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349 results on '"Novitzky‐Basso, Igor"'

1. Dual T cell depletion for graft versus host disease prevention in peripheral blood haploidentical hematopoietic cell transplantation for adults with hematological malignancies

Author

Alfaro Moya, Tommy, Salas, Maria Queralt, Santos Carreira, Abel, Atenafu, Eshetu G., Law, Arjun Datt, Lam, Wilson, Pasic, Ivan, Kim, Dennis (Dong Hwan), Michelis, Fotios V., Novitzky Basso, Igor, Gerbitz, Armin, Lipton, Jeffrey Howard, Kumar, Rajat, Mattsson, Jonas, and Viswabandya, Auro

Published
2024
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15. Letermovir as secondary prophylaxis of cytomegalovirus infection after allogeneic hematopoietic cell transplantation: A single center experience.

Author

Desai, Nihar, Pasic, Ivan, Law, Arjun D., Lam, Wilson, Gerbitz, Armin, Viswabandya, Auro, Kim, Dennis D., Kumar, Rajat, Mattsson, Jonas, Novitzky‐Basso, Igor, and Michelis, Fotios V.

Subjects
HEMATOPOIETIC stem cell transplantation, CYTOMEGALOVIRUS diseases, PREVENTIVE medicine, CYCLOPHOSPHAMIDE, GLOBULINS
Abstract

Letermovir, a novel anti‐cytomegalovirus (CMV) agent acts by inhibiting the viral terminase complex and is approved for primary prophylaxis in CMV seropositive patients post allogeneic hematopoietic cell transplantation (HCT). The favorable efficacy and safety profile make it an attractive option for use as secondary prophylaxis in patients at high‐risk for CMV reactivation. In this study, we report the efficacy and safety of letermovir secondary prophylaxis after at least one treated episode of CMV reactivation in a cohort of 39 high‐risk patients. Thirty two (82%) patients received anti‐thymocyte globulin (ATG), 27 (69%) received a combination of ATG and post‐transplant cyclophosphamide for graft‐versus‐host disease (GVHD) prophylaxis. Twenty one patients (54%) received CMV seronegative grafts. In addition, 18 (46%) patients had HLA mismatched unrelated or haploidentical donors while 18 (46%) had active GVHD requiring immunosuppression at the time of commencing secondary prophylaxis. Letermovir was initiated at a median of 47 days (range, 41–56) after HCT and was administered for a median duration of 77 days (range, 46–90). A single breakthrough CMV reactivation was noted in this high‐risk cohort. Four additional episodes of CMV reactivation occurred at a median of 28 days (range, 23–59 days) after discontinuation of secondary prophylaxis. The drug was well tolerated and 77% of the cohort completed the planned duration of secondary prophylaxis. None of the patients discontinued treatment due to treatment‐related adverse effects. In conclusion, letermovir is effective and well tolerated and may be considered for secondary prophylaxis in patients at high risk for CMV reactivation. Prospective studies are required to validate these findings. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Impact of cytomegalovirus (CMV) seroconversion pre‐allogeneic hematopoietic cell transplantation on posttransplant outcomes.

Author

Sayyed, Ayman, Wilson, Leeann, Stavi, Vered, Chen, Shiyi, Chen, Carol, Mattsson, Jonas, Lipton, Jeffrey H., Kim, Dennis D., Viswabandya, Auro, Kumar, Rajat, Lam, Wilson, Law, Arjun D., Gerbitz, Armin, Pasic, Ivan, Novitzky‐Basso, Igor, Mazzulli, Tony, and Michelis, Fotios V.

