bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparable Outcomes of High-Resolution HLA-Matched Unrelated and HLA-Identical Sibling Donor Stem Cell Transplantation for Childhood Acute Myeloid Leukemia in First Remission.
Authors: Lee Dae-Hyoung , Kwon Young-Joo , Chung Nak-Gyun , Jeong Dae-Chul , Kim Hack-Ki , Cho Bin 
Published: October 2019

Abstract
Purpose: The role of allogeneic stem cell transplantation (SCT) from unrelated donor for childhood acute myeloid leukemia (AML) in first remission remains unclear because of its high transplant-related mortality. In this study, we investigated the role of SCT from high-resolution HLA-matched unrelated donor for childhood acute myeloid leukemia in first remission by comparing the outcomes of SCT from HLA-identical sibling donors and high-resolution HLA-matched unrelated donors. Patients and
Method: Between June 2002 and August 2005, 40 children who have AML in first complete remission received SCT at Saint Mary’s hospital in Korea. In SCT from 17 sibling donors (M-SBMT), low-resolution typing (two-digit level) for HLA-A, -B, -C and -DRB1 was performed and all of donor-recipient pairs were 8/8 matches. Unrelated donors and recipients were typed for HLA-A, -B, and -DRB1 by high-resolution molecular typing (four-digit level). Of the 23 unrelated donor-recipients pairs, 14 were 6/6 matches (M-UBMT) and 9 were 5/6 matches (MM-UBMT). Conditioning regimen consisted of busulfan i.v. and cyclophosphamide. All patients received cyclosporin A and short-course methotrexate for GVHD prophylaxis.
Results: Of the 40 patients, 27 survived event-free with a median follow-up of 38 months (range, 23–57 months). Median times for neutrophil engraftment were 12 days(range, 11–15 days), 11 days(range, 10–16 days) and 12 days(range, 11–15 days) for M-SBMT, M-UBMT and MM-UBMT, respectively. The number of Grade II-IV acute GVHD was 5 (29%), 7 (50%) and 6 (67%) in the M-SBMT, M-UBMT and MM-UBMT, respectively. One patient in MM-UBMT developed grade III acute GVHD. The number of patients who developed chronic GVHD was 2, 6 and 4 in the M-SBMT, M-UBMT and MM-UBMT,respectively. The number of relapsed patients after SCT was 3, 2 and 1 in the M-SBMT, M-UBMT and MM-UBMT and the number of non-relapse death was 2, 2 and 4, respectively. The Kaplan-Meier estimates for event-free survival at 3 years were 70 ± 11%, 71 ± 12% and 44 ± 17% for M-SBMT, M-UBMT and MM-UBMT, respectively without statistical significance (p=0.38). The Kaplan-Meier estimates for overall survival at 3 years were 76 ± 10%, 71 ± 12% and 44 ± 17% for M-SBMT, M-UBMT and MM-UBMT,respectively (p=0.25).
Conclusion: In this study, we showed the outcome of SCT from high-resolpution HLA-matched unrelated donors was comparable with that of SCT from HLA-identical sibling donors in childhood AML in first remission. Therefore, high-resolution HLA-matched unrelated SCT might be recommended in patients without HLA-matched sibling donor in childhood AML in first remission.
Fludarabine, Amsacrine, High-Dose Cytarabine and Total Body Irridation Followed by Allogeneic Stem Cell Transplantation for the Treatment of High Risk or Relapsed Acute Lymphoblastic Leukemia.
