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Biology of Blood and Marrow Transplantation

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https://www.readbyqxmd.com/read/28918304/haploidentical-transplantation-for-older-patients-with-acute-myeloid-leukemia-and-myelodysplastic-syndrome
#1
Stefan O Ciurea, Mithun V Shah, Rima M Saliba, Sameh Gaballa, Piyanuch Kongtim, Gabriela Rondon, Julianne Chen, Whitney Wallis, Kai Cao, Marina Konopleva, Naval Daver, Jorge Cortes, Farhad Ravandi, Amin Alousi, Sairah Ahmed, Uday Popat, Simrit Parmar, Qaiser Bashir, Oran Betul, Chitra Hosing, Elizabeth J Shpall, Katayoun Rezvani, Issa F Khouri, Partow Kebriaei, Richard E Champlin
Allogeneic stem cell transplant (ASCT) with HLA matched donors is increasingly used for older patients with AML/MDS. It remains unclear if haploidentical transplantation (haploSCT) is a suitable option for older patients with this disease. We analyzed 43 patients with AML/MDS (median age 61 years) who underwent a haploSCT at our institution. All the patients received a fludarabine-melphalan-based reduced-intensity conditioning regimen and post-transplant cyclophosphamide-based GVHD prophylaxis. Except one patient who had early death, the remaining 42 patients (98%) engrafted donor cells...
September 13, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28890406/comparison-of-conditioning-with-fludarabine-busulfan-and-fludarabine-melphalan-in-allogeneic-transplant-recipients-50-years-or-older
#2
Koji Kawamura, Shinichi Kako, Shuichi Mizuta, Ken Ishiyama, Jun Aoki, Shingo Yano, Takahiro Fukuda, Naoyuki Uchida, Yukiyasu Ozawa, Tetsuya Eto, Koji Iwato, Heiwa Kanamori, Kaoru Kahata, Tadakazu Kondo, Masashi Sawa, Tatsuo Ichinohe, Yoshiko Atsuta, Yoshinobu Kanda
The optimal conditioning regimen for elderly patients in allogeneic hematopoietic stem cell transplantation (allo-HCT) remains unclear. We retrospectively analyzed 1607 patients aged 50 years or older with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), or myelodysplastic syndrome (MDS) who underwent allo-HCT using fludarabine/busulfan (FB) or fludarabine/melphalan (FM) between 2007 and 2014. We compared the clinical outcomes among FB2 (busulfan at 6.4 mg/kg iv, n=463), FB4 (busulfan at 12...
September 7, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28882447/improving-the-informed-consent-process-in-hematopoietic-cell-transplantation-patient-caregiver-and-provider-perspectives
#3
Minakshi Raj, Sung Won Choi, Tuba Suzer Gurtekin, Jodyn Platt
One of the significant modifications to the Common Rule is the requirement that prospective participants are given information sufficient for a "reasonable person". However, there is limited research on what types of information patients, caregivers, and providers consider "key information". Although certain aspects of informed consent (IC) may be considered standard, considering individualized needs and preferences of patients is necessary for patient-centered consent. In the current study, we qualitatively examined the specific types of information that patients and caregivers involved in hematopoietic cell transplantation (HCT), as well as their providers, believe are important and necessary as part of the IC process in order to make a decision about participating in clinical research; and further, how these perspectives are aligned...
September 4, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28882446/relationship-between-mixed-donor-recipient-chimerism-and-disease-recurrence-following-hematopoietic-cell-transplantation-for-sickle-cell-disease
#4
Allistair Abraham, Matthew Hsieh, Mary Eapen, Courtney Fitzhugh, Jeanette Carreras, Daniel Kessler, Gregory Guilcher, Naynesh Kamani, Mark C Walters, Jaap J Boelens, John Tisdale, Shalini Shenoy
Mixed donor chimerism following hematopoietic cell transplantation for sickle cell disease (SCD) can result in resolution of disease symptoms but symptoms recur when donor chimerism is critically low. The relationship between chimerism, hemoglobin S (HbS) level and symptomatic disease was correlated retrospectively in 95 patients who had chimerism reports available at day 100, 1 and 2 years after transplantation. Recurrent disease was defined as recurrence of vaso-occlusive crises, acute chest syndrome, or stroke, and/or HbS level >50%...
