Sharma A, et al. – Researchers examined the relationship between the public reporting of HCT center-specific survival analysis (CSA) scores at United States transplant centers and patient volume. Results showed that centers with negative CSA scores experienced an 8-9% drop in patient volume the following year while neighboring centers saw a 3.5% increase. This suggests there may be unintended consequences of the public disclosure of CSA scores that could potentially restrict access to care, warranting further research into the reasons and impacts of these changes.
Al-Homsi AS, et al. – A recent clinical trial shows that the combination of post-transplant cyclophosphamide, abatacept, and a short course of tacrolimus (CAST) is safe and effective in reducing acute GVHD risk in recipients of peripheral blood haploidentical HCT. Results show promise for larger-scale trials and the potential to address health disparities for diverse patient populations.
Mehta R, et al. – Research shows that acute myeloid leukemia (AML) patients undergoing reduced-intensity conditioning (RIC) HCT with post-transplantation cyclophosphamide (PTCy) GVHD prophylaxis from younger HLA-matched unrelated donors (MUD) had better overall survival and lower risk of nonrelapse mortality compared to younger and older haploidentical (haplo) donor recipients. Research suggests a younger MUD may be recommended over a haplo donor for adult AML patients in complete remission receiving RIC-HCT with PTCy GVHD prophylaxis.
Miklos DB, et al.- Novel research published in the Journal of Clinical Oncology investigated the effectiveness of ibrutinib as a first-line treatment for newly diagnosed moderate or severe chronic graft-versus-host disease (cGVHD) in patients without prior systemic treatment. While the results did not show statistical significance in response rates, duration of response, and overall survival, the study emphasized the urgent need for more effective cGVHD treatments and research in this vital area.
Dehn J, et al. – Research presented at the European Society for Blood and Marrow Transplantation (EBMT) Annual Meeting showed that a donor search prognosis-based algorithm can be implemented into a multicenter trial and results in equivalent chances of patients receiving HCT regardless of their baseline search prognosis. The study suggests the algorithm can be a valuable tool for defining the donor search strategy and improving the success rate of transplantation in patients needing curative cellular therapy.
Liberio N, et al. – The CIBMTR conducted a study to address the lack of data guiding haploidentical (haplo) donor selection for pediatric HCT. Research presented at the European Society for Blood and Marrow Transplantation (EBMT) Annual Meeting showed that sibling donors had a lower risk of acute and chronic graft-versus-host disease and graft failure when compared to parental donors. The study suggests sibling donors may be the optimal haplo donor choice for pediatric HCT to minimize risks and improve outcomes.
Hill JA, et al. – Researchers examined the safety and immune response of COVID-19 vaccinations within the first year post-transplant in allogeneic hematopoietic cell transplantation (alloHCT) recipients, finding comparable outcomes, irrespective of the vaccination's timing. However, the less robust immune responses in alloHCT recipients compared to non-immunocompromised patients suggest a need for additional preventive measures and treatments, with vaccination initiation recommended 3 months post-transplant.
Oshima MU, et al. – Research published in Blood Advances compared CMV reactivation and disease in seropositive HCT recipients using different GVHD prophylaxis approaches. Post-transplant cyclophosphamide (PTCy) combined with a calcineurin inhibitor and mycophenolate mofetil was associated with a higher risk of early CMV reactivation. However, the risk of CMV disease was not significantly different, though patients who develop GVHD are more susceptible to CMV. This highlights that GVHD prevention remains a priority.
Hamed AB, et al. – Research published in Transplantation and Cellular Therapy showed factors associated with potential hematopoietic cell transplantation (HCT) donors aged 30 and younger opting out of donation on national donor registries. Results suggest potential approaches that national registries could consider to improve donor availability.
Jain T, et al. – Research found that outcomes of myelofibrosis patients receiving HCT were comparable between unrelated and haploidentical donor sources, with matched sibling donors still being the preferred option. This data was presented at the 2023 Tandem Meetings of the ASTCT and the CIBMTR.
