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Civallero M, Schroers-Martin JG, Horwitz S, Manni M, Stepanishyna Y, Cabrera ME, Vose J, Spina M, Hitz F, Nagler A, Montoto S, Chiattone C, Skrypets T, Perez Saenz MA, Priolo G, Luminari S, Lymboussaki A, Pavlovsky A, Marino D, Liberati M, Trotman J, Mannina D, Federico M, Advani R. Long-term outcome of peripheral T-cell lymphomas: Ten-year follow-up of the International Prospective T-cell Project. Br J Haematol 2024. [PMID: 38532575 DOI: 10.1111/bjh.19433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/27/2024] [Accepted: 03/16/2024] [Indexed: 03/28/2024]
Abstract
Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of haematological cancers with generally poor clinical outcomes. However, a subset of patients experience durable disease control, and little is known regarding long-term outcomes. The International T-cell Lymphoma Project (ITCLP) is the largest prospectively collected cohort of patients with PTCLs, providing insight into clinical outcomes at academic medical centres globally. We performed a long-term outcome analysis on patients from the ITCLP with available 10-year follow-up data (n = 735). The overall response rate to first-line therapy was 68%, while 5- and 10-year overall survival estimates were 49% and 40% respectively. Most deaths occurred prior to 5 years, and for patients alive at 5 years, the chance of surviving to 10 years was 84%. However, lymphoma remained the leading cause of death in the 5- to 10-year period (67%). Low-risk International Prognostic Index and Prognostic Index for T-cell lymphoma scores both identified patients with improved survival, while in multivariate analysis, age >60 years and Eastern Cooperative Oncology Group performance status 2-4 were associated with inferior outcomes. The favourable survival seen in patients achieving durable initial disease control emphasizes the unmet need for optimal front-line therapeutic approaches in PTCLs.
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Affiliation(s)
- M Civallero
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | - J G Schroers-Martin
- Division of Oncology, Department of Medicine, Stanford University, Stanford, California, USA
| | - S Horwitz
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - M Manni
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Y Stepanishyna
- Department of Bone Marrow Transplant, National Cancer Institute, Kyiv, Ukraine
| | - M E Cabrera
- Sección Hematología, Hospital del Salvador, Universidad de Chile, Santiago, Chile
| | - J Vose
- Division of Hematology/Oncology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - M Spina
- Division of Medical Oncology and Immune-Related Tumors, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - F Hitz
- Department of Oncology/Haematology, The Swiss Group for Clinical Cancer Research, Cantonal Hospital, St Gallen, Switzerland
| | - A Nagler
- Department of Bone Marrow Transplantation, Tel-Aviv University, Tel-Aviv, Israel
| | - S Montoto
- Department of Haemato-Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - C Chiattone
- Higienopolis and Santa Casa Medical School of Sao Paulo, Samaritano Hospital, São Paulo, Brazil
| | - T Skrypets
- Hematology and Cell Therapy Department, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - M A Perez Saenz
- Department of Hematology, Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
| | - G Priolo
- Hematology 2, San Giovanni Battista Hospital and University, Turin, Italy
| | - S Luminari
- Hematology Unit, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - A Lymboussaki
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | - A Pavlovsky
- Fundación para Combatir la Leucemia (FUNDALEU), Centro de Hematología Pavlovsky, Buenos Aires, Argentina
| | - D Marino
- Department of Oncology, Oncology 1 Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - M Liberati
- A.O. Santa Maria, S.C. di Oncoematologia di Terni, Università Degli Studi di Perugia, Perugia, Italy
| | - J Trotman
- Concord Repatriation General Hospital, University of Sydney, Concord, New South Wales, Australia
| | - D Mannina
- Hematology Unit, AO Papardo, Messina, Italy
| | - M Federico
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | - R Advani
- Division of Oncology, Department of Medicine, Stanford University, Stanford, California, USA
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2
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Hayden PJ, Roddie C, Bader P, Basak GW, Bonig H, Bonini C, Chabannon C, Ciceri F, Corbacioglu S, Ellard R, Sanchez-Guijo F, Jäger U, Hildebrandt M, Hudecek M, Kersten MJ, Köhl U, Kuball J, Mielke S, Mohty M, Murray J, Nagler A, Rees J, Rioufol C, Saccardi R, Snowden JA, Styczynski J, Subklewe M, Thieblemont C, Topp M, Ispizua ÁU, Chen D, Vrhovac R, Gribben JG, Kröger N, Einsele H, Yakoub-Agha I. Management of adults and children receiving CAR T-cell therapy: 2021 best practice recommendations of the European Society for Blood and Marrow Transplantation (EBMT) and the Joint Accreditation Committee of ISCT and EBMT (JACIE) and the European Haematology Association (EHA). Ann Oncol 2022; 33:259-275. [PMID: 34923107 DOI: 10.1016/j.annonc.2021.12.003] [Citation(s) in RCA: 130] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/06/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Several commercial and academic autologous chimeric antigen receptor T-cell (CAR-T) products targeting CD19 have been approved in Europe for relapsed/refractory B-cell acute lymphoblastic leukemia, high-grade B-cell lymphoma and mantle cell lymphoma. Products for other diseases such as multiple myeloma and follicular lymphoma are likely to be approved by the European Medicines Agency in the near future. DESIGN The European Society for Blood and Marrow Transplantation (EBMT)-Joint Accreditation Committee of ISCT and EBMT (JACIE) and the European Haematology Association collaborated to draft best practice recommendations based on the current literature to support health care professionals in delivering consistent, high-quality care in this rapidly moving field. RESULTS Thirty-six CAR-T experts (medical, nursing, pharmacy/laboratory) assembled to draft recommendations to cover all aspects of CAR-T patient care and supply chain management, from patient selection to long-term follow-up, post-authorisation safety surveillance and regulatory issues. CONCLUSIONS We provide practical, clinically relevant recommendations on the use of these high-cost, logistically complex therapies for haematologists/oncologists, nurses and other stakeholders including pharmacists and health sector administrators involved in the delivery of CAR-T in the clinic.
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Affiliation(s)
- P J Hayden
- Department of Haematology, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
| | - C Roddie
- UCL Cancer Institute, London, UK; University College London Hospital NHS Foundation Trust, London, UK.
| | - P Bader
- Clinic for Children and Adolescents, University Children's Hospital, Frankfurt, Germany
| | - G W Basak
- Medical University of Warsaw, Department of Hematology, Transplantation and Internal Medicine, Warsaw, Poland
| | - H Bonig
- Institute for Transfusion Medicine and Immunohematology of Goethe University and German Red Cross Blood Service, Frankfurt, Germany
| | - C Bonini
- Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milan, Italy
| | - C Chabannon
- Aix-Marseille université, Inserm CBT-1409, Institut Paoli-Calmettes, centre de thérapie cellulaire, unité de transplantation et de thérapie cellulaire, département de biologie du cancer, Marseille, France
| | - F Ciceri
- Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy
| | - S Corbacioglu
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Franz-Josef-Strauss-Allee 11, University Hospital of Regensburg, Regensburg, Germany
| | - R Ellard
- Royal Marsden Hospital, Fulham Rd, London, UK
| | - F Sanchez-Guijo
- IBSAL-Hospital Universitario de Salamanca, CIC, Universidad de Salamanca, Salamanca, Spain
| | - U Jäger
- Clinical Department for Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - M Hildebrandt
- Department of Transfusion Medicine, Cell Therapeutics and Haemostaseology, LMU University Hospital Grosshadern, Munich
| | - M Hudecek
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany
| | - M J Kersten
- Department of Hematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam and LYMMCARE, Amsterdam, the Netherlands
| | - U Köhl
- Fraunhofer Institute for Cell Therapy and Immunology (IZI) and Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany; Institute of Cellular Therapeutics, Hannover Medical School, Hannover, Germany
| | - J Kuball
- Department of Hematology and Centre for Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - S Mielke
- Karolinska Institutet and University Hospital, Department of Laboratory Medicine/Department of Cell Therapy and Allogeneic Stem Cell Transplantation (CAST), Stockholm, Sweden
| | - M Mohty
- Hôpital Saint-Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - J Murray
- Christie Hospital NHS Trust, Manchester, UK
| | - A Nagler
- The Chaim Sheba Medical Center, Tel-Hashomer, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - J Rees
- University College London Hospital NHS Foundation Trust, London, UK; UCL Institute of Neurology, University College of London Hospitals NHS Foundation Trust, London, UK
| | - C Rioufol
- Hospices Civils de Lyon, UCBL1, EMR 3738 CICLY, Lyon, France
| | - R Saccardi
- Cell Therapy and Transfusion Medicine Department, Careggi University Hospital, Florence, Italy
| | - J A Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - J Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - M Subklewe
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Thieblemont
- AP-HP, Saint-Louis Hospital, Hemato-oncology, University of Paris, Paris, France
| | - M Topp
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Á U Ispizua
- Department of Hematology, ICMHO, Hospital Clínic de Barcelona, Barcelona, Spain
| | - D Chen
- University College London Hospital NHS Foundation Trust, London, UK; Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - R Vrhovac
- Department of Haematology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - J G Gribben
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - N Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg, Germany
| | - H Einsele
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany
| | - I Yakoub-Agha
- CHU de Lille, Univ Lille, INSERM U1286, Infinite, Lille, France
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Greenfield DM, Salooja N, Peczynski C, van der Werf S, Schoemans H, Hill K, Cortelezzi A, Lupo-Stangellini M, Özkurt ZN, Arat M, Metzner B, Turlure P, Rovo A, Socié G, Mohty M, Nagler A, Kröger N, Dreger P, Labopin M, Han TS, Tichelli A, Duarte R, Basak G, Snowden JA. Metabolic syndrome and cardiovascular disease after haematopoietic cell transplantation (HCT) in adults: an EBMT cross-sectional non-interventional study. Bone Marrow Transplant 2021; 56:2820-2825. [PMID: 34274955 PMCID: PMC8563418 DOI: 10.1038/s41409-021-01414-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/28/2021] [Accepted: 07/07/2021] [Indexed: 12/03/2022]
Abstract
Metabolic syndrome (MetS) is associated with cardiovascular disease in the general population and is also a potential cardiovascular risk factor in survivors of haematopoietic cell transplantation (HCT). We report an EBMT cross-sectional, multi-centre, non-interventional study of 453 adult HCT patients surviving a minimum of 2 years post-transplant attending routine follow-up HCT and/or late effects clinics in 9 centres. The overall prevalence of MetS was 37.5% rising to 53% in patients >50 years of age at follow-up. There were no differences in rates of MetS between autologous and allogeneic HCT survivors, nor any association with graft-versus-host disease (GvHD) or current immunosuppressant therapy. Notably, there was a significantly higher occurrence of cardiovascular events (CVE, defined as cerebrovascular accident, coronary heart disease or peripheral vascular disease) in those with MetS than in those without MetS (26.7% versus 9%, p < 0.001, OR 3.69, 95% CI 2.09-6.54, p < 0.001), and, as expected, MetS and CVE were age-related. Unexpectedly, CVE were associated with occurrence of second malignancy. Screening for and management of MetS should be integrated within routine HCT long-term follow-up care for both allogeneic and autologous HCT survivors. Further research is warranted, including randomised controlled trials of interventional strategies and mechanistic studies of cardiovascular risk in HCT survivors.
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Affiliation(s)
- D M Greenfield
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
| | | | | | | | - H Schoemans
- Department of Hematology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - K Hill
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Cortelezzi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Z N Özkurt
- Gazi University Hospital, Ankara/Turkey, Ankara, Turkey
| | - M Arat
- Sisli Florence Nightingale Hospital, Istanbul, Turkey
| | - B Metzner
- Klinikum Oldenburg, Oldenburg, Germany
| | | | - A Rovo
- University Hospital Bern, Bern, Switzerland
| | - G Socié
- Hospital St. Louis, Paris, France
| | - M Mohty
- Saint-Antoine Hospital, Sorbonne University, INSERM UMRs 938, Paris, France
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - N Kröger
- University Hospital Eppendorf, Hamburg, Germany
| | - P Dreger
- University of Heidelberg, Heidelberg, Germany
| | - M Labopin
- EBMT Paris Study Office, Paris, France
| | - T S Han
- Institute of Cardiovascular Research, Royal Holloway, University of London, Egham, UK
| | | | - R Duarte
- Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - G Basak
- The Medical University of Warsaw, Warsaw, Poland
| | - J A Snowden
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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4
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Beider K, Besser MJ, Jacoby E, Schachter J, Voevoda‐Dimenshtein V, Rosenberg E, Ostrovsky O, Danylesko I, Shimoni A, Avigdor A, Nagler A. IN VITRO ANALYSIS PREDICTS CLINICAL RESPONSE OF B CELL LYMPHATIC MALIGNANCIES TO CD19 CAR‐T CELLS: PHENOTYPIC, TRANSCRIPTIONAL AND FUNCTIONAL STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.191_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- K. Beider
- Sheba Medical Center Hematology Division Ramat Gan Israel
| | - M. J. Besser
- Sheba Medical Center Ella Institute of Immuno‐Oncology Ramat Gan Israel
| | - E. Jacoby
- Sheba Medical Center Department of Pediatrics The Edmond and Lily Safra Children's Hospital Ramat Gan Israel
| | - J. Schachter
- Sheba Medical Center Ella Institute of Immuno‐Oncology Ramat Gan Israel
| | | | - E. Rosenberg
- Sheba Medical Center Hematology Division Ramat Gan Israel
| | - O. Ostrovsky
- Sheba Medical Center Hematology Division Ramat Gan Israel
| | - I. Danylesko
- Sheba Medical Center Hematology Division Ramat Gan Israel
| | - A. Shimoni
- Sheba Medical Center Hematology Division Ramat Gan Israel
| | - A. Avigdor
- Sheba Medical Center Hematology Division Ramat Gan Israel
| | - A. Nagler
- Sheba Medical Center Hematology Division Ramat Gan Israel
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5
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Loke J, Labopin M, Craddock C, Niederwieser D, Cornelissen J, Afansayev B, Jindra P, Maertens J, Blaise D, Boriskina K, Gramatzki M, Ganser A, Savani B, Mohty M, Nagler A. Impact of patient: donor HLA disparity on reduced-intensity-conditioned allogeneic stem cell transplants from HLA mismatched unrelated donors for AML: from the ALWP of the EBMT. Bone Marrow Transplant 2020; 56:614-621. [PMID: 33009514 DOI: 10.1038/s41409-020-01072-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/06/2020] [Accepted: 09/21/2020] [Indexed: 11/09/2022]
Abstract
Patients with acute myeloid leukaemia (AML) who lack a matched sibling or unrelated donor commonly undergo transplantation from a donor matched at 9/10 HLA-A, -B, -C, -DRB1, -DQB1 alleles, and it is unclear if a specific locus mismatch is preferable to any other. We therefore studied 937 patients with AML in complete remission transplanted using a reduced intensity conditioning regimen from an unrelated donor mismatched at a single allele. In a multivariate analysis, patient age, adverse karyotype and patient cytomegalovirus (CMV) seropositivity were correlated with decreased leukaemia free survival (LFS) and overall survival (OS). There was no significant difference in LFS or OS between patients transplanted from donors mismatched at HLA-A, -B, -C or -DRB1 in comparison to a HLA-DQB1 mismatched transplant. In a multivariate analysis, patients transplanted with a HLA-A mismatched donor had higher rates of acute graft-versus-host disease (GVHD) and non-relapse mortality (NRM) than patients transplanted with a HLA-DQB1 mismatched donor. Patient CMV seropositivity was associated with an increase in NRM and acute GVHD and reduced LFS and OS, regardless of donor CMV status. For CMV seropositive patients lacking a fully matched donor, alternative GVHD and CMV prophylaxis strategies should be considered.
