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Peschke JC, Bergmann R, Mehnert M, Gonzalez Soto KE, Loureiro LR, Mitwasi N, Kegler A, Altmann H, Wobus M, Máthé D, Szigeti K, Feldmann A, Bornhäuser M, Bachmann M, Fasslrinner F, Arndt C. FLT3-directed UniCAR T-cell therapy of acute myeloid leukaemia. Br J Haematol 2023; 202:1137-1150. [PMID: 37460273 DOI: 10.1111/bjh.18971] [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: 03/09/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 09/12/2023]
Abstract
Adaptor chimeric antigen receptor (CAR) T-cell therapy offers solutions for improved safety and antigen escape, which represent main obstacles for the clinical translation of CAR T-cell therapy in myeloid malignancies. The adaptor CAR T-cell platform 'UniCAR' is currently under early clinical investigation. Recently, the first proof of concept of a well-tolerated, rapidly switchable, CD123-directed UniCAR T-cell product treating patients with acute myeloid leukaemia (AML) was reported. Relapsed and refractory AML is prone to high plasticity under therapy pressure targeting one single tumour antigen. Thus, targeting of multiple tumour antigens seems to be required to achieve durable anti-tumour responses, underlining the need to further design alternative AML-specific target modules (TM) for the UniCAR platform. We here present the preclinical development of a novel FMS-like tyrosine kinase 3 (FLT3)-directed UniCAR T-cell therapy, which is highly effective for in vitro killing of both AML cell lines and primary AML samples. Furthermore, we show in vivo functionality in a murine xenograft model. PET analyses further demonstrate a short serum half-life of FLT3 TMs, which will enable a rapid on/off switch of UniCAR T cells. Overall, the presented preclinical data encourage the further development and clinical translation of FLT3-specific UniCAR T cells for the therapy of AML.
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Affiliation(s)
- J C Peschke
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- Mildred Scheel Early Career Center, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
- National Center for Tumor Diseases Dresden (NCT/UCC): German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Partner Site, Dresden, Germany
| | - R Bergmann
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - M Mehnert
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- Mildred Scheel Early Career Center, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - K E Gonzalez Soto
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - L R Loureiro
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - N Mitwasi
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - A Kegler
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - H Altmann
- National Center for Tumor Diseases Dresden (NCT/UCC): German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Partner Site, Dresden, Germany
- Medical Clinic and Polyclinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Wobus
- Medical Clinic and Polyclinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - D Máthé
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
- Hungarian Centre of Excellence for Molecular Medicine, In Vivo Imaging Advanced Core Facility, Szeged, Hungary
| | - K Szigeti
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - A Feldmann
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- National Center for Tumor Diseases Dresden (NCT/UCC): German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Partner Site, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Bornhäuser
- National Center for Tumor Diseases Dresden (NCT/UCC): German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Partner Site, Dresden, Germany
- Medical Clinic and Polyclinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- School of Cancer and Pharmaceutical Science, King's College, London, UK
| | - M Bachmann
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- National Center for Tumor Diseases Dresden (NCT/UCC): German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Partner Site, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - F Fasslrinner
- Mildred Scheel Early Career Center, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
- Medical Clinic and Polyclinic I, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - C Arndt
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
- Mildred Scheel Early Career Center, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
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Büttelmann M, Hofheinz RD, Kröcher A, Ubbelohde U, Stintzing S, Reinacher-Schick A, Bornhäuser M, Folprecht G. Geriatric assessment and the variance of treatment recommendations in geriatric patients with gastrointestinal cancer-a study in AIO oncologists. ESMO Open 2023; 8:100761. [PMID: 36638708 PMCID: PMC10024156 DOI: 10.1016/j.esmoop.2022.100761] [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: 06/17/2022] [Revised: 11/27/2022] [Accepted: 11/30/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Geriatric assessment (GA) is recommended to detect vulnerabilities for elderly cancer patients. To assess whether results of GA actually influence the treatment recommendations, we conducted a case vignette-based study in medical oncologists. MATERIALS AND METHODS Seventy oncologists gave their medical treatment recommendations for a maximum of 4 out of 10 gastrointestinal cancer patients in three steps: (i) based on tumor findings alone to simulate the guideline recommendation for a '50-year-old standard patient without comorbidities'; (ii) for the same situation in elderly patients (median age 77.5 years) according to the comorbidities, laboratory values and a short video simulating the clinical consultation; and (iii) after the results of a full GA including interpretation aid [Barthel Index, Cumulative Illness Rating Scale (CIRS), Geriatric 8 (G8), Geriatric Depression Scale (GDS), Mini Mental Status Examination (MMSE), Mini-Nutritional Assessment (MNA), Timed Get Up and Go (TGUG), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-C30), stair climb test]. RESULTS Data on 164 treatment recommendations were analyzed. The recommendations had a significantly higher variance for elderly patients than for 'standard' patients (944 versus 602, P < 0.0001) indicating a lower agreement between oncologists. Knowledge on GA had marginal influence on the treatment recommendation or its variance (944 versus 940, P = 0.92). There was no statistically significant influence of the working place or the years of experience in oncology on the variance of recommendations. The geriatric tools were rated approximately two times higher as being 'meaningful' (53%) and 'useful for the presented cases' (49%) than they were 'used in clinical practice' (19%). The most commonly used geriatric tool in patient care was the MNA (30%). CONCLUSIONS The higher variance of treatment recommendations indicates that it is less likely for elderly patients to get the optimal recommendation. Although the proposed therapeutic regimen varied higher in elderly patients and the oncologists rated the GA results as 'useful', the GA results did not influence the individual recommendations or its variance. Continuing education on GA and research on implementation into clinical practice are needed.
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Affiliation(s)
- M Büttelmann
- TU Dresden / University Hospital Carl Gustav Carus, National Center for Tumor Diseases (NCT/UCC), Medical Dept. I, Dresden, Germany
| | | | - A Kröcher
- TU Dresden / University Hospital Carl Gustav Carus, National Center for Tumor Diseases (NCT/UCC), Medical Dept. I, Dresden, Germany
| | - U Ubbelohde
- TU Dresden / University Hospital Carl Gustav Carus, National Center for Tumor Diseases (NCT/UCC), Medical Dept. I, Dresden, Germany
| | - S Stintzing
- Charité - Universitaetsmedizin Berlin, Department of Hematology, Oncology, and Cancer Immunology (CCM), Berlin, Germany
| | - A Reinacher-Schick
- Ruhr University Bochum, St. Josef Hospital, Department of Hematology, Oncology and Palliative Care, Bochum, Germany
| | - M Bornhäuser
- TU Dresden / University Hospital Carl Gustav Carus, National Center for Tumor Diseases (NCT/UCC), Medical Dept. I, Dresden, Germany
| | - G Folprecht
- TU Dresden / University Hospital Carl Gustav Carus, National Center for Tumor Diseases (NCT/UCC), Medical Dept. I, Dresden, Germany.
