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Bouzianas D, Bouziana S. First pediatric B-acute lymphoblastic leukemia patient treated with anti-CD19 chimeric antigen receptor T-cell therapy: Long-term remission or early cure? Hum Vaccin Immunother 2024; 20:2321678. [PMID: 38402637 PMCID: PMC10898498 DOI: 10.1080/21645515.2024.2321678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/19/2024] [Indexed: 02/27/2024] Open
Affiliation(s)
- Dimitrios Bouzianas
- BReMeL, Biopharmaceutical and Regenerative Medicine Laboratories, Thessaloniki, Greece
| | - Stella Bouziana
- Department of Hematology, King’s College Hospital, London, UK
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Bouziana S. Editorial: Novel insights into CAR T-cell associated neurotoxicity. Front Neurol 2023; 14:1322843. [PMID: 38020630 PMCID: PMC10660261 DOI: 10.3389/fneur.2023.1322843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Stella Bouziana
- Department of Haematology, King's College Hospital NHS Foundation Trust, London, United Kingdom
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Bouzianas D, Bouziana S. A decade of CD4+ chimeric antigen receptor T-cell evolution in two chronic lymphocytic leukemia patients: were chronic lymphocytic leukemia cells present? Explor Target Antitumor Ther 2023; 4:1128-1135. [PMID: 37970204 PMCID: PMC10645517 DOI: 10.37349/etat.2023.00186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/22/2023] [Indexed: 11/17/2023] Open
Abstract
On Feb 2, 2022, Nature published the paper titled "Decade-long leukemia remissions with the persistence of CD4+ CAR T-cells" (Nature. 2022;602:503-9. doi: 10.1038/s41586-021-04390-6). According to the results presented, it could be argued that "chimeric antigen receptor (CAR) T-cells can actually cure patients with chronic lymphocytic leukemia (CLL)". CAR T-cells remained detectable more than ten years after infusion, and immunoglobulin heavy chain (IGH) rearrangement deep sequencing showed persistent deep molecular remission for both patients (no CLL clonotypes were detectable six months after CAR T-cell infusion and onwards). However, the existing actual disease status of both patients remained unclear, as it was unknown: (1) if CAR T-cells killed all leukemia cells during the initial anti-leukemic response phase, that is, soon after CAR T-cell infusion into both patients; (2) if few CLL cells survived, but persistent CAR T-cells had been able to destroy any leukemia cells before they reach detectable levels. In the first case, both patients could be considered definitely cured; in the second not and their decade-prolonged deep remission could be a consequence of the cytotoxic activity of the functionally active CD4+ CAR T-cells. The first version appears to be stronger and the supporting arguments have been included in a comprehensive commentary article. A new therapeutic intervention may emerge with the potential to fully improve the quality of life of both patients and in addition, ongoing research into CAR T-cells may turn in a new, more effective direction.
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Affiliation(s)
- Dimitrios Bouzianas
- Independent Researcher, BReMeL, Biopharmaceutical and Regenerative Medicine Laboratories, PC555 34 Thessaloniki, Greece
| | - Stella Bouziana
- Department of Hematology, King’s College Hospital, SE59RS London, UK
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Bouziana S, Bouzianas D. Anti-CD19 CAR-T cells: Digging in the dark side of the golden therapy. Crit Rev Oncol Hematol 2020; 157:103096. [PMID: 33181441 DOI: 10.1016/j.critrevonc.2020.103096] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 07/25/2020] [Accepted: 09/07/2020] [Indexed: 02/07/2023] Open
Abstract
The unprecedented technological advances in genetic engineering have resulted in the advent of the very promising chimeric antigen receptor (CAR)-T cell therapy. Based on the striking outcomes of clinical trials, the first two commercial CAR-T cell products, tisagenlecleucel and axicabtagene ciloleucel, have been approved in both the United States and Europe for the treatment of patients with highly aggressive CD19-positive hematological malignancies. Despite the initial remarkable responses many patients finally relapse, implying the presence of resistance mechanisms. In this review, we describe the limitations and resistance mechanisms to anti-CD19 CAR-T cells and address potential strategies to overcome CAR-T cell barriers.
