المؤلفون: Oran, Betül, Ahn, Kwang Woo, Fretham, Caitrin, Beitinjaneh, Amer, Bashey, Asad, Pawarode, Attaphol, Wirk, Baldeep, Scott, Bart L, Savani, Bipin N, Bredeson, Christopher, Weisdorf, Daniel, Marks, David I, Rizzieri, David, Copelan, Edward, Hildebrandt, Gerhard C, Hale, Gregory A, Murthy, Hemant S, Lazarus, Hillard M, Cerny, Jan, Liesveld, Jane L, Yared, Jean A, Yves-Cahn, Jean, Szer, Jeffrey, Verdonck, Leo F, Aljurf, Mahmoud, van der Poel, Marjolein, Litzow, Mark, Kalaycio, Matt, Grunwald, Michael R, Diaz, Miguel Angel, Sabloff, Mitchell, Kharfan-Dabaja, Mohamed A, Majhail, Navneet S, Farhadfar, Nosha, Reshef, Ran, Olsson, Richard F, Gale, Robert Peter, Nakamura, Ryotaro, Seo, Sachiko, Chhabra, Saurabh, Hashmi, Shahrukh, Farhan, Shatha, Ganguly, Siddhartha, Nathan, Sunita, Nishihori, Taiga, Jain, Tania, Agrawal, Vaibhav, Bacher, Ulrike, Popat, Uday, Saber, Wael

المساهمون: Medicine

المصدر: Transplantation and cellular therapy ; 27 ; 11 ; 921.e1 ; 921.e10 ; United States

مصطلحات موضوعية: MDS, Melphalan, Relapse, Survival, Transplantation

الوصف: Reduced-intensity conditioning (RIC) regimens developed to extend the use of allogeneic hematopoietic stem cell transplantation (HSCT) to older patients have resulted in encouraging outcomes. We aimed to compare the 2 most commonly used RIC regimens, i.v. fludarabine with busulfan (FluBu) and fludarabine with melphalan (FluMel), in patients with myelodysplastic syndrome (MDS). Through the Center for International Blood and Marrow Transplant Research (CIBMTR), we identified 1045 MDS patients age ≥60 years who underwent first HSCT with a matched related or matched (8/8) unrelated donor using an RIC regimen. The CIBMTR's definition of RIC was used: a regimen that incorporated an i.v. busulfan total dose ≤7.2 mg/kg or a low-dose melphalan total dose ≤150 mg/m2. The 2 groups, recipients of FluBu (n = 697) and recipients of FluMel (n = 448), were comparable in terms of disease- and transplantation-related characteristics except for the more frequent use of antithymocyte globulin or alemtuzumab in the FluBu group (39% versus 31%). The median age was 67 years in both groups. FluMel was associated with a reduced relapse incidence (RI) compared with FluBu, with a 1-year adjusted incidence of 26% versus 44% (P ≤ .0001). Transplantation-related mortality (TRM) was higher in the FluMel group (26% versus 16%; P ≤ .0001). Because the magnitude of improvement with FluMel in RI was greater than the improvement in TRM with FluBu, disease-free survival (DFS) was better at 1 year and beyond with FluMel compared with FluBu (48% versus 40% at 1 year [P = .02] and 35% versus 27% at 3 years [P = .01]). Overall survival was comparable in the 2 groups at 1 year (63% versus 61%; P = .4) but was significantly improved with FluMel compared with FluBu at 3 years (46% versus 39%; P = .03). Our results suggest that FluMel is associated with superior DFS compared with FluBu owing to reduced RI in older patients with MDS patients. © 2021 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.

