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Wong J, Govindasamy G, Prasath A, Hwang W, Ho A, Yeo S, Tong L. Allogeneic Umbilical Cord Plasma Eyedrops for the Treatment of Recalcitrant Dry Eye Disease Patients. J Clin Med 2023; 12:6750. [PMID: 37959215 PMCID: PMC10648694 DOI: 10.3390/jcm12216750] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/24/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Dry eye disease is a significant disease in Singapore. While there have been studies using allogenic cord serum for the treatment of dry eye disease, treatment of dry eyes with allogenic umbilical cord plasma drops has yet to be started in Singapore. PURPOSE To evaluate the effectiveness of umbilical cord plasma eyedrops for the treatment of recalcitrant dry eyes in a local Singaporean context. METHODS This is an observational, longitudinal, interventional study for dry eye patients who did not show clear improvement after standard therapy. Patients were recruited from 2020 to 2023 from the dry eye clinic of the Singapore National Eye Center. Umbilical cord plasma was delivered frozen to patients and stored in home freezers. All participants underwent a standardized clinical evaluation for dry eye, and data were collected. RESULTS There were 40 participants (7 males and 33 females). The duration of follow-up was 5.52 ± 1.57 months. Kerato-epitheliopathy staining score, TBUT (tear breakup time), and SPEED (Standard Patient Evaluation of Eye Dryness Questionnaire) scores significantly improved after treatment. No statistically significant improvement was found in terms of visual acuity, according to Schirmer's score. CONCLUSION Cord plasma eye drops significantly improved kerato-epitheliopathy staining scores in recalcitrant dry eye patients. Allogeneic plasma is a promising form of treatment for recalcitrant dry eye.
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Affiliation(s)
- Joy Wong
- Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore; (J.W.); (G.G.)
| | - Gayathri Govindasamy
- Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore; (J.W.); (G.G.)
| | - Arun Prasath
- Singapore Cord Blood Bank, 100 Bukit Timah Road, KK Women’s & Children’s Hospital Women’s Tower, Women’s Specialist Clinics, Level 1, Singapore 229899, Singapore; (A.P.); (W.H.); (A.H.)
| | - William Hwang
- Singapore Cord Blood Bank, 100 Bukit Timah Road, KK Women’s & Children’s Hospital Women’s Tower, Women’s Specialist Clinics, Level 1, Singapore 229899, Singapore; (A.P.); (W.H.); (A.H.)
- Department of Haematology, Singapore General Hospital, 31 Third Hospital Avenue, Singapore 168753, Singapore
| | - Aloysius Ho
- Singapore Cord Blood Bank, 100 Bukit Timah Road, KK Women’s & Children’s Hospital Women’s Tower, Women’s Specialist Clinics, Level 1, Singapore 229899, Singapore; (A.P.); (W.H.); (A.H.)
- Department of Haematology, Singapore General Hospital, 31 Third Hospital Avenue, Singapore 168753, Singapore
| | - Sharon Yeo
- Singapore Eye Research Institute, 20 College Road Discovery Tower Level 6, The Academia, Singapore 169856, Singapore;
| | - Louis Tong
- Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore; (J.W.); (G.G.)
- Singapore Eye Research Institute, 20 College Road Discovery Tower Level 6, The Academia, Singapore 169856, Singapore;
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
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2
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Xue F, Lin SJ, Song M, Hwang W, Klewe C, Lee CM, Turgut E, Shafer P, Vailionis A, Huang YL, Tsai W, Bao X, Wang SX. Field-free spin-orbit torque switching assisted by in-plane unconventional spin torque in ultrathin [Pt/Co] N. Nat Commun 2023; 14:3932. [PMID: 37402728 DOI: 10.1038/s41467-023-39649-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 06/22/2023] [Indexed: 07/06/2023] Open
Abstract
Electrical manipulation of magnetization without an external magnetic field is critical for the development of advanced non-volatile magnetic-memory technology that can achieve high memory density and low energy consumption. Several recent studies have revealed efficient out-of-plane spin-orbit torques (SOTs) in a variety of materials for field-free type-z SOT switching. Here, we report on the corresponding type-x configuration, showing significant in-plane unconventional spin polarizations from sputtered ultrathin [Pt/Co]N, which are either highly textured on single crystalline MgO substrates or randomly textured on SiO2 coated Si substrates. The unconventional spin currents generated in the low-dimensional Co films result from the strong orbital magnetic moment, which has been observed by X-ray magnetic circular dichroism (XMCD) measurement. The x-polarized spin torque efficiency reaches up to -0.083 and favors complete field-free switching of CoFeB magnetized along the in-plane charge current direction. Micromagnetic simulations additionally demonstrate its lower switching current than type-y switching, especially in narrow current pulses. Our work provides additional pathways for electrical manipulation of spintronic devices in the pursuit of high-speed, high-density, and low-energy non-volatile memory.
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Affiliation(s)
- Fen Xue
- Department of Electrical Engineering, Stanford University, Stanford, CA, 94305, USA.
| | - Shy-Jay Lin
- Taiwan Semiconductor Manufacturing Company, Hsinchu, Taiwan
| | - Mingyuan Song
- Taiwan Semiconductor Manufacturing Company, Hsinchu, Taiwan
| | - William Hwang
- Department of Electrical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Christoph Klewe
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - Chien-Min Lee
- Taiwan Semiconductor Manufacturing Company, Hsinchu, Taiwan
| | - Emrah Turgut
- Taiwan Semiconductor Manufacturing Company, Hsinchu, Taiwan
| | - Padraic Shafer
- Advanced Light Source, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - Arturas Vailionis
- Stanford Nano Shared Facilities, Stanford University, Stanford, CA, 94305, USA
- Department of Physics, Kaunas University of Technology, LT-51368, Kaunas, Lithuania
| | - Yen-Lin Huang
- Taiwan Semiconductor Manufacturing Company, Hsinchu, Taiwan
| | - Wilman Tsai
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Xinyu Bao
- Taiwan Semiconductor Manufacturing Company, Hsinchu, Taiwan
| | - Shan X Wang
- Department of Electrical Engineering, Stanford University, Stanford, CA, 94305, USA.
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, 94305, USA.
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3
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Ahn S, Hwang W, Cho S, Lee H, Kim J, Park H, Moon D, Oh M. Do changes in metabolic health and obesity affect the incidence of urolithiasis? A nationally representative cohort study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00429-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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4
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Jo S, Ahn S, Hwang W, Lee H, Kim J, Oh M, Moon D, Park H. Differences in the composition of urinary stone in metabolically healthy and unhealthy obese patients. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00436-0] [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: 02/12/2023]
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5
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Hong J, Seo K, Hwang W, Moon M. 303P Long-term oncologic outcomes for patients undergoing volatile versus intravenous anesthesia for non-small cell lung cancer surgery. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.331] [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: 12/07/2022] Open
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6
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Fan X, Ng CT, Guo D, Lim F, Tan JC, Law A, Goh LH, Poon ZY, Cheung A, Kong SL, Tan M, Li S, Loh A, James A, Lim T, Chen J, Thumboo J, Hwang W, Low A. Dampened Inflammation and Improved Survival After CXCL5 Administration in Murine Lupus via Myeloid and Neutrophil Pathways. Arthritis Rheumatol 2022; 75:553-566. [PMID: 36240108 DOI: 10.1002/art.42383] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 09/27/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the efficacy of CXCL5 administration in lupus-prone MRL/lpr (Faslpr ) mice and elucidate its working mechanisms. METHODS CXCL5 expression in blood (obtained from SLE patients and Faslpr mice) and major internal organs (obtained from Faslpr mice) was examined by Luminex, real-time polymerase chain reaction, and immunofluorescent staining analyses. Pharmacokinetic studies were performed in Faslpr mice and healthy Institute of Cancer Research mice. Efficacy of CXCL5 administration was demonstrated in Faslpr mice, and the working mechanism of CXCL5 treatment was elucidated by flow cytometry, Luminex, and RNA sequencing. RESULTS In SLE patients, serum CXCL5 levels were significantly lower than in healthy individuals (P < 0.0001) and negatively correlated with disease activity (P = 0.004). In Faslpr mice, disease severity progressed with age and was negatively associated with plasma CXCL5 levels. Intravenous administration of CXCL5 to Faslpr mice restored endogenous circulatory CXCL5, improved mice survival, and reduced anti-double-stranded DNA antibodies, proteinuria, lupus nephritis activity and chronicity indices, renal complements, and neutrophil extracellular traps over short-term (10 weeks) and long-term (2 years) time periods. In vitro and in vivo assays demonstrated that CXCL5 dictated neutrophil trafficking and suppressed neutrophil activation, degranulation, proliferation, and renal infiltration. Renal and splenic RNA sequencing further showed that CXCL5-mediated immunomodulation occurred by promoting energy production in renal-infiltrated immune cells, activating certain T cells, and reducing tissue fibrosis, granulocyte extravasation, complement components, and interferons. Further factorial design results indicated that CXCL5 appears to enhance host tolerability to cyclophosphamide in vulnerable individuals. CONCLUSION We found that serum CXCL5 levels were significantly lower in SLE patients than in healthy individuals and were negatively correlated with disease activity. By administering CXCL5 intravenously in a mouse model of lupus, mouse survival improved, and indices of disease activity reduced significantly. Taken together, these findings indicate CXCL5 administration may represent a novel myeloid/neutrophil-targeting therapy for SLE.
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Affiliation(s)
- Xiubo Fan
- Department of Clinical Translational Research, Singapore General Hospital, and SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Chin Teck Ng
- Department of Rheumatology and Immunology, Singapore General Hospital, and SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Dianyang Guo
- Department of Clinical Translational Research, Singapore General Hospital
| | - Frances Lim
- Department of Clinical Translational Research, Singapore General Hospital
| | - Jia Chi Tan
- Single-cell Computational Immunology, Singapore Immunology Network, Singapore
| | - Annie Law
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Lim Hee Goh
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Zhi Yong Poon
- Department of Clinical Translational Research, Singapore General Hospital, and Critical Analytics for Manufacturing Personalized Medicine, SMART, Singapore
| | - Alice Cheung
- Department of Hematology, Singapore General Hospital, and SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | | | - Michelle Tan
- Department of Clinical Translational Research, Singapore General Hospital
| | - Shang Li
- Cancer & Stem Cell Biology, Duke-NUS Medical School, Singapore
| | - Alwin Loh
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Anne James
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Tony Lim
- Department of Anatomical Pathology, Singapore General Hospital, Singapore
| | - Jinmiao Chen
- Single-cell Computational Immunology, Singapore Immunology Network, Singapore
| | - Julian Thumboo
- Department of Rheumatology and Immunology, Singapore General Hospital, and SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - William Hwang
- Department of Hematology, Singapore General Hospital, and National Cancer Centre Singapore, Singapore
| | - Andrea Low
- Department of Rheumatology and Immunology, Singapore General Hospital, and SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
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Lin C, Sajeev G, Sung A, Stiff P, Brunstein C, Cutler C, Sanz G, Lindemans C, Rezvani A, Hanna R, Koh L, Maziarz R, Hwang W, Song Y, Liu Q, Manghani R, Sivaraman S, Signorovitch J, Horwitz M. Abstract 8 Health-Related Quality of Life (HRQL) Following Transplantation with Omidubicel Versus Umbilical Cord Blood (UCB) in Patients with Hematologic Malignancies: Results from a Phase III Randomized, Multicenter Study. Stem Cells Transl Med 2022. [PMCID: PMC9446902 DOI: 10.1093/stcltm/szac057.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Omidubicel, an advanced cell therapy used for allogeneic hematopoietic stem cell transplant has demonstrated faster hematopoietic recovery, shorter hospitalization, and lower rates of bacterial, viral, and invasive fungal infections compared with umbilical cord blood (UCB) in a phase III randomized trial (NCT02730299;Blood 2021;138:1429).
