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Dyer C, Alquist CR, Cole-Sinclair M, Curnow E, Dunbar NM, Estcourt LJ, Kaufman R, Kutner JM, McCullough J, McQuilten Z, Potiphar L, Rioux-Masse B, Slichter S, Tinmouth A, Webert K, Yokoyama AP, Stanworth SJ. A multicentred study to validate a consensus bleeding assessment tool developed by the biomedical excellence for safer transfusion collaborative for use in patients with haematological malignancy. Vox Sang 2018; 113:251-259. [DOI: 10.1111/vox.12627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 12/24/2022]
Affiliation(s)
- C. Dyer
- NHS Blood and Transplant Clinical Trials Unit; Headington Oxford UK
| | - C. R. Alquist
- Section of Transfusion Medicine and Histocompatibility; Department of Pathology & Laboratory Medicine; Ochsner Health System; New Orleans LO USA
| | - M. Cole-Sinclair
- Laboratory Haematology; Pathology St Vincent's Hospital; Melbourne Vic. Australia
| | - E. Curnow
- Statistics and Clinical Studies; NHS Blood and Transplant; Bristol UK
| | - N. M. Dunbar
- Department of Pathology and Laboratory Medicine; Dartmouth-Hitchcock Medical Center; Lebanon NH USA
| | - L. J. Estcourt
- NHS Blood and Transplant; Oxford UK
- Radcliffe Department of Medicine; University of Oxford; Oxford UK
- Oxford BRC Haematology Theme; Oxford UK
| | - R. Kaufman
- Pathology, Brigham and Women; Boston MA USA
| | - J. M. Kutner
- Hemotherapy and Cell Therapy Department; Hospital Israelita Albert Einstein; Sao Paulo Brazil
| | | | - Z. McQuilten
- Department of Haematology; St Vincent's Hospital Melbourne; Melbourne Vic. Australia
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Vic. Australia
| | | | - B. Rioux-Masse
- Department of Hematology and Transfusion Medicine; Centre Hospitalier de l'Universite de Montreal; Montreal QC Canada
| | | | - A. Tinmouth
- Ottawa Hospital Research Institute; Ottawa ON Canada
| | - K. Webert
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton ON Canada
- Medical Science and Innovation; Canadian Blood Services; Ancaster ON Canada
| | - A. P. Yokoyama
- Hemotherapy and Cell Therapy Department; Hospital Israelita Albert Einstein; Sao Paulo Brazil
| | - S. J. Stanworth
- Radcliffe Department of Medicine; University of Oxford; Oxford UK
- Oxford BRC Haematology Theme; Oxford UK
- Transfusion Medicine; NHS Blood and Transplant; Oxford UK
- Department of Haematology; Oxford University Hospitals NHS Foundation Trust; Oxford UK
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Zordan R, Manitta V, Nandurkar H, Cole-Sinclair M, Philip J. Prevalence and predictors of fatigue in haemo-oncological patients. Intern Med J 2015; 44:1013-7. [PMID: 24989335 DOI: 10.1111/imj.12517] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 06/22/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fatigue is a common symptom in patients with advanced malignancy, and has been associated with both physiological and psychological factors in patients with solid tumours. AIM This study sought to explore the predictors of fatigue in a population with haematological malignancy. METHODS Consecutive outpatients and inpatients attending a haematology centre completed the Memorial Symptom Assessment Scale, and clinical, treatment and demographic information were noted. RESULTS Of 180 patients, fatigue was present in 69%, and causing considerable distress in 26%. Univariate analysis revealed fatigue was associated with poor performance status, low haemoglobin, feeling sad, worried, irritable and nervous. Multivariate modeling revealed that those factors predictive of fatigue were poor performance status, having active disease, feeling sad and irritable, while haemoglobin level was not predictive of fatigue. CONCLUSIONS Fatigue is a multidimensional symptom in patients with haematological malignancy whose presence must prompt a holistic assessment of potential contributors that goes beyond correction of haemoglobin levels.
