1
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Khera N, Ailawadhi S, Brazauskas R, Patel J, Jacobs B, Ustun C, Ballen K, Abid MB, Díaz MA, Al-Homsi AS, Hashem H, Hong S, Munker R, Schears R, Lazarus HM, Ciurea SO, Badawy SM, Savani BN, Wirk B, LeMaistre CF, Bhatt NS, Beitinjaneh A, Aljurf M, Sharma A, Cerny J, Knight JM, Kelkar AH, Yared JA, Kindwall-Keller T, Winestone LE, Steinberg A, Arnold SD, Seo S, Preussler JM, Hossain NM, Fingrut WB, Agrawal V, Hashmi S, Lehmann LE, Wood WA, Rangarajan HG, Saber W, Hahn T. Trends in Volumes and Survival After Hematopoietic Cell Transplantation in Racial/Ethnic Minorities. Blood Adv 2024:bloodadvances.2023012469. [PMID: 38661372 DOI: 10.1182/bloodadvances.2023012469] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 04/26/2024] Open
Abstract
There has been an increase in volume as well as improvement in overall survival (OS) after hematopoietic cell transplantation (HCT) for hematologic disorders. It is unknown if these changes have impacted racial/ethnic minorities equally. In this observational study from Center for International Blood and Marrow Transplant Research of 79,904 autologous (auto) and 65,662 allogeneic (allo) HCTs, we examined the volume and rates of change of auto HCT and allo HCT over time and trends in OS in 4 racial/ethnic groups: Non-Hispanic Whites (NHWs), Non-Hispanic African Americans (NHAAs), Hispanics across five 2-year cohorts from 2009 to 2018. Rates of change were compared using Poisson model. Adjusted and unadjusted Cox proportional hazards models examined trends in mortality in the 4 racial/ethnic groups over 5 study time periods. The rates of increase in volume were significantly higher for Hispanics and NHAAs vs. NHW for both autoHCT and alloHCT. Adjusted overall mortality after autoHCT was comparable across all racial/ethnic groups. NHAA adults (HR 1.13; 95% CI 1.04-1.22; p=0.004) and pediatric patients (HR 1.62; 95% CI 1.3-2.03; p<0.001 had a higher risk of mortality after alloHCT compared to NHWs. Improvement in OS over time was seen in all 4 groups after both autoHCT and alloHCT.Our study shows the rate of change for the use of autoHCT and alloHCT is higher in NHAAs and Hispanics compared to NHWs. Survival after autoHCT and alloHCT improved over time, however NHAAs have worse OS after alloHCT which has persisted. Continued efforts are needed to mitigate disparities for patients requiring alloHCT.
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Affiliation(s)
- Nandita Khera
- Mayo Clinic in Arizona, Phoenix, Arizona, United States
| | | | - Ruta Brazauskas
- Center for International Blood and Marrow Transplant Research (CIBMTR), United States
| | - Jinalben Patel
- Center for International Blood and Marrow Transplant Research (CIBMTR), Milwaukee, Wisconsin, United States
| | - Benjamin Jacobs
- Center for International Blood and Marrow Transplant Research (CIBMTR), Milwaukee, Wisconsin, United States
| | | | - Karen Ballen
- University of Virginia Health, Charlottesville, Virginia, United States
| | | | | | - A Samar Al-Homsi
- New York University Langone Medical Center, New York, New York, United States
| | | | - Sanghee Hong
- Duke University School of Medicine, Durham, North Carolina, United States
| | | | - Raquel Schears
- University of Central Florida, Rochester, Minnesota, United States
| | | | - Stefan O Ciurea
- University of California, Irvine, Orange, California, United States
| | - Sherif M Badawy
- Northwestern University Feinberg School of Medicine, United States
| | - Bipin N Savani
- Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Baldeep Wirk
- Virginia Commonwealth University Medical Center, Richmond, Virginia, United States
| | | | - Neel S Bhatt
- University of Washington School of Medicine, United States
| | - Amer Beitinjaneh
- University of Miami Health System, Miami, Florida, United States
| | | | - Akshay Sharma
- St Jude Children's Research Hospital, Memphis, Tennessee, United States
| | - Jan Cerny
- University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States
| | | | - Amar H Kelkar
- Dana-Farber Cancer Institute, Boston, Massachusetts, United States
| | - Jean A Yared
- University of Maryland, Greenebaum Cancer Center, Baltimore, Maryland, United States
| | | | - Lena E Winestone
- University of California San Francisco Benioff Children's Hospitals, San Fransisco, California, United States
| | - Amir Steinberg
- Westchester Medical Center, Hawthorne, New York, United States
| | | | | | - Jaime M Preussler
- CIBMTR (Center for International Blood and Marrow Transplant Research) & NMDP, Minneapolis, Minnesota, United States
| | - Nasheed M Hossain
- University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | | | - Vaibhav Agrawal
- City of Hope National Medical Center, Duarte, California, United States
| | - Shahrukh Hashmi
- Sheikh Shakhbout Medical City; Khalifa University, United Arab Emirates
| | - Leslie Elaine Lehmann
- Dana-Farber Cancer Institute / Children's Hospital, Boston, Boston, Massachusetts, United States
| | - William A Wood
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | | | - Wael Saber
- Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Theresa Hahn
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States
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2
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Patel SA, Gerber WK, Zheng R, Khanna S, Hutchinson L, Abel GA, Cerny J, DaSilva BA, Zhang TY, Ramanathan M, Khedr S, Selove W, Woda B, Miron PM, Higgins AW, Gerber JM. Natural history of clonal haematopoiesis seen in real-world haematology settings. Br J Haematol 2024. [PMID: 38522849 DOI: 10.1111/bjh.19423] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
Recursive partitioning of healthy consortia led to the development of the Clonal Hematopoiesis Risk Score (CHRS) for clonal haematopoiesis (CH); however, in the practical setting, most cases of CH are diagnosed after patients present with cytopenias or related symptoms. To address this real-world population, we characterize the clinical trajectories of 94 patients with CH and distinguish CH harbouring canonical DNMT3A/TET2/ASXL1 mutations alone ('sole DTA') versus all other groups ('non-sole DTA'). TET2, rather than DNMT3A, was the most prevalent mutation in the real-world setting. Sole DTA patients did not progress to myeloid neoplasm (MN) in the absence of acquisition of other mutations. Contrastingly, 14 (20.1%) of 67 non-sole DTA patients progressed to MN. CHRS assessment showed a higher frequency of high-risk CH in non-sole DTA (vs. sole DTA) patients and in progressors (vs. non-progressors). RUNX1 mutation conferred the strongest risk for progression to MN (odds ratio [OR] 10.27, 95% CI 2.00-52.69, p = 0.0053). The mean variant allele frequency across all genes was higher in progressors than in non-progressors (36.9% ± 4.62% vs. 24.1% ± 1.67%, p = 0.0064). This analysis in the post-CHRS era underscores the natural history of CH, providing insight into patterns of progression to MN.
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Affiliation(s)
- Shyam A Patel
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
- Center for Clinical and Translational Science, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - William K Gerber
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Rena Zheng
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Shrinkhala Khanna
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Lloyd Hutchinson
- Department of Pathology, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Gregory A Abel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
- Center for Clinical and Translational Science, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Brandon A DaSilva
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Tian Y Zhang
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, California, USA
| | - Muthalagu Ramanathan
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
- Center for Clinical and Translational Science, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Salwa Khedr
- Department of Pathology, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - William Selove
- Department of Pathology, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Bruce Woda
- Department of Pathology, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Patricia M Miron
- Department of Pathology, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Anne W Higgins
- Department of Pathology, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Jonathan M Gerber
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, Massachusetts, USA
- Center for Clinical and Translational Science, UMass Chan Medical School, Worcester, Massachusetts, USA
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3
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Cerny J, Soukup J, Petrosian K, Loukotova L, Novotny T. Efficacy and Complication Rates of Percutaneous Vertebroplasty and Kyphoplasty in the Treatment of Vertebral Compression Fractures: A Retrospective Analysis of 280 Patients. J Clin Med 2024; 13:1495. [PMID: 38592338 PMCID: PMC10933847 DOI: 10.3390/jcm13051495] [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: 01/29/2024] [Revised: 02/18/2024] [Accepted: 02/27/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) are established methods in the treatment of vertebral compression fractures (VCFs). In our manuscript, the target was to evaluate the efficacy of PVPs/PKPs and to determine the implications of potential periprocedural complications. Methods: 280 patients, specifically 194 women (69.3%) and 86 men (30.7%), were enrolled. We used the AO spine fractures classification and the Yeom classification to determine the subtype of cement leakage. Only single-level VCFs of the thoracic or lumbar spine were included. Visual analogue scale (VAS) was assessed preoperatively and regularly after the surgery. Vertebral compression ratio (VBCR) was used to determine postoperative vertebral body collapse. Results: We recorded 54 cases (19.3%) of cement leakage. There was a significant decrease in mean VAS scores (6.82-0.76 in PVPs, 7.15-0.81 in PKPs). The decrease in VBCR was greater in the VP group (4.39%; 84.21-79.82) compared to the KP group (1.95%; 74.36-72.41). Conclusions: No significant difference in the risk of cement leakage when comparing KPs and VPs was found. VPs and KPs provide rapid and significant pain relief in patients with VCFs. Clinically relevant complications of VPs and KPs are rare. Kyphoplasties prevent further vertebral body collapse more effectively compared to vertebroplasties.
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Affiliation(s)
- Jan Cerny
- Department of Orthopaedics, Faculty of Health Studies, Jan Evangelista Purkyne University in Usti nad Labem and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic; (J.C.); (J.S.); (K.P.)
| | - Jan Soukup
- Department of Orthopaedics, Faculty of Health Studies, Jan Evangelista Purkyne University in Usti nad Labem and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic; (J.C.); (J.S.); (K.P.)
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic
| | - Kadzhik Petrosian
- Department of Orthopaedics, Faculty of Health Studies, Jan Evangelista Purkyne University in Usti nad Labem and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic; (J.C.); (J.S.); (K.P.)
| | - Lucie Loukotova
- Department of Mathematics, Faculty of Science, Jan Evangelista Purkyne University in Usti nad Labem, 400 96 Usti nad Labem, Czech Republic;
| | - Tomas Novotny
- Department of Orthopaedics, Faculty of Health Studies, Jan Evangelista Purkyne University in Usti nad Labem and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic; (J.C.); (J.S.); (K.P.)
- Department of Orthopaedic Surgery, Faculty of Medicine in Hradec Kralove, Charles University, 500 03 Hradec Kralove, Czech Republic
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4
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Kennedy A, Patel S, Ramanathan M, Gerber J, Cerny J. Midostaurin for FLT3-mutated AML: a real-world analysis of effectiveness and infection risk at a single center. Ann Hematol 2024; 103:1031-1033. [PMID: 38195923 DOI: 10.1007/s00277-024-05614-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/28/2023] [Indexed: 01/11/2024]
Affiliation(s)
- Alice Kennedy
- Tufts Medical Center, Department of Internal Medicine, Boston, MA, USA
- University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Shyam Patel
- Division of Hematology and Oncology, Department of Internal Medicine, UMass Memorial Health Care, Worcester, MA, USA
| | - Muthalagu Ramanathan
- Division of Hematology and Oncology, Department of Internal Medicine, UMass Memorial Health Care, Worcester, MA, USA
| | - Jonathan Gerber
- Division of Hematology and Oncology, Department of Internal Medicine, UMass Memorial Health Care, Worcester, MA, USA
| | - Jan Cerny
- Division of Hematology and Oncology, Department of Internal Medicine, UMass Memorial Health Care, Worcester, MA, USA.
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5
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Ustun C, Chen M, Kim S, Auletta JJ, Batista MV, Battiwalla M, Cerny J, Gowda L, Hill JA, Liu H, Munshi PN, Nathan S, Seftel MD, Wingard JR, Chemaly RF, Dandoy CE, Perales MA, Riches M, Papanicolaou GA. Post-transplantation cyclophosphamide is associated with increased bacterial infections. Bone Marrow Transplant 2024; 59:76-84. [PMID: 37903992 DOI: 10.1038/s41409-023-02131-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 10/05/2023] [Accepted: 10/13/2023] [Indexed: 11/01/2023]
Abstract
Post-transplant cyclophosphamide (PTCy) is increasingly used to reduce graft-versus-host disease after hematopoietic cell transplantation (HCT); however, it might be associated with more infections. All patients who were ≥2 years old, receiving haploidentical or matched sibling donor (Sib) HCT for acute leukemias or myelodysplastic syndrome, and either calcineurin inhibitor (CNI)- or PTCy-based GVHD prophylaxis [Haploidentical HCT with PTCy (HaploCy), 757; Sibling with PTCy (SibCy), 403; Sibling with CNI-based (SibCNI), 1605] were included. Most bacterial infections occurred within the first 100 days; 953 patients (34.5%) had at least 1 infection and 352 patients (13%) had ≥2 infections. Patients receiving PTCy had a greater incidence of bacterial infections by day 180 [HaploCy 46%; SibCy 48%; SibCNI 35%; p < 0.001]. Compared with the SibCNI without infection cohort, 1.99-fold, 3.33-fold, 2.78-fold, and 2.53-fold increased TRM was seen for the HaploCy cohort without infection and HaploCy, SibCy, and SibCNI cohorts with infection, respectively. Bacterial infections increased mortality [HaploCy (HR1.84, 99% CI: 1.45-2.33, p < 0.0001), SibCy cohort (HR,1.68, 99% CI: 1.30-2.19, p < 0.0001), and SibCNI cohort (HR,1.76, 99% CI: 1.43-2.16, p < 0.0001). PTCy was associated with increased bacterial infections regardless of donor, and bacterial infections were associated with increased mortality irrespective of GVHD prophylaxis. Patients receiving PTCy should be monitored carefully for bacterial infections following PTCy.
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Affiliation(s)
- Celalettin Ustun
- Division of Hematology/Oncology/Cell Therapy, Rush University, Chicago, IL, USA.
| | - Min Chen
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Soyoung Kim
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jeffery J Auletta
- CIBMTR® (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
- Hematology/Oncology/BMT and Infectious Diseases, Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Minoo Battiwalla
- Sarah Cannon Transplant and Cell Therapy Network, Nashville, TN, USA
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Chan Medical School and Medical Center, Worcester, MA, USA
| | - Lohith Gowda
- Yale Cancer Center and Yale School of Medicine, New Haven, CT, USA
| | - Joshua A Hill
- Fred Hutchinson Cancer Center, Seattle, WA, USA
- University of Washington School of Medicine, Seattle, WA, USA
| | - Hongtao Liu
- Section of Hematology/Oncology, University of Chicago Medicine, Chicago, IL, USA
| | - Pashna N Munshi
- Stem Cell Transplant and Cellular Immunotherapy Program, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Sunita Nathan
- Division of Hematology/Oncology/Cell Therapy, Rush University, Chicago, IL, USA
| | - Matthew D Seftel
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - John R Wingard
- Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Roy F Chemaly
- The University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA
| | - Christopher E Dandoy
- Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, USA
| | - Miguel-Angel Perales
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Marcie Riches
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Genovefa A Papanicolaou
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
- Infectious Diseases Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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6
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Murthy HS, Zhang MJ, Chen K, Ahmed S, Deotare U, Ganguly S, Kansagra A, Michelis FV, Nishihori T, Patnaik M, Abid MB, Aljurf M, Arai Y, Bacher U, Badar T, Badawy SM, Ballen K, Battiwalla M, Beitinjaneh A, Bejanyan N, Bhatt VR, Brown VI, Martino R, Cahn JY, Castillo P, Cerny J, Chhabra S, Copelan E, Daly A, Dholaria B, Diaz Perez MA, Freytes CO, Grunwald MR, Hashmi S, Hildebrandt GC, Jamy O, Joseph J, Kanakry CG, Khera N, Krem MM, Kuwatsuka Y, Lazarus HM, Lekakis LJ, Liu H, Modi D, Munshi PN, Mussetti A, Palmisiano N, Patel SS, Rizzieri DA, Seo S, Shah MV, Sharma A, Sohl M, Solomon SR, Ulrickson M, Ustun C, van der Poel M, Verdonck LF, Wagner JL, Wang T, Wirk B, Zeidan A, Litzow M, Kebriaei P, Hourigan CS, Weisdorf DJ, Saber W, Kharfan-Dabaja MA. Allogeneic hematopoietic cell transplantation for blastic plasmacytoid dendritic cell neoplasm: a CIBMTR analysis. Blood Adv 2023; 7:7007-7016. [PMID: 37792849 PMCID: PMC10690553 DOI: 10.1182/bloodadvances.2023011308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 10/06/2023] Open
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy with a poor prognosis and considered incurable with conventional chemotherapy. Small observational studies reported allogeneic hematopoietic cell transplantation (allo-HCT) offers durable remissions in patients with BPDCN. We report an analysis of patients with BPDCN who received an allo-HCT, using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). We identified 164 patients with BPDCN from 78 centers who underwent allo-HCT between 2007 and 2018. The 5-year overall survival (OS), disease-free survival (DFS), relapse, and nonrelapse mortality (NRM) rates were 51.2% (95% confidence interval [CI], 42.5-59.8), 44.4% (95% CI, 36.2-52.8), 32.2% (95% CI, 24.7-40.3), and 23.3% (95% CI, 16.9-30.4), respectively. Disease relapse was the most common cause of death. On multivariate analyses, age of ≥60 years was predictive for inferior OS (hazard ratio [HR], 2.16; 95% CI, 1.35-3.46; P = .001), and higher NRM (HR, 2.19; 95% CI, 1.13-4.22; P = .02). Remission status at time of allo-HCT (CR2/primary induction failure/relapse vs CR1) was predictive of inferior OS (HR, 1.87; 95% CI, 1.14-3.06; P = .01) and DFS (HR, 1.75; 95% CI, 1.11-2.76; P = .02). Use of myeloablative conditioning with total body irradiation (MAC-TBI) was predictive of improved DFS and reduced relapse risk. Allo-HCT is effective in providing durable remissions and long-term survival in BPDCN. Younger age and allo-HCT in CR1 predicted for improved survival, whereas MAC-TBI predicted for less relapse and improved DFS. Novel strategies incorporating allo-HCT are needed to further improve outcomes.
