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Acute GVHD

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https://www.readbyqxmd.com/read/28632323/clinical-outcomes-of-hla-dpb1-mismatches-in-10-10-hla-matched-unrelated-donor-recipient-pairs-undergoing-allogeneic-stem-cell-transplant
#1
Ann M Moyer, Shahrukh K Hashmi, Cynthia M Kroning, Walter K Kremers, Steven R De Goey, Mrinal Patnaik, Mark Litzow, Dennis A Gastineau, William J Hogan, Eapen K Jacob, Justin D Kreuter, Laurie L Wakefield, Manish J Gandhi
OBJECTIVE: HLA-DPB1 matching may impact allogeneic hematopoietic stem cell transplantation (ASCT) outcomes; however, this locus is not in linkage disequilibrium with the remainder of the HLA genes. After classifying HLA-DPB1 mismatches based on T-cell epitope, avoiding non-permissive mismatches may impact survival. We tested this hypothesis at a single academic institution. METHODS: Retrospective HLA-DPB1 genotyping was performed on 153 adult patients who underwent ASCT and unrelated donors matched for HLA-A, B, C, DRB1 and DQB1 loci (10/10)...
June 20, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28628276/acute-myeloid-leukaemia-relapsing-after-allogeneic-haematopoietic-stem-cell-transplantation-prognostic-factors-and-impact-of-initial-therapy-of-relapse
#2
Andrew B M Lim, Cameron Curley, Chun Yew Fong, Ian Bilmon, Ashanka Beligaswatte, Duncan Purtill, Bartlomiej Getta, Anne Maree Johnston, Tasman Armytage, Marnie Collins, Kate Mason, Katherine Fielding, Matthew Greenwood, John Gibson, Mark Hertzberg, Matthew Wright, Ian Lewis, John Moore, David Curtis, Jeff Szer, Glen Kennedy, David Ritchie
AIMS: We sought to determine factors associated with overall survival from relapse (OSR) of acute myeloid leukaemia (AML) after allogeneic haematopoietic stem cell transplantation (alloHSCT), and the effect of first salvage therapy and subsequent GVHD on OSR. METHODS: Data on 386 patients from nine Australian centres with relapsed AML post-alloHSCT were collected retrospectively. OSR was calculated using the Kaplan-Meier method. Univariate and multivariate analyses were conducted using the logrank test and proportional hazards modelling respectively, and a prognostic index for OSR was derived from multivariate modelling...
June 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28628089/elevated-bone-marrow-eosinophil-count-is-associated-with-high-incidence-of-severe-acute-gvhd-after-allogeneic-hematopoietic-stem-cell-transplantation
#3
Y Shimomura, M Hara, H Hashimoto, T Ishikawa
Predicting severe acute GvHD (aGvHD) after allogeneic hematopoietic stem cell transplantation (HSCT) is challenging but critical. Mild aGvHD may have a favorable impact on relapse, whereas severe aGvHD is associated with poor outcomes. The aim of this study was to evaluate whether elevated eosinophil count in the bone marrow (BM) at 1 month after HSCT is associated with a high incidence of new and severe aGvHD. We enrolled 101 consecutive patients; median age was 50 years, and 50.5% patients were male. The median eosinophil concentration in BM at 1 month after HSCT was 1...
June 19, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28627158/evaluation-of-serum-interleukin-21-and-hla-c1-polymorphism-in-pediatrician-hematopoietic-stem-cell-transplantation-for-early-diagnosis-of-acute-graft-versus-host-disease
#4
N Sehati, P Kokhaei, A Motevalizade Ardekani, R Tootoonchian, F Pak
Background: Allogenic hematopoietic stem cell transplantation (HSCT) is a strategy used for treatment of different malignant diseases. However, success of allo-HSCT can be hampered by graft-versus-host-disease (GVHD). Natural killer (NK) cells may play an important role in activating antigen presenting cells and subsequent activation of T cells. The main purpose of this study was the evaluation of IL-21, as a blood biomarker, for early detection of acute GVHD (aGVHD) in children after HSCT and also the study of human leukocytes antigen (HLA)-C1 polymorphism, as a targeting ligand for NK cells in these patients...
