scholarly journals Saving Lives with Pride: Development and Evaluation of Multimedia Resources to Engage Gay, Bisexual, and Queer Men in Canada As Stem Cell Donors

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3017-3017
Author(s):  
Rupal Hatkar ◽  
Lauren Sano ◽  
Natalie DeGurse ◽  
Elena Kum ◽  
Michelle Ho ◽  
...  

Abstract Background: Since 2009, gay, bisexual, and other men who have sex with men (gbMSM) have been eligible to register as stem cell donors in Canada and donate to patients in need. However, many gbMSM are unaware of their eligibility to be donors. Targeted recruitment of gbMSM could augment efforts to recruit donors from needed demographic groups and support a more inclusive donor registry. Here, we describe the development and evaluation of multimedia to engage gbMSM in Canada as stem cell donors. Methods: Multimedia resources were developed by gbMSM in Canada, in collaboration with recruiters from Stem Cell Club (stemcellclub.ca) and were designed to highlight gbMSM eligibility and educate about the need for donors from diverse ancestries. Resources were reviewed for accuracy by transplantation experts and appeal by focus groups of gbMSM. The resources were published to stemcellclub.ca/savingliveswithpride/ and disseminated to members of the community of practice (CoP) in stem cell donor recruitment in Canada during an e-meeting. We evaluated stakeholder perspective on these multimedia and their impact 1) across social and traditional media; 2) on gbMSM eligible donors' knowledge and attitudes towards donation; and 3) on reducing barriers for gbMSM donation. Results: Multimedia developed included: infographics emphasizing gbMSM eligibility regardless of recent sexual contact (Fig. A); @WhyWeSwab (twitter.com/whyweswab) story arcs featuring a stem cell donor and a stem cell recipient (Fig. B) from the LGBTQ2+ community; TikToks and other short videos (Fig. C), and testimonials (Fig. D) featuring gbMSM advocating for their communities to register as donors; and statements from Transplant Hematologists emphasizing that gbMSM donors will be treated sensitively and with respect (Fig. E). 33 CoP members from 6 provinces across Canada, and with a median of 2-years recruitment experience, participated in a survey post-publication. The majority felt the resources would engage gbMSM as donors (84%) and clarify gbMSM eligibility (87%); noted experiencing a lack of awareness from potential registrants on whether gbMSM were eligible to donate stem cells (69%); and felt that a national campaign to recruit gbMSM is needed (97%), would support a more inclusive registry (97%), and would augment recruitment of diverse donors (94%). 37 gbMSM eligible stem cell donors (84% gay men and 11% bisexual men; from 13 different ancestral groups; living in 5 provinces across Canada) completed surveys evaluating the impact of these multimedia on their knowledge and attitudes towards donation. After being shown these multimedia, mean scores on a 4 question knowledge test improved from 66% to 93% (p<0.001, Fig. F); mean scores on the Simmons Ambivalence Scale significantly decreased from 38% to 24% (p<0.001, Fig. G); and participants were more willing to register as donors (59% vs 84%, p=0.027) and less likely to believe there are significant barriers to donation for gbMSM (51% vs 11%, p=0.033). Qualitative analysis of feedback from focus groups with these participants identified examples of how the multimedia decreased barriers to donation impacting gbMSM (Fig. H). Multimedia were included in a Pride Month (6/2021) Campaign in Canada, "Saving Lives With Pride", and were shared on social media by LGBTQ2+ groups including on campuses (e.g. SFU Out On Campus), in the community (e.g. Abbey of the Long Cedar Canoe, JQT Vancouver), and nationally (e.g. Canadian Queer Medical Students Association). They were also profiled and shared by major medical organizations (e.g. Canadian Blood Services blood.ca/en/stories/stem-cell-club-volunteers-aim-save-lives-pride-month-campaign) and by media across Canada including CityNews (ctvnews.ca/health/pride-month-tiktok-drive-encourages-stem-cell-donations-from-gay-bi-men-1.5475113) and CTV News (toronto.citynews.ca/video/2021/06/17/doctors-turn-to-queer-communities-for-stem-cell-donors), who also highlighted the resources and their message as one of the top stories in Canada on 6/18/21 (ctvnews.ca/mobile/5-things/5-things-to-know-for-friday-june-18-2021-1.5475813). Conclusions: We developed an array of high-quality multimedia to support recruitment of gbMSM as potential stem cell donors and reduce barriers to donation. Our work is relevant to recruitment organizations worldwide seeking to develop more inclusive recruitment approaches. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4025-4025
Author(s):  
Brady Park ◽  
Lauren Sano ◽  
Becky Shields ◽  
Sylvia Okonofua ◽  
Mikyla Tak ◽  
...  

