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Buske C, Dreyling M, Alvarez-Larrán A, Apperley J, Arcaini L, Besson C, Bullinger L, Corradini P, Giovanni Della Porta M, Dimopoulos M, D'Sa S, Eich HT, Foà R, Ghia P, da Silva MG, Gribben J, Hajek R, Harrison C, Heuser M, Kiesewetter B, Kiladjian JJ, Kröger N, Moreau P, Passweg JR, Peyvandi F, Rea D, Ribera JM, Robak T, San-Miguel JF, Santini V, Sanz G, Sonneveld P, von Lilienfeld-Toal M, Wendtner C, Pentheroudakis G, Passamonti F. Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus. ESMO Open 2022; 7:100403. [PMID: 35272130 PMCID: PMC8795783 DOI: 10.1016/j.esmoop.2022.100403] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has created enormous challenges for the clinical management of patients with hematological malignancies (HMs), raising questions about the optimal care of this patient group. METHODS This consensus manuscript aims at discussing clinical evidence and providing expert advice on statements related to the management of HMs in the COVID-19 pandemic. For this purpose, an international consortium was established including a steering committee, which prepared six working packages addressing significant clinical questions from the COVID-19 diagnosis, treatment, and mitigation strategies to specific HMs management in the pandemic. During a virtual consensus meeting, including global experts and lead by the European Society for Medical Oncology and the European Hematology Association, statements were discussed and voted upon. When a consensus could not be reached, the panel revised statements to develop consensual clinical guidance. RESULTS AND CONCLUSION The expert panel agreed on 33 statements, reflecting a consensus, which will guide clinical decision making for patients with hematological neoplasms during the COVID-19 pandemic.
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Affiliation(s)
- C Buske
- Institute of Experimental Cancer Research, Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany.
| | - M Dreyling
- Department of Medicine III at LMU Hospital, Munich, Germany
| | - A Alvarez-Larrán
- Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - J Apperley
- Centre for Haematology, Imperial College London, Hammersmith Hospital, London, UK
| | - L Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - C Besson
- Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France; UVSQ, Inserm, CESP, Villejuif, France
| | - L Bullinger
- Department of Hematology, Oncology, and Tumorimmunology, Campus Virchow Klinikum, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - P Corradini
- Hematology Division, University of Milan, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M Giovanni Della Porta
- Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - M Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - S D'Sa
- UCLH Centre for Waldenström and Neurohaematology, University College London Hospitals NHS Foundation Trust, London, UK
| | - H T Eich
- Department of Radiation Oncology, University of Muenster, Münster, Germany
| | - R Foà
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - P Ghia
- Strategic Research Program on Chronic Lymphocytic Leukemia and Laboratory of B Cell Neoplasia, Division of Molecular Oncology, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - M G da Silva
- Department Of Hematology, Portuguese Institute of Oncology, Lisbon, Portugal
| | - J Gribben
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | - R Hajek
- Department of Hematooncology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - C Harrison
- Clinical Director - Haematology, Haemostasis, Palliative Care, Cellular Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Heuser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hanover, Germany
| | - B Kiesewetter
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - J J Kiladjian
- Université de Paris, APHP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, Paris, France
| | - N Kröger
- Department of Stem Cell Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - P Moreau
- Hematology Department, University Hospital Hotel-Dieu, Nantes, France
| | - J R Passweg
- Hematology Division, Basel University Hospital, Basel, Switzerland
| | - F Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - D Rea
- University Medical Department of Hematology and Immunology, France Intergroupe des Leucémies Myéloïdes Chroniques (Fi-LMC), Hôpital Saint-Louis, Paris, France
| | - J-M Ribera
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - T Robak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - J F San-Miguel
- Clínica Universidad de Navarra (CUN), Centro de Investigación Aplicada (CIMA), Instituto de Investigación Sanitaria de Navarra (IDISNA), CIBERONC, Pamplona, Spain
| | - V Santini
- MDS Unit, Hematology, DMSC, AOUC, University of Florence, Florence, Italy
| | - G Sanz
- Hematology Department, Hospital Univesitario y Politecnico La Fe, Valencia; CIBERONC, IS Carlos III, Madrid, Spain
| | - P Sonneveld
- Erasmus MC Cancer Institute, Department of Haematology, Rotterdam, The Netherlands
| | - M von Lilienfeld-Toal
- Department of Hematology and Medical Oncology, University Hospital Jena, Jena, Germany; Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll Institute, Jena, Germany
| | - C Wendtner
- Munich Clinic Schwabing, Academic Teaching Hospital, Ludwig-Maximilian University, Munich, Germany
| | - G Pentheroudakis
- Scientific and Medical Division, European Society for Medical Oncology, Lugano, Switzerland
| | - F Passamonti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy.
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Ghione P, Ghesquieres H, Bobillo S, Patel AR, Kanters S, Deighton K, Dong H, Yang Y, Ma L, Limbrick‐Oldfield EH, Thornton Snider J, Wade SW, Riberio MT, Sudhindra A, Radford J, Palomba ML, Gribben J. OUTCOMES IN LATER‐LINES OF THERAPY FOR RELAPSED/REFRACTORY FOLLICULAR LYMPHOMA: RESULTS FROM THE INTERNATIONAL SCHOLAR‐5 STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.26_2880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- P. Ghione
- Roswell Park Comprehensive Cancer Center and Memorial Sloan Kettering Cancer Center Buffalo and New York New York USA
| | - H. Ghesquieres
- Hospices Civils de Lyon Centre Hospitalier Lyon Sud Lyon France
| | - S. Bobillo
- Vall D’Hebron Insitute of Oncology Department of Haematology and Oncology Barcelona Spain
| | | | | | | | - H. Dong
- RainCity Analytics Vancouver Canada
| | - Y. Yang
- Kite, A Gilead Company Santa Monica USA
| | - L. Ma
- Kite, A Gilead Company Santa Monica USA
| | | | | | - S. W. Wade
- Wade Outcomes Research and Consulting Salt Lake City, Utah USA
| | - M. T. Riberio
- Portuguese Oncology Institute of Porto Porto Portugal
| | | | - J. Radford
- The Christie NHS Foundation Trust and University of Manchester Manchester UK
| | - M. L. Palomba
- Memorial Sloan Kettering Cancer Center, New York New York USA
| | - J. Gribben
- Cancer Research UK Barts Centre London UK
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Leonard J, Trneny M, Izutsu K, Fowler N, Hong X, Zhang H, Offner F, Scheliga A, Nowakowski G, Pinto A, Re F, Fogliatto L, Scheinberg P, Flinn I, Moreira C, Czuczman M, Kalambakas S, Fustier P, Wu C, Gribben J. AUGMENT PHASE III STUDY: LENALIDOMIDE/RITUXIMAB (R2
) IMPROVED EFFICACY OVER RITUXIMAB/PLACEBO IN RELAPSED/REFRACTORY FOLLICULAR PATIENTS IRRESPECTIVE OF POD24 STATUS. Hematol Oncol 2019. [DOI: 10.1002/hon.75_2629] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- J. Leonard
- Meyer Cancer Center; Weill Cornell Medicine and New York Presbyterian Hospital; New York United States
| | - M. Trneny
- General Hospital; Charles University; Prague Czech Republic
| | - K. Izutsu
- Hematology; National Cancer Center Hospital; Tokyo Japan
| | - N. Fowler
- Department of Lymphoma and Myeloma; The University of Texas MD Anderson Cancer Center; Houston United States
| | - X. Hong
- Hematology; Fudan University Shanghai Cancer Center; Shanghai China
| | - H. Zhang
- Hematology; Tianjin Medical University Cancer Institute and Hospital; Tianjin China
| | | | - A. Scheliga
- Hematology; INCA Instituto Nacional De Câncer; Rio de Janeiro Brazil
| | - G. Nowakowski
- Division of Hematology; Department of Internal Medicine, Mayo Clinic; Rochester United States
| | - A. Pinto
- Hematology; Istituto Nazionale Tumori, Fondazione ‘G. Pascale’, IRCCS; Naples Italy
| | - F. Re
- Hematology; Azienda Ospedaliero-Universitaria di Parma; Parma Italy
| | - L. Fogliatto
- Hematology; Hospital de Clinicas de Porto Alegre; Porto Alegre Brazil
| | - P. Scheinberg
- Hematology; Hospital A Beneficência Portuguesa de São Paulo; São Paulo Brazil
| | - I. Flinn
- Hematology; Sarah Cannon Research Institute/Tennessee Oncology; Nashville United States
| | - C. Moreira
- Hematology; Instituto Português de Oncologia Do Porto Francisco Gentil Epe; Porto Portugal
| | - M. Czuczman
- Global Clinical R&D Hematology/Oncology; Celgene Corporation; Summit United States
| | - S. Kalambakas
- Global Medical Affairs; Celgene Corporation; Summit United States
| | - P. Fustier
- Global Medical Affairs; Celgene International Sarl; Boudry Switzerland
| | - C. Wu
- BioStatistics; Celgene Corporation; Summit United States
| | - J. Gribben
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
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Thieblemont C, Leonard J, Trneny M, Izutsu K, Fowler N, Hong X, Zhang H, Offner F, Scheliga A, Nowakowski G, Pinto A, Re F, Fogliatto L, Scheinberg P, Flinn I, Moreira C, Czuczman M, Kalambakas S, Fustier P, Wu C, Gribben J. POST HOC ANALYSES OF PATIENTS WITH RELAPSED/REFRACTORY MARGINAL ZONE LYMPHOMA WHO RECEIVED LENALIDOMIDE PLUS RITUXIMAB (R 2
) VS RITUXIMAB/PLACEBO (AUGMENT). Hematol Oncol 2019. [DOI: 10.1002/hon.41_2630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- C. Thieblemont
- Hemato-Oncology; APHP, Hopital Saint-Louis; Paris France
| | - J. Leonard
- Meyer Cancer Center; Weill Cornell Medicine and New York Presbyterian Hospital; New York United States
| | - M. Trneny
- General Hospital; Charles University; Prague Czech Republic
| | - K. Izutsu
- Hematology; National Cancer Center Hospital; Tokyo Japan
| | - N. Fowler
- Department of Lymphoma and Myeloma; The University of Texas MD Anderson Cancer Center; Houston United States
| | - X. Hong
- Hematology; Fudan University Shanghai Cancer Center; Shanghai China
| | - H. Zhang
- Hematology; Tianjin Medical University Cancer Institute and Hospital; Tianjin China
| | | | - A. Scheliga
- Hematology; INCA Instituto Nacional De Câncer; Rio de Janeiro Brazil
| | - G. Nowakowski
- Division of Hematology; Department of Internal Medicine, Mayo Clinic; Rochester United States
| | - A. Pinto
- Hematology; Istituto Nazionale Tumori, Fondazione ‘G. Pascale’, IRCCS; Naples Italy
| | - F. Re
- Hematology; Azienda Ospedaliero-Universitaria di Parma; Parma Italy
| | - L. Fogliatto
- Hematology; Hospital de Clinicas de Porto Alegre; Porto Alegre Brazil
| | - P. Scheinberg
- Hematology; Hospital A Beneficência Portuguesa de São Paulo; São Paulo Brazil
| | - I. Flinn
- Hematology; Sarah Cannon Research Institute/Tennessee Oncology; Nashville United States
| | - C. Moreira
- Hematology; Instituto Português de Oncologia Do Porto Francisco Gentil Epe; Porto Portugal
| | - M. Czuczman
- Global Clinical R&D Hematology/Oncology; Celgene Corporation; Summit United States
| | - S. Kalambakas
- Global Medical Affairs; Celgene Corporation; Summit United States
| | - P. Fustier
- Global Medical Affairs; Celgene International Sarl; Boudry Switzerland
| | - C. Wu
- BioStatistics; Celgene Corporation; Summit United States
| | - J. Gribben
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
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Korfi K, Araf S, Bewicke-Copley F, Kumar E, Cummin T, Ashton-Key M, Barrans S, Van Hoppe S, Burton C, Elshiekh M, Rule S, Crosbie N, Clear A, Calaminici M, Menon G, Sha C, Bentley M, Nagano A, Davies A, Painter D, Smith A, Okosun J, Gribben J, Naresh K, Westhead D, Wang J, Johnson P, Fitzgibbon J. LONGITUDINAL ANALYSES OF DIAGNOSTIC-RELAPSE BIOPSIES OF DIFFUSE LARGE B CELL LYMPHOMA SUGGEST THAT RELAPSE IS MEDIATED BY DISTINCT MECHANISMS IN ABC AND GCB LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.100_2629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- K. Korfi
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - S. Araf
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - F. Bewicke-Copley
- Centre for Molecular Oncology; Barts Cancer Institute; London United Kingdom
