The BMT Data Book is an essential guide to the data, outcome studies and complex decision-making processes involved in blood and marrow stem cell transplantation. Organized according to types of diseases and procedures, it contains more than hundred tables, figures and algorithms that reflect up-to-date research and give guidance on the choices between stem cell versus bone marrow transplantation, autologous versus allogeneic transplantation, and conventional versus experimental treatments. This new edition summarizes research of the last 5 years and gives mature data for all established indications, such as acute myeloid leukemia, myelodysplastic syndromes, Hodgkin's and Non-Hodgkin's lymphomas. In addition, controversies and new indications - like renal cell cancer and autoimmune disorders - are discussed plus new drugs and therapies, new stem cell sources (cord blood), new transplant protocols (reduced-intensity conditioning), and a guide to electronic databases.
Author(s): Reinhold Munker, Hillard M. Lazarus, Kerry Atkinson
Edition: 2
Publisher: Cambridge University Press
Year: 2009
Language: English
Pages: 546
Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
Contributors......Page 11
Foreword......Page 13
Preface......Page 15
Acknowledgments......Page 18
Section 1 Basic science......Page 19
Hemopoietic growth factors......Page 21
The hemopoietic stem cell......Page 23
Hematopoietic stem cell differentiation......Page 24
The human marrow microenvironment......Page 25
Stem cell homing......Page 26
The human immune system......Page 27
T cell-B cell collaboration......Page 28
CD markers and currently recognized leukocyte surface antigens......Page 29
Cytokines and their function......Page 30
Natural killer cells......Page 31
NK cell inhibition and activation......Page 32
The mesenchymal stem cells......Page 34
Further Reading......Page 37
Section 2 Hematologic malignancies......Page 39
Classification of acute myeloid leukemia......Page 41
Cytochemical and immunohistochemical stains used for the classification of acute leukemia......Page 43
Acute mixed lineage leukemia......Page 44
Results with conventional therapy in adults......Page 45
Results with allogeneic and autologous transplant......Page 49
Indications for transplant......Page 54
Treatment algorithm for acute myeloid leukemia (AML)......Page 55
Further reading......Page 56
FAB classification......Page 59
Immune phenotype classification......Page 60
Results with conventional therapy in adults......Page 61
CIBMTR data......Page 66
Autologous blood/marrow stem cell transplant......Page 71
Pretransplant workup......Page 72
Further Reading......Page 73
Classification of chronic myeloid leukemia......Page 75
Prognostic factors for outcome with conventional chemotherapy......Page 76
Definitions of hematologic, cytogenetic, and molecular responses......Page 77
Results with conventional therapy......Page 78
CIBMTR-data......Page 79
Donor lymphocyte infusions for relapse of CML after allogeneic transplant......Page 82
Results with reduced-intensity allogeneic transplant for CML......Page 84
Indications for allogeneic transplant in CML (Recommendations of the European Leukemia NET)......Page 85
Pretransplant workup......Page 86
Further Reading......Page 87
5 Therapeutic decision making in BMT/SCT for chronic lymphatic leukemia......Page 89
Immune phenotype and cytogenetic abnormalities......Page 90
Prognostic factors......Page 91
Results with conventional therapy......Page 92
Purine analogues......Page 93
Results with pentostatin and cyclophosphamide......Page 95
Autologous compared with allogeneic stem cell transplantation for poor-risk CLL......Page 96
Nonmyeloablative transplantation for advanced chronic lymphocytic leukemia......Page 97
Results with autologous transplant......Page 98
Special problems in transplantation for CLL......Page 99
HLA-identical sibling transplant......Page 100
Further reading......Page 101
Disease staging and classification......Page 103
Cytogenetic abnormalities......Page 105
Options for conventional treatment for MDS......Page 106
Results with conventional therapy and new agents......Page 107
Results with autologous transplant......Page 109
