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post transplantation cyclophosphamide

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
D E Gladstone, M Petri, J Bolanos-Meade, A E Dezern, R J Jones, D Fine, R A Brodsky
Systemic lupus erythematosus (SLE), a disorder of the immune system, is potentially curable by allogeneic bone marrow transplantation (alloBMT). Until recently, alloBMT was limited by donor availability and toxicity. Reduced intensity conditioning (RIC) combined with post-transplantation cyclophosphamide (PTCy) has improved the availability and safety of alloBMT permitting its exploration in severe-refractory autoimmune illnesses. We report the six-year follow-up of a young female whose refractory SLE-associated nephrosis resolved after RIC alloBMT with PTCy...
September 29, 2016: Lupus
Martina Ahlmann, Georg Hempel
Cyclophosphamide is an alkylating agent belonging to the group of oxazaphosporines. As cyclophosphamide is in clinical use for more than 40 years, there is a lot of experience using this drug for the treatment of cancer and as an immunosuppressive agent for the treatment of autoimmune and immune-mediated diseases. Besides antimitotic and antireplicative effects, cyclophosphamide has immunosuppressive as well as immunomodulatory properties. Cyclophosphamide shows selectivity for T cells and is therefore now frequently used in tumour vaccination protocols and to control post-transplant allo-reactivity in haplo-identical unmanipulated bone marrow after transplantation...
October 2016: Cancer Chemotherapy and Pharmacology
Alexandra F Freeman, Nirali N Shah, Mark Parta, Helen C Su, Alessandra Brofferio, Irma Gradus-Pizlo, Sabah Butty, Thomas E Hughes, David E Kleiner, Daniele Avila, Theo Heller, Heidi H Kong, Steven M Holland, Dennis D Hickstein
No abstract text is available yet for this article.
September 15, 2016: Journal of Allergy and Clinical Immunology in Practice
Laurent Garderet, Eric Beohou, Denis Caillot, Anne Marie Stoppa, Cyrille Touzeau, Marie Lorraine Chretien, Lionel Karlin, Philippe Moreau, Jean Fontan, Didier Blaise, Emmanuelle Polge, Mor Seny Gueye, Souhila Ikhlef, Zora Marjanovic, Myriam Labopin, Mohamad Mohty
The feasibility and efficacy of high-dose melphalan followed by autologous hematopoietic stem cell transplantation in newly diagnosed elderly patients with multiple myeloma was analyzed prospectively. Fifty-six multiple myeloma patients, aged 65 or older, from 6 French centers were studied. The induction therapy was bortezomib-based in combination with dexamethasone and either thalidomide, cyclophosphamide or lenalidomide, for 4 to 6 cycles. Peripheral blood stem cells were collected after high-dose cyclophosphamide plus G-CSF or G-CSF alone, with plerixafor if needed...
September 9, 2016: Haematologica
Sarita Rani Jaiswal, Shamsuz Zaman, Aditi Chakrabarti, Amit Sehrawat, Satish Bansal, Mahesh Gupta, Suparno Chakrabarti
The outcome of hyperacute grade 3-4 steroid-refractory graft-versus-host-disease (SR-GVHD) remains dismal despite a plethora of agents being tried alone or in combination. Following T replete haploidentical transplantation with post-transplantation cyclophosphamide on 75 patients, 10 patients (13%) aged 2-20years, developed hyperacute SR-GVHD. We report on the outcome of two different regimens for treatment of SR-GVHD on the outcome of these patients. Five patients were treated in Regimen A consisting of anti-thymocyte globulin, Etanercept and Basiliximab...
August 27, 2016: Transplant Immunology
A Rashidi, M Slade, J F DiPersio, P Westervelt, R Vij, R Romee
Post-transplant cyclophosphamide (PT-Cy) is the backbone of GvHD prophylaxis following haploidentical hematopoietic cell transplantation (haplo-HCT). PT-Cy has also been used in matched related (MRD) and unrelated (MUD) settings. It is not known whether outcomes are similar between haplo-HCT and MRD/MUD HCT when PT-Cy is used. We performed a retrospective analysis of 83 patients with AML who underwent HCT (using PT-Cy-based GvHD prophylaxis) from MRD, MUD or haploidentical donors. The groups were similar in baseline characteristics with the exception of older age in the MRD/MUD group (P=0...
