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  • 1. Abelsson, J
    et al.
    Merup, M
    Birgegård, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    WeisBjerrum, O
    Brinch, L
    Brune, M
    Johansson, P
    Kauppila, M
    Lenhoff, S
    Liljeholm, M
    Malm, C
    Remes, K
    Vindelöv, L
    Andréasson, B
    The outcome of allo-HSCT for 92 patients with myelofibrosis in the Nordic countries2012In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 47, no 3, p. 380-386Article in journal (Refereed)
    Abstract [en]

    Between 1982 and 2009 a total of 92 patients with myelofibrosis (MF) in chronic phase underwent allo-SCT in nine Nordic transplant centers. Myeloablative conditioning (MAC) was given to 40 patients, and reduced intensity conditioning (RIC) was used in 52 patients. The mean age in the two groups at transplantation was 46±12 and 55±8 years, respectively (P<0.001). When adjustment for age differences was made, the survival of the patients treated with RIC was significantly better (P=0.003). Among the RIC patients, the survival was significantly (P=0.003) better for the patients with age <60 years (a 10-year survival close to 80%) than for the older patients. The type of stem cell donor did not significantly affect the survival. No significant difference was found in TRM at 100 days between the MAC- and the RIC-treated patients. The probability of survival at 5 years was 49% for the MAC-treated patients and 59% in the RIC group (P=0.125). Patients treated with RIC experienced significantly less aGVHD compared with patients treated with MAC (P<0.001). The OS at 5 years was 70, 59 and 41% for patients with Lille score 0, 1 and 2, respectively (P=0.038, when age adjustment was made). Twenty-one percent of the patients in the RIC group were given donor lymphocyte infusion because of incomplete donor chimerism, compared with none of the MAC-treated patients (P<0.002). Nine percent of the patients needed a second transplant because of graft failure, progressive disease or transformation to AML, with no significant difference between the groups. Our conclusions are (1) allo-SCT performed with RIC gives a better survival compared with MAC. (2) age over 60 years is strongly related to a worse outcome and (3) patients with higher Lille score had a shorter survival.

  • 2.
    Afram, G.
    et al.
    Karolinska Inst, Med, Stockholm, Sweden..
    Watz, E.
    ONK PAT, Ctr Apheresis, Stockholm, Sweden..
    Remberger, M.
    ONK PAT, Ctr Allogene Stem Cell Transplantat, Immunol, Stockholm, Sweden..
    Axdorph-Nygell, U.
    ONK PAT, Ctr Apheresis, Stockholm, Sweden..
    Sundin, M.
    Karolinska Inst, Pediat Haematol, Stockholm, Sweden..
    Hagglund, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Mattsson, J.
    Karolinska Inst, Ctr Stem Cell Transplantat, Stockholm, Sweden..
    Uhlin, M.
    Karolinska Inst, Ctr Stem Cell Transplantat, Stockholm, Sweden..
    Extracorporeal photopheresis as treatment for moderate-severe chronic graft-versus-host disease2016In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 51, p. S138-S138Article in journal (Other academic)
  • 3. Al Hashmi, S.
    et al.
    Sadeghi, B.
    Hassan, Z.
    Abedi-Valugerdi, M.
    Lindskog, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Oncology.
    Hassan, M.
    Omega-3 from fish oil augments GVHD through the enhancement of chemotherapy conditioning regimen and selective FoxP3 depletion2013In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 48, no 6, p. 843-848Article in journal (Refereed)
    Abstract [en]

    Omega-3 is known to enhance the effects of several chemotherapeutic agents and to exert several immunoregulatory actions In the present study, we evaluated the effects of a 21-day feeding regimen with omega-3-rich fish oil (FO) and its corresponding control, omega-6 rich corn oil (CO), on the BU-CY conditioning and the development of GVHD after BMT in mice. Before conditioning, FO, but not CO, feeding caused a significant attenuation in the number and functionality of splenic FoxP3+ T regulatory cells (Treg). FO feeding also enhanced the effects of the conditioning through severe depletion of Treg cells in the spleen and CD11b+ myeloid cells in both the BM and spleen. Consequently, FO-fed animals conditioned with BU-CY showed exacerbated GVHD following transplantation with allogeneic BM and splenic cells. In contrast, identical transplantation in CO-fed mice resulted in poor engraftment and body weight loss. Moreover, in standard-fed recipients, BMT with cells from FO-fed donors resulted in moderate GVHD and improved the survival time, whereas BMT with cells from CO-fed donors shortened the survival time and caused anemia. We conclude that food supplements should be considered in patients undergoing BMT and/or chemotherapy treatment.

  • 4.
    Burman, J
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
    Kirgizov, K
    Carlson, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Badoglio, M
    Mancardi, G L
    De Luca, G
    Casanova, B
    Ouyang, J
    Bembeeva, R
    Haas, J
    Bader, P
    Snowden, J
    Farge, D
    Autologous hematopoietic stem cell transplantation for pediatric multiple sclerosis: a registry-based study of the Autoimmune Diseases Working Party (ADWP) and Pediatric Diseases Working Party (PDWP) of the European Society for Blood and Marrow Transplantation (EBMT).2017In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 52, no 8, p. 1133-1137Article in journal (Refereed)
    Abstract [en]

    Autologous hematopoietic stem cell transplantation (aHSCT) is a promising therapy for multiple sclerosis (MS), which has mainly been used in adults. The purpose of this study was to investigate efficacy and adverse events of aHSCT in the treatment of children with MS using data from the European Society for Blood and Marrow Transplantation registry. Twenty-one patients with a median follow-up time of 2.8 years could be identified. PFS at 3 years was 100%, 16 patients improved in expanded disability status scale score and only 2 patients experienced a clinical relapse. The procedure was generally well tolerated and only two instances of severe transplant-related toxicity were recorded. There was no treatment-related mortality, although one patient needed intensive care. aHSCT may be a therapeutic option for children with disease that does not respond to standard care.

  • 5.
    Chen, Y-B
    et al.
    Massachusetts Gen Hosp, Yawkey 9E 9052 55 Fruit St, Boston, MA 02114 USA..
    Wang, T.
    Med Coll Wisconsin, Ctr Int Blood, Marrow Transplant Res, Dept Med, Milwaukee, WI USA.;Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI USA..
    Hemmer, M. T.
    Med Coll Wisconsin, Ctr Int Blood, Marrow Transplant Res, Dept Med, Milwaukee, WI USA..
    Brady, C.
    Natl Marrow Donor Program Be Match, Ctr Int Blood, Marrow Transplant Res, Minneapolis, MN USA..
    Couriel, D. R.
    Marrow Transplant Program, Utah Blood, Salt Lake City, UT USA..
    Alousi, A.
    Univ Texas MD Anderson Canc Ctr, Div Canc Med, Dept Stem Cell Transplantat, Houston, TX 77030 USA..
    Pidala, J.
    H Lee Moffitt Canc Ctr & Res Inst, Res Inst, Tampa, FL USA..
    Urbano-Ispizua, A.
    Univ Barcelona, IDIBAPS, Hosp Clin, Barcelona, Spain.;Univ Barcelona, Inst Res Josep Carreras, Dept Hematol, Hosp Clin, Barcelona, Spain..
    Choi, S. W.
    Univ Michigan, Ann Arbor, MI 48109 USA..
    Nishihori, T.
    H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA..
    Teshima, T.
    Univ Hosp, Fukuoka, Japan..
    Inamoto, Y.
    Natl Canc Ctr, Div Hematopoiet Stem Cell Transplantat, Tokyo, Japan..
    Wirk, B.
    Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA..
    Marks, D. I.
    Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England..
    Abdel-Azim, H.
    Univ So Calif, Keck Sch Med, Marrow Transplantat, Div Hematol Oncol & Blood, Los Angeles, CA 90033 USA..
    Lehmann, L.
    Boston Childrens Hosp, Dana Farber Canc Inst, Boston, MA USA..
    Yu, L.
    Louisiana State Univ, Med Ctr, Div Hematol Oncol, Childrens Hosp,Ctr Canc & Blood Disorders,HSC, New Orleans, LA USA..
    Bitan, M.
    Tel Aviv Sourasky Med Ctr, Tel Aviv, Dept Pediat Hematol Oncol, Tel Aviv, Israel..
    Cairo, M. S.
    New York Med Coll, Div Pediat Hematol Oncol, Stem Cell Transplantat, Dept Pediat, Valhalla, NY USA..
    Qayed, M.
    Emory Univ, Sch Med, Dept Pediat, Atlanta, GA, Australia..
    Salit, R.
    Fred Hutchinson Canc Res Ctr, Seattle, WA USA..
    Gale, R. P.
    Imperial Coll London, Hematol Res Ctr, Div Expt Med, Dept Med, London, England..
    Martino, R.
    Hosp Santa Creu St Pau, Div Clin Hematol, Barcelona, Spain..
    Jaglowski, S.
    Ohio State Univ, Med Ctr, Div Hematol, Columbus, OH 43210 USA..
    Bajel, A.
    Royal Melbourne Hosp City Campus, Melbourne, Australia..
    Savani, B.
    Vanderbilt Univ, Med Ctr, Div Hematol Oncol, Dept Med, Nashville, TN USA..
    Frangoul, H.
    Vanderbilt Univ, Sch Med, Div Hematol Oncol, Dept Pediat, Nashville, TN USA..
    Lewis, I. D.
    Royal Adelaide Hosp, Haematol & Bone Marrow Transplant Unit, Adelaide, SA, Australia..
    Storek, J.
    Univ Calgary, Dept Med, Calgary, AB, Canada..
    Askar, M.
    Baylor Univ, Med Ctr, Dallas, TX USA..
    Kharfan-Dabaja, M. A.
    H Lee Mofitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA..
    Aljurf, M.
    King Faisal Specialist Hosp Ctr & Res, Dept Oncol, Riyadh, Saudi Arabia..
    Ringden, O.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Div Therapeut Immunol, Dept Lab Med, Stockholm, Sweden..
    Reshef, R.
    Columbia Univ, Med Ctr, Blood & Marrow Transplantat Program, Columbia Ctr Translat Immunol, New York, NY USA..
    Olsson, R. F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Div Therapeut Immunol, Dept Lab Med, Stockholm, Sweden..
    Hashmi, S.
    Mayo Clin Rochester, Rochester, MN USA..
    Seo, S.
    Nat Canc Res Ctr, East Hosp, Kashiwa, Chiba, Japan..
    Spitzer, T. R.
    MacMillan, M. L.
    Univ Minnesota, Med Ctr, Minneapolis, MN USA..
    Lazaryan, A.
    Univ Minnesota, Med Ctr, Div Hematol Oncol, Dept Med, Minneapolis, MN USA..
    Spellman, S. R.
    Arora, M.
    Cutler, C. S.
    Dana Farber Canc Inst, Ctr Hematol Oncol, Dept Med Oncol, Boston, MA USA..
    GvHD after umbilical cord blood transplantation for acute leukemia: an analysis of risk factors and effect on outcomes2017In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 52, no 3, p. 400-408Article in journal (Refereed)
    Abstract [en]

    Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, we analyzed 1404 umbilical cord blood transplantation (UCBT) patients (single (>= 18 years) = 810, double (< 18 years) = 594) with acute leukemia to define the incidence of acute GvHD (aGvHD) and chronic GvHD (cGvHD), analyze clinical risk factors and investigate outcomes. After single UCBT, 100-day incidence of grade II-IV aGvHD was 39% (95% confidence interval (CI), 36-43%), grade III-IV aGvHD was 18% (95% CI, 15-20%) and 1-year cGvHD was 27% (95% CI, 24-30%). After double UCBT, 100-day incidence of grade II-IV aGvHD was 45% (95% CI, 41-49%), grade III-IV aGvHD was 22% (95% CI, 19-26%) and 1-year cGvHD was 26% (95% CI, 22-29%). For single UCBT, multivariate analysis showed that absence of antithymocyte globulin (ATG) was associated with aGvHD, whereas prior aGvHD was associated with cGvHD. For double UCBT, absence of ATG and myeloablative conditioning were associated with aGvHD, whereas prior aGvHD predicted for cGvHD. Grade III-IV aGvHD led to worse survival, whereas cGvHD had no significant effect on disease-free or overall survival. GvHD is prevalent after UCBT with severe aGvHD leading to higher mortality. Future research in UCBT should prioritize prevention of GvHD.

  • 6.
    Frisk, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Arvidson, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Bratteby, Lars-Eric
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Hedenström, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Lönnerholm, Gudmar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Pulmonary function after autologous bone marrow transplantation in children: a long-term prospective study2004In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 33, p. 645-650Article in journal (Refereed)
    Abstract [en]

    We performed serial pulmonary function tests (PFTs) consisting of spirometry and diffusing capacity in 26 children after BMT. The median follow-up was 10 years. The influence of total body irradiation (TBI) on long-term pulmonary function was of particular interest. In the 20 children who had received TBI, after an initial decrease the PFTs showed recovery, but the mean lung volumes were still significantly decreased 5 years after BMT at 10% below baseline. The proportions of children with restrictive impairment 5 and 10 years after BMT were 20 and 21%, respectively. Only one child was diagnosed with obstructive impairment. The proportions of children with isolated diffusing impairment at 5 and 10 years were 7/20 (35%) and 7/13 (54%), respectively. Six children had received chemotherapy only and showed isolated diffusing impairment as the only long-term sequela in 4/5 and 1/3 at 5 and 10 years. Our main finding was that there was little change in PFTs 1–10 years after BMT. TBI was associated with persistently decreased lung volumes in a proportion of patients, whereas chemotherapy also might have been of importance for the development of impaired gas exchange.

  • 7.
    Frisk, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Arvidson, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Gustafsson, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Lönnerholm, Gudmar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Pubertal development and final height after autologous bone marrow transplantation for acute lymphoblastic leukemia2004In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 33, no 2, p. 205-210Article in journal (Refereed)
    Abstract [en]

    We describe pubertal development and growth in 17 children who underwent bone marrow transplantation (BMT), including total body irradiation (TBI) for ALL. Seven children also received cranial irradiation (CI) and five boys testicular irradiation. All underwent transplantation before (n=15) or at the beginning of (n=2) puberty and reached a final height (FH). Puberty started spontaneously in all boys not given testicular irradiation. All boys who received testicular irradiation developed hypergonadotrophic hypogonadism. Puberty started spontaneously in two girls and was induced with increasing doses of ethinylestradiol in two girls. In two girls, a low dose of ethinylestradiol was given until menarche. In one girl with early onset of puberty and short stature, puberty was blocked with a GnRH analogue. The standard deviation score for height decreased significantly from BMT to FH, both in the children who received TBI only (-1.1, P=0.005) as well as in those given additional CI (-1.7, P=0.027). Most of the loss occurred during puberty. In all, 10 children received growth hormone (GH) treatment. CI, young age at BMT, and short duration of GH treatment were predictors of height loss after BMT. Although limited by the small and heterogeneous sample, our study supports the use of early GH treatment in children with decelerating growth rate and low GH levels.

  • 8.
    Frisk, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Arvidson, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Ljunggren, Östen
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Gustafsson, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Decreased bone mineral density in young adults treated with SCT in childhood: the role of 25-hydroxyvitamin D2012In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 47, no 5, p. 657-662Article in journal (Refereed)
    Abstract [en]

    We measured bone mineral density (BMD) with dual-energy X-ray absorptiometry in the total body, at the lumbar spine, at the femoral neck and in the total hip, in 18 young adults with a median of 18.2 years after SCT. Fifteen patients had undergone auto-SCT and all patients had received TBI. The patients had significantly lower BMD in the total body, at the femoral neck, and in the total hip compared with age- and sex-matched controls. Six of 18 patients (33%) had low bone mass (z-score <−1) at one or more measurement sites, as opposed to two of the controls (11%, P=0.29). We found no significant influence of growth hormone levels or of untreated hypogonadism on BMD variables. Levels of 25-hydroxy (25(OH)) vitamin D were lower among the patients (35.2 vs 48.8 nmol/L, P=0.044) and were significantly correlated with total body BMD in the patient group (r=0.55, P=0.021). All six patients with low bone mass had hypovitaminosis D (37 nmol/L as opposed to 4 of the 11 (36%) patients without low bone mass (P=0.035). In conclusion, we found decreased BMD in SCT survivors, which may in part be caused by 25(OH) vitamin D deficiency.

  • 9.
    Frisk, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Boman, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Pauksen, Karlis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Petrini, B.
    Lönnerholm, Gudmar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Skin infection caused by Mycobacterium szulgai after allogenic bone marrow transplantation2003In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 31, no 6, p. 511-513Article in journal (Refereed)
    Abstract [en]

    Infections are responsible for a large part of the morbidity and mortality after BMT because of the sustained impairment of host defenses. We report a case of cutaneous infection caused by Mycobacterium szulgai in a boy who underwent BMT with marrow from a matched unrelated donor.

  • 10.
    Frisk, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Rössner, S M
    Department of Woman and Child Health, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
    Norgren, S
    Department of Woman and Child Health, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
    Arvidson, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Gustafsson, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Glucose metabolism and body composition in young adults treated with TBI during childhood2011In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 46, no 10, p. 1303-1308Article in journal (Refereed)
    Abstract [en]

    After SCT in childhood, survivors may develop disorders of glucose metabolism. The role of obesity is controversial. We measured insulin sensitivity using the homeostasis model assessment (HOMA) and the frequently sampled i.v. glucose tolerance test (FSIVGTT), as well as body composition using dual-energy X-ray absorptiometry in 18 young adults median 18.2 years after SCT and compared them with matched controls. We also measured growth hormone (GH) secretion, and levels of leptin and adiponectin. HOMA showed insulin resistance in eight patients (44%), as opposed to none of the controls (P=0.008) and FSIVGTT showed a decreased sensitivity index in the patients (2.98 vs 4.54 mU/L/min, P=0.042). Dual energy X-ray absorptiometry showed a higher percentage fat mass in the patients (34.9 vs 24.3%, P=0.011), which correlated inversely with the sensitivity index (r=-0.52, P=0.032). The patients had a lower peak value of GH (GH(max) 9 vs 20.7 mU/L, P=0.002). Time post SCT correlated with percentage fat mass and inversely with GH(max). The patients had higher levels of leptin and lower levels of adiponectin, even after adjustment for fat mass. We propose that the decreased insulin sensitivity may primarily be explained by the adverse body composition, which may owe to long-standing GH deficiency.

