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Chronic GVHD

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https://www.readbyqxmd.com/read/28527984/personalized-prognostic-risk-score-for-long-term-survival-for-children-with-acute-leukemia-after-allogeneic-transplant
#1
Menachem Bitan, Kwang Woo Ahn, Heather R Millard, Michael A Pulsipher, Hisham Abdel-Azim, Jeffery J Auletta, Valerie Brown, Ka Wah Chan, Miguel Angel Diaz, Andrew Dietz, Marta González Vincent, Gregory Guilcher, Gregory A Hale, Robert J Hayashi, Amy Keating, Parinda Mehta, Kasiani Myers, Kristin Page, Tim Prestidge, Nirali N Shah, Angela R Smith, Ann Woolfrey, Elizabeth Thiel, Stella M Davies, Mary Eapen
We studied leukemia-free (LFS) and overall survival (OS) in children with acute myeloid (AML; n=790) and acute lymphoblastic leukemia (ALL; n=1096), transplanted between 2000 and 2010, who survived for at least 1 year in remission after related or unrelated donor transplantation. Analysis of patient-, disease- and transplantation characteristics and acute and chronic graft versus host disease (GVHD) were performed to identify factors with adverse effects on LFS and OS. These data were used to develop risk scores for survival...
May 17, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28526296/mesenchymal-stem-cells-mscs-attenuate-cutaneous-sclerodermatous-graft-versus-host-disease-scl-gvhd-through-inhibition-of-immune-cell-infiltration-in-a-mouse-model
#2
Ji-Young Lim, Da-Bin Ryu, Sung-Eun Lee, Gyeongsin Park, Chang-Ki Min
Human chronic graft-versus-host disease (CGVHD) shares clinical characteristics with a murine sclerodermatous GVHD (Scl-GVHD) model that is characterized by skin thickening and lung fibrosis. A B10.D2 → BALB/c transplant model of Scl-GVHD was used to address the therapeutic effect of mesenchymal stem cells (MSCs) on the development of CGVHD. The clinical and pathological severity of cutaneous Scl-GVHD was significantly attenuated in MSC-treated recipients relative to Scl-GVHD controls. After MSC treatment, skin collagen production was significantly reduced with consistent downregulation of TGF-β expression...
May 16, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28524885/ocular-surface-analysis-in-hematological-patients-before-and-after-allogeneic-hematopoietic-stem-cell-transplantation-implication-for-daily-clinical-practice
#3
G Giannaccare, F Bonifazi, M Sessa, E Dan, M Arpinati, M Fresina, G Bandini, M Cavo, P Versura, E C Campos
PurposeTo evaluate ocular surface parameters before and after hematopoietic stem cell transplantation (HSCT) and to correlate them with clinical and transplant variables.MethodsThis is a retrospective analysis of data from 93 patients affected by hematological malignancies undergoing HSCT. Values from Ocular Surface Disease Index, Schirmer test, Break-up Time, ocular surface staining, and Meibomian Gland Dysfunction score obtained before HSCT and 3-6 months after were retrieved from charts. Diagnosis and staging of dry eye (DE) disease was performed according to Dry Eye WorkShop criteria...
May 19, 2017: Eye
https://www.readbyqxmd.com/read/28506261/a-possible-role-of-low-regulatory-t-cells-in-anti-acetylcholine-receptor-antibody-positive-myasthenia-gravis-after-bone-marrow-transplantation
#4
Masahiko Fukatsu, Takenobu Murakami, Hiroshi Ohkawara, Shunichi Saito, Kazuhiko Ikeda, Suguru Kadowaki, Itaru Sasaki, Mari Segawa, Tomoko Soeda, Akihiko Hoshi, Hiroshi Takahashi, Akiko Shichishima-Nakamura, Kazuei Ogawa, Yoshihiro Sugiura, Hitoshi Ohto, Yasuchika Takeishi, Takayuki Ikezoe, Yoshikazu Ugawa
BACKGROUND: Chronic graft-versus-host disease (GVHD) appears several months following allogenic hematopoietic stem cell transplantation (HSCT) and is clinically analogous to autoimmune disorder. Polymyositis is a common neuromuscular disorder in chronic GVHD, but myasthenia gravis (MG) is extremely rare. Hence, its pathophysiology and treatment have not been elucidated. CASE PRESENTATION: A 63-year-old man with a history of chronic GVHD presented with ptosis, dropped head, and dyspnea on exertion, which had worsened over the previous several months...