Subjects
HEMATOPOIETIC stem cell transplantation, STEM cell transplantation, IMMUNOGLOBULIN M, IMMUNOGLOBULIN G, SEROCONVERSION, HIV seroconversion
Abstract

Cytomegalovirus (CMV) reactivation post‐allogeneic hematopoietic cell transplantation (post‐alloHCT) increases morbidity and mortality. We sought to determine the frequency of CMV seroconversion in patients pre‐alloHCT and to investigate the impact on posttransplant outcomes. We retrospectively investigated 752 adult patients who underwent alloHCT at our center from January 2015 to February 2020 before the adoption of letermovir prophylaxis. CMV serology was assessed at consult and pretransplant. The cohort was divided into four groups based on pretransplant CMV seroconversion: negative to positive (Group 1), positive to negative (Group 2), consistently negative (Group 3), and consistently positive (Group 4). Eighty‐nine patients (12%) had seroconverted from negative to positive, 17 (2%) from positive to negative, 151 (20%) were consistently seronegative, and 495 (66%) were consistently seropositive pretransplant. For the four CMV serostatus groups, cumulative incidence of CMV reactivation at 6 months posttransplant was 4.5%, 47.1%, 6.6%, and 76.6% for Groups 1, 2, 3, and 4, respectively (p <.0001). No differences between groups were seen regarding Grade III–IV acute graft‐versus‐host disease (GVHD) (p =.91), moderate/severe chronic GVHD (p =.41), or graft failure (p =.28). On multivariable analysis, there was no impact of CMV serostatus group on overall survival (p =.67), cumulative incidence of relapse (p =.83) or non‐relapse mortality. alloHCT patients who demonstrate CMV seroconversion pretransplant from negative to positive have a very low risk of CMV reactivation posttransplant. The observed seroconversion may be due to passive CMV immunity acquired through blood products. Quantitative CMV immunoglobulin G/immunoglobulin M pretransplant may help differentiate between true seroconversion and passively transmitted CMV immunoglobulin. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Biology of Graft-Versus-Host Disease

Author

Novitzky-Basso, Igor, Viswabandya, Auro, Radhakrishnan, Vivek, Section editor, Doria, Cataldo, Series Editor, Chandy, Mammen, editor, Radhakrishnan, Vivek S., editor, and Sukumaran, Reghu K., editor

Published
2021
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19. Outcomes of Antithymocyte Globulin-Post-Transplantation Cyclophosphamide-Cyclosporine-Based versus Antithymocyte Globulin-Based Prophylaxis for 10/10 HLA-Matched Unrelated Donor Allogeneic Hematopoietic Cell Transplantation

Author

Salas, Maria Queralt, Alfaro-Moya, Tommy, Atenafu, Eshetu G., Datt Law, Arjun, Lam, Wilson, Pasic, Ivan, Novitzky-Basso, Igor, Santos Carreira, Abel, Chen, Carol, Michelis, Fotios V., Gerbitz, Armin, Howard Lipton, Jeffrey, Kim, Dennis (Dong Hwan), Kumar, Rajat, Mattsson, Jonas, and Viswabandya, Auro

Published
2024
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20. Prognostic impact of the adverse molecular-genetic profile on long-term outcomes following allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia

Author

Daher-Reyes, Georgina, Kim, TaeHyung, Novitzky-Basso, Igor, Kim, Kyuoung Ha, Smith, Adam, Stockley, Tracy, Capochichi, Jose-Mario, Al-Shaibani, Zeyad, Pasic, Ivan, Law, Arjun, Lam, Wilson, Michelis, Fotios V., Gerbitz, Armin, Viswabandya, Auro, Lipton, Jeffrey, Kumar, Rajat, Mattsson, Jonas, Schimmer, Aaron, McNamara, Caroline, Murphy, Tracy, Maze, Dawn, Gupta, Vikas, Sibai, Hassan, Chan, Steven, Yee, Karen, Minden, Mark, Zhang, Zhaolei, Schuh, Andre, and Kim, Dennis D. H.

Published
2021
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21. Letermovir prophylaxis for cytomegalovirus reactivation in allogeneic hematopoietic cell transplant recipients : Single center Canadian data

Author

Pang, Ian, Chen, Peggy, Trinh, Gertrude V., Remberger, Mats, Novitzky-Basso, Igor, Gerbitz, Armin, Kim, Dennis D., Kumar, Rajat, Lam, Wilson, Law, Arjun D., Lipton, Jeffrey H., Viswabandya, Auro, Pasic, Ivan, Mattsson, Jonas, Michelis, Fotios V., Pang, Ian, Chen, Peggy, Trinh, Gertrude V., Remberger, Mats, Novitzky-Basso, Igor, Gerbitz, Armin, Kim, Dennis D., Kumar, Rajat, Lam, Wilson, Law, Arjun D., Lipton, Jeffrey H., Viswabandya, Auro, Pasic, Ivan, Mattsson, Jonas, and Michelis, Fotios V.

