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Chronic graft versus host

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https://www.readbyqxmd.com/read/28627425/a-multicenter-retrospective-analysis-stressing-importance-of-long-term-follow-up-after-hematopoietic-cell-transplantation-for-%C3%AE-thalassemia
#1
S Chaudhury, M Ayas, C Rosen, M Ma, M Viqaruddin, S Parikh, S Kharbanda, K Y Chiang, A Haight, M Bhatia, Gmt Guilcher, A Thompson, S Shenoy
Allogeneic hematopoietic cell transplantation (HCT) is curative in patients with β-thalassemia major. However, the majority of reports on HCT outcomes lack long-term follow-up data with the exception of single center reports. An international multicenter retrospective data collection and analysis was conducted in 176 β-Thalassemia patients who were 1 year or beyond after first HCT to evaluate follow up methods and outcomes at 7 centers- Median age at HCT was 5.5 years (range, 0.6- 18.5) and median follow-up was 7 years (range, 1-20)...
June 13, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28623394/disease-specific-hematopoietic-stem-cell-transplantation-in-children-with-inherited-bone-marrow-failure-syndromes
#2
Qian Li, Changying Luo, Chengjuan Luo, Jianmin Wang, Benshang Li, Lixia Ding, Jing Chen
Hematopoietic stem cell transplantation (HSCT) using an optimized conditioning regimen is essential for the long-term survival of patients with inherited bone marrow failure syndromes (IBMFS). We report HSCT in 24 children with Fanconi anemia (FA, n = 12), Diamond-Blackfan anemia (DBA, n = 7), and dyskeratosis congenita (DC, n = 5) from a single HSCT center. The graft source was peripheral blood stem cells (n = 19) or cord blood stem cells (n = 5). FA and DC patients received reduced-intensity conditioning, while DBA patients had myeloablative conditioning...
June 16, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28620195/attenuation-of-cgvhd-by-c5a-c5ar-blockade-is-associated-with-increased-frequency-of-treg
#3
Yulian Wang, Peilong Lai, Xiaomei Chen, Chang He, Xin Huang, Suxia Geng, Chenwei Luo, Suijing Wu, Wei Ling, Liye Zhong, Zesheng Lu, Peng Li, Jianyu Weng, Xin Du
C5aR signaling plays an important role in the regulation of T cell activation and alloimmune responses in chronic graft-versus-host disease (cGVHD). However, direct evidence of this modulation and the efficacy of C5aR blockade in the treatment of cGVHD have not been demonstrated. We observed higher expression of C5aR on both monocytes and T cells of patients with cGVHD compared with healthy controls and non-GVHD patients after allogeneic hematopoietic stem cell transplantation. Our data also demonstrated a significant negative correlation between C5aR expression and regulatory T cells (Treg) frequency in cGVHD patients, indicating a potential role of C5aR in the generation and regulation of Treg...
June 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28614903/thiotepa-based-conditioning-versus-total-body-irradiation-as-myeloablative-conditioning-prior-to-allogeneic-stem-cell-transplantation-for-acute-lymphoblastic-leukemia-a-matched-pair-analysis-from-the-acute-leukemia-working-party-of-the-european-society-for
#4
Sandra Eder, Jonathan Canaani, Eric Beohou, Myriam Labopin, Miguel A Sanz, William Arcese, Reuven Or, Juergen Finke, Agostino Cortelezzi, Dietrich Beelen, Jakob Passweg, Gerard Socié, Gunhan Gurman, Mahmoud Aljurf, Matthias Stelljes, Sebastian Giebel, Mohamad Mohty, Arnon Nagler
The optimal conditioning regimen to employ before hematopoieitic stem cell transplantation in acute lymphoblastic leukemia (ALL) is still undecided, and while Cy/TBI is the most commonly used myeloablative regimen, there are concerns regarding long term toxicity for patients conditioned with this regimen. Thiotepa based conditioning is an emerging radiation free regimen with recent publications indicative of comparable clinical outcomes to TBI based conditioning. In this analysis of the acute leukemia working party of the EBMT, we performed a retrospective matched-pair analysis, evaluating the outcome of adult patients with ALL who received thiotepa-based conditioning (n=180) with those receiving Cy/TBI conditioning (n=540)...
