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Preview: pubmed: BMT[Jour]

pubmed: BMT[Jour]



NCBI: db=pubmed; Term="Bone marrow transplantation"[Jour]



 



Risks factors and timing of genital human papillomavirus (HPV) infection in female stem cell transplant survivors: a longitudinal study.

Risks factors and timing of genital human papillomavirus (HPV) infection in female stem cell transplant survivors: a longitudinal study.

Bone Marrow Transplant. 2017 Oct 16;:

Authors: Shanis D, Anandi P, Grant C, Bachi A, Vyas N, Merideth MA, Pophali PA, Koklanaris E, Ito S, Savani BN, Barrett AJ, Battiwalla M, Stratton P

Abstract
This longitudinal single-center study describes the timing and risk factors for genital human papillomavirus (HPV) disease in women after allogeneic hematopoietic cell transplantation (HCT). Between 1994 and 2014, 109 females underwent HCT of whom 82 surviving transplant for >1 year had regular, comprehensive genital tract assessment and treatment of HPV disease. The cumulative proportions of any genital HPV infection at 1, 3, 5, 10 and 20 years were 4.8%, 14.9%, 28.1%, 36.7% and 40.9%, respectively. Demographic, disease-related factors, chronic GvHD (cGvHD) and its treatment were analyzed for their association with persistent, multifocal or severe genital HPV disease. Pre-transplant HPV disease was strongly associated with any posttransplant HPV (odds ratio (OR)=6.5, 95% confidence interval (CI)=1.65-25.85, P=0.008). Having either extensive or genital cGvHD was associated with increased risk of any HPV disease (OR=5.7, 95% CI=1.90-17.16, P=0.002) and a higher risk for severe genital dysplasia (CIN II-III/VIN II-III; OR=13.1, 95% CI=1.59-108.26, P=0.017), but no one developed HPV-related genital cancer. Persistent, multifocal or severe HPV disease occurred more frequently than in healthy populations. Women with extensive cGvHD, genital cGvHD or pre-transplant HPV are at greatest risk for post-transplant HPV disease. Early initiation of annual screening, comprehensive genital tract assessment and active management are cornerstones of their gynecology care.Bone Marrow Transplantation advance online publication, 16 October 2017; doi:10.1038/bmt.2017.210.

PMID: 29035398 [PubMed - as supplied by publisher]




Engender trust and edify.

Engender trust and edify.

Bone Marrow Transplant. 2017 Oct 16;:

Authors: D'Souza A, Spellecy R, Derse A

PMID: 29035397 [PubMed - as supplied by publisher]




Successful correction of familial hemophagocytic lymphohistiocytosis using prenatal genetic testing and preemptive hematopoietic stem cell transplantation.

Successful correction of familial hemophagocytic lymphohistiocytosis using prenatal genetic testing and preemptive hematopoietic stem cell transplantation.

Bone Marrow Transplant. 2017 Oct 16;:

Authors: Michniacki TF, Mulcahy Levy JM, Quinones RR, Giller RH

PMID: 29035396 [PubMed - as supplied by publisher]




Replacing carmustine by thiotepa and cyclophosphamide for autologous stem cell transplantation in Hodgkin's and non-Hodgkin's B-cell lymphoma.

Replacing carmustine by thiotepa and cyclophosphamide for autologous stem cell transplantation in Hodgkin's and non-Hodgkin's B-cell lymphoma.

