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  • 1.
    Abelsson, J.
    et al.
    NU Hospital Organization, Uddevalla.
    Merup, M.
    Karolinska Universitetssjukhuset, Huddinge.
    Birgegård, G.
    Uppsala University.
    WeisBjerrum, O.
    Rigshospitalet, University of Copenhagen.
    Brinch, L.
    Rikshospitalet, Oslo University Hospital.
    Brune, M.
    Sahlgrenska Universitetssjukhuset, Göteborg.
    Johansson, P.
    NU Hospital Organization, Uddevalla.
    Kauppila, M.
    Turku University Hospital, Finland.
    Lenhoff, S.
    Skåne University Hospital.
    Liljeholm, M.
    Norrlands Universitetssjukhus, Umeå.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Remes, K.
    Turku University Hospital, Finland.
    Vindelöv, L.
    Rigshospitalet, University of Copenhagen.
    Andréasson, Björn
    NU Hospital Organization, Uddevalla.
    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.Bone Marrow Transplantation advance online publication, 9 May 2011; doi:10.1038/bmt.2011.91.

  • 2.
    Auner, H W.
    et al.
    University of London Imperial Coll Science Technology and Med, England .
    Szydlo, R
    University of London Imperial Coll Science Technology and Med, England .
    van Biezen, A
    Leiden University, Netherlands .
    Iacobelli, S
    University of Roma Tor Vergata, Italy .
    Gahrton, G
    Karolinska Institute, Sweden .
    Milpied, N
    Hop Haut Leveque, France .
    Volin, L
    University of Helsinki, Finland .
    Janssen, J
    Vrije University of Amsterdam, Netherlands .
    Nguyen Quoc, S
    Grp Hospital Pitie Salpetriere, France .
    Michallet, M
    Hop Edouard Herriot, France .
    Schoemans, H
    University Hospital Gasthuisberg, Belgium .
    el Cheikh, J
    Institute J Paoli I Calmettes, France .
    Petersen, E
    University of Medical Centre, Netherlands .
    Guilhot, F
    Hop La Miletrie, France .
    Schoenland, S
    Heidelberg University, Germany .
    Ahlberg, Lucia
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology.
    Morris, C
    Queens University of Belfast, North Ireland .
    Garderet, L
    Hop St Antoine, France .
    de Witte, T
    Radboud University of Nijmegen, Netherlands .
    Kroeger, N
    University Hospital Eppendorf, Germany .
    Reduced intensity-conditioned allogeneic stem cell transplantation for multiple myeloma relapsing or progressing after autologous transplantation: a study by the European Group for Blood and Marrow Transplantation2013In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 48, no 11, p. 1395-1400Article in journal (Refereed)
    Abstract [en]

    Outcomes and prognostic factors of reduced intensity-conditioned allo-SCT (RIC allo-SCT) for multiple myeloma (MM) relapsing or progressing after prior autologous (auto)-SCT are not well defined. We performed an analysis of 413 MM patients who received a related or unrelated RIC allo-SCT for the treatment of relapse/progression after prior auto-SCT. Median age at RIC allo-SCT was 54.1 years, and 44.6% of patients had undergone two or more prior auto-SCTs. Median OS and PFS from the time of RIC allo-SCT for the entire population were 24.7 and 9.6 months, respectively. Cumulative non-relapse mortality (NRM) at 1 year was 21.5%. In multivariate analysis, CMV seronegativity of both patient and donor was associated with significantly better PFS, OS and NRM. Patient-donor gender mismatch was associated with better PFS, fewer than two prior auto-SCT was associated with better OS, and shorter time from the first auto-SCT to the RIC allo-SCT was associated with lower NRM. The results of this study identify patient and donor CMV seronegativity as the key prognostic factor for outcome after RIC allo-SCT for MM relapsing or progressing after prior auto-SCT.

