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https://www.readbyqxmd.com/read/29909152/early-fever-after-haploidentical-bmt-correlates-with-class-ii-hla-mismatching-and-myeloablation-but-not-outcomes
#1
Shannon R McCurdy, Stephen T Muth, Hua-Ling Tsai, Heather J Symons, Carol Ann Huff, William H Matsui, Ivan Borrello, Douglas E Gladstone, Lode J Swinnen, Kenneth R Cooke, Robert A Brodksy, Javier Bolaños-Meade, Richard F Ambinder, Ravi Varadhan, Leo Luznik, Rick J Jones, Maria P Bettinotti, Ephraim J Fuchs
Non-infectious fevers are common early after T-cell replete HLA-haploidentical (haplo) peripheral blood transplants and have been associated with cytokine release syndrome and overall mortality. However, less is known regarding the incidence and associations of early fever after bone marrow transplantation (BMT) with post-transplant cyclophosphamide (PTCy). We hypothesized that early fever would be associated with myeloablative conditioning (MAC), because of its relative increase in tissue damage augmenting antigen-presentation, and Class II HLA-mismatching, due recognition of antigen-presenting cells by CD4+ T-cells...
June 15, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29685953/outcomes-of-medicare-age-eligible-nhl-patients-receiving-ric-allogeneic-transplantation-a-cibmtr-analysis
#2
Nirav N Shah, Kwang Woo Ahn, Carlos Litovich, Timothy S Fenske, Sairah Ahmed, Minoo Battiwalla, Nelli Bejanyan, Parastoo B Dahi, Javier Bolaños-Meade, Andy I Chen, Stefan O Ciurea, Veronika Bachanova, Zachariah DeFilipp, Narendranath Epperla, Nosha Farhadfar, Alex F Herrera, Bradley M Haverkos, Leona Holmberg, Nasheed M Hossain, Mohamed A Kharfan-Dabaja, Vaishalee P Kenkre, Hillard M Lazarus, Hemant S Murthy, Taiga Nishihori, Andrew R Rezvani, Anita D'Souza, Bipin N Savani, Matthew L Ulrickson, Edmund K Waller, Anna Sureda, Sonali M Smith, Mehdi Hamadani
The application of allogeneic hematopoietic cell transplantation (allo-HCT) in non-Hodgkin lymphoma (NHL) patients ≥65 years in the United States is limited by lack of Medicare coverage for this indication. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we report allo-HCT outcomes of NHL patients aged ≥65 years (older cohort; n = 446) compared with a cohort of younger NHL patients aged 55-64 years (n = 1183). We identified 1629 NHL patients undergoing a first reduced-intensity conditioning (RIC) or nonmyeloablative conditioning allo-HCT from 2008 to 2015 in the United States...
April 24, 2018: Blood Advances
https://www.readbyqxmd.com/read/29685874/impact-of-oral-side-effects-from-conditioning-therapy-before-hematopoietic-stem-cell-transplantation-protocol-for-a-multicenter-study
#3
Michael T Brennan, Bengt Hasséus, Allan J Hovan, Judith E Raber-Durlacher, Nicole Ma Blijlevens, Marie-Charlotte Huysmans, Karin Garming Legert, Jan-Erik Johansson, Charity G Moore, Inger von Bültzingslöwen
BACKGROUND: The oral cavity is a common site of complications related to the cytotoxic effect of high-dose chemotherapy and radiation therapy. Considering our limited understanding of the burden of illness in the oral cavity from various cytotoxic therapies, it is difficult to produce evidence-based, preventive and management protocols. A prospective multicenter study is necessary to collect data on the burden of illness from various cytotoxic regimens. OBJECTIVE: The objectives of this prospective international observational multicenter study in hematopoietic stem cell transplant (HSCT) patients are to establish the nature, incidence and temporal relationship of oral complications related to conditioning regimens (chemotherapy with or without total body irradiation), stem cell transplantation and the immunologic reactions (mainly graft-vs-host-disease) that may follow, and to determine what subjective and objective oral complications related to treatment can predict negative clinical and economic outcomes and reduced quality of life...
