1201
|
Prenc E, Pulanic D, Pucic-Bakovic M, Pezer M, Desnica L, Vrhovac R, Nemet D, Pavletic SZ. Potential of glycosylation research in graft versus host disease after allogeneic hematopoietic stem cell transplantation. Biochim Biophys Acta Gen Subj 2016; 1860:1615-22. [PMID: 26923767 DOI: 10.1016/j.bbagen.2016.02.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 02/21/2016] [Accepted: 02/22/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Glycans, complex oligosaccharides, are directly involved in almost every biological process, have a fundamental role in the immune system, and are probably involved in nearly every human disease. However, glycosylation has been greatly ignored in the area of allogeneic hematopoietic stem cell transplantation (alloHSCT) and graft versus host disease (GVHD). Both acute and chronic GVHD are multisystemic debilitating immunological disturbances arising after alloHSCT. SCOPE OF REVIEW In this paper, we review the glycosylation research already done in the field of alloHSCT and GVHD and evaluate further potential of glycan analysis in GVHD by looking into resembling inflammatory and autoimmune conditions. MAJOR CONCLUSIONS Glycan research could bring significant improvement in alloHSCT procedure with reduction in following complications, such as GVHD. Identifying glycan patterns that induce self-tolerance and the ones that cause the auto- and allo-immune response could lead to innovative and tissue-specific immunomodulative therapy instead of the current immunosuppressive treatment, enabling preservation of the graft-versus-tumor effect. Moreover, improved glycan pattern analyses could offer a more complete assessment and greatly needed dynamic biomarkers for GVHD. GENERAL SIGNIFICANCE This review is written with a goal to encourage glycan research in the field of alloHSCT and GVHD as a perspective tool leading to improved engraftment, discovery of much needed biomarkers for GVHD, enabling an appropriate therapy and improved monitoring of therapeutic response. This article is part of a Special Issue entitled "Glycans in personalised medicine" Guest Editor: Professor Gordan Lauc.
Collapse
Affiliation(s)
- Ema Prenc
- Croatian Cooperative Group for Hematologic Diseases, Zagreb, Croatia
| | - Drazen Pulanic
- Division of Haematology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia; Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, Osijek, Croatia.
| | | | - Marija Pezer
- Genos Glycoscience Research Laboratory, Zagreb, Croatia
| | - Lana Desnica
- Division of Haematology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Radovan Vrhovac
- Division of Haematology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
| | - Damir Nemet
- Division of Haematology, Department of Internal Medicine, University Hospital Centre Zagreb, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia; Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, Osijek, Croatia
| | - Steven Z Pavletic
- Graft-versus-Host and Autoimmunity Section, Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
1202
|
Kook H, Chung NG, Kang HJ, Im HJ. Acquired aplastic anemia in Korean children: treatment guidelines from the Bone Marrow Failure Committee of the Korean Society of Pediatric Hematology Oncology. Int J Hematol 2016; 103:380-6. [PMID: 26894608 DOI: 10.1007/s12185-016-1956-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 01/25/2016] [Indexed: 10/22/2022]
Abstract
The treatment of choice for aplastic anemia (AA) in children has been HLA-matched family donor (MFD) hematopoietic stem cell transplantation (HSCT). For those lacking MFD, immunosuppressive therapy (IST) consisting of horse antithymocyte globulin (ATG) and cyclosporine has been successful. The choices of second and third line treatments are more complex and debatable, especially in the situation of unavailability of horse ATG. IST with rabbit ATG seems to be less effective. Recently, improved survival of non-MFD HSCTs has been documented. The outcome of matched or mismatched unrelated donor, umbilical cord blood, or haploidentical family donor transplantations will be discussed in AA children after IST failure. Experimental approaches of upfront HSCT using non-MFDs will be briefly touched. In this review, a treatment guideline for children with AA from the Korean Society of Pediatric Hematology Oncology will be presented along with a brief review of literature on current clinical practices in Korea.
Collapse
|
1203
|
Bilinski J, Robak K, Peric Z, Marchel H, Karakulska-Prystupiuk E, Halaburda K, Rusicka P, Swoboda-Kopec E, Wroblewska M, Wiktor-Jedrzejczak W, Basak GW. Impact of Gut Colonization by Antibiotic-Resistant Bacteria on the Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective, Single-Center Study. Biol Blood Marrow Transplant 2016; 22:1087-93. [PMID: 26900084 DOI: 10.1016/j.bbmt.2016.02.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 02/12/2016] [Indexed: 12/19/2022]
Abstract
Gut colonization by antibiotic-resistant bacteria may underlie hard-to-treat systemic infections. There is also accumulating evidence on the immunomodulatory function of gut microbiota after allogeneic stem cell transplantation (alloSCT) and its impact on graft-versus-host disease (GVHD). We investigated the epidemiology and clinical impact of gut colonization after alloSCT and retrospectively analyzed data on 107 alloSCTs performed at a single transplant center. Pretransplant microbiology screening identified colonization in 31% of cases. Colonization had a negative impact on overall survival after alloSCT in univariate (34% versus 74% at 24 months, P < .001) and multivariate (hazard ratio, 3.53; 95% confidence interval, 1.71 to 7.28; P < .001) analyses. Nonrelapse mortality was significantly higher in colonized than in noncolonized patients (42% versus 11% at 24 months, P = .001). Colonized patients more frequently experienced bacteremia (48% versus 24%, P = .01), and more deaths were attributable to infectious causes in the colonized group (42% versus 11% of patients and 67% versus 29% of deaths, P < .05). We observed a significantly higher incidence of grades II to IV acute GVHD in colonized than in noncolonized patients (42% versus 23%, P < .05), especially involving the gastrointestinal system (33% versus 13.5%, P = .07). In summary, we determined that gut colonization by antibiotic-resistant bacteria decreases the overall survival of patients undergoing alloSCT by increasing nonrelapse mortality and the incidences of systemic infection and acute GVHD.
Collapse
|
1204
|
Sakurada M, Kondo T, Umeda M, Kawabata H, Yamashita K, Takaori-Kondo A. Successful treatment with intravesical cidofovir for virus-associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation: A case report and a review of the literature. J Infect Chemother 2016; 22:495-500. [PMID: 26898668 DOI: 10.1016/j.jiac.2016.01.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 01/16/2016] [Accepted: 01/19/2016] [Indexed: 11/20/2022]
Abstract
Virus-associated hemorrhagic cystitis (VAHC) is a formidable complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The standard management of severe VAHC after allo-HSCT has not been established. Intravenous administration of cidofovir (CDV), an acyclic nucleoside analogue with broad-spectrum activity against DNA viruses, has been reported to be effective for VAHC, but it can cause severe renal toxicity. Here we report four cases who achieved clinical responses with intravesical instillation of CDV for severe VAHC after allo-HSCT. Median age was 57 years (40-63), and all were male. The underlying diseases were hematological malignancies. Three had received bone marrow transplantation, and one received cord blood transplantation twice. Conditioning regimen was myeloablative for one, and reduced-intensity for three. The viral types were BK virus and/or adenovirus. Two patients had received CDV intravenously prior to the intravesical therapy. A dose of intravesical CDV was 2-5 mg/kg. In all cases, symptoms of cystitis improved dramatically within a few days without showing any systemic adverse effects. The virological response was observed in two cases. This local therapy was effective even in the cases refractory to the intravenous CDV and a case with severe renal failure. Along with the review of literature, we propose that the intravesical instillation of CDV can be a therapeutic option for severe VAHC after allo-HSCT.
Collapse
|
1205
|
Haro S, Tavenard A, Rialland F, Taque S, Guillerm G, Blouin P, Esvan M, Pellier I, Gandemer V. Keep in Mind Quality of Life: Outcome of a Ten-Year Series of Post-Transplantation Early Relapses in Childhood Acute Lymphoblastic Leukemia-A Report from the Grand Ouest Oncology Study Group for Children in France. Biol Blood Marrow Transplant 2016; 22:889-94. [PMID: 26845034 DOI: 10.1016/j.bbmt.2016.01.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/26/2016] [Indexed: 10/22/2022]
Abstract
Relapses of acute lymphoblastic leukemia (ALL) early after hematopoietic stem cell transplantations in children are uncommon but associated with a very poor prognosis. Whereas there are no current recommendations for the management of these relapses, the children's quality of life is an important issue. We studied the outcomes, including 1-year overall survival, complete remission, and quality of life, of 19 children with ALL who relapsed within the first year after their transplantation treated in the 5 participating centers between 2000 and 2011 Patients were distributed as follows: supportive care only (group A), outpatient treatment (mainly steroid and vincristine, group B), or intensive inpatient treatment (group C). There were no significant differences in 1-year overall survival (31.5% for the entire cohort) or remission rate for time between transplantation and relapse (< 6 months or 6 to 12 months), transplantation or disease characteristics, or treatment group. However, time spent in hospital (for treatment and complications) significantly differed between treatment groups B and C (20.8% ± 13.0 versus 59.1% ± 32.9, respectively; P < .05). No differences in organ toxicities, school attendance, or Lansky scores were found between treatment groups. Our sample size-limited data indicate, in a prepersonalized medicine era, that children treated with steroid and vincristine have the same prognosis as those treated with intensive therapy, but they may benefit from improved quality of life. Nevertheless, new therapeutic strategies are required and future prospective trials would help to establish recommendations.
Collapse
Affiliation(s)
- Sophie Haro
- Department of Pediatrics and Genetics, University Hospital of Brest, Brest, France.
| | - Aude Tavenard
- Grand Ouest Oncology Study Group for Children Biostatistic Unit, University Hospital of Rennes, France
| | - Fanny Rialland
- Department of Pediatric Hematology/Oncology, University Hospital of Nantes, Nantes, France
| | - Sophie Taque
- Department of Pediatric Hematology/Oncology, University Hospital of Rennes, Rennes 1 University, France
| | - Gaelle Guillerm
- Department of Clinical Haematology, Institute of Cancerology and Hematology, University Hospital Brest, Brest, France
| | - Pascale Blouin
- Department of Pediatric Onco-Hematology, University Hospital of Tours, Tours, France
| | - Maxime Esvan
- Grand Ouest Oncology Study Group for Children Biostatistic Unit, University Hospital of Rennes, France
| | - Isabelle Pellier
- Department of Pediatric Onco-Hematology, University Hospital of Angers, Angers, France
| | - Virginie Gandemer
- Department of Pediatric Hematology/Oncology, University Hospital of Rennes, Rennes 1 University, France
| |
Collapse
|
1206
|
Yabe H, Tanaka A, Chinen Y, Kato S, Sawamoto K, Yasuda E, Shintaku H, Suzuki Y, Orii T, Tomatsu S. Hematopoietic stem cell transplantation for Morquio A syndrome. Mol Genet Metab 2016; 117:84-94. [PMID: 26452513 PMCID: PMC5016080 DOI: 10.1016/j.ymgme.2015.09.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 09/29/2015] [Accepted: 09/29/2015] [Indexed: 12/15/2022]
Abstract
Morquio A syndrome features systemic skeletal dysplasia. To date, there has been no curative therapy for this skeletal dysplasia. No systemic report on a long-term effect of hematopoietic stem cell transplantation (HSCT) for Morquio A has been described. We conducted HSCT for 4 cases with Morquio A (age at HSCT: 4-15years, mean 10.5years) and followed them at least 10years (range 11-28years; mean 19years). Current age ranged between 25 and 36years of age (mean 29.5years). All cases had a successful full engraftment of allogeneic bone marrow transplantation without serious GVHD. Transplanted bone marrow derived from HLA-identical siblings (three cases) or HLA-identical unrelated donor. The levels of the enzyme activity in the recipient's lymphocytes reached the levels of donors' enzyme activities within two years after HSCT. For the successive over 10years post-BMT, GALNS activity in lymphocytes was maintained at the same level as the donors. Except one case who had osteotomy in both legs one year later post BMT, other three cases had no orthopedic surgical intervention. All cases remained ambulatory, and three of them could walk over 400m. Activity of daily living (ADL) in patients with HSCT was better than untreated patients. The patient who underwent HSCT at four years of age showed the best ADL score. In conclusion, the long-term study of HSCT has demonstrated therapeutic effect in amelioration of progression of the disease in respiratory function, ADL, and biochemical findings, suggesting that HSCT is a therapeutic option for patients with Morquio A.
Collapse
Affiliation(s)
- Hiromasa Yabe
- Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Isehara, Japan.
| | - Akemi Tanaka
- Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - Yasutsugu Chinen
- Department of Pediatrics, Faculty of Medicine, University of the Ryukyus, Japan.
| | - Shunichi Kato
- Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Kazuki Sawamoto
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, United States
| | - Eriko Yasuda
- Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, United States
| | - Haruo Shintaku
- Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yasuyuki Suzuki
- Medical Education Development Center, Gifu University, Japan
| | - Tadao Orii
- Department of Pediatrics, Gifu University, Gifu, Japan
| | - Shunji Tomatsu
- Department of Pediatrics, Gifu University, Gifu, Japan; Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, United States.
| |
Collapse
|
1207
|
Nelson AS, Marsh RA, Myers KC, Davies SM, Jodele S, O'Brien TA, Mehta PA. A Reduced-Intensity Conditioning Regimen for Patients with Dyskeratosis Congenita Undergoing Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2016; 22:884-8. [PMID: 26845033 DOI: 10.1016/j.bbmt.2016.01.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 01/28/2016] [Indexed: 11/27/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative option for progressive marrow failure, myelodysplastic syndrome, or leukemia associated with dyskeratosis congenita (DC). HSCT for DC is limited by a high incidence of treatment-related mortality, thought to be related to underlying chromosomal instability and sensitivity to chemotherapy and radiation. We report our experience in 7 patients with DC who underwent allogeneic transplantation using a reduced-intensity conditioning (RIC) preparative regimen that contained chemotherapy only (no radiation). This RIC regimen, designed specifically for patients with DC, contained alemtuzumab, fludarabine, and melphalan (with melphalan at 50% reduced dosing), with the goal of decreasing toxicity and improving outcome. All 7 patients engrafted, with none developing mixed chimerism or rejection. Two patients experienced acute graft-versus-host disease (GVHD) and 1 went on to develop limited chronic GVHD of the skin. Five patients remain alive and well at a median follow-up of 44 months (range, 14 to 57 months). We conclude that a radiation-free RIC regimen results in durable engraftment, acceptable toxicity, and improved overall survival in patients with DC undergoing allogeneic HSCT.
