360 results on '"Snowden, JA"'
Search Results
2. Association of genetic variants with patient reported quality of life and pain experience in patients in the UK NCRI Myeloma X Relapse [Intensive]) trial; an exploratory study
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Snowden, JA, Ahmedzai, SH, Cox, A, Cairns, DA, Ashcroft, AJ, Williams, C, Cavenagh, JD, Hockaday, A, Brown, JM, Brock, IW, Morris, TCM, Cook, G, and on behalf of the National Cancer Research Institute Haemato-onco
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The Myeloma X trial provided a platform to explore genetics in relation to systematic assessment of patient-reported outcomes at key points during salvage treatment in multiple myeloma (MM) patients. Blood DNA was obtained in 191 subjects for single nucleotide polymorphism (SNP) genotyping. By univariable analysis, the non-coding rs2562456 SNP, upstream of LINC00664, was associated with several relevant pain and health-related quality-of-life (HRQoL) scores at 100 days after allocation to consolidation with autologous stem cell transplantation or weekly cyclophosphamide. Presence of the minor (C) allele was associated with lower pain interference (p = 0.014) and HRQoL pain (p = 0.003), and higher HRQoL global health status (p = 0.011) and physical functioning (p = 0.007). These effects were not modified by treatment arm and were no longer significant at 6 months. Following induction therapy, the rs13361160 SNP near the CCT5 and FAM173B genes was associated with higher global health (p = 0.027) and physical functioning (p = 0.013). This exploratory study supports associations between subjective parameters in MM with SNPs previously identified in genome-wide association studies of pain. Conversely, SNPs in candidate genes involved in opioid and transporter pathways showed no effect. Further studies are warranted in well-defined cancer populations, and potentially assisted by whole genome sequencing with germline analysis in routine diagnostics in haematological cancers.
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- 2022
3. Haematopoietic stem cell transplantation for severe autoimmune diseases in children : a review of current literature, registry activity and future directions on behalf of the autoimmune diseases and paediatric diseases working parties of the European Society for Blood and Marrow Transplantation
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Achini‐Gutzwiller, FR, Snowden, JA, Corbacioglu, S, Greco, R, Alexander, T, Snowden, J, Badoglio, M, Labopin, M, Abinun, M, Apte, S, Arnold, R, Domenech, A, Brierley, C, Burman, J, Castilla‐Llorente, C, Cooper, N, Daghia, G, Daikeler, T, del Papa, N, de Vries‐Bouwstra, J, Farge, D, Finke, J, Hagglund, H, Hawkey, C, Henes, J, Hiepe, F, Jessop, H, Kiely, D, Kazmi, M, Kirgizov, K, Kramer, E, Mancardi, G, Marjanovic, Z, Martin, R, Martin, T, Ma, D, Moore, J, Miller, P, Muraro, P, Oliveira, M, Polushin, A, Onida, F, Simoes, B, Puyade, M, Resnick, I, Ricart, E, Rovira, M, Saccardi, R, Saif, M, Sakellari, I, Sharrack, B, Snarski, E, Scherer, HU, Sossa, C, Withers, B, Wulffraat, N, Zaccara, E, Amrolia, P, Ansari, M, Balduzzi, A, Dalassier, A, Dalle, J, Diaz, CH, Feuchtinger, T, Locatelli, F, Lucchini, G, Galimard, J, Vincent, MG, Handgretinger, R, Kleinschmidt, K, Lawitschka, A, Martinez, AP, Peters, C, Rocha, V, Ruggeri, A, Sedlacek, P, Svec, P, Toporski, J, Yesilipek, A, Achini-Gutzwiller, F, Snowden, J, Corbacioglu, S, Greco, R, Alexander, T, Badoglio, M, Labopin, M, Abinun, M, Apte, S, Arnold, R, Domenech, A, Brierley, C, Burman, J, Castilla-Llorente, C, Cooper, N, Daghia, G, Daikeler, T, del Papa, N, de Vries-Bouwstra, J, Farge, D, Finke, J, Hagglund, H, Hawkey, C, Henes, J, Hiepe, F, Jessop, H, Kiely, D, Kazmi, M, Kirgizov, K, Kramer, E, Mancardi, G, Marjanovic, Z, Martin, R, Martin, T, Ma, D, Moore, J, Miller, P, Muraro, P, Oliveira, M, Polushin, A, Onida, F, Simoes, B, Puyade, M, Resnick, I, Ricart, E, Rovira, M, Saccardi, R, Saif, M, Sakellari, I, Sharrack, B, Snarski, E, Scherer, H, Sossa, C, Withers, B, Wulffraat, N, Zaccara, E, Amrolia, P, Ansari, M, Balduzzi, A, Dalassier, A, Dalle, J, Diaz, C, Feuchtinger, T, Locatelli, F, Lucchini, G, Galimard, J, Vincent, M, Handgretinger, R, Kleinschmidt, K, Lawitschka, A, Martinez, A, Peters, C, Rocha, V, Ruggeri, A, Sedlacek, P, Svec, P, Toporski, J, and Yesilipek, A
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autoimmune diseases, haematopoietic stem cell transplantation, paediatric ,ddc:610 ,paediatric ,surgical procedures, operative ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,haematopoietic stem cell transplantation ,610 Medizin ,autoimmune diseases ,autoimmune disease ,Hematology - Abstract
Although modern clinical management strategies have improved the outcome of paediatric patients with severe autoimmune and inflammatory diseases over recent decades, a proportion will experience ongoing or recurrent/relapsing disease activity despite multiple therapies often leading to irreversible organ damage, and compromised quality of life, growth/development and long-term survival. Autologous and allogeneic haematopoietic stem cell transplantation (HSCT) have been used successfully to induce disease control and often apparent cure of severe treatment-refractory autoimmune diseases (ADs) in children. However, transplant-related outcomes are disease-dependent and long-term outcome data are limited in respect to efficacy and safety. Moreover, balancing risks of HSCT against AD prognosis with continually evolving non-transplant options is challenging. This review appraises published literature on HSCT strategies and outcomes in individual paediatric ADs. We also provide a summary of the European Society for Blood and Marrow Transplantation (EBMT) Registry, where 343 HSCT procedures (176 autologous and 167 allogeneic) have been reported in 326 children (
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- 2022
4. One and a half million hematopoietic stem cell transplants: continuous and differential improvement in worldwide access with the use of non-identical family donors.
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Niederwieser, D, Baldomero, H, Bazuaye, N, Bupp, C, Chaudhri, N, Corbacioglu, S, Elhaddad, A, Frutos, C, Galeano, S, Hamad, N, Hamidieh, AA, Hashmi, S, Ho, A, Horowitz, MM, Iida, M, Jaimovich, G, Karduss, A, Kodera, Y, Kröger, N, Péffault de Latour, R, Lee, JW, Martínez-Rolón, J, Pasquini, MC, Passweg, J, Paulson, K, Seber, A, Snowden, JA, Srivastava, A, Szer, J, Weisdorf, D, Worel, N, Koh, MBC, Aljurf, M, Greinix, H, Atsuta, Y, Saber, W, Niederwieser, D, Baldomero, H, Bazuaye, N, Bupp, C, Chaudhri, N, Corbacioglu, S, Elhaddad, A, Frutos, C, Galeano, S, Hamad, N, Hamidieh, AA, Hashmi, S, Ho, A, Horowitz, MM, Iida, M, Jaimovich, G, Karduss, A, Kodera, Y, Kröger, N, Péffault de Latour, R, Lee, JW, Martínez-Rolón, J, Pasquini, MC, Passweg, J, Paulson, K, Seber, A, Snowden, JA, Srivastava, A, Szer, J, Weisdorf, D, Worel, N, Koh, MBC, Aljurf, M, Greinix, H, Atsuta, Y, and Saber, W
- Abstract
The Worldwide Network of Blood and Marrow Transplantation (WBMT) pursues the mission of promoting hematopoietic cell transplantation (HCT) for instance by evaluating activities through member societies, national registries and individual centers. In 2016, 82,718 first HCT were reported by 1,662 HCT teams in 86 of the 195 World Health Organization member states representing a global increase of 6.2% in autologous HCT and 7.0% in allogeneic HCT and bringing the total to 1,298,897 procedures. Assuming a frequency of 84,000/year, 1.5 million HCT were performed by 2019 since 1957. Slightly more autologous (53.5%) than allogeneic and more related (53.6%) than unrelated HCT were reported. A remarkable increase was noted in haploidentical related HCT for leukemias and lymphoproliferative diseases, but even more in non-malignant diseases. Transplant rates (TR; HCT/10 million population) varied according to region reaching 560.8 in North America, 438.5 in Europe, 76.7 in Latin America, 53.6 in South East Asia/Western Pacific (SEA/WPR) and 27.8 in African/East Mediterranean (AFR/EMR). Interestingly, haploidentical TR amounted to 32% in SEA/WPR and 26% in Latin America, but only 14% in Europe and EMR and 4.9% in North America of all allogeneic HCT. HCT team density (teams/10 million population) was highest in Europe (7.7) followed by North America (6.0), SEA/WPR (1.9), Latin America (1.6) and AFR/EMR (0.4). HCT are increasing steadily worldwide with narrowing gaps between regions and greater increase in allogeneic compared to autologous activity. While related HCT is rising, largely due to increase in haploidentical HCT, unrelated HCT is plateauing and cord blood HCT is in decline.
