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Biology of Blood and Marrow Transplantation

Juan Gea-Banacloche, Krishna Komanduri, Paul Carpenter, Sophie Paczesny, Stefanie Sarantopoulos, Jo-Anne Young, Nahed El Kassar, Robert Q Le, Kirk Schultz, Linda M Griffith, Bipin Savani, John R Wingard
Immune reconstitution following hematopoietic stem cell transplantation (HCT) beyond one year is not completely understood. Many transplant recipients who are free of graft versus host disease (GVHD) and not receiving any immunosuppression more than a year after transplant seem to be able to mount appropriate immune responses to common pathogens and respond adequately to immunizations. However, two large registry studies over the last two decades seem to indicate that infection is a significant cause of late mortality in some patients, even in the absence of concomitant GVHD...
October 14, 2016: Biology of Blood and Marrow Transplantation
Galen E Switzer, Jessica Bruce, Deidre M Kiefer, Hati Kobusingye, Rebecca Drexler, RaeAnne M Besser, Dennis L Confer, Mary M Horowitz, Roberta J King, Bronwen E Shaw, Marcie Riches, Brandon Hayes-Lattin, Michael Linenberger, Brian Bolwell, Scott D Rowley, Mark R Litzow, Michael A Pulsipher
The increasing number of older adults with blood-related disorders and the introduction of reduced intensity conditioning regimens has led to increases in hematopoietic stem cell (HSC) transplantation among older adults and a corresponding increase in the age of siblings who donate HSCs to these patients. Data regarding the donation-related experiences of older donors is lacking. The Related Donor Safety Study (RDSafe) aimed to examine/compare health-related quality of life (HRQoL) of older versus younger HSC donors...
October 14, 2016: Biology of Blood and Marrow Transplantation
Aline Clavert, Zinaida Peric, Eolia Brissot, Florent Malard, Thierry Guillaume, Jacques Delaunay, Viviane Dubruille, Steven Le Gouill, Beatrice Mahe, Thomas Gastinne, Nicolas Blin, Jean-Luc Harousseau, Philippe Moreau, Noel Milpied, Mohamad Mohty, Patrice Chevallier
Late complications (LC) and quality of life (QOL) were analyzed in 110 adult patients who underwent reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (allo-SCT) and were alive for more than two years after allo-SCT. Overall survival of these patients was 93% (95%CI, 88-99%) and 81% (95%CI, 71-94%) at 5 and ten years, respectively. The primary cause of death was a recurrence of primary malignancy. With a median follow-up of 4.6 years (range, 2-12.1), chronic graft versus host disease (cGVHD) was the most prevalent late effect with a cumulative incidence (CI) of 66% (95%CI, 57-74) at ten years...
October 14, 2016: Biology of Blood and Marrow Transplantation
Gretchen A Hoff, Johannes C Fischer, Katharine Hsu, Sarah Cooley, Jeffrey S Miller, Tao Wang, Michael Haagenson, Stephen Spellman, Stephanie J Lee, Markus Uhrberg, Jeffrey M Venstrom, Michael R Verneris
Natural Killer (NK) cells are important in graft versus leukemia responses following hematopoietic cell transplantation (HCT). A variety of surface receptors dictate NK cell function, including killer immunoglobulin receptor (KIR) recognition of HLA-C. Previous single center studies show that HLA-C epitopes, designated C1 and C2, were associated with allogeneic-HCT outcomes; specifically recipients homozygous for the C1 epitope (C1/C1) experienced a survival benefit. Additionally, mismatching at HLA-C was beneficial in recipients possessing at least one C2 allele, while the opposite was true for homozygous C1 (C1/C1) recipients where HLA-C mismatching resulted in worse outcomes...
October 13, 2016: Biology of Blood and Marrow Transplantation
Eva Rettinger, Michael Merker, Emilia Salzmann-Manrique, Hermann Kreyenberg, Thomas Krenn, Matthias Dürken, Jörg Faber, Sabine Huenecke, Claudia Cappel, Melanie Bremm, Andre Willasch, Shahrzad Bakhtiar, Andrea Jarisch, Jan Soerensen, Thomas Klingebiel, Peter Bader
Monitoring of minimal residual disease (MRD) or chimerism may help guide pre-emptive immunotherapy (IT) with a view to preventing relapse in childhood acute lymphoblastic leukemia (ALL) post-transplant. ALL-patients consecutively transplanted in Frankfurt/Main, Germany between January 1(st), 2005, and July 1(st), 2014, were included in this retrospective study. Chimerism monitoring was performed in all, MRD assessment in 58 of 89 patients. IT was guided in 19 of 24 patients with mixed chimerism (MC) and MRD and by MRD only in another 4 patients with complete chimerism (CC)...
