Cancer Research and Treatment

Original Articles

Hematologic malignancy

Current Treatment Patterns and the Role of Upfront Autologous Stem Cell Transplantation in Patients with Peripheral T-Cell Lymphoma: A Korean Nationwide, Multicenter Prospective Registry Study (CISL 1404): Hyungwoo Cho, Dok Hyun Yoon, Dong-Yeop Shin, Youngil Koh, Sung-Soo Yoon, Seok Jin Kim, Young Rok Do, Gyeong-Won Lee, Jae-Yong Kwak, Yong Park, Min Kyoung Kim, Hye Jin Kang, Jun Ho Yi, Kwai Han Yoo, Won Sik Lee, Byeong Bae Park, Jae Cheol Jo, Hyeon-Seok Eom, Hyo Jung Kim, Seong Hyun Jeong, Young-Woong Won, Byeong Seok Sohn, Ji-Hyun Kwon, Cheolwon Suh, Won Seog Kim; Cancer Res Treat. 2023;55(2):684-692. Published online January 2, 2023; DOI: https://doi.org/10.4143/crt.2022.1434

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Purpose
We conducted a nationwide, multicenter, prospective registry study for newly diagnosed patients with peripheral T-cell lymphoma (PTCL) to better define the clinical characteristics, treatment patterns, survival outcomes, and the role of upfront autologous stem cell transplantation (ASCT) in these patients.
Materials and Methods
Patients with PTCL receiving chemotherapy with curative intent were registered and prospectively monitored. All patients were pathologically diagnosed with PTCL.
Results
A total of 191 patients with PTCL were enrolled in this prospective registry study. PTCL, not otherwise specified (PTCL-NOS) was the most common pathologic subtype (n=80, 41.9%), followed by angioimmunoblastic T-cell lymphoma (AITL) (n=60, 31.4%). With a median follow-up duration of 3.9 years, the 3-year progression-free survival (PFS) and overall survival (OS) rates were 39.5% and 60.4%, respectively. The role of upfront ASCT was evaluated in patients who were considered transplant-eligible (n=59). ASCT was performed as an upfront consolidative treatment in 32 (54.2%) of these patients. There were no significant differences in PFS and OS between the ASCT and non-ASCT groups for all patients (n=59) and for patients with PTCL-NOS (n=26). However, in patients with AITL, the ASCT group was associated with significantly better PFS than the non-ASCT group, although there was no significant difference in OS.
Conclusion
The current study demonstrated that the survival outcomes with the current treatment options remain poor for patients with PTCL-NOS. Upfront ASCT may provide a survival benefit for patients with AITL, but not PTCL-NOS.

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Successful Treatment, with Chemotherapy and Intravenous Administration of Ascorbic Acid, of a Patient with Peripheral T-Cell Lymphoma, Not Otherwise Specified
Chiaki Tokoro, Atsushi Tashiro, Kenji Ina, Yoshiteru Tanaka, Hiroyuki Kobayakawa, Takashi Yoshida, Satoshi Kayukawa
Journal of Cancer Research Updates.2024; 13: 1. CrossRef
Role of upfront autologous transplant for peripheral T-cell lymphoma patients achieving a complete remission with first-line therapy: a systematic review and meta-analysis
L. Girard, Y. J. Koh, L. P. Koh, Y. L. Chee, H. L. Chan, J. Lee, S. de Mel, L. M. Poon, M. Samuel
Bone Marrow Transplantation.2024; 59(6): 838. CrossRef
Angioimmunoblastic T-cell lymphoma and correlated neoplasms with T-cell follicular helper phenotype: from molecular mechanisms to therapeutic advances
Luís Alberto de Pádua Covas Lage, Hebert Fabricio Culler, Cadiele Oliana Reichert, Sheila Aparecida Coelho da Siqueira, Juliana Pereira
Frontiers in Oncology.2023;[Epub] CrossRef
Advances in the pathogenesis and therapeutic strategies of angioimmunoblastic T-cell lymphoma
Qingyang Zhang, Le Yin, Qinqiao Lai, Yan Zhao, Hongling Peng
Clinical and Experimental Medicine.2023; 23(8): 4219. CrossRef