| | - E. Kumar
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - T. Cummin
- Cancer Research UK Centre; University of Southampton; Southampton United Kingdom
| | - M. Ashton-Key
- Cellular Pathology; University Hospital Southampton NHS Foundation Trust; Southampton United Kingdom
| | - S. Barrans
- HMDS; Leeds Teaching Hospitals NHS Trust; Leeds United Kingdom
| | - S. Van Hoppe
- HMDS; Leeds Teaching Hospitals NHS Trust; Leeds United Kingdom
| | - C. Burton
- HMDS; Leeds Teaching Hospitals NHS Trust; Leeds United Kingdom
| | - M. Elshiekh
- Cellular & Molecular Pathology; Imperial College NHS Trust & Imperial College London; London United Kingdom
| | - S. Rule
- Department of Haematology; Derriford Hospital, University of Plymouth; Plymouth United Kingdom
| | - N. Crosbie
- Department of Haematology; University Hospitals Plymouth NHS Trust; Plymouth United Kingdom
| | - A. Clear
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - M. Calaminici
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - G. Menon
- Haemato-Oncology Diagnostic Service; Liverpool Clinical Laboratories; Liverpool United Kingdom
| | - C. Sha
- School of Molecular and Cellular Biology; University of Leeds; Leeds United Kingdom
| | - M. Bentley
- School of Molecular and Cellular Biology; University of Leeds; Leeds United Kingdom
| | - A. Nagano
- Centre for Molecular Oncology; Barts Cancer Institute; London United Kingdom
| | - A. Davies
- Cancer Research UK Centre; University of Southampton; Southampton United Kingdom
| | - D. Painter
- Epidemiology and Cancer Statistics Group; University of York; York United Kingdom
| | - A. Smith
- Epidemiology and Cancer Statistics Group; University of York; York United Kingdom
| | - J. Okosun
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - J. Gribben
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - K.N. Naresh
- Cellular & Molecular Pathology; Imperial College NHS Trust & Imperial College London; London United Kingdom
| | - D. Westhead
- School of Molecular and Cellular Biology; University of Leeds; Leeds United Kingdom
| | - J. Wang
- Centre for Molecular Oncology; Barts Cancer Institute; London United Kingdom
| | - P. Johnson
- Cancer Research UK Centre; University of Southampton; Southampton United Kingdom
| | - J. Fitzgibbon
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
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Gribben J, Trneny M, Izutsu K, Fowler N, Hong X, Zhang H, Offner F, Scheliga A, Nowakowski G, Pinto A, Re F, Fogliatto L, Scheinberg P, Flinn I, Moreira C, Czuczman M, Kalambakas S, Fustier P, Wu C, Leonard J. AUGMENT: RELAPSED/REFRACTORY INDOLENT NHL PATIENTS WERE MORE SENSITIVE TO NEXT TREATMENT FOLLOWING LENALIDOMIDE/RITUXIMAB (R 2
) THAN RITUXIMAB/PLACEBO. Hematol Oncol 2019. [DOI: 10.1002/hon.42_2630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- J. Gribben
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - M. Trneny
- General Hospital; Charles University; Prague Czech Republic
| | - K. Izutsu
- Hematology; National Cancer Center Hospital; Tokyo Japan
| | - N.H. Fowler
- Department of Lymphoma and Myeloma; The University of Texas MD Anderson Cancer Center; Houston United States
| | - X. Hong
- Department of Medical Oncology; Fudan University Shanghai Cancer Center; Shanghai China
| | - H. Zhang
- Hematology; Tianjin Medical University Cancer Institute and Hospital; Tianjin China
| | | | - A. Scheliga
- Hematology; INCA Instituto Nacional De Câncer; Rio de Janeiro Brazil
| | - G. Nowakowski
- Division of Hematology; Department of Internal Medicine, Mayo Clinic; Rochester United States
| | - A. Pinto
- Hematology; Istituto Nazionale Tumori, Fondazione ‘G. Pascale’, IRCCS; Naples Italy
| | - F. Re
- Hematology; Azienda Ospedaliero-Universitaria di Parma; Parma Italy
| | - L. Fogliatto
- Hematology; Hospital de Clinicas de Porto Alegre; Porto Alegre Brazil
| | - P. Scheinberg
- Hematology; Hospital A Beneficência Portuguesa de São Paulo; São Paulo Brazil
| | - I. Flinn
- Hematology; Sarah Cannon Research Institute/Tennessee Oncology; Nashville United States
| | - C. Moreira
- Hematology; Instituto Português de Oncologia Do Porto Francisco Gentil Epe; Porto Portugal
| | - M. Czuczman
- Global Clinical R&D Hematology/Oncology; Celgene Corporation; Summit United States
| | - S. Kalambakas
- Global Medical Affairs; Celgene Corporation; Summit United States
| | - P. Fustier
- Global Medical Affairs; Celgene International Sarl; Boudry Switzerland
| | - C. Wu
- BioStatistics; Celgene Corporation; Summit United States
| | - J. Leonard
- Meyer Cancer Center; Weill Cornell Medicine and New York Presbyterian Hospital; New York United States
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7
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Gribben J, Trneny M, Izutsu K, Fowler N, Hong X, Zhang H, Offner F, Scheliga A, Nowakowski G, Pinto A, Re F, Fogliatto L, Scheinberg P, Flinn I, Moreira C, Czuczman M, Kalambakas S, Fustier P, Wu C, Leonard J. PS1252 PATIENTS WITH RELAPSED/REFRACTORY INDOLENT NON-HODGKIN LYMPHOMA WERE MORE SENSITIVE TO NEXT TREATMENT FOLLOWING LENALIDOMIDE/RITUXIMAB (R2) THAN RITUXIMAB/PLACEBO (AUGMENT). Hemasphere 2019. [DOI: 10.1097/01.hs9.0000563288.81673.b1] [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] Open
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Jurczak W, Rule S, Townsend W, Tucker D, Sarholz B, Scheele J, Gribben J, Zinzani P. Phase I/II, first in human trial with M7583, a Bruton’s tyrosine kinase inhibitor (BTKi), in patients with B cell malignancies. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy286.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Klymenko T, Bloehdorn J, Bahlo J, Robrecht S, Akylzhanova G, Cox K, Estenfelder S, Wang J, Edelmann J, Strefford JC, Wojdacz TK, Fischer K, Hallek M, Stilgenbauer S, Cragg M, Gribben J, Braun A. Lamin B1 regulates somatic mutations and progression of B-cell malignancies. Leukemia 2018; 32:364-375. [PMID: 28804121 PMCID: PMC5808072 DOI: 10.1038/leu.2017.255] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 07/07/2017] [Accepted: 07/31/2017] [Indexed: 12/24/2022]
Abstract
Somatic hypermutation (SHM) is a pivotal process in adaptive immunity that occurs in the germinal centre and allows B cells to change their primary DNA sequence and diversify their antigen receptors. Here, we report that genome binding of Lamin B1, a component of the nuclear envelope involved in epigenetic chromatin regulation, is reduced during B-cell activation and formation of lymphoid germinal centres. Chromatin immunoprecipitation-Seq analysis showed that kappa and heavy variable immunoglobulin domains were released from the Lamin B1 suppressive environment when SHM was induced in B cells. RNA interference-mediated reduction of Lamin B1 resulted in spontaneous SHM as well as kappa-light chain aberrant surface expression. Finally, Lamin B1 expression level correlated with progression-free and overall survival in chronic lymphocytic leukaemia, and was strongly involved in the transformation of follicular lymphoma. In summary, here we report that Lamin B1 is a negative epigenetic regulator of SHM in normal B-cells and a 'mutational gatekeeper', suppressing the aberrant mutations that drive lymphoid malignancy.
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MESH Headings
- B-Lymphocytes/pathology
- Cell Line, Tumor
- Chromatin Immunoprecipitation/methods
- Disease Progression
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Variable Region/genetics
- Lamin Type B/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/pathology
- Somatic Hypermutation, Immunoglobulin/genetics
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Affiliation(s)
- T Klymenko
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - J Bloehdorn
- Department of Internal Medicine III, University of Ulm, Ulm, Germany
| | - J Bahlo
- Department I of Internal Medicine, Center for Integrated Oncology Cologne, University Hospital of Cologne, Cologne, Germany
| | - S Robrecht
- Department I of Internal Medicine, Center for Integrated Oncology Cologne, University Hospital of Cologne, Cologne, Germany
| | - G Akylzhanova
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - K Cox
- Academic Unit of Cancer Sciences, Faculty of Medicine, Cancer Research UK Centre and Experimental Cancer Medicine Centre, University of Southampton, Southampton, UK
| | - S Estenfelder
- Department of Internal Medicine III, University of Ulm, Ulm, Germany
| | - J Wang
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - J Edelmann
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - J C Strefford
- Academic Unit of Cancer Sciences, Faculty of Medicine, Cancer Research UK Centre and Experimental Cancer Medicine Centre, University of Southampton, Southampton, UK
| | - T K Wojdacz
- Academic Unit of Cancer Sciences, Faculty of Medicine, Cancer Research UK Centre and Experimental Cancer Medicine Centre, University of Southampton, Southampton, UK
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - K Fischer
- Department I of Internal Medicine, Center for Integrated Oncology Cologne, University Hospital of Cologne, Cologne, Germany
| | - M Hallek
- Department I of Internal Medicine, Center for Integrated Oncology Cologne, University Hospital of Cologne, Cologne, Germany
| | - S Stilgenbauer
- Department of Internal Medicine III, University of Ulm, Ulm, Germany
| | - M Cragg
- Academic Unit of Cancer Sciences, Faculty of Medicine, Cancer Research UK Centre and Experimental Cancer Medicine Centre, University of Southampton, Southampton, UK
| | - J Gribben
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - A Braun
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
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Daly A, Pinto A, Evans S, Almeida M, Assoun M, Belanger-Quintana A, Bernabei S, Bollhalder S, Cassiman D, Champion H, Chan H, Dalmau J, de Boer F, de Laet C, de Meyer A, Desloovere A, Dianin A, Dixon M, Dokoupil K, Dubois S, Eyskens F, Faria A, Fasan I, Favre E, Feillet F, Fekete A, Gallo G, Gingell C, Gribben J, Kaalund Hansen K, Ter Horst N, Jankowski C, Janssen-Regelink R, Jones I, Jouault C, Kahrs G, Kok I, Kowalik A, Laguerre C, Le Verge S, Lilje R, Maddalon C, Mayr D, Meyer U, Micciche A, Och U, Robert M, Rocha J, Rogozinski H, Rohde C, Ross K, Saruggia I, Schlune A, Singleton K, Sjoqvist E, Skeath R, Stolen L, Terry A, Timmer C, Tomlinson L, Tooke A, Vande Kerckhove K, van Dam E, van den Hurk T, van der Ploeg L, van Driessche M, van Rijn M, van Wegberg A, Vasconcelos C, Vestergaard H, Vitoria I, Webster D, White F, White L, Zweers H, MacDonald A. Dietary practices in propionic acidemia: A European survey. Mol Genet Metab Rep 2017; 13:83-89. [PMID: 29021961 PMCID: PMC5633157 DOI: 10.1016/j.ymgmr.2017.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 07/05/2017] [Accepted: 09/21/2017] [Indexed: 12/02/2022] Open
Abstract
Background The definitive dietary management of propionic acidaemia (PA) is unknown although natural protein restriction with adequate energy provision is of key importance. Aim To describe European dietary practices in the management of patients with PA prior to the publication of the European PA guidelines. Methods This was a cross-sectional survey consisting of 27 questions about the dietary practices in PA patients circulated to European IMD dietitians and health professionals in 2014. Results Information on protein restricted diets of 186 PA patients from 47 centres, representing 14 European countries was collected. Total protein intake [PA precursor-free L-amino acid supplements (PFAA) and natural protein] met WHO/FAO/UNU (2007) safe protein requirements for age in 36 centres (77%). PFAA were used to supplement natural protein intake in 81% (n = 38) of centres, providing a median of 44% (14–83%) of total protein requirement. Seventy-four per cent of patients were prescribed natural protein intakes below WHO/FAO/UNU (2007) safe levels in one or more of the following age groups: 0–6 m, 7–12 m, 1–10 y, 11–16 y and > 16 y. Sixty-three per cent (n = 117) of patients were tube fed (74% gastrostomy), but only 22% received nocturnal feeds. Conclusions There was high use of PFAA with intakes of natural protein commonly below WHO/FAO/UNU (2007) safe levels. Optimal dietary management can only be determined by longitudinal, multi-centre, prospective case controlled studies. The metabolic instability of PA and small patient cohorts in each centre ensure that this is a challenging undertaking.