October 11, 2016: Biology of Blood and Marrow Transplantation
John R Wingard, William A Wood, Michael Martens, Jennifer Le-Rademacher, Brent Logan, Jennifer M Knight, Paul B Jacobsen, Heather Jim, Navneet S Majhail, Karen Syrjala, J Douglas Rizzo, Stephanie J Lee
Blood and Marrow Transplant Clinical Trials Network (BMT CTN) Protocol 0902 evaluated whether exercise and stress management training prior to hematopoietic cell transplantation (HCT) improved physical and mental functioning after HCT. Neither overall survival nor other patient-reported transplant outcomes were improved by the training intervention. In some animal studies of HCT, moderate intensity exercise for 8 weeks before HCT has been associated with positive effects on hematopoietic progenitors resulting in improved donor engraftment and improved survival...
October 11, 2016: Biology of Blood and Marrow Transplantation
Andrew C Dietz, Christine N Duncan, Blanche P Alter, Dorine Bresters, Morton J Cowan, Luigi Notarangelo, Philip S Rosenberg, Shalini Shenoy, Roderick Skinner, Mark C Walters, John Wagner, K Scott Baker, Michael A Pulsipher
An international consensus conference sponsored by the Pediatric Blood and Marrow Transplant consortium entitled, "Late Effects Screening and Recommendations Following Allogeneic Hematopoietic Cell Transplant for Immune Deficiency and Non-malignant Hematologic Disease was held in Minneapolis, Minnesota on May 10-11, 2016. The purpose of the conference was to address the unmet need for a greater understanding of and the screening for long-term complications in the growing population of survivors of transplantation for non-malignant disorders...
October 10, 2016: Biology of Blood and Marrow Transplantation
Yu-Tong Wang, Yuan Kong, Yang Song, Wei Han, Yuan-Yuan Zhang, Xiao-Hui Zhang, Ying-Jun Chang, Zheng-Fan Jiang, Xiao-Jun Huang
No abstract text is available yet for this article.
October 7, 2016: Biology of Blood and Marrow Transplantation
Miguel-Angel Perales
No abstract text is available yet for this article.
October 6, 2016: Biology of Blood and Marrow Transplantation
Silke Heidenreich, Dimitris Ziagkos, Liesbeth C de Wreede, Anja van Biezen, Jürgen Finke, Uwe Platzbecker, Dietger Niederwieser, Hermann Einsele, Wolfgang Bethge, Michael Schleuning, Dietrich W Beelen, Johanna Tischer, Arnon Nagler, Bertram Glass, Johan Maertens, Lucrecia Yáñez, Yves Beguin, Heinz Sill, Christof Scheid, Matthias Stelljes, Arnold Ganser, Pierre Zachée, Dominik Selleslag, Theo de Witte, Marie Robin, Nicolaus Kröger
In this retrospective analysis we evaluated the outcome of 313 patients aged 70 years or older in the registry of the European Society for Blood and Marrow Transplantation (EBMT) with MDS (n=221) and secondary acute myeloid leukemia (sAML) (n= 92) who underwent allogeneic hematopoietic stem cell transplantation (HSCT) from related (n=79) or unrelated donors (n=234). Median age at HSCT was 72 years (70-78 years). Conditioning regimen was non-myeloablative (NMA, n=54), reduced-intensity (RIC, n=207) or standard-intensity (MAC, n=52)...
October 5, 2016: Biology of Blood and Marrow Transplantation
William Nigel Patton, Ian Nivison-Smith, Peter Bardy, Anthony Dodds, David Ma, Peter John Shaw, John Kwan, Leonie Wilcox, Andrew Butler, John M Carter, Hilary Blacklock, Jeffrey Szer
A previous study found that platelet recovery and mortality were worse in recipients of myeloablative bone marrow transplants where graft transit times were longer than 20 hours. This retrospective study of unrelated myeloablative allogeneic transplantation performed within Australia and NZ analysed transplant outcomes according to graft transit times. Of evaluable cases (n=233), 76 (33%) grafts were sourced from bone marrow (BM) and 157 (67%) from peripheral blood. Grafts sourced from Australia and NZ (47% of total) were associated with a median transit time of 6 hours versus 32 hours for overseas sourced grafts (53% of total)...
