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Graft versus host disease

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https://www.readbyqxmd.com/read/29330757/-myelodysplastic-syndrome-acute-leukemia-and-stem-cell-transplantation
#1
REVIEW
M Schmalzing, M Aringer, M Bornhäuser, J Atta
Myelodysplastic syndromes (MDS) represent a heterogeneous group of clonal hematopoietic stem cell disorders. They are characterized by inefficient hematopoiesis leading to peripheral cytopenia of one or more lineages and a variable risk of transformation into acute myeloid leukemia. They may either arise de novo as well as following exposition to environmental toxins, previous radiotherapy or chemotherapy or in the context of autoinflammatory diseases and related therapy. Characteristic cytogenetic abnormalities, along with the numbers of hematopoietic lineages affected and bone marrow blasts, enable an assessment of the risk of leukemic transformation...
October 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29330402/chronic-graft-versus-host-disease-features-in-double-unit-cord-blood-transplantation-according-to-national-institutes-of-health-2005-cgvhd-consensus-criteria
#2
Hiromi Hayashi, Annalisa Ruggeri, Fernanda Volt, Jan J Cornelissen, Gerard Socié, Henrik Sengeloev, Mauricette Michallet, Dimitrios Karakasis, Eefke Petersen, Jean Yves Cahn, Hendrik Veelken, Mélanie Mercier, Pierre-Simon Rohrlich, Hanadi Rafii, Chantal Kenzey, Erick Xavier, Rafael F Duarte, Grzegorz W Basak, Vanderson Rocha, Eliane Gluckman
No abstract text is available yet for this article.
January 12, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29330269/central-nervous-system-graft-versus-host-disease-cns-gvhd-after-allogeneic-haematopoietic-stem-cell-transplantation
#3
Karolina Polchlopek Blasiak, Federico Simonetta, Maria-Isabel Vargas, Yves Chalandon
A 60-year-old man presented with impaired consciousness and psychomotor agitation after a second allogeneic haematopoietic stem cell transplantation (HSCT) from a matched unrelated donor for acute myeloid leukaemia. Clinical, biological and radiological evidence suggested a diagnosis of central nervous system graft-versus-host disease (CNS-GvHD). After intrathecal infusion of methylprednisolone, the clinical symptoms as well as the radiological abnormalities disappeared. The present report illustrates the difficulties in the diagnosis and the management of CNS-GvHD, a very rare and still challenging neurological complication that can occur after allogeneic HSCT...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29330112/macrochimerism-and-clinical-transplant-tolerance
#4
REVIEW
John D Scandling, Stephan Busque, Robert Lowsky, Judith Shizuru, Asha Shori, Edgar Engleman, Kent Jensen, Samuel Strober
Current theory holds that macrochimerism is essential to the development of transplant tolerance. Hematopoietic cell transplantation from the solid organ donor is necessary to achieve macrochimerism. Over the last 10 to 20 years, trials of tolerance induction with combined kidney and hematopoietic cell transplantation have moved from the preclinical to the clinical arena. The achievement of macrochimerism in the clinical setting is challenging, and potentially toxic due to the conditioning regimen necessary to hematopoietic cell transplantation and due to the risk of graft-versus-host disease...
January 9, 2018: Human Immunology
https://www.readbyqxmd.com/read/29326852/unusual-course-of-crystalline-keratopathy-in-a-patient-with-graft-versus-host-disease
#5
Başak Bostancı, Yonca Aydın Akova
We present a case of infectious crystalline keratopathy in a patient with Graft-versus-Host disease (GVHD) who developed satellite fungal keratitis. A 51-year-old man was referred for bilateral total persistent corneal epithelial defects with severe dry eye. Although persistent epithelial defect healed with medical therapy, he developed stromal keratitis with satellite lesions confirmed to be secondary to Candida albicans. After three months of antifungal treatment and debridement, improvement of the infiltrates was obtained...
December 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/29326124/bortezomib-based-immunosuppression-after-reduced-intensity-conditioning-hematopoietic-stem-cell-transplantation-randomized-phase-ii-results
#6
John Koreth, Haesook T Kim, Paulina B Lange, Samuel J Poryanda, Carol G Reynolds, Sharmila Chamling Rai, Philippe Armand, Corey S Cutler, Vincent T Ho, Brett Glotzbecker, Rushdia Yusuf, Sarah Nikiforow, Yi-Bin Chen, Bimalangshu Dey, Malgorzata McMasters, Jerome Ritz, Bruce R Blazar, Robert J Soiffer, Joseph H Antin, Edwin P Alyea
A prior phase I/II trial of bortezomib/tacrolimus/methotrexate prophylaxis after HLA-mismatched reduced intensity conditioning allogeneic hematopoietic stem cell transplantation documented low acute graft versus host disease incidence, with promising overall and progression-free survival. We performed an open-label 3-arm 1:1:1 phase II randomized-controlled-trial comparing grade II-IV acute graft versus host disease between conventional tacrolimus/methotrexate (A) versus bortezomib/tacrolimus/methotrexate (B); and versus bortezomib/sirolimus/tacrolimus (C), in reduced intensity conditioning allogeneic transplantation recipients lacking HLA-matched related donors...