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- 2022
5. Management of adults and children receiving CAR T- cell therapy: 2021 best practice recommendations of the European Society for Blood and Marrow Transplantation (EBMT) and the Joint Accreditation Committee of ISCT and EBMT (JACIE) and the European Haematology Association (EHA)
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Hayden, PJ, Roddie, C, Bader, P, Basak, GW, Bonig, H, Bonini, C, Chabannon, C, Ciceri, F, Corbacioglu, S, Ellard, R, Sanchez-Guijo, F, Jäger, U, Hildebrandt, M, Hudecek, M, Kersten, MJ, Köhl, U, Kuball, J, Mielke, S, Mohty, M, Murray, J, Nagler, A, Rees, J, Rioufol, C, Saccardi, R, Snowden, JA, Styczynski, J, Subklewe, M, Thieblemont, C, Topp, M, Ispizua, ÁU, Chen, D, Vrhovac, Radovan, Gribben, JG, Kröger, N, Einsele, H, and Yakoub-Agha, I
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CAR T-cell therapy ,best practice recommendations - Abstract
Background: Several commercial and academic autologous chimeric antigen receptor T-cell (CAR-T) products targeting CD19 have been approved in Europe for relapsed/refractory B-cell acute lymphoblastic leukemia, high-grade B-cell lymphoma and mantle cell lymphoma. Products for other diseases such as multiple myeloma and follicular lymphoma are likely to be approved by the European Medicines Agency in the near future. Design: The European Society for Blood and Marrow Transplantation (EBMT)-Joint Accreditation Committee of ISCT and EBMT (JACIE) and the European Haematology Association collaborated to draft best practice recommendations based on the current literature to support health care professionals in delivering consistent, high-quality care in this rapidly moving field. Results: Thirty-six CAR-T experts (medical, nursing, pharmacy/laboratory) assembled to draft recommendations to cover all aspects of CAR-T patient care and supply chain management, from patient selection to long-term follow-up, post- authorisation safety surveillance and regulatory issues. Conclusions: We provide practical, clinically relevant recommendations on the use of these high- cost, logistically complex therapies for haematologists/oncologists, nurses and other stakeholders including pharmacists and health sector administrators involved in the delivery of CAR-T in the clinic. Keywords: B-cell acute lymphoblastic leukemia (B ALL) ; CAR T-cells ; cytokine release syndrome (CRS) ; immune effector cell associated neurotoxicity syndrome (ICANS) ; large B-cell lymphoma (LBCL) ; multiple myeloma (MM).
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- 2022
6. Autologous haematopoietic stem cell transplantation as a first-line disease-modifying therapy in patients with ‘aggressive’ multiple sclerosis
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Das, J, primary, Snowden, JA, additional, Burman, J, additional, Freedman, MS, additional, Atkins, H, additional, Bowman, M, additional, Burt, RK, additional, Saccardi, R, additional, Innocenti, C, additional, Mistry, S, additional, Laud, PJ, additional, Jessop, H, additional, and Sharrack, B, additional
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- 2021
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7. Safety and Efficacy of Autologous Stem Cell Transplantation in Dialysis-Dependent Myeloma Patients – the Diadem Study from the Chronic Malignancies Working Party of the EBMT
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Gyan, E, Schroyens, W, Potter, V, Nikolousis, M, Basak, GW, Sever, M, Baurmann, H, Bulabois, CE, ARAT, MUTLU, Ills, A, Dreger, P, Snowden, JA, ÖZKURT, ZÜBEYDE NUR, Guffroy, B, Sirait, T, Wreede, LC, Wang, J, Anna, WG, Hayden, PJ, Serna, J, BEKSAÇ, MERAL, Gorkom, GV, Schönland, SO, and YakoubAgha, I
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- 2019
8. Collection of hematopoietic stem cells from patients with autoimmune diseases
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Burt, RK, Fassas, A, Snowden, JA, van Laar, JM, Kozak, T, Wulffraat, NM, Nash, RA, Dunbar, CE, Arnold, R, Prentice, G, Bingham, S, Marmont, AM, and McSweeney, PA
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- 2001
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9. Assessment of cardiotoxicity during haemopoietic stem cell transplantation with plasma brain natriuretic peptide
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Snowden, JA, Hill, GR, Hunt, P, Carnoutsos, S, Spearing, RL, Espiner, E, and Hart, DNJ
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- 2000
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10. Autologous haematopoietic stem cell transplants for autoimmune disease – feasibility and transplant-related mortality
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Tyndall, A, Fassas, A, Passweg, J, Ruiz de Elvira, C, Attal, M, Brooks, P, Black, C, Durez, P, Finke, J, Forman, S, Fouillard, L, Furst, D, Holmes, JA, Joske, D, Jouet, JP, Kötter, I, Locatelli, F, Prentice, HG, Marmont, AM, McSweeney, P, Musso, M, Peter, HH, Snowden, JA, Sullivan, K, Tichelli, A, Vavriec, J, Wulffraat, NM, Schmitz, N, and Gratwohl, A
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- 1999
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11. A randomised, blinded, placebo-controlled, dose escalation study of the tolerability and efficacy of filgrastim for haemopoietic stem cell mobilisation in patients with severe active rheumatoid arthritis
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Snowden, JA, Biggs, JC, Milliken, ST, Fuller, A, Staniforth, D, Passuello, F, Renwick, J, and Brooks, PM
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- 1998
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12. Prolonged remission of longstanding systemic lupus erythematosus after autologous bone marrow transplant for non-Hodgkin’s lymphoma
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Snowden, JA, Patton, WN, O’Donnell, JL, Hannah, EE, and Hart, DNJ
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- 1997
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13. Patient-reported outcome results from the open-label, randomized phase III myeloma X trial evaluating salvage autologous stem-cell transplantation in relapsed multiple myeloma
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Ahmedzai, SH, Snowden, JA, Ashcroft, AJ, Cairns, DA, Williams, C, Hockaday, A, Cavenagh, JD, Ademokun, D, Tholouli, E, Allotey, D, Dhanapal, V, Jenner, M, Yong, K, Cavet, J, Hunter, H, Bird, JM, Pratt, G, Parrish, C, Brown, JM, Morris, TCM, Cook, G, and NCRI Haemato-Oncology Clinical Studies Group
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humanities - Abstract
PURPOSE: Salvage autologous stem-cell transplantation (sASCT) in patients with multiple myeloma (MM) relapsing after a prior autologous stem-cell transplantation leads to increased remission duration and overall survival. We report a comprehensive study on patient-reported outcomes, including quality of life (QoL) and pain in sASCT. \ud \ud \ud \ud METHODS: Patients were randomly assigned to either sASCT or nontransplantation consolidation (NTC). Pain and QoL were assessed as secondary outcomes using validated QoL instruments (European Organisation for Research and Treatment of Cancer QLQ-C30 and myeloma-specific module, QLQ-MY20; the Brief Pain Inventory [Short Form]; and the Leeds Assessment of Neuropathic Symptoms and Signs [Self-Assessment] scale). \ud \ud \ud \ud RESULTS: A total of 288 patients (> 96%) consented to the QoL substudy. The median follow-up was 52 months. The European Organisation for Research and Treatment of Cancer QLQ-C30 Global health status scores were higher (better) in the NTC group at 100 days after random assignment ( P = .0496), but not at later time points. Pain interference was higher (worse) in the sASCT group than in the NTC group at 6 months after random assignment ( P = .0267), with patients with sASCT reporting higher scores for Pain interference with daily living for up to 2 years after random assignment. Patients reporting lower concerns about adverse effects of treatment after sASCT had a time to progression advantage. \ud \ud \ud \ud CONCLUSION: Patients with sASCT with relapsed MM demonstrated a comparative reduction in QoL and greater impact of treatment adverse effects lasting for 6 months and up to 2 years for pain, after which patients who had received sASCT reported better outcomes. Patients who experienced lower adverse effects after sASCT had longer time to progression and overall survival, showing the need to improve symptom management peritransplantation. To our knowledge, this study provides the most comprehensive picture of QoL before and after sASCT in patients with relapsed MM.
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- 2019
14. Current Practice in Vitamin D Management in Allogeneic Hematopoietic Stem Cell Transplantation: A Survey by the Transplant Complications Working Party of the European Society for Blood and Marrow Transplantation
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Ros-Soto, J, Snowden, JA, Salooja, N, Gilleece, M, Parker, A, Greenfield, DM, Anthias, C, Alfred, A, Harrington, A, Peczynski, C, Peggs, K, Madrigal, A, Basak, GW, Schoemans, H, and Transplant Complications Working Party of the EBMT
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MECHANISM ,Male ,D SUPPLEMENTATION ,medicine.medical_specialty ,Transplantation Conditioning ,medicine.medical_treatment ,Immunology ,Post-transplant complications ,Hematopoietic stem cell transplantation ,Disease ,vitamin D deficiency ,D DEFICIENCY ,03 medical and health sciences ,0302 clinical medicine ,Transplant complications ,Surveys and Questionnaires ,VERSUS-HOST-DISEASE ,ADOLESCENTS ,Vitamin D and neurology ,D METABOLISM ,Medicine ,Humans ,Transplantation, Homologous ,In patient ,ENDOCRINE ,Vitamin D ,Survey ,Intensive care medicine ,Transplantation ,Science & Technology ,business.industry ,Marrow transplantation ,LONG-TERM SURVIVORS ,Hematopoietic Stem Cell Transplantation ,Hematology ,medicine.disease ,Vitamin D Deficiency ,Europe ,surgical procedures, operative ,Current practice ,030220 oncology & carcinogenesis ,LIFE-STYLE ,Female ,business ,Life Sciences & Biomedicine ,Supportive care ,030215 immunology - Abstract
Beyond its impact on bone health, numerous studies have investigated the immune-regulatory properties of vitamin D and shown how its deficiency can affect outcomes in allogeneic hematopoietic stem cell transplantation (HSCT), particularly in acute or chronic graft-versus-host disease. This survey, carried out by the Transplant Complications Working Party of the European Society for Blood and Marrow Transplantation (EBMT), describes the current clinical practice discrepancies across the EBMT HSCT programs. We therefore recommend the development of evidence-based guidelines to standardize evaluation criteria and to harmonize the management of vitamin D deficiency in patients undergoing allogeneic HSCT. ispartof: Biology Of Blood And Marrow Transplantation vol:25 issue:10 pages:2079-2085 ispartof: location:United States status: published
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- 2019
15. Pre-transplantation Risks and Transplant-Techniques in Haematopoietic Stem Cell Transplantation for Acute Leukaemia
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Gratwohl, A, Duarte, R, Snowden, JA, v.d. Biezen, A, Baldomero, H, Apperley, J, Cornelissen, Jan, Putter, H, Brand, R, Gratwohl, A, Duarte, R, Snowden, JA, v.d. Biezen, A, Baldomero, H, Apperley, J, Cornelissen, Jan, Putter, H, and Brand, R
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- 2019
16. Allogeneic bone marrow transplantation from a donor with severe active rheumatoid arthritis not resulting in adoptive transfer of disease to recipient
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Snowden, JA, Atkinson, K, Kearney, P, Brooks, P, and Biggs, JC
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- 1997
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17. The role of ixazomib as an augmented conditioning therapy in salvage autologous stem cell transplant (ASCT) and as a post-ASCT consolidation and maintenance strategy in patients with relapsed multiple myeloma (ACCoRd [UK-MRA Myeloma XII] trial): study protocol for a Phase III randomised controlled trial
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Striha, A, Ashcroft, AJ, Hockaday, A, Cairns, DA, Boardman, K, Jacques, G, Williams, C, Snowden, JA, Garg, M, Cavenagh, J, Yong, K, Drayson, MT, Owen, R, Cook, M, and Cook, G
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Boron Compounds ,Male ,Neoplasm, Residual ,Time Factors ,Transplantation Conditioning ,Glycine ,Antineoplastic Agents ,Transplantation, Autologous ,Drug Administration Schedule ,Randomised ,Maintenance Chemotherapy ,Study Protocol ,Recurrence ,Multiple myeloma ,Journal Article ,Humans ,Multicenter Studies as Topic ,ASCT ,Randomized Controlled Trials as Topic ,Augmented ASCT ,Salvage Therapy ,lcsh:R5-920 ,Progression-Free Survival ,United Kingdom ,Treatment Outcome ,Clinical Trials, Phase III as Topic ,Quality of Life ,Female ,lcsh:Medicine (General) ,Proteasome Inhibitors ,Depth of response ,Haematology ,Stem Cell Transplantation - Abstract
Background Multiple myeloma (MM) is a plasma cell tumour with an approximate annual incidence of 4500 in the UK. Therapeutic options for patients with MM have changed in the last decade with the arrival of proteasome inhibitors and immunomodulatory drugs. Despite these options, almost all patients will relapse post first-line autologous stem cell transplantation (ASCT). First relapse management (second-line treatment) has evolved in recent years with an expanding portfolio of novel agents, driving response rates influencing the durability of response. A second ASCT, as part of relapsed disease management (salvage ASCT), has been shown to prolong the progression-free survival and overall survival following a proteasome inhibitor-containing re-induction regimen, in the Cancer Research UK-funded National Cancer Research Institute Myeloma X (Intensive) study. It is now recommended that salvage ASCT be considered for suitable patients by the International Myeloma Working Group and the National Institute for Health and Care Excellence NG35 guidance. Methods/design ACCoRd (Myeloma XII) is a UK-nationwide, individually randomised, multi-centre, multiple randomisation, open-label phase III trial with an initial single intervention registration phase aimed at relapsing MM patients who have received ASCT in first-line treatment. We will register 406 participants into the trial to allow 284 and 248 participants to be randomised at the first and second randomisations, respectively. All participants will receive re-induction therapy until maximal response (four to six cycles of ixazomib, thalidomide and dexamethasone). Participants who achieve at least stable disease will be randomised (1:1) to receive either ASCTCon, using high-dose melphalan, or ASCTAug, using high-dose melphalan with ixazomib. All participants achieving or maintaining a minimal response or better, following salvage ASCT, will undergo a second randomisation (1:1) to consolidation and maintenance or observation. Participants randomised to consolidation and maintenance will receive consolidation with two cycles of ixazomib, thalidomide and dexamethasone, and maintenance with ixazomib until disease progression. Discussion The question of how best to maximise the durability of response to salvage ASCT warrants clinical investigation. Given the expanding scope of oral therapeutic agents, patient engagement with long-term maintenance strategies is a real opportunity. This study will provide evidence to better define post-relapse treatment in MM. Trial registration ISRCTN, ISRCTN10038996. Registered on 15 December 2016. Electronic supplementary material The online version of this article (10.1186/s13063-018-2524-8) contains supplementary material, which is available to authorized users.