العلاقة: Transplantation and Cellular Therapy; https://doi.org/10.1016/j.jtct.2021.08.007Test; Oran B, Ahn KW, Fretham C, Beitinjaneh A, Bashey A, Pawarode A, Wirk B, Scott BL, Savani BN, Bredeson C, Weisdorf D, Marks DI, Rizzieri D, Copelan E, Hildebrandt GC, Hale GA, Murthy HS, Lazarus HM, Cerny J, Liesveld JL, Yared JA, Yves-Cahn J, Szer J, Verdonck LF, Aljurf M, van der Poel M, Litzow M, Kalaycio M, Grunwald MR, Diaz MA, Sabloff M, Kharfan-Dabaja MA, Majhail NS, Farhadfar N, Reshef R, Olsson RF, Gale RP, Nakamura R, Seo S, Chhabra S, Hashmi S, Farhan S, Ganguly S, Nathan S, Nishihori T, Jain T, Agrawal V, Bacher U, Popat U, Saber W. Fludarabine and Melphalan Compared with Reduced Doses of Busulfan and Fludarabine Improve Transplantation Outcomes in Older Patients with Myelodysplastic Syndromes. Transplant Cell Ther. 2021 Nov;27(11):921.e1-921.e10. doi:10.1016/j.jtct.2021.08.007. Epub 2021 Aug 14. PMID: 34403791; PMCID: PMC9562611.; http://hdl.handle.net/20.500.14038/51890Test

الإتاحة: https://doi.org/10.1016/j.jtct.2021.08.007Test
https://doi.org/20.500.14038/51890Test
https://hdl.handle.net/20.500.14038/51890Test

المؤلفون: Oran, Betül, Ahn, Kwang Woo, Fretham, Caitrin, Beitinjaneh, Amer, Bashey, Asad, Pawarode, Attaphol, Wirk, Baldeep, Scott, Bart L., Savani, Bipin N., Bredeson, Christopher, Weisdorf, Daniel, Marks, David I., Rizzieri, David, Copelan, Edward, Hildebrandt, Gerhard C., Hale, Gregory A., Murthy, Hemant S., Lazarus, Hillard M., Cerny, Jan, Liesveld, Jane L., Yared, Jean A., Yves-Cahn, Jean, Szer, Jeffrey, Verdonck, Leo F., Aljur, Mahmoud, van der Poel, Marjolein, Litzow, Mark, Kalaycio, Matt, Grunwald, Michael R., Diaz, Miguel Angel, Sabloff, Mitchell, Kharfan-Dabaja, Mohamed A., Majhail, Navneet S., Farhadfar, Nosha, Reshef, Ran, Olsson, Richard F., Gale, Robert Peter, Nakamura, Ryotaro, Seo, Sachiko, Chhabra, Saurabh, Hashmi, Shahrukh, Farhan, Shatha, Ganguly, Siddhartha, Nathan, Sunita, Nishihori, Taiga, Jain, Tania, Agrawal, Vaibhav, Bacher, Ulrike, Popat, Uday, Saber, Wael

المساهمون: Medicine, School of Medicine

المصدر: PMC

مصطلحات موضوعية: MDS, Melphalan, Relapse, Survival, Transplantation

الوصف: Reduced-intensity conditioning (RIC) regimens developed to extend the use of allogeneic hematopoietic stem cell transplantation (HSCT) to older patients have resulted in encouraging outcomes. We aimed to compare the 2 most commonly used RIC regimens, i.v. fludarabine with busulfan (FluBu) and fludarabine with melphalan (FluMel), in patients with myelodysplastic syndrome (MDS). Through the Center for International Blood and Marrow Transplant Research (CIBMTR), we identified 1045 MDS patients age ≥60 years who underwent first HSCT with a matched related or matched (8/8) unrelated donor using an RIC regimen. The CIBMTR's definition of RIC was used: a regimen that incorporated an i.v. busulfan total dose ≤7.2 mg/kg or a low-dose melphalan total dose ≤150 mg/m2. The 2 groups, recipients of FluBu (n = 697) and recipients of FluMel (n = 448), were comparable in terms of disease- and transplantation-related characteristics except for the more frequent use of antithymocyte globulin or alemtuzumab in the FluBu group (39% versus 31%). The median age was 67 years in both groups. FluMel was associated with a reduced relapse incidence (RI) compared with FluBu, with a 1-year adjusted incidence of 26% versus 44% (P ≤ .0001). Transplantation-related mortality (TRM) was higher in the FluMel group (26% versus 16%; P ≤ .0001). Because the magnitude of improvement with FluMel in RI was greater than the improvement in TRM with FluBu, disease-free survival (DFS) was better at 1 year and beyond with FluMel compared with FluBu (48% versus 40% at 1 year [P = .02] and 35% versus 27% at 3 years [P = .01]). Overall survival was comparable in the 2 groups at 1 year (63% versus 61%; P = .4) but was significantly improved with FluMel compared with FluBu at 3 years (46% versus 39%; P = .03). Our results suggest that FluMel is associated with superior DFS compared with FluBu owing to reduced RI in older patients with MDS patients.

