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Schorb E, Isbell LK, Kerkhoff A, Mathas S, Braulke F, Egerer G, Röth A, Schliffke S, Borchmann P, Brunnberg U, Kroschinsky F, Möhle R, Rank A, Wellnitz D, Kasenda B, Pospiech L, Wendler J, Scherer F, Deckert M, Henkes E, von Gottberg P, Gmehlin D, Backenstraß M, Jensch A, Burger-Martin E, Grishina O, Fricker H, Malenica N, Orbán A, Duyster J, Ihorst G, Finke J, Illerhaus G. High-dose chemotherapy and autologous haematopoietic stem-cell transplantation in older, fit patients with primary diffuse large B-cell CNS lymphoma (MARTA): a single-arm, phase 2 trial. Lancet Haematol 2024; 11:e196-e205. [PMID: 38301670 DOI: 10.1016/s2352-3026(23)00371-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND Available treatments for older patients with primary diffuse large B-cell CNS lymphoma (PCNSL) offer progression-free survival of up to 16 months. We aimed to investigate an intensified treatment of high-dose chemotherapy and autologous haematopoietic stem-cell transplantation (HSCT) in older patients with PCNSL. METHODS MARTA was a prospective, single-arm, phase 2 study done at 15 research hospitals in Germany. Patients aged 65 years or older with newly diagnosed, untreated PCNSL were enrolled if they had an Eastern Cooperative Oncology Group performance status of 0-2 and were fit for high-dose chemotherapy and autologous HSCT. Induction treatment consisted of two 21-day cycles of high-dose intravenous methotrexate 3·5 g/m2 (day 1), intravenous cytarabine 2 g/m2 twice daily (days 2 and 3), and intravenous rituximab 375 mg/m2 (days 0 and 4) followed by high-dose chemotherapy with intravenous rituximab 375 mg/m2 (day -8), intravenous busulfan 3·2 mg/kg (days -7 and -6), and intravenous thiotepa 5 mg/kg (days -5 and -4) plus autologous HSCT. The primary endpoint was progression-free survival at 12 months in all patients who met eligibility criteria and started treatment. The study was registered with the German clinical trial registry, DRKS00011932, and recruitment is complete. FINDINGS Between Nov 28, 2017, and Sept 16, 2020, 54 patients started induction treatment and 51 were included in the full analysis set. Median age was 71 years (IQR 68-75); 27 (53%) patients were female and 24 (47%) were male. At a median follow-up of 23·0 months (IQR 16·8-37·4), 23 (45%) of 51 patients progressed, relapsed, or died. 12-month progression-free survival was 58·8% (80% CI 48·9-68·2; 95% CI 44·1-70·9). During induction treatment, the most common grade 3-5 toxicities were thrombocytopenia and leukopenia (each in 52 [96%] of 54 patients). During high-dose chemotherapy and autologous HSCT, the most common grade 3-5 toxicity was leukopenia (37 [100%] of 37 patients). Treatment-related deaths were reported in three (6%) of 54 patients, all due to infectious complications. INTERPRETATION Although the primary efficacy threshold was not met, short induction followed by high-dose chemotherapy and autologous HSCT is active in selected older patients with PCNSL and could serve as a benchmark for comparative trials. FUNDING Else Kröner-Fresenius Foundation, Riemser Pharma, and Medical Center-University of Freiburg.
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Affiliation(s)
- Elisabeth Schorb
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Lisa Kristina Isbell
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andrea Kerkhoff
- Medizinische Klinik A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany
| | - Stephan Mathas
- Charité-Universitätsmedizin Berlin, Haematology, Oncology and Cancer Immunology, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Group Biology of Malignant Lymphomas, Berlin, Germany; Experimental and Clinical Research Center, Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Friederike Braulke
- Comprehensive Cancer Center, University Medical Center Göttingen, Göttingen, Germany; Department of Haematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Gerlinde Egerer
- Department of Haematology and Oncology, Heidelberg University, Heidelberg, Germany
| | - Alexander Röth
- Department of Haematology and Stem Cell Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Simon Schliffke
- Department of Oncology and Haematology, BMT with Section Pneumology, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Borchmann
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Uta Brunnberg
- Department of Internal Medicine II, Haematology and Oncology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Robert Möhle
- Department of Haematology and Oncology, University of Tübingen, Tübingen, Germany
| | - Andreas Rank
- Department of Haematology and Oncology, Augsburg Medical Center, Augsburg, Germany
| | - Dominique Wellnitz
- Department of Internal Medicine II-Haematology and Oncology, University Clinics Schleswig Holstein-Campus Kiel, Kiel, Germany
| | - Benjamin Kasenda
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Lisa Pospiech
- Department of Haematology, Oncology and Palliative Care, Klinikum Stuttgart, Stuttgart, Germany
| | - Julia Wendler
- Department of Haematology, Oncology and Palliative Care, Klinikum Stuttgart, Stuttgart, Germany
| | - Florian Scherer
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Martina Deckert
- Institute of Neuropathology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Elina Henkes
- Clinic for Neuroradiology, Klinikum Stuttgart, Stuttgart, Germany
| | | | - Dennis Gmehlin
- Institute for Clinical Psychology, Klinikum Stuttgart, Stuttgart, Germany
| | | | - Antje Jensch
- Stuttgart Cancer Center-Tumorzentrum Eva Mayr-Stihl, Klinikum Stuttgart, Stuttgart, Germany
| | - Elvira Burger-Martin
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Clinical Trials Unit, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Olga Grishina
- Clinical Trials Unit, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Heidi Fricker
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Natalie Malenica
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - András Orbán
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Justus Duyster
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gabriele Ihorst
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Clinical Trials Unit, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Juergen Finke
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gerald Illerhaus
- Department of Haematology, Oncology and Palliative Care, Klinikum Stuttgart, Stuttgart, Germany
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2
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Spyridonidis A, Labopin M, Gedde-Dahl T, Ganser A, Stelljes M, Craddock C, Wagner-Drouet EM, Versluis J, Schroeder T, Blau IW, Wulf GG, Dreger P, Olesen G, Sengeloev H, Kröger N, Potter V, Forcade E, Passweg J, de Latour RP, Maertens J, Wilson KMO, Bourhis JH, Finke J, Brissot E, Bazarbachi A, Giebel S, Savani BP, Nagler A, Ciceri F, Mohty M. Validation of the transplant conditioning intensity (TCI) index for allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2024; 59:217-223. [PMID: 37978322 PMCID: PMC10849946 DOI: 10.1038/s41409-023-02139-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
The intensity of the conditioning regimen given before allogeneic hematopoietic cell transplantation (allo-HCT) can vary substantially. To confirm the ability of the recently developed transplant conditioning intensity (TCI) score to stratify the preparative regimens of allo-HCT, we used an independent and contemporary patient cohort of 4060 transplant recipients with acute myeloid leukemia meeting inclusion criteria from the discovery study (allo-HCT in first complete remission, matched donor), but who were allografted in a more recent period (2018-2021) and were one decade older (55-75 years, median 63.4 years), we assigned them to a TCI category (low n = 1934, 48%; intermediate n = 1948, 48%, high n = 178, 4%) according to the calculated TCI score ([1-2], [2.5-3.5], [4-6], respectively), and examined the validity of the TCI category in predicting early non-relapse mortality (NRM), 2-year NRM and relapse (REL). In the unadjusted comparison, the TCI index provided a significant risk stratification for d100 and d180 NRM, NRM and REL risk. In the multivariate analysis adjusted for significant variables, there was an independent association of TCI with early NRM, NRM and REL. In summary, we confirm in contemporary treated patients that TCI reflects the conditioning regimen related morbidity and anti-leukemic efficacy satisfactorily and across other established prognostic factors.
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Affiliation(s)
- Alexandros Spyridonidis
- Bone Marrow Transplantation Unit and Institute of Cellular Therapy, University of Patras, Patras, Greece.
| | - Myriam Labopin
- EBMT Unit, Sorbonne University, Saint-Antoine Hospital, AP-HP, INSERM UMRs 938, Paris, France
| | - Tobias Gedde-Dahl
- Oslo University Hospital, Rikshospitalet Clinic for Cancer Medicine, Hematology Dept. Section for Stem Cell Transplantation, Oslo, Norway
| | - Arnold Ganser
- Hannover Medical School, Department of Haematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover, Germany
| | | | - Charles Craddock
- University Hospital Birmingham NHSTrust, Queen Elizabeth Medical Centre, Edgbaston, Dept. of Haematology, Birmingham, United Kingdom
| | - Eva Maria Wagner-Drouet
- University Medical Center Mainz, Department of Hematology, Oncology and Pneumology, Mainz, Germany
| | - Jurjen Versluis
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Hematology, Rotterdam, Netherlands
| | - Thomas Schroeder
- University Hospital Essen, Dept. of Bone Marrow Transplantation, Essen, Germany
| | - Igor Wolfgang Blau
- Charité Universitätsmedizin Berlin, Onkologie und Tumorimmunologie, Berlin, Germany
| | - Gerald G Wulf
- Universitaetsklinikum Goettingen, Abteilung Hämatologie und Onkologie, Goettingen, Germany
| | - Peter Dreger
- University of Heidelberg, Medizinische Klinik u. Poliklinik V, Heidelberg, Germany
| | | | - Henrik Sengeloev
- National University Hospital, Bone Marrow Transplant Unit, Copenhagen, Denmark
| | - Nicolaus Kröger
- University Hospital Eppendorf, Bone Marrow Transplantation Centre, Hamburg, Germany
| | - Victoria Potter
- Kings College Hospital, Dept. of Haematological Medicine, King's Denmark Hill Campus, London, United Kingdom
| | | | - Jakob Passweg
- University Hospital Basel, Dept of Hematology, Basel, Switzerland
| | | | - Johan Maertens
- University Hospital Gasthuisberg Dept. of Hematology, Leuven, Belgium
| | - Keith M O Wilson
- University Hospital of Wales, Department of Haematology, Cardiff, United Kingdom
| | - Jean Henri Bourhis
- Gustave Roussy Cancer Campus, Department of Hematology, Villejuif, France
| | - Juergen Finke
- University of Freiburg, Department of Hematology/Oncology, Freiburg, Germany
| | - Eolia Brissot
- Hospital Saint Antoine, Department of Hematology, Paris, France
| | - Ali Bazarbachi
- American University of Beirut-Medical Center, Department of Internal Medicine-Bone Marrow Transplantation Program, Beirut, Lebanon
| | - Sebastian Giebel
- Maria Sklodowska-Curie National Research Institute of Oncology, Department of Hematology, Gliwice, Poland
| | - Bipin P Savani
- Vanderbilt University Medical Center, Department of Hematology, Nashville, TN, USA
| | - Arnon Nagler
- Chaim Sheba Medical Center, Department of Hematology, Tel-Hashomer, Israel
| | - Fabio Ciceri
- Hematology Division, Ospedale San Raffaele s.r.l., Haematology and BMT, Milano, Italy
| | - Mohamad Mohty
- EBMT Unit, Sorbonne University, Saint-Antoine Hospital, AP-HP, INSERM UMRs 938, Paris, France
- Hospital Saint Antoine, Department of Hematology, Paris, France
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3
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Potter V, Gras L, Koster L, Kroger N, Sockel K, Ganser A, Finke J, Labussiere-Wallet H, Peffault de Latour R, Koc Y, Salmenniemi U, Smidstrup Friis L, Jindra P, Schroeder T, Tischer J, Arat M, Pascual Cascon M, de Wreede LC, Hayden P, Raj K, Drozd-Sokolowska J, Scheid C, McLornan DP, Robin M, Yakoub-Agha I. Sequential vs myeloablative vs reduced intensity conditioning for patients with myelodysplastic syndromes with an excess of blasts at time of allogeneic haematopoietic cell transplantation: a retrospective study by the chronic malignancies working party of the EBMT. Bone Marrow Transplant 2024; 59:224-231. [PMID: 37993503 DOI: 10.1038/s41409-023-02111-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 06/27/2023] [Accepted: 09/15/2023] [Indexed: 11/24/2023]
Abstract
The optimal conditioning for patients with higher risk MDS receiving potentially curative allogeneic haematopoietic stem cell transplant(allo-HCT) remains to be defined. This is particularly the case for patients with excess of blasts at time of allo-HCT. Sequential (Seq) conditioning, whereby chemotherapy is followed rapidly by transplant conditioning, offers an opportunity to decrease disease burden, potentially improving outcomes allo-HCT outcomes. Herein we present the only analysis comparing Seq to myeloablative (MAC) and reduced intensity conditioning (RIC) specifically focussed on MDS patients with excess of blasts at allo-HCT. 303 patients were identified in the EBMT registry, receiving RIC (n = 158), Seq (n = 105), and MAC (n = 40). Median follow-up was 67.2 months and median age at allo-HCT was 59.5 years (IQR 53.5-65.6). For the entire cohort, 3 y overall survival (OS) was 50% (95% CI 45-56%) and relapse free survival (RFS) 45% (95% CI 40-51%). No significant differences in OS (log-rank p = 0.13) and RFS (log-rank p = 0.18) were observed between conditioning protocols. On multivariable analysis, lower performance status, worse IPSS-R cytogenetics, sibling donor (compared to 8/8 MUD) and ≥20% blasts at allo-HCT were associated with worse outcomes. In conclusion, the Seq protocol did little to influence the outcome in this high-risk group of patients, with outcomes mostly determined by baseline disease risk and patient characteristics such as performance status.
