The allogeneic graft‐<i>versus</i>‐cancer effect

Ringdén, Olle; Karlsson, Helén; Olsson, Richard F.; Omazic, Brigitta; Uhlin, Michael

doi:10.1111/j.1365-2141.2009.07886.x

Cited by 136 publications

(97 citation statements)

References 239 publications

(270 reference statements)

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“…[30][31][32][33][34] However, it has also been observed in patients with solid tumours. [35][36][37] Similar to haematologic malignancies, the disease status at the time of HSCT and the occurrence of chronic GvHD are strong predictive outcome parameters. Patients with t-MNs and a primary malignancy not in CR are, however, ineligible for allo HSCT in many centres, donor registries and clinical studies.…”

Section: Discussionmentioning

confidence: 99%

Reduced-intensity allografting in patients with therapy-related myeloid neoplasms and active primary malignancies

Zinke-Cerwenka

Valentin

Posch

et al. 2011

Bone Marrow Transplant

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Therapy-related myeloid neoplasms (t-MNs) are severe long-term consequences of cytotoxic treatments for a primary, often, malignant disorder. So far, the majority of patients eligible for transplantation have undergone myeloablative allo haematopoietic SCT (HSCT) as a potentially curative treatment, but it has been associated with high transplantation-related mortality (TRM) rates. In this retrospective study, we analysed the outcome of patients with t-MNs undergoing HSCT with reducedintensity conditioning (RIC). Of 55 patients, seen at a single centre over a 10-year period, 17 underwent RIC HSCT with related or unrelated donors. The estimated overall survival was 53% at 1 year and 47% at 3 years, and disease-free survival was 47% at 1 year. At 1 year, the cumulative incidence of relapse and TRM were 24% and 30%, respectively. Of five patients with active primary neoplasms who underwent transplantation, two are alive beyond 1 year and show CR of both t-MNs and the primary malignancy. These data indicate that RIC HSCT is an encouraging approach for patients with t-MNs. The issue of primary malignancies not being in remission at the time of transplantation should be explored in further studies.

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Section: Discussionmentioning

confidence: 99%

Reduced-intensity allografting in patients with therapy-related myeloid neoplasms and active primary malignancies

Zinke-Cerwenka

Valentin

Posch

et al. 2011

Bone Marrow Transplant

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“…The GVL effect is mediated by donor-derived allogeneic T cells directly attacking the leukemic cells [2]. This advantageous effect was elegantly described by Horowitz et al [21] who observed that patients who received identical twin transplants had an increased probability of relapse compared with allograft recipients.…”

Section: Graft Versus Leukaemia As An Immunological Tool After Sctmentioning

confidence: 74%

Mixed Chimerism after Allogeneic Stem Cell Transplantation – Focus on Double Cord Blood Transplantation

Gertow¹,

Stikvoort²,

Watz³

et al. 2012

J Blood Disord Transfus

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Allogeneic hematopoietic Stem Cell Transplantation (ASCT) is well established as a curative treatment for many hematological malignancies and non-malignant disorders. The aim of ASCT in these diseases is to achieve sustained donor engraftment to fight leukemic cells in malignant disease, improve hematopoietic function, provide immune competence or normalize enzyme deficiency. Peripheral blood or bone marrow is commonly used to monitor engraftment after ASCT. The presence of mixed donor/recipient chimerism after transplantation, donor/donor chimerism after double cord blood transplantation can be used and interpreted differently based on the initial disease status. In patients with malignant diseases, chimerism is primarily used to detect early relapse but can also indicate threatening rejection. In individuals with non malignant disease, chimerism is merely used to monitor successful engraftment. After double cord blood transplantation, the unique situation with two existing donor immune systems can occur. Most often one of the immune systems rapidly succumbs with one immune system prevailing, but in certain situations mixed donor/donor chimerism can exist for prolonged periods. This review describes the importance of mixed chimerism and the possible interpretation after ASCT in patients with both malignant and non-malignant diseases. It also focuses specifically on the situation and mechanisms donor/ donor chimerism after double cord blood transplantation.

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“…o r g most common long-term complication and occurs in 30% to 70% of adults who survive for more than 100 days after receiving their transplantation [3]. cGVHD has been associated with a reduced risk of relapse, possibly because of a concomitant graft-versus-leukemia effect [4][5][6]. Despite this, cGVHD correlates with increased morbidity and mortality and has a major impact on the quality of life of subjects who have undergone allo-HSCT [7].…”

Section: Introductionmentioning

confidence: 99%

A Single-Center Pilot Prospective Study of Topical Application of Platelet-Derived Eye Drops for Patients with Ocular Chronic Graft-versus-Host Disease

Zallio

Mazzucco

Monaco

et al. 2016

Biology of Blood and Marrow Transplantation

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a b s t r a c tOcular involvement of chronic graft-versus-host disease (cGVHD) is a complication that occurs in up to 60% of patients after allogeneic hematopoietic stem cell transplantation. Conventional therapeutic options include medical and surgical procedures that are administered depending on the severity of the condition, but most of them have provided unsatisfactory results and, to date, there is no consensus about treatment. We considered that topical application of a platelet lysate, administered as eye drops, might be considered an alternative worthwhile of investigation to treat ocular surface disorders in patients suffering from cGVHD. Therefore, we conducted a single-center prospective pilot study to assess the efficacy and safety of using eye drops made from reconstituted lysed platelet concentrate. Twenty-six patients with ocular cGVHD were eligible for the study; all but 2 completed their scheduled 1-year treatment and complied with the hematologic and ophthalmic regimen. At their first assessment interviews, after 30 days of treatment, 91% of patients reported an improvement in their symptoms and for 32%, substantive objective differences were measured. Remission of corneal damage was seen for 86% of our cohort, and improved National Institutes of Health scores for 73%, of whom 8% achieved the best score of 0 (ie, nonedry eye). Similar results were seen at later time points. Comparing outcomes for our patient cohort to those determined retrospectively for patients in our institutional database revealed a 5-year overall survival (OS) of 65%. This OS is comparable to patients with limited cGVHD (75%) and is superior to that of patients with nonocular extensive cGVHD or without cGVHD (30% and 59%, respectively) (P ¼ .013). Our results suggest that platelet-derived eye drops are a safe, practical, and well-tolerated therapeutic option that offers substantial benefits for most patients affected by ocular cGVHD at onset. The favorable OS of our patient cohort suggests that this topical therapy, rather than systemic immunosuppression, may be the treatment of choice. Ó

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The allogeneic graft‐versus‐cancer effect

Cited by 136 publications

References 239 publications

Reduced-intensity allografting in patients with therapy-related myeloid neoplasms and active primary malignancies

Reduced-intensity allografting in patients with therapy-related myeloid neoplasms and active primary malignancies

Mixed Chimerism after Allogeneic Stem Cell Transplantation – Focus on Double Cord Blood Transplantation

A Single-Center Pilot Prospective Study of Topical Application of Platelet-Derived Eye Drops for Patients with Ocular Chronic Graft-versus-Host Disease

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