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Waters AR, Biddell CB, Killela M, Kasow KA, Page K, Wheeler SB, Drier SW, Kelly MS, Robles J, Spees LP. Financial burden and recommended multilevel solutions among caregivers of pediatric hematopoietic stem cell transplant recipients. Pediatr Blood Cancer 2023; 70:e30700. [PMID: 37776093 PMCID: PMC10615841 DOI: 10.1002/pbc.30700] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND The healthcare costs of patients who receive hematopoietic stem cell transplantation (HSCT) are substantial. At the same time, the increasing use of pediatric HSCT leaves more caregivers of pediatric HSCT recipients at risk for financial burden-an understudied area of research. METHODS Financial burden experienced by caregivers of recipients who received autologous or allogeneic transplants was assessed using an explanatory mixed-methods design including a one-time survey and semi-structured interviews. Financial burden was assessed through an adapted COmprehensive Score for financial Toxicity (COST) as well as questions about the types of out-of-pocket costs and cost-coping behaviors. Chi-squared or Fisher's exact tests were used to assess differences in costs incurred and coping behaviors by financial toxicity and financial toxicity by demographic factors. Interviews were audio recorded, transcribed, and analyzed using directed content analysis. RESULTS Of 99 survey participants, 64% experienced high financial toxicity (COST ≤ $ \le \;$ 22). Caregivers with high financial toxicity were more likely to report costs related to transportation and diet. High financial toxicity was associated with nearly all cost-coping behaviors (e.g., borrowed money). High financial toxicity was also associated with increased use of hospital financial support and transportation assistance. Qualitative analysis resulted in four categories that were integrated with quantitative findings: (1) care-related out-of-pocket costs incurred, (2) cost-coping behaviors, (3) financial support resources used, and (4) multilevel recommendations for reducing financial burden. CONCLUSIONS Considering the substantial, long-term financial burden among pediatric HSCT patients and their caregivers, this population would benefit from adapted and tailored financial burden interventions.
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Affiliation(s)
- Austin R Waters
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, North Carolina, USA
| | - Caitlin B Biddell
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, North Carolina, USA
| | - Mary Killela
- School of Nursing, UNC-CH, Chapel Hill, North Carolina, USA
| | - Kimberly A Kasow
- Department of Pediatrics, UNC-CH, Chapel Hill, North Carolina, USA
| | - Kristin Page
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Stephanie B Wheeler
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, North Carolina, USA
| | - Sarah W Drier
- Lineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, North Carolina, USA
| | - Matthew S Kelly
- Department of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Joanna Robles
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Duke University Medical Center, Durham, North Carolina, USA
| | - Lisa P Spees
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, North Carolina, USA
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Correa-Salazar C, Amon J, Page K, Groves A, Bilal U, Vera A, Martínez-Donate A. Barriers and facilitators to HIV prevention and care for Venezuelan migrant/refugee women and girls in Colombia. J Migr Health 2023; 8:100206. [PMID: 38047140 PMCID: PMC10690627 DOI: 10.1016/j.jmh.2023.100206] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/30/2023] [Accepted: 11/04/2023] [Indexed: 12/05/2023] Open
Abstract
Venezuelan migrant and refugee women and girls (VMRWG) face risks of exposure to and infection from HIV and threats of multiple forms of violence (including GBV) during and after migration. Yet, there is a lack of evidence on barriers and facilitators to VMRWGs' access to HIV prevention and care services this population at all stages of their migration. We addressed this evidence gap by conducting a qualitative study composed of fifty-four semi-structured interviews with practitioners (n = 24) and VMRWG (n = 30) in the two largest receiving cities of migrants in Colombia. We sought to identify perceived barriers and facilitators to HIV prevention and care to inform policies and programmatic efforts. Analysis followed a theory-informed approach using the Socioecological Model. Findings describe multi-level barriers to access to HIV prevention and care related to discrimination, gender-based violence, rigid gender norms, lack of information and system fragmentation. Policies that integrate community-based networks and support intersectoral work are pivotal to breach the gaps between services and communities and develop a gender-sensitive approach that tackles the relationship between gender-based violence and HIV risk.
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Affiliation(s)
- C. Correa-Salazar
- Community health and prevention Department, Drexel University, United States
| | - J.J. Amon
- Community health and prevention Department, Drexel University, United States
| | - K. Page
- John Hopkins Medicine, United States
| | - A.K. Groves
- Community health and prevention Department, Drexel University, United States
| | - U. Bilal
- Department of Epidemiology and Biostatistics, United States
| | | | - A. Martínez-Donate
- Community health and prevention Department, Drexel University, United States
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3
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Blue BJ, Brazauskas R, Chen K, Patel J, Zeidan AM, Steinberg A, Ballen K, Kwok J, Rotz SJ, Perez MAD, Kelkar AH, Ganguly S, Wingard JR, Lad D, Sharma A, Badawy SM, Lazarus HM, Hashem H, Szwajcer D, Knight JM, Bhatt NS, Page K, Beattie S, Arai Y, Liu H, Arnold SD, Freytes CO, Abid MB, Beitinjaneh A, Farhadfar N, Wirk B, Winestone LE, Agrawal V, Preussler JM, Seo S, Hashmi S, Lehmann L, Wood WA, Rangarajan HG, Saber W, Majhail NS. Racial and Socioeconomic Disparities in Long-Term Outcomes in ≥1 Year Allogeneic Hematopoietic Cell Transplantation Survivors: A CIBMTR Analysis. Transplant Cell Ther 2023; 29:709.e1-709.e11. [PMID: 37482244 DOI: 10.1016/j.jtct.2023.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/17/2023] [Revised: 07/10/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
Racial/ethnic minorities have demonstrated worse survival after allogeneic hematopoietic cell transplantation (HCT) compared to whites. Whether the racial disparity in HCT outcomes persists in long-term survivors and possibly may be even exacerbated in this population, which frequently transitions back from the transplant center to their local healthcare providers, is unknown. In the current study, we compared long-term outcomes among 1-year allogeneic HCT survivors by race/ethnicity and socioeconomic status (SES). The Center for International Blood and Marrow Transplant Research database was used to identify 5473 patients with acute myeloid leukemia, acute lymphocytic leukemia, chronic myeloid leukemia, or myelodysplastic syndromes who underwent their first allogeneic HCT between 2007 and 2017 and were alive and in remission for at least 1 year after transplantation. The study was restricted to patients who underwent HCT in the United States. SES was defined using patient neighborhood poverty level estimated from the recipient's ZIP code of residence; a ZIP code with ≥20% of persons below the federal poverty level was considered a high poverty area. The primary outcome was to evaluate the associations of race/ethnicity and neighborhood poverty level with overall survival (OS), relapse, and nonrelapse mortality (NRM). Cox regression models were used to determine associations of ethnicity/race and SES with OS, relapse, and NRM. Standardized mortality ratios were calculated to compare mortality rates of the study patients and their general population peers matched on race/ethnicity, age, and sex. The study cohort was predominately non-Hispanic white (n = 4385) and also included non-Hispanic black (n = 338), Hispanic (n = 516), and Asian (n = 234) patients. Overall, 729 patients (13%) resided in high-poverty areas. Significantly larger proportions of non-Hispanic black (37%) and Hispanic (26%) patients lived in high-poverty areas compared to non-Hispanic whites (10%) and Asians (10%) (P < .01). Multivariable analysis revealed no significant associations between OS, PFS, relapse, or NRM and race/ethnicity or poverty level when adjusted for patient-, disease- and transplantation-related covariates. Our retrospective cohort registry study shows that among adult allogeneic HCT recipients who survived at least 1 year in remission, there were no associations between race/ethnicity, neighborhood poverty level, and long-term outcomes.
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Affiliation(s)
| | - Ruta Brazauskas
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI; Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - Karen Chen
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Jinalben Patel
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Amer M Zeidan
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine and Yale Cancer Center, Yale University, New Haven, CT
| | | | - Karen Ballen
- Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA
| | - Janette Kwok
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - Seth J Rotz
- Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH
| | - Miguel Angel Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - Amar H Kelkar
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | | | - John R Wingard
- Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, FL
| | - Deepesh Lad
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, India
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN
| | - Sherif M Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Hematology, Oncology, and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
| | - Hasan Hashem
- Division of Pediatric Hematology/Oncology and Bone marrow Transplantation, King Hussein Cancer Center, Amman, Jordan
| | - David Szwajcer
- Cancer Care Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jennifer M Knight
- Section of BMT & Cellular Therapies; Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI; Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI; Department of Microbiology & Immunology, Medical College of Wisconsin, Milwaukee, WI
| | - Neel S Bhatt
- University of Washington School of Medicine, Department of Pediatrics, Division of Hematology/Oncology, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA
| | - Kristin Page
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI; Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
| | - Sara Beattie
- Department of Psychosocial Oncology and Rehabilitation, Tom Baker Cancer Centre, Calgary, Canada; Department of Oncology, University of Calgary, Canada
| | - Yasuyuki Arai
- Kyoto University Hospital, Kyoto University, Kyoto, Japan
| | - Hongtao Liu
- Section of Hematology/Oncology, University of Chicago Medicine, Chicago, IL
| | - Staci D Arnold
- Aflac Cancer and Blood Disorder Center Children's Healthcare of Atlanta Emory University, Atlanta, GA
| | - César O Freytes
- University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, BMT & Cellular Therapy Program, Medical College of Wisconsin, Milwaukee, WI
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, PA
| | - Lena E Winestone
- Division of Allergy, Immunology, and Blood & Marrow Transplant, University of California San Francisco Benioff Children's Hospitals, San Francisco, CA
| | - Vaibhav Agrawal
- Division of Leukemia, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Jaime M Preussler
- CIBMTR® (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Shahrukh Hashmi
- Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, UAE; Mayo Clinic Cancer Center, Mayo Clinic, Rochester, MN; College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, UAE
| | - Leslie Lehmann
- Dana-Farber Cancer Institute/Boston Children's Hospital, Boston, MA
| | - William A Wood
- Division of Hematology, Department of Medicine, University of North Carolina, Chapel Hill, NC
| | - Hemalatha G Rangarajan
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Nationwide Children's hospital, Columbus, OH
| | - Wael Saber
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
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Ho VT, Klumpp TR, Liang WH, Prestegaard M, Horwitz M, Hamilton BK, Page K, Jaglowski S, Huber J, Martinez C, Shenoy V, Chen A, Rizzo D. Cell Therapy Informatics: Updates on the Integration of HCT/IEC Functionalities into an Electronic Medical Record System in the US to Promote Efficiency, Patient Safety, Research, and Data Interoperability. Transplant Cell Ther 2023; 29:539-547. [PMID: 37379969 DOI: 10.1016/j.jtct.2023.06.014] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
The use of electronic health/medical record (EMR) systems has streamlined medical practice and improved efficiency of clinical care in recent years. However, EMR systems are not generally well designed to support research and tracking of longitudinal outcomes across populations, which are particularly important in hematopoietic stem cell transplantation (HCT) and immune effector cell therapy (IEC), where data reporting to registries and regulatory agencies are often required. Since its formation in 2014, the HCT EMR user group has worked with a large EMR vendor (Epic) to develop many functionalities within the EMR to improve the care of HCT/IEC patients and facilitate the capture of HCT/IEC data in an easily interoperable format. Awareness and the widespread adoption of these new tools among transplant centers remains a challenge, however. In this report, we aim to increase awareness and adoption of these new features in the Epic EMR across the transplantation community, advocate for the use of data standards, and promote future collaboration with other commercial EMRs to develop standardized HCT/IEC content to improve patient care and facilitate interoperable data exchange.
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Affiliation(s)
- Vincent T Ho
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
| | - Thomas R Klumpp
- Department of Medical Oncology, Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania
| | - Wayne H Liang
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia
| | | | - Mitchell Horwitz
- Adult Blood and Marrow Transplant Program, Duke University Medical Center, Durham, North Carolina
| | - Betty K Hamilton
- Blood and Marrow Transplant Program, Cleveland Clinic, Cleveland, Ohio
| | - Kristin Page
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Madison, Wisconsin
| | | | - John Huber
- Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Charles Martinez
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, Texas
| | - Vinaya Shenoy
- Software Development, Epic Systems Corporation, Verona, Wisconsin
| | - Allen Chen
- Pediatric Hematology and Oncology, Johns Hopkins University, Baltimore, Maryland
| | - Douglas Rizzo
- Division of Hematology and Oncology, Froedtert & the Medical College of Wisconsin Cancer Center Cancer, Medical College of Wisconsin, Madison, Wisconsin
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5
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Boyiadzis M, Zhang MJ, Chen K, Abdel-Azim H, Abid MB, Aljurf M, Bacher U, Badar T, Badawy SM, Battiwalla M, Bejanyan N, Bhatt VR, Brown VI, Castillo P, Cerny J, Copelan EA, Craddock C, Dholaria B, Perez MAD, Ebens CL, Gale RP, Ganguly S, Gowda L, Grunwald MR, Hashmi S, Hildebrandt GC, Iqbal M, Jamy O, Kharfan-Dabaja MA, Khera N, Lazarus HM, Lin R, Modi D, Nathan S, Nishihori T, Patel SS, Pawarode A, Saber W, Sharma A, Solh M, Wagner JL, Wang T, Williams KM, Winestone LE, Wirk B, Zeidan A, Hourigan CS, Litzow M, Kebriaei P, de Lima M, Page K, Weisdorf DJ. Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients. Leukemia 2023; 37:1006-1017. [PMID: 36310182 PMCID: PMC10148918 DOI: 10.1038/s41375-022-01738-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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] [Received: 05/25/2022] [Revised: 10/06/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022]
Abstract
We investigated the impact of the number of induction/consolidation cycles on outcomes of 3113 adult AML patients who received allogeneic hematopoietic cell transplantation (allo-HCT) between 2008 and 2019. Patients received allo-HCT using myeloablative (MAC) or reduced-intensity (RIC) conditioning in first complete remission (CR) or with primary induction failure (PIF). Patients who received MAC allo-HCT in CR after 1 induction cycle had 1.3-fold better overall survival (OS) than 2 cycles to CR and 1.47-fold better than ≥3 cycles. OS after CR in 2 or ≥3 cycles was similar. Relapse risk was 1.65-fold greater in patients receiving ≥3 cycles to achieve CR. After RIC allo-HCT, the number of induction cycles to CR did not affect OS. Compared to CR in 1 cycle, relapse risk was 1.24-1.41-fold greater in patients receiving 2 or ≥3 cycles. For patients receiving only 1 cycle to CR, consolidation therapy prior to MAC allo-HCT was associated with improved OS vs. no consolidation therapy. Detectable MRD at the time of MAC allo-HCT did not impact outcomes while detectable MRD preceding RIC allo-HCT was associated with an increased risk of relapse. For allo-HCT in PIF, OS was significantly worse than allo-HCT in CR after 1-3 cycles.