Authors: Zohren Fabian , Graef Thorsten , Bruns Ingmar , Czibere Akos , Roland Fenk , Rainer Haas , Guido Kobbe 
Published: October 2019

Abstract
In this prospective study we examined the use of an intensified conditioning regimen followed by allogeneic blood-stem-cell transplantation (BSCT) for the treatment of young adults in physically good condition with relapsed or high risk acute lymphoblastic leukaemia (ALL). Eleven patients with ALL received FLAMSA chemotherapy (fludarabine 30mg/m2 - cytarabine 2000mg/m2 -amsacrine 100 mg/m2 on day −10, − 9, − 8and −7), Anti-Thymocyte-Globulin (ATG 20 mg/kg BW on day −6, −5 and −4) and fractionated TBI (2 x 2 Gy on day −3, − 2 and −1) followed by matched unrelated donor (n=10) or matched sibling donor (n=1) SCT. The principle reasons for high risk stratification were refractory disease during first-line induction therapy (6, 55%), relapse (2, 18%), extramedullary disease manifestation (1, 9%), ALL subtype (6, 55%), unfavorable cytogenetics (5, 45%) and white blood count >30000 μL at time of diagnosis (3, 27%). After a median follow-up time of 604 days (range 202 – 1042 days) 8 patients (73%) are alive and 3 patients (27%) died. The median overall survival was not reached. Two patients died after relapse on days +121 and +449, another patient died from treatment related complications (HUS-TTP) on day +87. One patient relapsed on day +200 and is currently alive, the remaining 7 patients are alive and free of desease. Treatment related toxicities were acceptable. With 6 out of 11 patients developing grade III/IV infections during neutropenia, infectious complications remained of major importance. Other non-haematological side effects seen within this group of patients were less frequent and almost exclusively limited to gastrointestinal toxicities. Five patients (45%) had grade III/IV mucositis and 5 patients (45%) had grade III/IV nausea, while 4 patients (36%) showed grade III/IV diarrhoea. There was no case of acute toxicity related to the cardiavascular or central nervous system. The incidence of acute GvHD (aGvHD) was 36% (n = 4) and limited to grades II-III. Eight patients were evaluable for chronic GvHD (cGvHD). Out of those 4 patients (36%) developed cGvHD (3 limited disease, 1 extensive disease). We conclude that allogeneic transplatation after the FLAMSA-ATG-TBI regimen is feasible and provides effective therapy for this group of high-risk patients.
Initial Cytoreductive Treatment with Thalidomide Plus Bolus Vincristine/Doxorubicin and Reduced Dexamethasone (T-bVAd) Followed by Autologous Stem Cell Transplantation (ASCT) for Multiple Myeloma.
Authors: Jo Jae-Cheol , Kang Byung Wook , Sym Sun Jin , Lee Sung Sook , Jang Geundoo , Lee Dae Ho , Kim Sang-We , Suh Cheolwon 
Published: October 2019

Abstract
High-dose chemotherapy supported by autologous stem cell transplantation (ASCT) after the combined chemotherapy with vincristine, doxorubicin and dexamethasone (VAD) is an effective therapy for newly diagnosed, multiple myeloma. Bolus vincristine/doxorubicin intravenous administration as an outpatient route is convenient and has acceptable efficacy and toxicity. Thalidomide has recently shown significant antimyeloma activity. We studied the efficacy and toxicity of the combination of bolus vincristine/doxorubicin and reduced-dose of dexamethaxone with thalidomide (T-bVAd), administered on an outpatient basis in previously untreated multiple myeloma. From August 2005 to December 2006, 26 patients were enrolled in a prospective study. All patients received T-bVAd, which consisted of vincristine 0.4 mg intravenously i.v., doxorubicin 9 mg/m2 i.v. administered as single bolus dose on days 1 to 4, and dexamethasone 20 mg per os daily for 4 days. Dexamethasone was also given on days 8 to 11, 15 to18 of the each cycle of treatment. The regimen was administered every 4 weeks for four courses. Thalidomide was given daily at a dose of 200 mg at bedtime. Response to treatment was evaluated after each cycle of treatment. After achieving response, the patients were allowed to proceed to high-dose chemotherapy with ASCT. On an intention-to-treat basis, 23 of the 26 patients (88.4%) responded to treatment. Sixteen patients (61.5%) achieved complete and seven (26.9%) partial response. Only three (11.6%) were rated as non-responders. Grade 3 or 4 toxicities consisted of neutropenia (9%), febrile neutropenia (6%), thrombocytopenia (4%) without significant nonhematologic events. Of the 23 patients who showed response, 9 proceeded to single ASCT and 7 tandem ASCT. Median event-free survival and median overall survival were not reached yet. As an induction therapy, T-bVAd administered as an outpatient regimen, seems to be efficient and well tolerated.