Abstract

Background: Cytomegalovirus (CMV) is associated with morbidity and mortality following allogeneic hematopoietic cell transplantation (alloHCT). Letermovir is a novel antiviral agent that prevents CMV reactivation in alloHCT patients, with limited data regarding influence on post-alloHCT outcomes. Methods: We retrospectively examined 273 alloHCT recipients, 158 in the non-letermovir cohort (NLC), and 115 in the cohort using letermovir prophylaxis (LC). Patients that received letermovir were CMV-seropositive and met criteria for high risk of CMV reactivation. Results: Median start of letermovir was 21 days post-alloHCT, median duration of prophylaxis was 86 days. Letermovir prophylaxis demonstrated a statistically significant reduction in first CMV reactivation (at 200 days post 63.9% in the NLC vs. 35.7% in the LC; p < .001). On univariate analysis at 1 year, overall survival (OS) for NLC was 79.6% and 79.5% for LC (p = .54). Non relapse mortality (NRM) at 1 year for NLC was 12% and 12.3% for LC (p = .69). Cumulative incidence of relapse (CIR) at 1 year was 13.9% for NLC versus 17.1 for the LC (p = .27). On multivariable analysis, there was no significant difference between the two cohorts for OS, NRM, and CIR. Conclusions: Letermovir prophylaxis started at day +21 post-alloHCT reduced CMV reactivation, with no impact on posttransplant outcomes.

Published
2024
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22. Propensity Score Matching Analysis Comparing the Efficacy and Steroid Tapering Benefit of Extracorporeal Photopheresis to Best Available Therapy in Third-Line or Beyond Treatment for Chronic GvHD

Author

Novitzky-Basso, Igor, Patriquin, Christopher, Linn, Swe Mar, Chiarello, Caden, Pasic, Ivan, Lam, Wilson, Law, Arjun, Michelis, Fotios V., Gerbitz, Armin, Viswabandya, Auro, Lipton, Jeffrey, Kumar, Rajat, Mattsson, Jonas, Barth, David, and Kim, Dennis Dong Hwan

Published
2023
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23. Choosing Between Older Matched Sibling Donor and Younger Matched Unrelated Donor in Allogeneic Hematopoietic Cell Transplantation: Comparison of Clinical Outcomes in Acute Myeloid Leukemia and Myelodysplastic Syndrome

Author

Pereira, Mariana Pinto, Remberger, Mats, Chen, Carol, Gerbitz, Armin, Kim, Dennis Dong Hwan, Kumar, Rajat, Lam, Wilson, Law, Arjun Datt, Lipton, Jeffrey H., Michelis, Fotios V., Novitzky-Basso, Igor, Viswabandya, Auro, Mattsson, Jonas, and Pasic, Ivan

Published
2023
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24. Allogeneic transplant can abrogate the risk of relapse in the patients of first remission acute myeloid leukemia with detectable measurable residual disease by next-generation sequencing

Author

Ahn, Jae-Sook, Kim, TaeHyung, Jung, Sung-Hoon, Ahn, Seo-Yeon, Jung, Seung-Yeon, Song, Ga-Young, Kim, Mihee, Yang, Deok-Hwan, Lee, Je-Jung, Choi, SeungHyun, Lee, Ja-Yeon, Park, Seong-Kyu, Moon, Joon Ho, Lee, Hui Young, Kim, Kyoung Ha, Cai, Yu, Yi, Seong Yoon, Novitzky-Basso, Igor, Zhang, Zhaolei, Kim, Hyeoung-Joon, and Kim, Dennis Dong Hwan

Published
2021
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25. Cell Therapy Transplant Canada (CTTC) Consensus-Based Guideline 2024 for Management and Treatment of Chronic Graft-Versus-Host Disease and Future Directions for Development

