Read by QxMD icon Read

post transplantation cyclophosphamide

Kevin Rakszawski, Kosuke Miki, David Claxton, Henry Wagner, Hiroko Shike, Shin Mineishi, Seema Naik
Approximately 30-40% of patients with acute myeloid leukemia (AML) experience induction failures. In these patients who do not achieve remission with two cycles of standard induction therapies, the probability of achieving remission with subsequent inductions is very limited. Hematopoietic stem cell transplantation (HSCT) is the only curative option for these patients, but high relapse rate and transplant-related mortality often preclude them to proceed to transplant. Thus, AML not in remission at time of HSCT remains a huge unmet need in current HSCT practice, particularly if the patient does not have an HLA-matched donor identified by the time of two induction failures...
March 14, 2018: International Journal of Hematology
Zhuoyan Li, Myriam Labopin, Fabio Ciceri, Didier Blaise, Johanna Tischer, Gerhard Ehninger, M T Van Lint, Yener Koc, Stella Santarone, Edouard Forcade, Luca Castagna, Emmanuelle Polge, Audrey Mailhol, Annalisa Ruggeri, Mohamad Mohty, Bipin N Savani, Arnon Nagler
Secondary acute myeloid leukemia (sAML) traditionally has inferior outcomes compared to de novo AML. Allogeneic hematopoietic cell transplantation (HCT) is the sole potentially curative therapy. This study analyzes the outcomes for unmanipulated haploidentical HCT (haploHCT) for sAML using the EBMT aute leukemia working group (ALWP) registry. We identified 154 patients with sAML who underwent haploHCT from 2006-2016. Median age at HCT was 60 years with time from diagnosis to HCT 5 months. At transplantation, 69 patients were in first CR and 85 had active disease...
March 14, 2018: American Journal of Hematology
Christopher C Dvorak, Prakash Satwani, Elliot Stieglitz, Mitchell S Cairo, Ha Dang, Qinglin Pei, Yun Gao, Donna Wall, Tali Mazor, Adam B Olshen, Joel S Parker, Samir Kahwash, Betsy Hirsch, Susana Raimondi, Neil Patel, Micah Skeens, Todd Cooper, Parinda A Mehta, Stephan A Grupp, Mignon L Loh
BACKGROUND: Most patients with juvenile myelomonocytic leukemia (JMML) are curable only with allogeneic hematopoietic cell transplantation (HCT). However, the current standard conditioning regimen, busulfan-cyclophosphamide-melphalan (Bu-Cy-Mel), may be associated with higher risks of morbidity and mortality. ASCT1221 was designed to test whether the potentially less-toxic myeloablative conditioning regimen containing busulfan-fludarabine (Bu-Flu) would be associated with equivalent outcomes...
March 12, 2018: Pediatric Blood & Cancer
Zain A Bashey, Xu Zhang, Stacey Brown, Katelin Jackson, Lawrence E Morris, H Kent Holland, Asad Bashey, Scott R Solomon, Melhem Solh
Allografting from HLA-haploidentical donors (HID) is being increasingly utilized worldwide for patients lacking a conventional matched donor. However, its efficacy in older patients with AML and MDS is unclear. We analyzed 127 consecutive allografts for AML/MDS patients aged ≥ 60 years at our center to compare outcomes using HID to those of contemporaneous transplants using matched sibling (MRD) or matched unrelated (MUD) donors. Patient characteristics were similar except HID transplants were more likely in non-white patients and were more commonly performed with reduced intensity conditioning and a marrow graft...
March 9, 2018: Bone Marrow Transplantation
Karoly Toth, Jacqueline F Spencer, Baoling Ying, Ann E Tollefson, Caroll B Hartline, Eric T Richard, Jiajun Fan, Jinglei Lyu, Boris A Kashemirov, Cheryl Harteg, Dawn Reyna, Elke Lipka, Mark N Prichard, Charles E McKenna, William S M Wold
Human adenoviruses (AdV) cause generally mild infections of the respiratory and GI tracts as well as some other tissues. However, AdV can cause serious infection in severely immunosuppressed individuals, especially pediatric patients undergoing allogeneic hematopoietic stem cell transplantation, where mortality rates are up to 80% with disseminated disease. Despite the seriousness of AdV disease, there are no drugs approved specifically to treat AdV infections. We report here that USC-087, an N-alkyl tyrosinamide phosphonate ester prodrug of HPMPA, the adenine analog of cidofovir, is highly effective against multiple AdV types in cell culture...
