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Delgadillo J, Kerkelä E, Waters A, Akker EVD, Lechanteur C, Baudoux E, Gardiner N, De Vos J, Vives J. A management model in blood, tissue and cell establishments to ensure rapid and sustainable patient access to advanced therapy medicinal products in Europe. Cytotherapy 2023; 25:1259-1264. [PMID: 37737767 DOI: 10.1016/j.jcyt.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/02/2023] [Accepted: 08/02/2023] [Indexed: 09/23/2023]
Abstract
Blood, tissue and cell establishments (BTCs) stand out in the management of donor selection, procurement and processing of all types of substances of human origin (SoHO). In the last decades, the framework created around BTCs, including hospitals and national health system networks, and their links to research, development and innovation organizations and agencies have spurred their involvement in the study of groundbreaking advanced therapy medicinal products (ATMP). To further improve strategic synergies in the development of ATMPs, it will be required to promote intra- and inter-European collaborations by creating an international network involving BTCs and major stakeholders (i.e., research organizations, hospitals, universities, patient associations, public agencies). This vision is already shared with the European Blood Alliance, the association of non-profit blood establishments, with 26 member states throughout the European Union and European Free Trade Association states. Herein we present and analyze the "BTC for ATMP Development And Manufacture" (BADAM) model, an ethically responsible business model based on the values and missions of BTCs and their commitment to health equity, patient access and education (based on voluntary donation of SoHO to address unmet clinical needs, while contributing to training professionals and scientific literacy of our Society).
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Affiliation(s)
- Joaquín Delgadillo
- Banc de Sang i Teixits (BST), Edifici Dr. Frederic Duran i Jordà, Barcelona, Spain; Transfusion Medicine Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Erja Kerkelä
- Finnish Red Cross Blood Service, Vantaa, Finland
| | - Allison Waters
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | - Emile van den Akker
- Department of Hematopoiesis and Sanquin Research, Landsteiner Laboratory, Department of Molecular Hematology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Chantal Lechanteur
- University of Liège, Laboratory of Cell and Gene Therapy LTCG, Liège, Belgium
| | - Etienne Baudoux
- University of Liège, Laboratory of Cell and Gene Therapy LTCG, Liège, Belgium
| | - Nicola Gardiner
- Cryobiology Laboratory Stem Cell Facility, St. James's Hospital, Dublin, Ireland
| | - John De Vos
- Département d'ingénierie Cellulaire et Tissulaire, Unité de Thérapie Cellulaire, Hôpital Saint-Eloi, Montpellier, France
| | - Joaquim Vives
- Banc de Sang i Teixits (BST), Edifici Dr. Frederic Duran i Jordà, Barcelona, Spain; Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Thibodeaux SR, Coble D, Day V, Fontaine MJ, Gabelli M, Gardiner N, Geach T, Schwartz J, Vasovic LV, Wyre R, Girdlestone J. Assessing deviations for HPCs obtained during COVID-19 (ADHOC): Evaluating impact of the COVID-19 pandemic on cellular therapy products and processes, the BEST collaborative study. Transfusion 2023; 63:782-790. [PMID: 36924403 DOI: 10.1111/trf.17311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 03/18/2023]
Abstract
BACKGROUND The success of allogeneic hematopoietic stem cell transplantation is dependent on a world-wide network of collection centers providing donations that predominantly have been infused as fresh cells. The logistics chain that supports the just-in-time delivery model for stem cell and immunotherapy products was severely stressed by the COVID pandemic, and in early 2020 a number of national and international bodies recommended that cells should be cryopreserved at the collection or transplant center to avoid interruptions in their acquisition or delivery to patients who had started conditioning. STUDY DESIGN To assess the potential consequences of such pandemic-related deviations to normal practice, we surveyed nine international laboratories to determine if the characteristics or transplant outcomes of allogeneic stem cell donations differed in the immediate periods before and after the switch to routine cryopreservation. RESULTS Nine centers on two continents provided data for 72 HSC donations just before, and 71 just after, switching to cryopreservation for allogeneic HSC products. No statistically significant differences between the period before and after cryopreservation were noted for time from product collection to receipt, product temperature at receipt, or CD34+ cell viability at receipt. There was an indication of slower absolute neutrophil count recovery after cryopreservation was required (mean time of 15 vs. 17.6 days). DISCUSSION While there were no apparent changes to most parameters studied, there was an indication of slower neutrophil engraftment that will need to be examined in larger, longer term studies.
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Affiliation(s)
- Suzanne R Thibodeaux
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Dean Coble
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Victoria Day
- National Health Service Blood and Transplant, Barnsley, UK
| | - Magali J Fontaine
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Maria Gabelli
- Department of Bone Marrow Transplantation, Great Ormond Street Hospital for Children, London, UK
| | - Nicola Gardiner
- Cryobiology Laboratory Stem Cell Facility, St. James's Hospital, Dublin, Ireland
| | - Tamara Geach
- Cell Therapy and Transplant Program, The London Clinic, London, UK
| | - Joseph Schwartz
- Department of Pathology, Molecular and Cell-Based Medicine, Mount Sinai Health System, New York, New York, USA
| | - Ljiljana V Vasovic
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Rachael Wyre
- Stem Cells and Immunotherapies, National Health Service Blood and Transplant, Southampton, UK
| | - John Girdlestone
- Stem Cells and Immunotherapies, National Health Service Blood and Transplant, The John Radcliffe Hospital, Oxford, UK
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Brophy S, Amet R, Foy-Stones H, Gardiner N, McElligott AM. Isolation and Cryopreservation of Mononuclear Cells from Peripheral Blood and Bone Marrow of Blood Cancer Patients. Methods Mol Biol 2023; 2645:179-187. [PMID: 37202619 DOI: 10.1007/978-1-0716-3056-3_10] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Peripheral blood and bone marrow aspirates are routinely obtained from blood cancer patients for diagnostic investigations and provide an accessible source of patient-specific cancer cells, as well as non-malignant cells, for research proposes. The simple and reproducible method presented here allows isolation of viable mononuclear cells, including malignant cells, from fresh peripheral blood or bone marrow aspirates using density gradient centrifugation. The cells obtained using the protocol described can be further purified for a variety of cellular, immunological, molecular, and functional assays. In addition, these cells can be cryopreserved and bio-banked for future research studies.
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Affiliation(s)
- Sarah Brophy
- The John Durkan Leukaemia Laboratory, Trinity Translational Medicine Institute, Trinity College and St James's Hospital, Dublin, Ireland
| | - Rebecca Amet
- The John Durkan Leukaemia Laboratory, Trinity Translational Medicine Institute, Trinity College and St James's Hospital, Dublin, Ireland
| | - Hayley Foy-Stones
- Cryobiology Laboratory Stem Cell Facility, St James's Hospital, Dublin, Ireland
| | - Nicola Gardiner
- Cryobiology Laboratory Stem Cell Facility, St James's Hospital, Dublin, Ireland
| | - Anthony M McElligott
- The John Durkan Leukaemia Laboratory, Trinity Translational Medicine Institute, Trinity College and St James's Hospital, Dublin, Ireland.
- Trinity St. James's Cancer Institute, Trinity College and St James's Hospital, Dublin, Ireland.
