Corporate Banner
Satellite Banner
RNAi
Scientific Community
 
Become a Member | Sign in
Home>News>This Article
  News
Return

Early Stem Cell Transplants Evaluated for NHLs Patients at High Risk of Early Relapse

Published: Tuesday, November 05, 2013
Last Updated: Tuesday, November 05, 2013
Bookmark and Share
Remissions last longer, but survival not affected.

Performing early stem cell transplants in patients with aggressive non-Hodgkin’s lymphoma does not improve overall survival in high-risk patients, according to a study published in the New England Journal of Medicine.

But early transplantation does appear to be beneficial among a small group of patients who are at the very highest risk, the study found.

Lead author is Patrick Stiff, MD, director of Loyola University Medical Center’s Cardinal Bernardin Cancer Center. The study was developed by the SWOG cancer research cooperative group and funded by the National Cancer Institute. Stiff is chair of the SWOG Bone Marrow and Stem Cell Transplantation Committee.

The traditional first-line therapy for aggressive non-Hodgkin’s lymphoma is a combination of four chemotherapy drugs. In recent years, physicians have added a fifth drug, the monoclonal antibody rituximab. This five-drug regimen is known as R-CHOP. The treatment typically puts patients into remission. But many patients relapse and go on to get an autologous stem cell transplant after second-line chemotherapy.

The study was designed to determine whether doing an early stem cell transplant - without first waiting to see whether a patient relapses - would increase survival.

The clinical trial included 40 sites in the United States and Canada. In addition to SWOG, the study included the Eastern Cooperative Oncology Group, Cancer and Leukemia Group B and Canadian NCIC Clinical Trials Group.

The study included 397 patients who were in defined groups of high risk or intermediate high risk of relapsing. After initial chemotherapy, those who responded were randomly assigned to receive an autologous stem cell transplant (125 patients) or to a control group of 128 patients who received three additional cycles of the R-CHOP regimen. Enrollment began in 1999 and ended in 2007. (Some of the patients in the beginning of the study did not receive rituximab.)

After two years, 69 percent of the transplantation patients had no disease progression, compared with 55 percent of the control group - a statistically significant difference. However, the difference in two-year survival rates (74 percent in the transplantation group and 71 percent in the control group) was not statistically significant. This is probably because patients in the control group who relapsed were later offered stem cell transplants, Stiff and colleagues wrote.

But while stem cell transplants did not improve overall survival among the entire group of high risk and high intermediate risk patients, the subset of high risk patients did appear to receive both a remission and survival benefit. A retrospective analysis of the data showed that among these high risk patients, the two-year survival rate was 82 percent in the transplantation group and 64 percent in the control group.

“Early transplantation and late transplantation achieve roughly equivalent overall survival in the combined risk groups,” researchers concluded, yet “early transplantation appears to be beneficial for the small group of patients presenting with high risk disease."

Stiff said this finding “hopefully will trigger discussions between such patients and their physicians as to the feasibility of doing early transplants."

An autologous stem cell transplant enables a patient to tolerate very high doses of chemotherapy and/or radiation. In addition to killing cancer cells, this high dose treatment also destroys the patient’s immune system cells.

So prior to treatment, stem cells are removed from the patient’s blood or bone marrow. After the chemotherapy and/or radiation, these stem cells are infused back into the patient. The stem cells develop into new immune cells, replacing the immune cells destroyed by the treatment.

Previous studies have found that patients who undergo stem cell transplants have a slightly higher risk of developing secondary cancers caused by the chemotherapy and/or radiation.

However, the new study did not find a statistically significant difference - 11 patients in the control group developed secondary cancer, compared with 12 patients in the transplantation group.

Researchers are continuing to analyze the data. “As years go by, there may be additional analysis that may help fine-tune the results so that we will be able to more carefully and concisely define any potential benefit of transplant,” Stiff said.


Further Information

Join For Free

Access to this exclusive content is for Technology Networks Premium members only.

Join Technology Networks Premium for free access to:

  • Exclusive articles
  • Presentations from international conferences
  • Over 3,000+ scientific posters on ePosters
  • More than 4,500+ scientific videos on LabTube
  • 35 community eNewsletters


Sign In



Forgotten your details? Click Here
If you are not a member you can join here

*Please note: By logging into TechnologyNetworks.com you agree to accept the use of cookies. To find out more about the cookies we use and how to delete them, see our privacy policy.


Scientific News
Turning Skin Cells into Heart, Brain Cells
In a major breakthrough, scientists at the Gladstone Institutes transformed skin cells into heart cells and brain cells using a combination of chemicals.
Detection of HPV in First-Void Urine
Similar sensitivity of HPV test on first void urine sample compared to cervical smear.
Potential “Good Fat” Biomarker
New method to measure the activity of energy consuming brown fat cells could ease the testing weight loss drugs.
Shape Of Tumor May Affect Whether Cells Can Metastasize
Illinois researchers found that the shape of a tumor may play a role in how cancer cells become primed to spread.
MicroRNA Pathway Could Lead to New Avenues for Leukemia Treatment
Cancer researchers at the University of Cincinnati have found a particular signaling route in microRNA (miR-22) that could lead to targets for acute myeloid leukemia, the most common type of fast-growing cancer of the blood and bone marrow.
Analysis of Dog Genome will Provide Insight into Human Disease
An important model in studying human disease, the non-coding RNA of the canine genome is an essential starting point for evolutionary and biomedical studies – according to a new study led by The Genome Analysis Centre (TGAC).
New Blood Test for The Earlier Diagnosis of Breast Cancer Spread
Researchers at University of Westminster have confirmed that a new blood test can detect if breast cancer has spread to other parts of the body.
First Gene Therapy Successful Against Human Aging
American woman gets biologically younger after gene therapies.
Targeting an ‘Undruggable’ Cancer Gene
RAS genes are mutated in more than 30 percent of human cancers and represent one of the most sought-after cancer targets for drug developers.
Altered Metabolism of Four Compounds Drives Glioblastoma Growth
Findings suggest new ways to treat the malignancy, slow its progression and reveal its extent more precisely.
SELECTBIO

SELECTBIO Market Reports
Go to LabTube
Go to eposters
 
Access to the latest scientific news
Exclusive articles
Upload and share your posters on ePosters
Latest presentations and webinars
View a library of 1,800+ scientific and medical posters
3,000+ scientific and medical posters
A library of 2,500+ scientific videos on LabTube
4,500+ scientific videos
Close
Premium CrownJOIN TECHNOLOGY NETWORKS PREMIUM FOR FREE!