January 11, 2018: Haematologica
https://www.readbyqxmd.com/read/29325830/blood-and-marrow-transplant-clinical-trials-network-report-on-development-of-novel-endpoints-and-selection-of-promising-approaches-for-graft-versus-host-disease-prevention-trials
#7
Marcelo C Pasquini, Brent Logan, Richard J Jones, Amin M Alousi, Frederick R Appelbaum, Javier Bolaños-Meade, Mary E D Flowers, Sergio Giralt, Mary M Horowitz, David Jacobsohn, John Koreth, John E Levine, Leo Luznik, Richard Maziarz, Adam Mendizabal, Steven Pavletic, Miguel-Angel Perales, David Porter, Ran Reshef, Daniel Weisdorf, Joseph H Antin
Graft versus host disease (GVHD) is a common complication after hematopoietic cell transplantation (HCT) and associated with significant morbidity and mortality. Preventing GVHD without chronic therapy or increasing relapse is a desired goal. Here, we report a benchmark analysis to evaluate the performance of six GVHD prevention strategies tested at single institutions compared to a large multicenter outcomes database as a control. Each intervention was compared to the control for the incidence of acute and chronic GVHD and overall survival and against novel composite endpoints: acute and chronic GVHD, relapse-free survival (GRFS) and chronic GVHD, relapse-free survival (CRFS)...
January 8, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29322835/toxic-epidermal-necrolysis-versus-cutaneous-graft-versus-host-disease-in-a-hematopoietic-stem-cell-transplant-recipient-the-role-of-elafin
#8
Alessandra Chen, Kevin Chao, Lina Rodriguez, William Munday, Scott Worswick
No abstract text is available yet for this article.
January 11, 2018: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/29317998/new-and-emerging-therapies-for-acute-and-chronic-graft-versus-host-disease
#9
REVIEW
LaQuisa Hill, Amin Alousi, Partow Kebriaei, Rohtesh Mehta, Katayoun Rezvani, Elizabeth Shpall
Graft versus host disease (GVHD) remains a major cause of morbidity and mortality following allogeneic hematopoietic stem-cell transplantation (HSCT). Despite the use of prophylactic GVHD regimens, a significant proportion of transplant recipients will develop acute or chronic GVHD following HSCT. Corticosteroids are standard first-line therapy, but are only effective in roughly half of all cases with ~50% of patients going on to develop steroid-refractory disease, which increases the risk of nonrelapse mortality...
January 2018: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/29316837/ruxolitinib-for-the-treatment-of-patients-with-steroid-refractory-gvhd-an-introduction-to-the-reach-trials
#10
Madan Jagasia, Robert Zeiser, Michael Arbushites, Patricia Delaite, Brian Gadbaw, Nikolas von Bubnoff
For patients with hematologic malignancies and disorders, allogeneic hematopoietic stem cell transplantation offers a potentially curative treatment option. Many patients develop graft-versus-host disease (GVHD), a serious complication and leading cause of nonrelapse mortality. Corticosteroids are the standard first-line treatment for GVHD; however, patients often become steroid-refractory or remain corticosteroid-dependent. New second-line treatment options are needed to improve patient outcomes. Here we review the role of JAK1 and JAK2 in acute and chronic GVHD...
January 10, 2018: Immunotherapy
https://www.readbyqxmd.com/read/29311761/plasma-vascular-non-inflammatory-molecule-3-is-associated-with-gastrointestinal-acute-graft-versus-host-disease-in-mice
#11
Na Wang, Xiaoyi Qin, Yigeng Cao, Bin Liang, Kang Yu, Haige Ye
Background: Gastrointestinal acute graft-versus-host disease (GI aGVHD) is a lethal complication following allogeneic hematopoietic stem cell transplantation (HSCT). However, it is still very difficult to make a diagnosis of GI aGVHD in practice. To date, no consensus plasma biomarker of GI aGVHD can be used to help make a diagnosis. Here, we attempted to identify GI aGVHD associated plasma proteins in murine model, which can help make a diagnosis of GI aGVHD. Methods: We used 8-plex isobaric tags for relative and absolute quantitation (8-plex iTRAQ) to screen out proteins in plasma samples taken from murine models before and after allogeneic HSCT...
