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Acute GVHD

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https://www.readbyqxmd.com/read/29143281/long-term-outcome-in-patients-treated-at-home-during-the-pancytopenic-phase-after-allogeneic-haematopoietic-stem-cell-transplantation
#1
Olle Ringdén, Behnam Sadeghi, Gianluca Moretti, Sigrun Finnbogadottir, Brita Eriksson, Jonas Mattsson, Britt-Marie Svahn, Mats Remberger
Patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT) were given the option to be treated at home during the pancytopenic phase. Daily visits by a nurse and phone calls from a physician from the unit were part of the protocol. During almost two decades, 252 patients with haematological malignancies and non-malignant disorders were included. Median age was 47 (range 0-72) years. Myeloablative conditioning was given to 102 patients and reduced intensity to 150. Donors were matched unrelated (n = 160), HLA-identical siblings (n = 71), or HLA-mismatched (n = 21)...
November 15, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/29142307/genetic-polymorphism-related-to-monocyte-macrophage-function-is-associated-with-graft-versus-host-disease
#2
Kati Hyvärinen, Jarmo Ritari, Satu Koskela, Riitta Niittyvuopio, Anne Nihtinen, Liisa Volin, David Gallardo, Jukka Partanen
Despite detailed human leukocyte antigen (HLA) matching and modern immunosuppressive therapy, severe graft-versus-host disease (GvHD) remains a major hurdle for successful allogeneic hematopoietic stem cell transplantation (HSCT). As the genetic diversity in GvHD complicates the systematic discovery of associated variants across populations, we studied 122 GvHD-associated single nucleotide polymorphisms (SNPs) in 492 HLA-matched sibling HSCT donor-recipient pairs from Finland and Spain. The association between these candidate SNPs and grade III-IV acute GvHD and extensive chronic GvHD was assessed...
November 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29140405/the-apoptotic-crypt-abscess-an-underappreciated-histologic-finding-in-gastrointestinal-pathology
#3
Geoffrey Talmon, Tristan Manasek, Ross Miller, David Muirhead, Audrey Lazenby
Objectives: To differentiate apoptotic crypt abscesses (ACAs) from neutrophilic crypt abscesses (NCAs). Methods: Cases with crypt abscesses were classified as containing ACAs, NCAs, or mixed crypt abscesses (MCAs) by H&E staining. Sections were stained with cleaved caspase 3 and myeloperoxidase and recategorized. Results: Fifty-nine cases were reviewed: inflammatory bowel disease (IBD; n = 33), acute cellular rejection (n = 5), graft vs host disease (GVHD; n = 14), cytomegalovirus (n = 5), and drug reaction (n = 2)...
November 11, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/29134658/-best-practice-for-extracorporeal-photopheresis-in-acute-and-chronic-graft-versus-host-disease-by-societa-italiana-di-emaferesi-and-manipolazione-cellulare-and-gruppo-italiano-trapianto-midollo-osseo-a-national-survey-to-ascertain-its-degree-of-application
#4
Luca Pierelli, Alberto Bosi, Attilio Olivieri
BACKGROUND: A recent "best practice" promoted and published by Gruppo Italiano Trapianto Midollo Osseo (GITMO) and Societa' Italiana di Emaferesi and Manipolazione Cellulare (SIDEM) on the use of extracorporeal photopheresis (ECP) in acute and chronic graft-versus-host disease (GVHD) has been tested for the degree of agreement and application among Italian transplant centers. STUDY DESIGN AND METHODS: Twenty-four Italian centers coordinating a pair number of transplant programs completed the Web-based survey within the fixed deadline, representing approximately 52% of those centers that have a GITMO-accredited allogeneic transplant program that routinely uses ECP in GVHD...
November 13, 2017: Transfusion
https://www.readbyqxmd.com/read/29131154/impact-of-hla-g-polymorphism-on-the-outcome-of-allogeneic-hematopoietic-stem-cell-transplantation-for-metastatic-renal-cell-carcinoma
#5
R Crocchiolo, O Ringden, J-O Bay, D Blaise, B Omasic, B Mazzi, C Picard, S Trinca, L Barkholt, J Peccatori, S Gregori, G Amodio, K Fleischhauer, F Ciceri, M Bregni
Renal cell carcinoma (RCC) is particularly sensitive to immune intervention. HLA-G, a non-classical HLA class I molecule with immunomodulatory properties, has been studied with regard to outcome after hematopoietic stem cell transplantation (HSCT), in particular the 14 bp insertion/deletion polymorphism in the 3' untranslated region. Here we analyzed n=56 patients affected by metastatic RCC who received an allogeneic HSCT between 1998 and 2006 in Milano, Marseille, Clermont-Ferrand and Stockholm. The 14 bp polymorphism was analyzed in correlation with overall survival (OS), PFS, acute and chronic GvHD...
