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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
Sandra Eder, Eric Beohou, Myriam Labopin, Jaime Sanz, Jürgen Finke, William Arcese, Reuven Or, Francesca Bonifazi, Mahmoud Aljurf, Gerard Socié, Jakob Passweg, Sebastian Giebel, Mohamad Mohty, Arnon Nagler
In this study, we analyzed a thiotepa-based conditioning regimen for allogeneic stem cell transplantation in adults with acute lymphoblastic leukemia, using the EBMT database. A total of 323 patients were identified. The median age was 43 years. Disease status at transplant was first complete remission (CR1) in 48.9%, CR2 in 21.7%, CR3 in 6.2%, while 23.2% of the patients had an active disease at the time of transplant. This was performed from a HLA-matched sibling (49.8%) or a matched-unrelated donor (51.2%)...
September 27, 2016: American Journal of Hematology
Carsten Speckmann, Sam Doerken, Alessandro Aiuti, Michael H Albert, Waleed Al-Herz, Luis M Allende, Allessia Scarselli, Tadej Avcin, Ruy Perez-Becker, Caterina Cancrini, Andrew Cant, Silvia Di Cesare, Andrea Finocchi, Alain Fischer, H Bobby Gaspar, Sujal Ghosh, Andrew Gennery, Kimberly Gilmour, Luis I González-Granado, Monica Martinez-Gallo, Sophie Hambleton, Fabian Hauck, Manfred Hoenig, Despina Moshous, Benedicte Neven, Tim Niehues, Luigi Notarangelo, Capucine Picard, Nikolaus Rieber, Ansgar Schulz, Klaus Schwarz, Markus G Seidel, Pere Soler-Palacin, Polina Stepensky, Brigitte Strahm, Thomas Vraetz, Klaus Warnatz, Christine Winterhalter, Austen Worth, Sebastian Fuchs, Annette Uhlmann, Stephan Ehl
BACKGROUND: Absent T cell immunity resulting in life-threatening infections provides a clear rationale for hematopoetic stem cell transplantation (HSCT) in patients with severe combined immunodeficiency (SCID). Combined immunodeficiencies (CID) and "atypical" SCID show reduced, not absent T-cell immunity. If associated with infections or autoimmunity, they represent profound CID (P-CID), for which outcome data are insufficient for unambiguous early transplant decisions. OBJECTIVES: We recruit non-transplanted P-CID patients aged 1-16 years to compare natural histories of severity-matched patients with/without subsequent transplantation and to determine whether immunological and/or clinical parameters may be predictive for outcome...
September 19, 2016: Journal of Allergy and Clinical Immunology
E M P Cremers, A van Biezen, L C de Wreede, M Scholten, A Vitek, J Finke, U Platzbecker, D Beelen, R Schwerdtfeger, L Volin, N Harhalakis, N Blijlevens, A Nagler, N Kröger, T de Witte
Many pre-transplant factors are known to influence the outcome of allogeneic stem cell transplantation (SCT) treatment in myelodysplastic syndromes (MDS). However, patient cohorts are often heterogeneous by disease stage and treatment modalities, which complicates interpretation of the results. This study aimed to obtain a homogeneous patient cohort by including only de novo MDS patients who received upfront allogeneic SCT after standard high dose myelo-ablative conditioning. The effect of pre-transplant factors such as age, disease stage, transfusions, iron parameters and comorbidity on overall survival (OS), non-relapse mortality (NRM), and relapse incidence (RI) was evaluated in 201 patients...
September 20, 2016: Annals of Hematology
Laurent Garderet, Gordon Cook, Holger W Auner, Benedetto Bruno, Henk Lokhorst, Jose Antonio Perez-Simon, Firoozeh Sahebi, Christof Scheid, Curly Morris, Anja van Biezen, Mohamad Sobh, Mauricette Michallet, Gösta Gahrton, Stefan Schönland, Nicolaus Kröger
Major improvements have been made in the treatment of myeloma. However, all patients, perhaps with some exceptions, eventually relapse, even after autologous stem cell transplantation (ASCT). In that setting, the combinations of new drugs, namely the IMiDs and the proteasome inhibitors along with steroids, give encouraging results in relapsed patients. The median progression-free survival (PFS) is 20 months with lenalidomide plus dexamethasone plus ixazomib and 26 months with lenalidomide plus dexamethasone plus carfilzomib...
