Brentuximab vedotin as consolidation after hematopoietic cell transplant for relapsed Hodgkin lymphoma in pediatric patients

2019 ◽  
Vol 66 (12) ◽  
Author(s):  
Jamie E. Flerlage ◽  
Xinyu Buttlar ◽  
Matthew Krasin ◽  
Brandon Triplett ◽  
Sue C. Kaste ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Pediatric Patients ◽  
Brentuximab Vedotin ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant

Defining a Hodgkin lymphoma population for novel therapeutics after relapse from autologous hematopoietic cell transplant

2013 ◽  
Vol 54 (11) ◽  
pp. 2531-2533 ◽  
Author(s):  
Sally Arai ◽  
Michelle Fanale ◽  
Sven deVos ◽  
Andreas Engert ◽  
Tim Illidge ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Novel Therapeutics

An Innovative Educational Program for International Hematopoietic Cell Transplant Pediatric Patients

2016 ◽  
Vol 32 (2) ◽  
pp. 401-405
Author(s):  
MariaEugenia Álvarez MacWilliams ◽  
Estela Cabrera Lunar ◽  
Ellen M. Denzen
Keyword(s):  
Educational Program ◽  
Pediatric Patients ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant

Weight gain and supplemental O2 : Risk factors during the hematopoietic cell transplant admission in pediatric patients

2017 ◽  
Vol 64 (11) ◽  
pp. e26561 ◽  
Author(s):  
Courtney M. Rowan ◽  
Mara E. Nitu ◽  
Elizabeth A. S. Moser ◽  
Nancy L. Swigonski ◽  
Jamie L. Renbarger
Keyword(s):  
Risk Factors ◽  
Weight Gain ◽  
Pediatric Patients ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant

Outcomes of Human Adenovirus Infection and Disease in a Retrospective Cohort of Pediatric Hematopoietic Cell Transplant Recipients

2018 ◽  
Vol 8 (4) ◽  
pp. 317-324 ◽  
Author(s):  
Brian T Fisher ◽  
Craig L K Boge ◽  
Hans Petersen ◽  
Alix E Seif ◽  
Matthew Bryan ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Pediatric Patients ◽  
Hematopoietic Cell Transplantation ◽  
Case Fatality ◽  
Human Adenovirus ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Transplant Recipients ◽  
Allogeneic Transplant ◽  
Hematopoietic Cell Transplant

Human adenoviruses were commonly detected in this cohort of pediatric patients undergoing hematopoietic cell transplantation, and the case-fatality rate in allogeneic transplant recipients was high (25.9%). Preemptive cidofovir therapy was not associated with a reduction in the progression to human adenovirus disease.

scholarly journals Isavuconazonium Sulfate Use in Multi-Modal Management of Invasive Zygomycosis in Four Pediatric Allogeneic Hematopoietic Cell Transplant Patients

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 27-27
Author(s):  
Asmaa Ferdjallah ◽  
Kristina M Nelson ◽  
Kailey Meyer ◽  
Cathryn A Jennissen ◽  
Christen L. Ebens
Keyword(s):  
Pediatric Patients ◽  
Hematopoietic Cell Transplantation ◽  
Conflicts Of Interest ◽  
Safety Data ◽  
Drug Level ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Loading Dose ◽  
Duration Of Treatment ◽  
Hematopoietic Cell Transplant

Prolonged neutropenia increases risk for lethal invasive fungal infection (IFI) such as Rhizopus. Isavuconazonium sulfate is a new triazole that lacks pediatric dosing recommendations. Clinical courses of 4 pediatric patients with IFI in the peri-allogeneic hematopoietic cell transplantation (alloHCT) period between 2015 and 2017 were reviewed, including previously unreported pharmacokinetic and safety data. IFI included Rhizopus and presumed fungal meningitis. Isavuconazonium sulfate was initiated with a loading dose followed by daily dosing, adjusted to a goal trough >3 ug/mL based on adult literature. This target was achieved at a median of 7 days, demonstrating varying rates of metabolism. Renal insufficiency, electrolyte disturbances, and transaminitis were noted, though attribution was confounded by other alloHCT complications. 1 patient survived infection-free to hospital discharge and 1 of 3 deceased patients had evidence of unresolved IFI (Case 2). Case 2 was subtherapeutic for 39% of the duration of treatment, compared to others at an average of 29%, suggesting this target trough to be clinically relevant. We recommend initiation of isavuconazonium sulfate at 10 mg/kg with a max dose of 372 mg. A loading dose of 10 mg/kg is utilized every 8 hours for 6 doses followed by 10 mg/kg dosing every 24 hours. Monitoring must continue beyond steady state. If early monitoring is not possible, we recommend a first drug level at week 3. If dose increases are required, a partial reload has been more successful instead of increasing daily doses. Further larger studies are needed to demonstrate optimum dosing in pediatric patients. Figure 1 Disclosures No relevant conflicts of interest to declare.

scholarly journals Transplant strategies in relapsed/refractory Hodgkin lymphoma

Blood ◽  
2018 ◽  
Vol 131 (15) ◽  
pp. 1689-1697 ◽  
Author(s):  
Gunjan L. Shah ◽  
Craig H. Moskowitz
Keyword(s):  
Side Effects ◽  
Hodgkin Lymphoma ◽  
Checkpoint Inhibitors ◽  
Remission Rate ◽  
Therapeutic Option ◽  
Response Rates ◽  
Hematopoietic Cell ◽  
High Dose ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant

Abstract The majority of patients with Hodgkin lymphoma (HL) are cured with initial therapy. However, high-dose therapy with autologous hematopoietic cell transplant (AHCT) allows for the cure of an additional portion of patients with relapsed or primary refractory disease. Positron emission tomography–negative complete remission before AHCT is critical for long-term disease control. Several salvage options are available with comparable response rates, and the choice can be dependent of comorbidities and logistics. Radiation therapy can also improve the remission rate and is an important therapeutic option for selected patients. Brentuximab vedotin (BV) maintenance after AHCT is beneficial in patients at high risk for relapse, especially those with more than 1 risk factor, but can have the possibility of significant side effects, primarily neuropathy. Newer agents with novel mechanisms of action are under investigation to improve response rates for patients with subsequent relapse, although are not curative alone. BV and the checkpoint inhibitors nivolumab and pembrolizumab are very effective with limited side effects and can bridge patients to curative allogeneic transplants (allo-HCT). Consideration for immune-mediated toxicities, timing of allogeneic hematopoietic cell transplant based on response, and the potential for increased graft-versus-host disease remain important. Overall, prospective investigations continue to improve outcomes and minimize toxicity for relapsed or primary refractory HL patients.

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