Pilot study using post-transplant cyclophosphamide (PTCy), tacrolimus and mycophenolate GVHD prophylaxis for older patients receiving 10/10 HLA-matched unrelated donor hematopoietic stem cell transplantation.

Abstract:

:Allogeneic SCT for older patients remains challenging at least in part due to graft-versus-host disease (GVHD) and higher non-relapse mortality (NRM). We conducted a prospective pilot study primarily for older patients undergoing matched unrelated donor (MUD) SCT using a reduced-intensity (RIC) melphalan-based conditioning and post-transplant cyclophosphamide (PTCy)-based GVHD prophylaxis with tacrolimus and mycophenolate mofetil. Twenty-two patients (median age 64, IQR 58, 66) underwent RIC MUD SCT for high-risk hematological malignancies including AML/MDS (73%), CML/MPD (18%), and other (10%). Two (9%) patients had early death; the rest (100%) engrafted. After a median follow-up of 17 months, 11 patients were alive and disease-free with an estimated 2-year progression-free (PFS) and overall (OS) survival of 48%. The cumulative incidences of grades 2-4 and 3-4 acute GVHD (aGVHD) at day + 100 and 2-years were 32 and 4%, and 59 and 24%, respectively. No cases of chronic GVHD (cGVHD) were noted. However, late acute GVHD was observed in 6 (27%) patients. In conclusion, RIC MUD SCT with melphalan-based conditioning and PTCy-based GVHD-based prophylaxis for older patients appears effective in controlling relapse. While cGVHD was not seen and early aGVHD appears controllable, a significant proportion developed late aGVHD responsible for higher NRM seen in these patients.

journal_name

Bone Marrow Transplant

authors

Shah MV,Saliba RM,Rondon G,Chen J,Soebbing D,Rus I,Alousi A,Oran B,Kebriaei P,Qazilbash M,Parmar S,Hosing C,Khouri IF,Popat UR,Champlin RE,Ciurea SO

doi

10.1038/s41409-018-0367-2

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

601-606

issue

4

eissn

0268-3369

issn

1476-5365

pii

10.1038/s41409-018-0367-2

journal_volume

54

pub_type

杂志文章
  • Transplantation of patients with high risk acute myeloid leukemia in first remission with autologous marrow cultured in interleukin-2 followed by interleukin-2 administration.

    abstract::Relapse rates in patients after autologous bone marrow transplantation (BMT) for acute myeloid leukemia (AML) continue to be high despite the use of aggressive conditioning regimens. Based on studies in the murine system a clinical protocol was developed that utilizes immunotherapy to obtain a graft-versus-leukemia (G...

    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章

    doi:

    authors: Klingemann HG,Eaves CJ,Barnett MJ,Eaves AC,Hogge DE,Nantel SH,Reece E,Shepherd JD,Sutherland HJ,Phillips GL

    更新日期:1994-09-01 00:00:00

  • Management of CMV, HHV-6, HHV-7 and Kaposi-sarcoma herpesvirus (HHV-8) infections in patients with hematological malignancies and after SCT.

    abstract::These recommendations were prepared by the European Conference on Infections in Leukaemia following a predefined methodology. Literature searches were made to identify studies pertinent to management of CMV, HHV-6, -7 and -8 infections. For CMV, 76 studies were reviewed: 72 published and 4 presented as abstracts. Twen...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章,实务指引

    doi:10.1038/bmt.2008.162

    authors: Ljungman P,de la Camara R,Cordonnier C,Einsele H,Engelhard D,Reusser P,Styczynski J,Ward K,European Conference on Infections in Leukemia.

    更新日期:2008-08-01 00:00:00

  • Hematopoietic stem cell transplantation in Oman.

    abstract::Hematopoietic SCT (HSCT) is an integral part of the management of patients with hematologic disorders. The Sultanate of Oman, with a population of 2.3 million, has an HSCT program based in the Sultan Qaboos University (SQU) hospital. Initiated in 1995, this two-bed unit continues to be the only program in the country....

