Higher Total Body Irradiation (TBI) Dose-Intensity in Fludarabine (Flu)/TBI-Based Reduced-Intensity Conditioning (RIC) Regimen Is Associated with Inferior Survival in Non-Hodgkin Lymphoma (NHL) Patients Undergoing Allogeneic Hematopoietic Cell Transplantation (alloHCT).

Disease relapse is the most common cause of therapy failure in NHL patients undergoing RIC alloHCT. Whether increasing TBI dose from 2Gy to 4Gy in RIC-platform can provide improved disease control without increasing non-relapse mortality (NRM) is not known. Using the CIBMTR database we evaluated the outcomes of NHL patients receiving RIC alloHCT with either Flu/2Gy TBI vs. Flu/4Gy TBI.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Tags: 24 Source Type: research

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AbstractAutologous stem cell transplant (ASCT) is an effective treatment for non-Hodgkin lymphoma (NHL). However, recent supply issues and toxicity of carmustine have necessitated a new conditioning regimen. We conducted a multicenter, phase II study of BEB (busulfan, etoposide, and bendamustine) conditioning regimen for ASCT in patients with NHL. Thirty-one patients were enrolled and underwent ASCT with the BEB conditioning regimen. The most common subtype was diffuse large B-cell lymphoma (n = 23, 74.2%). Nine patients (29.0%) had a history of relapse, and 18 patients (58.1%) received more than 2 lines of c...
Source: Annals of Hematology - Category: Hematology Source Type: research
We previously reported results of allogeneic hematopoietic cell transplantation (HCT) in 93 older or medically unfit patients with non-Hodgkin's lymphoma (NHL) or chronic lymphocytic lymphoma (CLL) after conditioning with fludarabine (FLU) and 2-3 Gy total body irradiation (TBI). Three-year survival ranged from 45% to 52% depending on the underlying histology and disease stage. The major complication in those studies was disease relapse (24% at 1 year).The current prospective study in 63 NHL patients tested the hypothesis that disease relapse could be reduced, and overall survival (OS) improved, by peri-transplant rituximab (RTX).
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Tags: 338 Source Type: research
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
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. ...
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
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