1
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Sadowska-Klasa A, Zaucha JM, Labopin M, Bourhis JH, Blaise D, Yakoub-Agha I, Salmenniemi U, Passweg J, Fegueux N, Schroeder T, Giebel S, Brissot E, Ciceri F, Mohty M. Allogeneic hematopoietic cell transplantation is equally effective in secondary acute lymphoblastic leukemia (ALL) compared to de-novo ALL-a report from the EBMT registry. Bone Marrow Transplant 2024; 59:387-394. [PMID: 38195982 DOI: 10.1038/s41409-023-02192-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024]
Abstract
Secondary acute lymphoblastic leukemia (s-ALL) comprises up to 10% of ALL patients. However, data regarding s-ALL outcomes is limited. To answer what is the role of allogeneic hematopoietic cell transplantation (HCT) in s-ALL, a matched-pair analysis in a 1:2 ratio was conducted to compare outcomes between s-ALL and de novo ALL (dn-ALL) patients reported between 2000-2021 to the European Society for Blood and Marrow Transplantation registry. Among 9720 ALL patients, 351 (3.6%) were s-ALL, of which 80 were in first complete remission (CR1) with a known precedent primary diagnosis 58.8% solid tumor (ST), 41.2% hematological diseases (HD). The estimated 2-year relapse incidence (RI) was 19.1% (95%CI: 11-28.9), leukemia-free survival (LFS) 52.1% (95%CI: 39.6-63.2), non-relapse mortality (NRM) 28.8% (95%CI: 18.4-40), GvHD-free, relapse-free survival (GRFS) 39.4% (95%CI: 27.8-50.7), and overall survival (OS) 60.8% (95%CI: 47.9-71.4), and did not differ between ST and HD patients. In a matched-pair analysis, there was no difference in RI, GRFS, NRM, LFS, or OS between s-ALL and dn-ALL except for a higher incidence of chronic GvHD (51.9% vs. 31.4%) in s-ALL. To conclude, patients with s-ALL who received HCT in CR1 have comparable outcomes to patients with dn-ALL.
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Affiliation(s)
- A Sadowska-Klasa
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland.
| | - J M Zaucha
- Department of Hematology and Transplantology, Medical University of Gdańsk, Gdańsk, Poland.
| | - M Labopin
- Department of Hematology, Sorbonne University, Hopital Saint Antoine, Paris, France
| | - J H Bourhis
- Department of Hematology, Gustave Roussy Cancer Campus, BMT Service, Villejuif, France
| | - D Blaise
- Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | - I Yakoub-Agha
- CHU de Lille, LIRIC, INSERM U995, Université de Lille, Lille, France
| | - U Salmenniemi
- HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
| | - J Passweg
- University Hospital, Hematology, Basel, Switzerland
| | - N Fegueux
- CHU Lapeyronie, Département d'Hématologie Clinique, Montpellier, France
| | - T Schroeder
- Department of Bone Marrow Transplantation, University Hospital, Essen, Germany
| | - S Giebel
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - E Brissot
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne University, and INSERM UMRs 938, Paris, France
| | - F Ciceri
- Ospedale San Raffaele, Haematology and BMT, Milan, Italy
| | - M Mohty
- Department of Hematology, Sorbonne University, Hopital Saint Antoine, Paris, France
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2
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Zeiser R, Russo D, Ram R, Hashmi S, Chakraverty R, Moritz Middeke J, Giebel S, Sarkar R, Gowda M, Gunes S, Stefanelli T, Lee SJ, Teshima T, Locatelli F. P1389: RUXOLITINIB DEMONSTRATES A GREATER CORTICOSTEROID-SPARING EFFECT THAN BEST AVAILABLE THERAPY IN PATIENTS WITH CORTICOSTEROID-REFRACTORY/DEPENDENT CHRONIC GRAFT-VS-HOST DISEASE. Hemasphere 2022. [PMCID: PMC9429566 DOI: 10.1097/01.hs9.0000848416.66197.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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3
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Szlauer‐Stefańska AT, Sawicki W, Paszkiewicz‐Kozik E, Romejko‐Jarosińska J, Czerw T, Giebel S. AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION IN FOLLICULAR LYMPHOMA IN THE ERA OF NOVEL THERAPIES‐ A RETROSPECTIVE ANALYSIS BY POLISH LYMPHOMA RESEARCH GROUP. Hematol Oncol 2021. [DOI: 10.1002/hon.24_2881] [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: 11/06/2022]
Affiliation(s)
- A. T Szlauer‐Stefańska
- Maria Skłodowska‐Curie National Research Institute of Oncology Department of Bone Marrow Transplantation and Onco‐Hematology Gliwice Poland
| | - W Sawicki
- Military Institute of Medicine Department of Internal Medicine and Hematology Warsaw Poland
| | - E Paszkiewicz‐Kozik
- Maria Skłodowska‐Curie National Research Institute of Oncology (MSCNRIO) in Warsaw Department of Lymphoid Malignancies Warsaw Poland
| | - J Romejko‐Jarosińska
- Maria Skłodowska‐Curie National Research Institute of Oncology (MSCNRIO) in Warsaw Department of Lymphoid Malignancies Warsaw Poland
| | - T Czerw
- Maria Skłodowska‐Curie National Research Institute of Oncology Department of Bone Marrow Transplantation and Onco‐Hematology Gliwice Poland
| | - S Giebel
- Maria Skłodowska‐Curie National Research Institute of Oncology Department of Bone Marrow Transplantation and Onco‐Hematology Gliwice Poland
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Paszkiewicz-Kozik E, Michalski W, Taszner M, Knopińska-Posłuszny W, Mordak-Domagała M, Najda J, Borawska A, Romejko-Jarosińska J, Chełstowska M, Świerkowska M, Dąbrowska-Iwanicka A, Malenda A, Druzd-Sitek A, Konecki R, Kuniega B, Osowiecki M, Ostrowska B, Szpila T, Domańska-Czyż K, Szymański M, Targoński Ł, Poplawska L, Kotarska M, Giebel S, Lange A, Pluta A, Warzocha K, Zaucha J, Rymkiewicz G, Walewski J. OFATUMUMAB WITH IVAC FOR DLBCL PATIENTS WHO FAILED R-CHOP AND WERE NOT CANDIDATES FOR HIGH-DOSE THERAPY AND ASCT - PHASE 2 TRIAL OF THE POLISH LYMPHOMA RESEARCH GROUP (PLRG-8). Hematol Oncol 2019. [DOI: 10.1002/hon.111_2631] [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: 11/07/2022]
Affiliation(s)
- E. Paszkiewicz-Kozik
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - W. Michalski
- Biostatistics Unit; Maria Sklodowska-Curie Institute - Oncology Center; Warsaw Poland
| | - M. Taszner
- Hematology Department; Medical University; Gdansk Poland
| | - W. Knopińska-Posłuszny
- Hematology Department; Independent Public Health Care of the Ministry of the Internal Affairs with the Oncology Centre; Olsztyn Poland
| | - M. Mordak-Domagała
- Hematology Department; Lower Silesia Cell Transplantation Center; Wroclaw Poland
| | - J. Najda
- Hematology Department; Maria Sklodowska-Curie Institute - Oncology Center; Gliwice Poland
| | - A. Borawska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - J. Romejko-Jarosińska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - M. Chełstowska
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - M. Świerkowska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - A. Dąbrowska-Iwanicka
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - A. Malenda
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - A. Druzd-Sitek
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - R. Konecki
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - B. Kuniega
- Hematology Department; Oncology Centre of the Podkarpackie Province; Brzozów Poland
| | - M. Osowiecki
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - B. Ostrowska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - T. Szpila
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - K. Domańska-Czyż
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - M. Szymański
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - Ł. Targoński
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - L. Poplawska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - M. Kotarska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - S. Giebel
