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Nutritional status and quality of life in adults undergoing allogeneic hematopoietic stem cell transplantation.

Although the effects of malnutrition on morbidity and mortality in adult patients undergoing allogeneic hematopoietic stem cell transplantation are clear, the relationship with quality of life (QOL) is less clear. The purpose of this study was to assess the relationship between malnutrition and QOL. A prospective observational study was conducted in 36 adult patients undergoing allogeneic hematopoietic stem cell transplantation. Adapted criteria of the Global Leadership Initiative on malnutrition have been used for the diagnosis of malnutrition in clinical settings. A cancer linear analog scal

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… myeloid leukemia; MM/PCD multiple myeloma/ plasma cells diseases; CLL chronic lymphocytic leukemia; ALL acute lymphocytic leukemia; Ly lymphoma; MDS/MPD myelodysplastic syndromes/myeloproliferative diseases; BM bone marrow; PBSC peripheral blood stem cell; CB cord blood; HLA human leukocyte antigen; TBF thiotepa …

Clinical review: specific aspects of acute renal failure in cancer patients.

Acute renal failure (ARF) in cancer patients is a dreadful complication that causes substantial morbidity and mortality. Moreover, ARF may preclude optimal cancer treatment by requiring a decrease in chemotherapy dosage or by contraindicating potentially curative treatment. The pathways leading to ARF in cancer patients are common to the development of ARF in other conditions. However, ARF may also develop due to etiologies arising from cancer treatment, such as nephrotoxic chemotherapy agents or the disease itself, including post-renal obstruction, compression or infiltration, and metabolic o

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… Patient characteristics | Age | Pre-existing liver disease | Hormonal treatment Conditioning regimen | Cyclophosphamide | Total body irradiation | Busulfan | Carmustine | Carboplatin | Thiotepa | Melphalan | Gemtuzumab ozogamicin Transplant source | HLA-identical non-related donor | HLA mismatch …

Exploring Affordable Curative Therapy for Sickle Cell Disease in Africa: A Comprehensive Overview.

The practical aspects of developing curative treatments for sickle cell disease (SCD) in Africa, such as gene therapy and hematopoietic stem cell transplantation, involve strengthening healthcare infrastructure, training healthcare professionals, establishing regional treatment centers, and creating national SCD programs. The costs associated with gene therapy and stem cell transplants can be prohibitive, especially in low- and middle-income countries. Strategies to address affordability, including local manufacturing, government funding, and partnerships with global health agencies, are essen

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… The related haplo‐BMT approach, combined with thiotepa [ 69 , 70 ] or low‐dose radiation (400 cGy TBI) [ 68 ], is a tolerated and scalable approach for increasing curative options for most eligible individuals with SCD and no MSD, even in LMICs. … Alasbali R., Alzahrani M., Alhayli S., et al., “Excellent Outcomes of HLA Matched Related Donor Transplant for Adults With Severe Sickle Cell Disease Using a Non‐Myeloablative Conditioning With Thiotepa and Post‐Transplant Cyclophosphamide: Multi‐Center International Experience,” Blood 142, no. …

Epidemiologic and Clinical Characteristics of Coronavirus and Bocavirus Respiratory Infections after Allogeneic Stem Cell Transplantation: A Prospective Single-Center Study.

Epidemiologic data about coronaviruses (CoVs) and human bocavirus (HBoV) in the setting of allogeneic hematopoietic stem cell transplantation (allo-HSCT) are scarce. We conducted a prospective longitudinal study on respiratory viral infections (RVIs) in allo-HSCT recipients with respiratory symptoms from December 2013 until June 2016. Respiratory virus in upper and/or lower respiratory tract (URT and LRT) specimens were tested using Luminex xTAG RVP Fast v1 assay. Seventy-nine consecutive allo-HSCT recipients developed a total of 192 virologically documented RVI episodes over 30 months. The me

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… myeloproliferative neoplasm; NHL, non-Hodgkin lymphoma; HL, Hodgkin lymphoma; CLL, chronic lymphocytic leukemia; MM, multiple myeloma; CR, complete remission; PR, partial remission; ASCT, autologous stem cell transplantation; RIC, reduced-intensity conditioning; Flu, fludarabine; Mel, melphalan; Bu, busulfan; Thio, thiotepa …

The 48th Annual Meeting of the European Society for Blood and Marrow Transplantation: Physicians - Oral Sessions (O009-O155).

