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Salmanton-García J, Marchesi F, Farina F, Weinbergerová B, Itri F, Dávila-Valls J, Martín-Pérez S, Glenthøj A, Hersby DS, Gomes da Silva M, Nunes Rodrigues R, López-García A, Córdoba R, Bilgin YM, Falces-Romero I, El-Ashwah S, Emarah Z, Besson C, Kohn M, Van Doesum J, Ammatuna E, Marchetti M, Labrador J, Zambrotta GPM, Verga L, Jaksic O, Nucci M, Piukovics K, Cabirta-Touzón A, Jiménez M, Arellano E, Espigado I, Blennow O, Nordlander A, Meers S, van Praet J, Aiello TF, Garcia-Vidal C, Fracchiolla N, Sciumè M, Seval GC, Žák P, Buquicchio C, Tascini C, Gräfe SK, Schönlein M, Adžić-Vukičević T, Bonuomo V, Cattaneo C, Nizamuddin S, Čerňan M, Plantefeve G, Prin R, Szotkovski T, Collins GP, Dargenio M, Petzer V, Wolf D, Čolović N, Prezioso L, Valković T, Passamonti F, Méndez GA, Sili U, Vena A, Bavastro M, Limongelli A, Duarte RF, Ledoux MP, Cvetanoski M, Stojanoski Z, Machado M, Batinić J, Magliano G, Biernat MM, Pantić N, Poulsen CB, Cuccaro A, Del Principe MI, Kulasekararaj A, Ormazabal-Vélez I, Busca A, Demirkan F, Ijaz M, Klimko N, Stoma I, Khostelidi S, Fernández N, Omrani AS, Bergantim R, De Jonge N, Fouquet G, Navrátil M, Abu-Zeinah G, Samarkos M, Maertens J, De Ramón C, Guidetti A, Magyari F, González-López TJ, Lahmer T, Finizio O, Ali N, Pinczés LI, Lavilla-Rubira E, Romano A, Merelli M, Delia M, Calbacho M, Meletiadis J, Antić D, Hernández-Rivas JÁ, Marques de Almeida J, Al-Khabori M, Hoenigl M, Tisi MC, Khanna N, Barać A, Eisa N, Di Blasi R, Liévin R, Miranda-Castillo C, Bahr NC, Lamure S, Papa MV, Yahya A, Aujayeb A, Novák J, Erben N, Fernández-Galán M, Ribera-Santa Susana JM, Rinaldi I, Fazzi R, Piedimonte M, Duléry R, Gonzaga Y, Soto-Silva A, Sapienza G, Serris A, Drgoňa Ľ, Groh A, Serrano L, Gavriilaki E, Tragiannidis A, Prattes J, Coppola N, Otašević V, Mladenović M, Mitrović M, Mišković B, Jindra P, Zompi S, Sacchi MV, Krekeler C, Infante MS, García-Bordallo D, Çolak GM, Mayer J, Nygaard M, Hanáková M, Ráčil Z, Bonanni M, Koehler P, Rahimli L, Cornely OA, Pagano L. Decoding the historical tale: COVID-19 impact on haematological malignancy patients-EPICOVIDEHA insights from 2020 to 2022. EClinicalMedicine 2024; 71:102553. [PMID: 38533127 PMCID: PMC10963230 DOI: 10.1016/j.eclinm.2024.102553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
Background The COVID-19 pandemic heightened risks for individuals with hematological malignancies due to compromised immune systems, leading to more severe outcomes and increased mortality. While interventions like vaccines, targeted antivirals, and monoclonal antibodies have been effective for the general population, their benefits for these patients may not be as pronounced. Methods The EPICOVIDEHA registry (National Clinical Trials Identifier, NCT04733729) gathers COVID-19 data from hematological malignancy patients since the pandemic's start worldwide. It spans various global locations, allowing comprehensive analysis over the first three years (2020-2022). Findings The EPICOVIDEHA registry collected data from January 2020 to December 2022, involving 8767 COVID-19 cases in hematological malignancy patients from 152 centers across 41 countries, with 42% being female. Over this period, there was a significant reduction in critical infections and an overall decrease in mortality from 29% to 4%. However, hospitalization, particularly in the ICU, remained associated with higher mortality rates. Factors contributing to increased mortality included age, multiple comorbidities, active malignancy at COVID-19 onset, pulmonary symptoms, and hospitalization. On the positive side, vaccination with one to two doses or three or more doses, as well as encountering COVID-19 in 2022, were associated with improved survival. Interpretation Patients with hematological malignancies still face elevated risks, despite reductions in critical infections and overall mortality rates over time. Hospitalization, especially in ICUs, remains a significant concern. The study underscores the importance of vaccination and the timing of COVID-19 exposure in 2022 for enhanced survival in this patient group. Ongoing monitoring and targeted interventions are essential to support this vulnerable population, emphasizing the critical role of timely diagnosis and prompt treatment in preventing severe COVID-19 cases. Funding Not applicable.
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Affiliation(s)
- Jon Salmanton-García
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Barbora Weinbergerová
- Masaryk University and University Hospital Brno - Department of Internal Medicine, Hematology and Oncology, Brno, Czech Republic
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | | | | | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ditte Stampe Hersby
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | | | - Alberto López-García
- Fundación Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Raúl Córdoba
- Fundación Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | | | - Iker Falces-Romero
- Microbiology and Parasitology Department, University Hospital La Paz, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
- King Abdullah Medical City, Makkah, Saudi Arabia
| | - Caroline Besson
- Centre Hospitalier de Versailles, Le Chesnay, France
- Université Paris-Saclay, UVSQ, Inserm, Équipe “Exposome et Hérédité”, CESP, Villejuif, France
| | - Milena Kohn
- Centre Hospitalier de Versailles, Le Chesnay, France
- Université Paris-Saclay, UVSQ, Inserm, Équipe “Exposome et Hérédité”, CESP, Villejuif, France
| | | | | | - Monia Marchetti
- Hematology and Transplant Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain
| | | | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | | | - Marcio Nucci
- Department of Internal Medicine, Federal University of Rio de Janeiro and Grupo Oncoclinicas, Rio de Janeiro, Brazil
| | - Klára Piukovics
- Department of Internal Medicine, South Division Faculty of Medicine University of Szeged, Szeged, Hungary
| | - Alba Cabirta-Touzón
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Moraima Jiménez
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Jens van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Tommaso Francesco Aiello
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Carolina Garcia-Vidal
- Department of Infectious Diseases, Hospital Clinic de Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Nicola Fracchiolla
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mariarita Sciumè
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | | | - Carlo Tascini
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | | | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Summiya Nizamuddin
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Martin Čerňan
- University Hospital Olomouc, Olomouc, Czech Republic
| | - Gaëtan Plantefeve
- Head ICU and CRC, Centre Hospitalier Victor DUPOUY, Argenteuil, France
| | - Romane Prin
- CRA from CRC Centre Hospitalier Victor DUPOUY, Argenteuil, France
| | | | | | | | - Verena Petzer
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Dominik Wolf
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | | | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Toni Valković
- University Hospital Centre Rijeka, Rijeka, Croatia
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Croatia
- Faculty of Medicine and Faculty of Health Studies of University of Rijeka, Rijeka, Croatia
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | | | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | | | | | | | | | | | | | | | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Josip Batinić
- Croatian Cooperative Group for Hematological Diseases (CROHEM), Croatia
- University Hospital Centre Zagreb, Zagreb, Croatia
- Faculty of Medicine University of Zagreb, Zagreb, Croatia
| | | | | | - Nikola Pantić
- University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Annarosa Cuccaro
- Hematology Unit, Center for Translational Medicine, Azienda USL Toscana NordOvest, Livorno, Italy
- National Cancer Institute, Fondazione ‘G. Pascale’, IRCCS, Hematology-Oncology and Stem Cell Transplantation Unit, Naples, Italy
| | | | - Austin Kulasekararaj
- Department of Hematological Medicine, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Fatih Demirkan
- Dokuz Eylul University, Division of Hematology, Izmir, Turkey
| | - Marriyam Ijaz
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Nikolai Klimko
- North-Western State Medical University Named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Igor Stoma
- Gomel State Medical University, Gomel, Belarus
| | - Sofya Khostelidi
- North-Western State Medical University Named after Iliá Ilich Méchnikov, Saint-Petersburg, Russia
| | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Rui Bergantim
- Centro Hospitalar e Universitário São João, Porto, Portugal
| | - Nick De Jonge
- Amsterdam UMC, Location VUmc, Amsterdam, Netherlands
| | | | | | | | - Michail Samarkos
- Laikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Anna Guidetti
- University of Milan and Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Ferenc Magyari
- Division of Hematology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Tobias Lahmer
- Medizinische Klinik II, Klinikum Rechts der Isar, TU München, Munich, Germany
| | | | | | - László Imre Pinczés
- Division of Hematology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary
| | | | | | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | - Mario Delia
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | | | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Darko Antić
- University Clinical Center of Serbia, Belgrade, Serbia
| | | | | | | | - Martin Hoenigl
- Division of Infectious Diseases, ECMM Excellence Center for Clinical Mycology, Department of Internal Medicine, Medical University of Graz, Austria
- BioTechMed, Graz, Austria
| | | | - Nina Khanna
- University Hospital of Basel, Basel, Switzerland
| | | | - Noha Eisa
- Aseer Central Hospital, Abha, Saudi Arabia
- Oncology Center Mansoura University, Mansoura, Egypt
| | | | | | | | - Nathan C. Bahr
- University of Kansas Medical Center, Kansas City, United States
| | - Sylvain Lamure
- Department of Clinical Hematology, Montpellier University Hospital, IGMM UMR5535 CNRS, University of Montpellier, Montpellier, France
| | | | - Ayel Yahya
- Aseer Central Hospital, Abha, Saudi Arabia
| | | | - Jan Novák
- University Hospital of Královské Vinohrady, Prague, Czech Republic
| | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine Eskisehir Osmangazi University, Eskisehir, Turkey
| | | | | | | | - Rita Fazzi
- Hematology and Stem Cell Transplant Unit, Osperadiela University Pisana Company, Pisa, Italy
| | | | - Rémy Duléry
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Inserm UMRs 938, Paris, France
| | - Yung Gonzaga
- Instituto Nacional do Cancer, Rio de Janeiro, Brazil
| | - Andrés Soto-Silva
- Faculty of Medicine, University of Chile. Infectious Diseases Unity, Salvador Hospital of Santiago, Santiago de Chile, Chile
| | - Giuseppe Sapienza
- Azienda Ospedaliera “Ospedali Riuniti Villa Sofia-Cervello”, Palermo, Italy
| | | | - Ľuboš Drgoňa
- Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Ana Groh
- Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Germany
| | | | - Eleni Gavriilaki
- General Hospital of Thessaloniki “George Papanikolaou”, Thessaloniki, Greece
| | | | | | - Nicola Coppola
- Department of Mental Health and Public Medicine, University of Campania, Naples, Italy
| | | | | | | | - Bojana Mišković
- Center for Radiology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Pavel Jindra
- University Hospital Pilsen, Pilsen, Czech Republic
| | - Sofia Zompi
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Maria Vittoria Sacchi
- Hematology and Transplant Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Carolin Krekeler
- Department of Medicine A for Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | | | | | - Gökçe Melis Çolak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Jiří Mayer
- Masaryk University and University Hospital Brno - Department of Internal Medicine, Hematology and Oncology, Brno, Czech Republic
| | | | - Michaela Hanáková
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Matteo Bonanni
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Oliver A. Cornely
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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Kosmidou A, Gavriilaki E, Tragiannidis A. The Challenge for a Correct Diagnosis of Refractory Thrombocytopenia: ITP or MDS with Isolated Thrombocytopenia? Cancers (Basel) 2024; 16:1462. [PMID: 38672544 DOI: 10.3390/cancers16081462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Immune thrombocytopenia (ITP) is an autoimmune disease characterized by isolated thrombocytopenia. It is diagnosed in patients with a platelet count below 100,000 per cubic millimeter in whom other causes of thrombocytopenia have been ruled out, and its diagnosis is generally one of exclusion. Clinical manifestations of patients may vary from asymptomatic disease to mild mucocutaneous or life-threatening bleeding. Glucocorticoids are used as first-line treatment for ITP, while other second-line medications, mainly thrombopoietin-receptor agonists (TPO-RA) and rituximab, are given to patients in whom ITP does not remit, or relapses soon after glucocorticoid treatment. Refractoriness of ITP strongly questions its diagnosis and necessitates a thorough clinical and laboratory work-up to decide whether that is the case of refractory ITP or a misdiagnosis. The aim of this review is to summarize the conditions associated with isolated thrombocytopenia and highlight the characteristics of confusing cases. Even though the case of a myelodysplastic syndrome presented with isolated thrombocytopenia (MDS-IT) is relatively rare and not well-established in the literature, it constitutes one of the most predominant misdiagnoses of refractory ITP. MDS-IT patients are thought to present with multilineage dysplasia, normal karyotype and low risk prognostic score, based on IPSS-R. It has been shown that a significant proportion of MDS-IT patients are misdiagnosed as having the more common ITP. Therefore, it is crucial that in confusing cases of persistent thrombocytopenia a detailed diagnostic work-up is applied-including evaluation of peripheral-blood smear, bone marrow examination and cytogenetic testing-to avoid unnecessary therapy delay.
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Affiliation(s)
- Aikaterini Kosmidou
- 2nd Department of Internal Medicine, General Hospital of Kavala, 65500 Kavala, Greece
| | - Eleni Gavriilaki
- 2nd Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Athanasios Tragiannidis
- 2nd Department of Pediatrics, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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Gavriilaki E, Huang CL, Nayak L. Editorial: Women in science - hematology 2023. Front Med (Lausanne) 2024; 11:1402357. [PMID: 38654830 PMCID: PMC11035892 DOI: 10.3389/fmed.2024.1402357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 03/28/2024] [Indexed: 04/26/2024] Open
Affiliation(s)
- Eleni Gavriilaki
- Hematology Department, Bone Marrow Transplantation (BMT) Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Chien-Ling Huang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China
| | - Lalitha Nayak
- Department of Medicine, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
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Aiello TF, Salmanton-Garcia J, Marchesi F, Weinbergerova B, Glenthoj A, Van Praet J, Farina F, Davila-Valls J, Martin-Perez S, El-Ashwah S, Schonlein M, Falces-Romero I, Labrador J, Sili U, Buquicchio C, Vena A, Plantefeve G, Petzer V, Biernat MM, Lahmer T, Espigado I, Van Doesum J, Blennow O, Piukovics K, Tascini C, Samarkos M, Bilgin YM, Fianchi L, Itri F, Valković T, Fracchiolla NS, Dargenio M, Jimenez M, Magyari F, Lopez-Garcia A, Prezioso L, Čolović N, Shumilov E, Abu-Zeinah G, Krekeler C, Lavilla-Rubira E, Papa MV, Gonzalez-Lopez TJ, Pinczes LI, Demirkan F, Ali N, Besson C, Fouquet G, Romano A, Hernandez-Rivas JA, Del Principe MI, Aujayeb A, Merelli M, Lamure S, De Almeida JM, Da Silva MG, Eisa N, Meletiadis J, Rinaldi I, Finizio O, Jaksic O, Delia M, Nizamuddin S, Marchetti M, Ijaz M, Machado M, Bailen-Almorox R, Čerňan M, Coppola N, Gavriilaki E, Cattaneo C, Groh A, Stojanoski Z, Erben N, Pantic N, Mendez GA, Di Blasi R, Meers S, De Ramon C, Bahr NC, Emarah Z, Varricchio G, Cvetanoski M, Garcia-Sanz R, Mitrovic M, Lievin R, Hanakova M, Račil Z, Vehreschild M, Tragiannidis A, Rodrigues RN, Garcia-Bordallo D, Cordoba R, Cabirta A, Nordlander A, Ammatuna E, Arellano E, Wolf D, Prin R, Limongelli A, Bavastro M, Colak GM, Grafe S, Hersby DS, Rahimli L, Cornely OA, Garcia-Vidal C, Pagano L. Dexamethasone treatment for COVID-19 is related to increased mortality in hematologic malignancy patients: results from the EPICOVIDEHA Registry. Haematologica 2024. [PMID: 38572549 DOI: 10.3324/haematol.2023.284678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Indexed: 04/05/2024] Open
Abstract
Not available.
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Affiliation(s)
- Tommaso Francesco Aiello
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, Universitat de Barcelona, Barcelona
| | - Jon Salmanton-Garcia
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne.
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome
| | - Barbora Weinbergerova
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czech Republic
| | - Andreas Glenthoj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jens Van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge
| | | | | | | | | | - Martin Schonlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - Iker Falces-Romero
- La Paz University Hospital, Madrid, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos
| | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul
| | | | | | | | - Verena Petzer
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Monika M Biernat
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Tobias Lahmer
- Medizinische Klinik II, Klinikum rechts der Isar, TU Munchen, Munich
| | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla, Seville
| | | | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Klara Piukovics
- Department of Internal Medicine, South Division Faculty of Medicine University of Szeged, Szeged, Hungary
| | - Carlo Tascini
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine
| | | | | | - Luana Fianchi
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome
| | | | - Toni Valković
- University Hospital Centre Rijeka, Rijeka, Croatia; Croatian Cooperative Group for Hematological Diseases (CROHEM) Faculty of Medicine and Faculty of Health Studies University of Rijeka, Rijeka, Croatia
| | | | | | - Moraima Jimenez
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Departament de Medicina, Universitat Autonoma de Barcelona, Bellaterra
| | - Ferenc Magyari
- Division of Hematology, Institution of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Alberto Lopez-Garcia
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid
| | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma
| | - Natasha Čolović
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | | | - Ghaith Abu-Zeinah
- Division of Hematology and Oncology, Weill Cornell Medicine, New York
| | - Carolin Krekeler
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Munster (UKM), Munster
| | | | | | | | - Laszlo Imre Pinczes
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | | | | | - Caroline Besson
- Centre Hospitalier de Versailles, Le Chesnay, France; Universite Paris-Saclay, UVSQ, Inserm, Equipe "Exposome et Heredite", CESP, Villejuif
| | | | | | | | | | | | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine
| | - Sylvain Lamure
- Department of Clinical Hematology, Montpellier University Hospital, IGMM UMR5535 CNRS, University of Montpellier, Montpellier
| | | | | | | | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Medical School, "Attikon" University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ikhwan Rinaldi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - Ozren Jaksic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Mario Delia
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari
| | | | - Monia Marchetti
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria
| | - Marriyam Ijaz
- Memorial Cancer Hospital and Research Centre, Lahore
| | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Maranon, Madrid
| | | | - Martin Čerňan
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Nicola Coppola
- Department of Mental Health and Public Medicine, University of Campania, Naples
| | - Eleni Gavriilaki
- General Hospital of Thessaloniki "George Papanikolaou", Thessaloniki, Greece
| | | | - Ana Groh
- Infektiologie, Universitatsklinikum Frankfurt am Main, Frankfurt am Main
| | | | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine Eskisehir Osmangazi University, Eskisehir
| | - Nicola Pantic
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | | | - Roberta Di Blasi
- Service d'Hematologie-Oncologie, Hopital St Louis, Assistance Publique - Hopitaux de Paris; Universite de Paris Diderot, Paris
| | | | - Cristina De Ramon
- Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain; IBSAL, Centro de Investigacion del Cancer-IBMCC (USAL-CSIC), Salamanca
| | | | - Ziad Emarah
- Oncology Center, Mansoura University, Mansoura, Egypt
| | | | | | - Ramon Garcia-Sanz
- Hematology Department, Hospital Universitario de Salamanca, Salamanca
| | - Mirjana Mitrovic
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | | | - Michaela Hanakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Zdeněk Račil
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Maria Vehreschild
- Infektiologie, Universitatsklinikum Frankfurt am Main, Frankfurt am Main
| | | | | | | | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid
| | - Alba Cabirta
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla, Seville
| | - Dominik Wolf
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | | | | | | | - Gokce Melis Colak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul
| | - Stefanie Grafe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne
| | - Ditte Stampe Hersby
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne
| | - Carolina Garcia-Vidal
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, Universitat de Barcelona, Barcelona, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid.
