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graft versus host disease prevention prophylaxis

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https://www.readbyqxmd.com/read/28302045/complications-following-stem-cell-therapy-in-inflammatory-bowel-disease
#1
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
#2
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
#3
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...
February 2, 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
#4
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
https://www.readbyqxmd.com/read/28146188/-vaccination-of-adult-patients-receiving-hematopoietic-stem-cell-transplantation-perspective-of-costa-rica
#5
M Del Rosario Espínoza Mora, Gustavo Lazo Páez, M Paz León Bratti, Christian Schauer
In this article the present recommendations for immunization of adult patients who received hematopoietic stem cell transplantation -a common procedure in therapy of many types of hematological diseases and serious inborn defects of the immune system- are reviewed and discussed. Patients that undergo this kind of transplantation procedure exhibit, compared to the general population, an elevated susceptibility of immune-preventable infections, due to loss of the humoral and cellular protective immunity. A revaccination strategy for transplanted patients can result in a significant diminution of morbidity and mortality related to the treatment of these diseases...
December 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28122283/simvastatin-ameliorates-graft-vs-host-disease-by-regulating-angiopoietin-1-and-angiopoietin-2-in-a-murine-model
#6
Peng Zheng, Qiu-Ling Wu, Bei-Bei Li, Ping Chen, Di-Min Nie, Ran Zhang, Jun Fang, Ling-Hui Xia, Mei Hong
Angiopoietins play an important role in vascular endothelial function. Endothelial damage is an important pathogenesis relating with acute graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT), protecting endothelial cells (ECs) from damage may be a potent prophylaxis and therapeutic strategy of acute GVHD (aGVHD). In this study, we explored changes in Angiopoietin-1 (Ang-1) and Ang-2 expression in a aGVHD mouse model and determined whether simvastatin prevents GVHD through regulating Ang-1 and Ang-2 expression...
January 10, 2017: Leukemia Research
https://www.readbyqxmd.com/read/28052467/the-combination-of-cyclosporine-and-mycophenolate-mofetil-is-less-effective-than-cyclosporine-and-methotrexate-in-the-prevention-of-acute-graft-versus-host-disease-after-stem-cell-transplantation-from-unrelated-donors
#7
Ronit Yerushalmi, Noga Shem-Tov, Ivetta Danylesko, Roni Shouval, Arnon Nagler, Avichai Shimoni
Acute graft-versus-host disease (GVHD) is the major treatment-related complication after stem-cell transplantation (SCT) from unrelated-donors. Several GVHD prophylaxis regimens have been explored, but no regimen has shown superiority. We analyzed transplantation outcomes in 472 consecutive unrelated-donor SCT recipients, using cyclosporine/methotrexate (MTX, n = 314) or cyclosporine/mycophenolate-mofetil (MMF, n = 158) for GVHD prophylaxis. Neutrophil engraftment was faster after MMF, days 11 and 14, respectively (P = ...
March 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28049637/low-immunosuppressive-burden-after-hla-matched-related-or-unrelated-bmt-using-posttransplantation-cyclophosphamide
#8
Christopher G Kanakry, Javier Bolaños-Meade, Yvette L Kasamon, Marianna Zahurak, Nadira Durakovic, Terry Furlong, Marco Mielcarek, Marta Medeot, Ivana Gojo, B Douglas Smith, Jennifer A Kanakry, Ivan M Borrello, Robert A Brodsky, Douglas E Gladstone, Carol Ann Huff, William H Matsui, Lode J Swinnen, Kenneth R Cooke, Richard F Ambinder, Ephraim J Fuchs, Marcos J de Lima, Borje S Andersson, Ravi Varadhan, Paul V O'Donnell, Richard J Jones, Leo Luznik
The intensive and prolonged immunosuppressive therapy required to prevent or treat graft-versus-host disease (GVHD) after allogeneic blood or marrow transplantation (alloBMT) puts patients at substantial risk for life-threatening infections, organ toxicity, and disease relapse. Posttransplantation cyclophosphamide (PTCy) can function as single-agent GVHD prophylaxis after myeloablative, HLA-matched related (MRD), or HLA-matched unrelated (MUD) donor T-cell-replete bone marrow allografting, obviating the need for additional prophylactic immunosuppression...