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Advancing Medulloblastoma Treatment: Molecular Mechanisms, Drug Repurposing, and Precision Therapies.

Medulloblastomas are the most common malignant pediatric brain tumors, representing approximately 20% of the central nervous system cancers in children. These tumors are highly heterogeneous and classified into four molecular subgroups-WNT, SHH, Group 3, and Group 4-each with distinct genetic and epigenetic profiles that influence tumor behavior, therapeutic response, and patient outcomes. Advances in molecular diagnostics have improved the subclassification of medulloblastomas, yet treatment outcomes for high-risk subtypes, particularly Group 3, remain poor, with current modalities often asso

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… residual tumor Standard of care Craniospinal irradiation (23.4 Gy) + tumor bed boost (54 Gy) Proton therapy for reducing neurocognitive side effects Chemotherapy with cisplatin, lomustine, vincristine, and cyclophosphamide High-risk patients CSI doses from 36-39.6 Gy High-dose chemotherapy (carboplatin, thiotepa … tumor | Standard of care Craniospinal irradiation (23.4 Gy) + tumor bed boost (54 Gy) Proton therapy for reducing neurocognitive side effects Chemotherapy with cisplatin, lomustine, vincristine, and cyclophosphamide High-risk patients | CSI doses from 36-39.6 Gy High-dose chemotherapy (carboplatin, thiotepa …

Sex Differences in Cancer and Cardiotoxicity: Mechanisms, Outcomes, and Clinical Implications Across Solid and Hematological Malignancies.

Sex differences influence cancer incidence, treatment response, and susceptibility to cardiovascular toxicity. Males exhibit higher rates and poorer outcomes in most non-sex-specific cancers, while females more frequently experience treatment-related adverse events, including cancer therapy-related cardiac dysfunction. Biological factors such as hormonal status, genetic polymorphisms, immune responses, and pharmacokinetics contribute to these disparities. In cardio-oncology, women-particularly premenopausal or with specific genotypes-may be at increased risk for cardiotoxicity after treatment

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… In patients receiving thiotepa-containing conditioning regimens prior to hematopoietic stem cell transplantation, female sex has been independently associated with higher incidence of acute cardiomyopathy and HF, suggesting a potential sex-specific vulnerability to high-dose alkylator myocardial injury … Thiotepa-associated cardiomyopathy during blood or marrow transplantation: Association with the female sex and cardiac risk factors Biol. Blood Marrow Transplant. 1999 5 322 327 10.1016/S1083-8791(99)70008-X 10534063 101. Brahmer J.R. Dahlberg S.E. Gray R.J. Schiller J.H. Perry M.C. Sandler A. …

Blast Transformation of Chronic Myeloid Leukemia Driven by Acquisition of t(8;21)(q22;q22)/RUNX1::RUNX1T1: Selecting Optimal Treatment Based on Clinical and Molecular Findings.

The advent of tyrosine kinase inhibitors (TKIs) has changed the natural history of chronic myeloid leukemia (CML), and the transformation from the chronic phase to the blast phase (BP) is currently an uncommon situation. However, it is one of the major remaining challenges in the management of this disease, as it is associated with dismal outcomes. We report the case of a 63-year-old woman with a history of CML with poor response to imatinib who progressed to myeloid BP-CML, driven by the acquisition of t(8;21)(q22;q22)/RUNX1::RUNX1T1. The patient received intensive chemotherapy and dasatinib,

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… Due to the availability of an HLA-matched related donor, a peripheral blood allo-HSCT with reduced-intensity conditioning with fludarabine, busulfan and thiotepa was performed. Graft-versus-host disease (GVHD) prophylaxis consisted of tacrolimus plus sirolimus plus mycophenolate. …

Early Impact of Mobilization Process on Cardiac Function and Size in Patients Undergoing Autologous Hematopoietic Stem Cell Transplantation.

