101
|
Wiese F, Reinhardt-Heller K, Volz M, Gille C, Köstlin N, Billing H, Handgretinger R, Holzer U. Monocytes show immunoregulatory capacity on CD4 + T cells in a human in-vitro model of extracorporeal photopheresis. Clin Exp Immunol 2018; 195:369-380. [PMID: 30411330 DOI: 10.1111/cei.13232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 01/02/2023] Open
Abstract
Extracorporeal photopheresis (ECP) is a widely used immunomodulatory therapy for the treatment of various T cell-mediated disorders such as cutaneous T cell lymphoma (CTCL), graft-versus-host disease (GvHD) or systemic sclerosis. Although clinical benefits of ECP are already well described, the underlying mechanism of action of ECP is not yet fully understood. Knowledge on the fate of CD14+ monocytes in the context of ECP is particularly limited and controversial. Here, we investigated the immunoregulatory function of ECP treated monocytes on T cells in an in-vitro ECP model. We show that ECP-treated monocytes significantly induce proinflammatory T cell types in co-cultured T cells, while anti-inflammatory T cells remain unaffected. Furthermore, we found significantly reduced proliferation rates of T cells after co-culture with ECP-treated monocytes. Both changes in interleukin secretion and proliferation were dependent on cell-contact between monocytes and T cells. Interestingly, blocking interactions of programmed death ligand 1 (PD-L1) to programmed death 1 (PD-1) in the in-vitro model led to a significant recovery of T cell proliferation. These results set the base for further studies on the mechanism of ECP, especially the regulatory role of ECP-treated monocytes.
Collapse
Affiliation(s)
- F Wiese
- Tuebingen University Children's Hospital, Department of Hematology and Oncology, Tuebingen, Germany
| | - K Reinhardt-Heller
- Tuebingen University Children's Hospital, Department of Hematology and Oncology, Tuebingen, Germany
| | - M Volz
- Tuebingen University Children's Hospital, Department of Hematology and Oncology, Tuebingen, Germany
| | - C Gille
- Tuebingen University Children's Hospital, Department of Neonatology, Tuebingen, Germany
| | - N Köstlin
- Tuebingen University Children's Hospital, Department of Neonatology, Tuebingen, Germany
| | - H Billing
- Tuebingen University Children's Hospital, Department of Hematology and Oncology, Tuebingen, Germany
| | - R Handgretinger
- Tuebingen University Children's Hospital, Department of Hematology and Oncology, Tuebingen, Germany
| | - U Holzer
- Tuebingen University Children's Hospital, Department of Hematology and Oncology, Tuebingen, Germany
| |
Collapse
|
102
|
Rushton C, Jackson A, Goddard K, Alfred A. A case review of a patient experience of photopheresis using a peripherally inserted central catheter. J Clin Apher 2018; 34:73-74. [PMID: 30414332 DOI: 10.1002/jca.21674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 07/26/2018] [Accepted: 10/18/2018] [Indexed: 11/05/2022]
Abstract
Extracorporeal photopheresis (ECP) is a cell based immunomodulatory therapy in which the patient is attached intravenously to a cell separating machine. During ECP a patient's blood is collected via either a central venous access device (CVAD) or a peripherally inserted 16G arterial venous fistula needle in either one or both antecubital fossa. However, patients presenting for ECP with GVHD repeatedly present a challenge to the ECP team due to poor venous access resulting from previous therapies and skin changes. The use of peripherally inserted central venous catheters (PICCs) offers an alternative route of vascular access for this cohort of patients. Here we present a case report of a patient successfully treated with ECP following the insertion of a PICC line.
Collapse
Affiliation(s)
- Cherie Rushton
- Photopheresis, Rotherham Foundation Trust, Rotherham, United Kingdom
| | - Andrew Jackson
- Vascular Access, Rotherham Foundation Trust, Rotherham, United Kingdom
| | - Kathryn Goddard
- Photopheresis, Rotherham Foundation Trust, Rotherham, United Kingdom
| | - Arun Alfred
- Photopheresis, Rotherham Foundation Trust, Rotherham, United Kingdom
| |
Collapse
|
103
|
Sakellari I, Gavriilaki E, Batsis I, Mallouri D, Panteliadou AK, Lazaridou A, Vardi A, Constantinou V, Yannaki E, Papalexandri A, Kaloyannidis P, Smias C, Anagnostopoulos A. Favorable impact of extracorporeal photopheresis in acute and chronic graft versus host disease: Prospective single-center study. J Clin Apher 2018; 33:654-660. [DOI: 10.1002/jca.21660] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/01/2018] [Accepted: 08/11/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Ioanna Sakellari
- Hematology Department and BMT Unit; George Papanicolaou Hospital; Thessaloniki Greece
| | - Eleni Gavriilaki
- Hematology Department and BMT Unit; George Papanicolaou Hospital; Thessaloniki Greece
| | - Ioannis Batsis
- Hematology Department and BMT Unit; George Papanicolaou Hospital; Thessaloniki Greece
| | - Despina Mallouri
- Hematology Department and BMT Unit; George Papanicolaou Hospital; Thessaloniki Greece
| | | | - Andriana Lazaridou
- Hematology Department and BMT Unit; George Papanicolaou Hospital; Thessaloniki Greece
| | - Anna Vardi
- Hematology Department and BMT Unit; George Papanicolaou Hospital; Thessaloniki Greece
| | - Varnavas Constantinou
- Hematology Department and BMT Unit; George Papanicolaou Hospital; Thessaloniki Greece
| | - Evangelia Yannaki
- Hematology Department and BMT Unit; George Papanicolaou Hospital; Thessaloniki Greece
| | | | | | - Christos Smias
- Hematology Department and BMT Unit; George Papanicolaou Hospital; Thessaloniki Greece
| | | |
Collapse
|
104
|
Adamski J. Vascular access considerations for extracorporeal photopheresis. Transfusion 2018; 58 Suppl 1:590-597. [PMID: 29443405 DOI: 10.1111/trf.14500] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 12/18/2017] [Accepted: 12/22/2017] [Indexed: 12/18/2022]
Abstract
Extracorporeal photopheresis is an immunomodulatory therapy indicated for patients with cutaneous T-cell lymphoma, graft-versus-host disease, and heart or lung allograft rejection. Whole blood from the patient is drawn into the photopheresis instrument where it is separated into its components. Plasma, red blood cells, and the treated buffy coat are subsequently returned to the patient. Consistent, adequate blood flow is necessary to successfully complete the procedure. Vascular access options for photopheresis include peripheral vein cannulation, tunneled central venous catheters, and subcutaneous ports. Photopheresis is a very safe procedure; however, the complications and impact on the patient's quality of life associated with vascular access devices can be significant.
Collapse
Affiliation(s)
- Jill Adamski
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, Arizona
| |
Collapse
|
105
|
Cho A, Jantschitsch C, Knobler R. Extracorporeal Photopheresis-An Overview. Front Med (Lausanne) 2018; 5:236. [PMID: 30211164 PMCID: PMC6119964 DOI: 10.3389/fmed.2018.00236] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 08/03/2018] [Indexed: 12/23/2022] Open
Abstract
Extracorporeal photopheresis (ECP) has been in clinical use for over three decades after receiving FDA approval for the palliative treatment of the Sézary Syndrome variant of cutaneous T-cell lymphoma (CTCL) in 1988. After the first positive experiences with CTCL, additional indications have been successfully explored including areas such as graft-vs.-host disease (GVHD), scleroderma, and solid organ transplantation. The mechanism of action is still not fully resolved, but important steps in understanding ECP in recent years have been very informative. Originally, the primary hypothesis stated that psoralen and ultraviolet A (UVA) in combination induce apoptosis in the treated immune cells. This view shifted in favor of dendritic cell initiation, modification of the cytokine profile and stimulation of several T-cell lineages, in particular regulatory T-cells. A number of ECP guidelines have been produced to optimize treatment regimens in the clinical context. In CTCL, enough evidence is available for the use of ECP as a first line treatment for Sézary Syndrome (SS), but also as a second line or rescue treatment in therapy-refractory forms of mycosis fungoides (MF). ECP in the treatment of acute and chronic GVHD has shown promising results as second line therapy in steroid-refractory presentations. In solid organ transplantation, ECP has been used to increase tissue tolerance and decrease infections with opportunistic pathogens, attributed to the use of high doses of immunosuppressive medication. Infection with cytomegalovirus (CMV) remains a limiting factor affecting survival in solid organ transplantation and the role of ECP will be discussed in this review. A trend toward prophylactic use of ECP can be observed and may further contribute to improve the outcome in many patients. To further deepen our knowledge of ECP and thus facilitate its use in patients that potentially benefit most from it, future prospective randomized trials are urgently needed in this rapidly growing field. The aim of this review is to (1) introduce the method, (2) give an overview where ECP has shown promising effects and has become an essential part of treatment protocols, and (3) to give recommendations on how to proceed in numerous indications.
