Info

🌱 來自：HSCT

2024-01-21-post-ash

• How to overcome the OS difference between 7/8 and 8/8 URD?

  • Use of PTCy-based GvHD prophylaxis seems to have resolved previously observed differences in GRFS and OS between 8/8 and 7/8 URD HSCT.

• Choose between URD and Haplo donor.

  • Use of 8/8 URD is preferred, but both 7/8 URD and haploidentical donors are both good options if 8/8 URD does not exist or is not available.

• Alternative graft source with umbilical blood: Omidubicel

  • FDA approved Omidubicel in April 2023, the first UCB product.
  • CAST regimen

• Related and Unrelated Donor Matches (8/8 URD, 7/8 URD) and Half Match or Haploidentical Donor in Allo-HSCT.

• Introduction of Omidubicel, the first expanded Umbilical Cord Blood product rich in Hematopoietic Stem Cells (CD34+ cells).

• Use of Post-Transplantation Cyclophosphamide (PTCy) in Matched Related Donors (MRD), and Matched or Mismatched Unrelated Donors followed by a Therapy Infusion (BMT CTN1703).

• The addition of Abatacept to PTCy with or without Calcineurin Inhibitors (CNI).

• Study on T-cell repertoires following PTCy (BMT CTN 1801).

• Use of Vedolizumab in prevention of lower gastrointestinal acute Graft Versus Host Disease (lGI aGVHD).

• Use of Ruxolitinib and Axatilimab in the treatment of lung GVHD showing a 38% and 47% Overall Response Rate (ORR) respectively.

• The role of certain bacteria like VEnterococcus (enhanced by Urso) and Blautia in improving overall survival (OS) after Allo-HSCT.

• The negative impact of certain therapies, such as Piperacillin-Tazobactam-Imipenem (P-I-M) but not cefepime, on overall survival and progression-free survival when administered four weeks prior to a Chimeric Antigen Receptor T-cell Infusion (CAR-T infusion).