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Graft vs host disease

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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
#1
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/29330393/haploidentical-bone-marrow-transplantation-with-post-transplant-cyclophosphamide-for-patients-with-x-linked-adrenoleukodystrophy-a-suitable-choice-in-an-urgent-situation
#2
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/29330391/impact-of-antithymocyte-globulin-doses-in-reduced-intensity-conditioning-before-allogeneic-transplantation-from-matched-sibling-donor-for-patients-with-acute-myeloid-leukemia-a-report-from-the-acute-leukemia-working-party-of-european-group-of-bone-marrow-transplantation
#3
Raynier Devillier, Myriam Labopin, Patrice Chevallier, Marie-Pierre Ledoux, Gérard Socié, Anne Huynh, Jean-Henri Bourhis, Jean-Yves Cahn, Gabrielle Roth-Guepin, Ghulam Mufti, Déborah Desmier, Mauricette Michallet, Nathalie Fegueux, Fabio Ciceri, Fréderic Baron, Didier Blaise, Arnon Nagler, Mohamad Mohty
Antithymocyte globulin (ATG) is commonly used for graft-vs.-host disease (GVHD) prophylaxis in unrelated donor allogeneic transplantation (Allo-HSCT). However, its use is still controversial in matched sibling donor (MSD) Allo-HSCT, notably after reduced intensity conditioning (RIC). ATG dose may influence the outcome, explaining in part the discordant conclusions in MSD Allo-HSCT. We, therefore, analyzed the impact of ATG doses in patients with acute myeloid leukemia in first complete remission undergoing RIC Allo-HSCT from a MSD...
January 12, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29326124/bortezomib-based-immunosuppression-after-reduced-intensity-conditioning-hematopoietic-stem-cell-transplantation-randomized-phase-ii-results
#4
John Koreth, Haesook T Kim, Paulina B Lange, Samuel J Poryanda, Carol G Reynolds, Sharmila Chamling Rai, Philippe Armand, Corey S Cutler, Vincent T Ho, Brett Glotzbecker, Rushdia Yusuf, Sarah Nikiforow, Yi-Bin Chen, Bimalangshu Dey, Malgorzata McMasters, Jerome Ritz, Bruce R Blazar, Robert J Soiffer, Joseph H Antin, Edwin P Alyea
A prior phase I/II trial of bortezomib/tacrolimus/methotrexate prophylaxis after HLA-mismatched reduced intensity conditioning allogeneic hematopoietic stem cell transplantation documented low acute graft versus host disease incidence, with promising overall and progression-free survival. We performed an open-label 3-arm 1:1:1 phase II randomized-controlled-trial comparing grade II-IV acute graft versus host disease between conventional tacrolimus/methotrexate (A) versus bortezomib/tacrolimus/methotrexate (B); and versus bortezomib/sirolimus/tacrolimus (C), in reduced intensity conditioning allogeneic transplantation recipients lacking HLA-matched related donors...
January 11, 2018: Haematologica
https://www.readbyqxmd.com/read/29325063/epidemiology-and-outcomes-of-hematopoietic-stem-cell-transplant-in-hiv-patients-from-1998-to-2012-a-nationwide-analysis
#5
Kathan Mehta, Annie Im, Farah Rahman, Hong Wang, Peter Veldkamp
Background: Prior studies have shown that outcomes of hematopoietic stem cell transplantation (HSCT) in HIV (+) patients are similar to HIV (-) patients since effective implementation of HAART by 1998; but they are limited by small sample size or non-inclusion of recent data. Methods: We queried National Inpatient Sample, a large inpatient dataset in the US, from 1998 to 2012 for HSCT using ICD9 procedure code 41.0. HIV patients were identified by ICD9 diagnostic code of 042, 043, 044, V08 and 079...
January 6, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29309836/ocular-complications-in-a-young-pediatric-population-following-bone-marrow-transplantation
#6
Mary Ellen Hoehn, Julie Calderwood, Edwin Gannon, Brittany Cook, Richard Rochester, Christine Hartford, Brandon Triplett, Anusha Sunkara, Guolian Kang, R Christopher Walton
PURPOSE: To investigate ocular complications associated with bone marrow transplant and associated continued maintenance therapy in a preschool population. METHODS: The medical records of patients <7 years of age were reviewed retrospectively. Patient charts were screened for cataract formation, dry eye, and other anterior and posterior segment disease. RESULTS: Of 270 cases reviewed, 91 met inclusion criteria. Mean age at diagnosis was 3...
