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3. Thrombotic Microangiopathy after Post-Transplantation Cyclophosphamide-Based Graft-versus-Host Disease Prophylaxis

Author

Imus, Philip H., Tsai, Hua-Ling, DeZern, Amy E., Jerde, Kevin, Swinnen, Lode J., Bolaños-Meade, Javier, Luznik, Leo, Fuchs, Ephraim J., Wagner-Johnston, Nina, Huff, Carol Ann, Gladstone, Douglas E., Ambinder, Richard F., Gocke, Christian B., Ali, Syed Abbas, Borrello, Ivan M., Varadhan, Ravi, Brodsky, Robert, and Jones, Richard J.

Published
2020
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4. Shortened-Duration Immunosuppressive Therapy after Nonmyeloablative, Related HLA-Haploidentical or Unrelated Peripheral Blood Grafts and Post-Transplantation Cyclophosphamide

Author

DeZern, Amy E., Elmariah, Hany, Zahurak, Marianna, Rosner, Gary L., Gladstone, Douglas E., Ali, Syed Abbas, Huff, Carol Ann, Swinnen, Lode J., Imus, Phil, Borrello, Ivan, Wagner-Johnston, Nina D., Ambinder, Richard F., Brodsky, Robert A., Cooke, Kenneth, Luznik, Leo, Fuchs, Ephraim J., Bolaños-Meade, Javier, and Jones, Richard J.

Published
2020
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7. Allogeneic Blood or Marrow Transplantation with Post-Transplantation Cyclophosphamide for Peripheral T Cell Lymphoma: The Importance of Graft Source

Author

Sterling, Cole H., Hughes, Michael S., Tsai, Hua-Ling, Yarkony, Kathryn, Fuchs, Ephraim J., Swinnen, Lode J., Paul, Suman, Bolaños-Meade, Javier, Luznik, Leo, Imus, Philip H., Ali, Syed Abbas, Jain, Tania, Ambinder, Alexander, DeZern, Amy, Huff, Carol Ann, Gocke, Christian B., Varadhan, Ravi, Wagner-Johnston, Nina, Jones, Richard J., and Ambinder, Richard F.

Published
2023
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10. Development of Grade II Acute Graft-versus-Host Disease Is Associated with Improved Survival after Myeloablative HLA-Matched Bone Marrow Transplantation using Single-Agent Post-Transplant Cyclophosphamide

Author

McCurdy, Shannon R., Kanakry, Christopher G., Tsai, Hua-Ling, Gojo, Ivana, Smith, B. Douglas, Gladstone, Douglas E., Bolaños-Meade, Javier, Borrello, Ivan, Matsui, William H., Swinnen, Lode J., Huff, Carol Ann, Brodsky, Robert A., Ambinder, Richard F., Fuchs, Ephraim J., Rosner, Gary L., Jones, Richard J., and Luznik, Leo

Published
2019
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11. Effect of increased dose of total body irradiation on graft failure associated with HLA-haploidentical transplantation in patients with severe haemoglobinopathies: a prospective clinical trial

Author

Bolaños-Meade, Javier, Cooke, Kenneth R, Gamper, Christopher J, Ali, Syed Abbas, Ambinder, Richard F, Borrello, Ivan M, Fuchs, Ephraim J, Gladstone, Douglas E, Gocke, Christian B, Huff, Carol Ann, Luznik, Leo, Swinnen, Lode J, Symons, Heather J, Terezakis, Stephanie A, Wagner-Johnston, Nina, Jones, Richard J, and Brodsky, Robert A

Published
2019
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12. Early Fever after Haploidentical Bone Marrow Transplantation Correlates with Class II HLA-Mismatching and Myeloablation but Not Outcomes

Author

McCurdy, Shannon R., Muth, Stephen T., Tsai, Hua-Ling, Symons, Heather J., Huff, Carol Ann, Matsui, William H., Borrello, Ivan, Gladstone, Douglas E., Swinnen, Lode J., Cooke, Kenneth R., Brodsky, Robert A., Bolaños-Meade, Javier, Ambinder, Richard F., Varadhan, Ravi, Luznik, Leo, Jones, Richard J., Bettinot, Maria P., and Fuchs, Ephraim J.

