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Takano K, Monna-Oiwa M, Isobe M, Kato S, Takahashi S, Nannya Y, Konuma T. Low urinary sodium-to-potassium ratio in the early phase following single-unit cord blood transplantation is a predictive factor for poor non-relapse mortality in adults. Sci Rep 2024; 14:1413. [PMID: 38228718 DOI: 10.1038/s41598-024-51748-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 01/09/2024] [Indexed: 01/18/2024] Open
Abstract
Although daily higher urinary sodium (Na) and potassium (K) excretion ratio is associated with the risk of cardiovascular disease in the general population, a low Na/K ratio is associated with renal dysfunction in critically ill patients. Thus, we retrospectively analyzed the impact of daily urinary Na and K excretion and their ratio on non-relapse mortality (NRM) and overall mortality in 172 adult single-unit cord blood transplantation (CBT) patients treated at our institution between 2007 and 2020. Multivariate analysis showed that a low urinary Na/K ratio at both 14 days (hazard ratio [HR], 4.82; 95% confidence interval [CI], 1.81-12.83; P = 0.001) and 28 days (HR, 4.47; 95% CI 1.32-15.12; P = 0.015) was significantly associated with higher NRM. Furthermore, a low urinary Na/K ratio at 28 days was significantly associated with higher overall mortality (HR, 2.38; 95% CI 1.15-4.91; P = 0.018). Patients with a low urinary Na/K ratio had decreased urine volume, more weight gain, experienced more grade III-IV acute graft-versus-host disease, and required corticosteroids by 28 days after CBT. These findings indicate that a low urinary Na/K ratio early after single-unit CBT is associated with poor NRM and survival in adults.
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Affiliation(s)
- Kosuke Takano
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Maki Monna-Oiwa
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Masamichi Isobe
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Seiko Kato
- Division of Clinical Precision Research Platform, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Satoshi Takahashi
- Division of Clinical Precision Research Platform, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yasuhito Nannya
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Takaaki Konuma
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan.
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2
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Dong J, Buradagunta CS, Zhang T, Spellman S, Bolon YT, DeZern AE, Gadalla SM, Deeg HJ, Nazha A, Cutler C, Cheng C, Urrutia R, Auer P, Saber W. Prognostic landscape of mitochondrial genome in myelodysplastic syndrome after stem-cell transplantation. J Hematol Oncol 2023; 16:21. [PMID: 36899395 PMCID: PMC9999628 DOI: 10.1186/s13045-023-01418-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/26/2023] [Indexed: 03/12/2023] Open
Abstract
Despite mitochondrial DNA (mtDNA) mutations are common events in cancer, their global frequency and clinical impact have not been comprehensively characterized in patients with myelodysplastic neoplasia (also known as myelodysplastic syndromes, MDS). Here we performed whole-genome sequencing (WGS) on samples obtained before allogenic hematopoietic cell transplantation (allo-HCT) from 494 patients with MDS who were enrolled in the Center for International Blood and Marrow Transplant Research. We evaluated the impact of mtDNA mutations on transplantation outcomes, including overall survival (OS), relapse, relapse-free survival (RFS), and transplant-related mortality (TRM). A random survival forest algorithm was applied to evaluate the prognostic performance of models that include mtDNA mutations alone and combined with MDS- and HCT-related clinical factors. A total of 2666 mtDNA mutations were identified, including 411 potential pathogenic variants. We found that overall, an increased number of mtDNA mutations was associated with inferior transplantation outcomes. Mutations in several frequently mutated mtDNA genes (e.g., MT-CYB and MT-ND5) were identified as independent predictors of OS, RFS, relapse and/or TRM after allo-HCT. Integration of mtDNA mutations into the models based on the Revised International Prognostic Scores (IPSS-R) and clinical factors related to MDS and allo-HCT could capture more prognostic information and significantly improve the prognostic stratification efforts. Our study represents the first WGS effort in MDS receiving allo-HCT and shows that there may be clinical utility of mtDNA variants to predict allo-HCT outcomes in combination with more standard clinical parameters.
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Affiliation(s)
- Jing Dong
- Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, HRC 5860, Milwaukee, WI, 53226, USA.
- Medical College of Wisconsin Cancer Center, Milwaukee, WI, USA.
- Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Christopher Staffi Buradagunta
- Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, HRC 5860, Milwaukee, WI, 53226, USA
| | - Tao Zhang
- CIBMTR® (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program®/Be The Match®, Minneapolis, MN, USA
| | - Stephen Spellman
- CIBMTR® (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program®/Be The Match®, Minneapolis, MN, USA
| | - Yung-Tsi Bolon
- CIBMTR® (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program®/Be The Match®, Minneapolis, MN, USA
| | - Amy E DeZern
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Shahinaz M Gadalla
- Division of Cancer Epidemiology & Genetics, NIH-NCI Clinical Genetics Branch, Rockville, MD, USA
| | - H Joachim Deeg
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Aziz Nazha
- Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Corey Cutler
- Stem Cell Transplantation and Cellular Therapy, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Chao Cheng
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Raul Urrutia
- Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Paul Auer
- Division of Biostatistics, Institute for Health & Equity, and Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Hematology and Oncology, Department of Medicine, CIBMTR® (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI, 53226, USA
- Cancer Center Biostatistics Shared Resource, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Wael Saber
- Division of Hematology and Oncology, Department of Medicine, CIBMTR® (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI, 53226, USA.
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3
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Spector LG, Spellman SR, Thyagarajan B, Beckman KB, Hoffmann C, Garbe J, Hahn T, Sucheston-Campbell L, Richardson M, De For TE, Tolar J, Verneris MR. Neither Donor nor Recipient Mitochondrial Haplotypes Are Associated with Unrelated Donor Transplant Outcomes: A Validation Study from the CIBMTR. Transplant Cell Ther 2021; 27:836.e1-836.e7. [PMID: 34174468 DOI: 10.1016/j.jtct.2021.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/04/2021] [Accepted: 06/16/2021] [Indexed: 11/18/2022]
Abstract
Graft-versus-host-disease (GVHD) is a multistep process that involves T-cell recognition and priming toward alloantigen, expansion, acquisition of effector function, and repeated tissue injury, resulting in clinical manifestations of the disease. All of these processes have considerable metabolic demands and understanding the key role of mitochondria in cellular metabolism as it relates to GVHD has increased significantly. Mitochondrial DNA (mtDNA) haplotypes have been linked to functional differences in vitro, suggesting they have functional differences at an organismal level. We previously used mtDNA typing to assess the impact of mtDNA haplotypes on outcomes of ~400 allo-HCT patients. This pilot study identified uncommon mtDNA haplotypes potentially associated with inferior outcomes. We sought to validate pilot findings of associations between donor and recipient mitochondrial haplotypes and transplant outcome. We examined a cohort of 4143 donor-recipient pairs obtained from the Center for International Blood and Marrow Transplant Research. MtDNA was extracted from whole blood or peripheral blood mononuclear cells from donors and recipients and sequenced to discern haplotype. We used multiple regression analysis to examine the independent association of mtDNA haplotype with overall survival and grade III-IV acute GVHD (aGVHD) adjusting for known risk factors for poor transplant outcome. Neither recipient nor donor mtDNA haplotype reached groupwise significance for overall survival (P =.26 and .39, respectively) or grade III-IV aGVHD (P = .68 and.57, respectively). Adjustment for genomically determined ancestry in the subset of donor-recipient pairs for which this was available did not materially change results. We conclude that our original finding was due to chance in a small sample size and that there is essentially no evidence that mtDNA haplotype or haplotype mismatch contributes to risk of serious outcomes after allogeneic transplantation.
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Affiliation(s)
- Logan G Spector
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.