Background: The hematopoietic stem cell transplantation (HSCT) process is known to cause cardiac toxicity of different grades. In this paper, we aimed to evaluate the impact of mobilization procedure of hematopoietic stem cells for autologous HSCT process for left and right ventricle sizes and functions. Material and Methods: The data of 47 patients undergoing autologous HSCT were analyzed. All patients underwent hematopoietic stem cell mobilization with chemotherapy and filgrastim at 10 µg/kg/d. Echocardiography was performed two times: before enrolling in the transplantation process and afte

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… patients had cyclophosphamide 3000 mg/m 2 ; mantle cell lymphoma patients had rituximab 375 mg/m 2 and cytarabine 4 g/m 2 ; Hodgkin’s lymphoma patients had cisplatin 30 mg/m 2 and cytarabine 3.5 g/m 2 ; primary central nervous system (PCNS) diffuse large B cell lymphoma patients had cytarabine and thiotepa …

Myeloablative fractionated busulfan for allogeneic stem cell transplant in older patients or patients with comorbidities.

Traditional conditioning regimens for patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) provide suboptimal outcomes, especially for older patients and those with comorbidities. We hypothesized that a fractionated myeloablative busulfan dose delivered over an extended period would reduce nonrelapse mortality (NRM) while retaining antileukemic effects. Here, we performed a phase 2 trial for adults with hematological malignancies receiving matched related or unrelated allo-HCT. Participants received busulfan 80 mg/m2 as outpatients on days -20 and -13 before transplant.

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… Trials with venetoclax, sorafenib, cladribine, and thiotepa are underway. …

Allogeneic Stem Cell Transplantation in Relapsed/Refractory Multiple Myeloma Treatment: Is It Still Relevant? (Running Title: The Role of Salvage alloSCT in MM).

BackgroundDespite offering an attractive option, the role of allogeneic stem cell transplantation (alloSCT) for treatment of multiple myeloma (MM) remains unclear.MethodsRecognizing the paucity of data in the Asian population, we retrospectively evaluated the outcomes of 24 patients (median age 52) undergoing alloSCT between April 2003 and November 2017.ResultsThe median time from diagnosis to alloSCT was 39.4 months. The majority of the patients (70.8%) underwent alloSCT followed by reduced intensity conditioning regimens after a median of five lines of therapy. Among 24 patients, 15 patients

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… The MAC regimens included total body irradiation (TBI, daily 300 rad on days −7 to −4)-melphalan (Mel, 100 mg/m 2 on days −3 and −2), busulfan (Bu, 3.2 mg/kg on days −6 to −3)-fludarabine (Flu, 40 mg/m 2 on days −6 to −3) and thiotepa (200 mg/m 2 on days −9 to −7)-Bu (2.7 mg/kg on days −6 to −4)-cyclophosphamide …

Effect of leaving chronic oral foci untreated on infectious complications during intensive chemotherapy.

BackgroundLeukaemic patients receiving intensive chemotherapy and patients undergoing autologous stem-cell transplantation (ASCT) are routinely screened for oral foci of infection to reduce infectious complications that could occur during therapy. In this prospective study we assessed the effect of leaving chronic oral foci of infection untreated on the development of infectious complications in intensively treated haematological patients.MethodsWe included and prospectively evaluated all intensively treated leukaemic patients and patients undergoing ASCT who were referred to our medical centr

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… Musso M, Messina G, Marcacci G, Crescimanno A, Console G, Donnarumma D, Scalone R, Pinto A, Martino M (2015) High-dose melphalan plus thiotepa as conditioning regimen before second autologous stem cell transplantation for “de-novo” multiple myeloma patients: a phase II study. …

Effectiveness of biosimilar pegfilgrastim in patients with multiple myeloma after high-dose melphalan and autologous stem cell transplantation.

