Susana Roncon

Hematopoietic progenitor cells collection in pediatric patients with brain tumor.

To analyze the efficacy and safety of hematopoietic progenitor cells (HPC) collections by leukapheresis in pediatric patients with brain tumors.

Monitoring the extracorporeal photopheresis by immunophenotyping in a Sézary syndrome patient

Abstract The extracorporeal photopheresis is indicated as immunomodulatory treatment in primary cutaneous T‐cell lymphoma. There are no guidelines about the most suitable immunophenotypic panel to monitor and correlate clinical evolution and laboratory parameters. In this study we characterize a patient with Sézary syndrome stage III, who performed 98 sessions of photopheresis; in the last 30, the expression of T‐cells in peripheral blood was evaluated. The patient had exfoliative dermatitis (mainly in the lower limbs) and several analytical disorders: anemia, neutropenia and lymphocytosis; abnormal number of effector T‐cells and a CD4/CD8 ratio higher than 10; atypical cells (CD7, CD26) with aberrant phenotype (characteristic of malignant T‐cell clones); and regulatory T‐cells indicating an immunotolerance state. The clinical evolution verified can be related with the therapeutic scheme adopted. We propose a multiparameter flow cytometry approach to monitor patients with Sézary syndrome that realize photopheresis, including the aberrant cases.

Outcomes of allogeneic stem cell transplantation among patients with acute myeloid leukemia presenting active disease: Experience of a single European Comprehensive Cancer Center.

Introduction: Allogeneic hematopoietic stem cell transplantation (ASCT) representes a potentially curative approach for patients with relapsed or refractory acute myeloid leukemia (AML). We report the outcome of relapsed/refractory AML patients treated with ASCT. Method: A retrospective cohort from 1994 to 2013 that included 61 patients with diagnosis of relapsed/refractory AML. Outcomes of interest were transplant-related mortality (TRM), incidence of acute and chronic graft-versus-host disease (GVHD), relapse incidence, progression-free survival (PFS) and overall survival (OS). Statistical significance was set at p<0.05. Results: The median age was 61 years (range 1 to 65). The cumulative incidence of 90 days, 1 year, and 3 years TRM were 60%, 26.7%, and 13.3%, respectively (p<0.001). The incidence of relapse was 21.7% at 1 year, 13% at 3 years, and 8.7% at 5 years. Median OS was estimated to be 8 months (95CI 3.266-12.734) and median PFS, 3 months (95CI 1.835-4.165). Conclusion: In our cohort, TRM in first years after ASCT remains considerable, but ASCT in this setting seems to be a good choice for AML patients with active disease. However, novel approaches are needed to reduce TRM and relapse in this set of patients.

Twenty Years of Autologous Stem Cell Transplantation in Diffuse Large B-Cell Lymphoma: A Single Portuguese Center Experience

INTRODUCTION Diffuse large B-cell lymphoma can be cured in 60% - 70% of patients. Autologous stem cell transplantation is the standard treatment for relapsed disease. This high-intensity treatment after first complete remission in patients with high International Prognostic Index remains controversial and was performed in our department during some years. MATERIAL AND METHODS Retrospective study, review of clinical records. RESULTS This study evaluates the outcome of 113 patients transplanted between 1992 and 2012. Considering status before transplantation patients were divided in groups: a) first complete remission after 1 line of chemotherapy (n = 64); b) first complete remission after ≥ two chemotherapy lines (n = 15); c) second complete remission (n = 15); d) more advanced diseased (n = 19). Chemotherapy used in first line therapy was mainly R-CHOP (n = 71) and CHOP (n = 28). The median follow-up of patients still alive was 34 months (1 - 221). At five years, overall survival was 73% (± 5) and disease free survival was 75% (± 5). CONCLUSION Conventional chemotherapy followed by autologous stem cell transplant is a safe and efficient option for selected patients. In our series 70% high-risk patients were free from disease with this strategy.