1
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Cramer P, Fürstenau M, Giza A, Robrecht S, Tausch E, Schneider C, Wendtner CM, Hoechstetter M, Schetelig J, Böttcher S, Dreger P, Fink AM, Langerbeins P, Al-Sawaf O, Fischer K, Stilgenbauer S, Eichhorst B, Hallek M. P641: RETREATMENT WITH VENETOCLAX AFTER VENETOCLAX, OBINUTUZUMAB +/- IBRUTINIB: POOLED ANALYSIS OF 13 PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) TREATED IN GCLLSG TRIALS. Hemasphere 2022. [DOI: 10.1097/01.hs9.0000845448.71709.3a] [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: 11/25/2022] Open
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2
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Greenfield DM, Salooja N, Peczynski C, van der Werf S, Schoemans H, Hill K, Cortelezzi A, Lupo-Stangellini M, Özkurt ZN, Arat M, Metzner B, Turlure P, Rovo A, Socié G, Mohty M, Nagler A, Kröger N, Dreger P, Labopin M, Han TS, Tichelli A, Duarte R, Basak G, Snowden JA. Metabolic syndrome and cardiovascular disease after haematopoietic cell transplantation (HCT) in adults: an EBMT cross-sectional non-interventional study. Bone Marrow Transplant 2021; 56:2820-2825. [PMID: 34274955 PMCID: PMC8563418 DOI: 10.1038/s41409-021-01414-7] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/28/2021] [Accepted: 07/07/2021] [Indexed: 12/03/2022]
Abstract
Metabolic syndrome (MetS) is associated with cardiovascular disease in the general population and is also a potential cardiovascular risk factor in survivors of haematopoietic cell transplantation (HCT). We report an EBMT cross-sectional, multi-centre, non-interventional study of 453 adult HCT patients surviving a minimum of 2 years post-transplant attending routine follow-up HCT and/or late effects clinics in 9 centres. The overall prevalence of MetS was 37.5% rising to 53% in patients >50 years of age at follow-up. There were no differences in rates of MetS between autologous and allogeneic HCT survivors, nor any association with graft-versus-host disease (GvHD) or current immunosuppressant therapy. Notably, there was a significantly higher occurrence of cardiovascular events (CVE, defined as cerebrovascular accident, coronary heart disease or peripheral vascular disease) in those with MetS than in those without MetS (26.7% versus 9%, p < 0.001, OR 3.69, 95% CI 2.09-6.54, p < 0.001), and, as expected, MetS and CVE were age-related. Unexpectedly, CVE were associated with occurrence of second malignancy. Screening for and management of MetS should be integrated within routine HCT long-term follow-up care for both allogeneic and autologous HCT survivors. Further research is warranted, including randomised controlled trials of interventional strategies and mechanistic studies of cardiovascular risk in HCT survivors.
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Affiliation(s)
- D M Greenfield
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
| | | | | | | | - H Schoemans
- Department of Hematology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - K Hill
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Cortelezzi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Z N Özkurt
- Gazi University Hospital, Ankara/Turkey, Ankara, Turkey
| | - M Arat
- Sisli Florence Nightingale Hospital, Istanbul, Turkey
| | - B Metzner
- Klinikum Oldenburg, Oldenburg, Germany
| | | | - A Rovo
- University Hospital Bern, Bern, Switzerland
| | - G Socié
- Hospital St. Louis, Paris, France
| | - M Mohty
- Saint-Antoine Hospital, Sorbonne University, INSERM UMRs 938, Paris, France
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - N Kröger
- University Hospital Eppendorf, Hamburg, Germany
| | - P Dreger
- University of Heidelberg, Heidelberg, Germany
| | - M Labopin
- EBMT Paris Study Office, Paris, France
| | - T S Han
- Institute of Cardiovascular Research, Royal Holloway, University of London, Egham, UK
| | | | - R Duarte
- Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - G Basak
- The Medical University of Warsaw, Warsaw, Poland
| | - J A Snowden
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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3
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Cramer P, Fürstenau M, Robrecht S, Giza A, Fink AM, Fischer K, Langerbeins P, Al Sawaf O, Tausch E, Schneider C, Schetelig J, Dreger P, Böttcher S, Kreuzer KA, Schilhabel A, Brüggemann M, Kneba M, Wendtner CM, Stilgenbauer S, Eichhorst B, Hallek M. BENDAMUSTINE, FOLLOWED BY OBINUTUZUMAB, ACALABRUTINIB AND VENETOCLAX IN PATIENTS (PTS) WITH RELAPSED/REFRACTORY CHRONIC LYMPHOCYTIC LEUKEMIA (CLL): CLL2‐BAAG TRIAL OF THE GCLLSG. Hematol Oncol 2021. [DOI: 10.1002/hon.34_2879] [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: 11/07/2022]
Affiliation(s)
- P Cramer
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - M Fürstenau
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - S Robrecht
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - A Giza
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - A. M Fink
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - K Fischer
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - P Langerbeins
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - O Al Sawaf
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - E Tausch
- University Hospital Ulm Department III of Internal Medicine Ulm Germany
| | - C Schneider
- University Hospital Ulm Department III of Internal Medicine Ulm Germany
| | - J Schetelig
- University Hospital Carl Gustav Carus Department I of Internal Medicine Dresden Germany
| | - P Dreger
- University Hospital Heidelberg Department V of Internal Medicine Heidelberg Germany
| | - S Böttcher
- University Hospital Rostock Department III of Internal Medicine Rostock Germany
| | - K. A Kreuzer
- Klinikum Schwabing Department of Hematology, Oncology, Immunology, Palliative Care Infectious Diseases and Tropical Medicine Munich Germany
| | - A Schilhabel
- University of Schleswig‐Holstein Campus Kiel, Department II of Internal Medicine, Kiel Germany
| | - M Brüggemann
- University of Schleswig‐Holstein Campus Kiel, Department II of Internal Medicine, Kiel Germany
| | - M Kneba
- University of Schleswig‐Holstein Campus Kiel, Department II of Internal Medicine, Kiel Germany
| | - C. M Wendtner
- Klinikum Schwabing Department of Hematology, Oncology, Immunology, Palliative Care Infectious Diseases and Tropical Medicine Munich Germany
| | - S Stilgenbauer
- University Hospital Ulm Department III of Internal Medicine Ulm Germany
| | - B Eichhorst
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
| | - M Hallek
- University of Cologne Faculty of Medicine and University Hospital of Cologne Department I of Internal Medicine and German CLL Study Group Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne Germany
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4
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Dreger P, Martus P, Holtick U, Ayuk F, Wagner‐Drouet EM, Wulf G, Marks R, Penack O, Koenecke C, von Bonin M, von Tresckow B, Stelljes M, Baldus C, Vucinic V, Mougiakakos D, Topp M, Wolff D, Schroers R, Schmitt M, Schmitt T, Lengerke C, Thomas S, Beelen DW, Bethge W. OUTCOME DETERMINANTS OF COMMERCIAL CAR‐T CELL THERAPY FOR LARGE B‐CELL LYMPHOMA: RESULTS OF THE GLA/DRST REAL WORLD ANALYSIS. Hematol Oncol 2021. [DOI: 10.1002/hon.186_2880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- P. Dreger
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - P. Martus
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - U. Holtick
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - F. Ayuk
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - E. M. Wagner‐Drouet
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - G. Wulf
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - R. Marks
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - O. Penack
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - C. Koenecke
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - M. von Bonin
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - B. von Tresckow
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - M. Stelljes
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - C. Baldus
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - V. Vucinic
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - D. Mougiakakos
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - M. Topp
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - D. Wolff
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - R. Schroers
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - M. Schmitt
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - T. Schmitt
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - C. Lengerke
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - S. Thomas
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
| | - D. W. Beelen
- German Registry for Stem Cell Transplantation DRST Essen Germany
| | - W. Bethge
- German Lymphoma Alliance Working Group Hematopoietic Cell Therapy Muenster Germany
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5
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Dreger P, Ngoya M, Litovich C, Finel H, Herrera AF, Sauter C, Kharfan‐Dabaja M, Sureda A, Blaise D, Castagna L, Corradini P, Pastano R, Arat M, Boumendil A, Dietrich S, Schmitz N, Glass B, Montoto S, Hamadani M. ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION FOR PERIPHERAL T‐CELL LYMPHOMA: COMPARABLE OUTCOMES OF HAPLO‐IDENTICAL VS. MATCHED DONORS. A CIBMTR & EBMT ANALYSIS. Hematol Oncol 2021. [DOI: 10.1002/hon.53_2879] [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: 11/11/2022]
Affiliation(s)
- P. Dreger
- EBMT Lymphoma Working Party Paris France
| | - M. Ngoya
- EBMT Lymphoma Working Party Paris France
| | - C. Litovich
- CIBMTR Lymphoma Working Committee Milwaukee Wisconsin USA
| | - H. Finel
- EBMT Lymphoma Working Party Paris France
| | - A. F Herrera
- CIBMTR Lymphoma Working Committee Milwaukee Wisconsin USA
| | - C. Sauter
- CIBMTR Lymphoma Working Committee Milwaukee Wisconsin USA
| | | | - A. Sureda
- EBMT Lymphoma Working Party Paris France
| | - D. Blaise
- EBMT Lymphoma Working Party Paris France
| | | | | | - R. Pastano
- EBMT Lymphoma Working Party Paris France
| | - M. Arat
- EBMT Lymphoma Working Party Paris France
| | | | | | - N. Schmitz
- EBMT Lymphoma Working Party Paris France
| | - B. Glass
- EBMT Lymphoma Working Party Paris France
| | - S. Montoto
- EBMT Lymphoma Working Party Paris France
| | - M. Hamadani
- CIBMTR Lymphoma Working Committee Milwaukee Wisconsin USA
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6
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Pettengell R, Uddin R, Boumendil A, Johnson R, Metzner B, Martín A, Romejko-Jarosinska J, Bence-Bruckler I, Giri P, Niemann CU, Robinson SP, Kimby E, Schmitz N, Dreger P, Goldstone AH, Montoto S. Durable benefit of rituximab maintenance post-autograft in patients with relapsed follicular lymphoma: 12-year follow-up of the EBMT lymphoma working party Lym1 trial. Bone Marrow Transplant 2021; 56:1413-1421. [PMID: 33452448 DOI: 10.1038/s41409-020-01182-w] [Citation(s) in RCA: 4] [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: 04/03/2020] [Revised: 10/12/2020] [Accepted: 11/30/2020] [Indexed: 01/16/2023]
Abstract
We report the 12-year follow-up of the prospective randomized EBMT LYM1 trial to determine whether the benefit of brief duration rituximab maintenance (RM) on progression-free survival (PFS) in patients with relapsed follicular lymphoma (FL) receiving an autologous stem cell transplant (ASCT) is sustained. One hundred and thirty-eight patients received RM with or without purging. The median follow-up after random assignment is 12 years (range 10-13) for the whole series. The 10-year PFS after ASCT is 47% (95% CI 40-54) with only 4 patients relapsing after 7.5 years. RM continues to significantly improve 10-year PFS after ASCT in comparison with NM [P = 0.002; HR 0.548 (95% CI 0.38-0.80)]. Ten-year non-relapse mortality (NRM) was not significantly different between treatment groups (7% overall). 10-year overall survival (OS) after ASCT was 75% (69-81) for the whole series, with no significant differences according to treatment sub-groups. 10-year OS for patients who progressed within 24 months (POD24T) was 60%, in comparison with 85% for patients without progression. Thus the benefit of rituximab maintenance after ASCT on relapse prevention is sustained at 12 years, suggesting that RM adds to ASCT-mediated disease eradication and may enhance the curative potential of ASCT.
