scholarly journals DAYS ALIVE OUTSIDE HOSPITAL AND RE-ADMISSIONS IN PATIENTS UNDERGOING ALLOGENEIC TRANSPLANTS FROM IDENTICAL SIBLINGS, UNRELATED DONORS OR HAPLOIDENTICAL DONORS “.

2020 ◽  
Vol 12 (1) ◽  
pp. e2020055
Author(s):  
Federica Sorà ◽  
Patrizia Chiusolo ◽  
Luca Laurenti ◽  
Idanna Innocenti ◽  
Francesco Autore ◽  
...  
Keyword(s):  
Stem Cell Transplant ◽  
Median Number ◽  
Hemopoietic Stem Cell ◽  
Strong Impact ◽  
Cell Transplant ◽  
Graft Versus Host ◽  
Donor Type ◽  
Unrelated Donors ◽  
Comorbidity Index ◽  
Grade Ii

We have studied the number of days alive outside Hospital (DAOH) and the number of re-admissions within the first 100 days after transplant in 185 patients who received an allogeneic hemopoietic stem cell transplant (HSCT). The donors were matched siblings (SIB; n=61), or alternative donors (ALT; n=124). The median number of DAOH for SIB transplants (78 days) was significantly greater than DAOH for ALT donor grafts (73 days) (p=0.0003) . Other positive predictors of DAOH were the use of reduced intensity regimens (p=0.01), grade 0-I graft versus host disease (GvHD) (p=0.0006) and a comorbidity index equal or less than two (p=0.04). Fifty one patients required re-admission (22%), which was predicted by grade II-IV GvHD (p=0.009), higher comorbidity index (p=0.06) and ALT donors as compared to SIBS (p=0.08). The CI of re-admission was 18% for SIB and 30% for ALT donor grafts. The non relapse mortality (NRM) for patients re-admitted was 25%, compared to 5% for patients not readmitted (p=0.0001). In a multivariate analysis re-admission was the strongest predictor of non relapse mortality (NRM) (p=0.0006) and survival (p<0.0001). In conclusions: ALT donor transplants have lower numbers of DAOH, as compared to SIB grafts, which implies longer stay in hospital and greater cost. Re-admission to Hospital within 100 days, is predicted by GvHD, comorbidity index, donor type, and has a very strong impact on non relapse mortality and survival.

Allogenic stem cell transplant in patients over the age of 70, including octogenarians, with hematologic malignancies: A single institution experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18538-e18538
Author(s):  
Robert E. Gaudet ◽  
Jan Cerny ◽  
Muthalagu Ramanathan ◽  
Glen Raffel ◽  
Zheng Zhou ◽  
...  
Keyword(s):  
Stem Cell ◽  
Treatment Modality ◽  
Stem Cell Transplant ◽  
Medical Center ◽  
Hematologic Malignancies ◽  
Cell Transplant ◽  
Single Institution ◽  
Allogenic Stem Cell Transplant ◽  
Unrelated Donors ◽  
Grade Ii

e18538 Background: Patient age is an important factor when considering allogenic stem cell transplant (aSCT) as a treatment modality for hematologic malignancies. Previous series exploring older age and outcome in aSCT have generally not included fit, older adults beyond the age of 80: a group typically considered ineligible for aSCT. This report describes our single-institution experience with aSCT in patients age 70 and older, including octogenarians, from March 2010 through April 2016. Methods: Retrospective analysis was performed on all patients older than 70 years undergoing aSCT at UMass Memorial Medical Center (UMMMC) between March 2010 and April 2016. The study was approved by the UMMMC IRB. Results: 32 patients were identified: 19 men and 13 women. 1 patient underwent a second aSCT in the study period. Median age at time of aSCT was 73 years (range 70-83). 4 patients were age >80. Diseases treated were AML (19 pts.), MDS (12 pts.), and CLL (1 pt.). 24 transplants were performed with unrelated donors: 17 with 10/10 match, 3 with 11/12 match, 3 with 10/12 match, and 1 with 9/12 match. 9 were performed with umbilical cord blood units. Grade II-IV acute GVHD developed in 9 patients (27%). Day 100 survival by age following the transplant were 11/18 (61%) for patients aged 70-75, 6/10 (60%) for patients aged 75-80 and 4/4 (100%) for patients aged 80-85. Conclusions: Allogenic Stem Cell Transplant is a viable treatment modality in highly-selected elderly patients with hematologic malignancies. Further studies are warranted in a prospective fashion. [Table: see text]