Collapse
Affiliation(s)
- Adam S Nelson
- Division of Bone Marrow Transplantation and Immune Deficiency Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Rebecca A Marsh
- Division of Bone Marrow Transplantation and Immune Deficiency Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kasiani C Myers
- Division of Bone Marrow Transplantation and Immune Deficiency Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Stella M Davies
- Division of Bone Marrow Transplantation and Immune Deficiency Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Sonata Jodele
- Division of Bone Marrow Transplantation and Immune Deficiency Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Tracey A O'Brien
- Kids Cancer Centre, Sydney Children's Hospital, Randwick NSW Australia
| | - Parinda A Mehta
- Division of Bone Marrow Transplantation and Immune Deficiency Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| |
Collapse
|
1208
|
Abstract
Hematopoietic stem cell transplantation (HSCT) is a potentially life-saving therapy that often comes at the cost of complications such as graft-versus-host disease and post-transplant infections. With improved technology to understand the ecosystem of microorganisms (viruses, bacteria, fungi, and microeukaryotes) that make up the gut microbiota, there is increasing evidence of the microbiota's contribution to the development of post-transplant complications. Antibiotics have traditionally been the mainstay of microbiota-altering therapies available to physicians. Recently, interest is increasing in the use of prebiotics and probiotics to support the development and sustainability of a healthier microbiota. In this review, we will describe the evidence for the use of prebiotics and probiotics in combating microbiota dysbiosis and explore the ways in which they may be used in future research to potentially improve clinical outcomes and decrease rates of graft-versus-host disease (GVHD) and post-transplant infection.
Collapse
Affiliation(s)
- Tessa M Andermann
- Department of Medicine, Division of Infectious Diseases, Stanford University, Stanford, CA, USA
| | - Andrew Rezvani
- Department of Medicine, Division of Blood and Marrow Transplantation, Stanford University, Stanford, CA, USA
| | - Ami S Bhatt
- Department of Medicine, Division of Blood and Marrow Transplantation, Stanford University, Stanford, CA, USA.
- Department of Medicine, Division of Hematology, Stanford University, 269 Campus Drive, Stanford, CA, 94305, USA.
- Department of Genetics, Stanford University, Stanford, CA, USA.
| |
Collapse
|
1209
|
Scott JM, Armenian S, Giralt S, Moslehi J, Wang T, Jones LW. Cardiovascular disease following hematopoietic stem cell transplantation: Pathogenesis, detection, and the cardioprotective role of aerobic training. Crit Rev Oncol Hematol 2016; 98:222-34. [PMID: 26643524 PMCID: PMC5003053 DOI: 10.1016/j.critrevonc.2015.11.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 11/10/2015] [Accepted: 11/11/2015] [Indexed: 01/02/2023] Open
Abstract
Advances in hematopoietic cell transplantation (HCT) techniques and supportive care strategies have led to dramatic improvements in relapse mortality in patients with high-risk hematological malignancies. These improvements, however, conversely increase the risk of late-occurring non-cancer competing causes, mostly cardiovascular disease (CVD). HCT recipients have a significantly increased risk of CVD-specific mortality, including elevated incidence of coronary artery disease (CAD), cerebrovascular disease, and heart failure (HF) compared to age-matched counterparts. Accordingly, there is an urgent need to identify techniques for the detection of early CVD in HCT patients to inform early prevention strategies. Aerobic training (AT) is established as the cornerstone of primary and secondary disease prevention in multiple clinical settings, and may confer similar benefits in HCT patients at high-risk of CVD. The potential benefits of AT either before, immediately after, or in the months/years following HCT have received limited attention. Here, we discuss the risk and extent of CVD in adult HCT patients, highlight novel tools for early detection of CVD, and review existing evidence in oncology and non-oncology populations supporting the efficacy of AT to attenuate HCT-induced CVD. This knowledge can be utilized to optimize treatment, while minimizing CVD risk in individuals with hematological malignancies undergoing HCT.
Collapse
Affiliation(s)
- Jessica M Scott
- Universities Space Research Association NASA Johnson Space Center, Houston, TX, USA
| | - Saro Armenian
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Sergio Giralt
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Lee W Jones
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| |
Collapse
|
1210
|
Becker PS, Suck G, Nowakowska P, Ullrich E, Seifried E, Bader P, Tonn T, Seidl C. Selection and expansion of natural killer cells for NK cell-based immunotherapy. Cancer Immunol Immunother 2016; 65:477-84. [PMID: 26810567 DOI: 10.1007/s00262-016-1792-y] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 01/01/2016] [Indexed: 01/19/2023]
Abstract
Natural killer (NK) cells have been used in several clinical trials as adaptive immunotherapy. The low numbers of these cells in peripheral blood mononuclear cells (PBMC) have resulted in various approaches to preferentially expand primary NK cells from PBMC. While some clinical trials have used the addition of interleukin 2 (IL-2) to co-stimulate the expansion of purified NK cells from allogeneic donors, recent studies have shown promising results in achieving in vitro expansion of NK cells to large numbers for adoptive immunotherapy. NK cell expansion requires multiple cell signals for survival, proliferation and activation. Thus, expansion strategies have been focused either to substitute these factors using autologous feeder cells or to use genetically modified allogeneic feeder cells. Recent developments in the clinical use of genetically modified NK cell lines with chimeric antigen receptors, the development of expansion protocols for the clinical use of NK cell from human embryonic stem cells and induced pluripotent stem cells are challenging improvements for NK cell-based immunotherapy. Transfer of several of these protocols to clinical-grade production of NK cells necessitates adaptation of good manufacturing practice conditions, and the development of freezing conditions to establish NK cell stocks will require some effort and, however, should enhance the therapeutic options of NK cells in clinical medicine.
Collapse
|
1211
|
Dzieciatkowski T, Tomaszewska A, Przybylski M, Rusicka P, Basak GW, Jedrzejczak WW, Wroblewska M, Halaburda K. Analysis of the shedding of three β-herpesviruses DNA in Polish patients subjected to allogeneic hematopoietic stem cell transplantation: Six-year follow up. J Clin Virol 2016; 76:30-5. [PMID: 26809130 DOI: 10.1016/j.jcv.2016.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/25/2015] [Accepted: 01/07/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Infections with human β-herpesviruses are common worldwide and are still frequent in patients after hematopoietic stem cell transplantation. Some data suggest that HHV-6 and HHV-7 could take part in CMV reactivation from latency and/or progression of CMV disease in immunosupressed patients. OBJECTIVES The aims of this study were: (1) to summarise retrospectively the results of β-herpesviruses DNA detection in a large group of adult allogeneic haematopoietic stem cell transplant recipients; and (2) to find a potential correlation between viruses belonging to this subfamily. STUDY DESIGN AlloHSCT recipients (N=142) were examined in the early post-transplant period (median=89 days). The presence of CMV, HHV-6 and HHV-7 was confirmed through detection and quantification of viral DNA, isolated from 1679 sera samples. RESULTS CMV DNA alone was detected in 23.9% of patients, while single HHV-6 and HHV-7 were detected in 14.8% and 9.9% of individuals, respectively. The reactivation of more than one virus was identified in 31% of analysed patients. In cases of concurrent infection, HHV-7 was detected at the same time as HHV-6, and both of them were usually reactivated before CMV. The kinetics of virus reactivation and measured viral load may suggest a potential role of HHV-6 and HHV-7 as co-factors in CMV reactivation. CONCLUSIONS The observed kinetics of virus reactivation may strongly suggest a potential role of HHV-6 and/or HHV-7 as co-factors of CMV reactivation. The co-infection with these β-herpesviruses could predispose patients after hematopoietic stem cell transplantation to a longer and more severe CMV infection.
Collapse
Affiliation(s)
- Tomasz Dzieciatkowski
- Department of Microbiology, Central Clinical Hospital in Warsaw, 1A Banacha Str., 02-097 Warsaw, Poland; Chair and Department of Medical Microbiology, Medical University of Warsaw, 5 Chalubinskiego Str., 02-004 Warsaw, Poland
| | - Agnieszka Tomaszewska
- Department of Haematopoietic Stem Cell Transplantation, Institute of Haematology and Transfusion Medicine, 14 Gandhi Str., 02-776 Warsaw, Poland.
| | - Maciej Przybylski
- Department of Microbiology, Central Clinical Hospital in Warsaw, 1A Banacha Str., 02-097 Warsaw, Poland; Chair and Department of Medical Microbiology, Medical University of Warsaw, 5 Chalubinskiego Str., 02-004 Warsaw, Poland
| | - Patrycja Rusicka
- Department of Haematology, Oncology and Internal Medicine, Medical University of Warsaw, 1A Banacha Str., 02-097 Warsaw, Poland
| | - Grzegorz W Basak
- Department of Haematology, Oncology and Internal Medicine, Medical University of Warsaw, 1A Banacha Str., 02-097 Warsaw, Poland
| | - Wieslaw W Jedrzejczak
- Department of Haematology, Oncology and Internal Medicine, Medical University of Warsaw, 1A Banacha Str., 02-097 Warsaw, Poland
| | - Marta Wroblewska
- Department of Microbiology, Central Clinical Hospital in Warsaw, 1A Banacha Str., 02-097 Warsaw, Poland; Department of Dental Microbiology, Medical University of Warsaw, 1A Banacha Str., 02-097 Warsaw, Poland; Infection Control Unit, Institute of Haematology and Transfusion Medicine, 14 Gandhi Str., 02-776 Warsaw, Poland
| | - Kazimierz Halaburda
- Department of Haematopoietic Stem Cell Transplantation, Institute of Haematology and Transfusion Medicine, 14 Gandhi Str., 02-776 Warsaw, Poland
| |
Collapse
|
1212
|
Huijskens MJAJ, Wodzig WKWH, Walczak M, Germeraad WTV, Bos GMJ. Ascorbic acid serum levels are reduced in patients with hematological malignancies. Results Immunol 2016; 6:8-10. [PMID: 27014565 PMCID: PMC4792862 DOI: 10.1016/j.rinim.2016.01.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 10/28/2015] [Accepted: 01/11/2016] [Indexed: 11/26/2022]
Abstract
In this paper we demonstrate that patients treated with chemotherapy and/or hematopoietic stem cell transplantation (HSCT) have highly significant reduced serum ascorbic acid (AA) levels compared to healthy controls. We recently observed in in vitro experiments that growth of both T and NK cells from hematopoietic stem cells is positively influenced by AA. It might be of clinical relevance to study the function and recovery of immune cells after intensive treatment, its correlation to AA serum levels and the possible effect of AA supplementation.
Collapse
Affiliation(s)
- Mirelle J A J Huijskens
- Department of Internal Medicine, Division of Hematology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Will K W H Wodzig
- Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mateusz Walczak
- Department of Internal Medicine, Division of Hematology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Wilfred T V Germeraad
- Department of Internal Medicine, Division of Hematology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Gerard M J Bos
- Department of Internal Medicine, Division of Hematology, Maastricht University Medical Center, Maastricht, The Netherlands
| |
Collapse
|
1213
|
Yalvaç HD, Kotan Z, Tekgündüz E, Çayköylü A, Altuntaş F. Could psychiatric assessment before hematopoietic stem cell transplantation predict the need for psychiatric consultation during transplantation period? Transfus Apher Sci 2016; 54:85-90. [PMID: 26825282 DOI: 10.1016/j.transci.2016.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Psychiatric morbidity seems to be a significant concern associated with all stages of hematopoietic stem cell transplantation (HSCT). We aimed to understand whether psychiatric consultation before HSCT procedure could predict the need for psychiatric support during isolation period. Seventy-eight patients undergoing HSCT were included in the study. Patients were diagnosed according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Standard anxiety and depression scores were performed. Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and State and Trait Anxiety Inventory (STAI) were performed. Psychiatric consultation was required for 45 (58%) patients during hospitalization. Only pre-HSCT STAI trait scores were higher in patients who were found to have psychopathology at consultation during hospitalization compared to patients without established psychopathology. Sixteen (76%) and 29 (51%) patients needed consultation with and without pre-HSCT psychopathology, respectively. Our study showed that the psychiatric consultation request rate during the transplantation process was higher for cases previously diagnosed with psychopathology and who had high trait anxiety scale scores before HSCT.
Collapse
Affiliation(s)
- Hayriye Dilek Yalvaç
- Ankara Oncology Education and Research Hospital, Psychiatry Clinic, Ankara, Turkey.
| | - Zeynep Kotan
- Ankara Oncology Education and Research Hospital, Psychiatry Clinic, Ankara, Turkey
| | - Emre Tekgündüz
- Ankara Oncology Education and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
| | - Ali Çayköylü
- Yıldırım Beyazıt University Medical Faculty, Department of Internal Medicine, Division of Hematology, Ankara, Turkey
| | - Fevzi Altuntaş
- Ankara Oncology Education and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey
| |
Collapse
|
1214
|
Zhang XH, Zhou SY, Feng R, Wang YZ, Kong Y, Zhou Y, Zhang JM, Wang M, Zhao JZ, Wang QM, Feng FE, Zhu XL, Wang FR, Wang JZ, Han W, Chen H, Xu LP, Liu YR, Liu KY, Huang XJ. Increased prostacyclin levels inhibit the aggregation and activation of platelets via the PI3K-AKT pathway in prolonged isolated thrombocytopenia after allogeneic hematopoietic stem cell transplantation. Thromb Res 2016; 139:1-9. [PMID: 26916289 DOI: 10.1016/j.thromres.2016.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 11/28/2015] [Accepted: 01/02/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the role of prostacyclin (PGI2) in prolonged isolated thrombocytopenia (PT) following allogeneic hematopoietic stem cell transplantation (allo-HSCT) and the effect of PGI2 on the activation and aggregation of platelets in PT. METHODS We enrolled 37 patients with PT and 36 controls following allo-HSCT in this study. Platelet aggregation and activation and PGI2 levels were measured. Endothelial progenitor cells (EPCs) from either PT or control patients were cultured ex vivo with serum from either PT or control patients. PGI2 secretions were then measured. PGI2 was added to the platelets ex vivo, and platelet aggregation and activation and PI3K/Akt phosphorylation were analyzed. RESULTS A higher PGI2 level was observed in the PT patients. The activation and aggregation of platelets were significantly lower in the PT patients. EPCs from PT patients cultured in PT serum secreted higher levels of PGI2, and PGI2 inhibited platelet activation and aggregation in a concentration-dependent manner ex vivo. PI3K/Akt phosphorylation of platelets was regulated by PGI2 after allo-HSCT. Disease status, serum PGI2 level and platelet aggregation were independent risk factors in patients with PT after allo-HSCT. CONCLUSIONS Higher PGI2 levels and lower platelet activation and aggregation occurred simultaneously in PT patients. PGI2 inhibited platelet activation and aggregation, probably by regulating the phosphorylation of PI3K/Akt.
