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Allogenic HSCT

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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
#1
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
https://www.readbyqxmd.com/read/28712934/donor-lymphocyte-infusions-used-to-treat-mixed-chimeric-and-high-risk-patient-populations-in-the-relapsed-and-non-relapsed-settings-after-allogeneic-transplant-for-hematologic-malignancies-are-associated-with-high-5-year-survival-if-persistent-full-donor-chimerism
#2
Lauren E Caldemeyer, Luke P Akard, John R Edwards, Anand Tandra, Dawn R Wagenknecht, Michael J Dugan
Mixed chimerism (MC), a persistent or increasing number of host cells after allogeneic hematopoietic stem cell transplant (HSCT), is a predictor of disease relapse. Donor lymphocyte infusions (DLI) have the potential to enhance the graft vs. malignancy (GvM) effect, reducing the risk of relapse in patients with MC. Hence, in addition to utilizing DLI in the relapsed setting, there is a motivation to pursue pre-emptive DLI for patients in complete remissions (CR) after HSCT. To assess the safety and efficacy of DLI, records of 86 patients who received DLI between 2003 and 2015 at a single institution were studied retrospectively...
July 13, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28711754/stability-and-priority-of-symptoms-and-symptom-clusters-among-allogeneic-hsct-patients-within-a-5-year-longitudinal-study
#3
Peter Esser, Katharina Kuba, Angela Scherwath, Christoffer Johansen, Anke Schwinn, Lena Schirmer, Frank Schulz-Kindermann, Margitta Kruse, Uwe Koch, Axel Rolf Zander, Nicolaus Kröger, Heide Götze, Anja Mehnert
CONTEXT: Due to toxicity and invasiveness, allogeneic HSCT causes severe and longstanding symptom burden. Longitudinal studies on symptoms and symptom clusters (SC) would be helpful to optimize symptom control, but are rare to date. OBJECTIVES: To investigate stability of symptoms, extract time stable SC and to determine their priority in symptom management. METHODS: In this multicenter study, patients diagnosed with hematological cancer were assessed before conditioning (T0) and three months (T1), one year (T2) and five years (T3) after transplantation...
July 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28711727/a-chemotherapy-only-regimen-of-busulfan-melphalan-and-fludarabine-and-rabbit-atg-followed-by-allogeneic-t-cell-depleted-hematopoietic-stem-cell-transplants-for-the-treatment-of-myeloid-malignancies
#4
Barbara Spitzer, Ann A Jakubowski, Esperanza B Papadopoulos, Kirsten Fuller, Patrick D Hilden, James W Young, Juliet Barker, Guenther Koehne, Miguel-Angel Perales, Katharine C Hsu, Marcel R M van den Brink, Nancy A Kernan, Susan E Prockop, Andromachi Scaradavou, Hugo Castro-Malaspina, Richard J O'Reilly, Farid Boulad
We sought to develop a myeloablative chemotherapeutic regimen to secure consistent engraftment of T-cell depleted (TCD) hematopoietic stem cell transplants (HSCT) without the need for total body irradiation, thereby reducing toxicity, while maintaining low rates of GvHD and without increasing relapse. We investigated the myeloablative combination of busulfan and melphalan, with the immunosuppressive agents fludarabine and rabbit anti-thymocyte gloubin (r-ATG) as cytoreduction prior to a T-cell depleted HSCT...
July 12, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28710997/dynamics-of-torque-teno-virus-plasma-dnaemia-in-allogeneic-stem-cell-transplant-recipients
#5
Eliseo Albert, Carlos Solano, Tania Pascual, Ignacio Torres, Lisa Macera, Daniele Focosi, Fabrizio Maggi, Estela Giménez, Paula Amat, David Navarro
BACKGROUND: Torque Teno virus (TTV) plasma DNA load directly correlate with the level of immunosuppresion in different clinical settings. It is uncertain whether this may be the case in allogeneic hematopoietic stem cell transplant recipients (allo-HSCT). OBJECTIVES: We characterized the dynamics of TTV DNAemia in patients undergoing T-cell replete allo-SCT. STUDY DESIGN: Retrospective single-center observational study including 72 allo-HSCT patients...
July 8, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28708253/cytomegalovirus-appendicitis-after-hematopoietic-stem-cell-transplantation
#6
Atul Kothari, Kari D Caradine, Juan Carlos Crescencio Rico, Appalanaidu Sasapu, Muthu K Veeraputhiran, Yogesh Jethava, Mary J Burgess
We present the case of a young man with acute lymphoblastic leukemia who developed cytomegalovirus (CMV) appendicitis after receiving alemtuzumab for acute refractory graft-versus-host disease after allogeneic hematopoietic stem cell transplantation (HSCT). CMV appendicitis is a rare complication; and we are reporting the first case to our knowledge of CMV appendicitis following HSCT. Our case highlights the importance of recognition of CMV viral reactivation following the use of alemtuzumab. Using a preemptive strategy of checking CMV PCR, with initiation of early effective treatment on detection of CMV replication, may be appropriate following use of alemtuzumab in hematologic malignancies in patients after HSCT...
