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Papaioannou O, Karampitsakos T, Tsiri P, Sotiropoulou V, Koulousousa E, Tasiopoulos P, Schinas G, Katsaras M, Zarkadi E, Malakounidou E, Georgiopoulou V, Sampsonas F, Spyridonidis A, Akinosoglou K, Marangos M, Tzouvelekis A. Clinical outcomes in vaccinated and unvaccinated patients with COVID-19: a population-based analysis. Eur Rev Med Pharmacol Sci 2022; 26:7705-7712. [PMID: 36314348 DOI: 10.26355/eurrev_202210_30047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Real-life data for vaccination against COVID-19 are sorely needed. This was a population-based analysis aiming at investigating the hospitalization risk for COVID-19 of 98,982 subjects and compare features of vaccinated and unvaccinated patients. PATIENTS AND METHODS Hospitalized patients with COVID-19 between 01/07/2021 and 11/02/2022 were included in the study. RESULTS 582 patients were included in the analysis [males: 58.6% (n=341), vaccinated patients: 28.5% (n=166), unvaccinated patients: 71.5% (n=416)]. Median age of vaccinated patients was significantly higher compared to median age of unvaccinated [74.0 (95% CI: 72.0-77.0) vs. 59.0 (95% CI: 57.0-62.0), p=0.0001]. Mean latency time (±SD) from the second dose to hospitalization was 5.7±2.6 months. Between 01/07/2021 and 01/12/2021, unvaccinated subjects had higher risk for hospitalization compared to vaccinated [HR: 2.82, 95% CI: 2.30-3.45, p<0.0001]. Between 02/12/2021 and 11/02/2022, unvaccinated subjects presented with higher risk for hospitalization than subjects that had received booster dose [HR: 2.07, 95% CI: 1.44-2.98, p=0.005], but not than subjects that got two doses. Median value of hospitalization days was higher in unvaccinated patients compared to vaccinated [7.0 (95% CI: 7.0-8.0) vs. 6.0 (95% CI: 5.0-7.0), p=0.02]. Finally, age-adjusted analysis showed that hospitalized unvaccinated patients presented with significantly higher mortality risk compared to hospitalized vaccinated patients [HR: 2.59, 95% CI: 1.69-3.98, p<0.0001]. CONCLUSIONS Vaccination against COVID-19 remains the best way to contain the pandemic. There is an amenable need for booster dose during the omicron era.
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Affiliation(s)
- O Papaioannou
- Department of Respiratory Medicine, Department of Internal Medicine, Department of Hematology, University Hospital of Patras, Patras, Greece.
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Kefala D, Lysandrou M, Christofi P, Pieridou C, Papayanni P, Savvopoulos N, Kyriakou M, Chatzidaniil A, Stamou P, Anagnostopoulos A, Papadopoulou A, Costeas P, Yannaki E, Spyridonidis A. Immunotherapy: PRE-CLINICAL DEVELOPMENT OF A DECITABINE-INDUCED REGULATORY HLAG+CD4+-T CELL-ENRICHED CELL PRODUCT (IG-TREG) AGAINST GRAFT-VS-HOST-DISEASE. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00322-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Spyridonidis A, Polivka B, Hillbrand M, Montalta M, Aspradakis M. Implementation of a software platform for comprehensive quality assurance in radiotherapy. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00390-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Neroutsos E, Athanasiadou I, Paisiou A, Zisaki K, Goussetis E, Archontaki H, Tsirigotis P, Kitra M, Grafakos S, Spyridonidis A, Dokoumetzidis A, Valsami G. Dose individualization of intravenous busulfan in pediatric patients undergoing bone marrow transplantation: impact and in vitro evaluation of infusion lag-time. J Pharm Pharmacol 2021; 73:1340-1350. [PMID: 34244783 DOI: 10.1093/jpp/rgab087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/20/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To apply therapeutic drug monitoring and dose-individualization of intravenous Busulfan to paediatric patients and evaluate the impact of syringe-pump induced Busulfan infusion lag-time after in vitro estimation. METHODS 76 children and adolescents were administered 2 h intravenous Busulfan infusion every 6 h (16 doses). Busulfan plasma levels, withdrawn by an optimized sampling scheme and measured by a validated HPLC-PDA method, were used to estimate basic PK parameters, AUC, Cmax, kel, t1/2, applying Non-Compartmental Analysis. In vivo infusion lag-time was simulated in vitro and used to evaluate its impact on AUC estimation. KEY FINDINGS Mean (%CV) Busulfan AUC, Cmax, clearance and t1/2 for pediatric population were found 962.3 μm × min (33.1), 0.95 mg/L (41.4), 0.27 L/h/kg (33.3), 2.2 h (27.8), respectively. TDM applied to 76 children revealed 6 (7.9%) being above and 25 (32.9%) below therapeutic-range (AUC: 900-1350 μm × min). After dose correction, all patients were measured below toxic levels (AUC < 1500 μm × min), no patient below 900 μm × min. Incorporation of infusion lag-time revealed lower AUCs with 17.1% more patients and 23.1% more younger patients, with body weight <16 kg, being below the therapeutic-range. CONCLUSIONS TDM, applied successfully to 76 children, confirmed the need for Busulfan dose-individualization in paediatric patients. Infusion lag-time was proved clinically significant for younger, low body-weight patients and those close to the lower therapeutic-range limit.
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Affiliation(s)
- E Neroutsos
- Laboratory of Biopharmaceutics & Pharmacokinetics, Department of Pharmacy, School of Health Sciences, National & Kapodistrian University of Athens, Athens, Greece
| | - I Athanasiadou
- Laboratory of Biopharmaceutics & Pharmacokinetics, Department of Pharmacy, School of Health Sciences, National & Kapodistrian University of Athens, Athens, Greece
| | - A Paisiou
- Bone Marrow Transplantation Unit, "Agia Sophia" General Children's Hospital of Athens, Athens, Greece
| | - K Zisaki
- Bone Marrow Transplantation Unit, "Agia Sophia" General Children's Hospital of Athens, Athens, Greece
| | - E Goussetis
- Bone Marrow Transplantation Unit, "Agia Sophia" General Children's Hospital of Athens, Athens, Greece
| | - H Archontaki
- Laboratory of Analytical Chemistry, Department of Chemistry, School of Sciences, National & Kapodistrian University of Athens, Athens, Greece
| | - P Tsirigotis
- Clinic of Internal Medicine, University Hospital "Attikon", Department of Medicine, School of Health Sciences, National & Kapodistrian University of Athens, Athens, Greece
| | - M Kitra
- Bone Marrow Transplantation Unit, "Agia Sophia" General Children's Hospital of Athens, Athens, Greece
| | - S Grafakos
- Bone Marrow Transplantation Unit, "Agia Sophia" General Children's Hospital of Athens, Athens, Greece
| | - A Spyridonidis
- Bone Marrow Transplant Unit, University Hospital of Patras, Department of Medicine, School of Health Sciences, University of Patras, Rio, Patras, Greece
| | - A Dokoumetzidis
- Laboratory of Biopharmaceutics & Pharmacokinetics, Department of Pharmacy, School of Health Sciences, National & Kapodistrian University of Athens, Athens, Greece
| | - G Valsami
- Laboratory of Biopharmaceutics & Pharmacokinetics, Department of Pharmacy, School of Health Sciences, National & Kapodistrian University of Athens, Athens, Greece
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Spyridonidis A, Skamagkis T, Lambropoulos L, Stamatelatou K. Modeling of anaerobic digestion of slaughterhouse wastes after thermal treatment using ADM1. J Environ Manage 2018; 224:49-57. [PMID: 30031918 DOI: 10.1016/j.jenvman.2018.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 05/30/2018] [Accepted: 07/01/2018] [Indexed: 06/08/2023]
Abstract
According to the European legislation, thermal treatment of category 2 slaughterhouse by-products at 140 °C, 4-5 bar for 20 min is obligatory for their hygienization prior to disposal. This process is known as "rendering". The product of the rendering process is rich in lipids and proteins making it an appropriate feedstock for biogas plants. The mathematical modeling of biogas production from slaughterhouse wastes after the rendering process has been studied adjusting the anaerobic digestion model (ADM1). For this purpose, two mesophilic (38-39 °C) continuous stirred tank reactors (CSTRs) have been operated in parallel under a hydraulic retention time of 21.5 ± 2.14 d, while the organic load was increased from 50 to 149.6 g COD L-1. Recirculation of the mixed liquor suspended solids (MLSS) took place in one of the CSTRs, resulting in a different solids' concentration in it. The ADM1 was calibrated by estimating key kinetic parameters, such as the maximum specific consumption rate constant and the half-saturation constants of volatile fatty acids and verified. The degradation kinetics of this type of waste seemed to be faster, as a result of its emulsification through rendering, while the coefficient yields of the acidogens were lower than the default values of ADM1. The structure of the model was proven suitable for predicting the response of both bioreactors under small or medium step transitions, but not for abrupt impulse disturbances in the organic loading rate.
