Publications by authors named "Donal P McLornan"

Article Synopsis
  • Prophylaxis strategies for Graft versus Host Disease (GVHD) in allogeneic hematopoietic cell transplantation (allo-HCT) often include a calcineurin inhibitor (CNI) combined with either methotrexate (MTX) or mycophenolate mofetil (MMF).
  • A study analyzing data from 13,699 patients revealed that MTX-based prophylaxis was linked to lower overall mortality and non-relapse mortality compared to MMF, while showing no significant impact on relapse rates or relapse-free survival.
  • Overall, MTX in combination with CNI was associated with better survival outcomes and a lower risk of severe acute GVHD compared to MMF.
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Autologous hematopoietic cell transplants (auto-HCTs) remain the standard of care for transplant-eligible MM patients. The general practice has been to undergo upfront apheresis following induction to collect sufficient number of CD34+ cells to facilitate two auto-HCTs. However, 5-30% of MM patients do not initially mobilise a sufficient number of hematopoietic stem cells and are classified as poor mobilizers (PM).

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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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Heterogeneous approaches exist in regard to the management of disease-related co-morbidities in potential allogeneic haematopoietic cell transplantation (allo-HCT) candidates with myelofibrosis (MF). The EBMT Chronic Malignancies Working Party launched an electronic survey to evaluate how MF-specific comorbidities are approached and whether they ultimately affect the decision to transplant. A total of 41/63 (65%) Centers, all of whom were experienced in the management of MF allo-HCT, responded.

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Significant efforts have been made to effectively select myelofibrosis (MF) patients who can benefit from allogeneic hematopoietic cell transplantation (allo-HCT), the only current cure for MF. The recent EBMT/ELN 2024 recommendations offer valuable guidance for hematologists and transplant physicians. However, several grey areas remain in day-to-day clinical practice regarding the feasibility and optimal preparation for transplantation in patients with this disease.

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Article Synopsis
  • 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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Article Synopsis
  • * Both types of HCT are risky and complicated, but global collaboration among medical professionals has established it as a standard treatment for many serious blood-related illnesses, resulting in improved patient outcomes.
  • * Over 1.5 million HCT procedures were performed from 1957 to 2019, and this number continues to rise globally, supported by registries and international medical societies.
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Background: Pacritinib is a JAK2/IRAK1/ACVR1 inhibitor that is approved in the United States for the treatment of patients with myelofibrosis who have a platelet count < 50 × 109/L. Phase 3 clinical studies of pacritinib included patients across a wide range of baseline platelet and hemoglobin levels.

Patients And Methods: In order to assess the impact of baseline blood counts on pacritinib efficacy, an analysis of efficacy outcomes by baseline platelet and hemoglobin levels was performed using data pooled from 2 Phase 3 studies of pacritinib in patients with MF (PERSIST-1 and PERSIST-2).

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It has been reported in prospective randomized trials that antithymocyte globulin (ATG)-based graft-versus-host disease (GVHD) prophylaxis has benefits in the setting of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with unrelated donors (UDs). However, the optimal GVHD prophylaxis strategy has been challenged recently by the increasing use of posttransplant cyclophosphamide (PTCY). We report from the European Society for Blood and Marrow Transplantation registry the outcomes of 960 patients with myelodysplastic neoplasms who underwent allo-HSCT from UD with PTCY or ATG as GVHD prophylaxis.

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Article Synopsis
  • - In patients with myelodysplastic syndrome (MDS), higher revised International Prognostic Scoring System (IPSS-R) scores are linked to poorer transplant outcomes, leading to the idea that lowering these scores before transplant could be helpful, but there's currently no evidence to back this up.
  • - A study analyzing 1,482 MDS patients found that changes in IPSS-R scores before transplantation did not significantly impact outcomes for untreated patients, while beneficial results were seen in those improved by chemotherapy.
  • - Overall, prior treatments including hypomethylating agents showed no clear advantage in improving transplant outcomes, suggesting that the effectiveness of pre-transplant therapies in altering IPSS-R scores is limited and raising questions about their role in managing
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Promoting access to and excellence in hematopoietic cell transplantation (HCT) by collecting and disseminating data on global HCT activities is one of the principal activities of the Worldwide Network for Blood and Marrow Transplantation, a non-governmental organization in working relations with the World Health Organization. HCT activities are recorded annually by member societies, national registries and individual centers including indication, donor type (allogeneic/autologous), donor match and stem cell source (bone marrow/peripheral blood stem cells/cord blood). In 2018, 1,768 HCT teams in 89 countries (6 World Health Organization regions) reported 93,105 (48,680 autologous and 44,425 allogeneic) HCT.

