Acta Haematologica最新文献

{"title":"Sudden Blast Crisis in a Chronic Myeloid Leukemia Patient in Treatment-Free Remission: A Case Report and Literature Review.","authors":"Qiushi Liang, Zhigang Liu, Yu Wu, Huanling Zhu, Yunfan Yang","doi":"10.1159/000542153","DOIUrl":"10.1159/000542153","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment-free remission (TFR) has emerged as a new goal in the treatment of chronic myeloid leukemia (CML). TFR is considered a safe intervention because patients who experienced molecular relapse usually responded well to tyrosine kinase inhibitors resumption and regained molecular response quite efficiently. Nevertheless, there have been reports of occurrence of blast crisis during TFR.</p><p><strong>Case presentation: </strong>We report a case of sudden lymphoid blast crisis in a CML patient who had been in TFR for 21 months without any prior molecular loss. Whole-exon sequencing identified a frameshift mutation of SETD2. In addition, we reviewed the current literature on cases of blast crisis in TFR. Only eleven cases of blast crisis have been reported among thousands of patients who discontinued tyrosine kinase inhibitor (TKI) therapy, including our patient. Of these cases, nine presented with lymphoid blast crisis. Additional gene mutations are frequently observed.</p><p><strong>Conclusion: </strong>This case, along with others, emphasizes the necessity of implementing a long-term monitoring strategy following TKI discontinuation due to the potential for late onset of blast crisis. Systematic genetic studies in patients failing TFR should be properly carried out to further understand the mechanism and, eventually, to predict or prevent such adverse event in patients in TFR.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Belantamab Mafodotin in Relapsed/Refractory AL Amyloidosis: Real-World Multi-Center Experience and Review of the Literature.","authors":"Eyal Lebel, Vladimir Vainstein, Paolo Milani, Giovanni Palladini, Tamir Shragai, Noa Lavi, Hila Magen, Miri Assayag, Irit Avivi, Moshe E Gatt","doi":"10.1159/000541594","DOIUrl":"10.1159/000541594","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment for relapsed/refractory AL amyloidosis (AL) is an unmet need. The safety and efficacy of belantamab mafodotin (BLM) in multiple myeloma are known, whereas in AL data are limited.</p><p><strong>Methods: </strong>We report a multi-center cohort of AL patients receiving BLM, and review all previous data on BLM therapy in AL.</p><p><strong>Results: </strong>Twelve patients with a median of 3 (range 2-9) prior lines of therapy were included. The overall hematological response rate (ORR) was 75% (9/12), including 5 complete responses. Six of the 10 evaluable patients had organ responses. The median event-free survivals/overall survivals were 22.3 and 28.8 months, respectively. Grade 3 toxicities were mostly infections and keratopathy, occurring in 7/12 (58%). Hematological toxicities were rare. No grade 4/5 toxicities occurred. The review of the previous series reveals BLM provides an ORR of 60-83% with similar rates of corneal toxicity.</p><p><strong>Conclusion: </strong>BLM, being an off-the-shelf therapy, with acceptable toxicity even in frail patients, may be a valuable option in AL, with a high ORR, and a signal for durable responses and high-quality organ responses.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142363859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intake of Proton Pump Inhibitors Is Associated with a Shorter Time to First Treatment in Early-Stage Chronic Lymphocytic Leukemia.","authors":"Tamar Tadmor, Guy Melamed, Hilel Alapi, Sivan Gazit, Tal Patalon, Lior Rokach","doi":"10.1159/000541453","DOIUrl":"10.1159/000541453","url":null,"abstract":"<p><strong>Introduction: </strong>Proton pump inhibitors (PPIs) are one of the most widely used drugs worldwide [Gut Liver. 2017;11(1):27-37]. The use of PPI has become a common practice and is overprescribed for all patients with cancer including patients with hematological malignancies. In the current study, we aimed to explore retrospectively the effect of PPI, on time to first treatment (TTFT) in a large cohort of patients with chronic lymphocytic leukemia (CLL) who were under watch-and-wait approach.