Published
2018
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16. Major Histocompatibility Mismatch and Donor Choice for Second Allogeneic Bone Marrow Transplantation

Author

Imus, Philip H., Blackford, Amanda L., Bettinotti, Maria, Iglehart, Brian, Dietrich, August, Tucker, Noah, Symons, Heather, Cooke, Kenneth R., Luznik, Leo, Fuchs, Ephraim J., Brodsky, Robert A., Matsui, William H., Huff, Carol Ann, Gladstone, Douglas, Ambinder, Richard F., Borrello, Ivan M., Swinnen, Lode J., Jones, Richard J., and Bolaños-Meade, Javier

Published
2017
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18. Nonmyeloablative, HLA-Mismatched Unrelated Peripheral Blood Transplantation with High-Dose Post-Transplantation Cyclophosphamide

Author

Rappazzo, Katherine C., Zahurak, Marianna, Bettinotti, Maria, Ali, Syed Abbas, Ambinder, Alex J., Bolaños-Meade, Javier, Borrello, Ivan, Dezern, Amy E., Gladstone, Doug, Gocke, Christian, Fuchs, Ephraim, Huff, Carol Ann, Imus, Philip H., Jain, Tania, Luznik, Leo, Rahmat, Leena, Swinnen, Lode J., Wagner-Johnston, Nina, Jones, Richard J., and Ambinder, Richard F.

Published
2021
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19. Allogeneic Blood or Marrow Transplantation with Nonmyeloablative Conditioning and High-Dose Cyclophosphamide-Based Graft-versus-Host Disease Prophylaxis for Secondary Central Nervous System Lymphoma

Author

Sterling, Cole H., Tsai, Hua-Ling, Holdhoff, Matthias, Bolaños-Meade, Javier, Luznik, Leo, Fuchs, Ephraim J., Huff, Carol Ann, Gocke, Christian B., Ali, Syed Abbas, Borrello, Ivan M., Varadhan, Ravi, Jones, Richard J., Gladstone, Douglas E., Ambinder, Richard F., Wagner-Johnston, Nina, Swinnen, Lode J., and Imus, Philip H.

Published
2021
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20. Phase II Study of Nonmyeloablative Allogeneic Bone Marrow Transplantation for B Cell Lymphoma with Post-Transplantation Rituximab and Donor Selection Based First on Non-HLA Factors

Author

Kanakry, Jennifer A., Gocke, Christopher D., Bolaños-Meade, Javier, Gladstone, Douglas E., Swinnen, Lode J., Blackford, Amanda L., Fuchs, Ephraim J., Huff, Carol Ann, Borrello, Ivan, Matsui, William H., Brodsky, Robert A., Rosner, Gary L., Shanbhag, Satish, Luznik, Leo, Jones, Richard J., Ambinder, Richard F., and Kasamon, Yvette L.

Published
2015
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21. Risk-stratified outcomes of nonmyeloablative HLA-haploidentical BMT with high-dose posttransplantation cyclophosphamide

Author

McCurdy, Shannon R., Kanakry, Jennifer A., Showel, Margaret M., Tsai, Hua-Ling, Bolaños-Meade, Javier, Rosner, Gary L., Kanakry, Christopher G., Perica, Karlo, Symons, Heather J., Brodsky, Robert A., Gladstone, Douglas E., Huff, Carol Ann, Pratz, Keith W., Prince, Gabrielle T., Dezern, Amy E., Gojo, Ivana, Matsui, William H., Borrello, Ivan, McDevitt, Michael A., Swinnen, Lode J., Smith, B. Douglas, Levis, Mark J., Ambinder, Richard F., Luznik, Leo, Jones, Richard J., Fuchs, Ephraim J., and Kasamon, Yvette L.

Published
2015
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22. Single-agent GVHD prophylaxis with posttransplantation cyclophosphamide after myeloablative, HLA-matched BMT for AML, ALL, and MDS

Author

Kanakry, Christopher G., Tsai, Hua-Ling, Bolaños-Meade, Javier, Smith, B. Douglas, Gojo, Ivana, Kanakry, Jennifer A., Kasamon, Yvette L., Gladstone, Douglas E., Matsui, William, Borrello, Ivan, Huff, Carol Ann, Swinnen, Lode J., Powell, Jonathan D., Pratz, Keith W., DeZern, Amy E., Showel, Margaret M., McDevitt, Michael A., Brodsky, Robert A., Levis, Mark J., Ambinder, Richard F., Fuchs, Ephraim J., Rosner, Gary L., Jones, Richard J., and Luznik, Leo

