GVHD & GVL in the lymphoma setting: The case of CLL
|
|
- Henry Bradford
- 5 years ago
- Views:
Transcription
1 GVHD & GVL in the lymphoma setting: The case of CLL Peter Dreger Dept. Internal Medicine V University of Heidelberg
2 EBMT: SCT for CLL Update January 2012 allo auto The European Group for Blood and Marrow Transplantation
3 Transplant activity for lymphoma EBMT Absolute numbers 2011 % increase > 2011 allo CLL HL TCL FL DLC L MCL auto DLCL HL MCL FL TCL CLL Total lymphoma transplants 2011 (w/o CLL): allo 1431; auto 6125 The European Group for Blood and Marrow Transplantation
4 GVL vs GVHD in CLL: Key questions - do GVL effects exist?
5 CLL: OS after allosctby EBMT score Michallet et al, Leukemia 24:1725 (2010)
6 Sensitivity to GVL activity allows reduction of conditioning intensity: RIC!
7 Myelosuppression / Toxicity Conditioning Regimens: Immunosuppressive vs anti-tumor activities (adopted from Champlin et al) Bu8/F Bu/Cy BEAM MEL150/F TBI8/F TBI12/Cy MAC NMA TBI4/F Flu/Cy TBI2/F RIC Immunosuppression
8 Toxicity of RIC allosct for CLL Study GCLLSG Seattle Boston FCGCLL Houston Heidelb. n Mucositis 3-4 6% 12% na <5% na na Infection % 60% na 48% na na Early death (< d +100) <3% <10% <3% 0% 3% 3% NRM 23% (6y) 23% (5y) 16% (5y) 27% (3y) 17% (1y) 24% (3y) Ext. cgvhd 55% 49-53% 48% 42% 56% 53% Dreger Blood 2013; Sorror JCO 2008; Brown Leukemia 2013; Michallet Exp Hematol 2013; Khouri Cancer 2011; Hahn iwcll 2013
9 Percent EFS Percent EFS Survival after RIC allosct for CLL Study GCLLSG Seattle Boston FCGCLL Houston Heidelb. n PFS 38% (6y) 39% (5y) 43% (5y) 46% (3y) 36% (5y) 49% (5y) OS 58% (6y) 50% (5y) 63% (5y) 55% (3y) 51% (5y) 62% (5y) F/U mo 72 (7-129) (3-71) 37 (11-131) 34 (9-93) y EFS 38% (27, 48) Months from SCT 5-y EFS 49% (33, 65) Months from SCT Dreger Blood 2013; Sorror JCO 2008; Brown Leukemia 2013; Michallet Exp Hematol 2013; Khouri Cancer 2011; Hahn iwcll 2013
10 GVL in CLL: Lessons to learn from MRD studies MRD = Minimal Residual Disease
11 CLL: Quantitative MRD assessment by 4 color flow cytometry (MRD-flow) a = CD19 + B cells b = exclude doublets c = CD5 - background d = CD5 + CD20 low e = CD43 + CD20 low f = CD43 + CD5 + 10E- 4 Sensitivity 1 in 10 4 Böttcher et al, LEUKEMIA 2004; Rawstron et al, LEUKEMIA 2007
12 allosct for CLL: MRD response patterns A: MRD- after CSA taper CSA taper GVHD Ritgen et al, Leukemia 22:1377 (2008)
13 allosct for CLL: MRD response patterns Other pattern (42%) CLL3X (n=52) MRD- immediately after SCT (16%) Heidelberg (n=62) MRD- immediately after SCT (34%) MRD- after CSA taper (42%) MRD- after CSA taper (35%) Dreger et al, Blood 116:2438 (2010) Hahn et al, EBMT 2013
14 GVL vs GVHD in CLL: Key questions - GVL effects do exist - Are GVL effects durable?
15 CLL3X: Patient flow (MRD) ineligible (no CLL, late registration, comorbidity etc.) 10 no SCT (Richter s, ED, no donor, refusal) 38 no continuous MRD sampling event <12mo, 27 MRD-neg at +12mo 11 MRD-pos at +12mo 1 no MRD at +12mo
16 Percent relapsed Percent MRD or clinical relapse CLL3X 6-year follow-up: Relapse by MRD negativity at +12mo (of 38 patients with MRD monitoring and event-free at mo +12) Clinical Relapse MRD or clinical relapse MRD+ (10) +12 MRD- (28) HR 26.2 (6-115); p % (95%CI 1-50) Months from SCT Months from SCT Dreger et al, Blood 121:3284 (2013)
17 Clinical impact of MRD negativity at the +6mo landmark (Milan data) Farina et al, Haematologica 94:654 (2009)
18 MRD-level Evidence for durability of MRD response: Other intensive treatment Dx initial dx bef. SCT bef. Campath Alemtuzumab: Hillmen JCO 2005 autosct (CLL3) FC + alemtuzumab (CLL4B) Ritgen 2005
19 GVL vs GVHD in CLL: Key questions - GVL effects do exist - GVL effects are mostly durable - Can we have GVL w/o (chronic) GVHD?
20 Percent with relapse or progression CLL: Relapse risk and chronic GVHD (EBMT survey, n = 77) cgvhd always absent after cgvhd onset Months from SCT Dreger et al, Leukemia 17:841 (2005)
21 Can we separate GVL from GVHD by T cell depletion?
22 AlloBMT for CLL using ex-vivo CD6 TCD (Dana Farber results, n = 25) Gribben et al, Blood 106:4389 (2005)
23 Percent REL Percent event-free CLL3X: Impact of TCD (CD52 vs T replete or ATG, n = 12 vs 78) REL by TCD EFS by TCD med EFS 13 vs 33 mo HR 3.95 (1.54, 10.15); p HR 3.29 (.97, 11.17); p Months from SCT Months from SCT
24 Percent EFS CLL3X: Impact of ATG (UD w ATG vs SIB w/o ATG, n = 41 vs 36) 100 HR 0.93 ( ); p 0.88 WMUD + ATG (12) PMUD + ATG (29) SIB (36) 50 HR 0.79 ( ); p y EFS 42% vs 49% vs 55% Months from SCT
25 GVL vs GVHD in CLL: Key questions - GVL effects do exist - GVL effects are mostly durable - Can we have GVL w/o GVHD: not yet - Pre-emptive immune intervention?
