Classification of Conditioning Regimens for Bone Marrow Transplantation: Historical Background and Current Perspectives

Мелкова, К Н; Горбунова, Н В; Chernyavskaya, T.; Trofimova, OP

doi:10.21320/2500-2139-2017-10-4-494-500

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…In Europe, only about 15% of patients receive PT-Cy for leukemia in unrelated transplants, while this technology is dominant with haploidentical donors. It should also be noted that the proportion of haploidentical transplantations does not exceed 20% [4,[30][31][32][33]. Such differences are likely determined by demographic characteristics, low probability of having a related compatible donor, as well as shorter life expectancy in Russia and a large number of co-morbidities in Russian patients [34].…”

Section: Discussionmentioning

confidence: 99%

Multicenter non-interventional retrospective study: prevalence, clinical characteristics and approaches to the treatment of acute and chronic graft-versus-host disease in the Russian Federation

Moiseev,

Drokov,

Motorin

et al. 2023

CTT

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Prevalence and management of acute and chronic graftversus-host disease (GvHD) after allogeneic hematopoietic cell transplantation (allo-HCT) vary widely depending on standard practices adopted in individual centers and countries. For Russian Federation, neither large study data on the incidence of GvHD in allo-HCT recipients, nor the range of approaches for prevention and treatment of this complication have been previously published. This study concerned the prevalence of this complication and the main appropriate clinical practices. Materials and methodsThe retrospective multicenter study involved four Russian allo-HCT centers, which provided information on all transplanted patients aged ≥12 years from January 1, 2020 to June 30, 2022 as well as detailed information on patients with acute and chronic GvHD. The study included 756 patients, among whom 240 had acute GvHD, 197 had chronic GvHD. An electronic platform was used to collect data, and the quality of the entered data was monitored. Since organ staging data was available, all severity grades were adjusted to the MAGIC criteria for acute GvHD and the NIH 2015 criteria for chronic GvHD results. ResultsThe incidence of acute GvHD grades I-IV was 31.7% of all allo-HCT recipients, grade I -13.0%, grade II -10.1%, grade III -5.2%, grade IV -3.4% of the total number of transplanted patients. The incidence of steroid-refractory acute GvHD was 33.8% of all patients with grades II-IV GvHD. The incidence of chronic GvHD was 26.1%, mild -6.5%, moderate -9.0%, severe -10.6% of all allo-HCT recipients. The most common organs involved in chronic GvHD were skin (69.0%), mucous membranes (60.4%), eyes (43.1%), liver (35.0%), genitals (11.7%) and gastrointestinal tract (11.2%). Lung GvHD (9.1%) and joint GvHD (3.6%), as well as the scleroderma (4.1%), were observed in a small number of patients. Steroid-refractory course was observed in 38.7% of patients receiving systemic therapy. Overlap syndrome was observed in 2.9% of all transplanted patients.

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Section: Discussionmentioning

confidence: 99%

Multicenter non-interventional retrospective study: prevalence, clinical characteristics and approaches to the treatment of acute and chronic graft-versus-host disease in the Russian Federation

Moiseev,

Drokov,

Motorin

et al. 2023

CTT

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Immunological aspects of hematopoietic stem cell transplantation for hematologic malignancies and some immunological peculiarities of cancer radioimmunotherapy

Ширин

Baranova

Reshetnikova

2023

Rossijskij bioterapevtičeskij žurnal

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This literature review provides basic information about the role of hematopoietic stem cell transplantation in the treatment of myelodysplastic syndromes, acute myeloid leukemia, acute lymphoblastic leukemia. The recommendations for the use of stem cell transplantation are indicated. Conditioning regimens (myeloablative, non-myeloablative, reduced intensity), their advantages and disadvantages are considered. The issues of prevention and treatment of graft-versus-host disease, including graft preparation (T-cell depletion), extracorporeal photopheresis and mechanisms of graft-versus-tumor (-leukemia) reaction are highlighted. The historical milestones of theimmunotherapy development, the creation of therapeutic monoclonal antibodies, the development of targeted therapy, for example, conjugates of monoclonal antibodies with cytostatic drugs and radionuclides (targeted radionuclide therapy) are reported. Information about radioimmunotherapy as a method used for treatment of solid tumors and non-Hodgkin’s lymphoma, and information on the use of mesenchymal stem cells for the treatment and prevention of the graft-versus-host reaction are presented.

