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Chronic GVHD

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https://www.readbyqxmd.com/read/28346419/evolving-concepts-in-prognostic-scoring-of-chronic-gvhd
#1
REVIEW
A Lazaryan, M Arora
Chronic GvHD (cGvHD) remains one of the most complex and challenging complications after allogeneic hematopoietic cell transplantation. Emerging knowledge about the clinical manifestations and associated organ involvement of cGvHD has led to the establishment of prognostic parameters for post-transplant survival among affected allograft recipients. Studies employing the pre-National Institutes of Health (NIH) consensus data on cGvHD incidence and its risks have led to development of the CIBMTR's cGvHD risk stratification, which serves as the most refined and validated prognostic tool for estimating survival of patients with cGvHD...
March 27, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28346415/haplo-cord-transplantation-compared-to-haploidentical-transplantation-with-post-transplant-cyclophosphamide-in-patients-with-aml
#2
M Kwon, G Bautista, P Balsalobre, I Sánchez-Ortega, P Montesinos, A Bermúdez, A de Laiglesia, P Herrera, C Martin, K Humala, A Zabalza, M Torres, L Bento, L L Corral, I Heras, D Serrano, I Buño, J Anguita, C Regidor, R Duarte, R Cabrera, J Gayoso, J L Diez-Martin
For patients with AML, the best alternative donor remains to be defined. We analyze outcomes of patients who underwent myeloablative umbilical cord blood or haploidentical hemopoietic stem cell transplantation (HSCT) in Spain. Fifty-one patients underwent single umbilical cord blood transplantation supported by a third party donor (Haplo-Cord) between 1999 and 2012, and 36 patients received an haploidentical HSCT with post-transplant cyclophosphamide (PTCY-haplo) between 2012 and 2014 in GETH centers. The Haplo-Cord cohort included a higher proportion of patients with high disease risk index and use of TBI in the conditioning regimen, and hematopoietic cell transplantation-age Comorbidity Age Index was higher in PTCY-haplo patients...
March 27, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28346413/skin-allograft-for-severe-chronic-gvhd
#3
R Crocchiolo, V Dubois, F-E Nicolini, M Sobh, S Ducastelle-Lepretre, H Labussiere, L Lebras, C Auxenfans, A Mojallal, O Damour, F Braye, M Michallet
No abstract text is available yet for this article.
March 27, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28344563/a-review-of-demographic-medical-and-treatment-variables-associated-with-health-related-quality-of-life-hrqol-in-survivors-of-hematopoietic-stem-cell-hsct-and-bone-marrow-transplantation-bmt-during-childhood
#4
REVIEW
Trude Reinfjell, Marta Tremolada, Lonnie K Zeltzer
Hematopoietic stem cell transplantation (HSCT) is a standard treatment after disease relapse and failure of conventional treatments for cancer in childhood or as a first line treatment for some high-risk cancers. Since hematopoietic stem cells can be found in the marrow (previously called a bone marrow transplantation) or periphery, we refer to HSCT as inclusive of HSCT regardless of the origin of the stem cells. HSCT is associated with adverse side effects, prolonged hospitalization, and isolation. Previous studies have shown that survivors of HSCT are at particularly high risk for developing late effects and medical complications, and thus, in addition to survival, quality of life in survivors of HSCT is an important outcome...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28330607/association-between-anti-thymocyte-globulin-exposure-and-survival-outcomes-in-adult-unrelated-haemopoietic-cell-transplantation-a-multicentre-retrospective-pharmacodynamic-cohort-analysis
#5
Rick Admiraal, Stefan Nierkens, Moniek A de Witte, Eefke J Petersen, Ger-Jan Fleurke, Luka Verrest, Svetlana V Belitser, Robbert G M Bredius, Reinier A P Raymakers, Catherijne A J Knibbe, Monique C Minnema, Charlotte van Kesteren, Jurgen Kuball, Jaap J Boelens
BACKGROUND: Anti-thymocyte globulin (ATG) is used to prevent graft-versus-host disease (GvHD) after allogeneic haemopoietic cell transplantation (HCT). However, ATG can also cause delayed immune reconstitution of T cells, negatively affecting survival. We studied the relation between exposure to ATG and clinical outcomes in adult patients with acute leukaemia and myelodysplastic syndrome. METHODS: We did a retrospective, pharmacokinetic-pharmacodynamic analysis of data from patients with acute lymphoid leukaemia, acute myeloid leukaemia, or myelodysplastic syndrome receiving their first T-cell repleted allogeneic peripheral blood stem cell HCT with ATG (thymoglobulin) as part of non-myeloablative conditioning from March 1, 2004, to June 1, 2015...
