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Watanabe M, Kanda J, Volt F, Ruggeri A, Suzuki R, Rafii H, Kimura F, Cappelli B, Kondo E, Scigliuolo GM, Takahashi S, Kenzey C, Rivera-Franco MM, Okamoto S, Rocha V, Chevallier P, Sanz J, Fürst S, Cornelissen J, Milpied N, Uchida N, Sugio Y, Kimura T, Ichinohe T, Fukuda T, Mohty M, Peffault de Latour R, Atsuta Y, Gluckman E. Cord blood transplantation for adult mature lymphoid neoplasms in Europe and Japan. Blood Adv 2024; 8:640-652. [PMID: 38100431 PMCID: PMC10839608 DOI: 10.1182/bloodadvances.2023010598] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023] Open
Abstract
ABSTRACT To clarify the different characteristics and prognostic factors of cord blood transplantation (CBT) in adult patients with lymphoid neoplasms in Europe and Japan, we conducted a collaborative study. Patients aged 18-75 years receiving their first CBT (Europe: single CBT, n = 192; double CBT, n = 304; Japan: single CBT, n = 1150) in 2000-2017 were analyzed. Fewer patients with Hodgkin lymphoma (Europe vs Japan, 26% vs 5%), and older patients (≥50 years) (39% vs 59%) with a higher refined disease risk index (rDRI) (high-very high: 49% vs 14%) were included in the Japanese registry. High-very high rDRI was associated with inferior overall survival (OS) (vs low rDRI, Europe: hazard ratio [HR], 1.87; P = .001; Japan: HR, 2.34; P < .001) with higher progression/relapse risks. Total body irradiation (TBI)-containing conditioning contributed to superior OS both in Europe (vs TBI-reduced-intensity conditioning [RIC], non-TBI-RIC: HR, 1.93; P < .001; non-TBI-Myeloablative conditioning [MAC]: HR, 1.90; P = .003) and Japan (non-TBI-RIC: HR, 1.71; P < .001; non-TBI-MAC: HR 1.50, P = .007). The impact of HLA mismatches (≥2) on OS differed (Europe: HR, 1.52; P = .007; Japan: HR, 1.18; P = .107). CBT for lymphoid neoplasms, especially in those with high rDRI showed poor outcomes despite all the different characteristics in both registries. TBI should be considered in conditioning regimens to improve these outcomes. The different impacts of HLA mismatches call attention to the fundamental differences among these populations.
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Affiliation(s)
- Mizuki Watanabe
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Junya Kanda
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Fernanda Volt
- Eurocord, Hopital Saint Louis, Assistance Publique - Hopitaux de Paris, Institut de Recherche de Saint-Louis EA3518, Université de Paris Cité, Paris, France
| | - Annalisa Ruggeri
- Eurocord, Hopital Saint Louis, Assistance Publique - Hopitaux de Paris, Institut de Recherche de Saint-Louis EA3518, Université de Paris Cité, Paris, France
- Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ritsuro Suzuki
- Department of Oncology/Hematology, Shimane University School of Medicine, Izumo, Japan
| | - Hanadi Rafii
- Eurocord, Hopital Saint Louis, Assistance Publique - Hopitaux de Paris, Institut de Recherche de Saint-Louis EA3518, Université de Paris Cité, Paris, France
| | - Fumihiko Kimura
- Division of Hematology, National Defense Medical College, Tokorozawa, Japan
| | - Barbara Cappelli
- Eurocord, Hopital Saint Louis, Assistance Publique - Hopitaux de Paris, Institut de Recherche de Saint-Louis EA3518, Université de Paris Cité, Paris, France
- Monacord, Centre Scientifique de Monaco, Monaco
| | - Eisei Kondo
- Department of Hematology, Kawasaki Medical School, Okayama, Japan
| | - Graziana Maria Scigliuolo
- Eurocord, Hopital Saint Louis, Assistance Publique - Hopitaux de Paris, Institut de Recherche de Saint-Louis EA3518, Université de Paris Cité, Paris, France
- Monacord, Centre Scientifique de Monaco, Monaco
| | - Satoshi Takahashi
- Division of Molecular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Chantal Kenzey
- Eurocord, Hopital Saint Louis, Assistance Publique - Hopitaux de Paris, Institut de Recherche de Saint-Louis EA3518, Université de Paris Cité, Paris, France
| | - Monica M. Rivera-Franco
- Eurocord, Hopital Saint Louis, Assistance Publique - Hopitaux de Paris, Institut de Recherche de Saint-Louis EA3518, Université de Paris Cité, Paris, France
| | - Shinichiro Okamoto
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Vanderson Rocha
- Eurocord, Hopital Saint Louis, Assistance Publique - Hopitaux de Paris, Institut de Recherche de Saint-Louis EA3518, Université de Paris Cité, Paris, France
- Service of Hematology, Transfusion and Cell Therapy, and Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Hospital das Clínicas, Faculty of Medicine, São Paulo University, São Paulo, Brazil
| | - Patrice Chevallier
- Department D'Hematologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Jaime Sanz
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Sabine Fürst
- Department of Hematology, Institut Paoli Calmettes, Marseille, France
| | - Jan Cornelissen
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Noel Milpied
- Service d'Hématologie Clinique et Thérapie Cellulaire, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Tokyo, Japan
| | - Yasuhiro Sugio
- Department of Hematology, Kitakyusyu City Hospital Organization, Kitakyusyu Municipal Medical Center, Fukuoka, Japan
| | - Takafumi Kimura
- Preparation Department, Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima, Japan
| | - Takahiro Fukuda
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Mohamad Mohty
- Department of Hematology, Hopital Saint Antoine, Paris, France
| | | | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Aichi, Japan
| | - Eliane Gluckman
- Eurocord, Hopital Saint Louis, Assistance Publique - Hopitaux de Paris, Institut de Recherche de Saint-Louis EA3518, Université de Paris Cité, Paris, France
- Monacord, Centre Scientifique de Monaco, Monaco
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Piñana JL, Tridello G, Xhaard A, Wendel L, Montoro J, Vazquez L, Heras I, Ljungman P, Mikulska M, Salmenniemi U, Perez A, Kröger N, Cornelissen J, Sala E, Martino R, Geurten C, Byrne J, Maertens J, Kerre T, Martin M, Pascual MJ, Yeshurun M, Finke J, Groll AH, Shaw PJ, Blijlevens N, Arcese W, Ganser A, Suarez-Lledo M, Alzahrani M, Choi G, Forcade E, Paviglianiti A, Solano C, Wachowiak J, Zuckerman T, Bader P, Clausen J, Mayer J, Schroyens W, Metafuni E, Knelange N, Averbuch D, de la Camara R. Upper and/or Lower Respiratory Tract Infection Caused by Human Metapneumovirus After Allogeneic Hematopoietic Stem Cell Transplantation. J Infect Dis 2024; 229:83-94. [PMID: 37440459 DOI: 10.1093/infdis/jiad268] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Human metapneumovirus (hMPV) epidemiology, clinical characteristics and risk factors for poor outcome after allogeneic stem cell transplantation (allo-HCT) remain a poorly investigated area. METHODS This retrospective multicenter cohort study examined the epidemiology, clinical characteristics, and risk factors for poor outcomes associated with human metapneumovirus (hMPV) infections in recipients of allo-HCT. RESULTS We included 428 allo-HCT recipients who developed 438 hMPV infection episodes between January 2012 and January 2019. Most recipients were adults (93%). hMPV infections were diagnosed at a median of 373 days after allo-HCT. The infections were categorized as upper respiratory tract disease (URTD) or lower respiratory tract disease (LRTD), with 60% and 40% of cases, respectively. Patients with hMPV LRTD experienced the infection earlier in the transplant course and had higher rates of lymphopenia, neutropenia, corticosteroid use, and ribavirin therapy. Multivariate analysis identified lymphopenia and corticosteroid use (>30 mg/d) as independent risk factors for LRTD occurrence. The overall mortality at day 30 after hMPV detection was 2% for URTD, 12% for possible LRTD, and 21% for proven LRTD. Lymphopenia was the only independent risk factor associated with day 30 mortality in LRTD cases. CONCLUSIONS These findings highlight the significance of lymphopenia and corticosteroid use in the development and severity of hMPV infections after allo-HCT, with lymphopenia being a predictor of higher mortality in LRTD cases.
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Affiliation(s)
- Jose Luis Piñana
- Hematology Department, Hospital Clinico Universitario de Valencia, Valencia, Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria, Hospital Clínico, Universitario de Valencia, Valencia, Spain
| | - Gloria Tridello
- Azienda Ospedaliera, Universitaria Integrata Verona, Verona, Italy
| | - Aliénor Xhaard
- Service d'Hématologie-Greffe, Hôpital Saint-Louis, Université Paris-Diderot, Paris, France
| | - Lotus Wendel
- Leiden Study Unit, EBMT, Leiden, The Netherlands
| | - Juan Montoro
- Hematology División, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Lourdes Vazquez
- Hematology Department, Hospital Clinico Universitario de Salamanca, Salamanca, Spain
| | | | - Per Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska Comprehensive Cancer Center, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Malgorzata Mikulska
- Division of Infectious Diseases, Dipartimento di scienze della salute, University of Genoa, Genova, Italy
- IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Urpu Salmenniemi
- Hematology Department, Comprehensive Cancer Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Ariadna Perez
- Hematology Department, Hospital Clinico Universitario de Valencia, Valencia, Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria, Hospital Clínico, Universitario de Valencia, Valencia, Spain
| | - Nicolaus Kröger
- Department for Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Cornelissen
- Hematology Department, Erasmus Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Elisa Sala
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - Rodrigo Martino
- Hematology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Claire Geurten
- Hematology Department, Birmingham Children's Hospital, Birmingham, United Kingdom
- Centre Hospitalier Universitaire de Liege, Liege, Belgium
| | - Jenny Byrne
- Hematology Department, Nottingham University, Nottingham, United Kingdom
| | - Johan Maertens
- Hematology Department, University Hospital Gasthuisberg, Leuven, Belgium
| | - Tessa Kerre
- Hematology Department, Ghent University Hospital, Gent, Belgium
| | - Murray Martin
- Hematology Department, Leicester Royal Infirmary, Leicester, United Kingdom
| | | | - Moshe Yeshurun
- Institution of Hematology, Rabin Medical Center, Petach-Tikva, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jürgen Finke
- Hematology Department, University of Freiburg, Freiburg, Germany
| | - Andreas H Groll
- Infectious Disease Research Program, Department of Pediatric Hemtology and Oncology and Center for Bone Marrow Transplantation, University Children's Hospital, Muenster, Germany
| | - Peter J Shaw
- The Children`s Hospital at Westmead, Sydney, Australia
| | | | - William Arcese
- Hematology Department, Tor Vergata University of Rome, Rome, Italy
| | | | | | - Mohsen Alzahrani
- Department of Oncology, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Goda Choi
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Edouard Forcade
- Service d'Hématologie Clinique et Thérapie Cellulaire, Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | | | - Carlos Solano
- Hematology Department, Hospital Clinico Universitario de Valencia, Valencia, Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria, Hospital Clínico, Universitario de Valencia, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Jacek Wachowiak
- Department of Pediatric Oncology, Hematology, and Hematopoietic Cell Transplantation, University of Medical Sciences, Poznan, Poland
| | | | - Peter Bader
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Pediatrics and Adolescent Medicine, University Hospital, Goethe University, Frankfurt, Germany
| | - Johannes Clausen
- Department of Internal Medicine I, Ordensklinikum Linz-Elisabethinen, Johannes Kepler University, Linz, Austria
| | - Jiri Mayer
- Masaryk University Hospital Brno, Brno, Czech Republic
| | | | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica e EmatologiaGemelli Research Institute, Fondazione Policlinico Universitario Agostino Gemelli Research Institute, Roma, Italy
| | | | - Dina Averbuch
- Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel
| | - Rafael de la Camara
- Hematology Department, Hospital de la Princesa, Madrid, Spain
- Hematology Department, Hospital Universitario Sanitas La Zarzuela, Madrid, Spain
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Chen J, Labopin M, Pabst T, Zhang X, Jiang E, Tucci A, Cornelissen J, Meijer E, Khevelidze I, Polge E, Wu D, Mohty M, Gorin NC. Autologous stem cell transplantation in adult patients with intermediate-risk acute myeloid leukemia in first complete remission and no detectable minimal residual disease. A comparative retrospective study with haploidentical transplants of the global committee and the ALWP of the EBMT. Bone Marrow Transplant 2023; 58:1322-1330. [PMID: 37640797 PMCID: PMC10691968 DOI: 10.1038/s41409-023-02070-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/29/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023]
Abstract
In patients with acute myeloid leukemia (AML) of intermediate-risk (IR) in first remission (CR1) with no measurable residual disease (MRD negative), the choice of the best consolidation is questionable. 1122 adult patients from 196 centers, transplanted in 2010-21 were analyzed: 547 received an autologous stem cell transplantation (ASCT) and 575 a Haploidentical donor transplant. Because of a significant interaction, comparisons were done separately for patients with wild-type FLT3 (FLT3-wt) and FLT3-ITD mutation (FLT3-ITD). In FLT3-wt patients, haploidentical transplants had two year lower relapse incidence (RI) (16.9% versus 32.6%; HR = 0.40, p < 0.001), higher NRM higher (17.2% vs 3.5%; HR = 7.02, p < 0.001), similar LFS (65.9% vs 63.8%; p = 0.37) and lower OS (73.2% vs 80.6%; HR = 1.69, p = 0.018). In FLT3-ITD patients, haploidentical transplants had two year lower RI (8.2% vs 47.8%; HR = 0.14, p < 0.001) higher NRM (20.2% vs 5.6%; HR = 3.43, p = 0.002), better LFS (71.5% vs 46.6%; HR = 0.53, p = 0.007) and similar OS (73.5% vs 61.9%; p = 0.44). In IR AML patients with FLT3-wt in MRD negative CR1, autologous stem cell transplantation is a valid option, while in patients with FLT3-ITD, haploidentical transplant is better. Whether autologous transplantation is superior to chemotherapy in FLT3-wt patients and the role of maintenance therapy with FLT3 inhibitors remain to be studied.
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Affiliation(s)
- Jia Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Myriam Labopin
- Department of Clinical Hematology and Cellular Therapy, Saint-Antoine Hospital, AP-HP, Sorbonne University, EBMT Paris office, Paris, France
| | - Thomas Pabst
- Department of Medical Oncology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Xi Zhang
- Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Erlie Jiang
- Institute of Hematology, Chinese Academy of Medical Sciences, Hematopoietic stem cell transplantation center, Tianjin, China
| | - Alessandra Tucci
- Spedali Civili - Brescia, Hematology Division, Department of Medical Oncology, Brescia, Italy
| | - Jan Cornelissen
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Hematology, Rotterdam, Netherlands
| | - Ellen Meijer
- VU University Medical Center, Department of Hematology, Amsterdam, Netherlands
| | - Irma Khevelidze
- Department of Clinical Hematology and Cellular Therapy, Saint-Antoine Hospital, AP-HP, Sorbonne University, EBMT Paris office, Paris, France
| | - Emmanuelle Polge
- Department of Clinical Hematology and Cellular Therapy, Saint-Antoine Hospital, AP-HP, Sorbonne University, EBMT Paris office, Paris, France
| | - Depei Wu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Mohamad Mohty
- Department of Clinical Hematology and Cellular Therapy, Saint-Antoine Hospital, AP-HP, Sorbonne University, EBMT Paris office, Paris, France
| | - Norbert-Claude Gorin
- Department of Clinical Hematology and Cellular Therapy, Saint-Antoine Hospital, AP-HP, Sorbonne University, EBMT Paris office, Paris, France.
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4
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Beksac M, Iacobelli S, Koster L, Cornelissen J, Griskevicius L, Rabin NK, Stoppa AM, Meijer E, Mear JB, Zeerleder S, Mayer J, Fenk R, Fegueux N, Chevallier P, Konirova E, Snowden JA, Engelhardt M, Orchard K, Hulin C, Schaap N, Sossa C, Elmaagacli A, McLornan DP, Hayden PJ, Schönland S, Yakoub-Agha I. Correction: An early post-transplant relapse prediction score in multiple myeloma: a large cohort study from the chronic malignancies working party of EBMT. Bone Marrow Transplant 2023; 58:1065. [PMID: 37316543 DOI: 10.1038/s41409-023-02014-3] [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: 06/16/2023]
Affiliation(s)
| | | | - Linda Koster
- European Society for Blood and Marrow Transplantation Leiden Study Unit, Leiden, the Netherlands
| | - Jan Cornelissen
- Erasmus University Medical Center-Daniel Den Hoed, Rotterdam, the Netherlands
| | | | - Neil K Rabin
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Ellen Meijer
- VU University Medical Center, Amsterdam, the Netherlands
| | | | | | - Jiri Mayer
- University Hospital Brno, Brno, Czech Republic
| | - Roland Fenk
- University Hospital Duesseldorf, Dusseldorf, Germany
| | | | | | | | | | | | - Kim Orchard
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Nicolaas Schaap
- Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Claudia Sossa
- Clinica FOSCAL, Floridablanca, Santander, Colombia
- Universidad Autónoma de Bucaramanga-UNAB, Bucaramanga, Santander, Colombia
| | | | | | - Patrick J Hayden
- Department of Haematology, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Devillier R, Eikema DJ, Dufour C, Aljurf M, Wu D, Maschan A, Kulagin A, Halkes CJM, Collin M, Snowden J, Renard C, Ganser A, Sykora KW, Gibson BE, Maertens J, Itäla-Remes M, Corti P, Cornelissen J, Bornhäuser M, Araujo MC, Ozdogu H, Risitano A, Socie G, De Latour RP. Graft- versus-host disease and relapse/rejection-free survival after allogeneic transplantation for idiopathic severe aplastic anemia: a comprehensive analysis from the SAAWP of the EBMT. Haematologica 2023; 108:2305-2315. [PMID: 36951165 PMCID: PMC10483355 DOI: 10.3324/haematol.2022.281876] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/15/2023] [Indexed: 03/24/2023] Open
Abstract
Survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for severe idiopathic aplastic anemia (SAA) has improved in recent years, approaching 75% at 5 years. However, an SAA-adapted composite endpoint, graft-versus-host disease (GvHD) and relapse/rejection-free survival (GRFS), may more accurately assess patient outcomes beyond survival. We analyzed GRFS to identify risk factors and specific causes of GRFS failure. Our retrospective analysis from the Severe Aplastic Anemia Working Party of the European Society for Blood and Marrow Transplantation included 479 patients with idiopathic SAA who underwent allo-HSCT in two conventional situations: i) upfront allo-HSCT from a matched related donor (MRD) (upfront cohort), and ii) allo-HSCT for relapsed or refractory SAA (rel/ref cohort). Relevant events for GRFS calculation included graft failure, grade 3-4 acute GvHD, extensive chronic GvHD, and death. In the upfront cohort (n=209), 5-year GRFS was 77%. Late allo-HSCT (i.e., >6 months after SAA diagnosis) was the main poor prognostic factor, specifically increasing the risk of death as the cause of GRFS failure (hazard ratio [HR]=4.08; 95% confidence interval [CI]: 1.41-11.83; P=0.010). In the rel/ref cohort (n=270), 5-year GRFS was 61%. Age was the main factor significantly increasing the risk of death (HR=1.04; 95% CI: 1.02-1.06; P<0.001), acute GvHD (HR=1.03; 95% CI: 1.00-1.07; P=0.041), and chronic GvHD (HR=1.04; 95% CI: 1.01-1.08; P=0.032) as the cause of GRFS failure. GRFS after upfront MRD allo-HSCT was very good, notably with early allo-HSCT, confirming that younger patients with an MRD should be transplanted immediately. GRFS was worse in cases of salvage allo-HSCT, most notably in older patients, questioning the utility of allo-HSCT earlier in the disease course.
