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2. Combination Versus Monotherapy for Carbapenem-Resistant Acinetobacter Species Serious Infections: A Prospective IPTW Adjusted Cohort Study

Author

Manesh, Abi, George, Mithun Mohan, Palanikumar, Prasannakumar, Nagaraj, V., Bhanuprasad, Kundakarla, Krishnan, Ramya, Nivetha, G., Lal, Binesh, Triveni, K. Rajitha, Gautam, Priyanka, George, Biju, Kulkarni, Uday, Mathews, Vikram, Subramani, K., Rao, Shoma, Chacko, Binila, Zachariah, Anand, Sathyendra, Sowmya, Hansdak, Samuel George, Abraham, Ooriapadickal Cherian, Iyadurai, Ramya, Karthik, Rajiv, Peter, John Victor, Mo, Yin, Veeraraghavan, Balaji, Varghese, George M., and Paterson, David Leslie

Published
2024
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8. Relapse and transformation to myelodysplastic syndrome and acute myeloid leukemia following immunosuppressive therapy for aplastic anemia is more common as compared to allogeneic stem cell transplantation with a negative impact on survival

Author

Chattopadhyay, Sohini, Lionel, Sharon, Selvarajan, Sushil, Devasia, Anup J., Korula, Anu, Kulkarni, Uday, Aboobacker, Fouzia N., Lakshmi, Kavitha M., Srivastava, Alok, Mathews, Vikram, Abraham, Aby, and George, Biju

Published
2024
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13. Persistent bacteremia predicts poor outcomes among neutropenic patients with carbapenem-resistant gram-negative bloodstream infections receiving appropriate therapy

Author

Sathya Kumar, Abi Manesh, George, Mithun Mohan, Bhanuprasad, Kundakarla, John, Grace Mary, Korula, Anu, Abraham, Aby, Mathews, Vikram, Kulkarni, Uday Prakash, Shankar, Chaitra, Premkumar, Prasanna Samuel, Chacko, Binila, Subramani, K., Varghese, George M., Balaji, V., and George, Biju

Published
2023
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14. Multi-objective decision making for maintenance planning of deteriorating offshore floating systems

Author

George, Biju

Subjects
Computing
Abstract

Maintenance planning program of offshore assets is a complex activity due to its impact on the operational and safety risks and consequences, dependence on personnel resource availabilities, site constraints due to operational requirements and environmental factors, and uncertainties related to various vulnerabilities on asset. This thesis elaborates the challenges on offshore maintenance frameworks and have carried out a review of recent state-of-the-art literature from which have observed that the current state-of-the-art does not incorporate site constraints of the asset related to offshore personnel resource availability and impact of time required to carry out activities, into the maintenance plan and its impact on other activities due to the maintenance. Also, it has been identified that dynamic and autonomous resource allocations for maintenance activities are not employed in the offshore maintenance planning program that allows each maintenance item to independently adjust its resource allocation based on the time required to complete the activity, to improve the resource utilisation. In this work, a novel approach has been utilised to formulate a maintenance plan optimisation problem for a Floating Production Storage and Offloading Facility (FPSO) that maximises the maintenance personnel resource utilisation and enable FPSO condition enhancement, considering the priorities with respect to design features, operating conditions, deteriorations, and the consequences of not doing the maintenance, taking into consideration the personnel resource time required for activity completion. To find the Pareto-optimal solution, an overall objective function has been developed corresponding to maintenance priorities with respect to Stress Unity Check, Fatigue Damage Ratio, Bending Moment Ratio, Shear Force Ratio, Degree of Corrosion Scale, Degree of Metal Loss, Safety Risks in the event of not doing maintenance and Financial Risks in the event of not doing maintenance, taking into consideration the personnel resource time required for activity completion using the weighted sum approach. This formulation provides flexibility to direct the focus of the overall objective function towards any one or more of the objective functions by adjusting their respective weight according to the maintenance strategy followed, which would supplement the Regulatory oversight requirements of the FPSO. Also, in this work, a novel work management framework has been proposed that comprises of Deep Q-Reinforcement Learning (DQN) problem formulation as a solution to multi-objective optimisation problem for maintenance activities of FPSOs. The framework enables carrying out activities that have minimal site constraints, considering the design features, operating conditions, deteriorations, consequences of not doing the activities and time required to complete the activities, to get higher weighted sum of the completion times at short time as possible, whereby achieving higher resource utilisations. A greedy algorithm benchmarks the performances of DQN model and a hybrid model comprising of greedy and DQN parameters. This formulation enables achieving the optimal path for carrying out activities that liquidates the risks to the asset's performance, which would in turn supplement the Regulatory oversight requirements of the FPSO.

