A study assessing the feasibility of randomization of pediatric and young adult patients between matched unrelated donor bone marrow transplantation and immune‐suppressive therapy for newly diagnosed severe aplastic anemia: A joint pilot trial of the North American Pediatric Aplastic Anemia Consortium and the Pediatric Transplantation and Cellular Therapy Consortium

2020 ◽  
Vol 67 (10) ◽  
Author(s):  
Michael A. Pulsipher ◽  
Leslie E. Lehmann ◽  
Alison A. Bertuch ◽  
Ghadir Sasa ◽  
Timothy Olson ◽  
...  
Keyword(s):  
Aplastic Anemia ◽  
Cellular Therapy ◽  
Pilot Trial ◽  
Suppressive Therapy ◽  
Unrelated Donor ◽  
Matched Unrelated Donor ◽  
The North ◽  
Pediatric Transplantation ◽  
Donor Bone Marrow ◽  
Immune Suppressive Therapy

scholarly journals Severe aplastic anemia: allogeneic bone marrow transplantation as first-line treatment

2018 ◽  
Vol 2 (15) ◽  
pp. 2020-2028 ◽  
Author(s):  
George E. Georges ◽  
Kris Doney ◽  
Rainer Storb
Keyword(s):  
Bone Marrow ◽  
Aplastic Anemia ◽  
Marrow Transplantation ◽  
Severe Aplastic Anemia ◽  
Unrelated Donor ◽  
Line Treatment ◽  
First Line ◽  
Matched Unrelated Donor ◽  
First Line Treatment

Abstract Treatment of severe aplastic anemia has improved significantly over the past 4 decades. This review will summarize the key areas of progress in the use of allogeneic hematopoietic cell transplantation and nontransplant immunosuppressive therapy (IST) for the treatment of aplastic anemia and then summarize the recommendations for first-line treatment. Based on recent data, we argue that guidelines for the initial treatment of patients with newly diagnosed severe aplastic anemia require revision. At the time of diagnosis, before beginning treatment, HLA typing should be done to identify a marrow donor among family members or in the unrelated donor registries, and a marrow transplant should be considered first-line therapy. The priority order of donor source for bone marrow transplantation is: (1) HLA-identical sibling, (2) HLA-matched unrelated donor, and (3) HLA-haploidentical donor if an HLA-matched unrelated donor is not rapidly available. Each of these donor marrow sources may be preferable to nontransplant IST. We make this recommendation because of the long-term persistent risk for disease relapse and secondary myelodysplastic syndrome or acute myeloid leukemia with the use of nontransplant IST for patients with aplastic anemia. In contrast, marrow transplantation is associated with high cure rates of aplastic anemia and a relatively low risk for graft-versus-host disease, with many patients now living for decades without the risk for disease recurrence or the development of clonal disorders. Implementation of this first-line treatment strategy will provide patients with severe aplastic anemia the best chance of long-term disease-free survival.

scholarly journals Aplastic anemia secondary to dual cancer immunotherapies a physician nightmare: case report and literature review

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Romy G. Younan ◽  
Roy A. Raad ◽  
Bassem Y. Sawan ◽  
Rabih Said
Keyword(s):  
Adverse Events ◽  
Cancer Treatment ◽  
Aplastic Anemia ◽  
Checkpoint Inhibitors ◽  
White Male ◽  
Suppressive Therapy ◽  
Heavy Smoker ◽  
Immune Mediated ◽  
Wide Range ◽  
Immune Suppressive Therapy

Abstract Background Treatment with immune checkpoint inhibitors has revolutionized cancer treatment over the past several years. Despite their clinical benefits, a wide range of immune-mediated toxicities can be observed including hematological toxicities. Although, the majority can easily be managed, immune-mediated adverse events rarely can be severe and difficult to approach. Herein, we are reporting a case of very severe aplastic anemia secondary to ipilimumab (I) and nivolumab (N) treatment that failed various treatment including intensive immune suppressive therapy. Case presentation We described a case of a 45-year old white male, heavy smoker presented to the clinic complaining of left flank pain. He was found to have a metastatic renal cell carcinoma for which he was treated with dual immunotherapy and later complicated by severe immune related adverse events. The patient later died after failing intensive immune suppressive therapy. Conclusion Immunotherapy has become an established pillar of cancer treatment improving the prognosis of many patients with variant malignancies. Yet, lethal adverse events can occur in rare cases. It is our duty, as physicians, to remain alert and cautious.

scholarly journals Matched unrelated donor hematopoietic stem cell transplantation - our results

2017 ◽  
Vol 70 (suppl. 1) ◽  
pp. 63-65
Author(s):  
Marija Elez ◽  
Lavinika Atanaskovic ◽  
Svetlana Mirosavljevic ◽  
Gordana Ostojic ◽  
Biljana Todoric-Zivanovic ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Aplastic Anemia ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Myeloid Leukemia ◽  
Unrelated Donor ◽  
Matched Unrelated Donor ◽  
Hematopoietic Stem