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Affiliation(s)
| | - Mei-Jie Zhang
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Karen Chen
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Hisham Abdel-Azim
- Loma Linda University School of Medicine, Cancer Center, Children Hospital and Medical Center, Loma Linda, CA, USA
| | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Talha Badar
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Nelli Bejanyan
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Vijaya Raj Bhatt
- The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Valerie I Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, PA, USA
| | - Paul Castillo
- UF Health Shands Children's Hospital, Gainesville, FL, USA
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | - Edward A Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | | | | | - Miguel Angel Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - Christen L Ebens
- Division of Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Robert Peter Gale
- Haematology Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | | | - Lohith Gowda
- Yale Cancer Center and Yale School of Medicine, New Haven, CT, USA
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | | | - Madiha Iqbal
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Omer Jamy
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Nandita Khera
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Richard Lin
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dipenkumar Modi
- Division of Oncology, Karmanos Cancer Center/Wayne State University, Detroit, MI, USA
| | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Sagar S Patel
- Transplant and Cellular Therapy Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Attaphol Pawarode
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, MI, USA
| | - Wael Saber
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA
| | - John L Wagner
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Trent Wang
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, FL, USA
| | | | - Lena E Winestone
- Division of Allergy, Immunology, and Blood & Marrow Transplant, University of California San Francisco Benioff Children's Hospitals, San Francisco, CA, USA
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, PA, USA
| | - Amer Zeidan
- Bridgeport Hospital, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher S Hourigan
- Laboratory of Myeloid Malignancies, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, MN, USA
| | - Partow Kebriaei
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Kristin Page
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Daniel J Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
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6
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Boyiadzis M, Zhang MJ, Chen K, Abdel-Azim H, Abid MB, Aljurf M, Bacher U, Badar T, Badawy SM, Battiwalla M, Bejanyan N, Bhatt VR, Brown VI, Castillo P, Cerny J, Copelan EA, Craddock C, Dholaria B, Perez MAD, Ebens CL, Gale RP, Ganguly S, Gowda L, Grunwald MR, Hashmi S, Hildebrandt GC, Iqbal M, Jamy O, Kharfan-Dabaja MA, Khera N, Lazarus HM, Lin R, Modi D, Nathan S, Nishihori T, Patel SS, Pawarode A, Saber W, Sharma A, Solh M, Wagner JL, Wang T, Williams KM, Winestone LE, Wirk B, Zeidan A, Hourigan CS, Litzow M, Kebriaei P, de Lima M, Page K, Weisdorf DJ. Correction to: Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113AML patients. Leukemia 2023; 37:1173. [PMID: 36949156 DOI: 10.1038/s41375-023-01814-2] [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: 03/24/2023]
Affiliation(s)
| | - Mei-Jie Zhang
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Karen Chen
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Hisham Abdel-Azim
- Loma Linda University School of Medicine, Cancer Center, Children Hospital and Medical Center, Loma Linda, CA, USA
| | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology & Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Ulrike Bacher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Talha Badar
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Nelli Bejanyan
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Vijaya Raj Bhatt
- The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Valerie I Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, PA, USA
| | - Paul Castillo
- UF Health Shands Children's Hospital, Gainesville, FL, USA
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | - Edward A Copelan
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | | | | | - Miguel Angel Diaz Perez
- Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - Christen L Ebens
- Division of Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Robert Peter Gale
- Haematology Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | | | - Lohith Gowda
- Yale Cancer Center and Yale School of Medicine, New Haven, CT, USA
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | | | - Madiha Iqbal
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Omer Jamy
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Nandita Khera
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Richard Lin
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dipenkumar Modi
- Division of Oncology, Karmanos Cancer Center/Wayne State University, Detroit, MI, USA
| | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Sagar S Patel
- Transplant and Cellular Therapy Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Attaphol Pawarode
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, MI, USA
| | - Wael Saber
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA
| | - John L Wagner
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Trent Wang
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, FL, USA
| | | | - Lena E Winestone
- Division of Allergy, Immunology, and Blood & Marrow Transplant, University of California San Francisco Benioff Children's Hospitals, San Francisco, CA, USA
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, PA, USA
| | - Amer Zeidan
- Bridgeport Hospital, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher S Hourigan
- Laboratory of Myeloid Malignancies, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Mark Litzow
- Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, MN, USA
| | - Partow Kebriaei
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Kristin Page
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Daniel J Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
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Schoettler ML, Carreras E, Cho B, Dandoy CE, Ho VT, Jodele S, Moissev I, Sanchez-Ortega I, Srivastava A, Atsuta Y, Carpenter P, Koreth J, Kroger N, Ljungman P, Page K, Popat U, Shaw BE, Sureda A, Soiffer R, Vasu S. Harmonizing Definitions for Diagnostic Criteria and Prognostic Assessment of Transplantation-Associated Thrombotic Microangiopathy: A Report on Behalf of the European Society for Blood and Marrow Transplantation, American Society for Transplantation and Cellular Therapy, Asia-Pacific Blood and Marrow Transplantation Group, and Center for International Blood and Marrow Transplant Research. Transplant Cell Ther 2023; 29:151-163. [PMID: 36442770 PMCID: PMC10119629 DOI: 10.1016/j.jtct.2022.11.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022]
Abstract
Transplantation-associated thrombotic microangiopathy (TA-TMA) is an increasingly recognized complication of hematopoietic cell transplantation (HCT) associated with significant morbidity and mortality. However, TA-TMA is a clinical diagnosis, and multiple criteria have been proposed without universal application. Although some patients have a self-resolving disease, others progress to multiorgan failure and/or death. Poor prognostic features also are not uniformly accepted. The lack of harmonization of diagnostic and prognostic markers has precluded multi-institutional studies to better understand incidence and outcomes. Even current interventional trials use different criteria, making it challenging to interpret the data. To address this urgent need, the American Society for Transplantation and Cellular Therapy, Center for International Bone Marrow Transplant Research, Asia-Pacific Blood and Marrow Transplantation, and European Society for Blood and Marrow Transplantation nominated representatives for an expert panel tasked with reaching consensus on diagnostic and prognostic criteria. The panel reviewed literature, generated consensus statements regarding diagnostic and prognostic features of TA-TMA using the Delphi method, and identified future directions of investigation. Consensus was reached on 4 key concepts: (1) TA-TMA can be diagnosed using clinical and laboratory criteria or tissue biopsy of kidney or gastrointestinal tissue; however, biopsy is not required; (2) consensus diagnostic criteria are proposed using the modified Jodele criteria with additional definitions of anemia and thrombocytopenia. TA-TMA is diagnosed when ≥4 of the following 7 features occur twice within 14 days: anemia, defined as failure to achieve transfusion independence despite neutrophil engraftment; hemoglobin decline by ≥1 g/dL or new-onset transfusion dependence; thrombocytopenia, defined as failure to achieve platelet engraftment, higher-than-expected transfusion needs, refractory to platelet transfusions, or ≥50% reduction in baseline platelet count after full platelet engraftment; lactate dehydrogenase (LDH) exceeding the upper limit of normal (ULN); schistocytes; hypertension; soluble C5b-9 (sC5b-9) exceeding the ULN; and proteinuria (≥1 mg/mg random urine protein-to-creatinine ratio [rUPCR]); (3) patients with any of the following features are at increased risk of nonrelapse mortality and should be stratified as high-risk TA-TMA: elevated sC5b-9, LDH ≥2 times the ULN, rUPCR ≥1 mg/mg, multiorgan dysfunction, concurrent grade II-IV acute graft-versus-host disease (GVHD), or infection (bacterial or viral); and (4) all allogeneic and pediatric autologous HCT recipients with neuroblastoma should be screened weekly for TA-TMA during the first 100 days post-HCT. Patients diagnosed with TA-TMA should be risk-stratified, and those with high-risk disease should be offered participation in a clinical trial for TA-TMA-directed therapy if available. We propose that these criteria and risk stratification features be used in data registries, prospective studies, and clinical practice across international settings. This harmonization will facilitate the investigation of TA-TMA across populations diverse in race, ethnicity, age, disease indications, and transplantation characteristics. As these criteria are widely used, we expect continued refinement as necessary. Efforts to identify more specific diagnostic and prognostic biomarkers are a top priority of the field. Finally, an investigation of the impact of TA-TMA-directed treatment, particularly in the setting of concurrent highly morbid complications, such as steroid-refractory GVHD and infection, is critically needed.
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Affiliation(s)
- M L Schoettler
- Department Blood and Marrow Transplantation, Children's Healthcare of Atlanta, Aflac Cancer and Blood Disorders Center, Atlanta, Georgia
| | - E Carreras
- Spanish Bone Marrow Donor Registry, Josep Carreras Foundation and Leukemia Research Institute, Barcelona, Catalunya, Spain
| | - B Cho
- Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, Seoul, Korea
| | - C E Dandoy
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - V T Ho
- Department of Medical Oncology, Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA
| | - S Jodele
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - I Moissev
- RM Gorbacheva Research Institute, Pavlov University, Saint-Petersburg, Russian Federation
| | | | - A Srivastava
- Department of Haematology, Christian Medical College, Vellore, India
| | - Y Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
| | - P Carpenter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - J Koreth
- Department of Medical Oncology, Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA
| | - N Kroger
- Division of Hematology, Ohio State University, Columbus, Ohio
| | - P Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - K Page
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - U Popat
- Department of Stem Cell Transplantation & Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - B E Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - A Sureda
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain
| | - R Soiffer
- Department of Medical Oncology, Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA
| | - S Vasu
- Division of Hematology, Ohio State University, Columbus, Ohio.
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8
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Mehta RS, Ramdial J, Marin D, Alousi A, Kanakry CG, Champlin RE, Rezvani K, Shpall EJ, Page K, Gadalla SM, Kebriaei P, Weisdorf D. Impact of Donor Age in Haploidentical-PTCy Versus MUD-PTCy HCT in AML patients. Transplant Cell Ther 2023:S2666-6367(23)01203-4. [PMID: 36990221 DOI: 10.1016/j.jtct.2023.03.028] [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: 02/06/2023] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023]
Abstract
Haploidentical hematopoietic cell transplantation (HCT) with post-transplant cyclophosphamide (PTCy) graft-versus-host-disease (GVHD) prophylaxis is associated with inferior overall survival (OS) compared to HLA-matched unrelated donor (MUD) HCT with PTCy prophylaxis in patients undergoing reduced-intensity conditioning (RIC). Given prognostic implications of donor age, we investigated the differences in outcomes of patients with acute myeloid leukemia (AML, n=775) undergoing RIC-HCT with a younger MUD (donor age <35 years, n=84) versus younger haploidentical (donor age <35 years, n=302) versus an older haploidentical (≥35 years, n=389) donor. The older MUD group was excluded due to small numbers. Patients in the younger haploidentical group (median age 59.5 years) were somewhat younger than the younger MUD (median 66.8 years) and the older haploidentical (median 64.7 years) groups. More patients in the MUD group received peripheral blood grafts (82%) compared to the haploidentical groups (55-56%). In multivariate analysis, as compared to the younger MUD group, the younger haploidentical [hazard ratio (HR) 1.95, 95% confidence interval (CI) 1.22-3.12, p=0.005)] and the older haploidentical (HR 2.36, 95% CI 1.50-3.71, p<0.001) groups had a significantly inferior OS, and the younger haploidentical (HR 3.72, 95% CI 1.39-9.93, p=0.009) and older haploidentical group (HR 6.91, 95% CI 2.75-17.39, p<0.001) had a significantly higher risk of NRM. The older haploidentical group had a significantly higher risk of grade II-IV acute GVHD (HR 2.29, 95% CI 1.38-3.80, p=0.001) and grade III-IV acute GVHD (HR 2.70, 95% CI 1.09-6.71, p=0.03). There were no significant differences in chronic GVHD or relapse between the groups. Among adult AML patients in CR undergoing RIC-HCT with PTCy prophylaxis, a young MUD may be preferred over a younger haploidentical donor.
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Affiliation(s)
- Rohtesh S Mehta
- Clinical Research Division, Adult Blood and Marrow Transplantation, Fred Hutchison Cancer Center, Seattle, Washington.
| | - Jeremy Ramdial
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David Marin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Amin Alousi
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Christopher G Kanakry
- Center for Immuno-Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Katayoun Rezvani
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kristin Page
- Division of Pediatric Hematology, Oncology, and Transplant, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Shahinaz M Gadalla
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Daniel Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
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9
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Krem MM, Zhang MJ, Chen K, Hildebrandt GC, Maziarz RT, Hourigan CS, Kebriaei P, Litzow MR, Weisdorf DJ, Page K, Saber W. Ph-Positive ALL Patients Who Are Treated with Tyrosine Kinase Inhibitors Have Similar Post-Transplant Survival As Ph-Negative Patients. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00195-1] [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: 02/07/2023]
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10
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Fasugba O, Dale S, McInnes E, Cadilhac DA, Noetel M, Coughlan K, McElduff B, Kim J, Langley T, Cheung NW, Hill K, Pollnow V, Page K, Sanjuan Menendez E, Neal E, Griffith S, Christie LJ, Slark J, Ranta A, Levi C, Grimshaw JM, Middleton S. Evaluating remote facilitation intensity for multi-national translation of nurse-initiated stroke protocols (QASC Australasia): a protocol for a cluster randomised controlled trial. Implement Sci 2023; 18:2. [PMID: 36703172 PMCID: PMC9879239 DOI: 10.1186/s13012-023-01260-9] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Facilitated implementation of nurse-initiated protocols to manage fever, hyperglycaemia (sugar) and swallowing difficulties (FeSS Protocols) in 19 Australian stroke units resulted in reduced death and dependency for stroke patients. However, a significant gap remains in translating this evidence-based care bundle protocol into standard practice in Australia and New Zealand. Facilitation is a key component for increasing implementation. However, its contribution to evidence translation initiatives requires further investigation. We aim to evaluate two levels of intensity of external remote facilitation as part of a multifaceted intervention to improve FeSS Protocol uptake and quality of care for patients with stroke in Australian and New Zealand acute care hospitals. METHODS A three-arm cluster randomised controlled trial with a process evaluation and economic evaluation. Australian and New Zealand hospitals with a stroke unit or service will be recruited and randomised in blocks of five to one of the three study arms-high- or low-intensity external remote facilitation or a no facilitation control group-in a 2:2:1 ratio. The multicomponent implementation strategy will incorporate implementation science frameworks (Theoretical Domains Framework, Capability, Opportunity, Motivation - Behaviour Model and the Consolidated Framework for Implementation Research) and include an online education package, audit and feedback reports, local clinical champions, barrier and enabler assessments, action plans, reminders and external remote facilitation. The primary outcome is implementation effectiveness using a composite measure comprising six monitoring and treatment elements of the FeSS Protocols. Secondary outcome measures are as follows: composite outcome of adherence to each of the combined monitoring and treatment elements for (i) fever (n=5); (ii) hyperglycaemia (n=6); and (iii) swallowing protocols (n=7); adherence to the individual elements that make up each of these protocols; comparison for composite outcomes between (i) metropolitan and rural/remote hospitals; and (ii) stroke units and stroke services. A process evaluation will examine contextual factors influencing intervention uptake. An economic evaluation will describe cost differences relative to each intervention and study outcomes. DISCUSSION We will generate new evidence on the most effective facilitation intensity to support implementation of nurse-initiated stroke protocols nationwide, reducing geographical barriers for those in rural and remote areas. TRIAL REGISTRATION ACTRN12622000028707. Registered 14 January, 2022.
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Affiliation(s)
- O Fasugba
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | - S Dale
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | - E McInnes
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | - D A Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - M Noetel
- School of Psychology, University of Queensland, Brisbane, Australia
| | - K Coughlan
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | - B McElduff
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia
| | - J Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - T Langley
- St Vincent's Health Network Sydney, Sydney, New South Wales, Australia
| | - N W Cheung
- Centre for Diabetes and Endocrinology Research, Westmead Hospital and University of Sydney, Sydney, New South Wales, Australia
| | - K Hill
- Stroke Foundation, Sydney, New South Wales, Australia
| | - V Pollnow
- St Vincent's Health Network Sydney, Sydney, New South Wales, Australia
| | - K Page
- St Vincent's Health Network Sydney, Sydney, New South Wales, Australia
| | | | - E Neal
- Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - S Griffith
- School of Psychology, University of Queensland, Brisbane, Australia
| | - L J Christie
- Allied Health Research Unit, St Vincent's Health Network, Sydney, Australia
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
| | - J Slark
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - A Ranta
- Department of Medicine, University of Otago Wellington, Wellington, New Zealand
- Department of Neurology, Wellington Hospital, Wellington, New Zealand
| | - C Levi
- John Hunter Health and Innovation Precinct, New Lambton Heights, New South Wales, Australia
- Department of Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - J M Grimshaw
- University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - S Middleton
- Nursing Research Institute, St Vincent's Health Network Sydney & St Vincent's Hospital Melbourne & Australian Catholic University, Level 5, deLacy Building, St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia.