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Arterial structure and function in patients with hemoblastoses before and after high-dose chemotherapy and autologous hematopoietic stem cell transplantation

Potemkina,

Glezer,

Zeynalova

et al. 2023

Almanac of Clinical Medicine

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Background: High dose chemotherapy (HDCT) preceding autologous hematopoietic stem cell transplantation (autoSCT) can be toxic for cardiovascular system, which can be mediated with the development of endothelial dysfunction. No studies on the assessment of arterial stiffness and endothelial function after HDCT and autoSCT have been performed before. Aim: To evaluate endothelial function and arterial rigidity parameters by photoplethysmography in patient candidates for HDCT with autoSCT, to identify associated factors and to analyze changes of these parameters over time after HDCT and autoSCT. Materials and methods: In this cohort prospective observational study in 71 patients with verified hemoblastosis (mean age 43.8 ± 12.6 years) we assessed endothelial function and stiffness by photoplethysmography (AngioScan-01, Russia) before and after HDCT with autoSCT. Thirty two (32, 45%) patients had multiple myeloma (ММ), 39 (55%), lymphoproliferative disorders (LPD). We measured the stiffness index (SI), reflection index (RI), augmentation index normalized by heart rate of 75 beats per minute (AIp75) and performed the occlusion test with measurement of occlusion index (ОI) and phase shift (PS). Results: Mean RI in the total study group before HDCT with autoSCT was increased to RI 34.9% [24.5; 50.6], OI decreased to OI 1.5 [1.25; 1.80], and PS module decreased to PS 6.7 ms [3.9; 8.9]. After HDCT with autoSCT the PS module increased to 8.4 ms [5.0; 12.4] (p = 0.001) and OI increased to 1.7 [1.3; 2.2] (p = 0,007), which indicates an improvement in endothelial function. Changes in other parameters of arterial function were non-significant. We also analyzed a selected group of the patients with MM who had higher cardiovascular risk, compared to the LPD patients: they were older (53 vs 36.1 years; p 0.001), had higher rates of arterial hypertension (p 0.001) and diabetes mellitus (p = 0.048). Compared to the LPD patients, the MM patients had higher baseline values of SI (7.5 m/s [7.3; 7.9]), RI (42.9% [32.1; 53.6]), and AIp75 (6.3% [-1.65; 13.8]), indicating higher vascular stiffness. They also had lower PS module values (5.0 ms [2.1; 8.5]). The LPD patients had been more frequently treated with anthracyclines (p 0.001) and radiation (p = 0.002). After HDCT with autoSCT, they had a higher increment of OI, namely, from 1.4 [1.3; 1.8] to 1.7 [1.4; 2.1] (p = 0.003). Conclusion: This study was the first to show a high rate of endothelial dysfunction and vascular stiffness abnormalities in patients with hemoblastoses who were candidates for HDCT with autoSCT. After HDCT with autoSCT, changes of endothelial function and stiffness were multidirectional. Despite a significant improvement, endothelial function parameters were not normalized. We were unable to find any predictors of the abnormalities. Thus, the identified baseline abnormalities in stiffness and endothelial function cannot be a contraindication to HDCT with autoSCT.

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Classification of Conditioning Regimens for Bone Marrow Transplantation: Historical Background and Current Perspectives

Cited by 3 publications

References 11 publications

Multicenter non-interventional retrospective study: prevalence, clinical characteristics and approaches to the treatment of acute and chronic graft-versus-host disease in the Russian Federation

Multicenter non-interventional retrospective study: prevalence, clinical characteristics and approaches to the treatment of acute and chronic graft-versus-host disease in the Russian Federation

Immunological aspects of hematopoietic stem cell transplantation for hematologic malignancies and some immunological peculiarities of cancer radioimmunotherapy

Arterial structure and function in patients with hemoblastoses before and after high-dose chemotherapy and autologous hematopoietic stem cell transplantation

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