STEM CELL MOBILIZATION WITH HIGH DOSE ETOPOSIDE PREDICT AND IMPROVE THE OUTCOME OF AUTOLOGOUS PERIPHERAL BLOOD STEM CELL TRANSPLANTATION IN PATIENTS WITH REFRACTORY OR RELAPSED LYMPHOMA
(Abstract release date: 05/19/16)
EHA Library. Cai Y. 06/09/16; 135068; PB2168
Dr. Yu Cai
Contributions
Contributions
Abstract
Abstract: PB2168
Type: Publication Only
Background
Autologous hematopoietic stem cell transplantation is an effective treatment for refractory and relapsed lymphoma patients.Most studies show that chemotherapy sensitivity is an important prognostic factor for these patients.A significant proportion of patients with relapsed and refractory lymphomas fail to respond to conventional salvage therapy and never proceed to transplantation, most often due to chemotherapy-resistant disease.Etoposide is an epipodophyllotoxin that has a topoisomeraseII-inhibiting function and causes DNA-strand breaks. Several groups have described the effectiveness of etoposide alone or in combination regimens to mobilize PBSCs.
Aims
We report a respective study in treating 88 patients with relapsed or refractory lymphomas who received high-dose etoposide (VP16) in mobilization plus autologous peripheral blood stem cell transplantation as rescue therapy.To investigate the efficacy of stem cell mobilization with high-dose etoposide and granulocyte colony stimulating factor followed by autologous peripheral blood stem cell transplantation in patients with relapsed or refractory lymphoma as salvage therapy. We hypothesized that the response to high-dose etoposide may predict the outcome of ASCT.
Methods
From November 2005to December 2014, 88 patients with refractory or relapsed non-Hodgkin’s lymphoma (NHL, n=61) or Hodgkin lymphoma (HD, n=27) received high-dose etoposide (VP16 20~25mg/kg/d ×2) and G-CSF for stem cell mobilization. The median age of 59 male and 29 female patients was 33 years (range 16–60)Patients’ remission status prior to mobilization were partial remission (PR) (n=39) and progressive disease (PD) (n=49) . All patients underwent autologous peripheral blood stem cell transplantation (auto-PBSCT). Conditioning regimen was BEAM (n=30) or CBV (n=58).
Results
Among 88 patients, 65 (73.9%) patients had response. 36 of 39 (92.3%) PR patients had response, 30 of 49 (61.2%) PD patients had response. Median follow-up was 21.5 (1~85) months after stem cell transplantation. 58 (65.9%) patients achieved CR, 18 (20.45%) patients attained PR, 10 (11.36%) patients suffered disease progression, 1 (1.1%) patients relapsed, and 1 (1.1%) patient died of bone marrow failure. Among PR group, the estimated 2-year DFS for patients who had response and no response to etoposide were 83.6% and 33.0% respectively. In PD group, the estimated 2-year DFS for patients who had response and no response to etoposide were 69.4% and 26.7%, respectively. P < 0.01. The estimated 2-year OS for responders and non-responders were 72.0% and 25.9%, respectively. P < 0.01 .
Conclusion
Stem cell mobilization with high dose etoposide and G-CSF followed by auto-PBSCT was beneficial in the treatment of refractory lymphoma. Disease-free survival over 2 years can be achieved in some patients. Patients’ response to high dose etoposide was correlated to 2-year DFS and OS, which could also predict the outcome of auto-PBSCT for those patients. Utilizing high dose etoposide, we can select some chemotherapy-sensitive patients from refractory lymphoma. The outcome of autologous transplantation is correlated to the response of high dose etoposide.
Session topic: E-poster
Keyword(s): Autologous peripheral blood stem cell tansplantati, Etoposide, Lymphoma, Refractory
Type: Publication Only
Background
Autologous hematopoietic stem cell transplantation is an effective treatment for refractory and relapsed lymphoma patients.Most studies show that chemotherapy sensitivity is an important prognostic factor for these patients.A significant proportion of patients with relapsed and refractory lymphomas fail to respond to conventional salvage therapy and never proceed to transplantation, most often due to chemotherapy-resistant disease.Etoposide is an epipodophyllotoxin that has a topoisomeraseII-inhibiting function and causes DNA-strand breaks. Several groups have described the effectiveness of etoposide alone or in combination regimens to mobilize PBSCs.
