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Therapeutic options for patients with hodgkin’s disease and non-hodgkin’s lymphoma who relapse after autologous transplant

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Opinion statement

Although autologous stem cell transplantation for Hodgkin’s disease and non-Hodgkin’s lymphoma has become a safe and effective therapy, relapses after transplant are common. Emerging data indicate that an increasing number of patients can be re-induced into durable complete remission. Conventional dose-salvage chemotherapy and single-agent monoclonal antibody treatment provided limited success, but combination chemotherapy-monoclonal antibody treatments, second autografts, and reduced-intensity conditioning allografts provide encouraging results. For some patients, the best strategy may consist of participation in phase I to II studies of novel agents. New strategies designed to prevent relapse after autograft include cytokine therapy such as interleukin-2 in combination with monoclonal antibodies and the use of autologous antilymphoma vaccines.

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References and Recommended Reading

  1. Vose JM, Bierman PJ, Anderson JR, et al.: Progressive disease after high-dose chemotherapy and autologous marrow transplantation for lymphoid malignancy: clinical course and patient follow-up. Blood 1992, 80:2142–2148.

    PubMed  CAS  Google Scholar 

  2. Rodriguez-Monge EJ, Cabanillas F: Long-term follow-up of platinum-based lymphoma salvage regimens. The MD Anderson Cancer Center experi-ence. Hematol Oncol Clin North Am 1997, 11:937–947.

    Article  PubMed  CAS  Google Scholar 

  3. Van Besien KW, Tabocoff J, Rodriguez MA, et al.: Intensive chemotherapy with the BEAC regimen and autologous bone marrow transplantation in patients with refractory or recurrent intermediate grade and immunoblastic lymphoma; toxicity, long-term follow-up and identification of prognostic factors. Bone Marrow Transplant 1995, 15:549–555.

    PubMed  Google Scholar 

  4. Smith SM, Grinblatt D, van Besien K: Autologous and allogeneic transplantation for aggressive NHL. Cytotherapy 2002, 4:223–240.

    Article  PubMed  CAS  Google Scholar 

  5. Haioun C, Lepage E, Gisselbrecht C, et al.: Survival benefit of high-dose therapy in poor-risk aggressive non-Hodgkin’s lymphoma: final analysis of the prospective LNH87-2 protocol: a groupe d’Etude des lymphomes de l’Adulte study. J Clin Oncol 2000, 18:3025–3030.

    PubMed  CAS  Google Scholar 

  6. Tse WW, Lazarus HM, Van Besien K: Stem cell transplantation in follicular lymphoma: progress at last? Bone Marrow Transplant 2004, 34:929–938. This article reviews the most up-to-date transplant treatment options for follicular non-Hodgkin’s lymphoma.

    Article  PubMed  CAS  Google Scholar 

  7. Mounier N, Briere J, Gisselbrecht C, et al.: Rituximab plus CHOP (R-CHOP) overcomes bcl-2-associated resistance to chemotherapy in elderly patients with diffuse large B-cell lymphoma (DLBCL). Blood 2003, 101:4279–4284.

    Article  PubMed  CAS  Google Scholar 

  8. Johnson PW, Sweetenham JW, McCallum P, et al.: E-SHAP, inadequate treatment for poor prognosis recurrent lymphoma. Ann Oncol 1993, 4:63–67.

    PubMed  CAS  Google Scholar 

  9. Broun ER, Nichols CR, Tricot G, et al.: High-dose carbo-platin/VP-16 plus ifosfamide with autologous bone marrow support in the treatment of refractory germ cell tumors. Bone Marrow Transplant 1991, 7:53–56.

    PubMed  CAS  Google Scholar 

  10. Coiffier B, Lepage E, Briere J, et al.: Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 2002, 346:235–242.

    Article  PubMed  CAS  Google Scholar 

  11. Magni M, Di Nicola M, Devizzi L, et al.: Successful in vivo purging of CD34-containing peripheral blood harvests in mantle cell and indolent lymphoma: evidence for a role of both chemotherapy and rituximab infusion. Blood 2000, 96:864–869.

