Browsing by Subject "Hematologic neoplasms"

Now showing 1 - 5 of 5
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    Composite GRFS and CRFS Outcomes After Adult Alternative Donor HCT
    (American Society of Clinical Oncology, 2020-06-20) Mehta, Rohtesh S.; Holtan, Shernan G.; Wang, Tao; Hemmer, Michael T.; Spellman, Stephen R.; Arora, Mukta; Couriel, Daniel R.; Alousi, Amin M.; Pidala, Joseph; Abdel-Azim, Hisham; Agrawal, Vaibhav; Ahmed, Ibrahim A.; Al-Homsi, Samer; Aljurf, Mahmoud; Antin, Joseph H.; Askar, Medhat; Auletta, Jeffery J.; Bhatt, Vijaya Raj; Chee, Lynette; Chhabra, Saurabh; Daly, Andrew; DeFilipp, Zachariah; Gajewski, James; Gale, Robert Peter; Gergis, Usama; Hematti, Peiman; Hildebrandt, Gerhard C.; Hogan, William J.; Inamoto, Yoshihiro; Martino, Rodrigo; Majhail, Navneet S.; Marks, David I.; Nishihori, Taiga; Olsson, Richard F.; Pawarode, Attaphol; Diaz, Miguel Angel; Prestidge, Tim; Rangarajan, Hemalatha G.; Ringden, Olle; Saad, Ayman; Savani, Bipin N.; Schoemans, Hélène; Seo, Sachiko; Schultz, Kirk R.; Solh, Melhem; Spitzer, Thomas; Storek, Jan; Teshima, Takanori; Verdonck, Leo F.; Wirk, Baldeep; Yared, Jean A.; Cahn, Jean-Yves; Weisdorf, Daniel J.; Medicine, School of Medicine
    Purpose: There is no consensus on the best choice of an alternative donor (umbilical cord blood [UCB], haploidentical, one-antigen mismatched [7/8]-bone marrow [BM], or 7/8-peripheral blood [PB]) for hematopoietic cell transplantation (HCT) for patients lacking an HLA-matched related or unrelated donor. Methods: We report composite end points of graft-versus-host disease (GVHD)-free relapse-free survival (GRFS) and chronic GVHD (cGVHD)-free relapse-free survival (CRFS) in 2,198 patients who underwent UCB (n = 838), haploidentical (n = 159), 7/8-BM (n = 241), or 7/8-PB (n = 960) HCT. All groups were divided by myeloablative conditioning (MAC) intensity or reduced intensity conditioning (RIC), except haploidentical group in which most received RIC. To account for multiple testing, P < .0071 in multivariable analysis and P < .00025 in direct pairwise comparisons were considered statistically significant. Results: In multivariable analysis, haploidentical group had the best GRFS, CRFS, and overall survival (OS). In the direct pairwise comparison of other groups, among those who received MAC, there was no difference in GRFS or CRFS among UCB, 7/8-BM, and 7/8-PB with serotherapy (alemtuzumab or antithymocyte globulin) groups. In contrast, the 7/8-PB without serotherapy group had significantly inferior GRFS, higher cGVHD, and a trend toward worse CRFS (hazard ratio [HR], 1.38; 95% CI, 1.13 to 1.69; P = .002) than the 7/8-BM group and higher cGVHD and trend toward inferior CRFS (HR, 1.36; 95% CI, 1.14 to 1.63; P = .0006) than the UCB group. Among patients with RIC, all groups had significantly inferior GRFS and CRFS compared with the haploidentical group. Conclusion: Recognizing the limitations of a registry retrospective analysis and the possibility of center selection bias in choosing donors, our data support the use of UCB, 7/8-BM, or 7/8-PB (with serotherapy) grafts for patients undergoing MAC HCT and haploidentical grafts for patients undergoing RIC HCT. The haploidentical group had the best GRFS, CRFS, and OS of all groups.
