M Remberger

..Low serum-levels of r-ATG early after transplantation seem to be a strong predictor for acute GVHD grades III-IV, TRM and a low incidence of relapse in patients treated with thymoglobulin before unrelated donor UCBT...

..005). We concluded that re-transplantation using RIC is a valid option for GF, especially in patients with non-malignant disorders...

..1%, while it was 38.0 and 85.0% in patients with one (n=29) or two (n=10) risk factors (P<0.001). We concluded that risk factors for acute GVHD using RIC are similar as using myeloablative conditioning...

..Reasons for this may be improved tissue-typing techniques and supportive care and optimisation of the ATG dose...

..It should be analyzed before conditioning, especially in patients with coexisting infection since patients with increased CRP and infection seem to have a very poor outcome after ASCT...

..In patients with and without major ABO mismatch the incidence of GF was 7.5% and 0.6% (P = .02), respectively. Using an ABO major mismatched graft increases the risk for GF after unrelated donor hematopoietic stem cell transplantation...

..The problem of relapse still has to be remedied. Thus, several different developments together have resulted in significantly lower TRM and improved survival after HSCT over the last few years...

..Further studies are needed to fully understand the value of anti-HLA antibody testing in dUCB graft selection and its impact on transplantation outcomes...

..023. Low serum levels of r-IgG seem to be a strong predictor for aGVHD grades II-IV in patients treated with Thymoglobulin before unrelated donor HSCT...

..1). We found no differences in transplant-related mortality and survival in children and adolescents receiving BM or PBSC from unrelated donors. More rapid engraftment and a trend for less relapses in patients given PBSC grafts was noted...

..The cumulative probabilities of relapse were 37% in the both groups. This suggests that the Scandinavian population is more homogeneous with regard to minor histocompatibility antigens important for chronic, but not acute GVHD...

..01). One-year transplant-related mortality was 21% and 27% and survival was 53% and 54% in the BM and PBSC groups, respectively (NS). The 2-year relapse-free survival was 41% and 46% in the two groups, respectively...

..01). In patients with chronic myeloid leukemia (CML) in first chronic phase, 7-year LFS was 72% and 83% in the two groups, respectively...

..An HLA-C or -DQ mismatch had no significant impact on survival, TRM and relapse. In conclusion, compared with MUD, HLA class I allele mmUD had an increased risk of acute GVHD and TRM...

..6; P=0.03). However, when analysing HSCT performed with URD or RD grafts separately, BKV (OR 8.5; 95% CI 1.8-19.3; P=0.004) and MC (OR 5.9; 95% CI 1.3-11.3; P=0.009) increased the risk for HC only with a URD, but not with an RD graft...

..Thus, co-transplantation of MSC resulted in fast engraftment of absolute neutrophil count (ANC) and platelets and 100% donor chimerism, even in three patients regrafted for graft failure/rejection...

..However, in patients with early leukemia conditioning with BU + CY, our method of individualizing the GVHD prophylaxis might be of value, since this group had the best RFS in this study...

..Does conditioning with fractionated total body irradiation (fTBI) or busulfan (Bu) causes less salivary dysfunction compared with single dose (sTBI) after hematopoietic stem cell transplantation (HSCT)...

..We investigated whether it were possible to induce mixed chimerism and obtain an antitumor effect in a patient with a large primary liver cancer after combined liver and bone marrow transplantation (BMT)...

..01). Hence, the use of polyclonal ATG as part of conditioning prior to ASCT in children is safe and the survival rate encouraging...

..02), and conditioning with busulphan (P =.02). Our conclusion is that norethisterone treatment should not be used in patients undergoing BMT and heparin prophylaxis did not affect the incidence or mortality of VOD...

..006). Although the material is small and heterogeneous, engraftment was delayed, leukocyte chimerism was not significantly different and survival was superior using UCB rather than MM URD transplants...

..04) and an increased incidence of transplant-related mortality (27 vs 9%, P<0.01). IgG levels generally increase after SCT. Persistent low levels of IgG are a risk factor for death after SCT...

..The likelihood of PTLD is increased in the presence of specific risk factors. Monitoring of EBV DNA load and early administration of rituximab in patients with high EBV loads is recommended for high-risk patients...