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- 2017
18. Human parainfluenza type 4 infection: a case report highlighting pathogenicity and difficulties in rapid diagnosis in the post-transplant setting
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Miall, F, Rye, A, Fraser, M, Hunter, A, and Snowden, JA
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- 2002
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19. Allogeneic PBPC transplantation: an effect on incidence and distribution of chronic graft-versus-host disease without long-term survival benefit?
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Snowden, JA, Nivison-Smith, I, Atkinson, K, Fay, K, Concannon, A, Dodds, A, Milliken, S, and Biggs, J
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- 2000
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20. Alloreactivity: the Janus-face of hematopoietic stem cell transplantation
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Gratwohl, A, Sureda, A, Cornelissen, Jan, Apperley, J, Dreger, P, Duarte, R, Greinix, HT, Mc Grath, E, Kroeger, N, Lanza, F, Nagler, A, Snowden, JA, Niederwieser, D, Brand, R, Gratwohl, A, Sureda, A, Cornelissen, Jan, Apperley, J, Dreger, P, Duarte, R, Greinix, HT, Mc Grath, E, Kroeger, N, Lanza, F, Nagler, A, Snowden, JA, Niederwieser, D, and Brand, R
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- 2017
21. Psychological interventions for distress in adults undergoing haematopoietic stem cell transplantation: a systematic review with meta-analysis
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Baliousis, M, Rennoldson, M, and Snowden, JA
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Objectives:\ud To investigate the characteristics, methodology, quality, and efficacy of psychological interventions for distress in adult patients undergoing haematopoietic stem cell\ud transplantation (HSCT).\ud \ud Methods:\ud A systematic review of relevant studies was conducted using six databases with supplementary hand searching. Included studies employed an experimental or quasiexperimental\ud design, interventions included at least one psychological component, and outcomes involved psychological distress in affective terms. Data were abstracted and study\ud quality was assessed using Cochrane Foundation criteria amended to include confounder and common factors control. Data were examined and synthesised using a narrative approach and meta-analysis.\ud \ud Results:\ud Eleven articles for nine interventions met the inclusion criteria out of 11741 abstracts. The studies varied in quality, general, intervention, and methodological characteristics while findings were mixed. Interventions tended to show better efficacy when incorporating a\ud major psychological component involving cognitive behavioural or emotional processing methods with substantial interventionist input. However, this was also associated with methodological limitations and threats to internal validity such as poor confounder and common factors control. A meta-analysis yielded a small but significant pooled effect size estimate in favour of interventions with inconsequential heterogeneity. Risk of bias remained a concern. \ud \ud Conclusions:\ud Psychological interventions may provide some benefit in alleviating distress in HSCT but conclusions remain tentative in light of methodological limitations and risk of bias. Further research is needed to evidence the individual contribution of intervention components and mechanism of change together with improving intervention efficiency and\ud methodological quality.
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- 2016
22. Meta-analysis of genome-wide association studies discovers multiple loci for chronic lymphocytic leukemia
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Berndt, SI, Camp, NJ, Skibola, CF, Vijai, J, Wang, Z, Gu, J, Nieters, A, Kelly, RS, Smedby, KE, Monnereau, A, Cozen, W, Cox, A, Wang, SS, Lan, Q, Teras, LR, Machado, M, Yeager, M, Brooks-Wilson, AR, Hartge, P, Purdue, MP, Birmann, BM, Vajdic, CM, Cocco, P, Zhang, Y, Giles, GG, Zeleniuch-Jacquotte, A, Lawrence, C, Montalvan, R, Burdett, L, Hutchinson, A, Ye, Y, Call, TG, Shanafelt, TD, Novak, AJ, Kay, NE, Liebow, M, Cunningham, JM, Allmer, C, Hjalgrim, H, Adami, H-O, Melbye, M, Glimelius, B, Chang, ET, Glenn, M, Curtin, K, Cannon-Albright, LA, Diver, WR, Link, BK, Weiner, GJ, Conde, L, Bracci, PM, Riby, J, Arnett, DK, Zhi, D, Leach, JM, Holly, EA, Jackson, RD, Tinker, LF, Benavente, Y, Sala, N, Casabonne, D, Becker, N, Boffetta, P, Brennan, P, Foretova, L, Maynadie, M, McKay, J, Staines, A, Chaffee, KG, Achenbach, SJ, Vachon, CM, Goldin, LR, Strom, SS, Leis, JF, Weinberg, JB, Caporaso, NE, Norman, AD, De Roos, AJ, Morton, LM, Severson, RK, Riboli, E, Vineis, P, Kaaks, R, Masala, G, Weiderpass, E, Chirlaque, M-D, Vermeulen, RCH, Travis, RC, Southey, MC, Milne, RL, Albanese, D, Virtamo, J, Weinstein, S, Clavel, J, Zheng, T, Holford, TR, Villano, DJ, Maria, A, Spinelli, JJ, Gascoyne, RD, Connors, JM, Bertrand, KA, Giovannucci, E, Kraft, P, Kricker, A, Turner, J, Ennas, MG, Ferri, GM, Miligi, L, Liang, L, Ma, B, Huang, J, Crouch, S, Park, J-H, Chatterjee, N, North, KE, Snowden, JA, Wright, J, Fraumeni, JF, Offit, K, Wu, X, de Sanjose, S, Cerhan, JR, Chanock, SJ, Rothman, N, Slager, SL, Berndt, SI, Camp, NJ, Skibola, CF, Vijai, J, Wang, Z, Gu, J, Nieters, A, Kelly, RS, Smedby, KE, Monnereau, A, Cozen, W, Cox, A, Wang, SS, Lan, Q, Teras, LR, Machado, M, Yeager, M, Brooks-Wilson, AR, Hartge, P, Purdue, MP, Birmann, BM, Vajdic, CM, Cocco, P, Zhang, Y, Giles, GG, Zeleniuch-Jacquotte, A, Lawrence, C, Montalvan, R, Burdett, L, Hutchinson, A, Ye, Y, Call, TG, Shanafelt, TD, Novak, AJ, Kay, NE, Liebow, M, Cunningham, JM, Allmer, C, Hjalgrim, H, Adami, H-O, Melbye, M, Glimelius, B, Chang, ET, Glenn, M, Curtin, K, Cannon-Albright, LA, Diver, WR, Link, BK, Weiner, GJ, Conde, L, Bracci, PM, Riby, J, Arnett, DK, Zhi, D, Leach, JM, Holly, EA, Jackson, RD, Tinker, LF, Benavente, Y, Sala, N, Casabonne, D, Becker, N, Boffetta, P, Brennan, P, Foretova, L, Maynadie, M, McKay, J, Staines, A, Chaffee, KG, Achenbach, SJ, Vachon, CM, Goldin, LR, Strom, SS, Leis, JF, Weinberg, JB, Caporaso, NE, Norman, AD, De Roos, AJ, Morton, LM, Severson, RK, Riboli, E, Vineis, P, Kaaks, R, Masala, G, Weiderpass, E, Chirlaque, M-D, Vermeulen, RCH, Travis, RC, Southey, MC, Milne, RL, Albanese, D, Virtamo, J, Weinstein, S, Clavel, J, Zheng, T, Holford, TR, Villano, DJ, Maria, A, Spinelli, JJ, Gascoyne, RD, Connors, JM, Bertrand, KA, Giovannucci, E, Kraft, P, Kricker, A, Turner, J, Ennas, MG, Ferri, GM, Miligi, L, Liang, L, Ma, B, Huang, J, Crouch, S, Park, J-H, Chatterjee, N, North, KE, Snowden, JA, Wright, J, Fraumeni, JF, Offit, K, Wu, X, de Sanjose, S, Cerhan, JR, Chanock, SJ, Rothman, N, and Slager, SL
- Abstract
Chronic lymphocytic leukemia (CLL) is a common lymphoid malignancy with strong heritability. To further understand the genetic susceptibility for CLL and identify common loci associated with risk, we conducted a meta-analysis of four genome-wide association studies (GWAS) composed of 3,100 cases and 7,667 controls with follow-up replication in 1,958 cases and 5,530 controls. Here we report three new loci at 3p24.1 (rs9880772, EOMES, P=2.55 × 10(-11)), 6p25.2 (rs73718779, SERPINB6, P=1.97 × 10(-8)) and 3q28 (rs9815073, LPP, P=3.62 × 10(-8)), as well as a new independent SNP at the known 2q13 locus (rs9308731, BCL2L11, P=1.00 × 10(-11)) in the combined analysis. We find suggestive evidence (P<5 × 10(-7)) for two additional new loci at 4q24 (rs10028805, BANK1, P=7.19 × 10(-8)) and 3p22.2 (rs1274963, CSRNP1, P=2.12 × 10(-7)). Pathway analyses of new and known CLL loci consistently show a strong role for apoptosis, providing further evidence for the importance of this biological pathway in CLL susceptibility.
