Publications by authors named "Jaime Sanz"

Background: Despite the high incidence of diarrhea in hematopoietic cell transplant (HCT) recipients, data on infectious enterocolitis with post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis remain limited.

Objectives: Evaluate the characteristics, incidence, risk factors, and impact on outcomes of infectious enterocolitis in patients with hematologic malignancies undergoing HCT from matched sibling, matched unrelated, and haploidentical donors using PTCy as GVHD prophylaxis.

Study Design: Retrospective analysis of infectious enterocolitis episodes in 399 patients undergoing HCT at a single institution.

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Patients (pts) with myelodysplasia-related AML (MR-AML) are now genetically recategorized, with three different groups in the International Consensus Classification: AML with mutated TP53 (TP53-AML), with myelodysplasia-related gene mutations (MR-GM AML), and with myelodysplasia-related cytogenetic abnormalities (MR-CG AML). Moreover, TP53-AML is determined by the presence of an additional complex karyotype (TP53-mut CK and non-CK AML, respectively). Nonetheless, the relevance of this classification to transplantation outcomes is largely unknown.

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We retrospectively analyzed the impact of conditioning intensity on transplant outcomes according to their cytogenetic/molecular risk in a cohort of 1823 patients with acute myeloid leukemia (AML) and intermediate- or adverse-risk cytogenetics in first complete remission (CR1). These patients received their first hematopoietic stem cell transplantation (HSCT) using post-transplant cyclophosphamide (PTCy). The intermediate-risk cytogenetic group included 1386 (76%) patients, and 608 (34%) had mutated FLT3-ITD.

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Post-transplant cyclophosphamide (PTCY) is increasingly used as effective graft-versus-host disease (GvHD) prophylaxis in allogeneic hematopoietic-cell transplantation (allo-HCT). However, PTCY is associated with toxicities. Whether patients with specific comorbidities are more vulnerable to cyclophosphamide-induced toxicity is unclear.

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BK hemorrhagic cystitis (BK-HC) is a common complication following hematopoietic stem cell transplantation (HSCT), particularly when posttransplant cyclophosphamide (PTCy) is used as graft-versus-host disease (GVHD) prophylaxis. However, comparative studies of BK-HC incidence in matched sibling donors (MSD) and unrelated donors (MUD) often include small haploidentical (HAPLO) donor cohorts and usually lack detailed information on disease evolution, coinfections, management and impact on outcomes. This study aimed to evaluate the incidence, risk factors, and outcomes in patients with hematologic malignancies undergoing HSCT from MSD, MUD, HAPLO donors using PTCy as GVHD prophylaxis.

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Article Synopsis
  • This study aims to create predictive models for treatment outcomes in patients with relapsed/refractory B-cell lymphoma undergoing CAR-T therapy by analyzing imaging data and clinical information.
  • It includes a cohort of 65 patients, utilizing imaging features from PET/CT scans to assess treatment response, overall survival, progression-free survival, and neurotoxicity risk associated with the therapy.
  • The results demonstrated that combining imaging features with clinical data significantly enhances prediction accuracy for treatment-related outcomes, highlighting the importance of metabolic tumor volume (MTV) in stratifying patient prognosis.
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Introduction: Intradialytic hypertension (IDH) is a poorly understood phenomenon with no consensus on its definition, etiology, or related factors, and there is limited evidence on its consequences.

Objective: To determine the prevalence of IDH according to different definitions in hemodialysis (HD) units, with different clinical practices and assessment of possible events after 18 months have passed.

Materials And Methods: A cross-sectional observational study was conducted in 2 HD units, including all prevalent patients from March 2021 to September 2022.

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Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is one of the most efficient therapeutic options available to cure many hematological malignancies. However, severe complications derived from this procedure, including graft-versus-host disease (GVHD) and infections, can limit its success and negatively impact survival. Previous studies have shown that alterations in the microbiome are associated with the development of allo-HSCT-derived complications.