Author

Kim, Dennis Dong Hwan, primary, Popradi, Gizelle, additional, Lepic, Kylie, additional, Paulson, Kristjan, additional, Allan, David, additional, Nampoothiri, Ram Vasudevan, additional, Lachance, Sylvie, additional, Deotare, Uday, additional, White, Jennifer, additional, Elemary, Mohamed, additional, Jamani, Kareem, additional, Fraga, Christina, additional, Lemieux, Christopher, additional, Novitzky-Basso, Igor, additional, Law, Arjun Datt, additional, Kumar, Rajat, additional, Walker, Irwin, additional, and Schultz, Kirk R., additional

Published
2024
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26. Life Is a Highway or a Long and Winding Road: A Look into Why Some Transplants Lead to Longer Length of Stay (LOS)

Author

Sayyed, Ayman, primary, Remberger, Mats, additional, Clarke, Susan, additional, Chen, Carol, additional, Lipton, Jeffrey H, additional, Kim, Dennis (Dong Hwan), additional, Viswabandya, Auro, additional, Kumar, Rajat, additional, Lam, Wilson, additional, Law, Arjun D., additional, Gerbitz, Armin, additional, Pasic, Ivan, additional, Novitzky-Basso, Igor, additional, Michelis, Fotios V., additional, and Mattsson, Jonas, additional

Published
2024
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27. Impact of Letermovir on Outcomes in Cytomegalovirus Seropositive Patients Undergoing Allogeneic HCT: Exploring Outcomes across Ethnicities

Author

Singhabahu, Sanjay, primary, Herrity, Elizabeth, additional, Remberger, Mats, additional, Pang, Ian, additional, Novitzky-Basso, Igor, additional, Pasic, Ivan, additional, Lam, Wilson, additional, Law, Arjun D., additional, Viswabandya, Auro, additional, Gerbitz, Armin, additional, Kumar, Rajat, additional, Kim, Dennis Dong Hwan, additional, Lipton, Jeffrey H, additional, Mattsson, Jonas, additional, and Michelis, Fotios V., additional

Published
2024
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28. Eltrombopag in the Treatment of Post Allogeneic Hematopoietic Stem Cell Transplantation Cytopenia: Efficacy, Response Durability and Potential Cost Benefit of Early Drug Tapering.

Author

Al-Omari, Rawan, primary, Nampoothiri, Ram Vasudevan, additional, Atenafu, Eshetu G., additional, SakhdarI, Ali, additional, Lipton, Jeff, additional, Kim, Dennis Dong Hwan, additional, Lam, Wilson, additional, Law, Arjun D., additional, Gerbitz, Armin, additional, Pasic, Ivan, additional, Novitzky-Basso, Igor, additional, Viswabandya, Auro, additional, Michelis, Fotios V., additional, Mattsson, Jonas, additional, and Kumar, Rajat, additional

Published
2024
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29. Exploring Outcomes By Ethnicity in Allogeneic Hematopoietic Cell Transplantation

Author

Herrity, Elizabeth, primary, Singhabahu, Sanjay, additional, Remberger, Mats, additional, Novitzky-Basso, Igor, additional, Pasic, Ivan, additional, Lam, Wilson, additional, Law, Arjun D., additional, Viswabandya, Auro, additional, Gerbitz, Armin, additional, Kumar, Rajat, additional, Kim, Dennis Dong Hwan, additional, Lipton, Jeffrey H, additional, Mattsson, Jonas, additional, and Michelis, Fotios V., additional

Published
2024
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30. A Single Center Experience of Central Nervous System Manifestations of Graft Versus Host Disease.

Author

Khaire, Niranjan S, primary, Cyriac, Sunu, additional, Nampoothiri, Ram Vasudevan, additional, Gerbitz, Armin, additional, Kim, Dennis (Dong Hwan), additional, Kumar, Rajat, additional, Lam, Wilson, additional, Law, Arjun D., additional, Lipton, Jeffrey H, additional, Pasic, Ivan, additional, Michelis, Fotios V., additional, Novitzky-Basso, Igor, additional, Mattsson, Jonas, additional, and Viswabandya, Auro, additional

Published
2024
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31. Limited Impact of Donor-Recipient Weight Difference on Outcomes of Allogeneic Hematopoietic Cell Transplantation