| | - Stephen R Spellman
- Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Kenneth B Beckman
- University of Minnesota Genomics Center, University of Minnesota, Minneapolis, Minnesota
| | - Cody Hoffmann
- University of Minnesota Genomics Center, University of Minnesota, Minneapolis, Minnesota
| | - John Garbe
- University of Minnesota Genomics Center, University of Minnesota, Minneapolis, Minnesota
| | - Theresa Hahn
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | | | - Michaela Richardson
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Todd E De For
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Jakub Tolar
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Michael R Verneris
- University of Colorado Denver, Children's Cancer and Blood Disorders, Denver, Colorado
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Dinu AR, Rogobete AF, Bratu T, Popovici SE, Bedreag OH, Papurica M, Bratu LM, Sandesc D. Cannabis Sativa Revisited-Crosstalk between microRNA Expression, Inflammation, Oxidative Stress, and Endocannabinoid Response System in Critically Ill Patients with Sepsis. Cells 2020; 9:E307. [PMID: 32012914 PMCID: PMC7072707 DOI: 10.3390/cells9020307] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/24/2020] [Accepted: 01/26/2020] [Indexed: 02/06/2023] Open
Abstract
Critically ill patients with sepsis require a multidisciplinary approach, as this situation implies multiorgan distress, with most of the bodily biochemical and cellular systems being affected by the condition. Moreover, sepsis is characterized by a multitude of biochemical interactions and by dynamic changes of the immune system. At the moment, there is a gap in our understanding of the cellular, genetic, and molecular mechanisms involved in sepsis. One of the systems intensely studied in recent years is the endocannabinoid signaling pathway, as light was shed over a series of important interactions of cannabinoid receptors with biochemical pathways, specifically for sepsis. Furthermore, a series of important implications on inflammation and the immune system that are induced by the activity of cannabinoid receptors stimulated by the delta-9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) have been noticed. One of the most important is their ability to reduce the biosynthesis of pro-inflammatory mediators and the modulation of immune mechanisms. Different studies have reported that cannabinoids can reduce oxidative stress at mitochondrial and cellular levels. The aim of this review paper was to present, in detail, the important mechanisms modulated by the endocannabinoid signaling pathway, as well as of the molecular and cellular links it has with sepsis. At the same time, we wish to present the possible implications of cannabinoids in the most important biological pathways involved in sepsis, such as inflammation, redox activity, immune system, and epigenetic expression.
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Affiliation(s)
- Anca Raluca Dinu
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.R.D.); (A.F.R.); (S.E.P.); (M.P.); (L.M.B.); (D.S.)
| | - Alexandru Florin Rogobete
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.R.D.); (A.F.R.); (S.E.P.); (M.P.); (L.M.B.); (D.S.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 325100 Timisoara, Romania
| | - Tiberiu Bratu
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.R.D.); (A.F.R.); (S.E.P.); (M.P.); (L.M.B.); (D.S.)
| | - Sonia Elena Popovici
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.R.D.); (A.F.R.); (S.E.P.); (M.P.); (L.M.B.); (D.S.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 325100 Timisoara, Romania
| | - Ovidiu Horea Bedreag
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.R.D.); (A.F.R.); (S.E.P.); (M.P.); (L.M.B.); (D.S.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 325100 Timisoara, Romania
| | - Marius Papurica
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.R.D.); (A.F.R.); (S.E.P.); (M.P.); (L.M.B.); (D.S.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 325100 Timisoara, Romania
| | - Lavinia Melania Bratu
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.R.D.); (A.F.R.); (S.E.P.); (M.P.); (L.M.B.); (D.S.)
| | - Dorel Sandesc
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.R.D.); (A.F.R.); (S.E.P.); (M.P.); (L.M.B.); (D.S.)
- Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, 325100 Timisoara, Romania
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Jimbo K, Konuma T, Watanabe E, Kohara C, Mizukami M, Nagai E, Oiwa-Monna M, Mizusawa M, Isobe M, Kato S, Takahashi S, Tojo A. T memory stem cells after allogeneic haematopoietic cell transplantation: unique long-term kinetics and influence of chronic graft-versus-host disease. Br J Haematol 2019; 186:866-878. [PMID: 31135974 DOI: 10.1111/bjh.15995] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 04/11/2019] [Indexed: 12/21/2022]
Abstract
T memory stem cells (TSCMs) are a subset of primitive T cells capable of both self-renewal and differentiation into all subsets of memory and effector T cells. Therefore, TSCMs may play a role in immune reconstitution and graft-versus-host disease (GVHD) in patients receiving allogeneic haematopoietic cell transplantation (HCT). We conducted a cross-sectional study to evaluate the proportions, absolute counts, phenotypes and functions of TSCMs in 152 adult patients without disease recurrence at least 12 months after undergoing HCT. CD4+ TSCMs were negatively correlated with number of months after transplantation in HCT patients that received cord blood transplantation, but not in patients that received bone marrow transplantation or peripheral blood stem cell transplantation. The proportions and absolute counts of CD4+ TSCMs and expression levels of inducible co-stimulator (ICOS) in CD8+ TSCMs were significantly higher in patients with mild and moderate/severe cGVHD compared to patients without cGVHD. These data suggested that, more than 12 months after allogeneic HCT, the kinetics of CD4+ TSCMs were dependent on the type of donor source, and further that CD4+ TSCMs and ICOS levels in CD8+ TSCMs were associated with cGVHD.
