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Oral Chronic Graft-versus-Host Disease and Oral Health after Allogeneic Hematopoietic Cell Transplantation - What the Care Team Needs to Know. 同种异体造血细胞移植后的口腔慢性移植物抗宿主疾病和口腔健康--护理团队须知。
IF 3.6 3区 医学
Transplantation and Cellular Therapy Pub Date : 2024-09-01 DOI: 10.1016/j.jtct.2024.07.006
Alexa M G A Laheij, Eduardo Rodrigues Fregnani, Leandro Dorigan de Macedo, Nathaniel S Treister
{"title":"Oral Chronic Graft-versus-Host Disease and Oral Health after Allogeneic Hematopoietic Cell Transplantation - What the Care Team Needs to Know.","authors":"Alexa M G A Laheij, Eduardo Rodrigues Fregnani, Leandro Dorigan de Macedo, Nathaniel S Treister","doi":"10.1016/j.jtct.2024.07.006","DOIUrl":"https://doi.org/10.1016/j.jtct.2024.07.006","url":null,"abstract":"<p><p>Oral chronic graft-versus-host disease (cGVHD) can present with a multitude of clinical signs and is associated with morbidity and lower quality of life. Oral cGVHC may affect the oral mucosa (reticular white striae, erythema, and/or ulcerations), the salivary glands (hyposalivation and/or xerostomia) and the peri-oral soft tissues (fibrosis and trismus). This review provides a practical and concise approach to the diagnosis and management of oral health needs in pediatric and adult alloHCT recipients within the first 2 years post-transplantation.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Infectious Disease Considerations in Chronic Graft-versus-Host Disease and Transplantation Survivors. 慢性移植物抗宿主病和移植幸存者的传染病注意事项。
IF 3.6 3区 医学
Transplantation and Cellular Therapy Pub Date : 2024-09-01 DOI: 10.1016/j.jtct.2024.05.019
David J Epstein, Salman Otoukesh, Zainab Shahid, Sanjeet S Dadwal
{"title":"Infectious Disease Considerations in Chronic Graft-versus-Host Disease and Transplantation Survivors.","authors":"David J Epstein, Salman Otoukesh, Zainab Shahid, Sanjeet S Dadwal","doi":"10.1016/j.jtct.2024.05.019","DOIUrl":"https://doi.org/10.1016/j.jtct.2024.05.019","url":null,"abstract":"<p><p>Chronic graft-versus-host disease is a frequent and serious complication of allogeneic hematopoietic cell transplantation and is associated with an increased risk of serious infections. Impaired humoral immunity increases the risk of recurrent or severe sinopulmonary infections, and functional asplenia predisposes to infections from encapsulated organisms. Herpesvirus infections and community-acquired respiratory viral infections are problematic as well. Pneumocystis pneumonia remains a risk, and mold infections occur in some patients. Understanding the epidemiology and pathophysiology of these infections is important for determining optimal monitoring and prophylaxis, and guiding patient counseling.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Biobehavioral Perspective on Caring for Allogeneic Hematopoietic Stem Cell Transplant Survivors with Graft-Versus-Host Disease. 从生物行为学角度看如何照顾患有移植物抗宿主病的异体造血干细胞移植幸存者。
IF 3.6 3区 医学
Transplantation and Cellular Therapy Pub Date : 2024-09-01 DOI: 10.1016/j.jtct.2024.05.024
Sheila Lahijani, Maria Rueda-Lara, Natalie McAndrew, Ashley M Nelson, Michelle Guo, Jennifer M Knight, Lori Wiener, Damien M Miran, Tamryn F Gray, Emma P Keane, Ming Hwei Yek, Timothy S Sannes, Allison J Applebaum, Patricia Fank, Pallavi Babu, Cristina Pozo-Kaderman, Hermioni L Amonoo