..In conclusion, the pretransplant cytotoxic T- and/or B-crossmatch is a poor predictor of rejection after allo-SCT...

..In conclusion, G-CSF given after HLA-identical sibling HSCT was associated with a higher risk of grades II-IV acute GVHD, but not transplant-related mortality...

..To conclude, major complications increased the costs of HSCT. Unrelated donor transplants were more expensive than HLA-identical sibling transplants. Costs were reduced in patients treated with NMC...

..On the basis of these findings we conclude that a consideration to NOD2/CARD15 mutation status is not pertinent when selecting a donor for Allo-SCT at our centre...

..04) influenced HHV-6 DNA levels. HHV-6 viral load was significantly correlated with delayed platelet engraftment in both univariate (P < 0.01) and multivariate analysis, and to the number of platelet transfusions...

..01). In multivariate analysis adjusted for diagnosis, busulphan-treated patients showed both a better survival (P=0.04) and less probability of relapse (0.03) compared to TBI-treated patients...

..Most patients died of GVHD, with virus or fungal infections as contributing causes of death. To conclude, treatment of severe acute GVHD is difficult and ATG, in our hands, adds nothing to conventional pharmacological treatment...

..The aim of this study was to investigate the relationship between cytomegalovirus (CMV) and extensive chronic graft-versus-host disease (GvHD) after allogeneic stem-cell transplantation (SCT)...

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..03). To conclude, home care after SCT is a novel and safe approach. This study found it to be advantageous, compared with hospital care...

..The 5-year survival was 72%, 48%, and 30% with 0, 1, and 2 risk factors, respectively. We concluded that unrelated hematopoietic stem cell transplantation may be improved if an optimal donor and immunosuppression are chosen...

..To investigate the correlation between age, degree of disturbances in dental development, and vertical growth of the face in children treated with hematopoietic stem cell transplantation (HSCT)...

..GVHD, infections and age are more important for immune reconstitution than type of conditioning...

..03). Treatment-related mortality was 4 and 15%, and 5-year survival was 89 and 85% in the FBC and MC groups. Although survival was similar, FBC is a promising alternative to MC in non-malignant disorders...

..Interindividual variations in CsA uptake and metabolism may explain the wide variation of C2 levels without prediction for increased risk for severe aGVHD or infectious complication when C0 guided the CsA dosing...

..PBSC from HLA-compatible unrelated donors can be used safely as an alternative to BM for stem cell transplantation...

..There were two patients in the NAC group who developed VOD, as compared to three of the controls. To conclude, NAC does not improve liver toxicity after ASCT...

..Patients with previous acute GVHD grades II to IV may benefit from more aggressive initial treatment. This possibility would have to be examined in clinical trials...

..Acute GVHD was not an independent predictor for relapse or death in this study. This study is in support of a GVL effect in childhood leukaemia related to chronic GVHD, reducing the risk of relapse and improving survival...

..In conclusion, infections occurring later than 6 months after HSCT are important contributors to late non-relapse mortality after HSCT. CMV infection or acute GVHD markedly increase the risk...

..In this study, PCR on peripheral blood was a poor indicator of IFI early after RIC HSCT. Aspergillus PCR tests performed on clinical suspicion after day 100 were insufficiently sensitive to be diagnostically useful...

..CONCLUSION: In multivariate analysis, high donor age, immunized female donor to male recipient, and grades II-IV acute GVHD were significantly associated with a longer time to clinical tolerance...

..In conclusion, PBSCs from HLA-compatible unrelated donors results in similar outcome compared to BM but implies an increased risk for extensive chronic GVHD...

..Our results provide evidence against the emergence of alloreactive NK cells in HLA-identical allogeneic SCT...

..52, P=0.001). The reduction in relapse risk associated with cGVHD is consistent with a beneficial graft-vs-myeloma effect, but this did not translate into a survival advantage...

..27-0.97, P value = 0.03). No significant difference in the risk of relapse was seen (P = 0.63). This suggests that Thymoglobulin during conditioning may reduce non-relapse mortality after unrelated donor marrow transplantation...

