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pubmed: BMT[Jour]



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Allogeneic stem cell transplantation for refractory acute myeloid leukemia in pediatric patients: the UK experience.
Related Articles

Allogeneic stem cell transplantation for refractory acute myeloid leukemia in pediatric patients: the UK experience.

Bone Marrow Transplant. 2017 Feb 20;:

Authors: O'Hare P, Lucchini G, Cummins M, Veys P, Potter M, Lawson S, Vora A, Wynn R, Peniket A, Kirkland K, Pearce R, Perry J, Amrolia PJ

Abstract
We report outcomes for 44 children who underwent stem cell transplantation (SCT) for refractory AML in the UK between 2000 and 2012. Median age at SCT was 11.5 years. Twenty-three patients had primary refractory and 21 relapsed refractory AML. Refractory disease was confirmed by cytogenetics/molecular genetics in 24 cases. Median follow-up of the whole cohort is 6.8 years (2.1-14.9 years). Thirty patients (68%) achieved a CR following SCT. Transplant-related mortality at 1 year was 18%. Acute GVHD incidence was 52% (grade ⩾III 19%), chronic 7%. Relapse was the major cause of treatment failure and occurred in 32% of patients at a median of 61 days post SCT. Five-year overall survival and leukemia-free survival (LFS) were 43% (95% CI 31-61%). All patients with favorable cytogenetics (n=6) are alive in CR. Outcomes in patients with primary refractory disease were equivalent to those with relapsed refractory AML. Blast percentage ⩽30% in the BM pre-SCT, myeloablative conditioning and acute GVHD proved to be favorable prognostic features. We could stratify patients according to age ⩾10 years and >30% blasts in BM pre-SCT. Patients with none/one of these risk factors were highly salvageable (5 years LFS 53%) whereas those with both factors had a very poor prognosis (5 years LFS 10%). This may facilitate decision making on whether it is appropriate to consider transplant in such patients.Bone Marrow Transplantation advance online publication, 20 February 2017; doi:10.1038/bmt.2017.3.

PMID: 28218757 [PubMed - as supplied by publisher]




Untreated donor specific antibodies against HLA are associated with poor outcomes in peripheral blood haploidentical hematopoietic cell transplantation.
Related Articles

Untreated donor specific antibodies against HLA are associated with poor outcomes in peripheral blood haploidentical hematopoietic cell transplantation.

Bone Marrow Transplant. 2017 Feb 20;:

Authors: Zou J, Romee R, Slade M, Phelan D, Keller J, Mohanakumar T, Grossman BJ

PMID: 28218756 [PubMed - as supplied by publisher]




Changes in the incidence, patterns and outcomes of graft failure following hematopoietic stem cell transplantation for Hurler syndrome.
Related Articles

Changes in the incidence, patterns and outcomes of graft failure following hematopoietic stem cell transplantation for Hurler syndrome.

Bone Marrow Transplant. 2017 Feb 20;:

Authors: Lum SH, Miller WP, Jones S, Poulton K, Ogden W, Lee H, Logan A, Bonney D, Lund TC, Orchard PJ, Wynn RF

Abstract
Hematopoietic stem cell transplantation (HSCT) is the standard of care in children with Hurler syndrome (HS) as it is the only therapy that can arrest disease progression. We examined the incidence, patterns and outcomes of graft failure in all HS children undergoing first HSCT at the Royal Manchester Children's Hospital or the University of Minnesota Children's Hospital from 1983 to 2016. Implementation of busulfan pharmacokinetic monitoring started in 2004 in both institutions. Two hundred and forty HS children were included in this analysis (historical era (pre-2004), n=131; current era (post 2004), n=109). The proportion of patients with graft failure was significantly lower in the current era compared with the historical era (37.2% vs 10.1%, respectively). Of 49 patients with graft failure in the historical era, 1 had aplasia and 48 had autologous reconstitution. All the 11 graft failures of the current era occurred in recipients of cord blood transplants (7 aplasia and 4 autologous reconstitution). The outcomes of second transplant in these patients has improved, with 89% of such patients alive and engrafted in the current era compared with 58% in the historical era. The pattern of graft failure has changed from autologous reconstitution, likely secondary to inadequate myelosuppression in the historical era, to aplasia in the current era, likely due to imperfect immunosuppression.Bone Marrow Transplantation advance online publication, 20 February 2017; doi:10.1038/bmt.2017.5.

PMID: 28218755 [PubMed - as supplied by publisher]




CMV viral load in bronchoalveolar lavage for diagnosis of pneumonia in allogeneic hematopoietic stem cell transplantation.
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CMV viral load in bronchoalveolar lavage for diagnosis of pneumonia in allogeneic hematopoietic stem cell transplantation.

