Autologous hematopoietic cell transplantation for the treatment of relapsed/refractory pediatric, adolescent, and young adult Hodgkin lymphoma: a single institutional experience

Talleur, Aimee C; Flerlage, Jamie E.; Shook, David; Chilsen, Abigail M; Hudson, Melissa M.; Cheng, Cheng; Huang, Sujuan

doi:10.1038/s41409-020-0879-4

Cited by 6 publications

(7 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the current study, the ICE regimen had a superior 3-year EFS in comparison to the GV; however, the 3-year OS was similar. Survival outcomes reported here were favorably similar to other children and adolescents series with R/R CHL ( 3 ) ( 9 ) ( 10 ) ( 33 – 35 ).…”

Section: Discussionsupporting

confidence: 85%

Outcome and toxicity of ifosfamide, carboplatin, and etoposide versus gemcitabine and vinorelbine regimen for pediatric patients with relapsed or refractory Hodgkin’s lymphoma

et al. 2023

View full text Add to dashboard Cite

BackgroundPediatric classical Hodgkin lymphoma (CHL) is a curable disease; however, the optimal salvage regimen is unclear for relapsed/refractory (R/R) disease. This study aimed to compare response rates, toxicity, event-free survival (EFS), and overall survival (OS) of ifosfamide, carboplatin, and etoposide (ICE) with gemcitabine and vinorelbine (GV) regimen after first-line doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) in pediatric patients with R/R CHL.MethodsThis is a retrospective cohort study of 132 pediatric patients with R/R CHL treated from July 2012 to December 2020 with ICE (n = 82) or GV (n = 50).ResultsThe median age at relapse was 13.9 years, and 68.2% were men. Rates of complete response, partial response, and progressive disease before consolidation were 50.6%, 3.7%, and 45.7% for ICE and 28.5%, 0%, and 71.5% for GV (P = 0.011). By multivariate analysis, regimen (P = 0.002), time to relapse (P = 0.0001), and B-symptoms (P = 0.002) were independent factors to lower response rates. Hematological toxicity, electrolyte disturbance, hemorrhagic cystitis, infectious complications, and hospital admission for fever neutropenia were statistically significant higher for the ICE regimen. Treatment-related mortalities were 2.4% for ICE and 2% for GV (P = 0.86). The 3-year EFS was 39.3% ± 11.4% for ICE and 24.9% ± 12.5% for GV (P = 0.0001), while 3-year OS was 69.3% ± 10.6% and 74% ± 12.9% (P = 0.3), respectively. By multivariate analysis, regimen (P = 0.0001), time to relapse (P = 0.011), B-symptoms (P = 0.001), and leukocytosis (P = 0.007) were significant for EFS, while anemia (P = 0.008), and progressive disease on early response evaluation (P = 0.022) were significant for OS.ConclusionsThe ICE regimen had a better overall response rate and EFS, but higher toxicity, than GV; however, OS and mortality were similar.

show abstract

Section: Discussionsupporting

confidence: 85%

Outcome and toxicity of ifosfamide, carboplatin, and etoposide versus gemcitabine and vinorelbine regimen for pediatric patients with relapsed or refractory Hodgkin’s lymphoma

et al. 2023

View full text Add to dashboard Cite

show abstract

“… 24 , 25 Other smaller studies have also reported excellent outcomes, particularly among patients treated in the last 20 years, with an EFS after ASCT ranging from 85% to 87%. 8 , 9 The explanation for exceptional outcomes in our group is likely multifactorial, including (1) an inherent selection bias in that our cohort included only patients who completed ASCT and started brentuximab consolidation, (2) improved salvage therapies, (3) increased use of FDG-PET to determine remission before ASCT and a significant portion of patients in our cohort (69%) entering ASCT with a negative FDG-PET, and (4) a potential benefit from the use of brentuximab vedotin consolidation.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 2 , 3 In the largest retrospective series, event-free survival (EFS) for patients with relapsed or refractory disease after high-dose therapy with autologous stem cell transplantation (ASCT) is only 42% to 57%, thus there is an urgent clinical need for improved therapies. 1 , 4 , 5 , 6 , 7 , 8 , 9 One approach to reducing the risk of posttransplantation recurrence is through the use of post-ASCT consolidative therapy. Brentuximab vedotin is an anti-CD30 antibody conjugated to the microtubule-disrupting agent monomethyl auristatin E that has demonstrated efficacy in the salvage and frontline settings in adult and pediatric patients with HL.…”

