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  • 1. Arai, Sally
    et al.
    Arora, Mukta
    Wang, Tao
    Spellman, Stephen R
    He, Wensheng
    Couriel, Daniel R
    Urbano-Ispizua, Alvaro
    Cutler, Corey S
    Bacigalupo, Andrea A
    Battiwalla, Minoo
    Flowers, Mary E
    Juckett, Mark B
    Lee, Stephanie J
    Loren, Alison W
    Klumpp, Thomas R
    Prockup, Susan E
    Ringdén, Olle T H
    Savani, Bipin N
    Socié, Gérard
    Schultz, Kirk R
    Spitzer, Thomas
    Teshima, Takanori
    Bredeson, Christopher N
    Jacobsohn, David A
    Hayashi, Robert J
    Drobyski, William R
    Frangoul, Haydar A
    Akpek, Görgün
    Ho, Vincent T
    Lewis, Victor A
    Gale, Robert Peter
    Koreth, John
    Chao, Nelson J
    Aljurf, Mahmoud D
    Cooper, Brenda W
    Laughlin, Mary J
    Hsu, Jack W
    Hematti, Peiman
    Verdonck, Leo F
    Solh, Melhelm M
    Norkin, Maxim
    Reddy, Vijay
    Martino, Rodrigo
    Gadalla, Shahinaz
    Goldberg, Jenna D
    McCarthy, Philip L
    Pérez-Simón, José A
    Khera, Nandita
    Lewis, Ian D
    Atsuta, Yoshiko
    Olsson, Richard F
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Saber, Wael
    Waller, Edmund K
    Blaise, Didier
    Pidala, Joseph A
    Martin, Paul J
    Satwani, Prakash
    Bornhäuser, Martin
    Inamoto, Yoshihiro
    Weisdorf, Daniel J
    Horowitz, Mary M
    Pavletic, Steven Z
    Increasing incidence of chronic graft-versus-host disease in allogeneic transplantation: a report from the Center for International Blood and Marrow Transplant Research.2015In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 21, no 2, p. 266-74Article in journal (Refereed)
    Abstract [en]

    Although transplant practices have changed over the last decades, no information is available on trends in incidence and outcome of chronic graft-versus-host disease (cGVHD) over time. This study used the central database of the Center for International Blood and Marrow Transplant Research (CIBMTR) to describe time trends for cGVHD incidence, nonrelapse mortality, and risk factors for cGVHD. The 12-year period was divided into 3 intervals, 1995 to 1999, 2000 to 2003, and 2004 to 2007, and included 26,563 patients with acute leukemia, chronic myeloid leukemia, and myelodysplastic syndrome. Multivariate analysis showed an increased incidence of cGVHD in more recent years (odds ratio = 1.19, P < .0001), and this trend was still seen when adjusting for donor type, graft type, or conditioning intensity. In patients with cGVHD, nonrelapse mortality has decreased over time, but at 5 years there were no significant differences among different time periods. Risk factors for cGVHD were in line with previous studies. This is the first comprehensive characterization of the trends in cGVHD incidence and underscores the mounting need for addressing this major late complication of transplantation in future research.

  • 2.
    Ayas, Mouhab
    et al.
    King Faisal Specialist Hosp & Res Ctr, Dept Pediat Hematol Oncol, Riyadh 11211, Saudi Arabia..
    Eapen, Mary
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Le-Rademacher, Jennifer
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA..
    Carreras, Jeanette
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Abdel-Azim, Hisham
    Univ So Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90033 USA..
    Alter, Blanche P.
    NCI, Clin Genet Branch, Div Canc Epidemiol & Genet, NIH, Bethesda, MD 20892 USA..
    Anderlini, Paolo
    Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat & Cellular Therapy, Houston, TX 77030 USA..
    Battiwalla, Minoo
    NHLBI, Hematol Branch, NIH, Bethesda, MD 20892 USA..
    Bierings, Marc
    Univ Med Ctr Utrecht, Dept Pediat Hematol, Utrecht, Netherlands..
    Buchbinder, David K.
    Childrens Hosp Orange Cty, Div Pediat Hematol, Orange, CA 92668 USA..
    Bonfim, Carmem
    Univ Fed Parana, Hosp Clin, BR-80060000 Curitiba, Parana, Brazil..
    Camitta, Bruce M.
    Med Coll Wisconsin, Midwest Ctr Canc & Blood Disorders, Milwaukee, WI 53226 USA.;Childrens Hosp Wisconsin, Milwaukee, WI 53201 USA..
    Fasth, Anders L.
    Univ Gothenburg, Dept Pediat, Gothenburg, Sweden..
    Gale, Robert Peter
    Univ London Imperial Coll Sci Technol & Med, Hematol Res Ctr, Div Expt Med, Dept Med, London, England..
    Lee, Michelle A.
    Dana Farber Boston Childrens Canc & Blood Disorde, Dept Pediat Oncol, Boston, MA USA..
    Lund, Troy C.
    Univ Minnesota, Dept Pediat, Med Ctr, Div Blood & Marrow Transplantat, Minneapolis, MN 55455 USA..
    Myers, Kasiani C.
    Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Div Bone Marrow Transplant & Immune Deficiency, Cincinnati, OH 45229 USA..
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Div Therapeut Immunol, Dept Lab Med, Stockholm, Sweden..
    Page, Kristin M.
    Duke Univ, Med Ctr, Pediat Blood & Marrow Transplant, Durham, NC USA..
    Prestidge, Tim D.
    Starship Childrens Hosp, Blood & Canc Ctr, Auckland, New Zealand..
    Radhi, Mohamed
    Childrens Mercy Hosp, Pediat Hematol Oncol Stem Cell Transplantat, Kansas City, MO 64108 USA..
    Shah, Ami J.
    Univ Calif Los Angeles, Dept Pediat, Mattel Childrens Hosp, Div Hematol Oncol, Los Angeles, CA 90024 USA..
    Schultz, Kirk R.
    Univ British Columbia, British Columbias Childrens Hosp, Dept Pediat Hematol Oncol & Bone Marrow Transplan, Vancouver, BC V5Z 1M9, Canada..
    Wirk, Baldeep
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA..
    Wagner, John E.
    Univ Minnesota, Dept Pediat, Med Ctr, Div Blood & Marrow Transplantat, Minneapolis, MN 55455 USA..
    Deeg, H. Joachim
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA..
    Second Allogeneic Hematopoietic Cell Transplantation for Patients with Fanconi Anemia and Bone Marrow Failure2015In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 21, no 10, p. 1790-1795Article in journal (Refereed)
    Abstract [en]

    A second allogeneic hematopoietic cell transplantation (HCT) is the sole salvage option for individuals who develop graft failure after their first HCT. Data on outcomes after second HCT in patients with Fanconi anemia (FA) are scarce. Here we report outcomes after second allogeneic HCT for FA (n = 81). The indication for second HCT was graft failure after the first HCT. Transplantations were performed between 1990 and 2012. The timing of the second HCT predicted subsequent graft failure and survival. Graft failure was high when the second HCT was performed less than 3 months from the first. The 3-month probability of graft failure was 69% when the interval between the first HCT and second HCT was less than 3 months, compared with 23% when the interval was longer (P < .001). Consequently, the 1-year survival rate was substantially lower when the interval between the first and second HCTs was less than 3 months compared with longer (23% vs 58%; P = .001). The corresponding 5-year probability of survival was 16% and 45%, respectively (P = .006). Taken together, these data suggest that fewer than one-half of patients with FA undergoing a second HCT for graft failure are long-term survivors. There is an urgent need to develop strategies to reduce the rate of graft failure after first HCT.

  • 3.
    Bejanyan, Nelli
    et al.
    Univ Minnesota, Div Hematol Oncol & Transplantat, 420 Delaware St SE,Mayo Mail Code 480, Minneapolis, MN 55455 USA.
    Zhang, Mei-Jie
    Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA;Med Coll Wisconsin, Dept Med, CIBMTR Ctr Int Blood & Marrrow Trasnsplantat, Milwaukee, WI 53226 USA.
    Wang, Hai-Lin
    Med Coll Wisconsin, Dept Med, CIBMTR Ctr Int Blood & Marrrow Trasnsplantat, Milwaukee, WI 53226 USA.
    Lazaryan, Aleksandr
    Univ Minnesota, Div Hematol Oncol & Transplantat, 420 Delaware St SE,Mayo Mail Code 480, Minneapolis, MN 55455 USA.
    de Lima, Marcos
    Univ Hosp Case Med Ctr, Seidman Canc Ctr, Dept Med, Cleveland, OH USA.
    Marks, David I.
    Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England.
    Sandmaier, Brenda M.
    Univ Washington, Div Med Oncol, Seattle, WA 98195 USA;Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA.
    Bachanova, Veronika
    Univ Minnesota, Div Hematol Oncol & Transplantat, 420 Delaware St SE,Mayo Mail Code 480, Minneapolis, MN 55455 USA.
    Rowe, Jacob
    Shaare Zedek Med Ctr, Dept Hematol, Jerusalem, Israel.
    Tallman, Martin
    Mem Sloan Kettering Canc Ctr, Dept Med, Leukemia Serv, 1275 York Ave, New York, NY 10021 USA.
    Kebriaei, Partow
    Univ Texas MD Anderson Canc Ctr, Div Canc Med, Dept Stem Cell Transplantat, Houston, TX 77030 USA.
    Kharfan-Dabaja, Mohamed
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA.
    Gale, Robert Peter
    Imperial Coll London, Div Expt Med, Dept Med, Hematol Res Ctr, London, England.
    Lazarus, Hillard M.
    Univ Hosp Cleveland Med Ctr, Seidman Canc Ctr, Cleveland, OH USA.
    Ustun, Celalettin
    Univ Minnesota, Div Hematol Oncol & Transplantat, 420 Delaware St SE,Mayo Mail Code 480, Minneapolis, MN 55455 USA.
    Copelan, Edward
    Carolinas HealthCare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA.
    Hamilton, Betty Ky
    Cleveland Clin, Taussig Canc Inst, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA.
    Schiller, Gary
    Univ Calif Los Angeles, David Geffen Sch Med, Hematol Malignancy Stem Cell Transplant Program, Los Angeles, CA 90095 USA.
    Hogan, William
    Mayo Clin Rochester, Dept Hematol, Rochester, MN USA;Mayo Clin Rochester, Transplant Ctr, Rochester, MN USA.
    Hashmi, Shahrukh
    Mayo Clin, Dept Internal Med, Rochester, MN USA;King Faisal Specialist Hosp & Res Ctr, Ctr Oncol, Riyadh, Saudi Arabia.
    Seftel, Matthew
    CancerCare Manitoba, Dept Med Oncol & Hematol, Winnipeg, MB, Canada.
    Kanakry, Christopher G.
    NCI, Expt Transplantat & Immunol Branch, Ctr Canc Res, NIH, Bethesda, MD 20892 USA.
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.
    Martino, Rodrigo
    Hosp Santa Creu & Sant Pau, Div Clin Hematol, Barcelona, Spain.
    Saber, Wael
    Med Coll Wisconsin, Dept Med, CIBMTR Ctr Int Blood & Marrrow Trasnsplantat, Milwaukee, WI 53226 USA.
    Khoury, H. Jean
    Emory Univ Hosp, 1364 Clifton Rd NE, Atlanta, GA 30322 USA.
    Weisdorf, Daniel J.
    Univ Minnesota, Div Hematol Oncol & Transplantat, 420 Delaware St SE,Mayo Mail Code 480, Minneapolis, MN 55455 USA.
    Pretransplant Consolidation Is Not Beneficial for Adults with ALL Undergoing Myeloablative Allogeneic Transplantation2018In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 24, no 5, p. 945-955Article in journal (Refereed)
    Abstract [en]

    Allogeneic hematopoietic cell transplantation (alloHCT) is curative for patients with acute lymphoblastic leukemia (ALL) who achieve complete remission (CR1) with chemotherapy. However, the benefit of consolidation chemotherapy remains uncertain in patients undergoing alloHCT. We compared clinical outcomes of 524 adult patients with ALL in CR1 who received ≥2 (n = 109), 1 (n = 93), or 0 cycles (n = 322) of consolidation before myeloablative alloHCT from 2008 to 2012. As expected, time to alloHCT was longer with increasing cycles of consolidation. Patients receiving ≥2, 1, or 0 cycles of consolidation had an adjusted 3-year cumulative incidence of relapse of 20%, 27%, and 22%; 1-year transplant-related mortality (TRM) of 16%, 18%, and 23%; adjusted 3-year leukemia-free survival (LFS) of 54%, 48%, and 47%; and 3-year overall survival (OS) of 63%, 59%, and 54% (all P values >.40). Multivariable analysis confirmed that consolidation was not prognostic for LFS (relative risk, 1.20, 95% confidence interval, .86 to 1.67; P = .28 for no consolidation; RR, 1.18, 95% confidence interval, .79 to 1.76; P = .41 for 1 cycle versus ≥2 cycles = reference). Similarly, consolidation was not associated with OS, relapse, TRM, or graft-versus-host disease. We conclude that consolidation chemotherapy does not appear to provide added benefit in adult ALL patients with available donors who undergo myeloablative alloHCT in CR1.

  • 4. Brunstein, Claudio G
    et al.
    Pasquini, Marcelo C
    Kim, Soyoung
    Fei, Mingwei
    Adekola, Kehinde
    Ahmed, Ibrahim
    Aljurf, Mahmoud
    Agrawal, Vaibhav
    Auletta, Jeffrey J
    Battiwalla, Minoo
    Bejanyan, Nelli
    Bubalo, Joseph
    Cerny, Jan
    Chee, Lynette
    Ciurea, Stefan O
    Freytes, Cesar
    Gadalla, Shahinaz M
    Gale, Robert Peter
    Ganguly, Siddhartha
    Hashmi, Shahrukh K
    Hematti, Peiman
    Hildebrandt, Gerhard
    Holmberg, Leona A
    Lahoud, Oscar B
    Landau, Heather
    Lazarus, Hillard M
    de Lima, Marcos
    Mathews, Vikram
    Maziarz, Richard
    Nishihori, Taiga
    Norkin, Maxim
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Reshef, Ran
    Rotz, Seth
    Savani, Bipin
    Schouten, Harry C
    Seo, Sachiko
    Wirk, Baldeep M
    Yared, Jean
    Mineishi, Shin
    Rogosheske, John
    Perales, Miguel-Angel
    Effect of Conditioning Regimen Dose Reduction in Obese Patients Undergoing Autologous Hematopoietic Cell Transplantation2019In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 25, no 3, p. 480-487Article in journal (Refereed)
    Abstract [en]

    Data are limited on whether to adjust high-dose chemotherapy before autologous hematopoietic cell transplant (autoHCT) in obese patients. This study explores the effects of dose adjustment on the outcomes of obese patients, defined as body mass index (BMI) ≥ 30 kg/m2. Dose adjustment was defined as a reduction in standard dosing ≥ 20%, based on ideal, reported dosing and actual weights. We included 2 groups of US patients who had received autoHCT between 2008 and 2014. Specifically, we included patients with multiple myeloma (MM, n = 1696) treated with high-dose melphalan and patients with Hodgkin or non-Hodgkin lymphomas (n = 781) who received carmustine, etoposide, cytarabine, and melphalan conditioning. Chemotherapy dose was adjusted in 1324 patients (78%) with MM and 608 patients (78%) with lymphoma. Age, sex, BMI, race, performance score, comorbidity index, and disease features (stage at diagnosis, disease status, and time to transplant) were similar between dose groups. In multivariate analyses for MM, adjusting for melphalan dose and for center effect had no impact on overall survival (P = .894) and treatment-related mortality (TRM) (P = .62), progression (P = .12), and progression-free survival (PFS; P = .178). In multivariate analyses for lymphoma, adjusting chemotherapy doses did not affect survival (P = .176), TRM (P = .802), relapse (P = .633), or PFS (P = .812). No center effect was observed in lymphoma. This study demonstrates that adjusting chemotherapy dose before autoHCT in obese patients with MM and lymphoma does not influence mortality. These results do not support adjusting chemotherapy dose in this population.

  • 5.
    Burke, Michael J.
    et al.
    Med Coll Wisconsin, Dept Pediat, Div Hematol Oncol Blood & Marrow Transplant, Milwaukee, WI 53226 USA.;Childrens Hosp Wisconsin, Milwaukee, WI 53226 USA..
    Verneris, Michael R.
    Univ Minnesota, Dept Pediat, Minneapolis, MN 55455 USA..
    Le Rademacher, Jennifer
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA..
    He, Wensheng
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Abdel-Azim, Hisham
    Univ So Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90033 USA..
    Abraham, Allistair A.
    Childrens Natl Med Ctr, Ctr Canc & Blood Disorders, Div Blood & Marrow Transplantat, Washington, DC 20010 USA..
    Auletta, Jeffery J.
    Nationwide Childrens Hosp, Div Hematol Oncol Bone Marrow Transplantat & Infe, Columbus, OH USA..
    Ayas, Mouhab
    King Faisal Specialist Hosp & Res Ctr, Dept Pediat Hematol Oncol, Riyadh, Saudi Arabia..
    Brown, Valerie I.
    Penn State Hershey Childrens Hosp, Dept Pediat, Div Pediat Oncol Hematol, Hershey, PA USA.;Penn State Univ, Milton S Hershey Med Ctr, Coll Med, Hershey, PA 17033 USA..
    Cairo, Mitchell S.
    New York Med Coll, Dept Pediat, Valhalla, NY 10595 USA..
    Chan, Ka Wah
    Texas Transplant Inst, Dept Pediat, San Antonio, TX USA..
    Diaz Perez, Miguel A.
    Hosp Infantil Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain..
    Dvorak, Christopher C.
    Univ Calif San Francisco, Dept Pediat, Med Ctr, San Francisco, CA USA..
    Egeler, R. Maarten
    Hosp Sick Children, Dept Hematol Oncol, Toronto, ON M5G 1X8, Canada..
    Eldjerou, Lamis
    Univ Florida, Dept Pediat, Gainesville, FL USA..
    Frangoul, Haydar
    Vanderbilt Univ, Dept Pediat, Div Hematol Oncol, Sch Med, Nashville, TN USA..
    Guilcher, Gregory M. T.
    Alberta Childrens Prov Gen Hosp, Sect Paediat Oncol & Blood & Marrow Transplant, Calgary, AB, Canada..
    Hayashi, Robert J.
    Washington Univ, Sch Med, Dept Pediat, Div Pediat Hematol Oncol, St Louis, MO 63110 USA..
    Ibrahim, Ahmed
    Makassed Gen Hosp, Dept Hematol Oncol, Beiruit, Lebanon..
    Kasow, Kimberly A.
    Univ N Carolina, Dept Pediat, Div Hematol Oncol, Chapel Hill, NC USA..
    Leung, Wing H.
    St Jude Childrens Res Hosp, Div Bone Marrow Transplantat, Memphis, TN 38105 USA..
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.
    Pulsipher, Michael A.
    Univ So Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90033 USA..
    Shah, Niketa
    Mayo Clin Arizona, Dept Pediat, Div Hematol Oncol, Phoenix, AZ USA.;Phoenix Childrens Hosp, Phoenix, AZ USA..
    Shah, Nirali N.
    Natl Canc Inst NIH, Pediat Oncol Branch, Ctr Canc Res, Bethesda, MD USA..
    Thiel, Elizabeth
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Talano, Julie-An
    Med Coll Wisconsin, Dept Pediat, Div Hematol Oncol Blood & Marrow Transplant, Milwaukee, WI 53226 USA.;Childrens Hosp Wisconsin, Milwaukee, WI 53226 USA..
    Kitko, Carrie L.
    Vanderbilt Univ, Dept Pediat, Stem Cell Transplant Program, Nashville, TN USA..
    Transplant Outcomes for Children with T Cell Acute Lymphoblastic Leukemia in Second Remission: A Report from the Center for International Blood and Marrow Transplant Research2015In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 21, no 12, p. 2154-2159Article in journal (Refereed)
    Abstract [en]

    Survival for children with relapsed T cell acute lymphoblastic leukemia (T-ALL) is poor when treated with chemotherapy alone, and outcomes after allogeneic hematopoietic cell transplantation (HCT) is not well described. Two hundred twenty-nine children with T-ALL in second complete remission (CR2) received an HCT after myeloablative conditioning between 2000 and 2011 and were reported to the Center for International Blood and Marrow Transplant Research. Median age was 10 years (range, 2 to 18). Donor source was umbilical cord blood (26%), matched sibling bone marrow (38%), or unrelated bone marrow/peripheral blood (36%). Acute (grades II to IV) and chronic graft-versus-host disease occurred in, respectively, 35% (95% confidence interval [CI], 27% to 45%) and 26% (95% CI, 20% to 33%) of patients. Transplant-related mortality at day 100 and 3-year relapse rates were 13% (95% CI, 9% to 18%) and 30% (95% CI, 24% to 37%), respectively. Three-year overall survival and disease-free survival rates were 48% (95% CI, 41% to 55%) and 46% (95% CI, 39% to 52%), respectively. In multivariate analysis, patients with bone marrow relapse, with or without concurrent extramedullary relapse before HCT, were most likely to relapse (hazard ratio, 3.94; P =.005) as compared with isolated extramedullary disease. In conclusion, HCT for pediatric T-ALL in CR2 demonstrates reasonable and durable outcomes, and consideration for HCT is warranted. (c) 2015 American Society for Blood and Marrow Transplantation.