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Brodie R, Lee G, Broderick V, Higgins E, Flavin R, Gardiner N, Browne P, Hayden P, Conneally E, Tuohy E, Flynn C, Bacon C, Vandenberghe E. A NATIONAL RETROSPECTIVE ANALYSIS OF CLINICAL OUTCOMES FOLLOWING ALLOGENEIC TRANSPLANTATION FOR HIGH GRADE B-CELL LYMPHOMA (HGBL). Hematol Oncol 2019. [DOI: 10.1002/hon.116_2631] [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: 11/06/2022]
Affiliation(s)
- R. Brodie
- Haematology Department; St. James Hospital; Dublin Republic of Ireland
| | - G. Lee
- Haematology Department; St. James Hospital; Dublin Republic of Ireland
| | - V. Broderick
- Haematology Department; St. James Hospital; Dublin Republic of Ireland
| | - E. Higgins
- Haematology Department; St. James Hospital; Dublin Republic of Ireland
| | - R. Flavin
- Histopathology Department; St. James Hospital; Dublin Republic of Ireland
| | - N. Gardiner
- Stem Cell Laboratory; St. James Hospital; Dublin Republic of Ireland
| | - P. Browne
- Haematology Department; St. James Hospital; Dublin Republic of Ireland
| | - P. Hayden
- Haematology Department; St. James Hospital; Dublin Republic of Ireland
| | - E. Conneally
- Haematology Department; St. James Hospital; Dublin Republic of Ireland
| | - E. Tuohy
- Haematology Department; St. James Hospital; Dublin Republic of Ireland
| | - C. Flynn
- Haematology Department; St. James Hospital; Dublin Republic of Ireland
| | - C.L. Bacon
- Haematology Department; St. James Hospital; Dublin Republic of Ireland
| | - E. Vandenberghe
- Haematology Department; St. James Hospital; Dublin Republic of Ireland
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Zhang Y, Wang YW, Yanni J, Cai X, Qureshi MA, Gardiner N, Howarth FC, Dobrzynski H. 118Dysfunction of the pacemaker of the heart in the rat model of streptozotocin-induced type I diabetes mellitus. Europace 2017. [DOI: 10.1093/ehjci/eux135.007] [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: 11/14/2022] Open
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7
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Akhtar R, Zhao X, Gardiner N, Derby B, Cruickshank J, Sherratt M. 4.5 LOCALISED MICROMECHANICAL REMODELLING OF THE AORTA IN A MODEL OF TYPE 1 DIABETES. Artery Res 2012. [DOI: 10.1016/j.artres.2012.09.029] [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: 10/27/2022] Open
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8
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Lalloo R, Moonsamy G, Ramchuran S, Görgens J, Gardiner N. Competitive exclusion as a mode of action of a novel Bacillus cereus aquaculture biological agent. Lett Appl Microbiol 2010; 50:563-70. [PMID: 20337929 DOI: 10.1111/j.1472-765x.2010.02829.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To determine the contribution of potential modes of action of a Bacillus cereus aquaculture biological control agent in inhibition of the fish pathogen, Aeromonas hydrophila. METHODS AND RESULTS When B. cereus was tested in plate well inhibition studies, no production of antimicrobial compounds was detected. Bacillus cereus had a high growth rate (0.96 h(-1)), whereas Aer. hydrophila concentration decreased by c. 70% in co-culture experiments. In nutrient limitation studies, B. cereus had a significantly higher growth rate when cultured under glucose (P < 0.05) and iron (P < 0.01) limitation in comparison with Aer. hydrophila. Bacillus cereus glucose (0.30 g l(-1) h(-1)) and iron (0.60 mg l(-1) h(-1)) uptake rates were also significantly higher (P < 0.01) than the Aer. hydrophila glucose (0.14 g l(-1) h(-1)) and iron (0.43 mg l(-1) h(-1)) uptake rates. Iron uptake was facilitated by siderophore production shown in time profile studies where relative siderophore production was c. 60% through the late exponential and sporulation phases. CONCLUSIONS Competitive exclusion by higher growth rate, competition for organic carbon and iron, facilitated by siderophore production, could be identified as mechanisms of pathogen growth inhibition by B. cereus. SIGNIFICANCE AND IMPACT OF THE STUDY This study is the first elucidation of the mechanism of action of our novel B. cereus biological agent in growth attenuation of pathogenic Aer. hydrophila. This study enhances the application knowledge and attractiveness for adoption of B. cereus NRRL 100132 for exploitation in aquaculture.
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Affiliation(s)
- R Lalloo
- CSIR Biosciences, Modderfontein, South Africa.
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9
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Akhtar R, Gardiner N, Derby B, Cruickshank J, Sherratt M. 3.6 NANOMECHANICAL PROPERTIES OF A MODEL OF TYPE 1 DIABETIC AORTA. Artery Res 2010. [DOI: 10.1016/j.artres.2010.10.171] [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: 11/24/2022] Open
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10
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Akhtar R, Gardiner N, Cruickshank J, Derby B, Sherratt M. P10.05 REDUCED MOLECULAR FLEXIBILITY IN THE LARGE ARTERIES OF DIABETIC RATS. Artery Res 2009. [DOI: 10.1016/j.artres.2009.10.136] [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] Open
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11
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Ritzema J, Richards M, Crozier I, Gardiner N, Melton I, Doughty R, Eigler N, Whiting J, Abraham WT, Troughton R. SERIAL DOPPLER ECHOCARDIOGRAPHY AND TISSUE DOPPLER IMAGING MEASUREMENTS CAN ACCURATELY DETECT ELEVATED DIRECTLY MEASURED LEFT ATRIAL PRESSURE IN CHRONIC HEART FAILURE. Heart Lung Circ 2008. [DOI: 10.1016/j.hlc.2008.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Lalloo R, Ramchuran S, Ramduth D, Görgens J, Gardiner N. Isolation and selection of Bacillus spp. as potential biological agents for enhancement of water quality in culture of ornamental fish. J Appl Microbiol 2007; 103:1471-9. [DOI: 10.1111/j.1365-2672.2007.03360.x] [Citation(s) in RCA: 73] [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] [Indexed: 11/30/2022]
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14
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Piccin A, O'Marcaigh A, Smith O, O'Riordan J, Crowley M, Vandenberg E, Gardiner N, McCann S. Outcome of bone marrow transplantation in acquired and inherited aplastic anaemia in the Republic of Ireland. Ir J Med Sci 2005; 174:13-9. [PMID: 16285332 DOI: 10.1007/bf03169141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Severe Aplastic Anaemia (SAA) and Fanconi Anaemia (FA) are rare haematological disorders characterised by pancytopenia and bone marrow hypoplasia. AIMS We performed a retrospective study of all patients who underwent BMT for SAA and FA at St James's Hospital, Dublin, and at OLHSC, Crumlin, between 1985 and 2002. METHODS The medical records of 63 patients, 50 with acquired SAA and 13 with FA, were reviewed. RESULTS The median age at the time of transplant was 14 years (range 3-43 years). The actuarial survival (OS) (n = 63) was 76% at 17 years. The transplant related mortality (TRM) was 22% (n = 14). The most common cause of death was infection (46%). The survival was significantly better in patients receiving their transplant after 1995 (p = 0.002). Outcome was superior in those receiving less than 20 red cell transfusions prior to transplant: OS 91% (< 20 Units) versus 62% (> or = 20 Units). CONCLUSIONS These national results are comparable to those of published international series and support the use of BMT in the treatment of SAA and FA. The known adverse effect of prior transfusion was confirmed.