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome
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5
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Venou TM, Vetsiou E, Varelas C, Daniilidis A, Psarras K, Koravou EE, Koutra M, Touloumenidou T, Tsolakidis V, Papalexandri A, Minti F, Mandala E, Dinas K, Vlachaki E, Gavriilaki E. Increased Complement Activation and Decreased ADAMTS13 Activity Are Associated with Genetic Susceptibility in Patients with Preeclampsia/HELLP Syndrome Compared to Healthy Pregnancies: An Observational Case-Controlled Study. J Pers Med 2024; 14:387. [PMID: 38673014 DOI: 10.3390/jpm14040387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/13/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Preeclampsia is a progressive multi-systemic disorder characterized by proteinuria, critical organ damage, and new-onset hypertension. It can be further complicated by HELLP syndrome (hemolysis, elevated liver enzymes, low platelets), resulting in critical liver or renal damage, disseminated coagulation, and grand mal seizures. This study aimed to examine the involvement of ADAMTS13, von Willebrand, and the complement system in the pathogenesis of preeclampsia/HELLP syndrome. We studied 30 Caucasian preeclamptic pregnant women and a control group of 15 healthy pregnancies. Genetic sequencing of ADAMTS13 and complement regulatory genes (MiniSeq System, Illumina) was performed. The modified Ham test was used to check for complement activation, ADAMTS13 activity, von Willebrand antigen (vWFAg) levels, and soluble C5b-9 levels were measured. Patients with preeclampsia had a decreased ADAMTS13 activity and increased C5b-9 levels. The vWFAg was significantly correlated with ADAMTS13 activity (r = 0.497, p = 0.003). Risk-factor variants were found in the genes of ADAMTS13, C3, thrombomodulin, CFB, CFH, MBL2, and, finally, MASP2. A portion of pregnant women with preeclampsia showed a decline in ADAMTS13 activity, correlated with vWFAg levels. These patients also exhibited an elevated complement activation and high-risk genetic variants in regulatory genes. Further research is needed to determine if these factors can serve as reliable biomarkers.
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Affiliation(s)
- Theodora-Maria Venou
- Hematological Laboratory, 2nd Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Evangelia Vetsiou
- Hematological Laboratory, 2nd Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Christos Varelas
- Hematology Department, Papanicolaou General Hospital, 57010 Thessaloniki, Greece
| | - Angelos Daniilidis
- 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 56429 Thessaloniki, Greece
| | - Kyriakos Psarras
- 2nd Propedeutical Department of Surgery, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | | | - Maria Koutra
- Hematology Department, Papanicolaou General Hospital, 57010 Thessaloniki, Greece
| | | | - Vasilis Tsolakidis
- Hematological Laboratory, 2nd Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | | | - Fani Minti
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Evdokia Mandala
- 4th Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Konstantinos Dinas
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Efthymia Vlachaki
- Hematological Laboratory, 2nd Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
| | - Eleni Gavriilaki
- 2nd Propedeutical Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece
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6
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Penack O, Peczynski C, Boreland W, Lemaitre J, Reinhardt HC, Afanasyeva K, Avenoso D, Holderried TAW, Kornblit BT, Gavriilaki E, Martinez C, Chiusolo P, Mico MC, Dagunet E, Wichert S, Ozdogu H, Piekarska A, Kinsella F, Basak GW, Schoemans H, Koenecke C, Moiseev I, Peric Z. ECP versus ruxolitinib in steroid-refractory chronic GVHD - a retrospective study by the EBMT transplant complications working party. Bone Marrow Transplant 2024; 59:380-386. [PMID: 38184740 PMCID: PMC10920188 DOI: 10.1038/s41409-023-02174-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/13/2023] [Accepted: 12/01/2023] [Indexed: 01/08/2024]
Abstract
Ruxolitinib has become the new standard of care for steroid-refractory and steroid-dependent chronic GVHD (SR-cGVHD). Our aim was to collect comparative data between ruxolitinib and extracorporeal photophoresis (ECP). We asked EBMT centers if they were willing to provide detailed information on GVHD grading, -therapy, -dosing, -response and complications for each included patient. 31 centers responded positively and we included all patients between 1/2017-7/2019 treated with ECP or ruxolitinib for moderate or severe SR-cGVHD. We identified 84 and 57 patients with ECP and ruxolitinib, respectively. We performed multivariate analyses adjusted on grading and type of SR-cGVHD (steroid dependent vs. refractory vs. intolerant to steroids). At day+180 after initiation of treatment for SR-cGVHD the odds ratio in the ruxolitinib group to achieve overall response vs. the ECP group was 1.35 (95% CI = [0.64; 2.91], p = 0.43). In line, we detected no statistically significant differences in overall survival, progression-free survival, non-relapse mortality and relapse incidence. The clinical significance is limited by the retrospective study design and the current data can't replace prospective studies on ECP in SR-cGVHD. However, the present results contribute to the accumulating evidence on ECP as an effective treatment option in SR-cGVHD.
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Affiliation(s)
- Olaf Penack
- Medical Clinic, Department for Haematology, Oncology and Tumorimmunology, Charité Universitätsmedizin Berlin, Berlin, Germany.
- EBMT Transplant Complications Working Party, Paris, France.
| | - Christophe Peczynski
- EBMT Transplant Complications Working Party, Paris, France
- EBMT Paris study office; Department of Haematology, Saint Antoine Hospital; INSERM UMR-S 938, Sorbonne University, Paris, France
| | - William Boreland
- EBMT Transplant Complications Working Party, Paris, France
- EBMT Paris study office; Department of Haematology, Saint Antoine Hospital; INSERM UMR-S 938, Sorbonne University, Paris, France
| | - Jessica Lemaitre
- EBMT Transplant Complications Working Party, Paris, France
- EBMT Paris study office; Department of Haematology, Saint Antoine Hospital; INSERM UMR-S 938, Sorbonne University, Paris, France
| | | | - Ksenia Afanasyeva
- RM Gorbacheva Research Institute, Pavlov University, St Petersburg, Russia
| | | | - Tobias A W Holderried
- Department of Oncology, Hematology, Immuno-Oncology and Rheumatology, University Hospital Bonn, Bonn, Germany
| | | | | | - Carmen Martinez
- Hematopoietic Stem Cell Unit, Hematology Department, ICMHO, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Patrizia Chiusolo
- Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore-Roma, Roma, Italy
| | | | | | | | - Hakan Ozdogu
- Department of Hematology, Baskent University Hospital, Adana, Türkiye
| | - Agnieszka Piekarska
- Department of Hematology and Transplantology, University Clinical Center and Medical University of Gdansk, Gdańsk, Poland
| | | | - Grzegorz W Basak
- EBMT Transplant Complications Working Party, Paris, France
- Department of Hematology, Oncology and Internal Medicine, the Medical University of Warsaw, Warsaw, Poland
| | - Hélène Schoemans
- EBMT Transplant Complications Working Party, Paris, France
- Department of Hematology, University Hospitals Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, ACCENT VV, KU Leuven - University of Leuven, Leuven, Belgium
| | - Christian Koenecke
- EBMT Transplant Complications Working Party, Paris, France
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Ivan Moiseev
- RM Gorbacheva Research Institute, Pavlov University, St Petersburg, Russia
| | - Zinaida Peric
- EBMT Transplant Complications Working Party, Paris, France
- Department of Haematology, University Hospital Centre Rijeka, Rijeka, Croatia
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7
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Gavriilaki E, Mallouri D, Laspa E, Papakonstantinou A, Lazaridou A, Varelas C, Baldoumi E, Giannakopoulou A, Demosthenous C, Vardi A, Bousiou Z, Batsis I, Gkioula G, Anagnostopoulos A, Sakellari I. Open-Label Randomized Controlled Study of Ciprofloxacin vs Rifaximin as Neutropenia Prophylaxis in Allogeneic Hematopoietic Stem Cell Transplantation. Transplant Proc 2024; 56:380-385. [PMID: 38368126 DOI: 10.1016/j.transproceed.2023.12.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/11/2023] [Accepted: 12/28/2023] [Indexed: 02/19/2024]
Abstract
Loss of microbiota diversity has been clearly associated with poor outcomes in the allogeneic hematopoietic stem cell transplantation setting. However, the choice of the optimal antibiotic prophylaxis during the pre-engraftment phase remains unclear. We designed a prospective randomized study to compare our standard-of-care neutropenia prophylaxis (ciprofloxacin) with rifaximin. We enrolled 38 consecutive adult patients who underwent allogeneic hematopoietic stem cell transplantation setting and were randomly assigned to receive ciprofloxacin (20 patients) or rifaximin (18 patients) at day -1. Pretransplant and transplant characteristics did not differ between groups. Cumulative incidence (CI) of acute graft-vs-host disease grade II to IV and moderate/severe chronic graft-vs-host disease was similar in both groups. With a median follow-up of 13.2 months (range, 6.8-30.2) in surviving patients, the 1-year CI of relapse was 20.8% in ciprofloxacin vs 17.8% in rifaximin (P = .616). Importantly, the 1-year CI of treatment-related mortality was significantly reduced in the ciprofloxacin group (10.2% vs 27.8%, P = .032), leading to higher 1-year overall survival (88.9% vs 74.6%, P = .038). In Cox-regression multivariate analysis, antibiotic prophylaxis remained the only predictor of overall survival, independently of donor type, disease risk index, and moderate/severe chronic graft-vs-host disease. Further studies are needed to assess the effects on microbiota diversity and confirm these outcomes.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Despina Mallouri
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Evgenia Laspa
- Hematology Department-BMT Unit, Geneva University Hospital, Geneva, Switzerland.
| | - Anna Papakonstantinou
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andriana Lazaridou
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Christos Varelas
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Eirini Baldoumi
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | | | | | - Anna Vardi
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Zoi Bousiou
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Ioannis Batsis
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Georgia Gkioula
- Microbiology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Ioanna Sakellari
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
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8
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Gavriilaki E. Hematology: the specialty with a record number of new approvals. Front Med (Lausanne) 2024; 11:1385052. [PMID: 38487026 PMCID: PMC10937422 DOI: 10.3389/fmed.2024.1385052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Affiliation(s)
- Eleni Gavriilaki
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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9
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Asteris PG, Gandomi AH, Armaghani DJ, Tsoukalas MZ, Gavriilaki E, Gerber G, Konstantakatos G, Skentou AD, Triantafyllidis L, Kotsiou N, Braunstein E, Chen H, Brodsky R, Touloumenidou T, Sakellari I, Alkayem NF, Bardhan A, Cao M, Cavaleri L, Formisano A, Guney D, Hasanipanah M, Khandelwal M, Mohammed AS, Samui P, Zhou J, Terpos E, Dimopoulos MA. Genetic justification of COVID-19 patient outcomes using DERGA, a novel data ensemble refinement greedy algorithm. J Cell Mol Med 2024; 28:e18105. [PMID: 38339761 PMCID: PMC10863978 DOI: 10.1111/jcmm.18105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 02/12/2024] Open
Abstract
Complement inhibition has shown promise in various disorders, including COVID-19. A prediction tool including complement genetic variants is vital. This study aims to identify crucial complement-related variants and determine an optimal pattern for accurate disease outcome prediction. Genetic data from 204 COVID-19 patients hospitalized between April 2020 and April 2021 at three referral centres were analysed using an artificial intelligence-based algorithm to predict disease outcome (ICU vs. non-ICU admission). A recently introduced alpha-index identified the 30 most predictive genetic variants. DERGA algorithm, which employs multiple classification algorithms, determined the optimal pattern of these key variants, resulting in 97% accuracy for predicting disease outcome. Individual variations ranged from 40 to 161 variants per patient, with 977 total variants detected. This study demonstrates the utility of alpha-index in ranking a substantial number of genetic variants. This approach enables the implementation of well-established classification algorithms that effectively determine the relevance of genetic variants in predicting outcomes with high accuracy.
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Affiliation(s)
- Panagiotis G. Asteris
- Computational Mechanics Laboratory, School of Pedagogical and Technological EducationAthensGreece
| | - Amir H. Gandomi
- Faculty of Engineering & ITUniversity of Technology SydneySydneyNew South WalesAustralia
- University Research and Innovation Center (EKIK), Óbuda UniversityBudapestHungary
| | - Danial J. Armaghani
- School of Civil and Environmental EngineeringUniversity of Technology SydneySydneyNew South WalesAustralia
| | - Markos Z. Tsoukalas
- Computational Mechanics Laboratory, School of Pedagogical and Technological EducationAthensGreece
| | - Eleni Gavriilaki
- 2nd Propedeutic Department of Internal MedicineAristotle University of ThessalonikiThessalonikiGreece
| | - Gloria Gerber
- Hematology DivisionJohns Hopkins UniversityBaltimoreUSA
| | - Gerasimos Konstantakatos
- Computational Mechanics Laboratory, School of Pedagogical and Technological EducationAthensGreece
| | - Athanasia D. Skentou
- Computational Mechanics Laboratory, School of Pedagogical and Technological EducationAthensGreece
| | - Leonidas Triantafyllidis
- Computational Mechanics Laboratory, School of Pedagogical and Technological EducationAthensGreece
| | - Nikolaos Kotsiou
- 2nd Propedeutic Department of Internal MedicineAristotle University of ThessalonikiThessalonikiGreece
| | | | - Hang Chen
- Hematology DivisionJohns Hopkins UniversityBaltimoreUSA
| | | | | | - Ioanna Sakellari
- Hematology Department – BMT UnitG Papanicolaou HospitalThessalonikiGreece
| | | | - Abidhan Bardhan
- Civil Engineering DepartmentNational Institute of Technology PatnaPatnaIndia
| | - Maosen Cao
- Department of Engineering MechanicsHohai UniversityNanjingChina
| | - Liborio Cavaleri
- Department of Civil, Environmental, Aerospace and Materials EngineeringUniversity of PalermoPalermoItaly
| | - Antonio Formisano
- Department of Structures for Engineering and ArchitectureUniversity of Naples “Federico II”NaplesItaly
| | - Deniz Guney
- Engineering FacultySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Mahdi Hasanipanah
- Department of Geotechnics and Transportation, Faculty of Civil EngineeringUniversiti Teknologi MalaysiaJohor BahruMalaysia
| | - Manoj Khandelwal
- Institute of Innovation, Science and SustainabilityFederation University AustraliaBallaratVictoriaAustralia
| | | | - Pijush Samui
- Civil Engineering DepartmentNational Institute of Technology PatnaPatnaIndia
| | - Jian Zhou
- School of Resources and Safety EngineeringCentral South UniversityChangshaChina
| | - Evangelos Terpos
- Department of Clinical Therapeutics, Medical School, Faculty of MedicineNational Kapodistrian University of AthensAthensGreece
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics, Medical School, Faculty of MedicineNational Kapodistrian University of AthensAthensGreece
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10
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Griffin M, Eikema DJ, Verheggen I, Kulagin A, Tjon JML, Fattizzo B, Ingram W, Zaidi U, Desnica L, Giammarco S, Drozd-Sokolowska J, Xicoy B, Patriarca A, Loschi M, Szmigielska-Kaplon A, Beier F, Cignetti A, Drexler B, Gavriilaki E, Lanza F, Orvain C, Risitano AM, De la Camara R, De Latour RP. SARS-CoV-2 vaccination in 361 non-transplanted patients with aplastic anemia and/or paroxysmal nocturnal hemoglobinuria. Haematologica 2024; 109:283-286. [PMID: 37584297 PMCID: PMC10772488 DOI: 10.3324/haematol.2023.283863] [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] [Received: 07/06/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023] Open
Affiliation(s)
| | | | | | - Alexander Kulagin
- RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russian Federation
| | | | - Bruno Fattizzo
- SC Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
| | | | - Uzma Zaidi
- National Institute of Blood Disease and Bone Marrow Transplantation, Karachi
| | | | - Sabrina Giammarco
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | | | - Blanca Xicoy
- Institut Català d'Oncologia-Hospital Universitari Germans Trias i Pujol; Josep Carreras Leukemia Research Institute, Barcelona
| | - Andrea Patriarca
- Azienda Ospedaliero-Universitaria Maggiore della Carità and translational medicine department University of Eastern Piedmont, Novara
| | | | | | - Fabian Beier
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, RWTH Aachen University, Aachen
| | | | | | | | - Francesco Lanza
- Metropolitan Transplant Network, Hospital Santa Maria delle Croci, Ravenna, Italy 21: Centre Hospitalier Universitaire d'Angers, Angers
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11
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Gavriilaki E, Bousiou Z, Batsis I, Vardi A, Mallouri D, Koravou EE, Konstantinidou G, Spyridis N, Karavalakis G, Noli F, Patriarcheas V, Masmanidou M, Touloumenidou T, Papalexandri A, Poziopoulos C, Yannaki E, Sakellari I, Politou M, Papassotiriou I. Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) and Growth Differentiation Factor-15 (GDF-15) Levels Are Significantly Associated with Endothelial Injury Indices in Adult Allogeneic Hematopoietic Cell Transplantation Recipients. Int J Mol Sci 2023; 25:231. [PMID: 38203404 PMCID: PMC10778584 DOI: 10.3390/ijms25010231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Hematopoietic stem cell transplantation-associated thrombotic microangiopathy (HSCT-TMA) and graft-versus-host disease (GvHD) represent life-threatening syndromes after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In both conditions, endothelial dysfunction is a common denominator, and development of relevant biomarkers is of high importance for both diagnosis and prognosis. Despite the fact that soluble urokinase plasminogen activator receptor (suPAR) and growth differentiation factor-15 (GDF-15) have been determined as endothelial injury indices in various clinical settings, their role in HSCT-related complications remains unexplored. In this context, we used immunoenzymatic methods to measure suPAR and GDF-15 levels in HSCT-TMA, acute and/or chronic GVHD, control HSCT recipients, and apparently healthy individuals of similar age and gender. We found considerably greater SuPAR and GDF-15 levels in HSCT-TMA and GVHD patients compared to allo-HSCT and healthy patients. Both GDF-15 and suPAR concentrations were linked to EASIX at day 100 and last follow-up. SuPAR was associated with creatinine and platelets at day 100 and last follow-up, while GDF-15 was associated only with platelets, suggesting that laboratory values do not drive EASIX. SuPAR, but not GDF-15, was related to soluble C5b-9 levels, a sign of increased HSCT-TMA risk. Our study shows for the first time that suPAR and GDF-15 indicate endothelial damage in allo-HSCT recipients. Rigorous validation of these biomarkers in many cohorts may provide utility for their usefulness in identifying and stratifying allo-HSCT recipients with endothelial cell impairment.