  • 6.
    Casulo, Carla
    et al.
    Univ Rochester, Wilmot Canc Inst, New York, NY USA.
    Friedberg, Jonathan W.
    Univ Rochester, Wilmot Canc Inst, New York, NY USA.
    Ahn, Kwang W.
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Dept Med, Milwaukee, WI 53226 USA;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA.
    Flowers, Christopher
    Emory Univ, Winship Canc Inst, Dept Hematol & Med Oncol, Sch Med, Atlanta, GA 30322 USA.
    DiGilio, Alyssa
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Dept Med, Milwaukee, WI 53226 USA.
    Smith, Sonali M.
    Univ Chicago, Sect Hematol Oncol, Chicago, IL 60637 USA.
    Ahmed, Sairah
    Univ MD Anderson Canc Ctr, Dept Stem Cell Transplantat, Div Canc Med, Houston, TX USA.
    Inwards, David
    Mayo Clin, Div Hematol, Rochester, MN USA.
    Aljurf, Mahmoud
    King Faisal Specialist Hosp Ctr & Res, Dept Oncol, Riydah, Saudi Arabia.
    Chen, Andy, I
    Oregon Hlth & Sci Univ, Blood & Marrow Transplant Program, Portland, OR 97201 USA.
    Choe, Hannah
    Weill Cornell Med Coll, Blood & Marrow Transplant Program, New York, NY USA.
    Cohen, Jonathon
    Emory Univ, Winship Canc Inst, Dept Hematol & Med Oncol, Sch Med, Atlanta, GA 30322 USA.
    Copelan, Edward
    Carolinas HealthCare Syst, Dept Hematol Oncol & Blood Disorders, Levine Canc Inst, Charlotte, NC USA.
    Farooq, Umar
    Univ Iowa, Dept Med, Iowa City, IA 52242 USA.
    Fenske, Timothy S.
    Med Coll Wisconsin, Dept Med, Div Hematol & Oncol, Milwaukee, WI 53226 USA.
    Freytes, Cesar
    Texas Transplant Inst, Blood & Marrow Transplant Program, San Antonio, TX USA.
    Gaballa, Sameh
    Thomas Jefferson Univ Hosp, Blood & Marrow Transplant Program, Philadelphia, PA 19107 USA.
    Ganguly, Siddhartha
    Univ Kansas, Div Hematol Malignancies & Cellular Therapeut, Med Ctr, Kansas City, KS 66103 USA.
    Jethava, Yogesh
    Univ Arkansas Med Sci, Blood & Marrow Transplant Program, Little Rock, AR 72205 USA.
    Kamble, Rammurti T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA.
    Kenkre, Vaishalee P.
    Univ Wisconsin, Div Hematol & Oncol, Madison, WI USA.
    Lazarus, Hillard
    Univ Hosp Cleveland, Seidman Canc Ctr, Med Ctr, Cleveland, OH 44106 USA.
    Lazaryan, Aleksandr
    Univ Minnesota, Blood & Marrow Transplant Program, Minneapolis, MN USA.
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.
    Rezvani, Andrew R.
    Stanford Hlth Care, Blood & Marrow Transplant Program, Stanford, CA USA.
    Rizzieri, David
    Duke Univ, Div Hematol Malignancies & Cellular Therapy, Durham, NC USA.
    Seo, Sachiko
    East Hosp, Natl Canc Res Ctr, Chiba, Japan.
    Shah, Gunjan L.
    Mem Sloan Kettering Canc Ctr, Blood & Marrow Transplant Program, 1275 York Ave, New York, NY 10021 USA.
    Shah, Nina
    Univ MD Anderson Canc Ctr, Dept Stem Cell Transplantat, Div Canc Med, Houston, TX USA.
    Solh, Melham
    Northside Hosp, Blood & Marrow Transplant Grp Georgia, Atlanta, GA USA.
    Sureda, Anna
    Inst Catala Oncol Hosp, Hematol Dept, Barcelona, Spain.
    William, Basem
    Ohio State Med Ctr, James Canc Ctr, Columbus, OH USA.
    Cumpston, Aaron
    West Virginia Univ Hosp, Blood & Marrow Transplant Program, Morgantown, WV USA.
    Zelenetz, Andrew D.
    Mem Sloan Kettering Canc Ctr, Blood & Marrow Transplant Program, 1275 York Ave, New York, NY 10021 USA.
    Link, Brian K.
    Med Coll Wisconsin, Dept Med, Div Hematol & Oncol, Milwaukee, WI 53226 USA.
    Hamadani, Mehdi
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Dept Med, Milwaukee, WI 53226 USA.
    Autologous Transplantation in Follicular Lymphoma with Early Therapy Failure: A National LymphoCare Study and Center for International Blood and Marrow Transplant Research Analysis2018In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 24, no 6, p. 1163-1171Article in journal (Refereed)
    Abstract [en]

    Patients with follicular lymphoma (FL) experiencing early therapy failure (ETF) within 2 years of frontline chemoimmunotherapy have poor overall survival (OS). We analyzed data from the Center for International Blood and Marrow Transplant Research (CIBMTR) and the National LymphoCare Study (NLCS) to determine whether autologous hematopoietic cell transplant (autoHCT) can improve outcomes in this high-risk FL subgroup. ETF was defined as failure to achieve at least partial response after frontline chemoimmunotherapy or lymphoma progression within 2 years of frontline chemoimmunotherapy. We identified 2 groups: the non-autoHCT cohort (patients from the NLCS with ETF not undergoing autoHCT) and the autoHCT cohort (CIBMTR patients with ETF undergoing autoHCT). All patients received rituximab-based chemotherapy as frontline treatment; 174 non-autoHCT patients and 175 autoHCT patients were identified and analyzed. There was no difference in 5-year OS between the 2 groups (60% versus 67%, respectively; P = .16). A planned subgroup analysis showed that patients with ETF receiving autoHCT soon after treatment failure (≤1 year of ETF; n = 123) had higher 5-year OS than those without autoHCT (73% versus 60%, P = .05). On multivariate analysis, early use of autoHCT was associated with significantly reduced mortality (hazard ratio, .63; 95% confidence interval, .42 to .94; P = .02). Patients with FL experiencing ETF after frontline chemoimmunotherapy lack optimal therapy. We demonstrate improved OS when receiving autoHCT within 1 year of treatment failure. Results from this unique collaboration between the NLCS and CIBMTR support consideration of early consolidation with autoHCT in select FL patients experiencing ETF.

  • 7.
    Chaudhury, Sonali
    et al.
    Ann & Robert H Lurie Childrens Hosp Chicago, Dept Pediat Hematol Oncol & Stem Cell Transplanta, 225 E Chicago Ave, Chicago, IL 60611 USA..
    Sparapani, Rodney
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Hu, Zhen-Huan
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Nishihori, Taiga
    Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL 33612 USA..
    Abdel-Azim, Hisham
    Univ So Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90033 USA..
    Malone, Adriana
    Icahn Sch Med Mt Sinai, Bone Marrow & Stem Cell Transplantat, New York, NY 10029 USA..
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.
    Hamadani, Mehdi
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Froedtert Mem Lutheran Hosp, Milwaukee, WI 53226 USA..
    Daly, Andrew
    Univ Calgary, Tom Baker Canc Ctr, Cumming Sch Med, Calgary, AB, Canada..
    Bacher, Ulrike
    Univ Canc Ctr Hamburg, Interdisciplinary Clin Stem Cell Transplantat, Hamburg, Germany..
    Wirk, Baldeep M.
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA..
    Kamble, Rammurti T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA..
    Gale, Robert P.
    Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Hematol Res Ctr, London, England..
    Wood, William A.
    Univ N Carolina, Div Hematol Oncol, Chapel Hill, NC USA..
    Hale, Gregory
    Univ S Florida, All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL 33701 USA..
    Wiernik, Peter H.
    Canc Res Fdn New York, Bronx, NY USA..
    Hashmi, Shahrukh K.
    Mayo Clin, Dept Blood & Marrow Transplantat, Rochester, MN USA..
    Marks, David
    Univ Hosp Bristol NHS Trust, Pediat Bone Marrow Transplant, Bristol, Avon, England..
    Ustun, Celalettin
    Univ Minneapolis, Div Hematol Oncol & Transplantat, Minneapolis, MN USA..
    Munker, Reinhold
    Louisiana State Univ Hlth Shreveport, Dept Internal Med, Sect Hematol Oncol, Shreveport, LA USA..
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Alyea, Edwin
    Dana Farber Canc Inst, Div Hematol Malignancies, Boston, MA 02115 USA.;Dana Farber Canc Inst, Dept Med Oncol, Boston, MA 02115 USA..
    Popat, Uday
    Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat & Cellular Therapy, Houston, TX 77030 USA..
    Sobecks, Ronald
    Cleveland Clin, Taussig Canc Inst, Dept Hematol & Med Oncol, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA..
    Kalaycio, Matt
    Cleveland Clin, Taussig Canc Inst, Dept Hematol & Med Oncol, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA..
    Maziarz, Richard
    Oregon Hlth & Sci Univ, Knight Canc Inst, Adult Blood & Marrow Stem Cell Transplant Program, Portland, OR 97201 USA..
    Hijiya, Nobuko
    Ann & Robert H Lurie Childrens Hosp Chicago, Dept Pediat Hematol Oncol & Stem Cell Transplanta, 225 E Chicago Ave, Chicago, IL 60611 USA..
    Saber, Wael
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Outcomes of Allogeneic Hematopoietic Cell Transplantation in Children and Young Adults with Chronic Myeloid Leukemia: A CIBMTR Cohort Analysis2016In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 22, no 6, p. 1056-1064Article in journal (Refereed)
    Abstract [en]

    Chronic myeloid leukemia (CML) in children and young adults is uncommon. Young patients have long life expectancies and low morbidity with hematopoietic cell transplantation (HCT). Prolonged tyrosine kinase inhibitor (TKI) use may cause significant morbidity. In addition, indication for HCT in patients in the first chronic phase is not established. We hence retrospectively evaluated outcomes in 449 CML patients with early disease receiving myeloablative HCT reported to the CIBMTR. We analyzed various factors affecting outcome, specifically the effect of age and pre-HCT TKI in pediatric patients (age < 18 years, n = 177) and young adults (age 18 to 29 years, n = 272) with the goal of identifying prognostic factors. Post-HCT probability rates of 5-year overall survival (OS) and leukemia-free survival (LFS) were 75% and 59%, respectively. Rates of OS and LFS were 76% and 57% in <18-year and 74% and 60% in 18- to 29-year group, respectively, by univariate analysis (P = .1 and = .6). Five-year rates of OS for HLA matched sibling donor (MSD) and bone marrow (BM) stem cell source were 83% and 80%, respectively. In multivariate analysis there was no effect of age (<18 versus 18 to 29) or pre-HCT TKI therapy on OS, LFS, transplant related mortality, or relapse. Favorable factors for OS were MSD (P < .001) and recent HCT (2003 to 2010; P = .04). LFS was superior with MSD (P < .001), BM as graft source (P = .001), and performance scores > 90 (P = .03) compared with unrelated or mismatched peripheral blood stem cells donors and recipients with lower performance scores. Older age was associated with increased incidence of chronic graft-versus-host disease (P = .0002). In the current era, HCT outcomes are similar in young patients and children with early CML, and best outcomes are achieved with BM grafts and MSD.

  • 8.
    Cornell, Robert F.
    et al.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Bachanova, Veronika
    Univ Minnesota, Med Ctr, Bone & Marrow Transplant Program, Minneapolis, MN 55455 USA..
    D'Souza, Anita
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Woo-Ahn, Kwang
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA..
    Martens, Michael
    Med Coll Wisconsin, Dept Oncol, Milwaukee, WI 53226 USA..
    Huang, Jiaxing
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Al-Homsi, A. Samer
    Spectrum Hlth, Blood & Marrow Transplant, Grand Rapids, MI USA..
    Chhabra, Saurabh
    Med Univ South Carolina, Dept Med, Charleston, SC USA..
    Copelan, Edward
    Carolinas HealthCare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA..
    Diaz, Miguel-Angel
    Hosp Infanta Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain..
    Freytes, Cesar O.
    Texas Transplant Inst, San Antonio, TX USA..
    Gale, Robert Peter
    Imperial Coll London, Dept Med, Div Expt Med, Hematol Res Ctr, London, England..
    Ganguly, Siddhartha
    Univ Kansas, Med Ctr, Blood & Marrow Transplantat, Div Hematol & Oncol, Kansas City, KS 66103 USA..
    Hamadani, Mehdi
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Hildebrandt, Gerhard
    Univ Kentucky, Div Hematol & Blood & Marrow Transplantat, Markey Canc Ctr, Lexington, KY USA..
    Kamble, Rammurti T.
    Baylor Coll Med, Div Hematol & Oncol, Ctr Cell & Gene Therapy, Houston, TX 77030 USA..
    Kharfan-Dabaja, Mohamed
    H Lee Moffitt Canc & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA..
    Kindwall-Keller, Tamila
    Univ Virginia Hlth Syst, Div Hematol Oncol, Charlottesville, VA USA..
    Lazarus, Hillard M.
    Univ Hosp Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA..
    Marks, David I.
    Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England..
    Nishihori, Taiga
    H Lee Moffitt Canc & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA..
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Div Therapeut Immunol, Dept Lab Med, Stockholm, Sweden..
    Saad, Ayman
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA..
    Usmani, Saad
    Carolinas HealthCare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA..
    Vesole, David H.
    Hackensack UMC, John Theurer Canc Ctr, Hackensack, NJ USA..
    Yared, Jean
    Univ Maryland, Dept Med, Blood & Marrow Transplantat Program, Div Hematol Oncol,Greenebaum Canc Ctr, Baltimore, MD 21201 USA..
    Mark, Tomer
    Weill Cornell Med Coll, Dept Med, New York, NY USA..
    Nieto, Yago
    Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat & Cellular Therapy, Houston, TX 77030 USA..
    Hari, Parameswaran
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Allogeneic Transplantation for Relapsed Waldenström Macroglobulinemia and Lymphoplasmacytic Lymphoma2017In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 23, no 1, p. 60-66Article in journal (Refereed)
    Abstract [en]

    Waldenstrom macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) is characterized by lymphoplasmacytic proliferation, lymph node and spleen enlargement, bone marrow involvement, and IgM production. Treatment varies based on the extent and biology of disease. In some patients, the use of allogeneic hematopoietic cell transplantation (alloHCT) may have curative potential. We evaluated long-term outcomes of 144 patients who received adult alloHCT for WM/LPL. Data were obtained from the Center for International Blood and Marrow Transplant Research database (2001 to 2013). Patients received myeloablative (n = 67) or reduced-intensity conditioning (RIC; n = 67). Median age at alloHCT was 53 years, and median time from diagnosis to transplantation was 41 months. Thirteen percent (n = 18) failed prior autologous HCT. About half (n = 82, 57%) had chemosensitive disease at the time of transplantation, whereas 22% had progressive disease. Rates of progression-free survival, overall survival, relapse, and nonrelapse mortality at 5 years were 46%, 52%, 24%, and 30%, respectively. Patients with chemosensitive disease and better pretransplant disease status experienced significantly superior overall survival. There were no significant differences in progression-free survival based on conditioning (myeloablative, 50%, versus RIC, 41%) or graft source. Conditioning intensity did not impact treatment-related mortality or relapse. The most common causes of death were primary disease and graft-versus-host disease (GVHD). AlloHCT yielded durable survival in select patients with WM/LPL. Strategies to reduce mortality from GVHD and post-transplant relapse are necessary to improve this approach.

  • 9. Cornell, Robert F
    et al.
    D'Souza, Anita
    Kassim, Adetola A
    Costa, Luciano J
    Innis-Shelton, Racquel D
    Zhang, Mei-Jie
    Huang, Jiaxing
    Abidi, Muneer
    Aiello, Jack
    Akpek, Gorgun
    Bashey, Asad
    Bashir, Qaiser
    Cerny, Jan
    Comenzo, Raymond
    Diaz, Miguel Angel
    Freytes, César
    Gale, Robert Peter
    Ganguly, Siddhartha
    Hamadani, Mehdi
    Hashmi, Shahrukh
    Holmberg, Leona
    Hossain, Nasheed
    Kamble, Rammurti T
    Kharfan-Dabaja, Mohamed
    Kindwall-Keller, Tamila
    Kyle, Robert
    Kumar, Shaji
    Lazarus, Hillard
    Lee, Cindy
    Maiolino, Angelo
    Marks, David I
    Meehan, Kenneth
    Mikhael, Joe
    Nath, Rajneesh
    Nishihori, Taiga
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Ramanathan, Muthalagu
    Saad, Ayman
    Seo, Sachiko
    Usmani, Saad
    Vesole, David
    Vij, Ravi
    Vogl, Dan
    Wirk, Baldeep M
    Yared, Jean
    Krishnan, Amrita
    Mark, Tomer
    Nieto, Yago
    Hari, Parameswaran
    Maintenance versus Induction Therapy Choice on Outcomes after Autologous Transplantation for Multiple Myeloma2017In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 23, no 2, p. 269-277Article in journal (Refereed)
    Abstract [en]

    Bortezomib (V), lenalidomide (R), cyclophosphamide (C), and dexamethasone (D) are components of the most commonly used modern doublet (RD, VD) or triplet (VRD, CVD) initial induction regimens before autologous hematopoietic cell transplantation (AHCT) for multiple myeloma (MM) in the United States. In this study we evaluated 693 patients receiving "upfront" AHCT after initial induction therapy with modern doublet or triplet regimens using data reported to the Center for International Blood and Marrow Transplant Research from 2008 to 2013. Analysis was limited to those receiving a single AHCT after 1 line of induction therapy within 12 months from treatment initiation for MM. In multivariate analysis, progression-free survival (PFS) and overall survival were similar irrespective of induction regimen. However, high-risk cytogenetics and nonreceipt of post-transplant maintenance/consolidation therapy were associated with higher risk of relapse. Patients receiving post-transplant therapy had significantly improved 3-year PFS versus no post-transplant therapy (55% versus 39%, P = .0001). This benefit was most evident in patients not achieving at least a complete response post-AHCT (P = .005). In patients receiving upfront AHCT, the choice of induction regimen (doublet or triplet therapies) appears to be of lower impact than use of post-transplant therapy.

  • 10.
    Gerds, Aaron T.
    et al.
    Cleveland Clin, Taussig Canc Inst, Hematol & Med Oncol, Cleveland, OH 44106 USA..
    Ahn, Kwang Woo
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA..
    Hu, Zhen-Huan
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Abdel-Azim, Hisham
    Univ Southern Calif, Keck Sch Med, Childrens Hosp Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90033 USA..
    Akpek, Gorgun
    Rush Univ, Med Ctr, Dept Internal Med, Stem Cell Transplantat & Cell Therapy, Chicago, IL 60612 USA..
    Aljurf, Mahmoud
    King Faisal Specialist Hosp & Res Ctr, Dept Oncol, Riyadh, Saudi Arabia..
    Ballen, Karen K.
    Massachusetts Gen Hosp, Dept Hematol Oncol, Boston, MA 02114 USA..
    Beitinjaneh, Amer
    Univ Miami, Div Hematol & Oncol, Miami, FL USA..
    Bacher, Ulrike
    Inselspital Bern, Dept Hematol, Bern, Switzerland.;Univ Canc Ctr Hamburg, Interdisciplinary Clin Stem Cell Transplantat, Hamburg, Germany..
    Cahn, Jean-Yves
    Univ Hosp, Dept Hematol, Grenoble, France..
    Chhabra, Saurabh
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Cutler, Corey
    Dana Farber Canc Inst, Ctr Hematol Oncol, Boston, MA 02115 USA..
    Daly, Andrew
    Tom Baker Canc Clin, Calgary, AB, Canada..
    DeFilipp, Zachariah
    Massachusetts Gen Hosp, Dept Hematol Oncol, Boston, MA 02114 USA..
    Gale, Robert Peter
    Imperial Coll London, Dept Med, Div Expt Med, Hematol Res Ctr, London, England..
    Gergis, Usama
    New York Presbyterian Hosp, Weill Cornell Med Ctr, Dept Med Oncol, Hematolg Malignancies & Bone Marrow Transplant, New York, NY USA..
    Grunwald, Michael R.
    Levine Canc Inst, Charlotte, NC USA..
    Hale, Gregory A.
    Johns Hopkins All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL USA..
    Hamilton, Betty Ky
    Cleveland Clin, Taussig Canc Inst, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA..
    Jagasia, Madan
    Vanderbilt Univ, Med Ctr, Div Hematol Oncol, 221 Kirkland Hall, Nashville, TN 37235 USA..
    Kamble, Rammurti T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA..
    Kindwall-Keller, Tamila
    Univ Virginia Hlth Syst, Div Hematol Oncol, Charlottesville, VA USA..
    Nishihori, Taiga
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA..
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden..
    Ramanathan, Muthalagu
    UMass Mem Med Ctr, Dept Med, Div Hematol & Oncol, Worcester, MA USA..
    Saad, Ayman A.
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA..
    Solh, Melhem
    Northside Hosp, Blood & Marrow Transplant Grp Georgia, Atlanta, GA USA..
    Ustun, Celalettin
    Univ Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN 55455 USA..
    Valcarcel, David
    Hosp Valle De Hebron, Dept Hematol, Barcelona, Spain..
    Warlick, Erica
    Univ Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN 55455 USA..
    Wirk, Baldeep M.
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA..
    Kalaycio, Matt
    Cleveland Clin, Taussig Canc Inst, Hematol & Med Oncol, Cleveland, OH 44106 USA..
    Alyea, Edwin
    Dana Farber Canc Inst, Ctr Hematol Oncol, Boston, MA 02115 USA..
    Popat, Uday
    MD Anderson Canc Ctr, Houston, TX USA..
    Sobecks, Ronald
    Cleveland Clin, Taussig Canc Inst, Hematol & Med Oncol, Cleveland, OH 44106 USA..
    Saber, Wael
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Outcomes after Umbilical Cord Blood Transplantation for Myelodysplastic Syndromes2017In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 23, no 6, p. 971-979Article in journal (Refereed)
    Abstract [en]

    For patients with hematologic malignancies undergoing allogeneic hematopoietic cell transplantation, umbilical cord blood transplantation (UCBT) has become an acceptable alternative donor source in the absence of a matched sibling or unrelated donor. To date, however, there have been few published series dedicated solely to describing the outcomes of adult patients with myelodysplastic syndrome (MDS) who have undergone UCBT. Between 2004 and 2013, 176 adults with MDS underwent UCBT as reported to the Center for International Blood and Marrow Transplant Research. Median age at the time of transplantation was 56 years (range, 18-73 years). The study group included 10% with very low, 23% with low, 19% with intermediate, 19% with high, and 13% with very high-risk Revised International Prognostic Scoring System (IPSS-R) scores. The 100-day probability of grade II-IV acute graft-versus-host disease (GVHD) was 38%, and the 3-year probability of chronic GVHD was 28%. The probabilities of relapse and transplantation-related mortality (TRM) at 3 years were 32% and 40%, respectively, leading to a 3-year disease-free survival (DFS) of 28% and an overall survival (OS) of 31%. In multivariate analysis, increasing IPSS-R score at the time of HCT was associated with inferior TRM (P = .0056), DFS (P = .018), and OS (P = .0082), but not with GVHD or relapse. The presence of pretransplantation comorbidities was associated with TRM (P = .001), DFS (P = .02), and OS (P = .001). Reduced intensity conditioning was associated with increased risk of relapse (relative risk, 3.95; 95% confidence interval, 1.78-8.75; P < .001), and although a higher proportion of myeloablative UCBTs were performed in patients with high-risk disease, the effect of conditioning regimen intensity was the same regardless of IPSS-R score. For some individuals who lack a matched sibling or unrelated donor, UCBT can result in long-term DFS; however, the success of UCBT in this population is hampered by a high rate of TRM. (C) 2017 American Society for Blood and Marrow Transplantation.