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2008.131

    authors: Dennison D,Al Kindi S,Pathare A,Daar S,Nusrat N,Ur Rehman J,Zia F,Khan H,Khan MI,Alghazaly A,Al Zadjali S,Tauro M,Al Lawatia A,Ganguly S

    更新日期:2008-08-01 00:00:00

  • Myasthenia gravis in association with allogeneic bone marrow transplantation: clinical observations, therapeutic implications and review of literature.

    abstract::Myasthenia gravis (MG) is a rare complication of allogeneic bone marrow transplantation (BMT). We present the 11th case in the medical literature, a 23-year-old female 100 months post-allogeneic bone marrow transplantation for acute myelogenous leukemia (AML). After discontinuation of immunosuppression for chronic gra...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1700759

    authors: Mackey JR,Desai S,Larratt L,Cwik V,Nabholtz JM

    更新日期:1997-05-01 00:00:00

  • Human-ovine xenogenic transplantation of stem cells in utero.

    abstract::The preimmune status of the early gestational age fetus provides a permissive environment that bypasses the immunological barrier and permits the engraftment and expression of hemopoietic stem cells (HSC). We used in utero approach to establish long term (greater than 2 years) engraftment and expression of human fetal...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Zanjani ED,Pallavacini MG,Ascensao JL,Flake AW,Harrison MR,Tavassoli M

    更新日期:1992-01-01 00:00:00

  • G-CSF alone vs cyclophosphamide plus G-CSF in PBPC mobilization of patients with lymphoma: results depend on degree of previous pretreatment.

    abstract::We performed a randomized study to compare 'G-CSF alone' (administered at dose of 10 mcg/kg/day) and 'cyclophosphamide plus G-CSF' (cyclophosphamide at dose of 4 g/m(2) and G-CSF at dose of 10 microg/kg/day), as PBPC mobilization schedules in 52 patients with NHL or HD. Randomization was stratified according to the am...

    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1038/sj.bmt.1703912

    authors: Milone G,Leotta S,Indelicato F,Mercurio S,Moschetti G,Di Raimondo F,Tornello A,Consoli U,Guido G,Giustolisi R

    更新日期:2003-05-01 00:00:00

  • Reduced-intensity conditioning with fludarabine and thiotepa for second allogeneic transplantation of relapsed patients with AML.

    abstract::A second allograft was offered to 58 relapsed AML patients after conditioning with fludarabine 90-150 mg/m(2) and thiotepa 15 mg/kg, in most cases with active disease. Median age was 53 years (range 23-69), median time to relapse after the first allo-SCT was 326 (47-2189) days and median follow-up was 6.7 years. GVHD ...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2012.267

    authors: Christopoulos P,Schmoor C,Waterhouse M,Marks R,Wäsch R,Bertz H,Finke J

    更新日期:2013-07-01 00:00:00

  • Plerixafor plus granulocyte CSF can mobilize hematopoietic stem cells from multiple myeloma and lymphoma patients failing previous mobilization attempts: EU compassionate use data.

    abstract::Plerixafor was recently approved by the US Food and Drug Administration (FDA) and the European Medicines Evaluation Agency (EMEA) to enhance stem cell mobilization for autologous transplant in patients with lymphoma and multiple myeloma. In this study, we present the first European compassionate use experience in mobi...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2010.54

    authors: Duarte RF,Shaw BE,Marín P,Kottaridis P,Ortiz M,Morante C,Delgado J,Gayoso J,Goterriz R,Martínez-Chamorro C,Mateos-Mazón JJ,Ramírez C,de la Rubia J,Achtereekte H,Gandhi PJ,Douglas KW,Russell NH

    更新日期:2011-01-01 00:00:00

  • Graft-versus-lymphoma effect of donor lymphocyte infusion in indolent lymphomas relapsed after allogeneic stem cell transplantation.

    abstract::Donor lymphocyte infusions (DLI) are used to treat relapsed haematological diseases after allogeneic stem cell transplantation (SCT). We treated seven patients with DLI for indolent non-Hodgkin's lymphoma relapsed after SCT. In available blood and bone marrow samples, lymphoma cells were analysed by real-time quantita...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1704290

    authors: Mandigers CM,Verdonck LF,Meijerink JP,Dekker AW,Schattenberg AV,Raemaekers JM

    更新日期:2003-12-01 00:00:00

  • Combination therapy with carfilzomib, lenalidomide and dexamethasone (KRd) results in an unprecedented purity of the stem cell graft in newly diagnosed patients with myeloma.