Collapse
Affiliation(s)
- Xiao-Hui Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China; Collaborative Innovation Center of Hematology, Peking University, People's Republic of China.
| | - Shi-Yuan Zhou
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China; Collaborative Innovation Center of Hematology, Peking University, People's Republic of China
| | - Ru Feng
- Department of Hematology, Beijing Hospital, Ministry of Health, Beijing, People's Republic of China
| | - Ya-Zhe Wang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Yuan Kong
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Yi Zhou
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Jia-Min Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Min Wang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Jing-Zhong Zhao
- Peking University People's Hospital, Department of Clinical Laboratory, Beijing, People's Republic of China
| | - Qian-Ming Wang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Fei-Er Feng
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Xiao-Lu Zhu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Feng-Rong Wang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Jing-Zhi Wang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Wei Han
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Huan Chen
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Lan-Ping Xu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Yan-Rong Liu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Kai-Yan Liu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China
| | - Xiao-Jun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China; Collaborative Innovation Center of Hematology, Peking University, People's Republic of China
| |
Collapse
|
1215
|
Khattry N, Gupta A, Jain R, Gore A, Thippeswamy R, Jeevangi N, Kannan S, Nair R, Saikia T. LACE versus BEAM conditioning in relapsed and refractory lymphoma transplant: retrospective multicenter analysis of toxicity and efficacy. Int J Hematol 2016; 103:292-8. [PMID: 26729297 DOI: 10.1007/s12185-015-1927-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 12/09/2015] [Accepted: 12/11/2015] [Indexed: 11/26/2022]
Abstract
We compared the lomustine, cytarabine, cyclophosphamide and etoposide (LACE) and BCNU, etoposide, cytarabine, melphalan (BEAM) conditioning regimens for toxicity, engraftment kinetics, and efficacy in 139 patients undergoing autologous hematopoietic stem cell transplant for primary refractory or relapsed lymphoma. Ninety-two patients with Hodgkin lymphoma and 47 with non-Hodgkin lymphoma were enrolled. Seventy-five patients received LACE while 64 received BEAM. The incidence of grade 3-4 oral mucositis (9 vs 38%; P < 0.001) and parenteral nutrition requirement (32 vs 69%; P < 0.001) were significantly lower in the LACE cohort. The median days to myeloid (10 vs 11; P = 0.007) and platelet engraftment (13 vs 15; P = 0.026) were shorter for the LACE cohort. Transplant-related mortality in the LACE group was 9% compared to 13% in patients treated with BEAM (P = NS). The probability of overall survival (OS) and progression-free survival (PFS) at 5 years for entire cohort was 46 and 41%, respectively. Probability of OS (LACE 46% vs BEAM 47%; P = NS) and PFS (LACE 37% vs BEAM 47%; P = NS) at 5 years was comparable between two groups. We conclude that LACE has better toxicity profile compared to BEAM and results in similar long-term survival in primary refractory or relapsed lymphoma transplant.
Collapse
Affiliation(s)
- Navin Khattry
- Bone Marrow Transplant Unit, Department of Medical Oncology, Room No. 247, Paymaster Shodhika, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, 410210, India.
| | - Alok Gupta
- Bone Marrow Transplant Unit, Department of Medical Oncology, Room No. 247, Paymaster Shodhika, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, 410210, India
| | - Reetu Jain
- Department of Medical Oncology, Jaslok Hospital, Mumbai, India
| | - Adwaita Gore
- Department of Medical Oncology, Prince Aly Khan Hospital, Mumbai, India
| | - Ravi Thippeswamy
- Bone Marrow Transplant Unit, Department of Medical Oncology, Room No. 247, Paymaster Shodhika, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, 410210, India
| | - Nandish Jeevangi
- Bone Marrow Transplant Unit, Department of Medical Oncology, Room No. 247, Paymaster Shodhika, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, 410210, India
| | - Sadhana Kannan
- Department of Biostatistics, ACTREC, Tata Memorial Centre, Navi Mumbai, India
| | - Reena Nair
- Bone Marrow Transplant Unit, Department of Medical Oncology, Room No. 247, Paymaster Shodhika, ACTREC, Tata Memorial Centre, Sector 22, Kharghar, Navi Mumbai, 410210, India
| | - Tapan Saikia
- Department of Medical Oncology, Prince Aly Khan Hospital, Mumbai, India
| |
Collapse
|
1216
|
Braamse AMJ, van Meijel B, Visser OJ, Boenink AD, Cuijpers P, Eeltink CE, Hoogendoorn AW, van Marwijk Kooy M, van Oppen P, Huijgens PC, Beekman ATF, Dekker J. A randomized clinical trial on the effectiveness of an intervention to treat psychological distress and improve quality of life after autologous stem cell transplantation. Ann Hematol 2016; 95:105-114. [PMID: 26420062 PMCID: PMC4700101 DOI: 10.1007/s00277-015-2509-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 09/13/2015] [Indexed: 01/22/2023]
Abstract
Psychological distress contributes to impaired quality of life in hematological cancer patients. Stepped care treatment, in which patients start with the least intensive treatment most likely to work and only receive more intensive interventions if needed, could improve distress. We aimed to evaluate the outcome of stepped care treatment on psychological distress and physical functioning in patients treated with autologous stem cell transplantation for hematological malignancies. In the present study, we performed a randomized clinical trial with two treatment arms: stepped care and care as usual. Baseline assessment and randomization occurred during pre-transplant hospitalization. Stepped care was initiated after 6 weeks, consisting of (1) watchful waiting, (2) Internet-based self-help intervention, and (3) face-to-face counseling/ psychopharmacological treatment/ referral. Follow-up measurements were conducted at 13, 30, and 42 weeks after transplantation. Stepped care (n = 47) and care as usual (n = 48) were comparable on baseline characteristics. The uptake of the intervention was low: 24 patients started with step 1, 23 with step 2, and none with step 3. Percentages of distressed patients ranged from 4.1 to 9.7 %. Ten percent of patients received external psychological or psychiatric care. No statistically significant differences were found between stepped care and care as usual on psychological distress or physical functioning in intention to treat analyses, nor in per protocol analyses. The stepped care program was not effective in decreasing psychological distress. The low intervention uptake, probably related to the low levels of psychological distress, offers an explanation for this outcome. Future research should take into account patients' specific care needs. Netherlands Trial Registry identifier: NTR1770.
Collapse
Affiliation(s)
- Annemarie M J Braamse
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, A.J.Ernststraat 1187, Amsterdam, 1081 HL, Netherlands.
- Department of Health, Sports & Welfare/Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, Netherlands.
| | - B van Meijel
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, A.J.Ernststraat 1187, Amsterdam, 1081 HL, Netherlands
- Department of Health, Sports & Welfare/Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, Netherlands
- Parnassia Psychiatric Institute, The Hague, Netherlands
| | - O J Visser
- Department of Hematology, VU University Medical Center, Amsterdam, Netherlands
| | - A D Boenink
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, A.J.Ernststraat 1187, Amsterdam, 1081 HL, Netherlands
| | - P Cuijpers
- Department of Clinical Psychology, VU University, Amsterdam, Netherlands
| | - C E Eeltink
- Department of Hematology, VU University Medical Center, Amsterdam, Netherlands
| | - A W Hoogendoorn
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, A.J.Ernststraat 1187, Amsterdam, 1081 HL, Netherlands
| | | | - P van Oppen
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, A.J.Ernststraat 1187, Amsterdam, 1081 HL, Netherlands
| | - P C Huijgens
- Department of Hematology, VU University Medical Center, Amsterdam, Netherlands
| | - A T F Beekman
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, A.J.Ernststraat 1187, Amsterdam, 1081 HL, Netherlands
| | - J Dekker
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, A.J.Ernststraat 1187, Amsterdam, 1081 HL, Netherlands
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, Netherlands
| |
Collapse
|
1217
|
Teär Fahnehjelm K, Törnquist AL, Olsson M, Bäckström I, Andersson Grönlund M, Winiarski J. Cataract after allogeneic hematopoietic stem cell transplantation in childhood. Acta Paediatr 2016; 105:82-9. [PMID: 26331596 DOI: 10.1111/apa.13173] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 08/12/2015] [Accepted: 08/28/2015] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to study long-term visual outcome and cataract development in children and adolescents after hematopoietic stem cell transplantation (HSCT) in childhood. METHODS Best corrected visual acuity (BCVA), refraction and lens status were examined in a prospective study of 139 children and adolescents. RESULTS In total, 139 patients (58 female), median age 6.6 years at HSCT (range 0.4-17.5 years), were followed up for a median of 8.0 years (1-19.4 years). Median BCVA in the better eye was 1.0 decimal. Altogether 19 of 131 patients developed cataract requiring surgery, while 46 developed less prominent lens opacities and 66 had clear lenses at time of latest follow-up. Patients conditioned with total body irradiation had a higher risk of developing lens opacities or cataract (p < 0.0001) as did patients with malignant disease, irrespective of irradiation treatment (p < 0.0001). Cumulative analysis showed that 50% of all patients had developed lens opacities/cataract after 10.2 years. Patients who ultimately needed cataract surgery developed cataract earlier than others (p = 0.006). CONCLUSION Lens opacities or cataract were more common in children or adolescents with malignant disease and after conditioning with irradiation. Regular ophthalmological follow-up is important after HSCT for early intervention to avoid amblyopia.
Collapse
Affiliation(s)
- Kristina Teär Fahnehjelm
- Department of Clinical Neuroscience; Karolinska Institutet; St Erik Eye Hospital; Karolinska University Hospital; Huddinge Stockholm Sweden
- Department of Ophthalmology; Vrinnevi Hospital; Norrköping Sweden
| | - Alba Lucia Törnquist
- Department of Clinical Neuroscience; Karolinska Institutet; St Erik Eye Hospital; Karolinska University Hospital; Huddinge Stockholm Sweden
| | - Monica Olsson
- Department of Clinical Neuroscience; Karolinska Institutet; St Erik Eye Hospital; Karolinska University Hospital; Huddinge Stockholm Sweden
| | - Ingrid Bäckström
- Institute of Neuroscience and Physiology/Ophthalmology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Marita Andersson Grönlund
- Institute of Neuroscience and Physiology/Ophthalmology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Jacek Winiarski
- Department of Paediatrics; Astrid Lindgren's Children's Hospital; Karolinska University Hospital; Huddinge Stockholm Sweden
- Department of Clintec; Karolinska Institutet; Karolinska University Hospital; Huddinge Stockholm Sweden
| |
Collapse
|
1218
|
Yi HG, Yahng SA, Kim I, Lee JH, Min CK, Kim JH, Kim CS, Song SU. Allogeneic clonal mesenchymal stem cell therapy for refractory graft-versus-host disease to standard treatment: a phase I study. Korean J Physiol Pharmacol 2015; 20:63-7. [PMID: 26807024 PMCID: PMC4722192 DOI: 10.4196/kjpp.2016.20.1.63] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 08/27/2015] [Accepted: 09/11/2015] [Indexed: 01/17/2023]
Abstract
Severe graft-versus-host disease (GVHD) is an often lethal complication of allogeneic hematopoietic stem cell transplantation (HSCT). The safety of clinical-grade mesenchymal stem cells (MSCs) has been validated, but mixed results have been obtained due to heterogeneity of the MSCs. In this phase I study, the safety of bone marrow-derived homogeneous clonal MSCs (cMSCs) isolated by a new subfractionation culturing method was evaluated. cMSCs were produced in a GMP facility and intravenously administered to patients who had refractory GVHD to standard treatment resulting after allogeneic HSCT for hematologic malignancies. After administration of a single dose (1×106 cells/kg), 11 patients were evaluated for cMSC treatment safety and efficacy. During the trial, nine patients had 85 total adverse events and the rate of serious adverse events was 27.3% (3/11 patients). The only one adverse drug reaction related to cMSC administration was grade 2 myalgia in one patient. Treatment response was observed in four patients: one with acute GVHD (partial response) and three with chronic GVHD. The other chronic patients maintained stable disease during the observation period. This study demonstrates single cMSC infusion to have an acceptable safety profile and promising efficacy, suggesting that we can proceed with the next stage of the clinical trial.
Collapse
Affiliation(s)
- Hyeon Gyu Yi
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Korea
| | - Seung-Ah Yahng
- Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon 21431, Korea
| | - Inho Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University School of Medicine, Seoul 03080, Korea
| | - Je-Hwan Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Chang-Ki Min
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Korea
| | - Jun Hyung Kim
- Translational Research Center, Inha University School of Medicine and SCM Lifescience Co., Ltd., Incheon 22332, Korea
| | - Chul Soo Kim
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Korea
| | - Sun U Song
- Translational Research Center, Inha University School of Medicine and SCM Lifescience Co., Ltd., Incheon 22332, Korea
| |
Collapse
|
1219
|
Abstract
In observational studies with an aim of assessing treatment effect or comparing groups of patients, several approaches could be used. Often, baseline characteristics of patients may be imbalanced between groups, and adjustments are needed to account for this. It can be accomplished either via appropriate regression modeling or, alternatively, by conducting a matched pairs study. The latter is often chosen because it makes groups appear to be comparable. In this article we considered these 2 options in terms of their ability to detect a treatment effect in time-to-event studies. Our investigation shows that a Cox regression model applied to the entire cohort is often a more powerful tool in detecting treatment effect as compared with a matched study. Real data from a hematopoietic cell transplantation study is used as an example.
