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Psychosocial, health and demographic characteristics of quality of life among patients with acute myeloid leukemia and malignant lymphoma who underwent autologous hematopoietic stem cell transplantation
Slovacek, Ladislav;Slovackova, Birgita;Jebavy, Ladislav;Macingova, Zuzana;
Sao Paulo Medical Journal , 2007, DOI: 10.1590/S1516-31802007000600012
Abstract: context and objective: this study evaluated the effect of selected psychosocial, health and demographic characteristics of quality of life (qol) among patients treated with autologous hematopoietic stem cell transplantation (hsct). design and setting: this was a retrospective study at charles university hospital, hradec kralove. methods: the czech version of the international generic european quality-of-life questionnaire (eq-5d) was applied to evaluate qol among patients with acute myeloid leukemia (aml) and malignant hodgkin?s and non-hodgkin?s lymphoma (ml). the total number of respondents was 36: 12 with aml (seven males and five females) and 24 with ml (11 males and 13 females). the mean age of aml respondents was 46 years and the mean age of ml respondents was 44.5 years. results: age, smoking status and education level had statistically significant effects on qol among aml respondents (p < 0.05), and age had a statistically significant effect on qol among ml respondents (p < 0.05). the overall qol among aml and ml respondents was generally good: the mean eq-5d score among aml respondents was 71.5% and among ml respondents it was 82.7%. conclusion: the qol among aml and ml respondents treated with autologous hsct was good. however, patients more than 50 years old, smokers and patients with lower education levels presented worse qol. these findings need to be better evaluated in longitudinal studies, using large samples.
Hematopoietic stem cell transplantation for the management of follicular lymphoma  [cached]
Chitra Hosing
Stem Cells and Cloning: Advances and Applications , 2010,
Abstract: Chitra HosingDepartment of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USAAbstract: Although much has been published on the application of autologous and allogeneic hematopoietic stem cell transplantation in patients with follicular lymphoma (FL), no uniform consensus exists among physicians on when to use this strategy. Three large randomized trials failed to show a survival benefit using autologous transplantation for FL patients in first complete remission. Similarly, many Phase II or registry-based studies have also failed to show a survival benefit with autologous transplantation in relapsed or refractory FL patients, although the progression-free survival seems to be prolonged in transplant recipients. Allogeneic stem cell transplantation can cure a subset of patients with FL, but high nonrelapse mortality and morbidity remain a concern. No consensus exists on what conditioning regimen should be used,or how the newer monoclonal antibodies should be incorporated into the transplant paradigm. Here we present a review of the role of autologous and allogeneic hematopoietic stem cell transplantation in patients with FL.Keywords: review, follicular lymphoma, allogeneic transplantation, autologous transplantation
Hematopoietic stem cell transplantation for the management of follicular lymphoma
Chitra Hosing
Stem Cells and Cloning: Advances and Applications , 2010, DOI: http://dx.doi.org/10.2147/SCCAA.S7014
Abstract: topoietic stem cell transplantation for the management of follicular lymphoma Review (3291) Total Article Views Authors: Chitra Hosing Published Date May 2010 Volume 2010:3 Pages 69 - 80 DOI: http://dx.doi.org/10.2147/SCCAA.S7014 Chitra Hosing Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA Abstract: Although much has been published on the application of autologous and allogeneic hematopoietic stem cell transplantation in patients with follicular lymphoma (FL), no uniform consensus exists among physicians on when to use this strategy. Three large randomized trials failed to show a survival benefit using autologous transplantation for FL patients in first complete remission. Similarly, many Phase II or registry-based studies have also failed to show a survival benefit with autologous transplantation in relapsed or refractory FL patients, although the progression-free survival seems to be prolonged in transplant recipients. Allogeneic stem cell transplantation can cure a subset of patients with FL, but high nonrelapse mortality and morbidity remain a concern. No consensus exists on what conditioning regimen should be used,or how the newer monoclonal antibodies should be incorporated into the transplant paradigm. Here we present a review of the role of autologous and allogeneic hematopoietic stem cell transplantation in patients with FL.
