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Davis KA, Mazzenga M, Hall PB, Buchbinder D, Alderfer MA, Oberoi AR, Sharkey CM, Blakey AO, Long KA. Development of a blueprint for sibling psychosocial services: A nationwide study. Pediatr Blood Cancer 2024:e30993. [PMID: 38605546 DOI: 10.1002/pbc.30993] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Siblings of youth with cancer have heightened risk for poor long-term psychosocial outcomes. Although sibling psychosocial care is a standard in pediatric oncology, this standard is among those least likely to be met. To address barriers to providing sibling services, a blueprint for systematic psychosocial screening and support of siblings was developed based on feedback from a national sample of psychosocial providers. PROCEDURE Semi-structured interviews were conducted with a purposive sample of psychosocial care providers (N = 27) of various disciplines working in US pediatric cancer centers, varied in size, type, and extent of sibling support. Interviews queried providers' suggestions for the future of sibling psychosocial care and impressions of a blueprint for sibling service delivery, which was iteratively refined based on respondents' feedback. Interviews were analyzed using applied thematic analysis. RESULTS Based on existing literature and refined according to providers' recommendations, the Sibling Services Blueprint was developed to provide a comprehensive guide for systematizing sibling psychosocial care. The blueprint content includes: (i) a timeline for repeated sibling screening and assessment; (ii) a stepped model of psychosocial support; (iii) strategies for circumventing barriers to sibling care; and (iv) recommendations for how centers with varying resources might accomplish sibling-focused care. The blueprint is available online, allowing providers to easily access and individualize the content. Providers indicated enthusiasm and high potential utility and usability of the blueprint. CONCLUSIONS The Sibling Services Blueprint may be a useful tool for systematizing sibling psychosocial care, promoting wider availability of sibling-focused services, and addressing siblings' unmet needs.
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Affiliation(s)
- Kathryn A Davis
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Marcella Mazzenga
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Phoebe Brosnan Hall
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - David Buchbinder
- Division of Hematology, Children's Hospital of Orange County, Orange, California, USA
| | - Melissa A Alderfer
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, Delaware, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Anjali R Oberoi
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Christina M Sharkey
- Department of Psychology, The Catholic University of America, Columbia, Washington, USA
| | - Ariel O Blakey
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Kristin A Long
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
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2
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Rotz SJ, Bhatt NS, Hamilton BK, Duncan C, Aljurf M, Atsuta Y, Beebe K, Buchbinder D, Burkhard P, Carpenter PA, Chaudhri N, Elemary M, Elsawy M, Guilcher GM, Hamad N, Karduss A, Peric Z, Purtill D, Rizzo D, Rodrigues M, Ostriz MBR, Salooja N, Schoemans H, Seber A, Sharma A, Srivastava A, Stewart SK, Baker KS, Majhail NS, Phelan R. International Recommendations for Screening and Preventative Practices for Long-Term Survivors of Transplantation and Cellular Therapy: A 2023 Update. Transplant Cell Ther 2024; 30:349-385. [PMID: 38413247 DOI: 10.1016/j.jtct.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 02/29/2024]
Abstract
As hematopoietic cell transplantation (HCT) and cellular therapy expand to new indications and international access improves, the number of HCTs performed annually continues to rise. Parallel improvements in HCT techniques and supportive care entails more patients surviving long term, creating further emphasis on survivorship needs. Survivors are at risk for developing late complications secondary to pretransplantation, peritransplantation, and post-transplantation exposures and other underlying risk factors. Guidelines for screening and preventive practices for HCT survivors were originally published in 2006 and then updated in 2012. An international group of experts was convened to review the contemporary literature and update the recommendations while considering the changing practices of HCT and cellular therapy. This review provides updated pediatric and adult survivorship guidelines for HCT and cellular therapy. The contributory role of chronic graft-versus-host disease (cGVHD) to the development of late effects is discussed, but cGVHD management is not covered in detail. These guidelines emphasize the special needs of patients with distinct underlying HCT indications or comorbidities (eg, hemoglobinopathies, older adults) but do not replace more detailed group-, disease-, or condition-specific guidelines. Although these recommendations should be applicable to the vast majority of HCT recipients, resource constraints may limit their implementation in some settings.
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Affiliation(s)
- Seth J Rotz
- Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Pediatric Institute, Cleveland Clinic Foundation, Cleveland, Ohio; Blood and Marrow Transplant Program, Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
| | - Neel S Bhatt
- Fred Hutchinson Cancer Center, Seattle, Washington
| | - Betty K Hamilton
- Blood and Marrow Transplant Program, Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Christine Duncan
- Dana Farber/Boston Children's Cancer and Blood Disorders Center, Harvard University, Boston, Massachusetts
| | - Mahmoud Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Yoshiko Atsuta
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
| | - Kristen Beebe
- Phoenix Children's Hospital and Mayo Clinic Arizona, Phoenix, Arizona
| | - David Buchbinder
- Division of Hematology, Children's Hospital of Orange County, Orange, California
| | | | | | - Naeem Chaudhri
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mohamed Elemary
- Hematology and BMT, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Mahmoud Elsawy
- Division of Hematology, Dalhousie University, QEII Health Sciences Center, Halifax, Nova Scotia, Canada
| | - Gregory Mt Guilcher
- Section of Pediatric Oncology/Transplant and Cellular Therapy, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Nada Hamad
- Department of Haematology, St Vincent's Hospital Sydney, St Vincent's Clinical School Sydney, University of New South Wales, School of Medicine Sydney, University of Notre Dame Australia, Australia
| | - Amado Karduss
- Bone Marrow Transplant Program, Clinica las Americas, Medellin, Colombia
| | - Zinaida Peric
- BMT Unit, Department of Hematology, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Duncan Purtill
- Fiona Stanley Hospital, Murdoch, PathWest Laboratory Medicine WA, Australia
| | - Douglas Rizzo
- Medical College of Wisconsin, Milwaukee, Wisconsin; Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Maria Belén Rosales Ostriz
- Division of hematology and bone marrow transplantation, Instituto de trasplante y alta complejidad (ITAC), Buenos Aires, Argentina
| | - Nina Salooja
- Centre for Haematology, Imperial College London, London, United Kingdom
| | - Helene Schoemans
- Department of Hematology, University Hospitals Leuven, Department of Public Health and Primary Care, ACCENT VV, KU Leuven, University of Leuven, Leuven, Belgium
| | | | - Akshay Sharma
- Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Alok Srivastava
- Department of Haematology, Christian Medical College, Vellore, India
| | | | | | - Navneet S Majhail
- Sarah Cannon Transplant and Cellular Therapy Network, Nashville, Tennessee
| | - Rachel Phelan
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
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3
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Ohlsen TJD, Wang H, Buchbinder D, Huang IC, Desai AD, Zheng Z, Kirchhoff AC, Park ER, Krull K, Conti RM, Yasui Y, Leisenring W, Armstrong GT, Yabroff KR, Nathan PC, Chow EJ. Financial hardship among siblings of long-term survivors of childhood cancer: A Childhood Cancer Survivor Study report. Cancer 2024; 130:1125-1136. [PMID: 38100563 PMCID: PMC10939878 DOI: 10.1002/cncr.35150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Siblings of children with cancer may experience adverse household economic consequences, but their financial outcomes in adulthood are unknown. METHODS A total of 880 siblings (aged 18-64 years) of adult-aged childhood cancer survivors were surveyed to estimate the prevalence of financial hardship by three established domains (behavioral, material, and psychological). For individual financial hardship items matching the contemporaneous National Health Interview Survey or Behavioral Risk Factor Surveillance System, siblings were compared with the general population by calculating adjusted prevalence odds ratios (ORs) to sample-weighted responses. Multivariable logistic regression models examined associations between sibling characteristics and each hardship domain and between sibling hardship and survivors' cancer/treatment characteristics. RESULTS Behavioral, material, and psychological hardship was reported by 24%, 35%, and 28%, respectively. Compared with national survey respondents, siblings were more likely to report worries about medical bills (OR, 1.14; 95% confidence interval [CI], 1.06-1.22), difficulty affording nutritious foods (OR, 1.79; 95% CI, 1.54-2.07), and forgoing needed medical care (OR, 1.38; 95% CI, 1.10-1.73), prescription medications (OR, 2.52; 95% CI, 1.99-3.20), and dental care (OR, 1.34; 95% CI, 1.15-1.57) because of cost. Sibling characteristics associated with reporting financial hardship in one or more domains included female sex, older age, chronic health conditions, lower income, not having health insurance, high out-of-pocket medical expenditures, and nonmedical/nonhome debt. No survivor cancer/treatment characteristics were associated with sibling financial hardship. CONCLUSIONS Adult siblings of childhood cancer survivors were more likely to experience financial hardship compared with the general population. Childhood cancer may adversely affect entire households, with potentially lasting implications.
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Affiliation(s)
- Timothy J. D. Ohlsen
- Seattle Children’s Hospital, University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Huiqi Wang
- St. Jude Children’s Research Hospital, Memphis, TN, USA
| | | | - I-Chan Huang
- St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Arti D. Desai
- Seattle Children’s Hospital, University of Washington, Seattle, WA, USA
| | | | - Anne C. Kirchhoff
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Kevin Krull
- St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Rena M. Conti
- Questrom School of Business, Boston University, Boston, MA, USA
| | - Yutaka Yasui
- St. Jude Children’s Research Hospital, Memphis, TN, USA
| | | | | | | | - Paul C. Nathan
- The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Eric J. Chow
- Seattle Children’s Hospital, University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Center, Seattle, WA, USA
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4
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Rotz SJ, Bhatt NS, Hamilton BK, Duncan C, Aljurf M, Atsuta Y, Beebe K, Buchbinder D, Burkhard P, Carpenter PA, Chaudhri N, Elemary M, Elsawy M, Guilcher GMT, Hamad N, Karduss A, Peric Z, Purtill D, Rizzo D, Rodrigues M, Ostriz MBR, Salooja N, Schoemans H, Seber A, Sharma A, Srivastava A, Stewart SK, Baker KS, Majhail NS, Phelan R. International recommendations for screening and preventative practices for long-term survivors of transplantation and cellular therapy: a 2023 update. Bone Marrow Transplant 2024:10.1038/s41409-023-02190-2. [PMID: 38413823 DOI: 10.1038/s41409-023-02190-2] [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: 12/05/2023] [Revised: 12/08/2023] [Accepted: 12/19/2023] [Indexed: 02/29/2024]
Abstract
As hematopoietic cell transplantation (HCT) and cellular therapy expand to new indications and international access improves, the volume of HCT performed annually continues to rise. Parallel improvements in HCT techniques and supportive care entails more patients surviving long-term, creating further emphasis on survivorship needs. Survivors are at risk for developing late complications secondary to pre-, peri- and post-transplant exposures and other underlying risk-factors. Guidelines for screening and preventive practices for HCT survivors were originally published in 2006 and updated in 2012. To review contemporary literature and update the recommendations while considering the changing practice of HCT and cellular therapy, an international group of experts was again convened. This review provides updated pediatric and adult survivorship guidelines for HCT and cellular therapy. The contributory role of chronic graft-versus-host disease (cGVHD) to the development of late effects is discussed but cGVHD management is not covered in detail. These guidelines emphasize special needs of patients with distinct underlying HCT indications or comorbidities (e.g., hemoglobinopathies, older adults) but do not replace more detailed group, disease, or condition specific guidelines. Although these recommendations should be applicable to the vast majority of HCT recipients, resource constraints may limit their implementation in some settings.
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Affiliation(s)
- Seth J Rotz
- Division of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Pediatric Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
- Blood and Marrow Transplant Program, Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
| | | | - Betty K Hamilton
- Blood and Marrow Transplant Program, Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Christine Duncan
- Dana Farber/Boston Children's Cancer and Blood Disorders Center, Harvard University, Boston, MA, USA
| | - Mahmoud Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Yoshiko Atsuta
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
| | - Kristen Beebe
- Phoenix Children's Hospital and Mayo Clinic Arizona, Phoenix, AZ, USA
| | - David Buchbinder
- Division of Hematology, Children's Hospital of Orange County, Orange, CA, USA
| | - Peggy Burkhard
- National Bone Marrow Transplant Link, Southfield, MI, USA
| | | | - Naeem Chaudhri
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mohamed Elemary
- Hematology and BMT, University of Saskatchewan, Saskatoon, SK, Canada
| | - Mahmoud Elsawy
- Division of Hematology, Dalhousie University, Halifax, NS, Canada
- QEII Health Sciences Center, Halifax, NS, Canada
| | - Gregory M T Guilcher
- Section of Pediatric Oncology/Transplant and Cellular Therapy, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nada Hamad
- Department of Haematology, St Vincent's Hospital Sydney, Sydney, NSW, Australia
- St Vincent's Clinical School Sydney, University of New South Wales, Sydney, NSW, Australia
- School of Medicine Sydney, University of Notre Dame Australia, Sydney, WA, Australia
| | - Amado Karduss
- Bone Marrow Transplant Program, Clinica las Americas, Medellin, Colombia
| | - Zinaida Peric
- BMT Unit, Department of Hematology, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Duncan Purtill
- Fiona Stanley Hospital, Murdoch, WA, Australia
- PathWest Laboratory Medicine, Nedlands, WA, Australia
| | - Douglas Rizzo
- Medical College of Wisconsin, Milwaukee, WI, USA
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Maria Belén Rosales Ostriz
- Division of hematology and bone marrow transplantation, Instituto de trasplante y alta complejidad (ITAC), Buenos Aires, Argentina
| | - Nina Salooja
- Centre for Haematology, Imperial College London, London, UK
| | - Helene Schoemans
- Department of Hematology, University Hospitals Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, ACCENT VV, KU Leuven-University of Leuven, Leuven, Belgium
| | | | - Akshay Sharma
- Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Alok Srivastava
- Department of Haematology, Christian Medical College, Vellore, India
| | - Susan K Stewart
- Blood & Marrow Transplant Information Network, Highland Park, IL, 60035, USA
| | | | - Navneet S Majhail
- Sarah Cannon Transplant and Cellular Therapy Network, Nashville, TN, USA
| | - Rachel Phelan
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
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5
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Zinter MS, Brazauskas R, Strom J, Chen S, Bo-Subait S, Sharma A, Beitinjaneh A, Dimitrova D, Guilcher G, Preussler J, Myers K, Bhatt NS, Ringden O, Hematti P, Hayashi RJ, Patel S, De Oliveira SN, Rotz S, Badawy SM, Nishihori T, Buchbinder D, Hamilton B, Savani B, Schoemans H, Sorror M, Winestone L, Duncan C, Phelan R, Dvorak CC. Intensive care risk and long-term outcomes in pediatric allogeneic hematopoietic cell transplant recipients. Blood Adv 2024; 8:1002-1017. [PMID: 38127268 PMCID: PMC10879681 DOI: 10.1182/bloodadvances.2023011002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/16/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
ABSTRACT Allogeneic hematopoietic cell transplantation (HCT) can be complicated by life-threatening organ toxicity and infection necessitating intensive care. Epidemiologic data have been limited by single-center studies, poor database granularity, and a lack of long-term survivors. To identify contemporary trends in intensive care unit (ICU) use and long-term outcomes, we merged data from the Center for International Blood and Marrow Transplant Research and the Virtual Pediatric Systems databases. We identified 6995 pediatric patients with HCT aged ≤21 years who underwent first allogeneic HCT between 2008 and 2014 across 69 centers in the United States or Canada and followed patients until the year 2020. ICU admission was required for 1067 patients (8.3% by day +100, 12.8% by 1 year, and 15.3% by 5 years after HCT), and was linked to demographic background, pretransplant organ toxicity, allograft type and HLA-match, and the development of graft-versus-host disease or malignancy relapse. Survival to ICU discharge was 85.7%, but more than half of ICU survivors required ICU readmission, leading to 52.5% and 42.6% survival at 1- and 5-years post-ICU transfer, respectively. ICU survival was worse among patients with malignant disease, poor pretransplant organ function, and alloreactivity risk factors. Among 1-year HCT survivors, those who required ICU in the first year had 10% lower survival at 5 years and developed new dialysis-dependent renal failure at a greater rate (P<.001). Thus, although ICU management is common and survival to ICU discharge is high, ongoing complications necessitate recurrent ICU admission and lead to a poor 1-year outcome in select patients who are at high risk.
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Affiliation(s)
- Matt S. Zinter
- Division of Critical Care Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA
- Division of Allergy, Immunology, and BMT, Department of Pediatrics, University of California, San Francisco, San Francisco, CA
| | | | | | | | | | | | | | - Dimana Dimitrova
- National Institutes of Health, National Cancer Institute, Bethesda, MD
| | | | | | - Kasiani Myers
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | | | - Olle Ringden
- Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden
| | | | | | - Sagar Patel
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | | | | | - Sherif M. Badawy
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | | | | | - Bipin Savani
- Vanderbilt University Medical Center, Nashville, TN
| | | | | | - Lena Winestone
- Division of Allergy, Immunology, and BMT, Department of Pediatrics, University of California, San Francisco, San Francisco, CA
| | | | | | - Christopher C. Dvorak
- Division of Allergy, Immunology, and BMT, Department of Pediatrics, University of California, San Francisco, San Francisco, CA
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6
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Taylor MR, Cole SW, Strom J, Brazauskas R, Baker KS, Phelan R, Buchbinder D, Hamilton B, Schoemans H, Shaw BE, Sharma A, Bhatt NS, Badawy SM, Winestone LE, Preussler JM, Mayo S, Jamani K, Nishihori T, Lee MA, Knight JM. Unfavorable transcriptome profiles and social disadvantage in hematopoietic cell transplantation: a CIBMTR analysis. Blood Adv 2023; 7:6830-6838. [PMID: 37773924 PMCID: PMC10679811 DOI: 10.1182/bloodadvances.2023010746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/23/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023] Open
Abstract
Patient-reported outcomes (PROs) capture subjective social determinants of health (SDOHs), which can affect health outcomes through the stress response pathway. The conserved transcriptional response to adversity (CTRA) is a stress-mediated proinflammatory transcriptomic pattern that has been linked to adverse hematopoietic cell transplant (HCT) outcomes. This study examined the association of pretransplant CTRA with patient-reported SDOHs in allogeneic HCT recipients. In this cross-sectional study, pre-HCT SDOH-related PROs included the 36-Item Short Form Health Survey and the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT). CTRA was assessed by RNA sequencing of whole blood specimens, with mixed effects linear regression models relating CTRA expression to PRO scores while controlling for age, sex, race, disease, and performance status. Among 121 patients, the median age was 54 years, 42% were female, and 91% were White. CTRA was elevated in participants reporting lower scores on the FACT-BMT (P = .003), including the general (P = .003) and BMT-specific (P = .014) components. Effects were driven by the social well-being domain (P = .0001). This corresponded to an 8% to 15% difference in CTRA RNA expression across a 4 standard deviation range in patient-reported SDOHs. Ancillary bioinformatics analyses confirmed the association of well-being with reduced proinflammatory transcription pathway activity [cyclic AMP response element-binding protein, (CREB), NF-κB, and activating protein-1 (AP-1)]. In conclusion, HCT-treated patients who experience unfavorable social conditions show elevated CTRA expression in pretransplant blood samples. These data highlight the biologic sequelae of social well-being and community context and suggest a potential molecular mechanism for the impact of social gradients in HCT outcomes. Targeting this pathway could optimize outcomes in this high-risk population.
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Affiliation(s)
- Mallory R. Taylor
- Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA
| | - Steve W. Cole
- Departments of Psychiatry & Biobehavioral Sciences and Medicine, UCLA School of Medicine, Los Angeles, CA
| | - Joelle Strom
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Ruta Brazauskas
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - K. Scott Baker
- Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA
- Departments of Psychiatry & Biobehavioral Sciences and Medicine, UCLA School of Medicine, Los Angeles, CA
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA
| | - Rachel Phelan
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA
- Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
| | - David Buchbinder
- Division of Pediatric Hematology, Children’s Hospital of Orange County, Orange, CA
| | - Betty Hamilton
- Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
| | - Hélène Schoemans
- Department of Hematology, University Hospitals Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, ACCENT VV, KU Leuven University of Leuven, Leuven, Belgium
| | - Bronwen E. Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN
| | - Neel S. Bhatt
- Division of Hematology/Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA
- Ben Towne Center for Childhood Cancer Research, Seattle Children’s Research Institute, Seattle, WA
- Departments of Psychiatry & Biobehavioral Sciences and Medicine, UCLA School of Medicine, Los Angeles, CA
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA
| | - Sherif M. Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lena E. Winestone
- Division of Allergy, Immunology, and BMT, Department of Pediatrics, University of California San Francisco Benioff Children’s Hospital, San Francisco, CA
| | - Jaime M. Preussler
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN
| | - Samantha Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Kareem Jamani
- Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada
| | - Taiga Nishihori
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Michelle A. Lee
- Division of Hematology, Oncology, and Cellular Therapy, Department of Pediatrics, Children’s Hospital at Montefiore, Bronx, NY
| | - Jennifer M. Knight
- Section of BMT & Cellular Therapies, Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI
- Department of Microbiology & Immunology, Medical College of Wisconsin, Milwaukee, WI
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7
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Buchbinder D, Bhatt NS, Wang H, Yasui Y, Armenian S, Bhatia S, Chow EJ, Huang IC, Kirchoff AC, Leisenring W, Park ER, Yabroff KR, Armstrong GT, Nathan PC, Khera N. Financial Hardship in Childhood Cancer Survivors Treated with Hematopoietic Cell Transplantation: A Report from the Childhood Cancer Survivor Study. Transplant Cell Ther 2023; 29:705.e1-705.e9. [PMID: 37541329 PMCID: PMC10834839 DOI: 10.1016/j.jtct.2023.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/25/2023] [Accepted: 07/30/2023] [Indexed: 08/06/2023]
Abstract
Long-term survivors of childhood cancer are at risk for financial hardship. However, it is not known if HCT leads to an incremental change in financial hardship for survivors who received it versus those who did not. We examined financial outcomes among adult survivors of childhood cancer who had undergone HCT. Using a cross-sectional survey in the Childhood Cancer Survivor Study population between 2017 and 2019, self-reported financial hardship was compared between survivors who received HCT, survivors treated without HCT ("non-HCT"), and siblings and categorized into 3 domains: material hardship/financial sacrifices, behavioral, and psychological hardship. The standardized score of each domain of financial hardship was calculated by adding the item responses and dividing by the standard deviation among siblings. Multivariable linear and logistic regression were used to evaluate associations between sociodemographic characteristics, cancer diagnosis, post-treatment complications, and financial hardship among survivors. The mean adjusted score for each hardship domain was not significantly different between HCT survivors (n = 133) and non-HCT survivors (n = 2711); mean differences were .18 (95% confidence interval [CI], -.05 to .41) for material hardship/financial sacrifices, .07 (95% CI, -.18 to .32) for behavioral hardship, and .19 (95% CI, -.04 to .42) for psychological hardship. Within specific items, a higher proportion of survivors treated with HCT reported greater financial hardship compared to non-HCT survivors. HCT survivors also had significantly higher mean domain scores compared to sibling controls (n = 1027) in all domains. Household income and chronic health conditions, but not HCT, were associated with financial hardship among all survivors. Adult survivors of childhood cancer treated with HCT do not report greater overall financial hardship compared to non-HCT survivors but do report greater overall financial hardship compared to sibling controls. Surveillance and intervention may be necessary for all survivors regardless of HCT status.
