scholarly journals “Influence of Body Composition Assessed by Computed Tomography on Mortality in Older Adults Undergoing Hematopoietic Stem Cell Transplantation”

2021 ◽  
Author(s):  
Ludmila Koch ◽  
Andrea Z Pereira ◽  
Nelson Hamerschlak ◽  
Adham do Amaral e Castro ◽  
Adriano Tachibana ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Body Composition ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Positive Association ◽  
Allogeneic Transplantation ◽  
Hematopoietic Stem ◽  
Death Risk ◽  
Graft Versus Host

Abstract Aim: The incidence of most hematologic malignancies increases with age. Hematopoietic stem cell transplantation (HSCT) provides a potentially life-prolonging or curative option for many patients in this scenario. Limited data is available on muscle mass and density assessed from CT-images on outcomes after HSCT. We aimed to evaluate the influence of body composition on morbidity and mortality in older adults undergoing (HSCT). Methods: Retrospective longitudinal study conducted with 50 patients ≥ 60 years undergoing HSCT at Hospital Israelita Albert Einstein, São Paulo. Body composition was assessed by chest computed tomography and treatment related mortality, graft versus host disease, neutrophil grafting, and overall survival were analyzed.Results: 148 HSCT patients were evaluated, 50 patients were eligible: 60% with autologous and 40% with allogeneic transplantation. Body mass index in patients was (female: 26.9 ± 4.7 kg/m2; 30.1± 4.9 kg/m2) - autologous and (female: 24.3 ± 5.15 kg/m2; male: 26.4 ± 2.0 kg/m2) - allogeneic. In autologous transplant group, we found a positive association between age and death risk with an increase of 63.5% in this risk (p=0.006) and also Karnofsky performance scale with decrease of 11.9% in death risk (p<0.001). A negative association between muscle radiodensity and death risk was observed in allogeneic transplantation patients with risk decrease of 20.1% (p = 0.032). We found a positive association between T4 muscle area and radiodensity with risk of acute graft versus host disease (p= 0.028). Conclusion: In population studied, body composition assessed by chest tomography showed the importance of radiodensity for better prognosis.

POSSIBILITIES OF USING RUXOLITINIB TO IMPROVE THE RESULTS OF allo-HSCT (LITERATURE REVIEW)

2019 ◽  
Vol 65 (3) ◽  
pp. 330-336
Author(s):  
Irina Gribkova ◽  
I. Ishmatova ◽  
Mariya Davydovskaya ◽  
K. Kokushkin
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Literature Review ◽  
Stem Cell Transplantation ◽  
Clinical Improvement ◽  
Cell Transplantation ◽  
Graft Versus Host Disease ◽  
Post Transplantation ◽  
Hematopoietic Stem ◽  
Graft Versus Host

The aim of the study was to systematize and summarize the current available data on ruxolitinib use in patients with myelofibrosis (MF) prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) to improve its results. The review includes data from foreign and domestic articles found in the PubMed and elibrary.ru databases describing the results of the use of ruxolitinib in patients with MF prior to allo-HSCT, including clinical cases, original scientific studies and reviews. It is reported that ruxolitinib therapy is safe, reduces mortality in the early post-transplantation period, reduces the incidence of acute and chronic graft-versus-host disease, and decreases the frequency of relapses. Clinical improvement with ruxolitinib therapy prior to allo-HSCT can be considered a prognostically favorable factor.

scholarly journals Mesenchymal stromal cells as prophylaxis for graft-versus-host disease in haplo-identical hematopoietic stem cell transplantation recipients with severe aplastic anemia?—a systematic review and meta-analysis

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Ruonan Li ◽  
Jingke Tu ◽  
Jingyu Zhao ◽  
Hong Pan ◽  
Liwei Fang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Stromal Cells ◽  
Acute Gvhd ◽  
Meta Analysis ◽  
Cmv Infection ◽  
Hematopoietic Stem ◽  
Graft Versus Host

