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graft versus host disease prevention prophylaxis

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https://www.readbyqxmd.com/read/29197677/distinct-biomarker-profiles-in-ex-vivo-t-cell-depletion-graft-manipulation-strategies-cd34-selection-vs-cd3-19-depletion-in-matched-sibling-allogeneic-peripheral-blood-stem-cell-transplantation
#1
Caroline R Cantilena, Sawa Ito, Xin Tian, Prachi Jain, Fariba Chinian, Prathima Anandi, Keyvan Keyvanfar, Debbie Draper, Eleftheria Koklanaris, Sara Hauffe, Jeanine Superata, David Stroncek, Pawel Muranski, A John Barrett, Minoo Battiwalla
Various approaches have been developed for ex vivo T cell depletion in allogeneic stem cell transplantation to prevent graft versus host disease (GVHD). However, direct comparisons between T-cell depletion strategies have not been well studied. We evaluated cellular and plasma biomarkers in two different graft manipulation strategies: CD3+CD19+ cell depletion (CD3/19D) versus CD34+ selection (CD34S) and their association with clinical outcomes. Identical conditions including the myeloablative preparative regimen, HLA-identical sibling donor, GVHD prophylaxis, and graft source were used for each cohort...
November 29, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29112242/a-randomized-study-of-cyclosporine-and-methotrexate-with-or-without-methylprednisolone-for-the-prevention-of-graft-versus-host-disease-improved-long-term-survival-with-triple-prophylaxis
#2
Tapani Ruutu, Anne Nihtinen, Riitta Niittyvuopio, Eeva Juvonen, Liisa Volin
BACKGROUND: In a previously published study, the authors randomized 108 adult patients with a malignant hematologic disorder undergoing allogeneic bone marrow transplantation from a human leukocyte antigen-identical sibling to receive methylprednisolone (53 patients; MP+) or not to receive methylprednisolone (55 patients; MP-) as a part of graft-versus-host disease (GVHD) prophylaxis. All patients received cyclosporine and methotrexate. The cumulative incidence of acute GVHD was found to be significantly lower among the patients given MP...
November 7, 2017: Cancer
https://www.readbyqxmd.com/read/29100905/post-transplant-cyclophosphamide-ptcy-as-sole-gvhd-prophylaxis-is-feasible-in-patients-undergoing-peripheral-blood-stem-cell-transplantation-for-severe-aplastic-anaemia-using-matched-sibling-donors
#3
Biju George, Nisham Pn, Anup J Devasia, Uday Kulkarni, Anu Korula, Kavitha M Lakshmi, Aby Abraham, Alok Srivastava, Vikram Mathews
High-dose cyclophosphamide (PTCY) following allogeneic hematopoietic cell transplantation (HSCT) has been shown to be effective in preventing graft-versus-host disease (GVHD) following HLA-matched bone marrow transplantation. We performed a phase II study of PTCY given at 50 mg/kg IV on days 3 and 4 as sole GVHD prophylaxis following HSCT for severe aplastic anemia (SAA) receiving G-CSF-mobilized peripheral blood stem cell (PBSC) grafts from HLA-matched related donors following conditioning with fludarabine, cyclophosphamide and single dose Total Body Irradiation (TBI)...
October 31, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29061535/pharmacodynamic-monitoring-predicts-outcomes-of-ccr5-blockade-as-graft-versus-host-disease-prophylaxis
#4
Austin P Huffman, Lee P Richman, Lisa Crisalli, Alex Ganetsky, David L Porter, Robert H Vonderheide, Ran Reshef
Blocking lymphocyte trafficking after allogeneic hematopoietic stem cell transplantation is a promising strategy to prevent graft-versus-host disease (GVHD) while preserving the graft-versus-tumor response. Maraviroc, a CCR5 antagonist, has shown promise in clinical trials, presumably by disrupting the migration of effector cells to GVHD target organs. We describe a phosphoflow assay to quantify CCR5 blockade during treatment with maraviroc and used it to evaluate 28 patients in a phase II study. We found that insufficient blockade of CCR5 was associated with significantly worse overall survival (HR, 10...
October 20, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29037136/effect-of-priming-of-multipotent-mesenchymal-stromal-cells-with-interferon-%C3%AE-on-their-immunomodulating-properties
#5
N M Kapranov, Y O Davydova, I V Galtseva, N A Petinati, N I Drize, L A Kuzmina, E N Parovichnikova, V G Savchenko
Multipotent mesenchymal stromal cells (MSCs) are widely used for cell therapy, in particular for prophylaxis and treatment of graft-versus-host disease. Due to their immunomodulatory properties, MSCs affect the composition of lymphocyte subpopulations, which depends on the immunological state of the organism and can change in different diseases and during treatment. Administration of MSCs is not always effective. Treatment of MSCs with different cytokines (in particular IFN-γ) leads to enhancement of their immunomodulatory properties...