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Affiliation(s)
- A Spyridonidis
- Democritus University of Thrace, Department of Environmental Engineering, Vas. Sofias 12, 67132 Xanthi, Greece; INVALOR: Research Infrastructure for Waste Valorization and Sustainable Management, Patras, Greece
| | - Th Skamagkis
- Democritus University of Thrace, Department of Environmental Engineering, Vas. Sofias 12, 67132 Xanthi, Greece; INVALOR: Research Infrastructure for Waste Valorization and Sustainable Management, Patras, Greece
| | - L Lambropoulos
- Democritus University of Thrace, Department of Environmental Engineering, Vas. Sofias 12, 67132 Xanthi, Greece; INVALOR: Research Infrastructure for Waste Valorization and Sustainable Management, Patras, Greece
| | - K Stamatelatou
- Democritus University of Thrace, Department of Environmental Engineering, Vas. Sofias 12, 67132 Xanthi, Greece; INVALOR: Research Infrastructure for Waste Valorization and Sustainable Management, Patras, Greece.
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Angelopoulou MK, Vassilakopoulos TP, Batsis I, Sakellari I, Gkirkas K, Pappa V, Giannoulia P, Apostolidis I, Apostolopoulos C, Roussou P, Panayiotidis P, Dimou M, Kyrtsonis M, Palassopoulou M, Vassilopoulos G, Moschogiannis M, Kalpadakis C, Margaritis D, Spyridonidis A, Michalis E, Anargyrou K, Repousis P, Hatzimichael E, Bousiou Z, Poulakidas E, Grentzelias D, Harhalakis N, Pangalis GA, Anagnostopoulos A, Tsirigotis P. Brentuximab vedotin in relapsed/refractory Hodgkin lymphoma. The Hellenic experience. Hematol Oncol 2018; 36:174-181. [PMID: 28219112 PMCID: PMC5836920 DOI: 10.1002/hon.2383] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 09/13/2016] [Revised: 12/02/2016] [Accepted: 12/09/2016] [Indexed: 01/24/2023]
Abstract
This retrospective study aimed to describe the Hellenic experience on the use of brentuximab vedotin (BV) in relapsed/refractory (R/R) Hodgkin lymphoma (HL) given within its indication. From June 2011 to April 2015, ninety-five patients with R/R HL, who received BV in 20 centers from Greece, were analyzed. Their median age was 33 years, and 62% were males. Sixty-seven patients received BV after autologous stem cell transplantation failure, whereas 28 patients were treated with BV without a prior autologous stem cell transplantation, due to advanced age/comorbidities or chemorefractory disease. The median number of prior treatments was 4 and 44% of the patients were refractory to their most recent therapy. The median number of BV cycles was 8 (range, 2-16), and the median time to best response was the fourth cycle. Fifty-seven patients achieved an objective response: twenty-two (23%), a complete response (CR), and 35 patients (37%), a partial, for an overall response rate of 60%. Twelve patients (13%) had stable disease, and the remaining twenty-six (27%) had progressive disease as their best response. At a median follow-up of 11.5 months, median progression-free survival and overall survival were 8 and 26.5 months, respectively. Multivariate analysis showed that chemosensitivity to treatment administered before BV was associated with a significantly increased probability of achieving response to BV (P = .005). Bulky disease (P = .01) and response to BV (P <.001) were significant for progression-free survival, while refractoriness to most recent treatment (P = .04), bulky disease (P = .005), and B-symptoms (P = .001) were unfavorable factors for overall survival. Among the 22 CRs, 5 remain in CR with no further treatment after BV at a median follow-up of 13 months. In conclusion, our data indicate that BV is an effective treatment for R/R HL patients even outside clinical trials. Whether BV can cure a fraction of patients remains to be seen.
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Affiliation(s)
- Maria K. Angelopoulou
- Department of Hematology, Laikon General HospitalNational and Kapodistrian University of AthensAthensGreece
| | | | - Ioannis Batsis
- Hematology and Bone Marrow Transplantation DepartmentGeneral Hospital of Thessaloniki PapanikolaouThessalonikiGreece
| | - Ioanna Sakellari
- Hematology and Bone Marrow Transplantation DepartmentGeneral Hospital of Thessaloniki PapanikolaouThessalonikiGreece
| | - Konstantinos Gkirkas
- 2nd Department of Internal Medicine, Faculty of Medicine, ATTIKON General University HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Vasiliki Pappa
- 2nd Department of Internal Medicine, Faculty of Medicine, ATTIKON General University HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | | | | | - Christos Apostolopoulos
- Third Department of Medicine, “Sotiria” General Hospital of Thoracic Diseases, Hematology UnitNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Paraskevi Roussou
- Third Department of Medicine, “Sotiria” General Hospital of Thoracic Diseases, Hematology UnitNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Panayiotis Panayiotidis
- 1st Department of Propedeutic Internal Medicine, Laikon General HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Maria Dimou
- 1st Department of Propedeutic Internal Medicine, Laikon General HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Marie‐Christine Kyrtsonis
- 1st Department of Propedeutic Internal Medicine, Laikon General HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Maria Palassopoulou
- Department of Hematology, Larissa University HospitalUniversity of ThessaliaLarissaGreece
| | - Georgios Vassilopoulos
- Department of Hematology, Larissa University HospitalUniversity of ThessaliaLarissaGreece
| | | | - Christina Kalpadakis
- Department of Hematology, Heraklion University HospitalUniversity of CreteHeraklionGreece
| | - Dimitrios Margaritis
- Department of HematologyDemocritus University of Thrace Medical SchoolAlexandroupolisGreece
| | | | - Eurydiki Michalis
- Department of Clinical Hematology“G.Gennimatas” Athens General HospitalAthensGreece
| | | | | | | | - Zoi Bousiou
- Hematology and Bone Marrow Transplantation DepartmentGeneral Hospital of Thessaloniki PapanikolaouThessalonikiGreece
| | - Elias Poulakidas
- Department of Hematology401 Military Hospital of AthensAthensGreece
| | | | | | - Gerassimos A. Pangalis
- Department of HematologyDemocritus University of Thrace Medical SchoolAlexandroupolisGreece
| | - Achilles Anagnostopoulos
- Hematology and Bone Marrow Transplantation DepartmentGeneral Hospital of Thessaloniki PapanikolaouThessalonikiGreece
| | - Panagiotis Tsirigotis
- 2nd Department of Internal Medicine, Faculty of Medicine, ATTIKON General University HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
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Tsirigotis P, Liga M, Gkirkas K, Stamouli M, Triantafyllou E, Marangos M, Pessach I, Sarantopoulos A, Spyridis N, Spyridonidis A. Low-dose alemtuzumab for GvHD prevention followed by prophylactic donor lymphocyte infusions in high-risk leukemia. Bone Marrow Transplant 2016; 52:445-451. [PMID: 27941776 DOI: 10.1038/bmt.2016.272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 08/09/2016] [Accepted: 08/16/2016] [Indexed: 12/19/2022]
Abstract
We analyzed the use of low-dose alemtuzumab in a cohort of 158 consecutive patients who underwent allogeneic PBSC transplantation. Patients with high-risk acute leukemia were prospectively screened for prophylactic donor lymphocyte infusion (pDLI). Lymphocytes were administered repeatedly at low and non-escalating doses (0.5-1 × 106/kg). Low-dose alemtuzumab was effective in prevention of acute GvHD after sibling or well-matched unrelated transplantation, whereas a more intensified approach was needed after mismatched transplantation. The cumulative incidence of chronic moderate/severe chronic-GvHD (cGvHD) was 15.6%. In total, 63 high-risk leukemia patients were eligible for pDLI. Only 1 out of the 39 pDLI recipients relapsed as compared with 7 out of the 24 recipients, who did not receive pDLI due to logistical hurdles. In multivariate analysis, the use of adjuvant lymphocyte therapy was significantly associated with reduced incidence of relapse and improved disease-free survival. In summary, low-dose alemtuzumab confers to a low cGvHD incidence and the administration of pDLIs in this context is very likely to reduce relapse risk in high risk leukemia patients. This is translated in an estimated 5-year probability of GvHD-free and relapse-free survival of 43.3% for the 136 leukemia patients.
