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Pérez A, Gómez D, Montoro J, Chorão P, Hernani R, Guerreiro M, Villalba M, Albert E, Carbonell-Asins JA, Hernández-Boluda JC, Navarro D, Solano C, Piñana JL. Are any specific respiratory viruses more severe than others in recipients of allogeneic stem cell transplantation? A focus on lower respiratory tract disease. Bone Marrow Transplant 2024:10.1038/s41409-024-02304-4. [PMID: 38730040 DOI: 10.1038/s41409-024-02304-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/23/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
In the general population, influenza virus, respiratory syncytial virus, and SARS-CoV-2 are considered the most severe community-acquired respiratory viruses (CARVs). However, allogeneic stem cell transplant (allo-SCT) recipients may also face severe courses from other CARVs. This retrospective study compared outcomes of various CARV lower respiratory tract diseases (LRTD) in 235 adult allo-SCT recipients, excluding co-infection episodes. We included 235 adults allo-SCT recipients experiencing 353 CARV LRTD consecutive episodes (130 rhinovirus, 63 respiratory syncytial virus, 43 influenza, 43 human parainfluenza virus, 23 human metapneumovirus, 19 Omicron SARS-CoV-2, 17 common coronavirus, 10 adenovirus and 5 human bocavirus) between December 2013 and June 2023. Day 100 overall survival ranged from 78% to 90% without significant differences among CARV types. Multivariable analysis of day 100 all-cause mortality identified corticosteroid use of >1 to <30 mg/d [Hazard ratio (HR) 2.45, p = 0.02) and ≥30 mg/d (HR 2.20, p = 0.015) along with absolute lymphocyte count <0.2 × 109/L (HR 5.82, p < 0.001) and number of CARV episodes as a continuous variable per one episode increase (HR 0.48, p = 0.001) as independent risk factors for all-cause mortality. Degree of immunosuppression, rather than intrinsic CARV virulence, has the most significant impact on mortality in allo-SCT recipients with CARV-LRTD.
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Affiliation(s)
- Ariadna Pérez
- Department of Hematology. Hospital Clínico Universitario of Valencia, Spain. INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Dolores Gómez
- Microbiology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Juan Montoro
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Pedro Chorão
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Rafael Hernani
- Department of Hematology. Hospital Clínico Universitario of Valencia, Spain. INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Manuel Guerreiro
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Marta Villalba
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Eliseo Albert
- Microbiology Service, Hospital Clínico Universitario, Valencia, Spain
| | | | - Juan Carlos Hernández-Boluda
- Department of Hematology. Hospital Clínico Universitario of Valencia, Spain. INCLIVA Biomedical Research Institute, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, Valencia, Spain
- Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
| | - Carlos Solano
- Department of Hematology. Hospital Clínico Universitario of Valencia, Spain. INCLIVA Biomedical Research Institute, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - José Luis Piñana
- Department of Hematology. Hospital Clínico Universitario of Valencia, Spain. INCLIVA Biomedical Research Institute, Valencia, Spain.
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2
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Hernani R, Aiko M, Victorio R, Benzaquén A, Pérez A, Piñana JL, Hernández-Boluda JC, Amat P, Pastor-Galán I, Remigia MJ, Ferrer-Lores B, Micó M, Carbonell N, Ferreres J, Blasco-Cortés ML, Santonja JM, Dosdá R, Estellés R, Campos S, Martínez-Ciarpaglini C, Ferrández-Izquierdo A, Goterris R, Gómez M, Teruel A, Saus A, Ortiz A, Morello D, Martí E, Carretero C, Calabuig M, Tormo M, Terol MJ, Cases P, Solano C. EEG before chimeric antigen receptor T-cell therapy and early after onset of immune effector cell-associated neurotoxicity syndrome. Clin Neurophysiol 2024; 163:132-142. [PMID: 38733703 DOI: 10.1016/j.clinph.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 03/24/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Immune effector cell-associated neurotoxicity syndrome (ICANS) is common after chimeric antigen receptor T-cell (CAR-T) therapy. OBJECTIVE This study aimed to assess the impact of preinfusion electroencephalography (EEG) abnormalities and EEG findings at ICANS onset for predicting ICANS risk and severity in 56 adult patients with refractory lymphoma undergoing CAR-T therapy. STUDY DESIGN EEGs were conducted at the time of lymphodepleting chemotherapy and shortly after onset of ICANS. RESULTS Twenty-eight (50%) patients developed ICANS at a median time of 6 days after CAR-T infusion. Abnormal preinfusion EEG was identified as a risk factor for severe ICANS (50% vs. 17%, P = 0.036). Following ICANS onset, EEG abnormalities were detected in 89% of patients [encephalopathy (n = 19, 70%) and/or interictal epileptiform discharges (IEDs) (n = 14, 52%)]. Importantly, IEDs seemed to be associated with rapid progression to higher grades of ICANS within 24 h. CONCLUSIONS If confirmed in a large cohort of patients, these findings could establish the basis for modifying current management guidelines, enabling the identification of patients at risk of neurotoxicity, and providing support for preemptive corticosteroid use in patients with both initial grade 1 ICANS and IEDs at neurotoxicity onset, who are at risk of neurological impairment.
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Affiliation(s)
- Rafael Hernani
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
| | - Mika Aiko
- Neurophysiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Ruth Victorio
- Neurophysiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Ana Benzaquén
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Ariadna Pérez
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - José Luis Piñana
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Juan Carlos Hernández-Boluda
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Paula Amat
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Irene Pastor-Galán
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - María José Remigia
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Blanca Ferrer-Lores
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Mireia Micó
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Nieves Carbonell
- Intensive Care Unit, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - José Ferreres
- Intensive Care Unit, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | | | - José Miguel Santonja
- Neurology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Rosa Dosdá
- Radiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Rocío Estellés
- Radiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Salvador Campos
- Radiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | | | | | - Rosa Goterris
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Montse Gómez
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Anabel Teruel
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Ana Saus
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Alfonso Ortiz
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Daniela Morello
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Edel Martí
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Carlos Carretero
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Marisa Calabuig
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Mar Tormo
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - María José Terol
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Paula Cases
- Neurophysiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Carlos Solano
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
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Pérez A, Montoro J, Chorão P, Gómez D, Guerreiro M, Giménez E, Villalba M, Sanz J, Hernani R, Hernández-Boluda JC, Lorenzo I, Navarro D, Solano C, Ljungman P, Piñana JL. Outcome of Human Parainfluenza Virus infection in allogeneic stem cell transplantation recipients: possible impact of ribavirin therapy. Infection 2024:10.1007/s15010-024-02213-0. [PMID: 38653955 DOI: 10.1007/s15010-024-02213-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/08/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND This retrospective study focused on analyzing community-acquired respiratory virus (CARV) infections, in particular human parainfluenza virus (hPIV) after allogeneic stem cell transplant (allo-SCT) in adults recipients. It aimed to assess the impact of ribavirin treatment, clinical characteristics, and risk factors associated with lower respiratory tract disease (LRTD) progression and all-cause mortality. PATIENTS AND METHODS The study included 230 allo-SCT recipients diagnosed with hPIV between December 2013 and June 2023. Risk factors for the development of LRTD, disease severity, and mortality were analyzed. Ribavirin treatment was administered at physician discretion in 61 out of 230 cases (27%). RESULTS Risk factors for LRTD progression in multivariate analysis were corticosteroids > 30 mg/day (Odds ratio (OR) 3.5, 95% Confidence Interval (C.I.) 1.3-9.4, p = 0.013), fever at the time of hPIV detection (OR 3.89, 95% C.I. 1.84-8.2, p < 0.001), and absolute lymphocyte count (ALC) < 0.2 × 109/L (OR 4.1, 95% C.I. 1.42-11.9, p = 0.009). In addition, the study found that ribavirin therapy significantly reduced progression to LRTD [OR 0.19, 95% C.I. 0.05-0.75, p = 0.018]. Co-infections (OR 5.7, 95% C.I. 1.4-23.5, p = 0.015) and ALC < 0.2 × 109/L (OR 17.7, 95% C.I. 3.6-87.1, p < 0.001) were independently associated with higher day + 100 after hPIV detection all-cause mortality. There were no significant differences in all-cause mortality and infectious mortality at day + 100 between the treated and untreated groups. CONCLUSION ALC, corticosteroids, and fever increased the risk for progression to LRTD while ribavirin decreased the risk. However, mortality was associated with ALC and co-infections. This study supports further research of ribavirin therapy for hPIV in the allo-HSCT setting.
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Affiliation(s)
- Ariadna Pérez
- Department of Hematology, Hospital Clínico Universitario of Valencia, Spain. INCLIVA, Biomedical Research Institute, Valencia, Spain
| | - Juan Montoro
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Pedro Chorão
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Dolores Gómez
- Microbiology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Manuel Guerreiro
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Estela Giménez
- Microbiology Service, Hospital Clínico Universitario, Valencia, Spain
| | - Marta Villalba
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Jaime Sanz
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Rafael Hernani
- Department of Hematology, Hospital Clínico Universitario of Valencia, Spain. INCLIVA, Biomedical Research Institute, Valencia, Spain
| | - Juan Carlos Hernández-Boluda
- Department of Hematology, Hospital Clínico Universitario of Valencia, Spain. INCLIVA, Biomedical Research Institute, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Ignacio Lorenzo
- Hematology Division, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, Valencia, Spain
- Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
| | - Carlos Solano
- Department of Hematology, Hospital Clínico Universitario of Valencia, Spain. INCLIVA, Biomedical Research Institute, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Per Ljungman
- Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Karolinska Institutet (KI), Huddinge, Sweden
| | - José Luis Piñana
- Department of Hematology, Hospital Clínico Universitario of Valencia, Spain. INCLIVA, Biomedical Research Institute, Valencia, Spain.
- Division of Clinical Hematology, Hospital Clinico Universitario de Valencia, Avda. Blasco Ibañez, N 17, 46010, Valencia, Spain.
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4
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Ramasco F, Aguilar G, Aldecoa C, Bakker J, Carmona P, Dominguez D, Galiana M, Hernández G, Kattan E, Olea C, Ospina-Tascón G, Pérez A, Ramos K, Ramos S, Tamayo G, Tuero G. Towards the personalization of septic shock resuscitation: the fundamentals of ANDROMEDA-SHOCK-2 trial. Rev Esp Anestesiol Reanim (Engl Ed) 2024; 71:112-124. [PMID: 38244774 DOI: 10.1016/j.redare.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/04/2023] [Indexed: 01/22/2024]
Abstract
Septic shock is a highly lethal and prevalent disease. Progressive circulatory dysfunction leads to tissue hypoperfusion and hypoxia, eventually evolving to multiorgan dysfunction and death. Prompt resuscitation may revert these pathogenic mechanisms, restoring oxygen delivery and organ function. High heterogeneity exists among the determinants of circulatory dysfunction in septic shock, and current algorithms provide a stepwise and standardized approach to conduct resuscitation. This review provides the pathophysiological and clinical rationale behind ANDROMEDA-SHOCK-2, an ongoing multicenter randomized controlled trial that aims to compare a personalized resuscitation strategy based on clinical phenotyping and peripheral perfusion assessment, versus standard of care, in early septic shock resuscitation.
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Affiliation(s)
- F Ramasco
- Hospital Universitario de La Princesa, Madrid, Spain.
| | - G Aguilar
- Hospital Clínico Universitario de Valencia, Spain
| | - C Aldecoa
- Hospital Universitario Río Hortega, Valladolid, Spain
| | - J Bakker
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile; The Latin American Intensive Care Network (LIVEN); Department of Intensive Care, Erasmus MC University Medical Center, Rotterdam, Netherlands; Division of Pulmonary Critical Care, and Sleep Medicine, New York University and Columbia University, New York, USA
| | - P Carmona
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - D Dominguez
- Hospital Universitario Ntra. Sra. de Candelaria, Santa Cruz de Tenerife, Spain
| | - M Galiana
- Hospital General Universitario Doctor Balmis, Alicante, Spain
| | - G Hernández
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile; The Latin American Intensive Care Network (LIVEN)
| | - E Kattan
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile; The Latin American Intensive Care Network (LIVEN)
| | - C Olea
- Hospital Universitario 12 de Octubre, Madrid. Spain
| | - G Ospina-Tascón
- The Latin American Intensive Care Network (LIVEN); Department of Intensive Care, Fundación Valle del Lili, Cali, Colombia; Translational Research Laboratory in Critical Care Medicine (TransLab-CCM), Universidad Icesi, Cali, Colombia
| | - A Pérez
- Hospital General Universitario de Elche, Spain
| | - K Ramos
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile; The Latin American Intensive Care Network (LIVEN)
| | - S Ramos
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - G Tamayo
- Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain
| | - G Tuero
- Hospital Can Misses, Ibiza, Spain
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5
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Benzaquén A, Giménez E, Iacoboni G, Guerreiro M, Hernani R, Albert E, Carpio C, Balaguer A, Pérez A, S de la Asunción C, Sánchez-Salinas MA, Chorão P, Piñana JL, Beas F, Montoro J, Hernández-Boluda JC, Facal A, Ferrer B, Villalba M, Amat P, Goméz MD, Campos D, Terol MJ, Sanz J, Barba P, Navarro D, Solano C. Torque Teno Virus plasma DNA load: a novel prognostic biomarker in CAR-T therapy. Bone Marrow Transplant 2024; 59:93-100. [PMID: 37919456 DOI: 10.1038/s41409-023-02114-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/31/2023] [Accepted: 09/20/2023] [Indexed: 11/04/2023]
Abstract
Torque Teno Virus (TTV) is a single-stranded circular DNA virus which has been identified as a surrogate marker of immune competence in transplantation. In this study we investigated the dynamics of plasma TTV DNAemia in 79 adult patients undergoing chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory large B-cell lymphoma, also evaluating the impact of TTV on immunotoxicities, response and survival outcomes. After lymphodepleting therapy, TTV DNA load was found to decrease slightly until reaching nadir around day 10, after which it increased steadily until reaching maximum load around day 90. TTV DNA load < 4.05 log10 copies/ml at immune effector cell-associated neurotoxicity syndrome (ICANS) onset identified patients at risk of progressing to severe forms of ICANS (OR 16.68, P = 0.048). Finally, patients who experienced falling or stable TTV DNA load between lymphodepletion and CAR-T infusion had better progression-free survival than those with ascending TTV DNA load (HR 0.31, P = 0.006). These findings suggest that TTV monitoring could serve as a surrogate marker of immune competence, enabling predictions of CAR-T efficacy and toxicity. This could pave the way for the development of TTV-guided therapeutic strategies that modulate clinical patient management based on plasma TTV load, similar to suggested strategies in solid organ transplant recipients.
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Affiliation(s)
- Ana Benzaquén
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Estela Giménez
- Microbiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Gloria Iacoboni
- Haematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Manuel Guerreiro
- Haematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Rafael Hernani
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Eliseo Albert
- Microbiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Cecilia Carpio
- Haematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Aitana Balaguer
- Haematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Ariadna Pérez
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Carlos S de la Asunción
- Microbiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | | | - Pedro Chorão
- Haematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - José Luis Piñana
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Francisco Beas
- Haematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Juan Montoro
- Haematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Juan Carlos Hernández-Boluda
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Ana Facal
- Haematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Blanca Ferrer
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Marta Villalba
- Haematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Paula Amat
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - María Dolores Goméz
- Microbiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Diana Campos
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - María José Terol
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Jaime Sanz
- Haematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Pere Barba
- Haematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.
| | - David Navarro
- Microbiology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
- Department of Microbiology, University of Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Carlos Solano
- Haematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
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6
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Gato E, Rodiño-Janeiro BK, Gude MJ, Fernández-Cuenca F, Pascual Á, Fernández A, Pérez A, Bou G. Diagnostic tool for surveillance, detection and monitoring of the high-risk clone K. pneumoniae ST15. J Hosp Infect 2023; 142:18-25. [PMID: 37802237 DOI: 10.1016/j.jhin.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND The global spread of Klebsiella pneumoniae ST15, causing multi-continental outbreaks, contributes to the movement of resistance genes between clones increasing the antimicrobial resistance crisis. The genomic traits providing it with the ability to outcompete other bacteria and cause epidemics remain unclear. AIM To identify the specific genomic traits of K. pneumoniae ST15 to develop a diagnostic test. METHODS An outbreak caused by K. pneumoniae occurred in Hospital A Coruña, Spain. Antimicrobial susceptibility analysis and molecular typing (PGFE and MLST) were performed. One isolate of each sequence type was selected for whole-genome sequencing analysis. Comparative analysis of genomes was performed using RAST. BLASTn was used to evaluate the presence of the fhaC and kpiD genes. Two hundred and ninety-four K. pneumoniae from a Spanish nationwide collection were analysed by PCR. FINDINGS Genotyping showed that 87.5% of the isolates tested belonged to a clone with a unique PFGE pattern which corresponded to ST15. Comparative genomic analysis of the different STs enabled us to determine the specific genomic traits of K. pneumoniae ST15. Two adherence-related systems (Kpi and KpFhaB/FhaC) were specific markers of this clone. Multiplex-PCR analysis with kpiD and fhaC oligonucleotides revealed that K. pneumoniae ST15 is specifically detected with a sensitivity of 100% and a specificity of 97.76%. The PCR results showed 100% concordance with the MLST and whole-genome sequencing data. CONCLUSION K. pneumoniae ST15 possesses specific genomic traits that could favour its dissemination. They could be used as targets to detect K. pneumoniae ST15 with high sensitivity and specificity.
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Affiliation(s)
- E Gato
- Institute for Biomedical Research of A Coruña (INIBIC), A Coruña, Spain; Carlos III Health Institute (ISCIII), Madrid, Spain
| | | | - M J Gude
- University Hospital Lucus Augusti (HULA), Lugo, Spain
| | - F Fernández-Cuenca
- University Hospital Virgen Macarena, Seville, Spain; Institute of Biomedicine of Sevilla, Seville, Spain; University of Sevilla, Seville, Spain
| | - Á Pascual
- University Hospital Virgen Macarena, Seville, Spain; Institute of Biomedicine of Sevilla, Seville, Spain; University of Sevilla, Seville, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - A Fernández
- University Hospital of A Coruña (HUAC), A Coruña, Spain
| | - A Pérez
- Institute for Biomedical Research of A Coruña (INIBIC), A Coruña, Spain; Carlos III Health Institute (ISCIII), Madrid, Spain.
| | - G Bou
- University Hospital of A Coruña (HUAC), A Coruña, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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7
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Piñana JL, Pérez A, Chorão P, Guerreiro M, García-Cadenas I, Solano C, Martino R, Navarro D. Respiratory virus infections after allogeneic stem cell transplantation: Current understanding, knowledge gaps, and recent advances. Transpl Infect Dis 2023; 25 Suppl 1:e14117. [PMID: 37585370 DOI: 10.1111/tid.14117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023]
Abstract
Before the COVID-19 pandemic, common community-acquired seasonal respiratory viruses (CARVs) were a significant threat to the health and well-being of allogeneic hematopoietic cell transplant (allo-HCT) recipients, often resulting in severe illness and even death. The pandemic has further highlighted the significant risk that immunosuppressed patients, including allo-HCT recipients, face when infected with SARS-CoV-2. As preventive transmission measures are relaxed and CARVs circulate again among the community, including in allo-HSCT recipients, it is crucial to understand the current state of knowledge, gaps, and recent advances regarding CARV infection in allo-HCT recipients. Urgent research is needed to identify seasonal respiratory viruses as potential drivers for future pandemics.
