This article appeared in the June 2018 issue of ASBMT eNews. Download the full issue in PDF format here.
Male Unrelated Donors Increase Risk of GVHD in Study
Recipients of male unrelated donors have a higher risk of developing graft-versus-host disease (GVHD) after allogeneic hematopoietic cell transplantation (HCT) than recipients of parous female sibling donors, reports a study from Blood Advances. The study consists of 2,813 patients from the Center for International Blood and Marrow Transplant Research registry who underwent T-cell replete HCT for acute myeloid leukemia, acute lymphoblastic leukemia or myelodysplastic syndrome. Researchers discovered that patients receiving male unrelated donor transplants had 1.6 times higher risk of developing grade 2 to 4 acute GVHD than parous female sibling recipients. In addition, women who received a male unrelated donor graft were more at risk for chronic GVHD than women who were parous female sibling recipients, while male recipients had similar rates of chronic GVHD regardless of the donor type. The donor type did not affect overall survival, disease-free survival, transplant-related mortality or relapse. Read More
Older Non-Hodgkin Lymphoma Patients Can Benefit from HCT
Medicare-age eligible non-Hodgkin lymphoma patients have similar outcomes after allogeneic hematopoietic cell transplantation as a younger cohort and should have access to the transplant procedure, according to a study appearing in Blood Advances. Researchers identified 1,629 patients from the Center for International Blood and Marrow Transplant Research registry undergoing first-time reduced intensity conditioning or nonmyeloablative conditioning for allogeneic HCT. Patients were divided into two groups: one group included patients at least 65 years of age, while the other group included patients ages 55 to 64. Although nonrelapse mortality was slightly higher for the older group (30% vs. 24%), relapse/progression, progression-free survival and overall survival were similar for both groups. Researchers concluded that age alone should not be a determinant for allogeneic HCT for non-Hodgkin lymphoma, and Medicare coverage should be expanded to older adults. Read More
Total Body Irradiation with Treosulfan and Fludarabine Cuts Relapse Risk
The addition of total body irradiation (TBI) to treosulfan and fludarabine transplant conditioning is effective and reduces the incidence of relapse in high-risk patients, according to a study published in Biology of Blood and Marrow Transplantation. The study included 100 patients ages 2 to 70 years with myelodysplastic syndrome (MDS)/chronic myelomonocytic leukemia or acute myeloid leukemia (AML). Patients were administered treosulfan and fludarabine alone or combined with 2Gy TBI. Patients who received TBI had a one-year overall survival of 80% compared to 69% for the non-TBI recipients. One-year relapse was 22% for the TBI recipients vs. 34% for the non-TBI patients. In addition, one-year relapse for the MDS patients was 27% with TBI and 33% without TBI, and among AML patients, relapse was 16% with TBI vs. 35% without TBI. Non-relapse mortality at six months post-transplant was 9% for both groups. These findings led researchers to conclude that conditioning with a combination of treosulfan, fludarabine and low-dose TBI is effective for high-risk patients up to 70 years of age but that the regimen had a more positive impact on AML patients than MDS patients. Read More