- Hematology Department; Maria Sklodowska-Curie Institute - Oncology Center; Gliwice Poland
| | - A. Lange
- Hematology Department; Lower Silesia Cell Transplantation Center; Wroclaw Poland
| | - A. Pluta
- Hematology Department; Oncology Centre of the Podkarpackie Province; Brzozów Poland
| | - K. Warzocha
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - J. Zaucha
- Oncology Department; Maritime Hospital; Gdynia Poland
| | - G. Rymkiewicz
- Pathology Department; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - J. Walewski
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
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Szlauer-Stefańska A, Kamińska-Winciorek G, Giebel S. Onychoscopy of non-infectious nail abnormalities in patients after allogeneic haematopoietic stem cell transplantation. J Eur Acad Dermatol Venereol 2018; 33:637-642. [PMID: 30468536 DOI: 10.1111/jdv.15357] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022]
Abstract
Nail abnormalities after allogeneic haematopoietic stem cell transplantation procedure (alloHSCT) are often reported. Usually, they are related to chronic graft-versus-host disease (cGvHD). So far, only clinical manifestations of selected nail abnormalities have been described, without the presentation of dermoscopic images. In this article, we present morphologic and dermoscopic manifestations of potential non-infectious nail abnormalities in patients after alloHSCT procedure based on reviewed literature and our own experience with dermoscopic iconography. In majority of studies published till now, nail changes are not connected to severity of other cGvHD symptoms; however, e.g. the presence of pterygium inversum unguis may be an indicator of lung dysfunction. As nail changes may be an early sign of cGvHD and always present in association with other manifestations, routine clinical assessment should include nails examination. Knowledge of possible presentation of nail involvement after alloHSCT may be valuable for treating physician.
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Affiliation(s)
- A Szlauer-Stefańska
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute- Oncology Centre, Gliwice Branch, Gliwice, Poland
| | - G Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute- Oncology Centre, Gliwice Branch, Gliwice, Poland
| | - S Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute- Oncology Centre, Gliwice Branch, Gliwice, Poland
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Ringdén O, Labopin M, Sadeghi B, Mailhol A, Beelen D, Fløisand Y, Ghavamzadeh A, Finke J, Ehninger G, Volin L, Socié G, Kröger N, Stuhler G, Ganser A, Schmid C, Giebel S, Mohty M, Nagler A. What is the outcome in patients with acute leukaemia who survive severe acute graft-versus-host disease? J Intern Med 2018; 283:166-177. [PMID: 29027756 DOI: 10.1111/joim.12695] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acute graft-versus-host disease (aGVHD) is a major complication of allogeneic haematopoietic stem cell transplantation (HSCT). With new promising therapies, survival may improve for severe aGVHD. OBJECTIVES We wanted to analyze the long-term outcome in patients who survive severe aGVHD. METHODS This study was a landmark analysis of 23 567 patients with acute Leukaemia who survived for more than 6 months after HSCT, 2002-2014. Patients alive after severe aGVHD (n = 1738) were compared to controls. RESULTS Patients with severe aGVHD had higher non-relapse mortality (NRM) and higher rate of extensive chronic GVHD (cGVHD) than the controls (P < 10-5 ). The probability of relapse was significantly lower in the severe aGVHD group, but Leukaemia-free survival (LFS) and overall survival were significantly lower than for the controls (P < 10-5 ). Five-year LFS in patients with severe aGVHD was 49%, as opposed to 61% in controls with no or mild GVHD and 59% in patients with moderate GVHD. CONCLUSIONS HSCT patients who survive severe aGVHD have higher risk of developing extensive cGVHD, a higher NRM, a lower relapse probability, and lower LFS than other HSCT patients. This study is a platform for outcome analysis in patients treated with novel therapies for acute GVHD.
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Affiliation(s)
- O Ringdén
- Division of Therapeutic Immunology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - M Labopin
- Hôpital Saint Antoine, Paris, France
| | - B Sadeghi
- Division of Therapeutic Immunology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - A Mailhol
- Hôpital Saint Antoine, Paris, France
| | - D Beelen
- University of Essen, Duisburg, Germany
| | - Y Fløisand
- Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - A Ghavamzadeh
- Shariati Hospital, Hematology-Oncology and BMT Research, Tehran, Iran
| | - J Finke
- Department of Medicine-Hematology, Oncology, University of Freiburg, Freiburg, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik 1, Universitätsklinikum Dresden, Dresden, Germany
| | - L Volin
- Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki University Hospital, Helsinki, Finland
| | - G Socié
- Department of Hematology - BMT, Hopital St. Louis, Paris, France
| | - N Kröger
- Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany
| | - G Stuhler
- Deutsche Klinik für Diagnostik, KMT Zentrum, Wiesbaden, Germany
| | - A Ganser
- Medical University Hannover, Hannover, Germany
| | - C Schmid
- University of Munich, Munich, Germany
| | - S Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - M Mohty
- Hôpital Saint Antoine, Paris, France
| | - A Nagler
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
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7
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Cahu X, Labopin M, Giebel S, Aljurf M, Kyrcz-Krzemien S, Socié G, Eder M, Bonifazi F, Bunjes D, Vigouroux S, Michallet M, Stelljes M, Zuckerman T, Finke J, Passweg J, Yakoub-Agha I, Niederwieser D, Sucak G, Sengeløv H, Polge E, Nagler A, Esteve J, Mohty M. Impact of conditioning with TBI in adult patients with T-cell ALL who receive a myeloablative allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT. Bone Marrow Transplant 2015; 51:351-7. [PMID: 26618548 DOI: 10.1038/bmt.2015.278] [Citation(s) in RCA: 56] [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] [Received: 04/14/2015] [Revised: 08/15/2015] [Accepted: 09/14/2015] [Indexed: 01/01/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a therapeutic option for adult patients with T-cell ALL (T-ALL). Meanwhile, few allo-SCT data specific to adult T-ALL have been described thus far. Specifically, the optimal myeloablative conditioning regimen is unknown. In this retrospective study, 601 patients were included. Patients received allo-SCT in CR1, CR2, CR >2 or in advanced disease in 69%, 15%, 2% and 14% of cases, respectively. With an overall follow-up of 58 months, 523 patients received a TBI-based regimen, whereas 78 patients received a chemotherapy-based regimen including IV busulfan-cyclophosphamide (IV Bu-Cy) (n=46). Unlike patients aged ⩾35 years, patients aged <35 years who received a TBI-based regimen displayed an improved outcome compared with patients who received a chemotherapy-based regimen (5-year leukemia-free survival (LFS) of 50% for TBI versus 18% for chemo-only regimen or IV Bu-Cy regimens, P=10(-5) and 10(-4), respectively). In multivariate analysis, use of TBI was associated with an improved LFS (hazard ratio (HR)=0.55 (0.34-0.86), P=0.01) and overall survival (HR=0.54 (0.34-0.87), P=0.01) in patients aged <35 years. In conclusion, younger adult patients with T-ALL entitled to receive a myeloablative allo-SCT may benefit from TBI-based regimens.