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Affiliation(s)
- V Potter
- Kings College Hospital NHS Foundation Trust, London, UK.
| | - L Gras
- EBMT Statistical Unit, Leiden, Netherlands
| | - L Koster
- EBMT Leiden Study Unit, Leiden, Netherlands
| | - N Kroger
- University Hospital Eppendorf, Hamburg, Germany
| | - K Sockel
- Universitaetsklinikum Dresden, Dresden, Germany
| | - A Ganser
- Hannover Medical School, Hannover, Germany
| | - J Finke
- University of Freiburg, Freiburg, Germany
| | | | | | - Y Koc
- Medicana International Hospital Istanbul, Istanbul, Turkey
| | | | | | - P Jindra
- Charles University Hospital, Pilsen, Czech Republic
| | - T Schroeder
- University Hospital Essen, Dusseldorf, Germany
| | - J Tischer
- Klinikum Grosshadern, Munich, Germany
| | - M Arat
- Demiroglu Bilim University Istanbul Florence Nightingale Hospital, Stanbul, Turkey
| | | | - L C de Wreede
- Leiden University Medical Center, Dept of Biomedical Data Sciences, Leiden, Netherlands
| | - P Hayden
- Department of Haematology, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
| | - K Raj
- University College London Hospitals NHS Trust, London, UK
| | | | - C Scheid
- University of Cologne, Cologne, Germany
| | - D P McLornan
- University College London Hospitals NHS Trust, London, UK
| | - M Robin
- Saint-Louis Hospital, BMT Unit, Paris, France
| | - I Yakoub-Agha
- CHU de Lille, Univ Lille, INSERM U1286, Infinite, 59000, Lille, France
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4
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Apostolova P, Kreutmair S, Toffalori C, Punta M, Unger S, Burk AC, Wehr C, Maas-Bauer K, Melchinger W, Haring E, Hoefflin R, Shoumariyeh K, Hupfer V, Lauer EM, Duquesne S, Lowinus T, Gonzalo Núñez N, Alberti C, da Costa Pereira S, Merten CH, Power L, Weiss M, Böke C, Pfeifer D, Marks R, Bertz H, Wäsch R, Ihorst G, Gentner B, Duyster J, Boerries M, Andrieux G, Finke J, Becher B, Vago L, Zeiser R. Phase II trial of hypomethylating agent combined with nivolumab for acute myeloid leukaemia relapse after allogeneic haematopoietic cell transplantation-Immune signature correlates with response. Br J Haematol 2023; 203:264-281. [PMID: 37539479 DOI: 10.1111/bjh.19007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 07/19/2023] [Indexed: 08/05/2023]
Abstract
Acute myeloid leukaemia (AML) relapse after allogeneic haematopoietic cell transplantation (allo-HCT) is often driven by immune-related mechanisms and associated with poor prognosis. Immune checkpoint inhibitors combined with hypomethylating agents (HMA) may restore or enhance the graft-versus-leukaemia effect. Still, data about using this combination regimen after allo-HCT are limited. We conducted a prospective, phase II, open-label, single-arm study in which we treated patients with haematological AML relapse after allo-HCT with HMA plus the anti-PD-1 antibody nivolumab. The response was correlated with DNA-, RNA- and protein-based single-cell technology assessments to identify biomarkers associated with therapeutic efficacy. Sixteen patients received a median number of 2 (range 1-7) nivolumab applications. The overall response rate (CR/PR) at day 42 was 25%, and another 25% of the patients achieved stable disease. The median overall survival was 15.6 months. High-parametric cytometry documented a higher frequency of activated (ICOS+ , HLA-DR+ ), low senescence (KLRG1- , CD57- ) CD8+ effector T cells in responders. We confirmed these findings in a preclinical model. Single-cell transcriptomics revealed a pro-inflammatory rewiring of the expression profile of T and myeloid cells in responders. In summary, the study indicates that the post-allo-HCT HMA/nivolumab combination induces anti-AML immune responses in selected patients and could be considered as a bridging approach to a second allo-HCT. Trial-registration: EudraCT-No. 2017-002194-18.
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Affiliation(s)
- Petya Apostolova
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefanie Kreutmair
- German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | - Cristina Toffalori
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Punta
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Center for OMICS Sciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Susanne Unger
- Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | - Ann-Cathrin Burk
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Claudia Wehr
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kristina Maas-Bauer
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Wolfgang Melchinger
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Eileen Haring
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rouven Hoefflin
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Khalid Shoumariyeh
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Valerie Hupfer
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Eliza Maria Lauer
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sandra Duquesne
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Theresa Lowinus
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Chiara Alberti
- Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | | | - Carla Helena Merten
- Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | - Laura Power
- Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | - Matthias Weiss
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Caroline Böke
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dietmar Pfeifer
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Reinhard Marks
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hartmut Bertz
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ralph Wäsch
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gabriele Ihorst
- Clinical Trials Unit, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernhard Gentner
- Translational Stem Cell and Leukemia Unit, San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Ludwig Institute for Cancer Research and Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Justus Duyster
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Melanie Boerries
- German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute of Medical Bioinformatics and Systems Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Geoffroy Andrieux
- Institute of Medical Bioinformatics and Systems Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Juergen Finke
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Burkhard Becher
- Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | - Luca Vago
- Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Robert Zeiser
- Department of Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK), Partner Site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Signalling Research Centres BIOSS and CIBSS-Centre for Integrative Biological Signalling Studies, University of Freiburg, Freiburg, Germany
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5
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Heinz AT, Calkoen FGJ, Derbich A, Miltner L, Seitz C, Doering M, Braun C, Atar D, Schumm M, Heubach F, Arendt AM, Schulz A, Schuster FR, Meisel R, Strahm B, Finke J, Heineking B, Stetter S, Silling G, Stachel D, Gruhn B, Debatin KM, Foell J, Schulte JH, Woessmann W, Mauz-Körholz C, Tischer J, Feuchtinger T, Handgretinger R, Lang P. Automated production of specific T cells for treatment of refractory viral infections after allogeneic stem cell transplantation. Haematologica 2023. [PMID: 36794500 PMCID: PMC10388273 DOI: 10.3324/haematol.2022.281996] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Indexed: 02/17/2023] Open
Abstract
Therapy resistant viral reactivations significantly contribute to mortality after hematopoietic stem cell transplantation. Adoptive cellular therapy with virus-specific T cells has shown efficacy in various single center trials. However, scalability of this therapy is hampered by laborious production methods. In this study we describe the in-house production of virus-specific T cells (VST) in a closed system (CliniMACS Prodigy® system by Miltenyi Biotec). In addition, we report the efficacy in 26 patients with viral disease post HSCT in a retrospective analysis (ADV n=7, CMV n=8, EBV n=4, multi-viral n=7). Production of VST was successful in 100% of cases. Safety profile of VST therapy was favorable (n=2 adverse event grade 3, n=1 grade 4; all three were reversible). A response was seen in 20 of 26 patients (77%). Responding patients had a significantly better OS than patients without response (p.
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Affiliation(s)
- Amadeus T Heinz
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen.
| | | | - Alexander Derbich
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen
| | - Lea Miltner
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen
| | - Christian Seitz
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen
| | - Michaela Doering
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen
| | - Christiane Braun
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen
| | - Daniel Atar
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen
| | - Michael Schumm
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen
| | - Florian Heubach
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen
| | - Anne-Marie Arendt
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen
| | - Ansgar Schulz
- Department of Pediatrics, University Medical Center Ulm, Ulm
| | - Friedhelm R Schuster
- Division of Pediatric Stem Cell Therapy, Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich-Heine-University, Duesseldorf
| | - Roland Meisel
- Division of Pediatric Stem Cell Therapy, Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich-Heine-University, Duesseldorf
| | - Brigitte Strahm
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical Center, Faculty of Medicine, University of Freiburg
| | - Juergen Finke
- Department of Hematology and Oncology, University Hospital Freiburg, Freiburg
| | - Beatrice Heineking
- Department of Pediatric Cardiology and Intensive Care Medicine, Ludwig-Maximilians-University, Munich
| | - Susanne Stetter
- Department of Medicine III, University Hospital Regensburg, Regensburg
| | - Gerda Silling
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, RWTH Aachen University, Aachen
| | - Daniel Stachel
- Hospital for Pediatric and Adolescent Medicine, University of Erlangen, Erlangen
| | - Bernd Gruhn
- Department of Pediatrics, Jena University Hospital, Jena
| | | | - Juergen Foell
- Department of Hematology and Oncology, University Children's Hospital Regensburg, Regensburg
| | - Johannes H Schulte
- Department of Pediatric Oncology and Hematology, Charité University Medicine, Berlin
| | - Wilhelm Woessmann
- Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen
| | - Christine Mauz-Körholz
- Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen, Germany; Medical Faculty of the Martin-Luther-University of Halle-Wittenberg, Halle
| | - Johanna Tischer
- Department of Medicine III, Ludwig-Maximilians-University, Munich
| | - Tobias Feuchtinger
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner University Children's Hospital, Munich
| | | | - Peter Lang
- Department of Pediatric Hematology and Oncology, University Children's Hospital Tübingen, Tübingen
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6
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Strüßmann T, Wäsch R, Scherer F, Mutter JA, Pfeifer D, Bartsch I, Giesler S, Graziani G, Duyster J, Finke J, Marks R. A patient with refractory high-grade B-cell lymphoma and rapid progression under CAR-T-cell therapy was successfully salvaged with inotuzumab- ozogamicin. Leuk Lymphoma 2022; 63:2260-2262. [DOI: 10.1080/10428194.2022.2074991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- T. Strüßmann
- Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R. Wäsch
- Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - F. Scherer
- Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium (DKTK) partner site Freiburg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J. A. Mutter
- Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - D. Pfeifer
- Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - I. Bartsch
- Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - S. Giesler
- Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - G. Graziani
- Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J. Duyster
- Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J. Finke
- Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R. Marks
- Department of Medicine I, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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7
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Schmid C, Labopin M, Schaap N, Veelken H, Brecht A, Stadler M, Finke J, Baron F, Collin M, Bug G, Ljungman P, Blaise D, Tischer J, Bloor A, Kulagin A, Giebel S, Gorin NC, Esteve J, Ciceri F, Savani B, Nagler A, Mohty M. Long-term results and GvHD after prophylactic and preemptive donor lymphocyte infusion after allogeneic stem cell transplantation for acute leukemia. Bone Marrow Transplant 2021; 57:215-223. [PMID: 34750562 PMCID: PMC8821014 DOI: 10.1038/s41409-021-01515-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 10/17/2021] [Accepted: 10/21/2021] [Indexed: 11/09/2022]
Abstract
We report on 318 patients with acute leukemia, receiving donor lymphocyte infusion (DLI) in complete hematologic remission (CHR) after allogeneic stem cell transplantation (alloSCT). DLI were applied preemptively (preDLI) for minimal residual disease (MRD, n = 23) or mixed chimerism (MC, n = 169), or as prophylaxis in high-risk patients with complete chimerism and molecular remission (proDLI, n = 126). Median interval from alloSCT to DLI1 was 176 days, median follow-up was 7.0 years. Five-year cumulative relapse incidence (CRI), non-relapse mortality (NRM), leukemia-free and overall survival (LFS/OS) of the entire cohort were 29.1%, 12.7%, 58.2%, and 64.3%. Cumulative incidences of acute graft-versus-host disease (aGvHD) grade II-IV°/chronic GvHD were 11.9%/31%. Nineteen patients (6%) died from DLI-induced GvHD. Age ≥60 years (p = 0.046), advanced stage at transplantation (p = 0.003), shorter interval from transplantation (p = 0.018), and prior aGvHD ≥II° (p = 0.036) were risk factors for DLI-induced GvHD. GvHD did not influence CRI, but was associated with NRM and lower LFS/OS. Efficacy of preDLI was demonstrated by decreasing MRD/increasing blood counts in 71%, and increasing chimerism in 70%. Five-year OS after preDLI for MRD/MC was 51%/68% among responders, and 37% among non-responders. The study describes response and outcome of DLI in CHR and helps to identify candidates without increased risk of severe GvHD.
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Affiliation(s)
- Christoph Schmid
- Department of Hematology and Oncology, Augsburg University Hospital and Medical Faculty, Augsburg, Germany.
| | - Myriam Labopin
- EBMT Study Office, Saint Antoine Hospital, Paris, France.,INSERM UMR 938, Sorbonne University, Paris, France
| | - Nicolaas Schaap
- Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Hendrik Veelken
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arne Brecht
- Helios Dr. Horst Schmidt Kliniken, Wiesbaden, Germany
| | - Michael Stadler
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Juergen Finke
- Department of Hematology and Medical Oncology, University of Freiburg, Freiburg, Germany
| | - Frederic Baron
- Department of Medicine, Division of Hematology, University of Liège, Belgium, Liege
| | - Matthew Collin
- Bone Marrow Transplant Unit, Northern Centre for Bone Marrow Transplantation, Newcastle-upon-Tyne, UK
| | - Gesine Bug
- Department of Medicine 2, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Per Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Didier Blaise
- Programme de Transplantation & Therapie Cellulaire-Centre de Recherche en Cancérologie de Marseille-Institut Paoli Calmettes, Marseille, France
| | - Johanna Tischer
- Department of Medicine 3, Hematology and Oncology, Ludwig-Maximilian-University, Munich, Germany
| | - Adrian Bloor
- Stem Cell Transplantation Unit, The Christie NHS Foundation Trust, Manchester, UK
| | - Aleksander Kulagin
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute - Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Norbert-Claude Gorin
- Faculté de Médicine Saint-Antoine and EBM study office, Saint Antoine Hospital, Paris, France
| | - Jordi Esteve
- Hospital Clinic Barcelona, Institute of Hematology and Oncology, Barcelona, Spain
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milano, Italy
| | - Bipin Savani
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Arnon Nagler
- BMT and Cord Blood Bank, Chaim Sheba Medical Center, Tel Aviv University, Tel-Hashomer, Israel
| | - Mohamad Mohty
- EBMT Study Office, Saint Antoine Hospital, Paris, France.,INSERM UMR 938, Sorbonne University, Paris, France.,Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne University, Paris, France
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8
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Finke J, Kaitlyn B, Indihar V, Oder A. 522: Impact of elexacaftor/tezacaftor/ivacaftor on respiratory bacterial cultures in adult patients with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01946-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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9
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Blackwelder J, Oder A, Finke J, Indihar V, Vonbokern L, Meyers M, Meyer B, Riddle J. 308: Depression and anxiety score changes after elexacaftor/tezacaftor/ivacaftor: University of Cincinnati adult CF center experience. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01733-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Oder A, Indihar V, Meyers M, Vonbokern L, Meyer B, Riddle J, Finke J, Shively L, Hostetter A. 130: Feedback from patients regarding their use of home spirometers. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01555-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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11
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Greil C, Engelhardt M, Ihorst G, Duque-Afonso J, Shoumariyeh K, Bertz H, Marks R, Zeiser R, Duyster J, Finke J, Wäsch R. Correction to: Prognostic factors for survival after allogeneic transplantation in acute lymphoblastic leukemia. Bone Marrow Transplant 2021; 56:2042. [PMID: 34239052 PMCID: PMC8338552 DOI: 10.1038/s41409-021-01366-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- C Greil
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - M Engelhardt
