Sergio A Giralt

..New agents being developed for MDS may have a potential impact on transplant outcomes. Therefore, design and implementation of clinical trials of transplant for MDS should be encouraged to improve the natural history of this disease...

..These trials should allow more patients with acute myeloid leukemia or myelodysplastic syndromes to achieve long and productive lives...

..The panel was asked to discuss a variety of issues regarding stem cell collection and transplantation in myeloma especially with the arrival of plerixafor. Herein, is a summary of their deliberations and conclusions...

..New agents being developed for MDS may have a potential impact on transplant outcomes. Therefore, design and implementation of clinical trials of transplant for MDS should be encouraged to improve the natural history of this disease...

..However, only prospective trials will define the optimal role of this therapy in patients with hematologic malignancies. Therefore, URD transplantation with RIC should continue to be explored in the context of clinical trials...

..Most patients now receive a trial of imatinib before proceeding to HCT...

..Estimated 3-year progression-free and overall survival rates were 31 and 57%. Our study suggested that the use of IL-2 and growth factors immunomodulation with HDC/AHST was feasible with comparable survival rates...

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..The outcomes of salvage autologous or allogeneic transplants were analyzed retrospectively in patients relapsing after an autograft...

..03). In conclusion, selected patients with a LVEF of < or =45% can safely receive allo-HCT without a significant increase in cardiac toxicity or NRM...

..In this analysis, a melphalan (Mel) dose of 200 mg/m(2) was not associated with an increase in toxicity or nonrelapse (Mel) mortality (NRM)...

..Our results suggest that age alone should not be the primary reason for exclusion from receiving myeloablative reduced-toxicity conditioning with i.v. Bu-Flu preceding transplantation in patients with AML/MDS...

..Thorough assessment and understanding of symptoms and risk factors for symptom development after ASCT are logical first steps toward developing strategies aimed at reducing the symptom burden associated with this procedure...

..The role of DLI needs to be further explored in prospective clinical trials...

..In conclusion, a significant number of CD34+ cells can be safely collected in patients with CML who are on imatinib therapy, but CD34+ cell yields improve when imatinib is temporarily withheld...

..We conclude that high tumor mass at diagnosis predicts a significantly shorter remission duration for myeloma patients undergoing autografting...

..02 and .08, respectively). Deletion 1p is associated with a significantly shorter remission and survival in patients undergoing high-dose therapy and a single autologous transplant for myeloma...

..Anti-HLA sensitization should be evaluated routinely in hematopoietic stem-cell transplantation with HLA mismatched donors...

..We conclude that evidence of disease on PET/G scanning prior to transplantation is associated with an increased risk for relapse after ASCT. Transplantation regimens containing rituximab can reduce this risk, regardless of PET/G status...

..The authors hypothesized that low doses of the hypomethylating agent 5-azacitidine may maximize the graft-versus-leukemia effect and may be tolerated well after allogeneic transplantation (HSCT)...

..Use of unrelated donors increased the risk of NRM only among patients with active disease. FM and HSCT elicited long-term disease control in a significant fraction of this high-risk cohort...

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..Unrelated donor transplantation is a treatment option for older patients with myeloid malignancies. The results in this cohort of patients are comparable with those reported in younger patients with similarly advanced disease...

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..Our data suggest that seropositivity for HBcAb and seronegativity for HBsAg at the time of transplantation does not seem to adversely affect outcome after allo-HSCT...

..We hypothesized that patients with positive BK viruria before unrelated or mismatched related donor allogeneic hematopoietic stem cell transplantation have a higher incidence of hemorrhagic cystitis...

..Lymphoma relapse occurred 4 months post-transplant. Immunosuppression withdrawal plus rituximab induced a complete response. He remains in complete remission (CR) 11 months post-immunosuppression withdrawal and 15 months post-transplant...

..Our data suggest that HSCT is preferable to chemotherapy alone in these patients with poor prognoses, with particular benefits noted in patients under age 50 years...

..Optimal strategies to precisely balance immune responses to favor GVL without harmful graft-versus-host disease (GVHD) are needed to protect against relapse, treat persistent disease and improve disease-free survival after HSCT...

..We concluded that HC is more prevalent in MUD and UCB transplantations...

..However, the mechanism underlying the development of multiple symptoms has not been established...