September 4, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28870778/outcome-analysis-of-pediatric-all-patients-treated-with-tbi-free-allogeneic-hematopoietic-stem-cell-transplantation-comparison-of-patients-with-and-without-central-nervous-system-involvement
#5
Amir Ali Hamidieh, Seyed Mostafa Monzavi, Maryam Kaboutari, Maryam Behfar, Mohsen Esfandbod
Conditioning regimens excluding total body irradiation (TBI) following by hematopoietic stem cell transplantation (HSCT) have been shown to be feasible in treating acute lymphoblastic leukemia (ALL). However, it is commonly believed that for extramedullary involvements of ALL in sanctuary sites such as central nervous system (CNS), TBI shall not be abandoned. In this study, the outcomes of pediatric ALL patients with (CNS(+)) and without CNS involvement (CNS(-)) treated with a TBI-free allogeneic HSCT were retrospectively compared...
September 1, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28870777/the-effects-of-late-toxicities-on-outcomes-in-long-term-survivors-of-ex-vivo-cd34-selected-allogeneic-hematopoietic-cell-transplantation
#6
Michael Scordo, Gunjan L Shah, Satyajit Kosuri, Diego Adrianzen Herrera, Christina Cho, Sean M Devlin, Molly A Maloy, Jimmy Nieves, Taylor Borrill, Scott T Avecilla, Richard C Meagher, Dean C Carlow, Richard J O'Reilly, Esperanza B Papadopoulos, Ann A Jakubowski, Guenther Koehne, Boglarka Gyurkocza, Hugo Castro-Malaspina, Roni Tamari, Miguel-Angel Perales, Sergio A Giralt, Brian C Shaffer
The late adverse events in long-term survivors after myeloablative conditioned allogeneic hematopoietic cell transplantation with ex-vivo CD34+ selection are not well characterized. Using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0, we assessed all grade ≥ 3 toxicities from the start conditioning to date of death, relapse, or last contact in 131 patients that survived > 1-year post-transplantation, identifying 285 individual toxicities among 17 organ-based toxicity groups...
September 1, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28870776/consensus-report-by-palisi-and-pbmtc-joint-working-committees-supportive-care-guidelines-for-management-of-vod-in-children-and-adolescents-part-3-focus-on-cardio-respiratory-dysfunction-infections-liver-dysfunction-and-delirium
#7
Nadia Ovchinsky, Warren Frazier, Jeffery J Auletta, Christopher C Dvorak, Monica Ardura, Enkyung Song, Jennifer McArthur, Asumthia Jeyapalan, Robert Tamburro, Kris M Mahadeo, Chani Traube, Christine N Duncan, Rajinder P S Bajwa
Some patients with veno-occlusive disease (VOD) have multi-organ dysfunction (MOD) and multiple teams are involved in their daily care in the pediatric intensive care units (PICU). Cardio-respiratory dysfunction is critical in these patients as it needs immediate action. Whether to use non-invasive or invasive ventilation strategy may be a difficult decision in the setting of mucositis or other comorbidities in patients with VOD. Similarly monitoring of their organ functions could be very challenging; they may have fulminant hepatic failure with or without hepatic encephalopathy complicated by delirium and/or infections...
