المؤلفون: Varma, Ankur, Sui, Dawen, Milton, Denái, Tang, Guilin, Saini, Neeraj, Hasan, Omar, Mukherjee, Akash, Joseph, Jacinth, Bashir, Qaiser, Rondon, Gabriela, Srour, Samer, Popat, Uday, Hosing, Chitra, Nieto, Yago, Kebriaei, Partow, Alousi, Amin, Ahmed, Sairah, Mehta, Rohtesh, Khouri, Issa, Ahmed, Haris, Iyer, Swaminathan, Weber, Donna, Thomas, Sheeba, Manasanch, Elisabet, Lee, Hans, Patel, Krina, Ciurea, Stefan, Shpall, Elizabeth, Orlowski, Robert, Champlin, Richard, Qazilbash, Muzaffar

المصدر: Transplantation and Cellular Therapy. 26(4)

مصطلحات موضوعية: Autologous stem cell transplantation, CDKN2C, CKS1B, Multiple myeloma, Chromosomes, Hematopoietic Stem Cell Transplantation, Humans, In Situ Hybridization, Fluorescence, Multiple Myeloma, Propensity Score, Retrospective Studies, Transplantation, Autologous, Treatment Outcome

الوصف: The gain/amplification CKS1B gene at chromosome region 1q21 (1q+) is one of the most common genetic aberrations in multiple myeloma (MM). Amplification of CKS1B is frequently associated with the deletion of the CDKN2C gene at chromosome region 1p32 (1p-), which is also associated with inferior outcomes. In this retrospective study, we evaluated the outcomes of patients with 1q+ and/or 1p- after high-dose therapy and autologous hematopoietic cell transplantation (auto-HCT). From January 2006 to December 2015, 1491 newly diagnosed patients with MM underwent upfront high-dose therapy and auto-HCT at our institution. Of those, 899 had the fluorescent in situ hybridization (FISH) data available. FISH was performed at diagnosis and before the start of induction in 686 (76%) patients and after the initiation of induction therapy in 213 (24%) patients. We identified 100 patients with 1q+ and/or 1p- by FISH from the cohort of 899 patients. A control group (n = 287) with diploid cytogenetics and normal FISH panel was selected from the same cohort. From the above 2 cohorts, using a propensity score matched analysis, we identified matched controls for 85 of the 100 patients with 1q+/1p-. Patients were matched for age at auto-HCT, sex, International Staging System stage, induction regimen, creatinine level, disease status at auto-HCT, conditioning regimen, and maintenance therapy. Sixty-seven (79%), 4 (5%), and 14 (16%) patients had 1q+, 1p-, or both 1q+ and 1p-, respectively. There was no significant difference in induction therapy, preparative regimen, or maintenance therapy between the 1q+/1p- and the control group. The median follow-up time for all patients was 29.2 months (range, 0.29 to 84.96). The cumulative incidence of 100-day nonrelapse mortality was 1.2% and 0% for the 1q+/1p- and the control group, respectively. Forty-two patients (50%) in the 1q+/1p- group achieved complete response compared with 40 patients (47%) in the control group. The estimated 3-year progression-free survival (PFS) and overall survival (OS) rates were 41% and 79% for the 1q+/1p- group and 56% and 86% for the control group. Patients in the 1q+/1p- group were at significantly increased risk of progression or death compared to the control group (hazard ratio [HR], 2.21; confidence interval [CI], 1.18 to 4.16; P = .014). No significant association between OS in the 2 groups was observed. The outcome of the 1q+/1p- alone (with no additional high-risk cytogenetics) and the propensity score matched control groups was also compared. Median PFS for the 1q+/1p- alone subgroup was 26.6 months, compared with 38.8 months for the control group (HR, 1.9; CI, 0.9 to 4.08; P = .09). The median OS had not been reached for the 1q+/1p- alone subgroup and was 81.1 months for the control group (HR, 1.25; CI, 0.3 to 4.6; P= .73). 1q+/1p- abnormalities with amplification of CKS1B and deletion ofCDKN2Cgenes were associated with shorter PFS compared with a propensity score matched group of patients with diploid cytogenetics and normal a FISH panel. The outcomes of 1q+/1p- patients with MM have improved with the use of more effective induction, conditioning, and maintenance therapy compared with historical controls, but we still need more effective therapeutic approaches to fully overcome the negative impact of 1q+/1p-.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/5n37b3zpTest

