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Biology of Blood and Marrow Transplantation

Tiziana Lazzarotto, Angela Chiereghin, Antonio Piralla, Giulia Piccirilli, Alessia Girello, Giulia Campanini, Liliana Gabrielli, Cristina Costa, Arcangelo Prete, Francesca Bonifazi, Alessandro Busca, Roberto Cairoli, Anna Amelia Colombo, Marco Zecca, Francesca Sidoti, Gabriele Bianco, Pierpaolo Paba, Carlo Federico Perno, Rossana Cavallo, Fausto Baldanti
Currently, no consensus has been reached on the optimal blood compartment to be used for surveillance of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) DNAemia. Although several comparative studies have been performed correlating CMV and EBV DNA loads in whole blood (WB) vs plasma, to our knowledge, no studies have ever analyzed the kinetics of both viruses in the two blood compartments. In this retrospective non-interventional multicenter cohort study the kinetics of CMV and EBV DNA in 121 hematopoietic stem cell transplant recipients (HSCTR) have been investigated by analyzing in parallel 569 and 351 paired samples from 80 and 58 sequential episodes of CMV and EBV DNAemia, respectively...
March 12, 2018: Biology of Blood and Marrow Transplantation
Aida Siyahian, Saad Ullah Malik, Adeela Mushtaq, Carol L Howe, Aneela Majeed, Tirdad Zangeneh, Samar Iftikhar, Shahid Habib, Umar Zahid, Irbaz Bin Riaz, Zabih Warraich, Warda Faridi, Faiz Anwer
Patients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT) are at a very high risk of hepatitis B virus reactivation (HBVr). Lamivudine is commonly used as prophylaxis against HBVr in high risk patients undergoing allo-HSCT. Unfortunately, its efficacy is diminishing due to the development of HBV mutant drug resistant strains. With the availability of newer antiviral agents like Entecavir, Telbivudine, Adefovir and Tenofovir, it is important to assess their role in HBVr prophylaxis. A comprehensive search of seven databases was performed to evaluate efficacy of antiviral prophylaxis against HBVr in allo-HSCT patients (PubMed/Medline, Embase, Scopus, Cochrane Library, Web of Science, CINAHL, and ClinicalTrials...
March 12, 2018: Biology of Blood and Marrow Transplantation
Andrea Bacigalupo, Luca Laurenti
No abstract text is available yet for this article.
March 12, 2018: Biology of Blood and Marrow Transplantation
Li Liu, Xuyan Zhang, Sizhou Feng
Epstein-Barr virus related post-transplant lymphoproliferative disorders (EBV-PTLDs) are rare but potentially fatal complications of allogeneic hematopoietic stem cell transplantation (allo-HSCT), characterized by uncontrolled proliferation of EBV-infected lymphocytes. The most frequent risk factors include T cell depletion of graft, HLA mismatch, severe graft versus host disease (GVHD), EBV sero-mismatch (recipient-/donor+) and so on. EBV-PTLDs commonly manifest as fever and lymphadenopathy and may rapidly progress to multi-organ failure and even death...
March 9, 2018: Biology of Blood and Marrow Transplantation
Starling A Sim, Vivian K Y Leung, David Ritchie, Monica A Slavin, Sheena G Sullivan, Benjamin W Teh
BACKGROUND: Viral respiratory tract infections (vRTI) are a significant cause of morbidity and mortality in patients undergoing allogeneic haematopoietic stem cell transplantation (alloHSCT). This study aimed to assess the epidemiological characteristics, risk factors, and outcomes of vRTI occurring from conditioning to 100 days after HSCT in the era of molecular testing. METHODS: This study was a retrospective record review of alloHSCT patients at Royal Melbourne Hospital from January 2010 to December 2015...
March 9, 2018: Biology of Blood and Marrow Transplantation
Elizabeth M Catchpoole, Caitlin E Thirunavukarasu, Antiopi Varelias, Sanmarié Schlebusch, Stuart Olver, Nienke Zomerdijk, Emma Osland, Glen A Kennedy, Siok-Keen Tey, Geoffrey R Hill, Kate A Markey
The key complications of allogeneic bone marrow transplant (BMT) remain graft-versus-host disease (GVHD) and opportunistic infection. We have analyzed the blood stream infections (BSI) occurring between day -7 and day 100 in a cohort of 184 adult patients undergoing allogeneic BMT in our center. 167 of the 184 patients (91%) had blood cultures collected, and 69 (38%) patients had a confirmed BSI. Enterobacteriaceae, Pseudomonas aeruginosa, Enterococcus spp. and viridans Streptococcus spp. were the most commonly isolated organisms...
