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elderly transplant

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https://www.readbyqxmd.com/read/29333406/stat3-expression-is-associated-with-poor-survival-in-non-elderly-adult-patients-with-newly-diagnosed-multiple-myeloma
#1
Sung-Hoon Jung, Seo-Yeon Ahn, Hyun-Woo Choi, Myung-Geun Shin, Seung-Shin Lee, Deok-Hwan Yang, Jae-Sook Ahn, Yeo-Kyeoung Kim, Hyeoung-Joon Kim, Je-Jung Lee
Background: Signal transducer and activator of transcription 3 (STAT3) is not only a key signaling molecule in the regulation of growth but is also involved in malignant transformation. We investigated the prognostic significance of STAT3 expression in 94 non-elderly adult patients (aged 38 to 65 yr) with newly diagnosed multiple myeloma (MM). Methods: Tumor cell-specific phosphotyrosine-STAT3 (PY-STAT3) expression at the time of diagnosis was evaluated with dual immunohistochemical (IHC) staining for PY-STAT3 and CD138...
December 2017: Blood Research
https://www.readbyqxmd.com/read/29324518/the-dawn-of-liver-perfusion-machines
#2
Danielle Detelich, James F Markmann
PURPOSE OF REVIEW: Despite high demand, a severe shortage of suitable allografts limits the use of liver transplantation for the treatment of end-stage liver disease. The transplant community is turning to the utilization of high-risk grafts to fill the void. This review summarizes the reemergence of ex-vivo machine perfusion for liver graft preservation, including results of recent clinical trials and its specific role for reconditioning DCD, steatotic and elderly grafts. RECENT FINDINGS: Several phase-1 clinical trials demonstrate the safety and feasibility of machine perfusion for liver graft preservation...
January 9, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29316901/dialysis-facility-staff-perceptions-of-racial-gender-and-age-disparities-in-access-to-renal-transplantation
#3
Kristie J Lipford, Laura McPherson, Reem Hamoda, Teri Browne, Jennifer C Gander, Stephen O Pastan, Rachel E Patzer
BACKGROUND: Racial/ethnic, gender, and age disparities in access to renal transplantation among end-stage renal disease (ESRD) patients have been well documented, but few studies have explored health care staff attitudes towards these inequalities. Staff perceptions can influence patient care and outcomes, and identifying staff perceptions on disparities could aid in the development of potential interventions to address these health inequities. The objective of this study was to investigate dialysis staff (n = 509), primarily social workers and nurse managers, perceptions of renal transplant disparities in the Southeastern United States...
January 10, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29312861/elderly-donor-graft-for-liver-transplantation-never-too-late
#4
REVIEW
Harleen Chela, Mohamad H Yousef, Abdelmajeed A Albarrak, Bhupinder S Romana, Dania N Hudhud, Veysel Tahan
The definitive treatment for end stage liver disease remains a liver transplant and hence livers are needed for these patients along with cases of acute fulminant liver failure. Hence livers are a scarce and highly valuable commodity in the current time. By extending the pool of donors to include the elderly livers, it allows for increased availability of donors and reduces the mortality that is associated with the waiting list itself. There is an increasing prevalence of end stage liver disease due to conditions like chronic hepatitis B and C, non-alcoholic steatohepatitis, alcoholic liver disease...
December 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/29296777/hla-mismatched-unrelated-donor-transplantation-using-tli-atg-conditioning-has-a-low-risk-of-gvhd-and-potent-antitumor-activity
#5
Michael A Spinner, Marcelo Fernández-Viña, Lisa E Creary, Olivia Quinn, Linda Elder, Sally Arai, Laura J Johnston, Everett H Meyer, David B Miklos, Lori S Muffly, Robert S Negrin, Judith A Shizuru, Wen-Kai Weng, Ginna G Laport, Samuel Strober, Robert Lowsky, Andrew R Rezvani
Many patients lack a fully HLA-matched donor for hematopoietic cell transplantation (HCT), and HLA mismatch is typically associated with inferior outcomes. Total lymphoid irradiation and antithymocyte globulin (TLI-ATG) is a nonmyeloablative conditioning regimen that is protective against graft-versus-host disease (GVHD), and we hypothesized that the protective effect would extend beyond HLA-matched donors. We report outcomes for all consecutively transplanted patients at Stanford University from December 2001 through May 2015 who received TLI-ATG conditioning and HCTs from 8 to 9 out of 10 HLA-mismatched unrelated donors (MMUDs, N = 72) compared with 10 out of 10 HLA-matched unrelated donors (MUDs, N = 193)...