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    Improved Reproducibility and Quality of GVHD Biomarker Assay- Application of Multiplex Microfluidic Channel System
    (Springer Nature, 2016) Anandi, Prathima; Tian, Xin; Chinian, Fariba; Cantilena, Caroline R.; Dunavin, Neil; Hensel, Nancy; Draper, Debbie; Koklanaris, Eleftheria; Maxwell, Sandra; Superata, Jeanine; Muranski, Pawel; Battiwalla, Minoo; Paczesny, Sophie; Barrett, A. John; Ito, Sawa; Pediatrics, School of Medicine
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    Risk and Outcome of Breakthrough COVID-19 Infections in Vaccinated Patients With Cancer: Real-World Evidence From the National COVID Cohort Collaborative
    (American Society of Clinical Oncology, 2022) Song, Qianqian; Bates, Benjamin; Shao, Yu Raymond; Hsu, Fang-Chi; Liu, Feifan; Madhira, Vithal; Mitra, Amit Kumar; Bergquist, Timothy; Kavuluru, Ramakanth; Li, Xiaochun; Sharafeldin, Noha; Su, Jing; Topaloglu, Umit; National COVID Cohort Collaborative Consortium; Biostatistics and Health Data Science, School of Medicine
    Purpose: To provide real-world evidence on risks and outcomes of breakthrough COVID-19 infections in vaccinated patients with cancer using the largest national cohort of COVID-19 cases and controls. Methods: We used the National COVID Cohort Collaborative (N3C) to identify breakthrough infections between December 1, 2020, and May 31, 2021. We included patients partially or fully vaccinated with mRNA COVID-19 vaccines with no prior SARS-CoV-2 infection record. Risks for breakthrough infection and severe outcomes were analyzed using logistic regression. Results: A total of 6,860 breakthrough cases were identified within the N3C-vaccinated population, among whom 1,460 (21.3%) were patients with cancer. Solid tumors and hematologic malignancies had significantly higher risks for breakthrough infection (odds ratios [ORs] = 1.12, 95% CI, 1.01 to 1.23 and 4.64, 95% CI, 3.98 to 5.38) and severe outcomes (ORs = 1.33, 95% CI, 1.09 to 1.62 and 1.45, 95% CI, 1.08 to 1.95) compared with noncancer patients, adjusting for age, sex, race/ethnicity, smoking status, vaccine type, and vaccination date. Compared with solid tumors, hematologic malignancies were at increased risk for breakthrough infections (adjusted OR ranged from 2.07 for lymphoma to 7.25 for lymphoid leukemia). Breakthrough risk was reduced after the second vaccine dose for all cancers (OR = 0.04; 95% CI, 0.04 to 0.05), and for Moderna's mRNA-1273 compared with Pfizer's BNT162b2 vaccine (OR = 0.66; 95% CI, 0.62 to 0.70), particularly in patients with multiple myeloma (OR = 0.35; 95% CI, 0.15 to 0.72). Medications with major immunosuppressive effects and bone marrow transplantation were strongly associated with breakthrough risk among the vaccinated population. Conclusion: Real-world evidence shows that patients with cancer, especially hematologic malignancies, are at higher risk for developing breakthrough infections and severe outcomes. Patients with vaccination were at markedly decreased risk for breakthrough infections. Further work is needed to assess boosters and new SARS-CoV-2 variants.
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    Somatic mutational landscape of hereditary hematopoietic malignancies caused by germline variants in RUNX1, GATA2, and DDX41
    (American Society of Hematology, 2023) Homan, Claire C.; Drazer, Michael W.; Yu, Kai; Lawrence, David M.; Feng, Jinghua; Arriola-Martinez, Luis; Pozsgai, Matthew J.; McNeely, Kelsey E.; Ha, Thuong; Venugopal, Parvathy; Arts, Peer; King-Smith, Sarah L.; Cheah, Jesse; Armstrong, Mark; Wang, Paul; Bödör, Csaba; Cantor, Alan B.; Cazzola, Mario; Degelman, Erin; DiNardo, Courtney D.; Duployez, Nicolas; Favier, Remi; Fröhling, Stefan; Rio-Machin, Ana; Klco, Jeffery M.; Krämer, Alwin; Kurokawa, Mineo; Lee, Joanne; Malcovati, Luca; Morgan, Neil V.; Natsoulis, Georges; Owen, Carolyn; Patel, Keyur P.; Preudhomme, Claude; Raslova, Hana; Rienhoff, Hugh; Ripperger, Tim; Schulte, Rachael; Tawana, Kiran; Velloso, Elvira; Yan, Benedict; Kim, Erika; Sood, Raman; Hsu, Amy P.; Holland, Steven M.; Phillips, Kerry; Poplawski, Nicola K.; Babic, Milena; Wei, Andrew H.; Forsyth, Cecily; Fan, Helen Mar; Lewis, Ian D.; Cooney, Julian; Susman, Rachel; Fox, Lucy C.; Blombery, Piers; Singhal, Deepak; Hiwase, Devendra; Phipson, Belinda; Schreiber, Andreas W.; Hahn, Christopher N.; Scott, Hamish S.; Liu, Paul; Godley, Lucy A.; Brown, Anna L.; NISC Comparative Sequencing Program; Pediatrics, School of Medicine
