Publications by authors named "Bazarbachi A"

Cytokines are pleiotropic molecules involved in hematopoiesis, immune responses, infections, and inflammation. They play critical roles in hematopoietic cell transplantation (HCT) and immune effector cell (IEC) therapies, mediating both therapeutic and adverse effects. Thus, cytokines contribute to the immunopathology of graft-versus-host disease (GVHD), cytokine release syndrome (CRS), and immune effector cell-associated neurotoxicity syndrome (ICANS).

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Minimal Residual Disease (MRD) in multiple myeloma has emerged as a significant prognostic factor, guiding treatment strategies and enhancing patient outcomes. Despite advancements in therapies such as proteasome inhibitors, immunomodulatory drugs, monoclonal antibodies, CAR-T cell therapy, and bispecific antibodies, complete eradication of malignant plasma cells remains challenging. MRD refers to a small number of residual cancer cells that persist after treatment and require sensitive methods like next-generation flow cytometry (NGF) and next-generation sequencing (NGS) for detection.

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We looked at treatment rates and center density across countries for patients treated in 2022; 46,143 HCTs (19,011 (41.2%) allogeneic, 27,132 (58.8%) autologous) reported by 689 centers.

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Acute myeloid leukemia (AML) with translocation t(8;16)(p11;p13) represents a rare entity that has been categorized as a disease-defining recurring cytogenetic abnormality with adverse risk in the 2022 European LeukemiaNet classification. This rating was mainly based on a retrospective analysis comprising patients from several large clinical trials, which, however, included only 21 patients treated with allogeneic stem cell transplantation (alloSCT). Therefore, the European Society for Blood and Marrow Transplantation performed a registry study on a larger cohort to evaluate the role of alloSCT in t(8;16) AML.

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Therapy-related myeloid neoplasms (t-MN) are a complication of multiple myeloma (MM) treatment. Our retrospective, EBMT registry study included 157 such patients allografted (allo-HCT) between 2006 and 2018. Most patients (130) had a prior autologous HCT.

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Article Synopsis
  • Autologous peripheral blood stem cell (PBSC) transplantation is a common treatment for conditions like multiple myeloma and lymphomas, and it usually involves freezing the stem cells before transplant.* -
  • A recent systematic review of 19 transplant centers that performed non-cryopreserved PBSC transplants showed that the procedure is feasible and safe, with high stem cell viability and low rates of complications.* -
  • The study found that stem cell viability was over 90% for multiple myeloma and over 75% for lymphomas, with quick engraftment times, and only 1% transplant-related mortality within 100 days.*
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  • * A significant number of respondents (67.0%) felt that early diagnosis was challenging, but many (75.8%) found the new 2023 EBMT diagnostic criteria useful and easy to apply.
  • * Key risk factors for VOD/SOS included second allo-HCT, pre-existing liver disease, and prior use of antibody-drug conjugates, with varied preferences on when to start treatment.
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  • - Adult T cell leukemia (ATL) is a serious blood cancer linked to HTLV-1 virus infection, with four subtypes that have varying effects on treatment response and prognosis.
  • - While some subtypes benefit from antiretroviral therapy, others, like acute ATL, are more aggressive with poor outcomes and may become resistant to chemotherapy.
  • - Newer treatment approaches, including targeted therapies and potential anti-viral strategies focusing on the Tax protein, show promise in improving ATL management, although allogeneic stem cell transplant remains the only curative option for a limited number of patients.
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  • * This subtype of MM does not indicate a high-risk phenotype, yet shows reduced response to treatments like proteasome inhibitors and immunomodulatory drugs, possibly due to lower immunoglobulin production.
  • * The distinct dependence on Bcl-2 makes t(11;14)-MM sensitive to the drug venetoclax, and further understanding of its morphological and genomic characteristics could improve predictions of treatment responses.
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Purpose Of Review: The past two decades have witnessed an impressive expansion in the treatment landscape of multiple myeloma, leading to significant improvements in progression-free; as well as overall survival. However, almost all patients still experience multiple relapses during their disease course, with biological and cytogenetic heterogeneity affecting response to subsequent treatments. The purpose of this review is to provide a historical background regarding the role of alkylating agents and an updated data regarding the use of peptide-drug conjugates such as melflufen for patients with multiple myeloma.

