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Novacic D, Uldrick T, Dulau-Florea A, Howe CE, Lee CCR, Kong HH, Gahl WA. Calciphylaxis in POEMS syndrome: Case report. Rare 2024; 2:100019. [PMID: 38435320 PMCID: PMC10907981 DOI: 10.1016/j.rare.2024.100019] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
POEMS Syndrome is a constellation of findings including Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal plasma cell disorder, and Skin changes. Calciphylaxis, a microangiopathy involving vascular calcification and thrombotic occlusions, occurs rarely in POEMS. We present a case of prominent calciphylaxis that antedated the diagnosis of POEMS. The patient presented with extensive ecchymoses progressing to necrotic lesions in the setting of acute renal injury. Previously, she had chronic slowly progressive polyneuropathy, splenomegaly, hypothyroidism, amenorrhea, and ascites. Calciphylaxis was diagnosed on skin biopsy, and POEMS was diagnosed based upon clinical findings plus a bone marrow biopsy showing 15% lambda chain restricted plasma cells. Treatment for the calciphylaxis was supportive with fluids, tissue debridement, wound vacuum devices and antibiotics for secondary infection. Myeloma was treated with bortezomib and steroids. All aspects of the patient's manifestations improved. We conclude that calciphylaxis can be a prominent feature of POEMS and can appear prior to recognition of the full-blown syndrome.
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Affiliation(s)
- Danica Novacic
- Undiagnosed Diseases Program, National Institutes of Health (NIH) Common Fund, Office of the Director, NIH, Bethesda, MD, USA
| | - Thomas Uldrick
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Colleen Evans Howe
- Undiagnosed Diseases Program, National Institutes of Health (NIH) Common Fund, Office of the Director, NIH, Bethesda, MD, USA
| | - Chyi-Chia R. Lee
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, NIH, USA
| | - Heidi H. Kong
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, USA
| | - William A. Gahl
- Undiagnosed Diseases Program, National Institutes of Health (NIH) Common Fund, Office of the Director, NIH, Bethesda, MD, USA
- Medical Genetics Branch, National Human Genome Research Institute, NIH, USA
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Moore K, Bouberhan S, Hamilton E, Liu J, O'Cearbhaill R, O'Malley D, Papadimitriou K, Schröder D, Van Nieuwenhuysen E, Yoo SY, Peterman M, Goncalves P, Schmidt T, Zhu M, Lowy I, Uldrick T, Miller E. 197TiP First-in-human (FIH) phase I/II study of ubamatamab, a MUC16xCD3 bispecific antibody, administered alone or in combination with cemiplimab in patients with recurrent ovarian cancer (OC). Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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3
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Citrin D, Valle L, Camphausen K, Cooley‑zgela T, Smart D, Yao M, Mitchell J, Thompson W, Sereti I, Uldrick T. Pilot trial of topical MTS‑01 application to reduce dermatitis in patients receiving chemoradiotherapy for stage I‑III carcinoma of the anal canal. Int J Oncol 2022; 60:68. [DOI: 10.3892/ijo.2022.5358] [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] [Received: 01/31/2022] [Accepted: 03/30/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Deborah Citrin
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Luca Valle
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA 90045, USA
| | - Kevin Camphausen
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Theresa Cooley‑zgela
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Deedee Smart
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Michael Yao
- Gastroenterology and Hepatology Section, Washington DC VA Medical Center, Washington, DC 20422, USA
| | - James Mitchell
- Radiation Biology Branch, Center for Cancer Research, NCI, NIH, Bethesda, MD 20892, USA
| | | | - Irini Sereti
- Laboratory of Immunoregulation, NIAID, Bethesda, MD 20814, USA
| | - Thomas Uldrick
- HIV and AIDS Malignancy Branch, Center for Cancer Research, NCI, NIH, Bethesda, MD 20892, USA
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4
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Lange C, Lindo N, Little R, Uldrick T, Hill S, Bell J, Lurain K, Ramaswami R, Yarchoan R, Maldarelli F. In vivo analysis of HIV from an occupational exposure to laboratory adapted HIV-IIIB with 20-year follow-up: implications for reservoir formation. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30144-8] [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] Open
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5
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Bozzi G, Simonetti FR, Watters SA, Anderson EM, Gouzoulis M, Kearney MF, Rote P, Lange C, Shao W, Gorelick R, Fullmer B, Kumar S, Wank S, Hewitt S, Kleiner DE, Hattori J, Bale MJ, Hill S, Bell J, Rehm C, Grossman Z, Yarchoan R, Uldrick T, Maldarelli F. No evidence of ongoing HIV replication or compartmentalization in tissues during combination antiretroviral therapy: Implications for HIV eradication. Sci Adv 2019; 5:eaav2045. [PMID: 31579817 PMCID: PMC6760922 DOI: 10.1126/sciadv.aav2045] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 08/29/2019] [Indexed: 05/28/2023]
Abstract
