Clinical Hematology International

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35 articles

Therapeutic Approaches for Blastic Plasmacytoid Dendritic Cell Neoplasm: Allogeneic Hematopoietic Cell Transplantation and Novel Therapies

Mohamed A. Kharfan-Dabaja, Naveen Pemmaraju, Mohamad Mohty
Pages: 2 - 9
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a clinically aggressive hematologic malignancy derived from precursors of plasmacytoid dendritic cells. There is no established standard therapy for BPDCN and the efficacy of conventional chemotherapy is limited, with an anticipated median overall...

Management of AML Beyond “3 + 7” in 2019

Jonathan Canaani
Pages: 10 - 18
The therapeutic paradigm for treatment of acute myeloid leukemia (AML) is rapidly changing with the advent of a new generation of drugs targeting diverse aspects of leukemogenesis. Whereas standard treatment for AML until recently consisted of a classic chemotherapy backbone, the incorporation of novel...

Current Status and Perspectives of Irradiation-Based Conditioning Regimens for Patients with Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation

Rashmika R. Potdar, Sorab Gupta, Sebastian Giebel, Bipin N Savani, Gabor Varadi, Arnon Nagler, Slawomir Blamek
Pages: 19 - 27
Acute myeloid leukemia and acute lymphoblastic leukemia are the most common indications for allogeneic hematopoietic stem cell transplantation. Total body irradiation (TBI) is an important part of conditioning regimens. TBI-based regimens offer advantages in sanctuary sites but are associated with significant...

Fecal Microbiota Transplantation for Treatment of Acute Graft-versus-Host Disease

Roni Shouval, Mika Geva, Arnon Nagler, Ilan Youngster
Pages: 28 - 35
The growing understanding of the bidirectional relationship between the gastrointestinal (GI) microbiome and the immune system has opened up new avenues for treatment of graft-versus-host disease (GVHD). Fecal microbiota transplantation (FMT) is the transfer of stool from a donor to a recipient who harbors...

Challenges in Conducting Studies in Chronic Graft-versus-Host Disease

Iskra Pusic, Steven Z. Pavletic
Pages: 36 - 44
The lack of standardized criteria for measuring therapeutic response has been a major obstacle to the development of therapeutic trials in chronic graft-versus-host disease (cGvHD). Nevertheless, recent advances have been made in understanding of the biology and pathophysiology of cGvHD, as well as establishing...

Endothelial Dysfunction in Hematopoietic Cell Transplantation

Marta Palomo, Maribel Diaz-Ricart, Enric Carreras
Pages: 45 - 51
The goal of this review is to look at the role of endothelial damage and dysfunction in the initiation and development of early complications that appear after hematopoietic cell transplantation (HCT). These early complications share overlapping clinical manifestations and the suspicion of underlying...

Idiopathic Aplastic Anemia: An Update

Elena E. Solomou
Pages: 52 - 57
“Bone marrow failure” encompass all the conditions and syndromes in which there are qualitative or quantitative disorders of one or more lineages (erythroid, myelomonocytic, and/or megakaryocytic). A few years ago, the pathophysiology of these syndromes was completely unknown. Today we have better knowledge...

Allogeneic Stem Cell Transplantation for FLT3-Mutated Acute Myeloid Leukemia: In vivo T-Cell Depletion and Posttransplant Sorafenib Maintenance Improve Survival. A Retrospective Acute Leukemia Working Party-European Society for Blood and Marrow Transplant Study

Ali Bazarbachi, Myriam Labopin, Giorgia Battipaglia, Azedine Djabali, Edouard Forcade, William Arcese, Gerard Socié, Didier Blaise, Joerg Halter, Sabine Gerull, Jan J. Cornelissen, Patrice Chevallier, Johan Maertens, Nicolaas Schaap, Jean El-Cheikh, Jordi Esteve, Arnon Nagler, Mohamad Mohty
Pages: 58 - 74
Acute myeloid leukemia (AML) with FLT3-mutation carries a poor prognosis, and allogeneic stem cell transplantation (allo-SCT) is recommended at first complete remission (CR1). We assessed 462 adults (median age 50 years) with FLT3-mutated AML allografted between 2010 and 2015 from a matched related (40%),...

Salvage Therapy after Allogeneic Hematopoietic Cell Transplantation: Targeted and Low-Intensity Treatment Options in Myelodysplastic Syndrome and Acute Myeloid Leukemia

Katie Culos, Michael Byrne
Pages: 94 - 100
Patients with high-risk myeloid neoplasms, including myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), are offered allogeneic hematopoietic cell transplantation (alloHCT) to improve the likelihood of long-term disease control. More than 50% of patients with high-risk disease will relapse...

