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Ruxolitinib, a potent JAK1/JAK2 inhibitor, induces temporary reductions in the allelic burden of concurrent CSF3R mutations in chronic neutrophilic leukemia.
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Ruxolitinib, a potent JAK1/JAK2 inhibitor, induces temporary reductions in the allelic burden of concurrent CSF3R mutations in chronic neutrophilic leukemia.

Haematologica. 2017 Mar 16;:

Authors: Gunawan AS, McLornan DP, Wilkins B, Waghorn K, Hoade Y, Cross NC, Harrison CN

PMID: 28302714 [PubMed - as supplied by publisher]




Family cord blood banking for sickle cell disease: a twenty-year experience in two dedicated public cord blood banks.
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Family cord blood banking for sickle cell disease: a twenty-year experience in two dedicated public cord blood banks.

Haematologica. 2017 Mar 16;:

Authors: Rafii H, Bernaudin F, Rouard H, Vanneaux V, Ruggeri A, Cavazzana M, Gauthereau V, Stanislas A, Benkerrou M, De Montalembert M, Ferry C, Girot R, Arnaud C, Kamdem A, Gour J, Touboul C, Cras A, Kuentz M, Rieux C, Volt F, Cappelli B, Maio KT, Paviglianiti A, Kenzey C, Larghero J, Gluckman E

Abstract
Efforts to implement family cord blood banking have been developed in the past decades for siblings requiring stem cell transplantation for conditions such as sickle cell disease. However, public banks are faced with challenging decisions about the units to be stored, discarded, or used for other endeavors. We report here 20 years of experience in family cord blood banking for sickle cell disease in two dedicated public banks. Participants were pregnant women who had previous child diagnosed with homozygous sickle cell disease. Participation was voluntary and free of charge. All mothers underwent mandatory serologic screening. Cord blood units were collected in different hospitals, but processed and stored in two public banks. A total of 338 units were stored for 302 families. Median recipient's age was 6 years (11 months - 15 years). Median collected volume and total nucleated cell count were 91 ml (23 - 230) and 8.6 x108 (0.7 - 75 x108), respectively. Microbial contamination was observed in 3.5% (n=12), positive Hepatitis B serology in 25% (n=84) and homozygous sickle cell disease in 11% (n=37) of the collections. Forty-four units were HLA-identical to intended recipient, and 28 units were released for transplantation either alone (n=23) or in combination with the bone marrow from the same donor (n=5), reflecting a utilization rate of 8%. Engraftment rate was 96% with 100% survival. Family cord blood banking yields good quality units for sibling transplantation. More comprehensive banking based on close collaboration among banks, clinical and transplant teams is recommended for optimized utilization of these units.

PMID: 28302713 [PubMed - as supplied by publisher]




Improved survival after acute graft vs host disease diagnosis in the modern era.
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Improved survival after acute graft vs host disease diagnosis in the modern era.

Haematologica. 2017 Mar 16;:

Authors: Khoury HJ, Wang T, Hemmer MT, Couriel D, Alousi A, Cutler C, Aljurf M, Antin JH, Ayas M, Battiwalla M, Cahn JY, Cairo M, Chen YB, Gale RP, Hashmi S, Hayashi RJ, Jagasia M, Juckett M, Kamble RT, Kharfan-Dabaja M, Litzow M, Majhail N, Miller A, Nishihori T, Qayed M, Schoemans H, Schouten HC, Socié G, Storek J, Verdonck L, Vij R, Wood WA, Yu L, Martino R, Carabasi M, Dandoy C, Gergis U, Hematti P, Solh M, Jamani K, Lehmann L, Savani B, Schultz KR, Wirk BM, Spellman S, Arora M, Pidala J

Abstract
Acute graft vs. host disease remains a major threat to successful outcome after allogeneic hematopoietic cell transplantation. While improvements in treatment and supportive care have occurred, it is unknown whether these advances have resulted in improved outcome specifically among those diagnosed with acute graft vs. host disease. We examined outcome following diagnosis of grade II-IV acute graft vs. host disease according to time period, and examine effects according to original graft vs. host disease prophylaxis regimen and maximum overall grade of acute GVHD. Between 1999 and 2012, 2,905 patients with acute myeloid leukemia (56%), acute lymphoblastic leukemia (30%) or myelodysplastic syndromes (14%) received sibling (24%) or unrelated donor (76%) blood (66%) or marrow (34%) transplant and developed grades II-IV acute graft vs. host disease (n=497 for 1999-2001, n=962 for 2002-2005, n=1,446 for 2006-2010). Median follow-up was 144 (4-174), 97 (4-147) and 60 (8-99) months for 1999-2001, 2002-2005, and 2006-2010, respectively. Among the grade II-IV acute graft vs. host disease cohort, there was a decrease in the proportion of grades III-IV acute graft vs. host disease over time with 56%, 47% , and 37% for 1999-2001, 2002-2005, and 2006-2012, respectively (p<0.001). Considering the total study population, univariate analysis demonstrated significant improvements in overall survival and treatment-related mortality over time, and deaths from organ failure and infection declined. On multivariate analysis, significant improvements in overall survival (p=0.003) and treatment-related mortality (p=0.008) were only noted among those originally treated with tacrolimus-based graft vs. host disease prophylaxis, and these effects were most apparent among those with overall grade II acute graft vs. host disease.
CONCLUSION: Survival has improved over time for tacrolimus-treated transplant recipients with acute graft vs. host disease.