    abstract::Still, many physicians give 4 cycles of combination therapy to multiple myeloma patients prior to collection of stem cells for autologous bone marrow transplant. This tradition originates from older doxorubicin-containing regiments which limited the number of cycles due to cumulative cardiotoxicity. Using older regime...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/s41409-018-0170-0

    authors: Tageja N,Korde N,Kazandjian D,Panch S,Manasanch E,Bhutani M,Kwok M,Mailankody S,Yuan C,Stetler-Stevenson M,Leitman SF,Sportes C,Landgren O

    更新日期:2018-11-01 00:00:00

  • Hexaminolevulinate-mediated photodynamic purging of marrow grafts with murine breast carcinoma.

    abstract::Photodynamic therapy (PDT) with porphyrin precursors is an established therapy for certain tumors. This study aimed to explore the use of hexaminolevulinate (HAL), a porphyrin precursor, for photodynamic purging of BM grafts contaminated with cells of the 4T1 breast carcinoma cell line. The optimal PDT dose was not ef...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2010.277

    authors: Čunderlíková B,Vasovič V,Sieber F,Furre T,Borgen E,Nesland JM,Peng Q

    更新日期:2011-08-01 00:00:00

  • The influence of early transplantation, age, GVHD prevention regimen, and other factors on outcome of allogeneic transplantation for CML following BuCy.

    abstract::Results in 164 patients who underwent allogeneic marrow transplantation following busulfan and cyclophosphamide over a 15 year period were analyzed. Age (median 37, range 14-66 years) did not significantly affect the incidence of graft-versus-host disease (GVHD), but patients who received methotrexate with cyclosporin...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1702689

    authors: Copelan EA,Penza SL,Theil KS,Elder PJ,Bechtel TP,Tighe MB,Ezzone SA,Scholl MD,Belt PS,Young DC,Avalos BR

    更新日期:2000-11-01 00:00:00

  • A comparison of serological, cellular and DNA-RFLP methods for HLA matching in the selection of related bone marrow donors.

    abstract::Serological, cellular and DNA-RFLP (restriction fragment length polymorphism) methods of determining HLA compatibility between 10 leukaemic patients and potential related bone marrow donors were systematically compared. DR beta/DQ alpha/DQ beta/DNA-RFLP typing of these families gave results in agreement with those obt...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Howell WM,Evans PR,Spellerberg MB,Wilson PJ,Smith JL

    更新日期:1989-01-01 00:00:00

  • Quality of life and behavioral adjustment after pediatric bone marrow transplantation.

    abstract::The purpose of this study was two-fold: to describe the quality of life and behavioral adjustment of survivors of pediatric bone marrow transplantation (BMT) prior to and 6 months post-BMT; and, to identify correlates of survivors' quality of life and behavioral adjustment. Participants were 26 children and adolescent...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1702527

    authors: Barrera M,Boyd-Pringle LA,Sumbler K,Saunders F

    更新日期:2000-08-01 00:00:00

  • The utility of plasma polymerase chain reaction for human herpes virus-6 among pediatric bone marrow transplant recipients: results of a pilot study.

    abstract::We evaluated the utility of plasma polymerase chain reaction (PCR) for surveillance of human herpes virus 6 (HHV-6) infection among pediatric bone marrow transplant (BMT) recipients. We used a prospective, non-interventional design involving a study group and controls. BMT recipients and healthy controls were evaluate...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1703153

    authors: Allen UD,Tellier R,Doyle J,Petric M,Wasfy S,Kumar P,Calderwood S,Freedman M,Saunders F

    更新日期:2001-09-01 00:00:00

  • Double high-dose chemoradiotherapy with autologous stem cell transplantation can induce molecular remissions in multiple myeloma.

    abstract::Fifteen patients with stage II-III multiple myeloma were intended to undergo two sequential cycles of myeloablative chemoradiotherapy with autologous bone marrow or blood stem cell transplantation after response to primary induction chemotherapy. BM grafts were used in 13 of the 15 first transplants whereas PBSC were ...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Björkstrand B,Ljungman P,Bird JM,Samson D,Gahrton G

    更新日期:1995-03-01 00:00:00

  • Urinary trypsin inhibitor concentration can predict the immunological insult of chemotherapy and complications after bone marrow transplantation.