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Affiliation(s)
- Jose L Piñana
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Ariadna Pérez
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Pedro Chorão
- Hematology Division, Hospital universitario y politécnico La Fe, Valencia, Spain
- Instituto de Investigación La Fe, Hospital Universitário y Politécncio La Fe, Valencia, Spain
| | - Manuel Guerreiro
- Hematology Division, Hospital universitario y politécnico La Fe, Valencia, Spain
- Instituto de Investigación La Fe, Hospital Universitário y Politécncio La Fe, Valencia, Spain
| | | | - Carlos Solano
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Rodrigo Martino
- Hematology Division, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - David Navarro
- Microbiology department, Hospital Clinico Universitario de Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
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8
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Forqué L, Albert E, Piñana JL, Pérez A, Hernani R, Solano C, Navarro D, Giménez E. Monitoring of plasma Torque teno virus, total Anelloviridae and Human Pegivirus 1 viral load for the prediction of infectious events and acute graft versus host disease in the allogeneic hematopoietic stem cell transplantation setting. J Med Virol 2023; 95:e29107. [PMID: 37721473 DOI: 10.1002/jmv.29107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023]
Abstract
Anelloviridae and Human Pegivirus 1 (HPgV-1) blood burden have been postulated to behave as surrogate markers for immunosuppression in transplant recipients. Here, we assessed the potential utility plasma Torque teno virus (TTV), total Anelloviridae (TAV), and HPgV-1 load monitoring for the identification of allogeneic hematopoietic stem cell transplantation recipients (allo-HSCT) at increased risk of infectious events or acute graft versus host disease (aGvHD). In this single-center, observational study, plasma TTV DNA, TAV DNA, and HPgV-1 RNA loads were monitored in 75 nonconsecutive allo-HSCT recipients (median age, 54 years). Monitoring was conducted before at baseline or by days +30, +60, +90, +120, and +180 after transplantation. Pneumonia due to different viruses or Pneumocystis jirovecii, BK polyomavirus-associated haemorrhagic cystitis (BKPyV-HC), and Cytomegalovirus DNAemia were the infectious events considered in the current study. Kinetics of plasma TTV, TAV DNA, and HPgV-1 RNA load was comparable, with though and peak levels measured by days +30 and day +90 (+120 for HPgV-1). Forty patients (53%) developed one or more infectious events during the first 180 days after allo-HSCT, whereas 29 patients (39%) had aGvHD (grade II-IV in 18). Neither, TTV, TAV, nor HPgV-1 loads were predictive of overall infection or CMV DNAemia. A TTV DNA load cut-off ≥4.40 log10 (pretransplant) and ≥4.58 log10 (baseline) copies/mL predicted the occurrence of BKPyV-HC (sensitivity ≥89%, negative predictive value, ≥96%). TTV DNA loads ≥3.38 log10 by day +30 anticipated the occurrence of aGvHD (sensitivity, 90%; negative predictive value, 97%). Pretransplant HPgV-1 loads were significantly lower (p = 0.03) in patients who had aGvHD than in those who did not. Monitoring of TTV DNA or HPgV-1 RNA plasma levels either before or early after transplantation may be ancillary to identify allo-HSCT recipients at increased risk of BKPyV-HC or aGvHD.
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Affiliation(s)
- Lorena Forqué
- Microbiology Service, Clinic University Hospital, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Eliseo Albert
- Microbiology Service, Clinic University Hospital, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - José L Piñana
- Hematology Service, Clinic University Hospital, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Ariadna Pérez
- Hematology Service, Clinic University Hospital, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Rafael Hernani
- Hematology Service, Clinic University Hospital, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Carlos Solano
- Hematology Service, Clinic University Hospital, INCLIVA Biomedical Research Institute, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - David Navarro
- Microbiology Service, Clinic University Hospital, INCLIVA Biomedical Research Institute, Valencia, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
| | - Estela Giménez
- Microbiology Service, Clinic University Hospital, INCLIVA Biomedical Research Institute, Valencia, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
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9
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Ripollés-Melchor J, Colomina MJ, Aldecoa C, Alonso-Cabello J, Alonso-Íñigo JM, Aya H, Basora M, Clau-Terre F, Del Cojo-Peces E, Cota-Delgado F, Ferrandis-Comes R, Galán-Menéndez P, García-López D, Garruti I, López IJ, Jover-Pinillos JL, Llau-Pitarch JV, Lorente JV, Mesquida J, Mojarro I, Monge-García MI, Montesinos-Fadrique SC, Muñoz-Rodes JL, de Nadal M, Ramasco F, Tomé-Roca JL, Pérez A, Uña-Orejón R, Yanes G, Zorrilla-Vaca A, Escarraman D, García-Fernández J. Research priorities in perioperative fluid therapy and hemodynamic monitoring: A Delphi Consensus Survey from the Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section (SHTF) of the Spanish Society of Anesthesiology and Critical Care (SEDAR). Rev Esp Anestesiol Reanim (Engl Ed) 2023; 70:319-326. [PMID: 37279834 DOI: 10.1016/j.redare.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/23/2022] [Indexed: 06/08/2023]
Abstract
BACKGROUND Research in fluid therapy and perioperative hemodynamic monitoring is difficult and expensive. The objectives of this study were to summarize these topics and to prioritize these topics in order of research importance. METHODS Electronic structured Delphi questionnaire over three rounds among 30 experts in fluid therapy and hemodynamic monitoring identified through the Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section of the Spanish Society of Anesthesiology and Critical Care. RESULTS 77 topics were identified and ranked in order of prioritization. Topics were categorized into themes of crystalloids, colloids, hemodynamic monitoring and others. 31 topics were ranked as essential research priority. To determine whether intraoperative hemodynamic optimization algorithms based on the invasive or noninvasive Hypotension Prediction Index versus other management strategies could decrease the incidence of postoperative complications. As well as whether the use of renal stress biomarkers together with a goal-directed fluid therapy protocol could reduce hospital stay and the incidence of acute kidney injury in adult patients undergoing non-cardiac surgery, reached the highest consensus. CONCLUSIONS The Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section of the Spanish Society of Anesthesiology and Critical Care will use these results to carry out the research.
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Affiliation(s)
- J Ripollés-Melchor
- Hospital Universitario Infanta Leonor, Madrid, Spain; Spanish Perioperative Audit and Research Network (ReDGERM), Spain; Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain.
| | - M J Colomina
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain; Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain; Universidad de Barcelona, Barcelona, Spain
| | - C Aldecoa
- Spanish Perioperative Audit and Research Network (ReDGERM), Spain; Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain; Hospital Universitario Río Hortega, Valladolid, Spain
| | | | | | - H Aya
- St George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - M Basora
- Hospital Clínico de Barcelona, Barcelona, Spain
| | - F Clau-Terre
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain; Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - E Del Cojo-Peces
- Hospital Área de Salud Don Benito y Villanueva, Don Benito, Badajoz, Spain
| | - F Cota-Delgado
- Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | | | | | - D García-López
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - I Garruti
- Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - I J López
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - J L Jover-Pinillos
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain; Hospital Universitario Virgen de los Lirios, Alcoy, Alicante, Spain
| | | | - J V Lorente
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain; Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | - J Mesquida
- Parc Taulí Hospital Universitari, Sabadell, Barcelona, Spain
| | - I Mojarro
- Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | - M I Monge-García
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain; Hospital Universitario Jerez de la Frontera, Jerez de la Frontera, Cádiz, Spain
| | - S C Montesinos-Fadrique
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain; Independent Researcher, Córdoba, Spain
| | | | - M de Nadal
- Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - F Ramasco
- Hospital Universitario La Princesa, Madrid, Spain
| | - J L Tomé-Roca
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - A Pérez
- Hospital Universitario de Elche, Elche, Alicante, Spain
| | | | - G Yanes
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain; Hospital Universitario Virgen de los Lirios, Alcoy, Alicante, Spain
| | - A Zorrilla-Vaca
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain; Brigham and Women's Hospital, Boston, United States
| | - D Escarraman
- Centro Médico Nacional La Raza, Mexico City, Mexico
| | - J García-Fernández
- Fluid Therapy and Hemodynamic Monitoring Group of the Spanish Society of Anaesthesiology and Critical Care (SEDAR), Spain; Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
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10
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Solano de la Asunción C, Hernani R, Albert E, Gómez MD, Giménez E, Benzaquén A, González-Barberá EM, Hernández-Boluda JC, Pérez A, Piñana JL, Chorao P, Guerreiro M, Montoro J, Sanz J, Solano C, Navarro D. Cytomegalovirus DNAemia in hematological patients undergoing CD19-directed CAR-T cell therapy: should it be systematically monitored? Clin Microbiol Infect 2023:S1198-743X(23)00234-3. [PMID: 37182642 DOI: 10.1016/j.cmi.2023.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/16/2023] [Accepted: 05/06/2023] [Indexed: 05/16/2023]
Affiliation(s)
| | - Rafael Hernani
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Eliseo Albert
- Microbiology Service,Hospital Clínico Universitario,INCLIVA Health Research Institute,Valencia,Spain
| | - María Dolores Gómez
- Microbiology Service,Hospital Universitario y Politécnico "La Fe",Valencia,Spain
| | - Estela Giménez
- Microbiology Service,Hospital Clínico Universitario,INCLIVA Health Research Institute,Valencia,Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Benzaquén
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | | | - Juan Carlos Hernández-Boluda
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain; Department of Medicine,School of Medicine,University of Valencia,Valencia,Spain
| | - Ariadna Pérez
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - José Luis Piñana
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Pedro Chorao
- Hematology Service, Hospital Universitario y Politécnico "La Fe", Valencia, Spain
| | - Manuel Guerreiro
- Hematology Service, Hospital Universitario y Politécnico "La Fe", Valencia, Spain
| | - Juan Montoro
- Hematology Service, Hospital Universitario y Politécnico "La Fe", Valencia, Spain
| | - Jaime Sanz
- Hematology Service, Hospital Universitario y Politécnico "La Fe", Valencia, Spain
| | - Carlos Solano
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain; Department of Medicine,School of Medicine,University of Valencia,Valencia,Spain
| | - David Navarro
- Microbiology Service,Hospital Clínico Universitario,INCLIVA Health Research Institute,Valencia,Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Department of Microbiology,School of Medicine,University of Valencia,Valencia,Spain.
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11
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Bazán-Díaz L, Pérez A, Bogireddy NKR, Velázquez-Salazar JJ, Betancourt I, José-Yacamán M, Herrera-Becerra R, Mendoza-Cruz R. PDDA induced step-pyramidal growth of nickel-platinum (Ni-Pt) nanoparticles for enhanced 4-nitrophenol reduction. Chem Commun (Camb) 2023. [PMID: 37157896 DOI: 10.1039/d3cc00791j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Herein, we report the synthesis of novel platinum-based nanoparticles with step-pyramidal growth induced by poly(diallyldimethylammonium chloride) (PDDA). The complex stepped pyramidal shape became the central point for outstanding catalytic reduction of 4-nitrophenol, overcoming the activity of bare Pt nanoparticles. These results are valuable for the catalytic degradation of reactive molecules.
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Affiliation(s)
- Lourdes Bazán-Díaz
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México (UNAM), Circuito Exterior, Ciudad Universitaria, Ciudad de Mexico, 04510, Mexico.
| | - Ariadna Pérez
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México (UNAM), Circuito Exterior, Ciudad Universitaria, Ciudad de Mexico, 04510, Mexico.
| | - Naveen Kumar Reddy Bogireddy
- Instituto de Física, Universidad Nacional Autónoma de México (UNAM), Circuito de la Investigación Científica, Ciudad Universitaria, Ciudad de Mexico, 04510, Mexico
| | - J Jesús Velázquez-Salazar
- Applied Physics and Materials Science Department and Center for Material Interfaces Research and Applications (MIRA), Northern Arizona University, Flagstaff, AZ, 86011, USA
| | - Israel Betancourt
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México (UNAM), Circuito Exterior, Ciudad Universitaria, Ciudad de Mexico, 04510, Mexico.
| | - Miguel José-Yacamán
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México (UNAM), Circuito Exterior, Ciudad Universitaria, Ciudad de Mexico, 04510, Mexico.
- Applied Physics and Materials Science Department and Center for Material Interfaces Research and Applications (MIRA), Northern Arizona University, Flagstaff, AZ, 86011, USA
| | - Raúl Herrera-Becerra
- Instituto de Física, Universidad Nacional Autónoma de México (UNAM), Circuito de la Investigación Científica, Ciudad Universitaria, Ciudad de Mexico, 04510, Mexico
| | - Rubén Mendoza-Cruz
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México (UNAM), Circuito Exterior, Ciudad Universitaria, Ciudad de Mexico, 04510, Mexico.
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12
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Huntley D, Giménez E, Vázquez L, Pascual MJ, Amat P, Remigia MJ, Hernández-Boluda JC, García M, Gago B, Torres I, de la Asunción CS, Hernani R, Pérez A, Albert E, Piñana JL, Solano C, Navarro D. Impact of cytomegalovirus immunodominant HLA-I donor-recipient matching on the incidence and features of virus DNAemia and virus-specific T-cell immune reconstitution in unmanipulated haploidentical hematopoietic stem cell transplantation. Transpl Infect Dis 2023:e14065. [PMID: 37120821 DOI: 10.1111/tid.14065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/15/2023] [Accepted: 04/20/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND We investigated whether donor-recipient mismatch involving one or more cytomegalovirus (CMV) immunodominant (ID) human leukocyte antigen (HLA)-I alleles may impact on the degree of CMV pp65/immediate-early 1 (IE-1) T-cell reconstitution and the incidence of CMV DNAemia in patients undergoing unmanipulated haploidentical hematopoietic stem cell transplantation with high-dose posttransplant cyclophosphamide (PT/Cy-haplo). METHODS Multicenter observational study including 106 consecutive adult PT/Cy-haplo patients (34 CMV ID HLA-I matched and 72 mismatched). A real-time PCR was used for plasma CMV DNA load monitoring. Enumeration of CMV-specific (pp65/IE-1) interferon (IFN)-γ-producing T cells from several patients was performed by flow cytometry by days +30, +60, +90 and +180 after transplantation. RESULTS The cumulative incidence of CMV DNAemia, clinically significant CMV DNAemia episodes (cs-CMVi), and recurrent CMV DNAemia was comparable across CMV ID HLA-I matched and mismatched patients (71.8% vs. 80.9%, p = .95; 40.7% vs. 44.2%, p = .85; 16.4% vs. 28.1%; p = .43, respectively). The percentage of patients exhibiting detectable CMV-specific IFN-γ-producing T-cell responses (either CD8+ or CD4+ ) was similar across groups; nevertheless, significantly higher CMV-specific CD8+ T-cell counts were enumerated in the CMV ID HLA-I matched compared to mismatched patients by day +60 (p = .04) and +180 (p = .016) after transplantation. CONCLUSION CMV ID HLA-I matching may impact on the magnitude of CMV-pp65/IE-1-specific CD8+ T-cell reconstitution; yet, this effect seemed not to have an impact on the incidence of initial, recurrent CMV DNAemia, or cs-CMVi.
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Affiliation(s)
- Dixie Huntley
- Microbiology Service, INCLIVA Research Institute, Hospital Clínico Universitario, Valencia, Spain
| | - Estela Giménez
- Microbiology Service, INCLIVA Research Institute, Hospital Clínico Universitario, Valencia, Spain
| | - Lourdes Vázquez
- Hematology Service, Hospital Clínico Universitario, Salamanca, Spain
| | | | - Paula Amat
- Hematology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - María José Remigia
- Hematology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Juan Carlos Hernández-Boluda
- Hematology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Magdalena García
- Hematology Service, Hospital Clínico Universitario, Salamanca, Spain
| | - Beatriz Gago
- Hematology Service, Hospital Regional Universitario, Málaga, Spain
| | - Ignacio Torres
- Microbiology Service, INCLIVA Research Institute, Hospital Clínico Universitario, Valencia, Spain
| | | | - Rafael Hernani
- Hematology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Ariadna Pérez
- Hematology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Eliseo Albert
- Microbiology Service, INCLIVA Research Institute, Hospital Clínico Universitario, Valencia, Spain
| | - José Luis Piñana
- Hematology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Carlos Solano
- Hematology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - David Navarro
- Microbiology Service, INCLIVA Research Institute, Hospital Clínico Universitario, Valencia, Spain
- Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
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13
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Pérez-Huertas S, Calero M, Ligero A, Pérez A, Terpiłowski K, Martín-Lara MA. On the use of plastic precursors for preparation of activated carbons and their evaluation in CO 2 capture for biogas upgrading: a review. Waste Manag 2023; 161:116-141. [PMID: 36878040 DOI: 10.1016/j.wasman.2023.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
In circular economy, useful plastic materials are kept in circulation as opposed to being landfilled, incinerated, or leaked into the natural environment. Pyrolysis is a chemical recycling technique useful for unrecyclable plastic wastes that produce gas, liquid (oil), and solid (char) products. Although the pyrolysis technique has been extensively studied and there are several installations applying it on the industrial scale, no commercial applications for the solid product have been found yet. In this scenario, the use of plastic-based char for the biogas upgrading may be a sustainable way to transform the solid product of pyrolysis into a particularly beneficial material. This paper reviews the preparation and main parameters of the processes affecting the final textural properties of the plastic-based activated carbons. Moreover, the application of those materials for the CO2 capture in the processes of biogas upgrading is largely discussed.
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Affiliation(s)
- S Pérez-Huertas
- Department of Chemical Engineering, University of Granada, 18071 Granada, Spain.
| | - M Calero
- Department of Chemical Engineering, University of Granada, 18071 Granada, Spain.
| | - A Ligero
- Department of Chemical Engineering, University of Granada, 18071 Granada, Spain.
| | - A Pérez
- Department of Chemical Engineering, University of Granada, 18071 Granada, Spain.
| | - K Terpiłowski
- Department of Interfacial Phenomena, Maria Curie Skłodowska University, M. Curie Skłodowska Sq. 3, 20-031 Lublin, Poland.
| | - M A Martín-Lara
- Department of Chemical Engineering, University of Granada, 18071 Granada, Spain.
