Dramatic response to brentuximab vedotin in refractory nontransformed CD 30 – mycosis fungoides allowing allogeneic stem cell transplant and long‐term complete remission

2019 ◽  
Vol 180 (6) ◽  
pp. 1517-1520 ◽  
Author(s):  
T. Mahévas ◽  
C. Ram‐Wolff ◽  
M. Battistella ◽  
M.D.V. Pennamen ◽  
J. Rivet ◽  
...  
Keyword(s):  
Stem Cell ◽  
Complete Remission ◽  
Mycosis Fungoides ◽  
Stem Cell Transplant ◽  
Brentuximab Vedotin ◽  
Cell Transplant ◽  
Allogeneic Stem Cell Transplant

Identifying Relapsed AML Patients Most Likely To Benefit from Allogeneic Stem Cell Transplant: A Statistical Subgroup Analysis.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 329-329
Author(s):  
Paul M. Armistead ◽  
Marcos de Lima ◽  
Sherry Pierce ◽  
Wei Qiao ◽  
Xuemei Wang ◽  
...  
Keyword(s):  
Stem Cell ◽  
Complete Remission ◽  
Subgroup Analysis ◽  
Stem Cell Transplant ◽  
Hepatic Function ◽  
Salvage Chemotherapy ◽  
Cell Transplant ◽  
Stable Model ◽  
Allogeneic Stem Cell Transplant ◽  
Salvage Regimen

Abstract Allogeneic stem cell transplant (alloSCT) is often recommended therapy for patients with acute myeloid leukemia (AML) who either achieve a second complete remission (CR2), or who fail to do so, following salvage chemotherapy; however, there are few comparisons of transplant and continued chemotherapy without transplant in patients in CR2 or who fail to enter CR2. We thus performed such comparisons with our database consisting of all 490 patients followed after 1st salvage chemotherapy (54% of which contained cytarabine) given here from 1995 through 2004. Median age was 59, median first complete remission (CR1) duration was 22 weeks, and poor risk cytogenetics (CG) (-5 or -7 deletions, complex karyotype) were present in 59%. The CR2 rate after receiving a first salvage regimen was 23% (N=113) while 77% (N=377) did not achieve a second complete remission (failed CR2). Overall survival was compared between patients who underwent allogeneic transplant (N=130, 27%) and those who did not (N=360, 73%) for both the CR2 and failed CR2 cohorts. As shown in the accompanying figure, survival for alloSCT patients was superior in both subgroups (CR2: 11.7 months versus 5.6 months, p<0.0001; failed CR2: 5.1 months versus 2.3 months, p=0.004). While the transplant and non-transplant groups showed similar baseline renal and hepatic function at the time of first salvage therapy, alloSCT patients had longer mean CR1 duration (41.4 weeks vs. 31.1 weeks, P=0.004), less unfavorable CG (50.8% vs. 62.2%, P=0.03), and were younger (44.4 years vs. 59.5 years, P<0.0001). Because of these strong associations between treatment and prognostic factors, a multivariate analysis including treatment and these factors failed to yield a stable model. Thus we divided the cohort into subgroups defined by age, cytogenetics, and CR1 duration. The first subgroup analysis created 8 subgroups divided by age (< or ≥50), CG (intermediate vs. unfavorable) and CR2 status. AlloSCT produced superior survival in the subgroup of patients <50 regardless of CG or remission status. No survival advantage was observed for transplant among patients ≥50 who achieved a CR2; however, a slight survival benefit (intermediate CG: 6.3 months vs. 2.7 months, P=0.006; adverse CG: 2.6 months vs. 2.0 months, P=0.09) favoring alloSCT was noted in patients ≥50 who failed to achieve a CR2. A second subgroup analysis created 6 groups divided according to age (< or ≥50) and CR1 duration (≥36 weeks, <36 weeks, and primary refractory). AlloSCT was again superior to chemotherapy in patients <50 regardless of CR1 duration; however, in the ≥50 cohort the benefit was only significant for patients with a short CR1 (CR1 <36 weeks: 2.7 months vs. 2.5 months, P=0.05). Bearing in mind that, although our results may have been influenced by selection biases, a randomized trial is unlikely to be done. These results suggest that all patients <50 in CR2 or who do not enter CR2 benefit from alloSCT as do patients ≥50 with a CR1 duration of 1–36 weeks. Figure Figure

Final Report Of Single-Center Study Of Chemotherapy Plus Dasatinib For The Initial Treatment Of Patients With Philadelphia-Chromosome Positive Acute Lymphoblastic Leukemia

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3914-3914
Author(s):  
Farhad Ravandi ◽  
Susan O'Brien ◽  
Rebecca Garris ◽  
Stefan H. Faderl ◽  
Deborah A. Thomas ◽  
...  
Keyword(s):  
Stem Cell ◽  
Acute Lymphoblastic Leukemia ◽  
Research Funding ◽  
Stem Cell Transplant ◽  
Lymphoblastic Leukemia ◽  
Philadelphia Chromosome ◽  
Cell Transplant ◽  
Newly Diagnosed ◽  
Allogeneic Stem Cell Transplant

