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Abstract
Over the past three decades, cord blood transplantation (CBT) has established its role as an alternative allograft stem cell source. But the future of stored CB units should be to extend their use in updated transplant approaches and develop new CB applications. Thus, CBT will require a coordinated, multicentric, review of transplantation methods and an upgrade and realignment of banking resources and operations. Significant improvements have already been proposed to support the clinical perspective including definition of the cellular threshold for engraftment, development of transplantation methods for adult patients, engraftment acceleration with single cell expansion and homing technologies, personalised protocols to improve efficacy, use of adoptive cell therapy to mitigate delayed immune reconstitution, and further enhancement of the graft-versus-leukaemia effect using advanced therapies. The role of CB banks in improving transplantation results are also critical by optimizing the collection, processing, storage and characterization of CB units, and improving reproducibility, efficiency and cost of banking. But future developments beyond transplantation are needed. This implies the extension from transplantation banks to banks that support cell therapy, regenerative medicine and specialized transfusion medicine. This new "CB banking 2.0" concept will require promotion of international scientific and technical collaborations between bank specialists, clinical investigators and transplant physicians.
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Affiliation(s)
- Sergio Querol
- Cell Therapy Services and Cord Blood Bank, Catalan Blood and Tissue Bank, Barcelona, Spain
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2
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Wynn LA, Madrigal A. Predictive analytics and cord blood banking: toward utilization-based unit selection. Cytotherapy 2021; 23:641-646. [PMID: 33736934 DOI: 10.1016/j.jcyt.2021.01.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 01/03/2021] [Accepted: 01/08/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AIMS Total nucleated cell (TNC) and CD34+ cell doses are considered among the most important parameters when assessing the suitability of a human leukocyte antigen-matched cord blood unit (CBU) for allogeneic hematopoietic stem cell transplantation (HSCT). Cord blood banks therefore frequently select CBUs for cryopreservation based on pre-process TNC content. However, cell loss during processing can lead to a significant quantity of CBUs that do not meet desired post-process quality criteria, and such grafts are less likely to be selected by transplant centers for HSCT. Here the authors present a multi-parameter linear regression (MLR) model capable of identifying CBUs that would process poorly, despite meeting established pre-process TNC and CD34+ quality thresholds. METHODS Historically processed CBUs were graded from A+ to D depending on post-process cell content, and the utilization rate of each grade category was examined. Eight pre-process predictors of post-process cell content were used to train the MLR model, including red blood cell (RBC) content; CBU volume; age of CBU when received; and TNC constituent cell subsets. The selection efficacy of this model was then compared to that of methods conventionally used to select CBUs for processing, with receiver operating characteristic (ROC) and mean inventory quality analysis forming the basis of assessment. RESULTS Within the Anthony Nolan Cell Therapy Centre, CBUs graded 'D' accounted for 37% of processing expenditures despite providing only 11% of grafts shipped for HSCT. The MLR model significantly improved pre-process identification of 'D' grade CBUs relative to thresholds based primarily on CD34+ cell content (P < 0.0001) and TNC content (P < 0.0001). At a comparable financial investment, this translated to a banked graft inventory of significantly higher quality than that produced by CD34+ (+8.8% mean increase, P = 0.007) and TNC (+9.9% mean increase, P = 0.010) selection methods. CONCLUSIONS A predictive modelling approach to pre-process CBU selection is a simple and effective means to increase graft inventory quality and potentially future graft utilization, at no additional financial investment.
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Affiliation(s)
- Liam A Wynn
- Anthony Nolan Cell Therapy Centre, Nottingham, UK.
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3
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Cuadrado MM, Szydlo RM, Watts M, Patel N, Renshaw H, Dorman J, Lowdell M, Ings S, Anthias C, Madrigal A, Mackinnon S, Kottaridis P, Carpenter B, Hough R, Morris E, Thomson K, Peggs KS, Chakraverty R. Predictors of recovery following allogeneic CD34+-selected cell infusion without conditioning to correct poor graft function. Haematologica 2020; 105:2639-2646. [PMID: 33131253 PMCID: PMC7604618 DOI: 10.3324/haematol.2019.226340] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/20/2019] [Indexed: 11/09/2022] Open
Abstract
Poor graft function is a serious complication following allogeneic hematopoietic stem cell transplantation. Infusion of CD34+-selected stem cells without pre-conditioning has been used to correct poor graft function, but predictors of recovery are unclear. We report the outcome of 62 consecutive patients who had primary or secondary poor graft function who underwent a CD34+-selected stem cell infusion from the same donor without further conditioning. Forty-seven of 62 patients showed hematological improvement and became permanently transfusion and growth factor-independent. In multivariate analysis, parameters significantly associated with recovery were shared CMV seronegative status for recipient/donor, the absence of active infection and matched recipient/donor sex. Recovery was similar in patients with mixed and full donor chimerism. Five -year overall survival was 74.4% (95% CI 59-89) in patients demonstrating complete recovery, 16.7% (95% CI 3-46) in patients with partial recovery and 22.2% (CI 95% 5-47) in patients with no response. In patients with count recovery, those with poor graft function in 1-2 lineages had superior 5-year overall survival (93.8%, 95% CI 82-99) than those with tri-lineage failure (53%, 95% CI 34-88). New strategies including cytokine or agonist support, or second transplant need to be investigated in patients who do not recover.
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Affiliation(s)
| | - Richard M. Szydlo
- Anthony Nolan Research Institute
- Department of Haematology, Imperial College London
| | - Mike Watts
- Wolfson Cellular Therapy Unit, University College Hospital London NHS Trust
| | - Nishil Patel
- Department of Haematology, Royal Free London NHS Trust
| | - Hanna Renshaw
- Department of Haematology, Royal Free London NHS Trust
| | - Jude Dorman
- Department of Haematology, University College Hospital NHS Trust
| | - Mark Lowdell
- Centre for Cell, Gene & Tissue Therapeutics, Royal Free London NHS Trust
| | - Stuart Ings
- Wolfson Cellular Therapy Unit, University College Hospital London NHS Trust
| | | | | | | | | | - Ben Carpenter
- Department of Haematology, University College Hospital NHS Trust
| | - Rachael Hough
- Department of Haematology, University College Hospital NHS Trust
| | - Emma Morris
- Department of Haematology, University College Hospital NHS Trust
| | - Kirsty Thomson
- Department of Haematology, University College Hospital NHS Trust
| | - Karl S. Peggs
- Department of Haematology, University College Hospital NHS Trust
- Department of Hematology, Cancer Institute, University College London, London, UK
| | - Ronjon Chakraverty
- Department of Haematology, University College Hospital NHS Trust
- Department of Hematology, Cancer Institute, University College London, London, UK
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4
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Petersdorf EW, Gooley T, Volt F, Kenzey C, Madrigal A, McKallor C, Querol S, Rafii H, Rocha V, Tamouza R, Chabannon C, Ruggeri A, Gluckman E. Use of the HLA-B leader to optimize cord-blood transplantation. Haematologica 2020; 106:3107-3114. [PMID: 33121238 PMCID: PMC8634170 DOI: 10.3324/haematol.2020.264424] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Indexed: 11/09/2022] Open
Abstract
Cord blood transplantation (CBT) can cure life-threatening blood disorders. The HLA-B leader affects the success of unrelated donor transplantation but its role in CBT is unknown. We tested the hypothesis that the HLA-B leader influences CBT outcomes in unrelated single-unit cord blood transplants performed by Eurocord/European Blood and Marrow Transplant (EBMT) centers between 1990 and 2018 with data reported to Eurocord. Among 4,822 transplants, 2,178 had one HLA-B mismatch of which 1,013 were HLAA and HLA-A and -DRB1 matched. The leader (methionine [M] or threonine [T]) was determined for each HLA-B allele in patients and units to define the genotype. Among single HLA-B-mismatched transplants, the patient/unit mismatched alleles were defined as leader-matched if they encoded the same leader, or leader-mismatched if they encoded different leaders; the leader encoded by the matched (shared) allele was determined. The risks of graft-versus-host disease, relapse, non-relapse mortality and overall mortality were estimated for various leader-defined groups using multi-variable regression models. Among the 1,013 HLA-A and -DRB1-matched transplants with one HLA-B mismatch, increasing numbers of cord blood unit M-leader alleles was associated with increased risk of relapse (hazard ratio [HR] for each increase in one Mleader allele 1.30, 95% Confidence Interval [CI]: 1.05-1.60, P=0.02). Furthermore, leader mismatching together with an M-leader of the shared HLA-B allele lowered non-relapse mortality (HR 0.44, 95% CI: 0.23-0.81; P=0.009) relative to leader matching and a shared T-leader allele. The HLA-B leader may inform relapse and non-relapse mortality risk after CBT. Future patients might benefit from the appropriate selection of units that consider the leader.
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Affiliation(s)
- Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave North, Seattle, WA 98109, USA; Department of Medicine, University of Washington, Seattle, WA 98105.
| | - Ted Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave North, Seattle, WA 98109
| | - Fernanda Volt
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris
| | - Chantal Kenzey
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris
| | | | - Caroline McKallor
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave North, Seattle, WA 98109
| | - Sergio Querol
- Cell Therapy Services, Catalan Blood and Tissue Bank, Barcelona
| | - Hanadi Rafii
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris
| | - Vanderson Rocha
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris, France; Hospital das Clínicas and LIM31, Faculty of Medicine University of São Paulo
| | - Ryad Tamouza
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris, France; INSERM U955, CHU Henri Mondor, Créteil
| | - Christian Chabannon
- Institut Paoli-Calmettes, Inserm CBT1409, Marseille, France; Cellular Therapy and Immunobiology Working Party of the European Society for Blood and Marrow Transplantation, Leiden
| | - Annalisa Ruggeri
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris, France; Cellular Therapy and Immunobiology Working Party of the European Society for Blood and Marrow Transplantation, Leiden, The Netherlands; Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan
| | - Eliane Gluckman
- Eurocord, Hôpital Saint Louis APHP, Institut de Recherche de Saint-Louis (IRSL) EA3518, Université de Paris, Paris, France; Monacord, International Observatory on Sickle Cell Disease, Centre Scientifique de Monaco
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5
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Plantinga M, Lo Presti V, de Haar CG, Dünnebach E, Madrigal A, Lindemans CA, Boelens JJ, Nierkens S. Clinical Grade Production of Wilms' Tumor-1 Loaded Cord Blood-Derived Dendritic Cells to Prevent Relapse in Pediatric AML After Cord Blood Transplantation. Front Immunol 2020; 11:559152. [PMID: 33101274 PMCID: PMC7546401 DOI: 10.3389/fimmu.2020.559152] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/14/2020] [Indexed: 12/22/2022] Open
Abstract
Hematopoietic cell transplantation (HCT) is a last resort, potentially curative treatment option for pediatric patients with refractory acute myeloid leukemia (AML). Cord blood transplantation (CBT) results in less relapses and less graft-versus-host disease when compared to other sources. Nevertheless, still more than half of the children die from relapses. We therefore designed a strategy to prevent relapses by inducing anti-AML immunity after CBT, using a CB-derived dendritic cell (CBDC) vaccine generated from CD34+ CB cells from the same graft. We here describe the optimization and validation of good manufacturing practice (GMP)-grade production of the CBDC vaccine. We show the feasibility of expanding low amounts of CD34+ cells in a closed bag system to sufficient DCs per patient for at least three rounds of vaccinations. The CBDCs showed upregulated costimulatory molecules after maturation and showed enhanced CCR7-dependent migration toward CCL19 in a trans-well migrations assay. CBDCs expressed Wilms’ tumor 1 (WT1) protein after electroporation with WT1-mRNA, but were not as potent as CBDCs loaded with synthetic long peptides (peptivator). The WT1-peptivator loaded CBDCs were able to stimulate T-cells both in a mixed lymphocyte reaction as well as in an antigen-specific (autologous) setting. The autologous stimulated T-cells lysed not only the WT1+ cell line, but most importantly, also primary pediatric AML cells. Altogether, we provide a GMP-protocol of a highly mature CBDC vaccine, loaded with WT1 peptivator and able to stimulate autologous T-cells in an antigen-specific manner. Finally, these T-cells lysed primary pediatric AML demonstrating the competence of the CBDC vaccine strategy.