</p><p><strong>Methods: </strong>The cohort is based on anonymized data obtained from electronic medical records of Maccabi Healthcare Services (MHS) members, who is the second-largest healthcare organization in Israel, with 2.5 million insured patients, and received a diagnosis of CLL during this period.</p><p><strong>Results: </strong>Our cohort included 3,474 patients with CLL who are treatment-naïve, and the median follow-up was 1,745 days (602-3,700). A total of 1,061 patients (30.5%) received a PPI agent, for a minimum of 3 months during the watch-and-wait period. The intake of PPI was found to be associated with a shorter TTFT: among PPI users, the 10-year treatment-free ratio is 79.2%, while among non-PPI users it is 90.6%.</p><p><strong>Conclusion: </strong>Routine use of PPI in CLL patients may negatively impact their clinical course. Biology of this primary observation requires further investigation.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BOSUTINIB TREATMENT OF CHRONIC MYELOID LEUKEMIA IN LOMBARDY.","authors":"Alessandra Iurlo,Cristina Bucelli,Tamara Intermesoli,Chiara Elena,Mariella D'Adda,Elena Agostani,Cristina Fiamenghi,Margherita Maffioli,Nicola Orofino,Francesca Lunghi,Angelo Gardellini,Maria Cristina Carraro,Alessandro Inzoli,Federica Gigli,Roberto Palazzolo,Vanda Bertolli,Daniele Cattaneo,Ester Maria Pungolino,Carlo Gambacorti-Passerini","doi":"10.1159/000540572","DOIUrl":"https://doi.org/10.1159/000540572","url":null,"abstract":"Introduction Up to 30% of CML patients will require a therapeutic change during follow-up, due to intolerance and/or resistance to first-line TKI approach. In this context, bosutinib (BOS) has not only demonstrated its effica-cy, but also presents a favorable safety profile, without comorbid conditions representing an absolute contraindication to its use. Methods To gain further into BOS treatment in real-life, we conducted a retrospective analysis on the outcome of CML patients receiving BOS in 18 hematological centers, all belonging to the \"REL\" (Lombard Hematology Network). Results Of 546 regularly followed CML cases, a total of 132 patients were reported as being treated with BOS, most frequently (62.9%) in second line. Interestingly, most patients (63.6%) switched to BOS due to intol-erance to the previous TKI, while resistance to the last treatment was reported in the remaining 36.4% of patients. Despite a permanent discontinuation rate of 18.9%, over 80% of patients achieved at least an MMR and seven cases were able to attempt treatment-free remission. Conclusion Although in this survey BOS represented the preferred option especially in patients intolerant rather than resistant to previous TKIs, we confirmed that BOS represents a safe and effective therapeutic option be-yond first line in the real-life setting.","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"16 1","pages":"1-13"},"PeriodicalIF":2.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Autologous Transplant in Newly Diagnosed Multiple Myeloma Patients Treated with Novel Triplets: A Systematic Review and Meta-Analysis.","authors":"Irina Amitai, Ronit Gurion, Pia Raanani, Iuliana Vaxman, Moshe Yeshurun, Hila Magen, Anat Gafter-Gvili, Liat Shargian","doi":"10.1159/000540232","DOIUrl":"10.1159/000540232","url":null,"abstract":"<p><strong>Introduction: </strong>High-dose therapy with melphalan followed by autologous stem cell transplant in the upfront setting (upfront ASCT) has significantly improved clinical outcomes of myeloma patients and become the standard of care for the past 30 years. However, with the advent of modern induction therapy, the role of upfront ASCT approach has been called into question. Several prospective studies have examined whether continuing with triplet therapy as consolidation with optional ASCT at relapse (triplet-alone) could result in comparable outcomes.</p><p><strong>Methods: </strong>This was a systematic review and meta-analysis of randomized controlled trials comparing upfront ASCT versus triplet-alone approach among myeloma patients treated with triplet therapy, which included two novel agents and a corticosteroid, as induction. Cochrane Library, PubMed and conference proceedings were searched. Primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS), safety, and second primary malignancies (SPM). Subgroup analysis was conducted for high-risk cytogenetics.