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Affiliation(s)
- P Tsirigotis
- BMT Unit, Department of Internal Medicine, 'Attikon' University Hospital of Athens, Athens, Greece
| | - M Liga
- BMT Unit, Department of Internal Medicine, University Hospital of Patras, Rio, Greece
| | - K Gkirkas
- BMT Unit, Department of Internal Medicine, 'Attikon' University Hospital of Athens, Athens, Greece
| | - M Stamouli
- BMT Unit, Department of Internal Medicine, 'Attikon' University Hospital of Athens, Athens, Greece
| | - E Triantafyllou
- BMT Unit, Department of Internal Medicine, University Hospital of Patras, Rio, Greece
| | - M Marangos
- BMT Unit, Department of Internal Medicine, University Hospital of Patras, Rio, Greece
| | - I Pessach
- BMT Unit, Department of Internal Medicine, 'Attikon' University Hospital of Athens, Athens, Greece
| | - A Sarantopoulos
- BMT Unit, Department of Internal Medicine, University Hospital of Patras, Rio, Greece
| | - N Spyridis
- BMT Unit, Department of Internal Medicine, University Hospital of Patras, Rio, Greece
| | - A Spyridonidis
- BMT Unit, Department of Internal Medicine, University Hospital of Patras, Rio, Greece
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Maulucci G, Cohen O, Daniel B, Sansone A, Petropoulou PI, Filou S, Spyridonidis A, Pani G, De Spirito M, Chatgilialoglu C, Ferreri C, Kypreos KE, Sasson S. Fatty acid-related modulations of membrane fluidity in cells: detection and implications. Free Radic Res 2016; 50:S40-S50. [PMID: 27593084 DOI: 10.1080/10715762.2016.1231403] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Metabolic homeostasis of fatty acids is complex and well-regulated in all organisms. The biosynthesis of saturated fatty acids (SFA) in mammals provides substrates for β-oxidation and ATP production. Monounsaturated fatty acids (MUFA) are products of desaturases that introduce a methylene group in cis geometry in SFA. Polyunsaturated fatty acids (n-6 and n-3 PUFA) are products of elongation and desaturation of the essential linoleic acid and α-linolenic acid, respectively. The liver processes dietary fatty acids and exports them in lipoproteins for distribution and storage in peripheral tissues. The three types of fatty acids are integrated in membrane phospholipids and determine their biophysical properties and functions. This study was aimed at investigating effects of fatty acids on membrane biophysical properties under varying nutritional and pathological conditions, by integrating lipidomic analysis of membrane phospholipids with functional two-photon microscopy (fTPM) of cellular membranes. This approach was applied to two case studies: first, pancreatic beta-cells, to investigate hormetic and detrimental effects of lipids. Second, red blood cells extracted from a genetic mouse model defective in lipoproteins, to understand the role of lipids in hepatic diseases and metabolic syndrome and their effect on circulating cells.
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Affiliation(s)
- G Maulucci
- a Institute of Physics, Università Cattolica del Sacro Cuore , Roma , Italy
| | - O Cohen
- b Institute for Drug Research, Section of Pharmacology, Diabetes Research Unit, Faculty of Medicine , The Hebrew University , Jerusalem , Israel
| | - B Daniel
- b Institute for Drug Research, Section of Pharmacology, Diabetes Research Unit, Faculty of Medicine , The Hebrew University , Jerusalem , Israel
| | - A Sansone
- c ISOF, BioFreeRadicals Group, Consiglio Nazionale delle Ricerche , Bologna , Italy
| | - P I Petropoulou
- d Department of Pharmacology , University of Patras Medical School , Rio , Greece
| | - S Filou
- d Department of Pharmacology , University of Patras Medical School , Rio , Greece
| | - A Spyridonidis
- e Hematology Department , University of Patras Medical School , Rio , Greece
| | - G Pani
- f Institute of General Pathology, Università Cattolica del Sacro Cuore , Roma , Italy
| | - M De Spirito
- a Institute of Physics, Università Cattolica del Sacro Cuore , Roma , Italy
| | - C Chatgilialoglu
- c ISOF, BioFreeRadicals Group, Consiglio Nazionale delle Ricerche , Bologna , Italy
| | - C Ferreri
- c ISOF, BioFreeRadicals Group, Consiglio Nazionale delle Ricerche , Bologna , Italy
| | - K E Kypreos
- d Department of Pharmacology , University of Patras Medical School , Rio , Greece
| | - S Sasson
- b Institute for Drug Research, Section of Pharmacology, Diabetes Research Unit, Faculty of Medicine , The Hebrew University , Jerusalem , Israel
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Tsirigotis P, Danylesko I, Gkirkas K, Shem-Tov N, Yerushalmi R, Stamouli M, Avigdor A, Spyridonidis A, Gauthier J, Goldstein G, Apostolidis J, Mohty M, Shimoni A, Nagler A. Brentuximab vedotin in combination with or without donor lymphocyte infusion for patients with Hodgkin lymphoma after allogeneic stem cell transplantation. Bone Marrow Transplant 2016; 51:1313-1317. [DOI: 10.1038/bmt.2016.129] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/29/2016] [Accepted: 04/01/2016] [Indexed: 11/09/2022]
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Gerasimou P, Skordis N, Picolos M, Spyridonidis A, Costeas P. HLA-G 14-bp polymorphism affects the age of onset in Type I Diabetes Mellitus. Int J Immunogenet 2016; 43:135-42. [PMID: 27080982 DOI: 10.1111/iji.12259] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 02/02/2016] [Accepted: 03/10/2016] [Indexed: 02/06/2023]
Abstract
Type I diabetes mellitus (T1DM) is an organ-specific autoimmune disorder affecting the insulin-producing pancreatic cells. T1DM genetic association studies have so far revealed the involvement of more than 40 loci, with particularly strong associations for the human leucocyte antigens (HLA). Further to the well-established HLA class II associations, the immunomodulatory elements in the telomeric major histocompatibility complex locus, specifically nonclassical HLA class I, were also associated with T1DM, either in conferring susceptibility or by contributing to the overall pathogenesis. This study investigates the involvement of a 14-bp deletion polymorphism (rs371194629) at the 3' untranslated region of HLA-G in the context of T1DM and age of onset. The frequency of the polymorphism was determined in unrelated T1DM Cypriot patients and findings that emerge from this study show a strong association between the HLA-G 14-bp polymorphism and T1DM with respect to the age of onset. Specifically, the deletion/deletion (DEL/DEL) genotype was found to be associated with an early age of onset (P = 0.001), while the presence of the insertion allele (INS) was associated to a later age of onset (P = 0.0001), portraying a possible dominant effect over the deletion allele, a role in delaying disease onset and an overall involvement of HLA-G in the pathogenesis of type I diabetes mellitus.