وصف الملف: application/pdf

العلاقة: Transplantation and Cellular Therapy; Oran B, Ahn KW, Fretham C, et al. Fludarabine and Melphalan Compared with Reduced Doses of Busulfan and Fludarabine Improve Transplantation Outcomes in Older Patients with Myelodysplastic Syndromes. Transplant Cell Ther. 2021;27(11):921.e1-921.e10. doi:10.1016/j.jtct.2021.08.007; https://hdl.handle.net/1805/35894Test

الإتاحة: https://doi.org/10.1016/j.jtct.2021.08.007Test
https://hdl.handle.net/1805/35894Test

المؤلفون: Htut, Myo, D'Souza, Anita, Krishnan, Amrita, Bruno, Benedetto, Zhang, Mei-Jie, Fei, Mingwei, Diaz, Miguel Angel, Copelan, Edward, Ganguly, Siddhartha, Hamadani, Mehdi, Kharfan-Dabaja, Mohamed, Lazarus, Hillard, Lee, Cindy, Meehan, Kenneth, Nishihori, Taiga, Saad, Ayman, Seo, Sachiko, Ramanathan, Muthalagu, Usmani, Saad Z, Gasparetto, Christina, Mark, Tomer M, Nieto, Yago, Hari, Parameswaran

المصدر: Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid
Consejería de Sanidad de la Comunidad de Madrid

مصطلحات موضوعية: Adult, Male, Survival, Hematopoietic Stem Cell Transplantation, Myeloma, Middle Aged, Allografts, Disease-Free Survival, Survival Rate, Sex Factors, Recurrence, Risk Factors, Allogeneic transplantation, Humans, Female, Relapse, Autografts, Multiple Myeloma, Aged

الوصف: We compared postrelapse overall survival (OS) after autologous/allogeneic (auto/allo) versus tandem autologous (auto/auto) hematopoietic cell transplantation (HCT) in patients with multiple myeloma (MM). Postrelapse survival of patients receiving an auto/auto or auto/allo HCT for MM and prospectively reported to the Center for International Blood and Marrow Transplant Research between 2000 and 2010 were analyzed. Relapse occurred in 404 patients (72.4%) in the auto/auto group and in 178 patients (67.4%) in the auto/allo group after a median follow-up of 8.5 years. Relapse occurred before 6 months after a second HCT in 46% of the auto/allo patients, compared with 26% of the auto/auto patients. The 6-year postrelapse survival was better in the auto/allo group compared with the auto/auto group (44% versus 35%; P = .05). Mortality due to MM was 69% (n = 101) in the auto/allo group and 83% (n = 229) deaths in auto/auto group. In multivariate analysis, both cohorts had a similar risk of death in the first year after relapse (hazard ratio [HR], .72; P = .12); however, for time points beyond 12 months after relapse, overall survival was superior in the auto/allo cohort (HR for death in auto/auto =1.55; P = .005). Other factors associated with superior survival were enrollment in a clinical trial for HCT, male sex, and use of novel agents at induction before HCT. Our findings shown superior survival afterrelapse in auto/allo HCT recipients compared with auto/auto HCT recipients. This likely reflects a better response to salvage therapy, such as immunomodulatory drugs, potentiated by a donor-derived immunologic milieu. Further augmentation of the post-allo-HCT immune system with new immunotherapies, such as monoclonal antibodies, checkpoint inhibitors, and others, merit investigation.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=RECOLECTA___::3a9c27411c6b0ae966f908b1ef5d8619Test
https://hdl.handle.net/20.500.12530/29949Test

المؤلفون: Copelan, Edward A., Chojecki, Aleksander, Lazarus, Hillard M., Avalos, Belinda R.