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Affiliation(s)
- A. Daly
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - A. Pinto
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - S. Evans
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - M.F. Almeida
- Centro de Genética Médica, Centro Hospitalar do Porto - CHP, Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Institute of Biomedical Sciences, University of Porto-UMIB/ICBAS/UP, Porto, Portugal
- Centro de Referência na área de Doenças Hereditárias do Metabolismo, Centro Hospitalar do Porto - CHP, Porto, Portugal
| | - M. Assoun
- Centre de référence des maladies héréditaires du métabolisme, Hôpital Necker Enfants Malades, Paris, France
| | - A. Belanger-Quintana
- Unidad de Enfermedades Metabolicas, Servicio de Pediatria, Hospital Ramon y Cajal Madrid, Spain
| | - S.M. Bernabei
- Children Hospital Bambino Gesù, Division of Artificial Nutrition, Rome, Italy
| | | | - D. Cassiman
- Metabolic Center, University Hospitals Leuven and KU Leuven, Belgium
| | | | - H. Chan
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J. Dalmau
- Unit of Nutrition and Metabolopathies, Hospital La Fe, Valencia, Spain
| | - F. de Boer
- University of Groningen, University Medical Center Groningen, Netherlands
| | - C. de Laet
- Hôpital Universitaire des Enfants, Reine Fabiola, Bruxelles, Belgium
| | - A. de Meyer
- Center of Metabolic Diseases, University Hospital, Antwerp, Belgium
| | | | - A. Dianin
- Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, University Hospital of Verona, Italy
| | - M. Dixon
- Great Ormond Street Hospital for Children NHS FoundationTrust, London, UK
| | - K. Dokoupil
- Dr. von Hauner Children's Hospital, Munich, Germany
| | - S. Dubois
- Centre de référence des maladies héréditaires du métabolisme, Hôpital Necker Enfants Malades, Paris, France
| | - F. Eyskens
- Center of Metabolic Diseases, University Hospital, Antwerp, Belgium
| | - A. Faria
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, EPE, Portugal
| | - I. Fasan
- Division of Inherited Metabolic Diseases, Department of Pediatrics, University Hospital of Padova, Italy
| | - E. Favre
- Reference center for Inborn Errors of Metabolism, Department of Pediatrics, Children's University Hospital, Nancy, France
| | - F. Feillet
- Reference center for Inborn Errors of Metabolism, Department of Pediatrics, Children's University Hospital, Nancy, France
| | | | - G. Gallo
- Children Hospital Bambino Gesù, Division of Artificial Nutrition, Rome, Italy
| | | | - J. Gribben
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - K. Kaalund Hansen
- Charles Dent Metabolic Unit National Hospital for Neurology and Surgery, London, UK
| | | | - C. Jankowski
- Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, UK
| | | | - I. Jones
- Center of Metabolic Diseases, University Hospital, Antwerp, Belgium
| | | | - G.E. Kahrs
- Haukeland University Hospital, Bergen, Norway
| | - I.L. Kok
- Wilhelmina Children's Hospital, University Medical Centre Utrecht, Netherlands
| | - A. Kowalik
- Institute of Mother & Child, Warsaw, Poland
| | - C. Laguerre
- Centre de Compétence de L'Hôpital des Enfants de Toulouse, France
| | - S. Le Verge
- Centre de référence des maladies héréditaires du métabolisme, Hôpital Necker Enfants Malades, Paris, France
| | - R. Lilje
- Oslo University Hospital, Norway
| | - C. Maddalon
- University Children's Hospital Zurich, Switzerland
| | - D. Mayr
- Ernährungsmedizinische Beratung, Universitätsklinik für Kinder- und Jugendheilkunde, Salzburg, Austria
| | - U. Meyer
- Clinic of Paediatric Kidney, Liver- and Metabolic Diseases, Medical School Hannover, Germany
| | - A. Micciche
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - U. Och
- University Children's Hospital, Munster, Germany
| | - M. Robert
- Hôpital Universitaire des Enfants, Reine Fabiola, Bruxelles, Belgium
| | - J.C. Rocha
- Centro de Genética Médica, Centro Hospitalar do Porto - CHP, Porto, Portugal
- Centro de Referência na área de Doenças Hereditárias do Metabolismo, Centro Hospitalar do Porto - CHP, Porto, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Portugal
- Centre for Health Technology and Services Research (CINTESIS), Portugal
| | | | - C. Rohde
- Hospital of Children's & Adolescents, University of Leipzig, Germany
| | - K. Ross
- Royal Aberdeen Children's Hospital, Scotland
| | - I. Saruggia
- Centre de Reference des Maladies Héréditaires du Métabolisme du Pr. B. Chabrol CHU Timone Enfant, Marseille, France
| | - A. Schlune
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany
| | | | - E. Sjoqvist
- Children's Hospital, University Hospital, Lund, Sweden
| | - R. Skeath
- Great Ormond Street Hospital for Children NHS FoundationTrust, London, UK
| | | | - A. Terry
- Alder Hey Children's Hospital NHS Foundation Trust Liverpool, UK
| | - C. Timmer
- Academisch Medisch Centrum, Amsterdam, Netherlands
| | - L. Tomlinson
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - A. Tooke
- Nottingham University Hospitals, UK
| | | | - E. van Dam
- University of Groningen, University Medical Center Groningen, Netherlands
| | - T. van den Hurk
- Wilhelmina Children's Hospital, University Medical Centre Utrecht, Netherlands
| | | | | | - M. van Rijn
- University of Groningen, University Medical Center Groningen, Netherlands
| | | | - C. Vasconcelos
- Centro Hospitalar São João - Unidade de Doenças Metabólicas, Porto, Portugal
| | | | - I. Vitoria
- Unit of Nutrition and Metabolopathies, Hospital La Fe, Valencia, Spain
| | - D. Webster
- Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, UK
| | - F.J. White
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - L. White
- Sheffield Children's Hospital, UK
| | - H. Zweers
- Radboud University Medical Center Nijmegen, Netherlands
| | - A. MacDonald
- Birmingham Women's and Children's Hospital, Birmingham, UK
- Corresponding author at: Dietetic Department, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.Dietetic DepartmentBirmingham Children's HospitalSteelhouse LaneBirminghamB4 6NHUK
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Younes A, Hilden P, Coiffier B, Hagenbeek A, Salles G, Wilson W, Seymour JF, Kelly K, Gribben J, Pfreunschuh M, Morschhauser F, Schoder H, Zelenetz AD, Rademaker J, Advani R, Valente N, Fortpied C, Witzig TE, Sehn LH, Engert A, Fisher RI, Zinzani PL, Federico M, Hutchings M, Bollard C, Trneny M, Elsayed YA, Tobinai K, Abramson JS, Fowler N, Goy A, Smith M, Ansell S, Kuruvilla J, Dreyling M, Thieblemont C, Little RF, Aurer I, Van Oers MHJ, Takeshita K, Gopal A, Rule S, de Vos S, Kloos I, Kaminski MS, Meignan M, Schwartz LH, Leonard JP, Schuster SJ, Seshan VE. International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017). Ann Oncol 2017; 28:1436-1447. [PMID: 28379322 PMCID: PMC5834038 DOI: 10.1093/annonc/mdx097] [Citation(s) in RCA: 200] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Indexed: 12/20/2022] Open
Abstract
In recent years, the number of approved and investigational agents that can be safely administered for the treatment of lymphoma patients for a prolonged period of time has substantially increased. Many of these novel agents are evaluated in early-phase clinical trials in patients with a wide range of malignancies, including solid tumors and lymphoma. Furthermore, with the advances in genome sequencing, new "basket" clinical trial designs have emerged that select patients based on the presence of specific genetic alterations across different types of solid tumors and lymphoma. The standard response criteria currently in use for lymphoma are the Lugano Criteria which are based on [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography or bidimensional tumor measurements on computerized tomography scans. These differ from the RECIST criteria used in solid tumors, which use unidimensional measurements. The RECIL group hypothesized that single-dimension measurement could be used to assess response to therapy in lymphoma patients, producing results similar to the standard criteria. We tested this hypothesis by analyzing 47 828 imaging measurements from 2983 individual adult and pediatric lymphoma patients enrolled on 10 multicenter clinical trials and developed new lymphoma response criteria (RECIL 2017). We demonstrate that assessment of tumor burden in lymphoma clinical trials can use the sum of longest diameters of a maximum of three target lesions. Furthermore, we introduced a new provisional category of a minor response. We also clarified response assessment in patients receiving novel immune therapy and targeted agents that generate unique imaging situations.
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Affiliation(s)
| | - P. Hilden
- Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - B. Coiffier
- Hematology, Université Lyon-1, Lyon-Sud Charles Mérieux, Lyon, France
| | - A. Hagenbeek
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - G. Salles
- Hematology, Université Lyon-1, Lyon-Sud Charles Mérieux, Lyon, France
| | - W. Wilson
- Lymphoid Malignancies Branch, National Cancer Institute, Bethesda, USA
| | - J. F. Seymour
- Peter MacCallum Cancer Centre and University of Melbourne, Australia
| | - K. Kelly
- Pediatrics Department, Roswell-Park Cancer Institute, Buffalo, USA
| | - J. Gribben
- Department of Haemato-Oncology, Barts Cancer Institute, London, UK
| | - M. Pfreunschuh
- Department of Internal Medicine, Universität des Saarlandes, Homburg, Germany
| | - F. Morschhauser
- Department of Hematology, Université de Lille 2, Lille, France
| | - H. Schoder
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York
| | | | - J. Rademaker
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York
| | - R. Advani
- Department of Oncology, Stanford University, Stanford
| | | | | | | | - L. H. Sehn
- British Columbia Cancer Agency, Vancouver, Canada
| | - A. Engert
- Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | | | - P.-L. Zinzani
- Department of Hematology, University of Bologna, Bologna
| | - M. Federico
- Department of Diagnostic Medicine, University of Modena, Modena, Italy
| | - M. Hutchings
- Department of Hematology, University of Copenhagen, Denmark
| | - C. Bollard
- Children’s National Health System, Washington, USA
| | - M. Trneny
- Lymphoma and Stem Cell Transplantation Program, Charles University, Prague, Czech Republic
| | | | - K. Tobinai
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - J. S. Abramson
- Massachusetts General Hospital, Center for Lymphoma, Boston
| | - N. Fowler
- U.T. M.D.Anderson Cancer Center, Houston
| | - A. Goy
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack
| | - M. Smith
- Cleveland Clinic, Cleveland, USA
| | | | - J. Kuruvilla
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - M. Dreyling
- Medicine Clinic III, Ludwig Maximilian University, Munich, Germany
| | | | - R. F. Little
- Divisions of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - I. Aurer
- Department of Hematology, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | | | - A. Gopal
- Fred Hutchinson Cancer Research Center, Seattle, USA
| | - S. Rule
- Haematology Department, Plymouth University, UK
| | | | - I. Kloos
- Servier, Neuilly sur Seine, France
| | - M. S. Kaminski
- University of Michigan Comprehensive Cancer Center, Ann Arbor, USA
| | - M. Meignan
- Nuclear Medicine, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - L. H. Schwartz
- Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York
| | - J. P. Leonard
- Weill Cornell Medicine and and New York Presbyterian Hospital, New York
| | - S. J. Schuster
- University of Pennsylvania School of Medicine, Philadelphia, USA
| | - V. E. Seshan
- Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
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12
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Pott C, Belada D, Danesi N, Fingerle-Rowson G, Gribben J, Harbron C, Hoster E, Kahl B, Kehden B, Mundt K, Nicolas-Virelizier E, Sehn L, Cheson B. MINIMAL RESIDUAL DISEASE AND OUTCOMES IN RELAPSED/REFRACTORY FOLLICULAR LYMPHOMA (FL) IN THE PHASE III GADOLIN TRIAL OF OBINUTUZUMAB AND BENDAMUSTINE VS BENDAMUSTINE. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- C. Pott
- Department of Medicine II; University Hospital Schleswig-Holstein; Kiel Germany
| | - D. Belada
- IV Department of Internal Medicine - Hematology; Charles University Hospital & Faculty of Medicine; Hradec Kralove Czech Republic
| | - N. Danesi
- Pharma Development Oncology; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | | | - J. Gribben
- Centre for Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - C.G. Harbron
- Pharma Development Biostatistics; F. Hoffmann-La Roche Ltd; Welwyn Garden City UK
| | - E. Hoster
- Medical Department III; Munich University Hospital; Munich Germany
| | - B.S. Kahl
- Division of Oncology; Washington University School of Medicine; St Louis USA
| | - B. Kehden
- Department of Medicine II; University Hospital Schleswig-Holstein; Kiel Germany
| | - K.E. Mundt
- Oncology Biomarker Development; F. Hoffmann-La Roche Ltd; Basel Switzerland
| | | | - L.H. Sehn
