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Adverse impact of high donor CD3+ cell dose on outcome following tandem auto-NMA allogeneic transplantation for high-risk myeloma.
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Adverse impact of high donor CD3+ cell dose on outcome following tandem auto-NMA allogeneic transplantation for high-risk myeloma.

Bone Marrow Transplant. 2017 Mar 20;:

Authors: Nair AP, Walker P, Kalff A, Bergin K, Hocking J, Avery S, Curtis DJ, Patil S, Das T, Klarica D, Morgan S, Muirhead J, Gorniak M, Reynolds J, Spencer A

Abstract
High-risk (HR) multiple myeloma (MM) has poor outcomes with conventional therapy. Tandem autologous-non-myeloablative (NMA) allogeneic stem cell transplantation (autologous stem cell transplantation (ASCT)-NMA allogeneic SCT) is potentially curative secondary to graft-versus-myeloma effect. We retrospectively analysed ASCT-NMA allogeneic SCT outcomes of 59 HR and relapsed MM patients. At a median follow-up of 35.8 months, the outcomes for HR-MM upfront tandem ASCT-NMA allogeneic SCT and standard-risk (SR) MM upfront ASCT alone were comparable (median PFS 1166 days versus 1465 days, P=0.36; median overall survival (OS) not reached in both cohorts, P=0.31). The 5-year PFS and OS of patients who had ASCT-NMA allogeneic SCT after relapsing from previous ASCT were 30% and 48% respectively. High CD3+ cell dose (>3 × 10(8)/kg) infusion was associated with more acute GvHD (grade 2-4) (47% vs 17.5%; P=0.03), extensive chronic GvHD (80% vs 50%; P=0.04), increased transplant-related mortality (26.3% vs 5%; P=0.009) and inferior OS (median OS 752 days vs not reached; P=0.002). On multivariate analysis, response achieved with tandem transplant (

PMID: 28319080 [PubMed - as supplied by publisher]




Permanent diffuse alopecia after haematopoietic stem cell transplantation in childhood.
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Permanent diffuse alopecia after haematopoietic stem cell transplantation in childhood.

Bone Marrow Transplant. 2017 Mar 20;:

Authors: Bresters D, Wanders DC, Louwerens M, Ball LM, Fiocco M, van Doorn R

Abstract
Permanent alopecia after haematopoietic stem cell transplantation (HSCT) is distressing and few studies have investigated this late effect. The aim of the study was to assess the percentage of patients with alopecia and investigate risk factors for alopecia. Patients who underwent allogeneic HSCT before age 19 years, from January 1990 to January 2013, who were at least 2 years after transplant and in follow-up in our clinic were included. Alopecia was defined as clinically apparent decreased hair density. Possible risk factors considered for alopecia after HSCT included: gender, age, diagnosis, donor type, conditioning regimen: cranial irradiation (TBI/cranial radiotherapy) and/or chemotherapy, which chemotherapeutic agents were used and acute/chronic GvHD. The percentage of permanent alopecia in our cohort was 15.6% (41/263 patients). All patients had diffuse alopecia except for one with alopecia totalis. In multivariate analysis, a conditioning regimen with busulphan and busulphan plus fludarabine (odds ratio (OR) 5.7 (confidence interval (CI): 2.5-12.7) and OR 7.4 (CI: 3.3-16.2), respectively, was the main risk factor and associated with alopecia independent of acute/chronic GvHD. Neither TBI nor other alkylating chemotherapy, including treosulfan, was associated with alopecia. In conclusion, permanent alopecia after HSCT is associated with busulphan and GvHD and occurs in 16% of patients.Bone Marrow Transplantation advance online publication, 20 March 2017; doi:10.1038/bmt.2017.15.

PMID: 28319079 [PubMed - as supplied by publisher]




Late recurrence of autologous GvHD in a myeloma patient: a myth or diagnostic challenge?
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Late recurrence of autologous GvHD in a myeloma patient: a myth or diagnostic challenge?

Bone Marrow Transplant. 2017 Mar 20;:

Authors: El-Jurdi N, Ueda M, Jia L, Lazarus H

PMID: 28319078 [PubMed - as supplied by publisher]




Non-myeloablative allogeneic stem cell transplant with post-transplant cyclophosphamide cures the first adult patient with congenital dyserythropoietic anemia.
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Non-myeloablative allogeneic stem cell transplant with post-transplant cyclophosphamide cures the first adult patient with congenital dyserythropoietic anemia.