January 5, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/29307717/peri-transplant-rbc-transfusion-is-associated-with-increased-risk-of-gvhd-after-allogeneic-stem-cell-transplantation
#7
Sakura Hosoba, Edmund K Waller, Neeta Shenvi, Michael Graiser, Kirk A Easley, Zaid Al-Kadhimi, Akira Andoh, Ana G Antun, Sheliagh Barclay, Cassandra D Josephson, Jean L Koff, H Jean Khoury, Amelia A Langston, James C Zimring, John D Roback, Cynthia R Giver
More than 90% of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients receive red blood cell (RBC) or platelet transfusions in the peritransplant period. We tested the hypothesis that transfusions are associated with development of severe acute graft-versus-host disease (grade III/IV aGvHD) or mortality in allo-HSCT in a retrospective study of 322 consecutive patients receiving allogeneic bone marrow or G-CSF-mobilized blood stem cell grafts for hematological malignancies. Counting RBC and platelet units between day -7 pre-transplant and +27 post-transplant, but excluding transfusions administered after a diagnosis of aGvHD, yielded medians of 5 RBC and 2 platelet units transfused...
January 4, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29305194/cd34-selection-vs-reduced-intensity-conditioning-and-unmodified-graft-for-allogeneic-hematopoietic-cell-transplantation-in-patients-with-aml-and-mds-50-years
#8
Pere Barba, Rodrigo Martino, Qin Zhou, Christina Cho, Hugo Castro-Malaspina, Sean Devlin, Albert Esquirol, Sergio Giralt, Ann A Jakubowski, Dolores Caballero, Molly Maloy, Esperanza B Papadopoulos, José Luís Piñana, María Laura Fox, Francisco Márquez, David Valcárcel, Carlos Solano, Lucía López-Corral, Jorge Sierra, Miguel-Angel Perales
Reduced-intensity conditioning (RIC) and t-cell depletion (TCD) through CD34+ selection without the use of post-transplant immunosuppression are 2 strategies used to reduce non-relapse mortality (NRM) in older patients after allogeneic hematopoietic cell transplantation (allo-HCT). To compare the efficacy of both approaches (RIC and TCD), we evaluated the outcomes of AML and MDS patients > 50 years who underwent allo-HCT from an HLA-matched donor with one of these strategies. Baseline characteristics were comparable between patients receiving TCD (n=204) and RIC (n=151) except for more unrelated donors (68% vs...
January 2, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29304116/the-sorafenib-anti-relapse-effect-after-allohsct-is-associated-with-heightened-alloreactivity-and-accumulation-of-cd8-pd-1-cd279-lymphocytes-in-marrow
#9
Andrzej Lange, Emilia Jaskula, Janusz Lange, Grzegorz Dworacki, Dorota Nowak, Aleksandra Simiczyjew, Monika Mordak-Domagala, Mariola Sedzimirska
We studied three FLT3 ITD acute myeloid leukemia (AML) patients who relapsed after allogeneic haematopoietic stem cell transplantation (alloHSCT) and received multikinase inhibitor (MKI) sorafenib as part of salvage therapy. MKI was given to block the effect of FLT3 ITD mutation which powers proliferation of blast cells. However, the known facts that sorafenib is more effective in patents post alloHSCT suggested that this MKI can augment the immune system surveillance on leukaemia. In the present study, we investigated in depth the effect of sorafenib on the alloreactivity seen post-transplant including that on leukaemia...
2018: PloS One
https://www.readbyqxmd.com/read/29296875/vaccination-with-autologous-myeloblasts-admixed-with-gm-k562-cells-in-patients-with-advanced-mds-or-aml-after-allogeneic-hsct
#10
Vincent T Ho, Haesook T Kim, Natalie Bavli, Martin Mihm, Olga Pozdnyakova, Matthias Piesche, Heather Daley, Carol Reynolds, Nicholas C Souders, Corey Cutler, John Koreth, Edwin P Alyea, Joseph H Antin, Jerome Ritz, Glenn Dranoff, Robert J Soiffer
We report a clinical trial testing vaccination of autologous myeloblasts admixed with granulocyte-macrophage colony-stimulating factor secreting K562 cells after allogeneic hematopoietic stem cell transplantation (HSCT). Patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) with ≥5% marrow blasts underwent myeloblast collection before HSCT. At approximately day +30, 6 vaccines composed of irradiated autologous myeloblasts mixed with GM-K562 were administered. Tacrolimus-based graft-versus-host disease (GVHD) prophylaxis was not tapered until vaccine completion (∼day 100)...
