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Biology of Blood and Marrow Transplantation

Tania Jain, Mohamad Bassam Sonbol, Belal Firwana, Kantha R Kolla, Diana Almader-Douglas, Jeanne Palmer, Rafael Fonseca
Autologous stem cell transplantation (SCT) is the standard of care for all transplant eligible patients diagnosed with multiple myeloma (MM). Various studies have compared clinical outcomes with frontline SCT ("Early SCT") versus standard dose therapy (SDT) alone, with or without salvage SCT ("SDT/ late SCT"). In this meta-analysis, we compare overall survival (OS) and progression free survival (PFS) outcomes with these two treatment approaches. Twelve studies were identified, including 3,633 patients, of which 1,811 received early SCT while 1,822 received SDT/ late SCT...
September 20, 2018: Biology of Blood and Marrow Transplantation
Firoozeh Sahebi, Laurent Garderet, Abraham S Kanate, Diderik-Jan Eikema, Nina Simone Knelange, Omar F Dávila Alvelo, Yener Koc, Didier Blaise, Qaiser Bashir, José M Moraleda, Peter Dreger, James F Sanchez, Stefan Ciurea, Harry Schouten, Nirav N Shah, Mareike Verbeek, Wolf Rösler, Jose L Diez-Martin, Stefan Schoenland, Anita D'Souza, Nicolaus Kröger, Parameswaran Hari
Allogeneic hematopoietic cell transplantation (allo-HCT) using siblings and matched donors has the potential for long-term disease control in a subset of high-risk multiple myeloma (MM) patients. However, the data on using haploidentical donors in this disease are limited. We conducted a retrospective analysis to examine the outcomes of patients with MM who underwent haploidentical allo-HCT within EBMT/CIBMTR centers. A total of 96 patients underwent haploidentical transplantation between 2008 and 2016. With a median follow up of 24...
September 20, 2018: Biology of Blood and Marrow Transplantation
Melhem M Solh, Scott R Solomon, Lawrence E Morris, Xu Zhang, H Kent Holland, Asad Bashey
The impact of conditioning intensity on different disease risk index (DRI) groups has not been evaluated. We retrospectively analyzed AML/MDS hematopoietic cell transplantation (HCT) recipients in two groups based on DRI, to assess the impact of conditioning intensity on overall survival, disease free survival (DFS), relapse, and non-relapse mortality (NRM). A total of 380 patients with either high/very high (n = 148) or low/intermediate DRI (232) myeloid malignancy (AML 278, MDS 102) were included in the analysis...
September 19, 2018: Biology of Blood and Marrow Transplantation
Erin E Hillhouse, Stéphanie Thiant, Moutuaata M Moutuou, Félix Lombard-Vadnais, Rachel Parat, Jean-Sébastien Delisle, Imran Ahmad, Denis-Claude Roy, Martin Guimond, Jean Roy, Sylvie Lesage
Chronic graft-versus-host disease (cGVHD) is a major complication affecting 50 to 80% of long-term survivors of allogeneic hematopoietic stem cell transplantation. Current cGVHD therapies are neither specific nor curative and patients are typically maintained for several months to years under immunosuppressive regimens that are associated with important side effects and increased susceptibility to life-threatening infections. As a result, continued investigation into the pathology of the disease and the search for novel diagnostic and therapeutic strategies to treat cGVHD remains a high priority...
September 19, 2018: Biology of Blood and Marrow Transplantation
Parinda A Mehta, Seth J Rotz, Navneet S Majhail
A slow but definite progress has been made in recognizing the differences in disease biology, host factors, and psychosocial issues related to management of hematologic malignancies including hematopoietic cell transplantation (HCT) in the adolescent and young adult (AYA) population. Improvement in survival rates among AYAs undergoing HCT for hematologic malignancies have paralleled those among children and older adults in the contemporary era. However, overall outcomes remain inferior compared to children largely due to higher rates of treatment related mortality and late relapses in AYA HCT recipients...
September 19, 2018: Biology of Blood and Marrow Transplantation
Joseph Mikhael
No abstract text is available yet for this article.
September 19, 2018: Biology of Blood and Marrow Transplantation
Ensi Voshtina, Aniko Szabo, Mehdi Hamadani, Timothy S Fenske, Anita D'Souza, Saurabh Chhabra, Wael Saber, William R Drobyski, Parameswaran Hari, Nirav N Shah
Allogeneic hematopoietic cell transplantation (allo-HCT) is a high-risk treatment option for patients with hematologic malignancies. Advanced age and obesity can impact outcomes after allo-HCT. Previous registry studies of all age groups found that obesity does not affect outcomes. However, obesity can accelerate age-related decline in physical function and exacerbate comorbid conditions in older patients. Studies evaluating the effect of obesity on elderly patients undergoing allo-HCT are lacking. We performed a retrospective analysis of 86 non-obese (BMI <30) and obese (BMI ≥30) patients age ≥60 who underwent allo-HCT for myeloid malignancies between January 2010 to June 2015...