Collapse
Affiliation(s)
| | | | - Robert Knobler
- Department of Dermatology, Medizinische Universität Wien, Vienna, Austria
| |
Collapse
|
106
|
Mawardi H, Hashmi SK, Elad S, Aljurf M, Treister N. Chronic graft‐versus‐host disease: Current management paradigm and future perspectives. Oral Dis 2018; 25:931-948. [DOI: 10.1111/odi.12936] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/04/2018] [Accepted: 07/04/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Hani Mawardi
- Faculty of Dentistry King AbdulAziz University Jeddah Kingdom of Saudi Arabia
- AlFarabi Private College Jeddah Kingdom of Saudi Arabia
| | - Shahrukh K. Hashmi
- Department of Medicine Mayo Clinic Rochester Minnesota
- Oncology Center KFSHRC Riyadh Kingdom of Saudi Arabia
| | - Sharon Elad
- Department of Dentistry University of Rochester Rochester New York
| | | | - Nathaniel Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital Boston Massachusetts
- Department of Oral Medicine, Infection and Immunity Harvard School of Dental Medicine Boston Massachusetts
| |
Collapse
|
107
|
Gorenkova LG, Kravchenko SK, Kovrigina AM, Kolomeitsev OA. Successful sequential immune epigenetic therapy of erythrodermic mycosis fungoidesessful sequential immune epigenetic therapy with the resistant course of erythrodermic mycosis fungoides. VESTNIK DERMATOLOGII I VENEROLOGII 2018. [DOI: 10.25208/0042-4609-2018-94-3-77-84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Mucosis fungoidea (МF) belongs to the class of epidermotropic T-cell lymphomas. MF is represented by over 10 sub-types only in terms of its clinical manifestations, with one of them being erythrodermic MF (EMF). This disease is characterized by diverse symptomatology in the form of erythroderma and intense skin itch, aggressive сlinical course and unfavorable prognosis. The disease prognosis also correlates with age, previous history of long-term systemic gluco-corticosteroid treatment (GCS), increased activity of lactate dehydrogenase (LDH) and hypereosinophilia. The choice of MF treatment is determined by the disease stage and somatic status of the patient. In EMF, a therapy combining various effective preparations and taking into account the specifics of the given case is required. Extracorporeal photopheresis (ECP) is frequently an approach of choice; however, it has demonstrated the highest efficacy in Sezary disease or in EFM associated with leucemization. Application of new pharmaceuticals (monoclonal antibodies, epigenetic agents) in combination or in sequence with immune therapy is a promising direction, particularly for treating patients older than 75 years. In this paper, we describe the clinical case of an elderly patient suffering from EMF without peripheral blood leukemia with multimodal factors of unfavorable prognosis, such as age, increased lactate dehy drogenase activity, history of prolonged inefficient treatment with gluco-cortecosteroid preparations and eosinophilia. A long-term positive response to the treatment using sequential immune epigenetic therapy has not been achieved, although the treatment tolerability and the patient's life quality were satisfactory.
Collapse
|
108
|
Prince HM, Querfeld C. Integrating novel systemic therapies for the treatment of mycosis fungoides and Sézary syndrome. Best Pract Res Clin Haematol 2018; 31:322-335. [PMID: 30213403 DOI: 10.1016/j.beha.2018.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 11/26/2022]
Abstract
Novel systemic therapies are generally prescribed to patients with advanced-stage disease or those with early-stage disease refractory to skin-directed therapies. In general, systemic chemotherapy should be reserved for patients who fail to respond to biological agents. Such biological agents include interferon alfa, bexarotene, histone deacetylase inhibitors (vorinostat, romidepsin), brentuximab vedotin and mogamulizumab. Extracorporeal photopheresis is particularly effective for patients with Sézary Syndrome. Allogeneic transplantation is becoming increasing used for younger patients. Novel agents in advanced development include the monoclonal antibody IPH4102,duvelisib,and the new modified formulation of denileukin diftitox. The choice of agents for patients is typically a balance of patient factors (age, co-morbidities, geographic location), relative efficacy and toxicity.
Collapse
Affiliation(s)
- H Miles Prince
- Epworth Healthcare and Sir Peter MacCallum Department of Oncology, University of Melbourne, 140 Clarendon Street, East Melbourne, Victoria, Australia.
| | - Christiane Querfeld
- City of Hope National Medical Center, Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA.
| |
Collapse
|
109
|
Yan J, Zhang J, Zhang X, Li X, Li L, Li Z, Chen R, Zhang L, Wu J, Wang X, Sun Z, Fu X, Chang Y, Nan F, Yu H, Wu X, Feng X, Li W, Zhang M. AEG-1 is involved in hypoxia-induced autophagy and decreases chemosensitivity in T-cell lymphoma. Mol Med 2018; 24:35. [PMID: 30134829 PMCID: PMC6038315 DOI: 10.1186/s10020-018-0033-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/05/2018] [Indexed: 02/07/2023] Open
Abstract
Background This study was to examine the link between astrocyte elevated gene-1 (AEG-1) and hypoxia induced-chemoresistance in T-cell non-Hodgkin’s lymphoma (T-NHL), as well as the underlying molecular mechanisms. Methods Expression of AEG-1, LC3-II, and Beclin-1 were initially examined in human T-NHL tissues (n = 30) and normal lymph node tissues (n = 16) using western blot, real-time PCR and immunohistochemistry. Western blot was also performed to analyze the expression of AEG-1, LC3-II, and Beclin-1 in T-NHL cells (Hut-78 and Jurkat cells) under normoxia and hypoxia. Additionally, the proliferation and apoptosis of Hut-78 cells exposed to different concentration of Adriamycin (ADM) in normoxia and hypoxia were evaluated by MTT and Annexin-V FITC/PI staining assay. Finally, the effects of AEG-1 on Hut-78 cells exposed to ADM in hypoxia were assessed by MTT and Annexin-V FITC/PI staining assay, and 3-MA (autophagy inhibitor) was further used to determine the underlying mechanism. Results AEG-1, LC3-II and Beclin-1 expression were significantly increased in T-NHL tissues compared with normal tissues. Incubation of Hut-78 and Jurkat cells in hypoxia obviously increased AEG-1, LC3-II and Beclin-1 expression. Hypoxia induced proliferation and reduced apoptosis of Hut-78 cells exposed to ADM. AEG-1 overexpression further increased proliferation and decreased apoptosis of Hut-78 cells exposed to ADM in hypoxia. Moreover, overexpression of AEG-1 significantly inversed 3-MA induced-changes in cell proliferation and apoptosis of Hut-78 cells exposed to ADM in hypoxia. Conclusions This study suggested that AEG-1 is associated with hypoxia-induced T-NHL chemoresistance via regulating autophagy, uncovering a novel target against hypoxia-induced T-NHL chemoresistance. Electronic supplementary material The online version of this article (10.1186/s10020-018-0033-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Jiaqin Yan
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Junhui Zhang
- Department of Otorhinolaryngology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Xudong Zhang
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Xin Li
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Ling Li
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Zhaoming Li
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Renyin Chen
- Department of pathology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Lei Zhang
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Jingjing Wu
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Xinhua Wang
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Zhenchang Sun
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Xiaorui Fu
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Yu Chang
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Feifei Nan
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Hui Yu
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Xiaolong Wu
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Xiaoyan Feng
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China
| | - Wencai Li
- Department of pathology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China
| | - Mingzhi Zhang
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, Henan, 450052, People's Republic of China.
| |
Collapse
|
110
|
Okamoto S, Teshima T, Kosugi-Kanaya M, Kahata K, Kawashima N, Kato J, Mori T, Ozawa Y, Miyamura K. Extracorporeal photopheresis with TC-V in Japanese patients with steroid-resistant chronic graft-versus-host disease. Int J Hematol 2018; 108:298-305. [PMID: 29959747 DOI: 10.1007/s12185-018-2483-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/15/2018] [Accepted: 06/20/2018] [Indexed: 01/31/2023]
Abstract
There are few established therapies for chronic graft-versus-host disease (cGVHD) refractory to first-line treatment with steroids. We evaluated the efficacy and safety of extracorporeal photopheresis (ECP) with a third-generation TC-V device in Japanese patients with cGVHD. Fifteen patients with steroid-resistant or -intolerant cGVHD after allogeneic hematopoietic stem cell transplantation participated in this multicenter open-label study. Extracorporeal photopheresis was conducted on days 1-3, week 1; days 1-2, weeks 2-12; and days 1-2, weeks 16, 20, and 24. The composite primary endpoint consisted of evaluation of response and changes in steroid dose 24 weeks after ECP initiation. Secondary endpoints included response over time, concomitant drug dose, quality of life, and safety. Twelve patients completed scheduled ECP therapy; eight (66.7%) showed a response at week 24. In all 15 patients, the mean (± standard deviation) steroid dose decreased 0.115 ± 0.230 mg/kg/day from screening to week 24. Five serious, potentially treatment-related adverse events (heart failure, thrombosis in the device, pneumonia, edema, and wheezing) occurred; none were fatal. This study confirmed that ECP using the TC-V device was effective, with an acceptable toxicity profile. Further studies in larger cohorts are clearly warranted to determine its optimal use in Japanese patients with cGVHD.