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Affiliation(s)
- David Buchbinder
- Department of Pediatrics, University of California at Irvine, Irvine, California; Division of Hematology, Oncology at Children's Hospital of Orange County, Orange, California.
| | - Neel S Bhatt
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Huiqi Wang
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Saro Armenian
- Department of Pediatrics, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama
| | - Eric J Chow
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Anne C Kirchoff
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah; Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Wendy Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Elyse R Park
- Mongan Institute, Harvard Medical School, Boston, Massachusetts
| | - K Robin Yabroff
- Surveillane and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Paul C Nathan
- Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Ontario, Canada; Division of Hematology, Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nandita Khera
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, Arizona
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8
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Zinter MS, Brazauskas R, Strom J, Chen S, Bo-Subait S, Sharma A, Beitinjaneh A, Dimitrova D, Guilcher G, Preussler J, Myers K, Bhatt NS, Ringden O, Hematti P, Hayashi RJ, Patel S, De Oliveira SN, Rotz S, Badawy SM, Nishihori T, Buchbinder D, Hamilton B, Savani B, Schoemans H, Sorror M, Winestone L, Duncan C, Phelan R, Dvorak CC. Critical Illness Risk and Long-Term Outcomes Following Intensive Care in Pediatric Hematopoietic Cell Transplant Recipients. medRxiv 2023:2023.07.31.23293444. [PMID: 37577706 PMCID: PMC10418579 DOI: 10.1101/2023.07.31.23293444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Background Allogeneic hematopoietic cell transplantation (HCT) can be complicated by the development of organ toxicity and infection necessitating intensive care. Risk factors for intensive care admission are unclear due to heterogeneity across centers, and long-term outcome data after intensive care are sparse due to a historical paucity of survivors. Methods The Center for International Blood and Marrow Transplant Research (CIBMTR) was queried to identify patients age ≤21 years who underwent a 1st allogeneic HCT between 2008-2014 in the United States or Canada. Records were cross-referenced with the Virtual Pediatric Systems pediatric ICU database to identify intensive care admissions. CIBMTR follow-up data were collected through the year 2020. Result We identified 6,995 pediatric HCT patients from 69 HCT centers, of whom 1,067 required post-HCT intensive care. The cumulative incidence of PICU admission was 8.3% at day +100, 12.8% at 1 year, and 15.3% at 5 years post HCT. PICU admission was linked to younger age, lower median zip code income, Black or multiracial background, pre-transplant organ toxicity, pre-transplant CMV seropositivity, use of umbilical cord blood and/or HLA-mismatched allografts, and the development of post-HCT graft-versus-host disease or malignancy relapse. Among PICU patients, survival to ICU discharge was 85.7% but more than half of ICU survivors were readmitted to a PICU during the study interval. Overall survival from the time of 1st PICU admission was 52.5% at 1 year and 42.6% at 5 years. Long-term post-ICU survival was worse among patients with malignant disease (particularly if relapsed), as well as those with poor pre-transplant organ function and alloreactivity risk-factors. In a landmark analysis of all 1-year HCT survivors, those who required intensive care in the first year had 10% lower survival at 5 years (77.1% vs. 87.0%, p<0.001) and developed new dialysis-dependent renal failure at a greater rate (p<0.001). Conclusions Intensive care management is common in pediatric HCT patients. Survival to ICU discharge is high, but ongoing complications necessitate recurrent ICU admission and lead to a poor 1-year outcome in many patients. Together, these data suggest an ongoing burden of toxicity in pediatric HCT patients that continues to limit long-term survival.
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Affiliation(s)
- Matt S Zinter
- Department of Pediatrics, Division of Critical Care Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Pediatrics, Division of Allergy, Immunology, and BMT, University of California, San Francisco, San Francisco, CA, USA
| | | | - Joelle Strom
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Stella Chen
- Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Akshay Sharma
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Dimana Dimitrova
- National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | | | - Jaime Preussler
- National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - Kasiani Myers
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Olle Ringden
- Karolinska Institutet, Karolinska University Hospital, Huddinge, The Netherlands
| | | | | | - Sagar Patel
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | | | - Seth Rotz
- Cleveland Clinic, Cleveland, OH, USA
| | - Sherif M Badawy
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | - Bipin Savani
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Lena Winestone
- Department of Pediatrics, Division of Allergy, Immunology, and BMT, University of California, San Francisco, San Francisco, CA, USA
| | | | | | - Christopher C Dvorak
- Department of Pediatrics, Division of Allergy, Immunology, and BMT, University of California, San Francisco, San Francisco, CA, USA
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9
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Schuetz C, Gerke J, Ege M, Walter J, Kusters M, Worth A, Kanakry JA, Dimitrova D, Wolska-Kuśnierz B, Chen K, Unal E, Karakukcu M, Pashchenko O, Leiding J, Kawai T, Amrolia PJ, Berghuis D, Buechner J, Buchbinder D, Cowan MJ, Gennery AR, Güngör T, Heimall J, Miano M, Meyts I, Morris EC, Rivière J, Sharapova SO, Shaw PJ, Slatter M, Honig M, Veys P, Fischer A, Cavazzana M, Moshous D, Schulz A, Albert MH, Puck JM, Lankester AC, Notarangelo LD, Neven B. Hypomorphic RAG deficiency: impact of disease burden on survival and thymic recovery argues for early diagnosis and HSCT. Blood 2023; 141:713-724. [PMID: 36279417 PMCID: PMC10082356 DOI: 10.1182/blood.2022017667] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/19/2022] [Accepted: 10/04/2022] [Indexed: 11/20/2022] Open
Abstract
Patients with hypomorphic mutations in the RAG1 or RAG2 gene present with either Omenn syndrome or atypical combined immunodeficiency with a wide phenotypic range. Hematopoietic stem cell transplantation (HSCT) is potentially curative, but data are scarce. We report on a worldwide cohort of 60 patients with hypomorphic RAG variants who underwent HSCT, 78% of whom experienced infections (29% active at HSCT), 72% had autoimmunity, and 18% had granulomas pretransplant. These complications are frequently associated with organ damage. Eight individuals (13%) were diagnosed by newborn screening or family history. HSCT was performed at a median of 3.4 years (range 0.3-42.9 years) from matched unrelated donors, matched sibling or matched family donors, or mismatched donors in 48%, 22%, and 30% of the patients, respectively. Grafts were T-cell depleted in 15 cases (25%). Overall survival at 1 and 4 years was 77.5% and 67.5% (median follow-up of 39 months). Infection was the main cause of death. In univariable analysis, active infection, organ damage pre-HSCT, T-cell depletion of the graft, and transplant from a mismatched family donor were predictive of worse outcome, whereas organ damage and T-cell depletion remained significant in multivariable analysis (hazard ratio [HR] = 6.01, HR = 8.46, respectively). All patients diagnosed by newborn screening or family history survived. Cumulative incidences of acute and chronic graft-versus-host disease were 35% and 22%, respectively. Cumulative incidences of new-onset autoimmunity was 15%. Immune reconstitution, particularly recovery of naïve CD4+ T cells, was faster and more robust in patients transplanted before 3.5 years of age, and without organ damage. These findings support the indication for early transplantation.
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Affiliation(s)
- C. Schuetz
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J. Gerke
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M. Ege
- Dr. von Hauner Children’s Hospital at Ludwig-Maximilians-Universität, München, Germany
- Helmholtz Zentrum München, Neuherberg, Germany
| | - J. Walter
- Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL
- Division of Allergy and Immunology, Department of Medicine, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
| | - M. Kusters
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
| | - A. Worth
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
| | - J. A. Kanakry
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - D. Dimitrova
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - B. Wolska-Kuśnierz
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
| | - K. Chen
- Division of Allergy and Immunology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - E. Unal
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - M. Karakukcu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - O. Pashchenko
- Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - J. Leiding
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Orlando Health Arnold Pamer Hospital for Children, Orlando, FL
| | - T. Kawai
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - P. J. Amrolia
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - D. Berghuis
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - J. Buechner
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
| | - D. Buchbinder
- Division of Hematology, Children's Hospital of Orange County, Orange, CA
| | - M. J. Cowan
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - A. R. Gennery
- Translational and Clinical Research Institute, Newcastle University, Paediatric Haematopoietic Stem Cell Transplant Unit, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
| | - T. Güngör
- Department of Hematology/Oncology/Immunology, Gene-therapy, and Stem Cell Transplantation, University Children’s Hospital Zurich–Eleonore Foundation & Children’s Research Center, Zürich, Switzerland
| | - J. Heimall
- Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
| | - M. Miano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - I. Meyts
- Department of Pediatrics, Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, Belgium
| | - E. C. Morris
- UCL Institute of Immunity & Transplantation, University College London Hospitals NHS Foundation Trust, Royal Free London Hospital NHS Foundation Trust, London, United Kingdom
| | - J. Rivière
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S. O. Sharapova
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
| | - P. J. Shaw
- Blood Transplant and Cell Therapies, Children’s Hospital at Westmead, Sydney, Australia
| | - M. Slatter
- Paediatric Immunology & HSCT, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
| | - M. Honig
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
| | - P. Veys
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - A. Fischer
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Collège de France, Paris, France
| | - M. Cavazzana
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Département de Biothérapie, Hôpital Universitaire Necker-Enfants Malades, Groupe Hospitalier Paris Centre, Assistance Publique–Hopitaux de Paris, Paris, France
- Centre d’Investigation Clinique Biothérapie, Groupe hospitalier Universitaire paris centre, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
| | - D. Moshous
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - A. Schulz
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
| | - M. H. Albert
- Pediatric SCT Program, Dr. von Hauner University Children’s Hospital, Ludwig-Maximilians Universität, München, Germany
| | - J. M. Puck
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - A. C. Lankester
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - L. D. Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - B. Neven
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
| | - Inborn Errors Working Party (IEWP) of the European Society for Immunodeficiencies (ESID) and European Society for Blood and Marrow Transplantation (EBMT) and the Primary Immune Deficiency Treatment Consortium (PIDTC)
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Dr. von Hauner Children’s Hospital at Ludwig-Maximilians-Universität, München, Germany
- Helmholtz Zentrum München, Neuherberg, Germany
- Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL
- Division of Allergy and Immunology, Department of Medicine, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
- Division of Allergy and Immunology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
- Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russia
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Orlando Health Arnold Pamer Hospital for Children, Orlando, FL
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Division of Hematology, Children's Hospital of Orange County, Orange, CA
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
- Translational and Clinical Research Institute, Newcastle University, Paediatric Haematopoietic Stem Cell Transplant Unit, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
- Department of Hematology/Oncology/Immunology, Gene-therapy, and Stem Cell Transplantation, University Children’s Hospital Zurich–Eleonore Foundation & Children’s Research Center, Zürich, Switzerland
- Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Pediatrics, Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, Belgium
- UCL Institute of Immunity & Transplantation, University College London Hospitals NHS Foundation Trust, Royal Free London Hospital NHS Foundation Trust, London, United Kingdom
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
- Blood Transplant and Cell Therapies, Children’s Hospital at Westmead, Sydney, Australia
- Paediatric Immunology & HSCT, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Collège de France, Paris, France
- Département de Biothérapie, Hôpital Universitaire Necker-Enfants Malades, Groupe Hospitalier Paris Centre, Assistance Publique–Hopitaux de Paris, Paris, France
- Centre d’Investigation Clinique Biothérapie, Groupe hospitalier Universitaire paris centre, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
- Pediatric SCT Program, Dr. von Hauner University Children’s Hospital, Ludwig-Maximilians Universität, München, Germany
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
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10
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Lipsitt A, Marón GM, Agarwal N, Albert J, Boelens JJ, Buchbinder D, Chavan R, Dallas R, Dandoy DCE, Eisenman D, Ferrolino JA, Rosa MG, Hanisch B, Hanna R, Katsanis E, Kim M, McLaughlin L, Onishi T, Sharma A, Su Y, Tang L, Sharma A. Impact of Trimethoprim/Sulfamethoxazole Prophylaxis on Engraftment in Pediatric Hematopoietic Cell Transplant Recipients. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00495-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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11
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Taylor M, Cole S, Strom J, Brazauskas R, Baker S, Phelan R, Buchbinder D, Hamilton BK, Schoemans PHM, Knight JM. Association between Patient-Reported Social Determinant of Health Outcomes and a Social Genomics Profile in Allogeneic Hematopoietic Cell Transplantation: A Center for International Blood and Marrow Transplant Research (CIBMTR) Analysis. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00560-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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12
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Ige K, Nguyen K, Buchbinder D, Butte M, Collins C, Cowan M, Dimitriades V, McGhee S, Shah A, Puck J, Smith H, Chen XH, Franck L, Dorsey M. Severe Combined Immunodeficiency (SCID) Patient and Families Report Significant Financial Burden. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.770] [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: 02/05/2023]
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13
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Davis KA, Brosnan P, Mazzenga M, Buchbinder D, Alderfer MA, Sharkey CM, Long KA. Inconsistent, uncoordinated, and reactive: The current state of sibling psychosocial care. Pediatr Blood Cancer 2023; 70:e30103. [PMID: 36385588 DOI: 10.1002/pbc.30103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although providing sibling psychosocial services is a standard of care in pediatric oncology, initial survey research suggests that this standard is rarely achieved and siblings' support needs remain unmet. Which sibling psychosocial services are available and how centers provide such services is unknown. To identify targetable services gaps, this qualitative study characterizes current sibling psychosocial care practices at select pediatric cancer centers across the United States. PROCEDURE Semi-structured interviews were conducted with a purposive sample of psychosocial care providers (N = 27) working across the United States in pediatric oncology centers of varied sizes. Interviews queried providers regarding sibling-focused parent psychoeducation, psychosocial screening, comprehensive assessment, and psychosocial support offerings. Interview data were analyzed using Applied Thematic Analysis. RESULTS Across cancer centers, sibling care practices did not align with consensus-based recommendations. The nature and availability of sibling-focused psychoeducation, screening, assessment, and support were variable between and within centers. Siblings themselves were largely absent from sibling psychosocial care, and care was rarely sibling-specific. The flow of information about siblings was discontinuous and uncoordinated across the care continuum, resulting in psychosocial care provided reactively, typically in response to parental concerns. CONCLUSIONS Sibling psychosocial care provision falls short of established care recommendations, leaving sibling psychosocial needs unmet. Findings highlight the need for tools and strategies to facilitate the implementation of sibling psychosocial care across the care continuum, to support siblings' psychosocial functioning across the life course.
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Affiliation(s)
- Kathryn A Davis
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Phoebe Brosnan
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Marcella Mazzenga
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - David Buchbinder
- Division of Hematology, Children's Hospital of Orange County, Orange, California, USA
| | - Melissa A Alderfer
- Center for Healthcare Delivery Science, Nemours Children's Hospital, Wilmington, Delaware, USA.,Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Christina M Sharkey
- Department of Neurology, Children's National Hospital, Washington, District of Columbia, USA
| | - Kristin A Long
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
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14
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Geier CB, Ellison M, Cruz R, Pawar S, Leiss-Piller A, Zmajkovicova K, McNulty SM, Yilmaz M, Evans MO, Gordon S, Ujhazi B, Wiest I, Abolhassani H, Aghamohammadi A, Barmettler S, Bhar S, Bondarenko A, Bolyard AA, Buchbinder D, Cada M, Cavieres M, Connelly JA, Dale DC, Deordieva E, Dorsey MJ, Drysdale SB, Ehl S, Elfeky R, Fioredda F, Firkin F, Förster-Waldl E, Geng B, Goda V, Gonzalez-Granado L, Grunebaum E, Grzesk E, Henrickson SE, Hilfanova A, Hiwatari M, Imai C, Ip W, Jyonouchi S, Kanegane H, Kawahara Y, Khojah AM, Kim VHD, Kojić M, Kołtan S, Krivan G, Langguth D, Lau YL, Leung D, Miano M, Mersyanova I, Mousallem T, Muskat M, Naoum FA, Noronha SA, Ouederni M, Ozono S, Richmond GW, Sakovich I, Salzer U, Schuetz C, Seeborg FO, Sharapova SO, Sockel K, Volokha A, von Bonin M, Warnatz K, Wegehaupt O, Weinberg GA, Wong KJ, Worth A, Yu H, Zharankova Y, Zhao X, Devlin L, Badarau A, Csomos K, Keszei M, Pereira J, Taveras AG, Beaussant-Cohen SL, Ong MS, Shcherbina A, Walter JE. Disease Progression of WHIM Syndrome in an International Cohort of 66 Pediatric and Adult Patients. J Clin Immunol 2022; 42:1748-1765. [PMID: 35947323 PMCID: PMC9700649 DOI: 10.1007/s10875-022-01312-7] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/17/2022] [Indexed: 11/26/2022]
Abstract
Warts, hypogammaglobulinemia, infections, and myelokathexis (WHIM) syndrome (WS) is a combined immunodeficiency caused by gain-of-function mutations in the C-X-C chemokine receptor type 4 (CXCR4) gene. We characterize a unique international cohort of 66 patients, including 57 (86%) cases previously unreported, with variable clinical phenotypes. Of 17 distinct CXCR4 genetic variants within our cohort, 11 were novel pathogenic variants affecting 15 individuals (23%). All variants affect the same CXCR4 region and impair CXCR4 internalization resulting in hyperactive signaling. The median age of diagnosis in our cohort (5.5 years) indicates WHIM syndrome can commonly present in childhood, although some patients are not diagnosed until adulthood. The prevalence and mean age of recognition and/or onset of clinical manifestations within our cohort were infections 88%/1.6 years, neutropenia 98%/3.8 years, lymphopenia 88%/5.0 years, and warts 40%/12.1 years. However, we report greater prevalence and variety of autoimmune complications of WHIM syndrome (21.2%) than reported previously. Patients with versus without family history of WHIM syndrome were diagnosed earlier (22%, average age 1.3 years versus 78%, average age 5 years, respectively). Patients with a family history of WHIM syndrome also received earlier treatment, experienced less hospitalization, and had less end-organ damage. This observation reinforces previous reports that early treatment for WHIM syndrome improves outcomes. Only one patient died; death was attributed to complications of hematopoietic stem cell transplantation. The variable expressivity of WHIM syndrome in pediatric patients delays their diagnosis and therapy. Early-onset bacterial infections with severe neutropenia and/or lymphopenia should prompt genetic testing for WHIM syndrome, even in the absence of warts.
