Cell Transplant Patients Research Articles

Pulmonary, Hepatic, and Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Telomere Biology Disorders.

This study aimed to summarize evidence and provide consensus-based guidelines for management of transplantation in patients with telomere biology disorders (TBD). Specifically, this review focuses on clinical management of lung, liver, and bone marrow transplantation in TBD patients. TBD patients have specific unique biological vulnerabilities such as T cell immunodeficiency, susceptibility to infections, hypersensitivity to chemotherapy and radiation, and cytopenias. Furthermore, multiple organ involvement at diagnosis makes clinical management especially challenging due to higher degree of organ damage, and stress-induced telomeric crisis. Sequential and combined organ transplants, development of novel radiation and alkylator-free conditioning regimen, and use of novel drugs for graft-versus-host disease prophylaxis are some of the recent updates in the field. Multidisciplinary management is essential to optimize transplant outcomes in patients with TBD. In this review, we provide consensus-based transplant management guidelines for clinical management of transplant in TBD.

Comparison of long-term outcomes between imatinib and dasatinib prophylaxis after allogeneic stem cell transplantation in patients with Philadelphia-positive acute lymphoblastic leukemia: A multicenter retrospective study.

Although the prognosis of Philadelphia-positive acute lymphoblastic leukemia (Ph+ALL) has improved with the introduction of tyrosine kinase inhibitors (TKIs) and stem cell transplantation, prevention of relapse after transplantation remains a concern. The aim of this study was to compare the impact of TKI prophylaxis with imatinib and dasatinib on long-term outcomes after transplantation. Patients with Ph+ALL who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) at first complete remission (CR1) and received TKI prophylaxis after allo-HSCT were included in this retrospective analysis. Two cohorts were established based on the choice of TKI prophylaxis: the imatinib (Ima) and dasatinib (Das) cohorts. The survival and safety outcomes of these cohorts were compared. Ninety-one patients in the Ima cohort and 50 in the Das cohort were included. After a median follow-up of 50.6months, the 5-year cumulative incidence of relapse, nonrelapse mortality rate, and overall survival in the Ima and Das cohorts were 16.1% and 12.5%, 5.2% and 9.8%, and 86.5% and 77.6%, respectively, with no statistical differences. The cumulative incidence of mild chronic graft-versus-host disease was higher in the Das cohort. The most common adverse event was neutropenia (64.7% vs. 69.5%). The Das cohort had a higher incidence of gastrointestinal bleeding (25.5% vs. 2.3%) and gastrointestinal reaction (48.9% vs. 31.4%) than the Ima cohort. The proportion of patients treated on schedule was significantly lower in the Das cohort than in the Ima cohort, and drug intolerance was the main reason for protocol violation. For patients with Ph+ALL undergoing allo-HSCT in CR1, imatinib prophylaxis achieved long-term outcomes similar to those of dasatinib.

Outpatient Autologous Stem Cell Transplantation in Patients with Multiple Myeloma Decreases Antibiotic Exposure: A Retrospective, Single-Center Cohort Study

Outpatient Autologous Stem Cell Transplantation in Patients with Multiple Myeloma Decreases Antibiotic Exposure: A Retrospective, Single-Center Cohort Study

Impact of CMV Reactivation on Clinical Outcomes Post Allogeneic Stem Cell Transplant in Patients with Sickle Cell Disease

Impact of CMV Reactivation on Clinical Outcomes Post Allogeneic Stem Cell Transplant in Patients with Sickle Cell Disease

Successful Hematopoietic Cell Transplantation in Patients with Fanconi Anemia with Severe Renal Insufficiency

Successful Hematopoietic Cell Transplantation in Patients with Fanconi Anemia with Severe Renal Insufficiency

Age and lymphocyte/monocyte ratio as prognostic factors for autologous transplantation in the treatment of patients with follicular lymphoma.

Follicular lymphoma (FL) is an indolent, lymphoproliferative disease of B-cell origin that has a heterogeneous disease course with varying outcomes. Certain patients may undergo autologous stem cell transplantation. We investigated the outcome of autologous stem cell transplantation in patients with FL. Patients who received autologous stem cell transplantation at the University of Debrecen's Department of Hematology between 2004 and 2021 were retrospectively analyzed. The overall survival (OS) and progression-free survival (PFS) after transplantation of patients with FL were examined. Prognostic factors that may influence the course of the disease were chosen. Data were collected from 49 patients. OS was influenced only by age, whereas PFS was affected by age and the lymphocyte/monocyte ratio. The combination of age and lymphocyte/monocyte ratio defined a patient population with a particularly unfavorable prognostic risk profile: patients over 47 years of age with a pre-transplant lymphocyte/monocyte ratio greater than or equal to 2.675. Age and lymphocyte/monocyte ratio were identified as useful prognostic factors for PFS in patients with FL following autologous stem cell transplantation.

