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Alois Gratwohl - One of the best experts on this subject based on the ideXlab platform.

  • superiority of the triple combination of bortezomib thalidomide dexamethasone over the dual combination of thalidomide dexamethasone in patients with multiple myeloma progressing or relapsing after autologous transplantation the mmvar ifm 2005 04 ran
    Journal of Clinical Oncology, 2012
    Co-Authors: Laurent Garderet, Dietger Niederwieser, Simona Iacobelli, Philippe Moreau, Mamoun Dib, Ingrid Lafon, Tamas Masszi, Jean Fontan, Mauricette Michallet, Alois Gratwohl
    Abstract:

    PURPOSE: This prospective multicenter phase III study compared the efficacy and safety of a triple combination (bortezomib-thalidomide-dexamethasone [VTD]) versus a dual combination (thalidomide-dexamethasone [TD]) in patients with multiple myeloma (MM) progressing or relapsing after autologous stem-cell transplantation (ASCT). PATIENTS AND METHODS: Overall, 269 patients were randomly assigned to receive bortezomib (1.3 mg/m(2) intravenous bolus) or no bortezomib for 1 year, in combination with thalidomide (200 mg per day orally) and dexamethasone (40 mg orally once a day on 4 days once every 3 weeks). Bortezomib was administered on days 1, 4, 8, and 11 with a 10-day rest period (day 12 to day 21) for eight cycles (6 months), and then on days 1, 8, 15, and 22 with a 20-day rest period (day 23 to day 42) for four cycles (6 months). RESULTS: Median time to progression (primary end point) was significantly longer with VTD than TD (19.5 v 13.8 months; hazard ratio, 0.59; 95% CI, 0.44 to 0.80; P = .001), the complete response plus near-complete response rate was higher (45% v 25%; P = .001), and the median duration of response was longer (17.2 v 13.4 months; P = .03). The 24-month survival rate was in favor of VTD (71% v 65%; P = .093). Grade 3 peripheral neuropathy was more frequent with VTD (29% v 12%; P = .001) as were the rates of grades 3 and 4 infection and thrombocytopenia. CONCLUSION: VTD was more effective than TD in the treatment of patients with MM with progressive or relapsing disease post-ASCT but was associated with a higher incidence of grade 3 neurotoxicity.

  • treatment of steroid resistant acute gvhd with okt3 and high dose steroids results in better disease control and lower incidence of infectious complications when compared to high dose steroids alone a randomized multicenter trial by the ebmt Chronic
    Leukemia, 2007
    Co-Authors: S Knop, Holger Hebart, Alois Gratwohl, C Kliem, Christoph Faul, Ernst Holler, Jane F Apperley, H J Kolb, A Schaefer, Dietger Niederwieser
    Abstract:

    Treatment of steroid-resistant acute GVHD with OKT3 and high-dose steroids results in better disease control and lower incidence of infectious complications when compared to high-dose steroids alone: a randomized multicenter trial by the EBMT Chronic Leukemia Working Party

  • human leukocyte antigen dr15 is associated with reduced relapse rate and improved survival after human leukocyte antigen identical sibling hematopoietic stem cell transplantation
    Biology of Blood and Marrow Transplantation, 2006
    Co-Authors: Martin Stern, Alois Gratwohl, Jakob Passweg, Jeanmarie Tiercy, Alexander Genitsch, Sandrine Meyermonard, Dominik Heim, Andre Tichelli, Catherine Nissendruey
    Abstract:

    Abstract Human leukocyte antigen (HLA) DR15 is associated with autoimmune cytopenia in patients with aplastic anemia, myelodysplastic syndrome, and paroxysmal nocturnal hemoglobinuria. Presence of this antigen also predicts response to immunosuppressive treatment. If DR15 expression on hematopoietic cells also favors induction of immune responses in an allogeneic setting, a lower relapse rate after hematopoietic stem cell transplantation (HSCT) might result through an enhanced graft-versus-Leukemia effect. We retrospectively analyzed outcome of HLA-identical sibling HSCT in 192 consecutive patients with acute or Chronic Leukemia or non-Hodgkin lymphoma. Patients carrying the DR15 antigen had a higher estimated 5-year overall survival (76%) than did DR15-negative patients (55%; P = .04). Improved survival for DR15 patients was due to a significant decrease in death from relapse (5% for DR15 + versus 24% for DR15 − ; P = .02), whereas no difference was seen for rates of transplant-related mortality (19% and 21%, respectively; P = .76). Findings were confirmed by multivariate analyses. Our results show an association of DR15 with a decreased risk of disease relapse and improved survival after HSCT for Leukemia or non-Hodgkin lymphoma. This adds to the growing list of links between DR15 and immune reactions in hematopoiesis.