المصدر: Blood Reviews; Mar2019, Vol. 34, p34-44, 11p

مستخلص: Abstract Allogeneic hematopoietic cell transplantation (HCT) provides the best chance for cure for many patients with malignant and nonmalignant hematologic disorders. Recent advances in selecting candidates and determining risk, procedure safety, utilization in older patients, use of alternative donors, and new or novel application of anti-cancer, immunosuppressive and antimicrobial agents have improved outcomes and expanded the role of HCT in hematologic disorders. Relapse remains the predominant cause of failure but enlightened use of new targeted and immunotherapeutic agents in combination with HCT promises to reduce relapse and further improve HCT outcomes. [ABSTRACT FROM AUTHOR]

: Copyright of Blood Reviews is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Advani, Anjali S., McDonough, Shannon, Copelan, Edward, Willman, Cheryl, Mulford, Deborah A., List, Alan F., Sekeres, Mikkael A., Othus, Megan, Appelbaum, Frederick R.

المصدر: British Journal of Haematology; Oct2014, Vol. 167 Issue 2, p233-237, 5p

مصطلحات موضوعية: ACUTE myeloid leukemia treatment, IDARUBICIN, CYTARABINE, PRAVASTATIN, CANCER relapse, COMBINATION drug therapy, CLINICAL trials, THERAPEUTICS, CANCER treatment

مستخلص: Inhibition of cholesterol synthesis and uptake sensitizes acute myeloid leukaemia ( AML) blasts to chemotherapy. A Phase 1 study demonstrated the safety of high dose pravastatin given with idarubicin and cytarabine in patients with AML and also demonstrated an encouraging response rate. The Southwestern Oncology Group ( SWOG) trial, SWOG S0919, was a Phase 2 trial evaluating the complete remission ( CR) rate in a larger number of patients with relapsed AML treated with idarubicin, cytarabine and pravastatin. This study closed to accrual after meeting the defined criterion for a positive study. Thirty-six patients with a median age of 59 years (range 23-78) were enrolled. The median time from diagnosis to registration was 18 months. Relapse status was first relapse, 17 patients (47%); second relapse, 15 patients (42%); third relapse, two patients (5·5%) and fourth relapse, two patients (5·5%). The response rate was 75% [95% confidence interval: 58-88%; 20 CRs, 7 CR with incomplete count recovery ( CRi)], and the median overall survival was 12 months. The P-value comparing 75-30% (the null response rate based on prior SWOG experience) was 3·356 × 10⁻⁴. Given the encouraging CR/ CRi rate, this regimen should be considered for testing in a prospective randomized trial against best conventional therapy. [ABSTRACT FROM AUTHOR]

: Copyright of British Journal of Haematology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Smith, Stephen D., Moskowitz, Craig H., Dean, Robert, Pohlman, Brad, Sobecks, Ronald, Copelan, Edward, Andresen, Steven, Bolwell, Brian, Maragulia, Jocelyn C., Vanak, Jill M., Sweetenham, John, Moskowitz, Alison J.

