Skip to main content
Erschienen in: InFo Hämatologie + Onkologie 4/2021

19.04.2021 | Schwerpunkt

Schwerpunkt "Zelluläre Therapien"

Allogene Blutstammzelltransplantation: Etabliertes und Neues

verfasst von: Dr. med. Alessia Fraccaroli, Elena Stauffer, Prof. Dr. med. Dr. rer. nat. Michael von Bergwelt-Baildon, PD Dr. med. Johanna Tischer

Erschienen in: InFo Hämatologie + Onkologie | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Auszug

Die allogene Blutstammzelltransplantation ist das älteste zelltherapeutische Verfahren, das in der Therapie von hämatologischen Erkrankungen gut etabliert und wirksam ist. Modifizierte Behandlungskonzepte erlauben zunehmend auch die Behandlung von Patienten mit rezidivierten/refraktären Erkrankungen, auch bei Patienten ohne HLA-kompatiblen Blutstammzellspender und bei älteren Patienten. Dieser Beitrag liefert einen Überblick über das Verfahren und seinen Ablauf sowie über wichtige Komplikationen und beinhaltet einen Ausblick auf neuere Entwicklungen.
Literatur
1.
Zurück zum Zitat Robert C. A decade of immune-checkpoint inhibitors in cancer therapy. Nat Commun. 2020;11(1):3801 Robert C. A decade of immune-checkpoint inhibitors in cancer therapy. Nat Commun. 2020;11(1):3801
2.
Zurück zum Zitat Srivastava S, Riddell SR. Engineering CAR-T cells: Design concepts. Trends Immunol. 2015;36(8):494-502 Srivastava S, Riddell SR. Engineering CAR-T cells: Design concepts. Trends Immunol. 2015;36(8):494-502
3.
Zurück zum Zitat Baeuerle PA, Reinhardt C. Bispecific T-cell engaging antibodies for cancer therapy. Cancer Res. 2009;69(12):4941-4 Baeuerle PA, Reinhardt C. Bispecific T-cell engaging antibodies for cancer therapy. Cancer Res. 2009;69(12):4941-4
4.
Zurück zum Zitat Thomas ED et al. Intravenous infusion of bone marrow in patients receiving radiation and chemotherapy. N Engl J Med. 1957;257(11):491-6 Thomas ED et al. Intravenous infusion of bone marrow in patients receiving radiation and chemotherapy. N Engl J Med. 1957;257(11):491-6
5.
Zurück zum Zitat Mathe G et al. Successful allogenic bone marrow transplantation in man: chimerism, induced specific tolerance, and possible anti-leukemic effects. Blood. 1965;25:179-96 Mathe G et al. Successful allogenic bone marrow transplantation in man: chimerism, induced specific tolerance, and possible anti-leukemic effects. Blood. 1965;25:179-96
6.
Zurück zum Zitat Horowitz MM et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood. 1990;75(3):555-62 Horowitz MM et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood. 1990;75(3):555-62
7.
Zurück zum Zitat Kolb HJ et al. Graft-versus-leukemia effect of donor lymphocyte transfusions in marrow grafted patients. Blood. 1995;86(5):2041-50 Kolb HJ et al. Graft-versus-leukemia effect of donor lymphocyte transfusions in marrow grafted patients. Blood. 1995;86(5):2041-50
8.
Zurück zum Zitat Kolb HJ. Graft-versus-leukemia effects of transplantation and donor lymphocytes. Blood. 2008;112(12):4371-83 Kolb HJ. Graft-versus-leukemia effects of transplantation and donor lymphocytes. Blood. 2008;112(12):4371-83
9.
Zurück zum Zitat Schmid C et al. Donor lymphocyte infusion in the treatment of first hematological relapse after allogeneic stem-cell transplantation in adults with acute myeloid leukemia: a retrospective risk factors analysis and comparison with other strategies by the EBMT Acute Leukemia Working Party. J Clin Oncol. 2007;25(31):4938-45 Schmid C et al. Donor lymphocyte infusion in the treatment of first hematological relapse after allogeneic stem-cell transplantation in adults with acute myeloid leukemia: a retrospective risk factors analysis and comparison with other strategies by the EBMT Acute Leukemia Working Party. J Clin Oncol. 2007;25(31):4938-45
10.