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Affiliation(s)
- Hemant S Murthy
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL
| | - Mei-Jie Zhang
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Karen Chen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Sairah Ahmed
- Department of Lymphoma/Myeloma and Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Uday Deotare
- London Health Sciences Centre, Toronto, ON, Canada
| | | | - Ankit Kansagra
- Blood and Marrow Transplant Program, UT Southwestern Medical Center, Dallas, TX
| | - Fotios V Michelis
- Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Taiga Nishihori
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL
| | | | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, Bone and Marrow Transplant & Cellular Therapy Program, Medical College of Wisconsin, Milwaukee, WI
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Yasuyuki Arai
- Kyoto University Hospital, Kyoto University, Kyoto, Japan
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Talha Badar
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL
| | - Sherif M Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
- Division of Hematology, Oncology, and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Karen Ballen
- Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA
| | | | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Nelli Bejanyan
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL
| | - Vijaya Raj Bhatt
- The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE
| | - Valerie I Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, PA
| | - Rodrigo Martino
- Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Paul Castillo
- UF Health Shands Children's Hospital, Gainesville, FL
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA
| | - Saurabh Chhabra
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
- Division of Hematology & Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Edward Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Andrew Daly
- Tom Baker Cancer Center, Calgary, AB, Canada
| | | | - Miguel Angel Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - César O Freytes
- University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN
- Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | - Omer Jamy
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Jacinth Joseph
- Methodist Healthcare Blood and Marrow Transplant Center, Memphis, TN
| | - Christopher G Kanakry
- Center for Immuno-Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Nandita Khera
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ
| | | | - Yachiyo Kuwatsuka
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
| | - Lazaros J Lekakis
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Hongtao Liu
- Section of Hematology/Oncology, University of Chicago Medicine, Chicago, IL
| | - Dipenkumar Modi
- Division of Oncology, Karmanos Cancer Center/Wayne State University, Detroit, MI
| | - Pashna N Munshi
- Stem Cell Transplant and Cellular Immunotherapy Program, MedStar Georgetown University Hospital, Washington, DC
| | - Alberto Mussetti
- Clinical Hematology Department, Catalan Institute of Oncology, Hospitalet, Barcelona, Spain
- Bellvitge Biomedical Research Institute, Barcelona, Spain
| | - Neil Palmisiano
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Sagar S Patel
- Transplant and Cellular Therapy Program, Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
| | | | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | | | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN
| | - Melhm Sohl
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA
| | - Scott R Solomon
- Blood and Marrow Transplant Program, Northside Hospital Cancer Institute, Atlanta, GA
| | | | - Celalettin Ustun
- Division of Hematology/Oncology/Cell Therapy, Rush University, Chicago, IL
| | - Marjolein van der Poel
- Division of Hematology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Leo F Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands
| | - John L Wagner
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Trent Wang
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, PA
| | - Amer Zeidan
- Bridgeport Hospital, Yale University School of Medicine, New Haven, CT
| | | | - Partow Kebriaei
- Division of Cancer Medicine, Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Christopher S Hourigan
- Laboratory of Myeloid Malignancies, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Daniel J Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL
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7
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Patel SA, Cerny J, Gerber WK, Ramanathan M, Ediriwickrema A, Tanenbaum B, Hutchinson L, Meng X, Flahive J, Barton B, Gillis‐Smith AJ, Suzuki S, Khedr S, Selove W, Higgins AW, Miron PM, Simin K, Woda B, Gerber JM. Prognostic heterogeneity and clonal dynamics within distinct subgroups of myelodysplastic syndrome and acute myeloid leukemia with TP53 disruptions. EJHaem 2023; 4:1059-1070. [PMID: 38024632 PMCID: PMC10660125 DOI: 10.1002/jha2.791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 12/01/2023]
Abstract
TP53 aberrations constitute the highest risk subset of myelodysplastic neoplasms (MDS) and acute myeloid leukemia (AML). The International Consensus Classification questions the blast threshold between MDS and AML. In this study, we assess the distinction between MDS and AML for 76 patients with TP53 aberrations. We observed no significant differences between MDS and AML regarding TP53 genomics. Median overall survival (OS) was 223 days for the entire group, but prognostic discrimination within subgroups showed the most inferior OS (46 days) for AML with multihit allelic state plus TP53 variant allele frequency (VAF) > 50%. In multivariate analysis, unadjusted Cox models revealed the following variables as independent risk factors for mortality: AML (vs. MDS) (hazard ratio [HR]: 2.50, confidence interval [CI]: 1.4-4.4, p = 0.001), complex karyotype (HR: 3.00, CI: 1.4-6.1, p = 0.003), multihit status (HR: 2.30, CI 1.3-4.2, p = 0.005), and absence of hematopoietic cell transplant (HCT) (HR: 3.90, CI: 1.8-8.9, p = 0.0009). Clonal dynamic modeling showed a significant reduction in TP53 VAF with front-line hypomethylating agents. These findings clarify the impact of specific covariates on outcomes of TP53-aberrant myeloid neoplasms, irrespective of the diagnosis of MDS versus AML, and may influence HCT decisions.
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Affiliation(s)
- Shyam A. Patel
- Division of Hematology and Oncology, Department of MedicineUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Jan Cerny
- Division of Hematology and Oncology, Department of MedicineUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - William K. Gerber
- Division of Hematology and Oncology, Department of MedicineUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Muthalagu Ramanathan
- Division of Hematology and Oncology, Department of MedicineUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Asiri Ediriwickrema
- Institute for Stem Cell Biology & Regenerative Medicine; Division of Hematology, Department of MedicineStanford UniversityStanfordCaliforniaUnited States
| | - Benjamin Tanenbaum
- Division of Hematology and Oncology, Department of MedicineUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Lloyd Hutchinson
- Department of PathologyUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Xiuling Meng
- Department of PathologyUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Julie Flahive
- Department of Population & Quantitative Health SciencesUMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Bruce Barton
- Department of Population & Quantitative Health SciencesUMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Andrew J. Gillis‐Smith
- Division of Hematology and Oncology, Department of MedicineUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Sakiko Suzuki
- Division of Hematology and Oncology, Department of MedicineUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Salwa Khedr
- Department of PathologyUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - William Selove
- Department of PathologyUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Anne W. Higgins
- Department of PathologyUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Patricia M. Miron
- Department of PathologyUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Karl Simin
- Dept. of MolecularCell & Cancer BiologyUMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Bruce Woda
- Department of PathologyUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
| | - Jonathan M. Gerber
- Division of Hematology and Oncology, Department of MedicineUMass Memorial Medical Center, UMass Chan Medical SchoolWorcesterMassachusettsUnited States
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8
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Patel SA, Bello E, Wilks A, Gerber JM, Sadagopan N, Cerny J. Harnessing autologous immune effector mechanisms in acute myeloid leukemia: 2023 update of trials and tribulations. Leuk Res 2023; 134:107388. [PMID: 37729719 PMCID: PMC10947503 DOI: 10.1016/j.leukres.2023.107388] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 09/22/2023]
Abstract
Numerous recent advances have been made in therapeutic approaches toward acute myeloid leukemia (AML). Since 2017, we have seen eleven novel Food & Drug Administration (FDA)-approved medications for AML, all of which extend beyond the classical cytarabine-based cytostatic chemotherapy. In the recent two decades, the role of immune surveillance in AML has been intensively investigated. The power of one's own innate and adaptive immunity has been harnessed pharmacologically toward the goal of clearance of AML cells. Specifically, pre-clinical studies have shown great promise for antibodies that disinhibit T cells and macrophages by blocking checkpoint receptors within the immunologic synapse, thereby resulting in the elimination of AML cells. Anti-CD33 CAR-T therapies and anti-CD3/CD123 bispecific antibodies have also exhibited encouraging results in pre-clinical and early clinical studies. However, despite these translational efforts, we currently have no immune-based therapies for AML on the market, with the exception of gemtuzumab ozogamicin. In this focused review, we discuss molecular target validation and the most relevant clinical updates for immune-based experimental therapeutics including anti-CD47 monoclonal antibodies, CAR-T therapies, and bispecific T cell engagers. We highlight barriers to the clinical translation of these therapies in AML, and we propose solutions to optimize the manufacturing and delivery of the most novel immune-based therapies in the pipeline.
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Affiliation(s)
- Shyam A Patel
- Dept. of Medicine - Division of Hematology/Oncology, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, MA, USA; Center for Clinical and Translational Science, UMass Chan Medical School, Worcester, MA, USA
| | - Elisa Bello
- UMass Chan Medical School, Worcester, MA, USA
| | - Andrew Wilks
- Dept. of Medicine - Division of Hematology and Medical Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Jonathan M Gerber
- Dept. of Medicine - Division of Hematology/Oncology, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, MA, USA; Center for Clinical and Translational Science, UMass Chan Medical School, Worcester, MA, USA
| | - Narayanan Sadagopan
- MedStar Health - Georgetown/Washington Hospital Center Hematology and Medical Oncology, Washington, DC, USA
| | - Jan Cerny
- Dept. of Medicine - Division of Hematology/Oncology, UMass Memorial Medical Center, UMass Chan Medical School, Worcester, MA, USA; Center for Clinical and Translational Science, UMass Chan Medical School, Worcester, MA, USA.
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9
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Song E, Lee SK, Dykxhoorn DM, Novina C, Zhang D, Crawford K, Cerny J, Sharp PA, Lieberman J, Manjunath N, Shankar P. Correction for Song et al., "Sustained Small Interfering RNA-Mediated Human Immunodeficiency Virus Type 1 Inhibition in Primary Macrophages". J Virol 2023; 97:e0093623. [PMID: 37830822 PMCID: PMC10617386 DOI: 10.1128/jvi.00936-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
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10
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Murthy GSG, Kim S, Estrada-Merly N, Abid MB, Aljurf M, Assal A, Badar T, Badawy SM, Ballen K, Beitinjaneh A, Cerny J, Chhabra S, DeFilipp Z, Dholaria B, Perez MAD, Farhan S, Freytes CO, Gale RP, Ganguly S, Gupta V, Grunwald MR, Hamad N, Hildebrandt GC, Inamoto Y, Jain T, Jamy O, Juckett M, Kalaycio M, Krem MM, Lazarus HM, Litzow M, Munker R, Murthy HS, Nathan S, Nishihori T, Ortí G, Patel SS, Van der Poel M, Rizzieri DA, Savani BN, Seo S, Solh M, Verdonck LF, Wirk B, Yared JA, Nakamura R, Oran B, Scott B, Saber W. Association between the choice of the conditioning regimen and outcomes of allogeneic hematopoietic cell transplantation for myelofibrosis. Haematologica 2023; 108:1900-1908. [PMID: 36779595 PMCID: PMC10316233 DOI: 10.3324/haematol.2022.281958] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 02/01/2023] [Indexed: 02/11/2023] Open
Abstract
Allogeneic hematopoietic cell transplantation (allo-HCT) remains the only curative treatment for myelofibrosis. However, the optimal conditioning regimen either with reduced-intensity conditioning (RIC) or myeloablative conditioning (MAC) is not well known. Using the Center for International Blood and Marrow Transplant Research database, we identified adults aged ≥18 years with myelofibrosis undergoing allo-HCT between 2008-2019 and analyzed the outcomes separately in the RIC and MAC cohorts based on the conditioning regimens used. Among 872 eligible patients, 493 underwent allo-HCT using RIC (fludarabine/ busulfan n=166, fludarabine/melphalan n=327) and 379 using MAC (fludarabine/busulfan n=247, busulfan/cyclophosphamide n=132). In multivariable analysis with RIC, fludarabine/melphalan was associated with inferior overall survival (hazard ratio [HR]=1.80; 95% confidenec interval [CI]: 1.15-2.81; P=0.009), higher early non-relapse mortality (HR=1.81; 95% CI: 1.12-2.91; P=0.01) and higher acute graft-versus-host disease (GvHD) (grade 2-4 HR=1.45; 95% CI: 1.03-2.03; P=0.03; grade 3-4 HR=2.21; 95%CI: 1.28-3.83; P=0.004) compared to fludarabine/busulfan. In the MAC setting, busulfan/cyclophosphamide was associated with a higher acute GvHD (grade 2-4 HR=2.33; 95% CI: 1.67-3.25; P<0.001; grade 3-4 HR=2.31; 95% CI: 1.52-3.52; P<0.001) and inferior GvHD-free relapse-free survival (GRFS) (HR=1.94; 95% CI: 1.49-2.53; P<0.001) as compared to fludarabine/busulfan. Hence, our study suggests that fludarabine/busulfan is associated with better outcomes in RIC (better overall survival, lower early non-relapse mortality, lower acute GvHD) and MAC (lower acute GvHD and better GRFS) in myelofibrosis.
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Affiliation(s)
| | - Soyoung Kim
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI; CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee
| | - Noel Estrada-Merly
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee
| | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology, and Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh
| | - Amer Assal
- Columbia University Irving Medical Center, Department of Medicine, Bone Marrow Transplant and Cell Therapy Program
| | | | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplantation, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Pediatrics, Northwestern University Feinberg School of Medicine
| | - Karen Ballen
- Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Slyvester Comprehensive Cancer Center, Miami, FL
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA
| | - Saurabh Chhabra
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee
| | - Zachariah DeFilipp
- Hematopoietic Cell Transplant and Cellular Therapy Program, Massachusetts General Hospital
| | | | | | - Shatha Farhan
- Henry Ford Health System Stem Cell Transplant and Cellular Therapy Program, Detroit, MI
| | - Cesar O Freytes
- University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS
| | - Vikas Gupta
- MPN Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | | | | | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center, Tokyo
| | - Tania Jain
- John Hopkins University School of Medicine, Baltimore, MD
| | - Omer Jamy
- University of Alabama at Birmingham, Birmingham, AL
| | - Mark Juckett
- University of Minnesota Blood and Marrow Transplant Program - Adults
| | - Matt Kalaycio
- Cleveland Clinic Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | | | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, MN
| | | | - Hemant S Murthy
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL
| | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center
| | - Taiga Nishihori
- Department of Blood and Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL
| | | | - Sagar S Patel
- Blood and Marrow Transplant Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Marjolein Van der Poel
- Department of Internal Medicine, Division of Hematology, GROW School for Oncology and Developmental Biology, Masstricht University Medical Center, Maastricht
| | - David A Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigo
| | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA
| | - Leo F Verdonck
- Department of Hematology/Oncology, Isala, Clinic, Zwolle
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, Pennsylvania
| | - Jean A Yared
- Transplantation and Cellular Therapy Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD
| | - Ryotaro Nakamura
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Betul Oran
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Bart Scott
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Wael Saber
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee
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11
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Thomas E, Kennedy A, Walsh W, Carpentier M, Adeyinka H, Patel S, Gerber J, Cerny J, Mittal K. Telehealth through the pandemic at a safety net hospital: observations and next steps for cancer care delivery. Front Public Health 2023; 11:1186350. [PMID: 37333537 PMCID: PMC10272595 DOI: 10.3389/fpubh.2023.1186350] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
The COVID-19 pandemic revolutionized cancer care delivery leading to rapid adoption of digital technology for telehealth in the United States. In this study, we describe telehealth utilization trends across the three largest waves of the pandemic at a safety net academic center. We also provide a perspective on lessons learnt and our vision for cancer care delivery using digital technology in the near future. The integration of interpreter services within the video platform and its integration within the electronic medical record system is crucial for safety net institutes that service a diverse patient population. Pay-parity for telehealth, especially ongoing support for audio-only visits, will be critical in overcoming health disparities for patients without access to smartphone technology. Use of telehealth in clinical trials, widespread adoption of hospital at home programs, electronic consults for rapid access, and structured telehealth slots in clinic templates will be crucial in making cancer care more equitable and efficient.
