bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective Analysis of Post-Transplant Complications in Autologous Hematopoietic Cell Transplantation Patients Receiving Hyperbaric Oxygen Therapy
Authors: Abdelhakim Haitham , Bhatti Sajjad Akbar , Cantilena Amy Rose , Lin Tara L. , Ganguly Siddhartha , Singh Anurag K. , Abhyankar Sunil , Lipe Brea , McGuirk Joseph , Allin Dennis , Shune Leyla , Aljitawi Omar 
Published: November 2019

Abstract
High-dose chemotherapy and autologous hematopoietic cell transplantation (Auto-HCT) is an established therapy for patients with multiple myeloma and lymphomas. Post-transplant complications during the neutropenia phase include pancytopenia requiring transfusions and G-CSF support, mucositis and infectious complications.
Previously, we have demonstrated that hyperbaric oxygen therapy (HBO) given day 0 prior to transplant reduced erythropoietin (EPO) levels and improved engraftment in umbilical cord blood transplantation. Subsequently, we conducted a pilot trial to study HBO effects EPO levels and engraftment in Auto-HCT setting. Herein, we review HBO effects on Auto-HCT post-transplant complications.
Methods:
Charts of patient who underwent HBO treatment prior to Auto-HCT on our pilot study and matched historic controls were retrospectively reviewed for post-transplant transfusion requirements, G-CSF support, mucositis and infectious complications
Results:
Nineteen patients completed HBO therapy and were compared to 118 patients in our historic cohort. Basic patient characteristics are listed in table-1. Average days of G-CSF use was 6.2 days in our HBO cohort compared to 9.16 days in the historic cohort (P=0.0007). Average number of transfused packed red cells was 2.1 and 2.58 units (P=0.22), while average number of platelet unit transfusions was 2.5 and 3.2 (P=0.17) in the HBO and historic cohorts, respectively. Mucositis incidence was 26.3% in the HBO cohort compared to 59.3% in controls (P=0.008). Similarly, the rate of neutropenic fever was 47% in the HBO cohort vs. 65% in controls (P=0.11). The rate of admissions, on the other hand, was 31.5% in the HBO cohort compared to 23.7% in controls (P=0.31) with an average length of hospital stay of 6.6 days in the HBO cohort compared to 7.68 days in controls (P=0.31).
Conclusions:
HBO therapy prior to Auto-HCT is associated with lower G-CSF use and lower incidence of mucositis in our retrospective study. Prospective studies are needed to determine HBO effects on Auto-HCT post-transplant complications.

Disclosures
Ganguly: Onyx: Speakers Bureau; Seattle Genetics: Speakers Bureau; Janssen: Research Funding.
Feasibility and Efficacy of High-Dose Chemotherapy and Autologous Hematopoietic Cell Transplantation for HIV-Related Lymphoma: A Single-Institution Experience
Authors: Sleiman Elsa , Gomez Alexandra , Chavez Julio C. , Kharfan-Dabaja Mohamed A , Ayala Ernesto 
Published: November 2019

Abstract
Background: High dose therapy (HDT) followed by autologous hematopoietic cell transplantation (autoHCT) has been shown to be safe and effective in patients with HIV-related lymphoma (HRL). Data is limited to small case series, transplant registries and a single prospective multicenter observational study. Here we report our institutional experience with auto-HCT in patients with HRL.
Patients and methods: Twenty patients with HRL [non-Hodgkin=14 (70%), Hodgkin=6 (30%)] and treatable HIV infection underwent HDT consisting of carmustine, etoposide, cytarabine and melphalan (BEAM) followed by peripheral blood auto-HCT from 04/2006 to 07/2015. In 2 cases rituximab was administered as part of the preparative regimen. Patient-, disease-, and transplant-related characteristics are summarized in Table 1.
Results: Median age was 48 years (range 35-61). The median follow-up for surviving patients was 42 months (range 6-110). At transplant, median peripheral blood CD4 count was 226 cells/µl (range 41-761). HIV viral load was undetectable in 14 out of 20 patients and lower than 4 logs in all of them. The median time to neutrophil and platelet engraftment were 11 days (range 10-13) and 14 days (range 13-176), respectively. Response rates at day +100 post-autografting in 17 evaluable patients were as follows: complete remission (CR)=11/17 (65%), partial response (PR)=2/17 (12%), and relapse/progression=4/17 (24%). Median event-free survival (EFS) was 58.4 months. Median overall survival (OS) was 74.3 months. At 5-years post-transplantation, EFS and OS were 68% and 53%, respectively. Non-hematologic toxicities consisted of mucositis in 8 (grade 1=3, grade 2=5), and enteritis in 13 patients (grade 1=2, grade 2=3, and grade 3=8). There were 13 documented infections in 11 patients (bacterial=9, viral=2, fungal=2). Six patients died from disease relapse/progression (n=5) and infection (n=1). Non-relapse mortality was 0% at day 100 and 5% at 5 years.
Conclusion: Patients with HRL and treatable HIV infection should be offered autoHCT if indicated. HIV infection is no longer a contraindication for autoHCT in this population.

