Peri-transplant red blood cell (RBC) transfusions appear to increase the risk of developing severe acute graft-vs-host disease (aGVHD) and experiencing worse overall survival following allogeneic hematopoietic stem cell transplant (allo-HSCT), according to a retrospective study involving 322 individuals. Participants with hematological malignancies received RBC transfusion before either allogeneic bone marrow or granulocyte colony-stimulating factor-mobilized blood stem cell grafts. Among the results:
- 1 in every 5 patients developed maximal grade of III-IV aGVHD.
- Onset occurred up to 150 days post-transplant (median onset 28 days).
- Patients with HLA mismatch and those with a higher number of RBC units were each >twice as likely to experience grade III-IV aGVHD.
- High-risk patients and those receiving more median RBC units were independently linked with inferior overall survival.
Hosoba S, Waller E, Shenva N, et al. Peri-transplant RBC transfusion is associated with increased risk of GvHD after allogeneic stem cell transplantation. [Published online ahead of print January 4, 2018]. Biol Blood Marrow Transplant. doi:10.1016/j.bbmt.2018.01.003.
This Week's Must Reads
Intensity modulated radiation therapy may be preferable in children with extremity nonrhabdomyosarcoma soft-tissue sarcomas, Source: Rao A et al. Intl J Rad Oncology*Biology*Physics; Jan. 2019, 38-44. https://doi.org/10.1016/j.ijrobp.2018.09.005
Thrombolysis for acute ischemic stroke safe in GI malignancy, Inohara T et al. Circulation. 2018 Nov 6;138[suppl 1], Abstract A12291
Ten years of anastrozole boosts disease-free survival, Ohtani S et al. SABCS 2018, Abstract GS3-04
Outcomes better in TNBC with adjuvant chemotherapy within 30 days of surgery, Morante Z et al., SABCS 2018 Abstract GS2-05
TAO: Nonwhite ethnicity, limb infection predict poor prognosis, Le Joncour A et al. Arthritis Rheumatol. 2018;70(Suppl 10): Abstract 1885
Must Reads in Myelodysplastic Syndrome
Gene sequencing bone marrow in myelodysplastic syndrome, Duncavage EJ et al. N Engl J Med 2018;379:1028-41.
JAK1/2 inhibitors tied to increased B-cell lymphoma risk, Porpaczy E et al. Blood. 2018 Jun 14. doi: 10.1182/blood-2017-10-810739.
Romiplostim safety confirmed in thrombocytopenic patients with low-risk myelodysplastic syndromes, Kantarjian H et al. The Lancet Haematology March 2018, Pages e117-e126 https://doi.org/10.1016/S2352-3026(18)30016-4
Simplifying the URD Selection Process for HCT, Biol Blood Marrow Transplant.; ePub 2018 Feb 14; Shaw, Logan, et al
Genetic Risk Model for MDS Shown to Be Feasible, Am J Hematol; ePub 2018 Feb 24; Gangat, et al