Articles related to TRANSPLANT MEDICINE

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.

A study published in Morbidity & Mortality Weekly Report (MMWR) argues that immunosuppressed patients and people with compromised immune systems need more than two vaccine doses to achieve adequate protection against COVID-19. After two vaccine doses, immunocompromised patients saw 77% vaccine effectiveness against hospitalization, versus 90% for immunocompetent individuals.

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.

Letermovir is a recently approved antiviral shown to decrease clinically significant cytomegalovirus (CMV) infection after hematopoietic cell transplantation (HCT) in a phase 3, randomized, placebo-controlled trial. Appearing in Blood, the authors make two key points: 1) Letermovir prophylaxis may be associated with decreased polyfunctional CMV-specific T-cell immunity after HCT, and 2) COMPASS is an analytical tool that can effectively measure polyfunctional CMV-specific T-cell immune responses.

In this article from Blood Advances highlighted by helpful visual abstracts, two key points are discussed. First, patient-specific next-generation sequencing (NGS)-based measurable residual disease (MRD) monitoring using non-DTA mutations after allogeneic hematopoietic cell transplantation (alloHCT) is independently prognostic for relapse and survival. Second, the kinetics rather than a single time point should be further evaluated when DTA mutations are used for MRD monitoring after alloHCT.