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  • The study investigates the relationship between graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL) effects in acute myeloid leukemia (AML) patients after stem-cell transplantation (SCT), specifically comparing standard and post-transplant cyclophosphamide (PTCy) methods.
  • Results show that while GVHD correlates with lower relapse rates and higher non-relapse mortality (NRM) and lower overall survival (OS) in standard cases, following PTCy, GVHD does not reduce relapse.
  • The findings indicate that although GVHD remains a significant factor in SCT outcomes, its role changes depending on the type of prophylaxis used, particularly diminishing its association with relapse in the PTC
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Gastrointestinal bleeding (GIB) is a serious complication following allogeneic hematopoietic stem cell transplantation (HSCT), with limited data on its incidence and characteristics, particularly for upper gastrointestinal bleeding (UGIB) of gastric origin. We aimed to evaluate the incidence, clinical, endoscopic, and histopathologic features, and outcomes of UGIB, with a focus on gastric vascular ectasias (GVEs) in patients undergoing HSCT with graft-versus-host disease (GVHD) prophylaxis using post-transplant cyclophosphamide (PTCY), sirolimus or calcineurin inhibitors, and mycophenolate mofetil. This retrospective, single-center study included all adult patients who underwent allogeneic HSCT at a single institution between January 2017 and December 2023.

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  • A study evaluated the impact of a single-unit red blood cell (1-RBC) transfusion policy on patients undergoing autologous stem cell transplantation (ASCT), comparing it to the traditional double-unit policy.
  • The 1-RBC policy resulted in a 32% reduction in overall RBC use, with fewer transfusions required 30 days post-transplant (median of 2 vs. 3 units).
  • Despite reduced transfusion needs, the overall number of transfusion episodes and clinical outcomes like length of hospital stay and 30-day mortality remained similar between the two groups.
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The best donor option for acute myeloid leukemia (AML) patients lacking an HLA-matched donor has remained intensively debated. We herein report the results of a large retrospective registry study comparing hematopoietic cell transplantation (HCT) outcomes between double-unit umbilical cord blood transplantation (dCBT, n = 209) versus 9/10 HLA-matched unrelated donor (UD) with posttransplant cyclophosphamide (PTCy)-based graft-versus-host disease (GVHD) prophylaxis (UD 9/10, n = 270) in patients with AML in first complete remission (CR1). Inclusion criteria consisted of adult patient, AML in CR1 at transplantation, either peripheral blood stem cells (PBSC) from UD 9/10 with PTCy as GVHD prophylaxis or dCBT without PTCy, transplantation between 2013 and 2021, and no in vivo T-cell depletion.

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Article Synopsis
  • Haploidentical hematopoietic stem cell transplantation (haploSCT) is gaining traction as a viable option for patients without suitable donors, especially following the advent of post-transplantation cyclophosphamide (PTCy).
  • This study analyzed 372 adult haploSCT patients who received different GVHD prophylaxis strategies, finding no significant differences in acute GVHD rates among the groups, but noted lower chronic GVHD rates in patients treated with single-agent tacrolimus.
  • The results indicate that while all three prophylaxis methods (single-agent tacrolimus, CNI + MMF, sirolimus + MMF) produced similar short-term outcomes, further research is needed to explore differences in chronic GVHD
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  • Core-binding factor acute myeloid leukemia (CBF-AML) accounts for 12-15% of AML cases, but despite a survival advantage for CBF positivity, overall survival rates are low.
  • Patients typically undergo chemotherapy with cytarabine and anthracycline, followed by allogeneic stem cell transplantation (allo-SCT) for relapse or high-risk cases, though its use in first complete remission (CR1) is debated.
  • A study involving 1,901 CBF-AML patients found that allo-SCT in CR1 is linked to worse outcomes compared to autologous transplantation (ASCT), particularly in terms of non-relapse mortality (NRM) and overall survival (OS).
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Chimeric antigen receptor (CAR)-T cell therapy is approved for the treatment of relapsed/refractory (R/R) large B cell lymphoma (LBCL). However, elderly patients might not be candidates for this therapy due to its toxicity, and criteria for candidate selection are lacking. Our aim was to analyze efficacy and toxicity results of CAR-T cell therapy in the population of patients 70 years and older as compared to those obtained in younger patients in the real-world setting.