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Affiliation(s)
- R Pettengell
- Institute of Medical & Biomedical Education, St George's University of London, London, United Kingdom.
| | - R Uddin
- EBMT Clinical Trials Office, European Society for Blood and Marrow Transplantation, London, United Kingdom
| | - A Boumendil
- Statistics, European Society for Blood and Marrow Transplantation, Paris, France
| | - R Johnson
- Department of Haematology, St James's University Hospital, Leeds, United Kingdom
| | - B Metzner
- University Clinic for Internal Medicine, Oncology and Haematology, Klinikum Oldenburg, Oldenburg, Germany
| | - A Martín
- Hematology Department, Hospital Universitario de Salamanca, IBSAL, CIBERONC, Salamanca, Spain
| | - J Romejko-Jarosinska
- Department of Lymphoproliferative Diseases, Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw, Poland
| | | | - P Giri
- Haematology, Royal Adelaide Hospital, Adelaide, Southern Australia, Australia
| | - C U Niemann
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - S P Robinson
- Department of Haematology, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - E Kimby
- Department of Hematology, Karolinska Institute, Stockholm, Sweden
| | - N Schmitz
- Department of Internal Medicine A, University Hospital Muenster, Muenster, Germany
| | - P Dreger
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - A H Goldstone
- University College London Hospital, London, United Kingdom
| | - S Montoto
- Department of Haemato-oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
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7
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Domingo-Domenech E, Duarte RF, Boumedil A, Onida F, Gabriel I, Finel H, Arcese W, Browne P, Beelen D, Kobbe G, Veelken H, Arranz R, Greinix H, Lenhoff S, Poiré X, Ribera JM, Thompson J, Zuckerman T, Mufti GJ, Cortelezzi A, Olavarria E, Dreger P, Sureda A, Montoto S. Allogeneic hematopoietic stem cell transplantation for advanced mycosis fungoides and Sézary syndrome. An updated experience of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 2021; 56:1391-1401. [PMID: 33420392 DOI: 10.1038/s41409-020-01197-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/05/2020] [Accepted: 12/09/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment option in advanced-stage mycosis fungoides (MF) and Sézary syndrome (SS). This study presents an updated analysis of the initial experience of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation (EBMT) describing the outcomes after allo-HSCT for MF and SS, with special emphasis on the impact of the use of unrelated donors (URD). METHODS AND PATIENTS Eligible for this study were patients with advanced-stage MF or SS who underwent a first allo-HSCT from matched HLA-identical related or URD between January/1997 and December/2011. Sixty patients have been previously reported. RESULTS 113 patients were included [77 MF (68%)]; 61 (54%) were in complete or partial remission, 86 (76%) received reduced-intensity protocols and 44 (39%) an URD allo-HSCT. With a median follow up for surviving patients of 73 months, allo-HSCT resulted in an estimated overall survival (OS) of 38% at 5 years, and a progression-free survival (PFS) of 26% at 5 years. Multivariate analysis demonstrated that advanced-phase disease (complete remission/partial remission >3, primary refractory or relapse/progression in patients that had received 3 or more lines of systemic treatment prior to transplant or the number of treatment lines was not known), a short interval between diagnosis and transplant (<18 months) were independent adverse prognostic factors for PFS; advanced-phase disease and the use of URDs were independent adverse prognostic factors for OS. CONCLUSIONS This extended series supports that allo-HSCT is able to effectively rescue over one third of the population of patients with advanced-stage MF/SS. High relapse rate is still the major cause of failure and needs to be improved with better strategies before and after transplant. The negative impact of URD is a matter of concern and needs to be further elucidated in future studies.
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Affiliation(s)
- E Domingo-Domenech
- Hematology Department, Institut Català d'Oncologia. Hospital Duran i Reynals, IDIBELL, Universitat de Barcelona, Barcelona, Spain.
| | - R F Duarte
- Hematology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - A Boumedil
- EBMT Central Registry Office, Paris, France
| | - F Onida
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico IRCCS, Milano, Italy
| | - I Gabriel
- Department of Hematology, Imperial College, Hammersmith Hospital, London, United Kingdom
| | - H Finel
- EBMT Central Registry Office, Paris, France
| | - W Arcese
- Tor Vergata University of Rome, Stem Cell Transplant Unit, Policlinico Universitario Tor Vergata, Rome, Italy
| | - P Browne
- St's James Hospital, Dublin, Ireland
| | - D Beelen
- University Hospital, Department of Bone Marrow Transplantation, Essen, Germany
| | - G Kobbe
- Heinrich Heine University, Medical F, Department of Hematology, Düsseldorf, Germany
| | - H Veelken
- Leiden University Medical Center, Leiden, The Netherlands
| | - R Arranz
- Hematology Department, Hospital La Princesa, Madrid, Spain
| | - H Greinix
- Division of Hematology, Medical University Graz, Graz, Austria
| | - S Lenhoff
- Skanes University Hospital, Department of Hematology, Lund, Sweden
| | - X Poiré
- Cliniques Universitaires St. Luc, Department of Hematology, Brussels, Belgium
| | - J M Ribera
- Hematology Department, Institut Català d'Oncologia, Josep Carreras Leukemia Research Institute, Badalona, Spain
| | - J Thompson
- Albert's Stem Cell Transplantation Center, Pretoria, South Africa
| | - T Zuckerman
- Ramban Medical Center, Department of Hematology and Bone Marrow Transplantation, Haifa, Israel
| | - G J Mufti
- GKT School of Medicine, Dept. of Haematological Medicine, King's Denmark Hill Campus, London, United Kingdom
| | - A Cortelezzi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico IRCCS, Milano, Italy
| | - E Olavarria
- Department of Hematology, Imperial College, Hammersmith Hospital, London, United Kingdom
| | - P Dreger
- Universitaetsklinkum Heidelberg, Heidelberg, Germany
| | - A Sureda
- Hematology Department, Institut Català d'Oncologia. Hospital Duran i Reynals, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - S Montoto
- Department of Haemato-Oncology, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
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8
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Schubert ML, Schmitt M, Wang L, Ramos CA, Jordan K, Müller-Tidow C, Dreger P. Side-effect management of chimeric antigen receptor (CAR) T-cell therapy. Ann Oncol 2020; 32:34-48. [PMID: 33098993 DOI: 10.1016/j.annonc.2020.10.478] [Citation(s) in RCA: 199] [Impact Index Per Article: 49.8] [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: 07/17/2020] [Revised: 10/15/2020] [Accepted: 10/15/2020] [Indexed: 12/18/2022] Open
Abstract
Chimeric antigen receptor (CAR) T cells directed against the B-cell marker CD19 are currently changing the landscape for treatment of patients with refractory and/or relapsed B-cell malignancies. Due to the nature of CAR T cells as living drugs, they display a unique toxicity profile. As CAR T-cell therapy is extending towards other diseases and being more broadly employed in hematology and oncology, optimal management strategies of side-effects associated with CAR T-cell therapy are of high relevance. Cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and cytopenias constitute challenges in the treatment of patients with CAR T cells. This review summarizes the current understanding of CAR T-cell toxicity and its management.
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Affiliation(s)
- M-L Schubert
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany.
| | - M Schmitt
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany; National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - L Wang
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - C A Ramos
- Center for Cell Gene Therapy, Baylor College of Medicine, Texas Children's Hospital and Houston Methodist Hospital, Houston, Texas, USA
| | - K Jordan
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - C Müller-Tidow
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany; National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - P Dreger
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany; National Centre for Tumor Diseases (NCT), Heidelberg, Germany
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9
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Domingo-Domènech E, Boumendil A, Climent F, Socié G, Kroschinsky F, Finel H, Vandenbergue E, Nemet D, Stelljes M, Bittenbring JT, Robinson S, Montoto S, Sureda A, Dreger P. Allogeneic hematopoietic stem cell transplantation for patients with relapsed/refractory systemic anaplastic large cell lymphoma. A retrospective analysis of the Lymphoma Working Party of the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 2019; 55:633-640. [PMID: 31695173 DOI: 10.1038/s41409-019-0732-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 08/07/2019] [Accepted: 08/13/2019] [Indexed: 11/09/2022]
Abstract
Information regarding the curative role of allogeneic stem cell transplantation (allo-HCT) in systemic anaplastic large cell lymphoma (sALCL) is scarce. We analyzed the results of allo-HCT in patients with relapsed/refractory sALCL with special emphasis on the role of brentuximab vedotin (BV) as a bridge to allo-HCT. Forty-four patients (24 females, median age 38 years) with sALCL were included. Twenty-three patients (52%) received BV before allo-HCT; BV-treated patients were more heavily pretreated (≥3 lines of therapy in 74% vs. 38%, p = 0.04). Twenty-three patients (52%) were in complete remission (CR) at allo-HCT. Three-year nonrelapse mortality and incidence of relapse (IR) after allo-HCT were 7% and 40%, respectively. With a median follow-up of 39 (12-69) months for survivors, 3-year progression-free survival (PFS) and overall survival were 53% and 74%, respectively. Univariate analysis showed that heavily pretreated patients and those not in CR had a higher IR and a lower PFS. The use of BV before transplant did not impact on any of the outcomes. Allo-HCT is a curative therapeutic strategy in a significant proportion of patients with relapsed/refractory sALCL; BV does not seem to modify transplant-related outcomes but might be able to render more patients candidates for this curative treatment.