..High-dose melphalan followed by autologous transplantation appears effective for improving the symptoms and systemic manifestations of scleromyxedema...

..In this review, the issues of who benefits from transplant, what is the optimal procedure, and whether there is a potential role for allografting are addressed...

..Therefore strategies aimed at improving the safety and tolerability of allografting to allow for its more frequent application in older patients are necessary...

..HDM should continue to be considered the standard preparative regimen for patients with myeloma...

..Better pre-HCT performance status predicted improved 2-year OS. CONCLUSION With these similar outcomes observed in older patients, we conclude that older age alone should not be considered a contraindication to HCT...

..Seven patients are alive (6 in CMR) for a median of 19 months. Allo-SCT remains an important salvage option for patients who develop resistance to imatinib through Bcr-Abl mutations...

..New combinations and novel therapies need to be explored to improve outcomes. This strategy should also be employed earlier in the course of the disease...

..Although limited by a small number of patients, this study suggests that patients with myelofibrosis and LT may achieve long-term remission after induction chemotherapy and ASCT...

..05). We conclude that MICA may represent novel a transplantation antigen recognized by human allogeneic T cells. This study was registered at ClinicalTrials.gov (Identifier NCT00506922)...

..We investigated the safety and efficacy of nonmyeloablative stem-cell transplantation in these patients...

..A review of the literature is also presented. High-dose chemotherapy followed by stem cell transplantation is a potential treatment option for patients with POEMS syndrome...

..The development of nonmyeloablative transplantation has allowed the application of a potentially curative procedure to elderly or medically infirm patients who would not be able to tolerate high-dose conditioning regimens...

..We review cases of adult HSP associated with malignancy in the literature...

..This study provides clinical data on the availability of circulating EPCs at steady state and after recombinant human granulocyte-colony-stimulating factor (rHuG-CSF) mobilization and their collection by leukapheresis...

..Further studies are also warranted in patients who are likely to experience suboptimal PBPC mobilization when treated with currently available techniques...

..We here present an update of our single-center experience with fludarabine-melphalan as a preparative regimen...

..To describe fatigue severity, fatigue interference, and associated factors in hematologic malignancies...

..We conclude that imatinib mesylate effectively controlled CML that recurred after allogeneic SCT, but it was associated with side effects including myelosuppression and recurrence of severe GVHD...

..In the subset of patients who undergo chemomobilization for non-Hodgkin's lymphoma platelet count at the time of mobilization is a predictor of mobilization failure...

..Only 5 patients were still undergoing immunosuppressive therapy at the time of last follow-up. We believe that the described results are a step forward toward developing a curative strategy for recurrent follicular lymphoma...

..This approach, including posttransplantation treatment with TKIs and donor lymphocyte infusion, produces a high fraction of durable molecular complete remissions...

..In patients with multiple myeloma, prior lenalidomide therapy is associated with failure of stem cell mobilization with filgrastim. Remobilization with chemotherapy and filgrastim is usually successful in these patients...

..These results support replacing BuCy +/- ATG with Bu-Flu +/- rabbit-antithymocyte globulin (ATG), and warrant a prospective comparison between allogeneic HSCT and conventional induction/consolidation chemotherapy for AML in CR1...

..Addition of ATO + AA to high-dose melphalan is safe and well tolerated as a preparative regimen for MM...

..The authors hypothesized that low-dose azacitidine administered after transplant would reduce recurrence rates, and conducted a study to determine a safe dose/schedule combination...

..Collection of autologous stem cells prior to high-risk allografting can salvage a fraction of patients and lead to prolonged survivals...

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..TRM rates are acceptable in this high-risk population but increase over time...

..With a minimum follow-up of 23 months, the median survival had not been reached and the median event-free survival was 22 months. 166Ho-DOTMP is a promising therapy for patients with multiple myeloma and merits further evaluation...

..Decitabine is a hypomethylating agent that has activity in patients with leukemia. The authors combined decitabine with busulfan and cyclophosphamide as a conditioning regimen prior to allogeneic hematopoietic stem cell transplantation...

..A single fixed dose of pegfilgrastim was effective in mobilising adequate peripheral blood progenitor cells in patients with multiple myeloma. The efficacy and toxicity profile was similar to that described with filgrastim treatment...