    Individuals with germ line variants associated with hereditary hematopoietic malignancies (HHMs) have a highly variable risk for leukemogenesis. Gaps in our understanding of premalignant states in HHMs have hampered efforts to design effective clinical surveillance programs, provide personalized preemptive treatments, and inform appropriate counseling for patients. We used the largest known comparative international cohort of germline RUNX1, GATA2, or DDX41 variant carriers without and with hematopoietic malignancies (HMs) to identify patterns of genetic drivers that are unique to each HHM syndrome before and after leukemogenesis. These patterns included striking heterogeneity in rates of early-onset clonal hematopoiesis (CH), with a high prevalence of CH in RUNX1 and GATA2 variant carriers who did not have malignancies (carriers-without HM). We observed a paucity of CH in DDX41 carriers-without HM. In RUNX1 carriers-without HM with CH, we detected variants in TET2, PHF6, and, most frequently, BCOR. These genes were recurrently mutated in RUNX1-driven malignancies, suggesting CH is a direct precursor to malignancy in RUNX1-driven HHMs. Leukemogenesis in RUNX1 and DDX41 carriers was often driven by second hits in RUNX1 and DDX41, respectively. This study may inform the development of HHM-specific clinical trials and gene-specific approaches to clinical monitoring. For example, trials investigating the potential benefits of monitoring DDX41 carriers-without HM for low-frequency second hits in DDX41 may now be beneficial. Similarly, trials monitoring carriers-without HM with RUNX1 germ line variants for the acquisition of somatic variants in BCOR, PHF6, and TET2 and second hits in RUNX1 are warranted.
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    The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms
    (Springer Nature, 2022) Alaggio, Rita; Amador, Catalina; Anagnostopoulos, Ioannis; Attygalle, Ayoma D.; Araujo, Iguaracyra Barreto de Oliveira; Berti, Emilio; Bhagat, Govind; Borges, Anita Maria; Boyer, Daniel; Calaminici, Mariarita; Chadburn, Amy; Chan, John K. C.; Cheuk, Wah; Chng, Wee-Joo; Choi, John K.; Chuang, Shih-Sung; Coupland, Sarah E.; Czader, Magdalena; Dave, Sandeep S.; de Jong, Daphne; Du, Ming-Qing; Elenitoba-Johnson, Kojo S.; Ferry, Judith; Geyer, Julia; Gratzinger, Dita; Guitart, Joan; Gujral, Sumeet; Harris, Marian; Harrison, Christine J.; Hartmann, Sylvia; Hochhaus, Andreas; Jansen, Patty M.; Karube, Kennosuke; Kempf, Werner; Khoury, Joseph; Kimura, Hiroshi; Klapper, Wolfram; Kovach, Alexandra E.; Kumar, Shaji; Lazar, Alexander J.; Lazzi, Stefano; Leoncini, Lorenzo; Leung, Nelson; Leventaki, Vasiliki; Li, Xiao-Qiu; Lim, Megan S.; Liu, Wei-Ping; Louissai, Abnerm, Jr.; Marcogliese, Andrea; Medeiros, L. Jeffrey; Michal, Michael; Miranda, Roberto N.; Mitteldorf, Christina; Montes-Moreno, Santiago; Morice, William; Nardi, Valentina; Naresh, Kikkeri N.; Natkunam, Yasodha; Ng, Siok-Bian; Oschlies, Ilske; Ott, German; Parrens, Marie; Pulitzer, Melissa; Rajkumar, S. Vincent; Rawstron, Andrew C.; Rech, Karen; Rosenwald, Andreas; Said, Jonathan; Sarkozy, Clémentine; Sayed, Shahin; Saygin, Caner; Schuh, Anna; Sewell, William; Siebert, Reiner; Sohani, Aliyah R.; Tooze, Reuben; Traverse-Glehen, Alexandra; Vega, Francisco; Vergier, Beatrice; Wechalekar, Ashutosh D.; Wood, Brent; Xerri, Luc; Xiao, Wenbin; Pathology and Laboratory Medicine, School of Medicine
    We herein present an overview of the upcoming 5th edition of the World Health Organization Classification of Haematolymphoid Tumours focussing on lymphoid neoplasms. Myeloid and histiocytic neoplasms will be presented in a separate accompanying article. Besides listing the entities of the classification, we highlight and explain changes from the revised 4th edition. These include reorganization of entities by a hierarchical system as is adopted throughout the 5th edition of the WHO classification of tumours of all organ systems, modification of nomenclature for some entities, revision of diagnostic criteria or subtypes, deletion of certain entities, and introduction of new entities, as well as inclusion of tumour-like lesions, mesenchymal lesions specific to lymph node and spleen, and germline predisposition syndromes associated with the lymphoid neoplasms.