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Re-induction therapy plus autologous stem cell transplant effective in pediatric ALCL
For patients with anaplastic large cell lymphoma who experienced relapse after first-line therapy, secondary treatment with re-induction chemotherapy and autologous stem cell transplantation was effective in a population-based cohort of 74 children.
In addition, researchers were able to identify several parameters that increased the likelihood of relapse among this patient population.
The study examined outcomes in a group of children and adolescents who had undergone Berlin-Frankfurt-Muenster-type first-line treatment for anaplastic large cell lymphoma (ALCL) between April 1990 and December 2003. All patients were given salvage therapy consisting of re-induction chemotherapy followed by hematopoietic stem cell transplantation.
The median follow-up was 8.4 years, and 5-year OS was 57% after first relapse. The researchers found that those patients who experienced progression during first-line therapy had a lower OS vs. those who had a later relapse (25% vs. 66%; P=.002). In addition, patients who had central nervous system or bone marrow involvement also had lower rates of survival (27% vs. 62%; P=.001).
Thirty-six patients were treated with autologous stem cell transplantation for a relapse occurring after first-line therapy. The event-free survival among this group was 64%; OS was 81%. In contrast, all three patients who underwent autologous stem cell transplantation for progression during initial treatment experienced treatment failure.
Only one of 11 patients who had relapsed CD3+ ALCL had sustained remission after undergoing autologous stem cell transplantation, indicating that “these patients may benefit from allogeneic stem cell transplantation,” the researchers said.
For more information:
- Woessmann W. J Clin Oncol. 2011;doi:10.1200/JCO.2011.34.8417.