August 15, 2016: Bone Marrow Transplantation
Melissa Baker, Hongkun Wang, Scott D Rowley, Ling Cai, Andrew L Pecora, Alan Skarbnik, David H Vesole, Barbara Adler-Brecher, Daniel Kim, Michele L Donato
Most patients eligible for allogeneic hematopoietic stem cell transplantation will require identification of an alternate (unrelated or mismatched related) donor. We explored the transplantation outcomes for a sequential series of 54 patients undergoing haploidentical donor transplantation (HAPLO) compared to those from a control group of patients receiving cells from matched or mismatched unrelated donors (URD) selected by diagnosis and stem cell source. Patients undergoing HAPLO transplantations received graft-versus-host disease (GVHD) prophylaxis with post-transplantation cyclophosphamide (Cy)...
November 2016: Biology of Blood and Marrow Transplantation
Raffaella Greco, Francesca Lorentino, Mara Morelli, Fabio Giglio, Daniele Mannina, Andrea Assanelli, Sara Mastaglio, Serena Dalto, Tommaso Perini, Lorenzo Lazzari, Simona Piemontese, Consuelo Corti, Magda Marcatti, Massimo Bernardi, Maria Teresa Lupo Stanghellini, Fabio Ciceri, Jacopo Peccatori
No abstract text is available yet for this article.
September 15, 2016: Blood
Marjolijn van Keep, Kerry Gairy, Divyagiri Seshagiri, Pushpike Thilakarathne, Dawn Lee
BACKGROUND: Mantle cell lymphoma (MCL) is a rare and aggressive form of non-Hodgkin's lymphoma. Bortezomib is the first product to be approved for the treatment of patients with previously untreated MCL, for whom haematopoietic stem cell transplantation is unsuitable, and is used in combination with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (VR-CAP). The National Institute of Health and Care Excellence recently recommended the use of VR-CAP in the UK following a technology appraisal...
2016: BMC Cancer
S Gallo, A E Woolfrey, L M Burroughs, B E Storer, M E D Flowers, P Hari, M A Pulsipher, S Heimfeld, H-P Kiem, B M Sandmaier, R Storb
A total of 21 patients with severe aplastic anemia (SAA) underwent marrow transplantation from HLA-identical siblings following a standard conditioning regimen with cyclophosphamide (50 mg/kg/day × 4 days) and horse antithymocyte globulin (30 mg/kg/day × 3 days). Post-grafting immunosuppression consisted of a short course of methotrexate (MTX) combined with cyclosporine (CSP). The transplant protocol tested the hypothesis that the incidence of chronic GvHD could be reduced by limiting the marrow grafts to ⩽2...
August 1, 2016: Bone Marrow Transplantation
Sarita Rani Jaiswal, Shamsuz Zaman, Aditi Chakrabarti, Subrata Sen, Shashwata Mukherjee, Sneh Bhargava, Kunal Ray, Paul V O'Donnell, Suparno Chakrabarti
We carried out post-transplantation cyclophosphamide (PTCy)-based haploidentical peripheral blood stem cell transplantation in 51 patients with refractory/relapsed acute myeloid leukemia not in remission. The first 10 patients received nonmyeloablative conditioning followed by planned granulocyte colony-stimulating factor (G-CSF)-mobilized donor lymphocyte infusions (DLIs) on days 35, 60, and 90. No patient developed graft-versus-host disease (GVHD), but 90% had disease progression between 3 and 6 months. A subsequent 41 patients received myeloablative conditioning (MAC); the first 20 patients did not receive DLIs (MAC group) and the next 21 patients received G-CSF-mobilized DLIs (G-DLI) on days 21, 35, and 60 (MAC-DLI group)...
October 2016: Biology of Blood and Marrow Transplantation
M Slade, B Fakhri, B N Savani, R Romee
In recent years, the use of haploidentical donors for hematopoietic cell transplantation has expanded rapidly. Approximately 50% of patients requiring hematopoietic cell transplant lack a traditional donor. The use of HLA haploidentical-related donors is attractive due to nearly universal availability of this graft source. We summarize the current and future need for haploidentical donors and detail the rise of post-transplant cyclophosphamide as the dominant haploidentical approach. Further, we examine ongoing controversies in the field of haploidentical transplant, including conditioning regimens and graft source...
July 25, 2016: Bone Marrow Transplantation
Scott R Goldsmith, Michael Slade, John F DiPersio, Peter Westervelt, Steven J Lawrence, Geoffrey L Uy, Camille N Abboud, Ravi Vij, Mark A Schroeder, Todd A Fehniger, Erik R Dubberke, Kathryn Trinkaus, Rizwan Romee
No abstract text is available yet for this article.
