RISK FACTORS FOR THE OUTCOME AFTER ALLOGENEIC STEM CELL TRANSPLANTATION: A SINGLE-CENTER EXEPERIENCE

Volume 8, Issue 1, February 2024     |     PP. 1-17      |     PDF (268 K)    |     Pub. Date: March 22, 2024
DOI: 10.54647/pm310251    45 Downloads     51491 Views  

Author(s)

Kameliya Milcheva, Specialized Hospital for Active Treatment of Hematological Diseases
Viktoria Yankova, Specialized Hospital for Active Treatment of Hematological Diseases
Yonka Lazarova, Specialized Hospital for Active Treatment of Hematological Diseases
Krasen Venkov, Specialized Hospital for Active Treatment of Hematological Diseases
Emilia Naseva, Department of Health Economics, Faculty of Public Health "Prof. Tsekomir Vodenicharov, MD, DSc", Medical University of Sofia
Georgi Mihaylov, Specialized Hospital for Active Treatment of Hematological Diseases

Abstract
Allogeneic stem cell transplantation (AlloSCT) is a therapeutic procedure for the treatment of a large number of malignant and non-malignant hematological diseases, unfortunately still associated with significant morbidity and mortality. Disease relapse and non-relapse mortality remain the main causes of treatment failure following AlloSCT. Identification of the risk factors associated with this continue to be a subject of extensive scientific research. The aim of our study is to estimate the risk factors that would have prognostic significance for the outcome of AlloSCT for our patient population. We evaluated 96 patients who received AlloSCT in the transplant unit at Specialized Hospital for Active Treatment of Hematological Diseases (SHATHD), between 2017-2022, with the following diagnoses: acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) and acute lymphoblastic leukemia (ALL. They were prospectively followed up to June 2023. Our results regarding success rates and complications related to the procedure did not differ from data reported in the literature. Along with the common risks for the outcome of AlloSCT, we found as an independent prognostic factors the lymphocyte recovery at D+21 after transplantation and the indicators of cytokine response in the pre engraftmen period.

Keywords
allogeneic stem cell transplantation, risk factors, transplant outcomes, absolute lymphocyte count

Cite this paper
Kameliya Milcheva, Viktoria Yankova, Yonka Lazarova, Krasen Venkov, Emilia Naseva, Georgi Mihaylov, RISK FACTORS FOR THE OUTCOME AFTER ALLOGENEIC STEM CELL TRANSPLANTATION: A SINGLE-CENTER EXEPERIENCE , SCIREA Journal of Medicine. Volume 8, Issue 1, February 2024 | PP. 1-17. 10.54647/pm310251

