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Butera S, Tavarozzi R, Brunello L, Rivela P, Sofia A, Viero L, Salvio M, Ladetto M, Zallio F. The black swan: a case of central nervous system graft-versus-host disease. J Basic Clin Physiol Pharmacol 2023; 34:805-809. [PMID: 37843253 DOI: 10.1515/jbcpp-2023-0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES Graft-versus-host disease (GVHD) of central nervous system is an atypical and rare manifestation of chronic GVHD, presenting with a heterogeneous spectrum of signs and symptoms. Diagnosis of neurological manifestations of GVHD can be highly challenging and remain associated with dismal prognosis, significant morbidity, and reduced quality of life. CASE PRESENTATION In this report, we describe a 39-year-old woman developing neurological signs and symptoms 8 months after allogeneic HSCT magnetic resonance imaging showed multifocal hyperintense lesions involving the periventricular region and frontal subcortical white matter. There was no laboratory evidence of infective or malignant etiology, and the case was diagnosed as CNS-GVHD. The patient was treated with intravenous methylprednisolone pulse therapy and the clinical conditions gradually improved. After few months, patient symptoms progressed despite the addition of high-dose intravenous immunoglobulin, tacrolimus, and a new course of high dose steroids. To engage targeted therapy, the patient underwent brain biopsy that revealed a loss of myelin fibers, perivascular and diffuse infiltration of T cells, and macrophages associated with reactive gliosis, representing a demyelinating disease. We intensified treatment with cyclophosphamide and subsequently introduced ibrutinib as salvage strategy. Despite a magnetic resonance imaging showing great regression of the demyelinating lesions, patient's conditions deteriorated and she died 16 months after HSCT. CONCLUSIONS CNS-GVHD is a rare complication of HSCT that is difficult to diagnose. Based on our experience, brain biopsy may represent a useful diagnostic tool when the clinical features of neurological symptoms are ambiguous or in patients without evidence of preceding chronic GVHD.
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Affiliation(s)
- Sara Butera
- Struttura Complessa di Ematologia a Direzione Universitaria, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Rita Tavarozzi
- Struttura Complessa di Ematologia a Direzione Universitaria, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Lucia Brunello
- Struttura Complessa di Ematologia a Direzione Universitaria, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Paolo Rivela
- Struttura Complessa di Ematologia a Direzione Universitaria, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Antonella Sofia
- Struttura Complessa di Ematologia a Direzione Universitaria, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Lorenzo Viero
- Struttura Complessa di Ematologia a Direzione Universitaria, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Michela Salvio
- Struttura Complessa di Ematologia a Direzione Universitaria, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Marco Ladetto
- Struttura Complessa di Ematologia a Direzione Universitaria, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Francesco Zallio
- Struttura Complessa di Ematologia a Direzione Universitaria, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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Butera S, Cerrano M, Brunello L, Dellacasa CM, Faraci DG, Vassallo S, Mordini N, Sorasio R, Zallio F, Busca A, Bruno B, Giaccone L. Impact of anti-thymocyte globulin dose for graft-versus-host disease prophylaxis in allogeneic hematopoietic cell transplantation from matched unrelated donors: a multicenter experience. Ann Hematol 2021; 100:1837-1847. [PMID: 33948721 PMCID: PMC8195753 DOI: 10.1007/s00277-021-04521-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 11/05/2020] [Accepted: 04/08/2021] [Indexed: 01/07/2023]
Abstract
Despite the widespread use of rabbit anti-thymocyte globulin (ATG) to prevent acute and chronic graft-versus-host disease (aGVHD, cGVHD) after allogeneic hematopoietic cell transplantation (allo-HCT), convincing evidence about an optimal dose is lacking. We retrospectively evaluated the clinical impact of two different ATG doses (5 vs 6-7.5 mg/kg) in 395 adult patients undergoing HSCT from matched unrelated donors (MUD) at 3 Italian centers. Cumulative incidence of aGVHD and moderate-severe cGVHD did not differ in the 2 groups. We observed a trend toward prolonged overall survival (OS) and disease-free survival (DFS) with lower ATG dose (5-year OS and DFS 56.6% vs. 46.3%, p=0.052, and 46.8% vs. 38.6%, p=0.051, respectively) and no differences in relapse incidence and non-relapse mortality. However, a significantly increased infection-related mortality (IRM) was observed in patients who received a higher ATG dose (16.7% vs. 8.8% in the lower ATG group, p=0.019). Besides, graft and relapse-free survival (GRFS) was superior in the lower ATG group (5-year GRFS 43.1% vs. 32.4%, p=0.014). The negative impact of higher ATG dose on IRM and GRFS was confirmed by multivariate analysis. Our results suggest that ATG doses higher than 5 mg/kg are not required for MUD allo-HCT and seem associated with worse outcomes.