September 21, 2016: Leukemia & Lymphoma
S Eder, M Labopin, J Finke, D Bunjes, A Olivieri, S Santarone, A Rambaldi, L Kanz, G Messina, M Mohty, A Nagler
This study evaluated the safety and efficacy of thiotepa-based regimens before allogeneic stem cell transplantation in 310 adult patients with AML. Disease status at the time of transplantation was CR1 in 50%, CR2+ in 23.5% and advanced disease in 26.5%. Transplantation was performed from haploidentical (35%), matched sibling (27%), unrelated (20%) or cord blood (18%) donors. As for safety: mucositis occurred in 46.8% of the patients and the cumulative incidence (CI) of sinusoidal obstruction syndrome was 4...
September 19, 2016: Bone Marrow Transplantation
Annalisa Ruggeri, Giorgia Battipaglia, Myriam Labopin, Gerhard Ehninger, Dietrich Beelen, Johanna Tischer, Arnold Ganser, Rainer Schwerdtfeger, Bertram Glass, Jurgen Finke, Mauricette Michallet, Matthias Stelljes, Pavel Jindra, Renate Arnold, Nicolaus Kröger, Mohamad Mohty, Arnon Nagler
BACKGROUND: Allogeneic stem cell transplantation is the only curative option for patients with acute myeloid leukemia (AML) experiencing relapse. Either matched sibling donor (MSD) or unrelated donor (UD) is indicated. METHODS: We analyzed 1554 adults with AML transplanted from MSD (n = 961) or UD (n = 593, HLA-matched 10/10, n = 481; 9/10, n = 112). Compared to MSD, UD recipients were older (49 vs 52 years, p = 0.001), transplanted more recently (2009 vs 2006, p = 0...
September 17, 2016: Journal of Hematology & Oncology
Gwendolyn van Gorkom, Herve Finel, Sebastian Giebel, David Pohlreich, Avichai Shimoni, Mark Ringhoffer, Gülsan Sucak, Nicolaas Schaap, Peter Dreger, Anna Sureda, Harry C Schouten
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) to rescue hematopoiesis is considered standard care for patients with a relapsed chemosensitive lymphoma, but diagnosis of lymphoma has been a risk factor for poor mobilization in several studies. The aim of this prospective noninterventional clinical audit was to review the mobilization strategies used by EBMT centers in relapsed lymphoma and to evaluate their efficacy. Between 2010 and 2014, 275 patients with relapsed lymphoma from 30 EBMT centers were prospectively registered...
September 10, 2016: Journal of Clinical Apheresis
Francesco Saraceni, Myriam Labopin, Norbert-Claude Gorin, Didier Blaise, Reza Tabrizi, Liisa Volin, Jan Cornelissen, Jean-Yves Cahn, Patrice Chevallier, Charles Craddock, Depei Wu, Anne Huynh, William Arcese, Mohamad Mohty, Arnon Nagler
BACKGROUND: Optimal post-remission strategy for patients with acute myeloid leukemia (AML) is matter of intense debate. Recent reports have shown stronger anti-leukemic activity but similar survival for allogeneic stem cell transplantation (allo-HSCT) from matched sibling donor compared to autologous transplantation (auto-HSCT); however, there is scarcity of literature confronting auto-HSCT with allo-HSCT from unrelated donor (UD-HSCT), especially mismatched UD-HSCT. METHODS: We retrospectively compared outcome of allogeneic transplantation from matched (10/10 UD-HSCT) or mismatched at a single HLA-locus unrelated donor (9/10 UD-HSCT) to autologous transplantation in patients with AML in first complete remission (CR1)...
2016: Journal of Hematology & Oncology
Georg Maschmeyer, Jannik Helweg-Larsen, Livio Pagano, Christine Robin, Catherine Cordonnier, Peter Schellongowski
The initiation of systemic antimicrobial treatment of Pneumocystis jirovecii pneumonia (PCP) is triggered by clinical signs and symptoms, typical radiological and occasionally laboratory findings in patients at risk of this infection. Diagnostic proof by bronchoalveolar lavage should not delay the start of treatment. Most patients with haematological malignancies present with a severe PCP; therefore, antimicrobial therapy should be started intravenously. High-dose trimethoprim/sulfamethoxazole is the treatment of choice...