Day 100 Absolute Monocyte/Lymphocyte Prognostic Score and Survival Post Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation in Diffuse Large B-Cell Lymphoma  [PDF]
Ana I. Velazquez, David J. Inwards, Stephen M. Ansell, Ivana N. Micallef, Patrick B. Johnston, William J. Hogan, Svetomir N. Markovic, Luis F. Porrata
Journal of Cancer Therapy (JCT) , 2013, DOI: 10.4236/jct.2013.48153
Abstract:


Day 100 prognostic factors post-autologous peripheral blood hematopoietic stem cell transplantation (APBHSCT) to predict clinical outcomes in diffuse large B-cell lymphoma (DLBCL) patients have not been studied. Thus, we retrospectively examined if day 100 absolute monocyte/lymphocyte prognostic score (AMLPS-100) affects clinical outcomes by landmark analysis from day 100 post-APBHSCT in DLBCL. Only DLBCL patients in complete remission at day 100 post-APBHSCT were evaluated. From 2000 to 2007, 134 consecutive DLBCL patients are qualified for the study. Patients with a day 100 absolute monocyte count (AMC-100) ≥ 630 cells/μL and day 100 absolute lymphocyte count (ALC-100) ≤ 1000 cells/μL experienced inferior overall survival (OS) and progression free survival (PFS). On multivariate analysis, the AMC-100 and ALC-100 remained independent predictors of OS and PFS. Combining both values into the AMLPS-100, the 5-year OS rates for low, intermediate, and high AMLPS-100 risk groups were 94% (95% CI, 83.0% - 98.1%), 70% (95% CI, 58.6% - 80.1%), and 13% (95% CI, 3.4% - 40.5%), respectively; and the 5-year PFS rates were 87% (95% CI, 74.0% - 94.1%), 68% (95% CI, 56.0% - 77.8%), and 13% (95% CI, 3.4% - 40.5%), respectively. The AMLPS-100 is a simple biomarker score that can stratify clinical outcomes from day 100 post-APBHSCT in DLBCL patients.


Efficacy and safety of high-dose chemotherapy with autologous hematopoietic stem cell rescue for relapsed/refractory Hodgkin's lymphoma patients in former USSR countries. Retrospective analysis of data from four transplantation centers in Belarus, Russia and the Ukraine
Ptushkin VV,Afanasyev BV,Zhukov NV,Uss AL
Cellular Therapy and Transplantation , 2008,
Abstract: High-dose chemotherapy (HDC) with autologous stem cell transplantation support is a routine treatment approach for relapsed or refractory Hodgkin's lymphoma (HL) patients. Unfortunately, HDC is much less common in the former USSR republics; among other reasons due to a lack of information about the efficacy and safety of this treatment as performed at local centers.We analyzed the outcome for 184 HL patients receiving HDC in the former USSR republics between January 1990 and March 2003. Most patients had primary refractory disease (44.8%), early (27.2%) or multiple (21.6%) relapses. Restaging revealed stage III–IV disease in 69%, and B-symptoms in 53% of cases. The patients received a mean of 9 (2 to 34) courses of standard chemotherapy prior to HDC.HDC yielded complete response or complete response uncertain (CR/CRu) in 68.2% of cases, and the 5-year overall survival (OS) rate was 60%; freedom from treatment failure (FFTF) survival was 41.5% with a median follow-up of 30 months (3 to 139 months). As estimated with respect to disease status, the 5-year FFTF was 35% among patients with primary refractory disease, 46.4% in patients with multiple relapses, and 59.2% in patients with early sensitive relapse. The early death rate was 5.4%, but has demonstrated a considerable decreasing trend over recent years (1.4% in 2000–2003). The HDC with autologous hematopoietic stem cell rescue procedure performed at transplant centers in the former USSR republics is associated with low mortality and satisfactory FFTF for patients with primary refractory or relapsed Hodgkin's disease.
