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Torrent A, Morgades M, García-Calduch O, de Llano MPQ, Montesinos P, Navarro I, Hernández-Rivas JM, Bárez-García A, González-Campos J, Oiartzabal I, Valero M, Cervera M, Zudaire T, Albors-Ferreiro M, López-Godino O, Gil-Cortés C, Villalón L, Saldaña R, Ribera JM. Results of the compassionate program of inotuzumab ozogamicin for adult patients with relapsed or refractory acute lymphoblastic leukemia in Spain. Eur J Haematol 2023. [PMID: 37381686 DOI: 10.1111/ejh.14031] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/30/2023]
Abstract
INTRODUCTION The prognosis of relapsed B cell precursor acute lymphoblastic leukemia (B-ALL) is poor and few patients can be successfully rescued with conventional therapies. Inotuzumab ozogamicin (IO), an antibody against the CD22 antigen linked to calicheamicin, has been approved as a rescue treatment in relapsed/refractory (R/R) B-ALL. PATIENTS AND METHODS This was an observational, retrospective, multicenter study of adult patients included in the Spanish program of compassionate use of IO in centers from the PETHEMA group (Programa Español de Tratamientos en Hematología). RESULTS Thirty-four patients with a median age of 43 years (range, 19-73) were included. Twenty patients (59%) were refractory to the last treatment, IO treatment was given as ≥3rd salvage treatment in 25 patients (73%) and 20 patients (59%) received allogeneic hematopoietic stem cell transplantation before IO treatment. After a median of 2 cycles of IO, 64% of patients achieved complete response (CR)/complete response with incomplete recovery. The median response duration, progression-free survival and overall survival (OS) were 4.7 (95%CI, 2.4-7.0 months), 3.5 (95%CI, 1.0-5.0 months) and 4 months (95%CI, 1.9-6.1 months) respectively, with better OS for patients with relapsed B-ALL versus refractory disease (10.4 vs. 2.5 months, respectively) (p = .01). There was a trend for better OS for patients with first CR duration >12 months (7.2 months [95%CI, 3.2-11.2] vs. 3 months [95% CI, 1.8-4.2] respectively) (p = .054). There was no sinusoidal obstruction syndrome (SOS) event during IO treatment, but three patients (9%) developed grade 3-4 SOS during alloHSCT after IO treatment. CONCLUSIONS Our study showed slightly inferior outcomes of the pivotal trial probably due to poorer risk factors and late onset of IO therapy of recruited patients. Our results support early use of IO in relapsed/refractory ALL patients.
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Affiliation(s)
- Anna Torrent
- Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Morgades
- Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Olga García-Calduch
- Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Pau Montesinos
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Irene Navarro
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Jesús María Hernández-Rivas
- Departamento de Medicina, Universidad de Salamanca & Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | | | | | - Itziar Oiartzabal
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Álava, Vitoria-Gasteiz, Álava, Spain
| | - Marta Valero
- Hematology Department, Hospital Arnau de Vilanova, Valencia, Spain
| | - Marta Cervera
- Hematology Department, Hospital Joan XXIII de Tarragona, Tarragona, Spain
| | - Teresa Zudaire
- Hematology Department, Hospital de Navarra, Navarra, Spain
| | | | - Oriana López-Godino
- Hematology Department, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | | | - Lucía Villalón
- Hematology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Josep-María Ribera
- Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Barcelona, Spain
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2
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Bailén R, Alenda R, Herruzo-Delgado B, Acosta-Fleitas C, Vallés A, Esquirol A, Fonseca M, Solán L, Sánchez-Vadillo I, Bautista G, Bento L, López-Godino O, Pérez-Martínez A, Torrent A, Zanabili J, Calbacho M, Moreno MÁ, Pascual-Cascón MJ, Guerra-Domínguez L, Chinea A, García-Cadenas I, López-Corral L, Boix-Giner F, López Lorenzo JL, Humala K, Duarte R, Sampol A, Heras I, Vicario JL, Balas A, Oarbeascoa G, Fernández-Caldas P, Anguita J, Kwon M. Results of haploidentical transplant in patients with donor-specific antibodies: a survey on behalf of the Spanish Group of Hematopoietic Transplant and Cell Therapy. Front Immunol 2023; 14:1165759. [PMID: 37304258 PMCID: PMC10250708 DOI: 10.3389/fimmu.2023.1165759] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/16/2023] [Indexed: 06/13/2023] Open
Abstract
Background Donor-specific antibodies (DSAs) are IgG allo-antibodies against mismatched donor HLA molecules and can cause graft failure (GF) in the setting of haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Our aim was to report the experience of the Spanish Group of Hematopoietic Transplant (GETH-TC) in DSA-positive patients who had undergone haplo-HSCT. Methods We conducted a survey of patients who underwent haplo-HSCT in GETH-TC centers between 2012 and 2021. Data were collected on the DSA assay used, monitoring strategy, complement fixation, criteria for desensitization, desensitization strategies and transplant outcomes. Results Fifteen centers from the GETH-TC responded to the survey. During the study period, 1,454 patients underwent haplo-HSCT. Seventy of the transplants were performed in 69 DSA-positive patients, all of whom lacked a suitable alternative donor; 61 (88%) patients were female (90% with prior pregnancies). All patients received post-transplant cyclophosphamide-based graft-versus-host disease prophylaxis. Regarding baseline DSA intensity, 46 (67%) patients presented mean fluorescence intensity (MFI) >5,000, including 21 (30%) with MFI >10,000 and three (4%) with MFI >20,000. Six patients did not receive desensitization treatment, four of them with MFI <5,000. Of 63 patients receiving desensitization treatment, 48 (76%) were tested after desensitization therapy, and a reduction in intensity was confirmed in 45 (71%). Three patients (5%) experienced an increase in MFI after desensitization, two of whom experienced primary GF. Cumulative incidence of neutrophil engraftment at day 28 was 74% in a median of 18 days (IQR, 15─20); six patients died before engraftment due to toxicity or infection and eight patients had primary GF despite desensitization in seven of them. After a median follow-up of 30 months, two-year overall and event-free survival were 46.5% and 39%, respectively. The two-year cumulative incidence of relapse was 16% and non-relapse mortality (NRM) was 43%. Infection was the most frequent cause of NRM, followed by endothelial toxicity. Multivariate analysis identified baseline MFI >20,000 as an independent risk factor for survival and an increase in titers after infusion as an independent risk factor for GF. Conclusions Haplo-HSCT is feasible in DSA-positive patients, with high rates of engraftment after desensitization guided by DSA intensity. Baseline MFI >20,000 and increased intensity after infusion are risk factors for survival and GF.
