Phase II study of autologous transplantation with interleukin-2-incubated peripheral blood stem cells and posttransplantation interleukin-2 in relapsed or refractory non-Hodgkin lymphoma

Koen Van Besien, Rakesh Mehra, Navin Wadehra, Wendy Stock, Issa Khouri, Sergio Giralt, Steve Devine, Amittha Wickrema, David Peace, Jeff Sosman, Jim Gajewski, Richard Champlin

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Previous work suggested that interleukin (IL)-2 can be used for eradicating residual disease in autologous grafts and for preventing recurrence. We report a phase II study of autologous peripheral blood stem cell transplantation with in vitro IL-2 incubation of peripheral blood stem cells and posttransplantation IL-2 in patients with recurrent or refractory non-Hodgkin lymphoma. Salvage chemotherapy consisted of ifosfamide and etoposide. Responding patients underwent autologous peripheral blood stem cell transplantation. IL-2-incubated stem cells were infused on day 0. IL-2 1 mIU/m2 was given from day 1 until day 28. Four monthly maintenance cycles of IL-2 4 mIU/m2 subcutaneously twice daily days 1 to 5 and days 8 to 11 were administered thereafter. Eighty-four evaluable patients were enrolled, and 60 proceeded to transplantation, of which 56 received IL-2-incubated stem cells. The average received dose of posttransplantation IL-2 was 30% to 50% of planned. Only 42 patients received maintenance IL-2. The average received maintenance dose of IL-2 was also approximately 30% of planned. Most dose reductions were due to toxicity or patient refusal. Three-year survival and progression-free survival for all registered patients were 43% (95% confidence interval [CI], 33%-53%) and 31% (95% CI, 21%-41%), respectively. For the 60 patients undergoing transplantation, they were 59% (95% CI, 46%-72%) and 44% (95% CI, 31%-57%), respectively. There was no relation between the dose of IL-2 received and outcome. Survival and disease-free survival of the study group were similar to those of a previous study cohort that received unmanipulated stem cells and no systemic IL-2. Administration of IL-2-incubated peripheral blood stem cells and intensive posttransplantation IL-2 was associated with considerable but rapidly reversible toxicity. No effect on long-term outcome was observed.

Original languageEnglish (US)
Pages (from-to)386-394
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume10
Issue number6
DOIs
StatePublished - Jun 2004
Externally publishedYes

Fingerprint

Autologous Transplantation
Non-Hodgkin's Lymphoma
Interleukin-2
Confidence Intervals
Peripheral Blood Stem Cell Transplantation
Stem Cells
Peripheral Blood Stem Cells
Disease-Free Survival
Transplantation
Maintenance
Ifosfamide
Survival
Etoposide
Interleukin-1
Interleukin-4

Keywords

  • Interleukin-2
  • Non-Hodgkin lymphoma
  • Peripheral blood stem cells
  • Survival

ASJC Scopus subject areas

  • Transplantation

Cite this

Phase II study of autologous transplantation with interleukin-2-incubated peripheral blood stem cells and posttransplantation interleukin-2 in relapsed or refractory non-Hodgkin lymphoma. / Van Besien, Koen; Mehra, Rakesh; Wadehra, Navin; Stock, Wendy; Khouri, Issa; Giralt, Sergio; Devine, Steve; Wickrema, Amittha; Peace, David; Sosman, Jeff; Gajewski, Jim; Champlin, Richard.

In: Biology of Blood and Marrow Transplantation, Vol. 10, No. 6, 06.2004, p. 386-394.

Research output: Contribution to journalArticle

Van Besien, K, Mehra, R, Wadehra, N, Stock, W, Khouri, I, Giralt, S, Devine, S, Wickrema, A, Peace, D, Sosman, J, Gajewski, J & Champlin, R 2004, 'Phase II study of autologous transplantation with interleukin-2-incubated peripheral blood stem cells and posttransplantation interleukin-2 in relapsed or refractory non-Hodgkin lymphoma', Biology of Blood and Marrow Transplantation, vol. 10, no. 6, pp. 386-394. https://doi.org/10.1016/j.bbmt.2004.01.004
Van Besien, Koen ; Mehra, Rakesh ; Wadehra, Navin ; Stock, Wendy ; Khouri, Issa ; Giralt, Sergio ; Devine, Steve ; Wickrema, Amittha ; Peace, David ; Sosman, Jeff ; Gajewski, Jim ; Champlin, Richard. / Phase II study of autologous transplantation with interleukin-2-incubated peripheral blood stem cells and posttransplantation interleukin-2 in relapsed or refractory non-Hodgkin lymphoma. In: Biology of Blood and Marrow Transplantation. 2004 ; Vol. 10, No. 6. pp. 386-394.
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abstract = "Previous work suggested that interleukin (IL)-2 can be used for eradicating residual disease in autologous grafts and for preventing recurrence. We report a phase II study of autologous peripheral blood stem cell transplantation with in vitro IL-2 incubation of peripheral blood stem cells and posttransplantation IL-2 in patients with recurrent or refractory non-Hodgkin lymphoma. Salvage chemotherapy consisted of ifosfamide and etoposide. Responding patients underwent autologous peripheral blood stem cell transplantation. IL-2-incubated stem cells were infused on day 0. IL-2 1 mIU/m2 was given from day 1 until day 28. Four monthly maintenance cycles of IL-2 4 mIU/m2 subcutaneously twice daily days 1 to 5 and days 8 to 11 were administered thereafter. Eighty-four evaluable patients were enrolled, and 60 proceeded to transplantation, of which 56 received IL-2-incubated stem cells. The average received dose of posttransplantation IL-2 was 30{\%} to 50{\%} of planned. Only 42 patients received maintenance IL-2. The average received maintenance dose of IL-2 was also approximately 30{\%} of planned. Most dose reductions were due to toxicity or patient refusal. Three-year survival and progression-free survival for all registered patients were 43{\%} (95{\%} confidence interval [CI], 33{\%}-53{\%}) and 31{\%} (95{\%} CI, 21{\%}-41{\%}), respectively. For the 60 patients undergoing transplantation, they were 59{\%} (95{\%} CI, 46{\%}-72{\%}) and 44{\%} (95{\%} CI, 31{\%}-57{\%}), respectively. There was no relation between the dose of IL-2 received and outcome. Survival and disease-free survival of the study group were similar to those of a previous study cohort that received unmanipulated stem cells and no systemic IL-2. Administration of IL-2-incubated peripheral blood stem cells and intensive posttransplantation IL-2 was associated with considerable but rapidly reversible toxicity. No effect on long-term outcome was observed.",
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AU - Khouri, Issa

AU - Giralt, Sergio

AU - Devine, Steve

AU - Wickrema, Amittha

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