A History of Allogeneic and Autologous Hematopoietic Cell Transplantation

Blume, Karl G.; Thomas, E. Donnall

doi:10.1002/9781118416426.ch1

Cited by 5 publications

(6 citation statements)

References 144 publications

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“…6 Therapeutically harnessing the myeloablative and cytotoxic properties of ionising radiation, American research teams devised and advanced bone marrow transplantation as a process to rescue patients from otherwise irreversible and lethal bone marrow failure. 7 Only in 1988 did haematologists identify the graft versus leukaemia effect propagated by bone marrow or haematopoietic stem cell transplant, which we now identify as the key process underlying successful transplantation, and the cure from cancer it entails. 8 Thus, rather inadvertently, bone marrow transplantation has been the progenitor of cell-based immunotherapies, and the technologies and discoveries pioneered by its practitioners have paved the way for the current cell therapy revolution we all eagerly anticipate.…”

Section: From the Front To The Frontiers: A Pioneering Spiritmentioning

confidence: 99%

“…Thereafter, the therapeutic use of cells marched onwards with the leap from transfusion to transplantation, beginning with clinical observations of acute radiation sickness in atomic‐bomb survivors in the Japanese city of Hiroshima 6 . Therapeutically harnessing the myeloablative and cytotoxic properties of ionising radiation, American research teams devised and advanced bone marrow transplantation as a process to rescue patients from otherwise irreversible and lethal bone marrow failure 7 . Only in 1988 did haematologists identify the graft versus leukaemia effect propagated by bone marrow or haematopoietic stem cell transplant, which we now identify as the key process underlying successful transplantation, and the cure from cancer it entails 8 .…”

Section: From the Front To The Frontiers: A Pioneering Spiritmentioning

confidence: 99%

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BSH 2020 Student Essay Prize ‐ ‘How are you inspired by haematology and how will you inspire others to become haematologists?’

Girard

2020

Br J Haematol

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SummaryAll medical personnel ponder their future career, and students perhaps more so than professionals. Indeed, there are many old and famous specialties in which we might envision ourselves forging a path, each competing for our attention. Far‐off from the clamour and glamour of venerable medicine and surgery, however, there lies younger specialties that reward quiet curiosity and stolid perseverance. Chief amongst them, in my eyes, is the speciality of haematology. Often misunderstood or otherwise unheard of, the subject of haematology and those practice it have steadily plotted a course through the maelstrom of blood disease and unremittingly turned its tide back in favour of the patients, for whom they labour. As the British Society for Haematology celebrates its 60th anniversary, the question rightly posed this year to interested students is, based on our own personal reflections, how should we continue to nourish the buds of enthusiasm and interest for this still‐blossoming specialty? In this essay, I put forth those intellectual and historical facets of haematology which have given me great inspiration, and I reflect on how we, as practitioners or as aspirants, can best cultivate the passion we feel for our subject in the hearts of others.

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Section: From the Front To The Frontiers: A Pioneering Spiritmentioning

confidence: 99%

Section: From the Front To The Frontiers: A Pioneering Spiritmentioning

confidence: 99%

BSH 2020 Student Essay Prize ‐ ‘How are you inspired by haematology and how will you inspire others to become haematologists?’

Girard

2020

Br J Haematol

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“…Several demographic and transplant characteristics, such as patient age, underlying disease (e.g., chronic myeloid leukemia), comorbidities before allo-HSCT, donor/recipient gender mismatching (i.e., female donor/male recipient combination), donor and recipient cytomegalovirus (CMV) serostatus, donor type (i.e., HLA‐non‐identical donors), HLA disparity, and GVHD prophylaxis methods are reported as important risk factors for aGVHD [ 11 , 12 ]. Particularly, donor/recipient relation [i.e., collateral relative donors (CRDs) [ 13 ] and maternal donors (MDs)] [ 14 , 15 ] is associated with aGVHD after HID HSCT with ATG or PTCY for GVHD prophylaxis.…”