  • 11. Hamadani, Mehdi
    et al.
    Hari, Parameswaran N.
    Zhang, Ying
    Carreras, Jeanette
    Akpek, Goerguen
    Aljurf, Mahmoud D.
    Ayala, Ernesto
    Bachanova, Veronika
    Chen, Andy I.
    Chen, Yi-Bin
    Costa, Luciano J.
    Fenske, Timothy S.
    Freytes, Cesar O.
    Ganguly, Siddhartha
    Hertzberg, Mark S.
    Holmberg, Leona A.
    Inwards, David J.
    Kamble, Rammurti T.
    Kanfer, Edward J.
    Lazarus, Hillard M.
    Marks, David I.
    Nishihori, Taiga
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Reddy, Nishitha M.
    Rizzieri, David A.
    Savani, Bipin N.
    Solh, Melhem
    Vose, Julie M.
    Wirk, Baldeep
    Maloney, David G.
    Smith, Sonali M.
    Montoto, Silvia
    Saber, Wael
    Early Failure of Frontline Rituximab-Containing Chemo-immunotherapy in Diffuse Large B Cell Lymphoma Does Not Predict Futility of Autologous Hematopoietic Cell Transplantation2014In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 20, no 11, p. 1729-1736Article in journal (Refereed)
    Abstract [en]

    The poor prognosis for patients with diffuse large B cell lymphoma (DLBCL) who relapse within 1 year of initial diagnosis after first-line rituximab-based chemo-immunotherapy has created controversy about the role of autologous transplantation (HCT) in this setting. We compared autologous HCT outcomes for chemosensitive DLBCL patients between 2000 and 2011 in 2 cohorts based on time to relapse from diagnosis. The early rituximab failure (ERF) cohort consisted of patients with primary refractory disease or those with first relapse within 1 year of initial diagnosis. The ERF cohort was compared with those relapsing >1 year after initial diagnosis (late rituximab failure [LRF] cohort). ERF and LRF cohorts included 300 and 216 patients, respectively. Nonrelapse mortality (NRM), progression/relapse, progression-free survival (PFS), and overall survival (OS) of ERF versus LRF cohorts at 3 years were 9% (95% confidence interval [CI], 6% to 13%) versus 9% (95% CI, 5% to 13%), 47% (95% CI, 41% to 52%) versus 39% (95% CI, 33% to 46%), 44% (95% CI, 38% to 50%) versus 52% (95% CI, 45% to 59%), and 50% (95% CI, 44% to 56%) versus 67% (95% CI, 60% to 74%), respectively. On multivariate analysis, ERF was not associated with higher NRM (relative risk [RR], 1.31; P = .34). The ERF cohort had a higher risk of treatment failure (progression/relapse or death) (RR, 2.08; P < .001) and overall mortality (RR, 3.75; P < .001) within the first 9 months after autologous HCT. Beyond this period, PFS and OS were not significantly different between the ERF and LRF cohorts. Autologous HCT provides durable disease control to a sizeable subset of DLBCL despite ERF (3-year PFS, 44%) and remains the standard-of-care in chemosensitive DLBCL regardless of the timing of disease relapse.

  • 12.
    Hill, Brian T.
    et al.
    Cleveland Clin, Taussig Canc Inst, Dept Hematol & Med Oncol, Cleveland, OH, USA.
    Ahn, Kwang Woo
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplantat, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Dept Med, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI, USA.
    Hu, Zhen-Huan
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplantat, Milwaukee, WI, USA; Med Coll Wisconsin, Dept Med, Milwaukee, WI, USA.
    Aljurf, Mahmoud
    King Faisal Specialist Hosp Ctr & Res, Dept Oncol, Riyadh, Saudi Arabia.
    Beitinjaneh, Amer
    Univ Miami, Miami, FL, USA.
    Cahn, Jean-Yves
    Univ Hosp, Dept Hematol, Grenoble, France.
    Cerny, Jan
    UMass Mem Med Ctr, Worcester, MA USA.
    Kharfan-Dabaja, Mohamed A.
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL, USA.
    Ganguly, Siddhartha
    Univ Kansas, Med Ctr, Div Hematol & Oncol, Blood & Marrow Transplantat, Kansas City, KS, USA.
    Ghosh, Nilanjan
    Carolinas Healthcare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC, USA.
    Grunwald, Michael R.
    Carolinas Healthcare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC, USA.
    Inamoto, Yoshihiro
    Natl Canc Ctr, Div Hematopoiet Stem Cell Transplantat, Tokyo, Japan.
    Kindwall-Keller, Tamila
    Univ Virginia Hlth Syst, Div Hematol Oncol, Charlottesville, VA, USA.
    Nishihori, Taiga
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL, USA.
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Div Therapeut Immunol, Dept Lab Med, Stockholm, Sweden.
    Saad, Ayman
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL, USA.
    Seftel, Matthew
    CancerCare Manitoba, Dept Med Oncol & Hematol, Winnipeg, MB, Canada.
    Seo, Sachiko
    Natl Canc Res Ctr East, Dept Hematol & Oncol, Chiba, Japan.
    Szer, Jeffrey
    Royal Melbourne Hosp, Dept Clin Haematol & Bone Marrow Transplantat, Parkville, Vic, Australia.
    Tallman, Martin
    Mem Sloan Kettering Canc Ctr, Dept Med, Leukemia Serv, New York, USA.
    Ustun, Celalettin
    Univ Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN, USA.
    Wiernik, Peter H.
    Our Lady Mercy Med Ctr, Bronx, NY USA.
    Maziarz, Richard T.
    Oregon Hlth & Sci Univ, Knight Canc Inst, Adult Blood & Marrow Stem Cell Transplant Program, Portland, OR, USA.
    Kalaycio, Matt
    Cleveland Clin, Cleveland, OH, USA.
    Alyea, Edwin
    Dana Farber Canc Inst, Ctr Hematol Oncol, Boston, MA, USA.
    Popat, Uday
    MD Anderson Canc Ctr, Houston, TX USA.
    Sobecks, Ronald
    Cleveland Clin, Cleveland, OH, USA.
    Saber, Wael
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplantat, Milwaukee, WI, USA; Med Coll Wisconsin, Dept Med, Milwaukee, WI, USA.
    Assessment of Impact of HLA Type on Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Lymphocytic Leukemia2018In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 24, no 3, p. 581-586Article in journal (Refereed)
    Abstract [en]

    Chronic lymphocytic leukemia (CLL) is a common hematologic malignancy with many highly effective therapies. Chemorefractory disease, often characterized by deletion of chromosome 17p, has historically been associated with very poor outcomes, leading to the application of allogeneic hematopoietic stem cell transplantation (allo-HCT) for medically fit patients. Although the use of allo-HCT has declined since the introduction of novel targeted therapy for the treatment of CLL, there remains significant interest in understanding factors that may influence the efficacy of allo-HCT, the only known curative treatment for CLL. The potential benefit of transplantation is most likely due to the presence of alloreactive donor T cells that mediate the graft-versus-leukemia (GVL) effect. The recognition of potentially tumor-specific antigens in the context of class I and II major histocompatibility complex on malignant B lymphocytes by donor T cells may be influenced by subtle differences in the highly polymorphic HLA locus. Given previous reports of specific HLA alleles impacting the incidence of CLL and the clinical outcomes of allo-HCT for CLL, we sought to study the overall survival and progression-free survival of a large cohort of patients with CLL who underwent allo-HCT from fully HLA-matched related and unrelated donors at Center for International Blood and Marrow Transplant Research transplantation centers. We found no statistically significant association of allo-HCT outcomes in CLL based on previously reported HLA combinations. Additional study is needed to further define the immunologic features that portend a more favorable GVL effect after allo-HCT for CLL.

  • 13. Holter-Chakrabarty, Jennifer L.
    et al.
    Pierson, Namali
    Zhang, Mei-Jie
    Zhu, Xiaochun
    Akpek, Goerguen
    Aljurf, Mahmoud D.
    Artz, Andrew S.
    Baron, Frederic
    Bredeson, Christopher N.
    Dvorak, Christopher C.
    Epstein, Robert B.
    Lazarus, Hillard M.
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Selby, George B.
    Williams, Kirsten M.
    Cooke, Kenneth R.
    Pasquini, Marcelo C.
    McCarthy, Philip L.
    The Sequence of Cyclophosphamide and Myeloablative Total Body Irradiation in Hematopoietic Cell Transplantation for Patients with Acute Leukemia2015In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 21, no 7, p. 1251-1257Article in journal (Refereed)
    Abstract [en]

    Limited clinical data are available to assess whether the sequencing of cyclophosphamide (Cy) and total body irradiation (TBI) changes outcomes. We evaluated the sequence in 1769 (CyTBI, n = 948; TBICy, n = 821) recipients of related or unrelated hematopoietic cell transplantation who received TBI (1200 to 1500 cGY) for acute leukemia from 2003 to 2010. The 2 cohorts were comparable for median age, performance score, type of leukemia, first complete remission, Philadelphia chromosome positive acute lymphoblastic leukemia, HLA-matched siblings, stem cell source, antithymocyte globulin use, TBI dose, and type of graft-versus-host disease (GVHD) prophylaxis. The sequence of TBI did not significantly affect transplantation-related mortality (24% versus 23% at 3 years, P = .67; relative risk, 1.01; P = .91), leukemia relapse (27% versus 29% at 3 years, P = .34; relative risk,.89, P = .18), leukemia-free survival (49% versus 48% at 3 years, P = .27; relative risk,.93; P = .29), chronic GVHD (45% versus 47% at 1 year, P = .39; relative risk,.9; P = .11), or overall survival (53% versus 52% at 3 years, P = .62; relative risk,.96; P = .57) for CyTBI and TBICy, respectively. Corresponding cumulative incidences of sinusoidal obstruction syndrome were 4% and 6% at 100 days (P = .08), respectively. This study demonstrates that the sequence of Cy and TBI does not impact transplantation outcomes and complications in patients with acute leukemia undergoing hematopoietic cell transplantation with myeloablative conditioning.

  • 14. Ifversen, Marianne
    et al.
    Winiarski, Jacek
    Saarinen-Pihkala, Ulla
    Mellgren, Karin
    Glomstein, Anders
    Arvidson, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Lahtenmaaki, Paivi
    Toporski, Jacek
    Rosthoej, Susanne
    Heyman, Mats
    Heilmann, Carsten
    Superior Survival Rate Following Conditioning with Etoposide in Childhood ALL2014In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 20, no 2, p. S173-S173Article in journal (Other academic)
  • 15.
    Khandelwal, Pooja
    et al.
    Cincinnati Childrens Hosp Med Ctr, Div Bone Marrow Transplantat & Immune Deficiency, Cincinnati, OH 45229 USA.
    Millard, Heather R.
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Dept Med, Milwaukee, WI 53226 USA.
    Thiel, Elizabeth
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Dept Med, Milwaukee, WI 53226 USA.
    Abdel-Azim, Hisham
    Univ Southern Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90033 USA.
    Abraham, Allistair A.
    Childrens Natl Med Ctr, Div Blood & Marrow Transplantat, Ctr Canc & Blood Disorders, Washington, DC 20010 USA.
    Auletta, Jeffery J.
    Nationwide Childrens Hosp, Host Def Program, Div Hematol Oncol Bone Marrow Transplant & Infect, Columbus, OH USA.
    Boulad, Farid
    Mem Sloan Kettering Canc Ctr, Dept Pediat, New York, NY 10021 USA.
    Brown, Valerie I.
    Penn State Hershey Childrens Hosp, Coll Med, Div Pediat Hematol Oncol, Dept Pediat, Hershey, PA USA.
    Camitta, Bruce M.
    Childrens Hosp Wisconsin, Milwaukee, WI 53201 USA;Med Coll Wisconsin, Midwest Ctr Canc & Blood Disorders, Milwaukee, WI 53226 USA.
    Chan, Ka Wah
    Texas Transplant Inst, Dept Pediat, San Antonio, TX USA.
    Chaudhury, Sonali
    Ann & Robert H Lurie Childrens Hosp Chicago, Div Pediat Hematol Oncol & Stem Cell Transplant, Dept Pediat, Chicago, IL 60611 USA.
    Cowan, Morton J.
    UCSF Benioff Childrens Hosp, Pediat Allergy Immunol & Blood & Marrow Transplan, San Francisco, CA USA.
    Angel-Diaz, Miguel
    Univ Nino Jesus, Hosp Infantil, Dept Hematol Oncol, Madrid, Spain.
    Gadalla, Shahinaz M.
    NCI, Div Canc Epidemiol & Genet, Clin Genet Branch, NIH, Rockville, MD USA.
    Gale, Robert Peter
    Imperial Coll London, Hematol Res Ctr, Div Expt Med, Dept Med, London, England.
    Hale, Gregory
    Johns Hopkins All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL USA.
    Kasow, Kimberly A.
    Univ North Carolina Chapel Hill, Div Hematol Oncol, Dept Pediat, Chapel Hill, NC USA.
    Keating, Amy K.
    Univ Colorado, Sch Med, Dept Pediat, Aurora, CO USA.
    Kitko, Carrie L.
    Vanderbilt Univ, Med Ctr, Pediat Hematol Oncol Div, Nashville, TN 37235 USA.
    MacMillan, Margaret L.
    Univ Minnesota, Blood & Marrow Transplant Program, Minneapolis, MN USA.
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Div Therapeut Immunol, Dept Lab Med, Stockholm, Sweden.
    Page, Kristin M.
    Duke Univ, Med Ctr, Div Pediat Blood & Marrow Transplantat, Durham, NC USA.
    Seber, Adriana
    Univ Sao Paulo, Sch Med, Internal Med, Sao Paulo, Brazil.
    Smith, Angela R.
    Univ Minnesota, Blood & Marrow Transplant Program, Minneapolis, MN USA.
    Warwick, Anne B.
    Uniformed Serv Univ Hlth Sci, Dept Pediat, Bethesda, MD 20814 USA.
    Wirk, Baldeep
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA.
    Mehta, Parinda A.
    Cincinnati Childrens Hosp Med Ctr, Div Bone Marrow Transplantat & Immune Deficiency, Cincinnati, OH 45229 USA.
    Hematopoietic Stem Cell Transplantation Activity in Pediatric Cancer between 2008 and 2014 in the United States: A Center for International Blood and Marrow Transplant Research Report2017In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 23, no 8, p. 1342-1349Article in journal (Refereed)
    Abstract [en]

    This Center for International Blood and Marrow Transplant Research report describes the use of hematopoietic stem cell transplantation (HSCT) in pediatric patients with cancer, 4408 undergoing allogeneic (allo) and3076 undergoing autologous (auto) HSCT in the United States between 2008 and 2014. In both settings, there was a greater proportion of boys (n = 4327; 57%), children < 10 years of age (n = 4412; 59%), whites (n = 5787; 77%), and children with a performance score 90% at HSCT (n = 6187; 83%). Leukemia was the most common indication for an allo-transplant (n = 4170; 94%), and among these, acute lymphoblastic leukemia in second complete remission (n = 829; 20%) and acute myeloid leukemia in first complete remission (n = 800; 19%) were the most common. The most frequently used donor relation, stem cell sources, and HLA match were unrelated donor (n = 2933; 67%), bone marrow (n = 2378; 54%), and matched at 8/8 HLA antigens (n = 1098; 37%) respectively. Most allo-transplants used myeloablative conditioning (n = 4070; 92%) and calcineurin inhibitors and methotrexate (n = 2245; 51%) for acute graft-versus-host disease prophylaxis. Neuroblastoma was the most common primary neoplasm for an auto-transplant (n = 1338; 44%). Tandem auto-transplants for neuroblastoma declined after 2012 (40% in 2011, 25% in 2012, and 8% in 2014), whereas tandem auto transplants increased for brain tumors (57% in 2008 and 77% in 2014). Allo-transplants from relatives other than HLA-identical siblings doubled between 2008 and 2014 (3% in 2008 and 6% in 2014). These trends will be monitored in future reports of transplant practices in the United States.

  • 16.
    Klyuchnikov, Evgeny
    et al.
    Univ Canc Ctr Hamburg, Dept Stem Cell Transplantat, Hamburg, Germany..
    Bacher, Ulrike
    Univ Gottingen, Dept Hematol & Internal Oncol, D-37073 Gottingen, Germany..
    Kroeger, Nicolaus M.
    Univ Canc Ctr Hamburg, Dept Stem Cell Transplantat, Hamburg, Germany..
    Hari, Parameswaran N.
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Ahn, Kwang Woo
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA..
    Carreras, Jeanette
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Bachanova, Veronika
    Univ Minnesota, Med Ctr, Bone & Marrow Transplant Program, Minneapolis, MN 55455 USA..
    Bashey, Asad
    Northside Hosp, Blood & Marrow Transplant Program, Atlanta, GA USA..
    Cohen, Jonathon B.
    Emory Univ, Sch Med, Winship Canc Inst, Dept Hematol & Med Oncol, Atlanta, GA USA..
    D'Souza, Anita
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Freytes, Cesar O.
    South Texas Vet Hlth Care Syst, San Antonio, TX USA.;Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA.;Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Hematol Res Ctr, London, England..
    Gale, Robert Peter
    Ganguly, Siddhartha
    Univ Kansas, Med Ctr, Blood & Marrow Transplantat, Div Hematol & Oncol, Kansas City, KS 66103 USA..
    Hertzberg, Mark S.
    Prince Wales Hosp, Dept Haematol, Randwick, NSW 2031, Australia..
    Holmberg, Leona A.
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA..
    Kharfan-Dabaja, Mohamed A.
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA..
    Klein, Andreas
    Tufts Med Ctr, Div Hematol Oncol, Dept Med, Boston, MA USA..
    Ku, Grace H.
    Univ Calif San Diego, Dept Med, Div Blood & Marrow Transplantat, San Diego, CA 92103 USA..
    Laport, Ginna G.
    Stanford Hosp & Clin, Div Bone Marrow Transplantat, Stanford, CA USA..
    Lazarus, Hillard M.
    Univ Hosp Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA..
    Miller, Alan M.
    Baylor Univ, Med Ctr, Dept Oncol, Dallas, TX USA..
    Mussetti, Alberto
    Fdn IRCCS Ist Nazl Tumori, SC Ematol & Trapianto Midollo Osseo, Milan, Italy.;Univ Milan, Milan, Italy..
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Div Therapeut Immunol, Dept Lab Med, Stockholm, Sweden..
    Slavin, Shimon
    Int Ctr Cell Therapy & Canc Immunotherapy, Tel Aviv, Israel..
    Usmani, Saad Z.
    Carolinas HealthCare Syst, Levine Canc Inst, Dept Hematol, Med Oncol, Charlotte, NC USA..
    Vij, Ravi
    Washington Univ, Sch Med, Div Hematol & Oncol, St Louis, MO USA..
    Wood, William A.
    Univ N Carolina, Dept Med, Div Hematol Oncol, Chapel Hill, NC USA..
    Maloney, David G.
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA..
    Sureda, Anna M.
    Hosp Duran & Reynals, Inst Catala Oncol, Serv Hematol, Barcelona, Spain.;European Grp Blood & Marrow Transplantat, Milan, Italy..
    Smith, Sonali M.
    Univ Chicago, Sect Hematol Oncol, Chicago, IL 60637 USA..
    Hamadani, Mehdi
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Reduced-Intensity Allografting as First Transplantation Approach in Relapsed/Refractory Grades One and Two Follicular Lymphoma Provides Improved Outcomes in Long-Term Survivors2015In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 21, no 12, p. 2091-2099Article in journal (Refereed)
    Abstract [en]

    This study was conducted to compare long-term outcomes in patients with refractory/relapsed grades 1 and 2 follicular lymphoma (FL) after allogeneic (allo) versus autologous (auto) hematopoietic cell transplantation (HCT) in the rituximab era. Adult patients with relapsed/refractory grades 1 and 2 FL undergoing first reduced-intensity allo-HCT or first autograft during 2000 to 2012 were evaluated. A total of 518 rituximab-treated patients were included. Allo-HCT patients were younger and more heavily pretreated, and more patients had advanced stage and chemoresistant disease. The 5-year adjusted probabilities, comparing auto-HCT versus allo-HCT groups for nonrelapse mortality (NRM) were 5% versus 26% (P <.0001); relapse/progression: 54% versus 20% (P <.0001); progression-free survival (PFS): 41% versus 58% (P <.001), and overall survival (OS): 74% versus 66% (P =.05). Auto-HCT was associated with a higher risk of relapse/progression beyond 5 months after HCT (relative risk [RR], 4.4; P <.0001) and worse PFS (RR, 2.9; P <.0001) beyond 11 months after HCT. In the first 24 months after HO', auto-HCT was associated with improved OS (RR,.41; P <.0001), but beyond 24 months, it was associated with inferior OS (RR, 2.2; P =.006). A landmark analysis of patients alive and progression-free at 2 years after HO' confirmed these observations, showing no difference in further NRM between both groups, but there was significantly higher risk of relapse/progression (RR, 7.3; P <.0001) and inferior PFS (RR, 3.2; P <.0001) and OS (RR, 2.1; P =.04) after auto-HCT. The 10-year cumulative incidences of second hematological malignancies after allo-HCT and auto-HCT were 0% and 7%, respectively. Auto-HCT and reduced-intensity conditioned allo-HCT as first transplantation approach can provide durable disease control in grades 1 and 2 FL patients. Continued disease relapse risk after auto-HCT translates into improved PFS and OS after allo-HCT in long-term survivors.