April 23, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29656138/inosine-monophosphate-dehydrogenase-pharmacogenetics-in-hematopoietic-cell-transplantation-patients
#4
Jeannine S McCune, Barry Storer, Sushma Thomas, Jožefa McKiernan, Rohan Gupta, Brenda M Sandmaier
We evaluated inosine monophosphate dehydrogenase (IMPDH) 1 and IMPDH2 pharmacogenetics in 247 recipient-donor pairs after nonmyeloablative hematopoietic cell transplant (HCT). Patients were conditioned with total body irradiation + fludarabine and received grafts from related or unrelated donors (10% HLA mismatch), with postgraft immunosuppression of mycophenolate mofetil (MMF) with a calcineurin inhibitor. Recipient and donor IMPDH genotypes (rs11706052, rs2278294, rs2278293) were not associated with day 28 T cell chimerism, acute graft-versus-host disease (GVHD), disease relapse, cytomegalovirus reactivation, nonrelapse mortality, or overall survival...
April 12, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29608324/the-devil-is-in-the-details-retention-of-recipient-group-a-type-5-years-after-a-successful-allogeneic-bone-marrow-transplant-from-a-group-o-donor
#5
Laura L W Cooling, Michelle Herrst, Sherri L Hugan
ABO-incompatible (ABOi) hematopoietic stem cell transplants (HSCTs) can present challenges in the blood bank. During transplantation, patients receive components that are ABO-compatible with both the donor graft and recipient; this practice can strain group O red blood cell (RBC) inventories.1 In addition, there are risks for acute hemolysis at the time of infusion and in the early post-transplant period.1,2 In ABO major-incompatible bone marrow HSCTs, which contain significant quantities of donor RBCs that are ABOi with recipient plasma, it is common to perform a RBC depletion of the bone marrow in an effort to minimize hemolysis at the time of infusion...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29555662/impact-of-donor-type-in-patients-with-aml-given-allogeneic-hematopoietic-cell-transplantation-after-low-dose-tbi-based-regimen
#6
Frédéric Baron, Myriam Labopin, Annalisa Ruggeri, Jan J Cornelissen, Ellen Meijer, Henrik Sengeloev, Dietger Niederwieser, Marco R De Groot, Harry C Schouten, Noel Milpied, Didier Blaise, Bipin N Savani, Eliane Gluckman, Mohamad Mohty, Arnon Nagler
Background: We assessed the impact of donor type in acute myeloid leukemia (AML) patients transplanted with 2 Gy total body irradiation (TBI)-based nonmyeloablative conditioning regimen. Experimental Design: Data from 1,715 adult patients, with AML in CR1 or CR2 were included in this retrospective survey. Results: Donors consisted either of HLA-matched sibling donors (MSD, n = 701), 10/10 HLA-matched unrelated donors (MUD, n = 611), HLA-haploidentical donors (haplo, n = 112) or single or double umbilical cord bloods (CBT, n = 291)...
March 19, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29545343/nonmyeloablative-allogeneic-hematopoietic-cell-transplantation-for-relapsed-or-refractory-waldenstrom-macroglobulinemia-evidence-for-a-graft-versus-lymphoma-effect
#7
Enrico Maffini, Larry D Anderson, Brenda M Sandmaier, Damian J Green, Barry E Storer, Dietger Niederwieser, Richard T Maziarz, David G Maloney, Rainer Storb
No abstract text is available yet for this article.
March 15, 2018: Haematologica
https://www.readbyqxmd.com/read/29506828/effect-of-the-vascularized-bone-components-on-the-survival-of-vascularized-composite-allografts
#8
Jianwu Chen, Dongliang Zhang, Tao Zhang, Chen Chen, Yajuan Song, Shiqiang Liu, Yingjun Su, Shuzhong Guo
BACKGROUND: Vascularized composite allograft (VCA), such as hand and face allograft, contains a vascularized bone component that may provide an immunologic benefit and induce tolerance for the simultaneous inclusion of marrow cells and a marrow microenvironment. We developed a chimeric groin cutaneous/femur flap to investigate the effect of vascularized bone marrow on VCA survival and its ability to induce chimerism. METHODS: Brown Norway and Lewis rats were used as donors and recipients, respectively...
