Why Patients Fail After Allogeneic Stem Cell Transplantation
Even if the majority of patients are cured after allogeneic stem cell transplantation a substantial number will fail due to relapse or non-relapse mortality. This session will focus on new insights into biological mechanisms of tumor escape after transplantation as well as on the impact of minimal measurable disease detection on outcome and how this insights and developments can be used in clinical practice. Lastly, causes of late non-relapse mortality and risk-based anticipatory intervention strategies will be presented.
Dr. Luca Vago will present the most recent discoveries in tumor escape by impaired leukemia cell recognition such as HLA loss and different immune-escape mechanisms such as inhibitory immune–checkpoint molecules or enzyme and cytokine mediated immunosuppression. He will also address the role of clonal evolution and based thereon he will present clinical strategies to circumvent immune escape.
Dr. Jacqueline Cloos will discuss the increasing importance of minimal measureable disease detection prior and after stem cell transplantation. She will present the pros and cons of different MRD methods such as multicolor flow cytometry, PCR techniques and NGS and present options how MRD detection can be used into a personalized relapse prevention strategy.
Dr. Smita Bhatia will present the risk and causes for late mortality other than relapse after stem cell transplantation such as secondary malignancies, chronic Graft-versus Host disease, infection, cardiopulmonary late effects or metabolic syndrome. She will also present recommendation how to monitor this patient after transplantation and provide risk based anticipatory intervention strategies to reduce late mortality.
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