Section: Introductionmentioning

confidence: 99%

Brentuximab vedotin after autologous transplantation in pediatric patients with relapsed/refractory Hodgkin lymphoma

et al. 2023

Self Cite

View full text Add to dashboard Cite

Outcomes for children and adolescents with relapsed and refractory Hodgkin lymphoma (HL) are poor, with approximately 50% of patients experiencing a subsequent relapse. The anti-CD30 antibody-drug conjugate brentuximab vedotin improved progression-free survival (PFS) when used as consolidation after autologous stem cell transplant (ASCT) in adults with high-risk relapsed/refractory HL. Data on brentuximab vedotin as consolidative therapy after ASCT in pediatric patients with HL are extremely limited, with only 11 patients reported in the literature. We performed a retrospective analysis of 67 pediatric patients who received brentuximab vedotin as consolidation therapy following ASCT for the treatment of relapsed/refractory HL to describe the experience of this regimen in the pediatric population. This is the largest cohort reported to date. We found that brentuximab vedotin was well tolerated with a safety profile similar to adult patients. With a median follow up of 37 months, the 3-year PFS was 85%. These data suggest a potential role for the use of brentuximab vedotin as consolidation therapy after ASCT for children with relapsed/refractory Hodgkin lymphoma.

show abstract

“…Recently, the efficacy of new target immune therapies, like brentuximab vedotin (BV) and checkpoint inhibitors, has been demonstrated both for adults and children with relapsed/refractory HL. 122,123 BV has been approved, not only as first-part of salvage treatment, but also as consolidation after auto-HSCT, with the role of reducing the further disease progression. [122][123][124][125] Checkpoint inhibitors, such as pembrolizumab, are currently under evaluation as maintenance therapy after auto-HSCT, in children and adolescents with HL (NCT02362997).…”

Section: Dovepressmentioning

confidence: 99%

Pediatric Autologous Hematopoietic Stem Cell Transplantation: Safety, Efficacy, and Patient Outcomes. Literature Review

Testi¹,

Moleti²,

Angi³

et al. 2023

PHMT

View full text Add to dashboard Cite

Autologous stem cell transplantation (auto-HSCT) is a part of the therapeutic strategy for various oncohematological diseases. The auto-HSCT procedure enables hematological recovery after high-dose chemotherapy, otherwise not tolerable, by the infusion of autologous hematopoietic stem cells. Unlike allogeneic transplant (allo-HSCT), auto-HSCT has the advantage of lacking acute-graft-versus-host disease (GVHD) and prolonged immunosuppression, however, these advantages are counterbalanced by the absence of graft-versus-leukemia. Moreover, in hematological malignancies, the autologous hematopoietic stem cell source may be contaminated by neoplastic cells, leading to disease reappearance. In recent years, allogeneic transplant-related mortality (TRM) has progressively decreased, almost approaching auto-TRM, and many alternative donor sources are available for the majority of patients eligible for transplant procedures. In adults, the role of auto-HSCT compared to conventional chemotherapy (CT) in hematological malignancies has been well defined in many extended randomized trials; however, such trials are lacking in pediatric cohorts. Therefore, the role of auto-HSCT in pediatric oncohematology is limited, in both first- and second-line therapies and still remains to be defined. Nowadays, the accurate stratification in risk groups, according to the biological characteristics of the tumors and therapy response, and the introduction of new biological therapies, have to be taken into account in order to assign auto-HSCT a precise role in the therapeutic strategies, also considering that in the developmental age, auto-HSCT has a clear advantage over allo-HSCT, in terms of late sequelae, such as organ damage and second neoplasms. The purpose of this review is to report the results obtained with auto-HSCT in the different pediatric oncohematological diseases, focusing on the most significant literature data in the context of the various diseases and discussing this data in the light of the current therapeutic landscape.

show abstract

Autologous hematopoietic cell transplantation for the treatment of relapsed/refractory pediatric, adolescent, and young adult Hodgkin lymphoma: a single institutional experience

Cited by 6 publications

References 35 publications

Outcome and toxicity of ifosfamide, carboplatin, and etoposide versus gemcitabine and vinorelbine regimen for pediatric patients with relapsed or refractory Hodgkin’s lymphoma

Outcome and toxicity of ifosfamide, carboplatin, and etoposide versus gemcitabine and vinorelbine regimen for pediatric patients with relapsed or refractory Hodgkin’s lymphoma

Brentuximab vedotin after autologous transplantation in pediatric patients with relapsed/refractory Hodgkin lymphoma

Pediatric Autologous Hematopoietic Stem Cell Transplantation: Safety, Efficacy, and Patient Outcomes. Literature Review

Contact Info

Product

Resources

About