29 results on '"Finke, Jürgen"'
Search Results
2. Association of uric acid levels before start of conditioning with mortality after allogeneic hematopoietic stem cell transplantation – a prospective, non-interventional study of the EBMT Transplant Complication Working Party
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Penack, Olaf, primary, Peczynski, Christophe, additional, van der Werf, Steffie, additional, Finke, Jürgen, additional, Ganser, Arnold, additional, Schoemans, Helene, additional, Pavlu, Jiri, additional, Niittyvuopio, Riitta, additional, Schroyens, Wilfried, additional, Kaynar, Leylagül, additional, Blau, Igor W., additional, van der Velden, Walter, additional, Sierra, Jorge, additional, Cortelezzi, Agostino, additional, Wulf, Gerald, additional, Turlure, Pascal, additional, Rovira, Montserat, additional, Ozkurt, Zubeydenur, additional, Pascual-Cascon, Maria J., additional, Moreira, Maria C., additional, Clausen, Johannes, additional, Greinix, Hildegard, additional, Duarte, Rafael F., additional, and Basak, Grzegorz W., additional
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- 2019
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3. Allogeneic stem cell transplantation using HLA-matched donors for acute myeloid leukemia with deletion 5q or monosomy 5: a study from the Acute Leukemia Working Party of the EBMT
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Poiré, Xavier, primary, Labopin, Myriam, additional, Polge, Emmanuelle, additional, Forcade, Edouard, additional, Ganser, Arnold, additional, Volin, Liisa, additional, Michallet, Mauricette, additional, Blaise, Didier, additional, Yakoub-Agha, Ibrahim, additional, Maertens, Johan, additional, Espiga, Carlos Richard, additional, Cornelissen, Jan, additional, Finke, Jürgen, additional, Mohty, Mohamad, additional, Esteve, Jordi, additional, and Nagler, Arnon, additional
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- 2019
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4. Long-term outcome after allogeneic hematopoietic cell transplantation for myelofibrosis
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Robin, Marie, primary, de Wreede, Liesbeth C., additional, Wolschke, Christine, additional, Schetelig, Johannes, additional, Eikema, Diderik-Jan, additional, Van Lint, Maria Teresa, additional, Knelange, Nina Simone, additional, Beelen, Dietrich, additional, Brecht, Arne, additional, Niederwieser, Dietger, additional, Vitek, Antonin, additional, Bethge, Wolfgang, additional, Arnold, Renate, additional, Finke, Jürgen, additional, Volin, Liisa, additional, Yakoub-Agha, Ibrahim, additional, Nagler, Arnon, additional, Poiré, Xavier, additional, Einsele, Hermann, additional, Chevallier, Patrice, additional, Holler, Ernst, additional, Ljungman, Per, additional, Robinson, Stephen, additional, Radujkovic, Alekxandar, additional, McLornan, Donal, additional, Chalandon, Yves, additional, and Kröger, Nicolaus, additional
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- 2019
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5. Optimized EBMT transplant-specific risk score in myelodysplastic syndromes after allogeneic stem-cell transplantation
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Gagelmann, Nico, primary, Eikema, Diderik-Jan, additional, Stelljes, Matthias, additional, Beelen, Dietrich, additional, de Wreede, Liesbeth, additional, Mufti, Ghulam, additional, Knelange, Nina Simone, additional, Niederwieser, Dietger, additional, Friis, Lone S., additional, Ehninger, Gerhard, additional, Nagler, Arnon, additional, Yakoub-Agha, Ibrahim, additional, Meijer, Ellen, additional, Ljungman, Per, additional, Maertens, Johan, additional, Kanz, Lothar, additional, Lopez-Corral, Lucia, additional, Brecht, Arne, additional, Craddock, Charles, additional, Finke, Jürgen, additional, Cornelissen, Jan J., additional, Bernasconi, Paolo, additional, Chevallier, Patrice, additional, Sierra, Jorge, additional, Robin, Marie, additional, and Kröger, Nicolaus, additional
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- 2019
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6. Haploidentical versus unrelated allogeneic stem cell transplantation for relapsed/refractory acute myeloid leukemia: a report on 1578 patients from the Acute Leukemia Working Party of the EBMT
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Brissot, Eolia, primary, Labopin, Myriam, additional, Ehninger, Gerhard, additional, Stelljes, Matthias, additional, Brecht, Arne, additional, Ganser, Arnold, additional, Tischer, Johanna, additional, Kröger, Nicolaus, additional, Afanasyev, Boris, additional, Finke, Jürgen, additional, Elmaagacli, Ahmet, additional, Einsele, Herman, additional, Mohty, Mohamad, additional, and Nagler, Arnon, additional
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- 2018
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7. Allogeneic transplantation of multiple myeloma patients may allow long-term survival in carefully selected patients with acceptable toxicity and preserved quality of life
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Greil, Christine, primary, Engelhardt, Monika, additional, Ihorst, Gabriele, additional, Schoeller, Katja, additional, Bertz, Hartmut, additional, Marks, Reinhard, additional, Zeiser, Robert, additional, Duyster, Justus, additional, Einsele, Hermann, additional, Finke, Jürgen, additional, and Wäsch, Ralph, additional
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- 2018
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8. Competing-risk outcomes after hematopoietic stem cell transplantation from the perspective of time-dependent effects
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Fuerst, Daniel, primary, Frank, Sandra, additional, Mueller, Carlheinz, additional, Beelen, Dietrich W, additional, Schetelig, Johannes, additional, Niederwieser, Dietger, additional, Finke, Jürgen, additional, Bunjes, Donald, additional, Kröger, Nicolaus, additional, Neuchel, Christine, additional, Tsamadou, Chrysanthi, additional, Schrezenmeier, Hubert, additional, Beyersmann, Jan, additional, and Mytilineos, Joannis, additional
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- 2018
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9. Outcome after relapse of myelodysplastic syndrome and secondary acute myeloid leukemia following allogeneic stem cell transplantation: a retrospective registry analysis on 698 patients by the Chronic Malignancies Working Party of the European Society of Blood and Marrow Transplantation
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Schmid, Christoph, primary, de Wreede, Liesbeth C., additional, van Biezen, Anja, additional, Finke, Jürgen, additional, Ehninger, Gerhard, additional, Ganser, Arnold, additional, Volin, Liisa, additional, Niederwieser, Dietger, additional, Beelen, Dietrich, additional, Alessandrino, Paolo, additional, Kanz, Lothar, additional, Schleuning, Michael, additional, Passweg, Jakob, additional, Veelken, Hendrik, additional, Maertens, Johan, additional, Cornelissen, Jan J., additional, Blaise, Didier, additional, Gramatzki, Martin, additional, Milpied, Noel, additional, Yakoub-Agha, Ibrahim, additional, Mufti, Ghulam, additional, Rovira, Montserrat, additional, Arnold, Renate, additional, de Witte, Theo, additional, Robin, Marie, additional, and Kröger, Nikolaus, additional
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- 2017
