autologic hematopoietic stem cell transplantation

Classification of Conditioning Regimens for Bone Marrow Transplantation: Historical Background and Current Perspectives

BONE MARROW TRANSPLANTATION , , , , , ,

KN Melkova, GD Petrova, NV Gorbunova, TZ Chernyavskaya, OP Trofimova

NN Blokhin National Medical Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

For correspondence: Kapitolina Nikolaevna Melkova, PhD, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; e-mail: frolov63@bk.ru

For citation: Melkova KN, Petrova GD, Gorbunova NV, et al. Classification of Conditioning Regimens for Bone Marrow Transplantation: Historical Background and Current Perspectives. Clinical oncohematology. 2017;10(4):494–500 (In Russ).

DOI: 10.21320/2500-2139-2017-10-4-494-500

ABSTRACT

Hematopoietic stem cells transplantation is a current standard treatment for many oncohematological diseases. The milestone of any type of transplantation is the choice of conditioning regimen. This article presents the principles of classification of conditioning regimens in terms of myeloablativity and discusses the concepts of “autologous transplantation”, “high-dose chemotherapy supported by hematopoietic stem cells”, “allogeneic transplantation” and “immunotherapy”. Up-to-date uniform classification of conditioning regimens may serve an important prognostic component in assessing both the risks and efficacy of hematopoietic stem cells transplantation.

Keywords: conditioning regimens, allogeneic hematopoietic stem cell transplantation, autologous hematopoietic stem cell transplantation, total therapeutic exposure, acute leukemia, Hodgkin’s lymphoma, multiple myeloma.

