22 results on '"Ljungman, Per"'
Search Results
2. Reduced immunogenicity of a third COVID-19 vaccination among recipients of allogeneic hematopoietic stem cell transplantation
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Einarsdottir, Sigrun, primary, Martner, Anna, additional, Nicklasson, Malin, additional, Wiktorin, Hanna Grauers, additional, Arabpour, Mohammad, additional, Törnell, Andreas, additional, Vaht, Krista, additional, Waldenström, Jesper, additional, Ringlander, Johan, additional, Bergström, Tomas, additional, Brune, Mats, additional, Hellstrand, Kristoffer, additional, Ljungman, Per, additional, and Lagging, Martin, additional
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- 2022
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3. Guidelines from the 2017 European Conference on Infections in Leukaemia for management of HHV-6 infection in patients with hematologic malignancies and after hematopoietic stem cell transplantation
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Ward, Katherine N, primary, Hill, Joshua A, additional, Hubacek, Petr, additional, de la Camara, Rafael, additional, Crocchiolo, Roberto, additional, Einsele, Hermann, additional, Navarro, David, additional, Robin, Christine, additional, Cordonnier, Catherine, additional, and Ljungman, Per, 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. Incidence and outcome of acquired aplastic anemia: real-world data from patients diagnosed in Sweden from 2000–2011
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Vaht, Krista, primary, Göransson, Magnus, additional, Carlson, Kristina, additional, Isaksson, Cecilia, additional, Lenhoff, Stig, additional, Sandstedt, Anna, additional, Uggla, Bertil, additional, Winiarski, Jacek, additional, Ljungman, Per, additional, Brune, Mats, additional, and Andersson, Per-Ola, additional
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- 2017
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7. A prospective randomized trial comparing cyclosporine/methotrexate and tacrolimus/sirolimus as graft-versus-host disease prophylaxis after allogeneic hematopoietic stem cell transplantation
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Törlén, Johan, primary, Ringdén, Olle, additional, Garming-Legert, Karin, additional, Ljungman, Per, additional, Winiarski, Jacek, additional, Remes, Kari, additional, Itälä-Remes, Maija, additional, Remberger, Mats, additional, and Mattsson, Jonas, additional
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- 2016
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8. 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
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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
9. Management of Epstein-Barr Virus infections and post-transplant lymphoproliferative disorders in patients after allogeneic hematopoietic stem cell transplantation: Sixth European Conference on Infections in Leukemia (ECIL-6) guidelines.
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Styczynski J, van der Velden W, Fox CP, Engelhard D, de la Camara R, Cordonnier C, and Ljungman P
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- Disease Management, Epstein-Barr Virus Infections epidemiology, Epstein-Barr Virus Infections prevention & control, Humans, Lymphoproliferative Disorders epidemiology, Practice Guidelines as Topic, Risk Factors, Epstein-Barr Virus Infections complications, Epstein-Barr Virus Infections etiology, Hematopoietic Stem Cell Transplantation adverse effects, Lymphoproliferative Disorders diagnosis, Lymphoproliferative Disorders etiology, Lymphoproliferative Disorders therapy
- Abstract
Epstein-Barr virus-related post-transplant lymphoproliferative disorders are recognized as a significant cause of morbidity and mortality in patients undergoing hematopoietic stem cell transplantation. To better define current understanding of post-transplant lymphoproliferative disorders in stem cell transplant patients, and to improve its diagnosis and management, a working group of the Sixth European Conference on Infections in Leukemia 2015 reviewed the literature, graded the available quality of evidence, and developed evidence-based recommendations for diagnosis, prevention, prophylaxis and therapy of post-transplant lymphoproliferative disorders exclusively in the stem cell transplant setting. The key elements in diagnosis include non-invasive and invasive methods. The former are based on quantitative viral load measurement and imaging with positron emission tomography; the latter with tissue biopsy for histopathology and detection of Epstein-Barr virus. The diagnosis of post-transplant lymphoproliferative disorder can be established on a proven or probable level. Therapeutic strategies include prophylaxis, preemptive therapy and targeted therapy. Rituximab, reduction of immunosuppression and Epstein-Barr virus-specific cytotoxic T-cell therapy are recommended as first-line therapy, whilst unselected donor lymphocyte infusions or chemotherapy are options as second-line therapy; other methods including antiviral drugs are discouraged., (Copyright© Ferrata Storti Foundation.)
