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Eberhard HP, Feldmann U, Bochtler W, Baier D, Rutt C, Schmidt AH, Müller CR. Estimating unbiased haplotype frequencies from stem cell donor samples typed at heterogeneous resolutions: a practical study based on over 1 million German donors. ACTA ACUST UNITED AC 2010; 76:352-61. [DOI: 10.1111/j.1399-0039.2010.01518.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schmidt AH, Solloch UV, Baier D, Stahr A, Wassmuth R, Ehninger G, Rutt C. Regional differences in HLA antigen and haplotype frequency distributions in Germany and their relevance to the optimization of hematopoietic stem cell donor recruitment. ACTA ACUST UNITED AC 2010; 76:362-79. [DOI: 10.1111/j.1399-0039.2010.01520.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Platz A, Schmidt A, Aurich AC, Solloch U, Rutt C, Ehninger G. Effects Of Obstetric Factors On Weights And Cell Counts Of Cord Blood Units. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.192] [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: 11/30/2022]
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Platzbecker U, Binder M, Schmid C, Rutt C, Ehninger G, Bornhauser M. Second donation of hematopoietic stem cells from unrelated donors for patients with relapse or graft failure after allogeneic transplantation. Haematologica 2008; 93:1276-8. [DOI: 10.3324/haematol.12798] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Abstract
With more than 11 million registered stem cell donors worldwide and limited resources for health systems, it seems questionable if investments in ongoing donor recruitment are useful. Since there is evidence that transplant outcomes are better with younger donors, the age distribution of registered donors is highly relevant in this context. One might argue that the usefulness of a donor file decreases if there is no new donor recruitment not only as a result of loss of donors who reach the age limit for donation but also since those donors who remain in the file get older. We established a multivariate model to quantify this effect and to estimate the number (designated R) of donors who must be recruited annually to keep donor file usefulness constant. The model is applied to real data from DKMS German Bone Marrow Donor Center. R exceeds the number of donors who reach the age limit by factors up to 7.3. The model can serve as an easy-to-use tool for strategic donor registry planning. Our results suggest that analyses regarding optimal size of donor registries should also include the age distribution of registered donors.
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Affiliation(s)
- A H Schmidt
- DKMS German Bone Marrow Donor Center, Tübingen, Germany.
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Schmidt AH, Stahr A, Baier D, Schumacher S, Ehninger G, Rutt C. Selective recruitment of stem cell donors with rare human leukocyte antigen phenotypes. Bone Marrow Transplant 2007; 40:823-30. [PMID: 17724442 DOI: 10.1038/sj.bmt.1705832] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Many patients in need of a hematopoietic stem cell transplant do not find a fully matching donor although more than 11,000,000 potential donors are registered worldwide. Therefore, it is relevant to recruit donors who add diversity to the donor pool. We present the 'Roots' approach that includes the selection of already registered donors with rare HLA phenotypes and the recruitment of relatives of these donors. Two projects (Roots A and B) with different donor selection criteria were carried out. HLA phenotype frequency distributions of new donors differ significantly from the respective control groups: 2.7% of Roots A donors versus 1.1% of the control group have an HLA-AB phenotype that is unique in the DKMS file (P=0.001). Additionally, 39.5% of Roots B donors but only 18.3% of the control group have a unique HLA-ABDR phenotype (P<0.001). Similar results are found when phenotypes that are at most available 10 times in the DKMS donor file are analyzed. The results show that the Roots approach is generally suited to increasing the ratio of donors with rare HLA phenotypes in a donor file. Additional costs of Roots donor recruitment seem justified through the ratio of recruited donors with rare HLA phenotypes.
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Affiliation(s)
- A H Schmidt
- DKMS German Bone Marrow Donor Center, Tübingen, Germany.
