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Haploidentical transplant

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https://www.readbyqxmd.com/read/29334367/unmanipulated-haploidentical-transplantation-conditioning-with-busulfan-cyclophosphamide-and-anti-thymoglobulin-for-adult-severe-aplastic-anaemia
#1
L-P Xu, Z-L Xu, F-R Wang, X-D Mo, T-T Han, W Han, Y-H Chen, Y-Y Zhang, J-Z Wang, Y Wang, C-H Yan, Y-Q Sun, F-F Tang, X-H Zhang, X-J Huang
We conducted a retrospective analysis to evaluate outcomes of haploidentical transplantation in adult severe aplastic anaemia (SAA) patients. Fifty-one adults received haploidentical transplantation between May 2011 and December 2016. Patients were administered busulfan (Bu), cyclophosphamide (Cy) and anti-thymoglobulin (ATG) as conditioning regimens, followed by bone marrow and peripheral blood transplantation. The patients' median age was 25 years. Forty-nine patients survived for more than 28 days and all achieved donor myeloid engraftment...
January 15, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29330405/better-outcome-with-haploidentical-over-hla-matched-related-donors-in-patients-with-hodgkin-s-lymphoma-undergoing-allogeneic-haematopoietic-cell-transplantation-a-study-by-the-francophone-society-of-bone-marrow-transplantation-and-cellular-therapy
#2
Jordan Gauthier, Xavier Poiré, Anne-Claire Gac, Mathieu Leclerc, Thierry Guillaume, Yves Chalandon, Stéphanie Nguyen, Edouard Forcade, Caroline Régny, Jacques-Olivier Bay, Ali Bazarbachi, Pierre-Simon Rohrlich, Anne Huynh, Jonathan Farhi, Tony Marchand, Jean-Valère Malfuson, Sylvain Pilorge, Hélène Labussière-Wallet, Cécile Renard, Luc-Matthieu Fornecker, Marie Detrait, Rémy Duléry, Jérémy Delage, Anne-Lise Ménard, Amandine Charbonnier, Brigitte Nelken, Charlotte Jubert, Felipe Suarez, Régis Peffault de la Tour, Yves Beguin, Hélène Schoemans, Didier Blaise, Ibrahim Yakoub-Agha
The question of the best donor type between haploidentical (HAPLO) and matched-related donors (MRD) for patients with advanced HL receiving an allogeneic hematopoietic cell transplantation (allo-HCT) is still debated. Given the lack of data comparing these two types of donor in the setting of non-myeloablative (NMA) or reduced-intensity (RIC) allo-HCT, we performed a multicentre retrospective study using graft-vs.-host disease-free relapse-free survival (GRFS) as our primary endpoint. We analysed the data of 151 consecutive HL patients who underwent NMA or RIC allo-HCT from a HAPLO (N  =  61) or MRD (N  =  90) between January 2011 and January 2016...
January 12, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29330396/comparable-survival-using-a-cmv-matched-or-a-mismatched-donor-for-cmv-patients-undergoing-t-replete-haplo-hsct-with-pt-cy-for-acute-leukemia-a-study-of-behalf-of-the-infectious-diseases-and-acute-leukemia-working-parties-of-the-ebmt
#3
Simone Cesaro, Roberto Crocchiolo, Gloria Tridello, Nina Knelange, Maria Teresa Van Lint, Yener Koc, Fabio Ciceri, Zafer Gülbas, Johanna Tischer, Boris Afanasyev, Benedetto Bruno, Luca Castagna, Didier Blaise, Mohamad Mohty, Giuseppe Irrera, J L Diez-Martin, Luca Pierelli, Pietro Pioltelli, Mutlu Arat, Mario Delia, Franca Fagioli, Gerhard Ehninger, Mahmoud Aljurf, Angelo Michele Carella, Hakan Ozdogu, Malgorzata Mikulska, Per Ljungman, Arnon Nagler, Jan Styczynski
The role of donor CMV serostatus in the setting of non T-cell depleted haplo-HSCT with post-transplant cyclophosphamide (PT-Cy) has not been specifically addressed so far. Here we analyzed the impact of the donor CMV serological status on the outcome of 983 CMV seropositive (CMV+), acute leukemia patients receiving a first, non T-cell depleted haplo-HSCT registered in the EBMT database. The 1-year NRM was 21.3% (95% CI: 18.4-24.8) and 18.8% (95% CI: 13.8-25.5) in the CMV D+/R+ and D-/R+ pairs, respectively (p = 0...