Results with allogeneic transplant......Page 110
Contraindications to transplant......Page 115
Further reading......Page 116
7 Therapeutic decision making in BMT/SCT for non-Hodgkin lymphoma......Page 117
Disease classification......Page 118
Immune phenotype of lymphoid neoplasms, cytogenetic,and molecular abnormalities......Page 119
Prognostic factors for outcome with conventional therapy......Page 120
CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large B-cell lymphoma......Page 124
Probability of survival after autotransplants for follicular lymphoma......Page 131
Primary mediastinal B-cell lymphoma......Page 142
T-cell lymphoma......Page 143
Disease classification......Page 145
Risk factors for early-stage Hodgkin lymphoma......Page 146
Results with autologous transplant......Page 147
Results with myeloablative allogeneic transplant......Page 151
Results with nonmyeloablative allogeneic transplant......Page 152
Contraindications to autologous transplant......Page 154
Further reading......Page 155
Diagnosis......Page 157
Adverse prognostic factors......Page 159
Standard-dose therapy in the up-front treatment of multiple myeloma......Page 160
Conclusions from recent studies......Page 169
Pretransplant workup......Page 170
Monitoring posttransplant......Page 171
Further reading......Page 172
Disease classification......Page 175
Results of autologous transplantation......Page 176
Contraindications to transplantation......Page 179
Further reading......Page 180
Section 3 Solid tumors......Page 181
11 Therapeutic decision making in stem cell transplantation for breast cancer......Page 183
Further reading......Page 185
Disease classification......Page 187
Prognostic factors for outcome with conventional therapy......Page 188
Results with autologous transplant......Page 189
Tandem versus single autologous transplantation......Page 191
Monitoring posttransplant......Page 192
Further reading......Page 193
Results of conventional treatment......Page 195
Results of allogeneic transplantation......Page 196
Mechanisms accounting for graft-versus-RCC responses after transplantation......Page 202
Future directions......Page 203
Further Reading......Page 204
Disease classification......Page 207
Neuroblastoma......Page 208
Ewing sarcoma and other soft tissue sarcomas......Page 209
Further reading......Page 211
Section 4 Nonmalignant disorders......Page 213
Etiology......Page 215
Results with conventional therapy......Page 216
Results with allogeneic transplant......Page 219
Pretransplant workup......Page 221
Further reading......Page 222
Introduction......Page 223
Results of BMT/SCT for SCID......Page 224
Results of BMT/SCT for non-SCID immunodeficiencies......Page 225
Reduced-intensity conditioning for congenital immunodeficiencies......Page 229
Further reading......Page 230
B-Thalassemia syndromes......Page 233
Results with conventional therapy for thalassemia......Page 234
Results with conventional therapy for sickle cell disease......Page 236
Results with allogeneic transplant for thalassemia major......Page 237
Results with allogeneic transplant for sickle cell disease......Page 240
Pretransplant workup......Page 241
Myeloablative or reduced-intensity conditioning regimen for hemoglobinopathy transplants......Page 242
Monitoring posttransplant......Page 243
Further reading......Page 244
Introduction......Page 245
Multiple sclerosis......Page 246
Systemic lupus erythematosus......Page 247
Further reading......Page 248
Section 5 Practical aspects and procedures......Page 251
19 Practical aspects and procedures, including conditioning protocols and haploidentical transplantation......Page 253
Exclusion criteria for transplantation......Page 255
SCT-specific comorbidity index......Page 256
General pretransplant workup......Page 258
When to start leukapheresis......Page 259
Alternative cytokines/chemokines for stem cell mobilization......Page 260
Approach to patients who are poor mobilizers......Page 261
Allogeneic donor workup......Page 262
Commonly used prophylactic medications......Page 263
Treatment of CNS leukemia pretransplant......Page 264
Triple-, double-, and single-lumen right atrial catheters......Page 265
