Vol. 9, No. 4: July/August 2009
Your opinion matters to us.
Please take our brief online survey to enhance future issues of our Advances in Transplantation e-newsletter. (Please disregard if you've already taken this survey.) |
Comparable HCT outcomes using partially matched related, unrelated donors
A study of 297 consecutive patients with hematologic malignancies who underwent T-cell replete hematopoietic cell transplantation (HCT) from partially matched related (n=219) or unrelated donors (n=78) at the Peking University People's Hospital. Of the 219 partially matched related donors, 116 were mother/father, 80 siblings, and 23 other relation. The incidence of grade II-IV acute GVHD was significantly higher in the partially matched related group than in the unrelated group: 47% vs. 31%, respectively (p=0.033). Four-year overall survival was the same (74%) in both cohorts. There were no significant differences in relapse, non-relapse mortality, and leukemia-free survival between the two groups.
Xiao-Jun H, et al. Clin Cancer Res 2009; 15(4): 4777-4783. (More)
|
 |
Higher CD34+ cell dose leads to better survival, no increase in GVHD
A report on 932 recipients of peripheral blood stem cell transplants between 1999-2003 using unrelated donors from the National Marrow Donor Program. For myeloablative transplant recipients, CD34+ counts >3.8 x 106/kg led to improved neutrophil and platelet engraftment. For all preparative regimens, CD34+ cell doses >4.5 x 106/kg improved overall survival (OS) and reduced transplant-related mortality. Higher infused doses of CD34+ cell dose did not result in increased rates of either acute or chronic GVHD. Three-year OS was significantly better with higher CD34+ cell doses than with lower cell doses: 39% vs. 25%, respectively, in myeloablative transplants (p=0.004), and 38% vs. 21%, respectively, in transplants using reduced-intensity or non-myeloablative conditioning (p=0.004).
Pulsipher MA, et al. Blood 2009; E-pub ahead of print, July 16. (More)
|
| |
HCT in patients with low left ventricular ejection fraction
Due to possible cardiac complications, patients with low left ventricular ejection fraction (LVEF) are typically excluded from hematopoietic cell transplantation (HCT). A new study shows no significant difference in transplant outcomes between 56 patients with LVEF ≤45% and 161 matched controls with LVEF ≥50%. 100-day non-relapse mortality was comparable between the low-LVEF group and the control group (12.5% and 14.9%, respectively), and no deaths were directly attributable to cardiac causes in either group.
Qazilbash MH, et al. Biol Blood Marrow Transplant 2009; E-pub ahead of print, August 3. (More)
|
| |
Allogeneic, not autologous, transplants best for ALL
Allogeneic hematopoietic cell transplantation (HCT) in acute lymphoblastic leukemia (ALL) leads to better outcomes than autologous transplantation, according to a study of 623 myeloablative transplants in adults and children with ALL between 1980-2005. Five-year overall survival (OS) was lowest in autologous transplants (17%) and mismatched unrelated donor transplants (28%). OS was higher and comparable (34% to 49%), among recipients of all other graft sources: related, matched unrelated and partially matched unrelated donors, and cord blood. The authors conclude that patients with ALL lacking a sibling donor can seek cord blood or a well-matched unrelated donor and have a good chance at long-term leukemia-free survival.
Tomblyn MB, et al. J Clin Oncol 2009; 27(22): 3634-3641. (More)
|
| |
Reduced-intensity transplants yield comparable survival in older AML patients
According to a study of transplants reported to the European Group for Blood and Marrow Transplantation (EBMT) registry, reduced-intensity conditioning (RIC) is suitable for patients with acute myelogenous leukemia (AML) patients aged 50 and older. The 401 RIC transplants were compared to 1,154 transplants using myeloablative conditioning between 1999-2005. In patients ≥50 years of age in the RIC group, non-relapse mortality was significantly lower (HR: 0.64; p=0.04) and leukemia-free survival was comparable (HR: 1.04; p=0.79) compared with patients in the myeloablative group.
Ringdén O, et al. J Clin Oncol 2009; E-pub ahead of print, August 3. (More)
|
| |
Review: HCT for pediatric autoimmune disease
Hematopoietic cell transplantation (HCT) can successfully treat autoimmune diseases, a proof of principle shown by case reports of patients with hematological diseases and concomitant autoimmune diseases undergoing transplant and achieving long-term, durable remissions of both conditions. The authors review the current data on allogeneic HCT in treating pediatric autoimmune diseases and propose that prospective clinical trials be initiated using HCT as upfront therapy for pediatric patients with severe autoimmune diseases.
Krauss AC, et al. Bone Marrow Transplant 2009; 44(3): 137-143. (More)
|
| |
Review: HCT for chronic lymphocytic leukemia
A review of transplant outcomes in patients with chronic lymphocytic leukemia (CLL). Topics discussed include the European Group for Blood and Marrow Transplantation (EBMT) criteria for HCT in CLL, use of conventional vs. reduced-intensity conditioning regimens, prognostic factors, transplant timing considerations, and post-transplant complications particularly common in CLL patients.
Delgado J, et al. Blood 2009; E-pub ahead of print July 29. (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 | |
|
Supported by an unrestricted educational grant from Otsuka America Pharmaceutical, Inc., provided to the National Marrow Donor Program through the Be The Match FoundationSM, the funding partner of the NMDP.
 | |
New CME programs on HCT
The NMDP is offering three new CME programs on:
- Comparing related, unrelated outcomes
- Factors that influence outcomes, graft choices
- Advances in HLA matching
Learn more
|
Save the Date: NMDP Symposium at ASH
Plan to attend the NMDP symposium prior to the ASH annual meeting: Navigating the Therapeutic Pathways for AML and MDS.
December 4, 7:00-11:00 a.m.
New Orleans Convention Center Learn more
| |
| 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. | | |