Published
2014
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25. Nonmyeloablative HLA-Haploidentical Bone Marrow Transplantation with High-Dose Posttransplantation Cyclophosphamide: Effect of HLA Disparity on Outcome

Author

Kasamon, Yvette L., Luznik, Leo, Leffell, Mary S., Kowalski, Jeanne, Tsai, Hua-Ling, Bolaños-Meade, Javier, Morris, Lawrence E., Crilley, Pamela A., O'Donnell, Paul V., Rossiter, Nancy, Huff, Carol Ann, Brodsky, Robert A., Matsui, William H., Swinnen, Lode J., Borrello, Ivan, Powell, Jonathan D., Ambinder, Richard F., Jones, Richard J., and Fuchs, Ephraim J.

Published
2010
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28. Mismatched donor transplantation with post-transplantation cyclophosphamide for advanced cutaneous T-cell lymphoma: a single-center retrospective study.

Author

Hughes, Michael S., Sterling, Cole H., Varadhan, Ravi, Ambinder, Richard F., Jones, Richard J., Sweren, Ronald J., Rozati, Sima, Bolaños-Meade, Javier, Luznik, Leo, Imus, Philip H., Ali, Syed Abbas, Borrello, Ivan M., Huff, Carol Ann, T., Jain, Ambinder, Alexander, DeZern, Amy E., Gocke, Christian B., Gladstone, Douglas E., Swinnen, Lode J., and Wagner-Johnston, Nina D.

Subjects
CUTANEOUS T-cell lymphoma, SEZARY syndrome, CORD blood transplantation, HEMATOPOIETIC stem cell transplantation
Abstract

Two individuals (patients 7 and 8) received immune checkpoint inhibition (ICI) prior to BMT; patient 7 received anti-CTLA-4 and anti-PD-1 combination therapy, and patient 8 received anti-PD-L1 and interferon combination therapy. From 2003 to 2020, eight patients received partially mismatched donor BMT for relapsed/refractory MF/SS. Seven patients received grafts from HLA-haploidentical related donors. Primary cutaneous T-cell lymphomas (CTCLs), a heterogeneous group of extranodal non-Hodgkin lymphomas involving the skin, are dominated by two main subtypes: mycosis fungoides (MF) and Sézary syndrome (SS) [[1]]. An eighth patient (patient 5) experienced graft failure after double unrelated donor umbilical cord blood transplantation and within 6 months underwent partially mismatched unrelated donor BMT. [Extracted from the article]

Published
2022
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30. Induction of Autologous Graft-versus-Host Disease: Results of a Randomized Prospective Clinical Trial in Patients with Poor Risk Lymphoma

Author

Bolaños-Meade, Javier, Garrett-Mayer, Elizabeth, Luznik, Leo, Anders, Viki, Webb, Jennifer, Fuchs, Ephraim J., Huff, Carol Ann, Matsui, William, Borrello, Ivan M., Brodsky, Robert, Kasamon, Yvette L., Swinnen, Lode J., Flinn, Ian W., Ambinder, Richard F., Jones, Richard J., Hess, Allan D., and Vogelsang, Georgia B.

Published
2007
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31. An Open Label Trial of Sustained-release Cytarabine (DepoCyt™) for the Intrathecal Treatment of Solid Tumor Neoplastic Meningitis

Author

Jaeckle, Kurt A., Batchelor, Tracy, O'Day, Steven J., Phuphanich, Surasak, New, Pamela, Lesser, Glenn, Cohn, Allen, Gilbert, Mark, Aiken, Robert, Heros, Deborah, Rogers, Lisa, Wong, Eric, Fulton, Dorcas, Gutheil, John C., Baidas, Said, Kennedy, Julia M., Mason, Warren, Moots, Paul, Russell, Christy, Swinnen, Lode J., and Howell, Stephen B.

Published
2002
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36. Increased incidence of lymphoproliferative disorder after immunosuppression with the monoclonal antibody OKT3 in cardiac-transplant recipients

Author

Swinnen, Lode J., Costanzo-Nordin, Maria R., Fisher, Susan G., O'Sullivan, E. Jeanne, Johnson, Maryl R., Heroux, Alain L., Dizikes, George J., Pifarre, Roque, and Fisher, Richard I.

