Single institution retrospective review of CD34+ apheresis collection based on mobilization regimen and primary diagnosis

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S161-S162
Author(s):  
C Puzo ◽  
P Li ◽  
A Siddon ◽  
C Tormey
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
B Cell Lymphoma ◽  
Primary Diagnosis ◽  
Lower Percentage ◽  
Non Hodgkin Lymphoma ◽  
Lower Baseline ◽  
Age Range ◽  
Stem Cell Collection

Abstract Introduction/Objective Plerixafor has been increasingly used in conjunction with G-CSF to increase mobilization of CD34+ stem cells in patients undergoing leukapheresis collection for autologous stem cell transplantation. While G- CSF and plerixafor have been shown to increase CD34+ counts, studies examining patients’ ability to meet collection goals for patients with multiple myeloma (MM), diffuse large B-cell lymphoma (DLBCL), Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL) have not been well documented. Methods/Case Report All autologous stem cell collection patients between 2017-2021 were retrospectively reviewed and categorized by primary diagnosis. Patients received a mobilization regimen of G-CSF alone, G-CSF and plerixafor, G-CSF and chemotherapy, or G-CSF, plerixafor, and chemotherapy. CD34+ stem cell collection results were recorded. All units of CD34+ stem cells were processed according to protocol and viability was assessed by Trypan blue method on a thawed aliquot 2 weeks after processing. Results (if a Case Study enter NA) 385 patients (271 MM, 41 DLBCL, 30 HL, and 43 NHL patients; male: 242; female: 143; age range: 16-78) were identified. Binomial logistic regression demonstrated that use of plerixafor with G- CSF was negatively associated with meeting CD34+ goal collection (OR= -1.57, p= 0.003) compared to G-CSF alone. This result was particularly true for MM patients (OR= -1.62, p= 0.014). A pairwise t-test indicated that patients receiving G-CSF and plerixafor had lower CD34+ cell viabilities (t= 2.21, p = 0.028); after Bonferroni correction for multiple comparisons, MM samples also had significantly lower percentage viability than DLBCL (p= 0.003) or HL (p= 0.022) samples. Conclusion A higher percentage of patients mobilized on G-CSF alone were able to meet collection goal versus patients who were mobilized on G-CSF and plerixafor. Patients who received G-CSF and plerixafor had significantly lower viability than those who received G-CSF alone. We hypothesize these findings to be due to lower baseline mobilization for patients on G-CSF and plerixafor.

scholarly journals Long-term outcomes, secondary malignancies and stem cell collection following bendamustine in patients with previously treated non-Hodgkin lymphoma

2017 ◽  
Vol 178 (2) ◽  
pp. 250-256 ◽  
Author(s):  
Peter Martin ◽  
Zhengming Chen ◽  
Bruce D. Cheson ◽  
Katherine S. Robinson ◽  
Michael Williams ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Secondary Malignancies ◽  
Long Term Outcomes ◽  
Non Hodgkin Lymphoma ◽  
Previously Treated ◽  
Stem Cell Collection

“Fludarabine Containing-Regimens May Adversely Affect Peripheral Blood Stem Cell Collection in Low-Grade Non Hodgkin Lymphoma Patients”

2000 ◽  
Vol 37 (1-2) ◽  
pp. 157-161 ◽  
Author(s):  
Daniele Laszlo ◽  
Piero Galieni ◽  
Donatella Raspadori ◽  
Giulia Scalia ◽  
Catia Bigazzi ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cell ◽  
Blood Stem Cell ◽  
Low Grade ◽  
Non Hodgkin Lymphoma ◽  
Stem Cell Collection

Comparison of Autologous Vs. Allogeneic Stem Cell Transplantation for Non-Hodgkin Lymphoma

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2036-2036
Author(s):  
Nishitha M. Reddy ◽  
Olalekan O Oluwole ◽  
John P Greer ◽  
David S Morgan ◽  
Stacey Goodman ◽  
...  
Keyword(s):  
Stem Cell ◽  
T Cell ◽  
Stem Cell Transplantation ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Cell Lymphoma ◽  
Conditioning Regimen ◽  
B Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Non Hodgkin Lymphoma