Author

Chiarello, Caden, primary, Remberger, Mats, additional, Chen, Carol, additional, Gerbitz, Armin, additional, Kim, Dennis (Dong Hwan), additional, Kumar, Rajat, additional, Lam, Wilson, additional, Law, Arjun D., additional, Lipton, Jeff, additional, Michelis, Fotios V., additional, Novitzky-Basso, Igor, additional, Viswabandya, Auro, additional, Mattsson, Jonas, additional, and Pasic, Ivan, additional

Published
2024
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32. Interaction Between High-Dose Intravenous Busulfan and Post-Transplantation Cyclophosphamide on Hemorrhagic Cystitis After Allogeneic Hematopoietic Cell Transplantation

Author

Santos Carreira, Abel, Salas, Maria Queralt, Remberger, Mats, Novitzky-Basso, Igor, Law, Arjun Datt, Lam, Wilson, Pasic, Ivan, Mazzulli, Tony, Cserti-Gazdewich, Christine, Kim, Dennis (Dong Hwan), Michelis, Fotios V., Viswabandya, Auro, Gerbitz, Armin, Lipton, Jeffrey Howard, Kumar, Rajat, Hassan, Moustapha, and Mattsson, Jonas

Published
2023
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33. The functional significance of the Duffy negative polymorphism

Author

Novitzky Basso, Igor Nicolas

Subjects
616.99, RC Internal medicine, RZ Other systems of medicine
Abstract

I investigated the impact of DARC expression on haematopoiesis using DARC-deficient (DD) mice and developed humanised transgenic DARC models expressing the \(FYB(ES)\) and \(FYB\) human genes. I developed murine irradiation chimeras with differential DARC expression and showed that the absence of erythroid DARC but continued DARC endothelial expression was associated with reduced peripheral blood neutrophil counts. FYB(ES)TG mice showed reduced peripheral neutrophil counts and expansion of BM myelopoiesis, and reduced lymphopoiesis and erythropoiesis, compared to FYBTG mice. FYB(ES)TG and DD mice had reduced GMP cells and LSK cells, and proliferation and apoptosis of these cells were reduced. Microarray analysis of differentially expressed genes showed increased myeloid gene expression in GMP and LSK cells. Mixed irradiation chimeras showed that DD BM retained these changes, suggesting an intrinsic cell effect. Analysis of BM and serum showed a significant increase in G-CSF and eotaxin. Morphological analysis of myeloid cells in femur sections revealed increased myeloid cell clustering in DD and FYB(ES)TG mice. These data suggest that neutrophils are preferentially retained in the DD BM, possibly as a result of loss of optimal chemokine gradients created by erythroblast DARC which may favour neutrophil egress and thereby leading to peripheral neutropenia.

Published
2015

36. Letermovir prophylaxis for cytomegalovirus reactivation in allogeneic hematopoietic cell transplant recipients: Single center Canadian data

Author

Pang, Ian, primary, Chen, Peggy, additional, Trinh, Gertrude V., additional, Remberger, Mats, additional, Novitzky‐Basso, Igor, additional, Gerbitz, Armin, additional, Kim, Dennis D., additional, Kumar, Rajat, additional, Lam, Wilson, additional, Law, Arjun D., additional, Lipton, Jeffrey H., additional, Viswabandya, Auro, additional, Pasic, Ivan, additional, Mattsson, Jonas, additional, and Michelis, Fotios V., additional

Published
2023
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40. Final report of TKI discontinuation trial with dasatinib for the second attempt of treatment‐free remission after failing the first attempt with imatinib: Treatment‐free Remission Accomplished by Dasatinib (TRAD) study

Author

Perusini, Maria Agustina, primary, Novitzky‐Basso, Igor, additional, Atenafu, Eshetu G., additional, Forrest, Donna, additional, Bence‐Bruckler, Isabelle, additional, Savoie, Lynn, additional, Keating, Mary‐Margaret, additional, Busque, Lambert, additional, Delage, Robert, additional, Xenocostas, Anargyros, additional, Liew, Elena, additional, Laneuville, Pierre, additional, Paulson, Kristjan, additional, Stockley, Tracy, additional, Lipton, Jeffrey H., additional, Leber, Brian, additional, and Kim, Dennis Dong Hwan, additional

