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Allogenic HSCT

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https://www.readbyqxmd.com/read/29226172/enteric-microbiome-markers-as-early-predictors-of-clinical-outcome-in-allogeneic-hematopoietic-stem-cell-transplant-results-of-a-prospective-study-in-adult-patients
#1
Nicasio Mancini, Raffaella Greco, Renée Pasciuta, Maria Chiara Barbanti, Giacomo Pini, Olivia Beatrice Morrow, Mara Morelli, Luca Vago, Nicola Clementi, Fabio Giglio, Maria Teresa Lupo Stanghellini, Alessandra Forcina, Laura Infurnari, Sarah Marktel, Andrea Assanelli, Matteo Carrabba, Massimo Bernardi, Consuelo Corti, Roberto Burioni, Jacopo Peccatori, Maria Pia Sormani, Giuseppe Banfi, Fabio Ciceri, Massimo Clementi
Background: Infections and graft-vs-host disease (GvHD) still represent major, not easily predictable complications in allogeneic hematopoietic stem cell transplant (allo-HSCT). Both conditions have been correlated to altered enteric microbiome profiles during the peritransplant period. The main objective of this study was to identify possible early microbiome-based markers useful in pretransplant risk stratification. Methods: Stool samples were collected from 96 consecutive patients at the beginning of the pretransplant conditioning regimen (T0) and at 10 (T1) and 30 (T2) days following transplant...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29224324/-clinical-analysis-of-lung-transplantation-in-eight-patients-with-obstructive-bronchiolitis-syndrome-after-hematopoietic-stem-cell-transplantation
#2
L L Wang, H Y Wang, Y F Shen, M Z Lu, J Y Chen, B Wu
Objective: To investigate the efficacy and prognosis of lung transplantation (LT) for end-stage bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: The clinical data of eight cases with end-stage BOS after allo-HSCT who were treated by LT in our hospital were retrospectively analyzed. Results: Eight patients with hematological malignancy underwent allo-HSCT, and the median age was 23 (12-40) years. The donors are parents or siblings. Severe BOS occurred in 8 patients after allo-HSCT, the median age for LT was 27...
November 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/29224314/-clinical-value-of-pcr-for-viral-detection-of-bronchoalveolar-lavage-fluid-in-the-diagnosis-and-treatment-of-pneumonia-after-allogeneic-hematopoietic-stem-cell-transplantation
#3
Y Y Chen, X Y Luo, X S Zhao, Z H Jiang, Y Chen, H Chen, X D Mo, W Han, F R Wang, J Z Wang, C H Yan, Y Q Sun, Y Y Zhang, T T Han, F F Tang, H X Fu, S Zhang, Y Wang, L P Xu, X H Zhang, K Y Liu, X J Huang
Objective: To analyze the clinical value of real-time PCR for virus detection in the diagnosis and treatment of patients after allo-HSCT who had no infection evidence of pneumonia using routine pathogen detection panel. Methods: The clinical data of 71 episodes with acute lung injury from May 2015 to March 2017 after allo-HSCT in hematology department of Peking University People's Hospital (PKUPH) were retrospectively analyzed. PCR for virus detection and other routine pathogen detection tests were performed on bronchoalveolar lavage fluid (BALF) samples...
November 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/29223388/transplantation-in-the-treatment-of-primary-cutaneous-aggressive-epidermotropic-cytotoxic-cd8-positive-t-cell-lymphoma
#4
Benoit M Cyrenne, Juliet Fraser Gibson, Antonio Subtil, Michael Girardi, Iris Isufi, Stuart Seropian, Francine Foss
BACKGROUND: Primary cutaneous aggressive epidermotropic cytotoxic CD8 positive T-cell lymphoma (CD8+ PCAETL) is a rare subtype of peripheral T-cell lymphoma with poor outcomes and without a standardized treatment strategy. Allogeneic hematopoietic stem cell transplantation (HSCT) has been suggested as a potential curative therapy. PATIENTS AND METHODS: We conducted a retrospective case series. We identified 8 patients with the diagnosis of CD8+ PCAETL, 4 of whom also underwent allogeneic HSCT...