  • allogeneic hematopoietic stem cell transplantation for Chronic myeloid Leukemia in europe 2006 transplant activity long term data and current results an analysis by the Chronic Leukemia working party of the european group for blood and marrow transpl
    Haematologica, 2006
    Co-Authors: Alois Gratwohl, Jane F Apperley, Ronald Brand, Charles Crawley, Tapani Ruutu, Paolo Corradini, Enric Carreras, A Devergie, C Guglielmi, Hansjochen Kolb
    Abstract:

    The introduction of imatinib mesylate has changed attitudes towards hematopoietic stem cell transplantation (HSCT) for Chronic myeloid Leukemia (CML). Information on the current use and results of HSCT is warranted. Data from 592 teams in 42 European countries described their use of HSCT for CML from 1990 to 2004. Outcomes were analyzed for 13,416 patients, with a median age of 36 years (range 1-71 years); 60% were male. The analysis considered three time cohorts, 1980 to 1990, 1991 to 1999 and 2000 to 2003. Survival, transplant-related mortality and relapse incidence were assessed at 20 years for the first cohort and compared at 2 years between the three cohorts. The numbers of HSCT for CML increased from 540 allogeneic HSCT in 1990 to 1,396 HSCT in 1999 and declined to 802 in 2004. One third of all patients and half of those with a low risk were alive at 20 years. Survival at 2 years has improved from 53% to 61% in the most recent years due to a reduction in transplant-related mortality from 41% to 30% in all patients and from 31% to 17% in low-risk patients. Stage, donor type, time interval, age and donor-recipient sex combination remain the main risk factors; patients with a risk score of 0 or 1 have a survival probability of 80% at 2 years. HSCT remains an important treatment option for patients with CML. The data describe the current status of this option and the outcome a patient can expect today. They provide an objective basis for decision making.

Dietger Niederwieser - One of the best experts on this subject based on the ideXlab platform.

Jane F Apperley - One of the best experts on this subject based on the ideXlab platform.

Nigel H Russell - One of the best experts on this subject based on the ideXlab platform.

Hansjochen Kolb - One of the best experts on this subject based on the ideXlab platform.

  • allogeneic hematopoietic stem cell transplantation for Chronic myeloid Leukemia in europe 2006 transplant activity long term data and current results an analysis by the Chronic Leukemia working party of the european group for blood and marrow transpl
    Haematologica, 2006
    Co-Authors: Alois Gratwohl, Jane F Apperley, Ronald Brand, Charles Crawley, Tapani Ruutu, Paolo Corradini, Enric Carreras, A Devergie, C Guglielmi, Hansjochen Kolb
    Abstract:

    The introduction of imatinib mesylate has changed attitudes towards hematopoietic stem cell transplantation (HSCT) for Chronic myeloid Leukemia (CML). Information on the current use and results of HSCT is warranted. Data from 592 teams in 42 European countries described their use of HSCT for CML from 1990 to 2004. Outcomes were analyzed for 13,416 patients, with a median age of 36 years (range 1-71 years); 60% were male. The analysis considered three time cohorts, 1980 to 1990, 1991 to 1999 and 2000 to 2003. Survival, transplant-related mortality and relapse incidence were assessed at 20 years for the first cohort and compared at 2 years between the three cohorts. The numbers of HSCT for CML increased from 540 allogeneic HSCT in 1990 to 1,396 HSCT in 1999 and declined to 802 in 2004. One third of all patients and half of those with a low risk were alive at 20 years. Survival at 2 years has improved from 53% to 61% in the most recent years due to a reduction in transplant-related mortality from 41% to 30% in all patients and from 31% to 17% in low-risk patients. Stage, donor type, time interval, age and donor-recipient sex combination remain the main risk factors; patients with a risk score of 0 or 1 have a survival probability of 80% at 2 years. HSCT remains an important treatment option for patients with CML. The data describe the current status of this option and the outcome a patient can expect today. They provide an objective basis for decision making.