Zurück zum Zitat Sorror ML et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005;106(8):2912-9 Sorror ML et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005;106(8):2912-9
11.
Zurück zum Zitat Finke J et al. Standard graft-versus-host disease prophylaxis with or without anti-T-cell globulin in haematopoietic cell transplantation from matched unrelated donors: a randomised, open-label, multicentre phase 3 trial. Lancet Oncol. 2009;10(9):855-64 Finke J et al. Standard graft-versus-host disease prophylaxis with or without anti-T-cell globulin in haematopoietic cell transplantation from matched unrelated donors: a randomised, open-label, multicentre phase 3 trial. Lancet Oncol. 2009;10(9):855-64
12.
Zurück zum Zitat Hilgendorf I et al. Long-term follow-up after allogeneic stem cell transplantation. Dtsch Arztebl Int. 2015;112(4):51-8 Hilgendorf I et al. Long-term follow-up after allogeneic stem cell transplantation. Dtsch Arztebl Int. 2015;112(4):51-8
13.
Zurück zum Zitat Savani BN et al. How I treat late effects in adults after allogeneic stem cell transplantation. Blood. 2011;117(11):3002-9 Savani BN et al. How I treat late effects in adults after allogeneic stem cell transplantation. Blood. 2011;117(11):3002-9
14.
Zurück zum Zitat Richardson PG et al. Defibrotide for the treatment of severe hepatic veno-occlusive disease and multiorgan failure after stem cell transplantation: a multicenter, randomized, dose-finding trial. Biol Blood Marrow Transplant. 2010;16(7):1005-17 Richardson PG et al. Defibrotide for the treatment of severe hepatic veno-occlusive disease and multiorgan failure after stem cell transplantation: a multicenter, randomized, dose-finding trial. Biol Blood Marrow Transplant. 2010;16(7):1005-17
15.
Zurück zum Zitat Zeiser R. Introduction to a How I Treat series on major complications after allogeneic stem cell transplantation. Blood. 2020;135(19):1609 Zeiser R. Introduction to a How I Treat series on major complications after allogeneic stem cell transplantation. Blood. 2020;135(19):1609
16.
Zurück zum Zitat Jagasia M et al. Randomized controlled study of ECP with methoxsalen as first-line treatment of patients with moderate to severe cGVHD. Blood Adv. 2019;3(14):2218-29 Jagasia M et al. Randomized controlled study of ECP with methoxsalen as first-line treatment of patients with moderate to severe cGVHD. Blood Adv. 2019;3(14):2218-29
17.
Zurück zum Zitat Saria MG, Gosselin-Acomb TK. Hematopoietic stem cell transplantation: implications for critical care nurses. Clin J Oncol Nurs. 2007;11(1):53-63 Saria MG, Gosselin-Acomb TK. Hematopoietic stem cell transplantation: implications for critical care nurses. Clin J Oncol Nurs. 2007;11(1):53-63
18.
Zurück zum Zitat Tischer J et al. Virus infection in HLA-haploidentical hematopoietic stem cell transplantation: incidence in the context of immune recovery in two different transplantation settings. Ann Hematol. 2015;94(10):1677-88 Tischer J et al. Virus infection in HLA-haploidentical hematopoietic stem cell transplantation: incidence in the context of immune recovery in two different transplantation settings. Ann Hematol. 2015;94(10):1677-88
19.
Zurück zum Zitat Hubmann M et al. Occurrence, risk factors and outcome of adenovirus infection in adult recipients of allogeneic hematopoietic stem cell transplantation. J Clin Virol. 2016;82:33-40 Hubmann M et al. Occurrence, risk factors and outcome of adenovirus infection in adult recipients of allogeneic hematopoietic stem cell transplantation. J Clin Virol. 2016;82:33-40
20.
Zurück zum Zitat Peterson L et al. Reactivation of polyomavirus in the genitourinary tract is significantly associated with severe GvHD and oral mucositis following allogeneic stem cell transplantation. Infection. 2016; 44(4):483-90 Peterson L et al. Reactivation of polyomavirus in the genitourinary tract is significantly associated with severe GvHD and oral mucositis following allogeneic stem cell transplantation. Infection. 2016; 44(4):483-90