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Affiliation(s)
- Christoph B Geier
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center University of Freiburg Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Rheumatology and Clinical Immunology, Center for Chronic Immunodeficiency, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maryssa Ellison
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA
| | - Rachel Cruz
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Sumit Pawar
- X4 Pharmaceuticals (Austria) GmbH, Vienna, Austria
| | | | | | - Shannon M McNulty
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Melis Yilmaz
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA
| | | | - Sumai Gordon
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA
| | - Boglarka Ujhazi
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA
| | - Ivana Wiest
- X4 Pharmaceuticals (Austria) GmbH, Vienna, Austria
| | - Hassan Abolhassani
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Asghar Aghamohammadi
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Barmettler
- Allergy and Clinical Immunology Unit, Division of Rheumatology, Allergy & Immunology, Massachusetts General Hospital, Boston, MA, USA
| | - Saleh Bhar
- Department of Pediatrics, Section of Hematology/Oncology and Critical Care Medicine, Bone Marrow Transplantation, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | | | - Audrey Anna Bolyard
- Severe Chronic Neutropenia International Registry, University of Washington, Seattle, WA, USA
| | - David Buchbinder
- Division of Hematology, CHOC Children's Hospital, Orange, CA, USA
| | - Michaela Cada
- Division of Hematology and Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Mirta Cavieres
- Hematology Unit, Dr Luis Calvo Mackenna Children's Hospital, Santiago, Chile
| | | | - David C Dale
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ekaterina Deordieva
- Immunology, the Dmitry Rogachev National Medical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Morna J Dorsey
- Division of Allergy, Immunology and Blood and Marrow Transplantation, Department of Pediatrics, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | - Simon B Drysdale
- Paediatric Infectious Diseases Research Group, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Stephan Ehl
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center University of Freiburg Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Reem Elfeky
- Department of Clinical Immunology, Royal Free Hospital, London, UK
| | | | - Frank Firkin
- Department of Medicine, St Vincent's Hospital, University of Melbourne, Vic, Fitzroy, Australia
- Department of Clinical Haematology, St Vincent's Hospital, Vic, Fitzroy, Australia
| | - Elizabeth Förster-Waldl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Division of Neonatology, Pediatric Intensive Care & Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Center for Congenital Immunodeficiencies, Medical University of Vienna & Jeffrey Modell Diagnostic and Research Center, Vienna, Austria
| | - Bob Geng
- Divisions of Adult and Pediatric Allergy and Immunology, University of California, San Diego, CA, USA
| | - Vera Goda
- Department for Pediatric Hematology and Hemopoietic Stem Cell Transplantation, Central Hospital of Southern Pest - National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Luis Gonzalez-Granado
- Immunodeficiencies Unit, Department of Pediatrics, University Hospital 12 de Octubre, Research Institute Hospital 12 Octubre, Madrid, Spain
| | - Eyal Grunebaum
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Immunology and Allergy, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elzbieta Grzesk
- Department of Pediatrics, Hematology and Oncology Collegium Medicum, Bydgoszcz Nicolaus Copernicus University, Torun, Poland
| | - Sarah E Henrickson
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Anna Hilfanova
- Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
| | - Mitsuteru Hiwatari
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chihaya Imai
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Pediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Winnie Ip
- Great Ormond Street Hospital for Children, London, UK
| | - Soma Jyonouchi
- Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Hirokazu Kanegane
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuta Kawahara
- Department of Pediatrics, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Amer M Khojah
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Vy Hong-Diep Kim
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Immunology and Allergy, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Marina Kojić
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Sylwia Kołtan
- Department of Pediatrics, Hematology and Oncology Collegium Medicum, Bydgoszcz Nicolaus Copernicus University, Torun, Poland
| | - Gergely Krivan
- Department for Pediatric Hematology and Hemopoietic Stem Cell Transplantation, Central Hospital of Southern Pest - National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Daman Langguth
- Department of Immunology, Sullivan and Nicolaides Pathology, Brisbane, Australia
| | - Yu-Lung Lau
- Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, China
| | - Daniel Leung
- Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, China
| | - Maurizio Miano
- Haematology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Irina Mersyanova
- Immunology, the Dmitry Rogachev National Medical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Talal Mousallem
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Duke University Medical Center, Durham, NC, USA
| | - Mica Muskat
- Department of Pediatrics, University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Flavio A Naoum
- Academia de Ciência e Tecnologia, Sao Jose do Rio Preto, Brazil
| | - Suzie A Noronha
- Department of Pediatrics, Division of Hematology-Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Monia Ouederni
- Faculty of Médecine, University Tunis El Manar, Tunis, Tunisia
- Department of Pediatrics: Immuno-Hematology and Stem Cell Transplantation, Bone Marrow Transplantation Center of Tunisia, Tunis, Tunisia
| | - Shuichi Ozono
- Department of Pediatrics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan
| | - G Wendell Richmond
- Section of Allergy and Immunology, Rush University Medical Center, Chicago, IL, USA
| | - Inga Sakovich
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
| | - Ulrich Salzer
- Department of Rheumatology and Clinical Immunology, Center for Chronic Immunodeficiency, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Catharina Schuetz
- Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Filiz Odabasi Seeborg
- Department of Pediatrics, Section of Immunology, Allergy and Rheumatology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Svetlana O Sharapova
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
| | - Katja Sockel
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Alla Volokha
- Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
| | - Malte von Bonin
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Dresden, Dresden, Germany
| | - Klaus Warnatz
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center University of Freiburg Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Rheumatology and Clinical Immunology, Center for Chronic Immunodeficiency, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Oliver Wegehaupt
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center University of Freiburg Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Pediatrics and Adolescent Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Geoffrey A Weinberg
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, University of Rochester Golisano Children's Hospital, Rochester, NY, USA
| | - Ke-Juin Wong
- Sabah Women and Children's Hospital, Sabah, Malaysia
| | - Austen Worth
- Great Ormond Street Hospital for Children, London, UK
| | - Huang Yu
- National Clinical Research Center for Child Health and disorders, Children Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Yulia Zharankova
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
| | - Xiaodong Zhao
- National Clinical Research Center for Child Health and disorders, Children Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China
| | - Lisa Devlin
- Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
- Regional Immunology Service, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | | | - Krisztian Csomos
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA
| | - Marton Keszei
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - Joao Pereira
- Department of Immunobiology, Yale University School of Medicine, Yale University, New Haven, CT, USA
| | | | | | - Mei-Sing Ong
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Anna Shcherbina
- Immunology, the Dmitry Rogachev National Medical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Jolan E Walter
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA.
- Division of Allergy and Immunology, Massachusetts General Hospital for Children, Boston, MA, USA.
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15
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Saliba RM, Alousi AM, Pidala J, Arora M, Spellman SR, Hemmer MT, Wang T, Abboud C, Ahmed S, Antin JH, Beitinjaneh A, Buchbinder D, Byrne M, Cahn JY, Choe H, Hanna R, Hematti P, Kamble RT, Kitko CL, Laughlin M, Lekakis L, MacMillan ML, Martino R, Mehta PA, Nishihori T, Patel SS, Perales MA, Rangarajan HG, Ringdén O, Rosenthal J, Savani BN, Schultz KR, Seo S, Teshima T, van der Poel M, Verdonck LF, Weisdorf D, Wirk B, Yared JA, Schriber J, Champlin RE, Ciurea SO. Characteristics of Graft-Versus-Host Disease (GvHD) After Post-Transplantation Cyclophosphamide Versus Conventional GvHD Prophylaxis. Transplant Cell Ther 2022; 28:681-693. [PMID: 35853610 PMCID: PMC10141544 DOI: 10.1016/j.jtct.2022.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 06/23/2022] [Accepted: 07/12/2022] [Indexed: 02/02/2023]
Abstract
Post-transplantation cyclophosphamide (PTCy) has been shown to effectively control graft-versus-host disease (GvHD) in haploidentical (Haplo) transplantations. In this retrospective registry study, we compared GvHD organ distribution, severity, and outcomes in patients with GvHD occurring after Haplo transplantation with PTCy GvHD prophylaxis (Haplo/PTCy) versus HLA-matched unrelated donor transplantation with conventional prophylaxis (MUD/conventional). We evaluated 2 cohorts: patients with grade 2 to 4 acute GvHD (aGvHD) including 264 and 1163 recipients of Haplo and MUD transplants; and patients with any chronic GvHD (cGvHD) including 206 and 1018 recipients of Haplo and MUD transplants, respectively. In comparison with MUD/conventional transplantation ± antithymocyte globulin (ATG), grade 3-4 aGvHD (28% versus 39%, P = .001), stage 3-4 lower gastrointestinal (GI) tract aGvHD (14% versus 21%, P = .01), and chronic GI GvHD (21% versus 31%, P = .006) were less common after Haplo/PTCy transplantation. In patients with grade 2-4 aGvHD, cGvHD rate after Haplo/PTCY was also lower (hazard ratio [HR] = .4, P < .001) in comparison with MUD/conventional transplantation without ATG in the nonmyeloablative conditioning setting. Irrespective of the use of ATG, non-relapse mortality rate was lower (HR = .6, P = .01) after Haplo/PTCy transplantation, except for transplants that were from a female donor into a male recipient. In patients with cGvHD, irrespective of ATG use, Haplo/PTCy transplantation had lower non-relapse mortality rates (HR = .6, P = .04). Mortality rate was higher (HR = 1.6, P = .03) during, but not after (HR = .9, P = .6) the first 6 months after cGvHD diagnosis. Our results suggest that PTCy-based GvHD prophylaxis mitigates the development of GI GvHD and may translate into lower GvHD-related non-relapse mortality rate.
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Affiliation(s)
- Rima M Saliba
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Amin M Alousi
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Joseph Pidala
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Mukta Arora
- CIBMTR® (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be the Match, Minneapolis, Minnesota; Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Stephen R Spellman
- CIBMTR® (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be the Match, Minneapolis, Minnesota
| | - Michael T Hemmer
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Tao Wang
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Divsion of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Camille Abboud
- Washington University in St. Louis School of Medicine, Division of Oncology, Section of BMT and Leukemia, St. Louis, Missouri
| | - Sairah Ahmed
- Department of Lymphoma-Myeloma, The University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Joseph H Antin
- Division of Hematologic Malignancies, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, Florida
| | - David Buchbinder
- Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, California
| | - Michael Byrne
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Hannah Choe
- The Ohio State University Wexner Medical Center, James Comprehensive Cancer Center, Columbus, Ohio
| | | | - Peiman Hematti
- Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin, Madison, Wisconsin
| | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Carrie L Kitko
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mary Laughlin
- Medical Director, Cleveland Cord Blood Center, Cleveland, Ohio
| | - Lazaros Lekakis
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Margaret L MacMillan
- Blood and Marrow Transplant Program, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Rodrigo Martino
- Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Parinda A Mehta
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, Florida
| | - Sagar S Patel
- Blood and Marrow Transplant Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Miguel-Angel Perales
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hemalatha G Rangarajan
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Nationwide Children's Hospital, Columbus, Ohio
| | - Olov Ringdén
- Translational Cell Therapy Group, CLINTEC (Clinical Science, Intervention and Technology), Karolinska Institutet, Stockholm, Sweden
| | | | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kirk R Schultz
- Department of Pediatric Hematology, Oncology and Bone Marrow Transplant, British Columbia's Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Takanori Teshima
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Marjolein van der Poel
- Department of Internal Medicine, Division of Hematology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Leo F Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands
| | - Daniel Weisdorf
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minnesota
| | - Baldeep Wirk
- Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, Pennsylvania
| | - Jean A Yared
- Transplantation & Cellular Therapy Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Jeffrey Schriber
- Cancer Treatment Centers of America Comprehensive Care and Research Center, Phoenix, Arizona
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stefan O Ciurea
- Hematopoietic Stem Cell Transplantation and Cellular Therapy Program, University of California, Irvine, Orange, California
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16
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Wang W, Min Q, Lai N, Csomos K, Wang Y, Liu L, Meng X, Sun J, Hou J, Ying W, Zhou Q, Sun B, Hui X, Ujhazi B, Gordon S, Buchbinder D, Schuetz C, Butte M, Walter JE, Wang X, Wang JY. Cellular Mechanisms Underlying B Cell Abnormalities in Patients With Gain-of-Function Mutations in the PIK3CD Gene. Front Immunol 2022; 13:890073. [PMID: 35799777 PMCID: PMC9253290 DOI: 10.3389/fimmu.2022.890073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/23/2022] [Indexed: 11/20/2022] Open
Abstract
Background Activated phosphoinositide 3 kinase (PI3K) -delta syndrome (APDS) is an inborn error of immunity with variable clinical phenotype of immunodeficiency and immune dysregulation and caused by gain-of-function mutations in PIK3CD. The hallmark of immune phenotype is increased proportions of transitional B cells and plasmablasts (PB), progressive B cell loss, and elevated levels of serum IgM. Objective To explore unique B cell subsets and the pathomechanisms driving B cell dysregulation beyond the transitional B cell stage in APDS. Methods Clinical and immunological data was collected from 24 patients with APDS. In five cases, we performed an in-depth analysis of B cell phenotypes and cultured purified naïve B cells to evaluate their survival, activation, Ig gene class switch recombination (CSR), PB differentiation and antibody secretion. We also analyzed PB differentiation capacity of sorted CD27-IgD- double-negative B (DNB) cells. Results The patients had increased B cell sizes and higher proportions of IgM+ DNB cells than healthy controls (HC). Their naïve B cells exhibited increased death, impaired CSR but relatively normal PB differentiation. Upon stimulation, patient’s DNB cells secreted a similar level of IgG but a higher level of IgM than DNB cells from HC. Targeted therapy of PI3K inhibition partially restored B cell phenotypes. Conclusions The present study suggests additional mechanistic insight into B cell pathology of APDS: (1) decreased peripheral B cell numbers may be due to the increased death of naïve B cells; (2) larger B cell sizes and expanded DNB population suggest enhanced activation and differentiation of naïve B cells into DNB cells; (3) the impaired CSR yet normal PB differentiation can predominantly generate IgM-secreting cells, resulting in elevated IgM levels.
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Affiliation(s)
- Wenjie Wang
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
| | - Qing Min
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
| | - Nannan Lai
- Key Laboratory of Whole-Period Monitoring and Precise Intervention of Digestive Cancer, Shanghai Municipal Health Commission (SMHC), Minhang Hospital, Fudan University, Shanghai, China
| | - Krisztian Csomos
- Division of Pediatric Allergy/Immunology and Jeffrey Modell Diagnostic and Research Center, University of South Florida and Johns Hopkins All Children’s Hospital, St. Petersburg, FL, United States
| | - Ying Wang
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
| | - Luyao Liu
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
| | - Xin Meng
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Jinqiao Sun
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
| | - Jia Hou
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
| | - Wenjing Ying
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
| | - Qinhua Zhou
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
| | - Bijun Sun
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
| | - Xiaoying Hui
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
| | - Boglarka Ujhazi
- Division of Pediatric Allergy/Immunology and Jeffrey Modell Diagnostic and Research Center, University of South Florida and Johns Hopkins All Children’s Hospital, St. Petersburg, FL, United States
| | - Sumai Gordon
- Division of Pediatric Allergy/Immunology and Jeffrey Modell Diagnostic and Research Center, University of South Florida and Johns Hopkins All Children’s Hospital, St. Petersburg, FL, United States
| | - David Buchbinder
- Division of Hematology, Children’s Hospital of Orange Country (CHOC), Irvine, CA, United States
| | - Catharina Schuetz
- Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Manish Butte
- Division of Immunology, Allergy, and Rheumatology, Department of Pediatrics and Jeffrey Modell Diagnostic and Research Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jolan E. Walter
- Division of Pediatric Allergy/Immunology and Jeffrey Modell Diagnostic and Research Center, University of South Florida and Johns Hopkins All Children’s Hospital, St. Petersburg, FL, United States
- Massachusetts General Hospital, Boston, MA, United States
- *Correspondence: Jolan E. Walter, ; Xiaochuan Wang, ; Ji-Yang Wang,
| | - Xiaochuan Wang
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China
- *Correspondence: Jolan E. Walter, ; Xiaochuan Wang, ; Ji-Yang Wang,
| | - Ji-Yang Wang
- Department of Clinical Immunology, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai, China
- Department of Immunology, School of Basic Medical Sciences, Fudan University, Shanghai, China
- Department of Microbiology and Immunology, College of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
- Division of Biochemistry, Faculty of Pharmacy and Graduate School of Pharmaceutical Science, Keio University, Tokyo, Japan
- *Correspondence: Jolan E. Walter, ; Xiaochuan Wang, ; Ji-Yang Wang,
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17
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Abstract
INTRODUCTION Wiskott-Aldrich syndrome (WAS) serves as the prototype of how variants in a gene which encodes a protein central to actin cytoskeletal homeostasis can manifest clinically in a variety of ways including infection, atopy, autoimmunity, inflammation, bleeding, neutropenia, non-malignant lymphoproliferation, and malignancy. Despite the discovery of the WAS gene almost 30 years ago, our understanding of the pathophysiological mechanisms underlying WAS continues to unfold. AREAS COVERED This review will provide an overview of the approach to the diagnosis of WAS as well as the management of its associated complications. Advances in the use of allogeneic hematopoietic stem cell transplantation (HSCT) and gene therapy as well as the associated challenges unique to WAS will be discussed. EXPERT OPINION Basic research, combined with clinical research focusing on longitudinal analysis of WAS patients, will help clarify determinants that influence WAS pathogenesis as well as clinical complications and outcomes. Advances in curative approaches including the use of alternative donor HSCT for WAS continue to evolve. Gene therapy employing safer and more effective protocols ensuring full correction of WAS will provide life-saving benefit to WAS patients that are unable to undergo HSCT.
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Affiliation(s)
- Corey Cavannaugh
- Department of Pediatrics University of California at Irvine 333 The City Blvd. West Suite 800 Orange, CA 92868
| | - Hans D Ochs
- Department of Pediatrics University of Washington and Seattle Children's Research Institute Seattle, WA 98105
| | - David Buchbinder
- Division of Hematology Children's Hospital of Orange County 1201 La Veta Avenue Orange, CA 92868
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18
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Phelan R, Im A, Hunter RL, Inamoto Y, Lupo-Stanghellini MT, Rovo A, Badawy SM, Burns L, Eissa H, Murthy HS, Prasad P, Sharma A, Suelzer E, Agrawal V, Aljurf M, Baker K, Basak GW, Buchbinder D, DeFilipp Z, Grkovic LD, Dias A, Einsele H, Eisenberg ML, Epperla N, Farhadfar N, Flatau A, Gale RP, Greinix H, Hamilton BK, Hashmi S, Hematti P, Jamani K, Maharaj D, Murray J, Naik S, Nathan S, Pavletic S, Peric Z, Pulanic D, Ross R, Salonia A, Sanchez-Ortega I, Savani BN, Schechter T, Shah AJ, Smith SM, Snowden JA, Steinberg A, Tremblay D, Vij SC, Walker L, Wolff D, Yared JA, Schoemans H, Tichelli A. Male-specific late effects in adult hematopoietic cell transplantation recipients: a systematic review from the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation. Bone Marrow Transplant 2022; 57:1150-1163. [PMID: 35523848 DOI: 10.1038/s41409-022-01591-z] [Citation(s) in RCA: 1] [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: 11/18/2021] [Revised: 12/10/2021] [Accepted: 01/18/2022] [Indexed: 12/15/2022]
Abstract
Male-specific late effects after hematopoietic cell transplantation (HCT) include genital chronic graft-versus-host disease (GvHD), hypogonadism, sexual dysfunction, infertility, and subsequent malignancies. They may be closely intertwined and cause prolonged morbidity and decreased quality of life after HCT. We provide a systematic review of male-specific late effects in a collaboration between transplant physicians, endocrinologists, urologists, dermatologists, and sexual health professionals through the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research, and the Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation. The systematic review summarizes incidence, risk factors, screening, prevention and treatment of these complications and provides consensus evidence-based recommendations for clinical practice and future research.
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Affiliation(s)
- Rachel Phelan
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. .,Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Annie Im
- University of Pittsburgh/UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Rebecca L Hunter
- Division of Hematology, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | | | - Alicia Rovo
- Department of Hematology and Central Hematology Laboratory, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Linda Burns
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Hesham Eissa
- Department of Pediatrics, Center for Cancer and Blood Disorders, University of Colorado School of Medicine, Aurora, CO, USA
| | - Hemant S Murthy
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA
| | - Pinki Prasad
- Louisiana State University Health Sciences Center/Children's Hospital of New Orleans, Department of Pediatrics, New Orleans, LA, USA
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Vaibhav Agrawal
- Division of Leukemia, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Karen Baker
- Duke University Medical Center, Durham, NC, USA
| | - Grzegorz W Basak
- University Clinical Centre, Medical University of Warsaw, Warsaw, Poland
| | - David Buchbinder
- Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA, USA
| | - Zachariah DeFilipp
- Hematopoietic Cell Transplant and Cellular Therapy Program, Massachusetts General Hospital, Boston, MA, USA
| | | | - Ajoy Dias
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Hermann Einsele
- Universitätsklinikum Würzburg, Department of Internal Medicine II, Würzburg, Germany
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Narendranath Epperla
- Division of Hematology, Department of Medicine, The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, Ohio, USA
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Arthur Flatau
- Association of Cancer Online Resources, Association of Cancer Online Resources, Austin, TX, USA
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, UK
| | | | - Betty K Hamilton
- Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Shahrukh Hashmi
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Peiman Hematti
- Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Kareem Jamani
- Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada
| | - Dipnarine Maharaj
- South Florida Bone Marrow Stem Cell Transplant Institute, Boynton Beach, FL, USA
| | - John Murray
- The Christie NHS Foundation Trust, Manchester, UK
| | - Seema Naik
- Division Hematology and Oncology, Department of Medicine, Penn State Cancer Institute, Milton Hershey Medical Center, Hershey, PA, USA
| | - Sunita Nathan
- Section of Bone Marrow Transplant and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Steven Pavletic
- Immune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Zinaida Peric
- University Hospital Centre Zagreb and Medical School University of Zagreb, Zagreb, Croatia
| | - Drazen Pulanic
- University Hospital Centre Zagreb and Medical School University of Zagreb, Zagreb, Croatia
| | | | - Andrea Salonia
- University Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tal Schechter
- Division of Pediatric Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Ami J Shah
- Division of Hematology/ Oncology/ Stem Cell Transplantation and Regenerative Medicine, Lucile Packard Children's Hospital, Stanford School of Medicine, Palo Alto, CA, USA
| | - Stephanie M Smith
- Division of Hematology/Oncology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - John A Snowden
- The University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - Douglas Tremblay
- Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah C Vij
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Lauren Walker
- Department of Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Daniel Wolff
- Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
| | - Hélène Schoemans
- Department of Hematology, University Hospitals Leuven, Leuven, Belgium.,Department of Public Health and Primary Care, ACCENT VV, KU Leuven - University of Leuven, Leuven, Belgium
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19
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Broglie L, Bo-Subait S, Chen Y, Brazauskas R, Buchbinder D, Hamilton BK, Schoemans HM, Phelan R, Satwani P. Trends in Late Mortality Amongst Two-Year Survivors of Pediatric and Young Adult Allogeneic Hematopoietic Cell Transplantation for Acute Leukemias: On Behalf of the CIBMTR Late Effects Working Committee. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00217-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Perelygina L, Faisthalab R, Abernathy E, Chen MH, Hao L, Bercovitch L, Bayer DK, Noroski LM, Lam MT, Cicalese MP, Al-Herz W, Nanda A, Hajjar J, Vanden Driessche K, Schroven S, Leysen J, Rosenbach M, Peters P, Raedler J, Albert MH, Abraham RS, Rangarjan HG, Buchbinder D, Kobrynski L, Pham-Huy A, Dhossche J, Cunningham Rundles C, Meyer AK, Theos A, Atkinson TP, Musiek A, Adeli M, Derichs U, Walz C, Krüger R, von Bernuth H, Klein C, Icenogle J, Hauck F, Sullivan KE. Rubella Virus Infected Macrophages and Neutrophils Define Patterns of Granulomatous Inflammation in Inborn and Acquired Errors of Immunity. Front Immunol 2022; 12:796065. [PMID: 35003119 PMCID: PMC8728873 DOI: 10.3389/fimmu.2021.796065] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 10/15/2021] [Accepted: 11/30/2021] [Indexed: 01/08/2023] Open
Abstract
Rubella virus (RuV) has recently been found in association with granulomatous inflammation of the skin and several internal organs in patients with inborn errors of immunity (IEI). The cellular tropism and molecular mechanisms of RuV persistence and pathogenesis in select immunocompromised hosts are not clear. We provide clinical, immunological, virological, and histological data on a cohort of 28 patients with a broad spectrum of IEI and RuV-associated granulomas in skin and nine extracutaneous tissues to further delineate this relationship. Combined immunodeficiency was the most frequent diagnosis (67.8%) among patients. Patients with previously undocumented conditions, i.e., humoral immunodeficiencies, a secondary immunodeficiency, and a defect of innate immunity were identified as being susceptible to RuV-associated granulomas. Hematopoietic cell transplantation was the most successful treatment in this case series resulting in granuloma resolution; steroids, and TNF-α and IL-1R inhibitors were moderately effective. In addition to M2 macrophages, neutrophils were identified by immunohistochemical analysis as a novel cell type infected with RuV. Four patterns of RuV-associated granulomatous inflammation were classified based on the structural organization of granulomas and identity and location of cell types harboring RuV antigen. Identification of conditions that increase susceptibility to RuV-associated granulomas combined with structural characterization of the granulomas may lead to a better understanding of the pathogenesis of RuV-associated granulomas and discover new targets for therapeutic interventions.