Received: March 29, 2017

Accepted: July 8, 2017

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REFERENCES

  1. Passweg JR, Baldomero H, Bader P, et al. Hematopoietic SCT in Europe 2013: recent trends in the use of alternative donors showing more haploidentical donors but fewer cord blood transplants. Bone Marrow Transplant. 2015;50(4):476–82. doi: 10.1038/bmt.2014.312.
  2. Мелкова К.Н., Абдусаламов С.Н., Горбунова Н.В. и др. Трансплантация костного мозга при острых лейкозах. Клиническая онкогематология. 2010;3(4):395–9.[Melkova KN, Abdusalamov SN, Gorbunova NV, et al. Bone Marrow Transplantation in Case of Acute Leukemia. Klinicheskaya onkogematologiya. 2010;3(4):395–9. (In Russ)]
  3. Петрова Г.Д., Мелкова К.Н., Чернявская Т.З. и др. Петрова Г.Д., Мелкова К.Н., Чернявская Т.З. и др. Аутологичная трансплантация гемопоэтических стволовых клеток при первично-рефрактерном течении лимфомы Ходжкина: мнимый цугцванг или промежуточный ход? Клиническая онкогематология. 2015;8(3):321–30. doi: 10.21320/2500-2139-2015-8-3-321-330.[Petrova GD, Melkova KN, Chernyavskaya TZ, et al. Autologous Stem Cell Transplantation in Primary Refractory Hodgkin’s Lymphoma: Supposed Zugzwang or Zwischenzug? Clinical oncohematology. 2015;8(3):321–30. doi: 10.21320/2500-2139-2015-8-3-321-330. (In Russ)]
  4. Петрова Г.Д., Мелкова К.Н., Чернявская Т.З. и др. Первично-рефрактерное течение лимфомы Ходжкина и аутологичная трансплантация гемопоэтических стволовых клеток. Результаты одноцентрового проспективного исследования. Российский онкологический журнал. 2015;20(3):4–11.[Petrova GD, Melkova KN, Chernyavskaya TZ, et al. Primary-Refractory Course of Hodgkin’s Lymphoma and Autologous Hematopoietic Stem Cell Transplantation. Results of Single Center Prospective Study. Rossiiskii onkologicheskii zhurnal. 2015;20(3):4–11. (In Russ)]
  5. Петрова Г.Д., Мелкова К.Н., Горбунова Н.В. и др. Аутологичная трансплантация гемопоэтических стволовых клеток для консолидации ремиссии острого миелобластного лейкоза с факторами неблагоприятного прогноза в дебюте заболевания. Онкогематология. 2016;11(1):52–61. doi: 10.17650/1818-8346-2016-11-1-52-61.[Petrova GD, Melkova KN, Gorbunova NV, et al. Autologous Hematopoietic Stem Cell Transplantation for Remission Consolidation of Acute Myeloblastic Leukemia with Factors of Poor Prognosis in Disease Onset. Oncohematology. 2016;11(1):52–61. doi: 10.17650/1818-8346-2016-11-1-52-61. (In Russ)]
  6. Мелкова К.Н., Петрова Г.Д., Чернявская Т.З. Заготовка гемопоэтических стволовых клеток для проведения аутологичной трансплантации у пациентов с лимфомой Ходжкина неблагоприятного прогноза. Вестник ФГБНУ «РОНЦ им. Н.Н. Блохина». 2015;26(3):51–6.[Melkova KN, Petrova GD, Chernyavskaya TZ. Hematopoietic Stem Cells Preparation for Autologous Transplantation in Patients with Hodgkin’s Lymphoma of Poor Prognosis. Vestnik FGBNU «RONTs im. N.N. Blokhina». 2015;26(3):51–6. (In Russ)]
  7. Чернявская Т.З., Мелкова К.Н., Горбунова Н.В. и др. Использование стимулированного костного мозга для трансплантации в онкологии. Онкология. 2012;(2, приложение):28–33.[Chernyavskaya TZ, Melkova KN, Gorbunova NV, et al. Usage of Stimulated Bone Marrow for Oncology Transplantation. Onkologiya. 2012;(2 Suppl):28–33. (In Russ)]
  8. Melkova K, Chernyavskaya T, Abdusalamov S, et al. Application of autologous stimulated bone marrow as a source of hematopoietic material for transplantation. Cell Ther Transplant. 2011;3(12):33.
  9. Melkova K, Chernyavskaya T, Abdusalamov S, et al. Using stimulated bone marrow as a source of hematopoietic stem cells for allogenic transplantation. Cell Ther Transplant. 2011;3(12):34.
  10. Мелкова К.Н., Абдусаламов С.Н., Горбунова Н.В. и др. Интенсивная сопроводительная терапия в онкологии и гематологии. Вестник московского онкологического общества. 2011;2:3–4.[Melkova KN, Abdusalamov SN, Gorbunova NV, et al. Intensive Supportive Therapy in Oncology and Hematology. Vestnik moskovskogo onkologicheskogo obshchestva. 2011;2:3–4. (In Russ)]