Specific Factors Influence the Success of Autologous and Allogeneic Hematopoietic Stem Cell Transplantation  [PDF]
Thissiane L. Gon alves,Dalila M. Benvegnú,Gabriela Bonfanti
Oxidative Medicine and Cellular Longevity , 2009, DOI: 10.4161/oxim.2.2.8355
Abstract: Successful hematopoietic stem cell transplantation (HSCT), both autologous and allogeneic, requires a rapid and durable engraftment, with neutrophil (>500/µL) and platelet (>20,000/µL) reconstitution. Factors influencing engraftment after autologous or allogeneic HSCT were investigated in 65 patients: 25 autologous peripheral stem cell transplantation (PBSCT) and 40 allogeneic bone marrow transplantation (BMT) patients. The major factor affecting engraftment was the graft source for HSCT. Neutrophil and platelet recovery were more rapid in autologous PBSCT than in allogeneic BMT [neutrophil occurring in median on day 10.00 (09.00/11.00) and 19.00 (16.00/23.00) and platelet on day 11.00 (10.00/13.00) and 21.00 (18.00/25.00), respectively; p < 0.0001]. The type of disease also affected engraftment, where multiple myeloma (MM) and lymphoma showed faster engraftment when compared with leukemia, syndrome myelodysplastic (SMD) and aplastic anemia (AA) and MM presented the best overall survival (OS) in a period of 12 months. Other factors included the drug used in the conditioning regimen (CR), where CBV, melphalan (M-200) and FluCy showed faster engraftment and M-200 presented the best OS, in a period of 12 months and age, where 50–59 years demonstrated faster engraftment. Sex did not influence neutrophil and platelet recovery.
Autologous hematopoietic stem cell transplantation in multiple sclerosis
Yury L. Shevchenko,Andrei A. Novik,Alexey N. Kuznetsov,Boris V. Afanasiev
Cellular Therapy and Transplantation , 2008,
Abstract: Background: Although there is no effective cure for this disease, high-dose chemotherapy (HDCT), together with autologous hematopoietic stem cell transplantation (auto-HSCT) offers promising results in the treatment of multiple sclerosis (MS) patients.Methods: In this paper we present results of a prospective clinical study of safety and efficacy of HDCT+auto-HSCT in MS patients. One hundred and nine patients with various types of MS were included in this study. The patients underwent early, conventional, or salvage/late transplantation.Results: The transplantation procedure was well tolerated by MS patients, with no transplant-related deaths at all. The efficacy analysis was performed in 79 patients. Forty-two achieved an objective improvement of neurological symptoms (defined as a ≥0.5 point decrease in EDSS score as compared to the baseline and confirmed over 6 months), and 37 patients had disease stabilization (steady EDSS level as compared to the baseline and confirmed over 6 months). Quality of life (QoL) was assessed in 44 patients. Thirty-nine patients exhibited a QoL response 1 year after transplantation.Conclusions: This study provides ample evidence in support of HDCT+auto-HSCT efficacy in MS patients. The results obtained show that transplantation appears to be effective in patients with various types of MS.
Brazilian experience using high dose sequential chemotherapy followed by autologous hematopoietic stem cell transplantation for malignant lymphomas
Duarte, Bruno Kosa Lino;Miranda, Eliana Cristina Martins;Nucci, Marcio;Vigorito, Afonso Celso;Penteado, Francisco José;Marques Jr, José Francisco Comenalli;Oliveira-Duarte, Gislaine Borba;Lorand-Metze, Irene Gyongyver Heidemarie;Pagnano, Katia Borgia;Delamain, Marcia Torresan;Baldissera, Renata;Valente, Isabella Salvetti;Souza, Carmino Antonio de;
Revista Brasileira de Hematologia e Hemoterapia , 2011, DOI: 10.5581/1516-8484.20110118
Abstract: objective: to evaluate the use of high-dose sequential chemotherapy in a brazilian population. methods: high-dose cyclophosphamide followed by autologous hematopoietic stem cell transplantation is an effective and feasible therapy for refractory/relapsed lymphomas; this regimen has never before been evaluated in a brazilian population. all patients (106 with high-grade non-hodgkin lymphoma and 77 with hodgkin's lymphoma) submitted to this treatment between 1998 and 2006 were analyzed. chemotherapy consisted of the sequential administration of high-dose cyclophosphamide (4 or 7 g/m2) and granulocyte-colony stimulating factor (300 μg/day), followed by peripheral blood progenitor cell harvesting, administration of etoposide (2g/m2) and methotrexate (8 g/m2 only for hodgkin's lymphoma) and autologous hematopoietic stem cell transplantation. results: at diagnosis, non-hodgkin lymphoma patients had a median age of 45 (range: 8-65) years old, 78% had diffuse large b-cell lymphoma and 83% had stage iii/iv disease. the hodgkin's lymphoma patients had a median age of 23 (range: 7-68) years old, 64.9% had the nodular sclerosis subtype and 65% had stage iii/iv disease. nine hodgkin's lymphoma patients (13%) and 10 (9%) non-hodgkin lymphoma patients had some kind of cardiac toxicity. the overall survival, disease-free survival and progression-free survival in hodgkin's lymphoma were 29%, 59% and 26%, respectively. in non-hodgkin lymphoma, these values were 40%, 49% and 31%, respectively. high-dose cyclophosphamide-related mortality was 10% for hodgkin's lymphoma and 5% for non-hodgkin lymphoma patients. high-dose cyclophosphamide dosing had no impact on toxicity or survival for both groups. conclusions: despite a greater prevalence of poor prognostic factors, our results are comparable to the literature. the incidence of secondary neoplasias is noteworthy. our study suggests that this approach is efficient and feasible, regardless of toxicity-related mortality.