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Bär T, Bornhäuser M, Kroschinsky F, Sockel K, Balaian E, Corinna J, Platzbecker U, Michael K. Topic: AS06-Prognosis/AS06a-Prognostic factors of outcome and risk assessment. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106681.43] [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]
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Wobus M, Magno V, Mies A, Winter S, Bains A, Wu LB, Cross M, Friedrichs J, Werner C, Bornhäuser M, Platzbecker U. Topic: AS04-MDS Biology and Pathogenesis/AS04i-Microenvironment and stem cell niche. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106681.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hentschel L, Richter S, Kopp HG, Kasper B, Kunitz A, Grünwald V, Kessler T, Chemnitz JM, Pelzer U, Schuler U, Freitag J, Schilling A, Hornemann B, Arndt K, Ehninger G, Bornhäuser M, Schuler M. Quality of life in patients with soft tissue sarcoma undergoing palliative treatment: A multicenter, cluster-randomized trial within the Germany Interdisciplinary Sarcoma Group (GISG-12). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Röllig C, Kramer M, Gabrecht M, Hänel M, Herbst R, Kaiser U, Schmitz N, Kullmer J, Fetscher S, Link H, Mantovani-Löffler L, Krümpelmann U, Neuhaus T, Heits F, Einsele H, Ritter B, Bornhäuser M, Schetelig J, Thiede C, Mohr B, Schaich M, Platzbecker U, Schäfer-Eckart K, Krämer A, Berdel W, Serve H, Ehninger G, Schuler U. Intermediate-dose cytarabine plus mitoxantrone versus standard-dose cytarabine plus daunorubicin for acute myeloid leukemia in elderly patients. Ann Oncol 2018; 29:973-978. [DOI: 10.1093/annonc/mdy030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Heidrich K, Thiede C, Schäfer-Eckart K, Schmitz N, Aulitzky WE, Krämer A, Rösler W, Hänel M, Einsele H, Baldus CD, Trappe RU, Stölzel F, Middeke JM, Röllig C, Taube F, Kramer M, Serve H, Berdel WE, Ehninger G, Bornhäuser M, Schetelig J. Allogeneic hematopoietic cell transplantation in intermediate risk acute myeloid leukemia negative for FLT3-ITD, NPM1- or biallelic CEBPA mutations. Ann Oncol 2018; 28:2793-2798. [PMID: 28945881 DOI: 10.1093/annonc/mdx500] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The value of allogeneic hematopoietic cell transplantation (alloHCT) as postremission treatment is not well defined for patients with intermediate-risk acute myeloid leukemia (AML) without FLT3-ITD, biallelic CEBPA-, or NPM1 mutations (here referred to as NPM1mut-neg/CEBPAdm-neg/FLT3-ITDneg AML) in first complete remission (CR1). Patients and methods We addressed this question using data from two prospective randomized controlled trials on intensive induction- and risk-stratified postremission therapy. The NPM1mut-neg/CEBPAdm-neg/FLT3-ITDneg AML subgroup comprised 497 patients, aged 18-60 years. Results In donor versus no-donor analyses, patients with a matched related donor had a longer relapse-free survival (HR 0.5; 95% CI 0.3-0.9, P = 0.02) and a trend toward better overall survival (HR 0.6, 95% CI 0.3-1.1, P = 0.08) compared with patients who received postremission chemotherapy. Notably, only 58% of patients in the donor group were transplanted in CR1. We therefore complemented the donor versus no-donor analysis with multivariable Cox regression analyses, where alloHCT was tested as a time-dependent covariate: overall survival (HR 0.58, 95% CI 0.37-0.9, P = 0.02) and relapse-free survival (HR 0.51, 95% CI 0.34-0.76; P = 0.001) for patients who received alloHCT compared with chemotherapy in CR1 were significantly longer. Conclusion Outside clinical trials, alloHCT should be the preferred postremission treatment of patients with intermediate risk NPM1mut-neg/CEBPAdm-neg/FLT3-ITDneg AML in CR1. Cinicaltrials.gov identifier NCT00180115, NCT00180102.
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Affiliation(s)
- K Heidrich
- Medical Clinic and Policlinic I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden.
| | - C Thiede
- Medical Clinic and Policlinic I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden
| | | | - N Schmitz
- Asklepios Hospital St. Georg, Hamburg
| | - W E Aulitzky
- Department of Hematology, Oncology and Palliative Care, Robert-Bosch-Hospital, Stuttgart
| | - A Krämer
- Department of Internal Medicine V, Medical University Clinic, Heidelberg
| | - W Rösler
- Medical Clinic 5, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
| | - M Hänel
- Department of Internal Medicine III, Klinikum Chemnitz, Chemnitz
| | - H Einsele
- Medical Clinic and Policlinic II, University Hospital Würzburg, Würzburg
| | - C D Baldus
- Division of Hematology, Oncology and Tumor Immunology, Medical Department, Charité-Universitätsmedizin Berlin, Berlin
| | - R U Trappe
- Medical Clinic II, DIAKO Ev. Diakonie-Krankenhaus gGmbH, Bremen
| | - F Stölzel
- Medical Clinic and Policlinic I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden
| | - J M Middeke
- Medical Clinic and Policlinic I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden
| | - C Röllig
- Medical Clinic and Policlinic I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden
| | - F Taube
- Medical Clinic and Policlinic I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden
| | - M Kramer
- Medical Clinic and Policlinic I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden
| | - H Serve
- Medical Clinic II, University Hospital Frankfurt, Frankfurt
| | - W E Berdel
- Medical Clinic A, University Hospital Münster, Münster
| | - G Ehninger
- Medical Clinic and Policlinic I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden
| | - M Bornhäuser
- Medical Clinic and Policlinic I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden; National Center for Tumor Diseases, Dresden, Germany
| | - J Schetelig
- Medical Clinic and Policlinic I, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden
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Stasik S, Schuster C, Ortlepp C, Platzbecker U, Bornhäuser M, Schetelig J, Ehninger G, Folprecht G, Thiede C. An optimized targeted Next-Generation Sequencing approach for sensitive detection of single nucleotide variants. Biomol Detect Quantif 2018; 15:6-12. [PMID: 29349042 PMCID: PMC5766748 DOI: 10.1016/j.bdq.2017.12.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/27/2017] [Accepted: 12/18/2017] [Indexed: 01/06/2023]
Abstract
NGS based detection of low-level SNVs is feasible with sensitivities up to 10−4. PCR-induced bias could be significantly reduced by the choice of adequate enzymes. The prevalent transition vs. transversion bias affects site-specific detection limits. Results from clinical data validated the feasibility of NGS-based MRD detection. Results help to select suitable biomarkers for MRD quantification.
Monitoring of minimal residual disease (MRD) has become an important clinical aspect for early relapse detection during follow-up care after cancer treatment. Still, the sensitive detection of single base pair point mutations via Next-Generation Sequencing (NGS) is hampered mainly due to high substitution error rates. We evaluated the use of NGS for the detection of low-level variants on an Ion Torrent PGM system. As a model case we used the c.1849G > T (p.Val617Phe) mutation of the JAK2-gene. Several reaction parameters (e.g. choice of DNA-polymerase) were evaluated and a comprehensive analysis of substitution errors was performed. Using optimized conditions, we reliably detected JAK2 c.1849G > T VAFs in the range of 0.01–0.0015% which, in combination with results obtained from clinical data, validated the feasibility of NGS-based MRD detection. Particularly, PCR-induced transitions (mainly G > A and C > T) were the major source of error, which could be significantly reduced by the application of proofreading enzymes. The integration of NGS results for several common point mutations in various oncogenes (i.e. IDH1 and 2, c-KIT, DNMT3A, NRAS, KRAS, BRAF) revealed that the prevalent transition vs. transversion bias (3.57:1) has an impact on site-specific detection limits of low-level mutations. These results may help to select suitable markers for MRD detection and to identify individual cut-offs for detection and quantification.