Objective
The objective was to compare changes in health-related quality of life (HRQL) between treatment groups in the phase III trial.
Methods
Patients who received protocol-defined treatment and provided HRQL evaluations at baseline and ≥1 follow-up visit were analyzed. Outcomes included Functional Assessment of Cancer Therapy General (FACT-G) domain scores for physical, social/family, functional and emotional well-being, and EQ-5D-3L index scores, at days 42, 100, 180, and 365 post-transplant. HRQL changes from baseline were compared using mixed effect models with repeated measures, adjusting for age, sex, race, region, primary diagnosis, HCT comorbidity index, and baseline HRQL score. Average HRQL over time was compared using the area under the curve (AUC) of mean HRQL trajectories in each treatment group.
Results
Seventy-five patients (omidubiceln = 37, UCB n = 38) provided HRQL data for inclusion and were representative of the full randomized population (N = 125) at baseline. Median age was 38 years, and 41% were female. During the first year post-transplant, patients receiving omidubicel had numerically superior average FACT-G domain and EQ-5D-3L index scores compared with UCB, with mean differences across time points ranging from 1.4 to 3.1 for physical well-being, 0 to 1.3 for social/family well-being, 0.5 to 1.4 for emotional well-being, 1.6 to 3.2 for functional well-being, and 0.03 to 0.09 for the EQ-5D-3L index score. Minimal clinically important differences (MCIDs) were exceeded at ≥1 time point for mean physical and functional well-being (MCIDs = 2 units) and for the EQ-5D-3L (MCID = 0.07 units). Initial mean declines in HRQL occurred for all measures at day 42 and were consistently numerically smaller in the omidubicel group than in the UCB group. Averaging across the first year post-transplant, patients receiving omidubicel had significantly improved HRQL for physical and functional well-being domains (P < .05 for comparison of AUCs).
Discussion
Along with faster time to engraftment, lower infection risk, and shorter hospitalization, omidubicel was associated with meaningfully greater preservation or improvement of important HRQL domains compared with UCB.
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Affiliation(s)
- Chenyu Lin
- Adult Stem Cell Transplant Program, Division of Cellular Therapy, Department of Medicine, Duke University Medical Center , Durham, NC , USA
| | | | - Anthony Sung
- Adult Stem Cell Transplant Program, Division of Cellular Therapy, Department of Medicine, Duke University Medical Center , Durham, NC , USA
| | - Patrick Stiff
- Loyola University Medical Center , Chicago, IL , USA
| | - Claudio Brunstein
- Division of Hematology, Oncology and Transplantation, University of Minnesota , Minneapolis, MN , USA
| | | | - Guillermo Sanz
- Servicio de Hematologia, Hospital Universitari i Politècnic La Fe , Valencia , Spain
| | - Caroline Lindemans
- Division of Pediatrics, University Medical Center Utrecht , Utrecht , The Netherlands
| | - Andrew Rezvani
- Department of Medicine, Division of Blood and Marrow Transplantation, Stanford University School of Medicine , Stanford, CA , USA
| | - Rabi Hanna
- Department of Pediatric Hematology Oncology and Bone Marrow Transplantation, Cleveland Clinic Children’s Hospital , Cleveland, OH , USA
| | - Liang Koh
- Department of Haematology-Oncology, National University Cancer Institute , Singapore , Singapore
| | - Richard Maziarz
- Knight Cancer Institute, Oregon Health and Science University , Portland, OR , USA
| | - William Hwang
- Department of Hematology, Singapore General Hospital , Singapore , Singapore
| | - Yan Song
- Analysis Group , Boston, MA , USA
| | - Qing Liu
- Analysis Group , Boston, MA , USA
| | | | | | | | - Mitchell Horwitz
- Adult Stem Cell Transplant Program, Division of Cellular Therapy, Department of Medicine, Duke University Medical Center , Durham, NC , USA
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8
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Lim JQ, Huang D, Chan JY, Laurensia Y, Wong EKY, Cheah DMZ, Chia BKH, Chuang WY, Kuo MC, Su YJ, Cai QQ, Feng Y, Rao H, Feng LN, Wei PP, Chen JR, Han BW, Lin GW, Cai J, Fang Y, Tan J, Hong H, Liu Y, Zhang F, Li W, Poon MLM, Ng SB, Jeyasekharan A, Ha JCH, Khoo LP, Chin ST, Pang WL, Kee R, Cheng CL, Grigoropoulos NF, Tang T, Tao M, Farid M, Puan KJ, Xiong J, Zhao WL, Khor CC, Hwang W, Kim WS, Campo E, Tan P, Teh BT, Chng WJ, Rötzschke O, Tousseyn T, Huang HQ, Rozen S, Lim ST, Shih LY, Bei JX, Ong CK. A genomic-augmented multivariate prognostic model for the survival of Natural-killer/T-cell lymphoma patients from an international cohort. Am J Hematol 2022; 97:1159-1169. [PMID: 35726449 DOI: 10.1002/ajh.26636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/17/2022] [Accepted: 06/16/2022] [Indexed: 11/09/2022]
Abstract
With lowering costs of sequencing and genetic profiling techniques, genetic drivers can now be detected readily in tumors but current prognostic models for Natural-killer/T cell lymphoma (NKTCL) have yet to fully leverage on them for prognosticating patients. Here, we used next-generation sequencing to sequence 260 NKTCL tumors, and trained a genomic prognostic model (GPM) with the genomic mutations and survival data from this retrospective cohort of patients using LASSO Cox regression. The GPM is defined by the mutational status of 13 prognostic genes and is weakly correlated with the risk-features in International Prognostic Index (IPI), Prognostic Index for Natural-Killer cell lymphoma (PINK) and PINK-Epstein-Barr virus (PINK-E). Cox-proportional hazard multivariate regression also showed that the new GPM is independent and significant for both progression-free survival (PFS, HR: 3.73, 95% CI 2.07-6.73; P<0.001) and overall survival (OS, HR: 5.23, 95% CI 2.57-10.65; P=0.001) with known risk-features of these indices. When we assign an additional risk-score to samples, which are mutant for the GPM, the Harrell's C-indices of GPM-augmented IPI, PINK and PINK-E improved significantly (P<0.001, χ2 test) for both PFS and OS. Thus, we report on how genomic mutational information could steer towards better prognostication of NKTCL patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jing Quan Lim
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Lymphoma Genomic Translational Research Laboratory, Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore.,ONCO-ACP, Duke-NUS Medical School, 8 College Road, Singapore
| | - Dachuan Huang
- Lymphoma Genomic Translational Research Laboratory, Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore.,ONCO-ACP, Duke-NUS Medical School, 8 College Road, Singapore
| | - Jason Yongsheng Chan
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Yurike Laurensia
- Lymphoma Genomic Translational Research Laboratory, Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Esther Kam Yin Wong
- Lymphoma Genomic Translational Research Laboratory, Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Daryl Ming Zhe Cheah
- Lymphoma Genomic Translational Research Laboratory, Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Burton Kuan Hui Chia
- Lymphoma Genomic Translational Research Laboratory, Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Wen-Yu Chuang
- Department of Anatomic Pathology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Chang Gung University, Taoyuan, Taiwan
| | - Ming-Chung Kuo
- Chang Gung University, Taoyuan, Taiwan.,Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yi-Jiun Su
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Qing-Qing Cai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yanfen Feng
- Guangdong Provincial People's Hospital.,Guangdong Academy of Medical Sciences
| | - Huilan Rao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Li-Na Feng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Pan-Pan Wei
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jie-Rong Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Bo-Wei Han
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Guo-Wang Lin
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jun Cai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yu Fang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jing Tan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Lymphoma Genomic Translational Research Laboratory, Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore.,Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Huangming Hong
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yanhui Liu
- Guangdong Provincial People's Hospital.,Guangdong Academy of Medical Sciences
| | - Fen Zhang
- Guangdong Provincial People's Hospital.,Guangdong Academy of Medical Sciences
| | - Wenyu Li
- Guangdong Provincial People's Hospital.,Guangdong Academy of Medical Sciences
| | - Michelle L M Poon
- Department of Haematology-Oncology, National University Cancer Institute of Singapore, National University Health System, Singapore
| | - Siok-Bian Ng
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Anand Jeyasekharan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.,Department of Haematology-Oncology, National University Health System, Singapore
| | - Jeslin Chian Hung Ha
- Lymphoma Genomic Translational Research Laboratory, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Lay Poh Khoo
- Lymphoma Genomic Translational Research Laboratory, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Suk Teng Chin
- Lymphoma Genomic Translational Research Laboratory, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Wan Lu Pang
- Lymphoma Genomic Translational Research Laboratory, Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Rebecca Kee
- Lymphoma Genomic Translational Research Laboratory, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Chee Leong Cheng
- Department of Pathology, Singapore General Hospital, 20 College Road, Academia, Singapore
| | | | - Tiffany Tang
- ONCO-ACP, Duke-NUS Medical School, 8 College Road, Singapore
| | - Miriam Tao
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Mohamad Farid
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore
| | - Kia Joo Puan
- Singapore Immunology Network (SIgN), A*STAR (Agency for Science, Technology and Research), 8A Biomedical Grove, Singapore, Singapore
| | - Jie Xiong
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei-Li Zhao
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chiea Chuen Khor
- Genome Institute of Singapore, 60 Biopolis Street Genome, Singapore
| | - William Hwang
- Director's office, National Cancer Centre, Singapore
| | - Won Seog Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Elias Campo
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain
| | - Patrick Tan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore.,Genome Institute of Singapore, 60 Biopolis Street Genome, Singapore.,Division of Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore