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Affiliation(s)
- Sara Butera
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy
| | - Marco Cerrano
- Department of Oncology, Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Lucia Brunello
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Hematology, A.O. Santissimi Antonio e Biagio e C Arrigo, Alessandria, Italy
| | - Chiara Maria Dellacasa
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
| | - Danilo Giuseppe Faraci
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy
| | - Sara Vassallo
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy
| | - Nicola Mordini
- Division of Hematology, A.O. Santi Croce e Carle, Cuneo, Italy
| | - Roberto Sorasio
- Division of Hematology, A.O. Santi Croce e Carle, Cuneo, Italy
| | - Francesco Zallio
- Department of Hematology, A.O. Santissimi Antonio e Biagio e C Arrigo, Alessandria, Italy
| | - Alessandro Busca
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
| | - Benedetto Bruno
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy
| | - Luisa Giaccone
- Department of Oncology, SSD Trapianto Allogenico di Cellule Staminali, A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy.
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy.
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3
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Giaccone L, Faraci DG, Butera S, Lia G, Di Vito C, Gabrielli G, Cerrano M, Mariotti J, Dellacasa C, Felicetti F, Brignardello E, Mavilio D, Bruno B. Biomarkers for acute and chronic graft versus host disease: state of the art. Expert Rev Hematol 2020; 14:79-96. [PMID: 33297779 DOI: 10.1080/17474086.2021.1860001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Despite significant advances in treatment and prevention, graft-versus-host disease (GVHD) still represents the main cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. Thus, considerable research efforts have been made to find and validate reliable biomarkers for diagnosis, prognosis, and risk stratification of GVHD. AREAS COVERED In this review the most recent evidences on different types of biomarkers studied for GVHD, such as genetic, plasmatic, cellular markers, and those associated with microbiome, were summarized. A comprehensive search of peer-review literature was performed in PubMed including meta-analysis, preclinical and clinical trials, using the terms: cellular and plasma biomarkers, graft-versus-host disease, cytokines, and allogeneic hematopoietic stem cell transplantation. EXPERT OPINION In the near future, several validated biomarkers will be available to help clinicians in the diagnosis of GVHD, the identification of patients at high risk of GVHD development and in patients' stratification according to its severity. Then, immunosuppressive treatment could be tailored to each patient's real needs. However, more efforts are needed to achieve this goal. Although most of the proposed biomarkers currently lack validation with large-scale clinical data, their study led to improved knowledge of the biological basis of GVHD, and ultimately to implementation of GHVD treatment.
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Affiliation(s)
- Luisa Giaccone
- Department of Oncology/Hematology, Stem Cell Transplant Program, A.O.U. Città Della Salute E Della Scienza Di Torino, Presidio Molinette , Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino , Torino, Italy
| | - Danilo Giuseppe Faraci
- Department of Oncology/Hematology, Stem Cell Transplant Program, A.O.U. Città Della Salute E Della Scienza Di Torino, Presidio Molinette , Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino , Torino, Italy
| | - Sara Butera
- Department of Oncology/Hematology, Stem Cell Transplant Program, A.O.U. Città Della Salute E Della Scienza Di Torino, Presidio Molinette , Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino , Torino, Italy
| | - Giuseppe Lia
- Department of Oncology/Hematology, Stem Cell Transplant Program, A.O.U. Città Della Salute E Della Scienza Di Torino, Presidio Molinette , Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino , Torino, Italy
| | - Clara Di Vito
- Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center , Milan, Italy.,Department of Medical Biotechnologies and Translational Medicine (Biometra), University of Milan , Milan, Italy
| | - Giulia Gabrielli
- Department of Oncology/Hematology, Stem Cell Transplant Program, A.O.U. Città Della Salute E Della Scienza Di Torino, Presidio Molinette , Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino , Torino, Italy
| | - Marco Cerrano
- Department of Oncology/Hematology, Stem Cell Transplant Program, A.O.U. Città Della Salute E Della Scienza Di Torino, Presidio Molinette , Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino , Torino, Italy
| | - Jacopo Mariotti
- Bone Marrow Transplant Unit, Humanitas Clinical and Research Center, IRCCS , Rozzano, Italy
| | - Chiara Dellacasa
- Department of Oncology/Hematology, Stem Cell Transplant Program, A.O.U. Città Della Salute E Della Scienza Di Torino, Presidio Molinette , Torino, Italy
| | - Francesco Felicetti
- Transition Unit for Childhood Cancer Survivors, A.O.U. Città Della Salute E Della Scienza Di Torino , University of Torino , Torino, Italy
| | - Enrico Brignardello
- Transition Unit for Childhood Cancer Survivors, A.O.U. Città Della Salute E Della Scienza Di Torino , University of Torino , Torino, Italy
| | - Domenico Mavilio
- Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center , Milan, Italy.,Department of Medical Biotechnologies and Translational Medicine (Biometra), University of Milan , Milan, Italy
| | - Benedetto Bruno
- Department of Oncology/Hematology, Stem Cell Transplant Program, A.O.U. Città Della Salute E Della Scienza Di Torino, Presidio Molinette , Torino, Italy.,Department of Molecular Biotechnology and Health Sciences, University of Torino , Torino, Italy
