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Post infusion CY

Antonio Russo, Giacomo Oliveira, Sofia Berglund, Raffaella Greco, Valentina Gambacorta, Nicoletta Cieri, Cristina Toffalori, Laura Zito, Francesca Lorentino, Simona Piemontese, Mara Morelli, Fabio Giglio, Andrea Assanelli, Maria Teresa Lupo Stanghellini, Chiara Bonini, Jacopo Peccatori, Fabio Ciceri, Leo Luznik, Luca Vago
The use of posttransplant cyclophosphamide (PT-Cy) as graft-versus-host disease (GVHD) prophylaxis has revolutionized haploidentical hematopoietic stem cell transplantation (HSCT), allowing safe infusion of unmanipulated T cell-replete grafts. PT-Cy selectively eliminates proliferating alloreactive T cells, but whether and how it affects natural killer (NK) cells and their alloreactivity is largely unknown. Here we characterized NK cell dynamics in 17 patients who received unmanipulated haploidentical grafts, containing high numbers of mature NK cells, according to PT-Cy-based protocols in 2 independent centers...
January 11, 2018: Blood
Hirohisa Nakamae, Hideo Koh, Takako Katayama, Mitsutaka Nishimoto, Yoshiki Hayashi, Yasuhiro Nakashima, Takahiko Nakane, Mika Nakamae, Asao Hirose, Masayuki Hino
Nonmyeloablative, human leukocyte antigen (HLA) haploidentical, T-cell-replete bone marrow transplantation followed by high-dose posttransplantation cyclophosphamide (PT/Cy) has recently been developed. This transplantation milieu has resulted in favorable outcomes with low transplantation-related mortality, owing to a low incidence of graft-versus-host disease (GVHD), without increased infectious complications. However, the high relapse rate remains a major concern. We therefore performed a prospective pilot study of HLA haploidentical peripheral blood stem cell transplantation (PBSCT) with intensified conditioning, followed by two lower doses of PT/Cy...
November 2015: Experimental Hematology
Mariana Bastos-Oreiro, Javier Anguita, Carolina Martínez-Laperche, Lucía Fernández, Elena Buces, Almudena Navarro, Cristina Pascual, Ana Pérez-Corral, Pascual Balsalobre, Cristina Muñoz, Mi Kwon, David Serrano, Antonio Perez-Martinez, Ismael Buño, Jorge Gayoso, José Luís Díez-Martín
Alloreactivity triggered by interaction between killer cell immunoglobulin-like receptors (KIRs) and natural killer (NK) cells plays a role in the graft-versus-tumor effect after hematopoietic stem cell transplantation (SCT). Our aim in this study was to evaluate this role in the setting of T-cell-repleted haploidentical SCT with postinfusion high-dose cyclophosphamide (PT-Cy). We included 33 patients. Among patient-donor pairs with at least 1 inhibitory KIR (iKIR) gene mismatch, event-free survival (EFS) and cumulative incidence of relapse 1 year after transplant were significantly better (85% vs...
May 2016: European Journal of Haematology
Scott R Solomon, Connie A Sizemore, Melissa Sanacore, Xu Zhang, Stacey Brown, H Kent Holland, Lawrence E Morris, Asad Bashey
We enrolled 30 patients on a prospective phase II trial utilizing a total body irradiation (TBI)-based myeloablative preparative regimen (fludarabine 30 mg/m2/day × 3 days and TBI 150 cGy twice per day on day -4 to -1 [total dose 1200 cGy]) followed by infusion of unmanipulated peripheral blood stem cells from a haploidentical family donor (haplo). Postgrafting immunosuppression consisted of cyclophosphamide 50 mg/kg/day on days 3 and 4, mycophenolate mofetil through day 35, and tacrolimus through day 180...
July 2015: Biology of Blood and Marrow Transplantation
Sandip A Shah, Kamlesh M Shah, Kinnari A Patel, Asha S Anand, Shailesh S Talati, Harsha P Panchal, Apurva A Patel, Sonia K Parikh, Bhavesh B Parekh, Shilin N Shukla, Shreeniwas S Raut
Beta thalassemia major, one of the most prevalent hemoglobinopathy throughout the word, can be cured by allogenic stem cell transplantation (SCT) (Bone Marrow Transplant 36:971-975, 2005). Many patients, however, lack a suitably matched related sibling donor. Unrelated umbilical cord blood (UCB) can be used as an alternative stem cell source for these patients. This report describes SCT for nine children with beta-thalassemia major using partially HLA-matched unrelated UCB. Conditioning included oral busulfan 16 mg/kg (day -10 to -7), cyclophosphamide (Cy) 200 mg/kg (day -5 to -2), fludarabine 90 mg/kg (day -13 to -11), and antithymocyte globulin (rabbit) 7...