    abstract::Urinary trypsin inhibitor has attracted attention as an index of the systemic inflammatory response syndrome. In this study, the urine concentration of trypsin inhibitor was measured to compare the immunological insult of conventional chemotherapy and conditioning chemotherapy for bone marrow transplantation. We also ...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1702755

    authors: Yamada S,Takatsuka H,Takemoto Y,Wada H,Fujimori Y,Okamoto T,Kanamaru A,Kakishita E

    更新日期:2001-01-01 00:00:00

  • Absence of IL-23p19 in donor allogeneic cells reduces mortality from acute GVHD.

    abstract::The p19 dimer of interleukin 23 (IL-23) has been reported to have a major role in the pathogenesis of many experimental and clinical autoimmune diseases and may also have a prominent role in transplantation. We reasoned that deficiency of p19 in the allogeneic donor transplant might reduce the inflammation caused by a...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2009.215

    authors: Thompson JS,Chu Y,Glass JF,Brown SA

    更新日期:2010-04-01 00:00:00

  • Long-term follow-up of metastatic renal cancer patients undergoing reduced-intensity allografting.

    abstract::SCT from an HLA-compatible sibling donor is an adoptive immunotherapy for cytokine-refractory, metastatic clear-cell renal cell cancer (RCC). However, the recent introduction of targeted therapy compounds has reduced the interest in this therapeutic strategy. We have reanalyzed our series with the aim to assess long-t...

    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1038/bmt.2009.9

    authors: Bregni M,Bernardi M,Servida P,Pescarollo A,Crocchiolo R,Treppiedi E,Corradini P,Ciceri F,Peccatori J

    更新日期:2009-08-01 00:00:00

  • Prospective pilot trial of calcipotriene as a novel topical treatment for acute skin graft versus host disease.

    abstract::Skin graft versus host disease (GVHD) can affect quality of life in hematopoietic stem cell transplant recipients. Therapeutic options for steroid-refractory GVHD are limited. We report the first prospective pilot study evaluating the topical vitamin D3 analog Calcipotriene (DOVONEX 0.005% cream) for acute skin GVHD i...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/s41409-020-01189-3

    authors: Wallace G,Khandelwal P,Myers KC,Perentesis EMR,Lane A,Teusink-Cross A,Smiley K,Davies SM,Jodele S

    更新日期:2021-01-08 00:00:00

  • Donor leucocyte infusions after chemotherapy for patients relapsing with acute leukaemia following allogeneic BMT.

    abstract::Four patients with acute myeloid leukaemia relapsed within 6 months of allogeneic BMT. Three patients were treated with cytosine arabinoside and amsacrine while the fourth received no chemotherapy. All patients received infusions of leucocytes obtained by repeated leukapheresis from the original bone marrow donor. Thr...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Szer J,Grigg AP,Phillips GL,Sheridan WP

    更新日期:1993-02-01 00:00:00

  • Enteral budesonide in treatment for mild and moderate gastrointestinal chronic GVHD.

    abstract::Budesonide (BUD) is a steroid with a low bioavailability, which has been used for the treatment of oral manifestations of chronic GVHD (cGVHD). We retrospectively evaluated the efficacy of BUD in the treatment of gastrointestinal cGVHD. Thirteen patients (median age 47 years) receiving BUD for the treatment of cGVHD a...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2008.209

    authors: Andree H,Hilgendorf I,Leithaeuser M,Junghanss C,Holzhueter S,Loddenkemper C,Steiner B,Freund M,Wolff D

    更新日期:2008-10-01 00:00:00

  • In vitro and in vivo depletion of T cells.

    abstract::Transplant related mortality and relapse after bmt have a negative influence on the outcome of patients transplanted for acute leukaemia in first remission. Transplant related mortality includes graft-versus-host disease, infections and graft failure. To prevent gvhd and associated infections without increased graft r...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Arnold R,Bunjes D,Wiesneth M,Hertenstein B,Theobald M,Heimpel H,Hale G,Waldmann H

    更新日期:1993-01-01 00:00:00

  • Immunomodulation of early engrafted natural killer cells with interleukin-2 and interferon-alpha in autologous stem cell transplantation.

