11/25/2023 0 Comments Nonmyeloablative stem cell transplant![]() “The main takeaway from this study is that there is no impact of intensive vs non-intensive consolidation before hematopoietic stem cell transplantation in AML over 60 years old in CR1,” lead study author Yosr Hicheri, MD, of the Department of Clinical Hematology at the Institut Paoli Clamettes in Marseille, France, said in a presentation of the data. However, the difference was not statistically significant. ![]() A trend toward worse NRM was reported with intensive therapy, possibly related to complications such as infections, with a 2-year rate of 27% vs 16% with non-intensive treatment ( P =.564). Allo-RIC has to be considered an effective therapeutic approach for patients who have had treatment failure with a previous autologous hematopoietic stem cell transplantation.Use of intensive vs non-intensive consolidation chemotherapy yielded no differences in relapse-free survival (RFS) or non–relapse mortality (NRM) in elderly patients with acute myeloid leukemia (AML) in first complete remission (CR1) set to undergo allogeneic hematopoietic stem cell transplantation, according to data from a retrospective analysis presented during the 2023 Society of Hematologic Oncology (SOHO) Annual Meeting.Īt a median follow-up of 52.2 months, the 2-year RFS rate was 51% with intensive therapy vs 50% with non-intensive therapy, showing no difference in outcome between the type of consolidation chemotherapy ( P =.546). Both responses observed after the development of GVHD and DLI may suggest a graft-versus-HL effect. Results are better in patients allografted in sensitive disease. These data suggest that allo-RIC is feasible in heavily pretreated HL patients and has an acceptable early transplant-related mortality. For patients with failure of a prior autologous hematopoietic stem cell transplantation, results were especially good for those who experienced late relapses (>/=12 months: 2-year OS and PFS were 75% +/- 16% and 70% +/- 18%, respectively). Refractoriness to chemotherapy was the only adverse prognostic factor for both OS (63% +/- 12% versus 35% +/- 13% P =. Overall survival (OS) and progression-free survival (PFS) were 48% +/- 10% and 32% +/- 10% at 2 years, respectively. The response rate after DLI was 54% (3 complete remissions and 3 partial remissions). Eleven patients received donor lymphocyte infusions (DLIs) for disease relapse. The response rate 3 months after the allo-RIC was 67% (21 complete remissions and 6 partial remissions). Chronic GVHD developed in 17 (45%) of the 31 evaluable patients. Acute GVHD developed in 18 patients (45%). One-year transplant-related mortality was 25%. Five patients (12%) died from early transplant-related mortality (before day +100 after allo-RIC). Twenty patients (50%) were allografted in resistant relapse, and 38 patients received hematopoietic cells from an HLA-identical sibling. Twenty-one patients (53%) had received >2 lines of chemotherapy, 23 patients (58%) had received radiotherapy, and 29 patients (73%) had experienced treatment failure with a previous autologous stem cell transplantation. Forty patients with relapsed or refractory HL were homogeneously treated with an RIC protocol (fludarabine 150 mg/m(2) intravenously plus melphalan 140 mg/m(2) intravenously) and cyclosporin A and methotrexate as graft-versus-host disease (GVHD) prophylaxis. We report the results of reduced-intensity conditioning allogeneic stem cell transplantation (allo-RIC) in patients with advanced Hodgkin lymphoma (HL).
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