Disclosures
Chavez: Janssen: Speakers Bureau. Kharfan-Dabaja:Seattle Genetics: Speakers Bureau; Incyte: Speakers Bureau.
High Dose Chemotherapy with Autologous Stem Cell Transplant in Treatment of Germ Cell Tumors: A Systematic Review and Meta-Analysis
Authors: Husnain Muhammad , Riaz Irbaz Bin , Kamal Muhammad Umar , Gondal Farva Razia , Ali Zeeshan , Sipra Qurat-ul-Ain Riaz , Javed Asad , Akbar Sara , Singh Parminder , Anwer Faiz 
Published: November 2019

Abstract
Background:
Cure rates for the poor risk, relapsed and refractory germ cell tumors are only 25 % with conventional dose chemotherapy. High Dose Chemotherapy (HDCT) followed by rescue stem cell transplant has since been studied in randomized controlled trails for the IGCCG poor risk group patients and for the relapsed and refractory testicular cancer patients. We conducted a meta-analysis of all prospective Phase II and III trials studying the role of high dose chemotherapy in germ cell tumors.
Methods:
Literature search was conducted using methods described in the PRISMA statement. Medline (PubMed and Ovid SP), Embase, Cochrane Central Register of Controlled Clinical Trials(CENTRAL) and Cochrane Database of Systematic Review (CDSR) were searched from the inception of these databases till present. We performed a meta-analysis using Comprehensive Meta-analysis 3.0 using random effects model. The heterogeneity was assessed using I2values and sensitivity analysis was performed to explain the heterogeneity where present.
Results:
After a comprehensive literature search 4440 studies were identified and finally 35 studies were included in the final analysis. 14 studies involving 905 patients with IGCCG poor risk germ cell cancer were treated with high dose chemotherapy. 44 % (398) patients were able to achieve CR with HDCT with HR of o.48 (0.33-0.62) p=0.75. The overall survival (OS) and Progression free survival (PFS ) were 0.62 (0.54-0.69, p=0.004) and 0.60 (0.52-0.68 p=0.011) respectively.
21 studies involving 1153 patients with relapsed and or refractory germ cell cancer were identified. CR rate with HDCT was 32 % (374 patients) with HR of 0.32 (0.26-0.40, p=0.00). The results for OS failed to show any significant results with HR of 0.52 (0.44-0.60, p=0.67) but was significant for PFS with HR of 0.60 (0.52-0.67, p=0.01).
Conclusion:
High dose chemotherapy followed by HSCT showed significant OS and PFS for IGCCG poor risk category germ cell tumors and significant CR and PFS for relapsed and or refractory germ cell cancer group.

Disclosures
Anwer: Incyte: Speakers Bureau; Seattle Genetics: Other: Advisory Board Participant.
Outcomes of Hematopoietic Stem Cell Transplant in Older Patients with Myelodysplastic Syndrome and Co-Existing Myelofibrosis: A Single Center Experience and Review of the Literature
Authors: Saste Abhijit B , Kuriakose Philip , Janakiraman Nalini , Peres Edward , Farhan Shatha Y. 
Published: November 2019

Abstract
Background:Myelodysplastic syndrome with coexisting bone marrow fibrosis has a dismal prognosis when treated with conventional chemotherapy suggesting that marrow fibrotic grade may be an important prognostic factor. Allogeneic stem cell transplantation (ASCT) has been utilized in young fit patients with this disorder. However outcomes in older patients are unknown.
Design and Methods: We conducted a retrospective study to assess the therapeutic efficacy of ASCT in 11 patients with myelodysplastic syndrome with a known co-existing high grade myelofibrosis (n=11) .Data were classified based on cytogenetic risk, conditioning regimen, donor source and cytoreduction pre-transplant. We evaluated rates of engraftment, graft versus host disease and overall survival.
Results : Higher median age of 66 years, high cytogenetic risk class and high grade bone marrow fibrosis in our study population was not associated with inferior survival in a univariate analysis. There were no patients who developed graft failure. Cumulative incidence of engraftment achieved at day +30 based on chimersim was 72.7%. The 3 year overall survival was 100% when pre-transplant cytoreduction was used. There were no cases of disease relapse.
Conclusions : Among patients with myelodysplastic syndrome and concomitant bone marrow fibrosis, advanced age, a higher grade of fibrosis or cytogenetic complexity did not adversely affect survival after ASCT.This treatment modality should therefore be considered in patients even with advanced age.