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4
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Cerrano M, Castella B, Lia G, Olivi M, Faraci DG, Butera S, Martella F, Scaldaferri M, Cattel F, Boccadoro M, Massaia M, Ferrero D, Bruno B, Giaccone L. Immunomodulatory and clinical effects of daratumumab in T-cell acute lymphoblastic leukaemia. Br J Haematol 2020; 191:e28-e32. [PMID: 32686081 DOI: 10.1111/bjh.16960] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Marco Cerrano
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | | | - Giuseppe Lia
- Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Matteo Olivi
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Danilo G Faraci
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Sara Butera
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Federica Martella
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Matilde Scaldaferri
- SC Farmacia, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy
| | - Francesco Cattel
- SC Farmacia, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy
| | - Mario Boccadoro
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | | | - Dario Ferrero
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Benedetto Bruno
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Luisa Giaccone
- Division of Haematology, Department of Oncology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy.,Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
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5
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Giaccone L, Felicetti F, Butera S, Faraci D, Cerrano M, Dionisi Vici M, Brunello L, Fortunati N, Brignardello E, Bruno B. Optimal Delivery of Follow-Up Care After Allogeneic Hematopoietic Stem-Cell Transplant: Improving Patient Outcomes with a Multidisciplinary Approach. J Blood Med 2020; 11:141-162. [PMID: 32523389 PMCID: PMC7237112 DOI: 10.2147/jbm.s206027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/02/2020] [Indexed: 01/05/2023] Open
Abstract
The increasing indications for allogeneic stem-cell transplant in patients with hematologic malignancies and non-malignant diseases combined with improved clinical outcomes have contributed to increase the number of long-term survivors. However, survivors are at increased risk of developing a unique set of complications and late effects, besides graft-versus-host disease and disease relapse. In this setting, the management capacity of a single health-care provider can easily be overwhelmed. Thus, to provide appropriate survivorship care, a multidisciplinary approach for the long-term follow-up is essential. This review aims at summarizing the most relevant information that a health-care provider should know to establish a follow-up care plan, in the light of individual exposures and risk factors, that includes all organ systems and considers the psychological burden of these patients.
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Affiliation(s)
- Luisa Giaccone
- Division of Hematology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, University of Torino, Torino, Italy
| | - Francesco Felicetti
- Transition Unit for Childhood Cancer Survivors, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Sara Butera
- Division of Hematology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, University of Torino, Torino, Italy
| | - Danilo Faraci
- Division of Hematology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, University of Torino, Torino, Italy
| | - Marco Cerrano
- Division of Hematology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, University of Torino, Torino, Italy
| | - Margherita Dionisi Vici
- Transition Unit for Childhood Cancer Survivors, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Lucia Brunello
- Division of Hematology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, University of Torino, Torino, Italy
| | - Nicoletta Fortunati
- Transition Unit for Childhood Cancer Survivors, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Enrico Brignardello
- Transition Unit for Childhood Cancer Survivors, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Benedetto Bruno
- Division of Hematology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, University of Torino, Torino, Italy.,Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, University of Torino, Torino, Italy
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6
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Butera S, Lioliou G, Zhao S, Whitaker MDC, Krysa AB, Barnett AM. InGaP electron spectrometer for high temperature environments. Sci Rep 2019; 9:11096. [PMID: 31366906 PMCID: PMC6668469 DOI: 10.1038/s41598-019-47531-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 07/16/2019] [Indexed: 11/13/2022] Open
Abstract
In this work, a 200 μm diameter InGaP (GaInP) p+-i-n+ mesa photodiode was studied across the temperature range 100 °C to 20 °C for the development of a temperature-tolerant electron spectrometer. The depletion layer thickness of the InGaP device was 5 μm. The performance of the InGaP detector was analysed under dark conditions and then under the illumination of a 183 MBq 63Ni radioisotope beta particle source. The InGaP photodiode was connected to a custom-made low-noise charge-sensitive preamplifier to realise a particle counting electron spectrometer. Beta spectra were collected at temperatures up to 100 °C with the InGaP device reverse biased at 5 V. The spectrum accumulated at 20 °C was compared with the spectrum predicted using Monte Carlo simulations; good agreement was found between the predicted and experimental spectra. The work is of importance for the development of electron spectrometers that can be used for planetary and space science missions to environments of high temperature or extreme radiation (e.g. Mercury, Jupiter’s moon Europa, near-Sun comets), as well as terrestrial applications.