Abid MB, et al. – Two research studies presented at the 2023 Tandem Meetings of the ASTCT and the CIBMTR compared the outcomes of adult allogeneic HCT recipients with AML and B-cell ALL based on donor type. Results showed recipients with older matched sibling donors had a significantly higher 5-year disease relapse than those with younger matched unrelated donors.
Mailankody S, et al. – A novel research study published in Nature Medicine reviewed the safety and feasibility of allogeneic chimeric antigen receptor (CAR) T-cell therapy in relapsed/refractory multiple myeloma patients. Results showed more than half of the patients responded to treatment despite expected adverse events, showing promise as a safe and effective option for patients with aggressive disease.
Abel GA, et al. – Research presented at the 64th American Society of Hematology (ASH) Annual Meeting and Exposition showed a shared care approach after allogeneic hematopoietic cell transplantation did not compromise non-relapse mortality and may be associated with improved quality of life.
Ballen K, et al. – According to research presented at the 64th American Hematology Association (ASH) Annual Meeting and Exposition, race and ethnicity matching may have minimal to no impact on umbilical cord hematopoietic cell transplant (UCB HCT) outcomes. Researchers compared outcomes of non-Hispanic White, non-Hispanic Black, Hispanic/Latinx, and Asian recipients of UCB HCT finding improved overall survival over time across all racial and ethnic groups.
Valcarcel B, et al. – Researchers examined the concordance of patient vital status and cause-specific mortality after first hematopoietic cell transplantation (HCT) between the CIBMTR database and the California Cancer Registry. Presented at the 64th American Society of Hematology (ASH) Annual Meeting and Exposition, results showed the consistency of vital status between the data sets was high; however, differences between reported data may be due to the length of follow-up and incomplete patient information.
Nosha F, et al. – Researchers found that low socioeconomic status, but not race and ethnicity, was associated with worse outcomes in patients with chronic graft-versus-host disease after allogeneic hematopoietic cell transplantation according to research presented at the 64th American Society of Hematology Annual Meeting and Exposition.
Stefanski HE, et al. – Research presented at the 64th American Society of Hematology (ASH) Annual Meeting and Exposition suggests peripheral blood stem cell donors receiving filgrastim are not at an increased risk of malignancy, autoimmune or thrombotic events compared to bone marrow donors who didn’t receive filgrastim.
Holtan SG, et al. – Research presented at the 64th American Society of Hematology Annual Meeting and Exposition showed patients with blood cancers who underwent allogeneic hematopoietic cell transplant and received a novel combination of post-transplant cyclophosphamide, tacrolimus, and mycophenolate mofetil (PTCy/Tac/MMF) compared to standard graft-versus-host disease (GVHD) prevention demonstrated significantly improved GVHD-free and relapse-free survival.
Najla El, J et al. – Research suggests no significant difference in patient-reported quality of life outcomes between patients receiving a related haploidentical donor or unrelated double umbilical cord blood donor hematopoietic cell transplant with reduced-intensity conditioning, according to data presented at the 64th American Society of Hematology Annual Meeting and Exposition.
Fingerson S, et al. – Research showed most patients who received haploidentical related donor hematopoietic cell transplantation were unlikely to have a fully matched (8/8) unrelated donor match but likely to have a single-mismatched (7/8) donor on the national registry. This data was presented at the 64th American Society of Hematology Annual Meeting and Exposition.
Niederwieser D, et al. – Research showed older patients with AML in their first complete remission who received allogeneic HCT had better outcomes than those who received non-transplant, conventional consolidation treatment. This data was presented at the 64th American Society of Hematology Annual Meeting and Exposition.
Stefanski HE, et al. – Research shows the number of HCT unrelated donors testing positive for COVID-19 following medical clearance for donation was 2.4-fold higher in the first half of 2022 compared to the first half of 2021 (n=53 vs. 22). Donor positivity led to transplantation postponement for some patients that already started conditioning and for all who had not started conditioning, highlighting the need for transplant centers to have a backup plan.
Stelljes M, et al. – Researchers presented this novel randomized controlled trial at the 64th Annual Meeting and Exposition of the American Society of Hematology. Results showed that patients with relapsed/refractory AML may have comparable remission and survival outcomes with sequential conditioning versus intensive induction chemotherapy before allogeneic HCT.