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10. Salvage use of allogeneic hematopoietic stem cell transplantation after reduced intensity conditioning from unrelated donors in multiple myeloma. A study by the Plasma Cell Disorders subcommittee of the European Group for Blood and Marrow Transplant Chronic Malignancies Working Party
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Sobh, Mohamad, primary, Michallet, Mauricette, additional, Dubois, Valérie, additional, Iacobelli, Simona, additional, Koster, Linda, additional, Van Biezen, Anja, additional, Fegueux, Nathalie, additional, Tabrizi, Reza, additional, Finke, Jürgen, additional, El-Cheikh, Jean, additional, Schipperus, Martin, additional, Meijer, Ellen, additional, von dem Borne, Peter, additional, Petersen, Eefke, additional, Russell, Nigel, additional, Tholouli, Eleni, additional, Passweg, Jakob, additional, Garban, Frédéric, additional, Maertens, Johan, additional, Chevalier, Patrice, additional, Maillard, Natacha, additional, Volin, Liisa, additional, Francois, Sylvie, additional, Lioure, Bruno, additional, Beguin, Yves, additional, Gluckman, Eliane, additional, Ruggeri, Annalisa, additional, Garderet, Laurent, additional, and Kröger, Nicolaus, additional
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- 2017
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11. Expanding transplant options to patients over 50 years. Improved outcome after reduced intensity conditioning mismatched-unrelated donor transplantation for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT
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Jordi Esteve, Gérard Socié, Fabio Ciceri, Jürgen Finke, Donald Bunjes, Myriam Labopin, Gerhard Ehninger, Norbert Claude Gorin, Bertram Glass, Nicolaus Kröger, Per Ljungman, Rainer Schwerdtfeger, Mohamad Mohty, Charles Craddock, Frédéric Baron, Sebastian Giebel, Bipin N. Savani, Arnon Nagler, Dietger Niederwieser, Christoph Schmid, Savani, Bipin N., Labopin, Myriam, Kröger, Nicolau, Finke, Jürgen, Ehninger, Gerhard, Niederwieser, Dietger, Schwerdtfeger, Rainer, Bunjes, Donald, Glass, Bertram, Socié, Gerard, Ljungman, Per, Craddock, Charle, Baron, Frédéric, Ciceri, Fabio, Gorin, Norbert Claude, Esteve, Jordi, Schmid, Christoph, Giebel, Sebastian, Mohty, Mohamad, and Nagler, Arnon
- Subjects
Adult ,Male ,medicine.medical_specialty ,Transplantation Conditioning ,medicine.medical_treatment ,Graft vs Host Disease ,Hematopoietic stem cell transplantation ,Article ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Internal medicine ,medicine ,Humans ,Transplantation, Homologous ,Survival analysis ,Aged ,Retrospective Studies ,Aged, 80 and over ,Acute leukemia ,business.industry ,Graft Survival ,Age Factors ,Hematopoietic Stem Cell Transplantation ,Myeloid leukemia ,Retrospective cohort study ,Hematology ,Middle Aged ,Survival Analysis ,Surgery ,Transplantation ,Leukemia, Myeloid, Acute ,Treatment Outcome ,030220 oncology & carcinogenesis ,Cohort ,Female ,Unrelated Donors ,business ,030215 immunology - Abstract
The outcome of patients undergoing HLA-matched unrelated donor allogeneic hematopoietic cell transplantation following reduced-intensity conditioning or myeloablative regimens is reported to be equivalent; however, it is not known if the intensity of the conditioning impacts outcomes after mismatched unrelated donor transplantation for acute myeloid leukemia. Eight hundred and eighty three patients receiving reduced-intensity conditioning were compared with 1041 myeloablative conditioning regimen recipients in the setting of mismatched unrelated donor transplantation. The donor graft was HLA-matched at 9/10 in 872 (83.8%) and at 8/10 in 169 (16.2%) myeloablative conditioning recipients, while in the reduced-intensity conditioning cohort, 754 (85.4%) and 129 (14.6%) were matched at 9/10 and 8/10 loci, respectively. Myeloablative conditioning regimen recipients were younger, 70% being
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- 2016
12. Incidence and outcome of central nervous system relapse after hematopoietic stem cell transplantation in patients suffering from acute myeloid leukemia and acute lymphoblastic leukemia: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.
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Blum S, Chalandon Y, Labopin M, Finke J, Gedde-Dahl T, Othman TB, Cornelissen JJ, Jindra P, Labussière-Wallet H, Collin M, Lenhoff S, Kobbe G, Gutiérrez NC, Nagler A, and Mohty M
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- Humans, Incidence, Male, Adult, Female, Middle Aged, Adolescent, Europe epidemiology, Recurrence, Young Adult, Treatment Outcome, Aged, Hematopoietic Stem Cell Transplantation methods, Leukemia, Myeloid, Acute therapy, Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy, Precursor Cell Lymphoblastic Leukemia-Lymphoma epidemiology, Precursor Cell Lymphoblastic Leukemia-Lymphoma mortality, Central Nervous System Neoplasms therapy
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- 2024
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13. Allogeneic hematopoietic stem cell transplantation in patients aged 60-79 years in Germany (1998-2018): a registry study.
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Weller JF, Lengerke C, Finke J, Schetelig J, Platzbecker U, Einsele H, Schroeder T, Faul C, Stelljes M, Dreger P, Blau IW, Wulf G, Tischer J, Scheid C, Elmaagacli A, Neidlinger H, Flossdorf S, Bornhäuser M, Bethge W, Fleischhauer K, Kröger N, De Wreede LC, and Christopeit M
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- Humans, Transplantation, Homologous adverse effects, Germany epidemiology, Chronic Disease, Transplantation Conditioning adverse effects, Recurrence, Retrospective Studies, Hematopoietic Stem Cell Transplantation adverse effects, Graft vs Host Disease epidemiology, Graft vs Host Disease etiology
- Abstract
Incidences of diseases treated with transplantation frequently peak at higher age. The contribution of age to total risk of transplantation has not been estimated amidst an aging society. We compare outcomes of 1,547 patients aged 70-79 years and 9,422 patients aged 60-69 years transplanted 1998-2018 for myeloid, lymphoid and further neoplasia in Germany. To quantify the contribution of population mortality to survival, we derive excess mortality based on a sex-, year- and agematched German population in a multistate model that incorporates relapse and graft-versus-host-disease (GvHD). Overall survival, relapse-free survival (RFS) and GvHD-free-relapse-free survival (GRFS) is inferior in patients aged 70-79 years, compared to patients aged 60-69 years, with 36% (95% Confidence Interval [CI]: 34-39%) versus 43% (41-44%), 32% (30- 35%) versus 36% (35-37%) and 23% (21-26%) versus 27% (26-28%) three years post-transplant (P<0.001). Cumulative incidences of relapse at three years are 27% (25-30%) for patients aged 70-79 versus 29% (29-30%) (60-69 years) (P=0.71), yet the difference in non-relapse mortality (NRM) (40% [38-43%] vs. 35% [34-36%] in patients aged 70-79 vs. 60-69 years) (P<0.001) translates into survival differences. Median OS of patients surviving >1 year relapse-free is 6.7 (median, 95% CI: 4.5-9.4, 70-79 years) versus 9 (8.4-10.1, 60-69 years) years since landmark. Three years after RFS of one year, excess NRM is 14% (95% CI: 12-18%) in patients aged 70-79 versus 12% [11-13%] in patients aged 60-69, while population NRM is 7% (6-7%) versus 3% (3-3%). Mortality for reasons other than relapse, GvHD, or age is as high as 27% (24-29%) and 22% (22-23%) four years after transplantation. In conclusion, survival amongst older patients is adequate after allogeneic stem cell transplantation.
