Transplantation with unrelated bone marrow in leukaemic patients above 40 years of age
|
|
- Andrea Owens
- 6 years ago
- Views:
Transcription
1 Bone Marrow Transplantation, (1998) 21, Stockton Press All rights reserved /98 $12.00 Transplantation with unrelated bone marrow in leukaemic patients above 40 years of age O Ringdén 1,2,3, M Remberger 2, J Mattsson 1,2,3, J Aschan 1,4, S Carlens 1,3,HHägglund 1,3, BLönnqvist 1,4, E Sparrelid 5 and P Ljungman 1,4 1 Bone Marrow Transplant Unit, Departments of 2 Clinical Immunology, 3 Transplantation Surgery, 4 Haematology and 5 Infectious Diseases, Huddinge Hospital, Huddinge, Sweden Summary: Twenty-seven patients above 40 years of age (range 40 55) with leukaemia underwent transplantation with haematopoietic stem cells from HLA-A, -B and -DR identical unrelated donors. They were compared to 69 younger patients, median age 23. In the older group, the diagnoses were acute myeloid leukaemia (AML) five, acute lymphoblastic leukaemia (ALL) three and chronic myeloid leukaemia (CML) 19. The corresponding figures in the younger patients were 21, 27 and 21, respectively. Conditioning consisted of cyclophosphamide (120 mg/kg) combined with 10 Gy total body irradiation. Immunosuppression was ATG or OKT3 for 5 days before transplantation and methotrexate combined with cyclosporin A. The probabilities of grades II IV acute graft-versus-host disease (GVHD) were 23 and 21%, and the cumulative incidences of chronic GVHD were 64 and 50% in the older and younger patient cohorts, respectively. Overall, 3-year transplantrelated mortality rates were 46% in patients 40 years of age and 32% in patients 40 years of age (P = 0.16). Three-year patient survival rates were 54 and 46% in the two groups, respectively. In patients with chronic phase CML, the corresponding figures were 67 and 68%, respectively. We conclude that patients above 40 years of age should be considered for transplantation with marrow from unrelated donors. Keywords: bone marrow transplantation; unrelated; leukaemia; age; ATG; graft-versus-host disease Bone marrow transplants from unrelated donors for leukaemias are increasing in number and greatly in proportion, compared to matched sibling donors. 1 7 The major obstacle to successful unrelated donor bone marrow transplantation (BMT) is the high incidence of acute graft-versus-host disease (GVHD) and other transplantation-related complications. The risks of acute GVHD and infectious complications have been more common in patients receiving bone marrow from unrelated donors than from HLA-identical siblings. 2,3,5,8 Correspondence: Prof O Ringdén, Dept of Clinical Immunology, Huddinge Hospital F79, S Huddinge, Sweden Received 29 April 1997; accepted 2 September 1997 Age is an important factor following BMT, using HLAidentical sibling donors Age is also important for survival, using unrelated donors. 1,4,7 Because of the adverse association between age and outcome after BMT, many centres limit transplants with unrelated bone marrow to patients less than 40 years old. However, more than half of patients with leukaemia are above 40 years of age. Particularly chronic myeloid leukaemia (CML), otherwise incurable, is more common in older patients. CML is the major indication for BMT with unrelated donors. 1 5,8 16 With a fixed age below 40 years, the vast majority of patients with CML will not be considered for BMT with unrelated marrow. Therefore, it was of interest to analyse the outcome in our patients above 40 years of age with leukaemia, who had received bone marrow from unrelated donors. Patients and methods Patients and tissue typing From 1988 until July 1997, 96 leukaemic patients underwent BMT using unrelated donors at Huddinge Hospital. Twenty-seven were above 40 years of age, median 43 (range 40 55) and 69 were below 40 years of age. The characteristics of these two groups are shown in Table 1. There were more ALL patients in 2nd remission in those below 40 years of age (P = 0.05). All recipient donor pairs were HLA-A, -B and -DR identical. HLA-A and -B class I typing was performed serologically using commercially available reagents to define new subgroups. HLA-DR class II antigens were determined serologically until October 1989 and thereafter using genomic methods. Initially, the RFLP method was used with the help of cdna probes to determine DRB, DQA and DQB alleles. 14 Since July 1992, the PCR-SPP method (PCR method using sequence-specific primer pairs) has been used to define DRB1-5, DQA1, DQB and DPB1 alleles. 15 Mixed lymphocyte culture (MLC) was negative in the case where HLA-DR class II antigens were determined serologically. 16 In the other cases, MLC reactivity was not considered. In patients 40 years of age/ 40 years of age, class II typing was performed serologically in 1/0, by RFLP in 0/10 and by PCR- SPP in 26/59. In patients 40 years of age, the donor origin was Scandinavia in nine, and in the remaining, Europe in eight and USA in 10. Among patients 40 years of age,
2 44 Table 1 Patient and donor characteristics Patients 40 Patients 40 P years of age years of age value Total numbers Diagnosis CML 1st chronic phase nd chronic phase 2 1 accelerated phase 2 blast crisis 1 3 AML 1st CR 2 4 partial remission 3 5 relapse 7 2nd remission 5 ALL 1st CR a nd CR Early/late a 18/9 32/37 NS Recipient age (years) 43 (40 55) b 23 (1 39) Donor age 34 (22 55) 34 (21 49) NS Recipient sex (female/male) 12/15 30/39 Donor sex (female/male) 13/14 23/46 Immune female donor to 4 6 NS male recipient ABO comp/minor/major 13/7/7 20/22/27 incomp. CMV serology, donor/ recipient +/ / /+ 2 9 / Cell dose c 10 8 /kg 2.0 ( ) 3.0 ( ) 0.05 Median follow-up (days) 688 ( ) 643 ( ) NS Median time diagnosis to 448 ( ) 384 ( ) BMT a CR = complete remission; early: 1st remission, 1st chronic phase; late: beyond these stages. b Median (range). c Bone marrow or peripheral blood progenitor cells in six cases. CSF. 17 As prophylaxis against GVHD, cyclosporin A (CsA) was combined with a short course of MTX. 16,18 At the first sign of grade I acute GVHD, prednisolone 2 mg/kg/day was given for 1 week. Thereafter, the dose was reduced, depending on response. Granulocyte transfusions were given to patients with septicaemia and high fever ( 40 C) who did not respond to antibiotics, or with disseminating local infections. Details regarding supportive care have been published. 