  11. Мелкова К.Н., Абдусаламов С.Н., Горбунова Н.В. и др. Интенсивная сопроводительная терапия в гематологии. Клиническая онкогематология. 2011;4(1):70–4.[Melkova KN, Abdusalamov SN, Gorbunova NV, et al. Intensive Supportive Therapy in Hematology. Klinicheskaya onkogematologiya. 2011;4(1):70–4. (In Russ)]
  12. Мелкова К.Н. Аллогенная трансплантация костного мозга. Клиническая онкогематология. 2012;5(1):1–12.[Melkova KN. Allogeneic Bone Marrow Transplantation. Klinicheskaya onkogematologiya. 2012;5(1):1–12. (In Russ)]
  13. Vriesendorp HM. Aims of the conditioning. Exp Hematol. 2003;31(10):844–54. doi: 10.1016/s0301-472x(03)00229-7.
  14. Bacigalupo A, Sormani MP, Lamparelli T, et al. Reducing transplant-related mortality after allogeneic hematopoietic stem cell transplantation. Haematologica. 2004;89(10):1238–47.
  15. Мелкова К.Н., Горбунова Н.В., Чернявская Т.З. и др. Тотальное облучение организма человека при трансплантации костного мозга. Клиническая онкогематология. 2012;5(2):96–114.[Melkova KN, Gorbunova NV, Chernyavskaya TZ, et al. Total Human Body Irradiation at Bone Marrow Transplantation. Klinicheskaya onkogematologiya. 2012;5(2):96–114. (In Russ)]
  16.  Gratwohl A, Carreras E. Principles of conditioning. In: Apperley J, Carreras E, Gluckman E, Masszi T, eds. Hematopoietic Stem Cell Transplantation, 6th edition. Genoa: Forum service editore; 2012. pp. 122–37.
  17. Bensinger WI. High-dose preparatory regimens. In: Forman SJ, Negrin RS, Antin JH, eds. Thomas’ Hematopoietic Cell Transplantation, 5th edition. Willey Blackwell; 2016. Vol. 1. pp. 223–31.
  18. Лебеденко И.М., Ратнер Т.Г., Водяник В.В. и др. Проведение тотального облучения пациента перед трансплантацией костного мозга. Радиационная онкология и ядерная медицина. 2012;2:30–6.[Lebedenko IM, Ratner TG, Vodyanik VV, et al. Performance of Total Patient Irradiation before Bone Marrow Transplantation. Radiatsionnaya onkologiya i yadernaya meditsina. 2012;2:30–6. (In Russ)]
  19. Лебеденко И.М., Ратнер Т.Г., Водяник В.В. и др. Техническое и дозиметрическое обеспечение тотального облучения пациента перед трансплантацией костного мозга. Медицинская физика. 2012;3(55):11–9.[Lebedenko IM, Ratner TG, Vodyanik VV, et al. Technical and Radiation-Monitoring Supply of Total Patient Irradiation before Bone Marrow Transplantation. Meditsinskaya fizika. 2012;3(5):11–9. (In Russ)]
  20. Лебеденко И.М., Чернявская Т.З., Ставицкий Р.В. и др. Технический контроль состояния организма и его систем в процессе химио-лучевой терапии и трансплантации костного мозга при острых лейкозах. Медицинская техника. 2014;5:32–7.[Lebedenko IM, Chernyavskaya TZ, Stavitskii RV, et al. Technical Control of Patient’s Body State and Its Systems in Process of Chemoradiotherapy and Bone Marrow Transplantation. Meditsinskaya tekhnika. 2014;5:32–7. (In Russ)]
  21. Storb RF, Champlin R, Riddell SR, et al. Non-myeloablative transplants for malignant disease. Hematology Am Soc Hematol Educ Program. 2001;1:375–91. doi: 10.1182/asheducation-2001.1.375.
  22. Мелкова К.Н., Петрова Г.Д. Материалы 41-го конгресса Европейского общества по трансплантации костного мозга. Клиническая онкогематология. 2015;8(3):343–52.[Melkova KN, Petrova GD. Materials of 41st Congress of European Society of Bone Marrow Transplantation. Clinical oncohematology. 2015;8(3):343–52. (In Russ)]
  23. Sorror ML, Maris MB, Storer B, et al. Comparing morbidity and mortality of HLA-matched unrelated donor hematopoietic cell transplantation after nonmyeloablative and myeloablative conditioning: influence of pretransplantation comorbidities. Blood. 2004;104(4):961–8. doi: 10.1182/blood-2004-02-0545.
  24. Giralt S, Ballen K, Rizzo D, et al. Reduced-intensity conditioning regimen workshop: defining the dose spectrum. Report of a workshop convened by the center for international blood and marrow transplant research. Biol Blood Marrow Transplant. 2009;15(3):367. doi: 10.1016/j.bbmt.2008.12.497.
  25. Khouri I, Giralt S, Champlin R. Non-Myeloablative Allogeneic Hematopoietic Transplantation and Induction of Graft-Versus-Malignancy. In: Bashey A, Ball ED, eds. Cancer Treatment and Research. Boston: Springer; 2002. рр. 137–47. doi: 10.1007/978-1-4615-0919-6_7.