</p><p><strong>Results: </strong>Our search yielded three trials, conducted between 2010-2018, including 1,737 patients. Two trials evaluated bortezomib plus lenalidomide (VRd) induction and the third study tested carfilzomib plus lenalidomide (KRd) induction. Maintenance was given in all trials to both arms. There was no difference in OS between the arms; the pooled OS in all patients and those with high-risk cytogenetics was hazard ratio (HR) 1.03 (95% CI, 0.85-1.26; I2 = 0%; 1,737 patients, 3 trials) and 0.85 (95% CI, 0.59-1.23; I2 = 0%; 222 patients, 2 trials), respectively. The pooled PFS for upfront ASCT versus triplet-alone was significantly improved in all the patients and in the high-risk cytogenetics subgroup, HR 0.67 (95% CI 0.59-0.76; I2 = 0%; 1,737 patients, 3 trials) and HR 0.59 (95% CI: 0.44-0.7; I2 = 0%; 306 patients, 3 trials), respectively. The risk of any grade 3-4 adverse events was higher in the upfront ASCT arm versus triplet-alone approach (relative risk = 1.17 [95% CI, 1.12-1.23; 1,737 patients]). The risk of secondary malignancies was reported in all three trials and was comparable between both arms. Two trials reported on secondary myeloid neoplasms, which were significantly higher among upfront ASCT arm versus triplet-alone approach, OR 9.7 (1.8-52.25, I2 = 0%, 1,422 patients).</p><p><strong>Conclusion: </strong>Although upfront ASCT approach, in the era of triplet therapy, resulted in a significantly longer PFS among all patients, this did not translate into a survival benefit, regardless of cytogenetic risk. Upfront ASCT was associated with an increased rate of secondary myeloid neoplasms. In the current plethora of innovative therapies, the role of upfront ASCT is debatable.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Fedratinib in routine Treatment of ruxolitinib-resistant or refractory patients with Primary and post-polycythemia vera or essential thrombocythemia Myelofibrosis: A nationalwide retrospective study.","authors":"Adrian Duek,Alexandra Tzinman,Kira Maziuk,Assaf Levy,Martin Ellis,Galia Stemer,Adi Shacham Abulafia,Amos Cohen,Noa Lavi,Aaron Ronson,Andrey Braester,Shirley Shapira,Jonathan Canaani,Yulia Volchek,Ronit Leiba,Merab Leiba","doi":"10.1159/000540906","DOIUrl":"https://doi.org/10.1159/000540906","url":null,"abstract":"INTRODUCTIONIn recent years, fedratinib, a selective JAK2 inhibitor, has emerged as a potential therapeutic option for patients who have failed or are intolerant to ruxolitinib. Despite the promising results observed in clinical studies, real-world evidence from the United States and Europe suggests that the efficacy of fedratinib may be less conclusive. We report the characteristics, treatment patterns, and clinical outcomes of patients with myelofibrosis (MF) treated with fedratinib following ruxolitinib failure in Israel's clinical practice.METHODSThis retrospective patient chart review included adults with a physician-reported diagnosis of MF, who initiated fedratinib after discontinuing ruxolitinib. Descriptive analyses characterized patient characteristics, clinical outcomes, and treatment patterns from MF diagnosis through ruxolitinib and fedratinib treatment.RESULTSWe extracted data for 16 eligible patients. Approximately 62.5 % of the patients were female, and the median age was 77 (range, 63-85) years. The median duration of ruxolitinib therapy was 17 months (range 3-84 ) months. Before the initiation of fedratinib, the median spleen size by palpation was 15.5cm below the costal margin (range 4-22cm). After three months the median spleen size was 13cm below the costal margin (range 2-21 cm). Only two patients showed minimal improvement after six months, while three patients progressed, and two patients showed no change in the spleen size. The spleen response did not improve after 12 months of treatment. At this point, the median spleen size was 19 cm below the costal margin (range 2-30 cm). Regarding the MF-related symptoms, 43.75% (n =7) of patients reported some improvement, 37.5% (n =6) showed no changes, whereas 18.75% (n =3) of the population complained of worsening. Gastrointestinal toxicity was the most frequent adverse effect of the drug, while 31% of patients died.CONCLUSIONOur observations showed that in MF patients who have failed to ruxolitinib, the therapeutic value from fedratinib may be modest especially when exposure time to ruxolitinib was more than 12 months. We may hypothesize that earlier switching from ruxolitinib to fedratinib may yield a better result.","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"15 1","pages":"1-11"},"PeriodicalIF":2.