    PubMed  CAS  Google Scholar 

  12. Witzig TE: Efficacy and safety of 90Y ibritumomab tiuxetan (Zevalin) radioimmunotherapy for non-Hodgkin’s lymphoma. Semin Oncol 2003, 30:11–16.

    Article  PubMed  CAS  Google Scholar 

  13. Vose JM: Bexxar: novel radioimmunotherapy for the treatment of low-grade and transformed low-grade non-Hodgkin’s lymphoma. Oncologist 2004, 9:160–172.

    Article  PubMed  CAS  Google Scholar 

  14. Fuks Z, Kaplan HS: Recurrence rates following radiation therapy of nodular and diffuse lymphomas. Radiology 1973, 108:675–684.

    PubMed  CAS  Google Scholar 

  15. Dowlati A, Lazarus HM, Hartman P, et al.: Phase I and correlative study of combination bryostatin-1 and vincristine in refractory B-cell malignancies. Clin Cancer Res 2003, 9:5929–5935.

    PubMed  CAS  Google Scholar 

  16. Frei E, III, Holden SA, Gonin R, et al.: Antitumor alkylating agents: in vitro cross-resistance and collateral sensitivity studies. Cancer Chemother Pharmacol 1993, 33:113–122.

    Article  PubMed  CAS  Google Scholar 

  17. de Lima M, van Besien K, Giralt SA, et al.: Bone marrow transplantation after failure of autologous transplant for non-Hodgkin’s lymphoma. Bone Marrow Transplant 1997, 19:121–127.

    Article  PubMed  Google Scholar 

  18. Smith SM, Levitan D, Welborne K, et al.: Thiotepa, busulfan, cyclophosphamide (TBC) conditioning for second autologous transplants in patients with primary mediastinal B cell lymphoma may induce durable remissions [abstract]. Blood 2003, 102.

  19. Przepiorka D, Nath R, Ippoliti C, et al.: A Phase I to II study of high-dose thiotepa, busulfan, and cyclophos-phamide as a preparative regimen for autologous transplantation for malignant lymphoma. Leuk Lymphoma 1995, 17:427–433.

    PubMed  CAS  Google Scholar 

  20. Vandenberghe E, Pearce R, Taghipour G, et al.: Role of a second transplant in the management of poor-prog-nosis lymphomas: a report from the European Blood and Bone Marrow Registry. J Clin Oncol 1997, 15:1595–1600.

    PubMed  CAS  Google Scholar 

  21. Lenain C, Dumontet C, Gargi T, et al.: Second auto-logous transplantation after failure of a first auto-logous transplant in 18 patients with non-Hodgkin’s lymphoma. Hematol J 2004, 5:403–409.

    Article  PubMed  Google Scholar 

  22. Schouten HC, Armitage JO, Klassen LW, et al.: Allogeneic bone marrow transplantation in patients with lymphoma relapsing after autologous marrow trans-plantation. Bone Marrow Transplant 1989, 4:119–121.

    PubMed  CAS  Google Scholar 

  23. Bierman P, Kottaridis P, Kollath J, et al.: Allogeneic transplantation following failure of autologous transplantation for lymphoma [abstract]. Blood 1998, 92:321.

    Google Scholar 

  24. Chiang KY, Weisdorf DJ, Davies SM, et al.: Outcome of second bone marrow transplantation following a uniform conditioning regimen as therapy for malig-nant relapse. Bone Marrow Transplant 1996, 17:39–42.

    PubMed  CAS  Google Scholar 

  25. Freytes CO, Loberiza FR, Rizzo JD, et al.: Myeloablative allogeneic hematopoietic stem cell transplantation in patients who experience relapse after autologous stem cell transplantation for lymphoma: a report of the International Bone Marrow Transplant Registry. Blood 2004, 104:3797–3803. This series reviews the International Blood and Marrow Trans-plant Registry (IBMTR) 1990 to 1999 data on 114 lymphoma patients treated using a myeloablative conditioning regimen and allogeneic hematopoietic stem cell transplantation.

    Article  PubMed  CAS  Google Scholar 

  26. Feinstein LC, Sandmaier BM, Maloney DG, et al.: Allografting after nonmyeloablative conditioning as a treatment after a failed conventional hematopoietic cell transplant. Biol Blood Marrow Transplant 2003, 9:266–272.