2018: Journal of Inflammation
https://www.readbyqxmd.com/read/29309836/ocular-complications-in-a-young-pediatric-population-following-bone-marrow-transplantation
#12
Mary Ellen Hoehn, Julie Calderwood, Edwin Gannon, Brittany Cook, Richard Rochester, Christine Hartford, Brandon Triplett, Anusha Sunkara, Guolian Kang, R Christopher Walton
PURPOSE: To investigate ocular complications associated with bone marrow transplant and associated continued maintenance therapy in a preschool population. METHODS: The medical records of patients <7 years of age were reviewed retrospectively. Patient charts were screened for cataract formation, dry eye, and other anterior and posterior segment disease. RESULTS: Of 270 cases reviewed, 91 met inclusion criteria. Mean age at diagnosis was 3...
January 5, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/29307717/peri-transplant-rbc-transfusion-is-associated-with-increased-risk-of-gvhd-after-allogeneic-stem-cell-transplantation
#13
Sakura Hosoba, Edmund K Waller, Neeta Shenvi, Michael Graiser, Kirk A Easley, Zaid Al-Kadhimi, Akira Andoh, Ana G Antun, Sheliagh Barclay, Cassandra D Josephson, Jean L Koff, H Jean Khoury, Amelia A Langston, James C Zimring, John D Roback, Cynthia R Giver
More than 90% of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients receive red blood cell (RBC) or platelet transfusions in the peritransplant period. We tested the hypothesis that transfusions are associated with development of severe acute graft-versus-host disease (grade III/IV aGvHD) or mortality in allo-HSCT in a retrospective study of 322 consecutive patients receiving allogeneic bone marrow or G-CSF-mobilized blood stem cell grafts for hematological malignancies. Counting RBC and platelet units between day -7 pre-transplant and +27 post-transplant, but excluding transfusions administered after a diagnosis of aGvHD, yielded medians of 5 RBC and 2 platelet units transfused...
January 4, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29305194/cd34-selection-vs-reduced-intensity-conditioning-and-unmodified-graft-for-allogeneic-hematopoietic-cell-transplantation-in-patients-with-aml-and-mds-50-years
#14
Pere Barba, Rodrigo Martino, Qin Zhou, Christina Cho, Hugo Castro-Malaspina, Sean Devlin, Albert Esquirol, Sergio Giralt, Ann A Jakubowski, Dolores Caballero, Molly Maloy, Esperanza B Papadopoulos, José Luís Piñana, María Laura Fox, Francisco Márquez, David Valcárcel, Carlos Solano, Lucía López-Corral, Jorge Sierra, Miguel-Angel Perales
Reduced-intensity conditioning (RIC) and t-cell depletion (TCD) through CD34+ selection without the use of post-transplant immunosuppression are 2 strategies used to reduce non-relapse mortality (NRM) in older patients after allogeneic hematopoietic cell transplantation (allo-HCT). To compare the efficacy of both approaches (RIC and TCD), we evaluated the outcomes of AML and MDS patients > 50 years who underwent allo-HCT from an HLA-matched donor with one of these strategies. Baseline characteristics were comparable between patients receiving TCD (n=204) and RIC (n=151) except for more unrelated donors (68% vs...
January 2, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29304213/echinocandin-prophylaxis-in-patients-undergoing-haematopoietic-cell-transplantation-and-other-treatments-for-haematological-malignancies
#15
David J Epstein, Susan K Seo, Janice M Brown, Genovefa A Papanicolaou
Antifungal prophylaxis is the standard of care for patients undergoing intensive chemotherapy for haematological malignancy or haematopoietic cell transplantation (HCT). Prophylaxis with azoles reduces invasive fungal infections and may reduce mortality. However, breakthrough infections still occur, and the use of azoles is sometimes complicated by pharmacokinetic variability, drug interactions, adverse events and other issues. Echinocandins are highly active against Candida species, including some organisms resistant to azoles, and have some clinical activity against Aspergillus species as well...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29304116/the-sorafenib-anti-relapse-effect-after-allohsct-is-associated-with-heightened-alloreactivity-and-accumulation-of-cd8-pd-1-cd279-lymphocytes-in-marrow
#16
Andrzej Lange, Emilia Jaskula, Janusz Lange, Grzegorz Dworacki, Dorota Nowak, Aleksandra Simiczyjew, Monika Mordak-Domagala, Mariola Sedzimirska
We studied three FLT3 ITD acute myeloid leukemia (AML) patients who relapsed after allogeneic haematopoietic stem cell transplantation (alloHSCT) and received multikinase inhibitor (MKI) sorafenib as part of salvage therapy. MKI was given to block the effect of FLT3 ITD mutation which powers proliferation of blast cells. However, the known facts that sorafenib is more effective in patents post alloHSCT suggested that this MKI can augment the immune system surveillance on leukaemia. In the present study, we investigated in depth the effect of sorafenib on the alloreactivity seen post-transplant including that on leukaemia...
