scholarly journals FRACTIONATED TOTAL‐BODY IRRADIATION AND CYCLOPHOSPHAMIDE FOLLOWED BY AUTOLOGOUS STEM‐CELL SUPPORT IN PATIENTS WITH T‐CELL LYMPHOBLASTIC LYMPHOMA

2021 ◽  
Vol 39 (S2) ◽  
Author(s):  
M Zhang ◽  
R. X Fu ◽  
R. J Ge ◽  
C. Z Sun ◽  
F. F Nan
Keyword(s):  
Stem Cell ◽  
T Cell ◽  
Total Body Irradiation ◽  
Lymphoblastic Lymphoma ◽  
Stem Cell Support ◽  
Total Body ◽  
Cell Support

scholarly journals Mesenchymal Stromal Cell-Derived Extracellular Vesicles Provide Long-Term Survival After Total Body Irradiation Without Additional Hematopoietic Stem Cell Support

Stem Cells ◽  
2017 ◽  
Vol 35 (12) ◽  
pp. 2379-2389 ◽  
Author(s):  
Jill-Sandra Schoefinius ◽  
Bärbel Brunswig-Spickenheier ◽  
Thomas Speiseder ◽  
Sabrina Krebs ◽  
Ursula Just ◽  
...  
Keyword(s):  
Stem Cell ◽  
Total Body Irradiation ◽  
Mesenchymal Stromal Cell ◽  
Stromal Cell ◽  
Term Survival ◽  
Hematopoietic Stem ◽  
Stem Cell Support ◽  
Total Body ◽  
Cell Support

High-Dose Melphalan, Etoposide, Total-Body Irradiation, and Autologous Stem-Cell Reconstitution as Consolidation Therapy for High-Risk Ewing’s Sarcoma Does Not Improve Prognosis

2001 ◽  
Vol 19 (11) ◽  
pp. 2812-2820 ◽  
Author(s):  
Paul A. Meyers ◽  
Mark D. Krailo ◽  
Marc Ladanyi ◽  
Ka-Wah Chan ◽  
Scott L. Sailer ◽  
...  
Keyword(s):  
Stem Cell ◽  
Progressive Disease ◽  
Peripheral Blood Stem Cell ◽  
High Dose ◽  
Consolidation Therapy ◽  
Newly Diagnosed ◽  
Stem Cell Support ◽  
Total Body ◽  
High Dose Melphalan ◽  
Cell Support

PURPOSE: To determine whether consolidation therapy with high-dose melphalan, etoposide, and total-body irradiation (TBI) with autologous stem-cell support would improve the prognosis for patients with newly diagnosed metastatic Ewing’s sarcoma (ES). PATIENTS AND METHODS: Thirty-two eligible patients with newly diagnosed ES metastatic to bone and/or bone marrow were enrolled onto this study. Treatment was initially comprised of five cycles of induction chemotherapy (cyclophosphamide, doxorubicin, and vincristine alternating with ifosfamide and etoposide) and local control. Peripheral-blood stem-cell collection was performed after the second cycle of chemotherapy, with delay if the bone marrow was persistently involved. If patients had a good response to initial therapy, they proceeded to consolidation therapy with melphalan, etoposide, TBI, and stem-cell support. RESULTS: Of the 32 eligible patients, 23 proceeded to high-dose therapy consolidation. Of the nine patients who did not proceed to consolidation, four were secondary to progressive disease and two were secondary to toxicity. Three patients died from toxicity during the high-dose phase of the therapy. The majority of the patients who underwent high-dose consolidation therapy experienced relapse and died with progressive disease. Two-year event-free survival (EFS) for all eligible patients is 20%. The 2-year post–stem-cell reconstitution EFS for the subset of 23 patients who received consolidation therapy is 24%. Analysis of peripheral-blood stem-cell collections by molecular techniques for minimal residual disease showed contamination of at least some samples by tumor cells in all three patients with available data. CONCLUSION: Consolidation with high-dose melphalan, etoposide, TBI, and autologous stem-cell support failed to improve the probability of EFS in this cohort of patients with newly diagnosed metastatic ES.

High Survival in Patients with Myelofibrosis Undergoing a Two-Step Approach to Hematopoietic Stem Cell Transplantation (HSCT): Effects of Donor Source and Pre-HSCT Splenic Therapy on Outcomes

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 37-38
Author(s):  
Shaik Rashid ◽  
Matthew Carabasi ◽  
Joanne Filicko-O'Hara ◽  
John L. Wagner ◽  
William O'Hara ◽  
...  
Keyword(s):  
Stem Cell ◽  
T Cell ◽  
Hematopoietic Stem Cell ◽  
Total Body Irradiation ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Splenic Sequestration ◽  
Donor Chimerism ◽  
Total Body ◽  
Donor Source