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Affiliation(s)
- Maud Plantinga
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Vania Lo Presti
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Colin G de Haar
- Pharmacy Department, Cell Therapy Facility, University Medical Center Utrecht, Utrecht, Netherlands
| | - Ester Dünnebach
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Caroline A Lindemans
- Princess Máxima Center for Pediatric Oncology, Blood and Marrow Transplantation Program, Utrecht, Netherlands
| | - Jaap Jan Boelens
- Stem Cell Transplant and Cellular Therapies, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Stefan Nierkens
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands.,Princess Máxima Center for Pediatric Oncology, Blood and Marrow Transplantation Program, Utrecht, Netherlands
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6
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Girdlestone J, Raymond M, Shaw B, Tulpule S, Devlia VR, Danby R, Ahyee T, Saudemont A, Hough R, Veys P, Ruggeri A, Vora A, Marks DI, Gibson B, Wynn R, Madrigal A, Navarrete CV. Immune reconstitution following umbilical cord blood transplantation: IRES, a study of UK paediatric patients. eJHaem 2020; 1:208-218. [PMID: 35847689 PMCID: PMC9176140 DOI: 10.1002/jha2.12] [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] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 11/09/2022]
Abstract
To obtain a qualitative as well as quantitative view immune reconstitution following umbilical cord blood (UCB) transplantation of paediatric patients, we utilised a broad panel of flow cytometry markers to monitor the phenotypes of lymphoid and myeloid cells at 1‐12 months post‐transplant. Samples were received from 46 patients with a median age of 3.3 years and survival was 76% at 1 year. Monocytes were at similar or higher median levels than in adult controls at all times tested, with a high CD16+ proportion in the first 3 months. NK cells were also within adult ranges, with a CD56++ high proportion in the first 6 months. B cell recovery was seen from 2 months in most patients and T cells from 3 months, both were delayed with anti‐thymocyte globulin (ATG) treatment. CD4:CD8 ratios were high in the first 6 months, and the proportion of T cells with recent thymic emigrant and naïve phenotypes rose from 3 months. NK and plasmacytoid dendritic cell numbers remained at reduced levels in patients not surviving to 1 year. Our results can serve as a useful reference for detailed monitoring of immune reconstitution in paediatric recipients of UCB.
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Affiliation(s)
| | | | - Bronwen Shaw
- Center for International Blood and Marrow Transplant ResearchMedical College of Wisconsin Milwaukee Wisconsin
| | - Sameer Tulpule
- Department of HaematologyKokilaben Dhirubhai Ambani Hospital Mumbai India
| | - Vikesh R. Devlia
- Department of ImmunotherapyAnthony Nolan Research Institute London UK
| | - Robert Danby
- Department of ImmunotherapyAnthony Nolan Research Institute London UK
| | - Trudy Ahyee
- Department of ImmunotherapyAnthony Nolan Research Institute London UK
| | - Aurore Saudemont
- Department of ImmunotherapyAnthony Nolan Research Institute London UK
| | - Rachael Hough
- Department of HaematologyUniversity College London Hospitals London UK
| | - Paul Veys
- Bone Marrow Transplant UnitGreat Ormond Street Hospital London UK
| | | | - Ajay Vora
- Bone Marrow Transplant UnitGreat Ormond Street Hospital London UK
| | - David I. Marks
- Bristol Haematology and Oncology CentreUniversity Hospitals Bristol Bristol UK
| | - Brenda Gibson
- Paediatric HaematologyRoyal Hospital for Sick Children Glasgow UK
| | - Robert Wynn
- Paediatric Bone Marrow Transplant ProgrammeRoyal Manchester Children's Hospital Manchester UK
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7
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Soto JR, Anthias C, Madrigal A, Snowden JA. Insights Into the Role of Vitamin D as a Biomarker in Stem Cell Transplantation. Front Immunol 2020; 11:966. [PMID: 32582151 PMCID: PMC7295104 DOI: 10.3389/fimmu.2020.00966] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 04/24/2020] [Indexed: 12/19/2022] Open
Abstract
Vitamin D was discovered 100 years ago and since then multiple studies have consistently proved its effect on bone health and mineral metabolism. Further research has also explored its so-called "non-classical" biological effects, encompassing immune regulation and control of cell proliferation and differentiation. Vitamin D downregulates pro-inflammatory immune cells and subsequently their cytokine production, while enhancing the anti-inflammatory subsets, thus mediating inflammation and fostering a more tolerogenic environment. Its biological action is exerted through the vitamin D receptor, a nuclear receptor that mediates gene transcription and is expressed in most cells from the innate and adaptive immunity. Owing to its immune-modulatory properties, its role in cancer pathophysiology, hematology disorders and stem cell transplantation has also been investigated. Vitamin D deficiency causes immune imbalance and cytokine dysregulation, contributing to some autoimmune diseases. In the hematopoietic stem cell transplant setting this could lead to complications such as acute and chronic graft-versus-host disease, ultimately impacting transplant outcomes. Other factors have also been linked to this, including specific polymorphisms of the vitamin D receptor in both stem cell donors and recipients. Nevertheless, studies thus far have shown conflicting results and the use of vitamin D or its receptor as biomarkers has not been validated yet, therefore there are no evidence-based consensus guidelines to guide clinicians in their day-to-day practice. To gain more insight in this topic, we have reviewed the existent literature and gathered the current evidence. This is an overview of the role of serum vitamin D and its receptor as biomarkers for clinical outcomes in patients undergoing hematopoietic stem cell transplantation. Further prospective studies with larger cohorts are warranted to validate the viability of using serum vitamin D, and its receptor, as biomarkers in potential stem cell donors and patients, to identify those at risk of post-transplant complications and enable early therapeutic interventions.
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Affiliation(s)
- Jose Ros Soto
- Anthony Nolan Research Institute, Royal Free Hospital and University College London, London, United Kingdom
| | - Chloe Anthias
- Anthony Nolan Research Institute, Royal Free Hospital and University College London, London, United Kingdom
- Department of Haemato-Oncology, The Royal Marsden Hospital, Sutton, United Kingdom
| | - Alejandro Madrigal
- Anthony Nolan Research Institute, Royal Free Hospital and University College London, London, United Kingdom
| | - John A. Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
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8
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Samarkanova D, Cox S, Hernandez D, Rodriguez L, Casaroli-Marano RP, Madrigal A, Querol S. Cord Blood Platelet Rich Plasma Derivatives for Clinical Applications in Non-transfusion Medicine. Front Immunol 2020; 11:942. [PMID: 32536916 PMCID: PMC7266986 DOI: 10.3389/fimmu.2020.00942] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 04/22/2020] [Indexed: 01/16/2023] Open
Abstract
Cord blood platelet rich plasma (CB-PRP) derivatives have been investigated as potential therapeutic agents for the treatment of diverse conditions including ocular surface disease and skin ulcers. We have developed processes for the formulation of several CB-PRP preparations, which have different composition and attributes. Here we describe the molecular characteristics of these preparations and we make recommendations as to their most appropriate clinical application based on functional and immunomodulatory profiles. We show that incubation of adult peripheral blood mononuclear cells (PBMCs) with all three preparations dramatically reduced the production of INFγ and the expression of NKG2D and CD107a in NK, NKT, and T cells thus diminishing their activation, we propose that the likely mechanism is the high levels of soluble NKG2D ligands present in plasma. Of the three preparations we investigated, CB platelet lysate (PL) and platelet releaseate (PR) have higher concentrations of trophic and pro-angiogenic factors, CB platelet poor plasma (PPP) has the lowest concentration of all analytes measured. Based on these finding we propose that CB-PR is the most suitable raw material for skin wound patches, while CB-PL and PPP can be used to prepare eye drops for severe ocular surface pathologies and inflammatory conditions such as corneal ulcers or severe dry eye disease, respectively.
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Affiliation(s)
- Dinara Samarkanova
- Banc de Sang i Teixits, Barcelona, Spain.,Transfusional Medicine Research Group, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Department of Medicine, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - Steven Cox
- Anthony Nolan Research Institute, Royal Free Hospital, London, United Kingdom.,UCL Cancer Institute, Royal Free Hospital, London, United Kingdom
| | - Diana Hernandez
- Anthony Nolan Research Institute, Royal Free Hospital, London, United Kingdom.,UCL Cancer Institute, Royal Free Hospital, London, United Kingdom
| | | | - Ricardo P Casaroli-Marano
- Banc de Sang i Teixits, Barcelona, Spain.,Department of Surgery, School of Medicine & Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Alejandro Madrigal
- Banc de Sang i Teixits, Barcelona, Spain.,Anthony Nolan Research Institute, Royal Free Hospital, London, United Kingdom.,UCL Cancer Institute, Royal Free Hospital, London, United Kingdom
| | - Sergio Querol
- Banc de Sang i Teixits, Barcelona, Spain.,Transfusional Medicine Research Group, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
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9
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Kilbride P, Meneghel J, Lamb S, Morris J, Pouzet J, Leonfort C, Jurgielewicz M, Gibson D, Madrigal A. Recovery And Post-Thaw Assessment Of Human Umbilical Cord Blood Cryopreserved In Quality Control Segments And Bulk Sample. Cryobiology 2019. [DOI: 10.1016/j.cryobiol.2019.10.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Kilbride P, Meneghel J, Lamb S, Morris J, Pouzet J, Jurgielewicz M, Leonforte C, Gibson D, Madrigal A. Recovery and Post-Thaw Assessment of Human Umbilical Cord Blood Cryopreserved as Quality Control Segments and Bulk Samples. Biol Blood Marrow Transplant 2019; 25:2447-2453. [PMID: 31499214 DOI: 10.1016/j.bbmt.2019.09.004] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/30/2019] [Accepted: 09/02/2019] [Indexed: 10/26/2022]
Abstract
Quality control (QC) segments conjoined to a bulk sample container are used to evaluate the viability and quality of cryopreserved umbilical cord blood (UCB). Such QC segments are typically attached lengths of sealed tubing that are cooled concurrently with the bulk sample, both containing material from the same donor. QC segments are thawed independently of the bulk sample to assess the quality of the cryopreserved product. In current practice, there is typically post-thaw variation between the QC segment and the bulk sample which if suggestive of inadequate performance, could lead to material being needlessly discarded. In this study, these performance differences were quantified. Two cooling protocols in common use, 1 with and 1 without a "plunge" step to induce ice nucleation, gave equivalent results that maintained the QC segment versus bulk sample differences. Ice nucleated at significantly lower temperatures in the QC segments compared with the bulk samples, a consequence of their lower volume, thereby enhancing damaging osmotic stress. A reduction in total viable cells of approximately 10% was recorded in the QC segments compared with comparable bulk samples. It has been shown that CD45+ cells are more adversely impacted by this lower ice nucleation temperature than CD34+ cells, which can result in altered composition of the post-thaw cell population.