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Busulfan, Melphalan, and Etoposide (BuME) Showed an Equivalent Effect to Busulfan, Cyclophosphamide, and Etoposide (BuCE) as Conditioning Therapy for Autologous Stem Cell Transplantation in Patients with Relapsed or High-Risk Non-Hodgkin’s Lymphoma: A Multicenter Randomized Phase II Study bythe Consortium for Improving Survival of Lymphoma (CISL): Kyoung Ha Kim, Jae Hoon Lee, Mark Lee, Hoon-Gu Kim, Young Rok Do, Yong Park, Sung Yong Oh, Ho-Jin Shin, Won Seog Kim, Seong Kyu Park, Jee Hyun Kong, Moo-Rim Park, Deok-Hwan Yang, Jae-Yong Kwak, Hye Jin Kang, Yeung-Chul Mun, Jong-Ho Won; Cancer Res Treat. 2023;55(1):304-313. Published online March 30, 2022; DOI: https://doi.org/10.4143/crt.2022.004

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Purpose
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard management for relapsed or high-risk non-Hodgkin’s lymphoma (NHL). We reported the busulfan, melphalan, and etoposide (BuME) conditioning regimen was effective in patients with relapsed or high-risk NHL. Moreover, the busulfan, cyclophosphamide, and etoposide (BuCE) conditioning regimen has been used widely in ASCT for NHL. Therefore, based on these encouraging results, this randomized phase II multicenter trial compared the outcomes of BuME and BuCE as conditioning therapies for ASCT in patients with NHL.
Materials and Methods
Patients were randomly assigned to receive either BuME (n=36) or BuCE (n=39). The BuME regimen was comprised of busulfan (3.2 mg/kg/day, intravenously) administered on days –7, –6, and –5, etoposide (400 mg/m² intravenously) on days –5 and –4, and melphalan (50 mg/m2/day intravenously) on days –3 and –2. The BuCE regimen was comprised of busulfan (3.2 mg/kg/day intravenously) on days –7, –6, and –5, etoposide (400 mg/m²/day intravenously) on days –5 and –4, and cyclophosphamide (50 mg/kg/day intravenously) on days –3 and –2. The primary endpoint was 2-year progression-free survival (PFS).
Results
Seventy-five patients were enrolled. Eleven patients (30.5%) in the BuME group and 13 patients (33.3%) in the BuCE group had disease progression or died. The 2-year PFS rate was 65.4% in the BuME group and 60.6% in the BuCE group (p=0.746). There were no non-relapse mortalities within 100 days after transplantation.
Conclusion
There were no significant differences in PFS between the two groups. Therefore, busulfan-based conditioning regimens, BuME and BuCE, may be important treatment substitutes for the BCNU-containing regimens.

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Shorting of existing conditioning regimen for relapsed/refractory gastric diffuse large B-cell lymphoma transplant and studying its related outcomes: A first of its kind case report
Priyatesh Chandra Dwivedi, Yasam Venkata Ramesh, Raj Nagarkar
Iraqi Journal of Hematology.2025;[Epub] CrossRef
CEAC (oral semustine, etoposide, cytarabine and cyclophosphamide) vs BEAM (carmustine, etoposide, cytarabine, and melphalan) conditioning regimen of autologous stem cell transplantation for diffuse large B-cell lymphoma: a post-hoc, propensity score-match
Tao Wang, Ping Liu, Lili Xu, Lei Gao, Xiong Ni, Gusheng Tang, Li Chen, Jie Chen, Libing Wang, Yang Wang, Weijia Fu, Wenqin Yue, Na Liu, Ruobing Li, Guihua Lu, Yanrong Luo, Jianmin Yang
Annals of Hematology.2024; 103(2): 575. CrossRef

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Clinical Characteristics and Treatment Results of Pediatric Osteosarcoma: The Role of High Dose Chemotherapy with Autologous Stem Cell Transplantation: Ji Won Lee, Hyery Kim, Hyoung Jin Kang, Han-Soo Kim, Sung-Hye Park, In-One Kim, Hyo Seop Ahn, Hee Young Shin; Cancer Res Treat. 2008;40(4):172-177. Published online December 31, 2008; DOI: https://doi.org/10.4143/crt.2008.40.4.172

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Purpose

In this study, we investigated the clinical characteristics and treatment results of osteosarcoma during the past 7 years, and evaluated the role of high dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT).