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Affiliation(s)
- Erin Thomas
- Hospital Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Alice Kennedy
- Division of Hematology-Oncology, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - William Walsh
- Division of Hematology-Oncology, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Michelle Carpentier
- Division of Hematology-Oncology, University of Massachusetts Memorial Medical Center, Worcester, MA, United States
| | - Hannah Adeyinka
- Division of Hematology-Oncology, University of Massachusetts Memorial Medical Center, Worcester, MA, United States
| | - Shyam Patel
- Division of Hematology-Oncology, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Jonathan Gerber
- Division of Hematology-Oncology, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Jan Cerny
- Division of Hematology-Oncology, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Kriti Mittal
- Division of Hematology-Oncology, University of Massachusetts Chan Medical School, Worcester, MA, United States
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12
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Boyiadzis M, Zhang MJ, Chen K, Abdel-Azim H, Abid MB, Aljurf M, Bacher U, Badar T, Badawy SM, Battiwalla M, Bejanyan N, Bhatt VR, Brown VI, Castillo P, Cerny J, Copelan EA, Craddock C, Dholaria B, Perez MAD, Ebens CL, Gale RP, Ganguly S, Gowda L, Grunwald MR, Hashmi S, Hildebrandt GC, Iqbal M, Jamy O, Kharfan-Dabaja MA, Khera N, Lazarus HM, Lin R, Modi D, Nathan S, Nishihori T, Patel SS, Pawarode A, Saber W, Sharma A, Solh M, Wagner JL, Wang T, Williams KM, Winestone LE, Wirk B, Zeidan A, Hourigan CS, Litzow M, Kebriaei P, de Lima M, Page K, Weisdorf DJ. Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients. Leukemia 2023; 37:1006-1017. [PMID: 36310182 PMCID: PMC10148918 DOI: 10.1038/s41375-022-01738-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/06/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022]
Abstract
We investigated the impact of the number of induction/consolidation cycles on outcomes of 3113 adult AML patients who received allogeneic hematopoietic cell transplantation (allo-HCT) between 2008 and 2019. Patients received allo-HCT using myeloablative (MAC) or reduced-intensity (RIC) conditioning in first complete remission (CR) or with primary induction failure (PIF). Patients who received MAC allo-HCT in CR after 1 induction cycle had 1.3-fold better overall survival (OS) than 2 cycles to CR and 1.47-fold better than ≥3 cycles. OS after CR in 2 or ≥3 cycles was similar. Relapse risk was 1.65-fold greater in patients receiving ≥3 cycles to achieve CR. After RIC allo-HCT, the number of induction cycles to CR did not affect OS. Compared to CR in 1 cycle, relapse risk was 1.24-1.41-fold greater in patients receiving 2 or ≥3 cycles. For patients receiving only 1 cycle to CR, consolidation therapy prior to MAC allo-HCT was associated with improved OS vs. no consolidation therapy. Detectable MRD at the time of MAC allo-HCT did not impact outcomes while detectable MRD preceding RIC allo-HCT was associated with an increased risk of relapse. For allo-HCT in PIF, OS was significantly worse than allo-HCT in CR after 1-3 cycles.
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Affiliation(s)
| | - Mei-Jie Zhang
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Karen Chen
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Hisham Abdel-Azim
- Loma Linda University School of Medicine, Cancer Center, Children Hospital and Medical Center, Loma Linda, CA, USA
| | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Talha Badar
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Nelli Bejanyan
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Vijaya Raj Bhatt
- The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Valerie I Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, PA, USA
| | - Paul Castillo
- UF Health Shands Children's Hospital, Gainesville, FL, USA
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | - Edward A Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | | | | | - Miguel Angel Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - Christen L Ebens
- Division of Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Robert Peter Gale
- Haematology Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | | | - Lohith Gowda
- Yale Cancer Center and Yale School of Medicine, New Haven, CT, USA
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | | | - Madiha Iqbal
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Omer Jamy
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Nandita Khera
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Richard Lin
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dipenkumar Modi
- Division of Oncology, Karmanos Cancer Center/Wayne State University, Detroit, MI, USA
| | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Sagar S Patel
- Transplant and Cellular Therapy Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Attaphol Pawarode
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, MI, USA
| | - Wael Saber
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA
| | - John L Wagner
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Trent Wang
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, FL, USA
| | | | - Lena E Winestone
- Division of Allergy, Immunology, and Blood & Marrow Transplant, University of California San Francisco Benioff Children's Hospitals, San Francisco, CA, USA
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, PA, USA
| | - Amer Zeidan
- Bridgeport Hospital, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher S Hourigan
- Laboratory of Myeloid Malignancies, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, MN, USA
| | - Partow Kebriaei
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Kristin Page
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Daniel J Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
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Boyiadzis M, Zhang MJ, Chen K, Abdel-Azim H, Abid MB, Aljurf M, Bacher U, Badar T, Badawy SM, Battiwalla M, Bejanyan N, Bhatt VR, Brown VI, Castillo P, Cerny J, Copelan EA, Craddock C, Dholaria B, Perez MAD, Ebens CL, Gale RP, Ganguly S, Gowda L, Grunwald MR, Hashmi S, Hildebrandt GC, Iqbal M, Jamy O, Kharfan-Dabaja MA, Khera N, Lazarus HM, Lin R, Modi D, Nathan S, Nishihori T, Patel SS, Pawarode A, Saber W, Sharma A, Solh M, Wagner JL, Wang T, Williams KM, Winestone LE, Wirk B, Zeidan A, Hourigan CS, Litzow M, Kebriaei P, de Lima M, Page K, Weisdorf DJ. Correction to: Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113AML patients. Leukemia 2023; 37:1173. [PMID: 36949156 DOI: 10.1038/s41375-023-01814-2] [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: 03/24/2023]
Affiliation(s)
| | - Mei-Jie Zhang
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Karen Chen
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Hisham Abdel-Azim
- Loma Linda University School of Medicine, Cancer Center, Children Hospital and Medical Center, Loma Linda, CA, USA
| | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Talha Badar
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Nelli Bejanyan
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Vijaya Raj Bhatt
- The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Valerie I Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, PA, USA
| | - Paul Castillo
- UF Health Shands Children's Hospital, Gainesville, FL, USA
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | - Edward A Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | | | | | - Miguel Angel Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - Christen L Ebens
- Division of Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Robert Peter Gale
- Haematology Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | | | - Lohith Gowda
- Yale Cancer Center and Yale School of Medicine, New Haven, CT, USA
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | | | - Madiha Iqbal
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Omer Jamy
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Nandita Khera
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Richard Lin
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dipenkumar Modi
- Division of Oncology, Karmanos Cancer Center/Wayne State University, Detroit, MI, USA
| | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Sagar S Patel
- Transplant and Cellular Therapy Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Attaphol Pawarode
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, MI, USA
| | - Wael Saber
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA
| | - John L Wagner
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Trent Wang
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, FL, USA
| | | | - Lena E Winestone
- Division of Allergy, Immunology, and Blood & Marrow Transplant, University of California San Francisco Benioff Children's Hospitals, San Francisco, CA, USA
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, PA, USA
| | - Amer Zeidan
- Bridgeport Hospital, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher S Hourigan
- Laboratory of Myeloid Malignancies, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, MN, USA
| | - Partow Kebriaei
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Kristin Page
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Daniel J Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
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Mian A, Wei W, Chakraborty R, Yi J, Preussler JM, Hill BT, Cerny J, Deol A, Hahn TE, Hashmi SK, Jaglowski S, Jim HS, Khera N, Loren AW, McGuirk JP, Savani B, Stiff P, Uberti J, Whalen V, Wingard JR, Reynolds J, Holtan SG, Wood WAA, Baker S, Syrjala KL, Hamilton BK, Majhail NS. Patient-Reported Outcomes in Long-Term Survivors of Autologous Hematopoietic Cell Transplantation (AHCT) for Hodgkin (HL) and Non-Hodgkin Lymphoma (NHL): Secondary Analysis from Two Multicenter Randomized Controlled Trials (RCT) of Hematopoietic Cell Transplant Survivorship Interventions. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00561-4] [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: 02/07/2023]
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15
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Rotz SJ, Yi JC, Hamilton BK, Wei W, Preussler JM, Cerny J, Deol A, Jim H, Khera N, Hahn T, Hashmi SK, Holtan S, Jaglowski SM, Loren AW, McGuirk J, Reynolds J, Saber W, Savani BN, Stiff P, Uberti J, Wingard JR, Wood WA, Baker KS, Majhail NS, Syrjala KL. Health-Related Quality of Life in Young Adult Survivors of Hematopoietic Cell Transplantation. Transplant Cell Ther 2022; 28:701.e1-701.e7. [PMID: 35872304 PMCID: PMC9547939 DOI: 10.1016/j.jtct.2022.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/06/2022] [Accepted: 07/16/2022] [Indexed: 11/17/2022]
Abstract
Young adults (YA), age 18 to 39 years, are at a stage of life that may make them more vulnerable than older adults to impairments in health-related quality of life (HRQOL) during and after hematopoietic cell transplantation (HCT). Health self-efficacy (HSE), the belief that one can implement strategies to produce a desired health outcome, has been associated with health outcomes in oncology research. Little is known about HRQOL or HSE in YA HCT survivors compared with older HCT survivors. Given the age-specific psychosocial challenges facing YA HCT recipients and research on non-transplant YA cancer survivors, we hypothesized that YA survivors would have worse post-HCT HRQOL compared with older adults, and that among YA HCT survivors, higher levels of HSE would be associated with higher levels of HRQOL and lower levels of cancer-related distress. This was a cross-sectional secondary analysis of 2 combined baseline datasets from multicenter studies of HCT survivors approached for participation in clinical trials of survivorship interventions. Participants from 20 transplantation centers in the United States were at 1 to 10 years post-HCT and age ≥18 years at the time of study enrollment, had no evidence of disease relapse/progression or subsequent malignancies, and could read English adequately to consent for and complete assessments. Medical record and patient-reported data were obtained for demographics and HCT-related clinical factors and complications (eg, total body irradiation, chronic graft-versus-host disease [cGVHD]). Participants completed surveys on HRQOL, including the Short-Form [SF]-12, HSE, and Cancer and Treatment Distress (CTXD), which includes 6 subscales and reports an overall mean score. On the SF-12, both the Mental Component Score (MCS) and Physical Component Score (PCS) were calculated. Two cohorts were compared: YAs (age 18 to 39 years at transplantation) and older adults (age ≥40 years at transplantation). Multiple linear regression analyses identified factors associated with HSE, PCS, MCS, and CTXD in YAs. In this analysis of 979 survivors, compared with the older adults, the YA participants had lower median mental health scores (SF-12 MCS: 48.40 versus 50.23; P = .04) and higher cancer-related distress (CTXD: .96 versus .85; P = .04), but better physical health (SF-12 PCS: 48.99 versus 47.18; P = .049). Greater overall cancer-related distress was driven by higher levels of uncertainty, financial concern, and medical demand subscales for YAs compared with older adults. Young adults also had lower HSE (2.93 versus 3.08; P = .0004). In a multivariate model, HSE was strongly associated with age group (P = .0005) after adjusting for multiple other transplantation-related factors. Among YAs, HSE was associated with the SF-12 MCS and PCS and the CTXD, and HSE remained significant after adjusting for other transplantation-related factors. Overall, the YA HCT survivors had lower mental health, increased cancer-related distress, and lower levels of HSE compared with the older adults. Although the direction of these effects cannot be determined with these data, the strong association between HSE and HRQOL among YAs suggests that targeting interventions to improve HSE may have broad impact on health outcomes.
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Affiliation(s)
- Seth J Rotz
- Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Pediatric Institute, Cleveland Clinic Foundation, Cleveland, Ohio; Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
| | - Jean C Yi
- Fred Hutchinson Cancer Center, University of Washington School of Medicine, Seattle, Washington
| | - Betty K Hamilton
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Wei Wei
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Jaime M Preussler
- National Marrow Donor Program/Be The Match; Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | - Jan Cerny
- University of Massachusetts, Chan Medical School, Department of Medicine, Div. of Hematology/Oncology, Worcester, Massachusetts
| | - Abhinav Deol
- Wayne State University, Karmanos Cancer Institute, Detroit, Michigan
| | - Heather Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | | | - Theresa Hahn
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Shahrukh K Hashmi
- Department of Medicine, SSMC, Abu Dhabi, UAE, Division of Hematology, Department of Medicine, Mayo Clinic, Minnesota
| | - Shernan Holtan
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota
| | | | - Alison W Loren
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph McGuirk
- Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Cancer Center, Westwood, Kansas
| | - Jana Reynolds
- Blood & Marrow Transplant, Baylor University Medical Center, Dallas, Texas
| | - Wael Saber
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Bipin N Savani
- Division of Hematology/ Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Patrick Stiff
- Loyola University Stritch School of Medicine, Maywood, Illinois
| | - Joseph Uberti
- Wayne State University, Karmanos Cancer Institute, Detroit, Michigan
| | | | - William A Wood
- Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - K Scott Baker
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Navneet S Majhail
- Sarah Cannon Transplant and Cellular Therapy Network, Nashville, Tennessee
| | - Karen L Syrjala
- Fred Hutchinson Cancer Center, University of Washington School of Medicine, Seattle, Washington
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16
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Cerny J, Soukup J, Cerna S, Novotny T. Current Approaches to Osteoid Osteoma and Minimally Invasive Surgery-A Minireview and a Case Report. J Clin Med 2022; 11:jcm11195806. [PMID: 36233673 PMCID: PMC9572602 DOI: 10.3390/jcm11195806] [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: 06/21/2022] [Revised: 09/09/2022] [Accepted: 09/27/2022] [Indexed: 11/21/2022] Open
Abstract
Osteoid osteoma is a benign bone tumor typically affecting the long bones of the lower limbs in young male patients. The lesion can be asymptomatic but, in most cases, patients present with characteristic nocturnal pain that is very responsive to the administration of non-steroidal anti-inflammatory drugs. Although osteoid osteomas can regress spontaneously over time, surgical therapy is often indicated in cases of long-lasting resistant pain. Apart from a traditional open resection, the modalities of minimally invasive surgery, such as radiofrequency ablation or cryoablation, have gradually become the option of choice in most cases. The first part of this manuscript is a minireview of the contemporary literature on the pathogenesis, diagnosis, and current trends in the treatment of osteoid osteoma. The second part is a case report of our own experience with a conventional C-arm-guided radiofrequency ablation of an osteoid osteoma located in the femoral neck in an adolescent patient. The aim was to prove that, even when more sophisticated guiding devices (CT, O-arm, etc.) are not available, the safe and reliable ablation of the lesion using a C-arm is still possible even in hard-to-reach areas. The case was a success, with no perioperative or postoperative complications.
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Affiliation(s)
- Jan Cerny
- Department of Orthopaedics, University J.E. Purkinje and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic
| | - Jan Soukup
- Department of Orthopaedics, University J.E. Purkinje and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, 150 06 Prague, Czech Republic
| | - Sarka Cerna
- Department of Genetics, University J.E. Purkinje and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic
| | - Tomas Novotny
- Department of Orthopaedics, University J.E. Purkinje and Masaryk Hospital, 401 13 Usti nad Labem, Czech Republic
- Correspondence: ; Tel.: +420-4-7711-3050
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17
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Roubicek T, Hodbodova M, Pidhorodecky J, Bitmanova B, Cerny J, Morava J, Jurak P, Polasek R. Evaluation of left ventricular dyssynchrony by ultra-high-frequency ECG in patients with non-LBBB conduction disorder treated with cardiac resynchronization therapy. Europace 2022. [DOI: 10.1093/europace/euac053.480] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
LBBB is a reliable left ventricular (LV) electrical dyssynchrony indicator. Patients with RBBB/IVCD are a heterogeneous group, where even with "larger" QRS complex expansion, LV dyssynchrony may not be present. Ultra-high-frequency (UHF) 14-lead ECG is a non-invasive method based on signal averaging that allows better assessment of local electrical activation of the ventricles than standard ECG. Our study aims to test the hypothesis of the usefulness of UHF ECG to select non-LBBB patients for cardiac resynchronization therapy (CRT) based on evidence of electrical dyssynchrony.
Methods
Using UHF ECG we analysed patients who underwent CRT implantation. The groups of patients with RBBB, IVCD, and LBBB were compared and the presence of electrical dyssynchrony (e-DYS) as a parameter of global ventricular activation, and delayed activation of the left ventricular lateral wall (LVLWd) as a marker of LV intravenricular dyssynchrony was assessed.
Results
UHF ECG was recorded in 49 patients treated with CRT. IVCD patients had lower e-DYS compared to LBBB patients (26±17 ms vs. 86±20 ms; p<0.0001) and lower LVLWd (26±16 ms vs. 83±22 ms; p<0.0001). In RBBB patients, e-DYS was -52±22 ms, corresponding to right ventricular delay. Delayed left ventricular free wall activation ("RBBB masking LBBB" activation pattern) was not found in any RBBB patient.
Conclusion
UHF ECG appears to be a promising tool to detect LV electrical dyssynchrony in non-LBBB candidates for cardiac resynchronization therapy. Delayed left ventricular free wall activation was not found in any RBBB patient. Our findings are consistent with the lack of effect of CRT in this group of patients.