Abstract Abstract 2036 Background: Stem cell transplantation (SCT) is a common indication for patients with Non-Hodgkin lymphoma (NHL). Auto-SCT is recommended for patients with relapsed NHL or as consolidative therapy in first remission. Allo-SCT is reserved for pts with either relapsed or primary refractory disease. The outcomes of these pts in large prospective studies are lacking and current recommendations and timing of selection of auto vs. allo-SCT are influenced by variety of factors including physician bias. Transplant outcomes of auto or allo-SCT have not been elucidated as a single cohort. Methods: We report a retrospective analysis of 270 pts with NHL who underwent auto-SCT or allo-SCT between January 2000- December 2010 after obtaining institutional IRB approval. Data were analyzed using SPSS.19. Results: Of the 270 pts, 238 patients underwent SCT for B-cell lymphoma (178 auto, 60 allo-SCT), and 32 for T-cell lymphoma (21 auto and 11 allo-SCT). Fifteen pts (6%) received prior auto-SCT. The median age of transplant was 52 years for the entire group. For those who underwent allo-SCT, median age was 47 (range 22–65 yrs) and 54 yrs (range 22–77) for auto-SCT. One hundred seventy (62%) were male. Majority of pts (76%) had advanced stage disease (stages III and IV). Fifty four (20%) received radiation therapy either before or after transplantation. The median number of prior regimens for allo-SCT were 3 (range 1–5) and 2 for auto-SCT (range 1 to 4). Within the allo-SCT group (n=71), 45 received matched-related donor transplants, and 26 unrelated donor transplants; majority of pts (n=47) received reduced intensity conditioning regimen. The auto-SCT group predominantly received CBV as their conditioning regimen. Median time from diagnosis to allo-SCT or auto-SCT was 1.4 yrs (range 0.32–13.1 yrs) and 1.69 (range 0.38–13.7 yrs), respectively. The median follow up time for the entire cohort was 6.2 yrs. The overall survival (OS) rates for the B- cell and T-cell NHL were 58% and 50% respectively (allo-SCT 51% vs. 54% for B and T-cell NHL, and auto-SCT 60% vs. 47% for B and T-cell lymphoma, respectively) (p=0.26). Within the allo-SCT group the relapse and non-relapse mortalities were 45% and 16%, respectively. In the auto-SCT group, the relapse and non-relapse mortality were 46% and 7% respectively. In B-cell lymphoma the relapse rate was 48% and 45% for auto and allo-SCT respectively (p=0.80). In T-cell lymphoma the relapse rate was 40% and 45% for auto and allo-SCT (p=0.67). Multivariate analysis of pts receiving auto vs. allo-SCT in NHL will be presented. Conclusions: We conclude that in this highly selected patient population with otherwise minimal comorbidities but chemo-sensitive aggressive lymphomas, about 50% of patients achieve long term survival after either an auto or allo-SCT approach. Despite recent evidence, there are intricate difficulties in patient selection for allo vs. auto-SCT and outcome of either approach is not satisfactory. Post transplant relapse is the most common cause of post-SCT failure. Tandem auto followed by allo-SCT and maintenance strategies need to be explored. We propose a larger prospective analysis on transplant outcomes in both B and T-cell lymphoma and improve strategies to prevent relapses after SCT. Disclosures: No relevant conflicts of interest to declare.

Comparison of Post-Transplant Outcomes in Non-Hodgkin Lymphoma (NHL) Patients Mobilized with or without Plerixafor Added to Chemomobilization

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4520-4520
Author(s):  
Ville Varmavuo ◽  
Johanna Rimpiläinen ◽  
Anne Nihtinen ◽  
Kaija Vasala ◽  
Maija Mikkola ◽  
...  
Keyword(s):  
Stem Cells ◽  
Hodgkin Lymphoma ◽  
B Cell Lymphoma ◽  
Control Group ◽  
Transplant Outcome ◽  
Post Transplant ◽  
Transplant Outcomes ◽  
Non Hodgkin Lymphoma ◽  
Cd34 Cells ◽  
The Impact

