Bone Marrow Transplantation最新文献

{"title":"Comparison of fludarabine/melphalan (FM140) with fludarabine/melphalan/BCNU (FBM110) in patients with relapsed/refractory AML undergoing allogeneic hematopoietic cell transplantation - a registry study on behalf of the EBMT Acute Leukemia Working Party.","authors":"Jesús Duque-Afonso, Jürgen Finke, Maud Ngoya, Jacques-Emmanuel Galimard, Johannes Schetelig, Matthias Eder, Wolf Rösler, Gesine Bug, Andreas Neubauer, Matthias Edinger, Gerald G Wulf, Pavel Jindra, Hermann Einsele, Matthias Stelljes, Dominik Selleslag, Eva Maria Wagner-Drouet, Donald Bunjes, Alexandros Spyridonidis, Eolia Brissot, Arnon Nagler, Fabio Ciceri, Mohamad Mohty","doi":"10.1038/s41409-024-02499-6","DOIUrl":"https://doi.org/10.1038/s41409-024-02499-6","url":null,"abstract":"<p><p>The treatment of relapsed/refractory acute myeloid leukemia (AML) is associated with a dismal prognosis. The allogeneic hematopoietic cell transplantation (allo-HCT) is frequently performed as salvage therapy. Reduced intensity conditioning protocols have been developed with the aim of reducing the leukemia burden without increasing their toxicity. We compared the reduced intensity conditioning FM140 (fludarabine, 150 mg/m²; melphalan 140 mg/m²) with FBM110 (fludarabine 150 mg/m²; BCNU, also known as carmustine, 300-400 mg/m²; and melphalan 110 mg/m²). From the European Bone Marrow Transplantation (EBMT) Acute Leukemia Working Party registry, we identified 293 adult patients (FM140, n = 118 and FBM110, n = 175) with AML with relapsed/refractory disease prior to allo-HCT. There were some differences such as age (FM140 = 59.5 years vs. FBM110 = 65.1 years, p < 0.001) and graft-versus-host disease (GvHD) prophylaxis based on in vivo T-cell depletion (TCD, FM140 = 39% vs. FBM110 = 75%, p < 0.001). No differences were observed between FM140- and FBM110-treated patients regarding overall survival (OS) (2-year OS: 39.3% vs. 45.7%, p = 0.58), progression-free survival (PFS) (2-year PFS: 36.1% vs. 37.3%, p = 0.69), non-relapse mortality (NRM) (2-year NRM: 15.3% vs. 25.7%, p = 0.10) and relapse incidence (RI) (2-year RI: 48.6% vs. 37.0%, p = 0.7). In conclusion, despite differences in age and GvHD prophylaxis, AML patients with active disease undergoing allo-HCT after FBM110 conditioning showed similar outcomes compared to FM140.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fludarabine melphalan reduced intensity conditioning vs radiation-based myeloablative conditioning in patients undergoing allogeneic transplantation for acute myeloid leukemia with measurable residual disease.","authors":"Amanda Blackmon, Michelle Afkhami, Dongyun Yang, Sally Mokhtari, Yazeed Samara, Hoda Pourhassan, Brian Ball, Amandeep Salhotra, Vaibhav Agrawal, Karamjeet Sandhu, Amrita Desai, Salman Otoukesh, Shukaib Arslan, Idoroenyi Amanam, Paul Koller, Jose Tinajero, Ahmed Aribi, Ibrahim Aldoss, Pamela Becker, Andy Artz, Haris Ali, Anthony Stein, Eileen Smith, Vinod Pullarkat, Stephen J Forman, Guido Marcucci, Ryotaro Nakamura, Monzr M Al Malki","doi":"10.1038/s41409-024-02491-0","DOIUrl":"https://doi.org/10.1038/s41409-024-02491-0","url":null,"abstract":"<p><p>Patients with AML and measurable residual disease (MRD) undergoing allogeneic hematopoietic cell transplantation (HCT) may benefit from myeloablative conditioning (MAC) when feasible to reduce relapse risk. Fludarabine-Melphalan (FluMel) is a common reduced intensity conditioning (RIC) regimen; however, data in MRD+ patients is sparse. We performed a retrospective review of AML patients who underwent their first HCT (2016-2021) without morphologic disease at City of Hope who had pre-transplant marrow evaluated for MRD using multicolor flow cytometry (MFC) and received radiation-based MAC or FluMel conditioning. We identified 312 patients; 44 with MRD+ disease pre-HCT. The 24-month overall survival (OS), leukemia-free survival (LFS) and cumulative incidence of relapse (CIR) were 47.7%, 40.9%, and 38.6% in MRD+, and 78.0%, 73.9%, and 14.6% in MRD- patients. Radiation-based MAC was given to 136 (43.5%) patients (n = 20 with MRD+) and FluMel was given to 174 (55.8%) patients (n = 24 with MRD+). In patients with MRD+, there was no statistically significant difference between those who received MAC vs. FluMel in 24-month OS (60% vs. 38%, p = 0.21), or CIR (35% vs. 42%, p = 0.59), respectively. Our data substantiates the adverse impact of MRD in patients with AML undergoing HCT; FluMel is a reasonable option for MRD+ patients unfit for MAC.