المؤلفون: Murthy, Hemant S, Zhang, Mei-Jie, Chen, Karen, Ahmed, Sairah, Deotare, Uday, Ganguly, Siddhartha, Kansagra, Ankit, Michelis, Fotios V, Nishihori, Taiga, Patnaik, Mrinal M, Abid, Muhammad Bilal, Aljurf, Mahmoud, Arai, Yasuyuki, Bacher, Ulrike, Badar, Talha, Badawy, Sherif M, Ballen, Karen, Battiwalla, Minoo, Beitinjaneh, Amer, Bejanyan, Nelli, Bhatt, Vijaya R, Brown, Valerie Inez, Martino, Rodrigo, Cahn, Jean-Yves, Castillo, Paul, Cerny, Jan, Chhabra, Saurabh, Copelan, Edward A, Daly, Andrew, Dholaria, Bhagirathbhai, Diaz, Miguel Angel, Freytes, César O, Grunwald, Michael R, Hashmi, Shahrukh, Hildebrandt, Gerhard C, Jamy, Omer, Joseph, Jacinth, Kanakry, Christopher G, Khera, Nandita, Krem, Maxwell M, Kuwatsuka, Yachiyo, Lazarus, Hillard M, Lekakis, Lazaros J, Liu, Hongtao, Modi, Dipenkumar, Munshi, Pashna, Mussetti, Alberto, Palmisiano, Neil, Patel, Sagar S, Rizzieri, David A, van der Poel, Marjolein, Saber, W.

المصدر: Murthy , H S , Zhang , M-J , Chen , K , Ahmed , S , Deotare , U , Ganguly , S , Kansagra , A , Michelis , F V , Nishihori , T , Patnaik , M M , Abid , M B , Aljurf , M , Arai , Y , Bacher , U , Badar , T , Badawy , S M , Ballen , K , Battiwalla , M , Beitinjaneh , A , Bejanyan , N , Bhatt , V R , Brown , V I , Martino , R , ....

الوصف: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with a poor prognosis and considered incurable with standard conventional chemotherapy. Small observational studies have shown that allogeneic hematopoietic cell transplantation (allo-HCT) offers durable remissions in patients with BPDCN. We conducted an analysis of 164 patients with BPDCN from 78 centers who underwent allo-HCT between 2007-2018 using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Results: Median follow up of survivors was 49 months (range 6-121). 5-year overall survival (OS), disease-free survival (DFS), relapse, and non-relapse (NRM) rates were 51.2% (95% confidence interval [95%CI]: 42.5-59.8%), 44.4% (95%CI: 36.2-52.8%), 32.2% (95%CI: 24.7-40.3%), and 23.3% (95%CI: 16.9-30.4%), respectively. Disease relapse was the most common cause of death. On multivariate analyses, age =60 was predictive for inferior OS (hazard ratio [HR]= 2.16, 95% CI 1.35-3.46, p= 0.001), and higher NRM [HR= 2.19, 95% CI 1.13-4.22, p= 0.02]. Remission status at time of allo-HCT (CR2/PIF/Relapse vs CR1) was predictive of inferior OS [HR= 1.87, 95% CI 1.14-3.06, p= 0.01] and DFS [HR= 1.75, 95% CI 1.11-2.76, p= 0.02]. Use of myeloablative conditioning with total body irradiation (TBI) was predictive for improved DFS and reduced risk of relapse. Conclusion: Allo-HCT is effective in providing durable remissions and long-term survival in BPDCN. Younger age and allo-HCT in CR1 predicted for improved survival, while myeloablative conditioning with TBI predicted for less relapse and improved DFS. Novel strategies incorporating allo-HCT are needed to further improve outcomes.