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Affiliation(s)
- P Gerasimou
- Karaiskakio Foundation, Nicosia, Cyprus.,Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus
| | - N Skordis
- Division of Paediatric Endocrinology, Paedi Centre for Specialized Paediatrics, Nicosia, Cyprus
| | - M Picolos
- Alithia Endocrinology Centre, Nicosia, Cyprus
| | - A Spyridonidis
- Division of Hematology/BMT Unit, University Hospital of Patras (PGNP), Rio, Greece
| | - P Costeas
- Karaiskakio Foundation, Nicosia, Cyprus
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Zeiser R, Burchert A, Lengerke C, Verbeek M, Maas-Bauer K, Metzelder SK, Spoerl S, Ditschkowski M, Ecsedi M, Sockel K, Ayuk F, Ajib S, de Fontbrune FS, Na IK, Penter L, Holtick U, Wolf D, Schuler E, Meyer E, Apostolova P, Bertz H, Marks R, Lübbert M, Wäsch R, Scheid C, Stölzel F, Ordemann R, Bug G, Kobbe G, Negrin R, Brune M, Spyridonidis A, Schmitt-Gräff A, van der Velden W, Huls G, Mielke S, Grigoleit GU, Kuball J, Flynn R, Ihorst G, Du J, Blazar BR, Arnold R, Kröger N, Passweg J, Halter J, Socié G, Beelen D, Peschel C, Neubauer A, Finke J, Duyster J, von Bubnoff N. Ruxolitinib in corticosteroid-refractory graft-versus-host disease after allogeneic stem cell transplantation: a multicenter survey. Leukemia 2015; 29:2062-8. [PMID: 26228813 DOI: 10.1038/leu.2015.212] [Citation(s) in RCA: 384] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 07/23/2015] [Accepted: 07/24/2015] [Indexed: 12/15/2022]
Abstract
Despite major improvements in allogeneic hematopoietic cell transplantation over the past decades, corticosteroid-refractory (SR) acute (a) and chronic (c) graft-versus-host disease (GVHD) cause high mortality. Preclinical evidence indicates the potent anti-inflammatory properties of the JAK1/2 inhibitor ruxolitinib. In this retrospective survey, 19 stem cell transplant centers in Europe and the United States reported outcome data from 95 patients who had received ruxolitinib as salvage therapy for SR-GVHD. Patients were classified as having SR-aGVHD (n=54, all grades III or IV) or SR-cGVHD (n=41, all moderate or severe). The median number of previous GVHD-therapies was 3 for both SR-aGVHD (1-7) and SR-cGVHD (1-10). The overall response rate was 81.5% (44/54) in SR-aGVHD including 25 complete responses (46.3%), while for SR-cGVHD the ORR was 85.4% (35/41). Of those patients responding to ruxolitinib, the rate of GVHD-relapse was 6.8% (3/44) and 5.7% (2/35) for SR-aGVHD and SR-cGVHD, respectively. The 6-month-survival was 79% (67.3-90.7%, 95% confidence interval (CI)) and 97.4% (92.3-100%, 95% CI) for SR-aGVHD and SR-cGVHD, respectively. Cytopenia and cytomegalovirus-reactivation were observed during ruxolitinib treatment in both SR-aGVHD (30/54, 55.6% and 18/54, 33.3%) and SR-cGVHD (7/41, 17.1% and 6/41, 14.6%) patients. Ruxolitinib may constitute a promising new treatment option for SR-aGVHD and SR-cGVHD that should be validated in a prospective trial.
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Affiliation(s)
- R Zeiser
- Department of Hematology, Oncology and Stem Cell Transplantation, Freiburg University Medical Center, Freiburg, Germany
| | - A Burchert
- Department of Hematology, Oncology and Immunology, Philipps University Marburg, and University Medical Center Giessen and Marburg, Marburg, Germany
| | - C Lengerke
- Division of Hematology, University Hospital of Basel, Basel, Switzerland
| | - M Verbeek
- III Department of Internal Medicine, Technical University of Munich, Munich, Germany
| | - K Maas-Bauer
- Department of Hematology, Oncology and Stem Cell Transplantation, Freiburg University Medical Center, Freiburg, Germany
| | - S K Metzelder
- Department of Hematology, Oncology and Immunology, Philipps University Marburg, and University Medical Center Giessen and Marburg, Marburg, Germany
| | - S Spoerl
- III Department of Internal Medicine, Technical University of Munich, Munich, Germany
| | - M Ditschkowski
- Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - M Ecsedi
- Division of Hematology, University Hospital of Basel, Basel, Switzerland
| | - K Sockel
- Department of Hematology and Oncology, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - F Ayuk
- Department of Stem Cell Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - S Ajib
- Department of Internal Medicine II, University Hospital, Frankfurt/Main, Germany
| | - F S de Fontbrune
- Hematology Stem cell transplant Unit, Saint Louis Hospital, APHP, Paris, France
| | - I-K Na
- Department of Stem Cell Transplantation, Charité University Medicine Berlin, Berlin, Germany
| | - L Penter
- Department of Stem Cell Transplantation, Charité University Medicine Berlin, Berlin, Germany
| | - U Holtick
- Department of Internal Medicine I, University Hospital Cologne, Cologne, Germany
| | - D Wolf
- Medical Clinic III, Oncology, Hematology and Rheumatology, University Hospital Bonn (UKB), Bonn, Germany
| | - E Schuler
- Department of Hematology, Oncology and Clinical Immunology, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - E Meyer
- Department of Bone Marrow Transplantation, Stanford University Medical School, Stanford, CA, USA
| | - P Apostolova
- Department of Hematology, Oncology and Stem Cell Transplantation, Freiburg University Medical Center, Freiburg, Germany
| | - H Bertz
- Department of Hematology, Oncology and Stem Cell Transplantation, Freiburg University Medical Center, Freiburg, Germany
| | - R Marks
- Department of Hematology, Oncology and Stem Cell Transplantation, Freiburg University Medical Center, Freiburg, Germany
| | - M Lübbert
- Department of Hematology, Oncology and Stem Cell Transplantation, Freiburg University Medical Center, Freiburg, Germany
| | - R Wäsch
- Department of Hematology, Oncology and Stem Cell Transplantation, Freiburg University Medical Center, Freiburg, Germany
| | - C Scheid
- Department of Internal Medicine I, University Hospital Cologne, Cologne, Germany
| | - F Stölzel
- Department of Hematology and Oncology, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - R Ordemann
- Department of Hematology and Oncology, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - G Bug
- Department of Internal Medicine II, University Hospital, Frankfurt/Main, Germany
| | - G Kobbe
- Department of Hematology, Oncology and Clinical Immunology, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - R Negrin
- Department of Bone Marrow Transplantation, Stanford University Medical School, Stanford, CA, USA
| | - M Brune
- Department of Internal Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - A Spyridonidis
- Department of Bone Marrow Transplantation, Patras University Medical School, Patras, Greece
| | - A Schmitt-Gräff
- Department of Pathology, Freiburg University Medical Center, Freiburg, Germany
| | | | - G Huls
- Radboud University Medical Centre, Nijmegen, The Netherlands
| | - S Mielke
- Department of Hematology and Oncology, University Medical Centre Würzburg, Würzburg, Germany
| | - G U Grigoleit
- Department of Hematology and Oncology, University Medical Centre Würzburg, Würzburg, Germany
| | - J Kuball
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Flynn
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - G Ihorst
- Clinical Trials Unit, Department of Hematology, Freiburg University Medical Center, Freiburg, Germany
| | - J Du
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - B R Blazar
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - R Arnold
- Department of Stem Cell Transplantation, Charité University Medicine Berlin, Berlin, Germany
| | - N Kröger
- Department of Stem Cell Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - J Passweg
- Division of Hematology, University Hospital of Basel, Basel, Switzerland
| | - J Halter
- Division of Hematology, University Hospital of Basel, Basel, Switzerland
| | - G Socié
- Hematology Stem cell transplant Unit, Saint Louis Hospital, APHP, Paris, France
| | - D Beelen
- Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - C Peschel
- III Department of Internal Medicine, Technical University of Munich, Munich, Germany
| | - A Neubauer
- Department of Hematology, Oncology and Immunology, Philipps University Marburg, and University Medical Center Giessen and Marburg, Marburg, Germany
| | - J Finke
- Department of Hematology, Oncology and Stem Cell Transplantation, Freiburg University Medical Center, Freiburg, Germany
| | - J Duyster
- Department of Hematology, Oncology and Stem Cell Transplantation, Freiburg University Medical Center, Freiburg, Germany
| | - N von Bubnoff
- Department of Hematology, Oncology and Stem Cell Transplantation, Freiburg University Medical Center, Freiburg, Germany
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Tsirigotis P, Resnick IB, Kapsimalli V, Dray L, Psarra E, Samuel S, Spyridonidis A, Konsta E, Vikentiou M, Or R, Slavin S, Shapira MY. Irradiated mononuclear cells express significant in vitro cytotoxic activity: promise for in vivo clinical efficacy of irradiated mismatched donor lymphocytes infusion. Immunotherapy 2014; 6:409-17. [PMID: 24815781 DOI: 10.2217/imt.14.10] [Citation(s) in RCA: 6] [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] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Relapse of the original disease remains the most common cause of treatment failure after allogeneic hematopoietic stem cell transplantation (allo-SCT). Patients who relapse post-allo-SCT can achieve prolonged remission after donor lymphocyte infusion. Donor lymphocyte infusion as well as other immunotherapeutic strategies are usually complicated by severe graft versus host disease. AIM In the present study, we examined the effect of irradiation on the cytotoxic activity of mononuclear cells (MNCs). MATERIALS & METHODS Cytotoxic activity of fresh and irradiated MNCs from healthy donors was tested against the leukemic cell line K562 and against fresh leukemic cells from patients with acute myeloid leukemia. Cytotoxicity was assessed by using a flow-cytometry assay. RESULTS & DISCUSSION Interestingly, we observed that 25 Gy irradiated MNCs retain significant cytotoxic activity against K562. Based on these in vitro data, the safety and efficacy of irradiated haploidentical, IL-2-activated lymphocytes were tested in six patients after allo-SCT. Acute skin graft versus host disease developed in two patients and was resolved after a short course of steroids. One patient with mixed chimera converted to full donor chimera after infusion of irradiated donor cells. CONCLUSION The efficacy of irradiated haploidentical lymphocytes should be further tested in a larger number of patients.
