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Biology of Blood and Marrow Transplantation

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https://www.readbyqxmd.com/read/29133250/success-of-immunosuppressive-treatments-in-patients-with-chronic-graft-versus-host-disease
#1
Stephanie J Lee, Tam D Nguyen, Lynn Onstad, Merav Bar, Elizabeth F Krakow, Rachel B Salit, Paul A Carpenter, Morgani Rodrigues, A Marcie Hall, Barry E Storer, Paul J Martin, Mary E Flowers
Moderate to severe chronic graft-versus-host disease (GVHD) is treated with potent immunosuppressive therapy (IST) to modulate the allo-immune response, control symptoms and prevent further organ damage. We sought to understand the types of treatments used in clinical practice and the likelihood of successful treatment associated with each. A chart review was performed for 250 adult patients at Fred Hutchinson Cancer Research Center enrolled in a prospective observational study. After a median follow-up of 5...
November 10, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29128556/pro-140-monoclonal-antibody-to-ccr5-prevents-acute-xenogeneic-graft-versus-host-disease-in-nod-scid-il-2ry-null-mice
#2
Denis R Burger, Yvonne Parker, Kathryn Guinta, Daniel Lindner
Graft-versus-Host Disease (GvHD) is a prevalent and potentially lethal complication of hematopoietic stem cell transplantation (HSCT). Humanized mouse models of xenogeneic-GvHD are important tools used to study the human immune response in vivo. Here we used NOD-scid IL-2Ry(null) mice (NSG) transplanted with human bone marrow stem cells to evaluate the role of immune cell engraftment in the production of acute GvHD. PRO 140, a humanized monoclonal antibody targeting the chemokine receptor, CCR5, was used to evaluate its influence on bone marrow cell engraftment and modulation of acute GvHD...
November 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29128555/combined-haploidentical-and-umbilical-cord-blood-allogeneic-stem-cell-transplantation-for-high-risk-lymphoma-and-cll
#3
Jingmei Hsu, Andrew Artz, Sebastian A Mayer, Danielle Guarner, Michael R Bishop, Ronit Reich-Slotky, Sonali M Smith, June Greenberg, Justin Kline, Rosanna Ferrante, Adrienne A Phillips, Usama Gergis, Hongtao Liu, Wendy Stock, Melissa Cushing, Tsiporah B Shore, Koen van Besien
Limited studies have reported on outcomes for lymphoid malignancy patients receiving alternative donor allogeneic stem cell transplants. We have previously described combining CD34-selected haploidentical grafts with umbilical cord blood (haplo-cord) to accelerate neutrophil and platelet engraftment. Here, we examine the outcome of patients with lymphoid malignancies undergoing haplo-cord transplantation at the University of Chicago and Weill Cornell Medical College. We analyzed 42 lymphoma and CLL patients who underwent haplo-cord allogeneic stem cell transplantation...
November 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29128554/immunomodulatory-effects-of-tyrosine-kinase-inhibitors-tkis-in-vitro-and-in-vivo-study
#4
Elena Marinelli Busilacchi, Andrea Costantini, Nadia Viola, Benedetta Costantini, Jacopo Olivieri, Luca Butini, Giorgia Mancini, Ilaria Scortechini, Martina Chiarucci, Monica Poiani, Antonella Poloni, Pietro Leoni, Attilio Olivieri
Pathogenesis of chronic Graft Versus Host Disease (cGVHD) is incompletely defined, involving donor-derived CD4 and CD8-positive T lymphocytes, as well as B cells. Standard treatment is lacking for steroid dependent/refractory cases; potential usefulness of tyrosine kinase inhibitors (TKIs) has been suggested, based on their potent anti-fibrotic effect. However, TKI seems to have pleiotropic activity. We sought to evaluate the in vitro and in vivo impact of different TKIs on lymphocyte phenotype and function...
November 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29128553/pediatric-hematopoietic-cell-transplant-patients-who-survive-critical-illness-frequently-have-significant-but-recoverable-decline-in-functional-status
#5
M S Zinter, R Holubkov, M A Steurer, C C Dvorak, C N Duncan, A Sapru, R F Tamburro, P S McQuillen, M M Pollack
BACKGROUND: The number of pediatric hematopoietic cell transplant (HCT) patients who survive pediatric intensive care unit (PICU) admission is increasing, yet little is known about their functional morbidity after PICU discharge. We hypothesized that relative to controls, pediatric HCT patients who survive PICU admission would have greater rates of new functional morbidity at the time of PICU discharge, and only a minority of these patients would return to their functional baseline by the end of the hospitalization...
