Contributions
Abstract: PB2478
Type: Publication Only
Background
High dose chemotherapy with autologous hematopoietic stem cell transplantation (autoHSCT) in combination with targeted medications is widely used in prognostically unfavorable variants of non-Hodgkin's lymphoma (NHL) treatment.
Aims
To estimate the results of autoHSCT in patients with NHL with unfavorable course.
Methods
48 autoHSCT to 42 NHL patients (18 – female, 25 – male, age 22-69 years, median 37,5 years) were performed from 1999 till February 2018. Of them: diffuse large B-cell lymphoma (DBCL) in PR1/CR2 – 21 patient, mantle cell lymphoma (MCL) in PR 1/2 – 8, follicular lymphoma (FL) 3B type in CR2 – 4 patients, rimary mediastinal lymphoma – 6 patients,peripheral T-cell lymphoma – 5 patients.
Patients were treated with more, than 2 lines of chemotherapy. Hematopoietic stem cells (HSC) were harvested after the second line therapy with G-CSF stimulation.
Six patients received 2 autoHSCTs (DBCL 4B in PR1 – 4, FL type 3 in PR2 FLIPI2 -1, primary mediastinal lymphoma – 1).
Conditioning regimen BendaEAM was used in 39% of cases, BEAM - in 37,25%, CVB - in 10%, ICE - in 13,75% (plus rituximab in 69,6% autoHSCTs). Transplant – cryopreserved HSCs, counting (2-21)х106/kg body weight CD34+ cells, (2,8-5,1)х108/kg myelokaryocytes. Leukocyte recovery more, than 1х109/l was achieved on 14 day, platelet count more, than 30х109/l – on day 17. Most of patients with B-cell lymphomas received 2 year rituximab maintenance therapy after autoHSCT.
Results
At time point February 2018 29 patients were alive, 10 died due to lymphoma progression, 3 – because of infection complications. Transplant failure was revealed in 5,4% of patients, 100 days mortality was 5.4%. Overall 3-year survival (OS) was 73%, 5 – year survival – 67%, 10– year survival – 58%. Overall survival median was 12,7 years.
Relapse free 3 – year survival (RFS) was 73%. Median relapse free survival was 98 months. DBCL patients had 3 – year OS 75%, 5 – year OS – 70%, 10-year OS – 63% and median OS 12,7 years. MCL patients had 3-year OS of 75%, 5 year OS – 75%, median OS was not achieved. All patients, who received repeated autoHSCT are alive, in PET-negative CR with surveillance median of 40 months.
The most common complications in post-transplant period were 1-2 grade mucositis – 81% of patients. Septic complications were revealed in 8.1% of cases, pulmonary aspergilosis – in 4%. Frequency of infections did not increase after repeated autoHSCT, engraftment occurred at usual time point.
Conclusion
AutoHSCT method is an effective therapeutic option for patients with high risk NHL.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Autologous hematopoietic stem cell transplantation, Conditioning, Non-Hodgkin's lymphoma, Survival
Abstract: PB2478
Type: Publication Only
Background
High dose chemotherapy with autologous hematopoietic stem cell transplantation (autoHSCT) in combination with targeted medications is widely used in prognostically unfavorable variants of non-Hodgkin's lymphoma (NHL) treatment.
Aims
To estimate the results of autoHSCT in patients with NHL with unfavorable course.
Methods
48 autoHSCT to 42 NHL patients (18 – female, 25 – male, age 22-69 years, median 37,5 years) were performed from 1999 till February 2018. Of them: diffuse large B-cell lymphoma (DBCL) in PR1/CR2 – 21 patient, mantle cell lymphoma (MCL) in PR 1/2 – 8, follicular lymphoma (FL) 3B type in CR2 – 4 patients, rimary mediastinal lymphoma – 6 patients,peripheral T-cell lymphoma – 5 patients.
Patients were treated with more, than 2 lines of chemotherapy. Hematopoietic stem cells (HSC) were harvested after the second line therapy with G-CSF stimulation.
Six patients received 2 autoHSCTs (DBCL 4B in PR1 – 4, FL type 3 in PR2 FLIPI2 -1, primary mediastinal lymphoma – 1).
Conditioning regimen BendaEAM was used in 39% of cases, BEAM - in 37,25%, CVB - in 10%, ICE - in 13,75% (plus rituximab in 69,6% autoHSCTs). Transplant – cryopreserved HSCs, counting (2-21)х106/kg body weight CD34+ cells, (2,8-5,1)х108/kg myelokaryocytes. Leukocyte recovery more, than 1х109/l was achieved on 14 day, platelet count more, than 30х109/l – on day 17. Most of patients with B-cell lymphomas received 2 year rituximab maintenance therapy after autoHSCT.
Results
At time point February 2018 29 patients were alive, 10 died due to lymphoma progression, 3 – because of infection complications. Transplant failure was revealed in 5,4% of patients, 100 days mortality was 5.4%. Overall 3-year survival (OS) was 73%, 5 – year survival – 67%, 10– year survival – 58%. Overall survival median was 12,7 years.
Relapse free 3 – year survival (RFS) was 73%. Median relapse free survival was 98 months. DBCL patients had 3 – year OS 75%, 5 – year OS – 70%, 10-year OS – 63% and median OS 12,7 years. MCL patients had 3-year OS of 75%, 5 year OS – 75%, median OS was not achieved. All patients, who received repeated autoHSCT are alive, in PET-negative CR with surveillance median of 40 months.
The most common complications in post-transplant period were 1-2 grade mucositis – 81% of patients. Septic complications were revealed in 8.1% of cases, pulmonary aspergilosis – in 4%. Frequency of infections did not increase after repeated autoHSCT, engraftment occurred at usual time point.
Conclusion
AutoHSCT method is an effective therapeutic option for patients with high risk NHL.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Autologous hematopoietic stem cell transplantation, Conditioning, Non-Hodgkin's lymphoma, Survival