January 12, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29330393/haploidentical-bone-marrow-transplantation-with-post-transplant-cyclophosphamide-for-patients-with-x-linked-adrenoleukodystrophy-a-suitable-choice-in-an-urgent-situation
#4
Juliana Folloni Fernandes, Carmem Bonfim, Fábio Rodrigues Kerbauy, Morgani Rodrigues, Iracema Esteves, Nathalia Halley Silva, Alessandra Prandini Azambuja, Luiz Fernando Mantovani, José Mauro Kutner, Gisele Loth, Cilmara Cristina Kuwahara, Clarissa Bueno, Andrea Tiemi Kondo, Andreza Alice Feitosa Ribeiro, Fernando Kok, Nelson Hamerschlak
Allogeneic hematopoietic stem cell transplantation (HSCT) is the only treatment that enhances survival and stabilizes neurologic symptoms in X-linked adrenoleukodystrophy (X-ALD) with cerebral involvement, a severe demyelinating disease of childhood. Patients with X-ALD who lack a well-matched HLA donor need a rapid alternative. Haploidentical HSCT using post transplant cyclophosphamide (PT/Cy) has been performed in patients with malignant and nonmalignant diseases showing similar outcomes compared to other alternative sources...
January 12, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29330392/haploidentical-hematopoietic-sct-using-helical-tomotherapy-for-total-body-irradiation-and-targeted-dose-boost-in-patients-with-high-risk-refractory-acute-lymphoblastic-leukemia
#5
Zujun Jiang, Junsong Jia, Chunyan Yue, Yan Pang, Zenghui Liu, Ling Ouyang, Hongbo Li, Jinjian Zhang, Ting Wen, Jing Li, Zhiqiang Li, Yan Wang, Yang Xiao, Haowen Xiao
A novel conditioning regimen using helical tomotherapy (HT) was developed to deliver 10 Gy for total body irradiation (TBI) and simultaneously augment dose to 12 Gy for targeted dose boost to total marrow, central nervous system leukemia, and extramedullary disease sites in patients with high-risk or relapsed/refractory acute lymphoblastic leukemia (ALL) receiving haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT). Fourteen patients were included, eight of these patients were in first complete remission (CR1), one was in CR2, one had a partial response and four patients had refractory disease at transplantation...
January 12, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29325312/-outcomes-of-alternative-donor-allogeneic-hematopoietic-stem-cell-transplantation-for-fanconi-anemia-a-five-cases-report
#6
W J Wang, Y Q Sun, F F Tang, T T Han, X D Mo, J Z Wang, X H Zhang, X J Huang, L P Xu
Five patients with Fanconi anemia who received hematopoietic cell transplantation were retrospectively analyzed. The conditioning regimens included fludarabine, cyclophosphamide and anti-thymocyte globulin. Two patients received both bone marrow and peripheral blood stem cells as the source of stem cell grafts from haploidentical matched related donors, while the others received peripheral blood stem cells from unrelated donors. All patients tolerated well and reached hematopoietic reconstitution. One patient died of intracranial infection...
January 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29307718/haploidentical-stem-cell-transplantation-for-refractory-relapsed-neuroblastoma
#7
Toni Illhardt, Jacek Toporski, Tobias Feuchtinger, Dominik Turkiewicz, Heiko-Manuel Teltschik, Martin Ebinger, Carl-Philipp Schwarze, Ursula Holzer, Holger N Lode, Michael H Albert, Bernd Gruhn, Christian Urban, Josefina H Dykes, Oliver Teuffel, Michael Schumm, Rupert Handgretinger, Peter Lang
BACKGROUND: Pediatric patients with refractory or relapsed metastatic neuroblastoma (NBL) have a poor prognosis despite autologous stem cell transplantation (SCT). Allogeneic SCT from haploidentical donors had remarkable alloreactive effects in leukemia patients; hence, we evaluated this approach in children with very high-risk NBL. METHODS: We analyzed data from two prospective phase I/II trials. 26 patients with refractory (n=5) or metastatic relapsed (n=20) or locally relapsed MYCN+ (n=1) neuroblastoma received a median of 17x106/kg T/B cell depleted CD34+ stem cells with 68x103/kg residual T cells and 107x106/kg NK cells...
January 4, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29297965/the-impact-of-alternative-donor-types-on-viral-infections-in-pediatric-hematopoietic-stem-cell-transplantation
#8
D Atay, A Akcay, F Erbey, G Ozturk
Viral infections remain one of the most important complications following allogeneic HSCT. Few reports compare virus infection between different donor types in pediatric patients. We retrospectively analyzed viral infections and the outcome of one hundred and seventy-one pediatric patients (median 7.38 years) who underwent allogeneic HSCT from matched related donor (MRD, n = 71), 10 of 10 HLA allele-matched unrelated donors (MUD1; n = 29), 9 of 10 HLA allele-matched unrelated donors (MUD2; n = 40), and haploidentical donors (n = 31)...