March 9, 2017: Blood
https://www.readbyqxmd.com/read/28039079/post-transplant-cyclophosphamide-and-tacrolimus-mycophenolate-mofetil-combination-prevents-graft-versus-host-disease-in-allogeneic-peripheral-blood-hematopoietic-cell-transplantation-from-hla-matched-donors
#9
Fabrizio Carnevale-Schianca, Daniela Caravelli, Susanna Gallo, Valentina Coha, Lorenzo D'Ambrosio, Elena Vassallo, Marco Fizzotti, Francesca Nesi, Luisa Gioeni, Massimo Berger, Alessandra Polo, Loretta Gammaitoni, Paolo Becco, Lidia Giraudo, Monica Mangioni, Dario Sangiolo, Giovanni Grignani, Delia Rota-Scalabrini, Antonino Sottile, Franca Fagioli, Massimo Aglietta
Allogeneic hematopoietic cell transplant (HCT) remains the only curative therapy for many hematologic malignancies but it is limited by high nonrelapse mortality (NRM), primarily from unpredictable control of graft-versus-host disease (GVHD). Recently, post-transplant cyclophosphamide demonstrated improved GVHD control in allogeneic bone marrow HCT. Here we explore cyclophosphamide in allogeneic peripheral blood stem cell transplantation (alloPBSCT). Patients with high-risk hematologic malignancies received alloPBSCT from HLA-matched unrelated/related donors...
March 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28007665/cd25-blockade-delays-regulatory-t-cell-reconstitution-and-does-not-prevent-graft-versus-host-disease-after-allogeneic-hematopoietic-cell-transplantation
#10
Frederick L Locke, Joseph Pidala, Barry Storer, Paul J Martin, Michael A Pulsipher, Thomas R Chauncey, Niels Jacobsen, Nicolaus Kröger, Irwin Walker, Susan Light, Bronwen E Shaw, Francisca Beato, Ginna G Laport, Auayporn Nademanee, Armand Keating, Gerard Socie, Claudio Anasetti
Daclizumab, a humanized monoclonal antibody, binds CD25 and blocks formation of the IL-2 receptor on T cells. A study of daclizumab as acute graft-versus-host disease (GVHD) prophylaxis after unrelated bone marrow transplantation was conducted before the importance of CD25(+)FOXP3(+) regulatory T cells (Tregs) was recognized. Tregs can abrogate the onset of GVHD. The relation between Tregs and a graft-versus-malignancy effect is not fully understood. An international, multicenter, double-blind clinical trial randomized 210 adult or pediatric patients to receive 5 weekly doses of daclizumab at 0...
December 19, 2016: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/27951736/efficacy-of-antithymocyte-globulin-for-allogeneic-hematopoietic-cell-transplantation-a-systematic-review-and-meta-analysis
#11
Yasuyuki Arai, Tomoyasu Jo, Hiroyuki Matsui, Tadakazu Kondo, Akifumi Takaori-Kondo
The efficacy of rabbit antithymocyte globulin (ATG) for the prevention of graft-versus-host disease (GVHD) has been evaluated in several randomized control trials, but the results show some discrepancies. Therefore, we performed a systematic review and meta-analysis covering the latest RCTs including six trials (total 845 patients). The incidence of acute and chronic GVHD was significantly lower in the ATG arms (risk ratio, 0.75 and 0.54, respectively). No significant differences were found regarding overall survival, the incidence of relapse, and non-relapse mortality; however, the incidence of cytomegalovirus and Epstein-Barr virus reactivation increased (risk ratio, 1...
August 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/27872737/immunity-to-infections-after-haploidentical-hematopoietic-stem-cell-transplantation
#12
REVIEW
Franco Aversa, Lucia Prezioso, Ilenia Manfra, Federica Galaverna, Angelica Spolzino, Alessandro Monti
The advantage of using a Human Leukocyte Antigen (HLA)-mismatched related donor is that almost every patient who does not have an HLA-identical donor or who urgently needs hematopoietic stem cell transplantation (HSCT) has at least one family member with whom shares one haplotype (haploidentical) and who is promptly available as a donor. The major challenge of haplo-HSCT is intense bi-directional alloreactivity leading to high incidences of graft rejection and graft-versus-host disease (GVHD). Advances in graft processing and pharmacologic prophylaxis of GVHD have reduced these risks and have made haplo-HSCT a viable alternative for patients lacking a matched donor...