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14
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Piñana JL, Martino R, Vazquez L, López-Corral L, Pérez A, Chorão P, Avendaño-Pita A, Pascual MJ, Sánchez-Salinas A, Sanz-Linares G, Olave MT, Arroyo I, Tormo M, Villalon L, Conesa-Garcia V, Gago B, Terol MJ, Villalba M, Garcia-Gutierrez V, Cabero A, Hernández-Rivas JÁ, Ferrer E, García-Cadenas I, Teruel A, Navarro D, Cedillo Á, Sureda A, Solano C. SARS-CoV-2-reactive antibody waning, booster effect and breakthrough SARS-CoV-2 infection in hematopoietic stem cell transplant and cell therapy recipients at one year after vaccination. Bone Marrow Transplant 2023; 58:567-580. [PMID: 36854892 PMCID: PMC9974060 DOI: 10.1038/s41409-023-01946-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 03/02/2023]
Abstract
The kinetics of SARS-CoV-2 reactive IgG antibodies after full vaccination and booster in allogeneic and autologous stem cell transplantation (allo-HSCT, ASCT) and chimeric antigen receptor T-cell therapy (CAR-T) are of utmost importance for estimating risk of infection. A prospective multicenter registry-based cohort study, conducted from December 2020 to July 2022 was used to analyze antibody waning over time, booster effect and the relationship of antibody response and breakthrough infection in 572 recipients (429 allo-HSCT, 121 ASCT and 22 CAR-T cell therapy). A significant decline in antibody titers was observed at 3 and 6 months after full vaccination in recipients without pre-vaccine SARS-CoV-2 infection, whereas recipients infected prior to vaccination showed higher and stable antibody titers over time. In poor responders, a booster dose was able to increase antibody titers in 83% of allo-HSCT and 58% of ASCT recipients but not in CART-T cell recipients [0%] (p < 0.01). One-year cumulative incidence of breakthrough infection was 15%, similar among cell therapy procedures. Immunosuppressive drugs at the time of vaccination [hazard ratio (HR) 1.81, p = 0.0028] and reduced intensity conditioning (HR 0.49, p = 0.011) were identified as the only conditions associated with different risk of breakthrough infection in allo-HSCT recipients. Antibody titers were associated with breakthrough infection and disease severity. No death was observed among the 72 breakthrough infections. Antibody level decay after the first two vaccine doses was common except in recipients with pre-vaccination SARS-CoV-2 infection. Poorly responding allo-HSCT recipients showed a response advantage with the booster as compared to ASCT and, especially, the null response found in CAR-T cell recipients. Antibody titers were positively correlated with the risk of breakthrough SARS-CoV-2 infection which was mainly driven by the immunosuppression status.
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Affiliation(s)
- José Luis Piñana
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain. .,Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain.
| | - Rodrigo Martino
- grid.413396.a0000 0004 1768 8905Hematology Division, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lourdes Vazquez
- grid.411258.bHematology Department, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), 37007 Salamanca, Spain
| | - Lucia López-Corral
- grid.411258.bHematology Department, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), 37007 Salamanca, Spain
| | - Ariadna Pérez
- grid.411308.fHematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain ,grid.411308.fFundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Pedro Chorão
- grid.84393.350000 0001 0360 9602Hematology Division, Hospital universitario y politécnico La Fe, Valencia, Spain
| | - Alejandro Avendaño-Pita
- grid.411258.bHematology Department, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), 37007 Salamanca, Spain
| | - María-Jesús Pascual
- grid.411457.2Hematology Division, Hospital Regional Universitario Carlos Haya, Malaga, Spain
| | - Andrés Sánchez-Salinas
- grid.411372.20000 0001 0534 3000Hematology Division, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Gabriela Sanz-Linares
- grid.414660.1Hematology Division, Institut Català Oncologia-Hospital Duran i reynals, Barcelona, Spain
| | - María T. Olave
- grid.411050.10000 0004 1767 4212Hematology Division, Hospital Clínico Universitario Lozano Blesa, IIS Aragon, Zaragoza, Spain
| | - Ignacio Arroyo
- grid.411308.fHematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Mar Tormo
- grid.411308.fFundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Lucia Villalon
- grid.411316.00000 0004 1767 1089Hematology Division, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Venancio Conesa-Garcia
- grid.411093.e0000 0004 0399 7977Hematology Division, Hospital General universitari d’Elx, Elche, Spain
| | - Beatriz Gago
- grid.411457.2Hematology Division, Hospital Regional Universitario Carlos Haya, Malaga, Spain
| | - María-José Terol
- grid.411308.fHematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain ,grid.411308.fFundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Marta Villalba
- grid.84393.350000 0001 0360 9602Hematology Division, Hospital universitario y politécnico La Fe, Valencia, Spain
| | | | - Almudena Cabero
- grid.411258.bHematology Department, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), 37007 Salamanca, Spain
| | - José Ángel Hernández-Rivas
- grid.414761.1Hematology Division, Hospital Universitario Infanta Leonor. Department of Medicine. Complutense University, Madrid, Spain
| | - Elena Ferrer
- grid.411308.fHematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain ,grid.411308.fFundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Irene García-Cadenas
- grid.413396.a0000 0004 1768 8905Hematology Division, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Anabel Teruel
- grid.411308.fHematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain ,grid.411308.fFundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - David Navarro
- grid.411308.fFundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain ,grid.411308.fMicrobiology department, Hospital Clinico Universitario de Valencia, Valencia, Spain
| | - Ángel Cedillo
- Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH), Valencia, Spain
| | - Anna Sureda
- grid.414660.1Hematology Division, Institut Català Oncologia-Hospital Duran i reynals, Barcelona, Spain
| | - Carlos Solano
- grid.411308.fHematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain ,grid.411308.fFundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain ,grid.5338.d0000 0001 2173 938XDepartment of Medicine, School of Medicine. University of Valencia, Valencia, Spain
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15
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Falkenhain-López D, Muniesa C, Estrach MT, Morillo-Andújar M, Peñate Y, Acebo E, Pujol RM, García-Muret MP, Machan S, Medina S, Botella-Estrada R, Fernández de Misa R, Blanes M, Flórez A, Pérez-Paredes G, Izu R, Yanguas I, Silva-Díaz E, Pérez-Ferriols A, Prieto-Torres L, Zayas A, Parera-Amer ME, Pérez A, Aspe L, Román C, Sánchez-Caminero MP, Bassas-Vila J, Domínguez-Auñón JD, Calzado L, Navedo M, Ortiz-Prieto A, Servitje O, Polo-Rodríguez I, Torres I, Hernández-Hernández MN, Mitxelena-Eceiza J, García-Vázquez A, García-Doval I, Ortiz-Romero PL. [Translated article] Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV): Data for the First 5 Years. Actas Dermosifiliogr 2023; 114:T291-T298. [PMID: 36848951 DOI: 10.1016/j.ad.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/12/2022] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. PATIENTS AND METHODS RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. RESULTS Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+ lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). CONCLUSION The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data.
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Affiliation(s)
- D Falkenhain-López
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - C Muniesa
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M T Estrach
- Departamento de Dermatología, Hospital Clínico, IDIBAPS, Universitario de Barcelona, Barcelona, Spain
| | - M Morillo-Andújar
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, Spain
| | - Y Peñate
- Departamento de Dermatología, Complejo Hospitalario Universitario Insular Materno-Infantil, Gran Canaria, Spain
| | - E Acebo
- Departamento de Dermatología, Hospital Universitario de Cruces, Barakaldo, Bizkaia, Spain
| | - R M Pujol
- Departamento de Dermatología, Hospital del Mar, Barcelona, Spain
| | - M P García-Muret
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, UAB Barcelona, Barcelona, Spain
| | - S Machan
- Departamento de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - S Medina
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - R Botella-Estrada
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - R Fernández de Misa
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | - M Blanes
- Departamento de Dermatología, Hospital General Universitario de Alicante, Alicante, Spain
| | - A Flórez
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - G Pérez-Paredes
- Departamento de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander Cantabria, Spain
| | - R Izu
- Departamento de Dermatología, Hospital Universitario de Basurto, Bilbao, Bizkaia, Spain
| | - I Yanguas
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, Spain
| | - E Silva-Díaz
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - A Pérez-Ferriols
- Departamento de Dermatología, Hospital General Universitario de Valencia, Valencia, Spain
| | - L Prieto-Torres
- Departamento de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - A Zayas
- Departamento de Dermatología, Hospital Universitario Dr. Peset, Valencia, Spain
| | - M E Parera-Amer
- Departamento de Dermatología, Hospital Universitario Son Llàtzer, Palma, Islas Baleares, Spain
| | - A Pérez
- Departamento de Dermatología, Hospital Universitario Nuestra Señora De Valme, Sevilla, Spain
| | - L Aspe
- Departamento de Dermatología, Hospital Universitario de Araba, Vitoria-Gasteiz, Álava, Spain
| | - C Román
- Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - M P Sánchez-Caminero
- Departamento de Dermatología, Hospital General de Ciudad Real, Ciudad Real, Spain
| | - J Bassas-Vila
- Departamento de Dermatología, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - J D Domínguez-Auñón
- Departamento de Dermatología, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - L Calzado
- Departamento de Dermatología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - M Navedo
- Departamento de Dermatología, Complejo Asistencial Universitario de León, León, Spain
| | - A Ortiz-Prieto
- Departamento de Dermatología, Hospital Puerta del Mar, Cádiz, Spain
| | - O Servitje
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - I Polo-Rodríguez
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - I Torres
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - M N Hernández-Hernández
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | - J Mitxelena-Eceiza
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, Spain
| | - A García-Vázquez
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, León, Spain; Departamento de Dermatología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | - P L Ortiz-Romero
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
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16
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Giménez E, Guerreiro M, Torres I, Aguilar C, Albert E, Hernández-Boluda JC, Hernani R, Pérez A, Amat P, Piñana JL, Montoro J, Solano C, Navarro D. Features of cytomegalovirus DNAemia and virus-specific T-cell responses in allogeneic hematopoietic stem-cell transplant recipients during prophylaxis with letermovir. Transpl Infect Dis 2023; 25:e14021. [PMID: 36748748 DOI: 10.1111/tid.14021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND There is scarce information on the natural kinetics of cytomegalovirus (CMV) DNAemia and dynamics of CMV-specific T-cell reconstitution in allogeneic hematopoietic transplant recipients (allo-HSCT) undergoing letermovir (LMV) prophylaxis. METHODS Twelve adult CMV-seropositive high-risk recipients (median age, 53 years; 9 males/3 females) undergoing LMV prophylaxis and 13 non-LMV allo-HSCT controls (median age, 58 years; 7 males/6 females) were included. CMV DNAemia in plasma was monitored by real-time polymerase chain reaction. Preemptive antiviral therapy (PET) was administered upon detection of ≥1500 IU/ml. CMV-specific interferon-gamma (IFN-γ)-producing CD8+ and CD4+ T cells were enumerated by flow cytometry around days +30, +60, and +90 after allo-HSCT. Ex vivo experiments assessing of the potential effect of LMV on CMV-specific T-cell expansion in a single CMV-seropositive donor were also conducted. RESULTS Five LMV patients (41.6%) developed CMV DNAemia that cleared spontaneously. Four patients (33.3%) developed CMV DNAemia after LMV cessation, of which two required PET. Nine non-LMV patients (69.2%) developed CMV DNAemia (five required PET). The percentage of LMV and non-LMV patients exhibiting detectable CMV-specific T-cell responses was comparable (7/10 vs. 10/13; p = .71). Nevertheless, median CMV-specific CD4+ and CD8+ T-cell counts were lower in LMV patients by days +60 (p = .006 and .02, respectively) and +90 (p = .08 and .02). Ex vivo, CMV-specific CD8+ T cells expanded to the same level either in the presence (19.8%) or in the absence of LMV (20.6%). CONCLUSIONS In our series, episodes of CMV DNAemia in LMV patients cleared spontaneously. A diminished degree of CMV-specific T-cell reconstitution in LMV patients compared to non-LMV patients was observed.
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Affiliation(s)
- Estela Giménez
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Guerreiro
- Hematology Service, Hospital Universitario y Politécnico "La Fe", Valencia, Spain
| | - Ignacio Torres
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Cristobal Aguilar
- Hematology Service, Hospital Universitario y Politécnico "La Fe", Valencia, Spain
| | - Eliseo Albert
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Juan Carlos Hernández-Boluda
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Rafael Hernani
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Ariadna Pérez
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Paula Amat
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - José Luis Piñana
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain
| | - Juan Montoro
- Hematology Service, Hospital Universitario y Politécnico "La Fe", Valencia, Spain
| | - Carlos Solano
- Hematology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Health Research Institute, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.,Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
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17
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Abstract
Developing better treatments that work for the majority of patients with brain metastasis (BM) is highly necessary. Complementarily, avoiding those therapeutic procedures that will not benefit a specific patient is also very relevant. In general, existing therapies for patients with BM could be improved in terms of molecular stratification and therapeutic efficacy. By questioning the benefit of whole brain radiotherapy as provided nowadays and the lack of biomarkers detecting radioresistance, we identified S100A9 and receptor for advanced glycation end-products (RAGE) as a liquid biopsy biomarker and a potential target for a radiosensitizer, respectively. Both of them are being clinically tested as part of the first comprehensive molecular strategy to personalized radiotherapy in BM.
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Affiliation(s)
| | - J M Sepúlveda
- Neuro-Oncology Unit, Hospital Universitario 12 de Octubre, Madrid; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid.
| | - A Pérez
- Neuro-Oncology Unit, Hospital Universitario 12 de Octubre, Madrid; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid; Servicio de Neurocirugía, Hospital Universitario 12 de Octubre, Madrid; Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
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18
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Falkenhain-López D, Muniesa C, Estrach MT, Morillo-Andújar M, Peñate Y, Acebo E, Pujol RM, García-Muret MP, Machan S, Medina S, Botella-Estrada R, Fernández de Misa R, Blanes M, Flórez A, Pérez-Paredes G, Izu R, Yanguas I, Silva-Díaz E, Pérez-Ferriols A, Prieto-Torres L, Zayas A, Parera-Amer ME, Pérez A, Aspe L, Román C, Sánchez-Caminero MP, Bassas-Vila J, Domínguez-Auñón JD, Calzado L, Navedo M, Ortiz-Prieto A, Servitje O, Polo-Rodríguez I, Torres I, Hernández-Hernández MN, Mitxelena-Eceiza J, García-Vázquez A, García-Doval I, Ortiz-Romero PL. Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV): Data for the First 5 Years. Actas Dermosifiliogr 2022; 114:291-298. [PMID: 36529273 DOI: 10.1016/j.ad.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. PATIENTS AND METHODS RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. RESULTS Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). CONCLUSION The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data.
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Affiliation(s)
- D Falkenhain-López
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - C Muniesa
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - M T Estrach
- Departamento de Dermatología, Hospital Clínico, IDIBAPS, Universitario de Barcelona, Barcelona, España
| | - M Morillo-Andújar
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, España
| | - Y Peñate
- Departamento de Dermatología, Complejo Hospitalario Universitario Insular Materno-Infantil, Gran Canaria, España
| | - E Acebo
- Departamento de Dermatología, Hospital Universitario de Cruces, Barakaldo, Bizkaia, España
| | - R M Pujol
- Departamento de Dermatología, Hospital del Mar, Barcelona, España
| | - M P García-Muret
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, UAB Barcelona, Barcelona, España
| | - S Machan
- Departamento de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - S Medina
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, España
| | - R Botella-Estrada
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - R Fernández de Misa
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, España
| | - M Blanes
- Departamento de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - A Flórez
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | - G Pérez-Paredes
- Departamento de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander Cantabria, España
| | - R Izu
- Departamento de Dermatología, Hospital Universitario de Basurto, Bilbao, Bizkaia, España
| | - I Yanguas
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, España
| | - E Silva-Díaz
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - A Pérez-Ferriols
- Departamento de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - L Prieto-Torres
- Departamento de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - A Zayas
- Departamento de Dermatología, Hospital Universitario Dr. Peset, Valencia, España
| | - M E Parera-Amer
- Departamento de Dermatología, Hospital Universitario Son Llàtzer, Palma, Islas Baleares, España
| | - A Pérez
- Departamento de Dermatología, Hospital Universitario Nuestra Señora De Valme, Sevilla, España
| | - L Aspe
- Departamento de Dermatología, Hospital Universitario de Araba, Vitoria-Gasteiz, Álava, España
| | - C Román
- Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, España
| | - M P Sánchez-Caminero
- Departamento de Dermatología, Hospital General de Ciudad Real, Ciudad Real, España
| | - J Bassas-Vila
- Departamento de Dermatología, Hospital Germans Trias i Pujol, Barcelona, España
| | - J D Domínguez-Auñón
- Departamento de Dermatología, Hospital Universitario del Henares, Coslada, Madrid, España
| | - L Calzado
- Departamento de Dermatología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, España
| | - M Navedo
- Departamento de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - A Ortiz-Prieto
- Departamento de Dermatología, Hospital Puerta del Mar, Cádiz, España
| | - O Servitje
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - I Polo-Rodríguez
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, España
| | - I Torres
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - M N Hernández-Hernández
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, España
| | - J Mitxelena-Eceiza
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, España
| | - A García-Vázquez
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, León, España; Departamento de Dermatología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España
| | - P L Ortiz-Romero
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
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Uriarte-Gaspari L, Acuña A, Morales S, Fernández-Theoduloz G, Paz V, Pérez A, Cabana Á, Gradin V. Who do I want in my team: Social avoidance of high qualified partners in depression and social anxiety. Journal of Affective Disorders Reports 2022. [DOI: 10.1016/j.jadr.2022.100402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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20
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Pardo J, Ferrer C, Prieto C, Pérez A, Ramirez M, Rot M, Ruiz S, Vázquez V, Sánchez C, Suarez M, Vilanova J, Delgado J. The MARRTA Project: Safety and Risk Analysis in Radiation Oncology. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Gómez-Peralta F, Carrasco-Sánchez FJ, Pérez A, Escalada J, Álvarez-Guisasola F, Miranda-Fernández-Santos C, Mediavilla-Bravo JJ, Gómez-Huelgas R. Executive summary on the treatment of type 2 diabetes mellitus in elderly or frail individuals. 2022 update of the 2018 consensus document "Treatment of type 2 diabetes mellitus in the elderly". Rev Clin Esp 2022; 222:496-499. [PMID: 35753941 DOI: 10.1016/j.rceng.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/17/2022] [Indexed: 10/17/2022]
Abstract
The population with type 2 DM (DM2) is highly heterogeneous, representing an important challenge for healthcare professionals. The therapeutic choice should be individualized, considering the functional status, frailty, the occurrence of comorbidities, and the preferences of patients and their caregivers. New evidence on the cardiovascular and renal protection of specific therapeutic groups and on the usefulness of new technologies for DM2 management, among other aspects, warrant an update of the consensus document on the DM2 in the elderly that was published in 2018.
