2
|
Mtenga J, Orf K, Zheng J, Chamba C, Chuwa H, Luoga F, Malangahe SW, Iversen PO, Makani J. Haematopoietic stem cell transplantation in Tanzania. Br J Haematol 2020; 192:17-21. [PMID: 32976624 DOI: 10.1111/bjh.17106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/20/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Janeth Mtenga
- Department of Haematology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Kate Orf
- Department of Haematology, University College London Hospital, London, UK
| | - Jiexin Zheng
- Department of Haematology, University College London Hospital, London, UK
| | - Clara Chamba
- Department of Haematology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Harrison Chuwa
- Department of Haematology, Aga Khan Hospital, Dar es Salaam, Tanzania
| | - Frederick Luoga
- Department of Haematology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Cell Programme, Department of Haematology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Per Ole Iversen
- Department of Haematology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Department of Haematology, University of Oslo, Oslo, Norway.,Department of Nutrition, University of Oslo, Oslo, Norway
| | - Julie Makani
- Department of Haematology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Cell Programme, Department of Haematology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| |
Collapse
|
3
|
Ruiz-Argüelles GJ, Olivares-Gazca JC, Olivares-Gazca M, Leon-Peña AA, Murrieta-Alvarez I, Cantero-Fortiz Y, Gomez-Cruz GB, Ruiz-Argüelles A, Priesca-Marin M, Ruiz-Delgado GJ. Self-reported changes in the expanded disability status scale score in patients with multiple sclerosis after autologous stem cell transplants: real-world data from a single center. Clin Exp Immunol 2019; 198:351-358. [PMID: 31394007 DOI: 10.1111/cei.13358] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2019] [Indexed: 11/29/2022] Open
Abstract
In order to reset the immune system to baseline function, autologous hematopoietic stem cell transplantation (HSCT) has been performed in patients with multiple sclerosis (MS). After June 2015, 617 new consecutive patients with MS were autografted in our center with non-frozen peripheral blood stem cells. The autografts were performed on an out-patient basis, after conditioning with cyclophosphamide and rituximab. The aim of the study was the assessment of both safety and efficacy of the method. The study's primary co-end-points were recovery of granulocyte and platelet counts and transplant-related mortality. Secondary end-points were overall survival and clinical response (improvement or stabilization of the self-reported expanded disability status scale score). The protocol was registered in ClinicalTrials.gov identifier NCT02674217.0. We included 401 females and 216 males, with a median age of 46 years. A total of 259 patients had relapsing-remitting MS (RRMS), 228 had secondary progressive (SPMS) and 130 had primary progressive (PPMS) multiple sclerosis. All procedures were initially performed on an out-patient basis and only 32 individuals (5%) required hospitalization. One to three aphereses (median 1) were required to harvest at least 1 × 106 /kg viable CD34+ cells. The total number of viable CD34+ infused cells ranged between 1 and 37·83 × 106 /kg (median 5·68). Patients recovered more than 0·5 × 109 /l absolute granulocytes by day 8 (median, range = 2-14), and platelet values were above 20 × 109 /l by day 4 (median, range = 0-11). Eleven individuals required red blood cells and six needed platelet transfusions. To date, there have been no deaths attributable to the transplant, yielding a 30-month overall survival of 100%. Patients have been followed for 3-42 months (median = 12). The overall response rate (decrease or stabilization of the self-reported EDSS score) at 12 months was 78% for all patients (83% in RRMS, 78% in PPMS and 73% in SPMS), while the disability progression-free survival was 82% for all patients (86% in RRMS, 78·5% in SPMS and 78% in SPMS). Changes in the self-reported EDSS score in parallel with neurological improvement were observed in people with all types of MS after HSCT, employing the 'Mexican method'.