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Affiliation(s)
- A Piccin
- Trinity Centre, St James's Hospital, Dublin.
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15
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Hayden PJ, O'Driscoll A, Gardiner N, Swords R, Sargent J, Ni Ainle F, Fortune A, Murphy PT, Leahy M, Jackson F, Ryan M, Hennessy B, Cahill M, Crotty GM, Enright H, Conneally E, Vandenberghe E, McCann SR, Browne PV. Autologous stem cell transplantation in myeloma: the St James's Hospital experience, 1997-2003. Ir J Med Sci 2005; 174:26-32. [PMID: 16094909 DOI: 10.1007/bf03169125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND High-dose treatment with autologous stem cell transplantation (ASCT) has become the standard of care for patients with myeloma below the age of 65 years. AIMS We report an audit of 60 patients (median age: 52.5 years) who underwent ASCT in the National Bone Marrow Transplant centre in St James's Hospital in Dublin between 1997 and 2003 inclusive. METHODS Clinical and laboratory data were retrieved from patient medical records and hospital information management systems. RESULTS Thirty-six patients had IgG, 11 IgA, 1 IgD, 9 light chain and 3 non-secretory MM. Fifty-seven (95%) patients received anthracycline-corticosteroid combination chemotherapy prior to autografting. There was no transplant-related mortality (TRM). Complete (CR) and Partial Responses (PR) were seen in 16 (29.6%) and 29 (53.7%) of those evaluable (n = 54 (90%)). The actuarial Progression-Free (PFS) and Overall Survival (OS) rates at five years are 13% and 55% respectively. CONCLUSION Centre outcome is comparable to published international series and supports the use of ASCT in the treatment of this malignancy.
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Affiliation(s)
- P J Hayden
- Dept. of Haematology, St James's Hospital, Dublin 8, Ireland.
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16
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Hayden PJ, Keogh F, Ni Conghaile M, Carroll M, Crowley M, Fitzsimon N, Gardiner N, Vandenberghe E, O'Riordan J, McCann SR. A single-centre assessment of long-term quality-of-life status after sibling allogeneic stem cell transplantation for chronic myeloid leukaemia in first chronic phase. Bone Marrow Transplant 2005; 34:545-56. [PMID: 15343272 DOI: 10.1038/sj.bmt.1704638] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A total of 75 patients underwent sibling allogeneic stem cell transplantation (SCT) for chronic myeloid leukaemia in first chronic phase from 1984 to 2000. Of these patients, 51 (68%) were alive at a median follow-up of 98 months (range 34-217 months). Nine (18%) patients relapsed and seven (14%) received donor lymphocyte transfusions. Quality of life (QoL) was assessed cross-sectionally using the EORTC QLQ-C30, a Leukaemia-BMT-specific module and questionnaires on sexual functioning, fertility and late effects. A total of 46 (90%) replied. Scores for Role (P=0.018) and Cognitive (P<0.001) function were significantly lower when compared to an age-adjusted general population. Dyspnoea (P=0.022) and Financial Difficulties (P<0.001) were significantly more common in the SCT group. No difference was found for scores in the Physical, Emotional and Social domains or the overall Global Health Status/QoL. Decreased sexual functioning was found in one-third of respondents. Although most BMT recipients reported a good QoL, a minority have difficulty with reintegration into professional roles and consequent monetary problems. Identified cognitive and sexual impairments highlight the need for long-term access to psychosocial support.
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Affiliation(s)
- P J Hayden
- Department of Haematology, St James's Hospital and University of Dublin, Trinity College, Dublin, Ireland.
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17
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Chilton L, Middlemas A, Gardiner N, Tomlinson DR. The p75 neurotrophin receptor appears in plasma in diabetic rats-characterisation of a potential early test for neuropathy. Diabetologia 2004; 47:1924-30. [PMID: 15558233 DOI: 10.1007/s00125-004-1550-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2004] [Accepted: 07/18/2004] [Indexed: 10/26/2022]
Abstract
AIMS/HYPOTHESIS This study tested the premise that immunoreactivity representing the p75 neurotrophin receptor (p75(NTR)) appears in plasma of diabetic rats in association with the early stages of neuronal dysfunction or damage. We also examined whether treatment beneficial to neuropathy might reduce the p75(NTR) immunoreactivity. METHODS Plasma proteins were fractionated by SDS-PAGE and immunoblots exposed to p75(NTR) antibody, using receptor protein from cultured PC12 cells as an external standard. Rats were made diabetic with streptozotocin for various periods and exsanguinated. Plasma glucose, HbA(1)c and plasma proteins were determined. We also studied plasma samples from diabetic mice lacking the gene coding for p75(NTR), as well as the effect of sciatic nerve crush on healthy male Wistar rats. RESULTS Plasma p75(NTR) immunoreactivity began to exceed normal levels at 8 weeks after induction of diabetes, and was significantly raised at 10 (p<0.05) and 12 weeks (p<0.001). Treatment between 8 and 12 weeks with insulin, fidarestat (an aldose reductase inhibitor), nerve growth factor and neurotrophin 3 all normalised the plasma p75(NTR) immunoreactivity. Plasma from p75(NTR) (-/-) mice contained no such immunoreactivity, though it was present in plasma from wild-type mice. Following nerve crush, p75(NTR) immunoreactivity appeared in plasma of non-diabetic mice, indicating that this can be a result of nerve trauma. CONCLUSIONS/INTERPRETATION These observations suggest that plasma p75(NTR) immunoreactivity may serve as an early indicator of neuronal dysfunction or damage in diabetes. The time course of its appearance relates well to that of early neuropathy and its response to interventions that are neuroprotective suggests that it might mirror neurological status.
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Affiliation(s)
- L Chilton
- Division of Neuroscience, Faculty of Life Sciences, University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, UK
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18
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Hayden PJ, Gardiner N, Molloy K, Ryan J, Lawler M, McCann SR. Pure red cell aplasia after a major ABO-mismatched bone marrow transplant for chronic myeloid leukaemia: response to re-introduction of cyclosporin. Bone Marrow Transplant 2004; 33:459-61. [PMID: 14676777 DOI: 10.1038/sj.bmt.1704366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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19
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O'Connell N, Gardiner N, Duggan C, Enright H, Kennedy MJ, McCann SR, Daly PA, Browne PV. Effective progenitor cell mobilization in lymphoproliferative disorders using ifosfamide, epirubicin and etoposide (IEV). Eur J Haematol Suppl 2001; 64:33-6. [PMID: 11486399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The combination of ifosfamide, epirubicin and etoposide (IEV) is an effective salvage regimen for lymphoproliferative disease. We report our experience with this combination in mobilization of peripheral blood stem cells (PBSC) in patients with relapsed or refractory/high-risk lymphoma. The median time to leukapheresis was 14 days, with 85% of patients commencing PBSC collection in the range of 13-15 days. Mobilization was successful in 26 of 28 patients (93%), who achieved the minimum transplant dose of 2 x 10(6)/kg CD34+ cells in a median of 2 leukaphereses. Overall, the median CD34+ cell yield was 6.94 x 10(6)/kg (range 0.73-27.4). In 15 of 27 patients (54%), the yield was sufficient (> 6 x 10(6)/kg) to permit CD34+ cell selection and/or a second autograft. IEV was given as an inpatient in all cases. Patients were scheduled for discharge after chemotherapy. This was achieved in 71%, with readmission 1 week later for harvest. Therapy was complicated by neutropenic fever in 13 patients and mild nausea. In autografts carried out using IEV-mobilized PBSC (n = 20), the median time to neutrophils > 0.5 x 10(9)/L was 10 days (range 7-13 days), and to platelets > 20 x 10(9)/L was 13 days (range 11-18 days). There was no mobilization- or transplant-related mortality. We conclude that IEV is a safe, predictable and highly effective mobilization regimen in patients with lymphoma.
