Allogeneic hematopoietic cell transplant following crizotinib monotherapy for relapsed/refractory anaplastic large cell lymphoma.
Tami D JohnSwati NaikKathryn LeungGhadir SasaCaridad MartinezRobert A KrancePublished in: Pediatric transplantation (2018)
Relapsed ALK-positive ALCL often is responsive to CRZ monotherapy. The subsequent role of allogeneic HCT after achieving second remission is poorly understood. We report 6 children who underwent allogeneic HCT for relapsed ALCL after CRZ. Age at transplant ranged from 10.7 to 22.6 years. Follow-up ranged from 0.9 to 4.5 years. All patients engrafted. Three of 4 patients that received a reduced-toxicity conditioning regimen containing fludarabine, alemtuzumab, and low-dose irradiation showed progressive mixed chimerism. Five patients remain in remission. One patient developed isolated CNS relapse 3.6 years after HCT despite a lack of previous CNS involvement. No acute transplant-related complications were experienced. One patient developed chronic renal disease secondary to transplant-associated microangiopathy and one patient chronic GVHD secondary to DLI. Ultimately, allogeneic HCT appears safe and potentially curative after remission induction with CRZ. The role of conditioning therapy, ablative or reduced intensity, remains uncertain for patients' post-CRZ monotherapy, and further studies may be warranted.
Keyphrases
- end stage renal disease
- ejection fraction
- chronic kidney disease
- newly diagnosed
- bone marrow
- acute lymphoblastic leukemia
- prognostic factors
- acute myeloid leukemia
- diffuse large b cell lymphoma
- randomized controlled trial
- young adults
- clinical trial
- stem cells
- case report
- risk factors
- intensive care unit
- rheumatoid arthritis
- multiple myeloma
- open label
- rectal cancer
- single cell
- hodgkin lymphoma
- radiation therapy
- high intensity