Treatment of Adult Patients with Relapsed/Refractory B-Cell Philadelphia-Negative Acute Lymphoblastic Leukemia

Enrico Maffini, Francesco Saraceni, Francesco Lanza
Pages: 85 - 93
The majority of adult patients affected by B-cell acute lymphoblastic leukemia (B-ALL) will relapse after an initial response, while approximately 20% will display primary resistant disease. Patients suffering from relapsed/refractory B-ALL have a very poor outcome. Allogeneic hematopoietic cell transplantation...

Engraftment Syndrome: A Retrospective Analysis of the Experience at a Tertiary Care Institute

Raja Pramanik, Harish Kancharla, Sameer Bakhshi, Atul Sharma, Ajay Gogia, Prabhat Malik, Ranjit Kumar Sahoo, Atul Batra, Sanjay Thulkar, Lalit Kumar
Pages: 114 - 119
Engraftment syndrome (ES) is a clinical syndrome that occurs in the early neutrophil recovery phase following hematopoietic stem cell transplant (HSCT). Although also described for allogenic HSCT, it is basically diagnosed in the context of autologous HSCT. We retrospectively reviewed 171 consecutive...

Relapse and Resistance to CAR-T Cells and Blinatumomab in Hematologic Malignancies

Elad Jacoby
Pages: 79 - 84
Application of immunotherapeutic modalities changed paradigms in the treatment of hematologic malignancies, with regards to drug manufacturing, treatment protocols, short- and long-term toxicities. FDA-approved therapies, including blinatumomab, tisagenlecleucel, and axicabtagene ciloleucel, target T...

Low-Dose Acyclovir Prophylaxis for Varicella zoster Reactivation in Autologous Hematopoietic Cell Transplantation Recipients

Naomi Fei, Nilay Shah, Aaron Cumpston, Sijin Wen, Kelly G. Ross, Michael Craig, Abraham S. Kanate
Pages: 101 - 104
Varicella zoster virus (VZV) reactivation after autologous hematopoietic cell transplantation (auto-HCT) may be observed in a quarter of patients. Currently, prophylactic use of acyclovir 800 mg twice daily or valacyclovir 500 mg twice daily is recommended for prophylaxis against VZV reactivation for...

Nanosphere's Verigene® Blood Culture Assay to Detect Multidrug-Resistant Gram-Negative Bacterial Outbreak: A Prospective Study on 79 Hematological Patients in a Country with High Prevalence of Antimicrobial Resistance

Raffaella Greco, Maria Chiara Barbanti, Nicasio Mancini, Laura Infurnari, Renée Pasciuta, Alessandra Forcina, Chiara Oltolini, Gabriele Casirati, Daniele Mannina, Fabio Giglio, Carlo Messina, Mara Morelli, Francesca Lorentino, Sara Mastaglio, Tommaso Perini, Luca Vago, Paolo Scarpellini, Matteo Giovanni Carrabba, Maria Teresa Lupo Stanghellini, Sarah Marktel, Andrea Assanelli, Massimo Bernardi, Consuelo Corti, Jacopo Peccatori, Massimo Clementi, Fabio Ciceri
Pages: 120 - 123
Infections are a major cause of morbidity and mortality in hematological patients. We prospectively tested a new molecular assay (Verigene®) in 79 consecutive hematological patients, with sepsis by gram-negative bacteria. A total of 82 gram-negative microorganisms were isolated by blood cultures, of...

Safety and Efficacy of Haploidentical Peripheral Blood Stem Cell Transplantation for Myeloid Malignancies Using Post-transplantation Cyclophosphamide and Anti-thymocyte Globulin as Graft-versus-Host Disease Prophylaxis

Maria Queralt Salas, Arjun Datt Law, Wilson Lam, Zeyad Al-Shaibani, David Loach, Dennis (Dong Hwan) Kim, Fotios V. Michelis, Santhosh Thyagu, Rajat Kumar, Jeffrey Howard Lipton, Jonas Mattsson, Auro Viswabandya
Pages: 105 - 113
Haploidentical stem cell transplantation (haploSCT) has greatly improved access to curative treatment for myeloid malignancies in patients without suitable matched sibling/unrelated donors. We investigated the safety and efficacy of haploSCT after reduced intensity conditioning (RIC) with anti-thymocyte...

