Novel conditioning regimen in upfront autologous stem cell transplantation in high-risk DLBCL

Ma, Jiexian; Sun, Shunrong; Hu, Yingwei; Wu, Min; Lin, Senjie; Wulipan, Fulati; Huang, Zilan; Qian, Wensi; Chen, Pingping; Chen, Mingyue; Xie, Yanhui

doi:10.1038/s41409-022-01766-8

Cited by 2 publications

(1 citation statement)

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“…Patients received a detailed examination of their tumor tissue (including immunohistochemistry, flow cytometry, fluorescence in situ hybridization, and pathological assessment) using an excisional biopsy specimen evaluated by an expert hematopathologist and was diagnosed CD20 + BCL if it met the 2016 WHO diagnostic guidelines for hematopoietic and lymphoid tissue tumors. Following the descriptions of a previous study, [22][23][24][25][26] we defined high-risk BCL as: (1) patients with an IPI score of 4-5 (on a scale of 0-5, with higher scores indicating greater risk) in DLBCL; (2) patients with an IPI score <4 but with double-hit lymphoma (DHL) (MYC/BCL2, MYC/BCL6), or triple-hit lymphoma (THL) (MYC/BCL-2/BCL6), or double-protein expression (MYC/BCL2), or triple-protein expression (MYC/BCL2/BCL6), or ABC subtypes with IRF4 or BCL2 hyperexpression; (3) high-grade BCL with DHL or THL; and (4) high-grade BCL, NOS. All patients were required to have achieved a CR after induction treatment.…”

Section: Patientsmentioning

confidence: 99%

Maintenance regimen of GM‐CSF with rituximab and lenalidomide improves survival in high‐risk B‐cell lymphoma by modulating natural killer cells

et al. 2023

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Background:The treatment of high-risk B-cell lymphoma (BCL) remains a challenge, especially in the elderly.Methods: A total of 83 patients (median age 65 years), who have achieved a complete response after induction therapy, were divided into two groups: R 2 + GM-CSF regimen (lenalidomide, rituximab, granulocyte-macrophage colony-stimulating factor [GM-CSF]) as maintenance therapy (n = 39) and observation (n = 44). The efficacy of the R 2 + GM-CSF regimen as maintenance in patient with high-risk BCL was analyzed and compared with observation. Results:The number of natural killer cells in patients increased after R 2 + GM-CSF regimen administration (0.131 × 10 9 /L vs. 0.061 × 10 9 /L, p = 0.0244). Patients receiving the R 2 + GM-CSF regimen as maintenance therapy had longer remission (duration of response: 18.9 vs. 11.3 months, p = 0.001), and longer progressionfree survival (not reached (NR) vs. 31.7 months, p = 0.037), and overall survival (OS) (NR vs. NR, p = 0.015). The R 2 + GM-CSF regimen was safe and well tolerated. High international prognostic index score (p = 0.012), and high tumor burden (p = 0.005) appeared to be independent prognostic factors for worse PFS. Conclusions:The maintenance therapy of R 2 + GM-CSF regimen may improve survival in high-risk BCL patients, which might be modulated by amplification of natural killer cells. The efficacy of the R 2 + GM-CSF maintenance regimen has to be further validated in prospective random clinical trials.

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Section: Patientsmentioning

confidence: 99%

Maintenance regimen of GM‐CSF with rituximab and lenalidomide improves survival in high‐risk B‐cell lymphoma by modulating natural killer cells

et al. 2023

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Mitoxantrone‐Based Novel Conditioning Regimen Leads to Great Survival Benefit in Peripheral T‐Cell Lymphoma Compared to BEAM Regimen

Zuo,

Qian,

et al. 2024

Cancer Medicine

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BackgroundPeripheral T‐cell lymphomas (PTCL) frequently result in relapsed or refractory diseases. Upfront autologous hematopoietic stem cell transplantation (ASCT) using the BEAM (carmustine, etoposide, cytarabine, and melphalan) regimen is recommended. However, relapses are common in PTCL, highlighting a critical need for improved survival outcomes in these patients.ObjectiveAnthracycline drugs are essential in treating PTCL. We compared the efficacy and tolerability of a high‐dose mitoxantrone‐based conditioning regimen [mitoxantrone, cyclophosphamide, and etoposide (MCE)] to the BEAM regimen in upfront ASCT for newly diagnosed PTCL patients who achieved complete or partial remission after induction therapy.Study DesignA retrospective study was conducted to analyze the treatment response, progression‐free survival (PFS), overall survival (OS), hematologic engraftment time, and adverse events of 64 patients between two regimens, who achieved complete or partial remission after induction chemotherapy. Twenty‐eight patients received the MCE regimen, while 36 patients were treated with the BEAM regimen.ResultsThere were no significant differences in clinical characteristics or the incidence of adverse events between the two groups. However, the median OS significantly favored the MCE group at 102.4 (95% CI, 87.0–117.8) months compared to 62.6 (95% CI, 50.8–74.5) months in the BEAM group (p = 0.023). Similarly, the median PFS was longer in the MCE group at 87.8 (95% CI, 65.8–109.8) months versus 42.5 (95% CI, 30.0–55.0) months in the BEAM group (p = 0.031).ConclusionASCT with the mitoxantrone‐based conditioning regimen is tolerable and appears to significantly improve the prognosis of PTCL patients, offering a promising alternative to the current standard of care.

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Novel conditioning regimen in upfront autologous stem cell transplantation in high-risk DLBCL

Cited by 2 publications

References 12 publications

Maintenance regimen of GM‐CSF with rituximab and lenalidomide improves survival in high‐risk B‐cell lymphoma by modulating natural killer cells

Maintenance regimen of GM‐CSF with rituximab and lenalidomide improves survival in high‐risk B‐cell lymphoma by modulating natural killer cells

Mitoxantrone‐Based Novel Conditioning Regimen Leads to Great Survival Benefit in Peripheral T‐Cell Lymphoma Compared to BEAM Regimen

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