Disclosures
No relevant conflicts of interest to declare.
Antithymocyte Globulin Improves the Survival of Patients with Myelodysplastic Syndrome Undergoing HLA-Matched Unrelated Donor and Haplo-Identical Donor Transplants
Authors: Miao Miao , Wang Hong , Liu Hong , Zhou Jinyi , Zhang Tongtong , Jin Song , Zhang Xiang , Chen Suning , Li Weiyang , Xu Yang , Wu Depei 
Published: November 2019

Abstract
Background: Significant advances have been achieved in the outcomes of patients with myelodysplastic syndromes (MDS) after both HLA-matched sibling donor transplants (MSDT) and non-MSDT in the past few years, the latter including HLA-matched unrelated donor (MUDT) and haplo-identical donor transplants (HIDT).
Methods: We retrospectively analyzed the data of 85 consecutive patients with MDS who received allogeneic HSCT between Dec 2007 and Apr 2014 in our center. These patients comprised 38 (44.7%) who received MSDT, 29 (34.1%) MUDT, and 18 (21.2%) HIDT.
Results: The median follow-up was 30.0 months. Over all, the median overall survival (OS) was 60.2 months and the probabilities of OS at the first, second and fifth year were 63%, 57% and 48%, respectively. Median OS post transplant (OSPT) was 57.2 months and the probabilities of OSPT at the first, second and fifth year were 58%, 55% and 48%, respectively. Relapses occurred in 16 patients (18.8%), and the cumulative incidence of relapse at the first, second and third year were 14%, 23% and 27%, respectively. The survival of patients receiving non-MSDT was superior to that of MSDT, median OSPT being 84.0 months and 23.6 months, respectively (P=0.042);
And the similar result was observed when we analyzed the OS of patients who underwent non-MSDT or MSDT (median OS: 120 months vs. 27.0 months; P=0.028). We also found that using antithymocyte globulin (ATG) in conditioning regimens significantly improved survival after non-MSDT, with better OS and OSPT (P=0.016 and P=0.025). Furthermore, we compared OS or OSPT of patients who received non-MSDT with ATG (n=38) and MSDT without ATG (n=37). Our results showed that using ATG in conditioning regimen significantly improved survival of non-MSDT, with better OSPT (median OS: 84.0 months vs. 23.0 months; P=0.026) and OS (median OS: 120 months vs. 25.1 months; P=0.016).
Conclusions: These data suggest that, non-MSDT could be a valid alternative when MSDT is not available, and ATG may improve the survival of MDS patients after non-MSDT.

Disclosures
No relevant conflicts of interest to declare.
Autoimmune Hematological Diseases Following Haploidentical Donor Hematopoietic Stem Cell Transplant Compared with Matched Sibling and Unrelated Donor
Authors: Lv Weiran , Liu Qifa , Fan Zhiping , Huang Fen , Xu Na , Xuan Li , Yu Guopan , Jiang Qianli , Zhou Hongsheng , Lin Ren , Sun Jing , Zhang Xin 
Published: November 2019

Abstract
Objective:Autoimmune hematological diseases (AHDs) occur more frequently than other autoimmune complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and are often refractory to treatment. The aim of this study was to analyze the incidence and risk factors of AHDs as well as its response to treatment in a series of patients undergoing allo-HSCT at our single institution.
Method:Forty hundred and forty-five adult malignant hematopoietic disorders underwent allo-HSCT were enrolled in this retrospective study, including 181 cases underwent HLA-matched sibling donor (MSD) transplants, 140 unrelated donor (MUD) transplants and 124 haploidentical donor transplants (HRD).
Result:Twelve patients developed AHDs, including 6 autoimmune hemolytic anemia (AIHA)and 6 Evans' syndrome.The median time of AHDs onset was 196 days (range, 60-756). Evans' syndrome all ocuured in HRD. The 3-year cumulative incidence of AHDs was 2.7%,and HRD had higher incidence than MSD (6.5% vs 1.1%,P=0.017) and MUD(6.5%vs1.4%,P=0.049). Eight of them received complete response (CR) and 3 no response (NR) after 11 patients received the corticosteroids combined with CSA as the initial treatment for 4 weeks. One obtained CR and 2 PR after 3 NR cases treated by rituximab. Eleven cases all not were AHDs recurrence at a median followup of 313 days (range, 153 to 1051 days after CR. HRD transplantation(vs MSD: hazard ratio [HR], 7.70; 95% confidence interval [CI], 1.63 to 36.44; P=.01 and vs MUD: hazard ratio [HR], 5.87; 95% confidence interval [CI], 1.24 to 27.73; P=.026) and concurrent chronic GVHD (hazard ratio [HR], 3.76; 95% confidence interval [CI], 1.18 to 11.92; P=.025)were risk factors for AHDs.
Conclusion:The patients undergoing HRD transplantation had higher risk of AHDs and manifested as Evan's syndrome was very common compared with MSD and MUD. Corticosteroids combined with CSA as the first line treatment of AHDs results in good response and low recurrence rate.