Subjects
Transplantation of organs, tissues, etc. -- Complications, Monoclonal antibodies -- Adverse and side effects, OKT3 -- Adverse and side effects, Immunosuppressive agents -- Adverse and side effects, Immunosuppression -- Complications, Lymphoproliferative disorders -- Causes of
Abstract

To a great degree, the success of organ transplantation procedures has resulted from improvements in methods of immunosuppression, which reduce the likelihood that the recipient's immune system will reject the new organ. However, this necessary immunosuppression is not without its own potential complications. Like the immunosuppression due to chemotherapy and that due to AIDS, the immunosuppression for transplantation may result in infection and lymphoproliferative disorder. The lymphoproliferative disorder, which can be life-threatening, is thought to result from primary or reactivated infection with the Epstein-Barr virus. An increase in the incidence of lymphoproliferative disorder was recently observed in a series of heart transplant patients at one institution. Researchers noticed that the increase seemed to occur at the same time that a new method of improving immunosuppression was introduced. A retrospective study of 154 heart-transplant patients was then undertaken to determine if this treatment was, indeed, responsible for the increase in lymphoproliferative disorder. The new treatment was the use of the drug OKT3 for immunosuppression. OKT3 is a monoclonal antibody which binds to the CD3 receptor on T cells. In humans, treatment with OKT3 results in a depletion of circulating T cells with the CD3-positive lymphocytes. Previously, OKT3 had been reserved as treatment for those cases in which conventional immunosuppression was failing, but recently it has come to be used prophylactically for all transplant patients at some medical centers. The review of the patient records revealed that post-transplantation lymphoproliferative disorders developed in 1 of 75 patients (1.3 percent) who did not receive OKT3, and in 9 of 79 patients (11.4 percent) who did get the monoclonal antibody. Statistical analysis showed that the OKT3 antibody was the only variable which was significantly associated with the development of lymphoproliferative disorder in these patients. Since the value of OKT3 as a prophylactic agent in transplant patients has not been clearly established, the risks must be carefully considered before the treatment is prescribed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

37. Positron Emission Tomography-Directed Therapy for Patients With Limited-Stage Diffuse Large B-Cell Lymphoma: Results of Intergroup National Clinical Trials Network Study S1001.

Author

Persky, Daniel O., Li, Hongli, Stephens, Deborah M., Park, Steven I., Bartlett, Nancy L., Swinnen, Lode J., Barr, Paul M., Winegarden III, Jerome D., Constine, Louis S., Fitzgerald, Thomas J., Leonard, John P., Kahl, Brad S., LeBlanc, Michael L., Song, Joo Y., Fisher, Richard I., Rimsza, Lisa M., Smith, Sonali M., Miller, Thomas P., Friedberg, Jonathan W., and Winegarden, Jerome D 3rd

Published
2020
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38. R-CHOP without radiation in frontline management of primary mediastinal B-cell lymphoma.

Author

Messmer, Marcus, Tsai, Hua-Ling, Varadhan, Ravi, Swinnen, Lode J., Jones, Richard J., Ambinder, Richard F., Shanbhag, Satish P., Borowitz, Michael J., and Wagner-Johnston, Nina

Subjects
DRUG side effects, RADIATION, PROGRESSION-free survival, LYMPHOMAS, DOXORUBICIN
Abstract

Prior to the introduction of rituximab, primary mediastinal B-cell lymphoma (PMBCL) had high rates of treatment failure with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), prompting the use of consolidative mediastinal radiation or more intensive chemotherapy regimens. Cure rates improved dramatically with rituximab, but mediastinal radiation was still commonly employed with R-CHOP. We performed a retrospective review of patients treated with R-CHOP alone without radiation for PMBCL. Of 43 patients with PMBCL, 16 received R-CHOP alone. High-risk factors included 56% with bulky disease, 75% with elevated LDH, 25% with SVC syndrome, and 13% with stage IV disease. Three-year progression-free survival (PFS) and overall survival (OS) were 93% and 100% respectively. These results suggest that R-CHOP alone has a high cure rate in PMBCL while avoiding the side effects of mediastinal radiation. [ABSTRACT FROM AUTHOR]

Published
2019
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39. Feasibility of interim positron emission tomography (PET)-adapted therapy in HIV-positive patients with advanced Hodgkin lymphoma (HL): a sub-analysis of SWOG S0816 Phase 2 trial.

