Maintenance Strategies after Hematopoietic Cell Transplantation

AbstractHematopoietic cell transplantation (HCT) is an essential component of potentially curative therapy for patients with hematologic malignancies. High dose chemotherapy with autologous (auto) stem cell rescue is used to overcome chemoresistance in multiple myeloma (MM), non ‐Hodgkin lymphoma (NHL), and Hodgkin lymphoma (HL). Alternatively, poor‐risk acute leukemias rely on the graft versus leukemia effect of allogeneic (allo) products. Long‐term remissions are feasible with both auto and allo HCT, however, disease relapse is the leading cause of death after HCT f or many patients. In recognition of this, novel therapies are being investigated in the upfront, relapsed/refractory, and post‐HCT maintenance settings to deepen response and maintain disease control. To date, the most robust data to support this approach is in MM, where post‐transplant maintena nce therapy has improved clinical outcomes. In HL, patients with high risk features may benefit from post‐auto HCT bretuximab vedotin (BV) regardless of pre‐HCT BV exposure. Apart from mantle cell lymphoma, where rituximab maintenance is generally accepted, post‐auto HCT maintenance in other f orms of NHL is less established. In patients who undergo allo HCT, the utilization of maintenance therapy is an important component of improving post‐HCT outcomes, however, an individualized approach that considers patient factors such as residual toxicity from HCT, an immature graft with poor gra ft function, inf...
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: SI ON STEM CELL TRANSPLANTATION Source Type: research