Biology-Driven Approaches to Prevent and Treat Relapse of Myeloid Neoplasia after Allogeneic Hematopoietic Stem Cell Transplantation
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Biology-Driven Approaches to Prevent and Treat Relapse of Myeloid Neoplasia after Allogeneic Hematopoietic Stem Cell Transplantation. / Zeiser, Robert; Beelen, Dietrich W; Bethge, Wolfgang; Bornhäuser, Martin; Bug, Gesine; Burchert, Andreas; Christopeit, Maximilian; Duyster, Justus; Finke, Jürgen; Gerbitz, Armin; Klusmann, Jan Henning; Kobbe, Guido; Lübbert, Michael; Müller-Tidow, Carsten; Platzbecker, Uwe; Rösler, Wolf; Sauer, Martin; Schmid, Christoph; Schroeder, Thomas; Stelljes, Mathias; Kröger, Nicolaus; Müller, Lutz P.
in: BIOL BLOOD MARROW TR, Jahrgang 25, Nr. 4, 04.2019, S. e128-e140.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Biology-Driven Approaches to Prevent and Treat Relapse of Myeloid Neoplasia after Allogeneic Hematopoietic Stem Cell Transplantation
AU - Zeiser, Robert
AU - Beelen, Dietrich W
AU - Bethge, Wolfgang
AU - Bornhäuser, Martin
AU - Bug, Gesine
AU - Burchert, Andreas
AU - Christopeit, Maximilian
AU - Duyster, Justus
AU - Finke, Jürgen
AU - Gerbitz, Armin
AU - Klusmann, Jan Henning
AU - Kobbe, Guido
AU - Lübbert, Michael
AU - Müller-Tidow, Carsten
AU - Platzbecker, Uwe
AU - Rösler, Wolf
AU - Sauer, Martin
AU - Schmid, Christoph
AU - Schroeder, Thomas
AU - Stelljes, Mathias
AU - Kröger, Nicolaus
AU - Müller, Lutz P
N1 - Copyright © 2019 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
PY - 2019/4
Y1 - 2019/4
N2 - The curative potential of allogeneic hematopoietic cell transplantation (allo-HCT) in the treatment of acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) relies mainly on the graft-versus-leukemia effect. Relapse after allo-HCT occurs in a considerable proportion of patients and has a dismal prognosis, with still very limited curative potential. This review provides an overview of the established and evolving approaches to preventing or treating relapse of AML and MDS after allo-HCT, in the context of novel insight into the biology of relapse. Established prophylactic measures to prevent relapse include optimized conditioning and graft-versus-host disease (GVHD) prophylaxis, as well as donor lymphocyte infusion (DLI) for high-risk patients; novel immunomodulatory interventions and maintenance approaches are still experimental. Improved diagnostics can detect persistent or recurring disease at a molecular level, enabling early preemptive interventions. Established options include hypomethylating agents and DLI. Standard treatments for hematologic relapse include chemotherapy, cessation of immunosuppressive treatment, and DLI. Experimental approaches include molecular targeted therapies, novel immunomodulatory treatments, and second allo-HCT. For all interventions, the potential risks, including occurrence of GVHD, must be weighed against the benefits individually in each patient. Concurrently, prevention and treatment of relapse after allo-HCT remain challenging and unmet medical needs.
AB - The curative potential of allogeneic hematopoietic cell transplantation (allo-HCT) in the treatment of acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS) relies mainly on the graft-versus-leukemia effect. Relapse after allo-HCT occurs in a considerable proportion of patients and has a dismal prognosis, with still very limited curative potential. This review provides an overview of the established and evolving approaches to preventing or treating relapse of AML and MDS after allo-HCT, in the context of novel insight into the biology of relapse. Established prophylactic measures to prevent relapse include optimized conditioning and graft-versus-host disease (GVHD) prophylaxis, as well as donor lymphocyte infusion (DLI) for high-risk patients; novel immunomodulatory interventions and maintenance approaches are still experimental. Improved diagnostics can detect persistent or recurring disease at a molecular level, enabling early preemptive interventions. Established options include hypomethylating agents and DLI. Standard treatments for hematologic relapse include chemotherapy, cessation of immunosuppressive treatment, and DLI. Experimental approaches include molecular targeted therapies, novel immunomodulatory treatments, and second allo-HCT. For all interventions, the potential risks, including occurrence of GVHD, must be weighed against the benefits individually in each patient. Concurrently, prevention and treatment of relapse after allo-HCT remain challenging and unmet medical needs.
KW - Journal Article
KW - Review
U2 - 10.1016/j.bbmt.2019.01.016
DO - 10.1016/j.bbmt.2019.01.016
M3 - SCORING: Review article
C2 - 30658222
VL - 25
SP - e128-e140
JO - BIOL BLOOD MARROW TR
JF - BIOL BLOOD MARROW TR
SN - 1083-8791
IS - 4
ER -