September 1, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28870775/ethical-challenges-in-hematopoietic-cell-transplantation-for-sickle-cell-disease-a-review
#8
REVIEW
Robert Sheppard Nickel, Naynesh R Kamani
Hematopoietic cell transplantation (HCT) using an HLA-identical sibling donor offers a very high likelihood of cure with good outcomes for patients with sickle cell disease (SCD), and alternative donor HCT for SCD is an area of active clinical research. HCT is thus potentially an option for a growing number of patients with SCD, but this expanded use of HCT has raised several ethical questions. Specifically, who is eligible for HCT, both in terms of disease severity and psychosocial factors? Should affected children with matched sibling donors be transplanted only when they have declared themselves as having significant symptomatology? In regards to donors, special ethical challenges include the use of pre-implantation genetic diagnosis to conceive an HLA-identical sibling...
September 1, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28865973/recovery-of-pulmonary-function-after-allogeneic-hematopoietic-cell-transplantation-in-children-is-associated-with-improved-survival
#9
Ashok Srinivasan, Anusha Sunkara, William Mitchell, Sudeep Sunthankar, Guolian Kang, Dennis C Stokes, Saumini Srinivasan
Abnormal pulmonary function is prevalent in survivors of allogeneic hematopoietic cell transplantation. Post-transplant recovery of pulmonary function, and its effect on survival in children is not known. This is a retrospective cohort study of 308 children followed for 10 years after transplantation at a single institution. There were 2 groups of patients. Group 1 included 188 patients with 3 or more pulmonary function test (PFT) results, of which at least 1 was abnormal, group 2 included 120 patients with 3 or more PFTs, all of which were normal...
August 30, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28865972/high-dose-melphalan-and-stem-cell-transplantation-in-patients-on-dialysis-due-to-al-amyloidosis-and-monoclonal-immunoglobulin-deposition-disease
#10
Felipe Batalini, Laura Econimo, Karen Quillen, J Mark Sloan, Shayna Sarosiek, Dina Brauneis, Andrea Havasi, Lauren Stern, Laura Dember, Vaishali Sanchorawala
The kidney is the most common organ affected by immunoglobulin light-chain (AL) amyloidosis and monoclonal immunoglobulin deposition disease (MIDD), often leading to end stage renal disease (ESRD). High-dose melphalan and stem cell transplantation (HDM/SCT) is effective for selected patients with AL amyloidosis, with high rates of complete hematologic responses and potential for improvement in organ dysfunction. Data on tolerability and response to HDM/SCT in patients with ESRD due to AL amyloidosis and MIDD are limited...
August 30, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28865971/haploidentical-hematopoietic-stem-cell-transplantation-for-myelodysplastic-syndrome
#11
Xiao-Dong Mo, Xiao-Hui Zhang, Lan-Ping Xu, Yu Wang, Chen-Hua Yan, Huan Chen, Yu-Hong Chen, Wei Han, Feng-Rong Wang, Jing-Zhi Wang, Kai-Yan Liu, Xiao-Jun Huang
This study aimed at validating the predictive ability of the Center for International Blood and Marrow Transplant Research (CIBMTR) prognostic scoring system on the outcomes of patients with myelodysplastic syndromes (MDS) who had received human leukocyte antigen (HLA)-haploidentical related donor hematopoietic stem cell transplantation (haplo-HSCT). We also tried to propose and validate a more suitable prognostic scoring system. A total of 157 patients with MDS, who received haplo-HSCT, were enrolled. The CIBMTR prognostic scoring system could predict the 2-year clinical outcomes after haplo-HSCT, but failed to predict the 100-day clinical outcomes after haplo-HSCT...
August 30, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28864140/donor-type-and-disease-risk-predict-the-success-of-allogeneic-hematopoietic-cell-transplantation-hct-a-single-center-analysis-of-613-adult-hct-recipients-using-a-modified-composite-endpoint
#12
Melhem Solh, Xu Zhang, Katelin Connor, Stacey Brown, Lawrence E Morris, H Kent Holland, Asad Bashey, Scott R Solomon
The composite endpoint GVHD free, relapse free survival (GRFS) has recently been developed as a tool to assess the success of allogeneic HCT and has been incorporated into recent randomized trials of GVHD prophylaxis by the Blood and Marrow Transplant Clinical Trials Network (BMTCTN). As developed, GRFS incorporates 'chronic GVHD requiring systemic immunosuppression' as a measure of clinically significant chronic GVHD (cGVHD). However, the decision to start patients on immunosuppression for chronic GVHD is subjective and physician dependent...