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Affiliation(s)
- S Butera
- Space Research Group, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK.
| | - G Lioliou
- Space Research Group, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
| | - S Zhao
- Space Research Group, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
| | - M D C Whitaker
- Space Research Group, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
| | - A B Krysa
- EPSRC National Epitaxy Facility, University of Sheffield, Mappin Street, Sheffield, S1 3JD, UK
| | - A M Barnett
- Space Research Group, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
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7
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Lia G, Butera S, Evangelista A, Tosti L, Comba L, Cena S, Brunello L, Gilestro M, Ruggeri M, Oddolo D, Caltagirone SA, Muccio VE, Saraci E, Festuccia M, Ciccone G, Maffini E, Boccadoro M, Giaccone L, Omede P, Bruno B. Long-Term Thymic Function and Reconstitution of the T Cell Compartment after T Cell-Replete Haplo-Identical Allografting. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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8
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Mesiano G, Grignani G, Fiorino E, Leuci V, Rotolo R, D'Ambrosio L, Salfi C, Gammaitoni L, Giraudo L, Pisacane A, Butera S, Pignochino Y, Basiricó M, Capozzi F, Sapino A, Aglietta M, Sangiolo D. Cytokine Induced Killer cells are effective against sarcoma cancer stem cells spared by chemotherapy and target therapy. Oncoimmunology 2018; 7:e1465161. [PMID: 30393581 PMCID: PMC6208452 DOI: 10.1080/2162402x.2018.1465161] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 03/24/2018] [Accepted: 04/10/2018] [Indexed: 12/11/2022] Open
Abstract
Metastatic bone and soft tissue sarcomas often relapse after chemotherapy (CHT) and molecular targeted therapy (mTT), maintaining a severe prognosis. A subset of sarcoma cancer stem cells (sCSC) is hypothesized to resist conventional drugs and sustain disease relapses. We investigated the immunotherapy activity of cytokine induced killer cells (CIK) against autologous sCSC that survived CHT and mTT. The experimental platform included two aggressive bone and soft tissue sarcoma models: osteosarcoma (OS) and undifferentiated-pleomorphic sarcoma (UPS). To visualize putative sCSC we engineered patient-derived sarcoma cultures (2 OS and 3 UPS) with a lentiviral sCSC-detector wherein the promoter of stem-gene Oct4 controls the expression of eGFP. We visualized a fraction of sCSC (mean 24.2 ± 5.2%) and confirmed their tumorigenicity in vivo. sCSC resulted relatively resistant to both CHT and mTT in vitro. Therapeutic doses of doxorubicin significantly enriched viable eGFP+sCSC in both OS (2.6 fold, n = 16) and UPS (2.3 fold, n = 29) compared to untreated controls. Treatment with sorafenib (for OS) and pazopanib (for UPS) also determined enrichment (1.3 fold) of viable eGFP+sCSC, even if less intense than what observed after CHT. Sarcoma cells surviving CHT and mTT were efficiently killed in vitro by autologous CIK even at minimal effector/target ratios (40:1 = 82%, 1:4 = 29%, n = 13). CIK immunotherapy did not spare sCSC that were killed as efficiently as whole sarcoma cell population. The relative chemo-resistance of sCSC and sensitivity to CIK immunotherapy was confirmed in vivo. Our findings support CIK as an innovative, clinically explorable, approach to eradicate chemo-resistant sCSC implicated in tumor relapse.