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Affiliation(s)
- F Gómez-Peralta
- Unidad de Endocrinología y Nutrición, Hospital General de Segovia, Segovia, Sociedad Española de Diabetes (SED), Spain
| | - F J Carrasco-Sánchez
- Servicio de Medicina Interna, Hospital Juan Ramón Jiménez, Huelva, Sociedad Española de Medicina Interna (SEMI), Spain
| | - A Pérez
- Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Universitat Autònoma de Barcelona y Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Sociedad Española de Diabetes (SED), Spain
| | - J Escalada
- Departamento de Endocrinología y Nutrición, Clínica Universidad de Navarra, Pamplona, España, Sociedad Española de Endocrinología y Nutrición (SEEN), CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - F Álvarez-Guisasola
- Centro de Salud Ribera del Órbigo, León, Grupo de trabajo de diabetes, Sociedad Española de Medicina de Familia y Comunitaria (semFYC), Spain
| | - C Miranda-Fernández-Santos
- Centro de Salud Buenavista Toledo, Toledo, Área Cardiovascular y Diabetes de la Sociedad Española de Médicos Generales y de Familia (SEMG), Spain
| | - J J Mediavilla-Bravo
- Centro de Salud Burgos Rural, Burgos, Sociedad Española de Médicos de Atención Primaria (SEMERGEN), Spain
| | - R Gómez-Huelgas
- Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), CIBER de Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Sociedad Española de Medicina Interna (SEMI), Spain.
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22
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Jayaraman S, Pérez A, Miñambres I, Quesada J, Gursky O. Heparin binding triggers VLDL remodeling by circulating lipoprotein lipase: Relevance to VLDL functionality in health and disease. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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23
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Lazzari L, Balaguer-Roselló A, Montoro J, Greco R, Hernani R, Lupo-Stanghellini MT, Villalba M, Giglio F, Facal A, Lorentino F, Guerreiro M, Bruno A, Pérez A, Xue E, Clerici D, Piemontese S, Piñana JL, Sanz MÁ, Solano C, de la Rubia J, Ciceri F, Peccatori J, Sanz J. Post-transplant cyclophosphamide and sirolimus based graft-versus-host disease prophylaxis after allogeneic stem cell transplantation for acute myeloid leukemia. Bone Marrow Transplant 2022; 57:1389-1398. [PMID: 35680995 PMCID: PMC9439951 DOI: 10.1038/s41409-022-01725-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/16/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022]
Abstract
Post-transplant cyclophosphamide (PTCy) has emerged as a promising graft-versus-host disease (GvHD) prophylaxis in allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, no studies have reported the efficacy of a GvHD prophylaxis based on PTCy with sirolimus (Sir-PTCy) in patients with acute myeloid leukemia (AML). In this retrospective study, we analyze the use of sirolimus in combination with PTCy, with or without mycophenolate mofetil (MMF), on 242 consecutive adult patients with AML undergoing a myeloablative first allo-HSCT from different donor types, in three European centers between January 2017 and December 2020. Seventy-seven (32%) patients received allo-HSCT from HLA-matched sibling donor, 101 (42%) from HLA-matched and mismatched unrelated donor, and 64 (26%) from haploidentical donor. Except for neutrophil and platelet engraftment, which was slower in the haploidentical cohort, no significant differences were observed in major transplant outcomes according to donor type in univariate and multivariate analysis. GvHD prophylaxis with Sir-PTCy, with or without MMF, is safe and effective in patients with AML undergoing myeloablative allo-HSCT, resulting in low rates of transplant-related mortality, relapse/progression, and acute and chronic GvHD in all donor settings.
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Affiliation(s)
- Lorenzo Lazzari
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milan, Italy.
| | | | - Juan Montoro
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Raffaella Greco
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Rafael Hernani
- Department of Hematology, Hospital Clínico Universitario, Valencia, Spain
| | | | - Marta Villalba
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Fabio Giglio
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Ana Facal
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Francesca Lorentino
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Manuel Guerreiro
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Alessandro Bruno
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Ariadna Pérez
- Department of Hematology, Hospital Clínico Universitario, Valencia, Spain
| | - Elisabetta Xue
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Daniela Clerici
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Simona Piemontese
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - José Luis Piñana
- Department of Hematology, Hospital Clínico Universitario, Valencia, Spain
| | - Miguel Ángel Sanz
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Carlos Solano
- Department of Hematology, Hospital Clínico Universitario, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Javier de la Rubia
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Jacopo Peccatori
- Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Jaime Sanz
- Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
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24
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Piñana JL, López-Corral L, Martino R, Vazquez L, Pérez A, Martin-Martin G, Gago B, Sanz-Linares G, Sanchez-Salinas A, Villalon L, Conesa-Garcia V, Olave MT, Corona M, Marcos-Corrales S, Tormo M, Hernández-Rivas JÁ, Montoro J, Rodriguez-Fernandez A, Risco-Gálvez I, Rodríguez-Belenguer P, Hernandez-Boluda JC, García-Cadenas I, Ruiz-García M, Muñoz-Bellido JL, Solano C, Cedillo Á, Sureda A, Navarro D. SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders. J Hematol Oncol 2022; 15:54. [PMID: 35526045 PMCID: PMC9077637 DOI: 10.1186/s13045-022-01275-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/25/2022] [Indexed: 12/24/2022] Open
Abstract
Background The clinical efficacy of SARS-CoV-2 vaccines according to antibody response in immunosuppressed patients such as hematological patients has not yet been established. Patients and methods A prospective multicenter registry-based cohort study conducted from December 2020 to December 2021 by the Spanish transplant and cell therapy group was used to analyze the relationship of antibody response at 3–6 weeks after full vaccination (2 doses) with breakthrough SARS-CoV-2 infection in 1394 patients with hematological disorders. Results At a median follow-up of 165 days after complete immunization, 37 out of 1394 (2.6%) developed breakthrough SARS-CoV-2 infection at median of 77 days (range 7–195) after full vaccination. The incidence rate was 6.39 per 100 persons-year. Most patients were asymptomatic (19/37, 51.4%), whereas only 19% developed pneumonia. The mortality rate was 8%. Lack of detectable antibodies at 3–6 weeks after full vaccination was the only variable associated with breakthrough infection in multivariate logistic regression analysis (Odds Ratio 2.35, 95% confidence interval 1.2–4.6, p = 0.012). Median antibody titers were lower in cases than in non-cases [1.83 binding antibody units (BAU)/mL (range 0–4854.93) vs 730.81 BAU/mL (range 0–56,800), respectively (p = 0.007)]. We identified 250 BAU/mL as a cutoff above which incidence and severity of the infection were significantly lower. Conclusions Our study highlights the benefit of developing an antibody response in these highly immunosuppressed patients. Level of antibody titers at 3 to 6 weeks after 2-dose vaccination links with protection against both breakthrough infection and severe disease for non-Omicron SARS-CoV-2 variants. Supplementary Information The online version contains supplementary material available at 10.1186/s13045-022-01275-7.
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Affiliation(s)
- José Luis Piñana
- Division of Clinical Hematology, Hematology Department, Hospital Clínico Universitario de Valencia, Avda Blasco Ibañez, 17, 46010, Valencia, Spain. .,Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain.
| | - Lucia López-Corral
- Hematology Division, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Rodrigo Martino
- Hematology Division, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lourdes Vazquez
- Hematology Division, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Ariadna Pérez
- Division of Clinical Hematology, Hematology Department, Hospital Clínico Universitario de Valencia, Avda Blasco Ibañez, 17, 46010, Valencia, Spain.,Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - Beatriz Gago
- Hematology Division, Hospital Regional Universitario Carlos Haya, Malaga, Spain
| | - Gabriela Sanz-Linares
- Hematology Division, Institut Català Oncologia-Hospital Duran i Reynals, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Andrés Sanchez-Salinas
- Hematology Division, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Lucia Villalon
- Hematology Division, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - María T Olave
- Hematology Division, Hospital Clínico Universitario Lozano Blesa, IIS Aragon, Saragossa, Spain
| | | | | | - Mar Tormo
- Division of Clinical Hematology, Hematology Department, Hospital Clínico Universitario de Valencia, Avda Blasco Ibañez, 17, 46010, Valencia, Spain.,Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - Juan Montoro
- Hematology Division, Hospital universitario y politécnico La Fe, Valencia, Spain
| | | | | | - Pablo Rodríguez-Belenguer
- Research Program on Biomedical Informatics (GRIB), Department of Experimental and Health Sciences, Hospital del Mar Medical Research Institute (IMIM), Universitat Pompeu Fabra, Barcelona, Spain
| | - Juan Carlos Hernandez-Boluda
- Division of Clinical Hematology, Hematology Department, Hospital Clínico Universitario de Valencia, Avda Blasco Ibañez, 17, 46010, Valencia, Spain.,Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | | | | | | | - Carlos Solano
- Division of Clinical Hematology, Hematology Department, Hospital Clínico Universitario de Valencia, Avda Blasco Ibañez, 17, 46010, Valencia, Spain.,Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Ángel Cedillo
- Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH) Office, Madrid, Spain
| | - Anna Sureda
- Hematology Division, Institut Català Oncologia-Hospital Duran i Reynals, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - David Navarro
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain.,Hospital Clinico Universitario de Valencia, Valencia, Spain
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Devant M, Pérez A, Medinyà C, Riera J, Grau J, Fernández B, Prenafeta-Boldú FX. Effect of decreasing dietary crude protein in fattening calves on the emission of ammonia and greenhouse gases from manure stored under aerobic and anaerobic conditions. Animal 2022; 16:100471. [PMID: 35245785 DOI: 10.1016/j.animal.2022.100471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 11/15/2022] Open
Abstract
Dietary strategies can potentially help to reduce nitrogen (N) emissions and decrease the environmental impact of beef production. This study aimed to evaluate the effects of dietary crude protein (CP) concentration on animal performance, N excretion, and manure N volatilisation of finishing Holstein animals. In a first study, 105 Holstein bulls (BW 344 ± 2.6 kg; age 252 ± 0.9 days) were allocated to eight pens to evaluate the effect of two treatments (medium (M) and low (L), which contained CP 14.5% and 12% on a DM basis, respectively) on performance, and results confirmed that dietary CP decrease did not impair animal growth. In a second study, N excretion study, 24 Holstein heifers (BW 310 ± 5.3 kg; age 251 ± 1.4 days) were distributed randomly depending on the initial BW to three treatments (high (H), M, and L, which contained CP 17%, 14.5% and 12% on a DM basis, respectively). Based on N excretion, urinary N excretion was greater (P < 0.001) in H than in M and L diets, but no differences in faecal N excretion were observed among treatments. A third study with in vitro assays under aerobic and anaerobic conditions was designed to analyse gaseous emissions (volatilisation of N and carbon, C) during the storage stage of manure. Manure, faecal and urine samples, mixed at a ratio of 1:1 (wet weight), were collected during the N excretion study (manure-H, manure-M, manure-L). Under aerobic conditions, manure-M and manure-L showed a delay of 4-5 days in manure ammonia emission compared with manure-H (P < 0.01). Total N content was lower (P < 0.01) in manure-L compared with manure-M and manure-H, but N volatilisation (percentage relative to initial N) in manure-L and manure-M was greater (P < 0.01) than in manure-H. In contrast, the anaerobic N volatilisation was 20 times greater in manure-M and 10 times greater in manure-H compared with manure-L. Under aerobic and anaerobic conditions, the emission of C, as C-CO2 and C-CH4, was greater in manure-L than in manure-H and manure-M. Therefore, the decrease of dietary CP concentration from 17% to 14.5% and 12% is an efficient strategy to reduce urinary N excretion by 40%, without impairing performance, and also to reduce manure N losses through ammonia volatilisation under anaerobic conditions. However, a dietary CP content of 14.5% resulted in less environmental impact than a CP content of 12.8% when also considering manure emissions under aerobic or anaerobic conditions.
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Affiliation(s)
- M Devant
- IRTA - Institut de Recerca i Tecnologies Agroalimentàries, Torre Marimon, 08140 Caldes de Montbui, Spain.
| | - A Pérez
- Corporación Alimentaria Guissona, S.A., 25210 Guissona, Lleida, Spain
| | - C Medinyà
- Nutrición Animal S.L., 08650 Sallent, Barcelona, Spain
| | - J Riera
- Nanta S.A., 28760 Tres Cantos, Madrid, Spain
| | - J Grau
- Setna Nutrición Animal SAU, 28521 Rivas Vaciamadrid, Madrid, Spain
| | - B Fernández
- IRTA - Institut de Recerca i Tecnologies Agroalimentàries, Torre Marimon, 08140 Caldes de Montbui, Spain
| | - F X Prenafeta-Boldú
- IRTA - Institut de Recerca i Tecnologies Agroalimentàries, Torre Marimon, 08140 Caldes de Montbui, Spain
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Torres I, Huntley D, Tormo M, Calabuig M, Hernández-Boluda JC, Terol MJ, Carretero C, de Michelena P, Pérez A, Piñana JL, Colomina J, Solano C, Navarro D. Multi-body-site colonization screening cultures for predicting multi-drug resistant Gram-negative and Gram-positive bacteremia in hematological patients. BMC Infect Dis 2022; 22:172. [PMID: 35189833 PMCID: PMC8862203 DOI: 10.1186/s12879-022-07154-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 02/12/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To investigate the multi-drug resistant bacteria (MDRB) colonization rate in hematological patients hospitalized for any cause using a multi-body-site surveillance approach, and determine the extent to which this screening strategy helped anticipate MDRB bloodstream infections (BSI). METHODS Single-center retrospective observational study including 361 admissions documented in 250 adult patients. Surveillance cultures of nasal, pharyngeal, axillary and rectal specimens (the latter two combined) were performed at admission and subsequently on a weekly basis. Blood culture samples were incubated in an automated continuous monitoring blood culturing instrument (BACTEC FX). RESULTS In total, 3463 surveillance cultures were performed (pharyngeal, n = 1201; axillary-rectal, n = 1200; nasal, n = 1062). MDRB colonization was documented in 122 out of 361 (33.7%) admissions corresponding to 86 patients (34.4%). A total of 149 MDRB were isolated from one or more body sites, of which most were Gram-negative bacteria, most frequently non-fermenting (n = 83) followed by Enterobacterales (n = 51). BSI were documented in 102 admissions (28%) involving 87 patients. Overall, the rate of BSI caused by MDRB was significantly higher (p = 0.04) in the presence of colonizing MDRB (16 out of 47 admissions in 14 patients) than in its absence (9 out of 55 admissions in 9 patients). Colonization by any MDRB was independently associated with increased risk of MDRB-BSI (HR, 3.70; 95% CI, 1.38-9.90; p = 0.009). CONCLUSION MDRB colonization is a frequent event in hematological patients hospitalized for any reason and is associated with an increased risk of MDRB BSI. The data lend support to the use of MDRB colonization surveillance cultures for predicting the occurrence of MDRB BSI in this cohort.
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Affiliation(s)
- Ignacio Torres
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Dixie Huntley
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Mar Tormo
- Hematology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Marisa Calabuig
- Hematology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | | | - María José Terol
- Hematology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Carlos Carretero
- Hematology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Paula de Michelena
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Ariadna Pérez
- Hematology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - José Luis Piñana
- Hematology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Javier Colomina
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Carlos Solano
- Hematology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - David Navarro
- Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain. .,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain. .,Department of Microbiology, School of Medicine, University of Valencia, Av. Blasco Ibáñez 17, 46010, Valencia, Spain.
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27
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Piñana JL, López‐Corral L, Martino R, Montoro J, Vazquez L, Pérez A, Martin‐Martin G, Facal‐Malvar A, Ferrer E, Pascual M, Sanz‐Linares G, Gago B, Sanchez‐Salinas A, Villalon L, Conesa‐Garcia V, Olave MT, López‐Jimenez J, Marcos‐Corrales S, García‐Blázquez M, Garcia‐Gutiérrez V, Hernández‐Rivas JÁ, Saus A, Espigado I, Alonso C, Hernani R, Solano C, Ferrer‐Lores B, Guerreiro M, Ruiz‐García M, Muñoz‐Bellido JL, Navarro D, Cedillo A, Sureda A. SARS-CoV-2-reactive antibody detection after SARS-CoV-2 vaccination in hematopoietic stem cell transplant recipients: Prospective survey from the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group. Am J Hematol 2022; 97:30-42. [PMID: 34695229 PMCID: PMC8646900 DOI: 10.1002/ajh.26385] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/17/2021] [Accepted: 10/20/2021] [Indexed: 02/06/2023]
Abstract
This is a multicenter prospective observational study that included a large cohort (n = 397) of allogeneic (allo‐HSCT; (n = 311) and autologous (ASCT) hematopoietic stem cell transplant (n = 86) recipients who were monitored for antibody detection within 3–6 weeks after complete severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccination from February 1, 2021, to July 20, 2021. Most patients (n = 387, 97.4%) received mRNA‐based vaccines. Most of the recipients (93%) were vaccinated more than 1 year after transplant. Detectable SARS‐CoV‐2‐reactive antibodies were observed in 242 (78%) of allo‐HSCT and in 73 (85%) of ASCT recipients. Multivariate analysis in allo‐HSCT recipients identified lymphopenia < 1 × 109/ml (odds ratio [OR] 0.33, 95% confidence interval [95% CI] 0.16–0.69, p = .003), active graft versus host disease (GvHD; OR 0.51, 95% CI 0.27–0.98, p = .04) and vaccination within the first year of transplant (OR 0.3, 95% CI 0.15–0.9, p = .04) associated with lower antibody detection whereas. In ASCT, non‐Hodgkin's lymphoma (NHL; OR 0.09, 95% CI 0.02–0.44, p = .003) and active corticosteroid therapy (OR 0.2, 95% CI 0.02–0.87, p = .03) were associated with lower detection rate. We report an encouraging rate of SARS‐CoV‐2‐reactive antibodies detection in these severe immunocompromised patients. Lymphopenia, GvHD, the timing of vaccine, and NHL and corticosteroids therapy should be considered in allo‐HSCT and ASCT, respectively, to identify candidates for SARS‐CoV‐2 antibodies monitoring.