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- 2024
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14. Association of uric acid levels before start of conditioning with mortality after allogeneic hematopoietic stem cell transplantation - a prospective, non-interventional study of the EBMT Transplant Complication Working Party.
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Penack O, Peczynski C, van der Werf S, Finke J, Ganser A, Schoemans H, Pavlu J, Niittyvuopio R, Schroyens W, Kaynar L, Blau IW, van der Velden W, Sierra J, Cortelezzi A, Wulf G, Turlure P, Rovira M, Ozkurt Z, Pascual-Cascon MJ, Moreira MC, Clausen J, Greinix H, Duarte RF, and Basak GW
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- Humans, Prospective Studies, Retrospective Studies, Transplantation Conditioning adverse effects, Transplantation, Homologous, Uric Acid, Graft vs Host Disease etiology, Hematopoietic Stem Cell Transplantation adverse effects
- Abstract
Uric acid is a danger signal contributing to inflammation. Its relevance to allogeneic stem cell transplantation (alloSCT) derives from preclinical models where the depletion of uric acid led to improved survival and reduced graft- versus -host disease (GvHD). In a clinical pilot trial, peri-transplant uric acid depletion reduced acute GvHD incidence. This prospective international multicenter study aimed to investigate the association of uric acid serum levels before start of conditioning with alloSCT outcome. We included patients with acute leukemia, lymphoma or myelodysplastic syndrome receiving a first matched sibling alloSCT from peripheral blood, regardless of conditioning. We compared outcomes between patients with high and low uric acid levels with univariate- and multivariate analysis using a cause-specific Cox model. Twenty centers from 10 countries reported data on 366 alloSCT recipients. There were no significant differences in terms of baseline comorbidity and disease stage between the high- and low uric acid group. Patients with uric acid levels above median measured before start of conditioning did not significantly differ from the remaining in terms of acute GvHD grades II-IV incidence (Hazard ratio [HR] 1.5, 95% Confidence interval [CI]: 1.0-2.4, P =0.08). However, they had significantly shorter overall survival (HR 2.8, 95% CI: 1.7-4.7, P <0.0001) and progression free survival (HR 1.6, 95% CI: 1.1-2.4, P =0.025). Non-relapse mortality was significantly increased in alloSCT recipients with high uric acid levels (HR 2.7, 95% CI: 1.4-5.0, P =0.003). Finally, the incidence of relapse after alloSCT was increased in patients with higher uric acid levels (HR 1.6, 95% CI: 1.0-2.5, P =0.04). We conclude that high uric acid levels before the start of conditioning correlate with increased mortality after alloSCT., (Copyright© 2020 Ferrata Storti Foundation.)
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- 2020
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15. Allogeneic stem cell transplantation using HLA-matched donors for acute myeloid leukemia with deletion 5q or monosomy 5: a study from the Acute Leukemia Working Party of the EBMT.
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Poiré X, Labopin M, Polge E, Forcade E, Ganser A, Volin L, Michallet M, Blaise D, Yakoub-Agha I, Maertens J, Espiga CR, Cornelissen J, Finke J, Mohty M, Esteve J, and Nagler A
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- Adult, Humans, Karyotyping, Monosomy, Prognosis, Transplantation, Homologous, Hematopoietic Stem Cell Transplantation, Leukemia, Myeloid, Acute diagnosis, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute therapy
- Abstract
Deletion 5q or monosomy 5 (-5/5q-) in acute myeloid leukemia (AML) is a common high-risk feature that is referred to allogeneic stem cell transplantation. However, -5/5q- is frequently associated with other high-risk cytogenetic aberrations such as complex karyotype, monosomal karyotype, monosomy 7 (-7), or 17p abnormalities (abn (17p)), the significance of which is unknown. In order to address this question, we studied adult patients with AML harboring -5/5q- having their first allogeneic transplantation between 2000 and 2015. Five hundred and one patients with -5/5q- have been analyzed. Three hundred and thirty-eight patients (67%) were in first remission and 142 (28%) had an active disease at time of allogeneic transplantation. The 2-year probabilities of overall survival and leukemia-free survival were 27% and 20%, respectively. The 2-year probability of treatment-related mortality was 20%. We identified four different cytogenetic groups according to additional abnormalities with prognostic impact: -5/5q- without complex karyotype, monosomal karyotype or abn(17p), -5/5q- within a complex karyotype, -5/5q- within a monosomal karyotype and the combination of -5/5q- with abn(17p). In multivariate analysis, factors associated with worse overall survival and leukemia-free survival across the four groups were active disease, age, monosomal karyotype, and abn(17p). The presence of -5/5q- without monosomal karyotype or abn(17p) was associated with a significantly better survival rate while -5/5q- in conjunction with monosomal karyotype or abn(17p) translated into a worse outcome. The patients harboring the combination of -5/5q- with abn(17p) showed very limited benefit from allogeneic transplantation., (Copyright© 2020 Ferrata Storti Foundation.)
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- 2020
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16. Haploidentical versus unrelated allogeneic stem cell transplantation for relapsed/refractory acute myeloid leukemia: a report on 1578 patients from the Acute Leukemia Working Party of the EBMT.
