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Stefanski AL, Rincon-Arevalo H, Schrezenmeier E, Karberg K, Szelinski F, Ritter J, Jahresdoerfer B, Schrezenmeier H, Ludwig C, Chen Y, Claußnitzer A, Lino A, Dörner T. POS0050 B CELL CHARACTERISTICS AT BASELINE PREDICT HUMORAL RESPONSE UPON SARS-CoV-2 VACCINATION AMONG PATIENTS TREATED WITH RITUXIMAB. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.275] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundVaccination is considered efficient in controlling infections incl. SARS-CoV-2. Prior studies showed that patients receiving rituximab (RTX) with low B cell counts are at increased infectious risk (1) and risk of inadequate vaccination responses (2, 3). Thus, the ability to further define and predict vaccination responses in these patients may guide their optimal protection.ObjectivesTo assess predictive biomarkers of vaccination responses upon SARS-CoV-2 vaccination in RTX treated patients.MethodsB cell characteristics before vaccination were evaluated to predict responses in 15 patients with autoimmune inflammatory rheumatic diseases receiving RTX. 11 patients with rheumatoid arthritis on other therapies (RA), 11 kidney transplant recipients (KTR) and 15 healthy volunteers (HC) served as controls. A multidimensional analysis of B cell subsets and a correlation matrix were performed to identify predictive biomarkers.ResultsSignificant differences regarding absolute B cell counts and specific subset distribution pattern between the groups were validated at baseline. Here, the majority of B cells from vaccination responders of the RTX group (RTX IgG+) comprised naïve and transitional B cells, whereas vaccination non-responders (RTX IgG-) carried preferentially plasmablasts and double negative (CD27-IgD-) B cells (Figure 1). Moreover, there was a positive correlation between neutralizing antibodies and absolute B cell numbers with B cells expressing HLA-DR and CXCR5 (involved in antigen presentation and germinal center formation) as well as an inverse correlation with CD95 expression and CD21low expression (marker for activation and exhaustion) on B cells.ConclusionSubstantial repopulation of naïve B cells upon RTX therapy appears to be essential for an adequate vaccination response requiring germinal center formation. In contrast, expression of exhaustion markers (CD21low, CXCR5-, CD95+) indicate negative predictors of vaccination responses. These results may guide optimized vaccination strategies in RTX treated patients clearly requiring antigen-inexperienced B cells for appropriate protection.References[1]Sparks JA, Wallace ZS, Seet AM, Gianfrancesco MA, Izadi Z, Hyrich KL, et al. Associations of baseline use of biologic or targeted synthetic DMARDs with COVID-19 severity in rheumatoid arthritis: Results from the COVID-19 Global Rheumatology Alliance physician registry. Annals of the Rheumatic Diseases. 2021;80(9):1137-46.[2]Stefanski AL, Rincon-Arevalo H, Schrezenmeier E, Karberg K, Szelinski F, Ritter J, et al. B cell numbers predict humoral and cellular response upon SARS-CoV-2 vaccination among patients treated with rituximab. Arthritis & Rheumatology. Accepted Author Manuscript.[3]Mrak D, Tobudic S, Koblischke M, Graninger M, Radner H, Sieghart D, et al. SARS-CoV-2 vaccination in rituximab-treated patients: B cells promote humoral immune responses in the presence of T-cell-mediated immunity. Annals of the rheumatic diseases. 2021;80(10):1345-50.Disclosure of InterestsNone declared
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Heyn J, Bräuninger S, Dimova-Dobreva M, Mathieson N, Koptelova N, Kolpakova A, Seidl C, Reinhardt P, Tsamadou C, Schrezenmeier H, Nakov R, Seifried E, Bonig H. Superior physical and mental health of healthy volunteers before and five years after mobilized stem cell donation. J Transl Med 2022; 20:121. [PMID: 35287672 PMCID: PMC8919626 DOI: 10.1186/s12967-022-03322-w] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/27/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Safety, tolerability and efficacy of granulocyte colony-stimulating factor (G-CSF) for mobilization of hematopoietic stem and progenitor cells (HSPCs) from healthy donors have been conclusively demonstrated. This explicitly includes, albeit for smaller cohorts and shorter observation periods, biosimilar G-CSFs. HSPC donation is non-remunerated, its sole reward being “warm glow”, hence harm to donors must be avoided with maximal certitude. To ascertain, therefore, long-term physical and mental health effects of HSPC donation, a cohort of G-CSF mobilized donors was followed longitudinally.
Methods
We enrolled 245 healthy volunteers in this bi-centric long-term surveillance study. 244 healthy volunteers began mobilization with twice-daily Sandoz biosimilar filgrastim and 242 underwent apheresis after G-CSF mobilization. Physical and mental health were followed up over a period of 5-years using the validated SF-12 health questionnaire.
Results
Baseline physical and mental health of HSPC donors was markedly better than in a healthy reference population matched for ethnicity, sex and age. Physical, but not mental health was sharply diminished at the time of apheresis, likely due to side effects of biosimilar G-CSF, however had returned to pre-apheresis values by the next follow-up appointment after 6 months. Physical and mental health slightly deteriorated over time with kinetics reflecting the known effects of aging. Hence, superior physical and mental health compared to the general healthy non-donor population was maintained over time.
Conclusions
HSPC donors are of better overall physical and mental health than the average healthy non-donor. Superior well-being is maintained over time, supporting the favorable risk–benefit assessment of volunteer HSPC donation.
