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Autografting

Interferon-α after autologous stem cell transplantation in pediatric patients with advanced Hodgkin's lymphoma

Bone Marrow Transplantation volume 38, pages 345–349 (2006)Cite this article

Abstract

Thirteen children with refractory or recurrent Hodgkin's lymphoma (HL) received high-dose chemotherapy and autologous hematopoietic stem cell transplant (ASCT). After hematologic recovery, 10 patients were given interferon-α (IFN-α) as adjuvant therapy, starting at a dose of 0.5 × 106 U/m2 subcutaneously, three times a week. The dose was escalated as tolerated. Patients were treated for a median of 12 (4–24) months. Transient myelosuppression was the most common toxicity and led to temporary treatment interruption in five patients. The IFN-α dose was increased in nine patients, to a median final dose of 3.5 × 106 U/m2/week. With a median follow-up of 67 (range 25–114) months, nine of the 10 patients are alive and in continuous remission. One patient relapsed. Three patients were not treated with IFN-α initially, two because of rapidly progressive disease. One patient received IFN-α for treatment of relapse after transplant, and is alive in remission 10 years later. IFN-α has activity in children with advanced HL, and prolonged, low-dose treatment given after ASCT can be tolerated. Its therapeutic effect as a post-transplant adjuvant warrants further investigation.

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References

  1. Kobrinsky N, Sposto R, Shah NR, Anderson JR, DeLaat C, Morse M et al. Outcomes of treatment of children and adolescents with recurrent non-Hodgkin's lymphoma and Hodgkin's disease with dexamethasone, etoposide, cisplatin, cytarabine and L-asparaginase, maintenance chemotherapy, and transplantation: Children's Cancer Group Study CCG-5912. J Clin Oncol 2001; 19: 2390–2396.

    Article  CAS  Google Scholar 

  2. Williams CD, Goldstone AH, Pearce R, Green S, Armitage JO, Carella A et al. Autologous bone marrow transplantation for pediatric Hodgkin's disease: a case-matched comparison with adult patients by the European Bone Marrow Transplant Group Lymphoma Registry. J Clin Oncol 1993; 11: 2243–2249.

    Article  CAS  Google Scholar 

  3. Baker KS, Gordon BG, Gross TG, Abromowitch MA, Lyden ER, Lynch JC et al. Autologous hematopoietic stem-cell transplantation for relapsed or refractory Hodgkin's disease in children and adolescents. J Clin Oncol 1999; 17: 825–831.

    Article  CAS  Google Scholar 

  4. Lieskovsky YE, Donaldson SS, Torres MA, Wong RM, Amylon MD, Link MP et al. High-dose therapy and autologous hematopoietic stem-cell transplantation for recurrent or refractory pediatric Hodgkin's disease: results and prognostic indices. J Clin Oncol 2004; 22: 4532–4540.

    Article  Google Scholar 

  5. Verdeguer A, Pardo N, Madero L, Martinez A, Bureo E, Fernandez JM et al. Autologous stem cell transplantation for advanced Hodgkin's disease in children. Bone Marrow Transplant 2000; 25: 31–34.

    Article  CAS  Google Scholar 

  6. Stoneham S, Ashley S, Pinkerton CR, Wallace WH, Shankar AG . Outcome after autologous hematopoietic stem cell transplantation in relapsed or refractory childhood Hodgkin disease. J Pediatr Hematol Oncol 2004; 26: 740–745.

    Article  Google Scholar 

  7. Stiff PJ, Unger JM, Forman SJ, McCall AR, LeBlanc M, Nademanee AP et al. The value of augmented preparative regimens combined with an autologous bone marrow transplant for the management of relapsed or refractory Hodgkin disease: a Southwest Oncology Group phase II trial. Biol Blood Marrow Transplant 2003; 9: 529–539.

    Article  Google Scholar 

  8. Stewart DA, Guo D, Gluck S, Morris D, Chaudhry A, deMetz C et al. Double high-dose therapy for Hodgkin's disease with dose-intensive cyclophosphamide, etoposide, and cisplatin (DICEP) prior to high-dose melphalan and autologous stem cell transplantation. Bone Marrow Transplant 2000; 26: 383–388.

    Article  CAS  Google Scholar 

  9. Mundt AJ, Sibley G, Williams S, Hallahan D, Nautiyal J, Weichselbaum RR . Patterns of failure following high-dose chemotherapy and autologous bone marrow transplantation with involved field radiotherapy for relapsed/refractory Hodgkin's disease. Int J Radiat Oncol Biol Phys 1995; 33: 261–270.

    Article  CAS  Google Scholar 

  10. Rapoport AP, Guo C, Badros A, Hakimian R, Akpek G, Kiggundu E et al. Autologous stem cell transplantation followed by consolidation chemotherapy for relapsed or refractory Hodgkin's lymphoma. Bone Marrow Transplant 2004; 34: 883–890.

    Article  CAS  Google Scholar 

  11. Rooney CM, Bollard C, Huls MH, Gahn B, Gottschalk S, Wagner HJ et al. Immunotherapy for Hodgkin's disease. Ann Hematol 2002; 81 (Suppl 2): S39–S42.

    CAS  PubMed  Google Scholar 

  12. Rybak ME, McCarroll K, Bernard S, Lester E, Barcos M, Ozer H et al. Interferon therapy of relapsed and refractory Hodgkin's disease: Cancer and Leukemia Group B Study 8652. J Biol Response Modifiers 1990; 9: 1–4.