January 3, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29297952/first-line-choice-for-severe-aplastic-anemia-in-children-transplantation-from-a-haploidentical-donor-vs-immunosuppressive-therapy
#9
Yifei Cheng, Zhengli Xu, Yuanyuan Zhang, Jun Wu, Fengrong Wang, Xiaodong Mo, Yuhong Chen, Wei Han, Jinsong Jia, Yu Wang, Xiaohui Zhang, Xiaojun Huang, Leping Zhang, Lanping Xu
We retrospectively compared the outcomes of children with severe aplastic anemia (SAA) who received immunosuppressive therapy (IST) or who underwent hematopoietic stem cell transplantation (HSCT) from a haploidentical donor (HID), between 2007 and 2016. A total of 52 children with SAA under the age of 17 years were initially treated with IST (n = 24) or haploidentical HSCT (n = 28) as first-line treatment. The estimated 10-year overall survival was 73.4 ± 12.6% and 89.3 ± 5.8% in patients treated with IST or HID-HSCT (P = ...
December 18, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29296864/immune-tolerance-induction-by-nonmyeloablative-haploidentical-hsct-combining-t-cell-depletion-and-posttransplant-cyclophosphamide
#10
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/29296834/haploidentical-transplant-in-patients-with-myelodysplastic-syndrome
#11
Marie Robin, Raphael Porcher, Fabio Ciceri, Maria Teresa van Lint, Stella Santarone, Gerhard Ehninger, Didier Blaise, Zafer Güllbas, Soledad Gonzáles Muñiz, Mauricette Michallet, Andrea Velardi, Linda Koster, Johan Maertens, Jorge Sierra, Dominik Selleslag, Aleksandar Radujkovic, José L Díez-Martin, Lothar Kanz, Concepcion Herrera Arroyo, Dietger Niederwieser, He Huang, Andrew McDonald, Theo de Witte, Yener Koc, Nicolaus Kröger
The only curative treatment in patients with intermediate or high-risk myelodysplastic syndrome (MDS) is allogeneic hematopoietic stem cell transplantation (HSCT), which usually results in a long-term, disease-free survival rate of between 30% and 50%, depending on the disease risk and the type of donor. In patients without an HLA-matched sibling donor, a family haploidentical donor is an alternative option. The present study reports the European Group for Blood and Marrow Transplantation activity for haploidentical transplantation in MDS patients...
October 10, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296709/the-impact-of-hla-matching-on-outcomes-of-unmanipulated-haploidentical-hsct-is-modulated-by-gvhd-prophylaxis
#12
Francesca Lorentino, Myriam Labopin, Katharina Fleischhauer, Fabio Ciceri, Carlheinz R Mueller, Annalisa Ruggeri, Avichai Shimoni, Martin Bornhäuser, Andrea Bacigalupo, Zafer Gülbas, Yener Koc, William Arcese, Benedetto Bruno, Johanna Tischer, Didier Blaise, Giuseppe Messina, Dietrich W Beelen, Arnon Nagler, Mohamad Mohty
Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with unmanipulated grafts is increasingly adopted for high-risk acute leukemia, with acute graft-versus-host disease (aGVHD) prophylaxis based on antithymocyte globulin (ATG) or posttransplant cyclophosphamide (PTCy) as main platforms. No consensus exists on selection criteria over several haploidentical donors. We evaluated the impact of donor-recipient antigenic and allelic HLA-A, -B, -C, and -DRB1 mismatches on mismatched haplotype on outcomes of 509 unmanipulated haplo-HSCTs performed for acute leukemia under a PTCy (N = 313) or ATG (N = 196) regimen...
April 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
#13
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/29289758/comparison-of-autologous-stem-cell-transplantation-versus-haploidentical-donor-stem-cell-transplantation-for-favorable-and-intermediate-risk-acute-myeloid-leukemia-patients-in-first-complete-remission
#14
Jia Chen, Lingyi Yang, Yi Fan, Yang Xu, Yue Han, Xiaowen Tang, Huiying Qiu, Chengcheng Fu, Miao Miao, Feng Chen, Depei Wu
Stem cell transplantation (SCT) is an attractive post-remission treatment option for patients with intermediate-risk acute myeloid leukemia (AML) and for some favorable-risk AML patients with additional non-genetic risk factors. Autologous SCT (auto-SCT) and haplo-identical donor SCT (haplo-SCT) are the widely used alternatives in case of a lack of a human leukocyte antigen (HLA)-matched donor. However, limited data have been published on the direct comparison between these two transplant types. Based on the transplantation database in our center, we conducted a retrospective study involving patients with favorable- and intermediate-risk AML in first complete remission (CR1), according to the NCCN guideline...