Collapse
Affiliation(s)
- Ruta Brazauskas
- Division of Biostatistics and Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Brent R Logan
- Division of Biostatistics and Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| |
Collapse
|
1220
|
Liu APY, Lee V, Li CK, Ha SY, Chiang AKS. Refractory acute lymphoblastic leukemia in Chinese children: bridging to stem cell transplantation with clofarabine, cyclophosphamide and etoposide. Ann Hematol 2015; 95:501-7. [PMID: 26666536 DOI: 10.1007/s00277-015-2577-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 12/07/2015] [Indexed: 01/25/2023]
Abstract
Refractory or relapsed acute lymphoblastic leukemia (r/r ALL) represents the leading cause of cancer mortality in children. Clofarabine is effective in inducing remission thus enabling bridging to hematopoietic stem cell transplantation (HSCT). We report the results in treating Hong Kong Chinese pediatric patients with r/rALL by clofarabine/cyclophosphamide/etoposide (CLO-218) combination therapy. A retrospective review of patients treated between January 2009 and December 2014 in the two tertiary referral pediatric oncology units in Hong Kong. Thirteen patients were identified. All were Chinese and seven were male. Median age at clofarabine treatment was 8 years and the median duration of follow-up was 10 months. Nine patients had B-ALL and four had T-ALL. All were refractory to the preceding regimen(s). The median number of prior treatment regimens was 2; two patients had previous HSCT. Complete remission (CR) was achieved in five patients, Complete remission with incomplete counts (CRi) in two, PR in two, and non-remission (NR) in two. All four patients with T-ALL responded with three patients achieving CR. Eight out of nine patients who responded could be bridged to HSCT. Among those who were transplanted, four remained alive and in remission, three relapsed post-HSCT, and one died from transplant-related mortality. Treatment toxicities were common including febrile neutropenia in all subjects and culture-proven bacteremia in five patients. Hepatotoxicity was mild and reversible with no case of veno-occlusive disease. The clofarabine-based regimen is a promising strategy to induce disease remission in r/rALL and bridge to HSCT. Septic complications are, however, frequent necessitating prompt management with adequate supportive care in specialized centers.
Collapse
Affiliation(s)
- Anthony P Y Liu
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, Hong Kong, China
| | - Vincent Lee
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - C K Li
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - S Y Ha
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, Hong Kong, China
| | - Alan K S Chiang
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, Hong Kong, China.
| |
Collapse
|
1221
|
Tseng WEJ, Wu T, Cheng MY, Wang PN, Toh CH, Lin WR, Chang CW, Hsieh HY, Chiang HI, Lim SN. Preemptive therapy with ganciclovir and cytomegalovirus hyperimmune globulin delayed the onset of Epstein-Barr virus-associated post-transplant acute limbic encephalitis. J Neurol Sci 2015; 359:124-6. [PMID: 26671100 DOI: 10.1016/j.jns.2015.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 10/27/2015] [Accepted: 11/02/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Wei-En Johnny Tseng
- Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tony Wu
- Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Mei-Yun Cheng
- Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Po-Nan Wang
- Division of Hematology/Oncology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Cheng Hong Toh
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Wey-Ran Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chun-Wei Chang
- Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hsiang-Yao Hsieh
- Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hsing-I Chiang
- Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Siew-Na Lim
- Section of Epilepsy, Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan.
| |
Collapse
|
1222
|
Fan F, Fu L, He G, Deng R, Qiu L, Liu Y, Miao X, Shuai Y, Su Y. Infusion of basic fibroblast growth factor ameliorates acute graft versus host disease in mice after haploidentical hematopoietic stem cell transplantation. Immunol Lett 2015; 170:1-6. [PMID: 26658465 DOI: 10.1016/j.imlet.2015.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 11/18/2015] [Accepted: 11/29/2015] [Indexed: 12/29/2022]
Abstract
The aim of this study was to investigate the effect of basic fibroblast growth factor (bFGF) on acute graft versus host disease (aGVHD) in mice after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Haplo-HSCT mice model was established followed by dividing into three groups with 12 mice in each group, group 1 with infusion of 100g/kg bFGF, group 2 with infusion of 20 g/kg bFGF and control group without infusion. Clinical manifestation and survival time of mice after haplo-HSCT were monitored. On day 14 post transplantation, mice were sacrificed for pathology analysis of liver and the changes of mesenchymal stem cells (MSC). Compared to haplo-HSCT group, clinical manifestations of aGVHD in bFGF infusion group were significantly ameliorated. Furthermore, bFGF infusion also significantly prolonged the survival time of mice after transplantation (P<0.05) as demonstrated by Kaplan-Meier survival analysis with more infusion of bFGF, the longer survival of mice. Pathology analysis showed the severity of aGVHD in bFGF infusion group (1 and 2) was less severe than haplo-HSCT group with higher proliferation of bone marrow MSC in group 1. In conclusion, these studies demonstrated that infusion of bFGF ameliorated aGVHD in mice after haplo-HSCT.
Collapse
Affiliation(s)
- Fangyi Fan
- Department of Hematology, The ChengDu Military General Hospital, China
| | - Li Fu
- Department of Hematology, The ChengDu Military General Hospital, China
| | - Guangcui He
- Department of Hematology, The ChengDu Military General Hospital, China
| | - Rui Deng
- Department of Hematology, The ChengDu Military General Hospital, China
| | - Ling Qiu
- Department of Hematology, The ChengDu Military General Hospital, China
| | - Yilan Liu
- Department of Hematology, The ChengDu Military General Hospital, China
| | - Xiaojuan Miao
- Department of Hematology, The ChengDu Military General Hospital, China
| | - Yanrong Shuai
- Department of Hematology, The ChengDu Military General Hospital, China
| | - Yi Su
- Department of Hematology, The ChengDu Military General Hospital, China.
| |
Collapse
|
1223
|
Gratwohl A, Sureda A, Baldomero H, Gratwohl M, Dreger P, Kröger N, Ljungman P, McGrath E, Mohty M, Nagler A, Rambaldi A, de Elvira CR, Snowden JA, Passweg J, Apperley J, Niederwieser D, Stijnen T, Brand R. Economics and Outcome After Hematopoietic Stem Cell Transplantation: A Retrospective Cohort Study. EBioMedicine 2015; 2:2101-9. [PMID: 26844291 PMCID: PMC4703735 DOI: 10.1016/j.ebiom.2015.11.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/04/2015] [Accepted: 11/10/2015] [Indexed: 11/24/2022] Open
Abstract
Hematopoietic stem cell transplantation (HSCT) is a lifesaving expensive medical procedure. Hence, more transplants are performed in more affluent countries. The impact of economic factors on patient outcome is less defined. We analyzed retrospectively a defined cohort of 102,549 patients treated with an allogeneic (N = 37,542; 37%) or autologous (N = 65,007; 63%) HSCT. They were transplanted by one of 404 HSCT centers in 25 European countries between 1999 and 2006. We searched for associations between center-specific microeconomic or country-specific macroeconomic factors and outcome. Center patient-volume and center program-duration were significantly and systematically associated with improved survival after allogeneic HSCT (HR 0·87; 0·84-0·91 per 10 patients; p < 0·0001; HR 0·90;0·85-0·90 per 10 years; p < 0·001) and autologous HSCT (HR 0·91;0·87-0·96 per 10 patients; p < 0·001; HR 0·93;0·87-0·99 per 10 years; p = 0·02). The product of Health Care Expenditures by Gross National Income/capita was significantly associated in multivariate analysis with all endpoints (R(2) = 18%; for relapse free survival) after allogeneic HSCT. Data indicate that country- and center-specific economic factors are associated with distinct, significant, systematic, and clinically relevant effects on survival after HSCT. They impact on center expertise in long-term disease and complication management. It is likely that these findings apply to other forms of complex treatments.
Collapse
Affiliation(s)
- Alois Gratwohl
- EBMT Activity Survey Office, University Hospital, Basel, Switzerland
| | - Anna Sureda
- JACIE Accreditation Office, Barcelona, Spain
| | - Helen Baldomero
- EBMT Activity Survey Office, University Hospital, Basel, Switzerland
| | - Michael Gratwohl
- Institute for Operations Research and Computational Finances, University of St. Gallen, Switzerland
| | | | | | - Per Ljungman
- Hematology, University Hospital and Karolinska Institutet, Stockholm, Sweden
| | | | | | - Arnon Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | | | - John A. Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, University of Sheffield, Sheffield, UK
- Department of Oncology, University of Sheffield, Sheffield, UK
| | - Jakob Passweg
- EBMT Activity Survey Office, University Hospital, Basel, Switzerland
| | - Jane Apperley
- Haematology, Hammersmith Hospital, London, United Kingdom
| | | | - Theo Stijnen
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Ronald Brand
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands
| | | |
Collapse
|
1224
|
Moreau J, Brassier A, Amaddeo A, Neven B, Caillaud C, Chabli A, Fernandez-Bolanos M, Olmo J, Valayannopoulos V, Fauroux B. Obstructive sleep apnea syndrome after hematopoietic stem cell transplantation in children with mucopolysaccharidosis type I. Mol Genet Metab 2015; 116:275-80. [PMID: 26602600 DOI: 10.1016/j.ymgme.2015.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 10/15/2015] [Accepted: 10/15/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) is very common in mucopolysaccharidosis I (MPS I). Hematopoietic stem cell transplantation (HSCT) is the preferred treatment for patients with severe MPS I diagnosed early in life. The protective effect of HSCT on the development of long term OSAS is not known. METHODS Overnight polysomnography (PSG) and biomarker data were analyzed during the annual follow-up in consecutive MPS I patients treated with HSCT. RESULTS The data of 13 patients (6 boys) were analyzed. Median age at HSCT was 17 (range 14-19) months, median age at PSG was 9.0 (4.5-14.5) years, and median time elapsed since HSCT was 7.6 (2.4-13.2) years. A significant correlation was observed between time elapsed since HSCT and the apnea-hypopnea index (AHI, r(2)=0.493, p=+0.003) and the oxygen desaturation index (r(2)=0.424, p=+0.02). Patients older than 10 years of age had a higher mean AHI (25.8/h vs 1.4/h, p=0.0008), a lower mean pulse oximetry (94.7% vs 97.2%, p=0.01) and a higher mean hypopnea index (18.8 vs 0.71/h, p=0.016) as compared to those younger than 10 years of age. No correlation was observed between the AHI and the metabolic clearance, assessed by urine glycosaminoglycan (GAG) excretion and residual enzyme activity, although there was a positive trend for the urinary GAG/higher normal value for age ratio (p=0.09). CONCLUSION HSCT does not offer long term protection against OSAS in MPS I with OSAS being documented in all patients after a time elapse since HSCT exceeding 10 years. The potential benefit of additional enzyme replacement therapy needs to be assessed.
Collapse
Affiliation(s)
- Johan Moreau
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker Enfants-Malades, Paris, France; Physiological Department and INSERM U1046 UMR 9214, University of Montpellier, Montpellier, France.
| | - Anais Brassier
- Reference Center for Inherited Metabolic Disease (MeMEA) and IMAGINE Institute, Hôpital Necker Enfants-Malades, Paris, France.
| | - Alessandro Amaddeo
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker Enfants-Malades, Paris, France; Paris Descartes University, Paris, France.
| | - Benedicte Neven
- Pediatric Immunology and Hematology Department, Hôpital Necker Enfants-Malades, Paris, France.
| | - Catherine Caillaud
- Metabolic Biochemistry Department, P-HP, Hôpital Necker Enfants-Malades, Paris, France.
| | - Allel Chabli
- Metabolic Biochemistry Department, P-HP, Hôpital Necker Enfants-Malades, Paris, France.
| | - Marta Fernandez-Bolanos
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker Enfants-Malades, Paris, France.
| | - Jorge Olmo
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker Enfants-Malades, Paris, France.
| | - Vassili Valayannopoulos
- Reference Center for Inherited Metabolic Disease (MeMEA) and IMAGINE Institute, Hôpital Necker Enfants-Malades, Paris, France.
| | - Brigitte Fauroux
- Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker Enfants-Malades, Paris, France; Paris Descartes University, Paris, France; Inserm U 955, Team 13, Créteil University, Paris XII, Créteil, France.
| |
Collapse
|
1225
|
Jeon YJ, Lee HY, Jung IA, Cho WK, Cho B, Suh BK. Cerebral salt-wasting syndrome after hematopoietic stem cell transplantation in adolescents: 3 case reports. Ann Pediatr Endocrinol Metab 2015; 20:220-5. [PMID: 26817009 PMCID: PMC4722162 DOI: 10.6065/apem.2015.20.4.220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 09/21/2015] [Accepted: 09/24/2015] [Indexed: 11/20/2022] Open
Abstract
Cerebral salt-wasting syndrome (CSWS) is a rare disease characterized by a extracellular volume depletion and hyponatremia induced by marked natriuresis. It is mainly reported in patients who experience a central nervous system insult, such as cerebral hemorrhage or encephalitis. The syndrome of inappropriate antidiuretic hormone secretion is a main cause of severe hyponatremia after hematopoietic stem cell transplantation, whereas CSWS is rarely reported. We report 3 patients with childhood acute leukemia who developed CSWS with central nervous system complication after hematopoietic stem cell transplantation. The diagnosis of CSW was made on the basis of severe hyponatremia accompanied by increased urine output with clinical signs of dehydration. All patients showed elevated natriuretic peptide and normal antidiuretic hormone. Aggressive water and sodium replacement treatment was instituted in all 3 patients and 2 of them were effectively recovered, the other one was required to add fludrocortisone administration.
