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Source: Seminars in Hematology - March 31, 2016 Category: Hematology Source Type: research
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Source: Seminars in Hematology - March 20, 2016 Category: Hematology Source Type: research
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Source: Seminars in Hematology - March 20, 2016 Category: Hematology Source Type: research
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(Source: Seminars in Hematology)
Source: Seminars in Hematology - March 20, 2016 Category: Hematology Source Type: research
Autologous Stem Cell Transplantation Versus Alternative Allogeneic Donor Transplants in Adult Acute Leukemias
The availability of alternative sources of stem cells including most recently T replete haploidentical marrow or peripheral blood, and the increasing use of reduced intensity conditioning renders feasible an allogeneic transplant to almost all patients with acute leukemia up to 70 years of age. Autologous stem cell transplantation for consolidation of complete remission, however, offers in some circumstances an alternative option. Although associated with a higher relapse rate, autologous transplant benefits from a lower non relapse mortality, the absence of graft versus host disease and a better quality of life for long t...
Source: Seminars in Hematology - January 19, 2016 Category: Hematology Authors: Norbert Claude Gorin Source Type: research
Introduction: Why alternative donor transplantation and what are the different options and current challenges?
When considering allogeneic hematopoietic stem cell transplantation (allo-SCT) for a patient with a hematologic malignancy, the standard approach involves searching for a human leukocyte antigen (HLA)-matched related donor (MRD) or a matched unrelated donor (MUD). However, on the basis of average family size, less than 30% of patients will have an HLA-matched sibling donor [1,2]. The use of HLA-matched unrelated donors widened the donor pool, but matched unrelated donors are not unavailable to many individuals, particularly those in need of rapid transplantation for advanced diseases or belonging to many minority groups. (...
Source: Seminars in Hematology - January 18, 2016 Category: Hematology Authors: Bipin N. Savani, Mohamad Mohty Tags: Alternative Donor Transplantation Source Type: research
Haploidentical Stem Cell Transplantation: Anti-thymocyte Globulin-Based Experience
Haploidentical stem cell transplantation (haplo-SCT) with an anti-thymocyte globulin (ATG) preparative regimen is associated with induced immune tolerance, rapid hematopoietic recovery, effective prevention of graft-versus-host disease (GVHD), and lower NRM. This has become a common and successfully applied protocol in patients with hematological diseases undergoing haplo-SCT. Survival rates among patients who undergo unmanipulated haploidentical blood and marrow transplantation (HBMT) with ATG-based regimens are comparable to those following human leukocyte antigen-matched sibling transplantation or unrelated donor transp...
Source: Seminars in Hematology - January 18, 2016 Category: Hematology Authors: Ying-Jun Chang, Xiao-Jun Huang Source Type: research
Why Alternative Donor Transplantation and What are the Different Options and Current Challenges?
When considering allogeneic hematopoietic stem cell transplantation (allo-SCT) for a patient with a hematologic malignancy, the standard approach involves searching for an HLA matched related donor (MRD) or a matched unrelated donor (MUD). However, on the basis of average family size, less than 30% of patients will have an HLA-matched sibling donor.1,2 The use of HLA-matched unrelated donors widened the donor pool, but marched unrelated donor not unavailable to many individuals, particularly those in need of rapid transplantation for advanced diseases or belonging to many minority groups. (Source: Seminars in Hematology)
Source: Seminars in Hematology - January 18, 2016 Category: Hematology Authors: Bipin N. Savani, Mohamad Mohty Source Type: research
HLA mismatching as a strategy to reduce relapse after alternative donor transplantation
Human leukocyte antigen (HLA) mismatches are targets of alloreactive T cells, mediators of graft-versus-leukemia (GvL) and graft-versus-host disease (GvHD) after alternative donor transplantation. Exploitation of HLA mismatching in order to reduce relapse is hampered by necessary interventions aimed at controlling GvHD on the one hand, and by the possibility of immune escape through selective loss of mismatched HLA in relapsing leukemia on the other. Retrospective studies reporting the impact of HLA mismatches on post-transplant relapse need to be interpreted with caution, due to many confounding factors, including disease...