March 5, 2018: Biology of Blood and Marrow Transplantation
Machiko Kusuda, Shun-Ichi Kimura, Yukiko Misaki, Kazuki Yoshimura, Ayumi Gomyo, Jin Hayakawa, Masaharu Tamaki, Yu Akahoshi, Tomotaka Ugai, Kazuaki Kameda, Hidenori Wada, Yuko Ishihara, Koji Kawamura, Kana Sakamoto, Miki Sato, Kiriko Terasako-Saito, Misato Kikuchi, Hideki Nakasone, Shinichi Kako, Aki Tanihara, Yoshinobu Kanda
The actual heparin concentration of harvested allogeneic bone marrow varies among harvest centers. We monitor the activated partial thromboplastin time (APTT) of the patient during bone marrow infusion and administer prophylactic protamine according to the APTT. We retrospectively reviewed the charts of consecutive patients who underwent bone marrow transplantation without bone marrow processing at our center between April 2007 and March 2016 (n=94). APTT was monitored during marrow transfusion in 52 patients...
March 5, 2018: Biology of Blood and Marrow Transplantation
Moniek A de Witte, Dhifaf Sarhan, Zachary Davis, Martin Felices, Daniel A Vallera, Peter Hinderlie, Julie Curtsinger, Sarah Cooley, John Wagner, Jurgen Kuball, Jeffrey S Miller
Relapse is the most frequent cause of treatment failure after allogeneic hematopoietic stem cell transplantation (allo-HCT). NK cells and γδ T cells reconstitute early after allo-HCT, contribute to tumor immunosurveillance via MHC independent mechanisms and do not induce graft-versus-host disease (GVHD). Here we performed a quantitative and qualitative analysis of the NK and γδ T cell repertoire in healthy individuals, recipients of HLA-matched sibling or unrelated donor allo-HCT (MSD/MUD-HCT) and umbilical cord blood-HCT (UCB-HCT)...
March 2, 2018: Biology of Blood and Marrow Transplantation
Sharon Elad, Kevin Zinchuk, Shuli Li, Corey Cutler, Jane Liesveld, Nathaniel Treister
BACKGROUND: Chronic graft-versus-host disease (cGVHD) frequently affects the oral mucosa and is generally responsive to topical immunomodulatory therapies. Clinicians may benefit from guidance in choosing the most appropriate therapy with respect to practicality and cost. OBJECTIVE: To assess the economic considerations related to topical immunomodulatory treatments for management of oral mucosal cGVHD and their practical implications. METHOD: Topical treatments used for management of oral cGVHD were obtained from the NIH Consensus document for ancillary and supportive care...
March 1, 2018: Biology of Blood and Marrow Transplantation
Alessandra Forcina, Francesca Lorentino, Vincenzo Marasco, Chiara Oltolini, Magda Marcatti, Raffaella Greco, Maria Teresa Lupo-Stanghellini, Matteo Carrabba, Massimo Bernardi, Jacopo Peccatori, Consuelo Corti, Fabio Ciceri
Multidrug-resistant Gram-negative bacteria (MDR-GNB) are an emerging cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). Three-hundred-forty-eight consecutive patients transplanted at our hospital from July 2012 to January 2016 were screened for a pre-transplant MDR-GNB colonization and evaluated for clinical outcomes. A pre-transplant MDR-GNB colonization was found in 16.9% of allo-HSCT and in 9.6% of auto-HSCT recipients. Both in auto- and in allo-HSCT, carriers of a MDR-GNB showed no significant differences in overall survival (OS), transplant-related mortality (TRM) nor infection-related mortality (IRM) compared to non-carriers...
March 1, 2018: Biology of Blood and Marrow Transplantation
Yago Nieto, Peter F Thall, Junsheng Ma, Benigno C Valdez, Sairah Ahmed, Paolo Anderlini, Uday Popat, Roy B Jones, Elizabeth J Shpall, Chitra Hosing, Muzaffar Qazilbash, Partow Kebriaei, Amin Alousi, Melissa Timmons, Alison Gulbis, Alan Myers, Yasuhiro Oki, Michelle Fanale, Bouthaina Dabaja, Chelsea Pinnix, Sarah Milgrom, Richard Champlin, Borje S Andersson
We conducted a prospective phase 2 trial of gemcitabine, busulfan and melphalan (Gem/Bu/Mel) with autologous stem-cell transplantation (ASCT) in Hodgkin's lymphoma (HL) patients with primary refractory or poor-risk relapsed disease (extranodal relapse or within 1 year of frontline therapy). The trial was powered to detect a 2-year progression-free survival (PFS) rate improvement from a historical 50% (using BEAM) to 65%. We compared the study population with all other concurrent patients who were eligible for the trial but instead received BEAM at our center...
