Autologous hematopoietic cell transplantation as a part of a sequential multi-phase therapeutic approach (R-COPADM/CYVE/ASCT) as first-line treatment of high-grade B-cell lymphoma: results of a retrospective study with long-term follow-up (2024)

FAQs

What are the odds of relapse after autologous stem cell transplant? ›

Recurrence of Hodgkin lymphoma (HL) occurs in about 50% of patients after autologous stem cell transplantation (ASCT), usually within the first year, and represents a significant therapeutic challenge. The natural history of recurrent HL in this setting may range from a rapidly progressive to a more indolent course.

An autologous stem cell transplant replaces a patient's stem cells that were destroyed by treatment with radiation or high doses of chemotherapy. An autologous stem cell transplant is most often used to treat blood cancers, such as leukemia and lymphoma.

Conditioning regimens may include irradiation, chemotherapy, serotherapy, monoclonal antibodies, and targeted therapy which varied in different malignancies and types of donors. The dose intensity of the pre-HSCT conditioning varied between MAC, RTC, RIC, and NMA in decreasing intensity order.

There are 5 distinct phases in the HSCT process, once an appropriate donor has been identified. These include a conditioning phase, the transplant phase, the neutropenic phase, the engraftment phase, and the postengraftment phase.

This subcohort included 2,546 patients transplanted between 2006 and 2014. Conditional on surviving ≥ 2 years, the cohort was at a 9.1-fold higher risk for all-cause mortality (95% CI, 8.51 to 9.69) compared with the general population (Data Supplement). The 15-year overall survival was 53.4%.

You should not expect to return to work or school for at least three to six months after transplantation. Even though blood tests may be normal, the immune system needs that time to recover. For some patients it may take six months to one year to recover.

Graft failure occurs if the transplanted stem cells fail to settle in your bone marrow and make new blood cells. This means your blood counts do not recover. Graft failure is serious but it is very rare after an autologous stem cell transplant. Your medical team monitors your blood counts closely.

Chemotherapy and radiation of the preparative regimen and post-transplant immunosuppression can induce severe pancytopenia in the first week following infusion of hematopoietic stem cells, leading to life-threatening infection.

This is also called engraftment. Recovery time depends on the type of transplant: Donated bone marrow or peripheral blood stem cell transplant can take 2-3 weeks. Cord blood engraftment can take 3-5 weeks.

Is hematopoietic stem cell transplantation painful? ›

Blood is removed from one arm and passed through a filter, before being returned to the body through the other arm. This procedure is not painful and is done while you're awake. It takes around 3 to 4 hours and may need to be repeated the next day if not enough cells are removed the first time.

If your bone marrow isn't functioning properly because of cancer or another disease, you may receive a stem cell transplant. To prepare for a stem cell transplant, you receive chemotherapy to kill the diseased cells and malfunctioning bone marrow.

Median survival after ICU admission was 50.5 (CI 95%, 20–430) days for allogeneic HSCT recipients and 1115 (CI 95%, 337–NA) days for autologous HSCT recipients. At 1 year after ICU admission, 21 (36.8%) autologous HSCT recipients and 18 (69.2%) allogeneic HSCT recipients had died (Figure 4).

An autologous stem cell transplant is how you receive healthy blood stem cells so your bone marrow can make new, healthy blood cells. This procedure may not cure cancer. But research shows it can put cancer into long-term remission, meaning you don't have symptoms and tests don't find signs of cancer.

Death from relapse was the most frequent cause of death (N = 133, 46.0%), followed by GvHD (N = 64, 22.1%), other causes (N = 39, 13.5%) and infections (N = 35, 12.1%) (Figure 1 and Supplemental Table 2).

Second ASCT is a feasible and safe option for salvage therapy in MM. The best outcome was observed in patients whose time to progression was >24 months after first ASCT, as these patients had a subsequent PFS lasting over 1 year and an OS of almost 6 years.

Although 40 to 80 % of patients may achieve curable remission which is a considerable high cure rate ⁵ depending on pretreatment clinical features, a significant proportion (10-20 %) will relapse and fail to achieve long-term disease- free survival ⁶.

Median overall survival (OS)/progression-free survival (PFS) from ASCT was 9 years/2.9 years. Five-year OS/PFS was 55% of 44% and 10-year OS/PFS was 49.4% of 37% for whole group. Twenty (10%) patients developed second cancer (seven secondary acute myeloid leukaemia (AML)/myelodysplastic syndrome (MDS)).

How effective is stem cell transplantation? In the treatment of multiple myeloma, stem cell transplants have been shown to lengthen patients' remission period. The complication rate for autologous transplants is far lower than for allogeneic transplants – 5 percent or less.