| | - Bin Tean Teh
- Laboratory of Cancer Epigenome, Division of Medical Sciences, National Cancer Centre Singapore, 11 Hospital Drive, Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Singapore.,Division of Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore
| | - Wee-Joo Chng
- Department of Haematology-Oncology, National University Cancer Institute of Singapore, National University Health System, Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Olaf Rötzschke
- Singapore Immunology Network (SIgN), A*STAR (Agency for Science, Technology and Research), 8A Biomedical Grove, Sinagpore, Singapore
| | - Thomas Tousseyn
- KU Leuven, Department of Imaging and Pathology, Translational Cell and Tissue Research Lab, Herestraat 49, Leuven, Belgium.,UZ Leuven, Department of Pathology, Leuven, Belgium
| | - Hui-Qiang Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Steve Rozen
- Division of Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore.,Centre for Computational Biology, Duke-NUS Medical School, 8 College Road, Singapore
| | - Soon Thye Lim
- Director's office, National Cancer Centre, Singapore.,Office of Education, Duke-NUS Medical School, Singapore
| | - Lee-Yung Shih
- Chang Gung University, Taoyuan, Taiwan.,Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Jin-Xin Bei
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Choon Kiat Ong
- Lymphoma Genomic Translational Research Laboratory, Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore.,Genome Institute of Singapore, 60 Biopolis Street Genome, Singapore.,Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, 8 College Road, Singapore
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Freed-Pastor W, Lambert L, Ely Z, Pattada N, Bhutkar A, Jaeger A, Eng G, Mercer K, Hwang W, Jacks T. Abstract PO-063: Functional interrogation of immune escape in neoantigen-expressing pancreatic cancer identifies a critical role for the CD155/TIGIT axis. Cancer Res 2021. [DOI: 10.1158/1538-7445.panca21-po-063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The CD155/TIGIT axis can be co-opted during immune evasion in chronic viral infections and cancer. While insights regarding mechanisms of immune escape have fueled tremendous clinical successes in a broad range of tumor types, microsatellite-stable pancreatic adenocarcinoma (PDAC), which represents greater than 98% of patients, is largely refractory to available immune checkpoint blockade. The recent recognition that a subset of pancreas cancer harbors potential neoantigens has intensified interest in defining the molecular and cellular mechanisms of immune evasion in PDAC to guide effective therapeutic strategies that leverage the adaptive immune system in this disease. However, difficulty in precisely defining the tumor-reactive T cell compartment has hampered prior efforts to delineate the full spectrum of mechanisms by which PDAC evades immune eradication. We recently developed multiple organoid-based and autochthonous preclinical models to delineate the molecular and cellular mechanisms of immune evasion in this subset of patients. Specifically, we utilized a high affinity MHC class I-restricted antigen (OVA257–264) or recently described missense-derived MHC class I-restricted neoantigens (mutations in the laminin 4 alpha subunit or in alpha-1,3-glucosyltransferase). While a subset of animals either successfully clear these tumors, or are arrested in a state of immune-mediated tumor dormancy, all three neoantigen models lead to a significant subset of tumors that acquire the ability to evade immune clearance. In these preclinical models, we demonstrate that intratumoral neoantigen-specific CD8+ T cells adopt multiple states of dysfunction, typified by T cell exhaustion (best marked by TIGIT+PD1+ co-positivity). Global profiling of the tumor-immune microenvironment in neoantigen-expressing murine PDAC compared to non-neoantigen-expressing PDAC identified an expected increase in CD8+ T cells, and specifically in neoantigen-specific CD8+ T cells, but also identified additional changes within the broader leukocyte contexture. Using flow cytometric and single-cell transcriptomic analyses, we demonstrate that human PDAC TILs express similar dysfunctional programs and are enriched in TIGIT+PD1+ TILs. Furthermore, we show that CD155, the high affinity TIGIT ligand, is highly expressed on the surface of murine and human PDAC tumor cells. Using genetic (CRISPR-activation) and/or pharmacologic modulation, we functionally interrogate the CD155/TIGIT axis and demonstrate that increased signaling through CD155 and/or TIGIT is sufficient to promote immune evasion in neoantigen-expressing PDAC. Lastly, we identified a combination immunotherapy (TIGIT/PD-1 co-blockade plus CD40 agonism) that elicits profound anti-tumor responses in these preclinical models. Using a suite of high-resolution analyses, we are dissecting the mechanisms of effectiveness and resistance to this combination immunotherapy, which is set to enter clinical trials in pancreatic cancer later this year.
Citation Format: William Freed-Pastor, Laurens Lambert, Zackery Ely, Nimisha Pattada, Arjun Bhutkar, Alex Jaeger, George Eng, Kim Mercer, William Hwang, Tyler Jacks. Functional interrogation of immune escape in neoantigen-expressing pancreatic cancer identifies a critical role for the CD155/TIGIT axis [abstract]. In: Proceedings of the AACR Virtual Special Conference on Pancreatic Cancer; 2021 Sep 29-30. Philadelphia (PA): AACR; Cancer Res 2021;81(22 Suppl):Abstract nr PO-063.
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Herman MA, Aiello BR, DeLong JD, Garcia-Ruiz H, González AL, Hwang W, McBeth C, Stojković EA, Trakselis MA, Yakoby N. A Unifying Framework for Understanding Biological Structures and Functions Across Levels of Biological Organization. Integr Comp Biol 2021; 61:2038-2047. [PMID: 34302339 DOI: 10.1093/icb/icab167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 12/14/2022] Open
Abstract
The relationship between structure and function is a major constituent of the rules of life. Structures and functions occur across all levels of biological organization. Current efforts to integrate conceptual frameworks and approaches to address new and old questions promise to allow a more holistic and robust understanding of how different biological functions are achieved across levels of biological organization. Here, we provide unifying and generalizable definitions of both structure and function that can be applied across all levels of biological organization. However, we find differences in the nature of structures at the organismal level and below as compared to above the level of the organism. We term these intrinsic and emergent structures, respectively. Intrinsic structures are directly under selection, contributing to the overall performance (fitness) of the individual organism. Emergent structures involve interactions among aggregations of organisms and are not directly under selection. Given this distinction, we argue that while the functions of many intrinsic structures remain unknown, functions of emergent structures are the result of the aggregate of processes of individual organisms. We then provide a detailed and unified framework of the structure-function relationship for intrinsic structures to explore how their unknown functions can be defined. We provide examples of how these scalable definitions applied to intrinsic structures provide a framework to address questions on structure-function relationships that can be approached simultaneously from all subdisciplines of biology. We propose that this will produce a more holistic and robust understanding of how different biological functions are achieved across levels of biological organization.
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Affiliation(s)
- M A Herman
- School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE 68588-0118
| | - B R Aiello
- Schools of Physics and Biological Sciences, Georgia Institute of Technology, Atlanta, GA 30332
| | - J D DeLong
- School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE 68588-0118
| | - H Garcia-Ruiz
- Department of Plant Pathology, Nebraska Center for Virology, University of Nebraska-Lincoln, Lincoln, NE 68503
| | - A L González
- Department of Biology & Center for Computational and Integrative Biology, Rutgers University, Camden, NJ
| | - W Hwang
- Departments of Biomedical Engineering, Materials Science & Engineering, and Physics & Astronomy, Texas A&M University, College Station, TX 77843-3127
| | - C McBeth
- Fraunhofer USA CMI and Boston University, Boston, MA
| | - E A Stojković
- Department of Biology, Northeastern Illinois University, Chicago, IL 60641, USA
| | - M A Trakselis
- Department of Chemistry and Biochemistry, Baylor University, One Bear Place #97348, Waco, TX 76798
| | - N Yakoby
- Department of Biology & Center for Computational and Integrative Biology, Rutgers University, Camden, NJ
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Xie B, Alismail S, Masood S, Lei X, Le M, Niu Z, Cordola Hsu AR, Li Y, Hwang W. Psychosocial adjustment mediates impacts of playmate positive support on body mass index and overweight risk in adolescents. Public Health 2021; 196:223-228. [PMID: 34280750 DOI: 10.1016/j.puhe.2021.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 05/19/2021] [Accepted: 05/28/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES We examined the mediation effects of psychosocial adjustment on the impact of playmate positive support throughout childhood and early adolescence (from age 54 months to 11 years) on later body mass index (BMI) and overweight risk in middle adolescence (age 15 years). STUDY DESIGN This was a prospective cohort study. METHODS Among 844 children and their families, positive support between child-playmate dyads was repeatedly assessed from child's age 54 months to Grade 5. Long-term positive support between child-playmate dyads throughout childhood and early adolescence was prospectively linked to child's BMI and overweight/obesity status at age 15 years. The average scores of repeated assessments of internalizing and externalizing behavior problems from Grades 3 to 6 were used as mediators. RESULTS Significant mediations of internalizing and externalizing behavior problems were observed on pathways from positive support between child-playmate dyads to later BMI and overweight/obesity status at age 15 years. The observed mediations were mainly sustained with pronounced magnitudes in girls, but not in boys. CONCLUSIONS Our findings demonstrated a significant mediating role of psychosocial adjustment. Future research efforts are highly encouraged to replicate our findings and further explore this underlying mediation mechanism.
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Affiliation(s)
- B Xie
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, 91711, USA.
