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Tombul Z, Bahaj W, Ozturk M, Patel B, Toprak A, Ibrahim I, Chen W, Fuda F, Ogbue OD, Gurnari C, Parker C, Young NS, Maciejewski JP, Duran M, Bat T. Ahemolytic PNH (white cell PNH): Clinical features and implications of a distinct phenotype of paroxysmal nocturnal haemoglobinuria. Br J Haematol 2024; 204:2121-2124. [PMID: 38471793 DOI: 10.1111/bjh.19395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/22/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Zehra Tombul
- Division of Hematology-Oncology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Waled Bahaj
- Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, Ohio, USA
| | - Merve Ozturk
- Division of Hematology-Oncology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Bhavisha Patel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ahmet Toprak
- Division of Hematology-Oncology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Ibrahim Ibrahim
- Division of Hematology-Oncology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Weina Chen
- Department of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Franklin Fuda
- Department of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Olisaemeka D Ogbue
- Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, Ohio, USA
| | - Carmelo Gurnari
- Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Charles Parker
- Division of Hematology and Hematologic Malignancies, Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Neal S Young
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Munevver Duran
- Division of Hematology-Oncology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Taha Bat
- Division of Hematology-Oncology, UT Southwestern Medical Center, Dallas, Texas, USA
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2
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Abdallah J, Williams RG, Awada H, Raman G, Ozcan YM, Orland MD, Mete M, Chen W, Gurnari C, Maciejewski JP, Bat T. Thrombocytosis and megakaryocyte changes associated with PRCA. Blood Adv 2024:bloodadvances.2023012309. [PMID: 38564765 DOI: 10.1182/bloodadvances.2023012309] [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: 11/30/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Affiliation(s)
- Joelle Abdallah
- University of Texas Southwestern Medical School, Dallas, Texas, United States
| | | | - Hussein Awada
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Ganesh Raman
- University of Texas Southwestern Medical School, Dallas, Texas, United States
| | - Yusuf M Ozcan
- University of Texas Dallas, Garland, Texas, United States
| | - Mark David Orland
- Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, United States
| | - Mutlu Mete
- Texas A&M University-Commerce, commerce, Texas, United States
| | - Weina Chen
- UT Southwestern Medical Center at Dallas, Dallas, Texas, United States
| | - Carmelo Gurnari
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | | | - Taha Bat
- University of Texas Southwestern, Dallas, Texas, United States
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3
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Gurnari C, Awada H, Pagliuca S, Dima D, Ullah F, Kawashima N, Kubota Y, Colak C, Visconte V, Patel BJ, Dhillon V, Marneni N, Balasubramanian SK, Kishtagari A, Bat T, Maciejewski JP. Paroxysmal nocturnal hemoglobinuria-related thrombosis in the era of novel therapies: a 2043 patient/years analysis. Blood 2024:blood.2024023988. [PMID: 38513233 DOI: 10.1182/blood.2024023988] [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] [Received: 01/18/2024] [Revised: 02/27/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024] Open
Abstract
Thrombophilia is one of the principal features of paroxysmal nocturnal hemoglobinuria (PNH) and constitutes the main cause of disease morbidity/mortality. Anti-complement treatment has revolutionized the natural history of PNH with control of the hemolytic process and abolition of thrombotic events (TE). However, no guidelines exist for the management of thromboembolic complications in this setting, with type and duration of anti-coagulation depending on individual practices. Besides, a scarcity of data is present on the efficacy of direct oral anti-coagulants (DOACs). Herein, we accrued a large real-world cohort of PNH patients from four US centers to explore features, predictors of TE and anti-coagulation strategies. Among 267 patients followed-up for a total of 2043 patient/years, 56 (21%) developed TE. This occurred at disease onset in 43% of cases, involving more frequently the venous system, typically as Budd-Chiari syndrome. Rate of TE was halved in patients receiving complement inhibitors (21 vs 40 TE per 1000 patient/years in untreated cases, with a 2-year cumulative incidence of thrombosis of 3.9% vs 18.3% respectively), and varied according to PNH granulocytes and erythrocytes clone size, type, disease activity parameters, as well as number (>2 mutations or less) and variant allelic frequency of PIGA mutations. Anti-coagulation with warfarin (39%), DOACs (37%), and low-molecular-weight heparin (16%) was administered for a median of 29 months (9-61.8). No thrombotic recurrence was observed in 19 patients treated with DOACs at a median observation of 17.1 months (8.9-45) while 14 cases discontinued anti-coagulation without TE recurrence at a median time of 51.4 months (29.9-86.8).
