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Acute graft versus host disease

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https://www.readbyqxmd.com/read/28802588/t-cell-costimulation-blockade-promotes-transplantation-tolerance-in-combination-with-sirolimus-and-post-transplantation-cyclophosphamide-for-haploidentical-transplantation-in-children-with-severe-aplastic-anemia
#1
Sarita Rani Jaiswal, Prakash Bhakuni, Shamsuz Zaman, Satish Bansal, Priyanka Bharadwaj, Sneh Bhargava, Suparno Chakrabarti
We conducted a pilot study employing extended T cell costimulation blockade (COSBL) with Abatacept along with sirolimus and post-transplantation cyclophosphamide (PTCy) in 10 patients (median age 12) with severe aplastic anemia (SAA). Nine patients engrafted in the COSBL group, compared to all 10 patients (median 14 vs 13days) treated on PTCy protocols without abatacept (CONTROL group). The incidence of acute graft-versus-host disease (GVHD) was 10.5% in the COSBL group compared to 50% in the CONTROL group (p=0...
August 9, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28801891/monitoring-of-busulphan-concentrations-in-children-undergone-hematopoietic-stem-cell-transplantation-unicentric-experience-over-10%C3%A2-years
#2
Maura Faraci, Carmine Tinelli, Edoardo Lanino, Stefano Giardino, Massimiliano Leoni, Marta Ferretti, Elio Castagnola, Monica Broglia, Annalisa De Silvestri, Daniela Di Martino, Antonella Bartoli
BACKGROUND AND OBJECTIVES: The aim of this report is to describe the experience in the management of busulphan-based conditioning regimen administered before hematopoietic stem cell transplantation (HSCT) in children. METHODS: We report the values of the first dose AUC (area under the concentration-time curve, normal target between 3600 and 4800 ng·h/mL) in children treated with oral and intravenous busulphan, and we analyze the impact of some clinical variables in this cohort of patients...
August 11, 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/28797779/long-term-outcomes-of-cord-blood-transplantation-from-an-hla-identical-sibling-for-patients-with-bone-marrow-failure-disorders-a-report-from-eurocord-cord-blood-committee-cbc-ctiwp-and-severe-aplastic-anemia-working-party-saawp-of-the-european-society-of-blood
#3
Simona Pagliuca, Régis Peffault de Latour, Fernanda Volt, Franco Locatelli, Marco Zecca, Jean-Hugues Dalle, Patrizia Comoli, Kim Vettenranta, Miguel Angel Diaz, Or Reuven, Yves Bertrand, Cristina Diaz de Heredia, Arnon Nagler, Ardeshir Ghavamzadeh, Sabina Sufliarska, Sarah Lawson, Chantal Kenzey, Vanderson Rocha, Carlo Dufour, Eliane Gluckman, Jakob Passweg, Annalisa Ruggeri
Cord blood transplantation (CBT) from HLA-identical sibling is an attractive option for patients with bone-marrow-failures syndromes (BMF), due to the low risk of graft-versus-host disease (GVHD) and the absence of risk to the donor. We analyzed outcomes of 117 patients with inherited or acquired BMF, who received CBT from a related HLA-identical donor in EBMT centers, between 1988 and 2014. Ninety-seven patients had inherited and 20 patients acquired BMF. Eighty-two patients received a single cord blood (CB) unit, whereas 35 patients received a combination of CB and bone marrow (BM) cells from the same donor...
August 7, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28780238/tcr%C3%AE-%C3%AE-and-cd19-cell-depleted-haploidentical-and-mismatched-hematopoietic-stem-cell-transplantation-in-primary-immune-deficiency
#4
Ravi M Shah, Reem Elfeky, Zohreh Nademi, Waseem Qasim, Persis Amrolia, Robert Chiesa, Kanchan Rao, Giovanna Lucchini, Juliana M F Silva, Austen Worth, Dawn Barge, David Ryan, Jane Conn, Andrew J Cant, Roderick Skinner, Intan Juliana Abd Hamid, Terence Flood, Mario Abinun, Sophie Hambleton, Andrew R Gennery, Paul Veys, Mary Slatter
BACKGROUND: Allogeneic hematopoietic stem cell transplantation (HSCT) is used as a therapeutic approach for primary immunodeficiencies (PIDs). The best outcomes have been achieved using HLA-matched donors, but when a matched donor is not available, a haploidentical or mismatched unrelated donor (mMUD) can be useful. Various strategies are used to mitigate the risk of graft versus host disease (GvHD) and rejection associated with such transplants. OBJECTIVE: We sought to evaluate the outcomes of haploidentical or mMUD HSCT after depleting GvHD causing TCRαβCD3+ cells from the graft...