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Affiliation(s)
- Eleni Gavriilaki
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Zoi Bousiou
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Ioannis Batsis
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Anna Vardi
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Despina Mallouri
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Evaggelia-Evdoxia Koravou
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Georgia Konstantinidou
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Nikolaos Spyridis
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Georgios Karavalakis
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Foteini Noli
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Vasileios Patriarcheas
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Marianna Masmanidou
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Tasoula Touloumenidou
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Apostolia Papalexandri
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Christos Poziopoulos
- Department of Hematology, Metropolitan Hospital, Neo Faliro, 18547 Athens, Greece;
| | - Evangelia Yannaki
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Ioanna Sakellari
- BMT Unit, Hematology Department, George Papanicolaou General Hospital, 57010 Thessaloniki, Greece; (Z.B.); (I.B.); (A.V.); (D.M.); (E.-E.K.); (G.K.); (N.S.); (G.K.); (F.N.); (V.P.); (M.M.); (T.T.); (A.P.); (E.Y.); (I.S.)
| | - Marianna Politou
- Hematology Laboratory-Blood Bank, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Ioannis Papassotiriou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece;
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12
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Penack O, Peczynski C, Boreland W, Lemaitre J, Afanasyeva K, Kornblit B, Jurado M, Martinez C, Natale A, Pérez-Simón JA, Brunello L, Avenoso D, Klein S, Ozkurt ZN, Herrera C, Wichert S, Chiusolo P, Gavriilaki E, Basak GW, Schoemans H, Koenecke C, Moiseev I, Peric Z. ECP versus ruxolitinib in steroid-refractory acute GVHD - a retrospective study by the EBMT transplant complications working party. Front Immunol 2023; 14:1283034. [PMID: 38149251 PMCID: PMC10750400 DOI: 10.3389/fimmu.2023.1283034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/27/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Extracorporal Photophoresis (ECP) is in clinical use for steroid-refractory and steroid-dependent acute GVHD (SR-aGVHD). Based on recent Phase-III study results, ruxolitinib has become the new standard of care for SR-aGVHD. Our aim was to collect comparative data between ruxolitinib and ECP in SR-aGVHD in order to improve the evidence base for clinical decision making. Methods We asked EBMT centers if they were willing to participate in this study by completing a data form (Med-C) with detailed information on GVHD grading, -therapy, -dosing, -response and complications for each included patient. Results 31 centers responded positively (14%) and we included all patients receiving alloSCT between 1/2017-7/2019 and treated with ECP or ruxolitinib for SR-aGVHD grades II-IV from these centers. We identified 53 and 40 patients with grades II-IV SR-aGVHD who were treated with ECP and ruxolitinib, respectively. We performed multivariate analyses adjusted on grading and type of SR-aGVHD (steroid dependent vs. refractory). At day+90 after initiation of treatment for SR-aGVHD we found no statistically significant differences in overall response. The odds ratio in the ruxolitinib group to achieve overall response vs. the ECP group was 1.13 (95% CI = [0.41; 3.22], p = 0.81). In line, we detected no statistically significant differences in overall survival, progression-free survival, non-relapse mortality and relapse incidence. Discussion The clinical significance is limited by the retrospective study design and the current data can't replace prospective studies on ECP in SR-aGVHD. However, the present results contribute to the accumulating evidence on ECP as an effective treatment option in SR-aGVHD.
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Affiliation(s)
- Olaf Penack
- Medical Clinic, Department for Haematology, Oncology and Tumorimmunology, Charité Universitätsmedizin Berlin, Berlin, Germany
- EBMT Transplant Complications Working Party, Paris, France
| | - Christophe Peczynski
- EBMT Transplant Complications Working Party, Paris, France
- EBMT Paris Study Office, Department of Haematology, Saint Antoine Hospital, INSERM UMR-S 938, Sorbonne University, Paris, France
| | - William Boreland
- EBMT Transplant Complications Working Party, Paris, France
- EBMT Paris Study Office, Department of Haematology, Saint Antoine Hospital, INSERM UMR-S 938, Sorbonne University, Paris, France
| | - Jessica Lemaitre
- EBMT Transplant Complications Working Party, Paris, France
- EBMT Paris Study Office, Department of Haematology, Saint Antoine Hospital, INSERM UMR-S 938, Sorbonne University, Paris, France
| | - Ksenia Afanasyeva
- Department of Haematology, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - Brian Kornblit
- Department of Haematology, Rigshospitalet, Copenhagen, Denmark
| | - Manuel Jurado
- Department of Haematology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Carmen Martinez
- Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | | | - Jose Antonio Pérez-Simón
- Department of Hematology, University Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS)/CSIC, Universidad de Sevilla, Sevilla, Spain
| | - Lucia Brunello
- Department of Haematology, SS. Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Daniele Avenoso
- Department of Haematology, Kings’ College Hospital, London, United Kingdom
| | - Stefan Klein
- Department of Haematology, Universitaetsmedizin, Mannheim, Germany
| | - Zubeyde Nur Ozkurt
- Department of Haematology, Gazi University Faculty of Medicine, Ankara, Türkiye
| | - Concha Herrera
- Servicio de Hematología Hospital Universitario Reina Sofía, IMIBIC, University of Cordoba, Cordoba, Spain
| | - Stina Wichert
- Department of Haematology, Skane University Hospital, Lund, Sweden
| | - Patrizia Chiusolo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore-Roma, Rome, Italy
| | - Eleni Gavriilaki
- Department of Haematology, Papanicolaou G. Hospital, Thessaloniki, Greece
| | - Grzegorz W. Basak
- EBMT Transplant Complications Working Party, Paris, France
- Department of Hematology, Oncology and Internal Medicine, The Medical University of Warsaw, Warsaw, Poland
| | - Hélène Schoemans
- EBMT Transplant Complications Working Party, Paris, France
- Department of Hematology, University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | - Christian Koenecke
- EBMT Transplant Complications Working Party, Paris, France
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Ivan Moiseev
- Department of Haematology, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - Zinaida Peric
- EBMT Transplant Complications Working Party, Paris, France
- Department of Haematology, University Hospital Centre Zagreb, Zagreb, Croatia
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13
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Gavriilaki E, Lazaridis A, Anyfanti P, Yiannaki E, Dolgyras P, Nikolaidou B, Vasileiadis I, Alexandrou ME, Margouta A, Markala D, Zarifis I, Sarafidis P, Doumas M, Gkaliagkousi E. Circulating microvesicles across a population with various degree of cardiovascular burden are associated with systolic blood pressure. J Hum Hypertens 2023; 37:1105-1111. [PMID: 37612421 DOI: 10.1038/s41371-023-00854-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 07/05/2023] [Accepted: 08/15/2023] [Indexed: 08/25/2023]
Abstract
Circulating microvesicles (MVs) have been studied in heterogeneous, divergent, and rather small patient populations with cardiovascular risk . Therefore, we measured endothelial (EMVs), platelet (PMVs) and erythrocyte (RMVs) MVs in patients with divergent cardiovascular risk. We then compared them to coronary artery disease (CAD) and healthy subjects and identified independent MVs' predictors. We enrolled consecutive patients from our Cardiology, Hypertension, Diabetic, Rheumatic, and Nephrology Outpatient Units with MVs measurements. Central blood pressure (BP) was measured by either applanation tonometry or Mobil-O-graph device, while MVs by a standardized flow cytometry protocol. We studied 369 participants with increased cardiovascular risk: 63 with high cardiovascular risk (47 diabetes mellitus type II/DM and 16 end-stage renal disease/ESRD), 92 with chronic inflammatory disorders and 73 with untreated essential hypertension/UEH. We further included 53 subjects with CAD and 87 otherwise healthy individuals. All MVs were lower in patients with increased cardiovascular risk compared to CAD, showing predictive value with high sensitivity and specificity. Furthermore, PMVs and EMVs were increased in patients with cardiovascular risk compared to healthy individuals. DM and ESRD patients had increased EMVs versus UEH and chronic inflammatory disorders. In the whole study population, RMVs were associated only with history of essential hypertension. In multivariate analysis, systolic BP predicted PMVs. Aage, systolic BP, and DM predicted EMVs. In a large population of patients with divergent cardiovascular risk, MVs are independently associated with systolic blood pressure.
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Affiliation(s)
- Eleni Gavriilaki
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonios Lazaridis
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiota Anyfanti
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efthalia Yiannaki
- Hematology Laboratory, Theagenion Cancer Center, Thessaloniki, Greece
| | - Panagiotis Dolgyras
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Barbara Nikolaidou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Maria Eleni Alexandrou
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Margouta
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Markala
- Hematology Laboratory, Theagenion Cancer Center, Thessaloniki, Greece
| | - Ioannis Zarifis
- Cardiology Department, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Panteleimon Sarafidis
- Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michail Doumas
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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14
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Evangelidis P, Venou TM, Fani B, Vlachaki E, Gavriilaki E. Endocrinopathies in Hemoglobinopathies: What Is the Role of Iron? Int J Mol Sci 2023; 24:16263. [PMID: 38003451 PMCID: PMC10671246 DOI: 10.3390/ijms242216263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Hemoglobinopathies, including β-thalassemia and sickle cell disease (SCD), are common genetic blood disorders. Endocrine disorders are frequent manifestations of organ damage observed mainly in patients with β-thalassemia and rarely in SCD. Iron overload, oxidative stress-induced cellular damage, chronic anemia, and HCV infection contribute to the development of endocrinopathies in β-thalassemia. The above factors, combined with vaso-occlusive events and microcirculation defects, are crucial for endocrine dysfunction in SCD patients. These endocrinopathies include diabetes mellitus, hypothyroidism, parathyroid dysfunction, gonadal and growth failure, osteoporosis, and adrenal insufficiency, affecting the quality of life of these patients. Thus, we aim to provide current knowledge and data about the epidemiology, pathogenesis, diagnosis, and management of endocrine disorders in β-thalassemia and SCD. We conducted a comprehensive review of the literature and examined the available data, mostly using the PubMed and Medline search engines for original articles. In the era of precision medicine, more studies investigating the potential role of genetic modifiers in the development of endocrinopathies in hemoglobinopathies are essential.
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Affiliation(s)
- Paschalis Evangelidis
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece;
| | - Theodora-Maria Venou
- Adult Thalassemia Unit, 2nd Department of Internal Medicine, Aristotle University of Thessaloniki, Hippocration General Hospital, 54642 Thessaloniki, Greece; (T.-M.V.); (E.V.)
| | | | - Efthymia Vlachaki
- Adult Thalassemia Unit, 2nd Department of Internal Medicine, Aristotle University of Thessaloniki, Hippocration General Hospital, 54642 Thessaloniki, Greece; (T.-M.V.); (E.V.)
| | - Eleni Gavriilaki
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece;
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15
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Papalexandri A, Gavriilaki E, Vardi A, Kotsiou N, Demosthenous C, Constantinou N, Touloumenidou T, Zerva P, Kika F, Iskas M, Batsis I, Mallouri D, Yannaki E, Anagnostopoulos A, Sakellari I. Pre-Emptive Use of Rituximab in Epstein-Barr Virus Reactivation: Incidence, Predictive Factors, Monitoring, and Outcomes. Int J Mol Sci 2023; 24:16029. [PMID: 38003218 PMCID: PMC10671524 DOI: 10.3390/ijms242216029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Post-transplant lymphoproliferative disease (PTLD) is a fatal complication of hematopoietic cell transplantation (HCT) associated with the Epstein-Barr virus (EBV). Multiple factors such as transplant type, graft-versus-host disease (GVHD), human leukocyte antigens (HLA) mismatch, patient age, and T-lymphocyte-depleting treatments increase the risk of PTLD. EBV reactivation in hematopoietic cell transplant recipients is monitored through periodic quantitative polymerase chain reaction (Q-PCR) tests. However, substantial uncertainty persists regarding the clinically significant EBV levels for these patients. Guidelines recommend initiating EBV monitoring no later than four weeks post-HCT and conducting it weekly. Pre-emptive therapies, such as the reduction of immunosuppressive therapy and the administration of rituximab to treat EBV viral loads are also suggested. In this study, we investigated the occurrence of EBV-PTLD in 546 HCT recipients, focusing on the clinical manifestations and risk factors associated with the disease. We managed to identify 67,150 viral genomic copies/mL as the cutoff point for predicting PTLD, with 80% sensitivity and specificity. Among our cohort, only 1% of the patients presented PTLD. Anti-thymocyte globulin (ATG) and GVHD were independently associated with lower survival rates and higher treatment-related mortality. According to our findings, prophylactic measures including regular monitoring, pre-emptive therapy, and supportive treatment against infections can be effective in preventing EBV-related complications. This study also recommends conducting EBV monitoring at regular intervals, initiating pre-emptive therapy when viral load increases, and identifying factors that increase the risk of PTLD. Our study stresses the importance of frequent and careful follow-ups of post-transplant complications and early intervention in order to improve survival rates and reduce mortality.
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Affiliation(s)
- Apostolia Papalexandri
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Eleni Gavriilaki
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece;
| | - Anna Vardi
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Nikolaos Kotsiou
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece;
| | - Christos Demosthenous
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Natassa Constantinou
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Tasoula Touloumenidou
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Panagiota Zerva
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Fotini Kika
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Michalis Iskas
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Ioannis Batsis
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Despina Mallouri
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Evangelia Yannaki
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Achilles Anagnostopoulos
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
| | - Ioanna Sakellari
- Hematology Department, BMT Unit, General Hospital “George Papanicolaou”, 57010 Thessaloniki, Greece; (A.P.); (A.V.); (C.D.); (T.T.); (P.Z.); (F.K.); (M.I.); (I.B.); (D.M.); (E.Y.); (A.A.); (I.S.)
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Gavriilaki E, Nikolousis E, Koravou EE, Dimou-Besikli S, Kartsios C, Papakonstantinou A, Mpanti A, Pontikoglou C, Kalpadaki C, Bitsani A, Tassi I, Touloumenidou T, Chatziconstantinou T, Papathanasiou M, Syrigou A, Ztriva E, Kaiafa G, Mandala E, Mellios Z, Karakasis D, Kourakli A, Symeonidis A, Kapsali E, Papadaki HH, Lalayanni C, Sakellari I. Caplacizumab for immune thrombotic thrombocytopenic purpura: real-world multicenter data. Front Med (Lausanne) 2023; 10:1226114. [PMID: 37901415 PMCID: PMC10600458 DOI: 10.3389/fmed.2023.1226114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
Given the limited real-world data of caplacizumab, our multicenter real-world study was designed to assess the safety and efficacy of caplacizumab in immune thrombotic thrombocytopenic pupura (iTTP), compared to historic controls. We have studied 70 patients: 23 in the caplacizumab and 47 in the historic control group. Plasma exchange was applied in all episodes except for two patients that denied plasma exchange. Rituximab as first-line treatment was more common in the caplacizumab group compared to historic control. Caplacizumab (10 mg daily) was given at a median on day 7 (1-43) from initial diagnosis for 32 (6-47) dosages. In the caplacizumab group, a median of 12 (8-23) patients required plasma exchange sessions versus 14 (6-32) in the control group. Caplacizumab administration did not produce any grade 3 complications or major hemorrhagic events. After a median of 19.0 (2.6-320) months since the iTTP diagnosis, 5 deaths occurred (4 in the control group and 1 in the caplacizumab group, p = 0.310). Caplacizumab patients achieved early platelet normalization and ADAMTS13 activity normalization at the end of treatment. Relapse was observed only in 2/23 (9%) caplacizumab patients, compared to 29/47 (62%) historic controls (p < 0.001). Overall, caplacizumab is safe and effective in treating iTTP, including cases refractory to plasma exchange, re-administration, and cases without previous plasma exchange treatment. No major hemorrhagic events were observed. Cessation of dosing guided by ADAMTS13 has ensured a low relapse rate.