Collapse
Affiliation(s)
- Yeon Jin Jeon
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Young Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - In Ah Jung
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Kyoung Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bin Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
1226
|
Bauters T, Bordon Cueto De Braem V, Schelstraete P, Van Lancker S, Laureys G, Benoit Y, Dhooge C. Evaluation of timing of first vaccination in children after hematopoietic allogeneic stem cell transplantation. Eur J Oncol Nurs 2015; 21:212-4. [PMID: 26645948 DOI: 10.1016/j.ejon.2015.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 09/03/2015] [Accepted: 10/26/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE Protective immunity to vaccine preventable infectious diseases might be lost over time following hematopoietic stem cell transplantation (HSCT). Limited data are available on the appropriate follow-up of vaccination schedules in pediatric HSCT patients. This study aims to ascertain whether the guidelines for vaccination recommended in our hospital are followed and to which extent of conformity they are used. METHODS A 5-year survey, including all pediatric allogeneic HSCT patients, transplanted at the Ghent University hospital, Belgium. Data were collected from the patient's electronic (nursing and medical) charts. RESULTS Data on vaccination schedules of 28 patients (54.9%) eligible for the recommended vaccinations were collected. Eleven patients (11/28; 39.3%) were vaccinated timely. In 14 out of 17 patients (82.4%) vaccination was postponed for medical reasons, while vaccination was postponed without medical reason in 17.6% (3/17). Vaccination data could not be retrieved in 43.1 (22/51) of patients. Vaccination was declined by the parents in one patient (2.0%). CONCLUSION There is high level of agreement between the hospital guideline and the vaccination of pediatric HSCT patients. Health-care providers play a crucial role in effectively appropriate follow-up of vaccination schedules.
Collapse
Affiliation(s)
- Tiene Bauters
- Department of Pediatric Hemato-Oncology and Hematopoietic Stem Cell Transplantation, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium.
| | - Victoria Bordon Cueto De Braem
- Department of Pediatric Hemato-Oncology and Hematopoietic Stem Cell Transplantation, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - Petra Schelstraete
- Department of Pediatric Pulmonology and Infectious Diseases, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - Sophie Van Lancker
- Department of Pediatric Hemato-Oncology and Hematopoietic Stem Cell Transplantation, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - Geneviève Laureys
- Department of Pediatric Hemato-Oncology and Hematopoietic Stem Cell Transplantation, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - Yves Benoit
- Department of Pediatric Hemato-Oncology and Hematopoietic Stem Cell Transplantation, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| | - Catharina Dhooge
- Department of Pediatric Hemato-Oncology and Hematopoietic Stem Cell Transplantation, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium
| |
Collapse
|
1227
|
Qiao J, Wu J, Li Y, Xia Y, Chu P, Qi K, Yan Z, Yao H, Liu Y, Xu K, Zeng L. Blockage of caspase-1 activation ameliorates bone marrow inflammation in mice after hematopoietic stem cell transplantation. Clin Immunol 2015; 162:84-90. [PMID: 26639193 DOI: 10.1016/j.clim.2015.11.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/07/2015] [Accepted: 11/26/2015] [Indexed: 01/18/2023]
Abstract
Conditioning regimens before hematopoietic stem cell transplantation (HSCT), cause damage to bone marrow and inflammation. Whether inflammasomes are involved in bone marrow inflammation remains unclear. The study aims to evaluate the role of inflammasomes in bone marrow inflammation after HSCT. On days 7, 14, 21 and 28 after HSCT, mice were sacrificed for analysis of bone marrow inflammation, pro-inflammatory cytokines secretion, inflammasomes expression and caspase-1 activation. Bone marrow inflammation with neutrophils and macrophages infiltration was observed after HSCT. Secretion of IL-1β, IL-18, TNF-α and IL-6 were elevated, with increased caspase-1 activation and inflammasomes expression. Caspase-1 inhibitor administration after HSCT significantly reduced infiltration of neutrophils and macrophages into bone marrow and increased the numbers of megakaryocytes and platelets. In conclusion, inflammasomes activation is involved in bone marrow inflammation after HSCT and caspase-1 inhibition attenuates bone marrow inflammation and promoted hematopoietic reconstitution, suggesting targeting caspase-1 might be beneficial for improving HSCT outcomes.
Collapse
Affiliation(s)
- Jianlin Qiao
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China; Blood Diseases Institute, Xuzhou Medical College, Xuzhou 221002, China; Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou 221002, China
| | - Jinyan Wu
- Blood Diseases Institute, Xuzhou Medical College, Xuzhou 221002, China; Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou 221002, China
| | - Yuanyuan Li
- Blood Diseases Institute, Xuzhou Medical College, Xuzhou 221002, China; Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou 221002, China
| | - Yuan Xia
- Blood Diseases Institute, Xuzhou Medical College, Xuzhou 221002, China; Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou 221002, China
| | - Peipei Chu
- Blood Diseases Institute, Xuzhou Medical College, Xuzhou 221002, China; Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou 221002, China
| | - Kunming Qi
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China
| | - Zhiling Yan
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China
| | - Haina Yao
- Blood Diseases Institute, Xuzhou Medical College, Xuzhou 221002, China; Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou 221002, China
| | - Yun Liu
- Blood Diseases Institute, Xuzhou Medical College, Xuzhou 221002, China; Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou 221002, China
| | - Kailin Xu
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China; Blood Diseases Institute, Xuzhou Medical College, Xuzhou 221002, China; Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou 221002, China.
| | - Lingyu Zeng
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China; Blood Diseases Institute, Xuzhou Medical College, Xuzhou 221002, China; Key Laboratory of Bone Marrow Stem Cell, Jiangsu Province, Xuzhou 221002, China.
| |
Collapse
|
1228
|
Porter JB, de Witte T, Cappellini MD, Gattermann N. New insights into transfusion-related iron toxicity: Implications for the oncologist. Crit Rev Oncol Hematol 2015; 99:261-71. [PMID: 26806144 DOI: 10.1016/j.critrevonc.2015.11.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 09/28/2015] [Accepted: 11/24/2015] [Indexed: 01/19/2023] Open
Abstract
Iron overload is a potentially life-threatening consequence of multiple red-blood-cell transfusions. Here, we review factors affecting excess iron distribution and its damage to specific tissues, as well as mechanisms of oncogenesis by iron. Although consequences of transfusional iron overload are best described in thalassemia major and related inherited anemias, they are increasingly recognized in acquired conditions, such as myelodysplastic syndromes (MDS). Iron overload in MDS not only impacts on certain tissues, but may affect the clonal evolution of MDS through generation of reactive oxygen species. Iron overload may also influence hematopoietic-stem-cell-transplantation outcomes. Novel MRI methods for assessing body iron have impacted significantly on outcome in inherited anemias by allowing monitoring of iron burden and iron chelation therapy. This approach is increasingly being used in MDS and stem-cell-transplant procedures. Knowledge gained from managing transfusional iron overload in inherited anemias may be translated to general oncology, with potential for improved patient outcomes.
Collapse
Affiliation(s)
- John B Porter
- Department of Haematology, University College London, UCL Cancer Institute, Paul O'Gorman Building, 72 Huntley Street, London WC1E 6BT, UK.
| | - Theo de Witte
- Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | | | | |
Collapse
|
1229
|
Abstract
Ocular graft-versus-host disease (GvHD) is predominantly an inflammatory ocular surface disorder after allogeneic hematopoietic stem cell transplantation (HSCT) with increasing incidence. It is not only associated with reduced quality of life because of dry eye syndromes but can also impair visual acuity and lead to blindness due to corneal complications. The GvHD is mostly associated with severe moisturizing disorder of the ocular surface, which is often resistant to therapy and accompanied by chronic inflammation. Corneal complications are an important problem in these patients. An individually adapted multimodal stage-related and interdisciplinary therapy in cooperation with hematologists and oncologists is therefore important for the treatment of patients with ocular GvHD.
Collapse
Affiliation(s)
- T Dietrich-Ntoukas
- Klinik für Augenheilkunde, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| | - P Steven
- Kompetenzzentrum okuläre GvHD, Zentrum für Augenheilkunde, Universität zu Köln, Kerpenerstraße 62, 50937, Köln, Deutschland. .,3 Cellular Stress Responses in Aging-associated Diseases, CECAD, Universität zu Köln, Köln, Deutschland.
| |
Collapse
|
1230
|
Park Y, Cheong JW, Park MH, Kim MS, Kim JS, Kim HS. Effect of major histocompatibility complex haplotype matching by C4 and MICA genotyping on acute graft versus host disease in unrelated hematopoietic stem cell transplantation. Hum Immunol 2015; 77:176-83. [PMID: 26602146 DOI: 10.1016/j.humimm.2015.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/05/2015] [Accepted: 11/17/2015] [Indexed: 10/22/2022]
Abstract
We explored whether matching of human leukocyte antigen (HLA) haplotypes between the recipient and donor of hematopoietic stem cell transplantation (HSCT) predicted by C4 and MICA typing is associated with the incidence of acute graft versus host disease (aGVHD). DNA preparations collected from a total of 81 recipient and donor pairs were used for PCR-based C4 subtyping and/or MICA sequence-based typing. Incidences of aGVHD were compared according to C4 and MICA matching. The six most common MICA alleles were MICA*008:01, *010:01, *002:01, *004, *009:01/049, and *012:01. Among the 59 unrelated pairs, HLA alleles were matched in 34 (57.6%). C4 subtypes were identical between the recipient and donor in 28 (82.4%) HLA-matched unrelated pairs, while MICA genotypes were matched in all HLA-matched unrelated pairs. In the 22 HLA-matched related pairs, all recipients showed identical C4 subtypes with their respective donors. In multivariate analysis, C4 mismatch was a significant risk factor associated with the development of aGVHD in unrelated HSCT (hazard ratio=3.24, P=0.006). PCR-based C4 subtyping is a simple method for assessing the genetic identity of the HLA region between a recipient and unrelated donor. This test would be also useful for prediction of aGVHD in HSCT.
Collapse
Affiliation(s)
- Yongjung Park
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - June-Won Cheong
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myoung Hee Park
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Korea Organ Donation Agency Laboratory, Seoul, Republic of Korea
| | - Myoung Soo Kim
- Division of Transplantation Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Sun Kim
- Department of Microbiology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyon-Suk Kim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
1231
|
Devine KA, Manne SL, Mee L, Bartell AS, Sands SA, Myers-Virtue S, Ohman-Strickland P. Barriers to psychological care among primary caregivers of children undergoing hematopoietic stem cell transplantation. Support Care Cancer 2015; 24:2235-2242. [PMID: 26576965 DOI: 10.1007/s00520-015-3010-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 11/01/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE This substudy of an intervention trial aimed to describe barriers to participation in psychological care among primary caregivers of children who were about to undergo a hematopoietic stem cell transplantation (HSCT), including demographic and medical correlates. METHOD Three hundred and twelve primary caregivers of children undergoing HSCT who were approached to participate in a psychological intervention trial (n = 218 enrollees and 94 decliners) completed a measure of barriers to psychological care. RESULTS The most frequently endorsed barriers to care were focusing on the child as priority, not wanting to leave the child's bedside, and already having adequate psychosocial support. The least frequently endorsed barriers were location, wait times, and stigma around seeking psychological care. CONCLUSIONS Results suggest that explaining how psychological care for a primary caregiver can positively affect their ill child may reduce barriers to seeking needed support services. Certain practical barriers to care may be irrelevant in inpatient settings where psychological support is offered.
Collapse
Affiliation(s)
- Katie A Devine
- Department of Medicine, Section of Population Sciences, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA.
| | - Sharon L Manne
- Department of Medicine, Section of Population Sciences, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA
| | - Laura Mee
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Abraham S Bartell
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stephen A Sands
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Shannon Myers-Virtue
- Department of Medicine, Section of Population Sciences, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08903, USA
| | - Pamela Ohman-Strickland
- Department of Biostatistics, Rutgers University School of Public Health, Piscataway Township, NJ, USA
| |
Collapse
|
1232
|
Deo SS, Virassamy B, Halliday C, Clancy L, Chen S, Meyer W, Sorrell TC, Gottlieb DJ. Stimulation with lysates of Aspergillus terreus, Candida krusei and Rhizopus oryzae maximizes cross-reactivity of anti-fungal T cells. Cytotherapy 2015; 18:65-79. [PMID: 26552765 DOI: 10.1016/j.jcyt.2015.09.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/13/2015] [Accepted: 09/23/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND AIMS Invasive fungal diseases caused by filamentous fungi and yeasts are significant causes of morbidity and mortality in immunosuppressed hematology patients. We previously published a method to expand Aspergillus fumigatus-specific T cells for clinical cell therapy. In the present study, we investigated expansion of T cells specific for other fungal pathogens and creation of a broadly reactive panfungal T-cell product. METHODS Fungal strains selected were those frequently observed in the clinical hematology setting and included Aspergillus, Candida, Fusarium, Rhizopus and Lomentospora/Scedosporium. Four T-cell cultures specific to each fungus were established. We selected lysates of Aspergillus terreus, Candida krusei and Rhizopus oryzae to expand panfungal T cells. Allelic restriction of anti-fungal activity was determined through the use of specific major histocompatibility complex class II-blocking antibodies. RESULTS Individual T-cell cultures specific to each fungus could be expanded in vitro, generating predominantly CD4(+) T cells of which 8% to 20% were fungus-specific. We successfully expanded panfungal T cells from the peripheral blood (n = 8) and granulocyte-colony-stimulating factor-primed stem cell products (n = 3) of normal donors by using a combination of lysates from Aspergillus terreus, Candida krusei and Rhizopus oryzae. Anti-fungal activity was mediated through human leukocyte antigen (HLA)-DR alleles and was maintained when antigen-presenting cells from partially HLA-DRB1-matched donors were used to stimulate T cells. CONCLUSIONS We demonstrate a method to manufacture panfungal T-cell products with specificity against a range of clinical fungal pathogens by use of the blood and stem cells of healthy donors as the starting material. The safety and efficacy of these products will need to be tested clinically.
