scholarly journals The impact of donor gender on outcome of allogeneic hematopoietic stem cell transplantation for multiple myeloma: reduced relapse risk in female to male transplants

2005 ◽  
Vol 35 (6) ◽  
pp. 609-617 ◽  
Author(s):  
G Gahrton ◽  
S Iacobelli ◽  
J Apperley ◽  
G Bandini ◽  
B Björkstrand ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem ◽  
Relapse Risk ◽  
The Impact

The Beneficial Impact of KIR-Ligand Mismatch and Absence of Donor-KIR2DS3 Gene On Outcome Following Unrelated Donor Stem Cell Transplantation for Myeloid Leukemia.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3396-3396
Author(s):  
Gongqiang Wu ◽  
Yanmin Zhao ◽  
Xiaoyu Lai ◽  
Yamin Tan ◽  
Yi Luo ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Myeloid Leukemia ◽  
Hematopoietic Stem ◽  
Relapse Risk ◽  
The Impact ◽  
Risk Of Relapse

Abstract Abstract 3396 Poster Board III-284 OBJECTIVE: Allogeneic hematopoietic stem cell transplantation (HSCT) is a successful curative therapy for a variety of hematological malignancies. The success of allogeneic HSCT partly depends on the graft-versus-leukemia (GVL) effect caused by donor lymphocytes. Apart from alloreactive T cells, alloreactive natural killer (NK) cells also play an important role in the induction of GVL effect after HSCT. However, the effect of NK cell alloreactivity on the outcome of unrelated hematopoietic stem cell transplantation is controversial. NK cell alloreactivity after allogeneic HSCT is regulated by killer cell immunoglobulin-like receptors (KIRs). So, our study is to investigate the impact of KIRs on the outcome after unrelated hematopoietic stem cell transplantation. METHODS: 116 cases of unrelated transplants between Jan. 2001 to May. 2008 were involved in the study. The inhibitory KIRs identified with HLA ligands are as follows: KIR2DL2/KIR2DL3 bind HLA-C1; KIR2DL1 recognizes HLA-C2; and KIR3DL1 recognizes HLA-Bw4. KIR-ligand mismatch was defined as the absence of one or more recipient HLA epitopes for the corresponding donor-inhibitory KIRs. Samples containing either one or two group B haplotypes were assigned the genotype designation B/x. Samples that lacked all KIR B loci were assigned the genotype A/A. RESULTS: We found that KIR-ligand mismatch was significantly associated with a decreased leukemic relapse risk (p=0.019; HR=0.329, 95% CI 0.131-0.830), mainly in myeloid disease (p=0.003; HR=0.193, 95% CI 0.066-0.563). In myeloid disease, the cumulative risk of relapse was lower in the patients with KIR-ligand mismatch than KIR-ligand match (10.7% vs. 41.5%, p=0.002). This effect of the KIR-ligand mismatch on relapse was comparably significant between AML/MDS subgroup (12.6% vs. 40%, p=0.03) and CML subgroup (4% vs. 41.7%, p=0.008). For standard-risk myeloid leukemia, KIR-ligand mismatch resulted in a lower relapse rate than KIR-ligand match, although no statistical significance was reached. (11.3% vs. 26%, p=0.356). For high-risk myeloid leukemia, the risk of relapse in patients with KIR-ligand mismatch was significantly lower than that in patients with KIR-ligand match (9.1% vs. 71.4%, p=0.002). Furthermore, the impact of KIR-ligand mismatch was found mainly in the HLA-match group (13.9% vs. 62.5%, p= 0.001) and KIR haplotype, Bx group (11.5% vs. 55%, p=0.01). In myeloid disease, KIR-ligand mismatch also improved 5-year overall survival (OS) (p=0.034; HR=0.430, 95% CI 0.194-0.924) and disease-free survival (DFS) (p=0.024; HR=0.445, 95% CI 0.221-0.897). No effect was seen in patients with lymphoid disease. AA in the donor significantly decreased the cumulative incidence of relapse compared with Bx (12.9% vs. 28.6%, p=0.024). We further found that more activating KIR genes in the donor resulted in an increased relapse risk (p=0.005; HR=1.463, 95% CI 1.123-1.906). Meanwhile, the presence of donor activating KIR2DS3 gene was associated with increased relapse risk (p=0.003; HR=5.046, 95% CI 1.746-14.575) and decreased OS (p=0.004; HR=3.181, 95% CI 1.432–7.064) and DFS (p=0.003; HR=2.919, 95% CI 1.430-5.959) in myeloid disease. CONCLUSION: Our study indicated that, in unrelated HSCT for myeloid leukemia, selection of donors with KIR-ligand mismatch offered a lower relapse risk and a long-term survival advantage. The presence of KIR2DS3 in the donor was an important risk factor for myeloid leukemia. If donors carry low number of activating KIR genes, the risk of relapse is reduced. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Tandem Autologous Hematopoietic Stem Cell Transplantation in Very Young Patients with Multiple Myeloma

2020 ◽  
Vol 09 (04) ◽  
pp. 233-235
Author(s):  
Rahul Naithani ◽  
Nitin Dayal ◽  
Reeta Rai
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Young Patients ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Platelet Recovery