- Division of Medical Oncology; British Columbia Cancer Agency and the University of British Columbia; Vancouver Canada
| | - B.D. Cheson
- Lombardi Comprehensive Cancer Center; Georgetown University Hospital; Washington DC USA
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13
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Baptista M, Tapia G, Muñoz-Marmol A, Muncunill J, Montoto S, Gribben J, Calaminici M, Martinez A, Gonzalez-Farre B, López-Guillermo A, González-Barca E, Terol M, Miralles P, Alcoceba M, Vall-Llovera F, Briones J, Abrisqueta P, Abella E, Provencio M, García-Ballesteros C, Moraleda J, Sancho J, Ribera J, Mate J, Navarro J. APPLICATION OF CELL-OF-ORIGIN SUBTYPES DETERMINED BY DIGITAL GENE EXPRESSION IN HIV-RELATED DIFFUSE LARGE B-CELL LYMPHOMAS. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- M. Baptista
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - G. Tapia
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - A. Muñoz-Marmol
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Muncunill
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - S. Montoto
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - J. Gribben
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - M. Calaminici
- Department of Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - A. Martinez
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - B. Gonzalez-Farre
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - A. López-Guillermo
- Department of Hematology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS); University of Barcelona; Barcelona Spain
| | - E. González-Barca
- Department of Hematology; ICO-Hospital Duran i Reynals, L'Hospitalet de Llobregat; Spain
| | - M. Terol
- Department of Hematology and Oncology; Hospital Clínic Universitari de València; Valencia Spain
| | - P. Miralles
- Department of Infectious Diseases; Hospital Gregorio Marañón; Madrid Spain
| | - M. Alcoceba
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - F. Vall-Llovera
- Servicio de Hematología Clínica; Hospital Universitari Mutúa de Terrassa; Terrassa Spain
| | - J. Briones
- Department of Hematology, Hospital de la Santa Creu i Sant Pau; Josep Carreras Leukaemia Research Institute; Barcelona Spain
| | - P. Abrisqueta
- Department of Hematology; Hospital Vall d'Hebrón; Barcelona Spain
| | - E. Abella
- Department of Hematology; Hospital del Mar; Barcelona Spain
| | - M. Provencio
- Department of Medical Oncology; Hospital Universitario Puerta De Hierro; Majadahonda Spain
| | | | - J. Moraleda
- Department of Hematology; Hospital Clinico Universitario Virgen de la Arrixaca; Murcia Spain
| | - J. Sancho
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Ribera
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Mate
- Department of Pathology; Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona; Badalona Spain
| | - J. Navarro
- Department of Hematology; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona; Badalona Spain
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Radford J, Gribben J, Johnson P, Malladi R, Neeson S, Asfaw B, O'Regan L, Law A, Ringrose C, Brownlow R, Jackson A, Nolan C, Nolan C. YourTreatmentChoices: FAST ACCESS TO TRIALS PROGRAMME. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J. Radford
- Department of Medical Oncology; University of Manchester and The Christie NHS Foundation Trust; Manchester UK
| | - J. Gribben
- Centre for Haemato-Oncology; Barts Cancer Institute; London UK
| | - P.W. Johnson
- Cancer Research UK Centre; University of Southampton; Southampton UK
| | - R. Malladi
- Centre for Clinical Haematology; University Hospitals Birmingham NHS Foundation Trust; Birmingham UK
| | - S. Neeson
- Division of Research and Education; The University of Manchester and the Christie NHS Foundation Trust; Manchester UK
| | - B. Asfaw
- Centre for Clinical Haematology; University Hospitals Birmingham NHS Foundation Trust; Birmingham UK
| | - L. O'Regan
- Medical School, St Georges NHS Foundation Trust; St Georges & Kingston University of London; Kingston upon Thames UK
| | - A. Law
- Barts Cancer Institute; Queen Mary University of London, St Bartholomews Hospital, Barts Health NHS Trust; London UK
| | - C. Ringrose
- Cancer Research UK Centre; University of Southampton; Southampton UK
| | | | | | - C. Nolan
- The Innovation Centre for Tomorrow's Medicines; Tomorrow's Medicines Ltd; Daresbury UK
| | - C. Nolan
- The Innovation Centre for Tomorrow's Medicines; Tomorrow's Medicines Ltd; Daresbury UK
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15
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Pinto A, Daly A, Evans S, Almeida MF, Assoun M, Belanger-Quintana A, Bernabei S, Bollhalder S, Cassiman D, Champion H, Chan H, Dalmau J, de Boer F, de Laet C, de Meyer A, Desloovere A, Dianin A, Dixon M, Dokoupil K, Dubois S, Eyskens F, Faria A, Fasan I, Favre E, Feillet F, Fekete A, Gallo G, Gingell C, Gribben J, Kaalund-Hansen K, Horst N, Jankowski C, Janssen-Regelink R, Jones I, Jouault C, Kahrs GE, Kok IL, Kowalik A, Laguerre C, Le Verge S, Lilje R, Maddalon C, Mayr D, Meyer U, Micciche A, Robert M, Rocha JC, Rogozinski H, Rohde C, Ross K, Saruggia I, Schlune A, Singleton K, Sjoqvist E, Stolen LH, Terry A, Timmer C, Tomlinson L, Tooke A, Vande Kerckhove K, van Dam E, van den Hurk T, van der Ploeg L, van Driessche M, van Rijn M, van Teeffelen-Heithoff A, van Wegberg A, Vasconcelos C, Vestergaard H, Vitoria I, Webster D, White FJ, White L, Zweers H, MacDonald A. Dietary practices in isovaleric acidemia: A European survey. Mol Genet Metab Rep 2017; 12:16-22. [PMID: 28275552 PMCID: PMC5328917 DOI: 10.1016/j.ymgmr.2017.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 01/28/2017] [Accepted: 02/14/2017] [Indexed: 12/21/2022] Open
Abstract
Background In Europe, dietary management of isovaleric acidemia (IVA) may vary widely. There is limited collective information about dietetic management. Aim To describe European practice regarding the dietary management of IVA, prior to the availability of the E-IMD IVA guidelines (E-IMD 2014). Methods A cross-sectional questionnaire was sent to all European dietitians who were either members of the Society for the Study of Inborn Errors of Metabolism Dietitians Group (SSIEM-DG) or whom had responded to previous questionnaires on dietetic practice (n = 53). The questionnaire comprised 27 questions about the dietary management of IVA. Results Information on 140 patients with IVA from 39 centres was reported. 133 patients (38 centres) were given a protein restricted diet. Leucine-free amino acid supplements (LFAA) were routinely used to supplement protein intake in 58% of centres. The median total protein intake prescribed achieved the WHO/FAO/UNU [2007] safe levels of protein intake in all age groups. Centres that prescribed LFAA had lower natural protein intakes in most age groups except 1 to 10 y. In contrast, when centres were not using LFAA, the median natural protein intake met WHO/FAO/UNU [2007] safe levels of protein intake in all age groups. Enteral tube feeding was rarely prescribed. Conclusions This survey demonstrates wide differences in dietary practice in the management of IVA across European centres. It provides unique dietary data collectively representing European practices in IVA which can be used as a foundation to compare dietary management changes as a consequence of the first E-IMD IVA guidelines availability.
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Affiliation(s)
- A Pinto
- Birmingham Children's Hospital, Birmingham, UK
| | - A Daly
- Birmingham Children's Hospital, Birmingham, UK
| | - S Evans
- Birmingham Children's Hospital, Birmingham, UK
| | - M F Almeida
- Centro de Genética Médica, Centro Hospitalar do Porto - CHP, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Institute of Biomedical Sciences, University of Porto-UMIB/ICBAS/UP, Porto, Portugal
| | - M Assoun
- Centre de référence des maladies héréditaires du métabolisme, hôpital Necker enfants Malades, Paris
| | - A Belanger-Quintana
- Unidad de Enfermedades Metabolicas, Servicio de Pediatria, Hospital Ramon y Cajal Madrid, Spain
| | - S Bernabei
- Children's Hospital Bambino Gesù, Division of Metabolism, Rome, Italy
| | | | - D Cassiman
- Metabolic Center, University Hospitals Leuven and KU Leuven, Belgium
| | | | - H Chan
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J Dalmau
- Unit of Nutrition and Metabolopathies, Hospital La Fe, Valencia, Spain
| | - F de Boer
- University of Groningen, University Medical Center Groningen, Netherlands
| | - C de Laet
- Hôpital Universitaire des Enfants, Reine Fabiola, Bruxelles, Belgium
| | - A de Meyer
- Center of Metabolic Diseases, University Hospital, Antwerp, Belgium
| | | | - A Dianin
- Pediatric Department, University Hospital of Borgo Roma Verona, Italy
| | - M Dixon
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - K Dokoupil
- Dr. von Hauner Children's Hospital, Munich, Germany
| | - S Dubois
- Centre de référence des maladies héréditaires du métabolisme, hôpital Necker enfants Malades, Paris
| | - F Eyskens
- Center of Metabolic Diseases, University Hospital, Antwerp, Belgium
| | - A Faria
- Hospital Pediatrico, Centro Hospitalar e Universitário de Coimbra, EPE, Portugal
| | - I Fasan
- Division of Inherited Metabolic Diseases, Department of Pediatrics, University Hospital of Padova, Italy
| | - E Favre
- Reference center for Inborn Errors of Metabolism, Department of Pediatrics, Children's University Hospital, Nancy, France
| | - F Feillet
- Reference center for Inborn Errors of Metabolism, Department of Pediatrics, Children's University Hospital, Nancy, France
| | - A Fekete
- Metabolic Centre of Vienna, Austria
| | - G Gallo
- Children's Hospital Bambino Gesù, Division of Metabolism, Rome, Italy
| | | | - J Gribben
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - K Kaalund-Hansen
- Charles Dent Metabolic Unit National Hospital for Neurology and Surgery, London, UK
| | - N Horst
- Emma Children's Hospital, AMC Amsterdam, Netherlands
| | - C Jankowski
- Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, UK
| | | | - I Jones
- Center of Metabolic Diseases, University Hospital, Antwerp, Belgium
| | | | - G E Kahrs
- Haukeland University Hospital, Bergen, Norway
| | - I L Kok
- Wilhelmina Children's Hospital, University Medical Centre Utrecht, Netherlands
| | - A Kowalik
- Institute of Mother & Child, Warsaw, Poland
| | - C Laguerre
- Centre de Compétence de L'Hôpital des Enfants de Toulouse, France
| | - S Le Verge
- Centre de référence des maladies héréditaires du métabolisme, hôpital Necker enfants Malades, Paris
| | - R Lilje
- Oslo University Hospital, Norway
| | - C Maddalon
- University Children's Hospital Zurich, Switzerland
| | - D Mayr
- Ernährungsmedizinische Beratung, Universitätsklinik für Kinder- und Jugendheilkunde, Salzburg, Austria
| | - U Meyer
- Clinic of Paediatric Kidney, Liver and Metabolic Diseases, Medical School Hannover, Germany
| | - A Micciche
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Robert
- Hôpital Universitaire des Enfants, Reine Fabiola, Bruxelles, Belgium
| | - J C Rocha
- Centro de Genética Médica, Centro Hospitalar do Porto - CHP, Porto, Portugal; Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Portugal; Centre for Health Technology and Services Research (CINTESIS), Portugal
| | - H Rogozinski
- Bradford Teaching Hospital NHS Foundation Trust, UK
| | - C Rohde
- Hospital of Children's & Adolescents, University of Leipzig, Germany
| | - K Ross
- Royal Aberdeen Children's Hospital, Scotland
| | - I Saruggia
- Centre de Reference des Maladies Héréditaires du Métabolisme du Pr. B. Chabrol CHU Timone Enfant, Marseille, France
| | - A Schlune
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Heinrich Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany
| | | | - E Sjoqvist
- Children's Hospital, University Hospital, Lund, Sweden
| | | | - A Terry
- Alder Hey Children's Hospital NHS Foundation Trust Liverpool, UK
| | - C Timmer
- Academisch Medisch Centrum, Amsterdam, Netherlands
| | - L Tomlinson
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - A Tooke
- Nottingham University Hospitals, UK
| | - K Vande Kerckhove
- Metabolic Center, University Hospitals Leuven and KU Leuven, Belgium
| | - E van Dam
- University of Groningen, University Medical Center Groningen, Netherlands
| | - T van den Hurk
- Wilhelmina Children's Hospital, University Medical Centre Utrecht, Netherlands
| | - L van der Ploeg
- Maastricht University Medical Centre + (MUMC +), Netherlands
| | | | - M van Rijn
- University of Groningen, University Medical Center Groningen, Netherlands
| | | | - A van Wegberg
- Radboud University Medical Center Nijmegen, The Netherlands
| | - C Vasconcelos
- Centro Hospitalar São João - Unidade de Doenças Metabólicas, Porto, Portugal
| | | | - I Vitoria
- Unit of Nutrition and Metabolopathies, Hospital La Fe, Valencia, Spain
| | - D Webster
- Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, UK
| | - F J White
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - L White
- Sheffield Children's Hospital, UK
