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Allogeneic Transplantation after Myeloablative Rituximab/BEAM ± Bortezomib for Patients with Relapsed/Refractory Lymphoid Malignancies: 5-Year Follow-Up Results.

Publication ,  Journal Article
Chamoun, K; Milton, DR; Ledesma, C; Young, KH; Jabbour, EJ; Alatrash, G; Anderlini, P; Bashir, Q; Ciurea, SO; Marin, D; Molldrem, JJ; Oran, B ...
Published in: Biol Blood Marrow Transplant
July 2019

Although bortezomib and rituximab have synergistic activity in patients with lymphoma and both can attenuate graft-versus-host disease (GVHD), the drugs have not been used together in patients undergoing allogeneic stem cell transplantation (alloSCT). In this phase I/II trial, we assessed the safety and activity of bortezomib added to the rituximab (R) plus BEAM (carmustine, etoposide, cytarabine, melphalan) regimen in patients with relapsed lymphoma undergoing alloSCT. Primary GVHD prophylaxis consisted of tacrolimus and methotrexate. Bortezomib (1 to 1.3 mg/m2 per dose) was administered i.v. on days -13, -6, -1, and +2. We performed inverse probability weighting analysis to compare GVHD and survival results with an historical control group that received R-BEAM without bortezomib. Thirty-nine patients were assessable for toxic effects and response. The median age was 54 years. The most common diagnosis was diffuse large B cell lymphoma (41%). Twenty-two patients (56%) and 17 patients (44%) received their transplants from matched related and matched unrelated donors, respectively. The maximum tolerated bortezomib dose was 1 mg/m2. The weighted cumulative incidences of grades II to IV and III or IV acute GVHD were 50% and 34%, respectively; these incidences and survival rates were not significantly different from those of the control group. Median survival was not reached in patients age ≤ 50 years and with a long follow-up time of 60.7 months. The R-BEAM regimen has a survival benefit in lymphoma patients age ≤ 50 years undergoing alloSCT. The addition of bortezomib has no impact on survival or incidence of GVHD.

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Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

July 2019

Volume

25

Issue

7

Start / End Page

1347 / 1354

Location

United States

Related Subject Headings

  • Survival Rate
  • Stem Cell Transplantation
  • Rituximab
  • Podophyllotoxin
  • Middle Aged
  • Melphalan
  • Male
  • Lymphoma, Large B-Cell, Diffuse
  • Immunology
  • Humans
 

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Chamoun, K., Milton, D. R., Ledesma, C., Young, K. H., Jabbour, E. J., Alatrash, G., … Khouri, I. F. (2019). Allogeneic Transplantation after Myeloablative Rituximab/BEAM ± Bortezomib for Patients with Relapsed/Refractory Lymphoid Malignancies: 5-Year Follow-Up Results. Biol Blood Marrow Transplant, 25(7), 1347–1354. https://doi.org/10.1016/j.bbmt.2019.02.022
Chamoun, Kamal, Denái R. Milton, Celina Ledesma, Ken H. Young, Elias J. Jabbour, Gheath Alatrash, Paolo Anderlini, et al. “Allogeneic Transplantation after Myeloablative Rituximab/BEAM ± Bortezomib for Patients with Relapsed/Refractory Lymphoid Malignancies: 5-Year Follow-Up Results.Biol Blood Marrow Transplant 25, no. 7 (July 2019): 1347–54. https://doi.org/10.1016/j.bbmt.2019.02.022.
Chamoun K, Milton DR, Ledesma C, Young KH, Jabbour EJ, Alatrash G, et al. Allogeneic Transplantation after Myeloablative Rituximab/BEAM ± Bortezomib for Patients with Relapsed/Refractory Lymphoid Malignancies: 5-Year Follow-Up Results. Biol Blood Marrow Transplant. 2019 Jul;25(7):1347–54.
Chamoun, Kamal, et al. “Allogeneic Transplantation after Myeloablative Rituximab/BEAM ± Bortezomib for Patients with Relapsed/Refractory Lymphoid Malignancies: 5-Year Follow-Up Results.Biol Blood Marrow Transplant, vol. 25, no. 7, July 2019, pp. 1347–54. Pubmed, doi:10.1016/j.bbmt.2019.02.022.
Chamoun K, Milton DR, Ledesma C, Young KH, Jabbour EJ, Alatrash G, Anderlini P, Bashir Q, Ciurea SO, Marin D, Molldrem JJ, Olson AL, Oran B, Popat UR, Rondon G, Champlin RE, Gulbis AM, Khouri IF. Allogeneic Transplantation after Myeloablative Rituximab/BEAM ± Bortezomib for Patients with Relapsed/Refractory Lymphoid Malignancies: 5-Year Follow-Up Results. Biol Blood Marrow Transplant. 2019 Jul;25(7):1347–1354.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

July 2019

Volume

25

Issue

7

Start / End Page

1347 / 1354

Location

United States

Related Subject Headings

  • Survival Rate
  • Stem Cell Transplantation
  • Rituximab
  • Podophyllotoxin
  • Middle Aged
  • Melphalan
  • Male
  • Lymphoma, Large B-Cell, Diffuse
  • Immunology
  • Humans