March 2015: Indian Journal of Hematology & Blood Transfusion
L Castagna, S Bramanti, S Furst, L Giordano, R Crocchiolo, B Sarina, E Mauro, L Morabito, R Bouabdallah, D Coso, M Balzarotti, F Broussais, J El-Cheikh, C C Stella, E Brusamolino, D Blaise, A Santoro
No abstract text is available yet for this article.
December 2014: Bone Marrow Transplantation
L Castagna, S Bramanti, S Furst, L Giordano, R Crocchiolo, B Sarina, E Mauro, L Morabito, R Bouabdallah, D Coso, M Balzarotti, F Broussais, J El-Cheikh, C C Stella, E Brusamolino, D Blaise, A Santoro
Allo-SCT is regularly performed in advanced lymphoma. Haploidentical family donors are a valuable source of hematopoietic stem cells and transplants from these donors, using T-repleted grafts, has recently been successfully reported. We report on 49 patients with refractory lymphoma who received T-repleted haploidentical SCT with a non-myeloablative regimen and post-transplant CY. The median time to recover ANC >0.5 × 10e9/L and transfusion independent plt count >20 × 10e9/L was 20 days (range 14-38) and 26 days (range 14-395)...
December 2014: Bone Marrow Transplantation
Kavita Raj, Antonio Pagliuca, Kenneth Bradstock, Victor Noriega, Victoria Potter, Matthew Streetly, Donal McLornan, Majid Kazmi, Judith Marsh, John Kwan, Gillian Huang, Lisa Getzendaner, Stephanie Lee, Katherine A Guthrie, Ghulam J Mufti, Paul O'Donnell
In a multicenter collaboration, we carried out T cell-replete, peripheral blood stem cell (PBSC) transplantations from related, HLA-haploidentical donors with reduced-intensity conditioning (RIC) and post-transplantation cyclophosphamide (Cy) as graft-versus-host disease (GVHD) prophylaxis in 55 patients with high-risk hematologic disorders. Patients received 2 doses of Cy 50 mg/kg i.v. on days 3 and 4 after infusion of PBSC (mean, 6.4 × 10(6)/kg CD34(+) cells; mean, 2.0 × 10(8)/kg CD3(+) cells). The median times to neutrophil (500/μL) and platelet (>20,000/μL) recovery were 17 and 21 days respectively...
June 2014: Biology of Blood and Marrow Transplantation
Luca Castagna, Roberto Crocchiolo, Sabine Furst, Stefania Bramanti, Jean El Cheikh, Barbara Sarina, Angela Granata, Elisa Mauro, Catherine Faucher, Bilal Mohty, Samia Harbi, Christian Chabannon, Carmelo Carlo-Stella, Armando Santoro, Didier Blaise
Recently, the administration of high-dose cyclophosphamide (Cy) after T cell-replete haploidentical stem cell infusion has been reported to be feasible and effective. In the original study, bone marrow (BM) was used as the source of stem cells. Here, we retrospectively analyzed the use of BM versus peripheral blood stem cells (PBSCs) in a cohort of patients receiving haploidentical T cell-replete transplantation after a nonmyeloablative conditioning regimen with postinfusion Cy. In the PBSC versus BM groups, the incidence of acute graft-versus-host disease (GVHD) was 33% versus 25%, respectively, and the incidence of chronic GVHD was 13% versus 13%, respectively...
May 2014: Biology of Blood and Marrow Transplantation
Fang Li, Volkan Turan, Sylvie Lierman, Claude Cuvelier, Petra De Sutter, Kutluk Oktay
STUDY QUESTION: Can Sphingosine-1-phosphate (S1P), a ceramide-induced death pathway inhibitor, prevent cyclophosphamide (Cy) or doxorubicin (Doxo) induced apoptotic follicle death in human ovarian xenografts? SUMMARY ANSWER: S1P can block human apoptotic follicle death induced by both drugs, which have differing mechanisms of cytotoxicity. WHAT IS KNOWN ALREADY: S1P has been shown to decrease the impact of chemotherapy and radiation on germinal vesicle oocytes in animal studies but no human translational data exist...
