Total Body Irradiation Compared With BEAM: Long-Term Outcomes of Peripheral Blood Autologous Stem Cell Transplantation for Non-Hodgkin's Lymphoma

Liu, Hongwei; Seftel, Matthew D.; Rubinger, Morel; Szwajcer, David; Demers, Alain; Nugent, Zoann; Schroeder, G.; Butler, James; Cooke, Andrew

doi:10.1016/j.ijrobp.2009.08.024

Cited by 14 publications

(6 citation statements)

References 30 publications

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“…Rates of peritransplantation toxicity were acceptable in our cohort, with 1 TRM in the TBI arm (2.3%). This compares favorably with other single-institution studies, which have reported a TRM of 8% to 16% with TBI-based conditioning and 4% with BEAM-based conditioning among patients treated in an earlier era [19,20]. No peritransplantation pneumonitis was observed, which may reflect more modern practices, including lung shielding to ensure a lung dose <10 Gy and reduced dose delivery rate.…”

Section: Discussionsupporting

confidence: 73%

Total Body Irradiation Is Safe and Similarly Effective as Chemotherapy-Only Conditioning in Autologous Stem Cell Transplantation for Mantle Cell Lymphoma

Tseng

Stevenson

Cassaday

et al. 2018

Biology of Blood and Marrow Transplantation

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Autologous stem cell transplant (ASCT) consolidation has become a standard approach for patients with mantle cell lymphoma (MCL), yet there is little consensus on the role of total body irradiation (TBI) as part of high-dose transplantation conditioning. We analyzed 75 consecutive patients with MCL who underwent ASCT at our institution between 2001 and 2011 with either TBI-based (n = 43) or carmustine, etoposide, cytarabine, melphalan (BEAM; n = 32) high-dose conditioning. Most patients (97%) had chemosensitive disease and underwent transplantation in first remission (89%). On univariate analysis, TBI conditioning was associated with a trend toward improved PFS (hazard ratio [HR], .53; 95% confidence interval [CI], .28-1.00; P = .052) and similar OS (HR, .59; 95% CI, .26-1.35; P = .21), with a median follow-up of 6.3 years in the TBI group and 6.6 years in the BEAM group. The 5-year PFS was 66% in the TBI group versus 52% in the BEAM group; OS was 82% versus 68%, respectively. However, on multivariate analysis, TBI-based conditioning was not significantly associated with PFS (HR, .57; 95% CI .24-1.34; P = .20), after controlling for age, disease status at ASCT, and receipt of post-transplantation rituximab maintenance. Likewise, early toxicity, nonrelapse mortality, and secondary malignancies were similar in the 2 groups. Our data suggest that both TBI and BEAM-based conditioning regimens remain viable conditioning options for patients with MCL undergoing ASCT.

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Section: Discussionsupporting

confidence: 73%

Total Body Irradiation Is Safe and Similarly Effective as Chemotherapy-Only Conditioning in Autologous Stem Cell Transplantation for Mantle Cell Lymphoma

Tseng

Stevenson

Cassaday

et al. 2018

Biology of Blood and Marrow Transplantation

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“…Among relapsed/refractory aggressive chemosensitive NHL patients, long-term OS and PFS ranged between 56%–64% and 49%--51% after ASCT with BEAM conditioning(120, 122, 123). In retrospective analyses, BEAM was also observed to be effective in the treatment of anaplastic large cell lymphomas and angioimmunoblastic lymphomas(126, 127).…”

Section: Lymphoid Malignanciesmentioning

confidence: 99%

Fifty Years of Melphalan Use in Hematopoietic Stem Cell Transplantation

Bayraktar

Bashir

Qazilbash

et al. 2013

Biology of Blood and Marrow Transplantation

101

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Melphalan remains the most widely used agent in preparative regimens for hematopoietic stem-cell transplantation. From its initial discovery more than 50 years ago, it has been gradually incorporated in the conditioning regimens for both autologous and allogeneic transplantation due to its myeloablative properties and broad antitumor effects as a DNA alkylating agent. Melphalan remains the mainstay conditioning for multiple myeloma and lymphomas; and has been used successfully in preparative regimens of a variety of other hematological and non-hematological malignancies. The addition of newer agents to conditioning like bortezomib or lenalidomide for myeloma, or clofarabine for myeloid malignancies, may improve antitumor effects for transplantation, while in combination with alemtuzumab may represent a backbone for future cellular therapy due to reliable engraftment and low toxicity profile. This review summarizes the development and the current use of this remarkable drug in hematopoietic stem-cell transplantation.