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- 2016
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10. Unrelated alternative donor transplantation for severe acquired aplastic anemia: a study from the French Society of Bone Marrow Transplantation and Cell Therapies and the EBMT Severe Aplastic Anemia Working Party.
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Devillier R, Dalle JH, Kulasekararaj A, D'aveni M, Clément L, Chybicka A, Vigouroux S, Chevallier P, Koh M, Bertrand Y, Michallet M, Zecca M, Yakoub-Agha I, Cahn JY, Ljungman P, Bernard M, Loiseau P, Dubois V, Maury S, Socié G, Dufour C, and Peffault de Latour R
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- Adolescent, Adult, Aged, Anemia, Aplastic mortality, Child, Child, Preschool, Female, France, Graft vs Host Disease etiology, Humans, Infant, Lymphocyte Depletion, Male, Middle Aged, Prognosis, Severity of Illness Index, Survival Analysis, Transplantation Conditioning adverse effects, Transplantation Conditioning methods, Transplantation, Homologous, Treatment Outcome, Young Adult, Anemia, Aplastic diagnosis, Anemia, Aplastic therapy, Bone Marrow Transplantation adverse effects, Bone Marrow Transplantation methods, Unrelated Donors
- Abstract
Unrelated allogeneic transplantation for severe aplastic anemia is a treatment option after immunosuppressive treatment failure in the absence of a matched sibling donor. Age, delay between disease diagnosis and transplantation, and HLA matching are the key factors in transplantation decisions, but their combined impact on patient outcomes remains unclear. Using the French Society of Bone Marrow Transplantation and Cell Therapies registry, we analyzed all consecutive patients (n=139) who underwent a first allogeneic transplantation for idiopathic severe aplastic anemia from an unrelated donor between 2000 and 2012. In an adjusted multivariate model, age over 30 years (Hazard Ratio=2.39; P=0.011), time from diagnosis to transplantation over 12 months (Hazard Ratio=2.18; P=0.027) and the use of a 9/10 mismatched unrelated donor (Hazard Ratio=2.14; P=0.036) were independent risk factors that significantly worsened overall survival. Accordingly, we built a predictive score using these three parameters, considering patients at low (zero or one risk factors, n=94) or high (two or three risk factors, n=45) risk. High-risk patients had significantly shorter survival (Hazard Ratio=3.04; P<0.001). The score was then confirmed on an independent cohort from the European Group for Blood and Marrow Transplantation database of 296 patients, with shorter survival in patients with at least 2 risk factors (Hazard Ratio=2.13; P=0.005) In conclusion, a simple score using age, transplantation timing and HLA matching would appear useful to help physicians in the daily care of patients with severe aplastic anemia., (Copyright© Ferrata Storti Foundation.)
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- 2016
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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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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
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- 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.)
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- 2016
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12. Monosomal karyotype as an adverse prognostic factor in patients with acute myeloid leukemia treated with allogeneic hematopoietic stem-cell transplantation in first complete remission: a retrospective survey on behalf of the ALWP of the EBMT.