Abstract Background Mesenchymal stromal cells (MSCs) are an emerging prophylaxis option for graft-versus-host disease (GVHD) in haplo-identical hematopoietic stem cell transplantation (haplo-HSCT) recipients with severe aplastic anemia (SAA), but studies have reported inconsistent results. This systematic review and meta-analysis evaluates the efficacy of MSCs as prophylaxis for GVHD in SAA patients with haplo-HSCT. Methods Studies were retrieved from PubMed, EMBASE, Cochrane, Web of Science, and http://clinicaltrials.gov from establishment to February 2020. Twenty-nine single-arm studies (n = 1456) were included, in which eight (n = 241) studies combined with MSCs and eleven (n = 1215) reports without MSCs in haplo-HSCT for SAA patients. The primary outcomes were the incidences of GVHD. Other outcomes included 2-year overall survival (OS) and the incidence of cytomegalovirus (CMV) infection. Odds ratios (ORs) were calculated to compare the results pooled through random or fixed effects models. Results Between MSCs and no MSCs groups, no significant differences were found in the pooled incidences of acute GVHD (56.0%, 95% CI 48.6–63.5% vs. 47.2%, 95% CI 29.0–65.4%; OR 1.43, 95% CI 0.91–2.25; p = 0.123), grade II–IV acute GVHD (29.8%, 95% CI 24.1–35.5% vs. 30.6%, 95% CI 26.6–34.6%; OR 0.97, 95% CI 0.70–1.32; p = 0.889), and chronic GVHD (25.4%, 95% CI 19.8–31.0% vs. 30.0%, 95% CI 23.3–36.6%; OR 0.79, 95% CI 0.56–1.11; p = 0.187). Furtherly, there was no obvious difference in 2-year OS (OR 0.98, 95% CI 0.60–1.61; p = 1.000) and incidence of CMV infection (OR 0.61, 95% CI 0.40–1.92; p = 0.018). Conclusions Our meta-analysis indicates that the prophylactic use of MSC co-transplantation is not an effective option for SAA patients undergoing haplo-HSCT. Hence, the general co-transplantation of MSCs for SAA haplo-HSCT recipients may lack evidence-based practice.

CD26 expression on donor harvest as a risk predictive biomarker for developing Graft-versus-Host Disease post-Allogeneic Hematopoietic Stem Cell Transplantation: A tenyear followup study

2021 ◽  
pp. 1-12
Author(s):  
Sachin Punatar ◽  
Shruti Kandekar ◽  
Navin Khattry ◽  
Anant Gokarn ◽  
Kumar Prabhash ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Clinical Outcomes ◽  
Graft Versus Host Disease ◽  
Transplant Recipients ◽  
Hematopoietic Stem ◽  
Graft Versus Host ◽  
Cd34 Cells ◽  
Cd26 Expression

BACKGROUND: Allogeneic hematopoietic stem cell transplantation (ASCT) is the preferred treatment option for patients with several hematologic disorders and immunodeficiency syndromes. Graft versus host disease (GVHD) is an immune mediated post-transplant complication which has a major impact on long term transplant outcomes. OBJECTIVE: Current efforts are focused on identification of new markers that serve as potential predictors of GVHD and other post-transplant clinical outcomes. METHODS: This study includes donor harvests collected from twenty-three allogeneic donors during period 2008–2009 and respective transplant recipients followed for clinical outcomes till March 2019. Percent CD26+ and CD34+ cells in donor harvest were analyzed using flow cytometry. Percent expression and infused dose of CD26+ and CD34+ cells were evaluated for association with various clinical outcomes. RESULTS: Total 23 healthy donors 28 years (13 males), and transplant recipients with median age 24 years (17 males) formed the study cohort. The diagnosis included malignant (n= 13) and non-malignant (n= 10) disorders. Median CD34brCD45lo HSC expression was 057% (IQR 024–103) while median CD26 expression was 1964% (IQR 896–3356) of all nucleated cells. CD26 expression was associated with donor age (P= 0.37). CD26 percent expression correlated with WBC engraftment (P= 0.015) and with acute GVHD (P= 0.023) whereas infused CD26 cell dose correlated with WBC engraftment (P= 0.004) and risk of CMV reactivation (P= 0.020). There was no statistically significant correlation of either CD26 expression or cell dose with chronic GVHD, EFS or OS.

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