August 2, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28774674/concurrent-hepatic-tuberculosis-and-hepatic-graft-versus-host-disease-in-an-allogeneic-hematopoietic-stem-cell-transplant-recipient-a-case-report
#5
Z Zhao, W Q Leow
BACKGROUND: Infection and graft-versus-host disease (GVHD) are among the most common complications after hematopoietic stem cell transplantation (HSCT). With well-known risk factors including allogeneic HSCT and GVHD, tuberculosis (TB) has a higher incidence and shorter survival rate in HSCT recipients than in the general population. CASE REPORT: A 55-year-old Indonesian female with a history of latent TB was found to have acute myeloid leukemia 3 months after allogeneic HSCT...
July 31, 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28759468/the-evaluation-of-critically-ill-transplant-patients-with-infectious-diarrhea
#6
Diana F Florescu
PURPOSE OF REVIEW: The review summarizes the epidemiology, risk factors, clinical presentation, diagnosis and management of the most important etiologic agents of infectious diarrhea in critically ill transplant recipients. RECENT FINDINGS: Diarrhea, frequently caused by infectious pathogens, can cause significant morbidity and mortality in transplant recipients. Diarrhea can lead to severe dehydration, acute renal failure, medication toxicity, rejection, graft-versus-host disease and impairs patients' quality of life...
July 29, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28752258/allogeneic-reduced-intensity-hematopoietic-stem-cell-transplantation-for-chronic-granulomatous-disease-a-single-center-prospective-trial
#7
Mark Parta, Corin Kelly, Nana Kwatemaa, Narda Theobald, Diane Hilligoss, Jing Qin, Douglas B Kuhns, Christa Zerbe, Steven M Holland, Harry Malech, Elizabeth M Kang
PURPOSE: The purpose of this study was to evaluate engraftment and adverse events with a conditioning and prophylactic regimen intended to achieve high rates of engraftment with minimal graft-versus-host disease (GVHD) in allogeneic transplantation for chronic granulomatous disease in a single center. METHODS: Forty patients, 37 male, with chronic granulomatous disease were transplanted. Transplant products were matched sibling peripheral blood stem cells (PBSCs) in four and matched unrelated donor (MUD) bone marrow in three, and one patient received mismatched unrelated PBSCs...
July 28, 2017: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/28751785/ctla4-cd28-chimera-gene-modification-of-t-cells-enhances-the-therapeutic-efficacy-of-donor-lymphocyte-infusion-for-hematological-malignancy
#8
Hyung Bae Park, Ji Eun Lee, Yu Mi Oh, Sang Jin Lee, Hyeon-Seok Eom, Kyungho Choi
Donor lymphocyte infusion (DLI) followed by hematopoietic stem cell transplantation has served as an effective prevention/treatment modality against the relapse of some hematologic tumors, such as chronic myeloid leukemia (CML). However, the therapeutic efficacies of DLI for other types of leukemia, including acute lymphocytic leukemia (ALL), have been limited thus far. Therefore, we examined whether increasing the reactivity of donor T cells by gene modification could enhance the therapeutic efficacy of DLI in a murine model of ALL...
July 28, 2017: Experimental & Molecular Medicine
https://www.readbyqxmd.com/read/28750779/pro-inflammatory-dual-receptor-t-cells-in-chronic-graft-versus-host-disease
#9
Amritha Balakrishnan, Nicholas Gloude, Roman Sasik, Edward D Ball, Gerald P Morris
Defective post-transplant thymopoiesis is associated with chronic graft versus host disease (cGVHD), a multi-organ pathology affecting up to 80% of patients following allogeneic hematopoietic stem cell transplantation (HSCT). Previous work demonstrated that the subset of T cells expressing two T cell receptors (TCRs) is predisposed to alloreactivity, driving selective and disproportionate activity in acute GVHD in both mouse models and HSCT patients. Here we investigate a potential role for this pathogenic T cell subset in cGVHD...
July 24, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28748621/outcomes-of-matched-sibling-donor-bone-marrow-transplantation-in-children-using-single-agent-calcineurin-inhibitors-as-prophylaxis-for-graft-versus-host-disease
#10
Caitlin W Elgarten, Danielle E Arnold, Nancy J Bunin, Alix E Seif
BACKGROUND: Optimal graft versus host disease (GVHD) prophylaxis prevents severe manifestations without excess immunosuppression. Standard prophylaxis includes a calcineurin inhibitor (CNI) with low-dose methotrexate. However, single-agent CNI may be sufficient prophylaxis for a defined group of patients. Single-agent CNI has been used for GVHD prophylaxis for human leukocyte antigen (HLA)-matched sibling donor (MSD) bone marrow transplants (BMTs) in young patients at the Children's Hospital of Philadelphia for over 20 years...
