Where does transplant fit in the age of targeted therapies?

Where does transplant fit in the age of targeted therapies? Hematology Am Soc Hematol Educ Program. 2019 Dec 06;2019(1):287-293 Authors: Chow VA, Gopal AK Abstract The role of hematopoietic cell transplantation (HCT) for indolent lymphoma has evolved over the last 5 years with the availability of novel low-toxicity therapies and a better understanding of the prognosis of these entities. However, despite numerous treatment options for patients with follicular lymphoma, none are thought to be curative, and many require ongoing therapy with chronic toxicity. Historical trials indicate that autologous HCT as initial consolidation leads to improved progression-free survival, but not overall survival (OS) and, thus, is not typically recommended. However, autologous HCT for chemosensitive relapse can be carried out with ∼1% early mortality risk, affording disease control lasting a median of 3 to 5 years and the potential to improve OS. These results may compare favorably in efficacy, toxicity, and cost vs multiple sequential novel therapies with shorter durations of benefit. Recent data indicate that autologous HCT in follicular lymphoma patients with early initial progression will result in more than one third being alive and without relapse at 5 years, leading to improved OS when used within a year of the first recurrence. Unlike other available therapies, allogeneic HCT has the potential to cure up to one half of those transplanted with indolent B-cell no...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Related Links:

CONCLUSIONThe findings highlight a significant burden associated with CDI in haematological patients undergoing induction chemotherapy in the US. There is an important need for prevention of CDI in this specific patient population.
Source: Journal of Hospital Infection - Category: Infectious Diseases Source Type: research
Authors: Ruan J Abstract Mantle cell lymphoma (MCL) is a distinct subtype of B-cell non-Hodgkin lymphoma characterized by the t(11;14)(q13;q32) translocation leading to cyclin D1 overexpression and cell cycle dysregulation. Molecular profiling with gene expression and deep sequencing analyses has identified genomic and epigenomic alterations in pathways regulating the cell cycle, DNA damage response, proliferation, and survival, which contribute to disease progression with important prognostic and therapeutic implications. Clinically, the nonnodal MCL subset is notable for leukemic presentation, indolent behavior, ...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
ConclusionVenetoclax therapy in a real-world cohort offered modest benefits in heavily pretreated patients. Adverse events were observed at a greater incidence than in the clinical trials. A wide heterogeneity of venetoclax dose escalation, multiagent combinations, and timing of initiation were identified and require investigation in subsequent clinical trials.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 2 October 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Avyakta Kallam, Julie M. VoseAbstractNon-Hodgkin lymphomas that are refractory to or relapse after frontline chemoimmunotherapy have a poor prognosis. Although high dose chemotherapy, followed by autologous stem cell transplantation remains the standard of care at relapse, this treatment modality leads to a cure in less than 50% of the patients. Adoptive cellular immunotherapy with anti CD 19 chimeric antigen receptor (CAR) T cell has changed the treatment landscape in B cell lymphomas. They have emerged as effective t...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
ConclusionVenetoclax therapy in a real-world cohort offered modest benefits in heavily-pretreated patients. Adverse events were observed at higher incidence compared to clinical trials. A wide heterogeneity of venetoclax dose escalation, multi-agent combinations, and timing of initiation were identified and would best be investigated in subsequent clinical trials.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Authors: Skrabek P, Assouline S, Christofides A, MacDonald D, Prica A, Sangha R, Matthews BA, Sehn LH Abstract Diffuse large B cell lymphoma (dlbcl) is an aggressive non-Hodgkin lymphoma, accounting for approximately 30% of lymphoma cases in Canada. Although most patients will achieve a cure, up to 40% will experience refractory disease after initial treatment, or relapse after a period of remission. In eligible patients, salvage therapy followed by high-dose therapy and autologous stem-cell transplantation (asct) is the standard of care. However, many patients are transplant-ineligible, and more than half of those...
Source: Current Oncology - Category: Cancer & Oncology Tags: Curr Oncol Source Type: research
High-dose chemotherapy and autologous stem cell transplantation (HDT-ASCT) is the standard of care for relapsed or primary refractory (rel/ref) chemorefractory diffuse large B-cell lymphoma. Only 50% of patients are cured with this approach. We investigated safety and efficacy of CD19-specific chimeric antigen receptor (CAR) T cells administered following HDT-ASCT. Eligibility for this study includes poor-risk rel/ref aggressive B-cell non-Hodgkin lymphoma chemosensitive to salvage therapy with: (1) positron emission tomography–positive disease or (2) bone marrow involvement. Patients underwe...
Source: Blood - Category: Hematology Authors: Tags: Immunobiology and Immunotherapy, Transplantation, Lymphoid Neoplasia, Clinical Trials and Observations Source Type: research
Abstract BACKGROUND: Obesity has implications for hematopoietic progenitor cell (HPC) mobilization, chemotherapy administration, and medication dosing. We analyzed the impact of obesity on HPC mobilization as well as key outcomes that are associated with cell dose in autologous hematopoietic cell transplantation (AHCT) recipients. METHODS: We conducted a retrospective cohort study on 556 consecutive eligible AHCT recipients at our institution from 1/2004 to 12/2009. Patients were categorized into four groups based on the body mass index (BMI): underweight (BMI 
Source: Clinical Lymphoma and Myeloma - Category: Cancer & Oncology Authors: Tags: J Clin Apher Source Type: research
DISCUSSION: Skin involvement in ENKTL is non-specific and uncommon, which can delay diagnosis. Treatment is based on polychemotherapy comprising L-asparaginase and possibly consolidation therapy with autologous or allogeneic hematopoietic stem cell transplantation. The prognosis of ENKTL-NT is poor due the more aggressive nature of the disease compared with the nasal forms, with frequent visceral involvement and macrophage activation syndrome. Skin involvement seems to be a poor prognostic factor. Although ocular involvement is documented, its association with skin involvement is rare and mainly secondary to nasal forms of...
Source: Annales de Dermatologie et de Cenereologie - Category: Dermatology Authors: Tags: Ann Dermatol Venereol Source Type: research
Rationale: HIV-related lymphoma, especially non-Hodgkin lymphoma, is one of the most common malignant tumors in HIV/acquired immune deficiency syndrome (AIDS) patients. Autologous hematopoietic stem cell transplantation (AHSCT) for the patients with Burkitt lymphoma (BL) is needed to be further explored. Patient concerns: A 57-year-old man was hospitalized with intermittent pain on upper abdomen and melena for>1 month. Diagnosis: HIV antibody testing was positive. The upper gastrointestinal endoscopy was performed and histopathology and immunohistochemistry revealed BL. Interventions: Highly effective antiret...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
More News: Education | Hematology | History of Medicine | Hodgkin's Disease | Lymphoma | Non-Hodgkin's Lymphoma | Toxicology | Transplants | Universities & Medical Training