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Affiliation(s)
- José Luis Piñana
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
| | | | - Rodrigo Martino
- Hematology Division Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Juan Montoro
- Hematology Division Hospital universitario y politécnico La Fe Valencia Spain
| | - Lourdes Vazquez
- Hematology Division Hospital Universitario de Salamanca Salamanca Spain
| | - Ariadna Pérez
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
| | | | - Ana Facal‐Malvar
- Hematology Division Hospital universitario y politécnico La Fe Valencia Spain
| | - Elena Ferrer
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
| | - María‐Jesús Pascual
- Hematology Division Hospital Regional Universitario Carlos Haya Malaga Spain
| | - Gabriela Sanz‐Linares
- Hematology Division Institut Català Oncologia‐Hospital Duran i reynals Barcelona Spain
| | - Beatriz Gago
- Hematology Division Hospital Regional Universitario Carlos Haya Malaga Spain
| | | | - Lucia Villalon
- Hematology Division Hospital Universitario Fundación Alcorcón Madrid Spain
| | | | - Maria T. Olave
- Hematology Division Hospital Clínico Universitario Lozano Blesa IIS Aragon, Zaragoza Spain
| | | | | | | | | | | | - Ana Saus
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
| | - Ildefonso Espigado
- Hematology Division Universidad de Sevilla, Hospital Universitario Virgen Macarena‐Hospital Universitario Virgen del Rocío, IBiS/CSIC Sevilla Spain
| | - Carmen Alonso
- Hematology Division Hospital Arnau de Vilanova Valencia Spain
| | - Rafael Hernani
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
| | - Carlos Solano
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
- Department of Medicine, School of Medicine University of Valencia Valencia Spain
| | - Blanca Ferrer‐Lores
- Hematology Department Hospital Clínico Universitario de Valencia Valencia Spain
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
| | - Manuel Guerreiro
- Hematology Division Hospital universitario y politécnico La Fe Valencia Spain
| | | | | | - David Navarro
- Fundación INCLIVA, Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia Valencia Spain
- Microbiology department Hospital Clinico Universitario de Valencia Valencia Spain
| | - Angel Cedillo
- Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH) Madrid Spain
| | - Anna Sureda
- Hematology Division Institut Català Oncologia‐Hospital Duran i reynals Barcelona Spain
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Lorente L, Martín MM, Ortiz-López R, González-Rivero AF, Pérez-Cejas A, Martín M, Gonzalez V, Pérez A, Rodin M, Jiménez A. Blood caspase-8 concentrations and mortality among septic patients. Med Intensiva 2022; 46:8-13. [PMID: 34991877 DOI: 10.1016/j.medine.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 06/27/2020] [Indexed: 06/14/2023]
Abstract
OBJECTIVE No data are available on blood caspase-8 concentrations (the initiator caspase in the extrinsic apoptosis pathway) in septic patients. The present study thus describes the blood caspase-8 concentrations in survivors and non-survivors, and examines the possible association between blood caspase-8 concentrations and mortality in septic patients. DESIGN A prospective observational study was carried out. SETTING Three Spanish Intensive Care Units. PATIENTS Septic patients. INTERVENTIONS Serum caspase-8 concentrations were determined at the diagnosis of sepsis. MAIN VARIABLE OF INTEREST Mortality after 30 days. RESULTS Patients not surviving at day 30 (n=81) compared to surviving patients (n=140) showed higher serum caspase-8 levels (p<0.001). Multiple logistic regression analysis found an association between serum caspase-8 levels>43.5ng/ml and mortality (OR=3.306; 95%CI=1.619-6.753; p=0.001). The area under the curve (AUC) for mortality predicted by serum caspase-8 levels was 67% (95% CI=60-73%; p<0.001). CONCLUSIONS The novel findings of our study were that blood caspase-8 concentrations are higher in non-survivors than in survivors, and that there is an association between blood caspase-8 concentrations and mortality in septic patients.
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Affiliation(s)
- L Lorente
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Tenerife, Spain.
| | - M M Martín
- Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Crta Rosario s/n., Santa Cruz Tenerife 38010, Spain
| | - R Ortiz-López
- Intensive Care Unit, Hospital General de La Palma, Buenavista de Arriba s/n, Breña Alta, La Palma 38713, Spain
| | - A F González-Rivero
- Laboratory Department, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Santa Cruz de Tenerife, Spain
| | - A Pérez-Cejas
- Laboratory Department, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Tenerife, Spain
| | - M Martín
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n., La Laguna, Santa Cruz de Tenerife 38320, Spain
| | - V Gonzalez
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n., La Laguna, Santa Cruz de Tenerife 38320, Spain
| | - A Pérez
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n., La Laguna, Santa Cruz de Tenerife 38320, Spain
| | - M Rodin
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n., La Laguna, Santa Cruz de Tenerife 38320, Spain
| | - A Jiménez
- Research Unit, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Tenerife, Spain
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Miñambres I, Sánchez-Hernandez J, Cuixart G, Sánchez-Pinto A, Sarroca J, Pérez A. Characterization of the hypertriglyceridemic waist phenotype in patients with type 2 diabetes mellitus in Spain: an epidemiological study. Rev Clin Esp 2021; 221:576-581. [PMID: 34839890 DOI: 10.1016/j.rceng.2020.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 06/03/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES In patients with type 2 diabetes mellitus (DM2), the presence of increased waist circumference and triglycerides is a reflection of increased visceral fat and insulin resistance. However, information about the prevalence and clinical characteristics of the hypertriglyceridemic waist (HTGW) phenotype in patients with DM2 is scarce. The aim of the present study was to analyze the prevalence and characteristics of DM2 patients with HTGW. METHODS We analyzed 4214 patients with DM2 in this epidemiological, cross-sectional study conducted in primary care centers across Spain between 2011 and 2012. The HTGW phenotype was defined as increased waist circumference according to the International Diabetes Federation criteria for Europids (≥ 94 cm for men and ≥ 80 cm for women) with the presence of triglyceride levels ≥ 150 mg/dL. We compared the demographic, clinical and analytical variables according to the presence or absence of the HTGW phenotype. RESULTS Thirty-five percent of patients presented the HTGW phenotype. Patients with the HTGW phenotype had a higher body mass index (31.14 ± 4.88 vs. 29.2 ± 4.82 kg/m2; p < .001) and glycated hemoglobin levels (7.38 ± 1.2% vs. 7 ± 1.07%; p < .001). The presence of hypertension, peripheral arterial disease, cardiac insufficiency and microvascular complications were higher when compared with patients without the HTGW phenotype. Patients with the HTGW phenotype were less adherent to prescribed diet (69.8 vs. 81%; p < .001), exercise (44.6 vs. 58.2%; p < .001) and presented greater weight increase within the year prior to the study visit (29.4 vs. 22.5%; p < .001). CONCLUSIONS The HTGW phenotype is prevalent in the Spanish DM2 population and identifies a subgroup of patients with higher cardiometabolic risk and prevalence of diabetic complications.
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Affiliation(s)
- I Miñambres
- Departamento de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Departamento de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Diabetes y Enfermedades Metabólicas Asociadas CIBER (CIBERDEM), Barcelona, Spain
| | - J Sánchez-Hernandez
- Departamento de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Departamento de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - G Cuixart
- Departamento de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - A Sánchez-Pinto
- Unidad de Enfermería, Hospital Vall d'Hebron, Barcelona, Spain
| | | | - A Pérez
- Departamento de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Departamento de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Diabetes y Enfermedades Metabólicas Asociadas CIBER (CIBERDEM), Barcelona, Spain.
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30
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Ferrer C, Huertas C, Plaza R, de la Monja P, Ocanto A, Escribano A, Pérez A, Sáez M. Simple template-based optimization for pediatric total lymphoid irradiation (TLI) radiotherapy treatments. Med Dosim 2021; 46:201-207. [PMID: 33309515 DOI: 10.1016/j.meddos.2020.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/27/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022]
Abstract
Total lymphoid irradiation (TLI) is used in the management of pediatric allogeneic hematopoietic stem cell transplantation (HSCT. This work aims to simplify the treatment planning process for TLI via a proposed template using the volumetric modulated arc therapy (VMAT) technique. Fifteen pediatric patients were planned, prescribed to 8 Gy in 4 fractions. Cost functions included in the template were the ones for the planning target volume (PTV), and conformality cost function (CCF) for the rest of the patient's volume. Conformity index (CI), homogeneity index (HI), conformation number (CN), gradient index (GI), integral dose, and doses to the organs at risk achieved with the template were reported. Cost function influence over various indexes was studied by Wilcoxon signed ranks test. Same 15 patients were planned with 3-dimensional conventional radiotherapy (3D-CRT) technique for comparison. Mean CI and HI were 1.33 and 0.13, respectively, which indicates good dose conformation and homogeneity. Mean CN and GI values were 0.69 and 4.51, respectively. Mean PTV coverage was reached (V100% > 95%). No correlation between the CCF and indexes values was found (p > 0.05). Doses to organs at risk (OARs) were as low as possible without losing PTV coverage. VMAT plan showed higher levels of conformation and similar homogeneity as 3D-CRT plans. Doses to OARs were inferior with VMAT except for the right kidney. The proposed template simplifies the planning of TLI treatments, and it is able to create acceptable plans with little modification in order to reduce doses to certain organs like the kidneys or the heart. VMAT technique showed higher conformation and lower doses to OAR compared to 3D-CRT.
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Affiliation(s)
- C Ferrer
- Department of Medical Physics and Radiation Protection, Hospital Universitario La Paz, Madrid, Spain.
| | - C Huertas
- Department of Medical Physics and Radiation Protection, Hospital Universitario La Paz, Madrid, Spain
| | - R Plaza
- Department of Medical Physics and Radiation Protection, Hospital Universitario La Paz, Madrid, Spain
| | - P de la Monja
- Department of Medical Physics and Radiation Protection, Hospital Universitario La Paz, Madrid, Spain
| | - A Ocanto
- Radiation Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - A Escribano
- Radiation Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - A Pérez
- Pediatric Hematology-Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - M Sáez
- Department of Medical Physics and Radiation Protection, Hospital Universitario La Paz, Madrid, Spain
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31
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Miarka L, Monteiro C, Dalmasso C, Yebra N, Fustero-Torre C, Hegarty A, Keelan S, Goy Y, Mohme M, Caleiras E, Vareslija D, Young L, Soffietti R, Fernández-Alén J, Blasco G, Alcázar L, Sepúlveda J, Pérez A, Lain A, Siegfried A, Wikman H, Cohen-Jonathan Moyal E, Valiente M. P02.01 A strategy to personalize the use of radiation in patients with brain metastasis based on S100A9-mediated resistance. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Finding effective treatment options for patients with brain metastasis remains an unmet need. Given the limitations imposed by the blood-brain-barrier for systemic approaches, radiotherapy offers a superior ability to access the brain. While clinical practice recently adapted the use of stereotactic radiosurgery (SRS), Whole-Brain-Radiotherapy (WBRT) continuous to be an important treatment option, since many patients present with multifocal lesions or bad performance scores, rendering them ineligible for SRS. Unfortunately, overall survival of patients remains unaffected by radiotherapy. Despite this clinical data, the molecular mechanisms that allow metastatic cells to resist radiotherapy in the brain is unknown.
MATERIAL AND METHODS
We have applied WBRT to experimental brain metastasis from lung and breast adenocarcinoma and validated their resistance in vivo.
RESULTS
An unbiased search to identify potential mediators of resistance identified the S100A9-RAGE-NFκB-JunB pathway. Targeting this pathway genetically reverts the resistance to radiotherapy and increases therapeutic benefits in vivo. In two independent cohorts of brain metastasis from lung and breast adenocarcinoma patients, levels of S100A9 correlate with the response to radiotherapy, offering a novel approach to stratify patients according to their expected benefit. In order to make this biomarker also available for brain metastasis patients receiving palliative WBRT without preceding surgery, we complemented our tumor-specimen based approach with the less invasive detection of S100A9 from liquid biopsies. Here, serum S100A9 also correlated with a worse response to WBRT in brain metastasis patients. Furthermore, we have validated the use of a blood-brain-barrier permeable RAGE inhibitor to restore radio-sensitivity in experimental brain metastasis models in vivo and in patient-derived organotypic cultures of radio-resistant brain metastasis ex vivo.
CONCLUSION
We identified S100A9 as a major mediator of radio-resistance in brain metastasis and offer the molecular framework to personalize radiotherapy by exploiting it as a biomarker and as a therapeutic target, thus maximizing the benefits for the patient.
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Affiliation(s)
- L Miarka
- Brain Metastasis Group, CNIO, Madrid, Spain
| | - C Monteiro
- Brain Metastasis Group, CNIO, Madrid, Spain
| | - C Dalmasso
- Radiation Oncology Department, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | - N Yebra
- Brain Metastasis Group, CNIO, Madrid, Spain
| | | | - A Hegarty
- Endocrine Oncology Research Group, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - S Keelan
- Endocrine Oncology Research Group, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Y Goy
- Radiation Oncology Department, UKE, Hamburg, Germany
| | - M Mohme
- Neurosurgery Department, UKE, Hamburg, Germany
| | - E Caleiras
- Histopathology Unit, CNIO, Madrid, Spain
| | - D Vareslija
- Endocrine Oncology Research Group, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - L Young
- Endocrine Oncology Research Group, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - R Soffietti
- Department of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy
| | | | - G Blasco
- Department of Neurosurgery, Hospital La Princesa, Madrid, Spain
| | - L Alcázar
- Department of Neurosurgery, Hospital La Princesa, Madrid, Spain
| | - J Sepúlveda
- Neuro-Oncology Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Pérez
- Neurosurgery Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Lain
- Neuropathology Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Siegfried
- Anatomopathology Department, CHU, Toulouse, France
| | - H Wikman
- Department of Tumor Biology, UKE, Hamburg, Germany
| | - E Cohen-Jonathan Moyal
- Radiation Oncology Department, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | - M Valiente
- Brain Metastasis Group, CNIO, Madrid, Spain
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32
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Bueno F, Albert E, Giménez E, Piñana JL, Pérez A, Dolores Gómez M, Hernández-Boluda JC, Gonzalez-Barberá EM, Montoro J, Buesa J, Guerreiro M, Balaguer-Roselló A, Hernani R, Sanz J, Solano C, Navarro D. An investigation of the potential association between gastrointestinal viral and bacterial infection and development of intestinal acute graft versus host disease following allogeneic hematopoietic stem cell transplantation. J Med Virol 2021; 93:4773-4779. [PMID: 33605457 DOI: 10.1002/jmv.26892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 12/15/2022]
Abstract
It is uncertain whether gastrointestinal (GI) infection caused by viral and bacterial pathogens may predispose to gastrointestinal acute Graft-versus-host disease (aGvHD-GI) in allogeneic hematopoietic stem cell transplant recipients (allo-HSCT). We investigated the potential association between detection of enteropathogenic viruses or bacteria in stools and subsequent occurrence of aGvHD-GI in a cohort of 121 allo-HSCT patients. Eighty-six out of 121 patients (71%) had acute diarrhea and underwent screening for primary GI pathogens by molecular diagnostic methods. One or more GI pathogens were detected in 27 out of the 86 patients with diarrhea (31.3%). Specifically, Clostridioides difficile was found in 16 patients (18.6%), enteropathogenic viruses in 11 patients (12.7%) (Astrovirus, n = 4; Norovirus, n = 2; Sapovirus, n = 2; Adenovirus, n = 2; and Rotavirus, n = 1), and Campylobacter spp. in two patients (2.3%). Thirty patients were diagnosed with all grade aGvHD-GI by histopathology. Detection of primary GI pathogens was achieved in 12 out of 30 patients (Clostridium difficile, n = 5; enteric viruses, n = 8; Campylobacter spp., n = 1) who either subsequently developed (n = 9) or previously had (n = 3) grade I-IV IaGvHD (n = 9). Neither the detection of these microorganisms (all combined), enteric viruses, nor C. difficile was significantly associated with subsequent aGvHD-GI development in Cox models (hazard ratio [HR] = 1.11, p = .80; HR = 1.64, p = .62; HR = 0.75, p = .64, respectively). Analogous results were obtained when grade II-IV aGvHD-GI was selected as the clinical outcome. In summary, data in the current study did not support an association between GI infection and subsequent occurrence of aGvHD-GI in an unselected cohort of allo-HSCT recipients.
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Affiliation(s)
- Felipe Bueno
- Microbiology Service, University Clinical Hospital, Institute for Research INCLIVA, Valencia, Spain
| | - Eliseo Albert
- Microbiology Service, University Clinical Hospital, Institute for Research INCLIVA, Valencia, Spain
| | - Estela Giménez
- Microbiology Service, University Clinical Hospital, Institute for Research INCLIVA, Valencia, Spain
| | - José L Piñana
- Hematology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Ariadna Pérez
- Hematology Service, University Clinical Hospital, Institute for Research INCLIVA, Valencia, Spain
| | - María Dolores Gómez
- Microbiology Service, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Juan C Hernández-Boluda
- Hematology Service, University Clinical Hospital, Institute for Research INCLIVA, Valencia, Spain
- Department of Medicine, , School of Medicine, University of Valencia, Valencia, Spain
| | | | - Juan Montoro
- Hematology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Javier Buesa
- Microbiology Service, University Clinical Hospital, Institute for Research INCLIVA, Valencia, Spain
- Department of Microbiology, , School of Medicine, University of Valencia, Valencia, Spain
| | - Manuel Guerreiro
- Hematology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | | | - Rafael Hernani
- Hematology Service, University Clinical Hospital, Institute for Research INCLIVA, Valencia, Spain
| | - Jaime Sanz
- Hematology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Carlos Solano
- Hematology Service, University Clinical Hospital, Institute for Research INCLIVA, Valencia, Spain
- Department of Medicine, , School of Medicine, University of Valencia, Valencia, Spain
| | - David Navarro
- Microbiology Service, University Clinical Hospital, Institute for Research INCLIVA, Valencia, Spain
- Department of Microbiology, , School of Medicine, University of Valencia, Valencia, Spain
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33
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Hernani R, Sancho A, Amat P, Hernández-Boluda JC, Pérez A, Piñana JL, Carretero C, Goterris R, Gómez M, Saus A, Ferrer B, Teruel AI, Terol MJ, Solano C. CAR-T therapy in solid transplant recipients with post-transplant lymphoproliferative disease: case report and literature review. Curr Res Transl Med 2021; 69:103304. [PMID: 34303899 DOI: 10.1016/j.retram.2021.103304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/21/2021] [Accepted: 07/03/2021] [Indexed: 10/20/2022]
Abstract
Patients with postransplant lymphoproliferative disease (PTLD) who are refractory to rituximab-based regimens have extremely poor prognosis. Data is lacking in the setting of solid organ transplantation (SOT)-related PTLD treated with chimeric antigen receptor T-cell (CAR-T) therapy. Moreover, limited information is available on the influence of concomitant immunosuppressive drugs on CAR-T function. Here, we describe the clinical outcome in one PTLD patient and propose a strategy for tailoring immunosuppressive treatment and organ monitoring in patients with kidney allografts after CAR-T infusion. This report also reviews the limited published data in the setting of SOT-related PTLD treated with CAR-T, which appears to be a feasible treatment in this clinical scenario, without severe toxicity and capable of inducing sustained responses. A noteworthy finding is that in most reported cases patients underwent complete or partial discontinuation of immunosuppressive drugs, with only one documented case of allograft rejection.