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Short-term outcome of myeloablative (MAC) and reduced intensity (RIC) conditioning in the prospective randomized international EBMT RICMAC study in patients with myelodyplastic syndrome (MDS) was comparable but longer follow up is lacking. Patients with MDS aged 18-65 years were randomized to receive MAC (N = 64) with busulfan/cyclophosphamide or RIC (n = 65) with busulfan/fludarabine followed by stem cell transplantation -(HCT) from HLA matched or mismatched donor. After a median follow-up of 6.

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Allogeneic haematopoietic cell transplantation (allo-HCT) remains an option for tyrosine kinase inhibitor-resistant chronic myeloid leukaemia (CML) in first chronic phase (CP1) and high-risk patients with advanced disease phases. In this European Society for Blood and Marrow Transplantation (EBMT) registry-based study of 1686 CML patients undergoing first allo-HCT between 2012 and 2019, outcomes were evaluated according to donor type, particularly focusing on mismatched related donors (MMRDs). Median age at allo-HCT was 46 years (IQR 36-55).

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Article Synopsis
  • Management of Richter transformation (RT) poses significant challenges, with patient survival often under one year; this study analyzes outcomes of 66 patients who received allogeneic hematopoietic cell transplantation (allo-HCT) between 2008 and 2018.
  • The majority of patients were treated with reduced intensity conditioning, and 42.4% achieved complete remission (CR) before undergoing allo-HCT, with a median follow-up of 6.6 years.
  • Survival rates were promising, showing 1-year overall survival at 65%, but the study highlights the need for strategies to reduce high rates of non-relapse mortality (NRM) and chronic graft versus host disease (GVHD), which were observed at
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We aimed to compare outcomes following treosulfan (TREO) or busulfan (BU) conditioning in a large cohort of myelofibrosis (MF) patients from the EBMT registry. A total of 530 patients were included; 73 received TREO and 457 BU (BU ≤ 6.4 mg/kg in 134, considered RIC, BU > 6.

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Systemic Mastocytosis (SM) is a multifaceted clinically heterogeneous disease. Advanced SM (AdvSM) comprises three entities: aggressive SM (ASM), mast cell leukaemia (MCL) and SM with an associated hematologic neoplasm (SM-AHN), the latter accounting for 60-70% of all AdvSM cases. Detection of a disease-triggering mutation in the KIT gene (esp.

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Article Synopsis
  • Bone marrow fibrosis (BMF) is linked to myelofibrosis and can affect prognosis, but this study explores its relationship with treatment outcomes in patients receiving JAK inhibitors momelotinib and ruxolitinib.
  • In a study of patients with BMF, only momelotinib showed increased transfusion independence and hemoglobin levels, while ruxolitinib showed a decrease in hemoglobin.
  • The findings suggest that changes in BMF do not correlate with clinical improvements or survival benefits, indicating that BMF may not be an effective surrogate marker for assessing the efficacy of JAK inhibitors.
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Investigating the evaluation of eligibility for transplant in myelofibrosis (MF): The role of HCT-CI and BMI. HCT-CI emerges as a key prognostic factor, while BMI shows limited impact. This study expands insights for better clinical decision-making in MF allo-HCT.

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Article Synopsis
  • - A randomized study (MC-FludT.14/L Trial II) found that fludarabine plus treosulfan (30 g/m²) is an effective and well-tolerated conditioning treatment for older patients (ages 50-70) undergoing allogeneic hematopoietic cell transplantation (allo-HCT) for acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS).
  • - Compared to other conditioning regimens (FluMel and BuCy), the study showed no difference in relapse rates after 2 years, but FluTreo resulted in significantly lower non-relapse mortality (NRM), indicating better tolerance.
  • - Overall survival (OS) rates were higher for
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Bortezomib (Vel)- Melphalan 200 mg/m2 (Mel200) (Vel-Mel) has been utilised to intensify conditioning in autologous hematopoietic stem cell transplantation (AHCT) for multiple myeloma (MM). This EBMT registry-based study compared Vel-Mel with Mel200 during upfront AHCT. Between 2010 and 2017, MM patients who received Vel-Mel (n = 292) conditioning were compared with 4,096 Mel200 patients in the same 58 centres.

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