Materials and Methods

We retrospectively analyzed the clinical data of patients who were diagnosed as osteosarcoma at our center from January, 2000 to December, 2007.

Results

The 5-year overall survival and event-free survival of the patients were 72.6% and 55.9%, respectively. Seventeen (41.5%) patients showed disease progression during treatment or relapse after the end of treatment. The patients who had metastasis at diagnosis or who had a lower grade of necrosis after neoadjuvant chemotherapy showed decreased overall and event-free survival. Four patients received ASCT after HDCT, and 3 of them are alive without disease.

Conclusions

The patients who relapsed or had refractory osteosarcoma or who had metastasis at diagnosis or a lower grade of necrosis after neoadjuvant chemotherapy showed poor prognosis. HDCT with ASCT could be an alternative treatment option for these patients.

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High‐dose chemotherapy followed by autologous stem cell transplantation in pediatric patients with relapsed osteosarcoma
Sung Han Kang, Wanlim Kim, Jong Seok Lee, Jin Kyung Suh, Hyery Kim, Dong Kwan Kim, Se Hoon Choi, Hee Won Cho, Hee Young Ju, Keon Hee Yoo, Ki Woong Sung, Hong Hoe Koo, Sung Wook Seo, Ho Joon Im, Ji Won Lee, Kyung‐Nam Koh
Pediatric Blood & Cancer.2023;[Epub] CrossRef
Favorable outcome of high-dose chemotherapy and autologous hematopoietic stem cell transplantation in patients with nonmetastatic osteosarcoma and low-degree necrosis
Kyung Taek Hong, Hyun Jin Park, Bo Kyung Kim, Hong Yul An, Jung Yoon Choi, Jung-Eun Cheon, Sung-Hye Park, Han-Soo Kim, Hyoung Jin Kang
Frontiers in Oncology.2022;[Epub] CrossRef
The Outcome of Children With Malignant Bone Tumors: A Single-Center Experience
Mohammadreza Bordbar, Ali Sarfaraz, Sezaneh Haghpanah, Omidreza Zekavat, Soheila Zareifar, Tahereh Zarei
Global Pediatric Health.2021;[Epub] CrossRef
1
L.V. Hryvkova
Practical oncology.2021; 4(1): 30. CrossRef
Retrospective analysis of high-dose chemotherapy followed by autologous stem cell transplantation for high-risk pediatric osteosarcoma
Suguru Uemura, Takeshi Mori, Shinya Ishiko, Satoru Takafuji, Nanako Nino, Nobuyuki Yamamoto, Akira Hayakawa, Noriyuki Nishimura, Hitomi Hara, Teruya Kawamoto, Toshihiro Akisue, Kazumoto Iijima
Pediatric Hematology and Oncology.2020; 37(4): 337. CrossRef
Pulmonary tuberculosis mimicking radiation pneumonitis in a patient with neck malignancy
Kyungsoo Bae, Kyung Nyeo Jeon, Hoon Sik Choi, Dae Hyun Song, Ho Cheol Kim
Medicine.2019; 98(27): e16398. CrossRef
High-dose chemotherapy and autologous stem cell transplantation with melphalan, etoposide and carboplatin for high-risk osteosarcoma
C R Hong, H J Kang, M S Kim, H Y Ju, J W Lee, H Kim, H-S Kim, S-H Park, K D Park, J D Park, H Y Shin, H S Ahn
Bone Marrow Transplantation.2015; 50(10): 1375. CrossRef
High‐dose chemotherapy with stem cell rescue in the primary treatment of metastatic and pelvic osteosarcoma: Final results of the ISG/SSG II study
Kjetil Boye, Adalberto Brach Del Prever, Mikael Eriksson, Gunnar Sæter, Amelia Tienghi, Paula Lindholm, Franca Fagioli, Sigmund Skjeldal, Stefano Ferrari, Kirsten Sundby Hall
Pediatric Blood & Cancer.2014; 61(5): 840. CrossRef
LY294002 suppresses the malignant phenotype and sensitizes osteosarcoma cells to pirarubicin chemotherapy
XIN HUA LONG, ZHEN HAO ZHONG, AI FEN PENG, LIANG BO ZHU, HENG WANG, GUO MEI ZHANG, ZHI LI LIU
Molecular Medicine Reports.2014; 10(6): 2967. CrossRef
Prognostic significance of early lymphocyte recovery in pediatric osteosarcoma
Colin Moore, Don Eslin, Alejandro Levy, Jessica Roberson, Vincent Giusti, Robert Sutphin
Pediatric Blood & Cancer.2010; 55(6): 1096. CrossRef
Cryoimmunologic Antitumor Effects Enhanced by Dendritic Cells in Osteosarcoma
Masanori Kawano, Hideji Nishida, Yasunari Nakamoto, Hiroshi Tsumura, Hiroyuki Tsuchiya
Clinical Orthopaedics and Related Research®.2010; 468(5): 1373. CrossRef

