| Vol. 6, No. 2: March/April 2006 |
NIH Report: Therapy and supportive care of chronic GVHD
Report of an NIH working group establishing guidelines for ancillary therapy and supportive care in chronic GVHD. The report outlines recommended treatments for symptoms and gives recommendations for patient education, preventive measures, and appropriate follow-up. The report also outlines areas with the greatest need for clinical research.
Couriel DR, et al. Biol Blood Marrow Transplant 2006; 12(4): 375-396. (More)
|
 |
Mismatched related and unrelated HCT for severe aplastic anemia
A study of 318 patients with severe aplastic anemia (SAA) who received allotransplants from one-antigen mismatched related donors (n=66), one or more antigen mismatched related donors (n=20), matched unrelated donors (n=181), and mismatched unrelated donors (n=51). Five-year overall survival was 49, 30, 39, and 36%, respectively. Poor performance score and older age adversely affected outcomes and the researchers conclude that early referral for transplantation is best for SAA patients who fail immunosuppressive therapy and have a suitable alternative donor.
Passweg JR, et al. Bone Marrow Transplant 2006; 37(7): 641-649. (More)
|
|
HLA-C mismatch leads to lower survival in unrelated non-myeloablative HCT
A retrospective analysis on the effect of HLA-C mismatch in 111 patients who underwent unrelated donor non-myeloablative transplantation. Seventy-eight patients were 10/10 matched (HLA-A, B, C, DRB1, DQB1) and 33 patients were mismatched at one or more antigens/alleles at the HLA-C locus. HLA-C mismatch had no effect on engraftment, however two-year overall survival was 30% in patients mismatched at HLA-C and 51% in patients receiving 10/10-matched grafts (p=0.008).
Ho VT, et al. Bone Marrow Transplant 2006; 37(9): 845-850. (More) |
|
Autologous HCT vs. matched unrelated donor HCT for AML
A study of 668 autologous and 476 unrelated donor transplants in patients with AML in 1st or 2nd complete remission (CR) reported to the CIBMTR. Transplant-related mortality (TRM) was significantly higher after unrelated donor transplantation, although relapse was lower. In patients transplanted in 1st CR, three-year survival was 57% (autologous patients) and 44% (unrelated donor) (p=0.002). In patients transplanted in 2nd CR, three-year survival was 46% (autologous) and 33% (unrelated donor) (p=0.006). The authors conclude that although autologous and unrelated donor transplantation can each produce extended leukemia-free survival, the high TRM in unrelated donor transplantation offsets its superior anti-leukemia effect.
Lazarus HM, et al. Br J Haematol 2006; 132(6): 755-769. (More) |
|
Effectiveness of DLI in relapsed patients
A single-center retrospective analysis of 83 consecutive recipients of donor lymphocyte infusions (DLI) who relapsed after allogeneic transplantation. Patients were eligible to receive DLI if they had evidence of donor chimerism and were not receiving treatment for GVHD. Twelve of 17 (71%) relapsed chronic phase CML patients achieved durable complete remissions (CR). Four of 13 (31%) of relapsed AML patients achieved durable CR. The CR rate in all other relapsed diseases was 9%. The researchers conclude that DLI has the potential to induce remissions in relapsed transplant patients, and the efficacy seems highest in certain CML patients and those with >50% donor chimerism at the time of DLI.
Huff CA, et al. Biol Blood Marrow Transplant 2006; 12(4): 414-421. (More) |
|
Rituximab for steroid-refractory chronic GVHD
A phase I-II study of anti-B cell therapy with rituximab in 21 transplanted patients with steroid-refractory chronic GVHD. Patients received a four-week cycle of rituximab therapy (375 mg/m2 per week), and non-responders were eligible for a second cycle eight weeks after the initial therapy. Overall, 21 patients received 38 cycles of rituximab. Toxicity was limited to infectious events and partial clinical responses were seen in 70% of patients; two patients had complete responses.
Cutler C, et al. Blood 2006; E pub ahead of print, March 21. (More) |
|
Extracorporeal photochemotherapy in the treatment of chronic GVHD
A retrospective evaluation of 71 patients with severe chronic GVHD treated with extracorporeal photochemotherapy (ECP). Overall response rate was 61% (n=43), and 14 patients had complete responses. The cumulative incidence of steroid discontinuation at one year was 22%. Overall survival since initiation of ECP was 53% at one year. Response to ECP and platelet count at start of therapy were the strongest predictors of non-relapse mortality.
Couriel DR, et al. Blood 2006; 107(8): 3074-3080. (More) |
|
Reduced-intensity transplantation in refractory AML
A study of 103 refractory AML patients receiving chemotherapy, reduced-intensity allogeneic HCT, and prophylactic donor lymphocyte infusion (pDLI). The sources of grafts were related donors (n=41) and unrelated donors (n=62). Seventeen of 73 (23%) patients without GVHD at day 120 received pDLI in escalating doses and 7 of these 17 patients (41%) subsequently developed GVHD. With a median follow-up of 25 months, overall survival at two years was 40% and leukemia-free survival was 37%. Three-year overall survival was 88% in the 17 patients who received pDLI.
Schmid C, et al. Blood 2006; E-pub ahead of print, March 21. (More) |
|
Other journal articles of note:
|
|
Advances in Transplantation is an electronic newsletter published six times a year by the Medical Education Team of the National Marrow Donor Program (NMDP).
This newsletter is sent only to those
individuals who have requested it.
To unsubscribe or change your subscription options,
see link at the bottom of this newsletter.
E-mail your comments or suggestions | |
|
This e-mail newsletter supported by an unrestricted educational grant from PDL BioPharma, Inc.
 | |
NMDP to host CME audioconference on pediatric AML
"Pediatric acute myeloid leukemia: Advances, evidence, and the future."
Wednesday, May 17, 2006, 11:30 a.m. Central Daylight Time
Presenter: Frank Smith, M.D.
Program will be available online and on CD-ROM following the audioconference. Online registration |
Online CME program on pediatric ALL
A CME program from the NMDP on advances in the management of high-risk pediatric ALL patients is now available online or on CD-ROM. More |
Transplantation for the older patient
This CME publication, Blood and Marrow Transplantation Reviews, summarizes presentations from the NMDP-sponsored symposium prior to the ASH annual meeting. Order reprints |
DVD available for transplant patients over 50
Order your free copy of the NMDP DVD and workbook, Transplant as an Option When You are 50 and Older, which can assist patients 50 and older to learn more about the transplant process and how it relates to them. Order DVD | |
| THANK YOU FOR SIGNING UP! |
Thank you for subscribing to Advances in Transplantation.
To unsubscribe or change your subscription options, see link at the bottom of this newsletter. | | |