August 29, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28864139/optimizing-anti-thymocyte-globulin-dosing-for-unrelated-donor-allogeneic-hematopoietic-cell-transplant-based-on-recipient-absolute-lymphocyte-count
#13
Vanessa E Kennedy, Heidi Chen, Bipin N Savani, John Greer, Adetola A Kassim, Brian G Engelhardt, Stacey Goodman, Salyka Sengsayadeth, Wichai Chinratanalab, Madan Jagasia
Anti-thymocyte globulin (ATG) is used as prophylaxis against graft-versus-host-disease (GVHD). Current dosing regimens for ATG are empiric, weight-based, and do not account for patient-specific factors. Furthermore, the target of ATG, recipient T cells post-cytotoxic chemotherapy, is not a function of recipient weight. We hypothesized the recipient peripheral blood absolute lymphocyte count (ALC) on day of ATG administration would interact with the amount of ATG administered to predict transplant outcomes. We retrospectively analyzed 135 patients who received ATG for GVHD prophylaxis for unrelated allogeneic hematopoietic cell transplantation at three different doses: 10 mg/kg, 7...
August 29, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28864138/comparison-of-different-rabbit-anti-thymocyte-globulin-formulations-in-allogeneic-stem-cell-transplantation-systematic-literature-review-and-network-meta-analysis
#14
Nico Gagelmann, Francis Ayuk, Christine Wolschke, Nicolaus Kröger
Since 2000, phase III randomized controlled trials (RCT) investigated the efficacy of rabbit anti-thymocyte globulins (ATG) in patients following allogeneic stem cell transplantation (allo-SCT). However, comparisons of different ATG formulations are lacking. Our aim was to synthesize all efficacy evidence, enabling a comparison of all available formulations of rabbit ATG in the allo-SCT setting. We performed a systematic literature review to identify all available phase III RCT evidence. We searched the Cochrane Library, MEDLINE, MEDLINE In-Process and the website www...
August 29, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28864137/adjuvant-peptide-pulsed-dendritic-cell-vaccination-in-addition-to-t-cell-adoptive-immunotherapy-for-cytomegalovirus-infection-in-allogeneic-hematopoietic-stem-cell-transplant-hsct-recipients
#15
Chun K K Ma, Leighton Clancy, Renee Simms, Jane Burgess, Shivashni Deo, Emily Blyth, Kenneth P Micklethwaite, David J Gottlieb
Adoptive cellular immunotherapy has been shown to be effective in the management of CMV reactivation and disease. It is unknown whether adjuvant dendritic cell vaccination will provide additional benefit in prophylaxis or treatment of CMV in HSCT patients. In this study, we administered prophylactic CMV-peptide specific T cell infusions, followed by 2 doses of intradermal CMV peptide-pulsed dendritic cell (DC) vaccine to 4 HSCT patients. There were no immediate adverse events associated with T cell infusion or DC vaccinations...
August 29, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28860002/thrombotic-microangiopathy-after-allogeneic-stem-cell-transplantation-a-comparison-of-eculizumab-therapy-and-conventional-therapy
#16
Stephan R Bohl, Florian Kuchenbauer, Stefanie von Harsdorf, Nadine Kloevekorn, Stefan S Schönsteiner, Arefeh Rouhi, Phyllis Schwarzwälder, Hartmut Döhner, Donald Bunjes, Martin Bommer
We report the results of a single center analysis of a cohort of 39 patients treated between 1997 and 2016 for transplantion-associated thrombotic microangiopathy. We evaluated two subgroups of patients: 24 patients treated between 1997 and 2014 who received conventional therapy and 15 patients who were treated with the complement-inhibiting monoclonal antibody eculizumab between 2014 and 2016. The conventional therapy group was predominantly treated with defibrotide alone or in combination with plasmapheresis or rituximab...