Bone Marrow Transplant. 2017 Oct 16;:

Authors: Joffe E, Rosenberg D, Rozovski U, Perry C, Kirgner I, Trestman S, Gur O, Aviv F, Sarid N, Kolomansky A, Gepstein L, Herishanu Y, Naparstek E

Abstract
This study aimed to compare the real-life results of TECAM, a thiotepa-based conditioning regimen consisting of thiotepa (40 mg/m(2) days -5 to -2), etoposide (200 mg/m(2) days -6 to -3), cytarabine (200 mg/m(2) days -4 to -1), cyclophosphamide (60 mg/kg day -3), and melphalan (60 mg/m(2) days -2 to -1) with that of the conventional carmustine-based regimen BEAM. We reviewed 125 consecutive patients who underwent a first autologous transplantation (ASCT) for B-cell lymphomas at a large tertiary transplantation center between 1999 and 2014. TECAM (n=65) and BEAM (n=60) had comparable results (3yPFS 49 vs 62%, P=0.16; 3yOS 64 vs 71%, P=0.44; TRM 1.6 vs 5%, P=0.35) without a difference in toxicity or time to engraftment. Notably, comparable outcomes were observed even though patients treated with TECAM were older (55 vs 44) and had a trend towards more prior lines of therapy (>2 prior lines: 43 vs 27%, P=0.08). In this regard, 23% of TECAM patients were over the age of 65 yet could withstand therapy with similar results to younger patients. We conclude that, replacing carmustine by thiotepa and cyclophosphamide for ASCT conditioning, has comparable efficacy and safety profiles with a possible advantage in older patients.Bone Marrow Transplantation advance online publication, 16 October 2017; doi:10.1038/bmt.2017.205.

PMID: 29035395 [PubMed - as supplied by publisher]




Infusion of autograft natural killer cell/CD14(+)HLA-DR(DIM) cell ratio predicts survival in lymphoma post autologous stem cell transplantation.

Infusion of autograft natural killer cell/CD14(+)HLA-DR(DIM) cell ratio predicts survival in lymphoma post autologous stem cell transplantation.

Bone Marrow Transplant. 2017 Oct 16;:

Authors: Kansagra A, Inwards DJ, Ansell SM, Micallef IN, Johnston PB, Hogan WJ, Markovic SN, Porrata LF

Abstract
The infusion of autograft absolute lymphocyte count (A-ALC) and autograft natural killer cells (A-NKC) are prognostic factors for overall survival (OS) and PFS in non-Hodgkin's lymphoma (NHL) patients undergoing autologous peripheral blood hematopoietic stem cell transplantation (APBHSCT). The human monocytic CD14(+)HLA-DR(DIM) cells are associated with worse prognosis in NHL. Thus, we investigated whether the autograft A-NKC/A-CD14(+)HLA-DR(DIM) ratio predicts survival in NHL. In a total of 111 NHL patients, we analyzed apheresis collection samples for the content of A-NKC and A-CD14(+)HLA-DR(DIM). With a median follow-up of 57.2 months (range: 2.1-84.6 months), patients with an A-NKC/A-CD14(+)HLA-DR(DIM) ratio of ⩾0.29 experienced superior OS (5-year OS rates of 84% (95% confidence interval (CI), 72-91%) vs 48% (95% CI, 34-62%), P<0.0002, respectively) and PFS (5-year PFS rates of 59% (95% CI, 47-71%) vs 32% (95% CI, 20-48%), P<0.002, respectively). Multivariate analysis revealed that A-NKC/A-CD14(+)HLA-DR(DIM) ratio was an independent predictor for PFS (hazard ratio (HR)=0.56, 95% CI, 0.32-0.96, P<0.03) and OS (HR=0.34, 95% CI, 0.16-0.68, P<0.002). The A-NKC/A-CD14(+)HLA-DR(DIM) ratio provides a platform to target specific autograft immune effector cells to improve clinical outcomes in NHL patients undergoing APBHSCT.Bone Marrow Transplantation advance online publication, 16 October 2017; doi:10.1038/bmt.2017.225.

PMID: 29035394 [PubMed - as supplied by publisher]




Donor-lymphocyte infusion following haploidentical hematopoietic cell transplantation with peripheral blood stem cell grafts and PTCy.

Donor-lymphocyte infusion following haploidentical hematopoietic cell transplantation with peripheral blood stem cell grafts and PTCy.