Bone Marrow Transplant. 2017 Mar 20;:

Authors: Oh A, Patel PR, Aardsma N, Mehendale SR, Chowdhery R, Sweiss K, Rondelli D

PMID: 28319077 [PubMed - as supplied by publisher]




Clinical impact of hyperglycemia on days 0-7 after allogeneic stem cell transplantation.
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Clinical impact of hyperglycemia on days 0-7 after allogeneic stem cell transplantation.

Bone Marrow Transplant. 2017 Mar 20;:

Authors: Kawajiri A, Fuji S, Tanaka Y, Kono C, Hirakawa T, Tanaka T, Ito R, Inoue Y, Okinaka K, Kurosawa S, Inamoto Y, Kim SW, Yamashita T, Fukuda T

Abstract
In order to clarify the association between hyperglycemia during the early period after allogeneic stem cell transplantation (allo-SCT) and adverse outcomes, we retrospectively analyzed 563 consecutive patients who underwent allo-SCT at our institute between 2008 and 2015. Patients were categorized into three groups according to mean fasting blood glucose levels on days 0-7 (normoglycemia group<110 mg/dL, n=347; mild hyperglycemia group 110-149 mg/dL, n=192 and moderate/severe hyperglycemia group≥150 mg/dL, n=24). The median follow-up was 2.7 years. Patients in the moderate/severe hyperglycemia group had significantly worse characteristics. The cumulative incidences of 2-year non-relapse mortality (NRM) and the probabilities of 2-year overall survival (OS) in the normoglycemia, mild hyperglycemia and moderate/severe hyperglycemia groups were 7.5%, 19% and 29%, respectively (P<0.01), and 69%, 53% and 33%, respectively (P<0.01). In multivariate analyses, hyperglycemia was an independent predictor of high NRM (vs normoglycemia; mild hyperglycemia, hazard ratio (HR) 2.56, 95% confidence interval (CI) 1.56-4.18; moderate/severe hyperglycemia, HR 4.46, 95% CI 1.92-10.3) and poor OS (vs normoglycemia; mild hyperglycemia, HR 1.54, 95% CI 1.14-2.07; moderate/severe hyperglycemia, HR 1.61, 95% CI 0.89-2.91). In conclusion, hyperglycemia on days 0-7 after allo-SCT was associated with inferior outcomes.Bone Marrow Transplantation advance online publication, 20 March 2017; doi:10.1038/bmt.2017.27.

PMID: 28319076 [PubMed - as supplied by publisher]




Autologous hematopoietic stem cell transplantation for pediatric multiple sclerosis: a registry-based study of the Autoimmune Diseases Working Party (ADWP) and Pediatric Diseases Working Party (PDWP) of the European Society for Blood and Marrow Transplantation (EBMT).
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Autologous hematopoietic stem cell transplantation for pediatric multiple sclerosis: a registry-based study of the Autoimmune Diseases Working Party (ADWP) and Pediatric Diseases Working Party (PDWP) of the European Society for Blood and Marrow Transplantation (EBMT).

Bone Marrow Transplant. 2017 Mar 20;:

Authors: Burman J, Kirgizov K, Carlson K, Badoglio M, Mancardi GL, De Luca G, Casanova B, Ouyang J, Bembeeva R, Haas J, Bader P, Snowden J, Farge D

Abstract
Autologous hematopoietic stem cell transplantation (aHSCT) is a promising therapy for multiple sclerosis (MS), which has mainly been used in adults. The purpose of this study was to investigate efficacy and adverse events of aHSCT in the treatment of children with MS using data from the European Society for Blood and Marrow Transplantation registry. Twenty-one patients with a median follow-up time of 2.8 years could be identified. PFS at 3 years was 100%, 16 patients improved in expanded disability status scale score and only 2 patients experienced a clinical relapse. The procedure was generally well tolerated and only two instances of severe transplant-related toxicity were recorded. There was no treatment-related mortality, although one patient needed intensive care. aHSCT may be a therapeutic option for children with disease that does not respond to standard care.Bone Marrow Transplantation advance online publication, 20 March 2017; doi:10.1038/bmt.2017.40.

