12 research outputs found
Busulfan-fludarabine- or treosulfan-fludarabine-based myeloablative conditioning for children with thalassemia major
Significant advances in supportive care for patients with transfusion-dependent thalassemia major (TDT) have improved patients' life expectancy. However, transfusion-associated iron overload remains a significant barrier to long-term survival with good quality of life. Today, allogeneic hematopoietic stem cell transplantation (HSCT) is the current curative standard of care. Alongside selection of the best available donor, an optimized conditioning regimen is crucial to maximize outcomes for patients with TDT undergoing HSCT. The aim of this retrospective analysis was to investigate the role of busulfan-fludarabine-based and treosulfan-fludarabine-based conditioning in TDT patients undergoing HSCT. We included 772 patients registered in the European Society for Blood and Marrow Transplantation (EBMT) database who underwent first HSCT between 2010 and 2018. Four hundred ten patients received busulfan-fludarabine-based conditioning (median age 8.6 years) and 362 patients received treosulfan-fludarabine-based conditioning (median age 5.7 years). Patient outcomes were retrospectively compared by conditioning regimen. Two-year overall survival was 92.7% (95% confidence interval: 89.3-95.1%) after busulfan-fludarabine-based conditioning and 94.7% (95% confidence interval: 91.7-96.6%) after treosulfan-fludarabine-based conditioning. There was a very low incidence of second HSCT overall. The main causes of death were infections, graft-versus-host disease, and rejection. In conclusion, use of busulfan or treosulfan as the backbone of myeloablative conditioning for patients with TDT undergoing HSCT resulted in comparably high cure rates. Long-term follow-up studies are warranted to address the important issues of organ toxicities and gonadal function.Transplantation and immunomodulatio
Autologous HSCT for severe progressive Multiple Sclerosis in a multicenter trial: impact on disease activity and quality of life
Hematopoietic stem cell transplantation
(HSCT) has been proposed for the treatment
of severe multiple sclerosis (MS). In
a phase 2 multicenter study we selected
19 non–primary progressive MS patients
showing high disease activity on the basis
of both brain magnetic resonance
imaging (MRI) and sustained clinical deterioration
despite conventional treatments.
After stem cell mobilization with cyclophosphamide
(CY) and filgrastim, patients
were conditioned with BCNU (1,3-
bis(2-chloroethyl)-1-nitrosourea), cytosine
arabinoside, etoposide, and melphalan
(BEAM) followed by antithymocyte globulin
(ATG). Unmanipulated peripheral blood stem
cells (PBSCs) were then infused. No maintenance
treatment was administered with a
median follow-up of 36 months (range, 12 to
72 months). All patients showed clinical
stabilization or improvement; 3 subsequently
deteriorated, 1 beyond the baseline.
No MRI active lesions were detected after
the HSCT except in 1 patient who showed a
new lesion at 4.5 years. Infections were
limitedandrestricted to 3monthsafterHSCT.
Health-related quality of life was assessed
through the 54-item MS quality of life
(MSQOL-54) questionnaire, showing a statistically
significant improvement in both composite
scores and in most of the individual
domains. HSCT is able to induce a prolonged
clinical stabilization in severe progressive
MS patients, resulting in both
sustained treatment-free periods and
quality of life improvemen
DUNES survey observational results
VizieR online Data Catalogue associated with article published in journal Astronomy & Astrophysics with title 'DUst around NEarby Stars. The survey observational results.' (bibcode: 2013A&A...555A..11E