Publications by authors named "Jan Vydra"

Background: The rate of immune reconstitution after allogeneic hematopoietic stem cell transplantation (allo-HSCT) plays the principal role in the development of serious post-transplant complications. However, the post-transplantation course has a significant impact on shaping the immune system of the recipient, per se, thus representing risk factors for subsequent unfavorable outcomes. The predictive power of an interferon gamma (IFNγ) release assay (IGRA) on graft-versus-host disease (GVHD) or hematological relapse in recipients of allo-HSCT treated with post-transplantation cyclophosphamide and the impact of these complications on the restoration of cellular immune responsiveness was evaluated.

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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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Aim: The aim of this study was to analyse the outcomes of patients with large B-cell lymphoma (LBCL) treated with chimeric antigen receptor T-cell therapy (CAR-Tx), with a focus on outcomes after CAR T-cell failure, and to define the risk factors for rapid progression and further treatment.

Methods: We analysed 107 patients with LBCL from the Czech Republic and Slovakia who were treated in ≥3rd-line with tisagenlecleucel or axicabtagene ciloleucel between 2019 and 2022.

Results: The overall response rate (ORR) was 60%, with a 50% complete response (CR) rate.

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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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Background: The non-viral production of CAR-T cells through electroporation of transposon DNA plasmids is an alternative approach to lentiviral/retroviral methods. This method is particularly suitable for early-phase clinical trials involving novel types of CAR-T cells. The primary disadvantage of non-viral methods is the lower production efficiency compared to viral-based methods, which becomes a limiting factor for CAR-T production, especially in chemotherapy-pretreated lymphopenic patients.

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  • A study analyzed outcomes of allogeneic hematopoietic stem cell transplantation (HSCT) for favorable risk Acute Myeloid Leukemia (AML) patients in complete remission across three time periods, involving 1850 patients.
  • Over the years from 2015 to 2021, older patients (≥60 years) and those with NPM1FLT3 diagnoses increased, while Haploidentical transplants also grew significantly.
  • The study found a reduction in chronic graft-versus-host disease and improved GVHD-free, relapse-free survival for patients transplanted after 2010 compared to earlier periods, though other outcomes showed no significant changes during the study period.
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We compared transplantation (HSCT) outcomes in AML patients undergoing HSCT with post-transplant cyclophosphamide (PTCy) in first complete remission from 1065 young (<35 years) haploidentical (Haplo) donors (yHaplo) vs. 147 old (≥35 years) mismatched unrelated donors (oMMUD) (first comparison) and from 271 young (<35 years) MMUD (yMMUD) vs. 1315 old (≥35 years) Haplo donors (oHaplo) (second comparison).

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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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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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Choice of calcineurin inhibitor may impact the outcome of patients undergoing T-cell replete hematopoietic cell transplantation (HCT) with post-transplant cyclophosphamide (PT-Cy) and mycophenolate mofetil (MMF) for prophylaxis of graft-versus-host disease (GVHD). We retrospectively analyzed 2427 patients with acute myeloid leukemia (AML) in first remission transplanted from a haploidentical (n = 1844) or unrelated donor (UD, n = 583) using cyclosporine A (CSA, 63%) or tacrolimus (TAC, 37%) and PT-Cy/MMF. In univariate analysis, CSA and TAC groups did not differ in 2-year leukemia-free or overall survival, cumulative incidence (CI) of relapse or non-relapse mortality.

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We compared relapse incidence (RI) post-unrelated transplantation with post-transplant cyclophosphamide (PTCy) versus no PTCy graft-versus-host disease (GVHD) prophylaxis, in 7049 acute myeloid leukemia (AML) patients in remission, 707 with PTCy, and 6342 without (No PTCy). The patients in the PTCy group were younger, 52.7 versus 56.

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In the context of T-cell replete haploidentical stem cell transplantation (Haplo-SCT) using post-transplantation cyclophosphamide (PT-Cy), it is still unknown whether peripheral blood (PB) or bone marrow (BM) is the best graft source. While PB is associated with a higher incidence of graft-versus-host disease (GVHD), it may induce a stronger graft-versus-leukemia effect compared to BM, notably in acute myeloid leukemia (AML). From the EBMT registry database, we compared T-cell replete PB (n = 595) versus BM (n = 209) grafts in a large cohort of 804 patients over the age of 60 years who underwent Haplo-SCT with PT-Cy for an AML in first or second complete remission.

