Indications for Autologous and Allogeneic Hematopoietic Cell Transplantation: Guidelines from the American Society for Blood and Marrow Transplantation

Majhail, Navneet S.; Farnia, Stephanie; Carpenter, Paul A.; Champlin, Richard E.; Crawford, Stephen W.; Marks, David I.; Omel, James; Orchard, Paul J.; Palmer, Jeanne; Saber, Wael; Savani, Bipin N.; Veys, Paul; Bredeson, Christopher; Giralt, Sergío; Lemaistre, Charles F.

doi:10.1016/j.bbmt.2015.07.032

Cited by 368 publications

(277 citation statements)

References 40 publications

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“…Worldwide annual numbers of allogeneic and autologous HSCT currently exceed sixty thousand and figures are still rising. [1][2][3][4] Several elements contribute to the success of HSCT. The conditioning therapy preceding the transplant prepares the recipient (host) to accept the graft, and reduces tumor load.…”

Section: Introductionmentioning

confidence: 99%

Alloreactivity: the Janus-face of hematopoietic stem cell transplantation

et al. 2017

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Differences in major and minor histocompatibility antigens between donor and recipient trigger powerful graft-versus-host reactions after allogeneic hematopoietic stem cell transplantation (HSCT). The clinical effects of alloreactivity present a Janus-face: detrimental graft-versus-host disease increases non-relapse mortality, beneficial graft-versus-malignancy may cure the recipient. The ultimate consequences on long-term outcome remain a matter of debate. We hypothesized that increasing donor-recipient antigen matching would decrease the negative effects, while preserving antitumor alloreactivity. We analyzed retrospectively a predefined cohort of 32 838 such patients and compared it to 59 692 patients with autologous HSCT as reference group. We found a significant and systematic decrease in non-relapse mortality with decreasing phenotypic and genotypic antigen disparity, paralleled by a stepwise increase in overall and relapse-free survival (Spearman correlation coefficients of cumulative excess event rates at 5 years 0.964; P o 0.00; respectively 0.976; P o0.00). We observed this systematic stepwise effect in all main disease and disease-stage categories. The results suggest that detrimental effects of alloreactivity are additive with each step of mismatching; the beneficial effects remain preserved. Hence, if there is a choice, the best match should be donor of choice. The data support an intensified search for predictive genomic and environmental factors of 'no-graft-versus-host disease'.

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Section: Introductionmentioning

confidence: 99%

Alloreactivity: the Janus-face of hematopoietic stem cell transplantation

et al. 2017

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“…On the other hand, alloSCT is still considered "developmental" for MM in initial response, but for patients in other disease stages or PCL, it is accepted as "standard of care with clinical evidence". 23 These recommendations do not take into account other factors such as age, comorbidities, donor source, and HLA incompatibilities. Overall, results of alloSCT are poor because of the high transplant-related mortality and high risk of relapse.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of unrelated cord blood transplantation in patients with multiple myeloma: a survey on behalf of Eurocord, the Cord Blood Committee of Cellular Therapy and Immunobiology Working Party, and the Chronic Leukemia Working Party of the EBMT

Paviglianiti¹,

Xavier²,

Ruggeri³

et al. 2016

Haematologica

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International audienceAlthough allogeneic stem cell transplantation is not a standard therapy for multiple myeloma, some patients can benefit from this intense therapy. There are few reports on outcomes after umbilical cord blood transplantation in multiple myeloma, and investigation of this procedure is warranted. We retrospectively analyzed 95 patients, 85 with multiple myeloma and 10 with plasma cell leukemia, receiving single or double umbilical cord blood transplantation from 2001 to 2013. Median follow up was 41 months. The majority of patients received a reduced intensity conditioning. The cumulative incidence of neutrophil engraftment was 97%±3% at 60 days, and that of 100-day acute graft-versus-host disease grade II-IV was 41%±5%. Chronic graft-versus-host disease at two years was 22%±4%. Relapse and non-relapse mortality was 47%±5% and 29%±5% at three years, respectively. Three-year progression-free survival and overall survival were 24%±5% and 40%±5%, respectively. Anti-thymocyte globulin was associated with decreased incidence of acute graft-versus-host disease, higher non-relapse mortality, decreased overall and progression-free survival. Patients with high cytogenetic risk had higher relapse, and worse overall and progression-free survival. In conclusion, umbilical cord blood transplantation is feasible for multiple myeloma patients

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“…For example, autologous transplantation is not useful for diseases in which normal HSCs cannot be collected as in CML or myelodysplasia (Rowley 2013). The indications for transplant are based on best available evidence from clinical trials or, where clinical trials are not available, registry, multicentre or single centre observational studies (Majhail et al 2015). The HSCT specialist determines if transplant should be considered as an option for disease consolidation, but the final decision will be made in conjunction with the patient (Maziarz 2015).…”

Section: Indications For Transplant In Malignant Diseasementioning

confidence: 99%

“…Well-matched donors must be considered as the primary cell source (Sureda et al 2015a;Majhail et al 2015;Rowley 2013). …”

Section: Indications For Allogeneic Hsctmentioning

confidence: 99%

HSCT: How Does It Work?

Galgano

Hutt

2017

The European Blood and Marrow Transplantation Textbook for Nurses

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The HSCT (haematopoietic stem cell transplant) is a particular treatment for many haematological and non-haematological diseases. Broadly, there are three different categories of transplantation, autologous, allogeneic and syngeneic, which can be applied to most disease scenarios. Haematopoietic stem cells can be derived from the bone marrow, peripheral blood and umbilical cord blood. HSCT treatment can be divided into separate phases that start with the harvest of the stem cells and passing through the conditioning, aplasia and engraftment until the recovery of the haematopoietic functions. HSCT is indicated in many diseases, and these indications depend on numerous factors such as the disease type, stage and response to previous treatment. Among non-malignant diseases, aplastic anaemia, sickle cell disease and, more recently, autoimmune diseases can also be effectively treated with HSCT. One third of the transplants in children are performed for rare indications such as severe combined immunodeficiencies. Allogeneic HSCT can also cure a number of non-malignant diseases in children, such as Wiskott-Aldrich syndrome and chronic granulomatous disease (CGD). This chapter will include transplant in primary immunodeficiency in children as well as inherited bone marrow failure and inborn errors of metabolism.

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Indications for Autologous and Allogeneic Hematopoietic Cell Transplantation: Guidelines from the American Society for Blood and Marrow Transplantation

Cited by 368 publications

References 40 publications

Alloreactivity: the Janus-face of hematopoietic stem cell transplantation

Alloreactivity: the Janus-face of hematopoietic stem cell transplantation

Outcomes of unrelated cord blood transplantation in patients with multiple myeloma: a survey on behalf of Eurocord, the Cord Blood Committee of Cellular Therapy and Immunobiology Working Party, and the Chronic Leukemia Working Party of the EBMT

HSCT: How Does It Work?

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