Biology-driven approaches to prevent and treat relapse of myeloid neoplasia after allogeneic hematopoietic stem cell transplantation

Journal article


Publication Details

Author(s): Zeiser R, Beelen DW, Bethge W, Bornhäuser M, Bug G, Burchert A, Christopeit M, Duyster J, Finke J, Gerbitz A, Klusmann JH, Kobbe G, Lübbert M, Müller-Tidow C, Platzbecker U, Rösler W, Sauer M, Schmid C, Schroeder T, Stelljes M, Kröger N, Müller LP
Journal: Biology of Blood and Marrow Transplantation
Publication year: 2019
ISSN: 1083-8791


Abstract

The curative potential of allogeneic hematopoietic cell transplantation (allo-HCT) in the treatment of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) mainly relies on the graft-versus-leukemia (GVL)-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 on the established and evolving approaches to prevent or treat relapse of AML and MDS after allo-HCT, in the context of novels insight into the biology of relapse. Established prophylactic measures to prevent relapse include optimized conditioning and GVHD-prophylaxis as well as donor lymphocyte transfusions for high risk patients while novel immunomodulatory interventions and maintenance approaches are still experimental. Improved diagnostics can detect persistent or recurring disease at a molecular level thus enabling early preemptive interventions. Established options include hypomethylating agents and donor lymphocytes. Standard treatments for haematological relapse comprise chemotherapy, cessation of immunosuppressive treatments and donor lymphocytes. Experimental approaches include molecular targeted therapies, novel immune-modulatory treatments or second allo-HCT. For all interventions, the potential risks including occurrence of GVHD have to be weighed against the benefits individually in each patient. Concurrently, prevention and treatment of relapse post-allo-HCT remains challenging and is an unmet medical need.


FAU Authors / FAU Editors

Rösler, Wolf Dr. med.
Medizinische Klinik 5 - Hämatologie und Internistische Onkologie


External institutions with authors

Charité - Universitätsmedizin Berlin
Klinikum Augsburg
Max-Planck-Institut für molekulare Zellbiologie und Genetik / Max Planck Institute of Molecular Cell Biology and Genetics (MPI-CBG)
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Universitätsklinikum Düsseldorf
Universitätsklinikum Essen
Universitätsklinikum Frankfurt
Universitätsklinikum Freiburg
Universitätsklinikum Gießen und Marburg (UKGM)
Universitätsklinikum Halle (Saale)
Universitätsklinikum Hamburg-Eppendorf
Universitätsklinikum Heidelberg
Universitätsklinikum Leipzig
Universitätsklinikum Tübingen
Westfälische Wilhelms-Universität (WWU) Münster


How to cite

APA:
Zeiser, R., Beelen, D.W., Bethge, W., Bornhäuser, M., Bug, G., Burchert, A.,... Müller, L.P. (2019). Biology-driven approaches to prevent and treat relapse of myeloid neoplasia after allogeneic hematopoietic stem cell transplantation. Biology of Blood and Marrow Transplantation. https://dx.doi.org/10.1016/j.bbmt.2019.01.016

MLA:
Zeiser, Robert, et al. "Biology-driven approaches to prevent and treat relapse of myeloid neoplasia after allogeneic hematopoietic stem cell transplantation." Biology of Blood and Marrow Transplantation (2019).

BibTeX: 

Last updated on 2019-20-02 at 19:08