Review
Biochemistry & Molecular Biology
Carmine Liberatore, Mauro Di Ianni
Summary: The management of relapsed acute myeloid leukemia (AML) post allogeneic hematopoietic stem cell transplantation (HSCT) remains a clinical challenge. Hypomethylating agents (HMAs) have become the standard therapeutic approach due to favorable tolerability and their ability to be combined with other anti-leukemic agents. The addition of donor lymphocytes infusions (DLI) generally leads to improved outcomes, while the introduction of novel targeted drugs offers new possibilities in salvage regimens.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Immunology
Yue Lu, Jian-Ping Zhang, Yan-Li Zhao, Min Xiong, Rui-Juan Sun, Xing-Yu Cao, Zhi-Jie Wei, Jia-Rui Zhou, De-Yan Liu, Jun-Fang Yang, Xian Zhang, Dao-Pei Lu, Peihua Lu
Summary: This study retrospectively analyzed 199 hematological malignancy patients who received a second allogeneic stem cell transplantation (allo-HSCT2) after relapse following the first allo-HSCT (allo-HSCT1), aiming to evaluate prognostic factors. The results showed that disease status of MRD-negative complete remission, HCT-CI score of 0 prior to allo-HSCT2, and a new mismatched haplotype donor were predictive factors for improved overall survival and leukemia-free survival. Based on these factors, a predictive scoring system was developed.
FRONTIERS IN IMMUNOLOGY
(2023)
Review
Oncology
Takashi Toya, Hironori Harada, Yuka Harada, Noriko Doki
Summary: Hereditary myeloid malignancies, especially in adults or elderly persons, were considered rare before the next-generation sequencing era. However, increased clinical sequencing has revealed a higher prevalence of inherited myeloid malignancies. The identification of hereditary myeloid malignancies and unresolved issues such as epidemiology, pathogenic mechanisms, and treatment strategies are discussed in this review.
FRONTIERS IN ONCOLOGY
(2022)
Review
Oncology
Desiree Kunadt, Friedrich Stoelzel
Summary: The number of patients receiving allogeneic hematopoietic stem cell transplantation (alloHCT) has been increasing due to advances in transplant technology, supportive care, transplant safety, and donor availability. Acute myeloid leukemia (AML) is the most common indication for alloHCT, but disease relapse remains a major challenge. Maintaining a strong graft-versus-leukemia (GvL) effect is crucial for patient prognosis and long-term survival.
CANCER MANAGEMENT AND RESEARCH
(2021)
Review
Cell & Tissue Engineering
Xiaoyu Zhu, Baolin Tang, Zimin Sun
Summary: Umbilical cord blood transplantation (UCBT) has been successfully used in clinics for over 30 years, offering advantages such as reliable source, ease of use, improved outcomes. Over time, UCBT has seen an increasing trend in Asia and China, while decreasing in the United States and Europe annually.
STEM CELLS TRANSLATIONAL MEDICINE
(2021)
Article
Biochemistry & Molecular Biology
Mark-Alexander Schwarzbich, Hao Dai, Lambros Kordelas, Dietrich W. Beelen, Aleksandar Radujkovic, Carsten Mueller-Tidow, Peter Dreger, Thomas Luft
Summary: The study demonstrates that pre-conditioning serum Leptin levels can serve as an independent prognostic marker for relapse following alloSCT in high-risk acute leukemia patients, particularly those in the intermediate to advanced stages. This effect was validated in an independent cohort, suggesting the potential utility of serum Leptin for predicting post-transplant outcomes in certain patient populations.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Review
Hematology
Elizabeth Herrity, Mariana Pinto Pereira, Dennis Dong Hwan Kim
Summary: This study describes the mechanistic diversity of relapse after hematopoietic stem cell transplantation and emphasizes the importance of these mechanisms in treatment selection and future research inspiration.
BRITISH JOURNAL OF HAEMATOLOGY
(2023)
Article
Cell & Tissue Engineering
Ying Yang, Ming Zhang, Mengqi Li, Yingchun Li, Wei Yang, Zhuogang Liu, Hongtao Wang
Summary: This study found that adding an unrelated umbilical cord blood unit to haploidentical hematopoietic stem cell transplantation can improve the prognosis and enhance the graft versus leukemia effect without increasing the incidence of graft versus host disease.
