Donor Lymphocyte Infusions Modulate Relapse Risk in Mixed Chimeras and Induce Durable Salvage in Relapsed Patients After T-Cell–Depleted Allogeneic Transplantation for Hodgkin's Lymphoma

Peggs, Karl S.; Kayani, Irfan; Edwards, Noha; Kottaridis, Panagiotis D.; Goldstone, Anthony H.; Linch, David C.; Hough, Rachael; Morris, Emma; Fielding, Adele K.; Chakraverty, Ronjon; Thomson, Kirsty; Mackinnon, Stephen

doi:10.1200/jco.2010.32.1711

Cited by 115 publications

(92 citation statements)

References 32 publications

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“…9 Two studies have demonstrated this effect. 27,28 In our study, among the 30 patients for whom response information was available, the response rate was 27%.…”

Section: Discussionmentioning

confidence: 99%

Impact of disease status and stem cell source on the results of reduced intensity conditioning transplant for Hodgkin's lymphoma: a retrospective study from the French Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)

Marçais¹,

Porcher²,

Robin³

et al. 2013

Haematologica

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“…9 Two studies have demonstrated this effect. 27,28 In our study, among the 30 patients for whom response information was available, the response rate was 27%.…”

Section: Discussionmentioning

confidence: 99%

Impact of disease status and stem cell source on the results of reduced intensity conditioning transplant for Hodgkin's lymphoma: a retrospective study from the French Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)

Marçais¹,

Porcher²,

Robin³

et al. 2013

Haematologica

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“…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%

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

et al. 2013

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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...

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“…5,6 Nevertheless, a substantial number of patients will also relapse after HDC and will require further therapy. In this setting, an allo-SCT folllowing reduced intensity conditioning or nonmyeloablative regimens (NMA) has been shown to be feasible [6][7][8][9][10][11][12][13][14] and superior in terms of survival and PFS, when compared with other therapeutic options. 15 The problem with an allo-SCT is that the majority of patients lack an identical sibling and no more than 50% of patients, searching the Registries for unrelated donors or cord blood units, undergo an allo-SCT (World Marrow Donor Association data, 2012 unpublished).…”

Section: Introductionmentioning

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

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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.

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Donor Lymphocyte Infusions Modulate Relapse Risk in Mixed Chimeras and Induce Durable Salvage in Relapsed Patients After T-Cell–Depleted Allogeneic Transplantation for Hodgkin's Lymphoma

Abstract: These data demonstrate the potential for allogeneic immunotherapy with donor lymphocytes both to reduce relapse risk and to induce durable antitumor responses in patients with Hodgkin's lymphoma after hematopoietic stem-cell transplantation that incorporates in vivo T-cell depletion.

Cited by 115 publications

References 32 publications

Impact of disease status and stem cell source on the results of reduced intensity conditioning transplant for Hodgkin's lymphoma: a retrospective study from the French Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)

Impact of disease status and stem cell source on the results of reduced intensity conditioning transplant for Hodgkin's lymphoma: a retrospective study from the French Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)

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

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

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