Publications by authors named "Sunita Nathan"

Article Synopsis
  • Hematopoietic stem cell transplantation (HSCT) can lead to various cardiovascular complications, and this study aimed to assess the occurrence and risk factors of these events in patients post-transplant.
  • Researchers analyzed data from 3,354 adult patients who underwent HSCT from 2008 to 2019, tracking cardiovascular outcomes within 100 days and beyond, with a focus on incidents like heart failure and atrial fibrillation.
  • Results showed a low short-term incidence of cardiovascular events (4.1%) but a higher long-term incidence (13.9%), particularly among allogeneic transplant recipients and individuals with pre-existing heart conditions.
View Article and Find Full Text PDF
Article Synopsis
  • A study aimed to create a risk score for assessing cardiovascular risks in patients undergoing hematopoietic stem cell transplantation (HSCT) due to limited existing guidelines.
  • Using data from the CARE-BMT study, researchers analyzed various predictive factors related to cardiovascular events in over 2,400 HSCT patients, leading to the development of a point-based risk score.
  • This score categorizes patients into low, intermediate, and high-risk groups for cardiovascular issues post-transplant, potentially aiding in specialist referrals and long-term monitoring of high-risk individuals.
View Article and Find Full Text PDF

Post-transplant cyclophosphamide (PTCy) is increasingly used to reduce graft-versus-host disease after hematopoietic cell transplantation (HCT); however, it might be associated with more infections. All patients who were ≥2 years old, receiving haploidentical or matched sibling donor (Sib) HCT for acute leukemias or myelodysplastic syndrome, and either calcineurin inhibitor (CNI)- or PTCy-based GVHD prophylaxis [Haploidentical HCT with PTCy (HaploCy), 757; Sibling with PTCy (SibCy), 403; Sibling with CNI-based (SibCNI), 1605] were included. Most bacterial infections occurred within the first 100 days; 953 patients (34.

View Article and Find Full Text PDF

Unlabelled: Fungal infection (FI) after allogeneic hematopoietic cell transplantation (HCT) is associated with increased morbidity and mortality. Neutropenia, HLA mismatch, graft-versus-host disease (GVHD), and viral infections are risk factors for FI. The objectives of this Center for International Blood and Marrow Transplant Research registry study were to compare the incidence and density of FI occurring within 180 days after HCT in matched sibling (Sib) transplants with either calcineurin inhibitor (CNI)-based or post-transplantation cyclophosphamide (PTCy)-based GVHD prophylaxis and related haploidentical transplants receiving PTCy, and to examine the impact of FI by day 180 on transplantation outcomes.

View Article and Find Full Text PDF

Autologous hematopoietic cell transplantation (auto-HCT) has long been the standard approach for patients with relapsed/refractory (R/R) chemosensitive diffuse large B cell lymphoma (DLBCL). However, the advent of chimeric antigen receptor (CAR) T cell therapy has caused a paradigm shift in the management of R/R DLBCL patients, especially with the recent approval of CD19-directed CAR-T therapy in the second-line setting in high-risk groups (primary refractory and early relapse [≤12 months]). Consensus on the contemporary role, optimal timing, and sequencing of HCT and cellular therapies in DLBCL is lacking; therefore, the American Society of Transplantation and Cellular Therapy (ASTCT) Committee on Practice Guidelines undertook this project to formulate consensus recommendations to address this unmet need.

View Article and Find Full Text PDF

Background: Scedosporium is a lesser-known non-Aspergillus genus of mold that can present in unsuspecting ways. If overlooked, it may disseminate and cause high mortality in high-risk allogeneic stem cell transplant recipients.

Case Presentation: This case report describes a 65-year-old patient with Acute Myeloid Leukemia who underwent an allogeneic hematopoietic stem cell transplant after a period of prolonged neutropenia with fluconazole prophylaxis.

View Article and Find Full Text PDF
Article Synopsis
  • Researchers created a prognostic model to predict outcomes for patients with myelofibrosis undergoing allogeneic hematopoietic cell transplantation by analyzing data from 623 patients in the U.S. (CIBMTR cohort) from 2000 to 2016.
  • They identified key factors that influence mortality, assigning weighted scores based on age, donor matching, hemoglobin levels, and donor compatibility, which resulted in differing survival rates among low, intermediate, and high score groupings.
  • The model was validated in a European cohort (EBMT), proving effective for predicting overall survival and transplant-related mortality, aiding clinicians in discussing transplantation prospects with myelofibrosis patients.
View Article and Find Full Text PDF
Article Synopsis
  • Lenalidomide maintenance following autologous stem cell transplant (ASCT) provides better progression-free and overall survival for multiple myeloma (MM) patients, but high-risk multiple myeloma (HRMM) patients don't see the same benefits.
  • A study examined 503 HRMM patients to compare outcomes of lenalidomide versus bortezomib-based maintenance therapies post-ASCT, finding that those on lenalidomide had better survival rates.
  • Results showed that while 67% of the patients were on lenalidomide, they had a 75% progression-free survival rate at 2 years compared to 63% for those on bortezomib, and overall survival was also higher
View Article and Find Full Text PDF

Allogeneic hematopoietic cell transplantation (allo-HCT) remains the only curative treatment for myelofibrosis. However, the optimal conditioning regimen either with reduced-intensity conditioning (RIC) or myeloablative conditioning (MAC) is not well known. Using the Center for International Blood and Marrow Transplant Research database, we identified adults aged ≥18 years with myelofibrosis undergoing allo-HCT between 2008-2019 and analyzed the outcomes separately in the RIC and MAC cohorts based on the conditioning regimens used.