2016: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/27795532/prophylactic-strategies-for-invasive-fungal-infections-after-allogeneic-hematopoietic-stem-cell-transplantation
#13
Yuki Asano-Mori
Invasive fungal infections (IFIs) are one of the most serious complications developing after allogeneic hematopoietic stem cell transplantation (allo-HSCT). They are difficult to treat once present and usually have a fatal course in profoundly immunosuppressed patients. Upfront prevention therefore plays an important role in overcoming this threat. The combination of a protected environment and antifungal prophylaxis against Candida spp. is conventionally applied to prevent IFIs during the neutropenic period after HSCT, whereas mold-active agents are recommended for prophylaxis against Aspergillus spp...
2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/27765055/targeting-of-pi3k-akt-mtor-pathway-to-inhibit-t-cell-activation-and-prevent-graft-versus-host-disease-development
#14
Mª Carmen Herrero-Sánchez, Concepción Rodríguez-Serrano, Julia Almeida, Laura San Segundo, Susana Inogés, Ángel Santos-Briz, Jesús García-Briñón, Luis Antonio Corchete, Jesús F San Miguel, Consuelo Del Cañizo, Belén Blanco
BACKGROUND: Graft-versus-host disease (GvHD) remains the major obstacle to successful allogeneic hematopoietic stem cell transplantation, despite of the immunosuppressive regimens administered to control T cell alloreactivity. PI3K/AKT/mTOR pathway is crucial in T cell activation and function and, therefore, represents an attractive therapeutic target to prevent GvHD development. Recently, numerous PI3K inhibitors have been developed for cancer therapy. However, few studies have explored their immunosuppressive effect...
October 20, 2016: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/27751936/national-institutes-of-health-hematopoietic-cell-transplantation-late-effects-initiative-the-immune-dysregulation-and-pathobiology-working-group-report
#15
REVIEW
Juan Gea-Banacloche, Krishna Komanduri, Paul Carpenter, Sophie Paczesny, Stefanie Sarantopoulos, Jo-Anne Young, Nahed El Kassar, Robert Q Le, Kirk Schultz, Linda M Griffith, Bipin Savani, John R Wingard
Immune reconstitution after hematopoietic stem cell transplantation (HCT) beyond 1 year is not completely understood. Many transplant recipients who are free of graft-versus-host disease (GVHD) and not receiving any immunosuppression more than 1 year after transplantation seem to be able to mount appropriate immune responses to common pathogens and respond adequately to immunizations. However, 2 large registry studies over the last 2 decades seem to indicate that infection is a significant cause of late mortality in some patients, even in the absence of concomitant GVHD...
October 14, 2016: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/27649744/extracellular-vesicles-released-from-human-umbilical-cord-derived-mesenchymal-stromal-cells-prevent-life-threatening-acute-graft-versus-host-disease-in-a-mouse-model-of-allogeneic-hematopoietic-stem-cell-transplantation
#16
Li Wang, Zhenyang Gu, Xiaoli Zhao, Nan Yang, Feiyan Wang, Ailing Deng, Shasha Zhao, Lan Luo, Huaping Wei, Lixun Guan, Zhe Gao, Yonghui Li, Lili Wang, Daihong Liu, Chunji Gao
Mesenchymal stromal cells (MSCs) are attractive agents for the prophylaxis of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, safety concerns remain about their clinical application. In this study, we explored whether extracellular vesicles released from human umbilical cord-derived MSCs (hUC-MSC-EVs) could prevent aGVHD in a mouse model of allo-HSCT. hUC-MSC-EVs were intravenously administered to recipient mice on days 0 and 7 after allo-HSCT, and the prophylactic effects of hUC-MSC-EVs were assessed by observing the in vivo manifestations of aGVHD, histologic changes in target organs, and recipient mouse survival...