{"title":"A Biobehavioral Perspective on Caring for Allogeneic Hematopoietic Stem Cell Transplant Survivors with Graft-Versus-Host Disease.","authors":"Sheila Lahijani, Maria Rueda-Lara, Natalie McAndrew, Ashley M Nelson, Michelle Guo, Jennifer M Knight, Lori Wiener, Damien M Miran, Tamryn F Gray, Emma P Keane, Ming Hwei Yek, Timothy S Sannes, Allison J Applebaum, Patricia Fank, Pallavi Babu, Cristina Pozo-Kaderman, Hermioni L Amonoo","doi":"10.1016/j.jtct.2024.05.024","DOIUrl":"https://doi.org/10.1016/j.jtct.2024.05.024","url":null,"abstract":"<p><p>Among the potential complications of allogeneic hematopoietic stem cell transplantation (HSCT), graft-versus-host disease (GVHD) is common and associated with significant physical and psychosocial symptom burden. Despite substantial advances in GVHD treatment, the global immune suppression that frequently accompanies GVHD treatment also contributes to high rates of physical and emotional suffering and mortality. The complex manifestations of GVHD and its treatment warrant a multidisciplinary team-based approach to managing patients' multi-organ system comorbidities. A biobehavioral framework can enhance our understanding of the complex association between medications, physical symptoms, and psychosocial distress in patients with GVHD. Hence, for this perspective, we highlight the importance of addressing both the physical and psychosocial needs experienced by patients with GVHD and provide guidance on how to approach and manage those symptoms and concerns as part of comprehensive cancer care.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CAST Regimen for GvHD Prophylaxis: A CIBMTR Propensity Score-Matched Analysis. 用于 GvHD 预防的 CAST 方案:CIBMTR 倾向评分匹配分析。
IF 3.6 3区 医学
Transplantation and Cellular Therapy Pub Date : 2024-08-30 DOI: 10.1016/j.jtct.2024.08.015
A Samer Al-Homsi, Todd E DeFor, Kelli Cole, Frank Cirrone, Stephanie King, Andres Suarez-Londono, George Yaghmour, Stephanie Boisclair, Caitrin Bupp, Stephen R Spellman
{"title":"CAST Regimen for GvHD Prophylaxis: A CIBMTR Propensity Score-Matched Analysis.","authors":"A Samer Al-Homsi, Todd E DeFor, Kelli Cole, Frank Cirrone, Stephanie King, Andres Suarez-Londono, George Yaghmour, Stephanie Boisclair, Caitrin Bupp, Stephen R Spellman","doi":"10.1016/j.jtct.2024.08.015","DOIUrl":"10.1016/j.jtct.2024.08.015","url":null,"abstract":"<p><p>Previously, we reported excellent results with the combination of post-transplant cyclophosphamide (PTCy), abatacept, and a short course of tacrolimus (CAST) for the prevention of graft-versus-host disease (GvHD) following peripheral blood haploidentical transplantation. To further substantiate these results, we performed a propensity score-matched analysis. Patients enrolled in the CAST trial were matched with patients from a contemporaneous cohort from the Center for International Blood and Marrow Transplant Research database who received PTCy, tacrolimus, and mycophenolate mofetil, using nearest neighbor propensity score matching. An excellent balance between pairs was achieved as measured by the density distribution and standardized differences of covariates (median 0.09). The rates of acute GvHD grades II to IV at day +120 and 1-year GvHD- and relapse-free survival were 16.7% and 66.7% in the CAST cohort versus 28.6% and 47.6% in the control group, respectively. This trend did not reach statistical significance (P = .14 and .07), possibly due to the small numbers of patients and events. On the other hand, CAST was associated with a statistically significant reduction in the incidence of relapse (9.5% versus 26.2%, P = .045) with improved disease-free survival (85.7% versus 61.9%, P = .01). Our data provides a strong impetus to examine CAST in a randomized clinical trial.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Metagenomic Next-Generation Sequencing in the Diagnosis of Pulmonary Infections after Allogeneic Hematopoietic Stem Cell Transplantation. 元基因组下一代测序在异体造血干细胞移植后肺部感染诊断中的应用》(Metagenomic Next-generation Sequencing in the Diagnosis of Pulmonary Infections After Allogeneic Hematopoietic Stem Cell Transplantation)。