Collapse
Affiliation(s)
- Shinichiro Okamoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Takanori Teshima
- Hematology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Mizuha Kosugi-Kanaya
- Hematology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Kaoru Kahata
- Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Naomi Kawashima
- Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Jun Kato
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yukiyasu Ozawa
- Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Koichi Miyamura
- Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| |
Collapse
|
111
|
Abstract
Cell death is a perpetual feature of tissue microenvironments; each day under homeostatic conditions, billions of cells die and must be swiftly cleared by phagocytes. However, cell death is not limited to this natural turnover-apoptotic cell death can be induced by infection, inflammation, or severe tissue injury. Phagocytosis of apoptotic cells is thus coupled to specific functions, from the induction of growth factors that can stimulate the replacement of dead cells to the promotion of tissue repair or tissue remodeling in the affected site. In this review, we outline the mechanisms by which phagocytes sense apoptotic cell death and discuss how phagocytosis is integrated with environmental cues to drive appropriate responses.
Collapse
Affiliation(s)
- Lidia Bosurgi
- I. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Bernard-Nocht-Institut für Tropenmedizin, Hamburg, Germany
| | - Lindsey D Hughes
- Department of Immunobiology, School of Medicine, Yale University, New Haven, CT, USA
| | - Carla V Rothlin
- Department of Immunobiology, School of Medicine, Yale University, New Haven, CT, USA.,Department of Pharmacology, School of Medicine, Yale University, New Haven, CT, USA
| | - Sourav Ghosh
- Department of Pharmacology, School of Medicine, Yale University, New Haven, CT, USA.,Department of Neurology, School of Medicine, Yale University, New Haven, CT, USA
| |
Collapse
|
112
|
Ventura A, Vassall A, Robinson E, Filler R, Hanlon D, Meeth K, Ezaldein H, Girardi M, Sobolev O, Bosenberg MW, Edelson RL. Extracorporeal Photochemotherapy Drives Monocyte-to-Dendritic Cell Maturation to Induce Anticancer Immunity. Cancer Res 2018; 78:4045-4058. [PMID: 29764863 DOI: 10.1158/0008-5472.can-18-0171] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 04/13/2018] [Accepted: 05/08/2018] [Indexed: 11/16/2022]
Abstract
Extracorporeal photochemotherapy (ECP) is a cancer immunotherapy for cutaneous T-cell lymphoma (CTCL) operative in more than 350 centers worldwide. Although its efficacy and favorable safety profile have driven its widespread use, elucidation of its underlying mechanism has been difficult. In this study, we identify the principal contributors to the anticancer immunotherapeutic effects of ECP, with the goal of enhancing potency and broadening applicability to additional malignancies. First, we scaled down the clinical ECP leukocyte-processing device to mouse size. Second, we used that miniaturized device to produce a cellular vaccine that regularly initiated therapeutic antimelanoma immunity. Third, we individually subtracted key factors from either the immunizing inoculum or the treated animal to ascertain their contribution to the in vivo antimelanoma response. Platelet-signaled monocyte-to-dendritic cell (DC) differentiation followed by sorting/processing/presentation of tumor antigens derived from internalized apoptotic tumor cells were absolute requirements. As in clinical ECP, immunogenic cell death of tumor cells was finely titrated by DNA cross-linkage mediated by photoactivated 8-methoxypsoralen (8-MOPA). ECP-induced tumor-loaded DC were effective immunotherapeutic agents only if they were spared exposure to 8-MOPA, indicating that healthy DC are required for ECP. Infusion of responder T cells into naïve tumor-challenged mice established the protective role of stimulated T-cell antitumor immunity. Collectively, these results reveal that selective antitumor effects of ECP are initiated by tumor antigen-loaded, ECP-induced DC, which promote potent collaboration between CD4 and CD8 tumor-specific T cells. These mechanistic insights suggest potential therapeutic applicability of ECP to solid tumors in addition to CTCL.Significance: These findings identify principal cellular contributors to the anticancer immunotherapeutic impact of ECP and suggest this treatment may be applicable to a broad spectrum of immunogenic malignancies. Cancer Res; 78(14); 4045-58. ©2018 AACR.
Collapse
Affiliation(s)
- Alessandra Ventura
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
- Dermatology Department, University of Rome Tor Vergata, Rome, Italy
| | - Aaron Vassall
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Eve Robinson
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Renata Filler
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Douglas Hanlon
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Katrina Meeth
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Harib Ezaldein
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Michael Girardi
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
- Comprehensive Cancer Center, Yale University School of Medicine, New Haven, Connecticut
| | - Olga Sobolev
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Marcus W Bosenberg
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
- Comprehensive Cancer Center, Yale University School of Medicine, New Haven, Connecticut
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Richard L Edelson
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.
- Comprehensive Cancer Center, Yale University School of Medicine, New Haven, Connecticut
| |
Collapse
|
113
|
Raval JS, Ratcliffe NR. Extracorporeal photopheresis and personalized medicine in the 21st century: The future's so bright! J Clin Apher 2018; 33:461-463. [PMID: 29736969 DOI: 10.1002/jca.21633] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 02/01/2023]
Affiliation(s)
- Jay S Raval
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Nora R Ratcliffe
- Department of Pathology and Laboratory Medicine, Department of Veterans Affairs, White River Junction, Vermont.,Transfusion Medicine, Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| |
Collapse
|
114
|
Wei YX, Sun B, Xiao L, Shi BY. Infusion of Lymphocytes Treated With 8-Methoxypsoralen and Ultraviolet A Light Induces CD19 +IL-10 + Regulatory B Cells and Promotes Skin Allograft Survival. Transplant Proc 2018; 50:3906-3910. [PMID: 30577285 DOI: 10.1016/j.transproceed.2018.04.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 04/27/2018] [Indexed: 12/27/2022]
Abstract
Extracorporeal photopheresis (ECP) represents an alternative to immunosuppression as a means of reducing rejection after thoracic organ transplantation. The mechanism by which ECP exerts its protective effects, until now, has remained elusive. Infusion of ECP-treated splenic lymphocytes (PUVA-SP) can induce CD4+CD25highFoxp3+ regulatory T cells. However, the regulatory effect of PUVA-SP on B cells remains poorly understood. In the present study, we measured IL-10 secretion from CD19+ B cells of peripheral blood mononuclear cells. Our results demonstrate that infusion of PUVA-SP (PUVA-BSP from BALB/c or PUVA-CSP from C57BL/6 mice), in the absence of an immunosuppressant, significantly promotes skin allograft survival. This effect was associated with upregulation of circulating regulatory B cells exhibiting preferential IL-10 secretion and a shift of cytokine profile from helper T cell type 1 to helper T cell type 2. Our results suggest that effective treatments involving infusion of PUVA-SP is likely related not only to the modulation of T cell and regulatory T cell functions but also to the function of B cell and regulatory B cells.
Collapse
Affiliation(s)
- Y X Wei
- Organ Transplantation Institute, Beijing Key Laboratory of Organ Transplantation and Immune Regulation, 309th Hospital of the Chinese People's Liberation Army, Beijing, China
| | - B Sun
- Organ Transplantation Institute, Beijing Key Laboratory of Organ Transplantation and Immune Regulation, 309th Hospital of the Chinese People's Liberation Army, Beijing, China
| | - L Xiao
- Organ Transplantation Institute, Beijing Key Laboratory of Organ Transplantation and Immune Regulation, 309th Hospital of the Chinese People's Liberation Army, Beijing, China
| | - B Y Shi
- Organ Transplantation Institute, Beijing Key Laboratory of Organ Transplantation and Immune Regulation, 309th Hospital of the Chinese People's Liberation Army, Beijing, China.
| |
Collapse
|
115
|
Niittyvuopio R, Juvonen E, Heiskanen J, Lindström V, Nihtinen A, Sahlstedt L, Volin L. Extracorporeal photopheresis in the treatment of acute graft-versus-host disease: a single-center experience. Transfusion 2018; 58:1973-1979. [DOI: 10.1111/trf.14649] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 03/05/2018] [Accepted: 03/09/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Riitta Niittyvuopio
- Department of Hematology; Comprehensive Cancer Center, Helsinki University Hospital; Helsinki Finland
| | - Eeva Juvonen
- Department of Hematology; Comprehensive Cancer Center, Helsinki University Hospital; Helsinki Finland
| | - Jouni Heiskanen
- Department of Hematology; Comprehensive Cancer Center, Helsinki University Hospital; Helsinki Finland
| | - Vesa Lindström
- Department of Hematology; Comprehensive Cancer Center, Helsinki University Hospital; Helsinki Finland
| | - Anne Nihtinen
- Department of Hematology; Comprehensive Cancer Center, Helsinki University Hospital; Helsinki Finland
| | - Leila Sahlstedt
- Department of Hematology; Comprehensive Cancer Center, Helsinki University Hospital; Helsinki Finland
| | - Liisa Volin
- Department of Hematology; Comprehensive Cancer Center, Helsinki University Hospital; Helsinki Finland
| |
Collapse
|
116
|
Dall'Amico R, Zulian F, Montini G, Andretta B, Murer L, Rossetti F, Livi U, Zacchello G, Zacchello F. Applications of Extracorporeal Photochemotherapy in “Non-oncological” Diseases. Int J Artif Organs 2018. [DOI: 10.1177/039139889301605s36] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Photopheresis (ECP) is a new therapy for oncological and autoimmune diseases consisting in the reinfusion of 3-9x 109 leukocytes, taken from the patient by leukapheresis, and treated in an extracorporeal system with 8-methoxypsoralen and ultraviolet light A. Nine patients affected by T cell immunomediated diseases (2 scleroderma, 1 chronic GVHD, 1 polyarteritis, 1 rheumatoid arthritis and 4 heart transplant patients with numerous episodes of acute rejection) were treated with ECP. Photopheresis was performed on 2 consecutive days every 3-4 weeks. All patients affected by autoimmune diseases experienced an improvement during treatment with ECP. In 2 of the 4 patients with heart transplant, rejection was reversed by photopheresis. No major side effects were observed during the treatment. In conclusion ECP is a safe and well tolerated therapy. Although the number of patients is small, ECP seems to be an effective modality in many diseases.