July 21, 2016: Haematologica
Max Hubmann, Susanne Fritsch, Anna-Katharina Zoellner, Dusan Prevalsek, Nicole Engel, Veit Bücklein, Friederike Mumm, Christoph Schulz, Hans Joachim Stemmler, Gundula Jäger, Georg Ledderose, Hans Jochem Kolb, Andreas Hausmann, Wolfgang Hiddemann, Andreas Moosmann, Johanna Tischer
BACKGROUND: Adenovirus (ADV) infections can have a high mortality in immunocompromised patients and are difficult to treat. OBJECTIVES AND STUDY DESIGN: We retrospectively analyzed occurrence and risk factors of ADV infection in 399 adults with hematological disorders undergoing hematopoietic stem cell transplantation (allo-HSCT), focusing on alternative donor transplantation (ADT) and disseminated disease. RESULTS: ADV infection occurred in 42 patients (10...
September 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
A Rimondo, R Crocchiolo, J El-Cheikh, S Bramanti, A Granata, S Furst, B Sarina, L Morabito, R Devillier, S Harbi, B Mohty, R Mineri, C Faucher, C Chabannon, A Santoro, D Blaise, L Castagna
No abstract text is available yet for this article.
July 18, 2016: Bone Marrow Transplantation
Juan Montoro, Jaime Sanz, Guillermo F Sanz, Miguel A Sanz
One of the most important advances in allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the use of alternative donors and cell sources, such as haploidentical transplants (haplo-HSCT) from family donors. Several approaches have been developed to overcome the challenging bidirectional alloreactivity. We discuss these approaches, including ex vivo T-cell-depleted grafts with megadose of CD34(+) cells, not requiring immunosuppression after allogeneic transplantation for graft-versus-host disease (GVHD) prophylaxis, and other strategies using unmanipulated T-cell-replete grafts with intensive immunosuppression or post-transplantation cyclophosphamide to minimize the GVHD...
August 2016: Leukemia & Lymphoma
Sameh Gaballa, Isabell Ge, Riad El Fakih, Jonathan E Brammer, Piyanuch Kongtim, Ciprian Tomuleasa, Sa A Wang, Dean Lee, Demetrios Petropoulos, Kai Cao, Gabriela Rondon, Julianne Chen, Aimee Hammerstrom, Lindsey Lombardi, Gheath Alatrash, Martin Korbling, Betul Oran, Partow Kebriaei, Sairah Ahmed, Nina Shah, Katayoun Rezvani, David Marin, Qaiser Bashir, Amin Alousi, Yago Nieto, Muzaffar Qazilbash, Chitra Hosing, Uday Popat, Elizabeth J Shpall, Issa Khouri, Richard E Champlin, Stefan O Ciurea
BACKGROUND: High-dose, post-transplantation cyclophosphamide (PTCy) to prevent graft-versus-host disease (GVHD) has improved outcomes in haploidentical (HAPLO) stem cell transplantation (SCT). However, it remains unclear whether this strategy is effective in SCT from 1-antigen human leukocyte antigen (HLA)-mismatched unrelated donors (9/10 MUD) and how the outcomes of these patients compare with those of haploidentical transplantation recipients. METHODS: A parallel, 2-arm, nonrandomized phase 2 clinical trial was conducted of melphalan-based reduced-intensity conditioning with PTCy, tacrolimus, and mycophenolate mofetil to prevent GVHD in patients with high-risk hematologic malignancies who underwent HAPLO (n = 60) or 9/10 MUD (n = 46) SCT...
July 12, 2016: Cancer
T L Bahr, T Lund, N M Sando, P J Orchard, W P Miller
No abstract text is available yet for this article.
July 4, 2016: Bone Marrow Transplantation
Jessica Gorgeis, Xu Zhang, Katelin Connor, Stacey Brown, Scott R Solomon, Lawrence E Morris, H Kent Holland, Asad Bashey, Melhem Solh
A second allogeneic hematopoietic stem cell transplantation (HSCT) using the same donor or another fully matched donor is an effective treatment approach for a subset of patients relapsing after a matched related (MRDT) or matched unrelated donor transplant (MUDT). There are limited data on the use of haploidentical transplantation (HIDT) with post-transplant cyclophosphamide in the setting of a second HSCT after an MRDT or MUDT. We analyzed the outcomes of 20 patients who received HIDT with post-transplant cyclophosphamide as a second HSCT after an MRDT (n = 10) or MUDT (n = 10)...
October 2016: Biology of Blood and Marrow Transplantation
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