    abstract::High relapse rates during the first year after autologous stem cell transplantation (ASCT) for multiple myeloma or non-Hodgkin lymphoma are due to the failure of high-dose chemotherapy to eradicate minimal residual disease. Post-ASCT immunorecovery studies have shown that quantities of natural killer (NK) cells return...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1703203

    authors: Porrata LF,Inwards DJ,Lacy MQ,Markovic SN

    更新日期:2001-10-01 00:00:00

  • Trajectories of acute graft-versus-host disease and mortality in critically ill allogeneic-hematopoietic stem cell recipients: the Allo-GRRR-OH score.

    abstract::Acute graft-versus-host disease (aGVHD) is a major cause of morbidity mortality in critically ill hematopoietic stem cell transplantation recipients. We assessed aGVHD trajectories in 191 allogeneic-HSCT recipients (age 42 (27-46)) admitted to our ICU between 2005 and 2015. aGVHD affected 130 (68%) patients (including...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/s41409-020-0857-x

    authors: Pichereau C,Lengliné E,Valade S,Michonneau D,Ghrenassia E,Lemiale V,Socié G,Azoulay E

    更新日期:2020-10-01 00:00:00

  • Effect of autologous hematopoietic stem cell transplantation on multiple sclerosis and neuromyelitis optica spectrum disorder: a PRISMA-compliant meta-analysis.

    abstract::We should consider both the treatment effects and adverse effects of autologous hematopoietic stem cell transplantation (AHSCT) on multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). Articles exploring the effect and safety of AHSCT in the treatment of MS and NMOSD and published before Decembe...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/s41409-020-0810-z

    authors: Zhang P,Liu B

    更新日期:2020-10-01 00:00:00

  • Allogeneic bone marrow transplantation in patients with lymphoma relapsing after autologous marrow transplantation.

    abstract::Two patients who underwent autologous bone marrow transplantation for recurrent non-Hodgkin's lymphoma relapsed at 46 and 28 days after the transplant. Both patients had an HLA-identical sibling and were treated with high-dose chemotherapy and allogeneic marrow transplantation. One patient is now 24 months after the a...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Schouten HC,Armitage JO,Klassen LW,Vaughan WP,Bierman PJ,Weisenburger D,Kessinger A

    更新日期:1989-01-01 00:00:00

  • Peripheral blood stem cell (PBSC) collection in extremely low-weight infants.

    abstract::While PBSC collection has become a safe procedure for adults, only a few reports exist about its efficacy, safety and feasibility in paediatric patients, especially extremely low-weight infants. We describe successful PBSC collection in three infants of less than 10 kg body weight (BW; range: 6.92-9.4 kg) suffering fr...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Nussbaumer W,Schönitzer D,Trieb T,Fink FM,Maurer-Dengg K,Höcker P,Wagner A,Schwaighofer H,Nachbaur D,Niederwieser D

    更新日期:1996-07-01 00:00:00

  • Allogeneic bone marrow transplantation with matched unrelated donors for patients with hematologic malignancies using a preparative regimen of high-dose cyclophosphamide and fractionated total body irradiation.

    abstract::Allogeneic bone marrow transplantation (BMT) from an HLA-identical sibling donor is effective therapy for patients with bone marrow failure states and those with hematologic malignancies. However, only a minority of them will have an HLA-identical sibling donor; unrelated donors, matched or partially mismatched, have ...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1700874

    authors: Geller RB,Devine SM,O'Toole K,Persons L,Keller J,Mauer D,Holland HK,Dix SP,Piotti M,Redei I,Connaghan G,Heffner LT,Hillyer CD,Waller EK,Winton EF,Wingard JR

    更新日期:1997-08-01 00:00:00

  • Allogeneic bone marrow transplantation for fucosidosis.

    abstract::Bone marrow transplantation was performed on an 8-month-old boy who was diagnosed as having fucosidosis following the diagnosis of the disease in his older brother. Although he was asymptomatic and his development was normal, abnomalities were found on an MRI scan prior to transplant. In the absence of a suitable rela...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Vellodi A,Cragg H,Winchester B,Young E,Young J,Downie CJ,Hoare RD,Stocks R,Banerjee GK

    更新日期:1995-01-01 00:00:00