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beneficial effect of integrated nutritional interventions in patients with hematological diseases undergoing hematopoietic stem cell transplant.","authors":"Mimi Geng,Zihui Sun","doi":"10.1159/000541154","DOIUrl":"https://doi.org/10.1159/000541154","url":null,"abstract":"INTRODUCTIONThe nutritional status of patients undergoing hematopoietic stem cell transplantation (HSCT) is critically important. This study was aimed to assess the impact of comprehensive nutritional interventions on the well-being of individuals with hematological diseases who underwent HSCT.METHODSA total of 175 patients with hematological diseases who underwent HSCT were included, with 94 in the control group and 81 in the research group. Patients in the control group received standard nursing care, while those in the research group underwent integrated nutritional interventions. Nutritional status was evaluated using the mini nutritional assessment (MNA) and subjective global assessment (SGA), along with body measurements and serum levels of albumin, prealbumin, and hemoglobin.RESULTSThere were no significant differences in the proportion of malnourished patients evaluated by MNA or SGA between the control and research groups at admission. However, at discharge and 3 months post-discharge, fewer patients in the research group were malnourished compared to the control group, as assessed by both MNA and SGA. At admission, there were no significant differences in albumin, prealbumin, hemoglobin levels, weight, calf circumference (CC), triceps skinfold thickness (TSF), or subscapular skinfold thickness (SSF) between groups. However, at discharge and 3 months post-discharge, the levels of these indicators significantly decreased compared to those upon admission. Levels of albumin, prealbumin, and hemoglobin, as well as weight, CC, TSF, and SSF, were significantly higher in the research group than in the control group at both discharge and 3 months post-discharge.CONCLUSIONHSCT led to a decline in nutritional status among patients with hematological diseases, but integrated nutritional interventions effectively improved their nutritional status.","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"39 1","pages":"1-14"},"PeriodicalIF":2.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Impact of Routine Addition of Antithymocyte Globulin to Standard GVHD Prophylaxis in Myeloablative Unrelated Donor Transplants: Important Gains in Graft-versus-Host Disease Prevention though No Difference in Overall Survival.","authors":"Ni Bai, Wasithep Limvorapitak, Robert Henderson, Yasser Abou Mourad, Shanee Chung, Donna Forrest, Kevin Hay, Florian Kuchenbauer, Stephen Nantel, Sujaatha Narayanan, Thomas Nevill, Maryse Power, Judith Rodrigo, Claudie Roy, David Sanford, Kevin Song, Ryan Stubbins, Heather Sutherland, Cynthia Toze, Jennifer White","doi":"10.1159/000541071","DOIUrl":"10.1159/000541071","url":null,"abstract":"<p><strong>Introduction: </strong>Antithymocyte globulin (ATG) has been demonstrated to reduce the incidence of graft-versus-host disease (GVHD); however, it remains controversial whether these gains are offset by an increase in relapse.</p><p><strong>Methods: </strong>We conducted a retrospective historical control study consisting of patients (n = 210) who underwent myeloablative allogeneic hematopoietic stem-cell transplantation (HSCT) from 2014 to 2020.</p><p><strong>Results: </strong>The incidence of acute GVHD was lower in the ATG group (51.4%) than the non-ATG group (control) (70.0%, p = 0.010). The incidence of chronic GVHD was also lower in the ATG group at 1-year (36.4% vs. 62.9%, p &lt; 0.001) and 2-year (40.0% vs. 65.7%, p &lt; 0.001) post-HSCT. The mortality due to GVHD was higher in the control (18.5%) than the ATG group (4.3%; p = 0.024). The severe GVHD-relapse-free survival was higher in the ATG group (36.4%) than the control (12.9%; p &lt; 0.001). Nevertheless, the 2-year overall survival was similar.