Disclosures
Lin: National Natural Science Foundation of China 81400141: Research Funding; National Natural Science Foundation of China 81270647: Research Funding; Science and technology planning project of Guangdong Province 2014B020226004: Research Funding; The project of health collaborative innovation of Guangzhou City 201400000003-4: Research Funding.
Feasibility and Outcome of Hematopoietic Stem Cell Transplantation Combined with Decitabine for Children with Juvenile Myelomonocytic Leukemia
Authors: Liu Huaying , Li Chunfu , He Yuelin 
Published: November 2019

Abstract
Background
Juvenile myelomonocytic leukemia(JMML) is a rare clonalmyelodysplastic/myeloproliferative disorder that occurs during infancy and early childhood with poor prognosis. Chemotherapy has not been found to be dffective, and Hematopoietic stem cell transplantation(HSCT) is currently the only curative treatment for JMML. Relapse and engraftment failure are the major causes of HSCT failure in JMML.
Patients and method
We report the outcomes of 4 patients with JMML who received HSCT combined with Decitabine between 2014-2015. Patient median age was 2 years(range,1-3years), and 3 were boys and 1 girl. Decitabine was given before and after the HSCT for one time(20mg/m2.d X 5d、10mg/m2 .d X 5d). Before HSCT, all the patients received mild chemotherapy(three or four course). The bone marrow evaluations of all the patients before HSCT were complete remission(CR). Two patients received human leukocyte antigen(HLA)-matched HSCT from unrelated donors, and two patients received haploidentical HSCT from parents followed by unrelated cord blood transplantation(UCB). Conditioning regimen of Unrelated donor-PBSCT was Busulfan+fludarabine+Thiotepa+Thymoglobuline, and the conditioning of haplo-HSCT was Busulfan+fludarabine+Cytarabine+Thymoglobuline. The number of nucleated cells of HLA-matched HSCT was 8×108/kg. The number of nucleated cells of Haplo-HSCT was 47.2×108/kg、61.26×108/kg , respectively, and the number of nucleated cells of UCB was 7.23×107/kg、9.4×107/kg, respectively. GVHD prophylaxis was based on post-transplant high-dose cyclophosphamide(PTCy, 50mg/kg on days +3 and +4) combined with mycophenolate plus cyclosporine A or tacrlimus.
Results:
The median follow-up was 21 months(range,11-27 months). The overall survival(OS) and the Disease free survival(DFS) both were 100%, All the patients got 100% engraftment(Unrelated-donor stem cell engrafted and Haploidentical-donor stem cell engrafted in 2 and 2 patients , respectively). None of the patients developed relaps, the bone marrow evaluations were complete remission(CR) after HSCT. The most common toxicities were infection with neutropenia(100%, n=4), The cumulative incidences of acute GVHD gradesII-III and CMV infection were 50% and 75% respectively.
Conclusion:
The combination of decitabine and HSCT shows encouraging results with highly effective and less toxicity for JMML. The futhuer study should be developed in the future.

Disclosures
No relevant conflicts of interest to declare.
Triterpene Glycosides from Cimicifuga FoetidaRegulate wnt/β-Catenin Signaling in Human KG-1a Leukemia Cells
Authors: Xu Rui-Rong , Cui Si-Yuan , Chen Chong , Jiao Ning , Wu Xiao-Long , Wang Xin , Qiu Ming-Hua 
Published: November 2019

