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Cesaro S, Donadieu J, Cipolli M, Dalle JH, Styczynski J, Masetti R, Strahm B, Mauro M, Alseraihy A, Aljurf M, Dufour C, de la Tour RP. Stem Cell Transplantation in Patients Affected by Shwachman-Diamond Syndrome: Expert Consensus and Recommendations From the EBMT Severe Aplastic Anaemia Working Party. Transplant Cell Ther 2022; 28:637-649. [PMID: 35870777 DOI: 10.1016/j.jtct.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/18/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
Shwachman-Diamond syndrome is a rare disorder that can develop malignant and nonmalignant hematological complications. Overall, 10% to 20% of Shwachman-Diamond patients need hematopoietic stem cell transplantation (HSCT), but most centers have a limited experience and different approaches. The European Society for Blood and Marrow Transplantation-Severe Aplastic Anaemia Working Party promoted an expert consensus to propose recommendations regarding key issues in the management of Shwachman-Diamond patients with hematological complications. The main items identified as relevant for improving survival were: the importance of regular and structured hematologic follow-up, the potential reduction of transplant-related mortality by using reduced-intensity conditioning regimens, the limitation of total body irradiation, particularly for non-malignant severe cytopenia/bone marrow failure, the early diagnosis of clonal malignant evolution and early recognition of an indication for HSCT. Finally, the poor results of HSCT in patients with acute myeloid leukemia, irrespective of cytoreductive chemotherapy treatment received prior to transplantation, highlights the need for innovative approaches. © 2023 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
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Affiliation(s)
- Simone Cesaro
- Paediatric Haematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Jean Donadieu
- Department of Paediatric Haematology and Oncology, Registre National des Neutropénies Chroniques, AP-HP Trousseau Hospital, Paris, France
| | - Marco Cipolli
- Cystic Fibrosis and Shwachman Diamond Regional Centre, Italian Registry of Shwachman Diamond Disease, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Jean Hugues Dalle
- Department of Paediatric Haematology, Robert Debré Hospital, GHU APHP Nord Université de Paris, France
| | - Jan Styczynski
- Department of Paediatric Haematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Jurasz University Hospital, Bydgoszcz, Poland
| | - Riccardo Masetti
- Paediatric Oncology and Haematology "Lalla Seràgnoli," Paediatric Unit-IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Brigitte Strahm
- Department of Paediatrics and Adolescent Medicine, Division of Paediatric Haematology and Oncology, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Margherita Mauro
- Paediatric Haematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Amal Alseraihy
- Department of Oncology, King Faisal Specialist Hospital & Research Centre, Jeddah, Saudi Arabia
| | - Mahmoud Aljurf
- Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Carlo Dufour
- Haematology Unit, IRCCS G. Gaslini Children's Hospital, Genoa, Italy
| | - Regis Peffault de la Tour
- French Reference Centre for Aplastic Anaemia and Paroxysmal Nocturnal Haemoglobinuria, Bone Marrow Transplantation Unit, APHP, Saint-Louis Hospital, Paris University, Paris, France
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Tan LQ, Fu XY, Xie XT. [Clinical features, diagnosis, and treatment of Chinese children with Shwachman-Diamond syndrome]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:505-511. [PMID: 32434649 PMCID: PMC7389390 DOI: 10.7499/j.issn.1008-8830.1911111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/19/2020] [Indexed: 06/11/2023]
Abstract
In order to clearly define the features of Shwachman-Diamond syndrome (SDS) in Chinese children, this article analyzes and summarizes the epidemiology, clinical features, and key points in the diagnosis and treatment of SDS in Chinese children with review of the clinical data of 27 children with SDS from related articles published previously. A comparative analysis was made between the Chinese and international data related to childhood SDS. The results showed a male/female ratio of about 2:1 in the Chinese children with SDS, with an age of onset of <1 month to 5 years (median 1 month) and an age of 3 months to 12 years (median 12 months) at the time of confirmed diagnosis. Reductions in peripheral blood cells due to myelopoiesis inhibition were observed in all 27 children with SDS, among whom 93% had neutropenia. Chronic diarrhea (85%), liver damage (78%), and short stature (83%) were the three main clinical features of SDS. Supplementation of pancreatin and component blood transfusion may temporarily alleviate the disease, while allogeneic hematopoietic stem cell transplantation is still an effective radical treatment. The comparative analysis of the Chinese and oversea data showed that compared with those in the European and American countries, the children with SDS in China had significantly higher incidence rates of chronic diarrhea, reductions in peripheral blood cells (three lineages), and liver damage, and there were also differences in the type of mutant genes.
