The role of checkpoint blockade after allogeneic stem cell transplantation in diseases other than Hodgkin's Lymphoma
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The role of checkpoint blockade after allogeneic stem cell transplantation in diseases other than Hodgkin's Lymphoma. / Holderried, Tobias A W; Fraccaroli, Alessia; Schumacher, Martin; Heine, Annkristin; Brossart, Peter; Stelljes, Matthias; Klobuch, Sebastian; Kröger, Nicolaus; Apostolova, Petya; Finke, Jürgen; Zeiser, Robert; Heinicke, Thomas; Bornhäuser, Martin; von Bergwelt-Baildon, Michael; Tischer, Johanna; Wolf, Dominik.
in: BONE MARROW TRANSPL, Jahrgang 54, Nr. 10, 10.2019, S. 1662-1667.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - The role of checkpoint blockade after allogeneic stem cell transplantation in diseases other than Hodgkin's Lymphoma
AU - Holderried, Tobias A W
AU - Fraccaroli, Alessia
AU - Schumacher, Martin
AU - Heine, Annkristin
AU - Brossart, Peter
AU - Stelljes, Matthias
AU - Klobuch, Sebastian
AU - Kröger, Nicolaus
AU - Apostolova, Petya
AU - Finke, Jürgen
AU - Zeiser, Robert
AU - Heinicke, Thomas
AU - Bornhäuser, Martin
AU - von Bergwelt-Baildon, Michael
AU - Tischer, Johanna
AU - Wolf, Dominik
PY - 2019/10
Y1 - 2019/10
N2 - Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only curative treatment option for many malignant high-risk hematological diseases. The Graft-vs.-Tumor (GvT) effect is the major hallmark of this treatment approach. However, disease relapse remains a major limitation. Boosting the GvT effect by checkpoint inhibitors (CI) is an attractive option in this desperate situation although potentially triggering Graft-vs.-Host Disease (GvHD). Early reports in patients with Hodgkin's lymphoma support the idea that CI therapy after HSCT is feasible and effective. We have retrospectively analyzed CI therapy for treatment of disease recurrence after allo-HSCT other than Hodgkin's lymphoma including 21 patients from eight German transplant centers. The median follow-up was 59 days. The overall response rate (ORR) was 43%. Patients receiving donor lymphocyte infusion (DLI) in combination with CI had superior response (ORR 80%). Severe acute GvHD grade III-IV and moderate to severe chronic GvHD were observed in 29% of all patients. Taken together, CI therapy in relapsed patients after HSCT, especially in combination with DLI, is effective but induces severe GvHD in a considerable proportion of patients. Thus, prospective trials or EBMT registry-based validation of different dosing and application schedules including immunosuppressive regimens in those patients are urgently needed.
AB - Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only curative treatment option for many malignant high-risk hematological diseases. The Graft-vs.-Tumor (GvT) effect is the major hallmark of this treatment approach. However, disease relapse remains a major limitation. Boosting the GvT effect by checkpoint inhibitors (CI) is an attractive option in this desperate situation although potentially triggering Graft-vs.-Host Disease (GvHD). Early reports in patients with Hodgkin's lymphoma support the idea that CI therapy after HSCT is feasible and effective. We have retrospectively analyzed CI therapy for treatment of disease recurrence after allo-HSCT other than Hodgkin's lymphoma including 21 patients from eight German transplant centers. The median follow-up was 59 days. The overall response rate (ORR) was 43%. Patients receiving donor lymphocyte infusion (DLI) in combination with CI had superior response (ORR 80%). Severe acute GvHD grade III-IV and moderate to severe chronic GvHD were observed in 29% of all patients. Taken together, CI therapy in relapsed patients after HSCT, especially in combination with DLI, is effective but induces severe GvHD in a considerable proportion of patients. Thus, prospective trials or EBMT registry-based validation of different dosing and application schedules including immunosuppressive regimens in those patients are urgently needed.
U2 - 10.1038/s41409-019-0498-0
DO - 10.1038/s41409-019-0498-0
M3 - SCORING: Journal article
C2 - 30833743
VL - 54
SP - 1662
EP - 1667
JO - BONE MARROW TRANSPL
JF - BONE MARROW TRANSPL
SN - 0268-3369
IS - 10
ER -