July 14, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28705839/circulating-dsdna-endothelial-injury-and-complement-activation-in-thrombotic-microangiopathy-and-gvhd
#7
Nicholas J Gloude, Pooja Khandelwal, Nathan Luebbering, Dana T Lounder, Sonata Jodele, Matthew N Alder, Adam Lane, Alyss Wilkey, Kelly E Lake, Bridget Litts, Stella M Davies
TA-TMA is a common and poorly recognized complication of HSCT associated with excessive complement activation, likely triggered by endothelial injury. An important missing piece is the link between endothelial injury and complement activation. We hypothesized that neutrophil extracellular traps (NETs) mechanistically link endothelial damage with complement activation and subsequent TA-TMA. Neutrophil activation releases granule proteins together with double stranded DNA (dsDNA), to form extracellular fibers known as NETs...
July 13, 2017: Blood
https://www.readbyqxmd.com/read/28705454/efficacy-of-two-different-doses-of-rabbit-anti-t-lymphocyte-globulin-to-prevent-graft-versus-host-disease-in-children-with-haematological-malignancies-transplanted-from-an-unrelated-donor-a-multicentre-randomised-open-label-phase-3-trial
#8
Franco Locatelli, Maria Ester Bernardo, Alice Bertaina, Carla Rognoni, Patrizia Comoli, Attilio Rovelli, Andrea Pession, Franca Fagioli, Claudio Favre, Edoardo Lanino, Giovanna Giorgiani, Pietro Merli, Daria Pagliara, Arcangelo Prete, Marco Zecca
BACKGROUND: Although rabbit anti-T-lymphocyte globulin (ATLG) is largely used for the prevention of immune-mediated complications in patients given allogeneic haemopoietic stem-cell transplantation (HSCT) from an unrelated donor, the optimum dose of this drug in children is still undefined. We aimed to test whether a higher dose of ATLG was superior to a lower dose for prevention of grade II-IV acute graft-versus-host disease (GVHD). METHODS: We conducted a multicentre, randomised, open-label, phase 3 trial in seven Italian centres comparing two different doses of ATLG (30 mg/kg vs 15 mg/kg, given intravenously over 3 days, from day -4 to -2) in children (aged 0-18 years) with haematological malignancies transplanted from an unrelated donor, selected using high-resolution typing for HLA-class I/II loci...
July 10, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28702856/dynamics-of-torque-teno-virus-viremia-could-predict-risk-of-complications-after-allogeneic-hematopoietic-stem-cell-transplantation
#9
Ramona Gilles, Marco Herling, Udo Holtick, Eva Heger, Sabine Awerkiew, Irina Fish, Konstantin Höller, Saleta Sierra, Elena Knops, Rolf Kaiser, Christof Scheid, Veronica Di Cristanziano
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an established treatment option for several hematological diseases. However, the first year post-transplantation is often complicated by infections and graft-versus-host disease (GVHD). Improvements in immunological monitoring could reduce such post-transplant complications. Torque Teno virus (TTV), a chronically persisting DNA virus, is reported to be a marker for immune function in immunocompromised patients. In the present study, the TTV kinetics were analyzed to investigate the potential role of TTV viremia as immune-competence read-out after allo-HSCT...
July 12, 2017: Medical Microbiology and Immunology
https://www.readbyqxmd.com/read/28698754/early-and-late-complications-in-patients-with-allogeneic-transplantation-of-hematopoietic-stem-cell-case-report
#10
Ivana Trajkovska, Borce Georgievski, Lidija Cevreska, Andrijana Gacovski, Taner Hasan, Natasha Nedeska-Minova
BACKGROUND: Allogeneic hematopoietic stem cells transplantation (HSCT) is a curative intervention in patients with haematological malignant and non-malignant diseases, immunodeficiency, autoimmune, and other genetic diseases. Early complications are complications that are occurring in the first 100 days, while complications arising after the 100th day of transplantation belong to late complications. CASE REPORT: Forty-nine years old patient with AML treated with allogeneic HSCT from HLA-identical (sister) donor...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28691152/reduced-bucy-2-and-g-csf-primed-bone-marrow-associates-with-low-graft-versus-host-disease-and-transplant-related-mortality-in-allogeneic-hsct
#11
Eucario Leon Rodriguez, Monica M Rivera Franco, Sandra I Perez Alvarez
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the ideal treatment for several diseases. However, the morbidity and mortality associated with the procedure might limit its widespread use; therefore, we implemented reduced BUCY2 as conditioning method along with the use of G-CSF-primed bone marrow (G-BM) in order to reduce complications, including graft-versus-host-disease (GVHD), and to improve survival in these patients. An analysis of transplant characteristics, complications, and survival of patients undergoing an allo-HSCT using this conditioning regimen (busulfan 12 mg/kg and cyclophosphamide 80 mg/kg) plus G-BM was performed...