16,19 IVIG 500 mg/kg was given once before BMT and once a week during the first 3 months after BMT to seven patients (26%) 40 years of age and to 21 (30%) of the younger patients 20 (Table 1). G-CSF 5 g/kg/day was given after BMT to all patients after May 1994, 16 (59%) and 47 (68%) in the two groups, respectively. Statistical analysis The data were analysed on 13 August Time to GVHD, relapse, survival rates etc, were analysed by the life table method with a log-rank (Mantel Haenszel) test, and sensor data were taken into account. The log-rank test was used for statistical comparisons of survival curves. For statistical comparisons of absolute numbers, the 2 test or Fisher s exact test was used. Cox s regression model was used for multivariate analysis. The following factors were included: recipient age, diagnosis, acute leukemia or CML, disease status, marrow cell dose, donor age, donor and recipient cytomegalovirus (CMV) serology. CMV disease was defined as CMV infection verified by biopsy, bronchoalveolar lavage, spinal fluid isolation or typical retinitis. 21 Chronic GVHD was described as limited or extensive. 22 Current leukaemia-free survival (LFS) was calculated such that patients who were given donor lymphocyte transfusions after a relapse and achieved complete cytogenetic and haematological remission were also counted as leukaemia-free. corresponding numbers were 19, 30 and 20, respectively. The incidence of grades II IV acute GVHD was 4/28 if the donor was from Scandinavia, 13/38 from Europe and 4/30 from the USA. All patients referred for BMT were considered if they fulfilled indication criteria and had no severe organ impairment that could hamper outcome. Conditioning and treatment All patients were treated with cyclophosphamide 60 mg/kg on days 5 and 4 or 4 and 3 before transplantation. Two 12 mg doses of intrathecal methotrexate (MTX) were given to patients with ALL and AML M4 and M5. This was followed by 10 Gy of total body irradiation with the lungs shielded to receive no more than 9 Gy. Most patients were given 5 days treatment with anti-thymocyte globulin (ATG) or OKT3 before transplantation, 26 in the older and 67 in the younger group, respectively. 16 OKT-3 was used after June 1996 because it is cheaper. As an alternative to bone marrow, five of the patients 40 years of age and five of the patients 40 years of age were given peripheral blood progenitor cells (PBPC) from donors treated with G- Results Engraftment and transfusion Engraftment was achieved in 96% of the patients above or below 40 years of age (Table 2). Time to engraftment, WBC/l and /l, did not differ between the two groups. Requirements for transfusions did not differ significantly in the two groups. Infections and GVHD The incidence of bacteraemia during the first month (positive blood culture) was the same in the two groups (Table 2). Positive CMV PCR was more common in patients 40 years of age (P = 0.01). CMV disease occurred in four patients 40 years of age; two interstitial pneumonitis (IP), one enteritis and one retinitis. Among patients below 40 years of age were one CMV IP, one encephalitis and two retinitis. The cumulative incidence of acute GVHD grades II IV was 23% in patients 40 years of age, compared to 21% in patients 40 years of age. The
3 Table 2 Engraftment, tranfusions, infections and GVHD 45 Patients 40 years of age Patients 40 years of age P value Engraftment 26/27 (96%) 66/69 (96%) Days to WBC /l 16 (10 24) a 15 (6 23) 0.27 Days to PMN /l 20 (11 31) 16 (10 33) 0.21 Transfusions Erythrocyte units 5 (0 22) 4 (0 58) NS Platelet tranfusions 14 (1 40) 10 (2 57) NS Granulocytes Number of patients Infections Bacteraemia 62% 51% -streptococci 4 16 Straphylococcus epidermidis 9 15 Other bacteraemia 1 3 Positive CMV PCR 21 (78%) 32 (46%) 0.01 CMV disease CMV interstitial pneumonitis 2 1 Acute GVHD GVHD I GVHD II 4 11 GVHD III 2 2 GVHD IV 0 1 Cumulative incidence, grades II IV 23% 21% Chronic GVHD, limited/extensive 9/2 14/5 Cumulative incidence at 3 years 64% 50% 0.10 a Median (range). cumulative incidence of chronic GVHD was 64 and 50% in the two groups, respectively. In the other patients, one died from acute and two from chronic GVHD. Four of the younger patients died of acute and one from chronic GVHD. Survival and relapse Twelve of the older and 33 of the younger patients died. Causes of death in the patients 40 years/ 40 years were relapse 0/13, bronchopneumonia 4/2, interstitial pneumonitis 3/2, septicaemia 1/3, invasive fungal infection 1/3, obstructive broncheolitis 0/3, encephalitis 1/1, VOD 0/2, liver insufficiency 0/2, GVHD 1/2 and hemorrhage 1/0. Overall, transplant-related mortality (TRM) was not statistically different in patients 40 years of age, compared to patients 40 years of age (Table 3). The probability of relapse was lower in the older patients (P = 0.03) and the overall patient survival rates at 3 years were the same, around 50% in both groups (Figure 1). In patients with early leukaemia, first remission of acute leukaemia and first chronic phase of CML, 3 year survival and LFS were similar in the two groups (Table 3). Current LFS at 3 years was 53% in patients 40 years of age and 56% in those 40 years of age in patients with early leukaemia. In patients with more advanced disease, there were only nine above 40 years of age. However, the outcome parameters did not differ significantly or numerically from those in the younger patients. Multivariate analysis was performed regarding TRM, LFS and survival. Recipient age above or below 40 years was not significantly different. None of the other factors analysed were significant in multivariate analysis. Table 3 Outcome parameters, 3-year probability of TRM, relapse, survival and leukaemia-free survival in recipients of unrelated bone marrow 40 years of age and 40 years of age Patients 40 Patients 40 P years of age years of age value % % All patients, n TRM Relapse Survival LFS NS Early leukaemia, n TRM Relapse Survival LFS Advanced disease, n 9 37 TRM Relapse NS Survival NS LFS CML chronic phase, n TRM Relapse Survival LFS NS Outcome in chronic phase CML The most homogeneous group comprises patients with CML in chronic phase. In those 40 of age, TRM was 33%, and none has so far had a relapse with a 3-year survival rate and LFS of 67% (Figure 2). In the younger patients with CML in chronic phase, TRM was 32% and
4 Probability of survival P = NS Years after BMT Figure 1 Probability of survival after BMT in recipients of marrow from HLA-A, -B and -DR identical, matched unrelated donors 40 years of age (n = 27, ), and patients 40 years of age (n = 69, ) Probability of survival P = NS Years after BMT Figure 2 Probability of survival in patients with CML in chronic phase receiving marrow from unrelated donors 40 years of age (n = 16, ), and patients 40 years of age (n = 18, ).