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- 2016
23. AUTOLOGOUS HAEMOPOIETIC STEM CELL TRANSPLANT IN MS: SHEFFIELD COHORT
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Kelsey, P, primary, Bell, SM, additional, Jessop, H, additional, Snowden, JA, additional, and Sharrack, B, additional
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- 2015
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24. Genome-wide association study identifies multiple risk loci for chronic lymphocytic leukemia
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Berndt, SI, Skibola, CF, Joseph, V, Camp, NJ, Nieters, A, Wang, Z, Cozen, W, Monnereau, A, Wang, SS, Kelly, RS, Lan, Q, Teras, LR, Chatterjee, N, Chung, CC, Yeager, M, Brooks-Wilson, AR, Hartge, P, Purdue, MP, Birmann, BM, Armstrong, BK, Cocco, P, Zhang, Y, Severi, G, Zeleniuch-Jacquotte, A, Lawrence, C, Burdette, L, Yuenger, J, Hutchinson, A, Jacobs, KB, Call, TG, Shanafelt, TD, Novak, AJ, Kay, NE, Liebow, M, Wang, AH, Smedby, KE, Adami, H-O, Melbye, M, Glimelius, B, Chang, ET, Glenn, M, Curtin, K, Cannon-Albright, LA, Jones, B, Diver, WR, Link, BK, Weiner, GJ, Conde, L, Bracci, PM, Riby, J, Holly, EA, Smith, MT, Jackson, RD, Tinker, LF, Benavente, Y, Becker, N, Boffetta, P, Brennan, P, Foretova, L, Maynadie, M, McKay, J, Staines, A, Rabe, KG, Achenbach, SJ, Vachon, CM, Goldin, LR, Strom, SS, Lanasa, MC, Spector, LG, Leis, JF, Cunningham, JM, Weinberg, JB, Morrison, VA, Caporaso, NE, Norman, AD, Linet, MS, De Roos, AJ, Morton, LM, Severson, RK, Riboli, E, Vineis, P, Kaaks, R, Trichopoulos, D, Masala, G, Weiderpass, E, Chirlaque, M-D, Vermeulen, RCH, Travis, RC, Giles, GG, Albanes, D, Virtamo, J, Weinstein, S, Clavel, J, Zheng, T, Holford, TR, Offit, K, Zelenetz, A, Klein, RJ, Spinelli, JJ, Bertrand, KA, Laden, F, Giovannucci, E, Kraft, P, Kricker, A, Turner, J, Vajdic, CM, Ennas, MG, Ferri, GM, Miligi, L, Liang, L, Sampson, J, Crouch, S, Park, J-H, North, KE, Cox, A, Snowden, JA, Wright, J, Carracedo, A, Lopez-Otin, C, Bea, S, Salaverria, I, Martin-Garcia, D, Campo, E, Fraumeni, JF, de Sanjose, S, Hjalgrim, H, Cerhan, JR, Chanock, SJ, Rothman, N, Slager, SL, Berndt, SI, Skibola, CF, Joseph, V, Camp, NJ, Nieters, A, Wang, Z, Cozen, W, Monnereau, A, Wang, SS, Kelly, RS, Lan, Q, Teras, LR, Chatterjee, N, Chung, CC, Yeager, M, Brooks-Wilson, AR, Hartge, P, Purdue, MP, Birmann, BM, Armstrong, BK, Cocco, P, Zhang, Y, Severi, G, Zeleniuch-Jacquotte, A, Lawrence, C, Burdette, L, Yuenger, J, Hutchinson, A, Jacobs, KB, Call, TG, Shanafelt, TD, Novak, AJ, Kay, NE, Liebow, M, Wang, AH, Smedby, KE, Adami, H-O, Melbye, M, Glimelius, B, Chang, ET, Glenn, M, Curtin, K, Cannon-Albright, LA, Jones, B, Diver, WR, Link, BK, Weiner, GJ, Conde, L, Bracci, PM, Riby, J, Holly, EA, Smith, MT, Jackson, RD, Tinker, LF, Benavente, Y, Becker, N, Boffetta, P, Brennan, P, Foretova, L, Maynadie, M, McKay, J, Staines, A, Rabe, KG, Achenbach, SJ, Vachon, CM, Goldin, LR, Strom, SS, Lanasa, MC, Spector, LG, Leis, JF, Cunningham, JM, Weinberg, JB, Morrison, VA, Caporaso, NE, Norman, AD, Linet, MS, De Roos, AJ, Morton, LM, Severson, RK, Riboli, E, Vineis, P, Kaaks, R, Trichopoulos, D, Masala, G, Weiderpass, E, Chirlaque, M-D, Vermeulen, RCH, Travis, RC, Giles, GG, Albanes, D, Virtamo, J, Weinstein, S, Clavel, J, Zheng, T, Holford, TR, Offit, K, Zelenetz, A, Klein, RJ, Spinelli, JJ, Bertrand, KA, Laden, F, Giovannucci, E, Kraft, P, Kricker, A, Turner, J, Vajdic, CM, Ennas, MG, Ferri, GM, Miligi, L, Liang, L, Sampson, J, Crouch, S, Park, J-H, North, KE, Cox, A, Snowden, JA, Wright, J, Carracedo, A, Lopez-Otin, C, Bea, S, Salaverria, I, Martin-Garcia, D, Campo, E, Fraumeni, JF, de Sanjose, S, Hjalgrim, H, Cerhan, JR, Chanock, SJ, Rothman, N, and Slager, SL
- Abstract
Genome-wide association studies (GWAS) have previously identified 13 loci associated with risk of chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL). To identify additional CLL susceptibility loci, we conducted the largest meta-analysis for CLL thus far, including four GWAS with a total of 3,100 individuals with CLL (cases) and 7,667 controls. In the meta-analysis, we identified ten independent associated SNPs in nine new loci at 10q23.31 (ACTA2 or FAS (ACTA2/FAS), P=1.22×10(-14)), 18q21.33 (BCL2, P=7.76×10(-11)), 11p15.5 (C11orf21, P=2.15×10(-10)), 4q25 (LEF1, P=4.24×10(-10)), 2q33.1 (CASP10 or CASP8 (CASP10/CASP8), P=2.50×10(-9)), 9p21.3 (CDKN2B-AS1, P=1.27×10(-8)), 18q21.32 (PMAIP1, P=2.51×10(-8)), 15q15.1 (BMF, P=2.71×10(-10)) and 2p22.2 (QPCT, P=1.68×10(-8)), as well as an independent signal at an established locus (2q13, ACOXL, P=2.08×10(-18)). We also found evidence for two additional promising loci below genome-wide significance at 8q22.3 (ODF1, P=5.40×10(-8)) and 5p15.33 (TERT, P=1.92×10(-7)). Although further studies are required, the proximity of several of these loci to genes involved in apoptosis suggests a plausible underlying biological mechanism.
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- 2013
25. Identification of prognostic factors predicting outcome in Hodgkin's lymphoma patients relapsing after autologous stem cell transplantation
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Martínez, C, Canals, C, Sarina, B, Alessandrino, Ep, Karakasis, D, Pulsoni, A, Sica, Simona, Trneny, M, Snowden, Ja, Kanfer, E, Milpied, N, Bosi, A, Guidi, S, De Souza, Ca, Willemze, R, Arranz, R, Jebavy, L, Hellmann, A, Sibon, D, Oneto, R, Luan, Jj, Dreger, P, Castagna, L, Sureda, A., Sica, Simona (ORCID:0000-0003-2426-3465), Martínez, C, Canals, C, Sarina, B, Alessandrino, Ep, Karakasis, D, Pulsoni, A, Sica, Simona, Trneny, M, Snowden, Ja, Kanfer, E, Milpied, N, Bosi, A, Guidi, S, De Souza, Ca, Willemze, R, Arranz, R, Jebavy, L, Hellmann, A, Sibon, D, Oneto, R, Luan, Jj, Dreger, P, Castagna, L, Sureda, A., and Sica, Simona (ORCID:0000-0003-2426-3465)
- Abstract
High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard of care for patients with relapsed Hodgkin's lymphoma (HL). However, there is currently little information on the predictors of outcome for patients whose disease recurs after ASCT.
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- 2013
26. Oral or parenteral therapy for vitamin B12 deficiency
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Snowden, JA, primary, Chan-Lam, D, additional, Thomas, SE, additional, and Ng, J-P, additional
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- 1999
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27. Autologous blood stem cell transplantation for autoimmune diseases
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Snowden, JA, primary, Biggs, JC, additional, and Brooks, PM, additional
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- 1996
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28. Risk taking in patients with rheumatoid arthritis: are the risks of haemopoietic stem cell transplantation acceptable?