November 13, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29131150/neurologic-complications-after-allogeneic-hematopoietic-stem-cell-transplantation-risk-factors-and-impact
#6
M R Dowling, S Li, B R Dey, S L McAfee, H R Hock, T R Spitzer, Y-B Chen, K K Ballen
Neurologic complications (NCs) may be a significant source of morbidity and mortality after hematopoietic cell transplantation (HCT). We performed a retrospective study of 263 consecutive patients undergoing allogeneic HCT for hematological malignancies to determine the incidence, risk factors and clinical impact of NCs in the first 5 years after HCT. We determined the incidence of central nervous system (CNS) infection, intracranial hemorrhage, ischemic stroke, metabolic encephalopathy, posterior reversal encephalopathy syndrome, seizure and peripheral neuropathy...
November 13, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29128556/pro-140-monoclonal-antibody-to-ccr5-prevents-acute-xenogeneic-graft-versus-host-disease-in-nod-scid-il-2ry-null-mice
#7
Denis R Burger, Yvonne Parker, Kathryn Guinta, Daniel Lindner
Graft-versus-Host Disease (GvHD) is a prevalent and potentially lethal complication of hematopoietic stem cell transplantation (HSCT). Humanized mouse models of xenogeneic-GvHD are important tools used to study the human immune response in vivo. Here we used NOD-scid IL-2Ry(null) mice (NSG) transplanted with human bone marrow stem cells to evaluate the role of immune cell engraftment in the production of acute GvHD. PRO 140, a humanized monoclonal antibody targeting the chemokine receptor, CCR5, was used to evaluate its influence on bone marrow cell engraftment and modulation of acute GvHD...
November 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29126928/predicting-an-hla-dpb1-expression-marker-based-on-standard-dpb1-genotyping-linkage-analysis-of-over-32-000-samples
#8
Bianca Schöne, Sabine Bergmann, Kathrin Lang, Ines Wagner, Alexander H Schmidt, Effie W Petersdorf, Vinzenz Lange
The risk of acute graft-versus-host disease (GvHD) after hematopoietic stem cell transplantation is increased with donor-recipient HLA-DPB1 allele mismatching. The single-nucleotide polymorphism (SNP) rs9277534 within the 3' untranslated region (UTR) correlates with HLA-DPB1 allotype expression and serves as a marker for permissive HLA-DPB1 mismatches. Since rs9277534 is not routinely typed, we analyzed 32,681 samples of mostly European ancestry to investigate if the rs9277534 allele can be reliably imputed from standard DPB1 genotyping...
November 7, 2017: Human Immunology
https://www.readbyqxmd.com/read/29126272/generation-of-alloantigen-specific-induced-treg-stabilized-by-vitamin-c-treatment-and-its-application-for-prevention-of-acute-graft-versus-host-disease-model
#9
Hidenori Kasahara, Taisuke Kondo, Hiroko Nakatsukasa, Shunsuke Chikuma, Minako Ito, Makoto Ando, Yutaka Kurebayashi, Takashi Sekiya, Taketo Yamada, Shinichiro Okamoto, Akihiko Yoshimura
Antigen-specific regulatory T cells (Tregs) possess the potential to reduce excess immune responses in autoimmune diseases, allergy, rejection after organ transplantation, and graft-versus-host disease (GVHD) in hematopoietic stem-cell transplantation. Although in vitro-expanded antigen-specific induced Tregs (iTregs) have been considered to be a promising therapeutic agent against such excessive immune reactions, the instability of iTregs after transfer is a fundamental problem in their clinical application...
November 4, 2017: International Immunology
https://www.readbyqxmd.com/read/29112242/a-randomized-study-of-cyclosporine-and-methotrexate-with-or-without-methylprednisolone-for-the-prevention-of-graft-versus-host-disease-improved-long-term-survival-with-triple-prophylaxis
#10
Tapani Ruutu, Anne Nihtinen, Riitta Niittyvuopio, Eeva Juvonen, Liisa Volin
BACKGROUND: In a previously published study, the authors randomized 108 adult patients with a malignant hematologic disorder undergoing allogeneic bone marrow transplantation from a human leukocyte antigen-identical sibling to receive methylprednisolone (53 patients; MP+) or not to receive methylprednisolone (55 patients; MP-) as a part of graft-versus-host disease (GVHD) prophylaxis. All patients received cyclosporine and methotrexate. The cumulative incidence of acute GVHD was found to be significantly lower among the patients given MP...