5 four patients had a relapse. Three had a relapse of their CML, 1 year, 1 year and 9 months and 2 years after BMT, respectively. All three were treated with donor lymphocytes and are now in haematological and cytogenetic remission 2 years, 2 years and 3 years and 1 month after donor lymphocyte treatment, respectively. The fourth patient became Philadelphia chromosome-positive 2 years after BMT, started interferon treatment in November 1996 and received donor lymphocyte transfusions in December 1996, 3 years after BMT. This patient did not enter remission and died of relapse. The 3-year patient survival rate in patients 40 years of age with CML in chronic phase is 67% and similar to that of 40 years of age (Figure 2). The current LFS at 3 years was 67% in those 40 years and 53% in patients 40 years of age. Discussion In this comparison between patients 40 years of age and younger patients receiving unrelated haematopoietic stem cells, more ALL patients with advanced disease were found in the younger group. Furthermore, there was a trend for more CMV seronegative donor/recipient pairs in the younger patients, who also received a significantly higher bone marrow cell dose. This may be expected, since ALL and CMV seronegativity are more common in younger patients. Furthermore, all donors were adults and the younger group also included children of low weight, who therefore received a higher cell dose. High bone marrow cell dose was associated with a lowered risk of dying from GVHD in a previous study from our unit. 10 A recent study from Seattle also showed improved survival in recipients who received a high cell dose of unrelated bone marrow. 23 In the present analysis, all were consecutive patients from a single institution. Therefore, treatment, conditioning and GVHD prophylaxis were the same in the two groups. Because of the small number of patients, the data should be interpreted with caution. The incidence of septicaemia (above 50%) was not significantly different between the two groups. The incidence of septicaemia is significantly higher in recipients of unrelated bone marrow, than in HLA-identical siblings. 8,16 The reasons for this may be more pronounced immunosuppressive therapy, delayed engraftment, minor HLA-incompatibility and high donor age. High donor age had previously been found to prolong immunological recovery after BMT. 24 Positive CMV PCR was more common in the older patients, 78 vs 46% (P = 0.01). This may be expected since there tended to be fewer CMV seronegative donor/recipient pairs in the older patients. 25 With early diagnosis using PCR and pre-emptive therapy with ganciclovir or foscarnet, CMV disease only occurred in four and three patients each in the two groups, respectively. 21 PBPC instead of bone marrow was given to five of the older patients and five of the younger ones. 17 It has rarely been used in recipients of unrelated stem cells, since the increased number of T cells in the graft may increase the risk of severe GVHD. However, using unmanipulated bone marrow in HLA-identical siblings, we found no correlation with the number of T cells in the graft and the consequent risk of acute GVHD. 10 Only three patients in this study, who received PBPC developed grade II III acute GVHD. Therefore, although experimental, PBPC from unrelated donors may be used as an alternative to bone marrow. Generally, age has not been associated with an increased risk of acute GVHD. 26,27 However, advanced age is associated with an increased risk of dying of acute GHVD. 9,10 This is one reason why older adults have not been considered for BMT from unrelated donors in all centres. In the present study, patients above and below 40 years of age had a probability of around 20% of developing moderate-to-severe acute GVHD. Mortality from GVHD was low in both groups. The reason for this may be the use of ATG, which may reduce the risk not only of rejection, but also of acute GVHD. 16 Bär et al 28 reported that T cell depletion, using elutriation, had a favourable outcome in HLA-identical siblings above 40 years of age. Therefore, T cell depletion in vivo and in vitro may be important in older adults undergoing BMT from unrelated donors. Chronic GVHD is strongly correlated with acute GVHD. 29,30 Chronic GVHD has also been shown to increase with age. 13,29,30 However, in this study, age above 40 years did not increase the risk of chronic GVHD. Overall, the risk of chronic GVHD in these patients was higher than that seen in HLA-identical siblings. 31 This may be due to mismatched minor HLA antigens and the high proportion of patients with CML. We have found an increased risk of chronic GVHD in patients with CML, compared to other diagnoses receiving HLA-identical sibling marrow and also unrelated marrow, respectively. 32 Most studies showing an effect of age on transplant outcome have compared children to adults However, in this analysis, we investigated whether BMT using unrelated donors is feasible in patients above 40 years of age. In our study of consecutive leukaemic patients receiving marrow from unrelated donors, survival was above 50% in recipients above and below 40 years of age (Table 3). In the most homogeneous cohort, patients with CML in chronic phase, 3-year survival rates were almost identical in those above and below 40 years of age, 67 and 68% respectively (Figure 2). This figure should be viewed with caution, because the patients were few (n = 16 and 18) and the observation time short. However, LFS was only 37% in the younger patients. With the use of donor lymphocyte transfusions, most CML patients with recurrent disease after BMT have a remission. 33 Therefore, it may be more relevant to compare survival or current LFS rather than LFS in CML patients after BMT. One explanation why patients 40 years of age and older benefited as much as the younger patients, may be that these patients have been more carefully selected. Nevertheless, this study suggests that age above 40 years should not be a determining factor for BMT from unrelated donors. Several investigations of HLA-identical siblings have indicated that patients above 40, 45 or 50 years of age should be considered for BMT. 28,34 36 A report from the International Bone Marrow Transplant Register showed that patients, 50 years of age and older, with early and intermediate leukaemia, benefited as much as those between 30 47
6 48 and 49 years of age. 35 Therefore, it is also reasonable that patients above 50 years of age with early leukaemia should be considered for BMT from unrelated donors. However, we cannot determine the upper age limit for receiving an unrelated BMT. Acknowledgements We are indebted to the nursing staff at the BMT Unit and the Depts of Transplantation Surgery, and Haematology at Huddinge Hospital for excellent patient care. We thank Inger Hammarberg for expert preparation of this manuscript. This study was supported by grants from the Swedish Cancer Foundation (0070-B95-09XCC), the Children s Cancer Foundation ( ), the Belvén Foundation, the Swedish Medical Research Council (B96-16X C), FRF Foundation, the Tobias Foundation and the Ellen Bachrach Foundation. References 1 McGlave PB, Beatty P, Ash R, Hows JM. Therapy for chronic myelogenous leukemia with unrelated donor bone marrow transplantation: results in 102 cases: published erratum appears in Blood 1990; 76: 654. Blood 1990; 75: Beatty PG, Hansen JA, Longton GM et al. Marrow transplantation from HLA-matched unrelated donors for treatment of hematologic malignancies. Transplantation 1991; 51: Marks DI, Cullis JO, Ward KN et al. Allogeneic bone marrow transplantation for chronic myeloid leukemia using sibling and volunteer unrelated donors. A comparison of complications in the first 2 years. Ann Intern Med 1993; 119: Kernan NA, Bartsch G, Ash RC et al. Analysis of 462 transplantations from unrelated donors facilitated by the National Marrow Donor Program. New Engl J Med 1993; 328: Hows J, Bradley BA, Gore S et al on behalf of the International Marrow Unrelated Search and Transplant (IMUST) Study. Prospective evaluation of unrelated donor bone marrow transplantation. Bone Marrow Transplant 1993; 12: Nademanee A, Schmidt GM, Parker P et al. The outcome of matched unrelated donor bone marrow transplantation in patients with hematologic malignancies using molecular typing for donor selection and graft-versus-host disease prophylaxis regimen of cyclosporine, methotrexate and prednisone. Blood 1995; 86: Davies SM, Shu XO, Blazar BR et al. Unrelated donor bone marrow transplantation: influence of HLA A and B incompatibility on outcome. Blood 1995; 86: Mattsson J, Ringdén O, Aschan J et al. A low incidence of grades II to IV acute GVHD, but high mortality from infections using HLA-A, -B and -DR-identical unrelated donors and immunosuppression with ATG, cyclosporine and methotrexate. Transplant Proc 1997; 29: Bortin MM, Gale RP, Rimm AA. Allogeneic bone marrow transplantation for 144 patients with severe aplastic anemia. JAMA 1981; 245: Ringdén O, Nilsson B. Death by graft-versus-host disease associated with HLA mismatch, high recipient age, low marrow cell dose, and splenectomy. Transplantation 1985; 40: Barrett AJ, Horowitz MM, Gale RP. Marrow transplantation for acute lymphoblastic leukemia: factors affecting relapse and survival. Blood 1989; 74: Goldman JM, Gale RP, Horowitz MM et al. Bone marrow transplantation for chronic myelogenous leukemia in chronic phase. Increased risk of relapse associated with T-cell depletion. Ann Intern Med 1988; 108: Ringdén O, Zwaan FE, Hermans J, Gratwohl A for the Leukemia Working