Comparison of target volume and clinical effects of four radiotherapy plans for acute lymphoblastic leukemia prior to hematopoietic stem cell transplantation.
Comparison of target volume and clinical effects of four radiotherapy plans for acute lymphoblastic leukemia prior to hematopoietic stem cell transplantation. Mol Med Rep. 2018 Jun 27;: Authors: Lin Y, Kong F, Li H, Xu D, Jia F, Zhang X, Wang B, Li G Abstract The present study aimed to investigate the variations in target volume, clinical reaction and transplantation effects of helical tomotherapy (HT)‑total body irradiation (TBI), HT‑total marrow and lymphatic irradiation (TMLI), intensity modulated radiotherapy (IMRT)‑TBI and IMRT‑TMLI within patients with acute lymphoblastic leukemia (ALL). A total of 18 patients with ALL were treated with the four aforementioned radiotherapy plans prior to hematopoietic stem cell transplantation. A planned prescribed dose of 12 Gy/6 Frequency was administered to determine planning target volume (PTV). Dosimetry evaluation indexes in PTV and organs at risk were analyzed. Comparison of clinical untoward effects and the results of transplantation among the four plans were performed. The conformity index of HT plans was significantly increased compared with those in IMRT plans. The mean dose (D) to the lung and volume ratio of target volume occupied by 5 Gy (V5) in TMLI plans were lower compared with TBI plans. Doses to organs were controlled within the normal range. Dmax, Dmean and V5 of bilateral lungs and Dmax and Dmean of bilateral crystalline lens in IMRT plans were significantly higher co...
This study demonstrates the important effects of glycosylation on L-ASNase properties and opens up new possibilities to use glycosylated L-ASNases for the treatment of ALL.
For patients with refractory or high-risk hematologic malignancies, like acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), and acute lymphoblastic leukemia (ALL), allogeneic hematopoietic stem cell transplant (Allo-HSCT) is a potentially curative approach. Morbidities and mortality associated with current conditioning regimens limit the use of this curative procedure. As a result, many eligible patients do not consider transplant and 2/3 of those transplanted are only able to tolerate a reduced intensity conditioning regimen, which is associated with increased relapse rates (Scott, J Clin Onc 2017).
Patients (pts) receiving CTL019 (tisagenlecleucel) for B-ALL with high tumor burden (HTB) are at high risk for developing severe CRS. Tocilizumab, an IL-6 receptor antibody, is a vital component of severe CRS management; however, its role in preventing severe CRS is not known. We sought to determine the effectiveness of preemptive tocilizumab (PT) administration in decreasing the rate of grade (gr) 4 CRS in HTB pts.
Chimeric antigen receptor T cell (CAR-T cell) therapy has become a promising treatment for children with acute lymphoblastic leukaemia (ALL) and Non-Hodgkin lymphoma (NHL). Cytokine release syndrome (CRS) and Immune effector cell associated neurotoxicity syndrome (ICANS) are well-documented serious side-effects of CAR-T cell therapy, and early recognition, intervention and aggressive supportive therapy is paramount.Tociluzimab is the mainstay of treatment for moderate to severe CRS, with early administration essential.
Transplant outcomes for patients with acute lymphoblastic leukemia (ALL) after haploidentical hematopoietic cell transplantation (haploHCT) with post-transplant cyclophosphamide (PTCy) compared to an HLA matched unrelated donors (MUD) transplantation are unknown. We, therefore retrospectively compared outcomes of 487 patients with ALL who underwent haploHCT with PTCy, reported from the participating centers (TCT-RC and EBMT) from 01/2005 to 06/2018, with a matched cohort of 974 patients (1:2 ratio) who underwent MUD-HCT and were reported to the EBMT. Patients were matched for sex, disease stage (CR1, CR2, other), di...
CD19 directed chimeric antigen receptor T cell (CART19) therapy has shown remarkable activity in B cell lymphoma and acute lymphoblastic leukemia (ALL). With the emergence of therapeutic anti CD19 antibodies for the treatment of B cell malignancies, it remains to be elucidated whether such antibodies would interfere with the ability of CART19 to exert their antitumor effect in a subsequent therapy.Tafasitamab is an Fc enhanced humanized anti CD19 monoclonal antibody which mediates antibody dependent cellular toxicity (ADCC), antibody dependent cellular phagocytosis and direct cytotoxicity.
Chimeric Antigen Receptor T-cell therapy (CAR-t) for patients with relapsed or refractory B cell precursor acute lymphoblastic leukemia (ALL) is associated with high overall remission rates but also with significant complications. Cytokine release syndrome (CRS) and Immune Cell Associated Neurotoxicity Syndrome (ICANS) are life-threatening sequelae that may occur in CAR-t recipients. ICANS presents with varying symptoms ranging from confusion to seizure and cerebral edema. There is no consensus on specific biological events that incite ICANS.
CART-cell therapy is associated with dramatic efficacy in patients with relapsed/refractory diffuse large B-cell lymphoma and B-acute lymphoblastic leukemia. However, the efficacy of CART therapy is limited by potentially fatal toxicities including cytokine release syndrome (CRS) and neurotoxicity. Increasingly, emerging reports have suggested the potential for significant hemodynamic collapse following CART therapy. Yet, whether the occurrence of these hemodynamic shifts or any other cardiovascular disease (CVD) events have bearing on clinical outcomes after CART initiation is unknown.
The objective of this study was to compare the outcomes of allo-SCT from T cell-repleted haploidentical donors (Haplo) with matched related donors (MRD) and unrelated donors, which include matched (MUD 10/10) or mismatched unrelated donor at a single HLA-locus (MMUD 9/10), for patients with acute leukemia.