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Affiliation(s)
| | | | - Carlo Dufour
- IRCCS Gaslini Children's Research Hospital, Genova
| | - Mahmoud Aljurf
- King Faisal Specialist Hospital and Research Center, Riyadh
| | - Depei Wu
- First Affiliated Hospital of Soochow University, Suzhou
| | - Alexei Maschan
- Federal Research Center for Pediatric Hematology, Moscow
| | | | | | | | - John Snowden
- Sheffield Teaching Hospitals, NHS Trust, Sheffield
| | - Cécile Renard
- Institut d`Hematologie et d'Oncologie Pediatrique, Lyon
| | - Arnold Ganser
- Hannover Medical School, Hematology Department, Hemostasis, Oncology and Stem Cell Transplantation, Hannover
| | - Karl-Walter Sykora
- Hannover Medical School, Hematology Department, Hemostasis, Oncology and Stem Cell Transplantation, Hannover
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6
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Maffini E, Ngoya M, Galimard JE, Harbi S, Kröger N, Platzbecker U, Sengeloev H, Craddock C, Potter V, Choi G, Chevallier P, Stölzel F, Tholouli E, Maertens J, Ciceri F, Cornelissen J, Sanz J, Spyridonidis A, Lanza F, Nagler A, Mohty M. Allogeneic hematopoietic cell transplantation for patients with AML aged 70 years or older in first remission. A study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 2023; 58:1033-1041. [PMID: 37386253 DOI: 10.1038/s41409-023-02027-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 06/04/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023]
Abstract
Accessibility to allogeneic hematopoietic cell transplantation (HCT) programs for older patients is growing constantly. We report on the clinical outcomes of a group of 701 adults aged ≥70 years, with acute myeloid leukemia (AML) in first complete remission (CR1), who received a first HCT, from HLA-matched sibling donors (MSD), 10/10 HLA-matched unrelated donors (UD), 9/10 HLA-mismatched unrelated donors (mUD) or haploidentical (Haplo) donors. The 2-year overall survival (OS) was 48.1%, leukemia-free survival (LFS) 45.3%, relapse incidence (RI) 25.2%, non-relapse mortality (NRM) 29.5% and GVHD-free, relapse-free survival (GRFS), 33.4%. Compared to MSD, patients transplanted from Haplo and UD presented lower RI (HR 0.46, 95% CI 0.25-0.8, p = 0.02 and HR 0.44, 95% CI: 0.28-0.69, p = 0.001, respectively); this translated into prolonged LFS for Haplo (HR 0.62, 95% CI: 0.39-0.99, p = 0.04). Patients transplanted from mUD exhibited the highest NRM incidence (HR 2.33, 95% CI: 1.26-4.31, p = 0.007). HCT in selected adult CR1 AML patients >70 years is feasible and could be associated with good clinical outcomes. Prospective clinical trials are warranted.
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Affiliation(s)
- Enrico Maffini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna; Istituto "L. e A. Seràgnoli", Bologna, Italy.
| | - Maud Ngoya
- EBMT ALWP Statistical Unit, Saint Antoine Hospital, Sorbonne University, Paris, France
| | | | - Samia Harbi
- Programme de Transplantation et Therapie Cellulaire, Centre de Recherche en Cancerologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Platzbecker
- Medical Clinic and Policlinic 1, Hematology and Cellular Therapy, University hospital Leipzig, Leipzig, Germany
| | - Henrik Sengeloev
- Bone Marrow Transplant Unit L 4043, National University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Charles Craddock
- Birmingham Centre for Cellular Therapy and Transplantation, Birmingham, UK
| | - Victoria Potter
- Department of Haematological Medicine, Kings College Hospital, King's Denmark Hill Campus, London, UK
| | - Goda Choi
- University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | | | - Friedrich Stölzel
- University Hospital Dresden, Medizinische Klinik und Poliklinik I, Dresden, TU Dresden, Germany
| | - Eleni Tholouli
- Haematology Department, Manchester Royal Infirmary, Oxford Road, Manchester, UK
| | - Johan Maertens
- Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Fabio Ciceri
- Ospedale San Raffaele s.r.l., Haematology and BMT, Milano, Italy
| | - Jan Cornelissen
- Department of Haematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jaime Sanz
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Alexandros Spyridonidis
- Bone Marrow Transplantation Unit and Institute of Cellular therapy, University of Patras, Patras, Greece
| | - Francesco Lanza
- Hematology Unit, Ravenna Public Hospital and Romagna Transplant Network, Ravenna, Italy
| | - Arnon Nagler
- Sheba Medical Center, Tel-Hashomer, Tel-Aviv University, Ramat-Gan, Israel
| | - Mohamad Mohty
- Clinical Hematology and Cellular Therapy Department, Sorbonne University, Saint Antoine Hospital, INSERM UMRs 938, Paris, France
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7
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Beksac M, Iacobelli S, Koster L, Cornelissen J, Griskevicius L, Rabin NK, Stoppa AM, Meijer E, Mear JB, Zeerleder S, Mayer J, Fenk R, Fegueux N, Chevallier P, Konirova E, Snowden JA, Engelhardt M, Orchard K, Hulin C, Schaap N, Sossa C, Elmaagacli A, McLornan DP, Hayden PJ, Schönland S, Yakoub-Agha I. An early post-transplant relapse prediction score in multiple myeloma: a large cohort study from the chronic malignancies working party of EBMT. Bone Marrow Transplant 2023; 58:916-923. [PMID: 37160942 DOI: 10.1038/s41409-023-01999-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 04/17/2023] [Accepted: 04/21/2023] [Indexed: 05/11/2023]
Abstract
Early relapse (ER) following Autologous Hematopoietic Cell Transplantation (AHCT) confers a poor prognosis. We therefore developed a novel scoring system to predict ER. A total of 14,367 AHCT-1 patients were transplanted between 2014 and 2019, and were conditioned with Melphalan 200 mg/m2 (Mel200) (n = 7228; 2014-2017) (training cohort); Mel200 (n = 5616; 2018-2019) or Mel140 (n = 1523; 2018-2019) (validation cohorts). PFS-12 and the Cumulative Incidence of Relapse at 12 months were 84.1% and 14.7% (training Mel200), 87.2% and 11.6% (validation Mel200), and 80.3% and 16.9% (validation Mel140), respectively. The points in the risk score were: 0, 1,2 for ISS stages I, II, and III; Disease status: 0 (CR/VGPR); 1 (PR); 2 (SD/MR); 4 (Relapse/Progression); and 1 for Karnofsky ≤ 70. The distribution of scores: 0 (24%), 1 (33.9%), 2 (29.6 %), 3 (9.5%), and ≥4 (2.7%). The score separated PFS-12, with the lowest risk group (n = 1752) having a PFS-12 of 91.7% and the highest risk group (n = 195) 57.1%. This also applied in cytogenetically high-risk patients. If the pre-score baseline risks are 15% (standard risk) and 25% (high-risk), a score of ≥4 confers calculated risks of 38% and 54%, respectively. This novel EBMT ER score, therefore, allows for the identification of five discrete prognostic groups.
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Affiliation(s)
| | | | - Linda Koster
- European Society for Blood and Marrow Transplantation Leiden Study Unit, Leiden, the Netherlands
| | - Jan Cornelissen
- Erasmus University Medical Center-Daniel Den Hoed, Rotterdam, the Netherlands
| | | | - Neil K Rabin
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Ellen Meijer
- VU University Medical Center, Amsterdam, the Netherlands
| | | | | | - Jiri Mayer
- University Hospital Brno, Brno, Czech Republic
| | - Roland Fenk
- University Hospital Duesseldorf, Dusseldorf, Germany
| | | | | | | | | | | | - Kim Orchard
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Nicolaas Schaap
- Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Claudia Sossa
- Clinica FOSCAL, Floridablanca, Santander, Colombia
- Universidad Autónoma de Bucaramanga - UNAB, Bucaramanga, Santander, Colombia
| | | | | | - Patrick J Hayden
- Department of Haematology, School of Medicine, Trinity College Dublin, Dublin, Ireland
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8
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Spyridonidis A, Labopin M, Brissot E, Moiseev I, Cornelissen J, Choi G, Ciceri F, Vydra J, Reményi P, Rovira M, Meijer E, Labussière-Wallet H, Blaise D, van Gorkom G, Kröger N, Koc Y, Giebel S, Bazarbachi A, Savani B, Nagler A, Mohty M. Should anti-thymocyte globulin be added in post-transplant cyclophosphamide based matched unrelated donor peripheral blood stem cell transplantation for acute myeloid leukemia? A study on behalf of the Acute Leukemia Working Party of the EBMT. Bone Marrow Transplant 2022; 57:1774-1780. [PMID: 36071114 DOI: 10.1038/s41409-022-01816-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/08/2022] [Accepted: 08/19/2022] [Indexed: 11/09/2022]
Abstract
In this registry-based study which includes acute myeloid leukemia patients who underwent a matched unrelated donor allogeneic peripheral-blood stem cell transplantation in complete remission and received post-transplant cyclophosphamide (PTCY) as graft-versus-host disease (GvHD) prophylaxis, we compared 421 recipients without anti-thymocyte globulin (ATG) with 151 patients with ATG. The only significant differences between PTCY and PTCY + ATG cohorts were the median year of transplant and the follow-up period (2017 vs 2015 and 19.6 vs 31.1 months, respectively, p < 0.0001). Overall, 2-year survival was 69.9% vs 67.1% in PTCY and PTCY + ATG, respectively, with deaths related to relapse (39% vs 43.5%), infection (21.9% vs 23.9%) or GvHD (17.1% vs 17.4%) not differing between groups. On univariate comparison, a significantly lower rate of extensive chronic GvHD was found when ATG was added (9.9% vs 21%, p = 0.029), a finding which was not confirmed in the multivariate analysis. The Cox-model showed no difference between PTCY + ATG and PTCY alone with respect to acute and chronic GvHD of all grades, non-relapse mortality, relapse, leukemia-free survival, overall survival, and GvHD-free-relapse-free survival between study cohorts. Our results highlight that the addition of ATG in PTCY does not provide any extra benefit in terms of further GvHD reduction, better GRFS or better survival.
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Affiliation(s)
- Alexandros Spyridonidis
- Bone Marrow Transplantation Unit and Institute of Cellular Therapy, University of Patras, Patras, Greece.
| | - Myriam Labopin
- EBMT Statistical Unit, Sorbonne Université, Hospital Saint-Antoine, Paris, France
| | - Eolia Brissot
- Department of Hematology, Hospital Saint Antoine, Paris, France
| | - Ivan Moiseev
- Gorbacheva Research Institute, Pavlov Univ., St Petersburg, Russian Federation
| | - Jan Cornelissen
- Erasmus MC Cancer Institute, University Medical Center, Rotterdam, Netherlands
| | - Goda Choi
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Fabio Ciceri
- Ospedale San Raffaele s.r.l., Haematology and BMT, Milano, Italy
| | - Jan Vydra
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | | | - Montserrat Rovira
- Hospital Clinic, Institute of Hematology & Oncology, Barcelona, Spain
| | - Ellen Meijer
- VU University Medical Center, Amsterdam, Netherlands
| | | | - Didier Blaise
- Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Marseille, France
| | | | - Nicolaus Kröger
- University Hospital Eppendorf, Bone Marrow Transplant Centre, Hamburg, Germany
| | - Yener Koc
- Bone Marrow Transplant Unit, Medicana International Hospital, Istanbul, Turkey
| | - Sebastian Giebel
- Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Ali Bazarbachi
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Bipin Savani
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Arnon Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Mohamad Mohty
- Department of Hematology, Hospital Saint Antoine, Paris, France
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9
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Ruggeri A, Galimard JE, Labopin M, Rafii H, Blaise D, Ciceri F, Diez-Martin JL, Cornelissen J, Chevallier P, Sanchez-Guijo F, Nicholson E, Castagna L, Forcade E, Kuball J, Rovira M, Koc Y, Pavlu J, Gulbas Z, Vydra J, Baron F, Sanz J, Spyridonidis A, Savani B, Gluckman E, Nagler A, Mohty M. Comparison of Outcomes after Unrelated Double-Unit Cord Blood and Haploidentical Peripheral Blood Stem Cell Transplantation in Adults with Acute Myelogenous Leukemia: A Study on Behalf of Eurocord and the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Transplant Cell Ther 2022; 28:710.e1-710.e10. [DOI: 10.1016/j.jtct.2022.07.006] [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] [Received: 04/05/2022] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
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10
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Onida F, Sbianchi G, Radujkovic A, Sockel K, Kröger N, Sierra J, Socié G, Cornelissen J, Poiré X, Raida L, Bourhis JH, Finke J, Passweg J, Salmenniemi U, Schouten HC, Beguin Y, Martin S, Deconinck E, Ganser A, Zver S, Lioure B, Rohini R, Koster L, Hayden P, Iacobelli S, Robin M, Yakoub-Agha I. Prognostic value of a new clinically-based classification system in patients with CMML undergoing allogeneic HCT: a retrospective analysis of the EBMT-CMWP. Bone Marrow Transplant 2022; 57:896-902. [PMID: 35352038 DOI: 10.1038/s41409-021-01555-9] [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: 12/08/2020] [Revised: 08/25/2021] [Accepted: 12/15/2021] [Indexed: 11/09/2022]
Abstract
Recently a new three-group clinical classification was reported by an International Consortium to stratify CMML patients with regard to prognosis. The groups were defined as follows: (1) Myelodysplastic (MD)-CMML: WBC ≤ 10 × 109/l, circulating immature myeloid cells (IMC) = 0, no splenomegaly; (2) MD/MP (overlap)-CMML: WBC 10-20 × 109/l or WBC ≤ 10 × 109/l but IMC > 0 and/or splenomegaly; (3) Myeloproliferative (MP)-CMML: WBC > 20 × 109/l. By analysing EBMT Registry patients who underwent allo-HCT for CMML between 1997 and 2016, we aimed to determine the impact of this classification on transplantation outcome and to make a comparison with the conventional WHO classification (CMML-0/CMML-1/CMML-2). Patient grouping was based on the data registered at time of transplantation, with IMC replaced by peripheral blasts. Among 151 patients included in the analysis, 38% were classified as MD-CMML, 42% as MD/MP-CMML and 20% as MP-CMML. With a median survival of 17 months in the whole series, MD-CMML patients were distinguished as a low-risk group with higher CR rate at transplant and a longer post-transplant 2-year progression-free survival in comparison to others (44.5% vs 33.5%, respectively), whereas the WHO classification was superior in identifying high-risk patients (CMML-2) with inferior survival outcomes.