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Affiliation(s)
- X Cahu
- Hématologie Clinique, Hôpital Pontchaillou, CHU Rennes, France
| | - M Labopin
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.,Université Pierre and Marie Curie, Paris, France.,INSERM, UMR_S 938, INSERM, Paris, France
| | - S Giebel
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - M Aljurf
- Adult Hematology/HSCT, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - S Kyrcz-Krzemien
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | - G Socié
- Hematology-Transplantation, Hospital St Louis, APHP, Paris, France
| | - M Eder
- Hannover Medical School, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover, Germany
| | - F Bonifazi
- Institute of Hematology, Department of Hematology and Oncological Sciences 'L. and A. Seràgnoli,' University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - D Bunjes
- Klinik für Innere Medizin III, Universitätsklinikum Ulm, Germany
| | - S Vigouroux
- Hématologie Clinique et Thérapie Cellulaire, Hôpital Haut Levêque, Pessac, France
| | - M Michallet
- Hématologie Clinique, Hospices Civils de Lyon, Lyon, France
| | - M Stelljes
- Department of Medicine A/Hematology and Oncology, University of Muenster Muenster, Germany
| | - T Zuckerman
- Department of Hematology and Bone Marrow Transplantation, Rambam MCH, Haifa, Israel
| | - J Finke
- Department of Medecine-Hematology, Oncology, University of Freiburg, Freiburg, Germany
| | - J Passweg
- Hematology, University Hospital of Basel, Basel, Switzerland
| | - I Yakoub-Agha
- Hématologie Clinique, Hôpital Claude Huriez, Lille, France
| | - D Niederwieser
- University Hospital Leipzig, Clinic for Hematology and Oncology, Leipzig, Germany
| | - G Sucak
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - H Sengeløv
- National University Hospital, Copenhagen, Denmark
| | - E Polge
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.,Université Pierre and Marie Curie, Paris, France.,INSERM, UMR_S 938, INSERM, Paris, France
| | - A Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - J Esteve
- Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - M Mohty
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.,Université Pierre and Marie Curie, Paris, France.,INSERM, UMR_S 938, INSERM, Paris, France
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8
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Smagur A, Mitrus I, Ciomber A, Panczyniak K, Fidyk W, Sadus-Wojciechowska M, Holowiecki J, Giebel S. Comparison of the cryoprotective solutions based on human albumin vs. autologous plasma: its effect on cell recovery, clonogenic potential of peripheral blood hematopoietic progenitor cells and engraftment after autologous transplantation. Vox Sang 2015; 108:417-24. [DOI: 10.1111/vox.12238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 10/15/2014] [Accepted: 11/29/2014] [Indexed: 12/30/2022]
Affiliation(s)
- A. Smagur
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - I. Mitrus
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - A. Ciomber
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - K. Panczyniak
- Analytics and Clinical Biochemistry Department; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - W. Fidyk
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - M. Sadus-Wojciechowska
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - J. Holowiecki
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - S. Giebel
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
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9
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Czerw T, Labopin M, Gorin NC, Giebel S, Blaise D, Dumas PY, Foa R, Attal M, Schaap N, Michallet M, Bonmati C, Veelken H, Mohty M. Use of G-CSF to hasten neutrophil recovery after auto-SCT for AML is not associated with increased relapse incidence: a report from the Acute Leukemia Working Party of the EBMT. Bone Marrow Transplant 2014; 49:950-4. [PMID: 24710564 DOI: 10.1038/bmt.2014.64] [Citation(s) in RCA: 4] [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] [Received: 08/31/2013] [Revised: 02/20/2014] [Accepted: 02/20/2014] [Indexed: 11/09/2022]
Abstract
Application of G-CSF in AML is controversial as leukemic blasts may express receptors interacting with the cytokine, which may stimulate leukemia growth. We retrospectively analyzed the impact of G-CSF use to accelerate neutrophil recovery after auto-SCT on outcome. Adults with AML in first CR autografted between 1994 and 2010 were included. Nine hundred and seventy two patients were treated with G-CSF after auto-SCT whereas 1121 were not. BM and PB were used as a source of stem cells in 454 (22%) and 1639 (78%) cases, respectively. The incidence of relapse at 5 years in the BM-auto-SCT group was 38% for patients receiving post-transplant G-CSF and 43% for those not treated with G-CSF, P=0.46. In the PB-auto-SCT cohort, respective probabilities were 48% and 49%, P=0.49. No impact of the use of G-CSF could be demonstrated with respect to the probability of leukemia-free survival: in the BM-auto-SCT group, 51% for G-CSF(+) and 48% for G-CSF(-), P=0.73; in PB-auto-SCT group, 42% for G-CSF(+) and 43% for G-CSF(-), P=0.83. Although G-CSF administration significantly shortened the neutropenic phase, no beneficial effect was observed with regard to non-relapse mortality. In patients with AML, the use of G-CSF after auto-SCT is not associated with increased risk of relapse irrespective of the source of stem cells used.