العلاقة: https://cris.maastrichtuniversity.nl/en/publications/48b6a95f-5dff-449d-b24f-7a90bc3ba8f5Test

الإتاحة: https://doi.org/10.1182/bloodadvances.2023011308Test
https://cris.maastrichtuniversity.nl/en/publications/48b6a95f-5dff-449d-b24f-7a90bc3ba8f5Test

المؤلفون: Murthy, Hemant S, Zhang, Mei-Jie, Chen, Karen, Ahmed, Sairah, Deotare, Uday, Ganguly, Siddhartha, Kansagra, Ankit, Michelis, Fotios V, Nishihori, Taiga, Patnaik, Mrinal M, Abid, Muhammad Bilal, Aljurf, Mahmoud, Arai, Yasuyuki, Bacher, Vera, Badar, Talha, Badawy, Sherif M, Ballen, Karen, Battiwalla, Minoo, Beitinjaneh, Amer, Bejanyan, Nelli, Bhatt, Vijaya R, Brown, Valerie Inez, Martino, Rodrigo, Cahn, Jean-Yves, Castillo, Paul, Cerny, Jan, Chhabra, Saurabh, Copelan, Edward A, Daly, Andrew, Dholaria, Bhagirathbhai, Diaz, Miguel Angel, Freytes, César O, Grunwald, Michael R, Hashmi, Shahrukh, Hildebrandt, Gerhard C, Jamy, Omer, Joseph, Jacinth, Kanakry, Christopher G, Khera, Nandita, Krem, Maxwell M, Kuwatsuka, Yachiyo, Lazarus, Hillard M, Lekakis, Lazaros J, Liu, Hongtao, Modi, Dipenkumar, Munshi, Pashna, Mussetti, Alberto, Palmisiano, Neil, Patel, Sagar S, Rizzieri, David A, Seo, Sachiko, Shah, Mithun Vinod, Sharma, Akshay, Solh, Melhem M, Solomon, Scott R, Ulrickson, Matthew L, Ustun, Celalettin, van der Poel, Marjolein W M, Verdonck, Leo F, Wagner, John L, Wang, Trent P, Wirk, Baldeep, Zeidan, Amer M, Litzow, Mark R, Kebriaei, Partow, Hourigan, Christopher S, Weisdorf, Daniel J, Saber, Wael, Kharfan-Dabaja, Mohamed A

المصدر: Murthy, Hemant S; Zhang, Mei-Jie; Chen, Karen; Ahmed, Sairah; Deotare, Uday; Ganguly, Siddhartha; Kansagra, Ankit; Michelis, Fotios V; Nishihori, Taiga; Patnaik, Mrinal M; Abid, Muhammad Bilal; Aljurf, Mahmoud; Arai, Yasuyuki; Bacher, Vera; Badar, Talha; Badawy, Sherif M; Ballen, Karen; Battiwalla, Minoo; Beitinjaneh, Amer; Bejanyan, Nelli; . (2023). Allogeneic Hematopoietic Cell Transplantation for Blastic Plasmacytoid Dendritic Cell Neoplasm: a CIBMTR analysis. Blood advances, 7(22), pp. 7007-7016. American Society of Hematology 10.1182/bloodadvances.2023011308

