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Robin M, Gras L, Koster L, Saccardi R, Finke J, Forcade E, Rovira M, Kobbe G, Reményi P, Apperley J, Smaranda A, Bay JO, Casper J, de Wreede LC, Giebel S, Grillo G, Heras I, Potter V, Tischer J, Trociukas I, Nachbaur D, Drozd-Sokolowska J, Raj K, Gurnari C, Yakoub-Agha I, Onida F, Scheid C, McLornan D. Are syngeneic donors a viable donor option in allogeneic haematopoietic cell transplantation for MDS? A brief report on behalf of the Chronic Malignancies Working Party of the EBMT and review of current literature. Bone Marrow Transplant 2023; 58:942-945. [PMID: 37185613 DOI: 10.1038/s41409-023-01991-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023]
Affiliation(s)
- Marie Robin
- Hopital Saint-Louis, APHP, Université de Paris Cité, Paris, France.
| | - Luuk Gras
- EBMT Statistical Unit, Leiden, the Netherlands
| | | | | | | | | | | | - Guido Kobbe
- University Hospital Düsseldorf, Department of Hematology, Oncology and clinical Immunology, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
| | | | | | - Arghirescu Smaranda
- BMT Center "Louis Turcanu" Emergency Hospital for Children, Timisoara, Romania
| | | | | | - Liesbeth C de Wreede
- Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Sebastian Giebel
- Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | | | | | | | | | | | | | | | - Kavita Raj
- University College London Hospitals NHS Trust, London, United Kingdom
| | - Carmelo Gurnari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Translational Hematology and Oncology Research Department, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, USA
| | | | - Francesco Onida
- Fondazione IRCCS - Ca' Granda - Ospedale Maggiore Policlinico IRCCS, Milan, Italy
| | | | - Donal McLornan
- University College London Hospitals NHS Trust, London, United Kingdom
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Dmitrova AA, Kuz'mina LA, Vasil'eva VA, Drokov MY, Parovichnikova EN. The late outcomes of syngeneic hematopoietic stem cell transplantation in patients with blood disorders. BULLETIN OF THE MEDICAL INSTITUTE "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH) 2022. [DOI: 10.20340/vmi-rvz.2022.5.tx.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Introduction. Syngeneic hematopoietic stem cell transplantation is a type of allogeneic stem cell transplantation when the donor of stem cells is a genetically identical (monozygotic) twin of the recipient. After this type of transplantation, there is no immunological conflict as the graft versus host disease, but at the same time, there is no positive effect of the graft-versus-leukemia effect.Aim: to assess the overall survival, event-free survival, probability of relapse, and transplant-related mortality rates associated with syngeneic stem cell transplantation.Patients and methods. In the National Research Center for Hematology from January 1988 to December 2018 we performed 654 allo-HSCT: 17 (2.5%) of them from a syngeneic donor. We performed a «paired analysis» with patients after allo-HSCT from a HLA-identical sibling donor. We included patients after allo-HSCT from an HLA-identical related donor (n = 28) in Group 1 and patients after syngeneic stem cell transplantation in group 2 (n = 14). Patients with aplastic anemia (n = 3) were excluded from the «paired analysis».Results. Patients after syngeneic stem cell transplantation did not develop a graft-versus-host disease. The relapse developed in 50% of cases (n = 7). Five patients (35.7%) died: 4 of them due to the relapse of the disease, and 1 – due to the graft failure. The relapse probability in patients after syngeneic HSCT was higher and amounted to 18.4% versus 54.2% (p = 0.047) for allo-HSCT from HLA-identical sibling donor and a syngeneic donor, respectively. Overall and event-free survival in patients after syngeneic HSCT is comparable to those in patients after allo-HSCT from an HLA-identical sibling donor.Conclusion. Syngeneic hematopoietic stem cell transplantation is justified in the absence of another related or unrelated donor of hematopoietic stem cells. The use of myeloablative conditioning regimens, peripheral blood stem cells as a source of stem cells, or high doses of nucleated cells/kg in the case of using bone marrow will improve post-transplant parameters in patients after syngeneic hematopoietic stem cell transplantation.