July 27, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28744284/safety-and-side-effects-of-using-placenta-derived-decidual-stromal-cells-for-graft-versus-host-disease-and-hemorrhagic-cystitis
#11
Arjang Baygan, Wictor Aronsson-Kurttila, Gianluca Moretti, Babylonia Tibert, Göran Dahllöf, Lena Klingspor, Britt Gustafsson, Bita Khoein, Guido Moll, Charlotta Hausmann, Britt-Marie Svahn, Magnus Westgren, Mats Remberger, Behnam Sadeghi, Olle Ringden
Mesenchymal stromal cells (MSCs) are increasingly used in regenerate medicine. Placenta-derived decidual stromal cells (DSCs) are a novel therapy for acute graft-versus-host-disease (GVHD) and hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (HSCT). DSCs are more immunosuppressive than MSCs. We assessed adverse events and safety using DSCs among 44 treated patients and 40 controls. The median dose of infused cells was 1.5 (range 0.9-2.9) × 10(6) DSCs/kg. The patients were given 2 (1-5) doses, with a total of 82 infusions...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28742948/microbial-metabolites-and-graft-versus-host-disease
#12
Mary Riwes, Pavan Reddy
The health of mammals is a reflection of the diversity and composition of the intestinal microbiota. Alterations in the composition and functions of the intestinal microbiota have been implicated in multiple disease processes. The impact of the microbiota in health and disease is in part a function of the nutrient processing and release of metabolites. Recent studies have uncovered a major role for microbial metabolites in the function of the host immune system by which they influence disease processes such as acute graft versus host disease (GVHD), which is the main complication of allogeneic hematopoietic cell transplantation (allo-HCT)...
July 25, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28737249/haploidentical-transplantation-compared-with-matched-sibling%C3%A2-and-unrelated-donor-transplantation-for-adults-with-standard-risk-acute-lymphoblastic-leukaemia-in-first-complete-remission
#13
Li-Jie Han, Yu Wang, Zhi-Ping Fan, Fen Huang, Jian Zhou, Yue-Wen Fu, Hong Qu, Li Xuan, Na Xu, Jie-Yu Ye, Zhi-Lei Bian, Yong-Ping Song, Xiao-Jun Huang, Qi-Fa Liu
We retrospectively investigated outcomes of haploidentical donor (HID) transplant for adults with standard-risk acute lymphoblastic leukaemia (ALL) in first complete remission (CR1) compared with human leucocyte antigen (HLA)-matched sibling donor (MSD) and HLA-matched unrelated donor (MUD) transplants. A total of 348 adult patients were enrolled, including 127 HID, 144 MSD and 77 MUD recipients. The cumulative incidence of grade II-IV acute graft-versus-host disease (aGVHD) was 39·5%, 24·0% and 40·3% for HID, MSD and MUD, respectively (P = 0·020)...
July 24, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28733895/clinical-impact-of-pre-transplant-gut-microbial-diversity-on-outcomes-of-allogeneic-hematopoietic-stem-cell-transplantation
#14
Noriko Doki, Masahiro Suyama, Satoshi Sasajima, Junko Ota, Aiko Igarashi, Iyo Mimura, Hidetoshi Morita, Yuki Fujioka, Daisuke Sugiyama, Hiroyoshi Nishikawa, Yutaka Shimazu, Wataru Suda, Kozue Takeshita, Koji Atarashi, Masahira Hattori, Eiichi Sato, Kyoko Watakabe-Inamoto, Kosuke Yoshioka, Yuho Najima, Takeshi Kobayashi, Kazuhiko Kakihana, Naoto Takahashi, Hisashi Sakamaki, Kenya Honda, Kazuteru Ohashi
Post-transplant microbial diversity in the gastrointestinal tract is closely associated with clinical outcomes following allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, little is known about the impact of the fecal microbiota before allo-HSCT. We analyzed fecal samples approximately 2 weeks before conditioning among 107 allo-HSCT recipients between 2013 and 2015. Microbial analysis was performed using 16S rRNA gene sequencing. Operational taxonomic unit-based microbial diversity was estimated by calculating the Shannon index...
July 21, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28733533/similar-outcomes-after-haploidentical-transplantation-with-post-transplant-cyclophosphamide-versus-hla-matched-transplantation-a-meta-analysis-of-case-control-studies
#15
Zhenyang Gu, Li Wang, Lei Yuan, Wenrong Huang, Meng Li, Lixun Guan, Qingyi Wang, Zhe Gao, Shasha Zhao, Lan Luo, Feiyan Wang, Nan Yang, Daihong Liu, Jon C Aster, Chunji Gao
BACKGROUND: Outcomes of haploidentical hematopoietic cell transplantation (haplo-HCT) with post-transplant cyclophosphamide (PT-Cy) have greatly improved. It remains unknown whether haplo-HCT with PT-Cy was associated with poor outcomes when compared with HLA-matched HCT. To address this issue, we performed a meta-analysis to compare outcomes of haplo-HCT with PT-Cy with those of HLA-matched HCT. METHODS: A systematic search for case-control studies were performed in PubMed, Embase and Cochrane Library databases...