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Affiliation(s)
- T Czerw
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice, Poland
| | - M Labopin
- 1] Clinical Hematology and Cellular Therapy Department, Hopital Saint-Antoine APHP, Paris, France [2] INSERM UMRs 938, Paris, France [3] Université Pierre et Marie Curie (UPMC, Paris VI), Paris, France
| | - N-C Gorin
- 1] Clinical Hematology and Cellular Therapy Department, Hopital Saint-Antoine APHP, Paris, France [2] INSERM UMRs 938, Paris, France [3] Université Pierre et Marie Curie (UPMC, Paris VI), Paris, France
| | - S Giebel
- Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice, Poland
| | - D Blaise
- Unité de transplantation et de thérapie cellulaire, Institut Paoli-Calmettes, Marseille, France
| | - P-Y Dumas
- Hématologie clinique et Thérapie celllulaire, Hôpital Haut-Lévêque, Pessac, France
| | - R Foa
- Dipartimento Biotecnologie Cellulari ed Ematologia, Università 'LaSapienza', Rome, Italy
| | - M Attal
- CHU Department Hematologie, Hopital de Purpan, Toulouse, France
| | - N Schaap
- Department of Hematology, Radboud University-Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - M Michallet
- Service Hematologie, Centre Hospitalier Lyon Sud, Lyon, France
| | - C Bonmati
- Department of Hematology, Centre Hospitalier Universitaire Brabois, Vandoeuvre les Nancy, France
| | - H Veelken
- BMT Centre Leiden, Leiden University Hospital, Leiden, The Netherlands
| | - M Mohty
- 1] Clinical Hematology and Cellular Therapy Department, Hopital Saint-Antoine APHP, Paris, France [2] INSERM UMRs 938, Paris, France [3] Université Pierre et Marie Curie (UPMC, Paris VI), Paris, France
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Matulewicz L, Radwan M, Miszczyk L, Giebel S, Slosarek K. PO-0843: Tomotherapy vs. VMAT for ottal marrow irradiation. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30961-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Matulewicz L, Miszczyk L, Giebel S, Slosarek K. Effective and Efficient Technique for Total Marrow Irradiation. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1978] [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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12
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Bazarbachi A, Labopin M, Ghavamzadeh A, Giebel S, Al-Zahrani H, Ladeb S, Leone G, Abdel-Rahman F, Liso V, Hamidieh AA, Rasheed W, Ibrahim A, Alabdulaaly A, Kyrcz-Krzemien S, Arnold R, Kharfan-Dabaja MA, Alimoghaddam K, Aljurf M, Mohty M. Allogeneic matched-sibling hematopoietic cell transplantation for AML: comparable outcomes between Eastern Mediterranean (EMBMT) and European (EBMT) centers. Bone Marrow Transplant 2013; 48:1065-9. [DOI: 10.1038/bmt.2013.1] [Citation(s) in RCA: 9] [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] [Received: 06/14/2012] [Revised: 11/29/2012] [Accepted: 12/22/2012] [Indexed: 01/01/2023]
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13
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Giebel S, Kruzel T, Czerw T, Sadus-Wojciechowska M, Najda J, Chmielowska E, Grosicki S, Jurczyszyn A, Pasiarski M, Nowara E, Glowala-Kosinka M, Chwieduk A, Mitrus I, Smagur A, Holowiecki J. Intermediate-dose Ara-C plus G-CSF for stem cell mobilization in patients with lymphoid malignancies, including predicted poor mobilizers. Bone Marrow Transplant 2013; 48:915-21. [DOI: 10.1038/bmt.2012.269] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 11/06/2012] [Accepted: 11/28/2012] [Indexed: 11/09/2022]
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14
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Smagur A, Mitrus I, Giebel S, Sadus-Wojciechowska M, Najda J, Kruzel T, Czerw T, Gliwinska J, Prokop M, Glowala-Kosinska M, Chwieduk A, Holowiecki J. Impact of different dimethyl sulphoxide concentrations on cell recovery, viability and clonogenic potential of cryopreserved peripheral blood hematopoietic stem and progenitor cells. Vox Sang 2012; 104:240-7. [DOI: 10.1111/j.1423-0410.2012.01657.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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15
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Kruzel T, Czerw T, Sadus-Wojciechowska M, Najda J, Glowala-Kosinska M, Chwieduk A, Holowiecki J, Giebel S. Very High Efficacy of Cytarabine + G-CSF Compared to Cyclophosphamide + G-CSF as Hematopoietic Stem Cell Mobilization in Patients with Lymphoid Malignancies Referred for Autologous Transplantation. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33638-3] [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: 11/25/2022] Open
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16
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Giebel S, Labopin M, Mohty M, Mufti GJ, Niederwieser D, Cornelissen JJ, Janssen JJWM, Milpied N, Vindelov L, Petersen E, Arnold R, Bacigalupo A, Blaise D, Craddock C, Nagler A, Frassoni F, Sadus-Wojciechowska M, Rocha V. The impact of center experience on results of reduced intensity: allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT. Bone Marrow Transplant 2012; 48:238-42. [PMID: 22773125 DOI: 10.1038/bmt.2012.131] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [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
Allogeneic hematopoietic SCT with reduced-intensity conditioning (RIC-HSCT) is increasingly adopted for the treatment of older adults with AML. Our goal was to verify for the first time, if center experience influences outcome of RIC-HSCT. Results of 1413 transplantations from HLA-matched related or unrelated donors for adult patients with AML in first CR were analyzed according to the level of center activity. Transplants were performed in 203 European centers between 2001 and 2007. The 2-year probability of leukemia-free survival (LFS) after RIC-HSCT performed in centers with the lowest activity (< or =15 procedures/7 years) was 43±3% compared with 55±2% in the remainder (P<0.001). The incidence of non-relapse mortality (NRM) was 24±3% and 15±1% (P=0.004), whilst relapse rate was 33±3% and 31±1% (P=0.33), respectively. In a multivariate model, adjusted for other prognostic factors, low RIC-HSCT activity was associated with decreased chance of LFS (hazard ratio (HR)=0.64; P<0.001) and increased risk of NRM (HR=1.47, P=0.04) and relapse (HR=1.41, P=0.01). Center experience is a very important predictor of outcome and should be considered in future analyses evaluating the results of RIC-HSCT. The reasons why centers with low RIC-HSCT activity have worse outcomes should be further investigated.
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Affiliation(s)
- S Giebel
- Department of Bone Marrow Transplantation, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Gliwice, Poland.