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  • Autologous hematopoietic cell transplantation (AHCT) is an effective treatment for multiple myeloma, with real-world data collected from 61,725 patients revealing median overall survival of 90.2 months and median progression-free survival of 36.5 months.* -
  • Cumulative relapse incidence and non-relapse mortality rates at 24 months were found to be 33% and 2.5% respectively, with better outcomes linked to factors like younger age, certain disease subtypes, and high performance status.* -
  • Global variations were observed in patient outcomes based on registry data, influenced by differences in patient characteristics, use of maintenance treatments, and macroeconomic factors, highlighting the safety and effectiveness of AH
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  • This study examines the effects of IDH1 and IDH2 mutations on adult AML patients who received allogeneic hematopoietic cell transplantation, finding that 15.91% had IDH1 mutations and 26.27% had IDH2 mutations.* -
  • Patients with IDH1 and IDH2 mutations experienced lower rates of acute graft-versus-host disease (GVHD) compared to those without mutations, with significant improvements in overall survival (OS) linked to IDH1 mutations.* -
  • IDH2 mutations were associated with a lower relapse rate and better leukemia-free survival (LFS) and OS, particularly in patients without NPM1 mutations, indicating these mutations may lead to better outcomes post
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The use of tyrosine kinase inhibitors (TKIs) during induction and consolidation, followed by allogeneic hematopoietic cell transplantation (allo-HCT), is a standard of care for patients with Philadelphia (Ph)-positive acute lymphoblastic leukemia (ALL). The goal of this study was to compare results of allo-HCT according to the type of TKI used pre-transplant, either imatinib, dasatinib or both. This was a retrospective, registry-based analysis including adult patients with Ph-positive ALL treated with allo-HCT between years 2010-2022.

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  • * This study compared outcomes for patients over 50 years old with AML in first complete remission who received stem cell transplants from younger matched unrelated donors (MUD) versus older MRD.
  • * The results showed that for patients receiving a more intense transplant conditioning regimen, younger MUDs led to better survival rates and fewer complications, making them preferable over older MRDs in this context.
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Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) constitutes a distinctive cytogenetic entity associated with challenging outcomes, particularly in adult patients. Current upfront chemotherapy-tyrosine kinase inhibitor (TKI)-based therapies include first, second and third-generation TKIs that have revolutionized patient outcomes including molecular remission and overall survival. Chemotherapy-free regimens such as blinatumomab-dasatinib or blinatumomab-ponatinib offer exciting possibilities, yet challenges arise, particularly in preventing central nervous system relapse.

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T-cell acute lymphoblastic leukemia (T-ALL) predominantly affects individuals in late childhood and young adulthood. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative modality particularly in the setting of poor risk genetics and/or persistent minimal residual disease. Limited studies have directly explored the impact of patient- and transplant-related factors on post-transplant outcomes in T-ALL.

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Background: Globally, multiple myeloma (MM) ranks 24 among the most common cancers. The Middle East and Africa are affected by an increasing trend in MM incidence, owing to several underlying factors. This systematic review aims to assess the epidemiology, patient characteristics, and treatment outcomes associated with MM in selected countries in the Middle East and Africa.

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  • * An analysis of data from 3649 patients showed that ATG had worse outcomes in terms of nonrelapse mortality and overall survival compared to PTCy alone; however, the combination of PTCy and ATG significantly reduced GVHD occurrences without affecting other transplant outcomes.
  • * The authors suggest that while ATG monotherapy is less effective, the PTCy and ATG combination may establish a new
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Second allogeneic stem cell transplantation (alloSCT2) is among the most effective treatments for acute myeloid leukemia (AML) relapse after first alloSCT (alloSCT1). Long-term EBMT registry data were used to provide large scale, up-to-date outcome results and to identify factors for improved outcome. Among 1540 recipients of alloSCT2, increasing age, better disease control and performance status before alloSCT2, more use of alternative donors and higher conditioning intensity represented important trends over time.

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  • Allogeneic hematopoietic cell transplantation (allo-HCT) is recommended for patients with core-binding factor mutated (CBF) acute myeloid leukemia (AML) who have achieved second complete remission (CR2), though 20% may relapse after the procedure.
  • A study analyzed outcomes from 865 CBF AML patients undergoing allo-HCT with different donor types (haploidentical, matched siblings, and matched unrelated donors) across 227 centers, revealing that haploidentical transplants were linked to a lower relapse incidence compared to the other donor types.
  • CBF-AML patients with the inv(16) mutation had better outcomes regarding relapse, overall survival, and graft-versus-host disease-free survival
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