PMID: 28302712 [PubMed - as supplied by publisher]




Precision and prognostic value of clone-specific minimal residual disease in acute myeloid leukemia.
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Precision and prognostic value of clone-specific minimal residual disease in acute myeloid leukemia.

Haematologica. 2017 Mar 16;:

Authors: Hirsch P, Tang R, Abermil N, Flandrin P, Moatti H, Favale F, Suner L, Lorre F, Marzac C, Fava F, Mamez AC, Lapusan S, Isnard F, Mohty M, Legrand O, Douay L, Bilhou-Nabera C, Delhommeau F

Abstract
The genetic landscape of adult acute myeloid leukemias has been recently unraveled. However, due to their genetic heterogeneity, only a handful of markers are currently used for the evaluation of minimal residual disease. Recent studies using multi-target strategies indicate that detection of residual mutations in less than 5% of cells in complete remission is associated with a better survival. Here, in a series of 69 acute myeloid leukemias with known clonal architecture, we design a clone-specific strategy based on fluorescent in situ hybridization and high-sensitivity next generation sequencing to detect chromosomal aberrations and mutations, respectively, in follow-up samples. The combination of these techniques allows tracking chromosomal and genomic lesions down to 0.5-0.4% of the cell population in remission samples. By testing all lesions in follow-up samples from 65/69 evaluable patients, we find that initiating events often persist, and appear to be, alone, inappropriate markers to predict short term relapse. In contrast, the persistence of two or more lesions in more than 0.4% of the cells from remission samples is strongly associated with lower leukemia-free and overall survivals in univariate and multivariate analyses. Although larger prospective studies are needed to extend these results, our data show that a personalized, clone-specific, minimal residual disease follow-up strategy is feasible in the vast majority of acute myeloid leukemia cases.

PMID: 28302711 [PubMed - as supplied by publisher]




Targeted therapy for a subset of acute myeloid leukemias that lack expression of aldehyde dehydrogenase 1A1.
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Targeted therapy for a subset of acute myeloid leukemias that lack expression of aldehyde dehydrogenase 1A1.

Haematologica. 2017 Mar 09;:

Authors: Gasparetto M, Pei S, Minhajuddin M, Khan N, Pollyea DA, Myers JR, Ashton JM, Becker MW, Vasiliou V, Humphries KR, Jordan CT, Smith CA

Abstract
Aldehyde dehydrogenase 1A1 (ALDH1A1) activity is high in hematopoietic stem cells and functions in part to protect stem cells from reactive aldehydes and other toxic compounds. In contrast, we found that ~25% of all acute myeloid leukemias expressed low or undetectable levels of ALDH1A1 and that this ALDH1A1- subset of leukemias correlates with good prognosis cytogenetics. ALDH1A1- cell lines as well as primary leukemia cells were found to be sensitive to treatment with compounds that directly and indirectly generate toxic ALDH substrates including 4-hydroxynonenal and the clinically relevant compounds arsenic trioxide and 4-hydroperoxycyclophosphamide. In contrast, normal hematopoietic stem cells were relatively resistant to these compounds. Using a murine xenotransplant model to emulate a clinical treatment strategy, established ALDH1A1- leukemias were also sensitive to in vivo treatment with cyclophosphamide combined with arsenic trioxide. These results demonstrate that targeting ALDH1A1- leukemic cells with toxic ALDH1A1 substrates such as arsenic and cyclophosphamide may be a novel targeted therapeutic strategy for this subset of acute myeloid leukemias.

PMID: 28280079 [PubMed - as supplied by publisher]




Pathophysiological consequences and benefits of HFE mutations - 20 years of research.
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Pathophysiological consequences and benefits of HFE mutations - 20 years of research.

Haematologica. 2017 Mar 09;:

Authors: Hollerer I, Bachmann A, Muckenthaler MU

Abstract
Mutations in the HFE (hemochromatosis) gene cause hereditary hemochromatosis, an iron overload disorder that is hallmarked by excessive accumulation of iron in parenchymal organs. The HFE mutation p.Cys282Tyr is pathologically most relevant and occurs in the Caucasian population with a carrier frequency of up to 1 in 8 in specific European regions. Despite this high prevalence, the mutation causes a clinically relevant phenotype only in a minority of cases. In this review, we summarize historical facts and recent research findings about hereditary hemochromatosis and outline the pathological consequences of the associated gene defects. In addition, we discuss potential advantages of HFE mutations in asymptomatic carriers.

PMID: 28280078 [PubMed - as supplied by publisher]




Survival of patients with lymphoplasmacytic lymphoma and solitary plasmacytoma in Germany and the United States in the early 21st century.
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Survival of patients with lymphoplasmacytic lymphoma and solitary plasmacytoma in Germany and the United States in the early 21st century.

Haematologica. 2017 Mar 09;:

Authors: Weberpals J, Pulte D, Jansen L, Luttmann S, Holleczek B, Nennecke A, Ressing M, Katalinic A, Merz M, Brenner H, GEKID Cancer Survival Working Group

PMID: 28280077 [PubMed - as supplied by publisher]