Publications by authors named "Rama Al-Hamed"
Article Synopsis
- 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).
Background: Allogeneic hematopoietic cell transplantation (allo-HCT) is the only cure for acute myeloid leukemia (AML) in second complete remission (CR2). Patients lacking a matched sibling donor (MSD) receive transplants from matched unrelated donors (MUDs), mismatched unrelated donors (MMUDs), haploidentical (haplo) donors, or cord blood.
Methods: This is a retrospective, registry-based European Society for Blood and Marrow Transplantation study that investigates changes in patient- and transplant-related characteristics and posttransplant outcomes over time.
Article Synopsis
- Adult T-cell leukemia/lymphoma (ATLL) has poor treatment outcomes, but allogeneic stem-cell transplantation (allo-SCT) shows promise, despite limited data.
- In a study involving 100 ATLL patients, 17 underwent allo-SCT with notable improvements in 3-year progression-free survival (31%) and overall survival (35%), compared to autologous SCT (ASCT) which had a higher relapse incidence.
- Factors such as achieving a complete response, a high Karnofsky score, and ethnicity influenced survival outcomes, indicating that allo-SCT may offer long-term survival benefits for select ATLL patients.
Myelodysplastic syndromes (MDS) are a heterogeneous clonal disease of myeloid neoplasms characterized by ineffective hematopoiesis, variable degree of cytopenias, and an increased risk of progression to acute myeloid leukemia (AML). Molecular and genetic characterization of MDS has led to a better understanding of the disease pathophysiology and is leading to the development of novel therapies. Targeted and immune therapies have shown promising results in different hematologic malignancies.
View Article and Find Full Text PDFThe current standard of care model for newly diagnosed fit multiple myeloma (NDMM) patients is the sequential treatment of induction, high dose melphalan, autologous stem cell transplantation (ASCT), and maintenance. Adequate induction is required to achieve good disease control and induce deep response rates while minimizing toxicity as a bridge to transplant. Doublet induction regimens have greatly fallen out of favor, with current international guidelines favoring triplet or quadruplet induction regimens built around the backbone of the proteasome inhibitor bortezomib and dexamethasone (Vd).
View Article and Find Full Text PDFNucleophosmin-1 (NPM1) mutations in acute myeloid leukemia (AML) confer a survival advantage in the absence of FLT3-internal tandem duplication (FLT3-ITD). Here, we investigated the main predictors of outcome after allogeneic hematopoietic stem cell transplantation (allo-HCT). We identified 1572 adult (age ≥ 18 year) patients with NPM1-mutated AML in first complete remission (CR1:78%) or second complete remission (CR2:22%) who were transplanted from matched sibling donors (30.
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- - Hodgkin lymphoma is largely treatable, but there are still challenges for patients, especially those experiencing relapse, older patients, and issues related to treatment side effects and quality of life.
- - New treatment strategies, such as checkpoint inhibitors and antibody-drug conjugates, are being explored to improve outcomes in frontline therapy and for tailored patient care.
- - The review discusses available treatments from initial therapy to advanced options like stem cell transplantation and highlights emerging clinical trials in Hodgkin lymphoma.
Article Synopsis
- AL amyloidosis is a serious disease caused by unstable immunoglobulin-free light chains from plasma cells that can lead to significant organ damage if not diagnosed early.
- Treatment focuses on timely diagnosis and may include autologous stem cell transplantation for about 20% of patients, while others are treated with bortezomib and the newer drug daratumumab.
- The article discusses management strategies, therapy goals, current guidelines based on transplant eligibility, monitoring for treatment response, toxicity management, and handling disease relapse or resistance.
Letermovir is approved for the prevention of cytomegalovirus (CMV) reactivation and clinical disease in patients undergoing allogeneic hematopoietic-cell transplantation (HCT). However, there is uncertainty about letermovir's ability to prevent clinical events during the period of prophylaxis as well as after the discontinuation of prophylaxis in the post-transplant setting. We performed a retrospective cohort study in CMV-seropositive allogeneic HCT recipients at high risk of CMV events, who received letermovir for primary prophylaxis from November 2017 through December 2019.
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- * A study of 202 alloHCT patients revealed that 35% had veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) as a significant cause of MOF, with 69% of these cases previously undiagnosed.
- * Factors such as prior liver issues and disease status were linked to the likelihood of developing VOD/SOS, and the findings point to the need for updated criteria to better identify and manage late-onset cases occurring more
Article Synopsis
- * New targeted therapies, like kinase inhibitors, are emerging as effective treatments and can be integrated into various stages of AML care, from initial treatment to post-transplant maintenance.
- * Challenges in treatment persist, including how to balance these new drugs with traditional chemotherapy, determining the best timing for their use, and clarifying the role of allogeneic stem cell transplantation, which offers the only true cure for high-risk patients.
Article Synopsis
- Treatment of relapsed/refractory acute lymphoblastic leukemia (RR-ALL) is challenging, with poor prognoses; a study on 115 patients showed limited success with allogeneic stem-cell transplantation.
- The study revealed cumulative incidences of acute graft-versus-host disease (GVHD) at 30% for grade II-IV and 17% for grade III-IV by day 100, while two-year leukemia-free survival rates were only 14%, highlighting the ongoing challenges in treatment.
- Factors influencing outcomes included a Karnofsky score below 90 and the type of conditioning used; those receiving chemotherapy alone faced worse relapse and survival rates compared to those treated with total body irradiation, emphasizing the need for innovative therapies.
Most patients with relapsed/refractory multiple myeloma (RRMM) have been treated with drug combinations including a proteasome inhibitor (PI) and/or an immunomodulatory drug (IMiD). The goal of therapy for such patients is therefore to achieve disease control with acceptable toxicity and patient-defined decent quality of life. Physicians face a difficult task not only deciding who to treat, but also when to treat and how to treat, utilizing knowledge of previously administered therapies, patient comorbidities, potential adverse events, and patient wishes to make such a critical decision.
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- * Factors like age, previous treatments, and other infections can increase the risk of developing PTLD, but there are limited clinical trials and no standard treatments approved for the condition, making it hard to manage.
- * Current first-line therapy for PTLD involves rituximab, but there's no consensus for cases where this treatment fails; ongoing clinical trials are exploring other potential therapies, such as specialized T-cells and new drugs.
Article Synopsis
- * New therapies like immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies have enhanced, rather than replaced, the importance of ASCT in the treatment process.
- * The review discusses key questions about ASCT, including patient suitability, age limits, timing of transplantation, optimal treatment protocols, and the impact of patient-specific factors on treatment decisions.