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Zhao J, Guo X, Zheng M, Su L. Meta-analysis on the efficacy of allogeneic hematopoietic stem cell transplantation to treat malignant lymphoma. Open Life Sci 2024; 19:20220771. [PMID: 38840889 PMCID: PMC11151731 DOI: 10.1515/biol-2022-0771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/19/2023] [Accepted: 10/19/2023] [Indexed: 06/07/2024] Open
Abstract
The goal of the study involved the comparison of clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and autologous hematopoietic stem cell transplantation (auto-HSCT) in the treatment of malignant lymphoma (ML). The effectiveness of allo-HSCT versus auto-HSCT in the treatment of ML was compared by searching EMBASE, PubMed, Web of Science, and the Cochrane Library for relevant studies. The confidence intervals (CI) and odds ratio (OR) of the article's outcomes were described by a forest plot. Finally, 972 patients in seven articles were included. Overall survival (OS) did not differ significantly between allo-HSCT and auto-HSCT groups (OR = 0.87, 95% CI: 0.66-1.14, P = 0.31). Furthermore, there was no significant difference in adverse reactions (AR) between the two groups (OR = 1.35, 95% CI: 0.81-2.24, P = 0.25). We observed a significant difference in progression-free survival (PFS) between the two groups (OR = 4.14, 95% CI: 2.93-5.35, P < 0.01). There was no evidence of publication bias in this meta-analysis. The incidence of OS and AR differ significantly between allo-HSCT and auto-HSCT, but the PFS was longer in ML patients who received allo-HSCT.
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Affiliation(s)
- Jin Zhao
- The Department of Hematology, Shanxi Provincial Cancer Hospital, Taiyuan, 030013, Shanxi, China
- Hematology Department of Shanxi Hospital, Cancer Hospital, Chinese Academy of Medical Sciences, Taiyuan, 030013, Shanxi, China
- Department of Hematology, Affiliated Cancer Hospital, Shanxi Medical University, Taiyuan, 030013, Shanxi, China
| | - Xiaojing Guo
- The Department of Hematology, Shanxi Provincial Cancer Hospital, Taiyuan, 030013, Shanxi, China
- Hematology Department of Shanxi Hospital, Cancer Hospital, Chinese Academy of Medical Sciences, Taiyuan, 030013, Shanxi, China
- Department of Hematology, Affiliated Cancer Hospital, Shanxi Medical University, Taiyuan, 030013, Shanxi, China
| | - Meijing Zheng
- The Department of Hematology, Shanxi Provincial Cancer Hospital, Taiyuan, 030013, Shanxi, China
- Hematology Department of Shanxi Hospital, Cancer Hospital, Chinese Academy of Medical Sciences, Taiyuan, 030013, Shanxi, China
- Department of Hematology, Affiliated Cancer Hospital, Shanxi Medical University, Taiyuan, 030013, Shanxi, China
| | - Liping Su
- The Department of Hematology, Shanxi Provincial Cancer Hospital, Taiyuan, 030013, Shanxi, China
- Hematology Department of Shanxi Hospital, Cancer Hospital, Chinese Academy of Medical Sciences, Taiyuan, 030013, Shanxi, China
- Department of Hematology, Affiliated Cancer Hospital, Shanxi Medical University, Taiyuan, 030013, Shanxi, China
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Lee C, Lin T, Yao M, Hsiao L, Ko B, Liu C, Chen T. Allogeneic hematopoietic stem cell transplantation for B-cell lymphoma in Taiwan. Cancer Med 2023; 12:21761-21769. [PMID: 38018321 PMCID: PMC10757116 DOI: 10.1002/cam4.6741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/05/2023] [Accepted: 11/13/2023] [Indexed: 11/30/2023] Open
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered for patients with high-risk B-cell lymphoma and relapsed or refractory disease. This study aimed to analyze the long-term follow-up data of patients who underwent allo-HSCT in Taiwan. This was a retrospective observational study using data from the Taiwan Society of Blood and Marrow Transplantation database. A total of 105 patients who underwent allo-HSCT because of high-risk, relapsed, or refractory disease between 2010 and 2019 were included. Forty-five percent of the patients previously underwent autologous stem cell transplantation (ASCT). The median follow-up duration was 18.6 months. The probability of 3-year progression-free survival and overall survival (OS) was 34.5% and 37%, respectively. The probability of 1-year non-relapse mortality was 31.4%, and the major cause was infection (75.8%). The multivariable analysis showed that not in remission at the time of transplantation and the absence of graft-versus-host disease (GVHD) were factors associated with inferior OS. The probability of 3-year OS in patients with diffuse large B-cell lymphoma who underwent allo-HSCT and allo-HSCT after ASCT was 40.2% and 25.2%, respectively. Allo-HSCT could be a salvage therapeutic option for relapsed or refractory B-cell lymphoma. Complete remission at the time of allo-HSCT and the presence of GVHD are independent variables for overall survival.