September 19, 2018: Biology of Blood and Marrow Transplantation
Reiko Ito, Yoshihiro Inamoto, Yoshitaka Inoue, Ayumu Ito, Takashi Tanaka, Shigeo Fuji, Keiji Okinaka, Saiko Kurosawa, Sung-Won Kim, Takuya Yamashita, Takahiro Fukuda
To characterize the incidences and outcomes of late acute (LA) and chronic GVHD in East Asians according to the 2014 NIH criteria, we retrospectively analyzed 506 consecutive Japanese patients who had a first allogeneic hematopoietic cell transplantation (HCT) at our center between 2006 and 2013. According to manifestations at onset, 91 patients (60%) had LA GVHD and 60 (40%) had chronic GVHD. The cumulative incidences of LA and chronic GVHD were 20% and 17%, respectively, at 48 months after HCT. The involved sites at the onset of LA GVHD included the skin (71%), gut (13%), and liver (8%)...
September 19, 2018: Biology of Blood and Marrow Transplantation
Troy C Lund, Kwang Woo Ahn, Heather R Tecca, Megan V Hilgers, Hisham Abdel-Azim, Allistair Abraham, Miguel Angel Diaz, Sherif M Badawy, Larisa Broglie, Valerie Brown, Christopher C Dvorak, Marta Gonzalez-Vicent, Hasan Hashem, Robert J Hayashi, David A Jacobsohn, Michael W Kent, Chi-Kong Li, Steven P Margossian, Paul L Martin, Parinda Mehta, Kasiani Myers, Richard Olsson, Kristin Page, Michael A Pulsipher, Peter J Shaw, Angela R Smith, Brandon M Triplett, Michael R Verneris, Mary Eapen
Children with acute leukemia who relapse after hematopoietic cell transplant (HCT) have few therapeutic options. We studied 251 children and young adults with acute myeloid or lymphoblastic leukemia who underwent a second HCT for relapse after their first HCT. The median age at second HCT was 11 years and the median interval between first and second HCT, 17 months. Most (n=187; 75%) were in remission, received myeloablative conditioning regimen (n=157; 63%) and unrelated donor HCT (n=230; 92%). The 2-year probability of leukemia-free survival (LFS) after transplantation in remission was 33% compared to 19% for transplantations that were not in remission (p=0...
September 19, 2018: Biology of Blood and Marrow Transplantation
Jessica Michaud Davis, Anastasia Ivanova, Yunro Chung, J Ryan Shaw, Kamakshi Rao, Jonathan PtachcinskidAndrew Sharf, Jonathan Serody, Paul Armistead, William A Wood, James Coghill, Katarzyna Jamieson, Benjamin G Vincent, Marcie Riches, Thomas Shea, Maurice Alexander
Targeted busulfan dosing helps to limit chemotherapy-related toxicity and optimize disease outcomes in hematopoietic stem cell transplant (HCT). The objective of this study was to evaluate busulfan exposure from a pharmacokinetic (PK)-guided dosing strategy utilizing a test dose. This retrospective evaluation included adult patients who underwent HCT at our institution with busulfan-based myeloablative (> 9 mg/kg) conditioning from January 2014 through October 2015. A weight-based test dose of 0.8 mg/kg was used with PK assessments to predict area under the curve (AUCpred ) achieved with weight-based dosing, with a goal AUC of 4800 µM*min (AUCtarget )...
September 19, 2018: Biology of Blood and Marrow Transplantation
Irit Avivi
No abstract text is available yet for this article.
September 19, 2018: Biology of Blood and Marrow Transplantation
Flora Hoodin, Leah LaLonde, Josh Errickson, Kristen Votruba, Rachel Kentor, Erin Gatza, Pavan Reddy, Sung Won Choi
Myeloablative conditioning allogeneic hematopoietic cell transplantation (HCT) puts patients at greater risk for significant cognitive and quality of life decline compared with recipients of reduced intensity conditioning or autologous HCT. Vorinostat, an HDAC inhibitor, has been shown to have neuroprotective and neurorestorative effects in preclinical models of neurological diseases. Thus, within the context of a myeloablative conditioning phase II clinical trial of vorinostat combined with tacrolimus and methotrexate for GVHD prophylaxis, we conducted an ancillary study to evaluate feasibility of assessing associations between Vorinostat and neurocognitive function and quality of life (ClinicalTrials...
September 19, 2018: Biology of Blood and Marrow Transplantation
Katharina Kriegsmann, Maurizio Wack, Petra Pavel, Anita Schmitt, Mark Kriegsmann, Thomas Bruckner, Carsten Müller-Tidow, Patrick Wuchter
Many transplant centers routinely collect one or more autologous peripheral blood stem cell (PBSC) grafts in patients with hemato-oncological and autoimmune disorders. However, subsequent high-dose chemotherapy (HD-CHT) and autologous blood stem cell transplantation (ABSCT) are often not performed for a variety of reasons. Currently, little is known about the actual utilization rate of the stored PBSCs. We retrospectively analyzed the collection, storage and disposal practices of PBSC products from a large cohort of patients (n=1,020) with hematological, oncological and autoimmune disorders at our institution during a 12-year period...