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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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This 45-year study (1978-2022) at a single institution evaluated HSCT outcomes and complications, emphasizing recent advances, with to provide insights into HSCT's evolving field and ongoing efforts to enhance patient outcomes. Involving 1707 patients, the study revealed an initial phase (1978-1987) with a limited activity that yielded modest outcomes, a nearly three-decade span (1988-2016) with a substantial increase in transplant activity, emphasizing umbilical cord blood transplantation (UCBT) for patients lacking a suitable matched sibling donor. In addition to a gradual increase in recipient age, significant improvement in outcomes emerged in the recent period (2017-2022), marked by UCBT replacement with haploidentical transplants, introduction of PTCY-based GVHD prophylaxis for all type of transplants, and increased use of conditioning regimens with thiotepa, busulfan, and fludarabine.

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  • A study compared the effectiveness of posttransplant cyclophosphamide (PTCy) versus conventional calcineurin inhibitor (CNI)-based regimens for preventing graft-versus-host disease (GVHD) in patients with Hodgkin lymphoma undergoing hematopoietic stem cell transplantation (HSCT) from HLA-matched donors.
  • Results showed that while PTCy was linked to slower recovery of blood cells, it significantly reduced the risk of chronic GVHD and improved long-term survival measures, including overall survival (OS) and progression-free survival (PFS).
  • Overall, PTCy exhibited better outcomes in reducing relapse rates and improving survival compared to CNI-based prophylaxis in this patient group, suggesting it may be a
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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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Total body irradiation (TBI)-based conditioning regimens are generally recommended for allogeneic HSCT (allo-HSCT) in patients with acute lymphoblastic leukemia (ALL). Recent evidence suggests that modern chemotherapy-based regimens may be as effective. This multicenter retrospective study compared the clinical outcomes of myeloablative allo-HSCT with thiotepa, busulfan, and cyclophosphamide/fludarabine (TTB) to TBI-based conditioning.

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There is a paucity of information on how to select the most appropriate unrelated donor (UD) in hematopoietic stem cell transplantation (HSCT) using posttransplant cyclophosphamide (PTCy). We retrospectively analyzed the characteristics of 10/10 matched UDs (MUDs) and 9/10 mismatched UDs (MMUDs) that may affect transplant outcomes in patients with acute myeloid leukemia (AML) in first or second complete remission (CR1 or CR2). The primary end point was leukemia-free survival (LFS).

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Background: This retrospective study focused on analyzing community-acquired respiratory virus (CARV) infections, in particular human parainfluenza virus (hPIV) after allogeneic stem cell transplant (allo-SCT) in adults recipients. It aimed to assess the impact of ribavirin treatment, clinical characteristics, and risk factors associated with lower respiratory tract disease (LRTD) progression and all-cause mortality.

Patients And Methods: The study included 230 allo-SCT recipients diagnosed with hPIV between December 2013 and June 2023.

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Selecting the most suitable alternative donor becomes challenging in severe aplastic anemia (SAA) when a matched sibling donor (MSD) is unavailable. We compared outcomes in patients with SAA undergoing stem cell transplantation (SCT) from matched unrelated donors (MUD) (n = 1106), mismatched unrelated donors (MMUD) (n = 340), and haploidentical donors (Haplo) (n = 206) registered in the European Society for Blood and Marrow Transplantation database (2012-2021). For Haplo SCT, only those receiving posttransplant cyclophosphamide for graft-versus-host disease (GVHD) prophylaxis were included.

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This study aimed to investigate the kinetics of immune recovery following umbilical cord blood transplantation (UCBT) in adults who received a myeloablative conditioning (MAC) regimen and antithymocyte globulin (ATG). While the immune recovery kinetics has been extensively studied in pediatric UCBT recipients, limited data exist for adults. We conducted a comprehensive analysis of 221 consecutive adult patients who underwent UCBT with MAC and ATG at a single institution.

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