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Affiliation(s)
- Chun‐Hui Lee
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung UniversityTainanTaiwan
- Department of OncologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Tzu‐Chien Lin
- Department of OncologyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
- Division of Hematology, Department of Internal MedicineNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
| | - Ming Yao
- Division of Hematology, Department of Internal MedicineNational Taiwan University Hospital, College of MedicineTaipeiTaiwan
| | - Liang‐Tsai Hsiao
- Division of Hematology, Department of Internal MedicineTaipei Veterans General HospitalTaipeiTaiwan
| | - Bor‐Sheng Ko
- Division of Hematology, Department of Internal MedicineNational Taiwan University Hospital, College of MedicineTaipeiTaiwan
- Department of Hematological OncologyNational Taiwan University Cancer CenterTaipeiTaiwan
| | - Chia‐Jen Liu
- Division of Hematology, Department of Internal MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Emergency and Critical Care Medicine, School of MedicineNational Yang‐Ming Chiao Tung UniversityTaipeiTaiwan
| | - Tsai‐Yun Chen
- Division of Hematology, Department of Internal MedicineNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
- Center for Cell TherapyNational Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainanTaiwan
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Wang R, Wang W, Liu X, Wang H, Zhang B, Li S, Zhang H, Yang J, Zhao J, He Q, Zhang J, Liu D, Hao L. Treatment for a B-cell acute lymphoblastic leukemia patient carrying a rare TP53 c.C275T mutation: A case report. Front Oncol 2023; 12:1018250. [PMID: 36798689 PMCID: PMC9928200 DOI: 10.3389/fonc.2022.1018250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/17/2022] [Indexed: 02/03/2023] Open
Abstract
TP53 mutations are associated with poor prognosis in the vast majority of cancers. In this study, we present a pediatric B-cell acute lymphoblastic leukemia (B-ALL) patient carrying a rare TP53 c.C275T mutation. This extremely rare mutation affects an amino acid residue located between the TAD domain and the DNA-binding domain of p53. The patient was resistant to most conventional chemotherapy regimens and remained minimal residual disease (MRD)-positive after five rounds of such regimens. We tested the sensitivity of the patient's leukemic cells to 21 anti-cancer drugs by performing in vitro drug sensitivity assays. The results showed that bortezomib had a very strong killing effect on the patient's leukemic cells. Therefore, we subsequently treated the patient with bortezomib combined with vindesine, cytarabine, and fludarabine. After one course of treatment, the patient became MRD-negative, and there was no recurrence during a 9-month follow-up. In conclusion, our report suggests that the TP53 c.C275T mutation is associated with poor prognosis in B-ALL. Fortunately, bortezomib combined with chemotherapy could achieve a better therapeutic effect than conventional regimens in this type of ALL.