Party of the European Group for Bone Marrow Transplantation: European experience of bone marrow transplantation for leukemia. Transplant Proc 1987; 19: Carlsson B, Wallin J, Böhme J, Möller E. HLA-DR-DQ haplotypes defined by restriction fragment analysis. Correlation to serology. Hum Immunol 1987; 20: Olerup O, Zetterquist H. HLA-DR typing by PCR amplification with sequence-specific primers (PCR-SPP) in 2 hours: an alternative to serological DR typing in clinical practice including donor recipient matching in cadaveric transplantation. Tissue Antigens 1992; 39: Ringdén O, Remberger M, Persson U et al. Similar incidence of graft-versus-host disease using HLA-A, -B and -DR identical unrelated bone marrow donors as with HLA-identical siblings. Bone Marrow Transplant 1995; 15: Ringdén O, Lönnqvist B, Hägglund H et al. Transplantation with peripheral blood stem cells from unrelated donors without serious graft-versus-host disease. Bone Marrow Transplant 1995; 16: Storb R, Deeg HJ, Whitehead J et al. Methotrexate and cyclosporine compared with cyclosporine alone for prophylaxis of acute graft versus host disease after marrow transplantation for leukemia. New Engl J Med 1986; 314: Ringdén O, Pihlstedt P, Markling L et al. Prevention of graftversus-host disease with T cell depletion or cyclosporin and methotrexate. A randomized trial in adult leukemic marrow recipients. Bone Marrow Transplant 1991; 7: Klaesson S, Ringdén O, Ljungman P et al. Does high-dose intravenous immune globin treatment after bone marrow transplantation increase mortality in veno-occlusive disease of the liver? Transplantation 1995; 60: Ljungman P, Loré K, Aschan J et al. Use of a semi-quantitative PCR for cytomegalovirus DNA as a basis for pre-emptive antiviral therapy in allogeneic bone marrow transplant patients. Bone Marrow Transplant 1996; 17: Shulman HM, Sullivan KM, Weiden PL et al. Chronic graftversus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients. Am J Med 1980; 69: Sierra J, Storer B, Hansen JA et al. Transplantation of marrow cells from unrelated donors for treatment of high-risk acute leukemia: the effect of leukemic burden, donor HLA-matching, and marrow cell dose. Blood 1997; 89: Paulin T, Ringdén O, Nilsson B. Immunological recovery after bone marrow transplantation: role of age, graft-versus-host disease, prednisolone treatment and infections. Bone Marrow Transplant 1987; 1: Paulin T, Ringdén O, Lönnqvist B et al. The importance of pre-bone marrow transplantation serology in determining subsequent cytomegalovirus infection. An analysis of risk factors. Scand J Infect Dis 1986; 18: Gale RP, Bortin MM, van Bekkum DW et al. Risk factors for acute graft-versus-host disease. Br J Haematol 1987; 67: Hägglund H, Boström L, Remberger M et al. Risk factors for acute graft-versus-host disease in 291 consecutive HLA-identical bone marrow transplant recipients. Bone Marrow Transplant 1995; 16: Bär BMAM, DeWitte T, Schattenberg A et al. Favourable outcome of patients older than 40 years of age after transplantation with marrow grafts depleted of lymphocytes by counterflow centrifugation. Br J Haematol 1990;
7 29 Storb R, Prentice RL, Sullivan KM et al. Predictive factors in chronic graft-versus-host disease in patients with aplastic anemia treated by marrow transplantation from HLA-identical siblings. Ann Intern Med 1983; 98: Ringdén O, Paulin T, Lönnqvist B, Nilsson B. An analysis of factors predisposing for chronic graft-versus-host disease. Exp Hematol 1985; 13: Ringdén O, Horowitz MM, Sondel P et al. Methotrexate, cyclosporine or both to prevent graft-versus-host disease after HLA-identical sibling bone marrow transplants for early leukemia? Blood 1993; 81: Carlens S, Ringdén O, Aschan J et al. Risk-factors for chronic graft-versus-host disease after bone marrow transplantation: a retrospective single center analysis. (Submitted). 33 Kolb HJ, Mittermüller J, Clemm CH et al. Donor leukocyte transfusions for treatment of recurrent chronic myelogenous leukemia in marrow transplant patients. Blood 1990; 76: Klingemann H-G, Storb R, Fefer A et al. Bone marrow transplantation in patients aged 45 years and older. Blood 1986; 67: Ringdén O, Horowitz M, Gale RP et al. Outcome after allogeneic bone marrow transplant for leukemia in older adults. JAMA 1993; 270: Rapoport AP, DiPersio JF, Martin BA et al. Patients age 40 years undergoing autologous or allogeneic BMT have regimen-related mortality rates and event-free survivals comparable to patients age 40 years. Bone Marrow Transplant 1995; 15:
Reduced-intensity Conditioning Transplantation
Reduced-intensity Conditioning Transplantation Current Role and Future Prospect He Huang M.D., Ph.D. Bone Marrow Transplantation Center The First Affiliated Hospital Zhejiang University School of Medicine,
More informationThe New England Journal of Medicine BONE MARROW TRANSPLANTS FROM UNRELATED DONORS FOR PATIENTS WITH CHRONIC MYELOID LEUKEMIA
BONE MARROW TRANSPLANTS FROM UNRELATED DONORS FOR PATIENTS WITH CHRONIC MYELOID LEUKEMIA JOHN A. HANSEN, M.D., THEODORE A. GOOLEY, PH.D., PAUL J. MARTIN, M.D., FREDERICK APPELBAUM, M.D., THOMAS R. CHAUNCEY,
More information5/9/2018. Bone marrow failure diseases (aplastic anemia) can be cured by providing a source of new marrow
5/9/2018 or Stem Cell Harvest Where we are now, and What s Coming AA MDS International Foundation Indianapolis IN Luke Akard MD May 19, 2018 Infusion Transplant Conditioning Treatment 2-7 days STEM CELL
More informationMUD HSCT as first line Treatment in Idiopathic SAA. Dr Sujith Samarasinghe Great Ormond Street Hospital for Children, London, UK
MUD HSCT as first line Treatment in Idiopathic SAA Dr Sujith Samarasinghe Great Ormond Street Hospital for Children, London, UK No Financial Disclosures Guidelines for management of aplastic anaemia British
More informationHematopoietic stem cell transplantation (HSCT)
Stem Cell Transplantation research paper A low body mass index is correlated with poor survival after allogeneic stem cell transplantation KATARINA LE BLANC, OLLE RINGDÉN, MATS REMBERGER Background and
More informationHLA-DR-matched Parental Donors for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with High-risk Acute Leukemia
BRIEF COMMUNICATION HLA-DR-matched Parental Donors for Allogeneic Hematopoietic Stem Cell Transplantation in Patients with High-risk Acute Leukemia Shang-Ju Wu, Ming Yao,* Jih-Luh Tang, Bo-Sheng Ko, Hwei-Fang
More informationUse of a five-agent GVHD prevention regimen in recipients of unrelated donor marrow
Bone Marrow Transplantation, (1999) 23, 889 893 1999 Stockton Press All rights reserved 0268 3369/99 $12.00 http://www.stockton-press.co.uk/bmt Use of a five-agent GVHD prevention regimen in recipients
More informationKEY WORDS: Allogeneic, Hematopoietic cell transplantation, Graft-versus-host disease, Immunosuppressants, Cyclosporine, Tacrolimus
A Retrospective Comparison of Tacrolimus versus Cyclosporine with Methotrexate for Immunosuppression after Allogeneic Hematopoietic Cell Transplantation with Mobilized Blood Cells Yoshihiro Inamoto, 1
More informationHematopoietic Stem Cell Transplantation for Patients with Chronic Myeloid Leukemia
398 Hematopoietic Stem Cell Transplantation for Patients with Chronic Myeloid Leukemia Qifa Uu Zhiping Fan Jing Sun Yu Zhang Xiaoli Uu Dan Xu Bing Xu Ru Feng Fanyi Meng Shuyun Zhou Department of Hematology,
More informationPoor Outcome in Steroid-Refractory Graft-Versus-Host Disease With Antithymocyte Globulin Treatment
Biology of Blood and Marrow Transplantation 8:155-160 (2002) 2002 American Society for Blood and Marrow Transplantation ASBMT Poor Outcome in Steroid-Refractory Graft-Versus-Host Disease With Antithymocyte
More informationTrends in Hematopoietic Cell Transplantation. AAMAC Patient Education Day Oct 2014
Trends in Hematopoietic Cell Transplantation AAMAC Patient Education Day Oct 2014 Objectives Review the principles behind allogeneic stem cell transplantation Outline the process of transplant, some of
More informationStem Cell Transplantation for Severe Aplastic Anemia
Number of Transplants 10/24/2011 Stem Cell Transplantation for Severe Aplastic Anemia Claudio Anasetti, MD Professor of Oncology and Medicine Chair, Blood and Marrow Transplant Dpt Moffitt Cancer Center
More informationMUD SCT. Pimjai Niparuck Division of Hematology, Department of Medicine Ramathibodi Hospital, Mahidol University
MUD SCT Pimjai Niparuck Division of Hematology, Department of Medicine Ramathibodi Hospital, Mahidol University Outlines Optimal match criteria for unrelated adult donors Role of ATG in MUD-SCT Post-transplant
More informationDiagnosis of CMV infection UPDATE ECIL
UPDATE ECIL-4 2011 Recommendations for CMV and HHV-6 management in patients with hematological diseases Per Ljungman, Rafael de la Camara, Hermann Einsele, Dan Engelhard, Pierre Reusser, Jan Styczynski,
More informationCMV Infection after Transplant from Cord Blood Compared to Other Alternative Donors: The Importance of Donor-Negative CMV Serostatus
CMV Infection after Transplant from Cord Blood Compared to Other Alternative Donors: The Importance of Donor-Negative CMV Serostatus Małgorzata Mikulska, 1 Anna Maria Raiola, 2 Paolo Bruzzi, 3 Riccardo
More informationRole of NMDP Repository in the Evolution of HLA Matching and Typing for Unrelated Donor HCT
Role of NMDP Repository in the Evolution of HLA Matching and Typing for Unrelated Donor HCT Stephen Spellman, MBS Director, Immunobiology and Observational Research Assistant Scientific Director CIBMTR,
More informationTherapeutic Advances in Treatment of Aplastic Anemia. Seiji Kojima MD. PhD.
