High Rate of Long-Term Survival for High-Risk Lymphoma Patients Treated With Hematopoietic Stem Cell Transplantation as Consolidation or Salvage Therapy

2008 ◽  
Vol 40 (9) ◽  
pp. 3104-3105 ◽  
Author(s):  
I. Espigado ◽  
E. Ríos ◽  
A. Marín-Niebla ◽  
M. Carmona ◽  
R. Parody ◽  
...  
Keyword(s):  
Stem Cell ◽  
High Risk ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Salvage Therapy ◽  
High Rate ◽  
Term Survival ◽  
Hematopoietic Stem

scholarly journals Allogeneic Stem Cell Transplantation in Multiple Myeloma

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 55
Author(s):  
Christine Greil ◽  
Monika Engelhardt ◽  
Jürgen Finke ◽  
Ralph Wäsch
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
High Risk ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Risk Groups ◽  
High Dose ◽  
Term Survival ◽  
Hematopoietic Stem

The development of new inhibitory and immunological agents and combination therapies significantly improved response rates and survival of patients diagnosed with multiple myeloma (MM) in the last decade, but the disease is still considered to be incurable by current standards and the prognosis is dismal especially in high-risk groups and in relapsed and/or refractory patients. Allogeneic hematopoietic stem cell transplantation (allo-SCT) may enable long-term survival and even cure for individual patients via an immune-mediated graft-versus-myeloma (GvM) effect, but remains controversial due to relevant transplant-related risks, particularly immunosuppression and graft-versus-host disease, and a substantial non-relapse mortality. The decreased risk of disease progression may outweigh this treatment-related toxicity for young, fit patients in high-risk constellations with otherwise often poor long-term prognosis. Here, allo-SCT should be considered within clinical trials in first-line as part of a tandem approach to separate myeloablation achieved by high-dose chemotherapy with autologous SCT, and following allo-SCT with a reduced-intensity conditioning to minimize treatment-related organ toxicities but allow GvM effect. Our review aims to better define the role of allo-SCT in myeloma treatment particularly in the context of new immunomodulatory approaches.

scholarly journals Prediction of Response and Survival Following Treatment with Azacitidine for Relapse of Acute Myeloid Leukemia and Myelodysplastic Syndromes after Allogeneic Hematopoietic Stem Cell Transplantation

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2255 ◽  
Author(s):  
Christina Rautenberg ◽  
Anika Bergmann ◽  
Ulrich Germing ◽  
Caroline Fischermanns ◽  
Sabrina Pechtel ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Term Outcome ◽  
Term Survival ◽  
Hematopoietic Stem ◽  
Long Term Outcome

To provide long-term outcome data and predictors for response and survival, we retrospectively analyzed all 151 patients with relapse of myeloid neoplasms after allogeneic hematopoietic stem cell transplantation (allo-HSCT) who were uniformly treated with first-line azacitidine (Aza) salvage therapy at our center. Patients were treated for molecular (39%) or hematologic relapse (61%), with a median of 5 cycles of Aza and at least one donor lymphocyte infusion in 70% of patients. Overall response was 46%, with 41% achieving complete (CR) and 5% achieving partial remission. CR was achieved after a median of 4 cycles and lasted for a median of 11 months (range 0.9 to 120 months). With a median follow-up of 22 months (range: 1 to 122 months), the 2-year survival rate was 38% ± 9%, including 17 patients with ongoing remission for >5 years. Based on results from multivariate analyses, molecular relapse and time to relapse were integrated into a score, clearly dividing patients into 3 subgroups with CR rates of 71%, 39%, and 29%; and 2-year survival rates of 64%, 38%, and 27%, respectively. In the subgroup of MDS and secondary AML, receiving upfront transplantation was associated with superior response and survival, and therefore pretransplant strategy was integrated together with relapse type into a MDS–sAML-specific score. Overall, Aza enables meaningful responses and long-term survival, which is a predictable with a simple-to-use scoring system.

Negative Impact of Pre-Transplant Anemia on Long-Term Outcome after Allogeneic Hematopoietic Stem Cell Transplantation.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1844-1844
Author(s):  
Chris Lazongas ◽  
Cindy J. Wong ◽  
David M. Sutton ◽  
Jeffrey H. Lipton ◽  
Anargyros Xenocostas ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Causes Of Death ◽  
Term Survival ◽  
Hematopoietic Stem

Abstract Background: Anemia is commonly present in patients with malignancies and is associated with reduced survival times. Recently, we described that low (<110 g/L) pre-transplant hemoglobin levels (PT-Hb) are associated with decreased early survival after allogeneic hematopoietic stem cell transplantation (alloHSCT)(Xenocostas et al. Transfusion2003;43:373–382). We are now presenting data on long-term survival and causes of death in BMT recipients with and without anemia prior to alloHSCT. Study Design and Methods: A retrospective analysis of 511 patients consecutively transplanted between January 1995 and March 2000 was performed to evaluate survival, cause of death, and PT-Hb. The end date for follow-up was June 2002. The median follow-up time was 993 days. Causes of death were categorized either as relapse, treatment-related mortality (TRM), or other. PT-Hb levels were determined within 2 weeks prior to transplantation, after commencing conditioning chemotherapy. Comparisons between groups were done using chi-squared tests. Results: The 180-day survival of patients with low PT-Hb levels (<110 g/L) was significantly worse than that of patients with PT-Hb levels ≥110 g/L (57.1% versus 83.1%, p<0.0001). The survival difference remained significant at 5 years (36.2% versus 59.4%, p<0.0001). The difference in 180-day survival was contributed to by an increase in TRM (36.1% versus 14.9%, p<0.0001) as well as a higher relapse rate (4.4% versus 0.3%, p=0.019 by Fisher’s exact test). For patients surviving more than 180 days, there was no difference in TRM (16.7% versus 16.7%, p=0.987) or relapse rate (12.0% versus 7.3%, p=0.150). No difference in the rate of other causes of death was found between the groups at either the 180-day or 5-year time points. Conclusions: Pre-transplant anemia is an independent risk factor for increased mortality following alloHSCT. Relapse and treatment-related deaths are both more likely to occur early in the post-transplant course of patients experiencing pre-transplant anemia. Differences in long-term survival are predominantly related to treatment-related deaths rather than relapse.