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Affiliation(s)
- Panagiotis Tsirigotis
- Second Department of Internal Medicine, Medical School, National & Kapodistrian University of Athens, Greece
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Gamaletsou MN, Walsh TJ, Zaoutis T, Pagoni M, Kotsopoulou M, Voulgarelis M, Panayiotidis P, Vassilakopoulos T, Angelopoulou MK, Marangos M, Spyridonidis A, Kofteridis D, Pouli A, Sotiropoulos D, Matsouka P, Argyropoulou A, Perloretzou S, Leckerman K, Manaka A, Oikonomopoulos P, Daikos G, Petrikkos G, Sipsas NV. A prospective, cohort, multicentre study of candidaemia in hospitalized adult patients with haematological malignancies. Clin Microbiol Infect 2013; 20:O50-7. [PMID: 23889746 DOI: 10.1111/1469-0691.12312] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 03/22/2013] [Accepted: 06/19/2013] [Indexed: 01/06/2023]
Abstract
Invasive candidiasis is a life-threatening infection in patients with haematological malignancies. The objective of our study was to determine the incidence, microbiological characteristics and clinical outcome of candidaemia among hospitalized adult patients with haematological malignancies. This is a population-based, prospective, multicentre study of patients ≥ 18 years admitted to haematology and/or haematopoietic stem cell transplantation units of nine tertiary care Greek hospitals from January 2009 through to February 2012. Within this cohort, we conducted a nested case-control study to determine the risk factors for candidaemia. Stepwise logistic regression was used to identify independent predictors of 28-day mortality. Candidaemia was detected in 40 of 27,864 patients with haematological malignancies vs. 967 of 1,158,018 non-haematology patients for an incidence of 1.4 cases/1000 admissions vs. 0.83/1000 respectively (p <0.001). Candidaemia was caused predominantly (35/40, 87.5%) by non-Candida albicans species, particularly Candida parapsilosis (20/40, 50%). In vitro resistance to at least one antifungal agent was observed in 27% of Candida isolates. Twenty-one patients (53%) developed breakthrough candidaemia while receiving antifungal agents. Central venous catheters, hypogammaglobulinaemia and a high APACHE II score were independent risk factors for the development of candidaemia. Crude mortality at day 28 was greater in those with candidaemia than in control cases (18/40 (45%) vs. 9/80 (11%); p <0.0001). In conclusion, despite antifungal prophylaxis, candidaemia is a relatively frequent infection associated with high mortality caused by non-C. albicans spp., especially C. parapsilosis. Central venous catheters and hypogammaglobulinaemia are independent risk factors for candidaemia that provide potential targets for improving the outcome.
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Affiliation(s)
- M N Gamaletsou
- Laikon General Hospital and Medical School, National and Kapodistrian University of Athens, Athens, Greece; Weill Cornell Medical Center of Cornell University, New York, NY, USA
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14
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Kelaidi C, Sakellari I, Tzannou I, Liga M, Spyridonidis A, Tsirigotis P, Papaioannou G, Mallouri D, Batsis I, Karakasis D, Baltadakis I, Harhalakis N, Athanasiadou A, Anagnostopoulos A. P-213 Impact of individual cytogenetic abnormalities, IPSS-R karyotype and monosomal karyotype on outcomes after allogeneic HCT for MDS/sAML. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70260-1] [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: 10/26/2022]
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15
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Spyridonidis A, Labopin M, Schmid C, Volin L, Yakoub-Agha I, Stadler M, Milpied N, Socie G, Browne P, Lenhoff S, Sanz MA, Aljurf M, Mohty M, Rocha V. Outcomes and prognostic factors of adults with acute lymphoblastic leukemia who relapse after allogeneic hematopoietic cell transplantation. An analysis on behalf of the Acute Leukemia Working Party of EBMT. Leukemia 2012; 26:1211-7. [PMID: 22290066 DOI: 10.1038/leu.2011.351] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
To describe outcomes, treatment and prognostic factors that influence survival of adult patients with acute lymphoblastic leukemia (ALL), who relapsed after allogeneic hematopoietic cell transplantation (HCT), we retrospectively analyzed 465 ALL adult patients from European Group for Blood and Marrow Transplantation (EBMT) centers who relapsed after a first HCT performed in complete remission (CR1 65%, CR2/3 35%). Salvage treatments were: supportive care (13%), cytoreductive therapy (43%), donor lymphocyte infusion without or with prior chemotherapy (23%) and second HCT (20%). Median time from HCT to relapse was 6.9 months, median follow-up was 46 months and median survival after relapse was 5.5 months. Estimated 1-, 2- and 5-year post-relapse survival was 30 ± 2%, 16 ± 2% and 8 ± 1%, respectively. In a multivariate analysis, adverse factors for survival were: late CR (CR2/3) at transplant (P<0.012), early relapse after transplant (<6.9 months, P <0.0001) and peripheral blast percent at relapse (P <0.0001). On the basis of multivariate model for survival, three groups of patients were identified with estimated 2 year survival of 6 ± 2, 17 ± 3 and 30 ± 7%. Outcome of ALL patients relapsing after HCT is dismal and there is a need for new therapies. Our study provides the standard expectations in ALL relapse and may help in the decision of post-relapse therapy.
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Affiliation(s)
- A Spyridonidis
- Division of Hematology , BMT Unit, University of Patras, Patras, Greece.
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16
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Lagadinou ED, Marangos M, Liga M, Panos G, Tzouvara E, Dimitroulia E, Tiniakou M, Tsakris A, Zoumbos N, Spyridonidis A. Human herpesvirus 6-related pure red cell aplasia, secondary graft failure, and clinical severe immune suppression after allogeneic hematopoietic cell transplantation successfully treated with foscarnet. Transpl Infect Dis 2011; 12:437-40. [PMID: 20561301 DOI: 10.1111/j.1399-3062.2010.00515.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Human herpesvirus 6 (HHV-6) is frequently detected after allogeneic hematopoietic cell transplantation (allo-HCT); however, the clinical interpretation of HHV-6 viremia in a transplant patient is challenging as it may signify asymptomatic reactivation, chromosomal integration of the virus genome in the donor or recipient with no clinical significance, or severe HHV-6 disease. Here we present a case of HHV-6 disease after allo-HCT presenting as pure red cell aplasia, secondary graft failure, and severe immunosuppression causing multiple severe bacterial super-infections. Examination of pre-transplant patient and donor samples as well as serial determination of HHV-6 DNA copy numbers after transplantation were necessary to definitively interpret HHV-6 viremia as active HHV-6 infection with a causative role in pancytopenia and immune suppression. Foscarnet treatment resulted both in viral load decline and disappearance of HHV-6-related bone marrow suppression and predisposition to severe infections. Clinicians should be aware of the wide array of clinical manifestations and the diagnostic pitfalls of post-transplant HHV-6 disease. These issues are extremely challenging, as they may result either in dangerous underestimation of HHV-6 disease or in the institution of unnecessary antiviral therapy. Late bone marrow aplasia and late severe infections after allo-HCT without other obvious causes may be HHV-6 related.