October 2017: Biochemistry. Biokhimii︠a︡
https://www.readbyqxmd.com/read/28978855/allogeneic-hematopoietic-stem-cell-transplantation-using-atg-prophylaxis-and-treatment
#6
Nobuhiro Nishio, Yoshiyuki Takahashi, Seiji Kojima
Graft versus host disease (GVHD) following allogeneic hematopoietic stem cell transplantation is associated with an increase in patient transplant-related morbidity and mortality and a decrease in quality of life. Adequate immune suppression is critical to prevent GVHD without increasing the risk of developing a severe infection or relapse of malignancy. Anti-T cell globulin (ATG) combined with other immunosuppressive drugs can reduce the risk of severe acute GVHD and extensive chronic GVHD without enhancing the rate of severe infection or relapse of malignancy...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
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
#7
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/28840382/new-photobiomodulation-protocol-prevents-oral-mucositis-in-hematopoietic-stem-cell-transplantation-recipients-a-retrospective-study
#8
Camila Weissheimer, Marina Curra, Lauro J Gregianin, Liane E Daudt, Vivian P Wagner, Marco Antonio T Martins, Manoela D Martins
Oral mucositis (OM) is an adverse side effect among hematopoietic stem cell transplantation (HSCT) recipients. The objective of this retrospective study was to evaluate the preventive effect of photobiomodulation (PBM) applied three times per week versus seven times per week in patients undergoing HSCT. The risk factors related to the incidence and severity of OM were also assessed. This was a retrospective study that evaluated 99 HSCT recipients who received different PBM protocols. Group I received three sessions per week, and group II received daily treatment...
December 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28748621/outcomes-of-matched-sibling-donor-bone-marrow-transplantation-in-children-using-single-agent-calcineurin-inhibitors-as-prophylaxis-for-graft-versus-host-disease
#9
Caitlin W Elgarten, Danielle E Arnold, Nancy J Bunin, Alix E Seif
BACKGROUND: Optimal graft versus host disease (GVHD) prophylaxis prevents severe manifestations without excess immunosuppression. Standard prophylaxis includes a calcineurin inhibitor (CNI) with low-dose methotrexate. However, single-agent CNI may be sufficient prophylaxis for a defined group of patients. Single-agent CNI has been used for GVHD prophylaxis for human leukocyte antigen (HLA)-matched sibling donor (MSD) bone marrow transplants (BMTs) in young patients at the Children's Hospital of Philadelphia for over 20 years...
January 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28731920/eye-movement-disorders-following-allogeneic-bone-marrow-transplantation-on-fk506-tacrolimus-and-ganciclovir
#10
Barbaros S Karagun, Tugana Akbas, Taner Arpaci, Bulent Antmen
FK506 (tacrolimus) is an immunosuppressive drug and more potent than cyclosporine. FK506 is widely used for immunosuppression in the prevention and treatment of graft-versus-host disease after allogeneic bone marrow transplantation and solid organ transplantation. Neurotoxicity is a recognized complication of FK506 therapy, but ptosis and weakness of eye abduction unilaterally has not been reported in association with FK506 administration to date. We discuss a 13-year-old male patient who developed ptosis and weakness of eye abduction unilaterally 90 days after transplantation with bone marrow from an unrelated donor, for acute lymphoblastic leukemia in this case report...
July 20, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28705454/efficacy-of-two-different-doses-of-rabbit-anti-t-lymphocyte-globulin-to-prevent-graft-versus-host-disease-in-children-with-haematological-malignancies-transplanted-from-an-unrelated-donor-a-multicentre-randomised-open-label-phase-3-trial
#11
RANDOMIZED CONTROLLED TRIAL
Franco Locatelli, Maria Ester Bernardo, Alice Bertaina, Carla Rognoni, Patrizia Comoli, Attilio Rovelli, Andrea Pession, Franca Fagioli, Claudio Favre, Edoardo Lanino, Giovanna Giorgiani, Pietro Merli, Daria Pagliara, Arcangelo Prete, Marco Zecca
BACKGROUND: Although rabbit anti-T-lymphocyte globulin (ATLG) is largely used for the prevention of immune-mediated complications in patients given allogeneic haemopoietic stem-cell transplantation (HSCT) from an unrelated donor, the optimum dose of this drug in children is still undefined. We aimed to test whether a higher dose of ATLG was superior to a lower dose for prevention of grade II-IV acute graft-versus-host disease (GVHD). METHODS: We conducted a multicentre, randomised, open-label, phase 3 trial in seven Italian centres comparing two different doses of ATLG (30 mg/kg vs 15 mg/kg, given intravenously over 3 days, from day -4 to -2) in children (aged 0-18 years) with haematological malignancies transplanted from an unrelated donor, selected using high-resolution typing for HLA-class I/II loci...
