Can Allogeneic Hematopoietic Cell Transplant Cure Therapy-related Acute Leukemia?
Publication date: Available online 26 February 2019Source: Best Practice &Research Clinical HaematologyAuthor(s): Yazan F. Madanat, Aaron T. GerdsAbstractTherapy-related myeloid neoplasms (t-MN) include both therapy-related myelodysplastic syndromes as well as therapy-related acute myeloid leukemia. These two entities were grouped together in the World Health Organization classification of AML due to having similarly poor outcomes and disease biology. Exposure to prior radiation therapy or chemotherapy for other malignant or benign conditions, namely autoimmune diseases or solid organ transplants, constitutes the principal risk factor to develop t-MN. Mechanisms for the development of t-MN include direct genotoxic damage from prior chemotherapy or radiation therapy exposure and the selection of pre-existing clones with malignant potential that are able to evolve with time and manifest as new cancers. Patients with t-MN are generally considered high-risk at the time of diagnosis and are commonly referred for consideration of an allogeneic hematopoietic cell transplantation, however, this patient population poses unique challenges, and little is known about the ideal sequence and timing of treatment. In this review, we summarize the data pertaining to transplant options, focusing on patient and disease characteristics in which transplantation may be most useful and populations where non-transplant options may also be considered.
AbstractAplastic anemia (AA) has been reported to be associated with inflammatory bowel disease (IBD), but mostly with ulcerative colitis (UC). Little is known about the associations between AA and Crohn ’s disease (CD). We aim to determine the portraits of patients with AA-CD. Among a total of 657 patients with CD registered in Xijing Hospital of Digestive Diseases IBD center from January 2008 to October 2018, the patients diagnosed with concurrent AA were reviewed. Clinical presentation, medical history, endoscopic features, response to treatment, and prognosis in this set of patients were collected. Six male patie...
AbstractIncidence and outcome of microbiologically documented bacterial/viral infections and invasive fungal disease (IFD) in children and adults after hematopoietic cell transplantation (HCT) were compared in 650 children and 3200 adults in multicenter cross-sectional nationwide study. Infections were diagnosed in 60.8% children and 35.0% adults, including respectively 69.1% and 63.5% allo-HCT, and 33.1% and 20.8% auto-HCT patients. The incidence of bacterial infections was higher in children (36.0% vs 27.6%;p
Gastric cancer remains one of the most common causes of cancer deaths worldwide. The best current option for reducing gastric cancer deaths is Helicobacter pylori eradication combined with risk assessment and surveillance programs for those deemed to be at high risk for gastric cancer so as to identify lesions at a stage amenable to curative therapy. In this issue, Nam et al1 report a retrospective study of Helicobacter pylori eradication on gastric cancer incidence among 10,328 Korean adults undergoing health checkups including an H pylori test-and-treat program.
We read with great interest the comment by Dr Li and colleagues1 referring to our study on endoscopic full-thickness resection (EFTR) for early colorectal cancer.2 We would like to thank the editors for the opportunity to reply.
Gastric cancer remains one of the most common cancers worldwide and is the third leading cause of cancer-related mortality, trailing only lung and colon cancer.1 Given its historically low survival rates, early detection and resection is the most effective strategy to improve prognosis. Endoscopic submucosal dissection (ESD), a technique developed in Japan, enables en bloc resection of early gastric cancer (EGC) and can be curative for selected lesions, depending on the histologic features, size, and tumor depth.
We read with interest the article by Kuellmer et al1 evaluating endoscopic full-thickness resection (EFTR) for early colorectal cancer. The authors found that EFTR for early colorectal cancer was feasible and safe. Because their findings are important to current practice, several questions deserve attention.
We have read with great interest the study by Januszewicz et al1 describing the concept of endoscopist biopsy rate (EBR) as a potential quality indicator for routine diagnostic outpatient EGD. The authors found a significant variability in EBR among 26 endoscopists and an association between higher EBR, a higher detection of gastric precancerous conditions, and a lower risk of missed gastric cancers.1
Conclusion MDS is rare and tends to be more aggressive in the AYA population. Karyotype was the most important prognostic factor. Allogeneic stem-cell transplantation offered younger patients the best outcomes. Micro-Abstract Little is known regarding myelodysplastic syndromes (MDS) in the younger population. This retrospective review reviewed the characteristics, outcomes, and response to treatment in the adolescent and young adult (AYA) population compared to an older population. MDS was found to be rare and more aggressive in AYA. Karyotype was the most important prognostic factor. Allogeneic stem-cell transplantation o...