مصطلحات موضوعية: 610 Medicine & health

الوصف: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with a poor prognosis and considered incurable with standard conventional chemotherapy. Small observational studies have shown that allogeneic hematopoietic cell transplantation (allo-HCT) offers durable remissions in patients with BPDCN. We conducted an analysis of 164 patients with BPDCN from 78 centers who underwent allo-HCT between 2007-2018 using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Results: Median follow up of survivors was 49 months (range 6-121). 5-year overall survival (OS), disease-free survival (DFS), relapse, and non-relapse (NRM) rates were 51.2% (95% confidence interval [95%CI]: 42.5-59.8%), 44.4% (95%CI: 36.2-52.8%), 32.2% (95%CI: 24.7-40.3%), and 23.3% (95%CI: 16.9-30.4%), respectively. Disease relapse was the most common cause of death. On multivariate analyses, age ≥60 was predictive for inferior OS (hazard ratio [HR]= 2.16, 95% CI 1.35-3.46, p= 0.001), and higher NRM [HR= 2.19, 95% CI 1.13-4.22, p= 0.02]. Remission status at time of allo-HCT (CR2/PIF/Relapse vs CR1) was predictive of inferior OS [HR= 1.87, 95% CI 1.14-3.06, p= 0.01] and DFS [HR= 1.75, 95% CI 1.11-2.76, p= 0.02]. Use of myeloablative conditioning with total body irradiation (TBI) was predictive for improved DFS and reduced risk of relapse. Conclusion: Allo-HCT is effective in providing durable remissions and long-term survival in BPDCN. Younger age and allo-HCT in CR1 predicted for improved survival, while myeloablative conditioning with TBI predicted for less relapse and improved DFS. Novel strategies incorporating allo-HCT are needed to further improve outcomes.

وصف الملف: application/pdf

العلاقة: https://boris.unibe.ch/186902Test/

الإتاحة: https://doi.org/10.1182/bloodadvances.2023011308Test
https://boris.unibe.ch/186902/1/blooda_adv-2023-011308-main.pdfTest
https://boris.unibe.ch/186902Test/

المؤلفون: Murthy, Hemant S., Zhang, Mei-Jie, Chen, Karen, Ahmed, Sairah, Deotare, Uday, Ganguly, Siddhartha, Kansagra, Ankit, Michelis, Fotios V., Nishihori, Taiga, Patnaik, Mrinal, Abid, Muhammad Bilal, Aljurf, Mahmoud, Arai, Yasuyuki, Bacher, Ulrike, Badar, Talha, Badawy, Sherif M., Ballen, Karen, Battiwalla, Minoo, Beitinjaneh, Amer, Bejanyan, Nelli, Bhatt, Vijaya Raj, Brown, Valerie I., Martino, Rodrigo, Cahn, Jean-Yves, Castillo, Paul, Cerny, Jan, Chhabra, Saurabh, Copelan, Edward, Daly, Andrew, Dholaria, Bhagirathbhai, Diaz Perez, Miguel Angel, Freytes, César O., Grunwald, Michael R., Hashmi, Shahrukh, Hildebrandt, Gerhard C., Jamy, Omer, Joseph, Jacinth, Kanakry, Christopher G., Khera, Nandita, Krem, Maxwell M., Kuwatsuka, Yachiyo, Lazarus, Hillard M., Lekakis, Lazaros J., Liu, Hongtao, Modi, Dipenkumar, Munshi, Pashna N., Mussetti, Alberto, Palmisiano, Neil D., Patel, Sagar S., Rizzieri, David A., Seo, Sachiko, Shah, Mithun Vinod, Sharma, Akshay, Sohl, Melhm, Solomon, Scott R., Ulrickson, Matthew, Ustun, Celalettin, van der Poel, Marjolein, Verdonck, Leo F., Wagner, John L., Wang, Trent, Wirk, Baldeep, Zeidan, Amer, Litzow, Mark, Kebriaei, Partow, Hourigan, Christopher S., Weisdorf, Daniel J., Saber, Wael, Kharfan-Dabaja, Mohamed A.

المصدر: Department of Medical Oncology Faculty Papers

مصطلحات موضوعية: Humans, Middle Aged, Transplantation, Homologous, Neoplasm Recurrence, Local, Hematopoietic Stem Cell Transplantation, Acute Disease, Myeloproliferative Disorders, Chronic Disease, Recurrence, Dendritic Cells, Hematology, Medicine and Health Sciences, Oncology