Aims
We report a respective study in treating 88 patients with relapsed or refractory lymphomas who received high-dose etoposide (VP16) in mobilization plus autologous peripheral blood stem cell transplantation as rescue therapy.To investigate the efficacy of stem cell mobilization with high-dose etoposide and granulocyte colony stimulating factor followed by autologous peripheral blood stem cell transplantation in patients with relapsed or refractory lymphoma as salvage therapy. We hypothesized that the response to high-dose etoposide may predict the outcome of ASCT.
Methods
From November 2005to December 2014, 88 patients with refractory or relapsed non-Hodgkin’s lymphoma (NHL, n=61) or Hodgkin lymphoma (HD, n=27) received high-dose etoposide (VP16 20~25mg/kg/d ×2) and G-CSF for stem cell mobilization. The median age of 59 male and 29 female patients was 33 years (range 16–60)Patients’ remission status prior to mobilization were partial remission (PR) (n=39) and progressive disease (PD) (n=49) . All patients underwent autologous peripheral blood stem cell transplantation (auto-PBSCT). Conditioning regimen was BEAM (n=30) or CBV (n=58).
Results
Among 88 patients, 65 (73.9%) patients had response. 36 of 39 (92.3%) PR patients had response, 30 of 49 (61.2%) PD patients had response. Median follow-up was 21.5 (1~85) months after stem cell transplantation. 58 (65.9%) patients achieved CR, 18 (20.45%) patients attained PR, 10 (11.36%) patients suffered disease progression, 1 (1.1%) patients relapsed, and 1 (1.1%) patient died of bone marrow failure. Among PR group, the estimated 2-year DFS for patients who had response and no response to etoposide were 83.6% and 33.0% respectively. In PD group, the estimated 2-year DFS for patients who had response and no response to etoposide were 69.4% and 26.7%, respectively. P < 0.01. The estimated 2-year OS for responders and non-responders were 72.0% and 25.9%, respectively. P < 0.01 .
Conclusion
Stem cell mobilization with high dose etoposide and G-CSF followed by auto-PBSCT was beneficial in the treatment of refractory lymphoma. Disease-free survival over 2 years can be achieved in some patients. Patients’ response to high dose etoposide was correlated to 2-year DFS and OS, which could also predict the outcome of auto-PBSCT for those patients. Utilizing high dose etoposide, we can select some chemotherapy-sensitive patients from refractory lymphoma. The outcome of autologous transplantation is correlated to the response of high dose etoposide.
Session topic: E-poster
Keyword(s): Autologous peripheral blood stem cell tansplantati, Etoposide, Lymphoma, Refractory
Abstract: PB2168
Type: Publication Only
Background
Autologous hematopoietic stem cell transplantation is an effective treatment for refractory and relapsed lymphoma patients.Most studies show that chemotherapy sensitivity is an important prognostic factor for these patients.A significant proportion of patients with relapsed and refractory lymphomas fail to respond to conventional salvage therapy and never proceed to transplantation, most often due to chemotherapy-resistant disease.Etoposide is an epipodophyllotoxin that has a topoisomeraseII-inhibiting function and causes DNA-strand breaks. Several groups have described the effectiveness of etoposide alone or in combination regimens to mobilize PBSCs.
Aims
We report a respective study in treating 88 patients with relapsed or refractory lymphomas who received high-dose etoposide (VP16) in mobilization plus autologous peripheral blood stem cell transplantation as rescue therapy.To investigate the efficacy of stem cell mobilization with high-dose etoposide and granulocyte colony stimulating factor followed by autologous peripheral blood stem cell transplantation in patients with relapsed or refractory lymphoma as salvage therapy. We hypothesized that the response to high-dose etoposide may predict the outcome of ASCT.
Methods
From November 2005to December 2014, 88 patients with refractory or relapsed non-Hodgkin’s lymphoma (NHL, n=61) or Hodgkin lymphoma (HD, n=27) received high-dose etoposide (VP16 20~25mg/kg/d ×2) and G-CSF for stem cell mobilization. The median age of 59 male and 29 female patients was 33 years (range 16–60)Patients’ remission status prior to mobilization were partial remission (PR) (n=39) and progressive disease (PD) (n=49) . All patients underwent autologous peripheral blood stem cell transplantation (auto-PBSCT). Conditioning regimen was BEAM (n=30) or CBV (n=58).
