ASH Clinical News ACN_5.5_full_issue_web | Page 28

On Location Conference Coverage ADVANCES IN TRANSPLANTATION Attendees in a session at the 2019 TCT Meeting. t the 2019 Transplantation & Cellular Therapy Meetings of ASBMT and CIBMTR, held February 20–24 in Houston, investigators, clinicians, researchers, and other health-care professionals gathered to hear the latest updates in the field of hematopoietic cell transplantation and cellular therapy. Here, we share highlights in hematologic research presented at the meeting. Look for more coverage in our May issue. 26 ASH Clinical News A Safer Conditioning Regimen for Patients With Bone Marrow Failure and Short Telomeres? A study of patients with bone marrow failure (BMF) and short telomeres found that a conditioning regimen that eli- minates radiation and DNA-alkylating agents led to successful engraftment and could spare patients from the toxicities associated with standard conditioning regimens. Removing the “necessary evils” of DNA-alkylating agents and radiation could enable transplant in patients with high-risk comorbidities, according to lead author Suneet Agarwal, MD, PhD, from Dana-Farber/Boston Children’s Cancer & Blood Disorders Center and Harvard Medical School, who presented the results as a late-breaking abstract at the 2019 Transplantation & Cellular Therapy Meeting. “Radiation and/or DNA-alkylating agents have been used to achieve myeloid engraftment since the inception of allo- geneic hematopoietic cell transplantation (HCT),” Dr. Agarwal told ASH Clinical News. If these preparative regimens can be avoided, he said, so can the potential toxicities that accompany them. For this study, researchers hypoth- esized that in patients with BMF and short telomeres, hematopoietic and immune cells have a replicative disadvantage that facilitates engraftment of healthy donor cells without the need for DNA-alkylating agents and radiation, he explained. Investigators enrolled 20 patients with BMF (age range = 1.7-31.5 years at time of HCT) who were treated at one of seven institutions between August 2012 and October 2018. All participants had dyskeratosis congenita (DC) or lym- phocyte telomere length below the first percentile, determined by flow cytometry fluorescent in situ hybridization. The pre-HCT preparative regimen consisted of fludarabine and alemtuzumab, and patients received cyclosporine A and my- cophenolate mofetil as graft-versus-host disease (GVHD) prophylaxis. The primary endpoint of the study was donor myeloid engraftment, defined as an absolute neutrophil count ≥500 cells/µL by 42 days post-HCT and donor chime- rism greater than 50 percent by 100 days post-HCT. April 2019