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Reduced intensity transplantation

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https://www.readbyqxmd.com/read/28646908/comparison-of-matched-sibling-donors-versus-unrelated-donors-in-allogeneic-stem-cell-transplantation-for-primary-refractory-acute-myeloid-leukemia-a-study-on-behalf-of-the-acute-leukemia-working-party-of-the-ebmt
#1
Eolia Brissot, Myriam Labopin, Matthias Stelljes, Gerhard Ehninger, Rainer Schwerdtfeger, Jürgen Finke, Hans-Jochem Kolb, Arnold Ganser, Kerstin Schäfer-Eckart, Axel R Zander, Donald Bunjes, Stephan Mielke, Wolfgang A Bethge, Noël Milpied, Peter Kalhs, Igor-Woflgang Blau, Nicolaus Kröger, Antonin Vitek, Martin Gramatzki, Ernst Holler, Christoph Schmid, Jordi Esteve, Mohamad Mohty, Arnon Nagler
BACKGROUND: Primary refractory acute myeloid leukemia (PRF-AML) is associated with a dismal prognosis. Allogeneic stem cell transplantation (HSCT) in active disease is an alternative therapeutic strategy. The increased availability of unrelated donors together with the significant reduction in transplant-related mortality in recent years have opened the possibility for transplantation to a larger number of patients with PRF-AML. Moreover, transplant from unrelated donors may be associated with stronger graft-mediated anti-leukemic effect in comparison to transplantations from HLA-matched sibling donor, which may be of importance in the setting of PRF-AML...
June 24, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28641099/reduced-intensity-versus-myeloablative-allogeneic-transplantation
#2
REVIEW
Daniel J Weisdorf
Allotransplantation cures patients by cytoreduction and the graft-versus-tumor (leukemia; graft-versus-leukemia [GVL]) alloresponse; both eliminate residual disease. The spectrum of conditioning intensity influences toxicities and non-relapse mortality. The spectrum of tumor sensitivity to the GVL response influences relapse. Balancing tolerable toxicities (influenced by patients' performance status and comorbidities) is also influenced by the graft. Intense immunosuppression (for engraftment and graft-versus-host disease prevention) may constrain the immunologic potency of the graft and limit the antineoplastic capacity of the transplant, thus requiring more intense or more effective conditioning regimens to limit the risks of relapse and permit satisfactory disease-free survival...
June 14, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28641096/hematopoietic-stem-cell-transplantation-for-sickle-cell-anemia-the-changing-landscape
#3
REVIEW
Adetola A Kassim, Deva Sharma
Allogeneic hematopoietic stem cell transplantation (HSCT) remains the only curative therapy for sickle cell disease (SCD); however, its use is limited by lack of suitable human leukocyte antigen (HLA)-matched donors and decreased application in older patients with significant morbidity. Myeloablative, HLA-identical sibling transplantation in children with SCD offers excellent long-term survival, with overall and event-free survival rates of 95% and 92%, respectively. However, the risk of graft-versus-host-disease, infections, infertility, and other long-term transplant complications, further limits its widespread use...
June 15, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28637512/single-or-double-unit-ucbt-following-ric-in-adults-with-al-a-report-from-eurocord-the-alwp-and-the-ctiwp-of-the-ebmt
#4
Frédéric Baron, Annalisa Ruggeri, Eric Beohou, Myriam Labopin, Mohamad Mohty, Didier Blaise, Jan J Cornelissen, Patrice Chevallier, Guillermo Sanz, Eefke Petersen, Bipin N Savani, Eliane Gluckman, Arnon Nagler
BACKGROUND: The feasibility of cord blood transplantation (CBT) in adults is limited by the relatively low number of hematopoietic stem/progenitor cells contained in one single CB unit. The infusion of two CB units from different partially HLA-matched donors (double CBT) is frequently performed in patients who lack a sufficiently rich single CB unit. METHODS: We compared CBT outcomes in patients given single or double CBT following reduced-intensity conditioning (RIC) in a retrospective multicenter registry-based study...