December 6, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/29222325/cells-to-prevent-treat-relapse-following-allogeneic-stem-cell-transplantation
#5
REVIEW
Andrew C Dietz, Alan S Wayne
Relapse of cancer remains one of the primary causes of treatment failure and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). A multitude of approaches have been used in the management of posttransplant relapse. This review focuses on recent data with cellular therapies designed to treat or prevent posttransplant relapse of hematologic malignancies, although many of these therapeutic approaches also have applications to solid tumors and in the nontransplant setting. Currently available cell therapies include second transplant, natural killer cells, monocyte-derived dendritic cell vaccines, and lymphocytes via donor lymphocyte infusion, antigen-primed cytotoxic T lymphocytes, cytokine-induced killer cells, marrow-infiltrating lymphocytes, and chimeric antigen receptor T cells...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222315/extracorporeal-photopheresis-cellular-therapy-for-the-treatment-of-acute-and-chronic-graft-versus-host-disease
#6
REVIEW
Jennifer Schneiderman
Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative option for many disease states. Despite significant improvements in strategies used to prevent and treat acute and chronic graft-versus-host disease (a/cGVHD), they continue to negatively affect outcomes of HSCT significantly. Standard, first-line treatment consists of corticosteroids; beyond this, there is little consistency in therapeutic regimens. Current options include the addition of various immunosuppressive agents, the use of which puts patients at even higher risks for infection and other morbidities...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29218389/primary-prophylaxis-of-invasive-fungal-infections-in-patients-with-haematological-malignancies-2017-update-of-the-recommendations-of-the-infectious-diseases-working-party-agiho-of-the-german-society-for-haematology-and-medical-oncology-dgho
#7
REVIEW
Sibylle C Mellinghoff, Jens Panse, Nael Alakel, Gerhard Behre, Dieter Buchheidt, Maximilian Christopeit, Justin Hasenkamp, Michael Kiehl, Michael Koldehoff, Stefan W Krause, Nicola Lehners, Marie von Lilienfeld-Toal, Annika Y Löhnert, Georg Maschmeyer, Daniel Teschner, Andrew J Ullmann, Olaf Penack, Markus Ruhnke, Karin Mayer, Helmut Ostermann, Hans-H Wolf, Oliver A Cornely
Immunocompromised patients are at high risk of invasive fungal infections (IFI), in particular those with haematological malignancies undergoing remission-induction chemotherapy for acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS) and recipients of allogeneic haematopoietic stem cell transplants (HSCT). Despite the development of new treatment options in the past decades, IFI remains a concern due to substantial morbidity and mortality in these patient populations. In addition, the increasing use of new immune modulating drugs in cancer therapy has opened an entirely new spectrum of at risk periods...
December 7, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/29209333/inhibition-of-acute-graft-versus-host-disease-with-retention-of-graft-versus-tumor-effects-by-dimethyl-fumarate
#8
Jingjing Han, Shoubao Ma, Huanle Gong, Shuangzhu Liu, Lei Lei, Bo Hu, Yang Xu, Haiyan Liu, Depei Wu
Acute graft-versus-host disease (aGVHD) remains a clinical challenge and a major source of morbidity and mortality following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Dimethyl fumarate (DMF), an activator of Nrf2, has been shown to have anti-inflammatory and immunomodulatory properties without significant immunosuppression. We therefore hypothesized that DMF could be potentially harnessed for the treatment of aGVHD with retention of graft-versus-tumor effect. In this study, we showed that DMF significantly inhibited alloreactive T cell responses in vitro in mixed lymphocyte reaction assay...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29207952/economic-burden-of-preemptive-treatment-of-cmv-infection-after-allogeneic-stem-cell-transplantation-a-retrospective-study-of-208-consecutive-patients
#9
Christine Robin, François Hémery, Christel Dindorf, Julien Thillard, Ludovic Cabanne, Rabah Redjoul, Florence Beckerich, Christophe Rodriguez, Cécile Pautas, Andrea Toma, Sébastien Maury, Isabelle Durand-Zaleski, Catherine Cordonnier
BACKGROUND: Cytomegalovirus (CMV) infection and disease (CMV episodes) are global concerns after allogeneic hematopoietic stem cell transplantation (HSCT). They affect survival, both by direct and indirect effects. Due to safety issues of current anti-CMV antivirals, long-term CMV prophylaxis is poorly tolerated and the most common strategy to decrease the incidence of CMV disease is preemptive. New, less toxic, molecules are currently being assessed for CMV prophylaxis which should replace or considerably decrease the preemptive approach...
