Impact of donor telomere length on survival in patients undergoing matched sibling donor transplantation for aplastic anaemia

2021 ◽  
Author(s):  
Aruna Barade ◽  
Fouzia Aboobacker ◽  
Anu Korula ◽  
Kavitha Lakshmi ◽  
Anup Devasia ◽  
...  
Keyword(s):  
Telomere Length ◽  
Aplastic Anaemia ◽  
Sibling Donor ◽  
Matched Sibling

scholarly journals Fludarabine and Cyclophosphamide Based Conditioning Is Associated with Good Outcomes in Patients Undergoing Matched Sibling Donor Transplants for Aplastic Anaemia

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3272-3272
Author(s):  
Biju George ◽  
Aby Abraham ◽  
Anu Korula ◽  
Anup Devasia ◽  
Kavitha M Lakshmi ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Aplastic Anaemia ◽  
Acute Gvhd ◽  
Conflicts Of Interest ◽  
Hemorrhagic Cystitis ◽  
Chronic Gvhd ◽  
Univariate Analysis ◽  
Entire Group ◽  
Sibling Donor ◽  
Matched Sibling

Background: Fludarabine based conditioning protocols are increasingly being used for transplant (SCT) in patients with aplastic anaemia (AA) especially in those who have received multiple transfusions. Patients and Methods: Between January 2004 and June 2019, 229 patients with AA and HLA identical sibling donors underwent SCT at CMC Vellore India using Fludarabine [180 mg/m2 over 6 days] and Cyclophosphamide [120 mg/kg over 2 days]. Few patients received low dose ATG [ATGAM 40 mg/kg]. Data on HSCT and outcomes were collected from the institutional database and individual medical records. Results: The median age was 23.9 years (range: 1.5 - 58) including 151 males and 78 females including 78 children (33.4%). Donors were matched sibling (n = 215) or family donors (n = 14). The graft source was Bone marrow in 11 and peripheral blood stem cells in 218. GVHD prophylaxis consisted mainly of cyclosporine and methotrexate mainly with few receiving post-transplant cyclophosphamide. Engraftment occurred in 90% with graft failure in 2.6% and early death in 7.4%. Regimen related toxicity (RRT) was seen in 4.7% and included veno-occlusive disease of liver and hemorrhagic cystitis. Acute GVHD (grade 2-4) occurred in 26.4% while chronic GVHD was seen in 40.3%. The 5 year overall survival (OS) for the entire group is 75.9 + 4.9%. The 5 yr OS was 81.4 + 3.9% for ages 0 - 20, 76.3 + 4.4% for ages 21-40 and 55.3 + 9.3% for ages > 40 years. Age > 40 years (p = 0.000), presence of fever requiring hospital admission within 4 weeks prior to SCT (p = 0.001) and acute GVHD (p = 0.051) were identified as risk factors associated with a poor outcome on a univariate analysis while on a multivariate analysis, older age and fever continued to remain significant. Conclusion: This is the largest series of patients with AA undergoing SCT using a fludarabine based conditioning and is associated with improved survival following sibling donor HSCT for AA. Presence of fever requiring a hospital admission immediately prior to SCT is associated with poor outcomes. Disclosures No relevant conflicts of interest to declare.

Outcomes of chronic graft-versus-host disease following matched sibling donor versus umbilical cord blood transplant

2021 ◽  
Author(s):  
Grigori Okoev ◽  
Daniel J. Weisdorf ◽  
John E. Wagner ◽  
Bruce R. Blazar ◽  
Margaret L. MacMillan ◽  
...  
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Graft Versus Host Disease ◽  
Umbilical Cord Blood ◽  
Host Disease ◽  
Graft Versus Host ◽  
Sibling Donor ◽  
Cord Blood Transplant ◽  
Matched Sibling

scholarly journals Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Annalisa Ruggeri ◽  
Giorgia Battipaglia ◽  
Myriam Labopin ◽  
Gerhard Ehninger ◽  
Dietrich Beelen ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Unrelated Donor ◽  
Sibling Donor ◽  
First Relapse ◽  
Matched Sibling ◽  
Acute Myeloid

scholarly journals Comparable Outcomes between Unrelated Donor (8/8 or 7/8 matched) and Haploidentical Donor for Allogeneic Stem Cell Transplantation in Adult Patients with Severe Aplastic Anemia

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4619-4619
Author(s):  
Jee Yon Shin ◽  
Sung-Soo Park ◽  
Gi June Min ◽  
Silvia Park ◽  
Sung-Eun Lee ◽  
...  
Keyword(s):  
Board Of Directors ◽  
Research Funding ◽  
Acute Gvhd ◽  
Chronic Gvhd ◽  
Advisory Committees ◽  
Sibling Donor ◽  
Alternative Donor ◽  
Matched Sibling ◽  
Grade Ii