July 9, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28691006/serum-vitamin-a-levels-may-affect-the-severity-of-ocular-graft-versus-host-disease
#12
Jiefeng Tong, Renjian Hu, Yingying Zhao, Yang Xu, Xiaoying Zhao, Xiuming Jin
Allogeneic hematopoietic stem cell transplantation (HSCT) is a well-established therapeutic option for a range of inherited and acquired hematological disorders. However, graft-versus-host disease (GVHD) remains the leading cause of non-relapse mortality in allogeneic HSCT recipients. Ocular involvement occurs in up to 80% of chronic GVHD patients. In our cases, the diagnosis of vitamin A deficiency was suspected for GVHD patients. Serum vitamin A measurements were conducted to confirm clinical suspicions. Our study revealed significant decrease in serum levels of vitamin A in chronic liver GVHD patients...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28690612/protection-of-mice-from-acute-graft-versus-host-disease-requires-cd28-co-stimulation-on-donor-cd4-foxp3-regulatory-t-cells
#13
Anna Uri, Sandra Werner, Fred Lühder, Thomas Hünig, Thomas Kerkau, Niklas Beyersdorf
Acute graft-versus-host disease (aGvHD) is a major cause of morbidity and mortality after allogeneic hematopoietic stem cell plus T cell transplantation (allo-HSCT). In this study, we investigated the requirement for CD28 co-stimulation of donor CD4(+) conventional (CD4(+)CD25(-)Foxp3(-), Tconv) and regulatory (CD4(+)CD25(+)Foxp3(+), Treg) T cells in aGvHD using tamoxifen-inducible CD28 knockout (iCD28KO) or wild-type (wt) littermates as donors of CD4(+) Tconv and Treg. In the highly inflammatory C57BL/6 into BALB/c allo-HSCT transplantation model, CD28 depletion on donor CD4(+) Tconv reduced clinical signs of aGvHD, but did not significantly prolong survival of the recipient mice...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28687251/associations-between-acute-gvhd-related-biomarkers-and-endothelial-cell-activation-after-allogeneic-hematopoietic-stem-cell-transplantation
#14
Shosaku Nomura, Kazuyoshi Ishii, Shinya Fujita, Aya Nakaya, Atsushi Satake, Tomoki Ito
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) can cause serious transplant-related complications such as graft-versus-host disease (GVHD). Acute GVHD (aGVHD) has been diagnosed by clinical manifestations, laboratory data and pathological effects until now, but recently the discovery of specific biomarkers such as suppression of tumorigenicity 2 (ST2), elafin and regenerating islet-derived 3α (REG3α) is challenging this approach. METHODS: We investigated the expression of aGVHD-related markers (regulated on activation normal T-cell expressed and secretes: RANTES, elafin, REG3α and ST2) and endothelial cell activation markers (soluble vascular cell adhesion molecule: sVCAM-1 and plasminogen activator inhibitor: PAI-1) in patients undergoing allogeneic HSCT...
July 4, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28686879/hematopoietic-stem-cell-transplantation-in-qatar-one-year-anniversary
#15
REVIEW
Mohammad Bakr, Ibrahim Al-Hijji, Naziha Menasria, Zeyd Merenkov, Safaa Al-Azzawi, Ruba Taha, Amaal Gulied, Catherine Anne Gillespie, Said Dermime, Effie Liakopoulou, Alexander Knuth
Hematopoietic stem cell transplantation (HSCT) offers potentially curative therapy for many hematologic and nonhematologic conditions. As a successful outcome of Qatar's National Cancer Strategy, the HSCT program was started in the National Center for Cancer Care and Research (NCCCR) in October 2015. The HSCT program in NCCCR is the only transplant program in Qatar and self-sufficient with all three core components: the stem cell collection facility, the stem cell processing facility, and the clinical program, which are locally available at Hamad Medical Corporation...