June 21, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28633038/hematopoietic-cell-transplantation-for-diffuse-large-b-cell-and-follicular-lymphoma-current-controversies-and-advances
#5
REVIEW
Narendranath Epperla, Mehdi Hamadani
Non-Hodgkin's lymphoma (NHL) constitutes a collection of lymphoproliferative disorders with diverse biologic, histologic, and clinical features. With a better understanding of the molecular pathogenesis, recently there have been major advances in the treatment of NHLs including addition of novel monoclonal antibodies, targeted therapies, and immune activators to the therapy armamentarium. Despite these remarkable developments, autologous hematopoietic cell transplantation (auto-HCT) remains not only a standard-of-care curative option for aggressive NHL but also an important therapeutic option for indolent NHL...
June 13, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28632322/reduced-intensity-conditioning-allogeneic-transplantation-after-salvage-treatment-with-dt-pace-in-myeloma-patients-relapsing-early-after-autologous-transplant
#6
K Randall, M Kaparou, E Xenou, S Paneesha, B Kishore, A Kanellopoulos, R Lovell, K Holder, J Suhr, L Baker, L Ryan, E Nikolousis
OBJECTIVE: In this retrospective single center study we have looked into the transplant outcomes(overall survival OS, progression free survival PFS,GvHD) and the role of chimerism, DLI and pre-transplant characteristics in patients who had a suboptimal response (<12 months)to an autologous stem cell transplant for myeloma and underwent an Alemtuzumab T-cell depleted reduced intensity allograft(RIC). METHODS: 24 patients were salvaged with 2 cycles of DT-PACE and received a RIC transplant with Fludarabine, Melphalan and Alemtuzumab...
June 20, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28631269/missing-hla-c-group-1-ligand-in-patients-with-aml-and-mds-is-associated-with-reduced-risk-of-relapse-and-better-survival-after-allogeneic-stem-cell-transplantation-with-fludarabine-and-treosulfan-reduced-toxicity-conditioning
#7
Avichai Shimoni, Luca Vago, Massimo Bernardi, Ronit Yerushalmi, Jacopo Peccatori, Raffaella Greco, Noga Shem-Tov, Alessandro Lo Russo, Ivetta Danylesko, Arie Apel, Chiara Bonini, Maria Teresa Lupo Stanghellini, Arnon Nagler, Fabio Ciceri
Reduced-toxicity conditioning with fludarabine and treosulfan is a dose-intensive regimen with enhanced anti-leukemia effect and acceptable toxicity in AML/MDS. HLA-C regulates natural-killer (NK) cell function by inhibiting Killer immunoglobulin-like receptors (KIR) and is divided into C1 and C2 epitopes. The missing-ligand theory suggests that missing recipient KIR ligands drives NK-alloreactivity after SCT, in the absence of HLA-mismatch by activating unlicensed donor NK cells. We analyzed SCT outcomes in 203 patients with AML/MDS, median age 58 years, given SCT from matched-siblings (n=97) or matched-unrelated donors (n=106), using two treosulfan doses (total 36 or 42 gr/m2)...
June 19, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28624905/reduced-intensity-allogeneic-hematopoietic-stem-cell-transplantation-combined-with-imatinib-has-comparable-event-free-survival-and-overall-survival-to-long-term-imatinib-treatment-in-young-patients-with-chronic-myeloid-leukemia
#8
Yanmin Zhao, Jiasheng Wang, Yi Luo, Jimin Shi, Weiyan Zheng, Yamin Tan, Zhen Cai, He Huang
The relative merits of reduced intensity hematopoietic stem cell transplantation (RIST) for chronic myeloid leukemia (CML) in the first chronic phase (CP) in imatinib era have not been evaluated. The study was designed to compare the outcomes of combination therapy of RIST plus imatinib (RIST + IM) vs. imatinib (IM) alone for young patients with early CP (ECP) and late CP (LCP). Of the patients, 130 were non-randomly assigned to treatment with IM alone (n = 88) or RIST + IM (n = 42). The 10-year overall survival (OS) and event-free survival (EFS) were comparable between RIST + IM and IM groups...
June 17, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28623394/disease-specific-hematopoietic-stem-cell-transplantation-in-children-with-inherited-bone-marrow-failure-syndromes
#9
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...