Source: Seminars in Hematology - January 15, 2016 Category: Hematology Authors: Katharina Fleischhauer, Dietrich W. Beelen Source Type: research
Alternative Donor Allogeneic Hematopoietic Cell Transplantation for Hemoglobinopathies
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative therapy for patients with hemoglobinopathies. However, the applicability of HSCT has been limited mainly by donor availability, with only 25-30% of patients having human leukocyte antigen (HLA)-matched sibling donors. Previous outcomes using alternate donor options have been markedly inferior due to increased regimen related toxicity, transplant related mortality, graft failure and graft-versus-host disease (GVHD). Advances in transplant technology, including high resolution HLA typing, improved GVHD prophylactic approaches with tolerance induction, an...
Source: Seminars in Hematology - January 15, 2016 Category: Hematology Authors: Feras Alfraih, Mahmoud Aljurf, Adetola Kassim Source Type: research
Alternative Donor Transplants for Severe Aplastic Anemia: Current Experience
Patients with acquired severe aplastic anemia (SAA), who lack and HLA identical sibling donor (SIB) , have two therapeutic options: immunosuppressive therapy with anti-thymocyte globulin (ATG) and cyclosporine (CsA), or a transplant from an alternative donor. In these patients, current guidelines of the European Group for Blood and Marrow Transplantation (EBMT), call for a course of ATG+CsA first and transplantation in case of no response. The alternative donor can be an unrelated donor (UD), a cord blood Unit (CB) or a family mismatched member, in most instances genetically HLA haplo-mismatched (HAPLO). (Source: Seminars in Hematology)
Source: Seminars in Hematology - January 15, 2016 Category: Hematology Authors: Andrea Bacigalupo Source Type: research
Haploidentical Bone Marrow and Stem Cell Transplantation: Experience with Post-Transplantation Cyclophosphamide
Allogeneic blood or bone marrow transplantation (BMT) is a potentially curative therapy for high-risk hematologic malignancies not curable by standard chemotherapy, but the procedure is limited by the availability of human leukocyte antigen-matched donors for many patients, as well as toxicities including graft-versus-host disease. Our group has developed the use of high-dose post-transplantation cyclophosphamide (PTCy) to selectively remove alloreactive T cells without compromising engraftment. (Source: Seminars in Hematology)
Source: Seminars in Hematology - January 15, 2016 Category: Hematology Authors: Tara M. Robinson, Paul V. O’Donnell, Ephraim J. Fuchs, Leo Luznik Source Type: research
Alternative Donors: Cord Blood for Adults
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative treatment for patients with hematological diseases. The probability of finding a human leucocyte antigen (HLA) identical donor among family members is around 25% and 30% that of having a full matched unrelated donor in the registry. Patients in need may also benefit of a HLA mismatched HSCT either from an haploidentical donors or from umbilical cord blood (UCB). Much has been learned about UCBT since the first human cord blood transplant (UCBT) was performed back in 1988. (Source: Seminars in Hematology)
Source: Seminars in Hematology - January 15, 2016 Category: Hematology Authors: Annalisa Ruggeri Source Type: research
Cord Blood Versus Haploidentical Stem Cell Transplantation for Hematological Malignancies
Umbilical cord blood and haploidentical donor stem cell sources represent common alternative donor strategies utilized when a matched sibling or unrelated donor are not available for hematopoietic stem cell transplantation. Both donor sources require less stringent HLA matching and thereby increase the donor pool for patients without a complete HLA matched donor. Although a randomized trial comparing these donor sources is ongoing, currently available comparisons rely on observational data and small phase II trials. (Source: Seminars in Hematology)
Source: Seminars in Hematology - January 15, 2016 Category: Hematology Authors: Natasha Kekre, Joseph H. Antin Source Type: research
Mismatched Unrelated Alternative Donors for Hematological Malignancies
For the majority of hematologic malignancies allogeneic hematopoietic cell transplantation (HCT) is the only curative treatment option. Sibling donors have been the standard for adult patients. Since there is not a suitable family donor for all patients, the need for alternative donors for HCT is great. Fortunately the availability of unrelated volunteer donor registries have expanded over the years and the results of HCT with matched unrelated donors (MUD) are comparable to the results with matched related donors (MRD). (Source: Seminars in Hematology)
Source: Seminars in Hematology - January 15, 2016 Category: Hematology Authors: Henning Sebastian Schäfer, Jürgen Finke Source Type: research