21.
Zurück zum Zitat Moosmann A et al. Effective and long-term control of EBV PTLD after transfer of peptide-selected T cells. Blood. 2010;115(14):2960-70 Moosmann A et al. Effective and long-term control of EBV PTLD after transfer of peptide-selected T cells. Blood. 2010;115(14):2960-70
22.
Zurück zum Zitat Feuchtinger T et al. Adoptive transfer of pp65-specific T cells for the treatment of chemorefractory cytomegalovirus disease or reactivation after haploidentical and matched unrelated stem cell transplantation. Blood. 2010;116(20):4360-7 Feuchtinger T et al. Adoptive transfer of pp65-specific T cells for the treatment of chemorefractory cytomegalovirus disease or reactivation after haploidentical and matched unrelated stem cell transplantation. Blood. 2010;116(20):4360-7
23.
Zurück zum Zitat Zeiser R et al. Ruxolitinib for Glucocorticoid-Refractory Acute Graft-versus-Host Disease. N Engl J Med. 2020;382(19):1800-10 Zeiser R et al. Ruxolitinib for Glucocorticoid-Refractory Acute Graft-versus-Host Disease. N Engl J Med. 2020;382(19):1800-10
24.
Zurück zum Zitat Rahmat LT, Logan AC. Ibrutinib for the treatment of patients with chronic graft-versus-host disease after failure of one or more lines of systemic therapy. Drugs Today (Barc). 2018;54(5):305-13 Rahmat LT, Logan AC. Ibrutinib for the treatment of patients with chronic graft-versus-host disease after failure of one or more lines of systemic therapy. Drugs Today (Barc). 2018;54(5):305-13
25.
Zurück zum Zitat Mielke S et al. Salvage therapy with everolimus reduces the severity of treatment-refractory chronic GVHD without impairing disease control: a dual center retrospective analysis. Bone Marrow Transplant. 2014;49(11):1412-8 Mielke S et al. Salvage therapy with everolimus reduces the severity of treatment-refractory chronic GVHD without impairing disease control: a dual center retrospective analysis. Bone Marrow Transplant. 2014;49(11):1412-8
26.
Zurück zum Zitat Kuzmina Z et al. Significantly worse survival of patients with NIH-defined chronic graft-versus-host disease and thrombocytopenia or progressive onset type: results of a prospective study. Leukemia. 2012;26(4):746-56 Kuzmina Z et al. Significantly worse survival of patients with NIH-defined chronic graft-versus-host disease and thrombocytopenia or progressive onset type: results of a prospective study. Leukemia. 2012;26(4):746-56
27.
Zurück zum Zitat Schmid C et al. Sequential regimen of chemotherapy, reduced-intensity conditioning for allogeneic stem-cell transplantation, and prophylactic donor lymphocyte transfusion in high-risk acute myeloid leukemia and myelodysplastic syndrome. J Clin Oncol. 2005;23(24):5675-87 Schmid C et al. Sequential regimen of chemotherapy, reduced-intensity conditioning for allogeneic stem-cell transplantation, and prophylactic donor lymphocyte transfusion in high-risk acute myeloid leukemia and myelodysplastic syndrome. J Clin Oncol. 2005;23(24):5675-87
28.
Zurück zum Zitat Luznik L, Fuchs EJ. High-dose, post-transplantation cyclophosphamide to promote graft-host tolerance after allogeneic hematopoietic stem cell transplantation. Immunol Res. 2010;47(1-3):65-77 Luznik L, Fuchs EJ. High-dose, post-transplantation cyclophosphamide to promote graft-host tolerance after allogeneic hematopoietic stem cell transplantation. Immunol Res. 2010;47(1-3):65-77
29.
Zurück zum Zitat Luznik L et al. HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide. Biol Blood Marrow Transplant. 2008;14(6):641-50. Luznik L et al. HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide. Biol Blood Marrow Transplant. 2008;14(6):641-50.
30.