November 14, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296872/chronic-disease-burden-and-frailty-in-survivors-of-childhood-hsct-a-report-from-the-st-jude-lifetime-cohort-study
#11
Hesham M Eissa, Lu Lu, Malek Baassiri, Nickhill Bhakta, Matthew J Ehrhardt, Brandon M Triplett, Daniel M Green, Daniel A Mulrooney, Leslie L Robison, Melissa M Hudson, Kirsten K Ness
Outcomes of hematopoietic stem cell transplantation (HSCT) have markedly improved over the past 2 decades, underscoring a need to better understand the long-term health effects of this intensive treatment modality. We describe the burden of chronic medical conditions and frail health among St. Jude Lifetime Cohort Study participants treated for childhood hematologic malignancies with HSCT (n = 112) or with conventional therapy (n = 1106). Chronic conditions and frail health were ascertained clinically and classified according to a modified version of the Common Terminology Criteria for Adverse Events (version 4...
November 14, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296834/haploidentical-transplant-in-patients-with-myelodysplastic-syndrome
#12
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/29296777/hla-mismatched-unrelated-donor-transplantation-using-tli-atg-conditioning-has-a-low-risk-of-gvhd-and-potent-antitumor-activity
#13
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/29296723/atg-vs-thiotepa-with-busulfan-and-cyclophosphamide-in-matched-related-bone-marrow-transplantation-for-thalassemia
#14
Lawrence Faulkner, Cornelio Uderzo, Sadaf Khalid, Priya Marwah, Rajpreet Soni, Naila Yaqub, Samina Amanat, Itrat Fatima, Sarah Khan Gilani, Tatheer Zahra, Stalin Ramprakash, Lallindra Gooneratne, Ruwangi Dissanayake, Senani Williams, Wasantha Rathnayake, Reshma Srinivas, Amit Sedai, Ankita Kumari, Lailith Parmar, Rakesh Dhanya, Rajat Kumar Agarwal
Matched-related bone marrow transplantation (BMT) may cure >80% of low-risk children with severe thalassemia (ST). Very long-term follow-up studies have shown how the standard busulfan-cyclophosphamide (BuCy) regimen may be associated with normalization of health-related quality of life, no second malignancies in the absence of chronic graft-versus-host disease, and fertility preservation in many patients. However, because BuCy may be associated with high rejection rates, some centers incorporate thiotepa (Tt) in busulfan- or treosulfan-based regimens, a combination that may increase the risk of permanent infertility...
May 23, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296651/long-standing-pili-torti-in-2-patients-with-chronic-graft-vs-host-disease
#15
Lauren R Penzi, Arturo Saavedra, Maryanne M Senna
No abstract text is available yet for this article.
January 2018: JAAD Case Reports
https://www.readbyqxmd.com/read/29258901/association-between-low-plasma-level-of-citrulline-before-allogeneic-hematopoietic-cell-transplantation-and-severe-gastrointestinal-graft-vs-host-disease
#16
Thomas Hueso, Jordan Gauthier, Marie Joncquel Chevalier-Curt, Leonardo Magro, Valerie Coiteux, Remy Dulery, Benjamin Carpentier, Julien Labreuche, Gandhi Damaj, Ibrahim Yakoub-Agha, David Seguy
BACKGROUND & AIMS: The gastrointestinal form of acute graft vs host disease increases morbidity and mortality following allogeneic hematopoietic cell transplantation. Plasma levels of citrulline, a non-proteinogenic amino acid, indicate functional enterocyte mass. We measured citrulline in patients before allogeneic hematopoietic cell transplantation and investigated its association with incidence and severity of gastrointestinal graft vs host disease. METHODS: We performed a retrospective study with 191 patients (69 women, 122 men; median age of 52 years) who underwent allogeneic hematopoietic cell transplantation for hematological malignancies at a tertiary center of France from January 2013 through April 2015...