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Autologous Stem Cell Transplantation using a Modified TAM Conditioning Regimen for Clinically Aggressive Non-Hodgkin's Lymphoma: Sook Hee Hong, Young Seon Hong, In Sook Woo, Yoon Ho Koh, Sang Young Rho, Ji Yean Peak, Myung Ah Lee, Byoung Yong Shim, Jae Ho Byun, Ji Chan Park, Jong Wook Lee, Woo Sung Min, Chun Choo Kim; Cancer Res Treat. 2007;39(2):54-60. Published online June 30, 2007; DOI: https://doi.org/10.4143/crt.2007.39.2.54

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Purpose

High-dose chemotherapy (HDT) and autologous stem cell transplantation (ASCT) have been used for the treatment of clinically aggressive non-Hodgkin's lymphoma (NHL). However, the superiority of specific conditioning regimens has not yet been established. The present study evaluated the efficacy and toxicity of a conditioning regimen involving fractionated total body irradiation (TBI), and the use of Ara-C and melphalan (TAM) for clinically aggressive NHL.

Materials and Methods

Between March 2002 and December 2004, 31 patients with aggressive NHL received fractionated TBI with a dose of 12 Gy over 3 days, and were administered 9 g/m² Ara-C and 100 mg/m² melphalan followed by autologous peripheral blood stem Cell Transplantation at the Catholic Hematopoietic Stem cell transplantation Center Korea. Patients that responded to first line chemotherapy and achieved complete remission (CR), or were in a first sensitive relapse were defined as having less advanced disease, while the other patients were defined as having more advanced disease.

Results

Objective responses were obtained in 24 of 31 patients (77.4%), comprising complete remission in 19 patients (61.3%) and partial remission in 5 (16.1%) patients. The median follow-up time was 28 months (range 1~62 months). At 3 years, the overall survival and event-free survival (EFS) rates were 62.3% and 47.3%, respectively. Patients with less advanced disease and more advanced disease showed 3-year EFS rates of 73.3% and 22.5 %, respectively (p=0.006). Early (within the first 100 days) treatment-related mortality occurred in 3 (9.7%) patients. Of the 31 total patients, 15 (48.4%) developed grade 3 mucositis, 22 (70.9%) developed neutropenic fever, and two (6.5%) developed interstitial pneumonia syndrome>grade 3.

Conclusion

The modified TAM conditioning regimen and ASCT appear to be a feasible treatment regimen for clinically aggressive NHL, particularly for patients with less advanced disease.

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Comparison of regional arterial chemotherapy and systemic intravenous chemotherapy for advanced pancreatic cancer: a systematic review and meta-analysis
Chengqing Li, Wenyi Guo, Shihong Chen, Jianwei Xu, Feng Li, Lei Wang
Journal of Pancreatology.2022; 5(2): 49. CrossRef

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High Dose Chemotherapy with Ifosfamide, Carboplatin, and Etoposide Followed by Autologous Stem Cell Transplantation in Breast Cancer: Soo Mee Bang, Se Hoon Lee, Eun Kyung Cho, Jung Ae Lee, Young Suk Park, Dong Bok Shin, Jae Hoon Lee, Yung Jue Bang, Seonyang Park, Byoung Kook Kim, Noe Kyeong Kim; J Korean Cancer Assoc. 2000;32(6):1059-1066.