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Brands-Nijenhuis AV, Labopin M, Schouten HC, Volin L, Socié G, Cornelissen JJ, Huynh A, Ljungman P, Malard F, Esteve J, Nagler A, and Mohty M
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- Adolescent, Adult, Aged, Antineoplastic Agents therapeutic use, Female, Humans, Karyotyping, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute mortality, Male, Middle Aged, Multivariate Analysis, Prognosis, Recurrence, Remission Induction, Retrospective Studies, Survival Analysis, Transplantation, Homologous, Treatment Outcome, Hematopoietic Stem Cell Transplantation, Leukemia, Myeloid, Acute diagnosis, Leukemia, Myeloid, Acute therapy, Monosomy pathology, Registries, Transplantation Conditioning methods
- Abstract
Despite the overall benefit from allogeneic hematopoietic stem cell transplantation observed in patients with poor cytogenetic risk acute myeloid leukemia in first complete remission, the precise effect of this procedure for different poor-risk subtypes has not been fully analyzed. This retrospective analysis was performed to investigate whether allogeneic hematopoietic stem cell transplantation performed in first complete remission in patients with monosomal karyotype can overcome the adverse prognosis associated with these patients. Of the 4635 patients included in the study, 189 (4%) harbored a monosomal karyotype. The presence of a monosomal karyotype was associated with a worse outcome, with an inferior leukemia-free survival and overall survival (5-year leukemia-free survival and overall survival: 24 ± 3% and 26 ± 3% vs. 53 ± 1% and 57 ± 1% in monosomal-karyotype and non-monosomal-karyotype, respectively; P<0.0001) and higher relapse risk after transplantation (cumulative incidence of relapse at 5 years: 56 ± 4% in monosomal-karyotype vs. 28 ± 1% in non-monosomal-karyotype; P<0.0001). The adverse negative impact of monosomal karyotype cytogenetics was confirmed in the entire cohort in a multivariate analysis [Hazard Ratio (HR): 1.88, 95% Confidence Interval (CI):1.29-2.73, P=0.001 for relapse incidence; HR:1.71, 95%CI:1.27-2.32, P<0.0001 for leukemia-free survival; HR:1.81, 95%CI:1.32-2.48, P=0.0002 for overall survival], and was independent of the presence of other poor-risk cytogenetic subtypes. In summary, monosomal karyotype arises as a strong negative prognostic feature in acute myeloid leukemia also in patients who undergo allogeneic hematopoietic stem cell transplantation in first complete remission, stressing the need to develop additional pre- and post-transplantation strategies aimed at improving overall results. Nonetheless, allogeneic hematopoietic stem cell transplantation in early phase is currently the best therapy for this very poor-risk acute myeloid leukemia subtype., (Copyright© Ferrata Storti Foundation.)
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- 2016
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13. Use of the quality management system "JACIE" and outcome after hematopoietic stem cell transplantation.
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Gratwohl A, Brand R, McGrath E, van Biezen A, Sureda A, Ljungman P, Baldomero H, Chabannon C, and Apperley J
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- Accreditation, Female, Humans, Male, Mortality, Patient Care Team standards, Quality Control, Recurrence, Retrospective Studies, Risk Factors, Total Quality Management, Hematopoietic Stem Cell Transplantation, Outcome Assessment, Health Care standards, Quality Assurance, Health Care
- Abstract
Competent authorities, healthcare payers and hospitals devote increasing resources to quality management systems but scientific analyses searching for an impact of these systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the quality management system "JACIE". We therefore tested the hypothesis that working towards and achieving "JACIE" accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58-0.69). Considering "JACIE"-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in "JACIE"-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71-0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75-0.95) and overall survival (hazard ratio 0.86; 0.76-0.98) were significantly higher at 72 months for those patients transplanted in the 162 "JACIE"-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99-1.13). Hence, working towards implementation of a quality management system triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a quality management system for complex medical procedures.
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- 2014
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14. Risk factors for Epstein-Barr virus-related post-transplant lymphoproliferative disease after allogeneic hematopoietic stem cell transplantation.