A Retrospective Analysis Comparing Orca-T to Post-Transplant Cyclophosphamide Based Allogeneic Hematopoietic Cell Transplant in Patients with Matched Unrelated Donors Receiving Myeloablative Conditioning

A Retrospective Analysis Comparing Orca-T to Post-Transplant Cyclophosphamide Based Allogeneic Hematopoietic Cell Transplant in Patients with Matched Unrelated Donors Receiving Myeloablative Conditioning

Real World Use of the Pediatric Disease Risk Index for Allogeneic Hematopoietic Cell Transplantation in Patients with Acute Lymphoblastic Leukemia and Acute Myeloid Leukemia: A Multicenter Study

Real World Use of the Pediatric Disease Risk Index for Allogeneic Hematopoietic Cell Transplantation in Patients with Acute Lymphoblastic Leukemia and Acute Myeloid Leukemia: A Multicenter Study

Hematopoietic Stem Cell Transplantation in Patients with Myelofibrosis and Splanchnic Vein Thrombosis

Hematopoietic Stem Cell Transplantation in Patients with Myelofibrosis and Splanchnic Vein Thrombosis

Pilot Prospective Study of Reduced Intensity Conditioning Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Vexas Syndrome

Pilot Prospective Study of Reduced Intensity Conditioning Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Vexas Syndrome

Prompt Autologous Hematopoietic Stem Cell Transplant in Patients with Large B-Cell Lymphoma Is Associated with Lower Rates of Progression of Disease Prior to Transplant

Prompt Autologous Hematopoietic Stem Cell Transplant in Patients with Large B-Cell Lymphoma Is Associated with Lower Rates of Progression of Disease Prior to Transplant

Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation in Patients Aged 70 Years and Older.

Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation in Patients Aged 70 Years and Older.

Novel Molecular Biomarkers Prognostic of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Myelodysplastic Neoplasms (MDS)

Novel Molecular Biomarkers Prognostic of Relapse after Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Myelodysplastic Neoplasms (MDS)

High doses of chemotherapy and autologous hematopoietic stem cell transplantation in patients with relapsed/refractory testicular germ cell tumors: Multicenter real-world experience in Argentina.

508 Background: Germ cell tumors (GCTs) are the most common type of cancer in adolescent and young adult males. Most of them are curable with multimodal treatment: platinum-based chemotherapy (CT) + surgery. Patients who fail first-line treatment usually receive salvage CT with response rates between 30 and 50%. High-dose chemotherapy and autologous hematopoietic stem cell transplantation (HDCT) is an effective treatment in this context. Methods: We conducted a multicenter retrospective analysis of patients ≥ 15 years old with relapsed/refractory GCTs who received HDCT in 13 centers of the Argentine Group of Bone Marrow Transplantation and Cellular Therapy (GATMO-TC) from 2010 to 2022. Results: 114 patients were included, with a median age of 32 years (range: 15-58). Most had non-seminoma histology (66%); The primary tumor site was testis (65%), retroperitoneum (17%), and mediastinum (9%). Forty percent (n:46) had an unfavorable prognosis according to the IGCCCG score. Eighty-two % received ≥ 2 lines of CT before HDCT, 27% being platinum-refractory disease (PRD), and 45% received 2 consecutive courses of HDCT (tandem). All patients received a carboplatin-etoposide-based conditioning regimen. The median engraftment time was 12 days (d) (r8;25) for neutrophils and 15 d (r6;58) for platelets. Bacteremia (25%) and Hepatotoxicity (14.9%) were the most frequent G3-4 adverse events. With a median follow-up of 12.6 months (r1-138), 100 pts were evaluable for survival. 12- and 24-months OS was 67%- 64%; and PFS 56%; - 54% respectively. PRD patients had worse OS and PFS. Eighteen patients remained alive and without relapsing beyond 5 years of follow-up. Conclusions: This real-world multicentric study demonstrates that some patients with refractory/relapsed metastatic GCT are curable by HDCT, being an effective and safe feasible treatment with response rates similar to those described in the literature. The superiority of the tandem approach could not be demonstrated due to the heterogeneity of the sample.[Table: see text]

Mesenchymal stem cells in the treatment of ischemic stroke

Over the past two decades, multiple preclinical studies have shown that transplantation of mesenchymal stem cells leads to a pronounced positive effect in animals with experimental stroke. Based on the promising results of preclinical studies, several clinical trials on the transplantation of mesenchymal stem cells to stroke patients have also been conducted. In this review, we present and analyze the results of completed clinical trials dedicated to the mesenchymal stem cells transplantation in patients with ischemic stroke. According to the obtained results, it can be concluded that transplantation of mesenchymal stem cells is safe and feasible from the economic and biomedical point of view. For the further implementa-tion of this promising approach into the clinical practice, randomized, placebo-controlled, multicenter clinical trials are needed with a large sample of patients and optimized cell transplantation protocols and patient inclusion criteria. In this review we also discuss possi-ble strategies to enhance the effectiveness of cell therapy with the use of mesenchymal stem cells.