August 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28623181/allele-level-hla-matching-for-umbilical-cord-blood-transplantation-for-non-malignant-diseases-in-children-a-retrospective-analysis
#10
Mary Eapen, Tao Wang, Paul A Veys, Jaap J Boelens, Andrew St Martin, Stephen Spellman, Carmem Sales Bonfim, Colleen Brady, Andrew J Cant, Jean-Hugues Dalle, Stella M Davies, John Freeman, Katherine C Hsu, Katharina Fleischhauer, Chantal Kenzey, Joanne Kurtzberg, Gerard Michel, Paul J Orchard, Annalisa Paviglianiti, Vanderson Rocha, Michael R Veneris, Fernanda Volt, Robert Wynn, Stephanie J Lee, Mary M Horowitz, Eliane Gluckman, Annalisa Ruggeri
BACKGROUND: The standard for selecting unrelated umbilical cord blood units for transplantation for non-malignant diseases relies on antigen-level (lower resolution) HLA typing for HLA-A and HLA-B, and allele-level for HLA-DRB1. We aimed to study the effects of allele-level matching at a higher resolution-HLA-A, HLA-B, HLA-C, and HLA-DRB1, which is the standard used for adult unrelated volunteer donor transplantation for non-malignant diseases-for umbilical cord blood transplantation...
June 13, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28620642/early-intervention-with-live-donor-liver-transplantation-reduces-resource-utilization-in-nash-the-toronto-experience
#11
Andrew S Barbas, Nicolas Goldaracena, Martin J Dib, David P Al-Adra, Aloysious D Aravinthan, Leslie B Lilly, Eberhard L Renner, Nazia Selzner, Mamatha Bhat, Mark S Cattral, Anand Ghanekar, Ian D McGilvray, Gonzalo Sapisochin, Markus Selzner, Paul D Greig, David R Grant
BACKGROUND: In parallel with the obesity epidemic, liver transplantation for nonalcoholic steatohepatitis (NASH) is increasing dramatically in North America. Although survival outcomes are similar to other etiologies, liver transplantation in the NASH population has been associated with significantly increased resource utilization. We sought to compare outcomes between live donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) at a high volume North American transplant center, with a particular focus on resource utilization...
June 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28613436/the-incremental-cost-of-incompatible-living-donor-kidney-transplant-a-national-cohort-analysis
#12
David Axelrod, Krista L Lentine, Mark A Schnitzler, Xun Luo, Huiling Xiao, Babak J Orandi, Allan Massie, Jacqueline Garonzik-Wang, Mark D Stegall, Stanley C Jordan, Jose Oberholzer, Ty B Dunn, Lloyd E Ratner, Sandip Kapur, Ronald P Pelletier, John P Roberts, Marc L Melcher, Pooja Singh, Debra L Sudan, Marc P Posner, Jose M El-Amm, Ron Shapiro, Matthew Cooper, George S Lipkowitz, Michael A Rees, Christopher L Marsh, Bashir R Sankari, David A Gerber, Paul W Nelson, Jason Wellen, Adel Bozorgzadeh, A Osama Gaber, Robert A Montgomery, Dorry L Segev
Incompatible living donor kidney transplant (ILDKT) has been established as an effective option for end stage renal disease (ESRD) patients with willing but HLA incompatible live donors, reducing mortality and improving quality of life. Depending upon antibody titer, ILDKT can require highly resource intensive procedure including intravenous immunoglobulin, plasma exchange and/or cell depleting antibody treatment as well as protocol biopsies and DSA testing. This study sought to compare the cost and Medicare reimbursement, exclusive of organ acquisition payment, for ILDKT recipients (N=926) with varying antibody titers to matched compatible transplants (N=2762) performed between 2002-2011...
June 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28606176/rituximab-containing-reduced-intensity-conditioning-improves-progression-free-survival-following-allogeneic-transplantation-in-b-cell-non-hodgkin-lymphoma
#13
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/28604665/gvhd-prophylaxis-after-single-unit-reduced-intensity-conditioning-cord-blood-transplantation-in-adults-with-acute-leukemia
#14
S Terakura, Y Kuwatsuka, S Yamasaki, A Wake, J Kanda, Y Inamoto, S Mizuta, T Yamaguchi, N Uchida, Y Kouzai, N Aotsuka, H Ogawa, H Kanamori, K Nishiwaki, S Miyakoshi, M Onizuka, I Amano, T Fukuda, T Ichinohe, Y Atsuta, M Murata, T Teshima
To investigate better GVHD prophylaxis in reduced intensity conditioning umbilical cord blood transplantation (RIC-UCBT), we compared transplant outcomes after UCBT among GvHD prophylaxes using the registry data. We selected patients transplanted for AML or ALL with a calcineurin inhibitor and methotrexate (MTX)/mycophenolate mofetil (MMF) combination. A total of 748 first RIC-UCBT between 2000 and 2012 (MTX+ group, 446, MMF+ group, 302) were included. The cumulative incidence of neutrophil and platelet counts higher than 50 000/μL was significantly better in the MMF+ group (relative risk (RR), 1...
