Unrelated Donor Stem Cell Transplantation: The Role of the National Marrow Donor Program

2006 ◽  
pp. 256-256
Author(s):  
Chatchada Karanes ◽  
Tim Walker
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Unrelated Donor

Shift to a New Donor Does Not Improve the Outcome After Second Allogeneic Stem Cell Transplantation (alloSCT) in Acute Leukemia Relapse After a First Allosct – a Risk Factor Analysis by the German Stem Cell Registry (DRST).

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3328-3328 ◽  
Author(s):  
Maximilian Christopeit ◽  
Ulrike Feldmann ◽  
Juergen Finke ◽  
Donald W. Bunjes ◽  
Dietrich W. Beelen ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Acute Leukemia ◽  
Cell Transplantation ◽  
Univariate Analysis ◽  
Unrelated Donor ◽  
Significant Difference ◽  
Alternative Donor ◽  
Active Disease

Abstract Abstract 3328 Poster Board III-216 Introduction Relapse is a major cause of treatment failure after alloSCT against acute leukaemia, and no standard treatment has been established in this challenging situation. The introduction of reduced conditioning regimens, and the broader availability of alternative donors have increased the possibilities to perform a second alloSCT as salvage treatment, using different preparative regimen and/or different stem cell donors. Methods To evaluate the role of a second alloSCT (tx2) for the treatment of relapse after first alloSCT (tx1), we performed a nationwide retrospective analysis based on the German registry for stem cell transplantation (DRST). Datasets were completed by the reporting centres on request, following a specifically designed questionnaire. Results 212 patients (69% AML, 31% ALL), from 23 centres were included. Median age at tx1 was 37y. Donor at tx1 were HLA identical siblings (41%), matched unrelated (39%), mismatched family or unrelated (17%) or syngeneic donors (3%). Conditioning intensity at tx1 was standard (SIC, 62%), intermediate (intC, 25%) or reduced (RIC, 13%). Median remission after tx1 was 7 months, median time from relapse to tx2 was 74d. At tx2, patients were aplastic (4%), in CR (20%) or showed active disease (76%). In 59%, the same donor was used for tx1 and tx2, whereas a different donor was chosen in 41%. Conditioning at tx1/tx2 were SIC/SIC (14%), intC/intC (10%), (RIC/RIC (10%), less intensive at tx2 (mostly intC or RIC after SIC, 58%), or more intensive at tx2 (SIC after RIC or intC, 8%). Following tx2, CR was achieved in 56% of patients, out of which 81% relapsed again. Hence, leukemia was the most frequent cause of death. With a median FU of 23 months after tx2, median OS after tx2 is 117d. In a univariate analysis (log rank), OS after tx2 depended on stage at tx1 (CR vs. active disease, p<.001), stage at tx2 (CR vs. aplastic/active disease, p=.011) and duration of remission after tx1 (<=6m (1y OS 5%) vs. 6-12m (15%) vs. >12m (31%), p<.001). No significant difference was observed regarding age ( median), AML vs. ALL, family versus unrelated donor, or time point of alloSCT (2002). Shift to an alternative donor did not improve the results either. In a multivariate analysis (Cox Regression Model), time of remission after tx1 was the only significant factor for OS (p<.001, hazard ratio .51, 95%CI .49-.74). Conclusion Survival of acute leukemia after second allogeneic SCT is determined by the duration of remission after tx1. Using an alternative donor for tx2 did not improve the results in our series. Further analysis is required to evaluate the role of RIC regimen for tx2. Disclosures No relevant conflicts of interest to declare.

scholarly journals Role of KIR typing in donor selection prior to allogeneic hematopoietic stem cell transplantation: literature review

2019 ◽  
Vol 13 (4) ◽  
pp. 67-74
Author(s):  
V. V. Zakharova
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Nk Cell ◽  
Conditioning Regimen ◽  
Unrelated Donor ◽  
Hematopoietic Stem

Natural killer (NK) cells are the first population to recover after allogeneic hematopoietic stem cell transplantation. Since the report in 2002 by L. Rugerri et al. showing the effectiveness of NK cell alloreactivity in haploidentical stem cell transplantation, a lot of conflicting studies have appeared about the role of NK alloreactivity in haploidentical and matched unrelated donor transplantations. Current studies demonstrate that the beneficial effects of donor NK alloreactivity are dependent on the transplant protocol – conditioning regimen, graft processing procedure and graft-versus-host disease.