2018: PloS One
https://www.readbyqxmd.com/read/29296949/th17-plasticity-and-transition-toward-a-pathogenic-cytokine-signature-are-regulated-by-cyclosporine-after-allogeneic-sct
#17
Kate H Gartlan, Antiopi Varelias, Motoko Koyama, Renee J Robb, Kate A Markey, Karshing Chang, Andrew N Wilkinson, David Smith, Md Ashik Ullah, Rachel D Kuns, Neil C Raffelt, Stuart D Olver, Katie E Lineburg, Bianca E Teal, Melody Cheong, Michele W L Teng, Mark J Smyth, Siok-Keen Tey, Kelli P A MacDonald, Geoffrey R Hill
T-helper 17 (Th17) cells have been widely implicated as drivers of autoimmune disease. In particular, Th17 cytokine plasticity and acquisition of an interleukin-17A+(IL-17A+)interferon γ(IFNγ)+ cytokine profile is associated with increased pathogenic capacity. Donor Th17 polarization is known to exacerbate graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT); however, donor Th17 cytokine coexpression and plasticity have not been fully characterized. Using IL-17 "fate-mapping" mice, we identified IL-6-dependent Th17 cells early after allo-SCT, characterized by elevated expression of proinflammatory cytokines, IL-17A, IL-22, granulocyte-macrophage colony-stimulating factor, and tumor necrosis factor...
February 14, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296892/allogeneic-bone-marrow-transplant-in-the-absence-of-cytoreductive-conditioning-rescues-mice-with-%C3%AE-thalassemia-major
#18
Yongliang Huo, Jonathan R Lockhart, Shanrun Liu, Suean Fontenard, Mike Berlett, Thomas M Ryan
β-thalassemia is a group of inherited blood disorders that result in defects in β-globin chain production. Cooley anemia (CA), or β-thalassemia major, is the most severe form of the disease and occurs when an individual has mutations in both copies of the adult β-globin gene. Patients with CA fail to make adult hemoglobin, exhibit ineffective erythropoiesis, experience severe anemia, and are transfusion dependent for life. Currently, allogeneic bone marrow transplantation (BMT) is the only cure; however, few patients have suitable donors for this procedure, which has significant morbidity and mortality...
November 28, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296875/vaccination-with-autologous-myeloblasts-admixed-with-gm-k562-cells-in-patients-with-advanced-mds-or-aml-after-allogeneic-hsct
#19
Vincent T Ho, Haesook T Kim, Natalie Bavli, Martin Mihm, Olga Pozdnyakova, Matthias Piesche, Heather Daley, Carol Reynolds, Nicholas C Souders, Corey Cutler, John Koreth, Edwin P Alyea, Joseph H Antin, Jerome Ritz, Glenn Dranoff, Robert J Soiffer
We report a clinical trial testing vaccination of autologous myeloblasts admixed with granulocyte-macrophage colony-stimulating factor secreting K562 cells after allogeneic hematopoietic stem cell transplantation (HSCT). Patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) with ≥5% marrow blasts underwent myeloblast collection before HSCT. At approximately day +30, 6 vaccines composed of irradiated autologous myeloblasts mixed with GM-K562 were administered. Tacrolimus-based graft-versus-host disease (GVHD) prophylaxis was not tapered until vaccine completion (∼day 100)...
November 14, 2017: Blood Advances
https://www.readbyqxmd.com/read/29296872/chronic-disease-burden-and-frailty-in-survivors-of-childhood-hsct-a-report-from-the-st-jude-lifetime-cohort-study
#20
Hesham M Eissa, Lu Lu, Malek Baassiri, Nickhill Bhakta, Matthew J Ehrhardt, Brandon M Triplett, Daniel M Green, Daniel A Mulrooney, Leslie L Robison, Melissa M Hudson, Kirsten K Ness
Outcomes of hematopoietic stem cell transplantation (HSCT) have markedly improved over the past 2 decades, underscoring a need to better understand the long-term health effects of this intensive treatment modality. We describe the burden of chronic medical conditions and frail health among St. Jude Lifetime Cohort Study participants treated for childhood hematologic malignancies with HSCT (n = 112) or with conventional therapy (n = 1106). Chronic conditions and frail health were ascertained clinically and classified according to a modified version of the Common Terminology Criteria for Adverse Events (version 4...
November 14, 2017: Blood Advances
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