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-CD19 CAR T-cell therapy for primary and secondary CNS lymphomas.","authors":"Giulia Losi, Alberto Mussetti, Marta Peña, Patricia Lopez-Pereira, Anna Sureda, Silvana Novelli","doi":"10.1038/s41409-024-02496-9","DOIUrl":"https://doi.org/10.1038/s41409-024-02496-9","url":null,"abstract":"<p><p>Central nervous system lymphomas (CNSL) are a heterogeneous group of generally aggressive tumors whose prognosis varies significantly, being more favorable in patients with primary disease and poorer in those with secondary lymphoma. Current treatments typically involve intensive chemotherapy followed by consolidation with autologous stem cell transplantation or whole-brain radiotherapy. However, if the disease relapses, there is no established standard of care. The recent approval of anti-CD19 chimeric antigen receptor (CAR) T-cell therapy for systemic B-cell lymphomas has shifted the treatment landscape for previously incurable patients. Even though this therapy was initially underexplored in the setting of CNSL due to safety and efficacy concerns, it could offer a new therapeutic avenue for these patients. In this review, we will provide a concise overview of the current treatment strategies for CNSL, highlighting their key limitations, including relapse rates and long-term toxicity. Following this, we will explore the most important studies and clinical trials on CNSL, focusing on recent advancements in anti-CD19 CAR T-cell therapy. This comprehensive analysis will offer insights into the successes and challenges of treating CNSL effectively.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune checkpoint inhibitors therapy for solid organ malignancies after allogeneic hematopoietic stem cell transplantation: a retrospective study from the EBMT Transplant Complications Working Party.","authors":"J Brijs, C Peczynski, W Boreland, A Cuoghi, J Maertens, M Mohty, N Kröger, P Nakov, A E C Broers, M Eder, C Herrera Arroyo, M Kaufmann, R Ram, N P M Schaap, C Graham, A Mussetti, O Penack, I Moiseev, Z Peric, H Schoemans","doi":"10.1038/s41409-024-02497-8","DOIUrl":"https://doi.org/10.1038/s41409-024-02497-8","url":null,"abstract":"","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruxolitinib in acute and chronic graft-versus-host disease: real life long-term experience in a multi-center study for adult and pediatric patients, on behalf of the GETH-TC.","authors":"Virginia Escamilla-Gómez, Valentín García Gutiérrez, Patricia Alcalde-Mellado, Beatriz Astibia-Mahillo, Anabelle Chinea-Rodriguez, Lucía López-Corral, Marina Acera-Gómez, Melissa Karina Torres Ochando, Asunción Borrero Borrego, Leslie González Pinedo, Teresa Zudaire Ripa, Marta González Vicent, Ana Benzaquén, Isabel Izquierdo Garcia, Pedro Asensi Cantó, Juan Montoro, Francisco Manuel Martín-Domínguez, Guillermo Orti, David Valcárcel, Maria Isabel Benitez-Carabante, Cristina Diaz-de-Heredia, Eloi Cañamero, Christelle Ferrá, Irene García-Cadenas, Sara Redondo, Luisa Sisinni, Antonio Perez-Martínez, Alberto Mussetti, Lucía Garcia-Mañó, María Del Pilar Palomo-Moraleda, Pedro Antonio González-Sierra, Manuel Jurado, Jose A Perez-Simon","doi":"10.1038/s41409-024-02483-0","DOIUrl":"https://doi.org/10.1038/s41409-024-02483-0","url":null,"abstract":"<p><p>Ruxolitinib has been approved for the treatment of adults and pediatric patients ≥12 years with steroid refractory graft-versus-host disease (GvHD). However, real-life studies are needed to confirm the results of clinical