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“…This complication develops ~6 months to several years after radiation exposure in humans and 100–120 days post-irradiation in the C57BL/6J mouse model (2). Recent clinical data have demonstrated that the incidence of irradiation-related pulmonary injury among patients with cancer who received radiotherapy ranged from 20.3% to 36.9% (3–6). The current clinical treatment for pulmonary fibrosis primarily involves drugs such as steroids or non-steroidal anti-inflammatory agents and immunosuppressive agents.…”

Section: Introductionmentioning

confidence: 99%

The green tea extract epigallocatechin-3-gallate inhibits irradiation-induced pulmonary fibrosis in adult rats

You

Sun

et al. 2014

International Journal of Molecular Medicine

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The present study evaluated the effect of epigallocatechin-3-gallate (EGCG), the most abundant catechin in green tea, on irradiation-induced pulmonary fibrosis and elucidated its mechanism of action. A rat model of irradiation-induced pulmonary fibrosis was generated using a 60Co irradiator and a dose of 22 Gy. Rats were intraperitoneally injected with EGCG (25 mg/kg) or dexamethasone (DEX; 5 mg/kg) daily for 30 days. Mortality rates and lung index values were calculated. The severity of fibrosis was evaluated by assaying the hydroxyproline (Hyp) contents of pulmonary and lung tissue sections post-irradiation. Alveolitis and fibrosis scores were obtained from semi-quantitative analyses of hematoxylin and eosin (H&E) and Masson’s trichrome lung section staining, respectively. The serum levels of transforming growth factor β1 (TGF-β1), interleukin (IL)-6, IL-10, and tumor necrosis factor-α (TNF-α) were also measured. Surfactant protein-B (SPB) and α-SMA expression patterns were evaluated using immunohistochemistry, and the protein levels of nuclear transcription factor NF-E2-related factor 2 (Nrf-2) and its associated antioxidant enzymes heme oxygenase-1 enzyme (HO-1) and NAD(P)H:quinone oxidoreductase-1 (NQO-1) were examined via western blot analysis. Treatment with EGCG, but not DEX, reduced mortality rates and lung index scores, improved histological changes in the lung, reduced collagen depositions, reduced MDA content, enhanced SOD activity, inhibited (myo)fibroblast proliferation, protected alveolar epithelial type II (AE2) cells, and regulated serum levels of TGF-β1, IL-6, IL-10, and TNF-α. Treatment with EGCG, but not DEX, activated Nrf-2 and its downstream antioxidant enzymes HO-1 and NQO-1. Taken together, these results showed that EGCG treatment significantly inhibits irradiation-induced pulmonary fibrosis. Furthermore, the results suggested promising clinical EGCG therapies to treat this disorder.

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Total Body Irradiation Compared With BEAM: Long-Term Outcomes of Peripheral Blood Autologous Stem Cell Transplantation for Non-Hodgkin's Lymphoma

Cited by 14 publications

References 30 publications

Total Body Irradiation Is Safe and Similarly Effective as Chemotherapy-Only Conditioning in Autologous Stem Cell Transplantation for Mantle Cell Lymphoma

Total Body Irradiation Is Safe and Similarly Effective as Chemotherapy-Only Conditioning in Autologous Stem Cell Transplantation for Mantle Cell Lymphoma

Fifty Years of Melphalan Use in Hematopoietic Stem Cell Transplantation

The green tea extract epigallocatechin-3-gallate inhibits irradiation-induced pulmonary fibrosis in adult rats

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