Published
2022

15. Clinical and Genomic Evolution of Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infections over Two Time Periods at a Tertiary Care Hospital in South India: A Prospective Cohort Study

Author

Manesh, Abi, Shankar, Chaitra, George, Mithun M., Jasrotia, Davinder S., Lal, Binesh, George, Biju, Mathews, Vikram, Eapen, C. E., Joseph, Philip, Subramani, K., Rao, Shoma, Peter, John V., Chacko, Binila, Zachariah, Anand, Sathyendra, Sowmya, Hansdak, Samuel G., Abraham, Ooriapadickal C., Iyadurai, Ramya, Vijayakumar, Saranya, Karthik, Rajiv, Marwick, Charis A., Parcell, Benjamin J., Gilbert, Ian H., Veeraraghavan, Balaji, and Varghese, George M.

Published
2023
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16. Clinical Implementation of “Plan of the Day” Strategy in Definitive Radiation Therapy of Cervical Cancer: Online Adaptation to Address the Challenge of Organ Filling Reproducibility

Author

Ghosh, Suman, Gurram, Lavanya, Kumar, Amrendra, Mulye, Gargee, Mittal, Prachi, Chopra, Supriya, Kharbanda, Disha, Hande, Vinod, Ghadi, Yogesh, Scaria, Libin, Dheera, A., Varghese, George Biju, Kole, Satish, Ansari, Sahebuzzama, Mahantshetty, Umesh, and Agarwal, Jai Prakash

Published
2024
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17. Haploidentical vs. sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia

Author

Wieduwilt, Matthew J, Metheny, Leland, Zhang, Mei-Jie, Wang, Hai-Lin, Estrada-Merly, Noel, Marks, David I, Al-Homsi, A Samar, Muffly, Lori, Chao, Nelson J, Rizzieri, David, Gale, Robert Peter, Gadalla, Shahinaz M, Cairo, Mitchell S, Mussetti, Alberto, Gore, Steven D, Bhatt, Vijaya Raj, Patel, Sagar S, Michelis, Fotios V, Inamoto, Yoshihiro, Badawy, Sherif M, Copelan, Edward, Palmisiano, Neil, Kharfan-Dabaja, Mohamed A, Lazarus, Hillard M, Ganguly, Siddhartha, Bredeson, Christopher N, Perez, Miguel Angel Diaz, Cassaday, Ryan, Savani, Bipin N, Ballen, Karen Kuhn, Martino, Rodrigo, Wirk, Baldeep, Bacher, Ulrike, Aljurf, Mahmoud, Bashey, Asad, Murthy, Hemant S, Yared, Jean A, Aldoss, Ibrahim, Farhadfar, Nosha, Liu, Hongtao, Abdel-Azim, Hisham, Waller, Edmund K, Solh, Melhem, Seftel, Matthew, van der Poel, Marjolein WM, Grunwald, Michael Richard, Liesveld, Jane L, Kamble, Rammurti T, McGuirk, Joseph P, Munker, Reinhold, Cahn, Jean-Yves, Lee, Jong Wook, Freytes, Cesar O, Krem, Maxwell, Winestone, Lena E, Gergis, Usama, Nathan, Sunita, Olsson, Richard F, Verdonck, Leo F, Sharma, Akshay, Ringden, Olle, Friend, Brian D, Cerny, Jan, Choe, Hannah K, Chhabra, Saurabh, Nishihori, Taiga, Seo, Sachiko, George, Biju, Baxter-Lowe, Lee Ann, Hildebrandt, Gerhard C, de Lima, Marcos, Litzow, Mark R, Kebriaei, Partow, Hourigan, Christopher S, Abid, Muhammad Bilal, Weisdorf, Daniel J, and Saber, Wael

