scholarly journals 135: Once-daily administration of modified-release tacrolimus capsule (MR) for the prophylaxis of graft-versus-host-disease (GVHD) after unrelated donor bone marrow transplantation (BMT)

2007 ◽  
Vol 13 (2) ◽  
pp. 51
Author(s):  
S. Okamoto ◽  
H. Gondo ◽  
M. Imamura ◽  
Y. Kodera
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Graft Versus Host Disease ◽  
Marrow Transplantation ◽  
Daily Administration ◽  
Unrelated Donor ◽  
Modified Release ◽  
Once Daily ◽  
Graft Versus Host ◽  
Donor Bone Marrow

High-producer interleukin-2 genotype increases risk for acute graft-versus-host disease after unrelated donor bone marrow transplantation

2003 ◽  
Vol 76 (12) ◽  
pp. 1758-1762 ◽  
Author(s):  
Margaret L. MacMillan ◽  
Gretchen A. Radloff ◽  
William R. Kiffmeyer ◽  
Todd E. DeFor ◽  
Daniel J. Weisdorf ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Graft Versus Host Disease ◽  
Marrow Transplantation ◽  
Interleukin 2 ◽  
Unrelated Donor ◽  
Host Disease ◽  
Graft Versus Host ◽  
Donor Bone Marrow ◽  
Acute Graft

scholarly journals High-risk HLA alleles for severe acute graft- versus -host disease and mortality in unrelated donor bone marrow transplantation

Haematologica ◽  
2016 ◽  
Vol 101 (4) ◽  
pp. 491-498 ◽  
Author(s):  
Satoko Morishima ◽  
Koichi Kashiwase ◽  
Keitaro Matsuo ◽  
Fumihiro Azuma ◽  
Toshio Yabe ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
High Risk ◽  
Graft Versus Host Disease ◽  
Marrow Transplantation ◽  
Unrelated Donor ◽  
Hla Alleles ◽  
Graft Versus Host ◽  
Donor Bone Marrow ◽  
Acute Graft

Full Donor Myeloid Engraftment with Minimal Toxicity in Dyskeratosis Congenita Patients Undergoing Allogeneic Bone Marrow Transplantation without Radiation or Alkylating Agents

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2941-2941 ◽  
Author(s):  
Leslie E. Lehmann ◽  
David A. Williams ◽  
Wendy B. London ◽  
Suneet Agarwal
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Graft Versus Host Disease ◽  
Marrow Transplantation ◽  
Alkylating Agents ◽  
Dyskeratosis Congenita ◽  
Unrelated Donor ◽  
Host Disease ◽  
Graft Versus Host ◽  
Transfusion Independence

Abstract Dyskeratosis congenita (DC) is an inherited bone marrow failure (BMF) syndrome caused by defects in telomere biology genes. BMF occurs in approximately 80% of patients by 30 years of age and, in addition to pulmonary failure and malignancies, remains a major contributor to mortality. Hematopoietic cell transplantation (HCT) cures BMF in DC patients but is associated with a high incidence of graft failure and transplant-related mortality. Radiation and/or alkylating agents (e.g. cyclophosphamide, busulfan, melphalan) used in conditioning may have a role in the poor outcomes in DC patients following HCT. Recently, reduced-intensity conditioning approaches have improved short-term outcomes, but concerns remain about the long-term effects of DNA damaging agents in these regimens, given the multisystem disease and lifelong predisposition to malignancy conferred by telomere dysfunction. Radiation and alkylating agents are mainstays of allogeneic HCT preparative regimens: their highly effective myeloablative and immunosuppressive properties provide a niche for donor hematopoietic progenitors and decrease graft rejection. Based on a rationale that presumes (1) niche availability in DC patients with BMF, and (2) an intrinsic replicative defect in DC hematopoietic cells, we hypothesized that engraftment would be feasible in DC patients using a regimen of immunosuppressive therapy alone. Here, we report that in a single-institution prospective study, 4 consecutive patients with DC have undergone successful HCT using a radiation- and alkylator-free preparative regimen. Patients received alemtuzumab and fludarabine, followed by bone marrow transplantation (BMT) from unrelated donors. Cyclosporine A and mycophenolate mofetil were used for graft versus host disease (GVHD) prophylaxis. The primary outcome measures were neutrophil engraftment at day +30 and overall survival at day +100. Secondary outcome measures included acute toxicities and rates of graft failure, infections, and GVHD. The first two patients were 18 month-old twins with TINF2 mutations and transfusion-dependent BMF who received a BMT from a fully HLA-matched unrelated donor. The third patient was an 18 year-old female with CTC1 mutations and transfusion-dependent BMF, who underwent a B-mismatched unrelated donor BMT. The fourth patient, a 22 year-old male with clinical DC and short telomeres, had significant pulmonary disease (diffusing capacity of lung for carbon monoxide 28% of predicted) and BMF, and underwent a fully HLA-matched unrelated donor BMT. All 4 patients engrafted neutrophils by day +30, and are alive and well with follow-up ranging from 6 months (1 patient) to 2 years (3 patients). Platelet transfusion-independence occured between day +4 to +18, and red cell transfusion-independence occured between day 0 to +90. No patients required transfusions thereafter. All patients showed full donor myeloid chimerism by day +60. 3 of 4 patients showed full donor lymphoid chimerism by year 2; the fourth patient has high and increasing mixed donor lymphoid chimerism (60%) at day +180. There were no significant, unexpected toxicities, bacterial or fungal bloodstream or tissue infections. All patients were monitored weekly by serum PCR for CMV, EBV, adenovirus and HHV6 until day +100; only one patient showed CMV reactivation which was controlled with pre-emptive ganciclovir therapy. There was no acute GVHD. Only one patient developed chronic GVHD with limited skin involvement controlled with topical steroids. These results provide promising early data for engraftment and a favorable short-term toxicity profile using a radiation- and alkylator-free conditioning regimen in HCT for BMF due to DC. This approach could spare DC patients the acceleration of non-hematologic complications and malignancies, which has been attributed to HCT, and improve long-term survival. The limited toxicity of the alemtuzumab/fludarabine regimen may also allow patients with severe disease-related co-morbidities such as pulmonary dysfunction to safely undergo HCT. To our knowledge, this is the first prospective HCT study to achieve full donor myeloid engraftment in a series of patients following conditioning without radiation or alkylating agents. Disclosures Off Label Use: alemtuzumab - conditioning for bone marrow transplantation fludarabine - conditioning for bone marrow transplantation cyclosporine A - graft versus host disease prophylaxis in bone marrow transplantation mycophenolate mofetil - graft versus host disease prophylaxis in bone marrow transplantation.

RISK FACTORS FOR ACUTE GRAFT-VERSUS-HOST DISEASE IN HISTOCOMPATIBLE DONOR BONE MARROW TRANSPLANTATION

1991 ◽  
Vol 51 (6) ◽  
pp. 1197-1202 ◽  
Author(s):  
DANIEL WEISDORF ◽  
ROBERT HAKKE ◽  
BRUCE BLAZAR ◽  
WESLEY MILLER ◽  
PHILIP MCGLAVE ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Graft Versus Host Disease ◽  
Marrow Transplantation ◽  
Host Disease ◽  
Graft Versus Host ◽  
Donor Bone Marrow ◽  
Acute Graft
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