Trial registration National Clinical Trial NCT01766934
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Manferdini C, Gabusi E, Trucco D, Rojewski M, Schrezenmeier H, Meliconi R, Addimanda O, Lisignoli G. Specific effects of osteoarthritic milieu and hypoxic conditions on adipose mesenchymal stromal cell migration and cytokine receptors expression. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.163] [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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Röth A, Nagy Z, Peffault de Latour R, Ninomya H, Panse J, Yoon S, Egyed M, Ichikawa S, Ito Y, Seok Kim J, Schrezenmeier H, Sica S, Usuki K, Sostelly A, Higginson J, Dieckmann A, Anzures-Cabreras J, Shinomiya K, Klughammer B, Jahreis A, Bucher C, Nishimura J. PF348 LONG TERM FOLLOW-UP OF PNH PATIENTS TREATED WITH THE SMART ANTI-HC5 ANTIBODY (SKY59/RO7112689) IN THE OPEN LABEL EXTENSION (OLE) OF THE COMPOSER TRIAL. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000559604.06488.14] [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] Open
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Fuerst D, Radecke F, Schrezenmeier H, Schwarz K, Mytilineos J. Resequencing of four novel alleles with nanopore technology. HLA 2018; 92:233-234. [DOI: 10.1111/tan.13360] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 11/30/2022]
Affiliation(s)
- D. Fuerst
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service; Baden Wuerttemberg-Hessen and University Hospital Ulm; Ulm Germany
- Institute of Transfusion Medicine; University of Ulm; Ulm Germany
| | - F. Radecke
- Institute of Transfusion Medicine; University of Ulm; Ulm Germany
| | - H. Schrezenmeier
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service; Baden Wuerttemberg-Hessen and University Hospital Ulm; Ulm Germany
- Institute of Transfusion Medicine; University of Ulm; Ulm Germany
| | - K. Schwarz
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service; Baden Wuerttemberg-Hessen and University Hospital Ulm; Ulm Germany
- Institute of Transfusion Medicine; University of Ulm; Ulm Germany
| | - J. Mytilineos
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service; Baden Wuerttemberg-Hessen and University Hospital Ulm; Ulm Germany
- Institute of Transfusion Medicine; University of Ulm; Ulm Germany
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Strunk D, Lozano M, Marks DC, Loh YS, Gstraunthaler G, Schennach H, Rohde E, Laner-Plamberger S, Öller M, Nystedt J, Lotfi R, Rojewski M, Schrezenmeier H, Bieback K, Schäfer R, Bakchoul T, Waidmann M, Jonsdottir-Buch SM, Montazeri H, Sigurjonsson OE, Iudicone P, Fioravanti D, Pierelli L, Introna M, Capelli C, Falanga A, Takanashi M, Lόpez-Villar O, Burnouf T, Reems JA, Pierce J, Preslar AM, Schallmoser K. International Forum on GMP-grade human platelet lysate for cell propagation: summary. Vox Sang 2017; 113:80-87. [PMID: 29076169 DOI: 10.1111/vox.12593] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- D Strunk
- Institute of Experimental and Clinical Cell Therapy, Paracelsus Medical University, Salzburg, Austria
| | - M Lozano
- Hospital Clinic, Department of Hemotherapy and Hemostasis, Hospital Clínic University of Barcelona , Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - K Schallmoser
- Department of Blood Group Serology and Transfusion Medicine, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria
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Strunk D, Lozano M, Marks DC, Loh YS, Gstraunthaler G, Schennach H, Rohde E, Laner-Plamberger S, Öller M, Nystedt J, Lotfi R, Rojewski M, Schrezenmeier H, Bieback K, Schäfer R, Bakchoul T, Waidmann M, Jonsdottir-Buch SM, Montazeri H, Sigurjonsson OE, Iudicone P, Fioravanti D, Pierelli L, Introna M, Capelli C, Falanga A, Takanashi M, López-Villar O, Burnouf T, Reems JA, Pierce J, Preslar AM, Schallmoser K. International Forum on GMP-grade human platelet lysate for cell propagation. Vox Sang 2017; 113:e1-e25. [PMID: 29071726 DOI: 10.1111/vox.12594] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
| | | | - D C Marks
- Australian Red Cross Blood Service, Research and Development, 17 O'Riordan Street, Sydney, New South Wales, 2015, Australia
| | - Y S Loh
- Australian Red Cross Blood Service, Research and Development, 17 O'Riordan Street, Sydney, New South Wales, 2015, Australia
| | - G Gstraunthaler
- Division of Physiology, Medical University Innsbruck, Schöpfstr. 41, Innsbruck, A-6020, Austria
| | - H Schennach
- Central Institute of Blood Transfusion and Immunology, University Hospital Innsbruck, Anichstr. 35, Innsbruck, A-6020, Austria
| | - E Rohde
- Department of Blood Group Serology and Transfusion Medicine, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, Lindhofstrasse 20-22, Salzburg, 5020, Austria
| | - S Laner-Plamberger
- Department of Blood Group Serology and Transfusion Medicine, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, Lindhofstrasse 20-22, Salzburg, 5020, Austria
| | - M Öller
- Department of Blood Group Serology and Transfusion Medicine, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, Lindhofstrasse 20-22, Salzburg, 5020, Austria
| | - J Nystedt
- Finnish Red Cross Blood Service, Advanced Cell Therapy Centre, Kivihaantie 7, FI-00310, Helsinki, Finland
| | - R Lotfi
- Institute for Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service, Baden-Wuerttemberg-Hessen , University Hospital Ulm, University of Ulm, Helmholtzstr. 10, Ulm, 89081, Germany
| | - M Rojewski
- Institute for Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service, Baden-Wuerttemberg-Hessen , University Hospital Ulm, University of Ulm, Helmholtzstr. 10, Ulm, 89081, Germany
| | - H Schrezenmeier
- Institute for Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service, Baden-Wuerttemberg-Hessen , University Hospital Ulm, University of Ulm, Helmholtzstr. 10, Ulm, 89081, Germany