March 16, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28323004/fresh-or-cryopreserved-cd34-selected-mobilized-peripheral-blood-stem-and-progenitor-cells-for-the-treatment-of-poor-graft-function-following-allogeneic-hematopoietic-cell-transplantation
#6
Armin Ghobadi, Mark A Fiala, Giridharan Ramsingh, Feng Gao, Camille N Abboud, Keith Stockerl-Goldstein, Geoffrey L Uy, Brenda J Grossman, Peter Westervelt, John F DiPersio
CD34(+)-selected stem cell boost (SCB) without conditioning have recently been utilized for poor graft function (PGF) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) with promising results. Unfortunately, many patients have been unable to receive the boost infusion as their donors were unwilling or unable to undergo an additional stem cell collection. Therefore, we conducted this study utilizing either fresh or cryopreserved peripheral blood stem cell products to create CD34(+)-selected boost infusions for the treatment of PGF...
March 17, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28319080/adverse-impact-of-high-donor-cd3-cell-dose-on-outcome-following-tandem-auto-nma-allogeneic-transplantation-for-high-risk-myeloma
#7
A P Nair, P Walker, A Kalff, K Bergin, J Hocking, S Avery, D J Curtis, S Patil, T Das, D Klarica, S Morgan, J Muirhead, M Gorniak, J Reynolds, A Spencer
High-risk (HR) multiple myeloma (MM) has poor outcomes with conventional therapy. Tandem autologous-non-myeloablative (NMA) allogeneic stem cell transplantation (autologous stem cell transplantation (ASCT)-NMA allogeneic SCT) is potentially curative secondary to graft-versus-myeloma effect. We retrospectively analysed ASCT-NMA allogeneic SCT outcomes of 59 HR and relapsed MM patients. At a median follow-up of 35.8 months, the outcomes for HR-MM upfront tandem ASCT-NMA allogeneic SCT and standard-risk (SR) MM upfront ASCT alone were comparable (median PFS 1166 days versus 1465 days, P=0...
March 20, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28319079/permanent-diffuse-alopecia-after-haematopoietic-stem-cell-transplantation-in-childhood
#8
D Bresters, D C M Wanders, M Louwerens, L M Ball, M Fiocco, R van Doorn
Permanent alopecia after haematopoietic stem cell transplantation (HSCT) is distressing and few studies have investigated this late effect. The aim of the study was to assess the percentage of patients with alopecia and investigate risk factors for alopecia. Patients who underwent allogeneic HSCT before age 19 years, from January 1990 to January 2013, who were at least 2 years after transplant and in follow-up in our clinic were included. Alopecia was defined as clinically apparent decreased hair density. Possible risk factors considered for alopecia after HSCT included: gender, age, diagnosis, donor type, conditioning regimen: cranial irradiation (TBI/cranial radiotherapy) and/or chemotherapy, which chemotherapeutic agents were used and acute/chronic GvHD...
March 20, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28304115/extracorporeal-photopheresis-in-pediatric-patients-practical-and-technical-considerations
#9
Robert A DeSimone, Joseph Schwartz, Jennifer Schneiderman
In adults, extracorporeal photopheresis (ECP) is widely utilized for a variety of indications, most commonly cutaneous T-cell lymphoma, acute or chronic graft-versus-host disease (GVHD), solid organ transplant rejection, and other autoimmune and T-cell-mediated disorders. In pediatric patients, the majority of case series and reports have focused on its use in the management of acute and chronic GVHD. Currently utilized ECP technologies were designed for adult patients and there are several challenges in adapting these technologies for use in children...