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Affiliation(s)
- Stella Bouziana
- Department of Hematology-BMT Unit, G. Papanikolaou Hospital, Thessaloniki, Greece.
| | - Dimitrios Bouzianas
- BReMeL Biopharmaceutical and Regenerative Medicine Laboratories, Thessaloniki, Greece
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Bouziana S, Bouzianas D. Exploring the Dilemma of Allogeneic Hematopoietic Cell Transplantation after Chimeric Antigen Receptor T Cell Therapy: To Transplant or Not? Biol Blood Marrow Transplant 2020; 26:e183-e191. [DOI: 10.1016/j.bbmt.2020.04.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/31/2020] [Accepted: 04/02/2020] [Indexed: 01/14/2023]
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Sakellari I, Gavriilaki E, Batsis I, Mallouri D, Gavriilaki M, Apostolou C, Iskas M, Voutiadou G, Bouziana S, Bousiou Z, Constantinou V, Masmanidou M, Sotiropoulos D, Yannaki E, Lalayanni C, Pilavaki M, Chatziioannou K, Papayannopoulos S, Anagnostopoulos A. Isolated Extramedullary Relapse as a Poor Predictor of Survival after Allogeneic Hematopoietic Cell Transplantation for Acute Leukemia. Biol Blood Marrow Transplant 2019; 25:1756-1760. [DOI: 10.1016/j.bbmt.2019.05.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/14/2019] [Accepted: 05/19/2019] [Indexed: 12/14/2022]
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Bouziana S, Tziomalos K, Goulas A, Vyzantiadis TA, Papadopoulou M, Panderi A, Ηatzitolios AΙ. Effects of major adipokines and the -420 C > G resistin gene polymorphism on the long-term outcome of patients with acute ischemic stroke. Int J Neurosci 2019; 129:978-985. [PMID: 30885017 DOI: 10.1080/00207454.2019.1596906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 12/29/2022]
Abstract
Aim: The association between adiponectin, leptin, and resistin and the long-term outcome of ischemic stroke are controversial. We aimed to evaluate this relationship. Methods: We prospectively studied 83 patients consecutively hospitalized for acute ischemic stroke (38.6% males, age 79.7 ± 6.3 years). Serum adiponectin, leptin, and resistin levels and the -420C > G polymorphism of the resistin gene were determined at admission. Stroke severity at admission was evaluated with the National Institutes of Health Stroke Scale (NIHSS). One year after discharge, functional status, incidence of cardiovascular events and all-cause mortality were recorded. Functional status was evaluated with the modified Rankin scale (mRS). Results: Patients with the G allele had lower mRS (p < .05) and patients with adverse outcome had higher serum resistin levels (p < .05). The only independent predictor of adverse outcome was mRS at discharge (risk ratio (RR) 2.78, 95% confidence interval (CI) 1.54-5.00; p < .001). Higher adiponectin levels were an independent predictor of cardiovascular morbidity (RR 1.07, 95% CI 1.01-1.14; p < .05). Patients who died had higher serum adiponectin levels than those who survived (p < .05). The only independent predictor of all-cause mortality was NIHSS at admission (RR 1.19, 95% CI 1.04-1.35; p < .01). Conclusions: In patients with acute ischemic stroke, the G allele of the -420C > G polymorphism of the resistin gene promoter is more frequent in those with a more favorable functional outcome at one year after discharge. Patients with higher serum resistin levels appear to have worse long-term functional outcome, while higher serum adiponectin levels are associated with higher incidence of cardiovascular events.
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Affiliation(s)
- Stella Bouziana
- First Propedeutic Department of Internal Medicine, AHEPA Hospital, School of Health Sciences, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Konstantinos Tziomalos
- First Propedeutic Department of Internal Medicine, AHEPA Hospital, School of Health Sciences, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Antonis Goulas
- First Laboratory of Pharmacology, Medical Department, School of Health Sciences, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Timoleon-Achilleas Vyzantiadis
- First Department of Microbiology, Medical Department School of Health Sciences, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Maria Papadopoulou
- First Propedeutic Department of Internal Medicine, AHEPA Hospital, School of Health Sciences, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Athanasia Panderi
- First Laboratory of Pharmacology, Medical Department, School of Health Sciences, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Apostolos Ι Ηatzitolios
- First Propedeutic Department of Internal Medicine, AHEPA Hospital, School of Health Sciences, Aristotle University of Thessaloniki , Thessaloniki , Greece
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Sakellari I, Gavriilaki E, Chatziioannou K, Papathanasiou M, Mallouri D, Batsis I, Bousiou Z, Bouziana S, Constantinou V, Douka V, Apostolou C, Iskas M, Lalayanni C, Athanasiadou A, Sotiropoulos D, Yannaki E, Gianouzakos V, Anagnostopoulos A. Long-term outcomes of total body irradiation plus cyclophosphamide versus busulfan plus cyclophosphamide as conditioning regimen for acute lymphoblastic leukemia: a comparative study. Ann Hematol 2018; 97:1987-1994. [DOI: 10.1007/s00277-018-3383-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/23/2018] [Indexed: 12/11/2022]
