Browsing by Author "Arat, Mutlu"

Now showing 1 - 9 of 9

Autologous Hematopoietic Progenitor Cell Mobilization and Collection in Adult Patients Presenting with Multiple Myeloma and Lymphoma: A Position-Statement from The Turkish Society of Apheresis (TSA)
(2017) Tekgunduz, Emre; Arat, Mutlu; Goker, Hakan; Ozdogu, Hakan; Kaynar, Leylagul; Cagirgan, Seckin; Erkurt, Mehmet Ali; Vural, Filiz; Kiki, Ilhami; Altuntas, Fevzi; Demirkan, Fatih; https://orcid.org/0000-0002-8902-1283; 29153306; AAD-5542-2021
Autologous hematopoietic cell transplantation (AHCT) is a routinely used procedure in the treatment of adult patients presenting with multiple myeloma (MM), Hodgkin lymphoma (HL) and various subtypes of non-Hodgkin lymphoma (NHL) in upfront and relapsed/refractory settings. Successful hematopoietic progenitor cell mobilization (HPCM) and collection are the rate limiting first steps for application of AHCT. In 2015, alinost 1700 AHCT procedures have been performed for MM, HL and NHL in Turkey. Although there are recently published consensus guidelines addressing critical issues regarding autologous HPCM, there is a tremendous heterogeneity in terms of mobilization strategies of transplant centers across the world. In order to pave the way to a more standardized HPCM approach in Turkey, Turkish Society of Apheresis (TSA) assembled a working group consisting of experts in the field. Here we report the position statement of TSA regarding autologous HPCM mobilization strategies in adult patients presenting with MM and lymphoma. (C) 2017 Elsevier Ltd. All rights reserved.
Comparable Survival Using A CMV-Matched Or A Mismatched Donor For CMV Plus Patients Undergoing T-Replete Haplo-HSCT With PT-Cy For Acute Leukemia: A Study Of Behalf Of The Infectious Diseases And Acute Leukemia Working Parties Of The EBMT
(2018) Cesaro, Simone; Crocchiolo, Roberto; Tridello, Gloria; Knelange, Nina; Van Lint, Maria Teresa; Koc, Yener; Ciceri, Fabio; Gulbas, Zafer; Tischer, Johanna; Afanasyev, Boris; Bruno, Benedetto; Castagna, Luca; Blaise, Didier; Mohty, Mohamad; Irrera, Giuseppe; Diez-Martin, J. L.; Pierelli, Luca; Pioltelli, Pietro; Arat, Mutlu; Delia, Mario; Fagioli, Franca; Ehninger, Gerhard; Aljurf, Mahmoud; Carella, Angelo Michele; Ozdogu, Hakan; Mikulska, Malgorzata; Ljungman, Per; Nagler, Arnon; Styczynski, Jan; https://orcid.org/0000-0002-8902-1283; 29330396; AAD-5542-2021
The role of donor CMV serostatus in the setting of non T-cell depleted haplo-HSCT with post-transplant cyclophosphamide (PT-Cy) has not been specifically addressed so far. Here we analyzed the impact of the donor CMV serological status on the outcome of 983 CMV seropositive (CMV+), acute leukemia patients receiving a first, non T-cell depleted haplo-HSCT registered in the EBMT database. The 1-year NRM was 21.3% (95% CI: 18.4-24.8) and 18.8% (95% CI: 13.8-25.5) in the CMV D+P/R+ and D-/R+ pairs, respectively (p = 0.40). Similarly, 1-year OS was 55.1% (95% CI: 50.1-58.0) and 55.7% (95% CI: 48.0-62.8) in the same groups (p = 0.50). The other main outcomes were comparable. No difference in NRM nor OS was observed after stratification for the intensity of conditioning and multivariate anaysis confirmed the lack of significant association with NRM or OS. In conclusion, the choice of a CMV-seronegative donor did not impair early survival of CMV-seropositive patients with acute leukemia after a first, non T-cell depleted haploidentical HSCT and PT-Cy among this series of 983 consecutive patients. Future research may focus on the assessment of the hierarchy of all the donor variables.