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Snowden, JA, Nivison-Smith, I, Biggs, JC, and Brooks, PM
- Abstract
Objectives: Autologous haemopoietic stem cell transplantation (HSCT), which carries defined risks of early treatment-related mortality (TRM), has recently been proposed as an experimental therapy for severe rheumatoid arthritis (RA). The aim of this study was to establish whether the risks of this approach are acceptable to patients with RA and whether risk taking related to disease associated or personal/social parameters.Methods: A standard gamble questionnaire was used to determine the acceptable risk of mortality for a potentially curative procedure in patients with RA aged <70 yr. Additional data collected included age, sex, duration of RA, number of second-line agents, domestic and workforce information, and self-assessed disability.Results: The 53 patients (age range 24-69 yr, 39 female, 14 male, disease duration 2-43 yr) interviewed were prepared to accept a broad range of treatment-related mortality in order to be returned to normality off all drugs (median 5%, range 0-50%). Risk taking was significantly related to degree of disability measured by the disability section of the Health Assessment Questionnaire (HAQ; P = 0.001) and negatively related to age (P = 0.04), although only HAQ score maintained significance on multivariate analysis. Using linear regression, we were able to determine that current TRM of autologous HSCT in Australia (3.3%) would be acceptable to patients with HAQ scores of <0.44 (84% of our sample), but allogeneic HSCT (with a TRM of 13.1%) would be acceptable only to severely disabled patients with HAQ scores of >2.45 (4% of our sample), assuming the procedure to be curative.Conclusion: Along with previous studies, these results suggest that, if long-term efficacy can be proven, then the risks of autografting may be acceptable to most patients with RA, particularly those with significant disability.Key words: Rheumatoid arthritis, Bone marrow transplantation, Stem cell transplantation, Autoimmune diseases.
- Published
- 1999
29. Morphometric assessment of ovarian stromal proliferation. A clinicopathological study
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Snowden, JA, primary, Harkin, PJR, additional, Thornton, JG, additional, and Wells, M, additional
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- 1989
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30. SCT for severe autoimmune diseases: consensus guidelines of the European Society for Blood and Marrow Transplantation for immune monitoring and biobanking
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Alexander, T., Bondanza, A., Muraro, P.A., Greco, R., Saccardi, R., Daikeler, T., Kazmi, M., Hawkey, C., Simoes, P., Leblanc, K., Fibbe, W.E., Moore, J., Snarski, E., Martin, T., Hiepe, F., Velardi, A., Toubert, A., Snowden, J.A., Farge, D., EBMT Autoimmune Dis Working Party, Immunobiology Working Party, Alexander, T, Bondanza, Attilio, Muraro, Pa, Greco, R, Saccardi, R, Daikeler, T, Kazmi, M, Hawkey, C, Simoes, Bp, Leblanc, K, Fibbe, We, Moore, J, Snarski, E, Martin, T, Hiepe, F, Velardi, A, Toubert, A, Snowden, Ja, and Farge, D.
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Preservation, Biological ,Hematopoietic stem cell transplantation ,medicine.disease_cause ,Severity of Illness Index ,Autoimmunity ,Autoimmune Diseases ,Immune system ,Medical ,Severity of illness ,medicine ,Humans ,Intensive care medicine ,Special Report ,Societies, Medical ,Biological Specimen Banks ,Congresses as Topic ,Practice Guidelines as Topic ,Hematopoietic Stem Cell Transplantation ,Transplantation ,business.industry ,Hematology ,medicine.disease ,Biological ,Biobank ,Preservation ,3. Good health ,Graft-versus-host disease ,Immunology ,Cohort ,business ,Societies - Abstract
Over the past 15 years, SCT has emerged as a promising treatment option for patients with severe autoimmune diseases (ADs). Mechanistic studies recently provided the proof-of-concept that restoration of immunological tolerance can be achieved by haematopoietic SCT in chronic autoimmunity through eradication of the pathologic, immunologic memory and profound reconfiguration of the immune system, that is, immune ‘resetting’. Nevertheless, a number of areas remain unresolved and warrant further investigation to refine our understanding of the underlying mechanisms of action and to optimize clinical SCT protocols. Due to the low number of patients transplanted in each centre, it is essential to adequately collect and analyse biological samples in a larger cohort of patients under standardized conditions. The European society for blood and marrow transplantation Autoimmune Diseases and Immunobiology Working Parties have, therefore, undertaken a joint initiative to develop and implement guidelines for ‘good laboratory practice’ in relation to procurement, processing, storage and analysis of biological specimens for immune reconstitution studies in AD patients before, during and after SCT. The aim of this document is to provide practical recommendations for biobanking of samples and laboratory immune monitoring in patients with ADs undergoing SCT, both for routine supportive care purposes and investigational studies.
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- 2015
31. Continuous and differential improvement in worldwide access to hematopoietic cell transplantation: activity has doubled in a decade with a notable increase in unrelated and non-identical related donors.
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Atsuta Y, Baldomero H, Neumann D, Sureda A, DeVos JD, Iida M, Karduss A, Purtill D, Elhaddad AM, Bazuaye NG, Bonfim C, De la Camara R, Chaudhri NA, Ciceri F, Correa C, Frutos C, Galeano S, Garderet L, Gonzalez-Ramella O, Greco R, Hamad N, Hazenberg MD, Horowitz MM, Kalwak K, Ko BS, Kodera Y, Koh MB, Liu K, McLornan DP, Moon JH, Neven B, Okamoto S, Pasquini MC, Passweg JR, Paulson K, Rondelli D, Ruggeri A, Seber A, Snowden JA, Srivastava A, Szer J, Weisdorf D, Worel N, Greinix H, Saber W, Aljurf M, and Niederwieser D
- Subjects
- Humans, Health Services Accessibility, Tissue Donors supply & distribution, Global Health, Registries, Hematopoietic Stem Cell Transplantation methods, Unrelated Donors
- Abstract
Promoting access to and excellence in hematopoietic cell transplantation (HCT) by collecting and disseminating data on global HCT activities is one of the principal activities of the Worldwide Network for Blood and Marrow Transplantation, a non-governmental organization in working relations with the World Health Organization. HCT activities are recorded annually by member societies, national registries and individual centers including indication, donor type (allogeneic/autologous), donor match and stem cell source (bone marrow/peripheral blood stem cells/cord blood). In 2018, 1,768 HCT teams in 89 countries (6 World Health Organization regions) reported 93,105 (48,680 autologous and 44,425 allogeneic) HCT. Major indications were plasma cell disorders and lymphoma for autologous, and acute leukemias and MDS/MPN for allogeneic HCT. HCT numbers increased from 48,709 in 2007. Notable increases were seen for autoimmune diseases in autologous and hemoglobinopathies in allogeneic HCT. The number of allogeneic HCT more than doubled with significant changes in donor match. While HCT from HLA-identical siblings has seen only limited growth, HCT from non-identical related donors showed significant increase worldwide. Strongest correlation between economic growth indicator of gross national income/capita and HCT activity/10 million population was observed for autologous HCT (correlation coefficient [r]=0.79). HCT from unrelated donors showed strong correlation (r=0.68), but only moderate correlation was detected from related donors (r=0.48 for HLA-identical sibling; r=0.45 for other). The use of HCT doubled in about a decade worldwide at different speed and with significant changes regarding donor match as a sign of improved access to HCT worldwide. Although narrowing, significant gaps remain between developing and non-developing countries.
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- 2024
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32. Adenovirus infections after allogeneic hematopoietic cell transplantation in children and adults: a study from the Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation.
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Styczynski J, Tridello G, Knelange N, Wendel L, Ljungman P, Mikulska M, Gil L, Cesaro S, Averbuch D, von dem Borne P, Xhaard A, Mielke S, Neven B, Snowden JA, Dalle JH, Rubio MT, Crawley C, Maertens J, Kuball J, Chevallier P, Michel G, Gabriel M, Burns D, Wynn RF, Renard C, Blijlevens N, Jubert C, Gedde-Dahl T, Collin M, Labussiere-Wallet H, Kalwak K, Broers AEC, Yakoub-Agha I, Itäla-Remes M, and de la Camara R
- Subjects
- Humans, Child, Adult, Male, Female, Adolescent, Child, Preschool, Middle Aged, Infant, Transplantation, Homologous, Risk Factors, Young Adult, Europe, Aged, Hematopoietic Stem Cell Transplantation adverse effects, Adenoviridae Infections etiology, Adenoviridae Infections mortality
- Abstract
The objective of the study was the analysis of clinical types, outcomes, and risk factors associated with the outcome of adenovirus (ADV) infection, in children and adults after allo-HCT. A total number of 2529 patients (43.9% children; 56.1% adults) transplanted between 2000 and 2022 reported to the EBMT database with diagnosis of ADV infection were analyzed. ADV infection manifested mainly as viremia (62.6%) or gastrointestinal infection (17.9%). The risk of 1-year mortality was higher in adults (p = 0.0001), and in patients with ADV infection developing before day +100 (p < 0.0001). The 100-day overall survival after diagnosis of ADV infections was 79.2% in children and 71.9% in adults (p < 0.0001). Factors contributing to increased risk of death by day +100 in multivariate analysis, in children: CMV seropositivity of donor and/or recipient (p = 0.02), and Lansky/Karnofsky score <90 (p < 0.0001), while in adults: type of ADV infection (viremia or pneumonia vs gastrointestinal infection) (p = 0.0004), second or higher HCT (p = 0.0003), and shorter time from allo-HCT to ADV infection (p = 0.003). In conclusion, we have shown that in patients infected with ADV, short-term survival is better in children than adults. Factors directly related to ADV infection (time, clinical type) contribute to mortality in adults, while pre-transplant factors (CMV serostatus, Lansky/Karnofsky score) contribute to mortality in children., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
- Published
- 2024
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33. Ixazomib as consolidation and maintenance versus observation in patients with relapsed multiple myeloma eligible for salvage autologous stem-cell transplantation (Myeloma XII [ACCoRD]): interim analysis of a multicentre, open-label, randomised, phase 3 trial.
