Graft Manipulation

Schumm, Michael; Lang, Peter; Handgretinger, Rupert

doi:10.1007/978-3-030-02278-5_19

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…Nonetheless, this retrospective analysis describes a relatively homogeneous population of 50 RMA patients. Considering TRM despite ex vivo graft manipulation is of utmost importance, although novel techniques for GvHD prophylaxis, such as post-transplant cyclophosphamide, were only implemented in one of the herein reported patients ( 21 , 24 ). None of the patients with PD at allo-HSCT survived.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous retrospective analysis ( 15 ), evaluating the role of allo-HSCT for advanced rhabdomyosarcoma, we did not address the role of HLA-mismatched versus HLA-matched to induce a hypothesized graft-versus-tumor effect due to low frequency of haploidentical transplantations at that time. With better standardization and quality of ex vivo graft manipulation (e.g., CD3/CD19 depletion) ( 21 ), there has been a shift towards the use of haploidentical/mismatched grafts. In our analysis, we did not observe significant differences in between both study groups (mismatched vs. matched) in regard to EFS and OS.…”

Section: Discussionmentioning

confidence: 99%

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No Improvement of Survival for Alveolar Rhabdomyosarcoma Patients After HLA-Matched Versus -Mismatched Allogeneic Hematopoietic Stem Cell Transplantation Compared to Standard-of-Care Therapy

Lang

2022

Front. Oncol.

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BackgroundPatients with stage IV alveolar rhabdomyosarcoma (RMA) have a 5-year-survival rate not exceeding 30%. Here, we assess the role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for these patients in comparison to standard-of-care regimens. We also compare the use of HLA-mismatched vs. HLA-matched grafts after reduced vs. myeloablative conditioning regimens, respectively.Patients and MethodsIn this retrospective analysis, we compare event-free survival (EFS), overall survival (OS), and toxicity of HLA-mismatched vs. -matched transplanted patients in uni- and multivariate analyses (total: n = 50, HLA-matched: n = 15, HLA-mismatched: n = 35). Here, the factors age at diagnosis, age at allo-HSCT, sex, Oberlin score, disease status at allo-HSCT, and HLA graft type are assessed. For 29 primarily transplanted patients, three matched non-transplanted patients per one transplanted patient were identified from the CWS registry. Outcomes were respectively compared for OS and EFS. Matching criteria included sex, age at diagnosis, favorable/unfavorable primary tumor site, and metastatic sites.ResultsMedian EFS and OS did not differ significantly between HLA-mismatched and -matched patients. In the mismatched group, incidence of acute GvHD was 0.87 (grade III–IV: 0.14) vs. 0.80 in HLA-matched patients (grade III–IV: 0.20). Transplant-related mortality (TRM) of all patients was 0.20 and did not differ significantly between HLA-mismatched and -matched groups. A proportion of 0.58 relapsed or progressed and died of disease (HLA-mismatched: 0.66, HLA-matched: 0.53) whereas 0.18 were alive in complete remission (CR) at data collection. Multivariate and competing risk analyses confirmed CR and very good partial response (VGPR) status prior to allo-HSCT as the only decisive predictor for OS (p < 0.001). Matched-pair survival analyses of primarily transplanted patients vs. matched non-transplanted patients also identified disease status prior to allo-HSCT (CR, VGPR) as the only significant predictor for EFS. Here, OS was not affected, however.ConclusionIn this retrospective analysis, only a subgroup of patients with good response at allo-HSCT survived. There was no survival benefit of allo-transplanted patients compared to matched controls, suggesting the absence of a clinically relevant graft-versus-RMA effect in the current setting. The results of this analysis do not support further implementation of allo-HSCT in RMA stage IV patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

No Improvement of Survival for Alveolar Rhabdomyosarcoma Patients After HLA-Matched Versus -Mismatched Allogeneic Hematopoietic Stem Cell Transplantation Compared to Standard-of-Care Therapy

Lang

2022

Front. Oncol.

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“…The residual number of CD3+ cells is usually less than 1% and for analysis is needed special protocol for the rare number of T cells. In addition, multigating strategy protocol should be implemented 46 . Nowadays, two different T‐cell depletions are used in haploidentical HSC transplantation: in vitro T‐cell depletion of PBSC and posttransplantation cyclophosphamide for in vivo T‐cell depletion 47 .…”

Section: Assessment Of Leukocyte Subpopulationmentioning

confidence: 99%

Role of flow cytometry in evaluation of the cellular therapy products used in haematopoietic stem cell transplantation

Rimac

Bojanić

2022

Int J Lab Hematology

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Novel approaches to acute graft-versus-host disease prevention

Watkins,

Qayed

2023

Hematology

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The field of graft-versus-host disease (GvHD) has experienced significant growth, with increased number of clinical trials and the approval of several agents by the US Food and Drug Administration for both acute and chronic GvHD treatment. In addition, the development of prognostic biomarker algorithms has enabled risk stratification in acute GvHD. However, prevention remains the cornerstone of GvHD management. Notable recent changes include the expansion of donor options with the increased use of haploidentical donor and unrelated donor transplantation, the development of ex vivo selective T-cell depletion strategies, recent approval by the Food and Drug Administration of abatacept for GvHD prevention, and the application of posttransplant cyclophosphamide in matched and mismatched donor settings. In this article, we review the results of recent clinical trials in GvHD prophylaxis and discuss the changes in clinical practice and promising emerging strategies driving the field forward.

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Graft Manipulation

Cited by 3 publications

References 28 publications

No Improvement of Survival for Alveolar Rhabdomyosarcoma Patients After HLA-Matched Versus -Mismatched Allogeneic Hematopoietic Stem Cell Transplantation Compared to Standard-of-Care Therapy

No Improvement of Survival for Alveolar Rhabdomyosarcoma Patients After HLA-Matched Versus -Mismatched Allogeneic Hematopoietic Stem Cell Transplantation Compared to Standard-of-Care Therapy

Role of flow cytometry in evaluation of the cellular therapy products used in haematopoietic stem cell transplantation

Novel approaches to acute graft-versus-host disease prevention

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