Biology of Blood and Marrow Transplantation最新文献

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Novel Approach for Bone Marrow Transplantation Conditioning in Acute Myelogenous Leukemia not Responding to the Induction Therapy Using Etoposide Carried in Lipid Core Nanoparticles: A Pilot Clinical Study 脂质核纳米颗粒携带依托泊苷诱导治疗对急性髓性白血病无反应的骨髓移植调节新方法:一项试点临床研究
IF 4.3
Biology of Blood and Marrow Transplantation Pub Date : 2020-11-01 DOI: 10.1016/j.bbmt.2020.07.010
Sandra S. Rohr , Raul C. Maranhão , Thauany M. Tavoni , Aleksandra T. Morikawa , Kelsy Areco , Debora F. Deus , José S.R. Oliveira
{"title":"Novel Approach for Bone Marrow Transplantation Conditioning in Acute Myelogenous Leukemia not Responding to the Induction Therapy Using Etoposide Carried in Lipid Core Nanoparticles: A Pilot Clinical Study","authors":"Sandra S. Rohr ,&nbsp;Raul C. Maranhão ,&nbsp;Thauany M. Tavoni ,&nbsp;Aleksandra T. Morikawa ,&nbsp;Kelsy Areco ,&nbsp;Debora F. Deus ,&nbsp;José S.R. Oliveira","doi":"10.1016/j.bbmt.2020.07.010","DOIUrl":"10.1016/j.bbmt.2020.07.010","url":null,"abstract":"<div><p>Allogeneic hematopoietic cell transplantation (HCT) is the treatment of choice for acute myelogenous leukemia (AML) not responding to induction therapy. It is a therapeutic choice for the blast phase of chronic myelogenous leukemia (CML-BP) in patients failing to respond to tyrosine kinase inhibitors (TKIs). Lipid core nanoparticles (LDEs) concentrate severalfold more in blast cells than in corresponding normal cells. Incorporation of anticancer drugs to LDE formulations increases the pharmacologic action and decreases the toxicity. We tested a drug-targeting system, LDE-etoposide plus total body irradiation (TBI; 1200 cGy dose), in 13 patients with AML not responding to the induction therapy and in 2 patients with CML-BP refractory to second-generation TKIs. The mean patient age was 46.7 years (range, 22 to 66 years). The LDE-etoposide dose was escalated at 20, 30, 40, 50, and 60 mg/kg. No patients developed grade 4 or 5 toxicity; however, mucositis grade 3 occurred in 6 patients, 3 patients experienced diarrhea, and 1 patient had an elevated total bilirubin level. No deaths were related to conditioning. All patients were successfully engrafted. The median times to neutrophil and platelet engraftment were 20 ± 5 days and 16 ± 4 days, respectively. Five patients (33.4%) had acute graft-versus-host-disease (GVHD), including 4 grade I, and 1 with grade II, and 8 patients (57.1%) had moderate-to-severe chronic GVHD<strong>.</strong> This pilot study shows the potential of LDE-etoposide plus TBI as an HCT conditioning regimen in AML patients not responding to the induction and refractory therapies for CML-BP patient. These findings pave the way for subsequent larger clinical trials.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 11","pages":"Pages 2027-2033"},"PeriodicalIF":4.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.07.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38167339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Comparison of Myeloablative (CyTBI, BuCy) versus Reduced-Intensity (FluBu2TBI400) Peripheral Blood Stem Cell Transplantation in Acute Myeloid Leukemia Patients with Pretransplant Low WT1 Expression 骨髓清除(CyTBI, BuCy)与降低强度(FluBu2TBI400)外周血干细胞移植在移植前低WT1表达急性髓系白血病患者中的比较
IF 4.3
Biology of Blood and Marrow Transplantation Pub Date : 2020-11-01 DOI: 10.1016/j.bbmt.2020.07.006
Silvia Park , Gi June Min , Sung Soo Park , Seung-Ah Yahng , Young-Woo Jeon , Seung-Hwan Shin , Jae-Ho Yoon , Sung-Eun Lee , Byung Sik Cho , Ki-Seong Eom , Yoo-Jin Kim , Seok Lee , Chang-Ki Min , Seok-Goo Cho , Dong-Wook Kim , Jong Wook Lee , Hee-Je Kim