View Article and Find Full Text PDF

Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative treatment for acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). While many factors influence the outcomes of allo-HCT, the independent impact of donor-recipient ABO mismatching remains unclear. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we identified patients aged ≥18 years with AML or ALL who underwent allo-HCT between 2008 and 2018.

View Article and Find Full Text PDF

Plasmablastic lymphoma (PBL) is a rare entity, commonly associated with immunosuppressed states such as human immunodeficiency virus (HIV) infection or solid organ transplant. The clinical course is characterized by high relapse rates and a poor prognosis, leading some clinicians to recommend aggressive frontline therapy. However, a specific review of limited stage (LS) PBL patients is not available to evaluate outcomes and justify treatment recommendations.

View Article and Find Full Text PDF

Long-term neurocognitive deficits after human herpesvirus-6 (HHV-6) infection are common in stem-cell transplant recipients, but SIADH (Syndrome of inappropriate antidiuretic hormone secretion) with persistent hyponatremia is rare. A 51-year-old woman presented with somnolence, hyponatremia (121 mmol/L) and HHV-6 viremia (80,330 copies/ml) on day +22 post umbilical cord blood transplant (UCBT). With waterrestriction, tolvaptan and combination of foscarnet and ganciclovir, patient's hyponatremia and HHV-6 viremia improved.

View Article and Find Full Text PDF

We investigated the impact of the number of induction/consolidation cycles on outcomes of 3113 adult AML patients who received allogeneic hematopoietic cell transplantation (allo-HCT) between 2008 and 2019. Patients received allo-HCT using myeloablative (MAC) or reduced-intensity (RIC) conditioning in first complete remission (CR) or with primary induction failure (PIF). Patients who received MAC allo-HCT in CR after 1 induction cycle had 1.

View Article and Find Full Text PDF

Male-specific late effects after hematopoietic cell transplantation (HCT) include genital chronic graft-versus-host disease (GvHD), hypogonadism, sexual dysfunction, infertility, and subsequent malignancies. They may be closely intertwined and cause prolonged morbidity and decreased quality of life after HCT. We provide a systematic review of male-specific late effects in a collaboration between transplant physicians, endocrinologists, urologists, dermatologists, and sexual health professionals through the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research, and the Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation.

View Article and Find Full Text PDF
Article Synopsis
  • * A study analyzed 313 adult CMML patients who underwent HCT from 2001 to 2017, finding that higher prognostic scoring (CPSS and CPSS-Mol) correlated with poorer overall survival rates.
  • * Common mutations like ASXL1, TET2, and TP53 were linked to adverse outcomes, with TP53 mutations specifically showing an increase in relapse rates, though their impact should be viewed cautiously due to their infrequency in CMML cases.
View Article and Find Full Text PDF
Article Synopsis
  • Matched sibling donors (MSDs) are generally preferred for allogeneic hematopoietic cell transplantation in myelodysplastic syndrome, but it's uncertain if older MSDs yield better outcomes than younger unrelated donors (MUDs).
  • The study aimed to determine if using younger MUDs leads to better disease-free survival and lower relapse rates compared to older MSDs.
  • Results showed that disease-free survival rates were significantly lower for older MSDs compared to younger MUDs, although overall survival did not show a significant difference between the two groups.
View Article and Find Full Text PDF

Male-specific late effects after hematopoietic cell transplantation (HCT) include genital chronic graft-versus-host disease (GVHD), hypogonadism, sexual dysfunction, infertility, and subsequent malignancies, such as prostate, penile, and testicular cancer. These effects may be closely intertwined and cause prolonged morbidity and decreased quality of life after HCT. Here we provide a systematic review of male-specific late effects in a collaboration among transplantation physicians, endocrinologists, urologists, dermatologists, and sexual health professionals through the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and the Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation.

View Article and Find Full Text PDF
Article Synopsis
  • - The study analyzed the impact of maintenance therapy following second autologous hematopoietic cell transplant (AHCT2) for multiple myeloma, using data from the Center for International Blood and Marrow Transplant Research registry, which included 522 patients.
  • - Results indicated that patients who received maintenance therapy (342 patients) had significantly better 5-year outcomes compared to those who did not (180 patients), showing lower rates of non-relapse mortality, relapse, and improved progression-free and overall survival.
  • - Maintenance therapies primarily included lenalidomide, pomalidomide, and bortezomib, with findings suggesting a consistent benefit from maintenance therapy without an increased risk of second cancers between the groups.
View Article and Find Full Text PDF

Cytogenetic and molecular abnormalities are known to influence post-transplant outcomes in acute myeloid leukemia (AML) but data assessing the prognostic value of combined genetic models in the HCT setting are limited. We developed an adapted European LeukemiaNet (aELN) risk classification based on available genetic data reported to the Center for International Blood and Marrow Transplant Research, to predict post-transplant outcomes in 2289 adult AML patients transplanted in first remission, between 2013 and 2017. Patients were stratified according to aELN into three groups: favorable (Fav, N = 181), intermediate (IM, N = 1185), and adverse (Adv, N = 923).

View Article and Find Full Text PDF