished from other lymphomas by its anaplastic cytology and constant membrane expression of the CD30 antigen.…”

Section: Current Standard Of Care In Hodgkin's Lymphoma and Systemic mentioning

confidence: 99%

Antibody–Drug Conjugates in Relapsed/Refractory CD30-positive Lymphomas

Jäger¹,

Hutchings²

2015

European Oncology &Amp; Haematology

View full text Add to dashboard Cite

Although chemotherapy and radiotherapy are associated with good outcomes in patients with advanced Hodgkin's lymphoma (HL) and systemic anaplastic large cell lymphoma (sALCL), there is a need for alternative approaches to maximise control of the lymphoma in refractory and relapsed cases. Antibody-drug conjugates (ADCs) allow specific targeting of drugs to neoplastic cells. The ADC brentuximab vedotin (BV) has the ability to target cluster of differentiation (CD) 30+ tumour cells and initiate cytotoxic effects. In two phase II trials, BV resulted in objective responses in 75 % and 86 % of patients with refractory or relapsed HL and sALCL, respectively, with an acceptable toxicity profile. Based on these data, BV was granted accelerated approval by the US Food and Drug Administration for the treatment of refractory and relapsed HL and ALCL. A promising indication for BV is acting as a bridge to stem cell transplantation (SCT). Numerous studies are currently examining the role of BV as salvage therapy prior to autologous or allogeneic SCT, as well as in other clinical settings. KeywordsAntibody-drug conjugates, brentuximab vedotin, Hodgkin's lymphoma, systemic anaplastic large cell lymphoma Disclosure: Ulrich Jager has received honoraria and participated in Advisory Boards for Takeda. Martin Hutchings has participated in Advisory Boards for Celgene, Genentech, Janssen and Takeda, and has been a consultant to Genentech and Takeda. Support:The publication of this article was supported by Takeda, who were given the opportunity to review the article for scientific accuracy before submission. Any resulting changes were made at the author's discretion. Antibody-Drug Conjugates inRelapsed/Refractory CD30-positive Lymphomas This review will focus on the unmet needs in the management of HL and sALCL and discuss clinical studies investigating the efficacy and safety of BV. Current Standard of Care in Hodgkin's Lymphoma and Systemic Anaplastic Large Cell LymphomaHL is characterised by the orderly spread of disease from one lymph node to the other. Systemic symptoms are associated with advanced disease. The incidence of HL shows a bimodal age distribution, with the first peak in incidence rates in young adults, and the second peak in older people. 5 It is the most common malignancy in adolescents. 6 Despite the fact that first-line combined chemotherapy regimens, including doxorubicin (Adriamycin), bleomycin, vinblastine and dacarbazine (ABVD), achieve durable remission rates in approximately 80 % of cases, 7 a substantial proportion of patients with advanced HL (20-30 %) are refractory to therapy or relapse after initial treatment. 8 Remission rates can be increased by around 10 % with the use of more intensive chemotherapy regimens such as bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone (BEACOPP), but this treatment carries the risk of serious adverse events (AEs). 9,10

show abstract

Allogeneic transplantation for Hodgkin’s lymphoma

Cited by 24 publications

References 78 publications

Unmanipulated haploidentical BMT following non-myeloablative conditioning and post-transplantation CY for advanced Hodgkin’s lymphoma

Unmanipulated haploidentical BMT following non-myeloablative conditioning and post-transplantation CY for advanced Hodgkin’s lymphoma

Classical Hodgkin's lymphoma: the Lymphoma Study Association guidelines for relapsed and refractory adult patients eligible for transplant

Antibody–Drug Conjugates in Relapsed/Refractory CD30-positive Lymphomas

Contact Info

Product

Resources

About