الوصف: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with a poor prognosis and considered incurable with conventional chemotherapy. Small observational studies reported allogeneic hematopoietic cell transplantation (allo-HCT) offers durable remissions in patients with BPDCN. We report an analysis of patients with BPDCN who received an allo-HCT, using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). We identified 164 patients with BPDCN from 78 centers who underwent allo-HCT between 2007 and 2018. The 5-year overall survival (OS), disease-free survival (DFS), relapse, and nonrelapse mortality (NRM) rates were 51.2% (95% confidence interval [CI], 42.5-59.8), 44.4% (95% CI, 36.2-52.8), 32.2% (95% CI, 24.7-40.3), and 23.3% (95% CI, 16.9-30.4), respectively. Disease relapse was the most common cause of death. On multivariate analyses, age of ≥60 years was predictive for inferior OS (hazard ratio [HR], 2.16; 95% CI, 1.35-3.46; P = .001), and higher NRM (HR, 2.19; 95% CI, 1.13-4.22; P = .02). Remission status at time of allo-HCT (CR2/primary induction failure/relapse vs CR1) was predictive of inferior OS (HR, 1.87; 95% CI, 1.14-3.06; P = .01) and DFS (HR, 1.75; 95% CI, 1.11-2.76; P = .02). Use of myeloablative conditioning with total body irradiation (MAC-TBI) was predictive of improved DFS and reduced relapse risk. Allo-HCT is effective in providing durable remissions and long-term survival in BPDCN. Younger age and allo-HCT in CR1 predicted for improved survival, whereas MAC-TBI predicted for less relapse and improved DFS. Novel strategies incorporating allo-HCT are needed to further improve outcomes.

وصف الملف: application/pdf

العلاقة: https://jdc.jefferson.edu/medoncfp/257Test; https://jdc.jefferson.edu/context/medoncfp/article/1257/viewcontent/REF_ID_5702.pdfTest; https://jdc.jefferson.edu/context/medoncfp/article/1257/filename/0/type/additional/viewcontent/Supplemental_Tables.pdfTest

الإتاحة: https://jdc.jefferson.edu/medoncfp/257Test
https://jdc.jefferson.edu/context/medoncfp/article/1257/viewcontent/REF_ID_5702.pdfTest
https://jdc.jefferson.edu/context/medoncfp/article/1257/filename/0/type/additional/viewcontent/Supplemental_Tables.pdfTest

المؤلفون: Joseph, Jacinth, Srour, Samer A., Milton, Denái R., Ramdial, Jeremy L., Saini, Neeraj Y., Olson, Amanda L., Bashir, Qaiser, Oran, Betul, Alousi, Amin M., Hosing, Chitra, Qazilbash, Muzaffar H., Kebriaei, Partow, Shpall, Elizabeth J., Champlin, Richard E., Popat, Uday R.

المساهمون: National Cancer Institute, National Institutes of Health

المصدر: Transplantation and Cellular Therapy ; volume 29, issue 12, page 770.e1-770.e6 ; ISSN 2666-6367

مصطلحات موضوعية: Transplantation, Cell Biology, Hematology, Molecular Medicine, Immunology and Allergy

الإتاحة: https://doi.org/10.1016/j.jtct.2023.09.013Test
https://api.elsevier.com/content/article/PII:S2666636723015531?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2666636723015531?httpAccept=text/plainTest

المؤلفون: Kamal, Mona, Baudo, Massimo, Joseph, Jacinth, Geng, Yimin, Mohamed, Omnia, Rahouma, Mohamed, Greenbaum, Uri

المصدر: Healthcare (2227-9032); Mar2024, Vol. 12 Issue 5, p530, 14p

مصطلحات موضوعية: STEROID drugs, HEMATOPOIETIC stem cell transplantation, HYDROXYCHLOROQUINE, ANTIBIOTICS, TREATMENT effectiveness, META-analysis, SYSTEMATIC reviews, ANTIVIRAL agents, MEDLINE, MEDICAL databases, CONFIDENCE intervals, ONLINE information services, COVID-19 pandemic, IMMUNOSUPPRESSION, HEALTH care teams, IMMUNOCOMPETENCE

