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2 results on '"Angel Diaz M"'

1. Outcomes following autologous hematopoietic stem cell transplant for patients with relapsed Wilms’ tumor: a CIBMTR retrospective analysis

Author

Malogolowkin, MH, Hemmer, MT, Le-Rademacher, J, Hale, GA, Mehta, PA, Smith, AR, Kitko, C, Abraham, A, Abdel-Azim, H, Dandoy, C, Angel Diaz, M, Gale, RP, Guilcher, G, Hayashi, R, Jodele, S, Kasow, KA, MacMillian, ML, Thakar, M, Wirk, BM, Woolfrey, A, and Thiel, EL

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Oncology and Carcinogenesis, Clinical Research, Stem Cell Research - Nonembryonic - Human, Stem Cell Research, Transplantation, Clinical Trials and Supportive Activities, Rare Diseases, Stem Cell Research - Nonembryonic - Non-Human, Cancer, Regenerative Medicine, Good Health and Well Being, Adolescent, Adult, Child, Child, Preschool, Female, Hematopoietic Stem Cell Transplantation, Humans, Infant, Male, Recurrence, Retrospective Studies, Salvage Therapy, Survival Analysis, Transplantation, Autologous, Treatment Outcome, Wilms Tumor, Young Adult, Clinical Sciences, Immunology, Cardiovascular medicine and haematology, Oncology and carcinogenesis
Abstract

Despite the marked improvement in the overall survival (OS) for patients diagnosed with Wilms' tumor (WT), the outcomes for those who experience relapse have remained disappointing. We describe the outcomes of 253 patients with relapsed WT who received high-dose chemotherapy (HDT) followed by autologous hematopoietic stem cell transplant (HCT) between 1990 and 2013, and were reported to the Center for International Blood and Marrow Transplantation Research. The 5-year estimates for event-free survival (EFS) and OS were 36% (95% confidence interval (CI); 29-43%) and 45% (95 CI; 38-51%), respectively. Relapse of primary disease was the cause of death in 81% of the population. EFS, OS, relapse and transplant-related mortality showed no significant differences when broken down by disease status at transplant, time from diagnosis to transplant, year of transplant or conditioning regimen. Our data suggest that HDT followed by autologous HCT for relapsed WT is well tolerated and outcomes are similar to those reported in the literature. As attempts to conduct a randomized trial comparing maintenance chemotherapy with consolidation versus HDT followed by stem cell transplant have failed, one should balance the potential benefits with the yet unknown long-term risks. As disease recurrence continues to be the most common cause of death, future research should focus on the development of consolidation therapies for those patients achieving complete response to therapy.

Published
2017

2. Impact of HLA mismatch direction on outcomes after umbilical cord blood transplantation for hematological malignant disorders: a retrospective Eurocord-EBMT analysis

Author

Cunha, R, Loiseau, P, Ruggeri, A, Sanz, G, Michel, G, Iori, Ap, Paolaiori, A, Socié, G, Arcese, W, Picardi, A, Dias de Heredia, C, Rio, B, Locatelli, F, O'Brien, Ta, Yakoub-Agha, I, Angel Diaz, M, Milpied, N, Bittencourt, H, Pedro Souza, M, Aljurf, M, Charron, D, Boudjedir, K, Labopin, M, Gluckman, E, and Rocha, V

Subjects
Oncology, Male, Cord blood transplantation, Neutrophils, Graft vs Host Disease, Histocompatibility Testing, HLA Antigens, Surveys and Questionnaires, Child, HLA mismatches direction, education.field_of_study, Homozygote, Hematology, Middle Aged, Treatment Outcome, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Cord blood, Child, Preschool, Hematologic Neoplasms, Histocompatibility, Female, Cord Blood Stem Cell Transplantation, Adult, Blood Platelets, medicine.medical_specialty, Adolescent, Population, cord blood transplantation, Human leukocyte antigen, Disease-Free Survival, Young Adult, Internal medicine, medicine, Settore MED/05 - Patologia Clinica, Humans, education, Preschool, malignant diseases, Aged, Retrospective Studies, Malignant diseases, Transplantation, Umbilical Cord Blood Transplantation, business.industry, Infant, Multivariate Analysis, medicine.disease, Settore MED/15, HLA Mismatch, Graft-versus-host disease, Immunology, business, Settore MED/15 - Malattie del Sangue
Abstract

HLA matching is a critical determinant of outcomes for patients who have undergone umbilical cord blood transplantation (UCBT). Data have been published on the importance of donor/recipient HLA mismatch direction on UCBT outcomes. HLA mismatch in the graft-versus-host (GVH) direction is defined as a donor homozygous at an HLA locus, while the recipient shares one HLA Ag with the donor. HLA mismatch in the host-versus-graft (HVG) direction is defined as a recipient homozygous with the donor sharing one HLA Ag. In our study we focused on confirming, using an independent population, whether transplantation outcomes would be different when HLA mismatch direction was considered. We analyzed 1565 patients who received a single-unit UCBT for malignant disease. Median age was 15 years and 72% of patients were transplanted for leukemia. In multivariate analysis, using the 5/6 HLA-matched population as reference, one or two HLA mismatches in the GVH or HVG direction were not associated with non-relapse related mortality and survival. On the basis of our results, there is no evidence to support a change in the current practice for cord blood unit selection.

Published
2014

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