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Schmidt A, Baier D, Stahr A, Rutt C. 14: Estimation of high-resolution HLA-a*, -B*, -c*, -DRB1* haplotypes and implications for stem cell donor registry planning. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.017] [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: 11/15/2022]
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Jones NF, Rutt C, Frank LD, Sallis JF, Saelens BE, Chapman J, Lekiachvili A. The development of a data model for research on the environmental correlates of physical inactivity and obesity. AMIA Annu Symp Proc 2006; 2006:970. [PMID: 17238589 PMCID: PMC1839301] [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] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Development of information systems to support research on environmental correlates of physical activity and nutrition has to date been largely ad hoc and driven by single research project requirements. In this rapidly growing field, research databases are becoming increasingly complex as researchers attempt to model the impact of multiple aspects of the environment such as neighborhood characteristics, site and building design, and nutritional environments on both aggregate and individual level measures of physical activity and weight. The presentation reports on the initial implementation of a logical data model in the context of an ongoing research program that is exploring the relation of neighborhood physical and demographic characteristics on physical activity levels measured in time and space.
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Affiliation(s)
- N F Jones
- Centers for Disease Control and Prevention, Public Health Informatics Fellowships Program, Career Development Division, Office of Workforce and Career Development, and National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
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Kroschinsky F, Kittner T, Mauersberger S, Rautenberg U, Schuler U, Rutt C, Laniado M, Ehninger G. Pelvic magnetic resonance imaging after bone marrow harvest – a retrospective study in 50 unrelated marrow donors. Bone Marrow Transplant 2005; 35:667-73. [PMID: 15723083 DOI: 10.1038/sj.bmt.1704873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A total of 50 unrelated marrow donors were examined by pelvic magnetic resonance imaging (MRI) to investigate the morphological sequelae of bone marrow harvesting (BMH). Signal increase in T2-weighted sequences and contrast media enhancement in T1 sequences at the operative sites were found as typical MRI morphology 4 weeks after harvest (group A, n=16), corresponding to edema, hyperemia and proliferative activity. Although tissue repair was completed in the majority of donors 1 year after BMH, about 36% of donors in group B (n=16) had abnormal findings. These included a persistence of the 'acute injury' signal pattern (2/16, 12%), and signal alterations due to fatty marrow conversion (4/16, 24%). The proportion of MRI abnormalities increased to over 70% in two-time donors (group C, n=11), which might indicate a cumulation of tissue damage after repetitive harvests. If donors had experienced prolonged discomfort after BMH (group D, n=7), MRI revealed pathological signals in 86%. In conclusion, the MRI morphology reflects the pathophysiological reactions after BMH, including inflammation and tissue repair. A further prospective evaluation in a larger number of donors is necessary to confirm these results and to identify the factors which influence the extent and duration of tissue damage.
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Affiliation(s)
- F Kroschinsky
- University Hospital Dresden, 1st Medical Department, Dresden, Germany.
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Baier D, Gawellek A, Rutt C. Replacement donor program: More than protecting stem cell donors from multiple donations for different patients. Biol Blood Marrow Transplant 2005. [DOI: 10.1016/j.bbmt.2004.12.099] [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: 10/25/2022]
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Gawellek A, Rall G, Rutt C, Baier D. 75 Replacement donor program: The duty to protect stem cell donors from multiple donations for different patients. Biol Blood Marrow Transplant 2003. [DOI: 10.1016/s1083-8791(03)80076-9] [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: 11/26/2022]
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Wittrock J, Rehm P, Rutt C, Baier D. 82 DNA based high resolution typing: Optimized preselection for confirmatory typing (CT). Biol Blood Marrow Transplant 2003. [DOI: 10.1016/s1083-8791(03)80083-6] [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: 11/27/2022]
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Schuler U, Rutt C, Baier D, Keller JV, Stahr A, Grathwohl A, Ehninger G. Approaches to managing volunteer marrow donor registry HLA data. Algorithms for directing donor center-initiated HLA-DR typing of selected donors. Rev Immunogenet 2002; 2:541-6. [PMID: 12361095] [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] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The German bone marrow donor center (DKMS) hasrecruited over 732 500 donors during the first 9 years of its existence. Initially, donors were typed for HLA-A and B, and DR typing was only done on request for a patient-initiated search. In 1994, a project was started which led to the donor center-initiated DR typing (DCI-DRT) of >35,000 donors. These donors were selected by donor-specific criteria (age, sex, height and weight) and according to HLA-A and B phenotypes. The latter was done to avoid unnecessary DR typing of the most common A, B phenotypes With a follow up of >6 years, this strategy has led to a number of confirmatory typings (CT) (n=4588) and stem cell harvests (n=568), which is at least comparable to those ensuing after patient-initiated HLA-DR typing (126 000 DR typings, 8,213 CTs, 888 resulting in stem-cell donation). DCI-DRT seems to be a cost-effective strategy which may help to reduce search times and improve search outcome, and improve the overall efficiency of donor center operations
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Affiliation(s)
- U Schuler
- University of Dresden, Department of Medicine, Germany.