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Affiliation(s)
- N O'Connell
- Blood and Marrow Transplant Programme, St. James's Hospital, Trinity College, Dublin, Ireland
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20
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Gardiner N, McCann SR, O'Riordan J, Lawler M. Chimerism following donor lymphocyte infusion for chronic myeloid leukemia. Blood 1999; 93:2748-9. [PMID: 10232894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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21
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Briones J, Urbano-Ispizua A, Lawler M, Rozman C, Gardiner N, Marín P, Salgado C, Féliz P, McCann S, Montserrat E. High frequency of donor chimerism after allogeneic transplantation of CD34+-selected peripheral blood cells. Exp Hematol 1998; 26:415-20. [PMID: 9590658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Ex vivo T cell depletion of allogeneic grafts is associated with a high (up to 80%) rate of mixed chimerism (MC) posttransplantation. The number of transplanted progenitor cells is an important factor in achieving complete donor chimerism in the T cell depletion setting. Use of granulocyte colony-stimulating factor (G-CSF) peripheral blood allografts allows the administration of large numbers of CD34+ cells. We studied the chimeric status of 13 patients who received allogeneic CD34+-selected peripheral blood progenitor cell transplants (allo-PBPCTs/CD34+) from HLA-identical sibling donors. Patients were conditioned with cyclophosphamide (120 mg/kg) and total-body irradiation (13 Gy in four fractions). Apheresis products were T cell-depleted by the immunoadsorption avidin-biotin method. The median number of CD34+ and CD3+ cells infused was 2.8x10(6)/kg (range 1.9-8.6x10(6)/kg) and 0.4x10(6)/kg (range 0.3-1x10(6)/kg), respectively. Molecular analysis of the engraftment was performed using polymerase chain reaction (PCR) amplification of highly polymorphic short tandem repeat (PCR-STR) sequences in peripheral blood samples. MC was detected in two (15%) of 13 patients. These two patients relapsed at 8 and 10 months after transplant, respectively. The remaining 11 patients showed complete donor chimerism and were in clinical remission after a maximum follow-up period of 24 months (range 6-24 months). These results were compared with those obtained in 10 patients who were treated with T cell-depleted bone marrow transplantation by means of elutriation and who received the same conditioning treatment and similar amounts of CD3+ cells (median 0.45x10(6)/kg; not significant) but a lower number of CD34+ cells (median 0.8x10(6)/kg; p = 0.001). MC was documented in six of 10 patients (60%), which was significantly higher than in the allo-PBPCT/CD34+ group (p = 0.04). We conclude that a high frequency of complete donor chimerism is achieved in patients receiving allo-PBPCT/CD34+ and that this is most likely due to the high number of progenitor cells administered.
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Affiliation(s)
- J Briones
- Department of Hematology and Postgraduate School of Hematology Farreras Valentí, Hospital Clinic, University of Barcelona, Spain
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Willison HJ, Lastovica AJ, Prendergast MM, Moran AP, Walsh C, Flitcroft I, Eustace P, McMahon C, Smith J, Smith OP, Lakshmandass G, Taylor MRH, Holland CV, Cox D, Good B, Kearns GM, Gaffney P, Shark K, Frauenshuh M, Ortmann W, Messner R, King R, Rich S, Behrens T, Mahmud N, Molloy A, McPartlin J, Scott JM, Weir DG, Walsh KM, Thorburn D, Mills P, Morris AJ, Good T, Cameron S, McCruden EAB, Bennett MW, O’Connell J, Brady C, Roche D, Collins JK, Shanahan F, O’Sullivant GC, Henry M, Koston S, McMahon K, MacNee W, FitzGerald MX, O’Connor CM, McGonagle D, Gibbon W, O’Connor P, Emery P, Murphy M, Watson R, Casey E, Naidu E, Murphy M, Watson R, Barnes L, McCann S, Murphy M, Watson R, Barnes L, Sweeney E, Barrett EJ, Graham H, Cunningham RT, Johnston CF, Curry WJ, Buchanan KD, Courtney CH, McAllister AS, McCance DR, Hadden DR, Bell PM, Leslie H, Sheridan B, Atkinson AB, Kilbane MT, Smith DF, Murray MJ, Shering SG, McDermott EWM, O’Higgins NJ, Smyth PPA, McEneny J, Trimble ER, Young IS, Sharpe P, Mercer C, McMaster D, Young IS, Evans AE, Young IS, Cundick J, Hasselwander O, McMaster D, McGeough J, Savage D, Maxwell AP, Evans AE, Kee F, Larkin CJ, Watson RGP, Johnston C, Ardill JES, Buchanan KD, McNamara DA, Walsh TN, Bouchier-Hayes DJ, Madden C, Timon C, Gardiner N, Lawler M, O’Riordan J, Duggan C, McCann SR, Gowing H, Braakman E, Lawler M, Byrne C, Martens ACM, Hagenbeek A, McCann SR, Kinsella N, Cusack S, Lawler M, Baker H, White B, Smith OP, Lawler M, Gardiner N, Molloy K, Gowing H, Wogan A, McCann SR, McElwaine S, Lawler M, Hollywood D, McCann SR, Mcmahon C, Merry C, Ryan M, Smith O, Mulcahy FM, Murphy C, Briones J, Gardiner N, McCann SR, Lawler M, White B, Lawler M, Cusack S, Kinsella N, Smith OP, Lavin P, McCaffrey M, Gillen P, White B, Smith OP, Thompson L, Lalloz M, Layton M, Barnes L, Corish C, Kennedy NP, Flood P, Mulligan S, McNamara E, Kennedy NP, Flood P, Mathias PM, Ball E, Duiculescu D, Calistru P, O’Gorman N, Kennedy NP, Abuzakouk M, Feighery C, Brannigan M, Pender S, Keeling F, Varghese J, Lee M, Colreavy M, Gaffney R, Hone S, Herzig M, Walsh M, Dolan C, Wogan A, Lawler M, McCann SR, Hollywood D, Donovan D, Harmey J, Bouchier-Hayes DJ, Haverty A, Wang JH, Harmey JH, Redmond HP, Bouchier-Hayes DJ, McGreal G, Shering SG, Moriarty MJ, Shortt A, Kilbane MT, Smith DF, McDermott EWM, O’Higgins NJ, Smyth PPA, McNamara DA, Harmey J, Wang JH, Donovan D, Walsh TN, Bouchier-Hayes DJ, Kay E, Pidgeon G, Harmey J, McNamara DA, Bouchier-Hayes DJ, Dunne P, Lambkin H, Russell JM, O’Neill AJ, Dunne BM, O’Donovan M, Lawler M, Gaffney EF, Gillan JE, Cotter TG, Horan J, Jones D, Biswas SK, Mulkerrin EC, Brady H, O’Donnell J, Neary J, Healy E, Watson A, Keogh B, Ryan M, Cassidy C, Ward S, Stokes E, Keoghan F, Barrett A, O’Connell P, Ryall N, O’Connell PA, Jenkinson A, O’Brien T, O’Connell PG, Harrison R, Barrett T, Bailey DMD, Butler A, Barton DE, Byrne C, McElwaine S, McCann SR, Lawler M, Cusack S, Lawler M, White B, Smith OP, Daly G, Gill M, Heron S, Hawi Z, Fitzgerald M, Hawi Z, Mynett-Johnson L, Shiels D, Kendler K, McKeon P, Gill M, Straub R, Walsh D, Ryan F, Barton DE, McCabe D, Murphy R, Segurado R, Mulcahy T, Larson B, Comerford C, O’Connell R, O’Mahony E, Gill M, Donnelly J, Minahan F, O’Neill D, Farrell Z, O’Neill D, Jones D, Horan J, Glynn C, Biswas SK, Mulkerrin E, Brady H, Lennox SE, Murphy A, Rea IM, McNulty H, McMeel C, O’Neill