December 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29207608/gsta1-diplotypes-affect-busulfan-clearance-and-toxicity-in-children-undergoing-allogeneic-hematopoietic-stem-cell-transplantation-a-multicenter-study
#10
Marc Ansari, Patricia Huezo-Diaz Curtis, Chakradhara Rao S Uppugunduri, Mohammed Aziz Rezgui, Tiago Nava, Vid Mlakar, Laurence Lesne, Yves Théoret, Yves Chalandon, Lee L Dupuis, Tao Schechter, Imke H Bartelink, Jaap J Boelens, Robbert Bredius, Jean-Hugues Dalle, Saba Azarnoush, Petr Sedlacek, Victor Lewis, Martin Champagne, Christina Peters, Henrique Bittencourt, Maja Krajinovic
Busulfan (BU) dose adjustment following therapeutic drug monitoring contributes to better outcome of hematopoietic stem cell transplantation (HSCT). Further improvement could be achieved through genotype-guided BU dose adjustments. To investigate this aspect, polymorphism within glutathione S transferase genes were assessed. Particularly, promoter haplotypes of the glutathione S transferase A1 (GSTA1) were evaluated in vitro, with reporter gene assays and clinically, in a pediatric multi-center study (N =138) through association with BU pharmacokinetics (PK) and clinical outcomes...
October 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/29207601/dissecting-the-mechanisms-involved-in-anti-human-t-lymphocyte-immunoglobulin-atg-induced-tolerance-in-the-setting-of-allogeneic-stem-cell-transplantation-potential-implications-for-graft-versus-host-disease
#11
Katia Beider, David Naor, Valeria Voevoda, Olga Ostrovsky, Hanna Bitner, Evgenia Rosenberg, Nira Varda-Bloom, Victoria Marcu-Malina, Jonathan Canaani, Ivetta Danilesko, Avichai Shimoni, Arnon Nagler
Polyclonal anti-human thymocyte globulins (ATG) have been recently shown to significantly reduce the incidence of graft versus host disease (GVHD) post allogeneic stem cell transplantation (HSCT) from both sibling and unrelated donors. Induction of regulatory T cells has been suggested as one of the possible mechanisms. The aim of current study was to further characterize the T cell populations induced by ATG treatment and to delineate the mechanisms involved in ATG-induced tolerance. Phenotypic characterization revealed a significant increase in the expression of FoxP3, GITR, CD95, PD-1 and ICOS as well as the complement inhibitory molecules CD55, CD58 and CD59 on CD4+CD25+ T cells upon ATG treatment...
October 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/29205259/cd34-selected-stem-cell-boosts-can-improve-poor-graft-function-after-paediatric-allogeneic-stem-cell-transplantation
#12
Chiara Mainardi, Martin Ebinger, Sigrid Enkel, Tobias Feuchtinger, Heiko-Manuel Teltschik, Matthias Eyrich, Michael Schumm, Armin Rabsteyn, Patrick Schlegel, Christian Seitz, Carl-Phillip Schwarze, Ingo Müller, Johann Greil, Peter Bader, Paul-Gerhardt Schlegel, David Martin, Ursula Holzer, Michaela Döring, Rupert Handgretinger, Peter Lang
Poor graft function (PGF) is a severe complication of haematopoietic stem cell transplantation (HSCT) and administration of donor stem cell boosts (SCBs) represents a therapeutic option. We report 50 paediatric patients with PGF who received 61 boosts with CD34+ selected peripheral blood stem cells (PBSC) after transplantation from matched unrelated (n = 25) or mismatched related (n = 25) donors. Within 8 weeks, a significant increase in median neutrophil counts (0·6 vs. 1·516 × 109 /l, P < 0·05) and a decrease in red blood cell and platelet transfusion requirement (median frequencies 1 and 7 vs...