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Affiliation(s)
- S. Stasik
- Universitätsklinikum Carl Gustav Carus, Medizinische Klinik und Poliklinik I, Dresden, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Partner Site Dresden, Germany
| | | | | | - U. Platzbecker
- Universitätsklinikum Carl Gustav Carus, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - M. Bornhäuser
- Universitätsklinikum Carl Gustav Carus, Medizinische Klinik und Poliklinik I, Dresden, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Partner Site Dresden, Germany
| | - J. Schetelig
- Universitätsklinikum Carl Gustav Carus, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - G. Ehninger
- Universitätsklinikum Carl Gustav Carus, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - G. Folprecht
- Universitätsklinikum Carl Gustav Carus, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - C. Thiede
- Universitätsklinikum Carl Gustav Carus, Medizinische Klinik und Poliklinik I, Dresden, Germany
- Corresponding author: Universitätsklinikum Carl Gustav Carus, Medizinische Klinik und Poliklinik I, Fetscherstraße 74, 01307 Dresden, Germany.
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Herold S, Sockel K, Sayehli C, Herbst R, Dührsen U, Oelschlägel U, Böttner A, Hindahl H, Kullmer J, Helas S, Sauer M, Mohr B, Mies A, Bornhäuser M, Ehninger G, Röllig C, Thiede C, Platzbecker U. Evolution of NPM1-negative therapy-related myelodysplastic syndromes following curative treatment of NPM1-mutant AML. Leukemia 2017; 31:2247-2251. [PMID: 28690314 DOI: 10.1038/leu.2017.217] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S Herold
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - K Sockel
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - C Sayehli
- Klinik für Hämatologie und Onkologie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - R Herbst
- Klinikum Chemnitz gGmbH, Klinik für Hämatologie/Onkologie, Chemnitz, Germany
| | - U Dührsen
- Universitätsklinikum Essen, Klinik für Hämatologie Essen, Essen, Germany
| | - U Oelschlägel
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - A Böttner
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - H Hindahl
- Klinik für Hämatologie und Onkologie, St Johannes Hospital, Dortmund, Germany
| | - J Kullmer
- DIAKO Bremen, Klinik für Hämatologie/Onkologie, Bremen, Germany
| | - S Helas
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - M Sauer
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - B Mohr
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - A Mies
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - M Bornhäuser
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - G Ehninger
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - C Röllig
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany
| | - C Thiede
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany.,German Cancer Consortium (DKTK), Dresden
| | - U Platzbecker
- Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany.,German Cancer Consortium (DKTK), Dresden
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Fuchs (Theil) A, Wilhelm C, Kuhn M, Petzold A, Tuve S, Oelschlägel U, Dahl A, Bornhäuser M, Bonifacio E, Eugster A. Regulatory T cell kinetics following adoptive transfer of expanded allogeneic regulatory T cells into patients with chronic graft-versus host disease. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Oelschlaegel U, Mohr B, Sockel K, Ehninger G, Bornhäuser M, Platzbecker U. Implementation of Diagnostic Flow Cytometry Allows for the Dissection of Age Related Loss of Y Chromosome from Myelodysplastic Syndrome (MDS). Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30272-2] [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: 10/19/2022]
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Wermke M, Eckoldt J, Götze K, Klein S, de Wreede L, Bug G, Stölzel F, von Bonin M, Schetelig J, Laniado M, Plodeck V, Hofmann W, Ehninger G, Bornhäuser M, Dominik W, Theurl I, Platzbecker U. Labile Plasma Iron Predicts for Survival in Patients Undergoing Allogeneic Stemcell-Transplantation – Results from the Prospective Multicenter German-Austrian Allive Trial. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30124-8] [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: 11/29/2022]
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13
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Herold S, Kuhn M, Bonin MV, Stange T, Platzbecker U, Radke J, Lange T, Sockel K, Gutsche K, Schetelig J, Röllig C, Schuster C, Roeder I, Dahl A, Mohr B, Serve H, Brandts C, Ehninger G, Bornhäuser M, Thiede C. Donor cell leukemia: evidence for multiple preleukemic clones and parallel long term clonal evolution in donor and recipient. Leukemia 2017; 31:1637-1640. [PMID: 28348390 DOI: 10.1038/leu.2017.104] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- S Herold
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
| | - M Kuhn
- Institut für Medizinische Informatik und Biometrie, TU Dresden, Dresden, Germany
| | - M V Bonin
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.,Deutsches Konsortium für Translationale Krebsforschung (DKTK), Dresden, Germany.,Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - T Stange
- Institut für Medizinische Informatik und Biometrie, TU Dresden, Dresden, Germany
| | - U Platzbecker
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
| | - J Radke
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
| | - T Lange
- Abteilung Hämatologie, Universitätsklinikum Leipzig AöR, Leipzig, Germany
| | - K Sockel
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
| | - K Gutsche
- Klinik für Hämatologie und Onkologie, Städtisches Klinikum Görlitz, Görlitz, Germany
| | - J Schetelig
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
| | - C Röllig
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
| | - C Schuster
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
| | - I Roeder
- Institut für Medizinische Informatik und Biometrie, TU Dresden, Dresden, Germany
| | - A Dahl
- Deep Sequencing Core Facility, Center for Regenerative Medicine, TU Dresden, Dresden, Germany
| | - B Mohr
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
| | - H Serve
- Medizinische Klinik II, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main, Germany
| | - C Brandts
- Medizinische Klinik II, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
| | - M Bornhäuser
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
| | - C Thiede
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany
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14
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Schetelig J, de Wreede LC, van Gelder M, Andersen NS, Moreno C, Vitek A, Karas M, Michallet M, Machaczka M, Gramatzki M, Beelen D, Finke J, Delgado J, Volin L, Passweg J, Dreger P, Henseler A, van Biezen A, Bornhäuser M, Schönland SO, Kröger N. Risk factors for treatment failure after allogeneic transplantation of patients with CLL: a report from the European Society for Blood and Marrow Transplantation. Bone Marrow Transplant 2017; 52:552-560. [PMID: 28112746 DOI: 10.1038/bmt.2016.329] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 08/23/2016] [Accepted: 08/31/2016] [Indexed: 11/09/2022]
Abstract
For young patients with high-risk CLL, BTK-/PI3K-inhibitors or allogeneic stem cell transplantation (alloHCT) are considered. Patients with a low risk of non-relapse mortality (NRM) but a high risk of failure of targeted therapy may benefit most from alloHCT. We performed Cox regression analyses to identify risk factors for 2-year NRM and 5-year event-free survival (using EFS as a surrogate for long-term disease control) in a large, updated EBMT registry cohort (n= 694). For the whole cohort, 2-year NRM was 28% and 5-year EFS 37%. Higher age, lower performance status, unrelated donor type and unfavorable sex-mismatch had a significant adverse impact on 2-year NRM. Two-year NRM was calculated for good- and poor-risk reference patients. Predicted 2-year-NRM was 11 and 12% for male and female good-risk patients compared with 42 and 33% for male and female poor-risk patients. For 5-year EFS, age, performance status, prior autologous HCT, remission status and sex-mismatch had a significant impact, whereas del(17p) did not. The model-based prediction of 5-year EFS was 55% and 64%, respectively, for male and female good-risk patients. Good-risk transplant candidates with high-risk CLL and limited prognosis either on or after failure of targeted therapy should still be considered for alloHCT.