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Affiliation(s)
- Rebeca Bailén
- Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Translational Oncology Section, Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Raquel Alenda
- Department of Histocompatibility, Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | - Beatriz Herruzo-Delgado
- Department of Hematology and Hemotherapy, Hospital Universitario Regional de Málaga, Málaga, Spain
| | - Cynthia Acosta-Fleitas
- Department of Hematology and Hemotherapy, Hospital Universitario Doctor Negrín, Gran Canaria, Spain
| | - Ana Vallés
- Department of Hematology and Hemotherapy, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Albert Esquirol
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Sant Pau Health Research Institute and Jose Carreras Leukemia Research Institutes, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Marta Fonseca
- Department of Hematology and Hemotherapy, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Laura Solán
- Department of Hematology and Hemotherapy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Irene Sánchez-Vadillo
- Department of Hematology and Hemotherapy, Hospital Universitario La Paz, Madrid, Spain
| | - Guiomar Bautista
- Department of Hematology and Hemotherapy, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Leyre Bento
- Department of Hematology and Hemotherapy, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Oriana López-Godino
- Department of Hematology and Hemotherapy, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Ariadna Pérez-Martínez
- Department of Hematology and Hemotherapy, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Anna Torrent
- Department of Hematology and Hemotherapy, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Joud Zanabili
- Department of Hematology and Hemotherapy, Hospital Universitario Central de Asturias, Asturias, Spain
| | - María Calbacho
- Department of Hematology and Hemotherapy, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Miguel Ángel Moreno
- Department of Histocompatibility, Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | | | - Luisa Guerra-Domínguez
- Department of Hematology and Hemotherapy, Hospital Universitario Doctor Negrín, Gran Canaria, Spain
| | - Anabelle Chinea
- Department of Hematology and Hemotherapy, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Irene García-Cadenas
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Sant Pau Health Research Institute and Jose Carreras Leukemia Research Institutes, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Lucía López-Corral
- Department of Hematology and Hemotherapy, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Francisco Boix-Giner
- Department of Hematology and Hemotherapy, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
- CIBERONC and Centro de Investigación del Cáncer-Instituto de Biología Molecular y Celular del Cáncer (Universidad de Salamanca - CSIC), Salamanca, Spain
| | - José Luis López Lorenzo
- Department of Hematology and Hemotherapy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Karem Humala
- Department of Hematology and Hemotherapy, Hospital Universitario La Paz, Madrid, Spain
| | - Rafael Duarte
- Department of Hematology and Hemotherapy, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Antonia Sampol
- Department of Hematology and Hemotherapy, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Inmaculada Heras
- Department of Hematology and Hemotherapy, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - José Luis Vicario
- Department of Histocompatibility, Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | - Antonio Balas
- Department of Histocompatibility, Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | - Gillen Oarbeascoa
- Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Translational Oncology Section, Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Paula Fernández-Caldas
- Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Anguita
- Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Translational Oncology Section, Gregorio Marañón Health Research Institute, Madrid, Spain
- Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Mi Kwon
- Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Translational Oncology Section, Gregorio Marañón Health Research Institute, Madrid, Spain
- Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain
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Mussetti A, Bento L, Bastos-Oreiro M, Rius-Sansalvador B, Albo C, Bailen R, Barba P, Benzaquén A, Briones J, Caballero AC, Campos A, Español I, Ferra C, López SG, González Sierra PA, Guerra LM, Hernani R, Iacoboni G, Jiménez-Ubieto A, Kwon M, Corral LL, López-Godino O, Munoz MCM, Martínez-Cibrián N, Gómez JM, Pérez-Ortega L, Ortí G, Ortiz-Maldonado V, Pascual MJ, Perera M, Perez A, Reguera JL, Sanchez JM, Sanz J, Torrent A, Yáñez L, Varela R, Echechipia IC, Caballero D, Sureda A. Correction: Role of allogeneic hematopoietic cell transplant for relapsed/refractory aggressive B-cell lymphomas in the CART era. Bone Marrow Transplant 2023:10.1038/s41409-023-01967-9. [PMID: 37076611 DOI: 10.1038/s41409-023-01967-9] [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: 04/21/2023]
Affiliation(s)
- Alberto Mussetti
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet De Llobregat, Barcelona, Spain.