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Affiliation(s)
- E Domingo-Domènech
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain
| | | | - F Climent
- Pathology Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - G Socié
- Hematology Department, Hopital St. Louis, Paris, France
| | | | - H Finel
- Lymphoma Working Party, EBMT, Paris, France
| | | | - D Nemet
- University Hospital Center Rebro, Zagreb, Croatia
| | - M Stelljes
- University of Münster, Muenster, Germany
| | - J T Bittenbring
- Department of Internal Medicine, University of Saarland, Homburg, Germany
| | - S Robinson
- Department of Hematology and Oncology, University Hospital Bristol, Bristol, UK
| | - S Montoto
- St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - A Sureda
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain.
| | - P Dreger
- Medizinische Klinik u. Poliklinik V, University of Heidelberg, Heidelberg, Germany
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10
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Fürstenau M, Bahlo J, Fink AM, Lange E, Dreger P, Dreyling M, Hess G, Ritgen M, Kneba M, Döhner H, Stilgenbauer S, Wendtner CM, Goede V, Fischer K, Böttcher S, Hallek M, Eichhorst B. Residual abdominal lymphadenopathy after intensive frontline chemoimmunotherapy is associated with inferior outcome independently of minimal residual disease status in chronic lymphocytic leukemia. Leukemia 2019; 34:924-928. [PMID: 31611627 DOI: 10.1038/s41375-019-0597-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 08/30/2019] [Accepted: 09/30/2019] [Indexed: 11/10/2022]
Affiliation(s)
- M Fürstenau
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, German CLL Study Group, University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - J Bahlo
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, German CLL Study Group, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - A M Fink
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, German CLL Study Group, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - E Lange
- Evangelisches Krankenhaus Hamm, Hamm, Germany
| | - P Dreger
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - M Dreyling
- Department of Internal Medicine III, University Hospital of the Ludwig Maximilians University Munich, Munich, Germany
| | - G Hess
- Department of Hematology, Medical Oncology and Pneumology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - M Ritgen
- Department II of Internal Medicine, University of Schleswig-Holstein, Kiel, Germany
| | - M Kneba
- Department II of Internal Medicine, University of Schleswig-Holstein, Kiel, Germany
| | - H Döhner
- Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany
| | - S Stilgenbauer
- Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany.,Department of Hematology, Oncology and Rheumatology and José Carreras Center for Immuno and Gene Therapy, Saarland University Medical School, Homburg/Saar, Germany
| | - C M Wendtner
- Department of Hematology, Oncology, Immunology, Palliative Care, Infectious Diseases and Tropical Medicine, München Klinik Schwabing, Munich, Germany
| | - V Goede
- Oncogeriatric Unit, Department of Geriatric Medicine, St. Marien Hospital, Cologne, Germany
| | - K Fischer
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, German CLL Study Group, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - S Böttcher
- Department II of Internal Medicine, University of Schleswig-Holstein, Kiel, Germany.,Medical Clinic III, Hematology, Oncology and Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - M Hallek
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, German CLL Study Group, University Hospital Cologne, University of Cologne, Cologne, Germany.,Cologne Cluster of Excellence in Cellular Stress Responses in Aging-associated Disease (CECAD), University of Cologne, Cologne, Germany
| | - B Eichhorst
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, German CLL Study Group, University Hospital Cologne, University of Cologne, Cologne, Germany.
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11
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Hendricks A, Treiber K, Dreger P, Nawroth P, Luft T, Zech U. SUN-PO077: Patients Undergoing Allogenic Stem Cell Transplantation Suffer from Poor Nutritional State Despite Supplementation. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32711-6] [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: 11/30/2022]
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12
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Tournilhac O, Truemper L, Ziepert M, Bouabdallah K, Nickelsen M, Maury S, Reimer P, Jaccard A, Herr W, Wilhelm M, Cartron G, Wulf G, Sanhes L, Dreger P, Lamy T, Kroschinsky F, Lindemann H, Roussel M, Viardot A, Sibon D, Delmer A, De Leval L, Damaj G, Gisselbrecht C, Gaulard P, Rosenwald A, Friedrichs B, Altmann B, Schmitz N. FIRST-LINE THERAPY OF T-CELL LYMPHOMA: ALLOGENEIC OR AUTOLOGOUS TRANSPLANTATION FOR CONSOLIDATION - FINAL RESULTS OF THE AATT STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.64_2629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- O. Tournilhac
- Service d'Hematologie, EA7453 Chelter, CIC-1405; CHU de Clermont-Ferrand, Université Clermont Auvergne; Clermont-Ferrand France
| | - L. Truemper
- Hematology and Oncology; Georg August University Göttingen; Goettingen Germany
| | - M. Ziepert
- Statistics and Epidemology; Institute for Medical Informatics, Leipzig University; Leipzig Germany
| | - K. Bouabdallah
- Department of Haematology; University Hospital of Bordeaux; Bordeaux Pessac France
| | - M. Nickelsen
- Onkologie Lerchenfeld; Onkologie Lerchenfeld; Hamburg Germany
| | - S. Maury
- Université Paris-Est Créteil Val De Marne; AP-HP Hôpital Henri Mondor; Créteil France
| | - P. Reimer
- Hämatologie; Kliniken Essen-Sued; Essen Germany
| | - A. Jaccard
- Hématologie Clinique et Thérapie Cellulaire; CHU de Limoges - Hôpital Dupuytren; Limoges France
| | - W. Herr
- Department of Internal Medicine III; University Medical Center of the Johannes Gutenberg-University; Mainz Germany
| | - M. Wilhelm
- Med. Klinik 5; Klinikum Nuernberg; Nuernberg Germany
| | - G. Cartron
- Service d'Hématologie Clinique; CHU de Montpellier, UMR CNRS 5235; Montpellier France
| | - G. Wulf
- Hematology and Oncology; Georg August University Göttingen; Goettingen Germany
| | - L. Sanhes
- Hematology; Centre Hospitalier Saint Jean; Perpignan France
| | - P. Dreger
- Internal Medicine V; University of Heidelberg; Heidelberg Germany
| | - T. Lamy
- Rennes University Hospital; INSERM Research Unit 1236, Rennes University; Rennes France
| | - F. Kroschinsky
- Medical Department I; Dresden University Hospital; Dresden Germany
| | - H. Lindemann
- Hematology Oncology Clinic; Saint Josefs Hospital; Hagen Germany
| | - M. Roussel
- Service d'Hématologie; IUC Oncopole; Toulouse France
| | - A. Viardot
- Internal Medicine III; University Hospital Ulm; Ulm Germany
| | - D. Sibon
- Hematology; CHU Necker; Paris France
| | - A. Delmer
- Hematology; CHU Robert Debré; Reims France
| | - L. De Leval
- Pathologie Clinique; Institut Universitaire de Pathologie; Lausanne Switzerland
| | - G.L. Damaj
- Institut d'Hématologie; CHU de Caen; Caen France
| | | | - P. Gaulard
- Département de Pathologie; Groupe Hospitalier Henri Mondor; Créteil France
| | - A. Rosenwald
- Institute of Pathology; University of Wuerzburg; Wuerzburg Germany
| | - B. Friedrichs
- Hämatologie; Medizinische Klinik A Hämatologie UniversitätsklinikMünster; Münster Germany
| | - B. Altmann
- Statistics and Epidemology; Institute for Medical Informatics (IMISE); Leipzig Germany
| | - N. Schmitz
- Hämatologie; Medizinische Klinik A Hämatologie UniversitätsklinikMünster; Münster Germany
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13
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Bazarbachi A, Boumendil A, Finel H, Castagna L, Dominietto A, Blaise D, Diez-Martin J, Tischer J, Gülbas Z, Labussière Wallet H, Lopez Corral L, Mohty M, Koc Y, Yakoub-Agha I, Schmid C, el Cheikh J, Arat M, Forcade E, Dreger P, Rocha V, Gutiérrez García G, Chalandon Y, Ferra C, Orvain C, Robinson S, Montoto S, Sureda A. HOW TO SELECT DONOR, STEM CELL SOURCE, AND CONDITIONING REGIMEN FOR HAPLOIDENTICAL TRANSPLANTS WITH POST-TRANSPLANT CYCLOPHOSPHAMIDE FOR LYMPHOMA: A REPORT OF THE EBMT LWP. Hematol Oncol 2019. [DOI: 10.1002/hon.108_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: 11/07/2022]
Affiliation(s)
- A. Bazarbachi
- Internal medicine American University of Beirut Medical Center Beirut, Lebanon
| | - A. Boumendil
- Lymphoma Working Party EBMT LWP Paris Office/Hôpital Saint-Antoine Paris; France
| | - H. Finel
- Lymphoma Working Party EBMT LWP Paris Office/Hôpital Saint-Antoine Paris; France
| | - L. Castagna
- Hematology Istituto Clinico Humanitas Rozzano Milano, Italy
| | - A. Dominietto
- Hematology Second Division of Hematology and Bone Marrow Transplantation, IRCCS AOU San Martino-IST Genoa, Italy
| | - D. Blaise
- Hematology Institut Paoli Calmettes Marseille, France
| | | | - J. Tischer
- Hematology Klinikum Grosshadern Munich, Germany
| | - Z. Gülbas
- Hematology Anadolu Medical Center Hospital Kocaeli, Turkey
| | | | | | - M. Mohty
- Hematology Hôpital Saint Antoine Paris, France
| | - Y. Koc
- Hematology Medical Park Hospitals Antalya, Turkey
| | | | - C. Schmid
- Hematology Klinikum Augsburg Augsburg, Germany
| | - J. el Cheikh
- Internal medicine American University of Beirut Medical Center Beirut, Lebanon
| | - M. Arat
- Hematology Florence Nightingale Sisli HospitalIstanbul, Turkey
| | | | - P. Dreger
- Hematology University of Heidelberg Heidelberg, Germany
| | - V. Rocha
- Hematology Hospital Sirio-Libanes Sao Paulo, Brazil
| | - G. Gutiérrez García
- Hematology Hospital Clinic, Universitat de Barcelona IDIBAPS, Barcelona, Spain
| | - Y. Chalandon
- Hematology Hôpitaux Universitaires Geneva, Switzerland
| | - C. Ferra
- Hematology ICO-Hospital Universitari Germans Trias i Pujol Barcelona, Spain
| | | | - S. Robinson
- Hematology Bristol Oncology Centre Bristol, United Kingdom
| | - S. Montoto
- Hematology Barts Health NHS TrustLondon, United kingdom
| | - A. Sureda
- Hematology ICO - Hospital Duran i Reynals Barcelona, Spain
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14
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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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15
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De Giorgi U, Richard S, Badoglio M, Kanfer E, Bourrhis JH, Nicolas-Virelizier E, Vettenranta K, Lioure B, Martin S, Dreger P, Schuler MK, Thomson K, Scarpi E, Rosti G, Selle F, Mangili G, Lanza F, Bregni M. Salvage high-dose chemotherapy in female patients with relapsed/refractory germ-cell tumors: a retrospective analysis of the European Group for Blood and Marrow Transplantation (EBMT). Ann Oncol 2018; 28:1910-1916. [PMID: 28510616 DOI: 10.1093/annonc/mdx259] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background High-dose chemotherapy (HDC) with hematopoietic progenitor cell transplantation is a standard option for relapsed/refractory testicular germ-cell tumor (GCT), but only few data have been reported in female patients with GCT. We conducted a retrospective analysis of female patients with GCT treated with HDC and registered with the European Society for Blood and Marrow Transplantation. Patients and methods Between 1985 and 2013, 60 registered female patients with GCT, median age 27 years (range 15-48), were treated with salvage HDC. Forty patients (67%) had primary ovarian GCT, 8 (13%) mediastinal, 7 (12%) retroperitoneal and 5 (8%) other primary sites/unknown. Twenty-two patients (37%) received HDC as second-line therapy, 29 (48%) as third-line, and 9 (15%) as fourth- to sixth-line. Nine of 60 patients (15%) received HDC as late-intensification with no evidence of metastasis before HDC. The conditioning HDC regimens comprised carboplatin in 51 of 60 cases (85%), and consisted of a single HDC cycle in 31 cases (52%), a multi-cycle HDC regimen in 29 (48%). Results Nine cases who underwent late intensification HDC were not evaluable for response. Of the other 51 assessable patients, 17 (33%) achieved a complete response (CR), 8 (16%) a marker-negative partial remission (PRm-), 5 (10%) a marker-positive partial remission, 5 (10%) stable disease, and 13 (25%) progressive disease. There were 3 toxic deaths (6%). With an overall median follow-up of 14 months (range 1-219), 7 of 9 (78%) patients with late intensification and 18 of the 25 patients (72%) achieving a CR/PRm- following HDC were free of relapse/progression. In total, 25 of 60 patients (42%) were progression-free following HDC at a median follow-up of 87 months (range 3-219 months). Conclusions Salvage HDC based on carboplatin represents a therapeutic option for female patients with relapsed/refractory GCT.