The Impact of First Complete Remission by PET-CT and Time to Next Treatment on Survival of Follicular Lymphoma Patients

Tran-Der Tan, Lun-Wei Chiou, Mau-Ching Wu, Jia-Shing Wu, Ming-Yuan Lee, Yu-Yi Huang, Shing-Su Chen
Pages: 168 - 172
We retrospectively analyzed the impact of initial positron emission tomography and computed tomography (PET-CT) complete remission (CR) and time to next treatment (TTNT) on patient outcome in follicular lymphoma. Between 2002 and 2014, 150 patients could be evaluated for treatment response and long-term...

Lower Genital Tract Precancer and Cancer in Hematopoietic Cell Transplant Survivors and the Role of HPV: A Systematic Review and Future Perspectives

Mohammad Shahrukh Tanweer, Mahmoud Aljurf, Bipin N. Savani, Perviz K. Iqbal, Shahrukh Hashmi
Pages: 142 - 153
Female recipients of hematopoietic cell transplant (HCT) may develop lower genital tract (LGT) dysplasia or new malignancies. A comprehensive systematic review to delineate the occurrence and risk factors for post-HCT LGT precancer and cancer in women was conducted via electronic search of the Cochrane...

Robust Selections of Various Hematopoietic Cell Fractions on the CliniMACS Plus Instrument

Sandhya R. Panch, Opal L. Reddy, Katherine Li, Thejaswi Bikkani, Anusha Rao, Swathi Yarlagadda, Steven Highfill, Daniel Fowler, Richard W. Childs, Minocher Battiwalla, John Barrett, Andre Larochelle, Crystal Mackall, Nirali Shah, David F. Stroncek
Pages: 161 - 167
Cell separation technologies play a vital role in the graft engineering of hematopoietic cellular fractions, particularly with the rapid expansion of the field of cellular therapeutics. The CliniMACS Plus Instrument (Miltenyi Biotec) utilizes immunomagnetic techniques to isolate hematopoietic progenitor...

Allogeneic Stem Cell Transplantation with CD34+ Cell Selection

Elisa Roldan, Miguel Angel Perales, Pere Barba
Pages: 154 - 160
The success of allogeneic stem cell transplant is hampered by the development of acute and chronic graft-versus-host disease (GvHD) which has direct impact on treatment-related mortality and morbidity. As a result, T cell depletion through positive selection of CD34+ cells has emerged as a promising...

Natural Killer Cell-Mediated Cellular Therapy of Hematological Malignancies

Ugur Sahin, Meral Beksac
Pages: 134 - 141
Our understanding on the mechanisms of graft versus tumor/leukemia (GvT/GvL) and graft versus host (GvH) effects has tremendously evolved within the past decades. During the search for a mechanism that augments GvT/GvL without increasing GvH effects, natural killer (NK) cells have clearly attracted attention....

Management of Sickle Cell Intrahepatic Cholestasis: An Argument in Favor of Automated Exchange Transfusion

Brian D. Adkins, Bipin N. Savani, Garrett S. Booth
Pages: 127 - 133
Sickle cell disease patients are commonly treated at transfusion medicine services, and understanding of the hepatic manifestations of the disease is key for optimal management, specifically, in individuals presenting with sickle cell intrahepatic cholestasis (SCIC). SCIC represents a rare, severe hepatic...

Immune Thrombocytopenia: Are We Stuck in the Mud or Is There Light at the End of the Tunnel?

James Bussel, Oriana Miltiadous
Pages: 173 - 179
The differences in diagnosis and management between immune thrombocytopenia (ITP) and leukemia are striking. Leukemia diagnosis and management have evolved substantially over the past 30 years and are now relatively precise. The tendency for leukemic cells to be the overwhelming majority of circulating...

The Clinical Course of Multiple Myeloma in the Era of Novel Agents: A Retrospective, Single-Center, Real-World Study

Agoston Gyula Szabo, Katrine Fladeland Iversen, Sören Möller, Torben Plesner
Pages: 220 - 228
In this retrospective study we reviewed the clinical course of every patient with multiple myeloma treated from 2006 to 2016 at Vejle Hospital: 303 patients with a median age of 69 years at diagnosis received a median of four (range 1–18) lines of therapy; 149 in a 2006–2010 cohort and 154 in a 2011–2016...

Induction Therapy with Novel Agents and Autologous Stem Cell Transplant Overcomes the Adverse Impact of Renal Impairment in Multiple Myeloma

Lalit Kumar, Santosh Kumar Chellapuram, Ramavat Dev, Ankur Varshneya, Satyajit Pawar, Aparna Sharma, Anjali Mookerjee, Ranjit Kumar Sahoo, Prabhat Singh Malik, Atul Sharma, Ritu Gupta, Omdutta Sharma, Ahitagni Biswas, Rakesh Kumar, Sanjay Thulkar, Sauumyaranjan Mallick
Pages: 205 - 219
We investigated the impact of renal impairment (RI) on the outcome in multiple myeloma (MM) patients following induction and autologous stem cell transplantation (ASCT). Among 349 patients who received a first ASCT for MM, 86 (24.6%) had RI at diagnosis, defined as estimation of glomerular filtration...

