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allogeneic hematopoietic stem cell transplantation

Kristine Doney, Kerry McMillen, Laura Buono, H Joachim Deeg, Ted Gooley
This retrospective analysis of 2503 adult (≥20 years of age) allogeneic hematopoietic cell transplantation (HCT) recipients assessed the effect of body mass index (BMI) on transplant outcome. Median patient age was 51.7 years. Both nonmalignant and malignant diagnoses were included. Patients received either a myeloablative (52%) or reduced-intensity (48%) conditioning regimen. Donors were either related (42%) or unrelated (58%). Cord blood recipients were excluded. G-CSF mobilized peripheral blood cells were the stem cell source in 86% of transplants...
October 10, 2018: Biology of Blood and Marrow Transplantation
Amer M Zeidan, Rory M Shallis, Rong Wang, Amy Davidoff, Xiaomei Ma
Myelodysplastic syndromes (MDS) consist of a heterogeneous group of myeloid neoplasms characterized by inefficient hematopoiesis, variable cytopenias and a considerable risk of progression to acute myeloid leukemia. Epidemiological assessment of MDS has been hampered by evolving diagnostic criteria and delayed classification of MDS as cancers until 2001. The poorly-understood nature of these neoplasms combined with the lack of effective therapies for decades contributed to suboptimal case ascertainment and underreporting...
September 21, 2018: Blood Reviews
Marta González-Vicent, Miguel A Díaz Perez
PURPOSE OF REVIEW: Nowadays, T-cell-depleted haploidentical transplantation is considered a valid approach for children lacking a human leukocyte antigen (HLA) identical donor for allogeneic transplantation. This kind of allogeneic transplant is now widely used especially for pediatric patients with high-risk hematological malignancies. However, relapsing disease and life-threatening viral infections are still relevant clinical problems as a consequence of delayed immune reconstitution...
November 2018: Current Opinion in Oncology
Sophie Paczesny, Jochen Metzger
Allogeneic hematopoietic stem cell transplantation (HSCT) is the most effective form of tumor immunotherapy available to date. However, while HSCT can induce beneficial graft-versus-leukemia (GVL) effect, the adverse effect of graft-versus-host disease (GVHD), which is closely linked to GVL, is the major source of morbidity and mortality following HSCT. Until recently, available diagnostic and staging tools frequently fail to identify those at higher risk of disease progression or death. Furthermore, there are shortcomings in the prediction of the need for therapeutic interventions or the response rates to different forms of therapy...
October 11, 2018: Proteomics. Clinical Applications
Koji Kato
Recent advances in the field of molecular-targeted therapy have revolutionized the treatment of hematological malignancies. Consequentially, the role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) has dramatically changed. However, allo-HSCT remains vital in the treatment of hematological malignancies because cure is rarely achieved by targeted therapy only. In the new era of molecular-targeted treatment, its incorporation into allo-HSCT is key to achieving therapeutic success. In particular, the understanding of the immune impact of molecular-targeted therapy on graft-versus-host-disease and graft-versus-leukemia is essential to improve the outcome of allo-HSCT...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Yasuyoshi Morita
Myelodysplastic syndromes (MDS) are clonal hematopoietic stem cell disorders characterized by cytopenia and leukemic transformation. Allogeneic hematopoietic stem cell transplantation is the only potential curative therapy for MDS; however, the first treatment option for transfusion-independent patients with low-risk MDS remains limited. Recently, lenalidomide has become available for patients with low-risk MDS and symptomatic anemia with del (5q) (5q-syndrome), darbepoetin (DA) for those with anemia without del (5q), and azacitidine for those with DA-resistant anemia or anemia with thrombocytopenia...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Makoto Onizuka
Tyrosine kinase inhibitors (TKIs) have improved the response and survival in patients with Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL) (Ph+ALL). Although the second and third generation TKIs are expected to greatly enhance treatment outcomes, no study has demonstrated the inferiority of allogeneic hematopoietic stem cell transplantation (allo-HSCT) to chemotherapy combined with TKIs in any subgroup of adults with Ph+ALL. Because the PCR-based detection of minimal residual disease (MRD) is easy and reliable, physicians can judge the level of treatment response...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Yazeed Sawalha, Anjali S Advani
The management of acute lymphoblastic leukemia (ALL) in older patients is challenging. Older patients often have multiple comorbidities and poor performance status, and disease factors associated with poor prognosis are more common in this age group. Patient and disease-related factors should be taken into account to determine whether intensive therapy is appropriate. The use of comorbidity indices and comprehensive geriatric assessment tools can be valuable in this setting. Fit patients should be considered for aggressive therapies including allogeneic hematopoietic stem cell transplantation, whereas low intensity options may be more suitable for the frail...