Collapse
Affiliation(s)
- Shivashni S Deo
- Centre for Cancer Research, Westmead Millennium Institute for Medical Research, Sydney, Australia; Sydney Medical School, University of Sydney, Australia.
| | - Balaji Virassamy
- Centre for Cancer Research, Westmead Millennium Institute for Medical Research, Sydney, Australia
| | - Catriona Halliday
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, Australia
| | - Leighton Clancy
- Sydney Cellular Therapies Laboratory, Westmead Hospital, Sydney, Australia
| | - Sharon Chen
- Sydney Medical School, University of Sydney, Australia; Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, Australia
| | - Wieland Meyer
- Sydney Medical School, University of Sydney, Australia; Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Australia
| | - Tania C Sorrell
- Sydney Medical School, University of Sydney, Australia; Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Australia
| | - David J Gottlieb
- Centre for Cancer Research, Westmead Millennium Institute for Medical Research, Sydney, Australia; Sydney Medical School, University of Sydney, Australia; Sydney Cellular Therapies Laboratory, Westmead Hospital, Sydney, Australia; Blood and Marrow Transplant Unit, Department of Haematology, Westmead Hospital, Sydney, Australia
| |
Collapse
|
1233
|
Imashuku S. Treatment of Epstein-Barr virus-related hemophagocytic lymphohistiocytosis: Study protocol of a prospective pilot study. World J Hematol 2015; 4:69-75. [DOI: 10.5315/wjh.v4.i4.69] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 09/06/2015] [Accepted: 10/13/2015] [Indexed: 02/05/2023] Open
Abstract
In this manuscript, a number of debatable issues related to the diagnosis and treatment of Epstein-Barr virus-related hemophagocytic lymphohistiocytosis (EBV-HLH) will be addressed. Considering the heterogeneous nature of EBV-HLH, diagnostic efforts are required to clarify the precise nature of the disease at diagnosis, the number of EBV genome copies in peripheral blood, and localization of the EBV genome in lymphoid cells (B, T, or natural killer cells). Although the majority of cases of EBV-HLH develop without evidence of immunodeficiency, some cases have been found to be associated with chronic active EBV infection, genetic diseases such as X-linked lymphoproliferative disease (XLP, type 1, or type 2), or familial HLH (FHL, types 2-5). Due to such background heterogeneity, the therapeutic results of EBV-HLH have also been found to vary. Patients have been found to respond to corticosteroids alone or an etoposide-containing regimen, whereas other patients require hematopoietic stem cell transplantation. Thus, decision-making for optimal treatment of EBV-HLH and its eventual outcome requires evaluation in consideration of the precise nature of the disease. A protocol for a pilot study on the treatment of patients with EBV-HLH is presented here.
Collapse
|
1234
|
Amarachintha S, Sertorio M, Wilson A, Li X, Pang Q. Fanconi Anemia Mesenchymal Stromal Cells-Derived Glycerophospholipids Skew Hematopoietic Stem Cell Differentiation Through Toll-Like Receptor Signaling. Stem Cells 2015; 33:3382-96. [PMID: 26212365 PMCID: PMC4618082 DOI: 10.1002/stem.2100] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/14/2015] [Accepted: 06/04/2015] [Indexed: 01/08/2023]
Abstract
Fanconi anemia (FA) patients develop bone marrow (BM) failure or leukemia. One standard care for these devastating complications is hematopoietic stem cell transplantation. We identified a group of mesenchymal stromal cells (MSCs)-derived metabolites, glycerophospholipids, and their endogenous inhibitor, 5-(tetradecyloxy)-2-furoic acid (TOFA), as regulators of donor hematopoietic stem and progenitor cells. We provided two pieces of evidence that TOFA could improve hematopoiesis-supporting function of FA MSCs: (a) limiting-dilution cobblestone area-forming cell assay revealed that TOFA significantly increased cobblestone colonies in Fanca-/- or Fancd2-/- cocultures compared to untreated cocultures. (b) Competitive repopulating assay using output cells collected from cocultures showed that TOFA greatly alleviated the abnormal expansion of the donor myeloid (CD45.2+Gr1+Mac1+) compartment in both peripheral blood and BM of recipient mice transplanted with cells from Fanca-/- or Fancd2-/- cocultures. Furthermore, mechanistic studies identified Tlr4 signaling as the responsible pathway mediating the effect of glycerophospholipids. Thus, targeting glycerophospholipid biosynthesis in FA MSCs could be a therapeutic strategy to improve hematopoiesis and stem cell transplantation.
Collapse
Affiliation(s)
- Surya Amarachintha
- Division of Experimental Hematology and Cancer Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Mathieu Sertorio
- Division of Experimental Hematology and Cancer Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Andrew Wilson
- Division of Experimental Hematology and Cancer Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Xiaoli Li
- Division of Experimental Hematology and Cancer Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Qishen Pang
- Division of Experimental Hematology and Cancer Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| |
Collapse
|
1235
|
Barajas MR, McCullough KB, Merten JA, Dierkhising RA, Bartoo GT, Hashmi SK, Hogan WJ, Litzow MR, Patnaik MM, Wilson JW, Wolf RC, Wermers RA. Correlation of Pain and Fluoride Concentration in Allogeneic Hematopoietic Stem Cell Transplant Recipients on Voriconazole. Biol Blood Marrow Transplant 2016; 22:579-83. [PMID: 26524731 DOI: 10.1016/j.bbmt.2015.10.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 10/26/2015] [Indexed: 11/23/2022]
Abstract
Supportive care guidelines recommend antimold prophylaxis in hematopoietic stem cell transplant (HSCT) recipients deemed to have high risk for invasive fungal infection, leading to long-term use of voriconazole after allogeneic HSCT in patients who remain immunocompromised. Voriconazole has been associated with periostitis, exostoses, and fluoride excess in patients after solid organ transplantation, HSCT, and leukemia therapy. The aims of this study were to describe the frequency and clinical presentation of patients presenting with pain and fluoride excess among allogeneic HSCT patients taking voriconazole, to identify when a plasma fluoride concentration was measured with respect to voriconazole initiation and onset of pain, and to describe the outcomes of patients with fluoride excess in the setting of HSCT. A retrospective review was conducted of all adult allogeneic HSCT patients receiving voriconazole at Mayo Clinic in Rochester, Minnesota, between January 1, 2009 and July 31, 2012. Of 242 patients included, 32 had plasma fluoride measured to explore the etiology of musculoskeletal pain. In 31 patients with fluoride measurement while on voriconazole, 29 (93.5%) had elevated levels. The median plasma fluoride was 11.1 μmol/L (range, 2.4 to 24.7). The median duration of voriconazole was 163 days (range, 2 to 1327). The median time to fluoride measurement was 128 days after voriconazole initiation (range, 28 to 692). At 1 year after the start of voriconazole after HSCT, 15.3% of patients had developed pain associated with voriconazole use and 35.7% developed pain while on voriconazole after 2 years. Of the patients with an elevated fluoride level, 22 discontinued voriconazole; pain resolved or improved in 15, stabilized in 3, and worsened in 4 patients. Ten patients continued voriconazole; pain resolved or improved in 7, was attributable to alternative causes in 2, and undefined in 1. Serum creatinine, estimated glomerular filtration rate, alkaline phosphatase, and voriconazole concentration did not predict for fluoride excess and associated pain. Periostitis due to fluoride excess is a common adverse effect of voriconazole that should be considered in patients presenting with pain and is often reversible after drug discontinuation. Alternative antifungal agents with a lower risk for fluoride excess should be considered in patients receiving voriconazole who develop fluoride excess and pain.
Collapse
|
1236
|
Quintela A, Escuret V, Roux S, Bonnafous P, Gilis L, Barraco F, Labussière-Wallet H, Duscastelle-Leprêtre S, Nicolini FE, Thomas X, Chidiac C, Ferry T, Frobert E, Morisset S, Poitevin-Later F, Monneret G, Michallet M, Ader F. HHV-6 infection after allogeneic hematopoietic stem cell transplantation: From chromosomal integration to viral co-infections and T-cell reconstitution patterns. J Infect 2015; 72:214-22. [PMID: 26518057 DOI: 10.1016/j.jinf.2015.09.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 08/29/2015] [Accepted: 09/29/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Human herpes virus 6 (HHV-6) can reactivate after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and may be associated with significant clinical manifestations. METHODS Case control study of HHV-6 infections after allo-HSCT. Chromosomal integration (ciHHV-6) for viral loads ≥ 5.5-log10 copies/mL was investigated. Viral co-infections, T-cell recovery, risk factors and outcome were compared in HHV-6- and non-HHV-6-infected patients. Antiviral treatment strategies were reviewed. RESULTS Among 366 adult allo-HSCT recipients, 75 HHV-6 infections occurred. Three (4%) recipients were ciHHV-6. HHV-6 infections were associated with CMV (p = 0.05; sdHR 1.73, CI 0.99-3.02) and/or BKV infections (p < 0.0001; sdHR 4.63, CI 2.04-10.53) but not EBV reactivation (p = 0.34). A slower CD8+ T-cells recovery was observed until 6 months after allo-HSCT in the HHV-6-infected group (p < 0.001), independently of acute and/or chronic graft-versus-host disease. The overall probability of survival after allo-HSCT was diminished for active HHV-6-infected patients (p = 0.0326). Cord blood unit recipients had a higher risk of developing HHV-6 infection compared to bone marrow recipients (p = 0.0007; sdHR 3.82, CI 1.76-8.27). Anti-HHV-6 treatment achieved complete response in only 2/3 of the cases. CONCLUSIONS In this series of allo-HSCT recipients, 4% were ciHHV-6, active HHV-6 infection was likely associated with CMV and BKV co-reactivations, delayed CD8+ T-cell recovery and poorer outcome.
Collapse
Affiliation(s)
- Adrien Quintela
- Hematology Department, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Vanessa Escuret
- Virology Laboratory, Laboratoire de Virologie Est, Hospices Civils de Lyon, F-69677 Bron, France
| | - Sandrine Roux
- Infectious Diseases Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, F-69004 Lyon, France
| | - Pascale Bonnafous
- Sorbonne Universités, UPMC, CIMI-Paris UMRS CR7, Inserm U1135, PVI Team, Paris, France
| | - Lila Gilis
- Hematology Department, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Fiorenza Barraco
- Hematology Department, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Hélène Labussière-Wallet
- Hematology Department, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | | | - Franck-Emmanuel Nicolini
- Hematology Department, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Xavier Thomas
- Hematology Department, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Christian Chidiac
- Infectious Diseases Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, F-69004 Lyon, France
| | - Tristan Ferry
- Infectious Diseases Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, F-69004 Lyon, France; Inserm U1111 CIRI, Claude Bernard Lyon I University, Lyon, France
| | - Emilie Frobert
- Virology Laboratory, Laboratoire de Virologie Est, Hospices Civils de Lyon, F-69677 Bron, France
| | - Stéphane Morisset
- Hematology Department, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Françoise Poitevin-Later
- Cellular Immunology Laboratory, Hôpital E. Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Guillaume Monneret
- Cellular Immunology Laboratory, Hôpital E. Herriot, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Mauricette Michallet
- Hematology Department, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Florence Ader
- Infectious Diseases Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, F-69004 Lyon, France; Inserm U1111 CIRI, Claude Bernard Lyon I University, Lyon, France.
| | | |
Collapse
|
1237
|
Wu X, Yao Y, Bao X, Zhou H, Tang X, Han Y, Ma X, Liu Y, Chen J, Zhou H, Jing S, Gu B, Xu Y, Sun A, He J, Wu D. KIR2DS4 and Its Variant KIR1D Are Associated with Acute Graft-versus-Host Disease, Cytomegalovirus, and Overall Survival after Sibling-Related HLA-Matched Transplantation in Patients with Donors with KIR Gene Haplotype A. Biol Blood Marrow Transplant 2015; 22:220-225. [PMID: 26476204 DOI: 10.1016/j.bbmt.2015.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 10/04/2015] [Indexed: 10/22/2022]
Abstract
Outcomes for hematopoietic stem cell transplantation (HSCT) in various donor and recipient killer immunoglobulin-like receptor (KIR) genotypes have been studied extensively. The associations between KIR2DS4 and its variant KIR1D with outcomes of HSCT from a sibling-related HLA-matched donor with KIR haplotype A have not been explored, however. To study this, we genotyped donor-recipient pairs and divided 165 recipients of HSCT from a KIR gene haplotype A donor into 3 groups: 2DS4+/2DS4+ (2 intact KIR2DS4 alleles), 2DS4+/1D+ (heterozygous), and 1D+/1D+ (homozygous for the deletion variant KIR1D). No difference in the recovery of neutrophils and platelets among the 3 groups was observed. The cumulative incidence of grade III-IV acute graft-versus-host disease (aGVHD) within day +100 was 28.94% in the 2DS4+/2DS4+ group, 14.11% in the 2DS4+/1D+ group, and 44.44% in the 1D+/1D+ group (P = .0159). Multivariate analysis identified 1D+/1D+ as an independent risk factor for aGVHD (hazard ratio [HR], 4.221; 95% confidence interval [CI], 1.470 to 12.124; P = .007). In contrast, the cumulative incidences of chronic GVHD, 3-year cumulative relapse, and treatment-related mortality did not differ significantly among the 3 groups. The rate of cytomegalovirus (CMV) reactivation was 46.96% in the 2DS4+/2DS4+ group, 20.16% in the 2DS4+/1D+ group, and 53.25% in the 1D+/1D+ group (P = .0017). Multivariate analysis identified 2DS4+/1D+ as an independent protective factor for CMV reactivation (HR, 0.268; 95% CI, 0.125 to 0.574; P = .001). Although overall survival (OS) did not differ among the groups in the first year, the 2DS4(+)/2DS4(+) group had significantly better OS than the other groups after 1 year (P = .0361). In patients with advanced-stage disease, the 3-year probability of disease-free survival was 51.06% in the 2DS4+/2DS4+ group, 34.01% in the 2DS4+/1D+ group, and 0% in the 1D+/1D+ group (P = .0314). Collectively, our data suggest that the KIR 2DS4/1D allelic variance is associated with the outcome of sibling-related HLA-matched HSCT, and that donor subclassification of KIR 2DS4/1D alleles should be considered in this setting.
