scholarly journals Analysis of Clinical Features and Prognosis in Patients with Refractory/Relapsed Acute Myeloid Leukemia- Results from Our Center

2020 ◽  
pp. 1-6
Author(s):  
Bao-An Chen ◽  
Xiaoyu Li ◽  
Fei Wang ◽  
Yixin Zhou ◽  
Bao-An Chen
Keyword(s):  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Clinical Features ◽  
Myeloid Leukemia ◽  
Hematopoietic Stem ◽  
Relapsed Acute Myeloid Leukemia ◽  
Acute Myeloid

Objective: To analyse the clinical features and survival of patients with refractory/relapsed acute myeloid leukemia (AML) in our center, thus, to find out whether there is a trend of improvement in the survival of these patients in the past years and to search for prognostic factors which are associated with patients’ survival. Method: A total of 45 patients with refractory/relapsed AML were retrospectively reviewed. Clinical data, including gender, age, FAB classification of AML, performance status (PS), cytogenetic and molecular abnormities, complete remission (CR) duration, choices of treatment (whether to undergo hematopoietic stem cell transplantation) before and after relapse. The Kaplan-Meier method and the Log-rank test were conducted to determine the influence of those above factors on the patients’ survival. Results: The mean survival time of the 45 patients with refractory/relapsed AML was (36.25±8.40) months and the median follow up was (9±2.58) months. The one-year and two-years overall survival (OS) rate was (40.6±7.5) % and (23.7±7.0) %, respectively. Univariate analysis results demonstrated that age (p<0.05) and undergoing hematopoietic stem cell transplantation (HSCT) after relapse (p<0.01) were significantly related to OS in these patients. Conclusion: Age and whether to undergo HSCT after relapse are the key factors for the survival of patients with refractory/relapsed AML in our center. HSCT is still an effective salvage therapy for patients with refractory/relapsed AML. Our findings highlight the divergent outcomes of these patients and provide evidence to support the importance of timely HSCT after relapse, which is beneficial for clinicians to make clinical decisions in the future.

scholarly journals Magnesium levels and outcome after allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia

2020 ◽  
Author(s):  
Linus Angenendt ◽  
Isabel Hilgefort ◽  
Jan-Henrik Mikesch ◽  
Bernhard Schlüter ◽  
Wolfgang E. Berdel ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Myeloid Leukemia ◽  
Epstein Barr Virus Infection ◽  
Hematopoietic Stem ◽  
Acute Myeloid

AbstractLow intake of magnesium has been associated with the occurrence of lymphomas and decreased magnesium levels suppress the cytotoxic function of T cells and natural killer cells in patients with “X-linked immunodeficiency with magnesium defect, Epstein-Barr virus infection, and neoplasia” (XMEN) syndrome. These cell types are also important mediators of immune-mediated effects after allogeneic hematopoietic stem cell transplantation. Here, we show that high posttransplant magnesium levels independently associate with a lower incidence of relapse, a higher risk of acute graft-versus-host disease, and a higher non-relapse mortality in 368 patients with acute myeloid leukemia from our center. Magnesium serum levels might impact on donor-cell-mediated immune responses in acute myeloid leukemia.

scholarly journals CD38-directed CAR-T cell therapy: a novel immunotherapy strategy for relapsed acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Qingya Cui ◽  
Chongsheng Qian ◽  
Nan Xu ◽  
Liqing Kang ◽  
Haiping Dai ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Cell Therapy ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Myeloid Leukemia ◽  
Hematopoietic Stem ◽  
Car T ◽  
Acute Myeloid

AbstractAllogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for acute myeloid leukemia (AML). However, most patients experience relapse after allo-HSCT, with a poor prognosis, and treatment options are limited. The lack of an ideal targetable antigen is a major obstacle for treating patients with relapsed AML. CD38 is known to be expressed on most AML and myeloma cells, and its lack of expression on hematopoietic stem cells (HSCs) renders it a potential therapeutic target for relapsed AML. To investigate the clinical therapeutic efficacy and safety of CD38-targeted chimeric antigen receptor T (CAR-T-38) cells, we enrolled 6 AML patients who experienced relapse post-allo-HSCT (clinicaltrials.gov: NCT04351022). Prior to CAR-T-38 treatment, the blasts in the bone marrow of these patients exhibited a median of 95% (92–99%) CD38 positivity. Four weeks after the initial infusion of CAR-T-38 cells, four of six (66.7%) patients achieved complete remission (CR) or CR with incomplete count recovery (CRi); the median CR or CRi time was 191 (range 117–261) days. The cumulative relapse rate at 6 months was 50%. The median overall survival (OS) and leukemia-free survival (LFS) times were 7.9 and 6.4 months, respectively. One case relapsed 117 days after the first CAR-T-38 cell infusion, with remission achieved after the second CAR-T-38 cell infusion. All six patients experienced clinically manageable side effects. In addition, multiparameter flow cytometry (FCM) revealed that CAR-T-38 cells eliminated CD38 positive blasts without off-target effects on monocytes and lymphocytes. Although this prospective study has a limited number of cases and a relatively short follow-up time, our preliminary data highlight the clinical utility and safety of CAR-T-38 cell therapy in treating relapsed AML post-allo-HSCT.

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