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Chronic GVHD

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https://www.readbyqxmd.com/read/28935847/cd56bright-nk-regulatory-cells-in-filgrastim-primed-donor-blood-or-marrow-products-regulate-chronic-gvhd-cbmtg-randomized-0601-study-results
#1
Amina Kariminia, Sabine Ivison, Bernard Ng, Jacob Rozmus, Susanna Sung, Avani Varshney, Mahmoud Aljurf, Silvy Lachance, Irwin Walker, Cindy Toze, Jeff Lipton, Stephanie J Lee, Jeff Szer, Richard Doocey, Ian Lewis, Clayton Smith, Naeen Chaudhri, Megan K Levings, Raewyn Broady, Gerald Devins, David Szwajcer, Ronan Foley, Sara Mostafavi, Steven Pavletic, Donna A Wall, Stephen Couban, Tony Panzarella, Kirk R Schultz
Randomized trials have conclusively shown higher rates of chronic graft-versus-host disease with filgrastim-stimulated apheresis peripheral blood as a donor source than unstimulated bone marrow. The Canadian Blood and Marrow Transplant Group conducted a phase 3 study of adults who received either filgrastim-stimulated apheresis peripheral blood or filgrastim-stimulated bone marrow from human leukocyte antigen-identical sibling donors. Because all donors received the identical filgrastim dosing schedule, this study allowed for a controlled evaluation of the impact of stem cell source on development of chronic graft-versus-host disease...
September 21, 2017: Haematologica
https://www.readbyqxmd.com/read/28918304/haploidentical-transplantation-for-older-patients-with-acute-myeloid-leukemia-and-myelodysplastic-syndrome
#2
Stefan O Ciurea, Mithun V Shah, Rima M Saliba, Sameh Gaballa, Piyanuch Kongtim, Gabriela Rondon, Julianne Chen, Whitney Wallis, Kai Cao, Marina Konopleva, Naval Daver, Jorge Cortes, Farhad Ravandi, Amin Alousi, Sairah Ahmed, Uday Popat, Simrit Parmar, Qaiser Bashir, Oran Betul, Chitra Hosing, Elizabeth J Shpall, Katayoun Rezvani, Issa F Khouri, Partow Kebriaei, Richard E Champlin
Allogeneic stem cell transplant (ASCT) with HLA matched donors is increasingly used for older patients with AML/MDS. It remains unclear if haploidentical transplantation (haploSCT) is a suitable option for older patients with this disease. We analyzed 43 patients with AML/MDS (median age 61 years) who underwent a haploSCT at our institution. All the patients received a fludarabine-melphalan-based reduced-intensity conditioning regimen and post-transplant cyclophosphamide-based GVHD prophylaxis. Except one patient who had early death, the remaining 42 patients (98%) engrafted donor cells...
September 13, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28911060/reduced-intensity-versus-reduced-toxicity-myeloablative-fludarabine-busulfan-based-conditioning-regimens-for-allografted-non-hodgkin-lymphoma-adult-patients-a-retrospective-study-on-behalf-of-the-soci%C3%A3-t%C3%A3-francophone-de-greffe-de-moelle-et-de-th%C3%A3-rapie-cellulaire
#3
A Le Bourgeois, M Labopin, D Blaise, P Ceballos, S Vigouroux, R Peffault de Latour, A Marçais, C E Bulabois, J O Bay, S Chantepie, E Deconinck, E Daguindau, N Contentin, I Yakoub-Agha, J Cornillon, M Mercier, P Turlure, A Charbonnier, P S Rorhlich, S N'Guyen, N Maillard, T Marchand, M Mohty, P Chevallier
Background: Fludarabine/busulfan-based conditioning regimens are widely used to perform allogeneic stem-cell transplantation (allo-SCT) in high-risk non-Hodgkin lymphoma (NHL) patients. The impact of the dose intensity of busulfan on outcomes has not been reported yet. Patients and methods: This was a retrospective with the aim to compare the outcomes of NHL patients who received before allo-SCT a fludarabine/busulfan conditioning regimen, either of reduced intensity (FB2, 2 days of busulfan at 4 mg/kg/day oral or 3...