April 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29452245/haploidentical-bone-marrow-transplantation-with-post-transplant-cyclophosphamide-using-non-first-degree-related-donors
#9
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
https://www.readbyqxmd.com/read/29353275/endocrine-and-metabolic-disturbances-in-survivors-of-hematopoietic-stem-cell-transplantation-in-childhood-and-adolescence
#10
Shlomit Shalitin, Lihi Pertman, Michal Yackobovitch-Gavan, Isaac Yaniv, Yael Lebenthal, Moshe Phillip, Jerry Stein
BACKGROUND/AIMS: The objective was to evaluate endocrine complications in survivors of hematopoietic stem cell transplantation (HSCT) performed during childhood. METHODS: Endocrine dysfunction and metabolic syndrome parameters were assessed by chart review of 178 childhood HSCT survivors (median age at evaluation, 15.5 [range: 3.8-29.8] years; median follow-up, 8.5 [range: 2-23.4] years). RESULTS: The following statistically significant associations were identified (p < 0...
2018: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/29353109/shortened-duration-tacrolimus-after-nonmyeloablative-hla-haploidentical-bone-marrow-transplantation
#11
Yvette L Kasamon, Ephraim J Fuchs, Marianna Zahurak, Gary L Rosner, Heather J Symons, Douglas E Gladstone, Carol Ann Huff, Lode J Swinnen, Robert A Brodsky, William H Matsui, Ivan Borrello, Satish Shanbhag, Kenneth R Cooke, Richard F Ambinder, Leo Luznik, Javier Bolaños-Meade, Richard J Jones
With post-transplantation cyclophosphamide (PTCy) as graft-versus-host disease (GVHD) prophylaxis, nonmyeloablative HLA-haploidentical (NMA haplo) and HLA-matched blood or marrow transplantation (BMT) have comparable outcomes. Early discontinuation of immunosuppression may reduce the risk of relapse and improve immune reconstitution, but may increase the risk of GVHD. We conducted a prospective trial of NMA haplo BMT for patients with hematologic malignancies (median age, 61 years), evaluating the safety of early discontinuation of tacrolimus...
January 17, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29300231/long-term-nonhuman-primate-renal-allograft-survival-without-ongoing-immunosuppression-in-recipients-of-delayed-donor-bone-marrow-transplantation
#12
Kiyohiko Hotta, Tetsu Oura, Abbas Dehnadi, Svjetlan Boskovic, Masatoshi Matsunami, Ivy Rosales, Rex N Smith, Robert B Colvin, A Benedict Cosimi, Tatsuo Kawai
BACKGROUND: We have previously reported successful induction of renal allograft tolerance in nonhuman primates (NHP) after an initial posttransplant period of conventional immunosuppression (delayed tolerance) using a nonmyeloablative conditioning regimen consisting of anti-CD154 and anti-CD8 mAbs plus equine antithymocyte globulin (Atgam) and donor bone marrow transplantation (DBMT). Because these reagents are not currently clinically available, the protocol was revised to be applicable to human recipients of deceased donor allografts...
April 2018: Transplantation
https://www.readbyqxmd.com/read/29298160/myeloablative-autologous-stem-cell-transplantation-for-severe-scleroderma
#13
RANDOMIZED CONTROLLED TRIAL
Keith M Sullivan, Ellen A Goldmuntz, Lynette Keyes-Elstein, Peter A McSweeney, Ashley Pinckney, Beverly Welch, Maureen D Mayes, Richard A Nash, Leslie J Crofford, Barry Eggleston, Sharon Castina, Linda M Griffith, Julia S Goldstein, Dennis Wallace, Oana Craciunescu, Dinesh Khanna, Rodney J Folz, Jonathan Goldin, E William St Clair, James R Seibold, Kristine Phillips, Shin Mineishi, Robert W Simms, Karen Ballen, Mark H Wener, George E Georges, Shelly Heimfeld, Chitra Hosing, Stephen Forman, Suzanne Kafaja, Richard M Silver, Leroy Griffing, Jan Storek, Sharon LeClercq, Richard Brasington, Mary E Csuka, Christopher Bredeson, Carolyn Keever-Taylor, Robyn T Domsic, M Bashar Kahaleh, Thomas Medsger, Daniel E Furst
BACKGROUND: Despite current therapies, diffuse cutaneous systemic sclerosis (scleroderma) often has a devastating outcome. We compared myeloablative CD34+ selected autologous hematopoietic stem-cell transplantation with immunosuppression by means of 12 monthly infusions of cyclophosphamide in patients with scleroderma. METHODS: We randomly assigned adults (18 to 69 years of age) with severe scleroderma to undergo myeloablative autologous stem-cell transplantation (36 participants) or to receive cyclophosphamide (39 participants)...