March 3, 2018: Antiviral Research
Yu-Qian Sun, Ying-Jun Chang, Xiao-Jun Huang
Haploidentical stem cell transplantation (Haplo-SCT) is currently a suitable alternative worldwide for patients with hematological diseases, who lack human leukocyte antigen (HLA)-matched siblings or unrelated donors. Areas covered: This review summarizes the advancements in Haplo-SCT in recent years, primarily focusing on the global trends of haploidentical allograft, the comparison of outcomes between Haplo-SCT and other transplantation modalities, strategies for improving clinical outcomes, including donor selection, hematopoietic reconstitution promotion, and graft-versus-host disease, and relapse prevention/management, as well as the expanded indications of Haplo-SCT, such as severe aplastic anemia, myeloma and lymphoma...
March 6, 2018: Expert Review of Hematology
Loredana Colla, Davide Diena, Maura Rossetti, Ana Maria Manzione, Luca Marozio, Chiara Benedetto, Luigi Biancone
Care of pregnant woman, including fertility and procreation counseling, has become a significant part of the nephrological practice in the last years. In this context, the management of immunosuppression assumes a primary role both for autoimmune diseases and for post-transplant follow up. The present review analyzes the latest evidence on immunosuppressive drugs of current use in nephrology and kidney transplantation. Although the placenta inactivates prednisone and prednisolone, it is advisable to limit the dose to the minimal effective one, to prevent side effects...
February 23, 2018: Journal of Nephrology
Hany Elmariah, Yvette L Kasamon, Marianna Zahurak, Karen W Macfarlane, Noah Tucker, Gary L Rosner, Javier Bolaños-Meade, Ephraim J Fuchs, Nina Wagner-Johnston, Lode J Swinnen, Carol Ann Huff, William H Matsui, Douglas E Gladstone, Shannon R McCurdy, Ivan Borrello, Christian B Gocke, Satish Shanbhag, Kenneth R Cooke, Syed Abbas Ali, Robert A Brodsky, Amy E DeZern, Leo Luznik, Richard J Jones, Richard F Ambinder
Outcomes of nonmyeloablative (NMA) haploidentical (haplo) blood or marrow transplant (BMT) with post-transplantation cyclophosphamide (PTCy) using non-first-degree relatives are unknown. We evaluated 33 consecutive adult patients (median age 56 years) with hematologic malignancies who underwent NMA haplo T-cell replete BMT with PTCy at Johns Hopkins using second- or third-degree related donors. Donors consisted of 10 nieces (30%), 9 nephews (27%), 7 first cousins (21%), 5 grandchildren (15%), and 2 uncles (6%)...
February 13, 2018: Biology of Blood and Marrow Transplantation
Patrizia Chiusolo, Gesine Bug, Attilio Olivieri, Mats Brune, Nicola Mordini, Paolo Emilio Alessandrino, Alida Dominietto, Anna Maria Raiola, Carmen Di Grazia, Francesca Gualandi, Maria Teresa Van Lint, Felicetto Ferrara, Olimpia Finizio, Emanuele Angelucci, Andrea Bacigalupo
We are reporting a modified post-transplant cyclophosphamide (PT-CY) regimen, for unmanipulated haploidentical marrow transplants (HAPLO), in 150 patients with acute myeloid leukemia (AML). All patients received a myeloablative regimen, cyclosporine (CsA) on day 0, mycophenolate on day +1, and PT-CY 50 mg/kg, on days +3 and +5. The median age was 51 years (17-74), 51 patients (34%) had active disease at transplant, and the median follow up of surviving patients 903 days (150-1955). The cumulative incidence (CI) of engraftment, acute graft versus host disease (GVHD) grade II-IV and moderate/severe chronic GvHD was respectively 92%, 17% and 15%...