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Affiliation(s)
- Carmelo Gurnari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata,, Italy
| | - Hussein Awada
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Simona Pagliuca
- Centre Hospitalier Régional Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Danai Dima
- Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, United States
| | - Fauzia Ullah
- Department of Hematology-Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Naomi Kawashima
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Yasuo Kubota
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | | | | | | | - Vikram Dhillon
- Karmanos Cancer Institute/Wayne State University, Detroit, Michigan, United States
| | - Naimisha Marneni
- Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | | | - Ashwin Kishtagari
- Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Taha Bat
- University of Texas Southwestern, Dallas, Texas, United States
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4
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Kewan T, Durmaz A, Bahaj W, Gurnari C, Terkawi L, Awada H, Ogbue OD, Ahmed R, Pagliuca S, Awada H, Kubota Y, Mori M, Ponvilawan B, Al-Share B, Patel BJ, Carraway HE, Scott J, Balasubramanian SK, Bat T, Madanat Y, Sekeres MA, Haferlach T, Visconte V, Maciejewski JP. Author Correction: Molecular patterns identify distinct subclasses of myeloid neoplasia. Nat Commun 2024; 15:1184. [PMID: 38332139 PMCID: PMC10853187 DOI: 10.1038/s41467-024-45644-x] [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] [Indexed: 02/10/2024] Open
Affiliation(s)
- Tariq Kewan
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
- Department of Hematology and Medical Oncology, Yale University, New Haven, CT, USA.
| | - Arda Durmaz
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Systems Biology and Bioinformatics Department, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Waled Bahaj
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Carmelo Gurnari
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Biomedicine and Prevention, Ph.D. in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Laila Terkawi
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Hussein Awada
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Olisaemeka D Ogbue
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ramsha Ahmed
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Simona Pagliuca
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Clinical Hematology, CHRU de Nancy, Nancy, France
| | - Hassan Awada
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Yasuo Kubota
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Minako Mori
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ben Ponvilawan
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Bayan Al-Share
- Department of Hematology and Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Bhumika J Patel
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Hetty E Carraway
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jacob Scott
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Systems Biology and Bioinformatics Department, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Suresh K Balasubramanian
- Department of Hematology and Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Taha Bat
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yazan Madanat
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mikkael A Sekeres
- Division of Hematology, Sylvester Cancer Center, University of Miami, Miami, FL, USA
| | | | - Valeria Visconte
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Jaroslaw P Maciejewski
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
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5
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Bahaj W, Kewan T, Gurnari C, Durmaz A, Ponvilawan B, Pandit I, Kubota Y, Ogbue OD, Zawit M, Madanat Y, Bat T, Balasubramanian SK, Awada H, Ahmed R, Mori M, Meggendorfer M, Haferlach T, Visconte V, Maciejewski JP. Novel scheme for defining the clinical implications of TP53 mutations in myeloid neoplasia. J Hematol Oncol 2023; 16:91. [PMID: 37537667 PMCID: PMC10401750 DOI: 10.1186/s13045-023-01480-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 03/05/2023] [Accepted: 07/14/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND TP53 mutations (TP53MT) occur in diverse genomic configurations. Particularly, biallelic inactivation is associated with poor overall survival in cancer. Lesions affecting only one allele might not be directly leukemogenic, questioning the presence of cryptic biallelic subclones in cases with dismal prognosis. METHODS We have collected clinical and molecular data of 7400 patients with myeloid neoplasms and applied a novel model by identifying an optimal VAF cutoff using a statistically robust strategy of sampling-based regression on survival data to accurately classify the TP53 allelic configuration and assess prognosis more precisely. RESULTS Overall, TP53MT were found in 1010 patients. Following the traditional criteria, 36% of the cases were classified as single hits, while 64% exhibited double hits genomic configuration. Using a newly developed molecular algorithm, we found that 579 (57%) patients had unequivocally biallelic, 239 (24%) likely contained biallelic, and 192 (19%) had most likely monoallelic TP53MT. Interestingly, our method was able to upstage 192 out of 352 (54.5%) traditionally single hit lesions into a probable biallelic category. Such classification was further substantiated by a survival-based model built after re-categorization. Among cases traditionally considered monoallelic, the overall survival of those with probable monoallelic mutations was similar to the one of wild-type patients and was better than that of patients with a biallelic configuration. As a result, patients with certain biallelic hits, regardless of the disease subtype (AML or MDS), had a similar prognosis. Similar results were observed when the model was applied to an external cohort. In addition, single-cell DNA studies unveiled the biallelic nature of previously considered monoallelic cases. CONCLUSION Our novel approach more accurately resolves TP53 genomic configuration and uncovers genetic mosaicism for the use in the clinical setting to improve prognostic evaluation.
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Affiliation(s)
- Waled Bahaj
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
- Division of Medical Oncology & Hematology, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Tariq Kewan
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
- Division of Hematology & Oncology, Yale School of Medicine, New Haven, CT, USA
| | - Carmelo Gurnari
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
- Department of Biomedicine and Prevention, Ph.D. in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Arda Durmaz
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
| | - Ben Ponvilawan
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
| | - Ishani Pandit
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
| | - Yasuo Kubota
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
| | - Olisaemeka D Ogbue
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
| | - Misam Zawit
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
| | - Yazan Madanat
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taha Bat
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Hussein Awada
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
| | - Ramsha Ahmed
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
| | - Minako Mori
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA
| | | | | | - Valeria Visconte
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA.
| | - Jaroslaw P Maciejewski
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, 9620 Carnegie Ave N Building, Building NE6-250, Cleveland, OH, 44106, USA.