January 4, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29296873/tandem-autologous-allogeneic-hematopoietic-cell-transplantation-with-bortezomib-maintenance-therapy-for-high-risk-myeloma
#14
Damian J Green, David G Maloney, Barry E Storer, Brenda M Sandmaier, Leona A Holmberg, Pamela S Becker, Min Fang, Paul J Martin, George E Georges, Michelle E Bouvier, Rainer Storb, Marco Mielcarek
We evaluated tandem autologous/allogeneic hematopoietic cell transplantation followed by bortezomib maintenance therapy in a prospective phase 2 trial of treatment of high-risk multiple myeloma. The high-dose conditioning regimen for autologous hematopoietic cell transplantation consisted of melphalan 200 mg/m2 . The nonmyeloablative conditioning regimen for the allogeneic transplant involved low-dose total body irradiation (2 Gy) with or without fludarabine (30 mg/m2 × 3 days). Among the 31 patients enrolled, 26 (84%) proceeded to HLA-matched allogeneic hematopoietic cell transplantation at a median of 61 (range, 41-168) days following the autologous transplant...
November 14, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296864/immune-tolerance-induction-by-nonmyeloablative-haploidentical-hsct-combining-t-cell-depletion-and-posttransplant-cyclophosphamide
#15
Franco Aversa, Esther Bachar-Lustig, Noga Or-Geva, Lucia Prezioso, Sabrina Bonomini, Ilenia Manfra, Alessandro Monti, Chiara Schifano, Yael Zlotnikov-Klionsky, Massimo F Martelli, Gabriella Sammarelli, Maria Sassi, Maurizio Soli, Silvia Giuliodori, Magda Benecchi, Nicola Giuliani, Frank Lohr, Silvia Pratissoli, Yair Reisner
The establishment of safe approaches to attain durable donor-type chimerism and immune tolerance toward donor antigens represents a major challenge in transplantation biology. Haploidentical hematopoietic stem cell transplantation (HSCT) is currently used for cancer therapy either as a T-cell-depleted megadose HSCT following myeloablative conditioning or with T-cell-replete HSCT following nonmyeloablative conditioning (NMAC) and high-dose posttransplant cyclophosphamide (PTCY). The latter approach suffers from a significant rate of chronic graft-versus-host disease (GVHD), despite prolonged immunosuppression...
November 14, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296777/hla-mismatched-unrelated-donor-transplantation-using-tli-atg-conditioning-has-a-low-risk-of-gvhd-and-potent-antitumor-activity
#16
Michael A Spinner, Marcelo Fernández-Viña, Lisa E Creary, Olivia Quinn, Linda Elder, Sally Arai, Laura J Johnston, Everett H Meyer, David B Miklos, Lori S Muffly, Robert S Negrin, Judith A Shizuru, Wen-Kai Weng, Ginna G Laport, Samuel Strober, Robert Lowsky, Andrew R Rezvani
Many patients lack a fully HLA-matched donor for hematopoietic cell transplantation (HCT), and HLA mismatch is typically associated with inferior outcomes. Total lymphoid irradiation and antithymocyte globulin (TLI-ATG) is a nonmyeloablative conditioning regimen that is protective against graft-versus-host disease (GVHD), and we hypothesized that the protective effect would extend beyond HLA-matched donors. We report outcomes for all consecutively transplanted patients at Stanford University from December 2001 through May 2015 who received TLI-ATG conditioning and HCTs from 8 to 9 out of 10 HLA-mismatched unrelated donors (MMUDs, N = 72) compared with 10 out of 10 HLA-matched unrelated donors (MUDs, N = 193)...