Bone Marrow Transplant. 2017 Oct 16;:

Authors: Goldsmith SR, Slade M, DiPersio JF, Westervelt P, Schroeder MA, Gao F, Romee R

Abstract
Donor-lymphocyte infusion (DLI) for relapse following haploidentical hematopoietic cell transplantation (haploHCT) with post-transplant cyclophosphamide (PTCy) has been described in recipients of bone marrow grafts, but not recipients of G-CSF mobilized peripheral blood (PB) grafts. We retrospectively identified patients who underwent DLI following PB-haploHCT with PTCy for relapse, or loss of chimerism (LOC). Twelve patients (57%) received DLI for hematologic relapse/persistent disease, seven (33%) for extramedullary relapse and two (10%) for LOC. Sixteen (76%) received chemotherapy prior to DLI, which did not correlate with response. The most common first dose was 1 × 10(6) CD3(+) cells/kg. Two patients developed grade I aGvHD post DLI, one had grade II and two had grade III. One developed mild skin cGvHD 1361 days post DLI. Pre-DLI aGvHD predicted post-DLI aGvHD (P=0.025). Six patients achieved CR after DLI for overt relapse, one achieved full donor chimerism after LOC. Patients with LOC or EM relapse had superior relapse-free survival following DLI (P=0.029). DLI following PB-haploHCT with PTCy is a viable salvage therapy for overt relapse or LOC without a substantial increase in GvHD, and donor lymphocytes may be collected simultaneously with graft collection to facilitate availability in patients at high risk of relapse.Bone Marrow Transplantation advance online publication, 16 October 2017; doi:10.1038/bmt.2017.193.

PMID: 29035393 [PubMed - as supplied by publisher]




Long-term outcome of mixed chimerism after stem cell transplantation for thalassemia major conditioned with busulfan and cyclophosphamide.

Long-term outcome of mixed chimerism after stem cell transplantation for thalassemia major conditioned with busulfan and cyclophosphamide.

Bone Marrow Transplant. 2017 Oct 16;:

Authors: Fouzia NA, Edison ES, Lakshmi KM, Korula A, Velayudhan SR, Balasubramanian P, Abraham A, Viswabandya A, George B, Mathews V, Srivastava A

Abstract
Mixed chimerism (MC) occurs frequently after allogeneic hematopoietic stem cell transplantation (HSCT) for thalassemia major (TM) and may be associated with rejection. We report the outcome of MC in 132 TM patients conditioned with Busulphan/Cyclophosphamide, who had successful engraftment and had ⩾1 year follow-up. Chimerism was first assessed at day +28, then every 3-9 months or more frequently if there was MC. If rejection was suspected, immunosuppression was stopped and donor-lymphocyte infusion (DLI) was given if there was no response. Among 132 patients, aged 7 years (range: 2-24), 46/132 (34.8%) had MC in the first year, 32/46 (69.6%) at day +28 and another 14 (30%) between day +28 and 1 year post HSCT. MC was quantified at level 1 (residual host chimerism (RHC) <10%) in 20 (43.5%), level II (RHC 10-25%) in 14 (30.4%) and level III (RHC >25%) in 12 (26.1%). On tapering immunosuppression, 15 (32.6%) developed acute GvHD and 8 (17.4%) had chronic GvHD with reversal to complete chimerism (CC). DLI was administered to 5/46 (10.9%), 1 evolved to CC but 4 rejected the graft. At median follow-up of 60 months (range: 16-172), 20/46 (43.5%) had CC, 18/46 (39.1%) had persistent MC with hemoglobin of 11.5 g/dL (range: 8.4-13.6), whereas 8 (17.4%) rejected the graft. Close monitoring and early intervention is needed with increasing recipient chimerism. Novel strategies are required for preventing graft rejection.Bone Marrow Transplantation advance online publication, 16 October 2017; doi:10.1038/bmt.2017.231.

PMID: 29035392 [PubMed - as supplied by publisher]