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Affiliation(s)
- T Roubicek
- Regional Hospital Liberec, Cardiology, Liberec, Czechia
| | - M Hodbodova
- Regional Hospital Liberec, Cardiology, Liberec, Czechia
| | | | - B Bitmanova
- Regional Hospital Liberec, Cardiology, Liberec, Czechia
| | - J Cerny
- Regional Hospital Liberec, Cardiology, Liberec, Czechia
| | - J Morava
- Regional Hospital Liberec, Cardiology, Liberec, Czechia
| | - P Jurak
- Czech Academy of Sciences, Institute of Scientific Instruments, Brno, Czechia
| | - R Polasek
- Regional Hospital Liberec, Cardiology, Liberec, Czechia
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18
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Mei M, Pillai R, Kim S, Estrada-Merly N, Afkhami M, Yang L, Meng Z, Abid MB, Aljurf M, Bacher U, Beitinjaneh A, Bredeson C, Cahn JY, Cerny J, Copelan E, Cutler C, DeFilipp Z, Perez MAD, Farhadfar N, Freytes CO, Gadalla SM, Ganguly S, Gale RP, Gergis U, Grunwald MR, Hamilton BK, Hashmi S, Hildebrandt GC, Lazarus HM, Litzow M, Munker R, Murthy HS, Nathan S, Nishihori T, Patel SS, Rizzieri D, Seo S, Shah MV, Solh M, Verdonck LF, Vij R, Sobecks RM, Oran B, Scott BL, Saber W, Nakamura R. The mutational landscape in chronic myelomonocytic leukemia and its impact on allogeneic hematopoietic cell transplantation outcomes: a Center for Blood and Marrow Transplantation Research (CIBMTR) analysis. Haematologica 2022; 108:150-160. [PMID: 35443559 PMCID: PMC9827167 DOI: 10.3324/haematol.2021.280203] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 11/25/2021] [Indexed: 02/05/2023] Open
Abstract
Somatic mutations are recognized as an important prognostic factor in chronic myelomonocytic leukemia (CMML). However, limited data are available regarding their impact on outcomes after allogeneic hematopoietic cell transplantation (HCT). In this registry analysis conducted in collaboration with the Center for International Blood and Marrow Transplantation Registry database/sample repository, we identified 313 adult patients with CMML (median age: 64 years, range, 28- 77) who underwent allogeneic HCT during 2001-2017 and had an available biospecimen in the form of a peripheral blood sample obtained prior to the start of conditioning. In multivariate analysis, a CMML-specific prognostic scoring system (CPSS) score of intermediate-2 (HR=1.46, P=0.049) or high (HR=3.22, P=0.0004) correlated significantly with overall survival. When the molecularly informed CPSS-Mol prognostic model was applied, a high CPSS-Mol score (HR=2 P=0.0079) correlated significantly with overall survival. The most common somatic mutations were in ASXL1 (62%), TET2 (35%), KRAS/NRAS (33% combined), and SRSF2 (31%). DNMT3A and TP53 mutations were associated with decreased overall survival (HR=1.70 [95% CI: 1.11-2.60], P=0.0147 and HR=2.72 [95% CI: 1.37-5.39], P=0.0042, respectively) while DNMT3A, JAK2, and TP53 mutations were associated with decreased disease-free survival (HR=1.66 [95% CI: 1.11-2.49], P=0.0138, HR=1.79 [95% CI: 1.06-3.03], P=0.0293, and HR=2.94 [95% CI: 1.50-5.79], P=0.0018, respectively). The only mutation associated with increased relapse was TP53 (HR=2.94, P=0.0201). Nonetheless, the impact of TP53 mutations specifically should be interpreted cautiously given their rarity in CMML. We calculated the goodness of fit measured by Harrell's C-index for both the CPSS and CPSS-Mol, which were very similar. In summary, via registry data we have determined the mutational landscape in patients with CMML who underwent allogeneic HCT, and demonstrated an association between CPSS-Mol and transplant outcomes although without major improvement in the risk prediction beyond that provided by the CPSS.
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Affiliation(s)
- Matthew Mei
- Department of Hematology/HCT, City of Hope National Medical Center, Duarte, CA, USA,*MM, RP, WS and RN contributed equally to this work
| | - Raju Pillai
- Department of Pathology, City of Hope, Duarte, CA, USA,*MM, RP, WS and RN contributed equally to this work
| | - Soyoung Kim
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA,CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Noel Estrada-Merly
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Lixin Yang
- Department of Pathology, City of Hope, Duarte, CA, USA
| | - Zhuo Meng
- Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, Fl, USA
| | - Christopher Bredeson
- The Ottawa Hospital Transplant & Cellular Therapy Program, Ottawa, Ontario, Canada
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | - Edward Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Corey Cutler
- Stem Cell Transplantation and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Zachariah DeFilipp
- Hematopoietic Cell Transplant and Cellular Therapy Program, Massachusetts General Hospital, Boston, MA, USA
| | - Miguel Angel Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL, USA
| | - César O. Freytes
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Shahinaz M. Gadalla
- Divsion of Cancer Epidemiology & Genetics, NIH-NCI Clinical Genetics Branch, Rockville, MD, USA
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS, USA
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Usama Gergis
- Department of Medical Oncology, Division of Hematological Malignancies, Thomas Jefferson University, Philadelphia, PA USA
| | - Michael R. Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Betty K. Hamilton
- Blood & Marrow Transplant Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA,Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | - Hillard M. Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, MN, USA
| | - Reinhold Munker
- Markey Cancer Center, University of Kentucky, Lexington, K Y, USA
| | - Hemant S. Murthy
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Sagar S. Patel
- Blood and Marrow Transplant Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | | | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | | | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA
| | - Leo F. Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands
| | - Ravi Vij
- Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Betul Oran
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Bart L. Scott
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Wael Saber
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA,*MM, RP, WS and RN contributed equally to this work
| | - Ryotaro Nakamura
- Department of Hematology/HCT, City of Hope National Medical Center, Duarte, CA, USA,*MM, RP, WS and RN contributed equally to this work
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19
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Guru Murthy GS, Kim S, Hu ZH, Estrada-Merly N, Abid MB, Aljurf M, Bacher U, Badawy SM, Beitinjaneh A, Bredeson C, Cahn JY, Cerny J, Diaz Perez MA, Farhadfar N, Gale RP, Ganguly S, Gergis U, Hildebrandt GC, Grunwald MR, Hashmi S, Hossain NM, Kalaycio M, Kamble RT, Kharfan-Dabaja MA, Hamilton BK, Lazarus HM, Liesveld J, Litzow M, Marks DI, Murthy HS, Nathan S, Nazha A, Nishihori T, Patel SS, Pawarode A, Rizzieri D, Savani B, Seo S, Solh M, Ustun C, van der Poel M, Verdonck LF, Vij R, Wirk B, Oran B, Nakamura R, Scott B, Saber W. Relapse and Disease-Free Survival in Patients With Myelodysplastic Syndrome Undergoing Allogeneic Hematopoietic Cell Transplantation Using Older Matched Sibling Donors vs Younger Matched Unrelated Donors. JAMA Oncol 2022; 8:404-411. [PMID: 35024768 PMCID: PMC8759031 DOI: 10.1001/jamaoncol.2021.6846] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
IMPORTANCE Matched sibling donors (MSDs) are preferred for allogeneic hematopoietic cell transplantation (allo-HCT) in myelodysplastic syndrome even if they are older. However, whether older MSDs or younger human leukocyte antigen-matched unrelated donors (MUDs) are associated with better outcomes remains unclear. OBJECTIVE To investigate whether allo-HCT for myelodysplastic syndrome using younger MUDs would be associated with improved disease-free survival and less relapse compared with older MSDs. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study assessed data reported to the Center for International Blood and Marrow Transplant Research database from 1761 adults 50 years or older with myelodysplastic syndrome who underwent allo-HCT using an older MSD or younger MUD between January 1, 2011, and December 31, 2017, with a median follow-up of 48 months. Data analysis was performed from January 8, 2019, to December 30, 2020. INTERVENTIONS/EXPOSURES Allo-HCT from an older MSD (donor age ≥50 years) or a younger MUD (donor age ≤35 years). MAIN OUTCOMES AND MEASURES The primary outcome was disease-free survival. Secondary outcomes were overall survival, relapse, nonrelapse mortality, acute graft-vs-host disease (GVHD), chronic GVHD, and GVHD-free relapse-free survival. RESULTS Of 1761 patients (1162 [66%] male; median [range] age, 64.9 [50.2-77.6] years in the MSD cohort and 66.5 [50.4-80.9] years in MUD cohort), 646 underwent allo-HCT with an older MSD and 1115 with a younger MUD. In multivariable analysis, the rate of disease-free survival was significantly lower in allo-HCTs with older MSDs compared with younger MUDs (hazard ratio [HR], 1.17; 95% CI, 1.02-1.34; P = .02), whereas the difference in overall survival rate of allo-HCT with younger MUDs vs older MSDs was not statistically significant (HR, 1.13; 95% CI, 0.98-1.29; P = .07). Allo-HCT with older MSDs was associated with significantly higher relapse (HR, 1.62; 95% CI, 1.32-1.97; P < .001), lower nonrelapse mortality (HR, 0.76; 95% CI, 0.59-0.96; P = .02), lower acute GVHD (HR, 0.52; 95% CI, 0.42-0.65; P < .001), chronic GVHD (HR, 0.77; 95% CI, 0.64-0.92; P = .005), and a lower rate of GVHD-free relapse-free survival beyond 12 months after allo-HCT (HR, 1.42; 95% CI, 1.02-1.98; P = .04). CONCLUSIONS AND RELEVANCE This cohort study found higher disease-free survival and lower relapse for allo-HCT in myelodysplastic syndrome using younger MUDs compared with older MSDs. The risk of nonrelapse mortality and GVHD was lower with older MSDs. These results suggest that the use of younger MUDs should be considered in the donor selection algorithm for myelodysplastic syndrome, in which it is pivotal to minimize relapse given limited treatment options for managing relapsed disease.
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Affiliation(s)
| | - Soyoung Kim
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee,Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee
| | - Zhen-Huan Hu
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee
| | - Noel Estrada-Merly
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee
| | - Muhammad Bilal Abid
- Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee,Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh, Saudi Arabia
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sherif M. Badawy
- Division of Hematology, Oncology, and Stem Cell Transplant, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
| | - Chris Bredeson
- Ottawa Hospital Transplant and Cellular Therapy Program, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Jan Cerny
- Division of Hematology-Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester
| | - Miguel Angel Diaz Perez
- Department of Hematology and Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - Nosha Farhadfar
- Division of Hematology and Oncology, University of Florida College of Medicine, Gainesville
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City
| | - Usama Gergis
- Division of Hematological Malignancies, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Michael R. Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota,Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Nasheed M. Hossain
- Division of Hematology and Oncology, Stem Cell Transplant Program, Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois
| | - Matt Kalaycio
- Blood and Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Rammurti T. Kamble
- Divsion of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Mohamed A. Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida
| | - Betty Ky Hamilton
- Blood and Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Hillard M. Lazarus
- Department of Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Jane Liesveld
- Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, Minnesota
| | - David I. Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol National Health Service Trust, Bristol, UK
| | - Hemant S. Murthy
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida
| | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, Illinois
| | - Aziz Nazha
- Cleveland Clinic Foundation, Cleveland, Ohio
| | - Taiga Nishihori
- Department of Blood and Marrow Transplant and Cellular Immunotherapy Moffitt Cancer Center, Tampa, Florida
| | - Sagar S. Patel
- Blood and Marrow Transplant Program, Huntsman Cancer Institute, University of Utah, Salt Lake City
| | - Attaphol Pawarode
- Blood and Marrow Transplantation Program, Division of Hematology and Oncology, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor
| | - David Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Bipin Savani
- Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Melhem Solh
- Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta
| | - Celalettin Ustun
- Division of Hematology, Oncology, and Cell Therapy, Rush University, Chicago, Illinois
| | | | - Leo F. Verdonck
- Department of Hematology and Oncology, Isala Clinic, Zwolle, the Netherlands
| | - Ravi Vij
- Division of Hematology and Oncology, Washington University School of Medicine, St Louis, Missouri
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, Pennsylvania
| | - Betul Oran
- Division of Cancer Medicine, Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston
| | - Ryotaro Nakamura
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Bart Scott
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Wael Saber
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee
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20
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Zou J, Wang T, He M, Bolon YT, Gadalla SM, Marsh SG, Kuxhausen M, Gale RP, Sharma A, Assal A, Prestidge T, Aljurf M, Cerny J, Paczesny S, Spellman SR, Lee SJ, Ciurea SO. Number of HLA-Mismatched Eplets Is Not Associated with Major Outcomes in Haploidentical Transplantation with Post-Transplantation Cyclophosphamide: A Center for International Blood and Marrow Transplant Research Study. Transplant Cell Ther 2022; 28:107.e1-107.e8. [PMID: 34774819 PMCID: PMC8848305 DOI: 10.1016/j.jtct.2021.11.001] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/15/2021] [Accepted: 11/03/2021] [Indexed: 02/03/2023]
Abstract
The number of haploidentical hematopoietic stem cell transplantations (haplo-HSCT) performed has increased substantially in recent years. Previous single-center studies using in silico algorithms to quantitively measure HLA disparity have shown an association of the number of HLA molecular mismatches with relapse protection and/or increased risk of acute graft-versus-host disease (GVHD) in haplo-HSCT. However, inconsistent results from small studies have made it difficult to understand the full clinical impact of molecular mismatch in haplo-HSCT. In this study, we investigated the potential of the HLA class I and II mismatched eplet (ME) score measured by HLAMatchmaker, as well as ME load at a specific locus to predict outcomes in a registry-based cohort of haplo-HSCT recipients. We analyzed data from 1287 patients who underwent their first haplo-HSCT for acute lymphoblastic leukemia, acute myelogenous leukemia, or myelodysplastic syndrome between 2013 and 2017, as entered in the Center for International Blood and Marrow Transplant Research database. ME load at each HLA locus and total class I and II were scored using the HLAMatchmaker module incorporated in HLA Fusion software v4.3, which identifies predicted eplets based on the crystalized HLA molecule models and identifies ME by comparing donor and recipient eplets. In the study cohort, ME scores derived from total HLA class I or class II loci or individual HLA loci were not associated with overall survival, disease-free survival, nonrelapse mortality, relapse, acute GVHD, or chronic GVHD (P < .01). An unexpected strong association was identified between total class II ME load in the GVH direction and slower neutrophil engraftment (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.75 to 0.91; P < .0001) and platelet engraftment (HR, 0.80; 95% CI, 0.72 to 0.88; P < .0001). This was likely attributable to ME load at the HLA-DRB1 locus, which was similarly associated with slower neutrophil engraftment (HR, 0.82; 95% CI, 0.73 to 0.92; P = .001) and slower platelet engraftment (HR, 0.76; 95% CI, 0.70 to 0.84; P < .0001). Additional analyses suggested that this effect is attributable to a match versus a mismatch in the graft-versus-host direction and not to ME load, as a dose effect was not identified. These findings contradict those of previous relatively small studies reporting an association between ME load, as quantified by HLAMatchmaker, and haplo-HSCT outcomes. This study failed to demonstrate the predictive value of ME from HLA molecules for major clinical outcomes, and other molecular mismatch algorithms in haplo-HSCT settings should be tested.
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Affiliation(s)
- Jun Zou
- Division of Pathology/Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA,Correspondence and reprint requests: Jun Zou, MD, Department of Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX 77030 (J. Zou)
| | - Tao Wang
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA,Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Meilun He
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota, USA
| | - Yung-Tsi Bolon
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota, USA
| | - Shahinaz M. Gadalla
- Division of Cancer Epidemiology & Genetics, NIH-NCI Clinical Genetics Branch, Rockville, Maryland, USA
| | - Steven G.E. Marsh
- Anthony Nolan Research Institute, London, United Kingdom,University College London Cancer Institute, University College London, London, United Kingdom
| | - Michelle Kuxhausen
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota, USA
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Amer Assal
- Columbia University Irving Medical Center, Department of Medicine, Bone Marrow Transplant and Cell Therapy Program, New York, USA
| | - Tim Prestidge
- Blood and Cancer Centre, Starship Children’s Hospital, Auckland, New Zealand
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts, USA
| | - Sophie Paczesny
- Medical University of South Carolina, Department of Microbiology and Immunology, Charleston, South Carolina, USA
| | - Stephen R. Spellman
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota, USA
| | - Stephanie J. Lee
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Stefan O. Ciurea
- Hematopoietic Stem Cell Transplantation and Cellular Therapy Program, University of California, Irvine, Orange, California, USA
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21
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Murthy HS, Ahn KW, Estrada-Merly N, Alkhateeb HB, Bal S, Kharfan-Dabaja MA, Dholaria B, Foss F, Gowda L, Jagadeesh D, Sauter C, Abid MB, Aljurf M, Awan FT, Bacher U, Badawy SM, Battiwalla M, Bredeson C, Cerny J, Chhabra S, Deol A, Diaz MA, Farhadfar N, Freytes C, Gajewski J, Gandhi MJ, Ganguly S, Grunwald MR, Halter J, Hashmi S, Hildebrandt GC, Inamoto Y, Jimenez-Jimenez AM, Kalaycio M, Kamble R, Krem MM, Lazarus HM, Lazaryan A, Maakaron J, Munshi PN, Munker R, Nazha A, Nishihori T, OIuwole OO, Ortí G, Pan DC, Patel SS, Pawarode A, Rizzieri D, Saba NS, Savani B, Seo S, Ustun C, van der Poel M, Verdonck LF, Wagner JL, Wirk B, Oran B, Nakamura R, Scott B, Saber W. Outcomes of Allogeneic Hematopoietic Cell Transplantation in T-cell Prolymphocytic Leukemia: A Contemporary Analysis from the Center for International Blood and Marrow Transplant Research. Transplant Cell Ther 2022; 28:187.e1-187.e10. [PMID: 35081472 PMCID: PMC8977261 DOI: 10.1016/j.jtct.2022.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
T cell prolymphocytic leukemia (T-PLL) is a rare, aggressive malignancy with limited treatment options and poor long-term survival. Previous studies of allogeneic hematopoietic cell transplantation (alloHCT) for T-PLL are limited by small numbers, and descriptions of patient and transplantation characteristics and outcomes after alloHCT are sparse. In this study, we evaluated outcomes of alloHCT in patients with T-PLL and attempted to identify predictors of post-transplantation relapse and survival. We conducted an analysis of data using the Center for International Blood and Marrow Transplant Research database on 266 patients with T-PLL who underwent alloHCT between 2008 and 2018. The 4-year rates of overall survival (OS), disease-free survival (DFS), relapse, and treatment-related mortality (TRM) were 30.0% (95% confidence interval [CI], 23.8% to 36.5%), 25.7% (95% CI, 20% to 32%), 41.9% (95% CI, 35.5% to 48.4%), and 32.4% (95% CI, 26.4% to 38.6%), respectively. In multivariable analyses, 3 variables were associated with inferior OS: receipt of a myeloablative conditioning (MAC) regimen (hazard ratio [HR], 2.18; P < .0001), age >60 years (HR, 1.61; P = .0053), and suboptimal performance status, defined by Karnofsky Performance Status (KPS) <90 (HR, 1.53; P = .0073). Receipt of an MAC regimen also was associated with increased TRM (HR, 3.31; P < .0001), an elevated cumulative incidence of grade II-IV acute graft-versus-host disease (HR, 2.94; P = .0011), and inferior DFS (HR, 1.86; P = .0004). Conditioning intensity was not associated with relapse; however, stable disease/progression was correlated with increased risk of relapse (HR, 2.13; P = .0072). Both in vivo T cell depletion (TCD) as part of conditioning and KPS <90 were associated with worse TRM and inferior DFS. Receipt of total body irradiation had no significant effect on OS, DFS, or TRM. Our data show that reduced-intensity conditioning without in vivo TCD (ie, without antithymocyte globulin or alemtuzumab) before alloHCT was associated with long-term DFS in patients with T-PLL who were age ≤60 years or who had a KPS >90 or chemosensitive disease.