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Affiliation(s)
- Runan Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Wenliang Wang
- Precision Targeted Therapy Discovery Center, Institute of Technology Innovation, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Xuan Liu
- Hematology Laboratory, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Huan Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Bin Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Shuang Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Haining Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Jiawei Yang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Jishun Zhao
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Qiuying He
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Jihong Zhang
- Hematology Laboratory, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Danping Liu
- Precision Targeted Therapy Discovery Center, Institute of Technology Innovation, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Liangchun Hao
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China,*Correspondence: Liangchun Hao,
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Wang J, Duan X, Yang L, Liu X, Hao C, Dong H, Gu H, Tang H, Dong B, Zhang T, Gao G, Liang R. Comparison of Survival Between Autologous and Allogeneic Stem Cell Transplantation in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma: A Meta-Analysis. Cell Transplant 2021; 29:963689720975397. [PMID: 33238731 PMCID: PMC7784574 DOI: 10.1177/0963689720975397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study aimed to compare the efficacy of allogeneic stem cell transplantation (allo-SCT) versus autologous SCT (auto-SCT) in patients with relapsed or refractory B-cell non-Hodgkin lymphoma (B-NHL). Medline, CENTRAL, and EMBASE databases through December 31, 2019 were searched. The primary endpoints were overall survival (OS) and progression-free survival (PFS) rates. The secondary outcomes include transplant-related mortality (TRM), event-free survival, relapse/or progression, and nonrelapse mortality (NRM). The 18 retrospective studies enrolled 8,058 B-NHL patients (allo-SCT = 1,204; auto-SCT = 6,854). The OS was significantly higher in patients receiving auto-SCT than allo-SCT (pooled odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.29 to 2.22, P < 0.001), but no significant difference was found in PFS (pooled OR: 0.98, 95% CI: 0.69 to 1.38, P = 0.891). Auto-SCT patients also had lower TRM and NRM (TRM: OR = 0.23, P < 0.001; NRM: OR = 0.16, P < 0.001), but higher relapse or progression rate (OR = 2.37, P < 0.001) than allo-SCT patients. Subgroup analysis performed for different grades and subtypes of B-NHL showed higher OS in auto-SCT patients with high-grade B-NHL and diffused large B-cell lymphoma (DLBCL). There was, nevertheless, higher PFS in allo-SCT patients with low-grade B-NHL and follicular lymphoma (FL), and lower PFS in allo-SCT patients with DLBCL than their auto-SCT counterparts. In conclusion, the meta-analysis demonstrated that relapsed or refractory B-NHL patients who received auto-SCT have improved OS than those treated with allo-SCT, especially among those with DLBCL, but lower PFS among those with FL. However, the study is limited by a lack of randomized trials, patients’ heterogeneity, and possible selection bias.
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Affiliation(s)
- Jianhong Wang
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
| | - Xiaohui Duan
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
| | - Lijie Yang
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
| | - Xiangxiang Liu
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
| | - Caixia Hao
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
| | - Hongjuan Dong
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
| | - Hongtao Gu
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
| | - Hailong Tang
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
| | - Baoxia Dong
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
| | - Tao Zhang
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
| | - Guangxun Gao
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
| | - Rong Liang
- Department of Hematology, Xijing Hospital, Fourth Military Medical University, Shaanxi Province, Xi'an, China
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Treatment and Outcome Analysis of 639 Relapsed Non-Hodgkin Lymphomas in Children and Adolescents and Resulting Treatment Recommendations. Cancers (Basel) 2021; 13:cancers13092075. [PMID: 33923026 PMCID: PMC8123268 DOI: 10.3390/cancers13092075] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/18/2021] [Accepted: 04/22/2021] [Indexed: 12/23/2022] Open
Abstract
