Publications by authors named "Yakoub-Agha I"

This workshop presents the recommendations of the Société francophone de greffe de moelle et de thérapie cellulaire (SFGM-TC) for simulation-based training on bone marrow harvesting from healthy donors. Due to the decline in bone marrow harvests in favor of peripheral stem cells, a loss of expertise has been observed among younger hematologists. The training consists of an online theoretical component and a hands-on workshop using a mannequin at the PRESAGE simulation center at the Lille University School of Medicine.

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  • 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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Introduction: The general-purpose rating scales used by clinical pharmacists to rate their activities have not been extensively studied in specialist care units. This study aims to describe drug-related problems (DRPs) and pharmacist interventions (PIs) in a French hematopoietic cell therapy (HCT) unit and to evaluate the PIs' likely clinical, economic, and organizational impacts.

Methods: We retrospectively assessed all DRPs reported and all PIs issued between December 2018 and December 2021.

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In patients diagnosed with B-acute lymphoblastic leukemia (B-ALL) or B-non-Hodgkin's lymphoma (B-NHL) relapsing after allogeneic stem cell transplantation (allo-HCT), it is a standard practice to perform anti-CD19 chimeric antigen receptor (CAR) T-cell therapy. When collected from the patient after allo-HCT, the produced CAR-T cells are likely to be donor T-cell-derived, creating unknown safety risks due to their potential allo-reactivity. We therefore performed an EBMT registry-based study on the incidence of graft-versus-host disease (GvHD) in this setting.

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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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  • Haploidentical hematopoietic cell transplantation (haplo-HCT) is increasingly used globally but remains uncommon in low- and middle-income countries, prompting a working group from the SFGM-TC to propose recommendations for implementation.
  • * The potential advantages of haplo-HCT include better accessibility to donors and lower costs; however, it should only be performed in experienced centers with a track record of related HLA-matched transplants.
  • * Regular evaluations are necessary to monitor the feasibility and outcomes of implementing haplo-HCT in these regions, particularly for patients lacking HLA-matched donors.*
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  • Autologous peripheral blood stem cell (PBSC) transplantation is a common treatment for conditions like multiple myeloma and lymphomas, and it usually involves freezing the stem cells before transplant.* -
  • A recent systematic review of 19 transplant centers that performed non-cryopreserved PBSC transplants showed that the procedure is feasible and safe, with high stem cell viability and low rates of complications.* -
  • The study found that stem cell viability was over 90% for multiple myeloma and over 75% for lymphomas, with quick engraftment times, and only 1% transplant-related mortality within 100 days.*
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  • * A significant number of respondents (67.0%) felt that early diagnosis was challenging, but many (75.8%) found the new 2023 EBMT diagnostic criteria useful and easy to apply.
  • * Key risk factors for VOD/SOS included second allo-HCT, pre-existing liver disease, and prior use of antibody-drug conjugates, with varied preferences on when to start treatment.
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The arrival of CAR-T cell treatments in Europe in 2018 has considerably changed the clinical and logistical management of lymphoma patients. The aim of this study is to evaluate pathways of patients eligible for axicabtagene ciloleucel (axi-cel), particularly previously and afterwards of its administration, stages that are currently poorly documented in the literature. Ninety-eight patients from eleven French qualified centers eligible for axi-cel treatment between June 2020 and February 2021 were retrospectively included.