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Affiliation(s)
- Francesco Onida
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico-University of Milan, Milan, Italy.
| | | | | | - Katja Sockel
- University Hospital Dresden, TU Dresden, Dresden, Germany
| | | | - Jorge Sierra
- Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Xavier Poiré
- Cliniques Universitaires St. Luc, Brussels, Belgium
| | - Luděk Raida
- Department of Hemato-Oncology-Faculty Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - Jean Henri Bourhis
- Gustave Roussy, Institut de Cancérologie, Val-de-Marne, Villejuif, France
| | | | | | | | | | - Yves Beguin
- CHU of Liege and University of Liege, Liege, Belgium
| | | | | | | | - Samo Zver
- University Medical Center, Ljubljana, Slovenia
| | | | | | - Linda Koster
- EBMT Data Office Leiden, Leiden, The Netherlands
| | - Patrick Hayden
- Department of Haematology, Trinity College Dublin, St. James's Hospital, Dublin 8, Ireland
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11
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Gutiérrez-García G, Martínez C, Boumendil A, Finel H, Malladi R, Afanasyev B, Tsoulkani A, Wilson KMO, Bloor A, Nikoloudis M, Richardson D, López-Corral L, Castagna L, Cornelissen J, Giltat A, Collin M, Fanin R, Bonifazi F, Robinson S, Montoto S, Peggs KS, Sureda A. Long-term outcome of patients receiving haematopoietic allogeneic stem cell transplantation as first transplant for high-risk Hodgkin lymphoma: a retrospective analysis from the Lymphoma Working Party-EBMT. Br J Haematol 2021; 196:1018-1030. [PMID: 34750806 DOI: 10.1111/bjh.17939] [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: 06/07/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022]
Abstract
We analysed long-term outcome of patients receiving haematopoietic allogeneic stem cell transplantation (allo-HSCT) as a first transplant for high-risk Hodgkin lymphoma (HL). One hundred and ninety patients were included in this study, 63% of them had previously received brentuximab vedotin and/or checkpoint inhibitors. Seventy patients (37%) received an unrelated donor allo-HSCT, 99 (51%) had myeloablative conditioning (MAC) and 60% had in vivo T-cell/depleted grafts (TCD). The 100-day cumulative incidence (CI) of grade II-IV acute graft-versus-host disease (GVHD) was 25% and the 3-year CI of chronic GVHD was 38%. The 3-year CI of non-relapse mortality (NRM) and relapse rate were 21% and 38% respectively. After a median follow-up of 58 months, 3-year overall survival (OS) and progression-free survival (PFS) were 58% and 41% respectively. Multivariate analysis showed that, in comparison to reduced-intensity conditioning regimens with or without TCD, MAC using TCD had similar NRM and a lower risk of relapse leading to significantly better OS and PFS. MAC without TCD was associated with higher NRM and worse survival outcomes. These results suggest that in patients with high-risk HL and candidates of allo-HSCT, a MAC strategy with TCD might be the best option.
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Affiliation(s)
- G Gutiérrez-García
- Department of Haematology, Bone Marrow Transplantation Unit, Hospital Clinic of Barcelona, University of Barcelona, Institut de Recerca Biomèdica August Pi i Sunyer, Barcelona, Spain
| | - C Martínez
- Department of Haematology, Bone Marrow Transplantation Unit, Hospital Clinic of Barcelona, University of Barcelona, Institut de Recerca Biomèdica August Pi i Sunyer, Barcelona, Spain
| | | | - H Finel
- Lymphoma Working Party, EBMT, Paris, France
| | - R Malladi
- School of Cancer Sciences, University of Birmingham, Centre for Clinical Haematology, Queen Elizabeth NHS Foundation Trust, Birmingham, UK
| | - B Afanasyev
- State Medical Pavlov University, St. Petersburg, Russia
| | | | | | - A Bloor
- Haematology and Transplant Unit, Christie Hospital NHS Foundation Trust and University of Manchester, Manchester, UK
| | - M Nikoloudis
- Haematology Department Heart of England NHS Trust, Birmingham, UK
| | - D Richardson
- Department of Haematology, Southampton General Hospital, Southampton, UK
| | | | - L Castagna
- Department of Haematology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - J Cornelissen
- Erasmus MC Cancer Institute University Medical Centre Rotterdam Department of Haematology, Rotterdam, Netherlands
| | - A Giltat
- Department of Haematology, Medical University Hospital, Angers, France
| | | | - R Fanin
- Department of Haematology and Cellular Therapy 'Carlo Melzi', S. Maria della Misericordia University Hospital, DAME, University of Udine, Udine, Italy
| | - F Bonifazi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - S Robinson
- Department of Haematology and Oncology, Bristol University Hospital, Bristol, UK
| | - S Montoto
- St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - K S Peggs
- Department of Haematology, University College London Cancer Institute, London, UK
| | - A Sureda
- Clinical Department of Haematology, Institut Català d'Oncologia-Hospitalet, IDIBELL, University of Barcelona, Barcelona, Spain
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12
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Dholaria B, Labopin M, Sanz J, Ruggeri A, Cornelissen J, Labussière-Wallet H, Blaise D, Forcade E, Chevallier P, Grassi A, Zubarovskaya L, Kuball J, Ceballos P, Ciceri F, Baron F, Savani BN, Nagler A, Mohty M. Allogeneic hematopoietic cell transplantation with cord blood versus mismatched unrelated donor with post-transplant cyclophosphamide in acute myeloid leukemia. J Hematol Oncol 2021; 14:76. [PMID: 33941226 PMCID: PMC8094558 DOI: 10.1186/s13045-021-01086-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 02/24/2021] [Accepted: 04/27/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Allogeneic hematopoietic cell transplantation (allo-HCT) using a mismatched unrelated donor (MMUD) and cord blood transplantation (CBT) are valid alternatives for patients without a fully human leukocyte antigen (HLA)-matched donor. Here, we compared the allo-HCT outcomes of CBT versus single-allele-mismatched MMUD allo-HCT with post-transplant cyclophosphamide (PTCy) in acute myeloid leukemia. METHODS Patients who underwent a first CBT without PTCy (N = 902) or allo-HCT from a (HLA 9/10) MMUD with PTCy (N = 280) were included in the study. A multivariate regression analysis was performed for the whole population. A matched-pair analysis was carried out by propensity score-based 1:1 matching of patients (177 pairs) with known cytogenetic risk. RESULTS The incidence of grade II-IV and grade III-IV acute graft-versus-host disease (GVHD) at 6 months was 36% versus 32% (p = 0.07) and 15% versus 11% (p = 0.16) for CBT and MMUD cohorts, respectively. CBT was associated with a higher incidence of graft failure (11% vs. 4%, p < 0.01) and higher 2-year non-relapse mortality (NRM) (30% vs. 16%, p < 0.01) compared to MMUD. In the multivariate analysis, CBT was associated with a higher risk of, NRM (HR = 2.09, 95% CI 1.46-2.99, p < 0.0001), and relapse (HR = 1.35, 95% CI 1-1.83, p = 0.05), which resulted in worse leukemia-free survival (LFS) (HR = 1.68, 95% CI 1.34-2.12, p < 0.0001), overall survival (OS) (HR = 1.7, 95% CI 1.33-2.17, p < 0.0001), and GVHD-free, relapse-free survival (GRFS) (HR = 1.49, 95% CI 1.21-1.83, p < 0.0001) compared to MMUD. The risk of grade II-IV acute GVHD (p = 0.052) and chronic GVHD (p = 0.69) did not differ significantly between the cohorts. These results were confirmed in a matched-pair analysis. CONCLUSIONS CBT was associated with lower LFS, OS, and GRFS due to higher NRM, compared to MMUD allo-HCT with PTCy. In the absence of a fully matched donor, 9/10 MMUD with PTCy may be preferred over CBT.
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Affiliation(s)
- Bhagirathbhai Dholaria
- Department of Hematology-Oncology, Vanderbilt University Medical Center, 220 Pierce Ave, 777 Preston Research Building, Nashville, TN, 37232, USA.
| | | | - Jaime Sanz
- Hematology Department, University Hospital La Fe, Valencia, Spain
| | - Annalisa Ruggeri
- Department of Pediatric Hematology and Oncology IRCCS, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Jan Cornelissen
- Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Didier Blaise
- Programme de Transplantation and Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | | | | | - Anna Grassi
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Ludmila Zubarovskaya
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russian Federation
| | - Jürgen Kuball
- Department of Haematology, University Medical Centre, Utrecht, The Netherlands
| | - Patrice Ceballos
- Département d'Hématologie Clinique, CHU Lapeyronie, Montpellier, France
| | - Fabio Ciceri
- Ospedale San Raffaele S.R.L., Haematology and BMT, Milan, Italy
| | | | - Bipin N Savani
- Department of Hematology-Oncology, Vanderbilt University Medical Center, 220 Pierce Ave, 777 Preston Research Building, Nashville, TN, 37232, USA
| | - Arnon Nagler
- Chaim Sheba Medical Center, Tel Hashomer, Israel
- ALWP Office Hôpital Saint-Antoine, Paris, France
| | - Mohamad Mohty
- EBMT ALWP Office, Hôpital Saint-Antoine, Paris, France
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, UMRs 938, AP-HP, Sorbonne University, and INSERM, Paris, France
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13
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Nagler A, Labopin M, Craddock C, Socié G, Yakoub-Agha I, Gedde-Dahl T, Niittyvuopio R, Byrne J, Cornelissen J, Labussière-Wallet H, Arcese W, Milpied N, Canaani J, Esteve J, Mohty M. The Role of Cytogenetic Risk Stratification in FLT3 Mutated NPM1 Negative AML Patients Undergoing Allogeneic Stem Cell Transplantation (alloSCT) in Remission: A Study on Behalf of the ALWP of the EBMT. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00084-1] [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: 11/28/2022]
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14
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Loke J, Labopin M, Craddock C, Niederwieser D, Cornelissen J, Afansayev B, Jindra P, Maertens J, Blaise D, Boriskina K, Gramatzki M, Ganser A, Savani B, Mohty M, Nagler A. Impact of patient: donor HLA disparity on reduced-intensity-conditioned allogeneic stem cell transplants from HLA mismatched unrelated donors for AML: from the ALWP of the EBMT. Bone Marrow Transplant 2020; 56:614-621. [PMID: 33009514 DOI: 10.1038/s41409-020-01072-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/06/2020] [Accepted: 09/21/2020] [Indexed: 11/09/2022]
Abstract
Patients with acute myeloid leukaemia (AML) who lack a matched sibling or unrelated donor commonly undergo transplantation from a donor matched at 9/10 HLA-A, -B, -C, -DRB1, -DQB1 alleles, and it is unclear if a specific locus mismatch is preferable to any other. We therefore studied 937 patients with AML in complete remission transplanted using a reduced intensity conditioning regimen from an unrelated donor mismatched at a single allele. In a multivariate analysis, patient age, adverse karyotype and patient cytomegalovirus (CMV) seropositivity were correlated with decreased leukaemia free survival (LFS) and overall survival (OS). There was no significant difference in LFS or OS between patients transplanted from donors mismatched at HLA-A, -B, -C or -DRB1 in comparison to a HLA-DQB1 mismatched transplant. In a multivariate analysis, patients transplanted with a HLA-A mismatched donor had higher rates of acute graft-versus-host disease (GVHD) and non-relapse mortality (NRM) than patients transplanted with a HLA-DQB1 mismatched donor. Patient CMV seropositivity was associated with an increase in NRM and acute GVHD and reduced LFS and OS, regardless of donor CMV status. For CMV seropositive patients lacking a fully matched donor, alternative GVHD and CMV prophylaxis strategies should be considered.
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Affiliation(s)
- J Loke
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - M Labopin
- Paris EBMT Data Coordination Office, Hospital Saint-Antoine, APHP, Université Pierre et Marie Curie UPMC and INSERM U 938, Paris, France.,Department of Hematology and Cell Therapy, Hospital Saint-Antoine, Paris, France
| | - C Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK.
| | | | - J Cornelissen
- Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | - B Afansayev
- State Medical Pavlov University, St. Petersburg, Russia
| | - P Jindra
- Department of Haematology/Oncology, Charles University Hospital, Alej Svobody 80, 304 60, Pilsen, Czech Republic
| | - J Maertens
- Department of Hematology, Acute Leukemia and Transplantation Unit, UZ Leuven, Herestraat 49, B-3000, Leuven, Belgium
| | - D Blaise
- Transplant and Cellular Therapy Unit, Institut Paoli Calmettes, Marseille, France
| | - K Boriskina
- Department of Hematology, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - M Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| | - A Ganser
- Department of Haematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Carl-Neuberg-Str.1, Hannover, Germany
| | - B Savani
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - M Mohty
- Paris EBMT Data Coordination Office, Hospital Saint-Antoine, APHP, Université Pierre et Marie Curie UPMC and INSERM U 938, Paris, France.,Department of Hematology and Cell Therapy, Hospital Saint-Antoine, Paris, France
| | - A Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
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15
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Sheth V, Volt F, Sanz J, Clement L, Cornelissen J, Blaise D, Sierra J, Michallet M, Saccardi R, Rocha V, Gluckman E, Chabannon C, Ruggeri A. Reduced-Intensity versus Myeloablative Conditioning in Cord Blood Transplantation for Acute Myeloid Leukemia (40-60 years) across Highly Mismatched HLA Barriers-On Behalf of Eurocord and the Cellular Therapy & Immunobiology Working Party (CTIWP) of EBMT. Biol Blood Marrow Transplant 2020; 26:2098-2104. [PMID: 32726672 DOI: 10.1016/j.bbmt.2020.07.025] [Citation(s) in RCA: 3] [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: 05/18/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 12/17/2022]
Abstract
The use of myeloablative conditioning (MAC) in umbilical cord blood transplantation (UCBT) has been associated with high nonrelapse mortality (NRM) in patients aged >40 years, especially those having a high HLA disparity, thus limiting wider applications. We hypothesized that the NRM advantage of reduced-intensity conditioning (RIC) and higher graft-versus-leukemia effect associated with greater HLA disparities would expand its use for patients (aged 40 to 60 years) without compromising efficacy and compared outcomes between RIC and MAC regimens. In total, 288 patients aged 40 to 60 years, with de novo acute myeloid leukemia, receiving UCBT with at least 2 HLA mismatches with RIC (n = 166) or MAC (n = 122) regimens were included. As compared to RIC, the MAC cohort included relatively younger patients, having received more single UCBT, with lower total nucleated cell counts and more in vivo T cell depletion. Median time to neutrophil engraftment, infections (bacterial, viral, and fungal), and grade II to IV acute and chronic graft-versus-host disease were similar in both groups. In the multivariate analysis, overall survival (hazard ratio [HR], 0.98; P = .9), NRM (HR, 0.68; P = .2), and relapse (HR, 1.24; P = .5) were not different between RIC and MAC. Refractory disease was associated with worse survival. Outcomes of UBCT for patients aged 40 to 60 years having ≥2 HLA mismatches are comparable after the RIC or MAC regimen.
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Affiliation(s)
- Vipul Sheth
- Clinical Research Division, Program in Immunology, Fred Hutchison Cancer Research Centre, Seattle, Washington
| | | | - Jaime Sanz
- Department of Stem Cell Transplant and Immunotherapy, Hospital Universitario La Fe, Valencia, Spain
| | - Laurence Clement
- Department of Stem Cell Transplant and Immunotherapy, Haut-Lévêque, Bordeaux, France
| | - Jan Cornelissen
- Department of Stem Cell Transplant and Immunotherapy, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands
| | - Didier Blaise
- Department of Stem Cell Transplant and Immunotherapy, Paoli Calmettes, Marseille, France
| | - Jorge Sierra
- Department of Stem Cell Transplant and Immunotherapy, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Mauricette Michallet
- Department of Stem Cell Transplant and Immunotherapy, Service d'Hematologie, Centre Leon Berard, Lyon, France
| | - Riccardo Saccardi
- Department of Stem Cell Transplant and Immunotherapy, Azienda Ospedaliero Universitaria Meyer-Ospedale di Careggi, Firenze, Italy
| | | | | | - Christian Chabannon
- Centre de Thérapie Cellulaire, Département de Biologie du Cancer, Institut Paoli-Calmettes, & Inserm CBT-1409, Aix-Marseille Université, Marseille, France
| | - Annalisa Ruggeri
- Eurocord, Hopital Saint Louis-EA3518, Paris, France; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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Griffioen K, Cornelissen J, Heuvelink A, Adusei D, Mevius D, Jan van der Wal F. Development and evaluation of 4 loop-mediated isothermal amplification assays to detect mastitis-causing bacteria in bovine milk samples. J Dairy Sci 2020; 103:8407-8420. [PMID: 32564949 DOI: 10.3168/jds.2019-18035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 12/10/2019] [Accepted: 04/06/2020] [Indexed: 12/22/2022]
Abstract
Farmers prefer fast, sensitive, and on-site tests for treatment decisions on mastitis. Due to the time to results of the currently available diagnostic tools, these are rarely used for that purpose. Genotypic tests that do not require a growth step may be suitable for on-site testing, for example loop-mediated isothermal amplification (LAMP), which has been described as a sensitive test that can be used on-site. Therefore, this study aimed to develop and evaluate LAMP assays for the detection of a subset of mastitis-causing pathogens, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus spp., in milk from cows with clinical mastitis. Furthermore, a generic nucleic acid lateral flow immunoassay (NALFIA) was evaluated as a potential on-site readout of the LAMP assays. For each assay of LAMP and NALFIA, the limit of detection and analytical specificity were determined using isolates, and the diagnostic specificity was determined using selected samples with known etiology. In addition, the diagnostic specificity of LAMP was determined using field samples with unknown etiology at testing. Bacteriological culture with identification by mass spectrometry was used as a reference method. The 4 assays had a kappa ≥0.73 with the reference method when testing the selected samples, but ≥0.47 when testing field samples. After correcting for prevalence, kappa was ≥0.80 for the E. coli, K. pneumoniae, and Staph. aureus assays. The Streptococcus spp. assay had a kappa of 0.47 (0.48 after correction) with the reference method, probably caused by the assay broadly targeting a genus instead of a particular species. The NALFIA readout was found to have kappa ≥0.81 for the E. coli, Staph. aureus, and Streptococcus spp. assays at a generic runtime, but for the K. pneumoniae assay a shorter runtime could be used. In conclusion, LAMP is a promising method for fast on-site tests for mastitis-causing pathogens if the current elaborate method for sample preparation is replaced by a simplified protocol. The NALFIA is an easy and reliable readout for on-site use, with the observation that for the current assay designs a generic runtime is not yet possible for the chosen set of pathogens. If associated with a simple and fast sample preparation protocol, the combination of LAMP and NALFIA has the potential to enable fast and reliable on-site testing of clinical mastitis milk samples.