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - G Ihorst
- Clinical Trials Unit, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Duque-Afonso
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - K Shoumariyeh
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - H Bertz
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Marks
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Zeiser
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Duyster
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Finke
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Wäsch
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany. .,Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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12
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Mutter JA, Alig S, Lauer EM, Esfahani MS, Mitschke J, Kurtz DM, Olsen M, Liu CL, Jin MC, Bleul S, Macaulay CW, Neidert NN, Heiland DH, Finke J, Duyster J, Wehrle J, Prinz M, Illerhaus G, Reinacher PC, Schorb E, Diehn M, Alizadeh AA, Scherer F. MATRIX INDUCTION FOLLOWED BY AUTOLOGOUS STEM CELL TRANSPLANT OR WHOLE‐BRAIN IRRADIATION IN PRIMARY CNS LYMPHOMA. 7‐YEAR RESULTS OF THE IELSG32 RANDOMIZED TRIAL. Hematol Oncol 2021. [DOI: 10.1002/hon.47_2879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- J. A. Mutter
- University Medical Center Freiburg Department of Hematology Oncology, and Stem Cell Transplantation Freiburg Germany
| | - S. Alig
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - E. M. Lauer
- University Medical Center Freiburg Department of Hematology Oncology, and Stem Cell Transplantation Freiburg Germany
| | - M. S. Esfahani
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - J. Mitschke
- University Medical Center Freiburg Department of Hematology Oncology, and Stem Cell Transplantation Freiburg Germany
| | - D. M. Kurtz
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - M. Olsen
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - C. L. Liu
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - M. C. Jin
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - S. Bleul
- University Medical Center Freiburg Department of Hematology Oncology, and Stem Cell Transplantation Freiburg Germany
| | - C. W. Macaulay
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - N. N. Neidert
- University Medical Center Freiburg Department of Neurosurgery Freiburg Germany
| | - D. H. Heiland
- University Medical Center Freiburg Department of Neurosurgery Freiburg Germany
| | - J. Finke
- University Medical Center Freiburg Department of Hematology Oncology, and Stem Cell Transplantation Freiburg Germany
| | - J. Duyster
- University Medical Center Freiburg Department of Hematology Oncology, and Stem Cell Transplantation Freiburg Germany
| | - J. Wehrle
- University Medical Center Freiburg Department of Hematology Oncology, and Stem Cell Transplantation Freiburg Germany
| | - M. Prinz
- University Medical Center Freiburg Institute of Neuropathology Freiburg Germany
| | - G. Illerhaus
- Klinikum Stuttgart Department of Hematology/Oncology and Palliative Care Stuttgart Germany
| | - P. C. Reinacher
- University Medical Center Freiburg Department of Stereotactic and Functional Neurosurgery Freiburg Germany
| | - E. Schorb
- University Medical Center Freiburg Department of Hematology Oncology, and Stem Cell Transplantation Freiburg Germany
| | - M. Diehn
- Stanford University Department of Radiation Oncology Stanford California USA
| | - A. A. Alizadeh
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - F. Scherer
- University Medical Center Freiburg Department of Hematology Oncology, and Stem Cell Transplantation Freiburg Germany
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13
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Mutter JA, Alig S, Lauer EM, Esfahani MS, Mitschke J, Kurtz DM, Olsen M, Liu CL, Jin MC, Bleul S, Macaulay CW, Neidert NN, Heiland DH, Finke J, Duyster J, Wehrle J, Prinz M, Illerhaus G, Reinacher PC, Schorb E, Diehn M, Alizadeh AA, Scherer F. NONINVASIVE DETECTION, CLASSIFICATION, AND RISK STRATIFICATION OF PRIMARY CNS LYMPHOMAS BY CTDNA PROFILING. Hematol Oncol 2021. [DOI: 10.1002/hon.46_2879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- J. A. Mutter
- University Medical Center Freiburg Department of Hematology, Oncology and Stem Cell Transplantation Freiburg Germany
| | - S. Alig
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - E. M. Lauer
- University Medical Center Freiburg Department of Hematology, Oncology and Stem Cell Transplantation Freiburg Germany
| | - M. S. Esfahani
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - J. Mitschke
- University Medical Center Freiburg Department of Hematology, Oncology and Stem Cell Transplantation Freiburg Germany
| | - D. M. Kurtz
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - M. Olsen
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - C. L. Liu
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - M. C. Jin
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - S. Bleul
- University Medical Center Freiburg Department of Hematology, Oncology and Stem Cell Transplantation Freiburg Germany
| | - C. W. Macaulay
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - N. N. Neidert
- University Medical Center Freiburg Department of Neurosurgery Freiburg Germany
| | - D. H. Heiland
- University Medical Center Freiburg Department of Neurosurgery Freiburg Germany
| | - J. Finke
- University Medical Center Freiburg Department of Hematology, Oncology and Stem Cell Transplantation Freiburg Germany
| | - J. Duyster
- University Medical Center Freiburg Department of Hematology, Oncology and Stem Cell Transplantation Freiburg Germany
| | - J. Wehrle
- University Medical Center Freiburg Department of Hematology, Oncology and Stem Cell Transplantation Freiburg Germany
| | - M. Prinz
- University Medical Center Freiburg Institute of Neuropathology Freiburg Germany
| | - G. Illerhaus
- Klinikum Stuttgart Department of Hematology/Oncology and Palliative Care Stuttgart Germany
| | - P. C. Reinacher
- University Medical Center Freiburg Department of Stereotactic and Functional Neurosurgery Freiburg Germany
| | - E. Schorb
- University Medical Center Freiburg Department of Hematology, Oncology and Stem Cell Transplantation Freiburg Germany
| | - M. Diehn
- Stanford University Department of Radiation Oncology Stanford California USA
| | - A. A. Alizadeh
- Stanford University Division of Oncology Department of Medicine Stanford California USA
| | - F. Scherer
- University Medical Center Freiburg Department of Hematology, Oncology and Stem Cell Transplantation Freiburg Germany
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14
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Greil C, Engelhardt M, Ihorst G, Duque-Afonso J, Shoumariyeh K, Bertz H, Marks R, Zeiser R, Duyster J, Finke J, Wäsch R. Prognostic factors for survival after allogeneic transplantation in acute lymphoblastic leukemia. Bone Marrow Transplant 2020; 56:841-852. [PMID: 33130821 PMCID: PMC8266681 DOI: 10.1038/s41409-020-01101-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/23/2020] [Accepted: 10/20/2020] [Indexed: 02/07/2023]
Abstract
Allogeneic stem cell transplantation (allo-SCT) offers a curative option in adult patients with acute lymphoblastic leukemia (ALL). Prognostic factors for survival after allo-SCT have not been sufficiently defined: pheno-/genotype, patients´ age, conditioning regimens and remission at allo-SCT are under discussion. We analyzed the outcome of 180 consecutive adult ALL-patients undergoing allo-SCT at our center between 1995 and 2018 to identify specific prognostic factors. In our cohort 19% were older than 55 years, 28% had Philadelphia-positive B-ALL, 24% T-ALL. 54% were transplanted in first complete remission (CR1), 13% in CR2 after salvage therapy, 31% reached no remission (8% within first-line, 23% within salvage therapy). In 66% conditioning contained total body irradiation (TBI). With a median follow-up of 10 years, we observed an overall survival of 33% at 10 years, and a progression free survival of 31%. The cumulative incidence of relapse was 41% at 10 years, the cumulative incidence of non-relapse mortality 28%. Acute graft-versus-host disease (GvHD) II°-IV° occurred in 31%, moderate/severe chronic GvHD in 27%. Survival was better in patients reaching CR before allo-SCT and in those receiving TBI. No difference between patients younger/older than 55 years and between different phenotypes was observed. Survival after allo-SCT improved considerably over the last decades.
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Affiliation(s)
- C Greil
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - M Engelhardt
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - G Ihorst
- Clinical Trials Unit, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Duque-Afonso
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - K Shoumariyeh
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - H Bertz
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Marks
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Zeiser
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Duyster
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Finke
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Wäsch
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, University of Freiburg, Freiburg, Germany. .,Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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15
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Regner K, Finke J, Horky A, Löwenberg F, Schroth M, Kainer F. Vorzeitiger Blasensprung (PPROM) in der 12. SSW – immer eine Indikation zum Schwangerschaftsabbruch? Eine Fallvorstellung. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- K Regner
- Klinik Hallerwiese, Geburtshilfe und Pränatalmedizin
| | - J Finke
- Klinik Hallerwiese, Geburtshilfe und Pränatalmedizin
| | - A Horky
- Klinik Hallerwiese, Geburtshilfe und Pränatalmedizin
| | - F Löwenberg
- Cnopfsche Kinderklinik, Neonatologie und Kinder-Intensivmedizin
| | - M Schroth
- Cnopfsche Kinderklinik, Neonatologie und Kinder-Intensivmedizin
| | - F Kainer
- Klinik Hallerwiese, Geburtshilfe und Pränatalmedizin
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16
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Horky A, Regner K, Löwenberg F, Finke J, Rauber S, Schälike M, Kainer F. Fallvorstellung: Blasensprung in der 12. SSW, extreme Prolongation bei persistierendem Oligohydramnion. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- A Horky
- Klinik Hallerweise, Abteilung Geburtshilfe und Pränatalmedizin, Nürnberg
| | - K Regner
- Klinik Hallerweise, Abteilung Geburtshilfe und Pränatalmedizin, Nürnberg
| | - F Löwenberg
- Neonatologie und Kinderintensivmedizin, Cnopfsche Kinderlinik, Nürnberg
| | - J Finke
- Klinik Hallerweise, Abteilung Geburtshilfe und Pränatalmedizin, Nürnberg
| | - S Rauber
- Klinik Hallerweise, Abteilung Geburtshilfe und Pränatalmedizin, Nürnberg
| | - M Schälike
- MVZ Pränatal, Pränatalmedizin, Gynäkologie und Genetik
| | - F Kainer
- Klinik Hallerweise, Abteilung Geburtshilfe und Pränatalmedizin, Nürnberg
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Beelen DW, Trenschel R, Stelljes M, Groth C, Masszi T, Reményi P, Wagner-Drouet EM, Hauptrock B, Dreger P, Luft T, Bethge W, Vogel W, Ciceri F, Peccatori J, Stölzel F, Schetelig J, Junghanß C, Grosse-Thie C, Michallet M, Labussiere-Wallet H, Schaefer-Eckart K, Dressler S, Grigoleit GU, Mielke S, Scheid C, Holtick U, Patriarca F, Medeot M, Rambaldi A, Micò MC, Niederwieser D, Franke GN, Hilgendorf I, Winkelmann NR, Russo D, Socié G, Peffault de Latour R, Holler E, Wolff D, Glass B, Casper J, Wulf G, Menzel H, Basara N, Bieniaszewska M, Stuhler G, Verbeek M, Grass S, Iori AP, Finke J, Benedetti F, Pichlmeier U, Hemmelmann C, Tribanek M, Klein A, Mylius HA, Baumgart J, Dzierzak-Mietla M, Markiewicz M. Treosulfan or busulfan plus fludarabine as conditioning treatment before allogeneic haemopoietic stem cell transplantation for older patients with acute myeloid leukaemia or myelodysplastic syndrome (MC-FludT.14/L): a randomised, non-inferiority, phase 3 trial. The Lancet Haematology 2020; 7:e28-e39. [DOI: 10.1016/s2352-3026(19)30157-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/15/2019] [Accepted: 07/16/2019] [Indexed: 01/10/2023]
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Schorb E, Kasenda B, Ihorst G, Fricker H, Holl H, Finke J, Illerhaus G. BICENTRIC PILOT STUDY ON AGE-ADAPTED HIGH-DOSE CHEMOTHERAPY AND AUTOLOGOUS STEM CELL TRANSPLANT IN NEWLY DIAGNOSED PRIMARY CNS LYMPHOMA PATIENTS > 65 YEARS - MARiTA TRIAL. Hematol Oncol 2019. [DOI: 10.1002/hon.81_2630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- E. Schorb
- Department of Hematology and Oncology; Faculty of Medicine, University of Freiburg; Freiburg Germany
| | - B. Kasenda
- Department of Hematology; Oncology and Palliative Care, Klinikum Stuttgart; Stuttgart Germany
| | - G. Ihorst
- Clinical Trials Unit; Faculty of Medicine, University of Freiburg; Freiburg Germany
| | - H. Fricker
- Department of Hematology and Oncology; Faculty of Medicine, University of Freiburg; Freiburg Germany
| | - H. Holl
- Department of Hematology; Oncology and Palliative Care, Klinikum Stuttgart; Stuttgart Germany
| | - J. Finke
- Department of Hematology and Oncology; Faculty of Medicine, University of Freiburg; Freiburg Germany
| | - G. Illerhaus
- Department of Hematology; Oncology and Palliative Care, Klinikum Stuttgart; Stuttgart Germany
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Robinson S, Boumendil A, Finel H, Khvedelidze I, Kanfer E, Peggs K, Fuesrt S, Ram R, Marjit E, Vandenberghe E, Afanasyev B, Wulf G, Maertens J, Tsolukani A, Schapp N, Beelen D, Chalandon Y, Gurman G, Finke J, Bron D, Tischer J, Corradini P, Caballero D, Potter V, Kroger N, Burney C, Schmitz N, Sureda A, Dreger P, Montoto S. DONOR LYMPHOCYTE INFUSIONS INDUCE DURABLE RESPONSES IN PATIENTS WITH FOLLICULAR, MANTLE AND T CELL LYMPHOMAS RELAPSING AFTER AN ALLOSCT. AN EBMT-LWP STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.125_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Robinson
- Haematology; University Hospital Bristol; Bristol United Kingdom
| | | | | | | | - E. Kanfer
- Haematology; Hammersmith Hospital; London United Kingdom
| | - K. Peggs
- Haematology; University College London Hospital; London United Kingdom
| | - S. Fuesrt
- Haematology; Paoli Calmettes; Marseille France
| | - R. Ram
- Haematology; Sourasky; Tel Aviv Israel
| | - E. Marjit
- Haematology; Leiden University; Leiden Netherlands
| | | | - B. Afanasyev
- Haematology; Pavlov Medical University; St Petersberg Russian Federation
| | - G. Wulf
- Haematology; University Hospital; Goettingen Germany
| | - J. Maertens
- Haematology; University Hospital; Leuven Netherlands
| | - A. Tsolukani
- Haematology; City Hospital; Nottingham United Kingdom
| | - N. Schapp
- Haematology; St Radboud Hospital; Nijmegen Netherlands
| | - D. Beelen
- Haematology; University Hospital; Essen Germany
| | - Y. Chalandon
- Haematology; University Hospital; Geneva Switzerland
| | - G. Gurman
- Haematology; Ankara University; Ankara Turkey
| | - J. Finke
- Haematology; University of Freiburg; Freiburg Germany
| | - D. Bron
- Haematology; Institute Jules Bordet; Brussels Belgium
| | - J. Tischer
- Haematology; Med Klinik Klinikum Grosshaderm; Munich Germany
| | - P. Corradini
- Haematology; Istituto Nazionale dei Tumori; Milan Italy
| | | | - V. Potter
- Haematology; Kings College hospital; London United Kingdom
| | - N. Kroger
- Haematology; University Hospital Eppendorf; Hamburg Germany
| | - C. Burney
- Haematology; University Hospital Bristol; Bristol United Kingdom
| | - N. Schmitz
- Haematology; University Hospital; Muenster Germany
| | - A. Sureda
- Haematology; Oncology Institute; Barcelona Spain
| | - P. Dreger
- Haematology; University of Heidelberg; Heidleberg Germany
| | - S. Montoto
- Haematology; St Bartholomew's Hospital; London United Kingdom
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Schorb E, Finke J, Ihorst G, Kasenda B, Fricker H, Illerhaus G. Age-adjusted high-dose chemotherapy and autologous stem cell transplant in elderly and fit primary CNS lymphoma patients. BMC Cancer 2019; 19:287. [PMID: 30925912 PMCID: PMC6440161 DOI: 10.1186/s12885-019-5473-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 03/14/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Primary central nervous system lymphoma (PCNSL) is a diffuse large B-cell lymphoma (DLBCL) confined to the central nervous system (CNS) with rising incidence among patients > 65 years. Although elderly patients are able to tolerate aggressive systemic chemotherapy, previous studies have demonstrated inferior outcomes for patients who present with a poor performance status (PS) and older age. Usually, intensive treatment approaches including high-dose chemotherapy followed by autologous stem cell transplantation (HDT-ASCT) are only offered to patients younger than 65-70 years of age. METHODS This is an open-label, multicentric, non-randomized, single arm phase II trial. We will recruit 51 immuno-competent patients with newly diagnosed PCNSL from 12 German centers. The objective is to investigate the efficacy of age-adapted induction treatment followed by HDT-ASCT. All enrolled patients will undergo induction chemotherapy consisting of 2 cycles of rituximab 375 mg/m2/d (days 0 & 4), methotrexate 3.5 g/m2 (d1), and cytarabine 2 × 2 g/m2/d (d2-3) every 21 days. After 2 cycles of induction chemotherapy, patients achieving at least stable disease will undergo HDT-ASCT with busulfan 3.2 mg/kg/d (days - 7-(- 6)) and thiotepa 5 mg/kg/d (days - 5-(- 4)) followed by autologous stem cell transplantation. The primary endpoint of this study is 1-year progression-free survival (PFS). Secondary endpoints include PFS, overall survival, treatment response and treatment-related morbidities. Minimal follow-up after treatment completion is 12 months. DISCUSSION Current treatment options for PCNSL have improved over the last years, resulting in the potential to achieve durable remission or cure in patients < 70 years. Age alone may not be the only criterion to select patients for this effective treatment approach and probably many elderly patients are undertreated just because of advanced age. There have been no multicentre trials investigating this curative treatment concept in elderly and fit PCNSL patients so far. We aim to answer whether HDT-ASCT is feasible and effective in fit patients > 65 years with newly-diagnosed PCNSL. TRIAL REGISTRATION German clinical trials registry DRKS00011932 registered 18 August 2017.