Unrelated Male Donors Versus Sibling Parous Female Donors: Impact on Transplant-Related Outcomes

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 70-70
Author(s):  
Anita J Kumar ◽  
Soyoung Kim ◽  
Michael Hemmer ◽  
Mukta Arora ◽  
Steve Spellman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Chronic Gvhd ◽  
Cell Transplant ◽  
Increased Risk ◽  
Donor Type ◽  
Unrelated Donors ◽  
Recipient Age ◽  
Grade Ii ◽  
Related Mortality

Abstract Introduction: Optimal donor selection is critical to reduce morbidity and mortality from allogeneic hematopoietic cell transplant (HCT). HLA identical female parous sibling donors (pSIB) confer an increased risk of chronic graft vs. host disease (cGVHD) compared to male sibling donors, possibly from alloimmunization and exposure to fetal antigens during pregnancy. Unrelated donors (URD) also confer higher GVHD risk than sibling donors. While both pSIB and URD donors confer increased GVHD risk, they have never been directly compared. This study compares incidence of acute GVHD (aGVHD), cGVHD, survival, and treatment- related mortality in patients who received transplants from pSIB donors to male unrelated donors (mURD). Methods: A retrospective cohort study was completed using the Center for International Bone Marrow Transplant Registry (CIBMTR). We identified patients with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), or myelodysplastic syndrome (MDS) who underwent a non-T cell depleted HCT from an HLA identical pSIB or a matched mURD between 2000-2012. Recipients were at least 25 years at time of transplant to ensure female sibling donors had biological opportunity to become parous. Primary outcome was Grade II-IV aGVHD, cGVHD, and overall survival (OS). Secondary outcomes were relative risk (RR) of leukemia free survival (LFS), transplant related mortality (TRM) and relapse. Results: We identified 892 pSIB donors and 1921 mURD donors. Median recipient age at transplant was 49 (pSIB) and 50 (mURD), p=0.14. Median donor age was higher in pSIB than mURD (48 vs. 32, p<0.001). Cumulative incidence of aGVHD was higher in mURD than pSIB at 100 days, 46% vs. 35%, p<0.001. Incidence of cGVHD at 100 days was also higher in mURD (9% vs. 4%, p<0.001), but was not different at 1 year (mURD 50%, pSIB 50%, p=0.99) or 2 years (mURD 56%, pSIB 56%, p=0.77). In multivariate analysis adjusting for other risks of GVHD (prophylaxis, graft source, gender, and transplant year), mURD had a 1.6 times higher risk of grade II-IV aGVHD (p<0.0001) and 1.23 times higher risk of cGVHD (p=0.0003) than pSIB donors (Table 1). A greater proportion of pSIB recipients were alive at 100 days (88% vs. 82%, p<.001), 1 year (62% vs. 57%, p=0.02), and 2 years (51% vs. 47%, p=0.02). However, in multivariate analysis donor type did not significantly affect OS (RR mURD 1.10, p=0.072), LFS (RR mURD 1.04, p=0.47), TRM (RR mURD 1.04, p=0.59), or relapse (RR mURD 1.03, p=0.62). Variables associated with OS included increasing recipient age (p<0.0001), Karnofsky performance status <90% (RR 1.37, p<0.0001), disease status at HCT (p<0.0001), and year of HCT (p<0.0001) (Table 2). Conclusion: Male URD confer a higher risk of grade II-IV acute and chronic GVHD compared to HLA-identical female parous sibling donors. Donor type does not significantly affect OS, LFS, TRM, or disease relapse. When available, female pSIB should be utilized rather than mURD donors to minimize toxicity of GVHD. Table 1. GVHD Outcomes Table 1. GVHD Outcomes Table 2. Overall Survival Table 2. Overall Survival Disclosures No relevant conflicts of interest to declare.

scholarly journals A Novel Secondary Neoplasm Following Allogeneic Hematopoietic Stem Cell Transplant: Mixed Donor-Recipient Primitive Mesenchymal Proliferation of the Liver

2021 ◽  
pp. 109352662110016
Author(s):  
Brian Earl ◽  
Zi Fan Yang ◽  
Harini Rao ◽  
Grace Cheng ◽  
Donna Wall ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Graft Versus Host Disease ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Host Disease ◽  
Graft Versus Host ◽  
Post Transplant