Collapse
Affiliation(s)
- R. Dall'Amico
- Department of Pediatrics, University of Padova, Padova - Italy
| | - F. Zulian
- Department of Pediatrics, University of Padova, Padova - Italy
| | - G. Montini
- Department of Pediatrics, University of Padova, Padova - Italy
| | - B. Andretta
- Department of Pediatrics, University of Padova, Padova - Italy
| | - L. Murer
- Department of Cardiosurgery, University of Padova, Padova - Italy
| | - F. Rossetti
- Department of Pediatrics, University of Padova, Padova - Italy
| | - U. Livi
- Department of Cardiosurgery, University of Padova, Padova - Italy
| | - G. Zacchello
- Department of Pediatrics, University of Padova, Padova - Italy
| | - F. Zacchello
- Department of Pediatrics, University of Padova, Padova - Italy
| |
Collapse
|
117
|
Abstract
PURPOSE OF REVIEW Cutaneous T-cell lymphoma (CTCL) is a rare form of non-Hodgkin lymphoma. Globally, the most common subtypes of CTCL are mycosis fungoides and Sézary syndrome. CTCL can confer significant morbidity and even mortality in advanced disease. Here we review the current and potential future treatments for advanced-stage CTCL. RECENT FINDINGS Heterogeneity of treatment choice has been demonstrated both in US and non-US centers. Systemic treatment choice is currently guided by prognostic features, incorporating stage, immunophenotypic and molecular findings, and patient-specific factors such as age and comorbidities. Randomized controlled studies are uncommon, and the literature is composed predominantly of retrospective, cohort, and early-phase studies. International consensus guidelines are available; however, the lack of comparative trials means that there is no clear algorithmic approach to treatment. This review article reports on the systemic treatment options in current use for advanced CTCL, and on the possible future therapies, acknowledging that an algorithmic approach is not yet forthcoming to guide treatment prioritization.
Collapse
|
118
|
Affiliation(s)
- I. Sniecinski
- Department of Transfusion Medicine City of Hope National Medical Center, Duarte CA- USA
| |
Collapse
|
119
|
Crovetti G, Carabelli A, Berti E, Guizzardi M, Fossati S, De Filippo C, Bertani E. Photopheresis in Cutaneous T-Cell Lymphoma: Five-Year Experience. Int J Artif Organs 2018. [DOI: 10.1177/039139880002300109] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- G. Crovetti
- Photopheresis Department, St. A. Abate Hospital, Gallarate
| | - A. Carabelli
- Photopheresis Department, St. A. Abate Hospital, Gallarate
| | - E. Berti
- Institute of Dermatological Science, IRCCS Maggiore Policlinico Hospital, University of Milano - Italy
| | - M. Guizzardi
- Institute of Dermatological Science, IRCCS Maggiore Policlinico Hospital, University of Milano - Italy
| | - S. Fossati
- Institute of Dermatological Science, IRCCS Maggiore Policlinico Hospital, University of Milano - Italy
| | - C. De Filippo
- Photopheresis Department, St. A. Abate Hospital, Gallarate
| | - E. Bertani
- Photopheresis Department, St. A. Abate Hospital, Gallarate
| |
Collapse
|
120
|
Dall'Amico R, Montini G, Murer L, Andreetta B, Zacchello G, Gambino A, Feltrin G, Caforio A, Tursi V, Livi U. Extracorporeal Photochemotherapy after Cardiac Transplantation: A New Therapeutic Approach to Allograft Rejection. Int J Artif Organs 2018. [DOI: 10.1177/039139880002300108] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Photopheresis (ECP) is a new immunomodulatory therapy in which recipient lymphocytes are treated extracorporeally with 8-methoxypsoralen and ultraviolet light. The treatment seems to induce an inhibition of both humoral and cellular rejection after transplantation. Objective Since recurrent rejection (RR) continues to be a severe complication after heart transplantation (HTx) and the immunosuppressive regimes used for the treatment are often associated with increased morbidity and mortality, we investigated whether ECP could have a beneficial effect on the number and severity of rejection episodes. Methods Eleven HTX recipients (5 M and 6 F, mean age 48.5 yrs) with RR were enrolled in the study. ECP was performed at weekly intervals during the 1st month, at 2 week intervals during the 2nd and 3rd month, and then monthly for another 3 months. Results The fraction of biopsies (EMB) with a grade 0/1A rejection increased during ECP from 46% to 72% while the EMB showing a 3A/3B rejection decreased from 42% to 18%. It is also noteworthy that out of the 78 EMB performed during ECP only one showed a 3B rejection in comparison with 13 out of 110 EMB in the pre-ECP period. Six rejection relapses were observed in a total follow-up of 60 months, two of them occurring during the tapering of oral steroid. Four relapses were reversed by ECP, one by IV steroids and the last by methotrexate after the failure of both IV steroids and ECP. The mean doses of immunosuppressive drugs resulted lower after 6 months of ECP: steroids were reduced from 13 to 8.25 mg/day, cyclosporine from 375 to 285 mg/day, azathioprine from 55 to 35 mg/day. Conclusions ECP is a well tolerated treatment. Its administration allows better RR control and significant reduction in immunosuppressive therapy. (Int J Artif Organs 2000; 23: 49–54)
Collapse
Affiliation(s)
| | | | | | | | | | - A. Gambino
- Institute of Cardiovascular Surgery, University of Padova, Padova - Italy
| | - G. Feltrin
- Institute of Cardiovascular Surgery, University of Padova, Padova - Italy
| | - A. Caforio
- Institute of Cardiovascular Surgery, University of Padova, Padova - Italy
| | - V. Tursi
- Institute of Cardiovascular Surgery, University of Padova, Padova - Italy
| | - U. Livi
- Institute of Cardiovascular Surgery, University of Padova, Padova - Italy
| |
Collapse
|
121
|
Holien T, Gederaas OA, Darvekar SR, Christensen E, Peng Q. Comparison between 8‐methoxypsoralen and 5‐aminolevulinic acid in killing T cells of photopheresis patients
ex vivo. Lasers Surg Med 2018; 50:469-475. [DOI: 10.1002/lsm.22806] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2018] [Indexed: 01/20/2023]
Affiliation(s)
- Toril Holien
- Department of Clinical and Molecular MedicineNTNU‐Norwegian University of Science and TechnologyN‐7491TrondheimNorway
- Department of HematologySt. Olav's University Hospital HFTrondheimN‐7491Norway
| | - Odrun Arna Gederaas
- Department of Clinical and Molecular MedicineNTNU‐Norwegian University of Science and TechnologyN‐7491TrondheimNorway
- Department of ChemistryNTNU‐Norwegian University of Science and TechnologyTrondheimN‐7489Norway
| | - Sagar Ramesh Darvekar
- Department of PathologyThe Norwegian Radium HospitalOslo University HospitalOsloN‐0379Norway
| | - Eidi Christensen
- Department of Clinical and Molecular MedicineNTNU‐Norwegian University of Science and TechnologyN‐7491TrondheimNorway
- Department of PathologyThe Norwegian Radium HospitalOslo University HospitalOsloN‐0379Norway
- Department of DermatologySt. Olav's University Hospital HFTrondheimN‐7491Norway
| | - Qian Peng
- Department of PathologyThe Norwegian Radium HospitalOslo University HospitalOsloN‐0379Norway
- Department of Optical Science and EngineeringSchool of Information Science and TechnologyFudan UniversityShanghaiChina
| |
Collapse
|
122
|
Motolese E, Rubegni P, Poggiali S, Motolese P, Marotta G, Russo L, D'ascenzo G, Carcagnì M, Fruschelli M, Motolese I, Fimiani M. Ocular Manifestations of Chronic Graft-Versus-Host Disease in Patients Treated with Extracorporeal Photochemotherapy. Eur J Ophthalmol 2018; 17:961-9. [DOI: 10.1177/112067210701700615] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose Eye involvement has long been appreciated in patients with chronic graft versus host disease (cGVHD). In particular, ocular complications are frequent and can be potentially severe in patients with steroid-refractory cGVHD, and therefore necessitate close monitoring. This prospective study was designed to describe eye manifestations of cGVHD in a large series of patients monitoring them before and after 1 year of extracorporeal photochemotherapy (ECP). ECP is a relatively new therapeutic approach based on the biological effects of psoralen 8-methoxypsoralen (8-MOP) and ultraviolet A light (UVA) on mononuclear cells collected by apheresis, and reinfused into the patient. Methods Only patients with steroid-refractory cGVHD under treatment with ECP, who developed cGVHD-related eye symptoms, were selected for the study. Ophthalmologic examination was repeated every 3 months. Only patients with complete recovery of the ocular manifestations and symptoms were considered responsive. Results In our study we observed eye alterations in 24 out of 140 patients (17%) with cGVHD. After 12 months of ECP, 10 out of 21 patients (48%) completely responded to the therapy. In all these cases the contribution of ECP was also essential in all the other organs subject to cGVHD. Conclusions Further studies are necessary to clarify the role of ECP in patients with cGVHD, especially in associated eye manifestations. Although our experience is limited, it suggests that ECP could be a safe and effective therapy for steroid-refractory eye manifestations of cGVHD.