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Affiliation(s)
- U De Giorgi
- Department of Medical Oncology and Hematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - S Richard
- Department of Medical Oncology, Hopital Tenon, Paris
| | | | - E Kanfer
- Department of Hematology, Imperial College, Hammersmith Hospital, London, UK
| | - J H Bourrhis
- Hematology-Marrow Transplant Service, Institute Gustave-Roussy, Villejuif
| | | | - K Vettenranta
- Department of Pediatrics, University of Helsinki, Helsinki, Finland
| | - B Lioure
- Department of Hematology/Oncology, Strasbourg University Hospital, Strasbourg, France
| | - S Martin
- Department of Internal Medicine II, Robert-Bosch-Hospital, Stuttgart
| | - P Dreger
- Department of Medicine V, University of Heidelberg, Heidelberg
| | - M K Schuler
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - K Thomson
- Department of Haematology, University College London Hospital, London, UK
| | - E Scarpi
- Biostatistics and Clinical Trials Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola
| | - G Rosti
- Department of Oncology, Policlinico San Matteo IRCCS, Pavia
| | - F Selle
- Department of Medical Oncology, Hopital Tenon, Paris
| | - G Mangili
- Department of Obstetrics and Gynaecology, San Raffaele Scientific Institute, Milan
| | - F Lanza
- Department of Onco-Hematology, Santa Maria delle Croci Hospital, Ravenna
| | - M Bregni
- Department of Medical Oncology, Busto Arsizio Hospital, Busto Arsizio, Italy
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16
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Zeisbrich M, Becker N, Benner A, Radujkovic A, Schmitt K, Beimler J, Ho AD, Zeier M, Dreger P, Luft T. Transplant-associated thrombotic microangiopathy is an endothelial complication associated with refractoriness of acute GvHD. Bone Marrow Transplant 2017. [PMID: 28650448 DOI: 10.1038/bmt.2017.119] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
There is increasing evidence that endothelial dysfunction is involved in refractoriness of acute GvHD (aGvHD). Here we investigated the hypothesis that another endothelial complication, transplant-associated thrombotic microangiopathy (TMA), contributes to the pathogenesis of aGvHD refractoriness. TMA was retrospectively assessed in 771 patients after allogeneic stem cell transplantation (alloSCT). Incidences of TMA and refractory aGvHD were correlated with biomarkers of endothelial damage obtained before alloSCT for patients receiving or not receiving statin-based endothelial prophylaxis (SEP). Diagnostic criteria for TMA and refractory aGvHD were met by 41 (5.3%) and 76 (10%) patients, respectively. TMA was overrepresented in patients with refractory aGvHD (45.0 vs 2.3% in all other patients, P<0.001). TMA independently increased mortality. Elevated pretransplant suppressor of tumorigenicity-2 and nitrates along with high-risk variants of the thrombomodulin gene were associated with increased risk of TMA. In contrast, SEP abolished the unfavorable outcome predicted by pretransplant biomarkers on TMA risk. Patients on SEP had a significantly lower risk of TMA (P=0.001) and refractory aGvHD (P=0.055) in a multivariate multistate model. Our data provide evidence that TMA contributes to the pathogenesis of aGvHD refractoriness. Patients with an increased TMA risk can be identified pretransplant and may benefit from pharmacological endothelium protection.
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Affiliation(s)
- M Zeisbrich
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - N Becker
- Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany
| | - A Benner
- Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany
| | - A Radujkovic
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - K Schmitt
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - J Beimler
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - A D Ho
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - M Zeier
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - P Dreger
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - T Luft
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
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17
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Pettengell R, Uddin R, Boumendil A, Robinson S, Smith G, Hawkins T, Metzner B, Caballero M, Tilly H, Romejko-Jarosinska J, Bence-Bruckler I, To B, Niemann C, Kimby E, Dreger P, Schmitz N, Goldstone A, Montoto S. DURABLE BENEFIT OF RITUXIMAB MAINTENANCE POST-AUTOGRAFT IN PATIENTS WITH RELAPSED FOLLICULAR LYMPHOMA: 12-YEAR FOLLOW-UP OF THE EBMT LYMPHOMA WORKING PARTY LYM1 TRIAL. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- R. Pettengell
- Institute of Medical & Biomedical Education; St George's University of London; London UK
| | - R. Uddin
- EBMT Clinical Trials Office; European Society for Blood and Marrow Transplantation; London UK
| | - A. Boumendil
- Statistics; European Society for Blood and Marrow Transplantation; Paris France
| | - S.P. Robinson
- Department of Haematology; University Hospitals Bristol NHS Foundation Trust; Bristol UK
| | - G. Smith
- Department of Haematology; St James's Hospital; Leeds UK
| | - T. Hawkins
- Haematology; Auckland City Hospital; Auckland New Zealand
| | - B. Metzner
- University Clinic for Internal Medicine; Oncology and Haematology, Klinikum Oldenburg; Oldenburg Germany
| | - M.D. Caballero
- Hematology Department, Hospital Universitario de Salamanca; Instituto Biosanitario, IBSAL; Salamanca Spain
| | - H. Tilly
- Haematology; Centre Henri Becquerel; Rouen France
| | - J. Romejko-Jarosinska
- Department of Lymphoproliferative Diseases; Maria Sklodowska-Curie Memorial Institute and Oncology Center; Warsaw Poland
| | | | - B. To
- Haematology; Royal Adelaide Hospital; Adelaide Australia
| | - C. Niemann
- Hematology; Rigshospitalet; Copenhagen Denmark
| | - E. Kimby
- Dept of Hematology; Karolinska Institute; Stockholm Sweden
| | - P. Dreger
- Hematology; University of Heidelberg; Heidelberg Germany
| | - N. Schmitz
- Hematology; Asklepios Hospital St Georg; Hamburg Germany
| | - A.H. Goldstone
- North London Cancer Network; Univ. College London Hospital; London UK
| | - S. Montoto
- Dept. of Haematology; Queen Mary University of London; London UK
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18
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Bazarbachi A, Boumendil A, Finel H, Mohty M, Castagna L, Blaise D, Peggs K, Afanasyev B, Diez-Martin J, Corradini P, Socié G, Robinson S, Gutiérrez-García G, Bonifazi F, Yakoub-Agha I, Gülbas Z, Bloor A, Delage J, Esquirol A, Malladi R, Scheid C, Ghesquières H, Montoto S, Dreger P, Sureda A. BRENTUXIMAB VEDOTIN FOR RELAPSED HODGKIN LYMPHOMA AFTER ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION: a RETROSPECTIVE STUDY OF THE EBMT LYMPHOMA WORKING PARTY. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_71] [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: 11/08/2022]
Affiliation(s)
- A. Bazarbachi
- Department of internal medicine; American University of Beirut; Beirut Lebanon
| | - A. Boumendil
- EBMT LWP Paris Office; Hôpital Saint-Antoine; Paris France
| | - H. Finel
- EBMT LWP Paris Office; Hôpital Saint-Antoine; Paris France
| | - M. Mohty
- Service d'Hématologie et Thérapie Cellulaire; Hôpital Saint Antoine; Paris France
| | - L. Castagna
- Department of Hematology; Istituto Clinico Humanitas; Milan Italy
| | - D. Blaise
- Department of internal medicine; Institut Paoli Calmettes; Marseille France
| | - K. Peggs
- Department of internal medicine; University College London Hospital; London UK
| | - B. Afanasyev
- Department of internal medicine; First State Pavlov Medical University of St. Petersburg; St. Petersburg Russian Federation
| | - J. Diez-Martin
- Department of internal medicine; Hospital Gregorio Marañón; Madrid Spain
| | - P. Corradini
- IRCCS Istituto Nazionale dei Tumori; University of Milano; Milan Italy
| | - G. Socié
- Department of internal medicine; Hopital St. Louis; Paris France
| | - S. Robinson
- Department of internal medicine; University Hospital Bristol; Bristol UK
| | | | - F. Bonifazi
- S.Orsola-Malpighi Hospital; Bologna University; Bologna Italy
| | | | - Z. Gülbas
- Department of internal medicine; Anadolu Medical Center Hospital; Kocaeli Turkey
| | - A. Bloor
- Department of internal medicine; Christie NHS Trust Hospital; Manchester UK
| | - J. Delage
- Department of internal medicine; CHU Lapeyronie; Montpellier France
| | - A. Esquirol
- Department of internal medicine; Hospital Santa Creu i Sant Pau; Barcelona Spain
| | - R. Malladi
- Department of internal medicine; Queen Elizabeth Hospital; Birmingham UK
| | - C. Scheid
- Department of internal medicine; University of Cologne; Cologne Germany
| | - H. Ghesquières
- Department of internal medicine; Centre Hospitalier Lyon Sud; Lyon France
| | - S. Montoto
- Department of Haemato-oncology; St Bartholomew's Hospital; London UK
| | - P. Dreger
- Dept Medicine V; University of Heidelberg; Heidelberg Germany
| | - A. Sureda
- Department of Haematology; Institut Catala d'Oncologia, Hospital Duran I Reynals; Barcelona Spain
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19
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Domingo Domenech E, Boumendil A, Climent F, Socié G, Kroschinsky F, Finel H, Vandenbergue E, Nemet D, Stelljes M, Bittenbring J, Montoto S, Sureda A, Dreger P. ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION (ALLO-HSCT) FOR PATIENTS WITH RELAPSED/REFRACTORY SYSTEMIC ANAPLASTIC LARGE CELL LYMPHOMA (R/R SALCL). A RETROSPECTIVE ANALYSIS OF THE LYMPHOMA WORKING PARTY-EBMT. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_106] [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: 11/06/2022]
Affiliation(s)
| | | | - F. Climent
- Pathology; Hospital Universitari de Bellvitge, Hospitalet de Llobregat; Spain
| | - G. Socié
- Hematology; Hospital St Louis; Paris France
| | | | - H. Finel
- EBMT, Lymphoma Working Party; Paris France
| | - E. Vandenbergue
- Hematology; St. James's Hospital; Dublin Ireland, Republic of
| | - D. Nemet
- Hematology; University Hospital Rebro; Zagreb Croatia