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28899741/small-bowel-stenosis-a-manifestation-of-chronic-graft-versus-host-disease-in-children
#4
Mickael Tordjman, Marie Ouachee, Arnaud Bonnard, Bogdana Tilea, Karima Yakouben, Jerome Viala, Michel Peuchmaur, Dominique Berrebi
Digestive graft versus host disease (GVHD) is a frequent complication after bone marrow transplantation (BMT), but small bowel obstruction is an extremely rare event. We present herein the first pediatric series of 4 cases of small bowel obstruction after BMT with detailed gross, histological data and their genetic status of the NOD2 gene. All patients had a history of severe acute GVHD treated by immunosuppressive agents and/or infliximab (in 3 cases). Acute or progressively worsening abdominal pain accompanied by small bowel occlusion occurred 5-16months after graft and CT-scan revealed multiple small intestinal stenosis...
September 9, 2017: Human Pathology
https://www.readbyqxmd.com/read/28892086/allogeneic-stem-cell-transplantation-and-subsequent-treatments-as-a-comprehensive-strategy-for-long-term-survival-of-multiple-myeloma-patients
#5
V Montefusco, A Mussetti, F Rezzonico, F Maura, M Pennisi, C de Philippis, M Capecchi, P Corradini
We evaluated 71 patients treated with allogeneic hematopoietic cell transplantation (allo-HCT) for multiple myeloma (MM). Forty-three patients (61%) received allo-HCT after the first line of therapy. Fifty-eight patients (82%) had chemosensitive disease at the time of allo-HCT. A HLA-matched related or unrelated donor was available for 68 patients (96%). Non-myeloablative or reduced-intensity conditioning regimen and peripheral blood hematopoietic cells as a graft source were used in most patients. The cumulative incidence of grade II-IV acute GVHD at day +100 and chronic GVHD at 5 years was 13% (95% CI 7-23%) and 35% (95% CI 24-46), respectively...
September 11, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28888028/effect-of-reduced-intensity-conditioning-and-the-risk-of-late-onset-non-infectious-pulmonary-complications-in-pediatric-patients
#6
Masayuki Nagasawa, Noriko Mitsuiki, Yuki Aoki, Toshiaki Ono, Takeshi Isoda, Kohsuke Imai, Masatoshi Takagi, Michiko Kajiwara, Hirokazu Kanegane, Tomohiro Morio
OBJECTIVE: Late-onset non-infectious pulmonary complications (LONIPCs) contribute to higher morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Therefore, we investigated the risk factors of LONIPCs in pediatric patients. METHOD: Between 2001 and 2011, 74 pediatric patients (range, 7 months to 22.7 years old; median 6.5 years old), including 29 with a primary immunodeficiency underwent 80 allo-HSCTs at our institution. Sixty-seven patients who survived more than 3 months after allo-HSCT were analyzed retrospectively...
September 9, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28887808/comparison-of-reference-values-for-immune-recovery-between-event-free-patients-receiving-haploidentical-allografts-and-those-receiving-human-leukocyte-antigen-matched-sibling-donor-allografts
#7
Xuying Pei, Xiangyu Zhao, Yu Wang, Lanping Xu, Xiaohui Zhang, Kaiyan Liu, Yingjun Chang, Xiaojun Huang
To establish optimal reference values for recovered immune cell subsets, we prospectively investigated post-transplant immune reconstitution (IR) in 144 patients who received allogeneic stem cell transplantation (allo- SCT) and without showing any of the following events: poor graft function, grades II‒IV acute graft-versus-host disease (GVHD), serious chronic GVHD, serious bacterial infection, invasive fungal infection, or relapse or death in the first year after transplantation. IR was rapid in monocytes, intermediate in lymphocytes, CD3(+) Tcells, CD8(+) T cells, and CD19(+) B cells, and very slow in CD4(+) T cells in the entire patient cohort...
