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Your Concise Update on Transplant Research
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| Vol. 11 | No. 10 |
| October 2011 |
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| ASBMT update: Role of HCT in adult ALL |
| An update to the American Society for Blood and Marrow Transplantation (ASBMT) 2006 evidence-based review on the role of hematopoietic cell transplantation (HCT) in the treatment of adults with acute lymphoblastic leukemia (ALL). Based on new data, the ASBMT has updated two treatment recommendations: myeloablative HCT is an appropriate treatment for patients <35 years in all disease risk groups in first complete remission, and reduced-intensity HCT may produce similar outcomes to myeloablative HCT. The expert panel also made three new treatment recommendations regarding autologous transplantation, cord blood transplantation, and imatinib therapy before and/or after HCT in Ph+ ALL patients. |
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| Oliansky DM, et al. Biol Blood Marrow Transplant 2011; published online Aug. 1. |
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| Tandem auto and auto/allo HCT yield similar outcome in multiple myeloma |
| In a Blood and Marrow Transplant Clinical Trials Network (BMT CTN) study of patients with standard-risk multiple myeloma, tandem autologous transplants were found to have similar outcomes as autologous transplantation followed by non-myeloablative allogeneic transplantation. Between 2003 and 2007, patients with standard-risk multiple myeloma <70 years old underwent autologous transplantation followed by either a non-myeloablative allogeneic transplant (n=256) if they had an HLA-matched sibling donor, or a second autologous transplant if they lacked a donor (n=366). Three-year overall survival was 77% vs. 80% in the auto/allo patients and the tandem autologous patients, respectively; (p=0.191). |
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| Krishnan A, et al. Lancet Oncol 2011; published online Sept. 30. |
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| Age not a factor in HCT outcomes in patients ≥60 years |
| A multi-center study to compare hematopoietic cell transplantation (HCT) outcomes of patients 60-65 years old (n=493) with patients >65 years (n=107) has found that older age per se is not an adverse factor for survival. This retrospective study examined transplant outcomes from 26 centers reporting to the French national registry between 1998 and 2008. Median age was 62.2 years (range, 60.0-70.7), and except for donor age, there were no significant clinical differences between the two patient cohorts. With a median follow-up of 22.8 and 23.7 months in the younger and the older groups, respectively, 2-year overall survival was comparable: 49.2% vs. 50.2%, respectively; (p=0.99). |
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| Chevallier P, et al. Biol Blood Marrow Transplant 2011; published online July 21. |
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| Donor specific anti-HLA antibodies affect double cord blood transplant outcomes |
| Pre-transplant blood component support causes many patients to become sensitized to HLA antigens, resulting in the production of antibodies. A new report has found that donor-specific anti-HLA antibodies (DSA) can lower outcomes in double cord blood transplants (CBT). In a study of 73 patients who underwent double CBT between 2004 and 2008, DSA were detected in 18 patients: 11 patients had DSA directed against the first or second infused cord blood unit, and 7 patients had DSA directed against both units. Three-year overall survival was significantly lower in patients with DSA against both cord blood units compared to those without DSA: 0% vs. 45.0%, respectively; (p=0.04). |
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| Cutler C, et al. Blood 2011; published online Sept. 22. |
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| Related article: DSA and graft failure |
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| Additional matching at HLA-C improves cord blood transplant outcomes |
| A study of 803 patients undergoing cord blood transplantation (CBT) for leukemia and myelodysplastic syndromes has shown higher transplant-related mortality in those patients having an HLA-C mismatch with their cord blood graft. Median age in this study was 10 years (range, <1-62). Compared with transplants matched at HLA-A, -B, -C, and -DRB1 (n=69), transplant-related mortality risk was significantly higher than transplants matched at HLA-A, -B, and -DRB1 and mismatched at HLA-C (n=23): Hazard ratio=3.97, 95% CI 1.27-12.40; p=0018. In an accompanying editorial, Dr. Alois Gratwohl concludes that “The degree of matching between donor and recipient, including HLA-C, needs to be integrated into the algorithm used to select for or against transplantation.” |
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| Eapen M, et al. Lancet Oncol 2011; published online Oct. 7. |
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| Special edition: Non-Hodgkin Lymphoma Advances in Transplantation |
| Access a special edition of Advances in Transplantation that summarizes the latest research in transplant therapy for non-Hodgkin lymphoma. This issue contains research results published in medical journals and presented at major medical meetings in the past year. Access NHL Special Edition |
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| CME: Management of Advanced Non-Hodgkin Lymphomas |
| A new NMDP-sponsored CME series is now available: Management of Advanced Non-Hodgkin Lymphomas. This four-part series reviews treatment options for follicular, mantle cell, diffuse large B-cell, and T-cell lymphomas. Learn about first- and second-line treatment options for relapsed/refractory patients, including novel agents, and both allogeneic and autologous transplantation. Access NHL CME program |
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| 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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| Advances in Transplantation is an electronic newsletter published monthly by the National Marrow Donor Program (NMDP). This newsletter is sent only to those individuals who have requested to receive clinical education updates from NMDP. |
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| If you are a member of the NMDP Be The Match Registry®, unsubscribing to the Advances in Transplantation e-newsletter does not change your status on the registry. The NMDP may still contact you by e-mail, postal mail or telephone if a patient needs you or to request that you update your address. |
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