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6
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Kewan T, Durmaz A, Bahaj W, Gurnari C, Terkawi L, Awada H, Ogbue OD, Ahmed R, Pagliuca S, Awada H, Kubota Y, Mori M, Ponvilawan B, Al-Share B, Patel BJ, Carraway HE, Scott J, Balasubramanian SK, Bat T, Madanat Y, Sekeres MA, Haferlach T, Visconte V, Maciejewski JP. Molecular patterns identify distinct subclasses of myeloid neoplasia. Nat Commun 2023; 14:3136. [PMID: 37253784 PMCID: PMC10229666 DOI: 10.1038/s41467-023-38515-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/03/2023] [Indexed: 06/01/2023] Open
Abstract
Genomic mutations drive the pathogenesis of myelodysplastic syndromes and acute myeloid leukemia. While morphological and clinical features have dominated the classical criteria for diagnosis and classification, incorporation of molecular data can illuminate functional pathobiology. Here we show that unsupervised machine learning can identify functional objective molecular clusters, irrespective of anamnestic clinico-morphological features, despite the complexity of the molecular alterations in myeloid neoplasia. Our approach reflects disease evolution, informed classification, prognostication, and molecular interactions. We apply machine learning methods on 3588 patients with myelodysplastic syndromes and secondary acute myeloid leukemia to identify 14 molecularly distinct clusters. Remarkably, our model shows clinical implications in terms of overall survival and response to treatment even after adjusting to the molecular international prognostic scoring system (IPSS-M). In addition, the model is validated on an external cohort of 412 patients. Our subclassification model is available via a web-based open-access resource ( https://drmz.shinyapps.io/mds_latent ).
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Affiliation(s)
- Tariq Kewan
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
- Department of Hematology and Medical Oncology, Yale University, New Haven, CT, USA.
| | - Arda Durmaz
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Systems Biology and Bioinformatics Department, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Waled Bahaj
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Carmelo Gurnari
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Biomedicine and Prevention, Ph.D. in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Laila Terkawi
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Hussein Awada
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Olisaemeka D Ogbue
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ramsha Ahmed
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Simona Pagliuca
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Clinical Hematology, CHRU de Nancy, Nancy, France
| | - Hassan Awada
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Yasuo Kubota
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Minako Mori
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ben Ponvilawan
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Bayan Al-Share
- Department of Hematology and Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Bhumika J Patel
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Hetty E Carraway
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jacob Scott
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Systems Biology and Bioinformatics Department, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Suresh K Balasubramanian
- Department of Hematology and Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Taha Bat
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yazan Madanat
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mikkael A Sekeres
- Division of Hematology, Sylvester Cancer Center, University of Miami, Miami, FL, USA
| | | | - Valeria Visconte
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Jaroslaw P Maciejewski
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
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7
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Hoff FW, Goksu SY, Premnath N, Patel PA, Ikpefan R, Kaur G, Vusirikala M, Bat T, Chen W, Geethakumari PR, Anderson LD, Awan FT, Collins RH, Weinberg OK, Muthukumar A, Chung SS, Madanat YF. SARS-CoV-2 Vaccination IgG Antibody Responses in Patients with Hematologic Malignancies in a Myeloid Enriched Cohort: A Single Center Observation. Acta Med Acad 2023; 52:30-36. [PMID: 37326395 DOI: 10.5644/ama2006-124.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 04/13/2023] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVE Patients diagnosed with hematologic malignancies are at increased risk for severe SARS-CoV-2 infection. We evaluated the serological IgG response following two doses of the SARS-CoV-2 vaccine in patients with hematologic malignancies. METHODS Patients treated at UT Southwestern Medical Center with a diagnosis of a myeloid or lymphoid neoplasm were included. SARS-CoV-2 vaccination response was defined as a positive quantifiable spike IgG antibody titer. RESULTS Sixty patients were included in the study and 60% were diagnosed with a myeloid neoplasm. The majority (85%) of the patients with a myeloid malignancy and 50% of the patients with a lymphoid malignancy mounted a serological response after receiving two doses of the vaccine. CONCLUSION Vaccination should be offered irrespective of ongoing treatment or active disease. Findings require validation in a larger cohort of patients.
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Affiliation(s)
- Fieke W Hoff
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Suleyman Y Goksu
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Naveen Premnath
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Prapti A Patel
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Ruth Ikpefan
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Gurbakhash Kaur
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Madhuri Vusirikala
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Taha Bat
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Weina Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Larry D Anderson
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Farrukh T Awan
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Robert H Collins
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Olga K Weinberg
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Alagarraju Muthukumar
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Stephen S Chung
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA
| | - Yazan F Madanat
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, Dallas, TX, USA.
