Francine M Foss1, Xin Victoria Wang2, Selina M Luger3, Opeyemi Jegede2, Kenneth B Miller4, Edward A Stadtmauer3, Theresa L Whiteside5, David E Avigan6, Randall D Gascoyne7, Daniel Arber8, Henry Wagner9, Roger K Strair10, William J Hogan11, Kellie A Sprague4, Hillard M Lazarus12, Mark R Litzow11, Martin S Tallman13, Sandra J Horning14. 1. Hematology and Bone Marrow Transplantation, Yale University School of Medicine, Boston, Massachusetts. 2. E-A Biostatistical Center, Dana Farber Cancer Institute, Boston, Massachusetts, USA. 3. Hematology Oncology, University of Pennsylvania/Abramson Cancer Center, Philadelphia, Pennsylvania. 4. Hematology and Oncology, Tufts Medical Center, Boston, Massachusetts. 5. Department of Pathology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania. 6. Hematology and Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts. 7. Department of Pathology and Laboratory Medicine, British Columbia Cancer Center for Lymphoid Malignancies, Vancouver, Canada. 8. University of Chicago, Chicago, Illinois. 9. Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania. 10. Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey. 11. Mayo Clinic, Rochester, Minnesota. 12. University Hospitals Seidman Cancer Center, Cleveland, Ohio. 13. Memorial Sloan Kettering Cancer Center, New York, New York. 14. Genentech Inc, San Francisco, California.
Abstract
BACKGROUND: Extracorporeal photopheresis (ECP) is an immunomodulatory cellular therapy which has been shown to induce a tolerogenic state in patients with acute and chronic graft-vs-host disease. ECOG-ACRIN explored the activity of ECP as a part of a reduced intensity conditioning regimen in two multicenter trials in patients with MDS (E1902) and lymphomas (E1402). While both studies closed before completing accrual, we report results in 23 patients (17 MDS and 6 lymphoma). STUDY DESIGN AND METHODS: Patients received 2 days of ECP followed by pentostatin 4 mg/m2 /day for two consecutive days, followed by 600 cGy of total body irradiation prior to stem cell infusion. Immunosuppression for aGVHD was infusional cyclosporine A or tacrolimus and methotrexate on day +1, +3, with mycophenolate mofetil starting on day 100 for chronic GVHD prophylaxis. RESULTS: All patients engrafted, with median time to neutrophil and platelet engraftment of 15-18 days and 10-18 days respectively. Grade 3 or 4 aGVHD occurred in 13% and chronic extensive GVHD in 30%. CONCLUSIONS: These studies demonstrate that ECP/pentostatin/TBI is well tolerated and associated with adequate engraftment of neutrophils and platelets in patients with lymphomas and MDS.
BACKGROUND: Extracorporeal photopheresis (ECP) is an immunomodulatory cellular therapy which has been shown to induce a tolerogenic state in patients with acute and chronic graft-vs-host disease. ECOG-ACRIN explored the activity of ECP as a part of a reduced intensity conditioning regimen in two multicenter trials in patients with MDS (E1902) and lymphomas (E1402). While both studies closed before completing accrual, we report results in 23 patients (17 MDS and 6 lymphoma). STUDY DESIGN AND METHODS: Patients received 2 days of ECP followed by pentostatin 4 mg/m2 /day for two consecutive days, followed by 600 cGy of total body irradiation prior to stem cell infusion. Immunosuppression for aGVHD was infusional cyclosporine A or tacrolimus and methotrexate on day +1, +3, with mycophenolate mofetil starting on day 100 for chronic GVHD prophylaxis. RESULTS: All patients engrafted, with median time to neutrophil and platelet engraftment of 15-18 days and 10-18 days respectively. Grade 3 or 4 aGVHD occurred in 13% and chronic extensive GVHD in 30%. CONCLUSIONS: These studies demonstrate that ECP/pentostatin/TBI is well tolerated and associated with adequate engraftment of neutrophils and platelets in patients with lymphomas and MDS.
Authors: P Perfetti; P Carlier; P Strada; F Gualandi; D Occhini; M T Van Lint; A Ibatici; T Lamparelli; B Bruno; A M Raiola; A Dominietto; C Di Grazia; S Bregante; S Zia; G M Ferrari; P Stura; E Pogliani; A Bacigalupo Journal: Bone Marrow Transplant Date: 2008-07-28 Impact factor: 5.483
Authors: Michael Gerner; Kristina Hölig; Rebekka Wehner; Senming Zhao; Knut Schäkel; Michael Philipp Bachmann; Ernst Peter Rieber; Martin Bornhäuser; Marc Schmitz Journal: Transplantation Date: 2009-04-27 Impact factor: 4.939
Authors: K B Miller; T F Roberts; G Chan; D P Schenkein; D Lawrence; K Sprague; G Gorgun; V Relias; H Grodman; A Mahajan; F M Foss Journal: Bone Marrow Transplant Date: 2004-05 Impact factor: 5.483
Authors: Udo Holtick; Xiao N Wang; Scott R Marshall; Christof Scheid; Michael von Bergwelt-Baildon; Anne M Dickinson Journal: Curr Stem Cell Res Ther Date: 2013-07 Impact factor: 3.828
Authors: P J Shaughnessy; B J Bolwell; K van Besien; M Mistrik; A Grigg; A Dodds; H M Prince; S Durrant; O Ilhan; D Parenti; J Gallo; F Foss; J Apperley; M-J Zhang; M M Horowitz; S Abhyankar Journal: Bone Marrow Transplant Date: 2009-11-16 Impact factor: 5.483
Authors: Lisa H Shiue; Amin M Alousi; Caimiao Wei; Chitra M Hosing; Madeleine Duvic; Xiao Ni Journal: J Invest Dermatol Date: 2013-03-21 Impact factor: 8.551