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Affiliation(s)
- Elisabeth Schorb
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Juergen Finke
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Gabriele Ihorst
- Clinical Trials Unit, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Benjamin Kasenda
- Clinic of Hematology, Oncology and Palliative Care, Klinikum Stuttgart, Stuttgart, Germany
- Department of Medical Oncology & Institute of Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - Heidi Fricker
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - Gerald Illerhaus
- Clinic of Hematology, Oncology and Palliative Care, Klinikum Stuttgart, Stuttgart, Germany
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Schmid C, Labopin M, Schaap N, Veelken H, Schleuning M, Stadler M, Finke J, Hurst E, Baron F, Ringden O, Bug G, Blaise D, Tischer J, Bloor A, Esteve J, Giebel S, Savani B, Gorin NC, Ciceri F, Mohty M, Nagler A. Prophylactic donor lymphocyte infusion after allogeneic stem cell transplantation in acute leukaemia - a matched pair analysis by the Acute Leukaemia Working Party of EBMT. Br J Haematol 2018; 184:782-787. [DOI: 10.1111/bjh.15691] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 10/15/2018] [Indexed: 01/31/2023]
Affiliation(s)
- Christoph Schmid
- Department of Haematology and Oncology; Klinikum Augsburg; University of Munich; Augsburg Germany
| | - Myriam Labopin
- Faculté de Médicine Saint-Antoine and EBMT data office; Paris France
| | | | - Hendrik Veelken
- BMT Centre Leiden; Leiden University Hospital; Leiden The Netherlands
| | | | - Michael Stadler
- Department of Haematology and Oncology; Medizinische Hochschule Hannover; Hannover Germany
| | - Juergen Finke
- Department of Medicine, Haematology and Oncology; University of Freiburg; Freiburg Germany
| | - Erin Hurst
- Bone Marrow Transplant Unit; NCCN Freeman Hospital; Newcastle-upon-Tyne United Kingdom
| | - Frederic Baron
- Department of Medicine; Division of Haematology; University of Liège; Liège Belgium
| | - Olle Ringden
- Department of Laboratory Medicine; Division of Therapeutic Immunology; Karolinska Institutet; Karolinska University Hospital Huddinge; Stockholm Sweden
| | - Gesine Bug
- Department of Medicine 2, Haematology and Oncology; Universitaetsklinikum; Frankfurt Germany
| | - Didier Blaise
- Programme de Transplantation & Therapie Cellulaire-Centre de Recherche en Cancérologie de Marseille-Institut Paoli Calmettes; Marseille France
| | - Johanna Tischer
- Department of Medicine 3, Haematology and Oncology; Ludwig-Maximilians-University; Munich Germany
| | - Adrian Bloor
- Stem Cell Transplantation Unit; The Christie NHS Foundation Trust; Manchester United Kingdom
| | - Jordi Esteve
- Department of Haematology; Hospital Clinic; IDIBAPS; Barcelona Spain
| | - Sebastian Giebel
- Maria Sklodowska-Curie Cancer Center and Institute of Oncology; Gliwice Branch; Gliwice Poland
| | - Bipin Savani
- Long term Transplant Clinic; Vanderbilt University Medical Center; Nashville TN USA
| | | | - Fabio Ciceri
- Department of Haematology, Osp. San Raffaele; Università degli Studi; Milano Italy
| | - Mohamad Mohty
- Faculté de Médicine Saint-Antoine and EBMT data office; Paris France
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22
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Brierley CK, Castilla-Llorente C, Labopin M, Badoglio M, Rovira M, Ricart E, Dierickx D, Vermeire S, Hasselblatt P, Finke J, Onida F, Cassinotti A, Satsangi J, Kazmi M, López-Sanromán A, Schmidt C, Farge D, Travis SPL, Hawkey CJ, Snowden JA. Autologous Haematopoietic Stem Cell Transplantation for Crohn's Disease: A Retrospective Survey of Long-term Outcomes From the European Society for Blood and Marrow Transplantation. J Crohns Colitis 2018; 12:1097-1103. [PMID: 29788233 PMCID: PMC6113702 DOI: 10.1093/ecco-jcc/jjy069] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/05/2018] [Accepted: 05/15/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Autologous haematopoietic stem cell transplantation [AHSCT] is a therapeutic option for patients with severe, treatment-refractory Crohn's disease [CD]. The evidence base for AHSCT for CD is limited, with one randomised trial [ASTIC] suggesting benefit. The aim of this study was to evaluate safety and efficacy for patients undergoing AHSCT for CD in Europe, outside the ASTIC trial. METHODS We identified 99 patients in the European Society for Blood and Marrow Transplantation [EBMT] registry, who were eligible for inclusion. Transplant and clinical outcomes were obtained for 82 patients from 19 centres in seven countries. RESULTS Median patient age was 30 years [range 20-65]. Patients had failed or been intolerant to a median of six lines of drug therapy; 61/82 [74%] had had surgery. Following AHSCT, 53/78 [68%] experienced complete remission or significant improvement in symptoms at a median follow-up of 41 months [range 6-174]; 22/82 [27%] required no medical therapy at any point post-AHSCT. In patients who had re-started medical therapy at latest follow-up, 57% [24/42] achieved remission or significant symptomatic improvement with therapies to which they had previously lost response or been non-responsive. Treatment-free survival at 1 year was 54%. On multivariate analysis, perianal disease was associated with adverse treatment-free survival (hazard ratio 2.34, 95% confidence interval [CI] 1.14-4.83, p = 0.02). One patient died due to infectious complications [cytomegalovirus disease] at Day +56. CONCLUSIONS In this multicentre retrospective analysis of European centres, AHSCT was relatively safe and appeared to be effective in controlling otherwise treatment-resistant Crohn's disease. Further prospective randomised controlled trials against standard of care are warranted.
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Affiliation(s)
- Charlotte K Brierley
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK,Corresponding author: Dr Charlotte Brierley, MA, MRCP, Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford OX3 7LE, UK.
| | - Cristina Castilla-Llorente
- Unité de transplantation des cellules souches, Département d’Hématologie Gustave Roussy, Villejuif, France
| | - Myriam Labopin
- EBMT Paris Study Office, Department of Haematology, Université Pierre et Marie Curie, Saint Antoine Hospital, Paris, France
| | - Manuela Badoglio
- EBMT Paris Study Office, Department of Haematology, Université Pierre et Marie Curie, Saint Antoine Hospital, Paris, France
| | - Montserrat Rovira
- BMT Unit, Haematology Department, Hospital Clínic of Barcelona, IDIBAPS, Institut Josep Carreras, Barcelona, Spain
| | - Elena Ricart
- Gastroenterology Department, Hospital Clínic of Barcelona, CIBER-EHD, IDIBAPS, Barcelona, Spain
| | - Daan Dierickx
- Department of Haematology, University Hospitals Leuven, Leuven, Belgium
| | - Severine Vermeire
- Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium
| | - Peter Hasselblatt
- Department of Medicine II, Medical Faculty and University Hospital Freiburg, Freiburg, Germany
| | - Juergen Finke
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Faculty and University Hospital Freiburg, Freiburg, Germany
| | - Francesco Onida
- Haematology - BMT Centre, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | | | - Jack Satsangi
- Gastro-intestinal Unit, Institute of Genetics and Molecular Medicine, Western General Hospital, University of Edinburgh, Edinburgh, UK
| | - Majid Kazmi
- Department of Haematology, Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital, London, UK
| | | | - Carsten Schmidt
- Department of Gastroenterology, Medizinische Klinik II, Klinikum Fulda AG, Universitätsmedizin Marburg-Campus, Fulda, Germany
| | - Dominique Farge
- Internal Medicine, Autoimmune and Vascular Diseases Unit, UF 04, AP-HP Hôpital Saint-Louis, Centre de Référence des Maladies auto-immunes systémiques Rares d’Ile-de-France [site constitutif], Filière FAI2R Paris 7 University, France
| | - Simon P L Travis
- Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, UK
| | - Chris J Hawkey
- Nottingham Digestive Diseases Centre, School of Clinical Sciences, Queen’s Medical Centre, Nottingham, UK
| | - John A Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Bluhmki T, Schmoor C, Dobler D, Pauly M, Finke J, Schumacher M, Beyersmann J. A wild bootstrap approach for the Aalen-Johansen estimator. Biometrics 2018; 74:977-985. [DOI: 10.1111/biom.12861] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 12/01/2018] [Accepted: 12/01/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | - Claudia Schmoor
- Clinical Trials Unit; Medical Center Freiburg; University of Freiburg; Freiburg Germany
| | - Dennis Dobler
- Institute of Statistics; Ulm University; Ulm Germany
| | - Markus Pauly
- Institute of Statistics; Ulm University; Ulm Germany
| | - Juergen Finke
- Department of Hematology; Oncology, and Stem-Cell Transplantation; Medical Center Freiburg; University of Freiburg; Freiburg Germany
| | - Martin Schumacher
- Institute for Medical Biometry and Statistics; Faculty of Medicine and Medical Center; University of Freiburg; Freiburg Germany
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Ringdén O, Labopin M, Sadeghi B, Mailhol A, Beelen D, Fløisand Y, Ghavamzadeh A, Finke J, Ehninger G, Volin L, Socié G, Kröger N, Stuhler G, Ganser A, Schmid C, Giebel S, Mohty M, Nagler A. What is the outcome in patients with acute leukaemia who survive severe acute graft-versus-host disease? J Intern Med 2018; 283:166-177. [PMID: 29027756 DOI: 10.1111/joim.12695] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acute graft-versus-host disease (aGVHD) is a major complication of allogeneic haematopoietic stem cell transplantation (HSCT). With new promising therapies, survival may improve for severe aGVHD. OBJECTIVES We wanted to analyze the long-term outcome in patients who survive severe aGVHD. METHODS This study was a landmark analysis of 23 567 patients with acute Leukaemia who survived for more than 6 months after HSCT, 2002-2014. Patients alive after severe aGVHD (n = 1738) were compared to controls. RESULTS Patients with severe aGVHD had higher non-relapse mortality (NRM) and higher rate of extensive chronic GVHD (cGVHD) than the controls (P < 10-5 ). The probability of relapse was significantly lower in the severe aGVHD group, but Leukaemia-free survival (LFS) and overall survival were significantly lower than for the controls (P < 10-5 ). Five-year LFS in patients with severe aGVHD was 49%, as opposed to 61% in controls with no or mild GVHD and 59% in patients with moderate GVHD. CONCLUSIONS HSCT patients who survive severe aGVHD have higher risk of developing extensive cGVHD, a higher NRM, a lower relapse probability, and lower LFS than other HSCT patients. This study is a platform for outcome analysis in patients treated with novel therapies for acute GVHD.
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Affiliation(s)
- O Ringdén
- Division of Therapeutic Immunology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - M Labopin
- Hôpital Saint Antoine, Paris, France
| | - B Sadeghi
- Division of Therapeutic Immunology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - A Mailhol
- Hôpital Saint Antoine, Paris, France
| | - D Beelen
- University of Essen, Duisburg, Germany
| | - Y Fløisand
- Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - A Ghavamzadeh
- Shariati Hospital, Hematology-Oncology and BMT Research, Tehran, Iran
| | - J Finke
- Department of Medicine-Hematology, Oncology, University of Freiburg, Freiburg, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik 1, Universitätsklinikum Dresden, Dresden, Germany
| | - L Volin
- Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki University Hospital, Helsinki, Finland
| | - G Socié
- Department of Hematology - BMT, Hopital St. Louis, Paris, France
| | - N Kröger
- Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany
| | - G Stuhler
- Deutsche Klinik für Diagnostik, KMT Zentrum, Wiesbaden, Germany
| | - A Ganser
- Medical University Hannover, Hannover, Germany
| | - C Schmid
- University of Munich, Munich, Germany
| | - S Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - M Mohty
- Hôpital Saint Antoine, Paris, France
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
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Herkel C, Joe AY, Altehoefer C, Finke J, Moser E, Reinhardt MJ, Bucerius J. 18F-FDG PET and conventional imaging for assessment of Hodgkin’s disease and non Hodgkin’s lymphoma. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe aim of this study was to assess the diagnostic value of FDG-PET and conventional imaging (CI) in a large series of patient with Hodgkin’s disease (HD) or non-Hodgkin’s lymphoma (NHL) at three time points during their course of disease. Patients, methods: 169 consecutive lymphoma patients (69 HD; 100 NHL) were included. 193 FDG-PET studies were performed for staging at baseline in 42 cases, for post-therapeutic monitoring in 103, and for diagnosis of recurrence in 48 cases. Performance indices of sensitivity, specificity, positive (PPV) and negative predictive value (NPV), and accuracy of metabolic FDG-PET and morphological CI were calculated. Differences in staging and diagnosis of residual or recurrent lymphoma were compared. Results: FDG-PET changed staging in 36% of cases for staging at baseline, in 52% of cases for monitoring response to treatment, and in 29% for diagnosis of recurrence. FDG-PET staging results were confirmed in 80% for staging at baseline, in 74% for monitoring response to treatment, and in 50% for diagnosis of recurrence. FDGPET and CI differed significantly at monitoring response to treatment for sensitivity (0.91 versus 0.69; p<0.02), specificity (0.90 versus 0.38; p<0.00001), PPV (0.77 versus 0.42; p<0.001), and accuracy (0.83 versus 0.55; p<0.02). Conclusion: FDG-PET should be considered as the diagnostic modality of choice for post-therapeutic assessment of lymphoma patients and may be a reliable alternative to CI for staging at baseline and diagnosis of recurrence.