Abstract Abstract 4520 Background: Plerixafor, a CXCR4 antagonist, is used in a combination with G-CSF with or without chemotherapy to enhance mobilization of hematopoietic stem cells (CD34+) from the bone marrow to circulation. Prior studies have shown that plerixafor may mobilize more primitive stem cells and also have impact on other cell populations too. These changes may have impact in engraftment, immunological reconstitution and post-transplant outcome. However, only limited data are available in regard to effects of plerixafor in post-transplant outcomes. Patients and methods: Eighty-nine patients with non-Hodgkin lymphoma (NHL) were included in this study. The patients received disease-specific chemomobilization (most commonly cytarabine based) with G-CSF. In addition, 33 patients (37 %) received plerixafor because of insufficient mobilization, poor collection yields or late mobilization (plerixafor group). Fifty-six patients served as controls (control group). The median age was 58 years in the plerixafor group and 57 years in the control group (p=0.515). The most common histology was diffuse large B-cell lymphoma in both groups. The proportion of patients beyond CR1 or PR1 was significantly higher (55 % vs. 32%, p=0.046) in the plerixafor group. All patients were treated with a single dose (6 mg) of pegfilgrastim after stem cell infusion. Patients were followed after high-dose chemotherapy in regard to haematopoietic engraftment and outcome. Results: The median amount of collected CD34+ cells was 3.5 × 106 CD34+ cells/kg (range 1.3 – 8.9 × 106 CD34+ cells/kg) in the plerixafor group and 4.2 × 106 CD34+ cells/kg (range 1.9 – 18.6 × 106 CD34+ cells/kg) in the control group (p=0.076). The median number of aphaeresis was two (range 1–5) in both groups (p=0.17). The median neutrophil engraftment was 10 days in both groups (range 8–81 days in the plerixafor group and 8–21 days in the control group). The median time to platelet engraftment was 14 days in both groups (range 10–165 days in the plerixafor group and 10–91 days in the control group). The incidence of neutropenic fever was comparable between the groups (71% vs. 76%, p=0.906). The median follow-up time from ASCT was 373 days (range 5–929 days) in the plerixafor group and 518 days (range 81–1175 days) in the control group (p=0.052). No difference in counts of haemoglobin, leucocytes, lymphocytes or platelets were observed at +1, +3, +6, +12 months except for haemoglobin which was significantly higher in the plerixafor group at +3 months. Progression-free survival (PFS) was 72 % in the plerixafor group and 75 % in the control group (p=0.69). Overall survival (OS) was also comparable between the groups (82 % vs. 84 %, p=0.67). Conclusions: The recovery from ASCT and outcome after ASCT seems to be comparable in lymphoma patients whether plerixafor is used or not. Prospective studies including more detailed characterisation of graft cellular content in regard to CD34+ cell subtypes, T-cell repertoire and NK-cells are needed to assess the impact of mobilization method post-transplant outcome. Disclosures: Jantunen: Genzyme: Has participated in EU Leadership meeting organized by Genzyme as well as Medical Advisory Board meeting organized by Genzyme Other, Honoraria.

scholarly journals Comparison of Survival Between Autologous and Allogeneic Stem Cell Transplantation in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma: A Meta-Analysis

2020 ◽  
Vol 29 ◽  
pp. 096368972097539
Author(s):  
Jianhong Wang ◽  
Xiaohui Duan ◽  
Lijie Yang ◽  
Xiangxiang Liu ◽  
Caixia Hao ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Meta Analysis ◽  
B Cell Lymphoma ◽  
Free Survival ◽  
Non Hodgkin Lymphoma

This study aimed to compare the efficacy of allogeneic stem cell transplantation (allo-SCT) versus autologous SCT (auto-SCT) in patients with relapsed or refractory B-cell non-Hodgkin lymphoma (B-NHL). Medline, CENTRAL, and EMBASE databases through December 31, 2019 were searched. The primary endpoints were overall survival (OS) and progression-free survival (PFS) rates. The secondary outcomes include transplant-related mortality (TRM), event-free survival, relapse/or progression, and nonrelapse mortality (NRM). The 18 retrospective studies enrolled 8,058 B-NHL patients (allo-SCT = 1,204; auto-SCT = 6,854). The OS was significantly higher in patients receiving auto-SCT than allo-SCT (pooled odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.29 to 2.22, P < 0.001), but no significant difference was found in PFS (pooled OR: 0.98, 95% CI: 0.69 to 1.38, P = 0.891). Auto-SCT patients also had lower TRM and NRM (TRM: OR = 0.23, P < 0.001; NRM: OR = 0.16, P < 0.001), but higher relapse or progression rate (OR = 2.37, P < 0.001) than allo-SCT patients. Subgroup analysis performed for different grades and subtypes of B-NHL showed higher OS in auto-SCT patients with high-grade B-NHL and diffused large B-cell lymphoma (DLBCL). There was, nevertheless, higher PFS in allo-SCT patients with low-grade B-NHL and follicular lymphoma (FL), and lower PFS in allo-SCT patients with DLBCL than their auto-SCT counterparts. In conclusion, the meta-analysis demonstrated that relapsed or refractory B-NHL patients who received auto-SCT have improved OS than those treated with allo-SCT, especially among those with DLBCL, but lower PFS among those with FL. However, the study is limited by a lack of randomized trials, patients’ heterogeneity, and possible selection bias.

