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https://www.readbyqxmd.com/read/28096088/how-i-treat-acquired-aplastic-anemia
#1
Andrea Bacigalupo
Acquired severe aplastic anemia (SAA) is a rare hematologic disease associated with significant morbidity and mortality. Immune destruction of hemopoietic stem cells, plays an important role in the pathogenesis, as shown by successful treatment with immunosuppressive agents (IST), leading to transfusion independence, or complete recovery of peripheral blood counts, in a proportion of patients. Growth factors, can be combined with IST, and may improve response rates, as recently shown with thrombopoietin analogs...
January 17, 2017: Blood
https://www.readbyqxmd.com/read/28092668/upregulation-of-ret-induces-perineurial-invasion-of-pancreatic-adenocarcinoma
#2
M Amit, S Na'ara, L Leider-Trejo, Y Binenbaum, N Kulish, E Fridman, A Shabtai-Orbach, R J Wong, Z Gil
Tumor spread along nerves, a phenomenon known as perineurial invasion, is common in various cancers including pancreatic ductal adenocarcinoma (PDAC). Neural invasion is associated with poor outcome, yet its mechanism remains unclear. Using the transgenic Pdx-1-Cre/KrasG12D /p53R172H (KPC) mouse model, we investigated the mechanism of neural invasion in PDAC. To detect tissue-specific factors that influence neural invasion by cancer cells, we characterized the perineurial microenvironment using a series of bone marrow transplantation (BMT) experiments in transgenic mice expressing single mutations in the Cx3cr1, GDNF and CCR2 genes...
January 16, 2017: Oncogene
https://www.readbyqxmd.com/read/28092357/risk-of-sinusoidal-obstruction-syndrome-in-allogeneic-stem-cell-transplantation-after-prior-gemtuzumab-ozogamicin-treatment-a-retrospective-study-from-the-acute-leukemia-working-party-of-the-ebmt
#3
G Battipaglia, M Labopin, A Candoni, R Fanin, J El Cheikh, D Blaise, M Michallet, A Ruggeri, N Contentin, J M Ribera, M Stadler, J Sierra, P A von dem Borne, A Bloor, G Socié, A Nagler, M Mohty
Gemtuzumab ozogamicin (GO) may increase the risk of sinusoidal obstruction syndrome (SOS) when used prior to allogeneic stem cell transplantation (HSCT). We assessed SOS incidence and outcomes after HSCT of 146 adults, with a median age of 50 years, previously receiving GO. SOS prophylaxis was used in 69 patients (heparin n=57, ursodeoxycholic acid n=8, defibrotide n=4). Cumulative incidence (CI) of SOS was 8% (n=11), with death in 3 patients. Median interval between last GO dose and HSCT was 130 days. Overall survival (OS) and SOS incidence did not differ for patients receiving GO ⩽3...
January 16, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28092353/non-myeloablative-conditioning-for-second-hematopoietic-cell-transplantation-for-graft-failure-in-patients-with-non-malignant-disorders-a-prospective-study-and-review-of-the-literature
#4
K Mallhi, P J Orchard, W P Miller, Q Cao, J Tolar, T C Lund
Allogeneic hematopoietic cell transplantation (HCT) effectively treats several non-malignant disorders such as selected lysosomal disorders, cerebral adrenoleukodystrophy and hemoglobinopathies. However, rates of graft failure (GF) in non-malignant populations exceed those of patients with malignant indications for HCT. Salvage conditioning regimens and outcomes for second HCT for GF vary immensely in the literature. We report 17 consecutive pediatric patients with non-malignant disorders who underwent a second allogenic HCT for GF using a non-myeloablative, low-dose busulfan-based regimen...
January 16, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28092350/long-term-renal-survival-in-patients-undergoing-t-cell-depleted-versus-conventional-hematopoietic-stem-cell-transplants
#5
I G Glezerman, S Devlin, M Maloy, M Bui, E A Jaimes, S A Giralt, A A Jakubowski
Calcineurin inhibitor (CNI)-sparing T-cell depleted (TCD) hematopoietic stem cell transplants (HSCTs) are presumed to be less nephrotoxic than conventional HSCTs. We evaluated incidence and risk factors for kidney failure and chronic kidney disease (CKD) in 231 TCD and 212 conventional HSCT recipients. Kidney failure required a median glomerular filtration rate (GFR) <60 ml/min/1.73 m(2) for ⩾100 days anytime after 180-days post-HSCT. Two-year cumulative incidence (CI) of kidney failure was 42% in the conventional versus 31% in the TCD group (P=0...