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Affiliation(s)
- Rafael Hernani
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain.
| | - Asunción Sancho
- Nephrology Department, Hospital Universitario Dr. Peset, Valencia, Spain
| | - Paula Amat
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Juan Carlos Hernández-Boluda
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Ariadna Pérez
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain
| | - Jose Luis Piñana
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain; CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Carlos Carretero
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain
| | - Rosa Goterris
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain
| | - Montse Gómez
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain
| | - Ana Saus
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain
| | - Blanca Ferrer
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain
| | - Ana Isabel Teruel
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - María José Terol
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | - Carlos Solano
- Haematology Department, Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain
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Amat P, López-Corral L, Goterris R, Pérez A, López O, Heras I, Arbona C, Viguria MC, Hernández-Boluda JC, Martínez-Ruiz F, Martínez A, Solano C. Biomarker profile predicts clinical efficacy of extracorporeal photopheresis in steroid-resistant acute and chronic graft-vs-host disease after allogenic hematopoietic stem cell transplant. J Clin Apher 2021; 36:697-710. [PMID: 34185332 DOI: 10.1002/jca.21918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 05/10/2021] [Accepted: 06/04/2021] [Indexed: 01/21/2023]
Abstract
We conducted a multicenter interventional study to assess the efficacy of Therakos ECP to treat steroid-resistant graft-vs-host disease (SRes-GVHD) after allogeneic HSCT and to identify biomarkers of GVHD response. A total of 62 patients were treated for acute SRes-GVHD (n = 37) or chronic SRes-GVHD (n = 25). Median time to best response was 35 days (range, 28-85) and 90 days (range, 27-240) in acute and chronic SRes-GVHD, respectively. Overall, 27 patients (72.9%) with SRes-aGVHD responded to treatment (40.5% CR and 32.4% PR). The response rate was significantly higher in grade I-II than in grade III-IV aGVHD (100% vs 50.0%, respectively, P-value = .001). In chronic SRes-GVHD, 22 patients (88%) achieved a clinical response (24.0% CR and 64% PR). Response was higher in moderate than in severe SRes-cGVHD (100% vs 75%, P = .096). In both acute and chronic SRes-GVHD patients, the percentage of peripheral blood CD3+ CD4+ was higher and CD3+ CD8+ lower in responding than nonresponding patients. Acute SRes-GVHD responding patients presented a higher number of Treg cells (CD4+ CD25+ CD127low/- ) at day 0 (P = .028) than nonresponding patients, differences that were maintained over the observation period. Phenotypic analysis of T-cell maturation showed a trend toward reduction in TCD8 naive cells, along with an increased percentage of TCD8 Mem Efect T cells after starting ECP in responding patients. None of the studied serum cytokines displayed statistically significant changes in either acute or chronic SRes-GVHD. ECP is an effective treatment for patients with SRes-GVHD. Biomarkers could help guide decision-making on ECP treatment initiation and duration.
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Affiliation(s)
- Paula Amat
- Department of Hematology, Hospital Clínico Universitario-INCLIVA, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Lucía López-Corral
- Department of Hematology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Rosa Goterris
- Department of Hematology, Hospital Clínico Universitario-INCLIVA, Valencia, Spain
| | - Ariadna Pérez
- Department of Hematology, Hospital Clínico Universitario-INCLIVA, Valencia, Spain
| | - Olga López
- Department of Hematology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Inmaculada Heras
- Department of Hematology, Hospital Universitario Morales Messenger, Murcia, Spain
| | - Cristina Arbona
- Department of Hematology, Hospital Clínico Universitario-INCLIVA, Valencia, Spain
| | | | - Juan Carlos Hernández-Boluda
- Department of Hematology, Hospital Clínico Universitario-INCLIVA, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Francisco Martínez-Ruiz
- Department of Statistics, Faculty of Mathematics Science, University of Valencia, Valencia, Spain
| | - Andreu Martínez
- Department of Hematology, Hospital Clínico Universitario-INCLIVA, Valencia, Spain
| | - Carlos Solano
- Department of Hematology, Hospital Clínico Universitario-INCLIVA, Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
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35
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Bueno F, Albert E, Piñana JL, Pérez A, Úbeda C, Gómez MD, Hernández-Boluda JC, Gonzalez-Barberá EM, Montoro J, Giménez E, Guerreiro M, Balaguer-Roselló A, Hernani R, Sanz J, Solano C, Navarro D. Kinetics of Torque Teno virus DNA in stools may predict occurrence of acute intestinal graft versus host disease early after allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis 2021; 23:e13507. [PMID: 33176050 DOI: 10.1111/tid.13507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/09/2020] [Accepted: 10/25/2020] [Indexed: 01/15/2023]
Abstract
Torque Teno virus (TTV) DNA load in blood may act as a marker of immune competence after allogeneic hematopoietic stem cell transplant recipients (allo-HSCT). Conflicting data have been reported as to the value of this biomarker for anticipating acute Graft versus host disease (aGvHD) occurrence. Here, we hypothesized that quantitation of TTV DNA load in stool specimens early after allo-HSCT could be used to identify patients at high risk of acute intestinal graft versus host disease (aIGvHD). In this prospective two-center study, we recruited a total of 83 nonconsecutive adult patients undergoing allo-HSCT. The study period comprised the first 120 days after allo-HSCT. TTV DNA was quantitated in paired stool samples collected at a median of 2 days prior to cell infusion and at a median of 14 days after allo-HSCT by real-time PCR. Thirty-seven patients developed aGVHD, of whom 25 had aIGVHD (diagnosed at a median of 42 days after allo-HSCT). Median TTV DNA load values in posttransplant stools specimens were comparable (P = .34) in patients with or without subsequent aIGvHD; nevertheless, a falling trajectory (decrease in TTV DNA load >0.5 log10 copies/0.1 g) in paired pretransplant and posttransplant specimens was independently associated with the occurrence of aIGvHD (OR, 5.2; 95% CI, 1.3-21.3; P = .02). Notably, displaying a rising trajectory had a negative predictive value of 87.5% for aIGvHD. In summary, in this hypothesis-generating study, we suggest that the decrease in TTV DNA load from baseline in stool specimens may identify patients at risk of aIGVHD.
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Affiliation(s)
- Felipe Bueno
- Microbiology Service, Hospital Clínico Universitario, Institute for Research INCLIVA, Valencia, Spain
| | - Eliseo Albert
- Microbiology Service, Hospital Clínico Universitario, Institute for Research INCLIVA, Valencia, Spain
| | - José Luis Piñana
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Ariadna Pérez
- Hematology Service, Hospital Clínico Universitario, Institute for Research INCLIVA Valencia, Spain
| | - Carlos Úbeda
- Centro Superior de Investigacion en Salud Publica - FISABIO, Valencia, Spain
| | - María Dolores Gómez
- Microbiology Service, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | | | - Juan Montoro
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Estela Giménez
- Microbiology Service, Hospital Clínico Universitario, Institute for Research INCLIVA, Valencia, Spain
| | - Manuel Guerreiro
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Rafael Hernani
- Hematology Service, Hospital Clínico Universitario, Institute for Research INCLIVA Valencia, Spain
| | - Jaime Sanz
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Carlos Solano
- Hematology Service, Hospital Clínico Universitario, Institute for Research INCLIVA Valencia, Spain
- Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, Institute for Research INCLIVA, Valencia, Spain
- Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
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36
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Sánchez-Velázquez A, Bauer-Alonso A, Estrach T, Vega-Díez D, Garcia-Muret P, Haya L, Peñate Y, Acebo E, Fernández de Misa R, Blanes M, Suh-Oh HJ, Izu R, Silva-Díaz E, Sarriugarte J, Román-Curto C, Botella-Estrada R, Mateu-Puchades A, Prieto-Torres L, Morillas V, Morillo M, Sánchez-Caminero P, Calzado L, Pérez-Ferriols A, Pérez A, Domínguez JD, Navedo M, Muniesa C, Combalia A, Arroyo-Andrés J, Descalzo MA, García-Doval I, Ortiz-Romero PL. Patients with primary cutaneous lymphoma are at risk for severe COVID-19. Data from the Spanish Primary Cutaneous Lymphoma Registry. J Eur Acad Dermatol Venereol 2021; 35:e624-e626. [PMID: 34062018 PMCID: PMC8242655 DOI: 10.1111/jdv.17430] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Sánchez-Velázquez
- Department of Dermatology, Institute i+12, CIBERONC, Medical School, Hospital Universitario 12 de Octubre, University Complutense, Madrid, Spain
| | - A Bauer-Alonso
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - T Estrach
- Department of Dermatology, IDIBAPS, Hospital Clinico, University of Barcelona, Barcelona, Spain
| | - D Vega-Díez
- Department of Dermatology, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - P Garcia-Muret
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, UAB, Barcelona, Spain
| | - L Haya
- Department of Dermatology, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Y Peñate
- Department of Dermatology, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas, Spain
| | - E Acebo
- Department of Dermatology, Hospital Universitario de Cruces, Bizkaia, Spain
| | - R Fernández de Misa
- Department of Dermatology, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - M Blanes
- Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
| | - H J Suh-Oh
- SERGAS-UVIGO, DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Pontevedra, Spain
| | - R Izu
- Department of Dermatology, Hospital Universitario Basurto, Bizkaia, Spain
| | - E Silva-Díaz
- Department of Dermatology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - J Sarriugarte
- Department of Dermatology, Complejo Hospitalario de Navarra, Navarra, Spain
| | - C Román-Curto
- Department of Dermatology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - R Botella-Estrada
- Department of Dermatology, Hospital Universitario la Fé, Valencia, Spain
| | - A Mateu-Puchades
- Department of Dermatology, Hospital Universitario Dr. Peset, Valencia, Spain
| | - L Prieto-Torres
- Department of Dermatology, Hospital Universitario Lozano Blesa, Valencia, Spain
| | - V Morillas
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Zaragoza, Spain
| | - M Morillo
- Department of Dermatology, Hospital Universitario Virgen de Rocío, Barcelona, Spain
| | - P Sánchez-Caminero
- Department of Dermatology, Hospital General Universitario de Ciudad Real, Sevilla, Spain
| | - L Calzado
- Department of Dermatology, Hospital Universitario de Torrejón, Ciudad Real, Spain
| | - A Pérez-Ferriols
- Department of Dermatology, Hospital General Universitario de Valencia, Madrid, Spain
| | - A Pérez
- Department of Dermatology, Hospital Universitario Nuestra Señora De Valme, Valencia, Spain
| | - J D Domínguez
- Department of Dermatology, Hospital Universitario del Henares, Sevilla, Spain
| | - M Navedo
- Department of Dermatology, Complejo Asistencial Universitario de León, Madrid, Spain
| | - C Muniesa
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - A Combalia
- Department of Dermatology, IDIBAPS, Hospital Clinico, University of Barcelona, Barcelona, Spain
| | - J Arroyo-Andrés
- Department of Dermatology, Institute i+12, CIBERONC, Medical School, Hospital Universitario 12 de Octubre, University Complutense, Madrid, Spain
| | - M A Descalzo
- Unidad de Investigación, Fundación Piel Sana AEDV, León, Spain
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, León, Spain.,Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Madrid, Spain
| | - P L Ortiz-Romero
- Department of Dermatology, Institute i+12, CIBERONC, Medical School, Hospital Universitario 12 de Octubre, University Complutense, Madrid, Spain
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37
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Selfa A, Ros B, Iglesias S, Ruiz F, Pérez A, Arráez MA. External cranial expansion as treatment of intracranial hypertension. Technical note. Neurosurg Rev 2021; 45:897-901. [PMID: 34075508 DOI: 10.1007/s10143-021-01571-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/13/2021] [Accepted: 05/26/2021] [Indexed: 11/28/2022]
Abstract
Intracranial hypertension may be idiopathic or due to multiple etiologies. Some bone dysplasias and chronic shunt overdrainage syndrome may sometimes lead to intracranial hypertension associated with craniocerebral disproportion due to thickening of cranial diploe. The internal cranial expansion procedure has been used for patients with intracranial hypertension, whether or not associated with craniocerebral disproportion. Its purpose is to increase the intracranial volume by drilling down the inner table. This technique enables the craniocerebral disproportion to be improved and intracranial hypertension reduced. In other etiologies of intracranial hypertension with non-thickened diploe, internal cranial expansion may not be enough to resolve the hypertension. For these cases we propose a modification of the technique by expanding the cranial vault outwards; external cranial expansion. We describe this technique as used in a pediatric patient who presented with chronic headache, tonsillar ectopia, and sleep apnea syndrome. This patient also had a multisuture craniosynostosis, a non-thickened diploe, and intracranial hypertension.
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Affiliation(s)
- A Selfa
- Department of Neurological Surgery, Regional University Hospital, Malaga, Spain.
| | - B Ros
- Pediatric Neurological Surgery Section, Department of Neurological Surgery, Regional University Hospital, Malaga, Spain
| | - S Iglesias
- Pediatric Neurological Surgery Section, Department of Neurological Surgery, Regional University Hospital, Malaga, Spain
| | - F Ruiz
- Pediatric Section, Department of Oral and Maxillofacial Surgery, Regional University Hospital, Malaga, Spain
| | - A Pérez
- Neuroradiology Section, Department of Radiology, Regional University Hospital, Malaga, Spain
| | - M A Arráez
- Department of Neurological Surgery, Regional University Hospital, Malaga, Spain
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38
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Esquirol A, Pascual MJ, Kwon M, Pérez A, Parody R, Ferra C, Garcia Cadenas I, Herruzo B, Dorado N, Hernani R, Sanchez-Ortega I, Torrent A, Sierra J, Martino R. Severe infections and infection-related mortality in a large series of haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide. Bone Marrow Transplant 2021; 56:2432-2444. [PMID: 34059802 PMCID: PMC8165955 DOI: 10.1038/s41409-021-01328-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/10/2021] [Accepted: 04/22/2021] [Indexed: 12/12/2022]
Abstract
Severe infections and their attributable mortality are major complications in recipients of allogeneic hematopoietic stem cell transplantation (alloSCT). We herein report 236 adult patients who received haploSCT with PTCy. The median follow-up for survivors was 37 months. The overall incidence of bloodstream infections by gram-positive and gram-negative bacteria at 37 months was 51% and 46%, respectively. The incidence of cytomegalovirus infection was 69%, while Epstein Barr virus infections occurred in 10% of patients and hemorrhagic cystitis in 35% of cases. Invasive fungal infections occurred in 11% at 17 months. The 3-year incidence of infection-related mortality was 19%. The median interval from transplant to IRM was 3 months (range 1–30), 53% of IRM occurred >100 days post-haploSCT. Risk factors for IRM included age >50 years, lymphoid malignancy, and developing grade III-IV acute GvHD. Bacterial infections were the most common causes of IRM (51%), mainly due to gram-negative bacilli BSI. In conclusion, severe infections are the most common causes of NRM after haploSCT with PTCy, with a reemergence of gram-negative bacilli as the most lethal pathogens. More studies focusing on the severe infections after haploSCT with PTCy and differences with other types of alloSCT in adults are clearly warranted.
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Affiliation(s)
- Albert Esquirol
- Hematology Department, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau and Jose Carreras Leukemia Research Institutes, Universitat Autonoma of Barcelona, Barcelona, Spain.
| | | | - Mi Kwon
- Hematology Department, Hospital Gregorio Marañón, Madrid, Spain
| | - Ariadna Pérez
- Hematology Department, Hospital Clinico Universitario, Valencia, Spain
| | - Rocio Parody
- Hematology Department, Hospital de Bellvitge, Barcelona, Spain
| | - Christelle Ferra
- Hematology Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Irene Garcia Cadenas
- Hematology Department, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau and Jose Carreras Leukemia Research Institutes, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Beatriz Herruzo
- Hematology Department, Hospital Regional Universitario, Malaga, Spain
| | - Nieves Dorado
- Hematology Department, Hospital Gregorio Marañón, Madrid, Spain
| | - Rafael Hernani
- Hematology Department, Hospital Clinico Universitario, Valencia, Spain
| | | | - Anna Torrent
- Hematology Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Jorge Sierra
- Hematology Department, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau and Jose Carreras Leukemia Research Institutes, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Rodrigo Martino
- Hematology Department, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau and Jose Carreras Leukemia Research Institutes, Universitat Autonoma of Barcelona, Barcelona, Spain
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39
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Martínez-Sánchez L, López-Ávila J, Barasoain-Millán A, Angelats-Romero CM, Azkunaga-Santibañez B, Molina-Cabañero JC, Alday A, Andrés A, Angelats C, Aquino E, Astete J, Baena I, Barasoain A, Bello P, Benito C, Benito H, Botifoll E, Burguera B, Campos C, Canduela V, Clerigué N, Comalrena C, Del Campo T, De Miguel B, Fernández R, Fernández B, García E, García M, García M, García M, García-Vao C, Herrero L, Huerta P, Humayor J, Hurtado P, Iturralde I, Jordá A, Khodayar P, Lalinde M, Lobato Z, López J, López V, Luaces C, Mangione L, Martín L, Martínez S. L, Martínez L, Martorell J, May M, Melguizo M, Mesa S, Molina J, Muñiz M, Muñoz J, Muñoz N, Oliva S, Palacios M, Pérez A, Pérez C, Pinyot M, Peñalba A, Pociello N, Rodríguez A, Rodríguez M, Señer R, Serrano I, Vázquez P, Vidal C. Actions that should not be taken with a paediatric patient who has been exposed to a potentially toxic substance. An Pediatr (Barc) 2021. [DOI: 10.1016/j.anpede.2020.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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40
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Hernani R, Piñana JL, Pérez A, Quintero A, Montoro J, Hernández‐Boluda JC, Carretero C, Balaguer‐Roselló A, Guerreiro M, Lorenzo I, Aguilar C, Giménez E, Navarro D, Sanz MA, Sanz J, Solano C. Sirolimus versus cyclosporine in haploidentical stem cell transplantation with posttransplant cyclophosphamide and mycophenolate mofetil as graft‐versus‐host disease prophylaxis. eJHaem 2021; 2:236-248. [PMID: 35845283 PMCID: PMC9175741 DOI: 10.1002/jha2.183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 11/12/2022]
Abstract
Sirolimus has emerged as an alternative to calcineurin inhibitors‐based (CNI) graft‐versus‐host disease (GVHD) prophylaxis. This retrospective study compares the outcome of 133 consecutive adult patients with haematological malignancies undergoing haploidentical stem cell transplantation with posttransplant cyclophosphamide (PTCy) and mycophenolate mofetil (MMF), combined with cyclosporine A (PTCy–CsA–MMF, n = 67) or sirolimus (PTCy–Sir–MMF, n = 66) as GVHD prophylaxis strategy. The median follow‐up was 48 (range 22–83) and 13 (range 3–33) months, respectively. PTCy–CsA–MMF was associated in multivariate analyses with a higher risk of acute kidney injury (HR 2.1, 95% CI, 1.21–3.57, p = .008) and thrombotic microangiopathy (HR 12.5, 95% CI, 1.66–93.5, p = .014), whereas PTCy–Sir–MMF was associated with a higher risk of hepatic sinusoidal obstruction syndrome (SOS) (HR 10.8, 95% CI, 1.52–77, p = .018), especially late‐onset forms, which totally resolved and none of the patients needed discontinuation of sirolimus. Two SOS‐related deaths were detected, both in the PTCy–CsA–MMF subgroup. Both GVHD prophylaxis strategies were otherwise comparable in terms of engraftment, GVHD incidence and survival.