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Affiliation(s)
- J Schetelig
- Medical Department I, University Hospital, Technische Universität Dresden, Dresden, Germany.,Clinical Trials Unit, DKMS, gemeinnützige GmbH, Tübingen, Germany
| | - L C de Wreede
- Clinical Trials Unit, DKMS, gemeinnützige GmbH, Tübingen, Germany.,Department Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - M van Gelder
- Department of Internal Medicine, Division of Hematology, University Medical Center Maastricht, The Netherlands
| | - N S Andersen
- BMT Unit, Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - C Moreno
- Hematologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - A Vitek
- Department of Hematology, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - M Karas
- Department of Hematology/Oncology, Charles University Hospital, Pilsen, Czech Republic
| | - M Michallet
- Hématologie, Center Hospitalier Lyon-Sud, Lyon, France
| | - M Machaczka
- Department of Medicine at Huddinge, Hematology Center Karolinska and Karolinska Institutet, Stockholm, Sweden
| | - M Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - D Beelen
- Department of Bone Marrow Transplantation, University Hospital, Essen, Germany
| | - J Finke
- Department of Medicine-Hematology, University of Freiburg, Oncology, Freiburg, Germany
| | - J Delgado
- Department of Hematology, Hospital Clinic, Institute of Hematology & Oncology, Barcelona, Spain
| | - L Volin
- Stem Cell Transplantation Unit, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
| | - J Passweg
- Department for Hematology, University Hospital, Basel, Switzerland
| | - P Dreger
- Medizinische Klinik und Poliklinik V, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - A Henseler
- Department Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - A van Biezen
- Department Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - M Bornhäuser
- Medical Department I, University Hospital, Technische Universität Dresden, Dresden, Germany
| | - S O Schönland
- Medizinische Klinik und Poliklinik V, Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
| | - N Kröger
- Bone Marrow Transplantation Center, University Hospital Eppendorf, Hamburg, Germany
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15
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Theil A, Wilhelm C, Kuhn M, Petzold A, Tuve S, Oelschlägel U, Dahl A, Bornhäuser M, Bonifacio E, Eugster A. T cell receptor repertoires after adoptive transfer of expanded allogeneic regulatory T cells. Clin Exp Immunol 2016; 187:316-324. [PMID: 27774628 DOI: 10.1111/cei.12887] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/16/2022] Open
Abstract
Regulatory T cell (Treg ) therapy has been exploited in autoimmune disease, solid organ transplantation and in efforts to prevent or treat graft-versus-host disease (GVHD). However, our knowledge on the in-vivo persistence of transfused Treg is limited. Whether Treg transfusion leads to notable changes in the overall Treg repertoire or whether longevity of Treg in the periphery is restricted to certain clones is unknown. Here we use T cell receptor alpha chain sequencing (TCR-α-NGS) to monitor changes in the repertoire of Treg upon polyclonal expansion and after subsequent adoptive transfer. We applied TCR-α-NGS to samples from two patients with chronic GVHD who received comparable doses of stem cell donor derived expanded Treg . We found that in-vitro polyclonal expansion led to notable repertoire changes in vitro and that Treg cell therapy altered the peripheral Treg repertoire considerably towards that of the infused cell product, to different degrees, in each patient. Clonal changes in the peripheral blood were transient and correlated well with the clinical parameters. We suggest that T cell clonotype analyses using TCR sequencing should be considered as a means to monitor longevity and fate of adoptively transferred T cells.
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Affiliation(s)
- A Theil
- DFG-Center for Regenerative Therapies Dresden, Dresden, Germany.,Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - C Wilhelm
- DFG-Center for Regenerative Therapies Dresden, Dresden, Germany
| | - M Kuhn
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - A Petzold
- Deep Sequencing Group, Biotechnology Center, Technische Universität Dresden, Dresden, Germany
| | - S Tuve
- Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - U Oelschlägel
- Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - A Dahl
- Deep Sequencing Group, Biotechnology Center, Technische Universität Dresden, Dresden, Germany
| | - M Bornhäuser
- Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - E Bonifacio
- DFG-Center for Regenerative Therapies Dresden, Dresden, Germany
| | - A Eugster
- DFG-Center for Regenerative Therapies Dresden, Dresden, Germany
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16
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Link CS, Mies F, Scheele J, Kramer M, Schetelig J, Ordemann R, Hänel M, Bornhäuser M, Ehninger G, Kroschinsky F. Long-term follow-up of patients with relapsed or refractory non-Hodgkin's lymphoma receiving allogeneic stem cell transplantation. Bone Marrow Transplant 2016; 51:1527-1529. [PMID: 27295271 DOI: 10.1038/bmt.2016.165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- C S Link
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - F Mies
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.,Klinik für Innere Medizin III, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - J Scheele
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - M Kramer
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - J Schetelig
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - R Ordemann
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - M Hänel
- Klinik für Innere Medizin III, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - M Bornhäuser
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - F Kroschinsky
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
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17
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Stächele J, Töpfner N, Herold C, Berner R, Bornhäuser M, Guck J, Suttorp M. Mechanical phenotyping of leukemic blast cells using real-time deformability cytometry. Klin Padiatr 2016. [DOI: 10.1055/s-0036-1582479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Link CS, Eugster A, Heidenreich F, Rücker-Braun E, Schmiedgen M, Oelschlägel U, Kühn D, Dietz S, Fuchs Y, Dahl A, Domingues AMJ, Klesse C, Schmitz M, Ehninger G, Bornhäuser M, Schetelig J, Bonifacio E. Abundant cytomegalovirus (CMV) reactive clonotypes in the CD8(+) T cell receptor alpha repertoire following allogeneic transplantation. Clin Exp Immunol 2016; 184:389-402. [PMID: 26800118 DOI: 10.1111/cei.12770] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 09/20/2015] [Indexed: 12/15/2022] Open
Abstract
Allogeneic stem cell transplantation is potentially curative, but associated with post-transplantation complications, including cytomegalovirus (CMV) infections. An effective immune response requires T cells recognizing CMV epitopes via their T cell receptors (TCRs). Little is known about the TCR repertoire, in particular the TCR-α repertoire and its clinical relevance in patients following stem cell transplantation. Using next-generation sequencing we examined the TCR-α repertoire of CD8(+) T cells and CMV-specific CD8(+) T cells in four patients. Additionally, we performed single-cell TCR-αβ sequencing of CMV-specific CD8(+) T cells. The TCR-α composition of human leucocyte antigen (HLA)-A*0201 CMVpp65- and CMVIE -specific T cells was oligoclonal and defined by few dominant clonotypes. Frequencies of single clonotypes reached up to 11% of all CD8(+) T cells and half of the total CD8(+) T cell repertoire was dominated by few CMV-reactive clonotypes. Some TCR-α clonotypes were shared between patients. Gene expression of the circulating CMV-specific CD8(+) T cells was consistent with chronically activated effector memory T cells. The CD8(+) T cell response to CMV reactivation resulted in an expansion of a few TCR-α clonotypes to dominate the CD8(+) repertoires. These results warrant further larger studies to define the ability of oligoclonally expanded T cell clones to achieve an effective anti-viral T cell response in this setting.
