Successful stem cell harvest and autologous transplantation in a patient with cold agglutinin syndrome and aggressive lymphoma

2020 ◽  
pp. 1-3
Author(s):  
Alice Morigi ◽  
Beatrice Casadei ◽  
Lisa Argnani ◽  
Vittorio Stefoni ◽  
Emanuela Sergio ◽  
...  
Keyword(s):  
Stem Cell ◽  
Autologous Transplantation ◽  
Cold Agglutinin ◽  
Aggressive Lymphoma ◽  
Cell Harvest

Rituximab + ESHAP as Salvage Chemotherapy for Relapsed/Refractory Aggressive Non-Hodgkins Lymphoma: A Phase II Trial.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5230-5230 ◽  
Author(s):  
Lisa Hicks ◽  
R. Buckstein ◽  
E. Piliotis ◽  
J. Mangel ◽  
K. Imrie ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Response Rate ◽  
Bone Marrow Involvement ◽  
B Cell Lymphoma ◽  
Salvage Chemotherapy ◽  
Aggressive Lymphoma ◽  
Indolent Lymphoma ◽  
Preliminary Results ◽  
Cell Harvest

Abstract Background: Patients with relapsed or refractory aggressive B-cell lymphoma have a poor prognosis. If sensitive to salvage chemotherapy, high dose therapy followed by autologous stem cell transplant (ASCT) can result in long-term survival for some. Unfortunately, 50% of patients are insensitive to standard salvage regimens and thus are ineligible for ASCT. Hypothesis: Combining Rituximab with ESHAP may improve chemosensitivity and ASCT eligibility, of patients with CD20+, relapsed or refractory aggressive lymphoma, or CD20+ transformed indolent lymphoma. Objectives: The primary outcome was response rate (CR + CRu + PR) to R-ESHAP. Secondary outcomes were toxicity, ability to undergo ASCT, presence of minimal resdidual disease in the stem cell harvest, and progression free and overall survival. Methods: Eligible patients were 16–65 years old, had ECOG performance status 0–2, and had pathologically confirmed CD20+, relapsed/refractory aggressive lymphoma or transformed indolent lymphoma. Patients with refractory disease had a PR with initial anthracycline-based therapy. ESHAP (etoposide 40mg/m2 day 1–4, solumderol 500mg day 1–5, cytosine arabinoside 2g/m2 day 5, cisplatin 25mg/m2 day 1–4) was given every 28 days with GCSF support until < 15% bone marrow involvement was achieved (2–4 cycles). Eight infusions of Rituximab (375mg/m2) were administered weekly concurrent with the first 2 cycles of ESHAP. GCSF mobilized stems cells were collected on day 10 or 11 when < 15% bone marrow involvement was achieved (mainly in cycles 1 or 2). Results: Preliminary results of 14 of 44 planned patients are presented. Median age was 54 years (range 42–64). All pts had CD20+ aggressive lymphoma, 6 had relapsed aggressive lymphoma, 2 had refractory aggressive lymphoma (with PR after initial therapy) and 6 had transformed indolent lymphoma. Twelve of 14 patients were stage III/IV. The response rate to R-ESHAP was 93% (2 CR, 2 CRu, 9 PR, 1 PD). Thirteen of 14 patients proceeded to ASCT. Data on minimal residual disease in the stem cell harvest is pending. Grade 3–4 thrombocytopenia, neutropenia and anemia occurred with 53%, 31%, and 20% of R-ESHAP cycles respectively. Two of 14 patients had febrile neutropenia, one with bacteremia. Two patients had non-neutropenic bacteremia (1 with septic shock). There were no toxic deaths. Median follow-up post-ASCT is 5 months (range 1–18). Two patients progressed 4 and 5 months post-ASCT respectively. There were 3 deaths, 2 lymphoma related and 1 due to accelerated Parkinson’s Disease. Median PFS has not yet been reached. Conclusions: This trial is still accruing patients. However, preliminary results are promising. R-ESHAP appears to be well tolerated with a high response rate. This regimen may enable more patients with relapsed/refractory aggressive lymphoma or transformed indolent lymphoma to proceed to ASCT.

