Terry J. Fry

Eradication of disseminated adenovirus infection in a pediatric hematopoietic stem cell transplantation recipient using the novel antiviral agent CMX001.

Adenovirus infection is a serious and often fatal complication in hematopoietic stem cell transplant patients. There are currently no FDA-approved therapies for adenovirus infection, with only anecdotal, off-label uses described for a variety of anti-viral agents or immune therapies. We report the first case of successful eradication of disseminated adenovirus infection by the novel antiviral agent CMX001 in a severely immunocompromised pediatric stem cell transplant recipient following failure to respond to intravenous cidofovir. Complete clinical and virologic response was documented; virologic and pharmacokinetic data are reported. CMX001 is a promising new oral antiviral agent under development for the prophylaxis and treatment of severe infections caused by double-stranded DNA viruses including adenovirus in immunocompromised patients.

CD34+ collection efficiency as a function of blood volumes processed in pediatric autologous peripheral blood stem cell collection

To characterize the relationship between CD34+ collection efficiency and blood volumes processed in pediatric patients undergoing autologous peripheral blood stem cell (PBSC) collection.

The Graft-Versus-Tumor Effect in Pediatric Malignancy

Because severe forms of the graft-versus-host reaction directed against normal tissues (also termed graft-versus-host disease [GVHD]) also contribute to morbidity and mortality following allogeneic hematopoietic stem cell transplantation, major efforts have focused on strategies to separate GVHD from the potentially beneficial immune reactivity against tumor (also called the graft-versus-tumor [GVT] effect). This article focuses on the data supporting the contribution of the GVT effect to cure of malignancy, what is known about the biology of the GVT reaction, and, finally, strategies to manipulate the GVT effect to increase the potency of HSCT.

Expanding options to improve outcomes following hematopoietic stem cell transplantation.

Allogeneic hematopoietic stem cell transplantation (HSCT) offers a curative option for children with a number of potentially lethal malignant and non‐malignant conditions. Decisions regarding the appropriateness of HSCT for a given patient involve careful consideration of the risks associated with HSCT and the likelihood of cure. This is particularly important as the procedure is being used with increasing frequency for diagnoses such as high‐risk sickle cell anemia where the disease is associated with shortened lifespan but death generally occurs in adulthood. Recent advances in supportive care such as improved anti‐microbial agents, the use of reduced intensity conditioning regimens and high‐resolution HLA typing that allows for better donor selection have all contributed to improved outcomes. However, the risk of treatment‐related mortality remains approximately 5–10%, in part due to complications such as veno‐occlusive disease (VOD) for which there has been less progress. Pediatr Blood Cancer. 2010;55:1043–1044.

Cancer Immunotherapy: Will Expanding Knowledge Lead to Success in Pediatric Oncology?

The past 25 years have seen an increase in our understanding of immunology and further expansion in the clinical use of immunotherapeutic modalities. How immunotherapy will be integrated with chemotherapy, radiation, and surgery remains to be established. Although there have been successes in the field of immunotherapy, they have been inconsistent, and it is hoped that increased understanding of the basic principles of immunology will improve the consistency of beneficial effects. In this article, we briefly provide a general overview of our current understanding of the immune system, with a focus on concepts in tumor immunology, followed by a discussion of how these concepts are being used in the clinic.

Cancer Immunotherapy : Will Expanding Knowledge Lead to Success in Pediatric Oncology?

The past 25 years have seen an increase in our understanding of immunology and further expansion in the clinical use of immunotherapeutic modalities. How immunotherapy will be integrated with chemotherapy, radiation, and surgery remains to be established. Although there have been successes in the field of immunotherapy, they have been inconsistent, and it is hoped that increased understanding of the basic principles of immunology will improve the consistency of beneficial effects. In this article, we briefly provide a general overview of our current understanding of the immune system, with a focus on concepts in tumor immunology, followed by a discussion of how these concepts are being used in the clinic.

Is a little GVHD a good thing

In this issue of Blood , Clave and colleagues explore the impact of acute GVHD on thymic recovery following hematopoietic stem cell transplantation and begin to address the mechanism by which alloreactivity may impair thymic function in humans.

Analysis of pediatric autologous PBSC apheresis and transplant: Age is a major factor affecting post-transplant toxicity†

High‐dose chemotherapy followed by autologous hematopoietic cell transplantation (HCT) is used in many therapeutic protocols for pediatric intra‐ and extra‐cranial solid tumors. HCT can be curative, but is associated with significant toxicity.