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Affiliation(s)
- C S Link
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus.,DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - A Eugster
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - F Heidenreich
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus
| | - E Rücker-Braun
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus
| | - M Schmiedgen
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus
| | - U Oelschlägel
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus
| | - D Kühn
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - S Dietz
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - Y Fuchs
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - A Dahl
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany.,BIOTEChnology Center, TU Dresden, Dresden, Germany
| | - A M J Domingues
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - C Klesse
- DKMS Clinical Trials Unit, Dresden, Germany
| | - M Schmitz
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany.,Institut Für Immunologie, Medizinische Fakultät, TU Dresden, Dresden, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus.,DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - M Bornhäuser
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus.,DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - J Schetelig
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus.,DKMS Clinical Trials Unit, Dresden, Germany
| | - E Bonifacio
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
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19
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Schuler M, Hornemann B, Pawandenat C, Kramer M, Hentschel L, Beck H, Kasten P, Singer S, Schaich M, Ehninger G, Platzbecker U, Schetelig J, Bornhäuser M. Feasibility of an exercise programme in elderly patients undergoing allogeneic stem cell transplantation - a pilot study. Eur J Cancer Care (Engl) 2015; 25:839-48. [DOI: 10.1111/ecc.12400] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2015] [Indexed: 11/26/2022]
Affiliation(s)
- M.K. Schuler
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
- University Cancer Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - B. Hornemann
- University Cancer Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - C. Pawandenat
- University Physiotherapy Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - M. Kramer
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - L. Hentschel
- University Cancer Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - H. Beck
- Department of Sports Medicine; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - P. Kasten
- Department of Sports Medicine; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - S. Singer
- Institute of Medical Biostatistics, Epidemiology, and Informatics; Division of Epidemiology and Health Services Research; University Medical Centre of Johannes Gutenberg University; Mainz Germany
| | - M. Schaich
- Department of Hematology/Oncology; Rems-Murr-Klinikum; Waiblingen Germany
| | - G. Ehninger
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
- University Cancer Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - U. Platzbecker
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - J. Schetelig
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
- DKMS Clinical Trials Unit; Dresden Germany
| | - M. Bornhäuser
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
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20
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Aliperta R, Cartellieri M, Feldmann A, Arndt C, Koristka S, Michalk I, von Bonin M, Ehninger A, Bachmann J, Ehninger G, Bornhäuser M, Bachmann MP. Bispecific antibody releasing-mesenchymal stromal cell machinery for retargeting T cells towards acute myeloid leukemia blasts. Blood Cancer J 2015; 5:e348. [PMID: 26383821 PMCID: PMC4648523 DOI: 10.1038/bcj.2015.73] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 06/03/2015] [Accepted: 06/09/2015] [Indexed: 12/13/2022] Open
Abstract
Bispecific antibodies (bsAbs) engaging T cells are emerging as a promising immunotherapeutic tool for the treatment of hematologic malignancies. Because their low molecular mass, bsAbs have short half-lives. To achieve clinical responses, they have to be infused into patients continously, for a long period of time. As a valid alternative we examined the use of mesenchymal stromal cells (MSCs) as autonomous cellular machines for the constant production of a recently described, fully humanized anti-CD33-anti-CD3 bsAb, which is capable of redirecting human T cells against CD33-expressing leukemic cells. The immortalized human MSC line SCP-1 was genetically modified into expressing bsAb at sufficient amounts to redirect T cells efficiently against CD33 presenting target cells, both in vitro and in an immunodeficient mouse model. Moreover, T cells of patients suffering from acute myeloid leukemia (AML) in blast crisis eliminated autologous leukemic cells in the presence of the bsAb secreting MSCs over time. The immune response against AML cells could be enhanced further by providing T cells an additional co-stimulus via the CD137-CD137 ligand axis through CD137L expression on MSCs. This study demonstrates that MSCs have the potential to be used as cellular production machines for bsAb-based tumor immunotherapy in the future.
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Affiliation(s)
- R Aliperta
- Department of Tumor-/Radioimmunology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - M Cartellieri
- Department of Tumor-/Radioimmunology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,University Cancer Center (UCC), Technical University Dresden, Tumorimmunology, Dresden, Germany.,Cellex Patient Treatment GmbH, Dresden, Germany
| | - A Feldmann
- Department of Tumor-/Radioimmunology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - C Arndt
- Department of Tumor-/Radioimmunology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - S Koristka
- Department of Tumor-/Radioimmunology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - I Michalk
- University Cancer Center (UCC), Technical University Dresden, Tumorimmunology, Dresden, Germany
| | - M von Bonin
- Medical Clinic and Polyclinic I, University Hospital 'Carl Gustav Carus', Technical University Dresden, Dresden, Germany
| | - A Ehninger
- Medical Clinic and Polyclinic I, University Hospital 'Carl Gustav Carus', Technical University Dresden, Dresden, Germany.,GEMoaB Monoclonals GmbH, Blasewitzer Strasse 41, Dresden, Germany
| | - J Bachmann
- University Cancer Center (UCC), Technical University Dresden, Tumorimmunology, Dresden, Germany
| | - G Ehninger
- Medical Clinic and Polyclinic I, University Hospital 'Carl Gustav Carus', Technical University Dresden, Dresden, Germany
| | - M Bornhäuser
- Medical Clinic and Polyclinic I, University Hospital 'Carl Gustav Carus', Technical University Dresden, Dresden, Germany
| | - M P Bachmann
- Department of Tumor-/Radioimmunology, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany.,University Cancer Center (UCC), Technical University Dresden, Tumorimmunology, Dresden, Germany.,DFG-Center for Regenerative Therapies Dresden, Technical University Dresden, Dresden, Germany
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21
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Thiel A, Schetelig J, Pönisch W, Schäfer-Eckart K, Aulitzky W, Peter N, Schulze A, Maschmeyer G, Neugebauer S, Herbst R, Hänel A, Morgner A, Kroschinsky F, Bornhäuser M, Lange T, Wilhelm M, Niederwieser D, Ehninger G, Fiedler F, Hänel M. Mito-FLAG with Ara-C as bolus versus continuous infusion in recurrent or refractory AML—long-term results of a prospective randomized intergroup study of the East German Study Group Hematology/Oncology (OSHO) and the Study Alliance Leukemia (SAL). Ann Oncol 2015; 26:1434-40. [DOI: 10.1093/annonc/mdv205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 04/21/2015] [Indexed: 11/13/2022] Open
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22
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Oelschlaegel U, Alexander Röhnert M, Mohr B, Sockel K, Herold S, Ehninger G, Bornhäuser M, Thiede C, Platzbecker U. Clonal architecture of del(5q) myelodysplastic syndromes: aberrant CD5 or CD7 expression within the myeloid progenitor compartment defines a subset with high clonal burden. Leukemia 2015; 30:517-20. [PMID: 26104659 PMCID: PMC4740451 DOI: 10.1038/leu.2015.158] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- U Oelschlaegel
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - M Alexander Röhnert
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - B Mohr
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - K Sockel