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22
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Cerny J, Soukup J, Novotny T. A Successful Case of TKA With Complex Deformity And Retained Hardware Using Computer Navigation. Arthroplast Today 2021; 13:29-34. [PMID: 34917718 PMCID: PMC8666612 DOI: 10.1016/j.artd.2021.11.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 11/26/2022] Open
Abstract
We present a case report of a 60-year-old Caucasian female patient, who had undergone a series of procedures for a periprosthetic (after total hip arthroplasty) Vancouver C type diaphyseal fracture of the right femur (reverse distal femoral locking compression plate [LCP] osteosynthesis, then a corrective osteotomy with another distal femoral LCP osteosynthesis). Subsequently, she developed high-grade osteoarthrosis of the right knee, indicated for a total knee arthroplasty. Considering the extent of previous procedures, which had significantly compromised the bone quality of the femur and therefore increased the risk of a refracture after an eventual hardware removal, we decided to retain the LCP plate. We concluded that the optimal solution would be the use of a computer-navigated total knee arthroplasty. This procedure obviated the need for intramedullary guiding, while ensuring optimal joint alignment. No postoperative complications emerged.
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Affiliation(s)
| | | | - Tomas Novotny
- Corresponding author. Department of Orthopaedics, University J.E. Purkinje, Masaryk Hospital, Usti nad Labem, 40113, Czech Republic. Tel: +420477113060.
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23
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Borogovac A, Sahu KK, Vishwanathan GK, Miron PM, Cerny J. A Case of Acute Myeloid Leukemia Harboring a Rare Three-Way Translocation t(5;7;7) Involving the PDGFRB Gene and Successfully Treated with Imatinib. Cancer Manag Res 2021; 13:8841-8847. [PMID: 34858057 PMCID: PMC8629764 DOI: 10.2147/cmar.s324718] [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: 08/25/2021] [Accepted: 10/22/2021] [Indexed: 11/23/2022] Open
Abstract
Platelet-derived growth factor-beta (PDGFRB) gene maps for the receptor tyrosine kinase PDGRFβ. PDGFRB gene fusions have been implicated in multiple myeloid and lymphoid neoplasms and have shown exquisite sensitivity to tyrosine kinase inhibitors. We report a case of a 29-year-old male who presented with acute myeloid leukemia who was eventually found to harbor a unique three-way translocation t(5;7;7)(q33.2;q32;q11.2) involving the PDGFRB gene. The patient initially achieved a complete response after induction with daunorubicin and cytarabine, but when he returned for consolidation, his white cell count had increased, and he was found to have an underlying myeloproliferative neoplasm. He was given consolidation with high-dose cytarabine and imatinib with excellent response, and ultimately received a matched unrelated donor transplant. The patient remains in remission to this day more than eight years later.
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Affiliation(s)
- Azra Borogovac
- Hematology-Oncology Section, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Kamal Kant Sahu
- Division of Hematology and Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | | | - Patricia Minehart Miron
- Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester, MA, USA
| | - Jan Cerny
- Division of Hematology and Oncology, Department of Medicine, University of Massachusetts Memorial Medical Center, Worcester, MA, USA
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24
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Soukup J, Cerny J, Cegan M, Kelbich P, Novotny T. Toxocariasis as a Rare Parasitic Complication of a Transthoracic Spine Surgery Procedure. Medicina (B Aires) 2021; 57:medicina57121328. [PMID: 34946273 PMCID: PMC8709433 DOI: 10.3390/medicina57121328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/31/2021] [Revised: 11/27/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
Human toxocariasis is a helminthozoonosis caused by the migration of Toxocara species larvae through an organism. The infection in humans is transmitted either by direct ingestion of the eggs of the parasite, or by consuming undercooked meat infested with Toxocara larvae. This parasitosis can be found worldwide, but there are significant differences in seroprevalence in different areas, depending mainly on hot climate conditions and on low social status. However, the literature estimates of seroprevalence are inconsistent. Infected patients commonly present a range of symptoms, e.g., abdominal pain, decreased appetite, restlessness, fever, and coughing. This manuscript presents a case report of a polytraumatic patient who underwent a two-phase spinal procedure for a thoracolumbar fracture. After the second procedure, which was a vertebral body replacement via thoracotomy, the patient developed a pathologic pleural effusion. A microscopic cytology examination of this effusion revealed the presence of Toxocara species larvae. Although the patient presented no specific clinical symptoms, and the serological exams (Enzyme–linked immunosorbent assay (ELISA), Western blot) were negative, the microscopic evaluation enabled a timely diagnosis. The patient was successfully treated with albendazole, with no permanent sequelae of the infection.
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Affiliation(s)
- Jan Soukup
- Department of Orthopaedics, University J.E. Purkinje, 401 13 Usti nad Labem, Czech Republic; (J.S.); (J.C.)
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, University Hospital Motol, Charles University, 150 06 Prague, Czech Republic
| | - Jan Cerny
- Department of Orthopaedics, University J.E. Purkinje, 401 13 Usti nad Labem, Czech Republic; (J.S.); (J.C.)
| | - Martin Cegan
- Department of Pathology, Masaryk Hospital Usti nad Labem, 401 13 Usti nad Labem, Czech Republic;
| | - Petr Kelbich
- Department of Biomedicine and Laboratory Diagnostics, Masaryk Hospital, University J.E. Purkinje, 401 13 Usti nad Labem, Czech Republic;
- Department of Clinical Immunology and Allergology, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University in Prague, 500 03 Hradec Kralove, Czech Republic
- Laboratory for Cerebrospinal Fluid, Neuroimmunology, Pathology and Special Diagnostics Topelex, 190 00 Prague, Czech Republic
| | - Tomas Novotny
- Department of Orthopaedics, University J.E. Purkinje, 401 13 Usti nad Labem, Czech Republic; (J.S.); (J.C.)
- Correspondence: ; Tel.: +420-477-113-050
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Metheny L, Callander NS, Hall AC, Zhang MJ, Bo-Subait K, Wang HL, Agrawal V, Al-Homsi AS, Assal A, Bacher U, Beitinjaneh A, Bejanyan N, Bhatt VR, Bredeson C, Byrne M, Cairo M, Cerny J, DeFilipp Z, Perez MAD, Freytes CO, Ganguly S, Grunwald MR, Hashmi S, Hildebrandt GC, Inamoto Y, Kanakry CG, Kharfan-Dabaja MA, Lazarus HM, Lee JW, Nathan S, Nishihori T, Olsson RF, Ringdén O, Rizzieri D, Savani BN, Savoie ML, Seo S, van der Poel M, Verdonck LF, Wagner JL, Yared JA, Hourigan CS, Kebriaei P, Litzow M, Sandmaier BM, Saber W, Weisdorf D, de Lima M. Allogeneic Transplantation to Treat Therapy-Related Myelodysplastic Syndrome and Acute Myelogenous Leukemia in Adults. Transplant Cell Ther 2021; 27:923.e1-923.e12. [PMID: 34428556 PMCID: PMC9064046 DOI: 10.1016/j.jtct.2021.08.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 01/22/2023]
Abstract
Patients who develop therapy-related myeloid neoplasm, either myelodysplastic syndrome (t-MDS) or acute myelogenous leukemia (t-AML), have a poor prognosis. An earlier Center for International Blood and Marrow Transplant Research (CIBMTR) analysis of 868 allogeneic hematopoietic cell transplantations (allo-HCTs) performed between 1990 and 2004 showed a 5-year overall survival (OS) and disease-free survival (DFS) of 22% and 21%, respectively. Modern supportive care, graft-versus-host disease prophylaxis, and reduced-intensity conditioning (RIC) regimens have led to improved outcomes. Therefore, the CIBMTR analyzed 1531 allo-HCTs performed in adults with t-MDS (n = 759) or t-AML (n = 772) between and 2000 and 2014. The median age was 59 years (range, 18 to 74 years) for the patients with t-MDS and 52 years (range, 18 to 77 years) for those with t-AML. Twenty-four percent of patients with t-MDS and 11% of those with t-AML had undergone a previous autologous (auto-) HCT. A myeloablative conditioning (MAC) regimen was used in 49% of patients with t-MDS and 61% of patients with t-AML. Nonrelapse mortality at 5 years was 34% (95% confidence interval [CI], 30% to 37%) for patients with t-MDS and 34% (95% CI, 30% to 37%) for those with t-AML. Relapse rates at 5 years in the 2 groups were 46% (95% CI, 43% to 50%) and 43% (95% CI, 40% to 47%). Five-year OS and DFS were 27% (95% CI, 23% to 31%) and 19% (95% CI, 16% to 23%), respectively, for patients with t-MDS and 25% (95% CI, 22% to 28%) and 23% (95% CI, 20% to 26%), respectively, for those with t-AML. In multivariate analysis, OS and DFS were significantly better in young patients with low-risk t-MDS and those with t-AML undergoing HCT with MAC while in first complete remission, but worse for those with previous auto-HCT, higher-risk cytogenetics or Revised International Prognostic Scoring System score, and a partially matched unrelated donor. Relapse remains the major cause of treatment failure, with little improvement seen over the past 2 decades. These data mandate caution when recommending allo-HCT in these conditions and indicate the need for more effective antineoplastic approaches before and after allo-HCT.
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Affiliation(s)
- Leland Metheny
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
| | | | - Aric C Hall
- University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | - Mei-Jei Zhang
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Khalid Bo-Subait
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Hai-Lin Wang
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Vaibhav Agrawal
- Division of Blood and Marrow Transplantation, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | | | - Amer Assal
- Columbia University Irving Medical Center, Department of Medicine, Bone Marrow Transplant and Cell Therapy Program, New York, New York
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
| | - Nelli Bejanyan
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Minneapolis, Minnesota
| | - Vijaya Raj Bhatt
- The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska
| | - Chris Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Michael Byrne
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mitchell Cairo
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, Valhalla, New York
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts
| | - Zachariah DeFilipp
- Hematopoietic Cell Transplant and Cellular Therapy Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Miguel Angel Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - César O Freytes
- University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhavi, United Arab Emirates
| | | | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Christopher G Kanakry
- Experimental Transplantation and Immunotherapy Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida
| | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Jong Wook Lee
- Division of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, Illinois
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, Florida
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Olov Ringdén
- Translational Cell Therapy Group, CLINTEC (Clinical Science, Intervention, and Technology) Karolinska Institutet, Stockholm Sweden
| | - David Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | | | - Leo F Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands
| | - John L Wagner
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Christopher S Hourigan
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Partow Kebriaei
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, Minnesota
| | - Brenda M Sandmaier
- Division of Medical Oncology, University of Washington and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Daniel Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Marcos de Lima
- Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio
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Patel SA, Lloyd MR, Cerny J, Shi Q, Simin K, Ediriwickrema A, Hutchinson L, Miron PM, Higgins AW, Ramanathan M, Gerber JM. Clinico-genomic profiling and clonal dynamic modeling of TP53-aberrant myelodysplastic syndrome and acute myeloid leukemia. Leuk Lymphoma 2021; 62:3348-3360. [PMID: 34496723 DOI: 10.1080/10428194.2021.1957869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
TP53-aberrant myelodysplastic syndrome and acute myeloid leukemia have dismal outcomes. Here, we define the clinico-genomic landscape of TP53 disruptions in 40 patients and employ clonal dynamic modeling to map the mutational hierarchy against clinical outcomes. Most TP53 mutations (45.2%) localized to the L3 loop or LSH motif of the DNA-binding domain. TP53 disruptions had high co-occurrence with mutations in epigenetic regulators, spliceosome machinery, and cohesin complex and low co-occurrence with mutations in proliferative signaling genes. Ancestral and descendant TP53 mutations constituted measurable residual disease and fueled relapse. High mutant TP53 gene dosage predicted low durability of remission. The median overall survival (OS) was 280 days. Hypomethylating agent-based therapy served as an effective bridge to transplant, leading to improved median OS compared to patients who did not receive a transplant (14.7 vs. 5.1 months). OS was independent of the genomic location of TP53 disruption, which has implications for rational therapeutic design.
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Affiliation(s)
- Shyam A Patel
- Department of Medicine-Hematology & Oncology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA
| | - Maxwell R Lloyd
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jan Cerny
- Department of Medicine-Hematology & Oncology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA
| | - Qiming Shi
- Department of Medicine-Hematology & Oncology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA.,Department of Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Karl Simin
- Department of Molecular, Cell & Cancer Biology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Asiri Ediriwickrema
- Division of Hematology, Department of Medicine, Institute for Stem Cell Biology & Regenerative Medicine, Stanford University, Stanford, CA, USA
| | - Lloyd Hutchinson
- Department of Pathology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA
| | - Patricia M Miron
- Department of Pathology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA
| | - Anne W Higgins
- Department of Pathology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA
| | - Muthalagu Ramanathan
- Department of Medicine-Hematology & Oncology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jonathan M Gerber
- Department of Medicine-Hematology & Oncology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA
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Sahu KK, E Vogt B, Shanahan L, Cerny J. A Splenic Infarction Related to Parainfluenza Infection in a Patient with AML: Lessons for COVID-19. Acta Biomed 2021; 92:e2021256. [PMID: 34487090 PMCID: PMC8477113 DOI: 10.23750/abm.v92i4.11095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/28/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Kamal Kant Sahu
- University of Massachusetts Medical School, Worcester, MA, United States.
| | - Bennett E Vogt
- Department of Internal Medicine, Umass, Worcester, Massachusetts United States of America, 01608.
| | - Lindsey Shanahan
- Department of Internal Medicine, Umass, Worcester, Massachusetts United States of America, 01608.
| | - Jan Cerny
- Department of Internal Medicine, Umass, Worcester, Massachusetts United States of America, 01608.
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28
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Oran B, Ahn KW, Fretham C, Beitinjaneh A, Bashey A, Pawarode A, Wirk B, Scott BL, Savani BN, Bredeson C, Weisdorf D, Marks DI, Rizzieri D, Copelan E, Hildebrandt GC, Hale GA, Murthy HS, Lazarus HM, Cerny J, Liesveld JL, Yared JA, Yves-Cahn J, Szer J, Verdonck LF, Aljurf M, van der Poel M, Litzow M, Kalaycio M, Grunwald MR, Diaz MA, Sabloff M, Kharfan-Dabaja MA, Majhail NS, Farhadfar N, Reshef R, Olsson RF, Gale RP, Nakamura R, Seo S, Chhabra S, Hashmi S, Farhan S, Ganguly S, Nathan S, Nishihori T, Jain T, Agrawal V, Bacher U, Popat U, Saber W. Fludarabine and Melphalan Compared with Reduced Doses of Busulfan and Fludarabine Improve Transplantation Outcomes in Older Patients with Myelodysplastic Syndromes. Transplant Cell Ther 2021; 27:921.e1-921.e10. [PMID: 34403791 DOI: 10.1016/j.jtct.2021.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/27/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
Reduced-intensity conditioning (RIC) regimens developed to extend the use of allogeneic hematopoietic stem cell transplantation (HSCT) to older patients have resulted in encouraging outcomes. We aimed to compare the 2 most commonly used RIC regimens, i.v. fludarabine with busulfan (FluBu) and fludarabine with melphalan (FluMel), in patients with myelodysplastic syndrome (MDS). Through the Center for International Blood and Marrow Transplant Research (CIBMTR), we identified 1045 MDS patients age ≥60 years who underwent first HSCT with a matched related or matched (8/8) unrelated donor using an RIC regimen. The CIBMTR's definition of RIC was used: a regimen that incorporated an i.v. busulfan total dose ≤7.2 mg/kg or a low-dose melphalan total dose ≤150 mg/m2. The 2 groups, recipients of FluBu (n = 697) and recipients of FluMel (n = 448), were comparable in terms of disease- and transplantation-related characteristics except for the more frequent use of antithymocyte globulin or alemtuzumab in the FluBu group (39% versus 31%). The median age was 67 years in both groups. FluMel was associated with a reduced relapse incidence (RI) compared with FluBu, with a 1-year adjusted incidence of 26% versus 44% (P ≤ .0001). Transplantation-related mortality (TRM) was higher in the FluMel group (26% versus 16%; P ≤ .0001). Because the magnitude of improvement with FluMel in RI was greater than the improvement in TRM with FluBu, disease-free survival (DFS) was better at 1 year and beyond with FluMel compared with FluBu (48% versus 40% at 1 year [P = .02] and 35% versus 27% at 3 years [P = .01]). Overall survival (OS) was comparable in the 2 groups at 1 year (63% versus 61%; P = .4) but was significantly improved with FluMel compared with FluBu at 3 years (46% versus 39%; P = .03). Our results suggest that FluMel is associated with superior DFS compared with FluBu owing to reduced RI in older patients with MDS patients. © 2021 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.