January 16, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28092349/recipient-donor-hla-and-cmv-matching-in-recipients-of-t-cell-depleted-unrelated-donor-haematopoietic-cell-transplants
#6
B E Shaw, N P Mayor, R M Szydlo, W P Bultitude, C Anthias, K Kirkland, J Perry, A Clark, S Mackinnon, D I Marks, A Pagliuca, M N Potter, N H Russell, K Thomson, J A Madrigal, S G E Marsh
Improving haematopoietic cell transplantation outcomes by selection of an HLA-matched unrelated donor is best practice; however, donor selection by secondary characteristics is controversial. We studied 1271 recipients with haematological malignancies who underwent T-cell-depleted allografts and had complete data on HLA-matching status for six loci (HLA-A, -B, -C, -DRB1, -DQB1, -DPB1) and clinical outcome data. Five-year overall survival was 40.6%. HLA mismatching (at HLA-A, -B, -C, -DRB1, -DQB1) relative risk (RR) 1...
January 16, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28092347/haploidentical-transplantation-with-post-infusion-cyclophosphamide-in-advanced-hodgkin-lymphoma
#7
L Castagna, S Bramanti, R Devillier, B Sarina, R Crocchiolo, S Furst, J E Cheikh, A Granata, C Faucher, S Harbi, L Morabito, J Mariotti, S Puvinathan, P J Weiller, C Chabannon, D Mokart, C Carlo-Stella, R Bouabdallah, A Santoro, D Blaise
We investigated the use of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in the treatment of advanced Hodgkin lymphoma (HL). Sixty-two consecutive HL patients underwent haplo-HSCT. Unmanipulated stem cells and post-transplant cyclophosphamide were given to all patients as GVHD prophylaxis. At 100 days, the cumulative incidence of grades 2-3 and grades 3-4 acute GVHD was 23% and 4%, respectively. The chronic GVHD (cGVHD) cumulative incidence was 16%, with one patient experiencing severe cGVHD...
January 16, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28077412/microvascular-outcomes-after-metabolic-surgery-moms-in-patients-with-type-2-diabetes-mellitus-and-class-i-obesity-rationale-and-design-for-a-randomised-controlled-trial
#8
Ricardo Vitor Cohen, Tiago Veiga Pereira, Cristina Mamédio Aboud, Pedro Paulo de Paris Caravatto, Tarissa Beatrice Zanata Petry, José Luis Lopes Correa, Carlos Aurélio Schiavon, Mariangela Correa, Carlos Eduardo Pompílio, Fernando Nogueira Quirino Pechy, Carel le Roux
INTRODUCTION: There are several randomised controlled trials (RCTs) that have already shown that metabolic/bariatric surgery achieves short-term and long-term glycaemic control while there are no level 1A of evidence data regarding the effects of surgery on the microvascular complications of type 2 diabetes mellitus (T2DM). PURPOSE: The aim of this trial is to investigate the long-term efficacy and safety of the Roux-en-Y gastric bypass (RYGB) plus the best medical treatment (BMT) versus the BMT alone to improve microvascular outcomes in patients with T2DM with a body mass index (BMI) of 30-34...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28072037/benzodiazepine-maintenance-in-opiate-substitution-treatment-good-or-bad-a-retrospective-primary-care-case-note-review
#9
Adam Bakker, Emmanuel Streel
BACKGROUND: Co-prescribing benzodiazepines to patients in opiate substitution treatment is controversial and often alleged to increase mortality. In an inner-London general practice, patients with problematic benzodiazepine co-dependence were allowed benzodiazepine maintenance treatment (BMT) since 1994, providing an opportunity for analysis. METHOD: 1) Case-note review of all 278 opiate substitution treatment patients, accruing 1289 patient treatment years; 46% had concurrent BMT...
January 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28067888/revisiting-nutritional-support-for-allogeneic-hematologic-stem-cell-transplantation-a-systematic-review
#10
REVIEW
A Baumgartner, A Bargetzi, N Zueger, M Bargetzi, M Medinger, L Bounoure, F Gomes, Z Stanga, B Mueller, P Schuetz
In 2009, the American Society of Parenteral and Enteral Nutrition and its European counterpart (Euopean Society for Parenteral and Enteral Nutrition) published guidelines regarding nutritional support of patients with hematologic stem cell transplantation. Our aim was to do an up-to-date literature review regarding benefit of nutritional interventions and treatment recommendations. We searched MEDLINE, EMBASE and Cochrane Library for interventional and observational clinical studies. We extracted data based on a predefined case report form and assessed bias...