June 14, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28614804/in-vivo-kinetics-and-nonradioactive-imaging-of-rapidly-proliferating-cells-in-graft-versus-host-disease
#5
Nataliya P Buxbaum, Donald E Farthing, Natella Maglakelidze, Martin Lizak, Hellmut Merkle, Andrea C Carpenter, Brittany U Oliver, Veena Kapoor, Ehydel Castro, Gregory A Swan, Liliane M Dos Santos, Nicolas J Bouladoux, Catherine V Bare, Francis A Flomerfelt, Michael A Eckhaus, William G Telford, Yasmine Belkaid, Remy J Bosselut, Ronald E Gress
Hematopoietic stem cell transplantation (HSCT) offers a cure for cancers that are refractory to chemotherapy and radiation. Most HSCT recipients develop chronic graft-versus-host disease (cGVHD), a systemic alloimmune attack on host organs. Diagnosis is based on clinical signs and symptoms, as biopsies are risky. T cells are central to the biology of cGVHD. We found that a low Treg/CD4+ T effector memory (Tem) ratio in circulation, lymphoid, and target organs identified early and established mouse cGVHD. Using deuterated water labeling to measure multicompartment in vivo kinetics of these subsets, we show robust Tem and Treg proliferation in lymphoid and target organs, while Tregs undergo apoptosis in target organs...
June 15, 2017: JCI Insight
https://www.readbyqxmd.com/read/28614794/an-activated-th17-prone-t-cell-subset-involved-in-chronic-graft-versus-host-disease-sensitive-to-pharmacological-inhibition
#6
Edouard Forcade, Katelyn Paz, Ryan Flynn, Brad Griesenauer, Tohti Amet, Wei Li, Liangyi Liu, Giorgos Bakoyannis, Di Jiang, Hong Wei Chu, Mercedes Lobera, Jianfei Yang, David S Wilkes, Jing Du, Kate Gartlan, Geoffrey R Hill, Kelli Pa MacDonald, Eduardo L Espada, Patrick Blanco, Jonathan S Serody, John Koreth, Corey S Cutler, Joseph H Antin, Robert J Soiffer, Jerome Ritz, Sophie Paczesny, Bruce R Blazar
Chronic graft-versus-host disease (cGvHD) remains a major complication of allogeneic stem cell transplantation requiring novel therapies. CD146 and CCR5 are expressed by activated T cells and associated with increased T cell migration capacity and Th17 polarization. We performed a multiparametric flow cytometry analysis in a cohort of 40 HSCT patients together with a cGvHD murine model to understand the role of CD146-expressing subsets. We observed an increased frequency of CD146+ CD4 T cells in the 20 patients with active cGvHD with enhanced RORγt expression...
June 15, 2017: JCI Insight
https://www.readbyqxmd.com/read/28611770/relevance-of-cd6-mediated-interactions-in-the-regulation-of-peripheral-t-cell-responses-and-tolerance
#7
Marta Consuegra-Fernández, Mario Martínez-Florensa, Fernando Aranda, José de Salort, Noelia Armiger-Borràs, Teresa Lozano, Noelia Casares, Juan José Lasarte, Pablo Engel, Francisco Lozano
The CD6 lymphocyte receptor has been involved in the pathophysiology of different autoimmune disorders and is now considered a feasible target for their treatment. In vitro data show the relevance of CD6 in the stabilization of adhesive contacts between T-cell and antigen-presenting cells, and the modulation of T-cell receptor signals. However, the in vivo consequences of such a function are yet undisclosed due to the lack of suitable genetically modified animal models. Here, the in vitro and in vivo challenge of CD6-deficient (CD6(-/-)) cells with allogeneic cells was used as an approach to explore the role of CD6 in immune responses under relative physiological stimulatory conditions...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28608529/comparison-of-the-cellex%C3%A2-and-uvar-xts%C3%A2-closed-system-extracorporeal-photopheresis-devices-in-the-treatment-of-chronic-graft-versus-host-disease
#8
Robert M Whittle, Helen Denney, Andrew D Chantry, Arun Alfred, Peter C Taylor
Extracorporeal Photopheresis (ECP) is a cellular immunotherapy frequently used for steroid-refractory graft-versus-host disease (GVHD). Chronic GVHD (cGVHD), response to ECP is associated with survival benefit. The UVAR-XTS(TM) system and the more recently developed CELLEX(TM) device (both Therakos(TM) ) are the mainstay for ECP-delivery in the UK and US. No comparison of treatment outcomes has been reported. We retrospectively compared cGVHD response and steroid reduction and withdrawal in patients treated exclusively over 12 months with either the XTS (n = 51) or CELLEX (n = 50)...
