Current Trends in Clinical Studies of Allogeneic Hematopoietic Stem Cell Transplantation

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is a specialized intervention performed at select centers worldwide. The extent to which specific aspects of care in allogeneic HSCT have been studied and the types of studies performed for different aspects of care remains incompletely documented. Studies in allogeneic HSCT were systematically identified from selected high-profile transplant journals between July 2010 and June 2011 and previously reported in a study addressing the definition of clinical outcomes in HSCT. All articles were retrieved and assessed for study characteristics and categorized by specific aspects of care related to allogeneic HSCT. One hundred sixteen articles were retrieved and reviewed in detail by 2 investigators. The most studied aspect of care was conditioning regimens. Transfusion practices were the most understudied aspect of care. Interestingly, most studies included both adult and pediatric patients. Studies involving all hematological malignancies were encountered more often than disease-specific studies. Geographically, most patients described in the published reports were treated only in North America or only in Europe. Most studies were retrospective (78), and 25 reported on multicenter registry data. Of the 38 prospective studies, 8 were randomized controlled trials (RCTs) and predominantly focused on prevention and treatment of graft-versus-host disease (GVHD) and infections. Median follow-up was longer in retrospective registry studies (54 months) and shortest in RCTs (32 months). The proportion of positive outcomes in retrospective and prospective studies was remarkably high (>80% for all categories) and not significantly different across all aspects of care (P > .05). When comparing RCTs and registry data studies, this proportion was similar and high (95% and 100%, respectively, P > .05). Our study highlights the established and important role of retrospective registry studies for many aspects of care and suggests RCTs may be most relevant for studies on infectious complications and GVHD.

Optimal transfusion practices after allogeneic hematopoietic cell transplantation: a systematic scoping review of evidence from randomized controlled trials

“…A systematic search of published RCTs was performed by an information specialist using a search strategy that was peer reviewed by an independent information specialist . Multiple electronic databases were searched from 1947 to May 2015 in Medline, EMBASE, and the Cochrane Register of Controlled Trials and bibliographies of relevant articles were reviewed to search for any additional citations.…”

Allogeneic transplantation of hematopoietic stem cells: Perspectives and alternatives, own experience

“…Более миелоаблативный режим чаще выбирают при выраженно агрессивных гемобластозах, а режимы со сниженной интенсивно-стью доз (РИК) и немиелоаблативные режимы могут быть предпочтительнее при индолентных заболева-ниях. При изучении тенденций в клинических иссле-дованиях алло-ТГСК наиболее изучаемым аспектом всех исследований закономерно оказались режимы кондиционирования [19]. Режимы кондиционирования могут иметь различ-ные показания, базирующиеся на данных из клини-ческих исследований, и в зависимости от интенсив-ности являются полностью миелоаблативными, РИК и немиелоаблативными (табл.…”

Decitabine shows synergistic effects with arsenic trioxide against myelodysplastic syndrome cells via endoplasmic reticulum stress-related apoptosis

“…5 Major clinical trials of DAC used in patients with MDS showed that about half responded to hypomethylating therapy, whereas the majority of patients with MDS failed were International Prognostic Scoring System (IPSS) intermediate or high-risk patients. 6 7 Allogeneic hematopoietic stem cell transplantation (HSCT) is a potential curable intervention for hematopoietic diseases, 8 which is one of the curative therapies for high-risk patients with MDS, but MDS tends to occur in the elderly with potential comorbid conditions who cannot afford the complications followed by HSCT, so combination chemotherapy with DAC was needed. Arsenic trioxide (ATO) is used in hematologic disorders and solid tumors, including acute promyelocytic leukemia, AML, MDS, lymphoma and sarcoma.…”