    Article  PubMed  Google Scholar 

  27. Branson K, Chopra R, Kottaridis PD, et al.: Role of non-myeloablative allogeneic stem cell transplantation after failure of autologous transplantation in patients with lymphoproliferative malignancies. J Clin Oncol 2002, 20:4022–4031.

    Article  PubMed  Google Scholar 

  28. Escalon MP, Champlin RE, Saliba RM, et al.: Nonmyeloablative allogeneic hematopoietic transplantation: a promising salvage therapy for patients with non-Hodgkin’s lymphoma whose disease has failed a prior autologous transplantation. J Clin Oncol 2004, 22:2419–2423. This single center investigated the safety and efficacy of nonmyeloablative (fludarabine-containing) stem cell transplantation in 20 consecutive lymphoma patients who experienced a recurrence after an autologous transplantation.

    Article  PubMed  Google Scholar 

  29. Ahmed T, Rashid K, Waheed F, et al.: Long-term survival of patients with resistant lymphoma treated with tandem stem cell transplant. Leuk Lymphoma 2005, 46:405–414.

    Article  PubMed  CAS  Google Scholar 

  30. Maloney DG: Graft-versus-lymphoma effect in various histologies of non-Hodgkin’s lymphoma. Leuk Lymphoma 2003, 44(Suppl 3):99–105.

    Article  Google Scholar 

  31. Horwitz SM, Negrin RS, Blume KG, et al.: Rituximab as adjuvant to high-dose therapy and autologous hematopoietic cell transplantation for aggressive non-Hodgkin’s lymphoma. Blood 2004, 103:777–783.

    Article  PubMed  CAS  Google Scholar 

  32. Hoerr AL, Gao F, Hidalgo J, et al.: Effects of pretransplant-ation treatment with rituximab on outcomes of autologous stem-cell transplantation for non-Hodgkin’s lymphoma. J Clin Oncol 2004, 22:4561–4566.

    Article  PubMed  CAS  Google Scholar 

  33. Lemieux B, Tartas S, Traulle C, et al.: Rituximab-related late-onset neutropenia after autologous stem cell transplantation for aggressive non-Hodgkin’s lymphoma. Bone Marrow Transplant 2004, 33:921–923.

    Article  PubMed  CAS  Google Scholar 

  34. Flinn IW, O’Donnell PV, Goodrich A, et al.: Immuno-therapy with rituximab during peripheral blood stem cell transplantation for non-Hodgkin’s lymphoma. Biol Blood Marrow Transplant 2000, 6:628–632.

    Article  PubMed  CAS  Google Scholar 

  35. Smith SM, Grinblatt D, Gajewski T, et al.: Prospective study of immunomodulation with GM-CSF, IL-2, and rituximab following autologous stem cell transplant (SCT) in patients with relapsed lymphomas [abstract]. Blood 2004, 104.

  36. van Besien K, Mehra R, Wadehra N, et al.: Phase II study of autologous transplantation with interleukin-2-incubated peripheral blood stem cells and post-transplantation interleukin-2 in relapsed or refractory non-Hodgkin’s lymphoma. Biol Blood Marrow Transplant 2004, 10:386–394.

    Article  PubMed  CAS  Google Scholar 

  37. Holman PR, deMagalhaes-Silverman M, Medina B, et al.: Idiotype (Id) immunotherapy (IT) following high-dose therapy and autologous stem cell transplant (HDT/ASCT) in mantle cell (MC) and indolent lym-phoma (IL): cellular, humoral and clinical responses [abstract]. Proc ASCO 2005. In press.

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Authors and Affiliations

  1. Section of Hematology/Oncology, University of Chicago, Rm I 209, 5841 South Maryland Ave, 60637, Chicago, Illinois, USA

    Koen van Besien MD

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  1. Koen van Besien MD
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  2. Sonali Smith MD
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  3. Hillard M. Lazarus MD, FACP
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van Besien, K., Smith, S. & Lazarus, H.M. Therapeutic options for patients with hodgkin’s disease and non-hodgkin’s lymphoma who relapse after autologous transplant. Curr. Treat. Options in Oncol. 6, 279–287 (2005). https://doi.org/10.1007/s11864-005-0032-z

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