{"title":"Comparison of Myeloablative (CyTBI, BuCy) versus Reduced-Intensity (FluBu2TBI400) Peripheral Blood Stem Cell Transplantation in Acute Myeloid Leukemia Patients with Pretransplant Low WT1 Expression","authors":"Silvia Park ,&nbsp;Gi June Min ,&nbsp;Sung Soo Park ,&nbsp;Seung-Ah Yahng ,&nbsp;Young-Woo Jeon ,&nbsp;Seung-Hwan Shin ,&nbsp;Jae-Ho Yoon ,&nbsp;Sung-Eun Lee ,&nbsp;Byung Sik Cho ,&nbsp;Ki-Seong Eom ,&nbsp;Yoo-Jin Kim ,&nbsp;Seok Lee ,&nbsp;Chang-Ki Min ,&nbsp;Seok-Goo Cho ,&nbsp;Dong-Wook Kim ,&nbsp;Jong Wook Lee ,&nbsp;Hee-Je Kim","doi":"10.1016/j.bbmt.2020.07.006","DOIUrl":"10.1016/j.bbmt.2020.07.006","url":null,"abstract":"<div><p>Relapse is a major concern with reduced-intensity conditioning. We analyzed 257 patients with acute myeloid leukemia (AML) who received allogeneic stem cell transplantation (SCT) and fulfilled the following criteria: intermediate- or poor-risk disease by National Comprehensive Cancer Network guidelines (2017, version 3), in first complete remission (CR1) at SCT, received either myeloablative conditioning (MAC; busulfan plus cyclophosphamide or cyclophosphamide plus total body irradiation) or reduced-intensity conditioning (RIC; FluBu2TBI400) peripheral blood SCT from 8/8 matched sibling or unrelated donor, and having bone marrow Wilms tumor gene 1 (<em>WT1</em>) expression results before transplant. We and other groups serially published a predictive value for pretransplant <em>WT1</em> expression in patients with AML to identify patients at higher risk of relapse. Among the total 257 patients, 191 (74.3%) and 66 (25.7%) patients received MAC and RIC transplants, respectively. <em>WT1</em> ≥250 copies/10<sup>4</sup> <em>ABL</em> was defined as <em>WT1<sup>high</sup>. WT1<sup>high</sup></em> before SCT was found to be an independent prognostic factor for inferior overall survival (OS), disease-free survival (DFS), and higher cumulative incidence of relapse (CIR). There were 201 patients with <em>WT1</em> low expression based upon pretransplant analysis. There was no significant difference in OS, DFS, CIR, and nonrelapse mortality between MAC and RIC patients. To conclude, post-transplant survival or relapse was not different by conditioning intensity in AML CR1 patients whose <em>WT1</em> level was below 250 copies per 10<sup>4</sup> <em>ABL</em> at transplantation.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 11","pages":"Pages 2018-2026"},"PeriodicalIF":4.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.07.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38154686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Challenging and Practical Aspects of Nutrition in Chronic Graft-versus-Host Disease 慢性移植物抗宿主病营养的挑战和实践方面
IF 4.3
Biology of Blood and Marrow Transplantation Pub Date : 2020-11-01 DOI: 10.1016/j.bbmt.2020.08.004
Andrea Z. Pereira , Sandra Elisa Adami Gonçalves , Morgani Rodrigues , Nelson Hamerschlak , Mary E. Flowers
{"title":"Challenging and Practical Aspects of Nutrition in Chronic Graft-versus-Host Disease","authors":"Andrea Z. Pereira ,&nbsp;Sandra Elisa Adami Gonçalves ,&nbsp;Morgani Rodrigues ,&nbsp;Nelson Hamerschlak ,&nbsp;Mary E. Flowers","doi":"10.1016/j.bbmt.2020.08.004","DOIUrl":"10.1016/j.bbmt.2020.08.004","url":null,"abstract":"<div><p>There is a paucity of information about nutrition in chronic graft-versus-host disease (GVHD). The role of nutrition is important because malnutrition is strongly associated with severe chronic GVHD manifestations. There is a high prevalence of metabolic syndrome and osteoporosis in this setting. Here we review the literature, describe main aspects of nutrition and discuss macronutrients (ie, vitamins), micronutrients (ie, Mg, Zn, Ca, and