مستخلص: This systematic review and meta-analysis aims to identify the outcomes of stem cell transplant (SCT) patients during the COVID-19 era. Pooled event rates (PER) were calculated, and meta-regression was performed. A random effects model was utilized. In total, 36 eligible studies were included out of 290. The PER of COVID-19-related deaths and COVID-19-related hospital admissions were 21.1% and 55.2%, respectively. The PER of the use of hydroxychloroquine was 53.27%, of the receipt of immunosuppression it was 39.4%, and of the use of antivirals, antibiotics, and steroids it was 71.61%, 37.94%, and 18.46%, respectively. The PER of the time elapsed until COVID-19 infection after SCT of more than 6 months was 85.3%. The PER of fever, respiratory symptoms, and gastrointestinal symptoms were 70.9, 76.1, and 19.3%, respectively. The PER of acute and chronic GvHD were 40.2% and 60.9%, respectively. SCT patients are at a higher risk of severe COVID-19 infection and mortality. The use of dexamethasone improves the survival of hospitalized SCT patients with moderate to severe COVID-19 requiring supplemental oxygen or ventilation. The SCT patient group is a heterogeneous group with varying characteristics. The quality of reporting on these patients when infected with COVID-19 is not uniform and further prospective or registry studies are needed to better guide clinical care in this unique setting. [ABSTRACT FROM AUTHOR]

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المؤلفون: Im, Jin S., Akin, Serkan, Srour, Samer A., Nieto, Yago, Champlin, Richard E., Shpall, Elizabeth, Flowers, Christopher R., Qazilbash, Muzaffar H., Popat, Uday R., Anderlini, Paolo, Dabaja, Bouthaina, Iyer, Swaminathan P., Westin, Jason, Steiner, Raphael, Daher, May, Rondon, Gabriela, Maadani, Farzaneh, Ramdial, Jeremy L., Truxillo, Jonathan, Joseph, Jacinth, Fowler, Nathan, Alousi, Amin, Ahmed, Sairah, Khouri, Issa, Hosing, Chitra

الوصف: Secondary central nervous system large B-cell lymphoma (SCNSL) is rare, with a generally poor prognosis. There is limited data about the role of autologous stem cell transplantation (ASCT) in these high-risk patients. We explored in this study treatment outcomes and prognostic factors for patients with SCNSL who underwent ASCT. We included all consecutive patients who underwent ASCT at our institution. Primary endpoints were progression-free survival (PFS) and overall survival (OS). One-hundred two patients were identified. Median age at transplant was 56 (range, 21-71) years. With a median follow-up of 56 (range, 1-256) months, the median PFS and OS were 40 and 88 months, respectively. The 4-year PFS and OS were 48% and 57%, respectively. In univariate analysis, complete remission (CR) at transplant, prior lines of therapy (<= 2), normal lactate dehydrogenase, and parenchymal involvement were significantly associated with improved PFS. For OS, only CR at transplant and <= 2 prior lines of therapy were associated with improved survival. On multivariable analysis for PFS, CR at transplant (hazard ratio [HR], 0.278; 95% CI, 0.153-0.506; P <= .0001) and <= 2 prior lines of therapy (HR, 0.485; 95% CI, 0.274-0.859; P = .0131) were significantly associated with superior PFS. Similarly, CR at transplant (HR, 0.352; 95% CI, 0.186-0.663; P = .0013) and <= 2 prior lines of therapy (HR, 0.476; 95% CI, 0.257-0.882; P = .0183) were associated with improved survival. In the largest single-center study, our findings indicate that ASCT is associated with durable responses and prolonged survival in patients with SCNSL. Patients in CR at transplant and those who received <= 2 lines of therapy have particularly excellent outcomes.