المصدر: British Journal of Haematology; May2011, Vol. 153 Issue 3, p358-363, 6p, 3 Charts, 2 Graphs

مصطلحات موضوعية: HODGKIN'S disease, DISEASE relapse, PROGNOSIS, STEM cell transplantation, MULTIVARIATE analysis

مستخلص: Prior series have demonstrated that early relapsed (within 1 year) or refractory Hodgkin lymphoma (HL) is associated with poor prognosis. To determine the outcome for patients with early relapsed/refractory HL in the modern era, we combined data from two large transplant centres, Cleveland Clinic Taussig Cancer Institute (CCTCI) and Memorial Sloan-Kettering Cancer Center (MSKCC), and analysed consecutive patients transplanted for relapsed/refractory HL following induction failure or remission durations of <1 year. Two hundred and fourteen patients were analysed and the event-free survival (EFS) and overall survival (OS) at 6 years for all patients were 45% and 55%, respectively. Factors significant for prognosis in multivariate analysis were extranodal disease and bulky disease (≥5 cm). Patients with 0, 1, or 2 risk factors achieved 6 year EFS of 65%, 47%, and 24% and 6 year OS of 81%, 55%, and 27%, respectively. Patients with the sole risk factor of early relapsed/refractory disease achieved good outcomes in this large series; however the presence of bulk and/or extranodal disease significantly reduced EFS and OS. Patients with these additional risk factors are best suited for clinical trials investigating novel salvage regimens and post-transplant maintenance strategies. [ABSTRACT FROM AUTHOR]

: Copyright of British Journal of Haematology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Dean, Robert M., Pohlman, Brad, Sweetenham, John W., Sobecks, Ronald M., Kalaycio, Matt E., Smith, Stephen D., Copelan, Edward A., Andresen, Steven, Rybicki, Lisa A., Curtis, Julie, Bolwell, Brian J.

المصدر: British Journal of Haematology; Jan2010, Vol. 148 Issue 2, p226-234, 9p, 4 Charts, 4 Graphs

مصطلحات موضوعية: AUTOTRANSPLANTATION, CELL transplantation, CYCLOPHOSPHAMIDE, ETOPOSIDE, PHARMACOKINETICS, LYMPHOMAS

مستخلص: Autologous stem cell transplantation (ASCT) with cyclophosphamide, etoposide and oral busulfan (BuCyVP) is an effective therapy for relapsed or refractory non-Hodgkin lymphoma (NHL). Substituting intravenous for oral busulfan reduces variability in drug exposure, potentially improving the safety and efficacy of the BuCyVP regimen. We retrospectively compared the outcomes of 604 consecutively treated patients who underwent ASCT for NHL with BuCyVP using oral ( n = 468) or IV ( n = 136) busulfan, without measurement of busulfan levels for pharmacokinetic (PK) analysis. Patients who received oral busulfan experienced more severe oral mucositis and a higher incidence of nonrelapse mortality. Median overall survival (OS) after ASCT was 72 months with oral busulfan but was not reached for the IV busulfan group. IV busulfan was associated with a lower rate of relapse, and superior relapse-free survival (RFS) and OS. In multivariate models, the route of busulfan administration was an independent prognostic factor for relapse ( P = 0·01), RFS ( P = 0·002) and OS ( P = 0·001). IV busulfan appears to provide better efficacy and lower toxicity than oral busulfan in ASCT with BuCyVP for NHL. Whether PK-based busulfan dosing can achieve further improvements in this setting is worthy of study. [ABSTRACT FROM AUTHOR]

: Copyright of British Journal of Haematology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Copelan, Edward A.¹ copelae@ccf.org, Crilley, Pamela Ann², Szer, Jeffrey³, Dodds, Anthony J.⁴, Stevenson, Dustin⁵, Phillips, Gary⁶, Elder, Patrick⁷, Nivison-Smith, Ian⁴, Avalos, Belinda R.⁷, Penza, Sam⁷, Topolsky, David², Sobecks, Ronald¹, Kalaycio, Matt¹, Bolwell, Brian J.¹

المصدر: Biology of Blood & Marrow Transplantation. Jul2009, Vol. 15 Issue 7, p851-855. 5p.