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Affiliation(s)
- Giulia Mesiano
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCS. Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy
| | - Giovanni Grignani
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCS. Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy
| | - Erika Fiorino
- Department of Oncology, University of Torino, Candiolo (Torino) Italy
| | - Valeria Leuci
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCS. Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy.,Department of Oncology, University of Torino, Candiolo (Torino) Italy
| | - Ramona Rotolo
- Department of Oncology, University of Torino, Candiolo (Torino) Italy
| | - Lorenzo D'Ambrosio
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCS. Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy.,Department of Oncology, University of Torino, Candiolo (Torino) Italy
| | - Chiara Salfi
- Department of Oncology, University of Torino, Candiolo (Torino) Italy
| | - Loretta Gammaitoni
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCS. Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy
| | - Lidia Giraudo
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCS. Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy
| | - Alberto Pisacane
- Pathology Division, Candiolo Cancer Institute, FPO-IRCCS, Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy
| | - Sara Butera
- Department of Molecular Biotechnologies and Healthy Sciences, Haematology Division 1, University of Torino, Italy
| | - Ymera Pignochino
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCS. Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy.,Department of Oncology, University of Torino, Candiolo (Torino) Italy
| | - Marco Basiricó
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCS. Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy
| | - Federica Capozzi
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCS. Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy
| | - Anna Sapino
- Pathology Division, Candiolo Cancer Institute, FPO-IRCCS, Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy.,Department of Medical Sciences, University of Torino, Italy
| | - Massimo Aglietta
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCS. Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy.,Department of Oncology, University of Torino, Candiolo (Torino) Italy
| | - Dario Sangiolo
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCS. Str. Prov. 142, km 3.95, I-10060, Candiolo (To), Italy.,Department of Oncology, University of Torino, Candiolo (Torino) Italy
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9
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Brunello L, Passera R, Dellacasa CM, Giaccone L, Audisio E, Ferrero D, D'Ardia S, Allione B, Aydin S, Festuccia M, Lia G, Crisà E, Maffini E, Butera S, Busca A, Bruno B. Haplo-identical allografting with post-transplant cyclophosphamide in high-risk patients. Ann Hematol 2018; 97:2205-2215. [PMID: 29987350 DOI: 10.1007/s00277-018-3433-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 07/03/2018] [Indexed: 12/19/2022]
Abstract
Haplo-identical transplants (Haplo-Tx) are an important alternative for patients with hematological malignancies who lack a HLA-identical donor. Seventy-one T-replete Haplo-Tx were performed in 70 high-risk patients at our center; 22/70 (31%) patients with refractory/relapsed leukemia received sequential salvage therapy (SeqTh) with high-dose chemotherapy followed by Haplo-Tx during the chemotherapy-induced neutropenia. Graft-versus-host disease (GVHD) prophylaxis consisted of post-transplant cyclophosphamide (days + 3 and + 4) with tacrolimus and mycophenolic acid. After a median follow-up of 29.2 months, 3-year overall survival (OS) and event-free survival (EFS) were 43.8 and 40.2%, while 3-year cumulative incidences (CIs) of non-relapse mortality (NRM) and relapse (RI) were 27 and 33%. Day 100 and day 400 CI of grade III-IV acute and moderate-severe chronic GVHD were 11 and 15%. Three-year RI was significantly lower in patients in complete remission (CR) versus those not in CR at the time of transplant (21.5 vs. 48%, p = 0.009) and in patients who received PBSC as compared to BM (22 vs. 45%, p = 0.009). In patients treated with SeqTh, 3-year OS was 19%, while 3-year RI and NRM were 52 and 28% at a median follow-up of 50 months. Overall, Haplo-Tx was feasible in heavily pretreated high-risk patients without a suitable HLA-identical donor.
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Affiliation(s)
- Lucia Brunello
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Roberto Passera
- Division of Nuclear Medicine, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Chiara Maria Dellacasa
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
| | - Luisa Giaccone
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Ernesta Audisio
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Dario Ferrero
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
- Department of Oncology, Division of Hematology Univ., Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Stefano D'Ardia
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Bernardino Allione
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Semra Aydin
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Moreno Festuccia
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Giuseppe Lia
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Elena Crisà
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
- Department of Oncology, Division of Hematology Univ., Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Enrico Maffini
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Sara Butera
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Alessandro Busca
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy
| | - Benedetto Bruno
- Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy.
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
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10
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Butera S, Lioliou G, Krysa AB, Barnett AM. InGaP (GaInP) mesa p-i-n photodiodes for X-ray photon counting spectroscopy. Sci Rep 2017; 7:10206. [PMID: 28860511 PMCID: PMC5579232 DOI: 10.1038/s41598-017-10502-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 08/10/2017] [Indexed: 11/08/2022] Open
Abstract
In this paper, for the first time an InGaP (GaInP) photon counting X-ray photodiode has been developed and shown to be suitable for photon counting X-ray spectroscopy when coupled to a low-noise charge-sensitive preamplifier. The characterisation of two randomly selected 200 μm diameter and two randomly selected 400 μm diameter In0.5Ga0.5P p+-i-n+ mesa photodiodes is reported; the i-layer of the p+-i-n+ structure was 5 μm thick. At room temperature, and under illumination from an 55Fe radioisotope X-ray source, X-ray spectra were accumulated; the best spectrometer energy resolution (FWHM) achieved at 5.9 keV was 900 eV for the 200 μm In0.5Ga0.5P diameter devices at reverse biases above 5 V. System noise analysis was also carried out and the different noise contributions were computed.