June 12, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28601677/impact-of-stem-cell-graft-on-early-viral-infections-and-immune-reconstitution-after-allogeneic-transplantation-in-adults
#15
Marina Illiaquer, Berthe-Marie Imbert-Marcille, Thierry Guillaume, Lucie Planche, Marie Rimbert, Céline Bressollette-Bodin, Amandine Le Bourgeois, Pierre Peterlin, Alice Garnier, Claire Le Houerou, Philippe Moreau, Mohamad Mohty, Patrice Chevallier
BACKGROUND: Viral infections are well-known complications after allogeneic stem cell transplant (allo-SCT). OBJECTIVES: We compared prospectively incidences of DNAemia and active infections (AI) for five opportunistic viruses (Human Herpesvirus 6 (HHV-6), Epstein-Barr virus (EBV), BK polyomavirus (BKPyV), Cytomegalovirus (CMV) and Adenovirus (ADV)) and kinetics of immune reconstitution (IR) in adults receiving either double umbilical cord blood (dUCB group) or unrelated peripheral blood stem cell (uPBSC group) allo-SCT after a reduced-intensity conditioning (RIC) regimen...
May 31, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28598565/atypical-teratoid-rhabdoid-tumors-in-children-treated-with-multimodal-therapies-the-necessity-of-upfront-radiotherapy-after-surgery
#16
Jeongshim Lee, Dong-Seok Kim, Jung Woo Han, Chang-Ok Suh
BACKGROUND: Atypical teratoid/rhabdoid tumor (ATRT) is a rare malignant pediatric brain tumor with a dismal prognosis. We evaluated the efficacy of multimodal therapy in children with ATRT. PROCEDURE: Nine children diagnosed with cranial ATRT, who received multimodal therapy between 2005 and 2014, including surgical resection followed by radiotherapy (RT), systemic chemotherapy (CT), and high-dose chemotherapy/stem cell transplantation (HDCT/SCT), were analyzed retrospectively...
June 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28594069/glucose-targets-for-preventing-diabetic-kidney-disease-and-its-progression
#17
REVIEW
Marinella Ruospo, Valeria M Saglimbene, Suetonia C Palmer, Salvatore De Cosmo, Antonio Pacilli, Olga Lamacchia, Mauro Cignarelli, Paola Fioretto, Mariacristina Vecchio, Jonathan C Craig, Giovanni Fm Strippoli
BACKGROUND: Diabetes is the leading cause of end-stage kidney disease (ESKD) around the world. Blood pressure lowering and glucose control are used to reduce diabetes-associated disability including kidney failure. However there is a lack of an overall evidence summary of the optimal target range for blood glucose control to prevent kidney failure. OBJECTIVES: To evaluate the benefits and harms of intensive (HbA1c < 7% or fasting glucose levels < 120 mg/dL versus standard glycaemic control (HbA1c ≥ 7% or fasting glucose levels ≥ 120 mg/dL for preventing the onset and progression of kidney disease among adults with diabetes...
June 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28592744/treatment-advances-and-prognosis-for-patients-with-adult-t-cell-leukemia-lymphoma
#18
Hiroo Katsuya, Kenji Ishitsuka
A classification for adult T-cell leukemia-lymphoma (ATL) based on clinical features was proposed in 1991: acute, lymphoma, chronic, and smoldering types, and their median survival times (MSTs) were reported to be 6.2, 10.2, 24.3 months, and not reached, respectively. Several new therapies for ATL have since been developed, i.e. dose-intensity multi-agent chemotherapies, allogeneic hematopoietic stem cell transplantation (allo-HSCT), monoclonal antibodies, and anti-viral therapy. The monoclonal antibody to CCR4, mogamulizumab, clearly improved response rates in patients with treatment-naïve and relapsed aggressive ATL, and has the potential to provide a survival advantage...
June 8, 2017: Journal of Clinical and Experimental Hematopathology: JCEH
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
#19
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/28587506/extracorporeal-photopheresis-for-gvhd-prophylaxis-after-reduced-intensity-conditioning-allogeneic-hematopoietic-stem-cell-transplantation-a-prospective-multicenter-phase-2-study
#20
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
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