August 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28860001/immune-mediated-hematopoietic-failure-after-allogeneic-hematopoietic-stem-cell-transplantation-a-common-cause-of-late-graft-failure-in-patients-with-complete-donor-chimerism
#17
Kana Maruyama, Nobuyuki Aotsuka, Yoshihisa Kumano, Naoko Sato, Naomi Kawashima, Yoshiyuki Onda, Hiroyuki Maruyama, Takamasa Katagiri, Yoshitaka Zaimoku, Noriharu Nakagawa, Kazuyoshi Hosomichi, Seishi Ogawa, Shinji Nakao
Late graft failure (LGF) without evidence of residual recipient cells is a serious complication after allogeneic hematopoietic stem cell transplantation (allo-SCT) and often requires stem cell infusion from the same donor when the patient fails to respond to conventional therapies. We screened the peripheral blood (PB) of 14 patients who developed donor-type LGF at 2-132 months after allo-SCT for the presence of the markers for immune-mediated bone marrow (BM) failure. Increased glycosylphosphatidyl inositol-anchored protein-deficient (GPI-AP(-)) leukocytes, which accounted for 0...
August 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28860000/pre-engraftment-bloodstream-infections-after-allogeneic-hematopoietic-cell-transplantation-the-impact-of-t-repleted-transplant-from-haploidentical-donors
#18
Malgorzata Mikulska, Anna Maria Raiola, Federica Galaverna, Elisa Balletto, Maria Lucia Borghesi, Riccardo Varaldo, Francesca Gualandi, Livia Giannoni, Giordana Pastori, Daniele Roberto Giacobbe, Alessio Signori, Valerio Del Bono, Claudio Viscoli, Andrea Bacigalupo, Emanuele Angelucci
Bloodstream infections (BSI) are frequent and important infectious complications after hematopoietic cell transplantation (HCT). The aim of this study was to analyze the incidence, risk factors and outcome of pre-engraftment BSI after allogeneic HCT. A retrospective analysis of data from 553 consecutive patients transplanted in years 2010-2016 was performed. Sixty percent of patients received T-repleted unmanipulated haploidentical bone marrow with high dose post-transplant cyclophosphamide. BSI rate was 30%; among isolated 213 pathogens, 54% were Gram-positive, 43% Gram-negative and 3% fungi...
August 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28847711/johannes-joseph-van-rood-transplantation-pioneer-april-7-1926-to-july-21-2017
#19
EDITORIAL
Robert Peter Gale
No abstract text is available yet for this article.
August 26, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28847710/lack-of-prognostic-impact-of-myd88-l265p-mutation-for-dlbcl-patients-undergoing-autologous-stem-cell-transplantation
#20
Yi-Shan Lee, Jingxia Liu, Kristine A Fricano, Erika M Webb, Dan R Toolsie, Sara Jones, James A Rhoads, Ravi Vij, Amanda F Cashen, Camille N Abboud, Peter Westervelt, Nancy L Bartlett, John F Dipersio, Friederike H Kreisel, Kian-Huat Lim
Cell-of-origin (COO) determination has emerged as an important prognostic factor for patients initially diagnosed with diffuse large B cell lymphoma (DLBCL). Specifically, the non-germinal center B cell like (non-GCB) subtype, comprising predominantly of the activated B cell-like (ABC) molecular subtype, has been shown to portend poor prognosis due to its more aggressive nature and resistance to standard CHOP-like chemotherapy compared to the GCB subtype. The recurrent MyD88 L265P mutation, present in 29% of ABC DLBCL, was reported as an independent poor prognostic factor for patients with newly diagnosed DLBCL...
August 25, 2017: Biology of Blood and Marrow Transplantation
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