A Retrospective Single Institute Analysis of 127 Lymphoma Patients Who Underwent Allogeneic Stem Cell Transplantation: Impact on Peripheral T-Cell Lymphoma (PTCL) Including ATLL.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3031-3031 ◽  
Author(s):  
Ryuji Tanosaki ◽  
Sung-Won Kim ◽  
Satoshi Yamazaki ◽  
Takahiro Fukuda ◽  
Shin-ichiro Mori ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Autologous Transplantation ◽  
Aggressive Lymphoma ◽  
Cell Transplant ◽  
Resistant Disease ◽  
Poor Outcomes

Abstract Background Clinical application of allogeneic stem cell transplantation (allo-SCT) for lymphoma patients (pts) has been hampered by its high mortality rate. In order to explore and establish safe and efficient procedures, reduced-intensity stem cell transplantation (RIST) has been incorporated in recent protocols for lymphoma. Here we retrospectively analyzed our single institute experiences of allo-SCT for lymphoma. Results Between 1999 and 2005, 127 allo-SCTs, including 94 RIST (74%), were performed for lymphoma in our single institute. The number of each pathological classification and the one in which RIST was used, which is shown in each parenthesis, were PTCL (non-ATLL) 15 (RIST 13), ATLL 25 (18), NK/T 3 (2), FL 36 (29), MCL 6 (5), DLBCL 23 (17), LPL 1(1), HL 5 (5) and LBL 13 (4). Most patients were not eligible for autologous transplantation (auto-SCT) because of relapse after auto-SCT or chemo-resistant disease. Transplant-related mortality (TRM) were 16% in RIST and 45% in conventional stem cell transplant (CST) (p<0.001), and it was as high as 54% in aggressive lymphoma pts treated with CST (n=26). 3-year OS and PFS of FL, PTCL including 2 ALCL and 1 AILT, and ATLL were 80.6±6.6% and 80.6±6.6%, 46.7±12.9% and 60.0±12.6%, 46.5±10.3 and 57.1±10.6%, respectively, with the median follow-up of 737 days (range, -4–2628) in all these pts. Pts with other histology had poor outcomes and the numbers of pts surviving more than 1 year were HL 1 (20%), MCL 2 (33%), DLBCL 7 (30%), NK/T 1 (33%) and LBL 3 (23%). 5 pts with DLBCL were treated with auto-SCT/RIST tandem transplantation according to in-house protocol, and 4 out of 5 were alive in current CR with median follow-up of 749 days (range, 580–1038). Discussion Since RIST was associated with lower TRM than CST, it could be applied safely in heavily treated pts with refractory lymphoma. Most pts with DLBCL, NK/T, and LBL relapsed or died of disease. However, pts with FL, PTCL and ATLL, even in chemo-refractory cases, had durable remissions after RIST. In refractory DLBCL, de-bulking of the tumor by prior auto-SCT might be promising. Conclusions RIST could be performed comparatively safely. Notably, PTCL, both ATLL and non-ATLL, were newly highlighted as a good indication of RIST and should be further investigated. Figure Figure

Dexamethasone and Cyclophosphamide: More Convenient and as Effective as VAD before High-Dose Melphalan and Autologous Transplantation in Newly Diagnosed Multiple Myeloma. Results of a Randomized NMSG Trial.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 793-793
Author(s):  
Ulf-Henrik Mellqvist ◽  
Stig Lenhoff ◽  
Martin Hjorth ◽  
Erik Holmberg ◽  
Gunnar Juliusson ◽  
...  
Keyword(s):  
Stem Cell ◽  
Initial Treatment ◽  
Autologous Transplantation ◽  
Group Versus ◽  
Initial Therapy ◽  
High Dose ◽  
Newly Diagnosed ◽  
Significant Difference ◽  
High Dose Melphalan ◽  
Cell Harvest