Collapse
Affiliation(s)
- E. Motolese
- Department of Ophthalmology and Neurosurgery
| | - P. Rubegni
- Department of Clinical Medicine and Immunological Sciences, Section of Dermatology
| | - S. Poggiali
- Department of Clinical Medicine and Immunological Sciences, Section of Dermatology
| | | | - G. Marotta
- Department of Clinical Medicine and Immunological Sciences, Section of Hematology, University of Siena - Italy
| | - L. Russo
- Department of Ophthalmology and Neurosurgery
| | - G. D'ascenzo
- Department of Clinical Medicine and Immunological Sciences, Section of Dermatology
| | - M.R. Carcagnì
- Department of Clinical Medicine and Immunological Sciences, Section of Dermatology
| | | | - I. Motolese
- Department of Ophthalmology and Neurosurgery
| | - M. Fimiani
- Department of Clinical Medicine and Immunological Sciences, Section of Dermatology
| |
Collapse
|
123
|
Sanyal S, Child F, Alfred A, Callaghan T, Alband N, Whittaker S, Cowan R, Parry E, Robinson S, Dunnill M, Wain M, Morris S, Malladi R, Tahir S, Howles A, Arumainathan A, Azurdia R, Grant-Casey J, Matin RN, Gilson D, Howell C, El-Gheriani K, Taylor P, Scarisbrick J. U.K. national audit of extracorporeal photopheresis in cutaneous T-cell lymphoma. Br J Dermatol 2018; 178:569-570. [DOI: 10.1111/bjd.15871] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- S. Sanyal
- Department of Dermatology; University Hospital Birmingham; Birmingham U.K
| | - F. Child
- Guy's and St Thomas’ NHS Trust; London U.K
| | - A. Alfred
- Rotherham Foundation NHS Trust; Rotherham U.K
| | - T. Callaghan
- Therapeutics and Tissue Services; NHS Blood and Transplant; Sheffield U.K
| | - N. Alband
- Guy's and St Thomas’ NHS Trust; London U.K
| | | | - R. Cowan
- Christie NHS Foundation Trust; Manchester U.K
| | - E. Parry
- Christie NHS Foundation Trust; Manchester U.K
| | - S. Robinson
- University Hospitals Bristol NHS Foundation Trust; Bristol U.K
| | - M.G.S. Dunnill
- University Hospitals Bristol NHS Foundation Trust; Bristol U.K
| | - M. Wain
- Guy's and St Thomas’ NHS Trust; London U.K
| | - S. Morris
- Guy's and St Thomas’ NHS Trust; London U.K
| | - R. Malladi
- Department of Dermatology; University Hospital Birmingham; Birmingham U.K
| | - S. Tahir
- University of Birmingham Medical School; Birmingham U.K
| | - A. Howles
- Department of Dermatology; University Hospital Birmingham; Birmingham U.K
| | - A. Arumainathan
- Royal Liverpool and Broadgreen University Hospitals NHS Trust; Liverpool U.K
| | - R. Azurdia
- Royal Liverpool and Broadgreen University Hospitals NHS Trust; Liverpool U.K
| | - J. Grant-Casey
- Therapeutics and Tissue Services - NHS Blood and Transplant; Sheffield U.K
| | | | - D. Gilson
- St James Institute of Oncology; Leeds U.K
| | - C. Howell
- Diagnostic and Therapeutic Services - NHS Blood and Transplant; Bristol U.K
| | - K. El-Gheriani
- Therapeutics and Tissue Services - NHS Blood and Transplant; Sheffield U.K
| | - P. Taylor
- Rotherham Foundation NHS Trust; Rotherham U.K
| | - J. Scarisbrick
- Department of Dermatology; University Hospital Birmingham; Birmingham U.K
| |
Collapse
|
124
|
Geskin L, Malone DC. An exploratory cost-effectiveness analysis of systemic treatments for cutaneous T-cell lymphoma. J DERMATOL TREAT 2017; 29:522-530. [DOI: 10.1080/09546634.2017.1412064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Larisa Geskin
- Department of Dermatology, Columbia University Medical Center, New York, NY, USA
| | | |
Collapse
|
125
|
Arrue L, Ratjen L. Internal Targeting and External Control: Phototriggered Targeting in Nanomedicine. ChemMedChem 2017; 12:1908-1916. [DOI: 10.1002/cmdc.201700621] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 10/24/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Lily Arrue
- Facultad de Ciencias Biológicas, Center for Bioinformatics and Integrative Biology (CBIB); Universidad Andres Bello; Av. Republica 239 Santiago Chile
| | - Lars Ratjen
- Facultad de Ciencias Biológicas, Center for Bioinformatics and Integrative Biology (CBIB); Universidad Andres Bello; Av. Republica 239 Santiago Chile
- Fundación Fraunhofer Chile Research; Mariano Sánchez Fontecilla 310, Piso 14, Las Condes Santiago Chile
| |
Collapse
|
126
|
Atilla E, Atilla P, Bozdag S, Yuksel M, Toprak S, Topcuoglu P, Akay B, Sanli H, Akan H, Demirer T, Beksac M, Arslan O, Ozcan M, Gurman G, Ilhan O. Extracorporeal photochemotherapy in mycosis fungoides. Transfus Clin Biol 2017; 24:454-457. [DOI: 10.1016/j.tracli.2017.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/02/2017] [Indexed: 01/27/2023]
|
127
|
Quaglino P, Maule M, Prince HM, Porcu P, Horwitz S, Duvic M, Talpur R, Vermeer M, Bagot M, Guitart J, Papadavid E, Sanches JA, Hodak E, Sugaya M, Berti E, Ortiz-Romero P, Pimpinelli N, Servitje O, Pileri A, Zinzani PL, Estrach T, Knobler R, Stadler R, Fierro MT, Alberti Violetti S, Amitay-Laish I, Antoniou C, Astrua C, Chaganti S, Child F, Combalia A, Fabbro S, Fava P, Grandi V, Jonak C, Martinez-Escala E, Kheterpal M, Kim EJ, McCormack C, Miyagaki T, Miyashiro D, Morris S, Muniesa C, Nikolaou V, Ognibene G, Onida F, Osella-Abate S, Porkert S, Postigo-Llorente C, Ram-Wolff C, Ribero S, Rogers K, Sanlorenzo M, Stranzenbach R, Spaccarelli N, Stevens A, Zugna D, Rook AH, Geskin LJ, Willemze R, Whittaker S, Hoppe R, Scarisbrick J, Kim Y. Global patterns of care in advanced stage mycosis fungoides/Sezary syndrome: a multicenter retrospective follow-up study from the Cutaneous Lymphoma International Consortium. Ann Oncol 2017; 28:2517-2525. [PMID: 28961843 DOI: 10.1093/annonc/mdx352] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Advanced-stage mycosis fungoides (MF)/Sézary syndrome (SS) patients are weighted by an unfavorable prognosis and share an unmet clinical need of effective treatments. International guidelines are available detailing treatment options for the different stages but without recommending treatments in any particular order due to lack of comparative trials. The aims of this second CLIC study were to retrospectively analyze the pattern of care worldwide for advanced-stage MF/SS patients, the distribution of treatments according to geographical areas (USA versus non-USA), and whether the heterogeneity of approaches has potential impact on survival. PATIENTS AND METHODS This study included 853 patients from 21 specialist centers (14 European, 4 USA, 1 each Australian, Brazilian, and Japanese). RESULTS Heterogeneity of treatment approaches was found, with up to 24 different modalities or combinations used as first-line and 36% of patients receiving four or more treatments. Stage IIB disease was most frequently treated by total-skin-electron-beam radiotherapy, bexarotene and gemcitabine; erythrodermic and SS patients by extracorporeal photochemotherapy, and stage IVA2 by polychemotherapy. Significant differences were found between USA and non-USA centers, with bexarotene, photopheresis and histone deacetylase inhibitors most frequently prescribed for first-line treatment in USA while phototherapy, interferon, chlorambucil and gemcitabine in non-USA centers. These differences did not significantly impact on survival. However, when considering death and therapy change as competing risk events and the impact of first treatment line on both events, both monochemotherapy (SHR = 2.07) and polychemotherapy (SHR = 1.69) showed elevated relative risks. CONCLUSION This large multicenter retrospective study shows that there exist a large treatment heterogeneity in advanced MF/SS and differences between USA and non-USA centers but these were not related to survival, while our data reveal that chemotherapy as first treatment is associated with a higher risk of death and/or change of therapy and thus other therapeutic options should be preferable as first treatment approach.
