NCI First International Workshop on the Biology, Prevention, and Treatment of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation: Report from the Committee on Treatment of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation.
Relapse is a major cause of treatment failure after allogeneic hematopoietic stem cell transplantation (alloHSCT). Treatment options for relapse have been inadequate, and the majority of patients ultimately die of their disease. There is no standard approach to treating relapse after alloHSCT. Withdrawal of immune suppression and donor lymphocyte infusions are commonly used for all diseases; although these interventions are remarkably effective for relapsed chronic myelogenous leukemia, they have limited efficacy in other hematologic malignancies. Conventional and novel chemotherapy, monoclonal antibody therapy, targeted therapies, and second transplants have been utilized in a variety of relapsed diseases, but reports on these therapies are generally anecdotal and retrospective. As such, there is an immediate need for well-designed, disease-specific trials for treatment of relapse after alloHSCT. This report summarizes current treatment options under investigation for relapse after alloHSCT in a disease-specific manner. In addition, recommendations are provided for specific areas of research necessary in the treatment of relapse after alloHSCT.
Porter
David L
DL
University of Pennsylvania Medical Center, Philadelphia, 19104, USA. david.porter@uphs.upenn.edu
Alyea
Edwin P
EP
Antin
Joseph H
JH
DeLima
Marcos
M
Estey
Eli
E
Falkenburg
J H Frederik
JH
Hardy
Nancy
N
Kroeger
Nicolaus
N
Leis
Jose
J
Levine
John
J
Maloney
David G
DG
Peggs
Karl
K
Rowe
Jacob M
JM
Wayne
Alan S
AS
Giralt
Sergio
S
Bishop
Michael R
MR
van Besien
Koen
K
D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000628:therapy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D017710:Lymphocyte Transfusion; D008228:Lymphoma, Non-Hodgkin; D009101:Multiple Myeloma / Q000628:therapy; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D012008:Recurrence; D014184:Transplantation, Homologous; D017211:Treatment Failure