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5 záznamů v Medvik Filtry

Článek

Impact of patient: donor HLA disparity on reduced-intensity-conditioned allogeneic stem cell transplants from HLA mismatched unrelated donors for AML: from the ALWP of the EBMT

Loke, J
Autor Loke, J Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
Labopin, M
Autor Labopin, M Paris EBMT Data Coordination Office, Hospital Saint-Antoine, APHP, Université Pierre et Marie Curie UPMC and INSERM U 938, Paris, France Department of Hematology and Cell Therapy, Hospital Saint-Antoine, Paris, France
Craddock, C., 1957-
Autor Autorita Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK. Charles.Craddock@uhb.nhs.uk
Niederwieser, D
Autor Niederwieser, D University of Leipzig, Leipzig, Germany
Cornelissen, J
Autor Cornelissen, J Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
Afansayev, B
Autor Afansayev, B State Medical Pavlov University, St. Petersburg, Russia
Jindra, P
Autor Jindra, P Department of Haematology/Oncology, Charles University Hospital, Alej Svobody 80, 304 60, Pilsen, Czech Republic
Maertens, J
Autor Maertens, J Department of Hematology, Acute Leukemia and Transplantation Unit, UZ Leuven, Herestraat 49, B-3000, Leuven, Belgium
Blaise, D
Autor Blaise, D Transplant and Cellular Therapy Unit, Institut Paoli Calmettes, Marseille, France
Boriskina, K
Autor Boriskina, K Department of Hematology, Karolinska University Hospital Huddinge, Stockholm, Sweden

Bone marrow transplantation. 2021 ; 56 (3) : 614-621. [pub] 20201002

Bone Marrow Transplant
ISSN 1476-5365
Medvik
Zdroj

Patients with acute myeloid leukaemia (AML) who lack a matched sibling or unrelated donor commonly undergo transplantation from a donor matched at 9/10 HLA-A, -B, -C, -DRB1, -DQB1 alleles, and it is unclear if a specific locus mismatch is preferable to any other. We therefore studied 937 patients with AML in complete remission transplanted using a reduced intensity conditioning regimen from an unrelated donor mismatched at a single allele. In a multivariate analysis, patient age, adverse karyotype and patient cytomegalovirus (CMV) seropositivity were correlated with decreased leukaemia free survival (LFS) and overall survival (OS). There was no significant difference in LFS or OS between patients transplanted from donors mismatched at HLA-A, -B, -C or -DRB1 in comparison to a HLA-DQB1 mismatched transplant. In a multivariate analysis, patients transplanted with a HLA-A mismatched donor had higher rates of acute graft-versus-host disease (GVHD) and non-relapse mortality (NRM) than patients transplanted with a HLA-DQB1 mismatched donor. Patient CMV seropositivity was associated with an increase in NRM and acute GVHD and reduced LFS and OS, regardless of donor CMV status. For CMV seropositive patients lacking a fully matched donor, alternative GVHD and CMV prophylaxis strategies should be considered.

MeSH
akutní myeloidní leukemie * terapie MeSH
lidé MeSH
lokální recidiva nádoru MeSH
nemoc štěpu proti hostiteli * MeSH
nepříbuzný dárce MeSH
retrospektivní studie MeSH
transplantace hematopoetických kmenových buněk * MeSH
Check Tag
lidé MeSH
Publikační typ
časopisecké články MeSH
práce podpořená grantem MeSH

Článek

Allogeneic haematopoietic stem cell transplant in patients with lower risk myelodysplastic syndrome: a retrospective analysis on behalf of the Chronic Malignancy Working Party of the EBMT

Bone marrow transplantation. 2017 ; 52 (2) : 209-215. [pub] 20161107

Bone Marrow Transplant
ISSN 1476-5365
Medvik
Zdroj

We report a retrospective analysis of 246 myelodysplastic syndrome (MDS) patients in the EBMT (The European Society for Blood and Marrow Transplantation) database who were transplanted for International Prognostic Scoring System (IPSS) low or intermediate-1 disease. The majority of these patients (76%) were reclassified as intermediate or higher risk according to R-IPSS. The 3-year overall survival (OS) and PFS were 58% and 54%, respectively. In a multivariate analysis, adverse risk factors for PFS were marrow blast percentage (hazard ratio (HR): 1.77, P=0.037), donor/recipient CMV serostatus (donor-/recipient+: HR: 2.02, P=0.011) and source of stem cells (marrow and non-CR: HR: 5.72, P<0.0001, marrow and CR: HR: 3.17, P=0.027). Independent risk factors for OS were disease status at time of transplant and the use of in vivo T-cell depletion (TCD). Patients who did not receive TCD and were transplanted from an unrelated donor had worse OS (HR: 4.08, P<0.0001). In conclusion, 'lower' risk MDS patients have better outcome than those with 'higher risk' after haematopoietic stem cell transplant (HSCT). Selecting the right source of stem cells, a CMV-positive donor for CMV-positive patients and using in vivo TCD results in the best outcome in these patients. More studies are needed to evaluate the role of HSCT in these patients as compared with conventional treatment.

MeSH
alografty MeSH
lidé MeSH
míra přežití MeSH
následné studie MeSH
přežití bez známek nemoci MeSH
refrakterní anemie s nadbytkem blastů mortalita terapie MeSH
registrace * MeSH
rizikové faktory MeSH
transplantace hematopoetických kmenových buněk MeSH
Check Tag
lidé MeSH
mužské pohlaví MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH

Článek

Impact of in vivo T-cell depletion on outcome of AML patients in first CR given peripheral blood stem cells and reduced-intensity conditioning allo-SCT from a HLA-identical sibling donor: a report from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation

Bone marrow transplantation. 2014 ; 49 (3) : 389-96. [pub] 20140113

Bone Marrow Transplant
ISSN 1476-5365
Medvik
Zdroj

The impact of in vivo T-cell depletion on transplantation outcomes in patients transplanted with reduced-intensity conditioning (RIC) remains controversial. This study assessed the outcome of 1250 adult patients with de novo AML in first CR (CR1) given PBSC from HLA-identical siblings after chemotherapy-based RIC. A total of 554 patients did not receive any form of in vivo T-cell depletion (control group), whereas antithymocyte globulin (ATG) and alemtuzumab were given in 444 and 252 patients, respectively. The incidences of grade II-IV acute GVHD were 21.4, 17.6 and 10.2% in control, ATG and alemtuzumab patients, respectively (P<0.001). In multivariate analysis, the use of ATG and the use of alemtuzumab were each associated with a lower risk of chronic GVHD (P<0.001 each), but a similar risk of relapse, and of nonrelapse mortality, and similar leukemia-free survival and OS. Further, among patients given BU-based RIC, the use of <6 mg/kg ATG did not increase the risk of relapse (hazard ratio, HR=1.1), whereas there was a suggestion for higher relapse risk in patients given 6 mg/kg ATG (HR=1.4, P=0.08). In summary, these data suggest that a certain amount of in vivo T-cell depletion can be safely used in the conditioning of AML patients in CR1 given PBSC after chemotherapy-based RIC.