| | - M. Stelljes
- Hematology; University of Münster; Münster Germany
| | - J. Bittenbring
- BMT Unit; University of Saarland University Hospital; Homburg Germany
| | - S. Montoto
- Hematology; St Bartholomew's hospital, Barts Health NHS Trust; London UK
| | - A. Sureda
- Hematology; Institut Catala d'Oncologia, Hospitalet de Llobregat; Spain
| | - P. Dreger
- Hematology; University of Heidelberg, Germany; Heidelberg Germany
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20
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Luft T, Hofmann A, Germing U, Radujkovic A, Kobbe G, Dreger P. It is Easix to Predict Mortality of Low Risk MDS Patients. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30363-6] [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: 10/19/2022]
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21
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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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22
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Genadieva-Stavrik S, Boumendil A, Dreger P, Peggs K, Briones J, Corradini P, Bacigalupo A, Socié G, Bonifazi F, Finel H, Velardi A, Potter M, Bruno B, Castagna L, Malladi R, Russell N, Sureda A. Myeloablative versus reduced intensity allogeneic stem cell transplantation for relapsed/refractory Hodgkin's lymphoma in recent years: a retrospective analysis of the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. Ann Oncol 2016; 27:2251-2257. [DOI: 10.1093/annonc/mdw421] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/16/2016] [Accepted: 08/29/2016] [Indexed: 11/14/2022] Open
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23
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Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P, Duarte RF, Dufour C, Kuball J, Farge-Bancel D, Gennery A, Kröger N, Lanza F, Nagler A, Sureda A, Mohty M. Impact of drug development on the use of stem cell transplantation: a report by the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 2016; 52:191-196. [PMID: 27819687 DOI: 10.1038/bmt.2016.258] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 05/30/2016] [Accepted: 06/01/2016] [Indexed: 11/09/2022]
Abstract
Hematopoietic stem cell transplantation (HSCT) is used with increasing frequency in Europe with 40 000 transplants reported in 2014. Transplant-related mortality remains high in allogeneic HSCT (10-20%); high-dose chemotherapy is toxic and demanding for patients. Drug development is accelerating and with limited toxicity of some targeted drugs may replace HSCT, whereas others may function as a 'bridge to transplant'. We analyzed HSCT reported to the activity survey for selected diseases in which major advances in drug development have been made. Tyrosine kinase inhibitors markedly changed the number of allogeneic HSCT in early CML. In myelodysplastic syndromes, hypomethylating agents show no effect on HSCT activity and Janus kinase inhibitors for myeloproliferative neoplasm appear to have only a temporary effect. For CLL autologous HSCT decreased after publication of trials showing improved PFS but no overall survival advantage and allogeneic rates are dropping after the introduction of Bruton kinase and PI3K Inhibitors. Whether these are 'game changers' as was imatinib for CML requires additional follow-up. For myeloma, proteasome inhibitors and new immunomodulatory drugs do not appear to impact transplant rates. Drug development data show different effects on HSCT use; highly effective drugs may replace HSCT, whereas other drugs may improve the patient's condition to allow for HSCT.
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Affiliation(s)
- J R Passweg
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - H Baldomero
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - P Bader
- Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt am Main, Germany
| | - C Bonini
- Università Vita-Salute San Raffaele, Milan, Italy
| | - S Cesaro
- Pediatric Haematology and Oncology, Policlinico GB Rossi, Verona, Italy
| | - P Dreger
- Medizinische Klinik V, University of Heidelberg, Heidelberg, Germany
| | - R F Duarte
- Hematology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - C Dufour
- Hematology Unit, G Gaslini Children's Institute, Genova, Italy
| | - J Kuball
- Department of Hematology, University Medical Centre, Utrecht, The Netherlands
| | - D Farge-Bancel
- Service de Médecine Interne, Maladies auto-immunes et pathologie vasculaire, Hôpital St Louis, Paris, France
| | - A Gennery
- Institute of Cellular Medicine, Newcastle University, Newcastle-Upon-Tyne, UK
| | - N Kröger
- University Hospital Eppendorf, Hamburg, Germany
| | - F Lanza
- Hematology and BMT Unit, University Hospital of Ravenna, Ravenna, Italy
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - A Sureda
- Hematology Department, Institut Català d'Oncologia-Hospital Duran I Reynals, Barcelona, Spain
| | - M Mohty
- Hospital Saint Antoine, Paris, France
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24
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Kayser S, Benner A, Thiede C, Martens U, Huber J, Stadtherr P, Janssen JWG, Röllig C, Uppenkamp MJ, Bochtler T, Hegenbart U, Ehninger G, Ho AD, Dreger P, Krämer A. Pretransplant NPM1 MRD levels predict outcome after allogeneic hematopoietic stem cell transplantation in patients with acute myeloid leukemia. Blood Cancer J 2016; 6:e449. [PMID: 27471865 PMCID: PMC5030374 DOI: 10.1038/bcj.2016.46] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [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: 05/01/2016] [Accepted: 05/19/2016] [Indexed: 12/19/2022] Open
Abstract
The objective was to evaluate the prognostic impact of pre-transplant minimal residual disease (MRD) as determined by real-time quantitative polymerase chain reaction in 67 adult NPM1-mutated acute myeloid leukemia patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). Twenty-eight of the 67 patients had a FLT3-ITD (42%). Median age at transplantation was 54.7 years, median follow-up for survival from time of allografting was 4.9 years. At transplantation, 31 patients were in first, 20 in second complete remission (CR) and 16 had refractory disease (RD). Pre-transplant NPM1 MRD levels were measured in 39 CR patients. Overall survival (OS) for patients transplanted in CR was significantly longer as compared to patients with RD (P=0.004), irrespective of whether the patients were transplanted in first or second CR (P=0.74). There was a highly significant difference in OS after allogeneic HSCT between pre-transplant MRD-positive and MRD-negative patients (estimated 5-year OS rates of 40 vs 89% P=0.007). Multivariable analyses on time to relapse and OS revealed pre-transplant NPM1 MRD levels >1% as an independent prognostic factor for poor survival after allogeneic HSCT, whereas FLT3-ITD had no impact. Notably, outcome of patients with pre-transplant NPM1 MRD positivity >1% was as poor as that of patients transplanted with RD.
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Affiliation(s)
- S Kayser
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - A Benner
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Thiede
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - U Martens
- Cancer Center Heilbronn-Franken, Heilbronn, Germany
| | - J Huber
- Cancer Center Heilbronn-Franken, Heilbronn, Germany
| | - P Stadtherr
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - J W G Janssen
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - C Röllig
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - M J Uppenkamp
- Department of Oncology, Hospital of Ludwigshafen, Ludwigshafen, Germany
| | - T Bochtler
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - U Hegenbart
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - G Ehninger
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - A D Ho
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - P Dreger
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - A Krämer
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
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25
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Robinson SP, Boumendil A, Finel H, Schouten H, Ehninger G, Maertens J, Crawley C, Rambaldi A, Russell N, Anders W, Blaise D, Yakoub-Agha I, Ganser A, Castagna L, Volin L, Cahn JY, Montoto S, Dreger P. Reduced intensity allogeneic stem cell transplantation for follicular lymphoma relapsing after an autologous transplant achieves durable long-term disease control: an analysis from the Lymphoma Working Party of the EBMT†. Ann Oncol 2016; 27:1088-1094. [PMID: 26961149 DOI: 10.1093/annonc/mdw124] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 02/17/2016] [Accepted: 02/22/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with follicular lymphoma (FL) relapsing after an autologous transplant (autoSCT) may be treated with a variety of therapies, including a reduced intensity allogeneic transplant (RICalloSCT). We conducted a retrospective analysis of a large cohort of patients undergoing RICalloSCT for FL in this setting. PATIENTS AND METHODS A total of 183 patients, median age 45 years (range 21-69), had undergone an autoSCT at a median of 30 months before the RICalloSCT. Before the RICalloSCT, they had received a median of four lines (range 3-10) of therapy and 81% of patients had chemosensitive disease and 16% had chemoresistant disease. Grafts were donated from sibling (47%) or unrelated donors (53%). RESULTS With a median follow-up of 59 months, the non-relapse mortality (NRM) was 27% at 2 years. The median remission duration post-autoSCT and RICalloSCT was 14 and 43 months, respectively. The 5-year relapse/progression rate, progression-free survival and overall survival were 16%, 48% and 51%, respectively, and were associated with age and disease status at RICalloSCT. CONCLUSION These data suggest that an RICalloSCT is an effective salvage strategy in patients with FL recurring after a prior autoSCT and might overcome the poor prognostic impact of early relapse after autoSCT.