September 19, 2018: Biology of Blood and Marrow Transplantation
Amandeep Salhotra, Matthew Mei, Tracey Stiller, Sally Mokhtari, Alex F Herrera, Robert Chen, Leslie Popplewell, Jasmine Zain, Haris Ali, Karamjeet Sandhu, Elizabeth Budde, Auayporn Nademanee, Stephen J Forman, Ryotaro Nakamura
Current standard of care for patients with Hodgkin's and non-Hodgkin's lymphoma is high does conditioning with autologous stem cell transplantation (ASCT). For some patients (i.e., highest risk disease, insufficient stem cell number after mobilization, or patients whose bone marrow is involved with the disease) allogeneic transplantation (alloHCT) offers potential cure. However, majority of patients undergoing alloHCT, receive reduced intensity conditioning as preparative regimen and studies assessing outcomes of patients after alloHCT with myeloablative conditioning (MAC) are limited...
September 15, 2018: Biology of Blood and Marrow Transplantation
Jocelyn S Gandelman, John Zic, Anna K Dewan, Stephanie J Lee, Mary Flowers, Corey Cutler, Joseph Pidala, Heidi Chen, Madan H Jagasia, Eric R Tkaczyk
Little is known about the anatomic distribution of cutaneous chronic graft-versus-host disease (cGVHD). Using data from the cGVHD Consortium Improving Outcomes Assessment Study, we describe the frequency and extent of erythema, superficial, and deep sclerosis in 8 anatomic sites in patients with incident disease (new cGVHD diagnosis within three months of study entry) and on systemic therapy. Of 339 patients with incident disease, 182 (54%) had skin involvement. When an extremity was involved, the same type of disease was present contralaterally in 92% of cases, revealing a high level of symmetry...
September 13, 2018: Biology of Blood and Marrow Transplantation
Nicole L Watts, Marisa B Marques, Daniel B Peavey, Racquel Innis-Shelton, Ayman Saad, Antonio Di Stasi, Donna Salzman, Lawrence S Lamb, Luciano J Costa
Filgrastim (FIL) is the most common growth factor combined with plerixafor for autologous hematopoietic progenitor cell mobilization, but requires daily, multi-injection administration. We adopted a standardized mobilization regimen with pegfilgrastim (PEG) and upfront plerixafor, allowing for a single injection given the long half-life and slow elimination of PEG. Between 2015 and 2017, 235 patients with lymphoma or plasma cell dyscrasias underwent mobilization with PEG 6 mg on day 1 and upfront plerixafor 24 mg on day 3 followed by apheresis on day 4 regardless of peripheral blood CD34+...
September 13, 2018: Biology of Blood and Marrow Transplantation
Charalampia Kyriakou, Ariane Boumendil, Herve Finel, NNNorbert Schmitz, Niels Smedegaard Andersen, Didier Blaise, Patrice Chevallier, Paul Browne, Ram Malladi, Dietger Niederwieser, Antonio Pagliuca, Frank Kroschinsky, Silvia Montoto, Peter Dreger
BACKGROUND: More than 60% of patients with non-Hodgkin lymphoma (NHL) are over 60 years old at presentation. The purpose of this study was to compare the potential risks and benefits of allogeneic HSCT in elderly patients with NHL with younger patients in a large sample taking also into account comorbidity information. METHODS: Eligible were all patients >=18 years who had received an alloHCT from a matched sibling or unrelated donor for NHL between 2003 and 2013 and were registered with the EBMT...
September 13, 2018: Biology of Blood and Marrow Transplantation
Kirsten Williams
No abstract text is available yet for this article.
September 12, 2018: Biology of Blood and Marrow Transplantation
Vikas Gupta, Heidi E Kosiorek, Adam Mead, Rebecca B Klisovic, John P Galvin, Dmitriy Berenzon, Abdulraheem Yacoub, Auro Viswabandya, Ruben A Mesa, Judith Goldberg, Leah Price, Mohamed E Salama, Rona Singer Weinberg, Raajit Rampal, Noushin Farnoud, Amylou C Dueck, John O Mascarenhas, Ronald Hoffman
We evaluated the feasibility of ruxolitinib therapy followed by a reduced intensity conditioning (RIC) regimen for myelofibrosis (MF) patients undergoing transplant in a two stage Simon phase II trial. The aims were to decrease the incidence of graft failure (GF) and non-relapse mortality (NRM) in comparison to previous Myeloproliferative Disorders Research consortium 101 study. The plan was to enrol 11 patients each in related donor (RD), and unrelated donor (URD) arms, with trial termination if ≥3 failures (GF or death by day +100 post-transplant) or ≥6 failures occurred in the RD and URD arm, respectively...
September 8, 2018: Biology of Blood and Marrow Transplantation
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