K) and supplements (probiotics and omega 3 fatty acids). A search was carried out in March 2020 using PubMed. Databases were screened for searching terms in titles and abstracts referring to chronic GVHD, nutrition intervention, protein, and body composition. Data were extracted for the following outcomes: nutrition, nutrition intervention, chronic GVHD, nutrition deficiencies, diet, vitamin, dry eye, probiotic, protein, and body composition. In this report, we summarize interventional nutrition studies reported in oncology and metabolic syndrome settings and describe our nutritional clinical practice in hematopoietic cell transplantation and chronic GVHD. The impact of nutrition evaluation and intervention on muscle mass loss, dry eye, dysgeusia, metabolic syndrome, osteoporosis, and comorbidities associated with chronic GVHD need to be studied prospectively.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 11","pages":"Pages e265-e270"},"PeriodicalIF":4.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38255033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Cryopreservation for All Is No Option in Unrelated Stem Cell Transplantation. Comment on Dholaria B, et al. Securing the Graft During Pandemic: Are We Ready for Cryopreservation for All? Biol Blood Marrow Transplant. 2020;26:e145-e146. 冷冻保存在非亲属干细胞移植中是没有选择的。对Dholaria B等的评论。在大流行期间保护移植物:我们准备好为所有人冷冻保存了吗?中华血液学杂志,2020;26:845 - 846。
IF 4.3
Biology of Blood and Marrow Transplantation Pub Date : 2020-11-01 DOI: 10.1016/j.bbmt.2020.08.011
Alexander H. Schmidt , Deborah Buk , Alexander Platz , Marcel R.M. van den Brink
{"title":"Cryopreservation for All Is No Option in Unrelated Stem Cell Transplantation. Comment on Dholaria B, et al. Securing the Graft During Pandemic: Are We Ready for Cryopreservation for All? Biol Blood Marrow Transplant. 2020;26:e145-e146.","authors":"Alexander H. Schmidt ,&nbsp;Deborah Buk ,&nbsp;Alexander Platz ,&nbsp;Marcel R.M. van den Brink","doi":"10.1016/j.bbmt.2020.08.011","DOIUrl":"10.1016/j.bbmt.2020.08.011","url":null,"abstract":"","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 11","pages":"Pages e298-e299"},"PeriodicalIF":4.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.08.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38296339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 12
Prognostic Factors for Postrelapse Survival after ex Vivo CD34+-Selected (T Cell-Depleted) Allogeneic Hematopoietic Cell Transplantation in Multiple Myeloma 多发性骨髓瘤患者体外CD34+选择(T细胞缺失)异体造血细胞移植术后复发后生存的预后因素
IF 4.3
Biology of Blood and Marrow Transplantation Pub Date : 2020-11-01 DOI: 10.1016/j.bbmt.2020.07.016
Alexandra Gomez-Arteaga , Gunjan L. Shah , Raymond E. Baser , Michael Scordo , Josel D. Ruiz , Adam Bryant , Parastoo B. Dahi , Arnab Ghosh , Oscar B. Lahoud , Heather J. Landau , Ola Landgren , Brian C. Shaffer , Eric L. Smith , Guenther Koehne , Miguel-Angel Perales , Sergio A. Giralt , David J. Chung
{"title":"Prognostic Factors for Postrelapse Survival after ex Vivo CD34+-Selected (T Cell-Depleted) Allogeneic Hematopoietic Cell Transplantation in Multiple Myeloma","authors":"Alexandra Gomez-Arteaga ,&nbsp;Gunjan L. Shah ,&nbsp;Raymond E. Baser ,&nbsp;Michael Scordo ,&nbsp;Josel D. Ruiz ,&nbsp;Adam Bryant ,&nbsp;Parastoo B. Dahi ,&nbsp;Arnab Ghosh ,&nbsp;Oscar B. Lahoud ,&nbsp;Heather J. Landau ,&nbsp;Ola Landgren ,&nbsp;Brian C. Shaffer ,&nbsp;Eric L. Smith ,&nbsp;Guenther Koehne ,&nbsp;Miguel-Angel Perales ,&nbsp;Sergio A. Giralt ,&nbsp;David J. Chung","doi":"10.1016/j.bbmt.2020.07.016","DOIUrl":"10.1016/j.bbmt.2020.07.016","url":null,"abstract":"<div><p>Allogeneic hematopoietic cell transplantation (alloHCT) for multiple myeloma (MM), with