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Affiliation(s)
- Rafael Hernani
- Department of Haematology Hospital Clínico Universitario Institute for Research INCLIVA Valencia Spain
| | - José Luis Piñana
- Department of Haematology Hospital Universitari i Politècnic La Fe Valencia Spain
- CIBERONC Instituto Carlos III Madrid Spain
| | - Ariadna Pérez
- Department of Haematology Hospital Clínico Universitario Institute for Research INCLIVA Valencia Spain
| | - Abdiel Quintero
- Department of Haematology Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Juan Montoro
- Department of Haematology Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Juan C. Hernández‐Boluda
- Department of Haematology Hospital Clínico Universitario Institute for Research INCLIVA Valencia Spain
- Department of Medicine University of Valencia Valencia Spain
| | - Carlos Carretero
- Department of Haematology Hospital Clínico Universitario Institute for Research INCLIVA Valencia Spain
| | | | - Manuel Guerreiro
- Department of Haematology Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Ignacio Lorenzo
- Department of Haematology Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Cristóbal Aguilar
- Department of Haematology Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Estela Giménez
- Microbiology Service Hospital Clínico Universitario Institute for Research INCLIVA Valencia Spain
| | - David Navarro
- Microbiology Service Hospital Clínico Universitario Institute for Research INCLIVA Valencia Spain
- Department of Microbiology University of Valencia Valencia Spain
| | - Miguel A. Sanz
- Department of Haematology Hospital Universitari i Politècnic La Fe Valencia Spain
- Department of Medicine University of Valencia Valencia Spain
- CIBERONC Instituto Carlos III Madrid Spain
| | - Jaime Sanz
- Department of Haematology Hospital Universitari i Politècnic La Fe Valencia Spain
- Department of Medicine University of Valencia Valencia Spain
- CIBERONC Instituto Carlos III Madrid Spain
| | - Carlos Solano
- Department of Haematology Hospital Clínico Universitario Institute for Research INCLIVA Valencia Spain
- Department of Medicine University of Valencia Valencia Spain
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41
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Bueno F, Solano C, Vázquez L, Giménez E, de la Cámara R, Albert E, Rovira M, Espigado I, Martín Calvo C, López-Jiménez J, Suárez-Lledó M, Chinea A, Esquirol A, Pérez A, Bermúdez A, Saldaña R, Heras I, González-Huerta AJ, Torrado T, Batlle M, Jiménez S, Vallejo C, Barba P, Cuesta MÁ, Duarte R, Piñana JL, Navarro D. Assessment of the association between cytomegalovirus DNAemia and subsequent acute graft-versus-host disease in allogeneic peripheral blood stem cell transplantation: A multicenter study from the Spanish hematopoietic transplantation and cell therapy group. Transpl Infect Dis 2021; 23:e13627. [PMID: 33908148 DOI: 10.1111/tid.13627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/02/2021] [Accepted: 04/21/2021] [Indexed: 12/01/2022]
Abstract
The potential role of active CMV infection in promoting acute Graft-versus-Host Disease (aGvHD) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a matter of debate. We further addressed this issue conducting a retrospective, observational, multicenter study of 632 patients subjected to allogeneic peripheral blood HSCT at 20 Spanish centers. Monitoring of CMV DNA load in plasma or whole blood was performed by real-time PCR assays. Cumulative incidence of CMV DNAemia was 48.9% (95% CI, 45%-52.9%), of any grade aGvHD, 45.6; 95% (CI, 41.3%-50.1%), and of grade II-IV aGvHD, 30.7 (95% CI, 24.9%-36.4%). Overall, development of CMV DNAemia at any level resulted in an increased risk of subsequent all grade (HR, 1.38; 95% CI, 1.08 - 1.76; P = .009) or grade II-IV (HR, 1.58; 95% CI, 1.22 - 2.06; P = .001) aGvHD. The increased risk of aGvHD linked to prior occurrence of CMV DNAemia was similar to the above when only clinically significant episodes were considered for the analyses (HR for all grade aGvHD, 1.48; 95% CI, 1.13 - 1.91; P = .041, and HR for grade II-IV aGvHD, 1.53; 95% CI. 1.13-1.81; P = .04). The CMV DNA doubling time in blood was comparable overall in episodes of CMV DNAemia whether followed by aGvHD or not. Whether CMV replication is a surrogate risk marker of aGvHD or it is causally involved is an important question to be addressed in future experimental research.
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Affiliation(s)
- Felipe Bueno
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Carlos Solano
- Hematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Lourdes Vázquez
- Hematology Department, Complejo Asistencial Universitario de Salamanca-IBSAL, Salamanca, Spain
| | - Estela Giménez
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | | | - Eliseo Albert
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Montserrat Rovira
- Hematology Department, Hospital Clinic Institute of Hematology & Oncology, Barcelona, Spain
| | | | | | | | - María Suárez-Lledó
- Hematology Department, Hospital Clinic Institute of Hematology & Oncology, Barcelona, Spain
| | - Anabella Chinea
- Hematology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - Albert Esquirol
- Hematology Department, Hospital Sant Creu i Sant Pau, Barcelona, Spain
| | - Ariadna Pérez
- Hematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Aránzazu Bermúdez
- Department of Hematology, Hospital Marques de Valdecilla, Santander, Spain
| | - Raquel Saldaña
- Hematology Department, Hospital Universitario de Jerez, Spain
| | - Inmaculada Heras
- Hematology Department, Hospital Universitario Morales Meseguer y Centro Regional de Hemodonación, IMIB, Universidad de Murcia, Spain
| | - Ana Julia González-Huerta
- Hematology-Stem cell Transplantation Unit, Hospital Universitario Central de Asturias, Oviedo IISPA. IUOPA, Oviedo, Spain
| | - Tamara Torrado
- Hematology Department, Complejo Hospitalario Universitario, Vigo, Spain
| | - Montserrat Batlle
- Hematology Department, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Santiago Jiménez
- Hematology Department, Hospital Universitario Doctor Negrín de Gran Canaria, Las Palmas, Spain
| | - Carlos Vallejo
- Hematology Department, Hospital Universitario Donostia-Aránzazu, San Sebastián, Spain
| | - Pere Barba
- Hematology Department Hospital, Universitario Vall de Hebrón, Barcelona, Spain
| | | | - Rafael Duarte
- Hematology Department, Hospital Puerta de Hierro, Madrid, Spain
| | - José Luis Piñana
- Hematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.,Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.,Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
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Casanovas F, Martínez L, Cirici R, Dinamarca F, García D, Pérez A, Diaz L, Nascimento M, Castro J. Psychiatric comorbidity in a patient with opsoclonus-myoclonus syndrome. differences in the transition from childhood to adulthood: A case report. Eur Psychiatry 2021. [PMCID: PMC9480130 DOI: 10.1192/j.eurpsy.2021.1729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Opsoclonus-Myoclonus syndrome (OMS), also known as Kinsbourne syndrome, is a paraneoplasic pediatric condition characterized by erratic eye movements and generalized myoclonus. Previous studies have described a wide range of psychiatric comorbidities in children with this syndrome. Cognitive impairment (especially intellectual capacity and language), affective symptoms (irritability, poor mood regulation) and behavioral problems are the most frequent presentations (1). However, there is a lack of literature describing the progression of this symptoms when the patient reaches the adulthood. Objectives To illustrate the psychiatric comorbidity of an adult patient with Opsoclonus-Myoclonus syndrome. Methods We present one case-report and literature research of the topic. Results We present a 18 year old girl diagnosed with OMS and Graves-Basedow hyperthyroidism. During her childhood she started presenting attention and comprehension difficulties. She was diagnosed with an Attention Deficit Hyperactivity Disorder (ADHD) and started treatment with methylphenidate. She completed elementary and secondary education. During the adulthood, the main psychiatric comorbidity was related to affective symptoms. We observed an impaired mood regulation, hypothymia, anhedonia, and frequent episodes of irritability, which persisted after the thyroid regulation. This caused incremented anxious symptoms and insomnia that were treated with mirtazapine and lormetazepam. After some weeks, she fulfilled criteria of a depressive episode and we started antidepressant treatment with vortioxetine. Conclusions - Adult patients diagnosed with OMS during childhood can persist presenting ADHD as a comorbidity. - Affective symptoms, and even a major depressive episode, should be considered during the follow-up of this population. Insight of the cognitive limitations could be a risk factor for a depression. Disclosure No significant relationships.
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González Vicent M, Díaz de Heredia C, González de Pablo J, Molina B, Regueiro A, Pérez Martinez A, Palomo P, López Corral L, García E, Fernández JM, Pérez A, Jiménez MJ, Guerreiro M, Vallejo C, Gallardo AI, López O, Benito A, Marsal J, Duarte M, Bento L, Badell I, Pedraza A, Jiménez Ubieto A, González P, Gómez Centurión I, Costilla L, Beléndez C, Esquirol A, Espigado I, Lavilla E, Díaz MÁ. Defibrotide in hematopoietic stem cell transplantation: A multicenter survey study of the Spanish Hematopoietic Stem Cell Transplantation Group (GETH). Eur J Haematol 2021; 106:842-850. [PMID: 33713387 DOI: 10.1111/ejh.13618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Defibrotide is approved in European Union for the treatment of severe sinusoidal obstruction syndrome (SOS) after HSCT. However, it has also been used for SOS prophylaxis, moderate SOS and in other complications such as transplant-associated thrombotic microangiopathy (TAM). The objective of this study was to evaluate current uses, effectiveness and safety of defibrotide in patients with HSCT. METHODS This multicenter, retrospective study included patients treated with defibrotide for any indication at 28 HSCT centers of the Grupo Español de Trasplante Hematopoyetico (GETH) including the pediatric subgroup Grupo Español de Trasplante de Medula en Niños (GETMON). RESULTS Three hundred and eighty eight patients treated with defibrotide between January 2011 and December 2018 were included. 253 patients were children, and 135 patients were adults. In total, 332 transplants were allogeneic, and the remainder were autologous. Main indications for defibrotide use were severe/very severe SOS in 173 patients, SOS prophylaxis in 135 patients, moderate SOS in 41 patients, TAM in six patients and suspected SOS in 33 patients. Overall survival (OS) at day +100 in the SOS prophylaxis group was 89% (95% CI, 87%-91%). In the group of patients with moderate and severe/very severe SOS, the OS at day +100 was 80% (95% CI, 74%-86%) and 62% (95% CI, 59%-65%), respectively (P = .0015). With a longer follow-up, median of 2 years (4 months-7 years), OS was 63% (95% CI, 59%-67%) in the SOS prophylaxis patients. OS for patients with moderate and severe/very severe SOS groups was 53% (95% CI, 47%-61%) and 26% (95% CI, 22%-30%), respectively (P = .006). 191 patients died, and SOS was the main cause of death in 23 patients (12%). CONCLUSIONS Defibrotide has an acceptable safety profile with an improved response in severe/very severe SOS compared with historical controls, mainly in pediatric patients. Use of defibrotide for prophylaxis may improve prognosis of patients at high risk of complications due to endothelial damage such as those who receive a second transplant. SOS has an important impact on the HSCT long-term survival, as can be concluded from our study.
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Affiliation(s)
| | | | | | | | | | | | - Pilar Palomo
- BMT Unit, Hospital Central de Asturias, Oviedo, Spain
| | | | | | | | | | | | | | - Carlos Vallejo
- BMT Unit, Hospital Universitario de Donosti, San Sebastián, Spain
| | | | - Oriana López
- BMT Unit, Hospital Morales Meseguer, Murcia, Spain
| | - Ana Benito
- BMT Unit, Hospital Regional de Málaga, Málaga, Spain
| | - Julia Marsal
- BMT Unit, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Mónica Duarte
- BMT Unit, Hospital Marqués de Valdecilla, Santander, Spain
| | - Leyre Bento
- BMT Unit, Hospital Son Espases, Mallorca, Spain
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Esquirol A, Pascual MJ, Garcia-Cadenas I, Herruzo B, Ferrà C, Pérez A, Torio A, Torrent A, Cuesta M, Martino R, Sierra J. Combining Three Different Pretransplantation Scores Improves Predictive Value in Patients after Haploidentical Stem Cell Transplantation with Thiotepa, Busulfan, and Fludarabine Conditioning and Post-Transplantation Cyclophosphamide. Transplant Cell Ther 2021; 27:614.e1-614.e8. [PMID: 33775908 DOI: 10.1016/j.jtct.2021.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/19/2021] [Accepted: 03/10/2021] [Indexed: 11/30/2022]
Abstract
One hundred and sixty-one patients underwent haploidentical stem cell transplantation (haploSCT) with thiotepa, busulfan, and fludarabine conditioning followed by post-transplantation cyclophosphamide (PTCy) (on days +3 and +4) and tacrolimus as graft-versus-host disease prophylaxis. Forty-two percent of patients had a high or very high revised Disease Risk Index (rDRI), 55% had an European Society for Blood and Marrow Transplantation risk score (EBMT-RS) ≥4, and 36% had an age-adjusted Hematopoietic Cell Transplant Comorbidity Index (HCT-CI-age) score ≥3. Each of these was considered an unfavorable score. Using the pretransplantation unfavorable scores that had an independent impact on each transplantation outcome studied in multivariate analysis allowed for better stratification of patient outcomes. Thus, the 3-year overall survival (OS) in patients with 0, 1, 2, and 3 unfavorable scores was 86%, 56%, 36%, and 24%, respectively. Nonrelapse mortality (NRM) was negatively impacted by the EBMT-RS and the HCT-CI-age score (3-year NRM in patients with 0, 1, and 2 unfavorable scores was 12%, 33%, and 43%, respectively), whereas the EBMT-RS and the rDRI had an impact on the 3-year relapse incidence (8%, 18%, and 41% in patients with 0, 1, and 2 unfavorable scores, respectively). In conclusion, our study shows that combining 2 or 3 of these well-defined pretransplantation scores improves the ability to predict transplantation outcomes in the setting of haploSCT with PTCy.
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Affiliation(s)
- Albert Esquirol
- Hematology Department, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau and Jose Carreras Leukemia Research Institute, Universitat Autonoma of Barcelona, Barcelona, Spain.
| | | | - Irene Garcia-Cadenas
- Hematology Department, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau and Jose Carreras Leukemia Research Institute, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Beatriz Herruzo
- Hematology Department, Hospital Regional Universitario, Malaga, Spain
| | - Christelle Ferrà
- Hematology Department, Institut Català d'Oncologia Hospital Germans Trias i Pujol, Badalona, Spain and Universitat de Vic-Universitat Central de Catalunya, Catalonia, Spain
| | - Ariadna Pérez
- Hematology Department, Hospital Clinico Universitario, Valencia, Spain
| | - Alberto Torio
- Immunology Department, Hospital Regional Universitario, Malaga, Spain
| | - Anna Torrent
- Hematology Department, Institut Català d'Oncologia Hospital Germans Trias i Pujol, Badalona, Spain and Universitat de Vic-Universitat Central de Catalunya, Catalonia, Spain
| | - Marian Cuesta
- Hematology Department, Hospital Regional Universitario, Malaga, Spain
| | - Rodrigo Martino
- Hematology Department, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau and Jose Carreras Leukemia Research Institute, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Jorge Sierra
- Hematology Department, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau and Jose Carreras Leukemia Research Institute, Universitat Autonoma of Barcelona, Barcelona, Spain
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45
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Novelli S, Bento L, Garcia I, Prieto L, López L, Gutierrez G, Hernani R, Pérez A, Esquirol A, Solano C, Bastos M, Dorado N, Rodríguez N, Rodríguez G, Piñana JL, Montoro J, Herrera P, Luna A, Parody R, Martín C, García E, López O, Heras I, Zanabili J, Moraleda JM, Yañez L, Gutierrez A, Zudaire T, Córdoba R, Varela R, Ferra C, Martínez J, Martínez C, Gonzalez-Barca E, Martino R, Caballero D. Allogeneic Stem Cell Transplantation in Mature T Cell and Natural Killer/T Neoplasias: A Registry Study from Spanish GETH/GELTAMO Centers. Transplant Cell Ther 2021; 27:493.e1-493.e8. [PMID: 33857447 DOI: 10.1016/j.jtct.2021.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/09/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
Despite advances in understanding the biology of mature T and natural killer (NK)/T cell neoplasia, current therapies, even the most innovative ones, are still far from ensuring its cure. The only treatment to date that has been shown to control aggressive T cell neoplasms in the long term is allogeneic stem cell transplantation (alloSCT). We aim to report the results of alloSCT for advanced mature T and NK/T neoplasias performed in centers from our national GELTAMO/GETH (Grupo Español de Linfoma y Trasplante de Médula Ósea/Grupo Español de Trasplante Hematopoyético y Terapia Celular) over the past 25 years. As a secondary objective, we analyzed the results of alloSCT from haploidentical donors. We performed a retrospective analysis of all patients who received an alloSCT in Spanish centers (n = 201) from September 1995 to August 2018. The 2-year overall survival (OS) and disease-free survival (DFS) were 65.5% and 58.2%, respectively. The univariate for OS and DFS showed statistically different hazard ratios for conditioning intensity, response pre-alloSCT, comorbidity index, donor/receptor cytomegalovirus status and Eastern Cooperative Oncology Group (ECOG) pre-alloSCT, but only a better ECOG pre-alloSCT remained significant in the multivariate analysis. There was an increased incidence of relapse in those patients who did not develop chronic graft-versus-host disease (GVHD) and an increased risk of death in those developing moderate to severe acute GVHD. The 1-year nonrelapse mortality was 21.9% and was mainly due to GVHD (30%) and bacterial infections (17%). When comparing unrelated donors with haploidentical donors, we found similar results in terms of OS and DFS. There was, however, a reduction of acute GVHD in the haploidentical group (P = .04) and trend to a reduction of chronic GVHD. In conclusion, alloSCT is the only curative option for most aggressive T cell neoplasias. Haploidentical donors offer similar results to related donors in terms of survival with a reduction of acute GVHD.
