5 research outputs found
Brentuximab Vedotin Followed By Allogeneic Stem-Cell Transplantation for Patients with CD30 Anaplastic or T Cell Non Hodgkin Lymphomas: A Study on Behalf of the SFGM-TC.
HSCT may lower leukemia risk in ELANE neutropenia: a beforeâafter study from the French Severe Congenital Neutropenia Registry
International audienceELANE neutropenia is associated with myelodysplasia and acute leukemia (MDSâAL), and severe infections. Because the MDSâAL risk has also been shown to be associated with exposure to GCSF, since 2005, in France, patients receiving high daily GCSF doses (>15âÎŒg/kg/day) are eligible for HSCT, in addition to classic indications (MDSâAL or GCSF refractoriness). We analyzed the effect of this policy. Among 144 prospectively followed ELANE-neutropenia patients enrolled in the French Severe Congenital Neutropenia Registry, we defined two groups according to period: âbefore 2005â for those born before 2005 and followed until 31/12/2004 (1588 person-years); and âafter 2005â comprised of those born after 2005 or born before 2005 but followed after 2005 until 31/03/2019 (1327 person-years). Sixteen of our cohort patients underwent HSCT (14 long-term survivors) and six developed MDSâALs. Six leukemic transformations occurred in the before-2005 group and none after 2005 (respective frequencies 3.8âĂâ10â3 vs. 0; Pâ<â0.01), while four HSCTs were done before 2005 and 12 since 2005 (respective HSCT rates increased 2.5âĂâ10â3 vs. 9âĂâ10â3; Pâ<â0.01). Our results support early HSCT for patients with ELANE mutations who received high GCSF doses, as it might lower the risk of leukemic transformation
Cord Blood Unit Dominance Analysis and Effect of the Winning Unit on Outcomes after Double-Unit Umbilical Cord Blood Transplantation in Adults with Acute Leukemia: A Retrospective Study on Behalf of Eurocord, the Cord Blood Committee of Cellular Therapy, Immunobiology Working Party, and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation
International audienceUsually, after double umbilical cord blood transplantation (DUCBT), only 1 of the transplanted units persists in the long term. The characteristics of the winning cord blood unit (W-CBU) that determine unit dominance and how they influence the outcomes of DUCBT remain unclear. We retrospectively analyzed 347 patients with acute leukemia transplanted with a DUCBT (694 CBU) from 2005 to 2013 who had documented neutrophil engraftment and a W-CBU identified by chimerism analysis, to identify unit characteristics impacting on dominance. Median age at DUCBT was 40 years and median follow-up was 35 months. Among W-CBUs, 41% were â„5/6 HLA matched to the recipient and 59% were â€4/6. Multivariate analysis indicated that â€4/6 HLA-matched W-CBUs led to lower leukemia-free survival (44% versus 56%; hazard ratio [HR], 1.5; Pâ=â.032) and overall survival (49% versus 62%; HR, 1.5; Pâ=â.028), increased nonrelapse mortality (26% versus 18%; HR, 1.9; Pâ=â.027), and acute graft-versus-host disease (46% versus 35%; HR, 1.7; Pâ=â.013). We were unable to predict unit dominance, but we demonstrated that outcomes were strongly influenced by the degree of HLA mismatch between W-CBU and recipient. Therefore, selection of both units with the lower number of HLA mismatches with the recipient is indicated