March 1, 2018: Biology of Blood and Marrow Transplantation
Karlo Perica, Kevin J Curran, Renier J Brentjens, Sergio A Giralt
Two commercial Chimeric Antigen Receptor (CAR) T cell therapies for CD19 expressing B cell malignancies, Kymriah and Yescarta, have recently been approved by the FDA. The administration of CAR T cells is a complex endeavor involving cell manufacture, tracking and shipping of apheresis products, and management of novel and severe toxicities. At Memorial Sloan Kettering Cancer Center, we have identified eight essential tasks that define the CAR T cell workflow. In this review, we discuss practical aspects of CAR T cell program development, including clinical, administrative, and regulatory challenges for successful implementation...
February 27, 2018: Biology of Blood and Marrow Transplantation
Nataliya P Buxbaum, Cemre Robinson, Ninet Sinaii, Alexander Ling, Lauren M Curtis, Steven Z Pavletic, Kristin Baird, Maya B Lodish
Pediatric allogeneic hematopoietic stem cell transplant (AHSCT) recipients with chronic graft-versus-host disease (cGVHD) are at high risk of endocrinopathies, particularly impaired bone mineral density (BMD). However, rates of BMD impairment in pediatric AHSCT recipients with cGVHD have not been well documented. We describe 33 patients with cGVHD that were referred to the NIH for the Natural History of Clinical and Biological Factors Determining Outcomes in Chronic Graft-Versus-Host Disease Study (NCT 0092235) and underwent formal BMD assessments via dual-energy X-ray absorptiometry (DEXA)...
February 26, 2018: Biology of Blood and Marrow Transplantation
Zachariah DeFilipp, Fabian M Troschel, David A Qualls, Shuli Li, Martin W Kuklinski, Maria Kempner, Ephraim Hochberg, Yi-Bin Chen, Areej El-Jawahri, Florian J Fintelmann
Sarcopenia, the loss of muscle mass, has been identified as a potential risk factor for adverse outcomes in hematopoietic cell transplantation (HCT) recipients. However, much remains unknown about change in body composition following HCT. We retrospectively evaluated computed tomography (CT) imaging from 315 lymphoma patients undergoing HCT at our institution between 2000 and 2014. Cross-sectional area of lean muscle, subcutaneous adipose tissue and visceral adipose tissue were measured on CT at the level of the third lumbar vertebral body prior to HCT, 1-year post-HCT, and 2...
February 26, 2018: Biology of Blood and Marrow Transplantation
Andrew J Cowan, Philip A Stevenson, Edward N Libby, Pamela S Becker, David G Coffey, Damian J Green, Teresa S Hyun, Jonathan R Fromm, Ajay K Gopal, Leona A Holmberg
BACKGROUND: Circulating plasma cells (CPCs) have been detected in patients with multiple myeloma (MM) at various stages of disease and associated with worse outcomes. Little data exist regarding the impact of CPCs at the time of autologous peripheral blood stem cell (PBSC) collection on outcomes, and the impact of maintenance therapy post autologous transplant (ASCT) on prognosis in patients with CPC containing collections. METHODS: All patients with MM who underwent first ASCT at Fred Hutchinson Cancer Research Center from 2012-2015 and had evaluation for CPCs at the time of PBSC collection were included in our analysis...
February 23, 2018: Biology of Blood and Marrow Transplantation
Adrien Picod, Agnès Bonnin, Giorgia Battipaglia, Federica Giannotti, Annalisa Ruggeri, Eolia Brissot, Florent Malard, Clémence Médiavilla, Ramdane Belhocine, Anne Vekhoff, Mor Sény Gueye, Simona Lapusan, Rosa Adaeva, Françoise Isnard, Ollivier Legrand, Minh-Tam Baylatry, Anne-Christine Joly, Myriam Labopin, Rémy Duléry, Mohamad Mohty
Sinusoidal obstruction syndrome (SOS), also known as hepatic veno-occlusive disease (VOD) is a serious complication after hematopoietic stem cell transplantation (HSCT). SOS/VOD usually occurs within 3 weeks of HSCT but the 2016 EBMT diagnosis criteria have been revised to include late forms. Prophylactic use of defibrotide is recommended in the pediatric setting but its value remains uncertain in the adult population. We report here a single center series of 63 adult patients considered at high risk of SOS/VOD, receiving defibrotide prophylaxis in combination with ursodeoxycholic acid between May 2012 and August 2016...