November 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29128552/venous-thromboembolism-in-pediatric-hematopoietic-cell-transplant-a-multicenter-cohort-study
#6
Hemalatha G Rangarajan, Joseph R Stanek, Rolla Abu-Arja, Rajinder P S Bajwa, Jeffery J Auletta, Dean A Lee, Sarah H O Brien, Riten Kumar
INTRODUCTION: Hematopoietic cell transplant (HCT) is associated with a pro-inflammatory, pro-coagulant environment which places recipients at increased risk of venous thromboembolism (VTE). While the incidence of VTE in adult HCT recipients has been extensively studied, similar data for children are lacking. We conducted a multicenter retrospective study to analyze the prevalence of VTE and associated risk factors in a large cohort of patients who underwent HCT at tertiary-care US children's hospitals...
November 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29128551/transplant-decisions-in-patients-with-myelofibrosis-should-mutations-be-the-judge
#7
REVIEW
Rachel B Salit, H Joachim Deeg
The prognosis of myeloproliferative neoplasms (MPN), including primary myelofibrosis (PMF), polycythemia vera (PV; post-PV MF) and essential thrombocythemia (ET; post-EMF) varies considerably, between these disorders as well as within each diagnosis. Molecular studies have identified "driver mutations", in JAK2, MPL1 and CALR, and additional somatic DNA mutations, including ASXL1, EZH2, IDH1/2 and SRSF2, that affect prognosis differentially. Patients with mutations in CALR (type1) have a better outlook than patients with mutations in JAK2 or MPL, while patients without any of the driver mutations (triple negative) have the shortest life expectancy...
November 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29102721/cellular-immunotherapy-for-haematological-malignancies-beyond-bone-marrow-transplant
#8
REVIEW
Melita Cirillo, Peter Tan, Marian Sturm, Catherine Cole
Immunotherapy has changed treatment practices for many haematological malignancies. Despite the current era of targeted therapy, chemotherapy remains the backbone of treatment for many haematological malignancies, especially in acute leukaemia, where relapse remains the major cause of mortality. Application of novel immunotherapies in haematology attempts to harness the killing power of the immune system against leukaemia and lymphoma. Cellular immunotherapy is evolving rapidly for high risk haematological disorders...
November 1, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29102720/poor-adherence-is-associated-with-more-infections-following-pediatric-hematopoietic-stem-cell-transplant
#9
Ahna L H Pai, Joseph Rausch, Sarah Drake, Caroline F Morrison, Jennifer L Lee, Adam Nelson, Alayna Tackett, Suzanne Berger, Lauren Szulczewski, Constance Mara, Stella Davies
To prospectively examine rates of outpatient oral medication adherence in children post hematopoietic stem cell transplant (post-HSCT). For six months following first discharge post-HSCT, 50 patients (0 - 16 years-old) and their primary caregivers agreed to store one oral medication in an electronic pill bottle that date and time stamps each bottle opening. Demographics, disease, donor type, and prescribed post-HSCT medication regimen were collected via chart review. For each patient percent adherence was calculated by dividing the number of doses taken as indicated by the electronic pill bottle, by the number of doses prescribed for the same time period...
November 1, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29100905/post-transplant-cyclophosphamide-ptcy-as-sole-gvhd-prophylaxis-is-feasible-in-patients-undergoing-peripheral-blood-stem-cell-transplantation-for-severe-aplastic-anaemia-using-matched-sibling-donors
#10
Biju George, Nisham Pn, Anup J Devasia, Uday Kulkarni, Anu Korula, Kavitha M Lakshmi, Aby Abraham, Alok Srivastava, Vikram Mathews
High-dose cyclophosphamide (PTCY) following allogeneic hematopoietic cell transplantation (HSCT) has been shown to be effective in preventing graft-versus-host disease (GVHD) following HLA-matched bone marrow transplantation. We performed a phase II study of PTCY given at 50 mg/kg IV on days 3 and 4 as sole GVHD prophylaxis following HSCT for severe aplastic anemia (SAA) receiving G-CSF-mobilized peripheral blood stem cell (PBSC) grafts from HLA-matched related donors following conditioning with fludarabine, cyclophosphamide and single dose Total Body Irradiation (TBI)...