IF 3.6 3区 医学
Transplantation and Cellular Therapy Pub Date : 2024-08-27 DOI: 10.1016/j.jtct.2024.08.014
Rong Fu, Jun Xu, Zhiping Fan, Hong Qu, Yirong Jiang, Wenjie Xiong, Fen Huang, Li Xuan, Na Xu, Hui Liu, Zhixiang Wang, Jing Sun, Qifa Liu, Ren Lin
{"title":"Metagenomic Next-Generation Sequencing in the Diagnosis of Pulmonary Infections after Allogeneic Hematopoietic Stem Cell Transplantation.","authors":"Rong Fu, Jun Xu, Zhiping Fan, Hong Qu, Yirong Jiang, Wenjie Xiong, Fen Huang, Li Xuan, Na Xu, Hui Liu, Zhixiang Wang, Jing Sun, Qifa Liu, Ren Lin","doi":"10.1016/j.jtct.2024.08.014","DOIUrl":"10.1016/j.jtct.2024.08.014","url":null,"abstract":"<p><p>Early and accurate identification of pathogens in pulmonary infections after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is critically important. The clinical usefulness of metagenomic next-generation sequencing (mNGS) in the diagnosis of pulmonary infections after allo-HSCT remains under discussion. This multicenter retrospective study was conducted to compare mNGS and conventional microbiological tests (CMTs) in identifying the pathogens of pulmonary infections in allo-HSCT recipients. One hundred forty allo-HSCT recipients with suspected pulmonary infections who underwent bronchoscopy were included. mNGS and CMTs performed on bronchoalveolar lavage fluid specimens showed 71.4% positivity on mNGS compared to 55.0% positivity on CMTs. mNGS identified 182 pathogens, including bacteria (n = 88), fungi (n = 35) and viruses (n = 59), compared to 106 pathogens detected by CMTs (bacteria, n = 31; fungi, n = 24; viruses, n = 51). Pulmonary infection was finally diagnosed in 98 patients, including 22 bacterial, 7 fungal, 18 viral, and 48 mixed infections and 3 infections with an unknown pathogen. Mixed infections were identified in 50.5% of the patients with pulmonary infection. The sensitivity of mNGS and CMTs for diagnosing pulmonary infections was 88.8% and 69.4%, respectively (P = .001), and the specificity were 81.0% and 85.7%, respectively (P = .688). Our findings suggest that mNGS may be a promising technology for diagnosing pulmonary infections in allo-HSCT recipients.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of a Modified Post-Transplant Cyclophosphamide Regimen for Unrelated Donor Hematopoietic Stem Cell Transplantation in Patients with Severe Aplastic Anemia: A Prospective Study. 重型再生障碍性贫血患者移植后改良环磷酰胺治疗方案的疗效:前瞻性研究。
IF 3.6 3区 医学
Transplantation and Cellular Therapy Pub Date : 2024-08-24 DOI: 10.1016/j.jtct.2024.08.016
Xiaowei Chen, Cunte Chen, Ming Zhou, Yuling Zhang, Caixia Wang, Yumiao Li, Ruiqing Zhou, Shilin Xu, Wei Zhou, Tingfen Deng, Shiyi Pan, Liangliang Wu, Yuping Zhang, Wenjian Mo, Shunqing Wang
{"title":"Efficacy of a Modified Post-Transplant Cyclophosphamide Regimen for Unrelated Donor Hematopoietic Stem Cell Transplantation in Patients with Severe Aplastic Anemia: A Prospective Study.","authors":"Xiaowei Chen, Cunte Chen, Ming Zhou, Yuling Zhang, Caixia Wang, Yumiao Li, Ruiqing Zhou, Shilin Xu, Wei Zhou, Tingfen Deng, Shiyi Pan, Liangliang Wu, Yuping Zhang, Wenjian Mo, Shunqing Wang","doi":"10.1016/j.jtct.2024.08.016","DOIUrl":"10.1016/j.jtct.2024.08.016","url":null,"abstract":"<p><p>The aim of the present study was to examine the efficacy of the modified post-transplant cyclophosphamide (PTCy) regimen, which involved reducing the Cy dose to 40 mg on days +3 and +4 in patients with severe aplastic anemia (SAA) subjected to unrelated donor allogeneic hematopoietic stem cell transplantation (URD-HSCT). For this purpose, a prospective single-center trial was conducted and the clinical outcomes were collected from 30 patients with SAA treated with the modified PTCy regimen for URD-HSCT. The median time to neutrophil and platelet engraftment was 13 days (range, 11 to 16) and 12 days (range, 5 to 33), respectively. The cumulative incidence of neutrophil and platelet engraftment was 93.1% ± 0.3% and 96.6% ± 0.2%, respectively. The 2-year overall survival (OS) was 97% (95% confidence interval [CI]: 90%-100%] and 2-year graft-versus-host disease (GVHD) and rejection-free survival (GRFS) was 93% (95% CI: 85%-100%). The incidence rates of acute GVHD (aGVHD) and chronic GVHD (cGVHD) were 13.8 ± 0.4% and 10.3 ± 0.3%, respectively, and no patients developed grades III-IV aGVHD. However, only one patient developed a moderate extensive cGVHD. The incidence of reconstitution varies among different subsets of immune cells after URD-HSCT. Natural killer (NK) cells recover first, followed by CD8<sup>+</sup> T and CD19<sup>+</sup> B cells, and finally CD4<sup>+</sup> T cells. In conclusion, the present study demonstrates that the modified PTCy regimen, with a reduced dose of 40 mg on days +3 and +4, may be an effective regimen for URD-HSCT in patients with SAA and reduce the occurrence of the GVHD.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tocilizumab Prophylaxis Following Axicabtagene Ciloleucel in Relapsed or Refractory Large B-Cell Lymphoma. Axicabtagene Ciloleucel 治疗复发性或难治性大 B 细胞淋巴瘤后的托珠单抗预防疗法
IF 3.6 3区 医学
Transplantation and Cellular Therapy Pub Date : 2024-08-24 DOI: 10.1016/j.jtct.2024.08.018
Frederick L Locke, Sattva S Neelapu, Nancy L Bartlett, Lazaros J Lekakis, Caron A Jacobson, Ira Braunschweig, Olalekan O Oluwole, Tanya Siddiqi, Yi Lin, John M Timmerman, Marie José Kersten, Yan Zheng, Teresa Zhang, Jenny Nater, Rhine Shen, Harry Miao, Jenny J Kim, David B Miklos
{"title":"Tocilizumab Prophylaxis Following Axicabtagene Ciloleucel in Relapsed or Refractory Large B-Cell Lymphoma.","authors":"Frederick L Locke, Sattva S Neelapu, Nancy L Bartlett, Lazaros J Lekakis, Caron A Jacobson, Ira Braunschweig, Olalekan O Oluwole, Tanya Siddiqi, Yi Lin, John M Timmerman, Marie José Kersten, Yan Zheng, Teresa Zhang, Jenny Nater, Rhine Shen, Harry Miao, Jenny J Kim, David B Miklos","doi":"10.1016/j.jtct.2024.08.018","DOIUrl":"10.1016/j.jtct.2024.08.018","url":null,"abstract":"<p><p>Axicabtagene ciloleucel (axi-cel) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved in patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL). Most patients treated with axi-cel experience cytokine release syndrome (CRS) and/or adverse neurologic events (NEs). To explore potential approaches for reducing CAR T-cell-related toxicities with axi-cel, several safety expansion cohorts were added to the pivotal ZUMA-1 trial. ZUMA-1 Cohort 3 was an exploratory safety cohort that investigated the use of the IL-6 receptor blocking antibody tocilizumab and anticonvulsant levetiracetam as prophylaxis against CRS and NEs in patients treated with axi-cel. Patients with R/R LBCL were enrolled in Cohort 3 and received conditioning chemotherapy on d- 5 through -3 followed by a single infusion of axi-cel (2 × 10<sup>6</sup> cells/kg) on d 0. Prophylactic tocilizumab (8 mg/kg) was administered 48 h after axi-cel infusion. Primary endpoints were incidence and severity of