  • 11.
    Furebring, Mia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Öberg, G.
    Sjölin, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Side-effects of Amphotericin B lipid complex (Abelcet) in the Scandinavian population2000In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 25, no 3, p. 341-343Article in journal (Refereed)
  • 12.
    Goyal, S. D.
    et al.
    St Louis Univ, Med Ctr, St Louis, MO USA..
    Zhang, M-J
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA..
    Wang, H-L
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Akpek, G.
    Banner MD Anderson Canc Ctr, Hematol Oncol Sect, Gilbert, AZ USA..
    Copelan, E. A.
    Carolinas HealthCare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA..
    Freytes, C.
    South Texas Vet Hlth Care Syst, San Antonio, TX USA.;Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA..
    Gale, R. P.
    Univ London Imperial Coll Sci Technol & Med, Dept Med, Hematol Res Ctr, Div Expt Med, London, England..
    Hamadani, M.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Inamoto, Y.
    Natl Canc Ctr, Tokyo, Japan..
    Kamble, R. T.
    Baylor Coll Med, Div Hematol & Oncol, Ctr Cell & Gene Therapy, Houston, TX 77030 USA..
    Lazarus, H. M.
    Univ Hosp Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA..
    Marks, D. I.
    Univ Hosp Bristol NHS Trust, Pediat Bone Marrow Transplant, Bristol, Avon, England..
    Nishihori, T.
    Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL 33612 USA..
    Olsson, R. F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden..
    Reshef, R.
    Univ Penn, Med Ctr, Dept Med, Abramson Canc Ctr, Philadelphia, PA 19104 USA..
    Ritchie, D. S.
    Royal Melbourne Hosp, Melbourne, Vic, Australia..
    Saber, W.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Savani, B. N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Seber, A.
    Hosp Samaritano, Sao Paulo, Brazil..
    Shea, T. C.
    Univ North Carolina Hlth Care, Dept Med, Div Hematol & Oncol, Chapel Hill, NC USA..
    Tallman, M. S.
    Mem Sloan Kettering Canc Ctr, Dept Med, Leukemia Serv, New York, NY 10021 USA..
    Wirk, B.
    SUNY Stony Brook, Dept Internal Med, Med Ctr, Stony Brook, NY 11794 USA..
    Bunjes, D. W.
    Univ Ulm Klinikum, Dept Internal Med 3, Ulm, Germany..
    Devine, S. M.
    Ohio State Univ, Ctr Comprehens Canc, Dept Internal Med, Columbus, OH 43210 USA..
    de Lima, M.
    Univ Hosp Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA..
    Weisdorf, D. J.
    Univ Minnesota, Dept Med, Med Ctr, Div Hematol Oncol & Transplantat, Minneapolis, MN 55455 USA..
    Uy, G. L.
    Washington Univ, Dept Med, Sch Med, St Louis, MO 63110 USA..
    Allogeneic hematopoietic cell transplant for AML: no impact of pre-transplant extramedullary disease on outcome2015In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 50, no 8, p. 1057-1062Article in journal (Refereed)
    Abstract [en]

    The impact of extramedullary disease (EMD) in AML on the outcomes of allogeneic hematopoietic cell transplantation (alloHCT) is unknown. Using data from the Center for International Blood and Marrow Transplant Research, we compared the outcomes of patients who had EMD of AML at any time before transplant, with a cohort of AML patients without EMD. We reviewed data from 9797 AML patients including 814 with EMD from 310 reporting centers and 44 different countries, who underwent alloHCT between and 1995 and 2010. The primary outcome was overall survival (OS) after alloHCT. Secondary outcomes included leukemia-free survival (LFS), relapse rate and treatment-related mortality (TRM). In a multivariate analysis, the presence of EMD did not affect either OS (hazard ratio 1.00, 95% confidence interval (Cl) 0.91-1.09), LFS (0.98, 0.89-1.09), TRM (relative risk 0.92, 95% CI 0.80-1.16, P=0.23) or relapse (relative risk= 1.03, 95% CI, 0.92-1.16; P=0.62). Furthermore, the outcome of patients with EMD was not influenced by the location, timing of EMD, or intensity of conditioning regimen. The presence of EMD in AML does not affect transplant outcomes and should not be viewed as an independent adverse prognostic feature.

  • 13.
    Hagglund, H.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Askmark, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
    Strömberg, U.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Axelsson, H.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
    Svenningsson, A.
    Isaksson, C.
    Wahlin, A.
    Andersen, O.
    Johansson, J.
    Press, R.
    Autologous haematopoietic stem cell transplantation: a viable treatment option for chronic inflammatory demyelinating polyneuropathy2013In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 48, no Suppl. 2, p. S336-S336Article in journal (Other academic)
  • 14.
    Hallböök, Helene
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Hägglund, Hans
    Stockelberg, Dick
    Nilsson, Per-Gunnar
    Karlsson, Karin
    Björkholm, Magnus
    Linderholm, Mats
    Wahlin, Anders
    Linder, Olle
    Smedmyr, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Autologous and allogeneic stem cell transplantation in adult ALL: The Swedish Adult ALL Group experience2005In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 35, no 12, p. 1141-1148Article in journal (Refereed)
    Abstract [en]

    Adult patients with acute lymphoblastic leukaemia (ALL) have been treated according to national protocols in Sweden since 1986. Stem cell transplantation (SCT) has been recommended in first remission for patients with risk factors for relapse, and for standard risk patients only after relapse. In this retrospective study, the results of autologous and allogeneic SCT in these populations were evaluated. In total, 187 patients with a median age of 34 years (17-66 years) underwent SCT. The 5-year disease-free survival (DFS), for all patients, was 26% (Confidence intervals (CI) 20-32%). The 5-year DFS was higher for patients transplanted in first remission 32% (CI 24-40%) compared to 14% (CI 5-23%; P<0.0001) in patients transplanted beyond first remission. No significant differences in DFS (P=0.06) were determined between autologous, related donor and unrelated donor SCT in the whole cohort. A lower relapse rate was counterbalanced by higher treatment-related mortality in patients undergoing allogeneic SCT. In Philadelphia-positive ALL, allogeneic SCT was superior to autologous SCT, with a 5-year DFS of 30% (CI 12-47%) vs 0% (P=0.04). Limited chronic graft-versus-host-disease (GVHD) was associated with an improved DFS of 53% (CI 38-69%) compared to no chronic GVHD of 22% (CI 10-36%; P=0.0008), indicating a clinically important graft-versus-leukaemia effect.

  • 15. Hammarström, Viera
    et al.
    Pauksen, Karlis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Björkstrand, B.
    Simonsson, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Öberg, G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Ljungman, P.
    Tetanus immunity in autologous bone marrow and blood stem cell transplant recipients1998In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 22, no 1, p. 67-71Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to assess long-term immunity and reimmunization responses against tetanus toxoid in recipients of autologous stem cell grafts and to compare immune status in patients who underwent ABMT or autologous blood stem cell transplantation (APBSCT). Ninety patients were included in the study; 52 had received ABMT and 38 APBSCT. Thirty of 52 ABMT patients (58%) and 25 of 38 APBSCT patients (66%) had protective antibody levels against tetanus before transplantation (P = NS). The rate of seropositivity had decreased at 1 year after transplantation; 15 of 52 (29%) ABMT patients and 18 of 38 (47%) APBSCT patients (P = NS) were still positive after 1 year. There were no cases of spontaneous recovery in seronegative patients. Most patients were reimmunized with three doses of tetanus toxoid given at 12, 13, 14 and or 18 months after transplantation. All immunized patients had protective immunity against tetanus at 1 year after vaccination. These results suggest that humoral immunity is defective both after ABMT and after APBSCT and in both cases the loss of immunity seems to be similar. Reimmunization of patients who have undergone ABMT or APBSCT is necessary to obtain protective immunity against tetanus.