Simple Summary Despite very poor survival, controversies remain in the treatment for refractory or relapsed non-Hodgkin lymphoma (r/r NHL) in children and adolescents. The current project identifies and reports international experience on re-induction treatment of r/r NHL, hematopoietic stem cell transplantation, risk factors associated with outcome, and suggests treatment recommendations. Abstract Despite poor survival, controversies remain in the treatment for refractory or relapsed pediatric non-Hodgkin lymphoma (r/r NHL). The current project aimed to collect international experience on the re-induction treatment of r/r NHL, hematopoietic stem cell transplantation (HSCT), risk factors associated with outcome, and to suggest treatment recommendations. Inclusion criteria were (i) refractory disease, disease progression or relapse of any NHL subtype except anaplastic large cell lymphoma, (ii) age < 18 years at initial diagnosis, (iii) diagnosis in/after January 2000. Data from 639 eligible patients were evaluable. The eight-year probability of overall survival was 34 ± 2% with highly significant differences according to NHL subtypes: 28 ± 3% for 254 Burkitt lymphoma/leukemia, 50 ± 6% for 98 diffuse large B-cell lymphomas, 57 ± 8% for 41 primary mediastinal large B-cell lymphomas, 27 ± 3% for 177 T-lymphoblastic lymphomas, 52 ± 10% for 34 precursor-B-cell lymphoblastic lymphomas and 30 ± 9% for 35 patients with rare NHL subtypes. Subtype-specific factors associated with survival and treatment recommendations are suggested. There were no survivors without HSCT, except in few very small subgroups. Conclusions: There is an urgent need to further improve survival in r/r NHL. The current study provides the largest real-world series, which underlines the role of HSCT and suggests treatment recommendations.
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Wen R, Dong C, Xu C, Zhao L, Yang Y, Zhang Z, Chen Y, Duan L, Chen H, Yang Z, Zhang B. UM171 promotes expansion of autologous peripheral blood hematopoietic stem cells from poorly mobilizing lymphoma patients. Int Immunopharmacol 2020; 81:106266. [PMID: 32062079 DOI: 10.1016/j.intimp.2020.106266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Autologous hematopoietic stem cell transplantation is an effective therapeutic strategy for lymphoma patients. However, some patients have to give up receiving transplantation because of failing to obtain sufficient CD34+ cells yields. Therefore, we ex vivo expanded HSCs of lymphoma patients using UM171 to solve the problem of HSCs deficiency. METHODS Mobilized peripheral blood-derived CD34+ cells from lymphoma patients were cultured for 10 days with or without UM171. The fold of cell expansion and the immunophenotype of expanded cells were assessed by flow cytometry. RNA-seq experiment was performed to identify the mechanism by which UM171 promoted HSCs expansion. RESULTS UM171 treatment increased the proportion of CD34+ (68.97 ± 6.91%), CD34+ CD38- cells (44.10 ± 9.20%) and CD34+CD38-CD45RA-CD90+ LT-HSCs (3.05 ± 2.08%) compared to vehicle treatment (36.08 ± 11.14%, 18.30 ± 9.49% and 0.56 ± 0.45%, respectively). UM171 treatment led to an 85.08-fold increase in LT-HSC numbers relative to initial cells. Importantly, UM171 promoted expansion of LT-HSCs achieved 138.57-fold in patients with poor mobilization. RNA-seq data showed that UM171 upregulated expression of HSC-, mast cell-specific genes and non-canonical Wnt signaling related genes, and inhibited genes expression of erythroid, megakaryocyte and inflammatory mediated chemokine. CONCLUSIONS Our study shows that UM171 can efficiently promote ex vivo expansion of HSCs from lymphoma patients, especially for poorly mobilizing patients. In terms of mechanism, UM171 upregulate HSC-specific genes expression and suppress erythroid and megakaryocytic differentiation, as well as activate non-classical Wnt signaling.
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Affiliation(s)
- Ruiting Wen
- Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, PR China; Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Chen Dong
- Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, PR China; Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Chen Xu
- Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, PR China; Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Long Zhao
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Yang Yang
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Zhihua Zhang
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Yanfu Chen
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Lian Duan
- The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China
| | - Hu Chen
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China
| | - Zhigang Yang
- Department of Hematology and Rheumatology, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang 524045, PR China.
| | - Bin Zhang
- Department of Hematopoietic Stem Cell Transplantation, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, PR China; Beijing Key Laboratory of Stem Cell Therapy and Transformation Research, Beijing 100071, PR China.
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