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Hannah K Choe, Usama Gergis, Sebastian A Mayer, Himanshu Nagar, Adrienne A Phillips, Tsiporah B Shore, Michael J Smith, Koen van Besien
BACKGROUND: Preliminary evidence indicates that the addition of low dose TBI (2-4 Gy) to reduced intensity conditioning may reduce the rate of relapse in allogeneic stem cell transplants. In very high risk patients receiving combination haploidentical-single unit cord blood transplants, we have added 4 Gy TBI to the widely used fludarabine, melphalan conditioning regimen, in hopes of reducing relapse and decreasing graft rejection. METHODS: We retrospectively reviewed the posttransplant outcomes of patients who underwent haplo-cord SCT between May 2013 and March 2015 and who received fludarabine 30mg/m2 D-7 to -3, melphalan 140mg/m2 D-2, and 2 Gy TBI D-4 and -3...
October 19, 2016: Transplantation
Annalisa Ruggeri, Yuqian Sun, Myriam Labopin, Andrea Bacigalupo, Francesca Lorentino, William Arcese, Stella Santarone, Zafar Gülbas, Didier Blaise, Giuseppe Messina, Ardeshi Ghavamzadeh, Florent Malard, Benedetto Bruno, Jose Luis Diez-Martin, Yener Koc, Fabio Ciceri, Mohamad Mohty, Arnon Nagler
Severe graft-versus-host-disease is a major barrier for non T-cell-depleted haploidentical stem cell transplantation and there is no consensus on the optimal GVHD prophylaxis. This study compared the two most commonly used graft-versus-host-disease prophylaxis regimens (post-transplant-cyclophosphamide-based (PTCY) versus the anti-thymocyte-globulin-based (ATG)) in adults with acute myeloid leukemia reported to the european society for blood and bone marrow transplantation. 308 patients were analyzed, 193 received PTCY and 115 ATG as anti- graft-versus-host-disease prophylaxis...
October 6, 2016: Haematologica
Xiao-Su Zhao, Ya-Zhen Qin, Yan-Rong Liu, Ying-Jun Chang, Lan-Ping Xu, Xiao-Hui Zhang, Xiao-Jun Huang
The minimal residual disease (MRD) before and after a haploidentical hematopoietic stem cell transplantation (HSCT) of 86 patients with acute myeloid leukemia (AML) in complete remission (CR) was measured using flow cytometry (FCM) and Wilms tumor 1 (WT1). In all, 18 patients met the criteria of pre-MRD + before HSCT. The FCM + (p = .028) and the combinative criteria for positive MRD (MRDco+) (p = .022) post-transplantation were significantly correlated to relapse in univariate analysis. A multivariate analysis showed that only MRDco + post-transplantation was an independent risk factor of leukemia relapse (p = ...
October 12, 2016: Leukemia & Lymphoma
Leylagul Kaynar, Koray Demir, Esra Ermiş Turak, Çiğdem Pala Öztürk, Gökmen Zararsız, Zeynep Burçin Gönen, Selma Gökahmetoğlu, Serdar Şıvgın, Bülent Eser, Yavuz Köker, Musa Solmaz, Ali Ünal, Mustafa Çetin
INTRODUCTION: The use of αβ+ T-cell-depleted grafts is a novel approach to prevent graft failure, graft-versus-host disease (GVHD), and non-relapse mortality (NRM) in patients undergoing haploidentical hematopoietic stem cell transplantation. PATIENT AND METHOD: Thirty-four patients with acute leukemia and lacking a match donor were treated with αβ T-cell-depleted allografts from haploidentical family donors. A total of 24 patients had acute myeloid leukemia (AML) and 10 had acute lymphoblastic leukemia...
October 10, 2016: Hematology (Amsterdam, Netherlands)
Hong-Hua Li, Fei Li, Chun-Ji Gao, Wen-Rong Huang, Jian Bo, Li-Ping Dou, Li-Li Wang, Yu Jing, Lu Wang, Wen-Jun Li, Li Yu, Dai-Hong Liu
The features of graft-versus-host disease (GVHD) were compared between patients who underwent myeloablative conditioning and received a peripheral blood stem cell transplant (PBSCT) from either a haploidentical donor (HID) or a matched sibling donor (MSD) during the same period of time. The HID group included more patients with advanced disease. Both groups received the same GVHD prophylaxis with the addition of antithymoglobulin (ATG) in HID group. Higher cumulative incidences (CI) of acute GVHD grade 2-4 (35·1% vs...
October 7, 2016: British Journal of Haematology
Antonella Mancusi, Loredana Ruggeri, Andrea Velardi
The present review describes the biology of human leukocyte antigen (HLA) haplotype mismatched ("haploidentical") transplantation, its translation to clinical practice to cure leukemia and the results of current transplantation protocols. The 1990s saw what had been major drawbacks of haploidentical transplantation, i.e., very strong host-versus-graft and graft-versus-host alloresponses which led respectively to rejection and graft-versus-host disease (GVHD), being overcome through transplantation of a "mega-dose" of T cell-depleted peripheral blood hematopoietic progenitor cells and no posttransplant pharmacological immunosuppression...
