TY - JOUR
T1 - A Phase II study of a nonmyeloablative allogeneic stem cell transplant with peritransplant rituximab in patients with BCell lymphoid malignancies
T2 - Favorably durable event-free survival in chemosensitive patients
AU - Sauter, Craig S.
AU - Barker, Juliet N.
AU - Lechner, Lauren
AU - Zheng, Junting
AU - Devlin, Sean M.
AU - Papadopoulos, Esperanza B.
AU - Perales, Miguel Angel
AU - Jakubowski, Ann A.
AU - Goldberg, Jenna D.
AU - Koehne, Guenther
AU - Ceberio, Izaskun
AU - Giralt, Sergio
AU - Zelenetz, Andrew D.
AU - Moskowitz, Craig H.
AU - Castro-Malaspina, Hugo
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/3
Y1 - 2014/3
N2 - The aim of this prospective phase II trial was to determine the safety and efficacy of a nonmyeloablative conditioning program incorporating peritransplant rituximab in patients with CD20+ B cell non-Hodgkin lymphoma (B-NHL) receiving an allogeneic stem cell transplant (allo-SCT). Fifty-one adult B-NHL patients, with a median age of 54years, were treated with cyclophosphamide, fludarabine, and 200cGy of total body irradiation. Rituximab 375mg/m2 was given on day-8 and in 4 weekly doses beginning day+21. Equine antithymocyte globulin was given to recipients of volunteer unrelated donor grafts. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and mycophenolate mofetil and tacrolimus, sirolimus, and methotrexate in 8 and 43 patients, respectively. Thirty-three patients received grafts from unrelated donors, and 18 received grafts from matched related donors. All patients engrafted. Full donor chimerism in bone marrow and peripheral T cells was seen in 92% and 89% of patients, respectively, at 3months after allo-SCT. The cumulative incidence of grades II to IV acute GVHD at 6months was 25% (95% confidence interval [CI], 13% to 38%) and grades III to IV was 11% (95% CI, 2% to 20%). The 2-year cumulative incidence of chronic GVHD was 29% (95% CI, 15% to 44%). The 2-year event-free and overall survival for all patients was 72% (95% CI, 59% to 85%) and 78% (95% CI, 66% to 90%), respectively. The 2-year event-free survival for chemosensitive patients was 84% (95% CI, 72% to 96%) compared with 30% (95% CI, 2% to 58%) for chemorefractory patients before allo-SCT (P<.001). This nonmyeloablative regimen, with peritransplant rituximab, is safe and effective in patients with B-NHL.
AB - The aim of this prospective phase II trial was to determine the safety and efficacy of a nonmyeloablative conditioning program incorporating peritransplant rituximab in patients with CD20+ B cell non-Hodgkin lymphoma (B-NHL) receiving an allogeneic stem cell transplant (allo-SCT). Fifty-one adult B-NHL patients, with a median age of 54years, were treated with cyclophosphamide, fludarabine, and 200cGy of total body irradiation. Rituximab 375mg/m2 was given on day-8 and in 4 weekly doses beginning day+21. Equine antithymocyte globulin was given to recipients of volunteer unrelated donor grafts. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and mycophenolate mofetil and tacrolimus, sirolimus, and methotrexate in 8 and 43 patients, respectively. Thirty-three patients received grafts from unrelated donors, and 18 received grafts from matched related donors. All patients engrafted. Full donor chimerism in bone marrow and peripheral T cells was seen in 92% and 89% of patients, respectively, at 3months after allo-SCT. The cumulative incidence of grades II to IV acute GVHD at 6months was 25% (95% confidence interval [CI], 13% to 38%) and grades III to IV was 11% (95% CI, 2% to 20%). The 2-year cumulative incidence of chronic GVHD was 29% (95% CI, 15% to 44%). The 2-year event-free and overall survival for all patients was 72% (95% CI, 59% to 85%) and 78% (95% CI, 66% to 90%), respectively. The 2-year event-free survival for chemosensitive patients was 84% (95% CI, 72% to 96%) compared with 30% (95% CI, 2% to 58%) for chemorefractory patients before allo-SCT (P<.001). This nonmyeloablative regimen, with peritransplant rituximab, is safe and effective in patients with B-NHL.
KW - Allogeneic stem cell transplant
KW - Non-Hodgkin lymphoma
KW - Nonmyeloablative
KW - Rituximab
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UR - http://www.scopus.com/inward/citedby.url?scp=84896846970&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2013.11.029
DO - 10.1016/j.bbmt.2013.11.029
M3 - Article
C2 - 24315843
AN - SCOPUS:84896846970
VL - 20
SP - 354
EP - 360
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 3
ER -