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Abid MB, Estrada-Merly N, Zhang MJ, Chen K, Bredeson C, Allan D, Sabloff M, Marks DI, Litzow M, Hourigan C, Kebriaei P, Saber W. Younger Matched Unrelated Donors Confer Decreased Relapse Risk Compared to Older Sibling Donors in Older Patients with B Cell Acute Lymphoblastic Leukemia Undergoing Allogeneic Hematopoietic Cell Transplantation. Transplant Cell Ther 2023; 29:611-618. [PMID: 37481243 PMCID: PMC10592336 DOI: 10.1016/j.jtct.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/08/2023] [Accepted: 07/16/2023] [Indexed: 07/24/2023]
Abstract
Although allogeneic hematopoietic cell transplantation (alloHCT) offers cure for older patients with acute lymphoblastic leukemia (ALL), disease relapse remains a major issue. Whether matched sibling donors (MSDs) are still the preferred donor choice compared to younger matched unrelated donors (MUDs) in the contemporary era of improved transplantation practices remains unknown. This retrospective cohort registry study queried the Center for International Blood and Marrow Transplant Research (CIBMTR) database in patients with B cell ALL (B-ALL) age ≥ 50 years undergoing alloHCT from older MSDs (age ≥ 50 years) or younger MUDs (age ≤ 35 years) between 2011 and 2018. The study included common allograft types, conditioning regimens, and graft-versus-host disease (GVHD) prophylaxis strategies. The primary outcome was relapse risk, and secondary outcomes included nonrelapse mortality (NRM), GVHD, leukemia-free survival (LFS), and overall survival (OS). Among 925 eligible patients in the study cohort, 386 underwent alloHCT with an older MSD (median donor age, 58 years) and 539 underwent alloHCT from a younger MUD (median donor age, 25 year). In multivariable analysis, younger MUDs conferred a significantly decreased risk of relapse (hazard ratio [HR], .68; P = .002) compared with older MSDs. The adjusted cumulative incidence of relapse at 5 years was significantly lower with younger MUDs than with older MSDs (26% versus 37%; P = .001). Younger MUDs were associated with a greater risk of chronic GVHD compared to older MSDs (HR, 1.33; 95% confidence interval [CI], 1.10 to 1.61; P = .003). Compared to older MSDs, younger MUDs conferred an increased NRM (HR, 1.38; P = .02) and higher adjusted cumulative incidence of NRM at 5 years (31% versus 22%; P = .006). There were no differences in post-alloHCT OS or LFS rates between younger MUDs and older MSDs (OS: HR, 1.09; [P = .37]; LFS: HR, .95 [P = .57]). The use of younger MUDs could be considered as a possible way to prevent relapse after alloHCT in older adults with ALL. Combining the use of younger MUDs with improved strategies to reduce GVHD merits further exploration to improve outcomes.
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Affiliation(s)
- Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, BMT & Cellular Therapy Program, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Noel Estrada-Merly
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mei-Jie Zhang
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Karen Chen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Christopher Bredeson
- Ottawa Hospital TCT Programme and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - David Allan
- Ottawa Hospital TCT Programme and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Mitchell Sabloff
- Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - David I Marks
- Bristol Hematology and Oncology Unit, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - Mark Litzow
- Division of Hematology, Blood and Marrow Transplantation Program, Mayo Clinic, Rochester, Minnesota
| | - Christopher Hourigan
- Laboratory of Myeloid Malignancies, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Partow Kebriaei
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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Abid MB, Estrada-Merly N, Zhang MJ, Chen K, Allan D, Bredeson C, Sabloff M, Guru Murthy GS, Badar T, Hashmi S, Aljurf M, Litzow MR, Kebriaei P, Hourigan CS, Saber W. Impact of Donor Age on Allogeneic Hematopoietic Cell Transplantation Outcomes in Older Adults with Acute Myeloid Leukemia. Transplant Cell Ther 2023; 29:578.e1-578.e9. [PMID: 37406882 PMCID: PMC10528825 DOI: 10.1016/j.jtct.2023.06.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/21/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
Allogeneic hematopoietic cell transplantation (alloHCT) provides cure for older patients with acute myeloid leukemia (AML); however, disease relapse remains a major concern. Based on recent data suggesting that younger donor age confers the greatest benefit for alloHCT with matched unrelated donors (MUDs), we attempted to answer a practical question: which donor type provides the best outcomes when an older patient with AML has a matched sibling donor (MSD, also older) versus the best MUD? This retrospective cohort registry study accessed data from the Center for International Blood and Marrow Transplant Research (CIBMTR) in patients with AML age ≥ 50 years undergoing alloHCT from older MSDs (age ≥ 50 years) or younger MUDs (age ≤ 35 years) between 2011 and 2018. The study included common allograft types, conditioning regimens, and graft-versus-host disease (GVHD) prophylaxis. The primary outcome was relapse risk. Secondary outcomes included nonrelapse mortality (NRM), GVHD, disease-free survival (DFS), and overall survival. Among 4684 eligible patients, 1736 underwent alloHCT with an older MSD (median donor age, 60 years), and 2948 underwent alloHCT from a younger MUD (median donor age, 25 years). In multivariable analysis, compared to older MSDs, the use of younger MUDs conferred a decreased relapse risk (hazard ratio [HR], .86; P = .005) and a significantly lower adjusted 5-year cumulative incidence of relapse (35% versus 41%; P = .003), but was associated with an increased risk for chronic GVHD (HR, 1.18; 95% confidence interval [CI], 1.08 to 1.29; P = .0002) and greater NRM only in the earlier period of 2011 to 2015 (HR, 1.24; P = .016). The corresponding NRM rates were significantly lower in the more recent period of 2016 to 2018 (HR, .78; P = .017). The adjusted 5-year DFS probability was 44% (95% CI, 42% to 46%) with an alloHCT from younger MUDs compared to 41% (95% CI, 38% to 43%) with older MSDs (P = .04). In summary, for older patients with AML undergoing alloHCT, the use of younger MUDs is associated with decreased relapse risk and improved DFS compared with the use of older MSDs.
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Affiliation(s)
- Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, BMT & Cellular Therapy Program, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Noel Estrada-Merly
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mei-Jie Zhang
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Karen Chen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - David Allan
- Ottawa Hospital TCT Programme and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Christopher Bredeson
- Ottawa Hospital TCT Programme and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Mitchell Sabloff
- Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Canada
| | | | - Talha Badar
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida
| | - Shahrukh Hashmi
- Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, UAE; Mayo Clinic Cancer Center, Mayo Clinic, Rochester, Minnesota; College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, UAE
| | - Mahmoud Aljurf
- Oncology Center, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Mark R Litzow
- Division of Hematology, Blood and Marrow Transplantation Program, Mayo Clinic, Rochester, Minnesota
| | - Partow Kebriaei
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center
| | - Christopher S Hourigan
- Laboratory of Myeloid Malignancies, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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3
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Tamari R, McLornan DP, Ahn KW, Estrada-Merly N, Hernández-Boluda JC, Giralt S, Palmer J, Gale RP, DeFilipp Z, Marks DI, van der Poel M, Verdonck LF, Battiwalla M, Diaz MA, Gupta V, Ali H, Litzow MR, Lazarus HM, Gergis U, Bashey A, Liesveld J, Hashmi S, Pu JJ, Beitinjaneh A, Bredeson C, Rizzieri D, Savani BN, Abid MB, Ganguly S, Agrawal V, Ulrike Bacher V, Wirk B, Jain T, Cutler C, Aljurf M, Kindwall-Keller T, Kharfan-Dabaja MA, Hildebrandt GC, Pawarode A, Solh MM, Yared JA, Grunwald MR, Nathan S, Nishihori T, Seo S, Scott BL, Nakamura R, Oran B, Czerw T, Yakoub-Agha I, Saber W. A simple prognostic system in patients with myelofibrosis undergoing allogeneic stem cell transplantation: a CIBMTR/EBMT analysis. Blood Adv 2023; 7:3993-4002. [PMID: 37134306 PMCID: PMC10410129 DOI: 10.1182/bloodadvances.2023009886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/05/2023] Open
Abstract
To develop a prognostic model for patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) for myelofibrosis (MF), we examined the data of 623 patients undergoing allo-HCT between 2000 and 2016 in the United States (the Center for International Blood and Marrow Transplant Research [CIBMTR] cohort). A Cox multivariable model was used to identify factors prognostic of mortality. A weighted score using these factors was assigned to patients who received transplantation in Europe (the European Bone Marrow Transplant [EBMT] cohort; n = 623). Patient age >50 years (hazard ratio [HR], 1.39; 95% confidence interval [CI], 0.98-1.96), and HLA-matched unrelated donor (HR, 1.29; 95% CI, 0.98-1.7) were associated with an increased hazard of death and were assigned 1 point. Hemoglobin levels <100 g/L at time of transplantation (HR, 1.63; 95% CI, 1.2-2.19) and a mismatched unrelated donor (HR, 1.78; 95% CI, 1.25-2.52) were assigned 2 points. The 3-year overall survival (OS) in patients with a low (1-2 points), intermediate (3-4 points), and high score (5 points) were 69% (95% CI, 61-76), 51% (95% CI, 46-56.4), and 34% (95% CI, 21-49), respectively (P < .001). Increasing score was predictive of increased transplant-related mortality (TRM; P = .0017) but not of relapse (P = .12). The derived score was predictive of OS (P < .001) and TRM (P = .002) but not of relapse (P = .17) in the EBMT cohort as well. The proposed system was prognostic of survival in 2 large cohorts, CIBMTR and EBMT, and can easily be applied by clinicians consulting patients with MF about the transplantation outcomes.
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Affiliation(s)
- Roni Tamari
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Donal P. McLornan
- Department of Medicine, University College Hospital, London, United Kingdom
| | - Kwang Woo Ahn
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI
| | - Noel Estrada-Merly
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI
| | | | - Sergio Giralt
- Department of Internal Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jeanne Palmer
- Department of Medicine, Mayo Clinic Arizona and Phoenix Children’s Hospital, Phoenix, AZ
| | - Robert Peter Gale
- Department of Immunology and Inflammation, Haematology Centre, Imperial College London, London, United Kingdom
| | - Zachariah DeFilipp
- Department of Medicine, Hematopoietic Cell Transplant and Cellular Therapy Program, Massachusetts General Hospital, Boston, MA
| | - David I. Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - Marjolein van der Poel
- Division of Hematology, Department of Internal Medicine, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Leo F. Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands
| | - Minoo Battiwalla
- Outcomes Research, Sarah Cannon Blood Cancer Network, Nashville, TN
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - Vikas Gupta
- Department of Internal Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Haris Ali
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Mark Robert Litzow
- Division of Hematology and Transplant Center, Mayo Clinic, Rochester, MN
| | - Hillard M. Lazarus
- Department of Hematology and Internal Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
| | - Usama Gergis
- Division of Hematological Malignancies, Department of Medicine Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Asad Bashey
- Department of Medicine, Blood and Marrow Transplant Program at Northside Hospital, Atlanta, GA
| | - Jane Liesveld
- Department of Medicine, University of Rochester Medical Center, Rochester, NY
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN
- Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Jeffrey J. Pu
- Department of Medicine, Banner University Medical Center Tucson, Syracuse, NY
| | - Amer Beitinjaneh
- Divison of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Christopher Bredeson
- Department of Medicine, The Ottawa Hospital Transplant & Cellular Therapy Program, Ottawa, ON, Canada
| | | | - Bipin N. Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Siddhartha Ganguly
- Department of Medicine, Houston Methodist Hospital and Cancer Center, Houston, TX
| | - Vaibhav Agrawal
- Division of Leukemia, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Vera Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Baldeep Wirk
- Department of Medicine, Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, PA
| | - Tania Jain
- Division of Hematological Malignancies and Bone Marrow Transplantation, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD
| | - Corey Cutler
- Stem Cell Transplantation and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Tamila Kindwall-Keller
- Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA
| | - Mohamed A. Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL
| | | | - Attaphol Pawarode
- Division of Hematology/Oncology, Department of Internal Medicine, Blood and Marrow Transplantation Program, University of Michigan Medical School, Ann Arbor, MI
| | - Melhem M. Solh
- The Blood and Marrow Transplant Program, Northside Hospital Cancer Institute, Atlanta, GA
| | - Jean A. Yared
- Division of Hematology/Oncology, Department of Medicine, Transplantation & Cellular Therapy Program, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD
| | - Michael R. Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Sunita Nathan
- Department of Internal Medicine, Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Bart L. Scott
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Ryotaro Nakamura
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Betul Oran
- Division of Cancer Medicine, Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tomasz Czerw
- Department of Haematology and BMT, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | | | - Wael Saber
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI
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Villeneuve PJA, Bredeson C. CAR-T Cells in Canada; Perspective on How to Ensure We Get Our Value’s Worth. Curr Oncol 2023; 30:4033-4040. [PMID: 37185418 PMCID: PMC10136494 DOI: 10.3390/curroncol30040305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 04/07/2023] Open
Abstract
New therapies in a publicly funded healthcare system are first appraised by health technology assessment agencies that provide funding recommendations to the payers. Treatment with Chimeric Antigen Receptor-T cell (CAR-T) therapy is revolutionizing the management of patients with relapsed/refractory aggressive B-cell lymphoma by providing an effective alternative to the standard of care. Yet, the implementation of CAR-T treatment has a substantial impact on the healthcare system due to its high cost, complex manufacturing process, and requirement for highly specialized services and expertise. CAR-T Cells, as a “living drug”, are fundamentally different from usual medications, and their approvals and funding recommendations pose unique challenges to the health technology agency. In this paper, we explore the specific challenges that face the health technology agencies in reviewing reimbursement recommendations for CAR-T therapy. We take a Canadian perspective and use CAR-T treatment of relapse/refractory aggressive B-cell lymphoma as an example.
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Affiliation(s)
- Pierre J. A. Villeneuve
- Division of Hematology, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Christopher Bredeson
- Division of Hematology, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
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5
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Abid MB, Estrada-Merly N, Zhang MJ, Chen K, Bredeson C, Allan D, Sabloff M, Litzow MR, Kebriaei P, Saber W. Younger Matched Unrelated Donors Confer a Decreased Relapse Risk As Compared to Older Sibling Donors for Adult B-Cell ALL Patients Undergoing Allogeneic Hematopoietic Cell Transplantation. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00097-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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6
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Kirkham AM, Bailey AJM, Masurekar A, Shorr R, Bredeson C, Sabloff M, Allan DS. Can GCSF-stimulated donor lymphocyte infusions improve outcomes for relapsed disease following allogeneic hematopoietic cell transplantation? A systematic review and meta-analysis. Leuk Lymphoma 2022; 63:3276-3287. [PMID: 36098248 DOI: 10.1080/10428194.2022.2118530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Donor lymphocyte infusions (DLI) can produce graft-versus tumor effects to treat relapse after allogeneic hematopoietic cell transplantation, however, durable responses remain uncommon. A systematic review and meta-analysis are needed to clarify whether DLI collected after stimulation with granulocyte colony-stimulating factor (GCSF; G-DLI) can improve clinical outcomes. Sixteen studies (4 controlled) involving 585 patients were identified in a systematic search up to 17 September 2020. A meta-analysis demonstrated no significant difference in the risk of all-cause mortality (RR: 0.94, 95% CI 0.52-1.68, p = 0.82; n = 3 studies) or relapse-related mortality (RR: 0.72, 0.44-1.18, p = 0.19; n = 3 studies) between G-DLI and conventional DLI (C-DLI) groups. G-DLI products had similar mean CD3+ cells compared to C-DLI products, but median CD34+ cells/kg were increased. No improvement in disease progression, complete response rates, or risk of developing GVHD was observed with G-DLI, however, greater non-relapse mortality was observed compared to C-DLI. Alternative approaches to enhancing graft-versus-tumor effects are needed.
