- Email: [email protected]
Autologous stem cell transplantation for advanced follicular lymphoma – One centre experience
37
acta haematologica polonica 44s (2013) 36–37
Tabela II – Immunofenotypowa diagnostyka różnicowa chłoniaków indolentnych Chłoniak
sIg
SLL/CLL MCL MZL (MALT,SMZL, NMZL) FL LPL
Monoklonalne (dim) Monoklonalne (bright) Monoklonalne (bright) Monoklonalne (bright) Monoklonalne (cIg w komórkach plazmatycznych)
CD20
CD23
CD10/BCL6
CD5
Cyklina D1
(dim)
+ +/+/-
+ -
+ + +/-
+ -
+ + + + +
(bright) (bright) (bright)
s (surface) – powierzchniowe, c (cytoplasmic) – cytoplazmatyczne
Tabela III – Genetyczna diagnostyka różnicowa chłoniaków indolentnych Chłoniak SLL/CLL MCL MALT SMZL NMZL FL LPL
Nieprawidłowości chromosomalne
Deregulowany gen lub białko fuzyjne
+12, delecja 13q, delecja 11q, delecja 17p, delecja 6q t(11;14)(q13;q32) t(11;18)(q21;q21), t(1;14)(p22;q32), t(1;2)(p22;p12), t(14;18)(q21;q32), t(3;14) (p14;q32) delecja 7q31-32 +3, +8, +18 t(14;18)(q32;q21) t(9;14)(p13;q32)
miR-15-16, DLEU7, TP53 CCND1 API2-MALT1, BCL10, BCL10, MALT1, FOXP1 Nieznane Nieznane BCL2 PAX5
immunofenotypowych i genetycznych oraz identyfikację cząsteczek koniecznych do zastosowania terapii celowanej takich jak CD20, CD22 i CD52. Morfologiczną, immunofenotypową i genetyczną diagnostykę różnicową chłoniaków indolentnych przedstawiono w tabelach I–III. http://dx.doi.org/10.1016/j.achaem.2013.07.237
Autologous stem cell transplantation for advanced follicular lymphoma – One centre experience G. Helbig 1,**, A. Kopińska 1,*, R. Kurzawa 2, T. Kandzia 2, M. Krawczyk-Kuliś 1, S. Kyrcz-Krzemień 1 Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland 2 Student's Research Group, Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland *Presenting author. **Corresponding author. Adres email: [email protected]
1
Introduction: Follicular lymphoma (FL) is a malignant disorder characterized by clonal proliferation of normal germinal centre B cells. Standard induction treatment includes anti-CD20 monoclonal antibody combined with chemotherapy. However highdose therapy followed by autologous stem cell transplantation (ASCT) is becoming more widely used, especially as a remission consolidation in patients with advanced disease or as a second-line therapy, leading to improved progressionfree survival (PFS) rates. Patients and Methods: We retrospectively evaluated the results of ASCT for 49 FL patients (25 male and 24 female) at median age of 50 years (range 20–71 years) transplanted in our centre between 1993 and 2012. 92% of transplanted patients had III/IV disease stage at diagnosis. Patients achieving first or subsequent complete (CR) or partial response (PR) after conventional chemotherapy were proceeded to ASCT. Results: The induction treatment consisted of R-CHOP (rituximab, cyclophosphamide, vincristine, adriamycin, prednisone) in 28 patients, CHOP in 8 patients, R-CVP (rituximab, cyclophosphamide, vincristine, prednisone) in 9 patients and other schema in 4 cases. The complete response was achieved in 26 patients (53%), and the partial response in 23 patients (47%). Conditioning regimen before ASCT consisted of CBV (cyclophosphamide, BCNU, etoposide) and BEAM (BCNU, cytarabine, etoposide, melphalan) for 43 and 3 patients, respectively. Six patients died 100 days after ASCT giving the transplant-related mortality (TRM) of 12%. The causes of death were infections and disease relapse. The median follow-up from ASCT is 2.5 years (range 0.03–19.06). The 3-year probability of overall survival (OS) for patients transplanted in CR was 59% and in PR was 49%, respectively. Twenty patients (41%) died due to disease progression and the remaining 29 were in CR. Conclusion: ASCT as a consolidation of remission for patients with FL after achieving first complete or partial response were found to be effective and relatively safe procedure. http://dx.doi.org/10.1016/j.achaem.2013.07.238