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Affiliation(s)
- S P Robinson
- BMT Unit, University Hospital Bristol NHS Foundation Trust, Bristol, UK; Lymphoma Working Party EBMT, Paris, France.
| | | | - H Finel
- Lymphoma Working Party EBMT, Paris, France
| | - H Schouten
- Department of Haematology, University Hospital, Maastricht, The Netherlands
| | - G Ehninger
- Department of Haematology, Universitaetsklinikum, Dresden, Germany
| | - J Maertens
- Department of Haematology, University Hospital Gasthuisberg, Leuven, Belgium
| | - C Crawley
- Department of Haematology, Addenbrookes Hospital, Cambridge, UK
| | - A Rambaldi
- Haematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - N Russell
- Department of Haematology, City Hospital, Nottingham, UK
| | - W Anders
- Department of Haematology, University Hospital, Umea, Sweden
| | - D Blaise
- Department of Haematology, Institut Paoli Calmettes, Marseille
| | - I Yakoub-Agha
- Department of Haematology, Hôpital Claude Huriez, Lille, France
| | - A Ganser
- Department of Haematology, Medical School, Hannover, Germany
| | - L Castagna
- Department of Haematology, Istituto Clinico Humanitas, Milano, Italy
| | - L Volin
- HUH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
| | - J-Y Cahn
- Haematology, Clinique Universitaire d'Hématologie CHU Grenoble UMR 38043, Grenoble Cedex 09, France
| | - S Montoto
- Lymphoma Working Party EBMT, Paris, France; Department of Haematology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - P Dreger
- Lymphoma Working Party EBMT, Paris, France; Department of Medicine V, University of Heidelberg, Heidelberg, Germany
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26
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Dreger P, Montserrat E. Transplantation in CLL: what we can learn from a dinosaur. Bone Marrow Transplant 2016; 51:765-6. [PMID: 26926227 DOI: 10.1038/bmt.2016.27] [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] [Received: 01/04/2016] [Accepted: 01/19/2016] [Indexed: 11/09/2022]
Affiliation(s)
- P Dreger
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany.,European Society for Blood and Marrow Transplantation (EBMT), Paris, France
| | - E Montserrat
- Department of Hematology, Hospital Clínic, University of Barcelona, Barcelona, Spain.,European Research Initiative on CLL (ERIC), Barcelona, Spain
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27
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Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P, Duarte RF, Dufour C, Kuball J, Farge-Bancel D, Gennery A, Kröger N, Lanza F, Nagler A, Sureda A, Mohty M. Hematopoietic stem cell transplantation in Europe 2014: more than 40 000 transplants annually. Bone Marrow Transplant 2016; 51:786-92. [PMID: 26901709 PMCID: PMC4895175 DOI: 10.1038/bmt.2016.20] [Citation(s) in RCA: 278] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 01/06/2016] [Indexed: 12/30/2022]
Abstract
A record number of 40 829 hematopoietic stem cell transplantation (HSCT) in 36 469 patients (15 765 allogeneic (43%), 20 704 autologous (57%)) were reported by 656 centers in 47 countries to the 2014 survey. Trends include: continued growth in transplant activity, more so in Eastern European countries than in the west; a continued increase in the use of haploidentical family donors (by 25%) and slower growth for unrelated donor HSCT. The use of cord blood as a stem cell source has decreased again in 2014. Main indications for HSCT were leukemias: 11 853 (33% 96% allogeneic); lymphoid neoplasias; 20 802 (57% 11% allogeneic); solid tumors; 1458 (4% 3% allogeneic) and non-malignant disorders; 2203 (6% 88% allogeneic). Changes in transplant activity include more allogeneic HSCT for AML in CR1, myeloproliferative neoplasm (MPN) and aplastic anemia and decreasing use in CLL; and more autologous HSCT for plasma cell disorders and in particular for amyloidosis. In addition, data on numbers of teams doing alternative donor transplants, allogeneic after autologous HSCT, autologous cord blood transplants are presented.
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Affiliation(s)
- J R Passweg
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - H Baldomero
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - P Bader
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt am Main, Germany
| | - C Bonini
- Università Vita-Salute San Raffaele, Milan, Italy
| | - S Cesaro
- Paediatric Haematology Oncology, Policlinico G.B. Rossi, Verona, Italy
| | - P Dreger
- Medizinische Klinik V, University of Heidelberg, Heidelberg, Germany
| | - R F Duarte
- Hematology Department, Institut Català d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain
| | - C Dufour
- Hematology Unit, G.Gaslini Children's Institute, Genova, Italy
| | - J Kuball
- Department of Haematology, University Medical Centre, Utrecht, The Netherlands
| | - D Farge-Bancel
- Service de Médecine Interne, Maladies Autoimmunes et Pathologie Vasculaire, Hôpital St Louis, Paris, France
| | - A Gennery
- Paediatric Team Children's BMT Unit, Great North Children's Hospital, Royal Victoria Infirmary, Newcastle University, Newcastle-Upon-Tyne, UK
| | - N Kröger
- Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany
| | - F Lanza
- Hematology and BMT Unit, Cremona, Italy
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - A Sureda
- Hematology Department, Institut Català d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain
| | - M Mohty
- Department of Hematology, Hôpital Saint Antoine, Paris, France
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28
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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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Necchi A, Miceli R, Bregni M, Bokemeyer C, Berger LA, Oechsle K, Schumacher K, Kanfer E, Bourhis JH, Massard C, Laszlo D, Montoro J, Flechon A, Arpaci F, Secondino S, Wuchter P, Dreger P, Crysandt M, Worel N, Kruger W, Ringhoffer M, Unal A, Nagler A, Campos A, Wahlin A, Michieli M, Sucak G, Donnini I, Schots R, Ifrah N, Badoglio M, Martino M, Raggi D, Giannatempo P, Rosti G, Pedrazzoli P, Lanza F. Prognostic impact of progression to induction chemotherapy and prior paclitaxel therapy in patients with germ cell tumors receiving salvage high-dose chemotherapy in the last 10 years: a study of the European Society for Blood and Marrow Transplantation Solid Tumors Working Party. Bone Marrow Transplant 2015; 51:384-90. [DOI: 10.1038/bmt.2015.300] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/21/2015] [Accepted: 10/24/2015] [Indexed: 11/09/2022]
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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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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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Hahn M, Böttcher S, Dietrich S, Hegenbart U, Rieger M, Stadtherr P, Bondong A, Schulz R, Ritgen M, Schmitt T, Tran TH, Görner M, Herth I, Luft T, Schönland S, Witzens-Harig M, Zenz T, Kneba M, Ho AD, Dreger P. Allogeneic hematopoietic stem cell transplantation for poor-risk CLL: dissecting immune-modulating strategies for disease eradication and treatment of relapse. Bone Marrow Transplant 2015; 50:1279-85. [DOI: 10.1038/bmt.2015.150] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 05/21/2015] [Accepted: 05/22/2015] [Indexed: 12/21/2022]
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Blume CJ, Hotz-Wagenblatt A, Hüllein J, Sellner L, Jethwa A, Stolz T, Slabicki M, Lee K, Sharathchandra A, Benner A, Dietrich S, Oakes CC, Dreger P, te Raa D, Kater AP, Jauch A, Merkel O, Oren M, Hielscher T, Zenz T. p53-dependent non-coding RNA networks in chronic lymphocytic leukemia. Leukemia 2015; 29:2015-23. [DOI: 10.1038/leu.2015.119] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 04/02/2015] [Accepted: 04/30/2015] [Indexed: 12/23/2022]
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Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P, Duarte RF, Dufour C, Falkenburg JHF, Farge-Bancel D, Gennery A, Kröger N, Lanza F, Nagler A, Sureda A, Mohty M. Hematopoietic SCT in Europe 2013: recent trends in the use of alternative donors showing more haploidentical donors but fewer cord blood transplants. Bone Marrow Transplant 2015; 50:476-82. [PMID: 25642761 PMCID: PMC4387247 DOI: 10.1038/bmt.2014.312] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 12/04/2014] [Indexed: 12/18/2022]
Abstract
A record number of 39,209 HSCT in 34,809 patients (14,950 allogeneic (43%) and 19,859 autologous (57%)) were reported by 658 centers in 48 countries to the 2013 survey. Trends include: more growth in allogeneic than in autologous HSCT, increasing use of sibling and unrelated donors and a pronounced increase in haploidentical family donors when compared with cord blood donors for those patients without a matched related or unrelated donor. Main indications were leukemias, 11,190 (32%; 96% allogeneic); lymphoid neoplasias, 19,958 (57%; 11% allogeneic); solid tumors, 1543 (4%; 4% allogeneic); and nonmalignant disorders, 1975 (6%; 91% allogeneic). In patients without a matched sibling or unrelated donor, alternative donors are used. Since 2010 there has been a marked increase of 96% in the number of transplants performed from haploidentical relatives (802 in 2010 to 1571 in 2013), whereas the number of unrelated cord blood transplants has slightly decreased (789 in 2010 to 666 in 2013). The use of donor type varies greatly throughout Europe.
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Affiliation(s)
- J R Passweg
- EBMT Activity Survey Office, Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - H Baldomero
- EBMT Activity Survey Office, Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - P Bader
- Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt am Main, Germany
| | - C Bonini
- Ospedale San Raffaele, Milan, Italy
| | - S Cesaro
- Paediatric Haematology Oncology, Policlinico G.B. Rossi, Verona, Italy
| | - P Dreger
- Medizinische Klinik V, University of Heidelberg, Heidelberg, Germany
| | - R F Duarte
- Hospital Duran i Reynals, Barcelona, Spain
| | - C Dufour
- Institute G. Gaslini, Genova, Italy
| | - J H F Falkenburg
- Department of Hematology, University Medical Center, Leiden, The Netherlands
| | - D Farge-Bancel
- Service de Médecine Interne, Hopital St Louis, Paris, France
| | - A Gennery
- Institute of Cellular Medicine, Newcastle University, Newcastle-Upon-Tyne, UK
| | - N Kröger
- University Hospital Eppendorf, Hamburg, Germany
| | - F Lanza
- Hematology and BMT Unit, Cremona, Italy
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - A Sureda
- Hospital Duran i Reynals, Barcelona, Spain
| | - M Mohty
- Hospital Saint Antoine, Paris, France
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Sureda A, Bader P, Cesaro S, Dreger P, Duarte RF, Dufour C, Falkenburg JHF, Farge-Bancel D, Gennery A, Kröger N, Lanza F, Marsh JC, Nagler A, Peters C, Velardi A, Mohty M, Madrigal A. Indications for allo- and auto-SCT for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2015. Bone Marrow Transplant 2015; 50:1037-56. [PMID: 25798672 DOI: 10.1038/bmt.2015.6] [Citation(s) in RCA: 216] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 01/09/2015] [Indexed: 12/17/2022]
Abstract
This is the sixth special report that the European Society for Blood and Marrow Transplantation regularly publishes on the current practice and indications for haematopoietic SCT for haematological diseases, solid tumours and immune disorders in Europe. Major changes have occurred in the field of haematopoietic SCT over the last years. Cord blood units as well as haploidentical donors have been increasingly used as stem cell sources for allo-SCT, thus, augmenting the possibility of finding a suitable donor for a patient. Continuous refinement of conditioning strategies has also expanded not only the number of potential indications but also has permitted consideration of older patients or those with co-morbidity for a transplant. There is accumulating evidence of the role of haematopoietic SCT in non-haematological disorders such as autoimmune diseases. On the other hand, the advent of new drugs and very effective targeted therapy has challenged the role of SCT in some instances or at least, modified its position in the treatment armamentarium of a given patient. An updated report with revised tables and operating definitions is presented.