Therapeutic Advances in Treatment of Aplastic Anemia Seiji Kojima MD. PhD. Department of Pediatrics Nagoya University Graduate School of Medicine Chairman of the Severe Aplastic Anemia Working Party Asia-Pacific
More informationImproved prognosis for acquired aplastic anaemia
158 Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK L A Pitcher I M Hann JPMEvans P Veys J M Chessells DKHWebb Correspondence to: Dr Webb.
More informationBone Marrow Transplantation in Myelodysplastic Syndromes. An overview for the Myelodysplasia Support Group of Ottawa
Bone Marrow Transplantation in Myelodysplastic Syndromes An overview for the Myelodysplasia Support Group of Ottawa Objectives Provide brief review of marrow failure Re emphasize the importance of predictions
More informationCMV pneumonia in allogeneic BMT recipients undergoing early treatment or pre-emptive ganciclovir therapy
(2000) 26, 413 417 2000 Macmillan Publishers Ltd All rights reserved 0268 3369/00 $15.00 www.nature.com/bmt CMV pneumonia in allogeneic BMT recipients undergoing early treatment or pre-emptive ganciclovir
More informationThe legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION. 18 July 2012
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 18 July 2012 ANTILYMPHOCYTE GLOBULINS FRESENIUS 20 mg/ml, solution to dilute for infusion 10 glass bottle(s) of 5
More informationCONSIDERATIONS IN DESIGNING ACUTE GVHD PREVENTION TRIALS: Patient Selection, Concomitant Treatments, Selecting and Assessing Endpoints
CONSIDERATIONS IN DESIGNING ACUTE GVHD PREVENTION TRIALS: Patient Selection, Concomitant Treatments, Selecting and Assessing Endpoints CENTER FOR INTERNATIONAL BLOOD AND MARROW TRANSPLANT RESEARCH Potential
More informationAn Introduction to Bone Marrow Transplant
Introduction to Blood Cancers An Introduction to Bone Marrow Transplant Rushang Patel, MD, PhD, FACP Florida Hospital Medical Group S My RBC Plt Gran Polycythemia Vera Essential Thrombocythemia AML, CML,
More informationNational Marrow Donor Program HLA-Matching Guidelines for Unrelated Marrow Transplants
Biology of Blood and Marrow Transplantation 9:610-615 (2003) 2003 American Society for Blood and Marrow Transplantation 1083-8791/03/0910-0003$30.00/0 doi:10.1016/s1083-8791(03)00329-x National Marrow
More informationOF TOTAL IRRADIATION. 0. RINGDEN, I. BARYD, B. JOHANSSON, G. GAHRTON, C. G. GROTH, G. LUNDGREN and B. LONNQVIST
Acra Radiologica Oncology (983) Fasc. 6 FROM THE DEPARTMENT OF TRANSPLANTATION SURGERY, AND DIVISION OF CLINICAL HEMATOLOGY AND ONCOLOGY, DEPARTMENT OF MEDICINE, HUDDINGE SJUKHUS, S-486 HUDDINGE. AND DEPARTMENT
More informationSupplemental Table 1 Multivariate analysis of neutrophil and platelet
Transplant using vs. HLA 1-AG mismatched RD Supplemental Table 1 Multivariate analysis of neutrophil and platelet engraftment Variable Neutrophil engraftment* Platelet engraftment HR (95% CI) P value HR
More informationOne Day BMT Course by Thai Society of Hematology. Management of Graft Failure and Relapsed Diseases
One Day BMT Course by Thai Society of Hematology Management of Graft Failure and Relapsed Diseases Piya Rujkijyanont, MD Division of Hematology-Oncology Department of Pediatrics Phramongkutklao Hospital
More informationThe clinical utility of CMV surveillance cultures and antigenemia following bone marrow transplantation
Bone Marrow Transplantation, (1999) 23, 45 51 1999 Stockton Press All rights reserved 0268 3369/99 $12.00 http://www.stockton-press.co.uk/bmt The clinical utility of CMV surveillance cultures and antigenemia
More informationIntensified conditioning regimen in bone marrow transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia
Bone Marrow Transplantation, (1998) 22, 1029 1033 1998 Stockton Press All rights reserved 0268 3369/98 $12.00 http://www.stockton-press.co.uk/bmt Intensified conditioning regimen in bone marrow transplantation
More informationHematology and Oncology, The Cleveland Clinic, Cleveland, Ohio; 3 Department of Biostatistics, The Ohio State University Hospitals, Columbus, Ohio
Biology of Blood and Marrow Transplantation 12:61-67 (2006) 2006 American Society for Blood and Marrow Transplantation 1083-8791/06/1201-0004$32.00/0 doi:10.1016/j.bbmt.2005.06.004 High Disease Burden
More informationImmunosuppressive Therapy and Bone Marrow Transplantation for Aplastic Anaemia The CMC Experience
36 supplement to Journal of the association of physicians of india Published on 1st of every month 1st march, 2015 Immunosuppressive Therapy and Bone Marrow Transplantation for Aplastic Anaemia The CMC
More informationPDF hosted at the Radboud Repository of the Radboud University Nijmegen
PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/2296
More informationIntroduction to Clinical Hematopoietic Cell Transplantation (HCT) George Chen, MD Thursday, May 03, 2018
Introduction to Clinical Hematopoietic Cell Transplantation (HCT) George Chen, MD Thursday, May 03, 2018 The transfer of hematopoietic progenitor and stem cells for therapeutic purposes Hematopoietic Cell
More informationThe National Marrow Donor Program. Graft Sources for Hematopoietic Cell Transplantation. Simon Bostic, URD Transplant Recipient
1988 199 1992 1994 1996 1998 2 22 24 26 28 21 212 214 216 218 Adult Donors Cord Blood Units The National Donor Program Graft Sources for Hematopoietic Cell Transplantation Dennis L. Confer, MD Chief Medical
More informationClinical Study CMV Serostatus of Donor-Recipient Pairs Influences the Risk of CMV Infection/Reactivation in HSCT Patients
Bone Marrow Research Volume 22, Article ID 37575, 8 pages doi:.55/22/37575 Clinical Study CMV Serostatus of Donor-Recipient Pairs Influences the Risk of CMV Infection/Reactivation in HSCT Patients Emilia
More informationSylwia Mizia, 1 Dorota Dera-Joachimiak, 1 Malgorzata Polak, 1 Katarzyna Koscinska, 1 Mariola Sedzimirska, 1 and Andrzej Lange 1, 2. 1.