..BAL resulted in a changed treatment in 32/68 (47%) episodes of pneumonia. To conclude, BAL is a safe and useful diagnostic procedure that should be performed early after the onset of pneumonia following allogeneic HSCT...

..04). Home care after ASCT is a novel approach that resulted in less TRM, similar incidence of chronic GVHD and relapse, and improved long-term survival compared to controls treated in the hospital...

..022). This study emphasizes the importance of early disease stage and presence of chronic GVHD for effective DLI...

..The purpose of this study was to determine whether body mass index (BMI, kg body weight/height (in m2) is related to survival in recipients of allogeneic stem cell transplantation (ASCT)...

..39) and death (RR 0.42). We conclude that in children with leukemia other specific donor characteristics such as HLA-matching, gender, parity, and exposure to herpes viruses were more important for outcome than relationship...

..49, 95% confidence interval (CI)=1.40-30, P=0.014) and seropositivity of the recipient for 3-4 herpesviruses (OR=6.57, 95% CI=1.26-34, P=0.021) and a low stimulated salivary secretion rate (<0.5 mL/min) was found 1 year after HSCT...

..While these sera promote cell growth and viability, they contain uncharacterized elements that may yield inconsistent results from batch to batch. Cell expansion in serum-free media would therefore be preferable...

..Overall and relapse-free survival were not improved by the occurrence of acute GVHD...

..CONCLUSION: Patients with metastatic RCC, less than three metastatic locations and a Karnofsky score >70% can be considered for HSCT. Posttransplant DLI and limited chronic GVHD improved the patient survival...

..01). In multivariate analysis of death, SOFA score was the only significant factor (P<0.001). In conclusion, SOFA score predicted prognosis in ASCT patients treated at the ICU...

..005). In conclusion, for patients entering transplantation while they have residual disease, a combination of acute and chronic graft-versus-host disease may be needed to decrease the risk of relapse after SCT...

..In conclusion, the quantitative RT-PCR of granzyme B, perforin and FasL may serve as a guide to the clinician in diagnosing acute GVHD and monitoring treatment...

..However, the regression of some metastases associated with GVHD provides suggestive evidence that the GVHD effect may occur in renal and colon adenocarcinoma using reduced intensity conditioning...

..We conclude that HSCT with HLA-A, -B, and -DRbeta1 genomically matched unrelated donors in combination with antithymocyte globulin in the conditioning regimen gives encouraging results in patients with SAA or IEM...

..Thymoglobulin given before allo-hematopoietic stem-cell transplantation (HSCT) from unrelated donors reduces acute graft-versus-host disease (GvHD), but the optimal dose is unknown...

..01), and an HLA-matched donor (P=.01). The association between herpes simplex virus infection and a low frequency of relapse is a new observation and may indicate that viral antigens play a role in the induction of an antileukemic effect...

..5% (five of eight) in the BuCy group. In conclusion, the addition of melphalan to the BuCy conditioning regimen resulted in severe gastrointestinal complications and did not improve overall survival...

..66, confidence interval 1.44-40.7, P=0.016). Poor oral intake early after SCT may be associated with an increased risk of developing severe acute GVHD...

..It has been suggested that MSC may be trapped in bone marrow (BM) filters during the stem cell procurement and lost from the HSC graft...

..It was found that the time the patients had GVHD did not differ among the three groups. In conclusion, the costs and survival rates associated with severe acute GVHD has increased in recent years...

..Therefore, this study evaluates the gene expression pattern in the peripheral blood of patients after allogeneic stem cell transplantation and correlates the results to acute GVHD...

..The aim of this study was to elucidate the effect of the type of chemo-radio therapy given before allogeneic hematopoietic stem-cell transplantation (HSCT) on cytokine release...

..Although they are not specific for acute GVHD, quantitative monitoring of the gene expression of chemokine receptors may be a valuable molecular method to monitor and diagnose acute GVHD...

..The role of serum concentrations of rabbit antithymoglobulin (ATG) in the development of acute graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (HSCT) with unrelated donors is unknown...

..The impact of lowering the platelet (PLT) count threshold for prophylactic PLT transfusion on bleeding and PLT use in allogeneic hematopoietic progenitor cell (HPC) transplant recipients is a matter of debate...