Subjects
Rare Diseases, Cancer, Pediatric, Pediatric Cancer, Stem Cell Research - Nonembryonic - Human, Orphan Drug, Hematology, Stem Cell Research, Transplantation, Good Health and Well Being, Fetal Blood, Hematopoietic Stem Cell Transplantation, Humans, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Retrospective Studies, Siblings, Unrelated Donors
Abstract

The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLA-matched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P ≤ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P ≤ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (≤18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.

Published
2022

18. An adapted European LeukemiaNet genetic risk stratification for acute myeloid leukemia patients undergoing allogeneic hematopoietic cell transplant. A CIBMTR analysis

Author

Jimenez Jimenez, Antonio M, De Lima, Marcos, Komanduri, Krishna V, Wang, Trent P, Zhang, Mei-Jie, Chen, Karen, Abdel-Azim, Hisham, Abid, Muhammad Bilal, Aljurf, Mahmoud, Alkhateeb, Hassan, Assal, Amer, Bacher, Ulrike, Baron, Frédéric, Battiwalla, Minoo, Beitinjaneh, Amer, Bejanyan, Nelli, Bhatt, Vijaya Raj, Byrne, Michael, Cahn, Jean-Yves, Cairo, Mitchell, Castillo, Paul, Copelan, Edward, DeFilipp, Zachariah, Perez, Miguel Angel Diaz, Elsawy, Mahmoud, Gale, Robert Peter, George, Biju, Grunwald, Michael R, Hildebrandt, Gerhard C, Hogan, William J, Kanakry, Christopher G, Kansagra, Ankit, Kharfan-Dabaja, Mohamed A, Khera, Nandita, Krem, Maxwell M, Lazaryan, Aleksandr, Maakaron, Joseph, Martino, Rodrigo, McGuirk, Joseph, Michelis, Fotios V, Milone, Giuseppe, Mishra, Asmita, Murthy, Hemant S, Mussetti, Alberto, Nathan, Sunita, Nishihori, Taiga, Olsson, Richard F, Palmisiano, Neil, Patel, Sagar, Saad, Ayman, Seo, Sachiko, Sharma, Akshay, Solh, Melhem, Verdonck, Leo F, Wirk, Baldeep, Yared, Jean A, Litzow, Mark, Kebriaei, Partow, Hourigan, Christopher S, Saber, Wael, and Weisdorf, Daniel

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Oncology and Carcinogenesis, Hematology, Genetics, Transplantation, Pediatric Research Initiative, Childhood Leukemia, Stem Cell Research, Cancer, Clinical Research, Pediatric Cancer, Rare Diseases, Pediatric, Stem Cell Research - Nonembryonic - Human, 4.1 Discovery and preclinical testing of markers and technologies, Detection, screening and diagnosis, Good Health and Well Being, Hematopoietic Stem Cell Transplantation, Humans, Leukemia, Myeloid, Acute, Retrospective Studies, Risk Assessment, Transplantation Conditioning, Transplantation, Homologous, Clinical Sciences, Immunology, Cardiovascular medicine and haematology, Oncology and carcinogenesis
Abstract

Cytogenetic and molecular abnormalities are known to influence post-transplant outcomes in acute myeloid leukemia (AML) but data assessing the prognostic value of combined genetic models in the HCT setting are limited. We developed an adapted European LeukemiaNet (aELN) risk classification based on available genetic data reported to the Center for International Blood and Marrow Transplant Research, to predict post-transplant outcomes in 2289 adult AML patients transplanted in first remission, between 2013 and 2017. Patients were stratified according to aELN into three groups: favorable (Fav, N = 181), intermediate (IM, N = 1185), and adverse (Adv, N = 923). Univariate analysis demonstrated significant differences in 2-year overall survival (OS) (Fav: 67.7%, IM: 64.9% and Adv: 53.9%; p