Results
Among 88 patients, 65 (73.9%) patients had response. 36 of 39 (92.3%) PR patients had response, 30 of 49 (61.2%) PD patients had response. Median follow-up was 21.5 (1~85) months after stem cell transplantation. 58 (65.9%) patients achieved CR, 18 (20.45%) patients attained PR, 10 (11.36%) patients suffered disease progression, 1 (1.1%) patients relapsed, and 1 (1.1%) patient died of bone marrow failure. Among PR group, the estimated 2-year DFS for patients who had response and no response to etoposide were 83.6% and 33.0% respectively. In PD group, the estimated 2-year DFS for patients who had response and no response to etoposide were 69.4% and 26.7%, respectively. P < 0.01. The estimated 2-year OS for responders and non-responders were 72.0% and 25.9%, respectively. P < 0.01 .
Conclusion
Stem cell mobilization with high dose etoposide and G-CSF followed by auto-PBSCT was beneficial in the treatment of refractory lymphoma. Disease-free survival over 2 years can be achieved in some patients. Patients’ response to high dose etoposide was correlated to 2-year DFS and OS, which could also predict the outcome of auto-PBSCT for those patients. Utilizing high dose etoposide, we can select some chemotherapy-sensitive patients from refractory lymphoma. The outcome of autologous transplantation is correlated to the response of high dose etoposide.
Session topic: E-poster
Keyword(s): Autologous peripheral blood stem cell tansplantati, Etoposide, Lymphoma, Refractory
Type: Publication Only
Background
Autologous hematopoietic stem cell transplantation is an effective treatment for refractory and relapsed lymphoma patients.Most studies show that chemotherapy sensitivity is an important prognostic factor for these patients.A significant proportion of patients with relapsed and refractory lymphomas fail to respond to conventional salvage therapy and never proceed to transplantation, most often due to chemotherapy-resistant disease.Etoposide is an epipodophyllotoxin that has a topoisomeraseII-inhibiting function and causes DNA-strand breaks. Several groups have described the effectiveness of etoposide alone or in combination regimens to mobilize PBSCs.
Aims
We report a respective study in treating 88 patients with relapsed or refractory lymphomas who received high-dose etoposide (VP16) in mobilization plus autologous peripheral blood stem cell transplantation as rescue therapy.To investigate the efficacy of stem cell mobilization with high-dose etoposide and granulocyte colony stimulating factor followed by autologous peripheral blood stem cell transplantation in patients with relapsed or refractory lymphoma as salvage therapy. We hypothesized that the response to high-dose etoposide may predict the outcome of ASCT.
Methods
From November 2005to December 2014, 88 patients with refractory or relapsed non-Hodgkin’s lymphoma (NHL, n=61) or Hodgkin lymphoma (HD, n=27) received high-dose etoposide (VP16 20~25mg/kg/d ×2) and G-CSF for stem cell mobilization. The median age of 59 male and 29 female patients was 33 years (range 16–60)Patients’ remission status prior to mobilization were partial remission (PR) (n=39) and progressive disease (PD) (n=49) . All patients underwent autologous peripheral blood stem cell transplantation (auto-PBSCT). Conditioning regimen was BEAM (n=30) or CBV (n=58).
Results
Among 88 patients, 65 (73.9%) patients had response. 36 of 39 (92.3%) PR patients had response, 30 of 49 (61.2%) PD patients had response. Median follow-up was 21.5 (1~85) months after stem cell transplantation. 58 (65.9%) patients achieved CR, 18 (20.45%) patients attained PR, 10 (11.36%) patients suffered disease progression, 1 (1.1%) patients relapsed, and 1 (1.1%) patient died of bone marrow failure. Among PR group, the estimated 2-year DFS for patients who had response and no response to etoposide were 83.6% and 33.0% respectively. In PD group, the estimated 2-year DFS for patients who had response and no response to etoposide were 69.4% and 26.7%, respectively. P < 0.01. The estimated 2-year OS for responders and non-responders were 72.0% and 25.9%, respectively. P < 0.01 .
Conclusion
Stem cell mobilization with high dose etoposide and G-CSF followed by auto-PBSCT was beneficial in the treatment of refractory lymphoma. Disease-free survival over 2 years can be achieved in some patients. Patients’ response to high dose etoposide was correlated to 2-year DFS and OS, which could also predict the outcome of auto-PBSCT for those patients. Utilizing high dose etoposide, we can select some chemotherapy-sensitive patients from refractory lymphoma. The outcome of autologous transplantation is correlated to the response of high dose etoposide.
Session topic: E-poster
Keyword(s): Autologous peripheral blood stem cell tansplantati, Etoposide, Lymphoma, Refractory
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