October 4, 2016: Biology of Blood and Marrow Transplantation
Kenneth R Cooke, Leo Luznik, Stefanie Sarantopoulos, Frances T Hakim, Madan Jagasia, Daniel H Fowler, Marcel R M van den Brink, John A Hansen, Robertson Parkman, David B Miklos, Paul J Martin, Sophie Paczesny, Georgia Vogelsang, Steven Pavletic, Jerome Ritz, Kirk R Schultz, Bruce R Blazar
Chronic graft-versus-host disease (GVHD) is the leading cause of late, non-relapse, mortality and disability in allogeneic hematopoietic cell transplantation (HCT) patients and a major obstacle to improving outcomes. Chronic GVHD biology remains enigmatic, but understanding the underpinnings of the immunologic mechanisms responsible for the initiation and progression of disease is fundamental to developing effective prevention and treatment strategies. The goals of this task force review are as follows: • Summarize the current "state-of-the-science" regarding pathogenic mechanisms of chronic GVHD and critical knowledge gaps...
October 3, 2016: Biology of Blood and Marrow Transplantation
Shahrukh K Hashmi, Christopher Bredeson, Rafael F Duarte, Stephanie Farnia, Susan Ferrey, Courtney Fitzhugh, Mary Ed Flowers, James Gajewski, Dennis Gastineau, Melissa Greenwald, Madan Jagasia, Patricia Martin, J Douglas Rizzo, Kimberly Schmit-Pokorny, Navneet S Majhail
Hematopoietic cell transplantation (HCT) survivors are at risk for development of late complications and require lifelong monitoring for screening and prevention of late effects. There is an increasing appreciation of the issues related to healthcare delivery and coverage that are faced by HCT survivors. The 2016 National Institutes of Health Blood and Marrow Transplant Late Effects Initiative included an international and broadly representative Healthcare Delivery Working Group that was tasked with identifying research gaps pertaining to healthcare delivery and to identify initiatives that may yield a better understanding of the long-term value and costs of care for HCT survivors...
October 3, 2016: Biology of Blood and Marrow Transplantation
Michael Scordo, Valkal Bhatt, Meier Hsu, Antonio M Omuro, Matthew J Matasar, Lisa M DeAngelis, Parastoo B Dahi, Craig H Moskowitz, Sergio A Giralt, Craig S Sauter
High-dose therapy and autologous stem cell transplantation (HDT-ASCT) with thiotepa, busulfan, cyclophosphamide (TBC) conditioning has emerged as an effective post-induction treatment strategy for patients with primary (PCNSL) or secondary central nervous system lymphoma (SCNSL), but it is associated with considerable toxicity and transplant-related mortality (TRM) in the modern era. Forty-three adult patients with chemosensitive PCNSL or SCNSL received TBC conditioned ASCT between 2006 and 2015. Twenty-eight of these patients received pharmacokinetically (PK)-targeted busulfan dosing...
October 3, 2016: Biology of Blood and Marrow Transplantation
Raffaella Greco, Lara Crucitti, Maddalena Noviello, Sara Racca, Daniele Mannina, Alessandra Forcina, Francesca Lorentino, Veronica Valtolina, Serena Rolla, Roee Dvir, Mara Morelli, Fabio Giglio, Maria Chiara Barbanti, Maria Teresa Lupo Stanghellini, Chiara Oltolini, Luca Vago, Paolo Scarpellini, Andrea Assanelli, Matteo G Carrabba, Sarah Marktel, Massimo Bernardi, Consuelo Corti, Massimo Clementi, Jacopo Peccatori, Chiara Bonini, Fabio Ciceri
Human herpesvirus 6 (HHV-6) is increasingly recognized as a potentially life-threatening pathogen in allogeneic hematopoietic stem cell transplantation (alloSCT). We retrospectively evaluated 54 adult patients who developed positivity to HHV-6 after alloSCT. The median time from alloSCT to HHV-6 reactivation was 34 days. HHV-6 was present in plasma samples from 31 patients, in bone marrow (BM) of 9 patients, in bronchoalveolar lavage fluid and liver or gut biopsy specimens from 33 patients, and in cerebrospinal fluid of 7 patients...
September 30, 2016: Biology of Blood and Marrow Transplantation
Alessandro Busca, Anna Candoni, Ernesta Audisio, Roberto Passera, Benedetto Bruno, Federico Monaco, Nicola Mordini, Adriana Vacca, Mario Delia, Franco Aversa, Livio Pagano
Patients with acute myeloid leukemia (AML) during induction chemotherapy and those who receive allogeneic hematopoietic stem cell transplantation (HSCT) are at higher risk of invasive fungal infections (IFI). In the present study, we investigated whether the risk of IFI in AML patients receiving HSCT might be affected by the antifungal prophylaxis with posaconazole administered during the induction/salvage chemotherapy treatment. Between August 2001 and April 2015, 130 patients with AML received itraconazole/fluconazole (group A) and 99 received posaconazole (group B) as antifungal prophylaxis after induction/salvage chemotherapy at 7 Italian centers and all patients received fluconazole as antifungal prophylaxis after HSCT...