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Roth-Guepin G, Canaani J, Ruggeri A, Labopin M, Finke J, Cornelissen JJ, Delage J, Stuhler G, Rovira M, Potter M, Stadler M, Veelken H, Cahn JY, Collin M, Beguin Y, Giebel S, Nagler A, Mohty M. Allogeneic stem cell transplantation in acute lymphoblastic leukemia patients older than 60 years: a survey from the acute leukemia working party of EBMT. Oncotarget 2017; 8:112972-112979. [PMID: 29348881 PMCID: PMC5762566 DOI: 10.18632/oncotarget.22934] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/05/2017] [Indexed: 01/13/2023] Open
Abstract
Hematopoietic stem cell transplantation (HSCT) is being increasingly explored as a treatment modality for older patients with acute lymphoblastic leukemia (ALL). Yet, concerns regarding the long term outcome of transplantation in older patients limit the wide spread applicability of this approach. In this analysis we set out to determine the outcome of ALL patients over the age of 60 who underwent reduced intensity HSCT. Herein, we present the experience of the acute leukemia working party (ALWP) of the EBMT in this age group. We analyzed a cohort of 142 patients transplanted in first remission with a median age of 62 (range 60–76 years) and a median follow-up period of 36 months post-transplant. At 3 years, overall survival (OS) and leukemia-free survival were 42% and 35%, respectively. Multivariate analyses identified cytomegalovirus (CMV) donor-recipient matching (CMV D+/R+) to be significantly associated with inferior OS. Patients transplanted from unrelated donors experienced increased grade II-IV acute graft versus host disease compared to those receiving grafts from matched related donors [Hazard ratio (HR) of 3.7, 95% confidence interval (CI), 1.75–7.8; p = 0.0005). Outcome was not impacted by Philadelphia chromosome status. A select subset of older ALL patients will benefit from extended survival and a disease free state following HSCT.
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Affiliation(s)
| | - Jonathan Canaani
- Hematology Division, Chaim Sheba Medical Center, Tel Aviv University, Tel-Aviv, Israel
| | - Annalisa Ruggeri
- Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, HÔpital Saint-Antoine, Paris, France
| | - Myriam Labopin
- Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, HÔpital Saint-Antoine, Paris, France.,INSERM UMR 938, Paris, France.,Université Pierre et Marie Curie, Paris, France
| | - Juergen Finke
- Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany
| | - Jan J Cornelissen
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Hematology, Rotterdam, The Netherlands
| | - Jeremy Delage
- Service d'Hématologie et d'Oncologie, Hospital Lapeyronie CHU , University Montpellier, Montpellier, France
| | - Gernot Stuhler
- Deutsche Klinik für Diagnostik, KMT Zentrum, Wiesbaden, Germany
| | - Monserrat Rovira
- Hospital Clinic Barcelona, Institute of Hematology and Oncology, Department of Hematology, Barcelona, Spain
| | - Mike Potter
- Institute of Hematology and Oncology, Department of Hematology, London, UK
| | - Michael Stadler
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover, Medical School, Hannover, Germany
| | - Hendrik Veelken
- Department of Hematology, Leiden University Medical Center, Leiden, Netherlands
| | - Jean Yves Cahn
- Department of Hematology, University Hospital, Grenoble, France
| | - Matthew Collin
- Newcastle University, Adult HSCT unit, Northern Centre for Bone Marrow Transplantation, Freeman Hospital, Newcastle upon Tyne, UK
| | - Yves Beguin
- University of Liege, Department of Hematology, CHU of Liège, Liège, Belgium
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Arnon Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel Aviv University, Tel-Aviv, Israel.,Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, HÔpital Saint-Antoine, Paris, France
| | - Mohamad Mohty
- Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy, HÔpital Saint-Antoine, Paris, France.,INSERM UMR 938, Paris, France.,Université Pierre et Marie Curie, Paris, France
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Ouzaid I, Rayman P, Haber G, Rini B, Ravery V, Finke J. Rôle du carcinome à cellules rénales dans l’induction de la dédifférenciation des polynucléaires neutrophiles en cellules suppressive dérivées de la moelle et l’expression des molécules immunosuppressives. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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28
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Eder S, Canaani J, Beohou E, Labopin M, Sanz J, Arcese W, Or R, Finke J, Cortelezzi A, Beelen D, Passweg J, Socié G, Gurman G, Aljurf M, Stelljes M, Giebel S, Mohty M, Nagler A. Thiotepa-based conditioning versus total body irradiation as myeloablative conditioning prior to allogeneic stem cell transplantation for acute lymphoblastic leukemia: A matched-pair analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Am J Hematol 2017; 92:997-1003. [PMID: 28614903 DOI: 10.1002/ajh.24823] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/06/2017] [Accepted: 06/12/2017] [Indexed: 12/13/2022]
Abstract
The optimal conditioning regimen to employ before hematopoietic stem cell transplantation in acute lymphoblastic leukemia (ALL) is still undecided, and while cyclophosphamide/total body irradiation (Cy/TBI) is the most commonly used myeloablative regimen, there are concerns regarding long-term toxicity for patients conditioned with this regimen. Thiotepa-based conditioning is an emerging radiation-free regimen with recent publications indicative of comparable clinical outcomes to TBI-based conditioning. In this analysis of the acute leukemia working party of the EBMT, we performed a retrospective matched-pair analysis, evaluating the outcome of adult patients with ALL who received thiotepa-based conditioning (n = 180) with those receiving Cy/TBI conditioning (n = 540). The 2-year leukemia-free survival and overall survival (OS) rates of both conditioning regimens were comparable, 33% for thiotepa [95% confidence interval (CI): 26.4-42.8] versus 39% for Cy/TBI (95% CI: 34.8-44.5] (P = .33) and 46.5% [95% CI: 38.6-56.1] versus 48.8% [95% CI: 44.2-54] (P = .9), respectively. There was no significant difference between the two regimens in the incidence of either acute graft versus host disease (GVHD) or chronic GVHD. Multivariate analysis demonstrated increased relapse incidence for thiotepa conditioning compared to Cy/TBI (HR = 1.78, 95% CI, 1.07-2.95; P = .03) which did not affect OS. Our results indicate that thiotepa-based conditioning may not be inferior to Cy/TBI for adult patients with ALL.
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Affiliation(s)
- Sandra Eder
- EBMT Office Paris, Hôpital Saint-Antoine; Paris France
| | - Jonathan Canaani
- Hematology Division, Chaim Sheba Medical Center; Tel Aviv University; Tel-Hashomer Israel
| | - Eric Beohou
- EBMT Office Paris, Hôpital Saint-Antoine; Paris France
| | | | - Jaime Sanz
- Hospital Universitario La Fe, Servicio de Hematologia; Valencia Spain
| | - William Arcese
- Stem Cell Transplant Unit; Tor Vergata University of Rome, Policlinico Universitario Tor Vergata; Rome Italy
| | - Reuven Or
- Department of Bone Marrow Transplantation; Hadassah University Hospital; Jerusalem Israel
| | - Juergen Finke
- Department of Medicine; Hematology, Oncology, University of Freiburg; Freiburg Germany
| | - Agostino Cortelezzi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico IRCCS; Milano Italy
| | - Dietrich Beelen
- Department of Bone Marrow Transplantation; University Hospital; Essen Germany
| | - Jakob Passweg
- Department of Hematology; University Hospital, Hematology; Basel Switzerland
| | - Gerard Socié
- Department of Hematology-BMT; Hopital St. Louis; Paris France
| | - Gunhan Gurman
- Transplantation Unit; Department of Hematology Adult Stem Cell, Ankara University Faculty of Medicine; Ankara Turkey
| | - Mahmoud Aljurf
- King Faisal Specialist Hospital & Research Centre, Oncology (Section of Adult Haematolgy/BMT); Riyadh Saudi Arabia
| | - Matthias Stelljes
- Department of Hematology/Oncology; University of Münster; Münster Germany
| | - Sebastian Giebel
- EBMT Office Paris, Hôpital Saint-Antoine; Paris France
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice Poland
| | - Mohamad Mohty
- EBMT Office Paris, Hôpital Saint-Antoine; Paris France
| | - Arnon Nagler
- EBMT Office Paris, Hôpital Saint-Antoine; Paris France
- Hematology Division, Chaim Sheba Medical Center; Tel Aviv University; Tel-Hashomer Israel
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29
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Themeli M, Waterhouse M, Finke J, Spyridonidis A. DNA chimerism and its consequences after allogeneic hematopoietic cell transplantation. Chimerism 2017; 2:25-8. [PMID: 21547035 DOI: 10.4161/chim.2.1.15276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 02/22/2011] [Accepted: 02/24/2011] [Indexed: 11/19/2022]
Abstract
The unphysiological formation of biological chimeras after allogeneic hematopoietic cell transplantation is not free of consequences. Recent findings suggest that in the transplant recipient some epithelial cells reveal, unexpectedly, donor-derived genotype and/or acquire genomic alterations. Since both phenomena are presented in the host epithelium, one could argue that they might be etiologically linked through a common background mechanism. We recently proposed that the incessant charge of the transplant recipient with donor-DNA and its integration in host epithelium by horizontal DNA transference may indeed be operative in the generation of epithelial cells with donor derived genome. On the other hand, the incessant incorporation of the foreign DNA into the host genome may result in genomic alterations. Lymphocyte-epithelial interactions between the two genetically distinct cell populations in the transplant recipient should be investigated more precisely not only in cellular but also in molecular level.
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Affiliation(s)
- Maria Themeli
- Hematology Division, BMT Unit, University of Patras; Patras, Greece
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30
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Robin M, Porcher R, Zinke-Cerwenka W, van Biezen A, Volin L, Mufti G, Craddock C, Finke J, Richard C, Passweg J, Peniket A, Maertens J, Sucak G, Gedde-Dahl T, Vitek A, Nagler A, Blaise D, Beelen D, Maillard N, Schwerdtfeger R, de Witte T, Kroger N. Allogeneic haematopoietic stem cell transplant in patients with lower risk myelodysplastic syndrome: a retrospective analysis on behalf of the Chronic Malignancy Working Party of the EBMT. Bone Marrow Transplant 2017; 52:1081. [PMID: 28677682 DOI: 10.1038/bmt.2017.86] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This corrects the article DOI: 10.1038/bmt.2016.266.
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31
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Kasenda B, Ihorst G, Schroers R, Korfel A, Schmidt-Wolf I, Egerer G, von Baumgarten L, Röth A, Bloehdorn J, Möhle R, Binder M, Keller U, Lamprecht M, Pfreundschuh M, Valk E, Fricker H, Schorb E, Fritsch K, Finke J, Illerhaus G. High-dose chemotherapy with autologous haematopoietic stem cell support for relapsed or refractory primary CNS lymphoma: a prospective multicentre trial by the German Cooperative PCNSL study group. Leukemia 2017; 31:2623-2629. [PMID: 28559537 DOI: 10.1038/leu.2017.170] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/08/2017] [Accepted: 05/15/2017] [Indexed: 01/08/2023]
Abstract
To investigate safety and efficacy of high-dose chemotherapy followed by autologous stem cell transplantation (HCT-ASCT) in relapsed/refractory (r/r) primary central nervous system lymphoma (PCNSL), we conducted a single-arm multicentre study for immunocompetent patients (<66 years) with PCNSL failing high-dose methotrexate)-based chemotherapy. Induction consisted of two courses of rituximab (375 mg/m2), high-dose cytarabine (2 × 3 g/m2) and thiotepa (40 mg/m2) with collection of stem cells in between. Conditioning for HCT-ASCT consisted of rituximab 375 mg/m2, carmustine 400 mg/m2 and thiotepa (4 × 5 mg/kg). Patients commenced HCT-ASCT irrespective of response after induction. Patients not achieving complete remission (CR) after HCT-ASCT received whole-brain radiotherapy. Primary end point was CR after HCT-ASCT. We enrolled 39 patients; median age and Karnofsky performance score are 57 years and 90%, respectively. About 28 patients had relapsed and 8 refractory disease. About 22 patients responded to induction and 32 patients commenced HCT-ASCT. About 22 patients (56.4%) achieved CR after HCT-ASCT. Respective 2-year progression-free survival (PFS) and overall survival (OS) rates were 46.0% (median PFS 12.4 months) and 56.4%; median OS not reached. We recorded four treatment-related deaths. Thiotepa-based HCT-ASCT is an effective treatment option in eligible patients with r/r PCNSL. Comparative studies are needed to further scrutinise the role of HCT-ASCT in the salvage setting.
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Affiliation(s)
- B Kasenda
- Department of Haematology/Oncology, Klinikum Stuttgart, Stuttgart, Germany.,Department of Medical Oncology & Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
| | - G Ihorst
- Clinical Trials Unit, Medical Centre - University of Freiburg, Freiburg, Germany
| | - R Schroers
- Department of Medicine, Hematology and Oncology, Ruhr-University of Bochum, Knappschaftskrankenhaus Bochum-Langendreer, Bochum, Germany
| | - A Korfel
- Department of Hematology, Oncology and Tumor Immunology, Charite University Medicine, Berlin, Germany
| | - I Schmidt-Wolf
- Department of Internal Medicine III, Center for Integrated Oncology (CIO), University Hospital Bonn, Bonn, Germany
| | - G Egerer
- Department of Haematology and Oncology, Heidelberg University, Heidelberg, Germany
| | - L von Baumgarten
- Department of Neurology, University Hospital Munich LMU, Munich, Germany
| | - A Röth
- Medical Faculty, Department of Haematology, University of Duisburg-Essen, Essen, Germany
| | - J Bloehdorn
- Department of Internal Medicine III, University of Ulm, Ulm, Germany
| | - R Möhle
- Department of Haematology and Oncology, University Tübingen, Tübingen, Germany
| | - M Binder
- Department of Oncology and Hematology, University of Hamburg, Hamburg, Germany
| | - U Keller
- III Medical Department, Technische Universität München, Munich, Germany
| | - M Lamprecht
- Department of Internal Medicine II, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - M Pfreundschuh
- Klinik für Innere Medizin I, Universität des Saarlandes, Homburg, Germany
| | - E Valk
- Department of Haematology/Oncology, Klinikum Stuttgart, Stuttgart, Germany
| | - H Fricker
- Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany
| | - E Schorb
- Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany
| | - K Fritsch
- Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany
| | - J Finke
- Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany
| | - G Illerhaus
- Department of Haematology/Oncology, Klinikum Stuttgart, Stuttgart, Germany.,Department of Haematology, Oncology and Stem Cell Transplantation, University Hospital Freiburg, Freiburg, Germany
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32
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Stickel N, Hanke K, Marschner D, Prinz G, Köhler M, Melchinger W, Pfeifer D, Schmitt-Graeff A, Brummer T, Heine A, Brossart P, Wolf D, von Bubnoff N, Finke J, Duyster J, Ferrara J, Salzer U, Zeiser R. MicroRNA-146a reduces MHC-II expression via targeting JAK/STAT signaling in dendritic cells after stem cell transplantation. Leukemia 2017; 31:2732-2741. [PMID: 28484267 PMCID: PMC6231537 DOI: 10.1038/leu.2017.137] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/13/2017] [Accepted: 04/24/2017] [Indexed: 02/07/2023]
Abstract
Acute Graft-versus-host disease (GVHD) is a major immunological complication after allogeneic hematopoietic cell transplantation and a better understanding of the molecular regulation of the disease could help to develop novel targeted therapies. Here we found that a G/C polymorphism within the human microRNA-146a (miR-146a) gene of transplant-recipients, which causes reduced miR-146a levels, was strongly associated with the risk of developing severe acute GVHD (n=289). In mice, deficiency of miR-146a in the hematopoietic system or transfer of recipient-type miR 146a-/- dendritic cells (DCs) enhanced GVHD, while miR-146a mimic-transfected-DCs ameliorated disease. Mechanistically, lack of miR-146a enhanced JAK2 STAT1-pathway activity, which led to higher expression of class II-transactivator (CIITA) and consecutively increased MHCII-levels on DCs. Inhibition of JAK1/2 or CIITA knockdown in DCs prevented miR-146a-/- DC-induced GVHD exacerbation. Consistent with our findings in mice, patients with the miR-146a polymorphism rs2910164 in hematopoietic cells displayed higher MHCII levels on monocytes, which could be targeted by JAK1/2-inhibition. Our findings indicate that the miR-146a polymorphism rs2910164 identifies patients at high risk for GVHD before allo HCT. Functionally we show that miR-146a acts as a central regulator of recipient-type DC activation during GVHD by dampening the pro-inflammatory JAK-STAT/CIITA/MHCII axis, which provides a scientific rationale for early JAK1/2-inhibition in selected patients.