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Affiliation(s)
- J Loke
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - M Labopin
- Paris EBMT Data Coordination Office, Hospital Saint-Antoine, APHP, Université Pierre et Marie Curie UPMC and INSERM U 938, Paris, France.,Department of Hematology and Cell Therapy, Hospital Saint-Antoine, Paris, France
| | - C Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK.
| | | | - J Cornelissen
- Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | - B Afansayev
- State Medical Pavlov University, St. Petersburg, Russia
| | - P Jindra
- Department of Haematology/Oncology, Charles University Hospital, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - J Maertens
- Department of Hematology, Acute Leukemia and Transplantation Unit, UZ Leuven, Herestraat 49, B-3000, Leuven, Belgium
| | - D Blaise
- Transplant and Cellular Therapy Unit, Institut Paoli Calmettes, Marseille, France
| | - K Boriskina
- Department of Hematology, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - M Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| | - A Ganser
- Department of Haematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Carl-Neuberg-Str.1, Hannover, Germany
| | - B Savani
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - M Mohty
- Paris EBMT Data Coordination Office, Hospital Saint-Antoine, APHP, Université Pierre et Marie Curie UPMC and INSERM U 938, Paris, France.,Department of Hematology and Cell Therapy, Hospital Saint-Antoine, Paris, France
| | - A Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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6
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Randazzo M, Priefer R, Smith PJ, Nagler A, Avery T, Froud K. Neural Correlates of Modality-Sensitive Deviance Detection in the Audiovisual Oddball Paradigm. Brain Sci 2020; 10:brainsci10060328. [PMID: 32481538 PMCID: PMC7348766 DOI: 10.3390/brainsci10060328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/15/2020] [Accepted: 05/25/2020] [Indexed: 11/16/2022] Open
Abstract
The McGurk effect, an incongruent pairing of visual /ga/–acoustic /ba/, creates a fusion illusion /da/ and is the cornerstone of research in audiovisual speech perception. Combination illusions occur given reversal of the input modalities—auditory /ga/-visual /ba/, and percept /bga/. A robust literature shows that fusion illusions in an oddball paradigm evoke a mismatch negativity (MMN) in the auditory cortex, in absence of changes to acoustic stimuli. We compared fusion and combination illusions in a passive oddball paradigm to further examine the influence of visual and auditory aspects of incongruent speech stimuli on the audiovisual MMN. Participants viewed videos under two audiovisual illusion conditions: fusion with visual aspect of the stimulus changing, and combination with auditory aspect of the stimulus changing, as well as two unimodal auditory- and visual-only conditions. Fusion and combination deviants exerted similar influence in generating congruency predictions with significant differences between standards and deviants in the N100 time window. Presence of the MMN in early and late time windows differentiated fusion from combination deviants. When the visual signal changes, a new percept is created, but when the visual is held constant and the auditory changes, the response is suppressed, evoking a later MMN. In alignment with models of predictive processing in audiovisual speech perception, we interpreted our results to indicate that visual information can both predict and suppress auditory speech perception.
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Affiliation(s)
- Melissa Randazzo
- Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY 11530, USA; (R.P.); (A.N.)
- Correspondence: ; Tel.: +1-516-877-4769
| | - Ryan Priefer
- Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY 11530, USA; (R.P.); (A.N.)
| | - Paul J. Smith
- Neuroscience and Education, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, USA; (P.J.S.); (T.A.); (K.F.)
| | - Amanda Nagler
- Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY 11530, USA; (R.P.); (A.N.)
| | - Trey Avery
- Neuroscience and Education, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, USA; (P.J.S.); (T.A.); (K.F.)
| | - Karen Froud
- Neuroscience and Education, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, USA; (P.J.S.); (T.A.); (K.F.)
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7
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Olivieri A, Mancini G, Olivieri J, Marinelli Busilacchi E, Cimminiello M, Pascale SP, Nuccorini R, Patriarca F, Corradini P, Bacigalupo A, Angelini S, Poloni A, Grillo G, Onida F, Martino M, Di Renzo N, Nagler A, Mordini N, Bruno B, Ciceri F, Bonifazi F. Nilotinib in steroid-refractory cGVHD: prospective parallel evaluation of response, according to NIH criteria and exploratory response criteria (GITMO criteria). Bone Marrow Transplant 2020; 55:2077-2086. [PMID: 32332918 DOI: 10.1038/s41409-020-0902-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/19/2020] [Accepted: 04/03/2020] [Indexed: 11/10/2022]
Abstract
We conducted a phase I-II study to evaluate Nilotinib (NIL) safety and pharmacokinetics in 22 SR-cGVHD patients; we also evaluated ORR by using in parallel NIH criteria and an exploratory approach, combining objective improvement (OI) without failure criteria (GITMO criteria). Results: 22 patients were enrolled. After dose escalation up to 600 mg/day, MTD was not reached. Main toxicities were asthenia, headache, nausea, pruritus, cramps, and mild anemia. Mean and median plasma concentrations of NIL (C-NIL) were 817 (SD ± 450) and 773 ng/ml. ORR at 6 months, according to 2005 and 2014 NIH and GITMO criteria were 27.8%, 22.2%, and 55.6% respectively; close correspondence has been observed for ORR, according to 2014 NIH criteria, both assessed in a conventional way and assisted by dedicated software (CROSY). At 48 months OS was 75% while FFS, according to NIH and GITMO criteria, was 30 and 25%. In conclusion the safety profile of NIL and long-term outcome makes NIL an attractive option in SR-cGVHD. Exploratory GITMO criteria could represent an alternative tool for easy response evaluation in patients with prevalent skin and lung involvement, but require validation in a larger population; CROSY software showed excellent reliability in capturing ORR according to the 2014 NIH criteria.
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Affiliation(s)
- A Olivieri
- Unit of Hematology, AUO Ospedali Riuniti di Ancona, Ancona, Italy. .,Department of Clinical and Molecular Science, Università Politecnica delle Marche, Ancona, Italy.
| | - G Mancini
- Unit of Hematology, AUO Ospedali Riuniti di Ancona, Ancona, Italy
| | - J Olivieri
- Department of Hematology, Centro Trapianti e Terapie Cellulari, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - E Marinelli Busilacchi
- Department of Clinical and Molecular Science, Università Politecnica delle Marche, Ancona, Italy
| | - M Cimminiello
- Regional Department of Hematology, U.O.C. of Hematology and Stem Cell Transplantation, Azienda Ospedaliera Regionale San Carlo, Potenza, Italy
| | - S P Pascale
- Regional Department of Hematology, U.O.C. of Hematology and Stem Cell Transplantation, Azienda Ospedaliera Regionale San Carlo, Potenza, Italy
| | - R Nuccorini
- Regional Department of Hematology, U.O.C. of Hematology and Stem Cell Transplantation, Azienda Ospedaliera Regionale San Carlo, Potenza, Italy
| | - F Patriarca
- Department of Hematology, Centro Trapianti e Terapie Cellulari, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - P Corradini
- Department of Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - A Bacigalupo
- Department of Hematology, Fondazione Policlinico Universitario Gemelli IRCCS, Universita' Cattolica del Sacro Cuore, Roma, Italy
| | - S Angelini
- U.O.C of Hematology, Ospedale C.G. Mazzoni, Ascoli Piceno, Italy
| | - A Poloni
- Unit of Hematology, AUO Ospedali Riuniti di Ancona, Ancona, Italy.,Department of Clinical and Molecular Science, Università Politecnica delle Marche, Ancona, Italy
| | - G Grillo
- Division of Hematology and Oncology, ASST Grande Ospedale Metropolitano Niguarda Milan, Milan, Italy
| | - F Onida
- BMT Center, Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - M Martino
- Stem Cell Transplantation Unit (CTMO), Department of Hemato-Oncology and Radiotherapy, Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - N Di Renzo
- Haematology and BMT Unit, Ospedale Vito Fazzi, Lecce, Italy
| | - A Nagler
- Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Tel Aviv University, Tel Aviv, Israel
| | - N Mordini
- BMT Center, Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - B Bruno
- S.S.D. Allogenic Stem Cell Transplantation, Department of Oncology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - F Ciceri
- IRCCS San Raffaele Scientific Institute, University Vita-Salute San Raffaele, Milano, Italy
| | - F Bonifazi
- Institute of Hematology, "Seragnoli" University Hospital S. Orsola-Malpighi, Bologna, Italy
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8
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Passweg JR, Labopin M, Christopeit M, Cornelissen J, Pabst T, Socié G, Russel N, Yakoub-Agha I, Blaise D, Gedde-Dahl T, Labussière-Wallet H, Malladi R, Forcade E, Maury S, Polge E, Lanza F, Gorin NC, Mohty M, Nagler A. Postremission Consolidation by Autologous Hematopoietic Cell Transplantation (HCT) for Acute Myeloid Leukemia in First Complete Remission (CR) and Negative Implications for Subsequent Allogeneic HCT in Second CR: A Study by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT). Biol Blood Marrow Transplant 2019; 26:659-664. [PMID: 31759159 DOI: 10.1016/j.bbmt.2019.11.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/02/2019] [Accepted: 11/15/2019] [Indexed: 11/29/2022]
Abstract
After autologous hematopoietic cell transplantation (HCT) in the first complete remission (CR1), patients with acute myeloid leukemia (AML) may relapse and undergo allogeneic HCT in the second complete remission (CR2). The aim of this study was to analyze the outcome of allogeneic HCT performed in CR2 comparing patients with prior consolidation by autologous HCT versus patients with chemotherapy consolidation. Included were 2619 adults with allogeneic HCT in CR2 from 2000 to 2017 with (n = 417) or without (n = 2202) prior autologous HCT. Patient groups were not entirely comparable; patients with prior autologous HCT were younger, had less often a favorable cytogenetic profile, had more commonly donors other than matched siblings, and more often received reduced-intensity conditioning. In multivariate analysis, nonrelapse mortality risks in patients with prior autologous HCT were 1.34 (1.07 to 1.67; P = .01) after adjustment for age, cytogenetic risk, transplant year, donor, conditioning intensity, sex matching, interval diagnosis-relapse, and relapse-allogeneic HCT as compared with chemotherapy consolidation. Similarly, risks of events in leukemia-free survival and graft-versus-host disease, relapse-free survival were higher with prior autologous HCT, 1.17 (1.01 to 1.35), P = .03 and 1.18 (1.03 to 1.35), P = .02, respectively. Risk of death was also higher, 1.13 (0.97 to 1.32), P = .1, but this was not significant. Postremission consolidation with autologous HCT for AML in CR1 increases toxicity of subsequent allogeneic HCT in CR2.
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Affiliation(s)
- J R Passweg
- Division of Hematology, University Hospital Basel, Basel, Switzerland.
| | - M Labopin
- Department of Hematology and Cell Therapy, Institut National de la Santé et de la Recherche Médicale (INSERM) UMRs 938, Hopital Saint Antoine Assistance Publique-Hopitaux de Paris, Paris Sorbonne University, Paris, France
| | - M Christopeit
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Cornelissen
- Department of Hematology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, Netherlands
| | - T Pabst
- Department of Medical Oncology, University Hospital, Bern, Switzerland
| | - G Socié
- Department of Hematology-BMT, Hopital St. Louis, Paris France
| | - N Russel
- Department of Haematology, Nottingham City Hospital, Nottingham University, Nottingham, UK
| | - I Yakoub-Agha
- CHU de Lille, LIRIC, INSERM U995, université de Lille, Lille, France
| | - D Blaise
- Programme de Transplantation & Therapie Cellulaire Centre de Recherche en Cancérologie de Marseille Institut Paoli Calmettes, Marseille, France
| | - T Gedde-Dahl
- Department of Hematology, Oslo University Hospital, Rikshospitalet, and Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - R Malladi
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - E Forcade
- CHU Bordeaux, Hôpital Haut-Leveque, Pessac, France
| | - S Maury
- Service d'Hématologie, Hôpital Henri Mondor, Creteil, France
| | - E Polge
- Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT), Paris, France
| | - F Lanza
- Romagna Transplant Network, Ravenna, Italy
| | - N C Gorin
- Department of Hematology and Cell Therapy, Institut National de la Santé et de la Recherche Médicale (INSERM) UMRs 938, Hopital Saint Antoine Assistance Publique-Hopitaux de Paris, Paris Sorbonne University, Paris, France
| | - M Mohty
- Department of Hematology and Cell Therapy, Institut National de la Santé et de la Recherche Médicale (INSERM) UMRs 938, Hopital Saint Antoine Assistance Publique-Hopitaux de Paris, Paris Sorbonne University, Paris, France
| | - A Nagler
- Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Ramat Gan, Israel
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9
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Dreyling M, Santoro A, Leppä S, Demeter J, Follows G, Lenz G, Kim W, Mollica L, Nagler A, Phipps Diong C, Provencio M, Magagnoli M, Munoz J, Hiemeyer F, Liu L, Miriyala A, Rodrigues L, Garcia-Vargas J, Childs B, Zinzani P. EFFICACY AND SAFETY IN HIGH-RISK RELAPSED OR REFRACTORY INDOLENT FOLLICULAR LYMPHOMA PATIENTS TREATED WITH COPANLISIB. Hematol Oncol 2019. [DOI: 10.1002/hon.57_2631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- M. Dreyling
- Department of Medicine III; University Hospital (LMU); Munich Germany
| | - A. Santoro
- Cancer Center; Humanitas Clinical and Research Center; Rozzano Italy
| | - S. Leppä
- Comprehensive Cancer Center; Helsinki University Hospital; Helsinki Finland
| | - J. Demeter
- First Department of Internal Medicine; Semmelweis University; Budapest Hungary
| | - G.A. Follows
- Haematology; Cambridge University Hospitals NHS Foundation Trust; Cambridge United Kingdom
| | - G. Lenz
- Translational Oncology; University Hospital Münster; Münster Germany
| | - W.S. Kim
- Hematology and Oncology; Sungkyunkwan University School of Medicine, Samsung Medical Center; Seoul Republic of Korea
| | - L. Mollica
- Clinical Research in Hematology and Clinical Oncology; Maisonneuve-Rosemont Hospital Research Centre; Montréal Quebec Canada
| | - A. Nagler
- Chaim Sheba Medical Center; Tel Aviv University; Tel HaShomer Israel
| | - C. Phipps Diong
- Department of Haematology; Singapore General Hospital; Bukit Merah Singapore
| | - M. Provencio
- Medical Oncology; Health Research Institute, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid; Madrid Spain
| | - M. Magagnoli
- Cancer Center; Humanitas Clinical and Research Center; Rozzano Italy
| | - J. Munoz
- Hematology and Oncology; Banner MD Anderson Cancer Center Clinic; Gilbert United States
| | - F. Hiemeyer
- Pharmaceutical Division; Bayer AG; Berlin Germany
| | - L. Liu
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - A. Miriyala
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | | | - J. Garcia-Vargas
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - B.H. Childs
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - P.L. Zinzani
- Institute of Hematology “Seràgnoli”; University of Bologna; Bologna Italy
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10
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Panayiotidis P, Kellner A, Follows G, Mollica L, Nagler A, Özcan M, Santoro A, Hiemeyer F, Liu L, Garcia-Vargas J, Childs B, Zinzani P, Dreyling M. COPANLISIB TREATMENT OF PATIENTS WITH RELAPSED OR REFRACTORY MARGINAL ZONE LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.69_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- P. Panayiotidis
- School of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - A. Kellner
- Hematology; Kaposi Mór Teaching Hospital; Kaposvár Hungary
| | - G.A. Follows
- Haematology; Cambridge University Hospitals NHS Foundation Trust; Cambridge United Kingdom
| | - L. Mollica
- Clinical Research in Hematology and Clinical Oncology; Maisonneuve-Rosemont Hospital Research Centre; Montréal Quebec Canada
| | - A. Nagler
- Chaim Sheba Medical Center; Tel Aviv University; Tel HaShomer Israel
| | - M. Özcan
- Hematology; Ankara University; Ankara Turkey
| | - A. Santoro
- Cancer Center; Humanitas Clinical and Research Center; Rozzano Italy
| | - F. Hiemeyer
- Pharmaceutical Division; Bayer AG; Berlin Germany
| | - L. Liu
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - J. Garcia-Vargas
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - B.H. Childs
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - P.L. Zinzani
- Institute of Hematology "Seràgnoli"; University of Bologna; Bologna Italy
| | - M. Dreyling
- Department of Medicine III; University Hospital (LMU); Munich Germany