| | - K Bieback
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, German Red Cross Blood Service Baden-Württemberg - Hessen, Heidelberg University, Friedrich-Ebert Str. 107, Mannheim, D-68167, Germany
| | - R Schäfer
- Institute for Transfusion Medicine and Immunohematology, German Red Cross Blood Donor Service Baden-Württemberg- Hessen gGmbH, Goethe-University Hospital, Sandhofstrasse 1, Frankfurt am Main, D-60528, Germany
| | - T Bakchoul
- Center for Clinical Transfusion Medicine, Otfried-Müller-Strasse 4/1, D-72076 , Tuebingen, Germany
| | - M Waidmann
- Center for Clinical Transfusion Medicine, Otfried-Müller-Strasse 4/1, D-72076 , Tuebingen, Germany
| | - S M Jonsdottir-Buch
- The Blood Bank, Landspitali University Hospital, Snorrabraut 60, 101, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Vatnsmyrarvegur 16, 101, Reykjavik, Iceland.,Platome Biotechnology, Alfaskeid 27, 220, Hafnarfjordur, Iceland
| | - H Montazeri
- The Blood Bank, Landspitali University Hospital, Snorrabraut 60, 101, Reykjavik, Iceland.,Platome Biotechnology, Alfaskeid 27, 220, Hafnarfjordur, Iceland
| | - O E Sigurjonsson
- The Blood Bank, Landspitali University Hospital, Snorrabraut 60, 101, Reykjavik, Iceland.,Platome Biotechnology, Alfaskeid 27, 220, Hafnarfjordur, Iceland.,School of Science and Engineering, University of Reykjavik, Menntavegur 1, 101, Reykjavik, Iceland
| | - P Iudicone
- San Camillo Forlanini Hospital, Circonvallazione Gianicolense 87, Rome, 00152, Italy
| | - D Fioravanti
- San Camillo Forlanini Hospital, Circonvallazione Gianicolense 87, Rome, 00152, Italy
| | - L Pierelli
- Department of Experimental Medicine, Sapienza University, Piazzale Aldo Moro 5, Rome, 00185, Italy
| | - M Introna
- QP USS Centro di Terapia Cellulare 'G. Lanzani', USC Ematologia, ASST Papa Giovanni XXIII, Via Garibaldi 11/13, Bergamo, 24124, Italy
| | - C Capelli
- USS Centro di Terapia Cellulare 'G. Lanzani', USC Ematologia, ASST Papa Giovanni XXIII, Via Garibaldi 11/13, Bergamo, 24124, Italy
| | - A Falanga
- Division of Immunohematology and Transfusion Medicine, ASST Papa Giovanni XXIII, Piazza OMS 1, Bergamo, 24127, Italy
| | - M Takanashi
- Japanese Red Cross Blood Service Headquarters, 1-2-1 Shiba-koen, Minato-ku, Tokyo, 105-0011, Japan
| | - O López-Villar
- Department of Hematology, University Hospital of Salamanca, P/San Vicente 58-182, Salamanca, 37007, Spain
| | - T Burnouf
- Graduate Institute of Biomedical Materials and Tissue Engineering, International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, 250 Wu-Shin Street, Taipei, 101, Taiwan
| | - J A Reems
- Division of Hematology and Hematologic Malignancies, Department of Medicine, University of Utah Cell Therapy and Regenerative Medicine, 675 Arapeen, Suite 300, Salt Lake City, Utah, 84108, USA
| | - J Pierce
- Division of Hematology and Hematologic Malignancies, Department of Medicine, University of Utah Cell Therapy and Regenerative Medicine, 675 Arapeen, Suite 300, Salt Lake City, Utah, 84108, USA
| | - A M Preslar
- Division of Hematology and Hematologic Malignancies, Department of Medicine, University of Utah Cell Therapy and Regenerative Medicine, 675 Arapeen, Suite 300, Salt Lake City, Utah, 84108, USA
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Socié G, Schrezenmeier H, Muus P, Lisukov I, Röth A, Kulasekararaj A, Lee JW, Araten D, Hill A, Brodsky R, Urbano-Ispizua A, Szer J, Wilson A, Hillmen P. Changing prognosis in paroxysmal nocturnal haemoglobinuria disease subcategories: an analysis of the International PNH Registry. Intern Med J 2017; 46:1044-53. [PMID: 27305361 DOI: 10.1111/imj.13160] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [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: 03/15/2016] [Revised: 05/17/2016] [Accepted: 05/29/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Paroxysmal nocturnal haemoglobinuria (PNH) is a rare disease. Although much progress has been made in the understanding of the pathophysiology of the disease, far less is known with respect to the clinical outcomes of patients with PNH. Few retrospective studies provide survival estimates, and even fewer have explored the clinical heterogeneity of the disease. Haemolytic and aplastic anaemia (AA) forms of the disease have been recognised as main disease categories, with the haemolytic form being associated with the worst prognosis by the largest studied cohort some years ago. AIMS To describe mortality and causes of death in PNH overall and by PNH classification and to evaluate risk factors associated with mortality. METHODS We analysed data of 2356 patients enrolled in the International PNH Registry with multivariate analyses, using time-dependent covariates. Patients were classified into haemolytic, AA/PNH syndrome or intermediate PNH. RESULTS Overall, 122 (5.2%) patients died after enrolment, the incidence according to subcategories being 5.1, 11.7, 2.0 and 4.8% for patients with haemolytic PNH, AA-PNH, intermediate and insufficient data respectively. Older age and decreased performance status also affected survival in multivariate analysis. Improved outcome of patients with haemolytic PNH suggests that eculizumab treatment in PNH may be associated with improved survival. CONCLUSION A detailed analysis of clinical presentations and causes of death in patients with PNH, overall and by disease subcategories, provide evidence that in the current era, patients with haemolytic PNH are no longer those who harbour the worst prognosis. This finding differs sharply from what has been previously reported.
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Affiliation(s)
- G Socié
- Hematology Transplantation, AP-HP, Hospital Saint Louis, University Paris VII Denis Diderot and Inserm UMR 1160, Paris, France.