March 2018: International Journal of Hematologic Oncology
Philip McCarthy
Philip McCarthy speaks to Roshaine Wijayatunga, Senior Editor: Oncology Philip McCarthy completed his MD at Tufts University School of Medicine, Boston, MA, USA and his Internal Medicine Residency at Yale, New Haven Hospital, New Haven, CT, USA. His Fellowship was completed at Brigham and Women's Hospital and the Dana Farber Cancer Insitute, Harvard University, Boston, MA, USA. His research interests are devoted to developing novel intensive and reduced intensity allogeneic (allo) and autologous (auto) hematopoietic stem cell transplant (HSCT) approaches for the treatment of hematologic disorders, leading to improved patient outcomes and decreased toxicity...
December 2017: International Journal of Hematologic Oncology
Omer Jamy, Sejong Bae, Luciano J Costa, Harry P Erba, Nikolaos Papadantonakis
BACKGROUND: Patients with acute myeloid leukemia (AML) treated with intensive chemotherapy may require re-induction based on the evaluation of day 14 bone marrow biopsy. METHODS: A retrospective chart review was performed to evaluate adult patients with AML who received re-induction with fludarabine, high dose cytarabine and granulocyte colony stimulating factor (FLAG) regimen for residual disease (≥ 5% blasts by morphology) on day 14 bone marrow examination between September 2012 and July 2017 at our institution...
September 27, 2018: Leukemia Research
Olle Ringden, Mats Remberger, Britt Gustafsson, Gianluca Moretti, Jonas Mattsson, Jacek Winiarski, Behnam Sadeghi
BACKGROUND: For many inborn errors of metabolism (IEM), allogeneic hematopoietic stem cell transplantation (HUSCT) is the only cure. METHODS: We report the outcome in 160 patients with inherited diseases, who were treated with HSCT in 3 decades. Median age was 3 years (range 0.1-63). Grafts were from matched related donors (MRDs, 56), matched unrelated donors (MUDs, 66), or HLA-mismatched donors (38). RESULTS: Graft failure (GF) occurred in 26 patients (16%), severe acute graft-versus-host disease (GVHD) in 9 (6%), and chronic GVHD in 23 (12%)...
October 8, 2018: Transplantation
Yaqiong Tang, Xinyou Zhang, Shiyu Han, Tiantian Chu, Jiaqian Qi, Hong Wang, Xiaowen Tang, Huiying Qiu, Chengcheng Fu, Changgeng Ruan, Depei Wu, Yue Han
Severe thrombocytopenia is a serious condition that frequently arises in patients with myelodysplastic syndrome (MDS) and is associated with poor prognosis. Few studies have investigated the prognostic significance of platelet recovery in patients with MDS having thrombocytopenia. We retrospectively analyzed 117 patients with de novo MDS complicated with thrombocytopenia (platelet count [PLT] < 100 × 109 /L). Patients received decitabine treatment (schedule A) or decitabine followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT; schedule B)...
October 8, 2018: Clinical and Applied Thrombosis/hemostasis
C Pou, M Barrientos-Somarribas, S Marin-Juan, G Bogdanovic, A Bjerkner, T Allander, B Gustafsson, B Andersson
BACKGROUND: Neurological complications (NC) in allogeneic hematopoietic stem cell transplant (HSCT) recipients lead to long-term sequelae and result in significant morbidity and mortality. Since risk factors for NC include viral infection or reactivation, virome inspection after HSCT might be helpful to the clinical management of patients after HSCT. OBJECTIVES AND STUDY DESIGN: In this study we investigated whether any viruses are found in association with NC after HSCT...
September 30, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
David A James, Jennifer Ng, Jiawei Wei, Marc Vandemeulebroecke
We present a case study for developing clinical trial scenarios in a complex progressive disease with multiple events of interest. The idea is to first capture the course of the disease in a multistate Markov model, and then to simulate clinical trials from this model, including a variety of hypothesized drug effects. This case study focuses on the prevention of graft-versus-host disease (GvHD) after allogeneic hematopoietic stem cell transplantation (HSCT). The patient trajectory after HSCT is characterized by a complex interplay of various events of interest, and there is no established best method of measuring and/or analyzing treatment benefits...
