scholarly journals IMPACT OF BONE MARROW FIBROSIS IN MYELOMA PATIENTS UNDERGONE AUTOLOGOUS STEM CELL TRANSPLANTATION

2021 ◽  
Vol 43 ◽  
pp. S17
Author(s):  
Senem Maral ◽  
Murat Albayrak ◽  
Berna Afacan Öztürk ◽  
Ünsal Han ◽  
Merih Reis Aras ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Bone Marrow Fibrosis ◽  
Marrow Fibrosis

Rapid Regression of Bone Marrow Fibrosis after Dose-Reduced Allogeneic Stem Cell Transplantation in Patients with Myelofibrosis.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 374-374
Author(s):  
Nicolaus Kroeger ◽  
Juergen Thiele ◽  
Axel Zander ◽  
Michael Kvasnicka
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Growth Factor ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Bone Marrow Fibrosis ◽  
Myeloid Metaplasia ◽  
Bone Marrow Histology ◽  
Marrow Fibrosis

Abstract Myelofibrosis with myeloid metaplasia [MMM] is a myeloproliferative disease of which bone marrow histology is characterized by substantial collagen fibrosis and osteosclerosis. Bone marrow histology changes in MMM are reactive and cytokine mediated. Studies suggested a pathogenic role of transforming growth factor β [TGF-β], platelet derived growth factor, and basic fibroblast growth factor. In the current study we investigated the dynamic and kinetic of fibrosis regression in 18 patients with myelofibrosis who underwent allogeneic stem cell transplantation after a dose-reduced conditioning. The conditioning regimen consisted of Busulfan 10 mg/kg, Fludarabin 180 mg/m2, and Antithymocyte globulin 30 – 60 mg/kg followed by peripheral stem cell transplantation (SCT). 18 patients with a median age of 45 [range 35 to 64] were included and bone marrow histology was investigated prior SCT, between day+30 and +40 after engraftment, on day+100, and 1 year after stem cell transplantation. The grading of myelofibrosis [MF] was performed according to the recently published European Consensus on Grading Bone Marrow Fibrosis [Thiele et al., Haematologica2005;90:1125–1132]. This consensus distinguishes between: MF - 0 Scattered linear reticulin with no intersections [cross-overs] corresponding to normal bone marrow MF - 1 Loose network of reticulin with many intersections, especially in perivascular areas MF - 2 Diffuse and dense increase in reticulin with extensive intersections, occasionally with only focal bundles of collagen and/or focal osteosclerosis MF - 3 Diffuse and dense increase in reticulin with extensive intersections with coarse bundles of collagen, often associated with significant osteosclerosis At time of transplantation all patients suffered from advanced myelofibrosis 2° [39 %] or 3° [61 %], resulting in a median MF grade of 3 [range 2–3]. After engraftment on day+30 a regression of MF grade to a median of 2 [range 0–3] was observed. Grade 2 or less was observed in 80 % and grade 1 or 0 in 40 % of the patients. On day+100 the median grade of MF was 1 [range 0–3] and 93 % of the patients had an MF-grade of 2 or less, while 73 % of the patients had MF grade-1 or 0. One year after transplantation the median MF-grade was 0 [range 0–2] and 100 % of the patients had a MF-grade of 2 or less and 92 % of the patients had MF grade 1 or 0. We conclude that allogeneic stem cell transplantation after a dose-reduced conditioning induces a rapid and nearly complete regression of bone marrow fibrosis within the first year after transplantation.

The Kinetic Of Bone Marrow Fibrosis Regression Predicts Outcome In Myelofibrosis Patients After Allogeneic SCT

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2078-2078
Author(s):  
Nicolaus Kröger ◽  
Haefaa Alchalby ◽  
Tatjana Zabelina ◽  
Hans-Michael Kvasnicka ◽  
Juergen Thiele ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
High Risk ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Complete Regression ◽  
Bone Marrow Fibrosis ◽  
Fibrosis Regression ◽  
Marrow Fibrosis