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Affiliation(s)
- Aidan M Kirkham
- Clinical Epidemiology & Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, Canada.,Faculty of Medicine, Department of Biochemistry, Microbiology & Immunology, University of Ottawa, Ottawa, Canada
| | - Adrian J M Bailey
- Clinical Epidemiology & Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Ashish Masurekar
- Clinical Epidemiology & Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, Canada.,Transplant and Cellular Therapy Division, The Ottawa Hospital, Ottawa, Canada.,Department of Medicine, The Ottawa Hospital, Ottawa, Canada
| | - Risa Shorr
- Medical Information and Learning Services Division, The Ottawa Hospital, Ottawa, Canada
| | - Christopher Bredeson
- Clinical Epidemiology & Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Transplant and Cellular Therapy Division, The Ottawa Hospital, Ottawa, Canada.,Department of Medicine, The Ottawa Hospital, Ottawa, Canada
| | - Mitchell Sabloff
- Clinical Epidemiology & Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Department of Medicine, The Ottawa Hospital, Ottawa, Canada.,Leukemia Program, The Ottawa Hospital, Ottawa, Canada
| | - David S Allan
- Clinical Epidemiology & Regenerative Medicine, Ottawa Hospital Research Institute, Ottawa, Canada.,Faculty of Medicine, Department of Biochemistry, Microbiology & Immunology, University of Ottawa, Ottawa, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Transplant and Cellular Therapy Division, The Ottawa Hospital, Ottawa, Canada.,Department of Medicine, The Ottawa Hospital, Ottawa, Canada
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7
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Mei M, Pillai R, Kim S, Estrada-Merly N, Afkhami M, Yang L, Meng Z, Abid MB, Aljurf M, Bacher U, Beitinjaneh A, Bredeson C, Cahn JY, Cerny J, Copelan E, Cutler C, DeFilipp Z, Perez MAD, Farhadfar N, Freytes CO, Gadalla SM, Ganguly S, Gale RP, Gergis U, Grunwald MR, Hamilton BK, Hashmi S, Hildebrandt GC, Lazarus HM, Litzow M, Munker R, Murthy HS, Nathan S, Nishihori T, Patel SS, Rizzieri D, Seo S, Shah MV, Solh M, Verdonck LF, Vij R, Sobecks RM, Oran B, Scott BL, Saber W, Nakamura R. The mutational landscape in chronic myelomonocytic leukemia and its impact on allogeneic hematopoietic cell transplantation outcomes: a Center for Blood and Marrow Transplantation Research (CIBMTR) analysis. Haematologica 2022; 108:150-160. [PMID: 35443559 PMCID: PMC9827167 DOI: 10.3324/haematol.2021.280203] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Indexed: 02/05/2023] Open
Abstract
Somatic mutations are recognized as an important prognostic factor in chronic myelomonocytic leukemia (CMML). However, limited data are available regarding their impact on outcomes after allogeneic hematopoietic cell transplantation (HCT). In this registry analysis conducted in collaboration with the Center for International Blood and Marrow Transplantation Registry database/sample repository, we identified 313 adult patients with CMML (median age: 64 years, range, 28- 77) who underwent allogeneic HCT during 2001-2017 and had an available biospecimen in the form of a peripheral blood sample obtained prior to the start of conditioning. In multivariate analysis, a CMML-specific prognostic scoring system (CPSS) score of intermediate-2 (HR=1.46, P=0.049) or high (HR=3.22, P=0.0004) correlated significantly with overall survival. When the molecularly informed CPSS-Mol prognostic model was applied, a high CPSS-Mol score (HR=2 P=0.0079) correlated significantly with overall survival. The most common somatic mutations were in ASXL1 (62%), TET2 (35%), KRAS/NRAS (33% combined), and SRSF2 (31%). DNMT3A and TP53 mutations were associated with decreased overall survival (HR=1.70 [95% CI: 1.11-2.60], P=0.0147 and HR=2.72 [95% CI: 1.37-5.39], P=0.0042, respectively) while DNMT3A, JAK2, and TP53 mutations were associated with decreased disease-free survival (HR=1.66 [95% CI: 1.11-2.49], P=0.0138, HR=1.79 [95% CI: 1.06-3.03], P=0.0293, and HR=2.94 [95% CI: 1.50-5.79], P=0.0018, respectively). The only mutation associated with increased relapse was TP53 (HR=2.94, P=0.0201). Nonetheless, the impact of TP53 mutations specifically should be interpreted cautiously given their rarity in CMML. We calculated the goodness of fit measured by Harrell's C-index for both the CPSS and CPSS-Mol, which were very similar. In summary, via registry data we have determined the mutational landscape in patients with CMML who underwent allogeneic HCT, and demonstrated an association between CPSS-Mol and transplant outcomes although without major improvement in the risk prediction beyond that provided by the CPSS.
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Affiliation(s)
- Matthew Mei
- Department of Hematology/HCT, City of Hope National Medical Center, Duarte, CA, USA,*MM, RP, WS and RN contributed equally to this work
| | - Raju Pillai
- Department of Pathology, City of Hope, Duarte, CA, USA,*MM, RP, WS and RN contributed equally to this work
| | - Soyoung Kim
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA,CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Noel Estrada-Merly
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Lixin Yang
- Department of Pathology, City of Hope, Duarte, CA, USA
| | - Zhuo Meng
- Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, Fl, USA
| | - Christopher Bredeson
- The Ottawa Hospital Transplant & Cellular Therapy Program, Ottawa, Ontario, Canada
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | - Edward Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Corey Cutler
- Stem Cell Transplantation and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Zachariah DeFilipp
- Hematopoietic Cell Transplant and Cellular Therapy Program, Massachusetts General Hospital, Boston, MA, USA
| | - Miguel Angel Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL, USA
| | - César O. Freytes
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Shahinaz M. Gadalla
- Divsion of Cancer Epidemiology & Genetics, NIH-NCI Clinical Genetics Branch, Rockville, MD, USA
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS, USA
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Usama Gergis
- Department of Medical Oncology, Division of Hematological Malignancies, Thomas Jefferson University, Philadelphia, PA USA
| | - Michael R. Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Betty K. Hamilton
- Blood & Marrow Transplant Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA,Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | - Hillard M. Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, MN, USA
| | - Reinhold Munker
- Markey Cancer Center, University of Kentucky, Lexington, K Y, USA
| | - Hemant S. Murthy
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Sagar S. Patel
- Blood and Marrow Transplant Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | | | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | | | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA
| | - Leo F. Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands
| | - Ravi Vij
- Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Betul Oran
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Bart L. Scott
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Wael Saber
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA,*MM, RP, WS and RN contributed equally to this work
| | - Ryotaro Nakamura
- Department of Hematology/HCT, City of Hope National Medical Center, Duarte, CA, USA,*MM, RP, WS and RN contributed equally to this work
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8
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Bailey A, Kirkham A, Monaghan M, Shorr R, Buchan A, Bredeson C, Allan D. A Portrait of Sars-Cov-2 Infection in Patients Undergoing Hematopoietic Cell Transplantation: A Systematic Review of the Literature. Transplant Cell Ther 2022. [PMCID: PMC8930028 DOI: 10.1016/s2666-6367(22)00650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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9
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Bailey AJM, Kirkham AM, Monaghan M, Shorr R, Buchan CA, Bredeson C, Allan DS. A Portrait of SARS-CoV-2 Infection in Patients Undergoing Hematopoietic Cell Transplantation: A Systematic Review of the Literature. Curr Oncol 2022; 29:337-349. [PMID: 35049704 PMCID: PMC8774852 DOI: 10.3390/curroncol29010030] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 12/15/2022] Open
Abstract
The management of COVID-19 in hematopoietic cell transplant (HCT) recipients represents a special challenge given the variable states of immune dysregulation and altered vaccine efficacy in this population. A systematic search (Ovid Medline and Embase on 1 June 2021) was needed to better understand the presenting features, prognostic factors, and treatment options. Of 897 records, 29 studies were identified in our search. Most studies reporting on adults and pediatric recipients described signs and symptoms that were typical of COVID-19. Overall, the mortality rates were high, with 21% of adults and 6% of pediatric HCT recipients succumbing to COVID-19. The factors reported to be associated with increased mortality included age (HR = 1.21, 95% CI 1.03-1.43, p = 0.02), ICU admission (HR = 4.42, 95% CI 2.25-8.65, p < 0.001 and HR = 2.26, 95% CI 1.22-4.20, p = 0.01 for allogeneic and autologous HCT recipients), and low platelet count (OR = 21.37, 95% CI 1.71-267.11, p = 0.01). Performance status was associated with decreased mortality (HR = 0.83, 95% CI 0.74-0.93, p = 0.001). A broad range of treatments was described, although no controlled studies were identified. The risk of bias, using the Newcastle-Ottawa scale, was low. Patients undergoing HCT are at a high risk of severe morbidity and mortality associated with COVID-19. Controlled studies investigating potential treatments are required to determine the efficacy and safety in this population.
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Affiliation(s)
- Adrian J. M. Bailey
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada; (A.J.M.B.); (A.M.K.); (C.A.B.); (C.B.)
| | - Aidan M. Kirkham
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada; (A.J.M.B.); (A.M.K.); (C.A.B.); (C.B.)
| | - Madeline Monaghan
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada;
| | - Risa Shorr
- Medical Library and Learning Services, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada;
| | - C. Arianne Buchan
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada; (A.J.M.B.); (A.M.K.); (C.A.B.); (C.B.)
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada;
- Division of Infectious Disease, Department of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada
| | - Christopher Bredeson
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada; (A.J.M.B.); (A.M.K.); (C.A.B.); (C.B.)
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada;
- Transplant & Cellular Therapy in the Department of Medicine, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
| | - David S. Allan
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada; (A.J.M.B.); (A.M.K.); (C.A.B.); (C.B.)
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada;
- Transplant & Cellular Therapy in the Department of Medicine, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
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10
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Halpenny M, William N, Elmoazzen H, Giulivi A, Martin L, Perron D, Bredeson C, Hamelin L, Huebsch L, Yang L, Birch P, Acker JP. The importance of evaluating differences in HES formulations used in hematopoietic progenitor cell cryopreservation. Cytotherapy 2021; 24:223-224. [PMID: 34688545 DOI: 10.1016/j.jcyt.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/06/2021] [Indexed: 11/27/2022]
Affiliation(s)
| | - Nishaka William
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | | | - Antonio Giulivi
- Canadian Blood Services, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Lisa Martin
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - Donna Perron
- Canadian Blood Services, Ottawa, Ontario, Canada
| | | | | | | | - Lin Yang
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - Paul Birch
- Canadian Blood Services, Ottawa, Ontario, Canada
| | - Jason P Acker
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Centre for Innovation, Canadian Blood Services, Edmonton, Alberta, Canada.
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11
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Oran B, Ahn KW, Fretham C, Beitinjaneh A, Bashey A, Pawarode A, Wirk B, Scott BL, Savani BN, Bredeson C, Weisdorf D, Marks DI, Rizzieri D, Copelan E, Hildebrandt GC, Hale GA, Murthy HS, Lazarus HM, Cerny J, Liesveld JL, Yared JA, Yves-Cahn J, Szer J, Verdonck LF, Aljurf M, van der Poel M, Litzow M, Kalaycio M, Grunwald MR, Diaz MA, Sabloff M, Kharfan-Dabaja MA, Majhail NS, Farhadfar N, Reshef R, Olsson RF, Gale RP, Nakamura R, Seo S, Chhabra S, Hashmi S, Farhan S, Ganguly S, Nathan S, Nishihori T, Jain T, Agrawal V, Bacher U, Popat U, Saber W. Fludarabine and Melphalan Compared with Reduced Doses of Busulfan and Fludarabine Improve Transplantation Outcomes in Older Patients with Myelodysplastic Syndromes. Transplant Cell Ther 2021; 27:921.e1-921.e10. [PMID: 34403791 DOI: 10.1016/j.jtct.2021.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/27/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
Reduced-intensity conditioning (RIC) regimens developed to extend the use of allogeneic hematopoietic stem cell transplantation (HSCT) to older patients have resulted in encouraging outcomes. We aimed to compare the 2 most commonly used RIC regimens, i.v. fludarabine with busulfan (FluBu) and fludarabine with melphalan (FluMel), in patients with myelodysplastic syndrome (MDS). Through the Center for International Blood and Marrow Transplant Research (CIBMTR), we identified 1045 MDS patients age ≥60 years who underwent first HSCT with a matched related or matched (8/8) unrelated donor using an RIC regimen. The CIBMTR's definition of RIC was used: a regimen that incorporated an i.v. busulfan total dose ≤7.2 mg/kg or a low-dose melphalan total dose ≤150 mg/m2. The 2 groups, recipients of FluBu (n = 697) and recipients of FluMel (n = 448), were comparable in terms of disease- and transplantation-related characteristics except for the more frequent use of antithymocyte globulin or alemtuzumab in the FluBu group (39% versus 31%). The median age was 67 years in both groups. FluMel was associated with a reduced relapse incidence (RI) compared with FluBu, with a 1-year adjusted incidence of 26% versus 44% (P ≤ .0001). Transplantation-related mortality (TRM) was higher in the FluMel group (26% versus 16%; P ≤ .0001). Because the magnitude of improvement with FluMel in RI was greater than the improvement in TRM with FluBu, disease-free survival (DFS) was better at 1 year and beyond with FluMel compared with FluBu (48% versus 40% at 1 year [P = .02] and 35% versus 27% at 3 years [P = .01]). Overall survival (OS) was comparable in the 2 groups at 1 year (63% versus 61%; P = .4) but was significantly improved with FluMel compared with FluBu at 3 years (46% versus 39%; P = .03). Our results suggest that FluMel is associated with superior DFS compared with FluBu owing to reduced RI in older patients with MDS patients. © 2021 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.
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Affiliation(s)
- Betul Oran
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Kwang Woo Ahn
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Caitrin Fretham
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
| | - Asad Bashey
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
| | - Attaphol Pawarode
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, Mchigan
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, Pennsylvania
| | - Bart L Scott
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christopher Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Daniel Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - David I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - David Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Edward Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | | | - Gregory A Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
| | - Hemant S Murthy
- Blood and Marrow Transplantation Program, Division of Hematology-Oncology, Mayo Clinic, Jacksonville, Florida
| | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts
| | - Jane L Liesveld
- Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Jean Yves-Cahn
- Department of Hematology, CHU Grenoble Alpes, Grenoble, France
| | - Jeffrey Szer
- Clinical Haematology at Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Leo F Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | | | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic, Rochester, Minnesota
| | - Matt Kalaycio
- Hematology and Medical Oncology, Transplantation Center, Cleveland Clinic, Cleveland, Ohio
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Mitchell Sabloff
- Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Mohamed A Kharfan-Dabaja
- Blood and Marrow Transplantation Program, Division of Hematology-Oncology, Mayo Clinic, Jacksonville, Florida
| | - Navneet S Majhail
- Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Ran Reshef
- Blood and Marrow Transplantation Program and Columbia Center for Translational Immunology, Columbia University Medical Center, New York, New York
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom
| | - Ryotaro Nakamura
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Saurabh Chhabra
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Shatha Farhan
- Henry Ford Hospital Bone Marrow Transplant Program, Henry Ford Health System, Detroit, Michigan
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | | | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida
| | - Tania Jain
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vaibhav Agrawal
- Division of Hematology-Oncology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Uday Popat
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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12
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Buchan CA, Li HOY, Herry C, Scales N, MacPherson P, Faller E, Bredeson C, Huebsch L, Hodgins M, Seely AJE. Early Warning of Infection in Patients Undergoing Hematopoietic Stem Cell Transplantation Using Heart Rate Variability and Serum Biomarkers. Transplant Cell Ther 2021; 28:166.e1-166.e8. [PMID: 33964517 DOI: 10.1016/j.jtct.2021.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
Early warning of infection is critical to reduce the risk of deterioration and mortality, especially in neutropenic patients following hematopoietic stem cell transplantation (HCT). Given that heart rate variability (HRV) is a sensitive and early marker for infection, and that serum inflammatory biomarkers can have high specificity for infection, we hypothesized their combination may be useful for accurate early warning of infection. In this study, we developed and evaluated a composite predictive model using continuous HRV with daily serum biomarker measurements to provide risk stratification of future deterioration in HCT recipients. A total of 116 ambulatory outpatients about to undergo HCT consented to collection of prospective demographic, clinical (daily vital signs), HRV (continuous electrocardiography [ECG] monitoring, laboratory [daily serum samples frozen at -80 °C]), and infection outcome variables (defined as the time of escalation of antibiotics), all from 24 hours pre-HCT to the onset of infection or 14 days post-HCT. Indications for antibiotic escalation were adjudicated as "true infection" or not by 2 blinded HCT clinicians. A composite time series of 8 HRV metrics was created for each patient, and the probability of deterioration within the next 72 hours was estimated using logistic regression modeling of composite HRV and serum biomarkers using a rule-based naïve Bayes model if the HRV-based probability exceeded a median threshold. Thirty-five patients (30%) withdrew within <24 hours owing to intolerability of ECG monitoring, leaving 81 patients, of whom 48 (59%) had antibiotic escalation adjudicated as true infection. The combined HRV and biomarker (TNF-α, IL-6, and IL-7) predictive model began increasing at ∼48 hours on average before the diagnosis of infection, could distinguish between high risk of impending infection (>90% incidence of subsequent infection within 72 hours), average risk (∼50%), and low risk (<10%), with an area under the receiver operating characteristic curve of 0.87. However, given that prophylactic predictive ECG monitoring and daily serum collection proved challenging for many patients, further refinement in measurement is necessary for further study.
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Affiliation(s)
- C Arianne Buchan
- Division of Infectious Diseases, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
| | - Heidi Oi-Yee Li
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Nathan Scales
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Paul MacPherson
- Division of Infectious Diseases, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Elliott Faller
- Division of Infectious Diseases, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Christopher Bredeson
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Hematology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Lothar Huebsch
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Division of Hematology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Michael Hodgins
- Division of Hematology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Andrew J E Seely
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Departments of Critical Care Medicine and Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
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13
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Mishra A, Preussler JM, Bhatt VR, Bredeson C, Chhabra S, D'Souza A, Dahi PB, Hacker ED, Gowda L, Hashmi SK, Howard DS, Jakubowski A, Jayani R, Koll T, Lin RJ, Olin RL, Popat UR, Rodriguez C, Rosko A, Sabloff M, Sorror ML, Sung AD, Ustun C, Wood WA, Burns L, Artz A. Breaking the Age Barrier: Physicians' Perceptions of Candidacy for Allogeneic Hematopoietic Cell Transplantation in Older Adults. Transplant Cell Ther 2021; 27:617.e1-617.e7. [PMID: 33836312 DOI: 10.1016/j.jtct.2021.03.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
Despite continuing increases in the use of allogeneic hematopoietic cell transplantation (alloHCT) in older adults, no standardized geriatric assessment (GA) has been established to risk stratify for transplantation-related morbidity. We conducted a survey of transplant physicians to determine perceptions of the impact of older age (≥60 years) on alloHCT candidacy, and utilization of tools to gauge candidacy. This 23-item online cross-sectional survey was distributed to HCT physicians caring for adults in the United States between May and July 2019. Of the 770 invited HCT physicians, 175 (22.7%) completed the survey. The majority of respondents were age 41 to 60 years and male and practiced in a higher-volume teaching hospital. When considering regimen intensity, 29 physicians (17%) stated they would consider a myeloablative regimen for patients age ≥70 years, and 141 (82%) would consider reduced-intensity/nonmyeloablative conditioning for patients age ≥70 years. Almost all (90%) endorsed the need for a specialized assessment of pre-HCT vulnerabilities to guide candidacy decisions for older adults. Most physicians reported that their centers rarely (33%) or never (46%) use a dedicated geriatrician/geriatric-oncologist to assess alloHCT candidates age ≥60 years. Common barriers to performing a GA included uncertainty about which tools to use, lack of knowledge and training, and lack of appropriate clinical support staff. Many alloHCT physicians will consider alloHCT in patients up to age 75 years and not uncommonly in patients older than that. However, the application of tools and domains to assess candidacy in older adults varies widely. Incorporation of a standardized pretransplantation health assessment tool for risk stratification is a significant unmet need.