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11
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Avigdor A, Davidson T, Shimoni A, Yerushalmi R, Shem-Tov N, Danylesko I, Itzhaki O, Toren A, Jacoby E, Besser M, Nagler A. BASELINE CLINICAL AND PET-CT TUMOR BURDEN PARAMETERS DO NOT PREDICT OUTCOME OF RELAPSE/REFRACTORY AGGRESSIVE B CELL LYMPHOMA PATIENTS TREATED WITH ANTI-CD19 CAR T-CELLS. Hematol Oncol 2019. [DOI: 10.1002/hon.188_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A. Avigdor
- Division of Hematology and Bone Marrow Transplantation; Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University; Tel Hashomer Israel
| | - T. Davidson
- Department of Nuclear Medicine; Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University; Tel Hashomer Israel
| | - A. Shimoni
- Division of Hematology and Bone Marrow Transplantation; Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University; Tel Hashomer Israel
| | - R. Yerushalmi
- Division of Hematology and Bone Marrow Transplantation; Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University; Tel Hashomer Israel
| | - N. Shem-Tov
- Division of Hematology and Bone Marrow Transplantation; Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University; Tel Hashomer Israel
| | - I. Danylesko
- Division of Hematology and Bone Marrow Transplantation; Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University; Tel Hashomer Israel
| | - O. Itzhaki
- Ella Lemelbaum Institute for Immuno Oncology; Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University; Tel Hashomer Israel
| | - A. Toren
- Department of Pediatric Hematology-Oncology; Safra Children's Hospital, Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University; Tel Hashomer Israel
| | - E. Jacoby
- Department of Pediatric Hematology-Oncology; Safra Children's Hospital, Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University; Tel Hashomer Israel
| | - M. Besser
- Ella Lemelbaum Institute for Immuno Oncology; Chaim Sheba Medical Center and Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University; Tel Hashomer Israel
| | - A. Nagler
- Division of Hematology and Bone Marrow Transplantation; Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University; Tel Hashomer Israel
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12
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Zinzani P, Santoro A, Leppä S, Demeter J, Follows G, Lenz G, Kim W, Mollica L, Nagler A, Phipps Diong C, Provencio M, Magagnoli M, Munoz J, Miriyala A, Liu L, Zhang M, Garcia-Vargas J, Childs B, Dreyling M. SAFETY ANALYSIS OF PATIENTS WITH A MEDICAL HISTORY OF RESPIRATORY DISORDERS TREATED WITH COPANLISIB FROM THE CHRONOS-1 STUDY IN RELAPSED OR REFRACTORY INDOLENT B-CELL LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.58_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- P.L. Zinzani
- Institute of Hematology “Seràgnoli”; University of Bologna; Bologna Italy
| | - A. Santoro
- Cancer Center; Humanitas Clinical and Research Center; Rozzano Italy
| | - S. Leppä
- Comprehensive Cancer Center; Helsinki University Hospital; Helsinki Finland
| | - J. Demeter
- First Department of Internal Medicine; Semmelweis University; Budapest Hungary
| | - G.A. Follows
- Haematology; Cambridge University Hospitals NHS Foundation Trust; Cambridge United Kingdom
| | - G. Lenz
- Translational Oncology; University Hospital Münster; Münster Germany
| | - W.S. Kim
- Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Republic of Korea
| | - L. Mollica
- Clinical Research in Hematology and Clinical Oncology; Maisonneuve-Rosemont Hospital Research Centre; Montréal, Quebec Canada
| | - A. Nagler
- Chaim Sheba Medical Center; Tel Aviv University; Tel HaShomer Israel
| | - C. Phipps Diong
- Department of Haematology; Singapore General Hospital; Bukit Merah Singapore
| | - M. Provencio
- Health Research Institute; Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid; Madrid Spain
| | - M. Magagnoli
- Cancer Center; Humanitas Clinical and Research Center; Rozzano Italy
| | - J. Munoz
- Hematology and Oncology; Banner MD Anderson Cancer Center Clinic; Gilbert United States
| | - A. Miriyala
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - L. Liu
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - M. Zhang
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - J. Garcia-Vargas
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - B.H. Childs
- Oncology; Bayer HealthCare Pharmaceuticals, Inc.; Whippany United States
| | - M. Dreyling
- Department of Medicine III; University Hospital (LMU); Munich Germany
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13
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Canaani J, Beohou E, Labopin M, Ghavamzadeh A, Beelen D, Hamladji RM, Niederwieser D, Volin L, Markiewicz M, Arnold R, Mufti G, Ehninger G, Socié G, Kröger N, Mohty M, Nagler A. Trends in patient outcome over the past two decades following allogeneic stem cell transplantation for acute myeloid leukaemia: an ALWP/EBMT analysis. J Intern Med 2019; 285:407-418. [PMID: 30372796 DOI: 10.1111/joim.12854] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Outcomes for patients with acute myeloid leukaemia (AML) undergoing allogeneic stem cell transplantation (allo-SCT) have significantly improved in recent years. OBJECTIVES To assess the incremental improvement of transplanted AML patients in the last two decades. METHODS Patients included in this analysis were adult AML patients who underwent allo-SCT from an HLA-matched sibling donor (MSD) or HLA-matched unrelated donor (MUD) in first remission. Patient outcomes were assessed between three cohorts according to the year of transplant (1993-2002, 2003-2007 and 2008-2012). RESULTS The analysis comprised a total of 20 187 patients of whom 4763 were transplanted between 1993 and 2002, 5835 in 2003 and 2007, and 9589 in 2008 and 2012. In multivariate analysis, leukaemia-free survival (LFS) rates were significantly improved in more recently transplanted patients compared to patients transplanted in 1993-2002 [Hazard ratio (HR) = 0.84, confidence interval (CI) 95%, 0.77-0.92; P = 0.003], a benefit which also extended to improved overall survival (OS; HR = 0.8, CI 95%, 0.73-0.89; P < 0.0001), and decreased nonrelapse mortality (NRM) rates (HR = 0.65, CI 95%, 0.56-0.75; P < 0.0001). Subset analysis revealed that in MSD, the rates of LFS, NRM and OS significantly improved in patients in the more recent cohort with similar results also seen in MUD. Finally, the incidence of acute graft-versus-host disease (GVHD) was significantly reduced leading to improved GVHD-free/relapse-free survival (GRFS) rates in more recently transplanted patients. CONCLUSION Outcome of allo-SCT for AML patients has markedly improved in the last two decades owing to decreased nonrelapse mortality and improved rates of leukaemia-free survival resulting in significantly longer survival.
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Affiliation(s)
- J Canaani
- Hematology Division, Chaim Sheba Medical Center, Tel Aviv University, Tel-Hashomer, Israel
| | - E Beohou
- Acute Leukemia Working Party -EBMT and Department of Hematology and Cell Therapy, Hȏpital Saint-Antoine, Paris, France
| | - M Labopin
- Acute Leukemia Working Party -EBMT and Department of Hematology and Cell Therapy, Hȏpital Saint-Antoine, Paris, France
| | - A Ghavamzadeh
- Hematology-Oncology and BMT Research, Shariati Hospital, Teheran, Iran
| | - D Beelen
- Department of Bone Marrow Transplantation, University Hospital, Essen, Germany
| | - R-M Hamladji
- Service Hématologie Greffe de Moëlle, Centre Pierre et Marie Curie, Alger, Algeria
| | - D Niederwieser
- Division of Haematology & Oncology, University Hospital Leipzig, Leipzig, Germany
| | - L Volin
- Stem Cell Transplantation Unit, Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland
| | - M Markiewicz
- Department of Haematology and BMT, Medical University of Silesia, Katowice, Poland
| | - R Arnold
- Medizinische Klinik m. S. Hämatologie/Onkologie, Charité Universitaetsmedizin Berlin, Berlin, Germany
| | - G Mufti
- Department of Haematological Medicine, GKT School of Medicine, London, UK
| | - G Ehninger
- Universitaetsklinikum Dresden Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - G Socié
- Department of Hematology - BMT, Hȏpital St. Louis, Paris, France
| | - N Kröger
- Bone Marrow Transplantation Centre, University Hospital Eppendorf, Hamburg, Germany
| | - M Mohty
- Acute Leukemia Working Party -EBMT and Department of Hematology and Cell Therapy, Hȏpital Saint-Antoine, Paris, France
| | - A Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel Aviv University, Tel-Hashomer, Israel.,Acute Leukemia Working Party -EBMT and Department of Hematology and Cell Therapy, Hȏpital Saint-Antoine, Paris, France
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14
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Baron F, Labopin M, Ruggeri A, Volt F, Mohty M, Blaise D, Chevallier P, Sanz J, Fegueux N, Cornelissen JJ, Rambaldi A, Savani BN, Gluckman E, Nagler A. Cord blood transplantation is associated with good outcomes in secondary Acute Myeloid Leukaemia in first remission. J Intern Med 2019; 285:446-454. [PMID: 30561052 DOI: 10.1111/joim.12870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND We conducted a retrospective survey within the European Society for Blood and Marrow Transplantation (EBMT) registry to assess the outcomes of cord blood transplantation (CBT) in secondary acute myeloid leukaemia (sAML). METHODS Inclusion criteria consisted of ≥18 years of age, sAML, first CBT between 2002 and 2016, and either first complete remission (CR) or active disease at CBT. RESULTS One hundred forty-six patients met the study inclusion criteria. Status at transplantation was first CR (n = 97), primary refractory sAML (n = 30) or relapsed (n = 19) sAML. Neutrophil engraftment was achieved in 118 patients while the remaining 25 patients (17%) failed to engraft. This includes 13% of patients transplanted in first CR versus 30% of those transplanted with active disease (P = 0.008). Two-year incidences of relapse were 25% in first CR patients versus 36% in those with advanced disease (P = 0.06) while 2-year incidences of nonrelapse mortality were 35% and 49% (P = 0.03), respectively. At 2-year overall survival, leukaemia-free survival and graft-versus-host disease (GVHD)-free relapse-free survival were 42% vs. 19% (P < 0.001), 40% vs. 16% (P < 0.001), and 26% vs. 12% (P = 0.002) in first CR patients versus those with advanced disease, respectively. CONCLUSIONS We report here the first study of CBT in a large cohort of sAML patients. Main observation was that CBT rescued approximately 40% of patients with sAML in first CR.
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Affiliation(s)
- F Baron
- Hematology, CHU and GIGA-I3, University of Liege, Liege, Belgium
| | - M Labopin
- AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France.,EBMT Paris Office, Hospital Saint Antoine, Paris, France
| | - A Ruggeri
- Department of Pediatric Hematology and Oncology, IRCCS Bambino Gesù Children's Hospital, Roma, Italy
| | - F Volt
- Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Monacord, Centre Scientifique de Monaco, Principauté de Monaco, Monaco
| | - M Mohty
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Université Pierre & Marie Curie and INSERM UMRs U938, Paris, France
| | - D Blaise
- Transplant and cellular immunotherapy program, Department of Hematology CRCM, Inserm, CNRS, Aix Marseille Univ, Institut Paoli Calmettes, Marseille, France
| | - P Chevallier
- Department of Hematology, CHU of Nantes, Nantes, France
| | - J Sanz
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, CIBERONC, Instituto Carlos III, Madrid, Spain
| | - N Fegueux
- Département d'Hématologie Clinique, CHU Lapeyronie, Montpellier, France
| | - J J Cornelissen
- Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | - A Rambaldi
- Department of Oncology and Hematology, University of Milan and Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - B N Savani
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - E Gluckman
- Eurocord, Hospital Saint Louis, AP-HP, and IUH University Paris VII, France Monacord, Centre Scientifique de Monaco, Principauté de Monaco, Monaco
| | - A Nagler
- EBMT Paris Office, Hospital Saint Antoine, Paris, France.,Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
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15
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Tzang O, Hershkovitz D, Nagler A, Cheshnovsky O. Pure sinusoidal photo-modulation using an acousto-optic modulator. Rev Sci Instrum 2018; 89:123102. [PMID: 30599569 DOI: 10.1063/1.5020796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 11/01/2018] [Indexed: 06/09/2023]
Abstract
We use an arbitrary waveform generator to generate a clean sinusoidal modulation from the otherwise nonlinear acousto-optic modulator (AOM). A closed loop optimization script is applied to reduce high order harmonic distortion to less than 0.05% in a high AOM diffraction efficiency regime. This low level of distortion allows us to measure the nonlinear response to photoexcitation of many materials. We demonstrate this technique in a pump-probe experiment to measure the Nonlinear Photo-Modulated Reflectivity (NPMR) of surfaces. NPMR served us as the basis for developing super-resolution microscopy for non-fluorescence samples (label-free) as well as a tool in studying the ultrafast nonlinear response of photo-excited plasmonic nano-structures. Our methodology could be applied to other imaging systems in which measuring nonlinearity is desirable, such as fluorescence and photoacoustic microscopy.
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Affiliation(s)
- O Tzang
- School of Chemistry, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - D Hershkovitz
- School of Chemistry, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - A Nagler
- School of Physics, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - O Cheshnovsky
- School of Chemistry, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv 69978, Israel
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16
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Affiliation(s)
- A. Nagler
- Institut für Biologie 1, Lehrstuhl Spezielle Botanik/Mykologie, Auf der Morgenstelle 1, D-7400 Tübingen, BRD
| | - R. Bauer
- Institut für Biologie 1, Lehrstuhl Spezielle Botanik/Mykologie, Auf der Morgenstelle 1, D-7400 Tübingen, BRD
| | - M. Berbee
- Institut für Biologie 1, Lehrstuhl Spezielle Botanik/Mykologie, Auf der Morgenstelle 1, D-7400 Tübingen, BRD
| | - K. Vánky
- Institut für Biologie 1, Lehrstuhl Spezielle Botanik/Mykologie, Auf der Morgenstelle 1, D-7400 Tübingen, BRD
| | - F. Oberwinkler
- Institut für Biologie 1, Lehrstuhl Spezielle Botanik/Mykologie, Auf der Morgenstelle 1, D-7400 Tübingen, BRD
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17
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Craddock C, Versluis J, Labopin M, Socie G, Huynh A, Deconinck E, Volin L, Milpied N, Bourhis JH, Rambaldi A, Chevallier P, Blaise D, Manz M, Vellenga E, Vekemans MC, Maertens J, Passweg J, Vyas P, Schmid C, Löwenberg B, Ossenkoppele G, Mohty M, Cornelissen JJ, Nagler A. Distinct factors determine the kinetics of disease relapse in adults transplanted for acute myeloid leukaemia. J Intern Med 2018; 283:371-379. [PMID: 29214689 DOI: 10.1111/joim.12720] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Disease recurrence remains the major cause of death in adults with acute myeloid leukaemia (AML) treated using either intensive chemotherapy (IC) or allogenic stem cell transplantation (allo-SCT). AIMS The timely delivery of maintenance drug or cellular therapies represent emerging strategies with the potential to reduce relapse after both treatment modalities, but whilst the determinants of overall relapse risk have been extensively characterized the factors determining the timing of disease recurrence have not been characterized. MATERIALS AND METHODS We have therefore examined, using a series of sequential landmark analyses, relapse kinetics in a cohort of 2028 patients who received an allo-SCT for AML in CR1 and separately 570 patients treated with IC alone. RESULTS In the first 3 months after allo-SCT, the factors associated with an increased risk of relapse included the presence of the FLT3-ITD (P < 0.001), patient age (P = 0.012), time interval from CR1 to transplant (P < 0.001) and donor type (P = 0.03). Relapse from 3 to 6 months was associated with a higher white cell count at diagnosis (P = 0.001), adverse-risk cytogenetics (P < 0.001), presence of FLT3-ITD mutation (P < 0.001) and time interval to achieve first complete remission (P = 0.013). Later relapse was associated with adverse cytogenetics, mutated NPM1, absence of chronic graft-versus-host disease (GVHD) and the use of in vivo T-cell depletion. In patients treated with IC alone, the factors associated with relapse in the first 3 months were adverse-risk cytogenetics (P < 0.001) and FLT3-ITD status (P = 0.001). The factors predicting later relapse were the time interval from diagnosis to CR1 (P = 0.22) and time interval from CR1 to IC (P = 0.012). DISCUSSION AND CONCLUSION Taken together, these data provide novel insights into the biology of disease recurrence after both allo-SCT and IC and have the potential to inform the design of novel maintenance strategies in both clinical settings.