July 25, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296707/cyclophosphamide-improves-engraftment-in-patients-with-scd-and-severe-organ-damage-who-undergo-haploidentical-pbsct
#17
Courtney D Fitzhugh, Matthew M Hsieh, Tiffani Taylor, Wynona Coles, Katherine Roskom, Delon Wilson, Elizabeth Wright, Neal Jeffries, Christopher J Gamper, Jonathan Powell, Leo Luznik, John F Tisdale
Peripheral blood stem cell transplantation (PBSCT) offers a curative option for sickle cell disease (SCD). Although HLA-matched sibling transplantation is promising, the vast majority of patients lack such a donor. We sought to develop a novel nonmyeloablative HLA-haploidentical PBSCT approach that could safely be used for patients with severe organ damage. Based on findings in our preclinical model, we developed a phase 1/2 trial using alemtuzumab, 400 cGy total body irradiation, and escalating doses of posttransplant cyclophosphamide (PT-Cy): 0 mg/kg in cohort 1, 50 mg/kg in cohort 2, and 100 mg/kg in cohort 3...
April 25, 2017: Blood Advances
https://www.readbyqxmd.com/read/29259833/small-split-doses-of-cd34-peripheral-blood-stem-cells-to-support-repeated-cycles-of-nonmyeloablative-chemotherapy
#18
Maxim Yankelevich, Sureyya Savasan, Igor Dolgopolov, Roland Chu, George Mentkevich
Cumulative myelosuppression is the main limiting factor for administration of repeated cycles of chemotherapy. We present a case series of five pediatric patients with high-risk solid malignancies who received small split peripheral blood stem cells (PBSC) doses of less than 1 × 106 /kg CD34+ cells obtained after a single leukapheresis procedure and given after repeated cycles of ICE (ifosfamide, carboplatin, and etoposide) chemotherapy. Mean duration to absolute neutrophil count (ANC) recovery to >1000/mm3 and platelet recovery to >50 × 103 /mm3 was 17...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/29242852/prospective-study-of-nonmyeloablative-hla-mismatched-unrelated-bmt-with-high-dose-posttransplantation-cyclophosphamide
#19
Yvette L Kasamon, Richard F Ambinder, Ephraim J Fuchs, Marianna Zahurak, Gary L Rosner, Javier Bolaños-Meade, Mark J Levis, Douglas E Gladstone, Carol Ann Huff, Lode J Swinnen, William H Matsui, Ivan Borrello, Robert A Brodsky, Richard J Jones, Leo Luznik
Allogeneic blood or marrow transplantation (BMT) candidates may lack HLA-matched, related haploidentical, and unrelated umbilical cord options. Barriers to partially HLA-mismatched, unrelated donor (mMUD) BMT include excess graft-versus-host disease (GVHD), graft failure, and death. We prospectively studied nonmyeloablative (NMA) mMUD BMT with high-dose posttransplantation cyclophosphamide (PTCy) for patients with hematologic malignancies. Three transplants were performed with busulfan/fludarabine conditioning, with subsequent change to fludarabine/Cy/total body irradiation (flu/Cy/TBI)...
2017: Blood Advances
https://www.readbyqxmd.com/read/29222306/therapy-of-primary-cns-lymphoma-role-of-intensity-radiation-and-novel-agents
#20
REVIEW
Andrés José María Ferreri
Primary central nervous system (CNS) lymphomas represent a subgroup of malignancies with specific characteristics, an aggressive course, and unsatisfactory outcome in contrast with other lymphomas comparable for tumor burden and histological type. Despite the high sensitivity to conventional chemotherapy and radiotherapy, remissions are frequently short lasting. Treatment efficacy is limited by several factors, including the biology and microenvironment of this malignancy and the "protective" effect of the blood-brain barrier, which limits the access of most drugs to the CNS...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
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