scholarly journals Single-Agent Pixantrone as a Bridge to Autologous Stem Cell Transplantation in a Patient with Refractory Diffuse Large B-Cell Lymphoma

Chemotherapy ◽  
2017 ◽  
Vol 62 (3) ◽  
pp. 187-191 ◽  
Author(s):  
Lorena Appio ◽  
Carlo Landoni ◽  
Maria La Targia ◽  
Vanda Bertolli ◽  
Martina Chiarucci ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Hodgkin Lymphoma ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Single Agent ◽  
B Cell Lymphoma ◽  
Term Survival ◽  
Bulky Disease ◽  
Non Hodgkin Lymphoma

Aggressive non-Hodgkin lymphoma is associated with poor long-term survival after relapse or resistance to chemotherapy. We report a case of aggressive non-Hodgkin lymphoma refractory to first-line R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) and second-line R-DHAP (rituximab, dexamethasone, cytarabine, and cisplatin) chemotherapy treatments. The patient achieved remission with single-agent pixantrone, and received a consolidation with high-dose BEAM (BCNU, etoposide, cytarabine, and melphalan) chemotherapy and autologous stem cell transplantation. He received consolidation radiotherapy on the site of bulky disease. At 20 months from transplant, the disease is in continuous complete remission. The successful use of pixantrone as a bridge to transplant is highlighted, together with the absence of serious side effects.

Detection of Pre-Transplant Clonal Cytogenetic Abnormalities in Stem Cells Used for Autologous Stem Cell Transplant in Relapsed Non-Hodgkin Lymphoma Is a Predictor of Relapse

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4451-4451
Author(s):  
Ana Maria Rojas ◽  
Lauren Pinter-Brown ◽  
Sven De Vos ◽  
Ronald Paquette ◽  
Gary J Schiller ◽  
...  
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Stem Cell Transplant ◽  
Autologous Stem Cell Transplant ◽  
High Dose ◽  
Cell Transplant ◽  
Cytogenetic Abnormalities ◽  
Non Hodgkin Lymphoma ◽  
Cytogenetic Changes

Abstract Autologous stem cell transplant is used for chemotherapy sensitive relapsed Non-Hodgkin Lymphoma (NHL). Patients who receive an autologous stem cell transplant after high dose chemotherapy for relapsed NHL have significantly superior survival compared to those receiving conventional chemotherapy. Relapsed patients who achieve a second remission are treated with myeloablative chemotherapy followed by autologous stem cell transplant. These patients can achieve 5-year event free survival close to 50% and 5-year overall survival of greater than 50%. We performed a retrospective analysis of our center’s transplant data and reviewed pre-transplant cytogenetic analysis on the patient’s collected stem cells. 259 patients underwent autologous stem cell transplant from 1998 through 2007 for relapsed NHL. Cytogenetic evaluations of the patient’s pre-transplant stem cells had been done to look for evidence of MDS or characteristics of their lymphoma. Clonal cytogenetic abnormalities were found in 12 of the 259 patients. Two of these patients died within 45 days of transplant without evidence of relapse. One from infection and a second from non-treatment related causes. Nine of the remaining 11 (81%) patients with clonal cytogenetic abnormalities have relapsed and died. All patients relapsed with their original lymphoma. The cytogenetic abnormalities were varied. Out of the 9 relapses, 3 had cytogenetic abnormalities in the stem cells that are associated with lymphoma, 2 that are associated with AML, 1 that is associated with MDS, and 2 were abnormalities whose significance was unknown. In one patient cytogenetic changes of the original lymphoma were identified. The patients that had clonal cytogenetic abnormalities in their collected stem cells had an 81% relapse rate as opposed to 30% in the patients whose stem cells had a normal karyotype. Our findings show that cytogenetic changes in the collected stem cells are associated with a higher rate of lymphoma relapse.