May 15, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28504665/upper-gi-gvhd-similar-outcomes-to-other-grade-ii-graft-versus-host-disease
#5
R S Mehta, Q Cao, S Holtan, M L MacMillan, D J Weisdorf
The significance of upper gastrointestinal tract (UGI) acute GVHD (aGVHD) compared with other grade II aGVHD is not clearly defined. We compared the outcomes of patients with grade II aGVHD with or without biopsy-proven UGI involvement in three groups: grade II aGVHD without UGI (n=178), grade II aGVHD with UGI and other sites (n=102) and isolated UGI aGVHD (n=32). The overall response (ORR) to steroids at day 28 differed among the three groups (76, 67 and 91%, respectively, P=0.01), but was only marginally different in direct comparison with those without or with UGI aGVHD (P=0...
May 15, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28499937/haploidentical-allogeneic-hematopoietic-cell-transplantation-for-multiple-myeloma-using-post-transplant-cyclophosphamide-gvhd-prophylaxis
#6
Luca Castagna, Alberto Mussetti, Raynier Devillier, Alida Dominietto, Magda Marcatti, Giuseppe Milone, Francesco Maura, Chiara de Philippis, Benedetto Bruno, Sabine Furst, Didier Blaise, Paolo Corradini, Vittorio Montefusco
Allogeneic Hematopoietic Cell Transplantation (allo-HCT) currently represents the only potentially curative therapy for patients affected by multiple myeloma (MM). Up to 30% of patients in western countries do not have a matched donor. Haploidentical HCT (haplo-HCT) may be an option, but currently, there is are available data regarding this treatment. We analyzed survival outcomes of 30 heavily pretreated MM patients who received haplo-HCT with post-transplant cyclophosphamide (PT-Cy) as graft-versus-host-disease (GVHD) prophylaxis...
May 9, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28499936/ucbt-without-antithymocyte-globulin-results-in-similar-survival-but-better-quality-of-life-compared-with-upbsct-for-the-treatment-of-acute-leukemia-a-retrospective-study-in-china
#7
J Tong, L Xuan, Y L Sun, D P Huang, H L Liu, C C Zheng, X Y Zhu, B L Tang, K D Song, X H Zhang, L Zhang, W Yao, D J Lin, Q F Liu, Z M Sun
While previous studies have demonstrated improved outcomes in umbilical cord blood transplantation (UCBT) by omitting antithymocyte globulin (ATG) in the conditioning regimen, this approach has not been comparatively studied in unrelated peripheral blood stem cell transplantation (UPBSCT). To compare the risks and benefits between UCBT without ATG and UPBSCT in patients with acute leukemia (AL). This was a multicenter retrospective study of 79 patients who underwent UCBT (myeloablative conditioning without ATG) and 96 patients who underwent UPBSCT (myeloablative conditioning with ATG)...
May 9, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28495794/an-endpoint-associated-with-clinical-benefit-after-initial-treatment-for-chronic-graft-versus-host-disease
#8
Paul J Martin, Barry E Storer, Yoshihiro Inamoto, Mary E D Flowers, Paul A Carpenter, Joseph Pidala, Jeanne Palmer, Mukta Arora, Madan Jagasia, Sally Arai, Corey Cutler, Stephanie J Lee
No gold standard has been established as a primary endpoint in trials of initial treatment for chronic graft-versus-host disease (GVHD), and evidence showing the association of any proposed primary endpoint with clinical benefit has not been conclusively demonstrated. To address this gap, we analyzed outcomes in a cohort of 328 patients enrolled in a prospective, multicenter, observational study within 3 months after diagnosis of chronic GVHD. Complete and partial response, stable disease and progressive disease were defined according to the 2014 NIH Consensus Development Conference on Criteria for Clinical Trials in Chronic Graft-versus-host Disease...