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Lowsky R, Strober S. Establishment of Chimerism and Organ Transplant Tolerance in Laboratory Animals: Safety and Efficacy of Adaptation to Humans. Front Immunol 2022; 13:805177. [PMID: 35222384 PMCID: PMC8866443 DOI: 10.3389/fimmu.2022.805177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
The definition of immune tolerance to allogeneic tissue and organ transplants in laboratory animals and humans continues to be the acceptance of the donor graft, rejection of third-party grafts, and specific unresponsiveness of recipient immune cells to the donor alloantigens in the absence of immunosuppressive treatments. Actively acquired tolerance was achieved in mice more than 60 years ago by the establishment of mixed chimerism in neonatal mice. Once established, mixed chimerism was self-perpetuating and allowed for acceptance of tissue transplants in adults. Successful establishment of tolerance in humans has now been reported in several clinical trials based on the development of chimerism after combined transplantation of hematopoietic cells and an organ from the same donor. This review examines the mechanisms of organ graft acceptance after establishment of mixed chimerism (allo-tolerance) or complete chimerism (self-tolerance), and compares the development of graft versus host disease (GVHD) and graft versus tumor (GVT) activity in complete and mixed chimerism. GVHD, GVT activity, and complete chimerism are also discussed in the context of bone marrow transplantation to treat hematologic malignancies. The roles of transient versus persistent mixed chimerism in the induction and maintenance of tolerance and organ graft acceptance in animal models and clinical studies are compared. Key differences in the stability of mixed chimeras and tolerance induction in MHC matched and mismatched rodents, large laboratory animals, and humans are examined to provide insights into the safety and efficacy of translation of results of animal models to clinical trials.
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Affiliation(s)
- Robert Lowsky
- Division of Blood and Marrow Transplantation and Cancer Cellular Therapy, Stanford University School of Medicine, Stanford, CA, United States
| | - Samuel Strober
- Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, CA, United States
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Syngeneic hematopoietic stem cell transplantation for acute myeloid leukemia: a propensity score-matched analysis. Blood Cancer J 2021; 11:159. [PMID: 34561419 PMCID: PMC8463668 DOI: 10.1038/s41408-021-00553-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/08/2022] Open
Abstract
The present study evaluated outcomes and prognostic factors in adult patients with acute myeloid leukemia (AML) after syngeneic hematopoietic stem cell transplantation (HSCT). Among patients in first complete remission (CR1), outcomes of syngeneic HSCT (Syn) were compared with those of autologous HSCT (Auto), allogeneic HSCT from human leukocyte antigen (HLA)-matched sibling donor (MSD), or allogeneic HSCT from HLA-matched unrelated donor (MUD). Among 11,866 patients receiving first HSCT, 26 in the Syn group were analyzed. The 5-year overall survival (OS) rate, the cumulative incidence of relapse, and the cumulative incidence of non-relapse mortality (NRM) were 47.8%, 59.6%, and 4.6%, respectively. The OS was significantly better in patients in CR1 (n = 13) than in patients in non-CR1 (P = 0.012). Furthermore, 39 patients in CR1 each were assigned to the Auto, MSD, and MUD groups using propensity score matching. The 5-year OS in the Syn (68.4%) was not significantly different from those in the Auto (55.9%, P = 0.265), MSD (62.4%, P = 0.419), or MUD (63.7%, P = 0.409) groups. A higher relapse in the Syn than in the MSD and MUD groups was offset by lower NRM. In summary, syngeneic HSCT might be an alternative option for AML patients in CR1.
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Patel SU, Yum K, Kim S, Isola LM, Scigliano E, Jakubowski R, Park D. A case of syngeneic graft-versus-host disease. J Oncol Pharm Pract 2018; 25:1762-1766. [PMID: 30319065 DOI: 10.1177/1078155218805541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Graft-versus-host disease has been reported to occur rarely in syngeneic hematopoietic stem cell transplant recipients. Clinical and histological changes consistent with graft-versus-host disease have been reported to occur in this patient population. We report a case of a 46-year-old Caucasian male with diffuse large B-cell lymphoma in complete remission who underwent a syngeneic hematopoietic stem cell transplant. He was diagnosed with grade III acute skin and gastrointestinal graft-versus-host disease requiring high-dose corticosteroids and immunosuppressive therapy and resulting in a complete response. Syngeneic graft-versus-host disease is an anomaly that needs to be considered as a differential diagnosis of patients experiencing dermatitis, gastroenteritis, or hepatitis after an identical twin hematopoietic stem cell transplant.