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8
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Bahaj W, Kewan T, Gurnari C, Durmaz A, Ponvilawan B, Pandit I, Kubota Y, Ogbue OD, Zawit M, Madanat Y, Bat T, Balasubramanian SK, Awada H, Ahmed R, Mori M, Meggendorfer M, Haferlach T, Visconte V, Maciejewski JP. Novel Scheme for Defining the Clinical Implications of TP53 Mutations in Myeloid Neoplasia. Res Sq 2023:rs.3.rs-2656206. [PMID: 36945617 PMCID: PMC10029089 DOI: 10.21203/rs.3.rs-2656206/v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Background: TP53 mutations ( TP53 MT ) occur in diverse genomic configurations. Particularly, biallelic inactivation is associated with poor overall survival in cancer. Lesions affecting only one allele might not be directly leukemogenic, questioning the presence of cryptic biallelic subclones in cases with dismal prognosis. Methods: We have collected clinical and molecular data of 7400 patients with myeloid neoplasms and applied a novel model to properly resolve the allelic configuration of TP53 MT and assess prognosis more precisely. Results: Overall, TP53 MT were found in 1010 patients. Following the traditional criteria, 36% of cases were classified as single hits while 64% exhibited double hits genomic configuration. Using a newly developed molecular algorithm, we found that 579 (57%) patients had unequivocally biallelic, 239 (24%) likely contained biallelic, and 192 (19%) had most likely monoallelic TP53 MT . Such classification was further substantiated by a survival-based model built after re-categorization. Among cases traditionally considered monoallelic, the overall survival of those with probable monoallelic mutations was similar to the one of wild-type patients and was better than that of patients with a biallelic configuration. As a result, patients with certain biallelic hits, regardless of the disease subtype (AML or MDS), had a similar prognosis. Similar results were observed when the model was applied to an external cohort. These results were recapitulated by single-cell DNA studies, which unveiled the biallelic nature of previously considered monoallelic cases. Conclusion: Our novel approach more accurately resolves TP53 genomic configuration and uncovers genetic mosaicism for the use in the clinical setting to improve prognostic evaluation.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Taha Bat
- University of Texas Southwestern Medical Center
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9
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Raman G, Ashraf B, Demir YK, Kershaw CD, Cheruku S, Atis M, Atis A, Atar M, Chen W, Ibrahim I, Bat T, Mete M. Machine learning prediction for COVID-19 disease severity at hospital admission. BMC Med Inform Decis Mak 2023; 23:46. [PMID: 36882829 PMCID: PMC9990559 DOI: 10.1186/s12911-023-02132-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 11/18/2022] [Accepted: 02/06/2023] [Indexed: 03/09/2023] Open
Abstract
IMPORTANCE Early prognostication of patients hospitalized with COVID-19 who may require mechanical ventilation and have worse outcomes within 30 days of admission is useful for delivering appropriate clinical care and optimizing resource allocation. OBJECTIVE To develop machine learning models to predict COVID-19 severity at the time of the hospital admission based on a single institution data. DESIGN, SETTING, AND PARTICIPANTS We established a retrospective cohort of patients with COVID-19 from University of Texas Southwestern Medical Center from May 2020 to March 2022. Easily accessible objective markers including basic laboratory variables and initial respiratory status were assessed using Random Forest's feature importance score to create a predictive risk score. Twenty-five significant variables were identified to be used in classification models. The best predictive models were selected with repeated tenfold cross-validation methods. MAIN OUTCOMES AND MEASURES Among patients with COVID-19 admitted to the hospital, severity was defined by 30-day mortality (30DM) rates and need for mechanical ventilation. RESULTS This was a large, single institution COVID-19 cohort including total of 1795 patients. The average age was 59.7 years old with diverse heterogeneity. 236 (13%) required mechanical ventilation and 156 patients (8.6%) died within 30 days of hospitalization. Predictive accuracy of each predictive model was validated with the 10-CV method. Random Forest classifier for 30DM model had 192 sub-trees, and obtained 0.72 sensitivity and 0.78 specificity, and 0.82 AUC. The model used to predict MV has 64 sub-trees and returned obtained 0.75 sensitivity and 0.75 specificity, and 0.81 AUC. Our scoring tool can be accessed at https://faculty.tamuc.edu/mmete/covid-risk.html . CONCLUSIONS AND RELEVANCE In this study, we developed a risk score based on objective variables of COVID-19 patients within six hours of admission to the hospital, therefore helping predict a patient's risk of developing critical illness secondary to COVID-19.