Reduced-Intensity Conditioning for Allografting Following Autografting for Myeloma: Lower Relapse Rates Compared with Single or Double Autografting but Similar Overall Survival. The Genoa Experience in 74 Patients.
Authors: Carella A.M. , Catania G. , Biasco S. , Congiu M. , Nati S. , Rossi E. , Vimercati R. , Ciapanna D. , Spriano M. 
Published: October 2019

Abstract
Multiple Myeloma (MM) is the most frequent indication for autolografting and allografting. Autografting (AutoSCT) represents the most effective palliation for these patients. Even the double AutoSCT where there is demonstrated good long-term control in a minority of patients do not appear to result in cure of disease. Myeloablative AlloSCT is penalized by excessive transplant-related mortality (TRM) and toxicity.The introduction of reduced-intensity conditioning for allografting (RICT) has renewed interest in the use of AlloSCT for MM. Recent studies have reported encouraging results with tandem AutoSCT followed shortly thereafter by RICT in MM patients as compared to AutoSCT or myeloablative AlloSCT alone. Here we present the results achieved in our Unit in patients receiving AutoSCT (single or double) compared to patients receiving tandem AutoSCT/RICT. The major results are summarized in the table. In the AutoSCT/RICT group the risk of disease progression was reduced for those patients who achieved full chimerism, acute and/or chronic GVHD. This finding confirms the existence of a graft-versus-myeloma effects. Since the first clinical signs of response of remitters patients were noted between 70 and 120 days and maximum response between 160 and 200 days after RICT (and after DLI in 2 patients) these responses should be considered immunological responses. In conclusion, these data suggest that AutoSCT/RICT significantly reduces the incidence of disease progression but did not impact on overall survival with respect to single or double AutoSCT.
Single Double AutoSCT AutoSCT AutoSCT + RICT (n=15) (n=35) (n=24) Age, median 64 (range 48–73) 62 (range 35–73) 50 (range 34–63) No. prior cycle chemoth., median 5 (range 3–8) 4 (range 3–6) 4 (range 3–6) Conditioning regimen for AutoSCT Melph. 200 mg/m2 Melph. 200 mg/m2 Melph. 200 mg/m2 Conditioning regimen for RICT ==== ==== TBI-Flu (19 pts) Flu-Melph. (5 pts) Days from Dx to AutoSCT, median 210 (range 120–390) 320 (range 120–840) Days from AutoSCT to RICT ==== ==== 80 Overall Survival 73,3% (11/15) 60% (21/35) 66% (16/24) Median Overall Survival 37 (range 10–132) 51 (range 13–147) 28 (range 6–87) Pts alive in CR 1 (6,6%) 4 (26,6%) 10 (41,6%) CR duration, median 20 mo. 56 mo. (range 28–70) 67 mo. (range 8–78) TRM 1 ==== 3
Hematopoietic Cell Transplantation - Comorbidity Index (HCT-CI) as a Surrgoate Marker for Predition of Transplant Outcome for Pateints (pts) with Multiple Myeloma (MM) Undergoing Autologous Stem Cell Transplantation (ASCT): High HCT-CI Score Predicts for Poor Outcome.
Authors: Farhat Mohamed I. , Myint Ronald , Gregory Stephanie A. , Venugopal Parameswaran , Kassar Mohamad , Gimelfarb Alla , Batus Marta , Nangia Julie , Maciejewski John , Law Amanda , Fung Henry C. 