D, McEvoy H, Freaney R, McKenna MJ, Crowe M, Keating D, Colreavy M, Hone S, Norman G, Widda S, Viani L, Galvin, Nolan CM, Hardiman O, Hardiman O, Brett F, Droogan O, Gallagher P, Harmey M, King M, Murphy J, Perryrnan R, Sukumaran S, Walsh J, Farrell MA, Hughes G, Cunningham C, Walsh JB, Coakley D, O’Neill D, Hurson M, Flood P, McMonagle P, Hardiman O, Ryan F, O’Sullivan S, Merry C, Dodd P, Redmond J, Mulcahy FM, Browne R, Keating S, O’Connor J, Cassidy BP, Smyth R, Sheppard NP, Cullivan R, Crown J, Walsh N, Denihan A, Bruce I, Radic A, Coakley D, Lawlor BA, Bridges PK, O’Doherty M, Farrington A, O’Doherty M, Farragher B, Fahy S, Kelly R, Carey T, Owens J, Gallagher O, Sloan D, McDonough C, Casey P, Horgan A, Elneihum A, O’Neill C, McMonagle T, Quinn J, Meagher D, Murphy P, Kinsella A, Mullaney J, Waddington JL, Rooney S, Rooney S, Bamford L, Sloan D, O’Connor JJ, Franklin R, O’Brien K, Fitzpatrick G, Laffey JG, Boylan JF, Laffey J, Coleman M, Boylan J, Laffey JG, McShane AJ, Boylan JF, Loughrey JPR, Gardiner J, McGinley J, Leonard I, Carey M, Neligan P, O’Rourke J, Cunningham A, Fennessy F, Kelly C, Bouchier-Hayes D, Fennessy F, Wang JH, Kelly C, Bouchier-Hayes D, Fennessy F, Wang JH, Kelly C, Bouchier-Hayes DJ, Kellett J, Laffey J, Murphy D, Regan J, O’Keeffe D, Mahmud A, Hemeryck L, Feely J, Mahmud A, Hemeryck L, Hall M, Feely J, Menown IBA, Mathew TP, Nesbitt GS, Syme M, Young IS, Adgey AAJ, Menown IBA, Turtle F, Allen J, Anderson J, Adgey AAJ, O’Hanlon R, Codd MB, Walkin S, McCann HA, Sugrue DD, Rasheed AM, Chen G, Kelly C, Bouchier-Hayes DJ, Leahy A, Rasheed AM, Kay E, Jina S, Bouchier-Hayes DJ, Leahy A, McDowell I, Rasheed AM, Wang JH, Wo Q, Kelly C, Bouchier-Hayes DJ, Leahy A, Shuhaibar MN, McGovern E, Turtle F, Menown IBA, Manoharan G, Kirkpatrick R, Campbell NPS, Walkin S, Codd MB, O’Hanlon R, McCarthy C, McCann HA, Sugrue DD, Wen Y, Killalea S, Hall M, Hemeryck L, Feely J, Fahy CJ, Griffith A, McGinley J, McCabe D, Fraser A, Casey E, Ryan T, Murphy R, Browne M, Fenton J, Hughes J, Timon CI, Fenton J, Curran A, Smyth D, Viani L, Walsh M, Hughes JP, Fenton J, Lee P, Kelly A, Timon CI, Hughes JP, Fenton J, Shine N, Blayney A, McShane DP, Timon CI, Hussey J, Howlett M, Langton A, McEvoy A, Slevin J, Fitzpatrick C, Turner MJ, Enright F, Goggin N, Costigan C, Duff D, Osizlok P, Wood F, Watson R, Fitzsimons RB, Flanagan N, Enright F, Barnes L, Watson R, Molloy E, Griffin E, Deasy PF, Sheridan M, White MJ, Moore R, Gray A, Hill J, Glasgow JFT, Middleton B, Slattery D, Donoghue V, McMahon A, Murphy J, Slattery D, McCarthy A, Oslislok P, Duff D, Colreavy M, Keogh I, Hone S, Walsh M, Henry M, Koston S, McMahon K, MacNee W, FitzGerald MX, O’Connor CM, Russell KJ, Henry M, Fitzgerald MX, O’Connor CM, Kavanagh PV, McNamara SM, Feely J, Barry M, O’Brien JE, McCormick P, Molony C, Doyle RM, Walsh JB, Coakley D, Codd MB, O’Connell PR, Dowey LC, McGlynn H, Thurnham DI, Elborn SJ, Flynn L, Carton J, Byrne B, O’Farrelly C, Kelehan P, O’Herlihy C, O’Hara AM, Moran AP, Orren A, Fernie BA, Merry C, Clarke S, Courtney G, de Gascun C, Mulcahy FM, Merry C, Ryan M, Barry M, Mulcahy FM, Merry C, Ryan M, Barry M, Mulcahy FM, Byrne M, Moylett E, Murphy H, Butler K, Nourse C, Thaker H, Barry C, Russell J, Sheehan G, Boyle B, Hone R, Conboy B, Butler C, Moris D, Cormican M, Flynn J, McCormack O, Corbally N, Murray A, Kirrane S, O’Keane C, Hone R, Lynch SM, Cryan B, Whyte D, Morris D, Butler C, Cormican M, Flynn J, Corbett-Feeney G, Murray A, Corbally N, Hone R, Mackle T, Colreavy M, Perkins J, Saidlear C, Young A, Eustace P, Wrigley M, Clifford J, Waddington JL, Tighe O, Croke DT, Drago J, Sibley DR, Feely J, Kelly A, Carvalho M, Hennessy M, Kelly M, Feely J, Hughes C, Hanlon M, Feely J, Sabra K, Keane T, Egan D, Ryan M, Maerry C, Ryan M, Barry M, Mulcahy FM, Maerry C, Ryan M, Barry M, Mulcahy FM, Sharma SC, Williams D, Kelly A, Carvalho M, Feely J, Williams D, Kelly A, Carvalho M, Feely J, Codd MB, Mahon NG, McCann HA, Sugrue DD, Sayers GM, Johnson Z, McNamara SM, Kavanagh PV, Feely J. National scientific medical meeting 1997 abstracts. Ir J Med Sci 1998. [DOI: 10.1007/bf02937234] [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: 10/21/2022]
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Gardiner N, Lawler M, O'Riordan JM, Duggan C, De Arce M, McCann SR. Monitoring of lineage-specific chimaerism allows early prediction of response following donor lymphocyte infusions for relapsed chronic myeloid leukaemia. Bone Marrow Transplant 1998; 21:711-9. [PMID: 9578312 DOI: 10.1038/sj.bmt.1701154] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Donor lymphocyte infusions (DLI) have been shown to enhance the graft-versus-leukaemia (GVL) effect and induce haematological and molecular remission in patients with relapsed CML following allogeneic bone marrow transplantation (BMT). The potent donor cell-mediated cytolysis following DLI may lead to a short period of aplasia before the re-establishment of donor haematopoiesis. The absence of detectable donor cells in patients prior to DLI infusion may result in permanent aplasia in certain patients. We report on four patients who relapsed 1, 3, 6.5 and 7 years post-BMT for chronic phase CML and were treated with DLI from their original BMT donor. Polymorphic short tandem repeats (STRs) were used to assess haematological chimaerism both prior to and following DLI. At the time of relapse, STR-PCR indicated the presence of donor cells in all four patients, at levels ranging from 1-40%. A clinical and molecular response was seen in 4/4 patients following a short period of cytopenia and all patients remain in clinical remission with a follow-up of 2 months-3 years post-DLI. STR-PCR indicated that a response was occurring during the period of pancytopenia when metaphase analysis was unsuccessful. Lineage-specific analysis of the cellular response to DLI was monitored using STR-PCR of peripheral blood (PB) and bone marrow (BM) lymphocyte-enriched fractions and CD2-positive and -negative T cell fractions. In one patient BM and PB CD34-positive and -negative fractions were also assessed. A change in the ratio of donor:recipient cells in the PB lymphocyte fraction was the earliest molecular indication of an anti-leukaemic response. Subsequent conversion to donor chimaerism occurred in the other lineages and the granulocyte fraction was the last lineage to convert. In conclusion, lineage-specific STR-PCR permits detailed monitoring of subtle changes in donor/recipient cell dynamics in specific lineages following DLI during the crucial pancytopenic phase and may be a useful predictor of haematological response to DLI therapy.