| | - S Alismail
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, 91711, USA
| | - S Masood
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, 91711, USA; School of Medicine, California University of Science and Medicine, San Bernardino, CA, 92408, USA
| | - X Lei
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, 91711, USA; Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - M Le
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, 91711, USA
| | - Z Niu
- Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, 14260
| | - A R Cordola Hsu
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, 91711, USA; Heart Disease Prevention Program, Division of Cardiology, Department of Medicine, University of California at Irvine School of Medicine, Irvine, CA, 92617, USA
| | - Y Li
- School of Social Work, San Diego State University, San Diego, CA, 92182, USA
| | - W Hwang
- Department of Psychological Science, Claremont McKenna College, Claremont, CA, 91711, USA
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Lim F, Guo D, Chen J, Law A, Poon ZY, Cheung A, Tan JC, Kong SL, Loh AHL, Tan MGK, Li S, Lim KH, Thumboo J, Ng CT, Hwang W, Low A, Fan X. POS0417 EXOGENOUS CXCL5 RESTORES ENDOGENOUS BLOOD-TISSUE CHEMOKINE GRADIENT TO IMPROVE SURVIVAL IN MURINE LUPUS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disease that is potentially fatal. There is an unmet need to improve current therapies. In patients with SLE, we observed that serum CXCL5 levels were significantly lower than healthy control subjects and negatively correlated with disease activity(1-9).Objectives:The aim of this study is to elucidate the effect of supplemental serum CXCL5 in abrogating the pathological processes of SLE.Methods:Ten doses of exogenous CXCL5 (3µg/kg) was administered to 16-week-old Faslpr mice weekly by intravenous injection. Mice were monitored for 10 weeks. Splenic immune profile was measured by flow cytometry. Circulating cytokine and immunoglobulin profile were detected by Luminex technology. Renal function was evaluated by urinary spot albumin creatinine ratio. In situ renal immune cell infiltration and complement 3 deposition were detected by Haematoxylin and Eosin (H&E) and immunohistochemistry staining. The molecular pathways involved were examined by RNA sequencing.Results:In Faslpr mice, intravenous administration of exogenous CXCL5 significantly improved mouse survival with concomitant reduction of autoantibody secretion, proteinuria, complement 3 deposition, neutrophil infiltration and lupus nephritis classes. Through evaluating the changes of immune profile, cytokine profile and molecular pathways, we found that intravenous CXCL5 reduced inflammation via an orchestral effect of regulating neutrophil trafficking and modulating helper T cell-mediated immune response. Pharmacokinetic and real-time Polymerase Chain Reaction studies further demonstrated that this orchestration was triggered by a cascade reaction - restoring vascular under-expressed CXCL5 by an exogenous stimulation, re-establishing the normal serum levels of endogenous CXCL5 and reverting the CXCL5 chemokine gradient between inflamed tissues and blood circulation.Conclusion:Managing the dysregulation of CXCL5 by exogenous supplement may provide a new option for SLE therapy.References:[1]Dufies M, Grytsai O, Ronco C, et al. New CXCR1/CXCR2 inhibitors represent an effective treatment for kidney or head and neck cancers sensitive or refractory to reference treatments. Theranostics. 2019;9(18):5332-5346. doi:10.7150/thno.34681[2]Yildirim K, Colak E, Aktimur R, et al. Clinical Value of CXCL5 for Determining of Colorectal Cancer. Asian Pac J Cancer Prev. Sep 26 2018;19(9):2481-2484. doi:10.22034/apjcp.2018.19.9.2481[3]Wu K, Yu S, Liu Q, Bai X, Zheng X. The clinical significance of CXCL5 in non-small cell lung cancer. Onco Targets Ther. 2017;10:5561-5573. doi:10.2147/ott.s148772[4]Zhao J, Ou B, Han D, et al. Tumor-derived CXCL5 promotes human colorectal cancer metastasis through activation of the ERK/Elk-1/Snail and AKT/GSK3beta/beta-catenin pathways. Mol Cancer. Mar 29 2017;16(1):70. doi:10.1186/s12943-017-0629-4[5]Han KQ, Han H, He XQ, et al. Chemokine CXCL1 may serve as a potential molecular target for hepatocellular carcinoma. Cancer Med. Oct 2016;5(10):2861-2871. doi:10.1002/cam4.843[6]Pappa CA, Tsirakis G, Kanellou P, et al. Monitoring serum levels ELR+ CXC chemokines and the relationship between microvessel density and angiogenic growth factors in multiple myeloma. Cytokine. Dec 2011;56(3):616-20. doi:10.1016/j.cyto.2011.08.034[7]Zhang L, Li H, Ge C, et al. CXCL3 contributes to CD133(+) CSCs maintenance and forms a positive feedback regulation loop with CD133 in HCC via Erk1/2 phosphorylation. Sci Rep. Jun 3 2016;6:27426. doi:10.1038/srep27426[8]Matsubara J, Honda K, Ono M, et al. Reduced plasma level of CXC chemokine ligand 7 in patients with pancreatic cancer. Cancer Epidemiol Biomarkers Prev. Jan 2011;20(1):160-71. doi:10.1158/1055- 9965.epi-10-0397[9]Ma Y, Ren Y, Dai ZJ, Wu CJ, Ji YH, Xu J. IL-6, IL-8 and TNF-alpha levels correlate with disease stage in breast cancer patients. Adv Clin Exp Med. May-Jun 2017;26(3):421-426. doi:10.17219/acem/62120Disclosure of Interests:None declared
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Gatellier L, Shankar A, Dewi LKM, Hussain QM, Dendup Wangdi T, Sukumaran DB, Sari NK, Tavakkoli Shiraji S, Biglari M, Tahmasebi M, Iwata S, Suzuki T, Myung SK, Chun JY, Han JS, Lau FN, Yusak S, Bayarsaikhan L, Mu KT, Pradhananga KK, Yusuf A, Lin CH, Chiang RCJ, Sangrajran S, Nguyen QT, Huong GN, Soe AN, Sharma DN, Sengar M, Pramesh CS, Matsuda T, Jarrahi AM, Hwang W. The Impact of COVID-19 on Cancer Care in the Post Pandemic World: Five Major Lessons Learnt from Challenges and Countermeasures of Major Asian Cancer Centres. Asian Pac J Cancer Prev 2021; 22:681-690. [PMID: 33773529 PMCID: PMC8286686 DOI: 10.31557/apjcp.2021.22.3.681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: The COVID-19 pandemic has dramatically affected healthcare services around Asia. The Asian National Cancer Centres Alliance and the Asia-Pacific Organisation for Cancer Prevention collaborated to assess the mid- and long- term impact of COVID-19 to cancer care in Asia. Methods: The two entities organised a combined symposium and post-meeting interactions among representatives of major cancer centres from seventeen Asian countries to outlining major challenges and countermeasures. Results: Participating stakeholders distilled five big questions. 1) “Will there be an explosion of late-stage cancers after the pandemic?” To address and recover from perceived delayed prevention, screening, treatment and care challenges, collaboration of key stakeholders in the region and alignment in cancer care management, policy intervention and cancer registry initiatives would be of essential value. 2) “Operations and Finance” The pandemic has resulted in significant material and financial casualties. Flagged acute challenges (shortages of supplies, imposition of lockdown) as well as longer-standing reduction of financial revenue, manpower, international collaboration, and training should also be addressed. 3) “Will telemedicine and technological innovations revolutionize cancer care?” Deploying and implementing telemedicine such as teleconsultation and virtual tumour boards were considered invaluable. These innovations could become a new regular practice, leading to expansion of tele-collaboration through collaboration of institutions in the region. 4) “Will virtual conferences continue after the pandemic?” Virtual conferences during the pandemic have opened new doors for knowledge sharing, especially for representatives of low- and middle-income countries in the region, while saving time and costs of travel. 5) “How do we prepare for the next pandemic or international emergency?” Roadmaps for action to improve access to appropriate patient care and research were identified and scrutinised. Conclusion: Through addressing these five big questions, focused collaboration among members and with international organisations such as City Cancer Challenge will allow enhanced preparedness for future international emergencies.
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Affiliation(s)
| | - Abhishek Shankar
- Lady Hardinge Medical College & Associated Hospitals, Delhi, India
| | - Luh K Mela Dewi
- Dharmais Hospital - National Cancer Center, Jakarta, Indonesia
| | | | | | | | | | - Sahar Tavakkoli Shiraji
- Hematology, Oncology and Bone Marrow transplantation Research Center, Shariati Hospital, Tehran University of Medical Science,Tehran, Iran
| | - Mohammad Biglari
- Hematology, Oncology and Bone Marrow transplantation Research Center, Shariati Hospital, Tehran University of Medical Science,Tehran, Iran
| | - Mamak Tahmasebi
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Seung-Kwon Myung
- National Cancer Center of Korea, Goyang-si Gyeonggi-do, Republic of Korea
| | - June Young Chun
- National Cancer Center of Korea, Goyang-si Gyeonggi-do, Republic of Korea
| | - Jong Soo Han
- National Cancer Center of Korea, Goyang-si Gyeonggi-do, Republic of Korea
| | - Fen Nee Lau
- National Cancer Institute, Putrajaya, Malaysia
| | | | | | - Khin Thin Mu
- Myanmar Yangon General Hospital, Yangon, Myanmar
| | | | - Aasim Yusuf
- Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
| | - Ching-Hung Lin
- National Taiwan University Cancer Center Hospital, Taipei City, Taiwan
| | - Ruru Chun-Ju Chiang
- Taiwan Cancer Registry, and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | | | | | | | - D N Sharma
- Dr BR Ambedkar Institute Rotary Cancer Hospital & National Cancer Institute, All India Institute of Medical Sciences, Delhi, India
| | - Manju Sengar
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - C S Pramesh
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Guo J, Hoffman H, Hwang P, Kim D, Alshalalfa M, Mahal B, Hong T, Hwang W. Pan-cancer Transcriptomic Determinants Of Perineural Invasion And Lymphovascular Invasion. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1609] [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: 11/24/2022]
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Westcott PMK, Sacks NJ, Smith O, Schenkel J, Ely Z, Zhang D, Beytagh MC, Hwang W, Eng G, Roper J, Yilmaz O, Jacks T. Abstract 3447: T cell antigen expression levels govern progression and therapy response in a novel model of colon cancer. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-3447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Genetically-engineered mouse models have greatly advanced our understanding of cancer, yet do not recapitulate the mutational complexity of human cancer, and likely lack neo-antigens capable of eliciting potent anti-tumor T cell responses. We developed a novel orthotopic organoid transplant model of colorectal cancer (CRC) harboring the strong T cell antigen SIINFEKL, and demonstrate the importance of antigen expression level in the anti-tumor T cell response. Although SIINFEKL low-expressing organoids (SIINLow) elicit an endogenous antigen-specific T cell response, the magnitude is substantially lower and kinetics delayed relative to SIINFEKL high-expressing organoids (SIINHi). Consistently, transplant of SIINHi results in rejection and T cell memory, while SIINLow results in tumor progression, terminally-exhausted T cells, and metastasis to the liver. We have shown that suboptimal T cell priming is the major factor underlying SIINLow tumor escape. Importantly, co-transplant of SIINHi and SIINLow organoids at distinct sites in the colon of the same animal results in complete rejection of both lines. In addition, co-transplant rescues the SIINLow tumor-infiltrating antigen-specific T cell response to a magnitude and quality comparable to that of SIINHi tumors. Single-cell RNA-sequencing of antigen-specific T cells from SIINHi and SIINLow tumors 8 days post-transplant revealed distinct clusters dominated by SIINLow-primed T cells, including a cluster enriched for immediate early response genes, Tox, and a number of immune checkpoints, indicative of early dysfunction. Collectively, our results establish the existence of a neo-antigen expression threshold at which T cell priming is limiting, resulting in attenuated magnitude and functionality of the T cell response, and tumor escape. To assess the therapeutic relevance of a poorly-expressed neo-antigen in CRC, we performed preclinical trials with immune checkpoint blockade and agonistic-CD40 (aCD40), which has been shown to potentiate T cell priming and response in poorly-immunogenic mouse and human pancreatic adenocarcinoma. While monotherapies showed only modest effects, the combination of checkpoint blockade and aCD40 resulted in an 80% response rate with a number of complete responses. In conclusion, antigen expression level is a critical determinant of T cell dysfunction, resulting from poor priming. Our results argue that targeting T cell priming may be a promising therapeutic strategy to invigorate anti-tumor immunity in human CRC, the majority of which remains refractory to immunotherapy.
Citation Format: Peter Maxwell Kienitz Westcott, Nathan J. Sacks, Olivia Smith, Jason Schenkel, Zackery Ely, Daniel Zhang, Mary Clare Beytagh, William Hwang, George Eng, Jatin Roper, Omer Yilmaz, Tyler Jacks. T cell antigen expression levels govern progression and therapy response in a novel model of colon cancer [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3447.