November 7, 2017: Cancer
https://www.readbyqxmd.com/read/29101827/differential-t-cell-subsets-and-cytokine-profile-between-steady-state-and-g-csf-primed-bone-marrow-and-its-association-with-graft-versus-host-disease
#11
Eucario León-Rodríguez, Monica M Rivera-Franco, Diana Gómez-Martín, Jorge Romo-Tena, Guillermo Juárez-Vega, Javier Merayo-Chalico, Jorge Alcocer-Varela
Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). At our Institution, patients transplanted using G-CSF-primed bone marrow (G-BM), have a lower incidence of GVHD when compared to other sources. The objective of this study was to analyze and compare T cell subsets and cytokines in donor G-BM and steady-state BM (SS-BM). A prospective study was performed in 48 donor samples. Mononuclear cells were isolated by gradient density. T cell subsets and cytokine production in supernatants were analyzed by multiparametric flow cytometry...
November 1, 2017: Leukemia Research
https://www.readbyqxmd.com/read/29097037/better-early-outcome-with-enteral-rather-than-parenteral-nutrition-in-children-undergoing-mac-allo-sct
#12
F Gonzales, B Bruno, M Alarcón Fuentes, E De Berranger, D Guimber, H Behal, V Gandemer, A Spiegel, A Sirvent, I Yakoub-Agha, B Nelken, A Duhamel, D Seguy
There is no consensus on the type of nutritional support to introduce in children undergoing allogeneic stem cell transplantation (allo-SCT) after myeloablative conditioning (MAC). This retrospective, multicenter, observational study compared the early administration of enteral nutrition (EN group, n = 97) versus parenteral nutrition (PN group, n = 97) in such patients with matching for important covariates. The primary endpoint was the study of day 100 overall mortality. The early outcome at day 100 was better in EN group regarding mortality rate (1% vs...
October 12, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29096332/high-prognostic-value-of-pre-allogeneic-stem-cell-transplantation-minimal-residual-disease-detection-by-wt1-gene-expression-in-aml-transplanted-in-cytologic-complete-remission
#13
Anna Candoni, Federico De Marchi, Maria Elena Zannier, Davide Lazzarotto, Carla Filì, Maria Vittoria Dubbini, Nicholas Rabassi, Eleonora Toffoletti, Bonnie W Lau, Renato Fanin
We analyzed the outcome of allogeneic stem cell transplantation (allo-SCT) in acute myeloid leukemia (AML) patients according to molecular Minimal Residual Disease (MRD) status prior to allo-SCT. MRD was assessed by the quantitative expression of the pan-leukemic marker Wilms' tumor (WT1) gene, according to the validated LeukemiaNet method. Between 2005 and 2016, 122 consecutive AML patients, WT1 positive at diagnosis, received allo-SCT in cytologic complete remission (cCR). The median age at SCT was 53 years (range 18-70)...
October 27, 2017: Leukemia Research
https://www.readbyqxmd.com/read/29095297/everolimus-for-pediatric-patients-with-acute-graft-versus-host-disease-after-hematopoietic-stem-cell-transplantation-a-pilot-study
#14
Yu-Hua Chao, Yin-Chen Chang, Han-Ping Wu, Ching-Tien Peng, Te-Fu Weng, Kang-Hsi Wu
Acute graft-versus-host disease (aGVHD) is a significant cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Due to the poor prognosis for patients not responding to first-line steroids treatment, improvements in aGVHD therapy are needed. Everolimus is a promising candidate that combines immunosuppressive properties with anti-neoplastic effects. Here, we retrospectively reviewed the efficacy of everolimus with steroids as primary treatment in 13 patients with grade II to grade IV aGVHD after HSCT...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29094350/transplant-results-in-adults-with-fanconi-anaemia
#15
Marc Bierings, Carmem Bonfim, Regis Peffault De Latour, Mahmoud Aljurf, Parinda A Mehta, Cora Knol, Farid Boulad, Abdelghani Tbakhi, Albert Esquirol, Grant McQuaker, Gulsan A Sucak, Tarek B Othman, Constantijn J M Halkes, Ben Carpenter, Dietger Niederwieser, Marco Zecca, Nicolaus Kröger, Mauricette Michallet, Antonio M Risitano, Gerhard Ehninger, Raphael Porcher, Carlo Dufour
The outcomes of adult patients transplanted for Fanconi anaemia (FA) have not been well described. We retrospectively analysed 199 adult patients with FA transplanted between 1991 and 2014. Patients were a median of 16 years of age when diagnosed with FA, and underwent transplantation at a median age of 23 years. Time between diagnosis and transplant was shortest (median 2 years) in those patients who had a human leucocyte antigen identical sibling donor. Fifty four percent of patients had bone marrow (BM) failure at transplantation and 46% had clonal disease (34% myelodysplasia, 12% acute leukaemia)...
