Indikationen allogenen Stammzelltransplantation und anderer zellulärer Therapien

Prof. Dr. Hildegard Greinix (retired), Medical University of Vienna This presentation provides a current overview of the indications for allogeneic stem cell transplantation and other cellular therapies based on the latest EBMT registry data. The most important transplantation indications for AML, ALL, MDS, CML, myelofibrosis, lymphomas, and multiple myeloma are discussed – including Austrian data – as well as the criteria for patient selection (age, comorbidities, frailty, remission status). A significant portion is dedicated to CAR T-cell therapies: production, mechanism of action, current long-term results, and the expansion of indications to include autoimmune and pediatric diseases. Finally, modern developments in GvHD prophylaxis, particularly post-transplant cyclophosphamide (PTCy), and donor selection are discussed. The presentation concludes with a discussion of current developments in GvHD prophylaxis, particularly post-transplant cyclophosphamide (PTCy), and donor selection. 0:00 Intro & EBMT Registry Data: Overview of Transplantation Trends 1:18 Developments After Diagnosis: Lymphomas, AML, ALL 2:19 Gene Therapy Overview 3:15 Unrelated Donors: Trends 4:34 Austrian Transplantation Data 5:14 CAR-T Cells: Production & Principle 5:59 CAR-T Cells: Mechanism of Action 6:42 Indications for CAR-T Cell Therapy 7:49 Increase in CAR-T Cell Therapy Use in Lymphomas & Myeloma 8:30 Patient Selection: Who is Eligible for Transplantation? 9:27 Risk Assessment: When is Transplantation Not an Option? 10:29 Decision Criteria: Comorbidity, Age, Frailty 11:28 AML: Transplantation Indications 12:12 AML: Benefits of Transplantation – Austrian Data 13:50 AML: When to Avoid Transplantation? 14:53 Young Adults: Special Considerations 16:17 MDS: Clonal Disease & Treatment Strategies 17:23 MDS: Transplantation as the Standard 18:03 CML: The Importance of Transplantation 19:03 Myelofibrosis: Indications & Special Considerations 20:24 Changed Recommendations Due to New Therapies 21:05 Lymphomas: Indications Beyond the Second Line 22:09 CAR-T Long-Term Results (Axi-cel & Others) 22:47 Relapse & Refractoriness After CAR-T 24:36 Multiple Myeloma: CAR-T Therapy 25:39 Current Developments in Myeloma Research 26:17 Severe Aplastic Anemia (SAA): Indications 26:38 SAA: Protocols & Special Considerations 27:19 CAR-T in Autoimmune Diseases 27:40 Autoimmune Diseases: CD19 CAR-T & Results 28:42 Pediatrics & Metabolic Diseases 29:33 Donor Selection: Principles 30:41 GvHD: Pathophysiology & Clinical Problem 31:47 New Developments in GvHD Prophylaxis 32:04 Sibling Donors & Age Limits 32:26 Post-Transplant Cyclophosphamide (PTCy)