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Brissot E, Labopin M, Ehninger G, Stelljes M, Brecht A, Ganser A, Tischer J, Kröger N, Afanasyev B, Finke J, Elmaagacli A, Einsele H, Mohty M, and Nagler A
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- Adolescent, Adult, Aged, Cause of Death, Drug Resistance, Neoplasm, Female, Graft vs Host Disease diagnosis, Graft vs Host Disease epidemiology, Graft vs Host Disease etiology, Humans, Incidence, Leukemia, Myeloid, Acute epidemiology, Leukemia, Myeloid, Acute pathology, Male, Middle Aged, Recurrence, Registries, Retreatment, Retrospective Studies, Siblings, Survival Analysis, Transplantation, Homologous, Treatment Outcome, Unrelated Donors, Young Adult, Hematopoietic Stem Cell Transplantation adverse effects, Hematopoietic Stem Cell Transplantation methods, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute therapy, Transplantation, Haploidentical
- Abstract
Primary refractory or relapsed acute myeloid leukemia is associated with a dismal prognosis. Allogeneic stem cell transplantation is the only therapeutic option that offers prolonged survival and cure in this setting. In the absence of a matched sibling donor, transplantation from unrelated 10/10 HLA allele-matched or 9/10 HLA allele-mismatched donors and haploidentical donors are potential alternatives. The current study aimed to compare the outcomes of acute myeloid leukemia patients with active disease who received allogeneic stem cell transplantation from a haploidentical donor with post-transplant cyclophosphamide (n=199) versus an unrelated 10/10-matched donor (n=1111) and versus an unrelated 9/10-mismatched donor (n=383) between 2007 and 2014 and who were reported to the European Society for Blood and Marrow Transplantation registry. Propensity score weighted analysis was conducted in order to control for disease risk imbalances between the groups. The leukemia-free survival rates at 2 years of recipients of grafts from a haploidentical donor, an unrelated 10/10-matched donor and an unrelated 9/10-mismatched donor were 22.8%, 28% and 22.2%, respectively ( P =NS). In multivariate analysis, there were no significant differences in leukemia-free survival, overall survival, relapse incidence, non-relapse mortality, or graft- versus -host-disease-free relapse-free survival between the three groups. Two predictive factors were associated with a higher relapse incidence: transplantation during first or second relapse compared to primary refractory acute myeloid leukemia and poor cytogenetics. Allogeneic stem cell transplantation may rescue about 25% of acute myeloid leukemia patients with active disease. Importantly, the outcomes of transplants from haploidentical donors were comparable to those from 10/10-matched and 9/10-mismatched unrelated donors. Therefore, a haploidentical donor is a valid option for acute myeloid leukemia patients with active disease., (Copyright© 2019 Ferrata Storti Foundation.)
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- 2019
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17. Allogeneic transplantation of multiple myeloma patients may allow long-term survival in carefully selected patients with acceptable toxicity and preserved quality of life.
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Greil C, Engelhardt M, Ihorst G, Schoeller K, Bertz H, Marks R, Zeiser R, Duyster J, Einsele H, Finke J, and Wäsch R
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- Adult, Aged, Combined Modality Therapy, Female, Graft Survival, Graft vs Host Disease etiology, Graft vs Host Disease prevention & control, Humans, Male, Middle Aged, Multiple Myeloma epidemiology, Multiple Myeloma pathology, Patient Selection, Recurrence, Retreatment, Retrospective Studies, Transplantation, Homologous, Treatment Outcome, Hematopoietic Stem Cell Transplantation adverse effects, Hematopoietic Stem Cell Transplantation methods, Multiple Myeloma mortality, Multiple Myeloma therapy, Quality of Life
- Abstract
Despite significantly improved survival and response rates in patients diagnosed with multiple myeloma, it still remains an incurable disease with a poor outcome, especially in high-risk groups. Allogeneic stem cell transplantation offers a potentially curative option but remains controversial due to considerable treatment-related toxicity. We analyzed 109 consecutive myeloma patients who had received reduced-intensity conditioning allogeneic transplantation at the Freiburg University Medical Center between 2000 and 2016. Although most patients were heavily pre-treated in high-risk constellations, the overall response rate was high with 70%, the median overall survival (OS) 39.2%, and the median progression-free survival (PFS) 14.2 months, with a median follow up of 71.5 months. Survival was significantly better in patients with response to previous therapies than in those with progressive disease (median OS 65 vs. 11.5 months, P =0.003; median PFS 18.4 vs. 5.1 months, P =0.001). Moreover, survival of patients transplanted in first-line was significantly prolonged compared to relapsed/refractory disease (median OS not reached vs. 21.6 months, P <0.001; median PFS 47.7 vs. 9.6 months, P <0.001). The non-relapse mortality was relatively low with a cumulative incidence of 12.4% at ten years. Acute graft- versus -host disease (GvHD) grade II-IV was observed in 25%, and moderate or severe chronic GvHD in 24%. Quality of life (QoL) assessed with the revised Myeloma Comorbidity Index before and after transplantation remained unchanged. Our data suggest that allogeneic transplantation in the context of novel immunotherapeutic approaches may enable long-term survival and even a potential cure in a carefully selected subgroup of high-risk multiple myeloma patients with acceptable toxicity and preserved QoL., (Copyright © 2019 Ferrata Storti Foundation.)
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- 2019
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18. Outcome after relapse of myelodysplastic syndrome and secondary acute myeloid leukemia following allogeneic stem cell transplantation: a retrospective registry analysis on 698 patients by the Chronic Malignancies Working Party of the European Society of Blood and Marrow Transplantation.
- Author
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Schmid C, de Wreede LC, van Biezen A, Finke J, Ehninger G, Ganser A, Volin L, Niederwieser D, Beelen D, Alessandrino P, Kanz L, Schleuning M, Passweg J, Veelken H, Maertens J, Cornelissen JJ, Blaise D, Gramatzki M, Milpied N, Yakoub-Agha I, Mufti G, Rovira M, Arnold R, de Witte T, Robin M, and Kröger N
- Subjects
- Adolescent, Adult, Aged, Allografts, Europe, Female, Humans, Lymphocyte Transfusion, Male, Middle Aged, Myelodysplastic Syndromes therapy, Recurrence, Registries, Reoperation, Retrospective Studies, Risk Factors, Treatment Outcome, Young Adult, Hematopoietic Stem Cell Transplantation methods, Leukemia, Myeloid, Acute etiology, Myelodysplastic Syndromes pathology
- Abstract
No standard exists for the treatment of myelodysplastic syndrome relapsing after allogeneic stem cell transplantation. We performed a retrospective registry analysis of outcomes and risk factors in 698 patients, treated with different strategies. The median overall survival from relapse was 4.7 months (95% confidence interval: 4.1-5.3) and the 2-year survival rate was 17.7% (95% confidence interval: 14.8-21.2%). Shorter remission after transplantation ( P <0.001), advanced disease ( P =0.001), older age ( P =0.007), unrelated donor ( P =0.008) and acute graft- versus -host disease before relapse ( P <0.001) adversely influenced survival. At 6 months from relapse, patients had received no cellular treatment, (i.e. palliative chemotherapy or best supportive care, n=375), donor lymphocyte infusion (n=213), or a second transplant (n=110). Treatment groups were analyzed separately because of imbalanced characteristics and difficulties in retrospectively evaluating the reason for individual treatments. Of the patients who did not receive any cellular therapy, 109 were alive at 6 months after relapse, achieving a median overall survival from this landmark of 8.9 months (95% confidence interval: 5.1-12.6). Their 2-year survival rate was 29.7%. Recipients of donor lymphocytes achieved a median survival from first infusion of 6.0 months (95% confidence interval: 3.7-8.3) with a 2-year survival rate of 27.6%. Longer remission after first transplantation ( P <0.001) and younger age ( P =0.009) predicted better outcome. Among recipients of a second transplant, the median survival from second transplantation was 4.2 months (95% confidence interval: 2.5-5.9), and their 2-year survival rate was 17.0%. Longer remission after first transplantation ( P <0.001), complete remission at second transplant ( P =0.008), no prior chronic graft- versus -host disease ( P <0.001) and change to a new donor ( P =0.04) predicted better outcome. The data enabled identification of patients benefiting from donor lymphocyte infusion and second transplantation, and may serve as a baseline for prospective trials., (Copyright© 2018 Ferrata Storti Foundation.)