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Affiliation(s)
- Peter Kilbride
- Asymptote, General Electric Healthcare, Cambridge, United Kingdom.
| | - Julie Meneghel
- Asymptote, General Electric Healthcare, Cambridge, United Kingdom
| | - Stephen Lamb
- Asymptote, General Electric Healthcare, Cambridge, United Kingdom
| | - John Morris
- Asymptote, General Electric Healthcare, Cambridge, United Kingdom
| | - Jerome Pouzet
- General Electric Healthcare, Biosafe SA, Eysins, Switzerland
| | - Monika Jurgielewicz
- Anthony Nolan Cell Therapy Centre, Nottingham Trent University, Nottingham, United Kingdom
| | - Christopher Leonforte
- Anthony Nolan Cell Therapy Centre, Nottingham Trent University, Nottingham, United Kingdom
| | - Daniel Gibson
- Anthony Nolan Cell Therapy Centre, Nottingham Trent University, Nottingham, United Kingdom
| | - Alejandro Madrigal
- Anthony Nolan Cell Therapy Centre, Nottingham Trent University, Nottingham, United Kingdom
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11
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Hernández-Blanco D, Madrigal A. Cell therapies: a new era in the battle against cancer. GAC MED MEX 2019. [DOI: 10.24875/gmm.m18000200] [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: 11/17/2022] Open
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12
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Miller PDE, de Silva TI, Leonard H, Anthias C, Hoschler K, Goddard K, Peggs K, Madrigal A, Snowden JA. A comparison of viral microneutralization and haemagglutination inhibition assays as measures of seasonal inactivated influenza vaccine immunogenicity in the first year after reduced intensity conditioning, lymphocyte depleted allogeneic haematopoietic stem cell transplant. Vaccine 2019; 37:452-457. [PMID: 30554797 DOI: 10.1016/j.vaccine.2018.11.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 11/17/2018] [Accepted: 11/21/2018] [Indexed: 01/04/2023]
Abstract
Traditionally, immune response to influenza vaccines has been measured using the haemagglutination inhibition (HAI) assay. A broader repertoire of techniques including the sensitive viral microneutralization (VMN) assay is now recommended by the European Medicines Agency (EMA). Comparing HAI and VMN, we determined immune response to a trivalent 2015-2016 seasonal inactivated influenza vaccine (SIIV) administered to 28 recipients of allogeneic haematopoietic stem cell transplant (HSCT). Vaccination was within the first-year post-transplant at a median of 78.5 (24-363) days. The proportion of patients with baseline and post-vaccination HAI titres ≥ 1:40 were 28.6% and 25% for A(H1N1)pdm09, 14.3% at both timepoints for A(H3N2), and 32.1% and 25% for B(Phuket). Pre and Post-vaccination geometric mean titres(GMT) were higher by VMN than HAI for A(H1N1)pdm09 and A(H3N2), but lower for B(Phuket)(p=<0.05). Geometric mean ratios(GMR) of baseline and post-vaccination titres were similar by HAI and VMN(p > 0.05) for all components. A single seroconversion to A(H1N1) was detected by ELISA-VMN. None of patient age, lymphocyte count, days from transplant to vaccination, donor type, or graft-versus-host disease (GVHD) or immunosuppressive therapy (IST) at vaccination correlated with baseline or post-vaccination titres by either assay. This absence of seroresponse to SIIV in the first-year post HSCT highlights the need for novel immunogenic vaccination formulations and schedules in this high-risk population.
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Affiliation(s)
- Paul D E Miller
- Anthony Nolan Research Institute, Royal Free Hospital, Pond Street, London NW3 2QU, United Kingdom.
| | - Thushan I de Silva
- Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Hayley Leonard
- Anthony Nolan Research Institute, Royal Free Hospital, Pond Street, London NW3 2QU, United Kingdom
| | - Chloe Anthias
- Anthony Nolan Research Institute, Royal Free Hospital, Pond Street, London NW3 2QU, United Kingdom; Department of Haemato-Oncology, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Katja Hoschler
- Respiratory Virus Reference Department, Public Health England, London, United Kingdom
| | - Kathryn Goddard
- Department of Haematology, Rothertham NHS Foundation Trust, Rotherham, United Kingdom
| | - Karl Peggs
- Department of Clinical Haematology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Alejandro Madrigal
- Anthony Nolan Research Institute, Royal Free Hospital, Pond Street, London NW3 2QU, United Kingdom
| | - John A Snowden
- Department of Clinical Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
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Hernández D, Madrigal A. [Terapias celulares: una nueva era en la batalla contra el cáncer]. GAC MED MEX 2018; 154:547-549. [PMID: 30407446 DOI: 10.24875/gmm.18004687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Diana Hernández
- Anthony Nolan. University College London, The Royal Free Hospital, Londres, Reino Unido
| | - Alejandro Madrigal
- Anthony Nolan. University College London, The Royal Free Hospital, Londres, Reino Unido
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Miller PDE, Forster AS, de Silva TI, Leonard H, Anthias C, Mayhew M, Klammer M, Paskar S, Hurst E, Peggs K, Madrigal A, Snowden JA. Sociodemographic and psychological determinants of influenza vaccine intention among recipients of autologous and allogeneic haematopoietic stem cell transplant: a cross-sectional survey of UK transplant recipients using a modified health belief model. BMJ Open 2018; 8:e021222. [PMID: 30093515 PMCID: PMC6089289 DOI: 10.1136/bmjopen-2017-021222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 04/29/2018] [Accepted: 05/30/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Studies exploring vaccination rates among haematopoietic stem cell transplant (HSCT) recipients have focused on physician factors that limit uptake. Understanding the patient factors that determine vaccination intention is crucial to delivering a successful vaccination programme. Using a modified health belief model (mHBM), we conducted a cross-sectional survey with the objective of exploring the sociodemographic and psychological factors that determined autologous and allogeneic HSCT recipients' intention to receive the seasonal inactivated influenza vaccine (SIIV) during the 2015-2016 influenza season. SETTING The setting of our study was three tertiary level, UK National Health Service (NHS) autologous and allogeneic HSCT centres. PARTICIPANTS Eligible patients were aged 16 years or over and recipients of autologous or allogeneic HSCT for any disease indication, with no absolute contraindication to receiving the SIIV during the next influenza season, and having not received the SIIV since transplant. 93 participants from 3 UK NHS HSCT centres completed an anonymous study-specific questionnaire. 78.5% were recipients of allogeneic and 21.5% autologous HSCT. RESULTS 23.7% of participants expressed low intent to receive the SIIV. Patients aged over 65 (OR 0.02, 95% CI 0.01 to 0.57, p=0.02) and those who had not received the SIIV prior to HSCT (OR 0.04, 95% CI 0.02 to 0.56, p=0.02) were less likely to have high intent. A multivariate logistic regression model incorporating constructs of the mHBM was statistically significant (p<0.001) and explained 74.7% of variation in SIIV intention. More patients felt that a recommendation from their HSCT team than their general practitioner would prompt them to receive the SIIV, and this was most pronounced in those who had low intent. CONCLUSIONS The mHBM may provide a useful structure for addressing low vaccine intent among HSCT recipients and further interventional studies are warranted. We would encourage HSCT and general practitioners to discuss SIIV intention as a routine part of care.
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Affiliation(s)
- Paul D E Miller
- Anthony Nolan Research Institute, Anthony Nolan Trust, London, UK
| | - Alice S Forster
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Thushan I de Silva
- Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Hayley Leonard
- Anthony Nolan Research Institute, Anthony Nolan Trust, London, UK
| | - Chloe Anthias
- Anthony Nolan Research Institute, Anthony Nolan Trust, London, UK
- Department of Haemato-Oncology, Royal Marsden NHS Foundation Trust, London, UK
| | - Michaela Mayhew
- Department of Haematology, St George's NHS Foundation Trust, London, UK
| | - Matthias Klammer
- Department of Haematology, St George's NHS Foundation Trust, London, UK
| | - Susan Paskar
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, UK
| | - Erin Hurst
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, UK
| | - Karl Peggs
- Department of Clinical Haematology, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - John A Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, London, UK
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15
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Madrigal A. Breves consideraciones sobre control de plagas, con especial referencia a los métodos biológicos. Actual Biol 2018. [DOI: 10.17533/udea.acbi.330550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Los insectos constituyen un grupo de gran importancia dentro del reino animal, no sólo por su número, cerca del 80% de la población animal del mundo, representado en más de un millón de especies, sino también por sus múltiples actividades y las diferentes relaciones que tienen con el hombre, ya sea de carácter benéfico o dañino, y por su valioso papel como componentes de la cadena trófica.
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Miller PDE, de Silva TI, Skinner R, Gilleece M, Peniket A, Hamblin A, Greenfield D, Anthias C, Peggs K, Madrigal A, Snowden JA. Routine vaccination practice after adult and paediatric allogeneic haematopoietic stem cell transplant: a survey of UK NHS programmes. Bone Marrow Transplant 2017; 52:775-777. [DOI: 10.1038/bmt.2016.362] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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17
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Pedroza-Pacheco I, Shah D, Domogala A, Luevano M, Blundell M, Jackson N, Thrasher A, Madrigal A, Saudemont A. Regulatory T cells inhibit CD34+ cell differentiation into NK cells by blocking their proliferation. Sci Rep 2016; 6:22097. [PMID: 26915707 PMCID: PMC4768165 DOI: 10.1038/srep22097] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 10/16/2015] [Accepted: 02/08/2016] [Indexed: 02/05/2023] Open
Abstract
Graft versus Host Disease (GvHD) remains one of the main complications after hematopoietic stem cell transplantation (HSCT). Due to their ability to suppress effector cells, regulatory T cells (Tregs) have been proposed as a cellular therapy to prevent GvHD, however they also inhibit the functions of natural killer (NK) cells, key effectors of the Graft versus Leukemia effect. In this study, we have explored whether a Tregs therapy will also impact on NK cell differentiation. Using an in vitro model of hematopoietic stem cell (HSC) differentiation into NK cells, we found that activated Tregs led to a 90% reduction in NK cell numbers when added at the time of commitment to the NK cell lineage. This effect was contact dependent and was reversible upon Tregs depletion. The few NK cells that developed in these cultures were mature and exhibited normal functions. Furthermore, adoptive transfer of activated Tregs in rag(-/-) γc(-/-) mice abrogated HSC differentiation into NK cells thus confirming our in vitro findings. Collectively, these results demonstrate for the first time that activated Tregs can inhibit NK cell differentiation from HSC under specific conditions.