trials and further assess its efficacy in special populations. We performed a descriptive, retrospective, multi-center study of 352 adults and 42 pediatric patients treated with ruxolitinib for steroid-refractory acute or chronic GvHD. Among 119 and 233 adult patients with acute and chronic GvHD, overall response rate (ORR) was 58.8% (CR 33.6%) and 65.7% (CR 18.5%), respectively. Corticosteroids were withdrawn in 59.2% and 40.1%, and ruxolitinib in 47.2% and 34.8% in the acute and chronic groups of responders. Among 29 and 13 pediatric patients with acute and chronic GvHD, ORR was 82.7% (CR 51.7%) and 100% (CR 23%), respectively. Among responder patients, corticosteroids were withdrawn in 72.7% and 50%, and ruxolitinib in 75% and 30.7% in both groups respectively. Ruxolitinib in the real world setting, showed similar results as compared to clinical trials. Its efficacy is maintained in subsequent lines of treatment. In the pediatric population, the data are more favorable. In the long-term follow-up, corticosteroids, ruxolitinib and other inmunosuppressive drugs could be eliminated in a remarkably proportion of patients.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-engraftment bloodstream infection after allogeneic haematopoietic cell transplant: 18-year trends in aetiology, resistance and mortality.","authors":"Anna Falcó-Roget, Anna Maria Raiola, Elisa Balletto, Riccardo Varaldo, Massimiliano Gambella, Emanuele Lanino, Chiara Sepulcri, Anna Ghiso, Livia Giannoni, Stefania Bregante, Antonella Laudisi, Monica Passannante, Matteo Bassetti, Emanuele Angelucci, Malgorzata Mikulska","doi":"10.1038/s41409-024-02494-x","DOIUrl":"https://doi.org/10.1038/s41409-024-02494-x","url":null,"abstract":"<p><p>Bloodstream infections (BSI) are frequent complications after allogeneic hematopoietic cell transplant (HCT). This study reports data on pre-engraftment BSI in years 2016-2021 and analyses changes in incidence, aetiology, resistance and mortality compared with two previous periods (2004-2009 and 2010-2015). In years 2004-2021, 1364 patients received HCT. De-escalation strategy for empirical antibiotic therapy was introduced in 2011. In 381 patients from years 2016-2021, the incidence of pre-engraftment BSI was 37.8%. Independent predictors of BSI were older age, AML/MDS and active disease. In 1364 patients, the incidence of BSI increased from 22% in period 1 to 38% in period 3 (p = 0.008), particularly gram-negative BSI: from 10.1% to 19.7% (p = 0.001). Among gram-negatives, resistance to third-generation cephalosporins remained stable (40.2% in period 3), while resistance to carbapenems and fluoroquinolones decreased (respectively, 12.6% and 59.8% in period 3). Seven and 30-day mortality after the first BSI decreased, respectively, from 11% in period 1 to 1.4% in period 3 and from 20.5% to 4.9% (p < 0.001 for both). Less recent transplant period was the only factor associated with higher mortality (p = 0.001). Incidence of pre-engraftment BSI is high and increased overtime, particularly for gram-negatives. Resistance rates remained stable, and mortality decreased overtime, documenting improvements in the BSI management.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantification of the FLT3 internal tandem duplication is a reliable marker for monitoring measurable residual disease in acute myeloid leukemia with FLT3-ITD mutations.","authors":"Meng-Miao Wang, Si-Man Huang, Yuan-Hong Huang, Jian Zhang, Hui-Ying Li, Shuai-Shuai Ge, Chao-Ling Wan, Miao Wang, Hai-Hui Liu, Han-Yu Cao, Zi-Hao Wang, Kai-Wen Tan, Hong-Feng Pang, Xiao-Yu Lyu, Song-Bai Liu, Hai-Ping Dai, Sheng-Li Xue, Qiao-Cheng Qiu","doi":"10.1038/s41409-024-02495-w","DOIUrl":"https://doi.org/10.1038/s41409-024-02495-w","url":null,"abstract":"","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The EASIX score as a predictor of sinusoidal obstruction syndrome and nonrelapse mortality in paediatric patients receiving allogeneic haematopoietic stem cell transplantation.","authors":"Edoardo