January 9, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28067886/dose-adapted-post-transplant-cyclophosphamide-for-hla-haploidentical-transplantation-in-fanconi-anemia
#11
M S Thakar, C Bonfim, M C Walters, R Storb, R Pasquini, L Burroughs, B M Sandmaier, A Woolfrey, H-P Kiem
We developed a haploidentical transplantation protocol with post-transplant cyclophosphamide (CY) for in vivo T-cell depletion (TCD) using a novel adapted-dosing schedule (25 mg/kg on days +3 and +4) for Fanconi anemia (FA). With median follow-up of 3 years (range, 37 days to 6.2 years), all six patients engrafted. Two patients with multiple pre-transplant comorbidities died, one from sepsis and one from sepsis with associated chronic GVHD. Four patients without preexisting comorbidities and early transplant referrals are alive with 100% donor chimerism and excellent performance status...
January 9, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28067883/clinical-management-of-genital-chronic-gvhd
#12
REVIEW
B K Hamilton, O Goje, B N Savani, N S Majhail, P Stratton
Chronic GvHD (cGvHD) of the genital tract is an underreported and infrequently recognized complication of allogeneic hematopoietic cell transplantation in both male and female long-term survivors. Its pathophysiology, clinical manifestations and management are not well understood, and studies are limited. We thus provide a comprehensive review of genital cGvHD in both men and women, as well as discuss related issues of sexual health and viral reactivation. We further provide guidance on screening, management and long-term follow-up, as well as future priority areas of study...
January 9, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28067882/skeletal-outcome-in-long-term-survivors-of-childhood-high-risk-neuroblastoma-treated-with-high-dose-therapy-and-autologous-stem-cell-rescue
#13
P Utriainen, A Vatanen, S Toiviainen-Salo, U Saarinen-Pihkala, O Mäkitie, K Jahnukainen
High-dose therapy and hematopoietic stem cell transplantation (HSCT) have been shown to improve survival rates in high-risk neuroblastoma (HR-NBL), but may cause adverse effects on the growing skeleton. We studied skeletal health in a national cohort of long-term survivors of HR-NBL (n=21; age 16-30 years, median 22 years) and in 20 healthy age- and sex-matched controls. In addition to clinical evaluation and measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry, we performed spinal magnetic resonance imaging...
January 9, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28067880/a-phase-i-ii-trial-of-intrabone-marrow-cord-blood-transplantation-and-comparison-of-the-hematological-recovery-with-the-japanese-nationwide-database
#14
N Kurita, M Gosho, Y Yokoyama, T Kato, N Obara, M Sakata-Yanagimoto, Y Hasegawa, N Uchida, S Takahashi, Y Kouzai, Y Atsuta, M Kurata, T Ichinohe, S Chiba
Intrabone marrow cord blood transplantation (IB-CBT) was proposed as a promising treatment modality to improve hematological recovery. However, clinical advantages of IB-CBT over conventional IV CBT have been unclear. We conducted a prospective single-center trial of IB-CBT to evaluate its safety and superiority in terms of hematological recovery. Fifteen adults with hematological malignancies were enrolled. A thawed and unwashed single cord blood unit was injected into the bilateral superior-posterior iliac crests under local anesthesia...
January 9, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28067878/successful-haploidentical-bmt-with-post-transplant-cyclophosphamide-for-refractory-autoimmune-pancytopenia-after-cord-blood-transplant-in-pediatric-myelodysplastic-syndrome
#15
H Shima, K Isshiki, Y Yamada, F Yamazaki, T Takahashi, H Shimada
No abstract text is available yet for this article.
January 9, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28067876/impact-of-wilms-tumor-1-expression-on-outcome-of-patients-undergoing-allogeneic-stem-cell-transplantation-for-aml
#16
R Duléry, O Nibourel, J Gauthier, V Elsermans, H Behal, V Coiteux, L Magro, A Renneville, A Marceau, T Boyer, B Quesnel, C Preudhomme, A Duhamel, I Yakoub-Agha
The monitoring of the minimal residual disease by Wilms' tumor 1 expression (MRD(WT1)) is a standardized test, which can be used in over 80% of patients with AML. To investigate the prognostic value of MRD(WT1) in patients undergoing allogeneic stem cell transplantation (allo-SCT) for AML, MRD(WT1) was monitored 3 months after transplantation in 139 patients. MRD(WT1) positivity did not lead to any therapeutic intervention. Median follow-up was 39.3 (6.4-99.8) months. Patients with positive MRD(WT1) at 3 months experienced more often post-transplant relapse (27/30, 90%) than those with negative MRD(WT1) (16/109, 14...
