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Herrera AF, Palmer J, Adhikarla V, Yamauchi D, Poku EK, Bading J, Yazaki P, Dandapani S, Mei M, Chen R, Cao T, Karras N, McTague P, Nademanee A, Popplewell L, Sahebi F, Shively JE, Simpson J, Smith DL, Song J, Spielberger R, Tsai NC, Thomas SH, Forman SJ, Colcher D, Wu AM, Wong J, Smith E. Anti-CD25 radioimmunotherapy with BEAM autologous hematopoietic cell transplantation conditioning in Hodgkin lymphoma. Blood Adv 2021; 5:5300-5311. [PMID: 34638132 PMCID: PMC9153018 DOI: 10.1182/bloodadvances.2021004981] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/31/2021] [Indexed: 11/27/2022] Open
Abstract
High-risk relapsed or refractory (R/R) classical Hodgkin lymphoma (HL) is associated with poor outcomes after conventional salvage therapy and autologous hematopoietic cell transplantation (AHCT). Post-AHCT consolidation with brentuximab vedotin (BV) improves progression-free survival (PFS), but with increasing use of BV early in the treatment course, the utility of consolidation is unclear. CD25 is often expressed on Reed-Sternberg cells and in the tumor microenvironment in HL, and we hypothesized that the addition of 90Y-antiCD25 (aTac) to carmustine, etoposide, cytarabine, melphalan (BEAM) AHCT would be safe and result in a transplantation platform that is agnostic to prior HL-directed therapy. Twenty-five patients with high-risk R/R HL were enrolled in this phase 1 dose-escalation trial of aTac-BEAM. Following an imaging dose of 111In-antiCD25, 2 patients had altered biodistribution, and a third developed an unrelated catheter-associated bacteremia; therefore, 22 patients ultimately received therapeutic 90Y-aTac-BEAM AHCT. No dose-limiting toxicities were observed, and 0.6 mCi/kg was deemed the recommended phase 2 dose, the dose at which the heart wall would not receive >2500 cGy. Toxicities and time to engraftment were similar to those observed with standard AHCT, though 95% of patients developed stomatitis (all grade 1-2 per Bearman toxicity scale). Seven relapses (32%) were observed, most commonly in patients with ≥3 risk factors. The estimated 5-year PFS and overall survival probabilities among 22 evaluable patients were 68% and 95%, respectively, and non-relapse mortality was 0%. aTac-BEAM AHCT was tolerable in patients with high-risk R/R HL, and we are further evaluating the efficacy of this approach in a phase 2 trial. This trial was registered at www.clinicaltrials.gov as #NCT01476839.
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Affiliation(s)
- Alex F. Herrera
- Department of Hematology and Hematopoietic Cell Transplantation
| | | | | | | | | | | | | | | | - Matthew Mei
- Department of Hematology and Hematopoietic Cell Transplantation
| | - Robert Chen
- Department of Hematology and Hematopoietic Cell Transplantation
| | - Thai Cao
- Department of Hematology and Hematopoietic Cell Transplantation
| | | | | | | | | | - Firoozeh Sahebi
- Department of Hematology and Hematopoietic Cell Transplantation
| | | | | | | | - Joo Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA
| | | | - Ni-Chun Tsai
- Department of Computational and Quantitative Biology
| | | | | | | | - Anna M. Wu
- Department of Immunology and Theranostics
| | | | - Eileen Smith
- Department of Hematology and Hematopoietic Cell Transplantation
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2
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Zorina T, Black L. Mesenchymal–Hematopoietic Stem Cell Axis: Applications for Induction of Hematopoietic Chimerism and Therapies for Malignancies. Stem Cells 2021. [DOI: 10.1007/978-3-030-77052-5_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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3
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Redondo AM, Valcárcel D, González‐Rodríguez AP, Suárez‐Lledó M, Bello JL, Canales M, Gayoso J, Colorado M, Jarque I, Campo R, Arranz R, Terol MJ, Rifón JJ, Rodríguez MJ, Ramírez MJ, Castro N, Sánchez A, López‐Jiménez J, Montes‐Moreno S, Briones J, López A, Palomera L, López‐Guillermo A, Caballero D, Martín A. Bendamustine as part of conditioning of autologous stem cell transplantation in patients with aggressive lymphoma: a phase 2 study from the GELTAMO group. Br J Haematol 2018; 184:797-807. [DOI: 10.1111/bjh.15713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 11/05/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Alba M. Redondo