Current Practice of Autologous Hematopoietic Progenitor Cell Mobilization in Adult Patients with Multiple Myeloma And Lymphoma: The Results of A Survey From Turkish Hematology Research And Education Group (Threg)
(2017) Tekgunduz, Emre; Demirkan, Fatih; Vural, Filiz; Goker, Hakan; Ozdogu, Hakan; Kiki, Ilhami; Aydogdu, Ismet; Kaynar, Leylagul; Erkurt, Mehmet Ali; Cagirgan, Seckin; Besisik, Sevgi; Dagdas, Simten; Koca, Ebru; Kadikoylu, Gurhan; Gunduz, Eren; Yilmaz, Mehmet; Bekoz, Huseyin; Ural, Ali Ugur; Basturk, Abdulkadir; Arat, Mutlu; Albayrak, Murat; Ozturk, Erman; Akyol, Alev; Bolaman, Ali Zahit; Nevruz, Oral; Ozkan, Hasan Atilla; Ozgur, Gokhan; Altuntas, Fevzi; 29153305
Autologous hematopoietic cell transplantation (AHCT) is an established treatment option for adult patients presenting with multiple myeloma (MM), Hodgkin lymphoma (HL) and various subtypes of non-Hodgkin lymphoma (NHL) in upfront and/or relapsed/refractory disease settings. Although there are recently published consensus guidelines addressing critical issues regarding autologous hematopoietic progenitor cell mobilization (HPCM), mobilization strategies of transplant centers show high variability in terms of routine practice. In order to understand the current institutional policies regarding HPCM in Turkey and to obtain the required basic data for preparation of a national positional statement on this issue, Turkish Hematology Research and Education Group (ThREG) conducted a web-based HPCM survey. The survey was designed to include multiple-choice questions regarding institutional practice of HPCM in adults presenting MM, HL, and NHL. The representatives of 27 adult HCT centers participated to the study. Here we report the results of this survey shedding light on the real world experience in Turkey in terms of autologous HPCM mobilization strategies in patients presenting with MM and lymphoma. (C) 2017 Elsevier Ltd. All rights reserved.
Haploidentical Versus Matched Sibling Donor Hematopoietic Stem Cell Transplantation for Adult Patients With Relapsed/Refractory Acute Lymphoblastic Leukemia: A Study From the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
(2022) Nagler, Arnon; Labopin, Myriam; Swoboda, Ryszard; Pioltelli, Pietro; Arat, Mutlu; Yakoub-Agha, Ibrahim; Kulagin, Alexander; Maria Raiola, Anna; Ozdogu, Hakan; Risitano, Antonio; Nur Ozkurt, Zubeyde; Sanz, Jaime; Brissot, Eolia; Zina, Peric; Giebel, Sebastian; Ciceri, Fabio; Mohty, Mohamad; 000892089600008
The results of haploidentical stem cell transplantation (haploHCT) for patients with acute lymphoblastic leukemia (ALL) transplanted in active disease remain largely unknown. We retrospectively analyzed adult patients with R/R ALL who underwent haploHCT or matched sibling donor (MSD-HCT) as a first transplantation between 2012 and 2020. The analysis comprised 274 patients, 94 had a haploHCT, and 180 had an MSD-HCT. The median follow-up was 32 months. The median age was 33 (range 18-76) and 37 (18-76) years in the haplo- and MSD-HCT groups, respectively. Post-transplant cyclophosphamide (PTCy) was used in 88% of haploHCT and in 4% of the MSD-HCT group. Graft-versus-host disease grade III-IV was higher in haploHCT than in the MSD-HCT group (18% versus 9%; P = 0.042). The 2-year chronic (c) graft-versus-host disease rates were 17% versus 33% (hazard ratio [HR] = 0.56; P = 0.14), respectively. By multivariate analysis, relapse incidence, and leukemia-free survival were not significatively different between the transplant groups, while nonrelapse mortality (NRM) was significantly higher (25% versus 18% at 2 years; HR = 2.03; P = 0.042) and overall survival (OS) lower (22% versus 38% at 2 years; HR = 1.72; P = 0.009) in the haploHCT group compared with the MSD-HCT group. We conclude that the 2-year OS of R/R ALL patients undergoing MSD transplants is significantly better than in haploHCT with a higher NRM in the latter.