its underlying graft-versus-tumor capacity, is a potentially curative approach for high-risk patients. Relapse is the main cause of treatment failure, but predictors for postrelapse survival are not well characterized. We conducted a retrospective analysis to evaluate predictors for postrelapse overall survival (OS) in 60 MM patients who progressed after myeloablative T cell-depleted alloHCT. The median patient age was 56 years, and 82% had high-risk cytogenetics. Patients received a median of 4 lines of therapy pre-HCT, and 88% achieved at least a partial response (PR) before alloHCT. Of the 38% who received preemptive post-HCT therapy, 13 received donor lymphocyte infusions (DLIs) and 10 received other interventions. Relapse was defined as very early (&lt;6 months; 28%), early (6 to 24 months; 50%), or late (&gt;24 months; 22%). At relapse, 27% presented with extramedullary disease (EMD). The median postrelapse overall survival (OS) by time to relapse was 4 months for the very early relapse group, 17 months for the early relapse group, and 72 months for the late relapse group (<em>P</em> = .002). Older age, relapse with EMD, &lt;PR before alloHCT, &lt;PR by day +100, and no maintenance were prognostic for inferior postrelapse OS on univariate analysis. On multivariate analysis adjusted for age and sex, very early relapse (hazard ratio [HR], 4.37; 95% confidence interval [CI], 1.42 to 13.5), relapse with EMD (HR, 5.20; 95% CI, 2.10 to 12.9), and DLI for relapse prevention (HR, .11; 95% CI, 2.10 to 12.9) were significant predictors for postrelapse survival. Despite their shared inherent high-risk status, patients with MM have significantly disparate post-HCT relapse courses, with some demonstrating long-term survival despite relapse.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 11","pages":"Pages 2040-2046"},"PeriodicalIF":4.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.07.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38195358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
FLAMSA-Based Reduced-Intensity Conditioning versus Myeloablative Conditioning in Younger Patients with Relapsed/Refractory Acute Myeloid Leukemia with Active Disease at the Time of Allogeneic Stem Cell Transplantation: An Analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation 同种异体干细胞移植时复发/难治性急性髓系白血病活动性年轻患者基于flamsa的降低强度调节与清髓调节:来自欧洲血液和骨髓移植学会急性白血病工作组的分析
IF 4.3
Biology of Blood and Marrow Transplantation Pub Date : 2020-11-01 DOI: 10.1016/j.bbmt.2020.07.020
Eduardo Rodríguez-Arbolí , Myriam Labopin , Johanna Tischer , Arne Brecht , Arnold Ganser , Jürgen Finke , Igor Wolfgang Blau , Nicolaus Kröger , Peter Kalhs , Edouard Forcade , Donald Bunjes , Alexandros Spyridonidis , Bipin Savani , Arnon Nagler , Mohamad Mohty
{"title":"FLAMSA-Based Reduced-Intensity Conditioning versus Myeloablative Conditioning in Younger Patients with Relapsed/Refractory Acute Myeloid Leukemia with Active Disease at the Time of Allogeneic Stem Cell Transplantation: An Analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation","authors":"Eduardo Rodríguez-Arbolí ,&nbsp;Myriam Labopin ,&nbsp;Johanna Tischer ,&nbsp;Arne Brecht ,&nbsp;Arnold Ganser ,&nbsp;Jürgen Finke ,&nbsp;Igor Wolfgang Blau ,&nbsp;Nicolaus Kröger ,&nbsp;Peter Kalhs ,&nbsp;Edouard Forcade ,&nbsp;Donald Bunjes ,&nbsp;Alexandros Spyridonidis ,&nbsp;Bipin Savani ,&nbsp;Arnon Nagler ,&nbsp;Mohamad Mohty","doi":"10.1016/j.bbmt.2020.07.020","DOIUrl":"10.1016/j.bbmt.2020.07.020","url":null,"abstract":"<div><p>The use of myeloablative conditioning (MAC) in the setting of active relapsed/refractory (R/R) acute myeloid leukemia (AML) has been hindered by high historical rates of nonrelapse mortality (NRM). FLAMSA (fludarabine, Ara-C, and amsacrine) chemotherapy (CT) followed by reduced-intensity conditioning (RIC) has been proposed as an effective and potentially safer alternative in this scenario. As improvements in supportive care have contributed to decreasing NRM rates after MAC, a comparative reassessment of these two strategies was performed. This was a registry-based analysis by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Eligibility criteria included age 18 to 50 years, primary refractory, first or second relapsed active AML, first allogeneic stem cell transplantation from a matched sibling donor (MSD) or an unrelated donor (UD) performed between 2005 and 2018, MAC or FLAMSA-RIC. A total of 1018 patients were included. The median patient age was 39 years (range, 18 to 50). Two hundred and fifty-eight patients received busulfan (Bu)/cyclophosphamide (Cy), 314 received Cy/total body irradiation (TBI), 318 received FLAMSA-TBI, and 128 received FLAMSA-CT. The median duration of follow-up was 50 months. In univariate analysis, the 2-year relapse incidence (RI) (54%; 95% confidence interval (CI), 50%-57%), leukemia-free survival (LFS) (30%; 95% CI, 27%-33%), and refined graft-versus-host disease-free, relapse-free survival (GRFS) (21%; 95% CI, 18%-24%) were not significantly different between cohorts. Lower 2-year NRM was observed in the FLAMSA-CT group (7% versus 16% in Bu/Cy, 19% in Cy/TBI, and 18% in FLAMSA-TBI; <em>P</em> = .04), as well as increased 2-year overall survival (OS) (50% versus 33% in Bu/Cy, 34% in Cy/TBI, and 36% in FLAMSA-TBI; <em>P</em> = .03). These results were maintained in the multivariate analysis (hazard ratio [HR] for NRM: .40, <em>P</em> = .01; HR for OS: .65, <em>P</em> = .01; Bu/Cy as reference). These data suggest that FLAMSA-CT may be a preferred conditioning regimen in patients with active R/R AML due to lower NRM. Yet, the high relapse rates observed in our analyses emphasize the need for novel therapeutic strategies in this clinical setting.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 11","pages":"Pages 2165-2173"},"PeriodicalIF":4.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.07.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38205688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
Identification of Neurotoxicity after Chimeric Antigen Receptor (CAR) T Cell Infusion without Deterioration in the Immune Effector Cell-Associated Encephalopathy (ICE) Score 嵌合抗原受体(CAR) T细胞输注后无免疫效应细胞相关脑病(ICE)评分恶化的神经毒性鉴定
IF 4.3
Biology of Blood and Marrow Transplantation Pub Date : 2020-11-01 DOI: 10.1016/j.bbmt.2020.07.031
Megan M. Herr, George L. Chen, Maureen Ross, Hillary Jacobson, Renee McKenzie, Laura Markel, Sophia R. Balderman, Christine M. Ho, Theresa Hahn, Philip L. McCarthy
{"title":"Identification of Neurotoxicity after Chimeric Antigen Receptor (CAR) T Cell Infusion without Deterioration in the Immune Effector Cell-Associated Encephalopathy (ICE) Score","authors":"Megan M. Herr,&nbsp;George L. Chen,&nbsp;Maureen Ross,&nbsp;Hillary Jacobson,&nbsp;Renee McKenzie,&nbsp;Laura Markel,&nbsp;Sophia R. Balderman,&nbsp;Christine M. Ho,&nbsp;Theresa Hahn,&nbsp;Philip L. McCarthy","doi":"10.1016/j.bbmt.2020.07.031","DOIUrl":"10.1016/j.bbmt.2020.07.031","url":null,"abstract":"<div><p>A consensus grading schema for cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) resulting from chimeric antigen receptor (CAR) T cell therapy was published in 2019. Although this consensus grading schema has been imperative in identifying and monitoring CRS and ICANS in our CAR T cell population, we observed patients exhibiting subtle neurotoxicity symptoms prior to a decrease in their immune effector