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Affiliation(s)
- S Butera
- Semiconductor Materials and Devices Laboratory, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK.
| | - G Lioliou
- Semiconductor Materials and Devices Laboratory, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
| | - A B Krysa
- EPSRC National Centre for III-V Technologies, University of Sheffield, Mappin Street, Sheffield, S1 3JD, UK
| | - A M Barnett
- Semiconductor Materials and Devices Laboratory, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
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11
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Butera S, Whitaker MDC, Krysa AB, Barnett AM. Temperature effects on an InGaP (GaInP) 55Fe X-ray photovoltaic cell. Sci Rep 2017; 7:4981. [PMID: 28694470 PMCID: PMC5504084 DOI: 10.1038/s41598-017-05181-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 05/24/2017] [Indexed: 11/30/2022] Open
Abstract
This paper investigates the effects of temperature on an InGaP (GaInP) 55Fe X-ray photovoltaic cell prototype for a radioisotope microbattery (also called a nuclear microbattery). An In0.5Ga0.5P p-i-n (5 μm i-layer) mesa photodiode was illuminated by a standard 206 MBq 55Fe radioisotope X-ray source and characterised over the temperature range −20 °C to 100 °C. The electrical power output of the device reached its maximum value of 1.5 pW at a temperature of −20 °C. An open circuit voltage and a short circuit current of 0.82 V and 2.5 pA, respectively, were obtained at −20 °C. While the electrical power output and the open circuit voltage decreased with increasing temperature, an almost flat trend was found for the short circuit current. The cell conversion efficiency decreased from 2.1% at −20 °C to 0.7% at 100 °C.
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Affiliation(s)
- S Butera
- Semiconductor Materials and Devices Laboratory, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK.
| | - M D C Whitaker
- Semiconductor Materials and Devices Laboratory, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
| | - A B Krysa
- EPSRC National Centre for III-V Technologies, University of Sheffield, Mappin Street, Sheffield, S1 3JD, UK
| | - A M Barnett
- Semiconductor Materials and Devices Laboratory, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
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12
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Butera S, Lioliou G, Barnett AM. Temperature effects on gallium arsenide 63Ni betavoltaic cell. Appl Radiat Isot 2017; 125:42-47. [PMID: 28407497 DOI: 10.1016/j.apradiso.2017.04.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 10/18/2016] [Revised: 02/23/2017] [Accepted: 04/01/2017] [Indexed: 11/29/2022]
Abstract
A GaAs 63Ni radioisotope betavoltaic cell is reported over the temperature range 70°C to -20°C. The temperature effects on the key cell parameters were investigated. The saturation current decreased with decreased temperature; whilst the open circuit voltage, the short circuit current, the maximum power and the internal conversion efficiency values decreased with increased temperature. A maximum output power and an internal conversion efficiency of 1.8pW (corresponding to 0.3μW/Ci) and 7% were observed at -20°C, respectively.
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Affiliation(s)
- S Butera
- Semiconductor Materials and Devices Laboratory, School of Engineering and Informatics, University of Sussex, Brighton BN1 9QT, UK.
| | - G Lioliou
- Semiconductor Materials and Devices Laboratory, School of Engineering and Informatics, University of Sussex, Brighton BN1 9QT, UK
| | - A M Barnett
- Semiconductor Materials and Devices Laboratory, School of Engineering and Informatics, University of Sussex, Brighton BN1 9QT, UK
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13
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Abstract
This paper describes the performance of a fabricated prototype Al0.2Ga0.8As 55Fe radioisotope microbattery photovoltaic cells over the temperature range −20 °C to 50 °C. Two 400 μm diameter p+-i-n+ (3 μm i-layer) Al0.2Ga0.8As mesa photodiodes were used as conversion devices in a novel X-ray microbattery prototype. The changes of the key microbattery parameters were analysed in response to temperature: the open circuit voltage, the maximum output power and the internal conversion efficiency decreased when the temperature was increased. At −20 °C, an open circuit voltage and a maximum output power of 0.2 V and 0.04 pW, respectively, were measured per photodiode. The best internal conversion efficiency achieved for the fabricated prototype was only 0.95% at −20 °C.