July 25, 2017: Blood Advances
https://www.readbyqxmd.com/read/29284757/autologous-stem-cell-transplantation-in-elderly-lymphoma-patients-in-their-70s-outcomes-and-analysis
#6
Lova Sun, Shuli Li, Areej El-Jawahri, Philippe Armand, Bimalangshu R Dey, David C Fisher, Eric D Jacobsen, Caron A Jacobson, Ann S LaCasce, Steven L McAfee, Thomas R Spitzer, Yi-Bin Chen, Zachariah DeFilipp
BACKGROUND: High-dose chemotherapy and autologous stem cell transplantation (ASCT) can offer durable remission in many patients with relapsed or high-risk lymphoma. However, elderly patients are often not considered ASCT candidates based on age alone. SUBJECTS, MATERIALS, AND METHODS: A retrospective analysis of patients ≥70 years of age with a diagnosis of Hodgkin or non-Hodgkin lymphoma receiving ASCT between 2000 and 2016 at two partner institutions was performed...
December 28, 2017: Oncologist
https://www.readbyqxmd.com/read/29282632/effects-of-cilostazol-and-renin-angiotensin-system-ras-blockers-on-the-renal-disease-progression-of-korean-patients-a-retrospective-cohort-study
#7
Yoojin Noh, Jimin Lee, Sooyoung Shin, Inwhee Park, Soo Kyung Bae, Euichul Oh, Sukhyang Lee
Background Decline in estimated glomerular filtration rate (eGFR) is an important surrogate marker for the assessment of renal function. Addition of a second agent to angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) treatment may improve current therapeutic strategies aimed at suppressing renal disease progression. Objective To determine the effect of cilostazol in combination with ACEI or ARB treatment on the decline in eGFR. Setting A tertiary hospital in Korea. Method In an observational cohort study, we analyzed 5505 patients who were prescribed ACEI or ARB and cilostazol or other antiplatelet agents...
December 27, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29260588/upfront-treatment-of-elderly-myeloma-patients-an-overview-and-update
#8
Hussein G Elsayed, Amal S Alabdulwahab
Multiple myeloma is primarily a disease of older age, with a median age of 70 years at diagnosis. Management of the disease in this diverse population is challenging, in the face comorbidities and frailties. Areas covered: This review discusses the management challenges of elderly myeloma patients in view of the current evidence and propose for performing a formal objective assessment of the functional status to guide choice of treatment. Expert commentary: The approval of many antimyeloma medications with various mechanisms of action in the past two decades had sparked the debate about choosing the best combination, duration of therapy, role of transplant and the possibility to cure myeloma after being changed to a chronic disease...
December 20, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/29249818/persistence-of-pre-leukemic-clones-during-first-remission-and-risk-of-relapse-in-acute-myeloid-leukemia
#9
M Rothenberg-Thurley, S Amler, D Goerlich, T Köhnke, N P Konstandin, S Schneider, M C Sauerland, T Herold, M Hubmann, B Ksienzyk, E Zellmeier, S K Bohlander, M Subklewe, A Faldum, W Hiddemann, J Braess, K Spiekermann, K H Metzeler
Some patients with acute myeloid leukemia (AML) who are in complete remission after induction chemotherapy harbor persisting pre-leukemic clones, carrying a subset of leukemia-associated somatic mutations. There is conflicting evidence on the prognostic relevance of these clones for AML relapse. Here, we characterized paired pre-treatment and remission samples from 126 AML patients for mutations in 68 leukemia-associated genes. Fifty patients (40%) retained ⩾1 mutation during remission at a variant allele frequency of ⩾2%...
December 18, 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/29242299/allogeneic-stem-cell-transplantation-benefits-for-patients-%C3%A2-60-years-with-acute-myeloid-leukemia-and-flt3-itd-a-study-from-the-acute-leukemia-working-party-alwp-of-the-european-society-of-blood-and-marrow-transplantation-ebmt
#10
Xavier Poiré, Myriam Labopin, Emmanuelle Polge, Jakob Passweg, Charles Craddock, Didier Blaise, Jan J Cornelissen, Liisa Volin, Nigel H Russell, Gérard Socié, Mauricette Michallet, Nathalie Fegueux, Patrice Chevallier, Arne Brecht, Mathilde Hunault-Berger, Mohamad Mohty, Jordi Esteve, Arnon Nagler
Intermediate-risk cytogenetic acute myeloid leukemia with an internal tandem duplication of FLT3 (FLT3-ITD) is associated with a high risk of relapse and is now a standard indication for allogeneic stem cell transplantation. Nevertheless, most studies supporting this strategy have been performed in young patients. To address the benefit of allogeneic transplantation in elderly patients, we selected from the EBMT registry de novo intermediate-risk cytogenetic acute myeloid leukemia harboring FLT3-ITD in patients with an age equal or over the age of 60 years and transplanted from a related or unrelated donor between January 2000 and December 2015...