STEM CELL RESEARCH & THERAPY
(2022)
Review
Immunology
Justin Loke, Richard Buka, Charles Craddock
Summary: While most AML patients achieve complete remission with intensive chemotherapy, many face a risk of relapse if treated with chemotherapy alone. Allogeneic stem cell transplant has become a key treatment strategy for AML patients, especially for those in first complete remission and advanced stages. Despite a decrease in transplant-related mortality, there remains a need to address the risk of disease relapse.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Immunology
Shuang Fan, Tian-Zhong Pan, Li-Ping Dou, Yan-Min Zhao, Xiao-Hui Zhang, Lan-Ping Xu, Yu Wang, Xiao-Jun Huang, Xiao-Dong Mo
Summary: The study aimed to assess the efficacy of preemptive interferon-alpha (IFN-alpha) treatment in patients with acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in a real-world setting. The results showed that preemptive IFN-alpha treatment can eliminate measurable residual disease (MRD) in AML patients and improve leukemia-free survival.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Hematology
Nan Wang, Haitao Wang, Shu Fang, Jishan Du, Sai Huang, Fei Li, Xiangshu Jin, Mingyu Jia, Lingmin Xu, Liping Dou, Daihong Liu
Summary: The optimal timing of rabbit anti-thymocyte globulin (rATG) in matched sibling donor peripheral blood stem cell transplantation (MSD-PBSCT) remains unknown. This study aimed to evaluate the effect of a new timing strategy of rATG on transplantation outcomes in MSD-PBSCT patients. The results showed no significant differences in engraftment, GVHD, and viral reactivation between the 2-day and 4-day rATG groups. However, the 4-day rATG group had a significantly higher relapse rate and lower disease-free survival compared to the historical control group.
TRANSPLANTATION AND CELLULAR THERAPY
(2022)
Review
Oncology
Ying-Jun Chang, Xiang-Yu Zhao, Xiao-Jun Huang
Summary: Haploidentical stem cell transplantation is an effective alternative donor source for AML patients, with outcomes comparable to traditional transplantation methods for various types of AML. Relapse and infections post haplo-SCT remain key challenges in improving clinical outcomes for AML patients. Areas of active research include relapse prophylaxis, intervention, treatment, as well as infection prevention and therapy.
FRONTIERS IN ONCOLOGY
(2021)
Review
Immunology
Natalie Kohler, Dietrich Alexander Ruess, Rebecca Kesselring, Robert Zeiser
Summary: Immune checkpoint molecules play a crucial role in relapse and treatment after allo-HCT by inhibiting the graft-versus-leukemia effect, allowing tumor cells to escape. The activation of inhibitory receptors on T cell surfaces by immune checkpoint molecules facilitates immune escape. Research shows that immune checkpoint blockade holds potential value in improving the immunotherapeutic effect of relapse after allo-HCT.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Hematology
Satoshi Yamasaki, Shohei Mizuno, Makoto Iwasaki, Sachiko Seo, Naoyuki Uchida, Miyakoshi Shigesaburo, Nobuaki Nakano, Kazuya Ishiwata, Yasufumi Uehara, Tetsuya Eto, Ken Takase, Toshiro Kawakita, Masatsugu Tanaka, Masashi Sawa, Yuta Katayama, Yuichiro Nawa, Onizuka Makoto, Tatsuo Ichinohe, Yoshiko Atsuta, Junya Kanda, Masamitsu Yanada
Summary: This study analyzed the applications and factors affecting unrelated donor bone marrow transplantation (UR-BMT), unrelated donor cord blood stem cell transplantation (UR-CBT), and haploidentical peripheral blood stem cell transplantation (Haplo-PBSCT) in older patients with acute myeloid leukemia (AML) in Japan. The results showed that overall survival (OS) was superior in the UR-BMT group compared to the other groups. However, in non-complete remission (non-CR) patients, Karnofsky performance status (KPS) <80 at HCT and poor-risk cytogenetics were identified as independent predictors of worse OS. Therefore, KPS <80 may serve as an alternative indicator for non-CR AML patients with poor-risk cytogenetics in the selection of HCT, alternative treatments, or best supportive therapy, and optimal KPS is crucial for the success of HCT.
ANNALS OF HEMATOLOGY
(2023)
Article
Oncology
Bhagirathbhai Dholaria, Myriam Labopin, Jaime Sanz, Annalisa Ruggeri, Jan Cornelissen, Helene Labussiere-Wallet, Didier Blaise, Edouard Forcade, Patrice Chevallier, Anna Grassi, Ludmila Zubarovskaya, Jurgen Kuball, Patrice Ceballos, Fabio Ciceri, Frederic Baron, Bipin N. Savani, Arnon Nagler, Mohamad Mohty
Summary: This study compared the outcomes of CBT and single-allele-mismatched MMUD allo-HCT with PTCy in acute myeloid leukemia. The results showed that CBT was associated with higher incidence of graft failure and non-relapse mortality compared to MMUD, leading to lower leukemia-free survival, overall survival, and GVHD-free, relapse-free survival. In conclusion, MMUD allo-HCT with PTCy may be a preferred choice over CBT for patients without a fully matched donor.
JOURNAL OF HEMATOLOGY & ONCOLOGY
(2021)