December 3, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/29204910/who-is-the-patient-at-risk-of-cmv-recurrence-a-review-of-the-current-scientific-evidence-with-a-focus-on-hematopoietic-cell-transplantation
#13
REVIEW
Jan Styczynski
Cytomegalovirus (CMV) is an agent of global infection, and its acquisition in a population is characterized by an age-dependent rise in seropositivity. After primary infection, CMV remains in the host cells in latent form, and it can reactivate in the case of immune suppression. The risk of CMV recurrence is dependent on the level of incompetency of the immune system, manifested as an impairment of T-cell immunity, including the presence and function of CMV-specific cytotoxic T lymphocytes. This article presents data on the incidence of CMV recurrence in groups of immunocompromised patients, including allogeneic hematopoietic stem cell transplantation (HSCT) patients and other groups of patients, based on a summary of reported data...
December 4, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29197961/burden-of-oral-mucositis-in-stem-cell-transplant-patients-the-patients-perspective
#14
Tim Staudenmaier, Irena Cenzer, Alexander Crispin, Helmut Ostermann, Karin Berger
PURPOSE: Purpose of this study was to determine the impact of Oral Mucositis (OM) on health-related quality of life (HRQoL) and quality of life associated symptoms and functions in patients undergoing hematopoietic stem cell transplantation (HSCT). METHODS: Prospective, non-interventional single-center observational study at a German tertiary teaching hospital. Inpatient allogenic and autologous stem cell transplant patients ≥18-year-old with high-dose chemotherapy...
December 2, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29196081/prognostic-impact-of-donor-source-on-allogeneic-hematopoietic-stem-cell-transplantation-outcomes-in-adults-with-chronic-myelomonocytic-leukemia-a-nationwide-retrospective-analysis-in-japan
#15
Hidehiro Itonaga, Kazunari Aoki, Jun Aoki, Takayuki Ishikawa, Ken Ishiyama, Naoyuki Uchida, Toru Sakura, Kazuteru Ohashi, Mineo Kurokawa, Yukiyasu Ozawa, Ken-Ichi Matsuoka, Yukinori Nakamura, Fumihiko Kimura, Koji Iwato, Yuichiro Nawa, Makoto Hirokawa, Koji Kato, Tatsuo Ichinohe, Yoshiko Atsuta, Yasushi Miyazaki
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapeutic option for chronic myelomonocytic leukemia (CMML). We retrospectively compared the post-transplant outcomes of 159 CMML patients who received allo-HSCT using 4 types of donor sources: human leukocyte antigen (HLA)-matched related donor grafts, unrelated bone marrow, unrelated cord blood, and HLA-mismatched related donor grafts. The median patient age at allo-HSCT was 54 years (range, 16 -75 years). In multivariate analyses, the use of HLA-matched related donor grafts correlated with better OS than unrelated bone marrow (hazard ratio [HR], 2...
November 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29196075/outcomes-after-allogeneic-transplant-in-patients-with-wiskott-aldrich-syndrome
#16
Alexander Ngwube, I Celine Hanson, Jordan Orange, Nicholas L Rider, Filiz Seeborg, William Shearer, Lenora Noroski, Sarah Nicholas, Lisa Forbes, Kathryn Leung, Ghadir Sasa, Swati Naik, Meenakshi Hegde, Bilal Omer, Nabil Ahmed, Carl Allen, Stephen Gottschalk, Meng-Fen Wu, Hao Liu, Malcolm Brenner, Helen Heslop, Robert Krance, Caridad Martinez
Wiskott-Aldrich syndrome (WAS) is a rare X-linked disorder characterized by a triad of immunodeficiency, eczema and thrombocytopenia. Currently, hematopoietic stem cell transplant (HSCT) is the most reliable curative treatment with excellent results for patients with HLA-matched family or unrelated donors. However, even after fully myeloablative preparative regimens, mixed donor chimerism is a potential concern. We performed a retrospective chart review of twelve children who underwent allogeneic hematopoietic stem cell transplant for WAS to report our experience...