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Affiliation(s)
- N Stickel
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Spemann Graduate School of Biology and Medicine, ALU Freiburg, Germany.,Faculty of Biology, ALU Freiburg, Germany
| | - K Hanke
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Faculty of Biology, ALU Freiburg, Germany
| | - D Marschner
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - G Prinz
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - M Köhler
- Spemann Graduate School of Biology and Medicine, ALU Freiburg, Germany.,Faculty of Biology, ALU Freiburg, Germany.,Signal Transduction in Tumour Development and Drug Resistance Group, Institute of Molecular Medicine and Cell Research (IMMZ), ALU Freiburg, Germany
| | - W Melchinger
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - D Pfeifer
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Schmitt-Graeff
- Department of Pathology, Freiburg University Medical Center, ALU Freiburg, Germany
| | - T Brummer
- Signal Transduction in Tumour Development and Drug Resistance Group, Institute of Molecular Medicine and Cell Research (IMMZ), ALU Freiburg, Germany.,Centre for Biological Signaling Studies BIOSS, ALU Freiburg, Germany
| | - A Heine
- Medical Clinic III, Oncology, Hematology and Rheumatology, University Hospital Bonn (UKB), Bonn, Germany
| | - P Brossart
- Medical Clinic III, Oncology, Hematology and Rheumatology, University Hospital Bonn (UKB), Bonn, Germany
| | - D Wolf
- Medical Clinic III, Oncology, Hematology and Rheumatology, University Hospital Bonn (UKB), Bonn, Germany
| | - N von Bubnoff
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK), Freiburg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J Finke
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Duyster
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - J Ferrara
- Department of Medicine, Hematology and Medical Oncology, Mount Sinai Hospital, New York, NY, USA
| | - U Salzer
- Center for Chronic Immunodeficiency, University Medical Center Freiburg and University of Freiburg, Germany.,Department of Rheumatology and Clinical Immunology, University Medical Center Freiburg, Germany
| | - R Zeiser
- Department of Hematology, Oncology and Stem Cell Transplantation, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Centre for Biological Signaling Studies BIOSS, ALU Freiburg, Germany.,German Cancer Consortium (DKTK), Freiburg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
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Rathmann S, Keck C, Kreutz C, Weit N, Müller M, Timmer J, Glatzel S, Follo M, Malkovsky M, Werner M, Handgretinger R, Finke J, Fisch P. Partial break in tolerance of NKG2A−/LIR-1− single KIR+ NK cells early in the course of HLA-matched, KIR-mismatched hematopoietic cell transplantation. Bone Marrow Transplant 2017; 52:1144-1155. [DOI: 10.1038/bmt.2017.81] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 02/17/2017] [Accepted: 03/02/2017] [Indexed: 02/03/2023]
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Schetelig J, de Wreede LC, van Gelder M, Andersen NS, Moreno C, Vitek A, Karas M, Michallet M, Machaczka M, Gramatzki M, Beelen D, Finke J, Delgado J, Volin L, Passweg J, Dreger P, Henseler A, van Biezen A, Bornhäuser M, Schönland SO, Kröger N. Risk factors for treatment failure after allogeneic transplantation of patients with CLL: a report from the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 2017; 52:552-560. [PMID: 28112746 DOI: 10.1038/bmt.2016.329] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 08/23/2016] [Accepted: 08/31/2016] [Indexed: 11/09/2022]
Abstract
For young patients with high-risk CLL, BTK-/PI3K-inhibitors or allogeneic stem cell transplantation (alloHCT) are considered. Patients with a low risk of non-relapse mortality (NRM) but a high risk of failure of targeted therapy may benefit most from alloHCT. We performed Cox regression analyses to identify risk factors for 2-year NRM and 5-year event-free survival (using EFS as a surrogate for long-term disease control) in a large, updated EBMT registry cohort (n= 694). For the whole cohort, 2-year NRM was 28% and 5-year EFS 37%. Higher age, lower performance status, unrelated donor type and unfavorable sex-mismatch had a significant adverse impact on 2-year NRM. Two-year NRM was calculated for good- and poor-risk reference patients. Predicted 2-year-NRM was 11 and 12% for male and female good-risk patients compared with 42 and 33% for male and female poor-risk patients. For 5-year EFS, age, performance status, prior autologous HCT, remission status and sex-mismatch had a significant impact, whereas del(17p) did not. The model-based prediction of 5-year EFS was 55% and 64%, respectively, for male and female good-risk patients. Good-risk transplant candidates with high-risk CLL and limited prognosis either on or after failure of targeted therapy should still be considered for alloHCT.
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Affiliation(s)
- J Schetelig
- Medical Department I, University Hospital, Technische Universität Dresden, Dresden, Germany.,Clinical Trials Unit, DKMS, gemeinnützige GmbH, Tübingen, Germany
| | - L C de Wreede
- Clinical Trials Unit, DKMS, gemeinnützige GmbH, Tübingen, Germany.,Department Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - M van Gelder
- Department of Internal Medicine, Division of Hematology, University Medical Center Maastricht, The Netherlands
| | - N S Andersen
- BMT Unit, Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - C Moreno
- Hematologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - A Vitek
- Department of Hematology, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - M Karas
- Department of Hematology/Oncology, Charles University Hospital, Pilsen, Czech Republic
| | - M Michallet
- Hématologie, Center Hospitalier Lyon-Sud, Lyon, France
| | - M Machaczka
- Department of Medicine at Huddinge, Hematology Center Karolinska and Karolinska Institutet, Stockholm, Sweden
| | - M Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - D Beelen
- Department of Bone Marrow Transplantation, University Hospital, Essen, Germany
| | - J Finke
- Department of Medicine-Hematology, University of Freiburg, Oncology, Freiburg, Germany
| | - J Delgado
- Department of Hematology, Hospital Clinic, Institute of Hematology & Oncology, Barcelona, Spain
| | - L Volin
- Stem Cell Transplantation Unit, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
| | - J Passweg
- Department for Hematology, University Hospital, Basel, Switzerland
| | - P Dreger
- Medizinische Klinik und Poliklinik V, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - A Henseler
- Department Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - A van Biezen
- Department Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - M Bornhäuser
- Medical Department I, University Hospital, Technische Universität Dresden, Dresden, Germany
| | - S O Schönland
- Medizinische Klinik und Poliklinik V, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - N Kröger
- Bone Marrow Transplantation Center, University Hospital Eppendorf, Hamburg, Germany
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Cremers EMP, van Biezen A, de Wreede LC, Scholten M, Vitek A, Finke J, Platzbecker U, Beelen D, Schwerdtfeger R, Volin L, Harhalakis N, Blijlevens N, Nagler A, Kröger N, de Witte T. Prognostic pre-transplant factors in myelodysplastic syndromes primarily treated by high dose allogeneic hematopoietic stem cell transplantation: a retrospective study of the MDS subcommittee of the CMWP of the EBMT. Ann Hematol 2016; 95:1971-1978. [PMID: 27650829 PMCID: PMC5093200 DOI: 10.1007/s00277-016-2802-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/26/2016] [Indexed: 01/28/2023]
Abstract
Many pre-transplant factors are known to influence the outcome of allogeneic stem cell transplantation (SCT) treatment in myelodysplastic syndromes (MDS). However, patient cohorts are often heterogeneous by disease stage and treatment modalities, which complicates interpretation of the results. This study aimed to obtain a homogeneous patient cohort by including only de novo MDS patients who received upfront allogeneic SCT after standard high dose myelo-ablative conditioning. The effect of pre-transplant factors such as age, disease stage, transfusions, iron parameters and comorbidity on overall survival (OS), non-relapse mortality (NRM), and relapse incidence (RI) was evaluated in 201 patients. In this cohort, characterized by low comorbidity and a short interval between diagnosis and transplantation, NRM was the most determinant factor for survival after SCT (47 % after 2-year follow-up). WHO classification and transfusion burden were the only modalities with a significant impact on overall survival after SCT. Estimated hazard ratios (HR) showed a strongly increased risk of death, NRM and RI, in patients with a high transfusion-burden (HR 1.99; P = 0.006, HR of 1.89; P = 0.03 and HR 2.67; P = 0.03). The HR's for ferritin level and comorbidity were not significantly increased.
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Affiliation(s)
- E M P Cremers
- VU University Medical Center, Amsterdam, The Netherlands. .,Department of Hematology, VU University Medical Center, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - A van Biezen
- Leiden University Medical Center, Leiden, The Netherlands
| | - L C de Wreede
- Leiden University Medical Center, Leiden, The Netherlands
| | - M Scholten
- Leiden University Medical Center, Leiden, The Netherlands
| | - A Vitek
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - J Finke
- University of Freiburg, Freiburg, Germany
| | | | - D Beelen
- University Hospital, Essen, Germany
| | | | - L Volin
- Helsinki University Central Hospital, Helsinki, Finland
| | | | - N Blijlevens
- Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - N Kröger
- University Hospital Eppendorf, Hamburg, Germany
| | - T de Witte
- Radboud University Medical Centre, Nijmegen, The Netherlands
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Eder S, Labopin M, Finke J, Bunjes D, Olivieri A, Santarone S, Rambaldi A, Kanz L, Messina G, Mohty M, Nagler A. Safety and efficacy of thiotepa-based conditioning for allogeneic transplantation in AML: a survey from the ALWP of the EBMT. Bone Marrow Transplant 2016; 52:238-244. [PMID: 27643865 DOI: 10.1038/bmt.2016.239] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/22/2016] [Accepted: 07/27/2016] [Indexed: 12/27/2022]
Abstract
This study evaluated the safety and efficacy of thiotepa-based regimens before allogeneic stem cell transplantation in 310 adult patients with AML. Disease status at the time of transplantation was CR1 in 50%, CR2+ in 23.5% and advanced disease in 26.5%. Transplantation was performed from haploidentical (35%), matched sibling (27%), unrelated (20%) or cord blood (18%) donors. As for safety: mucositis occurred in 46.8% of the patients and the cumulative incidence (CI) of sinusoidal obstruction syndrome was 4.0%. With a median follow-up of 37 months, the CI of acute GvHD grade>II was 26.5%, whereas CI of chronic GvHD was 28.1% at 3 years. CI for non-relapse mortality at 3 years was 38.4%, 49.7% and 45.4% for patients in CR1, CR2+ and advanced disease, respectively (P=0.10). Relapse incidence at 3 years was 20.2, 30.7 and 40.6% in these three respective groups (P=0.002). CI for 3-year leukemia-free survival and overall survival were 41.4% and 45.6% (CR1), 19.6% and 27.7% (CR2+), and 13.9% and 13.6% (advanced disease), respectively (P<10-4 for both). Our data suggest that thiotepa-based conditioning therapy in AML is feasible, effective and safe, as investigated for sinusoidal obstruction syndrome and mucositis.