Abstract Introduction TikTok is a rapidly growing social media platform that allows users to develop and share short videos. We hypothesized that a library of videos developed through TikTok (TikToks) would support the recruitment of committed hematopoietic stem cell donors from needed demographic groups (i.e. young, male, from diverse ancestries). Methods Members of the community of practice (CoP) in stem cell donor recruitment in Canada (facebook.com/groups/stemcellclub) were activated to develop TikToks. Training was provided during e-meetings of the CoP (8/2020, 1/2021, 5/2021) and in a video published online (stemcellclub.ca/training), highlighting the principles of effective TikTok design. These principles included the use of engaging hooks, music, and calls to action; short duration (< 30s); high educational value; and appeal to diverse donors. The training also outlined how to: record content, adjust clip lengths, apply audiovisual effects, and share across social media platforms. A CoP TikTok committee was formed to develop and review TikToks prior to publication. Following launch, we evaluated stakeholder perspective on these TikToks and the impact 1) across social and traditional media and 2) on eligible donors' knowledge and attitudes towards donation. Results Between 9/2020-7/2021, a network of TikTok channels was launched by CoP members, including a national donor recruitment TikTok library (tiktok.com/@stemcellclub). A total of 217 TikToks were produced across these channels (median length 17s, range 4-52s), covering a range of educational topics, designed for use in specific recruitment campaigns, and featuring unique video effects (Fig. A). The TikToks accumulated over 234,000 Views, 42,000 Likes, 3,000 Comments, and 14,200 Shares on TikTok, were republished by Canadian media outlets (e.g. CBC [twitter.com/cbcnewsbc/status/1361511367426080773], CTV News [ctvnews.ca/health/meet-the-women-hoping-to-recruit-more-stem-cells-donors-from-black-communities-1.5314038, ctvnews.ca/health/pride-month-tiktok-drive-encourages-stem-cell-donations-from-gay-bi-men-1.5475113], Victoria News [vicnews.com/news/most-black-canadians-wont-find-a-stem-cell-donor-in-time-this-group-is-working-to-change-that]) and were highlighted by major medical organizations (e.g. Canadian Blood Services [blood.ca/en/stories/meet-stem-cell-club, blood.ca/en/stories/stem-cell-club-volunteers-aim-save-lives-pride-month-campaign], American Association of Blood Banks [aabb.org/news-resources/news/article/2021/02/01/twitter-tiktok-aabb-virtual-journal-club-assesses-use-of-multimedia-resources-for-donor-recruitment]). 33 CoP members from 6 provinces across Canada, with a median of 2 years of recruitment experience, completed a post-launch survey. The majority felt that TikToks promote donation in an attention-grabbing way (94%), engage younger donors (100%), and teach key points in a short time period (94%). The majority were confident in their ability to make TikToks (63%), but felt they would benefit from additional training (63%). 46 eligible stem cell donors (from 12 different non-Caucasian ancestral groups; living in 5 provinces across Canada) completed surveys evaluating the impact of TikToks on their knowledge and attitudes towards donation. No participants were registered as donors and only four had a personal connection to an individual who needed a stem cell transplant. After being shown a series of TikToks, mean scores on a 6-question stem cell donation knowledge test improved from 59% to 73% (p=0.0012) (Fig. B); mean scores on a modified Simmons Ambivalence Scale decreased from 52% to 30% (p<0.0001) (Fig. C); and participants were more willing to register as donors (70% vs. 39%, p=0.0011). Participants reported that viewing TikToks positively impacted on their decision to register (87%), helped them understand stem cell donation (89%), and would help them talk about stem cell donation with friends/family (78%). Conclusions We report the first published experience using TikToks in a donor recruitment context. Our TikToks achieved significant social and traditional impact in a short period of time, and supported recruitment of committed stem cell donors from needed demographic groups. Our work is relevant to recruitment organizations worldwide seeking to modernize their recruitment approaches. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4576-4576
Author(s):  
Richard Lemal ◽  
Romain Guièze ◽  
Cécile Moluçon-Chabrot ◽  
Eric Hermet ◽  
Aurélie Ravinet ◽  
...  