June 13, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28606176/rituximab-containing-reduced-intensity-conditioning-improves-progression-free-survival-following-allogeneic-transplantation-in-b-cell-non-hodgkin-lymphoma
#9
Narendranath Epperla, Kwang Woo Ahn, Sairah Ahmed, Madan Jagasia, Alyssa DiGilio, Steven M Devine, Samantha Jaglowski, Vanessa Kennedy, Andrew R Rezvani, Sonali M Smith, Anna Sureda, Timothy S Fenske, Mohamed A Kharfan-Dabaja, Phillipe Armand, Mehdi Hamadani
BACKGROUND: In B cell non-Hodgkin lymphoma (B-NHL), rituximab-containing reduced-intensity conditioning regimens (R-RIC) have been shown to provide favorable outcomes in single-arm studies; however, large multicenter studies comparing R-RIC and non-rituximab-containing reduced-intensity conditioning regimens (nonR-RIC) have not been performed. Using the CIBMTR database, we report the outcomes of R-RIC versus nonR-RIC regimens in B-NHL. METHODS: We evaluated 1401 adult B-NHL patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) who received nonR-RIC (n = 1022) or R-RIC (n = 379) regimens...
June 12, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28598869/graft-versus-host-disease-what-should-the-oculoplastic-surgeon-know
#10
Cynthia I Tung
PURPOSE OF REVIEW: To provide a concise review of the oculoplastic manifestations of ocular graft versus host disease (GVHD), and to discuss their management. RECENT FINDINGS: Ocular GVHD occurs as a common immune-mediated complication of hematopoietic stem cell transplantation that presents as a Stevens-Johnson-like syndrome in the acute phase or a Sjögren-like syndrome in the chronic phase. Cicatricial conjunctivitis may be underreported in ocular GVHD. The spectrum of oculoplastic manifestations includes GVHD of the skin, cicatricial entropion, nasolacrimal duct obstruction, and lacrimal gland dysfunction...
June 8, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28596425/outcomes-of-hematopoietic-cell-transplantation-using-donors-or-recipients-with-inherited-chromosomally-integrated-hhv-6
#11
Joshua A Hill, Amalia S Magaret, Ruth Hall-Sedlak, Anna Mikhaylova, Meei-Li Huang, Brenda M Sandmaier, John A Hansen, Keith R Jerome, Danielle M Zerr, Michael Boeckh
Human herpesvirus 6 (HHV-6) species have a unique ability to integrate into chromosomal telomeres. Mendelian inheritance via gametocyte integration results in HHV-6 in every nucleated cell. The epidemiology and clinical impact of inherited chromosomally integrated (iciHHV-6) in hematopoietic cell transplant (HCT) recipients is unclear. We identified 4,319 HCT donor-recipient pairs (8,638 subjects) who received an allogeneic HCT and had archived pre-HCT peripheral blood mononuclear cell samples. We screened these samples for iciHHV-6 and compared characteristics of HCT recipients and donors with iciHHV-6 to recipients and donors without iciHHV-6, respectively...
