Phase I Trial of Post Allogeneic Stem Cell Transplant Maintenance Lenalidomide in Patients with High Risk Acute Myeloid Leukemia or Myelodysplastic Syndrome

Background: Patients (pts) with High-risk Acute Myeloid Leukemia (AML) or Myelodysplastic Syndrome (MDS) often proceed to allogeneic hematopoietic stem cell transplant (alloHSCT) due to poorer outcomes. This is the only chance of cure; however, relapse rates after alloHSCT remain high and range between 25-50%. Maintenance approaches post-HSCT, such as hypomethylating agents or tyrosine kinase inhibitors, have been used to decrease the relapse rate with mixed results. Lenalidomide is known to augment T/NK cell activity/proliferation which lead us to hypothesize that it will enhance the Graft-versus-Leukemia (GvL) effect without increasing the incidence of acute Graft-versus-Host (GvH).
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research

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CONCLUSIONS: We found no evidence for a difference between participants receiving ATRA in addition to chemotherapy or chemotherapy only for the outcome OS. Regarding DFS, CRR and on-study mortality, there is probably no evidence for a difference between treatment groups. Currently, it seems the risk of adverse events are comparable to chemotherapy only.As quality of life has not been evaluated in any of the included trials, further research is needed to clarify the effect of ATRA on quality of life. PMID: 30080246 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
z M, Alousi A, Couriel D, Pidala J, Arora M, Cutler C Abstract Upper gastrointestinal acute graft-versus-host disease is reported in approximately 30% of hematopoietic stem cell transplant recipients developing acute graft-versus-host disease. Currently classified as Grade II in Consensus criteria, upper gastrointestinal acute graft-versus-host disease is often treated with systemic immunosuppression. We reviewed the Center for International Blood and Marrow Transplant Research database to assess prognostic implications of upper gastrointestinal acute graft-versus-host disease in isolation or with other acute graf...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research
Conditions:   Acute Lymphoblastic Leukemia in Remission;   Acute Myeloid Leukemia Arising From Previous Myelodysplastic Syndrome;   Acute Myeloid Leukemia in Remission;   Blasts 5 Percent or Less of Bone Marrow Nucleated Cells;   Chronic Myelomonocytic Leukemia;   Chronic Phase Chronic Myelogen ous Leukemia, BCR-ABL1 Positive;   Donor;   Minimal Residual Disease;   Myelodysplastic Syndrome;   Myelofibrosis;   Myeloproliferative Neoplasm;   Recurrent Acute Myeloid Leukemia;   ...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Publication date: Available online 9 November 2017Source: Seminars in Cancer BiologyAuthor(s): Christian Flotho, Sebastian Sommer, Michael LübbertAbstractMyelodysplastic syndrome (MDS) is a clonal bone marrow disorder, typically of older adults, which is characterized by ineffective hematopoiesis, peripheral blood cytopenias and risk of progression to acute myeloid leukemia. Juvenile myelomonocytic leukemia (JMML) is an aggressive myeloproliferative neoplasm occurring in young children. The common denominator of these malignant myeloid disorders is the limited benefit of conventional chemotherapy and a particular resp...
Source: Seminars in Cancer Biology - Category: Cancer & Oncology Source Type: research
We report a case of myelodysplastic syndrome progressing to AML with calreticulin driver mutation in an adult male with TAR syndrome who was successfully treated with hematopoietic allogeneic stem cell transplantation.
Source: Hematology Oncology and Stem Cell Therapy - Category: Cancer & Oncology Source Type: research
We recently conducted a randomized double-blind study in which we demonstrated that moderate/severe chronic graft-versus-host disease (cGVHD) but not cGVHD-free survival was reduced in patients receiving anti-T lymphocyte globulin (ATLG) versus placebo. In a companion study we performed immunophenotypic analysis to determine the impact of ATLG on immune reconstitution (IR) and to correlate IR with clinical outcomes. The randomized study (n  = 254) included patients (aged 18 to 65 years) who underwent myeloablative transplants for acute myeloid leukemia, myelodysplastic syndrome, or acute lymphoblastic leukemia from HLA...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Publication date: Available online 9 November 2017Source: Seminars in Cancer BiologyAuthor(s): Christian Flotho, Sebastian Sommer, Michael LübbertAbstractMyelodysplastic syndrome (MDS) is a clonal bone marrow disorder, typically of older adults, which is characterized by ineffective hematopoiesis, peripheral blood cytopenias and risk of progression to acute myeloid leukemia. Juvenile myelomonocytic leukemia (JMML) is an aggressive myeloproliferative neoplasm occurring in young children. The common denominator of these malignant myeloid disorders is the limited benefit of conventional chemotherapy and a particular resp...
Source: Seminars in Cancer Biology - Category: Cancer & Oncology Source Type: research
We report a case of myelodysplastic syndrome progressing to AML with calreticulin driver mutation in an adult male with TAR syndrome who was successfully treated with hematopoietic allogeneic stem cell transplantation.
Source: Hematology Oncology and Stem Cell Therapy - Category: Cancer & Oncology Source Type: research
Hematopoietic allogeneic stem cell transplantation (HSCT) is an accepted and potentially curative treatment for a variety of hematological diseases, immunodeficiencies and metabolic disorders1, with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) to date representing more than half of the indications in adult patients2. An HLA-matched related donor (MRD) is available for about 25% of patients, while the probability of finding a fully HLA-matched unrelated donor (MUD) varies on average between 60 and 90%3,4.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Hematopoietic allogeneic stem cell transplantation (HSCT) is an accepted and potentially curative treatment for a variety of hematologic diseases, immunodeficiencies, and metabolic disorders [1], with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) to date representing more than half of the indications in adult patients [2]. An HLA-matched related donor (MRD) is available for about 25% of patients, whereas the probability of finding a fully HLA-matched unrelated donor (MUD) varies on average between 60% and 90% [3,4].
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
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