Browsing by keyword "hematopoietic cell transplantation"

Now showing items 1-2 of 2

    • Comparison of outcomes of HCT in blast phase of BCR-ABL1- MPN with de novo AML and with AML following MDS
      Gupta, Vikas; Cerny, Jan (2020-10-13)
      Comparative outcomes of allogeneic hematopoietic cell transplantation (HCT) for BCR-ABL1- myeloproliferative neoplasms (MPNs) in blast phase (MPN-BP) vs de novo acute myeloid leukemia (AML), and AML with prior myelodysplastic syndromes (MDSs; post-MDS AML), are unknown. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we compared HCT outcomes in 177 MPN-BP patients with 4749 patients with de novo AML, and 1104 patients with post-MDS AML, using multivariate regression analysis in 2 separate comparisons. In a multivariate Cox model, no difference in overall survival (OS) or relapse was observed in patients with MPN-BP vs de novo AML with active leukemia at HCT. Patients with MPN-BP in remission had inferior OS in comparison with de novo AML in remission (hazard ratio [HR], 1.40 [95% confidence interval [CI], 1.12-1.76]) due to higher relapse rate (HR, 2.18 [95% CI, 1.69-2.80]). MPN-BP patients had inferior OS (HR, 1.19 [95% CI, 1.00-1.43]) and increased relapse (HR, 1.60 [95% CI, 1.31-1.96]) compared with post-MDS AML. Poor-risk cytogenetics were associated with increased relapse in both comparisons. Peripheral blood grafts were associated with decreased relapse in MPN-BP and post-MDS AML (HR, 0.70 [95% CI, 0.57-0.86]). Nonrelapse mortality (NRM) was similar between MPN-BP vs de novo AML, and MPN-BP vs post-MDS AML. Total-body irradiation-based myeloablative conditioning was associated with higher NRM in both comparisons. Survival of MPN-BP after HCT is inferior to de novo AML in remission and post-MDS AML due to increased relapse. Relapse-prevention strategies are required to optimize HCT outcomes in MPN-BP.

    • Facing COVID-19 in the Hematopoietic Cell Transplant Setting: A New Challenge for Transplantation Physicians
      Sahu, Kamal Kant; Jindal, Vishal; Siddiqui, Ahmad Daniyal; Cerny, Jan (2020-04-11)
      Coronavirus disease (COVID-19) Pandemic has put enormous pressure on the health care system worldwide. As of 8th April 2020, more than 220 countries are already affected with a total of 1,462,698 confirmed COVID-19 cases and 84,792 deaths across the globe [1]. Absence of a specific antiviral agent and vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has strangled the treating health care providers. The special population that is at high risk of acquiring SARS-CoV 2 infection are immunocompromised, and HIV infected persons, pregnant woman, and cancer patients [2]. We hereby discuss the challenges being faced by cancer patients, specifically the transplant recipients and their respective donors during COVID-19 pandemic. Transplantation societies are working closely to provide optimal support and recommendations to the transplant specialists to guide them to conduct hematopoietic cell transplantation (HCT) in the safest manner.