PMID: 28319075 [PubMed - as supplied by publisher]




Tregs: hype or hope for allogeneic hematopoietic stem cell transplantation?
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Tregs: hype or hope for allogeneic hematopoietic stem cell transplantation?

Bone Marrow Transplant. 2017 Mar 20;:

Authors: Lussana F, Di Ianni M, Rambaldi A

Abstract
The discovery of T regulatory cells has been one of the most important advances in basic immunology and has opened the door to the development of innovative therapeutic strategies for improving the outcome of solid organ and hematopoietic stem cell transplantation. Basic immunology is rapidly elucidating the complex biology of these cells even though the difficulties in purifying or even expanding them in vitro represent a major limitation to the development of clinical studies. The clinical benefit potentially associated with this therapeutic approach remains to be demonstrated. Meanwhile, several drugs used for the treatment of hematologic malignancies or for other purposes have been shown to upregulate the number and function of Tregs in vivo. In the near future, both ex vivo or in vivo expanded T cells are likely to enter the therapeutic armamentarium of clinical transplantation.Bone Marrow Transplantation advance online publication, 20 March 2017; doi:10.1038/bmt.2017.30.

PMID: 28319074 [PubMed - as supplied by publisher]




Ex vivo T-cell depletion in allogeneic hematopoietic stem cell transplant: past, present and future.
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Ex vivo T-cell depletion in allogeneic hematopoietic stem cell transplant: past, present and future.

Bone Marrow Transplant. 2017 Mar 20;:

Authors: Saad A, Lamb LS

Abstract
The most common cause of post-transplant mortality in patients with hematological malignancy is relapse, followed by GvHD, infections, organ toxicity and second malignancy. Immune-mediated complications such as GvHD continue to be challenging, yet amenable to control through manipulation of the T-cell compartment of the donor graft with subsequent immunomodulation after transplant. However, risk of both relapse and infection increase concomitantly with T-cell depletion (TCD) strategies that impair immune recovery. In this review, we discuss the clinical outcome of current and emerging strategies of TCD in allogeneic hematopoietic stem cell transplant that have developed during the modern transplantation era, focusing specifically on ex vivo strategies that target selected T-cell subsets.Bone Marrow Transplantation advance online publication, 20 March 2017; doi:10.1038/bmt.2017.22.

PMID: 28319073 [PubMed - as supplied by publisher]




Long-term follow-up of a retrospective comparison of reduced-intensity conditioning and conventional high-dose conditioning for allogeneic transplantation from matched related donors in myelodysplastic syndromes.
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Long-term follow-up of a retrospective comparison of reduced-intensity conditioning and conventional high-dose conditioning for allogeneic transplantation from matched related donors in myelodysplastic syndromes.

Bone Marrow Transplant. 2017 Mar 20;:

Authors: Martino R, Henseler A, van Lint M, Schaap N, Finke J, Beelen D, Vigouroux S, Alessandrino EP, Mufti GJ, Veelken JH, Bruno B, Yakoub-Agha I, Volin L, Maertens J, Or R, Leblond V, Rovira M, Kalhs P, Alvarez AF, Vitek A, Sierra J, Wagner E, Robin M, de Witte T, Kröger N

Abstract
This study shows the long-term updated outcomes of a multicenter retrospective study which analyzed 843 patients with myelodysplastic syndrome (MDS) who underwent transplantation with an HLA-identical sibling donor with either reduced-intensity conditioning (RIC) in 213 patients, or standard myeloablative conditioning (MAC) in 630 patients. In multivariate analysis, the 13-year relapse rate was significantly increased after RIC (31% after MAC vs 48% in RIC; HR, 1.5; 95% CI, 1.1-1.9; P=0.04), but with no differences in overall survival (OS) (30% after MAC vs 27% in RIC; P=0.4) and PFS (29 vs 21%, respectively, P=0.3). Non-relapse mortality was higher in MAC (40 vs 31%; P=0.1), especially in patients older than 50 years (50 vs 33%, P<0.01). In addition, long-term follow-up confirms the importance of other variables on 13-year OS, mainly MDS risk category, disease phase, cytogenetics and receiving a high donor cell dose, irrespective of the conditioning regimen used.Bone Marrow Transplantation advance online publication, 20 March 2017; doi:10.1038/bmt.2017.19.

PMID: 28319072 [PubMed - as supplied by publisher]