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Uhlin M, Wikell H, Sundin M, Blennow O, Maeurer M, Ringden O, Winiarski J, Ljungman P, Remberger M, and Mattsson J
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- Allografts, Female, Follow-Up Studies, Humans, Male, Retrospective Studies, Risk Factors, Epstein-Barr Virus Infections etiology, Epstein-Barr Virus Infections mortality, Epstein-Barr Virus Infections prevention & control, Graft vs Host Disease etiology, Graft vs Host Disease mortality, Graft vs Host Disease prevention & control, Graft vs Host Disease virology, Hematopoietic Stem Cell Transplantation, Herpesvirus 4, Human, Lymphoproliferative Disorders etiology, Lymphoproliferative Disorders metabolism, Lymphoproliferative Disorders prevention & control, Lymphoproliferative Disorders virology
- Abstract
Allogeneic hematopoietic stem cell transplantation is a successful treatment for hematologic malignancies and a variety of genetic and metabolic disorders. In the period following stem cell transplantation, the immune-compromised milieu allows opportunistic pathogens to thrive. Epstein-Barr virus-associated post-transplant lymphoproliferative disease can be a life-threatening complication for transplanted patients because of suppressed T-cell-mediated immunity. We analyzed possible risk factors associated with post-transplant lymphoproliferative disease in a cohort of over 1,000 patients. The incidence of post-transplant lymphoproliferative disease was 4%. Significant risk factors identified by multivariate analysis were: human leukocyte antigen-mismatch (P<0.001), serological Epstein-Barr virus mismatch recipient-/donor+ (P<0.001), use of reduced intensity conditioning (P=0.002), acute graft-versus-host disease grade II to IV (P=0.006), pre-transplant splenectomy (P=0.008) and infusion of mesenchymal stromal cells (P=0.015). The risk of post-transplant lymphoproliferative disease has increased in more recent years, from less than 2% before 1998 to more than 6% after 2011. Additionally, we show that long-term survival of patients with post-transplant lymphoproliferative disease is poor despite initial successful treatment. The 3-year survival rate among the 40 patients with post-transplant lymphoproliferative disease was 20% as opposed to 62% among patients without post-transplant lymphoproliferative disease (P<0.001). The study identifies patients at risk of post-transplant lymphoproliferative disease after transplantation in need of pre-emptive measures.
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- 2014
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15. Outcome of pandemic H1N1 infections in hematopoietic stem cell transplant recipients.
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Ljungman P, de la Camara R, Perez-Bercoff L, Abecasis M, Nieto Campuzano JB, Cannata-Ortiz MJ, Cordonnier C, Einsele H, Gonzalez-Vicent M, Espigado I, Halter J, Martino R, Mohty B, Sucak G, Ullmann AJ, Vázquez L, Ward KN, and Engelhard D
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- Adolescent, Adult, Aged, Antiviral Agents therapeutic use, Child, Child, Preschool, Humans, Influenza, Human complications, Influenza, Human mortality, Lymphopenia complications, Middle Aged, Oseltamivir therapeutic use, Pneumonia complications, Risk Factors, Treatment Outcome, Vaccination, Young Adult, Hematopoietic Stem Cell Transplantation mortality, Influenza A Virus, H1N1 Subtype, Influenza, Human epidemiology, Pandemics
- Abstract
During 2009, a new strain of A/H1N1 influenza appeared and became pandemic. A prospective study was performed to collect data regarding risk factors and outcome of A/H1N1 in hematopoietic stem cell transplant recipients. Only verified pandemic A/H1N1 influenza strains were included: 286 patients were reported, 222 allogeneic and 64 autologous recipients. The median age was 38.3 years and the median time from transplant was 19.4 months. Oseltamivir was administered to 267 patients and 15 patients received zanamivir. One hundred and twenty-five patients (43.7%) were hospitalized. Ninety-three patients (32.5%) developed lower respiratory tract disease. In multivariate analysis, risk factors were age (OR 1.025; 1.01-1.04; P=0.002) and lymphopenia (OR 2.49; 1.33-4.67; P<0.001). Thirty-three patients (11.5%) required mechanical ventilation. Eighteen patients (6.3%) died from A/H1N1 infection or its complications. Neutropenia (P=0.03) and patient age (P=0.04) were significant risk factors for death. The 2009 A/H1N1 influenza pandemic caused severe complications in stem cell transplant recipients.
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- 2011
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16. Voriconazole as secondary antifungal prophylaxis in stem cell transplant recipients.
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Cordonnier C, Rovira M, Maertens J, Cornely OA, Ljungman P, and Einsele H
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- Humans, Leukemia microbiology, Voriconazole, Antifungal Agents therapeutic use, Leukemia therapy, Mycoses prevention & control, Pyrimidines therapeutic use, Stem Cell Transplantation, Triazoles therapeutic use
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- 2011
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17. The European LeukemiaNet: achievements and perspectives.