HIV persistence during combination antiretroviral therapy (cART) is the principal obstacle to cure. Mechanisms responsible for persistence remain uncertain; infections may be maintained by persistence and clonal expansion of infected cells or by ongoing replication in anatomic locations with poor antiretroviral penetration. These mechanisms require different strategies for eradication, and determining their contributions to HIV persistence is essential. We used phylogenetic approaches to investigate, at the DNA level, HIV populations in blood, lymphoid, and other infected tissues obtained at colonoscopy or autopsy in individuals who were on cART for 8 to 16 years. We found no evidence of ongoing replication or compartmentalization of HIV; we did detect clonal expansion of infected cells that were present before cART. Long-term persistence, and not ongoing replication, is primarily responsible for maintaining HIV. HIV-infected cells present when cART is initiated represent the only identifiable source of persistence and is the appropriate focus for eradication.
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Affiliation(s)
- G. Bozzi
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
- Department of Biomedical and Clinical Sciences, L. Sacco Hospital, University of Milan, Milan, Italy
| | - F. R. Simonetti
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
- Department of Biomedical and Clinical Sciences, L. Sacco Hospital, University of Milan, Milan, Italy
| | - S. A. Watters
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
- Department of Infection and Immunity, University College London, London, UK
| | - E. M. Anderson
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
| | - M. Gouzoulis
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
| | - M. F. Kearney
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
| | - P. Rote
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
| | - C. Lange
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
| | - W. Shao
- Advanced Biomedical Computing Center, Leidos Biomedical Research Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - R. Gorelick
- AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - B. Fullmer
- AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - S. Kumar
- Digestive Diseases Branch, NIDDK, NIH, Bethesda, MD, USA
| | - S. Wank
- Digestive Diseases Branch, NIDDK, NIH, Bethesda, MD, USA
| | - S. Hewitt
- Laboratory of Pathology, NCI, NIH, Bethesda, MD, USA
| | - D. E. Kleiner
- Laboratory of Pathology, NCI, NIH, Bethesda, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - J. Hattori
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
| | - M. J. Bale
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
| | - S. Hill
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
| | - J. Bell
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
| | - C. Rehm
- Laboratory of Immunoregulation, NIAID, NIH, Bethesda, MD, USA
| | - Z. Grossman
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
| | - R. Yarchoan
- HIV and AIDS Malignancy Branch, NCI, NIH, Bethesda, MD, USA
| | - T. Uldrick
- HIV and AIDS Malignancy Branch, NCI, NIH, Bethesda, MD, USA
| | - F. Maldarelli
- HIV Dynamics and Replication Program, NCI, NIH, Frederick, MD, USA
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Blumenthal MJ, Schutz C, Barr D, Locketz M, Marshall V, Whitby D, Katz AA, Uldrick T, Meintjes G, Schäfer G. The Contribution of Kaposi's Sarcoma-Associated Herpesvirus to Mortality in Hospitalized Human Immunodeficiency Virus-Infected Patients Being Investigated for Tuberculosis in South Africa. J Infect Dis 2019; 220:841-851. [PMID: 31004430 PMCID: PMC6667800 DOI: 10.1093/infdis/jiz180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/11/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite increasing numbers of human immunodeficiency virus (HIV)-infected South Africans receiving antiretroviral therapy (ART), tuberculosis (TB) remains the leading cause of mortality. Approximately 25% of patients treated for TB have microbiologically unconfirmed diagnoses. We assessed whether elevated Kaposi's sarcoma-associated herpesvirus (KSHV) viral load (VL) contributes to mortality in hospitalized HIV-infected patients investigated for TB. METHODS Six hundred eighty-two HIV-infected patients admitted to Khayelitsha Hospital, South Africa, were recruited, investigated for TB, and followed for 12 weeks. KSHV serostatus, peripheral blood KSHV-VL, and KSHV-associated clinical correlates were evaluated. RESULTS Median CD4 count was 62 (range, 0-526) cells/μL; KSHV seropositivity was 30.7% (95% confidence interval [CI], 27%-34%); 5.8% had detectable KSHV-VL (median, 199.1 [range, 13.4-2.2 × 106] copies/106 cells); 22% died. Elevated KSHV-VL was associated with mortality (adjusted odds ratio, 6.5 [95% CI, 1.3-32.4]) in patients without TB or other microbiologically confirmed coinfections (n = 159). Six patients had "possible KSHV-inflammatory cytokine syndrome" (KICS): 5 died, representing significantly worse survival (P < .0001), and 1 patient was diagnosed with KSHV-associated multicentric Castleman disease at autopsy. CONCLUSIONS Given the association of mortality with elevated KSHV-VL in critically ill HIV-infected patients with suspected but not microbiologically confirmed TB, KSHV-VL and KICS criteria may guide diagnostic and therapeutic evaluation.
