Long-term impact of prior rituximab therapy and early lymphocyte recovery on auto-SCT outcome for diffuse large B-cell lymphoma

Stover, Daniel G.; Reddy, Vishruth K.; Shyr, Yu; Savani, Bipin N.; Reddy, Nishitha

doi:10.1038/bmt.2011.29

Cited by 10 publications

(4 citation statements)

References 22 publications

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“…It is intriguing to note that a negative predictor of humoral responses was donor EBV serostatus, and accordingly, patients reactivating EBV showed a worse trend in B cell and IgM repertoire, regardless of previous anti‐CD20 exposure. This observation is in line with the effect of B‐cell depleting therapies shown in other disease settings 33–36 …”

Section: Discussionsupporting

confidence: 83%

“…This observation is in line with the effect of B-cell depleting therapies shown in other disease settings. [33][34][35][36] Besides the differences in age, we showed the impact of immune recovery on clinical outcomes, demonstrating a drop in survival when none of the immune subsets recovered within the first post-HCT year. The interesting aspect is that among all the lymphoid lineages, CD4+ T and B cells were those mostly impacting survival probabilities.…”

Section: Discussionmentioning

confidence: 86%

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Age‐related immune cell dynamics influence outcomes after allogeneic haematopoietic cell transplantation

et al. 2023

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Summary An efficient immunological reconstitution construes the pillar for the success of allogeneic haematopoietic cell transplantation (HCT) in haematological disorders. Factors influencing post‐transplant immune recovery have been largely investigated across multiple cohorts issuing heterogeneous results. Differences in outcomes in adult and paediatric populations suggest an age‐related contribution to post‐transplant immune reconstitution; however, it is unclear how recipient and donor age may affect the dynamics of single immune cells. Here, we retrospectively collected and analysed immunological data of 174 patients (58 children and 116 adults) consecutively transplanted for haematological disorders in our centre. We show that trajectories of specific immune cells were strictly dependent on recipient age and pretransplant virus exposure, with the strongest effect seen on T CD4+ and B‐cell counterparts, while donor age and transplant platforms had a minimal impact. This mirrored different kinetics of immune reconstitution in adult and paediatric patients, with major divergences in immune cell composition in late post‐transplant phases, featuring better survival, relapse‐free survival and cumulative incidence of pathogen‐specific infections in younger patients. Altogether, these findings underpin the importance of recipient age on post‐transplant immune cell recovery and define the basic dynamics of the immune reconstitution in paediatric and adult populations as a benchmark for future studies.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 86%

Age‐related immune cell dynamics influence outcomes after allogeneic haematopoietic cell transplantation

et al. 2023

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“…In addition, PTV size of RT was demonstrated as an independent predictor of immunotherapy efficacy, where a higher PTV size leads to worse PFS. It has been shown in multiple studies that RT could decrease lymphocyte count ( 35 ). Lymphocytes in the peripheral blood circulation are sensitive to radiation, even at low doses.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of immunoradiotherapy for advanced non-small cell lung cancer: a retrospective comparative cohort study

Gao¹,

Sun²,

Hou³

et al. 2023

J Thorac Dis

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Background Treatment of radiotherapy (RT) combined with immune checkpoint inhibitor (ICI) may remarkably improve the prognosis in patients with metastatic non-small cell lung cancer (NSCLC). However, the treatment time of RT, irradiated lesion and the optimum combined scheme, have not been fully determined. Methods Data regarding overall survival (OS), progression-free survival (PFS), treatment response, and adverse events of 357 patients with advanced NSCLC treated with ICI alone or in combination with RT prior to/during ICI treatment were retrospectively collected. Additionally, subgroup analyses for radiation dose, time interval between RT and immunotherapy, and number of irradiated lesions were performed. Results Median PFS of the ICI alone and ICI + RT groups was 6 and 12 months, respectively (P<0.0001). The objective response rate (ORR) and disease control rate (DCR) were significantly higher in the ICI + RT group than in the ICI alone group (P=0.014; P=0.015, respectively). However, OS, the distant response rate (DRR), and the distant control rate (DCRt) did not differ significantly between the groups. Out-of-field DRR and DCRt were defined in unirradiated lesions only. Compared with RT application prior to ICI, its application concomitant with ICI led to higher DRR (P=0.018) and DCRt (P=0.002). Subgroup analyses revealed that single-site, high biologically effective dose (BED) (≥72 Gy), planning target volume (PTV) size (<213.7 mL) RT groups had better PFS. In multivariate analysis, PTV volume [≥213.7 vs . <213.7 mL: hazard ratio (HR), 1.89; 95% confidence interval (CI): 1.04–3.42; P=0.035] was an independent predictor of immunotherapy PFS. Additionally, radio-immunotherapy increased the incidence rate of grade 1–2 immune-related pneumonitis compared with ICI alone. Conclusions Combination therapy using ICIs and radiation may improve PFS and tumor response rates in advanced NSCLC patients regardless of programmed cell death 1 ligand 1 (PD-L1) level or previous treatments. However, it may increase the incidence of immune-related pneumonitis.

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“…Early lymphocyte recovery after autoHCT has been shown to be associated with positive clinical outcome in non-Hodgkin lymphoma [26]. However, there are limited and conflicting data on whether it affects posttransplantation outcome in HL [27–29].…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors and long-term outcome of autologous haematopoietic stem cell transplantation following a uniform-modified BEAM-conditioning regimen for patients with refractory or relapsed Hodgkin lymphoma: a single-center experience

et al. 2013

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Despite the well-defined role of autologous haematopoietic stem cell transplantation (autoHCT) in the treatment of patients with relapsed or refractory Hodgkin lymphoma (HL), relapse remains the main cause of transplant failure. We retrospectively evaluated long-term outcome and prognostic factors affecting survival of 132 patients with refractory (n = 89) or relapsed HL (n = 43) treated with autoHCT following modified BEAM. With a median follow-up of 68 months, the 10-year overall survival (OS) and progression-free survival (PFS) were 76 and 66 %, respectively. The 10-year cumulative incidence of second malignancies was 7 %. In multivariate analysis, age ≥45 years, more than one salvage regimens and disease status at transplant worse than CR were factors predictive for poor OS. In relapsed HL, age at transplant, response duration (<12 vs. ≥12 months) and the number of salvage regimens were independent predictors for PFS. In the refractory setting, disease status at autoHCT and the number of salvage regimens impacted PFS. The number of risk factors was inversely correlated with PFS in both relapsed and refractory HL (p = 0.003 and <0.001, respectively). The median PFS for patients with >1 risk factor in the relapsed and refractory setting was 5 and 11 months, respectively, in comparison with the median PFS not reached for patients with 0–1 risk factor in both settings. We conclude that high proportion of patients with relapsed/refractory HL can be cured with autoHCT. However, the presence of two or more risk factors helps to identify poor prognosis patients who may benefit from novel treatment strategies.

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Long-term impact of prior rituximab therapy and early lymphocyte recovery on auto-SCT outcome for diffuse large B-cell lymphoma

Cited by 10 publications

References 22 publications

Age‐related immune cell dynamics influence outcomes after allogeneic haematopoietic cell transplantation

Age‐related immune cell dynamics influence outcomes after allogeneic haematopoietic cell transplantation

Efficacy and safety of immunoradiotherapy for advanced non-small cell lung cancer: a retrospective comparative cohort study

Prognostic factors and long-term outcome of autologous haematopoietic stem cell transplantation following a uniform-modified BEAM-conditioning regimen for patients with refractory or relapsed Hodgkin lymphoma: a single-center experience

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