| Vol. 8, No. 1: January/February 2008 |
Read the ASH Special Edition of Advances in Transplantation (PDF).
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ASBMT evidence-based review: Allo-HCT in adults with AML
A systematic evidence-based review by the American Society for Blood and Marrow Transplantation (ASBMT) of hematopoietic cell transplantation in adults (≥15 years) with acute myeloid leukemia (AML). The report includes a summary of treatment recommendations unanimously agreed upon by an ASBMT panel of experts. Treatment therapies are compared, including transplant vs. chemotherapy, autologous vs. allogeneic transplantation, and myeloablative vs. non-myeloablative conditioning regimens in allogeneic transplantation. The ASBMT panel also identified several areas of high-priority research to pursue.
Oliansky DM, et al. Biol Blood Marrow Transplant 2008; 14(2): 137-180. (More)
Related article: Summation of ASBMT review. (More)
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Reduced-intensity transplantation superior to non-transplant therapy in relapsed Hodgkin's lymphoma
A study of 72 relapsed Hodgkin's lymphoma patients comparing reduced-intensity transplantation with conventional non-transplant therapy. All 72 patients who relapsed after autologous transplant underwent salvage with chemotherapy and/or radiotherapy. Thirty-eight of these patients underwent reduced-intensity allogeneic transplantation and a group of historical controls (n=34) received continued salvage therapy. Ten-year overall survival was superior in the transplanted patients compared to controls (48% vs. 15%, respectively; p=0.0014).
Thomson KJ, et al. Bone Marrow Transplant 2008; E pub ahead of print, Jan. 14. (More)
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Cord blood suitable for patients >55 years without matched related donors
Reduced-intensity cord blood transplantation can be an appropriate treatment for patients older than 55 years with AML, MDS, or other hematological diseases. The study compared outcomes of 43 reduced-intensity unrelated donor umbilical cord blood transplants with 47 transplants using matched related adult donors (marrow or PBSC). Three-year overall survival was comparable in the cord blood and adult donor groups (34% vs. 43%, respectively; p=0.57). However, the incidence of chronic GVHD was significantly lower among the cord blood recipients compared to the adult donor recipients (17% vs. 40%, respectively; p=0.02).
Majhail N, et al. Biol Blood Marrow Transplant 2008; 14(3): 282-289. (More)
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High response to DLI after transplant for indolent NHL
Donor lymphocyte infusions (DLI) are an effective treatment for progressive lymphoid disease after allogeneic transplantation. That conclusion is based on a study of 28 patients with indolent (n=23) or transformed (n=5) non-Hodgkin lymphoma previously treated with allogeneic transplantation who received 68 donor lymphocyte infusions. No patients died from GVHD. DLI to treat progressive disease and persistent mixed chimerism achieved cumulative response rates of 76.5% and 91.6%, respectively. The authors conclude that there is a clinically significant graft-versus-tumor effect in indolent non-Hodgkin lymphoma.
Bloor AJC, et al. Biol Blood Marrow Transplant 2008; 14(1): 50-58. (More)
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HCT for multiple myeloma in the era of novel drugs
A review focusing on the role of autologous and allogeneic hematopoietic cell transplantation in the treatment of multiple myeloma in an era of novel drugs. These myeloma drugs have achieved higher rates of complete response and prolonged progression-free and overall survival than previous myeloma drugs. The author addresses the question of whether achievement of a complete response obviates the need for front-line transplantation altogether.
Bensinger W. J Clin Oncol 2008; 26(3): 480-492. (More)
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Pediatric blood and marrow transplantation: State of the Science
The entire January (2) issue of Bone Marrow Transplantation is devoted to a "State of the Science" of pediatric hematopoietic cell transplantation. Four manuscripts cover childhood non-malignant diseases, including metabolic/storage diseases, sickle cell anemia, primary immune deficiency, and aplastic and Fanconi anemia. Five manuscripts cover childhood malignant conditions , including acute lymphoblastic leukemia, acute and chronic myeloid leukemias, lymphomas, neuroblastoma and tumors of the central nervous system. Also covered are conditioning regimens, immunotherapy, unrelated donor transplantation, acute GVHD, and growth and development.
Cairo MS, Heslop H, guest editors. Bone Marrow Transplant 2008; 41(2). (More) |
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Review: HCT using adult unrelated donors as treatment for AML
A review of unrelated donor transplantation to treat acute myeloid leukemia (AML) and a discussion of the advances that have improved overall survival, such as high-resolution DNA methods for donor and recipient HLA matching. Topics covered include indications for unrelated donor transplants in AML, donor selection strategies, factors influencing outcome, unrelated donor transplantation vs. other transplant and non-transplant options, and unrelated donor transplantation using reduced intensity conditioning.
Sierra J, et al. Bone Marrow Transplant 2008; E pub ahead of print, Jan. 21. (More)
Related article: Cord blood transplantation in adult AML. (More) |
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Review: NMDP guidelines on HLA matching, outcome of unrelated cord blood transplants
An NMDP-sponsored review of the current and relevant data concerning the importance of HLA matching in umbilical cord blood transplantation. The article provides guidance for cord blood unit selection, and identifies the information needed to refine the minimum and optimal matching guidelines. The review also outlines the NMDP's current recommendations for tissue typing and matching of cord blood units for transplantation based on current medical knowledge.
Kamani N, et al. Biol Blood Marrow Transplant 2008; 14(1): 1-6. (More) |
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Other journal articles of note:
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Advances in Transplantation is an electronic newsletter published six times a year by the Medical Education Team of the National Marrow Donor Program (NMDP).
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Slides available: Transplant State of the Science
View slides from the NMDP-sponsored symposium reporting on the 2007 State of the Science Symposium. This NMDP symposium was held prior to the annual meeting of the American Society of Hematology.
View slides |
New Guidelines for Transplant Consultation and Post-Transplant Care
Developed by the NMDP in consultation with several leading transplant organizations, these new guidelines contain:
- NMDP/ASBMT referral guidelines
- Post-transplant screening and preventive practices
- Screening for chronic GVHD, including photo atlas
Order online |
Online CME: Applying New Data to Transplant Referral and Decision-Making
An online CME program from the NMDP focusing on the factors that have led to improved outcomes for unrelated donor transplantation, and how they affect clinical decision-making.
Online CME | |
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