Background Either allogeneic hematopoietic stem cell transplantation (SCT) from HLA-matched sibling donor or immunosuppressive therapy (IST) has been recommended as one of the standard treatments for severe aplastic anemia (SAA). Regarding only 30% of chance finding HLA‐matched sibling donor, SCT from an alternative donor including unrelated (URD) or haplo-identical related donor (HAPLO) is considered to be a treatment option after failure to IST in patients who lack of a HLA-matched sibling donor. The aim of this study was to compare the outcomes of URD SCT and HAPLO SCT for SAA patients. Method Consecutive 152 adult patients with SAA who received first SCT between March 2002 and May 2018 were included: 73 of HLA-well-matched (8/8) URD (WM-URD), 34 of HLA-mismatched URD (MM-URD), and 45 of HAPLO. With the intention to have a follow-up period at least 1 year, data were analyzed at May 2019. A conditioning regimen with total body irradiation (TBI) and cyclophosphamide was used for URD-SCT, whereas that with TBI and fludarabine was administered for HAPLO-SCT (Lee et al, BBMT 2011;17:101, Park et al, BBMT 2017;23:1498, Lee et al, Am J Hematol 2018;93:1368). The combination of tacrolimus and methotrexate were used as graft-versus-host disease (GVHD) prophylaxis. Results The median follow-up was 53.4 (range, 0.2-174.1) months. The median age of URD and HAPLO cohort was 30 (range 18-59) and 34 (range 18-59) years, respectively. Except for one and three patients who failed respective a neutrophil and platelet engraftment, other patients achieved neutrophil and platelet engraftments with median 11 and 15 days for WM-URD, 13 and 16.5 days for MM-URD, and 12 and 14 days for HAPLO, respectively. The five-years overall survival (OS), failure-free survival (FFS), and cumulative incidences (CIs) of graft-failure and transplant-related mortality were similar among three groups: 88.3%, 85.5%, 2.7%, and 11.7% for WM-URD; 81.7%, 81.7%, 0%, and 18.3% for MM-URD, and 86.3%, 84.1%, 6.7%, and 9.2% for HAPLO. The 180-days CI of grade II-IV acute GVHD in WM-URD, MM-URD and HAPLO were 35.6%, 52.9%, and 28.9%, respectively; and moderate to severe chronic GVHD were 28.7%, 38.7% and 11.8% in respective cohort. The CI of grade II-IV acute GVHD and moderate to severe chronic GVHD were significantly higher in MM-URD than those in HAPLO (both, p=0.026). ATG is the only factor affecting both grade II-IV acute GVHD (Hazard ratio 0.511, p=0.01) and moderate to severe chronic GVHD (Hazard ratio 0.378, p=0.003) in multivariate analysis. Other complications including CMV DNAemia, hemorrhagic cystitis, invasive fungal disease, secondary malignancy, and sinusoidal obstruction syndrome were similar among three groups. Survival outcomes of a subgroup of ≥ 2 allele MM-URD (n=16) extracted form MM-URD were inferior that of other donor types (n=136): 75.0% vs. 86.9% (p=0.163) for 5-year OS and 75.0% vs. 84.7% (p=0.272) for 5-year FFS. Conclusion This study shows that there were no significant differences between alternative donor sources in the absence of suitable matched sibling donor. Host/donor features and urgency of transplant should drive physician towards the best choice among alternative donor sources for SAA patients treated with SCT. However, selection of ≥ 2 allele MM-URD should not be recommended due to high incidence of GVHD and inferior outcomes. Figure Disclosures Kim: Celgene: Consultancy, Honoraria; Astellas: Consultancy, Honoraria; Hanmi: Consultancy, Honoraria; AGP: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; SL VaxiGen: Consultancy, Honoraria; Novartis: Consultancy; Amgen: Honoraria; Chugai: Honoraria; Yuhan: Honoraria; Sanofi-Genzyme: Honoraria, Research Funding; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees; Handok: Honoraria; Janssen: Honoraria; Daiichi Sankyo: Honoraria, Membership on an entity's Board of Directors or advisory committees; BL & H: Research Funding; Otsuka: Honoraria. Lee:Alexion: Consultancy, Honoraria, Research Funding; Achillion: Research Funding.

scholarly journals Long-Term Remission After Matched Sibling Donor Hematopoietic Cell Transplantation in a Patient With Primary Cutaneous CD8+ Aggressive Epidermotropic Cytotoxic T-Cell Lymphoma

Cureus ◽  
2021 ◽  
Author(s):  
Quinto Gesiotto ◽  
Yumeng Zhang ◽  
Ayesha Malik ◽  
Lucia Seminario-Vidal ◽  
Ernesto Ayala ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Cell Lymphoma ◽  
Hematopoietic Cell ◽  
T Cell Lymphoma ◽  
Cytotoxic T Cell ◽  
Sibling Donor ◽  
Matched Sibling

scholarly journals Tacrolimus and Mycophenolate Mofetil after Nonmyeloablative Matched-Sibling Donor Allogeneic Stem-Cell Transplantations Conditioned with Fludarabine and Low-Dose Total Body Irradiation

2006 ◽  
Vol 12 (2) ◽  
pp. 217-225 ◽  
Author(s):  
Yago Nieto ◽  
Nigel Patton ◽  
Timothy Hawkins ◽  
Ruth Spearing ◽  
Scott I. Bearman ◽  
...  
Keyword(s):  
Stem Cell ◽  
Mycophenolate Mofetil ◽  
Total Body Irradiation ◽  
Low Dose ◽  
Sibling Donor ◽  
Matched Sibling ◽  
Total Body
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