scholarly journals Salvage use of allogeneic hematopoietic stem cell transplantation after reduced intensity conditioning from unrelated donors in multiple myeloma. A study by the Plasma Cell Disorders subcommittee of the European Group for Blood and Marrow Transplant Chronic Malignancies Working Party

Haematologica ◽  
2017 ◽  
Vol 102 (7) ◽  
pp. e271-e274 ◽  
Author(s):  
Mohamad Sobh ◽  
Mauricette Michallet ◽  
Valérie Dubois ◽  
Simona Iacobelli ◽  
Linda Koster ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Working Party ◽  
Marrow Transplant ◽  
Reduced Intensity Conditioning ◽  
Hematopoietic Stem ◽  
Blood And Marrow Transplant ◽  
Plasma Cell Disorders ◽  
Unrelated Donors ◽  
European Group ◽  
Reduced Intensity

Treatment, risk factors, and outcome of adults with relapsed AML after reduced intensity conditioning for allogeneic stem cell transplantation

Blood ◽  
2012 ◽  
Vol 119 (6) ◽  
pp. 1599-1606 ◽  
Author(s):  
Christoph Schmid ◽  
Myriam Labopin ◽  
Arnon Nagler ◽  
Dietger Niederwieser ◽  
Luca Castagna ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Prognostic Score ◽  
Working Party ◽  
Reduced Intensity Conditioning ◽  
Term Survival ◽  
Hematopoietic Stem ◽  
Reduced Intensity

Abstract Because information on management and outcome of AML relapse after allogeneic hematopoietic stem cell transplantation (HSCT) with reduced intensity conditioning (RIC) is scarce, a retrospective registry study was performed by the Acute Leukemia Working Party of EBMT. Among 2815 RIC transplants performed for AML in complete remission (CR) between 1999 and 2008, cumulative incidence of relapse was 32% ± 1%. Relapsed patients (263) were included into a detailed analysis of risk factors for overall survival (OS) and building of a prognostic score. CR was reinduced in 32%; remission duration after transplantation was the only prognostic factor for response (P = .003). Estimated 2-year OS from relapse was 14%, thereby resembling results of AML relapse after standard conditioning. Among variables available at the time of relapse, remission after HSCT > 5 months (hazard ratio [HR] = 0.50, 95% confidence interval [CI], 0.37-0.67, P < .001), bone marrow blasts less than 27% (HR = 0.53, 95% CI, 0.40-0.72, P < .001), and absence of acute GVHD after HSCT (HR = 0.67, 95% CI, 0.49-0.93, P = .017) were associated with better OS. Based on these factors, 3 prognostic groups could be discriminated, showing OS of 32% ± 7%, 19% ± 4%, and 4% ± 2% at 2 years (P < .0001). Long-term survival was achieved almost exclusively after successful induction of CR by cytoreductive therapy, followed either by donor lymphocyte infusion or second HSCT for consolidation.

Transplant Outcome of Unrelated Hematopoietic Stem Cell Transplantation (HSCT) after Myelo-Ablative or Reduced Intensity Conditioning (RIC) for Chronic Lymphocytic Leukemia(CLL). A Study of EBMT Registry.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 561-561 ◽  
Author(s):  
Mauricette Michallet ◽  
Thomas Prebet ◽  
Quoc-Hung Le ◽  
Anne-Sophie Michallet ◽  
Anja Van Biezen ◽  
...  
Keyword(s):  
Chronic Gvhd ◽  
Hla Matching ◽  
Reduced Intensity Conditioning ◽  
Hematopoietic Stem ◽  
Allogeneic Hsct ◽  
Significant Difference ◽  
Unrelated Donors ◽  
Global Population ◽  
Reduced Intensity ◽  
Grade Iii