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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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  • 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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Optimizing natural killer (NK) cell alloreactivity could further improve outcome after allogeneic hematopoietic cell transplantation (alloHCT). The donor's Killer-cell Immunoglobulin-like Receptor (KIR) genotype may provide important information in this regard. In the past decade, different models have been proposed aiming at maximizing NK cell activation by activating KIR-ligand interactions or minimizing inhibitory KIR-ligand interactions.

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We compared the outcomes of haploidentical stem cell transplantation (haplo-HSCT) with posttransplant cyclophosphamide (PTCy) in 719 patients with primary refractory (PR) or first relapse (Rel) secondary acute myeloid leukemia (sAML; n = 129) vs those with de novo AML (n = 590), who received HSCT between 2010 and 2022. A higher percentage of patients with sAML vs de novo AML had PR disease (73.6% vs 58.

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  • * Involving 2200 patients, the findings revealed that factors such as older donor age, use of female donors for male recipients, and the choice of peripheral blood donation were linked to poorer survival outcomes and increased risks of complications.
  • * The research suggests that prioritizing younger donors and male donors for male recipients can enhance transplant success, and utilizing bone marrow instead of peripheral blood may help reduce incidences of GVHD.
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Background: Changes in DNA methylation are common events in the pathogenesis of acute myeloid leukemia (AML) and have been repeatedly reported as associated with prognosis. However, studies integrating these numerous and potentially prognostically relevant DNA methylation changes are lacking. Therefore, we aimed for an overall evaluation of these epigenetic aberrations to provide a comprehensive NGS-based approach of DNA methylation assessment for AML prognostication.

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Despite lower virulence, the omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) still poses a relevant threat for immunocompromised patients. A retrospective multicentric study was conducted to evaluate the efficacy of pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) with a 6-month follow-up for preventing severe COVID-19 in adult patients with hematology malignancy. Among the 606 patients in the cohort, 96 (16%) contracted COVID-19 with a median of 98.

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  • The study aimed to compare two immunosuppressive strategies—rabbit antithymocyte globulin (ATG) and posttransplant cyclophosphamide (PTCY)—for preventing graft-versus-host disease (GVHD) in adults with acute lymphoblastic leukemia (ALL) after receiving a transplant from matched unrelated donors.
  • A total of 896 adult patients (117 with PTCY and 779 with ATG) were analyzed, revealing that while both groups had similar rates of GVHD, the PTCY group showed lower relapse rates and better leukemia-free survival (71% vs. 59%).
  • Although ATG was linked to a reduced risk of extensive chronic GVHD, it corresponded with poorer leukemia-free survival
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Availability of haploidentical donors has broadened utilization of allogeneic hematopoietic cell transplantation (allo-HCT). Peripheral blood stem cells (PBSC) are being used with increased frequency in haploidentical allo-HCT. We evaluated extent of HLA disparity (2-3/8 versus 4/8 HLA antigen mismatches) on post-allograft outcomes when using T-cell replete PBSC from haploidentical donors for acute myeloid leukemia in first complete remission.

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Background: Allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are at high risk of complications associated with COVID-19 infection due to dysfunction of their immune system. Vaccination can protect from the adverse consequences of COVID-19. However, studies on the efficacy of COVID-19 vaccines in HSCT recipients with insufficient post-HSCT immune reconstitution are still scarce.

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Tisagenlecleucel (tisa-cel) is a CD19specific CAR-T cell product approved for the treatment of relapsed/refractory (r/r) DLBCL or B-ALL. We have followed a group of patients diagnosed with childhood B-ALL ( = 5), adult B-ALL ( = 2), and DLBCL ( = 25) who were treated with tisa-cel under non-clinical trial conditions. The goal was to determine how the intensive pretreatment of patients affects the produced CAR-T cells, their expansion, and the outcome of the therapy.

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