The Role of Cytotoxic Therapy with Hematopoietic Stem Cell Transplantation in the Treatment of Diffuse Large B Cell Lymphoma: Update of the 2001 Evidence-Based Review

Oliansky, Denise M; Czuczman, Myron S.; Fisher, Richard I.; Irwin, Frank D.; Lazarus, Hillard M.; Omel, James; Vose, Julie M.; Wolff, Steven N.; Jones, Roy B.; McCarthy, Philip L.; Hahn, Theresa

doi:10.1016/j.bbmt.2010.07.008

Cited by 95 publications

(56 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The outcome of our study, which was nearly identical to that reported with both the MCEC 4,5 and BCNU-based regimens, 1 remains unsatisfactory for these regimens to be used as salvage therapies. Our findings indicate that both CRP and sIL-2R levels may serve as useful markers for the selection of appropriate therapeutic strategies before transplantation in high-risk lymphoma patients.…”

supporting

confidence: 75%

Predictive role of levels of soluble interleukin-2 receptor and C-reactive protein in selecting autologous PBSC transplantation for lymphoma

Ariizumi

Saito

Uto

et al. 2014

Bone Marrow Transplant

View full text Add to dashboard Cite

High-dose chemotherapy (HDC) followed by autologous peripheral blood stem cell transplantation (HDC-auto-PBSCT) offers a cure for patients with lymphoma without the risk of GVHD. Conditioning regimens for Auto-SCT administered to patients in major studies have included BCNU in the BEAM or BEAC (BCNU, etoposide, cytarabine and cyclophosphamide) regimens. 1 However, BCNU is not available in Japan; therefore, various alternative regimens using ranimustine (MCNU) have been developed. An HDC regimen with MCNU, carboplatin, etoposide and cyclophosphamide (MCEC), which was first published by the Fukuoka Bone Marrow Transplantation Group, 2 has been widely used as a conditioning regimen for auto-PBSCT for non-Hodgkin lymphoma in Japan. [3][4][5] Multicenter trials have published the outcomes of the MCEC regimen, but only limited information is available with regard to prognostic factors (particularly laboratory parameters) for HDC-auto-PBSCT with the MCEC regimen. 4,5 Therefore, to establish predictive models for selecting appropriate therapeutic strategies, we retrospectively evaluated pre-transplantation factors that correlate with post-transplantation survival among patients with non-Hodgkin lymphoma who received first auto-PBSCT with the MCEC regimen as a historical cohort study.Patients who had received the MCEC regimen, which consisted of MCNU 200 mg/m 2 on days − 8 and − 3, carboplatin 300 mg/m 2 from days − 7 to − 4, etoposide 500 mg/m 2 from days − 6 to − 4 and cyclophosphamide 60 mg/kg on days − 3 and − 2, as arranged of which was described previously, 2,3 between August 1999 and December 2012 at Showa University Hospital, were enrolled. Responses to first-line chemotherapy, prior to chemotherapy of HDC-auto-PBSCT, and HDC-auto-PBSCT themselves were judged according to the International Working Group response criteria without evaluation using positron emission tomographycomputed tomography findings. 6 The responses to prior chemotherapies of HDC-auto-PBSCT were defined as disease status at SCT (CR as CR or CR/unconfirmed [CRu]; non-CR as less than CRu) and chemosensitivity at SCT (chemosensitive as CR, CRu or PR; chemoresistant as less than PR). Pre-transplantation factors, the prognostic impacts of most of which have been reported previously, were evaluated using univariate and multivariate analyses. The factors included laboratory parameters before HDC-auto-PBSCT, which were defined as the values determined between the latest chemotherapy end date and the administration of MCEC conditioning. All P values were determined from 2-tailed tests, with P o 0.05 considered significant. All statistical analyses were performed using EZR version 1.24 (Kanda Y, Saitama Medical Center, Jichi Medical University, Saitama, Japan). The study protocol was approved by the Ethics Committee of Showa University (Tokyo, Japan), which adhered to the principles of the Declaration of Helsinki.Thirty-eight patients (25 males and 13 females) with non-Hodgkin lymphoma who received the MCEC regimen because of non-CR achievement by first-...

show abstract

supporting

confidence: 75%

Predictive role of levels of soluble interleukin-2 receptor and C-reactive protein in selecting autologous PBSC transplantation for lymphoma

Ariizumi

Saito

Uto

et al. 2014

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…28 Because of the results reported from the randomized CORAL study, which are less favorable than those reported in nonrandomized study, 29 testing effective HDT schedules to increase responses and to reduce both TRM and the incidence of secondary diseases becomes an important area of research in relapsed/refractory lymphomas. 30 Furthermore, there is no evidence, to date, for a superior HDT regimen in the treatment of refractory or relapsed disease, in NHL or in HD. Carmustine For personal use only.…”