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Affiliation(s)
- N Gardiner
- Department of Haematology, St James Hospital, Dublin, Ireland
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Carter JH, Stewart BJ, Archbold PG, Inoue I, Jaglin J, Lannon M, Rost-Ruffner E, Tennis M, McDermott MP, Amyot D, Barter R, Cornelius L, Demong C, Dobson J, Duff J, Erickson J, Gardiner N, Gauger L, Gray P, Kanigan B, Kiryluk B, Lewis P, Mistura K, Malapira T, Zoog K. Living with a person who has Parkinson's disease: the spouse's perspective by stage of disease. Parkinson's Study Group. Mov Disord 1998; 13:20-8. [PMID: 9452321 DOI: 10.1002/mds.870130108] [Citation(s) in RCA: 172] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The objective of this study was to examine the experience of spouses caregiving for their spouse with Parkinson's disease (PD) and to determine whether their experiences differed by stage of disease. By using a cross-sectional design and mail questionnaire data from 380 spouse caregivers across 23 sites of the Parkinson Study Group, key caregiver variables were examined by stage of PD. Three categories of variables--caregiver role strain (10 measures), caregiver situation (four measures), and caregiver characteristics (four measures)--were analyzed by using t tests with Bonferroni correction. Specific types and amounts of role strain accumulated as the disease progressed, and they differed significantly between stages (p < 0.05). In the caregiving situation, the mean number of caregiving tasks tripled by stage 4/5. Negative changes in lifestyle plus decreases in predictability in caregivers' lives increased significantly in late-stage disease (p < 0.05). Caregiver characteristics of physical health and preparedness did not significantly differ across stages of disease. Depression was significantly higher by stage 4/5. Mutuality, the positive quality of the relationship as perceived by the caregiving spouse, declined beginning at stage 2. Caregiver strain is experienced across all stages of PD and accumulates significantly as the disease progresses. This study defines types and amounts of strain by stage of disease, which will be helpful in designing formal intervention trials to provide more effective help for spouse caregivers.
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Affiliation(s)
- J H Carter
- Department of Neurology, Oregon Health Sciences University, Portland 97201-3098, USA
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Palka G, Lawler M, Morizio E, Gardiner N, Stuppia L, De Arce MA, Di Bartolomeo PD, Capodiferro F, Sabatino G, Gatta V, Calabrese G, Cann SR. Comparative Study of FISH, PCR and Cytogenetics on 25 Patients Submitted to Bone Marrow Transplantation (BMT) for Chronic Myelogenous Leukemia (CML); Which Tests can we Use in Routine Analysis Post BMT? Hematology 1998; 3:193-203. [PMID: 27416528 DOI: 10.1080/10245332.1998.11746391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Chronic Myeloid Leukaemia (CML) shows an excellent response to allogeneic bone marrow transplantation (BMT) with a 60-80% long term disease free survival in recipients of unmanipulate marrow. The most frequent cause of treatment failure is leukaemic relapse, due to the re-emergence of malignant recipient clones. Clinical and haematological relapse is usually preceded by molecular evidence of relapse. Early detection of molecular relapse may allow intervention with immunotherapy such as donor lymphocyte infusions (DLI). This study was undertaken to compare results from two centres who employ either Fluorescent In Situ Hybridisation (FISH) or polymerase chain reaction (PCR) analysis of DNA polymorphisms as their routine method of detecting residual host cells following BMT for CML in order to establish (1) if these methods are equivalent for routine laboratory use in reporting of chimaerism results to the referring clinician, and (2) if these methods are beneficial for indicating new and early therapeutic strategies. FISH analyses for the X and Y chromosomes (in sex mismatched patients) and/or FISH for BCR and ABL loci were compared with short tandem repeat PCR (STR-PCR) and conventional karyotyping in serial analyses in 25 patients submitted to BMT for Philadelphia positive (Ph) CML. Comparison of all results on samples assessed between 1 and 13 years post BMT indicated that FISH and PCR, performed on the same bone marrow samples displayed similar results in more than 90% of patients in first 3 years after BMT which increased to a concordance rate of 100% in long term survivors. In contrast, comparison of FISH or PCR versus cytogenetic analysis indicated a low concordance rate, with less than 50% of samples showing similar results during all the follow-up period. Eighty percent of recipients (22 patients) had evidence of mixed chimaerism following BMT (initial level of positivity 1-6% recipient cells) during the follow-up period. This low percentage of recipient cells remained stable in 7 patients, while 9 patients reverted to a donor profile. All 16 patients are in haematological remission. In addition the 3 patients with complete donor chimaerism remain in remission. In the remaining 6 patients, a progressive increase in recipient cells occurred (progressive mixed chimaerism, PMC), and was followed by haematological relapse. We conclude that FISH and PCR can be used to monitor CML patients post BMT and transient or stable low level mixed chimaerism is not associated with leukaemia relapse, but PMC is predictive of imminent relapse and its detection may help to illucidate the timing of early intervention with donor lymphocyte infusion.