January 2014: Human Reproduction
Yu Wang, Dai-hong Liu, Kai-yan Liu, Lan-ping Xu, Xiao-hui Zhang, Wei Han, Huan Chen, Yu-hong Chen, Feng-rong Wang, Jing-zhi Wang, Hai-xia Fu, Xiao-jun Huang
OBJECTIVE: To explore the outcome of human leukocyte antigen (HLA)-mismatched/haploidentical hematopoietic stem cell transplantation (HSCT) for refractory/relapsed acute leukemia (AL) patients and its related risk factors. METHODS: 96 refractory/relapsed AL patients who received HLA-mismatched/haploidentical HSCT following conditioning regimen comprised of modified busulfan/cyclophosphamide (BU/CY) plus thymoglobulin (ATG) from Jan 2003 to Jun 2011 were analyzed retrospectively...
November 2012: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
Xin Chen, Jia-lin Wei, Yong Huang, Yi He, Dong-lin Yang, Er-lie Jiang, Qiao-ling Ma, Lu-kun Zhou, Xiao-ting Lin, Yu-yan Shen, Si-zhou Feng, Ming-zhe Han
OBJECTIVE: To evaluate the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) from HLA-matched sibling donor (MSD allo-HSCT) for severe aplastic anemia (SAA). METHODS: The clinical data of 41 SAA patients received MSD allo-HSCT from May. 2003 to Aug. 2011 were analyzed retrospectively. 24 patients were male, 17 were female. Median age was 23 (5 - 43) years old. 28 patients had SAA-I, 9 had SAA-II, and 4 had post-hepatitis aplastic anemia. 17 patients received allogeneic bone marrow (BM) transplantation (allo-BMT), and 24 received allogeneic peripheral blood stem cell (PBSC) transplantation (allo-PBSCT)...
August 2012: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
Jaap Jan Boelens, Vanderson Rocha, Mieke Aldenhoven, Robert Wynn, Anne O'Meara, Gerard Michel, Irina Ionescu, Suhag Parikh, Vinod K Prasad, Paul Szabolcs, Maria Escolar, Eliane Gluckman, Marina Cavazzana-Calvo, Joanne Kurtzberg et al.
Allogeneic stem cell transplantation (SCT) is considered effective in preventing disease progression in patients with Hurler syndrome (HS). Unrelated umbilical cord blood (UCB) grafts are suggested as an alternative to bone marrow (BM) or peripheral blood stem cells (PBSC). We studied 93 HS patients receiving an UCB graft to analyze risk factors for outcomes. The median time from diagnosis to transplant was 4.6 months, median follow-up was 29 months, and median number of nucleated CB cells infused was 7.6 x 10(7)/kg...
May 2009: Biology of Blood and Marrow Transplantation
M Akif Yesilipek, Gulsun Tezcan, Manuela Germeshausen, Alphan Kupesiz, Vedat Uygun, Volkan Hazar
SCN is an inherited hematological disorder with severe neutropenia and recurrent infections. Although there are some reports that recombinant rhG-CSF improves clinical outcome, allogeneic HSCT appears to be the only curative treatment for these patients. We report here two children with SCN successfully treated by CBT from unrelated donors. They were refractory to rhG-CSF treatment and have no identical family donor. Bu + CY were given as conditioning. Case 1 and Case 2 received 6/6 and 5/6 HLA-matched unrelated umbilical cord blood, respectively...
September 2009: Pediatric Transplantation
K W Chan, L McDonald, D Lim, M S Grimley, G Grayson, D A Wall
Early results of unrelated cord blood transplantation (UCBT) for severe aplastic anemia (SAA) were poor with a high rate of engraftment failure. This was attributed to the combination of lower graft cell dose and intact host immune system. We performed UCBT in nine children (median age 9 years) with refractory SAA using increasingly immunosuppressive preparative regimens. The time from diagnosis to UCBT was 3.4-20 months (median age 7.2 years), with all children having failed at least one course of immunosuppression...