Multiple myeloma (MM) is the main indication for autologous stem cell transplantation (ASCT). Novel supportive therapies (e.g., granulocyte colony-stimulating factor) have significantly improved post-ASCT-related mortality; however, data on biosimilar pegfilgrastim-bmez (BIO/PEG) in this setting is lacking. This prospective cohort study compared Italian patients with MM who received BIO/PEG post-ASCT with data collected retrospectively from historical control groups from the same center who received either filgrastim-sndz (BIO/G-CSF) or pegfilgrastim (PEG; originator). The primary endpoint was

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… High-dose melphalan plus thiotepa as conditioning regimen before second autologous stem cell transplantation for "de novo" multiple myeloma patients: a phase II study. Biol Blood Marrow Transplant. 2015;21:1932–1938. doi: 10.1016/j.bbmt.2015.06.011. 6. …

Политика и перспективы в отношении амбулаторных программ для аутологической трансплантации клеток и лечения иммуноэффективных клеток.

Высокодозированная химиотерапия с автоматической трансплантацией гематопоиетических клеток (AutoHCT) давно является комплексной формой лечения множественной миеломы и неходгкинской лимфомы. В прошлом 25 Многие учреждения сместили эту практику с госпитализации на one , которые могут быть выполнены в амбулаторном порядке, что приведет к экономии средств и повышению качества жизни пациентов. Недавно появившиеся методы лечения иммуноэффективных клеток (ИЭК) и расширение их масштабов приводят к изменению ландшафта лечения гематологовых и негематологических магнатов. Однако нынешние финансовые модел

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… More recently, outpatient autoHCT with BEAM or thiotepa/BCNU conditioning for NHL is being performed in carefully-selected patients. Patients may be already established with the treating hematologist or referred specifically for HCT. …

Mechanisms of Chemotherapy-Induced Neurotoxicity.

Since the first clinical trials conducted after World War II, chemotherapeutic drugs have been extensively used in the clinic as the main cancer treatment either alone or as an adjuvant therapy before and after surgery. Although the use of chemotherapeutic drugs improved the survival of cancer patients, these drugs are notorious for causing many severe side effects that significantly reduce the efficacy of anti-cancer treatment and patients' quality of life. Many widely used chemotherapy drugs including platinum-based agents, taxanes, vinca alkaloids, proteasome inhibitors, and thalidomide ana

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… the hippocampus | In vivo | Christie et al. (2012) Reduction of spinal and dendritic complexity | In vivo | Acharya et al. (2015) , Kang et al. (2018) Stimulation of neuroinflammation | In vivo | Shi et al. (2019b) , Gaman et al. (2016) Disruption of microglia function | In vivo | Shi et al. (2019a) thioTEPA … Intraperitoneal (IP) or intravenous (IV) injections of various drugs, ranging from MTX, 5-FU, CP, doxorubicin (DOX), DCTX, PCTX, cisplatin to thioTEPA were shown to increase the impairment of memory and decreased numbers of NPCs, immature or mature neurons ( Nguyen and Ehrlich, 2020 ). …

Успешное уничтожение антител de novo HLA с помощью Daratumumumab в иммунопосредованных цитопенциях после пересадки аллогенетических стволовых клеток: отчет по делу.

Рефракторные иммуномедиаментированные цитопенции (КМК) после трансплантации стволовых клеток с аллогенетической гематопоиетической гематозностью (аллоХСТ) представляют собой сложное осложнение с ограниченными терапевтическими возможностями. Несмотря на то, что ранее существовавшие антитела лейкоцитов человека (ХЛА), в частности конкретные для доноров антитела (АДС), являются хорошо зарекомендовавшими себя факторами риска в случае отказа от трансплантации, клиническая значимость и механистическая роль антител de novo HLA, появившихся после трансплантации, по-прежнему плохо определены. Не провод

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… Myeloablative conditioning included fludarabine (30 mg/m²/day for 5 days), busulfan (3.2 mg/kg/day for 1 day), cyclophosphamide (25 mg/kg/day for 2 days), thiotepa (5 mg/kg/day for 1 day), and thymoglobulin (2 mg/kg/day for 3 days). …

Post-Transplant Cyclophosphamide for the Prevention of Graft-vs.-Host Disease in Allogeneic Hematopoietic Cell Transplantation: A Guide to Management for the Advanced Practitioner.