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Affiliation(s)
- Ludmila Perelygina
- Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, United States
| | - Raeesa Faisthalab
- Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, United States
| | - Emily Abernathy
- Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, United States
| | - Min-Hsin Chen
- Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, United States
| | - LiJuan Hao
- Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, United States
| | - Lionel Bercovitch
- Department of Dermatology, Hasbro Children's Hospital and Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Diana K Bayer
- Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IA, United States
| | - Lenora M Noroski
- Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States
| | - Michael T Lam
- Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States
| | - Maria Pia Cicalese
- Pediatric Immunohematology and Bone Marrow Transplantation Unit and San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), Istituto di Ricovero e Cura a Carattere Scientifico (National Institute for Research and Treatment) (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Waleed Al-Herz
- Department of Pediatrics, Kuwait University, Kuwait City, Kuwait.,Allergy and Clinical Immunology Unit, Department of Pediatrics, Al-Sabah Hospital, Kuwait City, Kuwait
| | - Arti Nanda
- Pediatric Dermatology Unit, As'ad Al-Hamad Dermatology Center, Al-sabah Hospital, Kuwait City, Kuwait
| | - Joud Hajjar
- Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States
| | - Koen Vanden Driessche
- Department of Pediatrics, Queen Mathilde Mother and Child Centre, Antwerp University Hospital, Antwerp, Belgium
| | - Shari Schroven
- Department of Pediatrics, Queen Mathilde Mother and Child Centre, Antwerp University Hospital, Antwerp, Belgium
| | - Julie Leysen
- Department of Dermatology, Queen Mathilde Mother and Child Centre, Antwerp University Hospital, Antwerp, Belgium
| | - Misha Rosenbach
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Philipp Peters
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Johannes Raedler
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Michael H Albert
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Roshini S Abraham
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, United States
| | - Hemalatha G Rangarjan
- Department of Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, United States
| | - David Buchbinder
- Department of Hematology, Children's Hospital of Orange County, Orange, CA, United States.,Department of Pediatrics, University of California at Irvine, Orange, CA, United States
| | - Lisa Kobrynski
- Allergy/Immunology Section, Emory University, Atlanta, GA, United States
| | - Anne Pham-Huy
- Department of Pediatrics, University of Ottawa and Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Julie Dhossche
- Department of Dermatology, Oregon Health and Science University, Portland, OR, United States
| | - Charlotte Cunningham Rundles
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Anna K Meyer
- Department of Pediatrics, National Jewish Health, Denver, CO, United States
| | - Amy Theos
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - T Prescott Atkinson
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Amy Musiek
- Division of Dermatology, Washington University School of Medicine, St. Louis, MO, United States
| | - Mehdi Adeli
- Division of Immunology and Allergy, Sidra Medicine and Hamad Medical Corporation, Doha, Qatar
| | - Ute Derichs
- Center for Pediatric and Adolescent Medicine, University Medical Hospital Mainz, Mainz, Germany
| | - Christoph Walz
- Institute of Pathology, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Renate Krüger
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Horst von Bernuth
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany.,Labor Berlin GmbH, Department of Immunology, Berlin, Germany
| | - Christoph Klein
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Joseph Icenogle
- Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, United States
| | - Fabian Hauck
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Kathleen E Sullivan
- Division of Allergy Immunology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
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21
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Khanna C, Le Coz C, Vaccaro C, Pillarisetti P, Knox AVC, Sy A, Behrens EM, Buchbinder D, Romberg N. Lymphocytes Utilize Somatic Mutations, Epigenetic Silencing, and the Proteasome to Escape Truncated WASP Expression. J Clin Immunol 2022; 42:753-759. [PMID: 35149963 DOI: 10.1007/s10875-022-01224-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/28/2022] [Indexed: 11/25/2022]
Abstract
Wiskott-Aldrich Syndrome Protein (WASP) deficiency causes Wiskott-Aldrich Syndrome (WAS), a sex-linked disorder characterized by combined immunodeficiency, microthrombocytopenia, and eczema. Like WASP-deficient humans, WASP-deficient mice produce normal numbers of functionally defective T cells. Here, we report a WAS patient with a novel germline frameshifting WAS mutation encoding a truncated form of WASP lacking the C-terminal cofilin homology (C) and the acidic region (A) domains (WASPΔCA). Although stably overexpressed in embryonic kidney cell lines, WASPΔCA was undetectable in circulating patient leukocytes. Deep sequencing, transcript profiling, and protein degradation analyses demonstrated patient lymphocytes employ an array of genetic, epigenetic, and proteasomal strategies to avoid expressing WASPΔCA.
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Affiliation(s)
- Caroline Khanna
- Division of Immunology and Allergy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Carole Le Coz
- Division of Immunology and Allergy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Courtney Vaccaro
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Piyush Pillarisetti
- Division of Immunology and Allergy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ainsley V C Knox
- Division of Immunology and Allergy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Andrew Sy
- Department of Hematology, The Children's Hospital of Orange County, Orange, CA, USA
| | - Edward M Behrens
- Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David Buchbinder
- Department of Hematology, The Children's Hospital of Orange County, Orange, CA, USA
| | - Neil Romberg
- Division of Immunology and Allergy, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Leonard and Madlyn Abramson Pediatric Research Center, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA.
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22
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Brosnan P, Davis KA, Mazzenga M, Oberoi AR, Sharkey CM, Buchbinder D, Alderfer MA, Long KA. Psychosocial care providers' perspectives: Barriers to implementing services for siblings of children with cancer. Pediatr Blood Cancer 2022; 69:e29418. [PMID: 34786821 DOI: 10.1002/pbc.29418] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/01/2021] [Accepted: 10/05/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Siblings of children with cancer are at increased risk for poor long-term psychosocial outcomes. The standard of psychosocial care in pediatric oncology calling for sibling support is not routinely implemented, often leaving siblings with unmet psychosocial needs. Barriers to implementing the sibling standard may exist at multiple levels. This study addresses research gaps regarding multilevel barriers to supporting siblings at the health care system, oncology center, and family levels. PROCEDURE Qualitative interviews were conducted with psychosocial care providers (N = 27; 18 psychologists, five social workers, three psychiatrists, and one child life specialist) employed at oncology centers within hospitals across the United States, varying in extent of sibling programming and center size. Interviews included questions about providers' roles, oncology center characteristics, existing psychosocial sibling services, barriers to providing systematic sibling assessment, and ideas about how to overcome barriers. Data were analyzed using applied thematic analysis. RESULTS Qualitative analysis revealed (a) barriers to providing sibling services occur at multiple levels (health care system, oncology center, family); (b) barriers at multiple levels frequently interact with one another; and (c) interacting barriers maintain a cycle: barriers to providing services contribute to limited provision of services, low service provision leads to limited utilization of existing services and underprioritization of siblings, and together this leads to siblings being off the radar, which further limits sibling service provision. CONCLUSION Addressing health care system and oncology center barriers to implementing sibling assessment and support may be important potential targets for interventions to help ensure that siblings receive needed psychosocial assessment and support.
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Affiliation(s)
- Phoebe Brosnan
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Kathryn A Davis
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Marcella Mazzenga
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Anjali R Oberoi
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Christina M Sharkey
- Department of Neurology, Children's National Hospital, Washington, District of Columbia, USA
| | - David Buchbinder
- Division of Hematology, CHOC Children's Hospital, Orange, California, USA
| | - Melissa A Alderfer
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, DE & Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Kristin A Long
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
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23
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Abstract
With improvement in survival after hematopoietic cell transplantation (HCT), it has become important to focus on survivors' psychosocial issues in order to provide patient-centered care across the transplant continuum. The goals of this article are to describe updates in the literature on certain psychosocial domains (emotional/mental health and social/financial) in HCT survivors, offer a brief overview of the status of the screening and management of these complications, and identify opportunities for future practice and research. An evidence-based approach to psychosocial care can be broken down as primary (promoting health, raising awareness, and addressing risk factors), secondary (screening and directing early pharmacological and nonpharmacological interventions), and tertiary (rehabilitating, limiting disability, and improving quality of life) prevention. Implementing such an approach requires close coordination between multiple stakeholders, including transplant center staff, referring hematologist/oncologists, and other subspecialists in areas such as palliative medicine or psychiatry. Innovative models of care that leverage technology can bring these stakeholders together to fulfill unmet needs in this area by addressing barriers in the delivery of psychosocial care.
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Affiliation(s)
| | - Nandita Khera
- College of Medicine, Mayo Clinic in Arizona, Phoenix, AZ
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24
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Egg D, Rump IC, Mitsuiki N, Rojas-Restrepo J, Maccari ME, Schwab C, Gabrysch A, Warnatz K, Goldacker S, Patiño V, Wolff D, Okada S, Hayakawa S, Shikama Y, Kanda K, Imai K, Sotomatsu M, Kuwashima M, Kamiya T, Morio T, Matsumoto K, Mori T, Yoshimoto Y, Dybedal I, Kanariou M, Kucuk ZY, Chapdelaine H, Petruzelkova L, Lorenz HM, Sullivan KE, Heimall J, Moutschen M, Litzman J, Recher M, Albert MH, Hauck F, Seneviratne S, Pachlopnik Schmid J, Kolios A, Unglik G, Klemann C, Snapper S, Giulino-Roth L, Svaton M, Platt CD, Hambleton S, Neth O, Gosse G, Reinsch S, Holzinger D, Kim YJ, Bakhtiar S, Atschekzei F, Schmidt R, Sogkas G, Chandrakasan S, Rae W, Derfalvi B, Marquart HV, Ozen A, Kiykim A, Karakoc-Aydiner E, Králíčková P, de Bree G, Kiritsi D, Seidel MG, Kobbe R, Dantzer J, Alsina L, Armangue T, Lougaris V, Agyeman P, Nyström S, Buchbinder D, Arkwright PD, Grimbacher B. Therapeutic options for CTLA-4 insufficiency. J Allergy Clin Immunol 2021; 149:736-746. [PMID: 34111452 DOI: 10.1016/j.jaci.2021.04.039] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/23/2021] [Accepted: 04/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Heterozygous germline mutations in cytotoxic T lymphocyte-associated antigen-4 (CTLA4) impair the immunomodulatory function of regulatory T cells. Affected individuals are prone to life-threatening autoimmune and lymphoproliferative complications. A number of therapeutic options are currently being used with variable effectiveness. OBJECTIVE Our aim was to characterize the responsiveness of patients with CTLA-4 insufficiency to specific therapies and provide recommendations for the diagnostic workup and therapy at an organ-specific level. METHODS Clinical features, laboratory findings, and response to treatment were reviewed retrospectively in an international cohort of 173 carriers of CTLA4 mutation. Patients were followed between 2014 and 2020 for a total of 2624 months from diagnosis. Clinical manifestations were grouped on the basis of organ-specific involvement. Medication use and response were recorded and evaluated. RESULTS Among the 173 CTLA4 mutation carriers, 123 (71%) had been treated for immune complications. Abatacept, rituximab, sirolimus, and corticosteroids ameliorated disease severity, especially in cases of cytopenias and lymphocytic organ infiltration of the gut, lungs, and central nervous system. Immunoglobulin replacement was effective in prevention of infection. Only 4 of 16 patients (25%) with cytopenia who underwent splenectomy had a sustained clinical response. Cure was achieved with stem cell transplantation in 13 of 18 patients (72%). As a result of the aforementioned methods, organ-specific treatment pathways were developed. CONCLUSION Systemic immunosuppressants and abatacept may provide partial control but require ongoing administration. Allogeneic hematopoietic stem cell transplantation offers a possible cure for patients with CTLA-4 insufficiency.
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Affiliation(s)
- David Egg
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Ina Caroline Rump
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Noriko Mitsuiki
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Jessica Rojas-Restrepo
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Maria-Elena Maccari
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Charlotte Schwab
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Annemarie Gabrysch
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Klaus Warnatz
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany; Department of Rheumatology and Clinical Immunology, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Sigune Goldacker
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany; Department of Rheumatology and Clinical Immunology, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany
| | | | - Daniel Wolff
- Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Satoshi Okada
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Seiichi Hayakawa
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yoshiaki Shikama
- Division of Infection, Immunology and Infection, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Kenji Kanda
- Department of Pediatrics, Hikone Municipal Hospital, Shiga, Japan
| | - Kohsuke Imai
- Department of Community Pediatrics, Perinatal and Maternal Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Manabu Sotomatsu
- Department of Hematology/Oncology, Gunma Children's Medical Center, Shibukawa, Japan
| | - Makoto Kuwashima
- Department of Pediatrics, Kiryu Kosei General Hospital, Kiryū, Japan
| | - Takahiro Kamiya
- Department of Lifetime Clinical Immunology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomohiro Morio
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuaki Matsumoto
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Yuri Yoshimoto
- Department of Pediatrics, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Ingunn Dybedal
- Department of Hematology, Oslo University Hospital, Oslo, Norway
| | - Maria Kanariou
- Department of Immunology and Histocompatibility, Center for Primary Immunodeficiencies-Paediatric Immunology, Aghia Sophia Children's Hospital, Athens, Greece
| | - Zeynep Yesim Kucuk
- Division of Bone Marrow Transplantation and Immune Deficiency, Children's Hospital Medical Center, Cincinnati, Ohio
| | - Hugo Chapdelaine
- Division of Clinical Immunology, Montreal Clinical Research Institute, Montreal, Quebec, Canada
| | - Lenka Petruzelkova
- Department of Paediatrics, Motol University Hospital, Second Medical Faculty in Prague, Charles University, Prague, Czech Republic
| | - Hanns-Martin Lorenz
- Division of Rheumatology, Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Kathleen E Sullivan
- The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania
| | - Jennifer Heimall
- The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège
| | - Jiri Litzman
- Department of Clinical Immunology and Allergology, Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Clinical Immunology and Allergology, St. Anne's University Hospital, Brno, Czech Republic
| | - Mike Recher
- Immunodeficiency Clinic, Medical Outpatient Unit and Immunodeficiency Lab, Department Biomedicine, University Hospital, Basel, Switzerland
| | - Michael H Albert
- Department of Pediatrics, Dr von Hauner Children's Hospital, University Hospital, Ludwig Maximilians Universität München, Munich, Germany
| | - Fabian Hauck
- Department of Pediatrics, Dr von Hauner Children's Hospital, University Hospital, Ludwig Maximilians Universität München, Munich, Germany
| | - Suranjith Seneviratne
- Institute of Immunology and Transplantation, Royal Free Hospital, University College London, London, United Kingdom
| | - Jana Pachlopnik Schmid
- Division of Immunology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Antonios Kolios
- Department of Immunology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gary Unglik
- Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, Melbourne, Australia
| | - Christian Klemann
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Scott Snapper
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - Lisa Giulino-Roth
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Weill Cornell Medicine, New York, NY
| | - Michael Svaton
- Childhood Leukaemia Investigation Prague, Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Craig D Platt
- Division of Immunology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - Sophie Hambleton
- Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, and Newcastle University Translational and Clinical Research Institute, Newcastle upon Tyne, United Kingdom
| | - Olaf Neth
- Pediatric Infectious Diseases, Rheumatology and Immunology Unit, Hospital Virgen del Rocío/Instituto de Biomedicina de Sevilla, Sevilla, RECLIP, Spain
| | - Geraldine Gosse
- Montreal Clinical Research Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Steffen Reinsch
- Jena University Hospital, Pediatric Gastroenterology, Jena, Germany
| | - Dirk Holzinger
- Department of Pediatric Hematology-Oncology, University of Duisburg-Essen, Essen, Germany
| | - Yae-Jean Kim
- Division of Infectious Diseases and Immunodeficiency, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Shahrzad Bakhtiar
- Division of Stem Cell Transplantation and Immunology, Department of Children and Adolescents, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Faranaz Atschekzei
- Department for Clinical Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Reinhold Schmidt
- Department for Clinical Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Georgios Sogkas
- Department for Clinical Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Shanmuganathan Chandrakasan
- Division of Bone Marrow Transplant, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Ga
| | - William Rae
- Department of Immunology, University Hospital Southampton NHSFT, Southampton, United Kingdom; Southampton National Institute for Health Research Clinical Research Facility, University Hospital Southampton NHSFT, Southampton, United Kingdom
| | - Beata Derfalvi
- Division of Immunology, IWK Health Centre and Dalhousie University, Department of Pediatrics, Halifax, Nova Scotia, Canada
| | - Hanne Vibeke Marquart
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ahmet Ozen
- Marmara University School of Medicine, Division of Pediatric Allergy and Immunology, Istanbul, Turkey
| | - Ayca Kiykim
- Marmara University School of Medicine, Division of Pediatric Allergy and Immunology, Istanbul, Turkey
| | - Elif Karakoc-Aydiner
- Marmara University School of Medicine, Division of Pediatric Allergy and Immunology, Istanbul, Turkey
| | - Pavlína Králíčková
- Institute of Clinical Immunology and Allergy, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Godelieve de Bree
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Dimitra Kiritsi
- Department of Dermatology, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Markus G Seidel
- Research Unit for Pediatric Hematology and Immunology, Division of Pediatric Hemato-Oncology, Department of Pediatric and Adolescent Medicine, Medical University Graz, Graz, Austria
| | - Robin Kobbe
- Division of Infectious Diseases, First Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jennifer Dantzer
- Division of Pediatric Allergy and Immunology, and Rheumatology, Department of Pediatrics, John Hopkins University School of Medicine, Baltimore, Md
| | - Laia Alsina
- Clinical Immunology and Primary Immunodeficiencies Unit, Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu and Institut de Recerca Sant Joan de Déu, Barcelona; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Thais Armangue
- Neuroimmunology Program, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Vassilios Lougaris
- Pediatric Neuroimmunology Unit, Neurology Department, Sant Joan de Déu Children's Hospital, University of Barcelona, Barcelona, Spain
| | - Philipp Agyeman
- Pediatrics Clinic and Institute for Molecular Medicine A. Nocivelli, Department of Clinical and Experimental Sciences, University of Brescia, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - Sofia Nyström
- Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - David Buchbinder
- Department of Clinical Immunology and Transfusion Medicine, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Peter D Arkwright
- Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, Calif
| | - Bodo Grimbacher
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany; Department of Rheumatology and Clinical Immunology, Medical Center, Faculty of Medicine, Albert Ludwig University of Freiburg, Freiburg, Germany; Institute of Immunology and Transplantation, Royal Free Hospital, University College London, London, United Kingdom; Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Royal Manchester Children's Hospital, Manchester, United Kingdom; German Center for Infection Research, Satellite Center Freiburg, Freiburg, Germany; Centre for Integrative Biological Signaling Studies, Albert Ludwig University of Freiburg, Freiburg, Germany; RESIST-Cluster of Excellence 2155 to Hannover Medical School, Satellite Center Freiburg, Freiburg, Germany.
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Morales S, Salehabadi SM, Srivastava D, Gibson TM, Leisenring WM, Alderfer MA, Lown EA, Zeltzer LK, Armstrong GT, Krull KR, Buchbinder D. Health-related and cancer risk concerns among siblings of childhood cancer survivors: a report from the Childhood Cancer Survivor Study (CCSS). J Cancer Surviv 2021; 16:624-637. [PMID: 34075534 DOI: 10.1007/s11764-021-01056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/05/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To characterize the prevalence and predictors of concerns regarding future health and cancer risk among siblings of childhood cancer survivors. METHODS This study reports longitudinal data (baseline and follow-up) from 3969 adult siblings (median age = 29 [range 18-56] years) of long-term survivors of childhood cancer (median time since diagnosis 19.6 [9.6-33.8] years). Self-reported future health and cancer risk concerns (concerned vs not concerned) were assessed. Demographics and health data reported by both the siblings and their matched cancer survivors were examined as risk factors for health concerns using multivariable logistic regression. RESULTS Percentage of siblings reporting future health and cancer risk concerns, respectively, decreased across decade of survivors' diagnosis: 1970s (73.3%; 63.9%), 1980s (67.2%; 62.6%), and 1990s (45.7%; 52.3%). Risk factors associated with future health concerns included sibling chronic health conditions (grade 2 Odds Ratio [OR]=1.57, 95% CI: 1.12-2.20; grades 3-4 OR=1.86, 95% CI: 1.18-2.94; compared to less than grade 2). Risk factors associated with future cancer concerns included sibling chronic health conditions (grade 2 OR=1.43, 95% CI: 1.05-1.94; grades 3-4 OR=1.64, 95% CI: 1.09-2.47; compared to less than grade 2). CONCLUSIONS Sibling concerns regarding future health and cancer have diminished in recent decades. There are subgroups of siblings that are at-risk for future health and cancer risk concerns. IMPLICATIONS FOR CANCER SURVIVORS Routine screening of concerns in at-risk siblings of survivors of childhood cancer may benefit the siblings of cancer survivors. These individuals may benefit from early interventions during diagnosis and treatment of their siblings.
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Affiliation(s)
- Sonia Morales
- Department of Pediatrics, University of California at Irvine, Irvine, CA, USA.,Division of Hematology/Oncology at Children's Hospital of Orange County, 1201 W. La Veta Avenue, Orange, CA, 92868, USA
| | | | - Deokumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Todd M Gibson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Wendy M Leisenring
- Cancer Prevention Program at Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Melissa A Alderfer
- Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, DE, USA.,Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - E Anne Lown
- Department of Social and Behavioral Sciences and Osher Center for Integrative Medicine, University of California at San Francisco, San Francisco, CA, USA
| | - Lonnie K Zeltzer
- David Geffen School of Medicine at University of California at Los Angeles (UCLA) and UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - David Buchbinder
- Department of Pediatrics, University of California at Irvine, Irvine, CA, USA. .,Division of Hematology/Oncology at Children's Hospital of Orange County, 1201 W. La Veta Avenue, Orange, CA, 92868, USA.