| | - H Schrezenmeier
- Institute of Transfusion Medicine, University of Ulm Ulm and Institute of Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - P Muus
- Department of Hematology, Radboud UMC, Nijmegen, the Netherlands
| | - I Lisukov
- Institution of Children Hematology and Transplantation, St. Petersburg, Russia
| | - A Röth
- University Hospital Essen, Essen, Germany
| | | | - J W Lee
- Seoul St. Mary's Hospital, Seoul, Korea
| | - D Araten
- Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York VA Medical Center, USA
| | - A Hill
- St James's University Hospital, Leeds, UK
| | - R Brodsky
- Johns Hopkins University Medical Center, USA
| | | | - J Szer
- Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - A Wilson
- Alexion Pharmaceuticals, New Haven, Connecticut, USA
| | - P Hillmen
- St James's University Hospital, Leeds, UK
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Schrezenmeier H. Neues Logo – neue DGTI. Transfusionsmedizin 2015. [DOI: 10.1055/s-0034-1397902] [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: 10/23/2022]
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Rojewski M, Lotfi R, Schrezenmeier H. Durchflusszytometrische Kontrolle von MSC-Produkten im Rahmen der Herstellung als ATMP für klinische Prüfungen. Transfusionsmedizin 2015. [DOI: 10.1055/s-0041-102960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- M. Rojewski
- Institut für Transfusionsmedizin, Universitätsklinikum Ulm, Ulm
| | - R. Lotfi
- Institut für Transfusionsmedizin, Universitätsklinikum Ulm, Ulm
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Affiliation(s)
- H Schrezenmeier
- Institut für Klinische Transfusionsmedizin und Immungenetik Ulm
| | - S Körper
- Institut für Klinische Transfusionsmedizin und Immungenetik Ulm
| | - B Höchsmann
- Institut für Klinische Transfusionsmedizin und Immungenetik Ulm
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Fürst D, Schrezenmeier H, Mytilineos J. Die immungenetische Spenderauswahl für die unverwandte Stammzelltransplantation. Transfusionsmedizin 2014. [DOI: 10.1055/s-0033-1358024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- D. Fürst
- Institut für Transfusionsmedizin, Universität Ulm
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Vernikouskaya I, Fekete N, Bannwarth M, Erle A, Rojewski M, Landfester K, Schmidtke-Schrezenmeier G, Schrezenmeier H, Rasche V. Iron-loaded PLLA nanoparticles as highly efficient intracellular markers for visualization of mesenchymal stromal cells by MRI. Contrast Media Mol Imaging 2014; 9:109-21. [PMID: 24523056 DOI: 10.1002/cmmi.1544] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 03/22/2013] [Accepted: 04/22/2013] [Indexed: 12/14/2022]
Abstract
Monitoring of the fate of cells after injection appears paramount for the further development of cell therapies. In this context magnetic resonance imaging (MRI) is increasing in relevance owing to its unique tissue visualization properties. For assessment of cell trafficking and homing, the cells have to be labeled to become MR visible. The rather low sensitivity of MRI demands dedicated intracellular markers with high payloads of MR contrast agents for ensuring sensitive detection of local cell aggregations. In the presented work the application of custom-designed nanometer-sized iron oxide loaded poly-(l-lactide) (iPLLA) nanoparticles was investigated. The particles were synthesized by the mini-emulsion process and evaluated for labeling of mesenchymal stromal cells (MSCs). The efficient cellular uptake and long intracellular retention times of the particles as well as their nontoxicity are demonstrated. The average cellular iron content was 55 pg iron per cell. Further incorporation of, for example, fluorescent dye enables the generation of multireporter particles, providing the great potential for multimodal imaging. The efficiency of these nanoparticles as MRI contrast agent was evaluated in vitro using relaxation rate mapping, yielding relaxivities r2 = 273.3, r2 (*) = 545.1 mm(-1) s(-1) at 3 T and r2 = 415.7, r2 (*) = 872.3 mm(-1) s(-1) at 11.7 T. The high r2 (*) relaxivity of the iPLLA nanoparticles enabled visualization of a single labeled cell in vitro at 50-µm spatial resolution. In vivo evaluation in a rat injury model revealed the potential of the iPLLA particles to efficiently label MSCs for MRI monitoring of ~20 000-40 000 injected cells at 11.7 T. In conclusion the presented work demonstrates the applicability of iPLLA particles as efficient intracellular marker for MSC labeling for monitoring the fate of the cells by MRI.
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Affiliation(s)
- I Vernikouskaya
- Internal Medicine II, University Hospital of Ulm, Ulm, Germany; Small Animal MRI, University of Ulm, Ulm, Germany
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Murgia A, Veronesi E, Rasini V, Candini O, Sensebe L, Layrolle P, Schrezenmeier H, Paolucci P, Burns J, Dominici M. Correlating ex vivo and in vivo osteogenic assays for quality control of clinically destined CGMP grade BM-MSC. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.359] [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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Anliker M, von Zabern I, Höchsmann B, Dohna-Schwake C, Kyrieleis H, Schrezenmeier H, Weinstock C. CD59 is a blood group antigen. Mol Immunol 2013. [DOI: 10.1016/j.molimm.2013.05.114] [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: 11/16/2022]
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Schrezenmeier H. Die Weiterentwicklung des Spektrums im Blick. Transfusionsmedizin 2013. [DOI: 10.1055/s-0033-1356943] [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: 10/26/2022]
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Eichler H, Schrezenmeier H, Schallmoser K, Strunk D, Nystedt J, Kaartinen T, Korhonen M, Fleury-Cappellesso S, Sensebé L, Bönig H, Rebulla P, Giordano R, Lecchi L, Takanashi M, Watt SM, Austin EB, Guttridge M, McLaughlin LS, Panzer S, Reesink HW. Donor selection and release criteria of cellular therapy products. Vox Sang 2013; 104:67-91. [PMID: 23252690 DOI: 10.1111/j.1423-0410.2012.01619.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Veronesi E, Murgia A, Grisendi G, Caselli A, Piccinno S, Giordano R, Montemurro T, Schrezenmeier H, Rojewski M, Burin P, Sensebé L, Layrolle P, Catani F, Desantis G, Paolucci P, Burns J, Dominici M. Advancing approaches for bone regeneration using freshly shipped marrow human mesenchymal stromal/stem cell produced into several european cGMP facilities. Cytotherapy 2013. [DOI: 10.1016/j.jcyt.2013.01.176] [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: 10/27/2022]
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Murgia A, Veronesi E, Rasini V, Candini O, Sensebè L, Layrolle P, Schrezenmeier H, Paolucci P, Burns J, Dominici M. Correlating ex vivo and in vivo osteogenic assays for quality control of clinically destined cGMP grade BM-MSC. Cytotherapy 2013. [DOI: 10.1016/j.jcyt.2013.01.066] [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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Fürst D, Zollikofer C, Schrezenmeier H, Mytilineos J. TNFA promoter alleles--frequencies and linkage with classical HLA genes in a South German Caucasian population. ACTA ACUST UNITED AC 2013; 80:502-8. [PMID: 23137321 DOI: 10.1111/tan.12025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The tumor necrosis factor alpha (TNFA) promoter region exhibits several polymorphisms, which have been hypothesized to influence gene expression, thereby associating positively or negatively with inflammatory conditions. Many studies have focused on single nucleotide polymorphisms (SNPs) taking not into account additive or inverse effects between different SNPs. We typed 1,021 healthy Caucasian volunteer stem cell donors for their TNFA promoter as well as their HLA-A,-C,-B,-DRB1 loci. Using statistical methods, we reconstructed TNFA promoter alleles and analyzed their frequency and linkage with HLA genes. We show that the number of TNFA promoter alleles frequent enough to be analyzed in clinical studies is limited and that a strong linkage with classical HLA genes is present, especially for the extended HLA-haplotype HLA-A*01:01/HLA-C*07:01/HLA-B*08:01/TNFA promoter allele 3/HLA*DRB1*03:01. Taking into account SNP frequency information, it is possible to quite accurately deduce TNFA promoter alleles by generic Sanger sequencing, obviating the need for elaborating allele-specific sequencing. This information may enable investigators to consider the complete TNFA regulatory region in a phase-separated manner in contrast to previous approaches examining only one or few isolated SNPs.