العلاقة: 588ace28-c4d5-4903-8345-797b2d01885e; https://avesis.hacettepe.edu.tr/publication/details/588ace28-c4d5-4903-8345-797b2d01885e/oaiTest

الإتاحة: https://doi.org/10.1182/bloodadvances.2021005602Test
https://avesis.hacettepe.edu.tr/publication/details/588ace28-c4d5-4903-8345-797b2d01885e/oaiTest

المؤلفون: Rendo, Matthew J, Joseph, Jacinth J, Phan, Liem Minh, DeStefano, Christin B

المصدر: Blood and Lymphatic Cancer: Targets and Therapy ; volume Volume 12, page 119-136 ; ISSN 1179-9889

الإتاحة: https://doi.org/10.2147/blctt.s327016Test
https://www.dovepress.com/getfile.php?fileID=83403Test

المؤلفون: Saberian, Chantal, Abdel-Wahab, Noha, Abudayyeh, Ala, Rafei, Hind, Joseph, Jacinth, Rondon, Gabriela, Whited, Laura, Gruschkus, Stephen, Fa'ak, Faisal, Daher, May, Knape, Cristina, Safa, Houssein, Shoukier, Mahran, Suarez-Almazor, Maria E, Marcotulli, Megan, Ludford, Kaysia, Gulbis, Alison M, Konopleva, Marina, Ohanian, Maro, Ravandi, Farhad, Garcia-Manero, Guillermo, Oran, Betul, Popat, Uday R, Mehta, Rotesh, Alousi, Amin M, Daver, Naval, Champlin, Richard, Diab, Adi, Al-Atrash, Gheath

المصدر: Journal for ImmunoTherapy of Cancer ; volume 9, issue 2, page e001818 ; ISSN 2051-1426

الوصف: Background Immune checkpoint inhibitors (ICIs) are being used after allogeneic hematopoietic stem cell transplantation (alloHCT) to reverse immune dysfunction. However, a major concern for the use of ICIs after alloHCT is the increased risk of graft-versus-host disease (GVHD). We analyzed the association between GVHD prophylaxis and frequency of GVHD in patients who had received ICI therapy after alloHCT. Methods A retrospective study was performed in 21 patients with acute myeloid leukemia (n=16) or myelodysplastic syndromes (n=5) who were treated with antiprogrammed cell death protein 1 (16 patients) or anticytotoxic T lymphocyte-associated antigen 4 (5 patients) therapy for disease relapse after alloHCT. Associations between the type of GVHD prophylaxis and incidence of GVHD were analyzed. Results Four patients (19%) developed acute GVHD. The incidence of acute GVHD was associated only with the type of post-transplantation GVHD prophylaxis; none of the other variables included (stem cell source, donor type, age at alloHCT, conditioning regimen and prior history of GVHD) were associated with the frequency of acute GVHD. Twelve patients received post-transplantation cyclophosphamide (PTCy) for GVHD prophylaxis. Patients who received PTCy had a significantly shorter median time to initiation of ICI therapy after alloHCT compared with patients who did not receive PTCy (median 5.1 months compared with 26.6 months). Despite early ICI therapy initiation, patients who received PTCy had a lower observed cumulative incidence of grades 2–4 acute GVHD compared with patients who did not receive PTCy (16% compared with 22%; p=0.7). After controlling for comorbidities and time from alloHCT to ICI therapy initiation, the analysis showed that PTCy was associated with a 90% reduced risk of acute GVHD (HR 0.1, 95% CI 0.02 to 0.6, p=0.01). Conclusions ICI therapy for relapsed acute myeloid leukemia/myelodysplastic syndromes after alloHCT may be a safe and feasible option. PTCy appears to decrease the incidence of acute GVHD in ...

الإتاحة: https://doi.org/10.1136/jitc-2020-001818Test

المؤلفون: Kamal, Mona, Joseph, Jacinth, Greenbaum, Uri, Hicklen, Rachel, Kebriaei, Partow, Srour, Samer A., Wang, Xin Shelly

المساهمون: National Cancer Institute

المصدر: Transplantation and Cellular Therapy ; volume 27, issue 5, page 390.e1-390.e7 ; ISSN 2666-6367

الإتاحة: https://doi.org/10.1016/j.jtct.2021.01.003Test
https://api.elsevier.com/content/article/PII:S266663672100004X?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S266663672100004X?httpAccept=text/plainTest