Salit RB, et al. – The American Society of Transplantation and Cellular Therapy (ASTCT) gathered a panel of experts in survivorship, rehabilitation, and psychological and logistical challenges to review research about patients with hematologic cancers returning to work post-hematopoietic cell transplantation. These experts produced an evidence-based guidance document to assist healthcare providers in navigating the barriers of post-transplant care and optimizing collaboration to help patients achieve this quality-of-life milestone.
Mehta R, et al. – Research published in Transplantation and Cellular Therapy shows better outcomes for matched unrelated donor and matched sibling donor hematopoietic cell transplantation (HCT) than haploidentical donor HCT when using post-transplant cyclophosphamide for graft-versus-host disease prevention in a single center study.
Hourigan CS, et al. – Research presented at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting explores a standardized approach to measurable residual disease (MRD) testing in patients with acute myeloid leukemia (AML) undergoing hematopoietic stem cell transplant (HCT). Results support MRD as a useful prognostic tool with the potential to identify relapse risk and provide opportunities to individualize treatment for optimal outcomes.
Abraham I, et al. – Research published in Blood Advances reviews health disparities among Non-Hispanic Black and Hispanic patients with acute myeloid leukemia (AML). Results show a novel structural racism variable accounts for nearly all disparity in AML survival in this first-of-its-kind analysis.
Steffens K, et al. – Research shared at the 2022 Tandem Meetings of the ASTCT and CIBMTR presents survey outcomes from community hematology/oncology physicians regarding the strength of their relationships with local transplant centers. Community physicians with a lower self-rated relationship strength with transplant centers reported less support for early HCT treatment behaviors and lower confidence in managing patients post-transplant.
Maakaron JE, et al. – Research published in
Bone Marrow Transplantation suggests that age alone should not be a deciding
factor when determining candidacy for transplant in adult patients with acute
myeloid leukemia (AML), and transplant should be considered a standard of care
option for patients of all ages with AML in first complete remission. This
study showed that all age groups reached comparable 3-year overall survival,
and differences between younger and older groups were better explained by
comorbidities and other factors than age.
Chowdhury AS, et al. – Research presented at the 2022 Tandem Meetings of the ASTCT and CIBMTR shows that expanding donor registry models to include mismatched unrelated donors (MMUDs) down to a 5/8 HLA match expands access to nearly 100% of patients in need of HCT. Based on alternative graft sources and advances in graft-versus-host disease prophylaxis following allogeneic HCT, MMUD has the potential to expand HCT access, particularly among racially and ethnically diverse patients.
Horowitz MM, et al. – Research presented at the 2022 Tandem Meetings of the ASTCT and CIBMTR shows that racially and ethnically diverse patients considering hematopoietic stem cell transplantation (HCT) are underrepresented in clinical trials conducted by the Blood and Marrow Transplant Clinical Trials Network (BMT CTN). Data suggest major barriers not only for enrollment in clinical trials, but for ensuring underrepresented groups are included in the overall pipeline for HCT consideration.
Fingerson S, et al. – Presented at the 2022 Tandem Meetings of the ASTCT and CIBMTR, researchers evaluated a new Search Summary Score tool to provide rapid assessment of donor search productivity, showcasing its ability to streamline the search process for HCT. This tool allows clinical teams to focus their search strategies on the most likely available donor sources, particularly for racially and ethnically diverse patients and others less likely to have an HLA fully matched donor.
Stefanski H, et al. – A report presented at the 2022 Tandem Meetings of the ASTCT and CIBMTR from the NMDP/Be The Match shows that despite the challenges of the COVID-19 pandemic, HCT products can be reliably sourced and preserved without negative impacts to donors or patients. Cryopreserved products and products from COVID-19 positive donors appear to pose no overt risk.
Riches ML, et al. – Early data in an ongoing study presented at the 2022 Tandem Meetings of the ASTCT and CIBMTR show COVID-19 vaccination is less effective in those who have undergone cellular transplants and therapies in the last year, with more data needed to determine the ideal timing and number of boosters needed for this population. Vaccination continues to be important following transplant due to higher risk of COVID-19 complications in these vulnerable patients.
