ASBMT update: Role of HCT in diffuse large B cell lymphoma
An update to the American Society for Blood and Marrow Transplantation (ASBMT) 2001 evidence-based review on the role of hematopoietic cell transplantation (HCT) in the treatment of adults with diffuse large B cell lymphoma (DLBCL). Based on newly published data, an ASBMT panel of experts has provided recommendations on: autologous transplantation vs. non-transplant therapy; timing of autologous transplantation; autologous vs. allogeneic transplantation; and type of conditioning regimens in allogeneic transplantation. The expert panel also identified areas of needed research in the treatment of DLBCL.
HCT for adults with AML: myths, controversies, and unknowns
The authors review how molecular markers, in combination with cytogenetics, have improved the risk stratification and decision-making process in the clinical management of patients with acute myeloid leukemia (AML). Also discussed are clinical advances that have improved the safety of, and access to hematopoietic cell transplantation (HCT), including better supportive care, improved transplant technology, reduced-intensity conditioning, and increased availability of alternative donors. The authors also examine recent data showing outcomes of alternative donor transplantation approaching HLA-identical sibling donor transplant outcomes in high-risk AML.
A single-center study examining transplant outcomes has demonstrated significant differences in outcomes in the 2003-2007 period compared to the 1993-1997 period, including a 41% decrease in overall mortality. The study compared 1,418 patients undergoing hematopoietic cell transplantation (HCT) at the Fred Hutchinson Cancer Research Center between 1993-1997 and 1,148 patients transplanted between 2003-2007. There were significant differences in the 2003-2007 patients in: rate of relapse or progression of a malignant condition (21% decrease), non-relapse mortality (NRM) at day 200 (60% decrease), and overall NRM (52% decrease)
Two review articles explore the current indications for hematopoietic cell transplantation (HCT) in chronic myeloid leukemia (CML) in the era of imatinib and other tyrosine kinase inhibitors (TKIs). The authors discuss when HCT is indicated for patients with CML: when they fail to respond and/or develop intolerance to TKI therapy or progress to advanced phase disease. The authors also discuss the integration of TKIs with HCT, both pre-, peri- and post-transplant.
Donor-specific differences in HCT in adults with Ph-negative ALL
A long-term study of myeloablative hematopoietic cell transplantation (HCT) in 292 adults with Philadelphia-negative acute lymphoblastic leukemia (ALL) has demonstrated comparable survival for transplants using related donors and those using partially or well-matched unrelated donors. Five-year disease-free survival was comparable among related donors (53.5%), well-matched unrelated donors (63.3%), and partially matched unrelated donors (57.0%). Related donor HCT yielded comparable outcomes to autologous transplantation in standard-risk patients, but was superior to autologous transplantation in high-risk patients.
In response to a recent reader survey, the Advances e-newsletter has been updated to deliver the information you’ve told us you want. In addition to summarizing key journal publications, we’ve added interactive polling, optimized for viewing on mobile devices, and moved to monthly distribution. In the coming months, we will also include expert commentaries on important articles affecting clinical practice. We will also send occasional notices of upcoming educational programs that may be of interest to you. You can still give us your opinion on topics and features you’d like to see in the future, and we’re always open to receiving feedback from our readers. Send feedback
Access clinical guidelines through new mobile app
You can now instantly access our Transplant Clinical Guidelines through a free mobile app. The app contains clinical decision-making information from the NMDP/ASBMT Timing for Transplant Consultation Guidelines and Post-Transplant Care Guidelines. The app is now available on iPhone®, iPad™, and Android devices (coming soon to Blackberry and mobile web). Download free app
CME for AML/MDS programs available through February
Through February 11, CME will be available for a four-part online program, Navigating the Therapeutic Pathways for AML and MDS. Learn about optimal treatment algorithms for patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), including the role of risk stratification in treatment decision making, outcomes for various therapeutic options, and more. Access CME programs
Supported by an unrestricted educational grant from Otsuka America Pharmaceutical, Inc., provided to the National Marrow Donor Program through the Be The Match Foundation®, the funding partner of the NMDP.
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