scholarly journals A Retrospective Comparison of DLI and gDLI for Post-Transplant Treatment

2020 ◽  
Vol 9 (7) ◽  
pp. 2204
Author(s):  
Sylvain Lamure ◽  
Franciane Paul ◽  
Anne-Laure Gagez ◽  
Jérémy Delage ◽  
Laure Vincent ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Progression Free Survival ◽  
Donor Lymphocyte Infusion ◽  
Disease Rate ◽  
Free Survival ◽  
Graft Versus Host ◽  
Non Hodgkin Lymphoma ◽  
Retrospective Comparison ◽  
Stem Cell Collection

Donor lymphocyte infusion (DLI) is used to prevent or treat haematological malignancies relapse after allogeneic stem cell transplantation (allo-SCT). Recombinant human granulocyte colony-stimulated factor primed DLI (gDLI) is derived from frozen aliquots of the peripheral blood stem cell collection. We compared the efficacy and safety of gDLI and classical DLI after allo-SCT. We excluded haploidentical allo-SCT. Initial diseases were acute myeloblastic leukaemia (n = 45), myeloma (n = 38), acute lymphoblastic leukaemia (n = 20), non-Hodgkin lymphoma (n = 10), myelodysplasia (n = 8), Hodgkin lymphoma (n = 8), chronic lymphocytic leukaemia (n = 7), chronic myeloid leukaemia (n = 2) and osteomyelofibrosis (n = 1). Indications for DLI were relapse (n = 96) or pre-emptive treatment (n = 43). Sixty-eight patients had classical DLI and 71 had gDLI. The response rate was 38.2%, the 5-year progression-free survival (PFS) rate was 38% (29–48) and the 5-year overall survival (OS) rate was 37% (29–47). Graft versus host disease rate was 46.7% and 10.1% of patients died from toxicity. There were no differences between classical DLI and gDLI in terms of response (p = 0.28), 5-year PFS (p = 0.90), 5-year OS (p. 0.50), GvHD (p = 0.86), treated GvHD (p = 0.81) and cause of mortality (p. 0.14). In conclusion, this study points out no major effectiveness or toxicity of gDLI compared to classical DLI.

Evaluation of R-CHOP and R-CVP in the treatment of elderly patient with non-Hodgkin lymphoma

MedPharmRes ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 1-6
Author(s):  
Truc Phan ◽  
Tram Huynh ◽  
Tuan Q. Tran ◽  
Dung Co ◽  
Khoi M. Tran
Keyword(s):  
Elderly Patients ◽  
Hodgkin Lymphoma ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
The Elderly ◽  
Free Survival ◽  
Non Hodgkin Lymphoma ◽  
Common Sign ◽  
Related Mortality

Introduction: Little information is available on the outcomes of R-CHOP (rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone) and R-CVP (rituximab with cyclophosphamide, vincristine and prednisone) in treatment of the elderly patients with non-Hodgkin lymphoma (NHL), especially in Vietnam. Material and methods: All patients were newly diagnosed with CD20-positive non-Hodgkin lymphoma (NHL) at Blood Transfusion and Hematology Hospital, Ho Chi Minh city (BTH) between 01/2013 and 01/2018 who were age 60 years or older at diagnosis. A retrospective analysis of these patients was perfomed. Results: Twenty-one Vietnamese patients (6 males and 15 females) were identified and the median age was 68.9 (range 60-80). Most of patients have comorbidities and intermediate-risk. The most common sign was lymphadenopathy (over 95%). The proportion of diffuse large B cell lymphoma (DLBCL) was highest (71%). The percentage of patients reaching complete response (CR) after six cycle of chemotherapy was 76.2%. The median follow-up was 26 months, event-free survival (EFS) was 60% and overall survival (OS) was 75%. Adverse effects of rituximab were unremarkable, treatment-related mortality accounted for less than 10%. There was no difference in drug toxicity between two regimens. Conclusions: R-CHOP, R-CVP yielded a good result and acceptable toxicity in treatment of elderly patients with non-Hodgkin lymphoma. In patients with known cardiac history, omission of anthracyclines is reasonable and R-CVP provides a competitive complete response rate.

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