| | - H Zweers
- Radboud University Medical Center Nijmegen, The Netherlands
| | - A MacDonald
- Birmingham Children's Hospital, Birmingham, UK
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Gribben J, Bianculli A, Van de Rijn J, Akerman M, Hamilton E, Klein Z, Masick K, D'Amore J, Ward M, Leisman D. 64 Three-Hour Bundle Compliance May Confer Greater Mortality Benefit for Sepsis Patients Presenting With Less Severe Hyperlactemia. Ann Emerg Med 2016. [DOI: 10.1016/j.annemergmed.2016.08.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Conconi A, Lobetti-Bodoni C, Montoto S, Lopez-Guillermo A, Coutinho R, Matthews J, Franceschetti S, Bertoni F, Moccia A, Rancoita P, Gribben J, Cavalli F, Gaidano G, Lister T, Montserrat E, Ghielmini M, Zucca E. Life expectancy of young adults with follicular lymphoma. Ann Oncol 2015; 26:2317-22. [DOI: 10.1093/annonc/mdv376] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 09/07/2015] [Indexed: 11/13/2022] Open
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Vrhovac R, Labopin M, Ciceri F, Finke J, Holler E, Tischer J, Lioure B, Gribben J, Kanz L, Blaise D, Dreger P, Held G, Arnold R, Nagler A, Mohty M. Second reduced intensity conditioning allogeneic transplant as a rescue strategy for acute leukaemia patients who relapse after an initial RIC allogeneic transplantation: analysis of risk factors and treatment outcomes. Bone Marrow Transplant 2015; 51:186-93. [DOI: 10.1038/bmt.2015.221] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 08/18/2015] [Accepted: 08/20/2015] [Indexed: 11/09/2022]
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Aguiar A, Ahring K, Almeida MF, Assoun M, Belanger Quintana A, Bigot S, Bihet G, Blom Malmberg K, Burlina A, Bushueva T, Caris A, Chan H, Clark A, Clark S, Cochrane B, Corthouts K, Dalmau J, Dassy M, De Meyer A, Didycz B, Diels M, Dokupil K, Dubois S, Eftring K, Ekengren J, Ellerton C, Evans S, Faria A, Fischer A, Ford S, Freisinger P, Giżewska M, Gokmen-Ozel H, Gribben J, Gunden F, Heddrich-Ellerbrok M, Heiber S, Heidenborg C, Jankowski C, Janssen-Regelink R, Jones I, Jonkers C, Joerg-Streller M, Kaalund-Hansen K, Kiss E, Lammardo AM, Lang K, Lier D, Lilje R, Lowry S, Luyten K, MacDonald A, Meyer U, Moor D, Pal A, Robert M, Robertson L, Rocha JC, Rohde C, Ross K, Saruhan S, Sjöqvist E, Skeath R, Stoelen L, Ter Horst NM, Terry A, Timmer C, Tuncer N, Vande Kerckhove K, van der Ploeg L, van Rijn M, van Spronsen FJ, van Teeffelen-Heithoff A, van Wegberg A, van Wyk K, Vasconcelos C, Vitoria I, Wildgoose J, Webster D, White FJ, Zweers H. Practices in prescribing protein substitutes for PKU in Europe: No uniformity of approach. Mol Genet Metab 2015; 115:17-22. [PMID: 25862610 DOI: 10.1016/j.ymgme.2015.03.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND There appears little consensus concerning protein requirements in phenylketonuria (PKU). METHODS A questionnaire completed by 63 European and Turkish IMD centres from 18 countries collected data on prescribed total protein intake (natural/intact protein and phenylalanine-free protein substitute [PS]) by age, administration frequency and method, monitoring, and type of protein substitute. Data were analysed by European region using descriptive statistics. RESULTS The amount of total protein (from PS and natural/intact protein) varied according to the European region. Higher median amounts of total protein were prescribed in infants and children in Northern Europe (n=24 centres) (infants <1 year, >2-3g/kg/day; 1-3 years of age, >2-3 g/kg/day; 4-10 years of age, >1.5-2.5 g/kg/day) and Southern Europe (n=10 centres) (infants <1 year, 2.5 g/kg/day, 1-3 years of age, 2 g/kg/day; 4-10 years of age, 1.5-2 g/kg/day), than by Eastern Europe (n=4 centres) (infants <1 year, 2.5 g/kg/day, 1-3 years of age, >2-2.5 g/kg/day; 4-10 years of age, >1.5-2 g/kg/day) and with Western Europe (n=25 centres) giving the least (infants <1 year, >2-2.5 g/kg/day, 1-3 years of age, 1.5-2 g/kg/day; 4-10 years of age, 1-1.5 g/kg/day). Total protein prescription was similar in patients aged >10 years (1-1.5 g/kg/day) and maternal patients (1-1.5 g/kg/day). CONCLUSIONS The amounts of total protein prescribed varied between European countries and appeared to be influenced by geographical region. In PKU, all gave higher than the recommended 2007 WHO/FAO/UNU safe levels of protein intake for the general population.
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Affiliation(s)
- A Aguiar
- Hospital de Santo Espirito da Ilha Terceira, Portugal
| | - K Ahring
- Kennedy Centre, Department of Clinical Genetics, Rigshospitalet, University of Copenhagen, Glostrup, Denmark
| | - M F Almeida
- Centro de Genética Médica Doutor Jacinto de Magalhães, CHP EPE, Porto, Portugal; Multidisciplinary Unit for Biomedical Research, UMIB-FCT, Porto, Portugal
| | - M Assoun
- Service des Maladies Héréditaires du Métabolisme, Hospital Necker Enfants Malades, Paris, France
| | | | - S Bigot
- Centre Hospitalier Universitaire de Rennes, France
| | - G Bihet
- Centre Hospitalier Chrétien, Centre Pinocchio Liège, Belgium
| | | | - A Burlina
- Division of Inherited Metabolic Diseases, Department of Pediatrics, University Hospital of Padova, Italy
| | - T Bushueva
- Scientific Center of Children's Health, Moscow, Russian Federation
| | - A Caris
- Centre Wallon de Génétique Humaine, Maladies Métaboliques, CHU de Liège Sart-Tilman, Belgium
| | - H Chan
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Clark
- National Centre for Inherited Metabolic Disorders, Dublin, Ireland
| | - S Clark
- Addenbrooke's Hospital, Cambridge, UK
| | - B Cochrane
- Royal Hospital for Sick Children, Glasgow, Scotland, UK
| | - K Corthouts
- University Hospitals Leuven, Center of Metabolic Diseases, Leuven, Belgium
| | | | - M Dassy
- Cliniques Universitaires St Luc, Brussels, Belgium
| | - A De Meyer
- Center of Metabolic Diseases, University Hospital, Antwerp, Belgium
| | - B Didycz
- University Children's Hospital, Cracow, Poland
| | - M Diels
- University Hospitals Leuven, Center of Metabolic Diseases, ZOL, Genk, Belgium
| | - K Dokupil
- Dr. von Hauner Children's Hospital, Munich, Germany
| | - S Dubois
- Service des Maladies Héréditaires du Métabolisme, Hospital Necker Enfants Malades, Paris, France
| | - K Eftring
- Queen Silvia's Children Hospital, Gothenburg, Sweden
| | - J Ekengren
- Queen Silvia's Children Hospital, Gothenburg, Sweden
| | | | - S Evans
- Birmingham Children's Hospital, Birmingham, UK
| | - A Faria
- Hospital Pediatrico, Centro Hospitalar e Universitário de Coimbra, EPE, Portugal
| | - A Fischer
- Klinikum am Steinenberg, Klinik für Kinder- und Jugendmedizin Reutlingen, Germany
| | - S Ford
- North Bristol NHS Trust Southmead and Frenchay, UK
| | - P Freisinger
- Klinikum am Steinenberg, Klinik für Kinder- und Jugendmedizin Reutlingen, Germany
| | - M Giżewska
- Pomeranian Medical University, Szczecin, Poland
| | - H Gokmen-Ozel
- Haccettepe University Children's Hospital, Ankara, Turkey
| | - J Gribben
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - F Gunden
- Uludag University Medical Faculty, Bursa, Turkey
| | | | - S Heiber
- University Hospital, Basel, Switzerland
| | - C Heidenborg
- Karolinska University Hospital, Stockholm, Sweden
| | - C Jankowski
- University Hospitals Bristol NHS Foundation Trust, UK
| | | | - I Jones
- Center of Metabolic Diseases, University Hospital, Antwerp, Belgium
| | - C Jonkers
- Academic Medical Hospital, Amsterdam, Netherlands
| | - M Joerg-Streller
- Medical University of Innsbruck, Clinic for Pediatrics, Inherited Metabolic Disorders, Austria
| | | | - E Kiss
- Semmelweis University, Hungary
| | | | - K Lang
- Ninewells Hospital, Dundee, Scotland, UK
| | - D Lier
- Klinikum am Steinenberg, Klinik für Kinder- und Jugendmedizin Reutlingen, Germany
| | - R Lilje
- Oslo University Hospital Rikshospitalet, Norway
| | - S Lowry
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - K Luyten
- Center of Metabolic Diseases, University Hospital, Antwerp, Belgium
| | - A MacDonald
- Birmingham Children's Hospital, Birmingham, UK.
| | - U Meyer
- Clinic of Paediatric Kidney, Liver and Metabolic Diseases Medical School Hannover, Germany
| | - D Moor
- Kinderspital Zürich, Switzerland
| | - A Pal
- Akademiska University Hospital (Children's Centre), Sweden
| | - M Robert
- Hôpital Universitaire des Enfants, Reine Fabiola, Bruxelles, Belgium
| | | | - J C Rocha
- Centro de Genética Médica Doutor Jacinto de Magalhães, CHP EPE, Porto, Portugal; Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Portugal
| | - C Rohde
- Hospital for Children and Adolescents, University Hospitals, University of Leipzig, Germany
| | - K Ross
- Royal Aberdeen Children's Hospital, Scotland, UK
| | - S Saruhan
- Haccettepe University Children's Hospital, Ankara, Turkey
| | - E Sjöqvist
- Children's Hospital, University Hospital Skåne, Sweden
| | - R Skeath
- Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - L Stoelen
- Oslo University Hospital Rikshospitalet, Norway
| | | | - A Terry
- Alderhey Children's Hospital, Liverpool, UK
| | | | - N Tuncer
- Dokuz Eylül University Nevvar-Salih İşgören Children Hospital, Turkey
| | - K Vande Kerckhove
- University Hospitals Leuven, Center of Metabolic Diseases, Leuven, Belgium
| | | | - M van Rijn
- University of Groningen, University Medical Center, Groningen, Netherlands
| | - F J van Spronsen
- University of Groningen, University Medical Center, Groningen, Netherlands
| | | | - A van Wegberg
- Radboud University Nijmegen Medical Centre, Netherlands
| | - K van Wyk
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - C Vasconcelos
- Centro Hospitalar São João - Unidade de Doenças Metabólicas, Porto, Portugal
| | | | | | - D Webster
- University Hospitals Bristol NHS Foundation Trust, UK
| | - F J White
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - H Zweers
- Radboud University Nijmegen Medical Centre, Netherlands
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El-Najjar I, Boumendil A, Luan J, Bouabdallah R, Thomson K, Mohty M, Colombat P, Biron P, Tilly H, Pfreundschuh M, Cordonnier C, Sureda A, Cahn J, Vernant J, Gribben J, Cook G, Haynes A, Ferrant A, Finel H, Montoto S, Dreger P. The impact of total body irradiation on the outcome of patients with follicular lymphoma treated with autologous stem-cell transplantation in the modern era: a retrospective study of the EBMT Lymphoma Working Party. Ann Oncol 2014; 25:2224-2229. [DOI: 10.1093/annonc/mdu440] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Adam S, Almeida MF, Assoun M, Baruteau J, Bernabei SM, Bigot S, Champion H, Daly A, Dassy M, Dawson S, Dixon M, Dokoupil K, Dubois S, Dunlop C, Evans S, Eyskens F, Faria A, Favre E, Ferguson C, Goncalves C, Gribben J, Heddrich-Ellerbrok M, Jankowski C, Janssen-Regelink R, Jouault C, Laguerre C, Le Verge S, Link R, Lowry S, Luyten K, Macdonald A, Maritz C, McDowell S, Meyer U, Micciche A, Robert M, Robertson LV, Rocha JC, Rohde C, Saruggia I, Sjoqvist E, Stafford J, Terry A, Thom R, Vande Kerckhove K, van Rijn M, van Teeffelen-Heithoff A, Wegberg AV, van Wyk K, Vasconcelos C, Vestergaard H, Webster D, White FJ, Wildgoose J, Zweers H. Dietary management of urea cycle disorders: European practice. Mol Genet Metab 2013; 110:439-45. [PMID: 24113687 DOI: 10.1016/j.ymgme.2013.09.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 09/04/2013] [Accepted: 09/06/2013] [Indexed: 12/30/2022]
Abstract
BACKGROUND There is no published data comparing dietary management of urea cycle disorders (UCD) in different countries. METHODS Cross-sectional data from 41 European Inherited Metabolic Disorder (IMD) centres (17 UK, 6 France, 5 Germany, 4 Belgium, 4 Portugal, 2 Netherlands, 1 Denmark, 1 Italy, 1 Sweden) was collected by questionnaire describing management of patients with UCD on prescribed protein restricted diets. RESULTS Data for 464 patients: N-acetylglutamate synthase (NAGS) deficiency, n=10; carbamoyl phosphate synthetase (CPS1) deficiency, n=29; ornithine transcarbamoylase (OTC) deficiency, n=214; citrullinaemia, n=108; argininosuccinic aciduria (ASA), n=80; arginase deficiency, n=23 was reported. The majority of patients (70%; n=327) were aged 0-16y and 30% (n=137) >16y. Prescribed median protein intake/kg body weight decreased with age with little variation between disorders. The UK tended to give more total protein than other European countries particularly in infancy. Supplements of essential amino acids (EAA) were prescribed for 38% [n=174] of the patients overall, but were given more commonly in arginase deficiency (74%), CPS (48%) and citrullinaemia (46%). Patients in Germany (64%), Portugal (67%) and Sweden (100%) were the most frequent users of EAA. Only 18% [n=84] of patients were prescribed tube feeds, most commonly for CPS (41%); and 21% [n=97] were prescribed oral energy supplements. CONCLUSIONS Dietary treatment for UCD varies significantly between different conditions, and between and within European IMD centres. Further studies examining the outcome of treatment compared with the type of dietary therapy and nutritional support received are required.