| | - Leyre Bento
- Hematology Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Mariana Bastos-Oreiro
- Servicio de Hematología y Hemoterapia, Hospital Gral. Univ. Gregorio Marañón, Madrid, Madrid, Spain
| | - Blanca Rius-Sansalvador
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet De Llobregat, Barcelona, Spain
| | - Carmen Albo
- Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - Rebeca Bailen
- Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Pere Barba
- Department of Hematology, University Hospital Vall d'Hebron, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Ana Benzaquén
- Hematology Department, Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria INCLIVA, Valencia, Valencia, Spain
| | - Javier Briones
- Department of Hematology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | | | - António Campos
- Serviço de Transplantação de Medula Óssea, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Ignacio Español
- Hematology Department, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Christelle Ferra
- Institut Català d´Oncologia-H. Germans Trias i Pujol, Badalona, Spain
| | | | | | - Luisa Maria Guerra
- Hematology Department, Hospital Universitario de Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain
| | - Rafael Hernani
- Hematology Department, Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
| | - Gloria Iacoboni
- Department of Hematology, University Hospital Vall d'Hebron, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, WA, Spain
| | - Ana Jiménez-Ubieto
- Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Hospital Universitario 12 de Octubre, Complutense University, CNIO, Madrid, MADRID, Spain
| | - Mi Kwon
- Department of Hematology Institute of Health Research Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Lucía López Corral
- Department of Hematology, Hospital Clínico Universitario de Salamanca (CAUSA/IBSAL), Salamanca, Spain
| | - Oriana López-Godino
- Hematology Department, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Maria Carmen Martinez Munoz
- Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICMHO), IDIBAPS, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Juan Montoro Gómez
- Hematology Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | | | | | | | - Maria-Jesús Pascual
- Department of Hematology, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - María Perera
- Hematology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
| | - Antonio Perez
- Hematology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Juan Luis Reguera
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - Jose M Sanchez
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jaime Sanz
- Avinguda Fernando Abril Martorell, Hospital Universitario La Fe, Valencia, Valencia, Spain
| | - Anna Torrent
- Hematology Department, ICO-Hospital Germans Trias i Pujol. Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Lucrecia Yáñez
- Hematology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | - Dolores Caballero
- Department of Hematology, Hospital Universitario de Salamanca (HUS/IBSAL) and CIBERONC, Salamanca, Spain
| | - Anna Sureda
- Department of Clinical Hematology, Institut Català d'Oncologia - Hospital Duran I Reynals, IDIBELL, Barcelona, Spain
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Ferra Coll C, Morgades de la Fe M, Prieto García L, Vaz CP, Heras Fernando MI, Bailen Almorox R, Garcia-Cadenas I, Calabuig Muñoz M, Ripa TZ, Zanabili Al-Sibai J, Novoa S, Aguado B, Torrent Catarineu A, López-Godino O, Martino Bofarull R, Kwon M, Campos Júnior A, Caballero Barrigón D, Ribera Santasusana JM. Prognosis of patients with acute lymphoblastic leukaemia relapsing after allogeneic stem cell transplantation. Eur J Haematol 2023; 110:659-668. [PMID: 36813736 DOI: 10.1111/ejh.13947] [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: 12/10/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023]
Abstract
The outcomes of patients with acute lymphoblastic leukaemia (ALL) presenting relapse after allogeneic stem cell transplant (allo-SCT) are poor, with few data available in this setting. OBJECTIVE AND METHODS To evaluate the outcomes of patients with ALL presenting relapsed after allo-SCT, we performed a retrospective study including 132 from 11 centres in Spain. RESULTS Therapeutic strategies consisted of palliative treatment (n = 22), chemotherapy (n = 82), tyrosine kinase inhibitors (n = 26), immunotherapy with inotuzumab and/or blinatumumab (n = 19), donor lymphocyte infusions (n = 29 pts), second allo-SCT (n = 37) and CAR T therapy (n = 14). The probability of overall survival (OS) at 1 and 5 years after relapse was 44% (95% confidence interval [CI]: 36%; 52%) and 19% (95% CI: 11%; 27%). In the 37 patients undergoing a second allo-SCT, the 5-year estimated OS probability was 40% [22%; 58%]. Younger age, recent allo-SCT, late relapse, 1st complete remission at 1st allo-SCT and chronic graft-versus-host disease confirmed their positive impact on survival in the multivariable analysis. CONCLUSION Despite the poor prognosis of patients with ALL presenting relapse after a first allo-SCT, some can be satisfactorily rescued and a second allo-SCT still remains a valid option for selected patients. Moreover, emerging therapies really might improve ALL patients outcome when relapsing after an allo-SCT.