Results of Autologous Hematopoietic Stem Cell Transplantation in Patients with Multiple Myeloma(MM) and Renal Impairment: A Retrospective Single-Center Study.

Background: To assess the efficacy of autologous hematopoietic stem cell transplantation (auto-HSCT) in multiple myeloma (MM) patients with acute renal failure. Materials and Methods: A retrospective single-center study included 64 patients (30 men, 34 women) with MM and kidney damage at the onset of the disease, aged 19 to 65 years (median 54), who underwent auto-HSCT from 2013 to 2019. 23 patients (36%) were dialysis-dependent at the time of diagnosis. The analysis was carried out in two groups: the "HD-" group (patients who were independent of hemodialysis during auto-HSCT, n = 54), and the "HD +" group (patients who underwent auto-HSCT while treated with programmed hemodialysis, n = 10). Research results were statistically processed using the Statistica software (version 10.0); the data obtained were presented graphically. Statistical analysis was performed using survival analysis (using the Kaplan-Meier method, with a Log-Rank Test) and frequency analysis (using contingency tables and Fisher's test). Results: The patients dependent on hemodialysis were significantly more likely to require red blood cell transfusions compared to the dialysis-independent patients (100% versus 35%, p = 0.0001). Reactivation of a herpes viral infection and reversible toxic encephalopathy developed significantly more often in the patients from the "HD +" group compared with the patients from the "HD-" group (30% versus 6%, p = 0.04 and 20% versus 0%, p = 0.02, respectively). As a result of the treatment (induction + auto-HSCT), 14 patients (61%) became hemodialysis-independent. There was no transplant-related mortality. With a median follow-up of 48 months, the 5-year overall survival (OS) and progression-free survival (PFS) were 70% and 42%, respectively. Conclusion: Auto-HSCT is a safe and effective treatment for patients with MM complicated by acute kidney injury. Fourteen of 23 (61%) patients became dialysis-independent.

Early M-protein immune reconstitution after autologous haematopoietic stem cell transplantation is a good prognostic marker for patients with high-risk cytogenetic multiple myeloma.

The presence of transient abnormal protein banding (M-protein immune reconstitution) in serum immunofixation electrophoresis after autologous haematopoietic stem cell transplantation in patients with multiple myeloma has been reported. The purpose of this study was to investigate the impact of post-transplant M-protein immune reconstitution on the prognosis of patients with multiple myeloma. M-protein immune reconstitution was observed in 25.9% (75/290) of patients. The CR rate and MRD negativity were higher in the M-protein immune reconstitution group (85.3% vs. 69.3%, p = 0.013, 81.9% vs. 66.5%, p = 0.014). Although there were no significant differences between the groups, the overall median survival time was longer in the M-protein immune reconstruction group (80 vs. 72 m, p = 0.076; not reached vs. 105 m, p = 0.312). Among patients in the cytogenetic high-risk group, the occurrence of M-protein immune reconstitution predicted better PFS and OS (80 vs. 31 m, p = 0.010; not reached vs. 91 m, p = 0.026). Additionally, in revised-International Staging System stage III patients, PFS and OS were better in those who achieved M-protein immune reconstitution (80 vs. 20 m, p = 0.025; 57 vs. 32 m, p = 0.103). The better prognosis of M-protein immune reconstitution patients may be associated with the acquisition of a deeper response. In high-risk patients, early acquisition of M-protein immune reconstitution may suggest a better prognosis.

Primary Central Nervous System Lymphoma, Treatment Outcomes - 10 Year Experience. Single Center Study.