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Affiliation(s)
- C Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - J Versluis
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - M Labopin
- Department of Haematology, Hospital Saint Antoine, Paris, France
| | - G Socie
- Department of Hematology, Hospital Saint-Louis, Sorbonne University, Paris, France
| | - A Huynh
- Department of Haematology, CHU, Toulouse, France
| | - E Deconinck
- Department of Hematology, CHU, Besancon, France
| | - L Volin
- Stem Cell Transplantation Unit, HUCH Comprehensive Cancer Center, Helsinki, Finland
| | - N Milpied
- Department of Hamatology, CHU, Nantes, France
| | - J H Bourhis
- Department of Medical Oncology, Institute of Cancer, Villejuif, France
| | - A Rambaldi
- Department of Hematology, University of Milan, Milan, Italy
| | | | - D Blaise
- Department of Hematology, Centre of Cancer Research, Marseille, France
| | - M Manz
- Center for Hemato-Oncology, University Hospital Zurich, Zurich, Switzerland
| | - E Vellenga
- Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands
| | - M-C Vekemans
- Department of Hematology, Saint-Luc University, Brussels, Belgium
| | - J Maertens
- Department of Haematology, University Hospital Gasthuisberg, Leuven, Belgium
| | - J Passweg
- Department of Haematology, University of Basel, Basel, Switzerland
| | - P Vyas
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - C Schmid
- Stem Cell Transplantation Unit, Department of Medicine, University of Munich, Munich, Germany
| | - B Löwenberg
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - G Ossenkoppele
- Department of Haematology, University Medical Center, Amsterdam, The Netherlands
| | - M Mohty
- Hospital Saint-Antoine, University UPMC, Paris, France
| | - J J Cornelissen
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - A Nagler
- Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel.,ALWP office of the EBMT Hospital Saint Antoine, Paris, France
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18
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Baron F, Ruggeri A, Beohou E, Labopin M, Mohty M, Sanz J, Vigouroux S, Furst S, Bosi A, Chevallier P, Cornelissen JJ, Michallet M, Sierra J, Karakasis D, Savani BN, Gluckman E, Nagler A. Occurrence of graft-versus-host disease increases mortality after umbilical cord blood transplantation for acute myeloid leukaemia: a report from Eurocord and the ALWP of the EBMT. J Intern Med 2018; 283:178-189. [PMID: 28977716 DOI: 10.1111/joim.12696] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The efficacy of umbilical cord blood transplantation (UCBT) as treatment for acute myeloid leukaemia (AML) relies on immune-mediated graft-versus-leukaemia effects. Previous studies have suggested a strong association between graft-versus-host disease (GVHD) occurrence and graft-versus-leukaemia effects after allogeneic hematopoietic cell transplantation. METHODS Here, we evaluated the kinetics of relapse rate in correlation with GVHD occurrence after UCBT. The kinetics of relapse rate over time in correlation to GVHD occurrence were assessed by calculating the relapse rate per patient-year within sequential 90-day intervals. The impact of GVHD on relapse and mortality was further studied in multivariate Cox models handling GVHD as a time-dependent covariate. RESULTS The study included data from 1068 patients given single (n = 567) or double (n = 501) UCBT. The proportion of patients with grade II, III and IV acute GVHD was 20%, 7% and 4%, respectively. At 2 years, the cumulative incidence of chronic GVHD was 42%, the cumulative incidence of relapse was 32%, and overall survival was 32% as well. Relapse rates declined gradually over time during the first 30 months after transplantation. There was a possible suggestion that grade II-IV acute (HR = 0.8, P = 0.1) and chronic (HR = 0.65, P = 0.1) GVHD decreased relapse risk. However, grade II-IV acute GVHD significantly increased early (the first 18 months after UCBT) mortality (HR = 1.3, P = 0.02), whilst chronic GVHD increased each early (HR = 2.7, P < 0.001) and late (HR = 4.9, P < 0.001) mortality after UCBT. CONCLUSIONS The occurrence of grade II-IV acute or chronic GVHD each increases overall mortality after UCBT for AML mitigating the possible graft-versus-leukemia effect of GVHD.
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Affiliation(s)
- F Baron
- Laboratory of Hematology, GIGA-I3, University of Liege, Liege, Belgium
| | - A Ruggeri
- Eurocord, Hospital Saint Louis, AP-HP, IUH University Paris VII, Paris, France.,Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Université Pierre & Marie Curie and INSERM UMRs U938
| | - E Beohou
- EBMT Paris Office, Hospital Saint Antoine, Paris, France
| | - M Labopin
- EBMT Paris Office, Hospital Saint Antoine, Paris, France
| | - M Mohty
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Université Pierre & Marie Curie and INSERM UMRs U938
| | - J Sanz
- Servicio de Hematologia, Hospital Universitario La Fe, Valencia, Spain
| | - S Vigouroux
- Department of Hematology, University Hospital of Bordeaux, Bordeaux, France
| | - S Furst
- Department of Hematology, Institut Paoli Calmettes, Marseille, France
| | - A Bosi
- Hematology Unit, AOU Careggi, Florence, Italy
| | - P Chevallier
- Department of Hematology, CHU Nantes, Nantes, France
| | - J J Cornelissen
- Erasmus MC Cancer Institute, Department of Hematology, Rotterdam, The Netherlands
| | - M Michallet
- Department of Hematology, Centre Hospitalier Lyon-Sud, Lyon, France
| | - J Sierra
- Hematology Department, IIB Sant Pau and Josep Carreras Leukemia Research Institutes, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - D Karakasis
- Department of Hematology and Lymphomas, Evangelismos Hospital, Athens, Greece
| | - B N Savani
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - E Gluckman
- Eurocord, Hospital Saint Louis, AP-HP, France Monacord, Centre Scientifique de Monaco, IUH University Paris VII, Monaco city, Monaco
| | - A Nagler
- EBMT Paris Office, Hospital Saint Antoine, Paris, France.,Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
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19
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Ringdén O, Labopin M, Sadeghi B, Mailhol A, Beelen D, Fløisand Y, Ghavamzadeh A, Finke J, Ehninger G, Volin L, Socié G, Kröger N, Stuhler G, Ganser A, Schmid C, Giebel S, Mohty M, Nagler A. What is the outcome in patients with acute leukaemia who survive severe acute graft-versus-host disease? J Intern Med 2018; 283:166-177. [PMID: 29027756 DOI: 10.1111/joim.12695] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acute graft-versus-host disease (aGVHD) is a major complication of allogeneic haematopoietic stem cell transplantation (HSCT). With new promising therapies, survival may improve for severe aGVHD. OBJECTIVES We wanted to analyze the long-term outcome in patients who survive severe aGVHD. METHODS This study was a landmark analysis of 23 567 patients with acute Leukaemia who survived for more than 6 months after HSCT, 2002-2014. Patients alive after severe aGVHD (n = 1738) were compared to controls. RESULTS Patients with severe aGVHD had higher non-relapse mortality (NRM) and higher rate of extensive chronic GVHD (cGVHD) than the controls (P < 10-5 ). The probability of relapse was significantly lower in the severe aGVHD group, but Leukaemia-free survival (LFS) and overall survival were significantly lower than for the controls (P < 10-5 ). Five-year LFS in patients with severe aGVHD was 49%, as opposed to 61% in controls with no or mild GVHD and 59% in patients with moderate GVHD. CONCLUSIONS HSCT patients who survive severe aGVHD have higher risk of developing extensive cGVHD, a higher NRM, a lower relapse probability, and lower LFS than other HSCT patients. This study is a platform for outcome analysis in patients treated with novel therapies for acute GVHD.
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Affiliation(s)
- O Ringdén
- Division of Therapeutic Immunology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - M Labopin
- Hôpital Saint Antoine, Paris, France
| | - B Sadeghi
- Division of Therapeutic Immunology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - A Mailhol
- Hôpital Saint Antoine, Paris, France
| | - D Beelen
- University of Essen, Duisburg, Germany
| | - Y Fløisand
- Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - A Ghavamzadeh
- Shariati Hospital, Hematology-Oncology and BMT Research, Tehran, Iran
| | - J Finke
- Department of Medicine-Hematology, Oncology, University of Freiburg, Freiburg, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik 1, Universitätsklinikum Dresden, Dresden, Germany
| | - L Volin
- Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki University Hospital, Helsinki, Finland
| | - G Socié
- Department of Hematology - BMT, Hopital St. Louis, Paris, France
| | - N Kröger
- Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany
| | - G Stuhler
- Deutsche Klinik für Diagnostik, KMT Zentrum, Wiesbaden, Germany
| | - A Ganser
- Medical University Hannover, Hannover, Germany
| | - C Schmid
- University of Munich, Munich, Germany
| | - S Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - M Mohty
- Hôpital Saint Antoine, Paris, France
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
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20
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Gutwein O, Rahimi-Levene N, Herzog-Tzarfati K, Garach-Jehoshua O, Nagler A, Izak M, Koren-Michowitz M. Low Protein Z levels in patients with plasma cell neoplasms are inversely correlated with IL-6 levels. Leuk Res 2017; 62:104-107. [PMID: 29031125 DOI: 10.1016/j.leukres.2017.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 08/16/2017] [Accepted: 09/24/2017] [Indexed: 11/27/2022]
Abstract
Patients with multiple myeloma (MM) have an increased thrombotic risk, but pathogenesis remains uncertain. Low levels of Protein Z (PZ), a vitamin K-dependent plasma protein, are associated with venous as well as arterial thrombosis. The purpose of this study was to analyze PZ levels in patients with plasma cell neoplasms. PATIENTS AND METHODS The study consisted of 64 plasma cells neoplasm patients and 42 healthy individuals. Clinical investigations included measurement of plasma PZ and IL-6 levels. RESULTS PZ levels in patients with plasma cell neoplasms were significantly lower compared to healthy controls in the entire cohort (1392±659 vs.2010±603ng/mL, P<0.01), as well as in specific disease subgroups; symptomatic MM (1428±652ng/mL, p<0.01), smoldering MM (1437±883ng/mL, p=0.045) and monoclonal gammopathy of undetermined significance (MGUS) (1247±593ng/mL, p=0.01). PZ was negatively correlated with IL-6 levels in MM patients (r=-0.7, P<0.01). There was no significant difference in PZ levels between patients with or without thrombotic event. CONCLUSION Plasma cell neoplasm patients have low levels of PZ. This is presumably related to the increased IL-6 production by the bone marrow microenvironment, and could have a potential role in the increased thrombotic tendency in those patients.
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Affiliation(s)
- O Gutwein
- Division of Hematology, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel.
| | - N Rahimi-Levene
- Division of Hematology, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - K Herzog-Tzarfati
- Division of Hematology, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - O Garach-Jehoshua
- Division of Hematology, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - A Nagler
- Sackler Faculty of Medicine, Tel Aviv University, Israel; Division of Hematology, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - M Izak
- Division of Hematology, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - M Koren-Michowitz
- Division of Hematology, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
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21
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Provencio Pulla M, Santoro A, Mollica L, Leppä S, Follows G, Lenz G, Kim W, Nagler A, Panayiotidis P, Demeter J, Özcan M, Kosinova M, Bouabdallah K, Morschhauser F, Ishida T, Huang L, Garcia-Vargas J, Childs B, Zinzani P, Dreyling M. Copanlisib treatment in patients with relapsed or refractory indolent B-cell lymphoma: Subgroup analyses from the CHRONOS-1 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx373.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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Robin M, Porcher R, Zinke-Cerwenka W, van Biezen A, Volin L, Mufti G, Craddock C, Finke J, Richard C, Passweg J, Peniket A, Maertens J, Sucak G, Gedde-Dahl T, Vitek A, Nagler A, Blaise D, Beelen D, Maillard N, Schwerdtfeger R, de Witte T, Kroger N. Allogeneic haematopoietic stem cell transplant in patients with lower risk myelodysplastic syndrome: a retrospective analysis on behalf of the Chronic Malignancy Working Party of the EBMT. Bone Marrow Transplant 2017; 52:1081. [PMID: 28677682 DOI: 10.1038/bmt.2017.86] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This corrects the article DOI: 10.1038/bmt.2016.266.