November 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29193007/outcome-of-relapse-after-allogeneic-hsct-in-children-with-all-enrolled-in-the-all-sct-2003-2007-trial
#17
Michaela Kuhlen, Andre M Willasch, Jean-Hugues Dalle, Jacek Wachowiak, Isaac Yaniv, Marianne Ifversen, Petr Sedlacek, Tayfun Guengoer, Peter Lang, Peter Bader, Sabina Sufliarska, Adriana Balduzzi, Brigitte Strahm, Irene von Luettichau, Jessica I Hoell, Arndt Borkhardt, Thomas Klingebiel, Martin Schrappe, Arend von Stackelberg, Evgenia Glogova, Ulrike Poetschger, Roland Meisel, Christina Peters
Relapse remains the major cause of treatment failure in children with high-risk acute lymphoblastic leukaemia (ALL) undergoing allogeneic haematopoietic stem-cell transplantation (allo-SCT). Prognosis is considered dismal but data on risk factors and outcome are lacking from prospective studies. We analysed 242 children with recurrence of ALL after first allo-SCT enrolled in the Berlin-Frankfurt-Munster (BFM) ALL-SCT-BFM 2003 and ALL-SCT-BFM international 2007 studies. Median time from allo-SCT to relapse was 7·7 months; median follow-up from relapse after allo-SCT until last follow-up was 3·4 years...
November 28, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/29191665/augmenting-total-body-irradiation-with-a-cranial-boost-before-stem-cell-transplantation-protects-against-post-transplant-cns-relapse-in-acute-lymphoblastic-leukemia
#18
Robert W Gao, Kathryn E Dusenbery, Qing Cao, Angela R Smith, Jianling Yuan
PURPOSE: The purpose of this study was to determine the effect of a pre-transplant cranial boost (CB) on post-transplant central nervous system (CNS) relapse and survival in acute lymphoblastic leukemia (ALL) patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) using a total body irradiation (TBI)-containing preparation regimen. METHODS AND MATERIALS: Two hundred thirteen ALL patients were treated consecutively at our institution with allogeneic HSCT...
November 27, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29190347/ecil-guidelines-for-the-prevention-diagnosis-and-treatment-of-bk-polyomavirus-associated-haemorrhagic-cystitis-in-haematopoietic-stem-cell-transplant-recipients
#19
Simone Cesaro, Tina Dalianis, Christine Hanssen Rinaldo, Minna Koskenvuo, Anna Pegoraro, Hermann Einsele, Catherine Cordonnier, Hans H Hirsch
Objectives: To define guidelines for BK polyomavirus (BKPyV)-associated haemorrhagic cystitis (BKPyV-HC) after paediatric and adult HSCT. Methods: Review of English literature and evidence-based recommendations by expert consensus. Results: BKPyV-HC occurs in 8%-25% of paediatric and 7%-54% of adult recipients undergoing allogeneic HSCT. Diagnosis requires the triad of cystitis, macro-haematuria and high urine BKPyV loads >7 log 10 copies/mL, and exclusion of other relevant aetiologies...
September 8, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29189513/successful-nonmyeloablative-allogeneic-stem-cell-transplant-in-a-child-with-emberger-syndrome-and-gata2-mutation
#20
Neha Rastogi, Roshini S Abraham, Ritu Chadha, Dhwanee Thakkar, Shruti Kohli, Sagar Nivargi, Satya Prakash Yadav
Emberger syndrome with underlying guanine-adenine-thymine-adenine 2 (GATA2) mutation is a rare disorder and very few successful nonmyeloablative allogeneic hematopoietic stem cell transplants (HSCTs) have been reported. We report a case of Emberger syndrome with GATA2 mutation in a 9-year-old girl who presented with congenital sensorineural deafness, warts, lymphedema, and Myelodysplastic syndrome. Her sister had died of a similar illness. She underwent a nonmyeloablative matched related donor peripheral blood HSCT with rabbit antithymoglobulin (5 mg/kg), fludarabine (160 mg/m), cyclophophamide (29 mg/kg), and total body irradiation (2 Gray)...
November 17, 2017: Journal of Pediatric Hematology/oncology
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