Articles related to TRANSPLANT MEDICINE

Dr. Mohyudding summarizes key findings ASCO reports, including updates on teclistamab in CAR-T, the DETERMINATION trial assessing auto-transplantation, cilta-cel (covered by HCN here), and the ATLAS study evaluating carfilzomib with lenalidomide and dexamethasone as maintenance vs. lenalidomide alone.

Responses to conventional donor lymphocyte infusion for post-allogeneic hematopoietic cell transplantation relapse are typically poor. Natural killer cell-based therapy is a promising modality to treat post-HCT relapse. This ongoing phase I trial of adoptively transferred cytokine induced memory-like (CIML) NK cells in patients with myeloid malignancies relapsed after haploidentical HCT saw a dynamic evolution of the activated CIML NK cell phenotype, superimposed on the natural variation in donor NK cell repertoires.

This meta-analysis examined 1,212 published articles and abstracts, of which the 30 fulfilling their criteria were analyzed to evaluate the effect of vitamin D levels on OS, PFS, and secondarily on time to treatment, relapse rate, and non-relapse mortality in patients with hematologic malignancies. Lower vitamin D level at diagnosis was related to a significantly impaired prognosis for myeloid and lymphoid malignancies, as previously reported.

The authors analyzed the outcome of 349 patients with primary or secondary myelofibrosis undergoing reduced intensity transplantation, of whom 35 had accelerated-phase myelofibrosis. After a median follow-up of 5.9 years, estimated 5-year overall survival was between the two groups, and median overall survival was not reached. In terms of relapse, five-year incidence was 30% for the accelerated-phase group versus 15% for the chronic-phase group. Reduced intensity transplantation showed excellent survival but higher relapse for accelerated-phase myelofibrosis.

In ASH Clinical News, Dr. Geoffrey Uy, a professor in the Oncology Division at Washington University School of Medicine in St. Louis, discusses treatment options for a transplant-ineligible patient who has Philadelphia chromosome-positive (Ph+) acute lymphocytic leukemia (ALL). The patient under review is a 61-year-old female diagnosed with Ph+ ALL who has multiple comorbidities and is not a candidate for allogeneic hematopoietic cell transplantation.

Despite peripheral blood making up 80% of all of hematopoietic cell transplants, there are similar rates of overall survival, disease-free survival, and transplant-related mortality when comparing marrow and peripheral blood as graft sources. Chronic graft-versus-host disease (GVHD) and cytokine release syndrome (CRS) are more significant in those who received peripheral blood, yet the standard of care hasn’t changed. Here, two doctors reflect on the debate.