Published: October 2019

Abstract
Background: For all “transplant eligible” pts with MM, established practice guidelines recommend ASCT as part of the front line treatment. However, the definition of “transplant eligible” remains undefined. The HCT-CI is a new tool that encapsulates pre-transplant comorbidities used in predicting transplant outcomes in pts undergoing allogeneic SCT. This scoring system has been shown to be a good predictor for non-relapse mortality (NRM) & survival in pts undergoing alloSCT. In this study, we hypothesize that HCT-CI could predict the transplant outcome on pts with MM undergoing ASCT and could potentially be utilized as a tool for selecting pts with MM for transplant.
Methods: A retrospective analysis of 75 pts with multiple myeloma whom underwent ASCT in our institution between 02/99 and 12/03 with a median follow up of 30 months. Pts were assigned scores based on the HCT-CI. Definitions of comorbidities were as previously reported by Sorror et. al. (Blood2005; 106:2912).
Results: Median age was 56 years (38 – 73); M:F 1:1. 51 pts received a single & 24 had tandem ASCT. The majority of pt. had IgG myeloma (IgG kappa: 45; IgG Lambda 17). Comorbidities (points, number of pts): mild hepatic (1,16), renal (2,6), cardiac (1,8), arrhythmia (1,1), heart valve disease (3,4), cerebrovascular (1,8), DM (1,11), PUD (2,2), inflammatory bowel disease (1,0), Tumor (3,6), pulmonary (2,5), psychiatric (1,8), rheumatologic (2,3), infection (1,6), and obesity (1,10). HCT-CI score of 0 seen in 32%, 1 in 28%, 2–8 in 40% of the pts, with a median score of 1.65. 20 patients died with only one due to NRM. Pts were categorized into 2 groups: low-risk (scores of 0–1) – 46 pts and high-risk (scores 2–8) – 29. Using a cox regression model, the low risk group had a survival advantage (HR = 2.55, P = 0.04). Using Kaplan Meier survival estimate comparing the low risk and high risk group (figure1), the 5 yrs overall survival were 77% & 22% respectively (P = 0.04). While the median survival for the high risk group was 3.52 years, it has not been reached for the low risk group.
Conclusion: Here, we have demonstrated a survival benefit for pts with low (0–1) compared with high (≥ 2) HCT-CI score. In addition, the outcome of pts with high HCT-CI score was also similar to non-transplant pts as published in the literature. This raises the question of “benefit” of ASCT for pts with high HCT-CI score. Thus, HCT-CI may serve as a useful tool to select pts whom would benefit most from ASCT.
Figure 1 Figure 1
Rituximab Improves the Outcome of Upfront Autologous Stem Cell Transplantation in Mantle Cell Lymphoma: A Comparison of Different Strategies.
Authors: Rieger Michael , Witzens-Harig Mathias , Hensel Manfred , Seyfarth Baerbel , Nickelsen Maike , Kneba Michael , Schmitz Norbert , Ho Anthony D. , Dreger Peter 
Published: October 2019

Abstract
Introduction: First-line autologous stem cell transplantation (SCT) is an accepted therapy for mantle cell lymphoma (MCL). We have recently shown that 2 standard doses of rituximab significantly improve the outcome of TBI-based upfront SCT in MCL when administered peritransplant (Haematologica 92:42; 2007). The purpose of the present retrospective analysis was to compare this approach with alternative rituximab-based strategies. Patients and treatment strategies: 34 consecutive patients treated in KI-HH received 3–6 cycles of CHOP prior to stem cell mobilization with Dexa-BEAM (n=20) or DHAP (n=14), followed by TBI-cyclophosphamide-rituximab myeloablation and SCT (CHOP/R-TBI-CY group). Patients treated in HD received 3–8 cycles of R-CHOP for cytoreduction (n=28) and mobilization (n=23; the remaining 5 patients were mobilized with R-DHAP/HAM) followed by BEAM and SCT (R-CHOP/BEAM group). 12 patients of this group received additional rituximab maintenance after SCT.
