Reduced Intensity Allogeneic Transplant effective for Follicular Lymphoma

Reduced Intensity Salvage Allo-HSCT Effective for Follicular Lymphoma

Reduced intensity allogeneic hematopoietic stem cell transplantation (HSCT) is an effective salvage treatment strategy in patients with follicular lymphoma whose disease recurred following a prior autologous HSCT, a study published in the journal Annals of Oncology has shown.

Because patients with follicular lymphoma who experience relapse after an autologous HSCT may be treated with a variety of therapies, including reduced intensity allogeneic HSCT, researchers sought to evaluate outcomes of patients who undergo reduced intensity salvage allogeneic HSCT

For the retrospective study, investigators analysed data from 183 patients with follicular lymphoma who had undergone an autologous HSCT. Patients received a reduced intensity allogeneic HSCT a median of 30 months after undergoing an autologous HSCT, and prior to the allogeneic HSCT, patients had received a median of 4 lines of therapy.

Of those, 81% had chemo-sensitive disease and 16% had chemo-resistant disease. Forty-seven percent and 53% of grafts were donated from sibling and unrelated donors, respectively.

Results showed that at a median follow-up of 59 months, the non-relapse mortality rate at 2 years was 27%. The median duration of remission after autologous HSCT and reduced intensity allogeneic HSCT was 14 and 43 months, respectively

Furthermore, researchers found that the 5-year relapse/progression rate, progression-free survival, and overall survival were 16%, 48% and 51%, respectively; all were associated with age and disease status at the time of allogeneic HSCT.

The findings suggest that reduced intensity salvage HSCT might overcome the poor prognostic impact of early relapse after autologous HSCT in patients with follicular lymphoma.

REFERENCE

1. Robinson SP, Boumendil A, Finel H, et al. Reduced intensity allogeneic stem cell transplantation for follicular lymphoma relapsing after an autologous transplant achieves durable long term disease control. An analysis from the Lymphoma Working Party of the EBMT [published online ahead of print March 8, 2016]. Ann Oncol. doi:10.1093/annonc/mdw124.

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Useful Definitions

  • Refractory: This means the lymphoma does not get better with treatment. The treatment didn’t work as hoped.
  • Relapsed: This means the lymphoma came back after being gone for a while after treatment.
  • 2nd line treatment: This is the second treatment you get if the first one didn’t work (refractory) or if the lymphoma comes back (relapse).
  • 3rd line treatment: This is the third treatment you get if the second one didn’t work or the lymphoma comes back again.
  • Approved: Available in Australia and listed by the Therapeutics Goods Administration (TGA).
  • Funded: Costs are covered for Australian citizens. This means if you have a Medicare card, you shouldn’t have to pay for the treatment.[WO7]

You need healthy T-cells to make CAR T-cells. For this reason, CAR T-cell therapy cannot be used if you have a T-cell lymphoma – yet.

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Special Note: Although your T-cells are removed from your blood for CAR T-cell therapy, most of our T-cells live outside of our blood – in our lymph nodes, thymus, spleen and other organs.