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Affiliation(s)
- G Palka
- a Dipartimento di Scienze Biomediche , University of Chieti , Italy
| | - M Lawler
- b Dept Haematology, Sir Patrick Dun Research Laboratory , St. James Hospital Dublin , Ireland
| | - E Morizio
- a Dipartimento di Scienze Biomediche , University of Chieti , Italy
| | - N Gardiner
- b Dept Haematology, Sir Patrick Dun Research Laboratory , St. James Hospital Dublin , Ireland
| | - L Stuppia
- a Dipartimento di Scienze Biomediche , University of Chieti , Italy.,d Istituto di Citomorfologia Umana Normale e Patologica CNR , Chieti , Italy
| | - M A De Arce
- b Dept Haematology, Sir Patrick Dun Research Laboratory , St. James Hospital Dublin , Ireland
| | | | - F Capodiferro
- a Dipartimento di Scienze Biomediche , University of Chieti , Italy
| | - G Sabatino
- a Dipartimento di Scienze Biomediche , University of Chieti , Italy
| | - V Gatta
- a Dipartimento di Scienze Biomediche , University of Chieti , Italy
| | - G Calabrese
- a Dipartimento di Scienze Biomediche , University of Chieti , Italy
| | - S R Cann
- b Dept Haematology, Sir Patrick Dun Research Laboratory , St. James Hospital Dublin , Ireland
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Gardiner N, Lawler M, O'Riordan J, DeArce M, Humphries P, McCann SR. Persistent donor chimaerism is consistent with disease-free survival following BMT for chronic myeloid leukaemia. Bone Marrow Transplant 1997; 20:235-41. [PMID: 9257892 DOI: 10.1038/sj.bmt.1700861] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Chronic myeloid leukaemia (CML) can be treated successfully with allogeneic bone marrow transplantation (BMT) leading to long-term disease-free survival. Leukemia relapse, however, remains a significant clinical problem. Relapse following BMT presumably results from the expansion of small numbers of recipient leukaemic cells which have survived the conditioning therapy. In order to define patients who are at a high risk of leukaemia relapse, a variety of techniques have been employed to detect persistence of host haemopoiesis (mixed chimaerism, MC) or residual leukaemia (minimal residual disease, MRD). However, the precise relationship between the detection of MC and MRD post-BMT is unknown. We have investigated chimaerism and MRD status in 22 patients who were in clinical and haematological remission post-allogeneic BMT for chronic phase CML. Chimaerism was assessed using short tandem repeat PCR (STR-PCR) while BCR-ABL mRNA detection using reverse transcriptase polymerase chain reaction (RT-PCR) was performed to detect the presence of MRD. Seventeen patients received unmanipulated marrow (non-TCD) while in five patients a T cell-depleted transplant (TCD) was performed as additional GVHD prophylaxis. Chimaerism was evaluated in 18 patients (14 non-TCD, four TCD). Mixed chimaerism was an uncommon finding in recipients of unmanipulated BMT (21%) when compared to TCD BMT (100%). No evidence of MRD, as identified using the BCR-ABL mRNA RT-PCR assay, was detected in those patients who were donor chimaeras. Early and transient MC and MRD was detected in four patients (two non-TCD, two TCD) who have subsequently converted to a donor profile. One patient has stable low-level MC but remains MRD negative 4 years post-BMT. Late MC and MRD was observed in two patients who relapsed >6 years after TCD BMT for CML. We conclude that mixed chimaerism is a rare event in recipients of unmanipulated BMT and that donor chimaerism as detected by STR-PCR assay is consistent with disease-free survival and identifies patients with a low risk of leukaemic relapse post-BMT for CML.
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MESH Headings
- Adolescent
- Adult
- Bone Marrow Transplantation
- Disease-Free Survival
- Female
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/physiopathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Male
- Middle Aged
- Neoplasm, Residual
- Transplantation Chimera
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Affiliation(s)
- N Gardiner
- Department of Haematology/Oncology, St James Hospital, Dublin, Ireland
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Gardiner N, Lawler M, O'Riordan J, De'Arce M, McCann SR. Donor chimaerism is a strong indicator of disease free survival following bone marrow transplantation for chronic myeloid leukaemia. Leukemia 1997; 11 Suppl 3:512-5. [PMID: 9209441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Although Chronic Myeloid Leukaemia (CML) can be treated successfully with allogeneic bone marrow transplantation (BMT), leukaemia relapse remains a significant clinical problem. Molecular monitoring of the post transplant marrow can be useful in predicting relapse particularly in CML patients where the Philadelphia chromosome or its molecular counterpart, the BCR-ABL fusion messenger RNA can be used as a leukaemia specific marker of minimal residual disease (MRD). We have investigated chimaerism (using polymerase chain reaction of short tandem repeat sequences (STR-PCR)) and MRD status (using reverse transcriptase PCR of the BCR-ABL fusion mRNA) in a serial fashion in 18 patients who were in clinical and haematological remission post allogeneic BMT for chronic phase CML. Eleven patients exhibited complete donor chimaerism with no evidence of minimal residual disease. Five patients had transient or low level stable MC. Late MC and MRD was observed in two patients who relapsed > 6 years after T cell depleted BMT for CML. Thus STR-PCR is an appropriate screening test in the post transplant setting for CML patients, but those patients exhibiting mixed haemopoietic chimaerism should also be monitored using a leukaemia specific sensitive molecular assay.
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Affiliation(s)
- N Gardiner
- Department of Haematology/Oncology St James Hospital, Dublin, Ireland
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Grace A, Gillan JE, Crotty G, O’Riordan J, Gardiner N, Lawler M, McMahon C, D’Arce M, McCann SR, Nicholson S, Mooney EE, Ravichandran P, Geoghegan T, Kelehan P, Foley M, Thomas R, Swan N, Sheahan K, Dunne B. Royal Academy of Medicine in Ireland Section of Pathology. Ir J Med Sci 1996. [DOI: 10.1007/bf02942813] [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: 10/21/2022]
