FLUDARABINE-MELPHALAN-CAMPATH FOLLOWED BY UNMANIPULATED PERIPHERAL-BLOOD HAEMATOPOIETIC STEM CELLS CAN STILL CURE LYMPHOMA.

Main Article Content

Daniele Avenoso
Amal Alabdulwahab
Michelle Kenyon
Varun Mehra
Pramila Krishnamurthy
Francesco Dazzi
Ye Ting Leung
Sandra Anteh
Mili Naresh Shah
Andrea Kuhnl
Robin Sanderson
Piers Patten
Deborah Yallop
Antonio Pagliuca
Victoria Potter

Keywords

Allogeneic hematopoietic cell transplantation, Lymphoma

Abstract

Background: The second decade of this millennium was characterized by a widespread availability of chimeric antigen receptor T-cell (CAR-T)therapies to treat relapsed and refractory lymphomas.


As expected, the role and indication of allogeneic haematopoietic stem cell transplant(allo-HSCT)in the management of lymphoma changed. Currently a not unneglectable proportion of patients will be considered candidate for an allo-HSCT and the debate of which transplant platform should be offered is still active.


Objectives:to report the outcome of patients affected with relapsed/refractory lymphoma and transplanted following reduced intensity conditioning at King’s College Hospital, London, between January 2009 and April2021. Methods: Conditioning was with fludarabine 150mg/m2 and melphalan 140mg/m2. The graft was unmanipulated G-CSF mobilized peripheral blood haematopoietic stem cells(PBSC). Graft-versus-host disease (GVHD) prophylaxis consisted of pre-transplant Campath at the total dose of 60 mg in unrelated donors and 30 mg in fully matched sibling donors, and ciclosporin.


Results: One year and five years OS were87% and79.9%, respectively and median OS was not reached. Cumulative incidence of relapse was 16%.Incidence of acute GVHD was 48%(only grade I/II); no cases of grade III/IV were diagnosed. Chronic GVHD occurred in 39% of patients. TRM was 12%, with no cases developed within day 100 and 18months after the procedure.


Conclusions:The outcomes of heavily pretreated lymphoma patients are favorable with median OS and survival not reached after a median of 49months. In conclusion, even if some lymphoma subgroups can’t be treated (yet) with advanced cellular therapies, this study confirms the role of allo-HSCT as a safe and curative strategy.

Downloads

Download data is not yet available.


Abstract 622
PDF Downloads 465
HTML Downloads 136

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.