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Affiliation(s)
- Karien Griffioen
- Faculty of Veterinary Medicine, Department of Farm Animal Health, Utrecht University, PO Box 80151, 3508 TD Utrecht, the Netherlands.
| | - Jan Cornelissen
- Wageningen Bioveterinary Research, Department of Infection Biology, Wageningen UR, PO Box 65, 8200 AB Lelystad, the Netherlands
| | | | - Daniela Adusei
- Wageningen Bioveterinary Research, Department of Infection Biology, Wageningen UR, PO Box 65, 8200 AB Lelystad, the Netherlands
| | - Dik Mevius
- Wageningen Bioveterinary Research, Department of Infection Biology, Wageningen UR, PO Box 65, 8200 AB Lelystad, the Netherlands; Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, PO Box 80165, 3508 TD Utrecht, the Netherlands
| | - Fimme Jan van der Wal
- Wageningen Bioveterinary Research, Department of Infection Biology, Wageningen UR, PO Box 65, 8200 AB Lelystad, the Netherlands
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Peric Z, Labopin M, Peczynski C, Polge E, Cornelissen J, Carpenter B, Potter M, Malladi R, Byrne J, Schouten H, Fegueux N, Socié G, Rovira M, Kuball J, Gilleece M, Giebel S, Nagler A, Mohty M. Comparison of reduced-intensity conditioning regimens in patients with acute lymphoblastic leukemia >45 years undergoing allogeneic stem cell transplantation—a retrospective study by the Acute Leukemia Working Party of EBMT. Bone Marrow Transplant 2020; 55:1560-1569. [DOI: 10.1038/s41409-020-0878-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 03/14/2020] [Accepted: 03/18/2020] [Indexed: 01/08/2023]
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18
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Schmaelter AK, Labopin M, Socié G, Itälä-Remes M, Blaise D, Yakoub-Agha I, Forcade E, Cornelissen J, Ganser A, Beelen D, Labussière-Wallet H, Passweg J, Savani BN, Schmid C, Nagler A, Mohty M. Inferior outcome of allogeneic stem cell transplantation for secondary acute myeloid leukemia in first complete remission as compared to de novo acute myeloid leukemia. Blood Cancer J 2020; 10:26. [PMID: 32127519 PMCID: PMC7054545 DOI: 10.1038/s41408-020-0296-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 09/05/2019] [Accepted: 12/12/2019] [Indexed: 12/17/2022] Open
Abstract
Following chemotherapy, secondary acute myeloid leukemia (sAML), occurring after antecedent hematologic diseases, previous chemotherapy or radiation, has an inferior prognosis compared with de novo AML. To define the outcome of sAML in the context of allogeneic stem cell transplantation (alloSCT), a retrospective, registry-based comparison was performed, including 11,439 patients with de novo and 1325 with sAML. Among transplants in first complete remission (CR1) (n = 8,600), the 3-year cumulative incidence of relapse (RI) and non-relapse mortality (NRM) was 28.5% and 16.4% for de novo, and 35% and 23.4% for sAML. Three-year overall survival (OS), leukemia-free survival (LFS) and Graft-versus-Host Disease/relapse-free survival (GRFS) was 60.8%, 55.1%, and 38.6% for de novo, and 46.7%, 41.6%, and 28.4% for sAML, respectively. In multivariate analysis, sAML was associated with a lower OS (HR = 1.33 [95% CI = 1.21–1.48]; p < 10−5), LFS (HR = 1.32 [95% CI = 1.19–1.45]; p < 10−5) and GRFS (HR = 1.2 [95% CI = 1.1–1.31]; p < 10−4) and higher NRM (HR = 1.37 [95% CI = 1.17–1.59]; p < 10−4) and RI (HR = 1.27 [95% CI = 1.12–1.44]; p < 10−3). Results of the Cox model were confirmed in a matched-pair analysis. In contrast, results did not differ between de novo and sAML after alloSCT in induction failure or relapse. Hence, this analysis identified sAML as an independent risk factor for outcome after alloSCT in CR1.
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Affiliation(s)
| | - Myriam Labopin
- Department of Haematology, Saint Antoine Hospital, Université Pierre et Marie Curie, INSERM UMR 938, Paris, France.,EBMT Paris study office/ CEREST-TC, Paris, France
| | - Gerard Socié
- Hopital St. Louis, Dept.of Hematology - BMT, Paris, France
| | - Maija Itälä-Remes
- HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
| | - Didier Blaise
- Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | | | | | - Jan Cornelissen
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Hematology, Rotterdam, The Netherlands
| | - Arnold Ganser
- Hannover Medical School, Department of Haematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover, Germany
| | - Dietrich Beelen
- University Hospital, Department of Bone Marrow Transplantation, Essen, Germany
| | | | | | - Bipin N Savani
- Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christoph Schmid
- Department of Hematology and Oncology, Augsburg University Hospital, Augsburg, Germany.
| | - Arnon Nagler
- EBMT Paris study office/ CEREST-TC, Paris, France.,Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Mohamad Mohty
- Department of Haematology, Saint Antoine Hospital, Université Pierre et Marie Curie, INSERM UMR 938, Paris, France
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19
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Waidhauser J, Labopin M, Esteve J, Kröger N, Cornelissen J, Gedde-Dahl T, Van Gorkom G, Finke J, Rovira M, Schaap N, Petersen E, Beelen DW, Bunjes DW, Schmid C, Nagler A, Mohty M. Allogeneic Stem Cell Transplantation for AML Patients with RUNX1 Mutation in First Complete Remission: A Study on Behalf of the ALWP of the EBMT. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.072] [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: 11/28/2022]
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20
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Saraceni F, Labopin M, Forcade E, Kroger N, Socié G, Niittyvuopio R, Cornelissen J, Labussière-Wallet H, Blaise D, Choi G, Byrne J, Guillerm G, Lamy T, Esteve J, Bazarbachi A, Savani B, Nagler A, Mohty M. Allogeneic Stem Cell Transplantation in Patients with Acute Myeloid Leukemia and Poor Karnofsky Performance Status Score. a Study from the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT). Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.615] [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: 10/25/2022]
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21
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Saraceni F, Labopin M, Niittyvuopio R, Socié G, Kroger N, Forcade E, Browne P, Remenyi P, Cornelissen J, Robinson S, Yakoub-Agha I, Lamy T, Brissot E, Savani B, Nagler A, Mohty M. Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Acute Lymphoblastic Leukemia and Poor Karnofsky Performance Status. a Study from the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT). Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.616] [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: 10/25/2022]
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22
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Poiré X, Labopin M, Polge E, Volin L, Finke J, Ganser A, Blaise D, Yakoub‐Agha I, Beelen D, Forcade E, Lioure B, Socié G, Niederwieser D, Labussière‐Wallet H, Maertens J, Cornelissen J, Craddock C, Mohty M, Esteve J, Nagler A. The impact of concomitant cytogenetic abnormalities on acute myeloid leukemia with monosomy 7 or deletion 7q after HLA-matched allogeneic stem cell transplantation. Am J Hematol 2020; 95:282-294. [PMID: 31876307 DOI: 10.1002/ajh.25714] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/26/2019] [Accepted: 12/04/2019] [Indexed: 12/19/2022]
Abstract
Monosomy 7 or deletion 7q (-7/7q-) is the most frequent adverse cytogenetic features reported in acute myeloid leukemia (AML), and is a common indication for allogeneic stem cell transplantation (SCT). Nevertheless, -7/7q- occurs frequently with other high-risk cytogenetic abnormalities such as complex karyotype (CK), monosomal karyotype (MK), monosomy 5 or deletion 5q (-5/5q-), 17p abnormalities (abn(17p)) or inversion of chromosome 3 (inv(3)), the presence of which may influence the outcomes after SCT. A total of 1109 patients were allocated to this study. Two-year probability of leukemia-free survival (LFS) and overall survival (OS) were 30% and 36%, respectively. Two-year probability of non-relapse mortality (NRM) was 20%. We defined five different cytogenetic subgroups: the "-7/7q- ± CK group- designated group1," the "MK group-designated group 2," the "-5/5q- group- designated group 3," the "abn(17p) group- designated group 4" and the "inv(3) group- designated group 5." The 2-year probability of LFS in first remission was 48% for group 1, 36.4% for group 2, 28.4% for group 3, 19.1% for group 4 and 17.3% for group 5, respectively (P < .001). Multivariate analysis confirmed those significant differences across groups. Note, SCT in -7/7q- AML provides durable responses in one third of the patients. The presence of -7/7q- with or without CK in the absence of MK, abn(17p) or inv(3) is associated with a better survival after SCT. On the contrary, addition of MK, -5/5q-, abn(17p) or inv(3) identifies a sub-group of patients with poor prognosis even after SCT.
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Affiliation(s)
- Xavier Poiré
- Section of HematologyCliniques Universitaires St‐Luc Brussels Belgium
| | - Myriam Labopin
- Acute Leukemia Working Party of the EBMT
- Sorbonne Université Paris France
- INSERM UMR 938 Paris France
- Service d'HématologieHôpital Saint‐Antoine Paris France
| | - Emmanuelle Polge
- Acute Leukemia Working Party of the EBMT
- Sorbonne Université Paris France
- INSERM UMR 938 Paris France
- Service d'HématologieHôpital Saint‐Antoine Paris France
| | - Liisa Volin
- HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit Helsinki Finland
| | - Jürgen Finke
- Department of Medicine‐Hematology‐OncologyUniversity of Freiburg Freiburg Germany
| | - Arnold Ganser
- Department of Hematology, Hemostasis, Oncology and Stem Cell TransplantationHannover Medical School Hannover Germany
| | - Didier Blaise
- Institut Paoli Calmette, Programme de Transplantation & Therapie Cellulaire Marseille France
| | | | - Dietrich Beelen
- Department of Bone Marrow TransplantationUniversity Hospital Essen Germany
| | | | | | - Gérard Socié
- Department of Hematology, Bone Marrow TransplantationHôpital Saint‐Louis Paris France
| | - Dietger Niederwieser
- Division of Hematology, Oncology and HemostasiologyUniversity Hospital Leipzig Leipzig Germany
| | | | | | - Jan Cornelissen
- Department of HematologyErasmus MC Cancer Institute Rotterdam The Netherlands
| | - Charles Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital Birmingham UK
| | - Mohamad Mohty
- Acute Leukemia Working Party of the EBMT
- Sorbonne Université Paris France
- INSERM UMR 938 Paris France
- Service d'HématologieHôpital Saint‐Antoine Paris France
| | - Jordi Esteve
- Hematology DepartmentHospital Clinic, IDIBAPS, Josep Carreras Leukemia Research Institute Barcelona Spain
| | - Arnon Nagler
- Acute Leukemia Working Party of the EBMT
- Chaim Sheba Medical Center Tel‐Hashomer Israël
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23
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Sanz J, Galimard JE, Labopin M, Afanasyev B, Angelucci E, Ciceri F, Blaise D, Cornelissen J, Meijer E, Diez-Martin JL, Koc Y, Rovira M, Castagna L, Savani B, Ruggeri A, Nagler A, Mohty M. Comparison of Matched Sibling, Unrelated and Haploidentical Donor Transplants Using Post-Transplant Cyclophosphamide in Patients with Acute Myeloid Leukemia, a Study of the ALWP EBMT. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.132] [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: 10/25/2022]
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24
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Poiré X, Labopin M, Polge E, Forcade E, Ganser A, Volin L, Michallet M, Blaise D, Yakoub-Agha I, Maertens J, Espiga CR, Cornelissen J, Finke J, Mohty M, Esteve J, Nagler A. Allogeneic stem cell transplantation using HLA-matched donors for acute myeloid leukemia with deletion 5q or monosomy 5: a study from the Acute Leukemia Working Party of the EBMT. Haematologica 2020; 105:414-423. [PMID: 31048355 PMCID: PMC7012466 DOI: 10.3324/haematol.2019.216168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 01/07/2019] [Accepted: 04/24/2019] [Indexed: 01/12/2023] Open
Abstract
Deletion 5q or monosomy 5 (-5/5q-) in acute myeloid leukemia (AML) is a common high-risk feature that is referred to allogeneic stem cell transplantation. However, -5/5q- is frequently associated with other high-risk cytogenetic aberrations such as complex karyotype, monosomal karyotype, monosomy 7 (-7), or 17p abnormalities (abn (17p)), the significance of which is unknown. In order to address this question, we studied adult patients with AML harboring -5/5q- having their first allogeneic transplantation between 2000 and 2015. Five hundred and one patients with -5/5q- have been analyzed. Three hundred and thirty-eight patients (67%) were in first remission and 142 (28%) had an active disease at time of allogeneic transplantation. The 2-year probabilities of overall survival and leukemia-free survival were 27% and 20%, respectively. The 2-year probability of treatment-related mortality was 20%. We identified four different cytogenetic groups according to additional abnormalities with prognostic impact: -5/5q- without complex karyotype, monosomal karyotype or abn(17p), -5/5q- within a complex karyotype, -5/5q- within a monosomal karyotype and the combination of -5/5q- with abn(17p). In multivariate analysis, factors associated with worse overall survival and leukemia-free survival across the four groups were active disease, age, monosomal karyotype, and abn(17p). The presence of -5/5q- without monosomal karyotype or abn(17p) was associated with a significantly better survival rate while -5/5q- in conjunction with monosomal karyotype or abn(17p) translated into a worse outcome. The patients harboring the combination of -5/5q- with abn(17p) showed very limited benefit from allogeneic transplantation.
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Affiliation(s)
- Xavier Poiré
- Section of Hematology, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Myriam Labopin
- Acute Leukemia Working Party of the EBMT.,Sorbonne Université, Paris, France.,INSERM UMR 938, Paris, France.,Service d'Hématologie, Hôpital Saint-Antoine, Paris, France
| | - Emmanuelle Polge
- Acute Leukemia Working Party of the EBMT.,Sorbonne Université, Paris, France.,INSERM UMR 938, Paris, France.,Service d'Hématologie, Hôpital Saint-Antoine, Paris, France
| | | | - Arnold Ganser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Liisa Volin
- HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
| | | | - Didier Blaise
- Institut Paoli Calmette, Programme de Transplantation Thérapie Cellulaire, Marseille, France
| | | | | | - Carlos Richard Espiga
- Servicio de Hematologica-Hemoterapia, Hospital U. Marquès de Valdecilla, Santander, Spain
| | - Jan Cornelissen
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Jürgen Finke
- Department of Medicine-Hematology-Oncology, University of Freiburg, Freiburg, Germany
| | - Mohamad Mohty
- Acute Leukemia Working Party of the EBMT.,Sorbonne Université, Paris, France.,INSERM UMR 938, Paris, France.,Service d'Hématologie, Hôpital Saint-Antoine, Paris, France
| | - Jordi Esteve
- Hematology Department, Hospital Clinic, Barcelona, Spain
| | - Arnon Nagler
- Acute Leukemia Working Party of the EBMT.,Sorbonne Université, Paris, France.,Chaim Sheba Medical Center, Tel-Hashomer, Israel
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25
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Akand M, Muilwijk T, Cornelissen J, Van Bruwaene S, Vander Eeckt K, Baekelandt F, Mattelaer P, Van Reusel R, Van Cleynenbreugel B, Joniau S, Van Der Aa F. Development of a Prospective Data Registry System for Non-muscle-Invasive Bladder Cancer Patients Incorporated in the Electronic Patient File System. Front Oncol 2019; 9:1402. [PMID: 31921659 PMCID: PMC6917611 DOI: 10.3389/fonc.2019.01402] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/27/2019] [Indexed: 11/26/2022] Open
Abstract
Purpose: To develop a prospective non-muscle-invasive bladder cancer (NMIBC) data registry by generating NMIBC-specific electronic case report forms (eCRFs) in our institution's electronic patient file system, and to report on the development and implementation of a prospective multicentric registry. Methods: Templates for data collection, including clinical outcome parameters and quality indicators, were developed in InfoPath™ as an eCRF and were incorporated in our hospital's electronic patient file system. Quality parameters for managing NMIBC patients that were identified by comprehensive literature review were included in the eCRFs. Three separate eCRFs were developed for the management of NMIBC patients: surgery report, bladder instillation form, and multidisciplinary team form. Results: In August 2013, we started a Flemish prospective clinical and pathological data registry for all patients undergoing transurethral resection of bladder tumor (TURBT) for NMIBC in four participating hospitals, three of which continued using this to date. Three more hospitals started enrolling in 2017, 2018, and 2019, respectively. Written reports of the registered clinical actions are automatically generated within the electronic medical file. When urologists complete these eCRFs, an automated ready-to-send letter to the general practitioner is generated. Up till May 2019, 2,756 TURBTs in 2,419 patients are included in the dataset. Currently, we are recruiting over 600 TURBTs every year. Conclusions: Easy-to-use eCRFs were developed and included in the electronic patient file system. This registration tool was implemented in 7 hospitals, 6 of which are still using it today. The register harvests important clinical data, while performing routine clinical practice. The data will be used to analyze real-life data of NMIBC patients, to challenge the existing guidelines, to create novel risk stratification tools, and to develop, monitor and validate quality parameters for NMIBC management.
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Affiliation(s)
- Murat Akand
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
- Department of Urology, School of Medicine, Selçuk University, Konya, Turkey
| | - Tim Muilwijk
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Jan Cornelissen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | | | | | | | | | | | | | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Frank Van Der Aa
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
- *Correspondence: Frank Van Der Aa
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26
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Kenter MJH, Clevers JC, Cornelissen J, Medema RH. [Environmental regulations impede cancer research and treatment]. Ned Tijdschr Geneeskd 2019; 163:D4267. [PMID: 32073791] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In order to legally conduct clinical research into new cancer treatments with medicinal products based on genetically modified organisms (GMOs) and treat cancer patients with these products, Dutch hospitals must obtain an environmental permit from the Minister of Infrastructure & Water Management. In the Netherlands, permit applications are assessed more strictly than in other EU member states, even if the products do not pose any real risk to the population and the environment. As a result, Dutch patients have to wait longer before the clinical trial or therapy with these GMO products can commence. This makes current Dutch environmental policy a serious obstacle to public health. Recently physicians and researchers have therefore pleaded with Dutch MPs for an adjustment of the lower national environmental regulations. Unfortunately, these pleas were not supported by said elected members of parliament, and the Ministry of Infrastructure & Water Management seems to be holding on to a pointless environmental permit for clinical research and treatment of cancer patients with these GMO medicinal products.