Published
2023
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41. CT-343 Outcomes of Allogeneic Hematopoietic Cell Transplantation (HCT) for Lymphoma Patients: Single-Institution Experience

Author

Altareb, Majed, primary, Sayyed, Ayman, additional, Gerbitz, Armin, additional, Kim, Dennis, additional, Kumar, Rajat, additional, Lam, Wilson, additional, Law, Arjun, additional, Lipton, Jeffrey, additional, Michelis, Fotios, additional, Novitzky-Basso, Igor, additional, Viswabandya, Auro, additional, Mattsson, Jonas, additional, and Pasic, Ivan, additional

Published
2023
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42. POSTER: CT-343 Outcomes of Allogeneic Hematopoietic Cell Transplantation (HCT) for Lymphoma Patients: Single-Institution Experience

Author

Altareb, Majed, primary, Sayyed, Ayman, additional, Gerbitz, Armin, additional, Kim, Dennis, additional, Kumar, Rajat, additional, Lam, Wilson, additional, Law, Arjun, additional, Lipton, Jeffrey, additional, Michelis, Fotios, additional, Novitzky-Basso, Igor, additional, Viswabandya, Auro, additional, Mattsson, Jonas, additional, and Pasic, Ivan, additional

Published
2023
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43. Cell therapy with IL-10-producing group 2 innate lymphoid cells suppresses Graft-versus-Host disease

Author

Reid, Kyle T, primary, Colpitts, Sarah J, additional, Mathews, Jessica A, additional, Carreira, Abel Santos, additional, Murphy, Julia M, additional, Borovsky, Dorota T, additional, Cui, Wenhui, additional, Moya, Tommy Alfaro, additional, Sachewsky, Nadia, additional, An, James, additional, Xia, Yubing, additional, Mortha, Arthur, additional, Lee, Jong Bok, additional, Zhang, Li, additional, Novitzky-Basso, Igor, additional, Mattsson, Jonas, additional, and Crome, Sarah Q, additional

Published
2023
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44. A single centre, real-world experience of chronic GVHD treatment using ibrutinib, Imatinib and ruxolitinib and its treatment outcomes

Author

Linn, Swe Mar, primary, Novitzky-Basso, Igor, additional, Abduljalil, Omar, additional, Pasic, Ivan, additional, Lam, Wilson, additional, Law, Arjun, additional, Michelis, Fotios V., additional, Gerbitz, Armin, additional, Viswabandya, Auro, additional, Lipton, Jeffrey, additional, Kumar, Rajat, additional, Mattsson, Jonas, additional, and Kim, Dennis Dong Hwan, additional

Published
2023
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45. Influence of conditioning regimen intensity on outcomes post‐allogeneic hematopoietic cell transplantation for acute myeloid leukemia in complete morphological remission

Author

Alfaro Moya, Tommy, primary, Mattsson, Jonas, additional, Remberger, Mats, additional, Lipton, Jeffrey H., additional, Kim, Dennis D., additional, Viswabandya, Auro, additional, Kumar, Rajat, additional, Lam, Wilson, additional, Law, Arjun D., additional, Gerbitz, Armin, additional, Pasic, Ivan, additional, Novitzky‐Basso, Igor, additional, and Michelis, Fotios V., additional

Published
2023
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46. Real-world experience with ruxolitinib therapy for steroid-refractory acute graft versus host disease

Author

Murray, Alistair, Linn, Swe Mar, Yu, Benoit, Novitzky-Basso, Igor, Mattsson, Jonas, Kennah, Michael, Elemary, Mohamed, White, Jennifer, Lemieux, Christopher, Jamani, Kareem, and Kim, Dennis Dong Hwan