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Affiliation(s)
- A Sureda
- Department of Haematology, Institut Catala d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain
| | - P Bader
- Universitätsklinikum Frankfurt, Goethe-Universität, Klinik für Kinder- und Jugendmedizin, Frankfurt, Germany
| | - S Cesaro
- Paediatric Haematology Oncology, Policlinico G.B. Rossi, Verona, Italy
| | - P Dreger
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - R F Duarte
- Department of Haematology, Institut Catala d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain
| | - C Dufour
- Clinical And Experimental Hematology Unit. Institute G. Gaslini, Genoa, Italy
| | - J H F Falkenburg
- Department of Haematology, Leiden University Medical Center, Leiden, The Netherlands
| | - D Farge-Bancel
- Department of Haematology-BMT, Hopital St Louis, Paris, France
| | - A Gennery
- Children's BMT Unit, Great North Children's Hospital, Newcastle-Upon-Tyne, UK
| | - N Kröger
- Department of Stem Cell Transplantation, University hospital Eppendorf, Hamburg, Germany
| | - F Lanza
- Haematology and BMT Unit, Cremona, Italy
| | - J C Marsh
- Department of Haematological Medicine, King's College Hospital/King's College London, London, UK
| | - A Nagler
- Chaim Sheva Medical Center, Tel-Hashomer, Israel
| | - C Peters
- Stem Cell Transplantation Unit, St Anna Kinderspital, Vienna, Austria
| | - A Velardi
- Sezione di Ematologia, Dipartimento di Medicina Clinica e Sperimentale, Università di Perugia, Perugia, Italy
| | - M Mohty
- Department of Haematology, H. Saint Antoine, Paris, France
| | - A Madrigal
- Anthony Nolan Research Institute, Royal Free and University College, London, UK
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Basak GW, Wiktor-Jedrzejczak W, Labopin M, Schoemans H, Ljungman P, Kobbe G, Beguin Y, Lang P, Koenecke C, Sykora KW, Te Boome L, van Biezen A, van der Werf S, Mohty M, de Witte T, Marsh J, Dreger P, Kröger N, Duarte R, Ruutu T. Allogeneic hematopoietic stem cell transplantation in solid organ transplant recipients: a retrospective, multicenter study of the EBMT. Am J Transplant 2015; 15:705-14. [PMID: 25648262 DOI: 10.1111/ajt.13017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 08/21/2014] [Accepted: 09/11/2014] [Indexed: 01/25/2023]
Abstract
We conducted a questionnaire survey of the 565 European Society for Blood and Marrow Transplantation centers to analyze the outcome of allogeneic hematopoietic stem cell transplantation (alloSCT) in recipients of solid organ transplantation (SOT). We investigated 28 patients with malignant (N = 22) or nonmalignant diseases (N = 6), who underwent 31 alloSCT procedures: 12 after kidney, 13 after liver and 3 after heart transplantation. The incidence of solid organ graft failure at 60 months after first alloSCT was 33% (95% confidence interval [CI], 16-51%) for all patients, 15% (95% CI, 2-40%) for liver recipients and 50% (95% CI, 19-75%) for kidney recipients (p = 0.06). The relapse rate after alloSCT (22%) was low following transplantation for malignant disorders, despite advanced stages of malignancy. Overall survival at 60 months after first alloSCT was 40% (95% CI, 19-60%) for all patients, 51% (95% CI, 16-86%) for liver recipients and 42% (95% CI, 14-70%) for kidney recipients (p = 0.39). In summary, we show that selected SOT recipients suffering from hematologic disorders may benefit from alloSCT and experience enhanced long-term survival without loss of organ function.
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Affiliation(s)
- G W Basak
- The Medical University of Warsaw, Warsaw, Poland
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Abstract
OPINION STATEMENT The treatment of patients with classical Hodgkin's lymphoma relapsing after autologous stem cell transplantation represents a clear unmet need. Overall long-term outcome is not the same in these patients and therapeutic options in this setting are very heterogeneous and include salvage CT and/or RT followed or not by a second stem cell transplantation, palliative care, new drugs, or biological agents. Despite the absence of prospective, randomized, clinical trials, allogeneic stem cell transplantation either from a HLA identical sibling or a matched, unrelated donor represents an attractive option for those young patients with chemosensitive disease after being treated with a salvage protocol. The use of reduced intensity conditioning regimens has been able to drastically decrease nonrelapse mortality, although relapse rate remains a significant issue in this setting. More intense conditioning protocols could eventually decrease the relapse rate after the allogeneic procedure and, as indicated by a recent retrospective analysis of the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation, nonrelapse mortality does not represent a major problem nowadays for patients with multiply relapsed Hodgkin's lymphoma. Brentuximab vedotin is an antibody-drug conjugate that selectively delivers monomethyl auristatin E, an antimicrotubule agent, into CD30-expressing cells. Its use has been approved recently for patients with Hodgkin's lymphoma relapsing after autologous stem cell transplantation. As a single dose, brentuximab vedotin is able to achieve an objective response rate of 75 % with 34 % of the patients achieving a complete remission. Its widespread use will most certainly change the treatment paradigm of this subgroup of patients, either avoiding the allogeneic procedure in some patients or by increasing the group of potential candidates to an allogeneic transplant being used as a "bridge to allo." Additional information on long-term outcome of patients being treated with this drug or the development of prospective clinical trials in this setting will most probably give some light to this question we have nowadays.
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Affiliation(s)
- Anna Sureda
- Hematology Department, Institut Català d'Oncologia - Hospital Duran I Reynals, Avda. Gran Via, 199 - 203, L'Hospitalet de Llobregat, 08908, Barcelona, Spain,
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Müller C, Mytilineos J, Ottinger H, Arnold R, Bader P, Beelen D, Bornhäuser M, Dreger P, Eiermann T, Einsele H, Faé I, Fischer G, Füssel M, Holler E, Holzberger G, Horn P, Kröger N, Lindemann M, Seidl C, Spriewald B, Süsal C, Blasczyk R, Finke J. Deutscher Konsensus 2013 zur immungenetischen Spenderauswahl für die allogene Stammzelltransplantation. Transfusionsmedizin 2014. [DOI: 10.1055/s-0034-1383141] [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: 10/24/2022]
Affiliation(s)
- C. Müller
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - J. Mytilineos
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - H. Ottinger
- Klinik für Knochenmarktransplantation, Universitätsklinikum Essen
| | - R. Arnold
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - P. Bader
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - D. Beelen
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - M. Bornhäuser
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - P. Dreger
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - T. Eiermann
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - H. Einsele
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - I. Faé
- Vorstand der Dt. Gesellschaft für Immungenetik
| | - G. Fischer
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - M. Füssel
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - E. Holler
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | | | - P. Horn
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - N. Kröger
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | | | - C. Seidl
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | | | - C. Süsal
- Vorstand der Dt. Gesellschaft für Immungenetik
| | - R. Blasczyk
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - J. Finke
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
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Weidner CI, Ziegler P, Hahn M, Brümmendorf TH, Ho AD, Dreger P, Wagner W. Epigenetic aging upon allogeneic transplantation: the hematopoietic niche does not affect age-associated DNA methylation. Leukemia 2014; 29:985-8. [DOI: 10.1038/leu.2014.323] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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El-Najjar I, Boumendil A, Luan J, Bouabdallah R, Thomson K, Mohty M, Colombat P, Biron P, Tilly H, Pfreundschuh M, Cordonnier C, Sureda A, Cahn J, Vernant J, Gribben J, Cook G, Haynes A, Ferrant A, Finel H, Montoto S, Dreger P. The impact of total body irradiation on the outcome of patients with follicular lymphoma treated with autologous stem-cell transplantation in the modern era: a retrospective study of the EBMT Lymphoma Working Party. Ann Oncol 2014; 25:2224-2229. [DOI: 10.1093/annonc/mdu440] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Necchi A, Miceli R, Berger L, Schumacher K, Bourhis J, Laszlo D, Nicolas-Virelizier E, Arpaci F, Secondino S, Dreger P, Kruger W, Ringhoffer M, Unal A, Nagler A, Campos A, Wahlin A, Donnini I, Badoglio M, Pedrazzoli P, Lanza F. Impact of Response to Induction Chemotherapy in Patients with Germ Cell Tumors (Gct) Receiving Salvage High-Dose Chemotherapy (Hdct): a Study of the Ebmt Solid Tumors Working Party (Stwp). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu337.53] [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: 11/13/2022] Open
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Herth I, Dietrich S, Benner A, Hegenbart U, Rieger M, Stadtherr P, Bondong A, Tran TH, Weide R, Hensel M, Knauf W, Franz-Werner J, Welslau M, Procaccianti M, Görner M, Meissner J, Luft T, Schönland S, Witzens-Harig M, Zenz T, Ho AD, Dreger P. The impact of allogeneic stem cell transplantation on the natural course of poor-risk chronic lymphocytic leukemia as defined by the EBMT consensus criteria: a retrospective donor versus no donor comparison. Ann Oncol 2014; 25:200-6. [PMID: 24356631 DOI: 10.1093/annonc/mdt511] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In a single-center retrospective donor versus no-donor comparison, we investigated if allogeneic stem cell transplantation (alloSCT) can improve the dismal course of poor-risk chronic lymphocytic leukemia (CLL). PATIENTS AND METHODS All patients with CLL who were referred for evaluation of alloSCT within a 7-year time frame and had a donor search indication according to the EBMT criteria or because of Richter's transformation were included. Patients for whom a matched donor could be found within 3 months (matches) were compared with patients without such a donor (controls). Primary end point was overall survival measured from the 3-month landmark after search initiation. RESULTS Of 105 patients with donor search, 97 (matches 83; controls 14) were assessable at the 3-month landmark. Matches and controls were comparable for age, gender, time from diagnosis, number of previous regimens, and remission status. Disregarding if alloSCT was actually carried out or not, survival from the 3-month landmark was significantly better in matches versus controls [hazard ratio 0.38, 95% confidence interval (CI) 0.17-0.85; P = 0.014]. The survival benefit of matches remained significant on multivariate analysis. CONCLUSION This study provides first comparative evidence that alloSCT may have the potential to improve the natural course of poor-risk CLL as defined by the EBMT criteria.