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23
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Lugtenburg P, Avivi I, Berenschot H, Ilhan O, Marolleau J, Nagler A, Rueda A, Tani M, Turgut M, Osborne S, Smith R, Pfreundschuh M. RITUXIMAB SC AND IV PLUS CHOP SHOW SIMILAR EFFICACY AND SAFETY IN THE RANDOMISED MABEASE STUDY IN FIRST-LINE DLBCL. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_46] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- P.J. Lugtenburg
- Department of Hematology; Erasmus MC Cancer Institute; Rotterdam The Netherlands
| | - I. Avivi
- The Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - H.W. Berenschot
- Department of Hematology; Albert Schweitzer Hospital; Dordrecht The Netherlands
| | - O. Ilhan
- Department of Hematology; Ankara University School of Medicine; Ankara Turkey
| | - J.P. Marolleau
- Unit of Hematology; University Hospital of Amiens; Amiens France
| | - A. Nagler
- Division of Hematology; Chaim Sheba Medical Center; Tel Hashomer Israel
| | - A. Rueda
- Área de Oncología; Unidad de Oncología Médica, E. P. Hospital Costa del Sol; Marbella Spain
| | - M. Tani
- Hematology Unit; Santa Maria Delle Croci Hospital; Ravenna Italy
| | - M. Turgut
- Hematology Department; Ondokuz Mayis University; Samsun Turkey
| | - S.A. Osborne
- PDMA Operations (Biometrics); F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - R.B. Smith
- Pharma Development Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | - M. Pfreundschuh
- Department of Internal Medicine I; University Hospital of Saarland; Homburg Germany
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24
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Fox C, Bellei M, Manni M, Kim S, Ko Y, Shustov A, Cabrera M, Chiattone C, Horwitz S, Spina M, Advani R, Angrilli F, De Souza C, Dlouhy I, Fernandez-Alvarez R, Gabús R, Hitz F, Laszlo D, Montoto S, Nagler A, Pavlovsky A, Vitolo U, Zoppegno L, Federico M, Kim W. IMPROVED SURVIVAL OUTCOMES FOR PATIENTS WITH EXTRA-NODAL NK/T LYMPHOMA: DATA FROM 140 PATIENTS PROSPECTIVELY REGISTERED IN THE INTERNATIONAL T-CELL PROJECT. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- C.P. Fox
- Nottingham University Hospitals NHS Trust, and Institute of Cancer Sciences, University of Birmingham; Nottingham UK
| | - M. Bellei
- Dept. Diagnostic, Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - M. Manni
- Dept. Diagnostic, Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - S.J. Kim
- Division of Hematology-Oncology; Samsung Medical Center; Seoul Republic of Korea
| | - Y.H. Ko
- Department of Pathology; Sungkyunkwan University; Seoul Republic of Korea
| | - A.R. Shustov
- Division of Hematology, FHCRC; University of Washington Medical Center; Seattle USA
| | - M.E. Cabrera
- Sección Hematología, Hospital del Salvador; Universidad de Chile; Santiago de Chile Chile
| | - C.S. Chiattone
- Departamento de Clínica Médica, FCM da Santa Casa de São Paulo; Centro de Linfomas Núcleo de Oncologia Hospital Samaritano; São Paulo Brazil
| | - S.M. Horwitz
- Dept. Medicine; Memorial Sloan-Kettering Cancer Center; New York USA
| | - M. Spina
- Medical Oncology A; Aviano National Cancer Institute; Aviano Italy
| | - R.H. Advani
- Division of Oncology; Stanford University School of Medicine; Stanford USA
| | - F. Angrilli
- Dip. Ematologia, Medicina Trasfusionale e Biotecnologie; UOSD Centro Diagnosi e Terapia Linfomi; PO Pescara, Pescara Italy
| | - C.A. De Souza
- Departamento de Clínica Médica; Universidade Estadual de Campinas; Campinas Brazil
| | - I. Dlouhy
- Hematology Department; Hospital Clinic; Barcelona Italy
| | | | - R. Gabús
- Service of Hematology and Bone Marrow Transplantation; Hospital Maciel; Montevideo Uruguay
| | - F. Hitz
- Department of Oncology/Haematology; Cantonal Hospital; St Gallen Switzerland
| | - D. Laszlo
- Division of Haemato-Oncology; IEO - Istituto Europeo di Oncologia; Milan Italy
| | - S. Montoto
- Department of Haematology; Barts Health NHS Trust; London Italy
| | - A. Nagler
- Department of Bone Marrow Transplantation; Tel-Aviv University; Tel-Aviv Israel
| | | | - U. Vitolo
- S.C. Ematologia, Dipartimento di Oncologia ed Ematologia, S.C. Ematologia, Dipartimento di Oncologia ed Ematologia; Torino Italy
| | - L. Zoppegno
- Hematologia, Hospital provincial San Martín de La Plata; Buenos Aires Argentina
| | - M. Federico
- Dept. Diagnostic, Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - W.S. Kim
- Division of Hematology-Oncology; Samsung Medical Center; Seoul Republic of Korea
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25
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Dreyling M, Santoro A, Mollica L, Leppä S, Follows G, Lenz G, Kim W, Nagler A, Panayiotidis P, Demeter J, Özcan M, Kosinova M, Bouabdallah K, Morschhauser F, Stevens D, Trevarthen D, Giurescu M, Liu L, Koechert K, Peña C, Cupit L, Yin S, Hiemeyer F, Garcia-Vargas J, Childs B, Zinzani P. COPANLISIB IN PATIENTS WITH RELAPSED OR REFRACTORY INDOLENT B-CELL LYMPHOMA (CHRONOS-1). Hematol Oncol 2017. [DOI: 10.1002/hon.2437_107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Dreyling
- Medizinische Klinik und Poliklinik III; Klinikum der Universität München-Grosshadern; Munich Germany
| | - A. Santoro
- Department of Oncology and Hematology, Humanitas Cancer Center; Humanitas Clinical and Research Institute; Rozzano MI Italy
| | - L. Mollica
- Department of Hematology; Hôpital Maisonneuve-Rosemont-Montreal; Montreal Quebec Canada
| | - S. Leppä
- Department of Oncology; Helsinki University Central Hospital Cancer Center; Helsinki Finland
| | - G.A. Follows
- Department of Haematology; Cambridge University Hospitals NHS Foundation Trust Addenbrooke's Hospital; Cambridge UK
| | - G. Lenz
- Translational Oncology; University Hospital Münster; Münster Germany
| | - W. Kim
- Division of Hematology and Oncology, Department of Medicine; Sungkyunkwan University School of Medicine, Samsung Medical Center; Seoul Republic of Korea
| | - A. Nagler
- Hematology Division; Chaim Sheba Medical Center- Tel Aviv University; Tel-Hashomer Israel
| | - P. Panayiotidis
- Division of Hematology; Laikon University Hospital, National and Kapodistrian University of Athens; Athens Greece
| | - J. Demeter
- First Department of Internal Medicine, Division of Haematology; Semmelweis University; Budapest Hungary
| | - M. Özcan
- Department of Hematology; Ankara University School of Medicine; Ankara Turkey
| | - M. Kosinova
- Department of Hematology; Kemerovo Regional Clinical Hospital; Kemerovo Russian Federation
| | - K. Bouabdallah
- Service d'Hématologie et de Thérapie Cellulaire; University Hospital of Bordeaux; Pessac France
| | - F. Morschhauser
- Department of Hematology; CHRU - Hôpital Claude Huriez; Lille France
| | - D.A. Stevens
- Medical Oncology; Norton Cancer Institute; Louisville-KY USA
| | - D. Trevarthen
- Medical Oncology; Comprehensive Cancer Care and Research Institute of Colorado; Englewood-CO USA
| | - M. Giurescu
- Pharmaceutical Division, Bayer AG; Berlin Germany
| | - L. Liu
- Biomarkers; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - K. Koechert
- Pharmaceutical Division, Bayer AG; Berlin Germany
| | - C. Peña
- Biomarkers; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - L. Cupit
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - S. Yin
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - F. Hiemeyer
- Pharmaceutical Division, Bayer AG; Berlin Germany
| | - J. Garcia-Vargas
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - B.H. Childs
- Clinical Development; Bayer HealthCare Pharmaceuticals Inc; Whippany-NJ USA
| | - P. Zinzani
- Department of Hematology; Institute of Hematology "L. e A. Seràgnoli"- University of Bologna; Bologna Italy
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26
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Merkel D, Soffer S, Filanovsky K, Fibach E, Dana M, Mittelman M, Nagler A, Rachmilewitz E. The Oral Iron Chelator Deferiprone Decreases Iron Overload and Oxidative Stress in Transfusion Dependent Patients with Myelodysplastic Syndromes (MDS). Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30196-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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27
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Abraham M, Klein S, Bulvik B, Wald H, Weiss ID, Olam D, Weiss L, Beider K, Eizenberg O, Wald O, Galun E, Avigdor A, Benjamini O, Nagler A, Pereg Y, Tavor S, Peled A. The CXCR4 inhibitor BL-8040 induces the apoptosis of AML blasts by downregulating ERK, BCL-2, MCL-1 and cyclin-D1 via altered miR-15a/16-1 expression. Leukemia 2017; 31:2336-2346. [DOI: 10.1038/leu.2017.82] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 02/24/2017] [Accepted: 03/01/2017] [Indexed: 01/02/2023]
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28
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Piemontese S, Ciceri F, Labopin M, Arcese W, Kyrcz-Krzemien S, Santarone S, Huang H, Beelen D, Gorin NC, Craddock C, Gulbas Z, Bacigalupo A, Mohty M, Nagler A. A comparison between allogeneic stem cell transplantation from unmanipulated haploidentical and unrelated donors in acute leukemia. J Hematol Oncol 2017; 10:24. [PMID: 28103944 PMCID: PMC5248464 DOI: 10.1186/s13045-017-0394-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 01/03/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the absence of a HLA-matched related or matched unrelated donor, allogeneic stem cell transplantation (allo-SCT) from mismatched unrelated donors or haploidentical donors are potential alternatives for patients with acute leukemia with an indication to allo-SCT. The objective of this study was to compare the outcome of allo-SCT from T cell-replete haploidentical (Haplo) versus matched (MUD 10/10) or mismatched unrelated donor at a single HLA-locus (MMUD 9/10) for patients with acute leukemia in remission. METHODS Two hundred sixty-five adult patients with de novo acute leukemia in first or second remission that received a Haplo-SCT between January 2007 and December 2013 were compared with 2490 patients receiving a MUD 10/10 and 813 receiving a MMUD 9/10. Propensity score weighted analysis was conducted in order to control for disease risk imbalances between the groups. RESULTS The weighted 3-year non-relapse mortality and relapse incidence were 29 and 30% for Haplo, 21 and 29% for MUD 10/10, and 29 and 25% for MMUD 9/10, respectively. The weighted 3-year leukemia-free survival (LFS) and overall survival (OS) were 41 and 46% for Haplo, 50 and 56% for MUD 10/10, and 46 and 48% for MMUD 9/10, respectively. Using weighted Cox model, both LFS and OS were significantly higher in transplants from MUD 10/10 compared from those in Haplo but not different between transplants from MMUD 9/10 and Haplo. The type of donor was not significantly associated with neither acute nor chronic graft-versus-host disease. CONCLUSIONS Patients with acute leukemia in remission have better outcomes if transplanted from a MUD 10/10. We did not find any significant difference in outcome between transplants from MMUD 9/10 and Haplo, suggesting that both can be equally used in the absence of a 10/10 MUD. KEY POINT 1: Better outcomes using fully (10/10) matched unrelated donor for allo-SCT in acute leukemia in remission. KEY POINT 2: Similar outcomes after allo-SCT from unmanipulated haploidentical graft or mismatched (9/10) unrelated donor in acute leukemia in remission.
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Affiliation(s)
- Simona Piemontese
- Hematology and Bone Marrow Transplant Unit, San Raffaele Scientific Institute, Milan, Italy.,EBMT ALWP Office, Hospital Saint Antoine, Paris, France
| | - F Ciceri
- Hematology and Bone Marrow Transplant Unit, San Raffaele Scientific Institute, Milan, Italy.,EBMT ALWP Office, Hospital Saint Antoine, Paris, France
| | - M Labopin
- EBMT ALWP Office, Hospital Saint Antoine, Paris, France.,Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Universite Pierre et Marie Curie, INSERM UMRs 938, Paris, France
| | - W Arcese
- Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Tor Vergata University, Rome, Italy
| | - S Kyrcz-Krzemien
- University Department of Hematology and BMT, Medical University of Silesia, Katowice, Poland
| | - S Santarone
- Department of Hematology, Ospedale Civile, Pescara, Italy
| | - H Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China
| | - D Beelen
- Department of Bone Marrow Transplantation, University Hospital, Essen, Germany
| | - N C Gorin
- EBMT ALWP Office, Hospital Saint Antoine, Paris, France.,Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Universite Pierre et Marie Curie, INSERM UMRs 938, Paris, France
| | - C Craddock
- Center for Clinical Hematology, Queen Elizabeth Hospital, Birmingham, UK
| | - Z Gulbas
- Bone Marrow Transplantation Department, Anadolu Medical Center Hospital, Gebze, Turkey
| | - A Bacigalupo
- Division of Hematology II, IRCCS, San Martino University Hospital IST, Genoa, Italy
| | - M Mohty
- EBMT ALWP Office, Hospital Saint Antoine, Paris, France.,Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Universite Pierre et Marie Curie, INSERM UMRs 938, Paris, France
| | - A Nagler
- EBMT ALWP Office, Hospital Saint Antoine, Paris, France.,Division of Hematology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
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29
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Gay F, Oliva S, Petrucci MT, Montefusco V, Conticello C, Musto P, Catalano L, Evangelista A, Spada S, Campbell P, Ria R, Salvini M, Offidani M, Carella AM, Omedé P, Liberati AM, Troia R, Cafro AM, Malfitano A, Falcone AP, Caravita T, Patriarca F, Nagler A, Spencer A, Hajek R, Palumbo A, Boccadoro M. Autologous transplant vs oral chemotherapy and lenalidomide in newly diagnosed young myeloma patients: a pooled analysis. Leukemia 2016; 31:1727-1734. [PMID: 28008174 DOI: 10.1038/leu.2016.381] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/28/2016] [Accepted: 11/07/2016] [Indexed: 12/22/2022]
Abstract
In newly diagnosed myeloma patients, upfront autologous transplant (ASCT) prolongs progression-free survival 1 (PFS1) compared with chemotherapy plus lenalidomide (CC+R). Salvage ASCT at first relapse may still effectively rescue patients who did not receive upfront ASCT. To evaluate the long-term benefit of upfront ASCT vs CC+R and the impact of salvage ASCT in patients who received upfront CC+R, we conducted a pooled analysis of 2 phase III trials (RV-MM-209 and EMN-441). Primary endpoints were PFS1, progression-free survival 2 (PFS2), overall survival (OS). A total of 268 patients were randomized to 2 courses of melphalan 200 mg/m2 and ASCT (MEL200-ASCT) and 261 to CC+R. Median follow-up was 46 months. MEL200-ASCT significantly improved PFS1 (median: 42 vs 24 months, HR 0.53; P<0.001), PFS2 (4 years: 71 vs 54%, HR 0.53, P<0.001) and OS (4 years: 84 vs 70%, HR 0.51, P<0.001) compared with CC+R. The advantage was noticed in good and bad prognosis patients. Only 53% of patients relapsing from CC+R received ASCT at first relapse. Upfront ASCT significantly reduced the risk of death (HR 0.51; P=0.007) in comparison with salvage ASCT. In conclusion, these data confirm the role of upfront ASCT as the standard approach for all young myeloma patients.
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Affiliation(s)
- F Gay
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - S Oliva
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - M T Petrucci
- Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University of Roma, Roma, Italy
| | - V Montefusco
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - C Conticello
- Division of Hematology, Azienda Policlinico 'Vittorio Emanuele', University of Catania, Catania, Italy
| | - P Musto
- Scientific Direction, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Potenza, Italy
| | - L Catalano
- Hematology, Department of Clinical Medicine and Surgery, AOU Federico II, Napoli, Italy
| | - A Evangelista
- Unit of Clinical Epidemiology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino and CPO Piemonte, Torino, Italy
| | - S Spada
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - P Campbell
- Haematology Department, Cancer Services, Barwon Health, Geelong, Australia
| | - R Ria
- Department of Biomedical Science, University of Bari 'Aldo Moro' Medical School, Internal Medicine 'G. Baccelli' Policlinico, Bari, Italy
| | - M Salvini
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - M Offidani
- Hematology Department, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - A M Carella
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Martino-Ist, Genova, Italy
| | - P Omedé
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - A M Liberati
- Department of Oncohematology, AO S.Maria di Terni, Terni, Italy
| | - R Troia
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - A M Cafro
- Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - A Malfitano
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - A P Falcone
- Division of Hematology, Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - T Caravita
- UOC Ematologia S. Eugenio ASL RM2 Roma, Roma, Italy
| | - F Patriarca
- Department of Hematology, Azienda Ospedaliera-Universitaria di Udine, DISM, Università di Udine, Udine, Italy
| | - A Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - A Spencer
- Department of Clinical Haematology, Alfred Health-Monash University, Melbourne, Australia
| | - R Hajek
- Blood Cancer Research Group, Department of Haematooncology, Faculty Hospital Ostrava, Ostrava, Czech Republic.,Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - A Palumbo
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - M Boccadoro
- Myeloma Unit, Division of Hematology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
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30
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Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P, Duarte RF, Dufour C, Kuball J, Farge-Bancel D, Gennery A, Kröger N, Lanza F, Nagler A, Sureda A, Mohty M. Impact of drug development on the use of stem cell transplantation: a report by the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 2016; 52:191-196. [PMID: 27819687 DOI: 10.1038/bmt.2016.258] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 05/30/2016] [Accepted: 06/01/2016] [Indexed: 11/09/2022]
Abstract
Hematopoietic stem cell transplantation (HSCT) is used with increasing frequency in Europe with 40 000 transplants reported in 2014. Transplant-related mortality remains high in allogeneic HSCT (10-20%); high-dose chemotherapy is toxic and demanding for patients. Drug development is accelerating and with limited toxicity of some targeted drugs may replace HSCT, whereas others may function as a 'bridge to transplant'. We analyzed HSCT reported to the activity survey for selected diseases in which major advances in drug development have been made. Tyrosine kinase inhibitors markedly changed the number of allogeneic HSCT in early CML. In myelodysplastic syndromes, hypomethylating agents show no effect on HSCT activity and Janus kinase inhibitors for myeloproliferative neoplasm appear to have only a temporary effect. For CLL autologous HSCT decreased after publication of trials showing improved PFS but no overall survival advantage and allogeneic rates are dropping after the introduction of Bruton kinase and PI3K Inhibitors. Whether these are 'game changers' as was imatinib for CML requires additional follow-up. For myeloma, proteasome inhibitors and new immunomodulatory drugs do not appear to impact transplant rates. Drug development data show different effects on HSCT use; highly effective drugs may replace HSCT, whereas other drugs may improve the patient's condition to allow for HSCT.