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Affiliation(s)
- Koji Jimbo
- Department of Haematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Takaaki Konuma
- Department of Haematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Eri Watanabe
- Department of IMSUT Clinical Flow Cytometry Laboratory, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Chisato Kohara
- Department of Haematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Motoko Mizukami
- Department of Laboratory Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Etsuko Nagai
- Department of Laboratory Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Maki Oiwa-Monna
- Department of Haematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Mai Mizusawa
- Department of Haematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Masamichi Isobe
- Department of Haematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Seiko Kato
- Department of Haematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Satoshi Takahashi
- Department of Haematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Arinobu Tojo
- Department of Haematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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Sato T, Konuma T, Oiwa-Monna M, Tanoue S, Isobe M, Jimbo K, Kasuya F, Hisahara M, Kobayashi K, Kato S, Takahashi S, Tojo A. Does marital status affect the outcomes after allogeneic hematopoietic cell transplantation? Bone Marrow Transplant 2018; 53:774-779. [DOI: 10.1038/s41409-018-0217-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 11/09/2022]
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Konuma T, Kato S, Oiwa-Monna M, Ishii H, Tojo A, Takahashi S. Early phase mixed chimerism in bone marrow does not affect long-term outcomes of myeloablative single-unit cord blood transplantation for adult patients with hematological malignancies. Leuk Lymphoma 2016; 57:2848-2854. [PMID: 27124418 DOI: 10.3109/10428194.2016.1171860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Coexisting hematopoiesis from donor and recipient origin, called a mixed chimerism status, can occur in patients after myeloablative allogeneic hematopoietic stem cell transplantation. However, its impact on the outcomes of cord blood transplantation (CBT) has yet to be clarified. We retrospectively analyzed 150 adult patients who received myeloablative single-unit CBT for hematological malignancies in our institute. At the median time of first bone marrow analysis of 41 days after CBT, mixed chimerism was observed in 16 of the 150 patients. Among patients with mixed chimerism, 4 patients relapsed. The remaining 12 patients were alive and in remission at a median follow-up of 50 months. Bone marrow-mixed chimerism did not have a significant impact on the incidences of disease-free survival, relapse, or transplant-related mortality after CBT. These data show that early phase mixed chimerism did not have a significant impact on long-term outcomes after myeloablative single-unit CBT for hematological malignancies.
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Affiliation(s)
- Takaaki Konuma
- a Department of Hematology/Oncology , The Institute of Medical Science, The University of Tokyo , Tokyo , Japan
| | - Seiko Kato
- a Department of Hematology/Oncology , The Institute of Medical Science, The University of Tokyo , Tokyo , Japan
| | - Maki Oiwa-Monna
- a Department of Hematology/Oncology , The Institute of Medical Science, The University of Tokyo , Tokyo , Japan
| | - Hiroto Ishii
- a Department of Hematology/Oncology , The Institute of Medical Science, The University of Tokyo , Tokyo , Japan
| | - Arinobu Tojo
- a Department of Hematology/Oncology , The Institute of Medical Science, The University of Tokyo , Tokyo , Japan
| | - Satoshi Takahashi
- a Department of Hematology/Oncology , The Institute of Medical Science, The University of Tokyo , Tokyo , Japan
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Konuma T, Kato S, Oiwa-Monna M, Ishii H, Tojo A, Takahashi S. Comparison of graft-versus-host disease-free, relapse-free survival of transplantation using matched sibling donor, matched unrelated donor or unrelated cord blood after myeloablative conditioning for adult patients with hematological malignancies. Leuk Lymphoma 2016; 57:2126-32. [DOI: 10.3109/10428194.2015.1122784] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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