- Published
- 2018
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19. Expanding transplant options to patients over 50 years. Improved outcome after reduced intensity conditioning mismatched-unrelated donor transplantation for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT.
- Author
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Savani BN, Labopin M, Kröger N, Finke J, Ehninger G, Niederwieser D, Schwerdtfeger R, Bunjes D, Glass B, Socié G, Ljungman P, Craddock C, Baron F, Ciceri F, Gorin NC, Esteve J, Schmid C, Giebel S, Mohty M, and Nagler A
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Female, Graft Survival, Graft vs Host Disease diagnosis, Graft vs Host Disease etiology, Humans, Male, Middle Aged, Recurrence, Retrospective Studies, Survival Analysis, Transplantation, Homologous, Treatment Outcome, Young Adult, Hematopoietic Stem Cell Transplantation methods, Leukemia, Myeloid, Acute mortality, Leukemia, Myeloid, Acute therapy, Transplantation Conditioning methods, Unrelated Donors
- Abstract
The outcome of patients undergoing HLA-matched unrelated donor allogeneic hematopoietic cell transplantation following reduced-intensity conditioning or myeloablative regimens is reported to be equivalent; however, it is not known if the intensity of the conditioning impacts outcomes after mismatched unrelated donor transplantation for acute myeloid leukemia. Eight hundred and eighty three patients receiving reduced-intensity conditioning were compared with 1041 myeloablative conditioning regimen recipients in the setting of mismatched unrelated donor transplantation. The donor graft was HLA-matched at 9/10 in 872 (83.8%) and at 8/10 in 169 (16.2%) myeloablative conditioning recipients, while in the reduced-intensity conditioning cohort, 754 (85.4%) and 129 (14.6%) were matched at 9/10 and 8/10 loci, respectively. Myeloablative conditioning regimen recipients were younger, 70% being <50 years of age compared to only 30% in the reduced-intensity conditioning group (P=0.0001). Significantly, more patients had secondary acute myeloid leukemia (P=0.04) and Karnofsky Performance Status score <90% (P=0.02) in the reduced-intensity conditioning group. Patients <50 and ≥50 years were analyzed separately. On multivariate analysis and after adjusting for differences between the two groups, reduced-intensity conditioning in patients age ≥50 years was associated with higher overall survival (HR 0.78; P=0.01), leukemia-free survival (HR 0.82; P=0.05), and decreased non-relapse mortality (HR 0.73; P=0.03). Relapse incidence (HR 0.91; P=0.51) and chronic graft-versus-host disease (HR 1.31; P=0.11) were, however, not significantly different. In patients <50 years old, there were no statistically significant differences in overall survival, leukemia-free survival, relapse incidence, non-relapse mortality, and chronic graft-versus-host-disease between the groups. Our study shows no significant outcome differences in patients younger than 50 years receiving reduced-intensity vs myeloablative conditioning regimens after mismatched unrelated donor transplantation. Furthermore, the data support the superiority of reduced-intensity conditioning regimens in older adults receiving transplants from mismatched unrelated donors., (Copyright© Ferrata Storti Foundation.)
- Published
- 2016
- Full Text
- View/download PDF
20. Impact of the revised International Prognostic Scoring System, cytogenetics and monosomal karyotype on outcome after allogeneic stem cell transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia evolving from myelodysplastic syndromes: a retrospective multicenter study of the European Society of Blood and Marrow Transplantation.
- Author
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Koenecke C, Göhring G, de Wreede LC, van Biezen A, Scheid C, Volin L, Maertens J, Finke J, Schaap N, Robin M, Passweg J, Cornelissen J, Beelen D, Heuser M, de Witte T, and Kröger N
- Subjects
- Adolescent, Adult, Aged, Antineoplastic Agents therapeutic use, Bone Marrow drug effects, Bone Marrow pathology, Cytogenetic Analysis, Europe, Female, Humans, Karyotype, Leukemia, Myeloid, Acute etiology, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute mortality, Male, Middle Aged, Myelodysplastic Syndromes complications, Myelodysplastic Syndromes genetics, Myelodysplastic Syndromes mortality, Prognosis, Proportional Hazards Models, Recurrence, Retrospective Studies, Risk, Societies, Medical, Survival Analysis, Transplantation, Homologous, Hematopoietic Stem Cell Transplantation, Leukemia, Myeloid, Acute therapy, Monosomy, Myelodysplastic Syndromes therapy, Research Design
- Abstract
The aim of this study was to determine the impact of the revised 5-group International Prognostic Scoring System cytogenetic classification on outcome after allogeneic stem cell transplantation in patients with myelodysplastic syndromes or secondary acute myeloid leukemia who were reported to the European Society for Blood and Marrow Transplantation database. A total of 903 patients had sufficient cytogenetic information available at stem cell transplantation to be classified according to the 5-group classification. Poor and very poor risk according to this classification was an independent predictor of shorter relapse-free survival (hazard ratio 1.40 and 2.14), overall survival (hazard ratio 1.38 and 2.14), and significantly higher cumulative incidence of relapse (hazard ratio 1.64 and 2.76), compared to patients with very good, good or intermediate risk. When comparing the predictive performance of a series of Cox models both for relapse-free survival and for overall survival, a model with simplified 5-group cytogenetics (merging very good, good and intermediate cytogenetics) performed best. Furthermore, monosomal karyotype is an additional negative predictor for outcome within patients of the poor, but not the very poor risk group of the 5-group classification. The revised International Prognostic Scoring System cytogenetic classification allows patients with myelodysplastic syndromes to be separated into three groups with clearly different outcomes after stem cell transplantation. Poor and very poor risk cytogenetics were strong predictors of poor patient outcome. The new cytogenetic classification added value to prediction of patient outcome compared to prediction models using only traditional risk factors or the 3-group International Prognostic Scoring System cytogenetic classification., (Copyright© Ferrata Storti Foundation.)