    CAS  Google Scholar 

  13. Leavitt RD, Ratanatharathorn V, Ozer H, Ultmann JE, Portlack C, Myers JW et al. Alfa-2b interferon in the treatment of Hodgkin's disease and non-Hodgkin's lymphoma. Semin Oncol 1987; 14 (Suppl 2): 18–23.

    CAS  PubMed  Google Scholar 

  14. Maloisel F, Voillat L, Chenard MP, Boehn A, Lioure B, Oberling F . Interferon-α-2b in the management of patients with relapsed and/or refractory Hodgkin's disease. Ann Oncol 1997; 8: 405–406.

    Article  CAS  Google Scholar 

  15. Aviles A, Diaz-Maqueo JC, Talavera A, Nambo MJ, Garcia EL . Maintenance therapy with interferon Alfa 2b in Hodgkin disease. Leukemia Lymphoma 1998; 30: 651–656.

    Article  CAS  Google Scholar 

  16. Parmar S, Platanias LC . Interferons: mechanisms of action and clinical applications. Curr Opin Oncol 2003; 15: 431–439.

    Article  CAS  Google Scholar 

  17. Tompkins WA . Immunomodulation and therapeutic effects of the oral use of interferon-alpha: mechanism of action. J Interferon Cytokine Res 1999; 19: 817–828.

    Article  CAS  Google Scholar 

  18. Fidler IJ . Angiogeneis and cancer metastasis. Cancer J 2000; 6 (Suppl 2): S134–S141.

    PubMed  Google Scholar 

  19. Ezekowitz RA, Mulliken JB, Folkman J . Interferon alfa-2a therapy for life-threatening hemangiomas of infancy. N Engl J Med 1992; 326: 1456–1463.

    Article  CAS  Google Scholar 

  20. Emir S, Kutluk T, Chan KW, Yalçin B, Varli K, Büyükpamukçu M . Peripheral neuropathy during α-interferon therapy in a child with Hodgkin's disease. Pediatr Hematol Oncol 1999; 16: 557–560.

    Article  CAS  Google Scholar 

  21. Lazarus HM, Loberiza Jr FR, Zhang MJ, Armitage JO, Ballem KK, Bashey A et al. Autotransplants for Hodgkin's disease in first relapse or second remission: a report from the autologous blood and marrow transplant registry (ABMTR). Bone Marrow Transplant 2001; 27: 387–396.

    Article  CAS  Google Scholar 

  22. Matthay KK, Villablanca JG, Seeger RC, Stram DO, Harris RE, Ramsay NK et al. Treatment of high-risk neuroblastoma with intensive chemotherapy, radiotherapy, autologous bone marrow transplantation, and 13-cis-retinoic acid. Children's Cancer Group. N Engl J Med 1999; 341: 1165–1173.

    Article  CAS  Google Scholar 

  23. Klingemann H-G, Grigg AP, Wilkie-Boyd K, Barnett MJ, Eaves AC, Reece DE et al. Treatment with recombinant interferon (α–2β) early after bone marrow transplantation in patients at high risk for relapse. Blood 1991; 78: 3306–3311.

    CAS  Google Scholar 

  24. Schenkein DP, Dixon P, Desforges JF, Berkman E, Erban JK, Ascensao JL et al. Phase I/II study of cyclophosphamide, carboplatin, and etoposide and autologous hematopoietic stem-cell transplantation with posttransplant interferon alfa-2b for patients with lymphoma and Hodgkins' disease. J Clin Oncol 1994; 12: 2423–2431.

    Article  CAS  Google Scholar 

  25. Deschler B, Reincke M, Bley TA, Brink I, Engelhardt M . Striking complete remission after interferon-alpha for secondary recurrent non-Hodgkin's lymphoma but rare interferon-induced side effects. Ann Hematol 2005; 84: 263–266.

    Article  CAS  Google Scholar 

  26. Ozawa S, Shinohara H, Kanayama HO, Bruns CJ, Bucana CD, Ellis LM et al. Suppression of angiogenesis and therapy of human colon cancer liver metastasis by systemic administration of interferon-α. Neoplasia 2001; 3: 154–164.

    Article  CAS  Google Scholar 

  27. Schellong G, Dorffel W, Claviez A, Korholz D, Mann G, Scheel-Walter HG et al. Salvage therapy of progressive and recurrent Hodgkin's disease: results from a multicenter study of the pediatric DAL/GPOH-HD study group. J Clin Oncol 2005; 23: 6181–6189.

    Article  Google Scholar 

  28. Ozkaynak MF, Jayabose S . Gemcitabine and vinorelbine as a salvage regimen for relapse in Hodgkin lymphoma after autologous hematopoietic stem cell transplantation. Pediatr Hematol Oncol 2004; 21: 107–113.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    D Petropoulos, L L Worth, C A Mullen, M Choroszy & K W Chan

  2. Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA

    C A Mullen

  3. Children's Hospital of Austin, Austin, TX, USA

    S Lockhart

  4. Texas Transplant Institute, San Antonio, TX, USA

    K W Chan

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  1. D Petropoulos
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  2. L L Worth
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Correspondence to K W Chan.

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Petropoulos, D., Worth, L., Mullen, C. et al. Interferon-α after autologous stem cell transplantation in pediatric patients with advanced Hodgkin's lymphoma. Bone Marrow Transplant 38, 345–349 (2006). https://doi.org/10.1038/sj.bmt.1705458

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