  • 3.
    Bagesund, M
    et al.
    Karolinska Inst, Dept Pediat Dent, Stockholm, Sweden Huddinge Univ Hosp, Dept Nucl Med, S-14186 Huddinge, Sweden Huddinge Univ Hosp, Ctr Allogene Stem Cell Transplantat, S-14186 Huddinge, Sweden.
    Richter, S
    Karolinska Inst, Dept Pediat Dent, Stockholm, Sweden Huddinge Univ Hosp, Dept Nucl Med, S-14186 Huddinge, Sweden Huddinge Univ Hosp, Ctr Allogene Stem Cell Transplantat, S-14186 Huddinge, Sweden.
    Agren, B
    Karolinska Inst, Dept Pediat Dent, Stockholm, Sweden Huddinge Univ Hosp, Dept Nucl Med, S-14186 Huddinge, Sweden Huddinge Univ Hosp, Ctr Allogene Stem Cell Transplantat, S-14186 Huddinge, Sweden.
    Ringden, O
    Karolinska Inst, Dept Pediat Dent, Stockholm, Sweden Huddinge Univ Hosp, Dept Nucl Med, S-14186 Huddinge, Sweden Huddinge Univ Hosp, Ctr Allogene Stem Cell Transplantat, S-14186 Huddinge, Sweden.
    Dahllof, G
    Karolinska Inst, Dept Pediat Dent, Stockholm, Sweden Huddinge Univ Hosp, Dept Nucl Med, S-14186 Huddinge, Sweden Huddinge Univ Hosp, Ctr Allogene Stem Cell Transplantat, S-14186 Huddinge, Sweden.
    Scintigraphic study of the major salivary glands in pediatric bone marrow transplant recipients2000In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 26, no 7, p. 775-779Article in journal (Refereed)
    Abstract [en]

    Total body irradiation (TBI) at bone marrow transplantation (BMT) is shown to cause salivary gland dysfunction in children. The aim of the investigation was to study the function of major salivary glands in long-term surviving children following treatment with TBI, using salivary gland scintigraphy (SGS), Thirteen patients (seven male, six female), who had received TBI before the age of 13 years and survived more than 4 years, participated in the study. A reference group of 10 patients (nine male, one female) was examined shortly before they were to undergo BMT, The mean age was 14.1 +/- 4.1 years in the TBI-treated group and 12.8 +/- 5.9 years in the reference group, Unstimulated and stimulated whole salivary secretion rates were measured for 15 and 5 min, respectively, before SGS was performed, The percentage of stimulated secretion was 44.7 +/- 18.1% in the TBI-treated group compared to 58.4 +/- 13.0% in the reference group (P = 0.0438). Slower reaccumulation after excretion was found in the TBI-treated patients compared to the reference group (P = 0.0300). The function of the major salivary glands in long-term survivors treated with TBI at BMT before the age of 13 years was found to be diminished, as shown by the reduced trapping rate and reduced emptying capacity, compared to prior to BMT.

  • 4.
    Baron, F.
    et al.
    University of Liege, Belgium .
    Labopin, M.
    Hospital Saint Antoine / Pierre-and-Marie-Curie University, Paris, France.
    Blaise, D.
    CHU Marseille, France .
    Lopez-Corral, L.
    Hospital Clinico Universitario, Salamanca, Spain.
    Vigouroux, S.
    CHU Bordeaux, France .
    Craddock, C.
    Queen Elizabeth Hospital and School of Cancer Studies, University of Birmingham, UK .
    Attal, M.
    CHU Toulouse, France .
    Jindra, P.
    Charles University Medical School and Teaching Hospital, Pilsen, Czech Republic.
    Goker, H.
    Hacettepe University, Ankara,Turkey .
    Socie, G.
    Saint-Louis Hospital, Paris, France.
    Chevallier, P.
    CHU Nantes, France .
    Browne, P.
    St James Hospital, Dublin, Ireland.
    Sandstedt, A.
    Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology.
    Duarte, R. F.
    Hospital Llobregat, Barcelona, Spain .
    Nagler, A.
    Tel Aviv University, Israel.
    Mohty, M.
    Hospital Saint Antoine / Pierre-and-Marie-Curie University, Paris, France.
    Impact of in vivo T-cell depletion on outcome of AML patients in first CR given peripheral blood stem cells and reduced-intensity conditioning allo-SCT from a HLA-identical sibling donor: a report from the Acute Leukemia Working Party of the European group for Blood and Marrow Transplantation2014In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 49, no 3, p. 389-396Article in journal (Refereed)
    Abstract [en]