October 3, 2016: Blood
Raffaella Greco, Lara Crucitti, Maddalena Noviello, Sara Racca, Daniele Mannina, Alessandra Forcina, Francesca Lorentino, Veronica Valtolina, Serena Rolla, Roee Dvir, Mara Morelli, Fabio Giglio, Maria Chiara Barbanti, Maria Teresa Lupo Stanghellini, Chiara Oltolini, Luca Vago, Paolo Scarpellini, Andrea Assanelli, Matteo G Carrabba, Sarah Marktel, Massimo Bernardi, Consuelo Corti, Massimo Clementi, Jacopo Peccatori, Chiara Bonini, Fabio Ciceri
Human herpesvirus 6 (HHV-6) is increasingly recognized as a potentially life-threatening pathogen in allogeneic hematopoietic stem cell transplantation (alloSCT). We retrospectively evaluated 54 adult patients who developed positivity to HHV-6 after alloSCT. The median time from alloSCT to HHV-6 reactivation was 34 days. HHV-6 was present in plasma samples from 31 patients, in bone marrow (BM) of 9 patients, in bronchoalveolar lavage fluid and liver or gut biopsy specimens from 33 patients, and in cerebrospinal fluid of 7 patients...
September 30, 2016: Biology of Blood and Marrow Transplantation
Jeff Chang, Scott S Graves, Tiffany Butts-Miwongtum, George E Sale, Rainer Storb, David W Mathes
BACKGROUND: The development of safe and reliable protocols for the transplantation of the face and hands may be accomplished with animal modeling of transplantation of vascularized composite allografts (VCA). Previously, we demonstrated that tolerance to a VCA could be achieved after canine recipients were simultaneously given marrow from a dog leukocyte antigen (DLA) identical donor. In the present study, we extend those findings across a DLA mismatched barrier. METHODS: Eight Recipient dogs received total body irradiation (4...
September 27, 2016: Transplantation
P Navarria, B Sarina, L Castagna, A Rimondo, L Morabito, P Mancosu, A Santoro, M Scorsetti
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Roberto Crocchiolo, Laura Giordano, Andrea Rimondo, Muriel Bologna, Barbara Sarina, Lucio Morabito, Stefania Bramanti, Luca Castagna, Rossana Mineri
BACKGROUND AND OBJECTIVES: Since HHV-6 reactivation after transplant has been reported to increase the risk of CMV infection, we tested this hypothesis in the HLA-haploidentical hematopoietic stem cell transplantation setting. STUDY DESIGN: From February 2011 to October 2015, 75 patients received hematopoietic stem cell transplantation using a T-cell replete graft from a HLA-haploidentical donor at our Institution. RESULTS: Interestingly, 87% of HHV-6 reactivations were followed by a CMV reactivation, at a median of 15days between the two viruses...
September 20, 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
C Cho, M A Perales
No abstract text is available yet for this article.
September 26, 2016: Bone Marrow Transplantation
Lei Gao, Yuqian Sun, Fanyi Meng, Mingzhe Han, He Huang, Depei Wu, Li Yu, Hanyun Ren, Xiaojun Huang, Xi Zhang
BACKGROUND: Antifungal prophylaxis is currently regarded as the gold standard in situations with allo-genetic hematopoietic stem cell transplantation (allo-HSCT). However, the epidemiological information regarding prophylaxis of invasive fungal diseases (IFDs) is not clear in China. METHODS: We report the first large-scale (1053 patients) observational study of the prophylaxis and management of IFDs among patients with allo-HSCT in China. RESULTS: The incidence rates of IFD after primary antifungal prophylaxis (PAP), secondary antifungal prophylaxis (SAP), and non-prophylaxis were 22...
2016: Journal of Hematology & Oncology
Aziza T Shad, Jeffrey S Huo, Courtney Darcy, Amal Abu-Ghosh, Giuseppe Esposito, Mary-Jo Holuba, Nancy Robey, Kenneth R Cooke, Heather J Symons, Allen R Chen, Nicolas J Llosa
To date, there has been a lack of pediatric experience regarding the efficacy and tolerability of immune checkpoint inhibitors after haploidentical hematopoietic stem cell transplant (HSCT). We present the case of a 22-year-old female with multiple-relapsed Hodgkin lymphoma (HL) who presented with a new relapse after haploidentical (post-haplo) HSCT. Anti-PD-1 therapy with nivolumab resulted in significant objective disease response and clinical improvement without notable side effects, including the absence of a graft-versus-host disease (GVHD)...