June 29, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28686852/integrated-meta-omic-analyses-of-the-gastrointestinal-tract-microbiome-in-patients-undergoing-allogeneic-hematopoietic-stem-cell-transplantation
#16
Anne Kaysen, Anna Heintz-Buschart, Emilie E L Muller, Shaman Narayanasamy, Linda Wampach, Cédric C Laczny, Norbert Graf, Arne Simon, Katharina Franke, Jörg Bittenbring, Paul Wilmes, Jochen G Schneider
In patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT), treatment-induced changes to the gastrointestinal tract (GIT) microbiome have been linked to adverse outcomes, most notably graft-versus-host disease (GvHD). However, it is presently unknown whether this relationship is causal or consequential. Here, we performed an integrated meta-omic analysis to probe deeper into the GIT microbiome changes, during allo-HSCT, and its accompanying treatments. We used 16S and 18S rRNA gene amplicon sequencing to resolve archaea, bacteria, and eukaryotes within the GIT microbiomes of 16 patients undergoing allo-HSCT for the treatment of hematologic malignancies...
June 20, 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/28686179/when-less-is-good-is-none-better-the-prognostic-and-therapeutic-significance-of-peri-transplant-minimal-residual-disease-assessment-in-pediatric-acute-lymphoblastic-leukemia
#17
REVIEW
Adam Lamble, Rachel Phelan, Michael Burke
The measurement of minimal residual disease (MRD) in pediatric acute lymphoblastic leukemia (ALL) has become the most important prognostic tool of, and the backbone to, upfront risk stratification. While MRD assessment is the standard of care for assessing response and predicting outcomes for pediatric patients with ALL receiving chemotherapy, its use in allogeneic hematopoietic stem cell transplant (HSCT) has been less clearly defined. Herein, we discuss the importance of MRD assessment during the peri-HSCT period and its role in prognostication and management...
July 7, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28685308/pseudo-autologous-stem-cell-transplantation-for-donor-derived-mantle-cell-lymphoma-12%C3%A2-years-after-allogeneic-transplantation
#18
Masaharu Tamaki, Hidenori Wada, Ayumi Gomyo, Jin Hayakawa, Yu Akahoshi, Naonori Harada, Machiko Kusuda, Yuko Ishihara, Koji Kawamura, Aki Tanihara, Miki Sato, Kiriko Terasako-Saito, Kazuaki Kameda, Misato Kikuchi, Shun-Ichi Kimura, Hideki Nakasone, Shinichi Kako, Yoshinobu Kanda
Donor-derived malignancy is a rare morbidity after allogeneic hematopoietic stem cell transplantation (HSCT), in which most previous cases have presented as acute leukemia or myelodysplastic syndrome. There have, however, been very few reports of donor-derived lymphoma. Here, we present a case of donor-derived mantle cell lymphoma 12 years after allogeneic HSCT, which was successfully treated with chemotherapy followed by pseudo-autologous HSCT (pASCT), i.e., an autologous HSC transplant following allogeneic HSCT in which the infused stem cell is considered to be derived from the donor cells...
July 6, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28685218/influence-of-cyp2c19-genotypes-on-the-occurrence-of-adverse-drug-reactions-of-voriconazole-among-hematological-patients-after-allo-hsct
#19
Beata Sienkiewicz, Donata Urbaniak-Kujda, Jarosław Dybko, Andrzej Dryś, Magdalena Hurkacz, Tomasz Wróbel, Anna Wiela-Hojeńska
The aim of this study was to determine the influence of different CYP2C19 genotypes on selected liver function parameters, and ADR occurrence during VCZ prophylaxis in adult patients after allo-HSCT (allogeneic hematopoietic stem cell transplantation). CYP2C19 mutations were determined in a cohort of 30 adults using PCR-RFLP methods established by Sim et al. and Goldstein and Blaisdell. The patients' protocol included biometrical and biochemical data, information on the underlying disease, chemotherapy, molds infections occurring during VCZ treatment, adverse drug reactions typical for the use of voriconazole, and probable drug - drug interactions...
July 6, 2017: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/28680446/donor-selection-for-allogenic-hemopoietic-stem-cell-transplantation-clinical-and-ethical-considerations
#20
REVIEW
Irene Riezzo, Natascha Pascale, Raffaele La Russa, Arcangelo Liso, Monica Salerno, Emanuela Turillazzi
Allogenic hematopoietic progenitor cell transplantation (allo-HSCT) is an established treatment for many diseases. Stem cells may be obtained from different sources: mobilized peripheral blood stem cells, bone marrow, and umbilical cord blood. The progress in transplantation procedures, the establishment of experienced transplant centres, and the creation of unrelated adult donor registries and cord blood banks gave those without an human leucocyte antigen- (HLA-) identical sibling donor the opportunity to find a donor and cord blood units worldwide...
2017: Stem Cells International
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