Preoperative/local anesthetic preparation......Page 266
Management of a dislodged catheter......Page 267
Procedure......Page 268
Procedure......Page 269
Procedure......Page 270
Difficulty in sampling blood......Page 271
Procedure......Page 272
Streptokinase/urokinase/TPA instillation into a central venous catheter......Page 273
Other potential problems......Page 274
Fluid regime for conditioning regimens......Page 275
Antiemetic regime for conditioning regimens......Page 276
The marrow donor......Page 277
Procedure......Page 278
Obese donors......Page 279
Marrow cell dose......Page 280
ABO-compatible bone marrow infusion......Page 282
Protocol for ABO-incompatible bone marrow infusion......Page 283
Clinical and laboratory features of alloimmune hemolysis in BMT patients......Page 284
Autologous bone marrow/peripheral blood stem cell infusion......Page 285
Blood transfusion guidelines for BMT patients......Page 286
Packed red cell transfusion......Page 287
Human serum albumin......Page 289
Guidelines......Page 290
Fluid balance......Page 291
Pain relief......Page 292
Discharge planning......Page 293
Vaccination posttransplant......Page 294
Ocular complications......Page 295
Neurologic and psychologic abnormalities......Page 296
Gonadal dysfunction......Page 297
Methods for converting units of measure......Page 298
Karnofsky performance score......Page 302
Lansky play scale (for children)......Page 303
Grading organ toxicity after BMT (Seattle criteria, 1988)......Page 304
Indications......Page 306
Outcomes in different diseases......Page 308
Administration......Page 310
Extravasation......Page 311
Dose reductions for renal or hepatic dysfunction......Page 312
Autologous transplantation......Page 313
Testicular cancer......Page 314
HLA-identical sibling transplant......Page 315
Allogeneic transplantation (reduced intensity and nonmyeloablative)......Page 316
Introduction and historical background......Page 319
Immunologic features of UCB and hematopoietic engraftment......Page 320
UCB collection and banking......Page 322
Summary......Page 323
Further reading......Page 326
Section 6 Complications......Page 329
Introduction......Page 331
Genetic basis of acute GVHD......Page 332
Immunobiology of acute GVHD......Page 334
Phase 1: Activation of antigen-presenting cells......Page 335
Phase 2: Donor T-cell activation......Page 336
Phase 3: Cellular and inflammatory effector phase......Page 338
Immunobiology of chronic GVHD......Page 339
Acute Graft-Versus-Host Disease......Page 349
Consensus Criteria for Staging of Acute GVHD*......Page 350
Posttransplant immunosuppression to prevent GVHD......Page 351
Initial therapy......Page 352
Secondary therapy......Page 354
Definitions and staging......Page 356
General aspects and initial therapy......Page 365
Overview of most commonly used steroid-sparing therapies......Page 366
Conclusions......Page 370
Further reading......Page 371
Empiric antibiotic treatment for febrile neutropenia......Page 375
Empiric Antibiotic Regimes......Page 376
Management of continued febrile neutropenia in the absence of?documented infection (fever of unknown origin)......Page 377
Bacteremia......Page 378
Catheter Related Infections......Page 379
Respiratory tract......Page 380
Fungal infections......Page 381
Diagnosis of Herpes Virus Infections......Page 383
Antifungal prophylaxis......Page 385
Antiviral prophylaxis......Page 386
Management of specific infections......Page 388
Interstitial pneumonitis......Page 391
Diagnosis......Page 392
Prophylaxis of CMV disease and Pneumocystis carinii (jirovecii) pneumonia......Page 394
Addendum: Dose reduction for ganciclovir and foscarnet during impaired renal function (manufacturers' recommendations)......Page 395
Further reading......Page 396
24 Organ-related and miscellaneous complications......Page 397
Failure of sustained engraftment after allotransplantation......Page 398
Differential diagnosis of hepatic VOD in BMT recipients......Page 399
Risk factors for hepatic VOD......Page 400
Diagnosis......Page 401
Grading of hemorrhagic cystitis......Page 402
Transplant-associated microangiopathy......Page 403
Cyclosporin-associated blindness......Page 404