November 2, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/29084206/myeloablative-conditioning-regimens-with-combined-of-haploidentical-and-cord-blood-transplantation-for-myelodysplastic-syndrome-patients
#16
P Ke, X-B Bao, X-H Hu, J Zhuang, X-J Wu, Y-J Liu, X-F He, D-P Wu, S-L Xue, X Ma
The purpose of this study was to evaluate the strategy of haploidentical (HID) stem cell combined with a small doses of umbilical cord blood (UCB) from a third-party donor transplantation (haplo-cord transplant) for treatment of myelodysplastic syndromes (MDS), by comparing with identical-sibling donor (ISD) transplantation. Eighty-five patients were included between January 2012 and December 2015, with a median 40 years old. Forty-eight patients received haplo-cord transplant and 37 patients received ISD transplant...
October 30, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29084202/role-of-thymoglobulin-in-matched-sibling-allogeneic-hematopoietic-stem-cell-transplantation-with-busulfan-and-fludarabine-conditioning-in-myeloid-malignanicies
#17
D-Y Shin, J-H Lee, S Park, J-O Lee, J-H Moon, J-S Ahn, Y Choi, I-C Song, H-J Shin, W S Lee, H S Lee, S-S Yoon
In vivo T-cell depletion using anti-thymocyte globulin (ATG) is widely used in allogeneic hematopoietic stem cell transplantation (HSCT) for prophylaxis of GvHD. We investigated the influence of thymoglobulin dose (an ATG) on GvHD following matched sibling donor (MSD) HSCT with a busulfan and fludarabine preparative regimen. Medical records of 180 patients who received MSD HSCT with a conditioning regimen of busulfan, fludarabine, and ATG (BuFluATG) were reviewed retrospectively. The median age was 53 years (range 18-68)...
October 30, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29080380/nutritional-risk-factors-predict-severe-acute-graft-versus-host-disease-and-early-mortality-in-pediatric-allogeneic-hematopoietic-stem-cell-transplantation
#18
Eva H Kerby, Yimei Li, Kelly D Getz, Elizabeth C Smith, Laura T Smith, Nancy J Bunin, Alix E Seif
BACKGROUND: Malnutrition is a pro-inflammatory state, yet data on nutritional risk factors and development of acute graft-versus-host disease (aGVHD) are extremely limited. PROCEDURE: We conducted a retrospective cohort analysis of pediatric patients up to age 21 years who underwent allogeneic hematopoietic stem cell transplantation (HSCT) at the Children's Hospital of Philadelphia from January 2011 to September 2014 to determine whether malnutrition was associated with development of aGVHD and early mortality...
October 28, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29074374/-c-reactive-protein-levels-at-acute-gvhd-diagnosis-predict-steroid-refractory-disease-treatment-related-mortality-and-overall-survival-after-allogeneic-hematopoietic-stem-cell-transplantation
#19
Lia Minculescu, Brian Thomas Kornblit, Lone Smidstrups Friis, Ida Schiødt, Soeren Lykke Petersen, Niels Smedegaard Andersen, Henrik Sengeloev
Acute graft versus host disease (aGVHD) remains an excessive cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Primary treatment consists of high-dose corticosteroids, but a small group of patients develop steroid refractory disease and their prognosis is especially poor. There is experimental evidence that co-existing inflammation aggravates aGVHD. Since C-reactive protein (CRP) is a systemic inflammatory marker, we aimed to investigate whether plasma CRP concentrations at aGVHD diagnosis could predict the risk of failing first-line therapy and developing steroid refractory disease...
October 23, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29073260/etanercept-for-steroid-refractory-acute-graft-versus-host-disease-a-single-center-experience
#20
Cornelis N De Jong, Lotte Saes, Clara P W Klerk, Marjolein Van der Klift, Jan J Cornelissen, Annoek E C Broers
BACKGROUND: Acute graft-versus-host disease (aGVHD) is an important complication of allogeneic stem cell transplantation (alloSCT). High dose glucocorticosteroids, are currently recommended as first-line treatment for grade II-IV aGVHD resulting in overall complete responses (CR) in 40%-50% of patients. No standard second-line regimen has been established. Different options have been reported, including anti-TNFα antibodies. METHODS: We retrospectively reviewed the outcome of 15 patients with steroid-refractory (SR) aGVHD treated with etanercept at our institution...
2017: PloS One
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