25 research outputs found
In Vivo T-Cell Depletion (TCD) Does Not Improve Rates of Graft-Versus-Host Disease (GVHD) and Transplantation Outcomes in Patients Undergoing Peripheral Blood Allogeneic Hematopoietic Cell Transplant (AHCT)
High Rates of Non-Relapse Mortality and Graft-Versus-Host Disease in Patient Undergoing Allogeneic Stem Cell Transplantation (ASCT) Following Non-Myeloablative (NMA) Conditioning With TLI/ATG
Cyclophosphamide (CY)/G-CSF Cannot Completely Overcome Imid-Induced Impairment of Peripheral Blood Stem Cell (PBSC) Mobilization (Mob) in Patients With Multiple Myeloma (MM)
Allogeneic haematopoietic cell transplantation for extranodal natural killer/TĂą cell lymphoma, nasal type: a CIBMTR analysis
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146342/1/bjh14879.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146342/2/bjh14879_am.pd
Myeloablative vs Reduced-Intensity Conditioning Allogeneic Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia
Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative treatment of chronic myeloid leukemia (CML). Optimal conditioning intensity for allo-HCT for CML in the era of tyrosine kinase inhibitors (TKIs) is unknown. Using the Center for International Blood and Marrow Transplant Research database, we sought to determine whether reduced-intensity/nonmyeloablative conditioning (RIC) allo-HCT and myeloablative conditioning (MAC) result in similar outcomes in CML patients. We evaluated 1395 CML allo-HCT recipients between the ages of 18 and 60 years. The disease status at transplant was divided into the following categories: chronic phase 1, chronic phase 2 or greater, and accelerated phase. Patients in blast phase at transplant and alternative donor transplants were excluded. The primary outcome was overall survival (OS) after allo-HCT. MAC (n = 1204) and RIC allo-HCT recipients (n = 191) from 2007 to 2014 were included. Patient, disease, and transplantation characteristics were similar, with a few exceptions. Multivariable analysis showed no significant difference in OS between MAC and RIC groups. In addition, leukemia-free survival and nonrelapse mortality did not differ significantly between the 2 groups. Compared with MAC, the RIC group had a higher risk of early relapse after allo-HCT (hazard ratio [HR], 1.85; P = .001). The cumulative incidence of chronic graft-versus-host disease (cGVHD) was lower with RIC than with MAC (HR, 0.77; P = .02). RIC provides similar survival and lower cGVHD compared with MAC and therefore may be a reasonable alternative to MAC for CML patients in the TKI era
A prognostic model predicting autologous transplantation outcomes in children, adolescents and young adults with Hodgkin lymphoma
Autologous hematopoietic cell transplantation (AutoHCT) is a potentially curative treatment modality for relapsed/refractory Hodgkin lymphoma (HL). However, no large studies have evaluated pre-transplant factors predictive of outcomes of AutoHCT in children, adolescents and young adults (CAYA, age <30 years). In a retrospective study, we analyzed 606 CAYA patients (median age 23 years) with relapsed/refractory HL who underwent AutoHCT between 1995â2010. The probabilities of progression free survival (PFS) at 1, 5 and 10 years were 66% (95% CI: 62â70), 52% (95% CI: 48â57) and 47% (95% CI: 42â51), respectively. Multivariate analysis for PFS demonstrated that at the time of AutoHCT patients with Karnofsky/Lansky score â„90, no extranodal involvement and chemosensitive disease had significantly improved PFS. Patients with time from diagnosis to first relapse of <1 year had a significantly inferior PFS. A prognostic model for PFS was developed that stratified patients into low, intermediate and high-risk groups, predicting for 5-year PFS probabilities of 72% (95% CI: 64â80), 53% (95% CI: 47â59) and 23% (95% CI: 9â36), respectively. This large study identifies a group of CAYA patients with relapsed/refractory HL who are at high risk for progression after AutoHCT. Such patients should be targeted for novel therapeutic and/or maintenance approaches post-AutoHCT