December 14, 2017: Haematologica
https://www.readbyqxmd.com/read/29235399/reviewing-the-use-of-ventricular-assist-devices-in-the-elderly-where-do-we-stand-today
#11
Nandini Nair, Enrique Gongora
Implantation of left ventricular assist devices (LVADS) in older patients appears to be an attractive option in the wake of donor shortage and increasing incidence and prevalence of end stage heart failure. Since the inception of the artificial heart program half a century ago tremendous progress in research and development has led to utilization of more sophisticated devices. VADs have therefore emerged as a successful therapy for extending life with meaningful quality. Areas covered: This review will address the use of LVADS as a bridge to transplantation, destination therapy and comparison of LVAD therapy with alternate list heart transplantation in the elderly population...
December 13, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29226766/a-case-report-of-living-donor-liver-transplantation-for-fulminant-hepatitis-related-to-hepatitis-e-virus-infection
#12
Keita Shimata, Yasuhiko Sugawara, Hidekazu Yamamoto, Hiroaki Okamoto, Koushi Uchida, Seiichi Kawabata, Kaori Isono, Shintaro Hayashida, Yukihiro Inomata
Hepatitis E virus (HEV) infection which may become fulminant, especially in elderly people is more common than previously recognized in develop countries. Here we report successful living-donor liver transplantation (LDLT) in a case of acute liver failure due to HEV. A 63-year-old Japanese man with no previous history of liver disease was admitted for severe acute hepatitis. Detection of anti-HEV immunoglobulin A established a diagnosis of this virus-related liver failure. The patient suffered from hepatic encephalopathy 10 days after symptom onset and underwent LDLT...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29223104/improvement-of-relative-survival-in-elderly-patients-with-acute-myeloid-leukaemia-emerging-from-population-based-cancer-registries-in-switzerland-between-2001-and-2013
#13
Annatina Schnegg-Kaufmann, Anita Feller, Helen Baldomero, Alicia Rovo, Markus G Manz, Michael Gregor, Anna Efthymiou, Mario Bargetzi, Urs Hess, Olivier Spertini, Yves Chalandon, Jakob R Passweg, Georg Stussi, Volker Arndt, Nicolas Bonadies
Acute Myeloid Leukaemia (AML) is a rare and heterogeneous haematological malignancy with increasing incidence in the elderly. We performed a population-based, observational analysis of AML cases reported to the Cantonal Cancer Registries in Switzerland. Data was aggregated by the National Institute for Epidemiology and Cancer Registration and stratified for the two time periods 2001-2007 and 2008-2013. Overall, 2351 new AML cases were registered with a stable age-standardised incidence rate (3.0 [95 CI: 2.8-3...
December 6, 2017: Cancer Epidemiology
https://www.readbyqxmd.com/read/29222298/management-of-multiple-myeloma-in-the-newly-diagnosed-patient
#14
REVIEW
María-Victoria Mateos, Jesús F San Miguel
Multiple myeloma is the second most frequent hematological disease. The introduction of melphalan as high-dose therapy followed by autologous hematopoietic cell transplantation (HDT/ASCT) for young patients and the availability of novel agents for young and elderly patients with multiple myeloma have dramatically changed the perspective of treatment. However, further research is necessary if we want definitively to cure the disease. Treatment goals for transplant-eligible and non-transplant-eligible patients should be to prolong survival by achieving the best possible response while ensuring quality of life...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222258/fixed-duration-vs-continuous-therapy-in-multiple-myeloma
#15
REVIEW
Heinz Ludwig, Niklas Zojer
The introduction of new drugs with less severe toxicity profiles than those of conventional antimyeloma agents allowed the evaluation of continuous therapy compared with fixed duration therapy. In transplant-eligible patients, consolidation therapy with bortezomib or bortezomib-based regimens showed significant progression-free survival (PFS) benefit in cytogenetic standard-risk patients and to a lesser extent, high-risk patients. Continuous therapy with lenalidomide maintenance treatment after autologous stem cell transplantation resulted in a significant survival gain...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221319/lung-transplantation-in-elderly-patients
#16
REVIEW
Andrew Courtwright, Edward Cantu
Consensus statements on the selection of lung transplant candidates have consistently identified older age as a relative contraindication to transplantation. A combination of population-level demographic changes, revision of the lung allocation score (LAS), and clearer data on outcomes in elderly transplant recipients has, however, driven a steady increase in the threshold at which age is taken into consideration. This article reviews the current state of lung transplantation in elderly patients with an emphasis on the factors that have increased lung transplantation in older age groups, their expected outcomes including survival and health-related quality of life, and the factors that go in to appropriate candidate and procedure selection in this population...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29212466/exploring-the-use-of-tablet-computer-based-electronic-data-capture-system-to-assess-patient-reported-measures-among-patients-with-chronic-kidney-disease-a-pilot-study
#17
Dorothy Wong, Shen Cao, Heather Ford, Candice Richardson, Dmitri Belenko, Evan Tang, Luca Ugenti, Eleanor Warsmann, Amanda Sissons, Yalinie Kulandaivelu, Nathaniel Edwards, Marta Novak, Madeline Li, Istvan Mucsi
BACKGROUND: Collecting patient reported outcome measures (PROMs) via computer-based electronic data capture system may improve feasibility and facilitate implementation in clinical care. We report our initial experience about the acceptability of touch-screen tablet computer-based, self-administered questionnaires among patients with chronic kidney disease (CKD), including stage 5 CKD treated with renal replacement therapies (RRT) (either dialysis or transplant). METHODS: We enrolled a convenience sample of patients with stage 4 and 5 CKD (including patients on dialysis or after kidney transplant) in a single-centre, cross-sectional pilot study...