June 8, 2017: Blood
https://www.readbyqxmd.com/read/28592758/haploidentical-transplantation-using-post-transplant-high-dose-cyclophosphamide-for-adult-t-cell-lymphoma-after-mogamulizumab-treatment
#12
Manabu Kusakabe, Naoki Kurita, Hidekazu Nishikii, Rie Sato, Chikashi Yoshida, Yasuhisa Yokoyama, Mamiko Sakata-Yanagimoto, Naoshi Obara, Yuichi Hasegawa, Shigeru Chiba
A 53-year-old man diagnosed with adult T-cell lymphoma (ATL) was treated with mLSG15 chemotherapy and achieved a first complete remission. Subsequently, a liver tumor emerged that was pathologically diagnosed as ATL (first relapse). A second remission was achieved after local irradiation and four cycles of mogamulizumab treatment. The patient received peripheral blood stem cell transplantation (HSCT) from a one haplotype HLA-mismatched daughter after total body irradiation and the administration of fludarabine as a myeloablative conditioning regimen, followed by post-transplant cyclophosphamide...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28592129/allogeneic-stem-cell-transplantation-after-fludarabine-melphalan-and-thymoglobulin-followed-by-early-withdrawal-of-prophylactic-immunosuppression-in-patients-with-acute-lymphoblastic-leukemia-update-of-single-center-study
#13
L Raida, A Kuba, Z Rusinakova, R Szotkowska, I Skoumalova, E Faber, T Szotkowski, P Rohon, J Hubacek, K Indrak, Z Pikalova, M Jarosova, M Divoka, K Langova, T Papajik
Presented are updated results of allogeneic hematopoietic stem cell transplantations (HSCTs) in 25 adult patients with acute lymphoblastic leukemia (ALL) in complete remission (CR) after a reduced intensity conditioning (RIC) combining fludarabine (150 mg/m2) and melphalan (140 mg/m2) with thymoglobulin (4.5 mg/kg or recently 4.0 mg/kg) followed by early initiation of reduction and withdrawal of prophylactic posttransplant immunosuppression. The median post-transplant follow-up was 32 (range, 4-87) months. Stable engraftment of donor's hematopoiesis was achieved in all patients...
June 8, 2017: Neoplasma
https://www.readbyqxmd.com/read/28588018/outcome-of-children-with-acute-leukemia-given-hla-haploidentical-hsct-after-%C3%AE-%C3%AE-t-cell-and-b-cell-depletion
#14
Franco Locatelli, Pietro Merli, Daria Pagliara, Giuseppina Li Pira, Michela Falco, Daniela Pende, Roberto Rondelli, Barbarella Lucarelli, Letizia Pomponia Brescia, Riccardo Masetti, Giuseppe Maria Milano, Valentina Bertaina, Mattia Algeri, Rita Maria Pinto, Luisa Strocchio, Raffaella Meazza, Lavinia Grapulin, Rupert Handgretinger, Alessandro Moretta, Alice Bertaina, Lorenzo Moretta
Allogeneic hematopoietic stem cell transplantation (HSCT) from an HLA-haploidentical relative (haplo-HSCT) is a suitable option for children with acute leukemia (AL) either relapsed or at high-risk of treatment failure. We developed a novel method of graft manipulation based on negative depletion of αβ T and B cells and conducted a prospective trial evaluating the outcome of children with AL transplanted with this approach (ClinicalTrial.gov identifier: NCT01810120). Eighty AL children, transplanted between September 2011 and September 2014, were enrolled in the trial...
June 6, 2017: Blood
https://www.readbyqxmd.com/read/28587506/extracorporeal-photopheresis-for-gvhd-prophylaxis-after-reduced-intensity-conditioning-allogeneic-hematopoietic-stem-cell-transplantation-a-prospective-multicenter-phase-2-study
#15
Mauricette Michallet, Mohamad Sobh, Frederic Garban, Claude Eric Bulabois, Ibrahim Yakoub-Agha, Valerie Coiteux, Remy Dulery, Pierre-Simon Rohrlich, Faezeh Legrand, Laurence Clement, Aline Praire, Marie Detrait, Fiorenza Barraco, Franck Emmanuel Nicolini, Olivier Hequet
We performed a prospective multicenter phase 2 study to evaluate the safety and efficacy of prophylactic Extracorporeal Photopheresis (ECP) in adult patients with hematological malignancies early after RIC allo-HSCT on day 21 twice per week during the first two weeks and then once per week for the next four weeks for a total of eight ECP courses. A total of 20 patients were included; 10 were males, median age was 60 years. All patients engrafted, 17 (85%) received the total eight ECP courses. There were no adverse effects related to ECP...