Results: With a median follow-up of 38 months (9–111), estimated 4-year progression-free survival (PFS) from diagnosis of patients treated with CHOP/R-TBI-CY and R-CHOP/BEAM was 83% and 72% (log rank, p=.38), respectively. Of note, with a median follow-up of 30 months (14–57) there was no relapse in the 12 pts receiving maintenance therapy with rituximab, translating into a significantly better 4-y PFS in patients receiving R-CHOP/BEAM with rituximab maintenance vs those without (100% vs. 56%; p=.021). The PFS difference between the R-CHOP/BEAM group and the CHOP/R-TBI-CY group became borderline significant after omitting the rituximab maintenance patients (p=.055).
Conclusions: In advanced-stage MCL, addition of rituximab improves disease control provided by first-line SCT. Whereas the exact dose and timing of rituximab administration remains to be settled, prospective investigation of post-transplant rituximab maintenance appears to be particularly promising.
Transplantation in the Elderly: The Affect of Age on Clinical Course and Outcomes.
Authors: Canary Marcy , Hill John M. , Meehan Kenneth R. 
Published: October 2019

Abstract
Hematopoietic stem cell transplant (HSCT) is often the treatment of choice for a number of hematologic malignancies at the time of relapse. Historically, older patients have been excluded from receiving HSCT due to concerns about the potential for increased toxicity and treatment related mortality (TRM). We performed a retrospective analysis of patients undergoing autologous HSCT over a six year time period at our institution evaluating age as a prognostic factor. Adult patients (18 years and over) who received a HSCT between the years 2000 and 2006 were evaluated. The patients were divided into two cohorts based on age, the “senior” cohort (≥62 years) and the “younger” cohort (≤61 years). Individual patient chart reviews yielded pertinent information. Of the 181 patients who received a transplant during this time period, 131 patients (median age of 50 years: range 19–61) comprised the “younger” cohort and 50 patients (median age of 66 years: range 62–73) were included within the “senior” cohort. There was no statistical difference between these two groups when the following were evaluated: time to engraftment (p values of 0.13 for neutrophils and 0.2 for platelets), length of hospital stay (p = 0.5), incidence of infection (p = 1), transfer to the ICU (p = 0.08) or TRM (p = 0.3). This analysis is the largest study of its size evaluating outcome of autologous HSCT based on age using current transplant protocols, including primarily peripheral stem cell transplants. It is also the first study to specifically address incidence of infection in older patients, which has been suggested by other studies to increase TRM in elderly patients. Our data indicate that toxicity of autologous HSCT is similar in older patients when compared to younger patients and that this treatment should be offered to elderly patients with hematologic malignancies who may benefit from autologous stem cell transplantation.
Improved Relapse Free Survival Is Predicted by a Negative Pre-Transplant FDG-PET Scan Following Salvage Chemotherapy for Relapsed Diffuse Large B Cell Lymphoma (DLBCL) Treated with Autologous Stem Cell Transplantation.
Authors: Dickinson Michael J. , Hoyt Rosemary , Roberts Andrew , Grigg Andrew , Seymour John Francis , Szer Jeff , Prince H. Miles , Ritchie David 
Published: October 2019

Abstract
Introduction FDG-PET imaging is a powerful predictor of both positive and negative outcome of initial therapy for DLBCL. Existing data on the utility of PET to predict outcome of ASCT have included a range of histological subtypes, limiting its direct applicability to the setting of DLBCL.
Methods Data from 41 consecutive patients who had PET scans immediately prior to undergoing ASCT for treatment of first relapse of de novo DLBCL were analysed. We compared the clinical characteristics, event free survival (EFS) and overall survival (OS) of those with residual FDG avid disease (n=21) against those without FDG avid disease (n=20).