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - S Herold
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - M Bornhäuser
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - C Thiede
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - U Platzbecker
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
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23
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Flaxa J, Rosner A, Hölig K, Bornhäuser M, Wassmuth R. Methodological and clinical aspects of alloimmunization after granulocyte transfusion in patients undergoing allogeneic stem cell transplantation. ACTA ACUST UNITED AC 2014; 85:93-103. [DOI: 10.1111/tan.12487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 10/18/2014] [Accepted: 11/24/2014] [Indexed: 11/28/2022]
Affiliation(s)
- J. Flaxa
- Department of Medicine, University Medical Center “Carl Gustav Carus”; Technical University Dresden; Dresden Germany
| | - A. Rosner
- Department of Medicine, University Medical Center “Carl Gustav Carus”; Technical University Dresden; Dresden Germany
| | - K. Hölig
- Department of Medicine, University Medical Center “Carl Gustav Carus”; Technical University Dresden; Dresden Germany
| | - M. Bornhäuser
- Department of Medicine, University Medical Center “Carl Gustav Carus”; Technical University Dresden; Dresden Germany
- Center for Regenerative Therapies Dresden - CRTD
| | - R. Wassmuth
- Department of Medicine, University Medical Center “Carl Gustav Carus”; Technical University Dresden; Dresden Germany
- Center for Regenerative Therapies Dresden - CRTD
- Deutsche Knochenmarkspenderdatei - DKMS
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24
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Müller C, Mytilineos J, Ottinger H, Arnold R, Bader P, Beelen D, Bornhäuser M, Dreger P, Eiermann T, Einsele H, Faé I, Fischer G, Füssel M, Holler E, Holzberger G, Horn P, Kröger N, Lindemann M, Seidl C, Spriewald B, Süsal C, Blasczyk R, Finke J. Deutscher Konsensus 2013 zur immungenetischen Spenderauswahl für die allogene Stammzelltransplantation. Transfusionsmedizin 2014. [DOI: 10.1055/s-0034-1383141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- C. Müller
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - J. Mytilineos
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - H. Ottinger
- Klinik für Knochenmarktransplantation, Universitätsklinikum Essen
| | - R. Arnold
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - P. Bader
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - D. Beelen
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - M. Bornhäuser
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - P. Dreger
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - T. Eiermann
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - H. Einsele
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | - I. Faé
- Vorstand der Dt. Gesellschaft für Immungenetik
| | - G. Fischer
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - M. Füssel
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - E. Holler
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | | | - P. Horn
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - N. Kröger
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
| | | | - C. Seidl
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | | | - C. Süsal
- Vorstand der Dt. Gesellschaft für Immungenetik
| | - R. Blasczyk
- Kommission Stammzelltransplantation der Dt. Gesellschaft für Immungenetik
| | - J. Finke
- Vorstand der Dt. Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation
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25
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Bulycheva E, Rauner M, Medyouf H, Theurl I, Bornhäuser M, Hofbauer LC, Platzbecker U. Myelodysplasia is in the niche: novel concepts and emerging therapies. Leukemia 2014; 29:259-68. [PMID: 25394715 PMCID: PMC4320287 DOI: 10.1038/leu.2014.325] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [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: 08/28/2014] [Accepted: 09/25/2014] [Indexed: 12/28/2022]
Abstract
Myelodysplastic syndromes (MDSs) represent clonal disorders mainly of the elderly that are characterized by ineffective hematopoiesis and an increased risk of transformation into acute myeloid leukemia. The pathogenesis of MDS is thought to evolve from accumulation and selection of specific genetic or epigenetic events. Emerging evidence indicates that MDS is not solely a hematopoietic disease but rather affects the entire bone marrow microenvironment, including bone metabolism. Many of these cells, in particular mesenchymal stem and progenitor cells (MSPCs) and osteoblasts, express a number of adhesion molecules and secreted factors that regulate blood regeneration throughout life by contributing to hematopoietic stem and progenitor cell (HSPC) maintenance, self-renewal and differentiation. Several endocrine factors, such as erythropoietin, parathyroid hormone and estrogens, as well as deranged iron metabolism modulate these processes. Thus, interactions between MSPC and HSPC contribute to the pathogenesis of MDS and associated pathologies. A detailed understanding of these mechanisms may help to define novel targets for diagnosis and possibly therapy. In this review, we will discuss the scientific rationale of ‘osteohematology' as an emerging research field in MDS and outline clinical implications.
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Affiliation(s)
- E Bulycheva
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl-Gustav-Carus, Technische Universität, Dresden, Germany
| | - M Rauner
- Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl-Gustav-Carus, Technische Universität, Dresden, Germany
| | - H Medyouf
- Georg-Speyer-Haus, Institut for Tumor Biology and Experimental Therapy, 60596, Frankfurt am Main, Germany
| | - I Theurl
- Department of Internal Medicine VI, Medical University of Innsbruck, Innsbruck, Austria
| | - M Bornhäuser
- 1] Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl-Gustav-Carus, Technische Universität, Dresden, Germany [2] Center for Regenerative Therapies Dresden, Technical University, Dresden, Germany
| | - L C Hofbauer
- 1] Medizinische Klinik und Poliklinik III, Universitätsklinikum Carl-Gustav-Carus, Technische Universität, Dresden, Germany [2] Center for Regenerative Therapies Dresden, Technical University, Dresden, Germany
| | - U Platzbecker
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl-Gustav-Carus, Technische Universität, Dresden, Germany
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26
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Ehninger A, Kramer M, Röllig C, Thiede C, Bornhäuser M, von Bonin M, Wermke M, Feldmann A, Bachmann M, Ehninger G, Oelschlägel U. Distribution and levels of cell surface expression of CD33 and CD123 in acute myeloid leukemia. Blood Cancer J 2014; 4:e218. [PMID: 24927407 PMCID: PMC4080210 DOI: 10.1038/bcj.2014.39] [Citation(s) in RCA: 218] [Impact Index Per Article: 21.8] [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: 04/07/2014] [Accepted: 04/25/2014] [Indexed: 11/24/2022] Open
Abstract
Owing to the more recent positive results with the anti-CD33 immunotoxin gemtuzumab ozogamicin, therapy against acute myeloid leukemias (AMLs) targeting CD33 holds many promises. Here, CD33 and CD123 expression on AML blasts was studied by flow cytometry in a cohort of 319 patients with detailed information on French–American–British/World Health Organization (FAB/WHO) classification, cytogenetics and molecular aberrations. AMLs of 87.8% express CD33 and would therefore be targetable with anti-CD33 therapies. Additionally, 9.4% of AMLs express CD123 without concomitant CD33 expression. Thus, nearly all AMLs could be either targeted via CD33 or CD123. Simultaneous presence of both antigens was observed in 69.5% of patients. Most importantly, even AMLs with adverse cytogenetics express CD33 and CD123 levels comparable to those with favorable and intermediate subtypes. Some patient groups with unfavorable alterations, such as FMS-related tyrosine kinase 3-internal tandem duplication (FLT3-ITD) mutations, high FLT3-ITD mutant/wild-type ratios and monosomy 5 are even characterized by high expression of CD33 and CD123. In addition, blasts of patients with mutant nucleophosmin (NPM1) revealed significantly higher CD33 and CD123 expression pointing toward the possibility of minimal residual disease-guided interventions in mutated NPM1-positive AMLs. These results stimulate the development of novel concepts to redirect immune effector cells toward CD33- and CD123-expressing blasts using bi-specific antibodies or engineered T cells expressing chimeric antigen receptors.