March 17, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28301690/optimal-dose-of-rabbit-thymoglobulin-in-conditioning-regimens-for-unmanipulated-haploidentical-hematopoietic-stem-cell-transplantation-long-term-outcomes-of-a-prospective-randomized-trial
#10
Ying-Jun Chang, Yu Wang, Xiao-Dong Mo, Xiao-Hui Zhang, Lan-Ping Xu, Chen-Hua Yan, Huan Chen, Yu-Hong Chen, Yao Chen, Wei Han, Feng-Rong Wang, Jing-Zhi Wang, Kai-Yan Liu, Xiao-Jun Huang
BACKGROUND: Antithymocyte globulin (ATG) is an important component of conditioning regimens to prevent severe graft-versus-host disease (GVHD) in patients undergoing unmanipulated, haploidentical stem cell transplantation (haplo-SCT). However, to the authors' knowledge, the optimal dose of ATG is unknown. METHODS: In this prospective, randomized trial, the authors compared the long-term outcomes of 2 ATG doses (rabbit thymoglobulin) used in myeloablative conditioning before unmanipulated haplo-HSCT...
March 16, 2017: Cancer
https://www.readbyqxmd.com/read/28295181/long-term-follow-up-of-patients-receiving-allogeneic-stem-cell-transplant-for-chronic-lymphocytic-leukaemia-mixed-t-cell-chimerism-is-associated-with-high-relapse-risk-and-inferior-survival
#11
Philip A Thompson, Francesco Stingo, Michael J Keating, William G Wierda, Susan M O'Brien, Zeev Estrov, Celina Ledesma, Katayoun Rezvani, Muzaffar Qazilbash, Nina Shah, Simrit Parmar, Uday Popat, Paolo Anderlini, Nieto Yago, Stefan O Ciurea, Partow Kebriaei, Richard Champlin, Elizabeth J Shpall, Chitra M Hosing
There is limited information regarding the immunological predictors of post-allogeneic stem cell transplant (alloSCT) outcome in chronic lymphocytic leukaemia (CLL), such as mixed T-cell chimerism. We analysed 143 consecutive patients with relapsed/refractory CLL, transplanted between 2000 and 2012, to determine the prognostic relevance of mixed chimerism post-alloSCT and the ability of post-transplant immunomodulation to treat relapse. Mixed T-cell chimerism occurred in 50% of patients at 3 months and 43% at 6 months post-alloSCT; upon 3- and 6-month landmark analysis, this was associated with inferior progression-free survival (PFS) [Hazard ratio (HR) 1·93, P = 0·003 and HR 2·58, P < 0·001] and survival (HR 1·66, P = 0·05 and HR 2·17, P < 0·001), independent of baseline patient characteristics, and a lower rate of grade II-IV acute graft-versus-host disease (GHVD) (16% vs...
March 14, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28288952/outcomes-after-umbilical-cord-blood-transplantation-for-myelodysplastic-syndromes
#12
Aaron T Gerds, Kwang Woo Ahn, Zhen-Huan Hu, Hisham Abdel-Azim, Gorgun Akpek, Mahmoud Aljurf, Karen K Ballen, Amer Beitinjaneh, Ulrike Bacher, Jean-Yves Cahn, Saurabh Chhabra, Corey Cutler, Andrew Daly, Zachariah DeFilipp, Robert Peter Gale, Usama Gergis, Michael R Grunwald, Gregory A Hale, Betty Ky Hamilton, Madan Jagasia, Rammurti T Kamble, Tamila Kindwall-Keller, Taiga Nishihori, Richard F Olsson, Muthalagu Ramanathan, Ayman A Saad, Melhem Solh, Celalettin Ustun, David Valcárcel, Erica Warlick, Baldeep M Wirk, Matt Kalaycio, Edwin Alyea, Uday Popat, Ronald Sobecks, Wael Saber
For patients with hematologic malignancies undergoing allogeneic hematopoietic cell transplantation, umbilical cord blood transplantation (UCBT) has become an acceptable alternative donor source in the absence of a matched sibling or unrelated donor. However, there have been few published series dedicated solely to describing the outcomes of adult patients with myelodysplastic syndrome (MDS) who have undergone UCBT. From 2004 to 2013, 176 adult MDS patients underwent UCBT as reported to the Center for International Blood and Marrow Transplant Research...