Hematopoietic stem cell transplantation  [cached]
Eleftheria Hatzimichael,Mark Tuthill
Stem Cells and Cloning: Advances and Applications , 2010,
Abstract: Eleftheria Hatzimichael1, Mark Tuthill21Department of Haematology, Medical School of Ioannina, University of Ioannina, Ioannina, Greece; 2Department of Medical Oncology, Hammersmith Hospital, Imperial College National Health Service Trust, London, UKAbstract: More than 25,000 hematopoietic stem cell transplantations (HSCTs) are performed each year for the treatment of lymphoma, leukemia, immune-deficiency illnesses, congenital metabolic defects, hemoglobinopathies, and myelodysplastic and myeloproliferative syndromes. Before transplantation, patients receive intensive myeloablative chemoradiotherapy followed by stem cell “rescue.” Autologous HSCT is performed using the patient’s own hematopoietic stem cells, which are harvested before transplantation and reinfused after myeloablation. Allogeneic HSCT uses human leukocyte antigen (HLA)-matched stem cells derived from a donor. Survival after allogeneic transplantation depends on donor–recipient matching, the graft-versus-host response, and the development of a graft versus leukemia effect. This article reviews the biology of stem cells, clinical efficacy of HSCT, transplantation procedures, and potential complications.Keywords: hematopoietic stem cell transplantation, complications
Lenalidomide before and after Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma  [PDF]
S. A. Tuchman,N. J. Chao,C. G. Gasparetto
Advances in Hematology , 2012, DOI: 10.1155/2012/712613
Abstract: Although multiple myeloma remains incurable outside of allogeneic hematopoietic stem cell transplantation, novel agents made available only in the last few decades have nonetheless tremendously improved the landscape of myeloma treatment. Lenalidomide, of the immunomodulatory class of drugs, is one of those novel agents. In the non-transplant and relapsed/refractory settings, lenalidomide clearly benefits patients in terms of virtually all meaningful outcomes including overall survival. Data supporting the usage of lenalidomide as part of treatment approaches incorporating high-dose chemotherapy with autologous stem cell support (ASCT) are less mature as pertains to such long-term outcomes and toxicity, and lenalidomide is not currently approved by regulatory agencies for use in the context of ASCT in either the United States or Europe. That said, relatively preliminary efficacy data describing lenalidomide as a component of ASCT-based treatment approaches to MM are indeed promising, and consequently lenalidomide’s role in ASCT-based treatment strategies is growing. In this review we summarize existing data that pertains to lenalidomide in the specific context of ASCT, and we share our thoughts on how our own group applies these data to approach this complex issue clinically. 1. Introduction Multiple myeloma (MM) is a malignancy of plasma cells that strikes roughly 20,000 and kills 10,000 US Americans yearly [1]. Outside of allogeneic stem cell transplantation, MM remains incurable, albeit increasingly treatable, thanks to the advent of novel agents including those that are currently approved by the United States Food and Drug Administration (FDA) and European Medicines Agency (EMA)—bortezomib, thalidomide, and lenalidomide. Regarding the latter, the initial phase one study of lenalidomide (Revlimid), then known as CC-5013, first appeared in the scientific literature in 2002 and attention rapidly focused on CC-5013’s activity even in multiply relapsed and refractory MM (RRMM) [2]. That study and others led to the later definitive phase three MM-009 and 010 trials, which showed overall survival benefits for RRMM patients on lenalidomide and dexamethasone in contrast to those on dexamethasone alone [3, 4]. FDA and EMA approval for lenalidomide followed, and lenalidomide and dexamethasone became established as a standard of care for RRMM. Subsequent clinical trials have further explored the role of lenalidomide as a part of treatment strategies for newly diagnosed MM (NDMM) that both include or exclude high-dose therapy with autologous hematopoietic stem
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