- Department of Haematology Hospital Universitario de Salamanca ‐ IBSAL CIBERONC Salamanca Spain
| | - David Valcárcel
- Department of Haematology Hospital Vall d'Hebron University Autònoma of Barcelona (UAB) Barcelona Spain
- Experimental Haematology Unit Vall d’ Hebron Institute of Oncology (VHIO) Barcelona Spain
| | | | | | - José L. Bello
- Department of Haematology Complejo Hospitalario Universitario de Santiago (CHUS) Santiago de Compostela Spain
| | | | - Jorge Gayoso
- Department of Haematology Hospital Gregorio Marañón Madrid Spain
| | - Mercedes Colorado
- Department of Haematology Hospital Marqués de Valdecilla Santander Spain
| | - Isidro Jarque
- Department of Haematology Hospital Universitario La Fe CIBERONC Valencia Spain
| | - Raquel Campo
- Department of Haematology Hospital Son Llítzer Palma de Mallorca Spain
| | - Reyes Arranz
- Department of Haematology Hospital de La Princesa Madrid Spain
| | - María J. Terol
- Department of Haematology Hospital Clínico de Valencia Valencia Spain
| | - José J. Rifón
- Department of Haematology Clínica Universitaria de Navarra Pamplona Spain
| | - María J. Rodríguez
- Department of Haematology Hospital Universitario de Canarias Las Palmas de Gran Canaria Spain
| | - María J Ramírez
- Department of Haematology Hospital de Jerez Jerez de la Frontera Spain
| | - Nerea Castro
- Department of Haematology Hospital 12 de Octubre Madrid Spain
| | - Andrés Sánchez
- Department of Haematology Hospital Virgen de la Arrixaca Murcia Spain
| | | | - Santiago Montes‐Moreno
- Department of Pathology Hospital Universitario Marqués de Valdecilla IFIMAV Santander Spain
| | - Javier Briones
- Department of Haematology Hospital Santa Creu i Sant Pau Barcelona Spain
| | - Aurelio López
- Department of Haematology Hospital Arnau de Villanova Valencia Spain
| | - Luis Palomera
- Department of Haematology Hospital Clínico de Zaragoza Zaragoza Spain
| | | | - Dolores Caballero
- Department of Haematology Hospital Universitario de Salamanca ‐ IBSAL CIBERONC Salamanca Spain
| | - Alejandro Martín
- Department of Haematology Hospital Universitario de Salamanca ‐ IBSAL CIBERONC Salamanca Spain
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4
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Krishnan AY, Palmer J, Nademanee AP, Chen R, Popplewell LL, Tsai NC, Sanchez JF, Simpson J, Spielberger R, Yamauchi D, Forman SJ. Phase II Study of Yttrium-90 Ibritumomab Tiuxetan Plus High-Dose BCNU, Etoposide, Cytarabine, and Melphalan for Non-Hodgkin Lymphoma: The Role of Histology. Biol Blood Marrow Transplant 2017; 23:922-929. [PMID: 28267593 PMCID: PMC5646666 DOI: 10.1016/j.bbmt.2017.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 03/01/2017] [Indexed: 11/23/2022]
Abstract
Standard-dose 90yttrium-ibritumomab tiuxetan (.4 mci/kg) together with high-dose BEAM (BCNU, etoposide, cytarabine, and melphalan) (Z-BEAM) has been shown to be a well-tolerated autologous hematopoietic stem cell transplantation preparative regimen for non-Hodgkin lymphoma. We report the outcomes of a single-center, single-arm phase II trial of Z-BEAM conditioning in high-risk CD20+ non-Hodgkin lymphoma histologic strata: diffuse large B cell (DLBCL), mantle cell, follicular, and transformed. Robust overall survival and notably low nonrelapse mortality rates (.9% at day +100 for the entire cohort), with few short- and long-term toxicities, confirm the safety and tolerability of the regimen. In addition, despite a high proportion of induction failure patients (46%), the promising response and progression-free survival (PFS) rates seen in DLBCL (3-year PFS: 71%; 95% confidence interval, 55 to 82%), support the premise that the Z-BEAM regimen is particularly effective in this histologic subtype. The role of Z-BEAM in other strata is less clear in the context of the emergence of novel agents.
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Affiliation(s)
- Amrita Y Krishnan
- Judy and Bernard Briskin Center for Multiple Myeloma Research, City of Hope, Duarte, California; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California.
