In September, the golden autumn is full of fruits. On September 24, 2022, the CSCO Autologous Transplantation Working Group's 2022 Tour - Lymphoma Special Session (Jiangxi Fujian Station) was successfully held online, hosted by the Chinese Society of Clinical Oncology (CSCO), the CSCO Lymphoma Expert Committee and the CSCO Leukemia Expert Committee, and hosted by Jiangxi Provincial Cancer Hospital and Union Hospital Affiliated to Fujian Medical University. The conference specially invited Jiangxi Cancer Hospital Shuangyuerong Professor and Union Hospital Affiliated to Fujian Medical University Shen Jianzhen Professor to serve as the chairman of the conference, and Professor Huang Ruibin of the First Affiliated Hospital of Nanchang University and Professor Liu Tingbo of the Union Hospital Affiliated to Fujian Medical University to serve as the chairman of the conference. At the same time, well-known experts in the field were invited to serve as speakers and commentators to discuss the application and development of autologous hematopoietic stem cell transplantation (ASCT) in lymphoma. This article specially organizes the key content of the meeting for readers.
Opening Speech
At the beginning of the meeting, Professor Shuang Yuerong, Chairman of the Conference, and Professor Shen Jianzhen, , and Professor Shen Jianzhen, , delivered opening speeches in turn. Professor Shuang Yuerong said in his speech that he is very honored to have an in-depth discussion with everyone present on the role of transplantation in the full management and diagnosis and treatment of lymphoma. I hope that all the scholars attending the meeting can gain something from this study and discussion. Professor Shen Jianzhen said in his speech that with the improvement of medical level, the advancement of molecular diagnostic technology, and the rich treatment methods, we are gradually entering the era of precise diagnosis and treatment and the era of new drugs. For patients with lymphoma with strong heterogeneity and high malignancy, transplantation has always maintained an important position. In recent decades, transplant technology has developed in the direction of good safety and good efficacy, bringing patients a great survival benefit. Finally, I would like to thank the CSCO Lymphoma Expert Committee and the CSCO Leukemia Expert Committee for hosting this meeting, which has helped my country's transplant technology to advance rapidly towards maturity and standardization.
Professor Shuang Yuerong and Professor Shen Jianzhen delivered opening speeches
Academic special session
Academic special session is full of practical information and dazzled! This special session is hosted by Professor Huang Ruibin at .
Professor Huang Ruibin served as the academic special host
2022 European Hematology Association (EHA) Multiple Myeloma (MM) Lymphoma ASCT Progress Selection
First Affiliated Hospital of Fujian Medical University Professor Lin Junfang made a detailed report on the topic "Selected Progress of 2022 EHA MM Lymphoma". Patients with newly diagnosed MM (NDMM) with high-risk cytogenetic factors often relapse after a single ASCT, and tandem ASCT may overcome this adverse prognosis. For patients with mediastinal large B-cell lymphoma (PMBL), the 1-year PFS and OS of OS after 6 treatment courses of R-CHOEP-14 (rituximab + cyclophosphamide + doxorubicin + vincristine + etoposide + prednisone) and 2 treatment courses of DHAP (cisplatin + cytarabine + dexamethasone ) followed by ASCT with 1-year PFS and OS with previous DA-EPOCH-R (dose-adjusted etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone combined with rituximab) and good tolerated. Regarding the management of patients in the new crown era, the study found that the choice of pretreatment plans has little impact on the effectiveness of the new crown vaccine; the time between vaccination and rituximab is at least 6 months, which is better.
Professor Lin Junfang gave a report
discussion session, and the discussion guests Professor Kong Fancong, the First Affiliated Hospital of Nanchang University, and Professor Huang Yan, Jiangxi Provincial Cancer Hospital, , on the issues of "the efficacy of tandem transplantation", "TEAM (setipe + etoposide + cytarabine + melfalun) scheme, bendamustin combined with BEAM (carmustine + etoposide + cytarabine + melfalun) scheme", "the value of double transplantation in high-risk patients", and "new drugs or transplants should be selected when lymphoma recurses", and so on, and the academic atmosphere was strong.