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Affiliation(s)
- Melissa J Blumenthal
- Division of Medical Biochemistry and Structural Biology, Department of Integrative Biomedical Sciences
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa
| | - Charlotte Schutz
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa
- Department of Medicine, University of Cape Town, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, South Africa
| | - David Barr
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, South Africa
- Wellcome Trust Liverpool Glasgow Centre for Global Health Research, Institute of Infection and Global Health, University of Liverpool, United Kingdom
| | - Michael Locketz
- Division of Anatomical Pathology, National Health Laboratory Service, University of Cape Town, South Africa
| | - Vickie Marshall
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, National Institutes of Health, Maryland
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, National Institutes of Health, Maryland
| | - Arieh A Katz
- Division of Medical Biochemistry and Structural Biology, Department of Integrative Biomedical Sciences
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa
| | - Thomas Uldrick
- Fred Hutchison Cancer Research Center, Seattle, Washington
| | - Graeme Meintjes
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa
- Department of Medicine, University of Cape Town, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, South Africa
| | - Georgia Schäfer
- Division of Medical Biochemistry and Structural Biology, Department of Integrative Biomedical Sciences
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa
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7
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Manion M, Uldrick T, Polizzotto MN, Sheikh V, Roby G, Lurain K, Metzger D, Mican JM, Pau A, Lisco A, Laidlaw E, Hammoud DA, Whitby D, Yarchoan R, Sereti I. Emergence of Kaposi's Sarcoma Herpesvirus-Associated Complications Following Corticosteroid Use in TB-IRIS. Open Forum Infect Dis 2018; 5:ofy217. [PMID: 30568973 DOI: 10.1093/ofid/ofy217] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 03/10/2018] [Accepted: 10/02/2018] [Indexed: 11/13/2022] Open
Abstract
Corticosteroid use was associated with development of Kaposi's sarcoma or multicentric Castleman disease in 3 patients with mycobacterial immune reconstitution inflammatory syndrome (IRIS) treated with corticosteroids. Monitoring for development of Kaposi's sarcoma and alternative treatment may be beneficial for patients with IRIS, especially in the presence of preexisting co-infection with Kaposi's sarcoma-associated herpesvirus.