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Affiliation(s)
- Eleni Gavriilaki
- BMT Unit - Department of Hematology, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | | | | | | | | | - Anastasia Mpanti
- Department of Hematology, Papageorgiou Hospital, Thessaloniki, Greece
| | | | - Christina Kalpadaki
- Department of Hematology, University of Crete School of Medicine, Crete, Greece
| | - Aikaterini Bitsani
- First Department of Internal Medicine, LAIKO General Hospital, Athens, Greece
| | - Ilianna Tassi
- Department of Hematology, University Hospital, Ioannina, Greece
| | | | | | - Maria Papathanasiou
- BMT Unit - Department of Hematology, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Antonia Syrigou
- BMT Unit - Department of Hematology, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Eleutheria Ztriva
- 1st Medical Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Kaiafa
- 1st Medical Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evdokia Mandala
- 4th Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Zois Mellios
- Department of Hematology, Evangelismos Hospital, Athens, Greece
| | | | - Alexandra Kourakli
- Division of Hematology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece
| | - Argiris Symeonidis
- Division of Hematology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece
| | - Eleni Kapsali
- Department of Hematology, University Hospital, Ioannina, Greece
| | | | - Chrysavgi Lalayanni
- BMT Unit - Department of Hematology, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Ioanna Sakellari
- BMT Unit - Department of Hematology, G. Papanicolaou Hospital, Thessaloniki, Greece
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Salmanton-García J, Marchesi F, Koehler P, Weinbergerová B, Čolović N, Falces-Romero I, Buquicchio C, Farina F, van Praet J, Biernat MM, Itri F, Prezioso L, Tascini C, Vena A, Romano A, Delia M, Dávila-Valls J, Martín-Pérez S, Lavilla-Rubira E, Adžić-Vukičević T, García-Bordallo D, López-García A, Criscuolo M, Petzer V, Fracchiolla NS, Espigado I, Sili U, Meers S, Erben N, Cattaneo C, Tragiannidis A, Gavriilaki E, Schönlein M, Mitrovic M, Pantic N, Merelli M, Labrador J, Hernández-Rivas JÁ, Glenthøj A, Fouquet G, Del Principe MI, Dargenio M, Calbacho M, Besson C, Kohn M, Gräfe S, Hersby DS, Arellano E, Çolak GM, Wolf D, Marchetti M, Nordlander A, Blennow O, Cordoba R, Mišković B, Mladenović M, Bavastro M, Limongelli A, Rahimli L, Pagano L, Cornely OA. Molnupiravir compared to nirmatrelvir/ritonavir for COVID-19 in high-risk patients with haematological malignancy in Europe. A matched-paired analysis from the EPICOVIDEHA registry. Int J Antimicrob Agents 2023; 62:106952. [PMID: 37582478 DOI: 10.1016/j.ijantimicag.2023.106952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/24/2023] [Accepted: 08/05/2023] [Indexed: 08/17/2023]
Abstract
INTRODUCTION Molnupiravir and nirmatrelvir/ritonavir are antivirals used to prevent progression to severe SARS-CoV-2 infections and decrease hospitalisation and mortality rates. Nirmatrelvir/ritonavir was authorised in Europe in December 2021, whereas molnupiravir is not yet licensed in Europe as of February 2022. Molnupiravir may be an alternative to nirmatrelvir/ritonavir because it is associated with fewer drug-drug interactions and contraindications. A caveat for molnupiravir is the mode of action induces viral mutations. Mortality rate reduction with molnupiravir was less pronounced than that with nirmatrelvir/ritonavir in patients without haematological malignancy. Little is known about the comparative efficacy of the two drugs in patients with haematological malignancy at high-risk of severe COVID-19. Thus, molnupiravir and nirmatrelvir/ritonavir were compared in a cohort of patients with haematological malignancies. METHODS Clinical data from patients treated with molnupiravir or nirmatrelvir/ritonavir monotherapy for COVID-19 were retrieved from the EPICOVIDEHA registry. Patients treated with molnupiravir were matched by sex, age (±10 years), and severity of baseline haematological malignancy to controls treated with nirmatrelvir/ritonavir. RESULTS A total of 116 patients receiving molnupiravir for the clinical management of COVID-19 were matched to an equal number of controls receiving nirmatrelvir/ritonavir. In each of the groups, 68 (59%) patients were male; with a median age of 64 years (interquartile range [IQR] 53-74) for molnupiravir recipients and 64 years (IQR 54-73) for nirmatrelvir/ritonavir recipients; 56.9% (n=66) of the patients had controlled baseline haematological malignancy, 12.9% (n=15) had stable disease, and 30.2% (n=35) had active disease at COVID-19 onset in each group. During COVID-19 infection, one third of patients from each group were admitted to hospital. Although a similar proportion of patients in the two groups were vaccinated (molnupiravir n=77, 66% vs. nirmatrelvir/ritonavir n=87, 75%), more of those treated with nirmatrelvir/ritonavir had received four vaccine doses (n=27, 23%) compared with those treated with molnupiravir (n=5, 4%) (P<0.001). No differences were detected in COVID-19 severity (P=0.39) or hospitalisation (P=1.0). No statistically significant differences were identified in overall mortality rate (P=0.78) or survival probability (d30 P=0.19, d60 P=0.67, d90 P=0.68, last day of follow up P=0.68). Deaths were either attributed to COVID-19, or the infection was judged by the treating physician to have contributed to death. CONCLUSIONS Hospitalisation and mortality rates with molnupiravir were comparable to those with nirmatrelvir/ritonavir in high-risk patients with haematological malignancies and COVID-19. Molnupiravir is a plausible alternative to nirmatrelvir/ritonavir for COVID-19 treatment in patients with haematological malignancy.
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Affiliation(s)
- Jon Salmanton-García
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Barbora Weinbergerová
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czech Republic
| | - Natasa Čolović
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | - Iker Falces-Romero
- La Paz University Hospital, Madrid, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Jens van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Monika M Biernat
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Carlo Tascini
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | | | | | - Mario Delia
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | | | | | | | | | | | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Mariana Criscuolo
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Verena Petzer
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | | | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | | | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine Eskisehir Osmangazi University, Eskisehir, Turkey
| | | | | | | | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mirjana Mitrovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Nikola Pantic
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain; Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
| | - José-Ángel Hernández-Rivas
- Hospital Universitario Infanta Leonor, Madrid, Spain; Departmento de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | | | | | | | - Caroline Besson
- Centre Hospitalier de Versailles, Le Chesnay, France; Université Paris-Saclay, UVSQ, Inserm, Équipe "Exposome et Hérédité", CESP, Villejuif, France
| | - Milena Kohn
- Centre Hospitalier de Versailles, Le Chesnay, France; Université Paris-Saclay, UVSQ, Inserm, Équipe "Exposome et Hérédité", CESP, Villejuif, France
| | - Stefanie Gräfe
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ditte Stampe Hersby
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Gökçe Melis Çolak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Dominik Wolf
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Monia Marchetti
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Bojana Mišković
- Center of Radiology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Miloš Mladenović
- University Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Alessandro Limongelli
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy; Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany.
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Anyfanti P, Dimitriadou A, Dara A, Angeloudi E, Gavriilaki E, Nikolaidou B, Triantafyllou A, Dimitroulas T, Gkaliagkousi E. Circulating levels of galectin-3 and coronary microvascular perfusion in rheumatoid arthritis patients with suppressed inflammation. Clin Rheumatol 2023; 42:2881-2887. [PMID: 37418035 DOI: 10.1007/s10067-023-06685-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/18/2023] [Accepted: 06/24/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE Cardiovascular manifestations are the leading cause of mortality in rheumatoid arthritis (RA). Galectin-3, a lectin protein with major role in cellular, inflammatory, and fibrotic processes, has been introduced as a novel cardiac biomarker. We hypothesized that patients with RA present increased levels of galectin-3, and investigated potential associations with arterial stiffness and coronary microvascular dysfunction. METHODS This cross-sectional study enrolled RA patients and non-RA individuals without cardiovascular comorbidities. Galectin-3 and high-sensitivity C-reactive protein (hsCRP) were measured with enzyme-linked immunosorbent assay (ELISA) in serum samples. Subendocardial viability ratio (SEVR), an index of microvascular myocardial perfusion, and pulse wave velocity (PWV), the gold-standard measure of vascular stiffness, were estimated with applanation tonometry. RESULTS Cardiovascular risk factors and hsCRP were comparable between patients (n = 24) and controls (n = 24). However, galectin-3 was increased [6.9 (6.7) vs 4.6 (4.7)] ng/dl, p = 0.015], and coronary microvascular perfusion was decreased (142.6 ± 22.8 vs 159.7 ± 23.2%, p = 0.028) in RA patients compared to controls, whereas PWV did not significantly differ. Galectin-3 correlated with both PWV and SEVR in univariate analysis. However, after adjustment for cardiovascular risk factors and subclinical inflammation, these associations were rendered non-significant. CONCLUSION Galectin-3 appears increased in RA, even among patients with suppressed inflammation in the absence of cardiovascular comorbidities. The observed association of galectin-3 with coronary microvascular perfusion in our study was non-significant after adjustment for cardiovascular risk factors and inflammation. The potential role of galectin-3 as a cardiac biomarker in RA warrants further investigation. Key Points • Galectin-3 has emerged as a novel cardiac biomarker but remains understudied in RA. • Patients with RA present elevated levels of galectin-3 and impaired coronary microvascular perfusion compared to non-RA individuals. • These differences were observed in patients with suppressed inflammation, even in the absence of CVD. • The association of galectin-3 with coronary microvascular impairment in RA warrants further investigation.
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Affiliation(s)
- Panagiota Anyfanti
- Second Medical Department, Hippokration General Hospital, Aristotle University of Thessaloniki, 49, Konstantinoupoleos Str, 54642, Thessaloniki, Greece.
| | - Antonia Dimitriadou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasia Dara
- Fourth Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elena Angeloudi
- Second Medical Department, Hippokration General Hospital, Aristotle University of Thessaloniki, 49, Konstantinoupoleos Str, 54642, Thessaloniki, Greece
| | - Eleni Gavriilaki
- 2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Barbara Nikolaidou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Areti Triantafyllou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros Dimitroulas
- Fourth Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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19
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Margouta A, Anyfanti P, Lazaridis A, Gavriilaki E, Yiannaki E, Nikolaidou B, Goulas K, Lazaridou E, Triantafyllou A, Douma S, Patsatsi A, Gkaliagkousi E. Assessment of microvesicles from different cell origins in patients with psoriasis: evidence of thrombogenic, proinflammatory microenvironment in the absence of established cardiovascular disease. J Hum Hypertens 2023; 37:925-930. [PMID: 36482197 DOI: 10.1038/s41371-022-00787-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/13/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022]
Abstract
Psoriasis is associated with increased cardiovascular risk. Endothelial, platelet, and erythrocyte microvesicles (MVs) are novel biomarkers of endothelial dysfunction and thromboinflammation. We explored whether MVs of different cell types are elevated in patients with psoriasis, and investigated potential associations with disease severity and macrovascular function. Endothelial, platelet and erythrocyte MVs were measured using a standardized flow cytometry protocol in psoriasis patients and controls free from established cardiovascular disease. Carotid intima-media thickness (IMT) and pulse wave velocity (PWV) were measured as markers of subclinical atherosclerosis and arterial stiffness. Psoriasis severity was assessed with PASI (Psoriasis Area Severity Index). Both platelet (p < 0.001) and erythrocyte MVs (p = 0.046), yet not endothelial MVs, were significantly increased in patients with psoriasis (n = 41) compared with controls (n = 41). Patients with higher PASI (≥10) presented significantly higher levels of ErMVs compared to those with lower PASI (<10) (p = 0.047). Carotid IMT and PWV were comparable between psoriasis patients and controls and did not significantly correlate with MVs. In the multivariate analysis, psoriasis was identified as an independent predictor of both platelet (p < 0.001) and erythrocyte MVs (p = 0.043), while hypertension was independently associated with endothelial MVs (p < 0.001). Increased formation of platelet and erythrocyte MVs may be evident in psoriasis patients and is indicative of prothrombotic, proinflammatory microenvironment, even in the absence of subclinical macrovascular dysfunction and before the clinical onset of overt cardiovascular complications. Potential mechanistic links and prognostic implications of increased MVs in psoriasis warrant further investigation.
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Affiliation(s)
- Anastasia Margouta
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiota Anyfanti
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Antonios Lazaridis
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Gavriilaki
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efthalia Yiannaki
- Department of Hematology, Theagenion Cancer Center, Thessaloniki, Greece
| | - Barbara Nikolaidou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kyriakos Goulas
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elizabeth Lazaridou
- 2nd Department of Dermatology and Venereology, General Hospital "Papageorgiou", Medical School Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Areti Triantafyllou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stella Douma
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Patsatsi
- 2nd Department of Dermatology and Venereology, General Hospital "Papageorgiou", Medical School Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Gavriilaki E, Sakellari I, Labopin M, Bornhäuser M, Hamladji RM, Casper J, Edinger M, Zák P, Yakoub-Agha I, Ciceri F, Schroeder T, Zuckerman T, Kobbe G, Yeshurun M, Narni F, Finke J, Diez-Martin JL, Berceanu A, Hilgendorf I, Verbeek M, Olivieri A, Savani B, Spyridonidis A, Nagler A, Mohty M. Survival advantage of treosulfan plus fludarabine (FT14) compared to busulfan plus fludarabine (FB4) in active acute myeloid leukemia post allogeneic transplantation: an analysis from the European Society for Blood and Marrow Transplantation (EBMT) Acute Leukemia Working Party (ALWP). Bone Marrow Transplant 2023; 58:1084-1088. [PMID: 37420011 DOI: 10.1038/s41409-023-02028-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/02/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023]
Abstract
We compared FT14 (fludarabine 150-160 mg/m2, treosulfan 42 g/m2) versus FB4 (fludarabine 150-160 mg/m2, busulfan 12.8 mg/kg) in acute myeloid leukemia (AML) transplanted at primary refractory/relapsed disease. We retrospectively studied: (a) adults diagnosed with AML, (b) recipients of first allogeneic hematopoietic stem cell transplantation (HSCT) from unrelated/sibling donor (2010-2020), (c) HSCT with primary refractory/relapsed disease, (d) conditioning regimen with FT14 or FB4. We studied 346 patients, 113 transplanted with FT14, and 233 with FΒ4. FT14 patients were significantly older, more frequently had an unrelated donor and had received a lower dose of fludarabine. Cumulative incidence (CI) of acute graft-versus-host disease (GVHD) grade III-IV and extensive chronic GVHD was similar. With a median follow-up of 28.7 months, 2-year CI of relapse was 43.4% in FT14 versus 53.2% in FB4, while non-relapse mortality (NRM) was respectively 20.8% versus 22.6%. This led to 2-year leukemia-free survival (LFS) of 35.8% for FT14 versus 24.2% in FB4, and overall survival (OS) of 44.4% versus 34%. Adverse cytogenetics and conditioning regimen independently predicted CI of relapse. Furthermore, conditioning regimen was the only independent predictor of LFS, OS, and GVHD-free/relapse-free survival. Therefore, our real-world multicenter study suggests that FT14 is associated with better outcomes in primary refractory/relapsed AML.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece.
| | - Ioanna Sakellari
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Myriam Labopin
- Service d' Hématologie Clinique et Thérapie Cellulaire, Hospital Saint-Antoine, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France
| | - Martin Bornhäuser
- University Hospital Dresden, Medizinische Klinik und Poliklinik I, TU, Dresden, Germany
| | - Rose-Marie Hamladji
- Centre Pierre et Marie Curie, Service Hématologie Greffe de Moëlle, Alger, Algeria
| | - Jochen Casper
- Klinikum Oldenburg, Abt. Onkologie/Hämatologie, Oldenburg, Germany
| | - Matthias Edinger
- Department. of Hematology and Oncology, University Regensburg, Regensburg, Germany
| | - Pavel Zák
- Charles University Hospital, 4th Department of Internal Medicine - Hematology, Hradec_Kralove, Czech Republic
| | | | - Fabio Ciceri
- Ospedale San Raffaele s.r.l. Haematology and BMT, Milano, Italy
| | - Thomas Schroeder
- University Hospital Dept. of Bone Marrow Transplantation, Essen, Germany
| | - Tsila Zuckerman
- Dept. of Hematology & BMT, Rambam Medical Center, Haifa, Israel
| | - Guido Kobbe
- Heinrich Heine Universitaet, Klinik für Hämat,Onkol,Klin.Immun, Duesseldorf, Germany
| | - Moshe Yeshurun
- Hematology and BMT Department, Beilinson Hospital, Petach_Tikva, Israel
| | - Franco Narni
- Azienda Ospedaliero Universitaria di Modena Policlinico, Ematologia, Modena, Italy
| | - Jürgen Finke
- Department. of Medicine -Hematology, Oncology, University of Freiburg, Freiburg, Germany
| | | | - Ana Berceanu
- Hopital Jean Minjoz, Service d'Hématologie, Besancon, France
| | - Inken Hilgendorf
- Universitaetsklinikum Jena, Klinik für Innere Medizin II, (Abt. Hämatologie und Onkologie), Am Klinikum 1, Jena, Germany
| | - Mareike Verbeek
- Klinikum Rechts der Isar, III Med Klinik der TU, Munich, Germany
| | - Attilio Olivieri
- Azienda Ospedali Riuniti di Ancona, Department of Hematology, Ancona University, Ancona, Italy
| | - Bipin Savani
- Department of Hematology-Oncology, Vanderbilt University, Medical Center, Nashville, TN, USA
| | - Alexandros Spyridonidis
- Department of Internal Medicine, Bone Marrow Transplantation Unit, University Hospital of Patras, Patras, Greece
| | - Arnon Nagler
- Department of Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Mohamad Mohty
- Service d' Hématologie Clinique et Thérapie Cellulaire, Hospital Saint-Antoine, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France
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21
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Varelas C, Gavriilaki E. Sickle Cell Disease: Current Understanding and Future Options. J Clin Med 2023; 12:5943. [PMID: 37762884 PMCID: PMC10532277 DOI: 10.3390/jcm12185943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/17/2023] [Indexed: 09/29/2023] Open
Abstract
Sickle cell disease (SCD) is a prevalent inherited hemoglobin disorder encompassing a cluster of congenital hemolytic anemias, each distinguished by the prevalence of sickle hemoglobin (HbS) [...].
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Affiliation(s)
- Christos Varelas
- Hematology Department—BMT Unit, G .Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Eleni Gavriilaki
- 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54644 Thessaloniki, Greece
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22
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Gavriilaki E, Mallouri D, Bousiou Z, Demosthenous C, Vardi A, Dolgyras P, Batsis I, Stroggyli E, Karvouni P, Masmanidou M, Gavriilaki M, Bouinta A, Bitsianis S, Kapravelos N, Bitzani M, Vasileiadou G, Yannaki E, Sotiropoulos D, Papagiannopoulos S, Kazis D, Kimiskidis V, Anagnostopoulos A, Sakellari I. Molecular and Clinical Characteristics of Different Toxicity Rates in Anti-CD19 Chimeric Antigen Receptor T Cells: Real-World Experience. Cancers (Basel) 2023; 15:4253. [PMID: 37686529 PMCID: PMC10487155 DOI: 10.3390/cancers15174253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Commercially available anti-CD19 chimeric antigen receptor T cells (CARΤ cells) have offered long-term survival to a constantly expanding patient population. Given that novel toxicities including cytokine release syndrome (CRS) and neurotoxicity (ICANS) have been observed, we aimed to document the safety and toxicity of this treatment in a real-world study. We enrolled 31 adult patients referred to our center for CAR T therapy. Tisagenlecleucel was infused in 12 patients, axicabtagene ciloleucel in 14, and brexucabtagene autoleucel in 5. Cytokine release syndrome was noted in 26 patients while neurotoxicity was observed in 7. Tocilizumab was administered for CRS in 18 patients, along with short-term, low-dose steroid administration in one patient who developed grade III CRS and, subsequently, grade I ICANS. High-dose steroids, along with anakinra and siltuximab, were administered in only two MCL patients. With a median follow-up time of 13.4 months, nine patients were then in CR. The progression-free (PFS) and overall survival (OS) rates were 41.2% and 88.1% at one year, respectively. MCL diagnosis, which coincides with the administration of brexucabtagene autoleucel, was the only factor to be independently associated with poor OS (p < 0.001); meanwhile, increased LDH independently predicted PFS (p = 0.027).In addition, CRP at day 14 was associated with a poor OS (p = 0.001). Therefore, our real-world experience confirmed that commercial CAR T therapy can be administered with minimal toxicity.