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Affiliation(s)
- S Adam
- Royal Hospital for Sick Children, Glasgow Royal Infirmary, Glasgow, UK
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Pospisilova S, Gonzalez D, Malcikova J, Trbusek M, Rossi D, Kater AP, Cymbalista F, Eichhorst B, Hallek M, Döhner H, Hillmen P, van Oers M, Gribben J, Ghia P, Montserrat E, Stilgenbauer S, Zenz T. ERIC recommendations on TP53 mutation analysis in chronic lymphocytic leukemia. Leukemia 2012; 26:1458-61. [PMID: 22297721 DOI: 10.1038/leu.2012.25] [Citation(s) in RCA: 149] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Recent evidence suggests that - in addition to 17p deletion - TP53 mutation is an independent prognostic factor in chronic lymphocytic leukemia (CLL). Data from retrospective analyses and prospective clinical trials show that ∼5% of untreated CLL patients with treatment indication have a TP53 mutation in the absence of 17p deletion. These patients have a poor response and reduced progression-free survival and overall survival with standard treatment approaches. These data suggest that TP53 mutation testing warrants integration into current diagnostic work up of patients with CLL. There are a number of assays to detect TP53 mutations, which have respective advantages and shortcomings. Direct Sanger sequencing of exons 4-9 can be recommended as a suitable test to identify TP53 mutations for centers with limited experience with alternative screening methods. Recommendations are provided on standard operating procedures, quality control, reporting and interpretation. Patients with treatment indications should be investigated for TP53 mutations in addition to the work-up recommended by the International workshop on CLL guidelines. Patients with TP53 mutation may be considered for allogeneic stem cell transplantation in first remission. Alemtuzumab-based regimens can yield a substantial proportion of complete responses, although of short duration. Ideally, patients should be treated within clinical trials exploring new therapeutic agents.
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Affiliation(s)
- S Pospisilova
- Central European Institute of Technology, Masaryk University, Czech Republic
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Vargaftig J, Taussig DC, Griessinger E, Anjos-Afonso F, Lister TA, Cavenagh J, Oakervee H, Gribben J, Bonnet D. Frequency of leukemic initiating cells does not depend on the xenotransplantation model used. Leukemia 2011; 26:858-60. [PMID: 21926966 PMCID: PMC3272414 DOI: 10.1038/leu.2011.250] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Cotter F, Smith DA, Boyd TE, Richards DA, Alemany C, Loesch D, Salogub G, Tidmarsh GF, Gammon GM, Gribben J. Single-agent activity of GCS-100, a first-in-class galectin-3 antagonist, in elderly patients with relapsed chronic lymphocytic leukemia. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.7006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7006 Background: GCS-100 is a polysaccharide antagonist of galectin-3, a protein whose overexpression on certain tumor cells is associated with poor prognosis in cancer patients. GCS-100 has been shown to induce apoptosis of patient CLL cells ex vivo. In addition, GCS-100 potentiates the in vitro activity of other agents commonly used to treat CLL, including rituximab. This phase II clinical trial evaluated the potential of GCS-100 as a novel single-agent therapeutic for relapsed CLL. Methods: Patients with Rai Stage II or higher CLL who had relapsed after one or two prior therapies were eligible. Prior therapies included a range of chemotherapy combinations including FCR, cyclophosphamide/vincristine/rituximab, and chlorambucil/prednisone. Patients received GCS-100 i.v. at 160 mg/m2 for 5 days every 21 days until disease progression. Peripheral blood was collected on study days 1, 4, and 8 of each cycle to assess peripheral leukocyte counts and apoptosis. CD38 and Zap70 expression were assessed where possible. Results: 24 pts were enrolled;16 men and 8 women (median age 67 years, range 40–86 years, 15/24 pts were over 65 years). GCS-100 was well-tolerated. There were no cases of drug-related grade 3 or 4 hematological toxicity or other serious AE. Two patients discontinued treatment due to rash, which resolved with cessation of treatment and which has been shown to be responsive to steroids. Six (25%) patients experienced PR, including 4 patients with >50% shrinkage of lymph node lesions. Currently 6 patients remain on study with a median duration of 5 months (range 4.5–9 months). In addition, apoptosis of peripheral leukocytes was confirmed by caspase activation and by DNA fragmentation. Conclusions: GCS-100 has significant single-agent activity in relapsed CLL. Its lack of myelosuppression and potential synergy with other agents makes GCS-100 a strong candidate for further development in CLL, particularly for elderly patients for whom there is a major need for less toxic agents. [Table: see text]
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Affiliation(s)
- F. Cotter
- Barts and The London School of Medicine, London, United Kingdom; Northwest Cancer Specialists, Vancouver, WA; North Star Lodge Cancer Center, Yakima, WA; Tyler Cancer Center, Tyler, TX; Cancer Centers of Florida, Winter Park, FL; Central Indiana Cancer Centers, Indiannapolis, IN; St. Petersburg State Medical University, St. Petersburg, Russian Federation; Prospect Therapeutics, Woburn, MA
| | - D. A. Smith
- Barts and The London School of Medicine, London, United Kingdom; Northwest Cancer Specialists, Vancouver, WA; North Star Lodge Cancer Center, Yakima, WA; Tyler Cancer Center, Tyler, TX; Cancer Centers of Florida, Winter Park, FL; Central Indiana Cancer Centers, Indiannapolis, IN; St. Petersburg State Medical University, St. Petersburg, Russian Federation; Prospect Therapeutics, Woburn, MA
| | - T. E. Boyd
- Barts and The London School of Medicine, London, United Kingdom; Northwest Cancer Specialists, Vancouver, WA; North Star Lodge Cancer Center, Yakima, WA; Tyler Cancer Center, Tyler, TX; Cancer Centers of Florida, Winter Park, FL; Central Indiana Cancer Centers, Indiannapolis, IN; St. Petersburg State Medical University, St. Petersburg, Russian Federation; Prospect Therapeutics, Woburn, MA
| | - D. A. Richards
- Barts and The London School of Medicine, London, United Kingdom; Northwest Cancer Specialists, Vancouver, WA; North Star Lodge Cancer Center, Yakima, WA; Tyler Cancer Center, Tyler, TX; Cancer Centers of Florida, Winter Park, FL; Central Indiana Cancer Centers, Indiannapolis, IN; St. Petersburg State Medical University, St. Petersburg, Russian Federation; Prospect Therapeutics, Woburn, MA
| | - C. Alemany
- Barts and The London School of Medicine, London, United Kingdom; Northwest Cancer Specialists, Vancouver, WA; North Star Lodge Cancer Center, Yakima, WA; Tyler Cancer Center, Tyler, TX; Cancer Centers of Florida, Winter Park, FL; Central Indiana Cancer Centers, Indiannapolis, IN; St. Petersburg State Medical University, St. Petersburg, Russian Federation; Prospect Therapeutics, Woburn, MA
| | - D. Loesch
- Barts and The London School of Medicine, London, United Kingdom; Northwest Cancer Specialists, Vancouver, WA; North Star Lodge Cancer Center, Yakima, WA; Tyler Cancer Center, Tyler, TX; Cancer Centers of Florida, Winter Park, FL; Central Indiana Cancer Centers, Indiannapolis, IN; St. Petersburg State Medical University, St. Petersburg, Russian Federation; Prospect Therapeutics, Woburn, MA
| | - G. Salogub
- Barts and The London School of Medicine, London, United Kingdom; Northwest Cancer Specialists, Vancouver, WA; North Star Lodge Cancer Center, Yakima, WA; Tyler Cancer Center, Tyler, TX; Cancer Centers of Florida, Winter Park, FL; Central Indiana Cancer Centers, Indiannapolis, IN; St. Petersburg State Medical University, St. Petersburg, Russian Federation; Prospect Therapeutics, Woburn, MA
| | - G. F. Tidmarsh
- Barts and The London School of Medicine, London, United Kingdom; Northwest Cancer Specialists, Vancouver, WA; North Star Lodge Cancer Center, Yakima, WA; Tyler Cancer Center, Tyler, TX; Cancer Centers of Florida, Winter Park, FL; Central Indiana Cancer Centers, Indiannapolis, IN; St. Petersburg State Medical University, St. Petersburg, Russian Federation; Prospect Therapeutics, Woburn, MA
| | - G. M. Gammon
- Barts and The London School of Medicine, London, United Kingdom; Northwest Cancer Specialists, Vancouver, WA; North Star Lodge Cancer Center, Yakima, WA; Tyler Cancer Center, Tyler, TX; Cancer Centers of Florida, Winter Park, FL; Central Indiana Cancer Centers, Indiannapolis, IN; St. Petersburg State Medical University, St. Petersburg, Russian Federation; Prospect Therapeutics, Woburn, MA
| | - J. Gribben
- Barts and The London School of Medicine, London, United Kingdom; Northwest Cancer Specialists, Vancouver, WA; North Star Lodge Cancer Center, Yakima, WA; Tyler Cancer Center, Tyler, TX; Cancer Centers of Florida, Winter Park, FL; Central Indiana Cancer Centers, Indiannapolis, IN; St. Petersburg State Medical University, St. Petersburg, Russian Federation; Prospect Therapeutics, Woburn, MA
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Davies J, Gribben J, Brennan L, Nadler L, Guinan E. 38: Alloanergized HLA-Mismatched Bone Marrow Transplantation – Low Incidence of Clinically Significant GVHD and Viral Infection Resulting in Long Term Disease Free Survival. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ho VT, Kim HT, Liney D, Milford E, Gribben J, Cutler C, Lee SJ, Antin JH, Soiffer RJ, Alyea EP. HLA-C mismatch is associated with inferior survival after unrelated donor non-myeloablative hematopoietic stem cell transplantation. Bone Marrow Transplant 2006; 37:845-50. [PMID: 16532020 DOI: 10.1038/sj.bmt.1705315] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
HLA-C matching is an important determinant of outcome after myeloablative unrelated donor (URD) hematopoietic stem cell transplantation. However, its importance in non-myeloablative stem cell transplantation (NST) is not known. We report a retrospective analysis of 111 patients who underwent URD NST, of whom 78 were 10/10 matched at HLA-A, B, C, DRB1, DQB1 and 33 were mismatched at one or more HLA-C antigen/allele (24 HLA-C only; nine HLA-C+other locus mismatch). Patients were conditioned with busulfan (0.8 mg/kg/day i.v. x 4 days) and fludarabine (30 mg/m(2)/day i.v. x 4 days). Graft-versus-host disease prophylaxis included cyclosporine/prednisone- or tacrolimus/mini-methotrexate-based regimens. HLA-C disparity did not impair engraftment. Median marrow donor chimerisms were >or=90% donor at day+30 and +100 in both groups. Overall survival at 2 years was 30% in HLA-C-mismatched and 51% in 10/10-matched patients (P=0.008). In Cox regression, HLA-C mismatch was an independent predictor of death (hazard ratio 1.85, P=0.04). Treatment-related mortality was higher in the HLA-C-mismatched group: 48 versus 16% (P=0.0001). Cumulative relapse incidence was 35% in the HLA-C-mismatched and 55% in the 10/10-matched cohort, P=0.09. HLA-C mismatch is associated with inferior survival after URD NST.