- Published
- 2015
- Full Text
- View/download PDF
21. Tyrosine kinase inhibitors improve long-term outcome of allogeneic hematopoietic stem cell transplantation for adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia.
- Author
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Brissot E, Labopin M, Beckers MM, Socié G, Rambaldi A, Volin L, Finke J, Lenhoff S, Kröger N, Ossenkoppele GJ, Craddock CF, Yakoub-Agha I, Gürman G, Russell NH, Aljurf M, Potter MN, Nagler A, Ottmann O, Cornelissen JJ, Esteve J, and Mohty M
- Subjects
- Adolescent, Adult, Aged, Female, Histocompatibility Testing, Humans, Male, Middle Aged, Precursor Cell Lymphoblastic Leukemia-Lymphoma immunology, Precursor Cell Lymphoblastic Leukemia-Lymphoma mortality, Precursor Cell Lymphoblastic Leukemia-Lymphoma pathology, Prognosis, Remission Induction, Retrospective Studies, Siblings, Survival Analysis, Time Factors, Transplantation, Homologous, Treatment Outcome, Unrelated Donors, Antineoplastic Agents therapeutic use, Hematopoietic Stem Cell Transplantation, Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy, Protein Kinase Inhibitors therapeutic use
- Abstract
This study aimed to determine the impact of tyrosine kinase inhibitors given pre- and post-allogeneic stem cell transplantation on long-term outcome of patients allografted for Philadelphia chromosome-positive acute lymphoblastic leukemia. This retrospective analysis from the EBMT Acute Leukemia Working Party included 473 de novo Philadelphia chromosome-positive acute lymphoblastic leukemia patients in first complete remission who underwent an allogeneic stem cell transplantation using a human leukocyte antigen-identical sibling or human leukocyte antigen-matched unrelated donor between 2000 and 2010. Three hundred and ninety patients received tyrosine kinase inhibitors before transplant, 329 at induction and 274 at consolidation. Kaplan-Meier estimates of leukemia-free survival, overall survival, cumulative incidences of relapse incidence, and non-relapse mortality at five years were 38%, 46%, 36% and 26%, respectively. In multivariate analysis, tyrosine-kinase inhibitors given before allogeneic stem cell transplantation was associated with a better overall survival (HR=0.68; P=0.04) and was associated with lower relapse incidence (HR=0.5; P=0.01). In the post-transplant period, multivariate analysis identified prophylactic tyrosine-kinase inhibitor administration to be a significant factor for improved leukemia-free survival (HR=0.44; P=0.002) and overall survival (HR=0.42; P=0.004), and a lower relapse incidence (HR=0.40; P=0.01). Over the past decade, administration of tyrosine kinase inhibitors before allogeneic stem cell transplantation has significantly improved the long-term allogeneic stem cell transplantation outcome of adult Philadelphia chromosome-positive acute lymphoblastic leukemia. Prospective studies will be of great interest to further confirm the potential benefit of the prophylactic use of tyrosine kinase inhibitors in the post-transplant setting., (Copyright© Ferrata Storti Foundation.)
- Published
- 2015
- Full Text
- View/download PDF
22. Impact of the International Prognostic Scoring System cytogenetic risk groups on the outcome of patients with primary myelodysplastic syndromes undergoing allogeneic stem cell transplantation from human leukocyte antigen-identical siblings: a retrospective analysis of the European Society for Blood and Marrow Transplantation-Chronic Malignancies Working Party.
- Author
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Onida F, Brand R, van Biezen A, Schaap M, von dem Borne PA, Maertens J, Beelen DW, Carreras E, Alessandrino EP, Volin L, Kuball JH, Figuera A, Sierra J, Finke J, Kröger N, and de Witte T
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Myelodysplastic Syndromes mortality, Prognosis, Retrospective Studies, Transplantation Conditioning, Transplantation, Homologous, Treatment Outcome, Young Adult, HLA Antigens immunology, Hematopoietic Stem Cell Transplantation, Myelodysplastic Syndromes immunology, Myelodysplastic Syndromes therapy, Siblings
- Abstract
Acquired chromosomal abnormalities are important prognostic factors in patients with myelodysplastic syndromes treated with supportive care and with disease-modifying therapeutic interventions, including allogeneic hematopoietic stem cell transplantation. To assess the prognostic impact of cytogenetic characteristics after hematopoietic stem cell transplantation accurately, we investigated a homogeneous group of 523 patients with primary myelodysplastic syndromes who have received stem cells from human leukocyte antigen-identical siblings. Overall survival at five years from transplantation in good, intermediate, and poor cytogenetic risk groups according to the International Prognostic Scoring System was 48%, 45% and 30%, respectively (P<0.01). Both the disease status (complete remission vs. not in complete remission) and the morphological classification at transplant in the untreated patients were significantly associated with probability of overall survival and relapse-free survival (P<0.01). The cytogenetic risk groups have no prognostic impact in untreated patients with refractory anemia ± ringed sideroblasts (P=0.90). However, combining the good and intermediate cytogenetic risk groups and comparing them to the poor-risk group showed within the other three disease-status-at-transplant groups a hazard ratio of 1.86 (95%CI: 1.41-2.45). In conclusion, this study shows that, in a large series of patients with primary myelodysplastic syndromes, poor-risk cytogenetics as defined by the standard International Prognostic Scoring System is associated with a relatively poor survival after allogeneic stem cell transplantation from human leukocyte antigen-identical siblings except in patients who are transplanted in refractory anemia/refractory anemia with ringed sideroblasts stage before progression to higher myelodysplastic syndrome stages., (Copyright© Ferrata Storti Foundation.)
- Published
- 2014
- Full Text
- View/download PDF
23. Early administration of donor lymphocyte infusions upon molecular relapse after allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia: a study by the Chronic Malignancies Working Party of the EBMT.