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Affiliation(s)
| | - Nathan J. Sacks
- MIT Koch Institute for Integrated Cancer Res., Cambridge, MA
| | - Olivia Smith
- MIT Koch Institute for Integrated Cancer Res., Cambridge, MA
| | - Jason Schenkel
- MIT Koch Institute for Integrated Cancer Res., Cambridge, MA
| | - Zackery Ely
- MIT Koch Institute for Integrated Cancer Res., Cambridge, MA
| | - Daniel Zhang
- MIT Koch Institute for Integrated Cancer Res., Cambridge, MA
| | | | - William Hwang
- MIT Koch Institute for Integrated Cancer Res., Cambridge, MA
| | - George Eng
- MIT Koch Institute for Integrated Cancer Res., Cambridge, MA
| | - Jatin Roper
- MIT Koch Institute for Integrated Cancer Res., Cambridge, MA
| | - Omer Yilmaz
- MIT Koch Institute for Integrated Cancer Res., Cambridge, MA
| | - Tyler Jacks
- MIT Koch Institute for Integrated Cancer Res., Cambridge, MA
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Fan X, Guo D, Ng CT, Law A, Poon ZY, Cheung A, Lim KH, Thumboo J, Hwang W, Low A. AB0128 CXCL5 DAMPENS INFLAMMATION IN THE PRE-CLINICAL MODEL OF SYSTEMIC LUPUS ERYTHEMATOSUS VIA THE ORCHESTRAL EFFECT OF REGULATING NEUTROPHIL TRAFFICKING AND SUPPRESSING HELPER T CELL-MEDIATED IMMUNE RESPONSE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Patients with systemic lupus erythematosus (SLE) suffer from severe morbidity and mortality1-4, either from the disease itself or from side effects of immunosuppression5. Discovery of novel effective therapies with less toxicity is an urgent need.Objectives:The aim of this study is to elucidate the therapeutic potential and working mechanism of cytokine CXCL5 in lupus mice.Methods:Treatment with CXCL5, bone marrow (BM)-MSCs, standard of care (SOC) with combination of methylprednisolone and cyclophosphamide was given to 16-week-old Faslprmice. Mice were monitored for 10 weeks. Splenic immune cell subsets were measured by flow cytometry. Circulating cytokine and immunoglobulin were detected by Luminex technology. Renal function was evaluated by urinary spot albumin creatinine ratio. In situ renal immune cell infiltration and complement 3 deposition were detected by Haematoxylin and Eosin (H&E) staining and immunohistochemistry.Results:CXCL5 demonstrated consistent and potent immunosuppressive capacity in suppressing SLE with reduced autoantibody secretion, lymphoproliferation and preserved kidney function. With further exploration, we proved that CXCL5 reduced the proliferation of helper T cells (TH1 and TH2) in thein vitrofunctional assay. When we administrated CXCL5 to lupus mice, it promoted the proliferation of regulatory T cells and reduced the proliferation of TH17 cells, macrophages and neutrophils. Multiple proinflammatory cytokines including IL-2, IL-6, IL-12, IL-17A, KC/CXCL1, MIP-1β/CCL4 and TNF-α were also reduced. When combined with SOC, CXCL5 boosted its therapeutic effect and reduced the relevant indices of disease activity. When we correlated the effect of four different treatment groups (CXCL5, BM-MSCs, SOC, and CXCL5 plus SOC) on mice survival and target cell changes, we found that TH17 cells were the key effector cells involved in the pathogenesis of SLE.Conclusion:These findings demonstrated that CXCL5 dampens inflammation in the pre-clinical model of systemic lupus erythematosus via the orchestral effect of regulating neutrophil trafficking and suppressing helper T cell-mediated immune response. Administrating exogenous CXCL5 might be an attractive option to treat patients with lupus.References:[1]Ji S, Guo Q, Han Y, Tan G, Luo Y, Zeng F. Mesenchymal stem cell transplantation inhibits abnormal activation of Akt/GSK3beta signaling pathway in T cells from systemic lupus erythematosus mice.Cell Physiol Biochem.2012;29(5-6):705-712.[2]Peng SL. Altered T and B lymphocyte signaling pathways in lupus.Autoimmun Rev.2009;8(3):179-183.[3]Ferucci ED, Johnston JM, Gaddy JR, et al. Prevalence and incidence of systemic lupus erythematosus in a population-based registry of American Indian and Alaska Native people, 2007-2009.Arthritis Rheumatol.2014;66(9):2494-2502.[4]Jakes RW, Bae SC, Louthrenoo W, Mok CC, Navarra SV, Kwon N. Systematic review of the epidemiology of systemic lupus erythematosus in the Asia-Pacific region: prevalence, incidence, clinical features, and mortality.Arthritis Care Res (Hoboken).2012;64(2):159-168.[5]Sattwika PD, Mustafa R, Paramaiswari A, Herningtyas EH. Stem cells for lupus nephritis: a concise review of current knowledge.Lupus.2018;27(12):1881-1897.Acknowledgments:The work was supported by SMART II Centre Grant (NMRC/CG/M011/2017_SGH) and SingHealth Foundation (SHF/FG638P/2016).Disclosure of Interests:None declared
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Pwint KSW, Chen Y, Diong CP, Goh YT, Grant D, Ho A, Hwang W, Kumar S, Lee YS, Lim F, Loh Y, Nagarajan C, Quek J, Tao M, Than H, Linn YC. Mobilization kinetics of peripheral blood stem cells with rescue plerixafor - real-world experience from a single center. Leuk Lymphoma 2020; 61:1740-1743. [PMID: 32091287 DOI: 10.1080/10428194.2020.1731501] [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)
| | - Yunxin Chen
- Department of Hematology, Singapore General Hospital, Singapore
| | | | - Yeow-Tee Goh
- Department of Hematology, Singapore General Hospital, Singapore
| | - Dixon Grant
- Department of Hematology, Singapore General Hospital, Singapore
| | - Aloysius Ho
- Department of Hematology, Singapore General Hospital, Singapore
| | - William Hwang
- Department of Hematology, Singapore General Hospital, Singapore
| | - Sathish Kumar
- Department of Hematology, Singapore General Hospital, Singapore
| | - Yuh-Shan Lee
- Department of Hematology, Singapore General Hospital, Singapore
| | - Francesca Lim
- Department of Hematology, Singapore General Hospital, Singapore
| | - Yvonne Loh
- Department of Hematology, Singapore General Hospital, Singapore
| | | | - Jeffrey Quek
- Department of Hematology, Singapore General Hospital, Singapore
| | | | - Hein Than
- Department of Hematology, Singapore General Hospital, Singapore
| | - Yeh-Ching Linn
- Department of Hematology, Singapore General Hospital, Singapore
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Hwang W, Pleskow H, Czapla JAA, Fisher R, Kamran S, Lee R, Saylor P, Zietman A, Silvia B, Ting D, Maheswaran S, Haber D, Efstathiou J, Miyamoto D. Integrated Gene Expression Score in Circulating Tumor Cells to Predict Treatment Response in Muscle-Invasive Bladder Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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19
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Lim J, Huang D, Tang T, Cai Q, Tan D, Laurensia Y, Chia B, Rou-Jun P, Pang W, Cheah D, Ng C, Hong H, Tan J, Feng L, Chen J, Han B, Guo Y, Goh Y, Rötzschke O, Cheng C, Au-Yeung R, Chan T, Ng S, Kwong Y, Hwang W, Chng W, Tousseyn T, Tan P, Teh B, Khor C, Rozen S, Bei J, Lin T, Lim S, Ong C. WHOLE-GENOME SEQUENCING REVEALS IMMUNOTHERAPEUTIC OPTIONS FOR NATURAL-KILLER/T CELL LYMPHOMA PATIENTS. Hematol Oncol 2019. [DOI: 10.1002/hon.19_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Jeong DE, Kim JW, Kim BM, Hwang W, Kim DJ. Impact of Balloon-Guiding Catheter Location on Recanalization in Patients with Acute Stroke Treated by Mechanical Thrombectomy. AJNR Am J Neuroradiol 2019; 40:840-844. [PMID: 30948374 DOI: 10.3174/ajnr.a6031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 03/07/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Mechanical thrombectomy with proximal flow control and forced aspiration may improve the outcome of endovascular revascularization therapy for patients with acute stroke. The purpose of this study was to compare the impact of balloon-guiding catheter locations in patients treated for anterior circulation acute ischemic stroke using mechanical thrombectomy. MATERIALS AND METHODS The influence of the balloon-guiding catheter location (proximal, balloon-guiding catheter tip proximal to C1 vertebral body; distal, between the skull base and the C1 vertebral body) was analyzed in patients with acute anterior circulation stroke treated with stent-retriever thrombectomy. The baseline angiographic/clinical characteristics, time intervals, recanalization rates, and clinical outcomes were compared. RESULTS The clinical analysis included 102 patients (mean age, 69.5 ± 12.8 years; male/female ratio = 52:50). The balloon-guiding catheter was located distally in 49 patients and proximally in 53 patients for flow control and forced aspiration during stent retrieval. The puncture-to-recanalization time was shorter in the distal group than in the proximal group (40 versus 56 minutes, P = .02). Successful and complete recanalizations were more frequently achieved in the distal group compared with the proximal group (98.0% versus 75.5%. P = .003; 67.3% versus 45.3%, P = .04, respectively). Multivariate analysis showed that the distal catheterization location was independently associated with successful recanalization (adjusted OR, 13.4; 95% CI, 2.4-254.8; P = .02). CONCLUSIONS Location of the balloon-guiding catheter has a significant impact on recanalization in patients with acute stroke. The balloon-guiding catheter should be positioned as distally as safely possible in the cervical ICA for maximally effective thrombectomy.