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Affiliation(s)
- Isabela Pedroza-Pacheco
- Anthony Nolan Research Institute and University College London, Royal Free Campus, Pond Street, London NW3 2QG, UK
| | - Divya Shah
- Anthony Nolan Research Institute and University College London, Royal Free Campus, Pond Street, London NW3 2QG, UK
| | - Anna Domogala
- Anthony Nolan Research Institute and University College London, Royal Free Campus, Pond Street, London NW3 2QG, UK
| | - Martha Luevano
- Anthony Nolan Research Institute and University College London, Royal Free Campus, Pond Street, London NW3 2QG, UK
| | - Michael Blundell
- Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Nicola Jackson
- Anthony Nolan Research Institute and University College London, Royal Free Campus, Pond Street, London NW3 2QG, UK
| | - Adrian Thrasher
- Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Alejandro Madrigal
- Anthony Nolan Research Institute and University College London, Royal Free Campus, Pond Street, London NW3 2QG, UK
| | - Aurore Saudemont
- Anthony Nolan Research Institute and University College London, Royal Free Campus, Pond Street, London NW3 2QG, UK
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18
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Escobedo-Cousin M, Jackson N, Laza-Briviesca R, Ariza-McNaughton L, Luevano M, Derniame S, Querol S, Blundell M, Thrasher A, Soria B, Cooper N, Bonnet D, Madrigal A, Saudemont A. Natural Killer Cells Improve Hematopoietic Stem Cell Engraftment by Increasing Stem Cell Clonogenicity In Vitro and in a Humanized Mouse Model. PLoS One 2015; 10:e0138623. [PMID: 26465138 PMCID: PMC4605799 DOI: 10.1371/journal.pone.0138623] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 08/31/2015] [Indexed: 11/30/2022] Open
Abstract
Cord blood (CB) is increasingly used as a source of hematopoietic stem cells (HSC) for transplantation. Low incidence and severity of graft-versus-host disease (GvHD) and a robust graft-versus-leukemia (GvL) effect are observed following CB transplantation (CBT). However, its main disadvantages are a limited number of HSC per unit, delayed immune reconstitution and a higher incidence of infection. Unmanipulated grafts contain accessory cells that may facilitate HSC engraftment. Therefore, the effects of accessory cells, particularly natural killer (NK) cells, on human CB HSC (CBSC) functions were assessed in vitro and in vivo. CBSC cultured with autologous CB NK cells showed higher levels of CXCR4 expression, a higher migration index and a higher number of colony forming units (CFU) after short-term and long-term cultures. We found that CBSC secreted CXCL9 following interaction with CB NK cells. In addition, recombinant CXCL9 increased CBSC clonogenicity, recapitulating the effect observed of CB NK cells on CBSC. Moreover, the co-infusion of CBSC with CB NK cells led to a higher level of CBSC engraftment in NSG mouse model. The results presented in this work offer the basis for an alternative approach to enhance HSC engraftment that could improve the outcome of CBT.
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Affiliation(s)
- Michelle Escobedo-Cousin
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, Royal Free Campus, London, United Kingdom
| | - Nicola Jackson
- Anthony Nolan Research Institute, Royal Free Campus, London, United Kingdom
| | | | | | - Martha Luevano
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, Royal Free Campus, London, United Kingdom
| | - Sophie Derniame
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, Royal Free Campus, London, United Kingdom
| | - Sergio Querol
- Programa Concordia Banc de Sang i Teixits, Barcelona, Spain
| | - Michael Blundell
- University College London, Institute of Child Health, London, United Kingdom
| | - Adrian Thrasher
- University College London, Institute of Child Health, London, United Kingdom
| | - Bernat Soria
- Andalusian Center for Molecular Biology and Regenerative Medicine (CABIMER), Fundación Progreso y Salud, Seville, Spain
- Biomedical Research Network on Diabetes and Related Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Nichola Cooper
- Haematology Department, Hammersmith Hospital, London, United Kingdom
| | - Dominique Bonnet
- Cancer Research UK, London Research Institute, London, United Kingdom
| | - Alejandro Madrigal
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, Royal Free Campus, London, United Kingdom
| | - Aurore Saudemont
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, Royal Free Campus, London, United Kingdom
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19
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Chappell P, Meziane EK, Harrison M, Magiera Ł, Hermann C, Mears L, Wrobel AG, Durant C, Nielsen LL, Buus S, Ternette N, Mwangi W, Butter C, Nair V, Ahyee T, Duggleby R, Madrigal A, Roversi P, Lea SM, Kaufman J. Expression levels of MHC class I molecules are inversely correlated with promiscuity of peptide binding. eLife 2015; 4:e05345. [PMID: 25860507 PMCID: PMC4420994 DOI: 10.7554/elife.05345] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [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: 10/26/2014] [Accepted: 04/10/2015] [Indexed: 11/13/2022] Open
Abstract
Highly polymorphic major histocompatibility complex (MHC) molecules are at the heart of adaptive immune responses, playing crucial roles in many kinds of disease and in vaccination. We report that breadth of peptide presentation and level of cell surface expression of class I molecules are inversely correlated in both chickens and humans. This relationship correlates with protective responses against infectious pathogens including Marek's disease virus leading to lethal tumours in chickens and human immunodeficiency virus infection progressing to AIDS in humans. We propose that differences in peptide binding repertoire define two groups of MHC class I molecules strategically evolved as generalists and specialists for different modes of pathogen resistance. We suggest that differences in cell surface expression level ensure the development of optimal peripheral T cell responses. The inverse relationship of peptide repertoire and expression is evidently a fundamental property of MHC molecules, with ramifications extending beyond immunology and medicine to evolutionary biology and conservation.
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Affiliation(s)
- Paul Chappell
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - El Kahina Meziane
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Michael Harrison
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Łukasz Magiera
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Clemens Hermann
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Laura Mears
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Antony G Wrobel
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Charlotte Durant
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Lise Lotte Nielsen
- Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Buus
- Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nicola Ternette
- Target Discovery Institute, University of Oxford, Oxford, United Kingdom
| | | | | | | | - Trudy Ahyee
- Anthony Nolan Research Institute, The Royal Free Hospital, London, United Kingdom
| | - Richard Duggleby
- Anthony Nolan Research Institute, The Royal Free Hospital, London, United Kingdom
| | - Alejandro Madrigal
- Anthony Nolan Research Institute, The Royal Free Hospital, London, United Kingdom
| | - Pietro Roversi
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - Susan M Lea
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - Jim Kaufman
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
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20
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Sureda A, Bader P, Cesaro S, Dreger P, Duarte RF, Dufour C, Falkenburg JHF, Farge-Bancel D, Gennery A, Kröger N, Lanza F, Marsh JC, Nagler A, Peters C, Velardi A, Mohty M, Madrigal A. Indications for allo- and auto-SCT for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2015. Bone Marrow Transplant 2015; 50:1037-56. [PMID: 25798672 DOI: 10.1038/bmt.2015.6] [Citation(s) in RCA: 216] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 01/09/2015] [Indexed: 12/17/2022]
Abstract
This is the sixth special report that the European Society for Blood and Marrow Transplantation regularly publishes on the current practice and indications for haematopoietic SCT for haematological diseases, solid tumours and immune disorders in Europe. Major changes have occurred in the field of haematopoietic SCT over the last years. Cord blood units as well as haploidentical donors have been increasingly used as stem cell sources for allo-SCT, thus, augmenting the possibility of finding a suitable donor for a patient. Continuous refinement of conditioning strategies has also expanded not only the number of potential indications but also has permitted consideration of older patients or those with co-morbidity for a transplant. There is accumulating evidence of the role of haematopoietic SCT in non-haematological disorders such as autoimmune diseases. On the other hand, the advent of new drugs and very effective targeted therapy has challenged the role of SCT in some instances or at least, modified its position in the treatment armamentarium of a given patient. An updated report with revised tables and operating definitions is presented.
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Affiliation(s)
- A Sureda
- Department of Haematology, Institut Catala d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain
| | - P Bader
- Universitätsklinikum Frankfurt, Goethe-Universität, Klinik für Kinder- und Jugendmedizin, Frankfurt, Germany
| | - S Cesaro
- Paediatric Haematology Oncology, Policlinico G.B. Rossi, Verona, Italy
| | - P Dreger
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - R F Duarte
- Department of Haematology, Institut Catala d'Oncologia, Hospital Duran I Reynals, Barcelona, Spain
| | - C Dufour
- Clinical And Experimental Hematology Unit. Institute G. Gaslini, Genoa, Italy
| | - J H F Falkenburg
- Department of Haematology, Leiden University Medical Center, Leiden, The Netherlands
| | - D Farge-Bancel
- Department of Haematology-BMT, Hopital St Louis, Paris, France
| | - A Gennery
- Children's BMT Unit, Great North Children's Hospital, Newcastle-Upon-Tyne, UK
| | - N Kröger
- Department of Stem Cell Transplantation, University hospital Eppendorf, Hamburg, Germany
| | - F Lanza
- Haematology and BMT Unit, Cremona, Italy
| | - J C Marsh
- Department of Haematological Medicine, King's College Hospital/King's College London, London, UK
| | - A Nagler
- Chaim Sheva Medical Center, Tel-Hashomer, Israel
| | - C Peters
- Stem Cell Transplantation Unit, St Anna Kinderspital, Vienna, Austria
| | - A Velardi
- Sezione di Ematologia, Dipartimento di Medicina Clinica e Sperimentale, Università di Perugia, Perugia, Italy
| | - M Mohty
- Department of Haematology, H. Saint Antoine, Paris, France
| | - A Madrigal
- Anthony Nolan Research Institute, Royal Free and University College, London, UK
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21
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Petersdorf EW, Gooley TA, Malkki M, Bacigalupo AP, Cesbron A, Du Toit E, Ehninger G, Egeland T, Fischer GF, Gervais T, Haagenson MD, Horowitz MM, Hsu K, Jindra P, Madrigal A, Oudshoorn M, Ringdén O, Schroeder ML, Spellman SR, Tiercy JM, Velardi A, Witt CS, O'Huigin C, Apps R, Carrington M. HLA-C expression levels define permissible mismatches in hematopoietic cell transplantation. Blood 2014; 124:3996-4003. [PMID: 25323824 PMCID: PMC4271183 DOI: 10.1182/blood-2014-09-599969] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [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: 09/08/2014] [Accepted: 10/03/2014] [Indexed: 11/20/2022] Open
Abstract
Life-threatening graft-versus-host disease (GVHD) limits the use of HLA-C-mismatched unrelated donors in transplantation. Clinicians lack criteria for donor selection when HLA-C-mismatched donors are a patient's only option for cure. We examined the role for HLA-C expression levels to identify permissible HLA-C mismatches. The median fluorescence intensity, a proxy of HLA-C expression, was assigned to each HLA-C allotype in 1975 patients and their HLA-C-mismatched unrelated transplant donors. The association of outcome with the level of expression of patients' and donors' HLA-C allotypes was evaluated in multivariable models. Increasing expression level of the patient's mismatched HLA-C allotype was associated with increased risks of grades III to IV acute GVHD, nonrelapse mortality, and mortality. Increasing expression level among HLA-C mismatches with residue 116 or residue 77/80 mismatching was associated with increased nonrelapse mortality. The immunogenicity of HLA-C mismatches in unrelated donor transplantation is influenced by the expression level of the patient's mismatched HLA-C allotype. HLA-C expression levels provide new information on mismatches that should be avoided and extend understanding of HLA-C-mediated immune responses in human disease.
