BACKGROUND: Relapse of non-Hodgkin's lymphoma (NHL) remains a problem after autologous stem cell transplantation (ASCT). Soon after ASCT, the immune system is not very active, and this immune incompetence could thus result in decreased ability for immune-mediated tumor eradication. The early addition of immunotherapy after ASCT might decrease the incidence of relapse and prolong survival. In an initial phase I/II trial at our center, the immune modulator interleukin-2 (IL-2) increased over baseline natural killer and lymphokine-activated killer activity in vitro. Because rituximab can lyse CD20-bearing cells by antibody-dependent cellular cytotoxicity, adding IL-2 to rituximab might boost its effectiveness. It thus seemed reasonable to study this combination after ASCT. The results of our phase II study are reported herein. PATIENTS AND METHODS: Twenty patients with CD20+ NHL who had ASCT were treated. The median time to starting therapy was 79 days (range, 49-100 days) after transplantation. RESULTS: The majority of patients reported grade <or= 2 erythema, induration and pain at IL-2 injection sites, flu-like symptoms, and worsening fatigue. Neutropenia that responded to granulocyte colony-stimulating factor was the most common grade 3/4 toxicity, seen in 45% of patients. There were no treatment-related deaths. Eighteen of 20 patients remain alive in complete remission, with a median follow-up of 55.5 months (range, 17-64 months). CONCLUSION: Interleukin-2/rituximab can be administered after ASCT with manageable toxicity. A randomized trial is under way to address whether this combination therapy is beneficial to patients with NHL who have had ASCT.
BACKGROUND: Relapse of non-Hodgkin's lymphoma (NHL) remains a problem after autologous stem cell transplantation (ASCT). Soon after ASCT, the immune system is not very active, and this immune incompetence could thus result in decreased ability for immune-mediated tumor eradication. The early addition of immunotherapy after ASCT might decrease the incidence of relapse and prolong survival. In an initial phase I/II trial at our center, the immune modulator interleukin-2 (IL-2) increased over baseline natural killer and lymphokine-activated killer activity in vitro. Because rituximab can lyse CD20-bearing cells by antibody-dependent cellular cytotoxicity, adding IL-2 to rituximab might boost its effectiveness. It thus seemed reasonable to study this combination after ASCT. The results of our phase II study are reported herein. PATIENTS AND METHODS: Twenty patients with CD20+ NHL who had ASCT were treated. The median time to starting therapy was 79 days (range, 49-100 days) after transplantation. RESULTS: The majority of patients reported grade <or= 2 erythema, induration and pain at IL-2 injection sites, flu-like symptoms, and worsening fatigue. Neutropenia that responded to granulocyte colony-stimulating factor was the most common grade 3/4 toxicity, seen in 45% of patients. There were no treatment-related deaths. Eighteen of 20 patients remain alive in complete remission, with a median follow-up of 55.5 months (range, 17-64 months). CONCLUSION:Interleukin-2/rituximab can be administered after ASCT with manageable toxicity. A randomized trial is under way to address whether this combination therapy is beneficial to patients with NHL who have had ASCT.
Authors: Richard E Harris; Amanda M Termuhlen; Lynette M Smith; James Lynch; Michael M Henry; Sherrie L Perkins; Thomas G Gross; Phyllis Warkentin; Adrianna Vlachos; Lauren Harrison; Mitchell S Cairo Journal: Biol Blood Marrow Transplant Date: 2010-07-15 Impact factor: 5.742
Authors: S A Graf; P A Stevenson; L A Holmberg; B G Till; O W Press; T R Chauncey; S D Smith; M Philip; J J Orozco; A R Shustov; D J Green; E N Libby; W I Bensinger; J M Pagel; D G Maloney; Y Zhou; R D Cassaday; A K Gopal Journal: Ann Oncol Date: 2015-09-07 Impact factor: 32.976
Authors: John A Thompson; Richard I Fisher; Michael Leblanc; Stephen J Forman; Oliver W Press; Joseph M Unger; Auayporn P Nademanee; Patrick J Stiff; Stephen H Petersdorf; Alexander Fefer Journal: Blood Date: 2008-02-06 Impact factor: 22.113