Robyn Western

Human Gastrointestinal Neoplasia-Associated Myofibroblasts Can Develop from Bone Marrow-Derived Cells Following Allogeneic Stem Cell Transplantation†‡

This study characterized the contribution of bone marrow‐derived cells to human neoplasia and the perineoplastic stroma. The Australasian Bone Marrow Transplant Recipient Registry was used to identify solid organ neoplasia that developed in female recipients of male allogeneic stem cell transplants. Eighteen suitable cases were identified including several skin cancers, two gastric cancers, and one rectal adenoma. Light microscopy, fluorescence and chromogenic in situ hybridization, and immunohistochemistry were performed to determine the nature and origin of the neoplastic and stromal cells. In contrast to recent reports, donor‐derived neoplastic cells were not detected. Bone marrow‐derived neoplasia‐associated myofibroblasts, however, were identified in the rectal adenoma and in a gastric cancer. Bone marrow‐derived cells can generate myofibroblasts in the setting of human gastrointestinal neoplasia. STEM CELLS 2009;27: 1463–1468

Combination antithymocyte globulin and soluble TNFα inhibitor (etanercept) +/- mycophenolate mofetil for treatment of steroid refractory acute graft-versus-host disease

Antitumor necrosis factor-α antibodies are increasingly being used for the treatment of steroid-refractory acute graft-versus-host disease (GVHD) complicating allogeneic stem cell transplantation. We retrospectively reviewed the outcomes of 16 patients with refractory acute predominantly visceral GVHD treated with combination antithymocyte globulin (ATG), tacrolimus and etanercept +/− mycophenolate mofetil (MMF) at our institution. Overall response rate (CR+PR) was 81%, with median survival post commencing salvage immunosuppression 224 days (range 20–1216 days). In total, eight patients (50%) died, including from progressive GVHD in two cases (13%), infection in five (31%) and relapse of underlying malignancy in one (6%). In comparison to our previous experience of ATG+tacrolimus as treatment for refractory visceral GVHD, both response rate and overall survival were improved with addition of etanercept, with no apparent increase in infectious complications. As such, use of etanercept in combination with ATG +/− MMF for treatment of steroid refractory acute GVHD appears to be associated with high response rates, significant survival and no unexpected toxicity. Further study of this immunosuppression combination in a larger cohort of patients in this setting is indicated.

Impact of stem cell donation modality on normal donor quality of life: a prospective randomized study

Summary:As part of a previously reported trial comparing granulocyte-colony stimulating factor (G-CSF) stimulated bone marrow and peripheral blood stem cells (PBSCs) in allogeneic stem cell transplantation, we included a questionnaire to compare donor morbidity and long-term complications between the two donation procedures. Bone marrow donation was associated with significantly more donors experiencing localized pain at the donation site compared to PBSC collection. However, this was not associated with any increased delay in returning to normal activity. Although a minority of bone marrow donors suffered chronic pain at the donation site, no serious long-term side effects relating to G-CSF stimulated stem cell donation were identified.

Outcomes after major or bidirectional ABO‐mismatched allogeneic hematopoietic progenitor cell transplantation after pretransplant isoagglutinin reduction with donor‐type secretor plasma with or without plasma exchange

BACKGROUND: Major ABO mismatch in hematopoietic progenitor cell transplantation (HPCT) is associated with a range of immunohematologic consequences including progenitor cell infusion (PCI)‐related hemolysis, delayed red blood cell engraftment, and pure red cell aplasia (PRCA). Although pretransplant (recipient) isoagglutinin reduction may be associated with decreased immunohematologic complications in this setting, there is no consensus with respect to strategies for isoagglutinin reduction.

Outcome of myeloablative allogeneic stem cell transplantation in multiple myeloma with a 153Sm-EDTMP-based preparative regimen.

Outcome of myeloablative allogeneic stem cell transplantation in multiple myeloma with a 153 Sm-EDTMP-based preparative regimen

Predicting survival for myeloid leukemia after HLA-identical sibling donor allogeneic stem cell transplantation

Predicting survival for myeloid leukemia after HLA-identical sibling donor allogeneic stem cell transplantation