Published
2021

19. Impact of cytogenetic abnormalities on outcomes of adult Philadelphia-negative acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation: a study by the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research

Author

Lazaryan, Aleksandr, Dolan, Michelle, Zhang, Mei-Jie, Wang, Hai-Lin, Kharfan-Dabaja, Mohamed A, Marks, David I, Bejanyan, Nelli, Copelan, Edward, Majhail, Navneet S, Waller, Edmund K, Chao, Nelson, Prestidge, Tim, Nishihori, Taiga, Kebriaei, Partow, Inamoto, Yoshihiro, Hamilton, Betty, Hashmi, Shahrukh K, Kamble, Rammurti T, Bacher, Ulrike, Hildebrandt, Gerhard C, Stiff, Patrick J, McGuirk, Joseph, Aldoss, Ibrahim, Beitinjaneh, Amer M, Muffly, Lori, Vij, Ravi, Olsson, Richard F, Byrne, Michael, Schultz, Kirk R, Aljurf, Mahmoud, Seftel, Matthew, Savoie, Mary Lynn, Savani, Bipin N, Verdonck, Leo F, Cairo, Mitchell S, Hossain, Nasheed, Bhatt, Vijaya Raj, Frangoul, Haydar A, Abdel-Azim, Hisham, Al Malki, Monzr, Munker, Reinhold, Rizzieri, David, Khera, Nandita, Nakamura, Ryotaro, Ringdén, Olle, Van der Poel, Marjolein, Murthy, Hemant S, Liu, Hongtao, Mori, Shahram, De Oliveira, Satiro, Bolaños-Meade, Javier, Elsawy, Mahmoud, Barba, Pere, Nathan, Sunita, George, Biju, Pawarode, Attaphol, Grunwald, Michael, Agrawal, Vaibhav, Wang, Youjin, Assal, Amer, Caro, Paul Castillo, Kuwatsuka, Yachiyo, Seo, Sachiko, Ustun, Celalettin, Politikos, Ioannis, Lazarus, Hillard M, Saber, Wael, Sandmaier, Brenda M, De Lima, Marcos, Litzow, Mark, Bachanova, Veronika, and Weisdorf, Daniel

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Cancer, Blood, Adult, Chromosome Aberrations, Hematopoietic Stem Cell Transplantation, Humans, Leukemia, Myeloid, Acute, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Cardiorespiratory Medicine and Haematology, Immunology, Cardiovascular medicine and haematology
Abstract

The authors inadvertently included grant numbers OT3HL147741 & U24CA233032, which are grant-specific. This was an oversight on the authors’ part as these grants did not support the research in this publication.

Published
2021

22. Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index: A Center for International Blood and Marrow Transplant Research Study.

Author

Bejanyan, Nelli, Zhang, Meijie, Bo-Subait, Khalid, Brunstein, Claudio, Wang, Hailin, Warlick, Erica, Giralt, Sergio, Nishihori, Taiga, Martino, Rodrigo, Passweg, Jakob, Dias, Ajoy, Copelan, Edward, Hale, Gregory, Gale, Robert, Solh, Melhem, Kharfan-Dabaja, Mohamed, Diaz, Miguel, Ganguly, Siddhartha, Gore, Steven, Verdonck, Leo, Hossain, Nasheed, Kekre, Natasha, Savani, Bipin, Byrne, Michael, Kanakry, Christopher, Cairo, Mitchell, Ciurea, Stefan, Schouten, Harry, Bredeson, Christopher, Munker, Reinhold, Lazarus, Hillard, Cahn, Jean-Yves, van Der Poel, Marjolein, Rizzieri, David, Yared, Jean, Freytes, Cesar, Cerny, Jan, Aljurf, Mahmoud, Palmisiano, Neil, Pawarode, Attaphol, Bacher, Vera, Grunwald, Michael, Nathan, Sunita, Wirk, Baldeep, Hildebrandt, Gerhard, Seo, Sachiko, Olsson, Richard, George, Biju, de Lima, Marcos, Hourigan, Christopher, Sandmaier, Brenda, Litzow, Mark, Kebriaei, Partow, Saber, Wael, and Weisdorf, Daniel