September 8, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28875009/abo-incompatibility-and-hematopoietic-stem-cell-transplantation-outcomes
#8
Mohammad Vaezi, Davoud Oulad Dameshghi, Maryam Souri, Seyed Amin Setarehdan, Kamran Alimoghaddam, Ardeshir Ghavamzadeh
Introduction: The increased risk of hemolytic reactions and erythrocyte recovery delay in ABO incompatible hematopoietic stem cell transplantation (HSCT) are well established. Effects of ABO incompatibility on other transplantation outcomes are evaluated in this study. Subjects and Methods: We prospectively followed 501 patients undergoing allogeneic stem cell transplantation regarding their ABO compatibility groups for a median time of 34.7 months. Patients were studied in minor, major and bidirectional mismatched and matched groups...
April 1, 2017: International Journal of Hematology-oncology and Stem Cell Research
https://www.readbyqxmd.com/read/28870639/migratory-properties-of-ex-vivo-expanded-regulatory-t-cells-influence-of-all-trans-retinoic-acid-and-rapamycin
#9
J L Beermann, C T Thiesler, U Dringenberg, C Alter, S Kuhs, S Velaga, S N Ukena, A Franzke
Adoptively transferred regulatory T-cells represent a promising therapeutic approach for tolerance induction in autoimmunity and transplantation medicine. However, a major hurdle for clinical application is the manufacturing of sufficient Treg cell numbers with respect to the low frequency of naturally occurring Tregs in the peripheral blood. Therefore, ex vivo large-scale expansion is mandatory for most of the clinical conditions. Besides the Treg cell number other parameters of the cell product are of high relevance for safe and efficient clinical Treg cell application like Treg cell purity, suppressive capacity and genetic stability of the Treg cell phenotype...
September 1, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28869613/age-does-not-adversely-influence-outcomes-among-patients-older-than-60-years-who-undergo-allogeneic-hematopoietic-stem-cell-transplant-for-aml-and-myelodysplastic-syndrome
#10
D Modi, A Deol, S Kim, L Ayash, A Alavi, M Ventimiglia, D Bhutani, V Ratanatharathorn, J P Uberti
Allogeneic hematopoietic stem cell transplant (AHSCT) outcomes data of older AML/myelodysplastic syndrome (MDS) patients are limited. We retrospectively evaluated consecutive patients ⩾60 years old with AML/MDS who underwent AHSCT between January 2005 and December 2014. The primary objectives were to determine nonrelapse mortality (NRM), relapse, relapse-free survival (RFS) and overall survival (OS) at 1 year post AHSCT. A total of 159 patients underwent AHSCT with a median age of 64 (range, 60-75) years...
September 4, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28864814/rituximab-based-first-line-treatment-for-chronic-gvhd-after-allogeneic-sct-results-of-a-phase-2-study
#11
Florent Malard, Myriam Labopin, Ibrahim Yakoub-Agha, Sylvain Chantepie, Thierry Guillaume, Didier Blaise, Reza Tabrizi, Leonardo Magro, Bernard Vanhove, Gilles Blancho, Philippe Moreau, Béatrice Gaugler, Patrice Chevallier, Mohamad Mohty
Chronic graft-versus-host disease (cGVHD) is the main cause of late non-relapse mortality and morbidity after allogeneic stem-cell transplantation (allo-SCT). In order to improve such patients' outcome, we conducted a phase 2, prospective, multicenter trial to test the efficacy of addition of rituximab to corticosteroid and cyclosporine A as first line therapy for newly diagnosed cGVHD after allo-SCT. Twenty-four patients (median age, 47 years) with mild (n=2), moderate (n=7) or severe (n=15) cGVHD were included...
September 1, 2017: Blood
https://www.readbyqxmd.com/read/28864140/donor-type-and-disease-risk-predict-the-success-of-allogeneic-hematopoietic-cell-transplantation-hct-a-single-center-analysis-of-613-adult-hct-recipients-using-a-modified-composite-endpoint
#12
Melhem Solh, Xu Zhang, Katelin Connor, Stacey Brown, Lawrence E Morris, H Kent Holland, Asad Bashey, Scott R Solomon
The composite endpoint GVHD free, relapse free survival (GRFS) has recently been developed as a tool to assess the success of allogeneic HCT and has been incorporated into recent randomized trials of GVHD prophylaxis by the Blood and Marrow Transplant Clinical Trials Network (BMTCTN). As developed, GRFS incorporates 'chronic GVHD requiring systemic immunosuppression' as a measure of clinically significant chronic GVHD (cGVHD). However, the decision to start patients on immunosuppression for chronic GVHD is subjective and physician dependent...
