Bjørn Christer Linder Grønvold

• Grønvold, Bjørn Christer Linder; Ali, Maryan Mohamed; Myklebust, Tor Åge; Lenartova, Andrea; Remberger, Mats & Abrahamsen, Ingerid Weum [Show all 10 contributors for this article] (2024). Allogeneic stem cell transplant recipients surviving at least 2 years without relapse: outcome and risk factors. eJHaem. 5(1), p. 117–124. doi: 10.1002/jha2.842. Full text in Research Archive Show summary

  Outcomes of 2-year survivours undergoing allo-haematopoietic stem cell transplantation at Oslo University Hospital were retrospectively assessed with the objectives of identification of risk factors for late death as possible means for precautionary measures and interventions to improve long-term survival. 421 patients with haematological malignancy, transplanted between 2005 and 2019, alive and free of disease after 2 years were included with data reported from The OUS-HSCT registry. Median follow-up was 6.2 years (2.016.1), and 232 patients (55%) were observed for minimum 5 years. The probability of being alive 5 and 10 years after HSCT was 86% and 76%. Primary risk factors for late death included initial diagnosis of age ≥ 60 years, chronic lymphocytic leukaemia (CLL), previous blood stream- or invasive fungal infection (BSI, IFI), and chronic graft-versus-host disease (cGVHD). Transplant-related mortality (TRM) and relapse at 5 years were 9.0% and 7.7%, respectively. Two factors were associated with the latter: cytomegalovirus (CMV) seronegative donor and CLL. Compared with the age- and gender-matched Norwegian general population, life expectancy was lower for each disease, except for CML. The prospect for the long-term survival is good for 2-year survivors of the allogeneic hematopoietic stem cell transplantation. However, life expectancy remains inferior to the age- and gender-matched general population. Optimising prophylaxis and treatment for chronic GVHD, BSI and IFI are needed along with the improved adherence to guidelines for early detection of secondary malignancies. Measures to improve immune reconstitution, possibly the microbiota, and the use of CMV seropositive donors regardless of recipient sero-status may be warranted and should be addressed in further studies.

• Vo, Camilla Dao; Myhre, Anders Eivind; Abrahamsen, Ingerid Weum; Remberger, Mats; Mattsson, Jonas & Fløisand, Yngvar [Show all 10 contributors for this article] (2023). Allogen stamcelletransplantasjon hos voksne 2015–21. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 143(4). doi: 10.4045/tidsskr.22.0521. Full text in Research Archive Show summary

  BAKGRUNN Allogen stamcelletransplantasjon er eneste kurative behandling for flere maligne og ikke-maligne blodsykdommer, og er assosiert med risiko for alvorlige komplikasjoner. De siste årene er det innført flere endringer med mål om å redusere behandlingsrelaterte komplikasjoner. Denne retrospektive studien gjennomgår kvalitetsindikatorer for pasienter som gjennomgikk transplantasjon i perioden 2015–21. MATERIALE OG METODE Studien inkluderte 589 voksne pasienter som ble behandlet med allogen stamcelletransplantasjon for første gang ved Oslo universitetssykehus fra mai 2015 til mai 2021. Tre toårsperioder er sammenliknet med deskriptive metoder. RESULTATER Fra 2015 til 2021 økte antall årlige førstegangstransplantasjoner fra 85 til 113. Ettårsoverlevelse økte fra 68 % i første toårsperiode til 74 % i andre periode og til 82 % i siste periode. Det var en reduksjon i både akutt og kronisk transplantat-mot-vert-sykdom, og andelen pasienter i live ett år etter transplantasjonen uten transplantat-mot-vert-sykdom eller residiv økte fra 42 % til 60 % i studieperioden. FORTOLKNING Siden 2015 er antall transplantasjoner økt samtidig som overlevelsen er forbedret og risikoen for komplikasjoner lavere.