Collapse
Affiliation(s)
- P Quaglino
- Dermatologic Clinic, Department of Medical Sciences;.
| | - M Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Torino, Torino, Italy
| | - H M Prince
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne;; University of Melbourne, Melbourne, Australia
| | - P Porcu
- Division of Hematologic Malignancies, Ohio State University
| | - S Horwitz
- Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York
| | - M Duvic
- Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA
| | - R Talpur
- Department of Dermatology and Pathology, MD Anderson Cancer Centre, Houston, USA
| | - M Vermeer
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - M Bagot
- Dermatology Department, Hospital St Louis, Paris, France
| | - J Guitart
- Department of Dermatology and Pathology, Northwestern University, Chicago, USA
| | - E Papadavid
- 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece
| | - J A Sanches
- Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - E Hodak
- Beilinson Hospital, Petach Tikva;; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Sugaya
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - E Berti
- Dermatologic Clinic, University of Milano, Milano, Italy
| | - P Ortiz-Romero
- Department of Dermatology, Hospital 12 de Octubre, Madrid, Spain
| | - N Pimpinelli
- Dermatologic Clinic, University of Florence, Florence, Italy
| | - O Servitje
- Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - A Pileri
- Dermatologic Clinic, University of Bologna, Bologna
| | - P L Zinzani
- Seragnoli Institute of Haematology, Bologna, Italy
| | - T Estrach
- Department of Dermatology, Hospital Clinico, University of Barcelona, Barcelona, Spain
| | - R Knobler
- Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria
| | - R Stadler
- University Clinic for Dermatology, Venereology, Allergology and Phlebology, Minden, Germany
| | - M T Fierro
- Dermatologic Clinic, Department of Medical Sciences
| | | | - I Amitay-Laish
- Beilinson Hospital, Petach Tikva;; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - C Antoniou
- 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece
| | - C Astrua
- Dermatologic Clinic, Department of Medical Sciences
| | - S Chaganti
- Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham
| | - F Child
- Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK
| | - A Combalia
- Department of Dermatology, Hospital Clinico, University of Barcelona, Barcelona, Spain
| | - S Fabbro
- Division of Hematologic Malignancies, Ohio State University
| | - P Fava
- Dermatologic Clinic, Department of Medical Sciences
| | - V Grandi
- Dermatologic Clinic, University of Florence, Florence, Italy
| | - C Jonak
- Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria
| | - E Martinez-Escala
- Department of Dermatology and Pathology, Northwestern University, Chicago, USA
| | - M Kheterpal
- Department of Medicine, Memorial Sloan-Kettering Cancer Centre, New York
| | - E J Kim
- Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia
| | - C McCormack
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne;; University of Melbourne, Melbourne, Australia
| | - T Miyagaki
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - D Miyashiro
- Department of Dermatology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - S Morris
- Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK
| | - C Muniesa
- Department of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - V Nikolaou
- 2nd Department of Dermatology and Venereology, Attikon General Hospital, University of Athens, Chaidari, Greece
| | - G Ognibene
- Comprehensive Skin Cancer Center, Columbia University Medical Center
| | - F Onida
- Dermatologic Clinic, University of Milano, Milano, Italy
| | | | - S Porkert
- Dermatologic Clinic, University of Vienna Medical School, Vienna, Austria
| | | | - C Ram-Wolff
- Dermatology Department, Hospital St Louis, Paris, France
| | - S Ribero
- Dermatologic Clinic, Department of Medical Sciences
| | - K Rogers
- Comprehensive Skin Cancer Center, Columbia University Medical Center
| | - M Sanlorenzo
- Dermatologic Clinic, Department of Medical Sciences
| | - R Stranzenbach
- University Clinic for Dermatology, Venereology, Allergology and Phlebology, Minden, Germany
| | - N Spaccarelli
- Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia
| | - A Stevens
- Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham
| | - D Zugna
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Torino, Torino, Italy
| | - A H Rook
- Department of Dermatology and Pathology, University of Pennsylvania, Philadelphia
| | - L J Geskin
- Comprehensive Skin Cancer Center, Columbia University Medical Center
| | - R Willemze
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - S Whittaker
- Kings College London, Guys and St Thomas NHS Foundation Trust, London, UK
| | - R Hoppe
- Department of Dermatology, Stanford University Medical Centre, USA
| | - J Scarisbrick
- Cutaneous Lymphoma Service, University Hospital Birmingham, Birmingham
| | - Y Kim
- Department of Dermatology, Stanford University Medical Centre, USA
| |
Collapse
|
128
|
Wilcox RA. Cutaneous T-cell lymphoma: 2017 update on diagnosis, risk-stratification, and management. Am J Hematol 2017; 92:1085-1102. [PMID: 28872191 DOI: 10.1002/ajh.24876] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 07/27/2017] [Indexed: 12/12/2022]
Abstract
DISEASE OVERVIEW Cutaneous T-cell lymphomas are a heterogenous group of T-cell lymphoproliferative disorders involving the skin, the majority of which may be classified as Mycosis Fungoides (MF) or Sézary Syndrome (SS). DIAGNOSIS The diagnosis of MF or SS requires the integration of clinical and histopathologic data. RISK-ADAPTED THERAPY TNMB (tumor, node, metastasis, blood) staging remains the most important prognostic factor in MF/SS and forms the basis for a "risk-adapted," multi-disciplinary approach to treatment. For patients with disease limited to the skin, expectant management or skin-directed therapies is preferred, as both disease-specific and overall survival for these patients is favorable. In contrast, patients with advanced-stage disease with significant nodal, visceral or blood involvement are generally approached with biologic-response modifiers or histone deacetylase inhibitors prior to escalating therapy to include systemic, single-agent chemotherapy. In highly-selected patients, allogeneic stem-cell transplantation may be considered, as this may be curative in some patients.
Collapse
Affiliation(s)
- Ryan A. Wilcox
- Division of Hematology/Oncology; University of Michigan Comprehensive Cancer Center; Ann Arbor Michigan 48109-5948
| |
Collapse
|
129
|
Keehn CA, Belongie IP, Shistik G, Fenske NA, Glass LF. The Diagnosis, Staging, and Treatment Options for Mycosis Fungoides. Cancer Control 2017; 14:102-11. [PMID: 17387295 DOI: 10.1177/107327480701400203] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background Cutaneous T-cell lymphoma (CTCL) represents a spectrum of diseases composed of malignant T lymphocytes. The most common type is mycosis fungoides (MF). An accurate diagnosis of early MF may be difficult because of the varied clinical and histologic expressions of the disease. Methods The authors review the epidemiology, possible risk factors, clinical manifestations, diagnostic techniques, staging, prognosis, and treatment options for MF. Results The varied and often nonspecific clinical and bistologic presentations of MF may delay diagnosis and staging, thus necessitating further studies such as immunophenotyping and T-cell receptor gene rearrangement analysis. Conclusions A multidisciplinary approach to the diagnosis, staging, and treatment of MF assists in optimizing outcomes from management of patients with this disease.
Collapse
Affiliation(s)
- Connie A Keehn
- Cutaneous Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | | | | | | | | |
Collapse
|
130
|
Duvic M, Bates SE, Piekarz R, Eisch R, Kim YH, Lerner A, Robak T, Samtsov A, Becker JC, McCulloch W, Waksman J, Whittaker S. Responses to romidepsin in patients with cutaneous T-cell lymphoma and prior treatment with systemic chemotherapy. Leuk Lymphoma 2017; 59:880-887. [PMID: 28853310 DOI: 10.1080/10428194.2017.1361022] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Cutaneous T-cell lymphomas (CTCL) are a group of non-Hodgkin lymphomas that typically present in the skin but can progress to systemic involvement. The optimal treatment for patients who relapse from or are refractory to systemic chemotherapy remains unclear. Romidepsin is a potent, class-I selective histone deacetylase inhibitor approved for the treatment of patients with CTCL who have had ≥1 prior systemic therapy. Here, we present a subanalysis of two phase-2 trials (NCT00106431, NCT00007345) of romidepsin in patients with CTCL who had prior treatment with systemic chemotherapy. Patients with prior chemotherapy were able to achieve durable responses to romidepsin, and response rates were similar to those in patients who were chemotherapy naïve. Overall, no new safety signals emerged in patients who had received prior chemotherapy. The data presented here suggest that romidepsin is safe and effective in patients with CTCL who received prior systemic chemotherapy.