..Objective responses were observed in a substantial number of patients with both skin and visceral chronic GVHD failing corticosteroids and other immunosuppression...

..It is interesting to note that nonrelapse mortality with nonmyeloablative regimens in older and more debilitated patients was low (14%) and comparable to that achieved with standard high-dose regimens in younger patients...

..Survival after steroid-resistant acute GVHD continues to be problematic. The possibility of excessive fungal and other infections must be explored further...

..The results suggest that intravenous busulfan-fludarabine is an efficacious, reduced-toxicity, myeloablative-conditioning regimen for patients with AML or MDS undergoing HSCT...

..The patient developed autoimmune hemolytic anemia that failed to respond to steroids, intravenous immunoglobulins, and plasma exchange. She was then treated with rituximab that resulted in fatal acute liver toxicity...

..Survival was improved for patients in CR at transplantation. In conclusion, FM provided better disease control though at a cost of increased TRM and morbidity...

..With a median follow up of 12.3 months, 89% of patients are alive. The TMC regimen is well tolerated and produces high response rates. Further evaluation of TMC to fully assess response and survival is ongoing...

..In conclusion, high-dose rituximab given during stem cell mobilization does not negatively affect stem cell mobilization kinetics...

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..Laboratory studies have demonstrated that iron is essential for Aspergillus growth and virulence...

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..These results demonstrate a potent graft-versus-leukaemia effect that can overcome the adverse prognostic effect of ZAP-70 expression...

..Here we review current results of allogeneic blood and marrow transplantation for AML and MDS in the elderly...

..Control of TAM generally requires response of associated infections and GVHD. TMA response may occur despite continuation of tacrolimus treatment...

..Triple chimaerism was present from relapse until death due to leukaemia. This approach may potentially improve UCB transplantation outcome for adults lacking a histocompatible donor...

..99 (P=.004). Results were similar with respect to survival. While RIC-HSCT thus seems of interest, methods are needed to extend its applicability...

..It induces rapid complete donor chimerism without the need for donor lymphocyte infusion. Tumor regression associated with GVHD is consistent with graft-versus-tumor effect...

..To investigate the graft-vs-leukemia effect of allogeneic stem cell transplantation after a nonablative conditioning regimen as treatment for patients with chronic lymphocytic leukemia...

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..In this article, we will address the role of allogeneic transplantation in the context of imatinib and other tyrosine kinase inhibitors...

..In conclusion, hyperacute GVHD accounts for a substantial proportion of grade II-IV acute GVHD after HSCT. Patients at high risk or with a diagnosis of hyperacute GVHD should be included in clinical studies...

..Herein, we review the current literature on transplantation for older patients with this myeloid malignancy...

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..Median PFS and OS were 18 and 45 months, respectively. These results were comparable with patients receiving autologous HCT for other Ig subtypes of myeloma...

..With an emphasis on coordinating multidisciplinary efforts, this panel has presented a strategy to increase funding for the field and develop a coherent research agenda...

..Future studies of these augmentation procedures should measure multiple symptoms, in addition to pain and functional status...

..The stomach and pancreatic lesions were demonstrated as hypervascular nodules on computed tomography (CT), more conspicuous on arterial phase images. Early phase post-contrast imaging might improve the detection of extraosseous myeloma...

..One patient was changed to cyclosporine. In most patients, subsequent treatment with tacrolimus was well tolerated without recurrence of neurotoxicity...

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..Acute graft-versus-host disease rates were similar between IM(+) and IM(-) groups regardless of leukemia phase. These results should be reassuring to patients receiving IM before HCT...

..016). There were no differences in TRM, LFS and OS. CyTBI conditioning may lower relapse risk but produces comparable TRM, LFS and OS to BuCy for HLA-matched sibling transplantation in first remission AML...

..Sokal and Hasford Scores did not predict survival after HSCT. We concluded that the EBMT Risk Score does not currently require modification...

..49, 95% confidence interval [CI] 0.28-0.86, P = .011). Twin transplants have a significantly lower relapse risk than autotransplants in MM, suggesting that graft composition may impact outcomes following high-dose chemotherapy...

..5%) than among those given high-dose conditioning regimens (79%) for hematopoietic stem-cell transplantation (p=0.007)...

..End of abstract.) ..