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Affiliation(s)
- Betul Oran
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Kwang Woo Ahn
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Caitrin Fretham
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
| | - Asad Bashey
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
| | - Attaphol Pawarode
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, Mchigan
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, Pennsylvania
| | - Bart L Scott
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christopher Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Daniel Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - David I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - David Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Edward Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | | | - Gregory A Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
| | - Hemant S Murthy
- Blood and Marrow Transplantation Program, Division of Hematology-Oncology, Mayo Clinic, Jacksonville, Florida
| | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts
| | - Jane L Liesveld
- Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Jean Yves-Cahn
- Department of Hematology, CHU Grenoble Alpes, Grenoble, France
| | - Jeffrey Szer
- Clinical Haematology at Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Leo F Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | | | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic, Rochester, Minnesota
| | - Matt Kalaycio
- Hematology and Medical Oncology, Transplantation Center, Cleveland Clinic, Cleveland, Ohio
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Mitchell Sabloff
- Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Mohamed A Kharfan-Dabaja
- Blood and Marrow Transplantation Program, Division of Hematology-Oncology, Mayo Clinic, Jacksonville, Florida
| | - Navneet S Majhail
- Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Ran Reshef
- Blood and Marrow Transplantation Program and Columbia Center for Translational Immunology, Columbia University Medical Center, New York, New York
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom
| | - Ryotaro Nakamura
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Saurabh Chhabra
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Shatha Farhan
- Henry Ford Hospital Bone Marrow Transplant Program, Henry Ford Health System, Detroit, Michigan
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | | | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida
| | - Tania Jain
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vaibhav Agrawal
- Division of Hematology-Oncology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Uday Popat
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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Selove W, Hutchinson L, Makarenko V, Meng X, Tomaszewicz K, Ramanathan M, Cerny J, Nath R, Chen B, Woda B, Bledsoe JR. Impact of pretransplant mutation status on survival after allogeneic stem cell transplant for acute myeloid leukemia. eJHaem 2021; 2:514-519. [PMID: 35844698 PMCID: PMC9175694 DOI: 10.1002/jha2.260] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/27/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022]
Affiliation(s)
- William Selove
- Department of Pathology UMass Memorial Medical Center University of Massachusetts Worcester Massachusetts USA
| | - Lloyd Hutchinson
- Department of Pathology UMass Memorial Medical Center University of Massachusetts Worcester Massachusetts USA
| | - Vladislav Makarenko
- Department of Pathology UMass Memorial Medical Center University of Massachusetts Worcester Massachusetts USA
| | - Xiuling Meng
- Department of Pathology UMass Memorial Medical Center University of Massachusetts Worcester Massachusetts USA
| | - Keith Tomaszewicz
- Department of Pathology UMass Memorial Medical Center University of Massachusetts Worcester Massachusetts USA
| | - Muthalagu Ramanathan
- Department of Hematology‐Oncology UMass Memorial Medical Center University of Massachusetts Worcester Massachusetts USA
| | - Jan Cerny
- Department of Hematology‐Oncology UMass Memorial Medical Center University of Massachusetts Worcester Massachusetts USA
| | - Rajneesh Nath
- Department of Hematology Medical Oncology Banner MD Anderson Cancer Center Clinic Gilbert Arizona USA
| | - Benjamin Chen
- Bristol Myers Squibb Company Cambridge Massachusetts USA
| | - Bruce Woda
- Department of Pathology UMass Memorial Medical Center University of Massachusetts Worcester Massachusetts USA
| | - Jacob R. Bledsoe
- Department of Pathology UMass Memorial Medical Center University of Massachusetts Worcester Massachusetts USA
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30
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Patel SA, Litzow MR, Cerny J. Targeted and cytotoxic therapies as maintenance treatment for non-transplant eligible patients with acute myeloid leukemia. Blood Rev 2021; 50:100863. [PMID: 34210571 DOI: 10.1016/j.blre.2021.100863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/12/2020] [Revised: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 11/17/2022]
Abstract
In the recent years, there have been multiple approvals by the Food and Drug Administration (FDA) for therapeutics for acute myeloid leukemia (AML). The role of maintenance therapy in AML has been rather unrealized mostly due to lack of efficacy and increased toxicity of classical chemotherapy agents. Many clinical trials have demonstrated a disease-free survival benefit for various therapeutics in the maintenance setting for patients with AML who are ineligible for stem cell transplant. Notably, oral hypomethylating agent therapy has recently shown an overall survival and disease-free survival benefit in the maintenance setting for AML. In this review, we summarize the relevant data on maintenance therapy with a specific focus on cytotoxic antimetabolite chemotherapeutics, hypomethylating agents, targeted agents, and immunotherapeutics. We discuss our approach to maintenance therapy in AML in 2021 and propose a measurable residual disease (MRD)-adapted, personalized approach based on the best available evidence.
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Affiliation(s)
- Shyam A Patel
- Deparment of Medicine, Division of Hematology/Oncology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA
| | - Mark R Litzow
- Division of Hematology and Transplant Center, Mayo Clinic, Rochester, MN, USA
| | - Jan Cerny
- Deparment of Medicine, Division of Hematology/Oncology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA.
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31
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Dhakal B, Patel S, Girnius S, Bachegowda L, Fraser R, Davila O, Kanate AS, Assal A, Hanbali A, Bashey A, Pawarode A, Freytes CO, Lee C, Vesole D, Cornell RF, Hildebrandt GC, Murthy HS, Lazarus HM, Cerny J, Yared JA, Schriber J, Berdeja J, Stockerl-Goldstein K, Meehan K, Holmberg L, Solh M, Diaz MA, Kharfan-Dabaja MA, Farhadfar N, Bashir Q, Munker R, Olsson RF, Gale RP, Bayer RL, Seo S, Chhabra S, Hashmi S, Badawy SM, Nishihori T, Gonsalves W, Nieto Y, Efebera Y, Kumar S, Shah N, Qazilbash M, Hari P, D'Souza A. Correction to: Hematopoietic cell transplantation utilization and outcomes for primary plasma cell leukemia in the current era. Leukemia 2021; 35:2141. [PMID: 34091601 DOI: 10.1038/s41375-021-01304-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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)
- Binod Dhakal
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sagar Patel
- Blood and Marrow Transplant Program, University of Utah, Salt Lake City, UT, USA
| | | | | | - Raphael Fraser
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Omar Davila
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Abraham S Kanate
- Osborn Hematopoietic Malignancy and Transplantation Program, West Virginia University, Morgantown, WV, USA
| | - Amer Assal
- NYPH/ Columbia University Medical Center, New York, NY, USA
| | - Amr Hanbali
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Asad Bashey
- Blood and Marrow Transplant Program at Northside Hospital, Atlanta, GA, USA
| | - Attaphol Pawarode
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Cindy Lee
- Royal Adelaide Hospital, Adelaide, SA, Australia
| | - David Vesole
- John Theurer Cancer Center at Hackensack UMC, Hackensack, NJ, USA
| | - Robert Frank Cornell
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Hemant S Murthy
- Division of Hematology Oncology, Blood and Marrow Transplantation Program, Mayo Clinic Florida, Jacksonville, FL, USA
| | | | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
| | - Jeffrey Schriber
- Cancer Transplant Institute, Virginia G. Piper Cancer Center, Scottsdale, AZ, USA.,Arizona Oncology, Scottsdale, AZ, USA
| | | | | | | | - Leona Holmberg
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology Oncology, Blood and Marrow Transplantation Program, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL, USA.,FLHospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Qaiser Bashir
- Department of Stem Cell Transplantation & Cellular Therapy, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Reinhold Munker
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Robert P Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK
| | | | - Sachiko Seo
- Department of Haematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Saurabh Chhabra
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Yago Nieto
- Department of Stem Cell Transplantation & Cellular Therapy, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yvonne Efebera
- Ohio State medical Center, James Cancer Center, Columbus, OH, USA
| | | | - Nina Shah
- Department of Stem Cell Transplantation & Cellular Therapy, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Parameswaran Hari
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Anita D'Souza
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
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Wang X, Patel SA, Haddadin M, Cerny J. Post-allogeneic hematopoietic stem cell transplantation viral reactivations and viremias: a focused review on human herpesvirus-6, BK virus and adenovirus. Ther Adv Infect Dis 2021; 8:20499361211018027. [PMID: 34104434 PMCID: PMC8155777 DOI: 10.1177/20499361211018027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/05/2021] [Accepted: 04/27/2021] [Indexed: 12/30/2022] Open
Abstract
Human cytomegalovirus and Epstein-Barr virus have been recognized as potential drivers of morbidity and mortality of patients undergoing allogeneic stem cell transplantation for years. Specific protocols for monitoring, prophylaxis and pre-emptive therapy are in place in many transplant settings. In this review, we focus on the next three most frequent viruses, human herpesvirus-6, BK virus and adenovirus, causing reactivation and/or viremia after allogeneic transplant, which are increasingly detected in patients in the post-transplant period owing to emerging techniques of molecular biology, recipients' characteristics, treatment modalities used for conditioning and factors related donors or stem cell source. Given the less frequent detection of an illness related to these viruses, there are often no specific protocols in place for the management of affected patients. While some patients develop significant morbidity (generally older), others may not need therapy at all (generally younger or children). Furthermore, some of the antiviral therapies used are potentially toxic. With the addition of increased risk of secondary infections, risk of graft failure or increased risk of graft-versus-host disease as well as the relationship with other post-transplant complications, the outcomes of patients with these viremias remain unsatisfactory and even long-term survivors experience increased morbidity.
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Affiliation(s)
- Xin Wang
- Department of Medicine, UMass Memorial Medical Center, Worcester, MA, USA
| | - Shyam A Patel
- Division of Hematology-Oncology, Department of Medicine, UMass Memorial Medical Center, Worcester, MA, USA
| | - Michael Haddadin
- Division of Hematology-Oncology, Department of Medicine, UMass Memorial Medical Center, Worcester, MA, USA
| | - Jan Cerny
- Division of Hematology and Oncology, Department of Medicine, UMass Memorial Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA
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Sadagopan N, Simin K, Shi Q, Cerny J, Gerber JM, Patel SA. Treatment outcomes of cohesin complex-mutant myelodysplastic syndrome and acute myeloid leukemia. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e19007] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19007 Background: Mutations in the genes STAG1, STAG2, SMC1A, SMC3, and RAD21 which are part of the cohesin complex are recurrent in myelodysplastic syndrome and acute myeloid leukemia. The cohesin complex is involved in sister chromatid attachment during cell division and in DNA loop formation bringing enhancers and genes together. Prognosis and treatment efficacy for this subgroup has not been well studied in MDS or AML. We evaluated the treatment outcomes of a subgroup with cohesin mutations from a database of MDS and AML patients at the University of Massachusetts. Methods: We performed a retrospective analysis of adult patients with a new diagnosis of AML and/or MDS from 2015-2019 in the University of Massachusetts Leukemia Registry. Fisher’s exact test was used to compare initial response to treatment via induction chemotherapy or hypomethylating agents. Kaplan-Meier curves for overall survival were compared using the log-rank test. We considered < 5% blasts by morphology to be complete remission (regardless of hematologic recovery). Four patients who did not undergo treatment were excluded from treatment and survival analysis. Results: A total of 19 patients had mutations in a cohesin complex gene with one patient having mutations in both STAG2 and SMC1A. The cohesin complex mutation frequency was 9.95% (19 out of 191 patients) with STAG2 representing 70% of the mutations. First-line induction chemotherapy resulted in an improved rate of complete remission 83.3% compared to hypomethylating agents 0% (p = 0.002). For AML patients alone, there was improvement in complete response rate for induction chemotherapy vs. hypomethylating agents (p = 0.048). There was no overall survival benefit for induction chemotherapy compared to hypomethylating agents (44.4% vs 41.7% probability of survival at 2 years) with p = 0.87. Excluding the MDS patients, there was still no difference in overall survival with p = 0.63. Conclusions: In this retrospective analysis of cohesin complex-mutant MDS and AML, induction chemotherapy resulted in significantly improved complete remission rates compared to hypomethylating agents. There was no overall survival benefit. We also found one patient with simultaneous mutations in two cohesin genes while cohesin mutations were previously reported to be mutually exclusive. Further work looking at additional samples may be able to show induction chemotherapy is the treatment of choice for cohesin mutant AML.[Table: see text]
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Affiliation(s)
| | - Karl Simin
- University of Massachusetts Medical School, Worcester, MA
| | - Qiming Shi
- University of Massachusetts Medical School, Worcester, MA
| | - Jan Cerny
- University of Massachusetts, Worcester, MA
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Abstract
The ongoing COVID-19 pandemic is the most trending and talked topic across the World. From its point of origin in Wuhan, China to clinical laboratory at NIH, a mere six-month-old SARS-CoV-2 virus is keeping the clinicians, and scientists busy at various fronts. However, COVID-19 is an emerging and evolving disease and each day brings in more data, new figures, and findings from the field of clinical practice. The role of hematologists has been increasingly recognized during the current pandemic because of several reasons. Most important of them are the characteristic hematological findings of COVID-19 patients that also have prognostic implications and that were not seen in other viral infections. The treatment of hematological complications in COVID-19 patients is very challenging given the critical care setting. There are interim and limited guidelines thus far due to the novelty of the disease. As this remains to be a quite fluid situation, all the appropriate medical societies including the major hematology bodies are proposing initial and interim guidelines (e.g. ASH guideline). This puts a hematologist on consult service in a dubious position where, he/she must tailor the recommendations on case to case basis. The purpose of this review is to provide the background context about the impact of COVID-19 on the blood system and to summarize the current interim guidelines to manage the associated hematological issues in COVID-19 infection.
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Affiliation(s)
- Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, USA
| | - Jan Cerny
- Division of Hematology and Oncology, Department of Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA.
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35
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Wang X, Sahu KK, Cerny J. Coagulopathy, endothelial dysfunction, thrombotic microangiopathy and complement activation: potential role of complement system inhibition in COVID-19. J Thromb Thrombolysis 2021; 51:657-662. [PMID: 33063256 PMCID: PMC7561230 DOI: 10.1007/s11239-020-02297-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2020] [Indexed: 12/18/2022]
Abstract
Coronavirus disease-2019 (COVID-19) is a rapidly evolving health crisis caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 is a novel disease entity and we are in a learning phase with regards to the pathogenesis, disease manifestations, and therapeutics. In addition to the primary lung injury, many patients especially the ones with moderate to severe COVID-19 display evidence of endothelial damage, complement activation, which leads to a pro-coagulable state. While there are still missing links in our understanding, the interplay of endothelium, complement system activation, and immune response to the SARS-CoV-2 virus is a surprisingly major factor in COVID-19 pathogenesis. One could envision COVID-19 becoming a novel hematological syndrome. This review is to discuss the available literature with regards to the involvement of the complement system, and coagulation cascade and their interaction with endothelium.
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Affiliation(s)
- Xin Wang
- Department of Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA USA
| | - Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608 USA
| | - Jan Cerny
- Department of Medicine - Hematology, and Oncology, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA USA
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36
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Wang X, McIntosh L, Selove WJ, Zivny J, Cerny J. Pseudoprogression of triple-hit diffuse large B-cell lymphoma following polatuzumab vedotin-based salvage therapy. Leuk Lymphoma 2021; 62:2022-2025. [PMID: 33719894 DOI: 10.1080/10428194.2021.1894646] [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: 10/21/2022]
Affiliation(s)
- Xin Wang
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Lacey McIntosh
- Division of Oncologic Imaging, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
| | - William J Selove
- Department of Pathology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jaroslav Zivny
- Division of Gastroenterology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
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37
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Abstract
Bacillus Calmette–Guérin (BCG) has been studied in various cancers for its immune modulation. Although the mechanism is yet to be completely understood, we do have positive experiences in many oncological cases. Hereby, we present a case of an 82-year-old male with acute myeloid leukemia (AML) post allogeneic Stem Cell Transplants (AlloSCT) as a salvage therapy, now in remission, who presented with hematuria. Workup confirmed non-muscle invasive Bladder Cancer (NMIBC), for which he was treated with nine sessions of intravesical BCG therapy. During BCG treatment, the patient developed gradually increasing lymphocyte counts. Flowcytometry of a peripheral blood sample showed polyclonal cell lymphocytosis with CD8+ T-cell expansion. Although further work up his lymphocytosis to be polyclonal, it has persisted at follow-up for the last 4 years. Also, we did not find any evidence of leukemia recurrence at follow-up prompting us to associate the BCG use for this patient and it is role as immunomodulation to keep AML disease in remission.