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Affiliation(s)
- D Fürst
- Institute of Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service, Baden Wuerttemberg-Hessen, Ulm, Germany.
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21
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Risitano AM, Schrezenmeier H. Alternative immunosuppression in patients failing immunosuppression with ATG who are not transplant candidates: Campath (Alemtuzumab). Bone Marrow Transplant 2012; 48:186-90. [PMID: 23222381 DOI: 10.1038/bmt.2012.245] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Antithymocyte globulin (ATG)-based immunosuppression remains the standard immunosuppressive therapy (IST) for aplastic anemia (AA) patients lacking a sibling donor; however, treatment failures are relatively frequent, including about one-quarter to one-third of patients who do not show any response to initial IST, and about half of the initial responders who may experience subsequent relapses or require continuous maintenance IST. For these patients, there is the option of further IST, which may include additional courses of ATG-based IST, or attempts with alternative IST regimens. Alemtuzumab is a monoclonal anti-CD52 Ab, which has been recently investigated as novel IS agent for the treatment of AA patients. Recent data from different groups have clearly demonstrated the biological efficacy of Alemtuzumab in AA patients, ruling out the initial concerns about possible unacceptable infectious risks secondary to its extremely powerful lympholytic effect. Preliminary data demonstrate a remarkable efficacy, especially in the context of relapsed and, to less extent, refractory patients, whereas data in naïve patients are still limited. On the basis of these results, Alemtuzumab-based immunosuppression is a worthy option for AA and other marrow failure patients requiring a second-line IST. Here we describe a consensus regimen that the European Group for Blood and Marrow Transplantation Severe Aplastic Anemia Working Party suggests for AA patients failing initial IST who are not indicated for SCT.
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Affiliation(s)
- A M Risitano
- Hematology, Department of Biochemistry and Medical Biotechnologies, Federico II University of Naples, Naples, Italy.
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Schrezenmeier H. Und schon ist ein Jahr vergangen …. Transfusionsmedizin 2012. [DOI: 10.1055/s-0032-1315130] [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: 10/28/2022]
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23
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Fürst D, Bindja J, Arnold R, Herr W, Schwerdtfeger R, Müller CH, Recker K, Schrezenmeier H, Mytilineos J. HLA-E polymorphisms in hematopoietic stem cell transplantation. Tissue Antigens 2012; 79:287-90. [PMID: 22256791 DOI: 10.1111/j.1399-0039.2011.01832.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Human leukocyte antigen (HLA)-E is an inhibitory ligand of natural killer cells and γ/δ T-cells. Differential expression of HLA-E alleles on the cell surface has been reported to influence outcome of hematopoietic stem cell transplantation (HSCT). We performed HLA-E genotyping in 116 HSCT patients and their HLA-matched unrelated donors. The impact of HLA-E genotypes on patient's overall survival (OS), disease free survival (DFS), cumulative incidences for relapse, transplant-related mortality (TRM) and acute graft vs host disease (aGvHD) was assessed. Neither univariate nor multivariate analysis showed any influence of HLA-E polymorphisms on the investigated endpoints of HSCT in our cohort. We could not confirm any of the previous observations in our cohort and consider it unlikely that HLA-E polymorphisms affect outcome of HSCT.
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Affiliation(s)
- D Fürst
- Department of Transplantation Immunology, Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden-Wuerttemberg - Hessia, Ulm, Germany.
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24
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Fekete N, Rojewski M, Schmidtke-Schrezenmeier G, Schrezenmeier H. Mesenchymale Stromazellen und ihre klinische Anwendbarkeit. Transfusionsmedizin 2012. [DOI: 10.1055/s-0031-1271598] [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: 10/28/2022]
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25
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Höchsmann B, Leichtle R, von Zabern I, Kaiser S, Flegel WA, Schrezenmeier H. Paroxysmal nocturnal haemoglobinuria treatment with eculizumab is associated with a positive direct antiglobulin test. Vox Sang 2011; 102:159-66. [PMID: 21929681 DOI: 10.1111/j.1423-0410.2011.01530.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND/OBJECTIVES Paroxysmal nocturnal haemoglobinuria (PNH) is characterized by intravascular haemolysis with a negative direct antiglobulin test (DAT). Eculizumab is a humanized monoclonal antibody that inhibits complement component C5 and is approved for PNH treatment. Recent publications demonstrated that some patients with PNH develop a positive DAT during eculizumab treatment. These published clinical trials investigated a highly selected patient population. Therefore, it seems important to study this topic in a general PNH patient population with a longer follow-up. MATERIALS AND METHODS We analysed haemolytic activity, RBC transfusion requirement, effect on DAT and ferritin levels in 41 patients with PNH before and during eculizumab therapy with a median follow-up of 24 months (range 1-63 months). RESULTS During eculizumab therapy, median LDH decreased (1657-258 U/l; P < 0·0001), while median haemoglobin increased (9·2-10·3 g/dl). Eighteen of 32 pts (56%) who previously required regular transfusions became transfusion independent. DAT was positive for C3d in 72·4% of 21 eculizumab-treated pts with available DAT. Ferritin levels increased (69-348 ng/ml, P < 0·0001). This increase was more pronounced in pts with ongoing transfusion dependency during eculizumab therapy. CONCLUSION Eculizumab therapy for PNH should be added to the list of possible causes for a positive DAT. Intravascular haemolysis was inhibited by eculizumab, but signs of extravascular haemolysis should be monitored. Because renal iron loss was stopped, eculizumab-treated pts can be prone to iron overload and therefore ferritin concentrations should be monitored closely.
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Affiliation(s)
- B Höchsmann
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Wuerttemberg, Hessen, Germany.