scholarly journals Long-Term Survival After Hematopoietic Stem Cell Transplantation for Complete STAT1 Deficiency

2017 ◽  
Vol 37 (7) ◽  
pp. 701-706 ◽  
Author(s):  
Samuele Naviglio ◽  
Elena Soncini ◽  
Donatella Vairo ◽  
Arnalda Lanfranchi ◽  
Raffaele Badolato ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Term Survival ◽  
Hematopoietic Stem ◽  
Long Term Survival

scholarly journals Meta-analysis of the benefit of hypomethylating agents before allogeneic hematopoietic stem cell transplantation in myelodysplastic syndromes

2021 ◽  
Author(s):  
Liu Liu ◽  
Menglu Jia ◽  
Ling Sun ◽  
Wenliang Tian ◽  
Ping Tang ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Myelodysplastic Syndromes ◽  
Hypomethylating Agents ◽  
Bridging Therapy ◽  
Term Survival ◽  
Hematopoietic Stem

Abstract Hypomethylating agents (HMAs) are effective therapies in myelodysplastic syndromes (MDS), but allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only way to cure MDS. According to the current literature, it is difficult to confirm whether HMAs bridging therapy is beneficial for MDS patients receiving allo-HSCT. Therefore, we tried to evaluate the effect of HMAs on long-term survival of the MDS patients. Databases, including PubMed, Embase Ovid, and the Cochrane Library, were searched for studies published up to January 10, 2021. Patients who accepted HMAs bridging to allo-HSCT were defined as experimental group, while patients who received the best supportive care (BSC) before allo-HSCT were control group. Overall survival (OS) was the primary end point. Seven studies were included in the final analysis. The final results showed no OS differences between patients accepted HMAs before allo-HSCT and those received BSC (HR = 0.86, 95% CI: 0.64–1.15, p = 0.32), indicating that MDS patients' long-term survival did not benefit from HMAs bridging therapy before allo-HSCT. This conclusion needs to be further verified by a large number of prospective randomized controlled trials, which have guiding significance for the treatment of MDS patients.

Longitudinal Analysis of Antibody Response to Immunization in Pediatric Survivors After Allogeneic Hematopoietic Stem Cell Transplantation.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 795-795
Author(s):  
Hiroto Inaba ◽  
Meredith Posner ◽  
Christine Hartford ◽  
Jie Yang ◽  
Deqing Pei ◽  
...  
Keyword(s):  
Stem Cell ◽  
High Risk ◽  
Hematopoietic Stem Cell Transplantation ◽  
Antibody Response ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Vaccine Failure ◽  
Hematopoietic Stem ◽  
Igg Level

Abstract Abstract 795 Re-immunization is a common practice after allogeneic hematopoietic stem cell transplantation (allo-HSCT), but the optimal vaccine schedule and long-term response have not been established. We prospectively and longitudinally evaluated the antibody response to childhood vaccines in 210 survivors after allo-HSCT. Positive titer lasting for 5 years or more after immunization was observed more often for diphtheria (98.1%), tetanus (96.1%), rubella (92.9%), and polio vaccines (96.2% for type 1; 98.1% for type 2 and 3), but less often for pertussis (25.0%), measles (65.4%), mumps (64.3%), and hepatitis B (75.0%). As shown in the table below, vaccine failure was associated with patients who were older at the time of re-immunization, received a T cell depleted graft, had a high-risk hematological malignancy, lower IgG levels, higher IgM levels, chronic GvHD, positive recipient CMV status, and negative titers prior to immunization. These clinical factors are useful to formulate immunization and monitoring strategies for survivors after allo-HSCT. Patients at risk for vaccine failure should be monitored closely during long-term follow-up, and booster immunizations should be considered when there is no seroconversion.Table.Factors associated with negative titers after re-immunizationVaccineFactorOdds ratio95% confidence intervalp value DiphteriaT cell depleted graft5.521.14-26.820.034 TetanusOlder age at immunization1.541.05-2.220.026 Lower IgG level*1.031.00-1.050.033 MeaslesLower IgG level*1.011.00-1.020.022 MumpsHigh risk vs. standard risk2.631.02-6.670.045 RubellaHigher IgM level*1.121.03-1.230.012 High risk vs. standard risk16.71.56-100.000.02 PoliovirusType 1Older age at immunization1.431.05-1.920.021 Positive recipeint CMV titer3.181.58-6.410.001 Higher IgM level*1.081.01-1.150.027 Negative titer before immunization8.332.17-33.330.002 Type 2Older age at immunization1.411.04-1.920.027 Positive recipeint CMV titer2.651.36-5.200.004 Higher IgM level*1.061.00-1.140.04 Negative titer before immunization14.34.55-50.00<0.001 Type 3Older age at immunization1.411.04-1.890.027 Positive recipient CMV titer3.111.67-5.80<0.001 Higher IgM level*1.061.00-1.120.035 Chronic GVHD2.71.05-6.950.04 Negative titer before immunization5.881.92-20.000.002*Total IgG and IgM, not disease specific Ig levels Disclosures: No relevant conflicts of interest to declare.

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