February 5, 2018: Biology of Blood and Marrow Transplantation
Mark Parta, Nirali N Shah, Kristin Baird, Hind Rafei, Katherine R Calvo, Thomas Hughes, Kristen Cole, Meg Kenyon, Bazetta Blacklock Schuver, Jennifer Cuellar-Rodriguez, Christa S Zerbe, Steven M Holland, Dennis D Hickstein
Allogeneic hematopoietic stem cell transplantation (HSCT) reverses the bone marrow failure syndrome due to GATA2 deficiency. The intensity of conditioning required to achieve reliable engraftment and prevent relapse remains unclear. Here, we describe the results of a prospective study of HSCT in 22 patients with GATA2 deficiency using a busulfan-based conditioning regimen. The study includes 2 matched related donor (MRD) recipients, 13 matched unrelated donor (URD) recipients, and 7 haploidentical related donor (HRD) recipients...
February 2, 2018: Biology of Blood and Marrow Transplantation
Ana Sofia Jorge, María Suárez-Lledó, Arturo Pereira, Gonzalo Gutierrez, Francesc Fernández-Avilés, Laura Rosiñol, Noemí Llobet, Teresa Solano, Álvaro Urbano-Ispízua, Montserrat Rovira, Carmen Martínez
The optimal prophylaxis regimen for graft-versus-host disease (GVHD) in the setting of mismatched unrelated donor (MMUD) allogeneic hematopoietic stem cell transplantation (alloSCT) is not defined. The use of high-dose post-transplant cyclophosphamide (PTCy) in haploidentical transplantation has proven feasible and effective in overcoming the negative impact of HLA-disparity on survival. We hypothesized that PTCy could also be effective in the setting of MMUD transplantation. We retrospectively analyzed 86 consecutive adult recipients of alloHSCT in our institution, comparing two contemporaneous groups: PTCyMMUD (n=26) vs...
February 1, 2018: Biology of Blood and Marrow Transplantation
P S Malhotra, T Jorna, S Bhandari
Immunoglobulin A nephropathy (IgAN) is the most commonly occurring glomerulonephritis. Recurrence of disease in the transplanted kidney can significantly reduce allograft survival rates. Currently, there is no definitive management plan for IgAN recurrence in a transplant that reduces the rate of decline of allograft function and prolongs time to dialysis or re-transplantation. Herein we present a 48-year-old man who had received a renal transplantation in 2006 following his diagnosis of IgAN. In 2015, the patient was noted to have an elevated blood pressure and proteinuria (urinary protein:creatinine ratio [uPCR] 170 mg/mmol)...
January 2018: Transplantation Proceedings
H Ozdogu, C Boga, M Yeral, I Kozanoglu, C Gereklioglu, P Aytan, M Kasar, S Asma, N Buyukkurt, S Solmaz, A Korur, C Sariturk
Adult patients with sickle cell disease (SCD) are highly susceptible to stem cell transplant complications, including drug toxicity, graft versus host disease (GVHD), and graft rejection due to SCD-related tissue damage, endothelial activation, and inflammation. The scarcity of compatible stem cells for transplantation further limits treatment options, with only 43 cases of adult allogeneic peripheral blood stem cell transplantation (allo-PSCT) from human leukocyte antigen (HLA)-identical sibling donors reported in the international registry for the period 1986-2013...
February 5, 2018: Bone Marrow Transplantation
Scott R Solomon, Xu Zhang, H Kent Holland, Lawrence E Morris, Melhem Solh, Asad Bashey
Available evidence from large registry studies has shown inferior survival for black adult patients following both unrelated donor and cord blood transplantation. Post-transplant cyclophosphamide (PTCy)-based haploidentical donor transplantation (HIDT) is being increasingly used in ethnic minorities. However, no studies of the impact of race on outcomes following HIDT have been reported. We analyzed 203 consecutive patients (123 white, 80 black) who underwent first HIDT using PTCy for hematologic malignancy at a single institution...
January 25, 2018: Biology of Blood and Marrow Transplantation
Akiyoshi Takami
Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) yields a high rate of curability for acute myeloid leukemia (AML), it is also associated with transplant-related morbidity and mortality (TRM). The risk and severity of TRM increase with the use of an alternative donor graft in the absence of an HLA-matched sibling donor (MSD). With the declining birthrate and aging of the population, the numbers of patients with an MSD are decreasing, and alternative donor transplants, including the post-transplant cyclophosphamide method using haplo-identical donors, are increasing...