Quality of Life of Patients with Lymphomas at Different Time-Points after High-Dose Chemotherapy with Autologous Hematopoietic Stem Cell Transplantation

QUALITY OF LIFE , , ,

N.E. Mochkin1, D.A. Fedorenko1, V.Ya. Mel’nichenko1, T.I. Ionova2, T.P. Nikitina1,2, K.A. Kurbatova2, A.A. Novik1

1 N.I. Pirogov National Medical and Surgical Center under the Ministry of Health of the Russian Federation, 70 Nizhnyaya Pervomaiskaya str., Moscow, Russian Federation, 105203

2 International Quality of Life Research Center, 1 office 152, Artilleriiskaya str., Saint Petersburg, Russian Federation, 191014

For correspondence: N.E. Mochkin, PhD, assistant, 70 Nizhnyaya Pervomaiskaya str., Moscow, Russian Federation, 105203; Tel: +7(495)603-72-17; e-mail: nickmed@yandex.ru

For citation: Mochkin N.E., Fedorenko D.A., Mel’nichenko V.Ya., Ionova T.I., Nikitina T.P., Kurbatova K.A., Novik A.A. Quality of Life of Patients with Lymphomas at Different Time-Points after HighDose Chemotherapy with Autologous Hematopoietic Stem Cell Transplantation. Klin. Onkogematol. 2014; 7(4): 577–582 (In Russ.).

 

ABSTRACT

The article presents results of monitoring of quality of life of 103 patients with lymphomas (non-Hodgkin’s lymphomas, n = 36; Hodgkin’s lymphomas, n = 67) at different stages after high-dose chemotherapy with autologic hematopoietic stem cell transplantation (HDC + HSCT). The majority of patients experienced improvement or stabilization of their quality of life 1 year after the HDC + aHSCT. At that, the response associated with the quality of life and clinical response to the treatment did not coincide in all cases. Obtained results confirm the importance of a comprehensive approach to assessment of the efficacy of the treatment and may be use as a principle marker of patient’s recovery at different time points after the transplantation.

Keywords: quality of life, lymphomas, high-dose chemotherapy, autologic hematopoietic stem cell transplantation.