September 21, 2016: Pediatric Blood & Cancer
S Eder, M Labopin, J Finke, D Bunjes, A Olivieri, S Santarone, A Rambaldi, L Kanz, G Messina, M Mohty, A Nagler
This study evaluated the safety and efficacy of thiotepa-based regimens before allogeneic stem cell transplantation in 310 adult patients with AML. Disease status at the time of transplantation was CR1 in 50%, CR2+ in 23.5% and advanced disease in 26.5%. Transplantation was performed from haploidentical (35%), matched sibling (27%), unrelated (20%) or cord blood (18%) donors. As for safety: mucositis occurred in 46.8% of the patients and the cumulative incidence (CI) of sinusoidal obstruction syndrome was 4...
September 19, 2016: Bone Marrow Transplantation
A M Willasch, E Salzmann-Manrique, T Krenn, M Duerken, J Faber, J Opper, H Kreyenberg, R Bager, S Huenecke, C Cappel, M Bremm, V Pfirrmann, M Merker, E Ullrich, S Bakhtiar, E Rettinger, A Jarisch, J Soerensen, T E Klingebiel, P Bader
Therapy for post-transplant relapse of paediatric ALL is limited. Standardised curative approaches are not available. We hereby describe our local procedure in this life-threatening situation. A total of 101 ALL patients received their first allogeneic stem cell transplantation (SCT) in our institution. After relapse, our primary therapeutic goal was to cure the patient with high-dose chemotherapy or specific immunotherapy (HDCHT/SIT) followed by a second SCT from a haploidentical donor (transplant approach)...
September 19, 2016: Bone Marrow Transplantation
Alexandra F Freeman, Nirali N Shah, Mark Parta, Helen C Su, Alessandra Brofferio, Irma Gradus-Pizlo, Sabah Butty, Thomas E Hughes, David E Kleiner, Daniele Avila, Theo Heller, Heidi H Kong, Steven M Holland, Dennis D Hickstein
No abstract text is available yet for this article.
September 15, 2016: Journal of Allergy and Clinical Immunology in Practice
Mirei Horiuchi, Hoyuri Fuseya, Minako Tsutsumi, Yoshiki Hayashi, Kiyoyuki Hagihara, Hiroshi Kanashima, Takafumi Nakao, Yuko Fukushima, Takeshi Inoue, Takahisa Yamane
Double-hit lymphomas are rare tumors that are defined by a chromosomal breakpoint affecting the MYC/8q24 locus in combination with another recurrent breakpoint, mainly a t(14; 18)(q32;q21)involving BCL2. We report a case of a 38-yearold woman with a 2-month history of abdominaldistention. 18F-FDG PET showed multiple positive systemic lymph nodes, positive peritoneum, and multiple positive intra-abdominal masses. Histopathology results of the cervical lymph node were compatible with double-hit follicular lymphoma(Grade 3A)because fluorescence in situ hybridization(FISH)demonstrated both MYC rearrangement and BCL2 gene fusion...
September 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Gan-Lin He, Ying-Jun Chang, Lan-Ping Xu, Xiao-Hui Zhang, Yu Wang, Kai-Yan Liu, Xiao-Jun Huang
BACKGROUND: So far, there is very little literature on how pre-transplant pulmonary infection developed in horizontal laminar flow unit (HLFU) affects outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: A retrospective analysis was performed on allo-HSCT recipients who were diagnosed with pre-transplant pulmonary infection developed in HLFU between January 2012 and December 2012. Various tests were analyzed to evaluate the overall survival (OS) and pulmonary infection rate after allo-HSCT...
August 2016: Journal of Thoracic Disease
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
Allogeneic hematopoietic stem cell transplantation (HSCT) is an important therapy option for children with acute myeloid leukemia (AML) resistant to the first course of induction chemotherapy (IC1st). We aimed to identify the efficacy of unmanipulated haploidentical HSCT (haplo-HSCT) in children with AML in the first complete remission and whether children resistant (IC1st-resistant; n = 38) or sensitive (IC1st-sensitive; n = 59) to the IC1st can achieve comparable outcomes. The cumulative incidence of grades III to IV acute graft-versus-host disease (GVHD) and severe chronic GVHD was ...
September 7, 2016: Biology of Blood and Marrow Transplantation
George E Georges, Rainer Storb
PURPOSE OF REVIEW: There has been a steady improvement in outcomes with allogeneic bone marrow transplantation (BMT) for severe aplastic anemia (SAA), because of progress in optimization of the conditioning regimens, donor hematopoietic cell source, and supportive care. Here, we review recently published data that highlight the improvements and current issues in the treatment of SAA. RECENT FINDINGS: Approximately one-third of aplastic anemia patients treated with immune suppressive therapy (IST) have acquired mutations in myeloid cancer candidate genes...
November 2016: Current Opinion in Hematology
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