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Casper J, Holowiecki J, Trenschel R, Wandt H, Schaefer-Eckart K, Ruutu T, Volin L, Einsele H, Stuhler G, Uharek L, Blau I, Bornhaeuser M, Zander AR, Larsson K, Markiewicz M, Giebel S, Kruzel T, Mylius HA, Baumgart J, Pichlmeier U, Freund M, Beelen DW. Allogeneic hematopoietic SCT in patients with AML following treosulfan/fludarabine conditioning. Bone Marrow Transplant 2011; 47:1171-7. [PMID: 22158386 DOI: 10.1038/bmt.2011.242] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
An alternative reduced-toxicity conditioning regimen for allogeneic transplantation, based on treosulfan and fludarabine, has recently been identified. The safety and efficacy of this new conditioning regimen has been investigated prospectively in patients with AML. A total number of 75 patients with AML in CR were treated with 3 × 14 g/m(2) treosulfan and 5 × 30 mg/m(2) fludarabine, followed by matched sibling or unrelated SCT. Patients were evaluated for engraftment, adverse events, GVHD, and for non-relapse mortality, relapse incidence, overall and disease-free survival (DFS). All patients showed primary engraftment of neutrophils after a median of 20 days. Non-hematological adverse events grade III-IV in severity included mainly infections (59%) and gastrointestinal symptoms (7%). Acute GVHD grade II-IV occurred in 21% and extensive chronic GVHD occurred in 16% of the patients. After a median follow-up of 715 days, the 2-year overall and DFS estimates were 61% and 55%, respectively. The 2-year incidences of relapse and non-relapse mortality reached 34% and 11%, respectively. In summary, our data confirm promising safety and efficacy of the treosulfan-based conditioning therapy in AML patients, ClinicalTrials.gov Identifier: NCT01063660.
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Affiliation(s)
- J Casper
- Division of Hematology and Oncology, University of Rostock, Rostock, Germany.
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18
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Karabon L, Jedynak A, Giebel S, Wołowiec D, Kielbinski M, Woszczyk D, Kapelko-Slowik K, Kuliczkowski K, Frydecka I. KIR/HLA gene combinations influence susceptibility to B-cell chronic lymphocytic leukemia and the clinical course of disease. ACTA ACUST UNITED AC 2011; 78:129-38. [DOI: 10.1111/j.1399-0039.2011.01721.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Giebel S, Romaker J, Frechen FB. [Application computing frequency--analysis of sensory dating for determining the sulfide load]. Bull Soc Sci Med Grand Duche Luxemb 2010; Spec No 1:69-75. [PMID: 20653179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- S Giebel
- Luxembourg School of Finance, Universität Luxemburg.
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20
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Giebel S, Rainer M. Forecasting financial asset processes: stochastic dynamics via learning neural networks. Bull Soc Sci Med Grand Duche Luxemb 2010; Spec No 1:91-107. [PMID: 20653181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Models for financial asset dynamics usually take into account their inherent unpredictable nature by including a suitable stochastic component into their process. Unknown (forward) values of financial assets (at a given time in the future) are usually estimated as expectations of the stochastic asset under a suitable risk-neutral measure. This estimation requires the stochastic model to be calibrated to some history of sufficient length in the past. Apart from inherent limitations, due to the stochastic nature of the process, the predictive power is also limited by the simplifying assumptions of the common calibration methods, such as maximum likelihood estimation and regression methods, performed often without weights on the historic time series, or with static weights only. Here we propose a novel method of "intelligent" calibration, using learning neural networks in order to dynamically adapt the parameters of the stochastic model. Hence we have a stochastic process with time dependent parameters, the dynamics of the parameters being themselves learned continuously by a neural network. The back propagation in training the previous weights is limited to a certain memory length (in the examples we consider 10 previous business days), which is similar to the maximal time lag of autoregressive processes. We demonstrate the learning efficiency of the new algorithm by tracking the next-day forecasts for the EURTRY and EUR-HUF exchange rates each.
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Affiliation(s)
- S Giebel
- University of Luxembourg, Luxembourg School of Finance.
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21
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Giebel S, Stella-Holowiecka B, Krawczyk-Kulis M, Gökbuget N, Hoelzer D, Doubek M, Mayer J, Piatkowska-Jakubas B, Skotnicki AB, Dombret H, Ribera JM, Piccaluga PP, Czerw T, Kyrcz-Krzemien S, Holowiecki J. Status of minimal residual disease determines outcome of autologous hematopoietic SCT in adult ALL. Bone Marrow Transplant 2009; 45:1095-101. [PMID: 19855438 DOI: 10.1038/bmt.2009.308] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The role of autologous hematopoietic SCT (autoHSCT) in the treatment of high-risk (HR) adult ALL is controversial. In this study, we retrospectively analyzed the results of autoHSCT according to the status of minimal residual disease (MRD) at transplantation, as a joint analysis of the European Study Group for Adult ALL (EWALL). Data on 123 recipients of autoHSCT, aged 31 (16-59) years, with B-lineage (n=77) or T-lineage (n=46) ALL were included. In a cohort of Ph-negative ALL, the probability of leukemia-free survival at 5 years was higher for patients with MRD <0.1% compared with those with MRD > or = 0.1% (57 vs 17%, P=0.0002). The difference was significant for T-lineage ALL (62 vs 8%, P=0.001), and a tendency was observed for B-lineage ALL (54 vs 26%, P=0.17). In a multivariate analysis, adjusted for other potential prognostic factors, high MRD level remained the only independent factor associated with increased risk of failure (risk ratio, 2.8; P=0.0005). We conclude that MRD determines the outcome of autoHSCT in HR adult ALL. Our results suggest the need to reevaluate the role of this treatment option in prospective trials.
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Franke W, Frechen FB, Giebel S. H2S, VOC, TOC, electronic noses and odour concentration: use and comparison of different parameters for emission measurement on air treatment systems. Water Sci Technol 2009; 59:1721-1726. [PMID: 19448306 DOI: 10.2166/wst.2009.127] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Odour measurement via olfactometry is expensive and has a low accuracy compared with chemical or physical methods. In addition, olfactometry is not suited for online monitoring. Hence, an accurate online method for emission measurement would be an enormous improvement. There are several options to more or less replace the offline olfactometry by online measurement available today. Most common are H2S-concentration as a single gas parameter and VOC and TOC as composite parameters. A fairly new development are multi sensor arrays, usually referred to as "electronic noses" which carry out non-specific gas measurement and deliver measurement data that can visualized as a fingerprint diagram. This paper outlines the use of these different parameters and compares the results to those gained via olfactometry of several case studies.
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Affiliation(s)
- W Franke
- Department of Sanitary and Environmental Engineering (DESEE), Kassel University, Kurt-Wolters-Str. 3, Kassel 34125, Germany.