Elevated Galectin-3 Plasma Concentrations in Recipients of Allogeneic Hematopoietic Cell Transplantation

Zachariah DeFilipp, Nalu Navarro-Alvarez, Shuli Li, Alec R. Andrews, Ariel Johnson, Yi-Bin Chen, Vincent T. Ho, Jerome Ritz, Thomas R. Spitzer, Christene A. Huang
Pages: 201 - 204
Galectin-3 is a beta-galactoside-binding lectin with an established association to inflammatory and fibrotic conditions. We investigated galectin-3 levels in 68 recipients of allogeneic hematopoietic cell transplantation (HCT) to look for associations with chronic graft-versus-host disease (cGVHD). Plasma...

Managing Endocrine Disorders in Adults After Hematopoietic Stem Cell Transplantation

Juliana Matthews, Dwight Eplin, Bipin Savani, Barbara Gisella Carranza Leon, Leslee Matheny
Pages: 180 - 188
Hematopoietic stem cell transplantation (HSCT) has become a potentially curative therapy for an increasing number of malignant and non-malignant conditions. As survival rates continue to improve, the focus of patient care has shifted from managing not only immediate but also long-term complications....

Use of Biosimilar Granulocyte Colony-Stimulating Factor for Mobilization in Autologous and Allogeneic Hematopoietic Stem Cell Transplantation

Dwight D. Eplin, Anna D. Jackson, Austin M. Smith, Brent Salvig, Wichai Chinratanalab, Bipin N. Savani
Pages: 229 - 233
The biologic medication filgrastim is approved by the Food and Drug Administration (FDA) to mobilize hematopoietic progenitor cells (HPCs) for collection by leukapheresis for autologous hematopoietic stem cell transplant (HSCT). The FDA-approved biologic tbo-filgrastim is currently used off-label for...

Moving Toward Continuous Therapy in Multiple Myeloma

Francesca Bonello, Giusy Cetani, Luca Bertamini, Francesca Gay, Alessandra Larocca
Pages: 189 - 200
The introduction of novel agents, characterized by favorable toxicity profiles and higher manageability compared to conventional drugs employed in the past, has considerably changed the treatment paradigm for multiple myeloma. Continuous therapy currently represents the standard approach for myeloma...

Human Herpes Virus-6 Encephalitis Following Autologous Blood and Marrow Transplant

Jacques Mario Azzi, Doyun Park, Maher Abdul-Hay, Kelli Cole, Frank Cirrone, Maxim Kreditor, A. Samer Al-Homsi
Human herpesvirus-6 (HHV-6) is a highly prevalent virus that establishes lifelong latency in human hosts. Symptomatic HHV-6 reactivation rarely occurs in immunocompetent individuals and is best described in immunosuppressed patients such as recipients of bone marrow transplants (BMT). In that setting,...

Clinical Advancement and Challenges of ex vivo Expansion of Human Cord Blood Cells

Oluwadunni E. Emiloju, Rashmika Potdar, Vinicius Jorge, Sorab Gupta, Gabor Varadi
Apart from peripheral blood stem cell (PBSC), umbilical cord blood (UCB) is now a recognized source of stem cells for transplantation. UCB is an especially important source of stem cells for minority populations, which would otherwise be unable to find appropriately matched adult donors. UCB has fewer...

Emerging Therapies for the Myelodysplastic Syndromes

Jonathan Canaani
Despite considerable advances in our understanding of the molecular and epigenetic underpinnings of the myelodysplastic syndromes (MDS), this diverse group of myeloid neoplasms remains a significant clinical challenge. Considerable barriers to timely development of effective therapy include the diverse...

Timed Sequential Salvage Chemotherapy for Relapsed or Refractory Acute Myeloid Leukemia

Bogdan Popescu, Sheenu Sheela, Julie Thompson, Sophia Grasmeder, Therese Intrater, Christin B. DeStefano, Christopher S. Hourigan, Catherine Lai
Therapy for those with relapsed or refractory acute myeloid leukemia is suboptimal. Studies have suggested that timed sequential salvage combination cytotoxic chemotherapy may be particularly useful for that indication. We report here a series of ten such adult patients treated sequentially at a single...