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Affiliation(s)
- Li-Qun Tan
- Department of Pediatrics, Luodian Hospital, Baoshan District, Shanghai 201908, China.
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Long-term outcome after allogeneic hematopoietic stem cell transplantation for Shwachman-Diamond syndrome: a retrospective analysis and a review of the literature by the Severe Aplastic Anemia Working Party of the European Society for Blood and Marrow Transplantation (SAAWP-EBMT). Bone Marrow Transplant 2020; 55:1796-1809. [PMID: 32203264 DOI: 10.1038/s41409-020-0863-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/02/2020] [Accepted: 03/04/2020] [Indexed: 01/01/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative procedure in patients with Shwachman-Diamond syndrome (SDS) with bone marrow abnormalities. The results of 74 patients with SDS (6 acute myeloid leukemia, 7 myelodysplastic syndrome, and 61 bone marrow failure) treated with HSCT between 1988 and 2016 are reported. The donor source was: 24% sibling, 8% parent, and 68% unrelated donor. The stem cell source was: 70% bone marrow, 19% peripheral blood stem cells, and 11% cord blood. The conditioning regimen was myeloablative in 54% and reduced intensity in 46%. Neutrophil engraftment was achieved in 84% of patients after a median time of 17.5 days. Graft failure occurred in 15% of HSCTs. Grades I-IV acute and chronic GVHD were observed in 55% and 20% of patients, respectively. After a median follow-up of 7.3 years (95% CI 4.8-10.2), 28 patients died for progression/relapse (7) or toxicity (21). The 5-year overall survival and nonrelapse mortality were 63.3% (95% CI 50.8-73.4) and 19.8% (95% CI 10.8-30.8), respectively. In conclusion, this is the largest series so far reported and confirms that HSCT is a suitable option for patients with SDS. Further efforts are needed to lower transplant-related toxicity and reduce graft failure.
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Shimosato Y, Tanoshima R, Tsujimoto SI, Takeuchi M, Sasaki K, Kajiwara R, Goto H, Nagai J, Yanagimachi MD, Ito S, Yokota S. Association of isochromosome (7)(q10) in Shwachman-Diamond syndrome with the severity of cytopenia. Clin Case Rep 2017; 6:125-128. [PMID: 29375851 PMCID: PMC5771925 DOI: 10.1002/ccr3.1249] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 03/06/2017] [Accepted: 09/26/2017] [Indexed: 11/06/2022] Open
Abstract
We report two male siblings with SDS. They have the same compound heterozygous mutations. Only one of the siblings acquired cytogenetic abnormality of i(7q) 2 years after diagnosis, became transfusion-dependent, and underwent allogeneic hematopoietic stem cell transplantation. These cases indicate that i(7q) is associated with significant cytopenia in SDS patients.
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Affiliation(s)
- Yuko Shimosato
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Reo Tanoshima
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Shin-Ichi Tsujimoto
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Masanobu Takeuchi
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Koji Sasaki
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Ryosuke Kajiwara
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Hiroaki Goto
- Kanagawa Children's Medical Center Yokohama Japan
| | | | | | - Shuichi Ito
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Shumpei Yokota
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
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