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Platzbecker U, Prange-Krex G, Bornhäuser M, Koch R, Soucek S, Aikele P, Haack A, Haag C, Schuler U, Berndt A, Rutt C, Ehninger G, Hölig K. Spleen enlargement in healthy donors during G-CSF mobilization of PBPCs. Transfusion 2001; 41:184-9. [PMID: 11239220 DOI: 10.1046/j.1537-2995.2001.41020184.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Recombinant human G-CSF is widely used to mobilize PBPCs in healthy donors for allogeneic transplantation. There have been concerns about donor safety because of splenic ruptures during G-CSF application. To address this problem, changes in splenic size in 91 healthy donors during G-CSF mobilization of allogeneic PBPCs were investigated. STUDY DESIGN AND METHODS For mobilization, G-CSF in a dosage of 7.5 microg per kg per day was administered for 5 days and PBPC collection started Day 5. Splenic size was determined by ultrasound before G-CSF application was started and on the day of the first apheresis. RESULTS The mean increase in splenic length was 11 mm (range, 0-28 mm; p<0.0001), whereas a mean increase of 5 mm in width (range, 0-14 mm; p<0.0001) was measured. No major side effects could be observed. There was no significant correlation between the increase in splenic size and the hematologic values, or the age and body-mass index. In a multivariant analysis, no independent risk factor for the development of a spleen enlargement over 19 mm in length and 9 mm in thickness was found in 20 percent of investigated donors. CONCLUSION In this prospective trial, a significant spleen enlargement was observed in healthy donors during G-CSF mobilization of allogeneic PBPCs. Further investigations are needed to define the degree of spleen enlargement with higher G-CSF dosages to improve donor safety.
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Affiliation(s)
- U Platzbecker
- Medical Clinic I, the Institute of Transfusion Medicine, the Institute of Radiology, and the Institute of Biometry, University Hospital Carl Gustav Carus, Dresden, Germany.
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Bornhäuser M, Theuser C, Soucek S, Hölig K, Klingebiel T, Blau W, Fauser A, Runde V, Schwinger W, Rutt C, Ehninger G. Allogeneic transplantation of G-CSF mobilized peripheral blood stem cells from unrelated donors: a retrospective analysis. Haematologica 2000; 85:839-47. [PMID: 10942931] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Allogeneic peripheral blood stem cell transplantation (PBSCT) from matched siblings has lead to clinical results comparable to those of standard bone marrow transplantation (BMT). We report the outcome of 79 patients transplanted with PBSC from unrelated donors. DESIGN AND METHODS In 61 cases PBSC were used for primary transplantation whereas 18 patients were treated for relapse or graft-failure. In 35 patients receiving primary transplants, T-cell depletion (TCD) using CD34 positive selection of PBSC with or without additional T-cell depletion had been performed to reduce the risk of graft-versus-host-disease (GvHD). RESULTS The rate of primary graft-failure was higher (20%) in the TCD group than in that receiving unmanipulated grafts (UM) (5%, p=0.007). Patients with standard risk (n=34) receiving first transplants had a significantly better overall (60.4% vs. 24%, p=0.02) and disease-free survival (57.2% vs. 22.3%, p=0.006) compared to a high risk group of patients (n=21). There were no differences in the speed of neutrophil and platelet engraftment between TCD and UM transplants. As expected, the cumulative risk for acute GvHD grade II.-IV was significantly higher in the patients who had received UM grafts (71.8% vs. 38.1%, p=0.005). Although a trend towards a better survival rate was observed after TCD transplantation (52.2%) compared to the UM group (38.1%), this difference was not statistically significant. The probability of relapse was significantly higher in patients after UM transplants (38.8% vs. 8. 4%). This apparent paradox is explained by the higher number of high-risk patients in this group (p=0.03). Multivariable analysis of disease-free survival revealed risk category (p=0.02) and use of ATG (p=0.03) to be of significant impact. All patients (n=6) with non-malignant diseases are alive with full donor chimerism. INTERPRETATION AND CONCLUSIONS These data show that PBSC from unrelated donors can be transplanted either unmanipulated or CD34 selected. Prospective studies comparing BMT with PBSCT from unrelated donors are needed in defined disease categories.
