Soiffer Discusses Relapse After Transplant

Robert J. Soiffer, MD, the chair, Executive Committee for Clinical Programs, vice chair, Department of Medical Oncology, chief, Division of Hematologic Malignancies and institute physician at Dana-Farber Cancer Institute, discusses the current role of transplantation and relapse after transplant for patients with cancer.

According to Soiffer, experts tend to focus on adverse events and toxicities that arise when discussing transplant. However, a larger focus must be placed on maintenance therapies, the prevention of relapse, and understanding what kind of patient is most likely to relapse.

Soiffer adds that in the current setting, there have been many developments which now allow for the combination of transplantation with a variety of agents, including chemotherapy, immunotherapy, cellular therapy, and more.

Transcription:

0:08 | Oftentimes, when we consent patients for transplant, we concentrate on complications, like organ toxicity, infection, graft-vs-host disease, but we often don't address the elephant in the room, which is relapse after transplant, which is, of course, the real reason we're doing the transplant in the first place. Indeed, in patients who are beyond day 100 of relapse represents the primary reason for cause of death. We really have to make a concerted effort to address the issue of relapse.

0:42 | Years ago when I started in transplantation, we viewed a transplant as the last gasp [or] what we do at the end of a patient's treatment course to try to save them and try to cure them of their malignancy. It usually wasn't much to do after transplant or in conjunction with transplant because transplant itself was so toxic. These days, however, transplant is much better tolerated. We have the opportunity to combine transplantation with a variety of agents, both chemotherapy agents, immunotherapy agents, cellular therapy approaches, to actually treat relapse, or even better, prevent relapse using these agents in a maintenance setting.