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11
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Bevilacqua K, Arciniegas S, Page K, Steinberg A, Stellmann J, Flores-Miller A, Wirtz A. Contexts of violence victimization and service-seeking among Latino/a/x immigrant adults in Maryland and the District of Columbia: A qualitative study. J Migr Health 2022; 7:100142. [PMID: 36568828 PMCID: PMC9772540 DOI: 10.1016/j.jmh.2022.100142] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/08/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
In the United States (US), Latino/a/x immigrants are particularly vulnerable to discrimination and violence, which are associated with a host of negative physical and mental health consequences. Despite this, Latino/a/x immigrants may have limited access to resources and services to prevent and address its consequences. In-depth interviews (n = 17) and one focus group discussion (n = 5) were conducted among a maximum variation sample of adult Latino/a/x immigrants living in Maryland and the District of Columbia, following semi-structured interview guides to explore experiences of discrimination and violence, their impact on health, and barriers and facilitators to help-seeking. Experiences of discrimination and violence victimization were diverse in type and severity. Many women and one gender non-binary participant described experiences of intimate partner violence as well workplace violence. Men frequently described violence that occurred in public and in the workplace. Nearly all participants reported workplace discrimination. Lack of legal documentation, experiences of impunity in country of origin, and lack of knowledge of the US legal system presented barriers, while peers, social groups, and bystanders facilitated violence reporting and help-seeking. Results highlight clear opportunities to prevent and respond to violence through improved availability and accessibility of information, as well as expansion or adaptation of existing services across sectors.
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Affiliation(s)
- K.G. Bevilacqua
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Population and Reproductive Health, 615 N Wolfe St, Baltimore, MD 21205, USA,Corresponding author.
| | - S. Arciniegas
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - K. Page
- Johns Hopkins University School of Medicine, 773 N Broadway, Baltimore, MD 21205, USA
| | - A.K. Steinberg
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - J. Stellmann
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA,Behavioral Science Research Institute, 2600 Douglas Rd, Suite 712, Coral Gables, FL 33134, USA
| | - A. Flores-Miller
- Johns Hopkins University Center for Salud/Health and Opportunity for Latinos (Centro SOL), 5200 Eastern Ave, Baltimore, MD 21224, USA
| | - A.L. Wirtz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
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12
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Hourigan CS, Dillon LW, Gui G, Ravindra N, Wong Z, Andrew G, Mukherjee D, El Chaer F, Yoon C, Spellman S, Howard A, Auletta J, Devine SM, Jimenez Jimenez AM, De Lima MJ, Litzow MR, Kebriaei P, Saber W, Weisdorf DJ, Page K. Pre-MEASURE: Multicenter evaluation of the prognostic significance of measurable residual disease testing prior to allogeneic transplantation for adult patients with AML in first remission. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7006] [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: 11/20/2022] Open
Abstract
7006 Background: Measurable residual disease (MRD) prior to allogeneic hematopoietic cell transplantation (alloHCT) is associated with increased relapse and death in patients with acute myeloid leukemia (AML) in cytomorphological complete remission (CR). We recently demonstrated AML MRD detected in pre-alloHCT blood by DNA-sequencing was associated with increased relapse and decreased overall survival in patients randomized to reduced intensity conditioning (RIC) versus myeloablative conditioning (MAC). The clinical utility of such ultra-deep next-generation sequencing (NGS-MRD) had not yet been reported in a large multi-center cohort. Methods: Patients aged 18 or older who underwent first alloHCT between 2013-2017 for AML in first CR (CR1), reported to be FLT3, NPM1, IDH1, IDH2 and/or Kit mutated at diagnosis, with a pre-conditioning remission blood sample available in the CIBMTR biobank were eligible for this study. Ultra-deep anchored multiplex PCR-based NGS-MRD for the above mutations was performed on 500ng gDNA with error-corrected variant calling as previously described. The pre-specified statistical analysis plan was registered on OSF. Results: Of 457 patients with a sample available, 448 had sufficient clinical annotation and DNA for analysis. 147 of these 448 patients (33%) experienced relapse at a median of 5.6 months post-alloHCT. NGS-MRD was positive in 129 pre-alloHCT patient samples (29%), averaging 1.35 mutation(s)/patient (range: 1-4). 173 mutations were detected with a median VAF of 0.18% (range: 0.0054-62%), most frequently FLT3-ITD (n = 43 patients), NPM1 (n = 48), and IDH2 (n = 46). Testing positive by NGS-MRD prior to alloHCT was associated with a 3yr RFS of 36% (95% CI: 28-45%) compared with 56% (51-62%) in those testing negative (p < 0.001). Detection of NPM1 and/or FLT3-ITD mutations prior to alloHCT was associated with a 3yr relapse probability of 55% (43-67%) and RFS of 26% (16-37%). NGS-MRD impact was modified by conditioning intensity: positive patients receiving RIC/NMA had the highest relapse of 57% at 3yr, testing negative followed by RIC/NMA had the same relapse rate at 3yr (35%) as those who tested positive but received MAC (p < 0.001). At three years, those positive for FLT3-ITD and/or NPM1 mutations prior to RIC/NMA alloHCT had a relapse probability of 67% (50-83%) with a RFS of 19% (8-33%). HR for relapse if NGS-MRD positive pre-alloHCT in CR1 was 2.3 (p < 0.001, 95% CI 1.6-3.1) when adjusting for conditioning intensity and age group. Conclusions: In this largest cohort of NGS-MRD testing prior to alloHCT for AML reported to date, we confirm the ability to identify patients in CR1 but at high-risk of subsequent relapse. This evidence provides the foundation for future precision medicine approaches to reduce post-transplant AML relapse.
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Affiliation(s)
- Chris S. Hourigan
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Laura Williams Dillon
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Gege Gui
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Niveditha Ravindra
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Zoë Wong
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Georgia Andrew
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Devdeep Mukherjee
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | | | - Chris Yoon
- National Marrow Donor Program, Milwaukee, WI
| | - Stephen Spellman
- (CIBMTR) Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Alan Howard
- National Marrow Donor Program, Minneapolis, MN
| | | | | | - Antonio Martin Jimenez Jimenez
- Division of Transplantation and Cell Therapy, Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL
| | - Marcos J.G. De Lima
- Adult Hematologic Malignancies and Stem Cell Transplant Program, University Hospitals Seidman Cancer Center, Cleveland, OH
| | | | - Partow Kebriaei
- The University of Texas MD Anderson Cancer Center, Department of Stem Cell Transplantation & Cellular Therapy, Houston, TX
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI
| | - Daniel Jordan Weisdorf
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
| | - Kristin Page
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
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13
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Meyer R, Wang K, Yearley A, Grob S, Zeitlin J, Bloomfeld J, You M, Lee D, Bonner M, Shah N, Page K. Usability and Acceptability of the QuestLeukemia Mobile Application: A Pilot Study for An Educational and Psychological Intervention for Children with Chronic Illnesses. J Pediatr Hematol Oncol Nurs 2022; 39:137-142. [PMID: 35467435 DOI: 10.1177/27527530221068422] [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] [Indexed: 06/14/2023]
Abstract
It is widely accepted that educational interventions benefit children with chronic diseases (disease awareness and autonomy) or those undergoing medical procedures (decreased anxiety and improved satisfaction). Hematopoietic cell transplantation (HCT) is an intensive procedure to treat life-threatening diseases but is associated with multiple adverse medical experiences. QuestLeukemia (QuestED, Durham, NC) is a mobile app designed to educate pediatric patients preparing for HCT through age-appropriate videos and quizzes. Here we describe the results of the initial pilot study assessing acceptability and feasibility of QuestLeukemia app. Eligible participants were selected from a convenience sample (inpatient HCT unit and outpatient clinic). Participants spent 30-60 min using the app then completed a survey assessing the app for usability, accessibility, and user satisfaction. Participants identified the app as a useful tool for gaining disease-related knowledge and reported greater autonomy over their disease process. On average, patients indicated that the app was easy to use (M = 4.93), enjoyable (M = 4.79), and comprehensive (M = 4.71). Parents followed similar trends of satisfaction with the app. Pediatric HCT providers likewise reported that the app was easy to use (M = 4.22), enjoyable (M = 4.85), and educationally comprehensive (M = 4.77). The QuestLeukemia mobile application prototype provides an easy, enjoyable, and educational tool for pediatric patients undergoing HCT. This application was well received by patients, parents, and providers. These findings will be used to design future iterations of the game in clinical care.
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Affiliation(s)
| | - Kira Wang
- 3065Duke University, Durham, NC, USA
| | - Alexander Yearley
- 3065Duke University, Durham, NC, USA
- 1812Harvard Medical School, Durham, NC, USA
| | | | | | | | | | - Diane Lee
- 3065Duke University, Durham, NC, USA
| | - Melanie Bonner
- 213852Duke University Hospital, Durham, NC, USA
- 3065Duke University, Durham, NC, USA
| | - Nirmish Shah
- 213852Duke University Hospital, Durham, NC, USA
- 3065Duke University, Durham, NC, USA
| | - Kristin Page
- 213852Duke University Hospital, Durham, NC, USA
- 3065Duke University, Durham, NC, USA
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14
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Murthy H, Zhang MJ, Chen K, Ganguly S, Ahmed S, Michelis FV, Nishihori T, Deotare U, Kansagra A, Patnaik MM, Litzow MR, Kebriaei P, Hourigan CS, Page K, Kharfan-Dabaja MA, Saber W. Outcomes of Allogeneic Hematopoietic Cell Transplantation in Blastic Plasmacytoid Dendritic Cell Neoplasm: A CIBMTR Analysis. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00310-4] [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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15
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Cisneros-Villanueva M, Hidalgo-Pérez L, Rios-Romero M, Cedro-Tanda A, Ruiz-Villavicencio CA, Page K, Hastings R, Fernandez-Garcia D, Allsopp R, Fonseca-Montaño MA, Jimenez-Morales S, Padilla-Palma V, Shaw JA, Hidalgo-Miranda A. Cell-free DNA analysis in current cancer clinical trials: a review. Br J Cancer 2022; 126:391-400. [PMID: 35027672 PMCID: PMC8810765 DOI: 10.1038/s41416-021-01696-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/06/2021] [Accepted: 12/23/2021] [Indexed: 12/13/2022] Open
Abstract
Cell-free DNA (cfDNA) analysis represents a promising method for the diagnosis, treatment selection and clinical follow-up of cancer patients. Although its general methodological feasibility and usefulness has been demonstrated, several issues related to standardisation and technical validation must be addressed for its routine clinical application in cancer. In this regard, most cfDNA clinical applications are still limited to clinical trials, proving its value in several settings. In this paper, we review the current clinical trials involving cfDNA/ctDNA analysis and highlight those where it has been useful for patient stratification, treatment follow-up or development of novel approaches for early diagnosis. Our query included clinical trials, including the terms 'cfDNA', 'ctDNA', 'liquid biopsy' AND 'cancer OR neoplasm' in the FDA and EMA public databases. We identified 1370 clinical trials (FDA = 1129, EMA = 241) involving liquid-biopsy analysis in cancer. These clinical trials show promising results for the early detection of cancer and confirm cfDNA as a tool for real-time monitoring of acquired therapy resistance, accurate disease-progression surveillance and improvement of treatment, situations that result in a better quality of life and extended overall survival for cancer patients.
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Affiliation(s)
- M Cisneros-Villanueva
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Mexico, Periférico Sur No. 4809, Col. Arenal Tepepan, Delegación Tlalpan, Ciudad de Mexico, 14610, Mexico City, Mexico
| | - L Hidalgo-Pérez
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Mexico, Periférico Sur No. 4809, Col. Arenal Tepepan, Delegación Tlalpan, Ciudad de Mexico, 14610, Mexico City, Mexico
| | - M Rios-Romero
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Mexico, Periférico Sur No. 4809, Col. Arenal Tepepan, Delegación Tlalpan, Ciudad de Mexico, 14610, Mexico City, Mexico
| | - A Cedro-Tanda
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Mexico, Periférico Sur No. 4809, Col. Arenal Tepepan, Delegación Tlalpan, Ciudad de Mexico, 14610, Mexico City, Mexico
| | - C A Ruiz-Villavicencio
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Mexico, Periférico Sur No. 4809, Col. Arenal Tepepan, Delegación Tlalpan, Ciudad de Mexico, 14610, Mexico City, Mexico
| | - K Page
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - R Hastings
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - D Fernandez-Garcia
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - R Allsopp
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - M A Fonseca-Montaño
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Mexico, Periférico Sur No. 4809, Col. Arenal Tepepan, Delegación Tlalpan, Ciudad de Mexico, 14610, Mexico City, Mexico
| | - S Jimenez-Morales
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Mexico, Periférico Sur No. 4809, Col. Arenal Tepepan, Delegación Tlalpan, Ciudad de Mexico, 14610, Mexico City, Mexico
| | - V Padilla-Palma
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Mexico, Periférico Sur No. 4809, Col. Arenal Tepepan, Delegación Tlalpan, Ciudad de Mexico, 14610, Mexico City, Mexico
| | - J A Shaw
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, University Road, Leicester, LE1 7RH, UK.
| | - A Hidalgo-Miranda
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Mexico, Periférico Sur No. 4809, Col. Arenal Tepepan, Delegación Tlalpan, Ciudad de Mexico, 14610, Mexico City, Mexico.
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16
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Genovese E, Fiorini G, Corrao G, Page K, Cailhol J, Franchi M, Tlili R, Cella SG, Jackson YL. Multi-centric assessment of COVID-19 immunization access and demand among undocumented migrants. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.246] [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: 11/12/2022] Open
Abstract
Abstract
Background
Marginalization of undocumented migrants raises concerns about equitable access to COVID-19 immunization. This study describes their self-perceived accessibility of and demand for COVID-19 immunization.
Methods
A multi-centric cross-sectional survey was conducted in 4 health facilities providing care to undocumented immigrants in the USA, Switzerland, Italy, and France in February-April 2021. A convenience sample of minimum 100 patients per study site was recruited. Data was collected using an anonymous structured questionnaire including demographic variables, health status, and drivers/barriers for COVID-19 immunization. Descriptive statistics were used to characterize the primary and secondary outcomes: self-perceived accessibility of and demand for COVID-19 immunization.
Results
812 migrants completed the survey (54.3% Geneva, 17.5% Baltimore, 15.5% Milan, and 12.7% Paris). 60.9% were women, the median age was 40 years old (range 17-76), and 19 nationalities were represented: 55.9% Latin America, 12.7% Africa, 11.2% Western Pacific, 7.9% Eastern Mediterranean, 7.6% Europe, 4.7% Asia. Among participants, 14.1% and 26.2% reported prior COVID-19 infection and fear of developing severe COVID-19, respectively. Underlying co-morbidities were common (29.5%). Self-perceived accessibility of COVID-19 immunization was high (86.4%), yet demand was low (41.1%) correlating with age, co-morbidity, and views on immunization which were better for immunization in general (77.3%) than immunization against COVID-19 (56.5%). Hesitancy was mostly due to fear of adverse reactions (39.2%).
Conclusions
In this multi-centric study, undocumented migrants generally believed they would access local COVID-19 immunization programs. Yet, despite positive views about immunization in general, they reported limited confidence in COVID-19 immunization and willingness to be immunized.
Key messages
Self-perceived accessibility of COVID-19 immunization is high, yet demand is limited. COVID-19 immunization campaigns may engage communities and leverage confidence in immunization in general to address concerns about COVID-19 immunization.