January 27, 2018: International Journal of Hematology
A Regueiro-García, S Fariña-Nogueira, J Á Porto-Arceo, J M Couselo-Sánchez
Chronic granulomatous disease is a primary immunodeficiency caused by mutations in any one of the five components of the NADPH oxidase in phagocytic leucocytes. This causes impaired microbial killing, which leads to severe life-threatening bacterial and fungal infections. Currently, allogenic hematopoietic stem cell transplantation (HSCT) is the only curative treatment for chronic granulomatous disease, although gene therapy may provide a new therapeutic option for the treatment of patients with CGD. Haploidentical HSCT provides a potentially curative treatment option for patients who lack a suitably HLA-matched donor, but only a few cases have been reported in the literature...
January 16, 2018: Allergologia et Immunopathologia
Kate Markey, Rachel D Kuns, Daniel J Browne, Kate H Gartlan, Renee J Robb, J Paulo Martins, Andrea S Henden, Simone A Minnie, Melody Cheong, Motoko Koyama, Mark J Smyth, Raymond J Steptoe, Gabrielle Belz, Thomas Brocker, Mariapia A Degli-Esposti, Steven W Lane, Geoffrey R Hill
PURPOSE: Allogeneic bone marrow transplantation (BMT) provides curative therapy for leukemia via immunological graft-versus-leukemia (GVL) effects. In practice, this must be balanced against life threatening pathology induced by graft-versus-host disease (GVHD). Recipient dendritic cells (DC) are thought to be important in the induction of GVL and GVHD. EXPERIMENTAL DESIGN: We have utilized preclinical models of allogeneic BMT to dissect the role and modulation of recipient DC in controlling donor T cell mediated GVHD and GVL...
January 24, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Ivan S Moiseev, Olga V Pirogova, Alexandr L Alyanski, Elena V Babenko, Tatyana L Gindina, Elena I Darskaya, Olga A Slesarchuk, Tatyana A Bykova, Alexei B Chukhlovin, Dmitrii E Pevtcov, Sergey N Bondarenko, Boris V Afanasyev
INTRODUCTION: Although a number of studies were published on the efficacy of post-transplantation cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis, no large studies prospectively evaluated this strategy in related, unrelated and haploidentical grafts. METHODS: In this study GVHD prophylaxis for 57 matched bone marrow (MBM) grafts consisted of single-agent PTCy, for 88 matched PBSC grafts (MPBSC) - of PTCy, tacrolimus and mycophenolate mofetil (MMF) 30 mg/kg, and for 55 mismatched grafts (MMG)- of PTCy, tacrolimus and MMF 45 mg/kg...
January 23, 2018: European Journal of Haematology
Shuntaro Ikegawa, Nobuharu Fujii, Koh Tadokoro, Kota Sato, Miki Iwamoto, Masayuki Matsuda, Tomoko Inomata, Hiroyuki Sugiura, Takeru Asano, Shohei Yoshida, Hisakazu Nishimori, Ken-Ichi Matsuoka, Yoshinobu Maeda
A 52-year-old male suffered from progressive multifocal leukoencephalopathy (PML) after human leukocyte antigen (HLA)-haploidentical transplantation with post-transplantation cyclophosphamide (PTCY). Mirtazepam, mefloquine, and cytarabine failed to improve his symptoms and he finally died 4.5 months after PML onset. This is the first case report of a patient with PML after HLA-haploidentical transplantation with PTCY. Although T-cell replete HLA-haploidentical transplantation with PTCY has enabled early immune reconstitution, PML should be considered if a patient's mental condition deteriorates...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Scott R Solomon, Michael A Aubrey, Xu Zhang, Allison Piluso, Brian M Freed, Stacey Brown, Katelin C Jackson, Lawrence E Morris, H Kent Holland, Melhem M Solh, Asad Bashey
The use of post-transplant cyclophosphamide (PTCy)-based haploidentical (haplo) transplant is increasing worldwide. However, as multiple potential haplo donors are usually available, data-driven guidance is clearly needed to help transplant centers prioritize donors. To that end, we retrospectively analyzed 208 consecutive donor-recipient pairs receiving PTCy-based haplo transplant at a single institution. Median recipient and donor age was 52 (19-75) and 38 (15-73) years, PBSC was the stem cell source in 66%, and myeloablative conditioning was used in 41%...
January 17, 2018: Biology of Blood and Marrow Transplantation
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"