  • 17.
    Kolstad, Arne
    et al.
    Oslo Univ Hosp, Radiumhospitalet, Dept Oncol, Oslo, Norway..
    Pedersen, Lone Bredo
    Copenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark..
    Eskelund, Christian W.
    Copenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark..
    Husby, Simon
    Copenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark..
    Gronbaek, Kirsten
    Copenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark..
    Jerkeman, Mats
    Skane Univ Hosp, Dept Oncol, Lund, Sweden..
    Laurell, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology.
    Raty, Riikka
    Univ Helsinki, Cent Hosp, Dept Hematol & Oncol, Helsinki, Finland..
    Elonen, Erkki
    Univ Helsinki, Cent Hosp, Dept Hematol & Oncol, Helsinki, Finland..
    Andersen, Niels Smedegaard
    Copenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark..
    Brown, Peter deNully
    Copenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark..
    Kimby, Eva
    Karolinska Inst, Dept Hematol, S-10401 Stockholm, Sweden..
    Bentzen, Hans
    Aarhus Univ Hosp, Dept Hematol, DK-8000 Aarhus, Denmark..
    Sundström, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical and experimental pathology. Department of Pathology, Uppsala University Hospital, Uppsala, Sweden..
    Ehinger, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
    Karjalainen-Lindsberg, Marja-Liisa
    Skane Univ Hosp, Dept Pathol, Lund, Sweden..
    Delabie, Jan
    Helsinki Univ Cent Hosp, Dept Pathol, Helsinki, Finland..
    Ralfkiaer, Elisabeth
    Copenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark.;Oslo Univ Hosp, Dept Pathol, Oslo, Norway..
    Fagerli, Unn-Merete
    Copenhagen Univ Hosp, Rigshospitalet, Dept Pathol, Copenhagen, Denmark..
    Nilsson-Ehle, Herman
    St Olavs Univ Hosp, Dept Oncol, Trondheim, Norway..
    Lauritzsen, Grete Fossum
    Oslo Univ Hosp, Radiumhospitalet, Dept Oncol, Oslo, Norway..
    Kuittinen, Outi
    Sahlgrens Univ Hosp, Dept Hematol, Gothenburg, Sweden. Oulu Univ Hosp, Dept Oncol, Oulu, Finland..
    Niemann, Carsten
    Copenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark..
    Geisler, Christian Hartman
    Copenhagen Univ Hosp, Rigshospitalet, Dept Hematol, Copenhagen, Denmark..
    Molecular Monitoring after Autologous Stem Cell Transplantation and Preemptive Rituximab Treatment of Molecular Relapse; Results from the Nordic Mantle Cell Lymphoma Studies (MCL2 and MCL3) with Median Follow-Up of 8.5 Years2017In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 23, no 3, p. 428-435Article in journal (Refereed)
    Abstract [en]

    The main objectives of the present study were to monitor minimal residual disease (MRD) in the bone marrow of patients with mantle cell lymphoma (MCL) to predict clinical relapse and guide preemptive treatment with rituximab. Among the patients enrolled in 2 prospective trials by the Nordic Lymphoma Group, 183 who had completed autologous stem cell transplantation (ASCT) and in whom an MRD marker had been obtained were included in our analysis. Fresh samples of bone marrow were analyzed for MRD by a combined standard nested and quantitative real-time PCR assay for Bcl-1/immunoglobulin heavy chain gene (IgH) and clonal IgH rear-rangements. Significantly shorter progression-free survival (PFS) and overall survival (OS) was demonstrated for patients who were MRD positive pre-ASCT (54 patients) or in the first analysis post-ASCT (23 patients). The median PFS was only 20 months in those who were MRD-positive in the first sample post-ASCT, compared with 142 months in the MRD-negative group (P <.0001). OS was 75% at 10 years and median not reached in the MRD-negative group, compared with only 35 months in the MRD-positive group (P <.0001). Of the 86 patients (47%) who remained in continuous molecular remission, 73% were still in clinical remission after 10 years. For all patients, the median time from ASCT to first molecular relapse was 55 months, with a continuous occurrence of late molecular relapses. Fifty-eight patients who experienced MRD relapse received rituximab as preemptive treatment on 1 or more occasions, and in this group, the median time from first molecular relapse to clinical relapse was 55 months. In most cases, rituximab converted patients to MRD negativity (87%), but many patients became MRD-positive again later during follow-up (69%). By multivariate analysis, high-risk Mantle Cell Lymphoma International Prognostic Index score and positive MRD status pre-ASCT predicted early molecular relapse. In conclusion, preemptive rituximab treatment converts patients to MRD negativity and likely postpones clinical relapse. Molecular monitoring offers an opportunity to select some patients for therapeutic intervention and to avoid unnecessary treatment in others. MRD-positive patients in the first analysis post-ASCT have a dismal prognosis and thus are in need of novel strategies.

  • 18. Lanza, Francesco
    et al.
    Campioni, Diana C.
    Hellmann, Andrzej
    Milone, Giuseppe
    Wahlin, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Walewski, Jan
    Spedini, Pierangelo
    Fiamenghi, Cristina
    Cuneo, Antonio
    Knopinska, Wanda
    Swierkowska-Czeneszew, Monica
    Petriz, Jordi
    Fruehauf, Stefan
    Farge, Dominique
    Mohty, Mohamad
    Passweg, Jacob
    Ruuto, Tapani
    Madrigal, Alejandro
    Johnsen, Hans E.
    Individual Quality Assessment of Autografting by Probability Estimation for Clinical Endpoints: A Prospective Validation Study from the European Group for Blood and Marrow Transplantation2013In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 19, no 12, p. 1670-1676Article, review/survey (Refereed)
    Abstract [en]

    The aim of supportive autografting is to reduce the side effects from stem cell transplantation and avoid procedure-related health disadvantages for patients at the lowest possible cost and resource expenditure. Economic evaluation of health care is becoming increasingly important. We report clinical and laboratory data collected from 397 consecutive adult patients (173 non-Hodgkin lymphoma, 30 Hodgkin lymphoma, 160 multiple myeloma, 7 autoimmune diseases, and 28 acute leukemia) who underwent their first autologous peripheral blood stem cell transplantation (PBSCT). We considered primary endpoints evaluating health economic efficacy (eg, antibiotic administration, transfusion of blood components, and time in hospital), secondary endpoints evaluating toxicity (in accordance with Common Toxicity Criteria), and tertiary endpoints evaluating safety (le, the risk of regimen-related death or disease progression within the first year after PBSCT). A time-dependent grading of efficacy is proposed with day 21 for multiple myeloma and day 25 for the other disease categories (depending on the length of the conditioning regimen) as the acceptable maximum time in hospital, which together with antibiotics, antifungal, or transfusion therapy delineates four groups: favorable (<= 7 days on antibiotics and no transfusions; <= 21 [25] days in hospital), intermediate (from 7 to 10 days on antibiotics and <3 transfusions, <= 21 to 25 days in hospital or >= 7 days on antibiotics and no transfusions; from 21 to 30 days [25 to 34] in hospital), unfavorable (>7 days on antibiotics, >3 but <6 transfusions; >30/34 days in hospital after transplantation), and very unfavorable (>10 days on antibiotics, >6 transfusions; >30 to 34 days in hospital). The multivariate analysis showed that (1) PBSC harvests of >= 4 x 10(6)/kg CD34 + cells in 1 apheresis procedure were associated with a favorable outcome in all patient categories except acute myelogenous leukemia and acute lymphoblastic leukemia (P = .001), (2) >= 5 x 10(6)/kg CD34 + cells infused predicted better transplantation outcome in all patient categories (P < .0001) except acute myelogenous leukemia and acute lymphoblastic leukemia, (3) 1 or 2 aphereses (P = .001) predicted good outcome, (4) toxicity increased with higher graft volume reinfused (>500 mL) (P = .002), and (5) patients with a central venous catheter during both collection and infusion of PBSC had a more favorable outcome post-PBSCT than peripheral access (P = .007). The type of mobilization regimen did not affect the outcome of auto-PBSCT. The present study identified predictive variables, which may be useful in future individual pretransplantation probability evaluations with the goal to improve supportive care. (C) 2013 American Society for Blood and Marrow Transplantation.

  • 19. Liu, Hien Duong
    et al.
    Ahn, Kwang Woo
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA..
    Hu, Zhen-Huan
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Hamadani, Mehdi
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Nishihori, Taiga
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA..
    Wirk, Baldeep
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA..
    Beitinjaneh, Amer
    Univ Miami, Sylvester Canc Ctr, Dept Hematol & Oncol, Miami, FL USA..
    Rizzieri, David
    Duke Univ, Div Hematol Malignancies & Cellular Therapy, Durham, NC USA..
    Grunwald, Michael R.
    Carolinas HealthCare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA..
    Sabloff, Mitchell
    Univ Ottawa, Dept Med, Div Hematol, Ottawa, ON, Canada.;Ottawa Hosp Res Inst, Ottawa, ON, Canada..
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden..
    Bajel, Ashish
    Royal Melbourne Hosp, Dept Haematol & Bone Marrow Transplant, Parkville, Vic, Australia..
    Bredeson, Christopher
    Ottawa Hosp Res Inst, Ottawa, ON, Canada.;Ottawa Hosp, Blood & Marrow Transplant Program, Ottawa, ON, Canada..
    Daly, Andrew
    Tom Baker Canc Clin, Dept Med, Calgary, AB, Canada.;Tom Baker Canc Clin, Dept Oncol, Calgary, AB, Canada..
    Inamoto, Yoshihiro
    Natl Canc Ctr, Div Hematopoiet Stem Cell Transplantat, Tokyo, Japan..
    Majhail, Navneet
    Cleveland Clin, Taussig Canc Inst, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA..
    Saad, Ayman
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL USA..
    Gupta, Vikas
    Univ Hlth Network, Princess Margaret Canc Ctr, Blood & Marrow Transplant Program, Toronto, ON, Canada..
    Gerds, Aaron
    Cleveland Clin, Taussig Canc Inst, Hematol Oncol & Blood Disorders, Cleveland, OH 44106 USA..
    Malone, Adriana
    Icahn Sch Med Mt Sinai, Tisch Canc Inst, New York, NY 10029 USA..
    Tallman, Martin
    Mem Sloan, Dept Med, Leukemia Serv, New York, NY USA..
    Reshef, Ran
    Columbia Univ, Med Ctr, Blood & Marrow Transplantat Program, New York, NY USA.;Columbia Univ, Med Ctr, Columbia Ctr Translat Immunol, New York, NY USA..
    Marks, David I.
    Univ Hosp Bristol NHS Trust, Pediat Bone Marrow Transplant, Bristol, Avon, England..
    Copelan, Edward
    Carolinas HealthCare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA..
    Gergis, Usama
    New York Presbyterian Hosp, Weill Cornell Med Ctr, Dept Med Oncol, Hematol Malignancies & Bone Marrow Transplant, New York, NY USA..
    Savoie, Mary Lynn
    Tom Baker Canc Clin, Div Hematol & Hematol Malignancies, Calgary, AB, Canada..
    Ustun, Celalettin
    Univ Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN 55455 USA..
    Litzow, Mark R.
    Mayo Clin Rochester, Div Hematol, Rochester, MN USA.;Mayo Clin Rochester, Transplant Ctr, Rochester, MN USA..
    Cahn, Jean-Yves
    Univ Hosp, Dept Hematol, Grenoble, France..
    Kindwall-Keller, Tamila
    Univ Virginia Hlth Syst, Div Hematol Oncol, Charlottesville, VA USA..
    Akpek, Gorgun
    Banner MD Anderson Canc Ctr, Stem Cell Transplantat & Cellular Therapy Program, Gilbert, AZ USA..
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Aljurf, Mahmoud
    King Faisal Specialist Hosp Ctr & Res, Dept Oncol, Riyadh, Saudi Arabia..
    Rowe, Jacob M.
    Shaare Zedek Med Ctr, Dept Hematol, Jerusalem, Israel..
    Wiernik, Peter H.
    Our Lady Mercy Med Ctr, Bronx, NY USA..
    Hsu, Jack W.
    Shands HealthCare, Dept Med, Div Hematol & Oncol, Gainesville, FL USA.;Univ Florida, Gainesville, FL USA..
    Cortes, Jorge
    Univ Texas MD Anderson Canc Ctr, Div Canc Med, Dept Leukemia, Houston, TX 77030 USA..
    Kalaycio, Matt
    Cleveland Clin Fdn, Dept Hematol & Med Oncol, 9500 Euclid Ave, Cleveland, OH 44195 USA..
    Maziarz, Richard
    Oregon Hlth & Sci Univ, Knight Canc Inst, Adult Blood & Marrow Stem Cell Transplant Program, Portland, OR 97201 USA..
    Sobecks, Ronald
    Cleveland Clin Fdn, Dept Hematol & Med Oncol, 9500 Euclid Ave, Cleveland, OH 44195 USA..
    Popat, Uday
    Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat, Houston, TX 77030 USA..
    Alyea, Edwin
    Dana Farber Canc Inst, Ctr Hematol Oncol, Boston, MA 02115 USA..
    Saber, Wael
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Allogeneic Hematopoietic Cell Transplantation for Adult Chronic Myelomonocytic Leukemia2017In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 23, no 5, p. 767-775Article in journal (Refereed)
    Abstract [en]

    Allogeneic hematopoietic cell transplantation (HCT) is potentially curative for patients with chronic myelomonocytic leukemia (CMML); however, few data exist regarding prognostic factors and transplantation outcomes. We performed this retrospective study to identify prognostic factors for post-transplantation outcomes. The CMML-specific prognostic scoring system (CPSS) has been validated in subjects receiving nontransplantation therapy and was included in our study. From 2001 to 2012, 209 adult subjects who received HCT for CMML were reported to the Center for International Blood and Marrow Transplant Research. The median age at transplantation was 57 years (range, 23 to 74). Median follow-up was 51 months (range, 3 to 122). On multivariate analyses, CPSS scores, Karnofsky performance status (KPS), and graft source were significant predictors of survival (P = .004, P = .01, P = .01, respectively). Higher CPSS scores were not associated with disease-free survival, relapse, or transplantation-related mortality. In a restricted analysis of subjects with relapse after HCT, those with intermediate-2/high risk had a nearly 2-fold increased risk of death after relapse compared to those with low/intermediate-1 CPSS scores. Respective 1-year, 3-year, and 5-year survival rates for low/intermediate-1 risk subjects were 61% (95% confidence interval [CI], 52% to 72%), 48% (95% CI, 37% to 59%), and 44% (95% CI, 33% to 55%), and for intermediate-2/high risk subjects were 38% (95% CI, 28% to 49%), 32% (95% CI, 21% to 42%), and 19% (95% CI, 8% to 29%). We conclude that higher CPSS score at time of transplantation, lower KPS, and a bone marrow graft are associated with inferior survival after HCT. Further investigation of CMML disease-related biology may provide insights into other risk factors predictive of post-transplantation outcomes. (C) 2017 American Society for Blood and Marrow Transplantation.

  • 20. Mahindra, Anuj
    et al.
    Raval, Girindra
    Mehta, Paulette
    Brazauskas, Ruta
    Zhang, Mei-Jie
    Zhong, Xiaobo
    Bird, Jennifer M
    Freytes, César O
    Hale, Gregory A
    Herzig, Roger
    Holmberg, Leona A
    Kamble, Rammurti T
    Kumar, Shaji
    Lazarus, Hillard M
    Majhail, Navneet S
    Marks, David I
    Moreb, Jan S
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Saber, Wael
    Savani, Bipin N
    Schiller, Gary J
    Tay, Jason
    Vogl, Dan T
    Waller, Edmund K
    Wiernik, Peter H
    Wirk, Baldeep
    Lonial, Sagar
    Krishnan, Amrita Y
    Dispenzieri, Angela
    Brandenburg, Nancy A
    Gale, Robert Peter
    Hari, Parameswaran
    New Cancers after Autotransplantations for Multiple Myeloma2015In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 21, no 4, p. 738-745Article in journal (Refereed)
    Abstract [en]

    We describe baseline incidence and risk factors for new cancers in 4161 persons receiving autotransplants for multiple myeloma in the United States from 1990 to 2010. Observed incidence of invasive new cancers was compared with expected incidence relative to the US population. The cohort represented 13,387 person-years at-risk. In total, 163 new cancers were observed, for a crude incidence rate of 1.2 new cancers per 100 person-years and cumulative incidences of 2.6% (95% confidence interval [CI], 2.09 to 3.17), 4.2% (95% CI, 3.49 to 5.00), and 6.1% (95% CI, 5.08 to 7.24) at 3, 5, and 7 years, respectively. The incidence of new cancers in the autotransplantation cohort was similar to age-, race-, and gender-adjusted comparison subjects with an observed/expected (O/E) ratio of 1.00 (99% CI, .81 to 1.22). However, acute myeloid leukemia and melanoma were observed at higher than expected rates with O/E ratios of 5.19 (99% CI, 1.67 to 12.04; P = .0004), and 3.58 (99% CI, 1.82 to 6.29; P < .0001), respectively. Obesity, older age, and male gender were associated with increased risks of new cancers in multivariate analyses. This large data set provides a baseline for comparison and defines the histologic type specific risk for new cancers in patients with MM receiving postautotransplantation therapies, such as maintenance.

  • 21. McClune, Brian L.
    et al.
    Ahn, Kwang Woo
    Wang, Hai-Lin
    Antin, Joseph H.
    Artz, Andrew S.
    Cahn, Jean-Yves
    Deol, Abhinav
    Freytes, Cesar O.
    Hamadani, Mehdi
    Holmberg, Leona A.
    Jagasia, Madan H.
    Jakubowski, Ann A.
    Kharfan-Dabaja, Mohamed A.
    Lazarus, Hillard M.
    Miller, Alan M.
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Pedersen, Tanya L.
    Pidala, Joseph
    Pulsipher, Michael A.
    Rowe, Jacob M.
    Saber, Wael
    van Besien, Koen W.
    Waller, Edmund K.
    Aljurf, Mahmoud D.
    Akpek, Goergun
    Bacher, Ulrike
    Chao, Nelson J.
    Chen, Yi-Bin
    Cooper, Brenda W.
    Dehn, Jason
    de Lima, Marcos J.
    Hsu, Jack W.
    Lewis, Ian D.
    Marks, David I.
    McGuirk, Joseph
    Cairo, Mitchell S.
    Schouten, Harry C.
    Szer, Jeffrey
    Ramanathan, Muthalagu
    Savani, Bipin N.
    Seftel, Matthew
    Socie, Gerard
    Vij, Ravi
    Warlick, Erica D.
    Weisdorf, Daniel J.
    Allotransplantation for Patients Age >= 40 Years with Non-Hodgkin Lymphoma: Encouraging Progression-Free Survival2014In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 20, no 7, p. 960-968Article in journal (Refereed)
    Abstract [en]

    Non-Hodgkin lymphoma (NHL) disproportionately affects older patients, who do not often undergo allogeneic hematopoietic cell transplantation (HCT). We analyzed Center for International Blood and Marrow Transplant Research data on 1248 patients age >= 40 years receiving reduced-intensity conditioning (RIC) or nonmyeloablative (NMA) conditioning HCT for aggressive (n = 668) or indolent (n = 580) NHL Aggressive lymphoma was more frequent in the oldest cohort 49% for age 40 to 54 versus 57% for age 55 to 64 versus 67% for age >= 65; P = .0008). Fewer patients aged >= 65 had previous autografting (26% versus 24% versus 9%; P = .002). Rates of relapse, acute and chronic GVHD, and nonrelapse mortality (NRM) at 1 year post-HCT were similar in the 3 age cohorts (22% [95% confidence interval (CI), 19% to 26%] for age 40 to 54, 27% [95% CI, 23% to 31%] for age 55 to 64, and 34% [95% CI, 24% to 44%] for age >= 65. Progression-free survival (PFS) and overall survival (OS) at 3 years was slightly lower in the older cohorts (OS: 54% [95% CI, 50% to 58%] for age 40 to 54; 40% [95% CI, 36% to 44%] for age 55 to 64, and 39% [95% CI, 28% to 50%] for age >= 65; P < .0001). Multivariate analysis revealed no significant effect of age on the incidence of acute or chronic GVHD or relapse. Age >= 55 years, Karnofsky Performance Status <80, and HLA mismatch adversely affected NRM, PFS, and OS. Disease status at HCT, but not histological subtype, was associated with worse NRM, relapse, PFS, and OS. Even for patients age >= 55 years, OS still approached 40% at 3 years, suggesting that HCT affects long-term remission and remains underused in qualified older patients with NHL.

  • 22. Mullen, Craig A
    et al.
    Campbell, Andrew
    Tkachenko, Olena
    Jansson, Johan
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences. Univ Rochester, Med Ctr, Dept Pediat, Rochester, NY 14642 USA.
    Hsu, Yu-Chiao
    Evidence of B Cell Immune Responses to Acute Lymphoblastic Leukemia in Murine Allogeneic Hematopoietic Stem Cell Transplantation Recipients Treated with Donor Lymphocyte Infusion and/or Vaccination2010In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 17, no 2, p. 226-238Article in journal (Refereed)
    Abstract [en]

    These experiments explored mechanisms of control of acute lymphoblastic leukemia following allogeneic hematopoietic stem cell transplantation using a murine model of MHC-matched, minor histocompatibility antigen mismatched transplantation. The central hypothesis examined was that addition of active vaccination against leukemia cells would substantially increase the effectiveness of allogeneic donor lymphocyte infusion against ALL present in the host after transplant. While vaccination did increase the magnitude of type I T cell responses against leukemia cells associated with donor lymphocyte infusion, it did not lead to substantial improvement in long term survival. Analysis of immunological mechanisms of leukemia progression demonstrated that the failure of vaccination was not due to antigen loss in leukemia cells. However, analysis of survival provided surprising findings that, in addition to very modest type I T cell responses, a B cell response that produced antibodies that bind leukemia cells was found in long term survivors. The risk of death from leukemia was significantly lower in recipients that had higher levels of such antibodies. These studies raise the hypothesis that stimulation of B cell responses after transplant may provide a novel way to enhance allogeneic graft versus leukemia effects associated with transplantation.