  • 16.
    Hägglund, Hans
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Remberger, M.
    Ringden, O.
    Twenty-year follow-up of a randomized trial comparing intraosseous and i.v. BM transplantation2014In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 49, no 12, p. 1541-1542Article in journal (Refereed)
  • 17.
    Höglund, M.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Smedmyr, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Simonsson, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Tötterman, Thomas H.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
    Bengtsson, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
    Dose-dependent mobilisation of haematopoietic progenitor cells in healthy volunteers receiving glycosylated rHuG-CSF1996In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 18, no 1, p. 19-27Article in journal (Refereed)
    Abstract [en]

    In an attempt to optimise the dose of G-CSF for mobilisation of PBPC in allogeneic donors, four groups of six healthy male volunteers received lenograstim (glycosylated rHuG-CSF) at a dose of 3, 5, 7.5 or 10 micrograms/kg/day, respectively, for 6 days (days 1-6). All subjects underwent a 10 I leukapheresis. Lenograstim was well tolerated. Maximal mobilisation was observed on days 5 or 6, with a clear dose-response for all progenitor cell types (CD34+, CFU-GM, BFU-E, CFU-mix). The peak numbers of CD34+ cells/microlitre (mean, s.e.m.) were 30 +/- 5, 49 +/- 8, 44 +/- 5 and 122 +/- 30 in the 3, 5, 7.5 and 10 micrograms/kg groups, respectively. A good correlation was observed between the number of CD34+ cells in blood and leukapheresis product (LP), respectively. Increasing the dose of lenograstim did not increase the number of T cells in the LP. A comparison of LP and steady state BM CD34+ cells in paired samples from each individual, showed a higher proportion of primitive immunophenotypes (CDw90+, HLA-DR-, CD45RA-, CD33-) among LP CD34+ cells. We conclude that increased doses of G-CSF improve the mobilisation of PBPC, and that G-CSF favours mobilisation of primitive CD34+ cell subsets. Lenograstim 10 micrograms/kg/day for 6 days should provide a sufficiently effective mobilisation of PBPC in most healthy PBPC donors.

  • 18.
    Innocenti, C.
    et al.
    Careggi Univ Hosp, Hematol, Florence, Italy; Northwestern Hosp, Dept Immunotherapy & Autoimmune Dis, Chicago, IL USA.
    Burman, Joachim
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
    Burns, C.
    Northwestern Univ, Dept Immunotherapy & Autoimmune Dis, Chicago, IL USA.
    Burt, R.
    Northwestern Hosp, Dept Immunotherapy & Autoimmune Dis, Chicago, IL USA.
    Inflammatory immune response after autologous transplantation in neurologic diseases2017In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 52, no Supplement: 1, p. S420-S420Article in journal (Other academic)
  • 19. Jalmsell, Li
    et al.
    Onelöv, Erik
    Steineck, Gunnar
    Henter, Jan-Inge
    Kreicbergs, Ulrika
    Hematopoietic stem cell transplantation in children with cancer and the risk of long-term psychologicaal morbidity in bereaved parents2011In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365Article in journal (Refereed)
  • 20. Johansson, J-E
    et al.
    Remberger, M.
    Lazarevic, V. Lj
    Hallböök, Helene
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Internal Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Wahlin, A.
    Kimby, E.
    Juliusson, G.
    Omar, H.
    Hägglund, H.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Allogeneic haematopoietic stem-cell transplantation with reduced intensity conditioning for advanced stage Hodgkin's lymphoma in Sweden: high incidence of post transplant lymphoproliferative disorder2011In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 46, no 6, p. 870-875Article in journal (Refereed)
    Abstract [en]

    Allogeneic transplantation after reduced intensity conditioning (allo-RIC) is a treatment option for patients with Hodgkin's lymphoma (HL) relapsing after autologous transplantation. In all, 23 adult patients with HL underwent allo-RIC in Sweden between 2000 and 2007. The median number of previous treatment lines was five and 20 patients (87%) were previously autografted. TRM at 100 days and at 1 year was 13 and 22% respectively. Acute GVHD grades II-IV developed in 7 out of 23 patients (30%) and chronic GVHD in 10 out of 20 patients at risk (50%). The OS and EFS at three years was 59 and 27%, respectively. Four patients (17%) developed post transplant lymphoproliferative disease (PTLD) after a median time of 55 days (range 38-95); two of these patients later died. The study confirmed that allo-RIC is feasible, but associated with a substantial relapse rate: only 20% of the patients were still alive 7 years after the transplant. A finding of high incidence of PTLD needs to be confirmed in a larger trial that includes patients with non-HL and CLL.

  • 21.
    Kinch, Amelie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
    Hallböök, Helene
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Arvidson, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Neuropediatrics/Paediatric oncology.
    Sällström, K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
    Bondeson, Kåre
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infection medicine.
    Pauksen, Karlis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
    Epstein-Barr virus-related disease after allogeneic HSCT and use of pre-emptive rituximab: Clinical Features And Outcome2017In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 52, no Supplement: 1, p. S88-S88Article in journal (Other academic)
  • 22.
    Legert, K. G.
    et al.
    Karolinska Inst, Dept Orofacial Diag & Surg, Dentmed, Huddinge, Sweden..
    Svanberg, Anncarin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Zuckerman, T.
    Rambam Hlth Care Campus, Haifa, Israel..
    Ram, R.
    Tel Aviv Med Ctr & Sch Med, Tel Aviv, Israel.;Tel Aviv Univ, IL-69978 Tel Aviv, Israel..
    Kolomansky, A.
    Tel Aviv Univ, Tel Aviv Sourasky Med Ctr, IL-69978 Tel Aviv, Israel..
    Romejko-Jarosinska, J.
    Maria Sklodowska Curie Mem Canc Ctr & Inst Oncol, Warsaw, Poland..
    Nasilowska-Adamska, B.
    Inst Haematol & Transfus Med, Warsaw, Poland..
    Effect of episil (R) oral liquid on oral mucositis severity and duration in HSCT patients2016In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 51, p. S410-S411Article in journal (Other academic)
  • 23. Lenhoff, S.
    et al.
    Dreimane, A.
    Ejerblad, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Isaksson, C.
    Ljungman, P.
    Brune, M.
    Recent results of allogeneic stem cell transplantation for myelofibrosis using reduced intensity conditioning - the Swedish experience2015In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 50, p. S493-S494Article in journal (Other academic)
  • 24. Ljungman, P.
    et al.
    Ward, K. N.
    Crooks, B. N.
    Parker, A.
    Martino, R.
    Shaw, P. J.
    Brinch, L.
    Brune, M.
    De La Camara, R.
    Dekker, A.
    Pauksen, Karlis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Russell, N.
    Schwarer, A. P.
    Cordonnier, C.
    Respiratory virus infections after stem cell transplantation: a prospective study from the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation2001In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 28, no 5, p. 479-484Article in journal (Refereed)
    Abstract [en]

    Community-acquired respiratory virus infections are a cause of mortality after stem cell transplantation (SCT). A prospective study was performed at 37 centers to determine their frequency and importance. Additional cases were also collected to allow the analysis of risk factors for severe infection. Forty episodes were collected in the prospective study and 53 additional episodes through subsequent case collection. The frequency of documented respiratory virus infections was 3.5% among 819 allogeneic and 0.4% among 1154 autologous SCT patients transplanted during the study period. The frequency of lower respiratory tract infections (LRTI) was 2.1% among allogeneic and 0.2% among autologous SCT patients. The mortality within 28 days from diagnosis of a respiratory viral infection was 1.1% among allogeneic SCT while no autologous SCT patient died. The deaths of five patients (0.6%) were directly attributed to a respiratory virus infection (three RSV; two influenza A). On multivariate analysis, lymphocytopenia increased the risk for LRTI (P = 0.008). Lymphocytopenia was also a significant risk factor for LRTI in patients with RSV infections. The overall mortality in RSV infection was 30.4% and the direct RSV-associated mortality was 17.4%. For influenza A virus infection, the corresponding percentages were 23.0% and 15.3%. This prospective study supports the fact that community-acquired respiratory virus infections cause transplant-related mortality after SCT.

  • 25. Ljungman, P.
    et al.
    Öberg, G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Aschan, J.
    Ehrnst, A.
    Lönnqvist, B.
    Pauksen, Karlis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Sulila, P.
    Foscarnet for pre-emptive therapy of CMV infection detected by a leukocyte-based nested PCR in allogeneic bone marrow transplant patients1996In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 18, no 3, p. 565-568Article in journal (Refereed)
    Abstract [en]

    Fifteen allogeneic BMT patients in a phase II study were given foscarnet 60 mg/kg twice daily for 14 days as pre-emptive therapy against CMV disease. CMV infection was diagnosed by a leukocyte-based nested PCR. All 15 patients were evaluable for toxicity. One patient did not fulfill the inclusion criteria of two consecutively positive CMV PCR tests and therefore was not evaluable for efficacy. Thus, 14 of 15 patients were evaluable for development of CMV disease. None of the patients developed CMV disease and all 14 assessable patients had a negative CMV isolation at the end of therapy. None of the 15 patients had to discontinue therapy due to toxicity. Six patients reported mild gastrointestinal disturbances, three patients headaches, and three patients mild urethritis or hemorrhagic cystitis. Serum-electrolyte disturbances were common including abnormal magnesium, potassium and calcium levels. Two patients developed mild serum-creatinine increases requiring adjustment of the foscarnet dosage according to protocol. We conclude that a dosage of foscarnet of 60 mg/kg given twice daily seems to be safe and effective in preventing CMV disease in allogeneic BMT recipients. A study comparing foscarnet and ganciclovir is indicated.