September 17, 2018: Biometrical Journal. Biometrische Zeitschrift
Amir Ali Hamidieh, Amir Eslami Shahre Babaki, Tahereh Rostami, Amir Kasaeian, Leili Koochakzadeh, Leyla Sharifi Aliabadi, Maryam Behfar, Ardeshir Ghavamzadeh
OBJECTIVES: Allogeneic hematopoietic stem cell transplantation has been used for several decades to treat patients with acute lymphoblastic leukemia. Total body irradiation has been promoted as an important component of conditioning regimens for this process; however, recent reports of chemotherapy-based conditioning regimens have shown comparable outcomes. MATERIALS AND METHODS: We report our experience with radiation-free conditioning using busulfan and cyclophosphamide in 127 pediatric patients with acute lymphoblastic leukemia who were treated between 1997 and 2014...
October 5, 2018: Experimental and Clinical Transplantation
Van Kieu, Kristi Jhangiani, Sanjeet Dadwal, Ryotaro Nakamura, Doreen Pon
INTRODUCTION: Isavuconazole, a triazole antifungal, is an inhibitor of cytochrome P450 3A4, which also metabolizes tacrolimus and sirolimus. In previous studies, isavuconazole administration increased tacrolimus and sirolimus area under the curve values by 2.3-fold and 1.8-fold, respectively, in healthy adults and tacrolimus concentration/dose (C/D) ratio by 1.3-fold in solid organ transplant patients. We aimed to determine the magnitude of effect of isavuconazole administration on tacrolimus and sirolimus C/D ratios in allogeneic hematopoietic stem cell transplant (alloHSCT) patients...
October 8, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Zhen-Hua Wang, Hui-Hui Liu, Ning Ma, Li-Hong Wang, Wei Liu, Bo Tang, Zhi-Xiang Qiu, Xi-Nan Cen, Han-Yun Ren, Yu-Jun Dong
OBJECTIVE: To investigate the expression of CD160 on the surface of human natural killer (NK) cells and its possible relationship with hematological malignancies. METHODS: CD160 expression on human leukemia cell line NK92 cells was confirmed by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot. The proliferation characteristics and cell surface markers of this cell line were determined. Cytotoxicity of NK92 against 2 human myeloid leukemia cell lines, K562 and THP-1 was analyzed ex vivo...
October 2018: Zhongguo Shi Yan Xue Ye Xue za Zhi
Jing-Bo Wang, Lei Yuan, Hao-Yu Cheng, Xin-Hong Fei, Jiang-Ying Gu, Song Xue, Jun-Bao He, Wei-Jie Zhang
OBJECTIVE: To investigate the efficiency and safety of treating Epstein-Barr virus (EBV) infection of acute graft versus host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) by EBV specific cytotoxic T lymphocytes (EBV-CTL). METHODS: The Clinical characteristics, therapeutic efficacy and safety of 12 patients with EBV infection treated by EBV-CTL infusion after allo-HSCT in Department of Hemahlogy of Aero Space Center Hospital between Jan 2015 and May 2017 were analyzed retrospectioely...
October 2018: Zhongguo Shi Yan Xue Ye Xue za Zhi
Zeba N Singh, Vu H Duong, Rima Koka, Ying Zou, Sameer Sawhney, Li Tang, Maria R Baer, Nicholas Ambulos, Firas El Chaer, Ashkan Emadi
We describe two patients with acute promyelocytic leukemia (APL) with an unusual immunophenotype with co-expression of myeloperoxidase (MPO) with cytoplasmic CD3 (cCD3) representing myeloid and T-lineage differentiation. Both harbored FLT3 -ITD mutations. One additionally had a deletion in the PML gene affecting the primer binding site, thus limiting measurable residual disease (MRD) analysis during follow-up. Both patients achieved durable remission with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO)-based therapy, thus mitigating the need for repetitive conventional chemotherapy cycles and allogeneic stem cell transplantation...
September 2018: Journal of Hematopathology
Francesco Gaudio, Patrizio Mazza, Angelo Michele Carella, Anna Mele, Giulia Palazzo, Giovanni Pisapia, Paola Carluccio, Domenico Pastore, Nicola Cascavilla, Giorgina Specchia, Vincenzo Pavone
BACKGROUND: Hodgkin lymphoma (HL) is a potentially curable disease, and modern therapy is expected to successfully cure more than 80% of the patients. However, patients progressing after intensive treatments, such as autologous stem cell transplantation (SCT), have a very poor outcome. Allogeneic SCT offers the only strategy with a curative potential for these patients. This study reports a retrospective multicenter experience of the Rete Ematologica Pugliese (REP) over the past 17 years, aiming to define the impact of each patient's disease and transplant-related characteristics on outcomes...
September 12, 2018: Clinical Lymphoma, Myeloma & Leukemia
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