    The impact of in vivo T-cell depletion on transplantation outcomes in patients transplanted with reduced-intensity conditioning (RIC) remains controversial. This study assessed the outcome of 1250 adult patients with de novo AML in first CR (CR1) given PBSC from HLA-identical siblings after chemotherapy-based RIC. A total of 554 patients did not receive any form of in vivo T-cell depletion (control group), whereas antithymocyte globulin (ATG) and alemtuzumab were given in 444 and 252 patients, respectively. The incidences of grade II-IV acute GVHD were 21.4, 17.6 and 10.2% in control, ATG and alemtuzumab patients, respectively (P less than 0.001). In multivariate analysis, the use of ATG and the use of alemtuzumab were each associated with a lower risk of chronic GVHD (P less than 0.001 each), but a similar risk of relapse, and of nonrelapse mortality, and similar leukemia-free survival and OS. Further, among patients given BU-based RIC, the use of less than 6 mg/kg ATG did not increase the risk of relapse (hazard ratio, HR=1.1), whereas there was a suggestion for higher relapse risk in patients given greater than= 6 mg/kg ATG (HR=1.4, P=0.08). In summary, these data suggest that a certain amount of in vivo T-Cell depletion can be safely used in the conditioning of AML patients in CR1 given PBSC after chemotherapy-based RIC.

  • 5.
    Chevallier, P
    et al.
    CHU Hotel Dieu, France .
    Labopin, M
    University of Paris 06, France .
    Milpied, N
    CHU Bordeaux, France .
    Cornelissen, J J
    Erasmus MC Daniel den Hoed Cancer Centre, Netherlands .
    Blaise, D
    Institute Paoli Calmette, France .
    Petersen, E
    University of Medical Centre Utrecht, Netherlands .
    Sandstedt, A
    Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Goker, H
    Hacettepe University, Turkey .
    Socie, G
    Hop St Louis, France .
    Rocha, V
    Hop St Louis, France .
    Mohty, M
    n/a.
    Impact of cytogenetics risk on outcome after reduced intensity conditioning allo-SCT from an HLA-identical sibling for patients with AML in first CR: a report from the acute leukemia working party of EBMT2012In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 47, no 11, p. 1442-1447Article in journal (Refereed)
    Abstract [en]

    So far the impact of cytogenetics risk on outcome in the context of reduced intensity conditioning (RIC) allo-SCT has been poorly studied. We have identified 378 AML patients in first CR who underwent RIC allo-SCT from an HLA-matched sibling donor between 2000 and 2007 reported to the European Group for Bone and Marrow Transplantation and for whom detailed cytogenetics data were available (good risk: n = 21; intermediate risk: n = 304; and poor risk: n = 53). With a median follow-up of 24 months (range: 1-93), 2-year non-relapse mortality, relapse rate (RR), leukemia-free survival (LFS) and OS were 14%, 31%, 55% and 61%, respectively. Cytogenetics was significantly associated with RR (good risk: 10%; intermediate risk: 28%; and poor risk: 55% at 2 years, Pandlt;0.0001) and LFS (good risk: 64%; intermediate risk: 57%; and poor risk: 38% at 2 years, P = 0.003). In a multivariate analysis, RR and LFS were significantly higher and lower, respectively, in the high-risk cytogenetics group (P = 0.001, P = 0.004) and in patients with a higher WBC at diagnosis (andgt;10 x 10(9)/L) (Pandlt;0.001, P = 0.004). As documented in the setting of myeloablative allo-SCT, patients with poor cytogenetics had increased RR and decreased LFS after RIC allo-SCT, requiring new prospective strategies to improve results in this subgroup.

