@article{RobindeWreedeWolschkeetal.2019, author = {Robin, Marie and de Wreede, Liesbeth C. and Wolschke, Christine and Schetelig, Johannes and Eikema, Diderik-Jan and Van Lint, Maria Teresa and Knelange, Nina Simone and Beelen, Dietrich and Brecht, Arne and Niederwieser, Dietger and Vitek, Antonin and Bethge, Wolfgang and Arnold, Renate and Finke, J{\"u}rgen and Volin, Liisa and Yakoub-Agha, Ibrahim and Nagler, Arnon and Poir{\´e}, Xavier and Einsele, Hermann and Chevallier, Patrice and Holler, Ernst and Ljungman, Per and Robinson, Stephen and Radujkovic, Alekxandar and McLornan, Donal and Chalandon, Yves and Kr{\"o}ger, Nicolaus}, title = {Long-term outcome after allogeneic hematopoietic cell transplantation for myelofibrosis}, series = {Haematologica}, volume = {104}, journal = {Haematologica}, number = {9}, doi = {10.3324/haematol.2018.205211}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-226386}, pages = {1782-1788}, year = {2019}, abstract = {Allogeneic hematopoietic stem cell transplant remains the only curative treatment for myelofibrosis. Most post-transplantation events Aoccur during the first two years and hence we aimed to analyze the outcome of 2-year disease-free survivors. A total of 1055 patients with myelofibrosis transplanted between 1995 and 2014 and registered in the registry of the European Society for Blood and Marrow Transplantation were included. Survival was compared to the matched general population to determine excess mortality and the risk factors that are associated. In the 2-year survivors, disease-free survival was 64\% (60-68\%) and overall survival was 74\% (71-78\%) at ten years; results were better in younger individuals and in women. Excess mortality was 14\% (8-21\%) in patients aged <45 years and 33\% (13-53\%) in patients aged >= 65 years. The main cause of death was relapse of the primary disease. Graft-versus-host disease (GvHD) before two years decreased the risk of relapse. Multivariable analysis of excess mortality showed that age, male sex recipient, secondary myelofibrosis and no GvHD disease prior to the 2-year landmark increased the risk of excess mortality. This is the largest study to date analyzing long-term outcome in patients with myelofibrosis undergoing transplant. Overall it shows a good survival in patients alive and in remission at two years. However, the occurrence of late complications, including late relapses, infectious complications and secondary malignancies, highlights the importance of screening and monitoring of long-term survivors.}, subject = {Midollo-Osseo}, language = {en} } @article{TsamadouFuerstVucinicetal.2017, author = {Tsamadou, Chrysanthi and F{\"u}rst, Daniel and Vucinic, Vladan and Bunjes, Donald and Neuchel, Christine and Mytilineos, Daphne and Gramatzki, Martin and Arnold, Renate and Wagner, Eva Maria and Einsele, Hermann and M{\"u}ller, Carlheinz and Schrezenmeier, Hubert and Mytilineos, Joannis}, title = {Human leukocyte antigen-E mismatch is associated with better hematopoietic stem cell transplantation outcome in acute leukemia patients}, series = {Haematologica}, volume = {102}, journal = {Haematologica}, number = {11}, doi = {10.3324/haematol.2017.169805}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-173325}, pages = {1947-1955}, year = {2017}, abstract = {The immunomodulatory role of human leukocyte antigen (HLA)-E in hematopoietic stem cell transplantation (HSCT) has not been extensively investigated. To this end, we genotyped 509 10/10 HLA unrelated transplant pairs for HLA-E, in order to study the effect of HLA-E as a natural killer (NK)-alloreactivity mediator on HSCT outcome in an acute leukemia (AL) setting. Overall survival (OS), disease free survival (DFS), relapse incidence (RI) and non-relapse mortality (NRM) were set as endpoints. Analysis of our data revealed a significant correlation between HLA-E mismatch and improved HSCT outcome, as shown by both univariate (53\% vs. 38\%, P=0.002, 5-year OS) and multivariate (hazard ratio (HR)=0.63, confidence interval (CI) 95\%=0.48-0.83, P=0.001) analyses. Further subgroup analysis demonstrated that the positive effect of HLA-E mismatch was significant and pronounced in advanced disease patients (n=120) (5-year OS: 50\% vs. 18\%, P=0.005; HR=0.40, CI 95\%=0.22-0.72, P=0.002; results from univariate and multivariate analyses, respectively). The study herein is the first to report an association between HLA-E incompatibility and improved post-transplant prognosis in AL patients who have undergone matched unrelated HSCT. Combined NK and T cell HLA-E-mediated mechanisms may account for the better outcomes observed. Notwithstanding the necessity for in vitro and confirmational studies, our findings highlight the clinical relevance of HLA-E matching and strongly support prospective HLA-E screening upon donor selection for matched AL unrelated HSCTs.}, language = {en} }