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Giebel S, Nowak I, Majorczyk E, Kusnierczyk P. Reply to Verheyden and Demanet. Leukemia 2008. [DOI: 10.1038/leu.2008.110] [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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Giebel S, Nowak I, Wojnar J, Krawczyk-Kulis M, Holowiecki J, Kyrcz-Krzemien S, Kusnierczyk P. Association of KIR2DS4 and its variant KIR1D with leukemia. Leukemia 2008; 22:2129-30; discussion 2130-1. [PMID: 18463675 DOI: 10.1038/leu.2008.108] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Stella-Holowiecka B, Czerw T, Holowiecka-Goral A, Giebel S, Wojnar J, Holowiecki J. Beta-2-Microglobulin Level Predicts Outcome Following Autologous Hematopoietic Stem Cell Transplantation in Patients With Multiple Myeloma. Transplant Proc 2007; 39:2893-7. [DOI: 10.1016/j.transproceed.2007.08.052] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Giebel S, Dziaczkowska J, Wysoczanska B, Wojnar J, Krawczyk-Kulis M, Lange A, Holowiecki J. Lymphocyte reconstitution after allogeneic bone marrow transplantation in a previously thymectomized patient—no evidence of extrathymic T-cell maturation. Bone Marrow Transplant 2007; 40:705-6. [PMID: 17680024 DOI: 10.1038/sj.bmt.1705794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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27
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Markiewicz M, Wojnar J, Giebel S, Wieczorkiewicz A, Wylezoł I, Hołowiecki J. Post-transplant induction of donor-type anti-RhD antibodies production shortly followed by complete hemolysis of recipient-type erythrocytes in RhD-mismatched allogeneic bone marrow recipient. Bone Marrow Transplant 2006; 37:433-4. [PMID: 16400335 DOI: 10.1038/sj.bmt.1705254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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28
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Giebel S, Nowak I, Wojnar J, Markiewicz M, Dziaczkowska J, Wylezol I, Krawczyk-Kulis M, Bloch R, Kusnierczyk P, Holowiecki J. Impact of Activating Killer Immunoglobulin-like Receptor Genotype on Outcome of Unrelated Donor–Hematopoietic Cell Transplantation. Transplant Proc 2006; 38:287-91. [PMID: 16504727 DOI: 10.1016/j.transproceed.2005.11.091] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND In a previous study we demonstrated that incompatibility regarding ligands for inhibitory killer immunoglobulin-like receptors (KIRs) is associated with a survival advantage following unrelated donor-hematopoietic cell transplantation (URD-HCT). The goal of the present analysis was to evaluate whether genotype of activating KIRs of the donor may have an impact on the outcome of URD-HCT. PATIENTS AND METHODS Twenty-five URD-HCT recipients with hematological malignancies, mean age 27 years (range, 14-43 years), were included in the analysis. The conditioning regimen was myeloablative and based on chemotherapy alone (n = 20) or total body irradiation (n = 5). Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine, methotrexate, and pretransplant antithymocyte globulin. Patients were grouped according to their donors' activating KIR genotype including two loci: KIR2DS1 and KIR2DS2. RESULTS The presence of KIR2DS1 in the donor (n = 16/25) was not demonstrated to influence outcome. In contrast, the presence of KIR2DS2 (n = 13/25 donors) was associated with decreased probability of overall survival (0% vs 92%, P = .04) and disease-free survival (0% vs 92%, P = .046). The reason for failures in the KIR2DS2-positive group was chronic GVHD (n = 4), acute GVHD (n = 2), and relapse (n = 1). The cumulative incidence of nonrelapse mortality equaled 90% for the KIR2DS2-positive group and 8% for the KIR2DS2-negative group (P = .09). CONCLUSION The presence of KIR2DS2 gene in the donor is associated with a high risk of mortality following URD-HCT, resulting mainly from the incidence of severe GVHD. Whether this effect is associated with the activity of natural killer cells or KIR-bearing T lymphocytes requires further investigation.
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Affiliation(s)
- S Giebel
- Department of Hematology and BMT, Silesian Medical University, ul. Reymonta 8, 40-029 Katowice, Poland.
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29
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Zaucha JM, Prejzner W, Giebel S, Gooley TA, Szatkowski D, Kałwak K, Wojnar J, Kruzel T, Balon J, Hołowiecki J, Hellmann A. Imatinib therapy prior to myeloablative allogeneic stem cell transplantation. Bone Marrow Transplant 2005; 36:417-24. [PMID: 16007105 DOI: 10.1038/sj.bmt.1705087] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
It is unknown whether imatinib prior to myeloablative haematopoietic stem cell transplantation (HSCT) increases transplant-related toxicity. Among the side effects induced by imatinib, myelosuppression and liver injury might worsen HSCT outcomes. We retrospectively analysed engraftment, liver toxicity, acute graft-versus-host disease (aGVHD) incidence and 100-day mortality in 30 patients with BCR/ABL-positive leukaemias who received imatinib before HSCT and compared results of 48 age-matched controls who did not receive preceding imatinib. Both neutrophil and platelet engraftment occurred more rapidly among imatinib patients but the differences adjusted for Gratwohl scale were not statistically significant (P = 0.18 and 0.22, respectively). The adjusted hazards of having liver function tests (LFTs) >1.5 normal increased and the adjusted durations of elevated LFTs were not significantly different. The estimated adjusted difference in mean peak bilirubin values was also not significantly different (P = 0.48). However, the adjusted hazard of increased creatinine >1.5 normal was significantly higher in the imatinib group (HR = 4.09, P = 0.02). The adjusted odds of grades II-IV aGVHD were similar in both groups (OR = 0.86, P = 0.78), and while the adjusted odds of 100-day mortality were lower among imatinib patients, the difference was not significant (OR = 0.65, P = 0.60). These data do not provide any evidence that imatinib preceding HSCT increases acute transplant-related toxicities.
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MESH Headings
- Adolescent
- Adult
- Antineoplastic Agents/administration & dosage
- Benzamides
- Bilirubin/blood
- Blood Platelets/metabolism
- Creatinine/blood
- Female
- Graft Survival
- Graft vs Host Disease/blood
- Graft vs Host Disease/mortality
- Graft vs Host Disease/prevention & control
- Hematopoietic Stem Cell Transplantation/mortality
- Humans
- Imatinib Mesylate
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Liver/metabolism
- Male
- Middle Aged
- Neutrophils/metabolism
- Piperazines/administration & dosage
- Pyrimidines/administration & dosage
- Transplantation Chimera
- Transplantation Conditioning/methods
- Transplantation, Homologous
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Affiliation(s)
- J M Zaucha
- Department of Hematology, Medical University of Gdańsk, Gdańsk, Poland.