May 11, 2017: Blood
https://www.readbyqxmd.com/read/28495643/humoral-immune-reconstitution-kinetics-following-allogeneic-hematopoietic-stem-cell-transplantation-in-children-a-maturation-block-of-igm-memory-b-cells-may-lead-to-impaired-antibody-immune-reconstitution
#9
Hisham Abdel-Azim, Amro Elshoury, Kris M Mahadeo, Robertson Parkman, Neena Kapoor
Although T cell immune reconstitution following allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been well studied, long-term B cell immune reconstitution remains less characterized. We evaluated humoral immune reconstitution among 71-pediatric allo-HSCT recipients. While tetanus toxoid (TT) antibody levels were normal at 1-year post allo-HSCT, anti-polysaccharide carbohydrate (PRP) antibodies remained persistently low for up to 5-years. While naive B cell counts normalized by 6-months, IgM memory B cell deficiency persisted for up to 2-years (P=0...
May 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28495642/feasibility-of-lenalidomide-therapy-for-persistent-chronic-lymphocytic-leukemia-after-allogeneic-transplantation
#10
Maria R Khouri, Elias J Jabbour, Alison M Gulbis, Francesco Turturro, Celina Ledesma, Martin Korbling, Barry I Samuels, Sairah Ahmed, Amin M Alousi, Stefan O Ciurea, David Marin, Krina K Patel, Uday R Popat, Carlos E Bueso-Ramos, Roland L Bassett, Issa F Khouri
In patients with chronic lymphocytic leukemia (CLL), persistence of disease after allogeneic stem cell transplantation (alloSCT) can result in poor outcomes. In an effort to improve these outcomes, patients with persistent CLL who were 90-100 days post alloSCT with no evidence of graft-versus-host-disease (GVHD) were randomized to receive lenalidomide or standard care (withdrawal of immunosuppression followed by donor lymphocyte infusion). Lenalidomide was initiated at 5 mg every other day and increased to 10 mg daily if tolerated in each patient...
May 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28495143/central-and-peripheral-nervous-system-immune-mediated-demyelinating-disease-after-allogeneic-hematopoietic-stem-cell-transplantation
#11
M I Stefanou, F Bischof
OBJECTIVE: We aimed to evaluate clinical and diagnostic features of central and peripheral immune-mediated demyelinating disease (CPID) in allogeneic hematopoietic stem cell transplantation (aHSCT) recipients. BACKGROUND: CPID refers to the late-onset, immune-mediated neurological complications following aHSCT, when other frequent differential diagnoses have been ruled out, and when symptoms and signs of systemic GvHD manifestations are absent. METHODS: Case records at the University of Tuebingen, between 2001 and 2015, were screened to identify patients with CPID after aHSCT...
June 15, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28481353/b-cell-activating-factor-baff-plasma-level-at-the-time-of-chronic-gvhd-diagnosis-is-a-potential-predictor-of-non-relapse-mortality
#12
R M Saliba, S Sarantopoulos, C L Kitko, A Pawarode, S C Goldstein, J Magenau, A M Alousi, T Churay, H Justman, S Paczesny, P Reddy, D R Couriel
Biological markers for risk stratification of chronic GvHD (cGvHD) could improve the care of patients undergoing allogeneic hematopoietic stem cell transplantation. Increased plasma levels of B-cell activating factor (BAFF), chemokine (C-X-C motif) ligand 9 (CXCL9) and elafin have been associated with the diagnosis, but not with outcome in patients with cGvHD. We evaluated the association between levels of these soluble proteins, measured by ELISA at the time of cGvHD diagnosis and before the initiation of therapy, with non-relapse-mortality (NRM)...