  • 6.
    Frödin, Ulla
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Börjeson, Sussanne
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology UHL.
    Lyth, Johan
    Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology UHL.
    Lotfi, Kourosh
    Linköping University, Department of Medical and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Pharmacology.
    A prospective evaluation of patients' health-related quality of life during auto-SCT: a 3-year follow-up2011In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 46, no 10, p. 1345-1352Article in journal (Refereed)
    Abstract [en]

    Few studies have evaluated long-term health-related quality of life (HRQL) in patients during auto-SCT. This prospective study examined HRQL in 96 eligible patients before, during and up to 3 years after auto-SCT. The aim of the study was to make a comprehensive assessment of the frequency and severity of different symptoms in patients undergoing auto-SCT. The European Organization for Treatment and Research of Cancer Quality of Life Questionnaire (EORTC QLQ C-30) was administered 13 times. The second week during treatment was the period when patients had the lowest HRQL regarding both total quality of life and function and symptom scales. The patients recovered quickly and just two months after transplantation the baseline values were restored. Three years after transplantation most of the items in the questionnaire had stabilized, except role function and dyspnea, which had improved. There were significant differences between multiple myeloma (MM) and lymphoma patients’ physical function, quality of life, fatigue and pain during week 2. At the 3-year follow-up, lymphoma patients indicated a better HRQL than MM patients. The quick recovery of patients after transplantation suggests that treatment is well tolerated; however, the supportive care could be improved at week 2, especially for the lymphoma patients.

  • 7. Hallbook, H
    et al.
    Hagglund, H
    Stockelberg, D
    Nilsson, PG
    Karlsson, K
    Björkholm, M
    Linderholm, Mats
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Wahlin, A
    Linder, O
    Smedmyr, B
    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 counter-balanced 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. © 2005 Nature Publishing Group All rights reserved.

  • 8.
    Juliusson, Gunnar
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Theorin, Niklas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Karlsson, Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Frödin, U
    Malm, Claes
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Subcutaneous alemtuzumab vs ATG in adjusted conditioning for allogeneic transplantation: Influence of Campath dose on lymphoid recovery, mixed chimerism and survival2006In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 37, no 5, p. 503-510Article in journal (Refereed)
    Abstract [en]

    Sixty-nine consecutive patients (median age 54 years) were prospectively enrolled in a single-institution protocol for allogeneic transplantation with adjusted non-myeloablative fludarabine-melfalan-based conditioning including cyclosporin A and MMF, and one of three modes of serotherapy. Thirty-one donors (45%) were unrelated. The first cohort of 29 had ATG (Thymoglobulin 2 mg/kg × 3 days), the subsequent 26 had Campath 30 mg × 3 days subcutaneously, and the final cohort of 14 had 30 mg Campath once. The groups were similar as regards age, diagnosis and risk factors. Campath-patients had no acute toxicity, fewer days with fever and antibiotics, and required fewer transfusions than ATG-treated patients. 3-d-Campath patients showed lower lymphocyte counts from day + 4, and CD4 +, CD8 +, CD19 + and NK cells recovered slower than in ATG-treated patients. More Campath patients developed mixed chimerism that required DLI. 3-d-Campath induced more serious and opportunistic infections than ATG, which resulted in a greater non-relapse mortality and an impaired overall survival despite a low tumor-related mortality. The change of the Campath dosing schedule to one dose abrogated the deleterious effect of 3-d-Campath on immune recovery, severe infections and survival. Subcutaneous Campath is simple and provides strong immune suppression with no early toxicity, but dose limitation to 30 mg once is recommended. © 2006 Nature Publishing Group. All rights reserved.

  • 9. Lofti, K.
    et al.
    Peterson, Curt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology . Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Juliusson, G.
    Lund Strategic Centre for Stem Cell Biology and Therapy, Department of Hematology, Lund University Hospital, Lund, Sweden.
    Monitoring oral cyclosporine therapy [1]2005In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 36, no 4, p. 367Other (Other academic)
    Abstract [en]

    [No abstract available]

  • 10.
    Lotfi, Kourosh
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Peterson, Curt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Juliusson, Gunnar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Oncology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology UHL.
    Letter: Monitoring oral cyclosporine therapy2005In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 36, p. 367-367Article in journal (Other academic)
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