June 19, 2017: Iranian Biomedical Journal
https://www.readbyqxmd.com/read/28623394/disease-specific-hematopoietic-stem-cell-transplantation-in-children-with-inherited-bone-marrow-failure-syndromes
#5
Qian Li, Changying Luo, Chengjuan Luo, Jianmin Wang, Benshang Li, Lixia Ding, Jing Chen
Hematopoietic stem cell transplantation (HSCT) using an optimized conditioning regimen is essential for the long-term survival of patients with inherited bone marrow failure syndromes (IBMFS). We report HSCT in 24 children with Fanconi anemia (FA, n = 12), Diamond-Blackfan anemia (DBA, n = 7), and dyskeratosis congenita (DC, n = 5) from a single HSCT center. The graft source was peripheral blood stem cells (n = 19) or cord blood stem cells (n = 5). FA and DC patients received reduced-intensity conditioning, while DBA patients had myeloablative conditioning...
June 16, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28614903/thiotepa-based-conditioning-versus-total-body-irradiation-as-myeloablative-conditioning-prior-to-allogeneic-stem-cell-transplantation-for-acute-lymphoblastic-leukemia-a-matched-pair-analysis-from-the-acute-leukemia-working-party-of-the-european-society-for
#6
Sandra Eder, Jonathan Canaani, Eric Beohou, Myriam Labopin, Miguel A Sanz, William Arcese, Reuven Or, Juergen Finke, Agostino Cortelezzi, Dietrich Beelen, Jakob Passweg, Gerard Socié, Gunhan Gurman, Mahmoud Aljurf, Matthias Stelljes, Sebastian Giebel, Mohamad Mohty, Arnon Nagler
The optimal conditioning regimen to employ before hematopoieitic stem cell transplantation in acute lymphoblastic leukemia (ALL) is still undecided, and while Cy/TBI is the most commonly used myeloablative regimen, there are concerns regarding long term toxicity for patients conditioned with this regimen. Thiotepa based conditioning is an emerging radiation free regimen with recent publications indicative of comparable clinical outcomes to TBI based conditioning. In this analysis of the acute leukemia working party of the EBMT, we performed a retrospective matched-pair analysis, evaluating the outcome of adult patients with ALL who received thiotepa-based conditioning (n=180) with those receiving Cy/TBI conditioning (n=540)...
June 14, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28606176/rituximab-containing-reduced-intensity-conditioning-improves-progression-free-survival-following-allogeneic-transplantation-in-b-cell-non-hodgkin-lymphoma
#7
Narendranath Epperla, Kwang Woo Ahn, Sairah Ahmed, Madan Jagasia, Alyssa DiGilio, Steven M Devine, Samantha Jaglowski, Vanessa Kennedy, Andrew R Rezvani, Sonali M Smith, Anna Sureda, Timothy S Fenske, Mohamed A Kharfan-Dabaja, Phillipe Armand, Mehdi Hamadani
BACKGROUND: In B cell non-Hodgkin lymphoma (B-NHL), rituximab-containing reduced-intensity conditioning regimens (R-RIC) have been shown to provide favorable outcomes in single-arm studies; however, large multicenter studies comparing R-RIC and non-rituximab-containing reduced-intensity conditioning regimens (nonR-RIC) have not been performed. Using the CIBMTR database, we report the outcomes of R-RIC versus nonR-RIC regimens in B-NHL. METHODS: We evaluated 1401 adult B-NHL patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) who received nonR-RIC (n = 1022) or R-RIC (n = 379) regimens...