• Ali, Maryan Mohamed; Grønvold, Bjørn Christer Linder; Remberger, Mats; Abrahamsen, Ingerid Weum; Myhre, Anders Eivind & Tjønnfjord, Geir Erland [Show all 8 contributors for this article] (2021). Addition of Anti-thymocyte Globulin in Allogeneic Stem Cell Transplantation With Peripheral Stem Cells From Matched Unrelated Donors Improves Graft-Versus-Host Disease and Relapse Free Survival. Clinical Lymphoma, Myeloma & Leukemia. ISSN 2152-2650. 21(9), p. 598–605. doi: 10.1016/j.clml.2021.05.003. Full text in Research Archive Show summary

  Anti-thymocyte globulin (ATG) is commonly used to prevent graft-versus-host disease (GvHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). To evaluate the impact of ATG as part of the GvHD prophylaxis in our institution, we report the outcome of 415 patients with matched unrelated donors (MUD) transplanted for hematological malignancies with or without ATG from 2005 to 2019 at Oslo University Hospital, Norway. The following groups were compared: (1) 154 patients transplanted with peripheral blood stem cells (PBSC) without ATG 2005-2014. (2) 137 patients transplanted with bone marrow stem cells (BMSC) 2005-2019. (3) 124 patients transplanted with PBSC and ATG (PBSC + ATG) 2014-2019. Three years survival was similar in the groups, 61% following allografting with PBSC, 54% with BMSC, and 59% with PBSC + ATG. Acute GvHD grade III-IV was 14%, 14%, and 7%; chronic GvHD was 81%, 32, and 26%; and extensive cGvHD 44%, 15%, and 6% in the corresponding groups. Both acute and chronic GvHD were significantly reduced in the PBSC + ATG-versus the PBSC group (p < 0.05 and p < 0.001 respectively).Transplant-related mortality (TRM) was 33%, 25%, and 17% (p = 0.18). Graft versus host disease and relapse free survival (GRFS) at 3 years was 43 %, 43%, and 64% in the groups. Adding ATG to the GvHD prophylaxis regimen of MUD allo-HSCT with PBSC resulted in a substantial reduction of both acute and chronic GvHD without compromising the disease control, reflected in a superior 3 years GRFS.

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• Abrahamsen, Ingerid Weum; Grønvold, Bjørn Christer; Inderberg, Else Marit; Mensali, Nadia; Mattsson, Jonas & Gedde-Dahl, Tobias (2020). Posttransplantation Lymphoproliferative Disease Treated by Retransplantation. Case Reports in Immunology. ISSN 2090-6609. 2020. doi: 10.1155/2020/9403123. Full text in Research Archive Show summary

  Epstein–Barr virus- (EBV-) induced posttransplantation lymphoproliferative disease (PTLD) is a life-threatening complication following allogeneic stem cell transplantation. *e main risk factor is anti-thymocyte globulin (ATG). Patients who fail first-line treatment with rituximab have a poor prognosis. *ough adoptive transfer of EBV-specific T cells is a potentially effective option, it is not readily available. In this case report, the patient developed PTLD following transplantation for aplastic anemia using ATG as part of the conditioning. He failed rituximab treatment and developed graft failure. We were aware that the stem cell donor had a recent EBV infection prior to transplantation, whereas the patient most likely was EBV negative before transplant. We describe our strategy to meet the patient’s urgent need for EBV-specific Tcells, as well as new hematopoietic stem cells. *e same donor was used for a second transplant, using peripheral blood stem cells. *e conditioning used was thiotepa/busulfan/fludarabin with a single dose of cyclophosphamide after transplant as graft-versus-host disease (GVHD) prophylaxis. *e EBV DNA levels fell when conditioning was started, and have been undetectable since day +15 and remained so till 18 months after transplantation. *e patient is doing well. *is case reports successful use of cyclophosphamide after transplantation as GVHD prophylaxis, preserving virus-specific immunity.

• Grønvold, Bjørn Christer Linder; Ali, M.M.; Remberger, M.; Mattsson, J.; Egeland, Torstein & Lundin, Katrin [Show all 13 contributors for this article] (2020). HLA-DPB1 mismatch reduce relapse and improve survival in T-cell replete unrelated donor allogeneic stem cell transplantation. Bone Marrow Transplantation. ISSN 0268-3369. 55(8), p. 1658–1661. doi: 10.1038/s41409-020-0827-3. Full text in Research Archive

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