</p><p><strong>Conclusion: </strong>Our results confirm the effectiveness of ATG in prevention of GVHD in the real-world setting and enhanced GVHD-free survival. An important result is the equalization of overall survival between the ATG and control groups at 1- and 2-year post-HSCT and implies that earlier GVHD-associated mortality may be offset by later relapse mortality producing similar overall survival over time.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of the Pretransplant Fibrosis-4 Index on Non-Relapse and Overall Mortality following Unrelated Single-Unit Cord Blood Transplantation in Adults.","authors":"Takaaki Konuma, Maki Monna-Oiwa, Seiko Kato, Masamichi Isobe, Satoshi Takahashi, Yasuhito Nannya","doi":"10.1159/000541157","DOIUrl":"10.1159/000541157","url":null,"abstract":"<p><strong>Introduction: </strong>The fibrosis-4 (FIB-4) index is a noninvasive marker of liver fibrosis. The FIB-4 index predicts poor outcomes in patients with hepatic and non-hepatic diseases. However, the association of the FIB-4 index with mortality and liver-related clinical outcomes following cord blood transplantation (CBT) is unclear.</p><p><strong>Methods: </strong>We retrospectively evaluated the impact of the pretransplant FIB-4 index on outcomes in 336 adults following single-unit unrelated CBT at our institution.</p><p><strong>Results: </strong>In multivariate analyses, when the FIB-4 index &lt;1.3 group was used as the reference, non-relapse mortality was significantly higher in the FIB-4 index 1.3-2.67 (hazard ratio [HR], 2.51; 95% confidence interval [CI], 1.19-5.30) and FIB-4 index &gt;2.67 (HR, 2.34; 95% CI, 1.12-4.90) groups. Overall mortality was significantly higher in the FIB-4 index &gt;2.67 group (HR, 1.66; 95% CI, 1.00-2.73), but with only marginal significance in the FIB-4 index 1.3-2.67 group (HR, 1.59; 95% CI, 0.96-2.64). Hematopoietic recovery, acute and chronic graft-versus-host disease of the liver, and veno-occlusive disease/sinusoidal obstruction syndrome were not associated with the pretransplant FIB-4 index.</p><p><strong>Conclusion: </strong>The pretransplant FIB-4 index is accurate and useful in predicting mortality in adult patients undergoing single-unit unrelated CBT.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Patients with Myeloid Malignancies and Cardiovascular Disease Undergoing Allogeneic Stem Cell Transplantation.","authors":"Gabriela Sanchez-Petitto, Olga Goloubeva, James Childress, Tahreem Iqbal, Jack Masur, Max An, Safwan Muhammad, Justin Lawson, Grace Li, Brian Barr, Ashkan Emadi, Vu H Duong, Nancy M Hardy, Aaron P Rapoport, Maria R Baer, Sandrine Niyongere, Jean A Yared","doi":"10.1159/000541131","DOIUrl":"10.1159/000541131","url":null,"abstract":"<p><strong>Introduction/background: </strong>Reduced-intensity conditioning (RIC) and nonmyeloablative (NMA) regimens have enabled patients with cardiovascular disease (CVD) to undergo allogeneic stem cell transplantation (allo-HSCT). However, little is known about long-term outcomes, including cardiovascular (CV) complications.</p><p><strong>Methods: </strong>We retrospectively studied 99 consecutive patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) who underwent allo-HSCT between September 1, 2013, and November 30, 2020. Overall survival (OS), progression-free survival (PFS), nonrelapse mortality (NRM), cumulative incidence of relapse, and cumulative incidence of acute and chronic graft-versus-host disease (GvHD) were compared in patients with and without CV risk factors or disease.</p><p><strong>Results: </strong>Preexisting CVD was present in 34 of 99 patients (34%). CVD patients more commonly had reduced-intensity conditioning (91% vs. 60%, p = 0.001) and unrelated donors (56% vs. 35%, p = 0.04). Early adverse cardiac events occurred more frequently in the CVD versus no-CVD group (38% vs. 14%), particularly arrhythmias (21% vs. 5%; p = 0.04). CVD patients tended to have poorer OS and PFS outcomes (HR = 1.98, [1.00, 3.92]; HR = 1.89, [0.96-3.72], respectively). OS rate at 1, 2, and 3 years for CVD versus no-CVD patients was 66% versus 72%, 55% versus 64%, and 46% versus 62%, respectively. Causes of death in the CVD and no-CVD groups were infections (53% vs. 28%), relapsed disease (32% vs. 52%), and CV events (10% vs. 3%).</p><p><strong>Conclusion: </strong>Based on these data, predictive models to identify patients with CVD with higher risk of post-allo-HSCT complications and mortality and strategies to mitigate these risks should be developed.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}