  • 23. Norkin, Maxim
    et al.
    Shaw, Bronwen E
    Brazauskas, Ruta
    Tecca, Heather R
    Leather, Helen L
    Gea-Banacloche, Juan
    T Kamble, Rammurti
    DeFilipp, Zachariah
    Jacobsohn, David A
    Ringden, Olle
    Inamoto, Yoshihiro
    A Kasow, Kimberly
    Buchbinder, David
    Shaw, Peter
    Hematti, Peiman
    Schears, Raquel
    Badawy, Sherif M
    Lazarus, Hillard M
    Bhatt, Neel
    Horn, Biljana
    Chhabra, Saurabh
    M Page, Kristin
    Hamilton, Betty
    Hildebrandt, Gerhard C
    Yared, Jean A
    Agrawal, Vaibhav
    M Beitinjaneh, Amer
    Majhail, Navneet
    Kindwall-Keller, Tamila
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden.
    Schoemans, Helene
    Gale, Robert Peter
    Ganguly, Siddhartha
    A Ahmed, Ibrahim
    Schouten, Harry C
    L Liesveld, Jane
    Khera, Nandita
    Steinberg, Amir
    Shah, Ami J
    Solh, Melhem
    Marks, David I
    Rybka, Witold
    Aljurf, Mahmoud
    Dietz, Andrew C
    Gergis, Usama
    George, Biju
    Seo, Sachiko
    Flowers, Mary E D
    Battiwalla, Minoo
    Savani, Bipin N
    Riches, Marcie L
    Wingard, John R
    Characteristics of Late Fatal Infections after Allogeneic Hematopoietic Cell Transplantation2019In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 25, no 2, p. 362-368Article in journal (Refereed)
    Abstract [en]

    We analyzed late fatal infections (LFIs) in allogeneic stem cell transplantation (HCT) recipients reported to the Center for International Blood and Marrow Transplant Research. We analyzed the incidence, infection types, and risk factors contributing to LFI in 10,336 adult and 5088 pediatric subjects surviving for ≥2 years after first HCT without relapse. Among 2245 adult and 377 pediatric patients who died, infections were a primary or contributory cause of death in 687 (31%) and 110 (29%), respectively. At 12 years post-HCT, the cumulative incidence of LFIs was 6.4% (95% confidence interval [CI], 5.8% to 7.0%) in adults, compared with 1.8% (95% CI, 1.4% to 2.3%) in pediatric subjects; P < .001). In adults, the 2 most significant risks for developing LFI were increasing age (20 to 39, 40 to 54, and ≥55 years versus 18 to 19 years) with hazard ratios (HRs) of 3.12 (95% CI, 1.33 to 7.32), 3.86 (95% CI, 1.66 to 8.95), and 5.49 (95% CI, 2.32 to 12.99) and a history of chronic graft-versus-host disease GVHD (cGVHD) with ongoing immunosuppression at 2 years post-HCT compared with no history of GVHD with (HR, 3.87; 95% CI, 2.59 to 5.78). In pediatric subjects, the 3 most significant risks for developing LFI were a history of cGVHD with ongoing immunosuppression (HR, 9.49; 95% CI, 4.39 to 20.51) or without ongoing immunosuppression (HR, 2.7; 95% CI, 1.05 to 7.43) at 2 years post-HCT compared with no history of GVHD, diagnosis of inherited abnormalities of erythrocyte function compared with diagnosis of acute myelogenous leukemia (HR, 2.30; 95% CI, 1.19 to 4.42), and age >10 years (HR, 1.92; 95% CI, 1.15 to 3.2). This study emphasizes the importance of continued vigilance for late infections after HCT and institution of support strategies aimed at decreasing the risk of cGVHD.

  • 24.
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Stockholm, Sweden..
    Self-Destructive Behavior among Full-Donor Blood and Marrow Grafts and the Association with Long-Term Graft Function2018In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 24, no 1, p. 1-2Article in journal (Other academic)
  • 25.
    Pasquini, Marcelo C.
    et al.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Zhang, Mei-Jie
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA..
    Medeiros, Bruno C.
    Stanford Univ, Sch Med, Dept Hematol, Stanford, CA 94305 USA..
    Armand, Philippe
    Dana Farber Canc Inst, Dept Med Oncol Hematol Malignancies, Boston, MA 02115 USA..
    Hui, Zhen-Huan
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Nishihori, Taiga
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA..
    Aljurf, Mahmoud D.
    King Faisal Specialist Hosp & Res Ctr, Dept Oncol, Riyadh 11211, Saudi Arabia..
    Akpek, Goerguen
    Banner MD Anderson Canc Ctr, Stem Cell Transplantat & Cellular Therapy Program, Gilbert, AZ USA..
    Cahn, Jean-Yves
    Univ Hosp, Dept Hematol, Grenoble, France..
    Cairo, Mitchell S.
    New York Med Coll, Dept Pediat, Div Pediat Hematol Oncol & Stem Cell Transplantat, Valhalla, NY 10595 USA..
    Cerny, Jan
    UMass Mem Med Ctr, Dept Med, Worcester, MA USA..
    Copelan, Edward A.
    Carolinas HealthCare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA..
    Deol, Abhinav
    Wayne State Univ, Karmanos Canc Inst, Dept Oncol, Detroit, MI USA..
    Freytes, Cesar O.
    S Texas Vet Hlth Care Syst, Div Hematol & Oncol, San Antonio, TX USA.;Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA..
    Gale, Robert Peter
    Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Hematol Res Ctr, London, England..
    Ganguly, Siddhartha
    Univ Kansas, Med Ctr, Div Hematol & Oncol, Blood & Marrow Transplantat, Kansas City, KS 66103 USA..
    George, Biju
    Christian Med Coll & Hosp, Dept Haematol, Vellore, Tamil Nadu, India..
    Gupta, Vikas
    Univ Hlth Network, Princess Margaret Canc Ctr, Blood & Marrow Transplant Program, Toronto, ON, Canada..
    Hale, Gregory A.
    Univ S Florida, All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL 33701 USA..
    Kamble, Rammurti T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA..
    Klumpp, Thomas R.
    Thomas Jefferson Univ Hosp, Dept Med Oncol, Philadelphia, PA 19107 USA..
    Lazarus, Hillard M.
    Univ Hosp Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA..
    Luger, Selina M.
    Univ Penn, Med Ctr, Abramson Canc Ctr, Dept Med, Philadelphia, PA 19104 USA..
    Liesveld, Jane L.
    Univ Rochester, Med Ctr, Dept Med, Rochester, NY 14642 USA..
    Litzow, Mark R.
    Mayo Clin, Div Hematol & Transplant Ctr, Rochester, MN USA..
    Marks, David I.
    Univ Hosp Bristol NHS Trust, Pediat Bone Marrow Transplant, Bristol, Avon, England..
    Martino, Rodrigo
    Hosp Santa Creu & Sant Pau, Div Clin Hematol, Barcelona, Spain..
    Norkin, Maxim
    Univ Florida, Coll Med, Div Hematol Oncol, Gainesville, FL USA..
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology. Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden..
    Oran, Betul
    Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat, Div Canc Med, Houston, TX 77030 USA..
    Pawarode, Attaphol
    Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA..
    Pulsipher, Michael A.
    Univ So Calif, Keck Sch Med, Childrens Hosp Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90033 USA..
    Ramanathan, Muthalagu
    UMass Mem Med Ctr, Dept Med, Worcester, MA USA..
    Reshef, Ran
    Univ Penn, Med Ctr, Abramson Canc Ctr, Dept Med, Philadelphia, PA 19104 USA..
    Saad, Ayman A.
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA..
    Saber, Wael
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Savani, Bipin N.
    Vanderbilt Univ, Dept Med, Div Hematol Oncol, 221 Kirkland Hall, Nashville, TN 37235 USA..
    Schouten, Harry C.
    Acad Ziekenhuis, Dept Hematol, Maastricht, Netherlands..
    Ringden, Olle
    Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.;Ctr Allogene Stem Cell Transplantat, Stockholm, Sweden..
    Tallman, Martin S.
    Mem Sloan Kettering Canc Ctr, Dept Med, Leukemia Serv, 1275 York Ave, New York, NY 10021 USA..
    Uy, Geoffrey L.
    Washington Univ, Sch Med, Div Oncol, St Louis, MO USA..
    Wood, William A., Jr.
    Univ N Carolina, Dept Med, Div Hematol Oncol, Chapel Hill, NC USA..
    Wirk, Baldeep
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA..
    Perez, Waleska S.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Batiwalla, Minoo
    NHLBI, NIH, Hematol Branch, Bldg 10, Bethesda, MD 20892 USA..
    Weisdorf, Daniel J.
    Univ Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN 55455 USA..
    Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies2016In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 22, no 2, p. 248-257Article in journal (Refereed)
    Abstract [en]

    The presence of monosomal karyotype (MK+) in acute myeloid leukemia (AML) is associated with dismal outcomes. We evaluated the impact of MK+ in AML (MK+AML, n = 240) and in myelodysplastic syndrome (MDS) (MK+MDS, n = 221) on hematopoietic cell transplantation outcomes compared with other cytogenetically defined groups (AML, n = 3360; MDS, n = 1373) as reported to the Center for International Blood and Marrow Transplant Research from 1998 to 2011. MK+AML was associated with higher disease relapse (hazard ratio, 1.98; P < .01), similar transplantation-related mortality (TRM) (hazard ratio, 1.01; P = .90), and worse survival (hazard ratio, 1.67; P < .01) compared with those outcomes for other cytogenetically defined AML. Among patients with MDS, MK+ MDS was associated with higher disease relapse (hazard ratio, 2.39; P < .01), higher TRM (hazard ratio, 1.80; P < .01), and worse survival (HR, 2.02; P < .01). Subset analyses comparing chromosome 7 abnormalities (del7/7q) with or without MK+ demonstrated higher mortality for MK+ disease in for both AML (hazard ratio, 1.72; P < .01) and MDS (hazard ratio, 1.79; P < .01). The strong negative impact of MK+ in myeloid malignancies was observed in all age groups and using either myeloablative or reduced-intensity conditioning regimens. Alternative approaches to mitigate disease relapse in this population are needed.

  • 26.
    Prokopishyn, Nicole L.
    et al.
    Univ Calgary, Dept Pathol & Lab Med, Calgary, AB, Canada.
    Logan, Brent R.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA.
    Kiefer, Deidre M.
    Natl Marrow Donor Program Be Match, Ctr Int Blood & Marrow Transplant Res, Minneapolis, MN USA.
    Sees, Jennifer A.
    Natl Marrow Donor Program Be Match, Ctr Int Blood & Marrow Transplant Res, Minneapolis, MN USA.
    Chitphakdithai, Pintip
    Natl Marrow Donor Program Be Match, Ctr Int Blood & Marrow Transplant Res, Minneapolis, MN USA.
    Ahmed, Ibrahim A.
    Childrens Mercy Hosp & Clin, Dept Hematol Oncol & Bone Marrow Transplantat, Kansas City, MO USA.
    Anderlini, Paolo N.
    Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat & Cellular Therapy, Houston, TX 77030 USA.
    Beitinjaneh, Amer M.
    Univ Miami, Dept Hematol, Miami, FL USA.
    Bredeson, Christopher
    Ottawa Hosp, Blood & Marrow Transplant Program, Ottawa, ON, Canada;Ottawa Hosp Res Inst, Ottawa, ON, Canada.
    Cerny, Jan
    Univ Massachusetts, Med Ctr, Dept Med, Div Hematol Oncol, Worcester, MA USA.
    Chhabra, Saurabh
    Med Coll Wisconsin, Dept Med, Div Hematol Oncol, Milwaukee, WI 53226 USA.
    Daly, Andrew
    Tom Baker Canc Clin, Calgary, AB, Canada.
    Angel Diaz, Miguel
    Hosp Infantil Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain.
    Farhadfar, Nosha
    Univ Florida, Coll Med, Div Hematol Oncol, Gainesville, FL USA.
    Frangoul, Haydar A.
    TriStar Centennial, Childrens Hosp, Div Pediat Hematol & Oncol, Nashville, TN USA;Sarah Cannon Res Inst, Nashville, TN USA.
    Ganguly, Siddhartha
    Univ Kansas Hlth Syst, Div Hematol Malignancy & Cellular Therapeut, Kansas City, KS USA.
    Gastineau, Dennis A.
    Mayo Clin Rochester, Div Hematol, Rochester, MN USA.
    Gergis, Usama
    Weill Cornell Med Coll, New York Presbyterian Hosp, Dept Med Oncol, Hematolg Malignancies & Bone Marrow Transplant, New York, NY USA.
    Hale, Gregory A.
    Johns Hopkins All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL USA.
    Hematti, Peiman
    Univ Wisconsin Hosp & Clin, Dept Med, Div Hematol Oncol Bone Marrow Transplantat, Madison, WI 53792 USA.
    Kamble, Rammurti T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA.
    Kasow, Kimberly A.
    Univ N Carolina, Div Hematol Oncol, Dept Pediat, Chapel Hill, NC 27515 USA.
    Lazarus, Hillard M.
    Univ Hosp Cleveland, Med Ctr, Seidman Canc Ctr, Cleveland, OH 44106 USA.
    Liesveld, Jane L.
    Univ Rochester, Med Ctr, Strong Mem Hosp, Rochester, NY 14642 USA.
    Murthy, Hemant S.
    Univ Florida, Coll Med, Div Hematol Oncol, Gainesville, FL USA.
    Norkin, Maxim
    Univ Florida, Coll Med, Div Hematol Oncol, Gainesville, FL USA.
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.
    Papari, Mona
    ITxM Clin Serv Cord Blood Lab, Rosemont, IL USA.
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA.
    Szer, Jeffrey
    Peter MacCalluma Canc Ctr, Clin Haematol, Melbourne, Vic, Australia;Royal Melbourne Hosp, Parkville, Vic, Australia.
    Waller, Edmund K.
    Emory Univ Hosp, Dept Hematol & Meidcal Oncol, 1364 Clifton Rd NE, Atlanta, GA 30322 USA.
    Wirk, Baldeep
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA.
    Yared, Jean A.
    Univ Maryland, Greenebaum Canc Ctr, Blood & Marrow Transplantat Program, Div Hematol Oncol,Dept Med, Baltimore, MD 21201 USA.
    Pulsipher, Michael A.
    USC Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA USA.
    Shah, Nirali N.
    NCI, Pediat Oncol Branch, Ctr Canc Res, NIH, Bethesda, MD 20892 USA.
    Switzer, Galen E.
    Univ Pittsburgh, Dept Med, Pittsburgh, PA USA.
    O'Donnell, Paul V.
    Harvard Med Sch, Massachusetts Gen Hosp, Dept Hematol Oncol, Boston, MA 02115 USA.
    Confer, Dennis L.
    Natl Marrow Donor Program Be Match, Ctr Int Blood & Marrow Transplant Res, Minneapolis, MN USA;Natl Marrow Donor Program Be Match, Minneapolis, MN USA.
    Shaw, Bronwen E.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    The Concentration of Total Nucleated Cells in Harvested Bone Marrow for Transplantation Has Decreased over Time2019In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 25, no 7, p. 1325-1330Article in journal (Refereed)
    Abstract [en]

    Bone marrow (BM) is an essential source of hematopoietic stem cell grafts for many allogeneic hematopoietic cell transplant (HCT) recipients, including adult patients (for specific diseases and transplantation strategies) and the majority of pediatric recipient. However, since the advent of granulocyte colony-stimulating factor-mobilized peripheral blood stem cell (PBSC) grafts, there has been a significant decrease in the use of BM in HCT, thought to be due mainly to the increased logistical challenges in harvesting BM compared with PBSCs, as well as generally no significant survival advantage of BM over PBSCs. The decreased frequency of collection has the potential to impact the quality of BM harvests. In this study, we examined >15,000 BM donations collected at National Marrow Donor Program centers between 1994 and 2016 and found a significant decline in the quality of BM products, as defined by the concentration of total nucleated cells (TNCs). The mean TNC concentration in BM donations dropped from 21.8 x 10(6) cells/mL in the earliest era (1994 to 1996) to 18.7 x 10(6) cells/mL in the most recent era (2012 to 2016) (means ratio,.83; P < .001). This decline in BM quality was seen despite the selection of more donors perceived to be optimal (eg, younger and male). Multivariate regression analysis showed that higher volume centers (performing >30 collections per era) had better-quality harvests with higher concentrations of TNCs collected. In conclusion, we have identified a significant decrease in the quality of BM collections over time, and lower-volume collection centers had poorer-quality harvests. In this analysis, we could not elucidate the direct cause for this finding, suggesting the need for further studies to investigate the key factors responsible and to explore the impact on transplant recipients. (C) 2019 American Society for Blood and Marrow Transplantation.

  • 27.
    Qayed, Muna
    et al.
    Emory Univ, Sch Med, Aflac Canc & Blood Disorders Ctr, 2015 Uppergate Dr NE, Atlanta, GA, USA.
    Wang, Tao
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI, USA; Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI , USA.
    Hemmer, Michael T.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI, USA.
    Spellman, Stephen
    Natl Marrow Donor Program Be Match, Ctr Int Blood & Marrow Transplant Res, Minneapolis, MN, USA.
    Arora, Mukta
    Univ Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN, USA.
    Couriel, Daniel
    Utah Blood & Marrow Transplant Program, Div Hematol & Hematol Malignancies, Dept Internal Med, Salt Lake City, UT USA.
    Alousi, Amin
    Univ Texas MD Anderson Canc Ctr, Div Canc Med, Dept Stem Cell Transplantat, Houston, TX, USA.
    Pidala, Joseph
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA.
    Abdel-Azim, Hisham
    Univ Southern Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA, USA.
    Aljurf, Mahmoud
    King Faisal Specialist Hosp & Res Ctr, Dept Oncol, Riyadh, Saudi Arabia.
    Ayas, Mouhab
    King Faisal Specialist Hosp & Res Ctr, Dept Pediat Hematol Oncol, Riyadh, Saudi Arabia.
    Bitan, Menachem
    Tel Aviv Sourasky Med Ctr, Dept Pediat Hematol Oncol, Tel Aviv, Israel.
    Cairo, Mitchell
    New York Med Coll, Dept Pediat, Div Pediat Hematol Oncol & Stem Cell Transplantat, Valhalla, NY, USA.
    Choi, Sung Won
    Univ Michigan, Dept Pediat & Communicable Dis, Ann Arbor, MI, USA.
    Dandoy, Christopher
    Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Div Bone Marrow Transplantat & Immune Deficiency, Cincinnati, OH, USA.
    Delgado, David
    Indiana Univ Hosp, Dept Pediat, Indianapolis, IN, USA.
    Gale, Robert Peter
    Imperial Coll London, Dept Med, Div Expt Med, Hematol Res Ctr, London, England.
    Hale, Gregory
    Johns Hopkins All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL, USA.
    Frangoul, Haydar
    TriStar Centennial, Childrens Hosp, Pediat Hematol Oncol, Nashville, TN USA; Sarah Cannon Res Inst, Nashville, TN, USA.
    Kamble, Rammurti T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX, USA.
    Kharfan-Dabaja, Mohamed
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA.
    Lehman, Leslie
    Dana Farber Canc Inst, Dept Pediat Hematol Oncol, Boston, MA, USA.
    Levine, John
    Icahn Sch Med Mt Sinai, Tisch Canc Inst, New York, NY, USA.
    MacMillan, Margaret
    Univ Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN, USA.
    Marks, David I.
    Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England.
    Nishihori, Taiga
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA.
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.
    Hematti, Peiman
    Univ Wisconsin Hosp & Clin, Dept Med, Div Hematol Oncol Bone Marrow Transplantat, Madison, WI, USA.
    Ringden, Olov
    Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.
    Saad, Ayman
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL, USA.
    Satwani, Prakash
    Columbia Univ, Med Ctr, Dept Pediat, Div Pediat Hematol Oncol & Stem Cell Transplantat, New York, NY, USA.
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN, USA.
    Schultz, Kirk R.
    Univ British Columbia, British Columbias Childrens Hosp, Dept Pediat Hematol Oncol & Bone Marrow Transplan, Vancouver, BC, Canada.
    Seo, Sachiko
    East Hosp, Natl Canc Res Ctr, Kashiwa, Chiba, Japan.
    Shenoy, Shalini
    Washington Univ, Dept Pediat Hematol Oncol, St Louis, MO, USA.
    Waller, Edmund K.
    Emory Univ, Winship Canc Inst, Dept Hematol & Med Oncol, Atlanta, GA, USA.
    Yu, Lolie
    Louisiana State Univ, Hlth Sci Ctr, Ctr Canc & Blood Disorders, Div Hematol Oncol, New Orleans, LA, USA.
    Horowitz, Mary M.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI, USA.
    Horan, John
    Emory Univ, Sch Med, Aflac Canc & Blood Disorders Ctr, Atlanta, GA, USA.
    Influence of Age on Acute and Chronic GVHD in Children Undergoing HLA-Identical Sibling Bone Marrow Transplantation for Acute Leukemia: Implications for Prophylaxis2018In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 24, no 3, p. 521-528Article in journal (Refereed)
    Abstract [en]

    Relapse remains the major cause of mortality after hematopoietic cell transplantation (HCT) for pediatric acute leukemia. Previous research has suggested that reducing the intensity of calcineurin inhibitor-based graft-versus-host disease (GVHD) prophylaxis may be an effective strategy for abrogating the risk of relapse in pediatric patients undergoing matched sibling donor (MSD) HCT. We reasoned that the benefits of this strategy could be maximized by selectively applying it to those patients least likely to develop GVHD. We conducted a study of risk factors for GVHD, to risk-stratify patients based on age. Patients age <18 years with leukemia who received myeloablative, T cell-replete MSD bone marrow transplantation and calcineurin inhibitor-based GVHD prophylaxis between 2000 and 2013 and were entered into the Center for International Blood and Marrow Transplant Research registry were included. The cumulative incidence of grade II-IV acute GVHD (aGVHD) was 19%, that of grade II-IV aGVHD 7%, and that of chronic GVHD (cGVHD) was 16%. Compared with age 13 to 18 years, age 2 to 12 years was associated with a lower risk of grade II-IV aGVHD (hazard ratio [HR], .42; 95% confidence interval [CI], .26 to .70; P = .0008), grade II-IV aGVHD (HR, .24; 95% CI, .10 to .56; P = .001), and cGVHD (HR, .32; 95% CI, .19 to .54; P < .001). Compared with 2000-2004, the risk of grade II-IV aGVHD was lower in children undergoing transplantation in 2005-2008 (HR, .36; 95% CI, .20 to .65; P = .0007) and in 2009-2013 (HR, .24; 95% CI. .11 to .53; P = .0004). Similarly, the risk of grade III-IV aGVHD was lower in children undergoing transplantation in 2005-2008 (HR, .23; 95% CI, .08 to .65; P = .0056) and 2009-2013 (HR, .16; 95% CI, .04 to .67; P = .0126) compared with those doing so in 2000-2004. We conclude that aGVHD rates have decreased significantly over time, and that children age 2 to 12 years are at very low risk for aGVHD and cGVHD. These results should be validated in an independent analysis, because these patients with high-risk malignancies may be good candidates for trials of reduced GVHD prophylaxis.