Results The median age was 53(18–71). Patient characteristics are shown in the table. At 3 years, the OS was 67(±8)%, and the EFS was the 62(±8)%. EFS for PET positive patients was 38(±12)% vs 79(±9%) for PET negative patients (p=0.04). OS was 37(±17%) vs 81(±10%) (p=0.08) respectively.
Conclusion Excellent EFS and OS can be anticipated from ASCT when undertaken in those who have achieved a PET negative remission following salvage chemotherapy. Conversely, failure to achieve a PET negative remission after salvage chemotherapy in relapsed DLBCL predicts for a poorer, but not irretrievable outcome after ASCT, suggesting that a proportion of PET positive patients can be successfully salvaged by either ASCT or post-ASCT salvage therapies.
Patient Characteristics PET Positive (n=21) PET negative (n=20) PET negative (n=20) Female 28% 40% Median Age (Range) 53 (28–65) 53(81–71) Salvage Regimen ICE ±R 66% ICE ±R 80% Conditioning Regimen BEAM 47%, SBCNU 23% BuMel 14% other 16% BEAM 25%, SBCNU 25% , BuMel 25% other 25% Rituximab with salvage 71% 95% Rituximab in initial therapy 33% 25% RT with salvage or ASCT 43% 25%
Factors Predicting PBPC Collections in Healthy Adolescents and Children with Solid Tumours.
Authors: Roncon Susana , Barbosa Isabel L. , Lopes Sergio M. , Ferreira Sara , Avila Alcina , Norton Lucilia , Pimentel Pedro , Cravalhais Alzira 
Published: October 2019

Abstract
G-CSF is used for mobilization of hematopoietic cells in healthy adolescent donors and pediatric patients. In both groups it is important to ascertain factors predicting the success of apheresis as well as the number of procedures to achieve the target CD34+ cell number for hematologic recovery. We retrospectively analyzed factors predicting the yield for a target CD34+ cell dose in10 healthy adolescent donors and 43 children with solid tumours who were enrolled in the transplantation program at our center from January 1996 to July 2007. The healthy adolescents (n=10) had a median age of 15 years (range 13–16) and body weight (bw) of 45 kg (range 20–74) and the children with solid tumours (n=42) (Neuroblastoma n=28, Ewing sarcoma n=7 and other solid tumours n=7) had a median age of 4 years (range 1–15) and bw of 17 kg (range 9 – 63). Mobilization regimen consisted of G-CSF in a dosage of 10 μg/kg per day, applied subcutaneously for 5 or 6 days. A pre-collection peripheral blood (PB) CD34+ count was performed in all children, by flow cytometric analysis. Standard volume apheresis was carried out using a Cobe Spectra blood cell separator, through peripheral veins in donors and central lines in patients. We estimated a minimum of 4 x106 and 2x106 CD34+ cells/kg bw receptor for successful engraftment for allogeneic and autologous transplant, respectively. The healthy adolescent donors had high number of PB CD34+ cells (median 62/μl, range 42 – 75) and the majority (7/10) only required a single apheresis to collect sufficient cells for their family related recipients. The neuroblastoma patients with >10/μl PB CD34+ cells collected in one day the target cell dose (median 4.6x106 CD34+ cells/kg, range 2.6 – 27.0). Those with <10/μl PB CD34+ cells underwent 2 apheresis and the majority reached the cell target. The majority of children with Ewing sarcoma and other solid tumours (9/14) also collected >2.0 x106 CD34+ cells/kg in 2 apheresis. In summary all the children with solid tumours received a single course of G-CSF and presented on the 5th day of mobilization a median PB CD34+ cell count of 9/μl (range 1–216). The majority (75%) collected >2.0 x106 CD34+ cells/kg and the remaining (25%) had <10/μl PB CD34+ cells and did not achieve this minimum requirement. We found a correlation between the PB CD34+cell count and the number of apheresis and CD34+ cells yielded both for the adolescent donors and children with solid tumours. Based on these results, a PB CD34+ cell count >10/μl was a good indicator for performing PBPC collections in paediatric patients from our institution.