1 / 15

9 ème Congrès Magrébin d’Hématologie Dr Torjemane L 25/05/2012

Autologous pBSC transplantation for refractory or relapsed DBLCL Report of the « CNGMO, Tunis». 9 ème Congrès Magrébin d’Hématologie Dr Torjemane L 25/05/2012. Introduction.

Download Presentation

9 ème Congrès Magrébin d’Hématologie Dr Torjemane L 25/05/2012

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. AutologouspBSCtransplantation for refractory or relapsed DBLCL Report of the « CNGMO, Tunis» 9ème Congrès Magrébin d’Hématologie Dr Torjemane L 25/05/2012

  2. Introduction • High dose chemotherapy (HDC) followed by autologous peripheral stem cell transplantation (APSCT) is indicated in case of relapsed or refractory NHL. • From June 2000 to December 2011, a total of 28 autologous PSCT were performed at the « CNGMO »for DLCBCL in second line

  3. Patients & Methods(1)

  4. Transplant procedure • Conditioning regimen consisted in BEAM regimen (BICNU, Etoposid, Cytarabin, Melphalan) • Adjustment of dose of Melphalan (50%) to renalfunction: 2 patients • PBSC : 6,03 x106 CD34+/kg (range; 1,44- 13x106). (PBSC + Bone marrow : 2 patients)

  5. ResultsHematopoieticEngraftment • The mediansnumbers of days to reach: -Granulocytes > 500/mm3: 10 days ( range: 9 - 35) - Platelets ≥ 20 000/mm3: 15 days ( range; 12- 62) • Transfusion Requirements - RBC : 4 Units (range: 0- 19) - PCA: 6 Units (range: 2- 19)

  6. Transplant-relatedtoxicity • Stomatitis grade 3-4: 85% • Infectious complication: 100% - A median of 2 febrileneutropenia (range;1-4) - Pneumonia : n= 6, Abdominal pain - Septicemia (19%) : Gram + (n=6) Gram- (n=4) , Candida parapsilosis (n=2)

  7. Transplant-relatedtoxicity • Renaltoxicity (grade 1-2): n= 6 (21%) • Hepatictoxicity/VOD : n=1 (3,5%) • Cytomegalovirus Infections: n=4 (14%) • TreatmentrelatedMortality: n=2 (7%) ( Interstitiel Pneumonia + Septic choc)

  8. Therapeuticresults • At 3 monthsafter Transplants: - Complete Remission : 15/26 ( 58%) - Partial Remission: 8/26 (30%) - Resistantdisease: 3/26 (12 %) • Complementaryradiotherapy(2 resistantdiseases) : - 1 Complete Remission / negative TEP scanner - 1 Stable Partial Remission

  9. Therapeuticresults • Relapse rate: 10/26 (38%) • Mediandelai of relapse: 6 months (range; 3- 20) • After a median time of follow-up of 24 months, (range : 8- 120 months) 16 ( 57%) patients were alive and well.

  10. Overallsurvival, Cumulative Incidence of relapse and Event Free Survival OS at 3 years 50% CI Relapse 42% EFS at 3 years 53%

  11. EFS curvesaccordingpriorRituximabtreatment and disease statuts at transplant RC+RCu P= 0,2 RP

  12. Conclusion • The present results demonstrate the efficacy and moderatetoxicity of the HDC followed by autologous stem cell support in refractory or relapsedhigh-risk DLBCL • Addition of Rituximab significantly reduce the risk of relapse.

  13. THANKS • Equipe d’Hhématologie de l’Hôpital HédiChaker, Sfax • Equipe de Carcinologie Médicale de l’hôpital HédiChaker, Sfax • Equipe d’Hématologie de l’hôpital FarhatHached, Sousse • Equipe de Carcinologie Médicale de l’hôpital FarhatHached, Sousse • Equipe d’Hématologie de l’Hôpital de Monastir • Equipe d’Hématologie de l’Hôpital Aziza Othmana, Tunis • Equipe d’Hématologie de l’Hôpital Militaire de Tunis • Equipe de Carcinologie Médicale de l’Institut Salah Azaiez de Tunis • Médecins Hématologues et Oncologues du Privé (Tunis, Sousse, Sfax)

More Related