February 22, 2018: Biology of Blood and Marrow Transplantation
Patrick J Stiff, Pau Montesinos, Tony Peled, Efrat Landau, Noga Rosenheimer Goudsmid, Julie Mandel, Nira Hasson, Esti Olesinski, Ela Glukhman, David A Snyder, Einat Galamidi Cohen, Orna Srur Kidron, Dalia Bracha, Dorit Harati, Keren Ben-Abu, Etty Freind, Laurence S Freedman, Yael C Cohen, Liraz Olmer, Raya Barishev, Vanderson Rocha, Eliane Gluckman, Mary M Horowitz, Mary Eapen, Arnon Nagler, Guillermo Sanz
Umbilical cord blood transplantation (UCBT) has a high early mortality rate primarily related to transplanted stem cell dose. To decrease early mortality and enhance engraftment, a portion of selected cord blood units (20-50%) was expanded with cytokines and the copper chelator tetraethylenepentamine (carlecortemcel-L) and transplanted with the un-manipulated fraction after myeloablative conditioning. The primary endpoint was 100 day survival which was compared to a contemporaneous double-unit cord blood transplant (DUCBT) group...
February 22, 2018: Biology of Blood and Marrow Transplantation
Karina Tozatto-Maio, Federica Giannotti, Myriam Labopin, Annalisa Ruggeri, Fernanda Volt, Annalisa Paviglianiti, Chantal Kenzey, Hiromi Hayashi, Jan Cornelissen, Mauricette Michallet, Dimitrios Karakasis, Eric Deconinck, Pierre-Simon Rohrlich, Regis Peffault de la Tour, Didier Blaise, Eefke Petersen, Maud D'Aveni, Henrik Sengeloev, Thierry Lamy, Nigel H Russell, Edouard Forcade, Charles F Craddock, Arnon Nagler, Eliane Gluckman, Vanderson Rocha
Usually, after double umbilical cord blood transplant (DUCBT) only one of the transplanted units persists long term. The characteristics of the winning cord blood unit (W-CBU) that determine unit dominance and how they influence the outcomes of DUCBT remain unclear. We retrospectively analysed 347 patients with acute leukaemia transplanted with a DUCBT (694 CBU) from 2005 to 2013 who had documented neutrophil engraftment and a W-CBU identified by chimerism analysis, in order to identify unit characteristics impacting on dominance...
February 22, 2018: Biology of Blood and Marrow Transplantation
Stephanie J Lee, Betty K Hamilton, Joseph Pidala, Amin Alousi, Chareeni Kurukulasuriya, Lynn Onstad, Madan Jagasia, George Chen, Corey Cutler, Raewyn Brody, Mukta Arora, Sally Arai, Stefanie Sarantopoulos, Mary E Flowers
In 2014, the National Institutes of Health sponsored the second Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-vs-Host (GVHD). The purpose was to update recommendations about key elements of chronic GVHD research, including definitions for diagnosis, severity scoring, and response measures, based on empirical data published since the first 2005 Consensus Conference. The most significant modifications were to the response assessments, since studies demonstrated difficulty with the first consensus definitions...
February 21, 2018: Biology of Blood and Marrow Transplantation
Koji Kawamura, Hideki Nakasone, Saiko Kurosawa, Kazuki Yoshimura, Yukiko Misaki, Ayumi Gomyo, Jin Hayakawa, Masaharu Tamaki, Yu Akahoshi, Machiko Kusuda, Kazuaki Kameda, Hidenori Wada, Yuko Ishihara, Miki Sato, Kiriko Terasako-Saito, Misato Kikuchi, Shun-Ichi Kimura, Aki Tanihara, Shinichi Kako, Heiwa Kanamori, Takehiko Mori, Satoshi Takahashi, Shuichi Taniguchi, Yoshiko Atsuta, Yoshinobu Kanda
The aim of this study was to develop a new composite endpoint that accurately reflects the long-term success of allogeneic hematopoietic stem cell transplantation (allo-HCT), since the conventional graft-versus-host disease-free, relapse-free survival (GRFS) overestimates the impact of GVHD. First, we validated current GRFS (cGRFS), which recently was proposed as a more accurate endpoint of long-term transplant success. cGRFS was defined as survival without disease relapse/progression or active chronic GVHD at a given time after allo-HCT, calculated using two distinct methods; a linear combination of a Kaplan-Meier estimates approach and a multistate modelling approach...
February 21, 2018: Biology of Blood and Marrow Transplantation
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