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Markiewicz M, Wojciechowska M, Wylezoł I, Woźniczka K, Giebel S, Wojnar J, Krawczyk-Kuliś M, Mendek-Czajkowska E, Hołowiecki J. Unrelated donor bone marrow transplantation with treosulfan-based myeloablative conditioning for paroxysmal nocturnal hemoglobinuria- successful treatment despite multiple transplant-related risk factors for hemolysis including major Kidd group incompatibility. Bone Marrow Transplant 2005; 37:231-2. [PMID: 16247413 DOI: 10.1038/sj.bmt.1705210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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31
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Giebel S, Maccario R, Lilleri D, Zecca M, Avanzini MA, Marconi M, Di Cesare Merlone A, Campanini G, Montagna D, Travaglino P, Gentile R, Telli S, Pagliara D, Holowiecki J, Locatelli F. The immunosuppressive effect of human cytomegalovirus infection in recipients of allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2005; 36:503-9. [PMID: 16007103 DOI: 10.1038/sj.bmt.1705094] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In immune-competent individuals, human cytomegalovirus (HCMV) infection is associated with impairment of T-cell function. Our goal was to evaluate prospectively whether clinically asymptomatic HCMV infection in allogeneic hematopoietic stem cell transplantation (alloHSCT) recipients, treated pre emptively with ganciclovir, influences T-cell function as well. Mitogen-stimulated T-cell proliferative activity, together with cell surface markers, was tested in 49 patients on days + 30, + 45, + 60, and + 90 after alloHSCT and, additionally, in cases of positive HCMV pp65-antigenemia. HCMV infection was diagnosed in 19 patients. None of them developed HCMV disease. T-cell proliferative activity was significantly decreased on days when HCMV antigenemia was positive as compared to days without antigenemia. The number of pp65-positive cells negatively correlated with proliferative response. Comparison of patients who did experience HCMV infection with those who did not reveals significant decrease of T-cell proliferative activity observed on days + 30 and + 45, a time period when antigenemia was most frequently found to be positive, whereas no difference was detected on days + 60 and + 90. We conclude that, even clinically asymptomatic, HCMV infection has negative impact on T-cell proliferation capacity in alloHSCT recipients. However, pre emptive therapy with ganciclovir makes this immunosuppressive effect transient and restricted to the time of infection duration.
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Affiliation(s)
- S Giebel
- Oncoematologia Pediatrica, IRCCS Policlinico San Matteo, Pavia, Italy.
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Markiewicz M, Hołowiecki J, Wojnar J, Krawczyk-Kuliś M, Jagoda K, Giebel S, Kruzel T. Allogeneic transplantation of selected peripheral CD34+ cells with controlled CD3+ cells add-back in high-risk patients. Transplant Proc 2005; 36:3194-9. [PMID: 15686727 DOI: 10.1016/j.transproceed.2004.09.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We evaluated the feasibility of allogeneic transplantation of CliniMACS-selected peripheral CD34+ cells from siblings (four patients: AML-M4, M2, CLL, MDS); nonoptimal related donors (two patients: AML-M4, CML); and unrelated donors (two patients: CML, ALL, both without engraftment after preceding URDBMT). All patients had high-risk of aGVHD and/or graft failure due to multiple transplantation risk factors. Conditioning treatment was myeloablative (n=7) or nonmyeloablative (n=1). Immunosuppression consisted of CsA (n=8), Mtx (n=5), ATG (n=4). Selected CD34+ cells were transplanted (average 3.91 x 10(6)/kg, range 1.29 to 7.27 x 10(6)/kg) together with 0.01 to 0.5 x 10(7) CD3+ cells/kg to assure proper engraftment. The remaining CD34-negative fraction was cryopreserved for further CD3+ cell add-back. Average recovery and purity of CD34+ cells following CliniMACS selection were 74% and 97%. No severe complications were observed in the first 100 days. Regeneration times were satisfactory in seven of eight patients (87.5%) with ANO > 0.5 g/L and Plt > 50 g/L reached on average on days +26 and +32 (range 15 to 29 and 15 to 67), respectively. In three patients (37.5%) T-lymphocytes were added-back one to three times (due to low numbers of initially transfused CD3+ cells in two patients, in one patient with PRCA caused by ABO incompatibility). One to four additional transplantations of nonselected peripheral cells were performed on days +28 to +270 in consequence of infections (CMV-two patients; parvovirus-one patient), poor regeneration and residual disease (one patient) and prolonged transfusion dependency (one patient). Severe aGVHD grade III or IV developed in three patients (37.5%) following the nonselected cells transplantation. Finally, five patients (62.5%) are alive and in remission (median follow-up 815 days). We conclude that allogeneic transplantation of selected peripheral CD34+ cells (CliniMACS) with controlled add-back of CD3+ cells is an effective, well, tolerated procedure in high-risk patients.
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Affiliation(s)
- M Markiewicz
- Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland
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Giebel S, Krawczyk-Kulis M, Jakubas B, Adamczyk-Cioch M, Palynyczko G, Holowiecki J. Fludarabine, cytarabine, and mitoxantrone (FLAM) for the treatment of relapsed and refractory acute lymphoblastic leukemia in adults. A phase II study by the Polish Adult Leukemia Group (PALG). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.6723] [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: 11/20/2022] Open
Affiliation(s)
- S. Giebel
- Silesian Medical University, Katowice, Poland; Jagiellonian University, Cracow, Poland; Medical Academy, Lublin, Poland; Institute of Haematology and Blood Transfusion, Warsaw, Poland
| | - M. Krawczyk-Kulis
- Silesian Medical University, Katowice, Poland; Jagiellonian University, Cracow, Poland; Medical Academy, Lublin, Poland; Institute of Haematology and Blood Transfusion, Warsaw, Poland
| | - B. Jakubas
- Silesian Medical University, Katowice, Poland; Jagiellonian University, Cracow, Poland; Medical Academy, Lublin, Poland; Institute of Haematology and Blood Transfusion, Warsaw, Poland
| | - M. Adamczyk-Cioch
- Silesian Medical University, Katowice, Poland; Jagiellonian University, Cracow, Poland; Medical Academy, Lublin, Poland; Institute of Haematology and Blood Transfusion, Warsaw, Poland
| | - G. Palynyczko
- Silesian Medical University, Katowice, Poland; Jagiellonian University, Cracow, Poland; Medical Academy, Lublin, Poland; Institute of Haematology and Blood Transfusion, Warsaw, Poland
| | - J. Holowiecki
- Silesian Medical University, Katowice, Poland; Jagiellonian University, Cracow, Poland; Medical Academy, Lublin, Poland; Institute of Haematology and Blood Transfusion, Warsaw, Poland
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Holowiecki J, Grosicki S, Robak T, Kyrcz-Krzemien S, Giebel S, Hellmann A, Skotnicki A, Jedrzejczak WW, Konopka L, Kuliczkowski K, Zdziarska B, Dmoszynska A, Marianska B, Pluta A, Zawilska K, Komarnicki M, Kloczko J, Sulek K, Haus O, Stella-Holowiecka B, Baran W, Jakubas B, Paluszewska M, Wierzbowska A, Kielbinski M, Jagoda K. Addition of cladribine to daunorubicin and cytarabine increases complete remission rate after a single course of induction treatment in acute myeloid leukemia. Multicenter, phase III study. Leukemia 2004; 18:989-97. [PMID: 14999298 DOI: 10.1038/sj.leu.2403336] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To assess the efficacy of an original DAC-7 regimen: daunorubicine (DNR) 60 mg/m2/day, days 1-3; cytarabine (AraC) 200 mg/m2/day, days 1-7; cladribine (2-CdA) 5 mg/m2/day, days 1-5, 400 untreated adult acute myeloid leukemia patients (including 63 with preceding myelodysplastic syndrome), aged 45 (16-60) years were randomized to either DAC-7 (n=200) or DA-7 (without 2-CdA, n=200). The overall CR rate equaled 72% for DAC-7 and 69% for DA-7 arm (P=NS). After a single course of DAC-7 induction, the CR rate equaled 64% and was significantly higher compared to 47% in the DA-7 arm (P=0.0009). Median hospitalization time during the induction was 7 days shorter for DAC-7 compared to the DA-7 group (33 vs 40 days, P=0.002). Toxicity was comparable in both groups. The probability of 3-year leukemia-free survival (LFS) for DAC-7 and DA-7 group equaled 43 and 34%, respectively (P=NS). There was a trend toward higher LFS rate for patients aged >40 years receiving DAC-7 compared with DA-7 regimen (44 vs 28%, P=0.05). This study proves that addition of 2-CdA increases antileukemic potency of DNR+AraC regimen, thus resulting in a higher CR rate after one induction cycle when compared to DA-7, without additional toxicity. It shortens hospitalization time and may improve long-term survival in patients aged >40 years.