June 12, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28604665/gvhd-prophylaxis-after-single-unit-reduced-intensity-conditioning-cord-blood-transplantation-in-adults-with-acute-leukemia
#8
S Terakura, Y Kuwatsuka, S Yamasaki, A Wake, J Kanda, Y Inamoto, S Mizuta, T Yamaguchi, N Uchida, Y Kouzai, N Aotsuka, H Ogawa, H Kanamori, K Nishiwaki, S Miyakoshi, M Onizuka, I Amano, T Fukuda, T Ichinohe, Y Atsuta, M Murata, T Teshima
To investigate better GVHD prophylaxis in reduced intensity conditioning umbilical cord blood transplantation (RIC-UCBT), we compared transplant outcomes after UCBT among GvHD prophylaxes using the registry data. We selected patients transplanted for AML or ALL with a calcineurin inhibitor and methotrexate (MTX)/mycophenolate mofetil (MMF) combination. A total of 748 first RIC-UCBT between 2000 and 2012 (MTX+ group, 446, MMF+ group, 302) were included. The cumulative incidence of neutrophil and platelet counts higher than 50 000/μL was significantly better in the MMF+ group (relative risk (RR), 1...
June 12, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28603069/the-case-for-high-resolution-extended-6-loci-hla-typing-for-identifying-related-donors-in-the-indian-subcontinent
#9
Rajat Kumar Agarwal, Ankita Kumari, Amit Sedai, Lalith Parmar, Rakesh Dhanya, Lawrence Faulkner
Three-loci low- or intermediate-resolution HLA typing is generally considered adequate in the related blood and marrow transplantation (BMT) context. However, a single high-resolution (HR) mismatch may have a similar adverse impact on BMT outcome as a low resolution (LR) one. We sought to determine the frequency of mismatches which may go undetected when standard typing (LR or HR/3-loci) is employed as against HR/6-loci typing for related donors compatibility testing and assess its impact on relevant BMT outcomes...
June 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28602890/posterior-reversible-encephalopathy-syndrome-after-hematopoietic-cell-transplantation-in-children-with-hemoglobinopathies
#10
Javid Gaziev, Simone Marziali, Katia Paciaroni, Antonella Isgrò, Francesca Di Giuliano, Giorgia Rossi, Marco Marziali, Gioia De Angelis, Cecilia Alfieri, Michela Ribersani, Marco Andreani, Maria Giuseppina Palmieri, Fabio Placidi, Andrea Romigi, Francesca Izzi, Roberto Floris, Nicola Biagio Mercuri
Posterior reversible encephalopathy syndrome (PRES) is a serious adverse event associated with calcineurin inhibitors (CI) used for graft-versus-host disease (GVHD) prophylaxis. We compared the incidence of PRES in children with thalassemia (n=222, 1.4-17.8 years old) versus sickle cell disease (SCD; n=59, 2-17 years old) who underwent hematopoietic cell transplantation (HCT) from HLA-matched siblings or alternative donors and analyzed the risk factors for PRES. Overall, 31 children developed CI-related PRES (11%), including 30 patients with seizures and 1 patient without seizures...
June 5, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28598869/graft-versus-host-disease-what-should-the-oculoplastic-surgeon-know
#11
Cynthia I Tung
PURPOSE OF REVIEW: To provide a concise review of the oculoplastic manifestations of ocular graft versus host disease (GVHD), and to discuss their management. RECENT FINDINGS: Ocular GVHD occurs as a common immune-mediated complication of hematopoietic stem cell transplantation that presents as a Stevens-Johnson-like syndrome in the acute phase or a Sjögren-like syndrome in the chronic phase. Cicatricial conjunctivitis may be underreported in ocular GVHD. The spectrum of oculoplastic manifestations includes GVHD of the skin, cicatricial entropion, nasolacrimal duct obstruction, and lacrimal gland dysfunction...
June 8, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28596425/outcomes-of-hematopoietic-cell-transplantation-using-donors-or-recipients-with-inherited-chromosomally-integrated-hhv-6
#12
Joshua A Hill, Amalia S Magaret, Ruth Hall-Sedlak, Anna Mikhaylova, Meei-Li Huang, Brenda M Sandmaier, John A Hansen, Keith R Jerome, Danielle M Zerr, Michael Boeckh
Human herpesvirus 6 (HHV-6) species have a unique ability to integrate into chromosomal telomeres. Mendelian inheritance via gametocyte integration results in HHV-6 in every nucleated cell. The epidemiology and clinical impact of inherited chromosomally integrated (iciHHV-6) in hematopoietic cell transplant (HCT) recipients is unclear. We identified 4,319 HCT donor-recipient pairs (8,638 subjects) who received an allogeneic HCT and had archived pre-HCT peripheral blood mononuclear cell samples. We screened these samples for iciHHV-6 and compared characteristics of HCT recipients and donors with iciHHV-6 to recipients and donors without iciHHV-6, respectively...