  • 28.
    Raj, Kavita
    et al.
    Guys & St Thomas NHS Fdn Trust, Dept Haematol Med, London, England.
    Eikema, Diderik-Jan
    EBMT Stat Unit, Dept Med Stat & Bioinformat, Leiden, Netherlands.
    McLornanl, Donal P.
    Guys & St Thomas NHS Fdn Trust, Dept Haematol Med, London, England.
    Olavarria, Eduardo
    Hammersmith Hosp London, Dept Haematol Med, London, England.
    Bloke, Henric-Jan
    EBMT Stat Unit, Dept Med Stat & Bioinformat, Leiden, Netherlands.
    Bregante, Stefania
    Osped San Martino Genova, Dept Haematol, Genoa, Italy.
    Ciceri, Fabio
    Carattere Sci San Raffaele Sci Inst, Dept Hematol & Hematopoiet, Milan, Italy.
    Passweg, Jakob
    Univ Hosp, Dept Internal Med, Basel, Switzerland.
    Ljungman, Per
    Karolinska Univ Hosp, Div Hematol, Stockholm, Sweden.
    Schaap, Nicolaas
    Radboud Univ Nijmegen, Med Ctr, Dept Hematol, Nijmegen, Netherlands.
    Carlson, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Zuckerman, Tsila
    Rambam Med Ctr, Depatment Hematol & Bone Marrow Transplantat, Haifa, Israel.
    de Wreede, Liesbeth C.
    Deutsch Knochenmarkspenderdatei Clin Trials Unit, Dresden, Germany.
    Volin, Liisa
    Helsinki Univ Cent Hosp, Ctr Comprehens Canc, Dept Med, Helsinki, Finland.
    Koc, Yener
    Med Pk Hosp, Stem Cell Transplant Unit, Dept Oncol, Antalya, Turkey.
    Luis Diez-Martin, Jose
    Univ Complutense Med, Inst Invest Sanitaria Gregorio Maranon, Dept Hematol, Madrid, Spain.
    Brossart, Peter
    Univ Bonn, Dept Immunooncol & Rheumatol, Bonn, Germany.
    Wolf, Dominik
    Univ Bonn, Dept Immunooncol & Rheumatol, Bonn, Germany.
    Blaise, Didier
    Inst Paoli Calmettes, Transplantat & Cell Therapy Unit, Dept Oncohematol, Marseille, France.
    Di Bartolomeo, Paolo
    Osped Civile, Dept Hematol Transfus Med & Biotechnol, Marseille, France.
    Vitek, Antonin
    Inst Hematol & Blood Transfus, Prague, Czech Republic.
    Robin, Marie
    Hop St Louis, Dept Hematol & Bone Marrow Transplantat, Paris, France.
    Yakoub-Agha, Ibrahim
    Univ Lille, Lille Univ Hosp, INSERM U995, Dept Hematol, Lille, France.
    Chalandon, Yves
    Univ Geneva, Hematol Div, Hop Univ Geneve, Geneva, Switzerland.
    Kroger, Nicolaus
    Univ Hosp Eppendorf, Dept Stem Cell Transplantat, Hamburg, Germany.
    Family Mismatched Allogeneic Stem Cell Transplantation for Myelofibrosis: Report from the Chronic Malignancies Working Party of European Society for Blood and Marrow Transplantation2019In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 25, no 3, p. 522-528Article in journal (Refereed)
    Abstract [en]

    This analysis included 56 myelofibrosis (MF) patients transplanted from family mismatched donor between 2009 and 2015 enrolled in the European Society for Blood and Marrow Transplantation database. The median age was 57 years (range, 38 to 72); 75% had primary MF and 25% had secondary MF. JAK2 V617F was mutated in 61%. Donors were HLA mismatched at 2 or more loci. Stem cells were sourced from bone marrow in 66% and peripheral blood in 34%. The median CD34(+) cell dose was 4.8 x 10(6)/kg (range, 1.7 to 22.9; n = 43). Conditioning was predominantly myeloablative in 70% and reduced intensity in the remainder. Regimens were heterogeneous with thiotepa, busulfan, fludarabine, and post-transplant cyclophosphamide used in 59%. The incidence of neutrophil engraftment by 28 days was 82% (range, 70% to 93%), at a median of 21 days (range, 19 to 23). At 2 years the cumulative incidence of primary graft failure was 9% (95% CI 1% to 16%) and secondary graft failure was 13% (95% CI 4% to 22%). The cumulative incidence of acute graft-versus-host disease (GVHD) grades II to IV and Ill to IV was 28% (95% CI 16% to 40%) and 9% (95% CI 2% to 17%) at 100 days. The cumulative incidence of chronic GVHD at 1 year was 45% (95% CI 32% to 58%), but the cumulative incidence of death without chronic GVHD by 1 year was 20% (95% CI 10% to 31%). With a median follow-up of 32 months, the 1- and 2-year overall survival was 61% (95% CI 48% to 74%) and 56% (95% CI 41% to 70%), respectively. The 1- and 2- year progression-free survival was 58% (95% CI 45% to 71%) and 43% (95% CI 28% to 58%), respectively, with a 2-year cumulative incidence of relapse of 19% 95% CI 7% to 31%). The 2-year nonrelapse mortality was 38% (95% CI 24% to 51%). This retrospective study of MF allo-SCT using family mismatched donors demonstrated feasibility of the approach, timely neutrophil engraftment in over 80% of cases, and acceptable overall and progression-free survival rates with relapse rates not dissimilar to the unrelated donor setting. However, strategies to minimize the risk of graft failure and the relatively high nonrelapse mortality need to be used, ideally in a multicenter prospective fashion.

  • 29. Remberger, Mats
    et al.
    Ackefors, Malin
    Berglund, Sofia
    Blennow, Ola
    Dahllöf, Göran
    Dlugosz, Aldona
    Garming-Legert, Karin
    Gertow, Jens
    Gustafsson, Britt
    Hassan, Moustapha
    Hassan, Zuzana
    Hauzenberger, Dan
    Hägglund, Hans
    Department of Hematology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden.
    Karlsson, Helen
    Klingspor, Lena
    Kumlien, Gunilla
    Le Blanc, Katarina
    Ljungman, Per
    Machaczka, Maciej
    Malmberg, Karl-Johan
    Marschall, Hanns-Ulrich
    Mattsson, Jonas
    Olsson, Richard
    Omazic, Brigitta
    Sairafi, Darius
    Schaffer, Marie
    Svahn, Britt-Marie
    Svenberg, Petter
    Swartling, Lisa
    Szakos, Attila
    Uhlin, Michael
    Uzunel, Mehmet
    Watz, Emma
    Wernerson, Annika
    Wikman, Agneta
    Wikström, Ann-Charlotte
    Winiarski, Jacek
    Ringdén, Olle
    Improved survival after allogeneic hematopoietic stem cell transplantation in recent years: A single-center study2011In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 17, no 11, p. 1688-1697Article in journal (Refereed)
    Abstract [en]

    We analyzed the outcome of allogeneic hematopoietic stem cell transplantation (HSCT) over the past 2 decades. Between 1992 and 2009, 953 patients were treated with HSCT, mainly for a hematologic malignancy. They were divided according to 4 different time periods of treatment: 1992 to 1995, 1996 to 2000, 2001 to 2005, and 2006 to 2009. Over the years, many factors have changed considerably regarding patient age, diagnosis, disease stage, type of donor, stem cell source, genomic HLA typing, cell dose, type of conditioning, treatment of infections, use of granulocyte-colony stimulating factor (G-CSF), use of mesenchymal stem cells, use of cytotoxic T cells, and home care. When we compared the last period (2006-2009) with earlier periods, we found slower neutrophil engraftment, a higher incidence of acute graft-versus-host disease (aGVHD) of grades II-IV, and less chronic GVHD (cGHVD). The incidence of relapse was unchanged over the 4 periods (22%-25%). Overall survival (OS) and transplant-related mortality (TRM) improved significantly in the more recent periods, with the best results during the last period (2006-2009) and a 100-day TRM of 5.5%. This improvement was also apparent in a multivariate analysis. When correcting for differences between the 4 groups, the hazard ratio for mortality in the last period was 0.59 (95% confidence interval [CI]: 0.44-0.79; P < .001) and for TRM it was 0.63 (CI: 0.43-0.92; P = .02). This study shows that the combined efforts to improve outcome after HSCT have been very effective. Even though we now treat older patients with more advanced disease and use more alternative HLA nonidentical donors, OS and TRM have improved. The problem of relapse still has to be remedied. Thus, several different developments together have resulted in significantly lower TRM and improved survival after HSCT over the last few years.

  • 30. Ruutu, Tapani
    et al.
    Juvonen, Eeva
    Remberger, Mats
    Remes, Kari
    Volin, Liisa
    Mattsson, Jonas
    Nihtinen, Anne
    Hägglund, Hans
    Centre for Allogeneic Stem Cell Transplantation, Departments of Clinical Immunology and Medicine, Karolinska Hospital, Huddinge University Hospital, Huddinge, Sweden.
    Ringdén, Olle
    Improved survival with ursodeoxycholic acid prophylaxis in allogeneic stem cell transplantation: long-term follow-up of a randomized study2014In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 20, no 1, p. 135-138Article in journal (Refereed)
    Abstract [en]

    We report the long-term results of a prospective randomized study on the use of ursodeoxycholic acid (UDCA) for prevention of hepatic complications after allogeneic stem cell transplantation. Two hundred forty-two patients, 232 with malignant disease, were randomized to receive (n = 123) or not to receive (n = 119) UDCA from the beginning of the conditioning until 90 days post-transplantation. The results were reported after 1-year follow-up. UDCA administration reduced significantly the proportion of patients developing high serum bilirubin levels as well as the incidence of severe acute graft-versus-host disease (GVHD), liver GVHD, and intestinal GVHD. In the UDCA prophylaxis group, nonrelapse mortality (NRM) was lower and overall survival better than in the control group. After a 10-year follow-up, the difference in the survival and NRM in favor of the UDCA-treated group, seen at 1 year, was maintained (survival 48% versus 38%, P = .037; NRM 28% versus 41%, P = .01). A landmark analysis in patients surviving at 1 year post-transplantation showed no significant differences between the study groups in the long-term follow-up in chronic GVHD, relapse rate, NRM, disease-free survival, or overall survival. These long-term results continue to support the useful role of UDCA in the prevention of transplant-related complications in allogeneic transplantation.

  • 31. Sharma, Manish
    et al.
    Zhang, Mei-Jie
    Zhong, Xiaobo
    Abidi, Muneer H.
    Akpek, Goerguen
    Bacher, Ulrike
    Callander, Natalie S.
    Dispenzieri, Angela
    Freytes, Cesar O.
    Fung, Henry C.
    Gale, Robert Peter
    Gasparetto, Cristina
    Gibson, John
    Holmberg, Leona A.
    Kindwall-Keller, Tamila L.
    Klumpp, Thomas R.
    Krishnan, Amrita Y.
    Landau, Heather J.
    Lazarus, Hillard M.
    Lonial, Sagar
    Maiolino, Angelo
    Marks, David I.
    Mehta, Paulette
    Med, Joseph R. Mikhael
    Nishihori, Taiga
    Olsson, Richard
    Ramanathan, Muthalagu
    Roy, Vivek
    Savani, Bipin N.
    Schouten, Harry C.
    Scott, Emma
    Tay, Jason
    To, Luen Bik
    Vesole, David H.
    Vogl, Dan T.
    Hari, Parameswaran
    Older Patients with Myeloma Derive Similar Benefit from Autologous Transplantation2014In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 20, no 11, p. 1796-1803Article in journal (Refereed)
    Abstract [en]

    Autologous hematopoietic cell transplantation (AHCT) for plasma cell myeloma is performed less often in people >70 years old than in people <= 70 years old. We analyzed 11,430 AHCT recipients for plasma cell myeloma prospectively reported to the Center for International Blood and Marrow Transplant Research between 2008 and 2011, representing the majority of US AHCT activity during this period. Survival (OS) was compared in 3 cohorts: ages 18 to 59 years (n = 5818), 60 to 69 years (n = 4666), and >70 years (n = 946). Median OS was not reached for any cohort. In multivariate analysis, increasing age was associated with mortality (P = .0006). Myeloma-specific mortality was similar among cohorts at 12%, indicating an age-related effect on nonmyeloma mortality. Analyses were performed in a representative subgroup comparing relapse rate, progression-free survival (PFS), and nonrelapse mortality (NRM). One-year NRM was 0% for age >70 years and 2% for other ages (P = not significant). The three-year relapse rate was 56% in age 18 to 59 years, 61% in age 60 to 69 years, and 63% age >70 (P = not significant). Three-year PFS was similar at 42% in age 18 to 59 years, 38% in age 60 to 69 years, and 33% in age >70 years (P = not significant). Postrelapse survival was significantly worse for the older cohort (P = .03). Older subjects selected for AHCT derived similar antimyeloma benefit without worse NRM, relapse rate, or PFS.

  • 32.
    Shaw, Bronwen E.
    et al.
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Logan, Brent R.
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA.;CIBMTR, Natl Marrow Donor Program Be Match, Minneapolis, MN USA..
    Kiefer, Deidre M.
    CIBMTR, Natl Marrow Donor Program Be Match, Minneapolis, MN USA..
    Chitphakdithai, Pintip
    CIBMTR, Natl Marrow Donor Program Be Match, Minneapolis, MN USA..
    Pedersen, Tanya L.
    Allina Hlth, Minneapolis, MN USA..
    Abdel-Azim, Hisham
    Univ So Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90033 USA..
    Abidi, Muneer H.
    Wayne State Univ, Karmanos Canc Inst, Dept Oncol, Div BMT, Detroit, MI USA..
    Akpek, Gorgun
    Banner MD Anderson Canc Ctr, Stem Cell Transplantat & Cellular Therapy Program, Gilbert, AZ USA..
    Diaz, Miguel A.
    Hosp Infantil Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain..
    Artz, Andrew S.
    Dandoy, Christopher
    Univ Chicago, Hematol Oncol Sect, Chicago, IL 60637 USA.;Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA..
    Gajewski, James L.
    Oregon Hlth & Sci Univ, Portland, OR 97201 USA..
    Hematti, Peiman
    Univ Wisconsin Hosp & Clin, Div Hematol Oncol Bone Marrow Transplantat, Madison, WI 53792 USA..
    Kamble, Rammurti T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA..
    Kasow, Kimberley A.
    Univ N Carolina, Dept Pediat, Div Hematol Oncol, Chapel Hill, NC USA..
    Lazarus, Hillard M.
    Univ Hosp Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA..
    Liesveld, Jane L.
    Univ Rochester, Med Ctr, Dept Med, Rochester, NY 14642 USA..
    Majhail, Navneet S.
    Cleveland Clin, Taussig Canc Inst, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA..
    O'Donne, Paul V.
    Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA..
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden..
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Schears, Raquel M.
    Mayo Clin, Rochester, MN USA..
    Stroncek, David F.
    NIH, Dept Transfus Med, Clin Ctr, Bethesda, MD 20892 USA..
    Switzer, Galen E.
    Univ Pittsburgh, Pittsburgh, PA USA..
    Williams, Eric P.
    BeTheMatch Natl Marrow Donor Program, Minneapolis, MN USA..
    Wingard, John R.
    Univ Florida, Dept Med, Div Hematol & Oncol, Gainesville, FL USA..
    Wirk, Baldeep M.
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA..
    Confer, Dennis L.
    BeTheMatch Natl Marrow Donor Program, Minneapolis, MN USA..
    Pulsipher, Michael A.
    Univ So Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90033 USA..
    Analysis of the Effect of Race, Socioeconomic Status, and Center Size on Unrelated National Marrow Donor Program Donor Outcomes: Donor Toxicities Are More Common at Low-Volume Bone Marrow Collection Centers2015In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 21, no 10, p. 1830-1838Article in journal (Refereed)
    Abstract [en]

    Previous studies have shown that risks of collection-related pain and symptoms are associated with sex, body mass index, and age in unrelated donors undergoing collection at National Marrow Donor Program centers. We hypothesized that other important factors (race, socioeconomic status [SES], and number of procedures at the collection center) might affect symptoms in donors. We assessed outcomes in 2726 bone marrow (BM) and 6768 peripheral blood stem cell (PBSC) donors collected between 2004 and 2009. Pain/symptoms are reported as maximum levels over mobilization and collection (PBSC) or within 2 days of collection (BM) and at 1 week after collection. For PBSC donors, race and center volumes were not associated with differences in pain/symptoms at any time. PBSC donors with high SES levels reported higher maximum symptom levels 1 week after donation (P = .017). For BM donors, black males reported significantly higher levels of pain (OR, 1.90; CI, 1.14 to 3.19; P = .015). No differences were noted by SES group. BM donors from low-volume centers reported more toxicity (OR, 2.09; CI, 1.26 to 3.46; P = .006). In conclusion, race and SES have a minimal effect on donation-associated symptoms. However, donors from centers performing <= 1 BM collection every 2 months have more symptoms after BM donation. Approaches should be developed by registries and low-volume centers to address this issue.

  • 33.
    Stikvoort, Arwen
    et al.
    Karolinska Inst, Dept Oncol Pathol, SE-14186 Stockholm, Sweden..
    Gaballa, Ahmed
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden..
    Solders, Martin
    Karolinska Inst, Dept Lab Med, Stockholm, Sweden..
    Nederlof, Iris
    Karolinska Inst, Dept Oncol Pathol, SE-14186 Stockholm, Sweden..
    Önfelt, Björn
    KTH, School of Engineering Sciences (SCI), Applied Physics.
    Sundberg, Berit
    Karolinska Inst, Dept Oncol Pathol, SE-14186 Stockholm, Sweden..
    Remberger, Mats
    Karolinska Univ Hosp, CAST, Stockholm, Sweden..
    Sundin, Mikael
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Hematol Immunol HSCT Sect, Stockholm, Sweden..
    Mattsson, Jonas
    Karolinska Inst, Dept Oncol Pathol, SE-14186 Stockholm, Sweden.;Karolinska Univ Hosp, CAST, Stockholm, Sweden..
    Uhlin, Michael
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Clin Immunol & Transfus Med, Huddinge, Sweden..
    Risk Factors for Severe Acute Graft-versus-Host Disease in Donor Graft Composition2018In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 24, no 3, p. 467-477Article in journal (Refereed)
    Abstract [en]

    Acute graft-versus-host disease (aGVHD) is 1 of the main major complications of post-hematopoietic stem cell transplantation (HSCT). Identifying patients at risk of severe aGVHD may lead to earlier intervention and treatment, resulting in increased survival and a better quality of life. We aimed to identify biomarkers in donor grafts and patient plasma around the time of transplantation that might be predictive of aGVHD development. We build on our previously published methods by using multiplex assays and multicolor flow cytometry. We identified 5 easily assessable cellular markers in donor grafts that combined could potentially be used to calculate risk for severe aGVHD development. Most noteworthy are the T cell subsets expressing IL-7 receptor-a (CD127) and PD-1. Additionally, we identified a potential role for elevated tumor necrosis factor-a levels in both graft and patient before HSCT in development of aGVHD. 