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Affiliation(s)
- S Eder
- EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France
| | - M Labopin
- EBMT Office Paris, Hôpital Saint-Antoine, Paris, France
| | - J Finke
- Department of Medicine-Hematology, Oncology, University of Freiburg, Freiburg, Germany
| | - D Bunjes
- Klinik fuer Innere Medizin III, Universitätsklinikum Ulm, Ulm, Germany
| | - A Olivieri
- Department of Hematology, Azienda Ospedali Riuniti di Ancona, Ancona-Torrete, Italy
| | - S Santarone
- Department of Hematology, Ospedale Civile, Pescara, Italy
| | - A Rambaldi
- USC Ematologia, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - L Kanz
- Abteilung II, Universität Tübingen, Tübingen, Germany
| | - G Messina
- Centro Trapianti Midollo Osseo, Azienda Ospedaliera 'BMM', Reggio Calabria, Italy
| | - M Mohty
- EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France
| | - A Nagler
- EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.,Chaim Sheba Medical Center, Tel-Hashomer, Israel
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37
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Oliveira MC, Labopin M, Henes J, Moore J, Papa ND, Cras A, Sakellari I, Schroers R, Scherer HU, Cuneo A, Kyrcz-Krzemien S, Daikeler T, Alexander T, Finke J, Badoglio M, Simões B, Snowden JA, Farge D. Erratum: Does ex vivo CD34+ positive selection influence outcome after autologous hematopoietic stem cell transplantation in systemic sclerosis patients? Bone Marrow Transplant 2016; 51:889. [DOI: 10.1038/bmt.2016.126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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38
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Sobh M, Michallet M, Gahrton G, Iacobelli S, van Biezen A, Schönland S, Petersen E, Schaap N, Bonifazi F, Volin L, Meijer E, Niederwieser D, El-Cheikh J, Tabrizi R, Fegeux N, Finke J, Bunjes D, Cornelissen J, Einsele H, Bruno B, Potter M, Fanin R, Mohty M, Garderet L, Kröger N. Allogeneic hematopoietic cell transplantation for multiple myeloma in Europe: trends and outcomes over 25 years. A study by the EBMT Chronic Malignancies Working Party. Leukemia 2016; 30:2047-2054. [DOI: 10.1038/leu.2016.101] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 04/11/2016] [Accepted: 04/14/2016] [Indexed: 12/15/2022]
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39
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Schorb E, Finke J, Ferreri AJM, Ihorst G, Mikesch K, Kasenda B, Fritsch K, Fricker H, Burger E, Grishina O, Valk E, Zucca E, Illerhaus G. High-dose chemotherapy and autologous stem cell transplant compared with conventional chemotherapy for consolidation in newly diagnosed primary CNS lymphoma--a randomized phase III trial (MATRix). BMC Cancer 2016; 16:282. [PMID: 27098429 PMCID: PMC4839072 DOI: 10.1186/s12885-016-2311-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 04/12/2016] [Indexed: 02/08/2023] Open
Abstract
Background Primary central nervous system lymphoma (PCNSL) is a highly aggressive Non-Hodgkin lymphoma (NHL) with rising incidence over the past 30 years in immunocompetent patients. Although outcomes have improved, PCNSL is still associated with inferior prognosis compared to systemic NHL. Many questions regarding the optimal therapeutic approach remain unanswered. Methods/Design This is a randomized, open-label, international phase III trial with two parallel arms. We will recruit 250 patients with newly diagnosed PCNSL from approximately 35 centers within the networks of the German Cooperative PCNSL study group and the International Extranodal Lymphoma Study Group. All enrolled patients will undergo induction chemotherapy consisting of 4 cycles of rituximab 375 mg/m2/d (days 0 & 5), methotrexate 3.5 g/m2 (d1), cytarabine 2 × 2 g/m2/d (d2-3), and thiotepa 30 mg/m2 (d4) every 21 days. All patients will undergo stem-cell harvest after the second cycle. After 4 cycles of induction chemotherapy, patients achieving partial or complete response will be centrally randomized to 2 different consolidation treatments: (A) conventional-dose immuno chemotherapy with rituximab 375 mg/m2 (d0), dexamethasone 40 mg/d (d1-3), etoposide 100 mg/m2/d (d1-3), ifosfamide 1500 mg/m2/d (d1-3) and carboplatin 300 mg/m2 (d1) (R-DeVIC) or (B) high-dose chemotherapy with BCNU (or busulfan) and thiotepa followed by autologous stem cell transplantation (HCT-ASCT). The objective is to demonstrate superiority of HCT-ASCT compared to R-DeVIC with respect to progression-free survival (PFS, primary endpoint). Secondary endpoints include overall survival (OS), treatment response and treatment-related morbidities. Minimal follow-up after treatment completion is 24 months. Discussion The rationale for consolidation treatment in PCNSL is to eliminate residual lymphoma cells and to decrease the risk for relapse. This can be achieved by agents crossing the blood brain barrier either applied at conventional doses or at high doses requiring autologous stem cell support. HCT-ASCT has been shown to be feasible and highly effective in patients with newly-diagnosed PCNSL. However, it is unclear whether HCT-ASCT is really superior compared to conventional-dose chemotherapy after an intensified antimetabolites-based immunochemotherapy in patients with newly-diagnosed PCNSL. To answer this question, we designed this investigator initiated randomized phase III trial. Trial registration German clinical trials registry DRKS00005503 registered 22 April 2014 and ClinicalTrials.gov NCT02531841 registered 24 August 2015. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2311-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elisabeth Schorb
- Department of Hematology/Oncology, Freiburg University Medical Center, Freiburg, Germany
| | - Juergen Finke
- Department of Hematology/Oncology, Freiburg University Medical Center, Freiburg, Germany
| | - Andrés J M Ferreri
- Unit of Lymphoid Malignancies, Head Division of OncoHematological Medicine, Department of OncoHematology, San Raffaele Scientific Institute, Milan, Italy
| | - Gabriele Ihorst
- Clinical Trials Unit, Freiburg University Medical Center, Freiburg, Germany
| | - Kristina Mikesch
- Clinic of Hematology, Oncology and Palliative Care, Klinikum Stuttgart, Kriegsbergstr.60, Stuttgart, 70174, Germany
| | - Benjamin Kasenda
- Clinic of Hematology, Oncology and Palliative Care, Klinikum Stuttgart, Kriegsbergstr.60, Stuttgart, 70174, Germany
| | - Kristina Fritsch
- Department of Hematology/Oncology, Freiburg University Medical Center, Freiburg, Germany
| | - Heidi Fricker
- Department of Hematology/Oncology, Freiburg University Medical Center, Freiburg, Germany
| | - Elvira Burger
- Clinical Trials Unit, Freiburg University Medical Center, Freiburg, Germany
| | - Olga Grishina
- Clinical Trials Unit, Freiburg University Medical Center, Freiburg, Germany
| | - Elke Valk
- Clinic of Hematology, Oncology and Palliative Care, Klinikum Stuttgart, Kriegsbergstr.60, Stuttgart, 70174, Germany
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland, San Giovanni Hospital, Bellinzona, Switzerland
| | - Gerald Illerhaus
- Clinic of Hematology, Oncology and Palliative Care, Klinikum Stuttgart, Kriegsbergstr.60, Stuttgart, 70174, Germany.
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40
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Craddock C, Labopin M, Robin M, Finke J, Chevallier P, Yakoub-Agha I, Bourhis JH, Sengelov H, Blaise D, Luft T, Hallek M, Kröger N, Nagler A, Mohty M. Clinical activity of azacitidine in patients who relapse after allogeneic stem cell transplantation for acute myeloid leukemia. Haematologica 2016; 101:879-83. [PMID: 27081178 DOI: 10.3324/haematol.2015.140996] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/12/2016] [Indexed: 11/09/2022] Open
Abstract
Disease relapse is the most common cause of treatment failure after allogeneic stem cell transplantation for acute myeloid leukemia and myelodysplastic syndromes, yet treatment options for such patients remain extremely limited. Azacitidine is an important new therapy in high-risk myelodysplastic syndromes and acute myeloid leukemia but its role in patients who relapse post allograft has not been defined. We studied the tolerability and activity of azacitidine in 181 patients who relapsed after an allograft for acute myeloid leukemia (n=116) or myelodysplastic syndromes (n=65). Sixty-nine patients received additional donor lymphocyte infusions. Forty-six of 157 (25%) assessable patients responded to azacitidine therapy: 24 (15%) achieved a complete remission and 22 a partial remission. Response rates were higher in patients transplanted in complete remission (P=0.04) and those transplanted for myelodysplastic syndromes (P=0.023). In patients who achieved a complete remission, the 2-year overall survival was 48% versus 12% for the whole population. Overall survival was determined by time to relapse post transplant more than six months (P=0.001) and percentage of blasts in the bone marrow at time of relapse (P=0.01). The concurrent administration of donor lymphocyte infusion did not improve either response rates or overall survival in patients treated with azacitidine. An azacitidine relapse prognostic score was developed which predicted 2-year overall survival ranging from 3%-37% (P=0.00001). We conclude that azacitidine represents an important new therapy in selected patients with acute myeloid leukemia/myelodysplastic syndromes who relapse after allogeneic stem cell transplantation. Prospective studies to confirm optimal treatment options in this challenging patient population are required.
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Affiliation(s)
- Charles Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - Myriam Labopin
- Faculté de Médecine Saint Antoine Hospital, Paris, France
| | - Marie Robin
- Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, France
| | | | | | | | | | - Henrik Sengelov
- Department of Hematology, National University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Didier Blaise
- Hematology Department, Paoli Calmettes Institute, Marseille, France
| | - Thomas Luft
- Department Medicine V, University of Heidelberg, Germany
| | - Michael Hallek
- Department I of University Medicine, University of Cologne, Germany
| | - Nicolaus Kröger
- Department of Bone Marrow Transplantation, University Hospital of Hamburg-Eppendorf, Hamburg, Germany
| | - Arnon Nagler
- Chaim Sheba, Medical Centre, Tel Hasomer, Israel
| | - Mohamad Mohty
- Faculté de Médecine Saint Antoine Hospital, Paris, France
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41
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Baar J, Storkus W, Finke J, Butterfield L, Lazarus H, Reese J, Brufsky A, Downes K, Budd GT, Fu P. Abstract OT1-01-02: Pilot trial of a type I polarized autologous dendritic cell vaccine incorporating tumor blood vessel antigen-derived peptides in patients with metastatic breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-ot1-01-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND. Cancer vaccines based on tumor-associated antigens are rarely curative in advanced cancer. This limitation relates to the heterogeneity of cancer due to defects in antigen presentation and altered immunophenotypes. Therefore, another method to promote anti-tumor immunity is to prime T cells against tumor-associated stromal cells. We have reported that IL-12 gene-therapy of established HLA-A2neg B16 melanomas in HLA-A2 transgenic (Tg) mice resulted in CD8+ T cell-mediated immunity against the host HLA-A2+ stromal cells within the tumor microenvironment (TME). We have also shown that vaccines based on a subset of tumor blood vessel antigen (TBVA)-derived peptides (DLK1310-318, EphA2883-891, HBB31-39, NRP1433-441, RGS55-13 and TEM1691-700) prevented HLA-A2neg MC38 tumor establishment and promoted the regression of melanomas in HLA-A2 Tg mice by CD8+ T cell targeting of HLA-A2+ pericytes and vascular endothelial cells in the TME.
TRIAL DESIGN. Based on this pre-clinical data, we are undertaking a Susan G. Komen-funded (IIR13261822; IND 15722) IRB-approved clinical trial of chemo-immunotherapy using the immunomodulatory drug gemcitabine (GEM) to suppress tumor infiltrating suppressor cells such as myeloid-derived suppressor cells (MDSC) and regulatory T cells (Tregs) with a dendritic cell (DC) vaccine pulsed with the above six HLA-A2-presented TBVA-derived peptides (DC-TBVA) in 30 HLA-A2+ patients with metastatic breast cancer (MBC). Eligible patients will first undergo leukapheresis for the generation of the DC-TBVA vaccine. Patients will then receive 3 cycles of GEM, 1000 mg/m2 IV on days 1 and 8 of a 21-day cycle for 3 cycles. Patients will then receive the DC-TBVA vaccine administered twice intradermally 7 days apart.
ELIGIBILITY CRITERIA. Patients must be HLA-A2+ and have radiologically measurable MBC, an ECOG performance status of 0-1 and not have any active immune disorders. Prior GEM therapy is acceptable as long as the last dose was ≥ 3 months from registration on this study. Patients may not be on steroids.
SPECIFIC AIMS. The 4 specific aims are to 1) assess the safety of GEM + αDC1-TBVA vaccination, 2) assess the clinical response of MBC to GEM + αDC1-TBVA vaccination, 3) determine the clinical efficacy of GEM + αDC1-TBVA vaccination in generating Tc1 immunity, and 4) correlate changes in MDSC and Tregs with the generation of anti-TBVA Tc1-cell immunity
STATISTICAL METHODS. Clinical response: if the response rate is less than 10%, then there is probability 0.05 or less of accepting the vaccine therapy; if the response rate is bigger than 32%, then the probability of rejecting the combination is less than 0.2. While the secondary goals of the study are exploratory, there is sufficient statistical power to identify moderate to large effects (i.e., there will be statistical power >.80 to detect changes from baseline in the different immune function parameters that are >0.6 standard deviations of the parameter.)
TARGET ACCRUAL. We will enroll 30 patients over 3 years, with the first patient expected to be enrolled in July 2015.
CONTACT INFORMATION. Joseph Baar, MD, PhD. Seidman Cancer Center. E-mail: joseph.baar@uhhospitals.org.
Citation Format: Baar J, Storkus W, Finke J, Butterfield L, Lazarus H, Reese J, Brufsky A, Downes K, Budd GT, Fu P. Pilot trial of a type I polarized autologous dendritic cell vaccine incorporating tumor blood vessel antigen-derived peptides in patients with metastatic breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT1-01-02.
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Affiliation(s)
- J Baar
- Case Comprehensive Cancer Center - Seidman Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center - Taussig Cancer Center, Cleveland, OH; University of Pittsburgh Medical Center, Pittsburgh, PA
| | - W Storkus
- Case Comprehensive Cancer Center - Seidman Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center - Taussig Cancer Center, Cleveland, OH; University of Pittsburgh Medical Center, Pittsburgh, PA
| | - J Finke
- Case Comprehensive Cancer Center - Seidman Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center - Taussig Cancer Center, Cleveland, OH; University of Pittsburgh Medical Center, Pittsburgh, PA
| | - L Butterfield
- Case Comprehensive Cancer Center - Seidman Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center - Taussig Cancer Center, Cleveland, OH; University of Pittsburgh Medical Center, Pittsburgh, PA
| | - H Lazarus
- Case Comprehensive Cancer Center - Seidman Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center - Taussig Cancer Center, Cleveland, OH; University of Pittsburgh Medical Center, Pittsburgh, PA
| | - J Reese
- Case Comprehensive Cancer Center - Seidman Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center - Taussig Cancer Center, Cleveland, OH; University of Pittsburgh Medical Center, Pittsburgh, PA
| | - A Brufsky
- Case Comprehensive Cancer Center - Seidman Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center - Taussig Cancer Center, Cleveland, OH; University of Pittsburgh Medical Center, Pittsburgh, PA
| | - K Downes
- Case Comprehensive Cancer Center - Seidman Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center - Taussig Cancer Center, Cleveland, OH; University of Pittsburgh Medical Center, Pittsburgh, PA
| | - GT Budd
- Case Comprehensive Cancer Center - Seidman Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center - Taussig Cancer Center, Cleveland, OH; University of Pittsburgh Medical Center, Pittsburgh, PA
| | - P Fu
- Case Comprehensive Cancer Center - Seidman Cancer Center, Cleveland, OH; Case Comprehensive Cancer Center - Taussig Cancer Center, Cleveland, OH; University of Pittsburgh Medical Center, Pittsburgh, PA
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Sellner L, Boumendil A, Finel H, Choquet S, de Rosa G, Falzetti F, Scime R, Kobbe G, Ferrara F, Delmer A, Sayer H, Amorim S, Bouabdallah R, Finke J, Salles G, Yakoub-Agha I, Faber E, Nicolas-Virelizier E, Facchini L, Vallisa D, Zuffa E, Sureda A, Dreger P. Thiotepa-based high-dose therapy for autologous stem cell transplantation in lymphoma: a retrospective study from the EBMT. Bone Marrow Transplant 2016; 51:212-218. [PMID: 26569093 DOI: 10.1038/bmt.2015.273] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 09/28/2015] [Accepted: 09/30/2015] [Indexed: 11/08/2022]
Abstract
Clinical information about thiotepa-based autologous stem cell transplantation (auto-SCT) outside the primary central nervous system lymphoma (PCNSL) field is sparse. In this registry-based retrospective study, we evaluated potential risks and benefits of thiotepa-based preparative regimens compared with BEAM (carmustine, etoposide, cytarabine, melphalan) in auto-SCT for diffuse large B-cell lymphoma (DLBCL, excluding PCNSL), follicular lymphoma (FL) or Hodgkin lymphoma (HL). A total of 14 544 patients (589 thiotepa and 13 955 BEAM) met the eligibility criteria, and 535 thiotepa- and 1031 BEAM-treated patients were matched in a 1:2 ratio for final comparison. No significant differences between thiotepa and BEAM groups for any survival end point were identified in the whole sample or disease entity subsets. For a more detailed analysis, 47 TEAM (thiotepa, etoposide, cytarabine, melphalan)-treated patients were compared with 75 matched BEAM patients with additional collection of toxicity data. Again, there were no significant differences between the two groups for any survival end point. In addition, the frequency of common infectious and non-infectious complications including secondary malignancies was comparable between TEAM and BEAM. These results indicate that thiotepa-based high-dose therapy might be a valuable alternative to BEAM in DLBCL, HL and FL. Further evaluation by prospective clinical trials is warranted.
