Articles related to STEM CELLS

Patients with previously untreated mantle cell lymphoma (MCL) have relied on autologous stem cell transplant (ASCT) for more than 20 years; the current standard of care entails high-dose cytarabine-containing chemoimmunotherapy, ASCT, and rituximab maintenance. A recent clinical trial’s findings, which revealed that FFS was superior to ASCT when ibrutinib medication was added, may change this.

Acute lymphoblastic leukemia (ALL) with Philadelphia chromosome positivity (Ph+) has a poor prognosis historically, so allogeneic hematopoietic cell transplantation (allo-HCT) is advised after the first complete remission (CR1). The rapid achievement of a complete molecular remission (CMR), however, is associated with excellent outcomes without allo-HCT in the tyrosine kinase inhibitor (TKI) era, indicating transplant may not be necessary for these patients. To test this theory, the authors of this journal-based CME program looked into 5 transplant centers in the US to find adult Ph+ ALL patients who received induction therapy, such as TKIs, and received CMR within 90 days of diagnosis. They then compared the outcomes of people who received allo-HCT in the first remission versus those who did not.

Even with superior frontline therapy using A+CHP, this exploratory study suggests that consolidative SCT should be considered in CD30+ peripheral T-cell lymphoma (PTCL) patients. More large-scale studies are needed, especially in DUSP22-rearranged and low International Prognostic Index ALK ALCL, to determine whether there are favorable subgroups that could be treated with A+CHP alone.

Over a 4-year period, 500 patients were distributed equally between the two regimens. Two-year OS, relapse rates, and non-relapse mortality were similar between the two regiments, indicating that the busulfan regimen is non-inferior to the traditional TBI regimen.

This is an 8-year follow-up to the author’s initial report of a randomized phase II study in patients with newly diagnosed primary CNS lymphoma treated with high-dose methotrexate-based induction chemotherapy followed by whole-brain radiotherapy (WBRT) or high-dose chemotherapy (thiotepa-busulfan-cyclophosphamide) with autologous stem-cell transplantation (ASCT). They conclude that 40 Gy WBRT should be avoided in first-line treatment in this population because of its neurotoxicity and suboptimal efficacy in reducing relapses, while ASCT appears to be highly efficient in preventing relapses.

Even after allogeneic hematopoietic stem-cell transplant (HCT), poor outcomes are typically the case in patients with TP53-mutant (mTP53) acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). The data from recent trials using the combination of eprenetapopt (APR-246) and azacitidine showed positive preclinical results in mTP53 AML/MDS, and this trial sought to assess the efficacy and safety of the eprenetapopt and azacitidine combination as maintenance therapy after allogeneic HCT in patients with mTP53 AML or MDS.