September 22, 2016: Biology of Blood and Marrow Transplantation
Hirotoshi Sakaguchi, Nobuhiro Watanabe, Kimikazu Matsumoto, Hiromasa Yabe, Shunichi Kato, Atsushi Ogawa, Jiro Inagaki, Hiroaki Goto, Katsuyoshi Koh, Nao Yoshida, Keisuke Kato, Yuko Cho, Yoshiyuki Kosaka, Yoshiyuki Takahashi, Masami Inoue, Koji Kato, Yoshiko Atsuta, Koichi Miyamura
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the best therapeutic option for childhood high-risk acute leukemia. However, which donor source is optimal for children lacking an identical sibling remains unclear. To evaluate the clinical impact of donor source on allo-HSCT in childhood acute leukemia, we analyzed data from 577 children who underwent allo-HSCT after a myeloablative regimen during first or second complete remission from 2005 to 2012, using registry data of the Japan Society for Hematopoietic Cell Transplantation, and we compared outcomes of 7/8 to 8/8 HLA allelic-matched unrelated bone marrow transplantation (UR-BMT, n = 218) and 4/6 to 6/6 HLA allelic-matched unrelated cord blood transplantation (UR-CBT, n = 200) to those of HLA-identical related bone marrow transplantation (ID-BMT, n = 159)...
September 22, 2016: Biology of Blood and Marrow Transplantation
Shinsuke Takagi, Kazuhiro Masuoka, Naoyuki Uchida, Mineo Kurokawa, Hirohisa Nakamae, Kazunori Imada, Koji Iwato, Tatsuo Ichinohe, Yoshiko Atsuta, Akiyoshi Takami, Shingo Yano
To clarify the outcome of allogeneic hematopoietic cell transplantation (HCT) for leukemic transformation (LT) preceded by Philadelphia chromosome-negative (Ph-neg) myeloproliferative neoplasms (MPNs), we conducted a retrospective study using the national registry database of the Japan Society for Hematopoietic Cell Transplantation. From 2000 to 2013, 39 patients underwent their first allogeneic HCT with related bone marrow or peripheral blood stem cells (n = 8), unrelated bone marrow (n = 15), and unrelated umbilical cord blood (n = 16)...
September 22, 2016: Biology of Blood and Marrow Transplantation
Lia Minculescu, Hanne Vibeke Marquart, Lone Smidstrups Friis, Soeren Lykke Petersen, Ida Schiødt, Lars Peter Ryder, Niels Smedegaard Andersen, Henrik Sengeloev
Early immune reconstitution plays a critical role in clinical outcome after allogeneic hematopoietic stem cell transplantation (HSCT). Natural killer (NK) cells are the first lymphocytes to recover after transplantation and are considered powerful effector cells in HSCT. We aimed to evaluate the clinical impact of early NK cell recovery in T cell-replete transplant recipients. Immune reconstitution was studied in 298 adult patients undergoing HSCT for acute myeloid leukemia, acute lymphoblastic leukemia, and myelodysplastic syndrome from 2005 to 2013...
September 21, 2016: Biology of Blood and Marrow Transplantation
Pooja Khandelwal, Chie Emoto, Tsuyoshi Fukuda, Alexander A Vinks, Lisa Neumeier, Christopher E Dandoy, Javier El-Bietar, Sharat Chandra, Stella M Davies, Jacob J Bleesing, Michael B Jordan, Parinda A Mehta, Sonata Jodele, Michael S Grimley, Ashish Kumar, Kasiani C Myers, Rebecca A Marsh
We describe a single-center prospective study of alemtuzumab as a second-line agent for steroid-refractory (SR) acute graft-versus-host disease (aGVHD) in pediatric and young adult allogeneic hematopoietic stem cell transplant recipients. Alemtuzumab was administered for grades II to IV aGVHD if patients did not improve within 5 days or worsened within 48 hours after corticosteroids. Interim analyses of alemtuzumab levels and response were performed after every 5 patients enrolled, resulting in 3 dosing cohorts, as follows: (1) ...
September 21, 2016: Biology of Blood and Marrow Transplantation
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