Favorable Outcome After Adjuvant Involved-Field Radiotherapy After Autologous Hematopoietic Stem-Cell Transplantation in Patients With High-Risk Relapsed/Refractory Lymphoma: A Single-Center Experience |
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| Authors: | Panayotis Kaloyannidis Rawan Omari Eman Eldebawy Eshrak Al Shaibani John Apostolidis Taghreed Hindi Heba Raslan Ayed Al Garni Ahmed Al Buali Khalid Al Anezi Hani Al Hashmi |
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| Affiliation: | 1. Adult Hematology and Stem Cell Transplantation Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia;2. Radiation Oncology Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia;3. Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia;4. Department of Medical Imaging, King Fahad Specialist Hospital, Dammam, Saudi Arabia;1. Miami Cancer Institute, Baptist Healthcare System, Miami, FL;2. Department of Translational Medicine, Florida International University School of Medicine, Miami, FL;1. Hematology Department, University Clinic Hospital of Valladolid, Valladolid, Spain;2. Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain;3. Translational Research in Pediatric Oncology, Hematopoietic Transplantation and Cell Therapy, IdiPAZ, Madrid, Spain;4. Pediatric Hematology-Oncology Unit, University Clinic Hospital Virgen de la Arrixaca, El Palmar, Spain;5. Pediatric Hematology Unit, Maternal and Children Hospital, Regional University Hospital of Málaga, Málaga, Spain;6. Pediatric Hematology Department, Maternal Pediatric Hospital, University Hospital Complex of Badajoz, Badajoz, Spain;7. Hematological Malignancies Clinical Research Unit, National Center for Cancer Research (CNIO), Madrid, Spain;8. Hematology Department, La Paz University Hospital, Madrid, Spain;9. Pediatric Onco-Hematology Department, La Paz University Hospital, Madrid, Spain;10. Histocompatibility and HLA Typing Laboratory, Transfusion Center of the Community of Madrid, Madrid, Spain;11. Clinical Pharmacology Department, La Paz University Hospital, Madrid, Spain;12. Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain;1. Department of Pediatrics, Peking University People’s Hospital, Beijing, China;2. Research Department, Immunotech Applied Science Ltd, Beijing, China;1. Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China;2. Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China |
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| Abstract: | BackgroundPatients with refractory or relapsed lymphoma diagnosed with bulky disease at relapse or with residual disease after salvage treatment are considered to have a dismal outcome, even after autologous hematopoietic stem-cell transplantation, as a result of disease recurrence. To minimize the risk of relapse after receipt of a transplant, involved-field radiotherapy (IFRT) to sites of either bulky or localized residual disease has been utilized; however, the ideal timing for irradiation remains controversial. The aim of this study was to assess the safety and efficacy of IFRT in the early period after transplantation.Patients and MethodsWe retrospectively evaluated the outcome of 24 autografted patients with relapsed/refractory lymphoma who presented with bulky disease at relapse or who had a persistent localized residual mass after salvage treatment and consolidated with IFRT within 4 months after autografting.ResultsNo significant toxicity was noticed during the early postradiotherapy period, while graft function was not impaired. After a median follow-up of 3 years for survivors, 21 patients were alive, 19 of whom were event free, while 2 patients died of disease recurrence and 1 died of treatment-related myelodysplastic syndrome. The 3-year overall, lymphoma relapse-free, and event-free survival rates were 86%, 86%, and 82%, respectively.ConclusionTaking into consideration the poor-risk features of the study cohort, IFRT provided early after autologous hematopoietic stem-cell transplantation showed a safe and well-tolerated toxicity profile and demonstrated long-term effective tumor control, as reflected in the promising survival rates. |
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| Keywords: | Autologous hematopoietic stem-cell transplantation Hodgkin Lymphoma Non Hodgkin Lymphoma Radiotherapy Refractory lymphoma |
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