26 Real-time MRD Immunomodulation and MRD kinetics: monitoring allowing Results of GCLLSG CLL3X trial for pre-emptive immune intervention Trial-Id: NCT
27 CLL3X: Patient flow (MRD) ineligible (no CLL, late registration, comorbidity etc.) 10 no SCT (Richter s, ED, no donor, refusal) 38 no continuous MRD sampling 52 Cont. MRD sampling
28 Percent EFS Percent Survival Percent NRM Percent progressive CLL3X (n=90) f/u 46 (7-102) mo NRM MRD pp no (38) MRD pp yes (52) 4-y NRM 18% vs 33% (HR 0.62 ( ) REL 4-y REL 25% vs 65%; 0.28 (0.12, 0.58) MRD pp yes (52) MRD pp no (38) Months from SCT EFS 4-y EFS 59% vs 17% HR 0.31 (0.17, 0.56) Months from SCT MRD pp no MRD pp yes 50 MRD pp no MRD pp yes 50 4-y OS 72% vs 55% HR 0.55 ( ) OS Months from SCT Months from SCT Böttcher et al, Blood Reviews 25:91-96 (2011)
29 Better disease control with MRD monitoring center effect or the case for pre-emptive immunotherapy
30 GVL vs GVHD in CLL: Key questions - GVL effects do exist - GVL effects are mostly durable - Can we have GVL w/o GVHD: not yet - Pre-emptive immune intervention: Improves disease control w/o affecting NRM or QOL?
31 What does that mean in real life?
32 Evidence that allohct can improve the natural course of poor-risk CLL: Final results from a retrospective donor vs no donor comparison P Dreger, I Herth, A Benner, S Dietrich, M Rieger, U Hegenbart, P Stadtherr, A Bondong, TH Tran, T Zenz, AD Ho Department Medicine V, University of Heidelberg 12-ICML,
33 Department of Internal Medicine V Study design and patients Design: Single center retrospective analysis Patient eligibility: All consecutive patients referred for allosct for CLL between June 2005 and June 2012 to the University of Heidelberg
34 Department of Internal Medicine V Eligibility for donor search was either one of the three EBMT consensus criteria or symptomatic 17p- fludarabine refractoriness (non-response or relapse within 6 months after the last cycle) early relapse after intensive pretreatment (relapse after intensive treatment like FR, FCR, BR, R-CHOP or similar later than 6 months but within 2 years) Richter s transformation.
35 Department of Internal Medicine V Study population: patients for whom a 9/10 or 10/10 matched related or unrelated donor could be found within 3 months Control population: patients without 9/10 or 10/10 matched donor found within 3 months
36 Department of Internal Medicine V Primary endpoint Overall survival (OS), measured from the 3-month landmark after donor search initiation (to eliminate the early relapsemortality favoring the donor group).
37 Patient flow: Matches / Controls MCL 2, MZL 1 Observe OS R E F E R R A L No search 5 refusal, 1 comorbidity, 2 lost to f/u Donor search indication (=EBMT risk or Richter s)? no 21 yes SEARCH 8 lost w/i 3 months (6 dead PD, 1 refusal, 1 lost to f/u ) B 83 compatible donor within 3 Mo 14 no compatible donor within 3 Mo Observe OS Herth et al, Ann Oncol in press
38 Percent alive OS from 3-month landmark after start of search by compatible donor availability (primary endpoint; study population: matches vs controls, n=97) % (34%-90%) 78% (95%CI 69%-88%) Median follow-up 28 months 25 donor yes (83) donor no (14) Herth et al, Ann Oncol in press HR 0.38 (95% CI ); p= Months from 3-month landmark
39 GVL vs GVHD in CLL: Key questions - GVL effects do exist - GVL effects are mostly durable - Can we have GVL w/o GVHD: not yet - Pre-emptive immune intervention: Improves disease control w/o affecting NRM or QOL? - Perspectives?
40 2013: We are moving towards a new CLL treatment landscape with the advent of BTK inhibitors and BH3 mimetics ABT-199 From Wiestner et al, Blood 2012 From Souers et al, Nat Med 2013
41 Disease control by novel drugs in HR CLL (monotherapy) Drug Ibrutinib Idelalisib ABT-199 n ORR 71%/88%* 44%/56%* 85% CR 2% 4% 13% PFS 75% (26mo) 50% (17mo) 9 PDs (1y) F/U mo 21 (1-27) 9 (0-40) 8 (0-17) * ORR according to iwcll / OR incl. PR with persistent lymphocytosis Byrd NEJM 2013; Byrd ASCO 2013; Seymour ICML 2013
42 PFS Probability OS Probability PCYC-1102-CA: Ibrutinib (All relapsed/ refractory) 1.0 PFS 1.0 OS Censored Logrank p= del17p (n=28) Est. PFS at 26 mo is 57% del11q (n=23) Est. PFS at 26 mo is 73% No del17p or del11q (n=29) Est. PFS at 26 mo is 93% Months on Study Data cut-off of 19OCT Censored Logrank p= del17p (n=28) Est. OS at 26 mo is 70% del11q (n=23) Est. OS at 26 mo is 85% No del17p or del11q (n=29) Est. OS at 26 mo is 93% Data cut-off of 19OCT Months on Study Byrd et al, NEJM 369:32 (2013)
43 HSCT algorithm for HR-CLL 2014 Re-try HR-CLL, need for treatment, gogo, donor available yes no Richter? no Novel drug available? yes no Response to immuno-chemo salvage? yes no Ongoing response to novel drug? yes 2nd novel drug or immunochemo salvage Road construction ahead Discuss scenarios with patient Perform HSCT Postpone HSCT
44 Proposal: EBMT Slide template Barcelona 7 February 2008 Survey on the use of B cell receptor kinase inhibitors / BCL2 inhibitors in the context of HSCT for B cell lymphoma EBMT Lymphoma Working Party, Barcelona, October 2013 The European Group for Blood and Marrow Transplantation The European Group for Blood and Marrow Transplantation
45 Objectives To assess the safety and efficacy of (intended?) auto- and allohsct for B cell lymphoma for after previous exposure to MTD To assess the safety and efficacy of MTD if used for prophylactic, preemptive or therapeutic application following auto- or allohsct The European Group for Blood and Marrow Transplantation The European Group for Blood and Marrow Transplantation The European Group for Blood and Marrow Transplantation
46 GVL vs GVHD in CLL: Conclusions - GVL effects do exist - GVL effects are mostly durable - Can we have GVL w/o GVHD: not yet - Pre-emptive immune intervention: Improves disease control w/o affecting NRM or QOL? - Perspectives New drugs will re-shape the stage for HSCT in CLL and B cell lymphoma??
