Sequential myeloablative autologous stem cell transplantation and reduced intensity allogeneic hematopoietic cell transplantation is safe and feasible in children, adolescents and young adults with poor-risk refractory or recurrent Hodgkin and non-Hodgkin lymphoma

Leukemia
Prakash SatwaniMitchell S Cairo

Abstract

The outcome of children, adolescents and young adults (CAYA) with poor-risk recurrent/refractory lymphoma is dismal (⩽30%). To overcome this poor prognosis, we designed an approach to maximize an allogeneic graft vs lymphoma effect in the setting of low disease burden. We conducted a multi-center prospective study of myeloablative conditioning (MAC) and autologous stem cell transplantation (AutoSCT), followed by a reduced intensity conditioning (RIC) and allogeneic hematopoietic cell transplantation (AlloHCT) in CAYA, with poor-risk refractory or recurrent lymphoma. Conditioning for MAC AutoSCT consisted of carmustine/etoposide/cyclophosphamide, RIC consisted of busulfan/fludarabine. Thirty patients, 16 Hodgkin lymphoma (HL) and 14 non-Hodgkin lymphoma (NHL), with a median age of 16 years and median follow-up of 5years, were enrolled. Twenty-three patients completed both MAC AutoSCT and RIC AlloHCT. Allogeneic donor sources included unrelated cord blood (n=9), unrelated donor (n=8) and matched siblings (n=6). The incidence of transplant-related mortality following RIC AlloHCT was only 12%. In patients with HL and NHL, 10 year EFS was 59.8% and 70% (P=0.613), respectively. In summary, this approach is safe, and long-term EFS wit...Continue Reading

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Citations

Aug 19, 2015·Bone Marrow Transplantation·N EpperlaM Hamadani
May 3, 2016·British Journal of Haematology·Mitchell S Cairo, Ross Pinkerton
Jul 29, 2016·Current Opinion in Oncology·Philippe Lewalle, Sebastian Wittnebel
Mar 7, 2020·British Journal of Haematology·Maria L MoletiRobin Foà
Oct 18, 2019·Pediatric Radiology·Stephan D Voss, Mitchell S Cairo
Feb 8, 2019·British Journal of Haematology·Mitchell S Cairo, Auke Beishuizen
Nov 28, 2018·The Cancer Journal·Jessica Hochberg, Mitchell S Cairo

Related Concepts

Umbilical Cord Blood
HLA Antigens
Hodgkin Lymphoma, Lymphocyte Depletion
Reticulosarcoma
Relapse
Transplantation, Autologous
Transplantation, Homologous
Hemopoietic Stem Cell Transplant
Transplantation Conditioning
Graft Vs Tumor Effect

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