Bone Marrow Research Volume 2012, Article ID 873695, 5 pages doi:10.1155/2012/873695 Clinical Study Both Optimal Matching and Procedure Duration Influence Survival of Patients after Unrelated Donor Hematopoietic
More informationAIH, Marseille 30/09/06
ALLOGENEIC STEM CELL TRANSPLANTATION FOR MYELOID MALIGNANCIES Transplant and Cellular Therapy Unit Institut Paoli Calmettes Inserm U599 Université de la Méditerranée ée Marseille, France AIH, Marseille
More information3.1 Clinical safety of chimeric or humanized anti-cd25 (ch/anti-cd25)
3 Results 3.1 Clinical safety of chimeric or humanized anti-cd25 (ch/anti-cd25) Five infusions of monoclonal IL-2 receptor antibody (anti-cd25) were planned according to protocol between day 0 and day
More informationHaploidentical Transplantation today: and the alternatives
Haploidentical Transplantation today: and the alternatives Daniel Weisdorf MD University of Minnesota February, 2013 No matched sib: where to look? URD donor requires close HLA matching and 3-12 weeks
More information2/4/14. Disclosure. Learning Objective
Utilizing Intravenous Busulfan Pharmacokinetics for Dosing Busulfan And Fludarabine Conditioning Regimens In Institutions Where The Capability Of Doing Pharmacokinetics Is Not Present Shaily Arora, PharmD
More informationAllogeneic Hematopoietic Stem Cell Transplantation: State of the Art in 2018 RICHARD W. CHILDS M.D. BETHESDA MD
Allogeneic Hematopoietic Stem Cell Transplantation: State of the Art in 2018 RICHARD W. CHILDS M.D. BETHESDA MD Overview: Update on allogeneic transplantation for malignant and nonmalignant diseases: state
More informationHugo Castro-Malaspina, Richard E. Harris, James Gajewski, Norma Ramsay, Robert Collins, Bernie Dharan, Roberta King, and H.
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Unrelated donor marrow transplantation for myelodysplastic syndromes: outcome analysis in 510 transplants facilitated by the National Marrow
More informationHistocompatibility Evaluations for HSCT at JHMI. M. Sue Leffell, PhD. Professor of Medicine Laboratory Director
Histocompatibility Evaluations for HSCT at JHMI M. Sue Leffell, PhD Professor of Medicine Laboratory Director JHMI Patient Population Adults Peds NMDP data >20,000 HSCT JHMI HSCT Protocols Bone marrow
More informationINTRODUCTION Rabbit antithymocyte globulin (ratg), a polyclonal antibody that targets human T lymphocytes, is
Total and Active Rabbit Antithymocyte Globulin (ratg;thymoglobulinò) Pharmacokinetics in Pediatric Patients Undergoing Unrelated Donor Bone Marrow Transplantation Sandra K. Call, 1,2 Kimberly A. Kasow,
More informationPDF hosted at the Radboud Repository of the Radboud University Nijmegen
PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/24325
More informationDoes anti-thymocyte globulin have a place in busulfan/fludarabine
ORIGINAL ARTICLE Korean J Intern Med 2016;31:750-761 Does anti-thymocyte globulin have a place in busulfan/fludarabine conditioning for matched related donor hematopoietic stem cell transplantation? Young
More informationAllogeneic hematopoietic stem cell transplantation from family members other than HLA-identical siblings over the last decade ( )
TRANSPLANTATION Allogeneic hematopoietic stem cell transplantation from family members other than -identical siblings over the last decade (1991-2000) Yoshinobu Kanda, Shigeru Chiba, Hisamaru Hirai, Hisashi
More informationPUO in the Immunocompromised Host: CMV and beyond
PUO in the Immunocompromised Host: CMV and beyond PUO in the immunocompromised host: role of viral infections Nature of host defect T cell defects Underlying disease Treatment Nature of clinical presentation
More informationHaploidentical Transplantation: The Answer to our Donor Problems? Mary M. Horowitz, MD, MS CIBMTR, Medical College of Wisconsin January 2017
Haploidentical Transplantation: The Answer to our Donor Problems? Mary M. Horowitz, MD, MS CIBMTR, Medical College of Wisconsin January 2017 Allogeneic Transplant Recipients in the US, by Donor Type 9000
More informationKEY WORDS: Unrelated SCT, HLA-mismatch, ATG, Graft-versus-host disease
HLA-Mismatched Unrelated Donors as an Alternative Graft Source for Allogeneic Stem Cell Transplantation after Antithymocyte Globulin-Containing Conditioning Regimen Nicolaus Kröger, 1 Tatjana Zabelina,
More informationKT Godder, J Metha, KY Chiang, S Adams, F van Rhee, S Singhal, K Higgins-Smith, W O Neal, S DeRienzo and JP Henslee-Downey.