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Affiliation(s)
- Alice Kennedy
- Department of Internal Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, 01608, USA
| | - Jan Cerny
- Division of Hematology and Oncology, Department of Internal Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, 01655, USA
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38
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Wang M, Cerny J, Gerber JM, Patel S, Gillis-Smith A, Suzuki S, Shanahan L, Bednarik J, Nath R, Ramanathan M. Retrospective Single Institution Comparative Study of Outcomes after Post-Transplant Cyclophosphamide for Haploidentical, Matched Unrelated, Mismatched Unrelated and Matched Sibling PB HSCT. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00286-4] [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: 11/29/2022]
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39
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Abstract
The COVID-19 pandemic has led to a major setback in both the health and economic sectors across the globe. The scale of the problem is enormous because we still do not have any specific anti-SARS-CoV-2 antiviral agent or vaccine. The human immune system has never been exposed to this novel virus, so the viral interactions with the human immune system are completely naive. New approaches are being studied at various levels, including animal in vitro models and human-based studies, to contain the COVID-19 pandemic as soon as possible. Many drugs are being tested for repurposing, but so far only remdesivir has shown some positive benefits based on preliminary reports, but these results also need further confirmation via ongoing trials. Otherwise, no other agents have shown an impactful response against COVID-19. Recently, research exploring the therapeutic application of mesenchymal stem cells (MSCs) in critically ill patients suffering from COVID-19 has gained momentum. The patients belonging to this subset are most likely beyond the point where they could benefit from an antiviral therapy because most of their illness at this stage of disease is driven by inflammatory (over)response of the immune system. In this review, we discuss the potential of MSCs as a therapeutic option for patients with COVID-19, based on the encouraging results from the preliminary data showing improved outcomes in the progression of COVID-19 disease.
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Affiliation(s)
- Kamal Kant Sahu
- Department of Hematology and Oncology, Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts
| | - Ahmad Daniyal Siddiqui
- Department of Hematology and Oncology, Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts
| | - Jan Cerny
- Division of Hematology and Oncology, Department of Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, Massachusetts
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40
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Tay J, Beattie S, Bredeson C, Brazauskas R, He N, Ahmed IA, Aljurf M, Askar M, Atsuta Y, Badawy S, Barata A, Beitinjaneh AM, Bhatt NS, Buchbinder D, Cerny J, Ciurea S, D'Souza A, Dalal J, Farhadfar N, Freytes CO, Ganguly S, Gergis U, Gerull S, Lazarus HM, Hahn T, Hong S, Inamoto Y, Khera N, Kindwall-Keller T, Kamble RT, Knight JM, Koleva YN, Kumar A, Kwok J, Murthy HS, Olsson RF, Angel Diaz-Perez M, Rizzieri D, Seo S, Chhabra S, Schoemans H, Schouten HC, Steinberg A, Sullivan KM, Szer J, Szwajcer D, Ulrickson ML, Verdonck LF, Wirk B, Wood WA, Yared JA, Saber W. Pre-Transplant Marital Status and Hematopoietic Cell Transplantation Outcomes. Curr Oncol 2020; 27:e596-e606. [PMID: 33380875 PMCID: PMC7755447 DOI: 10.3747/co.27.6327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Evidence about the impact of marital status before hematopoietic cell transplantation (hct) on outcomes after hct is conflicting. Methods We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent hct between January 2008 and December 2015. Marital status before hct was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after hct. Results We identified 10,226 allogeneic and 5714 autologous hct cases with, respectively, a median follow-up of 37 months (range: 1-102 months) and 40 months (range: 1-106 months). No association between marital status and overall survival was observed in either the allogeneic (p = 0.58) or autologous (p = 0.17) setting. However, marital status was associated with grades 2-4 acute graft-versus-host disease (gvhd), p < 0.001, and chronic gvhd, p = 0.04. The risk of grades 2-4 acute gvhd was increased in separated compared with married patients [hazard ratio (hr): 1.13; 95% confidence interval (ci): 1.03 to 1.24], and single patients had a reduced risk of grades 2-4 acute gvhd (hr: 0.87; 95% ci: 0.77 to 0.98). The risk of chronic gvhd was lower in widowed compared with married patients (hr: 0.82; 95% ci: 0.67 to 0.99). Conclusions Overall survival after hct is not influenced by marital status, but associations were evident between marital status and grades 2-4 acute and chronic gvhd. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization.
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Affiliation(s)
- J Tay
- Alberta: Tom Baker Cancer Centre, University of Calgary, Calgary (Tay, Beattie)
| | - S Beattie
- Alberta: Tom Baker Cancer Centre, University of Calgary, Calgary (Tay, Beattie)
| | - C Bredeson
- Ontario: The Ottawa Hospital Blood and Marrow Transplant Program and The Ottawa Hospital Research Institute, Ottawa (Bredeson)
| | - R Brazauskas
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - N He
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - I A Ahmed
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - M Aljurf
- Saudi Arabia: Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh (Aljurf)
| | - M Askar
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - Y Atsuta
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - S Badawy
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - A Barata
- Spain: Hospital de la Santa Creu i Sant Pau, Barcelona (Barata); Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid (Angel Diaz-Perez)
| | - A M Beitinjaneh
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - N S Bhatt
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - D Buchbinder
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J Cerny
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Ciurea
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - A D'Souza
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J Dalal
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - N Farhadfar
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - C O Freytes
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Ganguly
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - U Gergis
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Gerull
- Switzerland: Department of Hematology, University Hospital, Basel (Gerull)
| | - H M Lazarus
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - T Hahn
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Hong
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - Y Inamoto
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - N Khera
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - T Kindwall-Keller
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - R T Kamble
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J M Knight
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - Y N Koleva
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - A Kumar
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J Kwok
- P.R.C.: Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong sar (Kwok)
| | - H S Murthy
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - R F Olsson
- Sweden: Department of Laboratory Medicine, Karolinska Institutet, Stockholm (Olsson); Centre for Clinical Research Sormland, Uppsala University, Uppsala (Olsson)
| | - M Angel Diaz-Perez
- Spain: Hospital de la Santa Creu i Sant Pau, Barcelona (Barata); Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid (Angel Diaz-Perez)
| | - D Rizzieri
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Seo
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - S Chhabra
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - H Schoemans
- Belgium: University Hospital Leuven and KU Leuven, Leuven (Schoemans)
| | - H C Schouten
- Netherlands: Department of Hematology, Acadeische Ziekenhuis, Maastrict (Schouten); Department of Hematology/Oncology, Isala Clinic, Zwolle (Verdonck)
| | - A Steinberg
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - K M Sullivan
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - J Szer
- Australia: Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Victoria (Szer)
| | - D Szwajcer
- Manitoba: CancerCare Manitoba, Winnipeg, MB (Szwajcer)
| | - M L Ulrickson
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - L F Verdonck
- Netherlands: Department of Hematology, Acadeische Ziekenhuis, Maastrict (Schouten); Department of Hematology/Oncology, Isala Clinic, Zwolle (Verdonck)
| | - B Wirk
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - W A Wood
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J A Yared
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - W Saber
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
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Dhakal B, D'Souza A, Callander N, Chhabra S, Fraser R, Davila O, Anderson K, Assal A, Badawy SM, Berdeja J, Cerny J, Comenzo R, Chakraborty R, Peter Gale R, Kamble R, Kharfan-Dabaja MA, Krem M, Ganguly S, Janakiram M, Kansagra A, Munker R, Murthy H, Patel S, Kumar S, Shah N, Qazilbash M, Hari P. Novel prognostic scoring system for autologous hematopoietic cell transplantation in multiple myeloma. Br J Haematol 2020; 191:442-452. [PMID: 33094839 DOI: 10.1111/bjh.16987] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/11/2020] [Indexed: 11/28/2022]
Abstract
We studied 2,528 patients with upfront autologous haematopoietic cell transplantation (AHCT) for multiple myeloma (MM) from 2008-2017 to develop a prognostic model to predict outcomes. High-risk cytogenetics included t(4;14), t(14;16), t(14;20), del13q on karyotype, del17p, +1q or 1pdel. A Cox model identified factors prognostic of progression/relapse in a training subset (n = 1,246). A weighted score using these factors was assigned to a validation cohort (n = 774). Presence of high-risk cytogenetics [hazard ratio, (HR) 1·68 (1·3-2·17)] and pre-AHCT bone marrow plasma cells (BMPCs) ≥10% [1·68 (1·33-2·12)] were assigned 4 points each; albumin at diagnosis <3·5 g/dl [1·31 (1·07-1·61)] 2; standard risk cytogenetics 1, and no cytogenetics abnormality, BMPCs <10% at AHCT and albumin ≥3·5 g/dl at diagnosis 0 points each. A three-category system with low risk (0-3), intermediate risk (4-8) and high risk (9-10) showed 3-year progression-free survival in the low vs. intermediate vs. high risk of 58% (95% CI: 52-63) vs. 49% (95% CI: 43-56) vs. 31% (95% CI: 12-51), P < 0.001 respectively, and 3-year OS in low vs. intermediate vs. high risk of 88% (95% CI: 84-91) vs. 81% (95% CI: 76-86) vs. 64% (95% CI: 39-80); P < 0·001. Our prognostic scoring system can identify MM patients at risk for early relapse after AHCT.
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Affiliation(s)
- Binod Dhakal
- BMT and Cellular Therapy, Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Anita D'Souza
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Saurabh Chhabra
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Raphael Fraser
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Omar Davila
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Amer Assal
- Department of Medicine, Bone Marrow Transplant and Cell Therapy Program, Columbia University Irving Medical Center, New York, NY, USA
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | | | | | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Rammurti Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX, USA
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Maxwell Krem
- University of Louisville Hospital/James Brown Cancer Center, Louisville, KY, USA
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS, USA
| | | | - Ankit Kansagra
- UT Southwestern Medical Center - BMT Program, Dallas, TX, USA
| | - Reinhold Munker
- Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Hemant Murthy
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Sagar Patel
- Blood and Marrow Transplant Program, University of Utah, Salt Lake City, UT, USA
| | - Shaji Kumar
- Taussig Cancer Center, Cleveland Clinic, Cleveland, Ohio, USA
| | - Nina Shah
- Division of Hematology-Oncology, University of California San Francisco, San Francisco, CA, USA
| | | | - Parameswaran Hari
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Hong S, Brazauskas R, Hebert KM, Ganguly S, Abdel-Azim H, Diaz MA, Beattie S, Ciurea SO, Szwajcer D, Badawy SM, Gratwohl AA, LeMaistre C, Aljurf MDSM, Olsson RF, Bhatt NS, Farhadfar N, Yared JA, Yoshimi A, Seo S, Gergis U, Beitinjaneh AM, Sharma A, Lazarus H, Law J, Ulrickson M, Hashem H, Schoemans H, Cerny J, Rizzieri D, Savani BN, Kamble RT, Shaw BE, Khera N, Wood WA, Hashmi S, Hahn T, Lee SJ, Rizzo JD, Majhail NS, Saber W. Community health status and outcomes after allogeneic hematopoietic cell transplantation in the United States. Cancer 2020; 127:609-618. [PMID: 33085090 DOI: 10.1002/cncr.33232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 01/30/2020] [Revised: 07/01/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The association of community factors and outcomes after hematopoietic cell transplantation (HCT) has not been comprehensively described. Using the County Health Rankings and Roadmaps (CHRR) and the Center for International Blood and Marrow Transplant Research (CIBMTR), this study evaluated the impact of community health status on allogeneic HCT outcomes. METHODS This study included 18,544 adult allogeneic HCT recipients reported to the CIBMTR by 170 US centers in 2014-2016. Sociodemographic, environmental, and community indicators were derived from the CHRR, an aggregate community risk score was created, and scores were assigned to each patient (patient community risk score [PCS]) and transplant center (center community risk score [CCS]). Higher scores indicated less healthy communities. The impact of PCS and CCS on patient outcomes after allogeneic HCT was studied. RESULTS The median age was 55 years (range, 18-83 years). The median PCS was -0.21 (range, -1.37 to 2.10; standard deviation [SD], 0.42), and the median CCS was -0.13 (range, -1.04 to 0.96; SD, 0.40). In multivariable analyses, a higher PCS was associated with inferior survival (hazard ratio [HR] per 1 SD increase, 1.04; 99% CI, 1.00-1.08; P = .0089). Among hematologic malignancies, a tendency toward inferior survival was observed with a higher PCS (HR, 1.04; 99% CI, 1.00-1.08; P = .0102); a higher PCS was associated with higher nonrelapse mortality (NRM; HR, 1.08; 99% CI, 1.02-1.15; P = .0004). CCS was not significantly associated with survival, relapse, or NRM. CONCLUSIONS Patients residing in counties with a worse community health status have inferior survival as a result of an increased risk of NRM after allogeneic HCT. There was no association between the community health status of the transplant center location and allogeneic HCT outcomes.
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Affiliation(s)
- Sanghee Hong
- Blood and Marrow Transplant Program, Taussig Cancer Center, Cleveland Clinic, Cleveland, Ohio
| | - Ruta Brazauskas
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.,Division of Biostatistics, Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Kyle M Hebert
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | - Hisham Abdel-Azim
- Division of Hematology, Oncology, and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Sara Beattie
- Department of Psychosocial Oncology and Rehabilitation, Tom Baker Cancer Centre, Calgary, Alberta, Canada.,Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Stefan O Ciurea
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Sherif M Badawy
- Division of Hematology, Oncology, and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Charles LeMaistre
- Hematology and Bone Marrow Transplant, Sarah Cannon, Nashville, Tennessee
| | - Mahmoud D S M Aljurf
- Department of Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden.,Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Neel S Bhatt
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Jean A Yared
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Ayami Yoshimi
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Usama Gergis
- Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Hillard Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Jason Law
- Division of Pediatric Hematology/Oncology, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts
| | | | - Hasan Hashem
- Division of Pediatric Hematology/Oncology and Bone Marrow Transplantation, King Hussein Cancer Center, Amman, Jordan
| | - Hélène Schoemans
- Department of Hematology, University Hospitals Leuven and Katholieke Universiteit Leuven, Leuven, Belgium
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts
| | - David Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Nandita Khera
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, Arizona
| | - William A Wood
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Theresa Hahn
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Stephanie J Lee
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.,Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - J Douglas Rizzo
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Navneet S Majhail
- Blood and Marrow Transplant Program, Taussig Cancer Center, Cleveland Clinic, Cleveland, Ohio
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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Bejanyan N, Zhang M, Bo-Subait K, Brunstein C, Wang H, Warlick ED, Giralt S, Nishihori T, Martino R, Passweg J, Dias A, Copelan E, Hale G, Gale RP, Solh M, Kharfan-Dabaja MA, Diaz MA, Ganguly S, Gore S, Verdonck LF, Hossain NM, Kekre N, Savani B, Byrne M, Kanakry C, Cairo MS, Ciurea S, Schouten HC, Bredeson C, Munker R, Lazarus H, Cahn JY, van Der Poel M, Rizzieri D, Yared JA, Freytes C, Cerny J, Aljurf M, Palmisiano ND, Pawarode A, Bacher VU, Grunwald MR, Nathan S, Wirk B, Hildebrandt GC, Seo S, Olsson RF, George B, de Lima M, Hourigan CS, Sandmaier BM, Litzow M, Kebriaei P, Saber W, Weisdorf D. Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index: A Center for International Blood and Marrow Transplant Research Study. Transplant Cell Ther 2020; 27:68.e1-68.e9. [PMID: 33010430 DOI: 10.1016/j.bbmt.2020.09.026] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/05/2020] [Accepted: 09/19/2020] [Indexed: 11/26/2022]
Abstract
Compared with reduced-intensity conditioning (RIC), myeloablative conditioning (MAC) is generally associated with lower relapse risk after allogeneic hematopoietic cell transplantation (HCT) for acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS). However, disease-specific risk factors in AML/MDS can further inform when MAC and RIC may yield differential outcomes. We analyzed HCT outcomes stratified by the Disease Risk Index (DRI) in 4387 adults (age 40 to 65 years) to identify the impact of conditioning intensity. In the low/intermediate-risk DRI cohort, RIC was associated with lower nonrelapse mortality (NRM) (hazard ratio [HR], .74; 95% confidence interval [CI], .62 to .88; P < .001) but significantly greater relapse risk (HR, 1.54; 95% CI, 1.35 to 1.76; P < .001) and thus inferior disease-free survival (DFS) (HR, 1.19; 95% CI, 1.07 to 1.33; P = .001). In the high/very high-risk DRI cohort, RIC was associated with marginally lower NRM (HR, .83; 95% CI, .68 to 1.00; P = .051) and significantly higher relapse risk (HR, 1.23; 95% CI, 1.08 to 1.41; P = .002), leading to similar DFS using either RIC or MAC. These data support MAC over RIC as the preferred conditioning intensity for patients with AML/MDS with low/intermediate-risk DRI, but with a similar benefit as RIC in high/very high-risk DRI. Novel MAC regimens with less toxicity could benefit all patients, but more potent antineoplastic approaches are needed for the high/very-high risk DRI group.