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Affiliation(s)
- Asmita Mishra
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
| | - Jaime M Preussler
- National Marrow Donor Program/Be The Match, Minneapolis, Minnesota; Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | | | | | | | | | | | | | | | | | - Dianna S Howard
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ann Jakubowski
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Reena Jayani
- Vanderbilt Ingram Cancer Center, Nashville, Tennessee
| | - Thuy Koll
- University of Nebraska Medical Center, Omaha, Nebraska
| | - Richard J Lin
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rebecca L Olin
- University of California San Francisco, San Francisco, California
| | - Uday R Popat
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Cesar Rodriguez
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ashley Rosko
- The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | | | | | - Anthony D Sung
- Duke University School of Medicine, Durham, North Carolina
| | | | - William A Wood
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Linda Burns
- National Marrow Donor Program/Be The Match, Minneapolis, Minnesota; Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
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14
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Fulcher J, Berardi P, Christou G, Villeneuve PJA, Bredeson C, Sabloff M. Nelarabine-containing regimen followed by daratumumab as an effective salvage therapy and bridge to allogeneic hematopoietic stem cell transplantation for primary refractory early T-cell precursor lymphoblastic leukemia. Leuk Lymphoma 2021; 62:2295-2297. [PMID: 33749497 DOI: 10.1080/10428194.2021.1901097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Jill Fulcher
- Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada
| | - Philip Berardi
- Department of Pathology and Laboratory Medicine, University of Ottawa and Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada
| | - Grace Christou
- Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada
| | - Pierre J A Villeneuve
- Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada
| | | | - Mitchell Sabloff
- Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada
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Farhadfar N, Dias A, Wang T, Fretham C, Chhabra S, Murthy HS, Broglie L, D'Souza A, Gadalla SM, Gale RP, Hashmi S, Al-Homsi AS, Hildebrandt GC, Hematti P, Rizzieri D, Chee L, Lazarus HM, Bredeson C, Jaimes EA, Beitinjaneh A, Bashey A, Prestidge T, Krem MM, Marks DI, Benoit S, Yared JA, Nishihori T, Olsson RF, Freytes CO, Stadtmauer E, Savani BN, Sorror ML, Ganguly S, Wingard JR, Pasquini M. Impact of Pretransplantation Renal Dysfunction on Outcomes after Allogeneic Hematopoietic Cell Transplantation. Transplant Cell Ther 2021; 27:410-422. [PMID: 33775617 DOI: 10.1016/j.jtct.2021.02.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/16/2020] [Accepted: 02/09/2021] [Indexed: 01/09/2023]
Abstract
Renal dysfunction is a recognized risk factor for mortality after allogeneic hematopoietic cell transplantation (alloHCT), yet our understanding of the effect of different levels of renal dysfunction at time of transplantation on outcomes remains limited. This study explores the impact of different degrees of renal dysfunction on HCT outcomes and examines whether the utilization of incremental degrees of renal dysfunction based on estimated glomerular filtration rate (eGFR) improve the predictability of the hematopoietic cell transplantation comorbidity index (HCT-CI). The study population included 2 cohorts: cohort 1, comprising patients age ≥40 years who underwent alloHCT for treatment of hematologic malignancies between 2008 and 2016 (n = 13,505; cohort selected given a very low incidence of renal dysfunction in individuals age <40 years), and cohort 2, comprising patients on dialysis at the time of HCT (n = 46). eGFR was measured using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) method. The patients in cohort 1 were assigned into 4 categories-eGFR ≥90 mL/min (n = 7062), eGFR 60 to 89 mL/min (n = 5264), eGFR 45 to 59 mL/min (n = 897), and eGFR <45 mL/min (n=282)-to assess the impact of degree of renal dysfunction on transplantation outcomes. Transplantation outcomes in patients on dialysis at the time of alloHCT were analyzed separately. eGFR <60 mL/min was associated with an increased risk for nonrelapse mortality (NRM) and requirement for dialysis post-HCT. Compared with the eGFR ≥90 group, the hazard ratio (HR) for NRM was 1.46 (P = .0001) for the eGFR 45 to 59 mL/min group and 1.74 (P = .004) for the eGFR <45 mL/min group. Compared with the eGFR ≥90 mL/min group, the eGFR 45 to 59 mL/min group (HR, 2.45; P < .0001) and the eGFR <45 mL/min group (HR, 3.09; P < .0001) had a higher risk of renal failure necessitating dialysis after alloHCT. In addition, eGFR <45 mL/min was associated with an increased overall mortality (HR, 1.63; P < .0001). An eGFR-based revised HCT-CI was also developed and shown to be predictive of overall survival (OS) and NRM, with predictive performance similar to the original HCT-CI. Among 46 patients on dialysis at alloHCT, the 1-year probability of OS was 20%, and that of NRM was 67%. The degree of pretransplantation renal dysfunction is an independent predictor of OS, NRM, and probability of needing dialysis after alloHCT. An eGFR-based HCT-CI is a validated index for predicting outcomes in adults with hematologic malignancies undergoing alloHCT. The outcomes of alloHCT recipients on dialysis are dismal; therefore, one should strongly weigh the significant risks of being on hemodialysis as a factor in determining alloHCT candidacy.
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Affiliation(s)
- Nosha Farhadfar
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Ajoy Dias
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Tao Wang
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Caitrin Fretham
- CIBMTR (Center for International Blood and Marrow Transplant Research), National marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Saurabh Chhabra
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Hemant S Murthy
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida
| | - Larisa Broglie
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | - Anita D'Souza
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Shahinaz M Gadalla
- Division of Cancer Epidemiology & Genetics, NIH-NCI Clinical Genetics Branch, Rockville, Maryland
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | | | - Peiman Hematti
- Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin, Madison, Wisconsin
| | - David Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Lynette Chee
- The Royal Melbourne Hospital City Campus and Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
| | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Christopher Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Edgar A Jaimes
- Renal Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
| | - Asad Bashey
- Blood and Marrow Transplant Program at Northside Hospital, Atlanta, Georgia
| | - Tim Prestidge
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand
| | - Maxwell M Krem
- Markey Cancer Center, University of Kentucky College of Medicine, Lexington, Kentucky
| | - David I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - Stefanie Benoit
- Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, Florida
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | | | - Edward Stadtmauer
- Abramson Cancer Center, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mohamed L Sorror
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | - John R Wingard
- Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, Florida
| | - Marcelo Pasquini
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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Fulcher J, Hertz S, Bredeson C. Soins primaires pour les bénéficiaires d’allogreffe de cellules souches hématopoïétiques. CMAJ 2021; 193:E225-E226. [PMID: 33558413 PMCID: PMC7954549 DOI: 10.1503/cmaj.200160-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jill Fulcher
- Institut de recherche de l'Hôpital d'Ottawa, Département de médecine (Fulcher, Bredeson), Université d'Ottawa, Ottawa, Ont.; Programmes cliniques et initiatives de qualité (Hertz), Action Cancer Ontario, Toronto, Ont.
| | - Sherrie Hertz
- Institut de recherche de l'Hôpital d'Ottawa, Département de médecine (Fulcher, Bredeson), Université d'Ottawa, Ottawa, Ont.; Programmes cliniques et initiatives de qualité (Hertz), Action Cancer Ontario, Toronto, Ont
| | - Christopher Bredeson
- Institut de recherche de l'Hôpital d'Ottawa, Département de médecine (Fulcher, Bredeson), Université d'Ottawa, Ottawa, Ont.; Programmes cliniques et initiatives de qualité (Hertz), Action Cancer Ontario, Toronto, Ont
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17
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Ghosh N, Ahmed S, Ahn KW, Khanal M, Litovich C, Aljurf M, Bacher VU, Bredeson C, Epperla N, Farhadfar N, Freytes CO, Ganguly S, Haverkos B, Inwards D, Kamble RT, Lazarus HM, Lekakis L, Murthy HS, Nishihori T, Ramakrishnan P, Rizzieri DA, Yared JA, Kharfan-Dabaja MA, Sureda A, Hamadani M. Association of Reduced-Intensity Conditioning Regimens With Overall Survival Among Patients With Non-Hodgkin Lymphoma Undergoing Allogeneic Transplant. JAMA Oncol 2021; 6:1011-1018. [PMID: 32496525 DOI: 10.1001/jamaoncol.2020.1278] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Importance Reduced-intensity conditioning and nonmyeloablative conditioning (RIC-NMAC) regimens are frequently used in allogeneic hematopoietic cell transplant (HCT) for non-Hodgkin lymphoma. However, the optimal RIC-NMAC regimen in allogeneic HCT for non-Hodgkin lymphoma is not known. Objective To investigate whether RIC-NMAC regimens at a higher end of the intensity spectrum are associated with increased nonrelapse mortality and lower overall survival compared with RIC-NMAC regimens at the lower end of the intensity spectrum in patients with non-Hodgkin lymphoma undergoing allogeneic HCT. Design, Setting, and Participants This cohort study used data from 1823 adult patients with non-Hodgkin lymphoma in the Center for International Blood and Marrow Transplant Research registry. Included patients underwent allogeneic HCT using matched related or unrelated donors between January 2008 and December 2016. Statistical analysis was performed from June 1, 2019, to February 10, 2020. Interventions Patients received 1 of 4 RIC-NMAC regimens: fludarabine-intravenous busulfan (Flu-Bu), approximately 6.4 mg/kg (n = 458); fludarabine-melphalan (Flu-Mel140), 140 mg/m2 (n = 885); fludarabine-cyclophosphamide (Flu-Cy) (n = 391); or Flu-Cy with 2 Gy total body irradiation (Flu-Cy-2GyTBI) (n = 89). Main Outcomes and Measures The primary outcome was overall survival. Secondary outcomes were nonrelapse mortality, incidence of relapse, progression-free survival, and the incidence of acute and chronic graft-vs-host disease (GVHD). Results Of 1823 patients, 1186 (65%) were male, with a mean (SD) age of 54.8 (9.9) years. The 4-year adjusted OS was 58% in the Flu-Bu cohort, 67% in the Flu-Cy-2GyTBI cohort, 49% in the Flu-Mel140 cohort, and 63% in the Flu-Cy cohort (P < .001). After adjustment for age, Karnofsky performance score, HCT comorbidity index, NHL subtype, remission status at HCT, and the use of antithymocyte globulin or alemtuzumab, the regression analysis showed a significantly higher mortality risk associated with Flu-Mel140 compared with Flu-Bu (hazard ratio [HR], 1.34; 95% CI, 1.13-1.59; P < .001). Compared with the Flu-Cy cohort, the Flu-Mel140 cohort had a higher risk of chronic GVHD (HR, 1.38; 95% CI, 1.15-1.65; P < .001). The Flu-Mel140 regimen was associated with a higher nonrelapse mortality risk (HR, 1.78; 95% CI, 1.37-2.31; P < .001) compared with the Flu-Bu regimen. Conclusions and Relevance The findings suggest that use of the more intense RIC-NMAC regimen, Flu-Mel140, may have a negative association with overall survival and may be associated with higher nonrelapse mortality. The Flu-Bu and Flu-Cy regimens with or without 2GyTBI regimens appeared to provide comparable overall survival.
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Affiliation(s)
- Nilanjan Ghosh
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Sairah Ahmed
- Department of Myeloma and Lymphoma, University of Texas, MD Anderson Cancer Center, Houston
| | - Kwang Woo Ahn
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee.,Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee
| | - Manoj Khanal
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee.,Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee
| | - Carlos Litovich
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh, Saudi Arabia
| | - Vera Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Christopher Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Narendranath Epperla
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus
| | - Nosha Farhadfar
- Division of Hematology and Oncology, University of Florida College of Medicine, Gainesville
| | | | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City
| | - Bradley Haverkos
- Department of Medicine, University of Colorado Hospital, Aurora, Colorado
| | - David Inwards
- Division of Hematology, Mayo Clinic, Rochester, Minnesota
| | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Hillard M Lazarus
- Department of Hematology and Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | | | - Hemant S Murthy
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic Florida, Jacksonville
| | - Taiga Nishihori
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida
| | - Praveen Ramakrishnan
- Lymphoma, Bone Marrow Transplant and Cellular Therapy Program, UT Southwestern Medical Center, Dallas, Texas
| | - David A Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Jean A Yared
- Division of Hematology and Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, Blood and Marrow Transplantation Program, University of Maryland, Baltimore
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic Florida, Jacksonville
| | - Anna Sureda
- Institut Català d'Oncologia-Hospitalet, Hematology Department, University of Barcelona, Barcelona, Spain
| | - Mehdi Hamadani
- Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee
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18
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Bhella S, Varela NP, Aw A, Bredeson C, Cheung M, Crump M, Fraser G, Sajkowski S, Kouroukis T. First-line therapy, autologous stem-cell transplantation, and post-transplantation maintenance in the management of newly diagnosed mantle cell lymphoma. Curr Oncol 2020; 27:e632-e644. [PMID: 33380879 PMCID: PMC7755434 DOI: 10.3747/co.27.7053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background In Ontario, no clearly defined standard of care for the management of mantle cell lymphoma (mcl) has been developed, and substantial variability from centre to centre is evident. This guidance document was prompted by the need to harmonize practice in Ontario with respect to first-line, conditioning, and post-transplantation maintenance therapy for patients newly diagnosed with transplantation-eligible mcl. Methods The medline and embase databases were systematically searched from January 2013 to January 2020 for evidence, and the best available evidence was used to draft recommendations relevant to first-line therapy, autologous stem-cell transplantation, and post-transplantation maintenance in the management of transplantation-eligible newly diagnosed mcl. Final approval of this guidance document was obtained from the Stem Cell Transplant Advisory Committee. Recommendations These recommendations apply to all cases of transplantation-eligible newly diagnosed mcl:■ Alternating cycles of r-chop (rituximab plus cyclophosphamide-doxorubicin-vincristine-prednisolone) and r-dhap [rituximab plus dexamethasone-high-dose cytarabine-cisplatin] is the recommended first-line treatment for symptomatic patients newly diagnosed with mcl before autologous stem-cell transplantation (asct).■ Rituximab plus hyperfractionated cyclophosphamide-vincristine-doxorubicin-dexamethasone (r-hypercvad), alternating with methotrexate and cytarabine, is not recommended for the treatment of patients with newly diagnosed mcl.■ beam (carmustine-etoposide-cytarabine-melphalan), beac (carmustine-etoposide-cytarabine-cyclophosphamide), and total-body irradiation-based regimens are reasonable conditioning options for patients with mcl who have responded to first-line therapy and who are undergoing asct.■ Maintenance therapy with rituximab is recommended for patients with newly diagnosed mcl who have undergone asct.
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Affiliation(s)
- S Bhella
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON
| | - N P Varela
- Program in Evidence-Based Care, Ontario Health (Cancer Care Ontario), and Department of Oncology, McMaster University, Hamilton, ON
| | - A Aw
- Division of Hematology, The Ottawa Hospital, Ottawa, ON
| | - C Bredeson
- Malignant Hematology and Stem Cell Transplantation, The Ottawa Hospital, Ottawa, ON
| | - M Cheung
- Division of Medical Oncology and Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON
| | - M Crump
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON
| | - G Fraser
- Division of Malignant Hematology, Juravinski Cancer Centre, and Department of Oncology, McMaster University, Hamilton, ON
| | | | - T Kouroukis
- Division of Malignant Hematology, Juravinski Cancer Centre, and Department of Oncology, McMaster University, Hamilton, ON
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19
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Tay J, Beattie S, Bredeson C, Brazauskas R, He N, Ahmed IA, Aljurf M, Askar M, Atsuta Y, Badawy S, Barata A, Beitinjaneh AM, Bhatt NS, Buchbinder D, Cerny J, Ciurea S, D'Souza A, Dalal J, Farhadfar N, Freytes CO, Ganguly S, Gergis U, Gerull S, Lazarus HM, Hahn T, Hong S, Inamoto Y, Khera N, Kindwall-Keller T, Kamble RT, Knight JM, Koleva YN, Kumar A, Kwok J, Murthy HS, Olsson RF, Angel Diaz-Perez M, Rizzieri D, Seo S, Chhabra S, Schoemans H, Schouten HC, Steinberg A, Sullivan KM, Szer J, Szwajcer D, Ulrickson ML, Verdonck LF, Wirk B, Wood WA, Yared JA, Saber W. Pre-Transplant Marital Status and Hematopoietic Cell Transplantation Outcomes. Curr Oncol 2020; 27:e596-e606. [PMID: 33380875 PMCID: PMC7755447 DOI: 10.3747/co.27.6327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Evidence about the impact of marital status before hematopoietic cell transplantation (hct) on outcomes after hct is conflicting. Methods We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent hct between January 2008 and December 2015. Marital status before hct was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after hct. Results We identified 10,226 allogeneic and 5714 autologous hct cases with, respectively, a median follow-up of 37 months (range: 1-102 months) and 40 months (range: 1-106 months). No association between marital status and overall survival was observed in either the allogeneic (p = 0.58) or autologous (p = 0.17) setting. However, marital status was associated with grades 2-4 acute graft-versus-host disease (gvhd), p < 0.001, and chronic gvhd, p = 0.04. The risk of grades 2-4 acute gvhd was increased in separated compared with married patients [hazard ratio (hr): 1.13; 95% confidence interval (ci): 1.03 to 1.24], and single patients had a reduced risk of grades 2-4 acute gvhd (hr: 0.87; 95% ci: 0.77 to 0.98). The risk of chronic gvhd was lower in widowed compared with married patients (hr: 0.82; 95% ci: 0.67 to 0.99). Conclusions Overall survival after hct is not influenced by marital status, but associations were evident between marital status and grades 2-4 acute and chronic gvhd. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization.