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Affiliation(s)
- V T Ho
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
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Alyea E, Weller E, Schlossman R, Canning C, Mauch P, Ng A, Fisher D, Gribben J, Freeman A, Parikh B, Richardson P, Soiffer R, Ritz J, Anderson KC. Outcome after autologous and allogeneic stem cell transplantation for patients with multiple myeloma: impact of graft-versus-myeloma effect. Bone Marrow Transplant 2003; 32:1145-51. [PMID: 14647268 DOI: 10.1038/sj.bmt.1704289] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A total of 228 patients with multiple myeloma (MM), 166 patients receiving autologous transplantation (124 PBSC and 38 BM) and 66 patients receiving T-cell-depleted allogeneic transplantation were analyzed to compare overall survival (OS), progression-free survival (PFS) and risk of relapse. Patients receiving autologous transplantation had a significantly improved OS (P=0.006) and PFS (P=0.002) at 2 years with OS and PFS for autologous transplant 74% and 48%, respectively, compared with 51% and 28% for allogeneic transplantation. By 4 years after transplantation, outcome was similar with OS and PFS for autologous transplantation 41% and 23%, respectively, compared with 39% and 18% for allogeneic transplantation. The 4-year cumulative incidence of nonrelapse mortality was significantly higher in patients receiving allogeneic transplantation (24% vs 13%) (P=0.004). Relapse was the principle cause of treatment failure for both groups; however, there was a significantly reduced risk of relapse associated with allogeneic transplantation at 4 years: 46% for allograft vs 56% for autograft (P=0.02). Despite a lower risk of relapse after allogeneic transplantation, autologous transplantation is associated with improved OS and PFS compared with allogeneic transplantation in patients with MM. Strategies focused on reducing nonrelapse mortality in allogeneic transplantation may translate into an improved outcome for patients receiving allogeneic transplantation.
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Affiliation(s)
- E Alyea
- Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, MA 02215, USA.
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Alyea E, Neuberg D, Mauch P, Marcus K, Freedman A, Webb I, Anderson K, Schlossman R, Fisher D, Gribben J, Ritz J, Soiffer R. Effect of total body irradiation dose escalation on outcome following T-cell-depleted allogeneic bone marrow transplantation. Biol Blood Marrow Transplant 2003; 8:139-44. [PMID: 11939603 DOI: 10.1053/bbmt.2002.v8.pm11939603] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Prior studies of non-T-cell-depleted (TCD) transplantation have demonstrated a reduction in relapse in patients receiving escalated doses of TBI; however, overall survival in these studies was not significantly improved due to increased treatment-related toxicity seen at the higher doses of irradiation. Toxicity was in part related to an increased incidence of GVHD. Because T-cell depletion of donor bone marrow reduces the incidence of GVHD and other treatment-related complications after allogeneic bone marrow transplantation, it was postulated that TBI dose may be safely escalated in this setting and may decrease the risk of relapse following TCD BMT. Herein, we report the results of a trial assessing the safety and impact of escalated doses of TBI after TCD BMT. Two hundred adults with hematologic malignancies were treated in consecutive cohorts defined by increasing doses of TBI (1400, 1480, and 1560 cGy) in combination with cyclophosphamide. In vitro T-cell depletion using anti-CD6 monoclonal antibody was used for GVHD prophylaxis. The incidence of grade II or greater acute GVHD in patients receiving 1560 cGy (36%) was significantly higher than in patients receiving 1400 cGy (18%) (P = .04) or 1480 cGy (13%) (P = .01). Two-year treatment-related mortality was significantly higher in patients who received 1560 cGy of TBI (33%) than in those who received 1400 cGy (20%) (P = .04) or 1480 cGy (19%) (P = .05). The increased dose of TBI did not reduce the rates of relapse, with the estimated 2-year risk of relapse being 24% (1400 cGy), 24% (1480 cGy), and 31% (1560 cGy) for the 3 cohorts of patients. Overall survival at 2 years was inferior for patients receiving 1560 cGy of TBI (36%) compared with those who received 1400 cGy (55%) or 1480 cGy (58%) (P = .01). We conclude that dose escalation of TBI is associated with increased GVHD and inferior survival following TCD BMT. Future efforts to reduce the risk of relapse after TCD BMT should focus on immunologic methods to induce the graft-versus-leukemia effect after BMT rather than intensification of the ablative regimen by escalation of irradiation dose.
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Affiliation(s)
- E Alyea
- Center for Hematologic Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
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Alyea E, Weller E, Schlossman R, Canning C, Webb I, Doss D, Mauch P, Marcus K, Fisher D, Freeman A, Parikh B, Gribben J, Soiffer R, Ritz J, Anderson K. T-cell--depleted allogeneic bone marrow transplantation followed by donor lymphocyte infusion in patients with multiple myeloma: induction of graft-versus-myeloma effect. Blood 2001; 98:934-9. [PMID: 11493435 DOI: 10.1182/blood.v98.4.934] [Citation(s) in RCA: 167] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Previous trials of allogeneic bone marrow transplantation (BMT) in patients with multiple myeloma (MM) have demonstrated high response rates but also high transplantation-related mortality (TRM) and high relapse rates. Exploitation of this strategy remains of interest because donor lymphocyte infusions (DLIs) can induce a potent graft-versus-myeloma (GVM) effect. CD6 T-cell--depleted allogeneic BMT was combined with prophylactic CD4(+) DLI administered 6 to 9 months after BMT in an effort to reduce TRM and to induce a GVM response after BMT. Twenty-four patients with matched sibling donors and chemotherapy-sensitive disease underwent BMT. CD6 T-cell depletion of donor bone marrow was the sole method of graft-versus-host disease (GVHD) prophylaxis. GVHD after BMT was minimal, 1 (4%) grade III and 4 (17%) grade II GVHD. Fourteen patients received DLI, 3 in complete response and 11 with persistent disease after BMT. Significant GVM responses were noted after DLI in 10 patients with persistent disease, resulting in 6 complete responses and 4 partial responses. After DLI, 50% of patients developed acute (> or = II) or extensive chronic GVHD. Two-year estimated overall survival and current progression-free survival (PFS) for all 24 patients is 55% and 42%, respectively. The 14 patients receiving DLI had an improved 2-year current PFS (65%) when compared with a historical cohort of MM patients who underwent CD6-depleted BMT survived 6 months with no GVHD and did not receive DLI (41%) (P =.13). Although this study suggests that prophylactic DLI induces significant GVM responses after allogeneic BMT, only 58% of patients were able to receive DLI despite T-cell--depleted BMT. Therefore, less toxic transplantation strategies are needed to allow a higher proportion of patients to receive DLI and the benefit from the GVM effect after transplantation. (Blood. 2001;98:934-939)
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Affiliation(s)
- E Alyea
- Center for Hematologic Oncology and Department of Biostatistics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA.
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Soiffer RJ, Weller E, Alyea EP, Mauch P, Webb IL, Fisher DC, Freedman AS, Schlossman RL, Gribben J, Lee S, Anderson KC, Marcus K, Stone RM, Antin JH, Ritz J. CD6+ donor marrow T-cell depletion as the sole form of graft-versus-host disease prophylaxis in patients undergoing allogeneic bone marrow transplant from unrelated donors. J Clin Oncol 2001; 19:1152-9. [PMID: 11181681 DOI: 10.1200/jco.2001.19.4.1152] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The role of donor marrow T-cell depletion (TCD) in preventing graft-versus-host disease (GVHD) after transplantation of unrelated allogeneic marrow remains undefined. Because different TCD methodologies differ in the degree and specificity with which T cells are removed, it is likely that transplant outcomes would depend on which technique is used. Herein, we report results in the first 48 recipients of unrelated marrow using CD6+ TCD as the sole form of GVHD prophylaxis. PATIENTS AND METHODS Median age of patients was 46 years (20 to 58 years). Donors were matched at A/B HLA loci. Ablation consisted of cyclophosphamide and fractionated total-body irradiation (TBI; 14 Gy). To facilitate engraftment, patients also received 7.5 Gy (22 patients) [corrected] or 4.5 Gy (26 patients) [corrected] of total lymphoid irradiation (TLI) before admission. No additional immune suppressive prophylaxis was administered. Granulocyte colony-stimulating factor was administered daily from day +1 to engraftment. RESULTS All 48 patients demonstrated neutrophil engraftment. An absolute neutrophil count of 500 x 10(6)/L was achieved at a median of 12 days (range, 9 to 23 days). There were no cases of late graft failure. The number of CD34+ cells infused/kg was associated with speed of platelet and neutrophil recovery. The dose of TLI did not influence engraftment. Grades 2-4 acute GVHD occurred in 42% of patients (95% confidence interval [CI], 0.28 to 0.57). Mortality at day 100 was 19%. There have been only five relapses. Estimated 2-year survival was 44% (95% CI, 0.28 to 0.59) for the entire group, 58% for patients less than 50 years of age. In multivariable analysis, age less than 50 years (P =.002), cytomegalovirus seronegative status (P =.04), and early disease status at bone marrow transplant (P =.05) were associated with superior survival. CONCLUSION CD6+ TCD does not impede engraftment of unrelated bone marrow after low-dose TLI, cyclophosphamide, and TBI. CD6+ TCD as the sole form of GVHD prophylaxis results in an incidence of GVHD that compares favorably with many adult studies of unrelated transplantation using unmanipulated marrow and immune-suppressive medications, especially in light of the median age of our patients (46 years). Although event-free survival in patients less than 50 years of age is very encouraging, older patients experience frequent transplantation-related complications despite TCD.
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Affiliation(s)
- R J Soiffer
- Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
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Donovan J, Temel J, Zuckerman A, Gribben J, Fang J, Pierson G, Ross A, Diller L, Grupp SA. CD34 selection as a stem cell purging strategy for neuroblastoma: preclinical and clinical studies. Med Pediatr Oncol 2000; 35:677-82. [PMID: 11107145 DOI: 10.1002/1096-911x(20001201)35:6<677::aid-mpo42>3.0.co;2-h] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The suitability of CD34 selection for purging peripheral blood progenitor cells (PBPC) collected from patients with neuroblastoma (NB) has been called into question, largely because of reports of detection of low levels of CD34 on the surface of some NB cell lines and tumors. PROCEDURE We used three approaches to address the issue of purging of NB from stem cell specimens and possible labeling of NB: 1) Flow cytometric detection of CD34 on NB cell lines. We assessed CD34 expression using a panel of anti-CD34 monoclonal antibodies (MoAbs) including 9C5, 12.8, and QBend10 and showed no increase in labeling over secondary-only control. 2) Spiking experiments with the Isolex 50 system. NB cell lines were used to contaminate aliquots of PBPC collections, after which the products were purified using the Isolex 50. Purging of NB was assessed by quantitative multiplex RT-PCR (TaqMan system) using a tumor-specific transcript, GAGE. We demonstrated >2 logs of tumor cell depletion from these specimens. 3) Analysis of clinical specimens. PBPC pre- and post-CD34 selection were analyzed from patients treated on the CHP-594 transplant trial. RESULTS In nine specimens selected using the Ceprate LC CD34 selection system where tumor was detectable by immunocytochemistry preselection, we observed >2.4 to >4.6 logs of NB purging after selection. We then analyzed 23 aliquots of PBPC infused into patients post-CD34 selection and compared them to the product preselection; 20/23 specimens showed depletion of NB, although some level of GAGE message was observed in most post-CD34 selection specimens. CONCLUSION These data show that purging of NB from PBPC specimens using CD34 selection is feasible, yielding infused products that are negative at the level of ICC but often positive at the level of RT-PCR.
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Affiliation(s)
- J Donovan
- Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Freedman A, Friedberg JW, Gribben J. High-dose therapy for follicular lymphoma. Oncology (Williston Park) 2000; 14:321-6, 329; discussion 330-2, 338. [PMID: 10742961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Most patients with advanced-stage follicular non-Hodgkin's lymphoma (NHL) are not cured with conventional therapy. The use of high-dose therapy and autologous stem-cell transplantation in patients with relapsed follicular NHL has received increasing attention. Several large studies suggest a disease-free survival rate of approximately 40% among patients transplanted during sensitive relapse, although the role of autologous transplantation in first remission remains controversial. Patients with histologic transformation from low-grade to diffuse large B-cell lymphoma whose disease remains sensitive to conventional therapy have a similar disease-free survival rate. Allogeneic transplantation has achieved relapse, overall survival, and treatment-related death rates of approximately 15%, 50%, and 40%, respectively, in patients with follicular NHL. Studies of minimal residual disease suggest that the presence of lymphoma cells in the autologous graft and within the patient before clinically apparent relapse is predictive of later recurrence. Therefore, treatment of minimal residual disease may improve the outcome of high-dose therapy. Use of a tumor-free stem-cell product through improved purging or allogeneic stem cells is one approach, although the morbidity and mortality of allogeneic transplantation remain high. Immunomodulatory strategies with monoclonal antibodies, vaccines, or adoptive immunotherapy may be particularly well suited to patients at high risk for relapse following high-dose therapy.