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26
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Sharma A, Badawy SM, Suelzer EM, Murthy HS, Prasad P, Eissa H, Carpenter PA, Hamadani M, Labopin M, Schoemans H, Tichelli A, Phelan R, Hamilton BK, Buchbinder D, Im A, Hunter R, Brazauskas R, Burns LJ. Systematic Reviews in Hematopoietic Cell Transplantation and Cellular Therapy: Considerations and Guidance from the American Society for Transplantation and Cellular Therapy, European Society for Blood and Marrow Transplantation, and Center for International Blood and Marrow Transplant Research Late Effects and Quality of Life Working Committee. Transplant Cell Ther 2021; 27:380-388. [PMID: 33965174 PMCID: PMC8415092 DOI: 10.1016/j.jtct.2020.12.002] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 02/08/2023]
Abstract
Systematic reviews apply rigorous methodologies to address a prespecified, clearly formulated clinical research question. The conclusion that results is often cited to more robustly inform decision making by clinicians, third-party payers, and managed care organizations about the clinical question of interest. Although systematic reviews provide a rigorous standard, they may be infeasible when the task is to create general disease-focused guidelines comprising multiple clinical practice questions versus a single major clinical practice question. Collaborating transplantation and cellular therapy society committees also recognize that the quantity and or quality of reference sources may be insufficient for a meaningful systematic review. As the conduct of systematic reviews has evolved over time in terms of grading systems, reporting requirements, and use of technology, here we provide current guidance on methodologies, resources for reviewers, and approaches to overcome challenges in conducting systematic reviews in transplantation and cellular therapy.
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Affiliation(s)
- Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Sherif M Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | | | - Hemant S Murthy
- Division of Hematology/Oncology, Mayo Clinic Florida, Jacksonville, Florida
| | - Pinki Prasad
- Division of Pediatric Hematology/Oncology, Louisiana State University Health Sciences Center/Children's Hospital of New Orleans, New Orleans, Louisiana
| | - Hesham Eissa
- Department of Pediatrics, University of Colorado School of Medicine, Blood and Marrow Transplant and Cellular Therapy Program, Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, Colorado
| | - Paul A Carpenter
- Fred Hutchinson Cancer Research Center and Department of Pediatrics, University of Washington, Seattle, Washington
| | - Mehdi Hamadani
- BMT and Cellular Therapy Program, Department of Medicine, Medical College of Wisconsin and Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin
| | - Myriam Labopin
- EBMT Paris Study Office, Department of Haematology, Saint Antoine Hospital; INSERM UMR 938, Sorbonne University, Paris, France
| | - Hélène Schoemans
- Department of Hematology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - André Tichelli
- Division of Hematology, University Hospital Basel, Basel, Switzerland
| | - Rachel Phelan
- Division of Hematology and Oncology, and BMT, Department of Pediatrics, Medical College of Wisconsin and Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin
| | - Betty K Hamilton
- Blood & Marrow Transplant Program, Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - David Buchbinder
- Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, California
| | - Annie Im
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rebecca Hunter
- Division of Hematology, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Ruta Brazauskas
- Division of Biostatistics, Medical College of Wisconsin and Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin
| | - Linda J Burns
- Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin.
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Sharma A, Badawy SM, Suelzer EM, Murthy HS, Prasad P, Eissa H, Carpenter PA, Hamadani M, Labopin M, Schoemans H, Tichelli A, Phelan R, Hamilton BK, Buchbinder D, Im A, Hunter R, Brazauskas R, Burns LJ. Systematic reviews in hematopoietic cell transplantation and cellular therapy: considerations and guidance from the American Society for Transplantation and Cellular Therapy, European Society for Blood and Marrow Transplantation, and the Center for International Blood and Marrow Transplant Research late effects and quality of life working committee. Bone Marrow Transplant 2021; 56:786-797. [PMID: 33514917 PMCID: PMC8168056 DOI: 10.1038/s41409-020-01199-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 01/30/2023]
Abstract
Systematic reviews apply rigorous methodologies to address a pre-specified, clearly formulated clinical research question. The conclusion that results is often cited to more robustly inform decision-making by clinicians, third-party payers and managed care organizations about the clinical question of interest. While systematic reviews provide a rigorous standard, they may be unfeasible when the task is to create general disease-focused guidelines comprised of multiple clinical practice questions versus a single major clinical practice question. Collaborating transplantation and cellular therapy societal committees also recognize that the quantity and or quality of reference sources may be insufficient for a meaningful systematic review. As the conduct of systematic reviews has evolved over time in terms of grading systems, reporting requirements and use of technology, here we provide current guidance in methodologies, resources for reviewers, and approaches to overcome challenges in conducting systematic reviews in transplantation and cellular therapy.
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Affiliation(s)
- Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sherif M Badawy
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | - Hemant S Murthy
- Division of Hematology/Oncology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Pinki Prasad
- Division of Pediatric Hematology/Oncology, Louisiana State University Health Sciences Center / Children's Hospital of New Orleans, New Orleans, LA, USA
| | - Hesham Eissa
- Department of Pediatrics, University of Colorado School of Medicine, Blood and Marrow Transplant and Cellular Therapy Program, Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO, USA
| | - Paul A Carpenter
- Fred Hutchinson Cancer Research Center and Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Mehdi Hamadani
- Department of Medicine, BMT and Cellular Therapy Program, Medical College of Wisconsin and Center for International Blood and Marrow Transplant Research, Milwaukee, WI, USA
| | - Myriam Labopin
- EBMT Paris study office; Department of Haematology, Saint Antoine Hospital; INSERM UMR 938, Sorbonne University, Paris, France
| | - Hélène Schoemans
- Department of Hematology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - André Tichelli
- Division of Hematology, University Hospital Basel, Basel, Switzerland
| | - Rachel Phelan
- Department of Pediatrics, Division of Hematology and Oncology, and BMT, Medical College of Wisconsin and Center for International Blood and Marrow Transplant Research, Milwaukee, WI, USA
| | - Betty K Hamilton
- Department of Hematology and Medical Oncology, Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - David Buchbinder
- Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA, USA
| | - Annie Im
- University of Pittsburgh, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Rebecca Hunter
- Division of Hematology, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| | - Ruta Brazauskas
- Division of Biostatistics, Medical College of Wisconsin and Center for International Blood and Marrow Transplant Research, Milwaukee, WI, USA
| | - Linda J Burns
- Center for International Blood and Marrow Transplant Research, Milwaukee, WI, USA.
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28
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Morales S, Nael A, Buchbinder D. Copper Deficiency and Cytopenias. J Pediatr Hematol Oncol 2021; 43:68-69. [PMID: 33448718 DOI: 10.1097/mph.0000000000002047] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/30/2020] [Indexed: 11/25/2022]
Affiliation(s)
| | | | - David Buchbinder
- Hematology, CHOC Children's Hospital, University of California (UC) Irvine, Orange County, CA
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29
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Lee CJ, Wang T, Chen K, Spellman SR, Kitko CL, MacMillan ML, Pidala JA, Auletta JJ, Badawy S, Battiwalla M, Bhatt VR, Buchbinder D, Cahn JY, DeFilipp Z, Diaz MA, Farhadfar N, Gadalla SM, Gale RP, Hashem H, Hashmi SK, Hematti P, Hong S, Hossain N, Inamoto Y, Kamble RT, Kumar A, Lekakis LJ, Modi D, Patel S, Savani B, Sharma A, Solomon SR, Verdonck L, Arora M, Couriel DR. First Late Effect in Pediatric Survivors with Chronic Graft-Versus-Host Disease Following Hematopoietic Cell Transplantation for Hematologic Malignancy. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00068-3] [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: 11/27/2022]
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Buchbinder D, Walter JE, Butte MJ, Chan WY, Chitty Lopez M, Dimitriades VR, Dorsey MJ, Nugent DJ, Puck JM, Singh J, Collins CA. When Screening for Severe Combined Immunodeficiency (SCID) with T Cell Receptor Excision Circles Is Not SCID: a Case-Based Review. J Clin Immunol 2021; 41:294-302. [PMID: 33411155 PMCID: PMC8179373 DOI: 10.1007/s10875-020-00931-2] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/18/2020] [Indexed: 12/19/2022]
Abstract
Newborn screening efforts focusing on the quantification of T cell receptor excision circles (TRECs), as a biomarker for abnormal thymic production of T cells, have allowed for the identification and definitive treatment of severe combined immunodeficiency (SCID) in asymptomatic neonates. With the adoption of TREC quantification in Guthrie cards across the USA and abroad, typical, and atypical SCID constitutes only ~ 10% of cases identified with abnormal TRECs associated with T cell lymphopenia. Several other non-SCID-related conditions may be identified by newborn screening in a term infant. Thus, it is important for physicians to recognize that other factors, such as prematurity, are often associated with low TRECs initially, but often improve with age. This paper focuses on a challenge that immunologists face: the diagnostic evaluation and management of cases in which abnormal TRECs are associated with variants of T cell lymphopenia in the absence of a genetically defined form of typical or atypical SCID. Various syndromes associated with T cell impairment, secondary forms of T cell lymphopenia, and idiopathic T cell lymphopenia are identified using this screening approach. Yet there is no consensus or guidelines to assist in the evaluation and management of these newborns, despite representing 90% of the patients identified, resulting in significant work for the clinical teams until a diagnosis is made. Using a case-based approach, we review pearls relevant to the evaluation of these newborns, as well as the management dilemmas for the families and team related to the resolution of genetic ambiguities.
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Affiliation(s)
- David Buchbinder
- Department of Hematology, Children's Hospital of Orange County, Orange, CA, USA.
- Department of Pediatrics, University of California at Irvine, Orange, CA, USA.
| | - Jolan E Walter
- Division of Pediatric, University of South Florida at Johns Hopkins All Children's Hospital, Allergy/ Immunology, St. Petersburg, FL, USA
- Division of Pediatric Allergy and Immunology, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Manish J Butte
- Division of Immunology, Allergy, and Rheumatology, Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA
| | - Wan-Yin Chan
- Department of Allergy & Immunology, Children's Hospital of Orange County, Orange, CA, USA
| | - Maria Chitty Lopez
- Division of Pediatric, University of South Florida at Johns Hopkins All Children's Hospital, Allergy/ Immunology, St. Petersburg, FL, USA
| | - Victoria R Dimitriades
- Division of Allergy, Immunology & Rheumatology, Department of Pediatrics, Sacramento, CA, USA
| | - Morna J Dorsey
- Department of Allergy & Immunology, University of California, San Francisco, CA, USA
| | - Diane J Nugent
- Department of Hematology, Children's Hospital of Orange County, Orange, CA, USA
- Department of Pediatrics, University of California at Irvine, Orange, CA, USA
| | - Jennifer M Puck
- Department of Allergy & Immunology, University of California, San Francisco, CA, USA
| | - Jasjit Singh
- Department of Infectious Disease, Children's Hospital of Orange County, Orange, CA, USA
| | - Cathleen A Collins
- Department of Pediatrics, Division of Allergy Immunology, University of California at San Diego, La Jolla, CA, USA
- Department of Pediatrics, Division of Allergy Immunology, Rady Children's Hospital, San Diego, CA, USA
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Saco T, Geier C, Buchbinder D, Hernandez J, Sharapova S, Cochino A, Milota T, Latysheva E, Westerman-Clark E, Fadugba O, Morris E, Albert M, Dimitrova D, Moshous D, Kanakry J, Holland S, Villartay JPD, Sargur R, Notarangelo L, Walter J. Are we diagnosing too late? RAG deficiency in young adults with end organ damage. J Allergy Clin Immunol 2021. [DOI: 10.1016/j.jaci.2020.12.270] [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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Phan M, Chavan R, Beuttler R, Benipayo N, Magedman G, Buchbinder D, Tomaszewski D, Yang S. Evaluating risk factors for acute graft versus host disease in pediatric hematopoietic stem cell transplant patients receiving tacrolimus. Clin Transl Sci 2021; 14:1303-1313. [PMID: 33503293 PMCID: PMC8301588 DOI: 10.1111/cts.12982] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/18/2020] [Accepted: 12/03/2020] [Indexed: 11/30/2022] Open
Abstract
To identify the clinical and pharmacological risk factors associated with tacrolimus pharmacodynamics for acute graft‐versus‐host disease (aGVHD) in pediatric patients receiving allogeneic hematopoietic stem cell transplantation (HSCT) from a matched related donor. A retrospective cohort single center chart review study was conducted with pediatric patients who received tacrolimus prophylaxis after allogeneic HSCT between January 1, 2017, and December 31, 2019. Potential risk factors were tested separately between aGVHD and non‐aGVHD cohorts and were further analyzed in a logistic regression model with backward elimination and a partial least squares discriminant analysis. Thirty‐three patient cases were included in our study and 52% (17/33) developed aGVHD while on tacrolimus prophylaxis. When tested independently, donor age and sibling versus parent donor/recipient relation were shown to be statistically significant between aGVHD and non‐aGVHD patients (p < 0.005). Pharmacological factors associated with tacrolimus treatment failed to demonstrate a significant impact on patient’s risk of aGVHD. Using a best fit logistic regression model that tested all the variables together, donor age was the only significant variable predicting patient’s risk of aGVHD (p < 0.01). Donor relationship and donor age were unable to be evaluated separately and are therefore confounding variables. Among pediatric patients receiving allogeneic HSCT, aGVHD risk is significantly decreased by either sibling donor and/or younger donors. Although no conclusions were drawn on the effect of tacrolimus therapy (p = 0.08), results warrant additional research with a larger sample size to evaluate the accuracy of monitoring tacrolimus serum trough levels.
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Affiliation(s)
- Michael Phan
- Department of Pharmacy Practice, Chapman University School of Pharmacy, Irvine, California, USA
| | - Rishikesh Chavan
- The Hyundai Cancer Institute, CHOC Children's Hospital, Orange, California, USA
| | - Richard Beuttler
- Department of Biomedical and Pharmaceutical Sciences, Chapman University School of Pharmacy, Irvine, California, USA
| | - Nicole Benipayo
- Chapman University School of Pharmacy, Irvine, California, USA
| | - Grace Magedman
- Department of Pharmacy, CHOC Children's Hospital, Orange, California, USA
| | - David Buchbinder
- The Hyundai Cancer Institute, CHOC Children's Hospital, Orange, California, USA
| | - Daniel Tomaszewski
- Department of Biomedical and Pharmaceutical Sciences, Chapman University School of Pharmacy, Irvine, California, USA
| | - Sun Yang
- Department of Pharmacy Practice, Chapman University School of Pharmacy, Irvine, California, USA
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Tay J, Beattie S, Bredeson C, Brazauskas R, He N, Ahmed IA, Aljurf M, Askar M, Atsuta Y, Badawy S, Barata A, Beitinjaneh AM, Bhatt NS, Buchbinder D, Cerny J, Ciurea S, D'Souza A, Dalal J, Farhadfar N, Freytes CO, Ganguly S, Gergis U, Gerull S, Lazarus HM, Hahn T, Hong S, Inamoto Y, Khera N, Kindwall-Keller T, Kamble RT, Knight JM, Koleva YN, Kumar A, Kwok J, Murthy HS, Olsson RF, Angel Diaz-Perez M, Rizzieri D, Seo S, Chhabra S, Schoemans H, Schouten HC, Steinberg A, Sullivan KM, Szer J, Szwajcer D, Ulrickson ML, Verdonck LF, Wirk B, Wood WA, Yared JA, Saber W. Pre-Transplant Marital Status and Hematopoietic Cell Transplantation Outcomes. Curr Oncol 2020; 27:e596-e606. [PMID: 33380875 PMCID: PMC7755447 DOI: 10.3747/co.27.6327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Evidence about the impact of marital status before hematopoietic cell transplantation (hct) on outcomes after hct is conflicting. Methods We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent hct between January 2008 and December 2015. Marital status before hct was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after hct. Results We identified 10,226 allogeneic and 5714 autologous hct cases with, respectively, a median follow-up of 37 months (range: 1-102 months) and 40 months (range: 1-106 months). No association between marital status and overall survival was observed in either the allogeneic (p = 0.58) or autologous (p = 0.17) setting. However, marital status was associated with grades 2-4 acute graft-versus-host disease (gvhd), p < 0.001, and chronic gvhd, p = 0.04. The risk of grades 2-4 acute gvhd was increased in separated compared with married patients [hazard ratio (hr): 1.13; 95% confidence interval (ci): 1.03 to 1.24], and single patients had a reduced risk of grades 2-4 acute gvhd (hr: 0.87; 95% ci: 0.77 to 0.98). The risk of chronic gvhd was lower in widowed compared with married patients (hr: 0.82; 95% ci: 0.67 to 0.99). Conclusions Overall survival after hct is not influenced by marital status, but associations were evident between marital status and grades 2-4 acute and chronic gvhd. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization.
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Affiliation(s)
- J Tay
- Alberta: Tom Baker Cancer Centre, University of Calgary, Calgary (Tay, Beattie)
| | - S Beattie
- Alberta: Tom Baker Cancer Centre, University of Calgary, Calgary (Tay, Beattie)
| | - C Bredeson
- Ontario: The Ottawa Hospital Blood and Marrow Transplant Program and The Ottawa Hospital Research Institute, Ottawa (Bredeson)
| | - R Brazauskas
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - N He
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - I A Ahmed
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - M Aljurf
- Saudi Arabia: Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh (Aljurf)
| | - M Askar
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - Y Atsuta
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - S Badawy
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - A Barata
- Spain: Hospital de la Santa Creu i Sant Pau, Barcelona (Barata); Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid (Angel Diaz-Perez)
| | - A M Beitinjaneh
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - N S Bhatt
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - D Buchbinder
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J Cerny
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Ciurea
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - A D'Souza
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J Dalal
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - N Farhadfar
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - C O Freytes
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Ganguly
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - U Gergis
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Gerull
- Switzerland: Department of Hematology, University Hospital, Basel (Gerull)
| | - H M Lazarus
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - T Hahn
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Hong
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - Y Inamoto
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - N Khera
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - T Kindwall-Keller
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - R T Kamble
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J M Knight
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - Y N Koleva
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - A Kumar
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J Kwok
- P.R.C.: Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong sar (Kwok)
| | - H S Murthy
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - R F Olsson
- Sweden: Department of Laboratory Medicine, Karolinska Institutet, Stockholm (Olsson); Centre for Clinical Research Sormland, Uppsala University, Uppsala (Olsson)
| | - M Angel Diaz-Perez
- Spain: Hospital de la Santa Creu i Sant Pau, Barcelona (Barata); Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid (Angel Diaz-Perez)
| | - D Rizzieri
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - S Seo
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - S Chhabra
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - H Schoemans
- Belgium: University Hospital Leuven and KU Leuven, Leuven (Schoemans)
| | - H C Schouten
- Netherlands: Department of Hematology, Acadeische Ziekenhuis, Maastrict (Schouten); Department of Hematology/Oncology, Isala Clinic, Zwolle (Verdonck)
| | - A Steinberg
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - K M Sullivan
- Japan: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya (Atsuta); Nagoya University Graduate School of Medicine, Nagoya (Atsuta); Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo (Inamoto); Department of Hematology and Oncology, Dokkyo Medical University, Tochigi (Seo, Sullivan)
| | - J Szer
- Australia: Clinical Haematology, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Victoria (Szer)
| | - D Szwajcer
- Manitoba: CancerCare Manitoba, Winnipeg, MB (Szwajcer)
| | - M L Ulrickson
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - L F Verdonck
- Netherlands: Department of Hematology, Acadeische Ziekenhuis, Maastrict (Schouten); Department of Hematology/Oncology, Isala Clinic, Zwolle (Verdonck)
| | - B Wirk
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - W A Wood
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - J A Yared
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
| | - W Saber
- U.S.A.: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI (Brazauskas, He, D'Souza, Chhabra, Saber); Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI (Brazauskas); Department of Hematology, Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO (Ahmed); Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX (Askar, Kamble); Division of Hematology, Oncology and Stem Cell Transplant, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (Badawy); Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago (Badawy); University of Miami, Miami (Beitinjaneh); St. Jude Children's Research Hospital, Memphis, TN (Bhatt); Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA (Buchbinder); Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA (Cerny); University of Texas MD Anderson Cancer Center, Houston, TX (Ciurea); Rainbow Babies and Children's Hospital, Cleveland, OH (Dalal); Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, FL (Farhadfar); Texas Transplant Institute, San Antonio, TX (Freytes); Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS (Ganguly); Haematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY (Gergis); Case Western Reserve University, Cleveland, OH (Lazarus); Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY (Hahn); Cleveland Clinic Taussig Cancer Center, Cleveland, OH (Hong); Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ (Khera); Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA (Kindwall-Keller); Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI (Knight); Tulane Cancer Center, New Orleans, LA (Koleva); Tufts Medical Center, Philadelphia, PA (Kumar); Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL (Murthy); Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC (Rizzieri); Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY (Steinberg); Banner MD Anderson Cancer Center, Gilbert, AZ (Ulrickson); Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA (Wirk); Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC (Wood); Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD (Yared)
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Afshar A, Greenberg S, Sobotka S, Turner M, Buchbinder D. Accuracy of Splintless Maxillary Positioning in Orthognathic Surgery Using Patient-Specific Titanium Plates. J Oral Maxillofac Surg 2020. [DOI: 10.1016/j.joms.2020.07.037] [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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Kahn JM, Brazauskas R, Tecca HR, Bo-Subait S, Buchbinder D, Battiwala M, Flowers MED, Savani BN, Phelan R, Broglie L, Abraham AA, Keating AK, Daly A, Wirk B, George B, Alter BP, Ustun C, Freytes CO, Beitinjaneh AM, Duncan C, Copelan E, Hildebrandt GC, Murthy HS, Lazarus HM, Auletta JJ, Myers KC, Williams KM, Page KM, Vrooman LM, Norkin M, Byrne M, Diaz MA, Kamani N, Bhatt NS, Rezvani A, Farhadfar N, Mehta PA, Hematti P, Shaw PJ, Kamble RT, Schears R, Olsson RF, Hayashi RJ, Gale RP, Mayo SJ, Chhabra S, Rotz SJ, Badawy SM, Ganguly S, Pavletic S, Nishihori T, Prestidge T, Agrawal V, Hogan WJ, Inamoto Y, Shaw BE, Satwani P. Subsequent neoplasms and late mortality in children undergoing allogeneic transplantation for nonmalignant diseases. Blood Adv 2020; 4:2084-2094. [PMID: 32396620 PMCID: PMC7218429 DOI: 10.1182/bloodadvances.2019000839] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 02/11/2020] [Indexed: 02/07/2023] Open
Abstract
We examined the risk of subsequent neoplasms (SNs) and late mortality in children and adolescents undergoing allogeneic hematopoietic cell transplantation (HCT) for nonmalignant diseases (NMDs). We included 6028 patients (median age, 6 years; interquartile range, 1-11; range, <1 to 20) from the Center for International Blood and Marrow Transplant Research (1995-2012) registry. Standardized mortality ratios (SMRs) in 2-year survivors and standardized incidence ratios (SIRs) were calculated to compare mortality and SN rates with expected rates in the general population. Median follow-up of survivors was 7.8 years. Diagnoses included severe aplastic anemia (SAA; 24%), Fanconi anemia (FA; 10%), other marrow failure (6%), hemoglobinopathy (15%), immunodeficiency (23%), and metabolic/leukodystrophy syndrome (22%). Ten-year survival was 93% (95% confidence interval [95% CI], 92% to 94%; SMR, 4.2; 95% CI, 3.7-4.8). Seventy-one patients developed SNs (1.2%). Incidence was highest in FA (5.5%), SAA (1.1%), and other marrow failure syndromes (1.7%); for other NMDs, incidence was <1%. Hematologic (27%), oropharyngeal (25%), and skin cancers (13%) were most common. Leukemia risk was highest in the first 5 years posttransplantation; oropharyngeal, skin, liver, and thyroid tumors primarily occurred after 5 years. Despite a low number of SNs, patients had an 11-fold increased SN risk (SIR, 11; 95% CI, 8.9-13.9) compared with the general population. We report excellent long-term survival and low SN incidence in an international cohort of children undergoing HCT for NMDs. The risk of SN development was highest in patients with FA and marrow failure syndromes, highlighting the need for long-term posttransplantation surveillance in this population.