Collapse
Affiliation(s)
- Madeleine Duvic
- a The University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Susan E Bates
- b Department of Hematology/Oncology , Columbia University , New York , NY , USA
| | - Richard Piekarz
- c Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis , National Cancer Institute , Bethesda , MD , USA
| | - Robin Eisch
- d National Cancer Institute , Bethesda , MD , USA
| | - Youn H Kim
- e Department of Dermatology , Stanford University , Stanford , CA , USA
| | | | - Tadeusz Robak
- g Department of Hematology , Medical University of Lodz, Copernicus Memorial Hospital , Lodz , Poland
| | - Alexey Samtsov
- h State Educational Institution of Military Medicine , St. Petersburg , Russia
| | - Jürgen C Becker
- i Translational Skin Cancer Research, German Cancer Consortium (DKTK) , University Clinic Essen , Germany
| | | | - Joel Waksman
- k Brightech International LLC , Somerset , NJ , USA
| | | |
Collapse
|
131
|
Mazzoni A, Giampietro C, Bianco I, Grazzini T, Nencini C, Pileggi C, Scatena F, Filipponi F, Ghinolfi D, Catalano G, Biancofiore G, Bindi M, Urbani L. Extracorporeal photopheresis and liver transplantation: Our experience and preliminary data. Transfus Apher Sci 2017; 56:515-519. [DOI: 10.1016/j.transci.2017.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
132
|
Savignano C, Rinaldi C, Tursi V, Dolfini C, Isola M, Livi U, De Angelis V. Extracorporeal photochemotherapy in heart transplant rejection: A single-center experience. Transfus Apher Sci 2017; 56:520-524. [DOI: 10.1016/j.transci.2017.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
133
|
Sirolimus Increases T-Cell Abundance in the Sun Exposed Skin of Kidney Transplant Recipients. Transplant Direct 2017; 3:e171. [PMID: 28706974 PMCID: PMC5498012 DOI: 10.1097/txd.0000000000000694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 04/26/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Kidney transplant recipients (KTRs) receiving the mammalian target of rapamycin inhibitor sirolimus may display a reduced risk of skin cancer development compared to KTRs receiving calcineurin inhibitors. Despite studies investigating the effects of these 2 drug classes on T cells in patient blood, the effect these drugs may have in patient skin is not yet known. METHODS Fifteen patients with chronic kidney disease (not recipients of immunosuppressive drugs), and 30 KTRs (15 receiving a calcineurin inhibitor, and 15 receiving sirolimus) provided matched samples of blood, sun exposed (SE) and non-SE skin. The abundance of total CD8+ and CD4+ T cells, memory CD8+ and CD4+ T cells, and regulatory T (Treg) cells in each sample was then assessed by flow cytometry. RESULTS Sirolimus treatment significantly increased absolute numbers of CD4+ T cells, memory CD8+- and CD4+ T cells, and Treg cells in SE skin versus paired samples of non-SE skin. No differences were found in the absolute number of any T cell subset in the blood. Correlation analysis revealed that the percentage of T cell subsets in the blood does not always accurately reflect the percentage of T-cell subsets in the skin of KTRs. Furthermore, sirolimus significantly disrupts the balance of memory CD4+ T cells in the skin after chronic sun exposure. CONCLUSIONS This study demonstrated that immunosuppressive drug class and sun exposure modify the abundance of multiple T-cell subsets in the skin of KTRs. Correlation analysis revealed that the prevalence of Treg cells in KTR blood does not accurately reflect the prevalence of Treg cells in KTR skin.
Collapse
|
134
|
Gillingham D, Geigle S, Anatole von Lilienfeld O. Properties and reactivity of nucleic acids relevant to epigenomics, transcriptomics, and therapeutics. Chem Soc Rev 2017; 45:2637-55. [PMID: 26992131 DOI: 10.1039/c5cs00271k] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Developments in epigenomics, toxicology, and therapeutic nucleic acids all rely on a precise understanding of nucleic acid properties and chemical reactivity. In this review we discuss the properties and chemical reactivity of each nucleobase and attempt to provide some general principles for nucleic acid targeting or engineering. For adenine-thymine and guanine-cytosine base pairs, we review recent quantum chemical estimates of their Watson-Crick interaction energy, π-π stacking energies, as well as the nuclear quantum effects on tautomerism. Reactions that target nucleobases have been crucial in the development of new sequencing technologies and we believe further developments in nucleic acid chemistry will be required to deconstruct the enormously complex transcriptome.
Collapse
Affiliation(s)
- Dennis Gillingham
- Department of Chemistry, University of Basel, St. Johanns-Ring 19, Basel, CH-4056, Switzerland.
| | - Stefanie Geigle
- Department of Chemistry, University of Basel, St. Johanns-Ring 19, Basel, CH-4056, Switzerland.
| | | |
Collapse
|
135
|
Adamson J, Mein S, Meng B, Gunasingha R, Yoon SW, Miles D, Walder H, Fathi Z, Beyer W, Spector N, Gieger TL, Nolan MW, Oldham M. Utilizing a diagnostic kV imaging system for x-ray psoralen activated cancer therapy (X-PACT). Biomed Phys Eng Express 2017. [DOI: 10.1088/2057-1976/aa6e58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
136
|
|
137
|
European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome – Update 2017. Eur J Cancer 2017; 77:57-74. [DOI: 10.1016/j.ejca.2017.02.027] [Citation(s) in RCA: 202] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 02/19/2017] [Accepted: 02/24/2017] [Indexed: 01/03/2023]
|
138
|
Novel Application of Extracorporeal Photopheresis as Treatment of Graft-versus-Host Disease Following Liver Transplantation. ACG Case Rep J 2017; 4:e48. [PMID: 28377936 PMCID: PMC5371721 DOI: 10.14309/crj.2017.48] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 02/17/2017] [Indexed: 12/14/2022] Open
Abstract
A 48-year-old man with hepatitis C virus (HCV) cirrhosis complicated by hepatocellular carcinoma underwent liver transplantation. His course was complicated by fever, diarrhea, abdominal pain, and pancytopenia. He developed a diffuse erythematous rash, which progressed to erythroderma. Biopsies of the colon and skin were consistent with acute graft-versus-host disease. Donor-derived lymphocytes were present in the peripheral blood. The patient was treated with corticosteroids and cyclosporine; however, he had minimal response to intensive immunosuppressive therapy. Extracorporeal photopheresis was initiated as a salvage therapy. He had a dramatic response, and his rash, diarrhea, and pancytopenia resolved. He is maintained on minimal immunosuppression 24 months later.
Collapse
|
139
|
Factual reflections and recommendations on extracorporeal photopheresis in pediatrics. Transfus Apher Sci 2017; 56:118-122. [DOI: 10.1016/j.transci.2017.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
140
|
Lewis DJ, Duvic M. Extracorporeal photopheresis for the treatment of early-stage mycosis fungoides. Dermatol Ther 2017; 30. [DOI: 10.1111/dth.12485] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 02/06/2017] [Accepted: 02/13/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel J. Lewis
- School of Medicine; Baylor College of Medicine; One Baylor Plaza Houston Texas
- Department of Dermatology; The University of Texas MD Anderson Cancer Center; 1515 Holcombe Boulevard, Unit 1452, Pickens 411 Houston Texas
| | - Madeleine Duvic
- Department of Dermatology; The University of Texas MD Anderson Cancer Center; 1515 Holcombe Boulevard, Unit 1452, Pickens 411 Houston Texas
| |
Collapse
|
141
|
Liu C, Schindler E, LeRoy M, Martin-Bredahl K, Dino M, Shah K, Dynis M, Eby CS, Grossman BJ. Safety and collection efficiency with a lower transfusion threshold for extracorporeal photopheresis in adult patients with graft-versus-host disease. Vox Sang 2017; 112:379-387. [DOI: 10.1111/vox.12504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 11/02/2016] [Accepted: 01/26/2017] [Indexed: 12/28/2022]
Affiliation(s)
- C. Liu
- Department of Pathology & Immunology; Washington University; Saint Louis MO USA
- Barnes-Jewish Hospital; Saint Louis MO USA
| | - E. Schindler
- Pathology Department; Mercy Hospital; Saint Louis MO USA
| | - M. LeRoy
- Department of Pathology; Louisiana State University Health Sciences Center; New Orleans LA USA
| | - K. Martin-Bredahl
- Department of Pathology & Immunology; Washington University; Saint Louis MO USA
| | - M. Dino
- Department of Pathology & Immunology; Washington University; Saint Louis MO USA
| | - K. Shah
- Barnes-Jewish Hospital; Saint Louis MO USA
| | - M. Dynis
- Barnes-Jewish Hospital; Saint Louis MO USA
| | - C. S. Eby
- Department of Pathology & Immunology; Washington University; Saint Louis MO USA
- Barnes-Jewish Hospital; Saint Louis MO USA
| | - B. J. Grossman
- Department of Pathology & Immunology; Washington University; Saint Louis MO USA
- Barnes-Jewish Hospital; Saint Louis MO USA
| |
Collapse
|
142
|
Alfred A, Taylor PC, Dignan F, El-Ghariani K, Griffin J, Gennery AR, Bonney D, Das-Gupta E, Lawson S, Malladi RK, Douglas KW, Maher T, Guest J, Hartlett L, Fisher AJ, Child F, Scarisbrick JJ. The role of extracorporeal photopheresis in the management of cutaneous T-cell lymphoma, graft-versus-host disease and organ transplant rejection: a consensus statement update from the UK Photopheresis Society. Br J Haematol 2017; 177:287-310. [PMID: 28220931 PMCID: PMC5412836 DOI: 10.1111/bjh.14537] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 11/23/2016] [Indexed: 12/17/2022]
Abstract
Extracorporeal photopheresis (ECP) has been used for over 35 years in the treatment of erythrodermic cutaneous T‐cell lymphoma (CTCL) and over 20 years for chronic and acute graft‐versus‐host disease (GvHD) and solid organ transplant rejection. ECP for CTCL and GvHD is available at specialised centres across the UK. The lack of prospective randomised trials in ECP led to the development of UK Consensus Statements for patient selection, treatment schedules, monitoring protocols and patient assessment criteria for ECP. The recent literature has been reviewed and considered when writing this update. Most notably, the national transition from the UVAR XTS® machine to the new CELLEX machine for ECP with dual access and a shorter treatment time has led to relevant changes in these schedules. This consensus statement updates the previous statement from 2007 on the treatment of CTCL and GvHD with ECP using evidence based medicine and best medical practise and includes guidelines for both children and adults.