..02). Finally, hemorrhagic cystitis and BK-viruria were less common in patients receiving RIC, rather than full conditioning (p<0.01 and p<0.01, respectively)...

..6; P=0.03). CONCLUSIONS: NM conditioning with posttransplant immunosuppression using CsA and MMF resulted in less leukopenia and fewer transfusions, but resulted in more cases of graft failure, acute GVHD, and TRM than in RIC patients...

..01). In conclusion, graft failure was only associated with inferior survival in malignant disease. Non-malignant disorders, HLA match, conditioning intensity, immunosuppression regimen and cell dose all influenced graft failure risk...

..Our study showed that outcome after allo-SCT in de novo AML differs depending on cytogenetic risk-group; however its position in post-remission therapy of eligible AML patients is not threatened...

..The awareness of HLA class I- and II-mismatches in a recipient-donor pair makes it possible to give appropriate pre- and post-transplantation treatment...

..BKV load in combination with acute GVHD discriminated the best, while BKV and viral load alone, but not GVHD, still showed predictive ability for HC...

..With four risk factors, the risk of HC development was 31%. Risk factors for severe HC of grades 3-5 were aGVHD and bacteremia...

..81, P=.02) and aGVHD (HR 0.84, P=.05). These results indicate that LC30 is an independent prognostic factor for transplant outcome in matched unrelated SCT for myelogenous malignancies...

..To conclude, NAC appears to increase acute GvHD and has an immunostimulatory effect on alloantigen-specific T cells...

..01). Acute GVHD grades II-IV were more common among patients homozygous for the IL-10-1064 allele 13 (P = 0.02). Patients homozygous for the TNF-308 allele (AA) correlated with higher TNF-alpha serum levels during conditioning (P = 0.02)...

..Total body irradiation and bone marrow were found to be prerequisites for acute GVHD. This study encouraged us to perform a retrospective clinical study...

..The use of reduced intensity conditioning (RIC) regimens in allogeneic hematopoietic stem cell transplantation (HSCT) has increased over the past five years...

..The objective of this study was to determine risk factors in PTLD following HSCT in order to identify high-risk patients for surveillance, prophylaxis and treatment...

..Some patients become full donor chimeras (DC) early after stem-cell transplantation (SCT), while others remain mixed chimeras for a longer time. Little is known about the mechanism behind these phenomena...

..These results show that major histocompatibility comlex (MHC) alleles may influence the incidence of GVHD in HSCT with HLA identical sibling donors...

..01). Thus, an increased level of I cytokines possibly mirrors tumor killing induced by type 1 T-cell response. Furthermore, anti-I cytokines might inhibit cytotoxic cells from exerting the antitumor effect of allogeneic SCT...

..Allogeneic hematopoietic stem cell transplantation (ASCT) is a possible cure for many inherited disorders...

..Mesenchymal stem cells (MSC) have immunomodulatory effects. The aim was to study the effect of MSC infusion on graft-versus-host disease (GVHD)...

..We performed a non-randomized study comparing low intensity conditioning with reduced intensity conditioning after stem cell transplantation to demonstrate the graft-versus-tumor effect...

..This study aims to determine the total costs after allogeneic hematopoietic stem cell transplantation (ASCT) and factors associated with increases or decreases in costs...

..Number of positive herpes group viral serologies in the recipient before transplantation and certain electrolyte disturbances may contribute to neurological complications after HSCT...

..Mesenchymal stem cells modulate immune responses in vitro and in vivo. We aimed to assess whether mesenchymal stem cells could ameliorate GVHD after haemopoietic-stem-cell transplantation...

..8% compared to 8.9% during the first decade. We conclude that the rate of mortality related to pneumonia has decreased over time, possibly as a result of improved diagnostic, prophylactic and therapeutic methods and treatment...

..Acute graft-versus-host disease (GVHD) was reduced using home care compared with hospital care after allogeneic hematopoietic stem-cell transplantation (ASCT)...

..We encourage the use of combination GVHD prophylaxis in children. ABO mismatch should be considered when choosing between otherwise equally suitable donors...

..G-CSF has no effect on relapse. Available findings suggest that there is no indication to use G-CSF as prophylaxis after ASCT...