November 2008: Bone Marrow Transplantation
S Bonanomi, S Bonnanomi, P Connor, D Webb, P Ancliff, P Amrolia, K Rao, D McCloskey, S Hemmatpour, N Goulden, P Veys
We report successful outcome in 13 children (median age 2.2 years) with high-risk AML who received SCT from an unrelated (11) or identical sibling (2) donor after a preparative regimen consisting of BU, CY and melphalan. Three children were 'poor'-risk in first CR, three in the second CR, five in PR and two had resistant disease. Immunotherapeutic strategies were employed to maximize a GVL response escalating through a reduced dose of alemtuzumab, early taper of CsA, donor lymphocyte infusion and treatment with alpha-IFN...
August 2008: Bone Marrow Transplantation
M Zakerinia, H N Khojasteh, M Ramzi, M Haghshenas
Allogeneic bone marrow transplantation (BMT) was performed on 113 Iranian transfusion-dependent thalassemia major patients from May 1993 through September 2003. To have at least 2 years follow-up, we report BMT on 90 patients transplanted up to December 2001. The donors were human leukocyte antigen (HLA)-identical, mixed lymphocyte culture (MLC)-nonreactive siblings (n = 74) on parents (n = 6); HLA-identical MLC-reactive siblings (n = 5) or parents (n = 1); and one HLA antigen-mismatched sibling (n = 4). The induction regimen in 11 patients was oral busulfan (BU) (14 mg/kg) and IV cyclophosphamide (CY; 200 mg/kg); in fifteen patients it was BU (15 mg/kg) and cyclophosphamide (CY; 200 mg/kg); in 47 patients, BU (15 mg/kg), CY (200 mg/kg), and short course of anti-thymocyte globulin (ATG, horse; 40 mg/kg including 10 mg/kg on days -2, -1, +1, +2); and in 15 patients, BU (15 mg/kg) CY (200 mg/kg), and ATG (60 to 100 mg/kg; 10 mg/kg at 3 to 5 days before and after BMT)...
December 2005: Transplantation Proceedings
B Horn, L-A Baxter-Lowe, L Englert, A McMillan, M Quinn, K Desantes, M Cowan
The major problems with busulfan/cyclophosphamide (Bu/Cy)-containing conditioning regimens are acute toxicities and graft failure. To decrease acute toxicities, we have prospectively evaluated a reduced intensity conditioning (RIC) regimen using targeted dosing of i.v. busulfan, fludarabine, and rabbit ATG (Bu/Flu/rATG) in children with diagnoses that historically would have been conditioned with Bu/Cy regimens. Nineteen pediatric patients were enrolled in the study. The donors included HLA-matched and one antigen-mismatched unrelated volunteers (n = 11), unrelated cord blood (n = 1), and related donors (n = 7)...
February 2006: Bone Marrow Transplantation
J Mayer, M Krejcí, M Doubek, Z Pospísil, Y Brychtová, M Tomíska, Z Rácil
Corticosteroid-resistant GVHD is difficult to manage and is associated with high morbidity and mortality. Cyclophosphamide (Cy) is an established immunosuppressive and cytotoxic drug widely used as part of pretransplant conditioning regimens. In a retrospective study of 15 patients who had not responded to corticosteroids (nine with acute GVHD, three with GVHD after donor leukocyte infusion, and three progressive chronic GVHD), pulse Cy at a median dose of 1 g/m(2) was very effective in the treatment of skin (100% response), liver (70% response), and the oral cavity (100% response)...
April 2005: Bone Marrow Transplantation
K U Hashmi, B Khan, P Ahmed, I Hussain, S Rasul, E Hanif, M Naeem, H Iqbal, H S Malik
OBJECTIVE: To evaluate outcome of allogeneic BMT in beta-Thalassaemia at the Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan from August 2001 to November 2003. METHODS: Nineteen patients with beta-Thalassaemia underwent allogeneic BMT/PBSC transplantation from HLA identical sibling donors. Patients were classified in three groups according to Pesaro (Italy) risk classification. Class-I (n = 9) and Class-II (n = 7) patients received conditioning with busulphan/cyclophosphamide, whereas Class-III (n = 3) patient received conditioning with hydroxyurea, azathioprine, fludarabine, along with Bu14 / Cy 200...
October 2004: JPMA. the Journal of the Pakistan Medical Association
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