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Affiliation(s)
- Ganesh Raman
- grid.267313.20000 0000 9482 7121Departments of Internal Medicine and Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Bilal Ashraf
- grid.267313.20000 0000 9482 7121Departments of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Yusuf Kemal Demir
- grid.266859.60000 0000 8598 2218School of Data Science, University of North Carolina at Charlotte, Charlotte, NC USA
| | - Corey D. Kershaw
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Sreekanth Cheruku
- grid.267313.20000 0000 9482 7121Department of Anesthesiology and Pain Management, Divisions of Cardiothoracic Anesthesiology and Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Murat Atis
- grid.267313.20000 0000 9482 7121Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Ahsen Atis
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Mustafa Atar
- grid.239578.20000 0001 0675 4725Cleveland Clinic, Cleveland, OH 44195 USA
| | - Weina Chen
- grid.267313.20000 0000 9482 7121Department of Pathology, Hematopathology Section, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Ibrahim Ibrahim
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Taha Bat
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Mutlu Mete
- grid.264758.a0000 0004 1937 0087Department of Computer Science and Information Systems, Texas A&M University – Commerce, Commerce, TX 75429-3011 USA
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10
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Lee NC, Demir YK, Ashraf B, Ibrahim I, Bat T, Dickerson KE. Immature Platelet Fraction as a Biomarker for Disease Severity in Pediatric Respiratory Coronavirus Disease 2019. J Pediatr 2022; 251:187-189. [PMID: 35944718 PMCID: PMC9356758 DOI: 10.1016/j.jpeds.2022.07.035] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/23/2022] [Accepted: 07/28/2022] [Indexed: 11/28/2022]
Abstract
In this retrospective single-institution cohort study of 113 hospitalized pediatric patients with respiratory coronavirus disease 2019, those admitted to the intensive care unit or requiring mechanical ventilation had significantly higher immature platelet fractions than those who did not require intensive care unit-level care or ventilation. Immature platelet fraction may be an accessible biomarker for disease severity in pediatric respiratory coronavirus disease 2019.
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Affiliation(s)
- Nicholas C.J. Lee
- Departments of Internal Medicine and Pediatrics, University of Texas Southwestern, Dallas, TX
| | - Yusuf Kemal Demir
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC
| | - Bilal Ashraf
- Departments of Internal Medicine and Pediatrics, University of Texas Southwestern, Dallas, TX
| | - Ibrahim Ibrahim
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Taha Bat
- Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Kathryn E. Dickerson
- Department of Pediatrics, Division of Hematology/Oncology, University of Texas Southwestern Medical Center, Dallas, TX,Reprint requests: Kathryn E. Dickerson, MD, MSCS, Department of Pediatrics, Division of Hematology/Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390
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11
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Parikh P, Mohamed M, Bat T, Nero A, Wang A, Yates SG, Ufret-Vincenty RL. Parafoveal acute middle maculopathy (PAMM) in sickle cell disease after discontinuation of hydroxyurea. Am J Ophthalmol Case Rep 2022; 28:101753. [DOI: 10.1016/j.ajoc.2022.101753] [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] [Received: 07/19/2022] [Revised: 10/22/2022] [Accepted: 11/03/2022] [Indexed: 11/13/2022] Open
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12
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Choi SH, Nguyen H, Kanjwal S, Ibrahim I, Bat T, Thomas A, Jeon-Slaughter H. COVID-19 associated Venous Thromboembolism (VTE) burden in Black women: Findings of Veterans Affairs COVID-19 Shared Data. Thromb Res 2022; 217:60-63. [PMID: 35908381 PMCID: PMC9303072 DOI: 10.1016/j.thromres.2022.07.007] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/03/2022] [Accepted: 07/18/2022] [Indexed: 12/04/2022]
Affiliation(s)
- Sung-Hee Choi
- Veterans Affairs North Texas Health Care System, Dallas, TX, United States of America; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Hang Nguyen
- Veterans Affairs North Texas Health Care System, Dallas, TX, United States of America; Southern Methodist University, Dallas, TX, United States of America
| | - Shifa Kanjwal
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Ibrahim Ibrahim
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Taha Bat
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Abey Thomas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Haekyung Jeon-Slaughter
- Veterans Affairs North Texas Health Care System, Dallas, TX, United States of America; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America.
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13
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Ashraf B, Bat T, Weinberg OK, Moe OW, Ibrahim I. “Ideal” parathyroid hormone in erythropoietin‐stimulating agents‐resistant anemia. eJHaem 2022; 3:159-162. [PMID: 35846199 PMCID: PMC9176131 DOI: 10.1002/jha2.316] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 11/08/2022]
Abstract
Erythropoietin‐stimulating agents (ESAs) have revolutionized anemia treatment in end‐stage renal disease (ESRD), but ESA resistance is increasingly identified. Secondary hyperparathyroidism (SHP) is one cause of ESA resistance. We describe a patient with ESA‐resistant, transfusion‐dependent anemia and mild SHP with remodeling and reticulin fibrosis on bone marrow biopsy, all of which resolved with stricter SHP management. We identified 64 patients with anemia, ESRD, and bone marrow biopsy. The parathyroid hormone (PTH) range for bony remodeling was 183–16,161.9 pg/ml versus 90.8–3283 pg/ml. The PTH range for fibrotic changes was 183–2487 pg/ml versus 90.8–16,161.9 pg/ml. We found no clear PTH range predictive for bone marrow changes.
