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https://www.readbyqxmd.com/read/28918304/haploidentical-transplantation-for-older-patients-with-acute-myeloid-leukemia-and-myelodysplastic-syndrome
#1
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/28914433/platelet-transfusion-refractoriness-after-t-cell-replete-haploidentical-transplantation-is-associated-with-inferior-clinical-outcomes
#2
Qiang Fu, Lanping Xu, Xiaohui Zhang, Yu Wang, Yingjun Chang, Kaiyan Liu, Xiaojun Huang
Haploidentical stem cell transplantation (haplo-SCT) has been an alternative source of bone marrow for patients without human leukocyte antigen (HLA)-matched donors. The aim of this study was to investigate the relationships between platelet transfusion refractoriness (PTR) and clinical outcomes in the setting of haplo-SCT. Between May 2012 and March 2014, 345 patients who underwent unmanipulated haplo-SCT were retrospectively enrolled. PTR occurred in 20.6% of all patients. Patients in the PTR group experienced higher transplant-related mortality (TRM, 43...
September 13, 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28901730/reduced-toxicity-alternate-donor-stem-cell-transplantation-with-posttransplant-cyclophosphamide-for-primary-immunodeficiency-disorders
#3
Neha Rastogi, Satyendra Katewa, Dhwanee Thakkar, Shruti Kohli, Sagar Nivargi, Satya Prakash Yadav
We describe here the outcomes of reduced-toxicity alternate-donor stem cell transplant (SCT) with posttransplant cyclophosphamide (PTCy) for primary immunodeficiency disorders (PIDs) in eight children (haploidentical-seven and matched unrelated donor-one). The conditioning was with serotherapy (alemtuzumab-3/rabbit-anti-thymoglobulin-5); fludarabine, cyclophosphamide, and total body irradiation-5 (additional thiotepa-3); fludarabine and treosulfan-2; and fludarabine and busulfan-1. All received PTCy 50 mg/kg on days 3 and 4 as graft versus host disease prophylaxis along with tacrolimus and mycophenolate...
September 13, 2017: Pediatric Blood & Cancer
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
#4
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/28883081/haploidentical-hematopoietic-cell-transplantation-for-adult-acute-myeloid-leukemia-a-position-statement-from-the-acute-leukemia-working-party-of-the-european-society-for-blood-and-marrow-transplantation
#5
Catherine J Lee, Bipin N Savani, Mohamad Mohty, Myriam Labopin, Annalisa Ruggeri, Christoph Schmid, Frédéric Baron, Jordi Esteve, Norbert C Gorin, Sebastian Giebel, Fabio Ciceri, Arnon Nagler
Allogeneic blood or marrow hematopoietic cell transplantation continues to be the most potent anti-leukemic treatment for adult patients with standard or high-risk, or chemo-refractory acute myeloid leukemia. Until recently, this procedure was generally limited to those recipients who had an available matched-sibling donor or matched-unrelated donor. Technical advances in graft cell processing and manipulation, control of bidirectional T cell alloreactivity, graft-versus-host disease prophylaxis, and other supportive measures in haploidentical transplantation now enables nearly all patients with acute myeloid leukemia to benefit from the graft-versus-leukemia effect with substantial reduction in procedure-related mortality...
September 7, 2017: Haematologica
https://www.readbyqxmd.com/read/28881839/decitabine-based-chemotherapy-followed-by-haploidentical-lymphocyte-infusion-improves-the-effectiveness-in-elderly-patients-with-acute-myeloid-leukemia
#6
Yu Jing, Xiangshu Jin, Lixin Wang, Liping Dou, Quanshun Wang, Yushi Yao, Shimei Lian, Jihao Zhou, Haiyan Zhu, Zilong Yao, Lijun Gao, Lili Wang, Yonghui Li, Xuefeng Bai, Meiyun Fang, Li Yu
In this study, we first initiated a multicenter, single-arm, phase-II clinical trial using decitabine (DAC) (20mg/m(2) for five days) based chemotherapy, followed by haploidentical lymphocyte infusion (HLI) that was applied as induction therapy for elderly patients with AML. Furthermore, the role of HLI infusion was explored in a mouse model. The clinical trial included 29 elderly patients (median age: 64, range 57-77) with AML. Sixteen cases achieved complete remission (CR) and 9 cases achieved partial remission (PR) after the first treatment cycle...