October 31, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29079457/autologous-allogeneic-hematopoietic-cell-transplantation-hct-versus-tandem-autologous-transplantation-for-multiple-myeloma-comparison-of-long-term-post-relapse-survival
#11
Myo Htut, Anita D'Souza, Amrita Krishnan, Benedetto Bruno, Mei-Jie Zhang, Mingwei Fei, Miguel Angel Diaz, Edward Copelan, Siddhartha Ganguly, Mehdi Hamadani, Mohamed Kharfan-Dabaja, Hillard Lazarus, Cindy Lee, Kenneth Meehan, Taiga Nishihori, Ayman Saad, Sachiko Seo, Muthalagu Ramanathan, Saad Z Usmani, Christina Gasparetto, Tomer M Mark, Yago Nieto, Parameswaran Hari
We compared post-relapse overall survival (OS) after autologous-allogenenic (auto/allo) versus tandem autologous (auto/auto) hematopoietic cell transplantation (HCT) in multiple myeloma (MM). Post-relapse survival of patients receiving an auto/auto or auto/allo HCT for MM and prospectively reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) between 2000 and 2010 were analyzed. 404 patients (72.4%) relapsed in the auto/auto group and 178 patients (67.4%) relapsed in the auto/allo group after a median follow up of 8...
October 24, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29074374/-c-reactive-protein-levels-at-acute-gvhd-diagnosis-predict-steroid-refractory-disease-treatment-related-mortality-and-overall-survival-after-allogeneic-hematopoietic-stem-cell-transplantation
#12
Lia Minculescu, Brian Thomas Kornblit, Lone Smidstrups Friis, Ida Schiødt, Soeren Lykke Petersen, Niels Smedegaard Andersen, Henrik Sengeloev
Acute graft versus host disease (aGVHD) remains an excessive cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Primary treatment consists of high-dose corticosteroids, but a small group of patients develop steroid refractory disease and their prognosis is especially poor. There is experimental evidence that co-existing inflammation aggravates aGVHD. Since C-reactive protein (CRP) is a systemic inflammatory marker, we aimed to investigate whether plasma CRP concentrations at aGVHD diagnosis could predict the risk of failing first-line therapy and developing steroid refractory disease...
October 23, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29074373/bone-marrow-harvest-in-pediatric-sibling-donors-role-of-g-csf-priming-and-cd34-cell-dose
#13
Aimee Furey, Sonal Rastogi, Remi Prince, Zhezhen Jin, Elana Smilow, Courtney Briamonte, Justine M Kahn, Yvette Tanhehco, Nita Patel, Diane George, James Garvin, Monica Bhatia, Prakash Satwani
To ensure optimal clinical outcomes for patients while retaining adequate protection for donors, the NMDP developed guidelines that state that up to 20 mL/kg of bone marrow can be harvested from donors. These guidelines, developed originally for unrelated adult donors, are followed in children as well. We studied the impact of G-CSF priming on the cellular composition of harvested bone marrow, sought to develop an algorithm to optimize bone marrow harvest volume from pediatric matched siblings, and studied the impact of CD34+ cell dose on clinical outcomes...
October 23, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29061536/total-body-irradiation-is-safe-and-similarly-effective-to-chemotherapy-only-conditioning-in-autologous-stem-cell-transplantation-for-mantle-cell-lymphoma-patients
#14
Yolanda D Tseng, Philip A Stevenson, Ryan D Cassaday, Andrew Cowan, Brian G Till, Mazyar Shadman, Solomon A Graf, Ralph Ermoian, Stephen D Smith, Leona A Holmberg, Oliver W Press, Ajay K Gopal
Autologous stem cell transplant (ASCT) consolidation has become a standard approach for patients with mantle cell lymphoma (MCL), yet there is little consensus on the role of total body irradiation (TBI) as part of high-dose transplant conditioning. We analyzed 75 consecutive MCL patients that underwent ASCT at our institution between 2001-2011 with either TBI-based (n=43) or carmustine, etoposide, cytarabine, melphalan (n=32; BEAM) high-dose conditioning. Most patients (97%) had chemosensitive disease and were transplanted in first remission (89%)...
October 20, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29061535/pharmacodynamic-monitoring-predicts-outcomes-of-ccr5-blockade-as-gvhd-prophylaxis
#15
Austin P Huffman, Lee P Richman, Lisa Crisalli, Alex Ganetsky, David L Porter, Robert H Vonderheide, Ran Reshef
Blocking lymphocyte trafficking after allogeneic hematopoietic stem cell transplantation is a promising strategy to prevent graft-versus-host disease (GVHD) while preserving the graft-versus-tumor response. Maraviroc, a CCR5 antagonist, has shown promise in clinical trials, presumably by disrupting the migration of effector cells to GVHD target organs. We describe a phosphoflow assay to quantify CCR5 blockade during treatment with maraviroc and used it to evaluate 28 patients in a phase II study. We found that insufficient blockade of CCR5 was associated with significantly worse overall survival (HR=10...