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Affiliation(s)
- Bilal Ashraf
- Division of Hematology and Oncology Department of Internal Medicine University of Texas Southwestern Medical Center Dallas Texas USA
| | - Taha Bat
- Division of Hematology and Oncology Department of Internal Medicine University of Texas Southwestern Medical Center Dallas Texas USA
| | - Olga K. Weinberg
- Department of Pathology Hematopathology Section University of Texas Southwestern Medical Center Dallas Texas USA
| | - Orson W. Moe
- Division of Nephrology Department of Internal Medicine University of Texas Southwestern Medical Center Dallas Texas USA
- Charles and Jane Pak Center for Mineral Metabolism and Clinical Research University of Texas Southwestern Medical Center Dallas Texas USA
| | - Ibrahim Ibrahim
- Division of Hematology and Oncology Department of Internal Medicine University of Texas Southwestern Medical Center Dallas Texas USA
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14
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Jizzini M, Akhtar OS, Atwood K, Ji W, Pleskow J, Bat T, Balderman S. Anti-Xa based dosing of enoxaparin in hematopoietic stem cell transplant and adoptive cell therapy patients: A single center experience. Thromb Res 2022; 211:6-9. [PMID: 35051832 DOI: 10.1016/j.thromres.2022.01.012] [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: 10/23/2021] [Revised: 01/09/2022] [Accepted: 01/11/2022] [Indexed: 10/19/2022]
Affiliation(s)
- Mazen Jizzini
- University at Buffalo, State University of New York, Buffalo, NY, United States of America
| | - Othman Salim Akhtar
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America
| | - Kris Atwood
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America
| | - Wenyan Ji
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America
| | - Jordan Pleskow
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America
| | - Taha Bat
- University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Sophia Balderman
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, United States of America.
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15
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Welder D, Jeon‐Slaughter H, Ashraf B, Choi S, Chen W, Ibrahim I, Bat T. Immature platelets as a biomarker for disease severity and mortality in COVID-19 patients. Br J Haematol 2021; 194:530-536. [PMID: 34132393 PMCID: PMC8444912 DOI: 10.1111/bjh.17656] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 12/19/2022]
Abstract
COVID-19, caused by SARS-CoV-2, is a contagious life-threatening viral disease that has killed more than three million people worldwide to date. Attempts have been made to identify biomarker(s) to stratify disease severity and improve treatment and resource allocation. Patients with SARS-COV-2 infection manifest with a higher inflammatory response and platelet hyperreactivity; this raises the question of the role of thrombopoiesis in COVID-19 infection. Immature platelet fraction (IPF, %) and immature platelet counts (IPC, ×109 /l) can be used to assess thrombopoiesis. This study investigates whether the level of thrombopoiesis correlates with COVID-19 severity. A large cohort of 678 well-characterized COVID-19 patients was analyzed, including 658 (97%) hospitalized and 139 (21%) admitted to the intensive care unit (ICU). Elevated percentage IPF at presentation was predictive of length of hospitalization (P < 0·01) and ICU admission (P < 0·05). Additionally, percentage IPF at the peak was significantly higher among ICU patients than non-ICU patients (6·9 ± 5·1 vs 5·3 ± 8·4, P < 0·01) and among deceased patients than recovered patients (7·9 ± 6·3 vs 5·4 ± 7·8, P < 0·01). Furthermore, IPC at the peak was significantly higher among ICU patients than non-ICU patients (18·5 ± 16·2 vs. 13·2 ± 8·3, P < 0·05) and among patients on a ventilator than those not (22·1 ± 20·1 vs.13·4 ± 8·4, P < 0·05). Our study demonstrated that elevated initial and peak values of percentage IPF and IPC might serve as prognostic biomarkers for COVID-19 progression to severe conditions.
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Affiliation(s)
- Daniel Welder
- Department of Pathology, Hematopathology SectionUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Haekyung Jeon‐Slaughter
- Department of Internal MedicineVA North Texas Health Care SystemUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Bilal Ashraf
- Department of Internal MedicineDivision of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Sung‐Hee Choi
- Department of Internal MedicineVA North Texas Health Care System and Division of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Weina Chen
- Department of Pathology, Hematopathology SectionUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Ibrahim Ibrahim
- Department of Internal MedicineDivision of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
| | - Taha Bat
- Department of Internal MedicineDivision of Hematology and OncologyUniversity of Texas Southwestern Medical CenterDallasTXUSA
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16
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Bat T, Buck DA, Nathan R, Cinquino J, Sikorski M, Elefante A, Herbst L, Sule N, Fabiano A, George S. Advanced Bladder Cancer Rechallenged With an Immune Checkpoint Inhibitor: A Case Report. Urology 2019; 131:24-26. [PMID: 31059726 DOI: 10.1016/j.urology.2019.04.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/17/2019] [Accepted: 04/23/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Taha Bat
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Dennis A Buck
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Rachel Nathan
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | | | | | | | - Laurie Herbst
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Norbert Sule
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | | | - Saby George
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
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17
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Balasubramanian SK, Aly M, Nagata Y, Bat T, Przychodzen BP, Hirsch CM, Adema V, Visconte V, Kuzmanovic T, Radivoyevitch T, Nazha A, Mukherjee S, Sekeres MA, Maciejewski JP. Distinct clinical and biological implications of various DNMT3A mutations in myeloid neoplasms. Leukemia 2017; 32:550-553. [PMID: 28935992 DOI: 10.1038/leu.2017.295] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- S K Balasubramanian