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Affiliation(s)
- Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Theodore A Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Mari Malkki
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Andrea P Bacigalupo
- Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Anne Cesbron
- Laboratoire d'Histocompatibilité et d'Immunogénétique, Etablissement Français du Sang Pays de Loire, Nantes, France
| | - Ernette Du Toit
- University of Cape Town, Cape Town and South African Bone Marrow Registry, Cape Town, South Africa
| | | | - Torstein Egeland
- Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Gottfried F Fischer
- Department for Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Thibaut Gervais
- Cliniques St. Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Michael D Haagenson
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Mary M Horowitz
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI
| | - Katharine Hsu
- Memorial Sloan-Kettering Cancer Center, New York, NY
| | | | - Alejandro Madrigal
- Anthony Nolan Research Institute, The Royal Free Hampstead NHS Trust, London, United Kingdom
| | - Machteld Oudshoorn
- Leiden University Medical Center and Europdonor Foundation, Leiden, The Netherlands
| | - Olle Ringdén
- Division of Therapeutic Immunology, Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Huddinge, Sweden
| | | | - Stephen R Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Jean-Marie Tiercy
- National Reference Laboratory for Histocompatibility, Department of Genetics and Laboratory Medicine, University Hospital Geneva, Geneva, Switzerland
| | - Andrea Velardi
- European Group for Blood and Marrow Transplantation and University of Perugia, Perugia, Italy
| | - Campbell S Witt
- Department of Clinical Immunology, Royal Perth Hospital, Perth, Australia
| | - Colm O'Huigin
- Cancer and Inflammation Program, SAIC Frederick, Inc., Frederick National Laboratories for Cancer Research, Frederick, MD; and
| | - Richard Apps
- Cancer and Inflammation Program, SAIC Frederick, Inc., Frederick National Laboratories for Cancer Research, Frederick, MD; and Ragon Institute of the Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Boston, MA
| | - Mary Carrington
- Cancer and Inflammation Program, SAIC Frederick, Inc., Frederick National Laboratories for Cancer Research, Frederick, MD; and Ragon Institute of the Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Boston, MA
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22
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Anthias C, Ethell ME, Potter MN, Madrigal A, Shaw BE. The impact of improved JACIE standards on the care of related BM and PBSC donors. Bone Marrow Transplant 2014; 50:244-7. [DOI: 10.1038/bmt.2014.260] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 09/27/2014] [Accepted: 09/30/2014] [Indexed: 11/09/2022]
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Alnabhan R, Madrigal A, Saudemont A. Differential activation of cord blood and peripheral blood natural killer cells by cytokines. Cytotherapy 2014; 17:73-85. [PMID: 25248279 DOI: 10.1016/j.jcyt.2014.08.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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: 04/24/2014] [Revised: 08/13/2014] [Accepted: 08/17/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND AIMS Natural killer (NK) cells play important roles in the clearance of infection and transformed cells. Cord blood (CB) is currently used as a source of hematopoietic stem cells for transplantation and is a potential source of NK cells for immunotherapy. We previously showed that CB NK cells are immature and less cytotoxic as compared with peripheral blood (PB) NK cells. We aimed to identify which cytokines, among interleukin (IL)-2, IL-12, IL-15 and IL-18 and their combinations, could fully activate CB NK cells as compared with PB NK cells. METHODS We performed a comprehensive analysis of phenotype and functionality of cytokine-activated NK cells. RESULTS Our results show that the lower responsiveness of CB NK cells to IL-2 is associated with lower levels of expression of IL-2 receptors and decreased phosphorylation of STAT5 as compared with PB NK cells. Activation of CB NK cells with IL-15+18 led to the most robust proliferative response and higher interferon-γ and tumor necrosis factor-α secretion, whereas activation with IL-15+2 promoted enhanced cytotoxicity. PB NK cells responded significantly better to IL-2 than to CB NK cells but were also fully activated with other cytokine treatments including IL-15, IL-15+2 or IL-15+18. It was also possible to use cytokines to generate memory-like NK cells, with sustained ability to produce interferon-γ, from both CB and PB. CONCLUSIONS CB NK cells are fully functional on activation with IL-15+2 or IL-15+18 rather than IL-2 alone as observed for PB NK cells. These cytokines should be considered in the future to activate CB NK cells for therapeutic purposes.
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Affiliation(s)
- Rehab Alnabhan
- University College London, Cancer Institute, Royal Free Campus, London, United Kingdom; Anthony Nolan Research Institute, Royal Free Campus, London, United Kingdom
| | - Alejandro Madrigal
- University College London, Cancer Institute, Royal Free Campus, London, United Kingdom; Anthony Nolan Research Institute, Royal Free Campus, London, United Kingdom
| | - Aurore Saudemont
- University College London, Cancer Institute, Royal Free Campus, London, United Kingdom; Anthony Nolan Research Institute, Royal Free Campus, London, United Kingdom.
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Lee F, Luevano M, Veys P, Yong K, Madrigal A, Shaw BE, Saudemont A. The effects of CAMPATH-1H on cell viability do not correlate to the CD52 density on the cell surface. PLoS One 2014; 9:e103254. [PMID: 25050704 PMCID: PMC4106894 DOI: 10.1371/journal.pone.0103254] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 06/30/2014] [Indexed: 11/23/2022] Open
Abstract
Graft versus host disease (GvHD) is one of the main complications after hematological stem cell transplantation (HSCT). CAMPATH-1H is used in the pre-transplant conditioning regimen to effectively reduce GvHD by targeting CD52 antigens on T cells resulting in their depletion. Information regarding CD52 expression and the effects of CAMPATH-1H on immune cells is scant and limited to peripheral blood (PB) T and B cells. To date, the effects of CAMPATH-1H on cord blood (CB) cells has not been studied. Here we aimed to analyze CD52 expression and the effects of CAMPATH-1H on fresh or frozen, resting or activated, PB mononuclear cells (PBMC) and CB mononuclear cells (CBMC). In resting state, CD52 expression was higher in CB than PB T cell subsets (653.66±26.68 vs 453.32±19.2) and B cells (622.2±20.65 vs 612.0±9.101) except for natural killer (NK) cells where CD52 levels were higher in PB (421.0±9.857) than CB (334.3±9.559). In contrast, CD52 levels were comparable across all cell types after activation. CAMPATH-1H depleted resting cells more effectively than activated cells with approximately 80–95% of apoptosis observed with low levels of necrosis. There was no direct correlation between cell surface CD52 density and depleting effects of CAMPATH-1H. In addition, no difference in cell viability was noted when different concentrations of CAMPATH-1H were used. CD52 was not expressed on HSC but began to be expressed as the cells differentiate, implying that CAMPATH-1H could potentially affect HSC differentiation and proliferation. Our study provides insightful information, which contributes to the better understanding in the use of CAMPATH-1H as part of the conditioning regime in HSCT.
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MESH Headings
- Alemtuzumab
- Antibodies, Monoclonal, Humanized/pharmacology
- Antigens, CD/analysis
- Antigens, CD/immunology
- Antigens, Neoplasm/analysis
- Antigens, Neoplasm/immunology
- Antineoplastic Agents/pharmacology
- B-Lymphocytes/drug effects
- B-Lymphocytes/immunology
- CD52 Antigen
- Cell Separation
- Cell Survival/drug effects
- Glycoproteins/analysis
- Glycoproteins/immunology
- Humans
- Killer Cells, Natural/drug effects
- Killer Cells, Natural/immunology
- Leukocytes, Mononuclear/drug effects
- Leukocytes, Mononuclear/immunology
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Affiliation(s)
- Fuiyee Lee
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
| | - Martha Luevano
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
| | - Paul Veys
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
- Great Ormond Street Hospital for Children NHS, London, United Kingdom
| | - Kwee Yong
- University College London, Cancer Institute, London, United Kingdom
| | - Alejandro Madrigal
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
| | - Bronwen E. Shaw
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
- Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Aurore Saudemont
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
- * E-mail:
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25
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Aljurf M, Rizzo JD, Mohty M, Hussain F, Madrigal A, Pasquini MC, Passweg J, Chaudhri N, Ghavamzadeh A, Solh HE, Atsuta Y, Szer J, Kodera Y, Niederweiser D, Gratwohl A, Horowitz MM. Challenges and opportunities for HSCT outcome registries: perspective from international HSCT registries experts. Bone Marrow Transplant 2014; 49:1016-21. [DOI: 10.1038/bmt.2014.78] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 03/05/2014] [Accepted: 03/07/2014] [Indexed: 11/09/2022]
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26
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Luevano M, Domogala A, Blundell M, Jackson N, Pedroza-Pacheco I, Derniame S, Escobedo-Cousin M, Querol S, Thrasher A, Madrigal A, Saudemont A. Frozen cord blood hematopoietic stem cells differentiate into higher numbers of functional natural killer cells in vitro than mobilized hematopoietic stem cells or freshly isolated cord blood hematopoietic stem cells. PLoS One 2014; 9:e87086. [PMID: 24489840 PMCID: PMC3906137 DOI: 10.1371/journal.pone.0087086] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 12/19/2013] [Indexed: 01/24/2023] Open
Abstract
Adoptive natural killer (NK) cell therapy relies on the acquisition of large numbers of NK cells that are cytotoxic but not exhausted. NK cell differentiation from hematopoietic stem cells (HSC) has become an alluring option for NK cell therapy, with umbilical cord blood (UCB) and mobilized peripheral blood (PBCD34+) being the most accessible HSC sources as collection procedures are less invasive. In this study we compared the capacity of frozen or freshly isolated UCB hematopoietic stem cells (CBCD34+) and frozen PBCD34+ to generate NK cells in vitro. By modifying a previously published protocol, we showed that frozen CBCD34+ cultures generated higher NK cell numbers without loss of function compared to fresh CBCD34+ cultures. NK cells generated from CBCD34+ and PBCD34+ expressed low levels of killer-cell immunoglobulin-like receptors but high levels of activating receptors and of the myeloid marker CD33. However, blocking studies showed that CD33 expression did not impact on the functions of the generated cells. CBCD34+-NK cells exhibited increased capacity to secrete IFN-γ and kill K562 in vitro and in vivo as compared to PBCD34+-NK cells. Moreover, K562 killing by the generated NK cells could be further enhanced by IL-12 stimulation. Our data indicate that the use of frozen CBCD34+ for the production of NK cells in vitro results in higher cell numbers than PBCD34+, without jeopardizing their functionality, rendering them suitable for NK cell immunotherapy. The results presented here provide an optimal strategy to generate NK cells in vitro for immunotherapy that exhibit enhanced effector function when compared to alternate sources of HSC.