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Giampatzis V, Tziomalos K, Bouziana S, Spanou M, Kostaki S, Aggelopoulou S, Christou K, Savopoulos C, Hatzitolios A. P4312Effect of prior treatment with non-vitamin K antagonist oral anticoagulants on severity and in-hospital outcome of acute ischemic stroke in patients with atrial fibrillation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bouziana S, Tziomalos K, Goulas A, Vyzantiadis T, Papadopoulou M, Panderi A, Hatzitolios A. Effects of major adipokines on the long-term outcome of patients with acute ischemic stroke. Atherosclerosis 2017. [DOI: 10.1016/j.atherosclerosis.2017.06.475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kakaletsis N, Tziomalos K, Savopoulos C, Riga M, Bouziana S, Spanou M, Kostaki S, Angelopoulou S, Karatzas K, Hatzitolios I. Outdoor air pollution and ischemic stroke severity: An ecological study in Thessaloniki. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tziomalos K, Giampatzis V, Bouziana S, Spanou M, Papadopoulou M, Kazantzidou P, Dourliou V, Kostaki S, Savopoulos C, Hatzitolios A. Real-life comparative effectiveness of anticoagulant agents in patients with atrial fibrillation discharged after acute ischemic stroke. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tziomalos K, Bouziana S, Spanou M, Papadopoulou M, Giampatzis V, Kazantzidou P, Dourliou V, Kostaki S, Savopoulos C, Hatzitolios A. Less aggressive compared with more aggressive statin treatment in patients with acute ischemic stroke. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tziomalos K, Giampatzis V, Bouziana S, Pavlidis A, Spanou M, Papadopoulou M, Kagelidis G, Boutari C, Savopoulos C, Hatzitolios A. Predictive value of the ankle brachial index in patients with acute ischemic stroke. VASA 2014; 43:55-61. [DOI: 10.1024/0301-1526/a000328] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Peripheral arterial disease (PAD) is frequently present in patients with acute ischemic stroke. However, there are limited data regarding the association between ankle brachial index (ABI) ≤ 0.90 (which is diagnostic of PAD) or > 1.40 (suggesting calcified arteries) and the severity of stroke and in-hospital outcome in this population. We aimed to evaluate these associations in patients with acute ischemic stroke. Patients and methods: We prospectively studied 342 consecutive patients admitted for acute ischemic stroke (37.4 % males, mean age 78.8 ± 6.4 years). The severity of stroke was assessed with the National Institutes of Health Stroke Scale (NIHSS)and the modified Rankin scale (mRS) at admission. The outcome was assessed with the mRS and dependency (mRS 2 - 5) at discharge and in-hospital mortality. Results: An ABI ≤ 0.90 was present in 24.6 % of the patients whereas 68.1 % had ABI 0.91 - 1.40 and 7.3 % had ABI > 1.40. At admission, the NIHSS score did not differ between the 3 groups (10.4 ± 10.6, 8.3 ± 9.3 and 9.3 ± 9.4, respectively). The mRS score was also comparable in the 3 groups (3.6 ± 1.7, 3.1 ± 1.8 and 3.5 ± 2.3, respectively). At discharge, the mRS score did not differ between the 3 groups (2.9 ± 2.2, 2.3 ± 2.1 and 2.7 ± 2.5, respectively) and dependency rates were also comparable (59.5, 47.6 and 53.3 %, respectively). In-hospital mortality was almost two-times higher in patients with ABI ≤ 0.90 than in patients with ABI 0.91 - 1.40 or > 1.40 but this difference was not significant (10.9, 6.6 and 6.3 %, respectively). Conclusions: An ABI ≤ 0.90 or > 1.40 does not appear to be associated with more severe stroke or worse in-hospital outcome in patients with acute ischemic stroke.
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Affiliation(s)
- Konstantinos Tziomalos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Vasilios Giampatzis
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Stella Bouziana
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Athinodoros Pavlidis
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Marianna Spanou
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Maria Papadopoulou
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Giannis Kagelidis
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Chrysoula Boutari
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Christos Savopoulos
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Apostolos Hatzitolios
- First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Tziomalos K, Bouziana S, Giampatzis V, Pavlidis A, Spanou M, Papadopoulou M, Doumarapis E, Kakaletsis N, Savopoulos C, Hatzitolios A. P4.62 PROGNOSTIC VALUE OF ARTERIAL STIFFNESS INDICES IN PATIENTS WITH ACUTE ISCHEMIC STROKE. Artery Res 2012. [DOI: 10.1016/j.artres.2012.09.208] [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] Open
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