Murthy GSG, et al. – Research published in JAMA Oncology finds relapse and disease-free survival advantages when using younger matched unrelated donors over older matched sibling donors for patients undergoing allogeneic hematopoietic stem cell transplantation for myelodysplastic syndrome.
Fuchs EJ, et al. – An observational study conducted by the CIBMTR published in Blood evaluated the impact of HLA-locus specific matching in haploidentical HCT using post-transplant cyclophosphamide (PTCy). The study results were used to create a tool to help with optimal haploidentical HCT donor selection based on predicted disease-free survival.
Wren J, et al. – Research presented at the 2022 Tandem Meetings of the ASTCT and CIBMTR shows the effectiveness of the NMDP/Be The Match BioBank, collaborating with multiple transplant centers and cell therapy labs to ensure access to hematopoietic cell transplantation (HCT) during the COVID-19 pandemic through cryopreservation.
Shaw BE, et al. – Research presented at the European Group for Blood and Marrow Transplantation (EBMT) Annual Meeting shows outcomes remain very good at 3-years for patients receiving a mismatched unrelated donor hematopoietic stem cell transplant (MMUD HCT) with post-transplant cyclophosphamide (PTCy). Patients receiving reduced-intensity conditioning (RIC) in particular have excellent survival and very low rates of chronic graft-versus-host disease (GVHD).
Qayed M, et al. – Research published in Blood Advances shows reductions in acute graft-versus-host disease (GVHD) in both matched unrelated and mismatched unrelated donor hematopoietic stem cell transplantation (MUD and MMUD HCT) when abatacept is added to standard of care treatment. Effects were substantial in MMUD, revealing abatacept as another promising tool to expand HCT access to those without a fully matched donor, which is more common for racially and ethnically diverse patients.
Battipaglia G, et al. – Research published in Bone Marrow Transplantation finds that less HLA mismatching is associated with better overall survival, non-relapse mortality, and leukemia-free survival when comparing one-antigen mismatched unrelated donor hematopoietic stem cell transplant to haploidentical donor HCT in the presence of post-transplant cyclophosphamide.
Nakamura R, et al. and Martens M, et al. – Outcomes of allogeneic hematopoietic cell transplantation (alloHCT) among older patients with advanced myelodysplastic syndrome (MDS) are similar to younger patients and result in no worse quality of life (QOL). Researchers shared these findings at the 62nd and 63rd American Society of Hematology (ASH) Annual Meeting and Exposition.
Zhang T, et al. – Two research studies presented at the 63rd American Society of Hematology (ASH) Annual Meeting and Exposition called attention to the National Marrow Donor Program®/Be The Match® precision medicine initiative by presenting novel prognostic signatures in allogeneic hematopoietic cell transplantation (HCT) patients with myelodysplastic syndrome (MDS) based on whole genome sequencing and examining the impact of genomic subgroups on survival.
Devine S, et al. – Planned cryopreservation of allogeneic hematopoietic cell transplantation (HCT) grafts during the COVID-19 pandemic did not adversely impact early post-HCT outcomes according to research presented at the 63rd American Society of Hematology (ASH) Annual Meeting and Exposition.
Kean LS, et al. – Patients treated with abatacept in combination with the current standard of care for acute graft-versus-host disease prophylaxis after mismatched unrelated donor (7/8 MMUD) allogeneic hematopoietic stem cell transplantation (HCT) had significantly better survival outcomes according to research presented at the 63rd American Society of Hematology (ASH) Annual Meeting and Exposition.
Mussetti A, et al. – More apples-to-apples research evidence that matched unrelated donor (MUD) hematopoietic cell transplant (HCT) results in superior patient outcomes than haploidentical related donor HCT when available was presented at the 63rd American Society of Hematology (ASH) Annual Meeting and Exposition.
Khera N, et al. – Research presented at the 63rd American Society of Hematology (ASH) Annual Meeting and Exposition shows that rates of autologous and allogeneic hematopoietic cell transplants (HCT) have increased more rapidly among African American, Hispanic, and other underserved populations than among non-Hispanic whites from 2009 to 2018. However, a challenge still exists to close the gaps in overall survival for African American and other pediatric patients.