cell-associated encephalopathy (ICE) score, which is one component of ICANS. Because we treat grade 1 ICANS at our institution, identification of early neurotoxicity symptoms is important. Additionally, we found changes in personality, occupational confusion, or inability to answer dichotomous questions were early signs of neurotoxicity. Therefore, we developed a 3-step command tool to supplement the ICE evaluation. We present 2 examples of patients who exhibited early neurotoxicity symptoms and led us to develop this tool and 1 in whom it was effective. We propose that CAR T cell patients are consistently followed by a clinical care provider who is familiar with the patient to recognize early changes in personality, behavior, and cognition. Additionally, we propose that the multistep command tool be used in conjunction with the ICE score to detect early symptoms of ICANS. Early intervention has the potential to prevent irreversible neurotoxicity.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 11","pages":"Pages e271-e274"},"PeriodicalIF":4.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.07.031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38212624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
ASTCT Notes ASTCT笔记
IF 4.3
Biology of Blood and Marrow Transplantation Pub Date : 2020-11-01 DOI: 10.1016/j.bbmt.2020.10.012
{"title":"ASTCT Notes","authors":"","doi":"10.1016/j.bbmt.2020.10.012","DOIUrl":"https://doi.org/10.1016/j.bbmt.2020.10.012","url":null,"abstract":"","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 11","pages":"Pages 2174-2175"},"PeriodicalIF":4.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.10.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137415573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Combination of FLT3-ITD Allelic Ratio, NPM1 Mutation, and Immunophenotypic Markers to Modulate Outcome Prediction in Patients with Normal Karyotype Acute Myelogenous Leukemia Undergoing Hematopoietic Stem Cell Transplantation FLT3-ITD等位基因比例、NPM1突变和免疫表型标记联合调节正常核型急性髓性白血病患者接受造血干细胞移植的预后预测
IF 4.3
Biology of Blood and Marrow Transplantation Pub Date : 2020-11-01 DOI: 10.1016/j.bbmt.2020.07.017
Gina Jiang , Jose-Mario Capo-Chichi , Aijun Liu , Eshetu G. Atenafu , Rajat Kumar , Mark D. Minden , Hong Chang
{"title":"Combination of FLT3-ITD Allelic Ratio, NPM1 Mutation, and Immunophenotypic Markers to Modulate Outcome Prediction in Patients with Normal Karyotype Acute Myelogenous Leukemia Undergoing Hematopoietic Stem Cell Transplantation","authors":"Gina Jiang ,&nbsp;Jose-Mario Capo-Chichi ,&nbsp;Aijun Liu ,&nbsp;Eshetu G. Atenafu ,&nbsp;Rajat Kumar ,&nbsp;Mark D. Minden ,&nbsp;Hong Chang","doi":"10.1016/j.bbmt.2020.07.017","DOIUrl":"10.1016/j.bbmt.2020.07.017","url":null,"abstract":"<div><p><em>NPM1</em> mutation status and the allelic ratio (AR) of <em>FLT3-</em>internal tandem duplication (FLT3-ITD) are routinely tested for disease risk stratification in patients with normal karyotype (NK) acute myelogenous leukemia (AML); however, the predictive impact of immunophenotypic markers on different <em>NPM1/FLT3</em> genotypes remains unclear. We performed a retrospective analysis of 423 patients with NK-AML subclassified into groups based on <em>NPM1/FLT3</em> genotype. Allogeneic hematopoietic stem cell transplantation (HSCT) was performed in 124 of 423 patients (29%) and was significantly associated with longer event-free survival (EFS) and overall survival (OS), except for patients with the favorable genotype, defined as mutated <em>NPM1</em> (<em>NPM1</em><sup>mut</sup>) combined with normal <em>FLT3</em> status (<em>FLT3</em>-ITD<sup>neg</sup>) or <em>FLT3</em>-ITD AR &lt;.5 (<em>FLT3</em>-ITD<sup>low</sup>). A subset of AML patients bearing the favorable <em>NPM1</em><sup>mut</sup>/<em>FLT3</em>-ITD<sup>neg/low</sup> genotype share similar outcomes with AML patients who have the intermediate <em>FLT3/NPM1</em> genotype defined by normal <em>NPM1</em> (<em>NPM1</em><sup>wt</sup>) and <em>FLT3</em>-ITD<sup>neg/low</sup>. In these individuals, the lack of CD13 expression (CD13<sup>neg</sup>) was associated with shorter EFS (<em>P</em> = .041) and OS (<em>P</em> = .017). CD13<sup>neg</sup> was an independent predictor for shorter OS (hazard ratio, 1.985; <em>P</em> = .028).</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 11","pages":"Pages 1995-2000"},"PeriodicalIF":4.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.07.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38195357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Development and Evaluation of a Whiteboard Video Series to Support the Education and Recruitment of Committed Unrelated Donors for Hematopoietic Stem Cell Transplantation 开发和评估白板视频系列,以支持教育和招募承诺的非亲属造血干细胞移植供者
IF 4.3
Biology of Blood and Marrow Transplantation Pub Date : 2020-11-01 DOI: 10.1016/j.bbmt.2020.07.008
Edward W. Li , Anna Lee , Maryam Vaseghi-Shanjani , Alexander Anagnostopoulos , Gabriele Jagelaviciute , Elena Kum , Tanya Petraszko , Heidi Elmoazzen , David Allan , Warren Fingrut
{"title":"Development and Evaluation of a Whiteboard Video Series to Support the Education and Recruitment of Committed Unrelated Donors for Hematopoietic Stem Cell Transplantation","authors":"Edward W. Li ,&nbsp;Anna Lee ,&nbsp;Maryam Vaseghi-Shanjani ,&nbsp;Alexander Anagnostopoulos ,&nbsp;Gabriele Jagelaviciute ,&nbsp;Elena Kum ,&nbsp;Tanya Petraszko ,&nbsp;Heidi Elmoazzen ,&nbsp;David Allan ,&nbsp;Warren Fingrut","doi":"10.1016/j.bbmt.2020.07.008","DOIUrl":"10.1016/j.bbmt.2020.07.008","url":null,"abstract":"<div><p>Whiteboard videos are a popular video format, allowing viewers to see drawings of concepts alongside explanatory text and speech. We hypothesized that whiteboard videos could support the education and recruitment of unrelated stem cell donors in Canada. A series of 5 sharable whiteboard videos about stem cell donation was produced and posted online in September 2018, including 1 full-length video (<span>https://youtu.be/V4fVBtxnWfM</span><svg><path></path></svg>) and 4 shorter videos titled “What Is Stem Cell Transplantation?” “How Does the Matching Process Work?” “How Are Stem Cells Donated?” and “How Can I Register as a Stem Cell Donor?” In the videos, metaphorical interpretations of stem cells as factories and genetic markers as barcode labels are employed to communicate complex concepts. The particular need for young, male, and ethnically diverse donors is reflected in the characters portrayed. Surveys demonstrated the videos (1) were used and valued by stakeholders in donor recruitment and (2) significantly improved objective and self-reported knowledge about stem cell donation and reduced donation-related ambivalence among viewers from the most-needed donor demographics. Use of the whiteboard videos was also associated with improved donor recruitment outcomes in Canada. Our work is relevant to donor registries and recruitment organizations worldwide that seek to improve their recruitment efforts.</p></div>","PeriodicalId":9165,"journal":{"name":"Biology of Blood and Marrow Transplantation","volume":"26 11","pages":"Pages 2155-2164"},"PeriodicalIF":4.3,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bbmt.2020.07.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38159944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
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