May 8, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28475513/nodular-sclerodermatous-chronic-cutaneous-graft-versus-host-disease-gvhd-a-new-clinicopathological-variant-of-cutaneous-sclerodermatous-gvhd-resembling-nodular-keloidal-scleroderma
#13
Lucía Prieto-Torres, Francesca Boggio, Alexandra Gruber-Wackernagel, Lorenzo Cerroni
Cutaneous chronic graft-versus-host disease (GvHD) has a broad spectrum of clinicopathological presentations, the most common ones being poikiloderma, lichen planus-like eruptions, lichen sclerosus-like lesions, morphea-like plaques, and deep sclerosis. New forms of chronic cutaneous GvHD with different clinicopathological characteristics have been described, most of them mimicking cutaneous manifestations of autoimmune diseases. We report the case of a 35-year-old man who underwent allogenic stem cell transplantation for a therapy-associated acute myeloid leukemia and developed an acute GvHD with involvement of skin and gastrointestinal tract...
April 25, 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/28474740/delayed-platelet-recovery-after-allogeneic-hematopoietic-stem-cell-transplantation-association-with-chronic-graft-versus-host-disease-and-survival-outcome
#14
Yu Akahoshi, Shun-Ichi Kimura, Ayumi Gomyo, Jin Hayakawa, Masaharu Tamaki, Naonori Harada, Machiko Kusuda, Kazuaki Kameda, Tomotaka Ugai, Hidenori Wada, Yuko Ishihara, Koji Kawamura, Kana Sakamoto, Miki Sato, Kiriko Terasako-Saito, Misato Kikuchi, Hideki Nakasone, Shinichi Kako, Yoshinobu Kanda
Delayed platelet recovery (DPR) despite prompt neutrophil engraftment is frequently observed after allogeneic hematopoietic stem cell transplantation (HSCT). However, few studies have evaluated the risk factors and long-term outcome. Therefore, we retrospectively analysed 219 adult patients who underwent their first allogenic HSCT with neutrophil engraftment. Of these 219 patients, 50 (22.8%) had DPR that was defined as relapse-free survival at day 60 after HSCT without primary platelet recovery despite neutrophil engraftment...
May 5, 2017: Hematological Oncology
https://www.readbyqxmd.com/read/28468799/pd-1-blockade-for-relapsed-lymphoma-post-allogeneic-hematopoietic-cell-transplant-high-response-rate-but-frequent-gvhd
#15
Bradley M Haverkos, Diana Abbott, Mehdi Hamadani, Philippe Armand, Mary E Flowers, Reid Merryman, Manali Kamdar, Abraham Sebastian Kanate, Ayman Saad, Amitkumar Mehta, Siddhartha Ganguly, Timothy S Fenske, Parameswaran Hari, Robert Lowsky, Leslie Andritsos, Madan Jagasia, Asad Bashey, Stacey Brown, Veronika Bachanova, Deborah Stephens, Shin Mineishi, Ryotaro Nakamura, Yi-Bin Chen, Bruce R Blazar, Jonathan Gutman, Steven M Devine
Given the limited treatment options for relapsed lymphoma post allogeneic hematopoietic cell transplantation (allo-HCT) and the success of PD-1 blockade in classical Hodgkin lymphoma (cHL) patients, anti-PD-1 monoclonal antibodies (mAbs) are increasingly being used off-label following allo-HCT. To characterize the safety and efficacy of PD-1 blockade in this setting, we conducted a multicenter retrospective analysis of 31 lymphoma patients receiving anti-PD-1 mAbs for relapse post allo-HCT. Twenty-nine (94%) patients had cHL and 27 had ≥1 salvage therapy post allo-HCT and prior to anti-PD-1...