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Affiliation(s)
- J Tay
- Alberta: Tom Baker Cancer Centre, University of Calgary, Calgary (Tay, Beattie)
| | - S Beattie
- Alberta: Tom Baker Cancer Centre, University of Calgary, Calgary (Tay, Beattie)
| | - C Bredeson
- Ontario: The Ottawa Hospital Blood and Marrow Transplant Program and The Ottawa Hospital Research Institute, Ottawa (Bredeson)
| | - R Brazauskas
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - N He
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - I A Ahmed
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - M Aljurf
- Saudi Arabia: Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh (Aljurf)
| | - M Askar
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - Y Atsuta
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - S Badawy
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - A Barata
- Spain: Hospital de la Santa Creu i Sant Pau, Barcelona (Barata); Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid (Angel Diaz-Perez)
| | - A M Beitinjaneh
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - N S Bhatt
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - D Buchbinder
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J Cerny
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Ciurea
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - A D'Souza
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J Dalal
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - N Farhadfar
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - C O Freytes
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Ganguly
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - U Gergis
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Gerull
- Switzerland: Department of Hematology, University Hospital, Basel (Gerull)
| | - H M Lazarus
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - T Hahn
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Hong
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - Y Inamoto
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - N Khera
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - T Kindwall-Keller
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - R T Kamble
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J M Knight
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - Y N Koleva
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - A Kumar
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J Kwok
- P.R.C.: Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong sar (Kwok)
| | - H S Murthy
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - R F Olsson
- Sweden: Department of Laboratory Medicine, Karolinska Institutet, Stockholm (Olsson); Centre for Clinical Research Sormland, Uppsala University, Uppsala (Olsson)
| | - M Angel Diaz-Perez
- Spain: Hospital de la Santa Creu i Sant Pau, Barcelona (Barata); Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid (Angel Diaz-Perez)
| | - D Rizzieri
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Seo
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - S Chhabra
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - H Schoemans
- Belgium: University Hospital Leuven and KU Leuven, Leuven (Schoemans)
| | - H C Schouten
- Netherlands: Department of Hematology, Acadeische Ziekenhuis, Maastrict (Schouten); Department of Hematology/Oncology, Isala Clinic, Zwolle (Verdonck)
| | - A Steinberg
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - K M Sullivan
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - J Szer
- Australia: Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Victoria (Szer)
| | - D Szwajcer
- Manitoba: CancerCare Manitoba, Winnipeg, MB (Szwajcer)
| | - M L Ulrickson
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - L F Verdonck
- Netherlands: Department of Hematology, Acadeische Ziekenhuis, Maastrict (Schouten); Department of Hematology/Oncology, Isala Clinic, Zwolle (Verdonck)
| | - B Wirk
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - W A Wood
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J A Yared
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - W Saber
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
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Fulcher J, Hertz S, Bredeson C. Primary care for recipients of allogeneic hematopoietic stem cell transplantation. CMAJ 2020; 192:E1538. [PMID: 33229349 DOI: 10.1503/cmaj.200160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Jill Fulcher
- Ottawa Hospital Research Institute, Department of Medicine (Fulcher, Bredeson), University of Ottawa, Ottawa, Ont.; Clinical Programs and Quality Initiatives (Hertz), Cancer Care Ontario, Toronto, Ont.
| | - Sherrie Hertz
- Ottawa Hospital Research Institute, Department of Medicine (Fulcher, Bredeson), University of Ottawa, Ottawa, Ont.; Clinical Programs and Quality Initiatives (Hertz), Cancer Care Ontario, Toronto, Ont
| | - Christopher Bredeson
- Ottawa Hospital Research Institute, Department of Medicine (Fulcher, Bredeson), University of Ottawa, Ottawa, Ont.; Clinical Programs and Quality Initiatives (Hertz), Cancer Care Ontario, Toronto, Ont
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21
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Bejanyan N, Zhang M, Bo-Subait K, Brunstein C, Wang H, Warlick ED, Giralt S, Nishihori T, Martino R, Passweg J, Dias A, Copelan E, Hale G, Gale RP, Solh M, Kharfan-Dabaja MA, Diaz MA, Ganguly S, Gore S, Verdonck LF, Hossain NM, Kekre N, Savani B, Byrne M, Kanakry C, Cairo MS, Ciurea S, Schouten HC, Bredeson C, Munker R, Lazarus H, Cahn JY, van Der Poel M, Rizzieri D, Yared JA, Freytes C, Cerny J, Aljurf M, Palmisiano ND, Pawarode A, Bacher VU, Grunwald MR, Nathan S, Wirk B, Hildebrandt GC, Seo S, Olsson RF, George B, de Lima M, Hourigan CS, Sandmaier BM, Litzow M, Kebriaei P, Saber W, Weisdorf D. Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index: A Center for International Blood and Marrow Transplant Research Study. Transplant Cell Ther 2020; 27:68.e1-68.e9. [PMID: 33010430 DOI: 10.1016/j.bbmt.2020.09.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/05/2020] [Accepted: 09/19/2020] [Indexed: 11/26/2022]
Abstract
Compared with reduced-intensity conditioning (RIC), myeloablative conditioning (MAC) is generally associated with lower relapse risk after allogeneic hematopoietic cell transplantation (HCT) for acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS). However, disease-specific risk factors in AML/MDS can further inform when MAC and RIC may yield differential outcomes. We analyzed HCT outcomes stratified by the Disease Risk Index (DRI) in 4387 adults (age 40 to 65 years) to identify the impact of conditioning intensity. In the low/intermediate-risk DRI cohort, RIC was associated with lower nonrelapse mortality (NRM) (hazard ratio [HR], .74; 95% confidence interval [CI], .62 to .88; P < .001) but significantly greater relapse risk (HR, 1.54; 95% CI, 1.35 to 1.76; P < .001) and thus inferior disease-free survival (DFS) (HR, 1.19; 95% CI, 1.07 to 1.33; P = .001). In the high/very high-risk DRI cohort, RIC was associated with marginally lower NRM (HR, .83; 95% CI, .68 to 1.00; P = .051) and significantly higher relapse risk (HR, 1.23; 95% CI, 1.08 to 1.41; P = .002), leading to similar DFS using either RIC or MAC. These data support MAC over RIC as the preferred conditioning intensity for patients with AML/MDS with low/intermediate-risk DRI, but with a similar benefit as RIC in high/very high-risk DRI. Novel MAC regimens with less toxicity could benefit all patients, but more potent antineoplastic approaches are needed for the high/very-high risk DRI group.
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Affiliation(s)
- Nelli Bejanyan
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida.
| | - Meijie Zhang
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Khalid Bo-Subait
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Claudio Brunstein
- Adult Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Hailin Wang
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Erica D Warlick
- Adult Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Sergio Giralt
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Taiga Nishihori
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida
| | - Rodrigo Martino
- Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jakob Passweg
- Division of Hematology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Ajoy Dias
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Edward Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Gregory Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St Petersburg, Florida
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | - Melhem Solh
- Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, Georgia
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | - Steven Gore
- Section of Medical Oncology, Department of Internal Medicine, Yale New Haven Hospital, New Haven, Connecticut
| | - Leo F Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherland
| | - Nasheed M Hossain
- Stem Cell Transplant Program, Division of Hematology/Oncology, Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois
| | - Natasha Kekre
- Blood & Marrow Transplant Program, Department of Medicine, Ottawa Hospital Ottawa, Ontario, Canada
| | - Bipin Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Michael Byrne
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christopher Kanakry
- Experimental Transplantation and Immunology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Mitchell S Cairo
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, Valhalla, New York
| | - Stefan Ciurea
- Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Harry C Schouten
- Department of Hematology, Academische Ziekenhuis, Maastricht, The Netherlands
| | - Christopher Bredeson
- Blood & Marrow Transplant Program, Department of Medicine, Ottawa Hospital Ottawa, Ontario, Canada
| | - Reinhold Munker
- Division of Medical Oncology, Markey Cancer Center, University of Kentucky School of Medicine, Lexington, Kentucky
| | - Hillard Lazarus
- Department of Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Grenoble, France
| | - Marjolein van Der Poel
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - David Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Cesar Freytes
- Hematopoietic Stem Cell Transplant Program, Texas Transplant Institute, San Antonio, Texas
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Neil D Palmisiano
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Attaphol Pawarode
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Vera Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, North Carolina
| | - Sunita Nathan
- Section of Bone Marrow Transplantation and Cellular Therapy, Division of Hematology, Oncology and Cell Therapy, Department of Internal Medicine, Rush Medical College, Chicago, Illinois
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, Pennsylvania
| | - Gerhard C Hildebrandt
- Division of Medical Oncology, Markey Cancer Center, University of Kentucky School of Medicine, Lexington, Kentucky
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Sweden
| | - Biju George
- Department of Haematology, Christian Medical College, Vellore, India
| | - Marcos de Lima
- Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Christopher S Hourigan
- Laboratory of Myeloid Malignancies, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Brenda M Sandmaier
- Division of Medical Oncology, University of Washington and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, Minnesota
| | - Partow Kebriaei
- Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wael Saber
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Daniel Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, 96
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22
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Fulcher J, Leung E, Christou G, Bredeson C, Sabloff M. Selecting the optimal targeted therapy for relapsed B-acute lymphoblastic leukemia. Leuk Lymphoma 2020; 61:2271-2273. [PMID: 32427017 DOI: 10.1080/10428194.2020.1761965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Jill Fulcher
- Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Health Research Institute, Ottawa, Canada
| | - Eugene Leung
- Division of Nuclear Medicine, Department of Medicine, University of Ottawa and Ottawa Health Research Institute, Ottawa, Canada
| | - Grace Christou
- Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Health Research Institute, Ottawa, Canada
| | - Christopher Bredeson
- Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Health Research Institute, Ottawa, Canada
| | - Mitchell Sabloff
- Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Health Research Institute, Ottawa, Canada
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23
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Kanate AS, Majhail NS, Savani BN, Bredeson C, Champlin RE, Crawford S, Giralt SA, LeMaistre CF, Marks DI, Omel JL, Orchard PJ, Palmer J, Saber W, Veys PA, Carpenter PA, Hamadani M. Indications for Hematopoietic Cell Transplantation and Immune Effector Cell Therapy: Guidelines from the American Society for Transplantation and Cellular Therapy. Biol Blood Marrow Transplant 2020; 26:1247-1256. [PMID: 32165328 DOI: 10.1016/j.bbmt.2020.03.002] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 03/02/2020] [Indexed: 12/20/2022]
Abstract
The American Society for Transplantation and Cellular Therapy (ASTCT) published its first white paper on indications for autologous and allogeneic hematopoietic cell transplantation (HCT) in 2015. It was identified at the time that periodic updates of indications would be required to stay abreast with state of the art and emerging indications and therapy. In recent years the field has not only seen an improvement in transplantation technology, thus widening the therapeutic scope of HCT, but additionally a whole new treatment strategy using modified immune effector cells, including chimeric antigen receptor T cells and engineered T-cell receptors, has emerged. The guidelines review committee of the ASTCT deemed it optimal to update the ASTCT recommendations for indications for HCT to include new data and to incorporate indications for immune effector cell therapy (IECT) where appropriate. The guidelines committee established a multiple stakeholder task force consisting of transplant experts, payer representatives, and a patient advocate to provide guidance on indications for HCT and IECT. This article presents the updated recommendations from the ASTCT on indications for HCT and IECT. Indications for HCT/IECT were categorized as (1) Standard of care, where indication is well defined and supported by evidence; (2) Standard of care, clinical evidence available, where large clinical trials and observational studies are not available but have been shown to be effective therapy; (3) Standard of care, rare indication, for rare diseases where demonstrated effectiveness exists but large clinical trials and observational studies are not feasible; (4) Developmental, for diseases where preclinical and/or early-phase clinical studies show HCT/IECT to be a promising treatment option; and (5) Not generally recommended, where available evidence does not support the routine use of HCT/IECT. The ASTCT will continue to periodically review these guidelines and update them as new evidence becomes available.
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Affiliation(s)
- Abraham S Kanate
- Hematopoietic Malignancy & Cellular Therapy Program, West Virginia University, Morgantown, West Virginia.
| | - Navneet S Majhail
- Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, Ohio
| | - Bipin N Savani
- Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christopher Bredeson
- Division of Hematology, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Sergio A Giralt
- Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - David I Marks
- Adult BMT Unit, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | - Paul J Orchard
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Jeanne Palmer
- Division of Hematology/Oncology, Mayo Clinic, Phoenix, Arizona
| | - Wael Saber
- BMT & Cellular Therapy Program, Medical College of Wisconsin, Milwaukee, Wisconsin; Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin
| | - Paul A Veys
- Bone Marrow Transplantation Unit, Great Ormond Street Hospital for Children, London, UK
| | - Paul A Carpenter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mehdi Hamadani
- BMT & Cellular Therapy Program, Medical College of Wisconsin, Milwaukee, Wisconsin; Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin
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24
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Buchbinder D, Brazauskas R, Bo-Subait K, Ballen K, Parsons S, John T, Hahn T, Sharma A, Steinberg A, D'Souza A, Kumar AJ, Yoshimi A, Wirk B, Shaw B, Freytes C, LeMaistre C, Bredeson C, Dandoy C, Almaguer D, Marks DI, Szwajcer D, Hale G, Schouten H, Hashem H, Schoemans H, Murthy HS, Lazarus HM, Cerny J, Tay J, Yared JA, Adekola K, Schultz KR, Lehmann L, Burns L, Aljurf M, Diaz MA, Majhail N, Farhadfar N, Kamble R, Olsson R, Schears R, Seo S, Beattie S, Chhabra S, Savani BN, Badawy S, Ganguly S, Ciurea S, Marino S, Gergis U, Kuwatsuka Y, Inamoto Y, Khera N, Hashmi S, Wood W, Saber W. Predictors of Loss to Follow-Up Among Pediatric and Adult Hematopoietic Cell Transplantation Survivors: A Report from the Center for International Blood and Marrow Transplant Research. Biol Blood Marrow Transplant 2020; 26:553-561. [PMID: 31726205 PMCID: PMC7367505 DOI: 10.1016/j.bbmt.2019.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/24/2019] [Accepted: 11/03/2019] [Indexed: 12/16/2022]
Abstract
Follow-up is integral for hematopoietic cell transplantation (HCT) care to ensure surveillance and intervention for complications. We characterized the incidence of and predictors for being lost to follow-up. Two-year survivors of first allogeneic HCT (10,367 adults and 3865 children) or autologous HCT (7291 adults and 467 children) for malignant/nonmalignant disorders between 2002 and 2013 reported to the Center for International Blood and Marrow Transplant Research were selected. The cumulative incidence of being lost to follow-up (defined as having missed 2 consecutive follow-up reporting periods) was calculated. Marginal Cox models (adjusted for center effect) were fit to evaluate predictors. The 10-year cumulative incidence of being lost to follow-up was 13% (95% confidence interval [CI], 12% to 14%) in adult allogeneic HCT survivors, 15% (95% CI, 14% to 16%) in adult autologous HCT survivors, 25% (95% CI, 24% to 27%) in pediatric allogeneic HCT survivors, and 24% (95% CI, 20% to 29%) in pediatric autologous HCT survivors. Factors associated with being lost to follow-up include younger age, nonmalignant disease, public/no insurance (reference: private), residence farther from the tranplantation center, and being unmarried in adult allogeneic HCT survivors; older age and testicular/germ cell tumor (reference: non-Hodgkin lymphoma) in adult autologous HCT survivors; older age, public/no insurance (reference: private), and nonmalignant disease in pediatric allogeneic HCT survivors; and older age in pediatric autologous HCT survivors. Follow-up focusing on minimizing attrition in high-risk groups is needed to ensure surveillance for late effects.