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Cook G, Ashcroft AJ, Senior E, Olivier C, Hockaday A, Richards J, Cavenagh JD, Snowden JA, Drayson MT, de Tute R, Roberts L, Owen RG, Yong K, Garg M, Boyd K, Sati H, Gillson S, Cook M, Cairns DA, and Parrish C
- Abstract
Background: The efficacy of consolidation and maintenance in the context of salvage autologous haematopoietic stem-cell transplantation (HSCT) for relapsed multiple myeloma remains unclear. We aimed to assess whether consolidation after salvage autologous HSCT, using ixazomib, thalidomide, and dexamethasone, followed by maintenance with single agent ixazomib is superior to observation., Methods: This is an interim analysis of Myeloma XII (ACCorD; referred to as ACCorD hereafter), an open-label, randomised, controlled, phase 3 trial done at 79 hospitals in the UK. Eligible patients were aged 18 years or older, had relapsed multiple myeloma with measurable disease, an ECOG performance status of 2 or less with adequate renal, hepatobiliary, pulmonary, and cardiac function, and required treatment for first progressive disease occurring at least 12 months after first autologous HSCT. In a first randomisation, patients were assigned (1:1) to receive either conventional autologous HSCT with melphalan or augmented autologous HSCT with melphalan and ixazomib. In the second randomisation, reported here, patients were assigned (1:1) to consolidation using ixazomib, thalidomide, and dexamethasone (oral ixazomib 4 mg per day on days 1, 8, and 15, oral thalidomide 100 mg per day on days 1-28, and oral dexamethasone 40 mg per day on days 1, 8, 15 and 22 of 28-day cycles), followed by maintenance with single agent ixazomib (oral ixazomib 4 mg per day on days 1, 8, and 15 of 28-day cycles until disease progression or intolerance), or observation. The primary endpoint was progression-free survival, analysed by intention-to-treat. Safety was analysed per-protocol. This study is registered with ISRCTN, ISRCTN10038996, and EudraCT, 2016-000905-35, and recruitment is complete., Findings: Between Dec 12, 2017, and April 21, 2023, 206 patients entered the second randomisation (103 in the consolidation and maintenance group and 103 in the observation group). This prespecified interim analysis (data cutoff April 21, 2023), was done at a median follow-up of 27 months (IQR 13-38). Median progression-free survival was 20 months (95% CI 15-29) in the consolidation and maintenance group and 13 months (11-18) in the observation group (hazard ratio 0·55 [95% CI 0·39-0·78]; p=0·0006). Serious adverse events were reported in 29 (32%) of 92 patients in the consolidation and maintenance group compared with seven (7%) of 103 patients in the observation group. The most common serious adverse events were infections and infestations in both the consolidation and maintenance group and the observation group. The most common grade 3, 4, or 5 adverse events for patients in the consolidation and maintenance group were upper respiratory infection (seven [8%] of 92 patients). No deaths in the consolidation and maintenance group were deemed treatment related., Interpretation: ACCorD provides evidence that an orally administered, deliverable, and tolerable post-salvage autologous HSCT treatment regimen can improve the durability of response for transplantation-eligible patients at first relapse. The findings are of relevance to patients who had durable disease control from autologous HSCT in the first line, representing a viable alternative to continuous parentally-administered relapse therapies., Funding: Cancer Research UK, Takeda Oncology., Competing Interests: Declaration of interests GC reports research funding from Janssen, Takeda Oncology, Amgen, and BMS/Celgene; and consultancy fees from Janssen, Takeda, Sanofi, Oncopeptides, Karyopharm, Pfizer, Roche, and BMS/Celgene. AJA reports speaker fees and participation on advisory boards for Janssen and participation on advisory boards for Takeda. ES reports receipt of unrestricted educational grants to his institution from Takeda Oncology, Celgene Corporation, Merck, Amgen, and Sanofi. CO reports receipt of unrestricted educational grants to her institution from Takeda Oncology, Celgene Corporation, Merck, Amgen, and Sanofi. AH reports receipt of unrestricted educational grants to his institution from Takeda Oncology, Celgene Corporation, Merck, Amgen, and Sanofi; and speaker fees from Abbvie. JR reports receipt of unrestricted educational grants to her institution from Takeda Oncology, Celgene Corporation, Merck, Amgen and Sanofi. JS reports speaker fees from Janssen, Jazz, Mallinckrodt, and Sanofi; participation on advisory boards for Medac and Vertex; and Independent Data Monitoring Committee membership for a Kiadis Pharma clinical trial. MG reports participation on advisory boards for Amgen, Sanofi, Celgene, Stemline therapeutics, Janssen, and Novartis; research grants from Janssen; speaker honoraria from Janssen, Amgen and Alnylam; and travel expenses to attend educational meetings from Novartis, Janssen, and Takeda. KB reports participation on advisory boards at Takeda, Janssen, and Celgene/BMS; speaker honoraria from Janssen, Sanofi, and Celgene/BMS; and travel expenses to attend educational meetings from Janssen, GSK, and Takeda. SG reports receipt of unrestricted educational grants to her institution from Takeda Oncology, Celgene Corporation, Merck, Amgen, and Sanofi. DAC reports receipt of unrestricted educational grants to his institution from Takeda Oncology, Celgene Corporation, Merck, Amgen, and Sanofi; payment to their institution for educational lectures from Janssen; participation on a Data Safety Monitoring Board for a multiple myeloma study; and personal payment for meeting attendance from European Myeloma Network, Rotterdam. LR is a patient and public contributor. CP reports speaker honoraria from Janssen, Amgen, and Novartis; and participation on advisory boards at Pfizer and Sanofi. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
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34. The Role of Chimeric Antigen Receptor T-Cell Therapy in Immune-Mediated Neurological Diseases.
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Brittain G, Roldan E, Alexander T, Saccardi R, Snowden JA, Sharrack B, and Greco R
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- Humans, Nervous System Diseases therapy, Nervous System Diseases immunology, Receptors, Chimeric Antigen immunology, Immunotherapy, Adoptive methods, Immunotherapy, Adoptive adverse effects
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Despite the use of 'high efficacy' disease-modifying therapies, disease activity and clinical progression of different immune-mediated neurological diseases continue for some patients, resulting in accumulating disability, deteriorating social and mental health, and high economic cost to patients and society. Although autologous hematopoietic stem cell transplant is an effective treatment modality, it is an intensive chemotherapy-based therapy with a range of short- and long-term side-effects. Chimeric antigen receptor T-cell therapy (CAR-T) has revolutionized the treatment of B-cell and other hematological malignancies, conferring long-term remission for otherwise refractory diseases. However, the toxicity of this treatment, particularly cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, and the complexity of production necessitate the need for a high level of specialization at treating centers. Early-phase trials of CAR-T therapies in immune-mediated B cell driven conditions, such as systemic lupus erythematosus, neuromyelitis optica spectrum disorder and myasthenia gravis, have shown dramatic clinical response with few adverse events. Based on the common physiopathology, CAR-T therapy in other immune-mediated neurological disease, including multiple sclerosis, chronic inflammatory polyradiculopathy, autoimmune encephalitis, and stiff person syndrome, might be an effective option for patients, avoiding the need for long-term immunosuppressant medications. It may prove to be a more selective immunoablative approach than autologous hematopoietic stem cell transplant, with potentially increased efficacy and lower adverse events. In this review, we present the state of the art and future directions of the use of CAR-T in such conditions. ANN NEUROL 2024;96:441-452., (© 2024 The Author(s). Annals of Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.)
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35. Patient engagement in hematopoietic stem cell transplantation and cell therapy: a survey by the EBMT patient engagement task force & transplantation complications working party.
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Schoemans H, Burns LJ, Liptrott SJ, Murray J, Kenyon M, Barata A, Bolaños N, Scholl I, Hamilton B, Phelan R, Buchbinder D, Penack O, Moiseev I, Boreland W, Peczynski C, De Geest S, Sureda A, Snowden JA, Shaw B, Peric Z, and Kroeger N
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- Humans, Male, Female, Cross-Sectional Studies, Surveys and Questionnaires, Middle Aged, Adult, Patient Reported Outcome Measures, Cell- and Tissue-Based Therapy methods, Hematopoietic Stem Cell Transplantation methods, Patient Participation
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The EBMT (European Blood and Marrow Transplantation Society) aims to connect patients, the scientific community, and other stakeholders to improve hematopoietic stem cell transplantation and cellular therapy outcomes. We performed a cross-sectional online survey to understand the perceptions regarding Patient Reported Outcomes (PROs) and Patient Active Involvement in Research (PAIR) in over 800 stakeholders (n = 813). Patients (n = 278) and health care professionals (HCPs) (n = 351) were compared. We observed high openness for EBMT PRO collection (n = 680, 84.5% across stakeholders' groups; patients n = 256, 93.1% versus HCPs n = 273, 78.4% [p < 0.001]) and PAIR (n = 702, 87.3% across stakeholder groups; patients n = 256, 92.4% versus HCPs n = 296, 85.8% [p = 0.009]), with a significantly higher proportion of patients expressing interest compared to HCPs. Priority domains for PROs data-collection identified were the assessment of symptom experience, psychosocial and cognitive functioning. The most important issues for patients specifically were the data-collection of PROs reflecting cognitive function, the option of reporting data at home, the importance of identifying actionable targets to improve their recovery, and receiving feedback on their input when participating in research projects. Our multistakeholder approach suggests an added value to embracing patient engagement in the development of meaningful research and service design within the transplantation and cellular therapy community., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
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36. ATG and other serotherapy in conditioning regimens for autologous HSCT in autoimmune diseases: a survey on behalf of the EBMT Autoimmune Diseases Working Party (ADWP).
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Ismail A, Nitti R, Sharrack B, Badoglio M, Ambron P, Labopin M, Alexander T, Snowden JA, and Greco R
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37. Health professional attitudes and perceptions of prehabilitation and nutrition before haematopoietic cell transplantation.
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Miller LJ, Halliday V, Snowden JA, Aithal GP, Lee J, and Greenfield DM
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- Humans, United Kingdom, Surveys and Questionnaires, Male, Female, Adult, Preoperative Care methods, Health Personnel psychology, Health Personnel statistics & numerical data, Middle Aged, Nutritional Status, Nutrition Therapy methods, Preoperative Exercise, Hematopoietic Stem Cell Transplantation psychology, Attitude of Health Personnel
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Background: Nutritional prehabilitation may improve haematopoietic cell transplantation (HCT) outcomes, although little evidence exists. The present study aimed to understand healthcare professional (HCP) perceptions of prehabilitation and nutritional care pre-HCT in UK centres., Methods: An anonymous online survey (developed and refined via content experts and piloting) was administered via email to multidisciplinary HCPs in 39 UK adult centres, between July 2021 and June 2022. Data are presented as proportions of responses. Routine provision denotes that care was provided >70% of time., Results: Seventy-seven percent (n = 66) of HCPs, representing 61.5% (n = 24) of UK adult HCT centres, responded. All HCPs supported prehabilitation, proposing feasible implementation between induction chemotherapy (60.4%; n = 40) and first HCT clinic (83.3%; n = 55). Only 12.5% (n = 3) of centres had a dedicated prehabilitation service. Nutrition (87.9%; n = 58), emotional wellbeing (92.4%; n = 61) and exercise (81.8%; n = 54) were considered very important constituents. HCPs within half of the HCT centres (n = 12 centres) reported routine use of nutrition screening pre-HCT with a validated tool; 66.7% of HCPs (n = 36) reported using the malnutrition universal screening tool (MUST). Sixty-two percent (n = 41) of HCPs reported those at risk, received nutritional assessments, predominantly by dietitians (91.6%; n = 22) using the dietetic care process (58.3%; n = 14). Body mass index (BMI) was the most frequently reported body composition measure used by HCPs (70.2%, n = 33). Of 59 respondents, non-dietitians most routinely provided dietary advice pre-HCT (82.4%; n = 28 vs. 68%; n = 17, p = 0.2); including high-energy/protein/fat and neutropenic diet advice. Prophylactic enteral feeding pre-HCT was rare, indicated by low BMI and significant unintentional weight loss. Just under half (n = 25 of 59, 42.4%) HCPs reported exercise advice was given routinely pre-HCT., Conclusions: Nutrition and prehabilitation pre-HCT are considered important and deliverable by HCPs, but current provision in UK centres is limited and inconsistent., (© 2024 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)
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38. Correction: Treosulfan compared to busulfan in allogeneic haematopoietic stem cell transplantation for myelofibrosis: a registry-based study from the Chronic Malignancies Working Party of the EBMT.