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Affiliation(s)
- R Zordan
- Centre for Palliative Care, St Vincent's Hospital, Melbourne, Victoria, Australia
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Kamel S, Horton L, Ysebaert L, Levade M, Burbury K, Tan S, Cole-Sinclair M, Reynolds J, Filshie R, Schischka S, Khot A, Sandhu S, Keating MJ, Nandurkar H, Tam CS. Ibrutinib inhibits collagen-mediated but not ADP-mediated platelet aggregation. Leukemia 2015; 29:783-7. [PMID: 25138588 DOI: 10.1038/leu.2014.247] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 08/07/2014] [Accepted: 08/14/2014] [Indexed: 02/03/2023]
Abstract
The BTK (Bruton's tyrosine kinase) inhibitor ibrutinib is associated with an increased risk of bleeding. A previous study reported defects in collagen- and adenosine diphosphate (ADP)-dependent platelet responses when ibrutinib was added ex vivo to patient samples. Whereas the collagen defect is expected given the central role of BTK in glycoprotein VI signaling, the ADP defect lacks a mechanistic explanation. In order to determine the real-life consequences of BTK platelet blockade, we performed light transmission aggregometry in 23 patients receiving ibrutinib treatment. All patients had reductions in collagen-mediated platelet aggregation, with a significant association between the degree of inhibition and the occurrence of clinical bleeding or bruising (P=0.044). This collagen defect was reversible on drug cessation. In contrast to the previous ex vivo report, we found no in vivo ADP defects in subjects receiving standard doses of ibrutinib. These results establish platelet light transmission aggregometry as a method for gauging, at least qualitatively, the severity of platelet impairment in patients receiving ibrutinib treatment.
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Affiliation(s)
- S Kamel
- Department of Hematology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - L Horton
- Department of Hematology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - L Ysebaert
- Département d'Hématologie, IUCT-Oncopole, Toulouse, France
| | - M Levade
- 1] Inserm, U1048 and Université Toulouse 3, Toulouse, France [2] Laboratoire d'Hématologie CHU de Toulouse, Toulouse, France
| | - K Burbury
- Department of Hematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - S Tan
- Department of Hematology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - M Cole-Sinclair
- Department of Hematology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - J Reynolds
- Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - R Filshie
- Department of Hematology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - S Schischka
- Department of Hematology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - A Khot
- Department of Hematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - S Sandhu
- Department of Hematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - M J Keating
- Leukemia Department, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - H Nandurkar
- 1] Department of Hematology, St Vincent's Hospital, Melbourne, Victoria, Australia [2] University of Melbourne, Parkville, Victoria, Australia
| | - C S Tam
- 1] Department of Hematology, St Vincent's Hospital, Melbourne, Victoria, Australia [2] Department of Hematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia [3] University of Melbourne, Parkville, Victoria, Australia
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Lai FPL, Cole-Sinclair M, Cheng WJ, Quinn JMW, Gillespie MT, Sentry JW, Schneider HG. Myeloma cells can directly contribute to the pool of RANKL in bone bypassing the classic stromal and osteoblast pathway of osteoclast stimulation. Br J Haematol 2004; 126:192-201. [PMID: 15238139 DOI: 10.1111/j.1365-2141.2004.05018.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Summary The ratio of osteoprotegerin [OPG, tumour necrosis factor receptor superfamily, member 11b (TNFRSF11B)] to receptor activator of nuclear factor kappaB ligand [RANKL, tumour necrosis factor (ligand) superfamily, member 11 (TNFSF11)] in bone is critical for the regulation of bone remodelling. Myeloma cells can home to bone, triggering increased RANKL and decreased OPG expression by stromal cells, leading to osteolysis. Whether myeloma cells contribute directly to the pool of RANKL or OPG in bone has been contentious. Here we provide evidence of RANKL expression by reverse transcription polymerase chain reaction and in situ hybridization, demonstrating transcripts encoding both the membrane-bound and secreted forms of RANKL in five human multiple myeloma cell lines (LP-1, NCI-H929, OPM-2, RPMI8226, U266) and myeloma cells purified from bone marrow aspirates of myeloma patients. We demonstrated that RANKL encoding mRNAs are translated to protein by antibody detection of RANKL. In vitro assays showed that myeloma cells induced bone marrow derived mononuclear cells to differentiate into adherent tartrate-resistant acid phosphatase positive multinucleated cells, indicative of the formation of functional osteoclasts. This differentiation could also be achieved with passaged myeloma media alone, implicating secreted products. Finally, we provide evidence that the differentiation observed is at least in part the result of myeloma cell expression of RANKL. We therefore conclude that myeloma cells can directly contribute to the pool of RANKL in bone.