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Affiliation(s)
- D E Jeong
- From the Department of Radiology (D.E.J., J.W.K., B.M.K., D.J.K.), Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
- Department of Neurology (D.E.J.), YeongNam University College of Medicine, Daegu, South Korea
| | - J W Kim
- From the Department of Radiology (D.E.J., J.W.K., B.M.K., D.J.K.), Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - B M Kim
- From the Department of Radiology (D.E.J., J.W.K., B.M.K., D.J.K.), Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - W Hwang
- Department of Mechanical and Aerospace Engineering (W.H.), Seoul National University, Seoul, South Korea
| | - D J Kim
- From the Department of Radiology (D.E.J., J.W.K., B.M.K., D.J.K.), Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
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Tan AT, Yang N, Lee Krishnamoorthy T, Oei V, Chua A, Zhao X, Tan HS, Chia A, Le Bert N, Low D, Tan HK, Kumar R, Irani FG, Ho ZZ, Zhang Q, Guccione E, Wai LE, Koh S, Hwang W, Chow WC, Bertoletti A. Use of Expression Profiles of HBV-DNA Integrated Into Genomes of Hepatocellular Carcinoma Cells to Select T Cells for Immunotherapy. Gastroenterology 2019; 156:1862-1876.e9. [PMID: 30711630 DOI: 10.1053/j.gastro.2019.01.251] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/26/2018] [Accepted: 01/17/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS Hepatocellular carcinoma (HCC) is often associated with hepatitis B virus (HBV) infection. Cells of most HBV-related HCCs contain HBV-DNA fragments that do not encode entire HBV antigens. We investigated whether these integrated HBV-DNA fragments encode epitopes that are recognized by T cells and whether their presence in HCCs can be used to select HBV-specific T-cell receptors (TCRs) for immunotherapy. METHODS HCC cells negative for HBV antigens, based on immunohistochemistry, were analyzed for the presence of HBV messenger RNAs (mRNAs) by real-time polymerase chain reaction, sequencing, and Nanostring approaches. We tested the ability of HBV mRNA-positive HCC cells to generate epitopes that are recognized by T cells using HBV-specific T cells and TCR-like antibodies. We then analyzed HBV gene expression profiles of primary HCCs and metastases from 2 patients with HCC recurrence after liver transplantation. Using the HBV-transcript profiles, we selected, from a library of TCRs previously characterized from patients with self-limited HBV infection, the TCR specific for the HBV epitope encoded by the detected HBV mRNA. Autologous T cells were engineered to express the selected TCRs, through electroporation of mRNA into cells, and these TCR T cells were adoptively transferred to the patients in increasing numbers (1 × 104-10 × 106 TCR+ T cells/kg) weekly for 112 days or 1 year. We monitored patients' liver function, serum levels of cytokines, and standard blood parameters. Antitumor efficacy was assessed based on serum levels of alpha fetoprotein and computed tomography of metastases. RESULTS HCC cells that did not express whole HBV antigens contained short HBV mRNAs, which encode epitopes that are recognized by and activate HBV-specific T cells. Autologous T cells engineered to express TCRs specific for epitopes expressed from HBV-DNA in patients' metastases were given to 2 patients without notable adverse events. The cells did not affect liver function over a 1-year period. In 1 patient, 5 of 6 pulmonary metastases decreased in volume during the 1-year period of T-cell administration. CONCLUSIONS HCC cells contain short segments of integrated HBV-DNA that encodes epitopes that are recognized by and activate T cells. HBV transcriptomes of these cells could be used to engineer T cells for personalized immunotherapy. This approach might be used to treat a wider population of patients with HBV-associated HCC.
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Affiliation(s)
| | - Ninghan Yang
- Genome Institute of Singapore, Agency for Science and Technology (A*STAR), Singapore
| | | | - Vincent Oei
- Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | | | | | | | - Adeline Chia
- Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Nina Le Bert
- Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Diana Low
- Institute of Molecular and Cell Biology, Agency for Science and Technology (A*STAR), Singapore
| | - Hiang Keat Tan
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Rajneesh Kumar
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Farah Gillan Irani
- Department of Vascular and Interventional Radiology, Singapore General Hospital, Singapore
| | | | - Qi Zhang
- Department of Biotherapy, The Third Affiliated Hospital of Sun Yat-Sen University, Guandong, China
| | - Ernesto Guccione
- Institute of Molecular and Cell Biology, Agency for Science and Technology (A*STAR), Singapore
| | - Lu-En Wai
- Lion TCR Pte Ltd, Singapore; Singapore Immunology Network, Agency for Science and Technology (A*STAR), Singapore
| | - Sarene Koh
- Lion TCR Pte Ltd, Singapore; Singapore Immunology Network, Agency for Science and Technology (A*STAR), Singapore
| | - William Hwang
- Department of Haematology, Singapore General Hospital, Singapore
| | - Wan Cheng Chow
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
| | - Antonio Bertoletti
- Emerging Infectious Diseases, Duke-NUS Medical School, Singapore; Singapore Immunology Network, Agency for Science and Technology (A*STAR), Singapore.
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22
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Quek J, Lee JJ, Lim FL, Diong C, Goh YT, Gopalakrishnan S, Ho A, Hwang W, Koh M, Loh Y, Linn YC. Donor-type fresh frozen plasma is effective in preventing hemolytic reaction in major ABO incompatible allogeneic stem cell transplant. Transfusion 2018; 59:335-339. [PMID: 30467850 DOI: 10.1111/trf.15053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 08/26/2018] [Accepted: 08/28/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hemolysis at the time of graft infusion is one of the immediate complications in major ABO-incompatible allogeneic hematopoietic stem cell transplants (HSCTs). We conducted a retrospective analysis to evaluate the efficacy of donor-type fresh frozen plasma (FFP) in reducing isohemagglutinin titer and preventing hemolysis, as well as its effect on delayed red cell engraftment. MATERIALS AND METHODS This is a single-center study on a series of 380 allogeneic HSCT between 2005 and 2015; of which 99 were either major (n = 74) or bidirectional (n = 25) ABO mismatched. Pre-transplant infusion of FFP, post-transplant complications and transfusion requirements were determined by retrospective review of individual medical records. Laboratory results were also reviewed for evidence of hemolysis and pure red cell aplasia (PRCA). RESULTS Clinical manifestation of hemolysis attributable to ABO mismatch was present in one recipient of major ABO-incompatible peripheral blood stem cell (PBSC) with a titer of 64. Another recipient of major ABO-incompatible PBSC with a titer of 64 showed biochemical evidence of hemolysis. Both patients recovered with supportive treatment. Hemolysis did not occur in any patients with titer of 32 or less at the time of stem cell infusion. We were unable to demonstrate the influence of any variables on the incidence of PRCA. CONCLUSION Our experience demonstrated that donor-type FFP is safe and effective in preventing acute hemolysis in major ABO-mismatched HSCT. We have also established the titer of 64 as the threshold that may cause hemolysis and therefore efforts should be made to reduce titer to below this level.
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Affiliation(s)
- Jeffrey Quek
- Department of Hematology, Singapore General Hospital, Singapore
| | - Jing Jing Lee
- Department of Hematology, Singapore General Hospital, Singapore
| | | | - Colin Diong
- Department of Hematology, Singapore General Hospital, Singapore
| | - Yeow Tee Goh
- Department of Hematology, Singapore General Hospital, Singapore
| | | | - Aloysius Ho
- Department of Hematology, Singapore General Hospital, Singapore
| | - William Hwang
- Department of Hematology, Singapore General Hospital, Singapore
| | - Mickey Koh
- Blood Service Group, Health Science Authority, Singapore
| | - Yvonne Loh
- Department of Hematology, Singapore General Hospital, Singapore
| | - Yeh Ching Linn
- Department of Hematology, Singapore General Hospital, Singapore
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Hwang W, Lamba N, Kim D, Marciscano A, Stemmer-Rachamimov A, Curry W, Barker F, Martuza R, Santagata S, Dunn I, Claus E, Bi W, Aizer A, Alexander B, Oh K, Loeffler J, Shih H. Atypical Histopathological Features and the Risk of Progression/Recurrence in WHO Grade I-II Meningiomas. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.773] [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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Marmarelis M, Bange E, Bagley S, Hwang W, Yang Y, Thompson J, Bauml J, Ciunci C, Alley E, Morrissette J, Cohen R, Langer C, Carpenter E, Aggarwal C. P1.01-64 Impact of STK11 Co-Mutation on Outcomes Following Immunotherapy Among Patients with TP53 and KRAS Mutated Stage IV NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.620] [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: 10/28/2022]
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25
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Chan TSY, Lee YS, Del Giudice I, Marinelli M, Ilari C, Cafforio L, Guarini A, Tan D, Phipps C, Goh YT, Hwang W, Goh AZK, Siu LLP, Wu S, Ha CY, Lin SY, Kwok CH, Lau CK, Wong KF, Foà R, Kwong YL, Tse E. Clinicopathological features and outcome of chronic lymphocytic leukaemia in Chinese patients. Oncotarget 2018; 8:25455-25468. [PMID: 28424415 PMCID: PMC5421943 DOI: 10.18632/oncotarget.16037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 02/13/2017] [Indexed: 12/27/2022] Open
Abstract
Chronic lymphocytic leukaemia (CLL) is uncommon in Chinese population and its biology, genetics and treatment outcome in Chinese patients have not been comprehensively investigated. In this study, we studied the clinicopathological features and outcome of 212 Chinese patients with newly diagnosed CLL in Hong Kong and Singapore. The median age at diagnosis was 64 years. The majority of patients presented with early-stage disease (Binet stage A, 56.1%). Del(13)(q14) was the most frequent abnormality (41.7%) detected by fluorescence in situ hybridization (FISH) analysis. Del(17p) and TP53 gene mutations were detected in 7.8% and 8.2% of patients, respectively. MYD88 mutations were found at a higher frequency (11.5%) than expected. CLL with unmutated variable region of the immunoglobulin heavy chain genes (IGHV) occurred in only 31.2% of cases, and was associated with advanced-stage disease (p <0.01) and adverse FISH abnormalities (p<0.01). With a median follow-up of 39 months, the median overall survival (OS) was 108 months. The presence of del(17p) or TP53 mutations was associated with a significantly shorter time to first treatment and an inferior OS (p <0.01). Unmutated IGHV was also associated with a significantly shorter time to treatment (p <0.01). Among patients who required treatment, the median OS and progression-free survival (PFS) were 107 and 23 months, respectively. The presence of del(17p) was associated with a significantly inferior OS and PFS (p <0.01). In summary, Chinese CLL patients had similar genetic aberrations at diagnosis compared with those of Western populations. FISH abnormalities are major factors affecting outcome.
