Role of HLA match on results of hematopoietic stem cell transplantations from unrelated donors in children with acute leukemia and bone marrow failure syndromes

Styczyński, Jan; Dębski, Robert; Krenska, Anna; Czyżewski, K; Bartoszewicz, Natalia; Demidowicz, Ewa; Irga‐Jaworska, Ninela; Drożyńska, Elżbieta; Płonowski, Marcin; Krawczuk‐Rybak, Maryna; Ociepa, Tomasz; Urasiński, Tomasz; Wysocki, Mariusz

doi:10.1016/j.achaem.2017.01.002

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…Presented large studies have determined the incidence of infectious complications and their outcome in pediatric HCT and PHO departments, as well as adult HCT centers in Poland. Emerging data from Polish PHO and HCT centers indicate high incidence of infectious complications in these populations [28][29][30]. Although the rate of bacterial infections is similar to data reported from international centers both for children and adults, our data suggest that the incidence of IFD in pediatric ALL and AML both in PHO and HCT settings is much higher than it was recently anticipated.…”

Section: Discussionsupporting

confidence: 82%

Infectious complications in children and adults with hematological malignancies

Styczyński

2019

Acta Haematologica Polonica

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Infections are the main cause of morbidity and mortality in pediatric hematology and oncology (PHO) and hematopoietic cell transplantation (HCT) settings in children and adults. The analysis of incidence and outcome of bacterial, fungal, and viral infections in Polish PHO/ HCT centers was performed over a period of 72 months (2012–2017). The summary of infections in 5628 patients with newly diagnosed malignancy and 971 HCTs is presented in this paper. Additionally, data of 650 pediatric HCTs from 2012 to 2015 were compared with the data of 3200 HCTs in adults. The risk of any infection per patient was higher in HCT vs PHO patients (2062/971 vs 7115/5628; 2.1 vs 1.3; HR=1.7, p<0.0001). The incidence of bacterial infections was 34,2±0,6% in PHO vs 41,5±1,6% in HCT patients, and the outcome was better in PHO patients: 97,9±0,2% vs 91,8±1,0%. The incidence of patients with fungal infection was 8,8±0,4% vs 21,2±1,3%, and the outcome was better in PHO patients: 95,9±0,7% vs 85,8±2,3%. Incidence of viral infections was 5,0±1,0% in PHO setting, including part of previously transplanted patients, and 47,8±2,2% in HCT setting (60,9±2,3% allo-HCT; 5,6±1,3% auto-HCT). In children, the incidence was higher for bacterial (36.0% vs 27.6%), fungal (25.3% vs 6.3%), and viral (56.3% vs 29.3% allo-HCT; 6.6% vs 0.8% auto-HCT) infections than in adults (p<0.0001), and the outcome was better for bacterial (95.5% vs 91.4%), fungal (88.0% vs 74.9%), and viral (98.6% vs 92.3%) infections. In conclusion, the presented large studies have determined the incidence of infectious complications and their outcomes in HCT and PHO centers in Poland.

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Section: Discussionsupporting

confidence: 82%

Infectious complications in children and adults with hematological malignancies

Styczyński

2019

Acta Haematologica Polonica

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“…Nevertheless, with the improvement of Poland's economical situation from the last decade of the 20th century, the outcomes of ALL have improved, and with the use of recent international protocols, the results are comparable to those of international groups (13). Still, we did not find any improvement to be associated with HCT, as was also observed in adolescent and young adults by others (17), although significant progress is being observed at our and other centers both in transplant and chemotherapy care (14,18). Despite Poland having one of the lowest values for GDP and HDI in Europe (5), Polish centers are able to strictly follow international protocols for children with ALL nowadays, and the results are even better, with 5-year EFS of 86.6%, 5-year OS of 90.7%, and RR 9.9%.…”

Section: Discussionsupporting

confidence: 66%

“…Except for group I, for all other time periods, international treatment protocols were used. During the past two decades, some patients with high-risk disease and those with relapse qualified for hematopoietic cell transplantation (HCT) (14).…”

Section: Methodsmentioning

confidence: 99%

Outcome of Pediatric Acute Lymphoblastic Leukemia: Sixty Years of Progress

et al. 2019

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Background: A retrospective analysis was performed to investigate the survival outcomes in pediatric acute lymphoblastic leukemia (ALL) based on time period. We hypothesized that improvement has been obtained with the time-dependent therapeutic era and rise in the gross domestic product (GDP) and Human Development Index (HDI). Materials and Methods: Data from 710 children who were treated for ALL between 1958 and 2018 at a single pediatric center were analyzed for probability of 5-year overall survival (pOS), event-free survival (pEFS) and relapse risk (pRR). Time periods were defined by the treatment protocols used in seven consecutive therapeutic eras. Results: Over the 60-year period analyzed, pOS increased from 1.2% to 90.7%, pEFS from 1.2% to 86.6%, and pRR decreased from 98.8% to 9.9% for patients treated in the past decade. Risk of mortality for patients who received chemotherapy and hematopoietic cell transplant was reduced to 9.9% in the recent era, however, no statistically significant survival difference was found between patients treated with stem cell transplant and those not. Conclusion: The therapeutic era, related to improved GDP and HDI, was a statistically significant predictor of increased OS from ALL.

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“…Types of transplants Transplants were divided as autologous and allogeneic from matched sibling donors (MSD) or unrelated donors: matched (MUD) or mismatched (MMUD). Most patients who underwent MUD/MMUD-HCT received antithymocyte globulin (ATG) [24].…”

Section: Methodsmentioning

confidence: 99%

Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study

Czyżewski

Styczyński

Giebel³

et al. 2019

Ann Hematol

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Incidence and outcome of microbiologically documented bacterial/viral infections and invasive fungal disease (IFD) in children and adults after hematopoietic cell transplantation (HCT) were compared in 650 children and 3200 adults in multicenter crosssectional nationwide study. Infections were diagnosed in 60.8% children and 35.0% adults, including respectively 69.1% and 63.5% allo-HCT, and 33.1% and 20.8% auto-HCT patients. The incidence of bacterial infections was higher in children (36.0% vs 27.6%; p < 0.0001). Infections with Gram-negative bacteria were more frequent than Gram-positives in adults (64.6% vs Krzysztof Czyżewski and Jan Styczyński contributed equally to this work.

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Role of HLA match on results of hematopoietic stem cell transplantations from unrelated donors in children with acute leukemia and bone marrow failure syndromes

Cited by 4 publications

References 11 publications

Infectious complications in children and adults with hematological malignancies

Infectious complications in children and adults with hematological malignancies

Outcome of Pediatric Acute Lymphoblastic Leukemia: Sixty Years of Progress

Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study

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