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Affiliation(s)
- Christelle Ferra Coll
- Clinical Hematology Department, Institut Català d'Oncologia, Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol. Badalona, Universitat Autònoma de Barcelona, Barcelona, Spain.,Universitat de Vic, Universitat Central de Catalunya, Catalunya, Spain
| | - Mireia Morgades de la Fe
- Clinical Hematology Department, Institut Català d'Oncologia, Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol. Badalona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Prieto García
- Hematology Department, Hospital Universitario de Salamanca, IBSAL (Instituto Biosanitario de Salamanca), Salamanca, Spain
| | - Carlos Pinho Vaz
- Marrow Transplant Department, Instituto Português de Oncologia, Porto, Portugal
| | | | - Rebeca Bailen Almorox
- Hematology Department Hospital General Universitario Gregorio Marañon, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | | | | | | | - Sandra Novoa
- Hematology Department Hospital Universitari Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Beatriz Aguado
- Hematology Department, Hospital Universitario La Princesa, Madrid, Spain
| | - Anna Torrent Catarineu
- Clinical Hematology Department, Institut Català d'Oncologia, Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol. Badalona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oriana López-Godino
- Hematology Department, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | | | - Mi Kwon
- Hematology Department Hospital General Universitario Gregorio Marañon, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Dolores Caballero Barrigón
- Hematology Department, Hospital Universitario de Salamanca, IBSAL (Instituto Biosanitario de Salamanca), Salamanca, Spain
| | - Josep-Maria Ribera Santasusana
- Clinical Hematology Department, Institut Català d'Oncologia, Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol. Badalona, Universitat Autònoma de Barcelona, Barcelona, Spain
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5
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Bailén R, Pascual-Cascón MJ, Guerreiro M, López-Corral L, Chinea A, Bermúdez A, Sampol A, Heras I, García-Torres E, Torres M, Roca JR, Herruzo B, Sanz J, Fonseca M, Herrera P, Colorado M, Bento L, López-Godino O, Martín-Calvo C, Fernández-Caldas P, Marcos-Jubilar M, Sánchez-Ortega I, Solano C, Noriega V, Humala K, Oarbeascoa G, José Luis Díez-Martín J, Kwon M. Post-transplant cyclophosphamide after HLA identical compared to Haploidentical donor transplant in Acute Myeloid Leukemia: a study on behalf of GETH-TC. Transplant Cell Ther 2022; 28:204.e1-204.e10. [DOI: 10.1016/j.jtct.2022.01.020] [Citation(s) in RCA: 3] [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: 10/11/2021] [Revised: 01/16/2022] [Accepted: 01/21/2022] [Indexed: 02/07/2023]
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Hernández-Boluda JC, Pereira A, Alvarez-Larran A, Martín AA, Benzaquen A, Aguirre L, Mora E, González P, Mora J, Dorado N, Sampol A, García-Gutiérrez V, López-Godino O, Fox ML, Reguera JL, Pérez-Encinas M, Pascual MJ, Xicoy B, Parody R, González-Pinedo L, Español I, Avendaño A, Correa JG, Vallejo C, Jurado M, García-Cadenas I, Osorio S, Durán MA, Sánchez-Guijo F, Cervantes F, Piñana JL. Predicting Survival after Allogeneic Hematopoietic Cell Transplantation in Myelofibrosis: Performance of the Myelofibrosis Transplant Scoring System (MTSS) and Development of a New Prognostic Model. Biol Blood Marrow Transplant 2020; 26:2237-2244. [DOI: 10.1016/j.bbmt.2020.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/19/2020] [Accepted: 07/19/2020] [Indexed: 12/21/2022]
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Fuster JL, Molinos-Quintana A, Fuentes C, Fernández JM, Velasco P, Pascual T, Rives S, Dapena JL, Sisinni L, López-Godino O, Palomo P, Villa-Alcázar M, Bautista F, González-Vicent M, López-Duarte M, García-Morín M, Ramos-Elbal E, Ramírez M. Blinatumomab and inotuzumab for B cell precursor acute lymphoblastic leukaemia in children: a retrospective study from the Leukemia Working Group of the Spanish Society of Pediatric Hematology and Oncology (SEHOP). Br J Haematol 2020; 190:764-771. [PMID: 32314348 DOI: 10.1111/bjh.16647] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 01/26/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
Blinatumomab and inotuzumab ozogamycin represent promising alternatives to conventional chemotherapy in acute lymphoblastic leukaemia (ALL). We analysed data from 29 children with ALL treated under compassionate use with blinatumomab, inotuzumab or both. The complete remission (CR) rate in a heavily pretreated population with overt relapse was 47·6%. At earlier stages (first/second CR), both antibodies represented a useful tool to reduce minimal residual disease, and/or avoid further toxic chemotherapy until stem cell transplantation. Six patients developed grade 3 reversible non-haematological toxicity. The 12-month overall survival and event-free survival rates were 50·8 ± 26·4% and 38·9 ± 25·3% with blinatumomab, 45·8 ± 26% and 27·5 ± 25% with inotuzumab.