December 16, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29250743/early-tapering-of-immunosuppressive-agents-after-hla-matched-donor-transplantation-can-improve-the-survival-of-patients-with-advanced-acute-myeloid-leukemia
#17
Jun Yang, Yu Cai, JieLing Jiang, LiPing Wan, HaiTao Bai, Jun Zhu, Su Li, Chun Wang, Xianmin Song
Disease recurrence is the most important obstacle to achieve long-term survival for patients with advanced acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In order to reduce the relapse risk and improve the survival, the strategy of early tapering of immunosuppressive agents was prospectively evaluated. Thirty-one patients with advanced AML received early tapering of immunosuppressive drugs, while 32 patients with AML in complete remission (CR) were given the routine tapering of immunosuppressive agents after HLA-matched donor transplantation...
December 18, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/29242294/in-vivo-il-12-il-23p40-neutralization-blocks-th1-th17-response-after-allogeneic-hematopoietic-cell-transplantation
#18
Joseph Pidala, Francisca Beato, Jongphil Kim, Brian Betts, Heather Jim, Elizabeth Sagatys, John E Levine, James Lm Ferrara, Umut Ozbek, Ernesto Ayala, Marco Davila, Hugo F Fernandez, Teresa Field, Mohamed A Kharfan-Dabaja, Divis Khaira, Farhad Khimani, Frederick L Locke, Asmita Mishra, Michael Nieder, Taiga Nishihori, Lia Perez, Marcie Riches, Claudio Anasetti
T helper 1 and T helper 17 lymphocytes mediate acute graft vs. host disease. Interleukin 12 is critical for T helper 1 differentiation and interleukin 23 for T helper 17 maintenance. Interleukin 12 and 23 are heterodimeric cytokines that share the p40 subunit (IL-12/IL-23p40). In a randomized, blinded, placebo-controlled trial, we examined the biologic impact and clinical outcomes following IL-12/IL-23p40 neutralization using ustekinumab. 30 patients received peripheral blood mobilized hematopoietic cell transplantation from HLA-matched sibling or unrelated donors, received sirolimus plus tacrolimus as graft vs...
December 14, 2017: Haematologica
https://www.readbyqxmd.com/read/29226172/enteric-microbiome-markers-as-early-predictors-of-clinical-outcome-in-allogeneic-hematopoietic-stem-cell-transplant-results-of-a-prospective-study-in-adult-patients
#19
Nicasio Mancini, Raffaella Greco, Renée Pasciuta, Maria Chiara Barbanti, Giacomo Pini, Olivia Beatrice Morrow, Mara Morelli, Luca Vago, Nicola Clementi, Fabio Giglio, Maria Teresa Lupo Stanghellini, Alessandra Forcina, Laura Infurnari, Sarah Marktel, Andrea Assanelli, Matteo Carrabba, Massimo Bernardi, Consuelo Corti, Roberto Burioni, Jacopo Peccatori, Maria Pia Sormani, Giuseppe Banfi, Fabio Ciceri, Massimo Clementi
Background: Infections and graft-vs-host disease (GvHD) still represent major, not easily predictable complications in allogeneic hematopoietic stem cell transplant (allo-HSCT). Both conditions have been correlated to altered enteric microbiome profiles during the peritransplant period. The main objective of this study was to identify possible early microbiome-based markers useful in pretransplant risk stratification. Methods: Stool samples were collected from 96 consecutive patients at the beginning of the pretransplant conditioning regimen (T0) and at 10 (T1) and 30 (T2) days following transplant...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29218366/haploidentical-natural-killer-cells-induce-remissions-in-non-hodgkin-lymphoma-patients-with-low-levels-of-immune-suppressor-cells
#20
Veronika Bachanova, Dhifaf Sarhan, Todd E DeFor, Sarah Cooley, Angela Panoskaltsis-Mortari, Bruce R Blazar, Julie M Curtsinger, Linda Burns, Daniel J Weisdorf, Jeffrey S Miller
We report a novel phase 2 clinical trial in patients with poor prognosis refractory non-Hodgkin lymphoma (NHL) testing the efficacy of haploidentical donor natural killer (NK) cell therapy (NK dose 0.5-3.27 × 107 NK cells/kg) with rituximab and IL-2 (clinicaltrials.gov NCT01181258). Therapy was tolerated without graft-versus-host disease, cytokine release syndrome, or neurotoxicity. Of 14 evaluable patients, 4 had objective responses (29%; 95% CI 12-55%) at 2 months: 2 had complete response lasting 3 and 9 months...
December 7, 2017: Cancer Immunology, Immunotherapy: CII
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