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Affiliation(s)
| | - J C Clevers
- Hubrecht Instituut, afd. Ontwikkelingsbiologie en Stamcelonderzoek, Utrecht
| | | | - René H Medema
- Nederlands Kanker Instituut-Antoni van Leeuwenhoek, afd. Celbiologie, Amsterdam
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Passweg JR, Labopin M, Christopeit M, Cornelissen J, Pabst T, Socié G, Russel N, Yakoub-Agha I, Blaise D, Gedde-Dahl T, Labussière-Wallet H, Malladi R, Forcade E, Maury S, Polge E, Lanza F, Gorin NC, Mohty M, Nagler A. Postremission Consolidation by Autologous Hematopoietic Cell Transplantation (HCT) for Acute Myeloid Leukemia in First Complete Remission (CR) and Negative Implications for Subsequent Allogeneic HCT in Second CR: A Study by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT). Biol Blood Marrow Transplant 2019; 26:659-664. [PMID: 31759159 DOI: 10.1016/j.bbmt.2019.11.021] [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: 09/23/2019] [Revised: 11/02/2019] [Accepted: 11/15/2019] [Indexed: 11/29/2022]
Abstract
After autologous hematopoietic cell transplantation (HCT) in the first complete remission (CR1), patients with acute myeloid leukemia (AML) may relapse and undergo allogeneic HCT in the second complete remission (CR2). The aim of this study was to analyze the outcome of allogeneic HCT performed in CR2 comparing patients with prior consolidation by autologous HCT versus patients with chemotherapy consolidation. Included were 2619 adults with allogeneic HCT in CR2 from 2000 to 2017 with (n = 417) or without (n = 2202) prior autologous HCT. Patient groups were not entirely comparable; patients with prior autologous HCT were younger, had less often a favorable cytogenetic profile, had more commonly donors other than matched siblings, and more often received reduced-intensity conditioning. In multivariate analysis, nonrelapse mortality risks in patients with prior autologous HCT were 1.34 (1.07 to 1.67; P = .01) after adjustment for age, cytogenetic risk, transplant year, donor, conditioning intensity, sex matching, interval diagnosis-relapse, and relapse-allogeneic HCT as compared with chemotherapy consolidation. Similarly, risks of events in leukemia-free survival and graft-versus-host disease, relapse-free survival were higher with prior autologous HCT, 1.17 (1.01 to 1.35), P = .03 and 1.18 (1.03 to 1.35), P = .02, respectively. Risk of death was also higher, 1.13 (0.97 to 1.32), P = .1, but this was not significant. Postremission consolidation with autologous HCT for AML in CR1 increases toxicity of subsequent allogeneic HCT in CR2.
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Affiliation(s)
- J R Passweg
- Division of Hematology, University Hospital Basel, Basel, Switzerland.
| | - M Labopin
- Department of Hematology and Cell Therapy, Institut National de la Santé et de la Recherche Médicale (INSERM) UMRs 938, Hopital Saint Antoine Assistance Publique-Hopitaux de Paris, Paris Sorbonne University, Paris, France
| | - M Christopeit
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Cornelissen
- Department of Hematology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, Netherlands
| | - T Pabst
- Department of Medical Oncology, University Hospital, Bern, Switzerland
| | - G Socié
- Department of Hematology-BMT, Hopital St. Louis, Paris France
| | - N Russel
- Department of Haematology, Nottingham City Hospital, Nottingham University, Nottingham, UK
| | - I Yakoub-Agha
- CHU de Lille, LIRIC, INSERM U995, université de Lille, Lille, France
| | - D Blaise
- Programme de Transplantation & Therapie Cellulaire Centre de Recherche en Cancérologie de Marseille Institut Paoli Calmettes, Marseille, France
| | - T Gedde-Dahl
- Department of Hematology, Oslo University Hospital, Rikshospitalet, and Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - R Malladi
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - E Forcade
- CHU Bordeaux, Hôpital Haut-Leveque, Pessac, France
| | - S Maury
- Service d'Hématologie, Hôpital Henri Mondor, Creteil, France
| | - E Polge
- Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT), Paris, France
| | - F Lanza
- Romagna Transplant Network, Ravenna, Italy
| | - N C Gorin
- Department of Hematology and Cell Therapy, Institut National de la Santé et de la Recherche Médicale (INSERM) UMRs 938, Hopital Saint Antoine Assistance Publique-Hopitaux de Paris, Paris Sorbonne University, Paris, France
| | - M Mohty
- Department of Hematology and Cell Therapy, Institut National de la Santé et de la Recherche Médicale (INSERM) UMRs 938, Hopital Saint Antoine Assistance Publique-Hopitaux de Paris, Paris Sorbonne University, Paris, France
| | - A Nagler
- Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Ramat Gan, Israel
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28
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Gratwohl A, Duarte R, Snowden JA, van Biezen A, Baldomero H, Apperley J, Cornelissen J, Greinix HT, Grath EM, Mohty M, Kroeger N, Nagler A, Niederwieser D, Putter H, Brand R. Pre-transplantation Risks and Transplant-Techniques in Haematopoietic Stem Cell Transplantation for Acute Leukaemia. EClinicalMedicine 2019; 15:33-41. [PMID: 31709412 PMCID: PMC6833359 DOI: 10.1016/j.eclinm.2019.07.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/06/2019] [Accepted: 07/30/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The role of conditioning intensity and stem cell source on modifying pre-transplantation risk in allogeneic haematopoietic stem cell transplantation (HSCT) is a matter of debate, but crucial when benchmarking centres. METHODS This Retrospective, multicenter exploratory-validation analysis of 9103 patients, (55.5% male, median age 50 years; 1-75 years range) with an allogeneic HSCT between 2010 and 2016 from a matched sibling (N = 8641; 95%) or matched unrelated donor (N = 462; 5%) for acute myeloid (N = 6432; 71%) or acute lymphoblastic (N = 2671; 29%) leukaemia in first complete remission, and reported by 240 centres in 30 countries to the benchmark database of the European Society for Blood and Marrow Transplantation (EBMT) searched for factors associated with use of transplant techniques (standard N = 6375;70% or reduced intensity conditioning N = 2728;30%, respectively bone marrow N = 1945;21% or peripheral blood N = 7158;79% as stem cell source), and their impact on outcome. FINDINGS Treatment groups differed significantly from baseline population (p < 0.001), and within groups regarding patient-, disease-, donor-, and centre-related pre-transplantation risk factors (p < 0.001); choice of technique did depend on pre-transplantation risk factors and centre (p < 0.001). Probability of overall survival at 5 years decreased systematically and significantly with increasing pre-transplantation risk score (score 2 vs 0/1 HR: 1·2, 95% c.i. [1·1-1·.3], p = 0.002; score 3 vs 0/1 HR: 1·5, 95% c.i. [1·3-1·7], p < 0.001; score 4/5/6 vs 0/1 HR: 1·9, 95% c.i. [1·6-2·2], p < 0.001) with no significant differences between treatment groups (likelihood ratio test on interaction: p = 0.40). Overall survival was significantly associated with selection steps and completeness of information (p < 0.001). INTERPRETATION Patients' pre-transplantation risk factors determine survival, independent of transplant techniques. Transplant techniques should be regarded as centre policy, not stratification factor in benchmarking. Selection criteria and completeness of data bias outcome. Outcomes may be improved more effectively through better identifying pre-transplantation factors as opposed to refinement of transplant techniques. FUNDING The study was funded by EBMT.
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Affiliation(s)
- Alois Gratwohl
- Hematology, Medical Faculty, University of Basel, Basel, Switzerland
- Corresponding author at: Hematology, Medical Faculty, University of Basel, Dittingerstrasse 4, CH-4053 Basel, Switzerland.
| | - Rafael Duarte
- Department of Hematology, University Hospital Puerta de Hierro Majadahonda, Madrid, Spain
| | - John A. Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Anja van Biezen
- Department of Biomedical Data Sciences, Section Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Helen Baldomero
- EBMT activity survey office, University Hospital, Basel, Switzerland
| | - Jane Apperley
- Centre for Haematology, Hammersmith Hospital, Imperial College London, United Kingdom
| | - Jan Cornelissen
- Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | | | - Mohamad Mohty
- Hematology, Hôpital St. Antoine, Paris, France
- Sorbonne University, Paris, France
| | - Nicolaus Kroeger
- Department of Stem Cell Transplantation, University Hospital Eppendorf, Hamburg, Germany
| | - Arnon Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Hein Putter
- Department of Biomedical Data Sciences, Section Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Ronald Brand
- Department of Biomedical Data Sciences, Section Medical Statistics, Leiden University Medical Centre, Leiden, the Netherlands
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29
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Styczynski J, Tridello G, Gil L, Ljungman P, Mikulska M, Ward KN, Cordonnier C, de la Camara R, Averbuch D, Knelange N, Socié G, Chevallier P, Blaise D, Yakoub-Agha I, Forcade E, Cornelissen J, Maertens J, Petersen E, Nguyen-Quoc S, Veelken H, Schaap N, Passweg J, Michallet M, Fegueux N, Deconinck E, Russell N, Basak G, Bader P, Montoto S, Kröger N, Cesaro S. Prognostic impact of EBV serostatus in patients with lymphomas or chronic malignancies undergoing allogeneic HCT. Bone Marrow Transplant 2019; 54:2060-2071. [PMID: 31363166 DOI: 10.1038/s41409-019-0627-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 04/11/2019] [Accepted: 05/20/2019] [Indexed: 11/09/2022]
Abstract
The influence of the donor (D) and recipient (R) pre-transplant Epstein-Barr Virus (EBV) serostatus on transplant outcomes (overall survival, relapse-free survival, relapse incidence, non-relapse mortality, acute and chronic GVHD) in 12,931 patients with lymphomas or chronic malignancies undergoing allogeneic hematopoietic cell transplant (allo-HCT) between 1997-2016 was analyzed. In multivariate analysis, the risk of development of chronic GVHD was increased for EBV R+/D+ (HR = 1.26; p = 0.003), R+/D- (HR = 1.21; p = 0.044), and R-/D + (HR = 1.21; p = 0.048) in comparison to R-/D- transplants. No significance was shown for other transplant outcomes; however, in univariate analysis, EBV-seropositive patients receiving grafts from EBV-seropositive donors (EBV R+/D+transplants) had inferior transplant outcomes in comparison to EBV-seronegative recipients of grafts from EBV-seronegative donors (EBV R-/D-): inferior overall survival (59.6% vs 65.9%), inferior relapse-free survival (51.1% vs 57.5%), increased incidence of chronic GVHD (49.5% vs 41.8%), and increased incidence of de novo chronic GVHD (30.5% vs 24.0%). In conclusion, an EBV-negative recipient with lymphoma or chronic malignancy can benefit from selection of an EBV-negative donor in context of chronic GVHD, while there are no preferences in donor EBV serostatus for EBV-seropositive recipient.
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Affiliation(s)
- Jan Styczynski
- Department of Pediatric Hematology and Oncology, Jurasz University Hospital, Collegium Medicum UMK Torun, Bydgoszcz, Poland.
| | - Gloria Tridello
- Pediatric Hematology Oncology, Ospedale Donna Bambino, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Lidia Gil
- Department of Hematology, Medical University, Poznan, Poland
| | - Per Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden.,Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Malgorzata Mikulska
- Division of Infectious Diseases, Department of Health Sciences, University of Genova, Ospedale Policlinco San Martino, Genova, Italy
| | | | - Catherine Cordonnier
- Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris (AP-HP) and Paris-Est-Créteil University, Creteil, France
| | | | | | | | | | | | | | - Ibrahim Yakoub-Agha
- CHU de Lille, LIRIC, INSERM U995, Université de Lille2, Lille, 59000, France
| | | | | | | | | | | | | | | | | | | | | | | | | | - Grzegorz Basak
- Department of Hematology, Medical University, Warsaw, Poland
| | - Peter Bader
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt am Main, Germany
| | - Silvia Montoto
- St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| | | | - Simone Cesaro
- Pediatric Hematology Oncology, Ospedale Donna Bambino, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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30
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Geneugelijk K, Thus KA, van Deutekom HWM, Calis JJA, Borst E, Keşmir C, Oudshoorn M, van der Holt B, Meijer E, Zeerleder S, de Groot MR, von dem Borne PA, Schaap N, Cornelissen J, Kuball J, Spierings E. Exploratory Study of Predicted Indirectly ReCognizable HLA Epitopes in Mismatched Hematopoietic Cell Transplantations. Front Immunol 2019; 10:880. [PMID: 31068946 PMCID: PMC6491737 DOI: 10.3389/fimmu.2019.00880] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/05/2019] [Indexed: 12/31/2022] Open
Abstract
HLA-mismatches in hematopoietic stem-cell transplantation are associated with an impaired overall survival (OS). The aim of this study is to explore whether the Predicted Indirectly ReCognizable HLA-Epitopes (PIRCHE) algorithm can be used to identify HLA-mismatches that are related to an impaired transplant outcome. PIRCHE are computationally predicted peptides derived from the patient's mismatched-HLA molecules that can be presented by donor-patient shared HLA. We retrospectively scored PIRCHE numbers either presented on HLA class-I (PIRCHE-I) or class-II (PIRCHE-II) for a Dutch multicenter cohort of 103 patients who received a single HLA-mismatched (9/10) unrelated donor transplant in an early phase of their disease. These patients were divided into low and high PIRCHE-I and PIRCHE-II groups, based on their PIRCHE scores, and compared using multivariate statistical analysis methods. The high PIRCHE-II group had a significantly impaired OS compared to the low PIRCHE-II group and the 10/10 reference group (HR: 1.86, 95%-CI: 1.02–3.40; and HR: 2.65, 95%-CI: 1.53–4.60, respectively). Overall, PIRCHE-II seem to have a more prominent effect on OS than PIRCHE-I. This impaired OS is probably due to an increased risk for severe acute graft-vs.-host disease. These data suggest that high PIRCHE-II scores may be used to identify non-permissible HLA mismatches within single HLA-mismatched hematopoietic stem-cell transplantations.
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Affiliation(s)
- Kirsten Geneugelijk
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Kirsten A Thus
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Jorg J A Calis
- Department of Theoretical Biology and Bioinformatics, Utrecht University, Utrecht, Netherlands
| | - Eric Borst
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Can Keşmir
- Department of Theoretical Biology and Bioinformatics, Utrecht University, Utrecht, Netherlands
| | - Machteld Oudshoorn
- Matchis Foundation, Leiden, Netherlands.,Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, Netherlands
| | - Bronno van der Holt
- HOVON Data Center, Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Ellen Meijer
- Department of Hematology, Cancer Center Amsterdam, Amsterdam UMC, VU Medical Center, Amsterdam, Netherlands
| | - Sacha Zeerleder
- Department of Hematology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Marco R de Groot
- Department of Haematology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | | | - Nicolaas Schaap
- Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Jan Cornelissen
- Department of Hematology, Erasmus Medical Center-Daniel Den Hoed Cancer Center, Rotterdam, Netherlands
| | - Jürgen Kuball
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands.,Department of Hematology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Eric Spierings
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
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31
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Schmidt-Hieber M, Tridello G, Ljungman P, Mikulska M, Knelange N, Blaise D, Socié G, Volin L, Blijlevens N, Fegueux N, Yakoub-Agha I, Forcade E, Maertens J, Chevallier P, Passweg J, Cornelissen J, Russell N, Craddock C, Bourhis JH, Marchand T, Reményi P, Cahn JY, Michallet M, Montoto S, Kröger N, Glaß B, Styczynski J. The prognostic impact of the cytomegalovirus serostatus in patients with chronic hematological malignancies after allogeneic hematopoietic stem cell transplantation: a report from the Infectious Diseases Working Party of EBMT. Ann Hematol 2019; 98:1755-1763. [PMID: 30993417 DOI: 10.1007/s00277-019-03669-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 11/09/2018] [Accepted: 03/11/2019] [Indexed: 02/02/2023]
Abstract
It has been shown recently that donor and/or recipient cytomegalovirus (CMV) seropositivity is associated with a significant overall survival (OS) decline in acute leukemia patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). We now analyzed the prognostic impact of the donor/recipient CMV serostatus in 6968 patients with chronic hematological malignancies who underwent allo-HSCT. Donor and/or recipient CMV seropositivity was associated with a significantly reduced 2-year progression-free survival (PFS, 50% vs. 52%, p = 0.03) and OS (62% vs. 65%, p = 0.01). Multivariate Cox regression analyses showed an independent negative prognostic impact of donor and/or recipient CMV seropositivity on PFS (HR, 1.1; 95% CI, 1.0-1.2; p = 0.03), OS (HR, 1.1; 95% CI, 1.0-1.2; p = 0.003), and non-relapse mortality (HR, 1.2; 95% CI, 1.0-1.3; p = 0.02). OS decline was strongest for CMV-seropositive recipients with a CMV-seronegative donor (HR, 1.2; 95% CI, 1.1-1.3), followed by CMV-seropositive patients with a CMV-seropositive donor (HR, 1.1; 95% CI, 1.0-1.2). Conversely, OS did not differ significantly between CMV-seronegative recipients allografted from a CMV-seropositive donor (HR, 1.0; 95% CI, 0.9-1.2) and patients with donor/recipient CMV seronegativity (p = 0.001 for the four groups together). Non-relapse mortality was also significantly (p = 0.01) higher for CMV-seropositive patients with a CMV-seronegative graft (HR, 1.2; 95% CI, 1.1-1.4) than for CMV-seropositive patients with a CMV-seropositive graft (HR, 1.1; 95% CI, 0.9-1.2) or CMV-seronegative recipients with a CMV-seropositive graft (HR, 1.0; 95% CI, 0.8-1.2). Donor and/or recipient CMV seropositivity still results in an OS decline in patients with chronic hematological malignancies who have undergone allo-HSCT. However, this OS decline seems to be lower than that described for acute leukemia patients previously.