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Affiliation(s)
- S Butera
- Semiconductor Materials and Device Laboratory, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
| | - M D C Whitaker
- Semiconductor Materials and Device Laboratory, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
| | - G Lioliou
- Semiconductor Materials and Device Laboratory, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
| | - A M Barnett
- Semiconductor Materials and Device Laboratory, School of Engineering and Informatics, University of Sussex, Brighton, BN1 9QT, UK
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14
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Giaccone L, Audisio E, Bruno B, Maffini E, D'Ardia S, Caracciolo D, Ferrando F, Butera S, Brunello L, Frairia C, Aydin S, Nicolino B, Festuccia M, Crisà E, Bruna R, Passera R, Boccadoro M, Vitolo U, Busca A, Falda M, Marmont F. Role of Chemotherapy and Allografting in the Treatment of Acute Lymphoblastic Leukemia. Clin Lymphoma Myeloma Leuk 2015; 16:96-103. [PMID: 26711180 DOI: 10.1016/j.clml.2015.11.002] [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] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 10/26/2015] [Accepted: 11/11/2015] [Indexed: 11/29/2022]
Abstract
We report the clinical outcomes of 83 patients with acute lymphoblastic leukemia (median age, 46 years; range, 18-75 years) treated at our institution between 1999 and 2011. Treatment refers to clinical trials open for accrual at the time of diagnosis or to institutional guidelines. Upfront allografting was considered for younger high-risk patients. Seventy-eight of 83 (94%) patients achieved complete remission after induction, although 53% of them eventually relapsed. Forty of 70 patients younger than 61 years underwent allografting. The median follow-up was 7.4 years (range, 0.2-15.0 years). Overall, the 5-year overall survival (OS) and event-free survival (EFS) were 40% and 39%, respectively. In patients undergoing transplantation, OS and EFS at 5 years were both 53%, whereas in a nontransplantation setting, both OS and EFS were 35% at 5 years (P = .044 for both OS and EFS). By multivariate analysis, the independent predictors of OS and EFS were age and leukocytosis in the overall population and allografting in young patients.
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Affiliation(s)
- Luisa Giaccone
- Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy; Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, Università di Torino, Scuola di Medicina, Torino, Italy.
| | - Ernesta Audisio
- Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Benedetto Bruno
- Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy; Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, Università di Torino, Scuola di Medicina, Torino, Italy
| | - Enrico Maffini
- Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Stefano D'Ardia
- Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Daniele Caracciolo
- Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Federica Ferrando
- Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Sara Butera
- Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Lucia Brunello
- Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Chiara Frairia
- Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Semra Aydin
- Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Barbara Nicolino
- Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Moreno Festuccia
- Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Elena Crisà
- Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Riccardo Bruna
- Dipartimento di Biotecnologie Molecolari e Scienze per la Salute, Università di Torino, Scuola di Medicina, Torino, Italy
| | - Roberto Passera
- Divisione di Medicina Nucleare 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Mario Boccadoro
- Ematologia 1, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Umberto Vitolo
- Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Alessandro Busca
- Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Michele Falda
- Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Filippo Marmont
- Ematologia 2, A.O. Città della Salute e della Scienza di Torino, Torino, Italy
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15
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Allegrini E, Butera S, Kosson DS, Van Zomeren A, Van der Sloot HA, Astrup TF. Life cycle assessment and residue leaching: the importance of parameter, scenario and leaching data selection. Waste Manag 2015; 38:474-485. [PMID: 25573739 DOI: 10.1016/j.wasman.2014.12.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 11/17/2014] [Accepted: 12/16/2014] [Indexed: 06/04/2023]
Abstract
Residues from industrial processes and waste management systems (WMSs) have been increasingly reutilised, leading to landfilling rate reductions and the optimisation of mineral resource utilisation in society. Life cycle assessment (LCA) is a holistic methodology allowing for the analysis of systems and products and can be applied to waste management systems to identify environmental benefits and critical aspects thereof. From an LCA perspective, residue utilisation provides benefits such as avoiding the production and depletion of primary materials, but it can lead to environmental burdens, due to the potential leaching of toxic substances. In waste LCA studies where residue utilisation is included, leaching has generally been neglected. In this study, municipal solid waste incineration bottom ash (MSWI BA) was used as a case study into three LCA scenarios having different system boundaries. The importance of data quality and parameter selection in the overall LCA results was evaluated, and an innovative method to assess metal transport into the environment was applied, in order to determine emissions to the soil and water compartments for use in an LCA. It was found that toxic impacts as a result of leaching were dominant in systems including only MSWI BA utilisation, while leaching appeared negligible in larger scenarios including the entire waste system. However, leaching could not be disregarded a priori, due to large uncertainties characterising other activities in the scenario (e.g. electricity production). Based on the analysis of relevant parameters relative to leaching, and on general results of the study, recommendations are provided regarding the use of leaching data in LCA studies.