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Affiliation(s)
- José L Fuster
- Pediatric Oncology and Haematology Department, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Agueda Molinos-Quintana
- Department of Hematology, Pediatric Hematology, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina (IBIS/CISC), Sevilla, Spain
| | - Carolina Fuentes
- Pediatric Oncology and Haematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - José M Fernández
- Pediatric Oncology and Haematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Pablo Velasco
- Pediatric Oncology and Haematology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Toñi Pascual
- Pediatric Hematology Unit, Hematology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Susana Rives
- Hematology Department, Hospital San Joan de Déu, Institut de Reserca Sant Joan de Déu, Barcelona, Spain
| | - José L Dapena
- Hematology Department, Hospital San Joan de Déu, Institut de Reserca Sant Joan de Déu, Barcelona, Spain
| | - Luisa Sisinni
- Pediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation Unit, Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | - Oriana López-Godino
- Hematology and Oncology Department, Centro Regional de Hemodonación, Hospital Universitario Morales Meseguer, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERER, Murcia, Spain
| | - Pilar Palomo
- Pediatric Hematology Unit, Hematology Department., Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Marta Villa-Alcázar
- Hematology and Oncology Department, Hospital Universitario HM Montepríncipe, HM/CIOCC, Madrid, Spain
| | - Francisco Bautista
- Pediatric Oncology, Haematology and Stem Cell Transplantation Department, Hospital Niño Jesús, Madrid, Spain
| | - Marta González-Vicent
- Pediatric Oncology, Haematology and Stem Cell Transplantation Department, Hospital Niño Jesús, Madrid, Spain
| | - Mónica López-Duarte
- Pediatric Hematology Unit, Hematology Department, Hospital de Valdecilla, Santander, Spain
| | - Marina García-Morín
- Pediatric Oncology and Haematology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Eduardo Ramos-Elbal
- Pediatric Oncology and Haematology Department, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Manuel Ramírez
- Pediatric Oncology, Haematology and Stem Cell Transplantation Department, Hospital Niño Jesús, Madrid, Spain
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8
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López-Corral L, Caballero-Velázquez T, López-Godino O, Rosiñol L, Pérez-Vicente S, Fernandez-Avilés F, Krsnik I, Morillo D, Heras I, Morgades M, Rifon JJ, Sampol A, Iniesta F, Ocio EM, Martin J, Rovira M, Cabero M, Castilla-Llorente C, Ribera JM, Torres-Juan M, Moraleda JM, Martinez C, Vázquez A, Gutierrez G, Caballero D, San Miguel JF, Mateos MV, Pérez-Simón JA. Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma. Biol Blood Marrow Transplant 2019; 25:1703-1712. [PMID: 31054983 DOI: 10.1016/j.bbmt.2019.04.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/21/2019] [Accepted: 04/30/2019] [Indexed: 12/12/2022]
Abstract
Multiple myeloma (MM) remains as an incurable disease and, although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative approach, most patients ultimately relapse, and their treatment remains challenging. Because allo-HSCT can modify not only the biology of the disease, but also the immune system and the microenvironment, it can potentially enhance the response to rescue therapies. Information on the efficacy and safety of novel drugs in patients relapsing after allo-HSCT is lacking, however. The objectives of this study were to evaluate the efficacy and toxicity of rescue therapies in patients with MM who relapsed after allo-HSCT, as well as to compare their efficacy before and after allo-HSCT. This retrospective multicenter study included 126 consecutive patients with MM who underwent allo-HSCT between 2000 and 2013 at 8 Spanish centers. All patients engrafted. The incidence of grade II-IV acute graft-versus-host disease (GVHD) was 47%, and nonrelapse mortality within the first 100 days post-transplantation was 13%. After a median follow-up of 92 months, overall survival (OS) was 51% at 2 years and 43% at 5 years. The median progression-free survival after allo-HSCT was 7 months, whereas the median OS after relapse was 33 months. Patients relapsing in the first 6 months after transplantation had a dismal prognosis compared with those who relapsed later (median OS, 11 months versus 120 months; P < .001). The absence of chronic GVHD was associated with reduced OS after relapse (hazard ratio, 3.44; P < .001). Most patients responded to rescue therapies, including proteasome inhibitors (PIs; 62%) and immunomodulatory drugs (IMiDs; 77%), with a good toxicity profile. An in-depth evaluation, including the type and intensity of PI- and IMiD-based combinations used before and after allo-HSCT, showed that the overall response rate and duration of response after allo-HSCT were similar to those seen in the pretransplantation period. Patients with MM who relapse after allo-HSCT should be considered candidates for therapy with new drugs, which can achieve similar response rates with similar durability as seen in the pretransplantation period. This pattern does not follow the usual course of the disease outside the transplantation setting, where response rates and time to progression decreases with each consecutive line of treatment.
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Affiliation(s)
- Lucia López-Corral
- Hematology Department, Complejo Asistencial Universitario de Salamanca-IBSAL, Centro de Investigación del Cáncer-IBMCC, Spain.