Bone Marrow Transplant. 2017 Feb 20;:

Authors: Iglesias L, Perera MM, Torres-Miñana L, Pena-López MJ

Abstract
The objective of this report is to analyze the value of CMV viral load (VL) in bronchoalveolar lavage (BAL) in recipients of allogeneic hematopoietic stem cell transplantation (AHSCT) and to analyze the concordance between CMV quantification in plasma and BAL samples. Fifty-six patients were included; in 16 (28.6%) patients with symptoms of lung disease a BAL sample was collected, 7 (43.7%) patients had a VL >150 copies/mL (six had probable CMV pneumonia). Patients with CMV pneumonia were female (100%), of median age 53.5 years, and the median time from transplantion to onset of symptoms was 67.5 days. Pneumonia was early in three cases (incidence 5.4%). Median BAL VL was 53 250 copies/mL and plasma VL was 538 copies/mL (in one patient, the plasma VL was negative). Three (50.0%) patients had an improvement in the first week of treatment, and plasma VL became negative; the other 3 (50.0%) patients died with a CMV pneumonia refractory to treatment. Therefore, any value of CMV VL in BAL, especially if it is greater than plasma, with compatible signs or symptoms, should be considered suggestive of CMV pneumonia in recipients of AHSCT and they should receive specific treatment.Bone Marrow Transplantation advance online publication, 20 February 2017; doi:10.1038/bmt.2017.11.

PMID: 28218754 [PubMed - as supplied by publisher]




A short tale of blood, kidney and brain: BK virus encephalitis in an allogeneic stem cell transplant recipient.
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A short tale of blood, kidney and brain: BK virus encephalitis in an allogeneic stem cell transplant recipient.

Bone Marrow Transplant. 2017 Feb 20;:

Authors: Bourlon C, Alamoudi S, Kumar D, Viswabandya A, Thyagu S, Michelis FV, Kim DD, Lipton JH, Messner HA, Deotare U

PMID: 28218753 [PubMed - as supplied by publisher]




The 'HLA conundrum in bone marrow transplantation': correct interpretation of anti-HLA antibodies in haploidentical donor selection.
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The 'HLA conundrum in bone marrow transplantation': correct interpretation of anti-HLA antibodies in haploidentical donor selection.

Bone Marrow Transplant. 2017 Feb 20;:

Authors: Dias AL, Hashmi S, Hogan W, Baig N, Wakefield L, Kreuter J, Gandhi MJ

PMID: 28218752 [PubMed - as supplied by publisher]




Scleral lenses for severe chronic GvHD-related keratoconjunctivitis sicca: a retrospective study by the SFGM-TC.
Related Articles

Scleral lenses for severe chronic GvHD-related keratoconjunctivitis sicca: a retrospective study by the SFGM-TC.

Bone Marrow Transplant. 2017 Feb 20;:

Authors: Magro L, Gauthier J, Richet M, Robin M, Nguyen S, Suarez F, Dalle JH, Fagot T, Huynh A, Rubio MT, Oumadely R, Vigouroux S, Milpied N, Delcampe A, Yakoub-Agha I

Abstract
Chronic GvHD-related keratoconjunctivitis sicca (cGvHD-related KCS) can significantly alter the quality of life of patients after allogeneic hematopoietic stem cell transplantation. The aim of this work was to assess the efficacy and tolerability of scleral lenses to treat severe cGvHD-related KCS. In this retrospective, multicenter study, we included 60 consecutive patients diagnosed with cGvHD-related KCS and fitted with scleral lenses. Patients were evaluated at baseline and at 2 months with the following tests: the Ocular Surface Disease Index (OSDI) to assess quality of life, the Oxford score to grade corneal damage and the logarithm of minimal angle of resolution (Log MAR) scale to determine visual acuity. We observed improvement in quality of life in 58 patients (97%). All parameters improved at 2 months. We observed significant differences at 2 months compared with baseline for the mean OSDI (86 versus 30, respectively, P<0.001), the mean Oxford score (3.2 versus 1.3, respectively, P<0.001) as well as visual acuity (Log MAR of 0.33 versus 0.10, respectively, P<0.001). Treatment with scleral lenses was discontinued in only 5 patients (8%) with a median follow-up of 20.5 months (range: 2-125 months). Scleral lenses were very efficient and well tolerated in patients with severe cGvHD-related KCS.Bone Marrow Transplantation advance online publication, 20 February 2017; doi:10.1038/bmt.2017.9.

PMID: 28218751 [PubMed - as supplied by publisher]