December 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29289741/immune-monitoring-of-transplant-patients-in-transient-mixed-chimerism-tolerance-trials
#15
REVIEW
Megan Sykes
This review focuses on mechanistic studies performed in recipients of non-myeloablative bone marrow transplant regimens developed at Massachusetts General Hospital in HLA-identical and HLA-mismatched haploidentical combinations, initially as a platform for treatment of hematologic malignancies with immunotherapy in the form of donor leukocyte infusions, and later in combination with donor kidney transplantation for the induction of allograft tolerance. These studies point to a prominent early role for regulatory T cells in tolerance induction, followed by partial and gradual deletion of donor-reactive T cells...
December 28, 2017: Human Immunology
https://www.readbyqxmd.com/read/29288821/reduced-intensity-allogeneic-transplant-for-acute-myeloid-leukemia-and-myelodysplastic-syndrome-using-combined-cd34-selected-haploidentical-graft-and-a-single-umbilical-cord-unit-compared-to-matched-unrelated-donor-stem-cells-in-older-adults
#16
Stephanie B Tsai, Joanna Rhodes, Hongtao Liu, Tsiporah Shore, Michael Bishop, Melissa M Cushing, Usama Gergis, Lucy Godley, Justin Kline, Richard A Larson, Sebastian Mayer, Olatoyosi Odenike, Wendy Stock, Amittha Wickrema, Koen van Besien, Andrew S Artz
Haplo/cord transplantation combines an umbilical cord blood (UCB) graft with CD34-selected haploidentical cells and results in rapid hematopoietic recovery followed by durable UCB engraftment. We compared outcomes of transplants in older patients with acute myeloid leukemia (AML) or high-risk myelodysplastic syndromes (MDS) who received either HLA-matched unrelated donor cells (MUD) or haplo/cord grafts. Between 2007 and 2013, 109 adults ages 50 and older underwent similar reduced intensity conditioning (RIC) with fludarabine and melphalan and antibody-mediated T-cell depletion for AML (n=83) or high risk MDS (n=26) followed by either a MUD (n=68) or haplo/cord (n=41) graft...
December 27, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29283908/have-haploidentical-transplants-replaced-umbilical-cord-transplants-for-acute-leukemias
#17
Jia Hau Liu, Christopher G Kanakry, Leo Luznik
PURPOSE OF REVIEW: Haploidentical stem cell transplantation (Haplo SCT) and umbilical cord blood stem cell transplantation (UCB SCT) have emerged over the past two to three decades as viable sources of alternative donor SCT when a human leukocyte antigen matched donor is not available. However, which of these two donor types is optimal for patients with leukemia in need of allografting is unknown. RECENT FINDINGS: For patients with acute leukemia, results of UCB SCT have been improved by the use of double umbilical cord units and emerging ex vivo expansion technologies...
December 27, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/29251580/successful-treatment-of-lung-aspergillus-terreus-infection-after-a-second-hematopoietic-stem-cell-transplant-in-a-patient-with-myelodysplastic-syndrome
#18
Yu Zhang, Junfa Chen, Lili Qian, Xuejing Yang, Jianping Shen
A 24-year-old man was diagnosed with myelodysplastic syndrome and received a haploidentical hematopoietic stem cell transplant. The patient experienced graft failure posttransplant. Analysis of specific antibodies revealed that the patient had strongly positive donor-specific antibodies; therefore, we changed the donor to the patient's mother and added a single unit of cord blood to perform the second transplant. Corresponding treatments targeting donor-specific antibodies were administered to reverse the graft rejection and to reduce the antibody load...
December 18, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29247781/kir-ligand-mismatch-in-donor-vs-recipient-direction-provides-better-graft-versus-tumor-effect-in-patients-with-hematological-malignancies-undergoing-allogeneic-t-replete-haploidentical-transplantation-followed-by-post-transplant-cyclophosphamide
#19
Anne Wanquet, Stephania Bramanti, Samia Harbi, Sabine Fürst, Faezeh Legrand, Catherine Faucher, Angela Granata, Boris Calmels, Claude Lemarie, Christophe Picard, Christian Chabannon, Pierre-Jean Weiller, Luca Castagna, Didier Blaise, Raynier Devillier
We evaluated the impact of unidirectional donor vs. recipient killer-cell immunoglobulin-like receptor (KIR)-ligand mismatch (KIR-Lmm) on the outcomes of T-replete Haplo-SCT with post-transplant cyclophosphamide (PT-Cy) in a cohort of 144 patients treated for various hematological diseases. We separately analyzed 81 patients in complete remission (CR group) and 63 with active disease (no CR group) at the time of Haplo-SCT. One-third of patients in each group had KIR-Lmm. In the no CR group, KIR-Lmm was associated with a significantly lower incidence of relapse (hazard ratio (HR) = 0...
December 13, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29242852/prospective-study-of-nonmyeloablative-hla-mismatched-unrelated-bmt-with-high-dose-posttransplantation-cyclophosphamide
#20
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
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