47 Thank you CLL3X trial S Stilgenbauer R Busch M Ritgen S Böttcher D Beelen S Cohen J Schubert N Schmitz M Hallek T Zenz H Döhner MRD P Corradini C Moreno S Böttcher M Ritgen Med V M Rieger S Dietrich AD Ho T Luft U Hegenbart LWP/CMWP A Boumendil H Finel JJ Luan Anna Sureda A van Biezen R Brand D Milligan D Niederwieser M Sobh J Schetelig T de Witte M Michallet and you for your interest!
48
Mantle cell lymphoma Allo stem cell transplantation in relapsed and refractory patients
Mantle cell lymphoma Allo stem cell transplantation in relapsed and refractory patients Olivier Hermine MD, PhD Department of Hematology INSERM and CNRS, Imagine Institute Necker Hospital Paris, France
More informationIs there a place for allogeneic stem cell transplantation in chronic lymphocytic leukaemia in the era of the new molecules?
185 Is there a place for allogeneic stem cell transplantation in chronic lymphocytic leukaemia in the era of the new molecules? D. Selleslag, MD SUMMARY Allogeneic stem cell transplantation can cure about
More informationallosct and CLL in the BCRi era time for a study
allosct and CLL in the BCRi era time for a study Patient characteristics in BCRi studies and allosct candidates DIFFER Facts on BCRi no Cure Risk factors for shorter BCRi efficacy in MV analysis? PA-refractory
More informationCorso nazionale SIE di aggiornamento in ematologia clinica. Il trapianto allogenico nella LLC
Corso nazionale SIE di aggiornamento in ematologia clinica Il trapianto allogenico nella LLC Bolzano, 18-19 giugno 2009 Francesco Zaja - Clinica Ematologica, Udine Curative strategy for CLL Induction Flu-CYT
More informationBACKGROUND AND RATIONALE
SYNOPSIS Observational study on the use of B cell receptor kinase inhibitors and BCL2 antagonists prior to allogeneic hematopoietic stem cell transplantation for B cell malignancies: A joint project of
More informationManagement of 17p Deleted CLL Patients in the Era of Targeted Therapy
Management of 17p Deleted CLL Patients in the Era of Targeted Therapy Jennifer R Brown, MD PhD Director, CLL Center Dana-Farber Cancer Institute Associate Professor Harvard Medical School November 11,
More informationClinical Overview: MRD in CLL. Dr. Matthias Ritgen UKSH, Medizinische Klinik II, Campus Kiel
Clinical Overview: MRD in CLL Dr. Matthias Ritgen UKSH, Medizinische Klinik II, Campus Kiel m.ritgen@med2.uni-kiel.de Remission in CLL Clinical criteria (NCI->WHO) Lymphadenopathy Splenomegaly Hepatomegaly
More informationE ancora proponibile il Trapianto di Cellule Staminali Allogeniche? Franco Aversa Università di Parma
E ancora proponibile il Trapianto di Cellule Staminali Allogeniche? Franco Aversa Università di Parma franco.aversa@unipr.it Clin Adv Hematol Oncol. 2015 Sep;13(9):586-94. New insights into hematopoietic
More information1. What to test. 2. When to test
Biomarkers: the triad of questions 1. What to test 2. When to test 3. Who to test Biomarkers: the triad of questions 1. What to test 2. When to test 3. Who to test Impact of CLL biological features on
More informationReduced-intensity Conditioning Transplantation
Reduced-intensity Conditioning Transplantation Current Role and Future Prospect He Huang M.D., Ph.D. Bone Marrow Transplantation Center The First Affiliated Hospital Zhejiang University School of Medicine,
More informationPatient Selection for allogeneic stem cell transplantation in CLL KOEN VAN BESIEN, MD WEILL CORNELL MEDICAL COLLEGE, NY
Patient Selection for allogeneic stem cell transplantation in CLL KOEN VAN BESIEN, MD WEILL CORNELL MEDICAL COLLEGE, NY Topics CLL Complicated CLL Richter s transformation What did we learn about allotransplant
More informationFCR and BR: When to use, how to use?
