Allogeneic and autologous stem cell transplantation for hepatosplenic T-cell lymphoma: a retrospective study of the EBMT Lymphoma Working Party.
Tanase A, Schmitz N, Stein H, Boumendil A, Finel H, Castagna L, Blaise D, Milpied N, Sucak G, Sureda A, Thomson K, Vandenberghe E, Vitek A, Dreger P.
Leukemia. 2014 Sep 19. doi: 10.1038/leu.2014.280. [Epub ahead of print]
Hepatosplenic T-cell lymphoma is a rare but aggressive peripheral T-cell lymphoma , which resulted in poor outcome after conventional therapy. Results of allogeneic or autologous stem cell transplantation for this disorder has not been studied in a larger cohort of patient. Within the EBMT database 76 patients could be identified who received stem cell transplantation. However within the study of the Lymphoma WP only 25 could be analyzed after diagnosis was histologically verified. Of those, 18 received an allograft and 7 and an autograft. While after autologous stem cell transplantation 5 out of 7 relapsed, the 3 year progression free survival after allogeneic stem cell transplantation was 48% suggesting a graft versus T-cell lymphoma effect which may cure patients with this aggressive form of T-cell lymphoma.
Treosulfan-based conditioning regimens for allogeneic HSCT in children with acute lymphoblastic leukaemia.
Boztug H, Zecca M, Sykora KW, Veys P, Lankester A, Slatter M, Skinner R, Wachowiak J, Pötschger U, Glogova E, Peters C; on behalf of the EBMT paediatric diseases working party.
Ann Hematol. 2014 Sep 19. [Epub ahead of print]
Total body irradiation is part of the standard conditioning regimen for allogeneic stem cell transplantation in patients with acute lymphoblastic leukemia (ALL). However, especially in children, total body irradiation can cause severe late effect such as growth retardation and secondary malignancies. Treosulfan has been shown to be an alkylating agent with antileukemic activity without severe side effects. The pediatric WP analyzed within a retrospective study the toxicity and efficacy of a treosulfan-based conditioning regimen in 71 patients with ALL prior to allogeneic stem cell transplantation. The toxicity was low and 14% died from non–relapse causes. The 3 year overall survival was 51% and in a multivariate analysis only not being in complete remission at time of transplantation influenced the outcome significantly. The authors conclude that treosulfan-based conditioning regimen may be a alternative to TBI containing regimen in children who need allogeneic stem cell transplantation for ALL.
Early administration of donor lymphocyte infusions upon molecular relapse after allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia: a study by the Chronic Malignancies Working Party of the EBMT.
Chalandon Y, Passweg JR, Guglielmi C, Iacobelli S, Apperley J, Schaap NP, Finke J, Robin M, Fedele R, Bron D, Yakoub-Agha I, van Biezen A, de Witte T, Kröger N, Olavarria E; Chronic Malignancies Working Party of the European Group for Blood and Marrow Transplantation (EBMT).
Haematologica. 2014 Sep;99(9):1492-
Donor lymphocyte infusion has been shown to be effective in treatment of relapse after allogeneic stem cell transplantation, especially for CML. Even if CML is now widely treated by TKI and transplantation is now only performed in more advanced disease or in TKI refractory patients, this study of the CMWP provide further insight into the efficacy of DLI. This study included 155 patient who received DLI for relapsed CML after allogeneic stem cell transplantation. The overall survival after 5 years was excellent with 76% and only negatively influenced by the use of unrelated donor T-cells. Interestingly, there was no benefit if DLI were given early after detection of molecular relapse. This study demonstrated again the high efficacy of DLI in CML patient who relapsed after allogeneic stem cell transplantation.
Unrelated cord blood transplantation for patients with primary or secondary myelofibrosis.
Robin M, Giannotti F, Deconinck E, Mohty M, Michallet M, Sanz G, Chevallier P, Cahn JY, Legrand F, Rovira M, Passweg J, Sierra J, Nguyen S, Maillard N, Yakoub-Agha I, Linkesch W, Cannell P, Marcatti M, Bay JO, Chalandon Y, Kröger N, Gluckman E, Rocha V, Olavarria E, Ruggeri A; Eurocord and Chronic Malignancies Working Party-European Group for Blood and Marrow Transplantation (CMWP-EBMT).
Biol Blood Marrow Transplant. 2014 Nov;20(11):1841-6.
Advanced phase of Primary and post ET/PV myelofibrosis has become a standard indication for stem cell transplantation. Retrospective and prospective studies suggest that unrelated mismatch transplantation resulted in worse outcome. Due to the spleen size and the bone marrow fibrosis graft failure and poor graft function are particular problems in allogeneic stem cell transplantation for myelofibrosis. In this study performed by Eurocord and the CMWP 35 patients with myelofibrosis were studied who received unrelated cord blood transplantation. The median age of the patients was 54 years. The major problem was engraftment and the cumulative incidence of neutrophil engraftment on day 60 was only 80%, resulting in a 2 year overall and event-free survival of 44% and 30%, respectively.
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