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Affiliation(s)
- E. Gavriilaki
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
- Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - D. Mallouri
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - Z. Bousiou
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - C. Demosthenous
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - A. Vardi
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - P. Dolgyras
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - I. Batsis
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - E. Stroggyli
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - P. Karvouni
- Medical School, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - M. Masmanidou
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - M. Gavriilaki
- 1st Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (M.G.); (V.K.)
| | - A. Bouinta
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - S. Bitsianis
- Department of Surgery, G. Papanicolaou Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - N. Kapravelos
- 1st Intensive Care Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (N.K.); (G.V.)
| | - M. Bitzani
- 2nd Intensive Care Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (M.B.); (S.P.)
| | - G. Vasileiadou
- 1st Intensive Care Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (N.K.); (G.V.)
| | - E. Yannaki
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - D. Sotiropoulos
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - S. Papagiannopoulos
- 2nd Intensive Care Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (M.B.); (S.P.)
| | - D. Kazis
- 3rd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - V. Kimiskidis
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
- 1st Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (M.G.); (V.K.)
| | - A. Anagnostopoulos
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
| | - I. Sakellari
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece; (D.M.); (Z.B.); (C.D.); (A.V.); (P.D.); (I.B.); (E.S.); (M.M.); (A.B.); (E.Y.); (D.S.); (A.A.); (I.S.)
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23
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Gavriilaki E. Editorial: 50 years of BMT: long-term outcomes and late complications after transplantation. Front Oncol 2023; 13:1253971. [PMID: 37601655 PMCID: PMC10433152 DOI: 10.3389/fonc.2023.1253971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023] Open
Affiliation(s)
- Eleni Gavriilaki
- 2 Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Romanidou G, Konstantinidis TG, Natsi AM, Kantartzi K, Panopoulou M, Kontomanolis E, Tsigalou C, Lambropoulou M, Gavriilaki E, Panagoutsos S, Pasadakis P, Mitroulis I. Decreased Levels of Soluble Developmental Endothelial Locus-1 Are Associated with Thrombotic Microangiopathy in Pregnancy. Int J Mol Sci 2023; 24:11762. [PMID: 37511523 PMCID: PMC10380227 DOI: 10.3390/ijms241411762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome is a life-threatening complication of pregnancy, which is often secondary to preeclampsia. To date, there is no biomarker in clinical use for the early stratification of women with preeclampsia who are under increased risk of HELLP syndrome. Herein, we show that the levels of circulating developmental endothelial locus-1 (DEL-1), which is an extracellular immunomodulatory protein, are decreased in patients with HELLP syndrome compared to preeclampsia. DEL-1 levels are also negatively correlated with the circulating levels of kidney injury molecule-1 (KIM-1), which is a biomarker for disorders associated with kidney damage. Receiver-operating characteristic curve analysis for DEL-1 levels and the DEL-1 to KIM-1 ratio demonstrates that these values could be used as a potential biomarker that distinguishes patients with HELLP syndrome and preeclampsia. Finally, we show that placental endothelial cells are a source for DEL-1, and that the expression of this protein in placenta from patients with HELLP syndrome is minimal. Taken together, this study shows that DEL-1 is downregulated in HELLP syndrome both in the circulation and at the affected placental tissue, suggesting a potential role for this protein as a biomarker, which must be further evaluated.
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Affiliation(s)
- Gioulia Romanidou
- Department of Nephrology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana Campus, 68100 Alexandroupolis, Greece
- General Hospital "Sismanoglio", Sismanoglou 45, 69133 Komotini, Greece
| | - Theocharis G Konstantinidis
- Laboratory of Microbiology, School of Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece
| | - Anastasia-Maria Natsi
- First Department of Internal Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece
| | - Konstantia Kantartzi
- Department of Nephrology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana Campus, 68100 Alexandroupolis, Greece
| | - Maria Panopoulou
- Laboratory of Microbiology, School of Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece
| | - Emmanouil Kontomanolis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana Campus, 68100 Alexandroupolis, Greece
| | - Christina Tsigalou
- Laboratory of Microbiology, School of Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece
| | - Maria Lambropoulou
- Laboratory of Histology-Embryology, School of Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece
| | - Eleni Gavriilaki
- Hematology Department-BMT Unit, General Hospital of Thessaloniki George Papanikolaou, 57010 Thessaloniki, Greece
| | - Stylianos Panagoutsos
- Department of Nephrology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana Campus, 68100 Alexandroupolis, Greece
| | - Ploumis Pasadakis
- Department of Nephrology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Dragana Campus, 68100 Alexandroupolis, Greece
| | - Ioannis Mitroulis
- First Department of Internal Medicine, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece
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Gavriilaki E, Dolgyras P, Dimou-Mpesikli S, Poulopoulou A, Evangelidis P, Evangelidis N, Demosthenous C, Zachrou E, Siasios P, Mallouri D, Vardi A, Bousiou Z, Panteliadou A, Batsis I, Masmanidou M, Lalayanni C, Yannaki E, Sotiropoulos D, Anagnostopoulos A, Vyzantiadis TA, Sakellari I. Risk Factors, Prevalence, and Outcomes of Invasive Fungal Disease Post Hematopoietic Cell Transplantation and Cellular Therapies: A Retrospective Monocenter Real-Life Analysis. Cancers (Basel) 2023; 15:3529. [PMID: 37444639 DOI: 10.3390/cancers15133529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: Autologous, allogeneic hematopoietic cell transplantation (HCT) and other cellular therapies, including CAR T cell and gene therapy, constitute a cornerstone in the management of various benign and malignant hematological disorders. Invasive fungal infections (IFD) remain a significant cause of morbidity and mortality in HCT recipients. Therefore, we investigated the prevalence and risk factors of IFD following HCT and other cellular therapies in an era of novel antifungal prophylaxis. (2) Methods: In this study, we retrospectively enrolled adult HCT recipients who were treated at our JACIE-accredited center according to standard operating procedures over the last decade (2013-2022). (3) Results: 950 patients who received cellular therapies were studied. None of the 19 CAR T cell and neither of the two gene therapy recipients developed IFD whereas 3/456 autologous HCT recipients who suffered from primary refractory/relapsed lymphomas presented with probable IFD. Overall, 11 patients who received allogeneic HCT experienced probable IFD, possible IFD was found in 31/473, and IFD was proven in 10/473. A second IFD episode was present in three patients. Four-year OS was significantly lower in proven compared to probable IFD (p = 0.041) and was independently associated with HCT-CI (p = 0.040) and chronic GVHD (p = 0.045). (4) Conclusions: In this real-world cohort, the prevalence of proven and probable IFD in an era of novel antifungal prophylaxis was found to be relatively low. However, IFDs were associated with poor outcomes for patients who received allogeneic HCT.
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Affiliation(s)
- Eleni Gavriilaki
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Panagiotis Dolgyras
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Sotiria Dimou-Mpesikli
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Aikaterini Poulopoulou
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Paschalis Evangelidis
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Nikolaos Evangelidis
- Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Christos Demosthenous
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Evangelia Zachrou
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Panagiotis Siasios
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Despina Mallouri
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Anna Vardi
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Zoi Bousiou
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Alkistis Panteliadou
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Ioannis Batsis
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Marianna Masmanidou
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Chrysavgi Lalayanni
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Evangelia Yannaki
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Damianos Sotiropoulos
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | - Achilles Anagnostopoulos
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
| | | | - Ioanna Sakellari
- Bone Marrow Transplantation Unit, Haematology Department, G. Papanicolaou Hospital, 57010 Thessaloniki, Greece
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Dolgyras P, Lazaridis A, Anyfanti P, Gavriilaki E, Koletsos N, Triantafyllou A, Nikolaidou B, Galanapoulou V, Douma S, Gkaliagkousi E. Microcirculation dynamics in systemic vasculitis: evidence of impaired microvascular response regardless of cardiovascular risk factors. Rheumatology (Oxford) 2023; 62:2510-2516. [PMID: 36394222 DOI: 10.1093/rheumatology/keac652] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/03/2022] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVES Systemic vasculitides (SVs) are a highly inflammatory group of diseases characterized by significant cardiovascular (CV) mortality. Microvascular damage closely linked with accelerated atherosclerosis and thrombosis represents a core pathophysiological mechanism contributing to the excess CV risk of patients with SVs. Skin represents an easily accessible tissue facilitating non-invasive microvascular study. In this study we aimed to investigate microcirculation dynamics and associate them with disease-related factors in patients with SVs. METHODS We assessed skin microcirculation using laser speckle contrast imaging (LSCI) and vascular reactivity by the post-occlusive reactive hyperaemia (PORH) protocol in a meticulously selected group of patients with SVs without CV disease and compared them to controls, matched for age, sex, BMI and smoking status. RESULTS Sixty individuals were included in the study, 30 patients and 30 controls. Patients with SVs presented a lower peak magnitude during reperfusion phase (median [interquartile range] 207 [60.1] vs 143.7 [41.0] laser speckle perfusion units, P < 0.001) and lower percentage cutaneous vascular conductance increase (mean (s.d.) 190.0 [49.6]% vs 149.6 [48.9]%, P = 0.002) as compared with controls. Importantly, microvascular damage was correlated with disease duration (P < 0.001, r = -0.563 and P < 0.001, r = 0.442, respectively). CONCLUSION For the first time we have shown that patients with SVs exhibit impaired microvascular function and blunted reactivity after occlusion, as this was demonstrated by the LSCI technique. Therefore, skin microcirculation may be a useful, non-invasive method in patients with SVs for the early detection of microvascular dysfunction, which is closely related to the high CV risk that these patients bear.
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Affiliation(s)
- Panagiotis Dolgyras
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonios Lazaridis
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiota Anyfanti
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Gavriilaki
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Koletsos
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Areti Triantafyllou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Barbara Nikolaidou
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Stella Douma
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Kosmidou A, Tragiannidis A, Gavriilaki E. Myeloid Leukemia of Down Syndrome. Cancers (Basel) 2023; 15:3265. [PMID: 37444375 DOI: 10.3390/cancers15133265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/01/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
Myeloid leukemia of Down syndrome (ML-DS) is characterized by a distinct natural history and is classified by the World Health Organization (WHO) as an independent entity, occurring with unique clinical and molecular features. The presence of a long preleukemic, myelodysplastic phase, called transient abnormal myelopoiesis (TAM), precedes the initiation of ML-DS and is defined by unusual chromosomal findings. Individuals with constitutional trisomy 21 have a profound dosage imbalance in the hematopoiesis-governing genes located on chromosome 21 and thus are subject to impaired fetal as well as to neonatal erythro-megakaryopoiesis. Almost all neonates with DS develop quantitative and morphological hematological abnormalities, yet still only 5-10% of them present with one of the preleukemic or leukemic conditions of DS. The acquired mutations in the key hematopoietic transcription factor gene GATA1, found solely in cells trisomic for chromosome 21, are considered to be the essential step for the selective growth advantage of leukemic cells. While the majority of cases of TAM remain clinically 'silent' or undergo spontaneous remission, the remaining 20% to 30% of them progress into ML-DS until the age of 4 years. The hypersensitivity of ML-DS blasts to chemotherapeutic agents, including but not limited to cytarabine, and drugs' increased infectious and cardiac toxicity have necessitated the development of risk-adapted treatment protocols for children with ML-DS. Recent advances in cytogenetics and specific molecular mechanisms involved in the evolution of TAM and ML-DS are reviewed here, as well as their integration in the improvement of risk stratification and targeted management of ML-DS.
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Affiliation(s)
- Aikaterini Kosmidou
- 2nd Department of Internal Medicine, General Hospital of Kavala, 65500 Kavala, Greece
| | - Athanasios Tragiannidis
- 2nd Department of Pediatrics, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Eleni Gavriilaki
- Hematology Department, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece
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28
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van Doesum JA, Salmanton-García J, Marchesi F, Di Blasi R, Falces-Romero I, Cabirta A, Farina F, Besson C, Weinbergerová B, Van Praet J, Schönlein M, Lopez-Garcia A, Lamure S, Guidetti A, De Ramón-Sánchez C, Batinic J, Gavriilaki E, Tragiannidis A, Tisi MC, Plantefeve G, Petzer V, Ormazabal-Velez I, Marques de Almeida J, Marchetti M, Maertens JA, Machado M, Kulasekararaj AG, Hernández-Rivas JÁ, Gomes da Silva M, Fernández N, Espigado I, Drgona L, Dragonetti G, Metafuni E, Calbacho M, Blennow O, Wolf D, van Anrooij B, Nunes Rodrigues R, Nordlander A, Martín-González JA, Lievin R, Jiménez M, Grafe SK, Garcia-Sanz R, Córdoba R, Rahimli L, van Meerten T, Cornely OA, Pagano L. Impact of SARS-CoV-2 vaccination and monoclonal antibodies on outcome post CD19-CAR-T: an EPICOVIDEHA survey. Blood Adv 2023:495340. [PMID: 37058479 PMCID: PMC10112941 DOI: 10.1182/bloodadvances.2022009578] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 04/15/2023] Open
Abstract
Patients with previous CD19 directed chimeric antigen receptor T cell therapy (CAR T)-cell therapy have a prolonged vulnerability to viral infections. Coronavirus diseases 2019 (COVID-19) has a great impact and has previously been shown to cause high mortality in this population. Until now, real world data of the impact of vaccination and treatment on patients with COVID-19 after CD19 directed CAR T-cell therapy are lacking. Therefore, this multicenter retrospective study was conducted with data from the EPICOVIDEHA survey. Sixty-four patients were identified. The overall mortality caused by COVID-19 was 31%. Patients infected with the Omicron variant had a significantly lower risk of death due to COVID-19 compared to patients infected with previous variants (7% versus 58% (P=0.012)). Twenty-six patients were vaccinated at time of COVID-19 diagnosis. Two vaccinations showed marked but unsignificant reduction risk of COVID-19 caused mortality (33.3% versus 14.2% (P=0.379)).Also the course of disease appears milder with less frequent ICU admissions (39% versus 14% (P=0.054)) and shorter duration of hospitalization (7 versus 27.5 days (P=0.022)). Of the available treatment options, only monoclonal antibodies seemed to be effectively reducing mortality from 32% to zero (P=0.036). We conclude that survival rates of CAR T-cell recipients with COVID-19 improved over time and that the combination of prior vaccination and monoclonal antibody treatment significantly reduces their risk of death.
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Affiliation(s)
- Jaap A van Doesum
- University Medical Center Groningen, Groningen, the Netherlands, Groningen, Netherlands
| | | | | | | | | | - Alba Cabirta
- Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119, Barcelona, Spain
| | | | | | | | - Jens Van Praet
- AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium, Brugge, Belgium
| | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Germany
| | - Alberto Lopez-Garcia
- Department of Hematology, Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain., Madrid, Spain
| | | | - Anna Guidetti
- Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Milano, Italy
| | | | - Josip Batinic
- University Hospital Centre Zagreb, Zagreb, Croatia, Zagreb, Croatia, Republic of
| | | | | | | | - Gaëtan Plantefeve
- Centre Hospitalier d'Argenteuil, Argenteuil, France, Centre Hospitalier d'Argenteuil, Argenteuil, France, France
| | | | | | | | - Monia Marchetti
- Az Osp SS Antonio e Biagio e Cesare Arrigo, Alessandria, Alessandria, Italy
| | | | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | | | | | - Noemí Fernández
- Hospital Universitario Marqués de Valdecilla de Santander, SANTANDER, Spain
| | - Ildefonso Espigado
- University Hospital Virgen Macarena / University Hospital Virgen del Rocío, Seville., Sevilla, Spain
| | - Lubos Drgona
- Oncohematology Clinic, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovak Republic
| | - Giulia Dragonetti
- Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Elisabetta Metafuni
- Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Rome, Idaho, Italy
| | | | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Dominik Wolf
- Medical University of Innsbruck, Innsbruck, Austria
| | - Bjorn van Anrooij
- University Medical Center Groningen, University of Groningen,, Groningen, Netherlands
| | - Raquel Nunes Rodrigues
- Departamento de Hematologia, Instituto Português de Oncologia, Lisboa, Portugal, Lisbon, Portugal
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital,, stockholm, Sweden
| | | | | | - Moraima Jiménez
- Servei d'Hematologia, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | | | | - Raúl Córdoba
- Department of Hematology, Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain., Madrid, Spain
| | - Laman Rahimli
- "University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany University of Cologne,, Köln, Germany
| | | | | | - Livio Pagano
- Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy, Rome, Italy
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29
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Vythoulkas D, Lazana I, Kroupis C, Gavriilaki E, Konstantellos I, Bousiou Z, Chondropoulos S, Griniezaki M, Vardi A, Gkirkas K, Karagiannidou A, Batsis I, Stamouli M, Sakellari I, Tsirigotis P. Endothelial Injury Syndromes after Allogeneic Hematopoietic Stem Cell Transplantation: Angiopetin-2 as a Novel Predictor of the Outcome and the Role of Functional Autoantibodies against Angiotensin II Type 1 and Endothelin A Receptor. Int J Mol Sci 2023; 24:ijms24086960. [PMID: 37108124 PMCID: PMC10138628 DOI: 10.3390/ijms24086960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/01/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Transplant-associated thrombotic microangiopathy (TMA) occurs in a significant percentage of patients after allogeneic stem cell transplantation (allo-SCT) and is associated with significant morbidity and mortality. The aim of the present study was to examine the association of serum angiopoetin-2 (Ang2) levels and the presence of antibodies against angiotensin II type 1 (AT1R) and ndothelin A Recreptor (ETAR) with the outcome of patients with TMA and/or graft-versus-host disease (GVHD) after allo-SCT. Analysis of our data showed that elevated serum Ang2 levels at the time of TMA diagnosis are significantly associated with increased non-relapse mortality and decreased overall survival. To our knowledge, this is the first study demonstrating an association between raised Ang2 levels and poor outcomes in patients with TMA. Antibodies against AT1R (AT1R-Abs) and ETAR (ETAR-Abs) were detected in 27% and 23% of the patients, respectively, but there was no association between the presence of autoantibodies and the outcome of patients with TMA. However, a significant finding was the strong positive correlation between the presence of AT1R-Abs with the occurrence of chronic fibrotic GVHD, such as scleroderma and cryptogenic organizing pneumonia, raising the possibility of the contribution of autoantibodies in the pathogenesis of fibrotic GVHD manifestations.
