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Stem Cell Transplants
Last update:
06/18/2013 |
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Introduction
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In the News
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Medicare coverage for
transplant in lymphoma?
This document might assist. It looks like it is
covered to us.
NC Division of Medical Assistance Medicaid and Health Choice
Hematopoietic Stem-Cell & Clinical Coverage Policy No:
11A-11
Bone Marrow Transplantation Revised Date: March 1, 2012 For
Non-Hodgkin's Lymphoma
http://www.ncdhhs.gov/dma/mp/11A11.pdf
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ASCO POST, May
2013: Role of Stem Cell Transplantation in
[transformed] Follicular Lymphoma
ascopost.com
Dr. Armitage is Joe Shapiro Professor of Medicine and
Professor and Chair of Oncology, University of Nebraska
Medical School, Omaha.
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ASCO POST, May
2013:
Autologous Stem Cell Transplant Improves Survival in
Transformed Follicular Lymphoma
ascopost.com
This retrospective cohort
study included 172 patients aged 18 to 65 years with
follicular lymphoma and subsequent biopsy-proven aggressive
histology transformation.
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PubMed:
Physical activity for patients undergoing an
allogeneic hematopoietic stem cell transplantation:
benefits of a moderate exercise intervention.
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Overview
Stem cell transplants
(bone marrow transplant) - the goal of this treatment is to cure the
patient with aggressive therapies that partially or completely kill
off (ablate) the normal stem cells in the marrow. These cells are then replaced with the patient's own stem cells
- harvested prior to treatment, or obtained from a donor.
Bone marrow is the spongy tissue found in the cavities of the body's bones, where all the body's blood cells are produced.
Stem cells are
immature cells found in the marrow and peripheral blood that develop
or mature into red blood cells, white blood cells and platelets.
Types:
allogeneic and autologous are the two main types of
stem cell transplantation (or rescue). Allogeneic stem cells
are derived from a matched donor (such as a sibling); in the
autologous type, stem cells are derived from the patient.
Each type has unique risks and benefits, and which is preferred
can depend on the clinical details.
See for example, one
study comparing SCT types
General exclusion
criteria? "Stem cell transplant (SCT)
protocols often require complete response with initial therapy as
a requirement for entry, although "good partial
remission" may be acceptable at certain centers. *
Other limitations for SCT protocols
include age greater than 60 or 65 years, significant chronic
obstructive pulmonary, renal, or cardiac disease, a poor
performance status, and central nervous system involvement."
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* Source: Treatment of relapsed
aggressive lymphomas: regimens with and without high-dose therapy
and stem cell rescue.
National Bone Marrow Donor
Program
call 800 MARROW2 ( 800 627-7692 )
and become a registered donor
BMTInfoNet
(Stem Cell Transplant Support)
2900 Skokie Valley Road, Suite B
Highland Park, IL 60035
Search
for Stem Cell Transplant Centers
BMTinfoNet
Also
provides: background, the number of transplants done,
Minimum Donor Match Criteria, Contacts, Support Groups Available
Phone: 847.433.3313 - during regular business hours, toll-free
888.597.7674
Be the Match
The Donor Selection & Transplant Process
marrow.org
Background & Resources
Also see Stem Cell Transplants: When and Which
Type?
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Role of Stem Cell transplant
in Follicular lymphoma,
Foster, Gabriel, Shea, 2010
ncbi.nlm.nih.gov |
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Full
Recovery After Cell Transplantation for Treating Leukemia or
Lymphoma
Can Take 3-5 Years fhcrc.org
n = 319 adults who had myeloablative (bone-marrow suppression) HCT
for treatment of leukemia or lymphoma, 5-year follow-up.
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University
of North Carolina Transplant guide for Patients and caregivers PDF
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About Hematopoietic Stem Cell Transplantation e-medicine
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Review Article:
Hematopoietic Cell Transplantation for NHL:
Yesterday, Today, and Tomorrow JCO
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Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation:
Questions and Answers cis.nci.nih.gov
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Comparison of
autologous and allogeneic hematopoietic stem cell transplantation
for follicular lymphoma - Blood First Edition Paper July 31,
2003 Summary
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Eligibility Criteria
for Stem Cell Transplants cancer.dartmouth.edu
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Long-term results favor allogeneic over autologous
hematopoietic stem cell transplantation in patients with
refractory or recurrent indolent non-Hodgkin's lymphoma.