CRS and NEs. Key secondary endpoints included the incidence of adverse events, objective response rate (ORR), duration of response, progression-free survival, overall survival (OS), and biomarker analyses (eg, circulating CAR T cells, cytokines, chemokines). Forty-two patients were enrolled in Cohort 3, 38 of whom received axi-cel. In the 24-month analysis, any-grade CRS and NEs occurred in 92% and 87% of patients, and Grade ≥3 CRS and NEs occurred in 3% and 42% of patients, respectively. One Grade 5 NE (cerebral edema) occurred. With 24-mo minimum follow-up, the ORR was 63%, and 39.5% of patients had ongoing response. With 48-month follow-up, median OS was 34.8 mo (95% CI, 5.4-not estimable). CAR T-cell expansion in ZUMA-1 Cohort 3 was comparable with pivotal Cohorts 1 and 2. Consistent with tocilizumab-mediated inhibition of IL-6R, serum IL-6 levels were increased relative to Cohorts 1 and 2. Grade ≥3 NEs were associated with elevated IL-6 levels, proinflammatory cytokines, and myeloid cells in the cerebrospinal fluid. Based on these findings, prophylactic tocilizumab is not recommended to prevent CAR T-cell-related adverse events, and beneficial effects of prophylactic levetiracetam remain uncertain in patients with R/R LBCL.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hypomethylating Agents are Effective in Treatment for Relapsed Myelofibrosis After Allogeneic Hematopoietic Cell Transplantation. 低甲基化药物可有效治疗异基因造血细胞移植后复发的骨髓纤维化。
IF 3.6 3区 医学
Transplantation and Cellular Therapy Pub Date : 2024-08-24 DOI: 10.1016/j.jtct.2024.08.013
Dat Ngo, Jose Tinajero, Abdullah Ladha, Monzr M Al Malki, Salman Otoukesh, Idoroenyi Amanam, Haris Ali
{"title":"Hypomethylating Agents are Effective in Treatment for Relapsed Myelofibrosis After Allogeneic Hematopoietic Cell Transplantation.","authors":"Dat Ngo, Jose Tinajero, Abdullah Ladha, Monzr M Al Malki, Salman Otoukesh, Idoroenyi Amanam, Haris Ali","doi":"10.1016/j.jtct.2024.08.013","DOIUrl":"10.1016/j.jtct.2024.08.013","url":null,"abstract":"<p><p>Myelofibrosis (MF) is a myeloproliferative neoplasm with a relapse rate of 10% to 30% after allogeneic transplantation (alloHCT). Current recommendations to treat relapse include withdrawal of immunosuppression, donor lymphocyte infusion, and potentially a second alloHCT. Hypomethylating agents (HMAs) have shown efficacy as salvage therapy by inducing an immune response and improving donor chimerism for myeloid neoplasm post-HCT. Data is limited on use of HMAs for MF post-alloHCT relapse. To determine the benefit of using HMAs for MF patients relapsing after alloHCT, we retrospectively analyzed 12 patients with MF post-alloHCT relapse who received HMA to determine response via restoration of donor chimerism and clearance of molecular mutation. The median age was 61 years (range 41-72) with 92% classified as intermediate-2/high-risk by the Dynamic International Prognostic Scoring System (DIPSS) and 83% as high/very high risk by the MIPSS70+ (Molecular International Prognostic Scoring System). The median time to relapse post-alloHCT was 282.5 days (range 96-2388) with median donor chimerism 57.82% (range 2.48-84.0) prior to starting an HMA. After two cycles of HMA, 58% experienced restoration of donor chimerism. Molecular clearance of pre-HCT driver mutations occurred in 50% of patients at the most recent follow-up. New chronic graft-vs.-host disease (cGVHD) occurred in 50% of patients, with most being mild to moderate that resolved after treatment. HMA was safe and effective in a high-risk population after post-alloHCT relapse and is an option for patients in the future.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Design and Development of a Multimodal Digital Intervention (SHIFT App) to Address Sexual Dysfunction in Hematopoietic Stem Cell Transplant (HSCT) Survivors. 设计和开发多模式数字干预(SHIFT App),解决造血干细胞移植(HSCT)幸存者的性功能障碍问题。