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Affiliation(s)
- F P L Lai
- Alfred Pathology Service, Alfred Hospital, Melbourne, Victoria, Australia
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O'Malley F, Rayeroux K, Cole-Sinclair M, Tong M, Campbell LJ. MYC amplification in two further cases of acute myeloid leukemia with trisomy 4 and double minute chromosomes. Cancer Genet Cytogenet 1999; 109:123-5. [PMID: 10087944 DOI: 10.1016/s0165-4608(98)00160-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report two cases of trisomy 4 with double minute chromosomes (dmin): one in a woman with acute myeloid leukemia (AML), French-American-British subtype M2, the other in a man with chronic myelomonocytic leukemia. In the former case, many cells without trisomy 4 but with dmin were present, a finding not observed in previously reported cases. In both cases, fluorescence in situ hybridization studies demonstrated the double minutes to be MYC amplicons. Ten cases of AML with trisomy 4 and dmin have now been described; in the five cases investigated, the dmin have been shown to be amplified MYC gene sequences.
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Affiliation(s)
- F O'Malley
- Victorian Cancer Cytogenetics Service, St. Vincent's Hospital, Victoria, Australia
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Cole-Sinclair M, Foroni L, Wright F, Mehta A, Prentice HG, Hoffbrand AV. Minimal residual disease in acute lymphoblastic leukaemia--PCR analysis of immunoglobulin gene rearrangements. Leuk Lymphoma 1993; 11 Suppl 2:49-58. [PMID: 8124233 DOI: 10.3109/10428199309064262] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Rearrangement of the immunoglobulin heavy chain (IgH) gene can be utilized as a marker of clonality in a number of B-lineage lymphoproliferative disorders including acute lymphoblastic leukaemia (ALL). We have used a PCR technique involving a panel of amplimers for the 6 different Variable (VH) region families and for a consensus sequence of the Joining (JH) segment to detect clonal IgH rearrangements in the peripheral blood (PB) and/or bone marrow (BM) of 28 patients (17 children and 11 adults) with B-lineage ALL at presentation (20 patients) or with overt relapse (8 patients). The age range of the patients was 2-65 years (mean 15.7 years). Follow up remission BM samples were analysed in 22 patients during and after therapy (2-7 samples per patient), 1-50 months after presentation or relapse. In 1 relapsed case, previously stored complete remission (CR) samples were analysed retrospectively. Clonal IgH chain rearrangements were detected by PCR in 90% of patients studied initially. The 2 VH region families most commonly used were the large VH3 family (65%) and the smaller more JH-proximal VH4 family (22%). More than one VH clone was detectable in 25% of the cases. A gene "fingerprinting" modification of a previously described method was applied to the detection of minimal residual disease (MRD) in follow up BM samples with a sensitivity of 10(-3) to 10(-4). In 8 of 14 patients remaining in complete remission (CR) during the time of study, all PCR analyses on BM samples in the first 6 months were negative, in some cases as early as 2 weeks post-induction therapy, and a further patient reverted from being PCR positive in the first month after the commencement of therapy to sustained PCR negativity. One adult remains in CR at 50 months after presentation and has been PCR negative at 2 time points after cessation of maintenance therapy (30 and 50 months). Eight patients relapsed in the study period comprising 6 BM and 2 isolated CNS relapses. In 4 cases of BM relapse occurring within 7 months of the start of therapy, all BM remission samples tested in this period were PCR positive. In 2 other patients BM samples tested 7 and 2 months respectively prior to relapse were PCR negative. In the 2 patients with isolated CNS relapse, PCR of BM samples from 2 and 10 months before the relapse were negative.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- M Cole-Sinclair
- Department of Haematology, Royal Free Hospital School of Medicine, London, United Kingdom
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Minchinton RM, Cunningham I, Cole-Sinclair M, Van der Weyden M, Vaughan S, McGrath KM. Autoreactive platelet antibody in post transfusion purpura. Aust N Z J Med 1990; 20:111-5. [PMID: 2188642 DOI: 10.1111/j.1445-5994.1990.tb01284.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Post transfusion purpura in a DR3, DRw52 positive, PlA1 negative woman rapidly responded to high-dose intravenous gammaglobulin therapy. Using the platelet immunofluorescence test (PIFT) high titre IgG and IgM alloantibodies were detected in the patient's acute serum. These alloantibodies had PlA1 specificity and the patient's serum produced a broad, 100 kDa band on Western Blot with PlA1 positive platelets. Acute phase serum also contained an IgG antibody which reacted in the PIFT with the patient's own platelets, and PlA1 negative platelets. When tested by Western Blot with PlA1 negative and Glanzmann's Thrombasthenia platelets, the acute serum produced bands at 180 and 200 kDa. The autoreactive antibody was not detected once the platelet count returned to normal. These findings provide evidence for the hypothesis that the mechanism of autologous platelet destruction in PTP is autoimmune.
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Affiliation(s)
- R M Minchinton
- Red Cross Blood Transfusion Service, Brisbane, Qld, Australia
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