Zurück zum Zitat Tischer J et al. Feasibility of clofarabine cytoreduction followed by haploidentical hematopoietic stem cell transplantation in patients with relapsed or refractory advanced acute leukemia. Ann Hematol. 2013;92(10):1379-88 Tischer J et al. Feasibility of clofarabine cytoreduction followed by haploidentical hematopoietic stem cell transplantation in patients with relapsed or refractory advanced acute leukemia. Ann Hematol. 2013;92(10):1379-88
31.
Zurück zum Zitat Fraccaroli A et al. Sequential HLA-haploidentical transplantation utilizing post-transplantation cyclophosphamide for GvHD prophylaxis in high-risk and relapsed/refractory AML/MDS. Am J Hematol. 2018;93(12):1524-31 Fraccaroli A et al. Sequential HLA-haploidentical transplantation utilizing post-transplantation cyclophosphamide for GvHD prophylaxis in high-risk and relapsed/refractory AML/MDS. Am J Hematol. 2018;93(12):1524-31
32.
Zurück zum Zitat Zoellner AK et al. Sequential therapy combining clofarabine and T-cell-replete HLA-haploidentical haematopoietic SCT is feasible and shows efficacy in the treatment of refractory or relapsed aggressive lymphoma. Bone Marrow Transplant. 2015;50(5):679-84 Zoellner AK et al. Sequential therapy combining clofarabine and T-cell-replete HLA-haploidentical haematopoietic SCT is feasible and shows efficacy in the treatment of refractory or relapsed aggressive lymphoma. Bone Marrow Transplant. 2015;50(5):679-84
33.
Zurück zum Zitat Bashey ZA et al. Comparison of outcomes following transplantation with T-replete HLA-haploidentical donors using post-transplant cyclophosphamide to matched related and unrelated donors for patients with AML and MDS aged 60 years or older. Bone Marrow Transplant. 2018;53(6):756-63 Bashey ZA et al. Comparison of outcomes following transplantation with T-replete HLA-haploidentical donors using post-transplant cyclophosphamide to matched related and unrelated donors for patients with AML and MDS aged 60 years or older. Bone Marrow Transplant. 2018;53(6):756-63
34.
Zurück zum Zitat Fraccaroli A et al. Favorable Outcome of Sequential HLA-Haploidentical Transplantation Using Ptcy As GvHD Prophylaxis in High Risk AML and MDS of the Elderly. Blood. 2018;132(Supplement 1):3458 Fraccaroli A et al. Favorable Outcome of Sequential HLA-Haploidentical Transplantation Using Ptcy As GvHD Prophylaxis in High Risk AML and MDS of the Elderly. Blood. 2018;132(Supplement 1):3458
35.
Zurück zum Zitat Schmid C et al. Donor lymphocyte infusion in the treatment of first hematological relapse after allogeneic stem-cell transplantation in adults with acute myeloid leukemia: a retrospective risk factors analysis and comparison with other strategies by the EBMT Acute Leukemia Working Party. J Clin Oncol. 2007;25(31):4938-45 Schmid C et al. Donor lymphocyte infusion in the treatment of first hematological relapse after allogeneic stem-cell transplantation in adults with acute myeloid leukemia: a retrospective risk factors analysis and comparison with other strategies by the EBMT Acute Leukemia Working Party. J Clin Oncol. 2007;25(31):4938-45
36.
Zurück zum Zitat Burchert A et al. Sorafenib Maintenance After Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia With FLT3-Internal Tandem Duplication Mutation (SORMAIN). J Clin Oncol. 2020;38(26):2993-3002 Burchert A et al. Sorafenib Maintenance After Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia With FLT3-Internal Tandem Duplication Mutation (SORMAIN). J Clin Oncol. 2020;38(26):2993-3002
37.
Zurück zum Zitat Dominietto A et al. Donor lymphocyte infusions for the treatment of minimal residual disease in acute leukemia. Blood. 2007;109(11):5063-4 Dominietto A et al. Donor lymphocyte infusions for the treatment of minimal residual disease in acute leukemia. Blood. 2007;109(11):5063-4
38.
