Meeting
2022 ASCO Annual Meeting
Mismatched donor transplantation with post-transplantation cyclophosphamide for advanced cutaneous T-cell lymphoma: A single-center experience.
Authors
Michael Sang Hughes
Johns Hopkins Medical Institution, Baltimore, MD
Michael Sang Hughes , Cole Harris Sterling , Ravi Varadhan , Richard F. Ambinder , Richard J. Jones , Sima Rozati , Javier Bolanos-Meade , Leo Luznik , Alexander Joseph Ambinder , Nina D. Wagner-Johnston , Ephraim Joseph Fuchs
Organizations
Johns Hopkins Medical Institution, Baltimore, MD, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, Johns Hopkins Univ, Ellicott City, MD, Johns Hopkins University, Baltimore, MD, Johns Hopkins, Baltimore, MD, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
Research Funding
No funding received
Background: Mismatched blood or marrow transplantation (BMT) using post-transplantation cyclophosphamide (PTCy) for graft-versus-host disease (GvHD) prophylaxis has not been well-studied in CTCL. Methods: We analyzed all patients above 18 years old with relapsed/refractory CTCL undergoing mismatched alloBMT. Primary endpoints included disease-free survival (DFS) and overall survival (OS). Secondary endpoints included time to neutrophil and platelet recovery, GvHD outcomes, and day +30 and day +60 donor chimerism. Results: From 2003-2020, 8 patients with relapsed CTCL underwent mismatched related (n=7) or mismatched unrelated (n=1) BMT. Mean age was 50 years (range 30-62); median time from diagnosis was 2 years (range 1.3-11.4). All had received prior treatment for their disease; two (25%) had received immune checkpoint inhibitors. Four (50%) were in partial response and 4 (50%) were in complete remission prior to BMT. Six received bone marrow grafts. Two received mobilized peripheral blood. Five (62.5%) achieved full donor chimerism by day 30 after BMT; 6 (75%) had achieved full donor chimerism by day 60 after BMT. One patient failed to engraft. Mean time to neutrophil recovery was 17.3 days (range 17-45); mean time to platelet recovery was 28.4 days (range 11-69). Median DFS was 11.3 months (95% confidence interval 2.6 months-not reached). Median OS was not reached. One patient developed grade 1 acute GvHD, and 2 patients developed mild chronic GvHD. There were no instances of transplantation-related mortality (TRM). At 1 year post-BMT, 4 patients had relapsed (50%), and no patients had died. At 3 years post-BMT, 7 patients had relapsed (87.5%), and 1 patient had died (12.5%). Conclusions: In our preliminary retrospective study, partially mismatched BMT with PTCy-based GVHD prophylaxis for advanced-stage CTCL was associated with minimal GvHD, no TRM, and good long-term survival. Investigation into relapse reduction is warranted.
| Case 1 | Case 2 | Case 3 | Case 4 | Case 5a | Case 5b | Case 6 | Case 7 | Case 8 | |
|---|---|---|---|---|---|---|---|---|---|
| DFS (months) | 99.2 | 5.8 | 6.1 | 2.6 | 6.8 | 12.9 | 9.8 | 26.5 | 13.1 |
| Survival time after relapse (months) | No relapse | 10.1 | 25.0 | 73.9 | 17.2 | 0.8 | 78.1 | No relapse | No relapse |
| Neutrophil recovery (days) | N/A | 45 | 14 | N/A | 17 | 18 | 9 | 7 | 13 |
| Platelet recovery (days) | 20 | 69 | 21 | 11 | 99 | 52 | 13 | 19 | 22 |
| Onset of acute GvHD (days) | None | None | 71 | None | None | None | None | None | None |
| Onset of chronic GvHD (days) | None | None | 125 | None | None | None | 186 | None | None |
Patient 5 first received double umbilical cord blood BMT, then mMUD (HLA 9/10 antigens matched) transplant after initial graft failure. “Case 5b” represents clinical course after mMUD.
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Details
Session Type
Publication Only
Session Title
Hematologic Malignancies—Leukemia, Myelodysplastic Syndromes, and Allotransplant
Track
Hematologic Malignancies
Sub Track
Allogenic Stem Cell Transplantation
Citation
J Clin Oncol 40, 2022 (suppl 16; abstr e19045)
DOI
10.1200/JCO.2022.40.16_suppl.e19045
Abstract #
e19045
Abstract Disclosures
Similar Abstracts
Abstract
2023 ASCO Gastrointestinal Cancers Symposium
An indirect assessment of individual-level association between disease-free survival (DFS) and overall survival (OS) for resectable esophageal or gastroesophageal junction cancer (EC/GEJC): A pooled analysis of randomized controlled trials (RCTs) by an illness-death model.
First Author: Oguzhan Alagoz
Abstract
2023 ASCO Annual Meeting
Disease-free survival (DFS) as a surrogate for overall survival (OS) in patients (pts) with HR+/HER2− early breast cancer (EBC): A correlation analysis.
First Author: Michael Untch
Abstract
2020 ASCO Virtual Scientific Program
Post-transplant cyclophosphamide as graft-versus-host disease prophylaxis in HLA matched sibling donor stem cell transplantation for patients with acute leukemia.
First Author: Alaa Nabil Elshamy
Abstract
2023 ASCO Gastrointestinal Cancers Symposium
Disease-free survival (DFS) as a surrogate endpoint (SE) for overall survival (OS) in early-stage resected esophageal/gastroesophageal junction cancer (EC/GEJC): An analysis of SEER-Medicare data.
First Author: Jaffer A. Ajani