- Graft-versus-leukaemia effect post fludarabine, melphalan and alemtuzumab reduced intensity allogeneic stem cell transplantat in HIV-infected patient with acute myeloid leukaemia. [Journal Article]
- BMBone Marrow Transplant 2018 Aug 16
- Allogeneic stem cell transplantation (Allo-HSCT) is sine qua non to cure high-risk acute myeloid leukaemia (AML). In spite the advent of highly active antiretroviral treatment, HIV-infected patients ...
Allogeneic stem cell transplantation (Allo-HSCT) is sine qua non to cure high-risk acute myeloid leukaemia (AML). In spite the advent of highly active antiretroviral treatment, HIV-infected patients display a remarkable risk for haematological neoplasms such as non-Hodgkin lymphomas, Hodgkin lymphoma and acute leukaemia. Several case series have confirmed the efficacy of the autologous stem cell transplantation for the treatment of non-Hodgkin lymphomas in the HIV setting. Nonetheless, there is a paucity of data for the role of the Allo-HSCT in HIV-infected individuals with haematological malignancies. Herein, we presented the successful long-term outcome of a HIV-infected patient who received reduced intensity conditioned, matched unrelated donor transplant with alemtuzumab as graft-versus-host disease prophylaxis for therapy-related acute myeloid leukaemia. We propose that Allo-HSCT in HIV patients is safe and that alemtuzumab-based conditioning could further work to eradicate HIV in those whose donor is not CCR5 homozygous.
- Unexpected high multiple sclerosis activity after switching from fingolimod to alemtuzumab. [Journal Article]
- MSMult Scler Relat Disord 2018 Aug 07; 25:216-218
- Unexpected high disease activity (UHDA) after Fingolimod withdrawal has recently become a controversial concern for physicians. Here, we report the case of a patient with severe exacerbation of MS af...
Unexpected high disease activity (UHDA) after Fingolimod withdrawal has recently become a controversial concern for physicians. Here, we report the case of a patient with severe exacerbation of MS after switching from Fingolimod to Alemtuzumab treatment. This UHDA despite profound lymphopenia raised the question of the management of sequential use of biotherapies such as Fingolimod and Alemtuzumab in MS.
- Anti-CD52 antibody treatment depletes B cell aggregates in the central nervous system in a mouse model of multiple sclerosis. [Journal Article]
- JNJ Neuroinflammation 2018 Aug 11; 15(1):225
- CONCLUSIONS: Anti-CD52 treatment abrogated B cell infiltration and disrupted existing B cell aggregates in the CNS.
- Infectious Complications of Multiple Sclerosis Therapies: Implications for Screening, Prophylaxis, and Management. [Review]
- OFOpen Forum Infect Dis 2018; 5(8):ofy174
- Multiple sclerosis therapies include interferons, glatiramer, and multiple immunosuppressive drugs. Discerning infectious risks of immunosuppressive drugs requires understanding their mechanisms of a...
Multiple sclerosis therapies include interferons, glatiramer, and multiple immunosuppressive drugs. Discerning infectious risks of immunosuppressive drugs requires understanding their mechanisms of action and analyzing interventional studies and postmarketing observational data. Though identical immunosuppressive therapies are sometimes used in non-neurologic conditions, infectious risks may differ in this population. Screening for and treatment of latent tuberculosis (TB) infection should be prioritized for patients receiving alemtuzumab; ocrelizumab is likely not associated with an increased risk of TB. Hepatitis B virus (HBV) reactivation can be devastating for patients treated with ocrelizumab and alemtuzumab, whereas the small molecule oral agents do not likely pose substantial risk of HBV. Progressive multifocal leukoencephalopathy is a particular concern with natalizumab. Alemtuzumab, and possibly natalizumab and fingolimod, risks herpes virus reactivation and may warrant prophylaxis. Unusual opportunistic infections have been described. Vaccination is an important tool in preventing infections, though vaccine timing and contraindications can be complex.
- Does Induction Type Influence Outcomes in Kidney Transplant Recipients at Different Phases of Hepatitis B Infection? [Journal Article]
- ECExp Clin Transplant 2018 Jul 31
- CONCLUSIONS: Our study did not show adverse graft and patient outcomes associated with depleting versus nondepleting antibody induction in kidney transplant recipients at different phases of hepatitis B virus infection. This supports the selection and use of induction agents based on immunologic risk in such patients.
- Hematopoietic stem-cell transplantation in systemic sclerosis: an update. [Journal Article]
- COCurr Opin Rheumatol 2018 Jul 30
- CONCLUSIONS: There is increasing evidence that patients with rapidly progressive SSc may benefit from HSCT. However, optimal patient selection, pretransplantation workup and posttransplant management, still have to be established.
- Postrenal transplant infection: What is the effect of specific immunosuppressant agents? [Journal Article]
- SSurgery 2018 Jul 27
- CONCLUSIONS: Alemtuzumab and mycophenolic acid mofetil as immunosuppressant agents in a multiagent protocol appear to decrease the incidence of infection. Cytomegalovirus antigenemia was the greatest risk for infection and mycophenolic acid mofetil possessed the greatest protective effect on viral infections.
- Tumefactive multiple sclerosis lesions associated with fingolimod treatment: Report of 5 cases. [Journal Article]
- MSMult Scler Relat Disord 2018 Jul 19; 25:95-98
- CONCLUSIONS: Our study, along with similar reports in literature, highlights the need for close monitoring in patients who plan to switch from fingolimod to other treatments because of the risk of severe rebound. The etiopathogenic association between fingolimod and TDLs is not clear, but given the increasing reports of cases it should be taken into account for treatment selection in patients with this type of lesions.
- Recent Advances and Long-Term Results of Medical Treatment of Acquired Aplastic Anemia: Are Patients Cured? [Review]
- HOHematol Oncol Clin North Am 2018; 32(4):609-618
- Horse antithymocyte globulin plus cyclosporine remains standard immunosuppressive therapy in severe aplastic anemia, with hematologic response rates of 60% to 70%. In those refractory to this regimen...
Horse antithymocyte globulin plus cyclosporine remains standard immunosuppressive therapy in severe aplastic anemia, with hematologic response rates of 60% to 70%. In those refractory to this regimen, a second course of therapy with rabbit antithymocyte globulin plus cyclosporine or alemtuzumab produces responses in 30% to 40%. Eltrombopag, a thrombopoietin receptor agonist, showed activity as a single agent in those refractory to initial immunosuppression with hematologic response rates of 40% to 50%. When combined with immunosuppression as frontline therapy, eltrombopag increased the rate of overall and complete response rates. Longer follow-up is needed to better define these outcomes.
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- Use of the new oral disease-modifying therapies for multiple sclerosis in British Columbia, Canada: the first five-years. [Journal Article]
- MSMult Scler Relat Disord 2018 Jul 09; 25:57-60
- CONCLUSIONS: The uptake and use of the oral DMTs increased substantially over the first 2 to 5 years after their introduction. These recent changes highlight the importance of monitoring the risks and benefits in the real world.