FCR and BR: When to use, how to use? Mitchell R. Smith, M.D., Ph.D. Director of Lymphoid Malignancy Program Taussig Cancer Institute Cleveland Clinic, Cleveland, OH DEBATE ISSUE 2013: Which is the optimal
More informationDr Claire Burney, Lymphoma Clinical Fellow, Bristol Haematology and Oncology Centre, UK
EMBT LWP 2017-R-05 Research Protocol: Outcomes of patients treated with Ibrutinib post autologous stem cell transplant for mantle cell lymphoma. A retrospective analysis of the LWP-EBMT registry. Principle
More informationAdvances in CLL 2016
Advances in CLL 2016 The Geoffrey P. Herzig Memorial Symposium, Louisville, KY Kanti R. Rai, MD Northwell-Hofstra School of Medicine Long Island Jewish Medical Center New Hyde Park, NY Disclosures Member
More informationChronic lymphocytic Leukemia
Chronic lymphocytic Leukemia after IwCLL, ICML and EHA 2017 Ann Janssens, MD, PhD Hematology, UZ Leuven Brussels, 14 september 2017 Front line treatment CLL Active or progressive disease No active or progressive
More informationSTEM-CELL TRANSPLANTATION FOR CHRONIC LYMPHOCYTIC LEUKEMIA
STEM-CELL TRANSPLANTATION FOR CHRONIC LYMPHOCYTIC LEUKEMIA Carol Moreno Department of Hematology, Hospital de la Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain Introduction
More informationRisikoprofil-gesteuerte, individualisierte Therapiestrategien bei der CLL. Michael Hallek University of Cologne
Risikoprofil-gesteuerte, individualisierte Therapiestrategien bei der CLL Michael Hallek University of Cologne 100 90 80 70 60 Substantial progress in CLL therapy in one decade 50 40 complete remissions
More informationADVANCES IN THE MANAGEMENT OF MYELODYSPLASTIC SYNDROMES
ADVANCES IN THE MANAGEMENT OF MYELODYSPLASTIC SYNDROMES Corey Cutler, MD MPH FRCPC Associate Professor of Medicine, Harvard Medical School Dana-Farber Cancer Institute, Boston, MA HCT Outcomes - MDS 2001-2011
More informationCLL treatment algorithm and state of the art
CLL treatment algorithm and state of the art Davide Rossi, M.D., Ph.D. Hematology IOSI - Oncology Institute of Southern Switzerland IOR - Institute of Oncology Research Bellinzona - Switzerland CLL subgroups
More informationAllogeneic Hematopoietic Stem Cell Transplantation: State of the Art in 2018 RICHARD W. CHILDS M.D. BETHESDA MD
Allogeneic Hematopoietic Stem Cell Transplantation: State of the Art in 2018 RICHARD W. CHILDS M.D. BETHESDA MD Overview: Update on allogeneic transplantation for malignant and nonmalignant diseases: state
More informationMolecular Markers to Guide Therapy - Chronic Lymphocytic Leukaemia - Stephan Stilgenbauer Ulm University
Molecular Markers to Guide Therapy - Chronic Lymphocytic Leukaemia - Stephan Stilgenbauer Ulm University Chronic Lymphocytic Leukaemia (CLL) Most common leukaemia in adults Diagnosis straightforward CD19+/CD5+/CD23+
More informationMRD Negativity as an Outcome in CLL: Ongoing Challenges with Del 17p Patients
MRD Negativity as an Outcome in CLL: Ongoing Challenges with Del 17p Patients Jennifer R Brown, MD PhD Director, CLL Center Dana-Farber Cancer Institute Associate Professor Harvard Medical School November
More informationMantle Cell Lymphoma. A schizophrenic disease
23 maggio, 2018 Mantle Cell Lymphoma A schizophrenic disease Patients relapsed after Auto transplant EBMT registry 2000-2009 (n=360) 19 months OS 24 months OS Dietrich S, Ann Oncol 2014 Patients receiving
More informationState of the Art Treatment for Relapsed Mantle Cell Lymphoma
Winship Cancer Institute of Emory University State of the Art Treatment for Relapsed Mantle Cell Lymphoma Jonathon B. Cohen, MD, MS Assistant Professor, BMT Program Emory University- Winship Cancer Institute
More informationMedical Benefit Effective Date: 07/01/12 Next Review Date: 05/13 Preauthorization* Yes Review Dates: 04/07, 05/08, 05/11, 05/12
Hematopoietic Stem-Cell Transplantation for Chronic Lymphocytic (80115) Medical Benefit Effective Date: 07/01/12 Next Review Date: 05/13 Preauthorization* Yes Review Dates: 04/07, 05/08, 05/11, 05/12 The
More informationASH up-date: Changing the Standard of Care for Patients with. (or: Who to treat with What When?)
