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Pendse S, Chavan S, Kale V, Vaidya A. A comprehensive analysis of cell-autonomous and non-cell-autonomous regulation of myeloid leukemic cells: The prospect of developing novel niche-targeting therapies. Cell Biol Int 2023; 47:1667-1683. [PMID: 37554060 DOI: 10.1002/cbin.12078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/12/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023]
Abstract
Leukemic cells (LCs) arise from the hematopoietic stem/and progenitor cells (HSCs/HSPCs) and utilize cues from the bone marrow microenvironment (BMM) for their regulation in the same way as their normal HSC counterparts. Mesenchymal stromal cells (MSCs), a vital component of the BMM promote leukemogenesis by creating a protective and immune-tolerant microenvironment that can support the survival of LCs, helping them escape chemotherapy, thereby resulting in the relapse of leukemia. Conversely, MSCs also induce apoptosis in the LCs and inhibit their proliferation by interfering with their self-renewal potential. This review discusses the work done so far on cell-autonomous (intrinsic) and MSCs-mediated non-cell-autonomous (extrinsic) regulation of myeloid leukemia with a special focus on the need to investigate the extrinsic regulation of myeloid leukemia to understand the contrasting role of MSCs in leukemogenesis. These mechanisms could be exploited to formulate novel therapeutic strategies that specifically target the leukemic microenvironment.
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Affiliation(s)
- Shalmali Pendse
- Symbiosis School of Biological Sciences, Symbiosis International (Deemed University), Pune, Maharashtra, India
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, Maharashtra, India
| | - Sayali Chavan
- Symbiosis School of Biological Sciences, Symbiosis International (Deemed University), Pune, Maharashtra, India
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, Maharashtra, India
| | - Vaijayanti Kale
- Symbiosis School of Biological Sciences, Symbiosis International (Deemed University), Pune, Maharashtra, India
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, Maharashtra, India
| | - Anuradha Vaidya
- Symbiosis School of Biological Sciences, Symbiosis International (Deemed University), Pune, Maharashtra, India
- Symbiosis Centre for Stem Cell Research, Symbiosis International (Deemed University), Pune, Maharashtra, India
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Milczarek S, Kulig P, Zuchmańska A, Baumert B, Osękowska B, Bielikowicz A, Wilk-Milczarek E, Machaliński B. Safety of Cryopreserved Stem Cell Infusion through a Peripherally Inserted Central Venous Catheter. Cancers (Basel) 2023; 15:cancers15041338. [PMID: 36831679 PMCID: PMC9954289 DOI: 10.3390/cancers15041338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
The management of patients undergoing stem cell transplantation requires a multipurpose central venous catheter (CVC) to facilitate drug administration, parenteral nutrition, transfusion of blood products, and collection of blood samples. Peripherally inserted central venous catheters (PICCs) appear to meet these requirements but are rarely used for stem cell infusion. We aimed to retrospectively assess the safety and feasibility of stem cell infusion through PICC and to evaluate its impact on transplantation kinetics. We retrospectively analyzed the outcomes of peripheral blood stem cell (PBSC) transplantation in patients receiving cryopreserved autologous or allogeneic PBSC by PICCs and compared the results with patients receiving transplants through a conventionally inserted central venous catheter (CICC). Despite statistically significant differences in CD34+ dose, infusion rate, and total length of administration, the clinical outcomes of transplantation, exemplified by platelet and neutrophil engraftment, along with the length of hospitalization, were not affected by the prolonged infusion time and lower infusion velocity in the PICC group. Our study showed that the clinical outcomes of PBSC transplantation did not differ between the PICC and CICC groups, suggesting that both types of catheters can be implemented in a PBSC transplantation setting.
