This article presents updated guidelines on the selection of unrelated donors and cord blood units for hematopoietic cell transplantation (HCT) developed by the NMDP and the CIBMTR (Center for International Blood and Marrow Transplant Research). The guidelines are based on large-scale studies correlating graft characteristics — primarily degree of donor-patient HLA match — with HCT outcomes. Other topics addressed include optimal timing of transplant, donor search strategies, and strategies to select the best partially matched unrelated donor or cord blood unit.
An update of the 1997 consensus guidelines for HCT in autoimmune diseases based on data reported to the European Group for Blood and Marrow Transplantation (EBMT). The guidelines discuss the use of HCT for treating autoimmune diseases in relation to the benefits, risks and health economic considerations of currently used non-transplant therapies. Patient safety and considerations for patient selection are also discussed.
Comparing outcomes by age over time in HCT for AML
A multi-center comparison of outcomes of children (<15 years, n=900), adolescents and young adults (15-40 years, n=2,708) and older adults (>40 years, n=2,728) who underwent HCT for acute myeloid leukemia (AML). Outcomes were reported to the CIBMTR, and were analyzed over three time periods (1980-1988, 1989-1997, 1998-2005) for sibling donor transplants and two time periods (1989-1997, 1998-2005) for unrelated donor HCT. In a univariate analysis of sibling donor HCT, 5-year overall survival for all age groups improved significantly for patients transplanted 1998-2005 compared to those transplanted 1980-1988. Survival for unrelated donor HCT recipients also improved significantly over time (1989-1997 vs. 1998-2005).
A review discussing the challenges in diagnosing, understanding and treating chronic GVHD including the recently proposed National Institutes of Health consensus criteria for chronic GVHD. The authors note that the incidence and prevalence of chronic GVHD are growing, likely due to increased use of unrelated donors, peripheral blood rather than marrow grafts, decreased early transplant-related mortality, and increasing frequency of allogeneic HCT. Finally, the authors evaluate the possible role of immunomodulatory drugs thalidomide, lenalidomide and pomalidomide in preventing and treating chronic GVHD.
This single-institution study of 49 consecutive patients transplanted for chronic lymphocytic leukemia (CLL) between 1991-2009 found an overall survival (OS) of 63% at 2 years and 55% at 5 years and beyond. Donors were related (n=29) and unrelated (n=20) and conditioning regimens used were reduced-intensity (n=27) and myeloablative (n=22). Factors significantly predicting superior OS were comorbidity index <3, donor chimerism >90%, FISH rank (Dohner) and 17p deletion, pre-transplant alemtuzumab, complete remission post-transplant, post-transplant clearance of FISH abnormality, and absence of high-grade (III-IV) GVHD.
Review: HCT for myelofibrosis in the era of JAK inhibitors
A review focusing on the risks/benefits of JAK inhibitor therapy as compared to HCT in patients with myelofibrosis (MF). Although JAK1/2 inhibitors such as ruxolitinib can decrease the burden of MF-related constitutional symptoms, allogeneic HCT remains the only potentially curative therapy. The authors outline a risk-adapted approach individualized to each patient’s biologic characteristics and co-morbidities to determine optimal treatment strategies for patients with MF.
July 8 is the last day to access a free online CME activity, sponsored by the NMDP, focusing on four different disease subtypes of non-Hodgkin lymphoma where transplantation is an option for treatment. Access four-part CME »
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Pediatric video wins awards
Our educational video for pediatric patients, Super Sam versus the Marrow Monsters, recently won a Gold Aster Award and two Silver Telly Awards, recognizing the exceptional quality of this resource. A special thanks to the remarkable patients, families and health care professionals who shared their experiences in this video. View Super Sam or order free copies »
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