| | - Teresa Caballero-Velázquez
- Hematology Department, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/CIBERON/Universidad de Sevilla, Spain
| | - Oriana López-Godino
- Hematology Department, Hospital Universitario Morales Meseguer y Centro Regional de Hemodonación, IMIB, Universidad de Murcia, Spain
| | - Laura Rosiñol
- Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Sabina Pérez-Vicente
- Hematology Department, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/CIBERON/Universidad de Sevilla, Spain
| | | | - Isabel Krsnik
- Hematology Department, Instituto de Investigación Puerta de Hierro Majadahonda, Madrid, Spain
| | - Daniel Morillo
- Hematology Department, Instituto de Investigación Puerta de Hierro Majadahonda, Madrid, Spain
| | - Inmaculada Heras
- Hematology Department, Hospital Universitario Morales Meseguer y Centro Regional de Hemodonación, IMIB, Universidad de Murcia, Spain
| | - Mireia Morgades
- Department of Hematology, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Jose J Rifon
- Hematology Service, Clínica Universidad de Navarra, CIMA, IDISNA, CIBERONC, Pamplona, Spain
| | - Antonia Sampol
- Hematology Department, Hospital Son Espases, Palma de Mallorca, Spain
| | - Francisca Iniesta
- Hematology Department, University Hospital of Virgen de la Arrixaca, Murcia, Spain
| | - Enrique-María Ocio
- Hematology Department, Complejo Asistencial Universitario de Salamanca-IBSAL, Centro de Investigación del Cáncer-IBMCC, Spain
| | - Jesús Martin
- Hematology Department, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/CIBERON/Universidad de Sevilla, Spain
| | - Montserrat Rovira
- Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Martín Cabero
- Hematology Department, Instituto de Investigación Puerta de Hierro Majadahonda, Madrid, Spain
| | | | - Josep-María Ribera
- Department of Hematology, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Marta Torres-Juan
- Hematology Department, Hospital Son Espases, Palma de Mallorca, Spain
| | - Jose María Moraleda
- Hematology Department, University Hospital of Virgen de la Arrixaca, Murcia, Spain
| | - Carmen Martinez
- Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Alejandro Vázquez
- Hematology Department, Instituto de Investigación Puerta de Hierro Majadahonda, Madrid, Spain
| | - Gonzalo Gutierrez
- Department of Hematology, Amyloidosis and Myeloma Unit, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Dolores Caballero
- Hematology Department, Complejo Asistencial Universitario de Salamanca-IBSAL, Centro de Investigación del Cáncer-IBMCC, Spain
| | - Jesús F San Miguel
- Hematology Service, Clínica Universidad de Navarra, CIMA, IDISNA, CIBERONC, Pamplona, Spain
| | - María-Victoria Mateos
- Hematology Department, Complejo Asistencial Universitario de Salamanca-IBSAL, Centro de Investigación del Cáncer-IBMCC, Spain
| | - Jose Antonio Pérez-Simón
- Hematology Department, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocío/CSIC/CIBERON/Universidad de Sevilla, Spain
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9
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Carrillo-Cruz E, García-Lozano JR, Márquez-Malaver FJ, Sánchez-Guijo FM, Montero Cuadrado I, Ferra I Coll C, Valcárcel D, López-Godino O, Cuesta M, Parody R, López-Corral L, Alcoceba M, Caballero-Velázquez T, Rodríguez-Gil A, Bejarano-García JA, Ramos TL, Pérez-Simón JA. Vitamin D Modifies the Incidence of Graft-versus-Host Disease after Allogeneic Stem Cell Transplantation Depending on the Vitamin D Receptor (VDR) Polymorphisms. Clin Cancer Res 2019; 25:4616-4623. [PMID: 31043390 DOI: 10.1158/1078-0432.ccr-18-3875] [Citation(s) in RCA: 7] [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: 11/30/2018] [Revised: 03/09/2019] [Accepted: 04/26/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE The biologically active metabolite of vitamin D3, 1,25-dihydroxyvitamin D3 (vit D), has immunoregulatory properties via binding vitamin D receptor (VDR). In a prospective trial, we previously reported a reduction in the incidence of chronic GvHD (cGvHD) among patients who received vit D after allogeneic stem cell transplantation (allo-HSCT; Clinical Trials.gov: NCT02600988). Here we analyze the role of patients and donors' VDR SNPs on the immunomodulatory effect of vit D. PATIENTS AND METHODS Patients undergoing allo-HSCT were included in a prospective phase I/II clinical trial (Alovita) in three consecutive cohorts: control (without vit D), low-dose (1,000 IU/day), and high-dose (5,000 IU/day) groups. Vit D was given from day -5 until +100 after transplant. Genotyping of four SNPs of the VDR gene, FokI, BsmI, ApaI, and TaqI, were performed using TaqMan SNP genotyping assays. RESULTS We observed a decrease in the incidence of overall cGvHD at 1 year after allo-HSCT depending on the use or not of vit D among patients with FokI CT genotype (22.5% vs 80%, P = 0.0004) and among those patients without BsmI/ApaI/TaqI ATC haplotype (22.2% vs 68.8%, P = 0.0005). In a multivariate analysis, FokI CT genotype significantly influenced the risk of cGvHD in patients treated with vit D as compared with the control group (HR 0.143, P interaction < 0.001). CONCLUSIONS Our results show that the immunomodulatory effect of vit D depends on the VDR SNPs, and patients carrying the FokI CT genotype display the highest benefit from receiving vit D after allo-HSCT.