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Robin M, Iacobelli S, Koster L, Passweg J, Avenoso D, Wilson KMO, Salmenniemi U, Dreger P, von dem Borne P, Snowden JA, Robinson S, Finazzi MC, Schroeder T, Collin M, Eder M, Forcade E, Loschi M, Bramanti S, Pérez-Simón JA, Czerw T, Polverelli N, Drozd-Sokolowska J, Raj K, Hernández-Boluda JC, and McLornan DP
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39. Does IPSS-R downstaging before transplantation improve the prognosis of patients with myelodysplastic neoplasms?
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Scheid C, Eikema DJ, van Gelder M, Salmenniemi U, Maertens J, Passweg J, Blaise D, Byrne JL, Kröger N, Sockel K, Chevallier P, Bourhis JH, Cornelissen JJ, Sengeloev H, Finke J, Snowden JA, Gedde-Dahl T, Cornillon J, Schanz U, Patel A, Koster L, de Wreede LC, Hayden P, Raj K, Drozd-Sokolowska J, Gurnari C, Onida F, McLornan DP, Robin M, and Yakoub-Agha I
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- Humans, Male, Female, Middle Aged, Aged, Retrospective Studies, Prognosis, Adult, Neoplasm Staging, Treatment Outcome, Young Adult, Myelodysplastic Syndromes therapy, Myelodysplastic Syndromes mortality, Myelodysplastic Syndromes pathology, Hematopoietic Stem Cell Transplantation methods
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Abstract: In patients with myelodysplastic syndrome (MDS), higher revised International Prognostic Scoring System (IPSS-R) scores at transplant are associated with worse transplant outcome and, thus, lowering IPSS-R scores by therapeutic intervention before transplantation may seem beneficial. However, there is no evidence, to date, to support this approach. In a retrospective analysis, a total of 1482 patients with MDS with sufficient data to calculate IPSS-R score at diagnosis and at time of transplantation were selected from the European Society for Blood and Marrow Transplantation transplant registry and analyzed for transplant outcome in a multivariable Cox model including IPSS-R score at diagnosis, treatment intervention, change in IPSS-R score before transplant, and several patient and transplant variables. Transplant outcome was unaffected by IPSS-R score change in untreated patients and moderately superior in patients treated with chemotherapy with improved IPSS-R score at transplant. Improved IPSS-R score after hypomethylating agents (HMAs) or other therapies showed no beneficial effect. However, when IPSS-R score progressed after chemotherapy, HMAs, or other therapies, transplant outcome was worse than without any prior treatment. Similar results were found when reduction or increase in bone marrow (BM) blasts between diagnosis and transplantation was considered. The results show a limited benefit of IPSS-R score downstaging or reduction of BM blasts after chemotherapy and no benefit for HMAs or other treatments and thus question the role of prior therapy in patients with MDS scheduled for transplantation. The model-based survival estimates should help inform decision-making for both doctors and patients., (© 2024 American Society of Hematology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)
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40. Treosulfan compared to busulfan in allogeneic haematopoietic stem cell transplantation for myelofibrosis: a registry-based study from the Chronic Malignancies Working Party of the EBMT.
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Robin M, Iacobelli S, Koster L, Passweg J, Avenoso D, Wilson KMO, Salmenniemi U, Dreger P, von dem Borne P, Snowden JA, Robinson S, Finazzi MC, Schroeder T, Collin M, Eder M, Forcade E, Loschi M, Bramanti S, Pérez-Simón JA, Czerw T, Polverelli N, Drozd-Sokolowska J, Raj K, Hernández-Boluda JC, and McLornan DP
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- Humans, Middle Aged, Male, Female, Adult, Aged, Transplantation Conditioning methods, Transplantation, Homologous methods, Graft vs Host Disease mortality, Busulfan analogs & derivatives, Busulfan therapeutic use, Primary Myelofibrosis therapy, Primary Myelofibrosis mortality, Hematopoietic Stem Cell Transplantation methods, Registries
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We aimed to compare outcomes following treosulfan (TREO) or busulfan (BU) conditioning in a large cohort of myelofibrosis (MF) patients from the EBMT registry. A total of 530 patients were included; 73 received TREO and 457 BU (BU ≤ 6.4 mg/kg in 134, considered RIC, BU > 6.4 mg/kg in 323 considered higher dose (HD)). Groups were compared using adjusted Cox models. Cumulative incidences of engraftment and acute GVHD were similar across the 3 groups. The TREO group had significantly better OS than BU-HD (HR:0.61, 95% CI: 0.39-0.93) and a trend towards better OS over BU-RIC (HR: 0.66, 95% CI: 0.41-1.05). Moreover, the TREO cohort had a significantly better Progression-Free-Survival (PFS) than both the BU-HD (HR: 0.57, 95% CI: 0.38-0.84) and BU-RIC (HR: 0.60, 95% CI: 0.39-0.91) cohorts, which had similar PFS estimates. Non-relapse mortality (NRM) was reduced in the TREO and BU-RIC cohorts (HR: 0.44, 95% CI: 0.24-0.80 TREO vs BU-HD; HR: 0.54, 95% CI: 0.28-1.04 TREO vs BU-RIC). Of note, relapse risk did not significantly differ across the three groups. In summary, within the limits of a registry-based study, TREO conditioning may improve PFS in MF HSCT and have lower NRM than BU-HD with a similar relapse risk to BU-RIC. Prospective studies are needed to confirm these findings., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
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41. Current challenges in cell and gene therapy: a joint view from the European Committee of the International Society for Cell & Gene Therapy (ISCT) and the European Society for Blood and Marrow Transplantation (EBMT).
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Sanchez-Guijo F, Vives J, Ruggeri A, Chabannon C, Corbacioglu S, Dolstra H, Farge D, Gagelmann N, Horgan C, Kuball J, Neven B, Rintala T, Rocha V, Sanchez-Ortega I, Snowden JA, Zwaginga JJ, Gnecchi M, and Sureda A
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- Humans, Europe, Registries, Societies, Medical, Accreditation methods, Genetic Therapy methods, Cell- and Tissue-Based Therapy methods
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Cell and gene therapy poses evolving challenges. The current article summarizes the discussions held by European Regional Committee of the International Society for Cell & Gene Therapy and the European Society for Blood and Marrow Transplantation (EBMT) on the current challenges in this field, focusing on the European setting. This article emphasizes the imperative assessment of real-world cell and gene therapy activity, advocating for expanded registries beyond hematopoietic transplantation and chimeric antigen receptor-T-cell therapy. Accreditation's role in ensuring standardized procedures, as exemplified by JACIE (The Joint Accreditation Committee of ISCT-Europe and EBMT), is crucial for safety. Access to commercial products and reimbursement variations among countries underscore the need for uniform access to advanced therapy medical products (ATMPs). Academic product development and point-of-care manufacturing face barriers to patient access. Hospital Exemption's potential, demonstrated by some initial experiences, may increase patient accessibility in individual situations. Regulatory challenges, including the ongoing European ATMPs legislation review, necessitate standardized criteria for Hospital Exemption and mandatory reporting within registries. Efforts to combat unproven therapies and fraud involve collaboration between scientific societies, regulatory bodies and patient groups. Finally, is important to highlight the vital role of education and workforce development in meeting the escalating demand for specialized professionals in the ATMP field. Collaboration among scientific societies, academic institutions, industry, regulatory bodies and patient groups is crucial for overcoming all these challenges to increase gene and cell therapy activity in Europe., Competing Interests: Declaration of Competing Interest FSG, JV, DF, JJZ and MG are members of the International Society for Cellular Therapy (ISCT-EU) Executive Committee. AR, CC, SC, HD, NG, CH, JHEK, BN, TR, ISG, JAS and AS are members of European Society for Blood and Marrow Transplantation (EBMT) executive committee or working groups representatives. FSG has received research support from Novartis, Gilead. Honoraria from Novartis, Gilead, Pfizer, BMS-Celgene and Pierre-Fabré. CC has received honoraria (personal and institutional) and travel support from Bellicum Pharmaceuticals, BMS, Jazz Pharmaceuticals, Kite / Gilead, Novartis and Sanofi SA as a compensation for speaker's bureau and advisory boards. JK was shareholder of Gadeta and is inventor on multiple patents dealing with engineered immune cells, and has received research support from Novartis, Milteny Biotech and Gadeta. JAS has received consultancy honoraria from Kiadis, Medac, Vertex and Jazz. AS has received research support from Takeda and honoraria from Takeda, BMS/Celgene, MSD, Novartis, Gilead Kite, Sanofi, Pierre Fabre, Janssen and Jazz Pharmaceuticals. All other authors have no commercial, proprietary or financial interest in the products or companies described in this article., (Copyright © 2024 International Society for Cell & Gene Therapy. Published by Elsevier Inc. All rights reserved.)
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42. European flow cytometry quality assurance guidelines for the diagnosis of primary immune deficiencies and assessment of immune reconstitution following B cell depletion therapies and transplantation.