Collapse
Affiliation(s)
- Arun Alfred
- Rotherham Foundation NHS Trust, Rotherham, UK
| | | | - Fiona Dignan
- Central Manchester NHS Foundation Trust, Manchester, UK
| | - Khaled El-Ghariani
- Therapeutics and Tissue Services, NHS Blood and Transplant, Sheffield, UK
| | - James Griffin
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Andrew R Gennery
- Institute of Cellular Medicine, Newcastle University and Great North Children's Hospital, Newcastle-Upon-Tyne, UK
| | - Denise Bonney
- Royal Manchester Children's Hospital, Manchester, UK
| | - Emma Das-Gupta
- Centre for Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Ram K Malladi
- University Hospitals Birmingham NHS Trust, Birmingham, UK
| | | | | | - Julie Guest
- Institute of Cellular Medicine, Newcastle University and Great North Children's Hospital, Newcastle-Upon-Tyne, UK
| | | | - Andrew J Fisher
- Institute of Transplantation, Newcastle University and Freeman Hospital, Newcastle-upon-Tyne, UK
| | - Fiona Child
- St John's Institute of Dermatology, Guy's and St Thomas' Hospital, London, UK
| | | |
Collapse
|
143
|
Polish Lymphoma Research Group Experience With Bexarotene in the Treatment of Cutaneous T-Cell Lymphoma. Am J Ther 2017; 23:e749-56. [PMID: 24732904 DOI: 10.1097/mjt.0000000000000056] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Bexarotene, a synthetic retinoid licensed for the treatment of refractory cutaneous T-cell lymphoma (CTCL), has been used clinically in Poland since 2007 in 21 patients. The objective of our retrospective, multicenter study was to evaluate our experience with bexarotene therapy, including efficacy, safety, and survival outcomes. We retrospectively identified 21 adult patients who were treated with bexarotene between the years 2007 and 2012. Starting dose of bexarotene was 300 mg/m per day. The analysis included 3 patients with early-stage mycosis fungoides (MF), 16 patients with advanced-stage MF, and 2 patients with Sézary syndrome (SS). The mean duration of therapy with bexarotene was 14.5 months. Use of bexarotene resulted in an overall response rate of 81.0%, although the overall mortality rate was 52.8%. In our study, early-stage CTCL responded better than advanced-stage CTCL (100.0% vs. 77.8%, respectively). The mean time to observable response was 1.8 months, and the mean duration of the response was 16.4 months. Most significant side effects were hyperlipidemia, hypothyroidism, and a bleeding gastric ulcer. Based on the results of our analysis, bexarotene is a valuable tool in the treatment of refractory early-stage CTCL. Although a majority of patients initially responded to therapy, the high mortality rate in the advanced-stage group suggests that bexarotene does not completely resolve the therapeutic problems in all stages of CTCL. Patient stratification for bexarotene treatment may need a thorough reassessment, in that bexarotene may not be an effective drug in the very advanced stages of CTCL.
Collapse
|
144
|
Hamblin MR. Ultraviolet Irradiation of Blood: "The Cure That Time Forgot"? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 996:295-309. [PMID: 29124710 PMCID: PMC6122858 DOI: 10.1007/978-3-319-56017-5_25] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Ultraviolet blood irradiation (UBI) was extensively used in the 1940s and 1950s to treat many diseases including septicemia, pneumonia, tuberculosis, arthritis, asthma and even poliomyelitis. The early studies were carried out by several physicians in USA and published in the American Journal of Surgery. However with the development of antibiotics, UBI use declined and it has now been called "the cure that time forgot". Later studies were mostly performed by Russian workers and in other Eastern countries and the modern view in Western countries is that UBI remains highly controversial.This chapter discusses the potential of UBI as an alternative approach to current methods used to treat infections, as an immune-modulating therapy and as a method for normalizing blood parameters. No resistance of microorganisms to UV irradiation has been reported, and multi-antibiotic resistant strains are as susceptible as their wild-type counterparts. Low and mild doses of UV kill microorganisms by damaging the DNA, while any DNA damage in host cells can be rapidly repaired by DNA repair enzymes. However the use of UBI to treat septicemia cannot be solely due to UV-mediated killing of bacteria in the blood-stream, as only 5-7% of blood volume needs to be treated with UV to produce the optimum benefit. UBI may enhance the phagocytic capacity of various phagocytic cells (neutrophils and dendritic cells), inhibit lymphocytes, and oxidize blood lipids. The oxidative nature of UBI may have mechanisms in common with ozone therapy and other oxygen therapies. There may be some similarities to extracorporeal photopheresis (ECP) using psoralens and UVA irradiation. However there are differences between UBI and ECP in that UBI tends to stimulate the immune system, while ECP tends to be immunosuppressive. With the recent emergence of bacteria that are resistant to all known antibiotics, UBI should be more investigated as an alternative approach to infections, and as an immune-modulating therapy.
Collapse
Affiliation(s)
- Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA.
- Department of Dermatology, Harvard Medical School, Boston, MA, 02115, USA.
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, 02139, USA.
| |
Collapse
|
145
|
Abstract
Extracorporeal photochemotherapy (ECP) is considered as an immune modulating therapy majorly targeting the T cells of the Immune system. ECP induces an anti-inflammatory condition with tolerogenic responses without inducing a global immunosuppression state which is a typical feature of other therapeutic options such as steroids. Clinical indication of ECP has grown over time since its initial applications. Our review discusses the technical aspects of the concept of photopheresis with the available methods for its clinical applications.
Collapse
Affiliation(s)
- Satyam Arora
- Department of Transfusion Medicine and Hematology, BLK Super Speciality Hospital, New Delhi, India
| | - Rasika Setia
- Department of Transfusion Medicine and Hematology, BLK Super Speciality Hospital, New Delhi, India
| |
Collapse
|
146
|
Vonderheid EC. Photopheresis: Current and Future Perspectives. J Cutan Med Surg 2016. [DOI: 10.1177/12034754030070s401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Eric C. Vonderheid
- Department of Dermatology, Johns Hopkins Medical Institutes, Baltimore, MD, USA
| |
Collapse
|
147
|
Affiliation(s)
- Todd L. Astor
- Division of Pulmonary and Critical Care Sciences, Lung Transplant Program, University of Colorado Health Sciences Center, Denver, Colorado, USA
| | - David Weill
- Division of Pulmonary and Critical Care Sciences, Lung Transplant Program, University of Colorado Health Sciences Center, Denver, Colorado, USA
| |
Collapse
|
148
|
Duvic M, Chiao N, Talpur R. Extracorporeal Photopheresis for the Treatment of Cutaneous T-Cell Lymphoma. J Cutan Med Surg 2016. [DOI: 10.1177/12034754030070s402] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Madeleine Duvic
- Department of Dermatology, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Nor Chiao
- Department of Dermatology, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Rakhshandra Talpur
- Department of Dermatology, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
149
|
Richardson SK, McGinnis KS, Shapiro M, Lehrer MS, Kim EJ, Vittorio CC, Hopkins JMJ, Rook AH. Extracorporeal Photopheresis and Multimodality Immunomodulatory Therapy in the Treatment of Cutaneous T-Cell Lymphoma. J Cutan Med Surg 2016. [DOI: 10.1177/12034754030070s403] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Stephen K. Richardson
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Karen S. McGinnis
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael Shapiro
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael S. Lehrer
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ellen J. Kim
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Carmela C. Vittorio
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Alain H. Rook
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
150
|
Ma H, Abdul-Hay M. T-cell lymphomas, a challenging disease: types, treatments, and future. Int J Clin Oncol 2016; 22:18-51. [PMID: 27743148 PMCID: PMC7102240 DOI: 10.1007/s10147-016-1045-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/26/2016] [Indexed: 02/06/2023]
Abstract
T-cell lymphomas are rare and aggressive malignancies associated with poor outcome, often because of the development of resistance in the lymphoma against chemotherapy as well as intolerance in patients to the established and toxic chemotherapy regimens. In this review article, we discuss the epidemiology, pathophysiology, current standard of care, and future treatments of common types of T-cell lymphomas, including adult T-cell leukemia/lymphoma, angioimmunoblastic T-cell lymphoma, anaplastic large-cell lymphoma, aggressive NK/T-cell lymphoma, and cutaneous T-cell lymphoma.
Collapse
Affiliation(s)
- Helen Ma
- Department of Internal Medicine, New York University, New York, NY, USA
| | - Maher Abdul-Hay
- Department of Internal Medicine, New York University, New York, NY, USA. .,Perlmutter Cancer Center, New York University, New York, NY, USA.
| |
Collapse
|