Abstract Background The dual Src and Abl inhibitor dasatinib has significant in vitro kinase inhibition against wild-type and mutant BCR-ABL, and significant clinical activity in patients with imatinib-resistant lymphoid blast phase CML (CML-LB) and Philadelphia-chromosome positive (Ph+) acute lymphoblastic leukemia (ALL). Aim To determine the long-term efficacy of the combination of the hyperCVAD regimen with dasatinib for treating patients with Ph+ ALL. Methods In this phase II trial, patients with newly diagnosed Ph+ ALL received dasatinib 50 mg po bid (or 100 mg daily) for the first 14 days of each of 8 cycles of alternating hyperCVAD and high dose cytarabine and methotrexate (induction/consolidation cycles). After 42 patients, the protocol was amended to give dasatinib 100 mg daily in the first 14 days of the first cycle and then 70 mg daily continuously from the second cycle. Patients in complete remission (CR) continued to receive maintenance dasatinib 50 mg po bid (or 100 mg daily) and vincristine and prednisone monthly for 2 years followed by dasatinib indefinitely. Patients eligible for allogeneic stem cell transplant proceeded to it in first CR. Results 63 patients with untreated Ph+ ALL and 9 patients with 1 or 2 prior cycles of chemotherapy (before Ph+/BCR-ABL+ status was known) have been enrolled in the study from September 2006 to March 2012. Patients have received a median of 6 cycles (range 1-8) of induction/consolidation. Median age is 55 years (range 21 – 80); 46 patients were older than 50 years, Median WBC at diagnosis was 12 x 109/L (range, 0.4 - 658.1 x 109/L). Ten patients had CNS involvement at presentation. All patients are evaluable for assessment of response to induction; 69 (96%) achieved CR after first cycle or were CR at start. 3 patients died before response assessment from infections. 57 of 69 (83%) evaluable patients achieved cytogenetic (CG) CR after 1 cycle; 5 had a major CG response (4 had 5% and one had 15% Ph+), 2 had insufficient metaphases, and 5 are unknown (no CG exam on day 21 marrow). To date, 45 patients (65%) have achieved complete molecular remission (CMR) and another 19 (28%) have achieved a major (but not complete) molecular response (MMR) at a median of 4 weeks from initiation of treatment (range, 2 – 38 weeks). Minimal residual disease assessment by flow cytometry is negative in 65 (94 %) patients at a median of 3 weeks (range, 2-37 weeks). The median time to neutrophil and platelet recovery for cycle 1 is 18 and 22 days and for subsequent cycles is 15 and 20 days. Grade 3 and 4 adverse events have included bleeding (GI, GU, soft tissue and subdural hematomas), pleural effusions, pericardial effusions, reversible rise in creatinine, deep vein thromboses, pulmonary emboli, as well as diarrhea, infections, hypophosphatemia, hypokalemia, hypocalcemia, hyperglycemia, and elevated transaminases. With a median follow up of 48 months in the surviving patients (range 16.5 - 81.5), 36 patients (50%) are alive and 31 (43%) are in CR. Twelve patients have undergone an allogeneic stem cell transplant. Thirty six patients have died [3 at induction, 16 after relapse, 7 post stem cell transplant performed in CR1, and 10 in CR (6 from infections, 1 from unrelated cardiac event, 1 from unrelated cancer, and 2 from an unknown cause)]. The median disease free survival is 31 months (range, 0.3 to 81) and the median overall survival is 44 months (range, 0.2 to 82). Twenty-one patients have relapsed with a median response duration of 16 months (range, 5 - 62) and 16 of them have died. In 6 patients morphological relapse was preceded by flow and molecular relapse. Six relapsed patients had ABL mutations (4 T315I, 1 F359V, and 1 V299L). Conclusion Combination of chemotherapy with dasatinib is effective in achieving long term remissions in patients with newly diagnosed Ph+ ALL. Disclosures: Ravandi: Bristol Myers Squibb: Honoraria, Research Funding. Off Label Use: Use of dasatinib for the frontline therapy of Ph+ ALL. O'Brien:Pharmacyclics: Research Funding. Jabbour:Bristol Myers Squibb: Consultancy, Honoraria. Cortes:Bristol Myers Squibb: Research Funding. Kantarjian:Bristol Myers Squibb: Research Funding.

Long-term survival after allogeneic stem cell transplant for relapsed large B cell lymphomas: a retrospective study

2011 ◽  
Vol 53 (3) ◽  
pp. 503-505
Author(s):  
Vladimir Lazarevic ◽  
Mats Remberger ◽  
Hans Hägglund ◽  
Gunnar Juliusson ◽  
Hamdy Omar ◽  
...  
Keyword(s):  
Stem Cell ◽  
Retrospective Study ◽  
B Cell ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Allogeneic Stem Cell Transplant ◽  
Term Survival ◽  
Long Term Survival ◽  
Large B Cell

scholarly journals 289: Impact of Longitudinal Long Term Transplant Clinic (LTTC) on Survival after Allogeneic Stem Cell Transplant (SCT)

2008 ◽  
Vol 14 (2) ◽  
pp. 107
Author(s):  
M. Jagasia ◽  
C. Clifton ◽  
L.A. Vaughan ◽  
W. Chinratanalab ◽  
H. Chen ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Allogeneic Stem Cell Transplant

Elimination of Aspergillus infection in allogeneic stem cell transplant recipients with long-term itraconazole prophylaxis: prevention is better than treatment

Blood ◽  
2004 ◽  
Vol 104 (5) ◽  
pp. 1581-1582 ◽  
Author(s):  
Drew J. Winston ◽  
Christos Emmanouilides ◽  
Kathy Bartoni ◽  
Gary J. Schiller ◽  
Ronald Paquette ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Allogeneic Stem Cell Transplant ◽  
Transplant Recipients ◽  
Aspergillus Infection ◽  
Better Than

Endocrine Complications in Long-Term Survivors After Allogeneic Stem Cell Transplant

2012 ◽  
Vol 49 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Uma Gunasekaran ◽  
Neena Agarwal ◽  
Madan H. Jagasia ◽  
Shubhada M. Jagasia
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Allogeneic Stem Cell Transplant ◽  
Long Term Survivors ◽  
Endocrine Complications
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