Most hematological malignancies occur in older patients. Until recently these patients and those with comorbidities were not candidates for treatment with allogeneic hematopoietic transplantation because they were unable to tolerate the heretofore used high-dose conditioning regimens. The finding that many of the cures achieved with allogeneic hematopoietic transplantation were due to graft-versus-tumor effects led to the development of less toxic and well-tolerated reduced intensity and nonmyeloablative regimens. These regimens enabled allogeneic engraftment, thereby setting the stage for graft-versus-tumor effects. This review summarizes the encouraging early results seen with the new regimens and discusses the two hurdles that need to be overcome for achieving even greater success, disease relapse and graft-versus-host disease.
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http://dx.doi.org/10.3324/haematol.2015.132860 | DOI Listing |
Ther Adv Hematol
January 2025
Hematology and Stem Cell Transplantation Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Italy.
Ann Hematol
January 2025
Department of Obstetrics and Gynecology, The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.
Chronic Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplantation (HSCT), affecting the female genital tract in 25-66% of the patients. This condition, referred to as Genital GVHD is an underdiagnosed gynecologic comorbidity, that can significantly impair quality of life. We aimed to describe the prevalence and management of genital GVHD following HSCT.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Pharmacy, University of Miyazaki Hospital, 5200 Kihara, Kiyotake-cho, Miyazaki, 889-1692, Japan.
Intra-patient variability in immunosuppressive blood drug concentrations is a potential biomarker in managing organ transplant patients. However, the association between the time in therapeutic range of tacrolimus blood concentrations and its efficacy in preventing graft-versus-host disease remains unknown. In this study, we analyzed the relationship between the time in therapeutic range of tacrolimus blood concentrations and its efficacy in acute graft-versus-host disease prophylaxis in patients undergoing allogeneic hematopoietic stem cell transplantation.
View Article and Find Full Text PDFJ Infect Chemother
January 2025
Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan; Department of Hematology, Oncology and Respiratory medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Enterovirus A71 (EV-A71) is a major pathogen responsible for hand, foot, and mouth disease (HFMD) in infants and children. EV-A71 infection represents an epidemic in the Asia-Pacific region, and can cause serious central nervous system (CNS) infections in immunocompromised patients that can result in paralysis, disability, or death. There have been few reports in the literature concerning EV-A71 CNS infections after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in adult patients.
View Article and Find Full Text PDFEJHaem
February 2025
Department of Lymphoma and Myeloma Research Center Beijing Gobroad Boren Hospital Beijing China.
Here, we report a case of Epstein-Barr virus-positive central nervous system-post-transplant lymphoproliferative disorder (CNS-PTLD) patient who failed to achieve complete metabolic remission (CMR) after successively trying a methotrexate-based regimen combined with orelabrutinib or whole-brain radiotherapy and encountered intracranial hemorrhage during orelabrutinib treatment. Ultimately, the patient achieved CMR after one cycle of acalabrutinib in combination with temozolomide, teniposide, liposomal doxorubicin, dexamethasone, and rituximab (TEDDi-R). Following another cycle of TEDDi-R treatment, he has been receiving acalabrutinib maintenance up to now and remained in CMR.
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