RT Book, Section
A1 Saini, Neeraj
A1 Nieto, Yago
A2 Kantarjian, Hagop M.
A2 Wolff, Robert A.
A2 Rieber, Alyssa G.
SR Print(0)
ID 1190833866
T1 Autologous Hematopoietic Progenitor-Cell Transplantation
T2 The MD Anderson Manual of Medical Oncology, 4e
YR 2022
FD 2022
PB McGraw Hill Education
PP New York, NY
SN 9781260467642
LK hemonc.mhmedical.com/content.aspx?aid=1190833866
RD 2024/04/20
AB KEY  CONCEPTSThe  use  of  autologous  hematopoietic  progenitor-cell  transplant  (AHPCT)  overcomes  myelotoxicity  of  high-dose  chemotherapy  (HDC).  Therefore,  drugs  with  a  markedly  myelosuppressive  side  effect  profile  and  a  steep  dose-response  effect  are  preferred.  The  most  common  nonhematologic  regimen-related  toxicity  (RRT)  is  oropharyngeal  mucositis,  which  is  rarely  life  threatening.  The  most  common  among  the  potentially  severe  extramedullary  RRT  are  interstitial  pneumonitis  and  veno-occlusive  disease  of  the  liver.HDC  with  AHPCT  has  been  the  standard  of  care  for  chemosensitive,  relapsed  diffuse  large  B-cell  lymphoma  (DLBCL)  for  the  last  three  decades.  However,  the  results  remain  suboptimal  in  patients  whose  disease  relapses  less  than  one  year  after  completion  of  frontline  chemoimmunotherapy  (eg,  R-CHOP).In  follicular  lymphoma,  HDC  with  AHPCT  should  be  considered  for  high-risk  relapses  occurring  within  two  years  of  completing  frontline  therapy  (POD24)  or  second  or  more  advanced  relapses.Management  of  relapsed  or  primary  refractory  Hodgkin  lymphoma  in  patients  should  be  a  salvage  strategy  using  one  or  more  lines  of  therapy,  including  regimens  such  as  bendamustine/brentuximab  vedotin  or  ifosfamide/carboplatin/etoposide  aiming  at  a  positron  emission  tomography–negative  remission  before  AHPCT.  Patients  with  a  high-risk  for  disease  relapse  should  be  considered  for  post-AHPCT  maintenance  with  brentuximab  vedotin.Modern  treatment  of  newly  diagnosed  myeloma  should  include  induction  with  a  proteasome  inhibitor  and  an  immunomodulatory  drug  (eg,  bortezomib/lenalidomide/dexamethasone  [VRD])  followed  by  melphalan-based  HDC  and  AHCPT,  and  consolidation  and/or  maintenance  with  drugs  like  lenalidomide,  with  the  goal  of  achieving  a  minimal  residual  disease-negative  remission.Tandem  cycles  of  carboplatin-containing  HDC  with  AHPCT  should  be  considered  for  any  patient  with  a  germ-cell  tumor  in  the  second  or  later  relapse.  Their  role  in  the  first  relapse  is  still  undetermined.