Collapse
Affiliation(s)
- Xiaojin Wu
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yao Yao
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaojing Bao
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China; HLA Laboratory, Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Huifeng Zhou
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaowen Tang
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yue Han
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiao Ma
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuejun Liu
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jia Chen
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Haixia Zhou
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Song Jing
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bing Gu
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yang Xu
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Aining Sun
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jun He
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China; HLA Laboratory, Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Depei Wu
- Department of Hematology, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China.
| |
Collapse
|
1238
|
Papadopoulou A, Kaloyannidis P, Yannaki E, Cruz CR. Adoptive transfer of Aspergillus-specific T cells as a novel anti-fungal therapy for hematopoietic stem cell transplant recipients: Progress and challenges. Crit Rev Oncol Hematol 2015; 98:62-72. [PMID: 26527379 DOI: 10.1016/j.critrevonc.2015.10.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 09/10/2015] [Accepted: 10/15/2015] [Indexed: 12/22/2022] Open
Abstract
Although newer antifungal drugs have substantially altered the natural history of invasive aspergillosis, the disease still accounts for significant morbidity and mortality in hematopoietic stem cell transplant recipients. Both the evidence supporting a protective role of T cells against this fungal pathogen and the documented efficacy of adoptive transfer of antigen-specific T cells for prophylaxis and treatment of viral infections post-transplant have stimulated much interest towards development of Aspergillus-specific T cells (Asp-STs) for adoptive immunotherapy in the allogeneic transplant setting. In contrast to the remarkable progress with virus-specific T cells, clinical development of fungus-specific T cells is still in its infancy. Several groups have characterized Asp-STs in healthy individuals and patients with malignant hematological diseases, while others sought to develop GMP-compliant methods of expanding or bioengineering Asp-STs ex vivo as immunotherapy. This review highlights the recent advances in this field, and discusses critical issues involved in development and protocol design of Asp-ST immunotherapy.
Collapse
Affiliation(s)
- Anastasia Papadopoulou
- Hematology Department/Hematopoietic Cell-Transplantation Unit, Gene and Cell Therapy Center, "George Papanicolaou" Hospital, Thessaloniki, Greece; Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece.
| | - Panayotis Kaloyannidis
- Adult Hematology & Stem cell Transplant, King Fahad Specialist Hospital Dammam, Saudi Arabia
| | - Evangelia Yannaki
- Hematology Department/Hematopoietic Cell-Transplantation Unit, Gene and Cell Therapy Center, "George Papanicolaou" Hospital, Thessaloniki, Greece; Department of Medicine, University of Washington, Seattle, WA, USA
| | - Conrad Russell Cruz
- Program for Cell Enhancement and Technologies for Immunotherapy, Center for Cancer and Immunology Research, and Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, WA, United States
| |
Collapse
|
1239
|
Liu N, Ning HM, Hu LD, Jiang M, Xu C, Hu JW, Wang J, Li YH, Li BT, Lou X, Yang F, Chen JL, Su YF, Li M, Wang HY, Ren J, Feng YQ, Zhang B, Wang DH, Chen H. Outcome of myeloablative allogeneic peripheral blood hematopoietic stem cell transplantation for refractory/relapsed AML patients in NR status. Leuk Res 2015; 39:1375-81. [PMID: 26530539 DOI: 10.1016/j.leukres.2015.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 10/13/2015] [Accepted: 10/14/2015] [Indexed: 10/22/2022]
Abstract
To further find effective method to improve the long term survival of refractory or relapsed acute myeloid leukemia (AML) patients, we retrospectively analyzed the outcomes of myeloablative hematopoietic stem cell transplantation (HSCT) for 133 consecutive patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) therapy related AML(t-AML) in not remission status. The overall 3-year OS and DFS were 40.9% and 35.6% respectively. The variables associated with improved long term DFS were a bone marrow blast cell count less than 20% and an intensified conditioning regimen. In addition, the t-AML group had higher rates of relapse and III-IV acute GVHD than the primary AML group. The unrelated donor group had similar OS and DFS with sibling groups. Our study suggested that decreasing bone marrow blast cell counts before HSCT and strengthening the conditioning regimen may improve long-term DFS for refractory/relapsed AML patients, and unrelated donor group can get similar effect when compared to the sibling group.
Collapse
Affiliation(s)
- Na Liu
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Hong-Mei Ning
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Liang-Ding Hu
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Min Jiang
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Chen Xu
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Jiang-Wei Hu
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Jun Wang
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Yu-Hang Li
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Bo-Tao Li
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Xiao Lou
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Fan Yang
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Jian-Lin Chen
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Yong-Feng Su
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Meng Li
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Hong-Ye Wang
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Jing Ren
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Yue-Qian Feng
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Bin Zhang
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Dan-Hong Wang
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China
| | - Hu Chen
- Department of Hematopoietic Stem Cell Transplantation Center, Affiliated Hospital to Academy of Military Medical Science (307Hospital, PLA), China.
| |
Collapse
|
1240
|
Vahlensieck U, Poley-Ochmann S, Hilger A, Heiden M, Seitz R. [Authorization of tissue and blood stem cell preparations for hematopoietic reconstitution: Documentation of clinical and nonclinical data in a central expert report]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 58:1247-53. [PMID: 26459568 DOI: 10.1007/s00103-015-2241-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In order to address the European Directive 2004/23 on human tissues and cells, the authorization obligation for tissue and blood stem cell preparations was introduced (§ 21a AMG) in the year 2007 in the German medicinal products act. Stem cell transplantation for hematopoietic reconstitution has been in use for decades and is well established for the treatment of many malignancies. The manufacture of stem cell preparations varies, but in terms of hematopoietic reconstitution, different products are intended for the same indication. Taking these aspects into account, it was considered inappropriate that every single applicant should provide their own documentation, including an expert report on clinical and nonclinical data. Consequently, the idea came up to create a central expert report, to which all applicants could refer and would include relevant clinical and nonclinical data according to current knowledge. A central expert report was therefore generated, called the "Gemeinsame Stellungnahme der Fachgesellschaften Deutsche Gesellschaft für Transfusionsmedizin und Immunhämatologie (DGTI), Deutsche Gesellschaft für Hämatologie und Onkologie (DGH) und Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH)". Applicants are allowed to refer to this central expert report provided their stem cell product is comparable with the cell preparations included in the report. In order to represent current knowledge, the content of the central expert report was already reworked once, but should be updated regularly.
Collapse
|
1241
|
René C, Lozano C, Villalba M, Eliaou JF. 5' and 3' untranslated regions contribute to the differential expression of specific HLA-A alleles. Eur J Immunol 2015; 45:3454-63. [PMID: 26399450 DOI: 10.1002/eji.201545927] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 08/19/2015] [Accepted: 09/21/2015] [Indexed: 12/17/2022]
Abstract
In hematopoietic stem cell transplantation (HSCT), when no HLA full-matched donor is available, alternative donors could include one HLA-mismatched donor. Recently, the low expressed HLA-C alleles have been identified as permissive mismatches for the best donor choice. Concerning HLA-A, the degree of variability of expression is poorly understood. Here, we evaluated HLA-A expression in healthy individuals carrying HLA-A*02 allele in different genotypes using flow cytometry and allele-specific quantitative RT-PCR. While an interindividual variability of HLA-A*02 cell surface expression, not due to the allele associated, was observed, no difference of the mRNA expression level was shown, suggesting the involvement of the posttranscriptional regulation. The results of qRT-PCR analyses exhibit a differential expression of HLA-A alleles with HLA-A*02 as the strongest expressed allele independently of the second allele. The associated non-HLA-A*02 alleles were differentially expressed, particularly the HLA-A*31 and HLA-A*33 alleles (strong expression) and the HLA-A*29 (low expression). The presence of specific polymorphisms in the 5' and 3' untranslated regions of the HLA-A*31 and HLA-A*33 alleles could contribute to this high level of expression. As previously described for HLA-C, low-expressed HLA-A alleles, such as HLA-A*29, could be considered as a permissive mismatch, although this needs to be confirmed by clinical studies.
Collapse
Affiliation(s)
- Céline René
- Department of Immunology, CHRU de Montpellier, University Hospital Saint-Eloi, Montpellier, France.,Faculté de Médecine, University of Montpellier, Montpellier, France.,INSERM U1183, Université de Montpellier, UFR Médecine, Montpellier, France
| | - Claire Lozano
- Department of Immunology, CHRU de Montpellier, University Hospital Saint-Eloi, Montpellier, France
| | - Martin Villalba
- INSERM U1183, Université de Montpellier, UFR Médecine, Montpellier, France.,Institute for Regenerative Medicine and Biotherapy (IRMB), CHRU Montpellier, Montpellier, France
| | - Jean-François Eliaou
- Department of Immunology, CHRU de Montpellier, University Hospital Saint-Eloi, Montpellier, France.,Faculté de Médecine, University of Montpellier, Montpellier, France.,INSERM U1194, IRCM University of Montpellier, Montpellier, France
| |
Collapse
|
1242
|
Chen N, Zhang ZY, Liu DW, Liu W, Tang XM, Zhao XD. The clinical features of autoimmunity in 53 patients with Wiskott-Aldrich syndrome in China: a single-center study. Eur J Pediatr 2015; 174:1311-8. [PMID: 25877044 DOI: 10.1007/s00431-015-2527-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 03/13/2015] [Accepted: 03/17/2015] [Indexed: 12/29/2022]
Abstract
UNLABELLED Autoimmune disease (AD) is common in patients with Wiskott-Aldrich syndrome (WAS) and patients with WAS who has an AD usually constitute a high-risk group with poor outcome. However, knowledge of AD in WAS is limited in China. In this study, medical records of 53 patients with WAS at Children´s Hospital of Chongqing Medical University from April 2004 to January 2014 were evaluated retrospectively and 14 patients (26%) had at least one AD. Autoimmune hemolytic anemia (AIHA) was the most common and detected in 12 patients (23%), other complications included immune thrombocytopenia (n = 1), immune neutropenia (n = 1), autoimmune arthritis (n = 1), and renal injury (n = 1). No significant differences were found in the level of serum immunoglobulins and lymphocyte subsets between the AD group and non-AD group. Although eight patients with AD received hematopoietic stem cell transplantation (HSCT), three patients died of pulmonary infection after HSCT. CONCLUSIONS AD is frequent in Chinese patients with WAS and AIHA was the most common. AD is a poor prognosis factor for WAS and should be treated as early as possible by HSCT. WHAT IS KNOWN • Autoimmune disease is common in patients with WAS. • Manifestations, follow-up finding, and treatment approaches of autoimmune disease in Chinese patients with WAS have received less attention in the literature. What is New: • This study is firstly intended for evaluation of the clinical and immune characteristics of autoimmune disease in a large series Chinese patients with WAS. • AD is frequent in Chinese patients with WAS and AIHA is the most common.
Collapse
Affiliation(s)
- Nan Chen
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
| | - Zhi-Yong Zhang
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
| | - Da-Wei Liu
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
| | - Wei Liu
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
| | - Xue-Mei Tang
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
| | - Xiao-Dong Zhao
- Division of Immunology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child, Development and Disorders, Chongqing, 400014, China.
| |
Collapse
|
1243
|
Seo JJ. Hematopoietic cell transplantation for hemophagocytic lymphohistiocytosis: recent advances and controversies. Blood Res 2015; 50:131-9. [PMID: 26457279 PMCID: PMC4595578 DOI: 10.5045/br.2015.50.3.131] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 09/16/2015] [Accepted: 09/16/2015] [Indexed: 01/09/2023] Open
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory clinical syndrome of uncontrolled immune response which results in hypercytokinemia due to underlying primary or secondary immune defect. A number of genetic defects in transport, processing and function of cytotoxic granules which result in defective granule exocytosis and cytotoxicity of cytotoxic T lymphocytes (CTL) and natural killer (NK) cells have been well identified at the cellular and molecular level. Important advances have been made during the last 20 years in the diagnosis and treatment of HLH. The Histiocyte Society has proposed diagnostic guideline using both clinical and laboratory findings in HLH-2004 protocol, and this has been modified partly in 2009. HLH used to be a fatal disease, but the survival of HLH patients has improved to more than 60% with the use of chemoimmunotherapy combined with hematopoietic cell transplantation (HCT) over the past 2 decades. However, HCT is still the only curative option of treatment for primary HLH and refractory/relapsed HLH after proper chemoimmunotherapy. The outcome of HCT for HLH patients was also improved steadily during last decades, but HCT for HLH still carries significant mortality and morbidity. Moreover, there remain ongoing controversies in various aspects of HCT including indication of HCT, donor selection, timing of HCT, conditioning regimen, and mixed chimerism after HCT. This review summarized the important practical issues which were proven by previous studies on HCT for HLH, and tried to delineate the controversies among them.
Collapse
Affiliation(s)
- Jong Jin Seo
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
1244
|
Lee HG, Kim SY, Kim I, Kim YK, Kim JA, Kim YS, Lee HS, Park J, Kim SJ, Shim H, Eom HS, Park BB, Lee J, Park SK, Cheong JW, Park KW. Prediction of survival by applying current prognostic models in diffuse large B-cell lymphoma treated with R-CHOP followed by autologous transplantation. Blood Res 2015; 50:160-6. [PMID: 26457283 PMCID: PMC4595582 DOI: 10.5045/br.2015.50.3.160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 07/16/2015] [Accepted: 08/17/2015] [Indexed: 11/17/2022] Open
Abstract
Background Among the currently available prognostic models for diffuse large B-cell lymphoma (DLBCL), we investigated to determine which is most adoptable for DLBCL patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) followed by upfront autologous stem cell transplantation (auto-SCT). Methods We retrospectively evaluated survival differences among risk groups based on the International Prognostic Index (IPI), the age-adjusted IPI (aaIPI), the revised IPI (R-IPI), and the National Comprehensive Cancer Network IPI (NCCN-IPI) at diagnosis in 63 CD20-positive DLBCL patients treated with R-CHOP followed by upfront auto-SCT. Results At the time of auto-SCT, 74.6% and 25.4% of patients had achieved complete remission and partial remission after R-CHOP, respectively. As a whole, the 5-year overall (OS) and progression-free survival (PFS) rates were 78.8% and 74.2%, respectively. The 5-year OS and PFS rates according to the IPI, aaIPI, R-IPI, and NCCN-IPI did not significantly differ among the risk groups for each prognostic model (P-values for OS: 0.255, 0.337, 0.881, and 0.803, respectively; P-values for PFS: 0.177, 0.904, 0.295, and 0.609, respectively). Conclusion There was no ideal prognostic model among those currently available for CD20-positive DLBCL patients treated with R-CHOP followed by upfront auto-SCT.