Abstract Place of allogeneic HSCT in the therapeutical strategy of CLL remains still controversial and unrelated allogeneic transplantation has to be better explored. This retrospective analysis concerned 214 patients (164 males and 50 females) who underwent allogeneic HSCT for CLL from unrelated donors (150 males and 64 females) and who were reported on EBMT registry. The median age was 49 years. Fifty two patients received bone marrow (BM) and 162 peripheral blood stem cells (PBSC) from 48 HLA mismatched and 166 HLA matched unrelated donors. Sex mismatch and ABO incompatibility were found in 33% and 52% of cases respectively. On 194 evaluated patients for conditioning, 80 received a myelo-ablative regimen, 114 a reduced intensity conditioning and a Total Boby Irradiation was performed in 70 cases. After transplant, 72 patients (37%) developed an acute GVHD grade II-IV (36% in BM patients and 37% in PBSC patients; 49% in myelo-ablative group and 28% in RIC group). On evaluated patients, a chronic GVHD was present in 61% of the patients (50% in BM patients and 67% in PBSC patients, 66% in myelo-ablative group and 63% in RIC group). With a median follow-up of 20 months, we found no significant difference for 3-year probability of Overall Survival between myelo-ablative group (59%, 46–76) and RIC group (48%, 37–63). No significant difference was observed when comparing BM and PBSC patients whatever the conditioning they received. OS was significantly better in HLA matched compared to HLA mismatched patients in RIC population (51% vs 36%, p=0.01) but not in myelo-ablative population. In multivariate analysis (table 1) studying pre and post transplantation factors, a significant impact of 2 variables, age and aGVHD (grade III-IV vs 0-I), was shown on OS for the global population, myelo-ablative and RIC groups. Other variables influenced also significantly the OS: HLA matching (global and RIC populations), sex matching (myelo-ablative and RIC), TBI (myelo-ablative group). Concerning BM and PBSC groups, we demonstrated the influence of age and aGVHD. In conclusion, besides the known influence of severe aGVHD on survival, this study points out the importance of age and HLA matching in allogeneic unrelated HSCT transplantation setting for CLL. No difference was found regarding conditioning regimen and further studies are needed to determine the most adequate regimen for this disease. Multivariate analyses Variables OS (HR) p Global population Age 1.04 (1-1.07) 0.05 HLA matching: yes vs no 0.44 (0.22-0.89) 0.02 aGVHD grade III-IV vs 0-I 1.37 (1.1-1.74) 0.01 Myelo-ablative group Age 1.07 (1-1.13) 0.04 Sex Mismatch: F to M vs F to F 6.26 (1.53-25.6) 0.01 TBI: yes vs no 16.3 (3.26-80.2) 0.0006 aGVHD grade III-IV vs 0-I 1.9 (1.18-3.06) 0.008 RIC group Age 1.05 (1-1.1) 0.05 HLA matching: yes vs no 0.28 (0.1-0.76) 0.01 Sex Mismatch M to F vs F to F 0.63 (0.42-0.96) 0.03 aGVHD grade III-IV vs 0-I 1.66 (1.16-2.39) 0.005 BM group Age 1.12 (1-1.24) 0.03 aGVHD grade III-IV vs 0-I 1.88 (1-1.36) 0.05 PBSC group aGVHD grade III-IV vs 0-I 1.38 (1.02-1.86) 0.03

scholarly journals A perspective on the selection of unrelated donors and cord blood units for transplantation

Blood ◽  
2012 ◽  
Vol 120 (2) ◽  
pp. 259-265 ◽  
Author(s):  
Stephen R. Spellman ◽  
Mary Eapen ◽  
Brent R. Logan ◽  
Carlheinz Mueller ◽  
Pablo Rubinstein ◽  
...  
Keyword(s):  
Cord Blood ◽  
Marrow Transplant ◽  
Hematopoietic Stem ◽  
Blood And Marrow Transplant ◽  
Unrelated Donors ◽  
Matching Criteria ◽  
Graft Selection ◽  
Transplantation Outcomes ◽  
Unrelated Adult ◽  
Selection Of

Abstract Selection of a suitable graft for allogeneic hematopoietic stem cell transplantation involves consideration of both donor and recipient characteristics. Of primary importance is sufficient donor-recipient HLA matching to ensure engraftment and acceptable rates of GVHD. In this Perspective, the National Marrow Donor Program and the Center for International Blood and Marrow Transplant Research provide guidelines, based on large studies correlating graft characteristics with clinical transplantation outcomes, on appropriate typing strategies and matching criteria for unrelated adult donor and cord blood graft selection.

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