Author

Danilov, Alexey V., Li, Hongli, Press, Oliver W., Shapira, Ilan, Swinnen, Lode J., Noy, Ariela, Reid, Erin, Smith, Sonali M., and Friedberg, Jonathan W.

Subjects
HIV, MORTALITY, HODGKIN'S disease, POSITRON emission tomography, CANCER
Abstract

The article discusses the leading cause of mortality in patients with HIV in which interim positron emission tomography (PET)-adapted therapy with advanced Hodgkin lymphoma is being studied. It cites that HIV-infected patients manifest an increase of AIDS-defining cancers and non-AIDS-defining cancers prevalent in population.

Published
2017
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40. Rituximab extended schedule or retreatment trial for low tumour burden non-follicular indolent B-cell non-Hodgkin lymphomas: Eastern Cooperative Oncology Group Protocol E4402.

Author

Williams, Michael E., Hong, Fangxin, Gascoyne, Randy D., Wagner, Lynne I., Krauss, John C., Habermann, Thomas M., Swinnen, Lode J., Schuster, Stephen J., Peterson, Christopher G., Sborov, Mark D., Martin, S. Eric, Weiss, Matthias, Ehmann, W. Christopher, Horning, Sandra J., and Kahl, Brad S.

Subjects
RITUXIMAB, LYMPHOMAS, MONOCLONAL antibodies, B cells, HEMATOLOGIC malignancies
Abstract

The rituximab extended schedule or retreatment trial ( RESORT; E4402) was a phase 3 randomized prospective trial comparing maintenance rituximab ( MR) versus a retreatment ( RR) dosing strategy in asymptomatic, low tumour burden indolent lymphoma. A planned exploratory sub-study compared the two strategies for small lymphocytic ( SLL) and marginal zone lymphomas ( MZL). Patients responding to rituximab weekly × 4 were randomized to MR (single dose rituximab every 3 months until treatment failure) or RR (rituximab weekly × 4) at the time of each progression until treatment failure. The primary endpoint was time to treatment failure ( TTTF). Patients with SLL ( n = 57), MZL ( n = 71) and unclassifiable small B-cell lymphoma ( n = 3) received induction rituximab. The overall response rate ( ORR) was 40% [95% confidence interval ( CI) 31-49%; SLL ORR 22·8%; MZL ORR 52·1%]; all 52 responders were randomized. At a median of 4·3 years from randomization, treatment failure occurred in 18/23 RR and 15/29 MR. The median TTTF was 1·4 years for RR and 4·8 years for MR ( P = 0·012); median time to first cytotoxic therapy was 6·3 years for RR and not reached for MR ( P = 0·0002). Survival did not differ ( P = 0·72). In low tumour burden SLL and MZL patients responding to rituximab induction, MR significantly improved TTTF as compared with RR. [ABSTRACT FROM AUTHOR]

Published
2016
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41. Therapeutic drug monitoring for either oral or intravenous busulfan when combined with pre- and post-transplantation cyclophosphamide.

Author

Lombardi, Lindsey R., Kanakry, Christopher G., Zahurak, Marianna, Durakovic, Nadira, Bolaños-Meade, Javier, Kasamon, Yvette L., Gladstone, Douglas E., Matsui, William, Borrello, Ivan, Huff, Carol Ann, Swinnen, Lode J., Brodsky, Robert A., Ambinder, Richard F., Fuchs, Ephraim J., Rosner, Gary L., Jones, Richard J., and Luznik, Leo

Subjects
BUSULFAN, CYCLOPHOSPHAMIDE, GRAFT versus host disease, PHARMACOKINETICS, HEPATOTOXICOLOGY
Abstract