Abstract Introduction Bone marrow fibrosis is a hallmark of primary or post ET/PV myelofibrosis. Recent studies have shown that allogeneic stem cell transplantation induces rapid bone marrow fibrosis regression suggesting that fibrosis is more a dynamic rather than a static process. So far, no data are reported if fibrosis regression influences outcome after transplantation. Methods and patients We studied 94 patients with myelofibrosis who received allogeneic stem cell transplantation at the University Medical Center Hamburg between 2002 and 2010. In 57 patients the complete bone marrow histology prior transplantation and/or on day+30 and +100 after transplantation were available. The median age was 57 years (r: 33–73) and patients were classified as IPSS low-risk (n = 1), intermediate-1 (n = 5), intermediate-2 (n = 18), and high-risk (n = 33). Donor source was unrelated (n = 46) or related (n = 11) and of these 38 were HLA-matched while 19 were HLA-mismatched. 41 had primary and 16 post ET or post PV myelofibrosis. The median number of blasts was 1% (r: 0–17%) and gender was male (n = 32) and female (n = 25). All patients received busulfan-based dose-reduced conditioning regimen. Bone marrow fibrosis was graded according to the European consensus and WHO (MF-0 – 3), respectively, and evaluated by experienced hematopathologists. Results Before transplantation 41 patients (72%) had MF grade 3 and 16 (28%) MF grade 2. After engraftment on day+30 (± 10 days) (n = 48), 3 (6%) had complete regression (MF-0) and 7 (15%) near complete regression of bone marrow fibrosis while 17 (35%) had MF-2 and 21 (44%) had MF-3. On day+100 (± 20 days) complete regression (MF-0) was noted in 11 (25%) and near complete regression (MF-1) in 13 (29%) while 12 (27%) and 8 (18%) had still MF-2 or MF-3, respectively. Patients with complete and near complete regression (MF-0 and MF-1) on day +30 had a 5-year estimated overall survival of 100% and those with MF-2 and MF-3 of 75% (p = 0.09). Patients with complete or near complete regression on day+100 had a 5-year estimated survival of 95% in contrast to 60% for those with MF-2 or MF-3 (p = 0.04). If analyzed by regression by grade at day+100 7 (16%) had a reduction of 3 grades (e.g. MF-3 to MF-0), 12 (27%) of 2 grades, 16 (36%) of 1 grade, and 9 (21%) had no grade reduction at day+100. Reduction of 2 or 3 grades at day+100 resulted in 95% survival at 5 years while reduction of 1 or no grade had a survival of 70% however this difference did not reach statistical significance (p = 0.1). There was no difference of fibrosis regression at day+100 between high risk IPSS and low/intermediate risk patients. Furthermore, in those patients with JAK2V617F mutation and complete or near complete regression 42% still had detectable JAK2V617F mutation level in peripheral blood. In contrast, 81% had complete donor cell chimerism if bone marrow fibrosis was MF-0/MF-1 while only 31% had complete chimerism at day+100 if fibrosis was classified as MF-2 or MF-3. Conclusion This data on fibrosis regression after allogeneic stem cell transplantation suggests that a more rapid regression - independently of IPSS risk score - resulted in a favorable survival and may be used as an early predictive factor for excellent survival. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Allogeneic stem cell transplantation for myelodysplastic syndromes with bone marrow fibrosis

Haematologica ◽  
2010 ◽  
Vol 96 (2) ◽  
pp. 291-297 ◽  
Author(s):  
N. Kroger ◽  
T. Zabelina ◽  
A. van Biezen ◽  
R. Brand ◽  
D. Niederwieser ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Myelodysplastic Syndromes ◽  
Bone Marrow Fibrosis ◽  
Marrow Fibrosis

scholarly journals Beginning of a Journey of Autologous Stem Cell Transplantation in Combined Military Hospital, Dhaka, Bangladesh

2018 ◽  
Vol 8 (2) ◽  
pp. 177-180
Author(s):  
Mohammed Mosleh Uddin ◽  
Huque Mahfuz ◽  
Md Mostafil Karim
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Hodgkin Lymphoma ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Peripheral Blood ◽  
Haematopoietic Stem Cell ◽  
Military Hospital

Haematopoietic stem cell transplantation (HSCT) involves the intravenous infusion of autologous or allogenic stem cells collected from bone marrow, peripheral blood or umbilical cord to re-establish haematopoietic function in patients whose bone marrow or immune system is damaged or defective. HSCT are mainly of two types –autologous stem cell transplantation (SCT) and allogenic SCT. Autologous SCT is mainly performed in multiple myeloma, Hodgkin lymphoma, non-Hodgkin lymphoma and less commonly in acute myeloid leukaemia. Haematopoietic stem cells are mobilized from bone marrow to the peripheral blood after the use of mobilizing agents, granulocyte colony stimulating factor (G-CSF) and plerixafor. Then the mobilized stem cells are collected from peripheral blood by apheresis and cryo-preserved. The patient is prepared by giving conditioning regimen (high dose melphelan). Stem cells, which are already collected, are re-infused into patient’s circulation by a blood transfusion set. Engraftment happens 7-14 days after auto SCT. Common side effects of this procedure include nausea, vomiting, diarrhoea, mucositis, infections etc. The first case of SCT performed in Combined Military Hospital, Dhaka, Bangladesh is presented here.Birdem Med J 2018; 8(2): 177-180

