scholarly journals High-Dose Etoposide Plus Granulocyte Colony-Stimulating Factor as an Effective Chemomobilization Regimen for Autologous Stem Cell Transplantation in Patients with Non-Hodgkin Lymphoma Previously Treated with CHOP-based Chemotherapy: A Study from the Consortium for Improving Survival of Lymphoma

2014 ◽  
Vol 20 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Shin Young Hyun ◽  
June-Won Cheong ◽  
Soo-Jeong Kim ◽  
Yoo Hong Min ◽  
Deok-Hwan Yang ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Hodgkin Lymphoma ◽  
Autologous Stem Cell Transplantation ◽  
High Dose ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Non Hodgkin Lymphoma ◽  
Previously Treated ◽  
Stimulating Factor

scholarly journals Antibiotic Prophylaxis or Granulocyte-Colony Stimulating Factor Support in Multiple Myeloma Patients Undergoing Autologous Stem Cell Transplantation

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3439
Author(s):  
Eva-Maria Klein ◽  
Sandra Sauer ◽  
Sabrina Klein ◽  
Diana Tichy ◽  
Axel Benner ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Antibiotic Prophylaxis ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Resistant Bacteria ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Stimulating Factor

We compare, in this manuscript, antibiotic prophylaxis versus granulocyte-colony stimulating factor (G-CSF) support as anti-infective strategies, in patients with multiple myeloma (MM), undergoing high-dose therapy followed by autologous stem cell transplantation (HDT/ASCT). At our institution, antibiotic prophylaxis after HDT/ASCT in MM was stopped in January 2017 and replaced by G-CSF support in March 2017. Consecutive MM patients who received HDT/ASCT between March 2016 and July 2018 were included in this single-center retrospective analysis. In total, 298 patients and 353 individual cases of HDT/ASCT were evaluated. In multivariate analyses, G-CSF support was associated with a significantly shortened duration of severe leukopenia < 1/nL (p < 0.001, hazard ratio (HR) = 16.22), and hospitalization (estimate = −0.19, p < 0.001) compared to antibiotic prophylaxis. Rates of febrile neutropenia, need of antimicrobial therapy, transfer to intensive care unit, and death, were similar between the two groups. Furthermore, antibiotic prophylaxis was associated with a significantly increased risk for the development of multidrug resistant bacteria especially vancomycin-resistant Enterococcus faecium compared to G-CSF support (odds ratio (OR) = 17.38, p = 0.01). Stop of antibiotic prophylaxis as an anti-infective strategy was associated with a reduction in overall resistance rates of bacterial isolates. These results indicate that G-CSF support should be the preferred option in MM patients undergoing HDT/ASCT.

Idiotype Immunization Following High-Dose Therapy and Autologous Stem Cell Transplantation for Non-Hodgkin Lymphoma,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4036-4036
Author(s):  
Caitlin L. Costello ◽  
Peter Holman ◽  
Margarida de Magalhaes-Silverman ◽  
Sue Corringham ◽  
Januario E. Castro ◽  
...  
Keyword(s):  
Overall Survival ◽  
Stem Cell ◽  
Immune Responses ◽  
Stem Cell Transplantation ◽  
Hodgkin Lymphoma ◽  
Autologous Stem Cell Transplantation ◽  
High Dose ◽  
High Dose Therapy ◽  
Non Hodgkin Lymphoma

Abstract Abstract 4036 Background: The treatment of low and intermediate grade subtypes of malignant lymphoma continues to evolve. Mantle cell lymphoma (MCL) accounts for 6% of all non-Hodgkin lymphoma (NHL) and is generally considered incurable. Although high response rates can be achieved with initial chemotherapy, median survival is only 3–4 years. Intensified consolidation with high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) has been reported to improve progression free survival (PFS) but most patients eventually relapse. Indolent lymphoma accounts for 35% of all NHL and is associated with a median survival of 9 years. Like MCL, it is also generally considered to be incurable, and the PFS also appears to be improved following HDT/ASCT. With this background, we initiated a pilot study evaluating idiotype (Id) vaccination following HDT and ASCT for patients with MCL, indolent NHL and transformed NHL to evaluate the ability of Id-keyhole limpet hemocyanin (KLH) to induce immune responses when administered following HDT/ASCT, and to evaluate overall survival (OS) and PFS for patients receiving Id-KLH post-ASCT. Methods: We enrolled patients with non-Hodgkin lymphoma between 2001–2006. Patients may have received any number of prior treatment regimens, and had adequate organ function. Tumor specific-Id was prepared from a lymph node or bone marrow biopsy, or peripheral blood sample. Patients whose lymphoma cells expressed surface Ig were then eligible to continue on the study. All patients had measurable disease after obtaining tissue for vaccine production. Following tissue collection, patients proceeded to undergo a standard cytoreductive chemotherapy regimen prior to stem cell mobilization, and HDT followed by ASCT. Vaccination was initiated at least 3 months after transplantation, and repeated for four consecutive months. This was followed by a final vaccination 2 months thereafter. 250mg GM-CSF was administered alone by daily injections for three days following each Id/KLH vaccination to enhance the immunogenicity and antitumor effects. Patients were subsequently followed for clinical and radiographic signs of relapse. Results: Fifteen patients were treated: 8 with MCL, 4 with follicular lymphoma, 1 with small lymphocytic lymphoma, and 2 with transformed lymphoma. Id immunizations were well tolerated with injection site reactions being the most commonly reported adverse effects. With a median follow-up of approximately 6.3 years (range 1–9), PFS and OS at 9.05 years from time of ASCT are 59% and 52%, respectively, as 8 of 15 patients are alive and are in a complete remission. The PFS and OS for patients with MCL median follow-up of up to 6.3 years from time of ASCT was 62.5% and 60%, respectively. During this follow up, no patient with MCL showed disease progression after 4 years or died after 6 years. Conclusion: Early and Id-specific immune responses are seen in vaccinated patients post-ASCT as treatment for both indolent and more aggressive lymphomas. Durable clinical responses were seen with this approach, even in this heavily pre-treated population. The early appearance and durability of specific immune responses may be attributable to the administration of Id immunization during a window of immune reconstitution following HDT/ASCT. The use of HDT/ASCT provides an ideal opportunity to note effective immune responses to vaccine based on the unique Ig protein expressed by tumor cells. Our data suggests the idea that there is an immune component that can be exploited in this setting, and this strategy may extend to more aggressive lymphomas. Id vaccination in patients with MCL who undergo ASCT shows early promise of providing durable remissions and prolonged overall survival. Further investigation of the use of Id vaccination in the post-transplant setting for MCL is necessary on a larger scale to confirm these findings. Disclosures: No relevant conflicts of interest to declare.

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