Busulfan (Bu)/cyclophosphamide (Cy) is a standard conditioning platform for allogeneic transplantation. We developed a strategy separating the Cy into two pre/post-transplantation doses (PTCy), providing myeloablative conditioning and single-agent graft-versus-host disease (GVHD) prophylaxis. We investigated the impact of Bu route on treatment-related toxicity for 131 consecutive adult patients. Busulfan was administered in four daily divided doses either orally (n = 72) or intravenously (n = 59) with pharmacokinetics on the first-dose and as necessary on subsequent doses to achieve a target area-under-the-concentration-curve (AUC) of 800-1400 µmol*min/L per dose. BuCy/PTCy with pharmacokinetics is well-tolerated with low treatment-related toxicity. Hepatic veno-occlusive disease incidence was 6% with two fatal events. Bu administration route in the context of BuCy/PTCy did not statistically impact hepatotoxicity, GVHD, relapse, disease-free survival, or overall survival. The BuCy/PTCy platform has a low incidence of treatment-related toxicity, including hepatotoxicity, in hematologic malignancies when using pharmacokinetics for a target AUC of 800-1400 µmol*min/L, irrespective of Bu administration route. [ABSTRACT FROM AUTHOR]

Published
2016
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42. Solid Organ Transplantation in Selected Patients With a History of Lymphoma: Has the Time Come?

Author

Swinnen, Lode J.

Subjects
*CANCER patients, *LYMPHOMAS, *TRANSPLANTATION of organs, tissues, etc.
Abstract

The article discusses the association between immunodeficiency and malignancy in patients with a history of lymphoma. Topics discussed include impact of viral oncogenesis in post-transplant malignancies, lymphoma not associated with Epstein-Barr virus, how oncologist can help in the transplant assessment process, and role of oncologists in an interdisciplinary effort for cancer care.

Published
2018
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43. Outcomes of Nonmyeloablative HLA-Haploidentical Blood or Marrow Transplantation With High-Dose Post-Transplantation Cyclophosphamide in Older Adults.

Author

Kasamon, Yvette L., Bolaños-Meade, Javier, Prince, Gabrielle T., Hua-Ling Tsai, McCurdy, Shannon R., Kanakry, Jennifer A., Rosner, Gary L., Brodsky, Robert A., Perica, Karlo, Smith, B. Douglas, Gladstone, Douglas E., Swinnen, Lode J., Showel, Margaret M., Matsui, William H., Huff, Carol Ann, Borrello, Ivan, Pratz, Keith W., McDevitt, Michael A., Gojo, Ivana, and Dezern, Amy E.

Published
2015
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45. Bevacizumab and cyclosphosphamide, doxorubicin, vincristine and prednisone in combination for patients with peripheral T-cell or natural killer cell neoplasms: an Eastern Cooperative Oncology Group study (E2404).

Author

Ganjoo, Kristen, Hong, Fangxin, Horning, Sandra J., Gascoyne, Randy D., Natkunam, Yasodha, Swinnen, Lode J., Habermann, Thomas M., Kahl, Brad S., and Advani, Ranjana H.

Subjects
HEALTH outcome assessment, PHYSIOLOGICAL effects of chemotherapy, T cells, KILLER cells, VASCULAR endothelial growth factors, LYMPHOMAS, DOXORUBICIN, BEVACIZUMAB, PATIENTS, CANCER
Abstract

Peripheral T-cell lymphoma (PTCL) and natural killer (NK) cell lymphoma have poor survival with conventional cytotoxic chemotherapy. Because angiogenesis plays an important role in the biology of PTCL, a fully humanized anti-vascular endothelial growth factor (VEGF) antibody, bevacizumab (A), was studied in combination with standard cyclosphosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy (ACHOP) to evaluate its potential to improve outcome in these patients. Patients were treated with 6-8 cycles of ACHOP followed by eight doses of maintenance A (15 mg/kg every 21 days). Forty-six patients were enrolled on this phase 2 study from July 2006 through March 2009. Forty-four patients were evaluable for toxicity and 39 were evaluable for response, progression and survival. A total of 324 cycles (range: 2-16, median 7) were administered to 39 evaluable patients and only nine completed all planned treatment. The overall response rate was 90% with 19 (49%) complete response/complete response unconfirmed (CR/CRu) and 16 (41%) a partial response (PR). The 1-year progression-free survival (PFS) rate was 44% at a median follow-up of 3 years. The median PFS and overall survival (OS) rates were 7.7 and 22 months, respectively. Twenty-three patients died (21 from lymphoma, two while in remission). Grade 3 or 4 toxicities included febrile neutropenia ( n = 8), anemia ( n = 3), thrombocytopenia ( n = 5), congestive heart failure ( n = 4), venous thrombosis ( n = 3), gastrointestinal hemorrhage/perforation ( n = 2), infection ( n = 8) and fatigue ( n = 6). Despite a high overall response rate, the ACHOP regimen failed to result in durable remissions and was associated with significant toxicities. Studies of novel therapeutics are needed for this patient population, whose clinical outcome remains poor. [ABSTRACT FROM AUTHOR]

Published
2014
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46. Brief intensive therapy for older adults with newly diagnosed Burkitt or atypical Burkitt lymphoma/leukemia.