May 3, 2017: Blood
https://www.readbyqxmd.com/read/28455006/association-of-plasma-cd163-concentration-with-de-novo-onset-chronic-graft-versus-host-disease
#16
Yoshihiro Inamoto, Paul J Martin, Sophie Paczesny, Laura Tabellini, Amin A Momin, Christen L Mumaw, Mary E D Flowers, Stephanie J Lee, Paul A Carpenter, Barry E Storer, Samir Hanash, John A Hansen
Chronic graft-versus-host disease (GVHD) is the leading cause of long-term morbidity and mortality after allogeneic hematopoietic cell transplantation. To identify prognostic plasma proteins associated with de novo- or quiescent-onset chronic GVHD (cGVHD), we performed a discovery and validation proteomic study. The total study cohort included 167 consecutive patients who had no clinical evidence of GVHD under minimum glucocorticoid administration and had available plasma samples obtained at 80 ± 14 days after transplantation...
April 25, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28452054/comparing-outcomes-of-matched-related-donor-and-matched-unrelated-donor-hematopoietic-cell-transplants-in-adults-with-b-cell-acute-lymphoblastic-leukemia
#17
Eric Segal, Michael Martens, Hai-Lin Wang, Ruta Brazauskas, Daniel Weisdorf, Brenda M Sandmaier, H Jean Khoury, Marcos de Lima, Wael Saber
BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) using human leukocyte antigen (HLA)-matched related donors (RDs) and allogeneic HCT using HLA-matched unrelated donors (URDs) produce similar outcomes for patients with acute myelogenous leukemia, whereas the donor source has been reported to be a predictor of outcomes in myelodysplastic syndrome. METHODS: Post-HCT outcomes for 1458 acute lymphoblastic leukemia patients from 2000 to 2011 were analyzed, and RD and URD transplants were compared...
April 27, 2017: Cancer
https://www.readbyqxmd.com/read/28447161/prediction-of-graft-versus-host-disease-a-biomarker-panel-based-on-lymphocytes-and-cytokines
#18
Holger Budde, Susanne Papert, Jens-Holger Maas, Holger M Reichardt, Gerald Wulf, Justin Hasenkamp, Joachim Riggert, Tobias J Legler
Graft-versus-host disease (GvHD) still belongs to the major challenges after allogeneic hematopoietic stem cell transplantation (HSCT). Immune-suppressive therapy against GvHD is a double-edged sword due to risk of infections and relapse. The ability to adapt prophylactic treatment according to the probability of severe GvHD would be an essential advantage for the patients. We analyzed different biomarkers for their potential to predict the development of GvHD in 28 patients who underwent allogeneic HSCT. Blood was taken once directly after hematopoietic engraftment...
April 26, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28439655/-ocular-graft-versus-host-disease-corneal-complications
#19
H Westekemper, S L Scholz, H Thomasen, C Halfwassen, K-P Steuhl
BACKGROUND: Ocular graft-versus-host disease (GvHD) following allogeneic blood stem cell transplantation leads to immunologically induced alterations in many ocular tissues, particularly at the ocular surface. Within the framework of the main topic, this article focuses primarily on corneal complications in chronic ocular GvHD. OBJECTIVE: This article aims to promote understanding of the influencing factors, diagnostics, and therapeutic options pertaining to corneal complications in ocular GvHD...
April 24, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28433882/hypothyroidism-following-allogeneic-hematopoietic-stem-cell-transplantation-for-acute-myeloid-leukemia
#20
Michael Medinger, Deborah Zeiter, Dominik Heim, Jörg Halter, Sabine Gerull, André Tichelli, Jakob Passweg, Nicole Nigro
BACKGROUND: Hypothyroidism may complicate allogeneic hematopoietic stem cell transplantation (allo-HSCT); we therefore analyzed risk factors in this study. PATIENTS AND METHODS: We studied 229 patients with acute myeloid leukemia (AML) who underwent an allo-HSCT between 2003 and 2013 with different conditioning regimens (myeloablative, reduced-intensity, chemotherapy-based, or total body irradiation-based). Thyroid-stimulating hormone (TSH) and free thyroxine levels (fT4) were available in 104 patients before and after allo-HSCT...
April 13, 2017: Leukemia Research
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