Introduction. Allogeneic stem-cell transplantation is only potentially curative therapy for variety of hematology malignancies, such as acute and chronic leukemia, myelodisplastic syndrome and aplastic anemia, but also promising treatment option for other disorders. If we know that only 25% of patients have an human leukocyte antigen identical sibling donor, it is obvious that matched unrelated donor hematopoietic stem cell transplantation is an alternative for the rest of the patients. Material and Methods. Since 2013, matched unrelated donor hematopoietic stem cell transplantation has been performed routinely in the Military Medical Academy. Results. We hereby present the outcome after 77 procedures in 75 patients. Considering primary diseases, 35 patients had acute myeloid leukemia, 25 patients had acute lymphoid leukemia, 5 patients had chronic myeloid leukemia, 9 patients had myelodisplastic syndrome and we performed the transplant on 1 patient with chronic lymphocyte leukemia, 1 patient with aplastic anemia and 1 patient with T lymphoblastic lymphoma. Conclusion. It is difficult to make clear conclusions based on this heterogeneous group of patients, but it seems that these results are encouraging. Future research will be performed to evaluate matched unrelated donor and identical sibling hematopoietic stem cell transplantation in the homogenous groups with respect to primary diseases.

scholarly journals The Course of COVID-19 in a Patient with Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria Clone: A Case Report and Literature Review

2021 ◽  
Vol 4 (3) ◽  
pp. 235-238
Author(s):  
Sreethish Sasi ◽  
Mohamed A. Yassin ◽  
Arun P. Nair ◽  
Afraa M. Fadul ◽  
Mohammed A. Abukhattab
Keyword(s):  
Case Report ◽  
Aplastic Anemia ◽  
Lymphocyte Count ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Case Reports ◽  
Bone Marrow Failure ◽  
Suppressive Therapy ◽  
Nasopharyngeal Swab ◽  
Bone Marrow Failure Syndromes ◽  
Immune Suppressive Therapy

<b><i>Introduction:</i></b> Aplastic anemia (AA) and paroxysmal nocturnal hemoglobinuria (PNH) are bone marrow failure syndromes. A 20–40% of patients with AA have a PNH clone at diagnosis. To date, there are little data about the course of COVID-19 in patients with AA and PNH. <b><i>Case Presentation:</i></b> A 36-year-old gentleman, who was previously diagnosed as a case of AA with PNH clones off immune-suppressive therapy, presented with fever and cough and was diagnosed with mild pneumonia due to COVID-19 with positive nasopharyngeal swab polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2. His clinical course was benign except transient thrombocytopenia. He was asymptomatic after day 4, and viral PCR was negative on day 21. <b><i>Discussion:</i></b> Though studies have shown that COVID-19 is associated with lymphopenia, our patient had a normal to high lymphocyte count. The neutrophil to lymphocyte ratio (NLR) was &#x3c;1 during COVID-19, which correlates with the mild course of the disease. To know whether elevated lymphocyte count, low NLR, and benign course of COVID-19 is a standard feature for all patients with underlying AA, we need more case reports and series. The significance of this case report is that it describes the course of COVID-19 in a patient with AA and PNH clones and, up to our knowledge, is the first report showcasing the association between these rare combinations of diseases.

Obstetric Outcome in a Patient with Aplastic Anemia

2017 ◽  
Vol 9 (2) ◽  
pp. 127-128
Author(s):  
Anuja Nanda ◽  
Vineeta Gupta ◽  
Prachi Maheshwari ◽  
Archna Tandon
Keyword(s):  
Bone Marrow ◽  
Aplastic Anemia ◽  
Pluripotent Stem Cells ◽  
Treatment Options ◽  
Suppressive Therapy ◽  
Obstetric Outcome ◽  
Child Treatment ◽  
Mother And Child ◽  
Immune Suppressive Therapy ◽  
Life Threatening

ABSTRACT Aplastic anemia is a rare disease caused by destruction of pluripotent stem cells in bone marrow. The etiology may be radiation exposure, chemotherapy, environmental toxins or it could be autoimmune. During pregnancy it can be life threatening for both mother and child. Treatment options are erythrocytes and platelet transfusions and immune suppressive therapy. We report a series of obstetric events in the life of a woman whose pregnancy was complicated due to aplastic anemia but her subsequent obstetric outcome improved after successful bone marrow transplantation. How to cite this article Gupta V, Maheshwari P, Tandon A, Nanda A. Obstetric Outcome in a Patient with Aplastic Anemia. J South Asian Feder Obst Gynae 2017;9(2):121-122.

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