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Rosskopf K, Ragg SJ, Worel N, Grommé M, Preijers FWMB, Braakman E, Schuurhuis GJ, van Riet I, Wendel S, Fontão-Wendel R, Lazar A, Goldman M, Halpenny M, Giulivi A, Letcher B, McGann L, Korhonen M, Arvola A, Humpe A, Buwitt-Beckmann U, Wiesneth M, Schauwecker P, Schrezenmeier H, Bönig H, Henschler R, Seifried E, Accorsi P, Bonfini T, Takanashi M, van Beckhoven JM, Brand A, Gounder D, Wong A, Dooccey R, Forrest E, Galea G, Smythe J, Pawson R, Reems JA, Oh J, Reesink HW, Panzer S. Quality controls of cryopreserved haematopoietic progenitor cells (peripheral blood, cord blood, bone marrow). Vox Sang 2011; 101:255-75. [DOI: 10.1111/j.1423-0410.2011.01471.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [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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27
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Schmidt M, Sireis W, Seifried E, Nguyen X, Klüter H, Lotfi R, Schrezenmeier H. Sicherheit der Blutprodukte – Update 2011. Transfusionsmedizin 2011. [DOI: 10.1055/s-0031-1271600] [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: 10/17/2022]
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28
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Bein G, Blasczyk R, Klüter H, Schrezenmeier H. Die Zeit ist reif. Transfusionsmedizin 2011. [DOI: 10.1055/s-0031-1271592] [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: 10/17/2022]
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29
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Nolte F, Höchsmann B, Lübbert M, Platzbecker U, Haase D, Lück A, Gattermann N, Giagounidis A, Leismann O, Junkes A, Schumann C, Hofmann WK, Schrezenmeier H. 347 Successful treatment of transfusional iron overload in MDS patients with deferasirox as indicated by Liver-MRI: A German, multi-center trial. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70349-6] [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: 10/18/2022]
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Abstract
Demographic changes in developed countries as their populations age lead to a steady increase in the consumption of standard blood components. Complex therapeutic procedures like haematopoietic stem cell transplantation, cardiovascular surgery and solid organ transplantation are options for an increasing proportion of older patients nowadays. This trend is likely to continue in coming years. On the other hand, novel aspects in transplant regimens, therapies for malignant diseases, surgical procedures and perioperative patient management have led to a moderate decrease in blood product consumption per individual procedure. The ageing of populations in developed countries, intra-society changes in the attitude towards blood donation as an important altruistic behaviour and the overall alterations in our societies will lead to a decline in regular blood donations over the next decades in many developed countries. Artificial blood substitutes or in vitro stem cell-derived blood components might also become alternatives in the future. However, such substitutes are still in early stages of development and will therefore probably not alleviate this problem within the next few years. Taken together, a declining donation rate and an increase in the consumption of blood components require novel approaches on both sides of the blood supply chain. Different blood donor groups require specific approaches and, for example, inactive or deferred donors must be re-activated. Optimal use of blood components requires even more attention.
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Affiliation(s)
- E Seifried
- Institute for Transfusion Medicine and Immunohaematology, German Red Cross Blood Donor Service Baden-Wuerttemberg-Hessen and Clinics of the Johann Wolfgang Goethe University Frankfurt/Main, Frankfurt/Main, Germany.
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31
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Fürst D, Solgi G, Recker K, Mytilineos D, Schrezenmeier H, Mytilineos J. Sequence-based typing of major histocompatibility complex class I chain-related gene A alleles by use of exons 2-5 information. ACTA ACUST UNITED AC 2011; 77:201-5. [DOI: 10.1111/j.1399-0039.2010.01601.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [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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34
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Leitner G, Panzer S, Reesink HW, Stiegler G, Fischer-Nielsen A, Dickmeiss E, Einsele H, Reinhardt P, Schrezenmeier H, Wiesneth M, Coluccia P, Nygell UA, Halter J, Sigle J, Gratwohl A, Buser AS, Ozturk G, Anak S. Preparation of granulocyte concentrates by apheresis. Vox Sang 2010; 98:567-75. [DOI: 10.1111/j.1423-0410.2010.01315.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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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35
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Piccin A, McCann S, Socié G, Oneto R, Bacigalupo A, Locasciulli A, Marsh J, Schrezenmeier H, Tichelli A, Hand E, Lawler M, Passweg J. Survival of patients with documented autologous recovery after SCT for severe aplastic anemia: a study by the WPSAA of the EBMT. Bone Marrow Transplant 2009; 45:1008-13. [DOI: 10.1038/bmt.2009.296] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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39
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Schäfer R, Dominici M, Müller I, Horwitz E, Asahara T, Bulte JWM, Bieback K, Le Blanc K, Bühring HJ, Capogrossi MC, Dazzi F, Gorodetsky R, Henschler R, Handgretinger R, Kajstura J, Kluger PJ, Lange C, Luettichau IV, Mertsching H, Schrezenmeier H, Sievert KD, Strunk D, Verfaillie C, Northoff H. Basic research and clinical applications of non-hematopoietic stem cells, 4-5 April 2008, Tubingen, Germany. Cytotherapy 2009; 11:245-55. [PMID: 19152153 DOI: 10.1080/14653240802582117] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
From 4 to 5 April 2008, international experts met for the second time in Tubingen, Germany, to present and discuss the latest proceedings in research on non-hematopoietic stem cells (NHSC). This report presents issues of basic research including characterization, isolation, good manufacturing practice (GMP)-like production and imaging as well as clinical applications focusing on the regenerative and immunomodulatory capacities of NHSC.
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Affiliation(s)
- R Schäfer
- Institute of Clinical and Experimental Transfusion Medicine, University Hospital Tubingen, Germany.
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40
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Reesink HW, Panzer S, Dettke M, Gabriel C, Lambermont M, Deneys V, Sondag D, Dickmeiss E, Fischer-Nielsen A, Korhonen M, Krusius T, Ali A, Tiberghien P, Schrezenmeier H, Tonn T, Seifried E, Klüter H, Politis C, Stavropoulou-Gioka A, Parara M, Flesland Ø, Nascimento F, Balint B, Marin P, Bart T, Chen FE, Pamphilon DH. New cellular therapies: Is there a role for transfusion services? Vox Sang 2009; 97:77-90. [DOI: 10.1111/j.1423-0410.2009.01184.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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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41
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Funke I, Späth-Schwalbe E, Stohlmann G, Prümmer O, Gallati H, Schrezenmeier H, Porzsolt F. Subcutaneous IL-2 and Low-Dose IFN-α2a in the Treatment of Unselected Patients with Advanced Renal Cell Cancer. Oncol Res Treat 2009. [DOI: 10.1159/000218423] [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: 11/19/2022]
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42
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Höchsmann B, Huber R, Schauwecker P, Schrezenmeier H, Wiesneth M, Storch A. Hemispheric stroke does not mobilize cd34+ hematopoietic stem cells into the peripheral blood. Neurology 2009; 72:1277-8. [PMID: 19349609 DOI: 10.1212/01.wnl.0000345669.99690.e9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- B Höchsmann
- Institute of Transfusion Medicine, University of Ulm, Germany
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43
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Röth A, Dührsen U, Schrezenmeier H, Schubert J. [Paroxysmal nocturnal hemoglobinuria (PNH). Pathogenesis, diagnosis and treatment]. Dtsch Med Wochenschr 2009; 134:404-9. [PMID: 19224425 DOI: 10.1055/s-0028-1124013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by the classic clinical triad of corpuscular hemolytic anemia, thrombophilia and cytopenia. This is caused by an acquired mutation of the PIG(phosphatidylinositol glycan)-A gene of the pluripotent hematopoetic stem cell. This results in a deficiency of GPI(glycosylphosphatidylinositol)-anchors and GPI-anchored proteins on the surface of affected blood cells. Flow cytometry is the standard for diagnosis and measurement of type and size of the PNH clone. Treatment of PNH is mainly symptomatic. Allogeneic bone marrow transplantation is the only curative option in case of severe complications during the course of the diseases. A new targeted treatment strategy is the inhibition of the terminal complement cascade with a monoclonal antibody (eculizumab). As shown in clinical studies this is efficient to reduce complement mediated intravascular hemolysis, reduce the need for transfusions, improve the quality of life in patients with PNH and reduce the risk for thromboembolic complications, which are the main cause of mortality in PNH.