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Affiliation(s)
- Silvana Novelli
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Hospital Sant Pau, Barcelona, Spain.
| | - Leyre Bento
- Hematology Department, Son Espases University Hospital, Palma de Mallorca, Spain
| | - Irene Garcia
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Hospital Sant Pau, Barcelona, Spain
| | - Laura Prieto
- Hematology Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Lucía López
- Hematology Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | - Rafael Hernani
- Hematology Department, Hospital Clínico de Valencia, Valencia, Spain
| | - Ariadna Pérez
- Hematology Department, Hospital Clínico de Valencia, Valencia, Spain
| | - Albert Esquirol
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Hospital Sant Pau, Barcelona, Spain
| | - Carlos Solano
- Hematology Department, Hospital Clínico de Valencia, Valencia, Spain
| | - Mariana Bastos
- Hematology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Nieves Dorado
- Hematology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Nancy Rodríguez
- Hematology Department, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC/CIBERONC), Universidad de Sevilla, Sevilla, Spain
| | - Guillermo Rodríguez
- Hematology Department, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC/CIBERONC), Universidad de Sevilla, Sevilla, Spain
| | - Jose L Piñana
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Juan Montoro
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Pilar Herrera
- Hematology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Alejandro Luna
- Hematology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Rocío Parody
- Hematology Department, Institut Catala d'Oncologia-Hospital Duran i Reynals, Barcelona, Spain
| | - Carmen Martín
- Hematology Department, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Estefanía García
- Hematology Department, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Oriana López
- Hematology Department, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Inmaculada Heras
- Hematology Department, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Joud Zanabili
- Hematology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Jose M Moraleda
- Hematology Department, Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Lucrecia Yañez
- Hematology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Antonio Gutierrez
- Hematology Department, Son Espases University Hospital, Palma de Mallorca, Spain
| | - Teresa Zudaire
- Hematology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Raúl Córdoba
- Hematology Department, Fundación Jiménez Díaz, Madrid, Spain
| | - Rosario Varela
- Hematology Department, Hospital Universitario de A Coruña, A Coruña, Spain
| | - Christelle Ferra
- Hematology Department, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Joaquin Martínez
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Carmen Martínez
- Hematology Department, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Eva Gonzalez-Barca
- Hematology Department, Institut Catala d'Oncologia-Hospital Duran i Reynals, Barcelona, Spain
| | - Rodrigo Martino
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Hospital Sant Pau, Barcelona, Spain
| | - Dolores Caballero
- Hematology Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
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Guerreiro M, Planelles D, Aguilar-Gallardo C, Lorenzo JI, Montoro J, Sanz J, Balaguer A, Gómez I, Solves P, Pérez A, Blanquer M, Espigado I, Solano C, Piñana JL. Allogeneic hematopoietic stem cell transplant recipients in Spain: Human leukocyte antigen characteristics and diversity by high-resolution analysis. HLA 2021; 97:198-213. [PMID: 33369244 DOI: 10.1111/tan.14179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/20/2020] [Accepted: 12/24/2020] [Indexed: 11/26/2022]
Abstract
There are many studies on the polymorphism of the HLA system in healthy donor populations, such as registries of unrelated bone marrow donors. Investigations on the characterization of the HLA complex in hematopoietic stem cell transplant (HSCT) patients, however, are scarce, at least in the Spanish population. This study presents a large-scale analysis of allelic diversity and HLA distribution at a high-resolution level in 2886 patients undergoing HSCT in Spanish centres of the "Grupo Español de Trasplante Hematopoyético y Terapia Celular" during a period of 11 years. Allelic diversity analysis identified 67 HLA-A, 133 HLA-B, 60 HLA-C, 63 HLA-DRB1, 24 HLA-DQB1 and 27 HLA-DPB1 different alleles. Rare alleles were detected among which 33 alleles had not been reported in the European catalog of common and well-documented HLA alleles. Regarding the distribution of five genes-haplotypes, it was observed that the five most frequent extended haplotypes found in our population were between the most common in other Spanish populations, both in patients and in healthy subjects. However, some particular haplotypes were also detected. Bilocus associations HLA-C ~ B and -DRB1 ~ DQB1 were analyzed in order to predict the probability of finding 10/10 matched donors in registries. We found HLA-B alleles showing a great diversity of combinations with HLA-C alleles and unusual associations involving a negative predicting factor. In the field of adoptive therapies, our work supports the necessity to expand further research of TCR-engineered cells, adoptive transfer of virus-specific T-cells and vaccines to target HLA alleles other than A*02:01. HLA alleles such as A*01:01, A*03:01, A*24:02, B*44:03, B*07:02 or B*51:01, might be considered new targets due to its high frequency in our population.
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Affiliation(s)
- Manuel Guerreiro
- Haematology Department, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - Dolores Planelles
- Department of Histocompatibility, Centro de Transfusión de la Comunidad Valenciana, Valencia, Spain
| | | | - José Ignacio Lorenzo
- Haematology Department, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - Juan Montoro
- Haematology Department, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - Jaime Sanz
- Haematology Department, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - Aitana Balaguer
- Haematology Department, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - Inés Gómez
- Haematology Department, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - Pilar Solves
- Haematology Department, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - Ariadna Pérez
- Haematology Department, Hospital Clínico Universitario. Fundación INCLIVA, Valencia, Spain
| | - Miguel Blanquer
- Grupo Español de Trasplante Hematopoyético y Terapia Celular (GETH), Madrid, Spain.,Cell Therapy Unit, IMIB-University Hospital Virgen de la Arrixaca, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Ildefonso Espigado
- Grupo Español de Trasplante Hematopoyético y Terapia Celular (GETH), Madrid, Spain.,Haematology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Carlos Solano
- Haematology Department, Hospital Clínico Universitario. Fundación INCLIVA, Valencia, Spain.,Grupo Español de Trasplante Hematopoyético y Terapia Celular (GETH), Madrid, Spain
| | - José Luis Piñana
- Haematology Department, Hospital Universitari i Politècnic la Fe, Valencia, Spain.,Grupo Español de Trasplante Hematopoyético y Terapia Celular (GETH), Madrid, Spain.,Hematology Division, CIBERONC, Instituto Carlos III, Madrid, Spain
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47
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Solano C, Vázquez L, Giménez E, de la Cámara R, Albert E, Rovira M, Espigado I, Calvo CM, López-Jiménez J, Suárez-Lledó M, Chinea A, Esquirol A, Pérez A, Bermúdez A, Saldaña R, Heras I, González-Huerta AJ, Torrado T, Bautista G, Batlle M, Jiménez S, Vallejo C, Barba P, Cuesta MÁ, Piñana JL, Navarro D. Cytomegalovirus DNAemia and risk of mortality in allogeneic hematopoietic stem cell transplantation: Analysis from the Spanish Hematopoietic Transplantation and Cell Therapy Group. Am J Transplant 2021; 21:258-271. [PMID: 32812351 DOI: 10.1111/ajt.16147] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/07/2020] [Accepted: 06/11/2020] [Indexed: 01/25/2023]
Abstract
The net impact of cytomegalovirus (CMV) DNAemia on overall mortality (OM) and nonrelapse mortality (NRM) following allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a matter of debate. This was a retrospective, multicenter, noninterventional study finally including 749 patients. CMV DNA monitoring was conducted by real-time polymerase chain reaction (PCR) assays. Clinical outcomes of interest were OM and NRM through day 365 after allo-HSCT. The cumulative incidence of CMV DNAemia in this cohort was 52.6%. A total of 306 out of 382 patients with CMV DNAemia received preemptive antiviral therapy (PET). PET use for CMV DNAemia, but not the occurrence of CMV DNAemia, taken as a qualitative variable, was associated with increased OM and NRM in univariate but not in adjusted models. A subcohort analysis including patients monitored by the COBAS Ampliprep/COBAS Taqman CMV Test showed that OM and NRM were comparable in patients in whom either low or high plasma CMV DNA threshold (<500 vs ≥500 IU/mL) was used for PET initiation. In conclusion, CMV DNAemia was not associated with increased OM and NRM in allo-HSCT recipients. The potential impact of PET use on mortality was not proven but merits further research.
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Affiliation(s)
- Carlos Solano
- Hematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Lourdes Vázquez
- Hematology Department, Complejo Asistencial Universitario de Salamanca-IBSAL, Salamanca, Spain
| | - Estela Giménez
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | | | - Eliseo Albert
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Montserrat Rovira
- Hematology Department, Hospital Clinic Institute of Hematology & Oncology, Barcelona, Spain
| | | | - Carmen M Calvo
- Hematology Department, Hospital Universitario Reina Sofía, Córdoba, Spain
| | | | - María Suárez-Lledó
- Hematology Department, Hospital Clinic Institute of Hematology & Oncology, Barcelona, Spain
| | - Anabella Chinea
- Hematology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - Albert Esquirol
- Hematology Department, Hospital Sant Creu i Sant Pau, Barcelona, Spain
| | - Ariadna Pérez
- Hematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain
| | - Aránzazu Bermúdez
- Department of Hematology, Hospital Marques de Valdecilla, Santander, Spain
| | - Raquel Saldaña
- Hematology Department, Hospital Universitario de Jerez, Jerez de la Frontera, Cádiz, Spain
| | - Inmaculada Heras
- Hematology Department, Hospital Universitario Morales Meseguer y Centro Regional de Hemodonación, IMIB, Universidad de Murcia, Murcia, Spain
| | - Ana J González-Huerta
- Hematology-Stem cell Transplantation Unit, Hospital Universitario Central de Asturias, Oviedo IISPA. IUOPA, Oviedo, Spain
| | - Tamara Torrado
- Hematology Department, Complejo Hospitalario Universitario, Vigo, Spain
| | - Guiomar Bautista
- Hematology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Montserrat Batlle
- Hematology Department, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Santiago Jiménez
- Hematology Department, Hospital Universitario Doctor Negrín de Gran Canaria, Las Palmas, Spain
| | - Carlos Vallejo
- Hematology Department Hospital Universitario Donostia-Aránzazu, San Sebastián, Spain
| | - Pere Barba
- Hematology Department Hospital, Universitario Vall de Hebrón, Barcelona, Spain
| | - María Á Cuesta
- Hematology Department, Hospital Regional Universitario, Málaga, Spain
| | - José L Piñana
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.,Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
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48
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Martín-Lara M, Chica-Redecillas L, Pérez A, Blázquez G, Garcia-Garcia G, Calero M. Liquid Hot Water Pretreatment and Enzymatic Hydrolysis as a Valorization Route of Italian Green Pepper Waste to Delivery Free Sugars. Foods 2020; 9:E1640. [PMID: 33182839 PMCID: PMC7697518 DOI: 10.3390/foods9111640] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/15/2020] [Accepted: 11/05/2020] [Indexed: 12/17/2022] Open
Abstract
In this work, liquid hot water pretreatment (autohydrolysis) was used to improve enzymatic hydrolysis of a commonly consumed vegetable waste in Spain, Italian green pepper, to finally produce fermentable sugars. Firstly, the effect of temperature and contact time on sugar recovery during pretreatment (in insoluble solid and liquid fraction) was studied in detail. Then, enzymatic hydrolysis using commercial cellulase was performed with the insoluble solid resulting from pretreatment. The objective was to compare results with and without pretreatment. The results showed that the pretreatment step was effective to facilitate the sugars release in enzymatic hydrolysis, increasing the global sugar yield. This was especially notable when pretreatment was carried out at 180 °C for 40 min for glucose yields. In these conditions a global glucose yield of 61.02% was obtained. In addition, very low concentrations of phenolic compounds (ranging from 69.12 to 82.24 mg/L) were found in the liquid fraction from enzymatic hydrolysis, decreasing the possibility of fermentation inhibition produced by these components. Results showed that Italian green pepper is an interesting feedstock to obtain free sugars and prevent the enormous quantity of this food waste discarded annually.
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Affiliation(s)
- M.A. Martín-Lara
- Chemical Engineering Department, Faculty of Sciences, University of Granada, Avda. Fuentenueva, s/n, 18071 Granada, Spain; (L.C.-R.); (A.P.); (G.B.); (M.C.)
| | - L. Chica-Redecillas
- Chemical Engineering Department, Faculty of Sciences, University of Granada, Avda. Fuentenueva, s/n, 18071 Granada, Spain; (L.C.-R.); (A.P.); (G.B.); (M.C.)
| | - A. Pérez
- Chemical Engineering Department, Faculty of Sciences, University of Granada, Avda. Fuentenueva, s/n, 18071 Granada, Spain; (L.C.-R.); (A.P.); (G.B.); (M.C.)
| | - G. Blázquez
- Chemical Engineering Department, Faculty of Sciences, University of Granada, Avda. Fuentenueva, s/n, 18071 Granada, Spain; (L.C.-R.); (A.P.); (G.B.); (M.C.)
| | - G. Garcia-Garcia
- Department of Chemical and Biological Engineering, The University of Sheffield, Sir Robert Hadfield Building, Sheffield S1 3JD, UK;
| | - M. Calero
- Chemical Engineering Department, Faculty of Sciences, University of Granada, Avda. Fuentenueva, s/n, 18071 Granada, Spain; (L.C.-R.); (A.P.); (G.B.); (M.C.)
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49
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Lorente L, Martín MM, Ortiz-López R, González-Rivero AF, Pérez-Cejas A, Martín M, Gonzalez V, Pérez A, Rodin M, Jiménez A. Blood caspase-8 concentrations and mortality among septic patients. Med Intensiva 2020; 46:S0210-5691(20)30246-1. [PMID: 32843190 DOI: 10.1016/j.medin.2020.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/23/2020] [Accepted: 06/27/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE No data are available on blood caspase-8 concentrations (the initiator caspase in the extrinsic apoptosis pathway) in septic patients. The present study thus describes the blood caspase-8 concentrations in survivors and non-survivors, and examines the possible association between blood caspase-8 concentrations and mortality in septic patients. DESIGN A prospective observational study was carried out. SETTING Three Spanish Intensive Care Units. PATIENTS Septic patients. INTERVENTIONS Serum caspase-8 concentrations were determined at the diagnosis of sepsis. MAIN VARIABLE OF INTEREST Mortality after 30 days. RESULTS Patients not surviving at day 30 (n=81) compared to surviving patients (n=140) showed higher serum caspase-8 levels (p<0.001). Multiple logistic regression analysis found an association between serum caspase-8 levels>43.5ng/ml and mortality (OR=3.306; 95%CI=1.619-6.753; p=0.001). The area under the curve (AUC) for mortality predicted by serum caspase-8 levels was 67% (95% CI=60-73%; p<0.001). CONCLUSIONS The novel findings of our study were that blood caspase-8 concentrations are higher in non-survivors than in survivors, and that there is an association between blood caspase-8 concentrations and mortality in septic patients.
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Affiliation(s)
- L Lorente
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Tenerife, Spain.
| | - M M Martín
- Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Crta Rosario s/n., Santa Cruz Tenerife 38010, Spain
| | - R Ortiz-López
- Intensive Care Unit, Hospital General de La Palma, Buenavista de Arriba s/n, Breña Alta, La Palma 38713, Spain
| | - A F González-Rivero
- Laboratory Department, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Santa Cruz de Tenerife, Spain
| | - A Pérez-Cejas
- Laboratory Department, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Tenerife, Spain
| | - M Martín
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n., La Laguna, Santa Cruz de Tenerife 38320, Spain
| | - V Gonzalez
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n., La Laguna, Santa Cruz de Tenerife 38320, Spain
| | - A Pérez
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n., La Laguna, Santa Cruz de Tenerife 38320, Spain
| | - M Rodin
- Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n., La Laguna, Santa Cruz de Tenerife 38320, Spain
| | - A Jiménez
- Research Unit, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Tenerife, Spain
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50
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Bueno F, Albert E, Giménez E, Piñana JL, Pérez A, Gómez MD, Hernández‐Boluda JC, Gonzalez‐Barberá EM, Montoro J, Guerreiro M, Balaguer‐Roselló A, Hernani R, Sanz J, Solano C, Navarro D. Cytomegalovirus DNA load monitoring in stool specimens for anticipating the occurrence of intestinal acute graft‐versus‐host disease following allogeneic hematopoietic stem cell transplantation: Is it of any value? Transpl Infect Dis 2020; 22:e13440. [DOI: 10.1111/tid.13440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/15/2020] [Accepted: 08/02/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Felipe Bueno
- Microbiology Service Hospital Clínico UniversitarioInstitute for Research INCLIVA Valencia Spain
| | - Eliseo Albert
- Microbiology Service Hospital Clínico UniversitarioInstitute for Research INCLIVA Valencia Spain
| | - Estela Giménez
- Microbiology Service Hospital Clínico UniversitarioInstitute for Research INCLIVA Valencia Spain
| | - José Luis Piñana
- Hematology Department Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Ariadna Pérez
- Hematology Service Hospital Clínico UniversitarioInstitute for Research INCLIVA Valencia Spain
| | - María Dolores Gómez
- Microbiology Service Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Juan Carlos Hernández‐Boluda
- Hematology Service Hospital Clínico UniversitarioInstitute for Research INCLIVA Valencia Spain
- Department of Medicine School of Medicine University of Valencia Valencia Spain
| | | | - Juan Montoro
- Hematology Department Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Manuel Guerreiro
- Hematology Department Hospital Universitari i Politècnic La Fe Valencia Spain
| | | | - Rafael Hernani
- Hematology Service Hospital Clínico UniversitarioInstitute for Research INCLIVA Valencia Spain
| | - Jaime Sanz
- Hematology Department Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Carlos Solano
- Hematology Service Hospital Clínico UniversitarioInstitute for Research INCLIVA Valencia Spain
- Department of Medicine School of Medicine University of Valencia Valencia Spain
| | - David Navarro
- Microbiology Service Hospital Clínico UniversitarioInstitute for Research INCLIVA Valencia Spain
- Department of Microbiology School of Medicine University of Valencia Valencia Spain
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