- Author
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Chalandon Y, Passweg JR, Guglielmi C, Iacobelli S, Apperley J, Schaap NP, Finke J, Robin M, Fedele R, Bron D, Yakoub-Agha I, van Biezen A, de Witte T, Kröger N, and Olavarria E
- Subjects
- Disease Progression, Female, Follow-Up Studies, Graft vs Host Disease immunology, Graft vs Host Disease mortality, Graft vs Host Disease pathology, Humans, Leukemia, Myelogenous, Chronic, BCR-ABL Positive immunology, Leukemia, Myelogenous, Chronic, BCR-ABL Positive mortality, Leukemia, Myelogenous, Chronic, BCR-ABL Positive pathology, Male, Neoplasm, Residual immunology, Neoplasm, Residual mortality, Neoplasm, Residual pathology, Recurrence, Siblings, Survival Analysis, Time Factors, Transplantation, Homologous, Unrelated Donors, Graft vs Host Disease therapy, Hematopoietic Stem Cell Transplantation, Leukemia, Myelogenous, Chronic, BCR-ABL Positive therapy, Lymphocyte Transfusion, Neoplasm, Residual therapy
- Abstract
Patients with chronic myeloid leukemia relapsing after allogeneic hematopoietic stem cell transplantation may be treated by tyrosine kinase inhibitors and/or by donor lymphocyte infusions. The best strategies and timing of administration of lymphocytes are unclear. We analyzed 155 patients who relapsed after allogeneic stem cell transplantation with disease detectable only by molecular methods and who subsequently received lymphocytes. Transplants were performed in first chronic phase (n=125) or in advanced disease (n=29) from identical siblings (n=84) or unrelated donors (n=71) between 1986 and 2003. They received lymphocytes either during molecular relapse (n=85) or upon progression to more advanced disease (1993 to 2004). The median interval from relapse to lymphocyte infusion was 210 (0-1673) days. The median follow up after it was 46 (3-135) months. Overall survival was 76±4% at five years after lymphocyte infusions (89±8% with sibling donors and 63±13% with unrelated donors (P=0.003)). Survival was 69±14% when lymphocytes were given within six months of the detection of molecular relapse and 81±10% (P=0.061) when given later; 81±11% if given at molecular relapse versus 71±12% (P=0.26) with more advanced disease. In multivariate analysis survival was worse if the donor was unrelated (HR 2.54 (95% CI: 1.15-5.53), P=0.021) and better with lymphocyte infusions beyond six months from molecular relapse (HR 0.4 (95%CI: 0.19-0.84), P=0.018). These data confirm the remarkable efficacy of lymphocyte infusions for this disease. There appears to be no advantage from administering it early upon detection of molecular relapse in patients who received allogeneic stem cell transplantation for chronic myeloid leukemia., (Copyright© Ferrata Storti Foundation.)
- Published
- 2014
- Full Text
- View/download PDF
24. Alternative donor hematopoietic stem cell transplantation for mature lymphoid malignancies after reduced-intensity conditioning regimen: similar outcomes with umbilical cord blood and unrelated donor peripheral blood.
- Author
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Rodrigues CA, Rocha V, Dreger P, Brunstein C, Sengeloev H, Finke J, Mohty M, Rio B, Petersen E, Guilhot F, Niederwieser D, Cornelissen JJ, Jindra P, Nagler A, Fegueux N, Schoemans H, Robinson S, Ruggeri A, Gluckman E, Canals C, and Sureda A
- Subjects
- Adolescent, Adult, Aged, Disease-Free Survival, Female, Follow-Up Studies, Hematologic Neoplasms mortality, Hematologic Neoplasms therapy, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Survival Rate, Cord Blood Stem Cell Transplantation, Graft vs Host Disease mortality, Graft vs Host Disease pathology, Graft vs Host Disease prevention & control, Hematopoietic Stem Cell Transplantation, Transplantation Conditioning, Unrelated Donors
- Abstract
We have reported encouraging results of unrelated cord blood transplantation for patients with lymphoid malignancies. Whether those outcomes are comparable to matched unrelated donor transplants remains to be defined. We studied 645 adult patients with mature lymphoid malignancies who received an allogeneic unrelated donor transplant using umbilical cord blood (n=104) or mobilized peripheral blood stem cells (n=541) after a reduced-intensity conditioning regimen. Unrelated cord blood recipients had more refractory disease. Median follow-up time was 30 months. Neutrophil engraftment (81% vs. 97%, respectively; P<0.0001) and chronic graft-versus-host disease (26% vs. 52%; P=0.0005) were less frequent after unrelated cord blood than after matched unrelated donor, whereas no differences were observed in grade II-IV acute graft-versus-host disease (29% vs. 32%), non-relapse mortality (29% vs. 28%), and relapse or progression (28% vs. 35%) at 36 months. There were also no significant differences in 2-year progression-free survival (43% vs. 58%, respectively) and overall survival (36% vs. 51%) at 36 months. In a multivariate analysis, no differences were observed in the outcomes between the two stem cell sources except for a higher risk of neutrophil engraftment (hazard ratio=2.12; P<0.0001) and chronic graft-versus-host disease (hazard ratio 2.10; P=0.0002) after matched unrelated donor transplant. In conclusion, there was no difference in final outcomes after transplantation between umbilical cord blood and matched unrelated donor transplant. Umbilical cord blood is a valuable alternative for patients with lymphoid malignancies lacking an HLA-matched donor, being associated with lower risk of chronic graft-versus-host disease.
- Published
- 2014
- Full Text
- View/download PDF
25. Prognosis of patients with primary central nervous system lymphoma after high-dose chemotherapy followed by autologous stem cell transplantation.
- Author
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Schorb E, Kasenda B, Atta J, Kaun S, Morgner A, Hess G, Elter T, von Bubnoff N, Dreyling M, Ringhoffer M, Krause SW, Derigs G, Klimm B, Niemann D, Fritsch K, Finke J, and Illerhaus G
- Subjects
- Adult, Aged, Antineoplastic Agents administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Central Nervous System Neoplasms therapy, Combined Modality Therapy, Female, Hematopoietic Stem Cell Transplantation, Humans, Lymphoma therapy, Male, Middle Aged, Prognosis, Radiotherapy, Retrospective Studies, Risk Factors, Transplantation, Autologous, Treatment Outcome, Young Adult, Central Nervous System Neoplasms mortality, Lymphoma mortality
- Abstract
High-dose chemotherapy followed by autologous stem cell transplantation has been shown to be feasible and highly effective in newly diagnosed primary central nervous system lymphoma. In this retrospective multicenter study, we investigated prognosis and baseline risk factors in patients with primary central nervous system lymphoma who underwent this treatment approach. We retrospectively analyzed 105 immunocompetent patients with primary central nervous system lymphoma who underwent high-dose chemotherapy followed by autologous stem cell transplantation with or without whole brain radiotherapy as first-line consolidation treated at 12 German centers between 1997 and 2011. We estimated survival rates and investigated the impact of age, performance status, serum lactate dehydrogenase level, and deep brain involvement on overall and progression-free survival. Patients were additionally categorized into three prognostic groups according to the Memorial Sloan Kettering Cancer Center prognostic model. After a median follow up of 47 months, median progression-free survival and overall survival was reached after 85 and 121 months; 2- and 5-year survival rates were 82% and 79%, respectively. The Memorial Sloan Kettering Cancer Center prognostic model did not predict survival. Only age revealed some evidence of prognostic relevance. Overall response rate was 95%; of those patients with progressive disease before high-dose chemotherapy, 7 of 20 achieved ongoing complete remission after therapy without whole brain radiation therapy. Transplantation-associated mortality was 2.8%. High-dose chemotherapy followed by autologous stem cell transplantation is a highly effective and safe treatment modality for selected primary central nervous system lymphoma patients. Superiority compared to standard chemotherapy still warrants further investigation.