Management of hypotension in patients receiving nimodipine......Page 405
Side effects of oral treatment......Page 406
New malignancy after BMT......Page 407
Solid tumors......Page 408
Dermatologic complications of BMT......Page 410
Late complications......Page 411
Eye complications of BMT......Page 412
Grading system for cataracts......Page 413
Nausea/vomiting......Page 414
Bleeding......Page 415
A "GVHD diet"......Page 416
Gynecologic complications......Page 417
Factors that contribute to the development of ovarian or testicular failure......Page 418
Options for preservation of fertility in males:......Page 419
Options for preservation of fertility in females:......Page 420
Causes of thrombocytopenia after BMT......Page 422
Liver disease after day 100......Page 423
Neurologic complications......Page 424
Causes of seizures in BMT patients......Page 425
Causes of metabolic encephalopathy in BMT patients......Page 426
Psychosocial problems after BMT......Page 429
Pulmonary complications......Page 430
Treatment of superficial thrombophlebitis in BMT recipients......Page 432
Urgent reduction of hyperkalemia......Page 433
Contraindications and side effects......Page 434
Disodium pamidronate......Page 435
Hypocalcemia......Page 436
Hyperuricemia......Page 437
Back pain with or without referred radicular pain......Page 438
Tumor lysis syndrome......Page 439
Anaphylaxis......Page 440
Precautions......Page 441
Prophylaxis of gout......Page 442
Contraindications......Page 443
Interactions......Page 444
Section 7 The BMT/SCT pharmacopoeia......Page 447
Analgesics and adjuvant analgesics......Page 449
Opioids......Page 450
Codeine......Page 451
Hydromorphone......Page 452
Meperidine/pethidine......Page 453
Morphine......Page 454
Oxycodone......Page 455
Clonazepam......Page 456
Aminoglycoside therapeutic monitoring......Page 457
Cephalosporins and other B-lactam antibiotics......Page 458
Cefotaxime......Page 459
Aztreonam......Page 460
General prescribing information......Page 461
Co-trimoxazole......Page 462
Co-trimoxazole......Page 463
Indications......Page 464
Moxifloxacin......Page 465
General prescribing information......Page 466
Linezolid......Page 467
Indications......Page 468
Low molecular-weight heparins......Page 469
Before commencing heparin......Page 470
High-risk situations with heparin usage......Page 471
Monitoring......Page 472
Recombinant human tissue plasminogen activator (rTPA, alteplase)......Page 473
Diphenoxylate/atropine (Lomotil)......Page 474
Side effects......Page 475
Antifungal agents: systemic use......Page 476
General prescribing information......Page 477
Contraindications and side effects......Page 478
Interactions......Page 479
General prescribing information......Page 480
Indications......Page 481
Griseofulvin......Page 482
Posaconazole......Page 483
Azacitidine......Page 484
Dosage......Page 485
Side effects......Page 486
Decitabine......Page 487
Melphalan......Page 488
Antivirals......Page 489
Acyclovir......Page 490
Contraindications and side effects......Page 491
Valganciclovir......Page 492
General prescribing information......Page 494
Indication......Page 495
Contraindications......Page 496
Oprelvekin......Page 497
Side effects......Page 498
Corticosteroids......Page 499
Methylprednisolone......Page 500
Interactions......Page 501
General prescribing information......Page 502
Side effects......Page 503
Drug interactions......Page 504
Alemtuzumab......Page 505
Asparaginase......Page 506
Infliximab......Page 507
Rasburicase......Page 508
Further reading......Page 509
Section 8 HLA-testing and laboratorymedicine......Page 511
Histocompatibility typing......Page 513
Overview of HLA typing......Page 514
Suggestions for typing for bone marrow and stem cell transplantation:......Page 515
Studies for chimerism......Page 525
Cytogenetic terminology......Page 526
Detection of minimal residual malignant disease (MRD)......Page 527
Further Reading......Page 528
American Society of Hematology......Page 529
Allogeneic Stem cell Transplantation, 1st edition, 454 p.......Page 530
Thomas' Hematopoietic Cell Transplantation, 4th edition, 1600 p.......Page 531
National Library of Medicine......Page 532
Index......Page 533