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Affiliation(s)
| | | | - Per Ljungman
- Karolinska University Hospital, Stockholm, Sweden
| | - Malgorzata Mikulska
- DISSAL, Division of Infectious Diseases, University of Genova and IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | | | | | - Liisa Volin
- HUCH Comprehensive Cancer Center, Helsinki, Finland
| | | | | | | | - Edouard Forcade
- CHU Bordeaux, Service d'Hematologie et Therapie Cellulaire, Bordeaux, France
| | | | | | | | | | | | | | | | - Tony Marchand
- Centre Hospitalier Universitaire de Rennes, Rennes, France
| | | | | | | | - Silvia Montoto
- Barts Health NHS Trust London, St Bartholomew's Hospital, London, UK
| | | | - Bertram Glaß
- Clinic for Hematology and Stem Cell Transplantation, HELIOS Clinic Berlin-Buch, Berlin, Germany
| | - Jan Styczynski
- Collegium Medicum UMK, University Hospital, Bydgoszcz, Poland
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32
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Nagler A, Labopin M, Niittyvuopio R, Maertens J, Poiré X, Cornelissen J, Remenyi P, Bourhis JH, Beguin Y, Craddock C, Kerre T, Schroyens W, Savani B, Mohty M. Allogeneic Hematopoietic Cell Transplantation for Acute Myeloid Leukemia Following Total Body Irradiation- the Effect of Anti- Thymocyte Globulin on Transplant Outcome: ALWP of the EBMT Study. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.772] [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: 11/24/2022]
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33
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Tozatto-Maio K, Giannotti F, Labopin M, Ruggeri A, Volt F, Paviglianiti A, Kenzey C, Hayashi H, Cornelissen J, Michallet M, Karakasis D, Deconinck E, Rohrlich PS, de la Tour RP, Blaise D, Petersen E, D'Aveni M, Sengeloev H, Lamy T, Russell NH, Forcade E, Craddock CF, Nagler A, Gluckman E, Rocha V. Cord Blood Unit Dominance Analysis and Effect of the Winning Unit on Outcomes after Double-Unit Umbilical Cord Blood Transplantation in Adults with Acute Leukemia: A Retrospective Study on Behalf of Eurocord, the Cord Blood Committee of Cellular Therapy, Immunobiology Working Party, and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2018; 24:1657-1663. [DOI: 10.1016/j.bbmt.2018.02.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/10/2018] [Indexed: 12/22/2022]
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34
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Niederwieser D, Lowenberg B, Berdel WE, Brand R, Chalandon Y, Junghanss C, Hasenclever D, Haenel M, Maschmeyer G, Mende M, Mohty M, Ten Ossenkoppele G, Passweg J, Sayer H, Schetelig J, Schouten HC, Schwind S, Stelljes M, Vucinic V, Cornelissen J. Feasibility of HSCT vs consolidation therapy for AML patients aged 60-75 in CR1: A randomized phase III, multicentre EBMT study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.7045] [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: 11/20/2022] Open
Affiliation(s)
- Dietger Niederwieser
- Universitatsklinikum Leipzig AoR, Abt. Hamatologie und internistische Onkologie, Leipzig, Germany
| | - Bob Lowenberg
- Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Ronald Brand
- Leiden University Medical Centre, Leiden, Netherlands
| | | | - Christian Junghanss
- Department of Hematology and Oncology, University Hospital, Rostock, Germany
| | - Dirk Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Mathias Haenel
- Klinik für Innere Medizin III, Klinikum Chemnitz, Chemnitz, Germany
| | | | | | | | | | | | | | | | | | | | | | | | - Jan Cornelissen
- Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, Netherlands
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35
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Baron F, Labopin M, Ruggeri A, Mohty M, Blaise D, Chevallier P, Sanz J, Fegueux N, Cornelissen J, Rambaldi A, Savani BN, Gluckman E, Nagler A. Umbilical Cord Blood Transplantation for Secondary AML: A Retrospective Study From the Acute Leukemia Working Party of the Ebmt and Eurocord. Biol Blood Marrow Transplant 2018. [DOI: 10.1016/j.bbmt.2017.12.418] [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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36
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Jongen PJ, Ruimschotel RP, Museler-Kreijns YM, Dragstra T, Duyverman L, Valkenburg-Vissers J, Cornelissen J, Lagrand R, Donders R, Hartog A. Improved health-related quality of life, participation, and autonomy in patients with treatment-resistant chronic pain after an intensive social cognitive intervention with the participation of support partners. J Pain Res 2017; 10:2725-2738. [PMID: 29238216 PMCID: PMC5716312 DOI: 10.2147/jpr.s137609] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Despite the availability of various specific treatments, most patients with chronic pain (CP) consider their pain problem as undertreated. Recently, multiple sclerosis (MS) patients who were given an intensive 3-day social cognitive treatment with the participation of support partners experienced lasting improvements in health-related quality of life (HRQoL) and self-efficacy. In this study, a similar intervention was given to treatment-resistant CP patients with stressors, relational problems with support partner, and distress, anxiety or depression. Before and 1, 3, and 6 months after the intervention, patients completed the Euro-Qol 5 Dimensions 5 Levels (EQ-5D-5L) and Impact on Participation and Autonomy (IPA) questionnaires (primary outcomes), and the Survey Of Pain Attitudes (SOPA), the Four-Dimensional Symptom Questionnaire (4DSQ) (distress, depression, anxiety, and somatization), and Visual Analog Scale for pain intensity, whereas the support partners completed the Caregiver Strain Index (CSI) questionnaire. Differences between baseline and post-treatment were tested via paired t-tests (significance level 0.05). Of the 39 patients who were included, 34 (87.2%) completed the 3-day treatment. At 1, 3, and 6 months, improvements were seen in EQ-5D-5L-Index (+40.6%; +22.4%; +31.7%), Health Today (+61.8%; +36.3%; +46.8%), Control attitude (+45.8%; not significant [NS]; +55.0%) and decreases in IPA-Problems (−14.8%; NS; −20.4%), Harm attitude (−18.9%; −15.0%; −17.7%), Distress (−17.7%; −31.8%; −37.1%), and Depression (−37.4%; −31.4%; −35.7%) scores. The CSI score had decreased by −29.0%, −21.4%, and −25.9%, respectively. In conclusion, after an intensive 3-day social cognitive intervention, treatment-resistant CP patients experienced substantial and lasting improvements in HRQoL and in problematic limitations to participation and autonomy, in association with improvements in pain attitudes, depression, and distress. To assess whether this innovative approach may be an effective treatment for this subgroup of CP patients, future randomized controlled studies are needed.
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Affiliation(s)
- Peter Joseph Jongen
- Department of Community and Occupational Medicine, University Medical Centre Groningen, Groningen.,MS4 Research Institute, Nijmegen
| | | | | | | | | | | | | | - R Lagrand
- Fysio- en Manuele Therapie R. & Y.M. Lagrand, Rotterdam
| | - Rogier Donders
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A Hartog
- DC Klinieken Rotterdam, Rotterdam
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37
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Canaani J, Savani BN, Labopin M, Michallet M, Craddock C, Socié G, Volin L, Maertens JA, Crawley C, Blaise D, Ljungman PT, Cornelissen J, Russell N, Baron F, Gorin N, Esteve J, Ciceri F, Schmid C, Giebel S, Mohty M, Nagler A. ABO incompatibility in mismatched unrelated donor allogeneic hematopoietic cell transplantation for acute myeloid leukemia: A report from the acute leukemia working party of the EBMT. Am J Hematol 2017; 92:789-796. [PMID: 28439910 DOI: 10.1002/ajh.24771] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 04/13/2017] [Accepted: 04/18/2017] [Indexed: 11/12/2022]
Abstract
ABO incompatibility is commonly observed in stem cell transplantation and its impact in this setting has been extensively investigated. HLA-mismatched unrelated donors (MMURD) are often used as an alternative stem cell source but are associated with increased transplant related complications. Whether ABO incompatibility affects outcome in MMURD transplantation for acute myeloid leukemia (AML) patients is unknown. We evaluated 1,013 AML patients who underwent MMURD transplantation between 2005 and 2014. Engraftment rates were comparable between ABO matched and mismatched patients, as were relapse incidence [34%; 95% confidence interval (CI), 28-39; for ABO matched vs. 36%; 95% CI, 32-40; for ABO mismatched; P = .32], and nonrelapse mortality (28%; 95% CI, 23-33; for ABO matched vs. 25%; 95% CI, 21-29; for ABO mismatched; P = .2). Three year survival was 40% for ABO matched and 43% for ABO mismatched patients (P = .35), Leukemia free survival rates were also comparable between groups (37%; 95% CI, 32-43; for ABO matched vs. 38%; 95% CI, 33-42; for ABO mismatched; P = .87). Incidence of grade II-IV acute graft versus host disease was marginally lower in patients with major ABO mismatching (Hazard ratio of 0.7, 95% CI, 0.5-1; P = .049]. ABO incompatibility probably has no significant clinical implications in MMURD transplantation.
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Affiliation(s)
- Jonathan Canaani
- Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Tel Aviv University; Israel
| | | | - Myriam Labopin
- Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy; Hȏpital Saint-Antoine; Paris
- INSERM UMR 938; Paris France
- Université Pierre et Marie Curie; Paris France
| | - Mauricette Michallet
- Centre Hospitalier Lyon Sud; Hematological Unit, Hospices Civils de Lyon; France
| | - Charles Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital; Birmingham United Kingdom
| | - Gerard Socié
- Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy; Hȏpital Saint-Antoine; Paris
| | - Lisa Volin
- HUH, Comprehensive Cancer Center, Stem Cell Transplantation Unit; Helsinki Finland
| | | | | | - Didier Blaise
- Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes; Marseille France
| | - Per T. Ljungman
- Department of Hematology; Karolinska University Hospital; Stockholm Sweden
| | - Jan Cornelissen
- Department of Hematology; Erasmus MC Cancer Institute, University Medical Center Rotterdam; The Netherlands
| | - Nigel Russell
- Department of Haematology; City Hospital, Nottingham University NHS Trust; Nottingham United Kingdom
| | - Frédéric Baron
- Department of Medicine, Division of Hematology; CHU of Liège; Liège Belgium
| | - Norbert Gorin
- INSERM UMR 938; Paris France
- Université Pierre et Marie Curie; Paris France
| | - Jordi Esteve
- Department of Hematology; Hospital Clinic; Barcelona Spain
| | - Fabio Ciceri
- Department of Hematology; Ospedale San Raffaele, Università degli Studi; Milano Italy
| | - Christoph Schmid
- Klinikum Augsburg, Department of Hematology and Oncology; University of Munich; Augsburg Germany
| | - Sebastian Giebel
- Maria Sklodowska-Curie Cancer Center and Institute of Oncology; Gliwice Branch Poland
| | - Mohamad Mohty
- INSERM UMR 938; Paris France
- Université Pierre et Marie Curie; Paris France
| | - Arnon Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Tel Aviv University; Israel
- Acute Leukemia Working Party-EBMT and Department of Hematology and Cell Therapy; Hȏpital Saint-Antoine; Paris
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38
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Canaani J, Labopin M, Socié G, Nihtinen A, Huynh A, Cornelissen J, Deconinck E, Gedde-Dahl T, Forcade E, Chevallier P, Bourhis JH, Blaise D, Mohty M, Nagler A. Long term impact of hyperleukocytosis in newly diagnosed acute myeloid leukemia patients undergoing allogeneic stem cell transplantation: An analysis from the acute leukemia working party of the EBMT. Am J Hematol 2017; 92:653-659. [PMID: 28370339 DOI: 10.1002/ajh.24737] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/19/2017] [Accepted: 03/20/2017] [Indexed: 11/09/2022]
Abstract
Up to 20% of acute myeloid leukemia (AML) patients present initially with hyperleukocytosis, placing them at increased risk for early mortality during induction. Yet, it is unknown whether hyperleukocytosis still retains prognostic value for AML patients undergoing hematopoietic stem cell transplantation (HSCT). Furthermore, it is unknown whether hyperleukocytosis holds prognostic significance when modern molecular markers such as FLT3-ITD and NPM1 are accounted for. To determine whether hyperleukocytosis is an independent prognostic factor influencing outcome in transplanted AML patients we performed a retrospective analysis using the registry of the acute leukemia working party of the European Society of Blood and Marrow Transplantation. A cohort of 357 patients with hyperleukocytosis (159 patients with white blood count [WBC] 50 K-100 K, 198 patients with WBC ≥ 100 K) was compared to 918 patients without hyperleukocytosis. Patients with hyperleukocytosis were younger, had an increased rate of favorable risk cytogenetics, and more likely to be FLT3 and NPM1 mutated. In multivariate analysis, hyperleukocytosis was independently associated with increased relapse incidence (hazard ratio [HR] of 1.55, 95% confidence interval [CI], 1.14-2.12; P = .004), decreased leukemia-free survival (HR of 1.38, 95% CI, 1.07-1.78; P = .013), and inferior overall survival (HR of 1.4, 95% CI, 1.07-1.84; P = .013). Hyperleukocytosis retains a significant prognostic role for AML patients undergoing HSCT.
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Affiliation(s)
- Jonathan Canaani
- Hematology Division; Chaim Sheba Medical Center, Tel Aviv University; Israel
| | - Myriam Labopin
- Acute Leukemia Working Party -EBMT and Department of Hematology and Cell Therapy; Hȏpital Saint-Antoine; Paris France
- INSERM UMR 938; Paris France
- Université Pierre et Marie Curie; Paris France
| | | | - Anne Nihtinen
- HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit; Helsinki Finland
| | - Anne Huynh
- Institut Universitaire du Cancer Toulouse, Oncopole; Toulouse France
| | - Jan Cornelissen
- Department of Hematology; Erasmus MC Cancer Institute, University Medical Center Rotterdam; Rotterdam The Netherlands
| | - Eric Deconinck
- Hopital Jean Minjoz, Service d`Hématologie; Besancon France
| | - Tobias Gedde-Dahl
- Department of Hematology; Clinic for Cancer, Surgery and Transplantation, Oslo University Hospital; Rikshospitalet Oslo Norway
| | | | | | - Jean H. Bourhis
- Division of Hematology; Department of Medical Oncology, Gustave Roussy institut de cancérologie, BMT Service; Villejuif France
| | - Didier Blaise
- Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes; Marseille France
| | - Mohamad Mohty
- Acute Leukemia Working Party -EBMT and Department of Hematology and Cell Therapy; Hȏpital Saint-Antoine; Paris France
- INSERM UMR 938; Paris France
- Université Pierre et Marie Curie; Paris France
| | - Arnon Nagler
- Hematology Division; Chaim Sheba Medical Center, Tel Aviv University; Israel
- Acute Leukemia Working Party -EBMT and Department of Hematology and Cell Therapy; Hȏpital Saint-Antoine; Paris France
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39
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Canaani J, Beohou E, Labopin M, Socié G, Huynh A, Volin L, Cornelissen J, Milpied N, Gedde-Dahl T, Deconinck E, Fegueux N, Blaise D, Mohty M, Nagler A. Impact of FAB classification on predicting outcome in acute myeloid leukemia, not otherwise specified, patients undergoing allogeneic stem cell transplantation in CR1: An analysis of 1690 patients from the acute leukemia working party of EBMT. Am J Hematol 2017; 92:344-350. [PMID: 28052366 DOI: 10.1002/ajh.24640] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/15/2016] [Accepted: 01/03/2017] [Indexed: 12/13/2022]
Abstract
The French, American, and British (FAB) classification system for acute myeloid leukemia (AML) is extensively used and is incorporated into the AML, not otherwise specified (NOS) category in the 2016 WHO edition of myeloid neoplasm classification. While recent data proposes that FAB classification does not provide additional prognostic information for patients for whom NPM1 status is available, it is unknown whether FAB still retains a current prognostic role in predicting outcome of AML patients undergoing allogeneic stem cell transplantation. Using the European Society of Blood and Bone Marrow Transplantation registry we analyzed outcome of 1690 patients transplanted in CR1 to determine if FAB classification provides additional prognostic value. Multivariate analysis revealed that M6/M7 patients had decreased leukemia free survival (hazard ratio (HR) of 1.41, 95% confidence interval (CI), 1.01-1.99; P = .046) in addition to increased nonrelapse mortality (NRM) rates (HR, 1.79; 95% CI, 1.06-3.01; P = .028) compared with other FAB types. In the NPM1wt AML, NOS cohort, FAB M6/M7 was also associated with increased NRM (HR, 2.17; 95% CI, 1.14-4.16; P = .019). Finally, in FLT3-ITD+ patients, multivariate analyses revealed that specific FAB types were tightly associated with adverse outcome. In conclusion, FAB classification may predict outcome following transplantation in AML, NOS patients.