March 10, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28288951/haploidentical-related-donor-hematopoietic-stem-cell-transplantation-for-dock8-deficiency-using-post-transplantation-cyclophosphamide
#13
Nirali N Shah, Alexandra F Freeman, Helen Su, Kristen Cole, Mark Parta, Niki M Moutsopoulos, Safa Baris, Elif Karakoc-Aydiner, Thomas E Hughes, Heidi H Kong, Steve M Holland, Dennis D Hickstein
Dedicator-of-Cytokinesis-8 (DOCK8) deficiency, a primary immunodeficiency disease, can be reversed by allogeneic hematopoietic stem cell transplant (HSCT); however, there are few reports describing the use of alternative donor sources for HSCT in DOCK8 deficiency. We describe HSCT for patients with DOCK8 deficiency who lack a matched related or unrelated donor using bone marrow from haploidentical related donors and post-transplantation cyclophosphamide (PT/CY) for GVHD prophylaxis. Seven patients with DOCK8 deficiency (median age 20 years, range 7-25 years) received a haploidentical related donor HSCT...
March 10, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28286611/the-relationship-between-str-pcr-chimerism-analysis-and-chronic-gvhd-following-hematopoietic-stem-cell-transplantation
#14
Seyed Asadollah Mousavi, Mina Javadimoghadam, Ardeshir Ghavamzadeh, Kamran Alimoghaddam, Azadeh Sayarifard, Seyed-Hamidollah Ghaffari, Bahram Chahardouli, Ali Basi
Background: The study attempts to assess the relationship between chimerism analysis using polymerase chain reaction of short tandem repeat (STR) and the incidence of chronic graft versus host disease (GvHD) as well as survival. Subjects and Methods: The retrospective cohort included all patients who received allo-HSCT during 2005-2013. Data collected by day +100 were reviewed in terms of the incidence of chronic GvHD and survival. Chimerism was evaluated for whole blood, T-cell and PMN cells on days 15, 30 and 60, respectively using polymerase chain reaction of short tandem repeat (STR)...
January 1, 2017: International Journal of Hematology-oncology and Stem Cell Research
https://www.readbyqxmd.com/read/28285386/comparison-of-outcomes-after-donor-lymphocyte-infusion-with-or-without-prior-chemotherapy-for-minimal-residual-disease-in-acute-leukemia-myelodysplastic-syndrome-after-allogeneic-hematopoietic-stem-cell-transplantation
#15
Xiao-Dong Mo, Xiao-Hui Zhang, Lan-Ping Xu, Yu Wang, Chen-Hua Yan, Huan Chen, Yu-Hong Chen, Wei Han, Feng-Rong Wang, Jing-Zhi Wang, Kai-Yan Liu, Xiao-Jun Huang
The efficacy of donor lymphocyte infusion (DLI) without chemotherapy was investigated and compared with that of chemotherapy prior to DLI (Chemo-DLI) in patients who were minimal residual disease (MRD)-positive after allogeneic hematopoietic stem cell transplantation (HSCT). We enrolled 115 consecutive patients who received either DLI (n = 20) or Chemo-DLI (n = 95) during the same period. For each DLI recipient, three recipients matched for age at the HSCT, underlying diseases, and the year of the HSCT were randomly selected from the Chemo-DLI cohort (n = 60)...
March 11, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28282218/immunotoxins-in-cancer-therapy-review-and-update
#16
Bahman Akbari, Safar Farajnia, Shiva Ahdi Khosroshahi, Fatemeh Safari, Mohammadreza Yousefi, Hassan Dariushnejad, Leila Rahbarnia
Immunotoxins are a novel class of cancer therapeutics that contains a cytotoxic agent fused to a targeting moiety. Various toxic agents from different sources are used in immunotoxin development, including bacterial, plant and human origin cytotoxic elements. Although bacterial and plant-derived toxins are highly toxic and commonly used in immunotoxins, their immunogenicity for human restricted their application in cancer therapy. Here, we discuss the advantages and limitations of bacterial toxins such as Pseudomonas and Diphtheria toxins, plant toxins such as ricin and gelonin, and some endogenous protein of human origin such as RNases and Granzymes...