acta haematologica polonica 44s (2013) 36–37
Tabela II – Immunofenotypowa diagnostyka różnicowa chłoniaków indolentnych Chłoniak
sIg
SLL/CLL MCL MZL (MALT,SMZL, NMZL) FL LPL
Monoklonalne (dim) Monoklonalne (bright) Monoklonalne (bright) Monoklonalne (bright) Monoklonalne (cIg w komórkach plazmatycznych)
CD20
CD23
CD10/BCL6
CD5
Cyklina D1
(dim)
+ +/+/-
+ -
+ + +/-
+ -
+ + + + +
(bright) (bright) (bright)
s (surface) – powierzchniowe, c (cytoplasmic) – cytoplazmatyczne
Tabela III – Genetyczna diagnostyka różnicowa chłoniaków indolentnych Chłoniak SLL/CLL MCL MALT SMZL NMZL FL LPL
Nieprawidłowości chromosomalne
Deregulowany gen lub białko fuzyjne
+12, delecja 13q, delecja 11q, delecja 17p, delecja 6q t(11;14)(q13;q32) t(11;18)(q21;q21), t(1;14)(p22;q32), t(1;2)(p22;p12), t(14;18)(q21;q32), t(3;14) (p14;q32) delecja 7q31-32 +3, +8, +18 t(14;18)(q32;q21) t(9;14)(p13;q32)
miR-15-16, DLEU7, TP53 CCND1 API2-MALT1, BCL10, BCL10, MALT1, FOXP1 Nieznane Nieznane BCL2 PAX5
immunofenotypowych i genetycznych oraz identyfikację cząsteczek koniecznych do zastosowania terapii celowanej takich jak CD20, CD22 i CD52. Morfologiczną, immunofenotypową i genetyczną diagnostykę różnicową chłoniaków indolentnych przedstawiono w tabelach I–III. http://dx.doi.org/10.1016/j.achaem.2013.07.237
Autologous stem cell transplantation for advanced follicular lymphoma – One centre experience G. Helbig 1,**, A. Kopińska 1,*, R. Kurzawa 2, T. Kandzia 2, M. Krawczyk-Kuliś 1, S. Kyrcz-Krzemień 1 Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland 2 Student's Research Group, Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland *Presenting author. **Corresponding author. Adres email: [email protected]
1
Introduction: Follicular lymphoma (FL) is a malignant disorder characterized by clonal proliferation of normal germinal centre B cells. Standard induction treatment includes anti-CD20 monoclonal antibody combined with chemotherapy. However highdose therapy followed by autologous stem cell transplantation (ASCT) is becoming more widely used, especially as a remission consolidation in patients with advanced disease or as a second-line therapy, leading to improved progressionfree survival (PFS) rates. Patients and Methods: We retrospectively evaluated the results of ASCT for 49 FL patients (25 male and 24 female) at median age of 50 years (range 20–71 years) transplanted in our centre between 1993 and 2012. 92% of transplanted patients had III/IV disease stage at diagnosis. Patients achieving first or subsequent complete (CR) or partial response (PR) after conventional chemotherapy were proceeded to ASCT. Results: The induction treatment consisted of R-CHOP (rituximab, cyclophosphamide, vincristine, adriamycin, prednisone) in 28 patients, CHOP in 8 patients, R-CVP (rituximab, cyclophosphamide, vincristine, prednisone) in 9 patients and other schema in 4 cases. The complete response was achieved in 26 patients (53%), and the partial response in 23 patients (47%). Conditioning regimen before ASCT consisted of CBV (cyclophosphamide, BCNU, etoposide) and BEAM (BCNU, cytarabine, etoposide, melphalan) for 43 and 3 patients, respectively. Six patients died 100 days after ASCT giving the transplant-related mortality (TRM) of 12%. The causes of death were infections and disease relapse. The median follow-up from ASCT is 2.5 years (range 0.03–19.06). The 3-year probability of overall survival (OS) for patients transplanted in CR was 59% and in PR was 49%, respectively. Twenty patients (41%) died due to disease progression and the remaining 29 were in CR. Conclusion: ASCT as a consolidation of remission for patients with FL after achieving first complete or partial response were found to be effective and relatively safe procedure. http://dx.doi.org/10.1016/j.achaem.2013.07.238