August 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28877042/hematopoietic-cell-transplantation-for-aplastic-anemia
#7
Rajat Kumar, Carmem Bonfim, Biju George
PURPOSE OF REVIEW: Improvements in allogeneic hematopoietic cell transplantation (HCT) with better donor selection, conditioning regimens and graft vs. host disease prophylaxis make it reasonable to move HCT earlier in the algorithm for management of severe aplastic anemia (SAA). Recent progress in transplantation is reviewed whereas issues related to developing countries are also addressed. RECENT FINDINGS: Multiple research centers are reporting on clonality, mutations and RK1 telomere disorders in SAA, which may help to choose the most appropriate therapy upfront...
September 4, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28867344/nk-cell-alloreactivity-against-kir-ligand-mismatched-hla-haploidentical-tissue-derived-from-hla-haplotype-homozygous-ipscs
#8
Hiroshi Ichise, Seiji Nagano, Takuya Maeda, Masaki Miyazaki, Yuki Miyazaki, Hiroto Kojima, Nobuyo Yawata, Makoto Yawata, Hidenori Tanaka, Hiroh Saji, Kyoko Masuda, Hiroshi Kawamoto
HLA haplotype-homozygous (HLA-homo) induced pluripotent stem cells (iPSCs) are being prepared to be used for allogeneic transplantation of regenerated tissue into recipients carrying an identical haplotype in one of the alleles (HLA-hetero). However, it remains unaddressed whether natural killer (NK) cells respond to these regenerated cells. HLA-C allotypes, known to serve as major ligands for inhibitory receptors of NK cells, can be classified into group 1 (C1) and group 2 (C2), based on their binding specificities...
September 12, 2017: Stem Cell Reports
https://www.readbyqxmd.com/read/28865971/haploidentical-hematopoietic-stem-cell-transplantation-for-myelodysplastic-syndrome
#9
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
This study aimed at validating the predictive ability of the Center for International Blood and Marrow Transplant Research (CIBMTR) prognostic scoring system on the outcomes of patients with myelodysplastic syndromes (MDS) who had received human leukocyte antigen (HLA)-haploidentical related donor hematopoietic stem cell transplantation (haplo-HSCT). We also tried to propose and validate a more suitable prognostic scoring system. A total of 157 patients with MDS, who received haplo-HSCT, were enrolled. The CIBMTR prognostic scoring system could predict the 2-year clinical outcomes after haplo-HSCT, but failed to predict the 100-day clinical outcomes after haplo-HSCT...
August 30, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28865164/viral-specific-t-cell-response-in-hemorrhagic-cystitis-after-haploidentical-donor-stem-cell-transplantation
#10
Nopporn Apiwattanakul, Suradej Hongeng, Usanarat Anurathapan, Samart Pakakasama, Supanart Srisala, Chonnamet Techasaensiri, Borje S Andersson
Viral hemorrhagic cystitis (HC) after hematopoietic stem cell transplantation (HSCT) can be devastating. Standard treatment modalities have not been well established, but immune reconstitution may be necessary for sustained viral clearance. We studied five pediatric patients who developed viral HC after haplo-identical HSCT. All patients developed virus-specific CD4- and CD8-positive T cells, and the emergence of these viral-specific T cells was temporally associated with successful viral clearance. This article is protected by copyright...
September 2, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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
#11
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/28860000/pre-engraftment-bloodstream-infections-after-allogeneic-hematopoietic-cell-transplantation-the-impact-of-t-repleted-transplant-from-haploidentical-donors
#12
Malgorzata Mikulska, Anna Maria Raiola, Federica Galaverna, Elisa Balletto, Maria Lucia Borghesi, Riccardo Varaldo, Francesca Gualandi, Livia Giannoni, Giordana Pastori, Daniele Roberto Giacobbe, Alessio Signori, Valerio Del Bono, Claudio Viscoli, Andrea Bacigalupo, Emanuele Angelucci
Bloodstream infections (BSI) are frequent and important infectious complications after hematopoietic cell transplantation (HCT). The aim of this study was to analyze the incidence, risk factors and outcome of pre-engraftment BSI after allogeneic HCT. A retrospective analysis of data from 553 consecutive patients transplanted in years 2010-2016 was performed. Sixty percent of patients received T-repleted unmanipulated haploidentical bone marrow with high dose post-transplant cyclophosphamide. BSI rate was 30%; among isolated 213 pathogens, 54% were Gram-positive, 43% Gram-negative and 3% fungi...