August 29, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28864139/optimizing-anti-thymocyte-globulin-dosing-for-unrelated-donor-allogeneic-hematopoietic-cell-transplant-based-on-recipient-absolute-lymphocyte-count
#13
Vanessa E Kennedy, Heidi Chen, Bipin N Savani, John Greer, Adetola A Kassim, Brian G Engelhardt, Stacey Goodman, Salyka Sengsayadeth, Wichai Chinratanalab, Madan Jagasia
Anti-thymocyte globulin (ATG) is used as prophylaxis against graft-versus-host-disease (GVHD). Current dosing regimens for ATG are empiric, weight-based, and do not account for patient-specific factors. Furthermore, the target of ATG, recipient T cells post-cytotoxic chemotherapy, is not a function of recipient weight. We hypothesized the recipient peripheral blood absolute lymphocyte count (ALC) on day of ATG administration would interact with the amount of ATG administered to predict transplant outcomes. We retrospectively analyzed 135 patients who received ATG for GVHD prophylaxis for unrelated allogeneic hematopoietic cell transplantation at three different doses: 10 mg/kg, 7...
August 29, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28864138/comparison-of-different-rabbit-anti-thymocyte-globulin-formulations-in-allogeneic-stem-cell-transplantation-systematic-literature-review-and-network-meta-analysis
#14
Nico Gagelmann, Francis Ayuk, Christine Wolschke, Nicolaus Kröger
Since 2000, phase III randomized controlled trials (RCT) investigated the efficacy of rabbit anti-thymocyte globulins (ATG) in patients following allogeneic stem cell transplantation (allo-SCT). However, comparisons of different ATG formulations are lacking. Our aim was to synthesize all efficacy evidence, enabling a comparison of all available formulations of rabbit ATG in the allo-SCT setting. We performed a systematic literature review to identify all available phase III RCT evidence. We searched the Cochrane Library, MEDLINE, MEDLINE In-Process and the website www...
August 29, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28859032/successful-reduced-intensity-conditioning-alternate-donor-stem-cell-transplant-for-wiskott-aldrich-syndrome
#15
Dhwanee Thakkar, Satyendra Katewa, Neha Rastogi, Shruti Kohli, Sagar Nivargi, Satya P Yadav
There are very few reports of reduced intensity conditioning (RIC) hematopoietic stem cell transplant (HSCT) with alternate donor for Wiskott-Aldrich syndrome (WAS) and there is no report of RIC with posttransplant cyclophosphamide (PTCy) in WAS. There is only 1 report of T cell receptor αβ and CD19-depleted haploidentical HSCT for WAS. Here we report successful outcome in 3 children with WAS who underwent successful RIC alternate donor HSCT of whom 2 (matched unrelated donor and T-cell replete haploidentical) received PTCy and 1 underwent T cell receptor αβ and CD19-depleted haploidentical HSCT...
August 30, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28855905/mesenchymal-stem-cells-may-ameliorate-nephrotic-syndrome-post-allogeneic-hematopoietic-stem-cell-transplantation-case-report
#16
Xin Zhang, Yanwen Peng, Zhiping Fan, Ke Zhao, Xiaoyong Chen, Ren Lin, Jing Sun, Guobao Wang, AndyPeng Xiang, Qifa Liu
INTRODUCTION: Because of their immunomodulatory and anti-inflammatory effects, mesenchymal stem cells (MSCs) have been considered as potential therapeutic agents for treating immune-related or autoimmune diseases, such as graft-versus-host disease (GVHD). Nephrotic syndrome (NS) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an uncommon complication with unclear etiology and pathogenesis. It may be an immune disorder involving immune complex deposition, B cells, regulatory T cells (Tregs), and Th1 cytokines and be a manifestation of chronic GVHD...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28851699/an-aberrant-notch2-bcr-signaling-axis-in-b-cells-from-patients-with-chronic-gvhd
#17
Jonathan C Poe, Wei Jia, Hsuan Su, Sarah Anand, Jeremy J Rose, Prasanthi V Tata, Amy N Suthers, Corbin D Jones, Pei Fen Kuan, Benjamin G Vincent, Jonathan S Serody, Mitchell E Horwitz, Vincent T Ho, Steven Z Pavletic, Frances T Hakim, Kouros Owzar, Dadong Zhang, Bruce R Blazar, Christian W Siebel, Nelson J Chao, Ivan Maillard, Stefanie Sarantopoulos
B Cell Receptor (BCR)-activated B cells contribute to pathogenesis in chronic graft-versus-host disease (cGVHD), a condition manifested by both B cell autoreactivity and immune deficiency. We hypothesized that constitutive BCR activation precluded functional B cell maturation in cGVHD. To address this, we examined BCR-NOTCH2 synergy, since Notch has been shown to increase BCR responsiveness in normal mouse B cells. We conducted ex vivo activation and signaling assays of 30 primary samples from HCT patients with and without cGVHD...
