Nonablative allogeneic stem cell transplantation for XXXX : impact of rituximab on immunomodulation and survival.

@entity1 @entity786 @entity1072 @entity3118 @entity1778
OBJECTIVE: To investigate the graft-vs- @entity1778 effect of allogeneic stem cell transplantation after a nonablative conditioning regimen as treatment for @entity1 with @entity1072 . @entity1 AND METHODS: @entity1 were eligible to treatment if they were refractory or recurred after a prior response to @entity3118 . Seventeen @entity1 were treated. All @entity1 received a preparative regimen of @entity3118 (30 mg/m(2) daily for 3 days) and intravenous @entity786 (750 mg/m(2) daily for 3 days). Ten @entity1 received rituximab in addition to chemotherapy. The median time from diagnosis to transplant was 67 months. Nine of 17 @entity1 had refractory disease. RESULTS: All @entity1 had engraftment of donor cells. Eleven (65%) did not require platelet transfusions. Ten @entity1 with persistent disease underwent immunomanipulation to augment GVL effects including immunosuppression withdrawal and donor lymphocyte infusion with or without rituximab treatment. Seven of these 10 @entity1 had a complete response and 2 had a partial response; 8 of these 9 responders had received rituximab with their immunomanipulation process. The final response was complete remission in 12 and partial remission in 4 @entity1 for an overall response rate of 94%. Overall survival was 100% for @entity1 who received the combined chemo-rituximab conditioning regimen, vs 14% for those who received chemotherapy alone (p=0.03). CONCLUSION: Our results indicate that a pronounced GVL effect occurs after nonmyeloablative allogeneic hematopoietic transplantation for advanced @entity1072 . This activity might be facilitated by rituximab. Prospective controlled trials are needed to define the role of nonablative allogeneic hematopoietic transplantation for treatment of this disease.