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Affiliation(s)
- Justine M Kahn
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University, New York, NY
| | - Ruta Brazauskas
- Center for International Blood and Marrow Transplant Research, Department of Medicine, and
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - Heather R Tecca
- Center for International Blood and Marrow Transplant Research, Department of Medicine, and
| | - Stephanie Bo-Subait
- Center for International Blood and Marrow Transplant Research, Department of Medicine, and
| | - David Buchbinder
- Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, CA
| | - Minoo Battiwala
- Hematology Branch, Sarah Cannon Bone and Marrow Transplant Program, Nashville, TN
| | - Mary E D Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Rachel Phelan
- Center for International Blood and Marrow Transplant Research, Department of Medicine, and
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
| | - Larisa Broglie
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University, New York, NY
| | - Allistair A Abraham
- Division of Blood and Marrow Transplantation, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC
| | - Amy K Keating
- Children's Hospital Colorado and University of Colorado, Aurora, CO
| | - Andrew Daly
- Tom Baker Cancer Center, Calgary, AB, Canada
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Alliance, Seattle, WA
| | - Biju George
- Department of Hematology, Christian Medical College, Vellore, India
| | - Blanche P Alter
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Celalettin Ustun
- Division of Hematology/Oncology/Cell Therapy, Rush University, Chicago, IL
| | | | - Amer M Beitinjaneh
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL
| | - Christine Duncan
- Department of Pediatric Oncology, Boston Children's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - Edward Copelan
- Levine Cancer Institute, Atrium Health, Carolinas HealthCare System, Charlotte, NC
| | | | - Hemant S Murthy
- Division of Hematology/Oncology, College of Medicine, University of Florida, Gainesville, FL
| | - Hillard M Lazarus
- Department of Medicine, University Hospitals Case Medical Center and Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Jeffery J Auletta
- Blood and Marrow Transplant Program and Host Defense Program, Division of Hematology/Oncology/Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, OH
| | - Kasiani C Myers
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Kirsten M Williams
- Children's Research Institute, Children's National Health Systems, Washington, DC
| | - Kristin M Page
- Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, NC
| | - Lynda M Vrooman
- Department of Pediatric Oncology, Boston Children's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - Maxim Norkin
- Division of Hematology/Oncology, College of Medicine, University of Florida, Gainesville, FL
| | - Michael Byrne
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Naynesh Kamani
- Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC
| | - Neel S Bhatt
- St Jude Children's Research Hospital, Memphis, TN
| | | | - Nosha Farhadfar
- Division of Hematology/Oncology, College of Medicine, University of Florida, Gainesville, FL
| | - Parinda A Mehta
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Peiman Hematti
- Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin-Madison, Madison, WI
| | - Peter J Shaw
- The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX
| | - Raquel Schears
- Division of Hematology/Bone Marrow Transplant, Mayo Clinic, Rochester, MN
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Robert J Hayashi
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Robert Peter Gale
- Hematology Research Center, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Samantha J Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Saurabh Chhabra
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
| | - Seth J Rotz
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS
| | - Steven Pavletic
- Experimental Transplantation and Immunology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Tim Prestidge
- Blood and Cancer Center, Starship Children's Hospital, Auckland, New Zealand
| | - Vaibhav Agrawal
- Simon Cancer Center, Indiana University, Indianapolis, IN; and
| | - William J Hogan
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX
- Division of Hematology/Bone Marrow Transplant, Mayo Clinic, Rochester, MN
| | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, and
| | - Prakash Satwani
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, Columbia University, New York, NY
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Buchbinder D, Sidhu S, Alderfer MA, Lown A, Kolarik RC, Wang T. Pediatric resident knowledge, experience, comfort, and perceived competency in providing sibling psychosocial support. Int J Med Educ 2020; 11:73-75. [PMID: 32199019 PMCID: PMC7246124 DOI: 10.5116/ijme.5e63.6a46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/07/2020] [Indexed: 06/10/2023]
Affiliation(s)
- David Buchbinder
- Department of Pediatrics, University of California at Irvine, Orange, CA, USA
| | - Sonam Sidhu
- Department of Pediatrics, University of California at Los Angeles, Los Angeles, CA, USA
| | - Melissa A. Alderfer
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Anne Lown
- Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Russ C. Kolarik
- Department of Internal Medicine-Pediatrics, University of South Carolina, Greenville, SC, USA
| | - Tommy Wang
- Department of Pediatrics, University of California at Irvine, Orange, CA, USA
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Buchbinder D, Brazauskas R, Bo-Subait K, Ballen K, Parsons S, John T, Hahn T, Sharma A, Steinberg A, D'Souza A, Kumar AJ, Yoshimi A, Wirk B, Shaw B, Freytes C, LeMaistre C, Bredeson C, Dandoy C, Almaguer D, Marks DI, Szwajcer D, Hale G, Schouten H, Hashem H, Schoemans H, Murthy HS, Lazarus HM, Cerny J, Tay J, Yared JA, Adekola K, Schultz KR, Lehmann L, Burns L, Aljurf M, Diaz MA, Majhail N, Farhadfar N, Kamble R, Olsson R, Schears R, Seo S, Beattie S, Chhabra S, Savani BN, Badawy S, Ganguly S, Ciurea S, Marino S, Gergis U, Kuwatsuka Y, Inamoto Y, Khera N, Hashmi S, Wood W, Saber W. Predictors of Loss to Follow-Up Among Pediatric and Adult Hematopoietic Cell Transplantation Survivors: A Report from the Center for International Blood and Marrow Transplant Research. Biol Blood Marrow Transplant 2020; 26:553-561. [PMID: 31726205 PMCID: PMC7367505 DOI: 10.1016/j.bbmt.2019.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/24/2019] [Accepted: 11/03/2019] [Indexed: 12/16/2022]
Abstract
Follow-up is integral for hematopoietic cell transplantation (HCT) care to ensure surveillance and intervention for complications. We characterized the incidence of and predictors for being lost to follow-up. Two-year survivors of first allogeneic HCT (10,367 adults and 3865 children) or autologous HCT (7291 adults and 467 children) for malignant/nonmalignant disorders between 2002 and 2013 reported to the Center for International Blood and Marrow Transplant Research were selected. The cumulative incidence of being lost to follow-up (defined as having missed 2 consecutive follow-up reporting periods) was calculated. Marginal Cox models (adjusted for center effect) were fit to evaluate predictors. The 10-year cumulative incidence of being lost to follow-up was 13% (95% confidence interval [CI], 12% to 14%) in adult allogeneic HCT survivors, 15% (95% CI, 14% to 16%) in adult autologous HCT survivors, 25% (95% CI, 24% to 27%) in pediatric allogeneic HCT survivors, and 24% (95% CI, 20% to 29%) in pediatric autologous HCT survivors. Factors associated with being lost to follow-up include younger age, nonmalignant disease, public/no insurance (reference: private), residence farther from the tranplantation center, and being unmarried in adult allogeneic HCT survivors; older age and testicular/germ cell tumor (reference: non-Hodgkin lymphoma) in adult autologous HCT survivors; older age, public/no insurance (reference: private), and nonmalignant disease in pediatric allogeneic HCT survivors; and older age in pediatric autologous HCT survivors. Follow-up focusing on minimizing attrition in high-risk groups is needed to ensure surveillance for late effects.
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Affiliation(s)
- David Buchbinder
- Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, California.
| | - Ruta Brazauskas
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Khalid Bo-Subait
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Karen Ballen
- Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, Virginia
| | - Susan Parsons
- The Center for Health Solutions at the Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
| | - Tami John
- Department of Pediatrics, Section of Hematology/Oncology, Baylor College of Medicine Center for Cell and Gene Therapy, Houston, Texas
| | - Theresa Hahn
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Amir Steinberg
- Division of Hematology and Oncology, Mount Sinai Hospital, New York, New York
| | - Anita D'Souza
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Anita J Kumar
- The Center for Health Solutions at the Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
| | - Ayami Yoshimi
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, University of Freiburg Medical Center, Freiburg, Germany
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington
| | - Bronwen Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Charles LeMaistre
- Hematology and Bone Marrow Transplant, Sarah Cannon, Nashville, Tennessee
| | - Christopher Bredeson
- Ottawa Hospital Blood and Marrow Transplant Program and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Christopher Dandoy
- UC Department of Pediatrics and Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - David Almaguer
- Hematology Service at the University Hospital in Monterrey Mexico, and the Stem cell Transplantation Program, Hospital Universitario Dr José E. González, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - David I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - David Szwajcer
- Department of Hematology/Oncology, CancerCare Manitoba/University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gregory Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St Petersburg, Florida
| | - Harry Schouten
- Department of Hematology, Academische Ziekenhuis, Maastricht, The Netherlands
| | - Hasan Hashem
- Division of Pediatric Hematology/Oncology and Bone marrow Transplantation, King Hussein Cancer Center, Amman, Jordan
| | - Hélène Schoemans
- Hematology department and Bone marrow transplant unit, University Hospital Leuven and KU Leuven, Leuven, Belgium
| | | | - Hillard M Lazarus
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Jan Cerny
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, Massachusetts
| | - Jason Tay
- Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Kehinde Adekola
- Division of Hematology/Oncology, Department of Medicine and Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kirk R Schultz
- Department of Pediatric Hematology, Oncology and Bone Marrow Transplant, British Columbia's Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Leslie Lehmann
- Dana-Farber Cancer Institute/Boston Children's Hospital, Boston, Massachusetts
| | - Linda Burns
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Navneet Majhail
- Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Nosha Farhadfar
- Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, Florida
| | - Rammurti Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Richard Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Raquel Schears
- Department of Emergency Medicine, University of Central Florida, Orlando, Florida
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Sara Beattie
- Department of Psychosocial Oncology and Rehabilitation, Tom Baker Cancer Centre, Calgary, Alberta, Canada; Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
| | - Saurabh Chhabra
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sherif Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | | | - Susana Marino
- Department of Pathology, University of Chicago Medicine, Chicago, Illinois
| | - Usama Gergis
- Hematologic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Yachiyo Kuwatsuka
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Nandita Khera
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, Arizona
| | - Shahrukh Hashmi
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia; Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - William Wood
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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Sacco KA, Smith MJ, Bahna SL, Buchbinder D, Burkhardt J, Cooper MA, Hartog NL, Kobrynski L, Patel KP, Abraham RS. NAPDH Oxidase-Specific Flow Cytometry Allows for Rapid Genetic Triage and Classification of Novel Variants in Chronic Granulomatous Disease. J Clin Immunol 2019; 40:191-202. [DOI: 10.1007/s10875-019-00712-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/21/2019] [Indexed: 01/11/2023]
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Buchbinder D, Patel SK, Casillas JN, Nugent DJ, Neudorf S, Sender LS, Torno L, Huszti H, Zeltzer LK, Parsons SK. Parent proxy assessment of sibling quality of life following pediatric hematopoietic cell transplantation. Health Qual Life Outcomes 2019; 17:162. [PMID: 31665035 PMCID: PMC6819636 DOI: 10.1186/s12955-019-1231-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 06/03/2019] [Accepted: 10/02/2019] [Indexed: 12/11/2022] Open
Abstract
Background When a child undergoes hematopoietic cell transplantation (HCT), the impact extends to the entire family, including siblings. Assessment of the quality of life (QoL) of siblings is challenged by their general lack of availability for regular assessment by clinical providers. Thus, the use of parent proxy reporting may be useful. Our aim was to describe the QoL of siblings of HCT survivors, as reported by their parents, as well as to identify parent and family factors associated with lower sibling QoL. Methods A cross-sectional study was utilized to assess parent-reported QoL of the HCT recipient’s sibling (Short Form (SF)-10 Health Survey for Children and the Pediatric Symptom Checklist (PSC)-17). Parent QoL was assessed using the SF-12. Multivariable linear regression was used to explore hypothesized predictors of sibling QoL, including parent QoL, family impact/function (Impact on Family Scale, Family Adaptability and Cohesion Evaluation Scales, IV, and a question asking about financial problems) while adjusting for demographic and HCT characteristics. Results Ninety-seven siblings (55% males) with a mean age of 12 years (standard deviation [SD] 4 years) were assessed, representing HCT survivors, who were an average of 5 years (SD 4 years) post-HCT. Neither sibling psychosocial (mean 49.84, SD 10.70, p = 0.87) nor physical health scores (mean 51.54, SD 8.42, p = 0.08) differed from norms. Parent proxies reported behavioral/emotional problems (PSC-17 total score > 15) in 24% of siblings. While parental ratings of their own physical health (SF-12 were higher than norms (mean 53.04, SD 8.17, p = 0.0005), mental health scores were lower (mean 45.48, SD 10.45, p < 0.0001). In multivariable analysis, lower parent emotional functioning and adverse family function were associated with lower sibling QoL, as reported by parents. Conclusions While proxy-reported QoL of siblings did not differ significantly from normative data, both parent QoL and family function were associated with sibling QoL. Future research is needed to understand how siblings themselves perceive their QoL following HCT.
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Affiliation(s)
- David Buchbinder
- Department of Pediatrics and Division of Pediatric Hematology, CHOC Children's Hospital and University of California at Irvine's Chao Family Comprehensive Cancer Center, Irvine, California, USA. .,CHOC Children's Hospital, 1201 W. La Veta Avenue, Orange, CA, 92868, USA.
| | - Sunita K Patel
- Department of Cancer Control and Population Sciences, City of Hope, Duarte, California, USA
| | - Jacqueline N Casillas
- Department of Pediatrics and Division of Pediatric Hematology and Oncology, David Geffen School of Medicine at University of California at Los Angeles and University of California at Los Angeles's Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
| | - Diane J Nugent
- Department of Pediatrics and Division of Hematology at CHOC Children's Hospital, Orange, California, USA
| | - Steven Neudorf
- Department of Pediatrics and Division of Oncology at CHOC Children's Hospital, Orange, California, USA
| | - Leonard S Sender
- Department of Pediatrics and Division of Oncology at CHOC Children's Hospital, Orange, California, USA
| | - Lilibeth Torno
- Department of Pediatrics and Division of Oncology at CHOC Children's Hospital, Orange, California, USA
| | - Heather Huszti
- Department of Pediatrics and Division of Psychology at CHOC Children's Hospital, Orange, California, USA
| | - Lonnie K Zeltzer
- Psychiatry / Biobehavioral Science, and Division of Cancer Prevention and Control Research, David Geffen School of Medicine at University of California at Los Angeles and University of California at Los Angeles's Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
| | - Susan K Parsons
- Institute of Clinical Research and Health Policy Studies at Tufts Medical Center and Departments of Medicine and Pediatrics, at Tufts University School of Medicine, Boston, Massachusetts, USA
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Herr MM, Curtis RE, Tucker MA, Tecca HR, Engels EA, Cahoon EK, Battiwalla M, Buchbinder D, Flowers ME, Brazauskas R, Shaw BE, Morton LM. Risk factors for the development of cutaneous melanoma after allogeneic hematopoietic cell transplantation. J Am Acad Dermatol 2019; 83:762-772. [PMID: 31654664 DOI: 10.1016/j.jaad.2019.10.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/17/2019] [Accepted: 10/02/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Melanoma risk is increased after allogeneic hematopoietic cell transplantation (HCT), but specific risk factors are unknown. OBJECTIVE Investigate risk factors for melanoma after allogeneic hematopoietic cell transplantation. METHODS We conducted a nested case-control study of 140 melanoma cases and 557 controls (matched by age at HCT, sex, primary disease, survival time) through the Center for International Blood and Marrow Transplant Research. RESULTS Melanoma risk was significantly increased among HCT survivors who received total body irradiation-based myeloablative conditioning (multivariable adjusted odds ratio [OR] = 1.77; 95% confidence interval [CI] = 1.00-3.15) or reduced-intensity conditioning containing melphalan (OR = 2.60; 95% CI = 1.13-6.02) or fludarabine (OR = 2.72; 95% CI = 1.02-7.30) versus busulfan-based myeloablative regimens; were diagnosed with acute graft-versus-host disease (GVHD) with stage 2+ skin involvement (OR = 1.92; 95% CI = 1.19-3.10), chronic GvHD without skin involvement (OR = 1.91; 95% CI = 1.03-3.57), or keratinocytic carcinoma (OR = 2.37; 95% CI = 1.16-4.83); and resided in areas with higher ambient ultraviolet radiation (ORtertile3 = 1.64; 95% CI = 1.01-2.67). LIMITATIONS Data on individual-level ultraviolet radiation exposure and clinical data on melanoma characteristics were lacking. Additionally, misclassification of melanoma is possible as not all pathology reports were available for review. CONCLUSION These results emphasize the importance of adherence to current surveillance guidelines (routine skin examination, photoprotection recommendations), particularly for HCT survivors at highest risk.
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Affiliation(s)
- Megan M Herr
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland; Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Rochelle E Curtis
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Margaret A Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Heather R Tecca
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Eric A Engels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Elizabeth K Cahoon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | | | - David Buchbinder
- Department of Hematology and Bone Marrow Transplant, Children's Hospital of Orange County, Orange, California
| | - Mary E Flowers
- Fred Hutchinson Cancer Research Center and University of Washington, Seattle, Washington
| | - Ruta Brazauskas
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
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Saad A, Lamb L, Wang T, Hemmer MT, Spellman S, Couriel D, Alousi A, Pidala J, Abdel-Azim H, Agrawal V, Aljurf M, Beitinjaneh AM, Bhatt VR, Buchbinder D, Byrne M, Cahn JY, Cairo M, Castillo P, Chhabra S, Diaz MA, Farhan S, Floisand Y, Frangoul HA, Gadalla SM, Gajewski J, Gale RP, Gandhi M, Gergis U, Hamilton BK, Hematti P, Hildebrandt GC, Kamble RT, Kanate AS, Khandelwal P, Lazaryan A, MacMillan M, Marks DI, Martino R, Mehta PA, Nishihori T, Olsson RF, Patel SS, Qayed M, Rangarajan HG, Reshef R, Ringden O, Savani BN, Schouten HC, Schultz KR, Seo S, Shaffer BC, Solh M, Teshima T, Urbano-Ispizua A, Verdonck LF, Vij R, Waller EK, William B, Wirk B, Yared JA, Yu LC, Arora M, Hashmi S. Impact of T Cell Dose on Outcome of T Cell-Replete HLA-Matched Allogeneic Peripheral Blood Stem Cell Transplantation. Biol Blood Marrow Transplant 2019; 25:1875-1883. [PMID: 31085303 PMCID: PMC7071947 DOI: 10.1016/j.bbmt.2019.05.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 01/24/2023]
Abstract
Data on whether the T cell dose of allogeneic peripheral blood stem cell (PBSC) products influences transplantation outcomes are conflicting. Using the Center for International Blood and Marrow Transplant Research database, we identified 2736 adult patients who underwent first allogeneic PBSC transplantation for acute leukemia or myelodysplastic syndrome between 2008 and 2014 using an HLA-matched sibling donor (MSD) or an 8/8-matched unrelated donor (MUD). We excluded ex vivo and in vivo T cell-depleted transplantations. Correlative analysis was performed between CD3+ T cell dose and the risk of graft-versus-host-disease (GVHD), relapse, nonrelapse mortality (NRM), disease-free survival (DFS), and overall survival (OS). Using maximum likelihood estimation, we identified CD3+ T cell dose cutoff that separated the risk of acute GVHD (aGVHD) grade II-IV in both the MSD and MUD groups. A CD3+ T cell dose cutoff of 14 × 107 cells/kg identified MSD/low CD3+ (n = 223) and MSD/high CD3+ (n = 1214), and a dose of 15 × 107 cells/kg identified MUD/low CD3+ (n = 197) and MUD/high CD3+ (n = 1102). On univariate analysis, the MSD/high CD3+ group had a higher cumulative incidence of day +100 aGVHD grade II-IV compared with the MSD/low CD3+ group (33% versus 25%; P = .009). There were no differences between the 2 groups in engraftment rate, risk of aGVHD grade III-IV or chronic GVHD (cGVHD), NRM, relapse, DFS, or OS. The MUD/high CD3+ group had a higher cumulative incidence of day +100 aGVHD grade II-IV compared with the MUD/low CD3+ group (49% versus 41%; P = .04). There were no differences between the 2 groups in engraftment rate, risk of severe aGVHD or cGVHD, NRM, relapse, DFS, or OS. Multivariate analysis of the MSD and MUD groups failed to show an association between CD3+ T cell dose and the risk of either aGVHD grade II-IV (P = .10 and .07, respectively) or cGVHD (P = .80 and .30, respectively). Subanalysis of CD4+ T cells, CD8+ T cells, and CD4+/CD8+ ratio failed to identify cutoff values predictive of transplantation outcomes; however, using the log-rank test, the sample size was suboptimal for identifying a difference at this cutoff cell dose. In this registry study, the CD3+ T cell dose of PBSC products did not influence the risk of aGVHD or cGVHD or other transplantation outcomes when using an MSD or an 8/8-matched MUD. Subset analyses of CD4+ and CD8+ T cell doses were not possible given our small sample size.