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Affiliation(s)
- E Allegrini
- Technical University of Denmark, Department of Environmental Engineering, Building 115, 2800 Lyngby, Denmark.
| | - S Butera
- Technical University of Denmark, Department of Environmental Engineering, Building 115, 2800 Lyngby, Denmark
| | - D S Kosson
- Vanderbilt University, Department of Civil and Environmental Engineering, Box 1831 Station B, Nashville, TN 37235, USA
| | - A Van Zomeren
- Energy Research Centre of the Netherlands (ECN), Department of Environmental Risk Assessment, P.O. Box 1, 1755 ZG Petten, The Netherlands
| | - H A Van der Sloot
- Hans van der Sloot Consultancy, Dorpsstraat 216, 1721 BV Langedijk, Netherlands
| | - T F Astrup
- Technical University of Denmark, Department of Environmental Engineering, Building 115, 2800 Lyngby, Denmark
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16
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Bhanich Supapol W, Remis R, Raboud J, Millson M, Tappero J, Kaul R, Kulkarni P, McConnell M, Mock P, McNicholl J, Vanprapar N, Asavapiriyanont S, Shaffer N, Butera S. Mother‐to‐Child Transmission of GB Virus C in a Cohort of Women Coinfected with GB Virus C and HIV in Bangkok, Thailand. J Infect Dis 2009; 200:227-35. [DOI: 10.1086/599793] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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17
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Pullium JK, Adams DR, Jackson E, Kim CN, Smith DK, Janssen R, Gould K, Folks TM, Butera S, Otten RA. Pig-tailed macaques infected with human immunodeficiency virus (HIV) type 2GB122 or simian/HIV89.6p express virus in semen during primary infection: new model for genital tract shedding and transmission. J Infect Dis 2001; 183:1023-30. [PMID: 11237826 DOI: 10.1086/319293] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2000] [Revised: 12/18/2000] [Indexed: 11/03/2022] Open
Abstract
Characterizing human immunodeficiency virus (HIV) expression in semen during primary infection remains essential to understanding the risk of sexual transmission. This investigation represents the first systematic evaluation of male genital tract shedding to use a nonhuman primate model, including the impact of exposure route and viral virulence. Male macaques were inoculated with either a chronic disease-causing virus (HIV-2(GB122); n=4 intravenous; n=4 intrarectal) or an acutely pathogenic simian/HIV strain (SHIV(89.6P); n=2 intravenous). All macaques were systemically infected, and seminal plasma virion-associated RNA (vRNA) levels were approximately 10-fold lower than those in blood. In HIV-2(GB122) infection, seminal virus was delayed by 1-2 weeks compared with that in blood. Intrarectal inoculation resulted in a shorter duration of seminal vRNA expression and intermittent seminal cell provirus. No delays, higher peaks ( approximately 50-fold), or longer durations in seminal virus expression were noted for SHIV(89.6P) infection. This novel model definitively establishes that virus dissemination results in early peak seminal levels and provides a basis for evaluating interventions targeting male genital tract expression.
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Affiliation(s)
- J K Pullium
- HIV/AIDS and Retrovirology Branch, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, and Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA
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18
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Otten RA, Smith DK, Adams DR, Pullium JK, Jackson E, Kim CN, Jaffe H, Janssen R, Butera S, Folks TM. Efficacy of postexposure prophylaxis after intravaginal exposure of pig-tailed macaques to a human-derived retrovirus (human immunodeficiency virus type 2). J Virol 2000; 74:9771-5. [PMID: 11000253 PMCID: PMC112413 DOI: 10.1128/jvi.74.20.9771-9775.2000] [Citation(s) in RCA: 160] [Impact Index Per Article: 6.7] [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: 11/20/2022] Open
Abstract
Postexposure prophylaxis (PEP) after intravaginal exposure to human immunodeficiency virus (HIV) was investigated using the HIV type 2 (HIV-2)/pig-tailed macaque transmission model. PEP for 28 days with the reverse transcriptase inhibitor (R)-9-(2-phosphonylmethoxypropyl)adenine (PMPA; tenofovir) was initiated 12 to 72 h following HIV-2 exposure. Systemic infection was not evident in the 12- and 36-h groups, as defined by plasma viremia, cell-associated provirus, antibody responses, and lymph node virus. Breakthrough infection in the 72-h group was detected at week 16 post-virus exposure. These results demonstrate for the first time using a vaginal transmission model that early intervention after high-risk sexual exposures may prevent infection.
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Affiliation(s)
- R A Otten
- Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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