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Affiliation(s)
- Martha Luevano
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
| | - Anna Domogala
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
| | - Michael Blundell
- Centre for Immunodeficiency, Molecular Immunology Unit, UCL Institute of Child Health, London, United Kingdom
| | - Nicola Jackson
- University College London, Cancer Institute, London, United Kingdom
| | - Isabela Pedroza-Pacheco
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
| | - Sophie Derniame
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
| | - Michelle Escobedo-Cousin
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
| | - Sergio Querol
- Programa Concordia Banc de Sang i Teixits, Barcelona, Spain
| | - Adrian Thrasher
- Centre for Immunodeficiency, Molecular Immunology Unit, UCL Institute of Child Health, London, United Kingdom
| | - Alejandro Madrigal
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
| | - Aurore Saudemont
- University College London, Cancer Institute, London, United Kingdom
- Anthony Nolan Research Institute, London, United Kingdom
- * E-mail:
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27
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Ruutu T, Gratwohl A, de Witte T, Afanasyev B, Apperley J, Bacigalupo A, Dazzi F, Dreger P, Duarte R, Finke J, Garderet L, Greinix H, Holler E, Kröger N, Lawitschka A, Mohty M, Nagler A, Passweg J, Ringdén O, Socié G, Sierra J, Sureda A, Wiktor-Jedrzejczak W, Madrigal A, Niederwieser D. Erratum: Prophylaxis and treatment of GVHD: EBMT–ELN working group recommendations for a standardized practice. Bone Marrow Transplant 2013. [DOI: 10.1038/bmt.2013.210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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28
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Passweg JR, Baldomero H, Bregni M, Cesaro S, Dreger P, Duarte RF, Falkenburg JHF, Kröger N, Farge-Bancel D, Bobby Gaspar H, Marsh J, Mohty M, Peters C, Sureda A, Velardi A, Ruiz de Elvira C, Madrigal A. Hematopoietic SCT in Europe: data and trends in 2011. Bone Marrow Transplant 2013; 48:1161-7. [PMID: 23584439 PMCID: PMC3763517 DOI: 10.1038/bmt.2013.51] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 03/01/2013] [Accepted: 03/08/2013] [Indexed: 11/20/2022]
Abstract
In all, 651 from 680 centers in 48 countries reported 35 660 hematopoietic SCT (HSCT) in 32 075 patients (13 470 allogeneic (42%), 18 605 autologous (58%)) to the 2011 survey. Main indications were: leukemias; 10 113 (32%; 94% allogeneic); lymphoid neoplasias; non-Hodgkin's lymphoma, Hodgkin's lymphoma, plasma cell disorders; 18 433 (57%; 12% allogeneic); solid tumours; 1573 (5%; 5% allogeneic); and non-malignant disorders; 1830 (6%; 92% allogeneic). There were more unrelated donors than HLA identical sibling donors (54% versus 39%); proportion of peripheral blood as stem cell source was 99% for autologous and 73% for allogeneic HSCT. Cord blood was only used in allogeneic transplants (6% of total). In the past 10 years, the overall number of transplants has increased by 53%. Allogeneic HSCT have doubled (from 7272 to 14 549) while, autologous have increased by 32% and continue to increase by about 1100 HSCT per year since 2001. In the past 2 years, an increase of >2000 HSCT per year was seen. Transplant activity is shown by team size. For allogeneic HSCT, we show use of reduced-intensity conditioning versus myeloablative conditioning across Europe and use of post-transplant donor lymphocyte infusions with considerable variation across different countries.
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Affiliation(s)
- J R Passweg
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - H Baldomero
- EBMT Activity Survey Office, Division of Hematology, Department of Medicine, University Hospital, Basel, Switzerland
| | - M Bregni
- Department of Oncology, Scientific Institute San Raffaele, Milan, Italy
| | - S Cesaro
- Paediatric Haematology Oncology, Policlinico G.B. Rossi, Verona, Italy
| | - P Dreger
- University of Heidelberg, Medizinische Klinik u. Poliklinik V, Heidelberg, Germany
| | - R F Duarte
- Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain
| | | | - N Kröger
- University Hospital Eppendorf, Hamburg, Germany
| | - D Farge-Bancel
- Service de Médecine Interne, Hopital St Louis, Paris, France
| | - H Bobby Gaspar
- Molecular Immunology Unit, UCL Institute of Child Health, London, UK
| | - J Marsh
- GKT School of Medicine, Department of Haematological Medicine, King's Denmark Hill Campus, London, UK
| | - M Mohty
- Universite Pierre and Maris Curie, INSERM UMRs 938, Hôpital Saint Antoine, Paris, France
| | - C Peters
- St Anna Kinderspital, BMT Unit, Vienna, Austria
| | - A Sureda
- Addenbrookes Hospital, Cambridge, UK
| | - A Velardi
- Ospedale Santa Maria della Misericordia - Sezione di Ematologia, Localitá Sant Andrea delle Fratte, Perugia, Italy
| | | | - A Madrigal
- Anthony Nolan Research Institute Royal Free Hospital, London, UK
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29
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Ruutu T, Gratwohl A, de Witte T, Afanasyev B, Apperley J, Bacigalupo A, Dazzi F, Dreger P, Duarte R, Finke J, Garderet L, Greinix H, Holler E, Kröger N, Lawitschka A, Mohty M, Nagler A, Passweg J, Ringdén O, Socié G, Sierra J, Sureda A, Wiktor-Jedrzejczak W, Madrigal A, Niederwieser D. Prophylaxis and treatment of GVHD: EBMT–ELN working group recommendations for a standardized practice. Bone Marrow Transplant 2013; 49:168-73. [DOI: 10.1038/bmt.2013.107] [Citation(s) in RCA: 200] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 05/16/2013] [Accepted: 05/18/2013] [Indexed: 11/09/2022]
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30
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Alvarez-Gonzalez C, Duggleby R, Vagaska B, Querol S, Gomez SG, Ferretti P, Madrigal A. Cord blood Lin(-)CD45(-) embryonic-like stem cells are a heterogeneous population that lack self-renewal capacity. PLoS One 2013; 8:e67968. [PMID: 23840798 PMCID: PMC3695943 DOI: 10.1371/journal.pone.0067968] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 05/24/2013] [Indexed: 02/02/2023] Open
Abstract
Human umbilical cord blood (hUCB) has been proposed to contain not only haematopoietic stem cells, but also a rare pluripotent embryonic-like stem cell (ELSc) population that is negative for hematopoietic markers (Lin−CD45−) and expresses markers typical of pluripotent cells. The aim of this work was to isolate, characterise and expand this ELSc fraction from hUCB, as it may provide a valuable cell source for regenerative medicine applications. We found that we could indeed isolate a Lin−CD45− population of small cells (3–10 µm diameter) with a high nucleus to cytoplasm ratio that expressed the stem cell markers CD34 and CXCR4. However, in contrast to some previous reports, this fraction was not positive for CD133. Furthermore, although these cells expressed transcripts typical of pluripotent cells, such as SOX2, OCT3/4, and NANOG, they were not able to proliferate in any of the culture media known to support stem cell growth that we tested. Further analysis of the Lin−CD45− population by flow cytometry showed the presence of a Lin−CD45−Nestin+ population that were also positive for CD34 (20%) but negative for CXCR4. These data suggest that the Lin−CD45− stem cell fraction present in the cord blood represents a small heterogeneous population with phenotypic characteristics of stem cells, including a Lin−CD45−Nestin+ population not previously described. This study also suggests that heterogeneity within the Lin−CD45− cell fraction is the likely explanation for differences in the hUCB cell populations described by different groups that were isolated using different methods. These populations have been widely called “embryonic-like stem cell” on the basis of their phenotypical similarity to embryonic stem cells. However, the fact they do not seem to be able to self-renew casts some doubt on their identity, and warns against defining them as “embryonic-like stem cell” at this stage.
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Affiliation(s)
- Cesar Alvarez-Gonzalez
- Anthony Nolan Research Institute, London, United Kingdom
- Cancer Institute, University College London, London, United Kingdom
| | | | - Barbora Vagaska
- Development Biology Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Sergio Querol
- Anthony Nolan Research Institute, London, United Kingdom
- Banc de Sang i Teixits, Barcelona, Spain
| | - Susana G. Gomez
- Anthony Nolan Research Institute, London, United Kingdom
- Anthony Nolan Cell Therapy Centre, Nottingham, United Kingdom
| | - Patrizia Ferretti
- Development Biology Unit, Institute of Child Health, University College London, London, United Kingdom
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31
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Pedroza-Pacheco I, Madrigal A, Saudemont A. Interaction between natural killer cells and regulatory T cells: perspectives for immunotherapy. Cell Mol Immunol 2013; 10:222-9. [PMID: 23524654 DOI: 10.1038/cmi.2013.2] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Regulatory T (Treg) cells and natural killer (NK) cells are key players in the immune system. The interaction between these two cell types has been reported to be beneficial in healthy conditions such as pregnancy. However, in the case of certain pathologies such as autoimmune diseases and cancer this interaction can become detrimental, as Treg cells have been described to suppress NK cells and in particular to impair NK cell effector functions. This review aims to discuss the recent information on the interaction between Treg cells and NK cells under healthy and pathologic conditions, to describe the specific conditions in which this interaction takes place, the effect of Treg cells on hematopoietic stem cell differentiation and the consequences of this interaction on the optimization of immunotherapeutic protocols.