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Affiliation(s)
- David Buchbinder
- Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, California.
| | - Ruta Brazauskas
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Khalid Bo-Subait
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Karen Ballen
- Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, Virginia
| | - Susan Parsons
- The Center for Health Solutions at the Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
| | - Tami John
- Department of Pediatrics, Section of Hematology/Oncology, Baylor College of Medicine Center for Cell and Gene Therapy, Houston, Texas
| | - Theresa Hahn
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Amir Steinberg
- Division of Hematology and Oncology, Mount Sinai Hospital, New York, New York
| | - Anita D'Souza
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Anita J Kumar
- The Center for Health Solutions at the Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
| | - Ayami Yoshimi
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, University of Freiburg Medical Center, Freiburg, Germany
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington
| | - Bronwen Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Charles LeMaistre
- Hematology and Bone Marrow Transplant, Sarah Cannon, Nashville, Tennessee
| | - Christopher Bredeson
- Ottawa Hospital Blood and Marrow Transplant Program and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Christopher Dandoy
- UC Department of Pediatrics and Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - David Almaguer
- Hematology Service at the University Hospital in Monterrey Mexico, and the Stem cell Transplantation Program, Hospital Universitario Dr José E. González, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - David I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - David Szwajcer
- Department of Hematology/Oncology, CancerCare Manitoba/University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gregory Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St Petersburg, Florida
| | - Harry Schouten
- Department of Hematology, Academische Ziekenhuis, Maastricht, The Netherlands
| | - Hasan Hashem
- Division of Pediatric Hematology/Oncology and Bone marrow Transplantation, King Hussein Cancer Center, Amman, Jordan
| | - Hélène Schoemans
- Hematology department and Bone marrow transplant unit, University Hospital Leuven and KU Leuven, Leuven, Belgium
| | | | - Hillard M Lazarus
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts
| | - Jason Tay
- Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Kehinde Adekola
- Division of Hematology/Oncology, Department of Medicine and Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kirk R Schultz
- Department of Pediatric Hematology, Oncology and Bone Marrow Transplant, British Columbia's Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie Lehmann
- Dana-Farber Cancer Institute/Boston Children's Hospital, Boston, Massachusetts
| | - Linda Burns
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Navneet Majhail
- Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, Florida
| | - Rammurti Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Richard Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Raquel Schears
- Department of Emergency Medicine, University of Central Florida, Orlando, Florida
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Sara Beattie
- Department of Psychosocial Oncology and Rehabilitation, Tom Baker Cancer Centre, Calgary, Alberta, Canada; Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
| | - Saurabh Chhabra
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sherif Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | | | - Susana Marino
- Department of Pathology, University of Chicago Medicine, Chicago, Illinois
| | - Usama Gergis
- Hematologic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Yachiyo Kuwatsuka
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Nandita Khera
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, Arizona
| | - Shahrukh Hashmi
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia; Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - William Wood
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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25
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Mishra A, Preussler JM, Al-Mansour Z, Bachanova V, Bhatt VR, Bredeson C, Chhabra S, D'Souza A, Dahi PB, DeFilipp Z, Gowda L, Hacker ED, Hashmi SK, Howard DS, Jakubowski AA, Jayani R, Johnston L, Koll T, Lin RJ, McCurdy SR, Michaelis LC, Muffly L, Nathwani N, Olin RL, Popat UR, Rodriguez C, Rosko A, Runaas L, Sabloff M, Shore TB, Shune L, Sorror ML, Sung AD, Ustun C, Wood W, Burns LJ, Artz AS. Transplant Physicians’ Attitudes on Candidacy for Allogeneic Hematopoietic Cell Transplantation (HCT) in Older Patients: The Need for a Standardized Geriatric Assessment (GA) Tool. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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French B, MacMillan ML, Majhail NS, Bredeson C. The Impact of Mentoring Our Future Leaders: 12 Years of the Astct Clinical Research Training Course. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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27
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Hsu JW, Shaw BE, Kim S, Logan BR, Sees JA, Confer DL, Pulsipher MA, Shah N, Switzer GE, Abidi MH, Ahmed IA, Anderlini PN, Bredeson C, Chhabra S, Dandoy CE, Diaz MA, Farhadfar N, Ganguly S, Gergis U, Hale GA, Hematti P, Kamble RT, Kasow KA, Lazarus HM, Liesveld JL, Murthy HS, Olsson RF, Savani BN, Schears R, Seo S, Solh M, Spitzer T, Steinberg A, Sugrue M, Warkentin P, Wingard JR. Collection of Peripheral Blood Progenitor Cells in 1 Day Is Associated with Decreased Donor Toxicity Compared to 2 Days in Unrelated Donors. Biol Blood Marrow Transplant 2020; 26:1210-1217. [PMID: 32088366 DOI: 10.1016/j.bbmt.2020.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 11/29/2022]
Abstract
Peripheral blood stem cells (PBSCs) have been increasingly used for allogeneic hematopoietic cell transplantation instead of bone marrow stem cells. Current National Marrow Donor Program policy recommends 5 days of daily filgrastim, followed by either 1 or 2 days of apheresis for unrelated donors, depending on collection center choice. To date, there are no published studies comparing the differences in donor experience between 1 day and 2 days of apheresis. We examined 22,348 adult unrelated donor collections in 184 centers between 2006 and 2016. Of these 22,348 donors, 20,004 (89.5%) had collection on 1 day, and the other 2344 (9.5%) had collection over 2 days. Information on why donors underwent apheresis in 1 day or 2 days was not available. Donors who underwent apheresis in 1 day were more likely to be male (67% versus 46%; P < .001), younger (age <30 years, 48% versus 36%; P < .001), and have a higher body weight (83.0 kg versus 75.9 kg; P< .001) and body mass index (BMI; >30, 30% versus 22%; P < .001). Successful collection of the requested CD34+ cell count was achieved on the first day in 82% of 1-day collections and in 16% of 2-day collections. Despite not administering filgrastim the evening after the first day of collection in patients who underwent 2 days of apheresis, the median concentration of CD34+ cells/L in the product was higher on the second day of apheresis compared with the first day (23.8 × 106 CD34+/L on day 1 versus 28.7 × 106 CD34+/L on day 2; P< .001). Donors who underwent collection in 1 day were less likely to experience citrate toxicity (36% versus 52%; P< .001), hospitalization (1% versus 6%; P< .001), and other side effects related to apheresis (Modified Toxicity Criteria incidence: 20% versus 26%; P < .001). Female sex, older age, collection via central lines, and higher BMI were factors associated with greater likelihood for the development of toxicity, whereas less toxicity was noted in those with higher CD34+ counts and more blood processed on the first day of collection. We conclude that although unrelated donors can be successfully collected in 1 day or 2 days, 1-day apheresis procedures were associated with less overall toxicity, and thus we recommend single-day collections, especially if the requested number of cells have been collected in 1 day.
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Affiliation(s)
- Jack W Hsu
- Division of Hematology and Oncology, College of Medicine, University of Florida, Gainesville, Florida.
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Soyoung Kim
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Brent R Logan
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jennifer A Sees
- Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Dennis L Confer
- Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, Minnesota; National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Michael A Pulsipher
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | - Nirali Shah
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Galen E Switzer
- University of Pittsburgh Medical Center- Cancer Center University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Muneer H Abidi
- Hematology and Oncology, Spectrum Health Hospital Group, Grand Rapids, Michigan
| | - Ibrahim A Ahmed
- Department of Hematology Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, Missouri
| | - Paulo N Anderlini
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Christopher Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Saurabh Chhabra
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Christopher E Dandoy
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Nosha Farhadfar
- Division of Hematology and Oncology, College of Medicine, University of Florida, Gainesville, Florida
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | - Usama Gergis
- Hematolgic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical College, New York, New York
| | - Gregory A Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St Petersburg, Florida
| | - Peiman Hematti
- Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Kimberly A Kasow
- Pediatrics, University of North Carolina, Chapel Hill, North Carolina
| | - Hillard M Lazarus
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Jane L Liesveld
- Department of Medicine, Strong Memorial Hospital-University of Rochester Medical Center, Rochester, New York
| | - Hemant S Murthy
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida
| | - Richard F Olsson
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Raquel Schears
- Department of Emergency Medicine, Mayo Medical School, Rochester, Minnesota
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Melhern Solh
- Northside Hospital Blood and Marrow Transplant and Leukemia Program, The Blood and Marrow Transplant Program at Northside Hospital, Atlanta, Georgia
| | - Thomas Spitzer
- Cellular Therapy and Transplantation Laboratory, Massachusetts General Hospital, Boston, Massachusetts
| | | | | | | | - John R Wingard
- Division of Hematology and Oncology, College of Medicine, University of Florida, Gainesville, Florida
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28
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Altouri S, Allan D, Atkins H, Fulcher J, Huebsch L, Kekre N, Maze D, Ramsay T, Samant R, Bredeson C, Sabloff M. Total body irradiation (18 Gy) without chemotherapy as conditioning for allogeneic hematopoietic cell transplantation in refractory acute myeloid leukemia. Bone Marrow Transplant 2020; 55:1454-1456. [PMID: 31992848 DOI: 10.1038/s41409-020-0799-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 12/07/2019] [Accepted: 01/16/2020] [Indexed: 01/26/2023]
Affiliation(s)
- Sultan Altouri
- Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - David Allan
- Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Harold Atkins
- Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Jill Fulcher
- Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Lothar Huebsch
- Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Natasha Kekre
- Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Dawn Maze
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Tim Ramsay
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Rajiv Samant
- Department of Radiation Oncology, The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada
| | - Christopher Bredeson
- Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Mitchell Sabloff
- Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada. .,Ottawa Hospital Research Institute, Ottawa, ON, Canada.
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29
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Kouroukis CT, Bredeson C, Pollett A, Meertens E, Monakova J, Wang J, Hart J, Beglaryan H, Moody L, Hertz S. A systematic approach for high-quality care in complex malignant hematology. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.27_suppl.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
57 Background: Capacity limits in Ontario, Canada, resulted in long waits and out-of-country care for hematopoietic cell therapy (HCT) and inconsistent access for acute leukemia (AL) patients. A multi-pronged system improvement approach was implemented to ensure high quality care as close to home as possible. Methods: Robust forecasting models and physician workload benchmarks were developed to quantify needs and drive health human resource and capital planning. Clinical and organizational guidelines were developed for new models of care, pathology and laboratory medicine services, and networks of care. Funding models were introduced to support care needs and service models. A comprehensive measurement strategy, including patient reported experience measures, was developed. Results: Six services sites providing HCT and AL care are networked with four AL sites and three supporting sites. Capital expansion projects have been completed and others continue. Two biomarker reference centers were established to serve as quality leads and ensure timely testing. Average turnaround time is 12 days for cytogenetic testing. 19 additional physician specialists and 5 additional fellowships were approved for allocation across Ontario. Three nurse practitioners participated in mentorship programs. Access has improved and wait times are monitored. In 2018 there were 736 autologous and 357 allogeneic transplants done vs 396 and 159 respectively in 2014. 43 patients were referred out of country in 2016 compared with two in 2018, with a median wait of 70 days from AL remission to transplant in 2018. Nine (of 14) regional cancer centers offer outpatient AL consolidation. Patient experience was highest in treatment planning, physical comfort and patient preferences. Conclusions: A multi-pronged approach to planning, funding and quality assurance resulted in measureable increased capacity and high quality care closer to home.
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30
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Sabloff M, Chhabra S, Wang T, Fretham C, Kekre N, Abraham A, Adekola K, Auletta JJ, Barker C, Beitinjaneh AM, Bredeson C, Cahn JY, Diaz MA, Freytes C, Gale RP, Ganguly S, Gergis U, Guinan E, Hamilton BK, Hashmi S, Hematti P, Hildebrandt G, Holmberg L, Hong S, Lazarus HM, Martino R, Muffly L, Nishihori T, Perales MA, Yared J, Mineishi S, Stadtmauer EA, Pasquini MC, Loren AW. Comparison of High Doses of Total Body Irradiation in Myeloablative Conditioning before Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2019; 25:2398-2407. [PMID: 31473319 DOI: 10.1016/j.bbmt.2019.08.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/14/2019] [Accepted: 08/14/2019] [Indexed: 12/16/2022]
Abstract
Malignancy relapse is the most common cause of treatment failure among recipients of hematopoietic cell transplantation (HCT). Conditioning dose intensity can reduce disease relapse but is offset by toxicities. Improvements in radiotherapy techniques and supportive care may translate to better outcomes with higher irradiation doses in the modern era. This study compares outcomes of recipients of increasing doses of high-dose total body irradiation (TBI) divided into intermediate high dose (IH; 13-13.75 Gy) and high dose (HD; 14 Gy) with standard dose (SD; 12 Gy) with cyclophosphamide. A total of 2721 patients ages 18 to 60 years with hematologic malignancies receiving HCT from 2001 to 2013 were included. Cumulative incidences of nonrelapse mortality (NRM) at 5 years were 28% (95% confidence interval [CI], 25% to 30%), 32% (95% CI, 29% to 36%), and 34% (95% CI, 28% to 39%) for SD, IH, and HD, respectively (P = .02). Patients receiving IH-TBI had a 25% higher risk of NRM compared with those receiving SD-TBI (12 Gy) (P = .007). Corresponding cumulative incidences of relapse were 36% (95% CI, 34% to 38%), 32% (95% CI, 29% to 36%), and 26% (95% CI, 21% to 31%; P = .001). Hazard ratios for mortality compared with SD were 1.06 (95% CI, .94 to 1.19; P = .36) for IH and .89 (95% CI, .76 to 1.05; P = .17) for HD. The study demonstrates that despite improvements in supportive care, myeloablative conditioning using higher doses of TBI (with cyclophosphamide) leads to worse NRM and offers no survival benefit over SD, despite reducing disease relapse.
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Affiliation(s)
- Mitchell Sabloff
- Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Canada
| | - Saurabh Chhabra
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Tao Wang
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Caitrin Fretham
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be the Match, Minneapolis, Minnesota
| | - Natasha Kekre
- The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Allistair Abraham
- Division of Blood and Marrow Transplantation, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC
| | - Kehinde Adekola
- Division of Hematology/Oncology, Department of Medicine and Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jeffery J Auletta
- Blood and Marrow Transplant Program and Host Defense Program, Divisions of Hematology/Oncology/Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio
| | - Christopher Barker
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Christopher Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Grenoble, France
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Cesar Freytes
- Adult Blood & Marrow Transplant Program, Texas Transplant Institute, San Antonio, Texas
| | - Robert Peter Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | - Usama Gergis
- Hematolgic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Eva Guinan
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Betty K Hamilton
- Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Peiman Hematti
- Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin, Madison, Wisconsin
| | | | - Leona Holmberg
- Division of Medical Oncology, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Sanghee Hong
- Department of Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland Ohio
| | | | - Rodrigo Martino
- Divison of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lori Muffly
- Division of Blood and Marrow Transplantation, Stanford University, Stanford, California
| | - Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Miguel-Angel Perales
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jean Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Shin Mineishi
- Division of Hematology and Oncology, Department of Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Edward A Stadtmauer
- Division of Hematology/Oncology, Department of Medicine, Abramson Cancer Center, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Marcelo C Pasquini
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Alison W Loren
- Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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31
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Scrivens N, Sabri E, Bredeson C, McDiarmid S. Comparison of complication rates and incidences associated with different peripherally inserted central catheters (PICC) in patients with hematological malignancies: a retrospective cohort study. Leuk Lymphoma 2019; 61:156-164. [PMID: 31387422 DOI: 10.1080/10428194.2019.1646908] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Patients with hematological malignancies (HM) or undergoing hematopoietic cell transplantation (HCT) require reliable vascular access. Peripherally inserted central catheters (PICC) meet this need, however, studies suggest these patients have higher rates of PICC-associated complications. This retrospective cohort study evaluates the influence of PICC type on the rates and incidences of complications. Four hundred and eighty-five dual lumen PICCs were inserted into 469 complex patients with HM or undergoing HCT: 161 Groshong®, 60 PowerPICC® Solo, 165 BioFlo®, and 99 Arrow®. The rates and incidences of complications differed significantly across the PICC types. The overall rate of complication ranged from 7.40 to 26.4/1000 catheter days (CDs). The rate of deep vein thrombosis (0.31-1.48/1000 CDs) and occlusion differed across the PICC types, while the rate of central line-associated bloodstream infection (0.53-0.74/1000 CDs) did not. Following multivariate adjustment, PICC type was associated with complication rate. This highlights that PICC type should be considered in clinical decisions.
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Affiliation(s)
| | - Elham Sabri
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Christopher Bredeson
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Division of Hematology, The Ottawa Hospital, Ottawa, ON, Canada.,The University of Ottawa, Ottawa, ON, Canada
| | - Sheryl McDiarmid
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Division of Hematology, The Ottawa Hospital, Ottawa, ON, Canada
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32
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Heelan F, Mallick R, Bryant A, Atkins H, Huebsch L, Bredeson C, Allan D, Kekre N. Comparison of Weight-Based and Lymphocyte Count-Based Dosing of Anti- Thymocyte Globulin in Matched Unrelated Donor Stem Cell Transplantation. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Prokopishyn NL, Logan BR, Kiefer DM, Sees JA, Chitphakdithai P, Ahmed IA, Anderlini PN, Beitinjaneh AM, Bredeson C, Cerny J, Chhabra S, Daly A, Diaz MA, Farhadfar N, Frangoul HA, Ganguly S, Gastineau DA, Gergis U, Hale GA, Hematti P, Kamble RT, Kasow KA, Lazarus HM, Liesveld JL, Murthy HS, Norkin M, Olsson RF, Papari M, Savani BN, Szer J, Waller EK, Wirk B, Yared JA, Pulsipher MA, Shah NN, Switzer GE, O'Donnell PV, Confer DL, Shaw BE. The Concentration of Total Nucleated Cells in Harvested Bone Marrow for Transplantation Has Decreased over Time. Biol Blood Marrow Transplant 2019; 25:1325-1330. [PMID: 30716454 PMCID: PMC6615955 DOI: 10.1016/j.bbmt.2019.01.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 01/29/2019] [Indexed: 10/27/2022]
Abstract
Bone marrow (BM) is an essential source of hematopoietic stem cell grafts for many allogeneic hematopoietic cell transplant (HCT) recipients, including adult patients (for specific diseases and transplantation strategies) and the majority of pediatric recipient. However, since the advent of granulocyte colony-stimulating factor-mobilized peripheral blood stem cell (PBSC) grafts, there has been a significant decrease in the use of BM in HCT, thought to be due mainly to the increased logistical challenges in harvesting BM compared with PBSCs, as well as generally no significant survival advantage of BM over PBSCs. The decreased frequency of collection has the potential to impact the quality of BM harvests. In this study, we examined >15,000 BM donations collected at National Marrow Donor Program centers between 1994 and 2016 and found a significant decline in the quality of BM products, as defined by the concentration of total nucleated cells (TNCs). The mean TNC concentration in BM donations dropped from 21.8 × 106 cells/mL in the earliest era (1994 to 1996) to 18.7 × 106 cells/mL in the most recent era (2012 to 2016) (means ratio, .83; P < .001). This decline in BM quality was seen despite the selection of more donors perceived to be optimal (eg, younger and male). Multivariate regression analysis showed that higher-volume centers (performing >30 collections per era) had better-quality harvests with higher concentrations of TNCs collected. In conclusion, we have identified a significant decrease in the quality of BM collections over time, and lower-volume collection centers had poorer-quality harvests. In this analysis, we could not elucidate the direct cause for this finding, suggesting the need for further studies to investigate the key factors responsible and to explore the impact on transplant recipients.