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Affiliation(s)
- J R Passweg
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - H Baldomero
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - P Bader
- Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt am Main, Germany
| | - C Bonini
- Università Vita-Salute San Raffaele, Milan, Italy
| | - S Cesaro
- Pediatric Haematology and Oncology, Policlinico GB Rossi, Verona, Italy
| | - P Dreger
- Medizinische Klinik V, University of Heidelberg, Heidelberg, Germany
| | - R F Duarte
- Hematology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - C Dufour
- Hematology Unit, G Gaslini Children's Institute, Genova, Italy
| | - J Kuball
- Department of Hematology, University Medical Centre, Utrecht, The Netherlands
| | - D Farge-Bancel
- Service de Médecine Interne, Maladies auto-immunes et pathologie vasculaire, Hôpital St Louis, Paris, France
| | - A Gennery
- Institute of Cellular Medicine, Newcastle University, Newcastle-Upon-Tyne, UK
| | - N Kröger
- University Hospital Eppendorf, Hamburg, Germany
| | - F Lanza
- Hematology and BMT Unit, University Hospital of Ravenna, Ravenna, Italy
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - A Sureda
- Hematology Department, Institut Català d'Oncologia-Hospital Duran I Reynals, Barcelona, Spain
| | - M Mohty
- Hospital Saint Antoine, Paris, France
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31
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Cremers EMP, van Biezen A, de Wreede LC, Scholten M, Vitek A, Finke J, Platzbecker U, Beelen D, Schwerdtfeger R, Volin L, Harhalakis N, Blijlevens N, Nagler A, Kröger N, de Witte T. Prognostic pre-transplant factors in myelodysplastic syndromes primarily treated by high dose allogeneic hematopoietic stem cell transplantation: a retrospective study of the MDS subcommittee of the CMWP of the EBMT. Ann Hematol 2016; 95:1971-1978. [PMID: 27650829 PMCID: PMC5093200 DOI: 10.1007/s00277-016-2802-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/26/2016] [Indexed: 01/28/2023]
Abstract
Many pre-transplant factors are known to influence the outcome of allogeneic stem cell transplantation (SCT) treatment in myelodysplastic syndromes (MDS). However, patient cohorts are often heterogeneous by disease stage and treatment modalities, which complicates interpretation of the results. This study aimed to obtain a homogeneous patient cohort by including only de novo MDS patients who received upfront allogeneic SCT after standard high dose myelo-ablative conditioning. The effect of pre-transplant factors such as age, disease stage, transfusions, iron parameters and comorbidity on overall survival (OS), non-relapse mortality (NRM), and relapse incidence (RI) was evaluated in 201 patients. In this cohort, characterized by low comorbidity and a short interval between diagnosis and transplantation, NRM was the most determinant factor for survival after SCT (47 % after 2-year follow-up). WHO classification and transfusion burden were the only modalities with a significant impact on overall survival after SCT. Estimated hazard ratios (HR) showed a strongly increased risk of death, NRM and RI, in patients with a high transfusion-burden (HR 1.99; P = 0.006, HR of 1.89; P = 0.03 and HR 2.67; P = 0.03). The HR's for ferritin level and comorbidity were not significantly increased.
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Affiliation(s)
- E M P Cremers
- VU University Medical Center, Amsterdam, The Netherlands. .,Department of Hematology, VU University Medical Center, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - A van Biezen
- Leiden University Medical Center, Leiden, The Netherlands
| | - L C de Wreede
- Leiden University Medical Center, Leiden, The Netherlands
| | - M Scholten
- Leiden University Medical Center, Leiden, The Netherlands
| | - A Vitek
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - J Finke
- University of Freiburg, Freiburg, Germany
| | | | - D Beelen
- University Hospital, Essen, Germany
| | | | - L Volin
- Helsinki University Central Hospital, Helsinki, Finland
| | | | - N Blijlevens
- Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - N Kröger
- University Hospital Eppendorf, Hamburg, Germany
| | - T de Witte
- Radboud University Medical Centre, Nijmegen, The Netherlands
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32
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Eder S, Labopin M, Finke J, Bunjes D, Olivieri A, Santarone S, Rambaldi A, Kanz L, Messina G, Mohty M, Nagler A. Safety and efficacy of thiotepa-based conditioning for allogeneic transplantation in AML: a survey from the ALWP of the EBMT. Bone Marrow Transplant 2016; 52:238-244. [PMID: 27643865 DOI: 10.1038/bmt.2016.239] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/22/2016] [Accepted: 07/27/2016] [Indexed: 12/27/2022]
Abstract
This study evaluated the safety and efficacy of thiotepa-based regimens before allogeneic stem cell transplantation in 310 adult patients with AML. Disease status at the time of transplantation was CR1 in 50%, CR2+ in 23.5% and advanced disease in 26.5%. Transplantation was performed from haploidentical (35%), matched sibling (27%), unrelated (20%) or cord blood (18%) donors. As for safety: mucositis occurred in 46.8% of the patients and the cumulative incidence (CI) of sinusoidal obstruction syndrome was 4.0%. With a median follow-up of 37 months, the CI of acute GvHD grade>II was 26.5%, whereas CI of chronic GvHD was 28.1% at 3 years. CI for non-relapse mortality at 3 years was 38.4%, 49.7% and 45.4% for patients in CR1, CR2+ and advanced disease, respectively (P=0.10). Relapse incidence at 3 years was 20.2, 30.7 and 40.6% in these three respective groups (P=0.002). CI for 3-year leukemia-free survival and overall survival were 41.4% and 45.6% (CR1), 19.6% and 27.7% (CR2+), and 13.9% and 13.6% (advanced disease), respectively (P<10-4 for both). Our data suggest that thiotepa-based conditioning therapy in AML is feasible, effective and safe, as investigated for sinusoidal obstruction syndrome and mucositis.
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Affiliation(s)
- S Eder
- EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France
| | - M Labopin
- EBMT Office Paris, Hôpital Saint-Antoine, Paris, France
| | - J Finke
- Department of Medicine-Hematology, Oncology, University of Freiburg, Freiburg, Germany
| | - D Bunjes
- Klinik fuer Innere Medizin III, Universitätsklinikum Ulm, Ulm, Germany
| | - A Olivieri
- Department of Hematology, Azienda Ospedali Riuniti di Ancona, Ancona-Torrete, Italy
| | - S Santarone
- Department of Hematology, Ospedale Civile, Pescara, Italy
| | - A Rambaldi
- USC Ematologia, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - L Kanz
- Abteilung II, Universität Tübingen, Tübingen, Germany
| | - G Messina
- Centro Trapianti Midollo Osseo, Azienda Ospedaliera 'BMM', Reggio Calabria, Italy
| | - M Mohty
- EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France
| | - A Nagler
- EBMT Office Paris, Hôpital Saint-Antoine, Paris, France.,Chaim Sheba Medical Center, Tel-Hashomer, Israel
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33
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Hájek R, Masszi T, Petrucci MT, Palumbo A, Rosiñol L, Nagler A, Yong KL, Oriol A, Minarik J, Pour L, Dimopoulos MA, Maisnar V, Rossi D, Kasparu H, Van Droogenbroeck J, Yehuda DB, Hardan I, Jenner M, Calbecka M, Dávid M, de la Rubia J, Drach J, Gasztonyi Z, Górnik S, Leleu X, Munder M, Offidani M, Zojer N, Rajangam K, Chang YL, San-Miguel JF, Ludwig H. A randomized phase III study of carfilzomib vs low-dose corticosteroids with optional cyclophosphamide in relapsed and refractory multiple myeloma (FOCUS). Leukemia 2016; 31:107-114. [PMID: 27416912 PMCID: PMC5220126 DOI: 10.1038/leu.2016.176] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 03/16/2016] [Accepted: 04/28/2016] [Indexed: 02/07/2023]
Abstract
This randomized, phase III, open-label, multicenter study compared carfilzomib monotherapy against low-dose corticosteroids and optional cyclophosphamide in relapsed and refractory multiple myeloma (RRMM). Relapsed and refractory multiple myeloma patients were randomized (1:1) to receive carfilzomib (10-min intravenous infusion; 20 mg/m2 on days 1 and 2 of cycle 1; 27 mg/m2 thereafter) or a control regimen of low-dose corticosteroids (84 mg of dexamethasone or equivalent corticosteroid) with optional cyclophosphamide (1400 mg) for 28-day cycles. The primary endpoint was overall survival (OS). Three-hundred and fifteen patients were randomized to carfilzomib (n=157) or control (n=158). Both groups had a median of five prior regimens. In the control group, 95% of patients received cyclophosphamide. Median OS was 10.2 (95% confidence interval (CI) 8.4-14.4) vs 10.0 months (95% CI 7.7-12.0) with carfilzomib vs control (hazard ratio=0.975; 95% CI 0.760-1.249; P=0.4172). Progression-free survival was similar between groups; overall response rate was higher with carfilzomib (19.1 vs 11.4%). The most common grade ⩾3 adverse events were anemia (25.5 vs 30.7%), thrombocytopenia (24.2 vs 22.2%) and neutropenia (7.6 vs 12.4%) with carfilzomib vs control. Median OS for single-agent carfilzomib was similar to that for an active doublet control regimen in heavily pretreated RRMM patients.
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Affiliation(s)
- R Hájek
- University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - T Masszi
- St István and St László Hospital of Budapest, Budapest, Hungary
| | | | | | - L Rosiñol
- Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Nagler
- Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - K L Yong
- University College London Cancer Institute, London, UK
| | - A Oriol
- Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - J Minarik
- University Hospital Olomouc and Medical Faculty of Palacky, University Olomouc, Olomouc, Czech Republic
| | - L Pour
- University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - M A Dimopoulos
- National and Kapodistrian University of Athens, Athens, Greece
| | - V Maisnar
- Charles University Teaching Hospital, Hradec Králové, Czech Republic
| | - D Rossi
- Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - H Kasparu
- Hospital Elisabethinen Linz, Linz, Austria
| | | | - D B Yehuda
- Hadassah Medical Center, Jerusalem, Israel
| | - I Hardan
- Meir Medical Center, Kfar-Saba, Israel
| | - M Jenner
- Southampton General Hospital, Hampshire, UK
| | - M Calbecka
- Nicolaus Copernicus Hospital, Toruń, Poland
| | - M Dávid
- University of Pécs, Pécs, Hungary
| | - J de la Rubia
- University Hospital La Fe and Universidad Católica de València 'San Vicente Mártir', València, Spain
| | - J Drach
- Medical University of Vienna, Vienna, Austria
| | - Z Gasztonyi
- Petz Aladár Megyei Oktató Kórház, Vasvári Pál, Hungary
| | - S Górnik
- Zamojski Szpital Niepubliczny, Zamosc, Poland
| | - X Leleu
- Hopital Huriez, CHRU, Lille, France
| | - M Munder
- University Medicine Mainz, Mainz, Germany
| | - M Offidani
- Clinica di Ematologia Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, Ancona, Italy
| | - N Zojer
- Center for Oncology, Hematology with Outpatient Department and Palliative Care, Wilhelminenspital, Vienna, Austria
| | - K Rajangam
- Onyx Pharmaceuticals, Inc., an Amgen subsidiary, South San Francisco, CA, USA
| | - Y-L Chang
- Onyx Pharmaceuticals, Inc., an Amgen subsidiary, South San Francisco, CA, USA
| | - J F San-Miguel
- Clínica Universidad de Navarra-CIMA-IDISNA, Navarra, Spain
| | - H Ludwig
- Wilhelminen Cancer Research Institute, Vienna, Austria
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Tsirigotis P, Danylesko I, Gkirkas K, Shem-Tov N, Yerushalmi R, Stamouli M, Avigdor A, Spyridonidis A, Gauthier J, Goldstein G, Apostolidis J, Mohty M, Shimoni A, Nagler A. Brentuximab vedotin in combination with or without donor lymphocyte infusion for patients with Hodgkin lymphoma after allogeneic stem cell transplantation. Bone Marrow Transplant 2016; 51:1313-1317. [DOI: 10.1038/bmt.2016.129] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/29/2016] [Accepted: 04/01/2016] [Indexed: 11/09/2022]
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35
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Ganzel C, Mathews V, Alimoghaddam K, Ghavamzadeh A, Kuk D, Devlin S, Wang H, Zhang MJ, Weisdorf D, Douer D, Rowe JM, Polge E, Esteve J, Nagler A, Mohty M, Tallman MS. Autologous transplant remains the preferred therapy for relapsed APL in CR2. Bone Marrow Transplant 2016; 51:1180-3. [PMID: 27088379 DOI: 10.1038/bmt.2016.96] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/06/2016] [Accepted: 03/07/2016] [Indexed: 02/02/2023]
Abstract
Despite their favorable prognosis, 10-20% of acute promyelocytic leukemia (APL) patients relapse. Reinduction therapy is often followed by autologous hematopoietic cell transplantation (auto-HCT). Arsenic trioxide (ATO) has become part of standard reinduction and is often followed by auto-HCT. Data on patients in CR2 were collected from two large transplant registries (Center for International Blood and Marrow Transplant Research (CIBMTR) and European Group for Blood and Marrow Transplant (EBMT)) and two specialty referral centers. The outcome of patients in CR2 who received only ATO-based therapy as reinduction was retrospectively compared with those who got an auto-HCT, with or without ATO. Prognostic factors included age, disease risk, extramedullary disease and duration of CR1. Of 207 evaluable patients, the median age was 31.5 years, 15.3% had extramedullary disease and median WBC at diagnosis was 4.8 × 10(9)/L. Sixty-seven patients received ATO alone and 140 underwent auto-HCT. The groups were comparable for age, gender, extramedullary disease, risk group and duration of CR1. At 5 years, overall survival (OS) was 42% and 78% for the ATO-only and auto-HCT groups, respectively (P<0.001). In addition, OS was associated with longer duration of CR1 (P=0.002), but not with disease risk at diagnosis. These data suggest that auto-HCT for APL patients in CR2 results in better OS than ATO-based therapy alone.
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Affiliation(s)
- C Ganzel
- Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - V Mathews
- Department of Hematology, Christian Medical College & Hospital, Vellore, India
| | - K Alimoghaddam
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - A Ghavamzadeh
- Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - D Kuk
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - S Devlin
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - H Wang
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M-J Zhang
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - D Weisdorf
- Bone Marrow Transplant Program, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - D Douer
- Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | - J M Rowe
- Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel.,Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - E Polge
- Saint-Antoine Hospital and University Pierre & Marie Curie, Paris, France.,Acute Leukemia Working Party, EBMT Paris Study Office/CEREST-TC, Paris, France
| | - J Esteve
- Hematology Department, Hospital Clinic, Institut d'investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
| | - A Nagler
- Acute Leukemia Working Party, EBMT Paris Study Office/CEREST-TC, Paris, France.,Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - M Mohty
- Saint-Antoine Hospital and University Pierre & Marie Curie, Paris, France.,Acute Leukemia Working Party, EBMT Paris Study Office/CEREST-TC, Paris, France
| | - M S Tallman
- Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
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Schmitt M, Hoffmann JM, Lorenz K, Publicover A, Schmitt A, Nagler A. Mobilization of autologous and allogeneic peripheral blood stem cells for transplantation in haematological malignancies using biosimilar G-CSF. Vox Sang 2016; 111:178-86. [PMID: 27509033 DOI: 10.1111/vox.12397] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 02/05/2016] [Accepted: 02/05/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVES Biosimilars of the granulocyte colony stimulating factor (G-CSF) filgrastim were approved by the European Medicines Agency (EMA) for registered indications of the originator G-CSF, including prevention and treatment of neutropenia, as well as mobilization of peripheral blood stem cells in 2008. Nevertheless, there is still an ongoing debate regarding the quality, efficacy and safety of biosimilar G-CSF. MATERIALS AND METHODS This article is a meta-analysis of clinical studies on the use of biosimilar G-CSF for mobilization and transplantation of haematopoietic stem cells as available in public databases. All data sets were weighted for the number of patients and parameters and then subjected to statistical meta-analysis employing the Mann-Whitney U-test followed by the Hodges-Lehmann estimator to assess differences between biosimilar and originator G-SCF. RESULTS A total of 1892 individuals, mostly with haematological malignancies but also including 351 healthy donors have been successfully mobilized for autologous or allogeneic stem cell transplantation using biosimilar G-CSF (Zarzio(TM) : 1239 individuals; Ratiograstim(TM) /Tevagrastim(TM) : 653 individuals). A total of 740 patients with multiple myeloma, 491 with non-Hodgkin's lymphoma (NHL), 150 with Hodgkin's lymphoma (HL) and other diseases are included in this meta-analysis, as well as 161 siblings and 190 volunteer unrelated donors. For biosimilar and originator G-CSF, bioequivalence was observed for the yield of CD34+ stem cells as well as for the engraftment of the transplants. CONCLUSION Biosimilar G-CSF has equivalent effects and safety as originator G-CSF.