Muratore, Giacomo Gambuti, Davide Leardini, Francesco Baccelli, Francesco Venturelli, Leyna Larcinese, Francesca Gottardi, Antonia Di Battista, Tamara Belotti, Arcangelo Prete, Riccardo Masetti","doi":"10.1038/s41409-024-02489-8","DOIUrl":"https://doi.org/10.1038/s41409-024-02489-8","url":null,"abstract":"<p><p>The endothelial activation and stress index (EASIX) score, calculated as [lactate dehydrogenase (LDH; U/L) × serum creatinine (mg/dL)]/platelets (10e9/L)], has been shown to be predictive of nonrelapse mortality (NRM) and endothelial complications in adults receiving allogeneic stem cell transplantation (allo-HSCT); however, definitive results are lacking for children. We retrospectively evaluated consecutive paediatric allo-HSCT recipients and calculated the log2 EASIX score every day from admission to day +35. In 167 allo-HSCT recipients, the EASIX score increased from before conditioning (-0.79) to a maximum score on day +20 (2.23). In multivariate analysis, the EASIX score at day +7 was an independent predictor of sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) (OR 1.52; 95% CI, 1.08-2.13; p = 0.017) and NRM (OR 1.68; 95% CI 1.16-2.42; p = 0.006). At several time points between day +0 and day +14, the EASIX score was independently associated with NRM, with the strongest predictive power being observed on day +12 (OR 3.05; 95% CI, 1.53-6.10; p = 0.002). Age correlated linearly with the EASIX score at all analysed time points, but score prediction was confirmed even when age was added to the multivariate model, indicating that age was not a confounding factor in the observed associations. The EASIX score determined shortly after transplantation can be further explored as a predictor of SOS/VOD and NRM in paediatric allo-HSCT recipients.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guinness 0.0: a miracle!","authors":"Shaun R McCann","doi":"10.1038/s41409-024-02492-z","DOIUrl":"https://doi.org/10.1038/s41409-024-02492-z","url":null,"abstract":"","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single versus tandem autologous stem cell transplantation in newly diagnosed multiple myeloma.","authors":"Nora Grieb, Alexander Oeser, Maximilian Ferle, Franziska Hanke, Sarah Flossdorf, Sandra Sauer, Hartmut Goldschmidt, Carsten Müller-Tidow, Hans-Jürgen Salwender, Roland Fenk, Monika Engelhardt, Robert Zeiser, Vladan Vucinic, Georg-Nikolaus Franke, Igor Wolfgang Blau, Daniel Teschner, Hermann Einsele, Christoph Kimmich, Miriam Kull, Britta Besemer, Nico Gagelmann, Nicolaus Kröger, Thomas Neumuth, Uwe Platzbecker, Maximilian Merz","doi":"10.1038/s41409-024-02490-1","DOIUrl":"https://doi.org/10.1038/s41409-024-02490-1","url":null,"abstract":"<p><p>Identifying patients who may benefit from autologous stem cell transplantation (ASCT) in newly diagnosed multiple myeloma is crucial, especially in the era of effective induction and consolidation strategies. We analyzed data from 12763 patients enrolled in the German Registry for Hematopoietic Stem Cell Transplantation and Cell Therapy (DRST), distinguishing those who underwent single (n = 8736) or tandem ASCT (n = 4027) from 1998 to 2021. Our findings show that the median age at first ASCT increased over time, while the use of tandem ASCT declined. The shift in treatment practices coincided with higher rates of complete response (CR) post-induction therapy. Significantly improved overall survival and event-free survival over time were observed across all age groups, especially in older patients, but not in patients under 40. Tandem ASCT showed benefits for patients who did not achieve CR after initial ASCT. However, patients with ISS III and renal impairment had poorer outcomes with tandem ASCT. In conclusion, while ASCT remains an important anti-myeloma tool, careful patient selection for tandem ASCT is essential, particularly avoiding its use in patients with ISS III and renal impairment, older age, and those already achieving CR after initial ASCT.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}