June 8, 2017: Blood
https://www.readbyqxmd.com/read/28592769/thrombotic-complications-after-hematopoietic-stem-cell-transplantation
#13
Shosaku Nomura
Hematopoietic stem cell transplantation (HSCT) involves some serious transplant-associated complications (TACs) or vascular disorders, such as veno-occlusive disease (VOD), thrombotic microangiopathy (TMA), and graft-versus-host disease (GVHD). VOD is related to a clinical syndrome characterized by tender hepatomegaly, jaundice, fluid retention, and unexplained weight gain. When TMA is described in patients who have undergone HSCT, it is often implied that the clinical diagnosis of TMA is similar to that of thrombotic thrombocytopenic purpura...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28592766/fecal-microbiota-transplantation-for-acute-graft-versus-host-disease-of-the-gut
#14
Kazuhiko Kakihana
Advances in microbial analysis have provided new insights into the complex interactions between the host and gut microbiota. An imbalance in the gut microbiota (dysbiosis) is associated with various disorders and their pathogenesis. Furthermore, in allogeneic stem cell transplantation, increasing evidence indicates that the gut microbiota is closely associated with acute graft-versus-host disease (GVHD) and transplant outcomes, suggesting that its manipulation could be a new treatment strategy for this acute condition...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28592758/haploidentical-transplantation-using-post-transplant-high-dose-cyclophosphamide-for-adult-t-cell-lymphoma-after-mogamulizumab-treatment
#15
Manabu Kusakabe, Naoki Kurita, Hidekazu Nishikii, Rie Sato, Chikashi Yoshida, Yasuhisa Yokoyama, Mamiko Sakata-Yanagimoto, Naoshi Obara, Yuichi Hasegawa, Shigeru Chiba
A 53-year-old man diagnosed with adult T-cell lymphoma (ATL) was treated with mLSG15 chemotherapy and achieved a first complete remission. Subsequently, a liver tumor emerged that was pathologically diagnosed as ATL (first relapse). A second remission was achieved after local irradiation and four cycles of mogamulizumab treatment. The patient received peripheral blood stem cell transplantation (HSCT) from a one haplotype HLA-mismatched daughter after total body irradiation and the administration of fludarabine as a myeloablative conditioning regimen, followed by post-transplant cyclophosphamide...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28592129/allogeneic-stem-cell-transplantation-after-fludarabine-melphalan-and-thymoglobulin-followed-by-early-withdrawal-of-prophylactic-immunosuppression-in-patients-with-acute-lymphoblastic-leukemia-update-of-single-center-study
#16
L Raida, A Kuba, Z Rusinakova, R Szotkowska, I Skoumalova, E Faber, T Szotkowski, P Rohon, J Hubacek, K Indrak, Z Pikalova, M Jarosova, M Divoka, K Langova, T Papajik
Presented are updated results of allogeneic hematopoietic stem cell transplantations (HSCTs) in 25 adult patients with acute lymphoblastic leukemia (ALL) in complete remission (CR) after a reduced intensity conditioning (RIC) combining fludarabine (150 mg/m2) and melphalan (140 mg/m2) with thymoglobulin (4.5 mg/kg or recently 4.0 mg/kg) followed by early initiation of reduction and withdrawal of prophylactic posttransplant immunosuppression. The median post-transplant follow-up was 32 (range, 4-87) months. Stable engraftment of donor's hematopoiesis was achieved in all patients...