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Affiliation(s)
- Nicole L Prokopishyn
- Department of Pathology and Laboratory Medicine,University of Calgary, Calgary, Alberta, Canada
| | - Brent R Logan
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Deidre M Kiefer
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Jennifer A Sees
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Pintip Chitphakdithai
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Ibrahim A Ahmed
- Department of Hematology Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, Missouri
| | - Paolo N Anderlini
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | - Christopher Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts
| | - Saurabh Chhabra
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Andrew Daly
- Tom Baker Cancer Center, Calgary, Alberta, Canada
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, Florida
| | - Haydar A Frangoul
- Division of Pediatric-Hematology and Oncology, The Children's Hospital at TriStar Centennial and Sarah Cannon Research Institute, Nashville, Tennessee
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | | | - Usama Gergis
- Hematolgic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical College, New York, New York
| | - Gregory A Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
| | - Peiman Hematti
- Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Kimberly A Kasow
- Department of Pediatrics in the Division of Hematology-Oncology, University of North Carolina, Chapel Hill, North Carolina
| | - Hillard M Lazarus
- Seidman Cancer Center-University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Jane L Liesveld
- Strong Memorial Hospital-University of Rochester Medical Center, Rochester, New York
| | - Hemant S Murthy
- Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, Florida
| | - Maxim Norkin
- Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, Florida
| | - Richard F Olsson
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Mona Papari
- ITxM Clinical Services Cord Blood Lab, Rosemont, Illinois
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jeffrey Szer
- Clinical Haematology at Peter MacCalluma Cancer Centre and The Royal Melbourne Hospital, Victoria, Australia
| | - Edmund K Waller
- Department of Hematology and Meidcal Oncology, Emory University Hospital, Atlanta, Georgia
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland
| | - Michael A Pulsipher
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | - Nirali N Shah
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Galen E Switzer
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Paul V O'Donnell
- Department of Hematology/Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Dennis L Confer
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota; National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
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Sullivan KM, Majhail NS, Bredeson C, Carpenter PA, Chatterjee S, Crofford LJ, Georges GE, Nash RA, Pasquini MC, Sarantopoulos S, Storek J, Savani B, St Clair EW. Systemic Sclerosis as an Indication for Autologous Hematopoietic Cell Transplantation: Position Statement from the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2018; 24:1961-1964. [PMID: 29953945 DOI: 10.1016/j.bbmt.2018.06.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 06/19/2018] [Indexed: 12/29/2022]
Abstract
Systemic sclerosis is a progressive inflammatory disease that is frequently fatal and has limited treatment options. High-dose chemotherapy with autologous hematopoietic cell transplantation (AHCT) has been evaluated as treatment for this disease in observational studies, multicenter randomized controlled clinical trials, and meta-analyses. On behalf of the American Society for Blood and Marrow Transplantation (ASBMT), a panel of experts in transplantation and rheumatology was convened to review available evidence and make a recommendation on AHCT as an indication for systemic sclerosis. Three randomized trials have compared the efficacy of AHCT with cyclophosphamide only, and all demonstrated benefit for the AHCT arm for their primary endpoint (improvement in the American Scleroderma Stem Cell versus Immune Suppression Trial, event-free survival in Autologous Stem Cell Transplantation International Scleroderma trial, and change in global rank composite score in Scleroderma: Cyclophosphamide or Transplantation trial). AHCT recipients also had better overall survival and a lower rate of disease progression. These findings have been confirmed in subsequent meta-analyses. Based on this high-quality evidence, the ASBMT recommends systemic sclerosis should be considered as a "standard of care" indication for AHCT. Close collaboration between rheumatologists and transplant clinicians is critical for optimizing patient selection and patient outcomes. Transplant centers in the United States are strongly encouraged to report patient and outcomes data to the Center for International Blood and Marrow Transplant Research on their patients receiving AHCT for this indication.
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Affiliation(s)
- Keith M Sullivan
- Department of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina.
| | - Navneet S Majhail
- Blood and Marrow Transplant Program, Cleveland Clinic, Cleveland, Ohio
| | | | - Paul A Carpenter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Soumya Chatterjee
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio
| | - Leslie J Crofford
- Division of Rheumatology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - George E Georges
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Richard A Nash
- Blood and Marrow Transplant Program, Colorado Blood Cancer Institute, Denver, Colorado
| | - Marcelo C Pasquini
- Department of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin; Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin
| | - Stefanie Sarantopoulos
- Department of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Jan Storek
- Blood and Marrow Transplant Program, University of Calgary, Calgary, Alberta, Canada
| | - Bipin Savani
- Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - E William St Clair
- Department of Rheumatology and Immunology, Duke University School of Medicine, Durham, North Carolina
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35
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Bhella S, Majhail NS, Betcher J, Costa LJ, Daly A, Dandoy CE, DeFilipp Z, Doan V, Gulbis A, Hicks L, Juckett M, Khera N, Krishnan A, Selby G, Shah NN, Stricherz M, Viswabandya A, Bredeson C, Seftel MD. Choosing Wisely BMT: American Society for Blood and Marrow Transplantation and Canadian Blood and Marrow Transplant Group's List of 5 Tests and Treatments to Question in Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2018; 24:909-913. [DOI: 10.1016/j.bbmt.2018.01.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 01/16/2018] [Indexed: 12/20/2022]
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36
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Monaghan M, Rizk M, Pilon S, Iyengar A, Shorr R, Tay J, Maze D, Bredeson C, Hutton B, Allan DS. Network geometry of evidence from randomised controlled trials addressing donor selection and source of haematopoietic progenitor cells used in allogeneic transplantation: a systematic scoping review. Transfus Med 2018; 28:371-379. [PMID: 29380924 DOI: 10.1111/tme.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 11/01/2017] [Accepted: 01/03/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND METHODS A scoping review of randomised controlled trials (RCTs) addressing source of cells and choice of donor for allogeneic haematopoietic cell transplantation (HCT) was performed to create a network of best evidence that allows us to identify new potential indirect comparisons for the strategic development of future studies that connect to the existing evidence network. RESULTS A total of 19 eligible RCTs (2589 total patients) were identified. Nine studies (1566 patients) compared clinical outcomes following the use of peripheral blood progenitor cells (PBPCs) with bone marrow (BM) from matched related donors (eight studies) or matched unrelated donors (one study). The remaining studies compared BM or PBPCs with various methods of BM stimulation or manipulation (six studies), compared different methods of surface molecule-based selection and/or depletion of grafts (two studies) or compared the optimal number of units for paediatric cord blood transplantation (two studies). No published RCTs compared different types of donors. The geometry of the evidence network was analysed to identify opportunities for potential novel indirect comparisons and to identify opportunities to expand the network. Few indirect comparisons are currently feasible due to small sample size and heterogeneity in patient diagnoses and demographics between treatment nodes in the network. CONCLUSION More RCTs that enrol greater numbers of similar patients are needed to leverage the current evidence network concerning donor choice and source of cells used in allogeneic HCT.
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Affiliation(s)
- M Monaghan
- Blood and Marrow Transplantation Program, Department of Medicine (Hematology), University of Ottawa, Ottawa, ON, Canada
| | - M Rizk
- Blood and Marrow Transplantation Program, Department of Medicine (Hematology), University of Ottawa, Ottawa, ON, Canada
| | - S Pilon
- Blood and Marrow Transplantation Program, Department of Medicine (Hematology), University of Ottawa, Ottawa, ON, Canada
| | - A Iyengar
- Blood and Marrow Transplantation Program, Department of Medicine (Hematology), University of Ottawa, Ottawa, ON, Canada
| | - R Shorr
- Information Services, The Ottawa Hospital, Ottawa, ON, Canada
| | - J Tay
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Medicine, University of Calgary, Canada
| | - D Maze
- Blood and Marrow Transplantation Program, Department of Medicine (Hematology), University of Ottawa, Ottawa, ON, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - C Bredeson
- Blood and Marrow Transplantation Program, Department of Medicine (Hematology), University of Ottawa, Ottawa, ON, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - B Hutton
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - D S Allan
- Blood and Marrow Transplantation Program, Department of Medicine (Hematology), University of Ottawa, Ottawa, ON, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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37
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Visram A, Bredeson C, Allan D, Sabloff M, Huebsch L, Tay J, Kekre N, McDiarmid S, Mallick R, Tinmouth A, Martin L, Hamelin L, Maze D. Long-term graft function following autologous hematopoietic cell transplantation and the impact of preemptive plerixafor in predicted poor mobilizers. Blood Cancer J 2018; 8:14. [PMID: 29379014 PMCID: PMC5802447 DOI: 10.1038/s41408-018-0050-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 12/04/2017] [Accepted: 12/11/2017] [Indexed: 11/09/2022] Open
Affiliation(s)
- Alissa Visram
- Department of Hematology, The Ottawa Hospital, Ottawa, Canada
| | | | - David Allan
- Department of Hematology, The Ottawa Hospital, Ottawa, Canada
| | | | - Lothar Huebsch
- Department of Hematology, The Ottawa Hospital, Ottawa, Canada
| | - Jason Tay
- Department of Medicine, Calgary, Canada
| | - Natasha Kekre
- Department of Hematology, The Ottawa Hospital, Ottawa, Canada
| | | | - Ranjeeta Mallick
- Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada
| | - Alan Tinmouth
- Department of Hematology, The Ottawa Hospital, Ottawa, Canada
| | - Lisa Martin
- Canadian Blood Services Stem Cell Processing Laboratory, Ottawa, Canada
| | - Linda Hamelin
- Department of Hematology, The Ottawa Hospital, Ottawa, Canada
| | - Dawn Maze
- Department of Hematology, The Ottawa Hospital, Ottawa, Canada.
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Buchbinder D, Kelly DL, Duarte RF, Auletta JJ, Bhatt N, Byrne M, DeFilipp Z, Gabriel M, Mahindra A, Norkin M, Schoemans H, Shah AJ, Ahmed I, Atsuta Y, Basak GW, Beattie S, Bhella S, Bredeson C, Bunin N, Dalal J, Daly A, Gajewski J, Gale RP, Galvin J, Hamadani M, Hayashi RJ, Adekola K, Law J, Lee CJ, Liesveld J, Malone AK, Nagler A, Naik S, Nishihori T, Parsons SK, Scherwath A, Schofield HL, Soiffer R, Szer J, Twist I, Warwick AB, Wirk BM, Yi J, Battiwalla M, Flowers MDE, Savani B, Shaw BE. Neurocognitive dysfunction in hematopoietic cell transplant recipients: expert review from the late effects and Quality of Life Working Committee of the CIBMTR and complications and Quality of Life Working Party of the EBMT. Bone Marrow Transplant 2018; 53:535-555. [PMID: 29343837 DOI: 10.1038/s41409-017-0055-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/19/2017] [Accepted: 11/19/2017] [Indexed: 12/13/2022]
Abstract
Hematopoietic cell transplantation (HCT) is a potentially curative treatment for children and adults with malignant and non-malignant diseases. Despite increasing survival rates, long-term morbidity following HCT is substantial. Neurocognitive dysfunction is a serious cause of morbidity, yet little is known about neurocognitive dysfunction following HCT. To address this gap, collaborative efforts of the Center for International Blood and Marrow Transplant Research and the European Society for Blood and Marrow Transplantation undertook an expert review of neurocognitive dysfunction following HCT. In this review, we define what constitutes neurocognitive dysfunction, characterize its risk factors and sequelae, describe tools and methods to assess neurocognitive function in HCT recipients, and discuss possible interventions for HCT patients with this condition. This review aims to help clinicians understand the scope of this health-related problem, highlight its impact on well-being of survivors, and to help determine factors that may improve identification of patients at risk for declines in cognitive functioning after HCT. In particular, we review strategies for preventing and treating neurocognitive dysfunction in HCT patients. Lastly, we highlight the need for well-designed studies to develop and test interventions aimed at preventing and improving neurocognitive dysfunction and its sequelae following HCT.
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Affiliation(s)
- David Buchbinder
- Division of Pediatrics Hematology, Children's Hospital of Orange County, Orange, CA, USA.
| | | | | | - Jeffery J Auletta
- Blood and Marrow Transplant Program and Host Defense Program, Divisions of Hematology/Oncology/Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, OH, USA
| | - Neel Bhatt
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michael Byrne
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zachariah DeFilipp
- Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA, USA
| | - Melissa Gabriel
- The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Anuj Mahindra
- Scripps Blood & Marrow Transplant Program, La Jolla, CA, USA
| | - Maxim Norkin
- Division of Pediatrics Hematology, Children's Hospital of Orange County, Orange, CA, USA
| | | | - Ami J Shah
- Division of Stem Cell Transplantation and Regenerative Medicine, Lucille Packard Children's Hospital, Stanford School of Medicine, Palo Alto, CA, USA
| | - Ibrahim Ahmed
- Rainbow Babies and Children's Hospital, Cleveland, OH, USA.,Division of Pediatric Hem/Onc/BMT, Children's Mercy Kansas City, Kansas City, Missouri; UMKC School of Medicine, Kansas City, MO, USA
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Sara Beattie
- Department of Psychosocial Oncology and Rehabilitation, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Sita Bhella
- Department of Medicine, School of Medicine, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Christopher Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Nancy Bunin
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jignesh Dalal
- Division of Pediatric Hem/Onc/BMT, Children's Mercy Kansas City, Kansas City, Missouri; UMKC School of Medicine, Kansas City, MO, USA.,Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Andrew Daly
- Tom Baker Cancer Centre, Calgary, AB, Canada
| | | | - Robert Peter Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK
| | - John Galvin
- Division of Hematology/Oncology, Department of Medicine and Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mehdi Hamadani
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Robert J Hayashi
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Kehinde Adekola
- Division of Hematology/Oncology, Department of Medicine and Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jason Law
- Tufts University Medical Center, Boston, MA, USA
| | - Catherine J Lee
- Utah Blood and Marrow Transplant Program Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Jane Liesveld
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Adriana K Malone
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Arnon Nagler
- Hematology Division and BMT, Chaim Sheba Medical Center, Tel Hashomer, Israel.,Tel Aviv University, Tel Aviv, Israel
| | - Seema Naik
- Texas Transplant Institute, San Antonino, TX, USA
| | - Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Angela Scherwath
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Jeff Szer
- Department Clinical Haematology and Bone Marrow Transplantation, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Ida Twist
- The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Anne B Warwick
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, USA
| | - Baldeep M Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Jean Yi
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Minoo Battiwalla
- Hematology Branch, National Heart, Lung and Blood Institute, Bethesda, MD, USA
| | - Mary D E Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Bipin Savani
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bronwen E Shaw
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Sullivan KM, Goldmuntz EA, Keyes-Elstein L, McSweeney PA, Pinckney A, Welch B, Mayes MD, Nash RA, Crofford LJ, Eggleston B, Castina S, Griffith LM, Goldstein JS, Wallace D, Craciunescu O, Khanna D, Folz RJ, Goldin J, St Clair EW, Seibold JR, Phillips K, Mineishi S, Simms RW, Ballen K, Wener MH, Georges GE, Heimfeld S, Hosing C, Forman S, Kafaja S, Silver RM, Griffing L, Storek J, LeClercq S, Brasington R, Csuka ME, Bredeson C, Keever-Taylor C, Domsic RT, Kahaleh MB, Medsger T, Furst DE. Myeloablative Autologous Stem-Cell Transplantation for Severe Scleroderma. N Engl J Med 2018; 378:35-47. [PMID: 29298160 PMCID: PMC5846574 DOI: 10.1056/nejmoa1703327] [Citation(s) in RCA: 336] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Despite current therapies, diffuse cutaneous systemic sclerosis (scleroderma) often has a devastating outcome. We compared myeloablative CD34+ selected autologous hematopoietic stem-cell transplantation with immunosuppression by means of 12 monthly infusions of cyclophosphamide in patients with scleroderma. METHODS We randomly assigned adults (18 to 69 years of age) with severe scleroderma to undergo myeloablative autologous stem-cell transplantation (36 participants) or to receive cyclophosphamide (39 participants). The primary end point was a global rank composite score comparing participants with each other on the basis of a hierarchy of disease features assessed at 54 months: death, event-free survival (survival without respiratory, renal, or cardiac failure), forced vital capacity, the score on the Disability Index of the Health Assessment Questionnaire, and the modified Rodnan skin score. RESULTS In the intention-to-treat population, global rank composite scores at 54 months showed the superiority of transplantation (67% of 1404 pairwise comparisons favored transplantation and 33% favored cyclophosphamide, P=0.01). In the per-protocol population (participants who received a transplant or completed ≥9 doses of cyclophosphamide), the rate of event-free survival at 54 months was 79% in the transplantation group and 50% in the cyclophosphamide group (P=0.02). At 72 months, Kaplan-Meier estimates of event-free survival (74% vs. 47%) and overall survival (86% vs. 51%) also favored transplantation (P=0.03 and 0.02, respectively). A total of 9% of the participants in the transplantation group had initiated disease-modifying antirheumatic drugs (DMARDs) by 54 months, as compared with 44% of those in the cyclophosphamide group (P=0.001). Treatment-related mortality in the transplantation group was 3% at 54 months and 6% at 72 months, as compared with 0% in the cyclophosphamide group. CONCLUSIONS Myeloablative autologous hematopoietic stem-cell transplantation achieved long-term benefits in patients with scleroderma, including improved event-free and overall survival, at a cost of increased expected toxicity. Rates of treatment-related death and post-transplantation use of DMARDs were lower than those in previous reports of nonmyeloablative transplantation. (Funded by the National Institute of Allergy and Infectious Diseases and the National Institutes of Health; ClinicalTrials.gov number, NCT00114530 .).