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Hehlmann R, Grimwade D, Simonsson B, Apperley J, Baccarani M, Barbui T, Barosi G, Bassan R, Béné MC, Berger U, Büchner T, Burnett A, Cross NC, de Witte TJ, Döhner H, Dombret H, Einsele H, Engelich G, Foà R, Fonatsch C, Gökbuget N, Gluckman E, Gratwohl A, Guilhot F, Haferlach C, Haferlach T, Hallek M, Hasford J, Hochhaus A, Hoelzer D, Kiladjian JJ, Labar B, Ljungman P, Mansmann U, Niederwieser D, Ossenkoppele G, Ribera JM, Rieder H, Serve H, Schrotz-King P, Sanz MA, and Saussele S
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- Europe, Humans, International Cooperation, Societies, Medical organization & administration, Biomedical Research organization & administration, Leukemia, Medical Oncology organization & administration
- Abstract
The only way to cure leukemia is by cooperative research. To optimize research, the European LeukemiaNet integrates 105 national leukemia trial groups and networks, 105 interdisciplinary partner groups and about 1,000 leukemia specialists from 175 institutions. They care for tens of thousands of leukemia patients in 33 countries across Europe. Their ultimate goal is to cure leukemia. Since its inception in 2002, the European LeukemiaNet has steadily expanded and has unified leukemia research across Europe. The European LeukemiaNet grew from two major roots: 1) the German Competence Network on Acute and Chronic Leukemias; and 2) the collaboration of European Investigators on Chronic Myeloid Leukemia. The European LeukemiaNet has improved leukemia research and management across Europe. Its concept has led to funding by the European Commission as a network of excellence. Other sources (European Science Foundation; European LeukemiaNet-Foundation) will take over when the support of the European Commission ends.
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- 2011
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18. Voriconazole for secondary prophylaxis of invasive fungal infections in allogeneic stem cell transplant recipients: results of the VOSIFI study.
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Cordonnier C, Rovira M, Maertens J, Olavarria E, Faucher C, Bilger K, Pigneux A, Cornely OA, Ullmann AJ, Bofarull RM, de la Cámara R, Weisser M, Liakopoulou E, Abecasis M, Heussel CP, Pineau M, Ljungman P, and Einsele H
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- Adult, Aged, Antifungal Agents, Female, Hematopoietic Stem Cell Transplantation methods, Humans, Incidence, Leukemia complications, Leukemia therapy, Male, Middle Aged, Mycoses drug therapy, Transplantation, Homologous, Treatment Outcome, Voriconazole, Young Adult, Hematopoietic Stem Cell Transplantation adverse effects, Mycoses prevention & control, Pyrimidines administration & dosage, Triazoles administration & dosage
- Abstract
Background: Recurrence of prior invasive fungal infection (relapse rate of 30-50%) limits the success of stem cell transplantation. Secondary prophylaxis could reduce disease burden and improve survival., Design and Methods: A prospective, open-label, multicenter trial was conducted evaluating voriconazole (4 mg/kg/12 h intravenously or 200 mg/12 h orally) as secondary antifungal prophylaxis in allogeneic stem cell transplant recipients with previous proven or probable invasive fungal infection. Voriconazole was started 48 h or more after completion of conditioning chemotherapy and was planned to be continued for 100-150 days. Patients were followed for 12 months. The primary end-point of the study was the incidence of proven or probable invasive fungal infection., Results: Forty-five patients were enrolled, 41 of whom had acute leukemia. Previous invasive fungal infections were proven or probable aspergillosis (n=31), proven candidiasis (n=5) and other proven or probable infections (n=6); prior infection could not be confirmed in three patients. The median duration of voriconazole prophylaxis was 94 days. Eleven patients (24%) died within 12 months of transplantation, but only one due to systemic fungal disease. Three invasive fungal infections occurred post-transplant: two relapses (one candidemia and one fatal scedosporiosis) and one new zygomycosis in a patient with previous aspergillosis. The 1-year cumulative incidence of invasive fungal disease was 6.7±3.6%. Two patients were withdrawn from the study due to treatment-related adverse events (i.e. liver toxicity)., Conclusions: Voriconazole appears to be safe and effective for secondary prophylaxis of systemic fungal infection after allogeneic stem cell transplantation. The observed incidence of 6.7% (with one attributable death) is considerably lower than the relapse rate reported in historical controls, thus suggesting that voriconazole is a promising prophylactic agent in this population.
