Allogeneic stem cell transplantation for high-risk acute leukemia and maintenance therapy: no time to waste

Scott, Bart L.

doi:10.1182/bloodadvances.2019000388

Cited by 9 publications

(2 citation statements)

References 34 publications

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“…Similarly, venetoclax combinations have a striking ability to deliver deep, MRD-negative remissions in NPM1 mutant AML while also delivering less treatment related toxicity, an ideal pre-transplant regimen 42 . Beyond remission induction, the field is now moving rapidly towards defining the role of post-transplant relapse prevention strategies with FLT3 inhibitors and small molecules, and also hypomethylating agents and immunotherapeutic approaches [43][44][45] .…”

Section: Towards Deeper Remission Less Intense Conditioning and Reduced Post-transplant Relapsementioning

confidence: 99%

Better the cure you know: why patients with AML ≥60 years of age should be offered early allogeneic stem cell transplantation

Tey

Lane

2022

Blood Advances

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Section: Towards Deeper Remission Less Intense Conditioning and Reduced Post-transplant Relapsementioning

confidence: 99%

Better the cure you know: why patients with AML ≥60 years of age should be offered early allogeneic stem cell transplantation

Tey

Lane

2022

Blood Advances

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“…With the remarkable expansion of the arsenal of mechanistically driven therapeutic options for hematologic malignancies, it has become evident that maintenance therapies might be crucial to sustain and boost the immunotherapeutic effects of allo-HSCT (165,166). These can include the sequential administration of antigen-specific or whole tumor cell cancer vaccines (167)(168)(169)(170), mAbs (such as Inotuzumab (NCT03104491), Blinatumumab (171), or gemtuzumab ozogamycin (172,173), cell-based therapeutics including but not limited to DLI (162,174,175) or additional use of targeted drugs.…”

Section: Hsct As a Springboard For The Rational Design Of Combinatori...mentioning

confidence: 99%

60 Years Young: The Evolving Role of Allogeneic Hematopoietic Stem Cell Transplantation in Cancer Immunotherapy

Cieri

Maurer

2021

Cancer Research

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The year 2020 marked the 30th anniversary of the Nobel Prize in Medicine awarded to E. Donnall Thomas for the development of allogeneic hematopoietic stem cell transplantation (allo-HSCT) to treat hematologic malignancies and other blood disorders. Dr. Thomas, “father of bone marrow transplantation,” first developed and reported this technique in 1957, and in the ensuing decades, this seminal study has impacted fundamental work in hematology and cancer research, including advances in hematopoiesis, stem cell biology, tumor immunology, and T-cell biology. As the first example of cancer immunotherapy, understanding the mechanisms of antitumor biology associated with allo-HSCT has given rise to many of the principles used today in the development and implementation of novel transformative immunotherapies. Here we review the historical basis underpinning the development of allo-HSCT as well as advances in knowledge obtained by defining mechanisms of allo-HSCT activity. We review how these principles have been translated to novel immunotherapies currently utilized in clinical practice and describe potential future applications for allo-HSCT in cancer research and development of novel therapeutic strategies.

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Impact of extramedullary disease in AML patients undergoing sequential RIC for HLA-matched transplantation: occurrence, risk factors, relapse patterns, and outcome

et al. 2023

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We sought to evaluate the role of extramedullary disease (EMD) in sequential RIC retrospectively analyzing data of 144 high-risk AML patients undergoing HLA-matched transplantation. Median long-term follow-up was 11.6 years. Eighteen percent of patients (n = 26/144) presented with extramedullary AML (EM AML) or a history of EMD at time of transplantation. Overall relapse rate was 25% (n = 36/144) with 15% (n = 21/144) of all patients developing isolated BM relapse and 10% (n = 15/144) developing EM AML relapse with or without concomitant BM relapse (EM ± BM). Manifestation of EM relapse after transplantation occurred frequently at multiple sites and presented mostly as solid tumor mass. Only 3/15 patients with EM ± BM relapse showed a prior EMD manifestation. EMD prior to allogeneic transplantation had no impact on post-transplant OS when compared to non-EMD (median post-transplant OS 3.8 years versus 4.8 years; ns). Risk factors (p = < 0.1) for EM ± BM relapse included younger age and a higher number of prior intensive chemotherapies, whereas the presence of chronic GVHD was a protective factor. Median post-transplant OS (15.5 months vs. 15.5 months), RFS (9.6 months vs 7.3 months), and post-relapse OS (6.7 months vs. 6.3 months) were not significantly different between patients with isolated BM vs. EM ± BM relapse. Taken together, occurrence of EMD prior to as well as of EM ± BM AML relapse after transplantation was moderate, presenting mostly as solid tumor mass after transplantation. However, diagnosis of those does not seem to influence outcomes after sequential RIC. A higher number of chemotherapy cycles prior to transplantation was identified as recent risk factor for EM ± BM relapse.

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Allogeneic stem cell transplantation for high-risk acute leukemia and maintenance therapy: no time to waste

Abstract: This article has a companion Counterpoint by Soiffer.

Cited by 9 publications

References 34 publications

Better the cure you know: why patients with AML ≥60 years of age should be offered early allogeneic stem cell transplantation

Better the cure you know: why patients with AML ≥60 years of age should be offered early allogeneic stem cell transplantation

60 Years Young: The Evolving Role of Allogeneic Hematopoietic Stem Cell Transplantation in Cancer Immunotherapy

Impact of extramedullary disease in AML patients undergoing sequential RIC for HLA-matched transplantation: occurrence, risk factors, relapse patterns, and outcome

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