August 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28672883/role-of-%C3%AE-%C3%AE-t-cell-depletion-in-prevention-of-graft-versus-host-disease
#12
REVIEW
Haitham Abdelhakim, Hisham Abdel-Azim, Ayman Saad
Graft versus host disease (GVHD) represents a major complication of allogeneic hematopoietic stem cell transplantation (allo HCT). Graft cellular manipulation has been used to mitigate the risk of GVHD. The αβ T cells are considered the primary culprit for causing GVHD therefore depletion of this T cell subset emerged as a promising cellular manipulation strategy to overcome the human leukocyte antigen (HLA) barrier of haploidentical (haplo) HCT. This approach is also being investigated in HLA-matched HCT...
June 26, 2017: Biomedicines
https://www.readbyqxmd.com/read/28651341/plasma-concentrations-of-atovaquone-given-to-immunocompromised-patients-to-prevent-pneumocystis-jirovecii
#13
Christine Robin, Minh Patrick Lê, Giovanna Melica, Laurent Massias, Rabah Redjoul, Nihel Khoudour, Mathieu Leclerc, Florence Beckerich, Sébastien Maury, Anne Hulin, Catherine Cordonnier
Objectives: Atovaquone is one of the alternatives to trimethoprim/sulfamethoxazole for prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in immunocompromised patients. In volunteers, there was wide inter-individual variability in atovaquone bioavailability. The aim of this study was to assess the plasma concentrations of atovaquone in immunocompromised patients under PCP prophylaxis. Methods: Adult haematology or HIV-positive patients receiving atovaquone (750 mg oral suspension twice a day) for PCP prophylaxis were included...
September 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28588018/outcome-of-children-with-acute-leukemia-given-hla-haploidentical-hsct-after-%C3%AE-%C3%AE-t-cell-and-b-cell-depletion
#14
Franco Locatelli, Pietro Merli, Daria Pagliara, Giuseppina Li Pira, Michela Falco, Daniela Pende, Roberto Rondelli, Barbarella Lucarelli, Letizia Pomponia Brescia, Riccardo Masetti, Giuseppe Maria Milano, Valentina Bertaina, Mattia Algeri, Rita Maria Pinto, Luisa Strocchio, Raffaella Meazza, Lavinia Grapulin, Rupert Handgretinger, Alessandro Moretta, Alice Bertaina, Lorenzo Moretta
Allogeneic hematopoietic stem cell transplantation (HSCT) from an HLA-haploidentical relative (haplo-HSCT) is a suitable option for children with acute leukemia (AL) either relapsed or at high-risk of treatment failure. We developed a novel method of graft manipulation based on negative depletion of αβ T and B cells and conducted a prospective trial evaluating the outcome of children with AL transplanted with this approach. Eighty AL children, transplanted between September 2011 and September 2014, were enrolled in the trial...
August 3, 2017: Blood
https://www.readbyqxmd.com/read/28536356/hla-c-kir-ligands-determine-the-impact-of-anti-thymocyte-globulin-atg-on-graft-versus-host-and-graft-versus-leukemia-effects-following-hematopoietic-stem-cell-transplantation
#15
Johannes Clausen, Alexandra Böhm, Irene Straßl, Olga Stiefel, Veronika Buxhofer-Ausch, Sigrid Machherndl-Spandl, Josef König, Stefan Schmidt, Hansjörg Steitzer, Martin Danzer, Hedwig Kasparu, Ansgar Weltermann, David Nachbaur
Rabbit anti-thymocyte globulins (ATGs) are widely used for the prevention of acute and chronic graft versus host disease (aGVHD, cGVHD) following allogeneic hematopoietic stem cell transplantation (HSCT). However, most prospective and retrospective studies did not reveal an overall survival (OS) benefit associated with ATG. Homozygosity for human leukocyte antigen (HLA)-C group 1 killer-cell immunoglobulin-like receptor ligands (KIR-L), i.e. C1/1 KIR-L status, was recently shown to be a risk factor for severe aGVHD...