Ann Oncol. 2003 May;14(5):737-44. PMID:
12702528 | Related
articles
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Managing Indolent Lymphomas in Relapse asheducation.org
Working Our Way Through a Plethora of Options (includes SCT
guidance)
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SCT for Low grade
Lymphoma asheducationbook.org
/2004 full text | PAL's
readable version
"In Section III, Dr. Koen Van Besien provides
a well-documented update on outcomes associated with
autologous and allogeneic stem cell transplantation for
FL. The results of trials of autologous stem cell
transplantation in first remission and recent data supporting
a role for graft purging are discussed.
Based on the
premise that a graft-versus-lymphoma effect is operative in
FL, reduced-intensity allogeneic transplantation is the preferred
approach in many cases, and recently reported results are
summarized. Criteria for patient selection and the
optimal role of transplantation in the overall
therapeutic plan for the patient with FL are presented."
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Stem Cell Transplants - Guest Author Series PLWC.org
(2007)
1) Understanding Bone Marrow and Stem Cell Transplantation
Part
I
2) Bone Marrow and Stem Cell Transplantation: Special types of
transplantation Part
II
3) Side Effects of Bone Marrow and Stem Cell Transplantation
Part
III
4) Questions and Answers About Bone Marrow and Stem Cell
Transplantation Part
IV
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Lymphoma subtype-specific
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Mantle Cell:
The Role of Autologous Transplantation in the Management of Mantle Cell Lymphoma:
A Study From the EBMT E. Vandenberghe, C. Ruiz de Elvira, P. Isaacson, E. Lopez-Guillermo,
E.
Conde, C. Gisselbrecht, F. Guilhot, A. Goldstone, N. Schmitz PDF
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Resources
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BMTInfoNet (Stem Cell Transplant Support)
2900 Skokie Valley Road, Suite B
Highland Park, IL 60035
Search
for Stem Cell Transplant Centers
Provides: Background, Number of transplants done,
Minimum Donor Match Criteria, Contacts, Support Groups Available
Phone: 847.433.3313 - during regular business hours, toll-free
888.597.7674
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BMT Worksheet - Factors to consider when
choosing a center fhcrc.org
- PDF
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What to bring to hospital cyberfamily
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How long does it take to have an SCT? AM's story
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Research News
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Outcomes
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Long-term survival of patients with resistant
lymphoma treated with tandem stem cell transplant.
Leuk Lymphoma. 2005 Mar;46(3):405-14.
PMID:
15621831 |
Related
articles |
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Stem cell transplantation in follicular lymphoma:
progress at last?
Bone Marrow Transplant. 2004 Oct 18
PMID:
15489883 |
Related
articles |
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Radioimmunotherapy as part of conditioning for SCT
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Tositumomab (Bexxar) Plus Stem Cell Transplant Induces Remission
in Refractory B-Cell Lymphoma
Medscape
free login req.
This "interesting approach"
increases the possibility of reduction of tumor burden before
transplant, Dr. Schrier said. "This looks really
promising." |
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The Role of Radiolabeled Monoclonal Antibodies as Part of the Conditioning Regimen for Non-Hodgkin’s Lymphoma Autografts John W. Sweetenham
~ University of Colorado Health Sciences Center, Denver, Colorado, USA
static.cjp.com
PDF |
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High-dose radioimmunotherapy (Bexxar) versus conventional
high-dose therapy and autologous hematopoietic stem cell
transplantation for relapsed follicular non-Hodgkin's lymphoma: a
multivariable cohort analysis. Blood. 2003 May 15
Full Text |
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Myeloablative radiochemotherapy followed by autologous stem
cell transplantation in first remission prolongs progression-free
survival [Compared to consolidation with INF] in follicular
lymphoma: results of a prospective, randomized trial of the German
Low-Grade Lymphoma Study Group
bloodjournal.org
Oct 2004
Commentary
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Side effects:
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Antibiotic prophylaxis in neutropenic patients:
new evidence, practical decisions.
Cancer. 2006 Oct 15;107(8):1743-51. Review.
PMID:
16977651
New evidence shows that antibiotic prophylaxis in neutropenic
patients reduces mortality, febrile episodes, and bacterial
infections. |
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Cognitive function recovers after stem cell transplant
oncolink.org
To investigate, the researchers initially studied 286 patients who
were randomized to be tested pre-transplant and 6 and 12 months, and
another 124 were tested at 6 and 12 months. Eighty-three patients who
were tested at 12 months only were not included in the analysis.