December 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29208453/comparison-of-survival-between-hemodialysis-and-peritoneal-dialysis-patients-with-end-stage-renal-disease-in-the-era-of-icodextrin-treatment
#18
I-Kuan Wang, Cheng-Li Lin, Tzung-Hai Yen, Shih-Yi Lin, Fung-Chang Sung
BACKGROUND: Icodextrin could reduce the risk of technique failure and improve patient survival in peritoneal dialysis (PD) patients. This study compared the survival between incident hemodialysis (HD) and PD patients, with and without diabetes, in the era of icodextrin treatment. METHODS: From the Taiwan health insurance database, 53,103 incident end-stage renal disease patients undergoing dialysis were identified from 2005 to 2010. The mortality risks among HD and PD patients with or without icodextrin treatment were compared...
December 3, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29207679/italian-real-life-experience-with-brentuximab-vedotin-results-of-a-large-observational-study-on-234-relapsed-refractory-hodgkin-s-lymphoma
#19
Cinzia Pellegrini, Alessandro Broccoli, Alessandro Pulsoni, Luigi Rigacci, Caterina Patti, Guido Gini, Donato Mannina, Monica Tani, Chiara Rusconi, Alessandra Romano, Anna Vanazzi, Barbara Botto, Armando Santoro, Stefan Hoaus, Gian Matteo Rigolin, Pellegrino Musto, Patrizio Mazza, Stefano Molica, Paolo Corradini, Angelo Fama, Francesco Gaudio, Michele Merli, Fioravante Ronconi, Giuseppe Gritti, Daniele Vallisa, Patrizia Tosi, Anna Marina Liberati, Antonello Pinto, Vincenzo Pavone, Filippo Gherlinzoni, Maria Paola Bianchi, Stefano Volpetti, Livio Trentin, Maria Cecilia Goldaniga, Maurizio Bonfichi, Amalia De Renzo, Corrado Schiavotto, Michele Spina, Angelo Michele Carella, Vittorio Stefoni, Lisa Argnani, Pier Luigi Zinzani
A large Italian multicenter observational retrospective study was conducted on the use of brentuximab vedotin (BV) for patients with relapsed Hodgkin's lymphoma (HL) to check if clinical trial results are confirmed even in a real life context. 234 CD30+ HL patients were enrolled. Best response was observed after a median of 4 cycles in 140 patients (59.8%): 74 (31.6%) patients obtained a complete response (CR) and 66 (28.2%) achieved a partial response (PR); overall response rate at the end of the treatment was 48...
October 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/29200113/primary-central-nervous-system-lymphoma
#20
Catherine H Han, Tracy T Batchelor
PURPOSE OF REVIEW: Primary central nervous system (CNS) lymphoma is a rare and aggressive extranodal non-Hodgkin lymphoma confined to the brain, eyes, spinal cord, or leptomeninges without systemic involvement. This article provides an overview of the clinical features, diagnosis, and management of primary CNS lymphoma in patients who are immunocompetent, focusing on recent advances in treatment. RECENT FINDINGS: Primary CNS lymphoma is sensitive to radiation therapy; however, whole-brain radiation therapy inadequately controls the disease when used alone and causes delayed neurotoxicity with significant neurocognitive impairment, especially in patients who are elderly...
December 2017: Continuum: Lifelong Learning in Neurology
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