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Affiliation(s)
- A Ehninger
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - M Kramer
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - C Röllig
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - C Thiede
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - M Bornhäuser
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - M von Bonin
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - M Wermke
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - A Feldmann
- Institute of Immunology, Medical Faculty 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - M Bachmann
- Institute of Immunology, Medical Faculty 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
| | - U Oelschlägel
- Medizinische Klinik und Poliklinik I, University Hospital 'Carl Gustav Carus', Technische Universität Dresden, Dresden, Germany
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27
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Stölzel F, Kramer M, Mohr B, Wermke M, Bornhäuser M, Ehninger G, Schaich M, Platzbecker U. Impact of the revised International Prognostic Scoring System on the outcome of patients with acute myeloid leukemia with or without antecedent myelodysplastic syndrome. Leukemia 2013; 28:723-5. [PMID: 24270741 DOI: 10.1038/leu.2013.356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- F Stölzel
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - M Kramer
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - B Mohr
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - M Wermke
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - M Bornhäuser
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - M Schaich
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Rems-Murr-Klinik, Waiblingen, Germany
| | - U Platzbecker
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
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28
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Schönefeldt C, Sockel K, Wehner R, Sopper S, Wolf D, Wermke M, Thiede C, Oelschlägel U, Ehninger G, Bornhäuser M, Platzbecker U, Schmitz M. Azacytidine impairs NK cell activity in AML and MDS patients undergoing MRD-based pre-emptive treatment after allogeneic stem cell transplantation. Blood Cancer J 2013; 3:e136. [PMID: 23995045 PMCID: PMC3763388 DOI: 10.1038/bcj.2013.35] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- C Schönefeldt
- Medical Clinic I, University Hospital Carl Gustav Carus, Dresden, Germany
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29
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Oelschlaegel U, Westers T, Mohr B, Parmentier S, Sockel K, Bornhäuser M, Van de Loosdrecht A, Platzbecker U. P-057 Myelodysplastic syndromes (MDS) with a deletion 5q display a specific immunophenotypic profile. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70106-1] [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: 10/26/2022]
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30
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Röhnert M, Oelschlaegel U, Sockel K, Parmentier S, Wermke M, Von Bonin M, Klotsche C, Thiede C, Ehninger G, Bornhäuser M, Mohr B, Platzbecker U. P-059 Distribution of clonal cells in flow cytometry-defined subpopulations of patients with myelodysplastic syndromes (MDS). Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70108-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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31
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Platzbecker U, Braulke F, Kündgen A, Götze K, Bug G, Schönefeldt C, Shirneshan K, Röllig C, Bornhäuser M, Naumann R, Neesen J, Giagounidis A, Hofmann WK, Ehninger G, Germing U, Haase D, Wermke M. Sequential combination of azacitidine and lenalidomide in del(5q) higher-risk myelodysplastic syndromes or acute myeloid leukemia: a phase I study. Leukemia 2013; 27:1403-7. [PMID: 23354011 PMCID: PMC3677141 DOI: 10.1038/leu.2013.26] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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32
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Arndt C, von Bonin M, Cartellieri M, Feldmann A, Koristka S, Michalk I, Stamova S, Bornhäuser M, Schmitz M, Ehninger G, Bachmann M. Redirection of T cells with a first fully humanized bispecific CD33-CD3 antibody efficiently eliminates AML blasts without harming hematopoietic stem cells. Leukemia 2013; 27:964-7. [PMID: 23325142 DOI: 10.1038/leu.2013.18] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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33
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Martino R, de Wreede L, Fiocco M, van Biezen A, von dem Borne PA, Hamladji RM, Volin L, Bornhäuser M, Robin M, Rocha V, de Witte T, Kröger N, Mohty M. Comparison of conditioning regimens of various intensities for allogeneic hematopoietic SCT using HLA-identical sibling donors in AML and MDS with <10% BM blasts: a report from EBMT. Bone Marrow Transplant 2012. [PMID: 23208314 DOI: 10.1038/bmt.2012.236] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this multicenter retrospective study, the long-term outcomes of 878 adults with AML and refractory anemia with excess blasts (RAEB) with BM blasts <10% who underwent transplantation with an HLA-identical sibling donor between 1998 and 2004 were analyzed according to four regimens of conditioning intensity: reduced-intensity conditioning (RIC) (either intermediate RIC (IntermRIC) or non-myeloablative (NMA) RIC), and myeloablative conditioning (MC) in 718 patients (either conventional MC or hyperintense MC. In multivariate cox analysis, patients undergoing NMA transplantation had lower non-relapse mortality risk in the first 100 days after transplantation (P<0.01), but a higher risk beyond day +100 (P=0.02), as well as higher relapse incidence in the first 12 months (P<0.01), but the risk was similar in all groups beyond 12 months. The probabilities of PFS and OS up to 7 years were significantly lower only in the NMA subgroup (P0.01 for both). The 7-year OS was 53%, 29%, 56% and 51%, respectively. Our data suggest that prospective studies comparing RIC regimens (especially IntermRIC) with MC are appropriate in patients with AML and RAEB who are in a non-advanced disease status.
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Affiliation(s)
- R Martino
- Hematology Department, Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain.
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Ordemann R, Stöhlmacher J, Beuthien-Baumann B, Platzek I, van den Hoff J, Kroschinsky F, Middeke JM, Platzbecker U, Zietz C, Bornhäuser M, Ehninger G. Use of targeted therapy for refractory ALK-positive anaplastic large cell lymphoma as a bridging strategy prior to allogeneic transplantation. Ann Hematol 2012; 92:125-7. [DOI: 10.1007/s00277-012-1524-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 07/06/2012] [Indexed: 11/29/2022]
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35
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Platzbecker U, Wermke M, Radke J, Oelschlaegel U, Seltmann F, Kiani A, Klut IM, Knoth H, Röllig C, Schetelig J, Mohr B, Graehlert X, Ehninger G, Bornhäuser M, Thiede C. Azacitidine for treatment of imminent relapse in MDS or AML patients after allogeneic HSCT: results of the RELAZA trial. Leukemia 2011; 26:381-9. [PMID: 21886171 PMCID: PMC3306138 DOI: 10.1038/leu.2011.234] [Citation(s) in RCA: 294] [Impact Index Per Article: 22.6] [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] [Indexed: 01/26/2023]
Abstract
This study evaluated azacitidine as treatment of minimal residual disease (MRD) determined by a sensitive donor chimerism analysis of CD34+ blood cells to pre-empt relapse in patients with CD34+ myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (HSCT). At a median of 169 days after HSCT, 20/59 prospectively screened patients experienced a decrease of CD34+ donor chimerism to <80% and received four azacitidine cycles (75 mg/m2/day for 7 days) while in complete hematologic remission. A total of 16 patients (80%) responded with either increasing CD34+ donor chimerism to ⩾80% (n=10; 50%) or stabilization (n=6; 30%) in the absence of relapse. Stabilized patients and those with a later drop of CD34+ donor chimerism to <80% after initial response were eligible for subsequent azacitidine cycles. A total of 11 patients (55%) received a median of 4 (range, 1–11) additional cycles. Eventually, hematologic relapse occurred in 13 patients (65%), but was delayed until a median of 231 days (range, 56–558) after initial decrease of CD34+ donor chimerism to <80%. In conclusion, pre-emptive azacitidine treatment has an acceptable safety profile and can substantially prevent or delay hematologic relapse in patients with MDS or AML and MRD after allogeneic HSCT.
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Affiliation(s)
- U Platzbecker
- Medical Clinic and Polyclinic I, University Hospital Carl Gustav Carus Technical University of Dresden, Dresden, Germany.
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36
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Oelschlaegel U, Mohr B, Schaich M, Kroschinsky F, Parmentier S, Bornhäuser M, Ehninger G, Thiede C. Reply to: ‘Flow cytometric identification of acute myeloid leukemia with limited differentiation and NPM1 type A mutation: a new biologically defined entity’ by Kern et al. Leukemia 2011; 25:895-7. [DOI: 10.1038/leu.2011.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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37
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Tuve S, Gayoso J, Scheid C, Radke J, Kiani A, Serrano D, Platzbecker U, Rodríguez-Macías G, Wermke M, Holtick U, Balsalobre P, Middeke JM, Shayegi N, Chemnitz JM, Krause A, Gruner N, Füssel M, Schetelig J, Thiede C, Ehninger G, Hallek M, Díez-Martín JL, Bornhäuser M. Haploidentical bone marrow transplantation with post-grafting cyclophosphamide: multicenter experience with an alternative salvage strategy. Leukemia 2011; 25:880-3. [DOI: 10.1038/leu.2011.11] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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38
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Shayegi N, Schweiger B, Duwe S, Pöhlmann C, Bornhäuser M, Ehninger G, Schetelig J. Antiviral treatment of influenza A (H1N1-09) guided by molecular resistance testing in aplasia after allo-SCT. Bone Marrow Transplant 2011; 46:1492-4. [PMID: 21243024 DOI: 10.1038/bmt.2010.331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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39
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Maiwald S, Wehner R, Schmitz M, Bornhäuser M, Loeb S, Wassmuth R. IDO1 and IDO2 gene expression analysis by quantitative polymerase chain reaction. ACTA ACUST UNITED AC 2010; 77:136-42. [PMID: 21092022 DOI: 10.1111/j.1399-0039.2010.01585.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Immunomodulatory properties of IDO1 relate to tryptophan catabolism. The degradation of tryptophan by IDO1 leads to suppression of T cell responses. Recently, another enzyme with IDO-like activity, indoleamine 2,3-dioxygenase-like-protein 1 (INDOL1, IDO2), has been described in both mice and humans. In order to study the gene expression of IDO1 and IDO2, we have developed a quantitative PCR (qPCR) assay. In an exploratory application to the study of the differential expression of IDO1 and IDO2 by professional antigen-presenting cells and MSCs (mesenchymal stromal cells) under the influence of interferon-γ (IFN-γ) and T-lymphocyte conditioned media (TCM), substantial differences were observed. IDO expression measured by qPCR was valid and reliable in the cell types investigated. Further studies are needed to delineate factors driving IDO expression in MSCs.