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Affiliation(s)
- Maura Manion
- National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH), Bethesda, Maryland
| | | | | | - Virginia Sheikh
- National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH), Bethesda, Maryland
| | - Gregg Roby
- National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH), Bethesda, Maryland
| | | | - Dorinda Metzger
- National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH), Bethesda, Maryland
| | - JoAnn M Mican
- National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH), Bethesda, Maryland
| | - Alice Pau
- National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH), Bethesda, Maryland
| | - Andrea Lisco
- National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH), Bethesda, Maryland
| | - Elizabeth Laidlaw
- National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH), Bethesda, Maryland
| | - Dima A Hammoud
- Center for Infectious Diseases Imaging, NIH, Bethesda, Maryland
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | | | - Irini Sereti
- National Institute of Allergy and Infectious Disease, National Institutes of Health (NIH), Bethesda, Maryland
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8
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Watters S, Polizzotto M, Shao W, Gorelick R, Anderson E, Sereti I, Aleman K, Kouyoudjian L, Zeldis J, Uldrick T, Yarchoan R, Maldarelli F. 35 Therapy with the immunomodulatory agent pomalidomide does not lead to changes in HIV-1 viral populations in vivo. J Virus Erad 2016. [DOI: 10.1016/s2055-6640(20)30980-8] [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: 10/23/2022] Open
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9
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Labo N, Miley W, Marshall V, Gillette W, Esposito D, Bess M, Turano A, Uldrick T, Polizzotto MN, Wyvill KM, Bagni R, Yarchoan R, Whitby D. Heterogeneity and breadth of host antibody response to KSHV infection demonstrated by systematic analysis of the KSHV proteome. PLoS Pathog 2014; 10:e1004046. [PMID: 24675986 PMCID: PMC3968157 DOI: 10.1371/journal.ppat.1004046] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 02/17/2014] [Indexed: 01/15/2023] Open
Abstract
The Kaposi sarcoma associated herpesvirus (KSHV) genome encodes more than 85 open reading frames (ORFs). Serological evaluation of KSHV infection now generally relies on reactivity to just one latent and/or one lytic protein (commonly ORF73 and K8.1). Most of the other polypeptides encoded by the virus have unknown antigenic profiles. We have systematically expressed and purified products from 72 KSHV ORFs in recombinant systems and analyzed seroreactivity in US patients with KSHV-associated malignancies, and US blood donors (low KSHV seroprevalence population). We identified several KSHV proteins (ORF38, ORF61, ORF59 and K5) that elicited significant responses in individuals with KSHV-associated diseases. In these patients, patterns of reactivity were heterogeneous; however, HIV infection appeared to be associated with breadth and intensity of serological responses. Improved antigenic characterization of additional ORFs may increase the sensitivity of serologic assays, lead to more rapid progresses in understanding immune responses to KSHV, and allow for better comprehension of the natural history of KSHV infection. To this end, we have developed a bead-based multiplex assay detecting antibodies to six KSHV antigens.
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Affiliation(s)
- Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Wendell Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Vickie Marshall
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - William Gillette
- Protein Expression Laboratory, Advanced Technology Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Dominic Esposito
- Protein Expression Laboratory, Advanced Technology Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Matthew Bess
- Protein Expression Laboratory, Advanced Technology Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Alexandra Turano
- Protein Expression Laboratory, Advanced Technology Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Thomas Uldrick
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Mark N. Polizzotto
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Kathleen M. Wyvill
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Rachel Bagni
- Protein Expression Laboratory, Advanced Technology Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | - Robert Yarchoan
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
- * E-mail:
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10
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Marshall V, Ray A, Han SJ, Uldrick T, Barsov E, Quinones O, Leighty R, Labo N, Wyvill K, Aleman K, Polizzotto MN, Little RF, Ott D, Yarchoan R, Renne R, Whitby D. Genetic variation in KSHV encoded microRNAs affects microRNA expression and is associated with multicentric Castleman’s disease risk. Infect Agent Cancer 2012. [PMCID: PMC3330049 DOI: 10.1186/1750-9378-7-s1-o5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Vickie Marshall
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC-Frederick, National Cancer Institute (NCI)-Frederick, Frederick, MD, USA
| | - Alex Ray
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC-Frederick, National Cancer Institute (NCI)-Frederick, Frederick, MD, USA
| | - Soo-Jin Han
- Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL, USA
| | | | - Eugene Barsov
- Retrovirus Assembly Laboratory, AIDS and Cancer Virus Program, SAIC-Frederick, Frederick, MD, USA