Section: Discussionmentioning

confidence: 99%

BeEAM (bendamustine, etoposide, cytarabine, melphalan) before autologous stem cell transplantation is safe and effective for resistant/relapsed lymphoma patients

Visani

Malerba

Stefani

et al. 2011

Blood

126

110

View full text Add to dashboard Cite

We designed a phase 1-2 study to evaluate the safety and the efficacy of increasing doses of bendamustine (160 mg/m 2 , 180 mg/m 2 , and 200 mg/m 2 given on days ؊7 and ؊6) coupled with fixed doses of etoposide, cytarabine, and melphalan (BeEAM regimen) as the conditioning regimen to autologous stem cell transplantation for resistant/relapsed lymphoma patients. Forty-three patients (median age, 47 years) with non-Hodgkin (n ‫؍‬ 28) or Hodgkin (n ‫؍‬ 15) lymphoma were consecutively treated. Nine patients entered the phase 1 study; no patients experienced a dose-limiting toxicity. Thirty-four additional patients were then treated in the phase 2. A median number of 6 ؋ 10 6 CD34 ؉ cells/kg (range, 2.4-15.5) were reinfused. All patients engrafted, with a median time to absolute neutrophil count > 0.5 ؋ 10 9 /L of 10 days. The 100-day transplantation-related mortality was 0%.

show abstract

“…28 For relapse/progression, disease status is an important variable, as chemorefractory disease before allo-HCT is the strongest adverse prognostic factor. [6][7][8][9][10][11][12][13][14][15][16][17]25,28,34,35 Other factors that have been associated with increased risk of relapse are increased age (440 years old), 16,17 relapse occurring o12 months after initial treatment, 26 and use of other sources of stem cells than peripheral blood stem cells (PBSC). 35 Interestingly, no study to date has revealed any association of cGVHD with risk of relapse, possibly reflecting a minor role of immunological mechanism in the response of DLBCL patients to allo-HCT.…”

Section: Prognostic Factors For Outcome After Allo-sct In Patients Wimentioning

confidence: 99%

“…6 This approach is most effective in those with chemosensitive disease 7 and is associated with prolonged survival in B40% of patients. 8,9 However, patients who relapse within 12 months of initial treatment with a rituximab-containing regimen and those who are resistant to salvage treatment or relapse after an auto-HCT have a poor prognosis with a median survival of less than a year. 10,11 Allogeneic haematopoietic progenitor cell transplantation (allo-HCT) increasingly has been used as salvage treatment for these patients.…”

Section: Introductionmentioning

confidence: 99%

The role of allogeneic haematopoietic progenitor cell transplantation in patients with diffuse large B-cell non-Hodgkin lymphomas (DLBCL)

Papageorgiou

Cwynarski

Kottaridis

2013

Bone Marrow Transplant

View full text Add to dashboard Cite

Despite the undoubted improvement in the prognosis of patients with diffuse large B-cell lymphomas (DLBCLs) with the addition of rituximab in the front-line treatment, a significant proportion of patients still relapse. Salvage immune-chemotherapy followed by high-dose therapy with autologous haematopoietic cell transplantation (auto-HCT) remains the treatment of choice for such patients, especially in those who demonstrate chemosensitive disease. In recent years, allogeneic haematopoietic cell transplantation (allo-HCT) has increasingly been used for patients who are resistant to salvage treatment or relapse after an auto-HCT. Strategies using reduced intensity conditioning regimens have allowed application of this approach to a broader range of patients. PFS is up to 55% with a risk of relapse up to 80% depending on different studies. In multivariate analysis, several factors have been associated with favourable outcome including chemosensitivity of the disease, younger age and Karnofsky performance status at the time of the transplant being the strongest ones. DLIs have shown to induce durable responses in relapsed or progressed disease; however, its role remains controversial as the results are inferior to the responses seen in other haematological malignancies. More recently, the addition of MoAbs in the non-myeloablative conditioning regimens has shown encouraging results. In conclusion, allo-HCT is a feasible option in selective patients with chemosensitive DBCL, as it reduces the risk of relapse; however, this is achieved at the cost of significant non-relapse mortality.

show abstract

The Role of Cytotoxic Therapy with Hematopoietic Stem Cell Transplantation in the Treatment of Diffuse Large B Cell Lymphoma: Update of the 2001 Evidence-Based Review

Cited by 95 publications

References 85 publications

Predictive role of levels of soluble interleukin-2 receptor and C-reactive protein in selecting autologous PBSC transplantation for lymphoma

Predictive role of levels of soluble interleukin-2 receptor and C-reactive protein in selecting autologous PBSC transplantation for lymphoma

BeEAM (bendamustine, etoposide, cytarabine, melphalan) before autologous stem cell transplantation is safe and effective for resistant/relapsed lymphoma patients

The role of allogeneic haematopoietic progenitor cell transplantation in patients with diffuse large B-cell non-Hodgkin lymphomas (DLBCL)

Contact Info

Product

Resources

About