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Affiliation(s)
- E D Lagadinou
- Department of Internal Medicine, Patras University Medical Center, Rio/Patras, Greece
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17
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Symeonidis A, Liga M, Triantafyllou E, Kouraklis A, Tiniakou M, Karakantza M, Spyridonidis A, Zoumbos N. Successful mobilization with plerixafor and autologous hematopoietic SCT in a patient with refractory Hodgkin's lymphoma and Gaucher disease. Bone Marrow Transplant 2010; 46:1161-2. [DOI: 10.1038/bmt.2010.263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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18
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Spyridonidis A, Waterhouse M, Themeli M, Bertz H, Petrikkos L, Lagadinou E, Zoumbos N, Finke J. DNA Transfer From Donor To Host Cells As A Mechanism For Epithelial Chimerism And Genomic Alterations After Allogeneic Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.112] [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]
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19
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Waterhouse M, Themeli M, Finke J, Spyridonidis A. Horizontal Gene Transfer Through Apoptotic Bodies Confers A Novel Mechanism Of Epithelial Chimerism After Allogeneic HCT. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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20
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Spyridonidis A, Liga M, Karakantza M, Triantafyllou E, Zoumbos N. Low Dose Alemtuzumab In Vivo Confers An Efficient GvHD Prophylaxis Protocol In Sibling And Matched Unrelated HCT. Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.411] [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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21
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Fourtounas C, Spyridonidis A, Dousdampanis P, Savidaki E, Kalliakmani P, Papachristou E, Goumenos D, Vlachojannis J. Microchimerism in Peripheral Blood and Urine in Renal Transplant Recipients: Preliminary Results. Transplant Proc 2008; 40:3434-6. [PMID: 19100406 DOI: 10.1016/j.transproceed.2008.03.171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Accepted: 03/26/2008] [Indexed: 10/21/2022]
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22
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Spyridonidis A, Bertz H, Waterhouse M, Finke J. Long-term lymphoid-restricted split chimerism after myeloablative allogeneic BMT for bcr-abl+ ALL. Bone Marrow Transplant 2008; 42:829-31. [DOI: 10.1038/bmt.2008.256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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23
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Lagadinou ED, Ziros PG, Tsopra OA, Dimas K, Kokkinou D, Thanopoulou E, Karakantza M, Pantazis P, Spyridonidis A, Zoumbos NC. c-Jun N-terminal kinase activation failure is a new mechanism of anthracycline resistance in acute myeloid leukemia. Leukemia 2008; 22:1899-908. [DOI: 10.1038/leu.2008.192] [Citation(s) in RCA: 31] [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: 01/17/2023]
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24
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Metaxas Y, Spyridonidis A, Bertz H, Finke J, Greiner J. Donor-derived mucosal epithelial cells after human hematopoietic cell transplantation are not derived from the CD34-positive fraction of the graft. Leukemia 2007; 21:2214-6. [PMID: 17541399 DOI: 10.1038/sj.leu.2404759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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25
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Lagadinou E, Ziros P, Tsopra O, Klamargias A, Thanopoulou E, Kouraklis A, Spyridonidis A, Karakantza M, Zoumbos N. P026 Different pattern of JNK activity in MDS-related versus de novo AML: implications for apoptosis-resistance and treatment failure in MDS-related AML. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70096-6] [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: 10/23/2022]
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26
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Heining C, Spyridonidis A, Bernhardt E, Schulte-Mönting J, Behringer D, Grüllich C, Jakob A, Bertz H, Finke J. Lymphocyte reconstitution following allogeneic hematopoietic stem cell transplantation: a retrospective study including 148 patients. Bone Marrow Transplant 2007; 39:613-22. [PMID: 17384658 DOI: 10.1038/sj.bmt.1705648] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Here we investigated the influence of parameters known before hematopoietic stem cell transplantation (HSCT) as well as the relevance of graft-versus-host disease (GvHD) and cytomegalovirus (CMV) reactivation on post transplant lymphocyte reconstitution in 148 patients treated in our institution between 1996 and 2003. Median patient age was 42 (19-68) years, HSCT followed standard high dose (n=91) or reduced-intensity conditioning regimens (n=57) with bone marrow (BM, n=67) or peripheral blood stem cells (PBSC, n=81) from related (n=71) or unrelated (n=77) donors. In the first months, we observed a partially faster reconstitution of CD3+4+, CD3+8+ and CD4+45RA+ T cells in patients following peripheral blood stem cell transplantation when compared to bone marrow transplantation. Prolonged CD3+4+ and CD4+45RA+ lymphopenia was noted after unrelated donor HSCT and GvHD prophylaxis containing anti-T-lymphocyte globulin. Lymphocyte subset counts in patients older than the median age were comparable to those in patients transplanted at a younger age and not influenced by the conditioning regimen. CD3+8+ T cell reconstitution was strongly correlated with CMV reactivation, but not significantly affected by CMV serostatus before HSCT. Incidence or extent of GvHD did not significantly influence lymphocyte reconstitution. Therefore, the source of graft is the most predictive parameter in early lymphocyte reconstitution, but the differences in lymphocyte recovery completely resolved within the first year after HSCT.
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Affiliation(s)
- C Heining
- Department of Hematology/Oncology, University of Freiburg, Hugstetterstrasse 55, Freiburg 79106, Germany
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Spyridonidis A, Faber P, Petrikkos L, Bertz H, Finke J. 55: Alloanatigenic reactions after hematopoietic cell transplantation (HCT) induce genomic alterations in epithelial cells as shown in human studies and in an in vitro model. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.058] [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: 10/23/2022]
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28
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Zouvelou C, Bertz H, Faber P, Finke J, Spyridonidis A. 141: P53 mutations in secondary malignancies after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant 2007. [DOI: 10.1016/j.bbmt.2006.12.145] [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: 10/23/2022]
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29
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Metaxas Y, Zeiser R, Schmitt-Graeff A, Waterhouse M, Faber P, Follo M, Bertz H, Finke J, Spyridonidis A. Human hematopoietic cell transplantation results in generation of donor-derived epithelial cells. Leukemia 2005; 19:1287-9. [PMID: 16074501 DOI: 10.1038/sj.leu.2403789] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Zeiser R, Spyridonidis A, Wäsch R, Ihorst G, Grüllich C, Bertz H, Finke J. Evaluation of immunomodulatory treatment based on conventional and lineage-specific chimerism analysis in patients with myeloid malignancies after myeloablative allogeneic hematopoietic cell transplantation. Leukemia 2005; 19:814-21. [PMID: 15772700 DOI: 10.1038/sj.leu.2403719] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Both conventional chimerism analysis (CCA) and lineage-specific chimerism analysis (LCA) have potential pitfalls as diagnostic means for the detection of minimal residual disease after allogeneic hematopoietic cell transplantation (aHCT). Therefore, the present study examines the results of both methods in order to determine how predictive consecutive evaluations were, with respect to the risk that the patient would relapse during post-transplant follow-up and with respect to responsiveness to immunomodulatory treatment. A total of 168 individuals with acute myeloid leukemia (AML) (n = 137) and myelo dysplastic syndrome (n = 31) were investigated with CCA and LCA at mean intervals of 24 days (range: 11-116). The median follow-up after myeloablative aHCT was 22 months (range: 4-49). Of 168 patients, 65 experienced a clinical relapse after aHCT. CCA and LCA were comparatively sensitive and specific for relapse at the intervals of chimerism testing employed in this study. Of 32 patients, 10 who were offered donor lymphocyte infusions (DLI) treatment for increasing (n = 29) or stable (n = 3) mixed chimerism (MC) achieved at least transitory CC. The observation that all patients with increasing MC relapsed despite DLI treatment (54%) or withdrawal of immune suppression (24%) indicates that novel strategies to deal with rapidly evolving relapse in AML patients, such as shortening of chimerism monitoring intervals, need to be evaluated.