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Affiliation(s)
- E Genovese
- Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - G Fiorini
- Istituti Clinici Zucchi, Monza, Italy
- Laboratory of Clinical Pharmacology and Pharmacoepidemiology, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - G Corrao
- Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - K Page
- School of Medicine, Johns Hopkins University, Baltimore, USA
| | - J Cailhol
- Department of Infectious Disease, Avicenne Teaching Hospital, Bobigny, France
| | - M Franchi
- Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - R Tlili
- Unit for Universal Access to Healthcare, Avicenne Teaching Hospital, Bobigny, USA
| | - SG Cella
- Laboratory of Clinical Pharmacology and Pharmacoepidemiology, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Y L Jackson
- Geneva University Hospital, University of Geneva, Geneva, Switzerland
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17
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Petrovic K, Depoil D, Gascoyne D, Page K, Curnock A, Benlahrech A. 1016P ImmTAC redirect exhausted tumor-infiltrating T-cells: An effect enhanced by pembrolizumab against PD-L1+ tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1400] [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: 10/20/2022] Open
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18
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Page K, Martinson LJ, Hastings RK, Fernandez-Garcia D, Gleason KLT, Gray MC, Rushton AJ, Goddard K, Guttery DS, Stebbing J, Coombes RC, Shaw JA. Prevalence of ctDNA in early screen-detected breast cancers using highly sensitive and specific dual molecular barcoded personalised mutation assays. Ann Oncol 2021; 32:1057-1060. [PMID: 33932505 DOI: 10.1016/j.annonc.2021.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/25/2021] [Indexed: 12/27/2022] Open
Affiliation(s)
- K Page
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - L J Martinson
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - R K Hastings
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - D Fernandez-Garcia
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - K L T Gleason
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - M C Gray
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - A J Rushton
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - K Goddard
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - D S Guttery
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - J Stebbing
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - R C Coombes
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - J A Shaw
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK.
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19
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Abdalla H, Aharonian F, Ait Benkhali F, Angüner EO, Arcaro C, Armand C, Armstrong T, Ashkar H, Backes M, Baghmanyan V, Barbosa Martins V, Barnacka A, Barnard M, Becherini Y, Berge D, Bernlöhr K, Bi B, Bissaldi E, Böttcher M, Boisson C, Bolmont J, de Bony de Lavergne M, Breuhaus M, Brun F, Brun P, Bryan M, Büchele M, Bulik T, Bylund T, Caroff S, Carosi A, Casanova S, Chand T, Chandra S, Chen A, Cotter G, Curyło M, Damascene Mbarubucyeye J, Davids ID, Davies J, Deil C, Devin J, Dirson L, Djannati-Ataï A, Dmytriiev A, Donath A, Doroshenko V, Dreyer L, Duffy C, Dyks J, Egberts K, Eichhorn F, Einecke S, Emery G, Ernenwein JP, Feijen K, Fegan S, Fiasson A, Fichet de Clairfontaine G, Fontaine G, Funk S, Füßling M, Gabici S, Gallant YA, Giavitto G, Giunti L, Glawion D, Glicenstein JF, Grondin MH, Hahn J, Haupt M, Hermann G, Hinton JA, Hofmann W, Hoischen C, Holch TL, Holler M, Hörbe M, Horns D, Huber D, Jamrozy M, Jankowsky D, Jankowsky F, Jardin-Blicq A, Joshi V, Jung-Richardt I, Kasai E, Kastendieck MA, Katarzyński K, Katz U, Khangulyan D, Khélifi B, Klepser S, Kluźniak W, Komin N, Konno R, Kosack K, Kostunin D, Kreter M, Lamanna G, Lemière A, Lemoine-Goumard M, Lenain JP, Leuschner F, Levy C, Lohse T, Lypova I, Mackey J, Majumdar J, Malyshev D, Malyshev D, Marandon V, Marchegiani P, Marcowith A, Mares A, Martí-Devesa G, Marx R, Maurin G, Meintjes PJ, Meyer M, Mitchell A, Moderski R, Mohrmann L, Montanari A, Moore C, Morris P, Moulin E, Muller J, Murach T, Nakashima K, Nayerhoda A, de Naurois M, Ndiyavala H, Niemiec J, Oakes L, O'Brien P, Odaka H, Ohm S, Olivera-Nieto L, de Ona Wilhelmi E, Ostrowski M, Panny S, Panter M, Parsons RD, Peron G, Peyaud B, Piel Q, Pita S, Poireau V, Priyana Noel A, Prokhorov DA, Prokoph H, Pühlhofer G, Punch M, Quirrenbach A, Raab S, Rauth R, Reichherzer P, Reimer A, Reimer O, Remy Q, Renaud M, Rieger F, Rinchiuso L, Romoli C, Rowell G, Rudak B, Ruiz-Velasco E, Sahakian V, Sailer S, Salzmann H, Sanchez DA, Santangelo A, Sasaki M, Scalici M, Schäfer J, Schüssler F, Schutte HM, Schwanke U, Seglar-Arroyo M, Senniappan M, Seyffert AS, Shafi N, Shapopi JNS, Shiningayamwe K, Simoni R, Sinha A, Sol H, Specovius A, Spencer S, Spir-Jacob M, Stawarz Ł, Sun L, Steenkamp R, Stegmann C, Steinmassl S, Steppa C, Takahashi T, Tam T, Tavernier T, Taylor AM, Terrier R, Thiersen JHE, Tiziani D, Tluczykont M, Tomankova L, Tsirou M, Tuffs R, Uchiyama Y, van der Walt DJ, van Eldik C, van Rensburg C, van Soelen B, Vasileiadis G, Veh J, Venter C, Vincent P, Vink J, Völk HJ, Wadiasingh Z, Wagner SJ, Watson J, Werner F, White R, Wierzcholska A, Wong YW, Yusafzai A, Zacharias M, Zanin R, Zargaryan D, Zdziarski AA, Zech A, Zhu SJ, Zorn J, Zouari S, Żywucka N, Evans P, Page K. Revealing x-ray and gamma ray temporal and spectral similarities in the GRB 190829A afterglow. Science 2021; 372:1081-1085. [PMID: 34083487 DOI: 10.1126/science.abe8560] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/07/2021] [Indexed: 11/02/2022]
Abstract
Gamma-ray bursts (GRBs), which are bright flashes of gamma rays from extragalactic sources followed by fading afterglow emission, are associated with stellar core collapse events. We report the detection of very-high-energy (VHE) gamma rays from the afterglow of GRB 190829A, between 4 and 56 hours after the trigger, using the High Energy Stereoscopic System (H.E.S.S.). The low luminosity and redshift of GRB 190829A reduce both internal and external absorption, allowing determination of its intrinsic energy spectrum. Between energies of 0.18 and 3.3 tera-electron volts, this spectrum is described by a power law with photon index of 2.07 ± 0.09, similar to the x-ray spectrum. The x-ray and VHE gamma-ray light curves also show similar decay profiles. These similar characteristics in the x-ray and gamma-ray bands challenge GRB afterglow emission scenarios.
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Affiliation(s)
| | - H Abdalla
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - F Aharonian
- Dublin Institute for Advanced Studies, Dublin 2, Ireland. .,Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.,High Energy Astrophysics Laboratory, Russian-Armenian University (RAU), Yerevan 0051, Armenia
| | - F Ait Benkhali
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - E O Angüner
- Aix Marseille Université, Centre national de la recherche scientifique (CNRS)/Institut National de Physique Nucléaire et Physique des Particules (IN2P3), Centre de Physique des Particules de Marseille (CPPM), Marseille, France
| | - C Arcaro
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Armand
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - T Armstrong
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - H Ashkar
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Backes
- University of Namibia, Department of Physics, Windhoek 10005, Namibia.,Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - V Baghmanyan
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | | | - A Barnacka
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - M Barnard
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - Y Becherini
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - D Berge
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - K Bernlöhr
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - B Bi
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - E Bissaldi
- Dipartimento Interateneo di Fisica, Politecnico di Bari, 70125 Bari, Italy.,Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125 Bari, Italy
| | - M Böttcher
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Boisson
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - J Bolmont
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - M de Bony de Lavergne
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - M Breuhaus
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - F Brun
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - P Brun
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Bryan
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - M Büchele
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - T Bulik
- Astronomical Observatory, The University of Warsaw, 00-478 Warsaw, Poland
| | - T Bylund
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - S Caroff
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Carosi
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - S Casanova
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.,Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | - T Chand
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - S Chandra
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - A Chen
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - G Cotter
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - M Curyło
- Astronomical Observatory, The University of Warsaw, 00-478 Warsaw, Poland
| | | | - I D Davids
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - J Davies
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - C Deil
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - J Devin
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - L Dirson
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - A Djannati-Ataï
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - A Dmytriiev
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - A Donath
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - V Doroshenko
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - L Dreyer
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C Duffy
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - J Dyks
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - K Egberts
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany
| | - F Eichhorn
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - S Einecke
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - G Emery
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - J-P Ernenwein
- Aix Marseille Université, Centre national de la recherche scientifique (CNRS)/Institut National de Physique Nucléaire et Physique des Particules (IN2P3), Centre de Physique des Particules de Marseille (CPPM), Marseille, France
| | - K Feijen
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - S Fegan
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - A Fiasson
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - G Fichet de Clairfontaine
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - G Fontaine
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - S Funk
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Füßling
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - S Gabici
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - Y A Gallant
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - G Giavitto
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - L Giunti
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France.,Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - D Glawion
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - J F Glicenstein
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M-H Grondin
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J Hahn
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - M Haupt
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - G Hermann
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - J A Hinton
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - W Hofmann
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - C Hoischen
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany
| | - T L Holch
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - M Holler
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Hörbe
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - D Horns
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - D Huber
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Jamrozy
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - D Jankowsky
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - F Jankowsky
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - A Jardin-Blicq
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - V Joshi
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - I Jung-Richardt
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - E Kasai
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - M A Kastendieck
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - K Katarzyński
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, 87-100 Torun, Poland
| | - U Katz
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - D Khangulyan
- Department of Physics, Rikkyo University, Toshima-ku, Tokyo 171-8501, Japan.
| | - B Khélifi
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - S Klepser
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - W Kluźniak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - Nu Komin
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - R Konno
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - K Kosack
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - D Kostunin
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - M Kreter
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - G Lamanna
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Lemière
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - M Lemoine-Goumard
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - J-P Lenain
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - F Leuschner
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - C Levy
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - T Lohse
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - I Lypova
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - J Mackey
- Dublin Institute for Advanced Studies, Dublin 2, Ireland
| | - J Majumdar
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - D Malyshev
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - D Malyshev
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - V Marandon
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - P Marchegiani
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - A Marcowith
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - A Mares
- Université Bordeaux, CNRS/IN2P3, Centre d'Études Nucléaires de Bordeaux Gradignan, 33175 Gradignan, France
| | - G Martí-Devesa
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - R Marx
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany.,Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - G Maurin
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - P J Meintjes
- Department of Physics, University of the Free State, Bloemfontein 9300, South Africa
| | - M Meyer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Mitchell
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R Moderski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - L Mohrmann
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Montanari
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Moore
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - P Morris
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - E Moulin
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - J Muller
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - T Murach
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - K Nakashima
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Nayerhoda
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | - M de Naurois
- Laboratoire Leprince-Ringuet, CNRS, Institut Polytechnique de Paris, F-91128 Palaiseau, France
| | - H Ndiyavala
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - J Niemiec
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland
| | - L Oakes
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - P O'Brien
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - H Odaka
- Department of Physics, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - S Ohm
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - L Olivera-Nieto
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | | | - M Ostrowski
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - S Panny
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - M Panter
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R D Parsons
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - G Peron
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - B Peyaud
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Q Piel
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - S Pita
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - V Poireau
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Priyana Noel
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - D A Prokhorov
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - H Prokoph
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - G Pühlhofer
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - M Punch
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden.,Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - A Quirrenbach
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - S Raab
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - R Rauth
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - P Reichherzer
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - O Reimer
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - Q Remy
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - M Renaud
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - F Rieger
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - L Rinchiuso
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - C Romoli
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.
| | - G Rowell
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5005, Australia
| | - B Rudak
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - E Ruiz-Velasco
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany.
| | - V Sahakian
- Yerevan Physics Institute, 375036 Yerevan, Armenia
| | - S Sailer
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - H Salzmann
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - D A Sanchez
- Laboratoire d'Annecy de Physique des Particules (LAPP), Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, 74000 Annecy, France
| | - A Santangelo
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - M Sasaki
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Scalici
- Institut für Astronomie und Astrophysik, Universität Tübingen, D 72076 Tübingen, Germany
| | - J Schäfer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - F Schüssler
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France.
| | - H M Schutte
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - U Schwanke
- Institut für Physik, Humboldt-Universität zu Berlin, D 12489 Berlin, Germany
| | - M Seglar-Arroyo
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - M Senniappan
- Department of Physics and Electrical Engineering, Linnaeus University, 351 95 Växjö, Sweden
| | - A S Seyffert
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - N Shafi
- School of Physics, University of the Witwatersrand, Braamfontein, Johannesburg 2050, South Africa
| | - J N S Shapopi
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - K Shiningayamwe
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - R Simoni
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - A Sinha
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - H Sol
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - A Specovius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - S Spencer
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - M Spir-Jacob
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - Ł Stawarz
- Obserwatorium Astronomiczne, Uniwersytet Jagielloński, 30-244 Kraków, Poland
| | - L Sun
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - R Steenkamp
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - C Stegmann
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany.,Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - S Steinmassl
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - C Steppa
- Institut für Physik und Astronomie, Universität Potsdam, D 14476 Potsdam, Germany
| | - T Takahashi
- Kavli Institute for the Physics and Mathematics of the Universe (World Premier International Research Center Initiative (WPI)), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Kashiwa, Chiba, 277-8583, Japan
| | - T Tam
- School of Physics and Astronomy, Sun Yat Sen University, Guangzhou 510275, People's Republic of China
| | - T Tavernier
- Institute for Research on the Fundamental Laws of the Universe (IRFU), Commissariat à l'énergie atomique (CEA), Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - A M Taylor
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany.
| | - R Terrier
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - J H E Thiersen
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - D Tiziani
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Tluczykont
- Universität Hamburg, Institut für Experimentalphysik, D 22761 Hamburg, Germany
| | - L Tomankova
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Tsirou
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R Tuffs
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - Y Uchiyama
- Department of Physics, Rikkyo University, Toshima-ku, Tokyo 171-8501, Japan
| | - D J van der Walt
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - C van Eldik
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - C van Rensburg
- University of Namibia, Department of Physics, Windhoek 10005, Namibia
| | - B van Soelen
- Department of Physics, University of the Free State, Bloemfontein 9300, South Africa
| | - G Vasileiadis
- Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, F-34095 Montpellier Cedex 5, France
| | - J Veh
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - C Venter
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - P Vincent
- Sorbonne Université, Université Paris Diderot, Sorbonne Paris Cité, CNRS/IN2P3, Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), F-75252 Paris, France
| | - J Vink
- Gravitation and Astroparticle Physics at the University of Amsterdam (GRAPPA), Anton Pannekoek Institute for Astronomy, University of Amsterdam, 1098 XH Amsterdam, Netherlands
| | - H J Völk
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - Z Wadiasingh
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - S J Wagner
- Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - J Watson
- University of Oxford, Department of Physics, Denys Wilkinson Building, Oxford OX1 3RH, UK
| | - F Werner
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - R White
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - A Wierzcholska
- Instytut Fizyki Jądrowej Polskiej Akademii Nauk (PAN), 31-342 Kraków, Poland.,Landessternwarte, Universität Heidelberg, Königstuhl, D 69117 Heidelberg, Germany
| | - Yu Wun Wong
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - A Yusafzai
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen Centre for Astroparticle Physics, D 91058 Erlangen, Germany
| | - M Zacharias
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa.,Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - R Zanin
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - D Zargaryan
- Dublin Institute for Advanced Studies, Dublin 2, Ireland.,High Energy Astrophysics Laboratory, Russian-Armenian University (RAU), Yerevan 0051, Armenia
| | - A A Zdziarski
- Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, 00-716 Warsaw, Poland
| | - A Zech
- Laboratoire Univers et Théories, Observatoire de Paris, Université PSL, CNRS, Université de Paris, 92190 Meudon, France
| | - S J Zhu
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany.