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Affiliation(s)
- J Holowiecki
- University Department of Haematology and BMT, Silesian Medical University, Katowice, Poland.
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35
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Giebel S, Giorgiani G, Martinetti M, Zecca M, Maccario R, Salvaneschi L, Holowiecki J, Locatelli F. Low incidence of severe acute graft-versus-host disease in children given haematopoietic stem cell transplantation from unrelated donors prospectively matched for HLA class I and II alleles with high-resolution molecular typing. Bone Marrow Transplant 2003; 31:987-93. [PMID: 12774049 DOI: 10.1038/sj.bmt.1704054] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We evaluated the outcome of 63 children given haematopoietic stem cell transplantation from unrelated donors (URD-HSCT) prospectively selected using DNA high-resolution typing of both HLA class I and class II loci. Thirty patient/donor pairs (48%) were fully matched. Among the others, HSCT was performed in the presence of one (n=22), two (n=9), or three (n=2) HLA disparities. Patients had either malignant (n=46) or non-malignant (n=17) disease. In all cases, graft-versus-host disease (GVHD) prophylaxis consisted of cyclospor-in A, short-term methotrexate and pretransplant anti-thymocyte globulin. The probability of haematopoietic recovery at day 100 was 97%. Two patients experienced primary graft failure. The cumulative probability of grades III-IV acute GVHD and of extensive chronic GVHD equalled 8 and 14%, respectively. A total of 12 patients died of transplant-related complications. The probability of transplant-related mortality (TRM) at 100 and 180 days was 10 and 15%, respectively, whereas the cumulative incidence of TRM was 22%. The probability of GVHD-related mortality equalled 6% at 2.5 years. The overall and disease-free survival rates were 67 and 65%, respectively. URD-HSCT with donor selection based on high-resolution HLA typing is associated with low incidence of both severe acute GVHD and graft failure. The observed outcome is comparable to that of children transplanted from HLA-identical siblings.
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Affiliation(s)
- S Giebel
- Oncoematologia Pediatrica, IRCCS Policlinico San Matteo, Università di Pavia, Pavia, Italy
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Holowiecki J, Giebel S, Wojnar J, Krawczyk-Kulis M, Stella-Holowiecka B, Kachel L, Wojciechowska M, Markiewicz M, Kata D. Autologous hematopoietic stem cell transplantation for high-risk Hodgkin's disease: a single-center experience with the first 100 patients. Transplant Proc 2002; 34:3378-83. [PMID: 12493478 DOI: 10.1016/s0041-1345(02)03690-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- J Holowiecki
- Department of Haematology and Bone Marrow Transplantation, Silesian Medical Academy, Poland
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Krawczyk-Kuliś M, Giebel S, Hołowiecki J. [Malignant external otitis: a rare complication after autologous bone marrow transplantation]. Wiad Lek 2000; 53:214-8. [PMID: 10946611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
We present a case of 39 year old woman who developed malignant external otitis (m.e.o.) of Pseudomonas aeruginosa aetiology during pancytopenia after autologous bone marrow transplantation (ABMT). The infection was probably of endogenous origin. 7 days before ABMT otolarygological examination including otoscopy and external ear lavage was performed. Slight inflammatory reaction of external ear was accompanied by the massive involvement of middle ear followed by infiltration of petrous pyramid and mastoid process and finally facial and vestibulocochlear nerve paralysis. Initially the symptoms indicated subarachnoid haemorrhage. Mononuclear cells detected in cerebrospinal fluid as well as CT scan were suggestive of leukaemic infiltration. The latter was negated by immunophenotyping of cerebrospinal fluid cells and MR imaging. Antibiotic therapy resulted in clinical improvement. Life-threatening complications are not frequent after ABMT (transplant related mortality--14/310 (4.5%) in our center). We have met m.e.o. for the first time. At present--13 months after ABMT the patient shows slight symptoms of nerve VII and VIII paresis and remains in complete remission of acute leukaemia. We emphasize the importance of proper preparation of patients for high dose chemotherapy followed by bone marrow transplantation as well as diagnostic difficulties related to pancytopenia.
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Affiliation(s)
- M Krawczyk-Kuliś
- Kliniki Hematologii i Transplantacji Szpiku Slaskiej Akademii Medycznej w Katowicach
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Hołowiecki J, Wojciechowska M, Giebel S, Krawczyk-Kuliś M, Wojnar J, Kachel L, Kata D, Markiewicz M. Ifosfamide, etoposide, epirubicine, and G-CSF: an effective mobilization regimen for PBSCT in heavily pretreated patients. Transplant Proc 2000; 32:1412-5. [PMID: 10995998 DOI: 10.1016/s0041-1345(00)01276-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- J Hołowiecki
- Department of Haematology and Bone Marrow Transplantation, Silesian Medical Academy, Katowice, Poland
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Giebel S. [Graft vs host disease and cytomegalovirus: looking for common pathogenetic link based on discussion about viral super-antigens]. Wiad Lek 1999; 52:118-28. [PMID: 10499021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Acute graft-versus-host reaction (GVH) is the most severe complication of allogeneic bone marrow transplantation. It has been shown that higher morbidity and heavier course refers to cytomegalovirus (CMV) seropositive recipients who obtain bone marrow from seronegative donors. In this work hypothetical model linking pathogenesis of acute GVH to CMV infection is discussed. CMV superantigen is postulated to trigger the immunological reaction. Antigen presenting cells of the host expose it on their surface which results in activation of allogeneic T lymphocytes.
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