September 2016: Journal of Antimicrobial Chemotherapy
Johan Maertens, Simone Cesaro, Georg Maschmeyer, Hermann Einsele, J Peter Donnelly, Alexandre Alanio, Philippe M Hauser, Katrien Lagrou, Willem J G Melchers, Jannik Helweg-Larsen, Olga Matos, Stéphane Bretagne, Catherine Cordonnier
The 5th European Conference on Infections in Leukaemia (ECIL-5) meeting aimed to establish evidence-based recommendations for the prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in non-HIV-infected patients with an underlying haematological condition, including allogeneic HSCT recipients. Recommendations were based on the grading system of the IDSA. Trimethoprim/sulfamethoxazole given 2-3 times weekly is the drug of choice for the primary prophylaxis of PCP in adults ( A-II: ) and children ( A-I: ) and should be given during the entire period at risk...
September 2016: Journal of Antimicrobial Chemotherapy
Alexandre Alanio, Philippe M Hauser, Katrien Lagrou, Willem J G Melchers, Jannik Helweg-Larsen, Olga Matos, Simone Cesaro, Georg Maschmeyer, Hermann Einsele, J Peter Donnelly, Catherine Cordonnier, Johan Maertens, Stéphane Bretagne
The Fifth European Conference on Infections in Leukaemia (ECIL-5) convened a meeting to establish evidence-based recommendations for using tests to diagnose Pneumocystis jirovecii pneumonia (PCP) in adult patients with haematological malignancies. Immunofluorescence assays are recommended as the most sensitive microscopic method (recommendation A-II: ). Real-time PCR is recommended for the routine diagnosis of PCP ( A-II: ). Bronchoalveolar lavage (BAL) fluid is recommended as the best specimen as it yields good negative predictive value ( A-II: )...
September 2016: Journal of Antimicrobial Chemotherapy
Catherine Cordonnier, Simone Cesaro, Georg Maschmeyer, Hermann Einsele, J Peter Donnelly, Alexandre Alanio, Philippe M Hauser, Katrien Lagrou, Willem J G Melchers, Jannik Helweg-Larsen, Olga Matos, Stéphane Bretagne, Johan Maertens
Pneumocystis jirovecii can cause life-threatening pneumonia following treatment for haematological malignancies or after HSCT. The mortality rate of P. jirovecii pneumonia (PCP) in these patients is 30%-60%, especially after HSCT. The clinical presentation of PCP in haematology differs from that associated with HIV infection, with the disease being acute and more often severe, having a lower fungal burden and being more frequently linked to treatment with corticosteroids. Most cases occur in patients not receiving adequate prophylaxis...
September 2016: Journal of Antimicrobial Chemotherapy
Z DeFilipp, R F Duarte, J A Snowden, N S Majhail, D M Greenfield, J L Miranda, M Arat, K S Baker, L J Burns, C N Duncan, M Gilleece, G A Hale, M Hamadani, B K Hamilton, W J Hogan, J W Hsu, Y Inamoto, R T Kamble, M T Lupo-Stanghellini, A K Malone, P McCarthy, M Mohty, M Norkin, P Paplham, M Ramanathan, J M Richart, N Salooja, H C Schouten, H Schoemans, A Seber, A Steinberg, B M Wirk, W A Wood, M Battiwalla, M E D Flowers, B N Savani, B E Shaw
Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus and all cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with the estimated prevalence of MetS being 31-49% among HCT recipients. Although MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality...
August 22, 2016: Bone Marrow Transplantation
Marie T Rubio, Bipin N Savani, Myriam Labopin, Emmanuelle Polge, Dietger Niederwieser, Arnold Ganser, Rainer Schwerdtfeger, Gerhard Ehninger, Jürgen Finke, Arnold Renate, Charles Craddock, Nicolaus Kröger, Michael Hallek, Pavel Jindra, Mohamad Mohty, Arnon Nagler
BACKGROUND: Data comparing fully matched and mismatched-unrelated-donor (M- and mM-URD) allogeneic hematopoietic stem cell transplant (allo-SCT) following reduced intensity conditioning regimens for acute myeloid leukemia are limited. METHODS: We retrospectively compared the outcome of 3398 patients above the age of 50 years who underwent 10/10 M-URD (n = 2567), 9/10 (n = 723), or 8/10 (n = 108) mM-URD allo-SCT for acute myeloid leukemia after reduced intensity conditioning regimen between 2000 and 2013...