ASH up-date: Changing the Standard of Care for Patients with B-cell Chronic Lymphocytic Leukaemia (or: Who to treat with What When?) Dr Anna Schuh, MD, PhD, MRCP, FRCPath Consultant and Senior Lecturer
More informationChronic Lymphocytic Leukemia (CLL): Refresher Course for Hematologists Ekarat Rattarittamrong, MD
Chronic Lymphocytic Leukemia (CLL): Refresher Course for Hematologists Ekarat Rattarittamrong, MD Division of Hematology Department of Internal Medicine Faculty of Medicine Chiang-Mai University Outline
More informationHaploidentical Transplants for Lymphoma. Andrea Bacigalupo Universita Cattolica Policlinico Gemelli Roma - Italy
Haploidentical Transplants for Lymphoma Andrea Bacigalupo Universita Cattolica Policlinico Gemelli Roma - Italy HODGKIN NON HODGKIN Non Myelo Ablative Regimen Luznik L et al BBMT 2008 Comparison of Outcomes
More informationRaising the Bar in CLL Michael E. Williams, MD, ScM Byrd S. Leavell Professor of Medicine Chief, Hematology/Oncology Division
Raising the Bar in CLL Michael E. Williams, MD, ScM Byrd S. Leavell Professor of Medicine Chief, Hematology/Oncology Division University of Virginia Cancer Center The Clinical Continuum of CLL Early asymptomatic
More informationMyeloablative and Reduced Intensity Conditioning for HSCT Annalisa Ruggeri, MD, Hôpital Saint Antoine Eurocord- Hôpital Saint Louis, Paris
Myeloablative and Reduced Intensity Conditioning for HSCT Annalisa Ruggeri, MD, Hôpital Saint Antoine Eurocord- Hôpital Saint Louis, Paris 18th ESH - EBMT Training Course on HSCT 8-10 May 2014, Vienna,
More informationLeukemia. Roland B. Walter, MD PhD MS. Fred Hutchinson Cancer Research Center University of Washington
Leukemia Roland B. Walter, MD PhD MS Fred Hutchinson Cancer Research Center University of Washington Discussed Abstracts Confirmatory open-label, single-arm, multicenter phase 2 study of the BiTE antibody
More informationHighlights in chronic lymphocytic leukemia
Congress Highlights CLL Highlights in chronic lymphocytic leukemia A. Janssens, MD, PhD 1 As new data on indolent non-hodgkin lymphoma (inhl) were not that compelling, only highlights on chronic lymphocytic
More informationNew Evidence reports on presentations given at EHA/ICML Bendamustine in the Treatment of Lymphoproliferative Disorders
New Evidence reports on presentations given at EHA/ICML 2011 Bendamustine in the Treatment of Lymphoproliferative Disorders Report on EHA/ICML 2011 presentations Efficacy and safety of bendamustine plus
More informationCLL: future therapies. Dr. Nathalie Johnson
CLL: future therapies Dr. Nathalie Johnson Disclosures Consultant and Advisory boards Roche, Abbvie, Gilead, Jansson, Lundbeck,Merck Research funding Roche, Abbvie, Lundbeck Outline Treatment of relapsed
More informationWhat s new in Blood and Marrow Transplant? Saar Gill, MD PhD Jan 22, 2016
What s new in Blood and Marrow Transplant? Saar Gill, MD PhD Jan 22, 2016 Division of Hematology-Oncology University of Pennsylvania Perelman School of Medicine 1 Who should be transplanted and how? Updates
More informationCARE at ASH 2014 Lymphoma. Dr. Diego Villa Medical Oncologist British Columbia Cancer Agency Vancouver Cancer Centre
CARE at ASH 2014 Lymphoma Dr. Diego Villa Medical Oncologist British Columbia Cancer Agency Vancouver Cancer Centre High-yield lymphoma sessions Sat, Dec 6 th Sun, Dec 7 th Mon, Dec 8 th EDUCATIONAL SESSIONS
More informationMED B Form CLL. Johannes Schetelig. London 09/April/
www.ebmt.org MED B Form CLL Johannes Schetelig London 09/April/2013 Content Update on CLL (15 ) Experiment with mini MED B CLL Assessment of pre-treatment in CLL Cytogenetics in CLL What is the IGVH-Gene
More informationLeukemia (2008) 22, & 2008 Macmillan Publishers Limited All rights reserved /08 $
ORIGINAL ARTICLE (2008) 22, 1377 1386 & 2008 Macmillan Publishers Limited All rights reserved 0887-6924/08 $30.00 www.nature.com/leu Quantitative MRD monitoring identifies distinct GVL response patterns
More informationO Papel do TCH na LLC. Fábio R. Kerbauy
O Papel do TCH na LLC Fábio R. Kerbauy (fkerbauy@gmail.com) Outline Autologous SCT Allogeneic SCT Indications Mieloablative x non-myeloablative Brazilian experience HCT Indications CIBMTR 2012 Pasquini
More informationBENDAMUSTINE + RITUXIMAB IN CLL
BENDAMUSTINE + RITUXIMAB IN CLL Barbara Eichhorst Bologna 13. November 2017 CONFLICT OF INTERESTS 1. Advisory Boards Janssen, Gilead, Roche, Abbvie, GSK 2. Honoraria Roche, GSK, Gilead, Janssen, Abbvie,
More informationPeripheral T-Cell Lymphoma. Pro auto. Peter Reimer. Klinik für Hämatologie / intern. Onkologie und Stammzelltransplantation
Peripheral T-Cell Lymphoma Pro auto Peter Reimer Klinik für Hämatologie / intern. Onkologie und Stammzelltransplantation Kliniken Essen Süd, Evang. Krankenhaus Essen-Werden ggmbh COSTEM, Berlin 09.09.2011
More informationChronic lymphocytic leukemia
Chronic lymphocytic leukemia How the Experts Treat Hematologic Malignancies Las Vegas, NV 3/2018 Tanya Siddiqi, MD Assistant Professor City of Hope National Medical Center Duarte, CA DISCLOSURES I am on
More informationGeorg Hopfinger 3. Med.Abt and LBI for Leukemiaresearch and Haematology Hanusch Krankenhaus,Vienna, Austria
Chronic lymphocytic Leukemia Georg Hopfinger 3. Med.Abt and LBI for Leukemiaresearch and Haematology Hanusch Krankenhaus,Vienna, Austria georg.hopfinger@wgkk.at CLL Diagnosis and Staging Risk Profile Assessment
More informationTransplantation in Chronic Lymphocytic Leukemia: Timing and Expectations
CLL Leukemia 2008 Proceedings Transplantation in Chronic Lymphocytic Leukemia: Timing and Expectations Simon Hallam, John G. Gribben Abstract Stem cell transplantation in chronic lymphocytic leukemia (CLL)