Cyclophosphamide remains a critical component to haploidentical transplant conditioning regimens. Post-transplant cyclophosphamide (PTCy) emerged as an effective component of graft-vs.-host disease (GVHD) prophylaxis in the nonmyeloablative haploidentical bone marrow transplant setting. The relative ease of administration compared with ex vivo manipulations and efficacy in reducing GVHD has led to increasing PTCy use in transplant centers around the world. The role of PTCy has expanded to haploidentical transplantation with myeloablative conditioning regimens and peripheral blood progenitor ce

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… Extremely high exposures in an obese patient receiving high-dose cyclophosphamide, thiotepa and carboplatin. Cancer Chemotherapy and Pharmacology, 50(3), 251–255. 10.1007/s00280-002-0494-7 DeFronzo, R. A., Colvin, O. M., Braine, H., Robertson, G. L., & Davis, P. J. (1974). …

Interleukin-6 as Biomarker for Acute GvHD and Survival After Allogeneic Transplant With Post-transplant Cyclophosphamide.

Background: Although the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) has dramatically improved in the past decade, it is still compromised by transplant-related mortality (TRM), mainly caused by Graft-vs. -Host Disease (GvHD). Methods: We conducted a prospective observational study to ascertain the potential of serum interleukin-6 (IL6) levels, measured before conditioning and 7 days after allo-HSCT, in predicting acute GvHD, TRM and survival after allo-HSCT with Post-Transplant Cyclophosphamide (PT-Cy) based GvHD prophylaxis. Results: Between April 2014 and June

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… The majority of patients received an intensified conditioning with the addition of melphalan 70 mg/m 2 /day on days −3 and −2 or thiotepa 5 mg/kg/day on days −3 and −2, classified as myeloablative conditioning (MAC) regimen. All patients received PT-Cy (50 mg/kg/day) on days 3 and 4 ( 17 , 18 ). …

Total Body Irradiation in Haematopoietic Stem Cell Transplantation: A Comprehensive Literature Review and Institutional Experience from the Policlinico of Catania.

Background and Objectives: Total body irradiation (TBI) remains a cornerstone of conditioning for allogeneic haematopoietic stem-cell transplantation (HSCT). Whereas early research debated the need for irradiation, contemporary investigations focus on optimising dose, fractionation and delivery techniques. Material and Methods: We synthesised six decades of evidence, spanning from single-fraction cobalt treatments to modern helical tomotherapy and intensity-modulated total-marrow/lymphoid irradiation (TMI/TMLI). To complement the literature, we reported our institutional experience on 77 paedi

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… The development of RIC regimens, including thiotepa-based conditioning, has allowed for the expansion of transplant eligibility over the years [ 26 ]. However, the potential risks of graft rejection or disease relapse must still be considered. …

Management of infection and ocular complications in pediatric SJS/TEN-like acute graft-versus-host disease: a clinical case study and literature review.

Acute graft-versus-host disease (aGVHD) with skin manifestations reminiscent of Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) is associated with poor outcomes. However, optimal management strategies to enhance quality of life in SJS/TEN-like aGVHD remain undefined. This study aims to investigate the management of complex infections and acute ocular injury in patients with SJS/TEN-like aGVHD following allogeneic hematopoietic stem cell transplantation. We conducted a comprehensive analysis of the treatment course for a patient with SJS/TEN-like aGVHD, complemented by a lit

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… CY, cyclophosphamide; BU, busulfan; FLU, fludarabine; TT, thiotepa; ATG, anti-thymocyte globulin; PtCy, post-transplant cyclophosphamide; CNS, central nervous system; NGS, next-generation sequencing. …