| | - J Zorn
- Max-Planck-Institut für Kernphysik, D 69029 Heidelberg, Germany
| | - S Zouari
- Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - N Żywucka
- Centre for Space Research, North-West University, Potchefstroom 2520, South Africa
| | - P Evans
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
| | - K Page
- School of Physics and Astronomy, The University of Leicester, Leicester LE1 7RH, UK
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Bohannon L, Tang H, Page K, Ren Y, Jung SH, Artica A, Britt A, Islam P, Siamakpour-Reihani S, Giri V, Lew M, Kelly M, Choi T, Gasparetto C, Long G, Lopez R, Rizzieri D, Sarantopoulos S, Chao N, Horwitz M, Sung A. Decreased Mortality in 1-Year Survivors of Umbilical Cord Blood Transplant vs. Matched Related or Matched Unrelated Donor Transplant in Patients with Hematologic Malignancies. Transplant Cell Ther 2021; 27:669.e1-669.e8. [PMID: 33991725 DOI: 10.1016/j.jtct.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 03/15/2021] [Revised: 04/27/2021] [Accepted: 05/02/2021] [Indexed: 11/30/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (HCT) has the potential to cure hematologic malignancies but is associated with significant morbidity and mortality. Although deaths during the first year after transplantation are often attributable to treatment toxicities and complications, death after the first year may be due to sequelae of accelerated aging caused by cellular senescence. Cytotoxic therapies and radiation used in cancer treatments and conditioning regimens for HCT can induce aging at the molecular level; HCT patients experience time-dependent effects, such as frailty and aging-associated diseases, more rapidly than people who have not been exposed to these treatments. Consistent with this, recipients of younger cells tend to have decreased markers of aging and improved survival, decreased graft-versus-host disease, and lower relapse rates. Given that umbilical cord blood (UCB) is the youngest donor source available, we studied the outcomes after the first year of UCB transplantation versus matched related donor (MRD) and matched unrelated donor (MUD) transplantation in patients with hematologic malignancies over a 20-year period. In this single-center, retrospective study, we examined the outcomes of all adult patients who underwent their first allogeneic HCT through the Duke Adult Bone Marrow Transplant program from January 1, 1996, to December 31, 2015, to allow for at least 3 years of follow-up. Patients were excluded if they died or were lost to follow-up before day 365 after HCT, received an allogeneic HCT for a disease other than a hematologic malignancy, or received cells from a haploidentical or mismatched adult donor. UCB recipients experienced a better unadjusted overall survival than MRD/MUD recipients (log rank P = .03, median overall survival: UCB not reached, MRD/MUD 7.4 years). After adjusting for selected covariates, UCB recipients who survived at least 1 year after HCT had a hazard of death that was 31% lower than that of MRD/MUD recipients (hazard ratio, 0.69; 95% confidence interval, 0.47-0.99; P = .049). This trend held true in a subset analysis of subjects with acute leukemia. UCB recipients also experienced lower rates of moderate or severe chronic graft-versus-host disease (GVHD) and nonrelapse mortality, and slower time to relapse. UCB and MRD/MUD recipients experienced similar rates of grade 2-4 acute GVHD, chronic GHVD, secondary malignancy, and subsequent allogeneic HCT. UCB is already widely used as a donor source in pediatric HCT; however, adult outcomes and adoption have historically lagged behind in comparison. Recent advancements in UCB transplantation such as the implementation of lower-intensity conditioning regimens, double unit transplants, and ex vivo expansion have improved early mortality, making UCB an increasingly attractive donor source for adults; furthermore, our findings suggest that UCB may actually be a preferred donor source for mitigating late effects of HCT.
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Affiliation(s)
- Lauren Bohannon
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Helen Tang
- Duke University School of Medicine, Durham, North Carolina
| | - Kristin Page
- Department of Pediatrics, Duke University, Durham, North Carolina
| | - Yi Ren
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Sin-Ho Jung
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Alexandra Artica
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Anne Britt
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Prioty Islam
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Sharareh Siamakpour-Reihani
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Vinay Giri
- Duke University School of Medicine, Durham, North Carolina
| | - Meagan Lew
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Matthew Kelly
- Department of Pediatrics, Duke University, Durham, North Carolina
| | - Taewoong Choi
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Cristina Gasparetto
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Gwynn Long
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Richard Lopez
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - David Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Stefanie Sarantopoulos
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Nelson Chao
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Mitchell Horwitz
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina
| | - Anthony Sung
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, North Carolina.
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21
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Hastings RK, Openshaw MR, Vazquez M, Moreno-Cardenas AB, Fernandez-Garcia D, Martinson L, Kulbicki K, Primrose L, Guttery DS, Page K, Toghill B, Richards C, Thomas A, Tabernero J, Coombes RC, Ahmed S, Toledo RA, Shaw JA. Longitudinal whole-exome sequencing of cell-free DNA for tracking the co-evolutionary tumor and immune evasion dynamics: longitudinal data from a single patient. Ann Oncol 2021; 32:681-684. [PMID: 33609721 DOI: 10.1016/j.annonc.2021.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- R K Hastings
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Level 3 Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
| | - M R Openshaw
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Level 3 Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
| | - M Vazquez
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
| | - A B Moreno-Cardenas
- Gastrointestinal and Endocrine Tumors, Vall d'Hebron Institute of Oncology (VHIO), Centro Cellex, Barcelona, Spain
| | - D Fernandez-Garcia
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Level 3 Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
| | - L Martinson
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Level 3 Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
| | - K Kulbicki
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Level 3 Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
| | - L Primrose
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Level 3 Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
| | - D S Guttery
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Level 3 Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
| | - K Page
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Level 3 Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
| | - B Toghill
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Level 3 Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
| | - C Richards
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - A Thomas
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Level 3 Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
| | - J Tabernero
- Gastrointestinal and Endocrine Tumors, Vall d'Hebron Institute of Oncology (VHIO), Centro Cellex, Barcelona, Spain; Instituto de Salud Carlos III, CIBERONC, Madrid, Spain
| | - R C Coombes
- Department of Surgery and Cancer, Imperial College London, ICTEM, London, UK
| | - S Ahmed
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - R A Toledo
- Gastrointestinal and Endocrine Tumors, Vall d'Hebron Institute of Oncology (VHIO), Centro Cellex, Barcelona, Spain; Instituto de Salud Carlos III, CIBERONC, Madrid, Spain.
| | - J A Shaw
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Level 3 Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK.
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22
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Camacho-Bydume C, Wang T, Sees JA, Fernandez-Viña M, Abid MB, Askar M, Beitinjaneh A, Brown V, Castillo P, Chhabra S, Gadalla SM, Hsu JM, Kamoun M, Lazaryan A, Nishihori T, Page K, Schetelig J, Fleischhauer K, Marsh SGE, Paczesny S, Spellman SR, Lee SJ, Hsu KC. Specific Class I HLA Supertypes but Not HLA Zygosity or Expression Are Associated with Outcomes following HLA-Matched Allogeneic Hematopoietic Cell Transplant: HLA Supertypes Impact Allogeneic HCT Outcomes. Transplant Cell Ther 2020; 27:142.e1-142.e11. [PMID: 33053450 DOI: 10.1016/j.bbmt.2020.10.010] [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: 07/09/2020] [Revised: 09/30/2020] [Accepted: 10/07/2020] [Indexed: 12/12/2022]
Abstract
Maximizing the probability of antigen presentation to T cells through diversity in HLAs can enhance immune responsiveness and translate into improved clinical outcomes, as evidenced by the association of heterozygosity and supertypes at HLA class I loci with improved survival in patients with advanced solid tumors treated with immune checkpoint inhibitors. We investigated the impact of HLA heterozygosity, supertypes, and surface expression on outcomes in adult and pediatric patients with acute myeloid leukemia (AML), myelodysplastic syndrome, acute lymphoblastic leukemia, and non-Hodgkin lymphoma who underwent 8/8 HLA-matched, T cell replete, unrelated, allogeneic hematopoietic cell transplant (HCT) from 2000 to 2015 using patient data reported to the Center for International Blood and Marrow Transplant Research. HLA class I heterozygosity and HLA expression were not associated with overall survival, relapse, transplant-related mortality (TRM), disease-free survival (DFS), and acute graft-versus-host disease following HCT. The HLA-B62 supertype was associated with decreased TRM in the entire patient cohort (hazard ratio [HR], 0.79; 95% CI, 0.69 to 0.90; P = .00053). The HLA-B27 supertype was associated with worse DFS in patients with AML (HR = 1.21; 95% CI, 1.10 to 1.32; P = .00005). These findings suggest that the survival benefit of HLA heterozygosity seen in solid tumor patients receiving immune checkpoint inhibitors does not extend to patients undergoing allogeneic HCT. Certain HLA supertypes, however, are associated with TRM and DFS, suggesting that similarities in peptide presentation between supertype members play a role in these outcomes. Beyond implications for prognosis following HCT, these findings support the further investigation of these HLA supertypes and the specific immune peptides important for transplant outcomes.
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Affiliation(s)
| | - Tao Wang
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI
| | - Jennifer A Sees
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | | | - Muhammad Bilal Abid
- Divisions of Hematology/Oncology and Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Medhat Askar
- Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, Texas
| | - Amer Beitinjaneh
- Department of Medicine, Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
| | - Valerie Brown
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, Pennsylvania
| | - Paul Castillo
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Florida Health Shands Children's Hospital, Gainesville, FL
| | - Saurabh Chhabra
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Shahinaz M Gadalla
- Division of Cancer Epidemiology & Genetics, NIH-NCI Clinical Genetics Branch, Rockville, Maryland
| | - Jing-Mei Hsu
- Division of Hematology/Oncology, Department of Medicine, Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY
| | - Malek Kamoun
- Deparment of Pathology and Laboratory Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Aleksandr Lazaryan
- Department of Blood and Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, Florida
| | - Taiga Nishihori
- Department of Blood and Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, Florida
| | - Kristin Page
- Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, North Carolina
| | - Johannes Schetelig
- Department of Internal Medicine I, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | | | - Steven G E Marsh
- Anthony Nolan Research Institute, Royal Free Hospital, London, UK; UCL Cancer Institute, London, UK
| | - Sophie Paczesny
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC
| | - Stephen R Spellman
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Stephanie J Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Medicine, University of Washington, Seattle, WA
| | - Katharine C Hsu
- Department of Medicine, Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York; Human Oncology & Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York.
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23
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Hollowell R, McLaughlin C, Skergan N, West T, Cash J, Crane S, Hoyle K, Page K, Prasad V, Kurtzberg J, Sun J. Umbilical Cord Blood Infusion Reactions. Stem Cells Transl Med 2020. [DOI: 10.1002/sctm.12815] [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: 11/11/2022] Open
Affiliation(s)
- Rachel Hollowell
- Marcus Center for Cellular Cures Duke University, Durham, North Carolina, USA
| | - Colleen McLaughlin
- Marcus Center for Cellular Cures Duke University, Durham, North Carolina, USA
| | - Natalie Skergan
- Marcus Center for Cellular Cures Duke University, Durham, North Carolina, USA
| | - Tara West
- Marcus Center for Cellular Cures Duke University, Durham, North Carolina, USA
| | - Jayne Cash
- Marcus Center for Cellular Cures Duke University, Durham, North Carolina, USA
| | - Sydney Crane
- Marcus Center for Cellular Cures Duke University, Durham, North Carolina, USA
| | - Kerry Hoyle
- Marcus Center for Cellular Cures Duke University, Durham, North Carolina, USA
| | - Kristin Page
- Marcus Center for Cellular Cures Duke University, Durham, North Carolina, USA
| | - Vinod Prasad
- Marcus Center for Cellular Cures Duke University, Durham, North Carolina, USA
| | - Joanne Kurtzberg
- Marcus Center for Cellular Cures Duke University, Durham, North Carolina, USA
| | - Jessica Sun
- Marcus Center for Cellular Cures Duke University, Durham, North Carolina, USA
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24
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Davies K, Barth M, Armenian S, Audino AN, Barnette P, Cuglievan B, Ding H, Ford JB, Galardy PJ, Gardner R, Hanna R, Hayashi R, Kovach AE, Machnitz AJ, Maloney KW, Marks L, Page K, Reilly AF, Weinstein JL, Xavier AC, McMillian NR, Freedman-Cass DA. Pediatric Aggressive Mature B-Cell Lymphomas, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2020; 18:1105-1123. [PMID: 32755986 DOI: 10.6004/jnccn.2020.0036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pediatric aggressive mature B-cell lymphomas are the most common types of non-Hodgkin lymphoma in children, and they include Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL). These diseases are highly aggressive but curable, the treatment is complex, and patients may have many complicated supportive care issues. The NCCN Guidelines for Pediatric Aggressive Mature B-Cell Lymphomas provide guidance regarding pathology and diagnosis, staging, initial treatment, disease reassessment, surveillance, therapy for relapsed/refractory disease, and supportive care for clinicians who treat sporadic pediatric BL and DLBCL.
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Affiliation(s)
- Kimberly Davies
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center
| | | | | | - Anthony N Audino
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | - Hilda Ding
- UCSD Rady Children's Hospital/UC San Diego Moores Cancer Center
| | | | | | - Rebecca Gardner
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | - Rabi Hanna
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | - Robert Hayashi
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | - Kelly W Maloney
- Children's Hospital of Colorado/University of Colorado Cancer Center
| | | | | | - Anne F Reilly
- Abramson Cancer Center at the University of Pennsylvania
| | | | - Ana C Xavier
- Children's of Alabama/O'Neal Comprehensive Cancer Center at UAB; and
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25
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Wu T, Tabata M, Hodgkinson LM, Page K, Huard C, Buhlmann J, Sarin K, Fiorentino D. LB971 Type I and II interferon signaling differentially associated with histopathologic findings in dermatomyositis skin. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.05.070] [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: 10/24/2022]
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26
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Dawson G, Sun JM, Baker J, Carpenter K, Compton S, Deaver M, Franz L, Heilbron N, Herold B, Horrigan J, Howard J, Kosinski A, Major S, Murias M, Page K, Prasad VK, Sabatos-DeVito M, Sanfilippo F, Sikich L, Simmons R, Song A, Vermeer S, Waters-Pick B, Troy J, Kurtzberg J. A Phase II Randomized Clinical Trial of the Safety and Efficacy of Intravenous Umbilical Cord Blood Infusion for Treatment of Children with Autism Spectrum Disorder. J Pediatr 2020; 222:164-173.e5. [PMID: 32444220 DOI: 10.1016/j.jpeds.2020.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/05/2020] [Accepted: 03/05/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate whether umbilical cord blood (CB) infusion is safe and associated with improved social and communication abilities in children with autism spectrum disorder (ASD). STUDY DESIGN This prospective, randomized, placebo-controlled, double-blind study included 180 children with ASD, aged 2-7 years, who received a single intravenous autologous (n = 56) or allogeneic (n = 63) CB infusion vs placebo (n = 61) and were evaluated at 6 months postinfusion. RESULTS CB infusion was safe and well tolerated. Analysis of the entire sample showed no evidence that CB was associated with improvements in the primary outcome, social communication (Vineland Adaptive Behavior Scales-3 [VABS-3] Socialization Domain), or the secondary outcomes, autism symptoms (Pervasive Developmental Disorder Behavior Inventory) and vocabulary (Expressive One-Word Picture Vocabulary Test). There was also no overall evidence of differential effects by type of CB infused. In a subanalysis of children without intellectual disability (ID), allogeneic, but not autologous, CB was associated with improvement in a larger percentage of children on the clinician-rated Clinical Global Impression-Improvement scale, but the OR for improvement was not significant. Children without ID treated with CB showed significant improvements in communication skills (VABS-3 Communication Domain), and exploratory measures including attention to toys and sustained attention (eye-tracking) and increased alpha and beta electroencephalographic power. CONCLUSIONS Overall, a single infusion of CB was not associated with improved socialization skills or reduced autism symptoms. More research is warranted to determine whether CB infusion is an effective treatment for some children with ASD.