October 20, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29061534/granulocyte-colony-stimulating-factor-use-after-autologous-peripheral-blood-stem-cell-transplantation-comparison-of-two-practices
#16
Amrita D Singh, Sapna Parmar, Khilna Patel, Shreya Shah, Tsiporah Shore, Usama Gergis, Sebastian Mayer, Adrienne Phillips, Jing-Mei Hsu, Ruben Niesvizky, Tomer M Mark, Roger Pearse, Adriana Rossi, Koen van Besien
Administration of granulocyte colony-stimulating factor (G-CSF) after autologous peripheral blood stem cell transplantation (PBSCT) is generally recommended to reduce the duration of severe neutropenia; however, there is limited and conflicting data regarding the optimal timing of G-CSFs post-transplant. A retrospective study was performed at NewYork-Presbyterian/Weill Cornell Medical Center (NYP/WC) from November 5, 2013 to August 9, 2016 of adult inpatient autologous PBSCT patients who received G-CSF empirically starting on day +5 (early) versus day +12 only if absolute neutrophil count (ANC) was <0...
October 20, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29061533/homeostatic-%C3%AE-%C3%AE-t-cell-contents-are-preserved-by-granulocyte-colony-stimulating-factor-priming-and-correlate-with-the-early-recovery-of-%C3%AE-%C3%AE-t-subsets-after-haploidentical-hematopoietic-transplantation
#17
Zhilei Bian, Lan-Ping Xu, Qiang Fu, Mingrui Huo, Long Liu, Xiaosu Zhao, Xiao-Jun Huang, Jiangying Liu
Emerging evidence from graft manipulations and immunotherapeutic treatments has highlighted a favorable effect of γδ T cells in the setting of allogeneic hematopoietic stem cell transplantation (alloHSCT). However, γδ T subsets and their distinct features in the allograft have not been characterized. Additionally, whether homeostatic γδ T-cell fractions are influenced by treatment with granulocyte colony-stimulating factor (G-CSF) remains elusive. We initially compared the phenotypes of γδ T subsets including CD27+, CD27(-), Vδ1+, Vδ2+, Vδ1+CD27+, Vδ1+CD27(-), Vδ2+CD27+, and Vδ2+CD27(-) cells, in the peripheral blood of 20 healthy donors before and after G-CSF mobilization...
October 20, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29061532/fluid-too-much-or-too-little-transplant-mortality-may-hang-in-the-balance
#18
EDITORIAL
Sangeeta Hingorani
No abstract text is available yet for this article.
October 20, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29061531/outcomes-of-unrelated-donor-stem-cell-transplant-with-post-transplant-cyclophosphamide-for-graft-versus-host-disease-prophylaxis-in-patients-with-severe-sickle-cell-disease
#19
Hemalatha G Rangarajan, Rolla Abu-Arja, Vinita Pai, Gregory M T Guilcher, Sandeep Soni
Unrelated donor (URD) hematopoietic cell transplants (HCT) in children with sickle cell disease (SCD) is associated with a high incidence of rejection and graft versus host disease. We report on first four patients with severe SCD who underwent URD HCT using a novel myeloablative and immunosuppressive regimen comprising of busulfan, fludarabine and anti-thymocyte globulin with a single dose of post-transplant cyclophosphamide along with tacrolimus and mycophenolate mofetil for graft versus host disease prophylaxis...
October 20, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29055682/grade-ii-acute-graft-versus-host-disease-and-higher-nucleated-cell-graft-dose-improve-progression-free-survival-after-hla-haploidentical-transplant-with-post-transplant-cyclophosphamide
#20
Shannon R McCurdy, Christopher G Kanakry, Hua-Ling Tsai, Yvette L Kasamon, Margaret M Showel, Javier Bolaños-Meade, Carol Ann Huff, Ivan Borrello, William H Matsui, Robert A Brodsky, Richard F Ambinder, Maria P Bettinotti, Ephraim J Fuchs, Gary L Rosner, Richard J Jones, Leo Luznik
Compared with standard graft-versus-host disease (GVHD) prophylaxis platforms, post-transplantation cyclophosphamide (PTCy) after T cell-replete HLA-haploidentical (haplo) bone marrow transplantation (BMT) reduces the risk of grades III to IV acute (a) and chronic (c) GVHD but maintains similar rates of grade II aGVHD. Given that mild GVHD has been associated with reduced treatment failure in HLA-matched BMT, we evaluated the risk factors for and effects of GVHD on survival in 340 adults with hematologic malignancies who engrafted after nonmyeloablative haplo-BMT with PTCy, mycophenolate mofetil, and tacrolimus...
October 18, 2017: Biology of Blood and Marrow Transplantation
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