| | - Octavio Quinones
- Data Management Services, Inc, NCI-Frederick, Frederick, MD, USA
| | - Robert Leighty
- Data Management Services, Inc, NCI-Frederick, Frederick, MD, USA
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC-Frederick, National Cancer Institute (NCI)-Frederick, Frederick, MD, USA
| | - Kathy Wyvill
- HIV and AIDS Malignancy Branch, NCI, Bethesda, MD, USA
| | - Karen Aleman
- HIV and AIDS Malignancy Branch, NCI, Bethesda, MD, USA
| | | | | | - David Ott
- Retrovirus Assembly Laboratory, AIDS and Cancer Virus Program, SAIC-Frederick, Frederick, MD, USA
| | | | - Rolf Renne
- Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, FL, USA
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, SAIC-Frederick, National Cancer Institute (NCI)-Frederick, Frederick, MD, USA
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11
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Ray A, Marshall V, Uldrick T, Leighty R, Labo N, Wyvill K, Aleman K, Polizzotto MN, Little RF, Yarchoan R, Whitby D. Sequence analysis of Kaposi sarcoma-associated herpesvirus (KSHV) microRNAs in patients with multicentric Castleman disease and KSHV-associated inflammatory cytokine syndrome. J Infect Dis 2012; 205:1665-76. [PMID: 22448005 DOI: 10.1093/infdis/jis249] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Kaposi sarcoma-associated herpesvirus (KSHV) encodes 12 pre-microRNAs that yield 25 mature microRNAs. We previously reported phylogenetic analysis of the microRNA-coding region of KSHV from Kaposi sarcoma (KS), primary effusion lymphoma (PEL), and multicentric Castleman disease (MCD) patients. We observed a high level of conservation for most sequences but also a divergent cluster of 5 KSHV sequences, including 2 from MCD patients. METHODS KSHV microRNA sequences from 23 MCD patients and 7 patients with a newly described KSHV-associated inflammatory cytokine syndrome (KICS) were examined by amplification, cloning, and sequencing of a 646-bp fragment of K12/T0.7 encoding microRNA-K12-10 and microRNA-K12-12 and a 2.8-kbp fragment containing the remaining 10 pre-microRNAs. RESULTS Phylogenetic analysis showed a distinct variant cluster consisting exclusively of MCD and KICS patients in all trees. Pearson χ(2) analysis revealed that 40 single-nucleotide polymorphisms (SNPs) at various loci were significantly associated with MCD and KICS risk. Cluster analysis of these SNPs generated several combinations of 3 SNPs as putative indicators of MCD and KICS risk. CONCLUSIONS These findings show that MCD and KICS patients frequently have unusual KSHV microRNA sequences and suggest an association between the observed sequence variation and risk of MCD and KICS.
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Affiliation(s)
- Alex Ray
- National Cancer Institute, Frederick, MD, USA
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12
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Mosam A, Shaik F, Uldrick T, Esterhuizen T, Friedland G, Scadden D, Aboobaker J, Coovadia H. HAART and response to therapy improve quality of life (QOL) of African patients with advanced HIV-associated Kaposi’s sarcoma (HIV-KS): a prospective analysis of QOL in the KAART trial. Infect Agent Cancer 2010. [PMCID: PMC3002689 DOI: 10.1186/1750-9378-5-s1-a30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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Uldrick T, Polizzotto M, O’Mahony D, Aleman K, Wyvill K, Steinberg SM, Pittaluga S, Marshall V, Whitby D, Tosato G, Little RF, Yarchoan R. Rituximab combined with liposomal doxorubicin (R-Dox) in HIV-infected patients with severe Kaposi sarcoma-associated herpes virus (KSHV) associated multicentric Castleman disease (MCD). Infect Agent Cancer 2010. [PMCID: PMC3002735 DOI: 10.1186/1750-9378-5-s1-a72] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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14
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Mosam A, Carrara H, Shaik F, Uldrick T, Berkman A, Aboobaker J, Coovadia HM. Increasing incidence of Kaposi's sarcoma in black South Africans in KwaZulu-Natal, South Africa (1983-2006). Int J STD AIDS 2009; 20:553-6. [PMID: 19625587 DOI: 10.1258/ijsa.2008.008372] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of the study was to describe the temporal trends in the incidence of Kaposi's sarcoma (KS) in black South Africans in KwaZulu-Natal (KZN). The study was designed as a retrospective record review. The incidence of Kaposi's sarcoma was estimated using administrative records for patients receiving care for KS through public sector oncology clinics in KZN, 1983-2006. Annual age-standardized incidence rates were calculated using provincial census data for the denominator. Age-specific rates were calculated for the pre-AIDS (1983-1989) and for the generalized AIDS epidemic eras (2006). Age-standardized incidence of KS increased in KZN from <1:100,000 in 1990 to at least 15:100,000 in 2006; this increase was observed in both men and women. There was a shift in the peak age-specific incidence rates from the sixth decade of life in the pre-AIDS era to the fourth and fifth decades in the AIDS era. In conclusion, KS is a growing public health problem in KZN, South Africa. These data reinforce the need for comprehensive national access to and roll-out of antiretroviral drugs, given their success in prevention and treatment of KS in first-world settings.
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Affiliation(s)
- A Mosam
- Department of Dermatology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal.