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Affiliation(s)
- A Freedman
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Soiffer RJ, Freedman AS, Neuberg D, Fisher DC, Alyea EP, Gribben J, Schlossman RL, Bartlett-Pandite L, Kuhlman C, Murray C, Freeman A, Mauch P, Anderson KC, Nadler LM, Ritz J. CD6+ T cell-depleted allogeneic bone marrow transplantation for non-Hodgkin's lymphoma. Bone Marrow Transplant 1998; 21:1177-81. [PMID: 9674848 DOI: 10.1038/sj.bmt.1701271] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
For patients with non-Hodgkin's lymphoma (NHL) undergoing blood or bone marrow transplantation (BMT), the use of autologous grafts has often been preferred to that of allogeneic stem cells because of a significantly lower incidence of non-relapse mortality. If complications associated with allo-BMT could be minimized without compromising efficacy, then it might become a preferred strategy for certain subsets of patients. In this report, we describe the toxicity and long-term efficacy of T cell-depleted allogeneic BMT using anti-CD6 monoclonal antibody and complement alone to reduce the risk of GVHD and its sequelae. Twenty-two patients, aged 18-60 years, with high (n = 10), intermediate (n = 9), or low (n = 3) grade NHL underwent HLA-identical allogeneic BMT from siblings. Patients had either relapsed after at least one remission or never achieved a full remission with chemotherapy. Twenty patients had a history of marrow involvement. Bone marrow was depleted of CD6+ T cells with T12 monoclonal antibody and complement as the sole form of GVHD prophylaxis. Stable hematopoietic engraftment occurred in all 22 patients. Four patients developed grade 2 and 1 patient grade 3 GVHD (23% grades 2-4 GVHD). Chronic GVHD has occurred in three patients. Treatment-related mortality was very low. Only one patient died while in remission. Thirteen patients are alive and free of disease with a median follow-up of 30 months. Estimated event-free and overall survivals are 54 and 59%, respectively. CD6 allogeneic marrow transplantation is associated with a low risk of transplant-related complications and may offer advantages for certain patients with recurrent NHL felt to be at high risk for relapse after autologous transplantation.
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Affiliation(s)
- R J Soiffer
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA 02115, USA
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Freedman A, Neuberg D, Mauch P, Gribben J, Soiffer R, Anderson K, Robertson M, Fisher DC, Schlossman R, Kroon M, Rhuda C, Kuhlman C, Ritz J, Nadler L. Cyclophosphamide, doxorubicin, vincristine, prednisone dose intensification with granulocyte colony-stimulating factor markedly depletes stem cell reserve for autologous bone marrow transplantation. Blood 1997; 90:4996-5001. [PMID: 9389719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Hematopoietic growth factors allow dose escalation of chemotherapy. This approach may potentially reduce the quality and quantity of hematopoietic stem cells. The capacity of stem cells recovered after dose intensification to support myeloablative therapy is unknown. In patients with previously untreated advanced follicular lymphoma, trilineage hematopoietic engraftment was compared in two sequential trials of induction therapy (standard dose cyclophosphamide, doxorubicin, vincristine, prednisone [CHOP] without growth factors or dose intensification CHOP supported by granulocyte colony-stimulating factor [G-CSF ]) followed by identical myeloablative therapy and autologous stem cell support. Neutrophil, platelet, and red blood cell (RBC) engraftment were compared on days 100, 180, and 360 after stem cell reinfusion. Despite similar patient characteristics including reinfusion of comparable numbers of marrow mononuclear cells, after stem cell transplantation, a highly significant prolongation of neutrophil and platelet engraftment was seen in patients who received high dose CHOP and G-CSF in comparison to standard dose CHOP. These findings suggest that dose intensified chemotherapy and G-CSF recruited stem cells into a proliferative phase and that G-CSF allowed retreatment at a time when stem cells were susceptible to damage by cytotoxic therapy. Such inadequate hematologic engraftment after myeloablative therapy might be avoided by either shortening the time that growth factor support is administered, lengthening the interval between cycles, or attempting to repetitively harvest additional stem cells either from the marrow or peripheral blood. Therefore, intensification of chemotherapy with growth factor support must be used with caution if stem cells are to be used to support myeloablative therapy.
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Affiliation(s)
- A Freedman
- Division of Hematologic Malignancies and Biostatistics, Dana-Farber Cancer Institute, Boston, MA 02115, USA
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MESH Headings
- Bone Marrow Purging
- Bone Marrow Transplantation
- Chromosomes, Human, Pair 14
- Chromosomes, Human, Pair 18
- Disease-Free Survival
- Fusion Proteins, bcr-abl/analysis
- Fusion Proteins, bcr-abl/biosynthesis
- Gene Rearrangement
- Humans
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/genetics
- Neoplasm, Residual/pathology
- Neoplasms/mortality
- Neoplasms/pathology
- Neoplasms/therapy
- Polymerase Chain Reaction/methods
- Prognosis
- Recurrence
- Sensitivity and Specificity
- Translocation, Genetic
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Affiliation(s)
- J Gribben
- Tumor Immunology Division, Dana-Farber Cancer Institution, Boston, MA 02115, USA
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Boussiotis VA, Freeman GJ, Gray G, Gribben J, Nadler LM. B7 but not intercellular adhesion molecule-1 costimulation prevents the induction of human alloantigen-specific tolerance. J Exp Med 1993; 178:1753-63. [PMID: 7901318 PMCID: PMC2191250 DOI: 10.1084/jem.178.5.1753] [Citation(s) in RCA: 172] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Presentation of antigen by the major histocompatibility complex to T lymphocytes without the requisite costimulatory signals does not induce an immune response but rather results in a state of antigen-specific unresponsiveness, termed anergy. To determine which costimulatory signals are critical for the T cell commitment to activation or anergy, we developed an in vitro model system that isolated the contributions of alloantigen and each candidate costimulatory molecule. Here, we show that transfectants expressing HLA-DR7 and either B7 or intercellular adhesion molecule 1 (ICAM-1) deliver independent costimulatory signals resulting in alloantigen-induced proliferation of CD4-positive T lymphocytes. Although equivalent in their ability to costimulate maximal proliferation of alloreactive T cells, B7 but not ICAM-1 induced detectable interleukin 2 secretion and prevented the induction of alloantigen-specific anergy. These results are consistent with the hypothesis that blockade of the ICAM-1:lymphocyte function-associated 1 pathway results in immunosuppression, whereas blockade of the B7:CD28/CTLA4 pathway results in alloantigen-specific anergy. This approach, using this model system, should facilitate the identification of critical costimulatory pathways which must be inhibited in order to induce alloantigen-specific tolerance before human organ transplantation.
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Affiliation(s)
- V A Boussiotis
- Division of Hematologic Malignancies, Dana Farber Cancer Institute, Boston, Massachusetts
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Spector NL, Samson W, Ryan C, Gribben J, Urba W, Welch WJ, Nadler LM. Growth arrest of human B lymphocytes is accompanied by induction of the low molecular weight mammalian heat shock protein (Hsp28). J Immunol 1992; 148:1668-73. [PMID: 1541812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A large number of protein and molecular markers have been identified that delineate the early stages of human B cell activation and proliferation. In contrast, few if any molecules are transiently expressed precisely as activated B cells stop proliferating and undergo growth arrest. We demonstrate that the low molecular weight heat shock protein (hsp28) exhibits unique induction kinetics that specifically demarcates this interval. After mitogenic activation of unstimulated splenic B cells, hsp28 protein and phosphorylation transiently increase coinciding precisely with the peak of cellular proliferation and the onset of growth arrest. Although most neoplastic B cells constitutively express hsp28, three cell lines were identified that were hsp28-. No differences in phenotype or growth kinetics were detected between hsp28+ and hsp28- neoplastic B cells demonstrating that hsp28 expression is not essential for cell growth. However, when treated with phorbol ester or heat shock, these hsp28- cell lines synthesize hsp28 followed by the onset growth arrest. The consistency with which hsp28 induction transiently delineates the interval from peak proliferation to the onset of growth arrest suggests hsp28 itself is likely to be involved in regulating this process.
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Affiliation(s)
- N L Spector
- Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA 02115
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Spector NL, Samson W, Ryan C, Gribben J, Urba W, Welch WJ, Nadler LM. Growth arrest of human B lymphocytes is accompanied by induction of the low molecular weight mammalian heat shock protein (Hsp28). The Journal of Immunology 1992. [DOI: 10.4049/jimmunol.148.6.1668] [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] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
A large number of protein and molecular markers have been identified that delineate the early stages of human B cell activation and proliferation. In contrast, few if any molecules are transiently expressed precisely as activated B cells stop proliferating and undergo growth arrest. We demonstrate that the low molecular weight heat shock protein (hsp28) exhibits unique induction kinetics that specifically demarcates this interval. After mitogenic activation of unstimulated splenic B cells, hsp28 protein and phosphorylation transiently increase coinciding precisely with the peak of cellular proliferation and the onset of growth arrest. Although most neoplastic B cells constitutively express hsp28, three cell lines were identified that were hsp28-. No differences in phenotype or growth kinetics were detected between hsp28+ and hsp28- neoplastic B cells demonstrating that hsp28 expression is not essential for cell growth. However, when treated with phorbol ester or heat shock, these hsp28- cell lines synthesize hsp28 followed by the onset growth arrest. The consistency with which hsp28 induction transiently delineates the interval from peak proliferation to the onset of growth arrest suggests hsp28 itself is likely to be involved in regulating this process.
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Affiliation(s)
- N L Spector
- Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA 02115
| | - W Samson
- Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA 02115
| | - C Ryan
- Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA 02115
| | - J Gribben
- Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA 02115
| | - W Urba
- Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA 02115
| | - W J Welch
- Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA 02115
| | - L M Nadler
- Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA 02115
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Lim SH, McMillan AK, Gribben J, Galvin MC, Goldstone AH. A Unique Case of Three Autografts for Acute Myelogenous Leukaemia with Subsequent Long Term Survival in Second Remission. Leuk Lymphoma 1991; 5:207-9. [DOI: 10.3109/10428199109068127] [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: 11/13/2022]
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Simpson IA, Rae AP, Simpson K, Gribben J, Boulton Jones JM, Allison ME, Hutton I. Ultrafiltration in the management of refractory congestive heart failure. Heart 1986; 55:344-7. [PMID: 3964500 PMCID: PMC1236736 DOI: 10.1136/hrt.55.4.344] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Ultrafiltration was performed in nine patients with congestive cardiac failure that was refractory to conventional medical treatment. A mean of 12 X 7 litres of fluid was removed, and there was a sustained symptomatic improvement in all patients. Weight loss continued after ultrafiltration and a sustained increase in serum sodium concentration was also noted. A transient fall in right atrial pressure was seen only at four hours after ultrafiltration. No adverse haemodynamic effects were seen four and eighteen hours after fluid removal. Intracardiac dimensions measured by echocardiography remained unchanged. Ultrafiltration can be used to relieve symptoms in patients with refractory congestive heart failure and gross oedema.
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Atrah HI, Sheehan T, Gribben J, Crawford RJ, O'Donnel JR, Sandilands GP. Improvement of post platelet transfusion increments following intravenous immunoglobulin therapy for leukaemic HLA-immunized patients. Scand J Haematol 1986; 36:160-4. [PMID: 3458291 DOI: 10.1111/j.1600-0609.1986.tb00821.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
3 patients with acute leukaemia, HLA antibodies and thrombocytopenia refractory to random donor platelet transfusions were treated with high-dose i.v. immunoglobulin. All 3 patients responded favourably with improved post-transfusion recovery of random platelets. In 1 patient, the recovery of transfused histocompatible platelets was also enhanced. Treatment was followed by reduction in the total lymphocyte count and marked changes in lymphocyte subsets in 1 patient.
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Abstract
Salmonella typhimurium, resistant only to trimethoprim and sulphamethoxazole, was isolated from the faeces and blood of a chronic alcoholic patient in acute renal failure. The isolates harboured an 18 Md non-conjugative plasmid. He was dialysed peritoneally and treated with ampicillin; four days later there was no clinical improvement and his peritoneal dialysis fluid (PDF) had become infected. Salm. typhimurium was isolated from faeces and PDF. Both isolates were additionally resistant to ampicillin and contained two plasmids (55 Md and 18 Md). Therapy was changed to chloramphenicol and gentamicin was added to the PDF. Two weeks later Salm. typhimurium was again isolated from PDF and faeces. The PDF isolate was unchanged but 4% of the colonies isolated from this faecal specimen were resistant to chloramphenicol and had acquired an additional 62 Md plasmid. From all PDF and faecal specimens two different strains of Escherichia coli and one strain of Klebsiella pneumoniae were isolated which contained plasmids indistinguishable, on the basis of molecular weight and transferable resistance markers, from those acquired by Salm. typhimurium. The transferability of these plasmids in vitro to E. coli K12 and to the patient's initial Salm. typhimurium was studied and the results discussed.
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Leung AC, Gribben J, Sleigh JD, Boulton Jones JM. Successful treatment of multiresistant pseudomonas peritonitis with combination of azlocillin and amikacin. Scott Med J 1983; 28:69-70. [PMID: 6403983 DOI: 10.1177/003693308302800115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Multiresistant Pseudomonas infection remains a problem in hospital practice. We report a case of pseudomonas peritonitis successfully treated by a combination of azlocillin and amikacin. This is the first case report of the intraperitoneal use of azlocillin.
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