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Affiliation(s)
- I Herth
- Department Medicine V, University of Heidelberg, Heidelberg
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Bazarbachi A, Cwynarski K, Boumendil A, Finel H, Fields P, Raj K, Nagler A, Mohty M, Sureda A, Dreger P, Hermine O. Outcome of patients with HTLV-1-associated adult T-cell leukemia/lymphoma after SCT: a retrospective study by the EBMT LWP. Bone Marrow Transplant 2014; 49:1266-8. [DOI: 10.1038/bmt.2014.143] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 05/19/2014] [Accepted: 05/23/2014] [Indexed: 12/11/2022]
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Dietrich S, Boumendil A, Finel H, Avivi I, Volin L, Cornelissen J, Jarosinska R, Schmid C, Finke J, Stevens W, Schouten H, Kaufmann M, Sebban C, Trneny M, Kobbe G, Fornecker L, Schetelig J, Kanfer E, Heinicke T, Pfreundschuh M, Diez-Martin J, Bordessoule D, Robinson S, Dreger P. Outcome and prognostic factors in patients with mantle-cell lymphoma relapsing after autologous stem-cell transplantation: a retrospective study of the European Group for Blood and Marrow Transplantation (EBMT). Ann Oncol 2014; 25:1053-8. [DOI: 10.1093/annonc/mdu097] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Ruutu T, Gratwohl A, de Witte T, Afanasyev B, Apperley J, Bacigalupo A, Dazzi F, Dreger P, Duarte R, Finke J, Garderet L, Greinix H, Holler E, Kröger N, Lawitschka A, Mohty M, Nagler A, Passweg J, Ringdén O, Socié G, Sierra J, Sureda A, Wiktor-Jedrzejczak W, Madrigal A, Niederwieser D. Erratum: Prophylaxis and treatment of GVHD: EBMT–ELN working group recommendations for a standardized practice. Bone Marrow Transplant 2013. [DOI: 10.1038/bmt.2013.210] [Citation(s) in RCA: 4] [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] [Indexed: 11/09/2022]
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Passweg JR, Baldomero H, Bregni M, Cesaro S, Dreger P, Duarte RF, Falkenburg JHF, Kröger N, Farge-Bancel D, Bobby Gaspar H, Marsh J, Mohty M, Peters C, Sureda A, Velardi A, Ruiz de Elvira C, Madrigal A. Hematopoietic SCT in Europe: data and trends in 2011. Bone Marrow Transplant 2013; 48:1161-7. [PMID: 23584439 PMCID: PMC3763517 DOI: 10.1038/bmt.2013.51] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 03/01/2013] [Accepted: 03/08/2013] [Indexed: 11/20/2022]
Abstract
In all, 651 from 680 centers in 48 countries reported 35 660 hematopoietic SCT (HSCT) in 32 075 patients (13 470 allogeneic (42%), 18 605 autologous (58%)) to the 2011 survey. Main indications were: leukemias; 10 113 (32%; 94% allogeneic); lymphoid neoplasias; non-Hodgkin's lymphoma, Hodgkin's lymphoma, plasma cell disorders; 18 433 (57%; 12% allogeneic); solid tumours; 1573 (5%; 5% allogeneic); and non-malignant disorders; 1830 (6%; 92% allogeneic). There were more unrelated donors than HLA identical sibling donors (54% versus 39%); proportion of peripheral blood as stem cell source was 99% for autologous and 73% for allogeneic HSCT. Cord blood was only used in allogeneic transplants (6% of total). In the past 10 years, the overall number of transplants has increased by 53%. Allogeneic HSCT have doubled (from 7272 to 14 549) while, autologous have increased by 32% and continue to increase by about 1100 HSCT per year since 2001. In the past 2 years, an increase of >2000 HSCT per year was seen. Transplant activity is shown by team size. For allogeneic HSCT, we show use of reduced-intensity conditioning versus myeloablative conditioning across Europe and use of post-transplant donor lymphocyte infusions with considerable variation across different countries.
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Affiliation(s)
- J R Passweg
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - H Baldomero
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - M Bregni
- Department of Oncology, Scientific Institute San Raffaele, Milan, Italy
| | - S Cesaro
- Paediatric Haematology Oncology, Policlinico G.B. Rossi, Verona, Italy
| | - P Dreger
- University of Heidelberg, Medizinische Klinik u. Poliklinik V, Heidelberg, Germany
| | - R F Duarte
- Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain
| | | | - N Kröger
- University Hospital Eppendorf, Hamburg, Germany
| | - D Farge-Bancel
- Service de Médecine Interne, Hopital St Louis, Paris, France
| | - H Bobby Gaspar
- Molecular Immunology Unit, UCL Institute of Child Health, London, UK
| | - J Marsh
- GKT School of Medicine, Department of Haematological Medicine, King's Denmark Hill Campus, London, UK
| | - M Mohty
- Universite Pierre and Maris Curie, INSERM UMRs 938, Hôpital Saint Antoine, Paris, France
| | - C Peters
- St Anna Kinderspital, BMT Unit, Vienna, Austria
| | - A Sureda
- Addenbrookes Hospital, Cambridge, UK
| | - A Velardi
- Ospedale Santa Maria della Misericordia - Sezione di Ematologia, Localitá Sant Andrea delle Fratte, Perugia, Italy
| | | | - A Madrigal
- Anthony Nolan Research Institute Royal Free Hospital, London, UK
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47
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Ruutu T, Gratwohl A, de Witte T, Afanasyev B, Apperley J, Bacigalupo A, Dazzi F, Dreger P, Duarte R, Finke J, Garderet L, Greinix H, Holler E, Kröger N, Lawitschka A, Mohty M, Nagler A, Passweg J, Ringdén O, Socié G, Sierra J, Sureda A, Wiktor-Jedrzejczak W, Madrigal A, Niederwieser D. Prophylaxis and treatment of GVHD: EBMT–ELN working group recommendations for a standardized practice. Bone Marrow Transplant 2013; 49:168-73. [DOI: 10.1038/bmt.2013.107] [Citation(s) in RCA: 200] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 05/16/2013] [Accepted: 05/18/2013] [Indexed: 11/09/2022]
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48
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Martínez C, Canals C, Sarina B, Alessandrino EP, Karakasis D, Pulsoni A, Sica S, Trneny M, Snowden JA, Kanfer E, Milpied N, Bosi A, Guidi S, de Souza CA, Willemze R, Arranz R, Jebavy L, Hellmann A, Sibon D, Oneto R, Luan JJ, Dreger P, Castagna L, Sureda A. Identification of prognostic factors predicting outcome in Hodgkin's lymphoma patients relapsing after autologous stem cell transplantation. Ann Oncol 2013. [PMID: 23712545 DOI: 10.1093/annonc/mdt206.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard of care for patients with relapsed Hodgkin's lymphoma (HL). However, there is currently little information on the predictors of outcome for patients whose disease recurs after ASCT. METHODS Five hundred and eleven adult patients with relapsed HL after ASCT from EBMT-GITMO databases were reviewed. RESULTS Treatments administered following ASCT failure included conventional chemotherapy and/or radiotherapy in 294 (64%) patients, second ASCT in 35 (8%), and alloSCT in 133 (29%). After a median follow-up of 49 months, overall survival (OS) was 32% at 5 years. Independent risk factors for OS were early relapse (<6 months) after ASCT, stage IV, bulky disease, poor performance status (PS), and age ≥50 years at relapse. For patients with no risk factors OS at 5 years was 62% compared with 37% and 12% for those having 1 and ≥2 factors, respectively. This score was also predictive for outcome in each group of rescue treatment after ASCT failure. CONCLUSION(S) Early relapse, stage IV, bulky disease, poor PS, and age ≥50 years at ASCT failure are relevant factors for outcome that may help to understand the results of different therapeutic approaches.
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Affiliation(s)
- C Martínez
- Hematology Department, Institute of Hematology and Oncology, Hospital Clinic, Barcelona, Spain.
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49
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Martínez C, Canals C, Sarina B, Alessandrino EP, Karakasis D, Pulsoni A, Sica S, Trneny M, Snowden JA, Kanfer E, Milpied N, Bosi A, Guidi S, de Souza CA, Willemze R, Arranz R, Jebavy L, Hellmann A, Sibon D, Oneto R, Luan JJ, Dreger P, Castagna L, Sureda A. Identification of prognostic factors predicting outcome in Hodgkin's lymphoma patients relapsing after autologous stem cell transplantation. Ann Oncol 2013; 24:2430-4. [PMID: 23712545 DOI: 10.1093/annonc/mdt206] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard of care for patients with relapsed Hodgkin's lymphoma (HL). However, there is currently little information on the predictors of outcome for patients whose disease recurs after ASCT. METHODS Five hundred and eleven adult patients with relapsed HL after ASCT from EBMT-GITMO databases were reviewed. RESULTS Treatments administered following ASCT failure included conventional chemotherapy and/or radiotherapy in 294 (64%) patients, second ASCT in 35 (8%), and alloSCT in 133 (29%). After a median follow-up of 49 months, overall survival (OS) was 32% at 5 years. Independent risk factors for OS were early relapse (<6 months) after ASCT, stage IV, bulky disease, poor performance status (PS), and age ≥50 years at relapse. For patients with no risk factors OS at 5 years was 62% compared with 37% and 12% for those having 1 and ≥2 factors, respectively. This score was also predictive for outcome in each group of rescue treatment after ASCT failure. CONCLUSION(S) Early relapse, stage IV, bulky disease, poor PS, and age ≥50 years at ASCT failure are relevant factors for outcome that may help to understand the results of different therapeutic approaches.
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Affiliation(s)
- C Martínez
- Hematology Department, Institute of Hematology and Oncology, Hospital Clinic, Barcelona, Spain.
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50
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Dietrich S, Andrulis M, Benner A, Pellagatti A, Giese T, Germing U, Baldus S, Boultwood J, Radujkovic A, Dreger P, Ho A, Luft T. P-105 Loss of proliferative phenotype and expression of CDKN1C/p57KIP2 in CD34+ cells predict poor prognosis of MDS. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70153-x] [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: 11/24/2022]
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