August 29, 2017: Blood
https://www.readbyqxmd.com/read/28846465/post-transplantation-cyclophosphamide-based-haploidentical-transplantation-as-alternative-to-matched-sibling-or-unrelated-donor-transplantation-for-hodgkin-lymphoma-a-registry-study-of-the-lymphoma-working-party-of-the-european-society-for-blood-and-marrow
#18
Carmen Martínez, Jorge Gayoso, Carmen Canals, Hervé Finel, Karl Peggs, Alida Dominietto, Luca Castagna, Boris Afanasyev, Stephen Robinson, Didier Blaise, Paolo Corradini, Maija Itälä-Remes, Arancha Bermúdez, Edouard Forcade, Domenico Russo, Michael Potter, Grant McQuaker, Ibrahim Yakoub-Agha, Christof Scheid, Adrian Bloor, Silvia Montoto, Peter Dreger, Anna Sureda
Purpose To compare the outcome of patients with Hodgkin lymphoma who received post-transplantation cyclophosphamide-based haploidentical (HAPLO) allogeneic hematopoietic cell transplantation with the outcome of patients who received conventional HLA-matched sibling donor (SIB) and HLA-matched unrelated donor (MUD). Patients and Methods We retrospectively evaluated 709 adult patients with Hodgkin lymphoma who were registered in the European Society for Blood and Marrow Transplantation database who received HAPLO (n = 98), SIB (n = 338), or MUD (n = 273) transplantation...
August 28, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28846051/in-vivo-or-ex-vivo-t-cell-depletion-or-both-to-prevent-graft-versus-host-disease-after-hematopoietic-stem-cell-transplantation
#19
Alessandro Busca, Franco Aversa
Hematopoietic stem cell transplantation (HSCT) represents a widely accepted therapeutic strategy for the treatment of hematologic disorders which are otherwise considered incurable. Alloreactive T cells infused with the stem cell inoculum may generate graft-versus-host disease (GVHD) representing one the most relevant obstacles to the successful outcome of patients receiving allogeneic HSCT. Areas covered: In this review, the authors provide an overview of the most recent approaches of T-cell depletion (TCD) including ex-vivo αβ+ TCD and in-vivo TCD with anti-thymocyte globulin (ATG)...
August 28, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28845543/t-cell-replete-haploidentical-second-hematopoietic-stem-cell-transplantation-for-primary-graft-failure-in-pediatric-patients-with-hematologic-malignancies
#20
Kazuhiro Mochizuki, Hideki Sano, Mitsuko Akaihata, Shogo Kobayashi, Tomoko Waragai, Yoshihiro Ohara, Nobuhisa Takahashi, Masaki Ito, Kazuhiko Ikeda, Hitoshi Ohto, Atsushi Kikuta
GF is one of the fatal complications of allogeneic HSCT. To rescue patients with primary GF, a second HSCT should be conducted as soon as possible, but the optimal donor source and technique have yet to be established. In this study, we retrospectively analyzed six children with hematologic malignancies who received TCR-haploidentical second HSCT for primary GF. The median interval between the prior HSCT and the second HSCT was 37.5 days. All patients received fludarabine and ATG containing reduced-intensity re-conditioning before the second HSCT...
August 28, 2017: Pediatric Transplantation
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