Subjects
AML, DRI, MDS, Myeloablative, RIC, Adult, Aged, Disease-Free Survival, Hematopoietic Stem Cell Transplantation, Humans, Leukemia, Myeloid, Acute, Middle Aged, Myelodysplastic Syndromes, Retrospective Studies, Transplantation Conditioning, Transplantation, Homologous
Abstract

Compared with reduced-intensity conditioning (RIC), myeloablative conditioning (MAC) is generally associated with lower relapse risk after allogeneic hematopoietic cell transplantation (HCT) for acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS). However, disease-specific risk factors in AML/MDS can further inform when MAC and RIC may yield differential outcomes. We analyzed HCT outcomes stratified by the Disease Risk Index (DRI) in 4387 adults (age 40 to 65 years) to identify the impact of conditioning intensity. In the low/intermediate-risk DRI cohort, RIC was associated with lower nonrelapse mortality (NRM) (hazard ratio [HR], .74; 95% confidence interval [CI], .62 to .88; P < .001) but significantly greater relapse risk (HR, 1.54; 95% CI, 1.35 to 1.76; P < .001) and thus inferior disease-free survival (DFS) (HR, 1.19; 95% CI, 1.07 to 1.33; P = .001). In the high/very high-risk DRI cohort, RIC was associated with marginally lower NRM (HR, .83; 95% CI, .68 to 1.00; P = .051) and significantly higher relapse risk (HR, 1.23; 95% CI, 1.08 to 1.41; P = .002), leading to similar DFS using either RIC or MAC. These data support MAC over RIC as the preferred conditioning intensity for patients with AML/MDS with low/intermediate-risk DRI, but with a similar benefit as RIC in high/very high-risk DRI. Novel MAC regimens with less toxicity could benefit all patients, but more potent antineoplastic approaches are needed for the high/very-high risk DRI group.

Published
2021

24. Impact of cytogenetic abnormalities on outcomes of adult Philadelphia-negative acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation: a study by the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research

Author

Lazaryan, Aleksandr, Dolan, Michelle, Zhang, Mei-Jie, Wang, Hai-Lin, Kharfan-Dabaja, Mohamed A, Marks, David I, Bejanyan, Nelli, Copelan, Edward, Majhail, Navneet S, Waller, Edmund K, Chao, Nelson, Prestidge, Tim, Nishihori, Taiga, Kebriaei, Partow, Inamoto, Yoshihiro, Hamilton, Betty, Hashmi, Shahrukh K, Kamble, Rammurti T, Bacher, Ulrike, Hildebrandt, Gerhard C, Stiff, Patrick J, McGuirk, Joseph, Aldoss, Ibrahim, Beitinjaneh, Amer M, Muffly, Lori, Vij, Ravi, Olsson, Richard F, Byrne, Michael, Schultz, Kirk R, Aljurf, Mahmoud, Seftel, Matthew, Savoie, Mary Lynn, Savani, Bipin N, Verdonck, Leo F, Cairo, Mitchell S, Hossain, Nasheed, Bhatt, Vijaya Raj, Frangoul, Haydar A, Abdel-Azim, Hisham, Malki, Monzr Al, Munker, Reinhold, Rizzieri, David, Khera, Nandita, Nakamura, Ryotaro, Ringdén, Olle, van der Poel, Marjolein, Murthy, Hemant S, Liu, Hongtao, Mori, Shahram, De Oliveira, Satiro, Bolaños-Meade, Javier, Elsawy, Mahmoud, Barba, Pere, Nathan, Sunita, George, Biju, Pawarode, Attaphol, Grunwald, Michael, Agrawal, Vaibhav, Wang, Youjin, Assal, Amer, Caro, Paul Castillo, Kuwatsuka, Yachiyo, Seo, Sachiko, Ustun, Celalettin, Politikos, Ioannis, Lazarus, Hillard M, Saber, Wael, Sandmaier, Brenda M, De Lima, Marcos, Litzow, Mark, Bachanova, Veronika, Weisdorf, Daniel, and Committee of the CIBMTR, Acute Leukemia