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Affiliation(s)
- M Schmitt
- University Clinic Heidelberg, Internal Medicine V (Hematology, Oncology and Rheumatology), University of Heidelberg, Heidelberg, Germany
| | - J-M Hoffmann
- University Clinic Heidelberg, Internal Medicine V (Hematology, Oncology and Rheumatology), University of Heidelberg, Heidelberg, Germany
| | - K Lorenz
- University Clinic Heidelberg, Internal Medicine V (Hematology, Oncology and Rheumatology), University of Heidelberg, Heidelberg, Germany
| | - A Publicover
- Human Dendritic Cell Laboratory, Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - A Schmitt
- University Clinic Heidelberg, Internal Medicine V (Hematology, Oncology and Rheumatology), University of Heidelberg, Heidelberg, Germany
| | - A Nagler
- Hematology Division, BMT and Cord Blood Bank, Chaim Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel
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Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P, Duarte RF, Dufour C, Kuball J, Farge-Bancel D, Gennery A, Kröger N, Lanza F, Nagler A, Sureda A, Mohty M. Hematopoietic stem cell transplantation in Europe 2014: more than 40 000 transplants annually. Bone Marrow Transplant 2016; 51:786-92. [PMID: 26901709 PMCID: PMC4895175 DOI: 10.1038/bmt.2016.20] [Citation(s) in RCA: 278] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 01/06/2016] [Indexed: 12/30/2022]
Abstract
A record number of 40 829 hematopoietic stem cell transplantation (HSCT) in 36 469 patients (15 765 allogeneic (43%), 20 704 autologous (57%)) were reported by 656 centers in 47 countries to the 2014 survey. Trends include: continued growth in transplant activity, more so in Eastern European countries than in the west; a continued increase in the use of haploidentical family donors (by 25%) and slower growth for unrelated donor HSCT. The use of cord blood as a stem cell source has decreased again in 2014. Main indications for HSCT were leukemias: 11 853 (33% 96% allogeneic); lymphoid neoplasias; 20 802 (57% 11% allogeneic); solid tumors; 1458 (4% 3% allogeneic) and non-malignant disorders; 2203 (6% 88% allogeneic). Changes in transplant activity include more allogeneic HSCT for AML in CR1, myeloproliferative neoplasm (MPN) and aplastic anemia and decreasing use in CLL; and more autologous HSCT for plasma cell disorders and in particular for amyloidosis. In addition, data on numbers of teams doing alternative donor transplants, allogeneic after autologous HSCT, autologous cord blood transplants are presented.
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Affiliation(s)
- J R Passweg
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - H Baldomero
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital Basel, Basel, Switzerland
| | - P Bader
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt am Main, Germany
| | - C Bonini
- Università Vita-Salute San Raffaele, Milan, Italy
| | - S Cesaro
- Paediatric Haematology Oncology, Policlinico G.B. Rossi, Verona, Italy
| | - P Dreger
- Medizinische Klinik V, University of Heidelberg, Heidelberg, Germany
| | - R F Duarte
- Hematology Department, Institut Català d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain
| | - C Dufour
- Hematology Unit, G.Gaslini Children's Institute, Genova, Italy
| | - J Kuball
- Department of Haematology, University Medical Centre, Utrecht, The Netherlands
| | - D Farge-Bancel
- Service de Médecine Interne, Maladies Autoimmunes et Pathologie Vasculaire, Hôpital St Louis, Paris, France
| | - A Gennery
- Paediatric Team Children's BMT Unit, Great North Children's Hospital, Royal Victoria Infirmary, Newcastle University, Newcastle-Upon-Tyne, UK
| | - N Kröger
- Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany
| | - F Lanza
- Hematology and BMT Unit, Cremona, Italy
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - A Sureda
- Hematology Department, Institut Català d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain
| | - M Mohty
- Department of Hematology, Hôpital Saint Antoine, Paris, France
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Ruggeri A, Labopin M, Ciceri F, Mohty M, Nagler A. Definition of GvHD-free, relapse-free survival for registry-based studies: an ALWP-EBMT analysis on patients with AML in remission. Bone Marrow Transplant 2015; 51:610-1. [PMID: 26657834 DOI: 10.1038/bmt.2015.305] [Citation(s) in RCA: 200] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A Ruggeri
- Service d'Hématologie et Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France
| | - M Labopin
- Service d'Hématologie et Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France.,Université Pierre et Marie Curie, Paris, France
| | - F Ciceri
- Unità di Ematologia e trapianto di midollo, Ospedale San Raffaele, Milano, Italia
| | - M Mohty
- Service d'Hématologie et Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France.,Université Pierre et Marie Curie, Paris, France
| | - A Nagler
- Université Pierre et Marie Curie, Paris, France.,Division of Hematology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
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Necchi A, Miceli R, Bregni M, Bokemeyer C, Berger LA, Oechsle K, Schumacher K, Kanfer E, Bourhis JH, Massard C, Laszlo D, Montoro J, Flechon A, Arpaci F, Secondino S, Wuchter P, Dreger P, Crysandt M, Worel N, Kruger W, Ringhoffer M, Unal A, Nagler A, Campos A, Wahlin A, Michieli M, Sucak G, Donnini I, Schots R, Ifrah N, Badoglio M, Martino M, Raggi D, Giannatempo P, Rosti G, Pedrazzoli P, Lanza F. Prognostic impact of progression to induction chemotherapy and prior paclitaxel therapy in patients with germ cell tumors receiving salvage high-dose chemotherapy in the last 10 years: a study of the European Society for Blood and Marrow Transplantation Solid Tumors Working Party. Bone Marrow Transplant 2015; 51:384-90. [DOI: 10.1038/bmt.2015.300] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/21/2015] [Accepted: 10/24/2015] [Indexed: 11/09/2022]
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40
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Cahu X, Labopin M, Giebel S, Aljurf M, Kyrcz-Krzemien S, Socié G, Eder M, Bonifazi F, Bunjes D, Vigouroux S, Michallet M, Stelljes M, Zuckerman T, Finke J, Passweg J, Yakoub-Agha I, Niederwieser D, Sucak G, Sengeløv H, Polge E, Nagler A, Esteve J, Mohty M. Impact of conditioning with TBI in adult patients with T-cell ALL who receive a myeloablative allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT. Bone Marrow Transplant 2015; 51:351-7. [PMID: 26618548 DOI: 10.1038/bmt.2015.278] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 08/15/2015] [Accepted: 09/14/2015] [Indexed: 01/01/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a therapeutic option for adult patients with T-cell ALL (T-ALL). Meanwhile, few allo-SCT data specific to adult T-ALL have been described thus far. Specifically, the optimal myeloablative conditioning regimen is unknown. In this retrospective study, 601 patients were included. Patients received allo-SCT in CR1, CR2, CR >2 or in advanced disease in 69%, 15%, 2% and 14% of cases, respectively. With an overall follow-up of 58 months, 523 patients received a TBI-based regimen, whereas 78 patients received a chemotherapy-based regimen including IV busulfan-cyclophosphamide (IV Bu-Cy) (n=46). Unlike patients aged ⩾35 years, patients aged <35 years who received a TBI-based regimen displayed an improved outcome compared with patients who received a chemotherapy-based regimen (5-year leukemia-free survival (LFS) of 50% for TBI versus 18% for chemo-only regimen or IV Bu-Cy regimens, P=10(-5) and 10(-4), respectively). In multivariate analysis, use of TBI was associated with an improved LFS (hazard ratio (HR)=0.55 (0.34-0.86), P=0.01) and overall survival (HR=0.54 (0.34-0.87), P=0.01) in patients aged <35 years. In conclusion, younger adult patients with T-ALL entitled to receive a myeloablative allo-SCT may benefit from TBI-based regimens.
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Affiliation(s)
- X Cahu
- Hématologie Clinique, Hôpital Pontchaillou, CHU Rennes, France
| | - M Labopin
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.,Université Pierre and Marie Curie, Paris, France.,INSERM, UMR_S 938, INSERM, Paris, France
| | - S Giebel
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - M Aljurf
- Adult Hematology/HSCT, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - S Kyrcz-Krzemien
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | - G Socié
- Hematology-Transplantation, Hospital St Louis, APHP, Paris, France
| | - M Eder
- Hannover Medical School, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover, Germany
| | - F Bonifazi
- Institute of Hematology, Department of Hematology and Oncological Sciences 'L. and A. Seràgnoli,' University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - D Bunjes
- Klinik für Innere Medizin III, Universitätsklinikum Ulm, Germany
| | - S Vigouroux
- Hématologie Clinique et Thérapie Cellulaire, Hôpital Haut Levêque, Pessac, France
| | - M Michallet
- Hématologie Clinique, Hospices Civils de Lyon, Lyon, France
| | - M Stelljes
- Department of Medicine A/Hematology and Oncology, University of Muenster Muenster, Germany
| | - T Zuckerman
- Department of Hematology and Bone Marrow Transplantation, Rambam MCH, Haifa, Israel
| | - J Finke
- Department of Medecine-Hematology, Oncology, University of Freiburg, Freiburg, Germany
| | - J Passweg
- Hematology, University Hospital of Basel, Basel, Switzerland
| | - I Yakoub-Agha
- Hématologie Clinique, Hôpital Claude Huriez, Lille, France
| | - D Niederwieser
- University Hospital Leipzig, Clinic for Hematology and Oncology, Leipzig, Germany
| | - G Sucak
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - H Sengeløv
- National University Hospital, Copenhagen, Denmark
| | - E Polge
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.,Université Pierre and Marie Curie, Paris, France.,INSERM, UMR_S 938, INSERM, Paris, France
| | - A Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - J Esteve
- Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - M Mohty
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.,Université Pierre and Marie Curie, Paris, France.,INSERM, UMR_S 938, INSERM, Paris, France
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Vrhovac R, Labopin M, Ciceri F, Finke J, Holler E, Tischer J, Lioure B, Gribben J, Kanz L, Blaise D, Dreger P, Held G, Arnold R, Nagler A, Mohty M. Second reduced intensity conditioning allogeneic transplant as a rescue strategy for acute leukaemia patients who relapse after an initial RIC allogeneic transplantation: analysis of risk factors and treatment outcomes. Bone Marrow Transplant 2015; 51:186-93. [DOI: 10.1038/bmt.2015.221] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 08/18/2015] [Accepted: 08/20/2015] [Indexed: 11/09/2022]
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Giannatempo P, Lo Vullo S, Mariani L, Raggi D, Schumacher K, Massard C, Kanfer E, Oechsle K, Laszlo D, Michieli M, Ifrah N, Crysandt M, Wuchter P, Nagler A, Wahlin A, Badoglio M, Pedrazzoli P, Lanza F, Necchi A. Conventional-dose (CDCT) versus high-dose chemotherapy (HDCT) in the salvage management of relapsed pure seminoma: results from an international database. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv341.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Andreola G, Labopin M, Beelen D, Chevallier P, Tabrizi R, Bosi A, Michallet M, Santarone S, Ehninger G, Polge E, Laszlo D, Schmid C, Nagler A, Mohty M. Long-term outcome and prognostic factors of second allogeneic hematopoietic stem cell transplant for acute leukemia in patients with a median follow-up of ⩾10 years. Bone Marrow Transplant 2015; 50:1508-12. [DOI: 10.1038/bmt.2015.193] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 06/23/2015] [Accepted: 07/12/2015] [Indexed: 11/09/2022]
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Peffault de Latour R, Labopin M, Cornelissen J, Vigouroux S, Craddock C, Blaise D, Huyn A, Vindelov L, Maertens J, Chevallier P, Fegueux N, Socié G, Cahn JY, Petersen E, Schouten H, Lioure B, Russell N, Corral LL, Ciceri F, Nagler A, Mohty M. In patients older than 55 years with AML in first CR, should we search for a matched unrelated donor when an old sibling donor is available? Bone Marrow Transplant 2015; 50:1411-5. [PMID: 26367237 DOI: 10.1038/bmt.2015.180] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/05/2015] [Accepted: 07/08/2015] [Indexed: 01/08/2023]
Abstract
Allogeneic hematopoietic transplantation is increasingly used in patients aged 55 years or more with AML. The question of whether outcomes can be improved with an allele-level 8/8 HLA-matched unrelated donor (MUD) rather than an older HLA-matched sibling (MSD, more than 55 years) is still unanswered. We thus analyzed outcomes in 714 patients aged 55 years and older with AML in first CR (CR1) who received PBSCs after a reduced-intensity conditioning hematopoietic cell transplant from a MUD (n=310) or a MSD (n=404) in a recent period (2005-2010). The 3-year cumulative incidences (CIs) of non-relapse mortality were 17% and 23% with MSD and MUD, respectively (P=0.17). The 3-year CIs of relapse were 37% and 30%, respectively (P=0.12), resulting in a 3-year CI of leukemia-free survival of 46% and 47%, respectively (P=0.51). The 3-year overall survival was 49% with both MSD and MUD. In conclusion, HLA-identical sibling donors aged 55 years or more should not be excluded because of age for patients aged 55 years and older with AML in CR1.
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Affiliation(s)
- R Peffault de Latour
- Service d'Hématologie Greffe, AP-HP-Hôpital Saint Louis, Paris, France.,Paris Diderot University, EA 3518, Paris, France
| | - M Labopin
- ALWP-EBMT, AP-HP-Hôpital Saint Antoine, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, AP-HP-Hôpital Saint Antoine, Paris, France.,Universite Pierre et Marie Curie, Paris, France.,INSERM, UMRs 938, Paris, France
| | - J Cornelissen
- Hematology Department, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands
| | - S Vigouroux
- CHU Bordeaux-Hôpital Haut-levêque, Pessac, France
| | - C Craddock
- BMT unit, Centre for Clinical Haematology-Queen Elizabeth Hospital, Birmingham, UK
| | - D Blaise
- Institut Paoli Calmettes-Unité de Transplantation et de Thérapie Cellulaire-Inserm UMR 891, Marseille, France
| | - A Huyn
- Department of Hematology, Hopital de Purpan-CHU, Toulouse, France
| | - L Vindelov
- Bone Marrow Transplant Unit L 4043, Rigshospitalet, Copenhagen, Denmark
| | - J Maertens
- Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium
| | - P Chevallier
- Department of Hematology, Hopital Hotel Dieu-CHU, Nantes, France
| | - N Fegueux
- CHU Lapeyronie-Service d'Hématologie et Oncologie, Montpellier, France
| | - G Socié
- Service d'Hématologie Greffe, AP-HP-Hôpital Saint Louis, Paris, France.,Université Paris Diderot, Paris, France.,INSERM 1160, Paris, France
| | - J Y Cahn
- Department of Hematology, University Hospital, Grenoble, France.,University Medical Centre UMR 525 CNRS, Grenoble, France
| | - E Petersen
- Department of Hematology, Utrecht, The Netherlands
| | - H Schouten
- Department Internal Medicine Hematology/Oncology, University Hospital Maastricht, Maastricht, The Netherlands
| | - B Lioure
- Department of Onco-Hematologiy, CHU Hautepierre, Strasbourg, France
| | - N Russell
- Division of Hematology and BMT, Nottingham City Hospital, Nottingham, UK
| | - L L Corral
- Hospital Clínico-Servicio de Hematología, Salamanca, Spain
| | - F Ciceri
- Hematology and BMT Unit, EBMT CIC 813, San Raffaele Scientific Institute, Milano, Italy
| | - A Nagler
- ALWP-EBMT, AP-HP-Hôpital Saint Antoine, Paris, France.,Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - M Mohty
- ALWP-EBMT, AP-HP-Hôpital Saint Antoine, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, AP-HP-Hôpital Saint Antoine, Paris, France.,Universite Pierre et Marie Curie, Paris, France.,INSERM, UMRs 938, Paris, France
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Ringdén O, Labopin M, Ciceri F, Velardi A, Bacigalupo A, Arcese W, Ghavamzadeh A, Hamladji RM, Schmid C, Nagler A, Mohty M. Is there a stronger graft-versus-leukemia effect using HLA-haploidentical donors compared with HLA-identical siblings? Leukemia 2015; 30:447-55. [PMID: 26293645 DOI: 10.1038/leu.2015.232] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/13/2015] [Accepted: 07/20/2015] [Indexed: 01/18/2023]
Abstract
Haploidentical hematopoietic stem cell transplants (HSCTs) are increasingly used, but it is unknown whether they have a stronger graft-versus-leukemia (GVL) effect. We analyzed 10 679 acute leukemia patients who underwent HSCT from an HLA-matched sibling donor (MSD, n=9815) or a haploidentical donor (⩾2 HLA-antigen disparity, n=864) between 2007 and 2012, reported to the European Group for Blood and Marrow Transplantation. In a Cox regression model, acute and chronic graft-versus-host disease (GVHD) was added as time-dependent variables. There was no difference in probability of relapse between recipients of haploidentical and MSD grafts. Factors of importance for relapse after T-cell-replete grafts included remission status at HSCT, Karnofsky score ⩽80, acute GVHD of grade II or higher and chronic GVHD (P<10(-5)). Patients with post-transplant cyclophosphamide (n=194) had similar outcome as other T-cell-replete haploidentical transplants (n=369). Non-relapse mortality was significantly higher in the haploidentical group compared with that in MSD patients (P<10(-5)). Leukemia-free survival was superior in the MSD patients receiving T-cell-replete (P<10(-5)) or T-cell-depleted grafts (P=0.0006). The risk of relapse was the same in acute leukemia patients who received haploidentical donor grafts as in those given MSD transplants, suggesting a similar GVL effect.