(2001) 28, 1031 1036 2001 Nature Publishing Group All rights reserved 0268 3369/01 $15.00 www.nature.com/bmt Acute myeloid leukaemia Partially mismatched related donor bone marrow transplantation as salvage
More informationHaploidentical Stem Cell Transplantation with post transplantation Cyclophosphamide for the treatment of Fanconi Anemia
Haploidentical Stem Cell Transplantation with post transplantation Cyclophosphamide for the treatment of Fanconi Anemia Carmem Bonfim Director Pediatric Blood and Marrow Transplantation Program HC Federal
More informationMedical Benefit Effective Date: 07/01/12 Next Review Date: 03/13 Preauthorization* Yes Review Dates: 04/07, 05/08, 03/10, 03/11, 03/12
Hematopoietic Stem-Cell Transplantation for Chronic Myelogenous (80130) Medical Benefit Effective Date: 07/01/12 Next Review Date: 03/13 Preauthorization* Yes Review Dates: 04/07, 05/08, 03/10, 03/11,
More informationCarol Cantwell Blood Transfusion Laboratory Manager St Mary s Hospital, ICHNT
Carol Cantwell Blood Transfusion Laboratory Manager St Mary s Hospital, ICHNT History Why is blood transfusion involved? What tests are performed in blood transfusion and why? What does a protocol look
More informationSamples Available for Recipient Only. Samples Available for Recipient and Donor
Unrelated HCT Research Sample Inventory - Summary for First Allogeneic Transplants in CRF and TED with biospecimens available through the CIBMTR Repository stratified by availability of paired samples,
More informationHee-Je Kim, Woo-Sung Min, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Chang-Ki Min, Seok Lee, Seok-Goo Cho, Jong-Youl Jin, Jong-Wook Lee, Chun-Choo Kim
Successful Prevention of Acute Graft-versus-Host Disease Using Low-Dose Antithymocyte Globulin after Mismatched, Unrelated, Hematopoietic Stem Cell Transplantation for Acute Myelogenous Leukemia Hee-Je
More informationHaplo vs Cord vs URD Debate
3rd Annual ASBMT Regional Conference for NPs, PAs and Fellows Haplo vs Cord vs URD Debate Claudio G. Brunstein Associate Professor University of Minnesota Medical School Take home message Finding a donor
More informationWhat s new in Blood and Marrow Transplant? Saar Gill, MD PhD Jan 22, 2016
What s new in Blood and Marrow Transplant? Saar Gill, MD PhD Jan 22, 2016 Division of Hematology-Oncology University of Pennsylvania Perelman School of Medicine 1 Who should be transplanted and how? Updates
More informationHCT for Myelofibrosis
Allogeneic HSCT for MDS and Myelofibrosis Sunil Abhyankar, MD Professor Medicine, Medical Director, Pheresis and Cell Processing University of Kansas Hospital BMT Program April 27 th, 213 HCT for Myelofibrosis
More informationObjectives. What is Aplastic Anemia. SAA 101: An Introductory Course to Severe Aplastic Anemia
SAA 101: An Introductory Course to Severe Aplastic Anemia David A. Margolis, MD Professor of Pediatrics/Medical College of Wisconsin Program Director/ Children s Hospital of Wisconsin BMT Program Objectives
More informationSamples Available for Recipient Only. Samples Available for Recipient and Donor
Unrelated HCT Research Sample Inventory - Summary for First Allogeneic Transplants in CRF and TED with biospecimens available through the CIBMTR Repository stratified by availability of paired samples,
More informationSamples Available for Recipient and Donor
Unrelated HCT Research Sample Inventory - Summary for First Allogeneic Transplants in CRF and TED with biospecimens available through the CIBMTR Repository stratified by availability of paired samples,
More informationAcute GVHD. ESH-EBMT 2009 Latimer A. Devergie
Acute GVHD ESH-EBMT 2009 Latimer A. Devergie Acute GVHD Activated Donor T cells damage host epithelial cells after an inflammatory cascade that begins after the preparative regimen GVHD is the major barrier
More informationPrevention of graft-versus-host disease in high risk patients by depletion of CD4 and reduction of CD8 lymphocytes in the marrow graft
Bone Marrow Transplantation, (1999) 23, 443 45 1999 Stockton Press All rights reserved 268 3369/99 $12. http://www.stockton-press.co.uk/bmt Prevention of graft-versus-host disease in high risk patients
More informationLe infezioni fungine nel trapianto di cellule staminali emopoietiche. Claudio Viscoli Professor of Infectious Disease University of Genova, Italy
Le infezioni fungine nel trapianto di cellule staminali emopoietiche Claudio Viscoli Professor of Infectious Disease University of Genova, Italy Potential conflicts of interest Received grants as speaker/moderator
More informationH Schroeder 1, G Gustafsson 2, UM Saarinen-Pihkala 3, A Glomstein 4, G Jonmundsson 5, K Nysom 6, O Ringdén 7 and L Mellander 8.
Bone Marrow Transplantation, (1999) 23, 555 560 1999 Stockton Press All rights reserved 0268 3369/99 $12.00 http://www.stockton-press.co.uk/bmt Allogeneic bone marrow transplantation in second remission
More informationAcute Graft-versus-Host Disease (agvhd) Udomsak Bunworasate Chulalongkorn University
Acute Graft-versus-Host Disease (agvhd) Udomsak Bunworasate Chulalongkorn University Graft-versus-Host Disease (GVHD) Background GVHD is an immunologic reaction of the donor immune cells (Graft) against
More informationAlloreattività e Tolleranza nei Trapianti di Cellule Staminali Emopoietiche Allogeniche
Alloreattività e Tolleranza nei Trapianti di Cellule Staminali Emopoietiche Allogeniche Massimo Fabrizio Martelli Ematologia ed Immunologia Clinica Università degli Studi di Perugia 41 Congresso Nazionale
More informationRob Wynn RMCH & University of Manchester, UK. HCT in Children
Rob Wynn RMCH & University of Manchester, UK HCT in Children Summary Indications for HCT in children Donor selection for Paediatric HCT Using cords Achieving engraftment in HCT Conditioning Immune action
More informationEBMT Complications and Quality of Life Working Party Educational Course
EBMT Complications and Quality of Life Working Party Educational Course Organisers: R. Duarte, G. Basak 23-24 October 2014, Warsaw, Poland #EBMT2014 www.ebmt.org EBMT Complications and Quality of Life
More informationUmbilical Cord Blood Transplantation
Umbilical Cord Blood Transplantation Current Results John E. Wagner, M.D. Blood and Marrow Transplant Program and Stem Cell Institute University of Minnesota Donor Choices Unrelated Marrow/PBSC Results
More informationThe function of the bone marrow. Living with Aplastic Anemia. A Case Study - I. Hypocellular bone marrow failure 5/14/2018
The function of the bone marrow Larry D. Cripe, MD Indiana University Simon Cancer Center Bone Marrow Stem Cells Mature into Blood Cells Mature Blood Cells and Health Type Function Term Red Cells Carry
More informationShall young patients with severe aplastic anemia without donors receive BMT from alternative source of HCT? Elias Hallack Atta, MD, PhD
Shall young patients with severe aplastic anemia without donors receive BMT from alternative source of HCT? Elias Hallack Atta, MD, PhD Declaração de Conflito de Interesse Declaro que possuo conflito de
More informationStem cells. -Dr Dinesh Bhurani, MD, DM, FRCPA. Rajiv Gandhi Cancer Institute, Delhi, -Director, Department of Haematology and BMT
Stem cells -Dr Dinesh Bhurani, MD, DM, FRCPA -Director, Department of Haematology and BMT Rajiv Gandhi Cancer Institute, Delhi, Flow of presentation Update on stem cell uses Haematopoietic stem cell transplantation
More informationIntroduction to Hematopoietic Stem Cell Transplantation
Faculty Disclosures Introduction to Hematopoietic Stem Cell Transplantation Nothing to disclose Jeanne McCarthy-Kaiser, PharmD, BCOP Clinical Pharmacist, Autologous Stem Cell Transplant/Long- Term Follow-Up
More informationA CLINICAL STUDY OF THE HEMATOPOIETIC STEM CELL TRANSPLANTATION IN 112 PATIENTS WITH LEUKEMIA AND OTHER MALIGNANT DISEASES
Chinese Journal of Cancer Research 9(1):36--40,1997, Clinical Observations A CLINICAL STUDY OF THE HEMATOPOIETIC STEM CELL TRANSPLANTATION IN 112 PATIENTS WITH LEUKEMIA AND OTHER MALIGNANT DISEASES Liu
More informationThe role of HLA in Allogeneic Hematopoietic Stem Cell Transplantation and Platelet Refractoriness.