More informationIndications for allogeneic stem cell transplantation in chronic lymphocytic leukemia: the EBMT transplant consensus
(2007) 21, 12 17 & 2007 Nature Publishing Group All rights reserved 0887-6924/07 $30.00 www.nature.com/leu LEADING ARTICLE Indications for allogeneic stem cell transplantation in chronic lymphocytic leukemia:
More informationCLL & SLL: Current Management & Treatment. Dr. Peter Anglin
CLL & SLL: Current Management & Treatment Dr. Peter Anglin Chronic Lymphocytic Leukemia Prolonged clinical course Chronic A particular type of blood cell B lymphocyte Lymphocytic Cancer of white blood
More informationYes Antonio M. Risitano, M.D., Ph.D. Head of Bone Marrow Transplantation Unit Federico II University of Naples
4ème Journée Nationale Maladies Rares Immuno-Hématologiques Paris, June 7th 2018 Matched unrelated upfront transplantation in idiopathic aplastic anemia? Yes Antonio M. Risitano, M.D., Ph.D. Head of Bone
More informationStem Cell Transplantation
Stem Cell Transplantation Evelyne Willems Centre Hospitalier Universitaire, ULg, Liège Post-ASH meeting, January 11, 2012, Brussels Plan 1. Select the patient: validation of HCT-CI 2. Select the donor
More informationAddition of Rituximab to Fludarabine and Cyclophosphamide in Patients with CLL: A Randomized, Open-Label, Phase III Trial
Addition of Rituximab to Fludarabine and Cyclophosphamide in Patients with CLL: A Randomized, Open-Label, Phase III Trial Hallek M et al. Lancet 2010;376:1164-74. Introduction > In patients with CLL, the
More informationLymphoma- Med A-new drugs and treatments
Lymphoma- Med A-new drugs and treatments Silvia Montoto Lisbon, 19/03/2018 #EBMT18 www.ebmt.or Disclosures: Roche, Gilead Silvia Montoto Lisbon, 19/03/2018 #EBMT18 www.ebmt.or Outline Lymphoma- what is
More informationGLSG/OSHO Study Group. Supported by Deutsche Krebshilfe
GLSG/OSHO Study Group Supported by Deutsche Krebshilfe founded in 1985 Comparison of Two Consecutive Study Generations of the GLSG Overall Survival Follicular Lymphomas Questions for the Next Steps of
More informationManagement of CLL in the Targeted Therapy Era
Management of CLL in the Targeted Therapy Era Jennifer A. Woyach, MD The Ohio State University The Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove
More informationChronic lymphocytic leukemia is eradication feasible and worthwhile?
Chronic lymphocytic leukemia is eradication feasible and worthwhile? Gianluca Gaidano, MD, PhD Division of Hematology Department of Clinical and Experimental Medicine Amedeo Avogardo University of Eastern
More informationFOLLICULAR LYMPHOMA: US vs. Europe: different approach on first relapse setting?
Indolent Lymphoma Workshop Bologna, Royal Hotel Carlton May 2017 FOLLICULAR LYMPHOMA: US vs. Europe: different approach on first relapse setting? Armando López-Guillermo Department of Hematology, Hospital
More informationTreatment Nodal Marginal Zone Lymphoma
Workshop : Indolent lymphomas Treatment Nodal Marginal Zone Lymphoma Catherine Thieblemont Hôpital Saint-Louis, Paris - France Bologna 16th, 2017 Ø No standardized treatment Ø Similarly treated as FL Treatment
More informationCLL Biology and Initial Management. Gordon D. Ginder, MD Director, Massey Cancer Center Lipman Chair in Oncology
CLL Biology and Initial Management Gordon D. Ginder, MD Director, Massey Cancer Center Lipman Chair in Oncology CLL- Epidemiology Most common adult leukemia 25-30% in western world Incidence in US 4.5
More informationAIH, Marseille 30/09/06
ALLOGENEIC STEM CELL TRANSPLANTATION FOR MYELOID MALIGNANCIES Transplant and Cellular Therapy Unit Institut Paoli Calmettes Inserm U599 Université de la Méditerranée ée Marseille, France AIH, Marseille
More informationHematopoietic Stem-Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
Hematopoietic Stem-Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma Policy Number: 8.01.15 Last Review: 6/2014 Origination: 12/2001 Next Review: 6/2015 Policy Blue Cross
More informationNew Targets and Treatments for Follicular Lymphoma
Winship Cancer Institute of Emory University New Targets and Treatments for Follicular Lymphoma Jonathon B. Cohen, MD, MS Assistant Professor Div of BMT, Emory University Intro/Outline Follicular lymphoma,
More informationBTK Inhibitors and BCL2 Antagonists
BTK Inhibitors and BCL2 Antagonists Constantine (Con) S. Tam Director of Haematology, St Vincent s Hospital Melbourne; Lead for Chronic Lymphocytic Leukemia and Indolent Lymphoma, Peter MacCallum Cancer
More informationL approccio terapeu-co. Maria Rosaria Villa U.O.C. Ematologia P.O. Ascalesi ASLNA1Centro
L approccio terapeu-co Maria Rosaria Villa U.O.C. Ematologia P.O. Ascalesi ASLNA1Centro DISCLOSURE Nome: Maria Rosaria Cognome: Villa Impiego nell industria farmaceu7ca negli ul7mi 5 anni: NO Interssi
More informationHematopoietic Stem-Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
Hematopoietic Stem-Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary,
More informationChronic lymphocytic leukemia. E. Van Den Neste Cliniques UCL Saint-Luc, Brussels Post-ASH meeting January 2015
Chronic lymphocytic leukemia E. Van Den Neste Cliniques UCL Saint-Luc, Brussels Post-ASH meeting January 2015 Disclosures Travelling to ASH: Roche Consulting services: Janssen Questions in CLL: answers
More informationSequencing of chronic lymphocytic leukemia therapies
CHRONIC LYMPHOCYTIC LEUKEMIA Sequencing of chronic lymphocytic leukemia therapies Jacqueline C. Barrientos CLL Research and Treatment Program, Department of Internal Medicine, Hofstra Northwell School
More informationUpdate on Management of CLL. Presenter Disclosure Information. Chronic Lymphocytic Leukemia. Audience Response Question?
