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Related Concept Videos

Bone Marrow Sampling and Transplants01:22

Bone Marrow Sampling and Transplants

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Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
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Stem Cell Therapy for Tissue Regeneration01:21

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Stem cell therapy is a method used in regenerative medicine to repair and restore function to damaged tissues and organs. Stem cells have the potential to proliferate and differentiate into various tissue types, making them ideal candidates for tissue regeneration. For example, hematopoietic stem cell transplants are commonly used in blood cancer treatment to replenish damaged bone marrow and restore healthy blood cells.
Types of Stem Cells used in Stem Cell Therapy
The two main cell...
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Infection Burden in Mismatched Unrelated Donor Hematopoietic Cell Transplantation: Results from the ACCESS Trial.

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Randomized, Placebo-Controlled Trial of B-Cell Depletion for Prevention of Corticosteroid-Requiring Chronic Graft-Versus-Host Disease.

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eGFR Discordance and Its Association with Outcomes After Allogeneic Hematopoietic Stem Cell Transplantation and Adoptive T-Cell Therapies.

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Mutational landscape changes of AML in patients relapsing after allogeneic hematopoietic cell transplantation.

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Related Experiment Video

Updated: Jun 4, 2025

Induction of Alloantigen-specific Anergy in Human Peripheral Blood Mononuclear Cells by Alloantigen Stimulation with Co-stimulatory Signal Blockade
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How I treat AML relapse after allogeneic HSCT.

Mahasweta Gooptu1, H Moses Murdock1, Robert J Soiffer1

  • 1Department of Hematology/Oncology, Dana-Farber Cancer Institute, Boston, MA.

Blood
|December 24, 2024
PubMed
Summary

Relapse after allogeneic stem cell transplant for acute myeloid leukemia (AML) is common. Treatment is individualized, incorporating chemotherapy, cellular therapies, and clinical trials for better outcomes.

Area of Science:

  • Hematology
  • Oncology
  • Immunology

Background:

  • Allogeneic hematopoietic stem cell transplantation (HSCT) is a primary curative treatment for acute myeloid leukemia (AML).
  • Relapse post-HSCT remains a significant challenge with poor prognosis, despite advances in understanding graft-versus-leukemia effects and immune escape mechanisms.
  • The incidence of AML relapse after HSCT has not decreased in the past 30 years.

Purpose of the Study:

  • To discuss current and evolving strategies for managing acute myeloid leukemia relapse after allogeneic hematopoietic stem cell transplantation.
  • To illustrate individualized treatment approaches for early, late, and incipient relapse using case studies.
  • To highlight the importance of measurable residual disease, clinical trials, and supportive care in managing post-transplant AML relapse.

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Author Spotlight: Exploring the Lifespan Dynamics of Healthy Human Hematopoiesis
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Main Methods:

  • Review of current therapeutic strategies for post-HSCT AML relapse.
  • Discussion of three illustrative cases representing early, late, and incipient relapse.
  • Summary of evolving treatment and prognostication frontiers, including measurable residual disease (MRD).

Main Results:

  • Treatment approaches are highly individualized, based on disease biology, genomics, patient status, and time to relapse.
  • Current strategies include immunosuppression taper, chemotherapy, and cellular therapies like donor lymphocyte infusions or a second HSCT.
  • Measurable residual disease (MRD) plays a critical role in prognostication and treatment decisions.

Conclusions:

  • Managing AML relapse post-HSCT requires a personalized approach integrating various therapeutic modalities.
  • Enrollment in clinical trials and careful consideration of goals of care are crucial for optimizing patient outcomes.
  • Supportive care for frail patients is a universal principle in addressing AML relapse after transplantation.