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Affiliation(s)
- M Bornhäuser
- Med. Klinik I, Universit tsklinikum Carl Gustav Carus, Fetscherstrasse 74, 01307 Dresden, Germany.
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Brim J, Wetzel RD, Reich T, Wood D, Viesselman J, Rutt C. Primary and secondary affective disorder: Part III. Longitudinal differences in depression symptoms. J Clin Psychiatry 1984; 45:64-9. [PMID: 6693364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Depressed inpatients (29 primary and 31 secondary) were blindly rated at several time points on 137 depressive symptoms. Of the 7 high-frequency symptoms or symptom clusters analyzed, significantly greater symptom persistence was seen for secondary depressives on low mood, pessimism, change in usual interests, and suicidal ideation. Day-to-day variability in symptoms did not differ between groups. Scalability of symptoms (Guttman scales) was acceptable for primary but not secondary depressives. Suicidal ideation tended to be the first symptom to remit in primary depression but persisted in the secondary group, even after remission of the most severe symptom. Implications for treatment are discussed.
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Abstract
Over a three-year period, we have seen in consultation four children whose mothers cited complaints referable to every organ system and which had persisted for many years. The parents had consulted a total of 99 physicians in eight states. Absence from school ranged from 40 to 200 days a year. Physical examinations of all patients and extensive and repeated laboratory studies were normal. On psychiatric examination the mothers exhibited paranoid thinking and a conviction of serious medical illness in their child which approached delusional proportions. They resisted psychiatric consultation and refused psychotherapy. The mother-child relationship was remarkably symbiotic, the two teen-age patients essentially voicing complaints which were indistinguishable from those reported by their mothers. The fathers invariably supported their wives' concerns. Subsequently, parents and children left treatment, continuing to "doctor shop." Long-standing multisystem complaints in a child with normal growth and maturation are incompatible with any known significant organic disease, but suggest a serious emotional problem within the family. Further, parents who take such children from doctor to doctor are frequently disturbed themselves and may use an offspring as a proxy patient. An accurate diagnosis depends on careful history-taking from parents, patient, health professionals, and schools.
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Brim J, Wetzel RD, Reich T, Wood D, Viesselman J, Rutt C. Primary and secondary affective disorder: Part II. Differences in usual state self-perceptions. Compr Psychiatry 1980; 21:388-95. [PMID: 7418381 DOI: 10.1016/0010-440x(80)90020-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Wood D, Othmer S, Reich T, Viesselman J, Rutt C. Primary and secondary affective disorder. 1. Past social history and current episodes in 92 depressed inpatients. Compr Psychiatry 1977; 18:201-10. [PMID: 858237 DOI: 10.1016/0010-440x(77)90014-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Friedenberg ZB, Gentchos E, Rutt C. Fixation in intertrochanteric fractures of the hip. Surg Gynecol Obstet 1972; 135:225-8. [PMID: 5049946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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