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Affiliation(s)
- Thomas Sau-Yan Chan
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Yuh-Shan Lee
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | - Ilaria Del Giudice
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Marilisa Marinelli
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Caterina Ilari
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Luciana Cafforio
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Anna Guarini
- Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Daryl Tan
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | - Colin Phipps
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | - Yeow-Tee Goh
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | - William Hwang
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | - Allan Zhi-Kai Goh
- Department of Haematology, Singapore General Hospital, Outram, Singapore
| | | | - Saliangi Wu
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Chun-Yin Ha
- Department of Medicine, Tuen Mun Hospital, Hong Kong, China
| | - Shek-Ying Lin
- Department of Medicine, United Christian Hospital, Hong Kong, China
| | - Chi-Hang Kwok
- Department of Medicine, Princess Margaret Hospital, Hong Kong, China
| | - Chi-Kuen Lau
- Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China
| | - Kit-Fai Wong
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong, China
| | - Robin Foà
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Yok-Lam Kwong
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Eric Tse
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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Phipps C, Lee YS, Ying H, Nagarajan C, Grigoropoulos N, Chen Y, Tang T, Goh AZ, Ghosh A, Ng HJ, Gopalakrishnan S, Loh Y, Lim ST, Hwang W, Tan D, Goh YT. The impact of time from diagnosis to treatment in diffuse large B-cell lymphoma. Leuk Lymphoma 2018; 59:2336-2341. [DOI: 10.1080/10428194.2017.1422863] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Colin Phipps
- Department of Haematology, Singapore General Hospital, Singapore
- Academic Medicine Programme, DUKE-NUS Graduate Medical School, Singapore
| | - Yuh Shan Lee
- Department of Haematology, Singapore General Hospital, Singapore
| | - Hao Ying
- Health Services Research Unit, Division of Medicine, Singapore General Hospital, Singapore
| | | | | | - Yunxin Chen
- Department of Haematology, Singapore General Hospital, Singapore
| | - Tiffany Tang
- Division of Medical Oncology, National Cancer Centre, Singapore
| | - Alan Z. Goh
- Department of Haematology, Singapore General Hospital, Singapore
| | - Aditi Ghosh
- Department of Haematology, Singapore General Hospital, Singapore
| | - Heng Joo Ng
- Department of Haematology, Singapore General Hospital, Singapore
- Academic Medicine Programme, DUKE-NUS Graduate Medical School, Singapore
| | | | - Yvonne Loh
- Department of Haematology, Singapore General Hospital, Singapore
| | - Soon Thye Lim
- Division of Medical Oncology, National Cancer Centre, Singapore
| | - William Hwang
- Department of Haematology, Singapore General Hospital, Singapore
- Academic Medicine Programme, DUKE-NUS Graduate Medical School, Singapore
| | - Daryl Tan
- Department of Haematology, Singapore General Hospital, Singapore
| | - Yeow Tee Goh
- Department of Haematology, Singapore General Hospital, Singapore
- Academic Medicine Programme, DUKE-NUS Graduate Medical School, Singapore
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Hwang W, Tendulkar R, Niemierko A, Agrawal S, Stephans K, Spratt D, Hearn J, Koontz B, Lee W, Michalski J, Pisansky T, Liauw S, Abramowitz M, Pollack A, Moghanaki D, Anscher M, Den R, Zietman A, Stephenson A, Efstathiou J. Multi-institutional Outcomes of Postprostatectomy Adjuvant Versus Early Salvage Radiation Therapy in Prostate Cancer Patients With Adverse Pathologic Features. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.232] [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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Hwang W, Niemierko A, Willers H, Gainor J, Keane F. Incidence of Pneumonitis in Metastatic Lung Cancer Patients Receiving Immune Checkpoint Inhibitors With or Without Thoracic Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hwang W, Silverstein M, Brown M. STEPPARENT-CHILD INTERGENERATIONAL SOLIDARITY IN 11 YEARS: MODERATING ROLE OF RELIGIOUS DISCORDANCE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3888] [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: 11/14/2022] Open
Affiliation(s)
- W. Hwang
- Syracuse University, Syracuse, New York
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Fan X, Guo D, Yap C, Cheung A, Poon Z, Bari S, Li S, Hwang W. Application of a mesenchymal stromal cell-derived two-factor cocktail in graft versus host disease therapy. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.080] [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: 11/28/2022]
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31
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Wang L, Allen J, Diong C, Goh YT, Gopalakrishnan S, Ho A, Hwang W, Lim F, Oon L, Tan TT, Linn YC, Tan BH. Respiratory virus infection after allogeneic hematopoietic stem cell transplant in a tropical center: Predictive value of the immunodeficiency scoring index. Transpl Infect Dis 2017; 19. [PMID: 28295964 PMCID: PMC7169866 DOI: 10.1111/tid.12693] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 12/14/2016] [Accepted: 12/30/2016] [Indexed: 11/30/2022]
Abstract
Background Respiratory virus infection (RVI) is a prevalent infection in patients after allogeneic hematopoietic stem cell transplant (allo‐HSCT) and can result in significant morbidity and mortality. Ability to assess the potential severity of RVI is important in the management of such patients. Methods We reviewed the cases of RVI in allo‐HSCT recipients and explored the predictive value of the immunodeficiency scoring index (ISI) established for respiratory syncytial virus (RSV) and its applicability for RVI caused by other respiratory viruses. Results RVI occurred year‐round in our tropical transplant center, with peaks in the middle and end of the year. Ninety‐five of the 195 recipients developed a total of 191 episodes of RVI, giving a cumulative incidence of 28% by 6 months and 52% by 24 months for the first episode of RVI. RSV, influenza, rhinovirus, and parainfluenza were the most common viruses. Pneumonia occurred in 63.64%, 42.31%, and 32.42% of adenovirus, influenza, and RSV RVI episodes, respectively, but was also non‐negligible in the more benign viruses, such as coronavirus (31.58%) and rhinovirus (23.68%). Nineteen of the 63 episodes of viral pneumonia required mechanical ventilation and 14 deaths occurred within 6 weeks of the RVI. Receiver operating characteristic analysis showed that an ISI of ≥8 predicted pneumonia with a positive predictive value of >80% for RVI caused by RSV, influenza, adenovirus, and parainfluenza, while it was not predictive for coronavirus and rhinovirus. Conclusions The ISI is a useful aid for decision‐making during clinic consultation for patients presenting with symptoms suggestive of an RVI.
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Affiliation(s)
- Lin Wang
- Haematology, Singapore General Hospital, Singapore
| | - John Allen
- Academic Medicine Research Institute, Duke-NUS Medical School, Singapore
| | - Colin Diong
- Haematology, Singapore General Hospital, Singapore
| | - Yeow-Tee Goh
- Haematology, Singapore General Hospital, Singapore
| | | | - Aloysius Ho
- Haematology, Singapore General Hospital, Singapore
| | | | | | - Lynette Oon
- Pathology, Singapore General Hospital, Singapore
| | - Thuan-Tong Tan
- Infectious Disease, Singapore General Hospital, Singapore
| | | | - Ban Hock Tan
- Infectious Disease, Singapore General Hospital, Singapore
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Zhou W, Sultana R, Diong C, Goh YT, Gopalakrishnan S, Ho A, Hwang W, Koh LP, Koh M, Loh Y, Tan P, Linn YC. Long-term renal outcome after allogeneic hemopoietic stem cell transplant: A comprehensive analysis of risk factors in an Asian patient population. Clin Transplant 2017; 31. [PMID: 28135776 DOI: 10.1111/ctr.12920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/21/2017] [Indexed: 01/22/2023]
Abstract
Allogeneic hemopoietic stem cell transplantation (allo-HSCT) poses a significant challenge to renal function due to multiple drug- and complication-related renal toxicity. In this single-center series of 216 adult Asian patients with a long and complete follow-up, 41 developed chronic kidney disease (CKD) giving a cumulative incidence of 19.0% at 25 years (median follow-up duration 7.84 years, range 2.0-27.7 years), but only two of the 41 patients reached stage 4 CKD and another two required dialysis. In contrast, acute kidney injury occurred in most patients, where glomerular filtration rate (GFR) suffered a mean fall of 50 mL/min/1.73 m2 at 6 months post-transplant compared with baseline. Suppression of renal function may last beyond 6 months but is potentially reversible, although not to baseline level in most patients. Analysis of a comprehensive range of 18 risk factors showed that older age, lower GFR at transplant, unrelated donor, diagnosis of AML, presence of diabetes mellitus at transplant, and duration of foscarnet use were significantly associated with CKD development, with the first three remaining as independent risks for CKD in multivariate analysis. Long-term survival is not affected by renal function, being 78.6% as compared to 85.5% for patients with low vs normal GFR at 2 years, respectively.
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Affiliation(s)
- Wei Zhou
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | | | - Colin Diong
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Yeow-Tee Goh
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | | | - Aloysius Ho
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - William Hwang
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Liang-Piu Koh
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Mickey Koh
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Yvonne Loh
- Department of Haematology, Singapore General Hospital, Singapore, Singapore.,Raffles Cancer Centre, Singapore, Singapore
| | - Patrick Tan
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Yeh-Ching Linn
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
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AbdelRazek M, Hwang W, Abdelmaksoud M, Louie J, Kothary N, Kunz P, Sze D. Selection between locoregional embolotherapies for hepatic metastases from neuroendocrine tumor: Stratification by tumor burden. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Kim D, Niemierko A, Hwang W, Stemmer-Rachamimov A, Curry W, Barker F, Martuza R, Loeffler J, Oh K, Shih H. Histopathologic Prognostic Factors of Recurrence Following Surgery and Radiation Therapy for Atypical and Malignant Meningiomas. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.792] [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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Kim K, Sikora A, Nakazawa H, Umetsu M, Hwang W, Teizer W. Isomorphic coalescence of aster cores formed in vitro from microtubules and kinesin motors. Phys Biol 2016; 13:056002. [PMID: 27652512 DOI: 10.1088/1478-3975/13/5/056002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We report fluorescence microscopy studies of the formation of aster-like structures emerging from a cellular element-based active system and a novel analysis of the aster condensation. The system consists of rhodamine labeled microtubules which are dynamically coupled by functionalized kinesin motor proteins cross-linked via streptavidin-coated quantum dots (QDs). The aster-shaped objects contain core structures. The cores are aggregates of the QD-motor protein complexes, and result from the dynamic condensation of sub-clusters that are connected to each other randomly. The structural specificity of the aster core reflects a configuration of the initial connectivity between sub-clusters. Detailed image analysis allows us to extract a novel correlation between the condensation speed and the sub-cluster separation. The size of the core is scaled down during the condensation process, following a power law dependence on the distance between sub-clusters. The exponent of the power law is close to two, as expected from a geometric model. This single exponent common to all the contractile lines implies that there exists a time regime during which an isomorphic contraction of the aster core continues during the condensation process. We analyze the observed contraction by using a model system with potential applicability in a wide range of emergent phenomena in randomly coupled active networks, which are prevalent in the cellular environment.
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Affiliation(s)
- K Kim
- WPI-Advanced Institute for Materials Research (WPI-AIMR), Tohoku University, Japan
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Ahn E, Kwon H, Hwang W, Lee E, Lee E, Song Y, Park J. FRI0487 Association between Fever Pattern and Clinical Manifestations in Adult Onset of Still's Disease: Unbiased Analysis of Fever Pattern Using Hierarchical Clustering. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4067] [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: 11/03/2022]
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Tang T, Chen Z, Praditsuktavorn P, Khoo LP, Ruan J, Lim ST, Tan D, Phipps C, Lee YS, Goh YT, Hwang W, Tao M, Quek R, Farid M, Furman RR, Leonard JP, Martin P. Role of Surveillance Imaging in Patients With Peripheral T-Cell Lymphoma. Clin Lymphoma Myeloma Leuk 2015; 16:117-21. [PMID: 26796979 DOI: 10.1016/j.clml.2015.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 11/27/2015] [Accepted: 12/15/2015] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The role of surveillance imaging (SI) in patients with peripheral T-cell lymphoma (PTCL) in first complete remission (CR1) is unclear. MATERIALS AND METHODS Patients with PTCL were identified through prospectively maintained T-cell lymphoma databases from the National Cancer Centre Singapore/Singapore General Hospital and Weill-Cornell Medical College after institutional review board approval. Patients with leukemia or indolent, composite, and cutaneous lymphomas were excluded. The patients' medical records were retrospectively reviewed to determine the frequency and type of SI used. Of those with relapse, the method of relapse detection and data on symptoms, signs, and elevated lactate dehydrogenase LDH were extracted. RESULTS A total of 338 patients were included in the present study. In the first year after achieving CR1, patients had an average of 1.2 and a median of 1 SI performed (range, 0-4). In the second year after achieving CR1, they had an average of 0.78 and a median of 1 SI performed (range, 0-4). Of the 135 patients who achieved CR1, 61 (45%) developed a relapse. Relapses were detected before SI in 48 (84%), and 9 patients had relapses detected during routine SI. Of the 9 patients whose relapses were detected during planned SI, only 3 did not have any symptoms or signs suggestive of relapsed disease. Of these 3 patients, 2 had angioimmunoblastic T-cell lymphoma and 1 had natural killer/T-cell lymphoma. CONCLUSION Most PTCL relapses were detected before planned SI, and most patients had symptoms with relapse. Only 3 patients (5.2%) were completely asymptomatic at relapse, suggesting a limited utility of routine imaging for detecting PTCL relapses.