Role of Allogeneic Stem Cell Transplantation in Lymphoplasmacytic Lymphoma. Analysis of 61 Cases from the European Bone Marrow Registry (EBMT).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3326-3326
Author(s):  
Charalampia A. Kyriakou ◽  
Anthony H. Goldstone ◽  
Anna Sureda ◽  
Kwee Yong ◽  
Goli Taghipour ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Residual Disease ◽  
Entire Group ◽  
Unrelated Donor ◽  
Lymphoplasmacytic Lymphoma ◽  
Significant Difference

Abstract Despite effectiveness of standard chemotherapy regimens, complete response is infrequent in Lymphoplasmacytic Lymphoma (LPL) patients and there is no cure. The role of allogeneic stem cell transplantation (ASCT) has not been explored extensively and the available data are limited. We studied retrospectively LPL patients from 47 European centres who underwent conventional (CT) and non-myeloablative (NMT) allogeneic stem cell transplantation between 1989 and 2003. Sixty-one patients (42 male) of median age at transplant of 41 years (38–57), underwent allogeneic transplantation for LPL. Thirty-two patients were treated with CT and 29 NMT. Thirteen patients received 1, 25 received 2 and 23 more than 2 previous treatment lines. Seven patients were in CR1, 20 in CR2, 19 in PR and 15 with PD. Conditioning used was a combination of TBI and cyclophosphamide or busulfan for the CT and Fludarabine based regimens for the NMT. Twenty-six NMT and 25 CT patients received stem cells from an HLA-identical sibling, while 3 NMT and 7 CT from a matched unrelated donor. For GVHD prophylaxis or treatment cyclosporin A, Methotrexate, ATG, MoAB, T-cell depletion were used. Nine NMT patients received donor lymphocyte infusion for either residual disease or mixed chimera. Median follow up is 7 months (1 to 168). Twenty-nine patients developed a-GVHD (47.5%) [Grade I-II (n=25), Grade III-IV (n=4)] with no statistically significant difference between the 2 groups. Eleven CT patients (34.4%) and 10 NMT (34.5%) patients died from regimen toxicity. Non-relapse mortality was the same for both groups. One CT and 2 NMT patients relapsed and died from disease progression. The progression free survival (PFS) is 51%, at 1 and 41% at 3 years for the entire group and comparison between CT and NMT has not shown a statistical significant difference. Relapse rate at 2 years for CT and NMT is 23% and 34% respectively. Overall survival for CT is 60% at 1 and 55% at 3 years and is similar in the two groups. In conclusion allogeneic stem cell transplantation is safe with moderate non-relapse toxicity and good overall response in this group of advanced and multitreated LPL patients.

Endothelial and Circulating Progenitor Cells in Hematological Diseases and Allogeneic Hematopoietic Stem Cell Transplantation

2018 ◽  
Vol 25 (35) ◽  
pp. 4535-4544 ◽  
Author(s):  
Annalisa Ruggeri ◽  
Annalisa Paviglianiti ◽  
Fernanda Volt ◽  
Chantal Kenzey ◽  
Hanadi Rafii ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Peripheral Blood ◽  
Circulating Endothelial Cells ◽  
Hematopoietic Stem ◽  
Hematological Diseases

Background: Circulating endothelial cells (CECs), originated form endothelial progenitors (EPCs) are mature cells not associated with vessel walls and detached from the endothelium. Normally, they are present in insignificant amounts in the peripheral blood of healthy individuals. On the other hand, elevated CECs and EPCs levels have been reported in the peripheral blood of patients with different types of cancers and other diseases. Objective: This review aims to provide an overview on the characterization of CECs and EPCs, to describe isolation methods and to identify the potential role of these cells in hematological diseases and hematopoietic stem cell transplantation. Methods: We performed a detailed search of peer-reviewed literature using keywords related to CECs, EPCs, allogeneic hematopoietic stem cell transplantation, and hematological diseases (hemoglobinopathies, hodgkin and non-hodgkin lymphoma, acute leukemia, myeloproliferative syndromes, chronic lymphocytic leukemia). Results: CECs and EPCs are potential biomarkers for several clinical conditions involving endothelial turnover and remodeling, such as in hematological diseases. These cells may be involved in disease progression and in the neoplastic process. Moreover, CECs and EPCs are probably involved in endothelial damage which is a marker of several complications following allogeneic hematopoietic stem cell transplantation. Conclusion: This review provides information about the role of CECs and EPCs in hematological malignancies and shows their implication in predicting disease activity as well as improving HSCT outcomes.

scholarly journals Endothelial cell dysfunction: a key determinant for the outcome of allogeneic stem cell transplantation

2021 ◽  
Author(s):  
Thomas Luft ◽  
Peter Dreger ◽  
Aleksandar Radujkovic
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Current Status ◽  
Sinusoidal Obstruction Syndrome ◽  
Hematopoietic Stem ◽  
Cell Dysfunction ◽  
Management Of Complications ◽  
Life Threatening

AbstractAllogeneic hematopoietic stem cell transplantation (alloSCT) carries the promise of cure for many malignant and non-malignant diseases of the lympho-hematopoietic system. Although outcome has improved considerably since the pioneering Seattle achievements more than 5 decades ago, non-relapse mortality (NRM) remains a major burden of alloSCT. There is increasing evidence that endothelial dysfunction is involved in many of the life-threatening complications of alloSCT, such as sinusoidal obstruction syndrome/venoocclusive disease, transplant-associated thrombotic microangiopathy, and refractory acute graft-versus host disease. This review delineates the role of the endothelium in severe complications after alloSCT and describes the current status of search for biomarkers predicting endothelial complications, including markers of endothelial vulnerability and markers of endothelial injury. Finally, implications of our current understanding of transplant-associated endothelial pathology for prevention and management of complications after alloSCT are discussed.

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