IF 3.6 3区 医学
Transplantation and Cellular Therapy Pub Date : 2024-08-23 DOI: 10.1016/j.jtct.2024.08.012
Richard Newcomb, Lara Traeger, Bailey Jones, Mathew Reynolds, Alexandra Tse, Jennifer B Reese, Don Dizon, Sharon L Bober, Joseph A Greer, Julie Vanderklish, Nicole Pensak, Zachariah DeFilipp, Yi-Bin Chen, Jennifer S Temel, Areej El-Jawahri
{"title":"Design and Development of a Multimodal Digital Intervention (SHIFT App) to Address Sexual Dysfunction in Hematopoietic Stem Cell Transplant (HSCT) Survivors.","authors":"Richard Newcomb, Lara Traeger, Bailey Jones, Mathew Reynolds, Alexandra Tse, Jennifer B Reese, Don Dizon, Sharon L Bober, Joseph A Greer, Julie Vanderklish, Nicole Pensak, Zachariah DeFilipp, Yi-Bin Chen, Jennifer S Temel, Areej El-Jawahri","doi":"10.1016/j.jtct.2024.08.012","DOIUrl":"10.1016/j.jtct.2024.08.012","url":null,"abstract":"<p><p>Hematopoietic stem cell transplant (HSCT) survivors frequently experience persistent sexual dysfunction, which is associated with impaired quality of life and increased psychological distress. The lack of availability of clinicians with expertise in sexual health limits the capacity to address sexual health concerns in HSCT survivors. Digital health applications may offer a patient-centered and scalable solution to address sexual health concerns in cancer survivors. The objective of this report is to delineate the iterative process of adapting an in-person sexual health intervention into a self-administered digital application called \"Sexual Health and Intimacy Following Transplant (SHIFT)\" and the refinement of SHIFT using stakeholder feedback. We used a five-step development model to adapt SHIFT that included: (1) implementation of a multimodal bio-psycho-social conceptual framework, (2) development of a comprehensive intervention manual and SHIFT content, (3) translation of the intervention manual into an interactive storyline with a focus on enhancing patient engagement, (4) creation of initial SHIFT wireframes, and (5) refinement of SHIFT through iterative alpha and beta testing. At each step, key stakeholders including HSCT survivors, HSCT clinicians, and experts in sexual health, psychology, and digital health provided iterative feedback. We adapted SHIFT based on our conceptual framework, prior in-person intervention work, and iterative stakeholder feedback in each application development stage. SHIFT incorporates medical information, educational materials, intimacy exercises, and activities to address the multiple etiologies of sexual health concerns in HSCT survivors. SHIFT includes strategies to enhance engagement including gamification, personalization, and incorporation of video from HSCT survivors and clinicians. Based on stakeholder feedback, SHIFT was refined with a focus on inclusivity of gender, sexual orientation, relationship status, and body image concerns. SHIFT is novel, patient-centered digital application to address sexual dysfunction in HSCT survivors. Iterative feedback from key stakeholders including HSCT survivors guided SHIFT adaptation and refinement, to optimize patient engagement and ensure inclusivity. The final prototype of SHIFT was initially acceptable to key stakeholders and is now under further testing in a pilot randomized trial to assess its feasibility and preliminary efficacy for improving sexual health outcomes in HSCT survivors.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