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  • First-line treatments for autoimmune systemic diseases (ARD) typically involve immunosuppressive drugs, but long-term use can lead to significant health risks.
  • Innovative therapies like mesenchymal stromal cells (MSCs) and Chimeric Antigen Receptor (CAR) T cell therapies are emerging as promising alternatives for severe or refractory cases of ARD.
  • A workshop by the French Speaking Society of Bone Marrow and Cell Transplantation focuses on establishing healthcare pathways and safety protocols for the deployment of MSCs and CAR-T therapies in ARD treatment, emphasizing patient safety and collaboration among specialists.
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  • HLA mismatching (different types of immune cells) can make it harder for patients with blood cancer to survive after getting a transplant.
  • In a study with over 17,000 patients, those with mismatched HLA types had lower survival rates, especially with certain HLA classes.
  • Using a new treatment called post-transplantation cyclophosphamide (PTCy) helps reduce some risks, but HLA mismatching still leads to higher death rates in both PTCy and traditional transplant methods.
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  • This study examines the effects of IDH1 and IDH2 mutations on adult AML patients who received allogeneic hematopoietic cell transplantation, finding that 15.91% had IDH1 mutations and 26.27% had IDH2 mutations.* -
  • Patients with IDH1 and IDH2 mutations experienced lower rates of acute graft-versus-host disease (GVHD) compared to those without mutations, with significant improvements in overall survival (OS) linked to IDH1 mutations.* -
  • IDH2 mutations were associated with a lower relapse rate and better leukemia-free survival (LFS) and OS, particularly in patients without NPM1 mutations, indicating these mutations may lead to better outcomes post
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HLA-DP permissive mismatches can be assigned a direction according to their immunopeptidome divergence across core and noncore subsets. Noncore permissive graft-versus-host mismatches show significantly reduced risks of relapse without increased nonrelapse mortality compared with allele-matched pairs.

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In 2023, the EBMT Practice harmonization and Guidelines Committee partnered with the EBMT Infection Diseases Working Party (IDWP) to undertake the task of delivering best practice recommendations, aiming to harmonize by expert consensus, the already existing definitions and future epidemiological and clinical studies among centers of the EBMT network. To attain this objective, a group of experts in the field was convened. The workgroup identified and discussed some critical aspects in definitions of community-acquired respiratory viruses (CARV) and adenovirus (ADV) infections in recipient of hematopoietic cell transplant (HCT).

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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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The objective of the study was the analysis of clinical types, outcomes, and risk factors associated with the outcome of adenovirus (ADV) infection, in children and adults after allo-HCT. A total number of 2529 patients (43.9% children; 56.

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Treatment of pediatric high-risk acute myeloid leukemia (AML), defined either on molecular or cytogenetic features, relies on bone marrow transplant after cytologic remission. However, relapse remains the first post-transplant cause of mortality. In this 13 session of practice harmonization of the francophone society of bone marrow transplantation and cellular therapy (SFGM-TC), our group worked on recommendations regarding the management of post-transplant relapse in AML pediatric patients based on international literature, national survey and expert opinion.

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Since the early description of three patients with relapsed leukaemia after allogeneic haematopoietic cell transplantation (HCT) who obtained complete remission after donor lymphocyte infusions (DLIs), the added value of this procedure to induce or maintain graft-versus-leukaemia immunity has been undisputed. For more than 30 years, DLIs have become common practice as prophylactic, pre-emptive, or therapeutic immunotherapy. However, as with many aspects of allogeneic HCT, centres have developed their own routines and practices, and many questions related to the optimal applications and toxicity, or to the immunobiology of DLI induced tumour-immunity, remain.

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Idecabtagene vicleucel (ide-cel), a chimeric antigen receptor T-cell therapy targeting B-cell maturation antigen (BCMA), received early access program (EAP) authorization in France in April 2021 for relapsed/refractory multiple myeloma (RRMM). We conducted a real-world registry-based multicentre observational study in 11 French hospitals to evaluate ide-cel outcomes. Data from 176 RRMM patients who underwent apheresis between June 2021 and November 2022 were collected from the French national DESCAR-T registry.

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  • - 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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  • 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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  • * Results show that patients requiring two courses of induction chemotherapy (IND2) to reach CR have poorer prognostic outcomes compared to those achieving CR after one course (IND1), with higher risks of relapse and death.
  • * Several adverse factors, such as age and specific genetic markers, influenced outcomes, emphasizing that the initial response to chemotherapy remains significant even after transplant.
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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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