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Affiliation(s)
- Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC; Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC.
| | - Jessica M Sun
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Jennifer Baker
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Kimberly Carpenter
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Scott Compton
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Megan Deaver
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Nicole Heilbron
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Brianna Herold
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Joseph Horrigan
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Jill Howard
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Andrzej Kosinski
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Samantha Major
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Michael Murias
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Kristin Page
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Vinod K Prasad
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | | | - Linmarie Sikich
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Ryan Simmons
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Allen Song
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC; Duke Brain Imaging and Analysis Center, Duke University School of Medicine, Durham, NC
| | - Saritha Vermeer
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC
| | - Barbara Waters-Pick
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Jesse Troy
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
| | - Joanne Kurtzberg
- Marcus Center for Cellular Cures, Duke University School of Medicine, Durham, NC
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27
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Marinho DH, Ribeiro LL, Nichele S, Loth G, Koliski A, Mousquer RTG, Funke VAM, Page K, Fasth A, Pasquini R, Boguszewski MCDS, Bonfim C. The challenge of long-term follow-up of survivors of childhood acute leukemia after hematopoietic stem cell transplantation in resource-limited countries: A single-center report from Brazil. Pediatr Transplant 2020; 24:e13691. [PMID: 32246550 DOI: 10.1111/petr.13691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/30/2020] [Accepted: 02/18/2020] [Indexed: 11/28/2022]
Abstract
With the number of long-term HSCT survivors steadily increasing, attention needs to be focused on the late complications and quality of life. We therefore analyzed the outcome of 101 pediatric patients (<18 years old at the time of HSCT) transplanted for acute leukemia between 1981 and 2015 at Complexo Hospital de Clínicas, Federal University of Paraná, Brazil, and who survived at least two years after HSCT. The median follow-up was 5.9 years (2.0-29.0); median age at follow-up was 17.5 years (2.98-39.0). The 5-year cumulative incidence of relapse was 27.5% (95% CI 18.6%-36.4%). Two-year cumulative incidence of chronic GVHD was 21.8% (95% CI 13.7%-29.8%). Of the 101 patients, 72 patients (71.3%) presented with late effects. Those surviving longer after HSCT experienced more complications. Patients who received TBI-based regimen developed more late effects (P = .013) and more endocrinological complications (P = .024). Endocrinological complications were the most common late sequelae found in this study. For childhood survivors, quality of life was not influenced by age (at HSCT or at last visit), time from HSCT, gender, donor, or GVHD. For survivors that no longer were children, only age at last visit impacted financial domain measures, irrespective of gender, donor, or GVHD. The current study confirms the high burden late complications after pediatric HSCT have on the survivors and underlines the importance of extended follow-up.
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Affiliation(s)
| | | | - Samantha Nichele
- Bone Marrow Transplantation Unit, Federal University of Paraná, Curitiba, Brazil
| | - Gisele Loth
- Bone Marrow Transplantation Unit, Federal University of Paraná, Curitiba, Brazil
| | - Adriana Koliski
- Bone Marrow Transplantation Unit, Federal University of Paraná, Curitiba, Brazil
| | | | | | - Kristin Page
- Pediatric Transplant and Cellular Therapy, Duke University, Durham, NC, USA
| | - Anders Fasth
- Department of Pediatrics, Institute of Clinical Sciencies at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ricardo Pasquini
- Bone Marrow Transplantation Unit, Federal University of Paraná, Curitiba, Brazil
| | | | - Carmem Bonfim
- Bone Marrow Transplantation Unit, Federal University of Paraná, Curitiba, Brazil
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28
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Zhang H, Liu S, Nelson CS, Bezmaternykh LN, Chen YS, Wang SG, Lobo RPSM, Page K, Matsuda M, Pajerowski DM, Williams TJ, Tyson TA. Structural features associated with multiferroic behavior in the RX 3(BO 3) 4 system. J Phys Condens Matter 2019; 31:505704. [PMID: 31484172 DOI: 10.1088/1361-648x/ab415f] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The magnetoelectric effect in the RX3(BO3)4 system (R = Ho, Eu, Sm, Nd, Gd; X = Fe, Al) varies significantly with the cation R despite very similar structural arrangements. Our structural studies reveal a symmetry reducing tilting of the BO3 planes and of the FeO6 polyhedra in the systems exhibiting low magnetic field induced electric polarization. Neutron scattering measurements reveal a lack of magnetic ordering indicating the primary importance of the atomic structure in the multiferroic behavior of this system.
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Affiliation(s)
- H Zhang
- Department of Physics, New Jersey Institute of Technology, Newark, NJ 071022, United States of America
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Rottapel R, Reid M, Bertisch S, Bron M, Kapur V, Bujanover S, Harrington Z, Bakker J, Hanson M, Figetakis K, Page K, Hanes S, Villa K, Redline S. Prevalence and morbidity of sleepiness among sleep apnea patients in an online cohort. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.919] [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: 10/25/2022]
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Brondon J, Page K, Polishchuk V, Driscoll T, Parikh S, Martin PL, Kurtzberg J, Prasad VK. Outcomes of Umbilical Cord Blood Transplantation in Children with Batten Disease. Stem Cells Transl Med 2019; 8:S12-S12. [PMCID: PMC6713523 DOI: 10.1002/sctm.12557] [Citation(s) in RCA: 1] [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: 07/26/2023] Open
Affiliation(s)
- Jennifer Brondon
- Marcus Center for Cellular Cures at DukeDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Kristin Page
- Marcus Center for Cellular Cures at DukeDuke University School of MedicineDurhamNorth CarolinaUSA
| | | | - Timothy Driscoll
- Marcus Center for Cellular Cures at DukeDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Suhag Parikh
- Marcus Center for Cellular Cures at DukeDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Paul L. Martin
- Marcus Center for Cellular Cures at DukeDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Joanne Kurtzberg
- Marcus Center for Cellular Cures at DukeDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Vinod K. Prasad
- Marcus Center for Cellular Cures at DukeDuke University School of MedicineDurhamNorth CarolinaUSA
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McLaughlin CA, West T, Hollowell R, Skergan NN, Baker J, Donner H, Cash J, Hoyle K, Crane S, Waters-Pick B, Hawkins T, Page K, Prasad VK, Sun J, Kurtzberg J. Expanded Access Protocol of Umbilical Cord Blood Infusion for Children with Neurological Conditions. Stem Cells Transl Med 2019. [DOI: 10.1002/sctm.12583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Colleen A. McLaughlin
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Tara West
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Rachel Hollowell
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Natalie N. Skergan
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Jennifer Baker
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Hildy Donner
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Jayne Cash
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Kerry Hoyle
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Sydney Crane
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Barbara Waters-Pick
- b Duke Stem Cell Transplant Lab Duke University School of Medicine, Durham, North Carolina, USA
| | - Tiffany Hawkins
- b Duke Stem Cell Transplant Lab Duke University School of Medicine, Durham, North Carolina, USA
| | - Kristin Page
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Vinod K. Prasad
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Jessica Sun
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
| | - Joanne Kurtzberg
- a Marcus Center for Cellular Cures at Duke Duke University School of Medicine, Durham, North Carolina, USA
- b Duke Stem Cell Transplant Lab Duke University School of Medicine, Durham, North Carolina, USA
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Naik S, Riches M, Hari P, Kim S, Chen M, Bachier C, Shaughnessy P, Hill J, Ljungman P, Battiwalla M, Chhabra S, Daly A, Storek J, Ustun C, Diaz MA, Cerny J, Beitinjaneh A, Yared J, Brown V, Page K, Dahi PB, Ganguly S, Seo S, Chao N, Freytes CO, Saad A, Savani BN, Woo Ahn K, Boeckh M, Heslop HE, Lazarus HM, Auletta JJ, Kamble RT. Survival outcomes of allogeneic hematopoietic cell transplants with EBV-positive or EBV-negative post-transplant lymphoproliferative disorder, A CIBMTR study. Transpl Infect Dis 2019; 21:e13145. [PMID: 31301099 DOI: 10.1111/tid.13145] [Citation(s) in RCA: 15] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/05/2019] [Accepted: 06/22/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Post-transplant lymphoproliferative disorders (PTLD) are associated with significant morbidity and mortality following allogeneic hematopoietic cell transplant (alloHCT). Although most PTLD is EBV-positive (EBVpos ), EBV-negative (EBVneg ) PTLD is reported, yet its incidence and clinical impact remain largely undefined. Furthermore, factors at the time of transplant impacting survival following PTLD are not well described. METHODS Between 2002 and 2014, 432 cases of PTLD following alloHCT were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). After exclusions, 267 cases (EBVpos = 222, 83%; EBVneg = 45, 17%) were analyzed. RESULTS Two hundred and eight patients (78%) received in vivo T-cell depletion (TCD) with either anti-thymocyte globulin (ATG) or alemtuzumab. Incidence of PTLD was highest using umbilical cord donors (UCB, 1.60%) and lowest using matched related donors (MRD, 0.40%). Clinical features and histology did not significantly differ among EBVpos or EBVneg PTLD cases except that absolute lymphocyte count recovery was slower, and CMV reactivation was later in EBVneg PTLD [EBVpos 32 (5-95) days versus EBVneg 47 (10-70) days, P = .016]. There was no impact on survival by EBV status in multivariable analysis [EBVneg RR 1.42, 95% CI 0.94-2.15, P = .097]. CONCLUSIONS There is no difference in survival outcomes for patients with EBVpos or EBVneg PTLD occurring following alloHCT and 1-year survival is poor. Features of conditioning and use of serotherapy remain important.
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Affiliation(s)
- Seema Naik
- Penn State Cancer Institute, Hershey, Pennsylvania
| | - Marcie Riches
- Division of Hematology/Oncology, The University of North Carolina, Chapel Hill, North California
| | - Parameswaran Hari
- Department of Medicine, Medical College of Wisconsin, Center for International Blood and Marrow Transplant Research (CIBMTR), Milwaukee, Wisconsin
| | - Soyoung Kim
- Department of Medicine, Medical College of Wisconsin, Center for International Blood and Marrow Transplant Research (CIBMTR), Milwaukee, Wisconsin.,Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Min Chen
- Department of Medicine, Medical College of Wisconsin, Center for International Blood and Marrow Transplant Research (CIBMTR), Milwaukee, Wisconsin
| | - Carlos Bachier
- Sarah Cannon Center for Blood Cancer, Nashville, Tennessee
| | - Paul Shaughnessy
- Texas Transplant Institute, Sarah Cannon Blood Cancer Network, San Antonio, Texas
| | - Joshua Hill
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Per Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden
| | | | - Saurabh Chhabra
- Department of Medicine, Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Andrew Daly
- Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Jan Storek
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Celalettin Ustun
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Jan Cerny
- UMass Memorial Medical Center, Worcester, Massachusetts
| | | | - Jean Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland
| | - Valerie Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, Pennsylvania
| | - Kristin Page
- Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, North Carolina
| | - Parastoo B Dahi
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | - Sachiko Seo
- Department of Hematology, Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Nelson Chao
- Division of Cell Therapy and Hematologica, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Cesar O Freytes
- Texas Transplant Institute, Sarah Cannon Blood Cancer Network, San Antonio, Texas
| | - Ayman Saad
- Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kwang Woo Ahn
- Department of Medicine, Medical College of Wisconsin, Center for International Blood and Marrow Transplant Research (CIBMTR), Milwaukee, Wisconsin.,Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Michael Boeckh
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Helen E Heslop
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Hillard M Lazarus
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Jeffery J Auletta
- Blood and Marrow Transplant Program and Host Defense Program, Divisions of Hematology/Oncology/Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio
| | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
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Guttman-Yassky E, Pavel A, Page K, Diaz A, Banerjee A, King B, Zhang W, Zhu L, Banfield C, Cox L, Vincent M, Dowty M, Peeva E. 544 Alopecia areata lesions show significant changes in immune and keratin biomarkers that correlate with clinical improvement with oral Janus kinase inhibitors PF-06651600 (JAK3) and PF-06700841 (TYK2/JAK1). J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.620] [Citation(s) in RCA: 4] [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: 10/27/2022]
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Parikh SH, Pentz RD, Haight A, Adeli M, Martin PL, Driscoll TA, Page K, Kurtzberg J, Prasad VK, Barfield RC. Ethical considerations of using a single minor donor for three bone marrow harvests for three HLA-matched siblings with primary immunodeficiency. Pediatr Blood Cancer 2019; 66:e27602. [PMID: 30609294 DOI: 10.1002/pbc.27602] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/23/2018] [Accepted: 12/11/2018] [Indexed: 11/07/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation is curative for primary immunodeficiencies. Bone marrow from an unaffected human leukocyte antigen (HLA)-identical sibling donor is the ideal graft source. For minor donors, meaningful consent or assent may not be feasible, and permission from parents or legal guardians is considered acceptable. Adverse events, albeit extremely small, can be associated with bone marrow harvest in pediatric donors. Donor safety concerns potentially increase with multiple bone marrow harvests. Very little is known about multiple bone marrow harvests from pediatric donors. We describe the ethical considerations and clinical decision-making in an unusual clinical situation where three patients with the same primary immunodeficiency were HLA identical to one another and their younger sibling, who underwent bone marrow harvests three times between 1.3 and 4 years of age, resulting in successful transplantation for all three patients. We hope that this experience will provide guidance to providers and families in a similar situation.
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Affiliation(s)
| | | | - Ann Haight
- Aflac Cancer and Blood Disorders Center, Emory University, Atlanta, Georgia
| | | | - Paul L Martin
- Duke University Medical Center, Durham, North Carolina
| | | | - Kristin Page
- Duke University Medical Center, Durham, North Carolina
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Coombes RC, Armstrong A, Ahmed S, Page K, Hastings RK, Salari R, Sethi H, Boydell AR, Shchegrova SV, Fernandez-Garcia D, Gleason KL, Goddard K, Guttery DS, Assaf ZJ, Balcioglu M, Moore DA, Primrose L, Navarro SL, Aleshin A, Rehman F, Toghill BJ, Louie MC, Zimmermann BG, Lin CHJ, Shaw JA. Abstract P4-01-02: Early detection of residual breast cancer through a robust, scalable and personalized analysis of circulating tumour DNA (ctDNA) antedates overt metastatic recurrence. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-01-02] [Citation(s) in RCA: 2] [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: 11/16/2022]
Abstract
Abstract
Background:
Many breast cancer patients relapse after primary treatment but there are no reliable tests to detect distant metastases before they become overt. Here we show earlier identification of recurring patients through a scalable personalised ctDNA analysis. The method is applicable to all patients, and not limited to hot-spot mutations typically detected by gene panels.
Methods:
Forty-nine non-metastatic breast cancer patients were recruited following surgery and adjuvant therapy. Plasma samples (n=208) were serially collected semi-annually. Using the analytically validated SignateraTM workflow, we determined mutational signatures from primary tumour whole exome data and designed personalised assays targeting 16 variants with high sensitivity by ultra-deep sequencing (average >100,000X). The patient-specific assay was used to detect the presence of the mutational signature in the plasma.
Results:
In 16 of 18 (89%) clinically-relapsing patients, ctDNA was detected ahead of metastatic relapse being diagnosed by clinical examination, radiological and biochemical (CA15-3) measurements, and remained ctDNA-positive through follow-up. Of the 2 patients not detected by ctDNA, one had a small local recurrence only (now resected) and the other had three primary tumours. None of the 31 non-relapsing patients were ctDNA-positive at any time point (n=142). Metastatic relapse was predicted by Signatera with high accuracy and a lead time of up to 2 years (median=9.5 months).
Conclusions:
The use of a scalable patient-specific ctDNA-based validated workflow detects breast cancer recurrence ahead of clinical detection. Accurate and earlier prediction by ctDNA analysis could provide a means of monitoring breast cancer patients in need of second-line salvage adjuvant therapy in order to prevent overt life-threatening metastatic progression.
Citation Format: Coombes RC, Armstrong A, Ahmed S, Page K, Hastings RK, Salari R, Sethi H, Boydell A-R, Shchegrova SV, Fernandez-Garcia D, Gleason KL, Goddard K, Guttery DS, Assaf ZJ, Balcioglu M, Moore DA, Primrose L, Navarro SL, Aleshin A, Rehman F, Toghill BJ, Louie MC, Zimmermann BG, Lin C-HJ, Shaw JA. Early detection of residual breast cancer through a robust, scalable and personalized analysis of circulating tumour DNA (ctDNA) antedates overt metastatic recurrence [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-01-02.