COVID-19 Outcomes Among Hematopoietic Cell Transplant and Chimeric Antigen Receptor T-Cell Recipients in the Era of SARS-CoV-2 Omicron Variants and COVID-19 Therapeutics. 在SARS-CoV-2 Omicron变异体和COVID-19疗法时代,造血细胞移植和嵌合抗原受体T细胞受者的COVID-19疗效。
IF 3.6 3区 医学
Transplantation and Cellular Therapy Pub Date : 2024-08-22 DOI: 10.1016/j.jtct.2024.08.010
Emily A Rosen, Elizabeth M Krantz, Denise J McCulloch, Marie H Wilson, Frank Tverdek, Zahra Kassamali Escobar, Darra Drucker, Eduardo Sanchez, Masumi Ueda Oshima, Marco Mielcarek, Jordan Gauthier, Steven A Pergam, Joshua A Hill, Catherine Liu
{"title":"COVID-19 Outcomes Among Hematopoietic Cell Transplant and Chimeric Antigen Receptor T-Cell Recipients in the Era of SARS-CoV-2 Omicron Variants and COVID-19 Therapeutics.","authors":"Emily A Rosen, Elizabeth M Krantz, Denise J McCulloch, Marie H Wilson, Frank Tverdek, Zahra Kassamali Escobar, Darra Drucker, Eduardo Sanchez, Masumi Ueda Oshima, Marco Mielcarek, Jordan Gauthier, Steven A Pergam, Joshua A Hill, Catherine Liu","doi":"10.1016/j.jtct.2024.08.010","DOIUrl":"10.1016/j.jtct.2024.08.010","url":null,"abstract":"<p><p>Recipients of cellular therapies, including hematopoietic cell transplant (HCT) and chimeric antigen receptor T-cell (CART) therapy, are at risk for poor outcomes from coronavirus disease 2019 (COVID-19). There are limited data describing outcomes among patients in the pre- and early post-cellular therapy period during the Omicron era when multiple antiviral therapeutics were widely available. The objective of this study is to describe COVID-19 treatment and outcomes in patients diagnosed with COVID-19 during the pre- or early post-cellular therapy period. This is a single-center retrospective cohort study of adult HCT and CART recipients diagnosed with COVID-19 in the pre- and early post-cellular therapy period who tested positive for COVID-19 at our cancer center between January 1, 2022 and March 1, 2023. Primary outcomes were 30-day COVID-19-related hospitalization and death. A secondary outcome was development of persistent COVID-19, defined by a positive SARS-CoV-2 polymerase chain reaction (PCR) 31 to 90 days after COVID-19 diagnosis. Among 65 patients included, 52 (80%) received at least one COVID-19 therapeutic. The most common treatment after initial COVID-19 diagnosis was nirmatrelvir/ritonavir (29%), followed by monoclonal antibody therapy (26%) and remdesivir (11%). Of the 64 patients with at least 30 days of follow-up, 8 (12%) had at least one COVID-19-related hospitalization and one patient died, though cause of death was not due to COVID-19. Of the 8 patients hospitalized for COVID-19, one had severe disease and 7 had mild or moderate infection. Persistent COVID-19 was observed in 13/65 (20%) patients, with 4 patients requiring additional antiviral therapy. Three pre-cellular therapy patients had delays in receiving cellular therapy due to persistent COVID-19. During the Omicron era, rates of 30-day COVID-19-related hospitalization and death were relatively low in this cohort of pre- and early post-HCT and CART recipients, the majority of whom received treatment with at least one antiviral agent. Persistent COVID-19 occurred in 1 in 5 patients in the peri-cellular therapy period and led to cellular therapy treatment delays in several patients, highlighting the need for new COVID-19 treatment strategies.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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