  • 34.
    Stroncek, David F
    et al.
    Department of Transfusion Medicine, Cell Processing Section, Clinical Center, National Institutes of Health, Bethesda, Maryland.
    Shaw, Bronwen E
    Center for International Blood and Bone Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
    Logan, Brent R
    Center for International Blood and Bone Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin.
    Kiefer, Deidre M
    Center for International Blood and Bone Marrow Transplant Research, National Marrow Donor Program, Minneapolis, Minnesota.
    Savani, Bipin N
    Hematology & Stem Cell Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee.
    Anderlini, Paolo
    Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
    Bredeson, Christopher N
    The Ottawa Hospital Blood & Marrow Transplant Program, University of Ottawa, Ottawa, Ontario, Canada.
    Hematti, Peiman
    Department of Medicine, University of Wisconsin, Madison, Wisconsin.
    Ganguly, Siddhartha
    Hematologic Malignancies and Cellular Therapies, University of Kansas Medical Center, Westwood, Kansas.
    Diaz, Miguel Angel
    Unidad de Trasplante Hematopoyetico, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
    Abdel-Azim, Hisham
    Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California.
    Ahmed, Ibrahim
    Children's Mercy Hospital—UMKC, Kansas City, Missouri.
    Maharaj, Dipnarine
    South Florida Bone Marrow Transplant/Stem Cell Transplant Institute, Bethesda Health City, Boynton Beach, Florida.
    Seftel, Matthew
    Medical Oncology and Haematology, CancerCare Manitoba, Winnipeg, Ontario, Canada.
    Beitinjaneh, Amer
    Stem Cell Transplantation and Cell Therapy Program, Miller School of Medicine, University of Miami, Miami, Florida.
    Seo, Sachiko
    Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
    Yared, Jean A
    Department of Medicine, Greenbaum Cancer Center, University of Maryland, Baltimore, Maryland.
    Halter, Joerg
    Department of Haematology, University Hospital Basel, Basel, Switzerland.
    O'Donnell, Paul V
    Blood and Marrow Transplant Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
    Hale, Gregory A
    Cancer and Blood Disorders Institute, All Children's Hospital, St. Petersburg, Florida.
    DeFilipp, Zachariah
    Blood and Marrow Transplant Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
    Lazarus, Hillard
    Department of Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio.
    Liesveld, Jane L
    Hematology-Oncology Unit, Department of Medicine, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, New York.
    Zhou, Zheng
    University of Massachusetts, Marlboro, Massachusetts.
    Munshi, Pashna
    Georgetown University Hospital, Washington, District of Columbia.
    Olsson, Richard F.
    Karolinska Institutet, Division of Therapeutic Immunology, Stockholm, Sweden.
    Kasow, Kimberly Anne
    Division of Hematology-Oncology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
    Szer, Jeffrey
    Department of Hematology and Bone Marrow Transplantation, Royal Melbourne Hospital City Campus, Victoria, Australia.
    Switzer, Galen E
    Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
    Chitphakdithai, Pintip
    Center for International Blood and Bone Marrow Transplant Research, National Marrow Donor Program, Minneapolis, Minnesota.
    Shah, Nirali
    Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
    Confer, Dennis L
    Center for International Blood and Bone Marrow Transplant Research, National Marrow Donor Program, Minneapolis, Minnesota.
    Pulsipher, Michael A
    Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California.
    Donor Experiences of Second Marrow or Peripheral Blood Stem Cell Collection Mirror the First, but CD34+ Yields Are Less2018In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 24, no 1, p. 175-184Article in journal (Refereed)
    Abstract [en]

    Little is known about the experiences of individuals donating peripheral blood stem cells (PBSCs) or marrow for a second time. To study this, unrelated donors making a second donation through the National Marrow Donor Program between 2004 and 2013 were evaluated. Experiences of second-time donors giving marrow (n = 118: first donation was PBSC in 76 and marrow in 42) were compared with those making only 1 marrow donation (n = 5829). Experiences of second-time donors giving PBSCs (n = 602) (first donation was PBSCs in 362; marrow in 240) were compared to first-time PBSC donors (n = 16,095). For donors giving a second PBSC or marrow donation there were no significant differences in maximum skeletal pain, maximum symptoms measured by an established modified toxicity criteria, and recovery time compared with those who donated only once. Notably, the yield of marrow nucleated cells and PBSC CD34+ cells with second donations was less. As previously noted with single first-time donations, female (PBSCs and marrow) and obese donors (PBSCs) had higher skeletal pain and/or toxicity with a second donation. PBSC donors who experienced high levels of pain or toxicity with the first donation also experienced high levels of these symptoms with their second donation and slower recovery times. In conclusion, for most donors second donation experiences were similar to first donation experiences, but CD34+ yields were less. Knowledge of the donor's first experience and stem cell yields may help centers decide whether second donations are appropriate and institute measures to improve donor experiences.

  • 35. Törlén, J.
    et al.
    Gaballa, A.
    Remberger, M.
    Mörk, L. -M
    Sundberg, B.
    Mattsson, J.
    Uhlin, Michael
    KTH, School of Engineering Sciences (SCI), Applied Physics, Biophysics.
    Effect of Graft-versus-Host Disease Prophylaxis Regimens on T and B Cell Reconstitution after Allogeneic Hematopoietic Stem Cell Transplantation2019In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 25, no 6, p. 1260-1268Article in journal (Refereed)
    Abstract [en]

    Lymphocyte reconstitution is pivotal for successful long-term outcome after allogeneic hematopoietic stem cell transplantation (HSCT), and conditioning regimen and post-transplantation immunosuppression are risk factors for prolonged immunodeficiency. Nevertheless, the effects of different immunosuppressive protocols on lymphocyte output and replicative capacity have not been investigated. Here we assessed T cell receptor excision circles (TREC), kappa-deleting recombination excision circles (KREC), and T cell telomere length (TL) as proxy markers for immune reconstitution in patients in a prospective randomized trial comparing graft-versus-host disease (GVHD) prophylaxis after transplantation (cyclosporine/methotrexate versus tacrolimus/sirolimus; n = 200). Results showed that medians of TREC, KREC, and TL were not significantly different between the prophylaxis groups at any assessment time point during follow-up (24 months), but the kinetics of TREC, KREC, and TL were significantly influenced by other transplantation-related factors. Older recipient age, the use of antithymocyte globulin before graft infusion, and use of peripheral blood stem cell grafts were associated with lower TREC levels, whereas acute GVHD transiently affected KREC levels. Patients with lymphocyte excision circle levels above the median at ≤6 months post-transplantation had reduced transplantation-related mortality and superior 5-year overall survival (P <.05). We noticed significant T cell telomere shortening in the patient population as a whole during follow-up. Our results suggest that lymphocyte reconstitution after transplantation is not altered by different immunosuppressive protocols. This study has been registered at ClinicalTrials.gov (identifier: NCT00993343). 

  • 36.
    Törlén, Johan
    et al.
    Karolinska Univ Hosp, Cell Therapy & Allogene Stem Cell Transplantat, Stockholm, Sweden;Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden.
    Gaballa, Ahmed
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    Remberger, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden;Uppsala Univ Hosp, Clin Res & Dev Unit, Uppsala, Sweden.
    Mörk, Lisa-Mari
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    Sundberg, Berit
    Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden.
    Mattsson, Jonas
    Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden;Karolinska Univ Hosp, Dept Immunol & Transfus Med, Stockholm, Sweden.
    Uhlin, Michael
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden;Karolinska Univ Hosp, Dept Immunol & Transfus Med, Stockholm, Sweden;Royal Inst Technol, Dept Appl Phys, Stockholm, Sweden.
    Effect of Graft-versus-Host Disease Prophylaxis Regimens on T and B Cell Reconstitution after Allogeneic Hematopoietic Stem Cell Transplantation2019In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 25, no 6, p. 1260-1268Article in journal (Refereed)
    Abstract [en]

    Lymphocyte reconstitution is pivotal for successful long-term outcome after allogeneic hematopoietic stem cell transplantation (HSCT), and conditioning regimen and post-transplantation immunosuppression are risk factors for prolonged immunodeficiency. Nevertheless, the effects of different immunosuppressive protocols on lymphocyte output and replicative capacity have not been investigated. Here we assessed T cell receptor excision circles (TREC), kappa-deleting recombination excision circles (KREC), and T cell telomere length (TL) as proxy markers for immune reconstitution in patients in a prospective randomized trial comparing graft-versus-host disease (GVHD) prophylaxis after transplantation (cyclosporine/methotrexate versus tacrolimus/sirolimus; n=200). Results showed that medians of TREC, KREC, and TL were not significantly different between the prophylaxis groups at any assessment time point during follow-up (24 months), but the kinetics of TREC, KREC, and TL were significantly influenced by other transplantation-related factors. Older recipient age, the use of antithymocyte globulin before graft infusion, and use of peripheral blood stem cell grafts were associated with lower TREC levels, whereas acute GVHD transiently affected KREC levels. Patients with lymphocyte excision circle levels above the median at <= 6 months post-transplantation had reduced transplantation-related mortality and superior 5-year overall survival (P<.05). We noticed significant T cell telomere shortening in the patient population as a whole during follow-up. Our results suggest that lymphocyte reconstitution after transplantation is not altered by different immunosuppressive protocols. This study has been registered at ClinicalTrials.gov (identifier: NCT00993343). (C) 2019 American Society for Blood and Marrow Transplantation.

  • 37.
    Urbano-Ispizua, Alvaro
    et al.
    Univ Barcelona, Hosp Clin, IDIBAPS, Dept Hematol, Barcelona, Spain.;Inst Res Josep Carreras, Barcelona, Spain..
    Pavletic, Steven Z.
    NCI, Expt Transplantat & Immunol Branch, Ctr Canc Res, Bethesda, MD 20892 USA..
    Flowers, Mary E.
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA..
    Klein, John P.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA..
    Zhang, Mei-Jie
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA..
    Carreras, Jeanette
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Montoto, Silvia
    Barts Hlth NHS Trust, St Bartholomews Hosp, Dept Haematooncol, London, England..
    Perales, Miguel-Angel
    Mem Sloan Kettering Canc Ctr, Dept Med, Bone Marrow Transplant Serv, New York, NY 10021 USA..
    Aljurf, Mahmoud D.
    King Faisal Specialist Hosp Ctr & Res, Dept Oncol, Riyadh, Saudi Arabia..
    Akpek, Goerguen
    Banner MD Anderson Canc Ctr, Hematol Oncol Sect, Gilbert, AZ USA..
    Bredeson, Christopher N.
    Ottawa Hosp, Blood & Marrow Transplant Program, Ottawa, ON, Canada.;Ottawa Hosp, Res Inst, Ottawa, ON, Canada..
    Costa, Luciano J.
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA..
    Dandoy, Christopher
    Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA..
    Freytes, Cesar O.
    South Texas Vet Hlth Care Syst, San Antonio, TX USA.;Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA..
    Fung, Henry C.
    Temple Hlth, Fox Chase Canc Ctr, Dept Med Oncol, Philadelphia, PA USA..
    Gale, Robert Peter
    Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Hematol Res Ctr, London, England..
    Gibson, John
    Royal Prince Alfred Hosp, Inst Haematol, Camperdown, NSW 2050, Australia..
    Hamadani, Mehdi
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Hayashi, Robert J.
    Washington Univ, Sch Med, Dept Pediat, Div Pediat Hematol Oncol, St Louis, MO 63110 USA..
    Inamoto, Yoshihiro
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA..
    Inwards, David J.
    Mayo Clin, Div Hematol, Rochester, MN USA..
    Lazarus, Hillard M.
    Univ Hosp Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA..
    Maloney, David G.
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA..
    Martino, Rodrigo
    Hosp Santa Creu & Sant Pau, Div Hematol, Barcelona, Spain..
    Munker, Reinhold
    Louisiana State Univ Hlth, Dept Internal Med, Div Hematol Oncol, Shreveport, LA USA..
    Nishihori, Taiga
    Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Med Oncol, Tampa, FL 33612 USA..
    Olsson, Richard F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden..
    Rizzieri, David A.
    Duke Univ, Div Hematol Malignancies & Cellular Therapy, Durham, NC USA..
    Reshef, Ran
    Univ Penn, Dept Med, Abramson Canc Ctr, Med Ctr, Philadelphia, PA 19104 USA..
    Saad, Ayman
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA..
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Schouten, Harry C.
    Acad Ziekenhuis, Dept Hematol, Maastricht, Netherlands..
    Smith, Sonali M.
    Univ Chicago, Hematol Oncol Sect, Chicago, IL 60637 USA..
    Socie, Gerard
    Hop St Louis, Dept Hematol, Paris, France..
    Wirk, Baldeep
    SUNY Stony Brook, Med Ctr, Dept Internal Med, Stony Brook, NY 11794 USA..
    Yu, Lolie C.
    Louisiana State Univ, Med Ctr, Childrens Hosp, Div Hematol Oncol,Ctr Canc & Blood Disorders, New Orleans, LA USA..
    Saber, Wael
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    The Impact of Graft-versus-Host Disease on the Relapse Rate in Patients with Lymphoma Depends on the Histological Subtype and the Intensity of the Conditioning Regimen2015In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 21, no 10, p. 1746-1753Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to analyze the impact of graft-versus-host disease (GVHD) on the relapse rate of different lymphoma subtypes after allogeneic hematopoietic cell transplantation (allo-HCT). Adult patients with a diagnosis of Hodgkin lymphoma, diffuse large B cell lymphoma, follicular lymphoma (FL), peripheral T cell lymphoma, or mantle cell lymphoma (MCL) undergoing HLA-identical sibling or unrelated donor hematopoietic cell transplantation between 1997 and 2009 were included. Two thousand six hundred eleven cases were included. A reduced-intensity conditioning (RIC) regimen was used in 62.8% of the transplantations. In a multivariate analysis of myeloablative cases (n = 970), neither acute (aGVHD) nor chronic GVHD (cGVHD) were significantly associated with a lower incidence of relapse/progression in any lymphoma subtype. In contrast, the analysis of RIC cases (n = 1641) showed that cGVHD was associated with a lower incidence of relapse/progression in FL (risk ratio [RR],.51; P = 3.049) and in MCL (RR,.41; P = .019). Patients with FL or MCL developing both aGVHD and cGVHD had the lowest risk of relapse (RR,.14; P = .007; and RR,.15; P = .0019, respectively). Of interest, the effect of GVHD on decreasing relapse was similar in patients with sensitive disease and chemoresistant disease. Unfortunately, both aGVHD and cGVHD had a deleterious effect on treatment-related mortality and overall survival (OS) in FL cases but did not affect treatment-related mortality, OS or PFS in MCL. This study reinforces the use of RIC allo-HCT as a platform for immunotherapy in FL and MCL patients.

  • 38.
    Ustun, Celalettin
    et al.
    Univ Minnesota, Div Hematol Oncol & Transplantat, Minneapolis, MN 55455 USA..
    Gotlib, Jason
    Stanford Univ, Div Hematol, Stanford, CA USA..
    Popat, Uday
    Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat, Houston, TX USA..
    Artz, Andrew
    Univ Chicago, Dept Med, Hematol Oncol Sect, Chicago, IL USA..
    Litzow, Mark
    Mayo Clin, Dept Internal Med, Div Hematol, Minneapolis, MN USA..
    Reiter, Andreas
    Univ Med Ctr Mannheim, Dept Hematol & Oncol, Mannheim, Germany..
    Nakamura, Ryotaro
    City Hope Med Ctr, Dept Hematol Hematopoiet Cell Transplantat, Duarte, CA USA..
    Kluin-Nelemans, Hanneke C.
    Univ Groningen, Univ Med Ctr Groningen, Dept Hematol, Groningen, Netherlands..
    Verstovsek, Srdan
    Univ Texas MD Anderson Canc Ctr, Dept Leukemia, Houston, TX USA..
    Gajewskil, James
    Oregon Hlth & Sci Univ, Dept Hematol, Portland, OR USA..
    Perales, Miguel-Angel
    Mem Sloan Kettering Canc Ctr, Dept Med, Div Hematol Oncol, New York, NY USA..
    George, Tracy
    Univ New Mexico, Dept Pathol, Albuquerque, NM USA..
    Shore, Tsiporah
    Weill Cornell Med Coll, Div Hematol & Oncol, New York, NY USA..
    Sperr, Wolfgang
    Med Univ Vienna, Dept Internal Med 1, Div Hematol & Hemostaseol & Ludwig Boltzmann Clus, Vienna, Austria..
    Saber, Wael
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Dept Med, Milwaukee, WI USA..
    Kota, Vamsi
    Emory Univ, Winship Canc Inst, Dept Hematol & Oncol, Div Hematol, Atlanta, GA USA..
    Yavuz, Akif Selim
    Istanbul Univ, Istanbul Med Sch, Div Hematol, Istanbul, Turkey..
    Pullarkat, Vinod
    Rogosheske, John
    Univ Minnesota, Div Hematol Oncol & Transplantat, Minneapolis, MN 55455 USA..
    Hogan, William
    Mayo Clin, Dept Internal Med, Div Hematol, Minneapolis, MN USA..
    Van Besien, Koen
    Weill Cornell Med Coll, Dept Med, New York, NY USA..
    Hägglund, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Damaj, Gandhi
    Univ Basse Normandie, Univ Hosp, Sch Med, Inst Hematol,Dept Hematol, Caen, France..
    Arock, Michel
    Ecole Normale Super, CNRS UMR 8113, Cellular & Mol Oncol Unit, Cachan, France.;Univ Pitie Salpetriere, Ctr Hosp, Hematol Lab, Paris, France..
    Horny, Hans-Peter
    LMU, Inst Pathol, Munich, Germany..
    Metcalfe, Dean D.
    NIAID, Mast Cell Biol Sect, Lab Allerg Dis, NIH, Bethesda, MD USA..
    Deeg, H. Joachim
    Univ Washington, Fred Hutchinson Canc Res Ctr, Seattle, WA USA.;Univ Washington, Sch Med, Seattle, WA USA..
    Devine, Steven
    Ohio State Univ, Dept Med, Div Hematol, Columbus, OH 43210 USA.;Ohio State Univ, Ctr Comprehens Canc, Columbus, OH 43210 USA..
    Weisdorfl, Daniel
    Univ Minnesota, Div Hematol Oncol & Transplantat, Minneapolis, MN 55455 USA..
    Akin, Cem
    Harvard Med Sch, Brigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA USA..
    Valent, Peter
    Consensus Opinion on Allogeneic Hematopoietic Cell Transplantation in Advanced Systemic Mastocytosis2016In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 22, no 8, p. 1348-1356Article in journal (Other academic)
  • 39. von Bahr, Lena
    et al.
    Sundberg, Berit
    Lönnies, Lena
    Sander, Birgitta
    Karbach, Holger
    Hägglund, Hans
    Haematology Centre, Department of Clinical Immunol- ogy, Department of Pathology, Departments of Paediatrics, and Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden.
    Ljungman, Per
    Gustafsson, Britt
    Karlsson, Helen
    Le Blanc, Katarina
    Ringdén, Olle
    Long-term complications, immunologic effects, and role of passage for outcome in mesenchymal stromal cell therapy2012In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 18, no 4, p. 557-564Article in journal (Refereed)
    Abstract [en]

    Thirty-one patients treated with mesenchymal stromal cells (MSCs) for acute graft-versus-host disease (aGVHD) or hemorrhagic cystitis between 2002 and 2007 were followed to investigate predictors of outcome, immunologic effects in vivo, and long-term survival. There was no correlation between in vitro suppression by MSCs in mixed lymphocyte cultures and outcome. Soluble IL-2 receptors were measured in blood before and after MSC infusion and declined significantly during the first week after MSC infusion (P = .03). Levels of interleukin-6 and HLA-G were unaffected. Infectious complications occurred several years after recovery from aGVHD. Cytomegalovirus viral load was high, and cytomegalovirus disease was common. Among patients recovering from aGVHD, 54% died of late infections, between 4 months and 2 years after MSC treatment. No increase in leukemia relapse or graft rejection was found. Children had a better survival rate than adults (P = .005). In GVHD patients, 1-year survival was 75% in patients who received early-passage MSCs (from passages 1-2) in contrast to 21% using later passage MSCs (from passages 3-4) (P < .01). We conclude that treatment with early-passage MSCs improved survival in patients with therapy-resistant GVHD. Death from infection was common in MSC-treated patients, but there was no increase in leukemia relapse.

  • 40.
    Vrooman, Lynda M.
    et al.
    Dana Farber Boston Childrens Canc & Blood Disorde, Dept Pediat, 450 Brookline Ave, Boston, MA 02215 USA.
    Millard, Heather R.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    Brazauskas, Ruta
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA;Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA.
    Majhail, Navneet S.
    Cleveland Clin, Taussig Canc Inst, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA.
    Battiwalla, Minoo
    NHLBI, Hematol Branch, Bethesda, MD 20892 USA.
    Flowers, Mary E.
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA.
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Div Hematol Oncol, Dept Med, Nashville, TN 37235 USA.
    Akpek, Gorgun
    Rush Univ, Med Ctr, Dept Internal Med, Stem Cell Transplantat & Cell Therapy, Chicago, IL 60612 USA.
    Aljurf, Mahmoud
    King Faisal Specialist Hosp Ctr & Res, Dept Oncol, Riyadh, Saudi Arabia.
    Bajwa, Rajinder
    Nationwide Childrens Hosp, Div Hematol Oncol BMT, Columbus, OH USA.
    Baker, K. Scott
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA.
    Beitinjaneh, Amer
    Univ Miami, Div Hematol & Oncol, Miami, FL USA.
    Bitan, Menachem
    Tel Aviv Sourasky Med Ctr, Dept Pediat Hematol Oncol, Tel Aviv, Israel.
    Buchbinder, David
    Childrens Hosp Orange Cty, Div Hematol, Orange, CA 92668 USA.
    Chow, Eric
    Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA.
    Dandoy, Christopher
    Cincinnati Childrens Hosp Med Ctr, Div Bone Marrow Transplant & Immune Deficiency, Cincinnati, OH 45229 USA.
    Dietz, Andrew C.
    Univ Southern Calif, Childrens Hosp Los Angeles, Div Hematol Oncol, Blood & Marrow Transplantat, Los Angeles, CA USA.
    Diller, Lisa
    Dana Farber Boston Childrens Canc & Blood Disorde, Dept Pediat, 450 Brookline Ave, Boston, MA 02215 USA.
    Gale, Robert Peter
    Imperial Coll London, Hematol Res Ctr, Dept Med, Div Expt Med, London, England.
    Hashmi, Shahrukh K.
    Mayo Clin, Div Hematol, Dept Internal Med, Rochester, MN USA.
    Hayashi, Roberti
    Washington Univ, Sch Med, Div Pediat Hematol Oncol, Dept Pediat, St Louis, MO USA.
    Hematti, Peiman
    Univ Wisconsin Hosp & Clin, Div Hematol Oncol Bone Marrow Transplantat, Dept Med, Madison, WI 53792 USA.
    Kamble, Rammurti T. f
    Baylor Coll Med, Div Hematol & Oncol, Ctr Cell & Gene Therapy, Houston, TX 77030 USA.
    Kasow, Kimberly A.
    Univ North Carolina Chapel Hill, Div Hematol Oncol, Dept Pediat, Chapel Hill, NC USA.
    Kletzel, Morris
    Ann & Robert H Lurie Childrens Hosp Chicago, Div Hematol Oncol & Stem Cell Transplant, Dept Pediat, Chicago, IL 60611 USA.
    Lazarus, Hillard M.
    Univ Hosp Cleveland, Med Ctr, Div Hematol & Oncol, Seidman Canc Ctr, Cleveland, OH 44106 USA.
    Malone, Adriana K.
    Icahn Sch Med Mt Sinai, Div Hematol Oncol, Tisch Canc Inst, New York, NY 10029 USA.
    Marks, David I.
    Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England.
    O'Brien, Tracey A.
    Sydney Childrens Hosp, Kids Canc Ctr, Blood & Marrow Transplant Program, Sydney, NSW, Australia.
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Div Therapeut Immunol, Dept Lab Med, Stockholm, Sweden.
    Ringden, Olle
    Karolinska Inst, Div Therapeut Immunol, Dept Lab Med, Stockholm, Sweden.
    Seo, Sachiko
    East Hosp, Natl Canc Res Ctr, Kashiwa, Chiba, Japan.
    Steinberg, Amir
    Icahn Sch Med Mt Sinai, Div Hematol Oncol, Tisch Canc Inst, New York, NY 10029 USA.
    Yu, Lolie C.
    Louisiana State Univ, Childrens Hosp, Med Ctr, Div Hematol Oncol,Ctr Canc & Blood Disorders, New Orleans, LA USA.
    Warwick, Anne
    Uniformed Serv Univ Hlth Sci, Dept Pediat, Bethesda, MD 20814 USA.
    Shaw, Bronwen
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    Duncan, Christine
    Dana Farber Boston Childrens Canc & Blood Disorde, Dept Pediat, 450 Brookline Ave, Boston, MA 02215 USA.
    Survival and Late Effects after Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancy at Less than Three Years of Age2017In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 23, no 8, p. 1327-1334Article in journal (Refereed)
    Abstract [en]

    Very young children undergoing hematopoietic cell transplantation (HCT) are a unique and vulnerable population. We analyzed outcomes of 717 patients from 117 centers who survived relapse free for year after allogeneic myeloablative HCT for hematologic malignancy at <3 years of age, between 1987 and 2012. The median follow-up was 8.3 years (range, 1.0 to 26.4 years); median age at follow-up was 9 years (range, 2 to 29 years). Ten-year overall and relapse-free survival were 87% (95% confidence interval [CI], 85% to 90%) and 84% (95% CI, 81% to 87%). Ten-year cumulative incidence of relapse was 11% (95% CI, 9% to 13%). Of 84 deaths, relapse was the leading cause (43%). Chronic graft-versus-host-disease 1 year after HCT was associated with increased risk of mortality (hazard ratio [HR], 2.1; 95% CI, 1.3 to 3.3; P=.0018). Thirty percent of patients experienced >= 1 organ toxicity/late effect >1 year after HCT. The most frequent late effects included growth hormone deficiency/growth disturbance (10-year cumulative incidence, 23%; 95% CI, 19% to 28%), cataracts (18%; 95% CI, 15% to 22%), hypothyroidism (13%; 95% CI, 10% to 16%), gonadal dysfunction/infertility requiring hormone replacement (3%; 95% CI, 2% to 5%), and stroke/seizure (3%; 95% CI, 2% to 5%). Subsequent malignancy was reported in 3.6%. In multivariable analysis, total body irradiation (TBI) was predictive of increased risk of cataracts (HR, 17.2; 95% CI, 7.4 to 39.8; P <.001), growth deficiency (HR, 3.5; 95% CI, 2.2 to 5.5; P <.001), and hypothyroidism (HR, 5.3; 95% CI, 3.0 to 9.4; P <.001). In summary, those who survived relapse free year after HCT for hematologic malignancy at <3 years of age had favorable overall survival. Chronic graft-versus host-disease and TBI were associated with adverse outcomes. Future efforts should focus on reducing the risk of relapse and late effects after HCT at early age.

