Myeloablative Versus Reduced-Intensity Hematopoietic Cell Transplantation for Acute Myeloid Leukemia and Myelodysplastic Syndromes

This research article has led to a Practice Changing Update on DynaMed Plus. It found that myeloablative conditioning increases relapse-free survival, but also increases treatment-related mortality compared to reduced intensity conditioning in patients with acute myeloid leukemia or myelodysplastic syndromes having first allogeneic hematopoietic cell transplantation
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news

Related Links:

Allogeneic stem cell transplantation (alloSCT) is a potentially curative therapeutic option for patients with myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML). Disease relapse occurs in 35-45% of patients following alloSCT, and is the most frequent cause of treatment failure and mortality [1-4]. Moreover, relapse after alloSCT is associated with poor prognosis despite salvage chemotherapy, donor lymphocyte infusions, and/or second transplants [4].
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
AbstractRecently, an immunodeficiency syndrome caused by guanine-adenine-thymine-adenine 2 (GATA2) deficiency has been described. The syndrome is characterized by (i) typical onset in early adulthood, (ii) profound peripheral blood cytopenias of monocytes, B lymphocytes, and NK cells, (iii) distinct susceptibility to disseminated non-tuberculous mycobacterial (NTM) and other opportunistic infections (particularly human papillomavirus), and (iv) a high risk of developing hematologic malignancies (myelodysplastic syndromes (MDS); acute myeloid leukemias (AML)). Considerable clinical heterogeneity exists among patients withGA...
Source: Annals of Hematology - Category: Hematology Source Type: research
Myelodysplastic syndromes (MDS) are clonal disorders of hematopoietic stem cells that mainly affect the elderly, characterized by ineffective hematopoiesis, leading to cytopenia, infections, and a significant reduction in the quality of life [1,2]. Intensive chemotherapy combined with hematopoietic stem cell transplantation (HSCT) is the only curative treatment for this disease. However, it's applicability in elderly patients is limited by comorbidities and poor performance status. Azacytidine (AZA) significantly reduces transfusion dependence, decreases the risk of transformation to acute myeloid leukemia (AML), and impro...
Source: Experimental Hematology - Category: Hematology Authors: Tags: Brief Communication Source Type: research
This study includes 2473 patients with acute myeloid leukemia, acute lymphoblastic leukemia, or myelodysplastic syndrome and 2221 10/10 HLA-matched donors treated from 2000 to 2011. Single-variant and gene-level analyses were performed on overall survival (OS), transplantation-related mortality (TRM), and disease-related mortality (DRM). Genotype mismatches between recipients and donors in a rare nonsynonymous variant of testis-expressed gene TEX38 significantly increased risk of TRM, which was more dramatic when either the recipient or donor was female. Using the SKAT-O test to evaluate gene-level effects, variant genotyp...
Source: Blood - Category: Hematology Authors: Tags: Transplantation Source Type: research
We report here indiscriminate killing of CD123+ normal and acute myeloid leukemia / myelodysplastic syndrome cells by SL-401, a diphtheria toxin interleukin-3 fusion protein. SL-401 induced cytotoxicity of CD123+ primary cells/blasts from acute myeloid leukemia and myelodysplastic syndrome patients but not CD123- lymphoid cells. Importantly, SL-401 was highly active even in cells expressing low levels of CD123, with minimal effect on modulation of the CD123 target in acute myeloid leukemia. SL-401 significantly prolonged survival of leukemic mice in acute myeloid leukemia patient-derived xenograft mouse models. In addition...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research
In patients with myeloid malignancies, such as acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS), relapse remains the main cause of treatment failure after allogeneic hematopoietic stem cell transplantation (allo-HSCT) [1-4]. Several studies addressing therapeutic strategies for relapse after allo-HSCT have shown that treatment is more effective when initiated at molecular relapse rather than at hematologic relapse [5]. Therefore, early detection of imminent relapse, ideally at a molecular level, is a prerequisite for successful therapeutic intervention and can be achieved by regular monitoring of minimal...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
This multicenter study evaluated a treosulfan-based regimen in children and young adults with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) undergoing allogeneic hematopoietic cell transplant (HCT). Forty patients with median age 11 years (1-19) underwent allogeneic HCT for AML in first (n=18), second (n=11), third or greater remission (n=3); or MDS (n=8) using bone marrow (n=25), peripheral blood stem cells (n=5) or cord blood (n=9). The regimen consisted of body surface area (BSA)-based treosulfan 10 g/m2/day (BSA ≤ 0.5 m2), 12 g/m2/day (BSA> 0.5 – 1.0 m2), or 14 g/m2/day (BSA> 1.0 m2) on ...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Hematologic malignancies are more prevalent in older patients, and because of the increased rate of elderly in the population, the number of patients presenting with hematologic malignancy has increased [1]. The median ages of patients with acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS), which are the most common indication for allogeneic hematopoietic transplantation (alloHCT), in this population are 69 and 76 years, respectively [2-4]. Despite the advent of the novel agents, alloHCT remains the only curative option for most of the common hematologic malignancies.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
This multicenter study evaluated a treosulfan-based regimen in children and young adults with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) undergoing allogeneic hematopoietic cell transplant (HCT). Forty patients with median age 11 years (range, 1 to 19) underwent allogeneic HCT for AML in first (n  = 18), second (n = 11), and third or greater remission (n = 3) or MDS (n = 8) using bone marrow (n = 25), peripheral blood stem cells (n = 5), or cord blood (n = 9). The regimen consisted of body surface area (BSA...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
AbstractPrimary graft failure can be a cause of early morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT), as it leads to a high risk of severe infections and bleeding. Splenomegaly is associated with primary graft failure in patients of myelofibrosis, but the association between splenomegaly and outcomes after HSCT in patients with myeloid malignancies has not been previously evaluated. The aim of this study was to investigate the effect of spleen volume on engraftment kinetics in patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). We enrolled 85 patients. The...
Source: Annals of Hematology - Category: Hematology Source Type: research
More News: Acute Leukemia | Acute Myeloid Leukemia | Health | Leukemia | Myelodysplastic Syndrome | Transplants