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Affiliation(s)
- Sławomir Milczarek
- Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland
- Department of Hematology and Transplantology, Pomeranian Medical University, 71-252 Szczecin, Poland
| | - Piotr Kulig
- Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Alina Zuchmańska
- Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Bartłomiej Baumert
- Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland
- Department of Hematology and Transplantology, Pomeranian Medical University, 71-252 Szczecin, Poland
| | - Bogumiła Osękowska
- Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland
- Department of Hematology and Transplantology, Pomeranian Medical University, 71-252 Szczecin, Poland
| | - Anna Bielikowicz
- Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Ewa Wilk-Milczarek
- Department of General and Dental Radiology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Bogusław Machaliński
- Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland
- Department of Hematology and Transplantology, Pomeranian Medical University, 71-252 Szczecin, Poland
- Correspondence:
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Takasawa K, Kanegane H, Kashimada K, Morio T. Endocrinopathies in Inborn Errors of Immunity. Front Immunol 2021; 12:786241. [PMID: 34887872 PMCID: PMC8650088 DOI: 10.3389/fimmu.2021.786241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Inborn errors of immunity (IEI), caused by hereditary or genetic defects, are a group of more than 400 disorders, in which the immune system, including lymphocytes, neutrophils, macrophages, and complements, does not function properly. The endocrine system is frequently affected by IEI as an associated clinical feature and a complex network of glands which regulate many important body functions, including growth, reproduction, homeostasis, and energy regulation. Most endocrine disorders associated with IEI are hypofunction which would be treated with supplementation therapy, and early diagnosis and appropriate management are essential for favorable long-term outcomes in patients with IEI. In this review, we aimed to comprehensively summarize and discuss the current understanding on the clinical features and the pathophysiology of endocrine disorders in IEI. This review is composed with three parts. First, we discuss the two major pathophysiology of endocrinopathy in IEI, autoimmune response and direct effects of the responsible genes. Next, the details of each endocrinopathy, such as growth failure, hypothyroidism, hypoparathyroidism, adrenal insufficiency, diabetes mellitus (DM) are specified. We also illustrated potential endocrinopathy due to hematopoietic stem cell transplantation, including hypogonadism and adrenal insufficiency due to glucocorticoid therapy.
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Affiliation(s)
- Kei Takasawa
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hirokazu Kanegane
- Deparment of Child Health Development, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kenichi Kashimada
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tomohiro Morio
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Apsel Winger B, Shukla P, Kharbanda S, Keizer RJ, Goswami S, Cowan MJ, Dvorak CC, Long-Boyle J. The Relationship Between Busulfan Exposure and Achievement of Sustained Donor Myeloid Chimerism in Patients with Non-Malignant Disorders. Transplant Cell Ther 2021; 27:258.e1-258.e6. [PMID: 33781528 DOI: 10.1016/j.jtct.2020.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/20/2020] [Accepted: 12/06/2020] [Indexed: 11/30/2022]
Abstract
The overall objective of allogeneic hematopoietic cell transplantation (HCT) in patients with non-malignant conditions involves replacing a dysfunctional or absent cell or gene product for disease correction. It is unclear whether lower busulfan exposure may be sufficient in this population to facilitate durable myeloid engraftment and limit toxicity. Given that neither the ideal level of mixed myeloid chimerism for specific non-malignant diseases nor how to condition a patient to achieve stable mixed myeloid chimerism is fully known, we sought to analyze the relationships among busulfan exposure, myeloid chimerism, and outcomes in patients with non-malignant conditions receiving busulfan as a part of combination pretransplant conditioning at our institution. This was a single-center, retrospective study including pediatric patients with a variety of non-malignant disorders who underwent allogeneic HCT at the University of California San Francisco Benioff Children's Hospital from March 2007 to June 2018. The busulfan cumulative area under the curve (cAUC) was estimated using a validated population pharmacokinetic model and nonlinear mixed effects modeling. Median busulfan cAUC for all patients was 70 mg·h/L (range, 53 to 108). All of the 29 patients with a busulfan cAUC of ≥70 mg·h/L achieved long-term disease correction with full or stable mixed (>20%) myeloid chimerism, compared to 78.5% (22/28) of patients with a cAUC of <70 mg·h/L (P = .01). Overall ksurvival was evaluated up to 3 years and was identical in patients with busulfan cAUC < 70 mg·h/L and patients with busulfan cAUC ≥70 mg·h/L (96% versus 93%; P = .92). Only three patients died, at days 65, 164 and 980 days post-HCT. Severe busulfan-related toxicities and graft-versus-host-disease (GVHD) were rare, with veno-occlusive disease occurring in four patients (7%), acute respiratory distress syndrome in three patients (5%), and GVHD in five patients (9%). These results demonstrate excellent outcomes and extremely low rates of toxicity across our entire cohort. Based on the results of this study, we recommend a busulfan exposure target of 75 mg·h/L (range, 70 to 80) in all non-malignant patients receiving allogeneic HCT to ensure optimal exposure for achievement of high-level stable myeloid chimerism.