Abstract Abstract 4576 Introduction Allo-HSCT procedure is associated with a frequent and potentially severe malnutrition which could highly participate to the transplant-related morbidity (TRM). Optimal nutritional management is still poorly known while both enteral nutrition (EN) and parenteral nutrition (PN) are effective. We proposed to retrospectively evaluate the impact of EN versus PN as nutritional support on early outcome of allo-HSCT. Patients and methods We retrospectively analyzed all the successive patients who needed a nutritional support during their first allo-HSCT in our center from January 2009 to October 2010, excepting whose who had a progressive disease at time of transplant. Datas were compared in an intent to treat analysis according the EN or PN initial nutritional support strategy. Results We analysed early outcome of 56 successive patients. Twenty of them received a myeloablative conditioning regimen and 36 a reduced intensity one. A total of 28 agreed to receive EN via a nasogastric feeding tube and the remaining 28 received PN. No significant difference in terms of age, diagnosis, disease status at transplant, conditioning regimens, stem cell source, GVHD nor antifungal secondary prophylaxis could be observed between the EN and PN groups. We found a lower median duration of fever in EN (2[0–8] vs. 5[0–17] (days); p=0.0026) and a lower need for antifungal therapy in EN group (7/28 vs. 17/28; p=0.0069), with a lower median duration of intravenous antifungal use (0 day [0–99] in EN vs. 7 days [0–93] in PN; p=0.00034) while incidence of bacteriemiae was not different. We observed a lower rate of replacement of central veinous catheter in EN group (3/28 in EN vs. 9/28 in PN; p=0.05) and a lower rate of transfer to ICU in the EN group (2/28 in EN vs. 8/28 in PN, p=0.036) but early death rate (<100 days) was the same in each group (4/28 vs. 4/28, p=NS). Median neutropenia and thrombopenia duration and median transfusion requirements were not significantly different. Fourteen patients in EN group and 18 in PN group presented a grade 3–4 oral mucositis (p=NS). Grade III-IV GVHD incidence was comparable in both groups (4/28 vs. 8/28; p=0.19). Conclusion Compared with PN, EN directly decreases the infectious risk, particularly the fungal risk, and its complications in allo-HSCT, without influencing hematopoietic toxicity nor GVHD incidence. Based on these encouraging results, we are now conducting a prospective, multicentric and randomized trial to confirm EN benefice in allo-HSCT. Disclosures: No relevant conflicts of interest to declare.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. SCI-37-SCI-37
Author(s):  
M. Celeste Simon

Abstract Abstract SCI-37 Stem and progenitor cells reside in specialized microenvironments that regulate their function. While some stem/progenitor cells are perivascular, others clearly occupy hypoxic niches and may be regulated by O2 gradients. We are currently evaluating underlying mechanisms for the impact of O2 levels on stem and progenitor cells within distinct microenvironments. We have previously shown that neural stem cells within the adult hippocampus are closely associated with low O2 regions and that hypoxia-inducible factor 1α (HIF-1α), a principle mediator of hypoxic adaptations, modulates Wnt-β catenin signaling to maintain stem cell proliferation, differentiation, and neuronal maturation. We have extended these findings to other stem cell populations, such as those of adult muscle and bone marrow. Our findings will be presented at this meeting. Disclosures: No relevant conflicts of interest to declare.


Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2006-2006
Author(s):  
Xiao-Ying Qin ◽  
Yu Wang ◽  
Guo-Xuan Li ◽  
Yazhen Qin ◽  
Lan-Ping Xu ◽  
...  

Abstract Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been established as an effective treatment for patients with hematological malignancies. Disease relapse remains a major cause of transplant failure.T cell homeostasis is critical to determine the potency of the GVT effect. Cytotoxic T lymphocyte antigen-4 (CTLA-4 or CD152) is a T cell activation negative regulator. Recent studies have shown the association of the CTLA-4 polymorphisms with the outcome after HLA-identical sibling allogeneic HSCT. Patients and Methods: In this study, we focused on four CTLA-4 polymorphisms, and analyzed the impact of donor genotypes and haplotypes on the conditions of 154 acute leukemia patients after related HLA-haplotype-mismatched transplantation. The four SNP genotypes (-1661, -318, CT60 and +49) were determined by TaqMan SNP genotyping assays. Results: Recipients of donors with +49 GG showed significantly lower OS (69.1% vs. 85.6%, P=0.024) and higher incidence of III-IV aGVHD (10.0% vs. 2.1%, P=0.032) than those with GA + AA(Fig.1,Fig.2). Multivariate analyses showed that +49GG was an independent risk factor for OS (HR:0.457,95%CI=0.227-0.920,P=0.028). Patients receiving mDLI showed significantly lower OS with +49 GG donor than those with AG+AA (P=0.011).The haplotype analysis revealed only three haplotypes in the donor population -1661/-318/CT60/+49 i.e.,ACGG,ACAA and GTGA,the frequencies were 64.3%, 19.5%, and 16.2%, respectively.Donors with and without the ACGG/ACGG haplotype had the same effect on transplant outcome as those with +49 GG and +49 AG+AA. Conclusion: The CTLA-4 +49 GG and the haplotype ACGG/ACGG reduced the overall survival and increased the aGVHD after allo-HSCT from the related HLA-haplotype-mismatched donor,knowledge of the CTLA-4 polymorphism and haplotype may provide useful information for donor selection and individual application of immunosuppressive agents and immunotherapy. CONFLICT OF INTEREST The authors declare no conflict of interest. Disclosures No relevant conflicts of interest to declare.


Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5434-5434
Author(s):  
Warren Fingrut

Abstract Patients with a variety of blood cancers and metabolic diseases may require a stem cell transplant as part of their treatment. However, 70% of patients do not have a suitable genetic match in their family. Stem cell donor-databases are used to match potential unrelated donors to patients worldwide. In Canada, individuals aged 17-35 years can register as donors online or at a stem cell drive where they provide consent and a tissue sample (buccal-swab) for Human Leukocyte Antigen (HLA) allele typing. To date, no guidelines have been published to recommend a process for stem cell donor recruitment at drives. Here, I outline a Canadian approach to stem cell drive design, which features evidence-based strategies to identify and recruit the most-needed stem cell donors and to minimize donor ambivalence and withdrawal from the registry. This model of stem cell drive design includes five stations: pre-screening, informed consent, registration, swabbing, and reconciliation. Registrant confidentiality and privacy is maintained at each station, and quality control is emphasized throughout. Registrants are first pre-screened to ensure donor eligibility. Recruiters at the prescreening station target the most-needed stem cell donors according to the literature: young, healthy, and ethnically-diverse males. Non-optimal and ineligible registrants are redirected to help out in other ways. Recruiters then explain the principles of stem cell donation and educate registrants about the stem cell donation process. Next, registrants proceed to the informed consent station, which is designed to meet the requirements of the World Marrow Donor Association's suggested procedures for procurement of informed consent at time of recruitment (2003). Here, recruiters hand registrants an information pamphlet, and explain blood and marrow stem cell collection procedure diagrams. The risks of donation are outlined, and registrants are informed of their right to withdraw at any time and about donor and patient anonymity. Registrants are subsequently guided through registration, where they provide their contact/demographic information, complete a health questionnaire, and sign a consent form to join the registry. Recruiters at this station error check registrants' forms to ensure correct completion, and educate registrants about the data collection, storage, usage, and confidentiality. Following registration, registrants proceed to swabbing, where they swab their cheeks to provide a tissue/DNA sample. Recruiters at this station affix barcode stickers to each swab kit component. While registrants swab their cheeks, volunteers perform an informed consent checkpoint by asking registrants if they understand the donation process, the risks involved, and the right to withdraw at any time. Finally, registrants visit reconciliation, where their paperwork is error checked again, their understanding of the donation process is assessed a final time to verify informed consent, and their kit processed for shipping. In summary, the five-station approach to stem cell drive design outlined in this presentation represents a new model for effective stem cell donor recruitment. Figure 1. Figure 1. Disclosures No relevant conflicts of interest to declare.


Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2363-2363
Author(s):  
Francesco Buccisano ◽  
Luca Maurillo ◽  
Maria Ilaria Del Principe ◽  
Gottardo De Angelis ◽  
Raffaella Cerretti ◽  
...  

Abstract Multiparametric flow cytometry (MPFC) detection of minimal residual disease (MRD) represents a robust surrogate for the quality of complete remission (CR) and reliably predicts clinical outcome. In our experience, MRD detection provides prognostically relevant information when assessed at the post-consolidation time point. Ten years ago we demonstrated that the amount of MRD before autologous stem cell transplant (AuSCT) affected outcome. More recently, other authors have extended this observation to allogeneic stem cell transplant (ASCT) showing that pre-transplant MRD is a major determinant of prognosis regardless of graft-versus-leukemia (GVL) effect. The aim of our study was to evaluate, in an extended series of patients submitted to AuSCT or ASCT, the impact of a pre-transplantation MRD positive (MRDpos) or negative (MRDneg) status on overall survival (OS) and disease free survival (DFS). We analyzed 173 MRDpos and 53 MRDneg patients of whom 67 were submitted to AuSCT and 51 to ASCT. Eighty-two patients received no transplant because of age, poor performance status or insufficient stem cell harvest whereas 26, all in the MRDpos group, relapsed before transplant delivery. In the AuSCT group, before transplant, 32/67 (48%) were MRDneg and 35/67 (52%) MRDpos, with MRDneg group showing a superior OS (55% vs 20%, p=0.007). In the ASCT group, before transplant, 45/51 (88%) were MRDpos and 6/51 (12%) MRDneg. For 21 out of 51 (41%) sources of stem cells were matched unrelated donors (12) or haploidentical donors (9). In this subgroup, MRDpos and MRDneg patients shared a comparable 5-years OS (60% vs 56%, p=NS), with a 36% survival gain for those MRDpos who received ASCT as compared to AuSCT. Among MRDneg patients, no survival differences were demonstrated between those submitted to AuSCT or ASCT (55% vs 60%, p=NS). Such a lack of difference is likely due to the higher treatment related mortality (ASCT 3/6, 50% vs AuSCT 2/32, 6%, p=0.003) which counterbalanced the lower relapse rate in the ASCT group (ASCT 0/6, 0% vs AuSCT 11/32, 34%, p=NS). In conclusion, ASCT confers a significant survival advantage to MRDpos patients, attenuating the negative prognostic impact of pre-transplant MRD positivity. ASCT may expose MRDneg patients to an excess of toxicity suggesting that in these patients the allogeneic option should be postponed after a second remission. In MRDpos patients, AuSCT does not represent a valid therapeutic choice and ASCT, which should be timely delivered, also considering alternative sources of stem cells. Disclosures No relevant conflicts of interest to declare.


Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 2957-2957
Author(s):  
Teruhiko Kozuka ◽  
Fumihiko Ishimaru ◽  
Keitaro Matsuo ◽  
Hiromi Nakashima ◽  
Nobuharu Fujii ◽  
...  

