Tags

Type your tag names separated by a space and hit enter

Haploidentical Bone Marrow Transplantation with Post-Transplant Cyclophosphamide/Bendamustine in Pediatric and Young Adult Patients with Hematologic Malignancies.
Biol Blood Marrow Transplant. 2018 10; 24(10):2034-2039.BB

Abstract

More than half of patients undergoing hematopoietic cell transplantation at our institution are ethnic or racial minorities, making the search for matched unrelated donors more challenging. Since the introduction of haploidentical bone marrow transplant (haplo-BMT) into our pediatric BMT program in 2015, 69.2% of recipients have been minorities. Herein, we describe our experience with the first 13 pediatric and young adult patients with hematologic malignancies who have undergone T cell-replete haplo-BMT after myeloablative conditioning (MAC) at our institution. We have previously documented that in experimental haplo-BMT, post-transplant bendamustine (PT-BEN) is at least as effective as post-transplant cyclophosphamide (PT-CY) against graft-versus-host disease (GVHD) and elicits superior graft-versus-leukemia (GVL) effects. We report on, for the first time in humans, 4 patients treated with PT-CY and PT-BEN after haplo-BMT as part of our ongoing institutional phase I/II study (NCT02996773). The remaining 9 patients reviewed in this report received PT-CY. Our findings indicate that MAC haplo-BMT is well tolerated by children and young adults with advanced hematologic malignancies with no observed nonrelapse mortality or grades III to IV GVHD. All patients who underwent haplo-BMT remain alive and disease-free with a median follow-up of 15.6 months (range, 1.5 to 31.2). Preliminary findings from our ongoing clinical trial demonstrate that partial substitution of PT-BEN for PT-CY is feasible and safe after haplo-BMT as an immune modulatory strategy to alleviate GVHD and potentially more effectively preserve GVL.

Authors+Show Affiliations

Department of Pediatrics, University of Arizona, Tucson, Arizona; Department of Immunobiology, University of Arizona, Tucson, Arizona; Department of Medicine, University of Arizona, Tucson, Arizona; Department of Pathology, University of Arizona, Tucson, Arizona; University of Arizona Cancer Center, Tucson, Arizona; University of Arizona, Arizona and Banner University Medical Center, Tucson, Arizona. Electronic address: ekatsani@email.arizona.edu.Department of Pediatrics, University of Arizona, Tucson, Arizona; University of Arizona, Arizona and Banner University Medical Center, Tucson, Arizona.University of Arizona, Arizona and Banner University Medical Center, Tucson, Arizona; College of Pharmacy, Tucson, Arizona.Department of Pathology, University of Arizona, Tucson, Arizona; University of Arizona, Arizona and Banner University Medical Center, Tucson, Arizona.University of Arizona Cancer Center, Tucson, Arizona; University of Arizona, Arizona and Banner University Medical Center, Tucson, Arizona; Department of Radiation Oncology, University of Arizona, Tucson, Arizona.Department of Pediatrics, University of Arizona, Tucson, Arizona; University of Arizona Cancer Center, Tucson, Arizona; University of Arizona, Arizona and Banner University Medical Center, Tucson, Arizona.

Pub Type(s)

Clinical Trial, Phase I
Clinical Trial, Phase II
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29908231

Citation

Katsanis, Emmanuel, et al. "Haploidentical Bone Marrow Transplantation With Post-Transplant Cyclophosphamide/Bendamustine in Pediatric and Young Adult Patients With Hematologic Malignancies." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 24, no. 10, 2018, pp. 2034-2039.
Katsanis E, Sapp LN, Varner N, et al. Haploidentical Bone Marrow Transplantation with Post-Transplant Cyclophosphamide/Bendamustine in Pediatric and Young Adult Patients with Hematologic Malignancies. Biol Blood Marrow Transplant. 2018;24(10):2034-2039.
Katsanis, E., Sapp, L. N., Varner, N., Koza, S., Stea, B., & Zeng, Y. (2018). Haploidentical Bone Marrow Transplantation with Post-Transplant Cyclophosphamide/Bendamustine in Pediatric and Young Adult Patients with Hematologic Malignancies. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 24(10), 2034-2039. https://doi.org/10.1016/j.bbmt.2018.06.007
Katsanis E, et al. Haploidentical Bone Marrow Transplantation With Post-Transplant Cyclophosphamide/Bendamustine in Pediatric and Young Adult Patients With Hematologic Malignancies. Biol Blood Marrow Transplant. 2018;24(10):2034-2039. PubMed PMID: 29908231.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Haploidentical Bone Marrow Transplantation with Post-Transplant Cyclophosphamide/Bendamustine in Pediatric and Young Adult Patients with Hematologic Malignancies. AU - Katsanis,Emmanuel, AU - Sapp,Lauren N, AU - Varner,Nicole, AU - Koza,Shannon, AU - Stea,Baldassarre, AU - Zeng,Yi, Y1 - 2018/06/14/ PY - 2018/03/12/received PY - 2018/06/06/accepted PY - 2018/6/17/pubmed PY - 2019/8/28/medline PY - 2018/6/17/entrez KW - Haploidentical BMT KW - PT-bendamustine KW - PT-cyclophosphamide SP - 2034 EP - 2039 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol. Blood Marrow Transplant. VL - 24 IS - 10 N2 - More than half of patients undergoing hematopoietic cell transplantation at our institution are ethnic or racial minorities, making the search for matched unrelated donors more challenging. Since the introduction of haploidentical bone marrow transplant (haplo-BMT) into our pediatric BMT program in 2015, 69.2% of recipients have been minorities. Herein, we describe our experience with the first 13 pediatric and young adult patients with hematologic malignancies who have undergone T cell-replete haplo-BMT after myeloablative conditioning (MAC) at our institution. We have previously documented that in experimental haplo-BMT, post-transplant bendamustine (PT-BEN) is at least as effective as post-transplant cyclophosphamide (PT-CY) against graft-versus-host disease (GVHD) and elicits superior graft-versus-leukemia (GVL) effects. We report on, for the first time in humans, 4 patients treated with PT-CY and PT-BEN after haplo-BMT as part of our ongoing institutional phase I/II study (NCT02996773). The remaining 9 patients reviewed in this report received PT-CY. Our findings indicate that MAC haplo-BMT is well tolerated by children and young adults with advanced hematologic malignancies with no observed nonrelapse mortality or grades III to IV GVHD. All patients who underwent haplo-BMT remain alive and disease-free with a median follow-up of 15.6 months (range, 1.5 to 31.2). Preliminary findings from our ongoing clinical trial demonstrate that partial substitution of PT-BEN for PT-CY is feasible and safe after haplo-BMT as an immune modulatory strategy to alleviate GVHD and potentially more effectively preserve GVL. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/29908231/Haploidentical_Bone_Marrow_Transplantation_with_Post_Transplant_Cyclophosphamide/Bendamustine_in_Pediatric_and_Young_Adult_Patients_with_Hematologic_Malignancies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(18)30319-7 DB - PRIME DP - Unbound Medicine ER -