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Affiliation(s)
- L Sellner
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - A Boumendil
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
| | - H Finel
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
| | - S Choquet
- Department of Hematology, Pitié-Salpêtrière Hospital, Paris, France
| | | | | | - R Scime
- Department of Hematology, Azienda Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - G Kobbe
- University Hospital Düsseldorf, Department of Hematology, Oncology and Clinical Immunology, Heinrich Heine University, Düsseldorf, Germany
| | | | - A Delmer
- Service d'Hématologie Clinique, Hôpital Robert Debré, Centre Hospitalier Universitaire (CHU) de Reims, Reims, France
| | - H Sayer
- Department of Hematology and Oncology, Helios Hospital Erfurt, Erfurt, Germany
| | - S Amorim
- APHP, Hopital Saint-louis, Hemato-Oncology Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - R Bouabdallah
- Hematology Department, Paoli Calmettes Institute, Marseille Aix-Marseille University, Marseille, France
| | - J Finke
- Department of Hematology, Freiburg University Medical Center, Freiburg, Germany
| | - G Salles
- Hematologie, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre Bénite, France
| | - I Yakoub-Agha
- LIRIC-U995, Hematology Department and Hematopoietic Stem Cell Transplantation Unit, University-Hospital of Lille, Lille, France
| | - E Faber
- Department of Hemato-Oncology, Faculty Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | | | - L Facchini
- Hematology Unit, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - D Vallisa
- Hematology Unit, Ospedale Civile, Piacenza, Italy
| | - E Zuffa
- Hematology Unit, S Maria delle Croci Hospital, Ravenna, Italy
| | - A Sureda
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
- Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain
| | - P Dreger
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
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Finke J, Schmoor C, Bertz H, Marks R, Wäsch R, Zeiser R, Hackanson B. Long-term follow-up of therapy-related myelodysplasia and AML patients treated with allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2016; 51:771-7. [PMID: 26752137 DOI: 10.1038/bmt.2015.338] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/11/2015] [Accepted: 12/01/2015] [Indexed: 12/18/2022]
Abstract
The outcome of patients with therapy-related myelodysplasia (t-MDS) or t-AML is very poor. The only curative treatment option implements allogeneic hematopoietic cell transplantation (aHCT); however, long-term follow-up data beyond 5 years are scarce. Here we report on a cohort of 79 consecutive patients with a median age of 58 years (range (r): 20-76) at transplantation and a median follow-up of 7.5 years (r: 0.07-19.0). Only 19 (24.1%) patients were in CR before aHCT. Non-relapse mortality and relapse rates were 23% (95% confidence interval, 15-35%) and 42% (32-55%) at 5 years, and 32% (22-46%) and 44% (34-57%) at 10 years, respectively. Disease-free survival (DFS) and overall survival (OS) rates were 35% (24-46%) and 38% (27-49%) at 5 years, and 24% (14-36%) and 24% (13-36%) at 10 years, respectively. Although cytogenetic aberrations were associated with shorter DFS and higher relapse risk, persistent disease at the time of transplantation, an unrelated donor and patient age were not associated with shorter OS. In conclusion, long-term survival beyond 10 years of t-MDS/t-AML patients after aHCT is possible, even for refractory patients. Therefore, early donor search and rapid transplantation are warranted, also to decrease the risk of disease-related deterioration of patients' performance status.
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Affiliation(s)
- J Finke
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
| | - C Schmoor
- Center for Clinical Trials and Biostatistics, University Medical Center, Freiburg, Germany
| | - H Bertz
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
| | - R Marks
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
| | - R Wäsch
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
| | - R Zeiser
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
| | - B Hackanson
- Department of Hematology/Oncology and Stem Cell Transplantation, University Medical Center, Freiburg, Germany
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Oliveira MC, Labopin M, Henes J, Moore J, Del Papa N, Cras A, Sakellari I, Schroers R, Scherer HU, Cuneo A, Kyrcz-Krzemien S, Daikeler T, Alexander T, Finke J, Badoglio M, Simões B, Snowden JA, Farge D, Farge D. Does ex vivo CD34+ positive selection influence outcome after autologous hematopoietic stem cell transplantation in systemic sclerosis patients? Bone Marrow Transplant 2015; 51:501-5. [PMID: 26642332 DOI: 10.1038/bmt.2015.299] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 10/22/2015] [Accepted: 10/23/2015] [Indexed: 12/20/2022]
Abstract
This EBMT Autoimmune Disease Working Party study aimed to evaluate the influence of CD34+ positive graft selection (CD34+) on the outcome of systemic sclerosis (SSc) patients after autologous hematopoietic stem cell transplantation (AHSCT). Clinical and laboratory data from 138 SSc patients at diagnosis, before and after AHSCT were retrospectively analyzed. CD34+ selection was performed in 47.1% (n=65) patients. By multivariate analysis adjusting for all factors differing between the two groups (without or with CD34+), there was no statistically significant difference in terms of overall survival (hazard ratio (HR): 0.98, 95% confidence interval (CI) 0.40-2.39, P=0.96), PFS (HR: 1.55, 95% CI 0.83-2.88, P=0.17) and incidence of relapse or progression (HR: 1.70, 95% CI 0.85-3.38, P=0.13). We demonstrate that CD34+ does not add benefit to the outcome of SSc patient treated with AHSCT. These findings should be further confirmed by prospective randomized trials.
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Affiliation(s)
- M C Oliveira
- Division of Clinical Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - M Labopin
- EBMT, Hôpital Saint Antoine, Paris, France
| | - J Henes
- Medizinische Universitätsklinik Abt. II, Tübingen, Germany
| | - J Moore
- Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - N Del Papa
- Scleroderma Clinic, U.O.C. Day Hospital Rheumatology, Osp. G. Pini, Milan, Italy
| | - A Cras
- Assistance Publique-Hôpitaux de Paris, Saint-Louis Hospital, Cell Therapy Unit, Cord Blood Bank and CIC-BT501, Paris, France.,INSERM UMRS 1140, Paris Descartes, Faculté de Pharmacie, Paris, France
| | - I Sakellari
- Bone Marrow Transplantation Unit, George Papanicolaou General Hospital, Thessaloniki, Greece
| | - R Schroers
- Ruhr-Universität Bochum, Medizinische Klinik Knappschaftskrankenhaus, Bochum, Germany
| | - H U Scherer
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - A Cuneo
- University of Ferrara-St Anna Hospital, Ferrara, Italy
| | - S Kyrcz-Krzemien
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | - T Daikeler
- Department of Rheumatology, University Hospital Basel, Basel, Switzerland
| | - T Alexander
- Department of Rheumatology and Clinical Immunology, Charité-University Medicine Berlin, Berlin, Germany
| | - J Finke
- Department of Medicine-Hematology and Oncology, University of Freiburg, Freiburg, Germany
| | - M Badoglio
- EBMT Paris Office, Hôpital Saint Antoine, Paris, France
| | - B Simões
- Division of Hematology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - J A Snowden
- Department of Hematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - D Farge
- Paris 7 University, INSERM U1160, Paris, France.,Unité de Médecine Interne et Pathologie Vasculaire, Saint Louis Hospital, Assistance Publique des Hôpitaux de Paris, Paris 7 Denis Diderot University, Paris, France
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45
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Cahu X, Labopin M, Giebel S, Aljurf M, Kyrcz-Krzemien S, Socié G, Eder M, Bonifazi F, Bunjes D, Vigouroux S, Michallet M, Stelljes M, Zuckerman T, Finke J, Passweg J, Yakoub-Agha I, Niederwieser D, Sucak G, Sengeløv H, Polge E, Nagler A, Esteve J, Mohty M. Impact of conditioning with TBI in adult patients with T-cell ALL who receive a myeloablative allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT. Bone Marrow Transplant 2015; 51:351-7. [PMID: 26618548 DOI: 10.1038/bmt.2015.278] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 08/15/2015] [Accepted: 09/14/2015] [Indexed: 01/01/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a therapeutic option for adult patients with T-cell ALL (T-ALL). Meanwhile, few allo-SCT data specific to adult T-ALL have been described thus far. Specifically, the optimal myeloablative conditioning regimen is unknown. In this retrospective study, 601 patients were included. Patients received allo-SCT in CR1, CR2, CR >2 or in advanced disease in 69%, 15%, 2% and 14% of cases, respectively. With an overall follow-up of 58 months, 523 patients received a TBI-based regimen, whereas 78 patients received a chemotherapy-based regimen including IV busulfan-cyclophosphamide (IV Bu-Cy) (n=46). Unlike patients aged ⩾35 years, patients aged <35 years who received a TBI-based regimen displayed an improved outcome compared with patients who received a chemotherapy-based regimen (5-year leukemia-free survival (LFS) of 50% for TBI versus 18% for chemo-only regimen or IV Bu-Cy regimens, P=10(-5) and 10(-4), respectively). In multivariate analysis, use of TBI was associated with an improved LFS (hazard ratio (HR)=0.55 (0.34-0.86), P=0.01) and overall survival (HR=0.54 (0.34-0.87), P=0.01) in patients aged <35 years. In conclusion, younger adult patients with T-ALL entitled to receive a myeloablative allo-SCT may benefit from TBI-based regimens.
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Affiliation(s)
- X Cahu
- Hématologie Clinique, Hôpital Pontchaillou, CHU Rennes, France
| | - M Labopin
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.,Université Pierre and Marie Curie, Paris, France.,INSERM, UMR_S 938, INSERM, Paris, France
| | - S Giebel
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - M Aljurf
- Adult Hematology/HSCT, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - S Kyrcz-Krzemien
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | - G Socié
- Hematology-Transplantation, Hospital St Louis, APHP, Paris, France
| | - M Eder
- Hannover Medical School, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover, Germany
| | - F Bonifazi
- Institute of Hematology, Department of Hematology and Oncological Sciences 'L. and A. Seràgnoli,' University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - D Bunjes
- Klinik für Innere Medizin III, Universitätsklinikum Ulm, Germany
| | - S Vigouroux
- Hématologie Clinique et Thérapie Cellulaire, Hôpital Haut Levêque, Pessac, France
| | - M Michallet
- Hématologie Clinique, Hospices Civils de Lyon, Lyon, France
| | - M Stelljes
- Department of Medicine A/Hematology and Oncology, University of Muenster Muenster, Germany
| | - T Zuckerman
- Department of Hematology and Bone Marrow Transplantation, Rambam MCH, Haifa, Israel
| | - J Finke
- Department of Medecine-Hematology, Oncology, University of Freiburg, Freiburg, Germany
| | - J Passweg
- Hematology, University Hospital of Basel, Basel, Switzerland
| | - I Yakoub-Agha
- Hématologie Clinique, Hôpital Claude Huriez, Lille, France
| | - D Niederwieser
- University Hospital Leipzig, Clinic for Hematology and Oncology, Leipzig, Germany
| | - G Sucak
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - H Sengeløv
- National University Hospital, Copenhagen, Denmark
| | - E Polge
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.,Université Pierre and Marie Curie, Paris, France.,INSERM, UMR_S 938, INSERM, Paris, France
| | - A Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - J Esteve
- Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - M Mohty
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.,Université Pierre and Marie Curie, Paris, France.,INSERM, UMR_S 938, INSERM, Paris, France
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46
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Waterhouse M, Bartsch I, Bertz H, Duyster J, Finke J. Cerebrospinal fluid chimerism analysis in patients with neurological symptoms after allogeneic cell transplantation. Bone Marrow Transplant 2015; 51:127-31. [DOI: 10.1038/bmt.2015.226] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 06/10/2015] [Accepted: 06/12/2015] [Indexed: 12/15/2022]
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47
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Vrhovac R, Labopin M, Ciceri F, Finke J, Holler E, Tischer J, Lioure B, Gribben J, Kanz L, Blaise D, Dreger P, Held G, Arnold R, Nagler A, Mohty M. Second reduced intensity conditioning allogeneic transplant as a rescue strategy for acute leukaemia patients who relapse after an initial RIC allogeneic transplantation: analysis of risk factors and treatment outcomes. Bone Marrow Transplant 2015; 51:186-93. [DOI: 10.1038/bmt.2015.221] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 08/18/2015] [Accepted: 08/20/2015] [Indexed: 11/09/2022]
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48
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Marchand T, Lamy T, Finel H, Arcese W, Choquet S, Finke J, Huynh A, Irrera G, Karakasis D, Konopacki J, Lambert J, Michieli M, Schouten HC, Schroyens W, Sucak G, Tischer J, Vandenberghe E, Dreger P. Hematopoietic stem cell transplantation for T-cell large granular lymphocyte leukemia: a retrospective study of the European Society for Blood and Marrow Transplantation. Leukemia 2015; 30:1201-4. [DOI: 10.1038/leu.2015.256] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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49
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Ackermann M, Ajello M, Atwood WB, Baldini L, Ballet J, Barbiellini G, Bastieri D, Gonzalez JB, Bellazzini R, Bissaldi E, Blandford RD, Bloom ED, Bonino R, Bottacini E, Brandt TJ, Bregeon J, Britto RJ, Bruel P, Buehler R, Buson S, Caliandro GA, Cameron RA, Caragiulo M, Caraveo PA, Carpenter B, Casandjian JM, Cavazzuti E, Cecchi C, Charles E, Chekhtman A, Cheung CC, Chiang J, Chiaro G, Ciprini S, Claus R, Cohen-Tanugi J, Cominsky LR, Conrad J, Cutini S, D’Abrusco R, D’Ammando F, Angelis AD, Desiante R, Digel SW, Venere LD, Drell PS, Favuzzi C, Fegan SJ, Ferrara EC, Finke J, Focke WB, Franckowiak A, Fuhrmann L, Fukazawa Y, Furniss AK, Fusco P, Gargano F, Gasparrini D, Giglietto N, Giommi P, Giordano F, Giroletti M, Glanzman T, Godfrey G, Grenier IA, Grove JE, Guiriec S, Hewitt JW, Hill AB, Horan D, Itoh R, Jóhannesson G, Johnson AS, Johnson WN, Kataoka J, Kawano T, Krauss F, Kuss M, Mura GL, Larsson S, Latronico L, Leto C, Li J, Li L, Longo F, Loparco F, Lott B, Lovellette MN, Lubrano P, Madejski GM, Mayer M, Mazziotta MN, McEnery JE, Michelson PF, Mizuno T, Moiseev AA, Monzani ME, Morselli A, Moskalenko IV, Murgia S, Nuss E, Ohno M, Ohsugi T, Ojha R, Omodei N, Orienti M, Orlando E, Paggi A, Paneque D, Perkins JS, Pesce-Rollins M, Piron F, Pivato G, Porter TA, Rainò S, Rando R, Razzano M, Razzaque S, Reimer A, Reimer O, Romani RW, Salvetti D, Schaal M, Schinzel FK, Schulz A, Sgrò C, Siskind EJ, Sokolovsky KV, Spada F, Spandre G, Spinelli P, Stawarz L, Suson DJ, Takahashi H, Takahashi T, Tanaka Y, Thayer JG, Thayer JB, Tibaldo L, Torres DF, Torresi E, Tosti G, Troja E, Uchiyama Y, Vianello G, Winer BL, Wood KS, Zimmer S. THE THIRD CATALOG OF ACTIVE GALACTIC NUCLEI DETECTED BY THEFERMILARGE AREA TELESCOPE. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/810/1/14] [Citation(s) in RCA: 424] [Impact Index Per Article: 47.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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50
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Ferrero S, Pastore A, Scholz CW, Forstpointner R, Pezzutto A, Bergmann L, Trümper L, Finke J, Keller U, Ghione P, Passera R, Hiddemann W, Weigert O, Unterhalt M, Dreyling M. Radioimmunotherapy in relapsed/refractory mantle cell lymphoma patients: final results of a European MCL Network Phase II Trial. Leukemia 2015; 30:984-7. [DOI: 10.1038/leu.2015.215] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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