  • 26.
    Machaczka, M.
    et al.
    Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden.;Karolinska Univ Hosp, Hematol Ctr Karolinska, Stockholm, Sweden.
    Hägglund, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology. Karolinska Inst, Dept Med Huddinge, Uppsala, Sweden.
    Staver, E.
    Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden.
    Joks, M.
    Poznan Univ Med Sci, Dept Hematol & Bone Marrow Transplantat, Poznan, Poland.
    Hassan, M.
    Karolinska Inst, Dept Lab Med, Clin Res Ctr, Expt Canc Med, Stockholm, Sweden; Karolinska Univ Hosp, Dept Clin Res Ctr, Stockholm, Sweden.
    Wahlin, B. E.
    Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden; Karolinska Univ Hosp, Hematol Ctr Karolinska, Stockholm, Sweden.
    Nygell, U. Axdorph
    Karolinska Inst, Dept Oncol & Pathol, Stockholm, Sweden; Karolinska Univ Hosp, Dept Clin Immunol & Transfus Med, Stockholm, Sweden.
    G-CSF mobilized peripheral blood stem cell collection for allogeneic transplantation in healthy donors: Analysis Of Factors Affecting Yield2017In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 52, no Supplement: 1, p. S139-S139Article in journal (Other academic)
  • 27. Nyman, H.
    et al.
    Jantunen, E.
    Juvonen, E.
    Elonen, E.
    Böhm, J.
    Kosma, V-M.
    Enblad, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology, Oncology.
    Karjalainen-Lindsberg, M-L.
    Leppä, Sirpa
    Impact of germinal center and non-germinal center phenotypes on overall and failure-free survival after high-dose chemotherapy and auto-SCT in primary diffuse large B-cell lymphoma2008In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 42, no 2, p. 93-8Article in journal (Refereed)
    Abstract [en]

    Non-germinal center (non-GC) phenotype is an adverse prognostic factor in chemotherapy (CT)-treated diffuse large B-cell lymphoma (DLBCL) patients. To determine how high-dose therapy (HDT) supported with auto-SCT as first line therapy influences GC-associated outcome in young high-risk DLBCL patients GC and non-GC phenotypes were determined immunohistochemically from 63 patients. Of these, 29 primary high-risk DLBCL patients were treated with auto-SCT, whereas 34 CT-treated patients served as a control group. Consistent with previous studies, non-GC phenotype was associated with adverse outcome in CT-treated high-risk patients. In contrast, immunohistochemical classification by cell of origin did not associate with survival after auto-SCT. When the impact of treatment on the predictive value of cell of origin was analyzed, the non-GC patients, who received HDT, had a better failure-free survival (FFS) and overall survival (OS) than the patients treated with CT alone. In multivariate analyses, both age-adjusted International Prognostic Index (aaIPI) and treatment were independent prognostic factors for FFS and OS. For the patients with GC phenotype, the influence of auto-SCT on survival was not significant. The data imply that auto-SCT can overcome the adverse prognostic impact of the non-GC phenotype in patients with high-risk DLBCL and warrant additional prospective studies.

  • 28.
    Pahnke, Simon
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology. Falun Cty Hosp, Haematol, Falun, Sweden..
    Fischer-Nielsen, A.
    Copenhagen Univ Hosp, Clin Immunol, Copenhagen, Denmark..
    Haastrup, E.
    Copenhagen Univ Hosp, Clin Immunol, Copenhagen, Denmark..
    Heldal, D.
    Oslo Univ Hosp, Haematol, Oslo, Norway..
    Itala-Remes, M.
    Turku Univ Hosp, Stem Cell Transplantat Unit, FIN-20520 Turku, Finland..
    Kauppila, M.
    Turku Univ Hosp, Haematol, FIN-20520 Turku, Finland..
    Larfors, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology. Univ Uppsala Hosp, Haematol, Uppsala, Sweden..
    Niittyvuopio, R.
    Helsinki Univ Hosp, Stem Cell Transplantat Unit, Helsinki, Finland..
    Hagglund, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology. Univ Uppsala Hosp, Haematol, Uppsala, Sweden..
    Differences in side effects, sick leave and the will to donate again: the Nordic Register of Haematopoietic Stem Cell Donors2016In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 51, p. S328-S329Article in journal (Other academic)
  • 29.
    Pauksen, Karlis
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Linde, A.
    Ljungman, P.
    Bolme, P.
    Lönnerholm, Gudmar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Öberg, G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sjölin, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Specific T and B cell immunity to measles after allogeneic and autologous bone marrow transplantation1995In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 16, no 6, p. 807-813Article in journal (Refereed)
    Abstract [en]

    Lymphocyte stimulation with measles virus antigen (MLY) and ELISA for measles IgG antibodies were performed on 60 patients after allogeneic bone marrow transplantation (BMT), and on 59 patients after autologous bone marrow transplantation (ABMT). The T cell response was significantly higher in the 75 measles seropositive patients than in the 29 seronegative patients (P < 0.001), but not significantly different from the MLY in the 15 patients with uncertain serologic reactivity. When the patient group was divided according to type of transplant, the T cell response to measles was also significantly higher in seropositive patients than in seronegative patients after both ABMT (P < 0.001) and after BMT (P < 0.05). Twenty-three seronegative children who were measles vaccinated after BMT had a significantly higher T cell response to measles (7100 c.p.m.) than 17 seronegative non-vaccinated children (100 c.p.m.; P < 0.01). No significant difference was seen in the T cell response in 12 seronegative children vaccinated after ABMT (2500 c.p.m.) compared to seven children not vaccinated (2800 c.p.m.; NS). Seroconversion after vaccination was more frequent in children after BMT (20/23; 87%) compared to ABMT (5/12; 42%; P < 0.05) but no significant difference was found in the T cell response. Therefore, most patients who lost IgG antibodies to measles after bone marrow transplantation also lost their T cell response to measles. A T cell response to measles developed in most patients who seroconverted after vaccination. Failure to develop antibodies to measles in ABMT patients after revaccination may depend on a persisting T cell immunity.

  • 30.
    Pauksen, Karlis
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Linde, A.
    Lönnerholm, Gudmar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Ljungman, P.
    Sjölin, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Influence of the specific T cell response on seroconversion after measles vaccination in autologous bone marrow transplant patients1996In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 18, no 5, p. 969-973Article in journal (Refereed)
    Abstract [en]

    Six patients who were seronegative to measles after autologous bone marrow transplantation (ABMT) were vaccinated with a live attenuated measles vaccine. The specific T helper cell response was studied by measuring lymphocyte proliferation induced by measles antigen and B cell response by measles specific IgG by ELISA. Blood samples were drawn before, at 1-3 months, and at 1 year after vaccination. It was found that a pre-existing T cell response correlated with an impaired B cell response 1 year after vaccination (r = 0.83, P = 0.04), whereas no correlation was found between IgG titers before vaccination and IgG titer increase, or T cell response after vaccination. Furthermore, there was a transient negative correlation between the T cell response at 1-3 months after vaccination and the T cell response before vaccination (r = -0.90, P = 0.04) that became positive at 1 year after vaccination (r = 0.90, P = 0.02). In conclusion, in patients seronegative to measles who were revaccinated with measles vaccine after ABMT, a pre-existing T cell response correlated with an impaired B cell response, while pre-existing low-level IgG antibodies had no significant influence on the IgG titer rise. A sustained T cell response to measles antigen before vaccination may thus be one possible explanation for measles vaccine failure in ABMT patients.

  • 31.
    Pauksen, Karlis
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Sjölin, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Linde, Annika
    Alm, G.
    Andersson, B.
    Lönnerholm, Gudmar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Ljungman, Per
    Th1 and Th2 cytokine response after measles antigen stimulation in vitro in bone marrow transplant patients: response to measles vaccination1997In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 20, no 4, p. 317-323Article in journal (Refereed)
    Abstract [en]

    In seronegative autologous bone marrow transplanted (ABMT) patients, a sustained cell-mediated immunity (CMI) has been shown to impair the antibody response after measles vaccination. To investigate if this might be caused by a preferential Th1 cytokine response, interferon (IFN)-gamma and interleukin (IL)-10 production of peripheral blood mononuclear cells (PBMC) was analyzed after measles antigen (M-ag) stimulation in vitro. The non-specific immune response was measured by IFN-alpha, and IL-12 analyses. Fifty non-vaccinated patients following ABMT or allogeneic bone marrow transplantation (BMT) were included. IFN-gamma production was significantly higher in patients with a retained CMI to measles than in patients without (2.3 vs 0.8 IU/ml; P = 0.01). Only a non-significant tendency was seen in IL-10 production (48.6 vs 26.7 pg/ml; NS), whereas no difference was found in IFN-alpha or IL-12 production. A positive correlation between IFN-gamma and IL-10 production was found (r(s) = 0.49; P < 0.001). After vaccination of 14 ABMT children, there was an increase in PBMC IFN-gamma production in vitro (2.5 vs <0.1 IU/ml; P < 0.05), whereas no changes were seen in the IL-10, IFN-alpha, or antibody levels. These results suggest that both Th1 and Th2 cytokine production are increased by M-ag stimulation in patients with a retained CMI to measles, but the Th1 response seems to be stronger. The preferential Th1 stimulation and increase in IFN-gamma production after vaccination may lead to a reduction in the humoral immune response which may explain the negative correlation between antibody production and T cell reactivity prior to vaccination.

