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- Title
Incorporation of extracorporeal photopheresis into a reduced intensity conditioning regimen in myelodysplastic syndrome and aggressive lymphoma: results from ECOG 1402 and 1902.
- Authors
Foss, Francine M.; Wang, Xin Victoria; Luger, Selina M.; Jegede, Opeyemi; Miller, Kenneth B.; Stadtmauer, Edward A.; Whiteside, Theresa L.; Avigan, David E.; Gascoyne, Randall D.; Arber, Daniel; Wagner, Henry; Strair, Roger K.; Hogan, William J.; Sprague, Kellie A.; Lazarus, Hillard M.; Litzow, Mark R.; Tallman, Martin S.; Horning, Sandra J.
- Abstract
<bold>Background: </bold>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).<bold>Study Design and Methods: </bold>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.<bold>Results: </bold>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%.<bold>Conclusions: </bold>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.
- Subjects
MYELODYSPLASTIC syndromes; TOTAL body irradiation; CELLULAR therapy; LYMPHOMAS; MYCOPHENOLIC acid; LYMPHOMA treatment; MYELODYSPLASTIC syndromes treatment; GRAFT versus host disease prevention; RESEARCH; HOMOGRAFTS; CLINICAL trials; RESEARCH methodology; IMMUNOSUPPRESSION; MEDICAL cooperation; EVALUATION research; CYCLOSPORINE; METHOTREXATE; COMPARATIVE studies; PHOTOCHEMOTHERAPY; RADIOTHERAPY; HEMATOPOIETIC stem cell transplantation; TACROLIMUS; ENZYME inhibitors
- Publication
Transfusion, 2020, Vol 60, Issue 8, p1867
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1111/trf.15798