Abstract PDF: PURPOSE
To establish the feasibility of high dose ifosfamide, carboplatin, and etoposide (ICE) chemotherapy followed by autologous stem cell transplantation (ASCT) in patients with high-risk or metastatic breast cancer.
MATERIALS AND METHODS
High-risk breast cancer is defined as 10 or more involved axillary lymph nodes (n=3) or stage III (n=2). Patients with metastatic cancer have relapsed diseases after curative resection (n=10) or initially metastatic lesion (n=1). Colony stimulating factor with either cyclophosphamide or combination chemotherapy was administered to mobilize the stem cells. High dose chemotherapy consisted of ifosfamide 16 g/m2, carboplatin 1.8 g/m2, and etoposide 0.75 g/m2 (dose I) and later modified to ifosfamide 12 g/m2, carboplatin 1.35 g/m2, and etoposide 1.2 g/m2 (dose II).
RESULTS
The median duration of grunulocyte nadir (<500/ microliter) was 11 (10~17) days and platelet transfusion dependency (<20,000/ microliter) was 11 (7~53) days in 14 patients who achieved engraftment. One out of 5 patients with high-risk breast cancer relapsed after high dose therapy. Two patients remain disease-free at 18th and 40th months. Two among the 4 patients treated with dose I died due to treatment-related complications. The responses of metastatic diseases to ICE chemotherapy were 1 continuing CR, 1 CR, 1 PR, 4 SD and 3 PD in 10 evaluable patients.
CONCLUSION
High dose ICE chemotherapy, especially dose II and ASCT were feasible in high-risk or metastatic breast cancer.

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Conventional Treatments in Patients with Hodgkin's Disease: Jong Beom Park, Chul Won Seo, Sang Hee Kim, Kyung No Lee, Hun Ho Song, Soon Seo Park, Hyo Jung Kim, Yung Joo Min, Jin Hee Park, Sung Joon Choe, Jung Koon Kim, Tae Won Kim, Dae Yung Jang, Je Hwan Lee, Sung Bae Kim, Sang Wee Kim, Koo Hyung Lee, Jung Sin Lee, Woo Keon Kim; J Korean Cancer Assoc. 1999;31(4):821-829.

Abstract PDF: PURPOSE
We conducted this study to determine the efficacy of conventional treatments for patients with Hodgkin's disease and identify the patients who have poor prognosis and need high-dose chemotherapy and autologous stem cell transplantation.
MATERIALS AND METHODS
Between Jun. 1989 and Dec. 1997, 50 patients were enrolled and 39 patients were evaluable. Patients were treated with radiotherapy (5 patients) or combination chemotherapy (21 patients) or combined chemotherapy and radiotherapy (13 patients) according to their disease stage. Chemotherapy regimens were C-MOPP (cyclo- phosphamide, vincristine, procarbazine, and prednisone), MOPP (mechlorethamine, vin- cristine, procarbazine, and prednisone), ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), alternating C-MOPP/ABVD, and MOPP/ABV hybrid. Radiation therapy was performed when there was residual tumor after chemotherapy or bulky disease. The response to treatments was analyzed by clinical stage I-II and stage III-IV patients group, respectively.
RESULTS
The complete response rate was 76.9% for total patients, 83.3% for stage I-II patients, and 71.4% for stage III-IV patients. Of the 30 patients achieving complete response, four (13.3%) relapsed at 6, 12, 22, and 28 months after complete response, respectively. The median follow-up duration was 24 months. Nine patients died. Four patients died of Hodgkins disease. Three-year overall survival rate was 72.9% for total patients, 72.5% for stage I-II patients, and 70% for stage III-IV patients. Two-year disease- free survival rate was 77.6% for total patients, 79% for stage I-II stage patients, and 73.9% for stage III-IV patients. The prognostic factor analysis showed that performance status affected the disease-free survival rate.
CONCLUSION
Conventional treatments in patients with Hodgkins disease showed results comparable to previous studies. But we were unable to identify the patients, who need high-dose chemotherapy and autologous stem cell transplantation, because of small number of study patients and short follow up duration.

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