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Affiliation(s)
- Dionysios Vythoulkas
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Ioanna Lazana
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Christos Kroupis
- Clinical Biochemistry and Molecular Diagnostics, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Eleni Gavriilaki
- Hematology and Bone Marrow Transplantation Department, "G. Papanikolaou" General Hospital, 57010 Thessaloniki, Greece
| | - Ioannis Konstantellos
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Zoi Bousiou
- Hematology and Bone Marrow Transplantation Department, "G. Papanikolaou" General Hospital, 57010 Thessaloniki, Greece
| | - Spiros Chondropoulos
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Marianna Griniezaki
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Anna Vardi
- Hematology and Bone Marrow Transplantation Department, "G. Papanikolaou" General Hospital, 57010 Thessaloniki, Greece
| | - Konstantinos Gkirkas
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Aggeliki Karagiannidou
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Ioannis Batsis
- Hematology and Bone Marrow Transplantation Department, "G. Papanikolaou" General Hospital, 57010 Thessaloniki, Greece
| | - Maria Stamouli
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Ioanna Sakellari
- Hematology and Bone Marrow Transplantation Department, "G. Papanikolaou" General Hospital, 57010 Thessaloniki, Greece
| | - Panagiotis Tsirigotis
- Hematology Division, 2nd Department of Internal Medicine, Propaedeutic, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
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30
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Gavriilaki M, Anyfanti P, Mastrogiannis K, Gavriilaki E, Lazaridis A, Kimiskidis V, Gkaliagkousi E. Association between ambulatory blood pressure monitoring patterns with cognitive function and risk of dementia: a systematic review and meta-analysis. Aging Clin Exp Res 2023; 35:745-761. [PMID: 36995461 PMCID: PMC10115699 DOI: 10.1007/s40520-023-02361-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/30/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND The objective of this systematic review and meta-analysis is to investigate whether nocturnal blood pressure fall, expressed by dipping patterns according to 24 h ambulatory blood pressure monitoring (ABPM), is associated with abnormal cognitive function (cognitive impairment or dementia). METHODS We systematically searched PubMed, Embase, and Cochrane databases to identify original articles through December 2022. We included any study with at least ten participants reporting on all-cause dementia or cognitive impairment incidence (primary outcome) or validated cognitive tests (secondary outcome) among ABPM patterns. We assessed risk of bias using Newcastle-Ottawa Quality Assessment Scale. We pooled odds ratios (OR) and standardized mean differences (SMD) using random-effect models for primary and secondary outcome, respectively. RESULTS In the qualitative synthesis, 28 studies examining 7595 patients were included. The pooled analysis of 18 studies showed that dippers had a 51% [OR 0.49(0.35-0.69)] lower risk of abnormal cognitive function and a 63% [OR 0.37(0.23-0.61)] lower risk of dementia alone, compared to non-dippers. Reverse dippers presented an up to sixfold higher risk [OR 6.06(3.15-11.64)] of abnormal cognitive function compared to dippers and an almost twofold higher risk [OR 1.81(1.26-2.6)] compared to non-dippers. Reverse dippers performed worse in global function neuropsychological tests compared with both dippers [SMD - 0.66(- 0.93 to - 0.39)] and non-dippers [SMD - 0.35(- 0.53 to - 0.16)]. CONCLUSION Dysregulation of the normal circadian BP rhythm, specifically non-dipping and reverse dipping is associated with abnormal cognitive function. Further studies are required to determine potential underlying mechanisms and possible prognostic or therapeutic implications. PROTOCOL REGISTRATION PROSPERO database (ID: CRD42022310384).
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Affiliation(s)
- Maria Gavriilaki
- 1st Department of Neurology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiota Anyfanti
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece
| | - Konstantinos Mastrogiannis
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece
| | - Eleni Gavriilaki
- Hematology Department, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Antonios Lazaridis
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece
| | - Vasilios Kimiskidis
- 1st Department of Neurology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Efkarpia, 56429, Thessaloniki, Greece.
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31
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Tsiftsoglou SA, Gavriilaki E, Touloumenidou T, Koravou EE, Koutra M, Papayanni PG, Karali V, Papalexandri A, Varelas C, Chatzopoulou F, Chatzidimitriou M, Chatzidimitriou D, Veleni A, Rapti E, Kioumis I, Kaimakamis E, Bitzani M, Boumpas DT, Tsantes A, Sotiropoulos D, Papadopoulou A, Sakellari I, Kokoris S, Anagnostopoulos A. Targeted genotyping of COVID-19 patients reveals a signature of complement C3 and factor B coding SNPs associated with severe infection. Immunobiology 2023; 228:152351. [PMID: 36805858 PMCID: PMC9928680 DOI: 10.1016/j.imbio.2023.152351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 01/19/2023] [Accepted: 02/11/2023] [Indexed: 02/17/2023]
Abstract
We have attempted to explore further the involvement of complement components in the host COVID-19 (Coronavirus disease-19) immune responses by targeted genotyping of COVID-19 adult patients and analysis for missense coding Single Nucleotide Polymorphisms (coding SNPs) of genes encoding Alternative pathway (AP) components. We have identified a small group of common coding SNPs in Survivors and Deceased individuals, present in either relatively similar frequencies (CFH and CFI SNPs) or with stark differences in their relative abundance (C3 and CFB SNPs). In addition, we have identified several sporadic, potentially protective, coding SNPs of C3, CFB, CFD, CFH, CFHR1 and CFI in Survivors. No coding SNPs were detected for CD46 and CD55. Our demographic analysis indicated that the C3 rs1047286 or rs2230199 coding SNPs were present in 60 % of all the Deceased patients (n = 25) (the rs2230199 in 67 % of all Deceased Males) and in 31 % of all the Survivors (n = 105, p = 0.012) (the rs2230199 in 25 % of all Survivor Males). When we analysed these two major study groups using the presence of the C3 rs1047286 or rs2230199 SNPs as potential biomarkers, we noticed the complete absence of the protective CFB rs12614 and rs641153 coding SNPs from Deceased Males compared to Females (p = 0.0023). We propose that in these individuals, C3 carrying the R102G and CFB lacking the R32W or the R32Q amino acid substitutions, may contribute to enhanced association dynamics of the C3bBb AP pre-convertase complex assembly, thus enabling the exploitation of the activation of the Complement Alternative pathway (AP) by SARS-CoV-2.
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Affiliation(s)
- Stefanos A Tsiftsoglou
- Laboratory of Pharmacology, Department of Pharmaceutical Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece.
| | - Eleni Gavriilaki
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece.
| | - Tasoula Touloumenidou
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | | | - Maria Koutra
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | | | - Vassiliki Karali
- Rheumatology and Clinical Immunology Unit, University General Hospital "Attikon", Αthens, Greece
| | - Apostolia Papalexandri
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | - Christos Varelas
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | - Fani Chatzopoulou
- Microbiology Department, Aristotle University of Thessaloniki, Greece
| | - Maria Chatzidimitriou
- Biomedical Sciences Alexander Campus International Hellenic University, Thessaloniki, Greece
| | | | - Anastasia Veleni
- Infectious Disease Committee, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Evdoxia Rapti
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital "Attikon", NKUA, Medical School, Athens, Greece
| | - Ioannis Kioumis
- Respiratory Failure Department, G Papanicolaou Hospital-Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Milly Bitzani
- 1st Intensive Care Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Dimitrios T Boumpas
- Rheumatology and Clinical Immunology Unit, University General Hospital "Attikon", Αthens, Greece
| | - Argyris Tsantes
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital "Attikon", NKUA, Medical School, Athens, Greece
| | - Damianos Sotiropoulos
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | - Anastasia Papadopoulou
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | - Ioanna Sakellari
- Hematology Department-BMT Unit, G. Papanicolaou Hospital, Exochi, Thessaloniki 57010, Greece
| | - Styliani Kokoris
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital "Attikon", NKUA, Medical School, Athens, Greece
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Halahleh K, Arai Y, Gavriilaki E. Post-Transplant Complications. Blood Cell Ther 2023; 6:23-29. [PMID: 37324567 PMCID: PMC10266915 DOI: 10.31547/bct-2022-021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
Hematopoietic cell transplantation (HCT) is a potentially curative therapy for patients with high-risk malignant and nonmalignant conditions. Nevertheless, various post-allogeneic HCT (allo-HCT) complications with diverse chronology, etiology, and pathophysiological background can develop, including general and organ-specific complications, such as graft dysfunction, infectious, and non-infectious etiologies, as well as non-infectious pulmonary complications (NIPCs). Post-transplant complications can also be related to conditioning intensity and drug-specific side effects. However, treatment options for these complications are suboptimal at present. Poor graft function (PGF) is a potentially life-threatening post-allo-HCT complication and is reported in 5-30% of patients. Nevertheless, consensus guidelines to define and treat PGF are not available. Most therapies are symptomatic with variable success rates. NIPCs are diverse and difficult to diagnose. The pathophysiology of NIPCs remains ill-defined, and effective treatment approaches have not been standardized, with mortality exceeding 50% for some conditions, such as idiopathic pneumonia syndrome (IPS). Modification of the conditioning regimen intensity and introduction of novel agents have been used to decrease post-allo-HCT complications, including infections, non-infectious complications, graft-versus-host disease (GvHD), as well as cardiopulmonary, neurological, hepatorenal, and other complications. Transplant-associated thrombotic microangiopathy (TA-TMA) is a lethal post-allo-HCT complication that may be associated with functional and genetic abnormalities in complement activation and related to the use of calcineurin inhibitors, such as cyclosporine and tacrolimus. The introduction of complement inhibitors has transformed TA-TMA from a lethal complication to a treatable syndrome.
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Affiliation(s)
- Khalid Halahleh
- Bone Marrow Transplantation Program and Cell Therapy, King Hussein Cancer Center, Amman, Jordan
| | - Yasuyuki Arai
- Department of Hematology and Oncology, Kyoto University, Kyoto, Japan
| | - Eleni Gavriilaki
- Hematology Department, G Papanicolaou Hospital, Thessaloniki, Greece
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Busca A, Salmanton-García J, Marchesi F, Farina F, Seval GC, Van Doesum J, De Jonge N, Bahr NC, Maertens J, Meletiadis J, Fracchiolla NS, Weinbergerová B, Verga L, Ráčil Z, Jiménez M, Glenthøj A, Blennow O, Tanase AD, Schönlein M, Prezioso L, Khanna N, Duarte RF, Žák P, Nucci M, Machado M, Kulasekararaj A, Espigado I, De Kort E, Ribera-Santa Susana JM, Marchetti M, Magliano G, Falces-Romero I, Ilhan O, Ammatuna E, Zompi S, Tsirigotis P, Antoniadou A, Zambrotta GPM, Nordlander A, Karlsson LK, Hanakova M, Dragonetti G, Cabirta A, Berg Venemyr C, Gräfe S, Van Praet J, Tragiannidis A, Petzer V, López-García A, Itri F, Groh A, Gavriilaki E, Dargenio M, Rahimli L, Cornely OA, Pagano L. Outcome of COVID-19 in allogeneic stem cell transplant recipients: Results from the EPICOVIDEHA registry. Front Immunol 2023; 14:1125030. [PMID: 36911708 PMCID: PMC9999728 DOI: 10.3389/fimmu.2023.1125030] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/01/2023] [Indexed: 03/04/2023] Open
Abstract
Background The outcome of COVID-19 in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is almost uniformely considered poor. The aim of present study was to retrospectively analyse the outcome and risk factors for mortality in a large series of patients who developed COVID-19 infection after an allogeneic HSCT. Methods This multicenter retrospective study promoted by the European Hematology Association - Infections in Hematology Study Working Group, included 326 adult HSCT patients who had COVID-19 between January 2020 and March 2022. Results The median time from HSCT to the diagnosis of COVID-19 was 268 days (IQR 86-713; range 0-185 days). COVID-19 severity was mild in 21% of the patients, severe in 39% and critical in 16% of the patients. In multivariable analysis factors associated with a higher risk of mortality were, age above 50 years, presence of 3 or more comorbidities, active hematologic disease at time of COVID-19 infection, development of COVID-19 within 12 months of HSCT, and severe/critical infections. Overall mortality rate was 21% (n=68): COVID-19 was the main or secondary cause of death in 16% of the patients (n=53). Conclusions Mortality in HSCT recipients who develop COVID-19 is high and largely dependent on age, comorbidities, active hematologic disease, timing from transplant and severity of the infection.
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Affiliation(s)
- Alessandro Busca
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | | | | | - Nathan C. Bahr
- University of Kansas Medical Center, Kansas, KS, United States
| | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, KULeuven, Leuven, Belgium
- Department of Hematology, UZ Leuven, Leuven, Belgium
| | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Barbora Weinbergerová
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czechia
| | - Luisa Verga
- Azienda Ospedaliera San Gerardo - Monza, Monza, Italy
- Università Milano-Bicocca, Milan, Italy
| | - Zdeněk Ráčil
- Institute of Hematology and Blood Transfusion, Prague, Czechia
| | - Moraima Jiménez
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Alina Daniela Tanase
- Fundeni Clinical Institute, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, and Department of Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | | | - Pavel Žák
- University Hospital Hradec Králové, Hradec Králové, Czechia
| | - Marcio Nucci
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marina Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Austin Kulasekararaj
- King’s College Hospital, London, United Kingdom
- King’s College London, London, United Kingdom
| | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | | | | | - Monia Marchetti
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | | | | | - Sofia Zompi
- Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Panagiotis Tsirigotis
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Antoniadou
- Clinical Microbiology Laboratory, Medical School, “Attikon” University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Giulia Dragonetti
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Alba Cabirta
- Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital, Barcelona, Spain
| | - Caroline Berg Venemyr
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Stefanie Gräfe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Jens Van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - Verena Petzer
- Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | - Ana Groh
- Infektiologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main, Germany
| | - Eleni Gavriilaki
- General Hospital of Thessaloniki “George Papanikolaou”, Thessaloniki, Greece
| | | | - Laman Rahimli
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Oliver A. Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
- German Centre for Infection Research (DZIF) , Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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Kokoris S, Gavriilaki E, Vrigκou E, Triantafyllou K, Roumelioti A, Kyriakou E, Lada E, Gialeraki A, Kalantzis D, Grouzi E. Anemia in Celiac Disease: Multiple Aspects of the Same Coin. Acta Haematol 2023; 146:82-87. [PMID: 36380606 DOI: 10.1159/000527463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022]
Abstract
Extraintestinal manifestations of celiac disease (CD) are an integral part of the disease's clinical profile and, frequently, appear as the presenting feature. Given that anemia in CD may be multifactorial, increased awareness is needed on the part of treating physicians, and especially hematologists, to screen for CD. In this study, we highlight anemia as the presenting feature of CD which has remained undiagnosed for several years. In patients with a positive antibody testing or high suspicion of CD, endoscopy with a biopsy of the small intestine is performed, as it is considered the "gold standard" for diagnosing CD. Since most of the manifestations of CD are preventable or treatable with a gluten-free diet, an early diagnosis is vital for the prevention of serious and potentially lethal complications.
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Affiliation(s)
- Styliani Kokoris
- Laboratory of Hematology and Blood Bank Unit, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Eleni Gavriilaki
- Hematology Department - BMT Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Eleni Vrigκou
- Second Department of Critical Care Medicine, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, Second Department of Internal Medicine-Propaedeutic and Research Institute, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Anna Roumelioti
- Department of Hematology and Lymphoma BMTU, Evangelismos General Hospital, Athens, Greece
| | - Elias Kyriakou
- Laboratory of Hematology and Blood Bank Unit, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Evangelia Lada
- Laboratory of Hematology and Blood Bank Unit, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Argyri Gialeraki
- Laboratory of Hematology and Blood Bank Unit, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Dimitrios Kalantzis
- Laboratory of Hematology and Blood Bank Unit, National and Kapodistrian University of Athens, Medical School, "Attikon" University General Hospital, Athens, Greece
| | - Elisavet Grouzi
- Department of Transfusion Service and Clinical Hemostasis, "Saint Savvas" Oncology Hospital, Athens, Greece
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35
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Anyfanti P, Gavriilaki E, Dolgyras P, Nikolaidou B, Dimitriadou A, Lazaridis A, Mastrogiannis K, Koletsos N, Triantafyllou A, Dimitroulas T, Aslanidis S, Doumas M, Douma S, Gkaliagkousi E. Skin microcirculation dynamics are impaired in patients with rheumatoid arthritis and no cardiovascular comorbidities. Clin Exp Rheumatol 2023:19230. [PMID: 36700655 DOI: 10.55563/clinexprheumatol/nf05o4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/14/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Rheumatoid arthritis (RA) is associated with increased cardiovascular disease (CVD) risk. Microvascular endothelial dysfunction contributes to the development of vascular injury and subsequent CVD. We hypothesised that RA patients exhibit blunted microvascular reactivity regardless of CVD risk factors and investigated potential associations with coronary microvascular perfusion and surrogate markers of CVD. METHODS This case-control study recruited RA patients and non-RA individuals in the absence of cardiovascular comorbidities. Skin microvascular reactivity was dynamically assessed using laser speckle contrast imaging coupled with post-occlusive reactive hyperaemia protocol. Applanation tonometry was applied to assess subendocardial viability ratio, an index of myocardial microvascular perfusion, and central arterial stiffness [carotid-femoral pulse wave velocity (PWV), augmentation index]. Peripheral arterial stiffness (carotid PWV, β-stiffness index) and carotid atherosclerosis (intima-media thickness) were assessed with carotid ultrasound software. RESULTS Skin microvascular responses before and following reperfusion [baseline flux, occlusion flux, time-to-peak, peak magnitude, peak-to-baseline magnitude, baseline cutaneous vascular conductance (CVC), and percentage increase in CVC] were significantly impaired in RA patients (n=35) compared to controls (n=35). Presence of RA independently predicted altered microvascular reactivity in multivariate analysis. Skin microcirculation dynamics significantly correlated with coronary microvascular perfusion and peripheral arterial stiffness, yet not carotid atherosclerosis, even after adjustment for CVD risk factors. CONCLUSIONS Patients with RA present impaired microvascular reactivity regardless of CVD risk factors at a preclinical stage preceding CVD. Assessment of skin microvascular dysfunction may reflect a state of generalised vasculopathy, including myocardial microvascular abnormalities, and serve as a non-invasive surrogate indicator of CVD risk in RA.
