Mismatched Bone Marrow Transplantation

Powles, R; Goss, Glenwood D.; Pedrazzini, A.; Crofts, M; Clink, H.M.; Millar, J. L.; Khan, Badshah; Pérez, Díaz

doi:10.1007/978-1-4613-3837-6_4

Cited by 9 publications

(9 citation statements)

References 5 publications

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“…43,46,[50][51][52][53][54][55] Moreover, the onset of GVHD is often early in cases of transplantation of haploidentical donor marrow with conventional immunoprophylaxis. 56,57 All these elements support the contention that ex vivo induction of anergy in donor marrow T cells can prevent or minimize GVHD.…”

Section: Discussionmentioning

confidence: 69%

Transplantation of Anergic Histoincompatible Bone Marrow Allografts

et al. 1999

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Section: Discussionmentioning

confidence: 69%

Transplantation of Anergic Histoincompatible Bone Marrow Allografts

et al. 1999

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“…A comparison between the incidence of hyperacute GVHD in the current study and in the few published reports is not possible because the definitions vary substantially in terms of both time of onset and clinical manifestations. 7,[13][14][15][16] In our study we used the same diagnostic criteria for hyperacute GVHD and acute GVHD occurring after HSCT. Although GVHD is classically related to reactivity of donor T cells against host tissues, the severity of acute GVHD is affected by the toxicity of the preparative regimen, 4,5 the breakdown of mucosal barriers, and inflammatory cytokines, in addition to the immune graft-versus-host reaction.…”

Section: Discussionmentioning

confidence: 99%

Hyperacute GVHD: risk factors, outcomes, and clinical implications

Saliba

Lima

Giralt

et al. 2006

Blood

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Acute graft-versus-host disease (GVHD) is a major limiting factor in allogeneic hematopoietic stem cell transplantation (HSCT), and the timing of acute GVHD may affect patient outcomes. We evaluated the incidence, risk factors, clinical manifestations, and outcomes of hyperacute GVHD, defined as that occurring within 14 days after transplantation, among 809 consecutive HSCTs at the University of Texas M. D. Anderson Cancer Center. Of 265 patients with grade II-IV acute GVHD, 27% had biopsy-proven hyperacute GVHD. Skin involvement was significantly more common (88% versus 44%) and more severe (stage III-IV, 88% versus 66%) in the hyperacute group compared with acute GVHD diagnosed after day 14. On multivariate analysis, significant risk factors for hyperacute GVHD included a mismatched related or matched unrelated donor, a myeloablative conditioning regimen, more than 5 prior chemotherapy regimens, and donor-recipient sex mismatch. Hyperacute GVHD was associated with a significantly lower response rate to first-line therapy and a higher rate of nonrelapse mortality in patients with a mismatched related or matched unrelated donor graft. In conclusion, hyperacute GVHD accounts for a substantial proportion of grade II-IV acute GVHD after HSCT. Patients at high risk or with a diagnosis of hyperacute GVHD should be included in clinical studies. (Blood. 2007;

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“…In perhaps its most dramatic form, Powles and colleagues 12,13 described an abrupt and often fatal clinical syndrome of fever, rash, massive noncardiogenic pulmonary edema, often with renal failure and seizures, following haploidentical bone marrow transplantation. This syndrome, which has often been referred to as 'hyperacute GVHD' was likely the result of a cytokine cascade accompanying what Powles referred to as an 'in vivo mixed lymphocyte reaction'.…”

Section: Allogeneic Stem Cell Transplantationmentioning

confidence: 99%

Engraftment syndrome following hematopoietic stem cell transplantation

Spitzer

2001

Bone Marrow Transplant

358

386

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Summary:During neutrophil recovery following hematopoietic stem cell transplantation, a constellation of symptoms and signs including fever, erythrodermatous skin rash, and noncardiogenic pulmonary edema often occur. These clinical findings have usually been referred to as engraftment syndrome, or, reflecting the manifestations of increased capillary permeability, capillary leak syndrome. While described most often following autologous stem cell transplantation, a similar clinical syndrome has been observed followed allogeneic stem cell transplantation. Distinction from graft-versus-host disease in the allogeneic setting however, has been difficult. Recent experience with non-myeloablative conditioning for stem cell transplantation, however, reveals that an engraftment syndrome independent of GVHD may occur. In some cases, this engraftment syndrome may be a manifestation of a host-versus-graft reaction (graft rejection). While cellular and cytokine interactions are believed to be responsible for these clinical findings, a distinct effector cell population and cytokine profile have not been defined. Engraftment syndromes are likely associated with an increased transplant-related mortality, mostly from pulmonary and associated multiorgan failure. Corticosteroid therapy is often dramatically effective for engraftment syndrome, particularly for the treatment of the pulmonary manifestations. A proposal for a more uniform definition of engraftment syndrome has been developed in order to allow for a reproducible method of reporting of this complication and for evaluating prophylactic and therapeutic strategies. Bone Marrow Transplantation (2001) 27, 893-898.

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Mismatched Bone Marrow Transplantation

Cited by 9 publications

References 5 publications

Transplantation of Anergic Histoincompatible Bone Marrow Allografts

Transplantation of Anergic Histoincompatible Bone Marrow Allografts

Hyperacute GVHD: risk factors, outcomes, and clinical implications

Engraftment syndrome following hematopoietic stem cell transplantation

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