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Affiliation(s)
- Ayman Saad
- Division of Hematology, The Ohio State University, Columbus, Ohio
| | - Lawrence Lamb
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Tao Wang
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin; Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Michael T Hemmer
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Stephen Spellman
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be the Match, Minneapolis, Minnesota
| | - Daniel Couriel
- Utah Blood and Marrow Transplant Program, Salt Lake City, Utah
| | - Amin Alousi
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Joseph Pidala
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Hisham Abdel-Azim
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital of Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Vaibhav Agrawal
- Division of Hematology-Oncology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Mahmoud Aljurf
- Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | - Vijaya Raj Bhatt
- The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, Nebraska
| | - David Buchbinder
- Division of Pediatric Hematology, Children's Hospital of Orange County, Orange, California
| | - Michael Byrne
- Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Grenoble, France
| | - Mitchell Cairo
- Division of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, New York, New York
| | - Paul Castillo
- UF Health Shands Children's Hospital, Gainesville, Florida
| | - Saurabh Chhabra
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Miguel Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Shatha Farhan
- Henry Ford Hospital Bone Marrow Transplant Program, Detroit, Michigan
| | | | - Hadar A Frangoul
- Children's Hospital at TriStar Centennial and Sarah Cannon Research Institute, Nashville, Tennessee
| | - Shahinaz M Gadalla
- Division of Cancer Epidemiology & Genetics, Clinical Genetics Branch, National Cancer Institute, Rockville, Maryland
| | | | - Robert Peter Gale
- Hematology Research Center, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Manish Gandhi
- Division of Transfusion Medicine, Mayo Clinic, Rochester, Minnesota
| | - Usama Gergis
- Hematologic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Betty Ky Hamilton
- Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Peiman Hematti
- Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | | | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Abraham S Kanate
- Osborn Hematopoietic Malignancy and Transplantation Program, West Virginia University, Morgantown, West Virginia
| | - Pooja Khandelwal
- Division of Bone Marrow Transplant and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Aleksandr Lazaryan
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Margaret MacMillan
- University of Minnesota Blood and Marrow Transplant Program, Pediatrics, Minneapolis, Minnesota
| | - David I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - Rodrigo Martino
- Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Parinda A Mehta
- Division of Bone Marrow Transplant and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Taiga Nishihori
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Richard F Olsson
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Sagar S Patel
- Blood and Marrow Transplant Program, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Muna Qayed
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Hemalatha G Rangarajan
- Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation, Nationwide Children's Hospital, Columbus, Ohio
| | - Ran Reshef
- Blood and Marrow Transplantation Program and Columbia Center for Translational Immunobiology, Columbia University Medical Center, New York, New York
| | - Olle Ringden
- Translational Cell Therapy Research, Karolinska Institute, Stockholm, Sweden
| | - Bipin N Savani
- Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Harry C Schouten
- Department of Hematology, Academische Ziekenhuis, Maastricht, Netherlands
| | - Kirk R Schultz
- Department of Pediatric Hematology, Oncology and Bone Marrow Transplant, British Columbia's Children's Hospital, The University of British Columbia, Vancouver, Britich Columbia, Canada
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | | | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, Georgia
| | | | - Alvaro Urbano-Ispizua
- Department of Hematology, Hospital Clinic, University of Barcelona, IDIBAPS, and Josep Carreras Institute of Research, Barcelona, Spain
| | - Leo F Verdonck
- Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands
| | - Ravi Vij
- Division of Hematology and Oncology, Washington University School of Medicine, St Louis, Missouri
| | - Edmund K Waller
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Basem William
- Division of Hematology, The Ohio State University, Columbus, Ohio
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington
| | - Jean A Yared
- Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland
| | - Lolie C Yu
- Division of Hematology/Oncology and HSCT, Center for Cancer and Blood Disorders, Children's Hospital/Louisiana State University Medical Center, New Orleans, Louisiana
| | - Mukta Arora
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota.
| | - Shahrukh Hashmi
- Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
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Paulson K, Brazauskas R, Khera N, He N, Majhail N, Akpek G, Aljurf M, Buchbinder D, Burns L, Beattie S, Freytes C, Garcia A, Gajewski J, Hahn T, Knight J, LeMaistre C, Lazarus H, Szwajcer D, Seftel M, Wirk B, Wood W, Saber W. Inferior Access to Allogeneic Transplant in Disadvantaged Populations: A Center for International Blood and Marrow Transplant Research Analysis. Biol Blood Marrow Transplant 2019; 25:2086-2090. [PMID: 31228584 DOI: 10.1016/j.bbmt.2019.06.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/06/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
Allogeneic hematopoietic cell transplantation (alloHCT) is offered in a limited number of medical centers and is associated with significant direct and indirect costs. The degree to which social and geographic barriers reduce access to alloHCT is unknown. Data from the Surveillance, Epidemiology and End Results Program (SEER) and the Center for International Blood and Marrow Transplant Research (CIBMTR) were integrated to determine the rate of unrelated donor (URD) alloHCT for acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL), and myelodysplastic syndrome (MDS) performed between 2000 and 2010 in the 612 counties covered by SEER. The total incidence of AML, ALL, and MDS was determined using SEER, and the number of alloHCTs performed in the same time period and geographic area were determined using the CIBMTR database. We then determined which sociodemographic attributes influenced the rate of alloHCT (rural/urban status, median family size, percentage of residents below the poverty line, and percentage of minority race). In the entire cohort, higher levels of poverty were associated with lower rates of alloHCT (estimated rate ratio [ERR], .86 for a 10% increase in the percentage of the population below the poverty line; P < .01), whereas rural location was not (ERR, .87; P = .11). Thus, patients from areas with higher poverty rates diagnosed with ALL, AML, and MDS are less likely patients from wealthier counties to undergo URD alloHCT. There is need to better understand the reasons for this disparity and to encourage policy and advocacy efforts to improve access to medical care for all.
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Affiliation(s)
- Kristjan Paulson
- CancerCare Manitoba/University of Manitoba, Winnipeg, Manitoba, Canada.
| | - Ruta Brazauskas
- Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin; Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Nandita Khera
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, Arizona
| | - Naya He
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Navneet Majhail
- Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Gorgun Akpek
- Stem Cell Transplantation and Cell Therapy, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
| | - David Buchbinder
- Division of Pediatrics Hematology, Children's Hospital of Orange County, Orange, California
| | - Linda Burns
- Be The Match/National Marrow Donor Program, Minneapolis, Minnesota
| | - Sara Beattie
- Department of Psychosocial Oncology and Rehabilitation, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | | | - Anne Garcia
- MedStar Georgetown University Hospital, Washington, DC
| | | | - Theresa Hahn
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York
| | - Jennifer Knight
- Department of Psychiatry, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Charles LeMaistre
- Hematology and Bone Marrow Transplant, Sarah Cannon, Nashville, Tennessee
| | - Hillard Lazarus
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - David Szwajcer
- CancerCare Manitoba/University of Manitoba, Winnipeg, Manitoba, Canada
| | - Matthew Seftel
- CancerCare Manitoba/University of Manitoba, Winnipeg, Manitoba, Canada
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington
| | - William Wood
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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Chandrakasan S, Chandra S, Davila Saldana BJ, Torgerson TR, Buchbinder D. Primary immune regulatory disorders for the pediatric hematologist and oncologist: A case-based review. Pediatr Blood Cancer 2019; 66:e27619. [PMID: 30697957 DOI: 10.1002/pbc.27619] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/04/2019] [Accepted: 01/08/2019] [Indexed: 12/20/2022]
Abstract
An array of monogenic immune defects marked by autoimmunity, lymphoproliferation, and hyperinflammation rather than infections have been described. Primary immune regulatory disorders pose a challenge to pediatric hematologists and oncologists. This paper focuses on primary immune regulatory disorders including autoimmune lymphoproliferative syndrome (ALPS) and ALPS-like syndromes, immunodysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) and IPEX-like disorders, common variable immunodeficiency (CVID), CVID-like, and late-onset combined immunodeficiency (CID) disorders. Hyperinflammatory disorders and those associated with increased susceptibility to lymphoid malignancies are also discussed. Using a case-based approach, a review of clinical pearls germane to the clinical and laboratory evaluation as well as the treatment of these disorders is provided.
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Affiliation(s)
- Shanmuganathan Chandrakasan
- Division of Bone Marrow Transplant, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | - Sharat Chandra
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Blachy J Davila Saldana
- Division of Blood and Marrow Transplantation, Children's National Medical Center, Washington, District of Columbia.,Department of Pediatrics, The George Washington University, Washington, District of Columbia
| | - Troy R Torgerson
- Department of Pediatrics, Divisions of Immunology/Rheumatology University of Washington and Seattle Children's Hospital, Seattle, Washington
| | - David Buchbinder
- Department of Hematology, Children's Hospital of Orange County, Orange, California.,Department of Pediatrics, University of California at Irvine, Orange, California
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Farmer JR, Foldvari Z, Ujhazi B, De Ravin SS, Chen K, Bleesing JJH, Schuetz C, Al-Herz W, Abraham RS, Joshi AY, Costa-Carvalho BT, Buchbinder D, Booth C, Reiff A, Ferguson PJ, Aghamohammadi A, Abolhassani H, Puck JM, Adeli M, Cancrini C, Palma P, Bertaina A, Locatelli F, Di Matteo G, Geha RS, Kanariou MG, Lycopoulou L, Tzanoudaki M, Sleasman JW, Parikh S, Pinero G, Fischer BM, Dbaibo G, Unal E, Patiroglu T, Karakukcu M, Al-Saad KK, Dilley MA, Pai SY, Dutmer CM, Gelfand EW, Geier CB, Eibl MM, Wolf HM, Henderson LA, Hazen MM, Bonfim C, Wolska-Kuśnierz B, Butte MJ, Hernandez JD, Nicholas SK, Stepensky P, Chandrakasan S, Miano M, Westermann-Clark E, Goda V, Kriván G, Holland SM, Fadugba O, Henrickson SE, Ozen A, Karakoc-Aydiner E, Baris S, Kiykim A, Bredius R, Hoeger B, Boztug K, Pashchenko O, Neven B, Moshous D, Villartay JPD, Bousfiha AA, Hill HR, Notarangelo LD, Walter JE. Outcomes and Treatment Strategies for Autoimmunity and Hyperinflammation in Patients with RAG Deficiency. J Allergy Clin Immunol Pract 2019; 7:1970-1985.e4. [PMID: 30877075 DOI: 10.1016/j.jaip.2019.02.038] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 02/15/2019] [Accepted: 02/19/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although autoimmunity and hyperinflammation secondary to recombination activating gene (RAG) deficiency have been associated with delayed diagnosis and even death, our current understanding is limited primarily to small case series. OBJECTIVE Understand the frequency, severity, and treatment responsiveness of autoimmunity and hyperinflammation in RAG deficiency. METHODS In reviewing the literature and our own database, we identified 85 patients with RAG deficiency, reported between 2001 and 2016, and compiled the largest case series to date of 63 patients with prominent autoimmune and/or hyperinflammatory pathology. RESULTS Diagnosis of RAG deficiency was delayed a median of 5 years from the first clinical signs of immune dysregulation. Most patients (55.6%) presented with more than 1 autoimmune or hyperinflammatory complication, with the most common etiologies being cytopenias (84.1%), granulomas (23.8%), and inflammatory skin disorders (19.0%). Infections, including live viral vaccinations, closely preceded the onset of autoimmunity in 28.6% of cases. Autoimmune cytopenias had early onset (median, 1.9, 2.1, and 2.6 years for autoimmune hemolytic anemia, immune thrombocytopenia, and autoimmune neutropenia, respectively) and were refractory to intravenous immunoglobulin, steroids, and rituximab in most cases (64.7%, 73.7%, and 71.4% for autoimmune hemolytic anemia, immune thrombocytopenia, and autoimmune neutropenia, respectively). Evans syndrome specifically was associated with lack of response to first-line therapy. Treatment-refractory autoimmunity/hyperinflammation prompted hematopoietic stem cell transplantation in 20 patients. CONCLUSIONS Autoimmunity/hyperinflammation can be a presenting sign of RAG deficiency and should prompt further evaluation. Multilineage cytopenias are often refractory to immunosuppressive treatment and may require hematopoietic cell transplantation for definitive management.
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Affiliation(s)
- Jocelyn R Farmer
- Massachusetts General Hospital, Harvard Medical School, Boston, Mass
| | - Zsofia Foldvari
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Boglarka Ujhazi
- University of South Florida and Johns Hopkins All Children's Hospital, Saint Petersburg, Fla
| | - Suk See De Ravin
- Laboratory of Host Defenses, National Institutes of Allergy and Infectious Diseases, NIH, Bethesda, Md
| | - Karin Chen
- Division of Allergy and Immunology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Jack J H Bleesing
- Division of Bone Marrow Transplantation and Immune Deficiency, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Catharina Schuetz
- Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Waleed Al-Herz
- Faculty of Medicine, Pediatrics Department, Kuwait University, Kuwait City, Kuwait; Allergy and Clinical Immunology Unit, Pediatrics Department, Alsabah Hospital, Kuwait City, Kuwait
| | - Roshini S Abraham
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minn
| | - Avni Y Joshi
- Division of Pediatric Allergy/Immunology, Mayo Clinic Children's Center Rochester, Rochester, Minn
| | | | - David Buchbinder
- Pediatrics/Hematology, CHOC Children's Hospital - UC Irvine, Irvine, Calif
| | - Claire Booth
- Department of Paediatric Immunology, Great Ormond Street Hospital, London, United Kingdom
| | - Andreas Reiff
- Division of Rheumatology, Children's Hospital Los Angeles, Keck School of Medicine, USC, Los Angeles, Calif
| | - Polly J Ferguson
- Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Asghar Aghamohammadi
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Abolhassani
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Jennifer M Puck
- Department of Pediatrics, University of California San Francisco and UCSF Benioff Children's Hospital, San Francisco, Calif
| | - Mehdi Adeli
- Sidra Medicine, Weill Cornell Medicine, and Hamad Medical Corporation, Doha, Qatar
| | - Caterina Cancrini
- Academic Department of Pediatrics (DPUO), Unit of Immune and Infectious Diseases, Childrens' Hospital Bambino Gesù, Rome, Italy; Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Palma
- Academic Department of Pediatrics (DPUO), Research Unit in Congenital and Perinatal Infection, Children's Hospital Bambino Gesù, Rome, Italy
| | - Alice Bertaina
- Department of Pediatric Hematology/Oncology and Cell and Gene Therapy, IRCCS, Ospedale Bambino Gesù, Rome, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology/Oncology and Cell and Gene Therapy, IRCCS, Ospedale Bambino Gesù, Rome, Italy; Department of Pediatrics, Sapienza, University of Rome, Rome, Italy
| | - Gigliola Di Matteo
- Academic Department of Pediatrics (DPUO), Unit of Immune and Infectious Diseases, Childrens' Hospital Bambino Gesù, Rome, Italy; Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Raif S Geha
- Immunology Division, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Maria G Kanariou
- Department of Immunology - Histocompatibility, Specialized Center & Referral Center for Primary Immunodeficiencies - Paediatric Immunology, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Lilia Lycopoulou
- 1st Department of Pediatrics, University of Athens, Aghia Sofia Children's Hospital, Athens, Greece
| | - Marianna Tzanoudaki
- Department of Immunology - Histocompatibility, Specialized Center & Referral Center for Primary Immunodeficiencies - Paediatric Immunology, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - John W Sleasman
- Division of Allergy, Immunology and Pulmonary Medicine, Duke University School of Medicine, Durham, NC
| | - Suhag Parikh
- Division of Pediatric Blood and Marrow Transplantation, Duke University School of Medicine, Durham, NC
| | - Gloria Pinero
- Division of Allergy, Immunology and Pulmonary Medicine, Duke University School of Medicine, Durham, NC
| | - Bernard M Fischer
- Division of Allergy, Immunology and Pulmonary Medicine, Duke University School of Medicine, Durham, NC
| | - Ghassan Dbaibo
- Department of Pediatrics and Adolescent Medicine, Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon
| | - Ekrem Unal
- Division of Pediatric Hematology and Oncology & HCST Unit, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Turkan Patiroglu
- Division of Pediatric Hematology and Oncology & HCST Unit, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey; Division of Pediatric Immunology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Musa Karakukcu
- Division of Pediatric Hematology and Oncology & HCST Unit, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Khulood Khalifa Al-Saad
- Salmanyia Medical Complex, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Manama, Bahrain
| | - Meredith A Dilley
- Department of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Sung-Yun Pai
- Division of Hematology-Oncology, Boston Children's Hospital, Boston, Mass; Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Cullen M Dutmer
- Division of Allergy & Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colo
| | - Erwin W Gelfand
- Department of Pediatrics, National Jewish Health, Denver, Colo
| | | | - Martha M Eibl
- Immunology Outpatient Clinic, Vienna, Austria; Biomedizinische Forschungs GmbH, Vienna, Austria
| | - Hermann M Wolf
- Immunology Outpatient Clinic, Vienna, Austria; Sigmund Freud Private University-Medical School, Vienna, Austria
| | - Lauren A Henderson
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Melissa M Hazen
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Carmem Bonfim
- Hospital Infantil Pequeno Principe, Curitiba, Brazil
| | | | - Manish J Butte
- Division of Immunology, Allergy, and Rheumatology, Department of Pediatrics and Jeffrey Modell Diagnostic and Research Center, University of California, Los Angeles, Los Angeles, Calif
| | - Joseph D Hernandez
- Department of Pediatrics, Division of Allergy, Immunology and Rheumatology, Stanford University, Stanford, Calif
| | - Sarah K Nicholas
- Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Polina Stepensky
- Department of Bone Marrow Transplantation, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Shanmuganathan Chandrakasan
- Division of Bone Marrow Transplant, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Ga
| | - Maurizio Miano
- Haematology Unit, Department of Pediatric Haematology-Oncology, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Emma Westermann-Clark
- Department of Internal Medicine, Division of Allergy/Immunology, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Vera Goda
- Department for Pediatric Hematology and Hemopoietic Stem Cell Transplantation, Central Hospital of Southern Pest- National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Gergely Kriván
- Department for Pediatric Hematology and Hemopoietic Stem Cell Transplantation, Central Hospital of Southern Pest- National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Steven M Holland
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Md
| | - Olajumoke Fadugba
- Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Sarah E Henrickson
- Allergy Immunology Division, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pa; Institute for Immunology, the University of Pennsylvania, Philadelphia, Pa
| | - Ahmet Ozen
- Marmara University School of Medicine, Division of Pediatric Allergy and Immunology, Istanbul, Turkey
| | - Elif Karakoc-Aydiner
- Marmara University School of Medicine, Division of Pediatric Allergy and Immunology, Istanbul, Turkey
| | - Safa Baris
- Marmara University School of Medicine, Division of Pediatric Allergy and Immunology, Istanbul, Turkey
| | - Ayca Kiykim
- Ministry of Health, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Robbert Bredius
- Department of Pediatrics, Section Pediatric Immunology, Infections and Stem Cell Transplantation, Leiden University Medical Center, Leiden, the Netherlands
| | - Birgit Hoeger
- Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria; CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Kaan Boztug
- Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria; CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria; St Anna Kinderspital and Children's Cancer Research Institute, Department of Pediatrics, Medical University of Vienna, Vienna, Austria; Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Olga Pashchenko
- Department of Immunology, Pirogov Russian National Research Medical University, Russian Clinical Children's Hospital, Moscow, Russia
| | - Benedicte Neven
- Paris Descartes Sorbonne Paris Cité University, Imagine Institute, Paris, France; Pediatric Hematology-Immunology and Rheumatology Unit, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Laboratory "Immunogenetics of Pediatric Autoimmune Diseases", INSERM UMR1163, Université Paris Descartes Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - Despina Moshous
- Paris Descartes Sorbonne Paris Cité University, Imagine Institute, Paris, France; Pediatric Hematology-Immunology and Rheumatology Unit, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Laboratory "Genome Dynamics in The Immune System", INSERM UMR1163, Université Paris Descartes Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - Jean-Pierre de Villartay
- Laboratory "Genome Dynamics in The Immune System", INSERM UMR1163, Université Paris Descartes Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - Ahmed Aziz Bousfiha
- Laboratoire d'Immunologie Clinique, d'Inflammation et d'Allergie LICIA, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco; Clinical Immunology Unit, Casablanca Children's Hospital, Ibn Rochd Medical School, Hassan II University, Casablanca, Morocco
| | - Harry R Hill
- Division of Clinical Immunology, Departments of Pathology, Pediatrics and Medicine, University of Utah, Salt Lake City, Utah
| | - Luigi D Notarangelo
- Haematology Unit, Department of Pediatric Haematology-Oncology, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Jolan E Walter
- University of South Florida and Johns Hopkins All Children's Hospital, Saint Petersburg, Fla; Division of Allergy and Immunology, Massachusetts General Hospital for Children, Boston, Mass.
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Perelygina L, Buchbinder D, Dorsey MJ, Eloit M, Hauck F, Hautala T, Moshous D, Uriarte I, Deripapa E, Icenogle J, Sullivan KE. Outcomes for Nitazoxanide Treatment in a Case Series of Patients with Primary Immunodeficiencies and Rubella Virus-Associated Granuloma. J Clin Immunol 2019; 39:112-117. [PMID: 30680653 DOI: 10.1007/s10875-019-0589-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/02/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Nitazoxanide was recently reported as having in vitro effectiveness against the rubella virus. Immunodeficiency-related vaccine-derived rubella occurs in some patients who have an inherited immunodeficiency and who received the MMR vaccine. This study investigated the in vivo effectiveness of nitazoxanide therapy. METHODS This is a retrospective analysis of seven patients treated with nitazoxanide as salvage therapy for immunodeficiency-related vaccine-derived rubella infection. The patients were recruited from an ongoing rubella detection surveillance project. RESULTS Seven patients with persistent rubella were treated with nitazoxanide and one demonstrated significant clinical improvement. Two additional patients exhibited diminished viral capsid production with one patient having transient slowing of progression. The cohort overall generally had low T cell counts and had a high burden of comorbidities. There were three deaths. Two deaths were from PML and one was related to hematopoietic stem cell transplantation. CONCLUSIONS Nitazoxanide has limited in vivo anti-viral effects for immunodeficiency-related vaccine-derived rubella. Most patients did not exhibit clinical improvement.