Collapse
Affiliation(s)
- G J Ruiz-Argüelles
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Laboratorios Clínicos de Puebla, Puebla, México.,Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | - J C Olivares-Gazca
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | - M Olivares-Gazca
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | - A A Leon-Peña
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - I Murrieta-Alvarez
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | - Y Cantero-Fortiz
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Universidad de las Américas Puebla, Puebla, México
| | - G B Gomez-Cruz
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - A Ruiz-Argüelles
- Laboratorios Clínicos de Puebla, Puebla, México.,Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | - M Priesca-Marin
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México
| | - G J Ruiz-Delgado
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Laboratorios Clínicos de Puebla, Puebla, México.,Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| |
Collapse
|
4
|
Carnot Uria J, Hernández Cruz C, Muñío Perurena J, Torres Yribar W, Diego de la Campa J, Del Castillo Carrillo C, Rodríguez Fraga Y, López Silva JA, Cepero Llauger K, Pardo Ramírez IK, García García A, Sweiss K, Patel PR, Rondelli D. Bone Marrow Transplantation in Patients With Acute Leukemia In Cuba: Results From the Last 30 Years and New Opportunities Through International Collaboration. J Glob Oncol 2018; 4:1-7. [PMID: 30582434 PMCID: PMC7010424 DOI: 10.1200/jgo.18.00109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Blood and marrow transplantation (BMT) has been performed in Cuba for over 30 years with limited resources and without international relationships. Researchers from University of Illinois at Chicago and Hermanos Ameijeiras Hospital (HAH) in Havana collaborated on retrospectively analyzing 101 consecutive patients with adult acute leukemia who received BMT at HAH from June 1986 to January 2016. Of these, 82 had acute myeloid leukemia (AML) and 19 had acute lymphoblastic leukemia (ALL). BMT eligibility criteria included prior morphologic complete remission, no severe comorbidities, and age between 16 and 60 years. Patients with an HLA-matched donor received an allogeneic BMT, whereas the others received an autologous BMT. All patients received fresh stem cells from marrow (80%) or mobilized peripheral blood (19%). Of 82 patients with AML, 35 received an allogeneic (AML-allo) and 47 an autologous (AML-auto) BMT. Both groups had comparable median age (37 years) and follow-up of survivors. Overall survival (OS) was 34% in AML-allo and 38% in AML-auto. The transplant-related mortality rate was 40% in AML-allo and 17% in AML-auto, whereas the relapse-related mortality rates were 25% and 40%, respectively. Of the 19 patients with ALL, six received an allogeneic transplant. Of these, transplant-related mortality occurred in one patient and three died after disease relapse (OS, 33%). Of 13 patients who received autologous transplants, transplant-related mortality occurred in three and six died after disease relapse (OS, 31%). To our knowledge, this is the first scientific report on BMT performed in patients with acute leukemia in Cuba. The collaboration between University of Illinois at Chicago and HAH will further develop capacity building in research and implementation of new diagnostic and therapeutic strategies in Cuba.
Collapse
Affiliation(s)
- José Carnot Uria
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Calixto Hernández Cruz
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Jorge Muñío Perurena
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Wilfredo Torres Yribar
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Jesús Diego de la Campa
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Concepción Del Castillo Carrillo
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Yusaima Rodríguez Fraga
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Julio A López Silva
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Kali Cepero Llauger
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Ibis K Pardo Ramírez
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Aliette García García
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Karen Sweiss
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Pritesh R Patel
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| | - Damiano Rondelli
- José Carnot Uria, Calixto Hernández Cruz, Jorge Muñío Perurena, Wilfredo Torres Yribar, Jesús Diego de la Campa, Concepción del Castillo Carrillo, Yusaima Rodríguez Fraga, Julio A. López Silva, Kali Cepero Llauger, Ibis K. Pardo Ramírez, Aliette García García, Universidad Hermanos Ameijeiras Hospital, Havana, Cuba; and Karen Sweiss, Pritesh R. Patel, and Damiano Rondelli, University of Illinois at Chicago, Chicago, IL
| |
Collapse
|