  • 41.
    Vrooman, Lynda
    et al.
    Dana Farber Canc Inst, Boston, MA 02115 USA..
    Millard, Heather
    Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA..
    Brazauskas, Ruta
    Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA..
    Majhail, Navneet S.
    Cleveland Clin, Blood & Marrow Transplant Program, Taussig Canc Inst, Cleveland, OH 44106 USA..
    Battiwallas, Minoo
    NHLBI, Hematol Branch, NIH, Bethesda, MD 20892 USA..
    Flowers, Mary E. D.
    Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA..
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Akpek, Goerguen
    Banner MD Anderson Canc Ctr, Gilbert, AZ USA..
    Aljurf, Mahmoud D.
    King Faisal Specialist Hosp Ctr & Res, Dept Oncol, Riyadh, Saudi Arabia..
    Bajwa, Rajinder
    Nationwide Childrens, Bone Marrow Transplantat, Columbus, OH USA..
    Baker, K. Scott
    Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA..
    Beitinjaneh, Amer
    Univ Virginia, Sch Med, Hematol Oncol, Charlottesville, VA 22908 USA..
    Bitan, Menachem
    Tel Aviv Sourasky Med Ctr, Pediat Hematol Oncol & BMT, Tel Aviv, Israel..
    Buchbinder, David
    Childrens Hosp Orange Cty, Div Pediat Hematol, Orange, CA 92668 USA..
    Dandoy, Christopher E.
    Cincinnati Childrens Hosp Med Ctr, Bone Marrow Transplantat & Immune Deficiency, Cincinnati, OH 45229 USA..
    Gale, Robert Peter
    Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Hematol Res Ctr, London, England..
    Hayashi, Robert J.
    Washington Univ, Sch Med, Dept Pediat, Div Pediat Hematol Oncol, St Louis, MO 63110 USA..
    Hematti, Peiman
    Univ Wisconsin Hosp & Clin, Dept Med, Div Hematol Oncol Bone Marrow Transplantat, Madison, WI 53792 USA..
    Kamble, Rammurti T.
    Baylor Coll Med, Div Hematol & Oncol, Ctr Cell & Gene Therapy, Houston, TX 77030 USA..
    Kasow, Kimberly A.
    Univ N Carolina, Div Hematol Oncol, Dept Pediat, Chapel Hill, NC USA..
    Kletzel, Morris
    Northwestern Univ, Ann & Robert H Lurie Childrens Hosp Chicago, Feinberg Sch Med, Div Hematol Oncol & Stem Cell Transplantat, Chicago, IL 60611 USA..
    Lazarus, Hillard M.
    Univ Hosp Case Med Ctr, Seidman Canc Ctr, Adult Hematol Malignancies & Stem Cell Transplant, Cleveland, OH USA..
    Malone, Adriana K.
    Icahn Sch Med Mt Sinai, Tisch Canc Inst, New York, NY 10029 USA..
    O'Brien, Tracey
    Sydney Childrens Hosp, Kids Canc Ctr, Blood & Marrow Transplant Program, Sydney, NSW, Australia..
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden..
    Reddy, Vijay
    Univ Cent Florida, Dept Internal Med, Gainesville, FL USA..
    Willert, Jennifer Reikes
    Univ Calif San Diego, Rady Childrens Hosp, Pediat Hematol Oncol BMT, San Diego, CA USA..
    Ringden, Olle
    Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.;Karolinska Univ Hosp, Ctr Allogene Stem Cell Transplantat, Stockholm, Sweden..
    Schears, Raquel M.
    Mayo Clin, Rochester, MN USA..
    Seo, Sachiko
    Fred Hutchinson Canc Res Ctr, 1124 Columbia St, Seattle, WA 98104 USA..
    Steinberg, Amir
    Mt Sinai Hosp, Dept Hematol Oncol, New York, NY 10029 USA..
    Yu, Lolie C.
    Louisiana State Univ, Med Ctr, Childrens Hosp, Div Hematol Oncol, New Orleans, LA USA.;Louisiana State Univ, Med Ctr, Childrens Hosp, Ctr Canc & Blood Disorders,HSCT, New Orleans, LA USA..
    Shaw, Bronwen E.
    CIBMTR, Dept Med, Milwaukee, WI USA.;Med Coll Wisconsin, Milwaukee, WI 53226 USA..
    Duncan, Christine
    Boston Childrens Hosp, Dept Pediat Oncol, Boston, MA USA.;Dana Farber Canc Inst, Boston, MA 02115 USA..
    Survival and Late Effects of Children Undergoing Myeloablative Allogeneic HCT at Less Than Three Years of Age: A Report from the Center for International Blood and Marrow Transplant Research2016In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 22, no 3, p. S28-S29Article in journal (Other academic)
  • 42. Wareham, N. E.
    et al.
    Heilmann, C.
    Abrahamsson, J.
    Forestier, Erik
    Umeå University, Faculty of Medicine, Department of Medical Biosciences.
    Gustafsson, B.
    Ha, S-Y
    Heldrup, J.
    Jahnukainen, K.
    Jonsson, O. G.
    Lausen, B.
    Palle, J.
    Zeller, B.
    Hasle, H.
    Outcome of poor response paediatric AML using early SCT2012In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 18, no 2, p. S235-S235Article in journal (Other academic)
  • 43.
    Wood, William A.
    et al.
    Univ N Carolina, Div Hematol Oncol, Dept Med, Chapel Hill, NC 27515 USA.
    Brazauskas, Ruta
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA.
    Hu, Zhen-Huan
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    Abdel-Azim, Hisham
    Univ Southern Calif, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Keck Sch Med, Los Angeles, CA USA.
    Ahmed, Ibrahim A.
    Childrens Mercy Hosp & Clin, Dept Hematol Oncol & Bone Marrow Transplantat, Kansas City, MO USA.
    Aljurf, Mahmoud
    King Faisal Specialist Hosp & Res Ctr, Dept Oncol, Riyadh, Saudi Arabia.
    Badawy, Sherif
    Ann & Robert H Lurie Childrens Hosp Chicago, Div Hematol Oncol & Stem Cell Transplantat, Chicago, IL 60611 USA.
    Beitinjaneh, Amer
    Univ Miami, Dept Hematol Oncol, Miami, FL USA.
    George, Biju
    Christian Med Coll & Hosp, Vellore, Tamil Nadu, India.
    Buchbinder, David
    Childrens Hosp Orange Cty, Div Pediat Hematol, Orange, CA 92668 USA.
    Cerny, Jan
    UMass Mem Med Ctr, Div Hematol Oncol, Worcester, MA USA.
    Dedeken, Laurence
    Hop Univ Enfants Reine Fabiola, Dept Hematol Oncol, Brussels, Belgium.
    Angel Diaz, Miguel
    Hosp Infantil Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain.
    Freytes, Cesar O.
    Texas Transplant Inst, San Antonio, TX USA.
    Ganguly, Siddhartha
    Univ Kansas, Med Ctr, Blood & Marrow Transplantat, Div Hematol & Oncol, Kansas City, KS 66103 USA.
    Gergis, Usama
    Presbyterian Hosp, Hematolg Malignancies & Bone Marrow Transplant, Dept Med Oncol, Weill Cornell Med Ctr, New York, NY USA.
    Gomez Almaguer, David
    Hosp Univ Autonoma Nuevo Leon, Monterrey, Mexico.
    Gupta, Ashish
    Univ Hosp Cleveland, Seidman Canc Ctr, Med Ctr, Cleveland, OH 44106 USA.
    Hale, Gregory
    Johns Hopkins All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL USA.
    Hashmi, Shahrukh K.
    Mayo Clin, Dept Internal Med, Rochester, MN USA;King Faisal Specialist Hosp & Res Ctr, Oncol Ctr, Riyadh, Saudi Arabia.
    Inamoto, Yoshihiro
    Natl Canc Ctr, Div Hematopoiet Stem Cell Transplantat, Tokyo, Japan.
    Kamble, Rammurti T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA.
    Adekola, Kehinde
    Northwestern Univ, Div Hematol Oncol, Dept Med, Chicago, IL 60611 USA;Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, Feinberg Sch Med, Chicago, IL 60611 USA.
    Kindwall-Keller, Tamila
    Univ Virginia Hlth Syst, Div Hematol Oncol, Charlottesville, VA USA.
    Knight, Jennifer
    Med Coll Wisconsin, Dept Psychol, Milwaukee, WI 53226 USA.
    Kumar, Lalit
    All India Inst Med Sci, Inst Rotary Canc Hosp, Dept Med Oncol, New Delhi, India.
    Kuwatsuka, Yachiyo
    Nagoya Univ, Ctr Adv Med & Clin Res, Grad Sch Med, Nagoya, Aichi, Japan.
    Law, Jason
    Floating Hosp Children, Tufts Med Ctr, Dept Pediat, Boston, MA USA.
    Lazarus, Hillard M.
    Univ Hosp Cleveland, Seidman Canc Ctr, Med Ctr, Cleveland, OH 44106 USA.
    LeMaistre, Charles
    Sarah Cannon, Hematol & Bone Marrow Transplant, Nashville, TN USA.
    Olsson, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.
    Pulsipher, Michael A.
    Univ Southern Calif, Childrens Hosp Los Angeles, Div Hematol & Blood & Marrow Transplantat, Keck Sch Med, Los Angeles, CA USA.
    Savani, Bipin N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA.
    Schultz, Kirk R.
    Univ British Columbia, British Columbias Childrens Hosp, Dept Pediat Hematol Oncol & Bone Marrow Transplan, Vancouver, BC, Canada.
    Saad, Ayman A.
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA.
    Seftel, Matthew
    CancerCare Manitoba, Dept Med Oncol & Hematol, Winnipeg, MB, Canada.
    Seo, Sachiko
    Natl Canc Res Ctr East, Dept Hematol & Oncol, Chiba, Japan.
    Shea, Thomas C.
    Univ N Carolina, Div Hematol Oncol, Dept Med, Chapel Hill, NC 27515 USA.
    Steinberg, Amir
    Mt Sinai Hosp, Dept Hematol Oncol, New York, NY 10029 USA.
    Sullivan, Keith
    Duke Univ, Med Ctr, Durham, NC USA.
    Szwajcer, David
    CancerCare Manitoba, Dept Med Oncol & Hematol, Winnipeg, MB, Canada.
    Wirk, Baldeep
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA.
    Yared, Jean
    Univ Maryland, Dept Med, Greenebaum Canc Ctr, Blood & Marrow Transplantat Program,Div Hematol O, Baltimore, MD 21201 USA.
    Yong, Agnes
    Univ Adelaide, Royal Adelaide Hosp, SA Pathol, Adelaide, SA, Australia;Univ Adelaide, Sch Med, Adelaide, SA, Australia.
    Dalal, Jignesh
    Univ Hosp Cleveland, Seidman Canc Ctr, Med Ctr, Cleveland, OH 44106 USA.
    Hahn, Theresa
    Roswell Pk Canc Inst, Dept Med, Buffalo, NY 14263 USA.
    Khera, Nandita
    Mayo Clin, Dept Hematol Oncol, Phoenix, AZ USA.
    Bonfim, Carmem
    Hosp Clin Fed Univ Parana, Curitiba, Parana, Brazil.
    Atsuta, Yoshiko
    Nagoya Univ, Ctr Adv Med & Clin Res, Grad Sch Med, Nagoya, Aichi, Japan.
    Saber, Wael
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
    Country-Level Macroeconomic Indicators Predict Early Post-Allogeneic Hematopoietic Cell Transplantation Survival in Acute Lymphoblastic Leukemia: A CIBMTR Analysis2018In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 24, no 9, p. 1928-1935Article in journal (Refereed)
    Abstract [en]

    For patients with acute lymphoblastic leukemia (ALL), allogeneic hematopoietic cell transplantation (alloHCT) offers a potential cure. Life-threatening complications can arise from alloHCT that require the application of sophisticated health care delivery. The impact of country-level economic conditions on post-transplantation outcomes is not known. Our objective was to assess whether these variables were associated with outcomes for patients transplanted for ALL. Using data from the Center for Blood and Marrow Transplant Research, we included 11,261 patients who received a first alloHCT for ALL from 303 centers across 38 countries between the years of 2005 and 2013. Cox regression models were constructed using the following macroeconomic indicators as main effects: Gross national income per capita, health expenditure per capita, and Human Development Index (HDI). The outcome was overall survival at 100 days following transplantation. In each model, transplants performed within lower resourced environments were associated with inferior overall survival. In the model with the HDI as the main effect, transplants performed in the lowest HDI quartile (n = 697) were associated with increased hazard for mortality (hazard ratio, 2.42; 95% confidence interval, 1.64 to 3.57; P < .001) in comparison with transplants performed in the countries with the highest HDI quartile. This translated into an 11% survival difference at 100 days (77% for lowest HDI quartile versus 88% for all other quartiles). Country-level macroeconomic indices were associated with lower survival at 100 days after alloHCT for ALL. The reasons for this disparity require further investigation.

  • 44.
    Worel, Nina
    et al.
    Med Univ Vienna, Dept Blood Grp Serol & Transfus Med, A-1090 Vienna, Austria..
    Buser, Andreas
    Swiss Red Cross, Ctr Blood Transfus, Basel, Switzerland.;Univ Basel Hosp, Dept Hematol, CH-4031 Basel, Switzerland..
    Greinix, Hildegard T.
    Med Univ Graz, Div Hematol, Graz, Austria..
    Hagglund, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Navarro, Willis
    Natl Marrow Donor Program, Minneapolis, MN USA..
    Pulsipher, Michael A.
    Univ Utah, Div Hematol & Hematol Malignancies, Huntsman Canc Inst, Primary Childrens Hosp, Salt Lake City, UT USA..
    de Faveri, Grazia Nicoloso
    Swiss Blood Stem Cell, Bern, Switzerland..
    Bengtsson, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology. Swedish Bone Marrow Donors, Tobias Registry, Uppsala, Sweden..
    Billen, Annelies
    UCL Canc Inst, London, England..
    Espino, German
    Univ Hosp Caja del Seguro Social, Hematol & Bone Marrow Transplantat Sect, Dept Internal Med, Panama City, Panama..
    Fechter, Mirjam
    Leiden Univ, Med Ctr, Europdonor Fdn Leiden, Leiden, Netherlands..
    Giudice, Valeria
    S Orsola Malpighi Univ Hosp, Dept Immunohematol & Transfus Med, Bologna, Italy..
    Hoelig, Kristina
    Tech Univ Dresden, Univ Hosp Carl Gustav Cams, Dept Internal Med 1, D-01062 Dresden, Germany..
    Kanamori, Heiwa
    Kanagawa Canc Ctr, Dept Hematol, Yokohama, Kanagawa, Japan..
    Kodera, Yoshihisa
    Aichi Med Univ, Asia Pacific Blood & Marrow Transplantat Grp, Sch Med, Nagakute, Aichi 48011, Japan.;Aichi Med Univ, Dept Promot Blood & Marrow Transplantat, Sch Med, Nagakute, Aichi 48011, Japan..
    Leitner, Gerda
    Med Univ Vienna, Dept Blood Grp Serol & Transfus Med, A-1090 Vienna, Austria..
    Netelenbos, Tanja
    Leiden Univ, Dept Immunohematol & Blood Transfus, Med Ctr, Leiden, Netherlands..
    Niedervvieser, Dietger
    Univ Hosp Leipzig, Dept Hematol, Leipzig, Germany..
    van Walraven, Suzanna M.
    Leiden Univ, Med Ctr, Europdonor Fdn Leiden, Leiden, Netherlands.;World Marrow Donor Assoc, Eth Working Grp, Leiden, Netherlands.;Oxford Univ Hosp NHS Trust, British Bone Marrow Donor Registry, Oxford, England..
    Rocha, Vanderson
    NHS BT, Cord Blood Banks, Oxford, England..
    Torosian, Tigran
    Fdn DKMS Polska, Warsaw, Poland..
    Vergueiro, Carmen
    FCM Santa Casa de Selo Paulo, Disciplina Hematol & Oncol, Sao Paulo, Brazil..
    Weisdorf, Daniel
    Univ Minnesota, Bone Marrow Transplant Program, Minneapolis, MN 55455 USA..
    Yabe, Hiromasa
    Tokai Univ, Sch Med, Dept Cell Transplantat & Regenerat Med, Tokyo 151, Japan..
    Halter, Joerg P.
    Univ Basel Hosp, Dept Hematol, CH-4031 Basel, Switzerland..
    Suitability Criteria for Adult Related Donors: A Consensus Statement from the Worldwide Network for Blood and Marrow Transplantation Standing Committee on Donor Issues2015In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 21, no 12, p. 2052-2060Article in journal (Refereed)
    Abstract [en]

    The number of allogeneic hematopoietic stem cell (HSC) transplants performed globally each year continues to increase. Advances in HLA typing, better supportive care, and administration of reduced-intensity conditioning regimens allow treatment of older patients with older sibling donors. Pretransplant donor assessment and testing are very important processes affecting the quality and safety of donation. For unrelated HSC donors detailed recommendations for health assessment have been published, allowing donation only if they are unrestrictedly healthy. Eligibility criteria for related donors are less strict and vary significantly between centers. In situations where a family donor does not meet the suitability criteria for unrelated donors, involved physicians often struggle with the decision whether the matched relative is suitable for donation or not. On behalf of the Worldwide Network for Blood and Marrow Transplantation Standing Committee on Donor Issues, we intended to develop a consensus document with recommendations for donor workup and final clearance of family donors who would not be able to serve as unrelated donors because of their age or pre-existing diseases. This article covers different topics intending to support decision-making, with the goal of minimizing medical risk to the donor and protection of the recipient from transmissible diseases.

  • 45. Worel, Nina
    et al.
    Buser, Andreas
    Greinix, Hildegard T
    Hägglund, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Navarro, Willis
    Pulsipher, Michael A
    Nicoloso de Faveri, Grazia
    Bengtsson, Mats
    Billen, Annelies
    Espino, German
    Fechter, Mirjam
    Giudice, Valeria
    Hölig, Kristina
    Kanamori, Heiwa
    Kodera, Yoshihisa
    Leitner, Gerda
    Netelenbos, Tanja
    Niederwieser, Dietger
    van Walraven, Suzanna M
    Rocha, Vanderson
    Torosian, Tigran
    Vergueiro, Carmen
    Weisdorf, Daniel
    Yabe, Hiromasa
    Halter, Jörg P
    Suitability Criteria for Adult Related Donors: A Consensus Statement from the Worldwide Network for Blood and Marrow Transplantation Standing Committee on Donor Issues.2015In: Biology of blood and marrow transplantation, ISSN 1083-8791, E-ISSN 1523-6536, Vol. 21, no 12Article in journal (Refereed)
    Abstract [en]

    The number of allogeneic hematopoietic stem cell (HSC) transplants performed globally each year continues to increase. Advances in HLA typing, better supportive care, and administration of reduced-intensity conditioning regimens allow treatment of older patients with older sibling donors. Pretransplant donor assessment and testing are very important processes affecting the quality and safety of donation. For unrelated HSC donors detailed recommendations for health assessment have been published, allowing donation only if they are unrestrictedly healthy. Eligibility criteria for related donors are less strict and vary significantly between centers. In situations where a family donor does not meet the suitability criteria for unrelated donors, involved physicians often struggle with the decision whether the matched relative is suitable for donation or not. On behalf of the Worldwide Network for Blood and Marrow Transplantation Standing Committee on Donor Issues, we intended to develop a consensus document with recommendations for donor workup and final clearance of family donors who would not be able to serve as unrelated donors because of their age or pre-existing diseases. This article covers different topics intending to support decision-making, with the goal of minimizing medical risk to the donor and protection of the recipient from transmissible diseases.

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