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Affiliation(s)
- A Röth
- Klinik für Hämatologie, Universitätsklinikum Essen, Universität Duisburg-Essen.
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44
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McCann S, Passweg J, Bacigalupo A, Locasciulli A, Locatelli F, Ryan J, Schrezenmeier H, Lawler M. The influence of cyclosporin alone, or cyclosporin and methotrexate, on the incidence of mixed haematopoietic chimaerism following allogeneic sibling bone marrow transplantation for severe aplastic anaemia. Bone Marrow Transplant 2006; 39:109-14. [PMID: 17173053 DOI: 10.1038/sj.bmt.1705552] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [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
We previously reported a randomized trial comparing Cyclosporin-A (CsA) and short-term methotrexate versus CsA alone for graft-versus-host disease (GvHD) prophylaxis in 71 patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT) from a human leucocyte antigen-identical sibling for severe aplastic anaemia (SAA). We found a better survival in the group receiving the two-drug prophylaxis regimen with no significant difference in the probability of developing GvHD between the two groups. The present study details chimaeric analysis and its influence on survival and GvHD occurrence in 45 of the original 71 patients in whom serial samples were available. Analysis was carried out in a blinded prospective manner. Seventy-two per cent achieved complete donor chimaerism (DC), 11% stable mixed chimaerism (SMC) and 17% progressive mixed chimaerism (PMC). The overall 5-year survival probability was 82% (+/-11%) with a significant survival advantage (P = 0.0009) in DC or SMC compared to those with PMC. Chronic GvHD was more frequent in DC patients, whereas no patient with SMC developed chronic GvHD. Graft failure occurred in 50% of the PMC group. This study demonstrates the relevance of chimaerism analysis in patients receiving HSCT for SAA and confirms the occurrence of mixed chimaerism in a significant proportion of recipients.
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Affiliation(s)
- S McCann
- Department of Haematology, St James's Hospital, Trinity College, Dublin, Ireland.
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45
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Passweg JR, Pérez WS, Eapen M, Camitta BM, Gluckman E, Hinterberger W, Hows JM, Marsh JCW, Pasquini R, Schrezenmeier H, Socié G, Zhang MJ, Bredeson C. Bone marrow transplants from mismatched related and unrelated donors for severe aplastic anemia. Bone Marrow Transplant 2006; 37:641-9. [PMID: 16489361 DOI: 10.1038/sj.bmt.1705299] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
For patients with acquired severe aplastic anemia without a matched sibling donor and not responding to immunosuppressive treatment, bone marrow transplantation from a suitable alternative donor is often attempted. We examined risks of graft failure, graft-versus-host disease and overall survival after 318 alternative donor transplants between 1988 and 1998. Sixty-six patients received allografts from 1-antigen and 20 from >1-antigen mismatched related donors; 181 from matched and 51 from mismatched unrelated donors. Most patients were young, had had multiple red blood cell transfusions and poor performance score at transplantation. We did not observe differences in risks of graft failure and overall mortality by donor type. The probabilities of graft failure at 100 days after 1-antigen mismatched related donor, >1-antigen mismatched related donor, matched unrelated donor and mismatched unrelated donor transplants were 21, 25, 15 and 18%, respectively. Corresponding probabilities of overall survival at 5 years were 49, 30, 39 and 36%, respectively. Although alternative donor transplantation results in long-term survival, mortality rates are high. Poor performance score and older age adversely affect outcomes after transplantation. Therefore, early referral for transplantation should be encouraged for patients who fail immunosuppressive therapy and have a suitable alternative donor.
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Affiliation(s)
- J R Passweg
- Department Innere Medizin, Kantonsspital, Basel, Switzerland.
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Huber R, Schauwecker P, Hoechsmann B, Schrezenmeier H, Wiesneth M, Ludolph A, Storch A. Fehlende Mobilisation CD34-positiver hämatopoetischer Stammzellen nach ischämischem Insult. Akt Neurol 2005. [DOI: 10.1055/s-2005-919689] [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: 10/26/2022]
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47
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Stadler M, Germing U, Kliche KO, Josten KM, Kuse R, Hofmann WK, Schrezenmeier H, Novotny J, Anders O, Eimermacher H, Verbeek W, Kreipe HH, Heimpel H, Aul C, Ganser A. A prospective, randomised, phase II study of horse antithymocyte globulin vs rabbit antithymocyte globulin as immune-modulating therapy in patients with low-risk myelodysplastic syndromes. Leukemia 2004; 18:460-5. [PMID: 14712285 DOI: 10.1038/sj.leu.2403239] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.6] [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
Immunosuppression has recently been proposed for low-risk myelodysplastic syndromes (MDS) to reverse bone marrow failure by inhibiting intramedullary secretion of proapoptotic cytokines. We treated 35 MDS patients (24 refractory anaemia (RA), 10 RA with excess blasts and one chronic myelomonocytic leukaemia) with either horse antithymocyte globulin 15 mg/kg/day or rabbit antithymocyte globulin 3.75 mg/kg/day, each for 5 days. Median age was 63 years (range: 41-75). After 1 to 34+ months of follow-up (mean: 15+), four patients experienced complete haematological responses (CR), six good responses (GR) and two minor responses. All CRs and GRs occurred in patients with RA, in whom both horse and rabbit ATG yielded five responses out of 12 (42%). Time to response varied between 1 and 10 (mean: 3) months. The median duration of response was 9+ (1-17+) months; five patients are in continuing response. In all, 23 patients suffered side effects > degrees II WHO (the degree of toxicity encountered according to the internationally accepted WHO toxicity grading); one patient died 2 weeks after rabbit ATG from rhinocerebral mucormycosis. Parameters that correlated with response were duration of disease and RA subgroup. In our experience, immune-modulating therapy with either horse or rabbit ATG is feasible in patients with RA and short duration of disease.