Haploidentical Versus Matched Sibling Donor Hematopoietic Stem Cell Transplantation for Adult Patients with Relapsed/Refractory Acute Lymphoblastic Leukemia: A Study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
(2021) Nagler, Arnon; Labopin, Myriam; Pioltelli, Pietro; Arat, Mutlu; Yakoub-Agha, Ibrahim; Kulagin, Aleksandr D.; Angelucci, Emanuele; Ozdogu, Hakan; Risitano, Antonio; Ciceri, Fabio; Ozkurt, Zubeyde Nur; Sanz, Jaime; Brissot, Eolia; Peric, Zinaida; Giebel, Sebastian; Mohty, Mohamad
Improved Outcomes of Haploidentical Hematopoietic Cell Transplantation with Total Body Irradiation-Based Myeloablative Conditioning in Acute Lymphoblastic Leukemia
(2021) Dholaria, Bhagirathbhai; Labopin, Myriam; Angelucci, Emanuele; Tischer, Johanna; Arat, Mutlu; Ciceri, Fabio; Guelbas, Zafer; Sica, Simona; Ozdogu, Hakan; Diez-Martin, Jose Luis; Koc, Yener; Pavlu, Jiri; Socie, Gerard; Giebel, Sebastian; Savani, Bipin N.; Nagler, Arnon; Mohty, Mohamad; 0000-0002-8902-1283; 33830029; AAD-5542-2021
The optimal myeloablative conditioning (MAC) for patients undergoing haploidentical hematopoietic cell transplantation (haplo-HCT) is unknown. We studied the outcomes of total body irradiation (TBI)-based versus chemotherapy (CT)-based MAC regimens in patients with acute lymphoblastic leukemia (ALL). The study included 427 patients who underwent first haplo-HCT with post-transplantation cyclophosphamide (PTCy), following TBI-based (n = 188; 44%) or CT-based (n = 239; 56%) MAC. The median patient age was 32 years. Fludarabine-TBI (72%) and thiotepa-busulfan-fludarabine (65%) were the most frequently used TBI- and CT-based regimens, respectively. In the TBI and CT cohorts, 2-year leukemia-free survival (LFS) was 45% versus 37% (P = .05), overall survival (OS) was 51% versus 47% (P = .18), relapse incidence (RI) was 34% versus 32% (P = .44), and nonrelapse mortality (NRM) was 21% versus 31% (P < .01). In the multivariate analysis, TBI was associated with lower NRM (hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.33 to 0.86; P = .01), better LFS (HR, 0.71; 95% CI, 0.52 to 0.98; P =.04), and increased risk for grade II-IV acute graft-versus-host disease (GVHD) (HR, 1.59; 95% CI, 1.08 to 2.34; P = .02) compared with CT-based MAC. The type of conditioning regimen did not impact RI, chronic GVHD, OS, or GVHD-free, relapse-free survival after adjusting for transplantation-related variables. TBI-based MAC was associated with lower NRM and better LFS compared with CT-based MAC in patients with ALL after haplo-HCT/PTCy. (C) 2020 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
Outcomes of Total Body Irradiation-Versus Chemotherapy-Based Myeloablative Conditioning Regimen in Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide for Acute Lymphoblastic Leukemia: ALWP of the EBMT Study
(2019) Dholaria, Bhagirathbhai; Labopin, Myriam; Angelucci, Emanuele; Tischer, Johanna; Arat, Mutlu; Ciceri, Fabio; Gulbas, Zafer; Ozdogu, Hakan; Sica, Simona; Diez-Martin, Jose L; Koc, Yener; Apperley, Jane; Socie, Gerard; Giebel, Sebastian; Savani, Bipin N.; Nagler, Arnon; Mohty, Mohamad; https://orcid.org/0000-0002-8902-1283; AAD-5542-2021
Post-transplant cyclophosphamide versus anti-thymocyte globulin for graft-versus-host disease prevention in haploidentical transplantation for adult acute lymphoblastic leukemia
(2021) Nagler, Arnon; Kanate, Abraham S.; Labopin, Myriam; Ciceri, Fabio; Angelucci, Emanuele; Koc, Yener; Gulbas, Zafer; Arcese, William; Tischer, Johanna; Pioltelli, Pietro; Ozdogu, Hakan; Afanasyev, Boris; Wu, Depei; Arat, Mutlu; Peric, Zinaida; Giebel, Sebastian; Savani, Bipin; Mohty, Mohamad; 32354866
