Treatment of Murine Leukaemia with X Rays and Homologous Bone Marrow

Barnes, David W.; Corp, M.J.; Loutit, J. F.; Neal, F. E.

doi:10.1136/bmj.2.4993.626

Cited by 380 publications

(154 citation statements)

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“…19,20,27 Our findings were similar: lymphoma patients whose pre-transplant disease was stable or in remission had a higher probability of long-term survival compared with CLL patients who underwent NST under the same treatment protocol (Figure 1). Patients with CLL had a high frequency of infection complications (Table 4).…”

Section: Discussionsupporting

confidence: 60%

“…It is noted that 80% of microbiologically diagnosed infection episodes were identified 30 days after NST. In NST, the stem cell graft induces an immune-mediated antitumor graft-versus-tumor/leukemia effect without the need for ablation of recipient immunity, [19][20][21] which can be further augmented by DLIs. 22,23 This strategy has been used to promote the antineoplastic effect in patients with residual disease or disease relapse after transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…42 A high leukemia burden at the time of transplantation also predicts poor outcome. 19,22,43 Measures to prevent opportunistic infections in at-risk population should be included in long-term management plans for NST recipients. 44 Patients with increased risk of fungal disease included (1) patients receiving highdose systemic corticosteroids usually for 42 weeks 39 and (2) patients with severe (grade III-IV) GVHD, whereas younger CMV-seropositive NST recipients with lymphoma, who received stem cell graft from a CMV-positive donor even in the absence of GVHD or corticosteroid use, need monitoring for viral reactivation during the postengraftment period.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Infections in non-myeloablative hematopoietic stem cell transplantation patients with lymphoid malignancies: spectrum of infections, predictors of outcome and proposed guidelines for fungal infection prevention

Safdar

Rodriguez

Mihu

et al. 2009

Bone Marrow Transplant

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The overall risk of infections is lower in patients undergoing non-myeloablative allogeneic stem cell transplantation (NST) than in conventional stem cell transplant recipients. We sought to evaluate conditions associated with increased risk of infections after NST. In 81 patients, 187 infection episodes were noted; chronic lymphocytic leukemia (138 episodes/100 person-years) and recipients of matched unrelated donor graft (128 episodes/100 person-years) had higher risk of infection. Only half of the cytomegalovirus (CMV) infections occurred 31-100 days after transplantation. Most patients with CMV infection were non-neutropenic (100%), had lymphoma (76%), were younger (o55 years; 72%) and had received matched related donor (MRD) graft (72%). However, graft-versus-host disease (GVHD) was present in only 15% of these patients. Seven (78%) of nine invasive fungal infections (IFI) were diagnosed 4100 days after NST and were associated with high mortality (78%). Most patients with IFI were also not neutropenic (100%), had received MRD graft (100%), had lymphoma (78%) and were given systemic steroids (78%); unlike CMV infection, 67% of these patients also had GVHD. On the basis of our results, we propose that NST recipients with lymphoma treated with high-dose corticosteroids for GVHD be considered for antifungal prophylaxis or preemptive antifungal therapy.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Infections in non-myeloablative hematopoietic stem cell transplantation patients with lymphoid malignancies: spectrum of infections, predictors of outcome and proposed guidelines for fungal infection prevention

Safdar

Rodriguez

Mihu

et al. 2009

Bone Marrow Transplant

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“…31 In AML, it has been clearly established that the relapse risk after allo-SCT is lower than that after autologous or syngeneic transplants. 32,33 The early observation that the development of GVHD correlates inversely with relapse risk suggested overlapping immune-mediated mechanisms between GVHD and GVL.…”

Section: Discussionmentioning

confidence: 99%

Alemtuzumab markedly reduces chronic GVHD without affecting overall survival in reduced-intensity conditioning sibling allo-SCT for adults with AML

Malladi

Peniket

Littlewood

et al. 2008

Bone Marrow Transplant

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By retrospective analysis of 88 patients from the British Society of Blood and Marrow Transplantation registry, we investigated the effect of in vivo T-cell depletion in HLA-identical sibling reduced-intensity conditioning (RIC) allografts for adult AML by comparing patients who received alemtuzumab with those without alemtuzumab conditioning. Both groups were equivalent for age, sex, karyotype and disease status at transplant. With a median follow-up of 27 months (3-72 months) and 48 months (7-72 months), the 2-and 5-year overall survival, with or without alemtuzumab, is 60 and 60% (P ¼ 0.80) and 61 and 53%, respectively (P ¼ 0.85). The 2-year nonrelapse mortality is 12% with alemtuzumab, and 17% without alemtuzumab (P ¼ 0.49). The 2-year relapse rate is 35% with alemtuzumab compared with 19% without alemtuzumab (P ¼ 0.28). Grades II-IV acute GVHD occurred in 22% (8/37) without alemtuzumab compared with 14% (7/51) given alemtuzumab (P ¼ 0.25). Extensive chronic GVHD occurred in 47% (14/30) not given alemtuzumab compared with 4% (2/45) who were given alemtuzumab (P ¼ 0.001). Among evaluable patients, the risk of infections was higher in those treated with alemtuzumab compared with those not treated with alemtuzumab (79 vs 57%, respectively, P ¼ 0.02). In conclusion, alemtuzumab has a beneficial effect by reducing chronic GVHD without affecting overall survival. Further studies are warranted before alemtuzumab can be recommended as standard in RIC allografts for AML.

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“…Mice could be rescued after lethally irradiation-transplantation grafts with health bone marrow donor cells [12]. The authors evoked the extrapolation of the results from mouse to man for the treatment of leukaemia.…”

Section: The Early Daysmentioning

confidence: 99%

Advances in Hematopoietic Stem Cell Transplantation

Alvarez-Silva¹

2017

Adv Tech Biol Med

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Treatment of Murine Leukaemia with X Rays and Homologous Bone Marrow

Cited by 380 publications

References 1 publication

Infections in non-myeloablative hematopoietic stem cell transplantation patients with lymphoid malignancies: spectrum of infections, predictors of outcome and proposed guidelines for fungal infection prevention

Infections in non-myeloablative hematopoietic stem cell transplantation patients with lymphoid malignancies: spectrum of infections, predictors of outcome and proposed guidelines for fungal infection prevention

Alemtuzumab markedly reduces chronic GVHD without affecting overall survival in reduced-intensity conditioning sibling allo-SCT for adults with AML

Advances in Hematopoietic Stem Cell Transplantation

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