Abstract
Background : Leukemia stem cells (LSCs) are a limitless cell source for the initiation and maintenance of leukemia. Activation of the Wnt/β-catenin pathway is required for the survival and development of LSCs. Therefore,targeting β-catenin is considered a therapeutic strategy for the treatment of leukemia. The goal of this study was to explore whether Triterpene Glycosides(A, DA and KCY4),the active components of the traditional medicine Cimicifuga foetida, regulate β-catenin expression in leukemia cells.
Methodology and Principal Findings: Triterpene glycosides(A, DA and KCY4) from Cimicifuga foetida, which grow in black stone town in Guizhou, had been isolated and reported their molecular structure and anti-tumor activity. In this study, we injected KG-1a cells into NOD/SCID mice to establish animal model of acute myelogenous leukemia(AML), and intervened model by three kinds of triterpene glycosides(A, DA and KCY4). Observing mice living conditions, cell cycle and apoptosis rate were analyzed by flow cytometry (FCM), meanwhile, protein expression changes of β-catenin, APC and cyclinD1 were tested by immunohistochemistry (IHC). The results demonstrated the function of medium concentration of triterpene glycosides against AML KG-1a cells was induced by self-renewal of Wnt/β-catenin signaling pathways in LSCs G1 arrest and apoptosis. Apparently, mediating the induction of expression of two key factors (APC and CyclinD1) could effect expression of β-catenin. It may play an important role in induction of G1 arrest and apoptosis by the self-renewal of Wnt/β-catenin signaling pathways.
Significance: Our findings show for the first time that Triterpene glycosides(A, DA and KCY4) from Cimicifuga foetida selectively reduces β-catenin stability in AML KG-1a cells. This suppressive effect is mediated by regulating APC and CyclinD1. The effect of KCY4 is more powerful than that of A or DA.KCY4 is likely to be used as a novel strategy to eradicate leukemia via elimination of LSCs.

Disclosures
No relevant conflicts of interest to declare.
"Osteonecrosis of Jaw (ONJ) after Bisphosphonate Treatment in Patients with Multiple Myeloma (MM) : Monocentric Experience of Decreasing ONJ Incidence after Preventive Measures."
Authors: Catania Gioacchino , Monaco Federico , Ladetto Marco , Pepe Paola , Limberti Giulia , Alessio Manuela , Baraldi Anna , Fasciolo Antonella , Fusco Vittorio 
Published: November 2019

Abstract

Disclosures
No relevant conflicts of interest to declare.
Taking "Cellfies": Blood Morphology in the Era of Smartphones
Authors: Fountzilas Christos , Le Isabelle , Mazo-Canola Marcela , Bowhay-Carnes Elizabeth , Karnad Anand 
Published: November 2019

Abstract
Background: Microscopic examination of blood and marrow smears by hematologists is an essential clinical skill at risk of extinction in this high-tech era. This skill is on the decline being replaced by the reliance on flow cytometry, FISH, and molecular diagnostics. Five years ago, we observed that photographs of the oil-immersion field (OIF) in focus could be taken by positioning the smartphone camera lens close to either eyepiece. The captured image could be viewed on the smartphone, swiped to view detail, stored, and shared. We coined the term "Cellfie" for this smartphone image of the OIF. Cellfies can be taken with any smartphone at any microscope, with most learners taking a few minutes for their first Cellfie, and experts able to take Cellfies in a few seconds. Since 2012, we have taught fellows to use Cellfies at the microscope in the hospital and in clinic, and we present the experience of our hematology fellows using Cellfies.
Methods: We surveyed past and current hematology fellows (Class of 2015-to Class of 2019) regarding their experience with Cellfies.
Results: Nineteen of the twenty fellows invited to participate in the survey responded (95%). Two were PGY IV, 4 were PGY V, and 6 were PGY-VI. Four were fellows who graduated and in practice for one year (3 fellows did not provide level of training). Fifteen of 19 fellows (79%) had taken a Cellfie at some point during their training. Five took <10 Cellfies, 4 took 10-20 Cellfies, and one fellow had taken 50 or more Cellfies. Eight (53%) fellows rated the technique as 'easy', and 6 as 'difficult' (40%); one patient found the technique 'very difficult'. Cellfies were commonly used for consultation (80% of responders) and morphology teaching or use in conferences (67%). Only 2 responders had ever used Cellfies to paste in the electronic medical record (EMR). Overall, 80% of the responders thought Cellfies as a very useful tool in their everyday hematology practice.
Conclusion: Cellfie use by hematology fellows has resurrected this essential clinical skill of expertise in blood morphology. We have found a way to rekindle a passion for morphology and renew enthusiasm amongst hematology fellows, residents, and students to use information from microscopy as an essential component of their clinical skills. Taking and sharing Cellfies has the potential to put microscope skills back at the bedside, enable rapid diagnosis and treatment, shorten time to intervention in emergencies (acute promyelocytic leukemia, microangiopathy syndromes for example), expedite consultation after-hours and weekends, improve the quality of documentation in EMRs, create a portfolio of stored images for review, and teaching, and enhance patient-care.

Disclosures
No relevant conflicts of interest to declare.