Welcome to Master Class for Oncologists New York, NY May 14, 2010 Session 5: 4:20 PM - 5:00 PM Update on Management of CLL John C. Byrd, MD D Warren Brown Professor of Leukemia Research Professor of Medicine
More informationIndustry Perspective: Minimal (Measurable) Residual Disease in Chronic Lymphocytic Leukemia
Industry Perspective: Minimal (Measurable) Residual Disease in Chronic Lymphocytic Leukemia Davy Chiodin with Nadia Ono Regulatory Science Acerta (A Member of the AstraZeneca Group) 09 November 2018 1
More informationCAR-T cell therapy pros and cons
CAR-T cell therapy pros and cons Stephen J. Schuster, MD Professor of Medicine Perelman School of Medicine of the University of Pennsylvania Director, Lymphoma Program & Lymphoma Translational Research
More informationShould peripheral T-cell lymphoma be treated by autologous or allogeneic SCT?
Francesco d Amore, MD, PhD Dept. Of Hematology Aarhus University Hospital, Aarhus, Denmark Should peripheral T-cell lymphoma be treated by autologous or allogeneic SCT? Disclosure of Interest: Nothing
More informationLEUCEMIA LINFATICA CRONICA: TERAPIA DEL PAZIENTE IN RECIDIVA
CORSO TEORICO-PRATICO PER LA GESTIONE OTTIMALE DEI PAZIENTI AFFETTI DA LINFOMA MANTELLARE, LINFOMA FOLLICOLARE E LEUCEMIA LINFATICA CRONICA Torino, 21-23 Maggio 2018 LEUCEMIA LINFATICA CRONICA: TERAPIA
More informationMantle cell lymphoma An update on management
Mantle cell lymphoma An update on management Dr Kim Linton Consultant Medical Oncologist The Christie NHS Foundation Trust 6 th October 2016 This educational meeting is organised and sponsored by Janssen-Cilag
More informationHematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Policy Number: 8.01.15 Last Review: 6/2017 Origination: 12/2001 Next Review: 6/2018 Policy Blue Cross and
More informationThe Role of Stem Cell Transplantation in Relapsed / Refractory Hodgkin s Lymphoma
The Role of Stem Cell Transplantation in Relapsed / Refractory Hodgkin s Lymphoma Anna Sureda Haematology Department Hospital Universitari Quirón Dexeus Barcelona, Spain 9 th Educational Course on Lymphomas
More information17p Deletion in Chronic Lymphocytic Leukemia
17p Deletion in Chronic Lymphocytic Leukemia Risk Stratification and Therapeutic Approach Andrea Schnaiter, MD, Stephan Stilgenbauer, MD* KEYWORDS CLL 17p deletion High-risk Targeted therapy BTK PI3K BH3
More informationMUD HSCT as first line Treatment in Idiopathic SAA. Dr Sujith Samarasinghe Great Ormond Street Hospital for Children, London, UK
MUD HSCT as first line Treatment in Idiopathic SAA Dr Sujith Samarasinghe Great Ormond Street Hospital for Children, London, UK No Financial Disclosures Guidelines for management of aplastic anaemia British
More informationHematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
Medical Policy Manual Transplant, Policy No. 45.35 Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma Next Review: September 2018 Last Review: December 2017
More informationIndication for unrelated allo-sct in 1st CR AML
Indication for unrelated allo-sct in 1st CR AML It is time to say! Decision of allo-sct: factors to be considered Cytogenetic risk status Molecular genetics FLT3; NPM1, CEBPA. Response to induction Refractoriness
More informationBendamustine is Effective Therapy in Patients with Rituximab-Refractory, Indolent B-Cell Non-Hodgkin Lymphoma
Bendamustine is Effective Therapy in Patients with Rituximab-Refractory, Indolent B-Cell Non-Hodgkin Lymphoma Kahl BS et al. Cancer 2010;116(1):106-14. Introduction > Bendamustine is a novel alkylating
More informationCLL: disease specific biology and current treatment. Dr. Nathalie Johnson
CLL: disease specific biology and current treatment Dr. Nathalie Johnson Disclosures Consultant and Advisory boards Roche, Abbvie, Gilead, Jansson, Lundbeck,Merck Research funding Roche, Abbvie, Lundbeck
More informationHaemato-Oncology ESMO PRECEPTORSHIP PROGRAMME IMMUNO-ONCOLOGY. Development and clinical experience Monique Minnema, hematologist
Haemato-Oncology ESMO PRECEPTORSHIP PROGRAMME IMMUNO-ONCOLOGY Development and clinical experience Monique Minnema, hematologist Consultancy for disclosures Amgen, Celgene, Jansen Cilag, BMS, Takeda Immune
More informationDr. A. Van Hoof Hematology A.Z. St.Jan, Brugge. ASH 2012 Atlanta
Dr. A. Van Hoof Hematology A.Z. St.Jan, Brugge ASH 2012 Atlanta DLBCL How to improve on R-CHOP What at relapse Mantle cell lymphoma Do we cure patients Treatment at relapse Follicular lymphoma Watch and
More informationLinfoma di Hodgkin Ruolo del trapianto nella strategia di salvataggio. Angelo Michele Carella U.O.C. Ematologia 1 IRCSS A.O.U. San Martino IST Genova
Linfoma di Hodgkin Ruolo del trapianto nella strategia di salvataggio Angelo Michele Carella U.O.C. Ematologia 1 IRCSS A.O.U. San Martino IST Genova Therapeutic Options for Relapsed/Refractory Patients
More informationMed A form: discussion forum
Copyright Statement As a registered E-materials Service user of the EBMT Annual Meeting in Marseille March 26-29th 2017, you have been granted permission to access a copy of the presentation in the following
More informationThe Role of Stem Cell Transplantation in Relapsed / Refractory Hodgkin s Lymphoma