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Affiliation(s)
- Estrella Carrillo-Cruz
- Department of Hematology, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBIS)/CSIC/CIBERONC, Universidad de Sevilla, Seville, Spain
| | - José R García-Lozano
- Department of Immunology, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Francisco J Márquez-Malaver
- Department of Hematology, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBIS)/CSIC/CIBERONC, Universidad de Sevilla, Seville, Spain
| | - Fermín M Sánchez-Guijo
- IBSAL-Hospital Universitario de Salamanca/CIBERONC, CIC-Universidad de Salamanca, Salamanca, Spain
| | - Isabel Montero Cuadrado
- Department of Hematology, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBIS)/CSIC/CIBERONC, Universidad de Sevilla, Seville, Spain
| | | | | | - Oriana López-Godino
- IBSAL-Hospital Universitario de Salamanca/CIBERONC, CIC-Universidad de Salamanca, Salamanca, Spain
| | | | - Rocío Parody
- Institut Catala d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain
| | - Lucía López-Corral
- IBSAL-Hospital Universitario de Salamanca/CIBERONC, CIC-Universidad de Salamanca, Salamanca, Spain
| | - Miguel Alcoceba
- IBSAL-Hospital Universitario de Salamanca/CIBERONC, CIC-Universidad de Salamanca, Salamanca, Spain
| | - Teresa Caballero-Velázquez
- Department of Hematology, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBIS)/CSIC/CIBERONC, Universidad de Sevilla, Seville, Spain.,Instituto de Biomedicina de Sevilla (IBIS)/ CSIC/ CIBERONC, Universidad de Sevilla, Seville, Spain
| | - Alfonso Rodríguez-Gil
- Instituto de Biomedicina de Sevilla (IBIS)/ CSIC/ CIBERONC, Universidad de Sevilla, Seville, Spain
| | - José A Bejarano-García
- Instituto de Biomedicina de Sevilla (IBIS)/ CSIC/ CIBERONC, Universidad de Sevilla, Seville, Spain
| | - Teresa Lopes Ramos
- Instituto de Biomedicina de Sevilla (IBIS)/ CSIC/ CIBERONC, Universidad de Sevilla, Seville, Spain
| | - José A Pérez-Simón
- Department of Hematology, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBIS)/CSIC/CIBERONC, Universidad de Sevilla, Seville, Spain. .,Instituto de Biomedicina de Sevilla (IBIS)/ CSIC/ CIBERONC, Universidad de Sevilla, Seville, Spain
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10
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Bastida JM, López-Godino O, Vicente-Sánchez A, Bonanad-Boix S, Xicoy-Cirici B, Hernández-Sánchez JM, Such E, Cervera J, Caballero-Berrocal JC, López-Cadenas F, Arnao-Herráiz M, Rodríguez I, Llopis-Calatayud I, Jiménez MJ, Del Cañizo-Roldán MC, Díez-Campelo M. Hidden myelodysplastic syndrome (MDS): A prospective study to confirm or exclude MDS in patients with anemia of uncertain etiology. Int J Lab Hematol 2018; 41:109-117. [PMID: 30290085 DOI: 10.1111/ijlh.12933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/30/2018] [Accepted: 09/07/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Diagnosis of myelodysplastic syndromes (MDSs) when anemia is the only abnormality can be complicated. The aim of our study was to investigate the primary causes of anemia and/or macrocytosis of uncertain etiology. METHODS We conducted a multicenter, prospective study over 4 months in three hematology laboratories. In step 1, we used an automated informatics system to screen 137 453 hemograms for cases of anemia and/or macrocytosis (n = 2702). In step 2, we excluded all patients whose anemia appeared to be due to a known cause. This left 290 patients had anemia of uncertain etiology. In step 3, we conducted further investigations, including a peripheral blood smear, and analysis of iron, vitamin B12, folate, and thyroid hormone levels. RESULTS A differential diagnosis was obtained in 139 patients (48%). The primary causes of anemia were iron deficiency (n = 59) and megaloblastic anemia (n = 39). In total, 25 hematologic disorders were diagnosed, including 14 patients with MDS (56%). The median age of MDS patients was 80 years, 12 had anemia as an isolated cytopenia, and most (n = 10) had lower-risk disease (IPSS-R ≤ 3.5). SF3B1 mutations were most frequent (n = 6) and correlated with the presence of ring sideroblasts (100%) and associated with better prognosis (P = 0.001). CONCLUSIONS Our prospective, four-step approach is an efficient and logical strategy to facilitate the diagnosis of MDS on the basis of unexplained anemia and/or macrocytosis, and may allow the early diagnosis of the most serious causes of anemia. Molecular analysis of genes related to MDS could be a promising diagnostic and prognostic approach.