| | - Joycelynne Palmer
- Department of Information Sciences, City of Hope, Duarte, California
| | - Auayporn P Nademanee
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Robert Chen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Leslie L Popplewell
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Ni-Chun Tsai
- Department of Information Sciences, City of Hope, Duarte, California
| | - James F Sanchez
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | | | - Ricardo Spielberger
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California; Southern California Kaiser Permanente Bone Marrow Transplant Program, Los Angeles, California
| | - Dave Yamauchi
- Department of Diagnostic Radiology, City of Hope, Duarte, California
| | - Stephen J Forman
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
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5
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Berger MD, Branger G, Klaeser B, Taleghani BM, Novak U, Banz Y, Mueller BU, Pabst T. Zevalin and BEAM (Z-BEAM) versus rituximab and BEAM (R-BEAM) conditioning chemotherapy prior to autologous stem cell transplantation in patients with mantle cell lymphoma. Hematol Oncol 2015; 34:133-9. [PMID: 25689832 DOI: 10.1002/hon.2197] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 01/17/2015] [Accepted: 01/21/2015] [Indexed: 11/06/2022]
Abstract
Early relapse is common in patients with mantle cell lymphoma (MCL) highlighting the unmet need for further improvement of therapeutic options for these patients. CD20 inhibition combined with induction chemotherapy as well as consolidation with high-dose chemotherapy (HDCT) is increasingly considered cornerstones within current therapy algorithms of MCL whereas the role of radioimmunotherapy is unclear. This retrospective single center study compared 46 consecutive MCL patients receiving HDCT in first or second remission. Thirty-five patients had rituximab and BEAM (R-BEAM), and 11 patients received ibritumomab tiuxetan (Zevalin®), an Yttrium-90 labeled CD20 targeting antibody, prior to BEAM (Z-BEAM) followed by autologous stem cell transplantation (ASCT). We observed that the 5-year overall survival (OS) in the R-BEAM and Z-BEAM groups was 55% and 71% (p = 0.288), and the 4-year progression free survival (PFS) was 32% and 41%, respectively (p = 0.300). There were no treatment related deaths in both groups, and we observed no differences in toxicities, infection rates or engraftment. Our data suggest that the Z-BEAM conditioning regimen followed by ASCT is well tolerated, but was not associated with significantly improved survival compared to R-BEAM. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Martin D Berger
- Department of Medical Oncology, University Hospital, Berne, Switzerland
| | - Giacomo Branger
- Department of Medical Oncology, University Hospital, Berne, Switzerland
| | - Bernd Klaeser
- Department of Nuclear Medicine, University Hospital, Berne, Switzerland
| | | | - Urban Novak
- Department of Medical Oncology, University Hospital, Berne, Switzerland
| | - Yara Banz
- Institute of Pathology, University of Berne, Berne, Switzerland
| | - Beatrice U Mueller
- Department of Clinical Research, University of Berne, Berne, Switzerland
| | - Thomas Pabst
- Department of Medical Oncology, University Hospital, Berne, Switzerland
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6
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Auger-Quittet S, Duny Y, Daures JP, Quittet P. Outcomes after (90) Yttrium-ibritumomab tiuxetan-BEAM in diffuse large B-cell lymphoma: a meta-analysis. Cancer Med 2014; 3:927-38. [PMID: 24740968 PMCID: PMC4303160 DOI: 10.1002/cam4.247] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 02/21/2014] [Accepted: 03/13/2014] [Indexed: 12/15/2022] Open
Abstract
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a standard therapy in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) who are chemosensitive. The combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) is commonly used as a conditioning regimen. The addition of yttrium-90 ((90) Y)-ibritumomab tiuxetan (Zevalin(®)) to BEAM (Z-BEAM) is increasingly being used to improve outcomes and overcome refractory disease. We conducted a literature review and meta-analysis in order to evaluate the clinical effects of Z-BEAM followed by ASCT in patients with DLBCL. A literature search was conducted for randomized controlled trials and observational studies of Z-BEAM as a conditioning regimen for ASCT in adult patients with DLBCL. Extracted data included baseline patient demographics, overall response (ORR), complete response (CR), overall survival (OS), progression-free survival (PFS), nonrelapse mortality (NRM), median time to ANC and platelet engraftment, and rate of myelodysplastic syndrome. Mixed-effects models were used to determine estimates. Ten studies (N = 328) were included in the meta-analysis. The 2-year OS and PFS were 84.5% (n = 328) and 67.2% (n = 285), respectively. Outcomes were superior in patients with nontransformed lymphoma. Posttransplant, ORR and CR rates were 72.6% and 68.5%, respectively. The NRM rate was 6.3% and the incidence rate of myelodysplastic syndrome was 2.5%. Two-year OS was significantly associated with pretransplant ORR (P = 0.008, τ(2) = 0). There was no significant association between PFS and pretransplant response. Z-BEAM is safe and effective as a conditioning regimen in relapsed/refractory DLBCL.
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Affiliation(s)
| | - Yohan Duny
- Department of Biostatistical and Epidemiology, INSERM Unit EAMontpellier, France
| | - Jean-Pierre Daures
- Department of Biostatistical and Epidemiology, INSERM Unit EAMontpellier, France
| | - Philipe Quittet
- Department of Hematology, University Hospital Saint-EloiMontpellier, France
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