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Cancers
Special Issues
Hematopoietic Stem Cell Transplant in Hematological Malignancies
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Hematopoietic Stem Cell Transplant in Hematological Malignancies

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 1207

Special Issue Editors

Dr. Luisa Giaccone

E-Mail Website
Guest Editor
Department of Molecular Biotechnology and Health Sciences, Università degli Studi di Torino, Torino, Italy
Interests: allogeneic stem cell transplantation; graft versus host disease; T cell therapies; post transplant immune-reconstitution; post-allografting long term complications
Special Issues, Collections and Topics in MDPI journals
Dr. Alessandro Cignetti

E-Mail Website
Guest Editor
SCDU Ematologia, Ospedale Mauriziano di Torino, Turin, Italy
Interests: immunology; cell therapy; allogeneic stem cell transplantation; acute leukemia; immunotherapy of hematological malignancies

Special Issue Information

Dear Colleagues,

In recent years, allogeneic stem cell transplant scenario has undergone significant innovative changes. While in certain cases, the introduction of new drugs acting on biological and immunological pathways of many hematological malignancies moved the indication to transplant, it increased the probability of achieving complete remission with favorable post-transplant outcomes in others. The use of high-resolution HLA typing on one hand and the increased use of haploidentical donors on the other impact the selection of donor/recipient pairs. The conditioning regimen is also being further developed with the aim of reducing toxicity while sparing efficacy: introduction of different drugs, different schema and the increased use of reduced intensity conditioning. Similarly, the prophylaxis and treatment of graft-versus-host disease (GVHD) evolved due to the development of schema with post-transplant cyclosphamide, use of anti-thymocyte globuline, as well as the introduction of new drugs for the treatment of refractory GVHD. Furthermore, improvements in supportive care measures such as novel antimicrobial agents and diagnostic procedures have also had an impact on stem cell transplant outcome over time. Additionally, new findings on the pathological pathway behind alloreaction, and the search of biological markers that can guide clinicians’ choices will set the base for further developments.

This Special Issue aims to highlight the impact of these novelties in allogeneic stem cell transplant setting, and invites submissions of both reviews of the literature and original manuscripts.

Dr. Luisa Giaccone
Dr. Alessandro Cignetti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • stem cell transplant
  • graft-versus-host disease
  • conditioning regimen
  • prophylaxes
  • immunology
  • donors
  • hematological disease

Published Papers (2 papers)

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Research

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10 pages, 1322 KiB  
Article
Ponatinib as a Prophylactic or Pre-Emptive Strategy to Prevent Cytological Relapse after Allogeneic Stem Cell Transplantation in Patients with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia Transplanted in Complete Cytological Remission
by Anna Candoni, Patrizia Chiusolo, Davide Lazzarotto, Chiara Sartor, Michelina Dargenio, Sabina Chiaretti, Cristina Skert, Fabio Giglio, Silvia Trappolini, Nicola Stefano Fracchiolla, Sara Medici, Paola Bresciani, Angela Cuoghi and Cristina Papayannidis
Cancers 2024, 16(11), 2108; https://doi.org/10.3390/cancers16112108 - 31 May 2024
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Abstract
The administration of TKIs after Allo-SCT in Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL) remains controversial, and the TKI approach (prophylactic, pre-emptive or salvage) is still heterogeneous in transplant centers. In this context, very little is known about the feasibility and safety [...] Read more.
The administration of TKIs after Allo-SCT in Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL) remains controversial, and the TKI approach (prophylactic, pre-emptive or salvage) is still heterogeneous in transplant centers. In this context, very little is known about the feasibility and safety of third-generation TKIs. In this paper, we analyze the efficacy and safety of ponatinib (PONA) administered after Allo-SCT to prevent cytologic relapse of Ph + ALL. This is a multicenter observational study including 48 patients (pts) with Ph + ALL (median age 49 years) who received PONA after Allo-SCT while in complete cytological remission (cCR); 26 (54%) had positive minimal residual disease (MRD pos) before Allo-SCT. PONA was administered after Allo-SCT prophylactically (starting with MRD neg) in 26 pts or pre-emptively (starting with MRD pos post-SCT and without hematological relapse) in 22 pts. Patients treated prophylactically with PONA started treatment earlier, at a median of 4.3 months (range 1.5–6) after Allo-SCT, than those treated pre-emptively, who started PONA at a median of 7.4 months (range 2–63) after Allo-SCT (p = 0.01). The median starting dose of PONA was 30 mg/day (range 15–45). A dose reduction was required in 10/48 (21%) of cases, but a permanent discontinuation of PONA, due to toxicity, was required in only 5/48 pts (10.5%). No deaths due to PONA-related adverse events (AEs) were reported. The median follow-up time after Allo-SCT was 34 months (range 7.7–118). At the last follow-up, the median duration of PONA therapy was 22 months (range 2–100). The 5-year OS and RFS after Allo-SCT were 92% and 71%, respectively. The 5-year RFS after Allo-SCT of pts who received PONA prophylaxis was 95%, and it was 57% for those who received PONA pre-emptively (log-rank p = 0.02). In conclusion, this multicenter analysis of 48 patients with Ph + ALL undergoing Allo-SCT while in CcR, although with the caution of the retrospective data, supports the feasibility of PONA maintenance strategy after Allo-SCT with a low rate of discontinuations (10.5%) due to PONA-related AE. Full article
(This article belongs to the Special Issue Hematopoietic Stem Cell Transplant in Hematological Malignancies)
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Review

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19 pages, 1708 KiB  
Review
Maintain Efficacy and Spare Toxicity: Traditional and New Radiation-Based Conditioning Regimens in Hematopoietic Stem Cell Transplantation
by Irene Dogliotti, Mario Levis, Aurora Martin, Sara Bartoncini, Francesco Felicetti, Chiara Cavallin, Enrico Maffini, Marco Cerrano, Benedetto Bruno, Umberto Ricardi and Luisa Giaccone
Cancers 2024, 16(5), 865; https://doi.org/10.3390/cancers16050865 - 21 Feb 2024
Viewed by 801
Abstract
Novelty in total body irradiation (TBI) as part of pre-transplant conditioning regimens lacked until recently, despite the developments in the field of allogeneic stem cell transplants. Long-term toxicities have been one of the major concerns associated with TBI in this setting, although the [...] Read more.
Novelty in total body irradiation (TBI) as part of pre-transplant conditioning regimens lacked until recently, despite the developments in the field of allogeneic stem cell transplants. Long-term toxicities have been one of the major concerns associated with TBI in this setting, although the impact of TBI is not so easy to discriminate from that of chemotherapy, especially in the adult population. More recently, lower-intensity TBI and different approaches to irradiation (namely, total marrow irradiation, TMI, and total marrow and lymphoid irradiation, TMLI) were implemented to keep the benefits of irradiation and limit potential harm. TMI/TMLI is an alternative to TBI that delivers more selective irradiation, with healthy tissues being better spared and the control of the radiation dose delivery. In this review, we discussed the potential radiation-associated long-term toxicities and their management, summarized the evidence regarding the current indications of traditional TBI, and focused on the technological advances in radiotherapy that have resulted in the development of TMLI. Finally, considering the most recent published trials, we postulate how the role of radiotherapy in the setting of allografting might change in the future. Full article
(This article belongs to the Special Issue Hematopoietic Stem Cell Transplant in Hematological Malignancies)
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