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Palifermin (Kepivance, Amgen), (rHu-KGF) Improves Quality of Life in Patients Undergoing Stem Cell Transplantation
CancerConsultants
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Cytochrome P450 2C19 loss-of-function polymorphism is
associated with an increased treatment-related mortality in patients
undergoing allogeneic transplantation. Bone Marrow Transplant. 2007
Oct;40(7):659-64. Epub 2007 Aug 6. PMID:
17680025
Comment: Probably this finding needs to be validated (reproduced by
an independent group) before being declared as true, but it shows how
normal variations in patients (a polymorphism) can affect
outcomes. In this case, treatment-related mortality is strongly
correlated with a specific normal genetic variation
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Prognostic
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The impact of histologic grade on the outcome
of high-dose therapy and autologous stem cell transplantation for
follicular lymphoma
Nature.com
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Prognostic value of FDG-PET scan imaging in
lymphoma patients undergoing autologous stem cell transplantation.
Bone Marrow Transplant. 2006 Jun 12; PMID:
16770314
A positive FDG-PET scan after salvage chemotherapy and prior
ASCT indicates an extremely poor chance of durable response after
ASCT. |
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Infused CD34 cell dose, but not tumour cell content
of peripheral blood progenitor cell grafts, predicts clinical outcome in
patients with diffuse large B-cell lymphoma and follicular lymphoma
grade 3 treated with high-dose therapy. Br J Haematol. 2004
Jun;125(5):605-12.
PMID:
15147376
Also see
Lazarus.pdf
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Comorbidity Index Aids Stem Cell Transplant Choices
Medscape
(free login req.)
"reporting co morbidity data of the type used in this index
will likely become as important as defining cancer diagnosis,
disease stage, remission status, and other more familiar
prognostic variables." |
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Life After SCT
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General:
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Study Finds Overall Health and Quality of Life Intact
10 Years
After Stem-Cell Transplantation prnewswire.com
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Re-immunization after SCT?
Question:
When you have a bone
marrow transplant does your immune system go back to that of a baby? Do
you then have to build immunity to everything all over again? What about
things like childhood vaccines? Are they lost?
Yes, the conditioning therapies for SCT are
likely to remove or impair immunities to infections gained from natural
exposures or vaccinations. The highest risk for infectious
complications is soon after the immune-ablative therapy prior to the
reconstitution of the engrafted immune system.2
The speed with which immune function
recovers after HSCT depends on many factors: the type of graft (Allogenic,
autologous, syngenic, T-cell repleted, T-cell depleted) 1,6
Immunocompromised patients and their
household contacts should not receive some live-attenuated vaccine.
Travel should be avoided if possible and
extra precautions should be taken when traveling is necessary. 5
Bottom line: Please talk with
your transplant team regarding the optimal schedule for re-vaccinations
and how to minimize risks of infection following recovery from SCT.
You should receive detailed information regarding which
immunizations to receive and when.
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Vaccination of stem cell transplant recipients: murciasalud.es
pdf
recommendations of the Infectious Diseases Working Party of the EBMT
The EBMT produced recommendations for vaccination of SCT recipients
in 1995, which were updated in 1999. The United States Center for
Disease Control (CDC) published recommendations in 2000. The aim of this
paper is to update our previous recommendations. These are graded
according to CDC guidelines as described in Table 1 and summarized in
Table 2.
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Vaccines for Transplant Recipients . Infectious Disease Clinics of North America , Volume 15 , Issue 1 , Pages 273 - 305 D . Molrine , P . Hibberd
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Recovery of immune reactivity after T-cell–depleted
bone marrow transplantation depends on thymic activity bloodjournal.hematologylibrary.org
pdf
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Travel vaccines: current practice and future aspects expert-reviews.com/
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Bone Marrow Transplantation, Long-Term Effects, immuno-suppressive
emedicine.com
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Vaccines following hematological stem cell transplants focosi.altervista.org
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Also See Immunization
Guide
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Adjuvants
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An adjuvant is an agent that may improve how a therapy works, or that
may reduce side effects without compromising efficacy.
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ASH 2002:
Proleukin®
Plus Rituxan® may Reduce Recurrences Following Stem Cell Transplant
in Non-Hodgkin’s Lymphoma CancerConsultants.com
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Cytokine improves immune function after bone marrow
transplantation in mice www.oncolink.com
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Filgrastim: Treatment of aggressive non-Hodgkin's
lymphoma with chemotherapy in combination with filgrastim. Drugs.
2002;62 Suppl 1:33-46. Review. PMID: 12479593 PubMed
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Parenteral
glutamine protects hepatic function during bone marrow transplantation.
Brown SA
et.al.
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Glutamine
supplementation in cancer patients receiving bone marrow transplantation
and high dose chemotherapy. J
Nutr. 2001 Sep;131(9 Suppl):2578S-84S;
discussion 2590S. Review. PMID: 11533316
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Oral
and parenteral glutamine in bone marrow transplantation: a randomized,
double-blind study. Schloerb PR, Skikne BS. PubMed
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