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Affiliation(s)
- Isabela Pedroza-Pacheco
- Anthony Nolan Research Institute and University College London, Royal Free Campus, London, UK
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32
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Gratwohl A, Baldomero H, Gratwohl M, Aljurf M, Bouzas LF, Horowitz M, Kodera Y, Lipton J, Iida M, Pasquini MC, Passweg J, Szer J, Madrigal A, Frauendorfer K, Niederwieser D. Quantitative and qualitative differences in use and trends of hematopoietic stem cell transplantation: a Global Observational Study. Haematologica 2013; 98:1282-90. [PMID: 23508009 DOI: 10.3324/haematol.2012.076349] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Fifty-five years after publication of the first hematopoietic stem cell transplantation this technique has become an accepted treatment option for defined hematologic and non-hematologic disorders. There is considerable interest in understanding differences in its use and trends on a global level and the macro-economic factors associated with these differences. Data on the numbers of hematopoietic stem cell transplants performed in the 3-year period 2006-2008 were obtained from Worldwide Network for Blood and Marrow Transplantation member registries and from transplant centers in countries without registries. Population and macro-economic data were collected from the World Bank and from the International Monetary Fund. Transplant rates were analyzed by indication, donor type, country, and World Health Organization regional offices areas and related to selected health care indicators using single and multiple linear regression analyses. Data from a total of 146,808 patients were reported by 1,411 teams from 72 countries over five continents. The annual number of transplants increased worldwide with the highest relative increase in the Asia Pacific region. Transplant rates increased preferentially in high income countries (P=0.02), not in low or medium income countries. Allogeneic transplants increased for myelodysplasia, chronic lymphocytic leukemia, acute leukemias, and non-malignant diseases but decreased for chronic myelogenous leukemia. Autologous transplants increased for autoimmune and lymphoproliferative diseases but decreased for leukemias and solid tumors. Transplant rates (P<0.01), donor type (P<0.01) aand disease indications (P<0.01) differed significantly between countries and regions. Transplant rates were associated with Gross National Income/capita (P<0.01) but showed a wide variation of explanatory content by donor type, disease indication and World Health Organization region. Hematopoietic stem cell transplantation activity is increasing worldwide. The preferential increase in high income countries, the widening gap between low and high income countries and the significant regional differences suggest that different strategies are required in individual countries to foster hematopoietic stem cell transplantation as an efficient and cost-effective treatment modality.
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Affiliation(s)
- Alois Gratwohl
- The European Group for Blood and Marrow Transplantation (EBMT) Transplant Activity Survey Office, University Hospital, Basel, Switzerland
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Lown R, Ogilvie A, Madrigal A, Shaw B. Significantly Higher Rates of Donor Attrition in Minority Ethnic, Female and Older Donors: A Review of 7542 Confirmatory Typing Requests at Anthony Nolan. Biol Blood Marrow Transplant 2013. [DOI: 10.1016/j.bbmt.2012.11.051] [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: 11/30/2022]
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34
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Petersdorf EW, Malkki M, Hsu K, Bardy P, Cesbron A, Dickinson A, Dubois V, Fleischhauer K, Kawase T, Madrigal A, Morishima Y, Shaw B, Spellman S, Spierings E, Stern M, Tiercy JM, Velardi A, Gooley T. 16th IHIW: international histocompatibility working group in hematopoietic cell transplantation. Int J Immunogenet 2012; 40:2-10. [PMID: 23279968 DOI: 10.1111/iji.12022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 10/22/2012] [Accepted: 10/23/2012] [Indexed: 11/28/2022]
Abstract
The International Histocompatibility Working Group is a collaborative international effort to understand the HLA and non-HLA genetics of the transplantation barrier. The Working Group is comprised of experts in the fields of histocompatibility and immunogenetics, hematopoietic cell transplantation and outcomes research. Data for 25 855 unrelated donor transplants were submitted in support of research studies for the 16th International Histocompatibility Workshop. Active investigation is in progress in seven key areas: the impact of HLA matching, role of race and ethnicity, identification of permissible HLA mismatches, haplotype-associated determinants, minor histocompatibility antigens, immune response genes and KIR genetics. New hypotheses for the 16th workshop were developed for immunogenetic studies in cord blood and haploidentical-related donor transplantation.
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Affiliation(s)
- E W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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35
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Luevano M, Madrigal A, Saudemont A. Transcription factors involved in the regulation of natural killer cell development and function: an update. Front Immunol 2012; 3:319. [PMID: 23087693 PMCID: PMC3470934 DOI: 10.3389/fimmu.2012.00319] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [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: 08/30/2012] [Accepted: 10/01/2012] [Indexed: 01/22/2023] Open
Abstract
Natural killer (NK) cells belong to the innate immune system and are key effectors in the immune response against cancer and infection. Recent studies have contributed to the knowledge of events controlling NK cell fate. The use of knockout mice has enabled the discovery of key transcription factors (TFs) essential for NK cell development and function. Yet, unwrapping the downstream targets of these TFs and their influence on NK cells remains a challenge. In this review, we discuss the latest TFs described to be involved in the regulation of NK cell development and maturation.
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Affiliation(s)
- Martha Luevano
- Anthony Nolan Research Institute London, UK ; University College London London, UK
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36
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Halter JP, van Walraven SM, Worel N, Bengtsson M, Hägglund H, Nicoloso de Faveri G, Shaw BE, Schmidt AH, Fechter M, Madrigal A, Szer J, Aljurf MD, Weisdorf D, Horowitz MM, Greinix H, Niederwieser D, Gratwohl A, Kodera Y, Confer D. Allogeneic hematopoietic stem cell donation-standardized assessment of donor outcome data: a consensus statement from the Worldwide Network for Blood and Marrow Transplantation (WBMT). Bone Marrow Transplant 2012; 48:220-5. [PMID: 22773129 DOI: 10.1038/bmt.2012.119] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The number of allogeneic hematopoietic SCTs performed globally each year continues to increase, paralleled by an increased demand for donors of therapeutic cells. Donor characteristics and collection procedures have undergone major changes during recent decades, and further changes are foreseen. Information on short- and long-term donor outcomes is of crucial importance to ensure maximal donor safety and availability. Current data, predominantly from unrelated donors, give reliable information on the frequent early events associated with donation-most of them of mild-to-moderate intensity. Information on the type and relative risk of serious adverse reactions is more limited. Moreover, only few data exist on long-term donor outcome. On the basis of this need, recommendations for a minimum data set for prospective donor follow-up were developed in a workshop with the participation of an international group of investigators actively involved in allogeneic stem cell donation under the auspices of and approved by the Worldwide Network for Blood and Marrow Transplantation. Establishment of a standardized global follow-up for both, related and unrelated, donors will enable monitoring of the short- and long-term safety profiles of hematopoietic cell donation and form a solid basis for future donor selection and counseling.
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Affiliation(s)
- J P Halter
- Department of Hematology, University Hospital Basel, Basel, Switzerland.
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Luevano M, Madrigal A, Saudemont A. Generation of natural killer cells from hematopoietic stem cells in vitro for immunotherapy. Cell Mol Immunol 2012; 9:310-20. [PMID: 22705914 DOI: 10.1038/cmi.2012.17] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Natural killer (NK) cells are part of the innate immune system and are an alluring option for immunotherapy due to their ability to kill infected cells or cancer cells without prior sensitization. Throughout the past 20 years, different groups have been able to reproduce NK cell development in vitro, and NK cell ontogeny studies have provided the basis for the establishment of protocols to produce NK cells in vitro for immunotherapy. Here, we briefly discuss NK cell development and NK cell immunotherapy approaches. We review the factors needed for NK cell differentiation in vitro, which stem cell sources have been used, published protocols, challenges and future directions for Good Manufacturing Practice protocols.
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Affiliation(s)
- Martha Luevano
- Anthony Nolan Research Institute, and University College London, Royal Free Campus, London, UK
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Passweg JR, Baldomero H, Gratwohl A, Bregni M, Cesaro S, Dreger P, de Witte T, Farge-Bancel D, Gaspar B, Marsh J, Mohty M, Peters C, Tichelli A, Velardi A, de Elvira CR, Falkenburg F, Sureda A, Madrigal A. The EBMT activity survey: 1990-2010. Bone Marrow Transplant 2012; 47:906-23. [PMID: 22543746 DOI: 10.1038/bmt.2012.66] [Citation(s) in RCA: 159] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A total of 654 centers from 48 countries were contacted for the 2010 survey. In all, 634 centers reported a total of 33 362 hematopoietic SCT (HSCT) with 30 012 patients receiving their first transplant (12 276 allogeneic (41%) and 17 736 autologous (59%)). Main indications were leukemias: 9355 (31%; 93% allogeneic), lymphoid neoplasias specifically Non Hodgkin's lymphoma, Hodgkin's lymphoma and plasma cell disorders: 17 362 (58%; 12% allogeneic), solid tumors: 1585 (5%; 6% allogeneic) and non-malignant disorders: 1609 (6%; 88% allogeneic). There were more unrelated donors than HLA-identical sibling donors (53% versus 41%); the proportion of peripheral blood as stem cell source was 99% for autologous and 71% for allogeneic HSCT. Cord blood was primarily used in allogeneic transplants (6% of total) with three autologous cord blood HSCT being reported. The number of transplants has increased by 19% since 2005 (allogeneic 37% and autologous 9%) and continued to increase by about 1100 HSCT per year since 2000. Patterns of increase were distinct and different. The data show the development of transplantation in Europe since 1990, with the number of patients receiving a HSCT increasing from 4200 to over 30 000 annually. The most impressive trend seen is the steady increase of unrelated donor transplantation, in parallel to the availability of unrelated donors through donor registries.
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Affiliation(s)
- J R Passweg
- EBMT Activity Survey Office, Department of Medicine, Division of Hematology, University Hospital Basel, Basel, Switzerland.
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Luevano M, Daryouzeh M, Alnabhan R, Querol S, Khakoo S, Madrigal A, Saudemont A. The unique profile of cord blood natural killer cells balances incomplete maturation and effective killing function upon activation. Hum Immunol 2012; 73:248-57. [DOI: 10.1016/j.humimm.2011.12.015] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Revised: 12/13/2011] [Accepted: 12/21/2011] [Indexed: 10/14/2022]
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40
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Kanga U, McWhinnie A, Mourya MK, Sharma R, Shaw BE, Madrigal A, Mehra NK. 191-P HLA–DPB1 polymorphism in North Indian population. Hum Immunol 2011. [DOI: 10.1016/j.humimm.2011.07.216] [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: 10/17/2022]
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41
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Baldomero H, Gratwohl M, Gratwohl A, Tichelli A, Niederwieser D, Madrigal A, Frauendorfer K. The EBMT activity survey 2009: trends over the past 5 years. Bone Marrow Transplant 2011; 46:485-501. [PMID: 21358689 DOI: 10.1038/bmt.2011.11] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Six hundred and twenty-four centers from 43 countries reported a total of 31,322 hematopoietic SCT (HSCT) to this 2009 European Group for Blood and Marrow Transplantation (EBMT) survey with 28,033 first transplants (41% allogeneic, 59% autologous). The main indications were leukemias (31%; 92% allogeneic), lymphomas (58%; 12% allogeneic), solid tumors (5%; 6% allogeneic) and non-malignant disorders (6%; 88% allogeneic). There were more unrelated than HLA-identical sibling donors (51 vs 43%) for allogeneic HSCT; the proportion of peripheral blood as stem cell source was 99% for autologous and 71% for allogeneic HSCT. Allogeneic and autologous HSCT continued to increase by about 1000 HSCT per year since 2004. Patterns of increase were distinct and different. In a trend analysis, allogeneic HSCT increased in all World Bank Categories (P=0.01, two sided; all categories), autologous HSCT increased in middle- (P=0.01, two sided) and low-income (P=0.01, two sided) countries. EBMT practice guidelines appeared to have an impact on trend, with a clear increase in absolute numbers within the categories 'standard' and 'clinical option' for both allogeneic and autologous HSCT (P=0.01, two sided; for both allogeneic and autologous HSCT) and a clear decrease in autologous HSCT for the 'developmental' and 'generally not recommended' indications (P=0.01, two sided). These data illustrate the status and trends of HST in Europe.