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Affiliation(s)
- Keith M Sullivan
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Ellen A Goldmuntz
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Lynette Keyes-Elstein
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Peter A McSweeney
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Ashley Pinckney
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Beverly Welch
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Maureen D Mayes
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Richard A Nash
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Leslie J Crofford
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Barry Eggleston
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Sharon Castina
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Linda M Griffith
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Julia S Goldstein
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Dennis Wallace
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Oana Craciunescu
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Dinesh Khanna
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Rodney J Folz
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Jonathan Goldin
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - E William St Clair
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - James R Seibold
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Kristine Phillips
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Shin Mineishi
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Robert W Simms
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Karen Ballen
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Mark H Wener
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - George E Georges
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Shelly Heimfeld
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Chitra Hosing
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Stephen Forman
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Suzanne Kafaja
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Richard M Silver
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Leroy Griffing
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Jan Storek
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Sharon LeClercq
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Richard Brasington
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Mary E Csuka
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Christopher Bredeson
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Carolyn Keever-Taylor
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Robyn T Domsic
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - M Bashar Kahaleh
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Thomas Medsger
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
| | - Daniel E Furst
- From the Duke University Medical Center (K.M.S., O.C., E.W.S.C.) and RTI International (D.W.), Durham, and Rho Federal Systems Division, Chapel Hill (L.K.-E., A.P., B.E., S.C.) - all in North Carolina; National Institute of Allergy and Infectious Diseases, Bethesda, MD (E.A.G., B.W., L.M.G., J.S.G.); Colorado Blood Cancer Institute, Denver (P.A.M., R.A.N.); University of Texas McGovern Medical School (M.D.M.) and M.D. Anderson Cancer Center (C.H.) - both in Houston; Vanderbilt University, Nashville (L.J.C., K.P.); University of Michigan, Ann Arbor (D.K., J.R.S.); Case Western Reserve University and University Hospitals, Cleveland (R.J.F.); University of Alabama, Birmingham (S.M.); Boston University, Boston (R.W.S.); University of Virginia, Charlottesville (K.B.); University of Washington (M.H.W., D.E.F.) and the Fred Hutchinson Cancer Research Center (G.E.G., S.H.) - both in Seattle; University of California, Los Angeles, Los Angeles (J.G., S.K., D.E.F.); City of Hope National Medical Center, Duarte, CA (S.F.); Medical University of South Carolina, Charleston (R.M.S.); Mayo Clinic, Scottsdale, AZ (L.G.); University of Calgary, Calgary, AB, Canada (J.S., S.L.); Washington University, St. Louis (R.B.); Medical College of Wisconsin, Milwaukee (M.E.C., C.K.-T.); Ottawa Hospital Research Institute, Ottawa (C.B.); University of Pittsburgh, Pittsburgh (T.M., R.T.D.); and University of Toledo Medical Center, Toledo, OH (M.B.K.)
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Kebriaei P, Anasetti C, Zhang MJ, Wang HL, Aldoss I, de Lima M, Khoury HJ, Sandmaier BM, Horowitz MM, Artz A, Bejanyan N, Ciurea S, Lazarus HM, Gale RP, Litzow M, Bredeson C, Seftel MD, Pulsipher MA, Boelens JJ, Alvarnas J, Champlin R, Forman S, Pullarkat V, Weisdorf D, Marks DI. Intravenous Busulfan Compared with Total Body Irradiation Pretransplant Conditioning for Adults with Acute Lymphoblastic Leukemia. Biol Blood Marrow Transplant 2017; 24:726-733. [PMID: 29197676 DOI: 10.1016/j.bbmt.2017.11.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 11/22/2017] [Indexed: 01/22/2023]
Abstract
Total body irradiation (TBI) has been included in standard conditioning for acute lymphoblastic leukemia (ALL) before hematopoietic cell transplantation (HCT). Non-TBI regimens have incorporated busulfan (Bu) to decrease toxicity. This retrospective study analyzed TBI and Bu on outcomes of ALL patients 18-60 years old, in first or second complete remission (CR), undergoing HLA-compatible sibling, related, or unrelated donor HCT, who reported to the Center for International Blood and Marrow Transplant Research from 2005 to 2014. TBI plus etoposide (25%) or cyclophosphamide (75%) was used in 819 patients, and intravenous Bu plus fludarabine (41%), clofarabine (30%), cyclophosphamide (15%), or melphalan (13%) was used in 299 patients. Bu-containing regimens were analyzed together, since no significant differences for patient outcomes were noted between them. Bu patients were older, with better performance status; took longer to achieve first CR and receive HCT; were treated more recently; and were more likely to receive peripheral blood grafts, antithymocyte globulin, or tyrosine kinase inhibitors. With median follow-up of 3.6 years for Bu and 5.3 years for TBI, adjusted 3-year outcomes showed treatment-related mortality Bu 19% versus TBI 25% (P = .04); relapse Bu 37% versus TBI 28% (P = .007); disease-free survival (DFS) Bu 45% versus TBI 48% (P = .35); and overall survival (OS) Bu 57% versus TBI 53% (P = .35). In multivariate analysis, Bu patients had higher risk of relapse (relative risk, 1.46; 95% confidence interval, 1.15 to 1.85; P = .002) compared with TBI patients. Despite the higher relapse, Bu-containing conditioning led to similar OS and DFS following HCT for ALL.
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Affiliation(s)
- Partow Kebriaei
- Department of Stem Cell Transplantation, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Claudio Anasetti
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center Research Institute, Tampa, Florida
| | - Mei-Jie Zhang
- Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Hai-Lin Wang
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Ibrahim Aldoss
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope Medical Center, Duarte, California
| | - Marcos de Lima
- Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio
| | - H Jean Khoury
- Division of Hematology and Oncology, Emory University Hospital, Atlanta, Georgia
| | - Brenda M Sandmaier
- Division of Medical Oncology, University of Washington and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mary M Horowitz
- CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Andrew Artz
- Section of Hematology/Oncology, University of Chicago School of Medicine, Chicago, Illinois
| | - Nelli Bejanyan
- Division of Hematology, Oncology and Transplantation, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Stefan Ciurea
- Department of Stem Cell Transplantation, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hillard M Lazarus
- Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Robert Peter Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Mark Litzow
- Division of Hematology, Department of Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota
| | - Christopher Bredeson
- Ottawa Hospital Blood and Marrow Transplant Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Matthew D Seftel
- Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Michael A Pulsipher
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | | | - Joseph Alvarnas
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope Medical Center, Duarte, California
| | - Richard Champlin
- Department of Stem Cell Transplantation, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen Forman
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope Medical Center, Duarte, California
| | - Vinod Pullarkat
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope Medical Center, Duarte, California
| | - Daniel Weisdorf
- Division of Hematology, Oncology and Transplantation, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - David I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
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Samant R, Sabloff M, Atkins H, Altouri S, Kekre N, Bredeson C, Huebsch L, Ramsay T, Allan D, Fulcher J, Nair V. High Dose Total Body Irradiation for Refractory Acute Myeloid Leukemia. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kelly DL, Buchbinder D, Duarte RF, Auletta JJ, Bhatt N, Byrne M, DeFilipp Z, Gabriel M, Mahindra A, Norkin M, Schoemans H, Shah AJ, Ahmed I, Atsuta Y, Basak GW, Beattie S, Bhella S, Bredeson C, Bunin N, Dalal J, Daly A, Gajewski J, Gale RP, Galvin J, Hamadani M, Hayashi RJ, Adekola K, Law J, Lee CJ, Liesveld J, Malone AK, Nagler A, Naik S, Nishihori T, Parsons SK, Scherwath A, Schofield HL, Soiffer R, Szer J, Twist I, Warwick A, Wirk BM, Yi J, Battiwalla M, Flowers ME, Savani B, Shaw BE. Neurocognitive Dysfunction in Hematopoietic Cell Transplant Recipients: Expert Review from the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and Complications and Quality of Life Working Party of the European Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2017; 24:228-241. [PMID: 28939455 DOI: 10.1016/j.bbmt.2017.09.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 09/04/2017] [Indexed: 12/25/2022]
Abstract
Hematopoietic cell transplantation (HCT) is a potentially curative treatment for children and adults with malignant and nonmalignant diseases. Despite increasing survival rates, long-term morbidity after HCT is substantial. Neurocognitive dysfunction is a serious cause of morbidity, yet little is known about neurocognitive dysfunction after HCT. To address this gap, collaborative efforts of the Center for International Blood and Marrow Transplant Research and the European Society for Blood and Marrow Transplantation undertook an expert review of neurocognitive dysfunction after HCT. In this review we define what constitutes neurocognitive dysfunction, characterize its risk factors and sequelae, describe tools and methods to assess neurocognitive function in HCT recipients, and discuss possible interventions for HCT patients with this condition. This review aims to help clinicians understand the scope of this health-related problem, highlight its impact on well-being of survivors, and help determine factors that may improve identification of patients at risk for declines in cognitive functioning after HCT. In particular, we review strategies for preventing and treating neurocognitive dysfunction in HCT patients. Finally, we highlight the need for well-designed studies to develop and test interventions aimed at preventing and improving neurocognitive dysfunction and its sequelae after HCT.
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Affiliation(s)
| | - David Buchbinder
- Divsison of Pediatrics Hematology, Children's Hospital of Orange County, Orange, California
| | | | - Jeffrey J Auletta
- Blood and Marrow Transplant Program and Host Defense Program, Division of Hematology, Nationwide Children's Hospital, Columbus, Ohio; Blood and Marrow Transplant Program and Host Defense Program, Division of Oncology, Nationwide Children's Hospital, Columbus, Ohio; Blood and Marrow Transplant Program and Host Defense Program, Division of Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio
| | - Neel Bhatt
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Michael Byrne
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Zachariah DeFilipp
- Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Melissa Gabriel
- The Children's Hospital at Westmead, New South Wales, Australia
| | - Anuj Mahindra
- Scripps Blood & Marrow Transplant Program, La Jolla, California
| | - Maxim Norkin
- Shands HealthCare and University of Florida, Gainesville, Florida
| | | | - Ami J Shah
- Division of Stem Cell Transplantation and Regenerative Medicine, Lucille Packard Children's Hospital, Stanford School of Medicine, Palo Alto, California
| | - Ibrahim Ahmed
- Division of Pediatric Hem/Onc/BMT, Children's Mercy Kansas City, Kansas City, Missouri; UMKC School of Medicine, Kansas City, Missouri
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan; Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Sara Beattie
- Department of Psychosocial Oncology and Rehabilitation, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Sita Bhella
- Department of Psychosocial Oncology and Rehabilitation, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Christopher Bredeson
- Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Nancy Bunin
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jignesh Dalal
- Case Western Reserve School of Medicine, Cleveland, Ohio; Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | - Andrew Daly
- Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | | | - Robert Peter Gale
- Division of Experimental Medicine, Department of Medicine, Imperial College London, Hematology Research Centre, London, United Kingdom
| | - John Galvin
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Mehdi Hamadani
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Robert J Hayashi
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Kehinde Adekola
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Jason Law
- Tufts University Medical Center, Boston, Massachusetts
| | - Catherine J Lee
- Utah Blood and Marrow Transplant Program Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Jane Liesveld
- Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Adriana K Malone
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Arnon Nagler
- Hematology Division and BMT, Chaim Sheba Medical Center, Tel Hashomer, Israel; Tel Aviv University, Tel Aviv, Israel
| | - Seema Naik
- Texas Transplant Institute, San Antonino, Texas
| | - Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | | | - Angela Scherwath
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Jeff Szer
- Department Clinical Haematology and Bone Marrow Transplantation, Royal Melbourne Hospital, Victoria, Australia
| | - Ida Twist
- The Children's Hospital at Westmead, New South Wales, Australia
| | - Anne Warwick
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Baldeep M Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington
| | - Jean Yi
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Minoo Battiwalla
- Hematopoietic Transplantation Section, Hematology Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Mary E Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Bipin Savani
- Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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Bourassa-Blanchette S, Knoll G, Tay J, Bredeson C, Cameron DW, Cowan J. A national survey of screening and management of hypogammaglobulinemia in Canadian transplantation centers. Transpl Infect Dis 2017; 19. [PMID: 28423227 DOI: 10.1111/tid.12706] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/18/2017] [Accepted: 02/06/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Infection remains one of the most common transplant-related causes of death in patients undergoing transplantation. Secondary hypogammaglobulinemia (HGG) as a component of immune suppression and deficiency is associated with both solid organ transplantation (SOT) and hematopoietic cell transplantation (HCT). Available data and clinical experience for the supplementation of immunoglobulin (Ig) in these patients is conflicting, and differing clinical opinion accounts for non-uniform practice in the use of Ig treatment. We aimed to survey lead transplant practitioners for current practice around polyvalent Ig use in post-transplant recipients across Canada. METHODS We performed a survey study using short questionnaires to estimate rate of screening of HGG, use of polyvalent Ig, and physician's opinion on Ig treatment and infection prevention. Directors of 24 SOT and 23 HCT centers across Canada were invited to participate in the survey via an electronic mail. RESULTS Overall response rate was 63.8%. Twenty percent of SOT programs routinely measured Ig levels pre-transplant compared to 33% of allogeneic (allo-) and 21% of autologous (auto-) HCT programs. Post-transplant Ig levels were measured in 13%, 75%, and 29% in SOT, allo-HCT, and auto-HCT, respectively. The SOT and auto-HCT groups indicated that they do not prescribe Ig therapy (100% and 86%), contrary to the allo-HCT group (42%). Of the respondents in the SOT, allo-HCT, and auto-HCT groups, 60%, 67%, and 36%, respectively, thought infections could be prevented with intravenous immunoglobulins (IVIg). A majority of respondents indicated they would be interested in participating in a randomized controlled trial evaluating the use of IVIg in the SOT and in both HCT groups (100%, 83%, and 57%, respectively). CONCLUSIONS Our study shows significant variation in practice between SOT and HCT centers with respect to screening and management of HGG. There is willingness to participate in a randomized controlled trial to address whether Ig treatment reduces infection in post-transplant recipients.
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Affiliation(s)
| | - Greg Knoll
- Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Jason Tay
- Division of Hematology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christopher Bredeson
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Donald W Cameron
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Juthaporn Cowan
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Division of Infectious Diseases, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
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44
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Liu HD, Ahn KW, Hu ZH, Hamadani M, Nishihori T, Wirk B, Beitinjaneh A, Rizzieri D, Grunwald MR, Sabloff M, Olsson RF, Bajel A, Bredeson C, Daly A, Inamoto Y, Majhail N, Saad A, Gupta V, Gerds A, Malone A, Tallman M, Reshef R, Marks DI, Copelan E, Gergis U, Savoie ML, Ustun C, Litzow MR, Cahn JY, Kindwall-Keller T, Akpek G, Savani BN, Aljurf M, Rowe JM, Wiernik PH, Hsu JW, Cortes J, Kalaycio M, Maziarz R, Sobecks R, Popat U, Alyea E, Saber W. Allogeneic Hematopoietic Cell Transplantation for Adult Chronic Myelomonocytic Leukemia. Biol Blood Marrow Transplant 2017; 23:767-775. [PMID: 28115276 DOI: 10.1016/j.bbmt.2017.01.078] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 01/12/2017] [Indexed: 10/20/2022]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) is potentially curative for patients with chronic myelomonocytic leukemia (CMML); however, few data exist regarding prognostic factors and transplantation outcomes. We performed this retrospective study to identify prognostic factors for post-transplantation outcomes. The CMML-specific prognostic scoring system (CPSS) has been validated in subjects receiving nontransplantation therapy and was included in our study. From 2001 to 2012, 209 adult subjects who received HCT for CMML were reported to the Center for International Blood and Marrow Transplant Research. The median age at transplantation was 57 years (range, 23 to 74). Median follow-up was 51 months (range, 3 to 122). On multivariate analyses, CPSS scores, Karnofsky performance status (KPS), and graft source were significant predictors of survival (P = .004, P = .01, P = .01, respectively). Higher CPSS scores were not associated with disease-free survival, relapse, or transplantation-related mortality. In a restricted analysis of subjects with relapse after HCT, those with intermediate-2/high risk had a nearly 2-fold increased risk of death after relapse compared to those with low/intermediate-1 CPSS scores. Respective 1-year, 3-year, and 5-year survival rates for low/intermediate-1 risk subjects were 61% (95% confidence interval [CI], 52% to 72%), 48% (95% CI, 37% to 59%), and 44% (95% CI, 33% to 55%), and for intermediate-2/high risk subjects were 38% (95% CI, 28% to 49%), 32% (95% CI, 21% to 42%), and 19% (95% CI, 8% to 29%). We conclude that higher CPSS score at time of transplantation, lower KPS, and a bone marrow graft are associated with inferior survival after HCT. Further investigation of CMML disease-related biology may provide insights into other risk factors predictive of post-transplantation outcomes.