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Affiliation(s)
- Sweta U Patel
- 1 Department of Pharmacy, The Mount Sinai Hospital, New York, NY, USA
| | - Kendra Yum
- 1 Department of Pharmacy, The Mount Sinai Hospital, New York, NY, USA
| | - Sara Kim
- 1 Department of Pharmacy, The Mount Sinai Hospital, New York, NY, USA
| | - Luis M Isola
- 2 Department of Medicine, Division of Hematology and Medical Oncology, The Mount Sinai Hospital, New York, NY, USA
| | - Eileen Scigliano
- 2 Department of Medicine, Division of Hematology and Medical Oncology, The Mount Sinai Hospital, New York, NY, USA
| | - Rita Jakubowski
- 2 Department of Medicine, Division of Hematology and Medical Oncology, The Mount Sinai Hospital, New York, NY, USA
| | - Doyun Park
- 2 Department of Medicine, Division of Hematology and Medical Oncology, The Mount Sinai Hospital, New York, NY, USA
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Pereira TDM, Danby R, Rocha V. Donor lymphocyte infusion after allogeneic hematopoietic stem cell transplantation. Int J Hematol Oncol 2015. [DOI: 10.2217/ijh.15.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Donor lymphocyte infusion, a rescue therapy after hematopoietic stem cell transplantation, has been increasingly adopted, as modalities of stem cell transplantation have widened. First described as donor lymphocyte transfusion or cell therapy, it consists of infusion of donor lymphocytes, collected in steady state or after growth factor enhancement. As in literature the most used name is donor lymphocyte infusion, we'll adopt it here. Its most striking efficacy is observed in patients with chronic myelogenous leukemia, who relapsed after allogeneic stem cells transplantation. However, graft-versus-host disease, its main complication, may still hamper its feasibility.
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Affiliation(s)
- Thales Dalessandro Meneguin Pereira
- Oxford University Hospitals NHS Trust, Department of Clinical Haematology, Level 2, Cancer & Haematology Centre, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, UK
| | - Robert Danby
- Oxford University Hospitals NHS Trust, Department of Clinical Haematology, Level 2, Cancer & Haematology Centre, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, UK
| | - Vanderson Rocha
- Oxford University Hospitals NHS Trust, Department of Clinical Haematology, Level 2, Cancer & Haematology Centre, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, UK
- BRC Blood Theme, NIHR Oxford Biomedical Centre, Oxford University Hospital, Oxford, OX3 9DS, UK
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PRECUP RADU, ARGHIRESCU SMARANDA, CUCUIANU ANDREI, ŞERBAN MARGIT. MATHEMATICAL MODELING OF CELL DYNAMICS AFTER ALLOGENEIC BONE MARROW TRANSPLANTATION. INT J BIOMATH 2012. [DOI: 10.1142/s1793524511001684] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In this paper a basic mathematical model is introduced to describe the dynamics of three cell lines after allogeneic stem cell transplantation: normal host cells, leukemic host cells and donor cells. Their evolution is one of competitive type and depends upon kinetic and cell–cell interaction parameters. Numerical simulations prove that the evolution can ultimately lead either to the normal hematopoietic state achieved by the expansion of the donor cells and the elimination of the host cells, or to the leukemic hematopoietic state characterized by the proliferation of the cancer line and the suppression of the other cell lines. One state or the other is reached depending on cell–cell interactions (anti-host, anti-leukemia and anti-graft effects) and initial cell concentrations at transplantation. The model also provides a theoretical basis for the control of post-transplant evolution aimed at the achievement of normal hematopoiesis.