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Affiliation(s)
- RC Coombes
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - A Armstrong
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - S Ahmed
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - K Page
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - RK Hastings
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - R Salari
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - H Sethi
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - A-R Boydell
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - SV Shchegrova
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - D Fernandez-Garcia
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - KL Gleason
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - K Goddard
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - DS Guttery
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - ZJ Assaf
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - M Balcioglu
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - DA Moore
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - L Primrose
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - SL Navarro
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - A Aleshin
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - F Rehman
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - BJ Toghill
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - MC Louie
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - BG Zimmermann
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - C-HJ Lin
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
| | - JA Shaw
- Imperial College London, London, United Kingdom; Leicester Infirmary, Leicester, United Kingdom; The Christie Foundation NHS Trust, Manchester, United Kingdom; Natera, San Carlos, CA; University of Leicester, Leicester, United Kingdom
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Ustun C, Young JAH, Papanicolaou GA, Kim S, Ahn KW, Chen M, Abdel-Azim H, Aljurf M, Beitinjaneh A, Brown V, Cerny J, Chhabra S, Kharfan-Dabaja MA, Dahi PB, Daly A, Dandoy CE, Dvorak CC, Freytes CO, Hashmi S, Lazarus H, Ljungman P, Nishihori T, Page K, Pingali SRK, Saad A, Savani BN, Weisdorf D, Williams K, Wirk B, Auletta JJ, Lindemans CA, Komanduri K, Riches M. Bacterial blood stream infections (BSIs), particularly post-engraftment BSIs, are associated with increased mortality after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2018; 54:1254-1265. [PMID: 30546070 PMCID: PMC6565512 DOI: 10.1038/s41409-018-0401-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 08/06/2018] [Revised: 10/29/2018] [Accepted: 11/09/2018] [Indexed: 01/18/2023]
Abstract
We analyzed CIBMTR data to evaluate the incidence of non-relapse mortality (NRM) and association with overall survival (OS) for Bacterial blood stream infections (BSIs) occurring within 100 days of alloHCT in 2 different phases: pre/peri engraftment (BSI very early phase, BSI-VEP) and BSI post engraftment (BSI occurring between 2 weeks after engraftment and Day100, late early phase, BSI-LEP). Of 7,128 alloHCT patients, 2,656 (37%) had ≥1 BSI by day100. BSI-VEP, BSI-LEP, BSI-Both constituted 56% (n=1492), 31% (n=824), and 13% (n=340) of total BSI, respectively. Starting in 2009 we observed a gradual decline in BSI incidence through 2012 (61% to 48%). Patients with BSI-VEP were more likely to receive a myeloablative conditioning (MAC) regimen with total body irradiation (TBI). NRM was significantly higher in patients with any BSI (RR 1.82 95CI 1.63–2.04 for BSI-VEP, RR 2.46, 95%CI 2.05–2.96 for BSI-LEP, and RR 2.29, 95%CI 1.87–2.81 for BSI-Both) compared with those without BSI. OS was significantly lower in patients with any BSI compared with patients without BSI (RR 1.36, 95%CI 1.26–1.47 for BSI-VEP; RR 1.83, 95%CI 1.58–2.12 for BSI-LEP: RR 1.66, 95%CI 1.43–1.94 for BSI-Both). BSIs within day100 after alloHCT are common and remain a risk factor for mortality.
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Affiliation(s)
- Celalettin Ustun
- Division of Hematology, Oncology and Cellular Therapy, Rush University, Chicago, IL, USA.
| | - Jo-Anne H Young
- Division of Infectious Disease and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | | | - Soyoung Kim
- CIBMTR© (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kwang Woo Ahn
- CIBMTR© (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Min Chen
- CIBMTR© (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI, USA
| | - Hisham Abdel-Azim
- Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Mahmoud Aljurf
- Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | - Valerie Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, PA, USA
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA
| | | | - Mohamed A Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Parastoo B Dahi
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew Daly
- Tom Baker Cancer Center, Calgary, AL, Canada
| | | | - Christopher C Dvorak
- Division of Pediatric Allergy, Immunology & Bone Marrow Transplantation, Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA
| | | | - Shahrukh Hashmi
- Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.,Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Hillard Lazarus
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Per Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden
| | - Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Kristin Page
- Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, NC, USA
| | | | - Ayman Saad
- Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel Weisdorf
- Division of Hematology, Oncology and Cellular Therapy, Rush University, Chicago, IL, USA
| | - Kirsten Williams
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Jeffery J Auletta
- Blood and Marrow Transplant Program and Host Defense Program, Divisions of Hematology/Oncology/Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, OH, USA
| | - Caroline A Lindemans
- Pediatric Blood and Marrow Transplantation Program, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Marcie Riches
- Division of Hematology/Oncology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Muñiz Alers SM, Page K, Simmons R, Waters-Pick B, Cheatham L, Troy JD, Kurtzberg J. Automated thawing increases recovery of colony-forming units from banked cord blood unit grafts. Transfusion 2018; 58:2911-2917. [PMID: 30307045 DOI: 10.1111/trf.14938] [Citation(s) in RCA: 1] [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] [Received: 05/18/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The cell dose infused for cord blood transplantation strongly correlates with outcomes following transplantation. Post thaw recoveries can be improved by washing cord blood units (CBUs) in dextran/albumin. Early methods used a labor-intensive manual process. We have recently developed and validated an automated washing method. We now report our results of a study comparing cellular recoveries achieved after manual and automated wash, as well as the impact on engraftment following allogeneic transplantation. STUDY DESIGN AND METHODS CBUs distributed by the Carolinas Cord Blood Bank for clinical use at Duke University after manual or automated wash were included in this report. Precryopreservation total nucleated cell count, total CD34+, colony-forming units, recoveries, and sterility were analyzed by wash method. Patient age, cell dose/weight, diagnosis, conditioning regimen, immunosuppression, and time to neutrophil engraftment were also analyzed. RESULTS Manual and automated washed CBUs yielded similar total nucleated cell count and total CD34+ recoveries. Significantly higher colony-forming units recoveries were achieved after automated washing. Patients who received CBUs washed via an automated method experienced earlier neutrophil engraftment. CONCLUSION While manual and automated washing achieved similar post thaw cellular recoveries, automated washed CBUs demonstrated higher colony-forming unit recovery, which is an important predictor of potency and engraftment. Furthermore, we demonstrated that automated washing was associated with earlier neutrophil engraftment. Our findings favor the use of an automated wash method over a manual approach.
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Affiliation(s)
| | - Kristin Page
- Marcus Center for Cellular Cures, Durham, North Carolina
- Carolinas Cord Blood Bank, Durham, North Carolina
| | - Ryan Simmons
- Marcus Center for Cellular Cures, Durham, North Carolina
| | - Barbara Waters-Pick
- Duke University Hospital Stem Cell Transplant Laboratory, Durham, North Carolina
| | - Lynn Cheatham
- Marcus Center for Cellular Cures, Durham, North Carolina
- Carolinas Cord Blood Bank, Durham, North Carolina
| | - Jesse D Troy
- Marcus Center for Cellular Cures, Durham, North Carolina
- Carolinas Cord Blood Bank, Durham, North Carolina
| | - Joanne Kurtzberg
- Marcus Center for Cellular Cures, Durham, North Carolina
- Carolinas Cord Blood Bank, Durham, North Carolina
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Allewelt H, Taskindoust M, Troy J, Page K, Wood S, Parikh S, Prasad VK, Kurtzberg J. Long-Term Functional Outcomes after Hematopoietic Stem Cell Transplant for Early Infantile Krabbe Disease. Biol Blood Marrow Transplant 2018; 24:2233-2238. [DOI: 10.1016/j.bbmt.2018.06.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 06/11/2018] [Indexed: 10/28/2022]
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Hastings R, Openshaw M, Vazquez M, Fernandez-Garcia D, Guttery D, Page K, Toghill B, Thomas A, Ahmed S, Toledo R, Shaw J. Whole-exome cfDNA profiling captures the mutational signatures of metastatic breast cancer for monitoring disease evolution. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.009] [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: 11/12/2022] Open
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Lund TC, Ahn KW, Tecca HR, Hilgers MV, Abdel-Azim H, Abraham A, Diaz MA, Badawy SM, Broglie L, Brown V, Dvorak CC, Gonzalez-Vicent M, Hashem H, Hayashi RJ, Jacobsohn DA, Kent MW, Li CK, Margossian SP, Martin PL, Mehta P, Myers K, Olsson R, Page K, Pulsipher MA, Shaw PJ, Smith AR, Triplett BM, Verneris MR, Eapen M. Outcomes after Second Hematopoietic Cell Transplantation in Children and Young Adults with Relapsed Acute Leukemia. Biol Blood Marrow Transplant 2018; 25:301-306. [PMID: 30244103 DOI: 10.1016/j.bbmt.2018.09.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 08/10/2018] [Accepted: 09/09/2018] [Indexed: 11/28/2022]
Abstract
Children with acute leukemia who relapse after hematopoietic cell transplantation (HCT) have few therapeutic options. We studied 251 children and young adults with acute myelogenous or lymphoblastic leukemia who underwent a second HCT for relapse after their first HCT. The median age at second HCT was 11 years, and the median interval between first and second HCT was 17 months. Most of the patients (n = 187; 75%) were in remission, received a myeloablative conditioning regimen (n = 157; 63%), and underwent unrelated donor HCT (n = 230; 92%). The 2-year probability of leukemia-free survival (LFS) was 33% after transplantation in patients in remission, compared with 19% after transplantation in patients not in remission (P = .02). The corresponding 8-year probabilities were 24% and 10% (P = .003). A higher rate of relapse contributed to the difference in LFS. The 2-year probability of relapse after transplantation was 42% in patients in remission and 56% in those in relapse (P = .05). The corresponding 8-year probabilities were 49% and 64% (P = .04). These data extend the findings of others showing that patients with a low disease burden are more likely to benefit from a second transplantation. Late relapse led to a 10% decrement in LFS beyond the second year after second HCT. This differs from first HCT, in which most relapses occur within 2 years after HCT.
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Affiliation(s)
- Troy C Lund
- Division of Pediatric Blood and Marrow Transplant, University of Minnesota, Minneapolis, Minnesota
| | - Kwang Woo Ahn
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Heather R Tecca
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Megan V Hilgers
- Division of Pediatric Blood and Marrow Transplant, University of Minnesota, Minneapolis, Minnesota
| | - Hisham Abdel-Azim
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | - Allistair Abraham
- Division of Blood and Marrow Transplantation, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Larisa Broglie
- Division of Pediatric Bone Marrow Transplantation, Columbia University Medical Center, New York, New York
| | - Valerie Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, Pennsylvania
| | - Christopher C Dvorak
- Pediatric Allergy Immunology and Blood and Marrow Transplant Division, UCSF Benioff Children's Hospital, San Francisco, California
| | - Marta Gonzalez-Vicent
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Hasan Hashem
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Robert J Hayashi
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - David A Jacobsohn
- Children's National Health System, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Michael W Kent
- Atrium Health/Levine Children's Hospital, Charlotte, North Carolina
| | - Chi-Kong Li
- Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Steven P Margossian
- Department of Pediatric Oncology, Boston Children's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Paul L Martin
- Department of Pediatrics, Duke University, Durham, North Carolina
| | - Parinda Mehta
- Division of Bone Marrow Transplant and Immune Deficiency, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kasiani Myers
- Division of Bone Marrow Transplant and Immune Deficiency, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Richard Olsson
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Kristin Page
- Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, North Carolina
| | - Michael A Pulsipher
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | - Peter J Shaw
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Angela R Smith
- Division of Pediatric Blood and Marrow Transplant, University of Minnesota, Minneapolis, Minnesota
| | - Brandon M Triplett
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Michael R Verneris
- Pediatric Hematology/Oncology/Bone Marrow Transplant, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Mary Eapen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
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Dos Santos AM, Molaison JJ, Haberl B, Krishna L, Page K, Loguillo M, Wang XP. The high pressure gas capabilities at Oak Ridge National Laboratory's neutron facilities. Rev Sci Instrum 2018; 89:092907. [PMID: 30278746 DOI: 10.1063/1.5032096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 07/09/2018] [Indexed: 06/08/2023]
Abstract
The study of samples subjected to high pressure gas is an important asset in materials research and has consequently been a priority of the sample environment development at the Oak Ridge National Laboratory's (ORNL) neutron program. Such effort has resulted in the availability of an extensive combination of pressure cells and gas intensifiers (both commercially available and custom made). These resources are available across both neutron facilities at ORNL: the Spallation Neutron Source and the High Flux Isotope Reactor. Current capabilities include, for example, in situ measurements up to 6 kbar and a 3 kbar hydrogen-capable intensifier with a gas recovery feature. In this communication, we will review the existing suite of high pressure gas capabilities, with special emphasis on recent in-house developments. A number of examples will be presented to illustrate how such capabilities are being deployed on neutron beamlines to enable frontier science.
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Affiliation(s)
- A M Dos Santos
- Neutron Sciences Directorate, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37830, USA
| | - J J Molaison
- Neutron Sciences Directorate, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37830, USA
| | - B Haberl
- Neutron Sciences Directorate, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37830, USA
| | - L Krishna
- Department of Physics, Colorado School of Mines, Golden, Colorado 80401, USA
| | - K Page
- Neutron Sciences Directorate, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37830, USA
| | - M Loguillo
- Neutron Sciences Directorate, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37830, USA
| | - X P Wang
- Neutron Sciences Directorate, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37830, USA
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Calder S, An K, Boehler R, Dela Cruz CR, Frontzek MD, Guthrie M, Haberl B, Huq A, Kimber SAJ, Liu J, Molaison JJ, Neuefeind J, Page K, Dos Santos AM, Taddei KM, Tulk C, Tucker MG. A suite-level review of the neutron powder diffraction instruments at Oak Ridge National Laboratory. Rev Sci Instrum 2018; 89:092701. [PMID: 30278771 DOI: 10.1063/1.5033906] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
The suite of neutron powder diffractometers at Oak Ridge National Laboratory (ORNL) utilizes the distinct characteristics of the Spallation Neutron Source and High Flux Isotope Reactor to enable the measurements of powder samples over an unparalleled regime at a single laboratory. Full refinements over large Q ranges, total scattering methods, fast measurements under changing conditions, and a wide array of sample environments are available. This article provides a brief overview of each powder instrument at ORNL and details the complementarity across the suite. Future directions for the powder suite, including upgrades and new instruments, are also discussed.
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Affiliation(s)
- S Calder
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - K An
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - R Boehler
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - C R Dela Cruz
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - M D Frontzek
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - M Guthrie
- European Spallation Source, Lund 221 00, Sweden
| | - B Haberl
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - A Huq
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - S A J Kimber
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - J Liu
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - J J Molaison
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - J Neuefeind
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - K Page
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - A M Dos Santos
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - K M Taddei
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - C Tulk
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
| | - M G Tucker
- Neutron Scattering Division, Oak Ridge National Laboratory, 1 Bethel Valley Rd., Oak Ridge, Tennessee 37831, USA
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Arnold LE, Ober N, Aman MG, Handen B, Smith T, Pan X, Hyman SL, Hollway J, Lecavalier L, Page K, Rice R. A 1.5-Year Follow-Up of Parent Training and Atomoxetine for Attention-Deficit/Hyperactivity Disorder Symptoms and Noncompliant/Disruptive Behavior in Autism. J Child Adolesc Psychopharmacol 2018; 28:322-330. [PMID: 29694241 PMCID: PMC5994674 DOI: 10.1089/cap.2017.0134] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To examine status of children with autism spectrum disorder (ASD) 10 months after a 34-week clinical trial of atomoxetine (ATX) and parent training (PT). METHODS In a 2 × 2 design, 128 children with ASD and attention-deficit/hyperactivity disorder (ADHD) were randomly assigned ATX, PT+placebo, PT+ATX, or placebo alone. PT was weekly for 10 weeks, and then monthly. ATX/placebo was titrated over 6 weeks [≤1.8 mg/kg/d], and then maintained until week 10. Responders continued to week 34 or nonresponse. Placebo nonresponders had a 10-week ATX open trial; ATX nonresponders were treated clinically. All continued to week 34. With no further treatment from the study, all were invited to follow-up (FU) at 1.5 years postbaseline; 94 (73%) participated. Changes from Week 34 to FU and from baseline to FU were tested by one-way analysis of variance or chi-squared test. PT versus no PT was tested by chi-squared test, Fisher's exact test, Welch's t-test, Student's t-test, and Mann-Whitney's U test. RESULTS For the whole sample, the primary outcomes (parent-rated ADHD on the Swanson, Nolan, and Pelham [SNAP] scale and noncompliance on the Home Situations Questionnaire [HSQ]) deteriorated mildly from week 34 to FU, but were still substantially better than baseline (SNAP: t = 12.177, df = 93, p < 0.001; HSQ: t = 8.999, df = 93, p < 0.001). On the SNAP, 61% improved ≥30% from baseline (67% did at week 34); on noncompliance, 56% improved ≥30% from baseline (77% did at week 34). Outcomes with PT were not significantly better than without PT (SNAP p = 0.30; HSQ p = 0.27). Originally assigned treatment groups did not differ significantly. Only 34% still took ATX; 27% were taking stimulants; and 25% took no medication. CONCLUSIONS The majority retained their 34-week end-of-study improvement 10 months later, even though most participants stopped ATX. For some children, ATX continuation may not be necessary for continued benefit or other drugs may be necessary. Cautious individual clinical experimentation may be justified. Twelve sessions of PT made little long-term difference. ClinicalTrials.gov Identifier: Atomoxetine, Placebo and Parent Management Training in Autism (Strattera) (NCT00844753).