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Lawler M, Locasciulli A, Bacigalupo A, Humphries P, Ljungman P, McCann SR, Nolan N, McDermott EW, Reynolds JR, McCann A, Rafferty R, Sweeney P, Carney D, O’Higgins NJ, Duffy MJ, Gardiner C, Reen DJ, O’Connell MA, Kelleher D, Hall N, O’Neill LAJ, Long A, McCarthy JV, Fernandes RS, Cotter TG, Ryan E, Kitching A, MacMathuna P, Mulligan E, Merriman R, Dervan P, Kelly P, Gorey TF, Lennon JR, Crowe J, Bennett MA, Kay EW, Curran B, O’Donoghue DP, Leader M, Croke DT, O’Connor JM, McKelvey-Martin VJ, McKenna PG, O’Riordan JM, Tobin A, O’Mahoney M, Keogh FM, O’Riordan J, McNamara C, McEneaney P, Daly PA, Farrell M, Young S, Gibbons D, McCarthy P, Mulcahy H, Parfrey NA, Sheahan K, Lambkin H, Mothersill C, Chin D, Sheehan K, Kelehan P, Parfrey N, Morrin M, Khan F, Delaney P, Rowan DM, Orminston WJ, Donnellan PP, Khalid A, Kerin M, O’Hanlon DM, Kent P, Given HF, Kennedy SM, McGeoch G, Spurr NK, Barrett J, O’Sullivan G, Collins JK, Willcocks T, Kennedy S, Dolan J, Gallagher W, McDermott E, O’Higgins N, Hagan R, McManus R, Ormiston W, Daly P, Sheils O, McDermott M, O’Briain DS, Maher D, Costello P, Flanagan F, Stack J, Ennis J, Grimes H, Yanni A, Harrison M, Lowry WS, Russell SEH, Atkinson RJ, White P, Hickey I, Bell DW, Biggart D, Doyle J, Staunton MJ, Gaffney EF, Dervan PA, McCabe MM, Fennelly JJ, Carney DN, O’Reilly M, McMahon JN, Moriarty M, Hurson B, O’Neill AJ, Magee H, O’Loughlin J, Dervan PA, Cremin P, Orminston W, McCarthy J, Redmond P, Duggan S, Rea S, Bouchier-Hayes D, O’Donnell J, Duggan C, Crown J, Bermingham D, Nugent A, Fleming C, Crosby P, Wolff S, McCarthy D, Walsh CB, Cassidy M, Husain S, Kay E, Thornhilll M, Whelan D, Barry D, Turner M, Prenderville W, Murphy F, Prendiville W, Gibson G, O’Grady T, Carmody M, Donohoe J, Walshe J, Murphy GM, O’Donoghue J, Kerin K, Ahern S, Molloy K, Goulden N, Pamphilon DH, O’Connell M, Power C, Leroux A, Perricaudet M, Walls D, Britton F, Brennan L, Barnett YA, Madden B, Wakelin LPG, Loughrey HC, Corley P, Redmond HP, Watson RWG, Keogh I, O’Hanlon D, Walsh S, Callaghan J, McNamara M, Benedict-Smith A, Barnes C, Neylon D, Fenton M, Searcey M, Topham CM, Wakelin LG, Howarth NM, Purohit A, Reed MJ, Potter BVL, Hatton WJ, McKerr G, Harvey D, Carson J, Hannigan BM, McCarthy PJ, McClean S, Hill BT, Costelloe C, Denny WA, Fingleton B, McDonnell S, Butler M, Corbally N, Dervan PA, Stephens JF, Martin G, McGirl A, Lawlor E, Gardiner N, Lynch S, Arce MD, O’Brien F, Duggan A, O’Herlihy S, Shanahan F, O’Keeffe G, McCann S, Sweeney K, Neill AO, Pamphilon D, Sheridan M, Reid I, Seymour CB, Walshe T, Hennessy TP, O’Mahony A, O’Connell’ J, Lawlor C, Nolan S, Morrisey D, Pedlow PJ, Walsh M, Lowry SW, McAleer JJA, McKeown SR, Afrasiabi M, Lappin TRJ, Joiner B, Hirst KV, Hirst DG, Sweeney E, VanderSpek J, Murphy J, Foss F. Irish Association for Cancer Research. Ir J Med Sci 1995. [DOI: 10.1007/bf02967834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Carson KD, Grimes SB, McGinley JM, Thornton MT, Mulhall J, Bourke AM, McCrory C, Marsh B, Hone R, Phelan D, White M, Fabry J, Hughes D, Carson K, Donnelly M, Shanahan E, Fitzpatrick GJ, Bourke M, Warde D, Buggy D, Hughes N, Taylor A, Dowd N, Markham T, Blunnie W, Nicholson G, O’Leary E, Cunningham AJ, Dwyer R, McMechan S, Cullen C, Dempsey G, Wright G, MacKenzie G, Anderson J, Adgey J, Walsh M, O’Callaghan P, Graham I, O’Hare JA, Geoghegan M, Iman N, Shah P, Chander R, Lavin F, Daly K, Johnston PW, Imam Z, Adgey AAJ, Rusk RA, Richardson SG, Hale A, Kinsella BM, FitzGerald GA, King G, Crean P, Gearty G, Cawley T, Docherty JR, Geraghty J, Osborne H, Upton J, D’Arcy G, Stinson J, Cooke T, Colgan MP, Hall M, Tyrrell J, Gaffney K, Grouden M, Moore DJ, Shanik G, Feely J, Delanty N, Reilly M, Lawson JA, Fitzgerald DJ, Reilly MP, McAdam BF, Bergin C, Walshe MJ, Herity NA, Allen JD, Silke B, Singh HP, O’Neill S, Hargrove M, Coleman E, Shorten E, Aherne T, Kelly BE, Hill DH, McIlrath E, Morrow BC, Lavery GG, Blackwood B, Fee JPH, Kevin L, Doran M, Tansey D, Boylan I, McShane AJ, O’Reilly G, Tuohy B, Grainger P, Larkin T, Mahady J, Malone J, Condon C, Donoghue T, O’Leary J, Lyons JF, Tay YK, Tham SN, Khoo Tan HS, Gibson G, O’Grady A, Leader M, Walshe J, Carmody M, Donohoe J, Murphy GM, O’Connor W, Barnes L, Watson R, Darby C, O’Moore R, Mulcahy F, O’Toole E, O’Briain DS, Young MM, Buckley D, Healy E, Rogers S, Ni Scannlain N, McKenna MJ, McBrinn Y, Murray B, Freaney R, Barrett E, Razza Q, Abuaisha F, Powell D, Murray TM, Powell AM, O’Mongain E, O’Neill J, Kernan RP, O’Connor P, Clarke D, Fearon U, Cunningham SK, McKenna TJ, Hayes F, Heffernan A, Sheahan K, Harper R, Johnston GD, Atkinson AB, Sheridan B, Bell PM, Heaney AP, Loughrey G, McCance DR, Hadden DR, Kennedy AL, McNamara P, O’Shaughnessy C, Loughrey HC, Reid I, Teahan S, Caldwell M, Walsh TN, McSweeney J, Hennessy TP, Caldwell MTP, Byrne PJ, Hennessy TPJ, El-Magbri AA, Stevens FM, O’Sullivan R, McCarthy CF, Laundon J, 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National Scientific Medical Meeting 1994 Abstracts. Ir J Med Sci 1994. [DOI: 10.1007/bf02943102] [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: 10/21/2022]
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Mc Cann SR, Lawler M, Gardiner N, O'Riordan J, Humphries P, De Arce M. Donor leukemia following allogeneic bone marrow transplantation. Leukemia 1994; 8 Suppl 1:S133-5. [PMID: 8152280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Although allogeneic bone marrow transplantation has been shown to be a highly effective treatment for acute and chronic leukemia, leukemic relapse remains a significant problem. Leukemic relapse occurs in recipient cells in the majority of cases, but the paucity of donor cell leukemias may reflect the sensitivity of the investigative technique. We have developed a highly sensitive technique to identify the origin of all hematopoietic cells in the post transplant state which is based on PCR amplification of microsatellites, polymorphic tandem repetitive elements. We have identified donor leukemia (AML M5) following a sex matched BMT for severe aplastic anemia, verified a previously reported case of donor leukemia following BMT for chronic granulocytic leukemia and recently identified an acquired cytogenetic abnormality(del 11q23) in donor cells four years following an apparently successful BMT for AML. In all cases the donors have remained healthy. Postulated mechanisms include transfer to the transplanted marrow of a dormant oncogene residing in the DNA of either a virus, the chromosomes of degenerating irradiation damaged host leukemic cells or in the marrow stroma which is radioresistant and host in origin following BMT. Using sensitive techniques donor leukemia has been shown to be a more common event than was previously thought and an understanding of its pathogenesis may allow us to elucidate leukemogenic mechanisms in man.
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Affiliation(s)
- S R Mc Cann
- Department of Haematology, St. James's Hospital, Dublin, Ireland
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