The Role of Stem Cell Transplantation in Relapsed / Refractory Hodgkin s Lymphoma Anna Sureda Haematology Department Institut Catala d Oncologia Hospital Duran I Reynals Barcelona, Spain 10 th Educational
More informationCLL Ireland Information Day Presentation
CLL Ireland Information Day Presentation 5 May 2018 Professor Patrick Thornton Consultant Haematologist, Senior Lecturer RCSI, and Clinical Director Hermitage Medical Clinic Laboratory Chronic Lymphocytic
More informationBrentuximab, Nivolumab: L esperienza Real Word della REP. Dr.ssa Clara De Risi Az. Osp. Card. G. Panico - Tricase
Brentuximab, Nivolumab: L esperienza Real Word della REP Dr.ssa Clara De Risi Az. Osp. Card. G. Panico - Tricase MEDICAL NEED IN HL OUTCOME REDUCE TOXICITY IMPROVE FIRST LINE RISK-ADAPTED STRATEGY IMPROVE
More informationQuando e se è possibile e u/le o0enere una remissione completa
Quando e se è possibile e u/le o0enere una remissione completa 1) Clinical heterogeneity Disease characteris:cs Pa:ent characteris:cs 2) Modern chemoimmunotherpy approaches 3) New mechanism- based treatment
More information15 th Annual Miami Cancer Meeting
15 th Annual Miami Cancer Meeting CLL and CML Mohamed A. Kharfan-Dabaja, MD, MBA, FACP Director, Blood and Marrow Transplantation and Cellular Therapies Mayo Clinic Jacksonville, FL 15 th Annual Miami
More informationT-Receptor Modified Immune Therapy is Better Than Conventional DLI
T-Receptor Modified Immune Therapy is Better Than Conventional DLI David L Porter, MD University of Pennsylvania Medical Center Abramson Cancer Center COSTEM, Berlin 10/13/13 Relapse After Allogeneic SCT:
More informationUpdate: Chronic Lymphocytic Leukemia
ASH 2008 Update: Chronic Lymphocytic Leukemia Improving Patient Response to Treatment with the Addition of Rituximab to Fludarabine-Cyclophosphamide ASH 2008: Update on chronic lymphocytic leukemia CLL-8
More informationChronic lymphocytic leukemia
Chronic lymphocytic leukemia Tanya Siddiqi, MD Assistant Professor City of Hope National Medical Center Duarte, CA How the Experts Treat Hematologic Malignancies Las Vegas, NV 3/2017 Disclosures Speaker
More informationManagement of Chronic Lymphatic Leukemia Beyond conventional therapy
3 rd Young Hematologists Orientation Program SGPGI Lucknow August 18 th -19 th 218 Management of Chronic Lymphatic Leukemia Beyond conventional therapy Prof. Hari Menon. MD DM Department of Hemato-Oncology
More informationBRIEF ARTICLES. KEY WORDS: Blastic plasmacytoid dendritic cell neoplasm, BPDCN, Allogeneic stem cell transplantation
BRIEF ARTICLES Blastic Plasmacytoid Dendritic Cell Neoplasia (BPDC) in Elderly Patients: Results of a Treatment Algorithm Employing Allogeneic Stem Cell Transplantation with Moderately Reduced Conditioning
More informationBackground. Approved by FDA and EMEA for CLL and allows for treatment without chemotherapy in all lines of therapy
Updated Efficacy and Safety From the Phase 3 RESONATE-2 Study: Ibrutinib As First-Line Treatment Option in Patients 65 Years and Older With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Abstract
More informationMP Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
Medical Policy MP 8.01.15 Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma BCBSA Ref. Policy: 8.01.15 Last Review: 01/30/2018 Effective Date: 01/30/2018 Section:
More informationHematopoietic Stem-Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
Hematopoietic Stem-Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma Policy Number: Original Effective Date: MM.07.011 04/01/2008 Line(s) of Business: Current Effective
More informationSIMPOSIO - Leucemia Linfatica Cronica: presente e futuro nella gestione del paziente refrattario
42 Congresso Nazionale SIE 18-21 ottobre 2009 - Milano Convention Centre SIMPOSIO - Leucemia Linfatica Cronica: presente e futuro nella gestione del paziente refrattario Paolo Ghia Lab of B Cell Neoplasia
More informationEBMT2008_22_44:EBMT :29 Pagina 454 CHAPTER 30. HSCT for Hodgkin s lymphoma in adults. A. Sureda
EBMT2008_22_44:EBMT2008 6-11-2008 9:29 Pagina 454 * CHAPTER 30 HSCT for Hodgkin s lymphoma in adults A. Sureda EBMT2008_22_44:EBMT2008 6-11-2008 9:29 Pagina 455 CHAPTER 30 HL in adults 1. Introduction
More informationLong-Term Follow-up of Reduced Intensity Allogeneic Stem Cell Transplantation for Chronic Lymphocytic Leukemia: Prognostic Model to Predict Outcome
Long-Term Follow-up of Reduced Intensity Allogeneic Stem Cell Transplantation for Chronic Lymphocytic Leukemia: Prognostic Model to Predict Outcome The Harvard community has made this article openly available.
More informationTransplantation - Challenges for the future. Dr Gordon Cook S t James s Institute of Oncology, Leeds Teaching Hospitals Trust
Transplantation - Challenges for the future Dr Gordon Cook S t James s Institute of Oncology, Leeds Teaching Hospitals Trust Bone Marrow Transplantation Timeline, 1957-2006 Appelbaum F. N Engl J Med 2007;357:1472-1475
More informationPERFORMANCE AFTER HSCT Mutlu arat, md ıstanbul bilim un., dept. hematology ıstanbul, turkey
PERFORMANCE AFTER HSCT Mutlu arat, md ıstanbul bilim un., dept. hematology ıstanbul, turkey Joint Educational Meeting of the EBMT Severe Aplastic Anaemia, Late Effects and Autoimmune Diseases Working Parties
More information