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Affiliation(s)
- Panagiota Anyfanti
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, and Second Medical Department Hippokration Hospital, Aristotle University of Thessaloniki, Greece.
| | - Eleni Gavriilaki
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece
| | - Panagiotis Dolgyras
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece
| | - Barbara Nikolaidou
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece
| | - Antonia Dimitriadou
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece
| | - Antonios Lazaridis
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece
| | - Konstantinos Mastrogiannis
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece
| | - Nikolaos Koletsos
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece
| | - Areti Triantafyllou
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece
| | - Theodoros Dimitroulas
- Fourth Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Greece
| | - Spyros Aslanidis
- Second Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Greece
| | - Michael Doumas
- Second Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Greece
| | - Stella Douma
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece
| | - Eugenia Gkaliagkousi
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece
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Gavriilaki E, Anyfanti P. Editorial: Endotheliopathies: Current concepts and importance in clinical practice. Front Med (Lausanne) 2023; 10:1162121. [PMID: 36936244 PMCID: PMC10022819 DOI: 10.3389/fmed.2023.1162121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Affiliation(s)
- Eleni Gavriilaki
- Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- *Correspondence: Eleni Gavriilaki
| | - Panagiota Anyfanti
- Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Koletsos N, Dipla K, Triantafyllou A, Lazaridis A, Papadopoulos NG, Dolgyras P, Gavriilaki E, Anyfanti P, Zafeiridis A, Koravou EE, Aslanidis S, Douma S, Gkaliagkousi E. Blunted cerebral oxygenation during exercise in systemic lupus erythematosus patients. Clin Exp Rheumatol 2023; 41:6-14. [PMID: 35238763 DOI: 10.55563/clinexprheumatol/q8iygd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/07/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Subclinical brain lesions have been reported in systemic lupus erythematosus (SLE) patients. Advanced neuroimaging techniques have revealed microstructural and microvascular alterations. Most studies examining structural or functional brain abnormalities were performed either at rest or during a mental task. Our study aimed to examine possible differences in cerebral oxygenation during exercise between SLE patients without known neuropsychiatric manifestations and age-matched controls, using near-infrared-spectroscopy (NIRS) and examine possible underlying mechanisms through evaluation of brain derived neurotrophic factor (BDNF) levels. METHODS The protocol involved a seated rest, a 3-min submaximal (30%) handgrip exercise, and a 3-min recovery. Continuous-NIRS was used to monitor changes in cerebral-oxygenated (O2Hb), de-oxygenated (HHb) and total-haemoglobin (tHb). BDNF levels were measured in serum samples. RESULTS Twenty-six SLE patients and 27 matched controls were enrolled. No differences were observed in baseline characteristics. During exercise, cerebral-O2Hb increased in both groups. However, SLE patients exhibited a significantly lower average- (1.20 ± 0.89 vs. 2.69 ± 2.46, p=0.001) and peak-O2Hb response (2.89 ± 1.56 vs. 5.83 ± 4.59, p=0.004) compared to controls. Serum BDNF levels were significantly lower in SLE patients compared to controls (p<0.01). CONCLUSIONS To our knowledge, this is the first study to evaluate cerebral oxygenation during exercise using NIRS in SLE patients compared to age-matched controls. Our data show that SLE patients even without overt neuropsychiatric manifestations exhibit a blunted increase in cerebral-O2Hb during a submaximal exercise stimulus. Examining brain oxygenation during a simple exercise task may assist in identifying patients with early alterations in cerebral function.
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Affiliation(s)
- Nikolaos Koletsos
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantina Dipla
- Exercise Physiology and Biochemistry Laboratory, Department of Sport Sciences, Aristotle University of Thessaloniki, Serres, Greece
| | - Areti Triantafyllou
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonios Lazaridis
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Panagiotis Dolgyras
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Gavriilaki
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, and Department of Haematology, BMT Unit, G. Papanikolaou General Hospital, Thessaloniki, Greece
| | - Panagiota Anyfanti
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Zafeiridis
- Exercise Physiology and Biochemistry Laboratory, Department of Sport Sciences, Aristotle University of Thessaloniki, Serres, Greece
| | | | - Spyros Aslanidis
- Rheumatology Department, 2nd Propedeutic Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, Greece
| | - Stella Douma
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Asteris PG, Kokoris S, Gavriilaki E, Tsoukalas MZ, Houpas P, Paneta M, Koutzas A, Argyropoulos T, Alkayem NF, Armaghani DJ, Bardhan A, Cavaleri L, Cao M, Mansouri I, Mohammed AS, Samui P, Gerber G, Boumpas DT, Tsantes A, Terpos E, Dimopoulos MA. Early prediction of COVID-19 outcome using artificial intelligence techniques and only five laboratory indices. Clin Immunol 2023; 246:109218. [PMID: 36586431 PMCID: PMC9797218 DOI: 10.1016/j.clim.2022.109218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/25/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022]
Abstract
We aimed to develop a prediction model for intensive care unit (ICU) hospitalization of Coronavirus disease-19 (COVID-19) patients using artificial neural networks (ANN). We assessed 25 laboratory parameters at first from 248 consecutive adult COVID-19 patients for database creation, training, and development of ANN models. We developed a new alpha-index to assess association of each parameter with outcome. We used 166 records for training of computational simulations (training), 41 for documentation of computational simulations (validation), and 41 for reliability check of computational simulations (testing). The first five laboratory indices ranked by importance were Neutrophil-to-lymphocyte ratio, Lactate Dehydrogenase, Fibrinogen, Albumin, and D-Dimers. The best ANN based on these indices achieved accuracy 95.97%, precision 90.63%, sensitivity 93.55%. and F1-score 92.06%, verified in the validation cohort. Our preliminary findings reveal for the first time an ANN to predict ICU hospitalization accurately and early, using only 5 easily accessible laboratory indices.
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Affiliation(s)
- Panagiotis G. Asteris
- Computational Mechanics Laboratory, School of Pedagogical and Technological Education, Athens, Greece
| | - Styliani Kokoris
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital "Attikon", National and Kapodistrian University of Athens, Medical School, Greece.
| | - Eleni Gavriilaki
- Hematology Department – BMT Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Markos Z. Tsoukalas
- Computational Mechanics Laboratory, School of Pedagogical and Technological Education, Athens, Greece
| | - Panagiotis Houpas
- Computational Mechanics Laboratory, School of Pedagogical and Technological Education, Athens, Greece
| | - Maria Paneta
- Fourth Department of Internal Medicine, University General Hospital "Attikon", National and Kapodistrian University of Athens, Medical School, Greece
| | | | | | - Nizar Faisal Alkayem
- Jiangxi Province Key Laboratory of Environmental Geotechnical Engineering and Hazards Control, Jiangxi University of Science and Technology, Ganzhou 341000, China
| | - Danial J. Armaghani
- Department of Urban Planning, Engineering Networks and Systems, Institute of Architecture and Construction, South Ural State University, 76, Lenin Prospect, Chelyabinsk 454080, Russian Federation
| | - Abidhan Bardhan
- Civil Engineering Department, National Institute of Technology Patna, Bihar, India
| | - Liborio Cavaleri
- Department of Civil, Environmental, Aerospace and Materials Engineering, University of Palermo, Palermo, Italy
| | - Maosen Cao
- Jiangxi Province Key Laboratory of Environmental Geotechnical Engineering and Hazards Control, Jiangxi University of Science and Technology, Ganzhou 341000, China
| | - Iman Mansouri
- Department of Civil and Environmental Engineering, Princeton University Princeton, Princeton, NJ 08544, USA
| | - Ahmed Salih Mohammed
- Engineering Department, American University of Iraq, Sulaimani, Kurdistan-Region, Iraq
| | - Pijush Samui
- Civil Engineering Department, National Institute of Technology Patna, Bihar, India
| | - Gloria Gerber
- Hematology Division, Johns Hopkins University, Baltimore, USA
| | - Dimitrios T. Boumpas
- "Attikon" University Hospital of Athens, Rheumatology and Clinical Immunology, Medical School, National and Kapodistrian University of Athens, Athens, Attica, Greece
| | - Argyrios Tsantes
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital "Attikon", National and Kapodistrian University of Athens, Medical School, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, Medical School, Faculty of Medicine, National Kapodistrian University of Athens, Athens, Greece
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics, Medical School, Faculty of Medicine, National Kapodistrian University of Athens, Athens, Greece
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Gavriilaki E, Kokoris S. COVID-19 sequelae: can long-term effects be predicted? Lancet Infect Dis 2022; 22:1651-1652. [PMID: 36030797 PMCID: PMC9411257 DOI: 10.1016/s1473-3099(22)00529-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 07/21/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Eleni Gavriilaki
- Hematology Department-BMT Unit, General Hospital of Thessaloniki George Papanikolaou, Thessaloniki 57010, Greece.
| | - Styliani Kokoris
- Laboratory of Hematology and Hospital Blood Transfusion Department, University General Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
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Gavriilaki E, Tragiannidis A, Papathanasiou M, Besikli S, Karvouni P, Douka V, Paphianou E, Hatzipantelis E, Papaioannou G, Athanasiadou A, Marvaki A, Panteliadou AK, Vardi A, Batsis I, Syrigou A, Mallouri D, Lalayanni C, Sakellari I. Aplastic anemia and paroxysmal nocturnal hemoglobinuria in children and adults in two centers of Northern Greece. Front Oncol 2022; 12:947410. [PMID: 36439498 PMCID: PMC9684709 DOI: 10.3389/fonc.2022.947410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/17/2022] [Indexed: 09/14/2023] Open
Abstract
Bone marrow failure (BMF) syndromes are a group of various hematological diseases with cytopenia as a main common characteristic. Given their rarity and continuous progress in the field, we aim to provide data considering the efficiency and safety of the therapeutic methods, focusing on the treatment of aplastic anemia(AA) and paroxysmal nocturnal hemoglobinuria (PNH). We enrolled consecutive patients diagnosed with BMF in two referral centers of Northern Greece from 2008 to 2020. We studied 43 patients with AA (37 adults and 6 children/adolescents) and 6 with classical PNH. Regarding classical PNH, 4 patients have received eculizumab treatment with 1/4 presenting extravascular hemolysis. Among 43 patients with aplastic anemia, PNH clones were detected in 11. Regarding patients that did not receive alloHCT (n=15), 14/15 were treated with ATG and cyclosporine as first line, with the addition of eltrombopag in patients treated after its approval (n=9). With a median follow-up of 16.7 (1.8-56.2) months from diagnosis, 12/14 (85.7%) are alive (4-year OS: 85.1%). AlloHCT was performed in 28 patients. Five patients developed TA-TMA which did not resolve in 3/5 (all with a pre-transplant PNH clone). With the follow-up among survivors reaching 86.3 (6.3-262.4) months, 10-year OS was 56.9%, independently associated with PNH clones after adjusting for age (p=0.024). In conclusion, our real-world experience confirms that novel treatments are changing the field of BMF syndromes. Nevertheless, there is still an unmet need to personalize algorithms in this field.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Athanasios Tragiannidis
- 2Paediatric Department, American Hellenic Educational Progressive Association (AHEPA) Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Papathanasiou
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Sotiria Besikli
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | | | - Vassiliki Douka
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Eleni Paphianou
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Emmanuel Hatzipantelis
- 2Paediatric Department, American Hellenic Educational Progressive Association (AHEPA) Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Giorgos Papaioannou
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Anastasia Athanasiadou
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Anastasia Marvaki
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Alkistis-Kira Panteliadou
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Anna Vardi
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Ioannis Batsis
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Antonia Syrigou
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Despina Mallouri
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Chrysavgi Lalayanni
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Ioanna Sakellari
- Hematology Department and Bone Marrow Transplant (BMT) Unit, G Papanicolaou Hospital, Thessaloniki, Greece
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Gavriilaki E, Labopin M, Sakellari I, Salmenniemi U, Yakoub-Agha I, Potter V, Berceanu A, Rambaldi A, Hilgendorf I, Kröger N, Mielke S, Zuckerman T, Sanz J, Busca A, Ozdogu H, Anagnostopoulos A, Savani B, Giebel S, Bazarbachi A, Spyridonidis A, Nagler A, Mohty M. Comparative study of treosulfan plus Fludarabine (FT14) with busulfan plus Fludarabine (FB4) for acute myeloid leukemia in first or second complete remission: An analysis from the European Society for Blood and Marrow Transplantation (EBMT) Acute Leukemia Working Party (ALWP). Bone Marrow Transplant 2022; 57:1803-1809. [PMID: 36138068 DOI: 10.1038/s41409-022-01830-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 08/26/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022]
Abstract
Different doses of treosulfan plus fludarabine have shown advantage over reduced intensity regimens. However, data comparing higher doses of treosulfan to myeloablative busulfan are limited. Thus, we compared outcomes between FT14 (fludarabine 150/160 mg/m2 and treosulfan 42 g/m2, or FT14) over FB4 (fludarabine 150/160 mg/m2 and busulfan 12.8 mg/kg). We retrospectively studied patients from European Society for Blood and Marrow Transplantation registry: a) adults diagnosed with acute myeloid leukemia (AML), b) recipients of first allogeneic hematopoietic stem cell transplantation (HSCT) from unrelated or sibling donor (2010-2020), c) HSCT at first or second complete remission, d) conditioning with FT14 or FB4. FT14 recipients (n = 678) were older, with higher rates of secondary AML, unrelated donors, peripheral blood grafts, and adverse cytogenetics, but lower percentage of female donor to male recipient compared to FB4 (n = 2025). Analysis was stratified on age. In patients aged < 55 years, FT14 was associated with higher relapse incidence (RI) and lower Leukemia-Free Survival (LFS). In patients aged≥55 years, acute GVHD CI was higher in FB4, without significant differences in other outcomes. Although FT14 has been used for higher-risk HSCT patients, our large real-world multicenter study suggests that FB4 is associated with better outcomes compared to FT14 in younger patients.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece.
| | - Myriam Labopin
- Service d' Hématologie Clinique et Thérapie Cellulaire, Hospital Saint-Antoine, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France
| | - Ioanna Sakellari
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Urpu Salmenniemi
- HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit - Helsinki, Helsinki, Finland
| | | | - Victoria Potter
- Kings College Hospital, Dept. of Haematological Medicine, King's Denmark Hill Campus - London, London, UK
| | - Ana Berceanu
- Hopital Jean Minjoz, Service d'Hématologie - Besançon, Besançon, France
| | - Alessandro Rambaldi
- Department of Oncology and Hematology, University of Milan and Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Inken Hilgendorf
- Universitaetsklinikum Jena, Klinik für Innere Medizin II - Jena, Jena, Germany
| | - Nicolaus Kröger
- University Hospital Eppendorf, Bone Marrow Transplantation Centre - Hamburg, Hamburg, Germany
| | - Stephan Mielke
- Karolinska University Hospital, Dept. of Hematology - Stockholm, Stockholm, Sweden
| | - Tsila Zuckerman
- Rambam Medical Center, Dept. of Hematology & BMT - Haifa, Haifa, Israel
| | - Jaime Sanz
- University Hospital La Fe, Hematology Department - Valencia, Valencia, Spain
| | - Alessandro Busca
- S.S.C.V.D Trapianto di Cellule Staminali, A.O.U Citta della Salute e della Scienza di Torino, Torino, Italy
| | - Hakan Ozdogu
- Baskent University Hospital, Haematology Division, BMT Unit, Haematology Reserach Laboratory, Training & Medical - Adana, Adana, Turkey
| | | | - Bipin Savani
- Vanderbilt University Medical Center, Division of Hematology/ Oncology, Nashville, TN, USA
| | - Sebastian Giebel
- Maria Sklodowska-Curie Institute, Department of Bone Marrow Transplantation and Oncohematology, Oncology Center - Gliwice, Gliwice, Poland
| | - Ali Bazarbachi
- American University of Beirut, Medical Center, Department of Internal Medicine - Beirut, Beirut, Lebanon
| | - Alexandros Spyridonidis
- Department of Internal Medicine, Bone Marrow Transplantation Unit, University Hospital of Patras, Patras, Greece
| | - Arnon Nagler
- Chaim Sheba Medical Center, Dept. of Bone Marrow Transplantation - Tel-Hashomer, Tel-Hashomer, Israel
| | - Mohamad Mohty
- Service d' Hématologie Clinique et Thérapie Cellulaire, Hospital Saint-Antoine, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France
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Varelas C, Gavriilaki E, Sakellari I, Klonizakis F, Anagnostopoulos A, Tsapas A, Vlachaki E. Hemoglobinopathies and COVID-19: The Experience of a Center in Northern Greece. Hemoglobin 2022; 46:143-145. [PMID: 36100258 DOI: 10.1080/03630269.2022.2090377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Healthcare systems around the globe are still facing the evolving threat of the coronavavirus-19 (COVID-19) pandemic. Hemoglobinopathies include a group of genetic disorders, with the two main entities being thalassemias and sickle cell disease. Due to their immunocompromised status, such patients have been protected as extremely vulnerable to COVID-19 infection. We studied patients with different hemoglobinopathies, consecutively monitored at our center, who were infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) during the second and third waves of the pandemic in Greece (September 2020-April 2021), and associated the outcomes of the infection with the following factors: age, employment, blood type, liver and heart hemosiderosis, splenectomy, concomitant endocrine disorders and transfusion dependency. Among 250 patients monitored at our center, 14 were infected with COVID-19. Nine of them were hospitalized but no one required intensive care unit support and all of them responded to the generally applied treatment plan, despite their comorbidities. Notwithstanding the slightly increased prevalence of COVID-19 in patients with hemoglobinopathies compared to the general population, self-applied measures are still thought to be effective, as our patients got infected through their already sick family members.