  • 32.
    Raj, K.
    et al.
    GKT Sch Med, London, England.
    Olavarria, E.
    Hammersmith Hosp, London, England.
    Eikema, D-J
    Dept Med Stat & Bioinoformat, Leiden, Netherlands.
    Blok, H-J
    Dept Med Stat & Bioinoformat, Leiden, Netherlands.
    Bregante, S.
    Osped San Martino Genova, Genoa, Italy.
    Ciceri, F.
    Osped San Raffaele Srl, Segrate, Italy.
    Passweg, J.
    Univ Hosp, Basel, Switzerland.
    Ljungmann, P.
    Karolinska Univ Hosp, Stockholm, Sweden.
    Schaap, M.
    Radboud Univ Nijmegen, Nijmegen Med Ctr, Nijmegen, Netherlands.
    Carlson, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Zuckerman, T.
    Rambam Med Ctr, Haifa, Israel.
    Volin, L.
    HUCH Comprehens Canc Ctr, Helsinki, Finland.
    Koc, Yener
    Med Pk Hosp, Antalya, Turkey.
    Diez-Martin, J.
    Hosp Gregorio Maranon, Madrid, Spain.
    Brossart, P.
    Univ Bonn, Bonn, Germany.
    Blaise, D.
    Inst Paoli Calmettes, Marseille, France.
    Natale, A.
    Osped Civile, Pescara, Italy.
    Vitek, A.
    Inst Hematol & Blood Transfus, Prague, Czech Republic.
    Mclornan, D.
    GKT Sch Med, London, England.
    Robin, M.
    Hop St Louis, Paris, France.
    Chalandon, Y.
    Hop Univ Geneve, Geneva, Switzerland.
    Kroger, N.
    Univ Hosp Eppendorf, Hamburg, Germany.
    Family mismatched allogeneic stem cell transplantationfor myelofibrosis: Report from the chronic malignancies working party of EBMT2017In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 52, no Supplement: 1, p. S182-S183Article in journal (Other academic)
  • 33.
    Rosengren, Sara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Mellqvist, U-H
    South Elvsborg Hosp, Dept Hematol, Boras, Sweden.
    Nahi, H
    Karolinska Inst, Dept Hematol, Stockholm, Sweden.
    Forsberg, K
    Norrlands Univ Hosp, Dept Hematol, Umeå, Sweden.
    Lenhoff, S
    Skåne Univ Hosp, Dept Hematol, Lund, Sweden.
    Strömberg, O
    Karolinska Inst, Dept Hematol, Stockholm, Sweden.
    Ahlberg, L
    Linköping Univ Hosp, Dept Hematol, Linköping, Sweden.
    Linder, O
    Örebro Univ Hosp, Dept Hematol, Örebro, Sweden.
    Carlson, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Outcome of AL amyloidosis after high-dose melphalan and autologous stem cell transplantation in Sweden, long-term results from all patients treated in 1994-2009.2016In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 51, no 12, p. 1569-1572Article in journal (Refereed)
    Abstract [en]

    High-dose melphalan and autologous stem cell transplantation (HDM/ASCT) is widely used in immunoglobulin light chain (AL) amyloidosis, but the benefit is debated mainly because of the high treatment-related mortality (24% in a randomised study comparing HDM/ASCT with oral melphalan/dexamethasone). We report here on the long-term outcome of all patients treated with HDM/ASCT for AL amyloidosis in Sweden between 1994 and 2009. Seventy-two patients were treated at eight Swedish centres. Median follow-up was 67.5 months. At least partial response (organ or haematological) was seen in 64% of the patients. Median overall survival was 98 months or 8.2 years, with 5-year survival 63.9% and 10-year survival 43.4%. In patients with cardiac involvement or multiple organ involvement, survival was significantly shorter, median overall survival 49 and 56 months, respectively. All mortality within 100 days from ASCT was 12.5% for all patients and 17.2% in the patients with cardiac involvement. For patients treated in the earlier time period (1994-2001), 100-day mortality was 23.8% compared with 7.8% in the later period (2002-2009). In conclusion, long survival times can be achieved in patients with AL amyloidosis treated with HDM/ASCT, also in smaller centres. Early mortality is high, but with a decreasing trend over time.

  • 34. Rubin, Johanna
    et al.
    Vettenranta, K.
    Vettenranta, J.
    Bierings, M.
    Abrahamsson, J.
    Békássy, A. N.
    Håkansson, Y.
    Frost, Britt-Marie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Arvidson, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Spendilow, C.
    Winiarski, J.
    Gustafsson, Britt
    Use of intrathecal chemoprophylaxis in children after SCT and the risk of central nervous system relapse2011In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 46, no 3, p. 372-378Article in journal (Refereed)
    Abstract [en]

    Conflicting conclusions can be drawn from the available data concerning antileukemic efficacy and risks of intrathecal (i.t.) chemoprophylaxis to children after hematopoietic SCT (HSCT). To address this, we enrolled six transplantation centers with similar treatment and patient material. Of the 397 children included, 136 patients had received post-HSCT i.t. treatment (i.t. group) and 261 had not (non-i.t. group). The two groups were, apart from the i.t. therapy given or not given, at equal risk of post-HSCT central nervous system (CNS) relapse, which was the primary endpoint studied. Isolated CNS relapses were observed in 2 (1.5%) patients from the i.t. group and 2 (1%) from the non-i.t. group. Combined relapses, including CNS, involved 4 (3%) patients from the i.t. group and 6 (2%) from the non-i.t. group. Overall survival and the occurrence of neurological side effects did not differ significantly between the groups. There was no statistically significant difference in the incidence of isolated or mixed CNS relapses between the two groups, suggesting little or no benefit from i.t. therapy post-HSCT in children.

  • 35.
    Sanner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Registered bone marrow donors' views on bodily donations1997In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 19, no 1, p. 67-76Article in journal (Refereed)
    Abstract [en]

    The attitudes of 463 potential bone marrow donors toward blood donation, kidney donation in life, organ donation after death, autopsy, and donation of the whole body for anatomic dissection were surveyed, using a questionnaire that had previously been employed for assessing the attitudes of the public. The response rate was 96%. Three quarters of the respondents were blood donors and recruited via the blood center. The proportion that accepted the procedures varied between 24% for anatomic dissection and 97% for autopsy. Differences were small between individuals with positive attitudes and individuals who had also actively taken steps to activate these attitudes. Compared with the public, the bone marrow donors were more positive to all kinds of bodily donations. The conclusion is that if one is prepared to give from the body in life, one is also prepared to give after death. The results may indicate less death anxiety and fear of physical injury, and less fear of chaos either with or without altruism compared to the public.

  • 36.
    Satwani, P.
    et al.
    Columbia Univ, Dept Pediat, Med Ctr, Div Pediat Hematol Oncol & Stem Cell Transplantat, New York, NY 10027 USA..
    Ahn, K. W.
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA..
    Carreras, J.
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Abdel-Azim, H.
    Univ So Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90033 USA..
    Cairo, M. S.
    New York Med Coll, Pediat Hematol Oncol & Stem Cell Transplantat, New York, NY USA..
    Cashen, A.
    Washington Univ, Sch Med, Div Oncol, St Louis, MO USA..
    Chen, A. I.
    Oregon Hlth & Sci Univ, Portland, OR 97201 USA..
    Cohen, J. B.
    Emory Univ, Sch Med, Winship Canc Inst, Dept Hematol & Med Oncol, Atlanta, GA USA..
    Costa, L. J.
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA..
    Dandoy, C.
    Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA..
    Fenske, T. S.
    Med Coll Wisconsin, Div Hematol & Oncol, Milwaukee, WI 53226 USA..
    Freytes, C. O.
    South Texas Vet Hlth Care Syst, San Antonio, TX USA.;Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA..
    Ganguly, S.
    Univ Kansas, Med Ctr, Div Hematol & Oncol, Blood & Marrow Transplantat, Kansas City, KS 66103 USA..
    Gale, R. P.
    Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Hematol Res Ctr, London, England..
    Ghosh, N.
    Carolinas Healthcare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA..
    Hertzberg, M. S.
    Prince Wales Hosp, Dept Haematol, Randwick, NSW 2031, Australia..
    Hayashi, R. J.
    Washington Univ, Dept Pediat, Sch Med St Louis, Div Pediat Hematol Oncol, St Louis, MO 63130 USA..
    Kamble, R. T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA..
    Kanate, A. S.
    W Virginia Univ, Osborn Hematopoiet Malignancy & Transplantat Prog, Morgantown, WV 26506 USA..
    Keating, A.
    Kharfan-Dabaja, M. A.
    Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL 33612 USA..
    Lazarus, H. M.
    Univ Hosp Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA..
    Marks, D. I.
    Univ Hosp Bristol NHS Trust, Pediat Bone Marrow Transplant, Bristol, Avon, England..
    Nishihori, T.
    Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL 33612 USA..
    Olsson, R. F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden..
    Prestidge, T. D.
    Starship Childrens Hosp, Blood & Canc Ctr, Auckland, New Zealand..
    Rolon, J. M.
    FUNDALEU, Bone Marrow Transplante Unit, Buenos Aires, DF, Argentina..
    Savani, B. N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN 37235 USA..
    Vose, J. M.
    Nebraska Med Ctr, Dept Internal Med, Omaha, NE USA..
    Wood, W. A.
    Univ N Carolina, Dept Med, Div Hematol Oncol, Chapel Hill, NC USA..
    Inwards, D. J.
    Mayo Clin, Div Hematol, Rochester, MN USA..
    Bachanova, V.
    Univ Minnesota, Med Ctr, Bone & Marrow Transplant Program, Minneapolis, MN 55455 USA..
    Smith, S. M.
    Univ Chicago, Sect Hematol Oncol, Chicago, IL 60637 USA..
    Maloney, D. G.
    Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA..
    Sureda, A.
    Hosp Duran & Reynals, Inst Catala Oncol, Serv Hematol, Barcelona, Spain..
    Hamadani, M.
    Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    A prognostic model predicting autologous transplantation outcomes in children, adolescents and young adults with Hodgkin lymphoma2015In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 50, no 11, p. 1416-1423Article in journal (Refereed)
    Abstract [en]