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Oncology and Carcinogenesis, Rare Diseases, Pediatric Cancer, Transplantation, Childhood Leukemia, Hematology, Cancer, Pediatric, Stem Cell Research, Adult, Chromosome Aberrations, Hematopoietic Stem Cell Transplantation, Humans, Leukemia, Myeloid, Acute, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Retrospective Studies, Transplantation Conditioning, Transplantation, Homologous, Acute Leukemia Committee of the CIBMTR, Cardiorespiratory Medicine and Haematology, Immunology, Cardiovascular medicine and haematology
Abstract

Cytogenetic risk stratification at diagnosis has long been one of the most useful tools to assess prognosis in acute lymphoblastic leukemia (ALL). To examine the prognostic impact of cytogenetic abnormalities on outcomes after allogeneic hematopoietic cell transplantation, we studied 1731 adults with Philadelphia-negative ALL in complete remission who underwent myeloablative or reduced intensity/non-myeloablative conditioning transplant from unrelated or matched sibling donors reported to the Center for International Blood and Marrow Transplant Research. A total of 632 patients had abnormal conventional metaphase cytogenetics. The leukemia-free survival and overall survival rates at 5 years after transplantation in patients with abnormal cytogenetics were 40% and 42%, respectively, which were similar to those in patients with a normal karyotype. Of the previously established cytogenetic risk classifications, modified Medical Research Council-Eastern Cooperative Oncology Group score was the only independent prognosticator of leukemia-free survival (P=0.03). In the multivariable analysis, monosomy 7 predicted post-transplant relapse [hazard ratio (HR)=2.11; 95% confidence interval (95% CI): 1.04-4.27] and treatment failure (HR=1.97; 95% CI: 1.20-3.24). Complex karyotype was prognostic for relapse (HR=1.69; 95% CI: 1.06-2.69), whereas t(8;14) predicted treatment failure (HR=2.85; 95% CI: 1.35-6.02) and overall mortality (HR=3.03; 95% CI: 1.44-6.41). This large study suggested a novel transplant-specific cytogenetic scheme with adverse [monosomy 7, complex karyotype, del(7q), t(8;14), t(11;19), del(11q), tetraploidy/near triploidy], intermediate (normal karyotype and all other abnormalities), and favorable (high hyperdiploidy) risks to prognosticate leukemia-free survival (P=0.02). Although some previously established high-risk Philadelphia-negative cytogenetic abnormalities in ALL can be overcome by transplantation, monosomy 7, complex karyotype, and t(8;14) continue to pose significant risks and yield inferior outcomes.

Published
2020

34. Choice of conditioning regimens for bone marrow transplantation in severe aplastic anemia.

Author

Bejanyan, Nelli, Kim, Soyoung, Hebert, Kyle M, Kekre, Natasha, Abdel-Azim, Hisham, Ahmed, Ibrahim, Aljurf, Mahmoud, Badawy, Sherif M, Beitinjaneh, Amer, Boelens, Jaap Jan, Diaz, Miguel Angel, Dvorak, Christopher C, Gadalla, Shahinaz, Gajewski, James, Gale, Robert Peter, Ganguly, Siddhartha, Gennery, Andrew R, George, Biju, Gergis, Usama, Gómez-Almaguer, David, Vicent, Marta Gonzalez, Hashem, Hasan, Kamble, Rammurti T, Kasow, Kimberly A, Lazarus, Hillard M, Mathews, Vikram, Orchard, Paul J, Pulsipher, Michael, Ringden, Olle, Schultz, Kirk, Teira, Pierre, Woolfrey, Ann E, Saldaña, Blachy Dávila, Savani, Bipin, Winiarski, Jacek, Yared, Jean, Weisdorf, Daniel J, Antin, Joseph H, and Eapen, Mary

Subjects
Transplantation, Regenerative Medicine, Stem Cell Research - Nonembryonic - Human, Stem Cell Research, Prevention, Hematology, Rare Diseases, Good Health and Well Being, Adolescent, Adult, Anemia, Aplastic, Bone Marrow Transplantation, Clinical Decision-Making, Disease Management, Graft vs Host Disease, HLA Antigens, Histocompatibility Testing, Humans, Prognosis, Severity of Illness Index, Siblings, Transplantation Conditioning, Transplantation, Homologous, Treatment Outcome, Young Adult
Abstract