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Affiliation(s)
- Ludmila Perelygina
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA
| | - David Buchbinder
- Division of Hematology, CHOC Children's Hospital, Orange, CA, USA
| | - Morna J Dorsey
- Department of Pediatrics, Division of Allergy, Immunology, and Blood and Marrow Transplant, Benioff Children's Hospital, University of California, San Francisco, 1975 4th Street, San Francisco, CA, 94158, USA
| | - Marc Eloit
- Institut Pasteur, Laboratory of Pathogen Discovery, Biology of Infection Unit, Inserm U1117, Paris, France
| | - Fabian Hauck
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Timo Hautala
- Research Unit of Internal Medicine, University of Oulu and Oulu University Hospital, Kajaanintie 50, 90220, Oulu, Finland
| | - Despina Moshous
- Department of Pediatric Immunology, Hematology and Rheumatology, Assistance Publique-Hôpitaux de Paris (AP-HP), Necker Children's Hospital, Paris, France.,Laboratory "Genome Dynamics in The Immune System," INSERM UMR1163, Université Paris Descartes Sorbonne Paris Cité, Institut Imagine, Paris, France
| | - Ignacio Uriarte
- Immunology Unit, The Child's and Mother Hospital, Vitorio Tetamanti, High School of Medicine, Mar del Plata National University, Castelli 2450 Mar del Plata, 7600, Buenos Aires, Argentina
| | - Elena Deripapa
- Department of Immunology, Center for Pediatric Hematology, Oncology, Immunology, Moscow, Russia
| | - Joseph Icenogle
- Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA
| | - Kathleen E Sullivan
- Division of Allergy Immunology, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA.
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46
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Buchbinder D, Hauck F, Albert MH, Rack A, Bakhtiar S, Shcherbina A, Deripapa E, Sullivan KE, Perelygina L, Eloit M, Neven B, Pérot P, Moshous D, Suarez F, Bodemer C, Bonilla FA, Vaz LE, Krol AL, Klein C, Seppanen M, Nugent DJ, Singh J, Ochs HD. Rubella Virus-Associated Cutaneous Granulomatous Disease: a Unique Complication in Immune-Deficient Patients, Not Limited to DNA Repair Disorders. J Clin Immunol 2019; 39:81-89. [PMID: 30607663 DOI: 10.1007/s10875-018-0581-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 12/05/2018] [Indexed: 11/26/2022]
Abstract
The association of immunodeficiency-related vaccine-derived rubella virus (iVDRV) with cutaneous and visceral granulomatous disease has been reported in patients with primary immunodeficiency disorders (PIDs). The majority of these PID patients with rubella-positive granulomas had DNA repair disorders. To support this line of inquiry, we provide additional descriptive data on seven previously reported patients with Nijmegen breakage syndrome (NBS) (n = 3) and ataxia telangiectasia (AT) (n = 4) as well as eight previously unreported patients with iVDRV-induced cutaneous granulomas and DNA repair disorders including NBS (n = 1), AT (n = 5), DNA ligase 4 deficiency (n = 1), and Artemis deficiency (n = 1). We also provide descriptive data on several previously unreported PID patients with iVDRV-induced cutaneous granulomas including cartilage hair hypoplasia (n = 1), warts, hypogammaglobulinemia, immunodeficiency, myelokathexis (WHIM) syndrome (n = 1), MHC class II deficiency (n = 1), Coronin-1A deficiency (n = 1), X-linked severe combined immunodeficiency (X-SCID) (n = 1), and combined immunodeficiency without a molecular diagnosis (n = 1). At the time of this report, the median age of the patients with skin granulomas and DNA repair disorders was 9 years (range 3-18). Cutaneous granulomas have been documented in all, while visceral granulomas were observed in six cases (40%). All patients had received rubella virus vaccine. The median duration of time elapsed from vaccination to the development of cutaneous granulomas was 48 months (range 2-152). Hematopoietic cell transplantation was reported to result in scarring resolution of cutaneous granulomas in two patients with NBS, one patient with AT, one patient with Artemis deficiency, one patient with DNA Ligase 4 deficiency, one patient with MHC class II deficiency, and one patient with combined immunodeficiency without a known molecular etiology. Of the previously reported and unreported cases, the majority share the diagnosis of a DNA repair disorder. Analysis of additional patients with this complication may clarify determinants of rubella pathogenesis, identify specific immune defects resulting in chronic infection, and may lead to defect-specific therapies.
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Affiliation(s)
- David Buchbinder
- Department of Pediatric Hematology, Children's Hospital of Orange County, 1201 W. La Veta Avenue, Orange, CA, 92868, USA.
- Department of Pediatrics, University of California at Irvine, Orange, CA, USA.
| | - Fabian Hauck
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Michael H Albert
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Anita Rack
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Shahrzad Bakhtiar
- Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt/Main, Germany
| | - Anna Shcherbina
- Department of Immunology, Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Elena Deripapa
- Department of Immunology, Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Kathleen E Sullivan
- Division of Allergy Immunology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ludmila Perelygina
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marc Eloit
- Biology of Infection Unit, Pathogen Discovery Laboratory, Institut Pasteur, Paris, France
| | - Bénédicte Neven
- Unité d'Immunologie-Hématologie et Rhumatologie Pédiatriques, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France
- INSERM U116 and Institut Imagine, Université Paris-Descartes, Sorbonne Paris Cité, Paris, France
| | - Philippe Pérot
- Biology of Infection Unit, Pathogen Discovery Laboratory, Institut Pasteur, Paris, France
- Centre d'innovation et de Recherche Technologique (Citech), Institut Pasteur, Paris, France
| | - Despina Moshous
- Unité d'Immunologie-Hématologie et Rhumatologie Pédiatriques, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France
- INSERM U116 and Institut Imagine, Université Paris-Descartes, Sorbonne Paris Cité, Paris, France
| | - Félipe Suarez
- Unité d'hématologie adulte, Hopital Necker-Enfants-Malades, AP-HP, INSERM U116 & Institut Imagine, Université Paris-Descartes, Sorbonne Paris Cité, Paris, France
| | - Christine Bodemer
- Service de dermatologie pédiatrique, Hopital Necker-Enfants-Malades, AP-HP, INSERM U116 & Institut Imagine, Université Paris-Descartes, Sorbonne Paris Cité, Paris, France
| | | | - Louise E Vaz
- Department of Infectious Disease, Doernbecher Children's Hospital, Oregon Health Sciences University, Portland, OR, USA
| | - Alfons L Krol
- Department of Dermatology, Doernbecher Children's Hospital, Oregon Health Sciences University, Portland, OR, USA
| | - Christoph Klein
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany
| | - Mikko Seppanen
- Rare Disease Center, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - Diane J Nugent
- Department of Pediatric Hematology, Children's Hospital of Orange County, 1201 W. La Veta Avenue, Orange, CA, 92868, USA
- Department of Pediatrics, University of California at Irvine, Orange, CA, USA
| | - Jasjit Singh
- Department of Pediatrics, University of California at Irvine, Orange, CA, USA
- Department of Infectious Disease, Children's Hospital of Orange County, Orange, CA, USA
| | - Hans D Ochs
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, WA, USA
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Radivoyevitch T, Dean RM, Shaw BE, Brazauskas R, Tecca HR, Molenaar RJ, Battiwalla M, Savani BN, Flowers MED, Cooke KR, Hamilton BK, Kalaycio M, Maciejewski JP, Ahmed I, Akpek G, Bajel A, Buchbinder D, Cahn JY, D’Souza A, Daly A, DeFilipp Z, Ganguly S, Hamadani M, Hayashi RJ, Hematti P, Inamoto Y, Khera N, Kindwall-Keller T, Landau H, Lazarus H, Majhail NS, Marks DI, Olsson RF, Seo S, Steinberg A, William BM, Wirk B, Yared JA, Aljurf M, Abidi MH, Allewelt H, Beitinjaneh A, Cook R, Cornell RF, Fay JW, Hale G, Chakrabarty JH, Jodele S, Kasow KA, Mahindra A, Malone AK, Popat U, Rizzo JD, Schouten HC, Warwick AB, Wood WA, Sekeres MA, Litzow MR, Gale RP, Hashmi SK. Risk of acute myeloid leukemia and myelodysplastic syndrome after autotransplants for lymphomas and plasma cell myeloma. Leuk Res 2018; 74:130-136. [PMID: 30055822 PMCID: PMC6219911 DOI: 10.1016/j.leukres.2018.07.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 06/26/2018] [Accepted: 07/17/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Exposures to DNA-damaging drugs and ionizing radiations increase risks of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). METHODS 9028 recipients of hematopoietic cell autotransplants (1995-2010) for Hodgkin lymphoma (HL; n = 916), non-Hodgkin lymphoma (NHL; n = 3546) and plasma cell myeloma (PCM; n = 4566), reported to the CIBMTR, were analyzed for risk of subsequent AML or MDS. RESULTS 335 MDS/AML cases were diagnosed posttransplant (3.7%). Variables associated with an increased risk for AML or MDS in multivariate analyses were: (1) conditioning with total body radiation versus chemotherapy alone for HL (HR = 4.0; 95% confidence interval [1.4, 11.6]) and NHL (HR = 2.5 [1.1, 2.5]); (2) ≥3 versus 1 line of chemotherapy for NHL (HR = 1.9 [1.3, 2.8]); and (3) subjects with NHL transplanted in 2005-2010 versus 1995-1999 (HR = 2.1 [1.5, 3.1]). Using Surveillance, Epidemiology and End Results (SEER) data, we found risks for AML/MDS in HL, NHL and PCM to be 5-10 times the background rate. In contrast, relative risks were 10-50 for AML and approximately 100 for MDS in the autotransplant cohort. CONCLUSIONS There are substantial risks of AML and MDS after autotransplants for HL, NHL and PCM.
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Affiliation(s)
- Tomas Radivoyevitch
- Dept. of Translational Hematology & Oncology Research, Cleveland Clinic Foundation, Cleveland, OH
| | - Robert M. Dean
- Dept. of Translational Hematology & Oncology Research, Cleveland Clinic Foundation, Cleveland, OH
| | - Bronwen E. Shaw
- CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI
| | - Ruta Brazauskas
- CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI
| | - Heather R. Tecca
- CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI
| | - Remco J. Molenaar
- Dept. of Translational Hematology & Oncology Research, Cleveland Clinic Foundation, Cleveland, OH
- Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands
| | - Minoo Battiwalla
- Hematology Branch, National Heart, Lung and Blood Institute, Bethesda, MD
| | - Bipin N. Savani
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Mary E. D. Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kenneth R. Cooke
- Pediatric Blood and Marrow Transplantation Program, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Betty K. Hamilton
- Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, Ohio
| | - Matt Kalaycio
- Blood & Marrow Transplant Program, Cleveland Clinic, Cleveland, Ohio
| | | | - Ibrahim Ahmed
- Department of Hematology Oncology and Bone Marrow Transplantation, The Children’s Mercy Hospitals and Clinics, Kansas City, MO
| | - Görgün Akpek
- Stem Cell Transplantation and Cell Therapy, Rush University Medical Center, Chicago, IL
| | - Ashish Bajel
- Royal Melbourne Hospital City Campus, Melbourne, Australia
| | - David Buchbinder
- Division of Pediatrics Hematology, Children’s Hospital of Orange County, Orange, CA
| | - Jean-Yves Cahn
- Department of Hematology, CHU Grenoble Alpes, Grenoble, France
| | - Anita D’Souza
- CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI
| | - Andrew Daly
- Tom Baker Cancer Center, Calgary, AB, Canada
| | - Zachariah DeFilipp
- Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA
| | - Siddhartha Ganguly
- Blood and Marrow Transplantation, University of Kansas Medical Center, Kansas City, KS
| | - Mehdi Hamadani
- CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI
| | - Robert J. Hayashi
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Peiman Hematti
- Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, WI
| | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Nandita Khera
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ
| | - Tamila Kindwall-Keller
- Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, VA
| | - Heather Landau
- Bone Marrow Transplant Service, Division of Hematology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Hillard Lazarus
- Seidman Cancer Center, Case Western Reserve University, Cleveland, OH
| | | | - David I. Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - Richard F. Olsson
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Sachiko Seo
- Department of Hematology & Oncology; National Cancer Research Center East, Chiba, Japan
| | - Amir Steinberg
- Department of Hematology-Oncology, Mount Sinai Hospital, New York, NY
| | | | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA
| | - Jean A. Yared
- Department of Medicine, University of Maryland, Baltimore, MD
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital,, Riyadh, Saudi Arabia
| | - Muneer H. Abidi
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | | | | | - Rachel Cook
- Oregon Health and Science University, Portland, OR
| | - Robert F. Cornell
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | | | - Gregory Hale
- Department of Hematology/Oncology, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
| | | | - Sonata Jodele
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | | | - Anuj Mahindra
- Scripps Blood & Marrow Transplant Program, La Jolla, CA
| | - Adriana K. Malone
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - J. Douglas Rizzo
- CIBMTR (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI
| | - Harry C. Schouten
- Department of Hematology, Academische Ziekenhuis, Maastricht, Netherlands
| | - Anne B. Warwick
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - William A. Wood
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Mikkael A. Sekeres
- Dept. of Translational Hematology & Oncology Research, Cleveland Clinic Foundation, Cleveland, OH
| | | | - Robert P. Gale
- Department of Medicine, Imperial College London, London, United Kingdom
| | - Shahrukh K. Hashmi
- Department of Oncology, King Faisal Specialist Hospital,, Riyadh, Saudi Arabia
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48
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Whyte MP, Lim E, McAlister WH, Gottesman GS, Trinh L, Veis DJ, Bijanki VN, Boden MG, Nenninger A, Mumm S, Buchbinder D. Unique Variant of NOD2 Pediatric Granulomatous Arthritis With Severe 1,25-Dihydroxyvitamin D-Mediated Hypercalcemia and Generalized Osteosclerosis. J Bone Miner Res 2018; 33:2071-2080. [PMID: 29933504 PMCID: PMC6636828 DOI: 10.1002/jbmr.3532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 05/27/2018] [Indexed: 12/18/2022]
Abstract
Pediatric granulomatous arthritis (PGA) refers to two formerly separate entities: autosomal dominant Blau syndrome (BS) and its sporadic phenocopy early-onset sarcoidosis (EOS). In 2001 BS and in 2005 EOS became explained by heterozygous mutations within the gene that encodes nucleotide-binding oligomerization domain-containing protein 2 (NOD2), also called caspase recruitment domain-containing protein 15 (CARD15). NOD2 is a microbe sensor in leukocyte cytosol that activates and regulates inflammation. PGA is characterized by a triad of autoinflammatory problems (dermatitis, uveitis, and arthritis) in early childhood, which suggests the causal NOD2/CARD15 mutations are activating defects. Additional complications of PGA were recognized especially when NOD2 mutation analysis became generally available. However, in PGA, hypercalcemia is only briefly mentioned, and generalized osteosclerosis is not reported, although NOD2 regulates NF-κB signaling essential for osteoclastogenesis and osteoclast function. Herein, we report a 4-year-old girl with PGA uniquely complicated by severe 1,25(OH)2 D-mediated hypercalcemia, nephrocalcinosis, and compromised renal function together with radiological and histopathological features of osteopetrosis (OPT). The classic triad of PGA complications was absent, although joint pain and an antalgic gait accompanied wrist, knee, and ankle swelling and soft non-tender masses over her hands, knees, and feet. MRI revealed tenosynovitis in her hands and suprapatellar effusions. Synovial biopsy demonstrated reactive synovitis without granulomas. Spontaneous resolution of metaphyseal osteosclerosis occurred while biochemical markers indicated active bone turnover. Anti-inflammatory medications suppressed circulating 1,25(OH)2 D, corrected the hypercalcemia, and improved her renal function, joint pain and swelling, and gait. Mutation analysis excluded idiopathic infantile hypercalcemia, type 1, and known forms of OPT, and identified a heterozygous germline missense mutation in NOD2 common in PGA (c.1001G>A, p.Arg334Gln). Thus, radiological and histological findings of OPT and severe hypercalcemia from apparent extrarenal production of 1,25(OH)2 D can complicate NOD2-associated PGA. Although the skeletal findings seem inconsequential, treatment of the hypercalcemia is crucial to protect the kidneys. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Michael P Whyte
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children, St. Louis, MO, USA.,Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO, USA
| | - Emilina Lim
- Pediatrics/Rheumatology, CHOC Children's Hospital, Orange, CA, USA
| | - William H McAlister
- Mallinckrodt Institute of Radiology, Washington University School of Medicine at St. Louis Children's Hospital, St. Louis, MO, USA
| | - Gary S Gottesman
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children, St. Louis, MO, USA
| | - Lien Trinh
- Pediatrics/Endocrinology, CHOC Children's Hospital, Orange, CA, USA
| | - Deborah J Veis
- Division of Biology and Biomedical Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Vinieth N Bijanki
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children, St. Louis, MO, USA
| | - Matthew G Boden
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children, St. Louis, MO, USA
| | - Angela Nenninger
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children, St. Louis, MO, USA
| | - Steven Mumm
- Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children, St. Louis, MO, USA.,Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO, USA
| | - David Buchbinder
- Pediatrics/Hematology, CHOC Children's Hospital - UC Irvine, Orange, CA, USA
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49
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Norkin M, Shaw BE, Brazauskas R, Tecca HR, Leather HL, Gea-Banacloche J, T Kamble R, DeFilipp Z, Jacobsohn DA, Ringden O, Inamoto Y, A Kasow K, Buchbinder D, Shaw P, Hematti P, Schears R, Badawy SM, Lazarus HM, Bhatt N, Horn B, Chhabra S, M Page K, Hamilton B, Hildebrandt GC, Yared JA, Agrawal V, M Beitinjaneh A, Majhail N, Kindwall-Keller T, Olsson RF, Schoemans H, Gale RP, Ganguly S, A Ahmed I, Schouten HC, L Liesveld J, Khera N, Steinberg A, Shah AJ, Solh M, Marks DI, Rybka W, Aljurf M, Dietz AC, Gergis U, George B, Seo S, Flowers MED, Battiwalla M, Savani BN, Riches ML, Wingard JR. Characteristics of Late Fatal Infections after Allogeneic Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2018; 25:362-368. [PMID: 30287390 DOI: 10.1016/j.bbmt.2018.09.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 08/15/2018] [Accepted: 09/26/2018] [Indexed: 11/29/2022]
Abstract
We analyzed late fatal infections (LFIs) in allogeneic stem cell transplantation (HCT) recipients reported to the Center for International Blood and Marrow Transplant Research. We analyzed the incidence, infection types, and risk factors contributing to LFI in 10,336 adult and 5088 pediatric subjects surviving for ≥2 years after first HCT without relapse. Among 2245 adult and 377 pediatric patients who died, infections were a primary or contributory cause of death in 687 (31%) and 110 (29%), respectively. At 12 years post-HCT, the cumulative incidence of LFIs was 6.4% (95% confidence interval [CI], 5.8% to 7.0%) in adults, compared with 1.8% (95% CI, 1.4% to 2.3%) in pediatric subjects; P < .001). In adults, the 2 most significant risks for developing LFI were increasing age (20 to 39, 40 to 54, and ≥55 years versus 18 to 19 years) with hazard ratios (HRs) of 3.12 (95% CI, 1.33 to 7.32), 3.86 (95% CI, 1.66 to 8.95), and 5.49 (95% CI, 2.32 to 12.99) and a history of chronic graft-versus-host disease GVHD (cGVHD) with ongoing immunosuppression at 2 years post-HCT compared with no history of GVHD with (HR, 3.87; 95% CI, 2.59 to 5.78). In pediatric subjects, the 3 most significant risks for developing LFI were a history of cGVHD with ongoing immunosuppression (HR, 9.49; 95% CI, 4.39 to 20.51) or without ongoing immunosuppression (HR, 2.7; 95% CI, 1.05 to 7.43) at 2 years post-HCT compared with no history of GVHD, diagnosis of inherited abnormalities of erythrocyte function compared with diagnosis of acute myelogenous leukemia (HR, 2.30; 95% CI, 1.19 to 4.42), and age >10 years (HR, 1.92; 95% CI, 1.15 to 3.2). This study emphasizes the importance of continued vigilance for late infections after HCT and institution of support strategies aimed at decreasing the risk of cGVHD.
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Affiliation(s)
- Maxim Norkin
- Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, Florida
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Ruta Brazauskas
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Heather R Tecca
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Helen L Leather
- Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, Florida
| | - Juan Gea-Banacloche
- Experimental Transplantation and Immunology Branch, National Cancer Institute. Bethesda, Maryland
| | - Rammurti T Kamble
- Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas
| | - Zachariah DeFilipp
- Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, Massachusetts
| | - David A Jacobsohn
- Division of Blood and Marrow Transplantation, Center for Cancer and Blood Disorders, Children's National Health System, Washington, DC
| | - Olle Ringden
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Yoshihiro Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Kimberly A Kasow
- Division of Hematology-Oncology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - David Buchbinder
- Division of Pediatrics Hematology, Children's Hospital of Orange County, Orange, California
| | - Peter Shaw
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Peiman Hematti
- Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | | | - Sherif M Badawy
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Hillard M Lazarus
- Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Neel Bhatt
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | | | - Kristin M Page
- Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, North Carolina
| | - Betty Hamilton
- Blood and Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | | | - Jean A Yared
- Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland
| | - Vaibhav Agrawal
- Indiana University Simon Cancer Center, Indianapolis, Indiana
| | | | - Navneet Majhail
- Blood and Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Tamila Kindwall-Keller
- Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, Virginia
| | - Richard F Olsson
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | | | - Robert Peter Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Siddhartha Ganguly
- Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas
| | - Ibrahim A Ahmed
- Department of Hematology Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, Missouri
| | - Harry C Schouten
- Department of Hematology, Academische Ziekenhuis, Maastricht, The Netherlands
| | - Jane L Liesveld
- Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Nandita Khera
- Department of Hematology/Oncology, Mayo Clinic, Phoenix, Arizona
| | - Amir Steinberg
- Department of Hematology-Oncology, Mount Sinai Hospital, New York, New York
| | - Ami J Shah
- Division of Stem Cell Transplantation and Regenerative Medicine, Lucille Packard Children's Hospital, Stanford School of Medicine, Palo Alto, California
| | - Melhem Solh
- The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, Georgia
| | - David I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom
| | - Witold Rybka
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | - Mahmoud Aljurf
- Department of Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Andrew C Dietz
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California
| | - Usama Gergis
- Hematologic Malignancies and Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | | | - Sachiko Seo
- Department of Hematology and Oncology, National Cancer Research Center East, Chiba, Japan
| | - Mary E D Flowers
- Medical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Marcie L Riches
- Division of Hematology/Oncology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John R Wingard
- Division of Hematology/Oncology, University Florida College of Medicine, Gainesville, Florida
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Seher C, Buchbinder D, Taylor K. Reaching Food Insecure College Students Through an On-campus Interactive Nutrition Education Program. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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