Collapse
Affiliation(s)
- Hong Ghi Lee
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Sung-Yong Kim
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Inho Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yeo-Kyeoung Kim
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Jeong-A Kim
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Suwon, Korea
| | - Yang Soo Kim
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Ho Sup Lee
- Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Jinny Park
- Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Seok Jin Kim
- Department of Internal Medicine, Samsung Medical Center, Seoul, Korea
| | - Hyeok Shim
- Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Hyeon Seok Eom
- Department of Internal Medicine, National Cancer Center, Goyang, Korea
| | - Byeong-Bae Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Junglim Lee
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Sung Kyu Park
- Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Korea
| | - June-Won Cheong
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Keon Woo Park
- Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea
| |
Collapse
|
1245
|
Sakamoto H, Takeda N, Arai F, Hosokawa K, Garcia P, Suda T, Frampton J, Ogawa M. Determining c-Myb protein levels can isolate functional hematopoietic stem cell subtypes. Stem Cells 2015; 33:479-90. [PMID: 25329760 DOI: 10.1002/stem.1855] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 08/26/2014] [Indexed: 12/20/2022]
Abstract
The transcription factor c-Myb was originally identified as a transforming oncoprotein encoded by two avian leukemia viruses. Subsequently, through the generation of mouse models that affect its expression, c-Myb has been shown to be a key regulator of hematopoiesis, including having critical roles in hematopoietic stem cells (HSCs). The precise function of c-Myb in HSCs although remains unclear. We have generated a novel c-myb allele in mice that allows direct observation of c-Myb protein levels in single cells. Using this reporter line we demonstrate that subtypes of HSCs can be isolated based upon their respective c-Myb protein expression levels. HSCs expressing low levels of c-Myb protein (c-Myb(low) HSC) appear to represent the most immature, dormant HSCs and they are a predominant component of HSCs that retain bromodeoxyuridine labeling. Hematopoietic stress, induced by 5-fluorouracil ablation, revealed that in this circumstance c-Myb-expressing cells become critical for multilineage repopulation. The discrimination of HSC subpopulations based on c-Myb protein levels is not reflected in the levels of c-myb mRNA, there being no more than a 1.3-fold difference comparing c-Myb(low) and c-Myb(high) HSCs. This illustrates how essential it is to include protein studies when aiming to understand the regulatory networks that control stem cell behavior.
Collapse
Affiliation(s)
- Hiroshi Sakamoto
- Department of Cell Differentiation, Institute of Molecular Embryology and Genetics, Kumamoto City, Japan
| | | | | | | | | | | | | | | |
Collapse
|
1246
|
Traul DL, Sieber F. Inhibitory effects of merocyanine 540-mediated photodynamic therapy on cellular immune functions: A role in the prophylaxis of graft-versus-host disease? J Photochem Photobiol B 2015; 153:153-63. [PMID: 26410039 DOI: 10.1016/j.jphotobiol.2015.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 09/05/2015] [Accepted: 09/13/2015] [Indexed: 11/28/2022]
Abstract
Merocyanine 540-mediated photodynamic therapy (MC540-PDT) has been used in clinical trials for the purging of autologous hematopoietic stem cell grafts. When the same combinations of dye and light were applied to human peripheral blood lymphocytes, a broad range of T- and B-cell functions were impaired, prompting speculations about a potential role of MC540-PDT in the prophylaxis of graft-versus-host disease (GVHD). We here report on the effects of MC540-PDT on in vitro functions of murine lymphocytes as well as a preliminary evaluation of MC540-PDT for the prevention of GVHD in murine models of allogeneic bone marrow transplantation. Mixed lymphocyte reactions, proliferative responses to lectins, interleukin-2 and lipopolysaccharide, T-cell-mediated lysis, and NK activity were all inhibited by moderate doses of MC540-PDT. Whether MC540-PDT reduced the incidence and/or the severity of GVHD in murine models of allogeneic hematopoietic stem cell transplantation depended on the composition of the mismatched grafts and the intensity of the preparative regimen. MC540-PDT was only beneficial (i.e. reduced the incidence and/or severity of GVHD) when the spleen cell content of grafts was low and/or the radiation dose of the preparative regimen was not myeloablative, and, therefore, may have encouraged mixed chimerism.
Collapse
Affiliation(s)
- Donald L Traul
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
| | - Fritz Sieber
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
| |
Collapse
|
1247
|
Park BG, Park CJ, Jang S, Chi HS, Kim DY, Lee JH, Lee JH, Lee KH. Reconstitution of lymphocyte subpopulations after hematopoietic stem cell transplantation: comparison of hematologic malignancies and donor types in event-free patients. Leuk Res 2015; 39:1334-41. [PMID: 26422556 DOI: 10.1016/j.leukres.2015.09.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 08/09/2015] [Accepted: 09/07/2015] [Indexed: 11/28/2022]
Abstract
The reconstitution of different immunocyte subsets after hematopoietic stem cell transplantation (HSCT), follows different timelines. We prospectively investigated changes in lymphocyte subsets after HSCT and their associations with primary diagnosis, conditioning regimen, and HSCT type in event-free patients. A total of 95 patients (48 with acute myeloid leukemia, 22 with acute lymphoid leukemia, and 25 with myelodysplastic syndrome) who underwent allogeneic HSCT (34 sibling matched, 37 unrelated matched, and 24 haploidentical HSCT) but did not experience any events such as relapse or death were enrolled in this study. Lymphocyte subpopulations (T cells, helper/inducer T cells, cytotoxic/suppressor T cells, memory T cells, regulatory T cells, natural killer (NK) cells, NK-T cells, and B cells) were quantified by flow cytometry of peripheral blood from recipients 7 days before and 1, 2, 3, 6, and 12 months after HSCT. Leukocyte counts recovered within 1 month after HSCT. However, the number of T and B lymphocytes recovered at 2 months after HSCT. NK cell counts recovered shortly after haploidentical HSCT. However, T lymphocytes and their subpopulations showed delayed recovery after haploidentical HSCT. Lymphocyte subsets showed different sequential patterns according to HSCT type but no differences were seen according to primary diagnosis or conditioning regimen.
Collapse
Affiliation(s)
- Borae G Park
- Department of Laboratory Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea; Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Chan-Jeoung Park
- Department of Laboratory Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea.
| | - Seongsoo Jang
- Department of Laboratory Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyun-Sook Chi
- Department of Laboratory Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea
| | - Dae-Young Kim
- Department of Internal Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea
| | - Jung-Hee Lee
- Department of Internal Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea
| | - Je-Hwan Lee
- Department of Internal Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyoo-Hyung Lee
- Department of Internal Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea.
| |
Collapse
|
1248
|
Kim KI, Kim JH, Ji EH, Jang JH, Kim JS, Kwon JH, Kim I, Park S, Velikova G, Yoon SS, Oh JM. Psychometric analysis of the Korean version of the high-dose chemotherapy specific quality of life questionnaire module from the European Organization for Research and Treatment of Cancer (EORTC QLQ-HDC29). Qual Life Res 2015; 25:881-90. [PMID: 26342931 DOI: 10.1007/s11136-015-1121-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE We evaluated the psychometric properties of the Korean version of the European Organization for Research and Treatment of Cancer high-dose chemotherapy specific quality of life questionnaire module (EORTC QLQ-HDC29) when implemented with Korean patients by conducting a multicenter, longitudinal study in three Korean hospitals. METHODS A total of 226 patients who scheduled to receive the HDC followed by hematopoietic stem cell transplantation (HSCT) were enrolled. The patients were asked to complete three questionnaires [the EORTC Core Questionnaire (QLQ-C30), QLQ-HDC29, and the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation] at four points in time: before HSCT and 100, 180, and 365 days after HSCT. Standard validity and reliability analyses were performed. RESULTS Internal consistency of the QLQ-HDC29 was generally acceptable, as tested by Cronbach's α, except for the scales body image and the inpatient issues. Cronbach's α values for the Korean version of the QLQ-HDC29 were almost in accordance with results of the original version, except for the scales body image (lower to the original QLQ-HDC29, α = 0.73) and impact on family (higher to the original QLQ-HDC29, α = 0.52). Known-group comparison analyses showed significantly higher symptom burdens in patients with poor performance status or graft versus host disease (similar to the original QLQ-HDC29). The QLQ-HDC29 indicated good convergent and discriminant validity and showed responsiveness to changes in line with a clinical course over time after HSCT. CONCLUSIONS The QLQ-HDC29 is generally reliable and adequate to assess QoL in Korean patients undergoing HDC followed by HSCT.
Collapse
Affiliation(s)
- Kyung Im Kim
- College of Pharmacy, Korea University, Sejong, Republic of Korea
| | - Jae Hyun Kim
- College of Pharmacy, Seoul National University, Seoul, Republic of Korea
| | - Eun Hee Ji
- College of Pharmacy, Gachon University, Incheon, Republic of Korea
| | - Jun Ho Jang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji-Hyun Kwon
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Inho Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seonyang Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Galina Velikova
- Cancer Research UK Clinical Centre - Leeds, St James's University Hospital, Leeds, UK
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. .,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea. .,Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Jung Mi Oh
- College of Pharmacy, Seoul National University, Seoul, Republic of Korea. .,Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.
| |
Collapse
|
1249
|
Jindra PT, Conway SE, Ricklefs SM, Porcella SF, Anzick SL, Haagenson M, Wang T, Spellman S, Milford E, Kraft P, McDermott DH, Abdi R. Analysis of a Genetic Polymorphism in the Costimulatory Molecule TNFSF4 with Hematopoietic Stem Cell Transplant Outcomes. Biol Blood Marrow Transplant 2015; 22:27-36. [PMID: 26348892 DOI: 10.1016/j.bbmt.2015.08.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 08/31/2015] [Indexed: 10/23/2022]
Abstract
Despite stringent procedures to secure the best HLA matching between donors and recipients, life-threatening complications continue to occur after hematopoietic stem cell transplantation (HSCT). Studying single nucleotide polymorphism (SNP) in genes encoding costimulatory molecules could help identify patients at risk for post-HSCT complications. In a stepwise approach we selected SNPs in key costimulatory molecules including CD274, CD40, CD154, CD28, and TNFSF4 and systematically analyzed their association with post-HSCT outcomes. Our discovery cohort analysis of 1157 HLA-A, -B, -C, -DRB1, and -DQB1 matched cases found that patients with donors homozygous for the C variant of rs10912564 in TNFSF4 (48%) had better disease-free survival (P = .029) and overall survival (P = .009) with less treatment-related mortality (P = .006). Our data demonstrate the TNFSF4C variant had a higher affinity for the nuclear transcription factor Myb and increased percentage of TNFSF4-positive B cells after stimulation compared with CT or TT genotypes. However, these associations were not validated in a more recent cohort, potentially because of changes in standard of practice or absence of a true association. Given the discovery cohort, functional data, and importance of TNFSF4 in infection clearance, TNFSF4C may associate with outcomes and warrants future studies.
Collapse
Affiliation(s)
- Peter T Jindra
- Transplant Research Center, Renal Division, Brigham and Women's Hospital and Children's Hospital, Boston, Massachusetts
| | - Susan E Conway
- Transplant Research Center, Renal Division, Brigham and Women's Hospital and Children's Hospital, Boston, Massachusetts
| | - Stacy M Ricklefs
- Genomics Unit, Research Technologies Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Stephen F Porcella
- Genomics Unit, Research Technologies Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Sarah L Anzick
- Genomics Unit, Research Technologies Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Mike Haagenson
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | - Tao Wang
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Stephen Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | - Edgar Milford
- Transplant Research Center, Renal Division, Brigham and Women's Hospital and Children's Hospital, Boston, Massachusetts
| | - Peter Kraft
- Departments of Epidemiology and Biostatistics, Harvard School of Public Health, Boston, Massachusetts
| | - David H McDermott
- Molecular Signaling Section, Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Reza Abdi
- Transplant Research Center, Renal Division, Brigham and Women's Hospital and Children's Hospital, Boston, Massachusetts.
| |
Collapse
|
1250
|
Ullrich CK, Rodday AM, Bingen K, Kupst MJ, Patel SK, Syrjala KL, Harris LL, Recklitis CJ, Schwartz L, Davies S, Guinan EC, Chang G, Wolfe J, Parsons SK. Parent Outlook: How Parents View the Road Ahead as They Embark on Hematopoietic Stem Cell Transplantation for Their Child. Biol Blood Marrow Transplant 2016; 22:104-11. [PMID: 26348891 DOI: 10.1016/j.bbmt.2015.08.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 08/23/2015] [Indexed: 11/22/2022]
Abstract
Pediatric hematopoietic stem cell transplantation (HSCT) offers cure for high-risk malignancies and other conditions, but carries a risk of complications. Parental outlook regarding their child's transplantation course and future health has been largely unexplored. This report presents the Parent Outlook Scale, describes its properties, and examines the outlook of parents embarking on their child's transplantation course and the associated variables. Parents of children scheduled to undergo HSCT (n = 363) at 8 US transplantation centers completed the Parent Outlook Scale, comprising 4 items assessing frequency of the parent's thoughts about the potential difficulty of the child's transplantation (Transplant Difficult subscale) and worsened health (Health Worse subscale). Item responses were rated on a 5-point Likert scale (ranging from "none" to "all of the time") and, along with scale/subscale scores, transformed to 100-point scales, with higher scores connoting greater thought frequency. Psychometrics were explored. Multivariable models identified personal and clinical characteristics associated with scale and subscale scores. The Parent Outlook Scale (α = 0.75) and subscales were found to have sound psychometric properties. Factor loading supported the single scale with 2 subscales representing distinct aspects of overall outlook. Mean scores (Parent Outlook, 52.5 ± 21.7; Transplant Difficult, 64.4 ± 25.6; Health Worse, 40.7 ± 25.7) revealed variability within and across scale/subscales. Significantly different mean subscale scores (P < .001) indicated more frequent Transplant Difficult thoughts than Health Worse thoughts. Clinical factors (solid tumor diagnosis and unrelated donor transplant) and a parent factor (worse emotional functioning) were associated with higher scale and subscale scores. Our findings show that the outlook of parents embarking on their child's HSCT course is varied and not solely a product of clinical factors readily apparent to clinicians. Referring and transplantation clinicians should create opportunities to explore with parents their perspectives and concerns before and during the course of HSCT.
Collapse
|