期刊
TRANSPLANTATION AND CELLULAR THERAPY
卷 27, 期 1, 页码 -出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2020.09.021
关键词
Radiotherapy; Immunotherapy; Anti-CD45; Antibody-radionuclide conjugate; Lymphoma
资金
- National Institutes of Health [P01 CA044991, P30 CA015704]
- National Cancer Institute
- Conquer Cancer Foundation
Autologous hematopoietic cell transplantation (AHCT) is a standard treatment for high-risk lymphoma, but often does not achieve long-term remissions. Research on using CD45-targeted antibody-radionuclide conjugate (ARC) preceding AHCT in lymphoma patients suggests potential improvement in outcomes by allowing curative doses of radiation with minimized toxicity. The use of ARC in conjunction with novel therapies or immunotherapies should be further explored based on the feasibility and tolerability shown in this study.
Autologous hematopoietic cell transplantation (AHCT) is a standard of care for several subtypes of high-risk lymphoma, but durable remissions are not achieved in the majority of patients. Intensified conditioning using CD45targeted antibody-radionuclide conjugate (ARC) preceding AHCT may improve outcomes in lymphoma by permitting the delivery of curative doses of radiation to disease sites while minimizing toxicity. We performed sequential phase I trials of escalating doses of yttrium-90 (90Y)-labeled anti-CD45 antibody with or without BEAM (carmustine, etoposide, cytarabine, melphalan) chemotherapy followed by AHCT in adults with relapsed/refractory or high-risk B cell non-Hodgkin lymphoma (NHL), T cell NHL (T-NHL), or Hodgkin lymphoma (HL). Twenty-one patients were enrolled (16 NHL, 4 HL, 1 T-NHL). Nineteen patients received BEAM concurrently. No dose-limiting toxicities were observed; therefore, the maximum tolerated dose is estimated to be similar to 34 Gy to the liver. Nonhematologic toxicities and engraftment kinetics were similar to standard myeloablative AHCT. Late myeloid malignancies and 100-day nonrelapse deaths were not observed. At a median follow-up of 5 years, the estimates of progression-free and overall survival of 19 patients were 37% and 68%, respectively. Two patients did not receive BEAM; one had stable disease and the other progressive disease post-transplant. The combination of 90Y-antiCD45 with BEAM and AHCT was feasible and tolerable in patients with relapsed and refractory lymphoma. The use of anti-CD45 ARC as an adjunct to hematopoietic cell transplantation regimens or in combination with novel therapies/immunotherapies should be further explored based on these and other data. (C) 2020 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据