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Merck
  • Sequential myeloablative autologous stem cell transplantation and reduced intensity allogeneic hematopoietic cell transplantation is safe and feasible in children, adolescents and young adults with poor-risk refractory or recurrent Hodgkin and non-Hodgkin lymphoma.

Sequential myeloablative autologous stem cell transplantation and reduced intensity allogeneic hematopoietic cell transplantation is safe and feasible in children, adolescents and young adults with poor-risk refractory or recurrent Hodgkin and non-Hodgkin lymphoma.

Leukemia (2014-06-19)
P Satwani, Z Jin, P L Martin, M Bhatia, J H Garvin, D George, S Chaudhury, J Talano, E Morris, L Harrison, J Sosna, M Peterson, O Militano, S Foley, J Kurtzberg, M S Cairo
ABSTRACT

The outcome of children, adolescents and young adults (CAYA) with poor-risk recurrent/refractory lymphoma is dismal (⩽30%). To overcome this poor prognosis, we designed an approach to maximize an allogeneic graft vs lymphoma effect in the setting of low disease burden. We conducted a multi-center prospective study of myeloablative conditioning (MAC) and autologous stem cell transplantation (AutoSCT), followed by a reduced intensity conditioning (RIC) and allogeneic hematopoietic cell transplantation (AlloHCT) in CAYA, with poor-risk refractory or recurrent lymphoma. Conditioning for MAC AutoSCT consisted of carmustine/etoposide/cyclophosphamide, RIC consisted of busulfan/fludarabine. Thirty patients, 16 Hodgkin lymphoma (HL) and 14 non-Hodgkin lymphoma (NHL), with a median age of 16 years and median follow-up of 5years, were enrolled. Twenty-three patients completed both MAC AutoSCT and RIC AlloHCT. Allogeneic donor sources included unrelated cord blood (n=9), unrelated donor (n=8) and matched siblings (n=6). The incidence of transplant-related mortality following RIC AlloHCT was only 12%. In patients with HL and NHL, 10 year EFS was 59.8% and 70% (P=0.613), respectively. In summary, this approach is safe, and long-term EFS with this approach is encouraging considering the poor-risk patient characteristics and the use of unrelated donors for RIC AlloHCT in the majority of cases.

MATERIALS
Product Number
Brand
Product Description

Supelco
Mycophenolate Mofetil, Pharmaceutical Secondary Standard; Certified Reference Material
Sigma-Aldrich
Mycophenolate mofetil, ≥98% (HPLC)
USP
Mycophenolate mofetil, United States Pharmacopeia (USP) Reference Standard
Mycophenolate mofetil, European Pharmacopoeia (EP) Reference Standard
Supelco
Busulfan, analytical standard, for drug analysis
Busulfan, European Pharmacopoeia (EP) Reference Standard
Mycophenolate mofetil for peak identification, European Pharmacopoeia (EP) Reference Standard