Abstract

Acute graft versus host disease (aGVHD) is a complication of allogeneic hematopoietic stem cell transplant (HCT) and is associated with significant morbidity and mortality. Steroid refractory aGVHD (SR-aGVHD) carries a particularly grim prognosis. Ruxolitinib has shown promise for treatment of SR-aGVHD in a phase 3 trial; however, safety and efficacy data outside of the clinical trial setting is lacking. We performed a multicenter retrospective study to examine the response to ruxolitinib and its efficacy in patients with SR-aGVHD. We included 59 patients treated with ruxolitinib for SR-aGVHD between 2015 and 2022. Of these 59 patients, 36 patients (61.0%) achieved a complete (CR) or partial response (PR) at 28 days, while 31 patients (52.5%) obtained a CR/PR at day 56. Patients that achieved a CR or PR at day 28 had a higher rate of overall survival (OS; 69.2%), compared with patients that did not (31.6%; p= 0.037). OS at 12 months was 41.5%, with a median OS duration of 5.3 months. Failure free survival (FFS) at 12 months was 29.1%, with a median FFS of 2.6 months. Overall, this real-world experience data support ruxolitinib as the standard of care for SR-aGVHD in a non-controlled trial population.

Published
2024
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47. Interaction Between High-Dose Intravenous Busulfan and Post-Transplantation Cyclophosphamide on Hemorrhagic Cystitis After Allogeneic Hematopoietic Cell Transplantation

Author

Carreira, Abel Santos, Salas, Maria Queralt, Remberger, Mats, Novitzky-Basso, Igor, Law, Arjun Datt, Lam, Wilson, Pasic, Ivan, Mazzulli, Tony, Cserti-Gazdewich, Christine, Kim, Dennis (Dong Hwan), Michelis, Fotios, V, Viswabandya, Auro, Gerbitz, Armin, Lipton, Jeffrey Howard, Kumar, Rajat, Hassan, Moustapha, Mattsson, Jonas, Carreira, Abel Santos, Salas, Maria Queralt, Remberger, Mats, Novitzky-Basso, Igor, Law, Arjun Datt, Lam, Wilson, Pasic, Ivan, Mazzulli, Tony, Cserti-Gazdewich, Christine, Kim, Dennis (Dong Hwan), Michelis, Fotios, V, Viswabandya, Auro, Gerbitz, Armin, Lipton, Jeffrey Howard, Kumar, Rajat, Hassan, Moustapha, and Mattsson, Jonas

Abstract

This study investigates the incidence and predictors of hemorrhagic cystitis (HC) in 960 adults undergoing allo- hematopoietic stem cell transplantation. Two hundred fifty-two (26.5%) patients received myeloablative conditioning regimens, and 81.4% received high-dose intravenous busulfan (HD Bu). Six hundred ninety-five (72.4%) patients received post-transplantation cyclophosphamide (PTCY)-based prophylaxis, and 91.4% additionally received anti-thymocyte globulin (ATG) and Cyclosporine A (CsA) (PTCY-ATG-CsA). Two hundred twenty-eight (23.8%) patients developed HC. The day 100 cumulative incidences of grades 2-4 and 3-4 HC were 11.1% and 4.9%. BK virus was isolated in 58.3% of urinary samples. Using HD BU myeloablative regimens increased the risk for grade 2-4 HC (hazard ratio [HR] = 1.97, P = .035), and HD BU combined with ATG-PTCY-CsA increased this 4 times (HR = 4.06, P < .001) for grade 2-4 HC compared to patients who received neither of these drugs. A significant correlation was documented between grade II-IV acute graft-versus-host disease and grade 2-4 HC (HR = 2.10, P < .001). Moreover, patients with BK-POS grade 2-4 HC had lower 1-year overall survival (HR = 1.51, P = .009) and higher non-relapse mortality (HR = 2.31, P < .001), and patients with BK-NEG grade 2-4 HC had comparable post-transplantation outcomes. In conclusion, intravenous HD Bu was identified as a predictor for grade 2-4 HC. Moreover, when HD Bu was combined with PTCY-ATG-CsA, the risk increased 4-fold. Based on the results provided by this study, preventing the onset of HC, especially in high-risk patients, is mandatory because its presence significantly increases the risk for mortality.