    Autologous hematopoietic cell transplantation (AutoHCT) is a potentially curative treatment modality for relapsed/ refractory Hodgkin lymphoma (HL). However, no large studies have evaluated pretransplant factors predictive of outcomes of AutoHCT in children, adolescents and young adults (CAYA, age < 30 years). In a retrospective study, we analyzed 606 CAYA patients (median age 23 years) with relapsed/refractory HL who underwent AutoHCT between 1995 and 2010. The probabilities of PFS at 1, 5 and 10 years were 66% (95% confidence interval (CI): 62-70), 52% (95% CI: 48-57) and 47% (95% CI: 42-51), respectively. Multivariate analysis for PFS demonstrated that at the time of AutoHCT patients with Karnofsky/Lansky score >= 90, no extranodal involvement and chemosensitive disease had significantly improved PFS. Patients with time from diagnosis to first relapse of < 1 year had a significantly inferior PFS. A prognostic model for PFS was developed that stratified patients into low-, intermediate-and high-risk groups, predicting for 5-year PFS probabilities of 72% (95% CI: 64-80), 53% (95% CI: 47-59) and 23% (95% CI: 9-36), respectively. This large study identifies a group of CAYA patients with relapsed/refractory HL who are at high risk of progression after AutoHCT. Such patients should be targeted for novel therapeutic and/or maintenance approaches post-AutoHCT.

  • 37. Shaw, B. E.
    et al.
    Ball, L.
    Beksac, M.
    Bengtsson, M.
    Department of Hematology, Uppsala University Hospital, Uppsala.
    Confer, D.
    Diler, S.
    Fechter, M.
    Greinix, H.
    Koh, M.
    Lee, S.
    Nicoloso-De-Faveri, G.
    Philippe, J.
    Pollichieni, S.
    Pulsipher, M.
    Schmidt, A.
    Yang, E.
    van Walraven, A-M
    Donor safety: the role of the WMDA in ensuring the safety of volunteer unrelated donors: clinical and ethical considerations2010In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 45, no 5, p. 832-838Article in journal (Refereed)
    Abstract [en]

    Since the beginning of hematopoietic stem cell harvesting from volunteer unrelated donors, ensuring donor safety has been a necessary goal of all parties involved in the process. As donation of BM or PBSCs is not in the interest of the donor's own physical health, donor registries and transplantation centers must take into account both medical and ethical aspects involved in the donation procedure. One of the principal goals leading to the formation of the World Marrow Donor Association (WMDA) was to establish internationally acceptable standards for all aspects of unrelated donor care.

  • 38.
    Simonsson, Bengt
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Tötterman, Thomas H.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
    Hokland, P.
    Lauria, F.
    Carella, A. M.
    Fernandez, M. N.
    Rozman, C.
    Ferrant, A.
    de Witte, T.
    Zander, A. R.
    Meier, K.
    Hansson, F.
    Nilsson, B. I.
    Roquinimex (Linomide) vs placebo in AML after autologous bone marrow transplantation2000In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 25, no 11, p. 1121-1127Article in journal (Refereed)
    Abstract [en]

    Roquinimex, Linomide, a quinoline derivative with pleiotropic immunomodulatory activity, has previously been shown to enhance natural killer (NK) cell number and activity after ABMT in patients with AML. In this study 278 AML patients in remission were randomized to receive Roquinimex 0.2 mg/kg body weight or placebo twice weekly for 2 years following ABMT. Out of 139 patients in each group, 109 Roquinimex patients and 108 placebo patients were in their first CR. Median age at inclusion was 41 years for Roquinimex patients and 39 years for placebo patients. Twelve patients in each group had their marrow purged prior to reinfusion. Relapse and death were study endpoints. Surviving patients were followed for 2.6 to 6. 9 years. The total number of relapses was 60 in the Roquinimex group and 63 in the placebo group (not significant). Leukemia-free and overall survivals were similar in the two groups. Recovery of platelet counts was significantly delayed in the Roquinimex group as compared to placebo. No other significant differences regarding toxicity parameters were recorded. In conclusion, previous findings on NK cells could not be confirmed and the study showed no benefit for Roquinimex over placebo regarding relapse or survival following ABMT for AML in remission.

  • 39. Snarski, E
    et al.
    Snowden, J A
    Oliveira, M C
    Simoes, B
    Badoglio, M
    Carlson, K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Burman, Joachim
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
    Moore, J
    Rovira, M
    Clark, R E
    Saiz, A
    Hadj-Khelifa, S
    Tan, J
    Crescimanno, A
    Musso, M
    Martin, T
    Farge, D
    Onset and outcome of pregnancy after autologous haematopoietic SCT (AHSCT) for autoimmune diseases: a retrospective study of the EBMT autoimmune diseases working party (ADWP)2015In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 50, no 2, p. 216-220Article in journal (Refereed)
    Abstract [en]

    Autologous haematopoietic SCT (AHSCT) is increasingly used to control severe and refractory autoimmune diseases (AD). Many patients are women of reproductive age with a potential desire for children. We present a multicentre retrospective analysis of pregnancy and childbirth in patients who underwent AHSCT for AD. The databases of the European Blood and Marrow Transplantation and University of Sao Paulo, Ribeirão Preto, Brazil were searched for female patients aged 18-50 years who had received AHSCT for AD between 1994-2011. In 324 adult female patients, 22 pregnancies were reported in 15 patients between 1997-2011. Indications for AHSCT included multiple sclerosis (n=7), systemic sclerosis (n=5), rheumatoid arthritis (n=1), juvenile idiopathic arthritis (n=1) and Takayasu disease (n=1). Of the 22 reported pregnancies, 20 followed natural conception. 15 pregnancies (68%) resulted in healthy life births, whereas 7 (32%) failed. Exacerbations of AD occurred in two patients during second pregnancies. No maternal mortality was associated with pregnancy or postpartum. There were no reports of congenital, developmental or any other disease in the children. This retrospective analysis confirms the possibility of pregnancy and childbirth following AHSCT for severe AD. The outcome of pregnancy is generally good and most led to the birth of a healthy child.

  • 40.
    Svanberg, Anncarin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Birgegård, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Addition of aprepitant (Emend (R)) to standard antiemetic care for seven days post-chemotherapy before stem cell transplantation gives significant reduction of vomiting2013In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 48, no Suppl.2, p. S463-S463Article in journal (Other academic)
  • 41. Tobiasson, M
    et al.
    Olsson, R
    Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden.
    Hellström-Lindberg, E
    Mattsson, J
    Early detection of relapse in patients with myelodysplastic syndrome after allo-SCT2011In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 46, no 5, p. 719-726Article in journal (Refereed)
    Abstract [en]

    Allo-SCT is the only potentially curative regimen for myelodysplastic syndromes (MDSs), but it is associated with a high relapse risk. The role of chimerism analysis for prediction of relapse is yet to be determined. To assess the clinical usefulness of mixed chimerism (MC) for predicting hematological relapse, 75 consecutively transplanted patients with MDS were analyzed with regard to lineage-specific chimerism, encompassing CD33+ cells in peripheral blood (PB, n=49) and CD34+ cells in BM (n= 35). A cutoff of 5% recipient cells was used to discriminate complete donor chimerism from MC. A total of 19 patients (25%) experienced hematological relapse after a median of 5 (1–31) months. Sensitivity for detection of relapse was 59% for CD33+ PB cells and 92% for CD34+ BM cells with corresponding specificities of 91% and 65%. CD34+ BM cells were analyzed before relapse in seven patients, five of whom showed MC at a median of 2.5 (0.5–7) months before relapse. In contrast, 8 of 18 patients showed MC involving CD33 PB with a median of one month (0.5–2) before relapse. Here, we provide a model for early detection of relapse after SCT in MDS, in which serial characterization of both CD33+ PB cells and CD34+ BM cells gives an opportunity for early treatment before overt relapse.

