Incorporation of extracorporeal photopheresis into a reduced intensity conditioning regimen in myelodysplastic syndrome and aggressive lymphoma: results from ECOG 1402 and 1902
| Autor: | David Avigan, Martin S. Tallman, Mark R. Litzow, Kellie Sprague, Francine M. Foss, Henry N. Wagner, Xin Victoria Wang, Roger Strair, Sandra J. Horning, William J. Hogan, Randall D. Gascoyne, Opeyemi Jegede, Theresa L. Whiteside, Selina M. Luger, Daniel A. Arber, Hillard M. Lazarus, Edward A. Stadtmauer, Kenneth B. Miller |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Transplantation Conditioning Lymphoma Platelet Engraftment medicine.medical_treatment Immunology Graft vs Host Disease Aggressive lymphoma 030204 cardiovascular system & hematology Gastroenterology Tacrolimus Article 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Internal medicine Extracorporeal Photopheresis medicine Humans Immunology and Allergy Pentostatin business.industry Hematopoietic Stem Cell Transplantation Immunosuppression Hematology Middle Aged Total body irradiation Allografts medicine.disease Regimen Methotrexate surgical procedures operative Myelodysplastic Syndromes Photopheresis Cyclosporine Female business Whole-Body Irradiation 030215 immunology medicine.drug |
| Zdroj: | Transfusion |
| ISSN: | 1537-2995 0041-1132 |
| Popis: | Background Extracorporeal photopheresis (ECP) is an immunomodulatory cellular therapy which has been shown to induce a tolerogenic state in patients with acute and chronic graft-vs-host disease. ECOG-ACRIN explored the activity of ECP as a part of a reduced intensity conditioning regimen in two multicenter trials in patients with MDS (E1902) and lymphomas (E1402). While both studies closed before completing accrual, we report results in 23 patients (17 MDS and 6 lymphoma). Study design and methods Patients received 2 days of ECP followed by pentostatin 4 mg/m2 /day for two consecutive days, followed by 600 cGy of total body irradiation prior to stem cell infusion. Immunosuppression for aGVHD was infusional cyclosporine A or tacrolimus and methotrexate on day +1, +3, with mycophenolate mofetil starting on day 100 for chronic GVHD prophylaxis. Results All patients engrafted, with median time to neutrophil and platelet engraftment of 15-18 days and 10-18 days respectively. Grade 3 or 4 aGVHD occurred in 13% and chronic extensive GVHD in 30%. Conclusions These studies demonstrate that ECP/pentostatin/TBI is well tolerated and associated with adequate engraftment of neutrophils and platelets in patients with lymphomas and MDS. |
| Databáze: | OpenAIRE |
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