Investigation of the late effects of allogeneic marrow transplantation for hematologic malignancies is vital for the overall quality of the database of this grant and CA 18029. The broad objective of this project is to reduce the late morbidity and mortality of allogeneic transplantation and improve the well-being of the marrow graft recipient. In project A we propose to reduce complications of transplantation by: 1) evaluating the role of intravenous immunoglobulin (IVIg) in preventing mortality and serious infection in unrelated-donor transplants, 2) testing whether a low- dose, intensive-schedule of IVIg retains efficacy in preventing graft- versus-host disease (GVHD) in adults given related-donor transplants, 3) documenting the pattern and etiology of cutaneous abnormalities after transplantation and evaluating the role of psoralen and ultraviolet A radiation (PUVA) in the treatment of refractory cutaneous acute GVHD. In project B we propose studies to reduce the morbidity and mortality of chronic GVHD by: 1) evaluating prolonged cyclosporine prophylaxis in patients at high risk to develop this complication, 2) investigating the benefit of PUVA therapy in chronic GVHD, 3) evaluating the toxicity and efficacy of rapamycin treatment, 4) conducting therapies of standard-risk and high-risk chronic GVHD. We anticipate that the orderly continuation of these investigations of the late effects of allogeneic transplantation will improve long-term disability-free survival following bone marrow transplantation from related and unrelated donors.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Program Projects (P01)
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Mielcarek, Marco; Storer, Barry E; Boeckh, Michael et al. (2009) Initial therapy of acute graft-versus-host disease with low-dose prednisone does not compromise patient outcomes. Blood 113:2888-94
Tseng, Li-Hui; Storer, Barry; Petersdorf, Effie et al. (2009) IL10 and IL10 receptor gene variation and outcomes after unrelated and related hematopoietic cell transplantation. Transplantation 87:704-10
Bensinger, W I (2009) Role of autologous and allogeneic stem cell transplantation in myeloma. Leukemia 23:442-8
Bensinger, William (2008) Stem-cell transplantation for multiple myeloma in the era of novel drugs. J Clin Oncol 26:480-92
Storek, Jan (2008) Immunological reconstitution after hematopoietic cell transplantation - its relation to the contents of the graft. Expert Opin Biol Ther 8:583-97
Bensinger, William I (2007) Is there still a role for allogeneic stem-cell transplantation in multiple myeloma? Best Pract Res Clin Haematol 20:783-95
Carpenter, Paul A; Hoffmeister, Paul; Chesnut 3rd, Charles H et al. (2007) Bisphosphonate therapy for reduced bone mineral density in children with chronic graft-versus-host disease. Biol Blood Marrow Transplant 13:683-90
Bensinger, William I (2007) Reduced intensity allogeneic stem cell transplantation in multiple myeloma. Front Biosci 12:4384-92
Zaucha, Renata E; Buckner, Dean C; Barnett, Todd et al. (2006) Modified total body irradiation as a planned second high-dose therapy with stem cell infusion for patients with bone-based malignancies. Int J Radiat Oncol Biol Phys 64:227-34
Alkindi, S; Deeg, J H; Flowers, M E D (2006) Recovery of normal autologous myelopoiesis after graft rejection following allogeneic bone marrow transplant for agnogenic myeloid metaplasia. Clin Lab Haematol 28:134-7

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