The role of HLA in Allogeneic Hematopoietic Stem Cell Transplantation and Platelet Refractoriness. Robert Liwski, MD, PhD, FRCPC Medical Director HLA Typing Laboratory Department of Pathology Dalhousie
More informationRecommendations for VZV management in. Dan Engelhard, Pierre Reusser, Rafael de la Camara, Hermann Einsele, Jan Styczynski, Kate Ward, Per Ljungman
Recommendations for VZV management in patients Cas cliniques with leukemia Dan Engelhard, Pierre Reusser, Rafael de la Camara, Hermann Einsele, Jan Styczynski, Kate Ward, Per Ljungman Introduction Acute
More informationIncreased incidence of EBV-associated. lymphoproliferative disorders after. allogeneic stem cell transplantation from
Chapter 6 Increased incidence of EBV-associated lymphoproliferative disorders after allogeneic stem cell transplantation from matched unrelated donors due to a change of T cell depletion technique Ellen
More informationSevere Viral Related Complications Following Allo-HCT for Severe Aplastic Anemia
Severe Viral Related Complications Following Allo-HCT for Severe Aplastic Anemia Liat Shragian Alon, MD Rabin Medical Center, ISRAEL #EBMT15 www.ebmt.org Patient: 25-year-old male No prior medical history
More informationHSCT for Myeloproliferative Disorders. Jane Apperley
HSCT for Myeloproliferative Disorders Jane Apperley Myeloproliferative disorders CML Polycythemia vera Essential thrombocythemia Primary myelofibrosis bcr-abl + bcr-abl - JAK2 (valine to phenylalanin an
More informationClinical Use of Umbilical Cord Blood Hematopoietic Stem Cells
Biology of Blood and Marrow Transplantation 12:34-41 (2006) 2006 American Society for Blood and Marrow Transplantation 1083-8791/06/1201-0107$32.00/0 doi:10.1016/j.bbmt.2005.09.006 Clinical Use of Umbilical
More informationCHAPTER 3 LABORATORY PROCEDURES
CHAPTER 3 LABORATORY PROCEDURES CHAPTER 3 LABORATORY PROCEDURES 3.1 HLA TYPING Molecular HLA typing will be performed for all donor cord blood units and patients in the three reference laboratories identified
More informationEMERGING FUNGAL INFECTIONS IN IMMUNOCOMPROMISED PATIENTS
EMERGING FUNGAL INFECTIONS IN IMMUNOCOMPROMISED PATIENTS DR LOW CHIAN YONG MBBS, MRCP(UK), MMed(Int Med), FAMS Consultant, Dept of Infectious Diseases, SGH Introduction The incidence of invasive fungal
More informationM Ayas, H Solh, MM Mustafa, M Al-Mahr, I Al-Fawaz, A Al-Jefri, L Shalaby, A Al-Nasser and R Al-Sedairy
(2001) 27, 139 143 2001 Nature Publishing Group All rights reserved 0268 3369/01 $15.00 www.nature.com/bmt Bone marrow transplantation from matched siblings in patients with Fanconi anemia utilizing low-dose
More informationBiol Blood Marrow Transplant 19 (2013) 314e320
Biol Blood Marrow Transplant 19 (2013) 314e320 Many Days at Home during Neutropenia after Allogeneic Hematopoietic Stem Cell Transplantation Correlates with Low Incidence of Acute Graft-versus-Host Disease
More informationXIV. HLA AND TRANSPLANTATION MEDICINE
XIV. HLA AND TRANSPLANTATION MEDICINE A. Introduction 1. The HLA system includes a complex array of genes and their molecular products that are involved in immune regulation and cellular differentiation.
More informationHematopoietic Cell Transplantation for Myelofibrosis. Outline
Hematopoietic Cell Transplantation for Myelofibrosis H.Joachim Deeg MD Fred Hutchinson Cancer Research Center & University of Washington, Seattle WA Great Debates, NY, 4/28/2012 Outline Rationale for hematopoietic
More informationThe Role of Outcomes Registries in Blood and Marrow Transplantation Mary M Horowitz, MD, MS Cape Town, South Africa November 2014
The Role of Outcomes Registries in Blood and Marrow Transplantation Mary M Horowitz, MD, MS Cape Town, South Africa November 2014 Worldwide Network for Blood and Marrow Transplantation Transplants A Little
More informationDr. Yi-chi M. Kong August 8, 2001 Benjamini. Ch. 19, Pgs Page 1 of 10 TRANSPLANTATION
Benjamini. Ch. 19, Pgs 379-399 Page 1 of 10 TRANSPLANTATION I. KINDS OF GRAFTS II. RELATIONSHIPS BETWEEN DONOR AND RECIPIENT Benjamini. Ch. 19, Pgs 379-399 Page 2 of 10 II.GRAFT REJECTION IS IMMUNOLOGIC
More informationOutcomes of pediatric bone marrow transplantation for leukemia and myelodysplasia using matched. unrelated donors
Outcomes of pediatric bone marrow transplantation for leukemia and myelodysplasia using matched sibling, mismatched related or matched unrelated donors Immunobiology Working Committee PIs: Peter Shaw and
More informationIntroduction. Patients and methods
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Transplant-related mortality and long-term graft function are significantly influenced by cell dose in patients undergoing allogeneic marrow
More informationHematopoietic Stem Cells, Stem Cell Processing, and Transplantation
Hematopoietic Stem Cells, Stem Cell Processing, and Joseph (Yossi) Schwartz, M irector, Hemotherapy and Stem Cell Processing Facility Bone Marrow Can Cure: Leukemia Lymphoma Multiple Myeloma Genetic iseases:
More informationSummary: Keywords: bone marrow transplantation; phenotypically identical related donor; mismatched related donor; graft failure; GVHD
(2000) 25, 815 821 2000 Macmillan Publishers Ltd All rights reserved 0268 3369/00 $15.00 www.nature.com/bmt Bone marrow transplantation from alternative donors for thalassemia: HLA-phenotypically identical
More informationXiao-Jun Huang & Yu Wang & Dai-Hong Liu & Lan-Ping Xu & Huan Chen & Yu-Hong Chen & Wei Han & Hong-Xia Shi & Kai-Yan Liu
J Clin Immunol (2008) 28:390 397 DOI 10.1007/s10875-008-9193-4 Modified Donor Lymphocyte Infusion (DLI) for the Prophylaxis of Leukemia Relapse after Hematopoietic Stem Cell Transplantation in Patients
More informationTransition from active to palliative care EBMT, Geneva, Dr. med. Gayathri Nair Division of Hematology
Transition from active to palliative care EBMT, Geneva, 03.04.2012 Dr. med. Gayathri Nair Division of Hematology 3 cases of patients who underwent an allogeneic stem cell transplantation in curative intent
More informationDonor Lymphocyte Infusion for Malignancies Treated with an Allogeneic Hematopoietic Stem-Cell Transplant
Last Review Status/Date: September 2014 Page: 1 of 8 Malignancies Treated with an Allogeneic Description Donor lymphocyte infusion (DLI), also called donor leukocyte or buffy-coat infusion is a type of
More informationThe graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation
TRANSPLANTATION The graft-versus-leukemia effect using matched unrelated donors is not superior to s for hematopoietic stem cell transplantation Olle Ringdén, 1 Steven Z. Pavletic, 2 Claudio Anasetti,
More informationALLOGENEIC STEM CELL TRANSPLANTATION FOR ACUTE MYELOBLASTIC LEUKEMIAS
ALLOGENEIC STEM CELL TRANSPLANTATION FOR ACUTE MYELOBLASTIC LEUKEMIAS Didier Blaise, MD Transplant and Cellular Therapy Unit (U2T) Department of Hematology Centre de Recherche en Cancérologie, Inserm U891
More informationStem cell transplantation. Dr Mohammed Karodia NHLS & UP
Stem cell transplantation Dr Mohammed Karodia NHLS & UP The use of haemopoeitic stem cells from a donor harvested from peripheral blood or bone marrow, to repopulate recipient bone marrow. Allogeneic From
More information