Allogeneic bone marrow transplantation (BMT) is curative therapy for the treatment of patients with severe aplastic anemia (SAA). However, several conditioning regimens can be used for BMT. We evaluated transplant conditioning regimens for BMT in SAA after HLA-matched sibling and unrelated donor BMT. For recipients of HLA-matched sibling donor transplantation (n = 955), fludarabine (Flu)/cyclophosphamide (Cy)/antithymocyte globulin (ATG) or Cy/ATG led to the best survival. The 5-year probabilities of survival with Flu/Cy/ATG, Cy/ATG, Cy ± Flu, and busulfan/Cy were 91%, 91%, 80%, and 84%, respectively (P = .001). For recipients of 8/8 and 7/8 HLA allele-matched unrelated donor transplantation (n = 409), there were no differences in survival between regimens. The 5-year probabilities of survival with Cy/ATG/total body irradiation 200 cGy, Flu/Cy/ATG/total body irradiation 200 cGy, Flu/Cy/ATG, and Cy/ATG were 77%, 80%, 75%, and 72%, respectively (P = .61). Rabbit-derived ATG compared with equine-derived ATG was associated with a lower risk of grade II to IV acute graft-versus-host disease (GVHD) (hazard ratio [HR], 0.39; P < .001) but not chronic GVHD. Independent of conditioning regimen, survival was lower in patients aged >30 years after HLA-matched sibling (HR, 2.74; P < .001) or unrelated donor (HR, 1.98; P = .001) transplantation. These data support Flu/Cy/ATG and Cy/ATG as optimal regimens for HLA-matched sibling BMT. Although survival after an unrelated donor BMT did not differ between regimens, use of rabbit-derived ATG may be preferred because of lower risks of acute GVHD.

Published
2019

35. Related and unrelated donor transplantation for β-thalassemia major: results of an international survey

Author

Li, Chunfu, Mathews, Vikram, Kim, Soyoung, George, Biju, Hebert, Kyle, Jiang, Hua, Li, Changgang, Zhu, Yiping, Keesler, Daniel A, Boelens, Jaap Jan, Dvorak, Christopher C, Agarwal, Rajni, Auletta, Jeffery J, Goyal, Rakesh K, Hanna, Rabi, Kasow, Kimberly, Shenoy, Shalini, Smith, Angela R, Walters, Mark C, and Eapen, Mary

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Immunology, Regenerative Medicine, Clinical Research, Transplantation, Adolescent, Adult, Age Factors, Child, Child, Preschool, Hematopoietic Stem Cell Transplantation, Histocompatibility, Humans, Myeloablative Agonists, Surveys and Questionnaires, Survival Analysis, Tissue Donors, Transplantation Conditioning, Transplantation, Homologous, Unrelated Donors, Young Adult, beta-Thalassemia, Cardiovascular medicine and haematology
Abstract

We studied 1110 patients with β-thalassemia major aged ≤25 years who received transplants with grafts from HLA-matched related (n = 677; 61%), HLA-mismatched related (n = 78; 7%), HLA-matched unrelated (n = 252; 23%), and HLA-mismatched unrelated (n = 103; 9%) donors between 2000 and 2016. Ninety percent of transplants were performed in the last decade. Eight-five percent of patients received ≥20 transfusions and 88% were inadequately chelated. All patients received myeloablative-conditioning regimen. Overall and event-free survival were highest for patients aged ≤6 years and after HLA-matched related and HLA-matched unrelated donor transplantation. The 5-year probabilities of overall survival for patients aged ≤6 years, 7 to 15 years, and 16 to 25 years, adjusted for donor type and conditioning regimen were 90%, 84%, and 63%, respectively (P < .001). The corresponding probabilities for event-free survival were 86%, 80%, and 63% (P < .001). Overall and event-free survival did not differ between HLA-matched related and HLA-matched unrelated donor transplantation (89% vs 87% and 86% vs 82%, respectively). Corresponding probabilities after mismatched related and mismatched unrelated donor transplantation were 73% vs 83% and 70% vs 78%. In conclusion, if transplantation is considered as a treatment option it should be offered early (age ≤6 years). An HLA-matched unrelated donor is a suitable alternative if an HLA-matched relative is not available.