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Affiliation(s)
- H Baldomero
- EBMT Activity Survey Office, Department of Medicine, Division of Hematology, University Hospital Basel, Basel, Switzerland.
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Yanover C, Petersdorf EW, Malkki M, Gooley T, Spellman S, Velardi A, Bardy P, Madrigal A, Bignon JD, Bradley P. HLA mismatches and hematopoietic cell transplantation: structural simulations assess the impact of changes in peptide binding specificity on transplant outcome. Immunome Res 2011; 7:4. [PMID: 24482668 PMCID: PMC3904355 DOI: 10.4172/1745-7580.1000048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The success of hematopoietic cell transplantation from an unrelated donor depends in part on the degree of Human Histocompatibility Leukocyte Antigen (HLA) matching between donor and patient. We present a structure-based analysis of HLA mismatching, focusing on individual amino acid mismatches and their effect on peptide binding specificity. Using molecular modeling simulations of HLA-peptide interactions, we find evidence that amino acid mismatches predicted to perturb peptide binding specificity are associated with higher risk of mortality in a large and diverse dataset of patient-donor pairs assembled by the International Histocompatibility Working Group in Hematopoietic Cell Transplantation consortium. This analysis may represent a first step toward sequence-based prediction of relative risk for HLA allele mismatches.
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Affiliation(s)
- Chen Yanover
- Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Effie W Petersdorf
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Mari Malkki
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ted Gooley
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Stephen Spellman
- Center for International Blood and Marrow Transplant Research, USA
| | - Andrea Velardi
- European Group for Blood and Marrow Transplantation, Italy
| | - Peter Bardy
- Australian Bone Marrow Donor Registry, Australia
| | | | | | - Philip Bradley
- Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Fleischhauer K, Shaw B, Malkki M, Gooley T, Zino E, Spellman S, Morishima Y, Velardi A, Brady P, Bignon JD, Madrigal A, Petersdorf E. 63-OR: Significant Correlation Between Donor-Recipient HLA-DPB1 T Cell Epitope Matching and Survival in 4490 Unrelated 10/10 Matched Hematopoietic Stem Cell Transplants Analyzed Within the 15th International Histocompatibility Workshop. Hum Immunol 2010. [DOI: 10.1016/j.humimm.2010.06.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Confer DL, Abress LK, Navarro W, Madrigal A. Selection of Adult Unrelated Hematopoietic Stem Cell Donors: Beyond HLA. Biol Blood Marrow Transplant 2010; 16:S8-S11. [DOI: 10.1016/j.bbmt.2009.10.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Tuthill M, Chen F, Paston S, De La Peña H, Rusakiewicz S, Madrigal A. The prevention and treatment of cytomegalovirus infection in haematopoietic stem cell transplantation. Cancer Immunol Immunother 2009; 58:1481-8. [PMID: 19466407 PMCID: PMC11030108 DOI: 10.1007/s00262-009-0722-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Accepted: 05/04/2009] [Indexed: 12/01/2022]
Abstract
Allogeneic haematopoietic stem cell transplantation (HSCT) is an intensive medical treatment involving myeloablative chemo-radiotherapy followed by stem cell rescue using allogeneic haematopoietic stem cells harvested from HLA-matched donors, which is primarily used for the treatment of haematological malignancies. Cytomegalovirus (CMV) infection is one of the major causes of morbidity and death after HSCT. This focused research review highlights the advances made with research into CMV in the HSCT setting. It provides the reader with an overview of current CMV research into the prevention and management of CMV infection.
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Affiliation(s)
- Mark Tuthill
- The Anthony Nolan Research Institute, Royal Free Hospital, London, UK.
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46
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Rusakiewicz S, Madrigal A, Travers P, Dodi AI. BCR/ABL-specific CD8+ T cells can be detected from CML patients, but are only expanded from healthy donors. Cancer Immunol Immunother 2009; 58:1449-57. [PMID: 19360407 PMCID: PMC11030944 DOI: 10.1007/s00262-009-0703-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [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: 09/10/2008] [Accepted: 03/17/2009] [Indexed: 01/09/2023]
Abstract
The BCR/ABL p210 fusion protein has long been considered an ideal target antigen for the development of immunotherapeutic strategies in chronic myeloid leukaemia (CML) due to its central role in malignant transformation and to its unique novel amino acid sequence solely expressed in leukaemia cells. However, the feasibility to expand BCR-ABL-specific T cells remains still controversial. Using BCR/ABL peptide/MHC tetramers, significantly higher frequencies of tetramer positive cells were detected in the peripheral blood of HLA-A*0301 (mean 0.38%) and HLA-B*0801 (mean 0.28%) CML patients than in healthy donors (P = 0.0025 and 0.0026, respectively). However, following stimulation with autologous peptide-pulsed DCs, BCR/ABL-specific T cells were only expanded from some healthy donors, suggesting that CML patients may have a specific immune deficit with respect to the BCR/ABL antigen.
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Affiliation(s)
- Sylvie Rusakiewicz
- The Anthony Nolan Research Institute, The Royal Free Hospital, University College of London, Medical School, Fleet Road, Hampstead, London, NW3 2QG UK
| | - Alejandro Madrigal
- The Anthony Nolan Research Institute, The Royal Free Hospital, University College of London, Medical School, Fleet Road, Hampstead, London, NW3 2QG UK
| | - Paul Travers
- The Anthony Nolan Research Institute, The Royal Free Hospital, University College of London, Medical School, Fleet Road, Hampstead, London, NW3 2QG UK
| | - Anthony I. Dodi
- The Anthony Nolan Research Institute, The Royal Free Hospital, University College of London, Medical School, Fleet Road, Hampstead, London, NW3 2QG UK
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Figueroa-Tentori D, Querol S, Dodi IA, Madrigal A, Duggleby R. High purity and yield of natural Tregs from cord blood using a single step selection method. J Immunol Methods 2008; 339:228-35. [DOI: 10.1016/j.jim.2008.09.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Accepted: 09/24/2008] [Indexed: 12/25/2022]
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Zal B, Kaski JC, Akiyu JP, Cole D, Arno G, Poloniecki J, Madrigal A, Dodi A, Baboonian C. Differential pathways govern CD4+ CD28- T cell proinflammatory and effector responses in patients with coronary artery disease. J Immunol 2008; 181:5233-41. [PMID: 18832677 DOI: 10.4049/jimmunol.181.8.5233] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Patients with acute coronary syndromes experience circulatory and intraplaque expansion of an aggressive and unusual CD4(+) lymphocyte subpopulation lacking the CD28 receptor. These CD4(+)CD28(-) cells produce IFN-gamma and perforin, and are thought to play an important role in coronary atheromatous plaque destabilization. Aberrant expression of killer Ig-like receptors (KIRs) in CD4(+)CD28(-) cells is broadly thought to be responsible for their cytotoxicity, but the mechanisms involved remain poorly defined. We therefore sought to investigate the mechanism and regulation of CD4(+)CD28(-) cell functionality using T cell clones (n = 536) established from patients with coronary artery disease (n = 12) and healthy volunteers (n = 3). Our functional studies demonstrated that KIR2DS2 specifically interacted with MHC class I-presenting human heat shock protein 60 (hHSP60) inducing cytotoxicity. Further investigations revealed the novel finding that hHSP60 stimulation of TCR alone could not induce a cytotoxic response, and that this response was specific and KIR dependent. Analysis of CD4(+)CD28(-)2DS2(+) clones (n = 162) showed that not all were hHSP60 cytotoxic; albeit, their prevalence correlated with coronary disease status (p = 0.017). A higher proportion of clones responded to hHSP60 by IFN-gamma compared with perforin (p = 0.008). In this study, for the first time, we define the differential regulatory pathways involved in CD4(+)CD28(-) cell proinflammatory and effector responses. We describe in this study that, contrary to previous reports, CD4(+)CD28(-) cell recognition and killing can be specific and discriminate. These results, in addition to contributing to the understanding of CD4(+)CD28(-) cell functionality, may have implications for the monitoring and management of coronary artery disease progression.
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Affiliation(s)
- Behnam Zal
- Division of Cardiac and Vascular Sciences, St. George's University of London, London, United Kingdom.
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49
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Pamphilon D, Nacheva E, Navarrete C, Madrigal A, Goldman J. The use of granulocytecolony-stimulating factor in volunteer unrelated hemopoietic stem cell donors. Transfusion 2008; 48:1495-501. [DOI: 10.1111/j.1537-2995.2008.01694.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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50
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Madrigal A, Shaw BE. Immunogenetic factors in donors and patients that affect the outcome of hematopoietic stem cell transplantation. Blood Cells Mol Dis 2007; 40:40-3. [PMID: 17964196 DOI: 10.1016/j.bcmd.2007.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2007] [Revised: 08/05/2007] [Accepted: 08/09/2007] [Indexed: 01/08/2023]
Abstract
We have correlated the clinical outcome with the level of HLA matching in 423 patients who received a transplant from a volunteer unrelated donor in the United Kingdom. HLA matching was performed at the allelic level (i.e. high-resolution) using reference strand mediated conformation analysis (RSCA) at HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1. The three-year probability of overall survival (OS) was 45% (median survival of 593 days; six-year overall survival probability was 40%). The mean follow-up was 1013 days (range 89-2697). Those matched for their HLA loci had a significantly better overall survival than the mismatched pairs (47% versus 40%, p=0.040). This result could be refined based on the number of alleles that were mismatched. In patients with a single HLA mismatch, the overall survival was 43%, compared to 30% in those with multiple mismatches; however, there was no statistically significant difference between matched pairs or those with one mismatch. Although there was no significant difference in the overall survival dependent on DPB1 matching in the group overall, in acute lymphocytic leukemia, DPB1-matched pairs had a significantly worse overall survival (log rank; p=0.025). Thus, a match for DPB1 is associated with a significantly increased risk of disease relapse, irrespective of the matching status for the other HLA molecules. In a multivariate analysis, a high pre-transplant levels of Tregs resulted in worse overall survival (relative risk (RR), 2.74; p=0.01), a trend to reduce disease-free survival (RR, 2.05; p=0.060) and to increase disease relapse (RR, 3.36; p=0.006). Residual patient CD4(+)CD25(hi) regulatory T cells may suppress graft-versus-tumour responses, decreasing the overall survival by increasing the rates of relapse. In acute leukemia, the presence of NOD2/CARD15 SNPs in the genotype of unrelated donor hematopoietic stem cell transplant pairs results in significant increases in disease relapse and consequently in death. These data show an important role for NOD2/CARD15 genotyping in transplantation and suggest a possible effect of the NOD2 protein in alloreactivity and tumour surveillance. Genotyping recipients and donors prior to transplant may present valuable information for planning and management of pre-transplant conditioning regimens, and for prognosis of the outcome.
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