Pegylated recombinant human granulocyte stimulator factor (PEG-rhG-CSF) clinical application in lymphoma hematopoietic stem cell transplantation
Professor Yi Kun of Jiangxi Cancer Hospital reported on the topic of "Clinical application of PEG-rhG-CSF in lymphoma hematopoietic stem cell transplantation". Professor Yi Kun first analyzed the epidemiological data of lymphoma , pointing out that compared with European and American countries, lymphoma patients in my country are relatively younger, with a higher incidence of aggressive lymphoma, patients need stronger combination chemotherapy regimens, and some patients need ASCT for consolidation. Subsequently, Professor Yikun interpreted several documents and concluded that PEG-rhG-CSf can be used for the mobilization and reconstruction of peripheral hematopoietic stem cell transplantation in MM and lymphoma patients, and its efficacy in transplantation and reconstruction is not inferior to or even better than rhG-CSF. In addition, PEG-rhG-CSF is more economical than rhG-CSF for reconstruction after peripheral hematopoietic stem cell transplantation of lymphoma.
Professor Yi Kun gave a report
Subsequently, Fujian Cancer Hospital Professor Lin Jianyang and Ganzhou People's Hospital Professor Zhong Mingxing participated in the discussion and had a wonderful exchange with Professor Yi Kun on topics such as "The timing of use of PEG-rhG-CSf in transplant patients and conventional chemotherapy patients" and "Page dosage and safety of PEG-rhG-CSf".
progress of autologous transplantation of lymphoma
Peking University Cancer Hospital Professor Liu Weiping mentioned in the report "Progress in Lymphoma Autologous Transplantation of Lymphoma" that ASCT is an important treatment strategy for lymphoma. At present, the ASCT method is mature, the evidence is sufficient, and the accessibility is strong, and it is suitable for most patients with relapsed refractory (R/R). ASCT has a wide range of applications. In addition to extending the survival time of non-Hodgkin lymphoma (NHL) patients, the benefits brought to R/R Hodgkin lymphoma (HL) patients cannot be ignored. Research data from Professor Liu Weiping Center showed that compared with non-transplant patients, the 1-year OS rate of R/R HL patients in the transplant group increased by 11% and the 2-year OS rate increased by 20%. In the era of new drugs, various types of new drugs have made an indelible contribution to improving the response rate and depth of induction treatment, but new drugs cannot completely replace transplantation. Consolidation treatment with transplantation can significantly improve patients' PFS and OS. The standardization of the combination of new drugs, new therapies and ASCT is worth further exploration in the future.
Professor Liu Weiping gave a report
discussion session, Second Affiliated Hospital of Nanchang University Professor Tang Duozhuang and Zhongshan Hospital Affiliated to Xiamen University Professor Zhang Kejie on issues such as "the age of patients who are recommended to undergo ASCT", "How to treat the following after primary central lymphoma patients undergoing ASCT", "The efficacy of the combined application of CAR-T and ASCT", and "the development of mesenchymal stem cells and induced pluripotent stem cells".
case sharing special session
case sharing special session was exciting and rewarding! This special session was hosted by Professor Liu Tingbo from Union Hospital Affiliated to Fujian Medical University, .
Professor Liu Tingbo served as the case sharing special host
Case sharing-relapsed intestinal NKT cell lymphoma (NKTCL)
Professor Chen Changkun of Ganzhou People's Hospital shared 1 case of ASCT treatment for relapsed intestinal NKTCL. The patient, male, 46 years old, had colon tumor surgery in the hospital before, and the pathology showed NKTCL. Later, he used 6 courses of Xindilizumab + anlotinib + peparase regimen for chemotherapy (the specific medication is unknown). After recurrence, he visited Professor Chen Changkun at and was diagnosed with extranodal NK/T cell lymphoma (ENKTCL) stage III; PINK score 3 points, high risk; PINK-E score 3 points, high risk; ECOG score 1 point, . Based on the actual situation of the patient and the recommendations of domestic and foreign guidelines, ASCT was selected after 3 treatment courses of P-Gemox (pegase + gemcitabine + oxaliplatin) regimen + PEG-rhG-CSF mobilized hematopoietic stem cells + 1 treatment course of P-Gemox regimen. The patient was given maintenance treatment with PD-1 monoclonal antibody combined with cidabenamine, but due to the change in reimbursement policy, cidabenamine was replaced with salitamide. No tumor lesions were found after the follow-up examination 14 months after ASCT. Finally, Professor Chen Changkun shared his experience that chemotherapy-sensitive R/R ENKTCL patients can benefit from ASCT; PEG-rhG-CSF mobilizes peripheral blood hematopoietic stem cells safe and reliable.