Published
2019

42. Early Immune Reconstitution Is Similar in Patients with and without Acute GvHD Undergoing Haploidentical HCT with Post-Transplant Cyclophosphamide As Gvhd Prophylaxis.

Author

Bijukumar, Nayanthara K, primary, Pai, Aswin Anand, additional, Renji, Rachel Mariam, additional, Manoj, A, additional, Mohanan, Ezhilpavai, additional, Jayaraman, Agila, additional, Illangeswaran, Raveen Stephen Stallon, additional, Edison, Eunice S, additional, Selvarajan, Sushil, additional, Srivastava, Alok, additional, Abraham, Aby, additional, Mathews, Vikram, additional, George, Biju, additional, Karumathil, Sujith, additional, Arunachalam, Arun Kumar, additional, Kulkarni, Uday, additional, and Balasubramanian, Poonkuzhali, additional

Published
2024
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43. T-Cell Reconstitution Can be a Predictive Biomarker for Severe Acute GvHD in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation with a Treosulfan/Fludarabine Conditioning Regimen

Author

Renji, Rachel Mariam, primary, Pai, Aswin Anand, additional, Bijukumar, Nayanthara K, additional, Jayaraman, Agila, additional, Illangeswaran, Raveen Stephen Stallon, additional, Edison, Eunice S, additional, Selvarajan, Sushil, additional, Aboobacker, Fouzia N, additional, Srivastava, Alok, additional, Abraham, Aby, additional, Mathews, Vikram, additional, George, Biju, additional, Karumathil, Sujith, additional, Arunachalam, Arun Kumar, additional, Kulkarni, Uday, additional, and Balasubramanian, Poonkuzhali, additional

Published
2024
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45. Alternative donor transplantation for myelodysplastic syndromes: haploidentical relative and matched unrelated donors

Author

Grunwald, Michael R., Zhang, Mei-Jie, Elmariah, Hany, Johnson, Mariam H., St. Martin, Andrew, Bashey, Asad, Battiwalla, Minoo, Bredeson, Christopher N., Copelan, Edward, Cutler, Corey S., George, Biju R., Gupta, Vikas, Kanakry, Christopher, Mehta, Rohtesh S., Milano, Filippo, Mussetti, Alberto, Nakamura, Ryotaro, Nishihori, Taiga, Saber, Wael, Solh, Melhem, Weisdorf, Daniel J., and Eapen, Mary

Published
2021
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47. Neighborhood poverty and pediatric allogeneic hematopoietic cell transplantation outcomes: a CIBMTR analysis

Author

Bona, Kira, Brazauskas, Ruta, He, Naya, Lehmann, Leslie, Abdel-Azim, Hisham, Ahmed, Ibrahim A, Al-Homsi, A Samer, Aljurf, Mahmoud, Arnold, Staci D., Badawy, Sherif M, Battiwalla, Minoo, Beattie, Sara, Bhatt, Neel S., Dalal, Jignesh, Dandoy, Christopher E., Diaz, Miguel Angel, Frangoul, Haydar A., Freytes, César O., Ganguly, Siddhartha, George, Biju, Gomez-Almaguer, David, Hahn, Theresa, Kamble, Rammurti T., Knight, Jennifer M., LeMaistre, C. Fred, Law, Jason, Lazarus, Hillard M., Majhail, Navneet S., Olsson, Richard F., Preussler, Jaime, Savani, Bipin N., Schears, Raquel, Seo, Sachiko, Sharma, Akshay, Srivastava, Alok, Steinberg, Amir, Szwajcer, David, Wirk, Baldeep, Yoshimi, Ayami, Khera, Nandita, Wood, William A., Hashmi, Shahrukh, Duncan, Christine N., and Saber, Wael

Published
2021
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