Zurück zum Zitat Krishnamurthy P et al. Outcome of donor lymphocyte infusion after T cell-depleted allogeneic hematopoietic stem cell transplantation for acute myelogenous leukemia and myelodysplastic syndromes. Biol Blood Marrow Transplant. 2013;19(4):562-8 Krishnamurthy P et al. Outcome of donor lymphocyte infusion after T cell-depleted allogeneic hematopoietic stem cell transplantation for acute myelogenous leukemia and myelodysplastic syndromes. Biol Blood Marrow Transplant. 2013;19(4):562-8
39.
Zurück zum Zitat Schroeder TM et al. Treatment of MDS, AML and CMML Relapse after Allogeneic Blood Stem Cell Transplantation with Azacitidine, Lenalidomide and Donor Lymphocyte Infusions Results from the Second Interim Analysis of the Prospective Azalena-Trial (NCT02472691). Blood. 2018;132(Supplement 1):703 Schroeder TM et al. Treatment of MDS, AML and CMML Relapse after Allogeneic Blood Stem Cell Transplantation with Azacitidine, Lenalidomide and Donor Lymphocyte Infusions Results from the Second Interim Analysis of the Prospective Azalena-Trial (NCT02472691). Blood. 2018;132(Supplement 1):703
40.
Zurück zum Zitat Schroeder T et al. Treatment of relapsed AML and MDS after allogeneic stem cell transplantation with decitabine and DLI-a retrospective multicenter analysis on behalf of the German Cooperative Transplant Study Group. Ann Hematol. 2018;97(2):335-42 Schroeder T et al. Treatment of relapsed AML and MDS after allogeneic stem cell transplantation with decitabine and DLI-a retrospective multicenter analysis on behalf of the German Cooperative Transplant Study Group. Ann Hematol. 2018;97(2):335-42
41.
Zurück zum Zitat Schuler E et al. Treatment of myeloid malignancies relapsing after allogeneic hematopoietic stem cell transplantation with venetoclax and hypomethylating agents-a retrospective multicenter analysis on behalf of the German Cooperative Transplant Study Group. Ann Hematol. 2021;100(4):959-68 Schuler E et al. Treatment of myeloid malignancies relapsing after allogeneic hematopoietic stem cell transplantation with venetoclax and hypomethylating agents-a retrospective multicenter analysis on behalf of the German Cooperative Transplant Study Group. Ann Hematol. 2021;100(4):959-68
42.
Zurück zum Zitat Christopeit M et al. Second allograft for hematologic relapse of acute leukemia after first allogeneic stem-cell transplantation from related and unrelated donors: the role of donor change. J Clin Oncol. 2013;31(26):3259-71 Christopeit M et al. Second allograft for hematologic relapse of acute leukemia after first allogeneic stem-cell transplantation from related and unrelated donors: the role of donor change. J Clin Oncol. 2013;31(26):3259-71
43.
Zurück zum Zitat Tischer J et al. Second haematopoietic SCT using HLA-haploidentical donors in patients with relapse of acute leukaemia after a first allogeneic transplantation. Bone Marrow Transplant. 2014;49(7):895-901 Tischer J et al. Second haematopoietic SCT using HLA-haploidentical donors in patients with relapse of acute leukaemia after a first allogeneic transplantation. Bone Marrow Transplant. 2014;49(7):895-901
Metadaten
Titel
Schwerpunkt "Zelluläre Therapien"
Allogene Blutstammzelltransplantation: Etabliertes und Neues
verfasst von
Dr. med. Alessia Fraccaroli
Elena Stauffer
Prof. Dr. med. Dr. rer. nat. Michael von Bergwelt-Baildon
PD Dr. med. Johanna Tischer
Publikationsdatum
19.04.2021
Verlag
Springer Medizin
Erschienen in
InFo Hämatologie + Onkologie / Ausgabe 4/2021
Print ISSN: 2662-1754
Elektronische ISSN: 2662-1762
DOI
https://doi.org/10.1007/s15004-021-8646-2

Weitere Artikel der Ausgabe 4/2021

InFo Hämatologie + Onkologie 4/2021 Zur Ausgabe

Neues aus der Forschung

RCT zur Radiatio gegen COVID-19

Neues aus der Forschung

Komorbiditäten berücksichtigen

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.