Author

Kasamon, Yvette L., Brodsky, Robert A., Borowitz, Michael J., Ambinder, Richard F., Crilley, Pamela A., Cho, Steve Y., Tsai, Hua-ling, Smith, B. Douglas, Gladstone, Douglas E., Carraway, Hetty E., Huff, Carol Ann, Matsui, William H., Bolaños-Meade, Javier, Jones, Richard J., and Swinnen, Lode J.

Subjects
OLDER patients, BURKITT'S lymphoma, CYCLOPHOSPHAMIDE, ANTHRACYCLINES, VINCRISTINE, RITUXIMAB
Abstract

Older patients with Burkitt lymphoma/leukemia (BL) have inferior outcomes. Because cyclophosphamide is highly active in BL and can be dose-escalated without stem-cell rescue, we designed a short, cyclophosphamide-intensive regimen without anthracyclines for patients aged ≥ 30 with untreated, non-HIV-associated BL/atypical BL. Two cycles involving cyclophosphamide 1500 mg/m2, vincristine, rituximab, prednisone, methotrexate 3 g/m2, and intrathecal cytarabine were delivered 2 weeks apart, followed by intensification with high-dose cyclophosphamide (50 mg/kg/day for 4 days) and rituximab. Of 21 patients, median age 53 (range, 34-75), 71% had stage IV, 95% were high-risk and 29% had performance status 3-4. Response occurred in all evaluable patients post-cycle 2 and in 76% post-intensification. Five non-relapse deaths occurred (four before intensification). The estimated 1-year and 3-year event-free survival was 52%; 1-year and 3-year overall survival was 57%. Seventeen (81%) received intensification (median 30 days to intensification). Brief, anthracycline-sparing, intensive cyclophosphamide (BASIC) therapy yields durable remissions in poorer-risk BL/atypical BL. [ABSTRACT FROM AUTHOR]

Published
2013
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47. High-dose cyclophosphamide and rituximab without stem cell transplant: a feasibility study for low grade B-cell, transformed and mantle cell lymphomas.

Author

Gladstone, Douglas E., Bolaños-Meade, Javier, Huff, Carol Ann, Zahurak, Marianna, Flinn, Ian, Borrello, Ivan, Luznik, Leo, Fuchs, Ephraim, Kasamon, Yvette, Matsui, William, Powell, Jonathan, Levitsky, Hyam, Brodsky, Robert A., Ambinder, Richard, Jones, Richard J., and Swinnen, Lode J.

Subjects
CYCLOPHOSPHAMIDE, RITUXIMAB, STEM cell transplantation, LYMPHOMAS, B cell lymphoma, TUMOR treatment
Abstract

Relapse after autologous stem cell transplant for low grade B-cell lymphoma is common secondary to ineffective conditioning and/or tumor autograft contamination. We investigated high-dose cyclophosphamide and rituximab without stem cell rescue as first-line or salvage therapy in lymphomas. After establishing safety, accrual was increased to evaluate event-free survival (EFS). Eighty-one adults received rituximab (375 mg/m2 days 1, 4, 8, 11, 45, 52), cyclophosphamide (50 mg/kg days 15-18), and pegfilgrastim (day 20). Forty-two patients had low grade B-cell lymphoma [grade I/II follicular (69%), transformed lymphoma (17%), other (15%)]: 45% were treated without measurable disease. Thirty-nine patients had mantle cell lymphoma: 82% were treated without measurable disease. All achieved hematopoietic recovery; 46% required brief hospitalizations. The 5-year EFS and overall survival (OS) for patients with low grade B-cell and transformed lymphoma were 40% and 72%, respectively. The 5-year EFS and OS for patients with MCL were 39% and 62%, respectively. This low-toxicity therapeutic approach obviates the need for stem cell products and establishes a platform for future therapies. [ABSTRACT FROM AUTHOR]

Published
2011
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