June 8, 2017: Neoplasma
https://www.readbyqxmd.com/read/28591758/are-the-polyomaviruses-bk-and-jc-associated-with-opportunistic-infections-graft-versus-host-disease-or-worse-outcomes-in-adult-patients-receiving-their-first-allogeneic-stem-cell-transplantation-with-low-dose-alemtuzumab
#17
Laila Schneidewind, Thomas Neumann, Florian Knoll, Kathrin Zimmermann, Sigrun Smola, Christian Andreas Schmidt, William Krüger
BACKGROUND: The association of polyomaviruses BK and JC with other opportunistic infections and graft-versus-host disease (GvHD) in allogeneic stem cell transplantation is controversially discussed. METHODS: We conducted a retrospective study of 64 adult patients who received their first allogeneic stem cell transplantation between March 2010 and December 2014; the follow-up time was 2 years. RESULTS: Acute leukemia was the most frequent underlying disease (45...
June 8, 2017: Acta Haematologica
https://www.readbyqxmd.com/read/28590550/osi-027-modulates-acute-graft-versus-host-disease-after-liver-transplantation-in-a-rat-model
#18
Xiao Zhi, Fei Xue, Wei Chen, Chao Liang, Hao Liu, Tao Ma, Xuefeng Xia, Liqiang Hu, Xueli Bai, Tingbo Liang
Despite its rarity (1%-2%), acute graft-versus-host disease after liver transplantation (LTx-aGVHD) has a high mortality rate (85%). A gradual decrease in regulatory T cells (T-regs) correlates with disease progression in a rat LTx-GVHD model and treatments which increase T-regs exert therapeutic effects on LTx-aGVHD. In this study, LTx-aGVHD model rats were treated with rapamycin (RAPA), OSI-027 or an equal quantity of vehicle. Rats treated with OSI-027 survived longer (>100 days) than those in the RAPA (70±8 days) or control (24±3 days) groups...
June 7, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28588018/outcome-of-children-with-acute-leukemia-given-hla-haploidentical-hsct-after-%C3%AE-%C3%AE-t-cell-and-b-cell-depletion
#19
Franco Locatelli, Pietro Merli, Daria Pagliara, Giuseppina Li Pira, Michela Falco, Daniela Pende, Roberto Rondelli, Barbarella Lucarelli, Letizia Pomponia Brescia, Riccardo Masetti, Giuseppe Maria Milano, Valentina Bertaina, Mattia Algeri, Rita Maria Pinto, Luisa Strocchio, Raffaella Meazza, Lavinia Grapulin, Rupert Handgretinger, Alessandro Moretta, Alice Bertaina, Lorenzo Moretta
Allogeneic hematopoietic stem cell transplantation (HSCT) from an HLA-haploidentical relative (haplo-HSCT) is a suitable option for children with acute leukemia (AL) either relapsed or at high-risk of treatment failure. We developed a novel method of graft manipulation based on negative depletion of αβ T and B cells and conducted a prospective trial evaluating the outcome of children with AL transplanted with this approach (ClinicalTrial.gov identifier: NCT01810120). Eighty AL children, transplanted between September 2011 and September 2014, were enrolled in the trial...
June 6, 2017: Blood
https://www.readbyqxmd.com/read/28587506/extracorporeal-photopheresis-for-gvhd-prophylaxis-after-reduced-intensity-conditioning-allogeneic-hematopoietic-stem-cell-transplantation-a-prospective-multicenter-phase-2-study
#20
Mauricette Michallet, Mohamad Sobh, Frederic Garban, Claude Eric Bulabois, Ibrahim Yakoub-Agha, Valerie Coiteux, Remy Dulery, Pierre-Simon Rohrlich, Faezeh Legrand, Laurence Clement, Aline Praire, Marie Detrait, Fiorenza Barraco, Franck Emmanuel Nicolini, Olivier Hequet
We performed a prospective multicenter phase 2 study to evaluate the safety and efficacy of prophylactic Extracorporeal Photopheresis (ECP) in adult patients with hematological malignancies early after RIC allo-HSCT on day 21 twice per week during the first two weeks and then once per week for the next four weeks for a total of eight ECP courses. A total of 20 patients were included; 10 were males, median age was 60 years. All patients engrafted, 17 (85%) received the total eight ECP courses. There were no adverse effects related to ECP...
June 7, 2017: Leukemia & Lymphoma
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