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Affiliation(s)
- L. Eugene Arnold
- Nisonger Center UCEDD, The Ohio State University, Columbus, Ohio
| | - Nicole Ober
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael G. Aman
- Nisonger Center UCEDD, The Ohio State University, Columbus, Ohio
| | - Benjamin Handen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tristram Smith
- Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, University of Rochester, Rochester, New York
| | - Xueliang Pan
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University, Columbus, Ohio
| | - Susan L. Hyman
- Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, University of Rochester, Rochester, New York
| | - Jill Hollway
- Nisonger Center UCEDD, The Ohio State University, Columbus, Ohio
| | - Luc Lecavalier
- Nisonger Center UCEDD, The Ohio State University, Columbus, Ohio
| | - Kristin Page
- Nisonger Center UCEDD, The Ohio State University, Columbus, Ohio
| | - Robert Rice
- Nisonger Center UCEDD, The Ohio State University, Columbus, Ohio
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Schmieder G, Draelos Z, Pariser D, Banfield C, Cox L, Hodge M, Kieras E, Parsons-Rich D, Menon S, Salganik M, Page K, Peeva E. Efficacy and safety of the Janus kinase 1 inhibitor PF-04965842 in patients with moderate-to-severe psoriasis: phase II, randomized, double-blind, placebo-controlled study. Br J Dermatol 2018; 179:54-62. [DOI: 10.1111/bjd.16004] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2017] [Indexed: 12/31/2022]
Affiliation(s)
| | - Z.D. Draelos
- Dermatology Consulting Services; High Point NC U.S.A
| | - D.M. Pariser
- Eastern Virginia Medical School and Virginia Clinical Research; Norfolk VA U.S.A
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Agnese R, Aramaki T, Arnquist IJ, Baker W, Balakishiyeva D, Banik S, Barker D, Basu Thakur R, Bauer DA, Binder T, Bowles MA, Brink PL, Bunker R, Cabrera B, Caldwell DO, Calkins R, Cartaro C, Cerdeño DG, Chang Y, Chen Y, Cooley J, Cornell B, Cushman P, Daal M, Di Stefano PCF, Doughty T, Fascione E, Figueroa-Feliciano E, Fritts M, Gerbier G, Germond R, Ghaith M, Godfrey GL, Golwala SR, Hall J, Harris HR, Hong Z, Hoppe EW, Hsu L, Huber ME, Iyer V, Jardin D, Jastram A, Jena C, Kelsey MH, Kennedy A, Kubik A, Kurinsky NA, Loer B, Lopez Asamar E, Lukens P, MacDonell D, Mahapatra R, Mandic V, Mast N, Miller EH, Mirabolfathi N, Mohanty B, Morales Mendoza JD, Nelson J, Orrell JL, Oser SM, Page K, Page WA, Partridge R, Penalver Martinez M, Pepin M, Phipps A, Poudel S, Pyle M, Qiu H, Rau W, Redl P, Reisetter A, Reynolds T, Roberts A, Robinson AE, Rogers HE, Saab T, Sadoulet B, Sander J, Schneck K, Schnee RW, Scorza S, Senapati K, Serfass B, Speller D, Stein M, Street J, Tanaka HA, Toback D, Underwood R, Villano AN, von Krosigk B, Welliver B, Wilson JS, Wilson MJ, Wright DH, Yellin S, Yen JJ, Young BA, Zhang X, Zhao X. Results from the Super Cryogenic Dark Matter Search Experiment at Soudan. Phys Rev Lett 2018; 120:061802. [PMID: 29481237 DOI: 10.1103/physrevlett.120.061802] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 01/02/2018] [Indexed: 06/08/2023]
Abstract
We report the result of a blinded search for weakly interacting massive particles (WIMPs) using the majority of the SuperCDMS Soudan data set. With an exposure of 1690 kg d, a single candidate event is observed, consistent with expected backgrounds. This analysis (combined with previous Ge results) sets an upper limit on the spin-independent WIMP-nucleon cross section of 1.4×10^{-44} (1.0×10^{-44}) cm^{2} at 46 GeV/c^{2}. These results set the strongest limits for WIMP-germanium-nucleus interactions for masses >12 GeV/c^{2}.
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Affiliation(s)
- R Agnese
- Department of Physics, University of Florida, Gainesville Florida 32611, USA
| | - T Aramaki
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - I J Arnquist
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - W Baker
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - D Balakishiyeva
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - S Banik
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni 752050, India
| | - D Barker
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - R Basu Thakur
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
| | - D A Bauer
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T Binder
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M A Bowles
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - P L Brink
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R Bunker
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - B Cabrera
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - D O Caldwell
- Department of Physics, University of California, Santa Barbara, California 93106, USA
| | - R Calkins
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - C Cartaro
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - D G Cerdeño
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Y Chang
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - Y Chen
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - J Cooley
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - B Cornell
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - P Cushman
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - M Daal
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - P C F Di Stefano
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - T Doughty
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - E Fascione
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - E Figueroa-Feliciano
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - M Fritts
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - G Gerbier
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - R Germond
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M Ghaith
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - G L Godfrey
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - S R Golwala
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - J Hall
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - H R Harris
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - Z Hong
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - E W Hoppe
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - L Hsu
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M E Huber
- Departments of Physics and Electrical Engineering, University of Colorado Denver, Denver, Colorado 80217, USA
| | - V Iyer
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni 752050, India
| | - D Jardin
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - A Jastram
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - C Jena
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni 752050, India
| | - M H Kelsey
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - A Kennedy
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - A Kubik
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - N A Kurinsky
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - B Loer
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - E Lopez Asamar
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - P Lukens
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D MacDonell
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - R Mahapatra
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - V Mandic
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - N Mast
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - E H Miller
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - N Mirabolfathi
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - B Mohanty
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni 752050, India
| | - J D Morales Mendoza
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - J Nelson
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - J L Orrell
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - S M Oser
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - K Page
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - W A Page
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - R Partridge
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | | | - M Pepin
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - A Phipps
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - S Poudel
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M Pyle
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - H Qiu
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - W Rau
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - P Redl
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - A Reisetter
- Department of Physics, University of Evansville, Evansville, Indiana 47722, USA
| | - T Reynolds
- Department of Physics, University of Florida, Gainesville Florida 32611, USA
| | - A Roberts
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A E Robinson
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - H E Rogers
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - T Saab
- Department of Physics, University of Florida, Gainesville Florida 32611, USA
| | - B Sadoulet
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Sander
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - K Schneck
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R W Schnee
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - S Scorza
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - K Senapati
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni 752050, India
| | - B Serfass
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - D Speller
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - M Stein
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - J Street
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - H A Tanaka
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - D Toback
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - R Underwood
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - A N Villano
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - B von Krosigk
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - B Welliver
- Department of Physics, University of Florida, Gainesville Florida 32611, USA
| | - J S Wilson
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - M J Wilson
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - D H Wright
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - S Yellin
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - J J Yen
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - B A Young
- Department of Physics, Santa Clara University, Santa Clara, California 95053, USA
| | - X Zhang
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - X Zhao
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
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van den Broek BTA, Page K, Paviglianiti A, Hol J, Allewelt H, Volt F, Michel G, Diaz MA, Bordon V, O'Brien T, Shaw PJ, Kenzey C, Al-Seraihy A, van Hasselt PM, Gennery AR, Gluckman E, Rocha V, Ruggeri A, Kurtzberg J, Boelens JJ. Early and late outcomes after cord blood transplantation for pediatric patients with inherited leukodystrophies. Blood Adv 2018; 2:49-60. [PMID: 29344584 PMCID: PMC5761624 DOI: 10.1182/bloodadvances.2017010645] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [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] [Received: 07/17/2017] [Accepted: 11/28/2017] [Indexed: 12/15/2022] Open
Abstract
Leukodystrophies (LD) are devastating inherited disorders leading to rapid neurological deterioration and premature death. Hematopoietic stem cell transplantation (HSCT) can halt disease progression for selected LD. Cord blood is a common donor source for transplantation of these patients because it is rapidly available and can be used without full HLA matching. However, precise recommendations allowing care providers to identify patients who benefit from HSCT are lacking. In this study, we define risk factors and describe the early and late outcomes of 169 patients with globoid cell leukodystrophy, X-linked adrenoleukodystrophy, and metachromatic leukodystrophy undergoing cord blood transplantation (CBT) at an European Society for Blood and Marrow Transplantation center or at Duke University Medical Center from 1996 to 2013. Factors associated with higher overall survival (OS) included presymptomatic status (77% vs 49%; P = .006), well-matched (≤1 HLA mismatch) CB units (71% vs 54%; P = .009), and performance status (PS) of >80 vs <60 or 60 to 80 (69% vs 32% and 55%, respectively; P = .003). For patients with PS≤60 (n = 20) or 60 to 80 (n = 24) pre-CBT, only 4 (9%) showed improvement. Of the survivors with PS >80 pre-CBT, 50% remained stable, 20% declined to 60 to 80, and 30% to <60. Overall, an encouraging OS was found for LD patients after CBT, especially for those who are presymptomatic before CBT and received adequately dosed grafts. Early identification and fast referral to a specialized center may lead to earlier treatment and, subsequently, to improved outcomes.
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Affiliation(s)
- Brigitte T A van den Broek
- Blood and Marrow Transplantation Program
- Laboratory for Translational Immunology, and
- Sylvia Toth Center for Multidisciplinary Follow Up After Hematopoietic Cell Transplantation, UMC Utrecht, Utrecht, The Netherlands
| | - Kristin Page
- Pediatric Blood and Marrow Transplantation Program, Duke University Medical Center, Durham, NC
| | | | | | - Heather Allewelt
- Pediatric Blood and Marrow Transplantation Program, Duke University Medical Center, Durham, NC
| | | | | | | | - Victoria Bordon
- Blood and Marrow Transplantation Program, Universiteits Ziekenhuis Gent, Gent, Belgium
| | | | - Peter J Shaw
- Children's Hospital at Westmead, Sydney, Australia
| | | | - Amal Al-Seraihy
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Peter M van Hasselt
- Sylvia Toth Center for Multidisciplinary Follow Up After Hematopoietic Cell Transplantation, UMC Utrecht, Utrecht, The Netherlands
| | - Andrew R Gennery
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; and
| | | | | | | | | | - Jaap Jan Boelens
- Blood and Marrow Transplantation Program
- Laboratory for Translational Immunology, and
- Sylvia Toth Center for Multidisciplinary Follow Up After Hematopoietic Cell Transplantation, UMC Utrecht, Utrecht, The Netherlands
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Page K, Hare D, Driscoll A, Charles P, Johnson D, Brentnall S, Hay M, Tsianakas M, Heland M, Cosgriff M, Farouque O. Delivering Heart Failure System Change Through Quality-Improvement Initiatives. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.107] [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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48
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Page K, Farouque O, Driscoll A, Johnson D, Charles P, Brentnall S, Hay M, Tsianakas M, Heland M, Cosgriff M, Hare D. Feasibility of Undertaking Standardised Patient-Reported Outcome Measures in Those with Heart Failure. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.128] [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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49
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Havers S, Russo P, Page K, Wilson A, Hall L. Aseptic technique and the implementation of national policy: Contextual factors for consideration. Infect Dis Health 2017. [DOI: 10.1016/j.idh.2017.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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50
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Bitan M, Ahn KW, Millard HR, Pulsipher MA, Abdel-Azim H, Auletta JJ, Brown V, Chan KW, Diaz MA, Dietz A, Vincent MG, Guilcher G, Hale GA, Hayashi RJ, Keating A, Mehta P, Myers K, Page K, Prestidge T, Shah NN, Smith AR, Woolfrey A, Thiel E, Davies SM, Eapen M. Personalized Prognostic Risk Score for Long-Term Survival for Children with Acute Leukemia after Allogeneic Transplantation. Biol Blood Marrow Transplant 2017; 23:1523-1530. [PMID: 28527984 DOI: 10.1016/j.bbmt.2017.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 04/18/2017] [Accepted: 05/10/2017] [Indexed: 10/19/2022]
Abstract
We studied leukemia-free (LFS) and overall survival (OS) in children with acute myeloid (AML, n = 790) and acute lymphoblastic leukemia (ALL, n = 1096) who underwent transplantation between 2000 and 2010 and who survived for at least 1 year in remission after related or unrelated donor transplantation. Analysis of patient-, disease-, and transplantation characteristics and acute and chronic graft-versus-host disease (GVHD) was performed to identify factors with adverse effects on LFS and OS. These data were used to develop risk scores for survival. We did not identify any prognostic factors beyond 4 years after transplantation for AML and beyond 3 years for ALL. Risk score for survival for AML includes age, disease status at transplantation, cytogenetic risk group, and chronic GVHD. For ALL, the risk score includes age at transplantation and chronic GVHD. The 10-year probabilities of OS for AML with good (score 0, 1, or 2), intermediate (score 3), and poor risk (score 4, 5, 6, or 7) were 94%, 87%, and 68%, respectively. The 10-year probabilities of OS for ALL were 89% and 80% for good (score 0 or 1) and poor risk (score 2), respectively. Identifying children at risk for late mortality with early intervention may mitigate some excess late mortality.
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Affiliation(s)
- Menachem Bitan
- Department of Pediatric Hematology/Oncology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Kwang Woo Ahn
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Heather R Millard
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Michael A Pulsipher
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | - Hisham Abdel-Azim
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | - Jeffery J Auletta
- Host Defense Program, Divisions of Hematology/Oncology/Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio
| | - Valerie Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, Pennsylvania
| | - Ka Wah Chan
- Department of Pediatrics, Texas Transplant Institute, San Antonio, Texas
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Andrew Dietz
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California
| | | | - Gregory Guilcher
- Section of Paediatric Oncology and Blood and Marrow Transplant, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Gregory A Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
| | - Robert J Hayashi
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Amy Keating
- University of Colorado-Children's Hospital, Aurora, Colorado
| | - Parinda Mehta
- Division of Bone Marrow Transplant and Immune Deficiency, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kasiani Myers
- Division of Bone Marrow Transplant and Immune Deficiency, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kristin Page
- Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, North Carolina
| | - Tim Prestidge
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, New Zealand
| | - Nirali N Shah
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Angela R Smith
- University of Minnesota Blood and Marrow Transplant Program, Minneapolis, Minnesota
| | - Ann Woolfrey
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Elizabeth Thiel
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Stella M Davies
- Division of Bone Marrow Transplant and Immune Deficiency, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Mary Eapen
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
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