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- 2010
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19. Risk factors for therapy-related myelodysplastic syndrome and acute myeloid leukemia treated with allogeneic stem cell transplantation.
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Kröger N, Brand R, van Biezen A, Zander A, Dierlamm J, Niederwieser D, Devergie A, Ruutu T, Cornish J, Ljungman P, Gratwohl A, Cordonnier C, Beelen D, Deconinck E, Symeonidis A, and de Witte T
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- Adolescent, Adult, Aged, Child, Child, Preschool, Humans, Leukemia, Myeloid, Acute mortality, Leukemia, Myeloid, Acute therapy, Middle Aged, Myelodysplastic Syndromes mortality, Myelodysplastic Syndromes therapy, Neoplasms, Second Primary epidemiology, Neoplasms, Second Primary mortality, Prognosis, Retrospective Studies, Risk Factors, Transplantation, Homologous, Treatment Outcome, Young Adult, Hematopoietic Stem Cell Transplantation mortality, Leukemia, Myeloid, Acute chemically induced, Myelodysplastic Syndromes chemically induced, Neoplasms, Second Primary therapy
- Abstract
Background: After successful treatment of malignant diseases, therapy-related myelodysplastic syndrome and acute myeloid leukemia have emerged as significant problems., Design and Methods: The aim of this study was to investigate outcome and risk factors in patients with therapy-related myelodysplastic syndrome or acute myeloid leukemia who underwent allogeneic stem cell transplantation. Between 1981 and 2006, 461 patients with therapy-related myelodysplastic syndrome or acute myeloid, a median age of 40 years and a history of solid tumor (n=163), malignant lymphoma (n=133), or other hematologic diseases (n=57) underwent stem cell transplantation and their data were reported to the European Group for Blood and Marrow Transplantation., Results: The cumulative incidence of non-relapse mortality and relapse at 3 years was 37% and 31%, respectively. In a multivariate analysis significant factors for relapse were not being in complete remission at the time of transplantation (p=0.002), abnormal cytogenetics (p=0.005), higher patients' age (p=0.03) and therapy-related myelodysplastic syndrome (p=0.04), while higher non-relapse mortality was influenced by higher patients' age. Furthermore, there was a marked reduction in non-relapse mortality per calendar year during the study period (p<0.001). The 3-year relapse-free and overall survival rates were 33% and 35%, respectively. In a multivariate analysis significant higher overall survival rates were seen per calendar year (p<0.001), for younger age (<40 years) and normal cytogenetics (p=0.05). Using age (<40 years), abnormal cytogenetics and not being in complete remission at the time of transplantation as risk factors, three different risk groups with overall survival rates of 62%, 33% and 24% could be easily distinguished., Conclusions: Allogeneic stem cell transplantation can cure patients with therapy-related myelodysplastic syndrome and acute myeloid leukemia and has markedly improved over time. Non-complete remission, abnormal cytogenetics and higher patients' age are the most significant factors predicting survival.
- Published
- 2009
- Full Text
- View/download PDF
20. Factors influencing cytomegalovirus seropositivity in stem cell transplant patients and donors.
- Author
-
Ljungman P and Brandan R
- Subjects
- Adolescent, Adult, Age Factors, Antibodies, Viral blood, Child, Child, Preschool, Cytomegalovirus immunology, Europe epidemiology, Female, Humans, Infant, Male, Middle Aged, Registries statistics & numerical data, Risk Factors, Seroepidemiologic Studies, Sex Factors, Transplantation, Homologous, Cytomegalovirus Infections epidemiology, Hematopoietic Stem Cell Transplantation, Tissue Donors statistics & numerical data
- Abstract
CMV status of the donor and the recipient influence the outcome of allogeneic stem cell transplantation. To study factors determining CMV status, 40,311 patients and 23,048 donors were identified in the EBMT registry. Logistic regression models predicting seropositivity were constructed. Female patients were more likely to be seropositive (p<0.001). The risk increased with age (p<0.001) but decreased according to the year of transplant (p<0.001). There were differences in the probability of seropositivity between patients from different countries. Adjusted for patient serostatus, the risk of a donor being seropositive was higher in females (p<0.001) and older donors (p<0.001).