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - M Aly
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - Y Nagata
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - T Bat
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - B P Przychodzen
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - C M Hirsch
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - V Adema
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - V Visconte
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - T Kuzmanovic
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - T Radivoyevitch
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
| | - A Nazha
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - S Mukherjee
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - M A Sekeres
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.,Department of Hematology and Medical Oncology, Leukemia Program, Cleveland Clinic, Cleveland, OH, USA
| | - J P Maciejewski
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, USA
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18
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Bat T, Abdelhamid ON, Balasubramanian SK, Mai A, Radivoyevitch T, Clemente M, Maciejewski JP. The evolution of paroxysmal nocturnal haemoglobinuria depends on intensity of immunosuppressive therapy. Br J Haematol 2017; 182:730-733. [PMID: 28804905 DOI: 10.1111/bjh.14862] [Citation(s) in RCA: 14] [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: 11/30/2022]
Affiliation(s)
- Taha Bat
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Omnia N Abdelhamid
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Suresh K Balasubramanian
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Aly Mai
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tomas Radivoyevitch
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Michael Clemente
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jaroslaw P Maciejewski
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
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19
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Bat T, Bat BE, El-Moghraby A, Patel S, Feng X, Dunbar CE, Sarac E. Thrombopoietic status of patients on haemodialysis. Br J Haematol 2016; 172:954-7. [PMID: 26887628 DOI: 10.1111/bjh.13918] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/06/2015] [Indexed: 12/20/2022]
Abstract
Thrombocytopenia is a potential dialysis-related treatment complication. Developments in bio-compatible dialyser membranes have decreased the occurrence of thrombocytopenia. We investigated whether thrombopoiesis is impaired in haemodialysis patients by measuring the thrombopoietin level and absolute immature platelet number (AIPN) in the blood of patients undergoing haemodialysis. Samples were collected from the dialysis tubing pre- and post- haemodialysis in a cohort of 45 well-characterized haemodialysis patients. Thrombopoietin levels and AIPN increased following haemodialysis, despite no change in platelet count. Observed increase in release of immature platelets from the bone marrow following haemodialysis indicates possible complement activation secondary to interaction between blood constituents and the dialysis membrane.
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Affiliation(s)
- Taha Bat
- Western Reserve Health Education, Northeastern Ohio Medical University (NEOMED), Youngstown, OH, USA
| | - Betul E Bat
- Western Reserve Health Education, Northeastern Ohio Medical University (NEOMED), Youngstown, OH, USA
| | - Ahmed El-Moghraby
- Western Reserve Health Education, Northeastern Ohio Medical University (NEOMED), Youngstown, OH, USA
| | - Samir Patel
- Western Reserve Health Education, Northeastern Ohio Medical University (NEOMED), Youngstown, OH, USA
| | - Xingmin Feng
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Cynthia E Dunbar
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Erdal Sarac
- Western Reserve Health Education, Northeastern Ohio Medical University (NEOMED), Youngstown, OH, USA
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20
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Glait-Santar C, Desmond R, Feng X, Bat T, Chen J, Heuston E, Mizukawa B, Mulloy JC, Bodine DM, Larochelle A, Dunbar CE. Functional Niche Competition Between Normal Hematopoietic Stem and Progenitor Cells and Myeloid Leukemia Cells. Stem Cells 2015; 33:3635-42. [PMID: 26388434 DOI: 10.1002/stem.2208] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 02/04/2015] [Revised: 07/23/2015] [Accepted: 08/24/2015] [Indexed: 12/23/2022]
Abstract
Hematopoietic stem and progenitor cells (HSPCs) reside in a specialized niche that regulates their proliferative capacity and their fate. There is increasing evidence for similar roles of marrow niches on controlling the behavior of leukemic cells; however, whether normal hematopoietic stem cell (HSC) and leukemic cells reside in or functionally compete for the same marrow niche is unclear. We used the mixed lineage leukemia-AF9 (MLL-AF9) murine acute myeloid leukemia (AML) in a competitive repopulation model to investigate whether normal HSPC and leukemic cells functionally compete for the same marrow niches. Irradiated recipient mice were transplanted with fixed numbers of MLL-AF9 cells mixed with increasing doses of normal syngeneic whole bone marrow (WBM) or with purified HSPC (LSK). Survival was significantly increased and leukemic progression was delayed proportional to increasing doses of normal WBM or normal LSK cells in multiple independent experiments, with all doses of WBM or LSK cells studied above the threshold for rapid and complete hematopoietic reconstitution in the absence of leukemia. Confocal microscopy demonstrated nests of either leukemic cells or normal hematopoietic cells but not both in the marrow adjacent to endosteum. Early following transplantation, leukemic cells from animals receiving lower LSK doses were cycling more actively than in those receiving higher doses. These results suggest that normal HSPC and AML cells compete for the same functional niche. Manipulation of the niche could impact on response to antileukemic therapies, and the numbers of normal HSPC could impact on leukemia outcome, informing approaches to cell dose in the context of stem cell transplantation.