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Affiliation(s)
- Jonathan Canaani
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer; Tel Aviv University; Israel
| | - Eric Beohou
- Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Universite Pierre & Marie Curie; Paris France
- EBMT Acute Leukemia Working Party office, Hôpital Saint-Antoine; Paris France
| | - Myriam Labopin
- Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Universite Pierre & Marie Curie; Paris France
- EBMT Acute Leukemia Working Party office, Hôpital Saint-Antoine; Paris France
| | - Gerard Socié
- EBMT Acute Leukemia Working Party office, Hôpital Saint-Antoine; Paris France
| | - Anne Huynh
- Institut Universitaire du Cancer Toulouse, Oncopole; Toulouse France
| | - Liisa Volin
- HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit; Helsinki Finland
| | - Jan Cornelissen
- Department of Hematology; Erasmus MC Cancer Institute, University Medical Center Rotterdam; Rotterdam The Netherlands
| | - Noel Milpied
- CHU Bordeaux, Hôpital Haut-leveque; Pessac France
| | - Tobias Gedde-Dahl
- Department of Hematology, Clinic for Cancer, Surgery and Transplantation; Oslo University Hospital, Rikshospitalet; Oslo Norway
| | - Eric Deconinck
- Service d`Hématologie; Hopital Jean Minjoz; Besancon France
| | - Nathalie Fegueux
- Département d`Hématologie Clinique; CHU Lapeyronie; Montpellier France
| | - Didier Blaise
- Centre de Recherche en Cancérologie de Marseille; Programme de Transplantation & Therapie Cellulaire; Marseille France
| | - Mohamad Mohty
- Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Universite Pierre & Marie Curie; Paris France
| | - Arnon Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer; Tel Aviv University; Israel
- EBMT Acute Leukemia Working Party office, Hôpital Saint-Antoine; Paris France
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40
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Dolstra H, Roeven MWH, Spanholtz J, Hangalapura BN, Tordoir M, Maas F, Leenders M, Bohme F, Kok N, Trilsbeek C, Paardekooper J, van der Waart AB, Westerweel PE, Snijders TJF, Cornelissen J, Bos G, Pruijt HFM, de Graaf AO, van der Reijden BA, Jansen JH, van der Meer A, Huls G, Cany J, Preijers F, Blijlevens NMA, Schaap NM. Successful Transfer of Umbilical Cord Blood CD34 + Hematopoietic Stem and Progenitor-derived NK Cells in Older Acute Myeloid Leukemia Patients. Clin Cancer Res 2017; 23:4107-4118. [PMID: 28280089 DOI: 10.1158/1078-0432.ccr-16-2981] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 12/21/2016] [Accepted: 03/07/2017] [Indexed: 11/16/2022]
Abstract
Purpose: Older acute myeloid leukemia (AML) patients have a poor prognosis; therefore, novel therapies are needed. Allogeneic natural killer (NK) cells have been adoptively transferred with promising clinical results. Here, we report the first-in-human study exploiting a unique scalable NK-cell product generated ex vivo from CD34+ hematopoietic stem and progenitor cells (HSPC) from partially HLA-matched umbilical cord blood units.Experimental Design: Ten older AML patients in morphologic complete remission received an escalating HSPC-NK cell dose (between 3 and 30 × 106/kg body weight) after lymphodepleting chemotherapy without cytokine boosting.Results: HSPC-NK cell products contained a median of 75% highly activated NK cells, with <1 × 104 T cells/kg and <3 × 105 B cells/kg body weight. HSPC-NK cells were well tolerated, and neither graft-versus-host disease nor toxicity was observed. Despite no cytokine boosting being given, transient HSPC-NK cell persistence was clearly found in peripheral blood up to 21% until day 8, which was accompanied by augmented IL15 plasma levels. Moreover, donor chimerism up to 3.5% was found in bone marrow. Interestingly, in vivo HSPC-NK cell maturation was observed, indicated by the rapid acquisition of CD16 and KIR expression, while expression of most activating receptors was sustained. Notably, 2 of 4 patients with minimal residual disease (MRD) in bone marrow before infusion became MRD negative (<0.1%), which lasted for 6 months.Conclusions: These findings indicate that HSPC-NK cell adoptive transfer is a promising, potential "off-the-shelf" translational immunotherapy approach in AML. Clin Cancer Res; 23(15); 4107-18. ©2017 AACR.
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Affiliation(s)
- Harry Dolstra
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
| | - Mieke W H Roeven
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.,Department of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | | | - Basav N Hangalapura
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | | | - Frans Maas
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Marij Leenders
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Fenna Bohme
- Glycostem Therapeutics, Oss, the Netherlands
| | - Nina Kok
- Glycostem Therapeutics, Oss, the Netherlands
| | - Carel Trilsbeek
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Jos Paardekooper
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Anniek B van der Waart
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | | | | | - Jan Cornelissen
- Department of Hematology, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands
| | - Gerard Bos
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Hans F M Pruijt
- Department of Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Aniek O de Graaf
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Bert A van der Reijden
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Joop H Jansen
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Arnold van der Meer
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Gerwin Huls
- Department of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Jeannette Cany
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Frank Preijers
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Nicolaas M Schaap
- Department of Hematology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
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41
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Gorin NC, Labopin M, Czerw T, Pabst T, Blaise D, Dumas PY, Nemet D, Arcese W, Trisolini SM, Wu D, Huynh A, Zuckerman T, Meijer E, Cagirgan S, Cornelissen J, Houhou M, Polge E, Mohty M, Nagler A. Autologous stem cell transplantation for adult acute myelocytic leukemia in first remission-Better outcomes after busulfan and melphalan compared with busulfan and cyclophosphamide: A retrospective study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT). Cancer 2016; 123:824-831. [PMID: 27906458 DOI: 10.1002/cncr.30400] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 08/08/2016] [Accepted: 08/24/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Autologous stem cell transplantation (ASCT) for adult acute myelogenous leukemia (AML) is a valid therapeutic option for patients with good-risk and intermediate-risk disease. The authors used the registry of the European Society for Blood and Marrow Transplantation to compare combined busulfan and melphalan (BUMEL) with combined busulfan and cyclophosphamide (BUCY) before transplantation. METHODS From 2005 to 2013, 853 patients with available cytogenetics underwent ASCT in first remission, including 257 after receiving BUMEL and 596 after receiving BUCY. The proportion of patients with good-risk AML was lower in those who received BUMEL (14% vs 20%; P = .02). More patients who received BUMEL underwent autograft in molecular remission (89% vs 78%; P = .02). Three years after transplantation, the relapse incidence (RI) was 48.7%, the leukemia-free survival (LFS) rate was 47.7%, the overall survival (OS) rate was 66.2%, and the nonrelapse mortality (NRM) rate was 3.6%. RESULTS Patients who underwent an autograft after receiving BUMEL fared better than those who underwent an autograft after receiving BUCY with a lower RI (39.5% vs 52.2%; hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.49-0.87; P = .003) a better LFS (55.4% vs 44.6%; HR, 0.69; 95% CI, 0.53-0.89; P = .005), and a better OS (73.8% vs 63%; HR, 0.62; 95% CI, 0.47-0.82; P = .0007). There was no difference in the NRM rate (BUMEL vs BUCY, 4.5% vs 3.2%, respectively). Among 74 patients in the BUMEL group and 187 in the BUCY group who underwent autograft in molecular remission, the RI was 30% versus 51%, respectively (univariate analysis; P = .01), and the LFS rate was 66% versus 47%, respectively (univariate analysis; P = .03). CONCLUSIONS In patients with AML in first complete remission who undergo ASCT, the BUMEL combination is a better preparative regimen. Cancer 2017;123:824-31. © 2016 American Cancer Society.
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Affiliation(s)
- Norbert-Claude Gorin
- Department of Hematology and Cellular Therapy, European Society for Blood and Marrow Transplantation (EBMT), National Institute of Health and Medical Research (INSERM) Unit 938, St. Antoine Public Assistance Hospital, Pierre and Marie Curie University, Paris, France.,EBMT Office, INSERM Unit 938, St. Antoine Public Assistance Hospital, Pierre and Marie Curie University, Paris, France
| | - Myriam Labopin
- EBMT Office, INSERM Unit 938, St. Antoine Public Assistance Hospital, Pierre and Marie Curie University, Paris, France
| | - Tomasz Czerw
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Thomas Pabst
- Department of Oncology, University Hospital Bern, Bern, Switzerland
| | - Didier Blaise
- Aix Marseille University, CNRS, INSERM, CRCM, Institut Paoli-calmettes, Marseille, France
| | - Pierre-Yves Dumas
- Department of Hematology, Haut-Leveque Hospital, University Hospital Center of Bordeaux, Pessac, France
| | - Damir Nemet
- Department of Hematology, University Hospital Center Rebro, Zagreb, Croatia
| | - William Arcese
- Stem Cell Transplant Unit, Rome Transplant Network, Tor Vergata University Polyclinic, Tor Vergata University, Rome, Italy
| | - Silvia Maria Trisolini
- Department of Cellular Biotechnology and Hematology, Louisiana Sapienza University, Rome, Italy
| | - Depei Wu
- Department of Hematology, First Affiliated Hospital of Soochow University, Suzhou Jiangsu, China
| | - Anne Huynh
- The Cancer University Institute of Toulouse Oncopole, Toulouse, France
| | - Tsila Zuckerman
- Department of Hematology and Bone Marrow Transplantation, Rambam Medical Center, Haifa, Israel.,Technion-Israel Institute of Technology, Haifa, Israel
| | - Ellen Meijer
- Department of Hematology, Free University Medical Center, Amsterdam, the Netherlands
| | - Seckin Cagirgan
- Department of Hematology, Ege University Medical School, Izmir, Turkey
| | - Jan Cornelissen
- Daniel den Hoed Cancer Center, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Mohamed Houhou
- Department of Hematology and Cellular Therapy, European Society for Blood and Marrow Transplantation (EBMT), National Institute of Health and Medical Research (INSERM) Unit 938, St. Antoine Public Assistance Hospital, Pierre and Marie Curie University, Paris, France
| | - Emmanuelle Polge
- Department of Hematology and Cellular Therapy, European Society for Blood and Marrow Transplantation (EBMT), National Institute of Health and Medical Research (INSERM) Unit 938, St. Antoine Public Assistance Hospital, Pierre and Marie Curie University, Paris, France
| | - Mohamad Mohty
- Department of Hematology and Cellular Therapy, European Society for Blood and Marrow Transplantation (EBMT), National Institute of Health and Medical Research (INSERM) Unit 938, St. Antoine Public Assistance Hospital, Pierre and Marie Curie University, Paris, France
| | - Arnon Nagler
- EBMT Office, INSERM Unit 938, St. Antoine Public Assistance Hospital, Pierre and Marie Curie University, Paris, France.,Department of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel Hashomer, Israel
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42
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Saraceni F, Labopin M, Gorin NC, Blaise D, Tabrizi R, Volin L, Cornelissen J, Cahn JY, Chevallier P, Craddock C, Wu D, Huynh A, Arcese W, Mohty M, Nagler A. Matched and mismatched unrelated donor compared to autologous stem cell transplantation for acute myeloid leukemia in first complete remission: a retrospective, propensity score-weighted analysis from the ALWP of the EBMT. J Hematol Oncol 2016; 9:79. [PMID: 27589849 PMCID: PMC5009662 DOI: 10.1186/s13045-016-0314-x] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 08/26/2016] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Optimal post-remission strategy for patients with acute myeloid leukemia (AML) is matter of intense debate. Recent reports have shown stronger anti-leukemic activity but similar survival for allogeneic stem cell transplantation (allo-HSCT) from matched sibling donor compared to autologous transplantation (auto-HSCT); however, there is scarcity of literature confronting auto-HSCT with allo-HSCT from unrelated donor (UD-HSCT), especially mismatched UD-HSCT. METHODS We retrospectively compared outcome of allogeneic transplantation from matched (10/10 UD-HSCT) or mismatched at a single HLA-locus unrelated donor (9/10 UD-HSCT) to autologous transplantation in patients with AML in first complete remission (CR1). A total of 2879 patients were included; 1202 patients received auto-HSCT, 1302 10/10 UD-HSCT, and 375 9/10 UD-HSCT. A propensity score-weighted analysis was conducted to control for disease risk imbalances between the groups. RESULTS Matched 10/10 UD-HSCT was associated with the best leukemia-free survival (10/10 UD-HSCT vs auto-HSCT: HR 0.7, p = 0.0016). Leukemia-free survival was not statistically different between auto-HSCT and 9/10 UD-HSCT (9/10 UD-HSCT vs auto-HSCT: HR 0.8, p = 0.2). Overall survival was similar across the groups (10/10 UD-HSCT vs auto-HSCT: HR 0.98, p = 0.84; 9/10 UD-HSCT vs auto-HSCT: HR 1.1, p = 0.49). Notably, in intermediate-risk patients, OS was significantly worse for 9/10 UD-HSCT (9/10 UD-HSCT vs auto-HSCT: HR 1.6, p = 0.049), while it did not differ between auto-HSCT and 10/10 UD-HSCT (HR 0.95, p = 0.88). In favorable risk patients, auto-HSCT resulted in 3-year LFS and OS rates of 59 and 78 %, respectively. CONCLUSIONS Our findings suggest that in AML patients in CR1 lacking an HLA-matched sibling donor, 10/10 UD-HSCT significantly improves LFS, but this advantage does not translate in better OS compared to auto-HSCT. In intermediate-risk patients lacking a fully HLA-matched donor, auto-HSCT should be considered as a valid option, as better survival appears to be provided by auto-HSCT compared to mismatched UD-HSCT. Finally, auto-HSCT provided an encouraging outcome in patients with favorable risk AML.
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Affiliation(s)
- Francesco Saraceni
- Hematology and Bone Marrow Transplantation, Polytechnic University of Marche—Ospedali Riuniti Ancona, Via Conca 71, 60126 Ancona, Italy
| | - Myriam Labopin
- ALWP-EBMT and Department of Hematology and Cell Therapy, Saint Antoine Hospital, Paris, France
| | - Norbert-Claude Gorin
- ALWP-EBMT and Department of Hematology and Cell Therapy, Saint Antoine Hospital, Paris, France
| | - Didier Blaise
- Programme de Transplantation et Therapie Cellulaire—Institut Paoli Calmettes, Marseille, France
| | - Reza Tabrizi
- CHU Bordeaux, Hôpital Haut-Leveque, Pessac, France
| | - Liisa Volin
- HUH, Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
| | - Jan Cornelissen
- Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands
| | - Jean-Yves Cahn
- Clinique Universitaire d’Hématologie CHU Grenoble, Grenoble, France
| | | | - Charles Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - Depei Wu
- Department of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Anne Huynh
- CHU Department Hématologie, Hôpital de Purpan, Toulouse, France
| | - William Arcese
- Rome Transplant Network, Stem Cell Transplant Unit, Tor Vergata University of Rome, Rome, Italy
| | - Mohamad Mohty
- ALWP-EBMT and Department of Hematology and Cell Therapy, Saint Antoine Hospital, Paris, France
| | - Arnon Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
- ALWP-EBMT Office, Saint Antoine Hospital, Paris, France
| | - Acute Leukemia Working Party (ALWP) of the European society for Blood and Marrow Transplantation (EBMT)
- Hematology and Bone Marrow Transplantation, Polytechnic University of Marche—Ospedali Riuniti Ancona, Via Conca 71, 60126 Ancona, Italy
- ALWP-EBMT and Department of Hematology and Cell Therapy, Saint Antoine Hospital, Paris, France
- Programme de Transplantation et Therapie Cellulaire—Institut Paoli Calmettes, Marseille, France
- CHU Bordeaux, Hôpital Haut-Leveque, Pessac, France
- HUH, Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
- Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands
- Clinique Universitaire d’Hématologie CHU Grenoble, Grenoble, France
- Department D’Hématologie, CHU Nantes, Nantes, France
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
- Department of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
- CHU Department Hématologie, Hôpital de Purpan, Toulouse, France
- Rome Transplant Network, Stem Cell Transplant Unit, Tor Vergata University of Rome, Rome, Italy
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
- ALWP-EBMT Office, Saint Antoine Hospital, Paris, France
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Sobh M, Michallet M, Gahrton G, Iacobelli S, van Biezen A, Schönland S, Petersen E, Schaap N, Bonifazi F, Volin L, Meijer E, Niederwieser D, El-Cheikh J, Tabrizi R, Fegeux N, Finke J, Bunjes D, Cornelissen J, Einsele H, Bruno B, Potter M, Fanin R, Mohty M, Garderet L, Kröger N. Allogeneic hematopoietic cell transplantation for multiple myeloma in Europe: trends and outcomes over 25 years. A study by the EBMT Chronic Malignancies Working Party. Leukemia 2016; 30:2047-2054. [DOI: 10.1038/leu.2016.101] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 04/11/2016] [Accepted: 04/14/2016] [Indexed: 12/15/2022]
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44
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Styczynski J, Tridello G, Gil L, Ljungman P, Hoek J, Iacobelli S, Ward KN, Cordonnier C, Einsele H, Socie G, Milpied N, Veelken H, Chevallier P, Yakoub-Agha I, Maertens J, Blaise D, Cornelissen J, Michallet M, Daguindau E, Petersen E, Passweg J, Greinix H, Duarte RF, Kröger N, Dreger P, Mohty M, Nagler A, Cesaro S. Impact of Donor Epstein-Barr Virus Serostatus on the Incidence of Graft-Versus-Host Disease in Patients With Acute Leukemia After Hematopoietic Stem-Cell Transplantation: A Study From the Acute Leukemia and Infectious Diseases Working Parties of the European Society for Blood and Marrow Transplantation. J Clin Oncol 2016; 34:2212-20. [PMID: 27091716 DOI: 10.1200/jco.2015.64.2405] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE We investigated the effect of Epstein-Barr virus (EBV) serostatus on the overall outcome of allogeneic hematopoietic stem-cell transplantation (allo-HSCT). PATIENTS AND METHODS The study included 11,364 patients who underwent allogeneic peripheral-blood or bone marrow transplantation for acute leukemia between 1997 and 2012. We analyzed the impact of donor and recipient EBV serologic status on overall survival, relapse-free survival, relapse incidence, nonrelapse mortality, and incidence of graft-versus-host disease (GVHD) after allo-HSCT. RESULTS Patients receiving grafts from EBV-seropositive donors had the same overall survival as patients who received grafts from EBV-seronegative donors (hazard ratio [HR], 1.05; 95% CI, 0.97 to 1.12; P = .23). Seropositive donors also had no influence on relapse-free survival (HR, 1.04; 95% CI, 0.97 to 1.11; P = 0.31), relapse incidence (HR, 1.03; 95% CI, 0.94 to 1.12; P = .58), and nonrelapse mortality (HR, 1.05; 95% CI, 0.94 to 1.17; P = .37). However, in univariate analysis, recipients receiving grafts from seropositive donors had a higher risk of chronic GVHD than those with seronegative donors (40.8% v 31.0%, respectively; P < .001; HR, 1.42; 95% CI, 1.30 to 1.56). When adjusting for confounders, higher risk was identified for both acute and chronic GVHD. In seronegative patients with seropositive donors, the HR for chronic GVHD was 1.30 (95% CI, 1.06 to 1.59; P = .039). In seropositive patients with seropositive donors, the HR was 1.24 (95% CI, 1.07 to 1.45; P = .016) for acute GVHD and 1.43 (95% CI, 1.23 to 1.67; P < .001) for chronic GVHD. Seropositive patients with seronegative donors did not have an increased risk of GVHD. CONCLUSION Our data suggest that donor EBV status significantly influences development of acute and chronic GVHD after allo-HSCT.