مصطلحات موضوعية: *MORTALITY, *DISEASE relapse, *HLA histocompatibility antigens, *STEM cell transplantation, *DRUG therapy, *HEMATOPOIETIC stem cells, *TREATMENT of chronic myeloid leukemia

مستخلص: Allogeneic hematopoietic stem cell transplantation (HSCT) is the only known curative therapy for chronic myelogenous leukemia (CML). Failure, because of relapse or nonrelapse mortality (NRM), generally occurs within 3 years of transplantation, but large studies with long-term follow-up are limited. We present mature results in 335 patients with CML who underwent allogeneic bone marrow transplantation (BMT) from HLA-identical siblings following busulfan and cyclophosphamide (BU/Cy2). Two hundred twenty-nine were in chronic phase (CP) and 106 in accelerated or blastic phase at transplantation. Median follow-up exceeded 14 years. The estimated probability of 18-year leukemia-free survival (LFS) for CP patients was 55.6% and for those beyond CP, 10.5%. Of 182 patients who survived leukemia-free at 3 years, the estimated probability of LFS at 18 years was 61.9%. Late relapse (P = .039) and late NRM (P = .008) occurred at higher rates in patients beyond CP at transplantation. There was no plateau in LFS. [Copyright &y& Elsevier]

المؤلفون: Advani, Anjali, Jin, Tao, Bolwell, Brian, Copelan, Edward, Sekeres, Mikkael, Sobecks, Ronald, Sungren, Shawnda, Yurch, Melissa, Kalaycio, Matt

المصدر: Leukemia & Lymphoma; Jul2009, Vol. 50 Issue 7, p1126-1131, 6p, 1 Diagram, 4 Charts, 2 Graphs

مصطلحات موضوعية: LYMPHOBLASTIC leukemia, BONE marrow transplantation, LACTATE dehydrogenase, PROGNOSTIC tests, GRAFT versus host disease, CLINICAL trials

مستخلص: The outcome of patients with acute lymphoblastic leukemia (ALL) in first relapse is poor. We retrospectively evaluated patients with ALL in first relapse, 18-60 years of age, to define a prognostic score. For all patients, a scoring system of 0-3 was developed with 1 point for each of the following: age at diagnosis ≥45 years, lactate dehydrogenase (LDH) at the time of relapse ≥1.5 times upper limits of normal (ULN), not proceeding to allogeneic bone marrow transplant (BMT). A similar scoring system was developed for patients proceeding to BMT. LDH ≥1.5 times ULN at the time of relapse predicted poor overall survival. Patients with a prognostic score of greater than 1 have a poor prognosis, even with BMT, and should be considered for treatment with innovative approaches such as Phase 1 clinical trials. [ABSTRACT FROM AUTHOR]

: Copyright of Leukemia & Lymphoma is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Mukherjee, Sudipto¹ mukhers2@ccf.org, Boccaccio, Dominic², Sekeres, Mikkael A.¹, Copelan, Edward³

المصدر: Biology of Blood & Marrow Transplantation. Mar2015, Vol. 21 Issue 3, p412-420. 9p.

مصطلحات موضوعية: *MYELODYSPLASTIC syndromes treatment, *MYELODYSPLASTIC syndromes, *MOLECULAR pathology, *HEMATOPOIETIC stem cell transplantation, *HOMOGRAFTS, *CYTOREDUCTIVE surgery, *PROGNOSIS

مستخلص: The landscape of transplantation in myelodysplastic syndrome (MDS) has evolved rapidly in the last decade, driven mostly by advances in patient selection through better risk stratification, increasing age of allogeneic recipients, introduction of reduced-intensity conditioning regimens, increased availability of unrelated donors, new donor sources, and improvements in transplant technology and supportive care. Despite these advances, several issues, mostly centering on approaches to improve post-transplant survival while minimizing transplant-related mortality, continue to present significant challenges. Advances in understanding the molecular pathogenesis of MDS have made it feasible to construct clinically useful risk models that integrate prognostic genes with conventional risk parameters for better selection of patients likely to benefit from hematopoietic cell transplantation. Simultaneous research efforts in several areas, including comorbidity assessment, novel preparative regimens, optimal pretransplant cytoreductive strategy, and post-transplantation therapies, are expected to improve long-term disease-free survival and quality of life. [ABSTRACT FROM AUTHOR]