Professor Chen Changkun gave a report
discussion session, Professor Peng Zhiqiang of Jiangxi Cancer Hospital and Quanzhou First Hospital Professor Xu Wenqian discussed the issues of "specific usage plan for cytarabine" and "the interval between PEG-rhG-CSF and hematopoietic stem cells collection" and other issues, and Professor Chen Changkun . Professor Liu Tingbo made a comment on and said that the treatment process of this patient is standardized and has good efficacy. He looks forward to the announcement of subsequent situations.
Case Sharing-T Lymphoblastic lymphoma (T-LBL)
Professor Luo Xiaofeng of Union Hospital Affiliated to Fujian Medical University shared the treatment process of a T-LBL patient. The patient, male, 24 years old, was diagnosed with in other hospitals as T-LBL, Lugano stage IV; hepatitis B virus carries . One course of chemotherapy was performed with 1 course of VDLP (changchundixin + demethoxyerythrin + peasparin + prednisone), one course of CAN (cyclophosphamide + cytarabine + 6-oxopurine), two courses of HD-MTX + 6-MP (methotrexate: 5g D1, 8g D15+6-oxopurine: 40 mg D1-28). During this period, symptoms such as myelosuppression, lung infection, drug-induced liver damage and even liver failure, hepatic encephalopathy were repeatedly experienced. After symptomatic treatment, the patient's condition improved, and the reexamination effect was evaluated as partial relief. Professor Luo Xiaofeng After starting to treat this patient, after comprehensive consideration, he successively gave chemotherapy with his reduction EA program (etoposide 150 mg D1-2 + cytarabine 1.2g D1-3) and reduced VDLP program (vincristine 2mg D1+ daunorubicin 60 mg D1-3 + asparaginase 3759IU/m2D1+ dexamethasone 12.5mg D1-7). After CT examination, he found that the mediastinal sternum was occupied by the posterior mediastinum, and the lymphoma might be large.
Professor Luo Xiaofeng gave a report
discussion session, First Affiliated Hospital of Gannan Medical College Professor Lin Chuanming and Professor Guo Jiangrui of Union Hospital Affiliated to Fujian Medical University discussed issues such as "selecting patients' subsequent chemotherapy regimen", "feasibility of radiotherapy" and "possibility of new drugs and new therapies such as daratuzumab and CAR-T". Professor Liu Tingbo said that the patient's condition in this case is complicated, and the choice of treatment plan needs to be considered from multiple aspects. If the patient enters myelosuppression after chemotherapy, hematopoietic stem cell transplantation can be performed in combination with PEG-rhG-CSF for supportive treatment, if necessary.
Conference Summary
At the end of the conference, Professor Shuang Yuerong and Professor Shen Jianzhen held a conference summary. They expressed: Thank you for your wonderful sharing, the meeting was a complete success! At present, the proportion of patients undergoing transplantation is still relatively low, and there is still no standard plan for the combination of new drugs and transplantation. In the future, the exploration of transplantation still needs to be without slack off imagination and pursuing false voices, and do it in practice! It is our goal to be kind to the doctor and be able to better serve patients; life first is our eternal belief. I hope that all doctors in the hematology department can uphold their true intentions, bring more benefits to patients with hematology tumors, and strive to achieve a better goal of clinical cure .
Professor Shuang Yuerong gave a meeting summary
Professor Shen Jianzhen gave a meeting summary
Edited by: Hui-Y
Review: Irena
Typesetting: Wenting
Execution: Wenting
Execution: Wenting