2016: Journal of Hematology & Oncology
Robert Chiesa, Annalisa Ruggeri, Annalisa Paviglianiti, Marco Zecca, Marta Gónzalez-Vicent, Victoria Bordon, Jerry Stein, Sarah Lawson, Sophie Dupont, Edoardo Lanino, Manuel Abecasis, Amal Al-Seraihy, Chantal Kenzey, Marc Bierings, Franco Locatelli, Eliane Gluckman, Ansgar Schulz, Andrew Gennery, Kristin Page, Joanne Kurtzberg, Vanderson Rocha
Hematopoietic stem cell transplantation (HSCT) is the only curative treatment for most children with osteopetrosis (OP). Timing of HSCT is critical; therefore, umbilical cord blood transplantation (UCBT) is an attractive option. We analyzed outcomes after UCBT in 51 OP children. Median age at UCBT was 6 months. Seventy-seven percent of the cord blood grafts had 0 or 1 HLA disparity with the recipient. Conditioning regimen was myeloablative (mostly busulfan-based in 84% and treosulfan-based in 10%). Antithymocyte globulin was given to 90% of patients...
November 2016: Biology of Blood and Marrow Transplantation
M Michallet, B Corront, L Molina, A Gratwohl, N Milpied, C Dauriac, S Brunet, J Soler, J P Jouet, H E Bourdeau, W Arcese, F Witz, A Moine, F E Zwaan
Allogeneic bone marrow transplantation (BMT) was performed in 17 patients with chronic lymphocytic leukemia (CLL): 15 resistant and 2 untreated forms; 12 males and 5 females with a mean age of 40 years (32-49). The conditioning regimen and graft versus host disease (GVHD) prophylaxis were varied. Successful engraftment was obtained in 15 evaluable cases. Lymphocytosis and clinical symptoms subsided in all but one case. All 15 evaluable patients developed acute GVHD. Among the 17 patients grafted, one early death was observed at the 15th day post-BMT, and one refractory form died 2 months after BMT...
1991: Leukemia & Lymphoma
Andrea Necchi, Salvatore Lo Vullo, Marco Bregni, Giovanni Rosti, Luigi Mariani, Daniele Raggi, Patrizia Giannatempo, Simona Secondino, Kathrin Schumacher, Christophe Massard, Edward Kanfer, Karin Oechsle, Daniele Laszlo, Mariagrazia Michieli, Norbert Ifrah, Melanie Mercier, Martina Crysandt, Patrick Wuchter, Arnon Nagler, Anders Wahlin, Massimo Martino, Manuela Badoglio, Paolo Pedrazzoli, Francesco Lanza
BACKGROUND: The optimal management of advanced seminoma that relapses after chemotherapy remains unknown. We retrospectively analyzed outcomes with the use of high-dose chemotherapy (HDCT). PATIENTS AND METHODS: Eligibility included adult male patients with pure seminomatous histology and treatment with salvage HDCT. Data of patients who received HDCT from 13 European Society for Blood and Marrow Transplantation (EBMT) centers were used. Multivariable Cox analyses evaluated the association of prespecified factors (line of treatment, prior radiotherapy, and chemosensitivity according to standard definition), with progression-free (PFS) and overall survival (OS)...
June 27, 2016: Clinical Genitourinary Cancer
Diana Averbuch, Dan Engelhard, Anna Pegoraro, Simone Cesaro
Neutropenic patients with malignancies and hematopoietic stem cell transplant recipients are prone to severe infections. Reversal of neutropenia with granulocyte transfusion (GTX) from donors stimulated with GCSF with/without steroids aims to improve outcome of infection. Cochrane analysis of randomized controlled studies, however, failed to show reduced mortality following GTX in conjunction with antibiotics. Non-randomized studies published during the last 20 years produced a very broad spectrum of results...
July 5, 2016: Current Drug Targets
Jan Styczynski, Walter van der Velden, Christopher P Fox, Dan Engelhard, Rafael de la Camara, Catherine Cordonnier, Per Ljungman
Epstein-Barr virus-related post-transplant lymphoproliferative disorders are recognized as a significant cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation. To better define current understanding of post-transplant lymphoproliferative disorders in stem cell transplant patients, and to improve its diagnosis and management, a working group of the Sixth European Conference on Infections in Leukemia 2015 reviewed the literature, graded the available quality of evidence, and developed evidence-based recommendations for diagnosis, prevention, prophylaxis and therapy of post-transplant lymphoproliferative disorders exclusively in the stem cell transplant setting...
July 2016: Haematologica
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