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Posted by on Mar 26, 2019 in Non-Hodgkin lymphoma | 0 comments

In a nutshell

This study aimed to investigate the impact of the graft-versus-lymphoma effect on the outcomes for patients with lymphoma who are treated with reduced-intensity conditioning (RIC) with alemtuzumab (Lemtrada) allogeneic hematopoietic stem cell transplant (allo-HSCT). 

This study concluded that the graft-versus-lymphoma effect leads to good long-term outcomes and is a protective factor against relapse for these patients.

Some background

Allogeneic hematopoietic stem cell transplant (allo-HSCT) is a potentially curative therapy for patients with relapsed/unresponsive lymphoma. Allo-HSCT is a procedure where the patient receives blood-forming stem cells from a non-identical donor such as a sister or brother. 

Reduced-intensity conditioning (RIC) uses less chemotherapy to kill cancer cells before a transplant. RIC with alemtuzumab reduces transplant-related mortality and graft-versus-host disease (GvHD). RIC may also be associated with an increased risk of relapse. GvHD can occur after an allo-HSCT. It occurs when the stem cells view the body as foreign and begin to attack it. Graft versus lymphoma (GVL) effect is a good response that occurs when donor cells attack lymphoma cells. Alemtuzumab is a monoclonal antibody. It works by targeting cancer cells to destroy them.

The impact of the GVL effect on outcomes for patients with lymphoma treated with RIC-alemtuzumab-alloHSCT is still unknown.

Methods & findings

This study involved 288 patients with lymphoma. 57% of patients had non-Hodgkin’s lymphoma and 24% had Hodgkin’s lymphoma. 58% of all patients involved had relapsed/unresponsive disease. All patients underwent RIC-alemtuzumab-alloHSCT. Patients were followed for an average of 64 months. 

The five-year overall survival rate was 47%. The relapse rate after 5 years was 33%. The GvHD/relapse-free survival rate was 37%. 

GVHD occurred in 22% of patients at 100 days. This rate was 21% at 5 years. The presence of GvHD protected against relapse. Patients who received stem cells from an unrelated donor were also protected from relapse.

The bottom line

This study concluded that the GVL effect leads to good long-term outcomes and is a protective factor against relapse for patients with lymphoma who are treated with RIC-alemtuzumab-alloHSCT.

The fine print

This study was based on medical records. Some data might have been missing.

Published By :

British Journal of Haematology

Date :

Nov 22, 2018

Original Title :

Impact of graft-versus-lymphoma effect on outcomes after reduced intensity conditioned-alemtuzumab allogeneic haematopoietic stem cell transplantation for patients with mature lymphoid malignancies.

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