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Affiliation(s)
- Chen Glait-Santar
- Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ronan Desmond
- Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.,Department of Haematology, Tallaght Hospital, Dublin, Ireland
| | - Xingmin Feng
- Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Taha Bat
- Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jichun Chen
- Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Elisabeth Heuston
- Genetics and Molecular Biology Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Benjamin Mizukawa
- Division of Experimental Hematology and Cancer Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - James C Mulloy
- Division of Experimental Hematology and Cancer Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - David M Bodine
- Genetics and Molecular Biology Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Andre Larochelle
- Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Cynthia E Dunbar
- Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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Affiliation(s)
- Taha Bat
- Department of Internal Medicine, Northeastern Ohio University College of Medicine (NEOUCOM), Youngstown, Ohio, USA
| | - Charles M Morgan
- Department of General Surgery, Northeastern Ohio University College of Medicine (NEOUCOM), Youngstown, Ohio, USA
| | - Robert Marx
- General Surgery, Northside Medical Center, Youngstown, Ohio, USA
| | - Rebecca S Bailey
- Department of Internal Medicine, Northeastern Ohio University College of Medicine (NEOUCOM), Youngstown, Ohio, USA
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Bat T, Steinberg SM, Childs R, Calvo KR, Barrett AJ, Battiwalla M, Baird K, Zhang D, Pulanic D, Dunbar CE, Pavletic SZ. Active thrombopoiesis is associated with worse severity and activity of chronic GVHD. Bone Marrow Transplant 2013; 48:1569-73. [PMID: 23832091 DOI: 10.1038/bmt.2013.95] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/22/2013] [Accepted: 05/25/2013] [Indexed: 11/09/2022]
Abstract
Chronic GVHD (cGVHD) is a major complication of allogeneic hematopoietic SCT. Post transplant thrombocytopenia in patients with cGVHD has been associated with poor outcome and its etiology is unclear. We investigated whether thrombopoiesis, assessed via measurement of the absolute immature platelet number (AIPN) in the blood, is impaired in cGVHD, and whether the level of thrombopoiesis correlates with the severity and activity of cGVHD as assessed via the National Institutes of Health (NIH) organ scoring system. We used a cohort of 110 well-characterized cGVHD patients, including 83 (75%) with severe cGVHD per NIH global score. Higher AIPN was associated with active therapeutic intent (P=0.026), lower Karnofsky score (P=0.0013), worse joint/fascia cGVHD (P=0.0005) and worse skin cGVHD (P=0.0044). AIPN correlated with platelet counts and was not correlated with ANC, WBC, C-reactive protein (CRP), absolute lymphocyte count (ALC), albumin, total and average NIH scores, or number of prior systemic therapies. AIPN values for cGVHD patients substantially overlapped those of the normal population. Higher AIPN, as marker of active thrombopoiesisis, was associated with worse severity and activity of cGVHD, especially skin and joints/fascia manifestations. Among patients with stable moderate or severe cGVHD, there was no evidence of hypoproduction of platelets. Future studies should further investigate the role of thrombopoiesis in cGVHD.
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Affiliation(s)
- T Bat
- Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Bat T, Leitman SF, Calvo KR, Chauvet D, Dunbar CE. Measurement of the absolute immature platelet number reflects marrow production and is not impacted by platelet transfusion. Transfusion 2012; 53:1201-4. [PMID: 23043309 DOI: 10.1111/j.1537-2995.2012.03918.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 08/14/2012] [Accepted: 08/22/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND The ability to distinguish increased platelet (PLT) destruction from PLT hypoproduction is important in the care of patients with marrow failure syndromes and patients receiving high-dose chemotherapy. The measurement of immature circulating PLTs based on RNA content using an automated counter is now feasible. This study evaluated the impact of recent PLT transfusion on measurement of immature PLT variables. STUDY DESIGN AND METHODS The immature PLT fraction (IPF) and absolute immature PLT number (AIPN) were measured using a hematology analyzer before and after PLT transfusion in nine transfusion-dependent patients with marrow failure secondary to aplastic anemia, myelodysplasia, or transplantation conditioning. IPF and AIPN were also measured serially over 5 days of storage in three plateletpheresis components collected from normal donors. RESULTS PLT transfusion did not significantly change the mean AIPN in transfused patients. In contrast, IPF decreased significantly from 6.6 ± 4.6% on Day -1 to 2.3 ± 1.4% on Day 0 before returning to 4.3 ± 2.3% on Day +1. In the PLT component, AIPN and IPF% increased significantly over 5 days of storage, most likely due to an artifact of the staining and detection process for stored PLTs, no longer detected in vivo once the PLTs were transfused. CONCLUSION PLT transfusion decreases the IPF due to the resultant increase in circulating PLT count. However, PLT transfusion does not change the circulating AIPN, validating this assay as a reflection of ongoing PLT production by the marrow in various clinical settings, regardless of proximity to PLT transfusion.
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Affiliation(s)
- Taha Bat
- Hematology Branch, National Heart, Lung, and BloodInstitute, National Institutes of Health, Bethesda, MD 20892, USA
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