December 15, 2016: Stem Cells and Development
https://www.readbyqxmd.com/read/27528221/mesenchymal-stem-cells-provide-prophylaxis-against-acute-graft-versus-host-disease-following-allogeneic-hematopoietic-stem-cell-transplantation-a-meta-analysis-of-animal-models
#17
Li Wang, Haiyan Zhang, Lixun Guan, Shasha Zhao, Zhenyang Gu, Huaping Wei, Zhe Gao, Feiyan Wang, Nan Yang, Lan Luo, Yonghui Li, Lili Wang, Daihong Liu, Chunji Gao
A meta-analysis of animal models was conducted to evaluate the prophylactic effects of mesenchymal stem cells (MSCs) on acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation. A total of 50 studies involving 1848 animals were included. The pooled results showed that MSCs significantly reduced aGVHD-associated mortality (risk ratio = 0.70, 95% confidence interval 0.62 to 0.79, P = 2.73×10-9) and clinical scores (standardized mean difference = -3.60, 95% confidence interval -4...
September 20, 2016: Oncotarget
https://www.readbyqxmd.com/read/27526283/antibiotic-mediated-modification-of-the-intestinal-microbiome-in-allogeneic-hematopoietic-stem-cell-transplantation
#18
REVIEW
J Whangbo, J Ritz, A Bhatt
Allogeneic hematopoietic stem cell transplantation (HSCT) is curative for many patients with severe benign and malignant hematologic disorders. The success of allogeneic HSCT is limited by the development of transplant-related complications such as acute graft-versus-host disease (GvHD). Early pre-clinical studies suggested that intestinal microflora contribute to the pathogenesis of acute GvHD, and that growth suppression or eradication of intestinal bacteria prevented the development of acute GvHD even in MHC-mismatched transplants...
February 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/27498124/a-pharmacokinetic-and-pharmacodynamic-study-of-maraviroc-as-acute-graft-versus-host-disease-prophylaxis-in-pediatric-allogeneic-stem-cell-transplant-recipients-with-nonmalignant-diagnoses
#19
Pooja Khandelwal, Tsuyoshi Fukuda, Kana Mizuno, Ashley Teusink-Cross, Parinda A Mehta, Rebecca A Marsh, Angela D M Kashuba, Alexander A Vinks, Stella M Davies
Maraviroc is an allosteric small molecule antagonist of chemokine receptor type 5 (CCR5) and has been used in adult allogeneic hematopoietic stem cell transplant (HSCT) recipients to prevent acute graft-versus-host disease (GVHD) of the gastrointestinal (GI) tract and liver. The goal of this study was to establish feasibility and pharmacokinetic and pharmacodynamic profiles of maraviroc in pediatric HSCT recipients. Children ages 2 to 12 years were enrolled and maraviroc was added to standard GVHD prophylaxis, which included a calcineurin inhibitor and either steroids or mycophenolate mofetil...
October 2016: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/27404668/results-of-a-2-arm-phase-2-clinical-trial-using-post-transplantation-cyclophosphamide-for-the-prevention-of-graft-versus-host-disease-in-haploidentical-donor-and-mismatched-unrelated-donor-hematopoietic-stem-cell-transplantation
#20
Sameh Gaballa, Isabell Ge, Riad El Fakih, Jonathan E Brammer, Piyanuch Kongtim, Ciprian Tomuleasa, Sa A Wang, Dean Lee, Demetrios Petropoulos, Kai Cao, Gabriela Rondon, Julianne Chen, Aimee Hammerstrom, Lindsey Lombardi, Gheath Alatrash, Martin Korbling, Betul Oran, Partow Kebriaei, Sairah Ahmed, Nina Shah, Katayoun Rezvani, David Marin, Qaiser Bashir, Amin Alousi, Yago Nieto, Muzaffar Qazilbash, Chitra Hosing, Uday Popat, Elizabeth J Shpall, Issa Khouri, Richard E Champlin, Stefan O Ciurea
BACKGROUND: High-dose, post-transplantation cyclophosphamide (PTCy) to prevent graft-versus-host disease (GVHD) has improved outcomes in haploidentical (HAPLO) stem cell transplantation (SCT). However, it remains unclear whether this strategy is effective in SCT from 1-antigen human leukocyte antigen (HLA)-mismatched unrelated donors (9/10 MUD) and how the outcomes of these patients compare with those of haploidentical transplantation recipients. METHODS: A parallel, 2-arm, nonrandomized phase 2 clinical trial was conducted of melphalan-based reduced-intensity conditioning with PTCy, tacrolimus, and mycophenolate mofetil to prevent GVHD in patients with high-risk hematologic malignancies who underwent HAPLO (n = 60) or 9/10 MUD (n = 46) SCT...
November 15, 2016: Cancer
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