scholarly journals Failure Pattern of Treatment of Hodgkin Lymphoma -- Retrospective from a Single Institution

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5366-5366
Author(s):  
Tran-Der Tan ◽  
Lun-Wei Chiou
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Treatment Failure ◽  
Hodgkin Lymphoma ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Salvage Chemotherapy ◽  
Hematopoietic Stem

Backgound: Hodgkin lymphoma is a highly curable malignant disease by chemotherapy or chemoradiation. However, there is still small percentage of patients can not achieved complete remission or relapsed later then died of disease refractoriness. We investigated the treatment failure pattern in those relapsed and refractory patients. Method: This is a retrospective study of patients treated at our institute in ten years with ABVD +/- RT. For relapsed patients, the salvage chemotherapy includes DHAP, ICE, or GDP, and patients may undergo high dose chemotherapy plus hematopoietic stem cell transplantation when second remission achieved. Results: Between 2002 and 2012, we have treated 108 patients of Hodgkin lymphom and the ten-year overall survival was 92% with stage I and II (N=63) versus III and IV (N=45) were 100% and 80%, respectively. Twenty patients got disease relapsed after ABVD +/- RT with 6 patients died of disease refractoriess and 14 patients achieved second remission after salvage chemotherapy then underwent hematopoietic stem cell transplantation with 11 survived over ten years. In these 20 relapsed patients, the initial involved sites include lung (n=8), bone (n=5),bone marrow (n=5), liver (n=3), mediastinal bulky (n=2), nodal only (n=2). Conclusion: Stage IV with extramedullary involvement over lung, bone, bone marrow and liver are high risk for treatment failure and earlier intensive treatment is warranted. Disclosures No relevant conflicts of interest to declare.

Gemcitabine-Based Salvage Chemotherapy as a Bridge to Allogeneic Hematopoietic Stem Cell Transplantation for the Patients with Relapse of Hodgkin Lymphoma After Autologous Hematopoietic Stem Cell Transplantation.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2822-2822
Author(s):  
Anna Czyz ◽  
Adam Nowicki ◽  
Lidia Gil ◽  
Dominik Dytfeld ◽  
Anna Lojko-Dankowska ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Hodgkin Lymphoma ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Response Rate ◽  
Salvage Chemotherapy ◽  
Hematopoietic Stem ◽  
Reduced Intensity

Abstract Abstract 2822 An optimal therapy for patients with Hodgkin lymphoma (HL) who experience relapse after autologous hematopoietic stem cell transplantation (autoHSCT) has not been established. Gemcitabine has been shown to be effective in patients with relapsed or refractory lymphoma. We evaluated the efficacy and safety of gemcitabine-based chemotherapy in 22 patients (median age 33 years, range 23–56 years) with relapse of HL at a median of 7 months (range 3–82) after autoHSCT preceded by a median of 3 (range 2–6) previous chemotherapy lines. Two patients relapsed after autoHSCT followed by allogeneic hematopoietic stem cell transplantation (alloHSCT). The patients received a median of 3 (range 1–4) gemcitabine-based chemotherapy courses with filgastrim support. Fourteen of patients received regimen which consisted of gemcitabine 1000 mg/m2 and vinorelbine 25 mg/m2 on days 1, 8 and 15 given every 28 days and eight of patients received gemcitabine 1000 mg/m2 on days 1, 8 and 15, cisplatin 100 mg/m2 on day 1 and methylprednisolone 1000 mg/m2 on days 1–4 of a treatment cycle repeated every 28 days. Twenty of the 22 patients were treated with the intent to proceed to reduced intensity alloHSCT. Two patients with relapse of HL after autoHSCT followed by alloHSCT were treated with the intent to proceed to donor lymphocyte infusion (DLI). Results: A toxicity of a total 60 gemcitabine-based cycles was analyzed. The dose of gemcitabine was omitted, delayed or reduced due to neutropenia or thrombocytopenia in 22/60 (33%) cycles. Neutropenia < 0,5 G/L occurred in 20/60 (33%) and thrombocytopenia < 20 G/L in 19/60 (32%) cycles. Two patients were thrombocytopenic before gemcitabine treatment. Seven of the 60 (12%) cycles were complicated by infection grade 3–4 according to NCI CTC (neutropenic febrile- 2 episodes, pneumonia- 5 episodes). Transient liver enzymes elevation grade 2 occurred in 2/60 (3%) cycles in 1 patient. The overall response rate was 64% (14/22 pts), with 6 CR confirmed by PET/CT and 8 PR. At the time of analysis 9 patients have proceeded to reduced intensity alloHSCT and 2 patients after prior autoHSCT and alloHSCT to DLI. After a median follow-up of 8 months (range 3–38) 11/22 patients remain alive. OS for all 22 patients was 39% (95% CI 14–64) at 24 months estimated with the Kaplan-Meier method. OS according to the response to gemcitabine-based salvage chemotherapy was 47% for patients who achieved CR/PR after treatment and 23% for refractory patients (p ns). Median of PFS for patients with response to gemcitabine-based chemotherapy was 8 (95% CI 5–11) months. Conclusion: Our observational study confirms that gemcitabine-based chemotherapy is a feasible regimen with significant response rate and acceptable toxicity profile in heavily pre-treated patients with relapse of HL after autoHSCT. However, the response duration is short and gemcitabine-based chemotherapy appears to be a treatment option to provide a bridge to alloHSCT. Disclosures: No relevant conflicts of interest to declare.

scholarly journals ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION FOR ADULT PATIENTS WITH FANCONI ANEMIA.

2016 ◽  
Vol 8 ◽  
pp. 2016054 ◽  
Author(s):  
Hosein Kamranzadeh fumani ◽  
Mohammad Zokaasadi ◽  
Amir Kasaeian ◽  
Kamran Alimoghaddam ◽  
Asadollah Mousavi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Fanconi Anemia ◽  
Bone Marrow Failure ◽  
Term Survival ◽  
Hematopoietic Stem

Background & objectives: Fanconi anemia (FA) is a rare genetic disorder caused by an impaired DNA repair mechanism which leads to an increased tendency toward malignancies and progressive bone marrow failure. The only curative management available for hematologic abnormalities in FA patients is hematopoietic stem cell transplantation (HSCT). This study aimed to evaluate the role of HSCT in FA patients.Methods: Twenty FA patients with ages of 16 or more who underwent HSCT between 2002 and 2015 enrolled in this study. All transplants were allogeneic and the stem cell source was peripheral blood and all patients had a full HLA-matched donor.Results: Eleven patients were female and 9 male (55% and 45%). Mean age was 24.05 years. Mortality rate was 50% (n=10) and the main cause of death was GVHD. Survival analysis showed an overall 5-year survival of 53.63% and 13 year survival of 45.96 % among patients.Conclusion: HSCT is the only curative management for bone marrow failure in FA patients and despite high rate of mortality and morbidity it seems to be an appropriate treatment with an acceptable long term survival rate for adolescent and adult group.

Late Donor Bone Marrow Failure After Allogeneic Hematopoietic Stem Cell Transplantation

2014 ◽  
Vol 97 (12) ◽  
pp. e75-e77 ◽  
Author(s):  
Mathieu Meunier ◽  
Anne-Claire Manez ◽  
Aliénor Xhaard ◽  
Régis Peffault de Latour ◽  
Flore Sicre de Fontbrune ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Bone Marrow Failure ◽  
Hematopoietic Stem ◽  
Donor Bone Marrow
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