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Affiliation(s)
- Tiffany Tang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore; Division of Hematology and Oncology, Weill Cornell Medical College, New York, NY.
| | - Zhengming Chen
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY
| | | | - Lay Poh Khoo
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Jia Ruan
- Division of Hematology and Oncology, Weill Cornell Medical College, New York, NY
| | - Soon Thye Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Daryl Tan
- Department of Hematology, Singapore General Hospital, Singapore, Singapore
| | - Colin Phipps
- Department of Hematology, Singapore General Hospital, Singapore, Singapore
| | - Yuh Shan Lee
- Department of Hematology, Singapore General Hospital, Singapore, Singapore
| | - Yeow Tee Goh
- Department of Hematology, Singapore General Hospital, Singapore, Singapore
| | - William Hwang
- Department of Hematology, Singapore General Hospital, Singapore, Singapore
| | - Miriam Tao
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Richard Quek
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Mohamad Farid
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Richard R Furman
- Division of Hematology and Oncology, Weill Cornell Medical College, New York, NY
| | - John P Leonard
- Division of Hematology and Oncology, Weill Cornell Medical College, New York, NY
| | - Peter Martin
- Division of Hematology and Oncology, Weill Cornell Medical College, New York, NY
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Hwang W, Marciscano A, Niemierko A, Kim D, Stemmer-Rachamimov A, Curry W, Barker F, Martuza R, Loeffler J, Oh K, Larvie M, Shih H. MNGO-05IMAGING AND EXTENT OF SURGICAL RESECTION PREDICT RISK OF MENINGIOMA RECURRENCE BETTER THAN WHO HISTOPATHOLOGICAL GRADE. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov220.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
We describe the case of a 16 year-old female with mixed phenotype acute leukemia B/myeloid, NOS (formerly biphenotypic leukemia) with masked hypodiploidy and somatic TP53 and CDKN2A/B deletions. She achieved morphologic remission with lymphoid-directed multi-agent chemotherapy, but experienced an early medullary relapse 11 months from initial diagnosis. Her case details the unusual finding of hypodiploidy in a patient with ambiguous lineage leukemia and highlights the complexity of therapy selection for these high-risk patients.
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Affiliation(s)
- Elizabeth G Salazar
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gerald B Wertheim
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jaclyn A Biegel
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - William Hwang
- Department of Hematology, Singapore General Hospital, Outram Park, Singapore
| | - Sarah K Tasian
- Division of Oncology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Susan R Rheingold
- Division of Oncology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Ma L, Hao S, Diong C, Goh YT, Gopalakrishnan S, Ho A, Hwang W, Koh LP, Koh M, Lim ZY, Loh Y, Poon M, Tan LK, Tan P, Linn YC. WPSS is a strong prognostic indicator for clinical outcome of allogeneic transplant for myelodysplastic syndrome in Southeast Asian patients. Ann Hematol 2014; 94:761-9. [PMID: 25519475 DOI: 10.1007/s00277-014-2275-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 12/05/2014] [Indexed: 10/24/2022]
Abstract
To better understand the predictive factors and improve clinical outcome of allogeneic transplant for patients with myelodysplastic syndrome (MDS), we retrospectively analyzed the post-transplant outcome of 60 Southeast Asian patients with MDS. Multivariate analysis showed that WHO classification-based Prognostic Scoring System (WPSS) significantly affect overall survival (OS), progression-free survival (PFS), cumulative incidence of relapse (CIR), and cumulative incidence of non-relapse mortality (CINRM). Stratified by WPSS into very low/low, intermediate, high, and very high-risk categories, 3-year OS was 100, 61, 37, and 18% (p = 0.02); PFS was 100, 55, 32, and 18% (p = 0.014); CIR was 12, 24, 38, and 59% (p = 0.024); CINRM was 0, 6, 12, and 26% (p = 0.037), respectively. WHO classification, Revised International Prognostic Scoring System (IPSS-R), IPSS-R-defined cytogenetic risk groups, donor gender, and acute and chronic graft vs host disease (GVHD) also influenced different aspects of transplant outcome. We found that WPSS is a powerful predictor of post-transplant outcome. WPSS provides an important model not only for prognostication but also for exploration of further post-transplant measures such as immunological maneuvers or novel therapy to improve the poor outcome of high-risk patients.
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Affiliation(s)
- Liyuan Ma
- Division of Hematology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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Ma L, Hao S, Diong C, Goh YT, Gopalakrishnan S, Ho A, Hwang W, Koh LP, Koh M, Lim ZY, Loh Y, Poon M, Tan LK, Tan P, Linn YC. Pre-transplant achievement of negativity in minimal residual disease and French-American-British L1 morphology predict superior outcome after allogeneic transplant for Philadelphia chromosome positive acute lymphoblastic leukemia: an analysis of Southeast Asian patients. Leuk Lymphoma 2014; 56:1362-9. [PMID: 25139689 DOI: 10.3109/10428194.2014.956318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
To better understand predictive factors and improve the clinical outcome of allogeneic transplant for patients with Philadelphia positive acute lymphoblastic leukemia, we analyzed 67 Southeast Asian patients transplanted in our institutions. Multivariate analysis showed that disease status before transplant, year of transplant and, interestingly, French-American-British (FAB) subtype had a significant impact on overall survival (OS) and non-relapse mortality. Patients who were minimal residual disease (MRD) negative at transplant had a 3-year OS of 73% compared to those who were MRD positive (45%) and refractory (0%). The 3-year cumulative incidence of relapse was 18% and 36% for the MRD negative and positive groups, respectively. FAB L1 subtype had a significantly superior 3-year OS of 63% vs. 29% for L2 subtype. Pre-transplant use of a tyrosine kinase inhibitor significantly improved outcomes in univariate but not multivariate analysis, as it served to induce more patients into MRD negativity, which was the factor that directly improved transplant outcome.
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Affiliation(s)
- Liyuan Ma
- Division of Hematology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai , People's Republic of China
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kim C, Yang T, Chang S, Kim H, Lee H, Kim J, Jang H, Han G, Park D, Hwang W, Kim G. SU-E-T-594: Preliminary Active Scanning Results of KHIMA. Med Phys 2014. [DOI: 10.1118/1.4888930] [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: 11/07/2022] Open
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Tang TPL, Chen Z, Praditsuktavorn P, Khoo LP, Ruan J, Lim ST, Tan DC, Diong C, Lee YS, Tee GY, Hwang W, Tao M, Quek RHH, Tay K, Farid M, Furman RR, Leonard J, Martin P. Role of surveillance imaging in the management of peripheral T-cell lymphomas. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.8543] [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)
| | | | | | | | - Jia Ruan
- Weill Cornell Medical College, New York, NY
| | | | | | - Colin Diong
- Singapore General Hospital, Singapore, Singapore
| | - Yuh Shan Lee
- Singapore General Hospital, Singapore, Singapore
| | - Goh Yeow Tee
- Singapore General Hospital, Singapore, Singapore
| | | | - Miriam Tao
- National Cancer Centre, Singapore, Singapore
| | | | - Kevin Tay
- National Cancer Centre, Singapore, Singapore
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Deville C, Hwang W, Both S, Thomas C, Chapman C. United States Radiation Oncology Residency Diversity Over the Past 20 Years. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1331] [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: 10/26/2022]
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Berman A, Hwang W, Grover S, O'Grady E, Baffic C, Vapiwala N. Standardizing the Radiation Oncology Medical Student Elective: A Novel Curriculum and Evaluation of Student Satisfaction. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1290] [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: 11/16/2022]
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Shaw BE, Chapman J, Fechter M, Foeken L, Greinix H, Hwang W, Phillips-Johnson L, Korhonen M, Lindberg B, Navarro WH, Szer J. Towards a global system of vigilance and surveillance in unrelated donors of haematopoietic progenitor cells for transplantation. Bone Marrow Transplant 2013; 48:1506-9. [PMID: 23892330 DOI: 10.1038/bmt.2013.104] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 06/14/2013] [Accepted: 06/17/2013] [Indexed: 11/09/2022]
Abstract
Safety of living donors is critical to the success of blood, tissue and organ transplantation. Structured and robust vigilance and surveillance systems exist as part of some national entities, but historically no global systems are in place to ensure conformity, harmonisation and the recognition of rare adverse events (AEs). The World Health Assembly has recently resolved to require AE/reaction (AE/R) reporting both nationally and globally. The World Marrow Donor Association (WMDA) is an international organisation promoting the safety of unrelated donors and progenitor cell products for use in haematopoietic progenitor cell (HPC) transplantation. To address this issue, we established a system for collecting, collating, analysing, distributing and reacting to serious adverse events and reactions (SAE/R) in unrelated HPC donors. The WMDA successfully instituted this reporting system with 203 SAE/R reported in 2011. The committee generated two rapid reports, reacting to specific SAE/R, resulting in practice changing policies. The system has a robust governance structure, formal feedback to the WMDA membership and transparent information flows to other agencies, specialist physicians and transplant programs and the general public.
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Affiliation(s)
- B E Shaw
- 1] Anthony Nolan Research Institute, Royal Free Hospital, UCL Cancer Centre, London, UK [2] Royal Marsden NHS Foundation Trust, London, UK
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Kim C, Yang T, Han G, Lee H, Kim H, Jang H, Kim J, Park D, Chang S, Hwang W, Kim G. SU-E-T-318: A Simulation Study for Active Scanning Nozzle Design Using Beam Optic Parameters. Med Phys 2013. [DOI: 10.1118/1.4814752] [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: 11/07/2022] Open
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49
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Phipps C, Ng HY, Appan P, Loh Y, Koh M, Ho AYL, Lee JJ, Linn YC, Tan BH, Goh YT, Hwang W. BK-virus prophylaxis: still no answer. Bone Marrow Transplant 2013. [PMID: 23645168 DOI: 10.1013/bmt.2013.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- C Phipps
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
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