Aggressive Primary Chemotherapy Plus Autologous Stem Cell Transplantation Improves Outcome for Peripheral T Cell Lymphomas Compared with CHOP-Like Regimens.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1660-1660 ◽  
Author(s):  
Michal Sieniawski ◽  
James Lennard ◽  
Christopher Millar ◽  
Simon Lyons ◽  
Philip Mounter ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
T Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Peripheral T Cell Lymphoma ◽  
Alk Positive

Abstract Abstract 1660 Poster Board I-686 Background In the past two decades we have observed improvement in the outcome of patients diagnosed with some subtypes of lymphoma. However, the prognosis of patient with peripheral T-cell lymphoma (PTCL) still remains unsatisfactory. We prospectively evaluated aggressive chemotherapy and autologous stem cell transplantation (ASCT): IVE/MTX-ASCT in patients with de-novo PTCL. Patients and methods: The regimen was piloted from 1997 for new patients eligible for intensive treatment: first for pts with enteropathy associated T-cell lymphoma (EATL) and subsequently for other types of PTCL. This therapy delivers one cycle of CHOP, followed by 3 courses of IVE (ifosfamide, etoposide, epirubicin), alternating with intermediate dose methotrexate (MTX). Stem cells are harvested after IVE and complete remissions (CR) were consolidated with myeloablative ASCT. The patients were evaluated with an intent to treat analysis for feasibility, response, progression free survival (PFS) and overall survival (OS). Results 57 patients were treated with the aggessive regimen, 26 pts had EATL and 31 other types of PTCL: 17 peripheral T-cell lymphoma NOS, 6 anaplastic T-cell lymphoma ALK positive, 4 extranodal NK/T cell lymphoma nasal type, 3 anaplastic T-cell lymphoma ALK negative and 1 hepatosplenic gamma/delta T-cell lymphoma. The median age at diagnosis was 51 years (range 23 – 69), 36/57 (63%) pts were male and 27/55 (49%) presented with ECOG >1. Early stage disease was diagnosed in 22/57 (39%) pts and advanced disease in 35/57 (61%). Bone marrow was involved in 6/53 (11%) pts and LDH was elevated in 23/46 (50%). Among pts with primary nodal disease 14/26 (54%) had at least one extranodal site involved and 6/26 (23%) bulky disease. At present, 55 pts are available for response evaluation. Eight pts discontinued treatment prematurely; 4 due to toxicity (one severe sepsis and death, one severe encephalopathy, one bone marrow failure and one bleeding from the gastrointestinal tract), and four pts due to disease progression. Of the remaining 47 pts 33 went on to receive ASCT. ASCT was omitted due to: refractory disease in 5 pts, poor general condition in 4 pts, insufficient stem cell mobilisation in 4 pts and one pt declined further treatment. The most common severe toxicities were pancytopenia, infection, nausea/vomiting and obstruction/perforation. Complete remission was confirmed in 39/55 (71%) pts, partial remission in 3/55 (5%) pts and 13/55 (24%) pts failed the treatment. The remission rates were: CR-17/26 (65%) pts and PR-1/26 (4%) for EATL and 22/29 (76%) and 2/29 (7%), respectively for other PTCL. During the study time 17/57 (30%) pts died, 15 due to lymphoma. For all pts 3-years PFS was 59% and OS 67%. For pts with EATL the 3-years PFS and OS were 52% and 60% and for other types 65% and 72%, respectively. These results were unchanged after the exclusion of anaplastic T-cell lymphoma ALK positive: (61% and 72%, respectively). Conclusions For patients with PTCL, we propose that intensive chemotherapy and ASCT significantly improves outcome compared to CHOP-like regimens, and has acceptable toxicities. In conclusion, where feasible patients with PTCL should be considered for aggressive treatments, like IVE/MTX – ASCT as primary therapy. Disclosures No relevant conflicts of interest to declare.

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