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Affiliation(s)
- Beth Apsel Winger
- Department of Pediatrics, Division of Hematology and Oncology, University of California San Francisco, San Francisco, California; Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California San Francisco, San Francisco, California
| | - Praveen Shukla
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California
| | - Sandhya Kharbanda
- Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California San Francisco, San Francisco, California
| | | | - Srijib Goswami
- Department of Pediatrics, Division of Hematology and Oncology, University of California San Francisco, San Francisco, California; Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California San Francisco, San Francisco, California; Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California; Insight Rx, Inc., San Francisco, California
| | - Morton J Cowan
- Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California San Francisco, San Francisco, California
| | - Christopher C Dvorak
- Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California San Francisco, San Francisco, California
| | - Janel Long-Boyle
- Department of Pediatrics, Division of Allergy, Immunology, and Bone Marrow Transplantation, University of California San Francisco, San Francisco, California; Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California.
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Marie E, Navallas M, Navarro OM, Punnett A, Shammas A, Gupta A, Chami R, Shroff MM, Vali R. Posttransplant Lymphoproliferative Disorder in Children: A 360-degree Perspective. Radiographics 2019; 40:241-265. [PMID: 31834850 DOI: 10.1148/rg.2020190103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
An earlier incorrect version of this article appeared online. This article was corrected on December 17, 2019.
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Affiliation(s)
- Eman Marie
- From the Departments of Medical Imaging (E.M., M.N., O.M.N., A.S., M.M.S., R.V.), Pediatrics (A.P.), and Laboratory Medicine and Pathobiology (R.C.), University of Toronto, Toronto, Ontario, Canada; and the Department of Diagnostic Imaging (E.M., M.N., O.M.N., A.G., M.M.S.), Division of Pediatric Hematology/Oncology, Department of Pediatrics (A.P.), Division of Nuclear Medicine, Department of Diagnostic Imaging (A.S., R.V.), and Department of Pediatric Pathology and Laboratory Medicine (R.C.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - María Navallas
- From the Departments of Medical Imaging (E.M., M.N., O.M.N., A.S., M.M.S., R.V.), Pediatrics (A.P.), and Laboratory Medicine and Pathobiology (R.C.), University of Toronto, Toronto, Ontario, Canada; and the Department of Diagnostic Imaging (E.M., M.N., O.M.N., A.G., M.M.S.), Division of Pediatric Hematology/Oncology, Department of Pediatrics (A.P.), Division of Nuclear Medicine, Department of Diagnostic Imaging (A.S., R.V.), and Department of Pediatric Pathology and Laboratory Medicine (R.C.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Oscar M Navarro
- From the Departments of Medical Imaging (E.M., M.N., O.M.N., A.S., M.M.S., R.V.), Pediatrics (A.P.), and Laboratory Medicine and Pathobiology (R.C.), University of Toronto, Toronto, Ontario, Canada; and the Department of Diagnostic Imaging (E.M., M.N., O.M.N., A.G., M.M.S.), Division of Pediatric Hematology/Oncology, Department of Pediatrics (A.P.), Division of Nuclear Medicine, Department of Diagnostic Imaging (A.S., R.V.), and Department of Pediatric Pathology and Laboratory Medicine (R.C.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Angela Punnett
- From the Departments of Medical Imaging (E.M., M.N., O.M.N., A.S., M.M.S., R.V.), Pediatrics (A.P.), and Laboratory Medicine and Pathobiology (R.C.), University of Toronto, Toronto, Ontario, Canada; and the Department of Diagnostic Imaging (E.M., M.N., O.M.N., A.G., M.M.S.), Division of Pediatric Hematology/Oncology, Department of Pediatrics (A.P.), Division of Nuclear Medicine, Department of Diagnostic Imaging (A.S., R.V.), and Department of Pediatric Pathology and Laboratory Medicine (R.C.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Amer Shammas
- From the Departments of Medical Imaging (E.M., M.N., O.M.N., A.S., M.M.S., R.V.), Pediatrics (A.P.), and Laboratory Medicine and Pathobiology (R.C.), University of Toronto, Toronto, Ontario, Canada; and the Department of Diagnostic Imaging (E.M., M.N., O.M.N., A.G., M.M.S.), Division of Pediatric Hematology/Oncology, Department of Pediatrics (A.P.), Division of Nuclear Medicine, Department of Diagnostic Imaging (A.S., R.V.), and Department of Pediatric Pathology and Laboratory Medicine (R.C.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Aaryan Gupta
- From the Departments of Medical Imaging (E.M., M.N., O.M.N., A.S., M.M.S., R.V.), Pediatrics (A.P.), and Laboratory Medicine and Pathobiology (R.C.), University of Toronto, Toronto, Ontario, Canada; and the Department of Diagnostic Imaging (E.M., M.N., O.M.N., A.G., M.M.S.), Division of Pediatric Hematology/Oncology, Department of Pediatrics (A.P.), Division of Nuclear Medicine, Department of Diagnostic Imaging (A.S., R.V.), and Department of Pediatric Pathology and Laboratory Medicine (R.C.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rose Chami