Introduction: Hematopoietic stem cell transplant (HSCT) remains the only curative therapy for myelofibrosis (MF). However as compared to other hematologic malignancies, HSCT for MF is associated with an increased risk of graft failure due to a limited marrow niche and splenic sequestration of allogeneic progenitors. We report on engraftment and other outcomes in 12 consecutive patients with MF undergoing matched (M-HSCT) and haplo-identical (HI-HSCT) utilizing a two-step T cell-tolerization approach. Methods: Regardless of donor source, all patients were conditioned with our institution's two-step approach. After reduced intensity conditioning consisting of fludarabine, 2 Gy total body irradiation, thiotepa (n=3) OR busulfan (n=8), and in 1 case myeloablative conditioning with 12 Gy total body irradiation, patients received an unmanipulated donor lymphocyte product (DLI) containing 2 x 108/kg CD3+ cells. After 2 days, cyclophosphamide (CY) 60 mg/kg was administered daily x 2 for bidirectional T cell tolerization. One day after CY completion, a CD34-selected stem cell product was infused. All patients received mycophenolate mofetil and tacrolimus beginning on d-1. Pre-conditioning splenic radiation was added starting in 2017 to decrease splenic sequestration of donor cells. This change affected the last six patients in the analysis. Results: Six patients had primary MF and six patients had secondary MF. Donor source was a HLA matched (n=5, median age 54y, range 44-65) or haploidentical (n=7, median age 66y, range 47-67) relative. Eight patients received pre-HSCT radiation or splenectomy. Outcome data is summarized in the table. Median follow-up is 29 (range 6-95.6) months. Median time to neutrophil and platelet engraftment was 12 (range 9-13) days and 19 (13-40) days respectively. Patients undergoing pre-HSCT splenic therapy recovered platelets more rapidly than those without, median 19 vs 27 days, (p=0.059). All patients ultimately achieved 100% donor chimerism. While there was a trend in the M-HSCT group for higher donor T cell chimerism at d+28 in patients undergoing pre-HSCT splenic therapy, (p=0.083), donor source had the most significant impact on the pace of donor chimerism recovery. All 4 DLIs given in this group for fluctuating donor T cell chimerism occurred in M-HSCT recipients. At d+28 median donor T cell chimerism was 100% (range 91-100) in HI-HSCT versus 92% (range 67-100%) in M-HSCT recipients, (p=0.037). Probability of OS at 3 years was 90%. No patient receiving splenic therapy experienced disease progression. Two patients who received DLI experienced graft versus host disease (GVHD), grade 3 acute GVHD in one and extensive chronic GVHD in the other. Conclusion: HSCT using the two-step approach is associated with rapid engraftment and excellent survival in patients with MF. Pre-HSCT splenic therapy was associated with more rapid platelet recovery. Unlike HI-HSCT, M-HSCT patients receiving RIC conditioning experienced initial fluctuating donor T-cell chimerism, a finding worth further exploration in larger trials. Table Disclosures Gergis: Jazz: Other: Ad board, Speakers Bureau; Astellas: Consultancy, Speakers Bureau; Kite: Speakers Bureau; Mesoblast: Other: Ad Board; Incyte: Speakers Bureau; Merck: Speakers Bureau. Flomenberg:Tevogen: Consultancy, Honoraria.

Phase I Trial of the 131I-Labelled Anti-CD25 Antibody Basiliximab in the Treatment of Patients with Relapsed or Refractory Lymphoma.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 648-648
Author(s):  
Gairin Dancey ◽  
John Violet ◽  
Shokri Othman ◽  
Sweta Parker ◽  
Alan Green ◽  
...  
Keyword(s):  
Stem Cell ◽  
T Cell ◽  
Phase I ◽  
Cell Lymphoma ◽  
Pneumocystis Carinii ◽  
High Dose ◽  
High Dose Therapy ◽  
Stem Cell Support ◽  
Dose Therapy ◽  
Cell Support

Abstract The survival of patients with Hodgkin lymphoma (HL) has improved over recent decades due to advances in therapy and supportive care. The outcome for patients with relapsed or refractory disease, however, is still unsatisfactory. High dose therapy with stem cell support can salvage many patients but results are poor in patients with chemo-resistant, PET-positive disease pre-transplant. Novel therapies for HL have focused on monoclonal antibodies to antigens such as CD30 but these treatments have produced response rates of only 10% when given as native antibody. Radio-immunotherapy is effective treatment for a range of lymphoproliferative disorders including those that are resistant to other therapies. This phase I study utilised basiliximab, a chimeric antibody to the α-chain of the IL-2 receptor, CD25, conjugated to iodine-131 (131I) in patients with relapsed or refractory lymphomas who were resistant to or intolerant of conventional therapies and who had demonstrable CD25 expression by immunohistochemistry on tissue sections. To determine dose-limiting toxicity an accelerated titration design was used with 6 different doses employed- 370, 740, 1480, 2220 and 2960MBq/m2. Fourteen patients (9M, 5F) with a median age of 38 years (range 28–70) were treated (HL 11 patients, primary mediastinal B-cell lymphoma 1, peripheral T-cell lymphoma NOS 1, adult T-cell leukaemia/lymphoma 1). They had previously received a median of 4 therapies (range 2–8) including autologous stem cell transplant in 9 patients. Five patients were being considered for an autologous or allogeneic stem cell transplantation but had not demonstrated chemosensitivity with standard therapies. All patients were FDG-positive by PET prior to therapy. One patient had a complete response at 740MBq/m2. Six of 9 patients responded to therapy at a dose of 1200MBq/m2 or higher. There were 3 complete responses and 3 partial responses. Two of these patients who had previously not been considered for high dose therapy because of a lack of response have now proceeded to autologous or allogeneic transplant. At a clinically active dose of 1200MBq/m2 the only side effects seen were delayed myelotoxicity; the median platelet count nadir was 31x109/L(range 9–83) and was observed at a median of 38 days (range 33–53) following treatment. Neutropenia (median nadir 1.31x109/L, range 0.9–7.5) was also noted at a median of 53 days (range 37–65) following therapy. One patient was treated at a dose of 2960MBq/m2 and developed prolonged grade 4 neutropenia and thrombocytopenia requiring stem cell support. The patient died of pneumocystis carinii pneumonia. There were no other grade 3 or 4 non-haematologic toxicities noted. The 131I-labelled anti-CD25 antibody basiliximab is well tolerated at doses of 1200MBq/m2 and demonstrates clinical activity at this dose in patients who are refractory to conventional therapies. Further studies are required to determine the long term outcome of patients treated with this agent and to assess its efficacy in the pre-autograft/allograft setting.

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