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Affiliation(s)
- O Ringdén
- Division of Therapeutic Immunology, F79, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - M Labopin
- EBMT-ALWP Office and University Pierre and Marie Curie, Department of Hematology, Hospital Saint Antoine, Paris, France
| | - F Ciceri
- Hospital San Raffaele, Milano, Italy
| | - A Velardi
- Sezione di Ematologia, Dipartimento di Medicina Clinical e Sperimentale, Università di Perugia Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - A Bacigalupo
- Ospedale San Martino, Department of Haematology II, Genova, Italy
| | - W Arcese
- Rome Transplant Network, 'Tor Vergata' University of Rome, Stem Cell Transplant Unit Policlinico Universitario Tor Vergata, Rome, Italy
| | - A Ghavamzadeh
- Tehran University of Medical Sciences, Shariati Hospital Hematology, Oncology and BMT Research Center, Tehran, Iran
| | - R M Hamladji
- Centre Pierre et Marie Curie, Service Hématologie Greffe de Moëlle, Alger, Algeria
| | - C Schmid
- II Medizinische Klinik, Klinikum Augsburg, Augsburg, Germany
| | - A Nagler
- EBMT-ALWP Office and University Pierre and Marie Curie, Department of Hematology, Hospital Saint Antoine, Paris, France.,Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - M Mohty
- EBMT-ALWP Office and University Pierre and Marie Curie, Department of Hematology, Hospital Saint Antoine, Paris, France
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46
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Yerushalmi R, Shem-Tov N, Danylesko I, Avigdor A, Nagler A, Shimoni A. Fludarabine and treosulfan compared with other reduced-intensity conditioning regimens for allogeneic stem cell transplantation in patients with lymphoid malignancies. Bone Marrow Transplant 2015; 50:1526-35. [DOI: 10.1038/bmt.2015.174] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 06/14/2015] [Accepted: 06/17/2015] [Indexed: 11/09/2022]
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47
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Pigneux A, Labopin M, Maertens J, Cordonnier C, Volin L, Socié G, Blaise D, Craddock C, Milpied N, Bacher U, Malard F, Esteve J, Nagler A, Mohty M. Outcome of allogeneic hematopoietic stem-cell transplantation for adult patients with AML and 11q23/MLL rearrangement (MLL-r AML). Leukemia 2015; 29:2375-81. [PMID: 26082270 DOI: 10.1038/leu.2015.143] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 05/19/2015] [Accepted: 05/21/2015] [Indexed: 12/20/2022]
Abstract
Acute myeloid leukemia (AML) with 11q23/MLL rearrangement (MLL-r AML) is allocated to the intermediate- or high-risk cytogenetic prognostic category depending on the MLL fusion partner. A more favorable outcome has been reported in patients receiving an allogeneic hematopoietic stem-cell transplantation (alloHSCT), but this has not been confirmed in large series. We analyzed the outcome of alloHSCT among adult patients reported to the Acute Leukemia Working Party between 2000 and 2010. We identified 159 patients with 11q23/MLL rearranged AML allografted in first complete remission (CR1, n=138) or CR2, mostly corresponding to t(9;11), t(11;19), t(6;11) and t(10;11) translocations. Two-year overall survival (OS), leukemia-free survival (LFS), relapse incidence and non-relapse mortality were 56±4%, 51±4%, 31±3% and 17±4%, respectively. The outcome differed according to 11q23/MLL rearrangement, being more favorable in patients with t(9;11) and t(11;19) compared with t(10;11) and t(6;11) (2-year OS: 64±6% and 73±10% vs 40±13% and 24±11%, respectively; P<0.0001). Multivariate analysis for OS identified t(6;11), t(10;11), age>40 years and CR2 as unfavorable features, whereas t(6;11), t(10;11), CR2 and the use of reduced-intensity conditioning regimen affected poorly the LFS. This study confirms the potential role of alloHSCT for adult patients with 11q23/MLL rearranged AML in CR1.
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Affiliation(s)
- A Pigneux
- Department of Hematology, CHU de Bordeaux, Bordeaux, France.,Hématopoïèses Leucémique et Cible Thérapeutique, INSERM U 1035, Université Bordeaux Segalen, Bordeaux, France
| | - M Labopin
- Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Paris, France.,ALWP EBMT, Hôpital Saint Antoine, Paris, France.,Universite Pierre et Marie Curie, Paris, France.,INSERM UMRs 938, Paris, France
| | - J Maertens
- Department of Hematology, Acute Leukemia and Stem Cell Transplantation Unit, University Hospitals Leuven Leuven, Belgium
| | - C Cordonnier
- Service d'Hématologie and Faculté de Médecine, Hôpital Henri Mondor, Paris, France
| | - L Volin
- Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - G Socié
- Bone Marrow Transplantation, Saint-Louis Hospital, Paris, France
| | - D Blaise
- Department of Hematology, Institut Paoli Calmettes, Marseille, France
| | - C Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital and School of Cancer Studies, University of Birmingham, Birmingham, UK
| | - N Milpied
- Department of Hematology, CHU de Bordeaux, Bordeaux, France
| | - U Bacher
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - F Malard
- Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Paris, France.,ALWP EBMT, Hôpital Saint Antoine, Paris, France.,Universite Pierre et Marie Curie, Paris, France.,INSERM UMRs 938, Paris, France
| | - J Esteve
- Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - A Nagler
- ALWP EBMT, Hôpital Saint Antoine, Paris, France.,Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - M Mohty
- Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Paris, France.,ALWP EBMT, Hôpital Saint Antoine, Paris, France.,Universite Pierre et Marie Curie, Paris, France.,INSERM UMRs 938, Paris, France
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48
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Ruggeri A, Labopin M, Sanz G, Piemontese S, Arcese W, Bacigalupo A, Blaise D, Bosi A, Huang H, Karakasis D, Koc Y, Michallet M, Picardi A, Sanz J, Santarone S, Sengelov H, Sierra J, Vincent L, Volt F, Nagler A, Gluckman E, Ciceri F, Rocha V, Mohty M. Comparison of outcomes after unrelated cord blood and unmanipulated haploidentical stem cell transplantation in adults with acute leukemia. Leukemia 2015; 29:1891-900. [PMID: 25882700 DOI: 10.1038/leu.2015.98] [Citation(s) in RCA: 171] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 04/01/2015] [Accepted: 04/07/2015] [Indexed: 12/27/2022]
Abstract
Outcomes after unmanipulated haploidentical stem cell transplantation (Haplo) and after unrelated cord blood transplantation (UCBT) are encouraging and have become alternative options to treat patients with high-risk acute leukemia without human leukocyte antigen (HLA) matched donor. We compared outcomes after UCBT and Haplo in adults with de novo acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Median follow-up was 24 months. Analysis was performed separately for patients with AML, n=918 (Haplo=360, UCBT=558) and ALL, n=528 (Haplo=158 and UCBT=370). UCBT was associated with delayed engraftment and higher graft failure in both AML and ALL recipients. In multivariate analysis, UCBT was associated with lower incidence of chronic graft-vs-host disease both in the AML group (hazard ratio (HR)=0.63, P=0.008) and in the ALL group (HR=0.58, P=0.01). Not statistically significant differences were observed between Haplo and UCBT for relapse incidence (HR=0.95, P=0.76 for AML and HR=0.82, P=0.31 for ALL), non-relapse mortality (HR=1.16, P=0.47 for AML and HR=1.23, P=0.23 for ALL) and leukemia-free survival (HR 0.78, P=0.78 for AML and HR=1.00, P=0.84 for ALL). There were no statistically differences on main outcomes after unmanipulated Haplo and UCBT, and both approaches are valid for acute leukemia patients lacking a HLA matched donor. Both strategies expand the donor pool for patients in need.
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Affiliation(s)
- A Ruggeri
- Hôpital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, Paris, France.,INSERM, UMRs 938, Paris, France.,Hôpital Saint Louis, Eurocord, IUH University Paris VII, Paris, France
| | - M Labopin
- Hôpital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, Paris, France.,Hôpital Saint Antoine, Université Pierre and Marie Curie, Paris, France
| | - G Sanz
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - S Piemontese
- Hematology and BMT Unit, San Raffaele Scientific Institute, Milano, Italy
| | - W Arcese
- Rome Transplant Network, University Tor Vergata, Rome, Italy
| | - A Bacigalupo
- Dipartimento di Ematologia, Ospedale San Martino, Genova, Italy
| | - D Blaise
- Institut Paoli Calmettes, Marseille, France
| | - A Bosi
- Careggi University Hospital, Firenze, Italy
| | - H Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - D Karakasis
- Evangelismos Hospital, Division of Hematology, BMT Unit, Athens, Greece
| | - Y Koc
- Stem Cell Transplant Unit, Medical Park, Antalya, Turkey
| | | | - A Picardi
- Rome Transplant Network, University Tor Vergata, Rome, Italy
| | - J Sanz
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - S Santarone
- Ospedale Civile, Dipartimento di Ematologia, BMT Unit, Pescara, Italy
| | | | - J Sierra
- Hospital Santa Creu i Sant Pau, Jose Carreras Institute, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - L Vincent
- CHU Montpellier, Montpellier, France
| | - F Volt
- Hôpital Saint Louis, Eurocord, IUH University Paris VII, Paris, France
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel.,ALWP Office Hôpital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, Paris, France
| | - E Gluckman
- Hôpital Saint Louis, Eurocord, IUH University Paris VII, Paris, France.,Monacord, Centre Scientifique de Monaco, Monaco, France
| | - F Ciceri
- Hematology and BMT Unit, San Raffaele Scientific Institute, Milano, Italy
| | - V Rocha
- Hôpital Saint Louis, Eurocord, IUH University Paris VII, Paris, France.,Churchill Hospital, Oxford University, Oxford, UK
| | - M Mohty
- Hôpital Saint Antoine, Service d'Hématologie et Thérapie Cellulaire, AP-HP, Paris, France.,INSERM, UMRs 938, Paris, France.,Hôpital Saint Antoine, Université Pierre and Marie Curie, Paris, France
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49
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Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P, Duarte RF, Dufour C, Falkenburg JHF, Farge-Bancel D, Gennery A, Kröger N, Lanza F, Nagler A, Sureda A, Mohty M. Hematopoietic SCT in Europe 2013: recent trends in the use of alternative donors showing more haploidentical donors but fewer cord blood transplants. Bone Marrow Transplant 2015; 50:476-82. [PMID: 25642761 PMCID: PMC4387247 DOI: 10.1038/bmt.2014.312] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 12/04/2014] [Indexed: 12/18/2022]
Abstract
A record number of 39,209 HSCT in 34,809 patients (14,950 allogeneic (43%) and 19,859 autologous (57%)) were reported by 658 centers in 48 countries to the 2013 survey. Trends include: more growth in allogeneic than in autologous HSCT, increasing use of sibling and unrelated donors and a pronounced increase in haploidentical family donors when compared with cord blood donors for those patients without a matched related or unrelated donor. Main indications were leukemias, 11,190 (32%; 96% allogeneic); lymphoid neoplasias, 19,958 (57%; 11% allogeneic); solid tumors, 1543 (4%; 4% allogeneic); and nonmalignant disorders, 1975 (6%; 91% allogeneic). In patients without a matched sibling or unrelated donor, alternative donors are used. Since 2010 there has been a marked increase of 96% in the number of transplants performed from haploidentical relatives (802 in 2010 to 1571 in 2013), whereas the number of unrelated cord blood transplants has slightly decreased (789 in 2010 to 666 in 2013). The use of donor type varies greatly throughout Europe.
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Affiliation(s)
- J R Passweg
- EBMT Activity Survey Office, Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - H Baldomero
- EBMT Activity Survey Office, Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - P Bader
- Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt am Main, Germany
| | - C Bonini
- Ospedale San Raffaele, Milan, Italy
| | - S Cesaro
- Paediatric Haematology Oncology, Policlinico G.B. Rossi, Verona, Italy
| | - P Dreger
- Medizinische Klinik V, University of Heidelberg, Heidelberg, Germany
| | - R F Duarte
- Hospital Duran i Reynals, Barcelona, Spain
| | - C Dufour
- Institute G. Gaslini, Genova, Italy
| | - J H F Falkenburg
- Department of Hematology, University Medical Center, Leiden, The Netherlands
| | - D Farge-Bancel
- Service de Médecine Interne, Hopital St Louis, Paris, France
| | - A Gennery
- Institute of Cellular Medicine, Newcastle University, Newcastle-Upon-Tyne, UK
| | - N Kröger
- University Hospital Eppendorf, Hamburg, Germany
| | - F Lanza
- Hematology and BMT Unit, Cremona, Italy
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - A Sureda
- Hospital Duran i Reynals, Barcelona, Spain
| | - M Mohty
- Hospital Saint Antoine, Paris, France
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50
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Sureda A, Bader P, Cesaro S, Dreger P, Duarte RF, Dufour C, Falkenburg JHF, Farge-Bancel D, Gennery A, Kröger N, Lanza F, Marsh JC, Nagler A, Peters C, Velardi A, Mohty M, Madrigal A. Indications for allo- and auto-SCT for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2015. Bone Marrow Transplant 2015; 50:1037-56. [PMID: 25798672 DOI: 10.1038/bmt.2015.6] [Citation(s) in RCA: 216] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 01/09/2015] [Indexed: 12/17/2022]
Abstract
This is the sixth special report that the European Society for Blood and Marrow Transplantation regularly publishes on the current practice and indications for haematopoietic SCT for haematological diseases, solid tumours and immune disorders in Europe. Major changes have occurred in the field of haematopoietic SCT over the last years. Cord blood units as well as haploidentical donors have been increasingly used as stem cell sources for allo-SCT, thus, augmenting the possibility of finding a suitable donor for a patient. Continuous refinement of conditioning strategies has also expanded not only the number of potential indications but also has permitted consideration of older patients or those with co-morbidity for a transplant. There is accumulating evidence of the role of haematopoietic SCT in non-haematological disorders such as autoimmune diseases. On the other hand, the advent of new drugs and very effective targeted therapy has challenged the role of SCT in some instances or at least, modified its position in the treatment armamentarium of a given patient. An updated report with revised tables and operating definitions is presented.
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Affiliation(s)
- A Sureda
- Department of Haematology, Institut Catala d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain
| | - P Bader
- Universitätsklinikum Frankfurt, Goethe-Universität, Klinik für Kinder- und Jugendmedizin, Frankfurt, Germany
| | - S Cesaro
- Paediatric Haematology Oncology, Policlinico G.B. Rossi, Verona, Italy
| | - P Dreger
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - R F Duarte
- Department of Haematology, Institut Catala d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain
| | - C Dufour
- Clinical And Experimental Hematology Unit. Institute G. Gaslini, Genoa, Italy
| | - J H F Falkenburg
- Department of Haematology, Leiden University Medical Center, Leiden, The Netherlands
| | - D Farge-Bancel
- Department of Haematology-BMT, Hopital St Louis, Paris, France
| | - A Gennery
- Children's BMT Unit, Great North Children's Hospital, Newcastle-Upon-Tyne, UK
| | - N Kröger
- Department of Stem Cell Transplantation, University hospital Eppendorf, Hamburg, Germany
| | - F Lanza
- Haematology and BMT Unit, Cremona, Italy
| | - J C Marsh
- Department of Haematological Medicine, King's College Hospital/King's College London, London, UK
| | - A Nagler
- Chaim Sheva Medical Center, Tel-Hashomer, Israel
| | - C Peters
- Stem Cell Transplantation Unit, St Anna Kinderspital, Vienna, Austria
| | - A Velardi
- Sezione di Ematologia, Dipartimento di Medicina Clinica e Sperimentale, Università di Perugia, Perugia, Italy
| | - M Mohty
- Department of Haematology, H. Saint Antoine, Paris, France
| | - A Madrigal
- Anthony Nolan Research Institute, Royal Free and University College, London, UK
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