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Affiliation(s)
- R Zeiser
- Department of Hematology and Oncology, Freiburg University Medical Center, Albert-Ludwigs University, Freiburg, Germany
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Zeiser R, Bertz H, Spyridonidis A, Houet L, Finke J. Donor lymphocyte infusions for multiple myeloma: clinical results and novel perspectives. Bone Marrow Transplant 2005; 34:923-8. [PMID: 15361911 DOI: 10.1038/sj.bmt.1704670] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Donor lymphocyte infusions (DLIs) provide effective therapy for patients with various hematological malignancies who have relapsed after allogeneic hematopoietic stem cell transplantation (HSCT). In patients with multiple myeloma (MM), DLIs can induce response rates of 40-52%. DLIs were employed as treatment for MM relapse or as prophylaxis for relapse in MM patients undergoing allo-HSCT. The clinically most relevant treatment-related morbidity with DLIs is the occurrence of graft-versus-host disease (GVHD). Secondly, graft failure and the immune escape of extramedullary plasmocytoma have been reported. The fact that previous clinical reports have documented graft-versus-myeloma (GVM) activity without GVHD suggests that at least two distinct immunocompetent cell populations mediating GVHD and/or GVM may exist. Further characterization of the effector cells such as T cells and/or NK cells and their targets may help to clarify the immune response that mediates the GVM effect. This review considers the results of clinical approaches with DLI for MM, with emphasis on strategies to prevent GVHD while preserving the GVM effect. Furthermore, currently investigated molecular antigenic targets for the GVM effect such as MM-specific idiotypic determinant of immunoglobulin variable regions, several PRAME epitopes and antigenic structures encoded by cancer germline-specific genes as candidates for immunotherapy trials are discussed.
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Affiliation(s)
- R Zeiser
- Department of Hematology and Oncology, Albert Ludwigs University Medical Center Freiburg, Freiburg, Germany
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Spyridonidis A, Thomas AK, Bertz H, Zeiser R, Schmitt-Gräff A, Lindemann A, Waller CF, Finke J. Evidence for a graft-versus-mast-cell effect after allogeneic bone marrow transplantation. Bone Marrow Transplant 2005; 34:515-9. [PMID: 15273711 DOI: 10.1038/sj.bmt.1704627] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Mast cell leukemia (MCL) is a rare form of aggressive mastocytosis with a reported median survival below 6 months. Casuistic reports suggest the effectiveness of allogeneic bone marrow transplantation (BMT) for MCL. However, these reports lack clear evidence for a graft-versus-mast-cell (GvMC) effect. We prospectively investigated the GvMC at different time points after allogeneic BMT and donor-lymphocyte infusions (DLI). Samples were gathered from a patient with MCL treated with allogeneic BMT from an unrelated HLA identical donor. Parameters for detection of a GvMC effect included flow cytometrical analysis of mast cell (MC) populations in peripheral blood and BM, BM smear and histology, chimerism analysis of flow cytometrically sorted BM CD117+/CD34- MC and testing for anti-mast cell reactivity of donor lymphocytes by interferon (IFN)-gamma ELISPOT. DLIs reduced MC from 5 to 0.5%. MC chimerism analysis demonstrated a complete recipient genotype after BMT, suggesting that the persistent mastocytosis was part of residual neoplastic disease. At 3.7 years after BMT, there is some evidence for relapse. In summary, BMT and DLIs attenuated the mastocytosis from an aggressive to an indolent form and may have improved the patients' prognosis. The in vitro data of our study indicate for the first time the existence of a GvMC effect.
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Affiliation(s)
- A Spyridonidis
- Department of Haematology/Oncology, Freiburg University Medical Center, Hugstetterstrasse 55, Freiburg, Germany
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Finke J, Spyridonidis A, Ihorst G, Gruellich C, Zeiser R, Bertz H. Hematopoietic cell transplantation from unrelated and related donors after a fludarabine-alkylator-based regimen is a reasonable treatment option for older patients (>60 years) with active hematologic malignancies. Biol Blood Marrow Transplant 2005. [DOI: 10.1016/j.bbmt.2004.12.185] [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: 10/25/2022]
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Spyridonidis A, Zeiser R, Metaxas Y, Faber P, Finke J. Epithelial chimerism in the oral mucosa after human hematopoietic cell transplantation. Biol Blood Marrow Transplant 2005. [DOI: 10.1016/j.bbmt.2004.12.256] [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: 10/25/2022]
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Spyridonidis A, Fischer KG, Glocker FX, Fetscher S, Klisch J, Behringer D. Paraneoplastic cerebellar degeneration and nephrotic syndrome preceding Hodgkin's disease: case report and review of the literature. Eur J Haematol 2002; 68:318-21. [PMID: 12144540 DOI: 10.1034/j.1600-0609.2002.01635.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A patient presented with symptoms of cerebellar degeneration and nephrotic syndrome. A work-up at that time failed to reveal an underlying disease; however, 20 months later Hodgkin's disease was diagnosed. Hodgkin's lymphadenopathy developed 2 wk after prednisone therapy for the nephrotic syndrome had been discontinued. Systemic polychemotherapy resulted in complete remission of both Hodgkin's disease and nephrotic syndrome, while the neurological deficit persisted. Patients with unexplained cerebellar degeneration and/or nephrotic syndrome demand extensive evaluation for the presence of Hodgkin's disease, and steroid therapy may delay diagnosis.
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Affiliation(s)
- A Spyridonidis
- Departmentof Hematology/Oncology, University Medical Center Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany
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Behringer D, Spyridonidis A, Fetscher S, Schmitt-Gräff A, Högerle S, Kaiser R. Paraneoplastic polyneuropathy preceding the diagnosis of Hodgkin's disease and non-small cell lung cancer in a patient with concomitant Borrelia burgdorferi infection. Ann Hematol 2001; 80:232-5. [PMID: 11401090 DOI: 10.1007/s002770000267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A patient with painful peripheral neuropathy is presented, whose symptoms were thought to result from an infection with Borrelia burgdorferi sensu lato. Investigations of the cerebrospinal fluid for signs of inflammation and borrelial antibodies were negative, and the patient did not benefit from repeated antibiotic treatment. Electrophysiologic studies and sural nerve biopsy showed axonal neuropathy consistent with a paraneoplastic syndrome. Further workup revealed mediastinal Hodgkin's disease (HD; nodular sclerosing subtype) Ann Arbor stage II and non-small cell cancer of the lung (stage T1N0M0). Surgical resection of the lung cancer and combined chemo- and radiotherapy for HD resulted in complete remission of both malignancies. While the preexisting neurologic symptoms persisted during treatment, neurography showed some improvement of the distal nerves. During radiation therapy the patient developed transient left-sided brachial plexopathy. This case illustrates that the diagnosis of borreliosis in patients with isolated painful peripheral neuritis cannot be based solely upon positive IgG titers and supports the requirement for a thorough workup for an underlying--potentially curable--disease. In addition, singular pulmonary lesions in the setting of HD should be suspected to have a separate cause.
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Affiliation(s)
- D Behringer
- Department of Hematology/Oncology, University of Freiburg, Germany.