Published
2023
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48. Population-based real-world registry study to evaluate clinical outcomes of chronic graft-versus-host disease

Author

Novitzky-Basso, Igor, Schain, Frida, Batyrbekova, Nurgul, Webb, Thomas, Remberger, Mats, Keating, Armand, Mattsson, Jonas, Novitzky-Basso, Igor, Schain, Frida, Batyrbekova, Nurgul, Webb, Thomas, Remberger, Mats, Keating, Armand, and Mattsson, Jonas

Abstract

Introduction: Chronic graft-versus-host disease (cGVHD) is a serious immune-mediated complication after allogeneic haematopoietic stem cell transplantation (HSCT), but in patients with malignancy, cGVHD development is associated with superior survival. Lack of reliable biomarkers and clinical underreporting means there is insufficient understanding of cGVHD clinical outcomes and balance between cGVHD treatment and maintaining beneficial graft-versus-tumour effects. Methods: We performed a Swedish population-wide registry study following patients who underwent allogeneic HSCT 2006-2015. cGVHD status was retrospectively classified using a real-world method based on the timing and extent of systemic immunosuppressive treatment. Results: cGVHD incidence among patients surviving >= 6 months post-HSCT (n = 1246) was 71.9%, significantly higher than previously reported. 5-year overall survival in patients surviving >= 6 months post-HSCT was 67.7%, 63.3%, and 65.3%, in non-, mild, and moderate-severe cGVHD, respectively. Non-cGVHD patients had a mortality risk almost five-fold higher compared to moderate-severe cGVHD patients 12-months post-HSCT. Moderate-severe cGVHD patients had greater healthcare utilization compared with mild and non cGVHD patients. Conclusion: cGVHD incidence was high among HSCT survivors. Non-cGVHD patients had higher mortality during the first 6 months of follow-up; however, moderate-severe cGVHD patients had more comorbidities and healthcare utilization. This study highlights the urgent need for new treatments and real-time methods to monitor effective immunosuppression after HSCT.

Published
2023
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49. Prognostic implication of pre-transplant FEV1 on long-term outcomes following allogeneic hematopoietic stem cell transplantation.

Author

Novitzky-Basso, Igor, Lam, Wilson, Chiarello, Caden, Pasic, Ivan, Law, Arjun D., Michelis, Fotios V., Gerbitz, Armin, Viswabandya, Auro, Lipton, Jeffrey H., Kumar, Rajat, Mattsson, Jonas, Messner, Hans A., Marras, Theodore K., Mittoo, Shikha, and Dong Hwan Kim, Dennis

Subjects
*HEMATOPOIETIC stem cell transplantation, *PROGNOSIS, *HEMATOPOIETIC stem cells, *STEM cell transplantation, *PULMONARY function tests
Abstract

Background: Pre-transplant pulmonary function testing (PFT) is essential before allogeneic hematopoietic stem cell transplant (HCT), yet the optimal cutoff value for affecting transplant outcomes remains poorly defined. Study Design: Retrospective analysis of pre-HCT PFT data from 605 consecutive patients at the Princess Margaret Cancer Centre between January 1, 2004 and December 31, 2013 used binary recursive partitioning to identify cutoff values for overall survival (OS) as an endpoint of transplant outcomes. These values were compared to HCT comorbidity index (HCT-CI) FEV1 cutoffs for OS, cumulative incidence of relapse and non-relapse mortality. Results: FEV1 ≥ 81% was the identified cutoff point. The OS rate at 3 years showed 49.8% (FEV1 ≥ 81%) vs. 36.6% (<81%, p < .001). For HCT-CI cutoffs, the OS rate at 3 years for FEV1 ≥ 80%, 66%-80% and =65% were 49.0%, 38.1% and 37.6% (p = .011), respectively. Multivariate analysis confirmed that FEV1 ≥ 81% predicted reduced mortality (HR 0.682, p = .001). Subgroup analysis showed both FEV1 ≥ 81% and FEV1 by HCT-CI cutoffs may stratify patients according to OS and NRM risk in subgroups receiving myeloablative, but not reduced intensity conditioning. Conclusion: FEV1 ≥ 81% can predict OS and NRM in our cohort and is potentially simpler when risk stratifying patients undergoing allogeneic HCT, particularly those receiving myeloablative conditioning. [ABSTRACT FROM AUTHOR]

Published
2023
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