March 28, 2017: Biomedicines
https://www.readbyqxmd.com/read/28417553/calcineurin-inhibitor-free-strategies-for-prophylaxis-and-treatment-of-gvhd-in-children-with-posterior-reversible-encephalopathy-syndrome-after-stem-cell-transplantation
#16
Vered Shkalim-Zemer, Osnat Konen, Yoel Levinsky, Orli Michaeli, Anat Yahel, Aviva Krauss, Isaac Yaniv, Jerry Stein
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a distinct clinico-radiologic entity that can occur following allogeneic hematopoietic stem cell transplantation, often in the context of treatment with calcineurin inhibitors (CNIs). PROCEDURE: We describe the results of CNI-free management of 14 children with PRES and review the clinical and radiologic manifestations of their presentation. RESULTS: Discontinuation of CNIs usually resulted in remission of PRES, but patients with established graft versus host disease (GVHD) at the time when treatment was changed often experienced progressive GVHD despite administration of immune suppressive and modulating treatments...
November 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28302045/complications-following-stem-cell-therapy-in-inflammatory-bowel-disease
#17
Hongyun Wei, Xiaowei Liu, Chunhui Ouyang, Jie Zhang, Shuijiao Chen, Fanggen Lu, Linlin Chen
Pharmacotherapy and surgery constitute the mainstay of treatment for inflammatory bowel disease (IBD). However, post-treatment relapsing and recurrence persist as concerns in patients with IBD. Together with a considerable economic burden, stem cell therapy (SCT) has emerged as a promising treatment strategy in IBD, including hematopoietic stem cells (HST), mensenchymal stem cells (MSCs). HSCT could restore the immune tolerance following chemotherapy-induced immune ablation, and MSCs could affect immune cells or secret trophic factors to treat IBD...
March 15, 2017: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28197380/the-influence-of-gut-decontamination-prophylactic-antibiotics-on-acute-graft-versus-host-disease-and-survival-following-allogeneic-hematopoietic-stem-cell-transplantation
#18
Bertrand Routy, Caroline Letendre, David Enot, Maxime Chénard-Poirier, Vikram Mehraj, Noémie Charbonneau Séguin, Khaled Guenda, Kathia Gagnon, Paul-Louis Woerther, David Ghez, Silvy Lachance
The intestinal microbiota plays a key role in the pathogenesis of acute graft-versus-host disease (aGVHD). High-dose conditioning regimens given prior to allogeneic hematopoietic stem cell transplantation (aHSCT) modulate the composition of gut microbiota and damage the gut epithelial barrier, resulting in increased systemic inflammation. We assessed whether gut decontamination with antibiotics (ATB) prior to aHSCT influenced the frequency of aGVHD and mortality in 500 patients from two Canadian centers between 2005 and 2012...
2017: Oncoimmunology
https://www.readbyqxmd.com/read/28173959/the-clinical-impact-of-cytomegalovirus-infection-following-allogeneic-hematopoietic-cell-transplantation-why-the-quest-for-meaningful-prophylaxis-still-matters
#19
REVIEW
Shawna T Chan, Aaron C Logan
Latent infection with human cytomegalovirus (CMV) is common. Functional immunity effectively contains such latent infections; however, CMV reactivation may cause significant complications in patients undergoing allogeneic hematopoietic cell transplantation (alloHCT). In spite of the universal implementation of post-transplant screening for CMV viremia and the institution of pre-emptive antiviral management, CMV disease still occurs in a small portion of patients. Moreover, interactions between CMV and the immune system have significant implications for the incidence of graft-versus-host disease, the recurrence of malignancy, and non-relapse mortality following alloHCT, even in the era of pre-emptive antiviral management...
May 2017: Blood Reviews
https://www.readbyqxmd.com/read/28169418/allogeneic-transplantation-using-cd34-selected-peripheral-blood-progenitor-cells-combined-with-non-mobilized-donor-t%C3%A2-cells-for-refractory-severe-aplastic-anaemia
#20
Enkhtsetseg Purev, Xin Tian, Georg Aue, Jeremy Pantin, Phuong Vo, Reem Shalabi, Robert N Reger, Lisa Cook, Catalina Ramos, Elena Cho, Tat'yana Worthy, Hanh Khuu, David Stroncek, Neal S Young, Richard W Childs
Allogeneic haematopoietic stem cell transplantation is curative for severe aplastic anaemia (SAA) unresponsive to immunosuppressive therapy. To reduce chronic graft-versus-host disease (GVHD), which occurs more frequently after peripheral blood stem cell (PBSC) transplantation compared to bone-marrow transplantation (BMT), and to prevent graft rejection, we developed a novel partial T-cell depleted transplant that infuses high numbers of granulocyte colony-stimulating factor-mobilized CD34(+) selected PBSCs combined with a BMT-equivalent dose of non-mobilized donor T-cells...
March 2017: British Journal of Haematology
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