Abstract Introduction Recently, reduced-intensity conditioning (RIC) regimens have been used in allogeneic stem cell transplantation (SCT) in which conventional myeloablative conditioning regimens are associated with high rates of non-relapse mortality. Most commonly used RIC regimens are fludarabine/total body irradiation, fludarabine/cyclophosphamide (F/C), fludarabine/busulfan (F/B), and fludarabine/melphalan, with increasing myelosuppressive intensity. Although patients receiving an allogeneic peripheral blood stem cell (PBSC) transplant after a preparative regimen of F/C were reported to develop first T-cell donor chimerism and later myeloid donor chimerism, how chimerism kinetics may be different for these regimens is not fully elucidated. We have retrospectively analyzed early kinetics of engraftment following reduced-intensity SCT and compared the results of F/C and F/B. Patients and methods Data were collected retrospectively on 30 patients who underwent allogeneic SCT after RIC regimens (F/C, n=13; F/B, n=17) between January 2001 and May 2006. F/C patients underwent conditioning a fludarabine and cyclophosphamide regimen consisting of fludarabine 30mg/m2 intravenously daily (days -7 through -2) and cyclophosphamide 30mg/kg intravenously (day -7, -6). F/B patients underwent a fludarabine and busulfan regimen in which busulfan 1mg/kg orally every 6 hours for 2 days (days -5, -4) was substituted for cyclophosphamide. All patients received GVHD prophylaxis with cyclosporine A (from day -1) and short term methotrexate (days +1, +3, +6). Donor chimerism was performed on days 14 and 28 using quantitative polymerase chain reaction of informative polymorphic short tandem repeat regions. Results On day 14, donor chimerism of myeloid cells was 25.8% and 68.1% in patients with F/C and F/B, respectively (p=0.023). On the contrary, donor chimerism of T-cells was 71.4% and 34.3% in patients with F/C and F/B, respectively (p=0.024). Similar results were obtained on day 28. Myeloid donor chimerism was 72.0% and 98.6% (p=0.002), and T-cell donor chimerism was 94.5% and 69.3% (p=0.006) in patients with F/C and F/B, respectively. Discussion Engraftment kinetics of allogeneic SCT after RIC regimens depend on the intensity of pretransplant chemotherapy, the intensity of the conditioning regimens, and the graft composition. Unfortunately, our analyses were retrospective, and the majority of stem cell source used in F/C was PBSC in contrast to bone marrow in F/B. However, even with PBSC, T-cell donor chimerism was previously reported to be delayed in F/B conditioning compared to myeloid donor chimerism. Our results clearly demonstrated that chimerism kinetics is strikingly different between F/C and F/B and suggested that not only the intensity but also the impact on chimerism of RIC regimens should not be considered equivalent.


Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1438-1438
Author(s):  
Natallia Mikhalkevich ◽  
Michael W. Becker