June 7, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28583289/long-term-outcomes-after-standard-graft-versus-host-disease-prophylaxis-with-or-without-anti-human-t-lymphocyte-immunoglobulin-in-haemopoietic-cell-transplantation-from-matched-unrelated-donors-final-results-of-a-randomised-controlled-trial
#16
Jürgen Finke, Claudia Schmoor, Wolfgang Andreas Bethge, Hellmut Ottinger, Matthias Stelljes, Liisa Volin, Dominik Heim, Hartmut Bertz, Olga Grishina, Gerard Socie
BACKGROUND: Previously, we demonstrated that the addition of anti-human-T-lymphocyte immunoglobulin (ATLG) to standard ciclosporin and methotrexate prophylaxis reduced graft-versus-host disease (GvHD) in adult patients treated with allogeneic haemopoietic cell transplantation from matched unrelated donors without negatively affecting relapse and survival. Since reports on long-term results from randomised trials testing anti-thymocyte globulin are scarce, we performed an extended follow-up of the trial...
June 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28582607/phase-2-study-of-intrabone-single-unit-cord-blood-transplantation-for-hematological-malignancies
#17
Makoto Murata, Yoshinobu Maeda, Masayoshi Masuko, Yasushi Onishi, Tomoyuki Endo, Seitaro Terakura, Yuichi Ishikawa, Chisako Iriyama, Yoko Ushijima, Tatsunori Goto, Nobuharu Fujii, Mitsune Tanimoto, Hironori Kobayashi, Yasuhiko Shibasaki, Noriko Fukuhara, Yoshihiro Inamoto, Ritsuro Suzuki, Yoshihisa Kodera, Tadashi Matsushita, Hitoshi Kiyoi, Tomoki Naoe, Tetsuya Nishida
The outcomes of cord blood transplantation with non-irradiated reduced-intensity conditioning for hematological malignancies need to be improved because of graft failure and delayed engraftment. Intrabone infusion of cord blood cells has the potential to resolve the problems. In this phase 2 study, twenty-one adult patients with hematological malignancy received intrabone transplantation of serological HLA-A, B, and DR ≥4/6 matched single cord blood with a median number of cryopreserved total nucleated cells of 2...
June 5, 2017: Cancer Science
https://www.readbyqxmd.com/read/28578010/unrelated-umbilical-cord-blood-transplantation-for-sickle-cell-disease-following-reduced-intensity-conditioning-results-of-a-phase-i-trial
#18
Allistair Abraham, Andrew Cluster, David Jacobsohn, David Delgado, Monica L Hulbert, Divyesh Kukadiya, Lisa Murray, Shalini Shenoy
Hematopoietic stem cell transplantation from HLA-matched sibling donors results in disease free survival of >90% in patients with sickle cell disease (SCD) but only about 18% have suitable donors. Unrelated cord blood transplantation (UCBT) is one way to expand donor options for patients with severe SCD but historically has been associated with high graft rejection rates (50-62%). We hypothesized that the addition of thiotepa to a previously tested reduced intensity conditioning (RIC) regimen would support engraftment after UCBT in SCD patients...
May 31, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28573910/haploidentical-hematopoietic-stem-cell-transplantation-for-adult-patients-with-epstein-barr-virus-associated-hemophagocytic-lymphohistiocytosis
#19
Zhihui Li, Yini Wang, Jingshi Wang, Jia Zhang, Zhao Wang
To assess the efficacy of haploidentical hematopoietic stem cell transplantation (HSCT) in adult patients with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH), we retrospectively analyzed 30 cases that presented at our institution. At the time of HSCT, 20 patients (66.7%) had achieved a response after receiving HLH-94 or salvage therapies. All patients underwent myeloablative conditioning followed by peripheral blood HSCT from their related, haploidentical donors. Twenty-six patients (86...
June 2, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28570330/neurologic-complications-of-transplantation
#20
Amy A Pruitt
PURPOSE OF REVIEW: This article describes the diagnosis and management of neurologic problems during hematopoietic cell and solid organ transplantation using time elapsed since transplantation as a guide to expected complications, including drug toxicities, infections, strokes, autoimmune phenomena, disease recurrence, and secondary neoplasms. RECENT FINDINGS: Growing clinical experience in the neurology of transplantation has led to appreciation of the diverse clinical and radiographic spectrum of calcineurin inhibitor-related posterior reversible encephalopathy syndrome (PRES) and progressive multifocal leukoencephalopathy...
June 2017: Continuum: Lifelong Learning in Neurology
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