Primary central nervous system lymphoma(PCNSL) is an aggressive, rare form of Non-Hodgkin lymphoma, characterized by the absence of systemic disease. There are limited data and no strictly defined guidelines for management of PCNSL. The aim of this study was to report a 10 year experience of PCNSL treatment, to evaluate treatment outcomes and asses Progression Free and Overall Survival of these patients. Study was conducted on the Haematology Clinic, Clinical center University of Sarajevo, BH, in the period from January 2012.-December 2022. Total sample of 24 patients were enrolled. All have undergone diagnostic surgery. Patients were treated with regimens based on High dose Methotrexate, with/without whole brain radiotherapy as consolidation. Treatment response was captured by imaging techniques. Patients who have relapsed were evaluated with imaging techniques and treated according to Methotrexate-based treatment protocols. We have captured equal gender distribution. The median age of patients was 59.5 years (range 20-79). Pathohistological analysis confirmed DLBCL diagnosis in 22 patients, T cell lymphoma and anaplastic large cell lymphoma, each in 1 patient. Chemotherapy, chemotherapy combined with WBRT and radiotherapy were given to 5, 18 and 1 patients, respectively. The overall complete response rate (CR) was 87,15%. Those receiving combined modality-treatment had higher CR than those receiving chemotherapy (94,4% versus 60%). Out of 24 patients, 11 of them relapsed. The median time to relapse was 29 months (from 1 to 105). After second line of the treatment, CR was 54,5%, while 45,45% of patients died during the treatment. 4 patients relapsed for the second time with median time to relapse of 9 months (from 2 to 77). 2 year OS rate was 67%, and the median OS rate was 45,9 months. 2 year PFS rate was 31%. The OS and PFS rates indicate the usage of new drugs and consolidation with autologous stem cell transplantation in patients with PCNSL in order to achieve better treatment outcomes.

Evaluation of the effects of MCVAC conditioning regimen followed by autologous hematopoietic stem cell transplantation in patients with relapsed and refractory Hodgkin lymphoma: A single-institution retrospective study.

High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (HDC/ASCT) has been useful in relapsed or refractory classic Hodgkin lymphoma (RRcHL). Furthermore, a ranimustine, cytarabine, etoposide, and cyclophosphamide (MCVAC) conditioning regimen has been effective in diffuse large B-cell lymphoma. However, limited data are available regarding this conditioning regimen for cHL. In this study, we investigated the efficacy and toxicity of MCVAC for RRcHL. We retrospectively analyzed 10 patients with RRcHL who underwent ASCT preceded by the MCVAC conditioning regimen between January 2009 and December 2021 at our institution. A total of 10 patients (median [range] age, 36 [23-64] years), including 5 (50%) men and 5 (50%) women, were treated with the MCVAC regimen followed by ASCT. The median follow-up duration of the 10 patients was 25.0 months. The 36-month PFS and OS rates were 43.8% (95% CI, 11.9%-72.6%) and 64.0% (95% CI, 22.6%-87.5%), respectively. Two patients died because of treatment-related factors, and one patient died because of disease progression. Based on our findings, recognizing the risk factors for adverse events (AEs) associated with this treatment, MCVAC may be a valid treatment option for the management of RRcHL.

The Impact of Pretransplant Use of Tyrosine Kinase Inhibitors on Allogeneic Stem Cell Transplantation in Patients with Chronic Myeloid Leukemia - A Single-institution Retrospective Study.

Objective Chronic myeloid leukemia (CML) is a malignant hematological disorder, and allogeneic stem cell transplantation (allo-SCT) was its only curative treatment until the introduction of tyrosine kinase inhibitors (TKIs). Allo-SCT is still considered for CML patients who are resistant to TKIs and in an advanced phase. Currently, second- and third-generation (2/3G TKIs are typically incorporated into the first-line treatment of CML. However, the impact of 2/3G TKIs on subsequent allo-SCT remains unclear. We therefore evaluated the effect of 2/3G TKIs on allo-SCT. Methods We retrospectively evaluated the effect of pretransplant therapy with TKIs on the outcome of allo-SCT for CML using clinical data at our institution. Patients Thirty-two CML patients who received their first allo-SCT procedure at our institute from 2001 to 2020 were included. We divided the patients into three subgroups based on TKI treatment before allo-SCT. Patients receiving no TKIs, only imatinib (IM), and 2/3G TKIs were classified into the Non-TKI, IM, and 2/3G TKI groups, respectively. Results In a univariate analysis, the pretransplant use of 2/3G TKIs was significantly associated with a higher 5-year overall survival (91.7%) and relapse-free survival (75.0%) than the use of IM (37.5% and 12.5%) in patients presenting with or progressing to the advanced phase. In addition, pretransplant use of 2/3G TKIs did not increase the incidence of graft-versus-host disease (GVHD). Conclusion We demonstrated that the pretransplant use of 2/3G TKIs was safe and improved the outcome of CML patients who presented with or progressed to the advanced phase without increasing the frequency of GVHD.