- Published
- 2013
- Full Text
- View/download PDF
26. Inhibition of protein geranylgeranylation and farnesylation protects against graft-versus-host disease via effects on CD4 effector T cells.
- Author
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Hechinger AK, Maas K, Dürr C, Leonhardt F, Prinz G, Marks R, Gerlach U, Hofmann M, Fisch P, Finke J, Pircher H, and Zeiser R
- Subjects
- Animals, Bone Marrow Transplantation adverse effects, CD4-Positive T-Lymphocytes drug effects, Graft vs Host Disease prevention & control, Graft vs Leukemia Effect drug effects, Graft vs Leukemia Effect immunology, Mice, Mice, Inbred BALB C, Mice, Inbred C57BL, Prenylation drug effects, Protein Prenylation drug effects, Quinolones pharmacology, Quinolones therapeutic use, Treatment Outcome, CD4-Positive T-Lymphocytes immunology, CD4-Positive T-Lymphocytes metabolism, Graft vs Host Disease immunology, Graft vs Host Disease metabolism, Prenylation physiology, Protein Prenylation physiology
- Abstract
Despite advances in immunosuppressive regimens, acute graft-versus-host disease remains a frequent complication of allogeneic hematopoietic cell transplantation. Pathogenic donor T cells are dependent on correct attachment of small GTPases to the cell membrane, mediated by farnesyl- or geranylgeranyl residues, which, therefore, constitute potential targets for graft-versus-host disease prophylaxis. A mouse model was used to study the impact of a farnesyl-transferase inhibitor and a geranylgeranyl-transferase inhibitor on acute graft-versus-host disease, anti-cytomegalovirus T-cell responses and graft-versus-leukemia activity. Treatment of mice undergoing allogeneic hematopoietic cell transplantation with farnesyl-transferase inhibitor and geranylgeranyl-transferase inhibitor reduced the histological severity of graft-versus-host disease and prolonged survival significantly. Mechanistically, farnesyl-transferase inhibitor and geranylgeranyl-transferase inhibitor treatment resulted in reduced alloantigen-driven expansion of CD4 T cells. In vivo treatment led to increased thymic cellularity and polyclonality of the T-cell receptor repertoire by reducing thymic graft-versus-host disease. These effects were absent when squalene production was blocked. The farnesyl-transferase inhibitor and geranylgeranyl-transferase inhibitor did not compromise CD8 function against leukemia cells or reconstitution of T cells that were subsequently responsible for anti-murine cytomegalovirus responses. In summary, we observed an immunomodulatory effect of inhibitors of farnesyl-transferase and geranylgeranyl-transferase on graft-versus-host disease, with enhanced functional immune reconstitution. In the light of the modest toxicity of farnesyl-transferase inhibitors such as tipifarnib in patients and the potent reduction of graft-versus-host disease in mice, farnesyl-transferase and geranylgeranyl-transferase inhibitors could help to reduce graft-versus-host disease significantly without having a negative impact on immune reconstitution.
- Published
- 2013
- Full Text
- View/download PDF
27. Lenalidomide maintenance after allogeneic HSCT seems to trigger acute graft-versus-host disease in patients with high-risk myelodysplastic syndromes or acute myeloid leukemia and del(5q): results of the LENAMAINT trial.
- Author
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Sockel K, Bornhaeuser M, Mischak-Weissinger E, Trenschel R, Wermke M, Unzicker C, Kobbe G, Finke J, Germing U, Mohr B, Greiner J, Beelen D, Thiede C, Ehninger G, and Platzbecker U
- Subjects
- Female, Humans, Male, Antineoplastic Agents administration & dosage, Chromosome Aberrations, Chromosomes, Human, Pair 5 genetics, Leukemia, Myeloid, Acute drug therapy, Myelodysplastic Syndromes drug therapy, Thalidomide analogs & derivatives
- Published
- 2012
- Full Text
- View/download PDF
28. High-dose chemotherapy and autologous stem-cell transplantation without consolidating radiotherapy as first-line treatment for primary lymphoma of the central nervous system.
- Author
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Illerhaus G, Müller F, Feuerhake F, Schäfer AO, Ostertag C, and Finke J
- Subjects
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Central Nervous System Neoplasms therapy, Disease-Free Survival, Female, Humans, Lymphoma therapy, Male, Methotrexate administration & dosage, Middle Aged, Treatment Outcome, Central Nervous System Neoplasms drug therapy, Central Nervous System Neoplasms radiotherapy, Combined Modality Therapy methods, Lymphoma drug therapy, Lymphoma radiotherapy, Stem Cell Transplantation methods, Transplantation, Autologous methods
- Abstract
Thirteen patients (age 38-67 years) with primary lymphoma of the central nervous system (CNS) were treated with methotrexate and cytarabine/thiotepa induction-chemotherapy followed by high-dose carmustine/thiotepa and autologous stem-cell transplantation. Radiotherapy was restricted to patients who did not respond completely to chemotherapy. With a median follow up of 25 months, 3-year DFS and OS was 77%.
- Published
- 2008
- Full Text
- View/download PDF
29. Incidence of monoclonal B-cell disease in siblings of patients with multiple myeloma.
- Author
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Engelhardt M, Ihorst G, Behringer D, Finke J, and Roth B
- Subjects
- Clone Cells pathology, Family Health, Hematopoietic Stem Cell Transplantation, Humans, Incidence, Siblings, B-Lymphocytes pathology, Multiple Myeloma pathology, Tissue Donors
- Abstract
We observed clustering of monoclonal B-cell disease in siblings being screened as allogeneic donors for patients with multiple myeloma (MM) scheduled for stem cell transplantation (SCT). Of 134 asymptomatic donors, the incidence of monoclonal B-cell disease was 8/84 in siblings and 1/50 in matched unrelated donors. From an analysis of five MM families scheduled for allogeneic SCT, monoclonal B-cell disease was detected in 8/27 siblings.
- Published
- 2006
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