January 9, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28067875/factors-predicting-outcome-after-allogeneic-transplant-in-refractory-acute-myeloid-leukemia-a-retrospective-analysis-of-gruppo-italiano-trapianto-di-midollo-osseo-gitmo
#17
E Todisco, F Ciceri, C Boschini, F Giglio, A Bacigalupo, F Patriarca, I Donnini, E P Alessandrino, W Arcese, A P Iori, P Marenco, I Cavattoni, P Chiusolo, E Terruzzi, L Castagna, A Santoro, A Bosi, E Oldani, B Bruno, F Bonifazi, A Rambaldi
The clinical outcome of primary refractory (PRF) AML patients is poor and only a minor proportion of patients is rescued by allogenic hematopoietic stem cell transplantation (HSCT). The identification of pre-HSCT variables may help to determine PRF AML patients who can most likely benefit from HSCT. We analyzed PRF AML patients transplanted between 1999 and 2012 from a sibling, unrelated donor or a cord blood unit. Overall, 227 patients from 26 Gruppo Italiano Trapianto di Midollo Osseo e Terapia cellulare centers were included in the analysis...
January 9, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28067873/cotransplantation-of-bone-marrow-derived-mesenchymal-stem-cells-in-haploidentical-hematopoietic-stem-cell-transplantation-in-patients-with-severe-aplastic-anemia-an-interim-summary-for-a-multicenter-phase-ii-trial-results
#18
Z Liu, Y Zhang, H Xiao, Z Yao, H Zhang, Q Liu, B Wu, D Nie, Y Li, Y Pang, Z Fan, L Li, Z Jiang, F Duan, H Li, P Zhang, Y Gao, L Ouyang, C Yue, M Xie, C Shi, Y Xiao, S Wang
Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for severe aplastic anemia (SAA) is mainly limited by the high incidence of graft failure and GvHD. Mesenchymal stem cells (MSCs) have been shown to support hematopoiesis in vivo and to display potent immunosuppressive effects to prevent or treat GvHD after HSCT. In a multicenter phase II trial, we developed an approach with co-transplantation of MSCs in patients undergoing haplo-HSCT. Forty-four patients with SAA were included. The conditioning regimen included busulfan, cyclophosphamide and thymoglobulin (ATG)...
January 9, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28067872/reduced-intensity-and-non-myeloablative-allogeneic-stem-cell-transplantation-from-alternative-hla-mismatched-donors-for-hodgkin-lymphoma-a-study-by-the-french-society-of-bone-marrow-transplantation-and-cellular-therapy
#19
J Gauthier, L Castagna, F Garnier, T Guillaume, G Socié, S Maury, N Maillard, R Tabrizi, T Marchand, J Malfuson, A Gac, E Gyan, M Mercier, Y Béguin, J Delage, P Turlure, A Marçais, S Nguyen, R Dulery, J Bay, A Huynh, E Daguindau, J Cornillon, C Régny, M Michallet, R Peffault de Latour, I Yakoub-Agha, D Blaise
Allogeneic stem cell transplantation (allo-SCT) following a non-myeloablative (NMA) or reduced-intensity conditioning (RIC) is considered a valid approach to treat patients with refractory/relapsed Hodgkin lymphoma (HL). When an HLA-matched donor is lacking a graft from a familial haploidentical (HAPLO) donor, a mismatched unrelated donor (MMUD) or cord blood (CB) might be considered. In this retrospective study, we compared the outcome of patients with HL undergoing a RIC or NMA allo-SCT from HAPLO, MMUD or CB...
January 9, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28067870/a-single-center-s-experience-using-four-different-front-line-mobilization-strategies-in-lymphoma-patients-planned-to-undergo-autologous-hematopoietic-cell-transplantation
#20
B M Haverkos, Y Huang, P Elder, L O'Donnell, D Scholl, B Whittaker, S Vasu, S Penza, L A Andritsos, S M Devine, S M Jaglowski
In an otherwise eligible patient with relapsed lymphoma, inadequate mobilization of hematopoietic stem cells (HSCs) is a limiting factor to proceeding with an autologous hematopoietic cell transplantation (auto-HCT). Multiple strategies have been used to mobilize an adequate number of HSCs with no obvious front-line strategy. We report a single institutional experience mobilizing HSCs using four different approaches in lymphoma patients. We prospectively collected mobilization outcomes on patients planned to undergo auto-HCT at Ohio State University...
January 9, 2017: Bone Marrow Transplantation
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