- Published
- 2007
- Full Text
- View/download PDF
21. The incidence of hemorrhagic cystitis and BK-viruria in allogeneic hematopoietic stem cell recipients according to intensity of the conditioning regimen.
- Author
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Giraud G, Bogdanovic G, Priftakis P, Remberger M, Svahn BM, Barkholt L, Ringden O, Winiarski J, Ljungman P, and Dalianis T
- Subjects
- Adolescent, Adult, Child, Cystitis urine, Female, Hemorrhage urine, Humans, Incidence, Male, Middle Aged, Polyomavirus Infections surgery, Polyomavirus Infections urine, Transplantation Conditioning adverse effects, Transplantation, Homologous, Tumor Virus Infections surgery, Tumor Virus Infections urine, BK Virus, Cystitis epidemiology, Cystitis virology, Hematopoietic Stem Cell Transplantation adverse effects, Hemorrhage epidemiology, Hemorrhage virology, Polyomavirus Infections epidemiology, Tumor Virus Infections epidemiology, Urine virology
- Abstract
The influence of BK-viruria, donor background, and conditioning on the development of hemorrhagic cystitis was examined in 90 allogeneic hematopoetic stem cell transplant patients, of whom 15 developed hemorrhagic cystitis. Thirty-two patients had related and 58 had unrelated donors, while 44 received full, and 46 received reduced intensity conditioning (RIC). BK-viruria was more common in patients with hemorrhagic cystitis than in those without (p<0.01), and hemorrhagic cystitis was less common in patients with related donors than in those with unrelated donors (p=0.02). Finally, hemorrhagic cystitis and BK-viruria were less common in patients receiving RIC, rather than full conditioning (p<0.01 and p<0.01, respectively).
- Published
- 2006
22. Risk factors for the development of cytomegalovirus disease after allogeneic stem cell transplantation.
- Author
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Ljungman P, Perez-Bercoff L, Jonsson J, Avetisyan G, Sparrelid E, Aschan J, Barkholt L, Larsson K, Winiarski J, Yun Z, and Ringdén O
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Humans, Incidence, Infant, Middle Aged, Opportunistic Infections, Premedication, Risk Factors, Transplantation, Homologous, Viral Load, Cytomegalovirus Infections etiology, Hematopoietic Stem Cell Transplantation adverse effects
- Abstract
Background and Objectives: Cytomegalovirus (CMV) disease remains an important complication of allogeneic stem cell transplantation (SCT). We studied viral load kinetics and correlated the viral load and other transplant factors with the development of CMV disease., Design and Methods: We studied 162 consecutive patients who were CMV seropositive or had CMV seropositive donors. Quantification of CMV DNA was performed by real-time polymerase chain reaction., Results: CMV DNA detected was detected in 105 of the 162 patients. The mean peak viral loads were similar at first and subsequent reactivations. The serologic status of the donors and recipients prior to SCT significantly influenced the viral load. The cumulative incidence of CMV disease was 1.8% at 100 days and 6.3% at 365 days after SCT. The peak viral load were higher in patients who developed CMV disease than in patients without CMV disease (log10 3.5; SE +/- 0.26/200,000 cells vs. log10 2.7; SE +/- 0.09/200,000 cells; p=0.02). However, in multivariate analysis, only acute graft-versus-host disease (GVHD) grade II-IV and a graft from a CMV-negative donor to a CMV-positive patient were significant risk factors for CMV disease. In patients who required more than one course of pre-emptive therapy, acute GVHD and the rate of decrease in viral load during first pre-emptive therapy were significant risk factors for subsequent development of CMV disease., Interpretation and Conclusions: A decrease in viral load during pre-emptive therapy is an important factor for later development of CMV disease.
- Published
- 2006
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