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Affiliation(s)
- Jan Styczynski
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
| | - Gloria Tridello
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Lidia Gil
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Per Ljungman
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Jennifer Hoek
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Simona Iacobelli
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Katherine N Ward
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Catherine Cordonnier
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Hermann Einsele
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Gerard Socie
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Noel Milpied
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Hendrik Veelken
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Patrice Chevallier
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Ibrahim Yakoub-Agha
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Johan Maertens
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Didier Blaise
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Jan Cornelissen
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Mauricette Michallet
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Etienne Daguindau
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Eefke Petersen
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Jakob Passweg
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Hildegard Greinix
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Rafael F Duarte
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Nicolaus Kröger
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Peter Dreger
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Mohamad Mohty
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Arnon Nagler
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Simone Cesaro
- Jan Styczynski, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz; Lidia Gil, Medical University, Poznan, Poland; Gloria Tridello and Simone Cesaro, Azienda Ospedaliera Universitaria Integrata, Verona; Simona Iacobelli, Università di Roma "Tor Vergata", Roma, Italy; Per Ljungman, Karolinska University Hospital, Stockholm, Sweden; Jennifer Hoek, European Bone Marrow Transplantation Group Data Office; Hendrik Veelken, Leiden University Medical Center, Leiden; Jan Cornelissen, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam; Eefke Petersen, University Medical Centre, Utrecht, the Netherlands; Katherine N. Ward, University College London, London, United Kingdom; Catherine Cordonnier, Hôpital Henri Mondor, Assistance Publique-Hopitaux de Paris and Paris-Est-Créteil University, Creteil; Gerard Socie, Hopital St Louis; Mohamad Mohty, Saint Antoine Hospital, Paris, Institut National de la Santé et de la Recherche Médicale UMR 938, Paris; Noel Milpied, Centre Hospitalier Universitaire Bordeaux, Pessac; Patrice Chevallier, Centre Hospitalier Universitaire, Nantes; Ibrahim Yakoub-Agha, Centre Hospitalier Régional Universitaire, Lille; Didier Blaise, Centre de Recherche en Cancerologie, Marseille; Mauricette Michallet, Centre Hospitalier Lyon Sud, Pierre-Benite; Etienne Daguindau, Hopital Jean Minjoz, Besancon, France; Hermann Einsele, University Hospital, Wurzburg; Nicolaus Kröger, University Hospital Eppendorf, Hamburg; Peter Dreger, University of Heidelberg, Heidelberg, Germany; Johan Maertens, University Hospital Gasthuisberg, Leuven, Belgium; Jakob Passweg, University Hospital, Basel, Switzerland; Hildegard Greinix, Medical University of Graz, Graz, Austria; Rafael F. Duarte, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; and Arnon Nagler, Chaim Sheba Medical Center, Tel-Hashomer, Israel
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Nijskens CM, Pas SD, Cornelissen J, Caliskan K, Hoek RA, Hesselink DA, van der Eijk AA, de Man RA. Hepatitis E virus genotype 3 infection in a tertiary referral center in the Netherlands: Clinical relevance and impact on patient morbidity. J Clin Virol 2016; 74:82-7. [DOI: 10.1016/j.jcv.2015.11.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/27/2015] [Accepted: 11/29/2015] [Indexed: 01/05/2023]
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Peffault de Latour R, Labopin M, Cornelissen J, Vigouroux S, Craddock C, Blaise D, Huyn A, Vindelov L, Maertens J, Chevallier P, Fegueux N, Socié G, Cahn JY, Petersen E, Schouten H, Lioure B, Russell N, Corral LL, Ciceri F, Nagler A, Mohty M. In patients older than 55 years with AML in first CR, should we search for a matched unrelated donor when an old sibling donor is available? Bone Marrow Transplant 2015; 50:1411-5. [PMID: 26367237 DOI: 10.1038/bmt.2015.180] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/05/2015] [Accepted: 07/08/2015] [Indexed: 01/08/2023]
Abstract
Allogeneic hematopoietic transplantation is increasingly used in patients aged 55 years or more with AML. The question of whether outcomes can be improved with an allele-level 8/8 HLA-matched unrelated donor (MUD) rather than an older HLA-matched sibling (MSD, more than 55 years) is still unanswered. We thus analyzed outcomes in 714 patients aged 55 years and older with AML in first CR (CR1) who received PBSCs after a reduced-intensity conditioning hematopoietic cell transplant from a MUD (n=310) or a MSD (n=404) in a recent period (2005-2010). The 3-year cumulative incidences (CIs) of non-relapse mortality were 17% and 23% with MSD and MUD, respectively (P=0.17). The 3-year CIs of relapse were 37% and 30%, respectively (P=0.12), resulting in a 3-year CI of leukemia-free survival of 46% and 47%, respectively (P=0.51). The 3-year overall survival was 49% with both MSD and MUD. In conclusion, HLA-identical sibling donors aged 55 years or more should not be excluded because of age for patients aged 55 years and older with AML in CR1.
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Affiliation(s)
- R Peffault de Latour
- Service d'Hématologie Greffe, AP-HP-Hôpital Saint Louis, Paris, France.,Paris Diderot University, EA 3518, Paris, France
| | - M Labopin
- ALWP-EBMT, AP-HP-Hôpital Saint Antoine, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, AP-HP-Hôpital Saint Antoine, Paris, France.,Universite Pierre et Marie Curie, Paris, France.,INSERM, UMRs 938, Paris, France
| | - J Cornelissen
- Hematology Department, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands
| | - S Vigouroux
- CHU Bordeaux-Hôpital Haut-levêque, Pessac, France
| | - C Craddock
- BMT unit, Centre for Clinical Haematology-Queen Elizabeth Hospital, Birmingham, UK
| | - D Blaise
- Institut Paoli Calmettes-Unité de Transplantation et de Thérapie Cellulaire-Inserm UMR 891, Marseille, France
| | - A Huyn
- Department of Hematology, Hopital de Purpan-CHU, Toulouse, France
| | - L Vindelov
- Bone Marrow Transplant Unit L 4043, Rigshospitalet, Copenhagen, Denmark
| | - J Maertens
- Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium
| | - P Chevallier
- Department of Hematology, Hopital Hotel Dieu-CHU, Nantes, France
| | - N Fegueux
- CHU Lapeyronie-Service d'Hématologie et Oncologie, Montpellier, France
| | - G Socié
- Service d'Hématologie Greffe, AP-HP-Hôpital Saint Louis, Paris, France.,Université Paris Diderot, Paris, France.,INSERM 1160, Paris, France
| | - J Y Cahn
- Department of Hematology, University Hospital, Grenoble, France.,University Medical Centre UMR 525 CNRS, Grenoble, France
| | - E Petersen
- Department of Hematology, Utrecht, The Netherlands
| | - H Schouten
- Department Internal Medicine Hematology/Oncology, University Hospital Maastricht, Maastricht, The Netherlands
| | - B Lioure
- Department of Onco-Hematologiy, CHU Hautepierre, Strasbourg, France
| | - N Russell
- Division of Hematology and BMT, Nottingham City Hospital, Nottingham, UK
| | - L L Corral
- Hospital Clínico-Servicio de Hematología, Salamanca, Spain
| | - F Ciceri
- Hematology and BMT Unit, EBMT CIC 813, San Raffaele Scientific Institute, Milano, Italy
| | - A Nagler
- ALWP-EBMT, AP-HP-Hôpital Saint Antoine, Paris, France.,Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - M Mohty
- ALWP-EBMT, AP-HP-Hôpital Saint Antoine, Paris, France.,Service d'Hématologie Clinique et de Thérapie Cellulaire, AP-HP-Hôpital Saint Antoine, Paris, France.,Universite Pierre et Marie Curie, Paris, France.,INSERM, UMRs 938, Paris, France
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Symeonidis A, van Biezen A, de Wreede L, Piciocchi A, Finke J, Beelen D, Bornhäuser M, Cornelissen J, Volin L, Mufti G, Chalandon Y, Ganser A, Bruno B, Niederwieser D, Kobbe G, Schwerdtfeger R, de Witte T, Robin M, Kröger N. Achievement of complete remission predicts outcome of allogeneic haematopoietic stem cell transplantation in patients with chronic myelomonocytic leukaemia. A study of the Chronic Malignancies Working Party of the European Group for Blood and Marrow Trans. Br J Haematol 2015. [DOI: 10.1111/bjh.13576] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Argiris Symeonidis
- Haematology Division; Department of Internal Medicine; University of Patras Medical School; Patras Greece
| | - Anja van Biezen
- Department of Medical Statistics & Bioinformatics; Leiden University Medical Centre; Leiden the Netherlands
| | - Liesbeth de Wreede
- Department of Medical Statistics & Bioinformatics; Leiden University Medical Centre; Leiden the Netherlands
| | | | - Juergen Finke
- Department of Medicine, Haematology, Oncology; University of Freiburg; Freiburg Germany
| | - Dietrich Beelen
- Department of Bone Marrow Transplantation; University Hospital; Essen Germany
| | - Martin Bornhäuser
- Medizinische Klinik und Poliklinik I; Universitätsklinikum Technische Universität Dresden; Dresden Germany
| | - Jan Cornelissen
- Erasmus MC-Daniel den Hoed Cancer Centre; Rotterdam the Netherlands
| | - Liisa Volin
- Stem Cell Transplantation Unit; Comprehensive Cancer Centre; Helsinki University Hospital; Helsinki Finland
| | - Ghulam Mufti
- Department of Haematological Medicine; GKT School of Medicine; London UK
| | - Yves Chalandon
- Département des Spécialités de Médecine Service d'Hématologie; Hôpitaux Universitaires de Genève, and Faculty of Medicine; University of Geneva; Geneva Switzerland
| | - Arnold Ganser
- Department of Haematology; Haemostasis and Oncology and Stem Cell Transplantation; Hannover Medical School; Hannover Germany
| | - Benedetto Bruno
- Division of Haematology; Città della Salute e della Scienza di Torino; Torino Italy
- Department of Molecular Biotechnology and Health Sciences; University of Torino; Torino Italy
| | - Dietger Niederwieser
- Division of Haematology, Oncology and Haemostasiology; University of Leipzig; Leipzig Germany
| | - Guido Kobbe
- Department for Haematology, Oncology and Clinical Immunology; University Hospital Dusseldorf; Heinrich Heine University; Dusseldorf Germany
| | | | - Theo de Witte
- Department of Tumourimmunology; Radboud University Medical Centre; Nijmegen the Netherlands
| | - Marie Robin
- Department of Haematology and BMT; Hopital Saint Louis; Paris France
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation; University Medical Centre Hamburg; Hamburg Germany
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Eder S, Labopin M, Arcese W, Or R, Majolino I, Bacigalupo A, de Rosa G, Volin L, Beelen D, Veelken H, Schaap NPM, Kuball J, Cornelissen J, Nagler A, Mohty M. Thiotepa-based versus total body irradiation-based myeloablative conditioning prior to allogeneic stem cell transplantation for acute myeloid leukaemia in first complete remission: a retrospective analysis from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Eur J Haematol 2015; 96:90-7. [PMID: 25807864 DOI: 10.1111/ejh.12553] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 11/30/2022]
Abstract
Thiotepa is an alkylating compound with an antineoplastic and myeloablative activity and can mimic the effect of radiation. However, it is unknown whether this new regimen could safely replace the long-established ones. This retrospective matched-pair analysis evaluated the outcome of adults with acute myeloid leukaemia in first complete remission who received myeloablative conditioning either with a thiotepa-based (n = 121) or a cyclophosphamide/total body irradiation-based (TBI; n = 358) regimen for allogeneic hematopoietic stem cell transplantation from an HLA-matched sibling or an unrelated donor. With a median follow-up of 44 months, the outcome was similar in both groups. Acute graft-versus-host disease grade II-IV was observed in 25% after thiotepa-containing regimen versus 35% after TBI (P = 0.06). The 2-yr cumulative incidence of chronic graft-versus-host disease was 40.5% for thiotepa and 41% for TBI (P = 0.98). At 2 yrs, the cumulative incidences of non-relapse mortality and relapse incidence were 23.9% (thiotepa) vs. 22.4% (TBI; P = 0.66) and 17.2% (thiotepa) vs. 23.3% (TBI; P = 0.77), respectively. The probabilities of leukaemia-free and overall survival at 2 yrs were not significantly different between the thiotepa and TBI groups, at 58.9% vs. 54.2% (P = 0.95) and 61.4% vs. 58% (P = 0.72), respectively. Myeloablative regimens using combinations including thiotepa can provide satisfactory outcomes, but the optimal conditioning remains unclear for the individual patient in this setting.
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Affiliation(s)
- Sandra Eder
- EBMT Office Paris, Hôpital Saint-Antoine, Paris, France
| | | | - William Arcese
- Rome Transplant Network "Tor Vergata", University of Rome Stem Cell Transplant Unit, Rome, Italy
| | - Reuven Or
- Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel
| | | | | | - Gennaro de Rosa
- Division of Hematology, University of Napoli Federico II Medical School, Napoli, Italy
| | - Liisa Volin
- Helsinki University Central Hospital, Helsinki, Finland
| | - Dietrich Beelen
- Department of Bone Marrow Transplantation, University Hospital of Essen, Essen, Germany
| | - Hendrik Veelken
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicolaas P M Schaap
- Department of Hematology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jurgen Kuball
- Department of Haematology, University Medical Centre, Utrecht, The Netherlands
| | - Jan Cornelissen
- Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands
| | - Arnon Nagler
- Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Mohamad Mohty
- Service d'Hématologie et Thérapie Cellulaire, Hôpital Saint Antoine, Paris, France
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Savani BN, Labopin M, Polge E, Blaise D, Niederwieser D, Ciceri F, Ganser A, Arnold R, Afanasyev B, Milpied N, Hallek M, Cornelissen J, Schwerdtfeger R, Giebel S, Mohty M, Nagler A. Influence of Stem Cell Source (Bone Marrow versus Peripheral Blood) on Outcome after Reduced-Intensity Conditioning Regimens for Acute Leukemia—a Report from the Acute Leukemia Working Party of the EBMT. Biol Blood Marrow Transplant 2015. [DOI: 10.1016/j.bbmt.2014.11.050] [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: 10/24/2022]
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Koenecke C, Göhring G, de Wreede LC, van Biezen A, Scheid C, Volin L, Maertens J, Finke J, Schaap N, Robin M, Passweg J, Cornelissen J, Beelen D, Heuser M, de Witte T, Kröger N. Impact of the revised International Prognostic Scoring System, cytogenetics and monosomal karyotype on outcome after allogeneic stem cell transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia evolving from myelodysplastic syndromes: a retrospective multicenter study of the European Society of Blood and Marrow Transplantation. Haematologica 2014; 100:400-8. [PMID: 25552702 DOI: 10.3324/haematol.2014.116715] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The aim of this study was to determine the impact of the revised 5-group International Prognostic Scoring System cytogenetic classification on outcome after allogeneic stem cell transplantation in patients with myelodysplastic syndromes or secondary acute myeloid leukemia who were reported to the European Society for Blood and Marrow Transplantation database. A total of 903 patients had sufficient cytogenetic information available at stem cell transplantation to be classified according to the 5-group classification. Poor and very poor risk according to this classification was an independent predictor of shorter relapse-free survival (hazard ratio 1.40 and 2.14), overall survival (hazard ratio 1.38 and 2.14), and significantly higher cumulative incidence of relapse (hazard ratio 1.64 and 2.76), compared to patients with very good, good or intermediate risk. When comparing the predictive performance of a series of Cox models both for relapse-free survival and for overall survival, a model with simplified 5-group cytogenetics (merging very good, good and intermediate cytogenetics) performed best. Furthermore, monosomal karyotype is an additional negative predictor for outcome within patients of the poor, but not the very poor risk group of the 5-group classification. The revised International Prognostic Scoring System cytogenetic classification allows patients with myelodysplastic syndromes to be separated into three groups with clearly different outcomes after stem cell transplantation. Poor and very poor risk cytogenetics were strong predictors of poor patient outcome. The new cytogenetic classification added value to prediction of patient outcome compared to prediction models using only traditional risk factors or the 3-group International Prognostic Scoring System cytogenetic classification.
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Affiliation(s)
- Christian Koenecke
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Germany
| | - Gudrun Göhring
- Institute of Cell and Molecular Pathology, Hannover Medical School, Germany
| | - Liesbeth C de Wreede
- Department of Medical Statistics LUMC, Leiden, The Netherlands DKMS, German Bone Marrow Donor Center, Cologne, Germany
| | - Anja van Biezen
- Department of Medical Statistics LUMC, Leiden, The Netherlands
| | | | - Liisa Volin
- Helsinki University Central Hospital, Finland
| | | | | | - Nicolaas Schaap
- Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | | | - Jan Cornelissen
- Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands
| | | | - Michael Heuser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Germany
| | - Theo de Witte
- Radboud University Medical Centre, Nijmegen, The Netherlands
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