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Affiliation(s)
| | | | | | | | - Blanca Xicoy-Cirici
- Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Badalona, Spain
| | - Jesus M Hernández-Sánchez
- Instituto de Investigacion Biomedica de Salamanca, IBMCC, Centro de Investigacion del Cancer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Esperanza Such
- Hematology, Laboratorio de Citogenética y Biología Molecular, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Jose Cervera
- Hematology, Laboratorio de Citogenética y Biología Molecular, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | | | | | - Inés Rodríguez
- Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Badalona, Spain
| | | | - María J Jiménez
- Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Badalona, Spain
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11
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Afram G, Simón JAP, Remberger M, Caballero-Velázquez T, Martino R, Piñana JL, Ringden O, Esquirol A, Lopez-Corral L, Garcia I, López-Godino O, Sierra J, Caballero D, Ljungman P, Vazquez L, Hägglund H. Reduced intensity conditioning increases risk of severe cGVHD: identification of risk factors for cGVHD in a multicenter setting. Med Oncol 2018; 35:79. [PMID: 29696461 PMCID: PMC5918523 DOI: 10.1007/s12032-018-1127-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 01/27/2018] [Accepted: 04/05/2018] [Indexed: 01/09/2023]
Abstract
Chronic graft-versus-host disease (cGVHD) remains a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Aim is to identify risk factors for the development of cGVHD in a multicenter setting. Patients transplanted between 2000 and 2006 were analyzed (n = 820). Donors were HLA-identical siblings (57%), matched unrelated donors (30%), and HLA-A, B or DR antigen mismatched (13%). Reduced intensity conditioning (RIC) was given to 65% of patients. Overall incidence of cGVHD was 46% for patients surviving more than 100 days after HSCT (n = 747). Older patient age [HR 1.15, p < 0.001], prior acute GVHD [1.30, p = 0.024], and RIC [1.36, p = 0.028] increased overall cGVHD. In addition, RIC [4.85, p < 0.001], prior aGVHD [2.14, p = 0.001] and female donor to male recipient [1.80, p = 0.008] increased the risk of severe cGVHD. ATG had a protective effect for both overall [0.41, p < 0.001] and severe cGVHD [0.20, p < 0.001]. Relapse-free survival (RFS) was impaired in patients with severe cGVHD. RIC, prior aGVHD, and female-to-male donation increase the risk of severe cGVHD. ATG reduces the risk of all grades of cGVHD without hampering RFS. GVHD prophylaxis may be tailored according to the risk profile of patients.
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Affiliation(s)
- Gabriel Afram
- Department of Hematology, Karolinska University Hospital Huddinge, Stockholm, Sweden.
| | - Jose Antonio Pérez Simón
- Department of Hematology, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Mats Remberger
- Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Teresa Caballero-Velázquez
- Department of Hematology, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Rodrigo Martino
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jose Luis Piñana
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Hematology, Hospital Clinico Universitario, Valencia, Spain
| | - Olle Ringden
- Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Albert Esquirol
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lucia Lopez-Corral
- Department of Hematology, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain
| | - Irene Garcia
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Oriana López-Godino
- Department of Hematology, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain
| | - Jordi Sierra
- Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Dolores Caballero
- Department of Hematology, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain
| | - Per Ljungman
- Department of Hematology, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Lourdes Vazquez
- Department of Hematology, Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain
| | - Hans Hägglund
- Division of Hematology, Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
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12
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Cabrero M, Martin A, Briones J, Gayoso J, Jarque I, López J, Grande C, Heras I, Arranz R, Bernal T, Perez-Lopez E, López-Godino O, Conde E, Caballero D. Phase II Study of Yttrium-90-Ibritumomab Tiuxetan as Part of Reduced-Intensity Conditioning (with Melphalan, Fludarabine ± Thiotepa) for Allogeneic Transplantation in Relapsed or Refractory Aggressive B Cell Lymphoma: A GELTAMO Trial. Biol Blood Marrow Transplant 2017; 23:53-59. [DOI: 10.1016/j.bbmt.2016.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
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13
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Caballero-Velázquez T, Montero I, Sánchez-Guijo F, Parody R, Saldaña R, Valcarcel D, López-Godino O, Ferra i Coll C, Cuesta M, Carrillo-Vico A, Sánchez-Abarca LI, López-Corral L, Márquez-Malaver FJ, Pérez-Simón JA. Immunomodulatory Effect of Vitamin D after Allogeneic Stem Cell Transplantation: Results of a Prospective Multicenter Clinical Trial. Clin Cancer Res 2016; 22:5673-5681. [DOI: 10.1158/1078-0432.ccr-16-0238] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 05/28/2016] [Accepted: 06/16/2016] [Indexed: 11/16/2022]
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14
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Alonso S, Cabrero M, Caballero JC, Dávila J, de la Calle VG, López-Godino O, López-Corral L, Pérez E, Vázquez L, Corral R, Caballero D, Del Cañizo C, Mateos MV. Acute graft-versus-host disease and bronchiolitis obliterans after autologous stem cell transplantation in a patient with multiple myeloma. Clin Case Rep 2015; 3:370-5. [PMID: 26185631 PMCID: PMC4498845 DOI: 10.1002/ccr3.231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 10/19/2014] [Revised: 12/30/2014] [Accepted: 01/20/2015] [Indexed: 12/22/2022] Open
Abstract
Sixty-seven-year-old patient, diagnosed with multiple myeloma who had received autologous stem cell transplantation, following bortezomib, dexamethasone and thalidomide conventional regimen, achieving complete response, developed rash, diarrhea, and severe respiratory failure, 80 days after the transplantation procedure. He was diagnosed with graft-versus-host disease and bronchiolitis obliterans syndrome.
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Affiliation(s)
- Sara Alonso
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Mónica Cabrero
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Juan C Caballero
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Julio Dávila
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | | | | | - Lucia López-Corral
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Estefanía Pérez
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Lourdes Vázquez
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Rocío Corral
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
| | - Dolores Caballero
- Hematology Department, University Hospital of Salamanca Salamanca, Spain
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