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Affiliation(s)
- S Maiwald
- Department of Medicine, University Medical Center Carl Gustav Carus, Technical University Dresden, Dresden, Germany
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40
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Wehner R, Schumacher P, Bornhäuser M, Ehninger G, Schäkel K, Bachmann M, Schmitz M. Acute myeloid leukemia cells fail to activate native human dendritic cells: a potential mechanism of immune evasion. Leukemia 2010; 24:1965-7. [DOI: 10.1038/leu.2010.189] [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: 11/09/2022]
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41
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Höolig K, Blechschmidt M, Poppe-Thiede K, Kramer M, Zimmer K, Kroschinsky F, Bornhäuser M, Ehninger G. 26 Collection of peripheral blood stem cells in allogeneic donors via femoral venous lines - safe, successful and well-tolerated. Transfus Apher Sci 2010. [DOI: 10.1016/s1473-0502(10)70012-4] [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: 11/25/2022]
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Koenecke C, Hertenstein B, Schetelig J, van Biezen A, Dammann E, Gratwohl A, Ganser A, Schleuning M, Bornhäuser M, Jacobsen N, Kröger N, Niederwieser D, de Witte T, Ruutu T. Solid organ transplantation after allogeneic hematopoietic stem cell transplantation: a retrospective, multicenter study of the EBMT. Am J Transplant 2010; 10:1897-906. [PMID: 20659095 DOI: 10.1111/j.1600-6143.2010.03187.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
To analyze the outcome of solid organ transplantation (SOT) in patients who had undergone allogeneic hematopoietic stem cell transplantation (HSCT), a questionnaire survey was carried out within 107 European Group of Blood and Marrow Transplantation centers. This study covered HSCT between 1984 and 2007 in Europe. Forty-five SOT in 40 patients were reported. Fifteen liver, 15 renal, 13 lung, 1 heart and 1 skin transplantations were performed in 28 centers. Overall survival (OS) of patients after SOT was 78% at 5 years (95% confidence interval [CI], 64% to 92%). OS at 5 years was 100% for renal, 71% (95% CI, 46% to 96%) for liver and 63% (95% CI, 23% to 100%) for lung transplant recipients. The 2-year-incidence of SOT failure was 20% (95% CI, 4% to 36%) in patients with graft-versus-host disease (GvHD) and 7% (95% CI, 0% to 21%) in patients without GvHD before SOT. The relapse incidence for underlying malignant diseases was 4% at 5 years (95% CI, 0% to 12%). In summary, this study shows that selected patients receiving SOT after HSCT have a remarkably good overall and organ survival. These data indicate that SOT should be considered in selected patients with single organ failure after HSCT.
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Affiliation(s)
- C Koenecke
- Hannover Medical School, Department of Hematology, Hemostasis, Hannover, Germany.
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Kasten P, Bernstein P, Biewener A, Bornhäuser M, Duda G, Gaissmaier C, Nöth U, Pfüller B, Reinhardt J, Zwipp H, Günther KP. [Perspectives of clinical stem cell therapy in the treatment of musculoskeletal diseases in Germany]. Z Orthop Unfall 2010; 148:149-54. [PMID: 20135615 DOI: 10.1055/s-0029-1240754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM The treatment of large bone defects remains a challenge for the orthopaedic surgeon. Regenerative therapies with the use of mesenchymal stem cells (MSC) may provide an alternative to autogenous bone transplantation, callus distraction or the use of allografts. MATERIAL AND METHODS On the occasion of an expert workshop of the German Society for Orthopaedic and Trauma Surgery, a literature search regarding studies with the use of MSC was performed to evaluate its potential for future clinical studies. Furthermore, the legislative requirements were examined. RESULTS Various in vitro and animal studies showed the benefit of MSC in bone regeneration. However, there are sparse data from clinical studies. Due to recent legislative changes there are several regulatory demands to meet if clinical studies are performed with MSC. CONCLUSIONS For further evaluation of the role of MSC in the treatment of bone defects there is a need for clinical trials. The current paper provides some assistance for the successful application for clinical trials with MSC. Planning and performance of these studies may require early consultation with the regulatory authorities and cooperation of research centres in order to obtain authorisation for the evaluation of MSC. Preclinical data have to be obtained according to good laboratory practice with equivalent protocols that will be used in the clinical trials. In the latter the implementation of the guidelines for good clinical practice are mandatory.
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Affiliation(s)
- P Kasten
- Klinik und Poliklinik für Orthopädie, Universitätsklinikum Carl Gustav Carus Dresden, Dresden
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44
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Jing D, Alakel N, Bornhäuser M, Ehninger G, Ordemann R. SDF-1/CXCR4 blockade to mobilize hematopoietic progenitor cells from the placenta. Bone Marrow Transplant 2010; 45:1661-2. [PMID: 20173795 DOI: 10.1038/bmt.2010.22] [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: 11/09/2022]
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45
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Wermke M, Thiede C, Kiani A, Ehninger G, Bornhäuser M, Platzbecker U. Successful treatment of molecular relapse in NPM1-positive AML using 5-azacytidine. Leukemia 2009; 24:236-7. [PMID: 19776758 DOI: 10.1038/leu.2009.204] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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46
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Affiliation(s)
- M Bornhäuser
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307 Dresden.
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Schuler U, Bornhäuser M, Ehninger G. Infektionsprophylaxe mit i.v.-lmmunglobulinen in der Knochenmarktransplantation. Transfus Med Hemother 2009. [DOI: 10.1159/000223354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Hauck F, Quick S, Habermann I, Bornhäuser M, Kiani A, Suttorp M. NFATs take part in the expression of the immunmodulatory PGE2 by hMSCs. Klin Padiatr 2009. [DOI: 10.1055/s-0029-1222642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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49
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Stölzel F, Pursche S, Brückner S, Bornhäuser M, Ehninger G, Schaich M. Yersinia pseudotuberculosis causing abscesses in a 31-year-old patient in the post-immunosuppression period after allogeneic HSCT. Bone Marrow Transplant 2008; 43:515-6. [DOI: 10.1038/bmt.2008.357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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50
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Schilling G, Hansen T, Shimoni A, Zabelina T, Pérez-Simón JA, Gutierrez NC, Bethge W, Liebisch P, Schwerdtfeger R, Bornhäuser M, Otterstetter S, Penas EMM, Dierlamm J, Ayuk F, Atanackovic D, Bacher U, Bokemeyer C, Zander A, San Miguel J, Nagler A, Kröger N. Erratum: Impact of genetic abnormalities on survival after allogeneic hematopoietic stem cell transplantation in multiple myeloma. Leukemia 2008. [DOI: 10.1038/leu.2008.254] [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: 11/09/2022]
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