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Affiliation(s)
- Christos Varelas
- Hematology Department and Hematopoietic Stem Cell Transplantation Unit, General Hospital "Georgios Papanikolaou", Thessaloniki, Greece
| | - Eleni Gavriilaki
- Hematology Department and Hematopoietic Stem Cell Transplantation Unit, General Hospital "Georgios Papanikolaou", Thessaloniki, Greece
| | - Ioanna Sakellari
- Hematology Department and Hematopoietic Stem Cell Transplantation Unit, General Hospital "Georgios Papanikolaou", Thessaloniki, Greece
| | - Filippos Klonizakis
- Adult Thalassemia Unit, Second Department of Internal Medicine, Hippokration Hospital, Thessaloniki, Greece
| | - Achilles Anagnostopoulos
- Hematology Department and Hematopoietic Stem Cell Transplantation Unit, General Hospital "Georgios Papanikolaou", Thessaloniki, Greece
| | - Apostolos Tsapas
- Adult Thalassemia Unit, Second Department of Internal Medicine, Hippokration Hospital, Thessaloniki, Greece
| | - Efthimia Vlachaki
- Adult Thalassemia Unit, Second Department of Internal Medicine, Hippokration Hospital, Thessaloniki, Greece
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Papadopoulou A, Stavridou F, Giannaki M, Paschoudi K, Chatzopoulou F, Gavriilaki E, Georgolopoulos G, Anagnostopoulos A, Yannaki E. Robust SARS-COV-2-specific T-cell immune memory persists long-term in immunocompetent individuals post BNT162b2 double shot. Heliyon 2022; 8:e09863. [PMID: 35815135 PMCID: PMC9250414 DOI: 10.1016/j.heliyon.2022.e09863] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/23/2022] [Accepted: 06/29/2022] [Indexed: 11/08/2022] Open
Abstract
Background A robust efficiency of mRNA vaccines against coronavirus disease-2019 has been demonstrated, however, the intended long-term protection against SARS-CoV-2 has been challenged by the waning humoral and cellular immunity over time, leading to a third vaccination dose recommendation for immunocompetent individuals, six months after completion of primary mRNA vaccination. Methods We here measured humoral responses via an immunoassay measuring SARS-CoV-2 neutralizing antibodies and T-cell responses using Elispot for interferon-γ 1- and 8- months post full BNT162b2 vaccination, in 10 health-care professionals. To explore whether the declining abundance of coronavirus-specific T-cells (CoV-2-STs) truly reflects decreased capacity for viral control, rather than the attenuating viral stimulus over time, we modeled ex vivo the T-cellular response upon viral challenge in fully vaccinated immunocompetent individuals, 1- and 8-months post BNT162b2. Findings. Notwithstanding the declining CoV-2-neutralizing antibodies and CoV-2-STs, re-challenged CoV-2-STs, 1- and 8-months post vaccination, presented similar functional characteristics including high cytotoxicity against both the unmutated virus and the delta variant. Interpretation. These findings suggest robust and sustained cellular immune response upon SARS-CοV-2 antigen exposure, 8 months post mRNA vaccination, despite declining CοV-2-STs over time in the presence of an attenuating viral stimulus.
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Gavriilaki E, Papakonstantinou A, Agrios KA. Novel Insights into Factor D Inhibition. Int J Mol Sci 2022; 23:ijms23137216. [PMID: 35806224 PMCID: PMC9267021 DOI: 10.3390/ijms23137216] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 01/15/2023] Open
Abstract
Complement-mediated diseases or complementopathies, such as Paroxysmal nocturnal hemoglobinuria (PNH), cold agglutinin disease (CAD), and transplant-associated thrombotic microangiopathy (TA-TMA), demand advanced complement diagnostics and therapeutics be adopted in a vast field of medical specialties, such as hematology, transplantation, rheumatology, and nephrology. The miracle of complement inhibitors as “orphan drugs” has dramatically improved morbidity and mortality in patients with otherwise life-threatening complementopathies. Efficacy has been significantly improved by upstream inhibition in patients with PNH. Different molecules may exert diverse characteristics in vitro and in vivo. Further studies remain to show safety and efficacy of upstream inhibition in other complementopathies. In addition, cost and availability issues are major drawbacks of current treatments. Therefore, further developments are warranted to address the unmet clinical needs in the field of complementopathies. This state-of-the-art narrative review aims to delineate novel insights into factor D inhibition as a promising target for complementopathies.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department, G Papanicolaou Hospital, 57010 Thessaloniki, Greece
- Correspondence: (E.G.); (K.A.A.)
| | - Anna Papakonstantinou
- Department of Urology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Konstantinos A. Agrios
- Department of Chemistry, Villanova University, 800 Lancaster Ave., Villanova, PA 19085, USA
- Correspondence: (E.G.); (K.A.A.)
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Gavriilaki E, Tsiftsoglou SA, Touloumenidou T, Farmaki E, Panagopoulou P, Michailidou E, Koravou EE, Mavrikou I, Iosifidis E, Tsiatsiou O, Papadimitriou E, Papadopoulou-Alataki E, Papayanni PG, Varelas C, Kokkoris S, Papalexandri A, Fotoulaki M, Galli-Tsinopoulou A, Zafeiriou D, Roilides E, Sakellari I, Anagnostopoulos A, Tragiannidis A. Targeted Genotyping of MIS-C Patients Reveals a Potential Alternative Pathway Mediated Complement Dysregulation during COVID-19 Infection. Curr Issues Mol Biol 2022; 44:2811-2824. [PMID: 35877417 PMCID: PMC9325260 DOI: 10.3390/cimb44070193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022] Open
Abstract
Complement dysregulation has been documented in adults with COVID-19 and implicated in relevant pediatric inflammatory responses against SARS-CoV-2. We propose that signatures of complement missense coding SNPs associated with dysregulation could also be identified in children with multisystem inflammatory syndrome (MIS-C). We investigated 71 pediatric patients with RT-PCR validated SARS-CoV-2 hospitalized in pediatric COVID-19 care units (November 2020–March 2021) in three major groups. Seven (7) patients suffered from MIS-C (MIS-C group), 32 suffered from COVID-19 and were hospitalized (admitted group), whereas 32 suffered from COVID-19, but were sent home. All patients survived and were genotyped for variations in the C3, C5, CFB, CFD, CFH, CFHR1, CFI, CD46, CD55, MASP1, MASP2, MBL2, COLEC11, FCN1, and FCN3 genes. Upon evaluation of the missense coding SNP distribution patterns along the three study groups, we noticed similarities, but also considerably increased frequencies of the alternative pathway (AP) associated with SNPs rs12614 CFB, rs1061170, and rs1065489 CFH in the MIS-C patients. Our analysis suggests that the corresponding substitutions potentially reduce the C3b-inactivation efficiency and promote slower and weaker AP C3bBb pre-convertase assembly on virions. Under these circumstances, the complement AP opsonization capacity may be impaired, leading to compromised immune clearance and systemic inflammation in the MIS-C syndrome.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
- Correspondence: (E.G.); (S.A.T.); Tel.: +30-697-3841-671 (E.G.); +30-697-9568-269 (S.A.T.)
| | - Stefanos A. Tsiftsoglou
- Laboratory of Pharmacology, Department of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence: (E.G.); (S.A.T.); Tel.: +30-697-3841-671 (E.G.); +30-697-9568-269 (S.A.T.)
| | - Tasoula Touloumenidou
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Evangelia Farmaki
- 1st Pediatric Department, Aristotle University of Thessaloniki, Hipporkation Hospital, 54642 Thessaloniki, Greece; (E.F.); (E.P.); (D.Z.)
| | - Paraskevi Panagopoulou
- 4th Pediatric Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, 56429 Thessaloniki, Greece; (P.P.); (E.P.-A.); (M.F.)
| | - Elissavet Michailidou
- 3rd Pediatric Department, Aristotle University of Thessaloniki, Hippokration Hospital, 54642 Thessaloniki, Greece; (E.M.); (E.I.); (O.T.); (E.R.)
| | - Evaggelia-Evdoxia Koravou
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Ioulia Mavrikou
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Elias Iosifidis
- 3rd Pediatric Department, Aristotle University of Thessaloniki, Hippokration Hospital, 54642 Thessaloniki, Greece; (E.M.); (E.I.); (O.T.); (E.R.)
| | - Olga Tsiatsiou
- 3rd Pediatric Department, Aristotle University of Thessaloniki, Hippokration Hospital, 54642 Thessaloniki, Greece; (E.M.); (E.I.); (O.T.); (E.R.)
| | - Eleni Papadimitriou
- 1st Pediatric Department, Aristotle University of Thessaloniki, Hipporkation Hospital, 54642 Thessaloniki, Greece; (E.F.); (E.P.); (D.Z.)
| | - Efimia Papadopoulou-Alataki
- 4th Pediatric Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, 56429 Thessaloniki, Greece; (P.P.); (E.P.-A.); (M.F.)
| | - Penelope Georgia Papayanni
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Christos Varelas
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Styliani Kokkoris
- Laboratory of Hematology and Hospital—Blood Transfusion Unit, Medical School, University General Hospital “Attikon”, NKUA, 12462 Athens, Greece;
| | - Apostolia Papalexandri
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Maria Fotoulaki
- 4th Pediatric Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, 56429 Thessaloniki, Greece; (P.P.); (E.P.-A.); (M.F.)
| | - Assimina Galli-Tsinopoulou
- 2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA Hospital, 54621 Thessaloniki, Greece; (A.G.-T.); (A.T.)
| | - Dimitrios Zafeiriou
- 1st Pediatric Department, Aristotle University of Thessaloniki, Hipporkation Hospital, 54642 Thessaloniki, Greece; (E.F.); (E.P.); (D.Z.)
| | - Emmanuel Roilides
- 3rd Pediatric Department, Aristotle University of Thessaloniki, Hippokration Hospital, 54642 Thessaloniki, Greece; (E.M.); (E.I.); (O.T.); (E.R.)
| | - Ioanna Sakellari
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Achilles Anagnostopoulos
- Hematology Department & BMT Unit, G Papanicolaou Hospital, 57010 Thessaloniki, Greece; (T.T.); (E.-E.K.); (I.M.); (P.G.P.); (C.V.); (A.P.); (I.S.); (A.A.)
| | - Athanasios Tragiannidis
- 2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA Hospital, 54621 Thessaloniki, Greece; (A.G.-T.); (A.T.)
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Gavriilaki E, Huang CL, Nayak L. Editorial: Women in Science—Hematology 2021. Front Med (Lausanne) 2022; 9:926204. [PMID: 35770014 PMCID: PMC9235568 DOI: 10.3389/fmed.2022.926204] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Eleni Gavriilaki
- Hematology Department—Bone Marrow Transplantation Unit, G Papanicolaou Hospital, Thessaloniki, Greece
- *Correspondence: Eleni Gavriilaki
| | - Chien-Ling Huang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Lalitha Nayak
- Division of Hematology and Oncology, University Hospitals, Case Western Reserve University, Cleveland, OH, United States
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Nikolaidou B, Triantafyllou A, Anyfanti P, Gavriilaki E, Lazaridis A, Stoimeni A, Dolgyras P, Douma S, Gkaliagkousi E. STUDY OF EARLY RETINAL CHANGES IN PATIENTS WITH NEWLY DIAGNOSED TYPE 2 DIABETES MELLITUS. J Hypertens 2022. [DOI: 10.1097/01.hjh.0000837356.37335.c7] [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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Nikolaidou B, Anyfanti P, Gavriilaki E, Dolgyras P, Koravou E, Lazaridis A, Vakalopoulos N, Malliora A, Triantafyllou A, Douma S, Gkaliagkousi E. DIABETIC STATUS AND NIGHT-TIME SYSTOLIC BLOOD PRESSURE PREDICT EARLY MYOCARDIAL DAMAGE IN NEWLY DIAGNOSED DIABETES MELLITUS TYPE 2 PATIENTS AS THIS IS DEPICTED BY GALECTIN-3 LEVELS. J Hypertens 2022. [DOI: 10.1097/01.hjh.0000836016.79236.24] [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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Gavriilaki E, Papadopoulou A, Touloumenidou T, Stavridou F, Koravou EE, Giannaki M, Papalexandri A, Karavalakis G, Batsis I, Kourelis A, Chatzopoulou F, Chatzidimitriou D, Sotiropoulos D, Yannaki E, Sakellari I, Anagnostopoulos A. Neutralizing antibody and T cell responses to SARS-CoV-2 vaccination in hematopoietic cell transplant recipients. Bone Marrow Transplant 2022; 57:1183-1186. [PMID: 35449455 PMCID: PMC9022618 DOI: 10.1038/s41409-022-01675-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/01/2022] [Accepted: 04/01/2022] [Indexed: 12/30/2022]
Affiliation(s)
- Eleni Gavriilaki
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Anastasia Papadopoulou
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Tasoula Touloumenidou
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Fani Stavridou
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Evaggelia-Evdoxia Koravou
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Maria Giannaki
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Apostolia Papalexandri
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Georgios Karavalakis
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Ioannis Batsis
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Andreas Kourelis
- Microbiology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fani Chatzopoulou
- Microbiology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Damianos Sotiropoulos
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Evangelia Yannaki
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece.
| | - Ioanna Sakellari
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Achilles Anagnostopoulos
- Hematology Department - Hematopoietic Cell Transplant (HCT) Unit - Gene and Cell Therapy Center, George Papanikolaou Hospital, Thessaloniki, Greece
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Asteris PG, Gavriilaki E, Touloumenidou T, Koravou E, Koutra M, Papayanni PG, Pouleres A, Karali V, Lemonis ME, Mamou A, Skentou AD, Papalexandri A, Varelas C, Chatzopoulou F, Chatzidimitriou M, Chatzidimitriou D, Veleni A, Rapti E, Kioumis I, Kaimakamis E, Bitzani M, Boumpas D, Tsantes A, Sotiropoulos D, Papadopoulou A, Kalantzis IG, Vallianatou LA, Armaghani DJ, Cavaleri L, Gandomi AH, Hajihassani M, Hasanipanah M, Koopialipoor M, Lourenço PB, Samui P, Zhou J, Sakellari I, Valsami S, Politou M, Kokoris S, Anagnostopoulos A. Genetic prediction of ICU hospitalization and mortality in COVID‐19 patients using artificial neural networks. J Cell Mol Med 2022; 26:1445-1455. [PMID: 35064759 PMCID: PMC8899198 DOI: 10.1111/jcmm.17098] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/13/2022] Open
Abstract
There is an unmet need of models for early prediction of morbidity and mortality of Coronavirus disease‐19 (COVID‐19). We aimed to a) identify complement‐related genetic variants associated with the clinical outcomes of ICU hospitalization and death, b) develop an artificial neural network (ANN) predicting these outcomes and c) validate whether complement‐related variants are associated with an impaired complement phenotype. We prospectively recruited consecutive adult patients of Caucasian origin, hospitalized due to COVID‐19. Through targeted next‐generation sequencing, we identified variants in complement factor H/CFH, CFB, CFH‐related, CFD, CD55, C3, C5, CFI, CD46, thrombomodulin/THBD, and A Disintegrin and Metalloproteinase with Thrombospondin motifs (ADAMTS13). Among 381 variants in 133 patients, we identified 5 critical variants associated with severe COVID‐19: rs2547438 (C3), rs2250656 (C3), rs1042580 (THBD), rs800292 (CFH) and rs414628 (CFHR1). Using age, gender and presence or absence of each variant, we developed an ANN predicting morbidity and mortality in 89.47% of the examined population. Furthermore, THBD and C3a levels were significantly increased in severe COVID‐19 patients and those harbouring relevant variants. Thus, we reveal for the first time an ANN accurately predicting ICU hospitalization and death in COVID‐19 patients, based on genetic variants in complement genes, age and gender. Importantly, we confirm that genetic dysregulation is associated with impaired complement phenotype.
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Affiliation(s)
- Panagiotis G. Asteris
- Computational Mechanics Laboratory School of Pedagogical and Technological Education Athens Greece
| | - Eleni Gavriilaki
- Hematology Department BMT Unit G Papanicolaou Hospital Thessaloniki Greece
| | | | | | - Maria Koutra
- Hematology Department BMT Unit G Papanicolaou Hospital Thessaloniki Greece
| | | | | | - Vassiliki Karali
- Rheumatology and Clinical Immunology Unit University General Hospital ‘Attikon’ Athens Greece
| | - Minas E. Lemonis
- Computational Mechanics Laboratory School of Pedagogical and Technological Education Athens Greece
| | - Anna Mamou
- Computational Mechanics Laboratory School of Pedagogical and Technological Education Athens Greece
| | - Athanasia D. Skentou
- Computational Mechanics Laboratory School of Pedagogical and Technological Education Athens Greece
| | | | - Christos Varelas
- Hematology Department BMT Unit G Papanicolaou Hospital Thessaloniki Greece
| | | | - Maria Chatzidimitriou
- Biomedical Sciences Alexander Campus International Hellenic University Thessaloniki Greece
| | | | - Anastasia Veleni
- Infectious Disease Committee G Papanicolaou Hospital Thessaloniki Greece
| | - Evdoxia Rapti
- Laboratory of Hematology and Hospital Blood Transfusion Department University General Hospital ‘Attikon’NKUAMedical School Athens Greece
| | - Ioannis Kioumis
- Respiratory Failure Department G Papanicolaou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | | | - Milly Bitzani
- 1 Intensive Care Unit G Papanicolaou Hospital Thessaloniki Greece
| | - Dimitrios Boumpas
- Rheumatology and Clinical Immunology Unit University General Hospital ‘Attikon’ Athens Greece
| | - Argyris Tsantes
- Laboratory of Hematology and Hospital Blood Transfusion Department University General Hospital ‘Attikon’NKUAMedical School Athens Greece
| | | | | | | | - Lydia A. Vallianatou
- Cath and EP Laboratory/Covid Intensive Care Unit Hellenic Red Cross Hospital Athens Greece
| | - Danial J. Armaghani
- Department of Civil Engineering Faculty of Engineering University of Malaya Kuala Lumpur Malaysia
| | - Liborio Cavaleri
- Department of Civil, Environmental, Aerospace and Materials Engineering University of Palermo Palermo Italy
| | - Amir H. Gandomi
- Faculty of Engineering & Information Technology University of Technology Sydney Ultimo NSW Australia
| | - Mohsen Hajihassani
- Department of Mining Engineering Faculty of Engineering Urmia University Urmia Iran
| | - Mahdi Hasanipanah
- Institute of Research and Development Duy Tan University Da Nang Vietnam
| | | | - Paulo B. Lourenço
- Department of Civil Engineering ISISEUniversity of Minho Guimarães Portugal
| | - Pijush Samui
- Department of Civil Engineering National Institute of Technology Patna Patna Bihar India
| | - Jian Zhou
- School of Resources and Safety Engineering Central South University Changsha China
| | - Ioanna Sakellari
- Hematology Department BMT Unit G Papanicolaou Hospital Thessaloniki Greece
| | - Serena Valsami
- Hematology Laboratory ‐ Blood Bank Aretaieion HospitalSchool of MedicineNKUA Athens Greece
| | - Marianna Politou
- Hematology Laboratory ‐ Blood Bank Aretaieion HospitalSchool of MedicineNKUA Athens Greece
| | - Styliani Kokoris
- Laboratory of Hematology and Hospital Blood Transfusion Department University General Hospital ‘Attikon’NKUAMedical School Athens Greece
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