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Affiliation(s)
- M Stadler
- Department of Haematology and Oncology, Medizinische Hochschule, Hannover, Germany
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48
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Urbano-Ispizua A, Schmitz N, de Witte T, Frassoni F, Rosti G, Schrezenmeier H, Gluckman E, Friedrich W, Cordonnier C, Socie G, Tyndall A, Niethammer D, Ljungman P, Gratwohl A, Apperley J, Niederwieser D, Bacigalupo A. Allogeneic and autologous transplantation for haematological diseases, solid tumours and immune disorders: definitions and current practice in Europe. Bone Marrow Transplant 2002; 29:639-46. [PMID: 12180107 DOI: 10.1038/sj.bmt.1703535] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [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
The Accreditation Sub-Committee of the EBMT regularly publishes special reports on current practice of haemopoietic stem cell transplantation for haematological diseases, solid tumours and immune disorders. Major changes have occurred since the last report in 1998. Haemopoietic stem cell transplantation today includes allogeneic and autologous stem cells derived from bone marrow, peripheral blood and cord blood. With reduced intensity conditioning regimens in allogeneic transplantation, the age limit has increased, permitting the inclusion of older patients. New indications have emerged, such as autoimmune disorders and AL amyloidosis for autologous, and solid tumours for allogeneic transplants. Other indications, such as autologous transplantation for breast cancer have been challenged. An updated report with revised tables and operating definitions is presented here.
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Rojewski MT, Baldus C, Knauf W, Thiel E, Schrezenmeier H. Dual effects of arsenic trioxide (As2O3) on non-acute promyelocytic leukaemia myeloid cell lines: induction of apoptosis and inhibition of proliferation. Br J Haematol 2002; 116:555-63. [PMID: 11849211 DOI: 10.1046/j.0007-1048.2001.03298.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.7] [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
Clinical efficacy of As2O3 has been shown in patients with relapsed acute promyelocytic leukaemia (APL). There is evidence that the effects of As2O3 are not restricted to events specific for APL. As2O3 might target mechanisms involved in the pathogenesis of other malignancies. We assessed susceptibility to induction of apoptosis by As2O3 and cytostatics in 22 myeloid and non-myeloid malignant cell lines. As2O3 was used in concentrations of 0.01-10 micromol/l. Cell lines displayed different kinetics of response and different sensitivity to As2O3. The minimum concentration of As2O3 for induction of apoptosis was 0.1 micromol/l. High concentrations of As2O3 (5 micromol/l) induced apoptosis in a large proportion of cells in all cell lines tested. Low (1 micromol/l As2O3) concentrations induced apoptosis in NB-4, HL-60, U-937, CEM, HL-60, KG-1a, PBL-985, ML-2 and MV-4-11, but not in HEL, K-562, KG-1 and Jurkat up to 35 d of incubation. However, the non-apoptotic population of 1 micromol/l As2O3-treated HEL, K-562, K-562 (0.02), K-562(0.1) and Jurkat showed reduced proliferation. CEM as well as its' multidrug-resistant derivatives were sensitive to 1 micromol/l As2O3. In summary, these data demonstrate that As2O3-induced apoptosis is not restricted to cell lines with t(15;17). Apoptosis was induced in vitro by As2O3 concentrations that are achievable in vivo after infusion of well-tolerated As2O3 doses. Thus, As2O3 might be a suitable therapeutic agent for malignancies other than APL provided the adequate dose and duration of As2O3 treatment are used.
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Affiliation(s)
- M T Rojewski
- Freie Universität Berlin, Universitätsklinikum Benjamin Franklin, Medizinische Klinik III (Hämatologie, Onkologie und Transfusionsmedizin), Berlin, Germany
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Foncuberta MC, Cagnoni PJ, Brandts CH, Mandanas R, Fields K, Derigs HG, Reed E, Sonis ST, Fay J, LeVeque F, Pouillart P, Schrezenmeier H, Emmons R, Thiel E. Topical transforming growth factor-beta3 in the prevention or alleviation of chemotherapy-induced oral mucositis in patients with lymphomas or solid tumors. J Immunother 2001; 24:384-8. [PMID: 11565840 DOI: 10.1097/00002371-200107000-00014] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [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: 11/26/2022]
Abstract
Transforming growth factor (TGF)-beta3 has been hypothesized to prevent or alleviate oral mucositis (OM) in cancer patients receiving high-dose chemotherapy (CT). Two double-blind, placebo-controlled, multicenter, phase II studies of TGF-beta3 were initiated in the United States, Europe, and Argentina in patients with lymphomas or solid tumors who were receiving highly stomatotoxic CT regimens. Patients were to apply 10-mL mouthwash applications of TGF-beta3 (25 microg/mL) or placebo four times daily (or twice daily) 1 day before and all days during CT. The patients were subsequently evaluated for OM incidence, severity, and duration using National Institute of Cancer Common Toxicity Criteria (NCI-CTC) criteria and an objective scoring system (1). After the start of the trials, negative results from new preclinical studies suggesting suboptimal formulation and/or dosing led to an interim analysis of the ongoing clinical trials. One hundred fifty-two patients from the combined studies were included in the interim analysis, with 116 patients on the TGF-beta3 four times daily and placebo arms. Most (72%) patients had breast cancer, 22% had lymphomas, and 6% had other solid tumors. Although 98% (149 of 152) of patients experienced adverse events, only 14% (22 of 152) experienced events that were judged as possibly or probably related to the study drug (primarily gastrointestinal symptoms). No clinically relevant differences were seen between the treatment and placebo arms regarding safety, nor was there evidence for systemic absorption of TGF-beta3. Finally, there was no advantage of TGF-beta3 treatment regarding the incidence (TGF-beta3 four times daily versus placebo [46% versus 47%]), onset, or duration of NCI-CTC grade 3 or 4 OM. For this dose, formulation, regimen. and patient population, TGF-beta3 was not effective in the prevention or alleviation of CT-induced OM.
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