August 28, 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
#13
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/28857712/a-novel-drug-interaction-between-busulfan-and-blinatumomab
#14
Karen Sweiss, John G Quigley, Annie Oh, Jonathan Lee, Rosa Ye, Damiano Rondelli, Pritesh Patel
Busulfan is an alkylating agent used in pre-transplant conditioning for patients undergoing hematopoietic stem cell transplantation. Several factors contribute to variations in busulfan drug disposition including bioavailability, age, liver function, genetic polymorphisms, and concurrent administration of other drugs. Busulfan is metabolized by hepatic oxidation via the cytochrome P450 3A4 system as well as through conjugation with glutathione. Interactions with drugs such as phenytoin, itraconazole, and metronidazole have been reported to alter busulfan clearance and result in sub- or supra-therapeutic concentrations...
January 1, 2017: Journal of Oncology Pharmacy Practice
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
#15
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
#16
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
#17
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
https://www.readbyqxmd.com/read/28844946/impact-of-fluid-overload-as-new-toxicity-category-on-hematopoietic-stem-cell-transplant-outcomes
#18
Gabriela Rondón, Rima M Saliba, Julianne Chen, Celina Ledesma, Amin M Alousi, Betul Oran, Chitra M Hosing, Partow Kebriaei, Issa F Khouri, Elizabeth J Shpall, Uday R Popat, Richard E Champlin, Stefan O Ciurea
Fluid overload (FO) is commonly seen during hospitalization for allogeneic hematopoietic stem-cell transplantation (AHSCT). We hypothesized that FO is associated with transplant outcomes and evaluated this complication in two cohorts of patients and graded based on post-transplant weight gain, symptoms, and need for treatment, and was scored in real time by an independent team. The first cohort (study cohort) underwent haploidentical transplantation for hematologic malignancies (N=145) following a melphalan-based conditioning regimen...
August 24, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28838796/nk-cell-based-immunotherapy-for-cancer
#19
REVIEW
Fang Fang, Weihua Xiao, Zhigang Tian
Natural killer (NK) cells can induce an antigen-independent immune response against malignant cells. A growing number of scientific reports and clinical studies have shown promising anti-tumor effects when using NK cell-based immunotherapy. Currently, various approaches are being used to enhance the number and function of NK cells. One approach uses cytokines to selectively boost both the number as well as the efficacy of anti-tumor functions of NK cells. Another emerging approach focuses on checkpoint inhibitors targeting the NK cell receptor...
August 21, 2017: Seminars in Immunology
https://www.readbyqxmd.com/read/28837858/risk-factors-for-herpes-simplex-virus-1-2-viremia-and-clinical-outcomes-following-unmanipulated-haploidentical-haematopoietic-stem-cell-transplantation
#20
Fei-Fei Tang, Xiao-Su Zhao, Lan-Ping Xu, Xiao-Hui Zhang, Yu-Hong Chen, Xiao-Dong Mo, Yu-Qian Sun, Kai-Yan Liu, Xiao-Jun Huang
BACKGROUND: Herpes simplex virus (HSV)-1/2 can still be reactivated after allogeneic haematopoietic stem cell transplantation (allo-HSCT) even when the prophylactic acyclovir is used. However, the risk factors for HSV-1/2 viremia and the clinical outcomes following unmanipulated haploidentical HSCT remain unknown. OBJECTIVES AND STUDY DESIGN: Nineteen patients with HSV-1/2 viremia and fifty-seven patients without HSV-1/2 viremia which were selected using the case-pair method after undergoing haploidentical HSCT were enrolled...
August 4, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
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