Graft-versus-host disease (GvHD) prophylaxis for unmanipulated haploidentical hematopoietic cell transplantation includes posttransplant cyclophosphamide (PTCy) and anti-thymocyte globulin (ATG). Utilizing data in the European Society for Blood and Marrow Transplantation registry, we compared ATG- versus PTCy-based GvHD prophylaxis in 434 adults with acute lymphoblastic leukemia undergoing haploidentical hematopoietic cell transplantation. Of the 434 patients included in this study, ATG was used in 98 and PTCy in 336.. The median follow-up was approximately 2 years. The baseline characteristics of the patients were similar between the groups except that the ATG group was more likely to have had relapsed/refractory acute lymphoblastic leukemia (P=0.008), had conditioning not including total body irradiation (P<0.001), have had peripheral blood as the source of their grafts (P=0.001) and to have been transplanted in an earlier timeperiod (median year of transplantation: 2011 vs. 2015). The 100-day rates of grade II-IV and III-IV acute GvHD were similar in the ATG and PTCy groups, as were 2-year chronic GvHD rates. On multivariate analysis, leukemia-free survival and overall survival were better with PTCy than with ATG prophylaxis. Relapse incidence was lower in the PTCy group (P=0.03), while non-relapse mortality was not different. Advanced disease and lower performance score were associated with poorer leukemia-free survival and overall survival and advanced disease was associated with inferior GvHD-free/relapse-free survival. Compared to bone marrow grafts, peripheral grafts were associated with higher rates of GvHD. In patients with acute lymphoblastic leukemia undergoing unmanipulated haploidentical hematopoietic cell transplantation, PTCy for GvHD prevention resulted in a lower incidence of relapse and improved leukemia-free survival and overall survival, compared to ATG.
Total Body Irradiation Plus Fludarabine Versus Busulfan Plus Fludarabine As A Myeloablative Conditioning for Adults with Acute Myeloid Leukemia Treated with Allogeneic Hematopoietic Cell Transplantation. A Study on Behalf of The Acute Leukemia Working Party of The EBMT
(2022) Swoboda, Ryszard; Labopin, Myriam; Giebel, Sebastian; Schroeder, Thomas; Kroeger, Nicolaus; Arat, Mutlu; Savani, Bipin; Spyridonidis, Alexandros; Hamladji, Rose-Marie; Potter, Victoria; Berceanu, Ana; Yakoub-Agha, Ibrahim; Rambaldi, Alessandro; Ozdogu, Hakan; Sanz, Jaime; Nagler, Arnon; Mohty, Mohamad; 36460819
Cyclophosphamide is frequently substituted with fludarabine (Flu) in conditioning regimens before allogeneic hematopoietic cell transplantation (allo-HCT). We aimed to compare retrospectively, total body irradiation (12 Gy) plus Flu (FluTBI12) versus busulfan (Bu) plus Flu (FB4) as a myeloablative conditioning before allo-HCT in patients with acute myeloid leukemia (AML). Out of 3203 patients who met the inclusion criteria, 109 patients treated with FluTBI12 and 213 treated with FB4 were included in a final matched-pair analysis. In both groups, median patient age was 41 years, first or second complete remission (CR1/CR2) proportion was 78%/22%, allo-HCT from an unrelated donor was performed in 78% of patients. The probabilities of leukemia-free survival and overall survival at 2 years in FluTBI12 and FB4 groups were 65% vs. 60% (p = 0.64) and 70% vs. 72% (p = 0.87), respectively. The cumulative incidence of relapse was 19% vs. 29% (p = 0.11), while non-relapse mortality was 16% vs. 11%, respectively (p = 0.13). There were no statistical differences in both acute and chronic graft-versus-host disease (GVHD) incidence. The probability of GVHD-free, relapse-free survival (GRFS) was 49% for both groups. FluTBI12 and FB4 are comparable myeloablative regimens before allo-HCT in AML patients transplanted in CR1 and CR2.