Accepted: September 16, 2014

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REFERENCES

  1. Colpo A., Hochberg E., Chen Y.B. Current status of autologous stem cell transplantation in relapsed and refractory Hodgkin’s lymphoma. Oncologist. 2012; 17: 80–90.
  2. d’Amore F., Relander T., Lauritzen G.F. et al. High-dose chemotherapy and autologous stem cell transplantation in previously untreated peripheral T-cell lymphoma — final analysis of a large prospective multicenter study (NLGT-01). Blood (ASH Annual Meeting Abstracts). 2011; 118: 331.
  3. Damon L.E., Johnson J.L., Neidzwiecki D. et al. Immunochemotherapy and autologous stem-cell transplantation for untreated patients with mantle-cell lymphoma: CALGB 59909. J. Clin. Oncol. 2009; 27: 6101–8.
  4. Freidberg J.W. Relapsed/refractory diffuse large B-cell lymphoma. Hematol. Am. Soc. Hematol. Educ. Program. 2011: 498–501.
  5. Geisler C.H., Polstad A., Laurell A. et al. Long-term progression-free survival of mantle cell lymphoma after intensive front-line immunochemotherapy with in vivo-purged stem cell rescue: a nonrandomized phase 2 multicenter study by the Nordic Lymphoma Group. Blood. 2008; 112: 2687–93.
  6. Hjermstad M.J., Kaasa S. Quality of life in adult cancer patients treated with bone marrow transplantation — a review of the literature. Eur. J. Cancer. 1995; 31A(2): 163–73.
  7. Kiss T.L., Abdolell M., Jamal N. et al. Long-term medical outcomes and quality-of-life assessment of patients with chronic myeloid leukemia followed at least 10 years after allogenic bone marrow transplantation. J. Clin. Oncol. 2002; 20(9); 2334–43.
  8. Anderson K.O., Giralt S.A., Mendoza T.R. et al. Symptom burden in patients undergoing autologous stem-cell transplantation. Bone Marrow Transplant. 2007; 39(12): 759–66.
  9. Grant M., Ferrel B., Schmidt G.M. et al. Measurement of quality of life in bone marrow transplantation survivors. Qual. Life Res. 1992; 1(6): 375–84.
  10. Новик А.А., Ионова Т.И., Афанасьев Б.В. и др. Результаты аутоло- гичной трансплантации костного мозга/стволовых кроветворных клеток у больных гемобластозами: клиническая эффективность и показатели ка- чества жизни. Вестник Межнационального центра исследования качества жизни. 2011; 17–18: 22–32. [Novik A.A., Ionova T.I., Afanas’ev B.V. et al. Results of autologic bone marrow transplantation/hematopoietic stem cells transplantation in patients with hemoblastoses: clinical efficacy and parameters of quality of life. Vestnik Mezhnatsional’nogo tsentra issledovaniya kachestva zhizni. 2011; 17–18: 22–32. (In Russ.)]
  11. Rock E.P., Kennedy D.L., Furness M.H. et al. Patient-reported outcomes supporting anticancer product approvals. J. Clin. Oncol. 2007; 25: 5094–9.
  12. Fairclough D. Patient-reported outcomes as endpoints in medical research. Sta. Meth. Med. Res. 2004; 13: 115–38.
  13. Gondek K., Sagnier P., Gichrist K., Wooley J. Current status of patientreported outcomes in industry-sponsored oncology clinical trials and product labels. J. Clin. Oncol. 2007; 25(32): 5087–93.
  14. Steven B. Patient-reported outcomes assessment in cancer trials: evaluating and enhancing the payoff to decision making. J. Clin. Oncol. 2007; 25(32): 5049–50.
  15. Watkins B. Issues and challenges with integrating patient-reported outcomes in clinical trials supported by the national cancer institute-sponsored clinical trials networks. J. Clin. Oncol. 2007; 25(32): 5051–7.
  16. Molassiotis A., Van der Akker O., Milligan D. et al. Quality of life in longterm survivors of marrow transplantation: Comparison with a matched group receiving maintenance chemotherapy. Bone Marrow Transplant. 1996; 17: 249–58.
  17. Руководство по исследованию качества жизни в медицине, 3-е изд., перераб. и доп. Под ред. Ю.Л. Шевченко. М.: Изд-во РАЕН, 2012. [Shevchenko Yu.L., ed. Rukovodstvo po issledovaniyu kachestva zhizni v meditsine (Guidelines for evaluation of the quality of life in medicine). 3rd revised edition. Moscow: RAEN Publ.; 2012.]
  18. Neitzert C.S., Ritvo P., Dancey J. et al. The psychosocial impact of bone marrow transplantation: A review of the literature. Bone Marrow Transplant. 1998; 22: 409–22.
  19. Wingard J.R. Quality of life following bone marrow transplantation. Curr. Opin. Oncol. 1998; 10: 108–11.
  20. Chao N.J., Tierney D.K., Bloom J.R. et al. Dynamic assessment of quality of life after autologous bone marrow transplantation. Blood. 1992; 80: 825–30.
  21. Cohen M.Z., Mendoza T., Neumann J. et al. Longitudinal assessment of symptoms and quality of life: Differences by ablative and nonablative blood and marrow transplantation. J. Clin. Oncol. 2004; 22(15S): 6630.
  22. Ganz P., Gotay C. Use of Patient-Reported Outcomes in Phase III Cancer Treatment Trials; Lessons Learned and Future Directions. J. Clin. Oncol. 2007; 25(32): 5063–9.
  23. Novik A., Salek S., Ionova T. Patient-reported outcomes in hematology. Guidelines. EHA SWG Quality of Life and Symptoms. Litoprint. Genoa, 2012.
  24. Hays R.D., Sherbourne C.D., Mazel R.M. User’s Manual for Medical Outcomes Study (MOS) Core measures of health-related quality of life. RAND Corporation, MR-162-RC. Available at www.rand.org.
  25. Новик А.А., Ионова Т.И. Исследование качества жизни в медицине: Учебное пособие для вузов. Под ред. Ю.Л. Шевченко. М.: ГЭОТАР-Медиа, 2004. [Novik A.A., Ionova T.I. Issledovanie kachestva zhizni v meditsine (Evaluation of the quality of life in medicine). Textbook for institutes of higher education. Shevchenko Yu.L., ed. Moscow: GEOTAR-Media Publ.; 2004.]
  26. Новик А.А., Ионова Т.И. Интегральный показатель качества жизни — новая категория в концепции исследования качества жизни. Вестник Межнационального центра исследования качества жизни. 2006; 7–8: 7–8. [Novik A.A., Ionova T.I. Integral assessment of quality of life is a new category in the concept of evaluation of quality of life. Vestnik Mezhnatsional’nogo tsentra issledovaniya kachestva zhizni. 2006; 7–8: 7–8. (In Russ.)]