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Affiliation(s)
- RADU PRECUP
- Department of Applied Mathematics, "Babeş–Bolyai" University, Cluj 400084, Romania
| | - SMARANDA ARGHIRESCU
- Department of Hematology, "Victor Babeş" University of Medicine and Pharmacy, Timişoara 300041, Romania
| | - ANDREI CUCUIANU
- Department of Hematology, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj 400012, Romania
| | - MARGIT ŞERBAN
- Department of Hematology, "Victor Babeş" University of Medicine and Pharmacy, Timişoara 300041, Romania
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Oncolytic virotherapy for hematological malignancies. Adv Virol 2011; 2012:186512. [PMID: 22312362 PMCID: PMC3265224 DOI: 10.1155/2012/186512] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 08/31/2011] [Indexed: 01/20/2023] Open
Abstract
Hematological malignancies such as leukemias, lymphomas, multiple myeloma (MM), and the myelodysplastic syndromes (MDSs) primarily affect adults and are difficult to treat. For high-risk disease, hematopoietic stem cell transplant (HCT) can be used. However, in the setting of autologous HCT, relapse due to contamination of the autograft with cancer cells remains a major challenge. Ex vivo manipulations of the autograft to purge cancer cells using chemotherapies and toxins have been attempted. Because these past strategies lack specificity for malignant cells and often impair the normal hematopoietic stem and progenitor cells, prior efforts to ex vivo purge autografts have resulted in prolonged cytopenias and graft failure. The ideal ex vivo purging agent would selectively target the contaminating cancer cells while spare normal stem and progenitor cells and would be applied quickly without toxicities to the recipient. One agent which meets these criteria is oncolytic viruses. This paper details experimental progress with reovirus, myxoma virus, measles virus, vesicular stomatitis virus, coxsackievirus, and vaccinia virus as well as requirements for translation of these results to the clinic.
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Oliansky DM, Larson RA, Weisdorf D, Dillon H, Ratko TA, Wall D, McCarthy PL, Hahn T. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the treatment of adult acute lymphoblastic leukemia: update of the 2006 evidence-based review. Biol Blood Marrow Transplant 2011; 18:18-36.e6. [PMID: 21803017 DOI: 10.1016/j.bbmt.2011.07.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 07/25/2011] [Indexed: 11/26/2022]
Abstract
Clinical research published since the first evidence-based review on the role of hematopoietic stem cell transplantation (SCT) in the treatment of acute lymphoblastic leukemia (ALL) in adults is presented and critically evaluated in this update. Treatment recommendations changed or modified based on new evidence include: (1) myeloablative allogeneic SCT is an appropriate treatment for adult (<35 years) ALL in first complete remission for all disease risk groups; and (2) reduced-intensity conditioning may produce similar outcomes to myeloablative regimens. Treatment recommendations unchanged or strengthened by new evidence include: (1) allogeneic SCT is recommended over chemotherapy for ALL in second complete remission or greater; (2) allogeneic is superior to autologous SCT; and (3) there are similar survival outcomes after related and unrelated allogeneic SCT. New treatment recommendations based on new evidence include: (1) in the absence of a suitable allogeneic donor, autologous SCT may be an appropriate therapy, but results in a high relapse rate; (2) it is appropriate to consider cord blood transplantation for patients with no HLA well-matched donor; and (3) imatinib therapy before and/or after SCT (for Ph+ ALL) yields significantly superior survival outcomes. Areas of needed research in the treatment of adult ALL with SCT were identified and presented in the review.
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Deeren D, Lammertijn L, Van Dorpe J. Relapsing infiltrates after pneumocystis pneumonia in stem cell transplant patients: think about BOOP! Acta Clin Belg 2010; 65:200-1. [PMID: 20669790 DOI: 10.1179/acb.2010.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Bronchiolitis Obliterans Organizing Pneumonia (BOOP) can complicate allogeneic haematopoietic stem cell transplantation. It is associated with prior graft-versus-host disease (GVHD) and the case fatality is 21%. In 22%, diagnosis is preceded by tapering the corticosteroids given as a treatment for GVHD. We report a fatal case of BOOP after tapering the corticosteroids that the patient received for a Pneumocystis jirovecii pneumonia after stem cell transplantation.
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Affiliation(s)
- D Deeren
- Dienst Inwendige Ziekten - Hematologie, Heilig-Hartziekenhuis Roeselare-Menen vzw, Roeselare, Belgium.
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Current Awareness in Hematological Oncology. Hematol Oncol 2008. [DOI: 10.1002/hon.833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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