Abstract Introduction Multiple myeloma (MM) in very young patients is uncommon, and no treatment guidelines exist for these patients. Patients and Methods We performed a retrospective analysis of five very young myeloma patients who underwent tandem autologous hematopoietic stem cell transplantation (HSCT). Results The median age was 37 years (range = 34–40 years). A median of two leukapheresis was performed (range = 1–4). The median number of hematopoietic stem cells collected was 5.4 × 106/kg (4.4–8.2 × 106/kg). During first transplant, four patients received melphalan of 200 mg/m2 and one patient received melphalan of 140 mg/m2 (due to renal failure) as conditioning regimen. Second transplant conditioning was melphalan of 200 mg/m2 for one patient and melphalan of 140 mg/m2 for remaining four patients. Two patients were in complete remission, and two were in very good partial remission and one patient progressed to active disease at the time of tandem autologous bone marrow transplant. All patients developed significant mucositis. Neutrophil and platelet recovery was longer in tandem autologous hematopoietic stem cell transplant. More viral infections were seen in tandem transplant. Day 30 and day 100 mortality was nil. Conclusion We present data on tandem autologous HSCTs in very young patients with MM in India. Responses continued to improve in this small series.

scholarly journals The Impact of Allogeneic Hematopoietic Stem Cell Transplantation on Kidney Function in Children—A Single Center Experience

2021 ◽  
Vol 10 (5) ◽  
pp. 1113
Author(s):  
Kinga Musiał ◽  
Krzysztof Kałwak ◽  
Danuta Zwolińska
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Serum Creatinine ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Kidney Function ◽  
Hematopoietic Stem ◽  
Oncological Patients ◽  
The Impact

Background: Knowledge about the impact of allogeneic hematopoietic stem cell transplantation (alloHSCT) on renal function in children is still limited. Objectives: The aim of the study was to evaluate kidney function in children undergoing alloHSCT, with special focus on differences between patients transplanted due to oncological and non-oncological indications. Materials and Methods: The data of 135 children undergoing alloHSCT were analyzed retrospectively. The serum creatinine and estimated glomerular filtration rate (eGFR) values were estimated before transplantation at 24 h; 1, 2, 3, 4 and 8 weeks; and 3 and 6 months after alloHSCT. Then, acute kidney injury (AKI) incidence was assessed. Results: Oncological children presented with higher eGFR values and more frequent hyperfiltration rates than non-oncological children before alloHSCT and until the 4th week after transplantation. The eGFR levels rose significantly after alloHSCT, returned to pre-transplant records after 2–3 weeks, and decreased gradually until the 6th month. AKI incidence was comparable in oncological and non-oncological patients. Conclusions: Children undergoing alloHSCT due to oncological and non-oncological reasons demonstrate the same risk of AKI, but oncological patients may be more prone to sustained renal injury. Serum creatinine and eGFR seem to be insufficient tools to assess kidney function in the early post-alloHSCT period, when hyperfiltration prevails, yet they reveal significant differences in long-term observation.

The impact of cytomegalovirus serostatus of donor and recipient before hematopoietic stem cell transplantation in the era of antiviral prophylaxis and preemptive therapy

Blood ◽  
2004 ◽  
Vol 103 (6) ◽  
pp. 2003-2008 ◽  
Author(s):  
Michael Boeckh ◽  
W. Garrett Nichols
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cohort Studies ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Preemptive Therapy ◽  
Prevention Strategies ◽  
Hematopoietic Stem ◽  
The Impact

AbstractIn the current era of effective prophylactic and preemptive therapy, cytomegalovirus (CMV) is now a rare cause of early mortality after hematopoietic stem cell transplantation (HSCT). However, the ultimate goal of completely eliminating the impact of CMV on survival remains elusive. Although the direct effects of CMV (ie, CMV pneumonia) have been largely eliminated, several recent cohort studies show that CMV-seropositive transplant recipients and seronegative recipients of a positive graft appear to have a persistent mortality disadvantage when compared with seronegative recipients with a seronegative donor. Recipients of T-cell–depleted allografts and/or transplants from unrelated or HLA-mismatched donors seem to be predominantly affected. Reasons likely include both incomplete prevention of direct and indirect or immunomodulatory effects of CMV as well as consequences of drug toxicities. The effect of donor CMV serostatus on outcome remains controversial. Large multicenter cohort studies are needed to better define the subgroups of seropositive patients that may benefit from intensified prevention strategies and to define the impact of CMV donor serostatus in the era of high-resolution HLA matching. Prevention strategies may require targeting both the direct and indirect effects of CMV infection by immunologic or antiviral drug strategies.

scholarly journals Acute acquired Fanconi syndrome in multiple myeloma after hematopoietic stem cell transplantation

2020 ◽  
Author(s):  
Janina Paula T. Sy-Go ◽  
David Dingli ◽  
Morie A. Gertz ◽  
Prashant Kapoor ◽  
Francis K. Buadi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Fanconi Syndrome ◽  
Hematopoietic Stem

Clinical features and survival of 338 multiple myeloma patients treated with hematopoietic stem cell transplantation or conventional chemotherapy

2015 ◽  
Vol 96 (4) ◽  
pp. 417-424 ◽  
Author(s):  
Raúl Pérez ◽  
Mª Sol Durán ◽  
Jose Mayans ◽  
Alfons Soler ◽  
Inmaculada Castillo ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Clinical Features ◽  
Conventional Chemotherapy ◽  
Hematopoietic Stem
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