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Affiliation(s)
- Hien Duong Liu
- Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio.
| | - Kwang Woo Ahn
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Zhen-Huan Hu
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mehdi Hamadani
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington
| | - Amer Beitinjaneh
- Department of Hematology and Oncology, University of Miami Sylvester Cancer Center, Miami, Florida
| | - David Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina
| | - Mitchell Sabloff
- Division of Hematology, Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Canada
| | - Richard F Olsson
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Ashish Bajel
- Department of Haematology and Bone Marrow Transplant, Royal Melbourne Hospital, Victoria, Australia
| | - Christopher Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Andrew Daly
- Department of Medicine, Tom Baker Cancer Centre, Calgary, Canada; Department of Oncology, Tom Baker Cancer Centre, Calgary, Canada
| | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Navneet Majhail
- Blood and Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Ayman Saad
- Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Vikas Gupta
- Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Aaron Gerds
- Hematologic Oncology and Blood Disorders, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
| | - Adriana Malone
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Martin Tallman
- Leukemia Service, Department of Medicine, Memorial Sloan, New York, New York
| | - Ran Reshef
- Blood and Marrow Transplantation Program and Columbia Center for Translational Immunology, Columbia University Medical Center, New York, New York
| | - David I Marks
- Pediatric Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - Edward Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina
| | - Usama Gergis
- Hematologic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Mary Lynn Savoie
- Division of Hematology and Hematologic Malignancies, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Celalettin Ustun
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Mark R Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, Minnesota
| | - Jean-Yves Cahn
- Department of Hematology, University Hospital, Grenoble, France
| | - Tamila Kindwall-Keller
- Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, Virginia
| | - Gorgun Akpek
- Stem Cell Transplantation and Cellular Therapy Program, Banner MD Anderson Cancer Center, Gilbert, Arizona
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh, Saudi Arabia
| | - Jacob M Rowe
- Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel
| | | | - Jack W Hsu
- Division of Hematology and Oncology, Department of Medicine, Shands HealthCare & University of Florida, Gainesville, Florida
| | - Jorge Cortes
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Matt Kalaycio
- Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Richard Maziarz
- Adult Blood and Marrow Stem Cell Transplant Program, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Ronald Sobecks
- Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Uday Popat
- Department of Stem Cell Transplantation, MD Anderson Cancer Center, Houston, Texas
| | - Edwin Alyea
- Center for Hematologic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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Rosko AE, Wang H, de Lima M, Sandmaier B, Khoury HJ, Artz A, Brammer J, Bredeson C, Farag S, Kharfan‐Dabaja M, Lazarus HM, Marks DI, Martino Bufarull R, McGuirk J, Mohty M, Nishihori T, Nivison‐Smith I, Rashidi A, Ringden O, Seftel M, Weisdorf D, Bachanova V, Saber W. Reduced intensity conditioned allograft yields favorable survival for older adults with B-cell acute lymphoblastic leukemia. Am J Hematol 2017; 92:42-49. [PMID: 27712033 DOI: 10.1002/ajh.24575] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/30/2016] [Accepted: 10/03/2016] [Indexed: 01/14/2023]
Abstract
Older adults with B-cell acute lymphoblastic leukemia (B-ALL) have poor survival. We examined the effectiveness of reduced intensity conditioning (RIC) hematopoietic cell transplant (HCT) in adults with B-ALL age 55 years and older and explored prognostic factors associated with long-term outcomes. Using CIBMTR registry data, we evaluated 273 patients (median age 61, range 55-72) with B-ALL with disease status in CR1 (71%), >CR2 (17%) and Primary Induction Failure (PIF)/Relapse (11%), who underwent RIC HCT between 2001 and 2012 using mostly unrelated donor (59%) or HLA-matched sibling (32%). Among patients with available cytogenetic data, the Philadelphia chromosome (Ph+) was present in 50%. The 3-year cumulative incidences of nonrelapse mortality (NRM) and relapse were 25% (95% confidence intervals (CI): 20-31%) and 47% (95% CI: 41-53%), respectively. Three-year overall survival (OS) was 38% (95% CI: 33-44%). Relapse remained the leading cause of death accounting for 49% of all deaths. In univariate analysis, 3 year risk of NRM was significantly higher with reduced Karnofsky performance status (KPS <90: 34% (95% CI: 25-43%) versus KPS ≥90 (18%; 95% CI: 12-24%, P = 0.006). Mortality was increased in older adults (66+ vs. 55-60: Relative Risk [RR] 1.51 95% CI: 1.00-2.29, P = 0.05) and those with advanced disease (RR 2.13; 95% CI: 1.36-3.34, P = 0.001). Survival of patients in CR1 yields 45% (95% CI: 38-52%) at 3 years and no relapse occurred after 2 years. We report promising OS and acceptable NRM using RIC HCT in older patients with B-ALL. Disease status in CR1 and good performance status are associated with improved outcomes. Am. J. Hematol. 92:42-49, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ashley E. Rosko
- Division of Hematology, Department of MedicineOhio State UniversityColumbus Ohio
| | - Hai‐Lin Wang
- Department of Medicine, Medical College of WisconsinCIBMTR, Center for International Blood and Marrow Transplant ResearchMilwaukee Wisconsin
| | - Marcos de Lima
- Department of Medicine, Seidman Cancer CenterUniversity Hospitals Case Medical CenterCleveland Ohio
| | - Brenda Sandmaier
- Division of Medical OncologyUniversity of Washington and Clinical Research Division, Fred Hutchinson Cancer Research CenterSeattle Washington
| | | | - Andrew Artz
- Section of Hematology/OncologyUniversity of Chicago School of MedicineChicago Illinois
| | | | - Christopher Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research InstituteOttawa Ontario Canada
| | - Sherif Farag
- Indiana University Hospital/Riley Hospital for ChildrenIndianapolis Indianapolis
| | - Mohamed Kharfan‐Dabaja
- Department of Blood and Marrow TransplantationH. Lee Moffit Cancer Center and Research InstituteTampa Florida
| | - Hillard M. Lazarus
- Seidman Cancer CenterUniversity Hospitals Case Medical CenterCleveland Ohio
| | - David I. Marks
- Adult Bone Marrow TransplantUniversity Hospitals Bristol NHS TrustBristol United Kingdom
| | | | | | - Mohamed Mohty
- Hopital Saint‐AntoineAPHP, Universite Pierre & Marie Curie, INSERM UMRs U938Paris France
| | - Taiga Nishihori
- Department of Blood and Marrow TransplantationH. Lee Moffit Cancer Center and Research InstituteTampa Florida
| | | | | | - Olle Ringden
- Division of Therapeutic Immunology, Department of Laboratory MedicineKarolinska InstitutetStockholm Sweden
- Centre for Allogeneic Stem Cell TransplantationStockholm Sweden
| | - Matthew Seftel
- Department of Medical Oncology and HematologyPrincess Margaret Cancer CentreToronto Ontario Canada
| | - Daniel Weisdorf
- Divsion of Hematology, Oncology and Transplantation, Department of MedicineUniversity of Minnesota Medical CenterMinneapolis Minnesota
| | - Veronika Bachanova
- Bone and Marrow Transplant ProgramUniversity of Minnesota Medical CenterMinneapolis Minnesota
| | - Wael Saber
- Department of Medicine, Medical College of WisconsinCIBMTR, Center for International Blood and Marrow Transplant ResearchMilwaukee Wisconsin
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Tay J, Allan D, Beattie S, Bredeson C, Fergusson D, Maze D, Sabloff M, Thavorn K, Tinmouth A. Rationale and design of platelet transfusions in haematopoietic stem cell transplantation: the PATH pilot study. BMJ Open 2016; 6:e013483. [PMID: 27798034 PMCID: PMC5093651 DOI: 10.1136/bmjopen-2016-013483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION In patients with transient thrombocytopenia being treated with high-dose chemotherapy followed by stem cell rescue-haematopoietic stem cell transplantation (HSCT), prophylactic transfusions are standard therapy to prevent bleeding. However, a recent multicentre trial suggests that prophylactic platelet transfusions in HSCT may not be necessary. Additionally, the potential overuse of platelet products places a burden on a scarce healthcare resource. Moreover, the benefit of prophylactic platelet transfusions to prevent clinically relevant haemorrhage is debatable. Current randomised data compare different thresholds for administering prophylactic platelets or prophylactic versus therapeutic platelet transfusions. An alternative strategy involves prescribing prophylactic antifibrinolytic agents such as tranexamic acid to prevent bleeding. METHODS AND ANALYSIS This report describes the design of an open-labelled randomised pilot study comparing the prophylactic use of oral tranexamic acid with platelet transfusions in the setting of autologous HSCT. In 3-5 centres, 100 patients undergoing autologous HSCT will be randomly assigned to either a prophylactic tranexamic acid or prophylactic platelets bleeding prevention strategy-based daily platelet values up to 30 days post-transplant. The study will be stratified by centre and type of transplant. The primary goal is to demonstrate study feasibility while collecting clinical outcomes on (1) WHO and Bleeding Severity Measurement Scale (BSMS), (2) transplant-related mortality, (3) quality of life, (4) length of hospital stay, (5) intensive care unit admission rates, (6) Bearman toxicity scores, (7) incidence of infections, (8) transfusion requirements, (9) adverse reactions and (10) economic analyses. ETHICS AND DISSEMINATION This study is funded by a peer-reviewed grant from the Canadian Institutes of Health Research (201 503) and is registered on Clinicaltrials.gov NCT02650791. It has been approved by the Ottawa Health Science Network Research Ethics Board. Study results will presented at national and international conferences. Importantly, the results of this trial will inform the feasibility and conduct of a larger study. TRIAL REGISTRATION NUMBER NCT02650791; Pre-results.
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Affiliation(s)
- Jason Tay
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - David Allan
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sara Beattie
- Department of Psychosocial Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Christopher Bredeson
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Dean Fergusson
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Dawn Maze
- Department of Medicine, University of Toronto
| | - Mitchell Sabloff
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Alan Tinmouth
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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47
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Hashmi SK, Bredeson C, Duarte RF, Farnia S, Ferrey S, Fitzhugh C, Flowers MED, Gajewski J, Gastineau D, Greenwald M, Jagasia M, Martin P, Rizzo JD, Schmit-Pokorny K, Majhail NS. National Institutes of Health Blood and Marrow Transplant Late Effects Initiative: The Healthcare Delivery Working Group Report. Biol Blood Marrow Transplant 2016; 23:717-725. [PMID: 27713091 DOI: 10.1016/j.bbmt.2016.09.025] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 09/30/2016] [Indexed: 12/16/2022]
Abstract
Hematopoietic cell transplantation (HCT) survivors are at risk for development of late complications and require lifelong monitoring for screening and prevention of late effects. There is an increasing appreciation of the issues related to healthcare delivery and coverage faced by HCT survivors. The 2016 National Institutes of Health Blood and Marrow Transplant Late Effects Initiative included an international and broadly representative Healthcare Delivery Working Group that was tasked with identifying research gaps pertaining to healthcare delivery and to identify initiatives that may yield a better understanding of the long-term value and costs of care for HCT survivors. There is a paucity of literature in this area. Critical areas in need of research include pilot studies of novel and information technology supported models of care delivery and coverage for HCT survivors along with development and validation of instruments that capture patient-reported outcomes. Investment in infrastructure to support this research, such as linkage of databases including electronic health records and routine inclusion of endpoints that will inform analyses focused around care delivery and coverage, is required.
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Affiliation(s)
| | - Christopher Bredeson
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Rafael F Duarte
- Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | | | | | | | - Mary E D Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | | | | | | | | | - J Douglas Rizzo
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
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Tisseverasinghe S, Samant R, Sabloff M, Xu Y, Bredeson C, Huebsch L, Genest P. Total Body Irradiation in Relapsed Follicular Lymphoma: Outcomes and Early Toxicity. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kharfan-Dabaja MA, Kumar A, Hamadani M, Stilgenbauer S, Ghia P, Anasetti C, Dreger P, Montserrat E, Perales MA, Alyea EP, Awan FT, Ayala E, Barrientos JC, Brown JR, Castro JE, Furman RR, Gribben J, Hill BT, Mohty M, Moreno C, O'Brien S, Pavletic SZ, Pinilla-Ibarz J, Reddy NM, Sorror M, Bredeson C, Carpenter P, Savani BN. Clinical Practice Recommendations for Use of Allogeneic Hematopoietic Cell Transplantation in Chronic Lymphocytic Leukemia on Behalf of the Guidelines Committee of the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2016; 22:2117-2125. [PMID: 27660167 DOI: 10.1016/j.bbmt.2016.09.013] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 09/14/2016] [Indexed: 12/21/2022]
Abstract
We sought to establish clinical practice recommendations to redefine the role of allogeneic hematopoietic cell transplantation (allo-HCT) for patients with chronic lymphocytic leukemia (CLL) in an era of highly active targeted therapies. We performed a systematic review to identify prospective randomized controlled trials comparing allo-HCT against novel therapies for treatment of CLL at various disease stages. In the absence of such data, we invited physicians with expertise in allo-HCT and/or CLL to participate in developing these recommendations. We followed the Grading of Recommendations Assessment, Development and Evaluation methodology. For standard-risk CLL we recommend allo-HCT in the absence of response or if there is evidence of disease progression after B cell receptor (BCR) inhibitors. For high-risk CLL an allo-HCT is recommended after failing 2 lines of therapy and showing an objective response to BCR inhibitors or to a clinical trial. It is also recommended for patients who fail to show an objective response or progress after BCR inhibitors and receive BCL-2 inhibitors, regardless of whether an objective response is achieved. For Richter transformation, we recommend allo-HCT upon demonstration of an objective response to anthracycline-based chemotherapy. A reduced-intensity conditioning regimen is recommended whenever indicated. These recommendations highlight the rapidly changing treatment landscape of CLL. Newer therapies have disrupted prior paradigms, and allo-HCT is now relegated to later stages of relapsed or refractory CLL.
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Affiliation(s)
- Mohamed A Kharfan-Dabaja
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, Tampa, Florida; Department of Oncologic Sciences, University of South Florida Morsani College of Medicine, Tampa, Florida.
| | - Ambuj Kumar
- Program for Comparative Effectiveness Research, University of South Florida College of Medicine, Tampa, Florida
| | - Mehdi Hamadani
- Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Paolo Ghia
- Department of Onco-Haematology and Division of Experimental Oncology, IRCCS San Raffaele Hospital and Università Vita-Salute San Raffaele, Milan, Italy
| | - Claudio Anasetti
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, Tampa, Florida; Department of Oncologic Sciences, University of South Florida Morsani College of Medicine, Tampa, Florida
| | - Peter Dreger
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Emili Montserrat
- Department of Hematology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Miguel-Angel Perales
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Edwin P Alyea
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Farrukh T Awan
- Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - Ernesto Ayala
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, Tampa, Florida; Department of Oncologic Sciences, University of South Florida Morsani College of Medicine, Tampa, Florida
| | - Jacqueline C Barrientos
- CLL Research and Treatment Program, Hofstra Northwell School of Medicine, New Hyde Park, New York
| | - Jennifer R Brown
- Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Januario E Castro
- University of California San Diego, Moores Cancer Center, La Jolla, California
| | - Richard R Furman
- Division of Hematology-Oncology, Weill Cornell Medical College, New York, New York
| | - John Gribben
- John Vane Cancer Centre, Charterhouse Square, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Brian T Hill
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
| | - Mohamad Mohty
- Department of Haematology, Saint Antoine Hospital, University Pierre & Marie Curie, and Inserm UMRs938, Paris, France
| | - Carol Moreno
- Hospital de la Santa Creu Sant Pau, Barcelona, Spain
| | - Susan O'Brien
- The University of California Irvine Chao Family Comprehensive Cancer Center, Orange, California
| | - Steven Z Pavletic
- National Institutes of Health-National Cancer Institute Experimental Transplantation and Immunology Branch, Bethesda, Maryland
| | - Javier Pinilla-Ibarz
- Department of Oncologic Sciences, University of South Florida Morsani College of Medicine, Tampa, Florida; Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Nishitha M Reddy
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Mohamed Sorror
- Department of Medicine, University of Washington School of Medicine and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Christopher Bredeson
- The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Paul Carpenter
- Department of Medicine, University of Washington School of Medicine and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Bipin N Savani
- Department of Medicine, Division of Hematology/Oncology, Vanderbilt University School of Medicine, Nashville, Tennessee
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Tisseverasinghe S, Samant R, Sabloff M, Xu Y, Bredeson C, Huebsch L, Genest P. 83: Late Toxicity after TBI in AHCT for Relapsed Follicular Lymphoma. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33482-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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