Section: Introdutionmentioning

confidence: 99%

A comprehensive model to predict severe acute graft-versus-host disease in acute leukemia patients after haploidentical hematopoietic stem cell transplantation

et al. 2022

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Background Acute graft-versus-host disease (aGVHD) remains the major cause of early mortality after haploidentical related donor (HID) hematopoietic stem cell transplantation (HSCT). We aimed to establish a comprehensive model which could predict severe aGVHD after HID HSCT. Methods Consecutive 470 acute leukemia patients receiving HID HSCT according to the protocol registered at https://clinicaltrials.gov (NCT03756675) were enrolled, 70% of them (n = 335) were randomly selected as training cohort and the remains 30% (n = 135) were used as validation cohort. Results The equation was as follows: Probability (grade III–IV aGVHD) = $$\frac{1}{{1 + \exp \left( { - \,{\text{Y}}} \right)}}$$ 1 1 + exp - Y , where Y = –0.0288 × (age) + 0.7965 × (gender) + 0.8371 × (CD3 + /CD14 + cells ratio in graft) + 0.5829 × (donor/recipient relation) − 0.0089 × (CD8 + cell counts in graft) − 2.9046. The threshold of probability was 0.057392 which helped separate patients into high- and low-risk groups. The 100-day cumulative incidence of grade III–IV aGVHD in the low- and high-risk groups was 4.1% (95% CI 1.9–6.3%) versus 12.8% (95% CI 7.4–18.2%) (P = 0.001), 3.2% (95% CI 1.2–5.1%) versus 10.6% (95% CI 4.7–16.5%) (P = 0.006), and 6.1% (95% CI 1.3–10.9%) versus 19.4% (95% CI 6.3–32.5%) (P = 0.017), respectively, in total, training, and validation cohort. The rates of grade III–IV skin and gut aGVHD in high-risk group were both significantly higher than those of low-risk group. This model could also predict grade II–IV and grade I–IV aGVHD. Conclusions We established a model which could predict the development of severe aGVHD in HID HSCT recipients.

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“…Most CMV infections occur during the early post-engraftment phase after HID HSCT (the median duration from HID HSCT to CMV infection is 31–35 days) ( Liu et al., 2015 ; Chen et al., 2016 ). CMV becomes latent in non-dividing cells, and reconstitution of blood elements post-HSCT stimulates the replication of CMV and provides a milieu for CMV reactivation ( Blume and Thomas, 2016 ). Thus, patients with a higher risk of CMV infection may need to receive further prophylaxis as soon as neutrophil engraftment is achieved, and variables in the pre-engraftment phase are critical for creating the predicted model.…”

Section: Introductionmentioning

confidence: 99%

A Predicted Model for Refractory/Recurrent Cytomegalovirus Infection in Acute Leukemia Patients After Haploidentical Hematopoietic Stem Cell Transplantation

Shen

Hong

Wang

et al. 2022

Front. Cell. Infect. Microbiol.

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ObjectiveWe aimed to establish a model that can predict refractory/recurrent cytomegalovirus (CMV) infection after haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT).MethodsConsecutive acute leukemia patients receiving HID HSCT were enrolled (n = 289). We randomly selected 60% of the entire population (n = 170) as the training cohort, and the remaining 40% comprised the validation cohort (n = 119). Patients were treated according to the protocol registered at https://clinicaltrials.gov (NCT03756675).ResultsThe model was as follows: Y = 0.0322 × (age) – 0.0696 × (gender) + 0.5492 × (underlying disease) + 0.0963 × (the cumulative dose of prednisone during pre-engraftment phase) – 0.0771 × (CD34+ cell counts in graft) – 1.2926. The threshold of probability was 0.5243, which helped to separate patients into high- and low-risk groups. In the low- and high-risk groups, the 100-day cumulative incidence of refractory/recurrent CMV was 42.0% [95% confidence interval (CI), 34.7%–49.4%] vs. 63.7% (95% CI, 54.8%–72.6%) (P < 0.001) for total patients and was 50.5% (95% confidence interval (CI), 40.9%–60.1%) vs. 71.0% (95% CI, 59.5%–82.4%) (P = 0.024) for those with acute graft-versus-host disease. It could also predict posttransplant mortality and survival.ConclusionWe established a comprehensive model that could predict the refractory/recurrent CMV infection after HID HSCT.Clinical Trial Registrationhttps://clinicaltrials.gov, identifier NCT03756675.

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A History of Allogeneic and Autologous Hematopoietic Cell Transplantation

Cited by 5 publications

References 144 publications

BSH 2020 Student Essay Prize ‐ ‘How are you inspired by haematology and how will you inspire others to become haematologists?’

BSH 2020 Student Essay Prize ‐ ‘How are you inspired by haematology and how will you inspire others to become haematologists?’

A comprehensive model to predict severe acute graft-versus-host disease in acute leukemia patients after haploidentical hematopoietic stem cell transplantation

A Predicted Model for Refractory/Recurrent Cytomegalovirus Infection in Acute Leukemia Patients After Haploidentical Hematopoietic Stem Cell Transplantation

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