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Spyridonidis A, Vaith P, Thürl C, Hasler C, Kleinschmidt M, Digel W. [66-year-old patient with anemia, thrombocytopenia and changes in plasma coagulation after surgery of femoral neck fracture]. Internist (Berl) 2001; 42:124-9. [PMID: 11271613 DOI: 10.1007/s001080050730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Spyridonidis
- Medizinische Klinik, Abteilung Innere Medizin I (Hämatologie/Onkologie), Universitätsklinik Freiburg
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Philippczik G, Fehrenbach J, Steinbrückner B, Potthoff K, Spyridonidis A, Lindemann A, Kist M, Bauer TM. Nosocomial diarrhea caused by Salmonella derby infection in two patients on chemotherapy. Clin Microbiol Infect 1999; 5:586-588. [PMID: 11851716 DOI: 10.1111/j.1469-0691.1999.tb00442.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Gabi Philippczik
- Department of Internal Medicine, University Hospital, Hughstetter str. 55, D-79106 Freiburg
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Spyridonidis A, Schollmeyer P, Katzenwadel A, Rump LC. Life-threatening hyperchloraemic acidosis in an azotaemic patient with normal serum creatinine. Nephrol Dial Transplant 1999; 14:1007-9. [PMID: 10328493 DOI: 10.1093/ndt/14.4.1007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Spyridonidis
- Department of Hematology, Freiburg University Medical Centre, Germany
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40
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Spyridonidis A, Bernhardt W, Behringer D, Köhler G, Azemar M, Pflug A, Henschler R. Proliferation and survival of mammary carcinoma cells are influenced by culture conditions used for ex vivo expansion of CD34(+) blood progenitor cells. Blood 1999; 93:746-55. [PMID: 9885238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Malignant cell contamination in autologous transplants is a potential origin of tumor relapse. Ex vivo expansion of CD34(+) blood progenitor cells (BPC) has been proposed as a tool to eliminate tumor cells from autografts. To characterize the influence of culture conditions on survival, growth, and clonogenicity of malignant cells, we isolated primary mammary carcinoma cells from pleural effusions and ascites of patients with metastatic breast cancer and cultured them in the presence of stem cell factor (SCF), interleukin-1beta (IL-1beta), IL-3, IL-6, and erythropoietin (EPO), ie, conditions previously shown to allow efficient ex vivo expansion of CD34(+) BPC. In the presence of serum, tumor cells proliferated during a 7-day culture period and no significant growth-modulatory effect was attributable to the presence of hematopoietic growth factors. When transforming growth factor-beta1 (TGF-beta1) was added to these cultures, proliferation of breast cancer cells was reduced. Expansion of clonogenic tumor cells was seen in the presence of SCF + IL-1beta + IL-3 + IL-6 + EPO, but was suppressed by TGF-beta1. Cocultures of tumor cells in direct cellular contact with hematopoietic cells showed that tumor cell growth could be stimulated by ex vivo expanded hematopoietic cells at high cell densities (5 x 10(5)/mL). In contrast, culture under serum-free conditions resulted in death of greater than 90% of breast cancer cells within 7 days and a further decrease in tumor cell numbers thereafter. In the serum-free cultures, hematopoietic cytokines and cellular contact with CD34(+) BPC could not protect the tumor cells from death. Therefore, ex vivo expansion of CD34(+) BPC in serum-free medium provides an environment for efficient purging of contaminating mammary carcinoma cells. These results have clinical significance for future protocols in autologous progenitor cell transplantation in cancer patients.
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Affiliation(s)
- A Spyridonidis
- Experimental Hematology Group, the Department of Hematology, Freiburg University Medical Center, Freiburg, Germany
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Spyridonidis A, Bernhardt W, Fetscher S, Behringer D, Mertelsmann R, Henschler R. Minimal residual disease in autologous hematopoietic harvests from breast cancer patients. Ann Oncol 1998; 9:821-6. [PMID: 9789603 DOI: 10.1023/a:1008344708061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The increasing use of high-dose chemotherapy with autologous hematopoietic transplantation for the treatment of solid malignancies has raised concern about the role of tumor cells contaminating the grafts. Minimal residual disease (MRD) in autologous grafts has became a dynamic and intensively studied field in oncology. This review discusses the current status of MRD in breast cancer autografts and presents existing data on detection methodology, clinical relevance, biologic characteristics and purging techniques.
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Affiliation(s)
- A Spyridonidis
- Department of Hematology/Oncology, University Medical Center, Freiburg, Germany
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Spyridonidis A, Schmidt M, Bernhardt W, Papadimitriou A, Azemar M, Wels W, Groner B, Henschler R. Purging of mammary carcinoma cells during ex vivo culture of CD34+ hematopoietic progenitor cells with recombinant immunotoxins. Blood 1998; 91:1820-7. [PMID: 9473251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Tumor cells have been found in autologous hematopoietic cell transplants used after high-dose chemotherapy. To specifically eliminate contaminating mammary tumor cells during ex vivo expansion of CD34+ hematopoietic progenitor cells, we used recombinant immunotoxins (ITs) directed against cell-surface antigens expressed on mammary carcinoma cells. ITs were expressed from fusion cDNAs combining a single-chain antibody fragment (scFv) directed against the Erb-B2 or epidermal growth factor (EGF) receptors with a truncated Pseudomonas exotoxin A fragment devoid of its cell-binding domain. CD34+ hematopoietic progenitor cells did not express Erb-B2 and EGF receptors as detected by Western blotting. Ex vivo expansion of total hematopoietic cells or of colony-forming cells from CD34+ progenitors in the presence of stem-cell factor (SCF), interleukin-1 (IL-1), IL-3, IL-6, and erythropoietin (Epo) was not affected when ITs were added to the cultures. In contrast, MDA-MB 453 and MCF-7 mammary carcinoma cells were depleted in a dose- and time-dependent manner by more than 3 log in coculture with CD34+ cells over a period of 7 days in the presence of 100 to 1,000 ng/mL of anti-Erb-B2 IT. This included elimination of the subpopulations with regrowth potential. Similarly, addition of either anti-Erb-B2 or anti-EGF receptor ITs to primary breast cancer cells isolated from patients with metastatic disease resulted in elimination of cytokeratin-positive cells in seven of seven samples. ITs are highly efficient and convenient to use for the depletion of mammary tumor cells during ex vivo expansion of hematopoietic progenitor-cell autografts.
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Affiliation(s)
- A Spyridonidis
- Department of Hematology/Oncology, University Medical Center, Freiburg, Germany
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Garbe A, Spyridonidis A, Möbest D, Schmoor C, Mertelsmann R, Henschler R. Transforming growth factor-beta 1 delays formation of granulocyte-macrophage colony-forming cells, but spares more primitive progenitors during ex vivo expansion of CD34+ haemopoietic progenitor cells. Br J Haematol 1997; 99:951-8. [PMID: 9432049 DOI: 10.1046/j.1365-2141.1997.4893291.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Ex vivo culture and expansion of autologous haemopoietic transplants has been developed to improve tumour cell purging and accelerate haemopoietic reconstitution by transplantation of increased progenitor cell numbers. We studied the effect of the negative haemopoietic regulator, transforming growth factor beta-1 (TGF-beta 1) on primitive precursors during ex vivo expansion of CD34+ cells. When added directly to methylcellulose colony-forming assays, TGF-beta 1 potently suppressed the development of granulocyte-macrophage colonies from CD34+ enriched peripheral blood progenitor cells (80-90% inhibition). In contrast, expansion of total nucleated cells and granulocyte-macrophage colony-forming cells (GM-CFC) from CD34+ progenitors in liquid culture in the presence of stem cell factor (SCF), interleukin (IL)-1 beta, IL-3, IL-6 and erythropoietin (EPO) was inhibited to 32-65% of control culture levels within 14 d when TGF-beta 1 was added, and still produced an average 3.3-fold absolute amplification of GM-CFC. The inhibitory effect of TGF-beta 1 on GM-CFC generation was reversed when it was washed out on day 6 of ex vivo expansion cultures, and total numbers of GM-CFC generated from expansion cultures then reached levels of untreated controls by day 16. Long-term bone marrow culture-initiating cell (LTCIC) numbers were preserved, at least at input levels, over a culture period of 14 d both in control and TGF-beta-1-treated expansion cultures. These findings suggest that TGF-beta 1, a cytokine which induces apoptosis or terminal differentiation in a number of malignant cell types, may be added to ex vivo expansion cultures without loss of primitive cells from autologous haemopoietic transplants.
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Affiliation(s)
- A Garbe
- Department of Haematology/Oncology, Freiburg University Medical Centre, Germany
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Abstract
The use of colony-stimulating factors to stimulate hematopoietic cell proliferation and differentiation in vivo is under still increasing investigation, particularly in the field of stem cell transplantation. This review discusses recently published results and tries to extrapolate lines of future development from the achievements reached to date.
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Affiliation(s)
- A Spyridonidis
- Department of Hematology/Oncology, Albert-Ludwigs-Universität Freiburg, Germany
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