Review: Allogeneic transplantation for subtypes of lymphoma
A review focusing on the strategies for hematopoietic cell transplantation in patients with lymphoma, including the use of reduced-intensity conditioning (RIC). The authors discuss the graft-versus lymphoma effect in Hodgkin lymphoma, and in major subtypes of non-Hodgkin lymphoma: follicular lymphoma, diffuse large B-cell lymphoma, mantle-cell lymphoma, and T-cell lymphomas. Also discussed is the role of risk-adapted trials in evaluating RIC transplantation in relation to immunochemotherapy or autologous transplantation.
Prognostic factors in HCT of older patients with AML
An analysis of 102 consecutive patients ≥55 years (range, 55-71) with acute myeloid leukemia (AML) shows significantly higher 3-year overall survival (OS) in patients transplanted in first complete remission than in patients transplanted in active/advanced disease: 67% vs. 27%, respectively (p=0.001). Transplants in this single-center study were performed between 1997-2008 and donors were related (n=27; 26%) or unrelated (n=75; 74%). Multivariate analysis revealed age ≥60 years and active/advanced disease as prognostic factors for decreased OS. The authors conclude that “disease status at transplantation is the most important prognostic factor for transplantation success.”
A CIBMTR (Center for International Blood and Marrow Transplant Research) multivariate analysis of 5,343 patients with chronic GVHD identified ten significant variables that predicted overall survival (OS) and non-relapse mortality. The variables were age, prior acute GVHD, time from transplant to chronic GVHD, donor type, disease status at transplant, GVHD prophylaxis, gender mismatch, serum bilirubin, Karnofsky score and platelet count. From the multivariate analysis, the researchers developed six risk groups (RG1-RG6), with 5-year OS of 91% (RG1), 67% (RG2), 51% (RG3), 40% (RG4), 21% (RG5), and 4% (RG6), all p<0.01.
Reduced-toxicity HCT for patients ≥55 with AML/MDS
A study of 79 patients ≥55 years (median age 58) transplanted using a myeloablative, but reduced-toxicity conditioning regimen has shown that patients in first complete remission (CR1) can achieve a two-year overall survival (OS) of 71%. Patients had acute myeloid leukemia (AML, n=63) or myelodysplastic syndromes (MDS, n=16) and were conditioned with i.v. busulfan and i.v. fludarabine. Two-year OS for patients in CR1, second CR, or refractory disease at time of transplantation were 71%, 44%, and 32%, respectively. The researchers concluded that age alone should not be the primary reason for exclusion from transplantation using a myeloablative, reduced-toxicity conditioning regimen.
You can now instantly access our Transplant Clinical Guidelines through a free mobile app. The app contains clinical decision-making information from the NMDP/ASBMT Timing for Transplant Consultation Guidelines and Post-Transplant Care Guidelines. The app is available via Blackberry®, iPhone®, iPad™, Android™, and mobile web. Download free app
Special Advances Edition: 2011 BMT Tandem Meetings
Read a special edition of Advances in Transplantation summarizing the latest research in hematopoietic cell transplantation presented at the 2011 BMT Tandem Meetings. Research highlights include:
• Using minimal residual disease testing to reduce relapse • Reduced-intensity cord blood transplantation in older patients • CMV-mediated virus-versus-leukemia effect in AML • New strategies in treating multiple myeloma
Supported by an unrestricted educational grant from Otsuka America Pharmaceutical, Inc., provided to the National Marrow Donor Program through the Be The Match Foundation®, the funding partner of the NMDP.
National Marrow Donor Program, 3001 Broadway St. N.E., Minneapolis, MN 55413-1753
Advances in Transplantation is an electronic newsletter published monthly by the National Marrow Donor Program (NMDP). This newsletter is sent only to those individuals who have requested to receive clinical education updates from NMDP.
If this e-mail message was forwarded to you and you’d like Advances in Transplantation delivered directly to you, please subscribe. If you would like to stop receiving Advances in Transplantation, please unsubscribe.
If you are a member of the NMDP Be The Match Registry®, unsubscribing to the Advances in Transplantation e-newsletter does not change your status on the registry. The NMDP may still contact you by e-mail, postal mail or telephone if a patient needs you or to request that you update your address.