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15
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Uldrick T, Hesdorffer M, Rasiej MJ, Austin JH, Taub RN. 18FDG-PET in the management of malignant peritoneal mesothelioma: A retrospective review of 145 scans in 37 patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.20519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
20519 Background: Malignant peritoneal mesothelioma is a rare tumor best managed by an interdisciplinary approach. The role of 18FDG-PET scans in monitoring patients with peritoneal mesothelioma has not been defined. Methods: Patients with peritoneal mesothelioma treated at Columbia University (October, 1997 - October, 2006) who had a PET scan were reviewed. Data were gathered on modes of therapy, imaging, and clinical outcome. The frequency with which PET scans led to a change in management, defined as scans that led to a biopsy or initiation of chemotherapy, was evaluated. Results: 37 patients, 21 women (57%) and 16 men (43%), were reviewed. The median age was 50 (range 14 - 79) years. All patients underwent surgery, 35 (95%) intraperitoneal chemotherapy, 15 (41%) external beam radiation, and 17 (46%) intravenous chemotherapy. At 43 (range 8.5 - 127) months median follow-up, 27 (73 %) are alive. Among 145 PET scans, 66 (46%) were PET/CT scans, 52 (26%) were PET scans with a CT scan performed within one month, and 27 (19%) were PET scans only. 8 (6%) of PET scans were for initial staging, and 137 (95%) for monitoring. A change in management based on findings in PET imaging occurred in 11 (30%) patients and 14 (10%) scans. Two patients were started on salvage chemotherapy without further evaluation. Two were diagnosed with peritoneal recurrence, 1 with lung metastasis, 1 with lymph node metastasis, 1 with a second malignancy, and 3 with colon polyps. One had a false positive scan, proven by negative surgical biopsy. PET provided early detection of disease progression in 6 (16%) of patients evaluated. One patient (3%) had biopsy proven progressive disease despite no 18FDG uptake on PET scan. Conclusions: 18FDG-PET findings changed management in 30% of patients with peritoneal mesothelioma undergoing multimodality therapy, and provided early detection of recurrence in 16% of patients. Further evaluation of test characteristics and prognostic value of 18FDG-PET in the setting of peritoneal mesothelioma is warranted. No significant financial relationships to disclose.
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Affiliation(s)
- T. Uldrick
- Columbia University Medical Center, New York, NY
| | | | - M. J. Rasiej
- Columbia University Medical Center, New York, NY
| | - J. H. Austin
- Columbia University Medical Center, New York, NY
| | - R. N. Taub
- Columbia University Medical Center, New York, NY
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16
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Hirano M, Martí R, Casali C, Tadesse S, Uldrick T, Fine B, Escolar DM, Valentino ML, Nishino I, Hesdorffer C, Schwartz J, Hawks RG, Martone DL, Cairo MS, DiMauro S, Stanzani M, Garvin JH, Savage DG. Allogeneic stem cell transplantation corrects biochemical derangements in MNGIE. Neurology 2006; 67:1458-60. [PMID: 16971696 PMCID: PMC4345106 DOI: 10.1212/01.wnl.0000240853.97716.24] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a multisystemic autosomal recessive disease due to primary thymidine phosphorylase (TP) deficiency. To restore TP activity, we performed reduced intensity allogeneic stem cell transplantations (alloSCTs) in two patients. In the first, alloSCT failed to engraft, but the second achieved mixed donor chimerism, which partially restored buffy coat TP activity and lowered plasma nucleosides. Thus, alloSCT can correct biochemical abnormalities in the blood of patients with MNGIE, but clinical efficacy remains unproven.
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Affiliation(s)
- M Hirano
- Department of Neurology, Columbia University Medical Center, 630 W. 168 St., P&S 4-443, New York, NY 10032, USA.
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17
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Uldrick T, Crew K, Tiersten A, Braffman L, Blozie K, Hershman D. Phase II evaluation of liposomal doxorubicin combined with docetaxel in patients with metastatic breast cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.907] [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: 11/20/2022] Open
Affiliation(s)
- T. Uldrick
- Columbia Univ Medcl Ctr, New York, NY; New York Univ, New York, NY
| | - K. Crew
- Columbia Univ Medcl Ctr, New York, NY; New York Univ, New York, NY
| | - A. Tiersten
- Columbia Univ Medcl Ctr, New York, NY; New York Univ, New York, NY
| | - L. Braffman
- Columbia Univ Medcl Ctr, New York, NY; New York Univ, New York, NY
| | - K. Blozie
- Columbia Univ Medcl Ctr, New York, NY; New York Univ, New York, NY
| | - D. Hershman
- Columbia Univ Medcl Ctr, New York, NY; New York Univ, New York, NY
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