References

[ 1 ] H.K.Mahmoud, A.M. Elhaddad, O.A. Fahmy, Samra M.A. Abdelfattah RM, Y.H.El-Nahass, et al.Allogeneic hematopoietic stem cell transplantation for non-malignant hematological disorders J. Adv. Res., 6(2015), pp.449-458.
[ 2 ] A. Gratwohl, H. Baldomero, J.F. Passweg, F. Frassoni, D. Niederwieser, N. Schmitz, et al.Hematopoietic stem cell transplantation for hematological malignancies in Euruope. Leukemia, 17 (5) (2003), pp. 941-959.
[ 3 ] E.D. Thomas. Bone marrow transplantation: a review Sem in Hematol, 36 (4 Suppl 7) (1999), pp. 95-103
[ 4 ] Gratwohl A, Carreras E. Principles of Conditioning. In: Apperley J, Carreras E, Gluckman E, Masszi T, editors. ESH-EBMT Handbook on Haematopoietic Stem Cell Transplantation 2012. 6th edition. European School of Haematology; 2012. p. 288e301.
[ 5 ] Weiden PL, Flournoy N, Thomas ED, Prentice R, Fefer A, Buckner CD et al. Antileukemic effect of graft-versus-host disease in human recipients of allogeneic-marrow grafts. N Engl J Med 1979; 300: 1068–1073.
[ 6 ] Horowitz MM, Gale RP, Sondel PM, Goldman JM, Kersey J, Kolb HJ et al. Graft-versus-leukemia reactions after bone marrow transplantation.Blood 1990; 75: 555–562.
[ 7 ] CIBMTR.org
[ 8 ] Delgado A, Guddati AK. Clinical endpoints in oncology - a primer. Am J Cancer Res. 2021 Apr 15;11(4):1121-1131. PMID: 33948349; PMCID: PMC8085844.
[ 9 ] Holler E, Greinix H, Zeiser R. Acute Graft-Versus-Host Disease. In: Carreras E, Dufour C, Mohty M, et al., editors. The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies [Internet]. 7th edition. Cham (CH): Springer; 2019. Chapter 43.
[ 10 ] Armand P, Kim HT, Logan BR, Wang Z, Alyea EP, Kalaycio ME, Maziarz RT, Antin JH, Soiffer RJ, Weisdorf DJ, Rizzo JD, Horowitz MM, Saber W. Validation and refinement of the Disease Risk Index for allogeneic stem cell transplantation. Blood. 2014 Jun 5;123(23):3664-71. doi: 10.1182/blood-2014-01-552984. Epub 2014 Apr 17. PMID: 24744269; PMCID: PMC4047501.
[ 11 ] Azam F, Latif MF, Farooq A, Tirmazy SH, AlShahrani S, Bashir S, Bukhari N. Performance Status Assessment by Using ECOG (Eastern Cooperative Oncology Group) Score for Cancer Patients by Oncology Healthcare Professionals. Case Rep Oncol. 2019 Sep 25;12(3):728-736.
[ 12 ] Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, Storer B. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005 Oct 15;106(8):2912-9.
[ 13 ] Auletta JJ, Kou J, Chen M et al. Real-World Data Showing Trends and Outcomes by Race and Ethnicity in Allogeneic Hematopoietic Cell Transplantation: A Report from the Center for International Blood and Marrow Transplant Research. Transplant Cell Ther. 2023 Jun;29(6):346.e1-346.e10. doi: 10.1016/j.jtct.2023.03.007. Epub 2023 Mar 15. PMID: 36924931; PMCID: PMC10239334.
[ 14 ] Jamal A, Khan MT, Parveen S, et al. Peripheral blood stem cell harvest HPC count is an effective surrogate marker for CD34+ cell count in allogeneic stem cell transplant setting. Transl Oncol 13: 100788, 2020.
[ 15 ] Gea-Banacloche J. Risks and Epidemiology of Infections After Hematopoietic Stem Cell Transplantation. Transplant Infections. 2016 Feb 15. 81-99.
[ 16 ] Zeiser R. Advances in understanding the pathogenesis of graft-versus-host disease. Br J Haematol. 2019 Dec. 187 (5):563-572.
[ 17 ] Ulas D. Bayraktar, Denái R. Et al. Optimal Threshold and Time of Absolute Lymphocyte Count Assessment for Outcome Prediction after Bone Marrow Transplantation,Biology of Blood and Marrow Transplantation,Volume 22, Issue 3,2016, Pages 505-513, ISSN 1083-8791
[ 18 ] Kubo H, Imataki O, Fukumoto T, Ishida T, Kubo YH, Kida JI, Uemura M, Fujita H, Kadowaki N. Prognostic impact of the simple L-index and absolute lymphocyte count early after allogeneic hematopoietic stem cell transplantation. Cytotherapy. 2023 Apr;25(4):415-422. doi: 10.1016/j.jcyt.2022.11.008. Epub 2023 Jan 3. PMID: 36599773.
[ 19 ] Shouval R, Fein JA, Labopin M et al. Development and validation of a disease risk stratification system for patients with haematological malignancies: a retrospective cohort study of the European Society for Blood and Marrow Transplantation registry. Lancet Haematol. 2021 Mar;8(3):e205-e215. doi: 10.1016/S2352-3026(20)30394-X. Erratum in: Lancet Haematol. 2021 Jun;8(6):e393. PMID: 33636142; PMCID: PMC9190021.