March 1, 2017: International Reviews of Immunology
https://www.readbyqxmd.com/read/28279825/optimal-practices-in-unrelated-donor-cord-blood-transplantation-for-hematologic-malignancies
#17
REVIEW
Juliet N Barker, Joanne Kurtzberg, Karen Ballen, Michael Boo, Claudio Brunstein, Corey Cutler, Mitchell Horwitz, Filippo Milano, Amanda Olson, Stephen Spellman, John E Wagner, Colleen Delaney, Elizabeth Shpall
Unrelated donor cord blood (CB) transplantation (CBT) results in disease-free survival comparable to that of unrelated adult donor transplantation in patients with hematologic malignancies. Extension of allograft access to racial and ethnic minorities, rapid graft availability, flexibility of transplant date, and low risks of disabling chronic graft-versus-host disease (GVHD) and relapse are significant advantages of CBT, and multiple series have reported a low risk of late transplant-related mortality (TRM) post-transplant...
March 6, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28278166/the-demanding-attention-of-tuberculosis-in-allogeneic-hematopoietic-stem-cell-transplantation-recipients-high-incidence-compared-with-general-population
#18
Hyo-Jin Lee, Dong-Gun Lee, Su-Mi Choi, Sun Hee Park, Sung-Yeon Cho, Jae-Ki Choi, Si-Hyun Kim, Jung-Hyun Choi, Jin-Hong Yoo, Byung-Sik Cho, Ki-Seong Eom, Seok Lee, Yoo-Jin Kim, Hee-Je Kim, Chang-Ki Min, Dong-Wook Kim, Jong-Wook Lee, Woo-Sung Min, Jung Im Jung
BACKGROUND: The risk of developing tuberculosis (TB) in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is expected to be relatively high in an intermediate TB burden country. This single-center retrospective study was conducted to investigate risk factors and the incidence of TB after allogeneic HSCT. METHODS: From January 2004 to March 2011, 845 adult patients were enrolled. Starting April 2009, patients were given isoniazid (INH) prophylaxis based on interferon-γ release assay results...
2017: PloS One
https://www.readbyqxmd.com/read/28273549/low-incidence-of-acute-graft-versus-host-disease-with-short-term-tacrolimus-in-haploidentical-hematopoietic-stem-cell-transplantation
#19
Lei Gao, Jia Liu, Yanqi Zhang, Xinghua Chen, Li Gao, Cheng Zhang, Yao Liu, Peiyan Kong, Jiangfan Zhong, Aihua Sun, Xin Du, Yi Su, Huimin Li, Hong Liu, Xiangui Peng, Xi Zhang
Although tacrolimus (Tac) has immunosuppressive properties and exhibits promising efficacy against graft-versus-host disease (GVHD), little is known about Tac in the prophylaxis of GVHD after HLA-haploidentical hematopoietic stem cell transplantation (haplo-HSCT). In a multicenter randomized controlled trial, 174 patients received haplo-HSCT with GVHD prophylaxis involving short-term Tac (from -8days to +30days) or cyclosporine (CsA). The 100day cumulative incidences of acute GVHD (aGVHD) and grade III-IV aGVHD with the short-term Tac regimen and CsA regimen were 29...
February 24, 2017: Leukemia Research
https://www.readbyqxmd.com/read/28254742/pirfenidone-ameliorates-murine-chronic-gvhd-through-inhibition-of-macrophage-infiltration-and-tgf-%C3%AE-production
#20
Jing Du, Katelyn Paz, Ryan Flynn, Ante Vulic, Tara M Robinson, Katie E Lineburg, Kylie A Alexander, Jingjing Meng, Sabita Roy, Angela Panoskaltsis-Mortari, Michael Loschi, Geoffrey R Hill, Jonathan S Serody, Ivan Maillard, David Miklos, John Koreth, Corey S Cutler, Joseph H Antin, Jerome Ritz, Kelli P MacDonald, Timothy W Schacker, Leo Luznik, Bruce R Blazar
Allogeneic hematopoietic stem cell transplantation is hampered by chronic graft-versus-host disease (cGVHD) resulting in multi-organ fibrosis and diminished function. Fibrosis in lung and skin leads to progressive bronchiolitis obliterans (BO) and scleroderma, respectively, for which new treatments are needed. We evaluated pirfenidone, a FDA approved drug for idiopathic pulmonary fibrosis, for its therapeutic effect in cGVHD mouse models with distinct pathophysiology. In a full MHC-mismatched, multi-organ system model with BO, donor T cell responses that support pathogenic antibody production are required for cGVHD development...
March 2, 2017: Blood
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