Abstract Background. High-dose melphalan with autologous stem cell transplantation (ASCT) is established in the first line treatment of myeloma patients. The initial tumour reducing therapy before high-dose treatment is usually VAD, i.e., vincristine and doxorubicin in continuous infusion plus high dose dexamethasone. The anti-myeloma effect of high dose corticosteroids is indisputable but the role of vincristine and doxorubicin is unclear, and never scrutinized in randomized studies. Both of these drugs do have well-known side effects and the administration of VAD is somewhat complicated. Melphalan is very effective in myeloma treatment but not suited for initial treatment because of the stem cell toxicity. However, another alkylating agent like cyclophosphamide is feasible to use before stem cell harvest and has well documented anti-myeloma effect. Trying to simplify initial treatment before ASCT, the Nordic Myeloma Study Group (NMSG) initiated a prospective, randomized multicentre study comparing conventional initial therapy of three 4-week courses of VAD with two 3-week courses of Cy-Dex. Patients and methods. From Nov 2001 to Oct 2003, 315 patients younger than 65 years with symptomatic newly diagnosed myeloma were randomized to receive 3–4 courses of VAD or 2–3 cycles of Cy-Dex (cyclophosphamide 1000mg/sqm and dexamethasone 40mg/d days 1–4 and 9–12). Thereafter, both groups received cyclophosphamide 2g/sqm plus rhG-CSF (filgrastim) sc as mobilization therapy followed by stem cell harvest and subsequent high dose melfalan 200 mg/sqm supported by stem cell infusion. CR was defined as the disappearance of M-protein from serum and urine in agarose gel electrophoresis and &lt; 5 % plasma cells in a bone marrow aspirate. Results. Patients in the Cy-Dex group came quicker to ASCT, 3.2 months versus 4.5 for the VAD group. The study showed no significant difference in the proportion of patients undergoing ASCT, 137/158 pts (87 %) in the Cy-Dex group versus 133/157 pts (85 %) in the VAD group. Neither were there any significant differences in response rate. After the initial therapy there were 54 % major responses (7 % CR and 47 % PR) in the Cy-Dex group versus 55 % (11 % CR and 44 % PR) in the VAD-group. After ASCT the response rates were 76 % (32 % CR and 44 % PR) versus 72 % (34 % CR and 38 % PR) in the Cy-Dex and the VAD group respectively. Also, survival data were identical with a median event free survival time of 29 months and 75 % overall survival at three years, calculated from start of therapy for both groups. Conclusion. This randomized trial indicates that Cy-Dex speeds up and simplifies initial treatment with an efficacy comparable to VAD. Cy-Dex can be recommended as a safe alternative for initial therapy in patients planned to undergo ASCT, and should be further studied in combination with novel agents, such as thalidomide, bortezomib and lenalidomide.

scholarly journals Peripheral Blood Stem Cell Harvest Regimen in Patients with Ewing's Sarcoma.

2000 ◽  
Vol 49 (1) ◽  
pp. 278-282 ◽  
Author(s):  
Tomoyuki Miyagi ◽  
Kazuhiro Tanaka ◽  
Shuichi Matsuda ◽  
Hisakata Yamada ◽  
Masanobu Oishi ◽  
...  
Keyword(s):  
Stem Cell ◽  
Peripheral Blood ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Peripheral Blood Stem Cell ◽  
Blood Stem Cell ◽  
Cell Harvest

scholarly journals The Feasibility and Applicability of Stem Cell Therapy for the Cure of Type 1 Diabetes

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1589
Author(s):  
Ryota Inoue ◽  
Kuniyuki Nishiyama ◽  
Jinghe Li ◽  
Daisuke Miyashita ◽  
Masato Ono ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Stem Cell ◽  
Cell Therapy ◽  
Stem Cell Therapy ◽  
Islet Cells ◽  
Autologous Transplantation ◽  
Insulin Injection ◽  
Islet Cell Transplantation ◽  
The Impact

Stem cell therapy using islet-like insulin-producing cells derived from human pluripotent stem cells has the potential to allow patients with type 1 diabetes to withdraw from insulin therapy. However, several issues exist regarding the use of stem cell therapy to treat type 1 diabetes. In this review, we will focus on the following topics: (1) autoimmune responses during the autologous transplantation of stem cell-derived islet cells, (2) a comparison of stem cell therapy with insulin injection therapy, (3) the impact of the islet microenvironment on stem cell-derived islet cells, and (4) the cost-effectiveness of stem cell-derived islet cell transplantation. Based on these various viewpoints, we will discuss what is required to perform stem cell therapy for patients with type 1 diabetes.

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