  • 42.
    Uy, G. L.
    et al.
    Washington Univ, Sch Med, Dept Med, St Louis, MO 63110 USA..
    Costa, L. J.
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA..
    Hari, P. N.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Zhang, M-J
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA..
    Huang, J-X
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Anderson, K. C.
    Dana Farber Canc Inst, Hematol Oncol Treatment Ctr, Boston, MA 02115 USA..
    Bredeson, C. N.
    Ottawa Hosp, Blood & Marrow Transplant Program, Ottawa, ON, Canada.;Ottawa Hosp, Res Inst, Ottawa, ON, Canada..
    Callander, N. S.
    Univ Wisconsin, Carbone Canc Ctr, Madison, WI USA..
    Cornell, R. F.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Perez, M. A. D.
    Univ Nino Jesus, Serv Oncohematol, Hosp Infantil, Madrid, Spain..
    Dispenzieri, A.
    Mayo Clin, Dept Hematol, Rochester, MN USA..
    Freytes, C. O.
    South Texas Vet Hlth Care Syst, San Antonio, TX USA.;Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA..
    Gale, R. P.
    Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Hematol Res Ctr, London, England..
    Garfall, A.
    Univ Penn, Abramson Canc Ctr, Perelman Ctr Adv Med, Div Hematol Oncol, Philadelphia, PA 19104 USA..
    Gertz, M. A.
    Mayo Clin, Dept Hematol, Rochester, MN USA..
    Gibson, J.
    Royal Prince Alfred Hosp, Dept Haematol, Inst Haematol, Camperdown, NSW 2050, Australia..
    Hamadani, M.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Lazarus, H. M.
    Univ Hosp, Seidman Canc Ctr, Case Med Ctr, Cleveland, OH USA..
    Kalaycio, M. E.
    Cleveland Clin, Hematol Oncol & Blood Disorders, Cleveland, OH 44106 USA..
    Kamble, R. T.
    Baylor Coll Med, Ctr Cell & Gene Therapy, Dept Hematol & Oncol, Houston, TX 77030 USA..
    Kharfan-Dabaja, M. A.
    Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL 33612 USA..
    Krishnan, A. Y.
    City Hope Natl Med Ctr, Dept Hematol Oncol, Duarte, CA 91010 USA..
    Kumar, S. K.
    Mayo Clin, Dept Hematol, Rochester, MN USA..
    Kyle, R. A.
    Mayo Clin, Dept Hematol, Rochester, MN USA..
    Landau, H. J.
    Mem Sloan Kettering Canc Ctr, Bone Marrow Transplant Serv, New York, NY 10021 USA..
    Lee, C. H.
    Royal Adelaide Hosp, SA Pathol, Haematol & Bone Marrow Transplant Unit, Adelaide, SA 5000, Australia..
    Maiolino, A.
    Univ Fed Rio de Janeiro, Hosp Univ Clementinio Fraga Filho, Rio De Janeiro, Brazil..
    Marks, D. I.
    Univ Hosp Bristol NHS Trust, Pediat Bone Marrow Transplant, Bristol, Avon, England..
    Mark, T. M.
    New York Presbyterian Hosp Cornell, Dept Med, New York, NY USA..
    Munker, R.
    Louisiana State Univ Hlth Shreveport, Dept Internal Med, Hematol Oncol Sect, Shreveport, LA USA..
    Nishihori, T.
    Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL 33612 USA..
    Olsson, R. F.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden..
    Ramanathan, M.
    UMass Mem Med Ctr, Dept Med, Div Hematol Oncol, Worcester, MA USA..
    Rodriguez, T. E.
    Loyola Univ, Med Ctr, Bone Marrow Transplant Program, Chicago, IL 60611 USA..
    Saad, A. A.
    Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA..
    Savani, B. N.
    Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA..
    Schiller, G. J.
    Univ Calif Los Angeles, Ctr Hlth Sci, Bone Marrow Transplant Program, Los Angeles, CA 90024 USA..
    Schouten, H. C.
    Acad Ziekenhuis, Dept Hematol, Maastricht, Netherlands..
    Schriber, J. R.
    Virginia G Piper Canc Ctr, Canc Transplant Inst, Scottsdale, AZ USA.;Arizona Oncol, Scottsdale, AZ USA..
    Scott, E.
    Oregon Hlth & Sci Univ, Ctr Hematol Malignancies, Portland, OR 97201 USA..
    Seo, S.
    Fred Hutchinson Canc Res Ctr, Dept Vaccine & Infect Dis, Seattle, WA 98104 USA..
    Sharma, M.
    Thomas Jefferson Univ, Dept Hematol Oncol, Philadelphia, PA 19107 USA..
    Ganguly, S.
    Univ Kansas, Med Ctr, Div Hematol & Oncol, Blood & Marrow Transplantat, Kansas City, KS 66103 USA..
    Stadtmauer, E. A.
    Univ Penn, Abramson Canc Ctr, Perelman Ctr Adv Med, Div Hematol Oncol, Philadelphia, PA 19104 USA..
    Tay, J.
    Univ Ottawa, Dept Med, Ottawa, ON, Canada..
    To, L. B.
    Royal Adelaide Hosp, SA Pathol, Haematol & Bone Marrow Transplant Unit, Adelaide, SA 5000, Australia..
    Vesole, D. H.
    Hackensack Univ, Med Ctr, Hackensack, NJ USA..
    Vogl, D. T.
    Univ Penn, Abramson Canc Ctr, Perelman Ctr Adv Med, Div Hematol Oncol, Philadelphia, PA 19104 USA..
    Wagner, J. L.
    Thomas Jefferson Univ, Dept Hematol Oncol, Philadelphia, PA 19107 USA..
    Wirk, B.
    Seattle Canc Care Alliance, Seattle, WA USA..
    Wood, W. A.
    Univ N Carolina, Dept Med, Div Hematol Oncol, Chapel Hill, NC USA..
    D'Souza, A.
    Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
    Contribution of chemotherapy mobilization to disease control in multiple myeloma treated with autologous hematopoietic cell transplantation2015In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 50, no 12, p. 1513-1518Article in journal (Refereed)
    Abstract [en]

    In patients with multiple myeloma (MM) undergoing autologous hematopoietic cell transplantation (auto-HCT), peripheral blood progenitor cells may be collected following mobilization with growth factor alone (GF) or cytotoxic chemotherapy plus GF (CC+GF). It is uncertain whether the method of mobilization affects post-transplant outcomes. We compared these mobilization strategies in a retrospective analysis of 968 patients with MM from the Center for International Blood and Marrow Transplant Research database who received an auto-Ha in the US and Canada between 2007 and 2012. The kinetics of neutrophil engraftment (>= 0.5 x 10(9)/L) was similar between groups (13 vs 13 days, P=0.69) while platelet engraftment (>= 20 x 10(9)/L) was slightly faster with CC+GF (19 vs 18 days, P=0.006). Adjusted 3-year PFS was 43% (95% confidence interval (CI) 38-48) in GF and 40% (95% CI 35-45) in CC+GF, P=0.33. Adjusted 3-year OS was 82% (95% CI 78-86) vs 80% (95% CI 75-84), P=0.43 and adjusted 5-year OS was 62% (95% CI 54-68) vs 60% (95% CI 52-67), P=0.76, for GF and CC+GF, respectively. We conclude that MM patients undergoing auto-Ha have similar outcomes irrespective of the method of mobilization and found no evidence that the addition of chemotherapy to mobilization contributes to disease control.

  • 43.
    Vejby, S.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Is it possible to increase the amount of physical activity for isolated haematological patients by educating the nursing staff in motivational interviewing?2013In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 48, no Suppl:2, p. S491-S491Article in journal (Other academic)
  • 44. Vrijmoet-Wiersma, C M J
    et al.
    Egeler, R M
    Koopman, H M
    Bresters, D
    Lindahl Norberg, Annika
    Karolinska institutet Inst f kvinnors o barns hälsa.
    Grootenhuis, M A
    Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT.2010In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 45, no 6, p. 1102-8Article in journal (Refereed)
    Abstract [en]

    With the aim of assessing parental stress after SCT, 73 parents of children and adolescents who underwent SCT 5 or 10 years ago responded to questionnaires on general distress (General Health Questionnaire (GHQ)), disease-related stress (Pediatric Inventory for Parents-short form (PIP-SF)) and perceptions of child vulnerability (Child Vulnerability Scale (CVS)). General distress scores were comparable with the reference groups, but 40% of the mothers at 5 years after SCT reported increased stress levels as compared with 26% in the community-based reference group. Disease-related stress was comparable with the reference group of parents of children who were just off cancer treatment, 5 years after SCT. At 10 years after SCT, scores were lower than the reference group. Perceived child vulnerability did diminish over time, but remained high in parents of SCT survivors, compared with parents of healthy children: 96% of the parents at 5 years after SCT and 76% of the parents at 10 years after SCT scored above the cutoff point. Perceived vulnerability was found to be a predictor for parental disease-related stress. To conclude, although most parents of SCT survivors are resilient, the majority of parents perceive their child to be much more vulnerable as compared with parents of healthy children. This perception is associated with disease-related stress and may induce overprotective parenting.

  • 45.
    Walladbegi, J.
    et al.
    Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Oral Med & Pathol, Gothenburg, Sweden.
    Svanberg, Anncarin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Jontell, M.
    Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Oral Med & Pathol, Gothenburg, Sweden.
    Optimal cooling temperature to prevent adverse effects of chemotherapeutic agents2017In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 52, no Supplement: 1, p. S301-S302Article in journal (Other academic)
1 - 45 of 45
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