June 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28733186/easix-in-patients-with-acute-graft-versus-host-disease-a-retrospective-cohort-analysis
#16
Thomas Luft, Axel Benner, Sonata Jodele, Christopher E Dandoy, Rainer Storb, Ted Gooley, Brenda M Sandmaier, Natalia Becker, Aleksandar Radujkovic, Peter Dreger, Olaf Penack
BACKGROUND: Endothelial dysfunction links thrombotic microangiopathy to steroid-refractory graft-versus-host disease (GVHD) after allogeneic stem-cell transplantation. We aimed to assess if the simple formula-lactate dehydrogenase (U/L) × creatinine (mg/dL)/thrombocytes (10(9) cells per L)-termed the Endothelial Activation and Stress Index (EASIX), might be valuable for the prediction of death in patients with acute GVHD after allogeneic stem-cell transplantation. METHODS: For this retrospective analysis, we analysed a training cohort (in Germany) and three validation cohorts (in Germany and the USA) of patients with acute GVHD who had received consecutive allogeneic stem-cell transplantation...
July 18, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28731920/eye-movement-disorders-following-allogeneic-bone-marrow-transplantation-on-fk506-tacrolimus-and-ganciclovir
#17
Barbaros S Karagun, Tugana Akbas, Taner Arpaci, Bulent Antmen
FK506 (tacrolimus) is an immunosuppressive drug and more potent than cyclosporine. FK506 is widely used for immunosuppression in the prevention and treatment of graft-versus-host disease after allogeneic bone marrow transplantation and solid organ transplantation. Neurotoxicity is a recognized complication of FK506 therapy, but ptosis and weakness of eye abduction unilaterally has not been reported in association with FK506 administration to date. We discuss a 13-year-old male patient who developed ptosis and weakness of eye abduction unilaterally 90 days after transplantation with bone marrow from an unrelated donor, for acute lymphoblastic leukemia in this case report...
July 20, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28728274/-a-retrospective-study-of-10-cases-of-post-transplant-bronchiolitis-obliterans
#18
J J Chai, T Liu, B Q Cai, H D Zhu
Objective: To analyze the clinical features of bronchiolitis obliterans syndrome (BOS) in patients with allogeneic hematopoietic stem cell transplantation (HSCT). Methods: This retrospective study included patients who underwent allogeneic HSCT from January 1998 to December 2016. The clinical features, radiological manifestations and treatment of clinically proven BOS were reviewed. Results: Of 681 patients who experienced HSCT, 10(1.47%) met the diagnostic criteria. The duration of BOS onset after transplantation was 5-48 months, averaging (18±15) months...
July 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28725544/successful-haploidentical-stem-cell-transplantation-with-prophylactic-administration-of-liposomal-amphotericin-b-after-invasive-pulmonary-zygomycosis
#19
Testuro Ochi, Yuta Katayama, Takeshi Okatani, Ryota Imanaka, Kohei Kyo, Mitsuhiro Itagaki, Shinya Katsutani, Koji Iwato, Hideki Asaoku
A 54-year-old woman with acute myeloid leukemia (AML) achieved complete remission by induction chemotherapy, but developed zygomycosis after consolidation therapy. As zygomycosis could not be cured by liposomal amphotericin B and micafungin, left lower lobectomy was performed. As AML relapsed 7 months after onset, she received haploidentical stem cell transplantation under administration of liposomal amphotericin B. Despite experiencing severe acute graft-versus-host disease, she remains alive with no relapse of either zygomycosis or AML...
December 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28721499/treg-protected-donor-lymphocyte-infusions-a-new-tool-to-address-the-graft-versus-leukemia-effect-in-the-absence-of-graft-versus-host-disease-in-patients-relapsed-after-hsct
#20
Mauro Di Ianni, Paola Olioso, Raffaella Giancola, Stella Santarone, Annalisa Natale, Gabriele Papalinetti, Ida Villanova, Stefano Baldoni, Ambra Di Tommaso, Tiziana Bonfini, Patrizia Accorsi, Paolo Di Bartolomeo
In high-risk acute leukemia patients undergoing haploidentical hematopoietic stem cell transplantation (HSCT), adoptive immunotherapy with T regulatory cells (Tregs) and T conventional cells (Tcons) prevented acute and chronic graft-versus-host disease (GvHD), favored post-transplant immunological reconstitution and was associated with a powerful graft-versus-leukemia (GvL) effect. With a particularly innovative approach, we developed a treatment with a Treg-protected donor lymphocyte infusion (DLI) for patients with early relapse after HSCT and we report here the results obtained in the first patient with APL (M3v) relapsed after a second matched allogeneic HSCT (15% blasts and 75% of donor cells in bone marrow)...
July 18, 2017: International Journal of Hematology
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