Abstract Abstract 1438 Poster Board I-461 We previously demonstrated the loss of expression of alpha-E-Catenin, the product of the CTNNA1 gene, in primary leukemic stem cells isolated from patients with advanced Myelodysplastic Syndrome (MDS) and Acute Myeloid Leukemia (AML) associated with loss of all or part of the long arm of chromosome 5. To formally assess the impact of loss of Ctnna1 expression on hematopoiesis, we employed a murine model for the hematopoietic specific conditional loss of Ctnna1 expression. We demonstrate that Ctnna1 deficiency is associated with normal hematopoietic maturation and proliferation as assessed by peripheral blood examination and methycellulose colony assays. We assessed stem cell and early progenitor frequencies using both flow cytometry and functional assays. Ctnna1 deficiency was associated with equivalent frequencies of Sca1+C-Kit+CD135-Lineage- HSCs in both experimental animals and controls. Short term HSC and MPP frequencies were likewise unaltered. We assessed HSC function using transplantation studies. In competitive repopulation experiments, HSCs deficient for Ctnna1 maintained stable engraftment of recipient mice for up to 1 year. Limiting dilution analyses detected no significant difference in HSC frequency between wild type and Ctnna1 deficient mice. We examined the potential role of Ctnna1 deficient hematopoietic stem cells in two murine models for myeloid neoplasms 1.) exposure to mutagen ENU and 2.) a model for murine AML driven by the HoxA9-Nup98 fusion product. Following exposure of HSCs to ENU, loss of Ctnna1 was not associated with an increased risk of development of a myeloid neoplasm. Expression of the HoxA9-Nup98 fusion product by retroviral infection of Ctnna1 deficient and wild type Sca1+C-Kit+Lineage- cells resulted in no difference in time to development of the previously characterized myeloproliferative disorder or acute leukemia. Taken together, these data demonstrate that in the absence of specific genetic abnormalities, loss of Ctnna1 expression in primary murine HSCs is not associated with aberrant HSC function or the development of myeloid neoplasms. Further studies are necessary to define a role for of loss of Ctnna1 expression in human myeloid malignancies. Disclosures No relevant conflicts of interest to declare.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4185-4185
Author(s):  
Koji Kato ◽  
Yoshiko Atsuta ◽  
Kazuteru Ohashi ◽  
Takahiro Fukuda ◽  
Shuichi Taniguchi ◽  
...  

Abstract Abstract 4185 Background: Since the clinical implication of anti-lymphocyte globulin (ATG/ALG) in allogeneic stem cell transplantation (allo-SCT) is not fully understood, we tried to identify the clinical impact of ATG/ALG in patients with acute leukemia who received allo-SCT in Japan. Patients and Methods: We analyzed patients with ALL (n=5494) and AML (n=8115) who received first allogeneic SCT from 1983 to 2009 with (n=356) or without (n=13253) ATG/ALG. Their stem cell sources were bone marrow (BM, n=9056), peripheral blood (PB, n=1918), and cord blood (CB, n=2575) and they were transplanted at 1st complete remission (CR1, n=5681), 2nd CR (CR2, n=2495), and advanced stages (>CR3, n=5033). Results: Five year overall survival (5y OS) of all patients with or without ATG/ALG was 33.6% vs 44.5%, respectively (P<0.001) and multivariate analysis showed that ATG/ALG significantly reduced acute GVHD (P<0.001, HR=1.980) as well as chronic GVHD (P<0.001, HR=1.894). According to stem cell sources, 5y OS with or without ATG/ALG was 35.8% vs 47.5% (P<0.001) in BM, 34.7% vs 37.6% (P=0.067) in PB and 18.3% vs 39.9% (P<0.001) in CB. By multivariate analysis, ATG/ALG significantly reduced A-GVHD (P=0.005, HR=1.565) but decreased OS (P=0.004, HR=0.729) in BM, it reduced A-GVHD (P<0.001, HR=2.376) and C-GVHD (P<0.001, HR=2.691) but lowered engraftment (P=0.046, HR=0.810) in PB, and it increased TRM (P=0.004, HR=0.437) with decreased OS (P=0.011, HR=0.576) in CB. In Haplo transplantation (SCT from 2 or 3 antigens of HLA mismatched family donor, n=337), multivariate analysis showed that ATG/ALG did not affect the relapse, TRM and OS but, it significantly lowered engraftment (P=0.002, HR=0.602), and reduced A-GVHD (P<0.001, HR=2.622) as well as C-GVHD (P<0.001, HR=3.834). In contrast to these results, ATG/ALG did not affect the relapse rate irrespective of stem cell source or diagnosis. Conclusion: In allogeneic stem cell transplantation for patients with ALL and AML, ATG/ALG contribute in reducing acute and chronic GVHD without affecting relapse rates but it was a risk factor of OS for patients who received BM or CB. Disclosures: No relevant conflicts of interest to declare.


2006 ◽  
Vol 12 (2) ◽  
pp. 73
Author(s):  
C.R. Mueller ◽  
K. Hirv ◽  
S.F. Goldmann ◽  
K. Schwarz
Keyword(s):  

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