Gooptu M, et al., Blood—An observational study from the CIBMTR Graft Sources Working Committee found that 8/8 matched unrelated donor hematopoietic cell transplantation (HCT) with PTCy based graft versus host disease (GVHD) prophylaxis resulted in superior overall survival and disease-free survival compared to haploidentical HCT with PTCy in the reduced intensity conditioning (RIC) setting for treatment of acute leukemia and myelodysplastic syndromes. It is the first known study that offers a direct comparison between the two donor sources using PTCy.
Use of MMUDs can expand HCT access for ethnically diverse populations.
John M.
Pagel, MD, PhD, Megan Othus, PhD, et al – Barriers to human leukocyte antigen (HLA) typing and
cytogenetic testing can significantly impact the overall survival of patients
newly diagnosed with acute myeloid leukemia (AML). In this landmark
study, a concerted effort to address those issues and streamline the initiation
of donor identification and referral for hematopoietic cell transplant (HCT)
consultation in early disease state led to a higher CR1 transplantation rate
and improved 2-year overall survival.
Hsu J, et. al., Blood—Researchers presented data at the 62nd ASH Annual Meeting and Exposition on the impact of using fresh versus cryopreserved allogeneic bone marrow (BM) and peripheral blood stem cells (PBSC) grafts on patient allogeneic hematopoietic cell transplant (alloHCT) outcomes.
Auletta J, et al., Transplantation and Cellular Therapy—A manuscript published in
Transplantation and Cellular Therapy offered the first report on the impact of
the COVID-19 pandemic on the ability of the National Marrow Donor Program®
(NMDP)/Be The Match® and the Network to safely deliver unrelated donor products
early in the pandemic. The authors found that the NMDP/Be The Match and Network
partners continued to effectively deliver domestic and unrelated donor products
to allogeneic transplant patients in similar or shorter timeframes than before
COVID-19, despite the many unexpected challenges brought about by the pandemic.
Maakaron J, et al., ASH abstract poster presentation, December 2020—The CIBMTR® (Center for International Blood and Marrow Transplant Research®) presented their study results suggesting that efforts should focus on minimizing residual disease and better donor selection as age alone is not a barrier to successful hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML) in CR1 and should not exclude patients from HCT.
Dehn J, et al., Blood – A panel of immunogeneticists and other experts in the field of hematopoietic cell transplantation (HCT) has published updated evidence-based guidelines for the optimal selection of unrelated donors and cord blood units used for transplants.
The updated guidelines make recommendations for both HLA and non-HLA factors to consider in graft selection, including donor availability, donor age, patient sensitivity to HLA antigens, natural killer (NK) cell alloreactivity, and minimum total nucleated cell doses and CD34+ cell doses for cord blood units.
Shimoni A, et al., Biol Blood Marrow Transplant – In an analysis of 1134 patients age 50 or older with acute myeloid leukemia (AML), two-year hematopoietic cell transplant (HCT) survivors experienced comparable 10-year leukemia-free survival (LFS) and overall survival (OS) with matched sibling or unre-lated donors.
Cappelli B, et al. Haematologica – The youngest of three age-based patient cohorts (age 0-5 years) in a study of 736 patients with sickle cell disease (SCD) undergoing HLA-identical sibling hematopoietic cell transplantation (HCT) experienced 4-year event-free survival of 93%, results the researchers characterized as “excellent.”
Bolaños-Meade J, et al., The Lancet Haematology – In a
prospective, phase II trial, researchers found that tacrolimus, mycophenolate mofetil, with
post-hematopoietic cell transplant (HCT) cyclophosphamide (TMMCy) produced the
best GVHD-free,
relapse-free survival (GRFS) for patients who received an allogeneic HCT when
compared to the current standard of care.
Zeiser R, et al. Blood – The latest research in cellular therapies, antibody-based treatments, and tyrosine kinase inhibitor (TKI)-based approaches to enhance GVL effects are outlined in articles published in a special edition of Blood.