Post-hematopoietic stem cell transplant secondary solid neoplasms are uncommon and usually host-derived. We describe a 6-year-old female who developed a mixed donor-recipient origin mesenchymal stromal tumor-like lesion in the liver following an unrelated hematopoietic stem cell transplant complicated by severe graft-versus-host disease. This lesion arose early post-transplant in association with hepatic graft-versus-host disease. At 12 years post-transplant, the neoplasm has progressively shrunken in size and the patient remains well with no neoplasm-associated sequelae. This report characterizes a novel lesion of mixed origin post-transplant and offers unique insights into the contribution of bone marrow-derived cells to extra-medullary tissues.

Voriconazole for Cryptococcal Meningitis in Children with Leukemia or Receiving Allogeneic Hemopoietic Stem Cell Transplant

2009 ◽  
Vol 21 (1) ◽  
pp. 108-109 ◽  
Author(s):  
R. Bandettini ◽  
E. Castagnola ◽  
M. Calvillo ◽  
C. Micalizzi ◽  
M. Ravegnani ◽  
...  
Keyword(s):  
Stem Cell ◽  
Cryptococcal Meningitis ◽  
Stem Cell Transplant ◽  
Hemopoietic Stem Cell ◽  
Cell Transplant ◽  
Meningitis In Children

A case of syngeneic graft-versus-host disease

2018 ◽  
Vol 25 (7) ◽  
pp. 1762-1766
Author(s):  
Sweta U Patel ◽  
Kendra Yum ◽  
Sara Kim ◽  
Luis M Isola ◽  
Eileen Scigliano ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Graft Versus Host Disease ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
B Cell Lymphoma ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Host Disease ◽  
Graft Versus Host

Graft-versus-host disease has been reported to occur rarely in syngeneic hematopoietic stem cell transplant recipients. Clinical and histological changes consistent with graft-versus-host disease have been reported to occur in this patient population. We report a case of a 46-year-old Caucasian male with diffuse large B-cell lymphoma in complete remission who underwent a syngeneic hematopoietic stem cell transplant. He was diagnosed with grade III acute skin and gastrointestinal graft-versus-host disease requiring high-dose corticosteroids and immunosuppressive therapy and resulting in a complete response. Syngeneic graft-versus-host disease is an anomaly that needs to be considered as a differential diagnosis of patients experiencing dermatitis, gastroenteritis, or hepatitis after an identical twin hematopoietic stem cell transplant.

Supportive care with art therapy, for patients in isolation during stem cell transplant

2012 ◽  
Vol 10 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Alessandra Agnese ◽  
Teresa Lamparelli ◽  
Andrea Bacigalupo ◽  
Paola Luzzatto
Keyword(s):  
Stem Cell ◽  
Art Therapy ◽  
Stem Cell Transplant ◽  
Hemopoietic Stem Cell ◽  
Cell Transplant ◽  
Self Assessment ◽  
Specific Factors ◽  
Meaningful Connections ◽  
Art Therapist ◽  
Made In

AbstractObjective:The aim of the art therapy study was twofold: 1) to identify the specific factors of the art therapy experience perceived as helpful by patients undergoing an allogenic hemopoietic stem cell transplant (HSCT); and 2) to establish an appropriate criterion for referral to art therapy among this population.Method:Between 2006 and 2010, a dedicated art therapist met all the patients who were referred to her by the hematologist. The art therapy approach and techniques are described. Outcome was evaluated by self-assessment, based on written questionnaires that were given to the patients before discharge.Results:Seventy-four patients followed the weekly individual sessions during isolation and filled out the questionnaire. All of them defined the art therapy experience as “helpful” and specified in which way it had been helpful. Through a thematic analysis of the patients' written comments, three specific aspects of art therapy, which the patients found most helpful, were identified: (1) being able to calm down from anxiety, through the use of art therapy techniques (77.02%); (2) feeling free to express and share difficult feelings, which they had not communicated verbally (75.67%); and (3) establishing meaningful connections with their loved ones, through images made in art therapy (36.48%). Case illustrations are provided.Significance of results:The results suggest that referral to art therapy from the team might be helpful and appropriate: (1) when patients are anxious; (2) when they are uncommunicative and hide their feelings; and (3) when they feel disconnected from their loved ones at home.

Sign in / Sign up

Export Citation Format

Share Document