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Affiliation(s)
- Nelli Bejanyan
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida.
| | - Meijie Zhang
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Khalid Bo-Subait
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Claudio Brunstein
- Adult Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Hailin Wang
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Erica D Warlick
- Adult Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Sergio Giralt
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Taiga Nishihori
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida
| | - Rodrigo Martino
- Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jakob Passweg
- Division of Hematology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Ajoy Dias
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Edward Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Gregory Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St Petersburg, Florida
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Melhem Solh
- Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, Georgia
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | - Steven Gore
- Section of Medical Oncology, Department of Internal Medicine, Yale New Haven Hospital, New Haven, Connecticut
| | - Leo F Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherland
| | - Nasheed M Hossain
- Stem Cell Transplant Program, Division of Hematology/Oncology, Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois
| | - Natasha Kekre
- Blood & Marrow Transplant Program, Department of Medicine, Ottawa Hospital Ottawa, Ontario, Canada
| | - Bipin Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Michael Byrne
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christopher Kanakry
- Experimental Transplantation and Immunology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Mitchell S Cairo
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, Valhalla, New York
| | - Stefan Ciurea
- Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Harry C Schouten
- Department of Hematology, Academische Ziekenhuis, Maastricht, The Netherlands
| | - Christopher Bredeson
- Blood & Marrow Transplant Program, Department of Medicine, Ottawa Hospital Ottawa, Ontario, Canada
| | - Reinhold Munker
- Division of Medical Oncology, Markey Cancer Center, University of Kentucky School of Medicine, Lexington, Kentucky
| | - Hillard Lazarus
- Department of Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Grenoble, France
| | - Marjolein van Der Poel
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - David Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Cesar Freytes
- Hematopoietic Stem Cell Transplant Program, Texas Transplant Institute, San Antonio, Texas
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Neil D Palmisiano
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Attaphol Pawarode
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Vera Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Sunita Nathan
- Section of Bone Marrow Transplantation and Cellular Therapy, Division of Hematology, Oncology and Cell Therapy, Department of Internal Medicine, Rush Medical College, Chicago, Illinois
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, Pennsylvania
| | - Gerhard C Hildebrandt
- Division of Medical Oncology, Markey Cancer Center, University of Kentucky School of Medicine, Lexington, Kentucky
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Sweden
| | - Biju George
- Department of Haematology, Christian Medical College, Vellore, India
| | - Marcos de Lima
- Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Christopher S Hourigan
- Laboratory of Myeloid Malignancies, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Brenda M Sandmaier
- Division of Medical Oncology, University of Washington and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, Minnesota
| | - Partow Kebriaei
- Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wael Saber
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Daniel Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, 96
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Patel S, Bledsoe J, Gordon J, Cerny J. Extramedullary Acute Myeloid Leukemia of the Renal Pelvis: Insights into a Visceral Niche. Acta Haematol 2020; 144:297-301. [PMID: 32814320 DOI: 10.1159/000508526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022]
Abstract
Acute myeloid leukemia (AML) is a stem cell malignancy that originates in the bone marrow and involves the peripheral blood. Extramedullary AML is rarer, but it is most commonly associated with the former French-American-British (FAB) subtypes M4 or M5 of AML. AML cells may also home to the central nervous system and other solid organs such as cortical bone and skin. Such target sites of metastasis depend on microenvironmental niche interactions, which have not been fully elucidated to date. Visceral organs usually do not represent a favorable niche for AML stem cell occupancy. Herein, we describe the case of an 80-year-old man with extramedullary AML involvement of the renal pelvis. Hypercalcemia and obstructive uropathy were presenting features. The visceral niche is a rare site of involvement of myeloid malignancy, and hypercalcemia may reflect a mechanism of extramedullary involvement. We propose a treatment paradigm for this uncommon subset of AML based on advanced age and complex karyotype.
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Abstract
The current pandemic due to coronavirus disease 2019 (COVID-19) has posed an unprecedented challenge for the medical communities, various countries worldwide, and their citizens. Severe acute respiratory syndrome coronavirus 2 has been studied for its various pathophysiological pathways and mechanisms through which it causes COVID-19. In this study, we discussed the immunological impact of COVID-19 on the hematological system, platelets, and red blood cells.
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Affiliation(s)
- Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent hospital, 123 Summer Street, Worcester, United States, 01608, United States
| | - Azra Borogovac
- Hematology-Oncology Section, Department of Medicine, University of Oklahoma Health Sciences Center, 865 Research Pkwy, Oklahoma City, Oklahoma, 73104, United States
| | - Jan Cerny
- Division of Hematology and Oncology, Department of Medicine, University of Massachusetts Memorial Medical Center, 55 N Lake Ave, Worcester, Massachusetts, 01655, United States
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Nazha A, Hu ZH, Wang T, Lindsley RC, Abdel-Azim H, Aljurf M, Bacher U, Bashey A, Cahn JY, Cerny J, Copelan E, DeFilipp Z, Diaz MA, Farhadfar N, Gadalla SM, Gale RP, George B, Gergis U, Grunwald MR, Hamilton B, Hashmi S, Hildebrandt GC, Inamoto Y, Kalaycio M, Kamble RT, Kharfan-Dabaja MA, Lazarus HM, Liesveld JL, Litzow MR, Majhail NS, Murthy HS, Nathan S, Nishihori T, Pawarode A, Rizzieri D, Sabloff M, Savani BN, Schachter L, Schouten HC, Seo S, Shah NN, Solh M, Valcárcel D, Vij R, Warlick E, Wirk B, Wood WA, Yared JA, Alyea E, Popat U, Sobecks RM, Scott BL, Nakamura R, Saber W. A Personalized Prediction Model for Outcomes after Allogeneic Hematopoietic Cell Transplant in Patients with Myelodysplastic Syndromes. Biol Blood Marrow Transplant 2020; 26:2139-2146. [PMID: 32781289 DOI: 10.1016/j.bbmt.2020.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/22/2020] [Revised: 07/21/2020] [Accepted: 08/01/2020] [Indexed: 01/01/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (HCT) remains the only potentially curative option for myelodysplastic syndromes (MDS). Mortality after HCT is high, with deaths related to relapse or transplant-related complications. Thus, identifying patients who may or may not benefit from HCT is clinically important. We identified 1514 patients with MDS enrolled in the Center for International Blood and Marrow Transplant Research Registry and had their peripheral blood samples sequenced for the presence of 129 commonly mutated genes in myeloid malignancies. A random survival forest algorithm was used to build the model, and the accuracy of the proposed model was assessed by concordance index. The median age of the entire cohort was 59 years. The most commonly mutated genes were ASXL1(20%), TP53 (19%), DNMT3A (15%), and TET2 (12%). The algorithm identified the following variables prior to HCT that impacted overall survival: age, TP53 mutations, absolute neutrophils count, cytogenetics per International Prognostic Scoring System-Revised, Karnofsky performance status, conditioning regimen, donor age, WBC count, hemoglobin, diagnosis of therapy-related MDS, peripheral blast percentage, mutations in RAS pathway, JAK2 mutation, number of mutations/sample, ZRSR2, and CUX1 mutations. Different variables impacted the risk of relapse post-transplant. The new model can provide survival probability at different time points that are specific (personalized) for a given patient based on the clinical and mutational variables that are listed above. The outcomes' probability at different time points may aid physicians and patients in their decision regarding HCT.
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Affiliation(s)
| | - Zhen-Huan Hu
- Department of Medicine, CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Tao Wang
- Department of Medicine, CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Hisham Abdel-Azim
- Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Asad Bashey
- Blood and Marrow Transplant Program at Northside Hospital, Atlanta, Georgia
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Grenoble, France
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Masschusetts
| | - Edward Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Zachariah DeFilipp
- Blood and Marrow Transplantation Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, Florida
| | - Shahinaz M Gadalla
- Division of Cancer Epidemiology & Genetics, NIH-NCI Clinical Genetics Branch, Rockville, Maryland
| | - Robert Peter Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | | | - Usama Gergis
- Hematologic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Betty Hamilton
- Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Shahrukh Hashmi
- Department of Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Department of Internal Medicine, Mayo Clinic, Minnesota, Rochester
| | | | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | | | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Mohamed A Kharfan-Dabaja
- Divison of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida
| | | | - Jane L Liesveld
- Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Mark R Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, Minnesota
| | - Navneet S Majhail
- Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Hemant S Murthy
- Divison of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida
| | | | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, Florida
| | - Attaphol Pawarode
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - David Rizzieri
- Divison of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Mitchell Sabloff
- Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Harry C Schouten
- Department of Hematology, Academische Ziekenhuis, Maastricht, Netherlands
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Nirav N Shah
- Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, Georgia
| | - David Valcárcel
- Department of Hematology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Ravi Vij
- Division of Hematology and Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Erica Warlick
- University of Minnesota Blood and Marrow Transplant Program, Minneapolis, Minnesota
| | - Baldeep Wirk
- Penn State Cancer Institute, Bone Marrow Transplant Program, Hershey, Pennsylvania
| | - William A Wood
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Edwin Alyea
- Center of Hematologic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Uday Popat
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Bart L Scott
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Ryotaro Nakamura
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Wael Saber
- Department of Medicine, CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, Wisconsin
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Sahu KK, Raturi M, Siddiqui AD, Cerny J. "Because Every Drop Counts": Blood donation during the COVID-19 Pandemic. Transfus Clin Biol 2020; 27:105-108. [PMID: 32782213 PMCID: PMC7351037 DOI: 10.1016/j.tracli.2020.06.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/13/2020] [Accepted: 06/18/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Kamal Kant Sahu
- Department of Hematology and Oncology, Saint Vincent Hospital, 01608 Worcester, MA, United States of America.
| | - Manish Raturi
- Immunohematology & Blood Transfusion, Himalayan Institute of Medical Sciences, 248016 Dehradun, Uttarakhand.
| | - Ahmad Daniyal Siddiqui
- Department of Hematology and Oncology, Saint Vincent Hospital, 01608 Worcester, MA, United States of America.
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA.
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Wang X, Vogt B, Shanahan L, Siddiqui AD, Subramonia-Iyer S, Khanani S, Bednarik JL, Mittal K, Ramanathan M, Gerber JM, Cerny J. Elotuzumab-based maintenance therapy following autologous stem cell transplant in multiple myeloma deepens post-transplant responses. Blood Cells Mol Dis 2020; 85:102482. [PMID: 32745939 DOI: 10.1016/j.bcmd.2020.102482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/25/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Post-transplant maintenance provides progression-free survival benefit in multiple myeloma (MM). Here we report our institution's experience with elotuzumab-based maintenance following autologous stem cell transplant. METHODS We retrospectively evaluated the outcomes of MM patients who were started on elotuzumab-based maintenance (elotuzumab/lenalidomide/dexamethasone, elotuzumab/bortezomib/dexamethasone, or elotuzumab/bortezomib/methylprednisolone) following transplant (N = 7). Baseline characteristics, treatment response, survival, and adverse events were reviewed. RESULTS Median age was 68 (56-81) years at the time of transplant, and median lines of induction therapy was 2 (1-6). Three patients (42.9%) had high-risk cytogenetics and five (71.4%) had stage II or greater disease at diagnosis. At a median follow-up of 24 months (12-50), five patients (71.4%) had improvement of quality of response, with a combined CR or VGPR rate increasing from 57.1% to 100% (CR = 3, VGPR = 4). All patients were alive without relapse or progression at the time of this analysis. Grade 3-4 adverse events were observed in three (42.9%) patients. None of the patients discontinued the treatment due to intolerance. CONCLUSIONS Our study demonstrates that elotuzumab-based maintenance may deepen response post-transplant in MM and can be safely administered even in older patients. Given its unique action and rare side effects, further studies of elotuzumab in the post-transplant setting are warranted.
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Affiliation(s)
- Xin Wang
- Department of Medicine, UMass Memorial Medical Center, Worcester, MA 01655, USA
| | - Bennett Vogt
- University of Massachussetts Medical School, Worcester, MA 01655, USA
| | - Lindsey Shanahan
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, Worcester, MA 01655, USA
| | - A Daniyal Siddiqui
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, Worcester, MA 01655, USA; Division of Hematology and Medical Oncology, Saint Vincent Hospital, Worcester, MA 01608, USA
| | | | - Saleem Khanani
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, Worcester, MA 01655, USA
| | - Jayde L Bednarik
- Department of Pharmacy, UMass Memorial Medical Center, Worcester, MA 01655, USA
| | - Kriti Mittal
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, Worcester, MA 01655, USA
| | - Muthalagu Ramanathan
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, Worcester, MA 01655, USA
| | - Jonathan M Gerber
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, Worcester, MA 01655, USA
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, UMass Memorial Medical Center, Worcester, MA 01655, USA.
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Hu B, Lin X, Lee HC, Huang X, Tidwell RSS, Ahn KW, Hu ZH, Jabbour E, Verstovsek S, Ravandi F, Garcia-Manero G, Kharfan-Dabaja MA, Hossain NM, Marks DI, Kamble RT, Inamoto Y, Kindwall-Keller T, Saad A, Litzow MR, Savani BN, Hale GA, Bacher U, Gerds AT, Liesveld JL, Ustun C, Olsson RF, Daly A, Grunwald MR, Solh M, DeFilipp Z, Aljurf M, Wirk B, Akpek G, Nishihori T, Cerny J, Seo S, Hsu JW, Champlin R, de Lima M, Alyea E, Popat U, Sobecks R, Scott BL, Kantarjian H, Cortes J, Saber W. Timing of allogeneic hematopoietic cell transplantation (alloHCT) for chronic myeloid leukemia (CML) patients. Leuk Lymphoma 2020; 61:2811-2820. [PMID: 32662346 DOI: 10.1080/10428194.2020.1783444] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
While TKI are the preferred first-line treatment for chronic phase (CP) CML, alloHCT remains an important consideration. The aim is to estimate residual life expectancy (RLE) for patients initially diagnosed with CP CML based on timing of alloHCT or continuation of TKI in various settings: CP1 CML, CP2 + [after transformation to accelerated phase (AP) or blast phase (BP)], AP, or BP. Non-transplant cohort included single-institution patients initiating TKI and switched TKI due to failure. CIBMTR transplant cohort included CML patients who underwent HLA sibling matched (MRD) or unrelated donor (MUD) alloHCT. AlloHCT appeared to shorten survival in CP1 CML with overall mortality hazard ratio (HR) for alloHCT of 2.4 (95% CI 1.2-4.9; p = .02). In BP CML, there was a trend toward higher survival with alloHCT; HR = 0.7 (0.5-1.1; p = .099). AlloHCT in CP2 + [HR = 2.0 (0.8-4.9), p = .13] and AP [HR = 1.1 (0.6-2.1); p = .80] is less clear and should be determined on a case-by-case basis.
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Affiliation(s)
- Bei Hu
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA.,Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, NC, USA
| | - Xiao Lin
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA.,Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Juangsu Sheng, China
| | - Hans C Lee
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Xuelin Huang
- Department of Biostatistics, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Kwang Woo Ahn
- Department of Medicine, Medical College of Wisconsin, CIBMTR (Center for International Blood and Marrow Transplant Research), Milwaukee, WI, USA.,Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Zhen-Huan Hu
- Department of Medicine, Medical College of Wisconsin, CIBMTR (Center for International Blood and Marrow Transplant Research), Milwaukee, WI, USA
| | - Elias Jabbour
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Srdan Verstovsek
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Farhad Ravandi
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA
| | | | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Nasheed M Hossain
- Loyola University Chicago-Stritch School of Medicine, Maywood, IL, USA
| | - David I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, UK
| | - Rammuriti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX, USA
| | - Yoshihiro Inamoto
- Divsion of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Tamila Kindwall-Keller
- Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA, USA
| | - Ayman Saad
- Division of Hematology, The Ohio State University, Columbus, OH, USA
| | - Mark R Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, MN, USA
| | - Bipin N Savani
- Divsion of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Gregory A Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, Petersburg, FL, USA
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Aaron T Gerds
- Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jane L Liesveld
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Celalettin Ustun
- Division of Hematology/Oncology/Cell Therapy, Rush University, Chicago, IL, USA
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Andrew Daly
- Tom Baker Cancer Center, Calgary, Alberta, Canada
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, NC, USA
| | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA
| | - Zachariah DeFilipp
- Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA, USA
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Gorgun Akpek
- Stem Cell Transplantation and Cell Therapy, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer and Research Institute, Tampa, FL, USA
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Jack W Hsu
- Division of Hematology & Oncology, Department of Medicine, Shands HealthCare and University of Florida, Gainesville, FL, USA
| | - Richard Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marcos de Lima
- Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Edwin Alyea
- Center of Hematologic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Uday Popat
- Department of Lymphoma/Myeloma, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Ronald Sobecks
- Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Bart L Scott
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Hagop Kantarjian
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jorge Cortes
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Division of Hematology/Oncology, Department of Medicine, Georgia Cancer Center at Augusta University, Augusta, GA, USA
| | - Wael Saber
- Department of Medicine, Medical College of Wisconsin, CIBMTR (Center for International Blood and Marrow Transplant Research), Milwaukee, WI, USA
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50
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Affiliation(s)
- Kamal Kant Sahu
- Division of Hematology and Oncology, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, USA
| | - Jan Cerny
- Division of Hematology and Oncology, Department of Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA
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