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How to Approach a Hodgkin Lymphoma Patient With Relapse After Autologous SCT: Allogeneic SCT

Hodgkin lymphoma (HL) is a highly curable B-cell lymphoma, and ∼90% of patients who present with early-stage (stage I-II) disease and 70% of patients who present with late-stage disease will be cured with standard frontline treatment. For patients with relapsed or refractory (r/r) disease after initial therapy, the standard of care is salvage chemotherapy, fo llowed by autologous transplantation (autoSCT). Although this approach will cure a significant proportion of patients, upto 50% of patients will experience disease progression after autoSCT, and this population has historically had a very poor prognosis.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Review Source Type: research

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Conclusion Our results suggest that achievement of a CR is imperative in patients with advanced ENKL, and is desirable for any patient for whom auto-SCT is utilized. SMILE-based chemotherapy appeared effective in attaining a CR, and was also an effective salvage regimen. For patients attaining a first CR, auto-SCT should be strongly considered, but should definitely be utilized in patients attaining CR2. For patients with refractory disease, allo-SCT can be considered in a selected group of patients. Micro-Abstract We present a cohort of primarily non-Asian patients with advanced stage and relapsed/refractory ENKL. Our res...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Conclusion CNS-directed high-dose chemotherapy and ASCT provides durable remission for patients with synchronous aggressive lymphoma and should be strongly considered as consolidative therapy for eligible patients with systemic NHL with CNS involvement in first complete remission. Micro-Abstract Systemic non-Hodgkin lymphoma with synchronous central nervous system involvement traditionally carries a poor prognosis. We found encouraging results with the use of high-dose chemotherapy and autologous stem cell transplantation as consolidation for patients in first complete remission. Central nervous system-directed conditionin...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 15 November 2017 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Matthew Mei, Robert Chen Hodgkin lymphoma (HL) is a highly curable B-cell lymphoma, and ∼90% of patients who present with early-stage (stage I-II) disease and 70% of patients who present with late-stage disease will be cured with standard frontline treatment. For patients with relapsed or refractory (r/r) disease after initial therapy, the standard of care is salvage chemotherapy, followed by autologous transplantation (autoSCT). Although this approach will cure a significant proportion of patients, upto 5...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Hodgkin lymphoma (HL) is a highly curable B-cell lymphoma, and approximately 90% of patients who present with early stage (I-II) disease (1) and 70% of patients who present with late-stage disease will be cured with standard frontline treatment(2). For patients with relapsed or refractory (r/r) disease after initial therapy, the standard of care is salvage chemotherapy followed by autologous transplant (autoSCT). While this approach will cure a significant proportion of patients, up to 50% of patients will experience disease progression after autoSCT(3), and this population has historically had a very poor prognosis.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Source Type: research
Extra-nodal natural killer/T-cell lymphoma (ENKL) is a rare lymphoma representing approximately 5-10% of T-cell non-Hodgkin lymphomas diagnosed in the United States each year.1, 2 ENKL is universally associated with Epstein-Barr virus (EBV) infection, and is more frequent in Asian, Central American and South American populations, where it constitutes 5-15% of all lymphomas.3-5 Patients with advanced stage ENKL (stage III-IV) and relapsed/refractory early stage disease are treated with systemic chemotherapy with or without radiotherapy.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Source Type: research
Early stage classical Hodgkin lymphoma (cHL) has a high rate of cure for patients for are interim PET/CT-2 or 3 negative (1, 2) Thus, given this there is an increased focus on treatment de-escalation for patients with a negative interim PET/CT scan including decreasing number of cycles of chemotherapy, adding in biologic therapies, and decreasing radiation ranging from decreasing radiation doses and field sizes to eliminating radiation. However, for patients who have residual disease activity on interim PET/CT (1,  2) the outcomes remain challenging in that often ultimately these patients develop refractory disease th...
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Source Type: research
Conclusion CNS-directed high-dose chemotherapy and ASCT provides durable remission for patients with synchronous aggressive lymphoma and should be strongly considered as consolidative therapy for eligible patients with systemic NHL with CNS involvement in CR1. Teaser Systemic non-Hodgkin lymphoma with synchronous central nervous system (CNS) involvement traditionally carries a poor prognosis. We found encouraging results with the use of high-dose chemotherapy and autologous stem cell transplantation as consolidation for patients in first complete remission. CNS-directed conditioning with a thiotepa-based regimen might redu...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Conclusion IFRT used prior or after ASCT might partially compensate for worse prognostic factors among the overall population; subgroup analysis showed a trend for survival benefit at 3 years in patients with limited stage at relapse and PET positivity prior to ASCT. Teaser We investigated the role of radiotherapy in 73 patients receiving autologous stem cell transplant (ASCT) for relapsed/refractory Hodgkin lymphoma by comparing patients who received peri-transplant RT with patients who received chemotherapy alone.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Conclusions HSCT is a rugged job in Hbs-Ag positive or HCV-Ab positive patients due to more complications in the form of more neutropenia, GVHD, drug toxicity of chemotherapy, acute fulminant liver failure, fear of delaying of engraftment, and TRM. Careful evaluation before embarking on HSCT and intensive assessment against complications are warranted in Hbs-Ag positive and HCV-Ab positive recipients.
Source: Indian Journal of Transplantation - Category: Transplant Surgery Source Type: research
Publication date: Available online 3 January 2015 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Ranjit Kumar Chaudhary , Vijaya Raj Bhatt , Julie M. Vose Extranodal natural killer/T-cell lymphoma, nasal type (NKTL) is an uncommon aggressive subtype of non-Hodgkin lymphoma, which is significantly more common in East Asia and Latin America. Three-quarters of patients present with stage I/II disease, and half of patients have a low-risk International Prognostic Index score. Although additional factors including natural killer/T-cell lymphoma prognostic index and peripheral blood Epstein-Barr virus load influence ...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
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