- From the Departments of Medical Imaging (E.M., M.N., O.M.N., A.S., M.M.S., R.V.), Pediatrics (A.P.), and Laboratory Medicine and Pathobiology (R.C.), University of Toronto, Toronto, Ontario, Canada; and the Department of Diagnostic Imaging (E.M., M.N., O.M.N., A.G., M.M.S.), Division of Pediatric Hematology/Oncology, Department of Pediatrics (A.P.), Division of Nuclear Medicine, Department of Diagnostic Imaging (A.S., R.V.), and Department of Pediatric Pathology and Laboratory Medicine (R.C.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Manohar M Shroff
- From the Departments of Medical Imaging (E.M., M.N., O.M.N., A.S., M.M.S., R.V.), Pediatrics (A.P.), and Laboratory Medicine and Pathobiology (R.C.), University of Toronto, Toronto, Ontario, Canada; and the Department of Diagnostic Imaging (E.M., M.N., O.M.N., A.G., M.M.S.), Division of Pediatric Hematology/Oncology, Department of Pediatrics (A.P.), Division of Nuclear Medicine, Department of Diagnostic Imaging (A.S., R.V.), and Department of Pediatric Pathology and Laboratory Medicine (R.C.), The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Reza Vali
- From the Departments of Medical Imaging (E.M., M.N., O.M.N., A.S., M.M.S., R.V.), Pediatrics (A.P.), and Laboratory Medicine and Pathobiology (R.C.), University of Toronto, Toronto, Ontario, Canada; and the Department of Diagnostic Imaging (E.M., M.N., O.M.N., A.G., M.M.S.), Division of Pediatric Hematology/Oncology, Department of Pediatrics (A.P.), Division of Nuclear Medicine, Department of Diagnostic Imaging (A.S., R.V.), and Department of Pediatric Pathology and Laboratory Medicine (R.C.), The Hospital for Sick Children, Toronto, Ontario, Canada
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Sutani A, Miyakawa Y, Tsuji-Hosokawa A, Nomura R, Nakagawa R, Nakajima K, Maru M, Aoki Y, Takasawa K, Takagi M, Imai K, Kashimada K, Morio T. Gonadal failure among female patients after hematopoietic stem cell transplantation for non-malignant diseases. Clin Pediatr Endocrinol 2019; 28:105-112. [PMID: 31666763 PMCID: PMC6801362 DOI: 10.1297/cpe.28.105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/21/2019] [Indexed: 12/30/2022] Open
Abstract
In addition to malignant diseases, hematopoietic stem cell transplantation (HSCT) is also
a vital option as a curative therapy for non-malignant diseases, such as immunodeficiency,
and other hematological disorders. Not only for malignant diseases, but for non-malignant
diseases, cytotoxic therapy of conditioning regimens are associated with high risks of
adverse effects; however, clinical details regarding the long term outcomes of cytotoxic
therapy for non-malignant diseases are not documented yet. To clarify the endocrinological
consequences of pediatric HSCT for non-malignant disease patients, we conducted a
retrospective analysis. From 1983 to 2014, 75 patients that underwent HSCT for
non-malignant diseases were selected for this study. Of these, 23 patients (19 men, 4
women) were continuously followed up in our institute, with regular health check-ups for
late effects. Based on a multiple linear regression analysis, the glucocorticoid treatment
duration for chronic graft-versus-host disease (cGVHD) and the conditioning regimen were
found to be independent predictors of growth retardation. All four female patients
developed hypogonadism, and required hormone replacement therapy. The conditioning regimen
for the four female patients with hypogonadism was based on the use of alkylating agents,
and two female patients were treated with a reduced-intensity conditioning (RIC) regimen.
Our study revealed that even the RIC regimen was toxic for the gonads in female patients,
and that the survivors of both non-malignant and malignant diseases should be followed up
carefully after pediatric HSCT.
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Affiliation(s)
- Akito Sutani
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuichi Miyakawa
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsumi Tsuji-Hosokawa
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Risa Nomura
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryuichi Nakagawa
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keisuke Nakajima
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Pediatrics, JA Toride Medical Center, Toride-shi, Japan
| | - Mitsue Maru
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan.,International Nursing Development, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe-shi, Japan
| | - Yuki Aoki
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kei Takasawa
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masatoshi Takagi
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohsuke Imai
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichi Kashimada
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomohiro Morio
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
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