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Kelleher P, Greathead L, Whitby L, Brando B, Barnett D, Bloxham D, deTute R, Dunlop A, Farren T, Francis S, Payne D, Scott S, Snowden JA, Sorour Y, Stansfield E, Virgo P, and Whitby A
- Abstract
Over the last 15 years activity of diagnostic flow cytometry services have evolved from monitoring of CD4 T cell subsets in HIV-1 infection to screening for primary and secondary immune deficiencies syndromes and assessment of immune constitution following B cell depleting therapy and transplantation. Changes in laboratory activity in high income countries have been driven by initiation of anti-retroviral therapy (ART) in HIV-1 regardless of CD4 T cell counts, increasing recognition of primary immune deficiency syndromes and the wider application of B cell depleting therapy and transplantation in clinical practice. Laboratories should use their experience in standardization and quality assurance of CD4 T cell counting in HIV-1 infection to provide immune monitoring services to patients with primary and secondary immune deficiencies. Assessment of immune reconstitution post B cell depleting agents and transplantation can also draw on the expertise acquired by flow cytometry laboratories for detection of CD34 stem cell and assessment of MRD in hematological malignancies. This guideline provides recommendations for clinical laboratories on providing flow cytometry services in screening for immune deficiencies and its emerging role immune reconstitution after B cell targeting therapies and transplantation., (© 2024 The Author(s). Cytometry Part B: Clinical Cytometry published by Wiley Periodicals LLC on behalf of International Clinical Cytometry Society.)
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43. Results from UKALL60+, a phase 2 study in older patients with untreated acute lymphoblastic leukemia.
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Patel B, Kirkwood AA, Rowntree CJ, Alapi KZ, Barretta E, Clifton-Hadley L, Creasey T, Lee S, Marks DI, Moorman AV, Morley N, Patrick P, Rana Z, Rijneveld A, Snowden JA, and Fielding AK
- Abstract
Competing Interests: The authors declare no conflict of interest.
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44. Immunogenicity of third dose COVID-19 vaccine strategies in patients who are immunocompromised with suboptimal immunity following two doses (OCTAVE-DUO): an open-label, multicentre, randomised, controlled, phase 3 trial.
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Goodyear CS, Patel A, Barnes E, Willicombe M, Siebert S, de Silva TI, Snowden JA, Lim SH, Bowden SJ, Billingham L, Richter A, Carroll M, Carr EJ, Beale R, Rea D, Parry H, Pirrie S, Lim Z, Satsangi J, Dunachie SJ, Cook G, Miller P, Basu N, Gilmour A, Hodgkins AM, Evans L, Hughes A, Longet S, Meacham G, Yong KL, A'Hearne MJ, Koh MBC, Burns SO, Orchard K, Paterson C, McIlroy G, Murray SM, Thomson T, Dimitriadis S, Goulston L, Miller S, Keillor V, Prendecki M, Thomas D, Kirkham A, McInnes IB, and Kearns P
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- Humans, Female, Male, Middle Aged, Aged, Antibodies, Viral blood, Prospective Studies, Immunization, Secondary, 2019-nCoV Vaccine mRNA-1273 immunology, Adult, T-Lymphocytes immunology, United Kingdom, ChAdOx1 nCoV-19 immunology, COVID-19 prevention & control, COVID-19 immunology, Immunocompromised Host immunology, SARS-CoV-2 immunology, COVID-19 Vaccines immunology, COVID-19 Vaccines administration & dosage, Immunogenicity, Vaccine, BNT162 Vaccine immunology, BNT162 Vaccine administration & dosage
- Abstract
Background: The humoral and T-cell responses to booster COVID-19 vaccine types in multidisease immunocompromised individuals who do not generate adequate antibody responses to two COVID-19 vaccine doses, is not fully understood. The OCTAVE DUO trial aimed to determine the value of third vaccinations in a wide range of patients with primary and secondary immunodeficiencies., Methods: OCTAVE-DUO was a prospective, open-label, multicentre, randomised, controlled, phase 3 trial investigating humoral and T-cell responses in patients who are immunocompromised following a third vaccine dose with BNT162b2 or mRNA-1273, and of NVX-CoV2373 for those with lymphoid malignancies. We recruited patients who were immunocompromised from 11 UK hospitals, aged at least 18 years, with previous sub-optimal responses to two doses of SARS-CoV-2 vaccine. Participants were randomly assigned 1:1 (1:1:1 for those with lymphoid malignancies), stratified by disease, previous vaccination type, and anti-spike antibody response following two doses. Individuals with lived experience of immune susceptibility were involved in the study design and implementation. The primary outcome was vaccine-specific immunity defined by anti-SARS-CoV-2 spike antibodies (Roche Diagnostics UK and Ireland, Burgess Hill, UK) and T-cell responses (Oxford Immunotec, Abingdon, UK) before and 21 days after the third vaccine dose analysed by a modified intention-to-treat analysis. The trial is registered with the ISRCTN registry, ISRCTN 15354495, and the EU Clinical Trials Register, EudraCT 2021-003632-87, and is complete., Findings: Between Aug 4, 2021 and Mar 31, 2022, 804 participants across nine disease cohorts were randomly assigned to receive BNT162b2 (n=377), mRNA-1273 (n=374), or NVX-CoV2373 (n=53). 356 (45%) of 789 participants were women, 433 (55%) were men, and 659 (85%) of 775 were White. Anti-SARS-CoV-2 spike antibodies measured 21 days after the third vaccine dose were significantly higher than baseline pre-third dose titres in the modified intention-to-treat analysis (median 1384 arbitrary units [AU]/mL [IQR 4·3-7990·0] compared with median 11·5 AU/mL [0·4-63·1]; p<0·001). Of participants who were baseline low responders, 380 (90%) of 423 increased their antibody concentrations to more than 400 AU/mL. Conversely, 166 (54%) of 308 baseline non-responders had no response after the third dose. Detectable T-cell responses following the third vaccine dose were seen in 494 (80%) of 616 participants. There were 24 serious adverse events (BNT612b2 eight [33%] of 24, mRNA-1273 12 [50%], NVX-CoV2373 four [17%]), two (8%) of which were categorised as vaccine-related. There were seven deaths (1%) during the trial, none of which were vaccine-related., Interpretation: A third vaccine dose improved the serological and T-cell response in the majority of patients who are immunocompromised. Individuals with chronic renal disease, lymphoid malignancy, on B-cell targeted therapies, or with no serological response after two vaccine doses are at higher risk of poor response to a third vaccine dose., Funding: Medical Research Council, Blood Cancer UK., Competing Interests: Declaration of interests DR reports research funding from Roche, Biotheranostics, RNA diagnostics, and Celgene; and honoraria or consultancy fees from Novartis, Pfizer, Lily, Roche, and AstraZeneca–Diiachi Sankyo. EB reports research funding from Vaccitech; consultancy fees from Roche, Vaccitech, and AstraZeneca; and holds patents in ChAdOx1 hepatitis B virus and hepatitis C virus vaccines. HP reports honoraria from AstraZeneca. IBM reports research funding or consultancy fees from AbbVie, Amgen, Bristol-Myers Squibb (BMS), Causeway Therapeutics Cabaletta, Eli Lilly, Evelo Biosciences, Gilead, GSK, Janssen, Novartis, Pfizer, Sanofi Regeneron, and UCB; consultancy fees from AbbVie, Amgen, BMS, Causeway Therapeutics Cabaletta, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, Sanofi Regeneron, and UCB; and is on the board of directors of Evelo Biosciences. KO reports royalties to his institution from Telix Pharmaceuticals for Radiolabelled anti-CD66 antibody; consulting fees from Sanofi and Takeda; and stocks in GSK. KLY reports honoraria from Sanofi Genzyme, Takeda, and Amgen; support for meeting attendance from Takeda; and participation on a trial steering committee for Sanofi and an advisory board for Janssen. MJA reports research funding from Pfizer. MW reports research funding from Oxford Immunotech. MBCK reports honoraria from Gilead. MC reports consultancy fees from VacciTech. PK reports research funding from Bayer; and consultancy fees from AstraZeneca, Merck, and BMS. SM reports stock options in TCB BioPharm. SHL reports honoraria from AstraZeneca. SS reports research funding from Amgen, Boehringer-Ingelheim, BMS, GSK, Janssen, and UCB; and consultancy fees or honoraria from AbbVie, Eli Lilly, GSK, Janssen, and UCB. SOB reports research funding from CSL Behring; and consultancy fees, honoraria, or support for attending meetings from GSK, Baxalta US, and Biotest. JAS reports honoraria from Novartis and Gilead; advisory board fees from the Kiadis clinical trial, Medac, and NHS England National Specialised Commissioning Clinical Reference Group for Blood and Marrow Transplantation; and unpaid roles as President of British Society of Blood and Marrow Transplantation and Cellular Therapy, secretary of the European Society for Blood and Marrow Transplantation and as a board member of the British Society of Haematology. SJD is a Scientific Advisor to the Scottish Parliament on COVID-19 for which she receives a fee. All other authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
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45. The role of registries in hematological disorders.
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Baldomero H, Neumann D, Hamad N, Atsuta Y, Sureda A, Iida M, Karduss A, Elhaddad AM, Bazuaye NG, Bonfim C, Camara R, Chaudhri NA, Ciceri F, Correa C, Frutos C, Galeano S, Garderet L, Greco R, Jaimovich G, Kodera Y, Koh MB, Liu K, Ljungman P, McLornan DP, Nair G, Okamoto S, Pasquini MC, Passweg J, Paulson K, Ruggeri A, Seber A, Snowden JA, Srivastava A, Worel N, Saber W, Rondelli D, Aljurf M, and Niederwieser D
- Subjects
- Humans, Registries, Hematopoietic Stem Cell Transplantation, Hematologic Diseases therapy
- Abstract
Hematopoietic cell transplantation (HCT) was developed more than 65 years ago to treat malignant blood disorders and irreversible bone marrow failures, with the aim of replacing a diseased hematopoietic system with a healthy one (allogeneic HCT). Decades later, the procedure was adapted to apply maximal chemotherapy or radiotherapy, which would result in bone marrow failure, but could be remedied by an infusion of a patient's own cryopreserved bone marrow (autologous HCT). Both treatments are high-risk and complex, especially during the initial phases. However, concerted efforts, vision, and collaboration between physicians and centers worldwide have resulted in HCT becoming a standard of care for many hematological disorders with progressive improvements in outcomes. Registries and the collaboration of societies worldwide have enabled the delivery of this curative therapy to many patients with fatal hematological diseases. More than 1.5 million HCT were performed between 1957 and 2019, and activity is continuously increasing worldwide., Competing Interests: Declaration of cometing interest NH reports advisory board honoraria from Janssen, Novartis, Takeda, Abbvie, Roche, Astellas and Bigene. YA reports consulting fees from JCR Pharmaceuticals Co., Ltd. and Kyowa Kirin Co., Ltd., lecture fees from Otsuka Pharmaceutical Co., Ltd, Chugai Pharmaceutical Co., Ltd., Novartis Pharma KK, AbbVie GK, and honorarium from Meiji Seika Pharma Co., Ltd. MI is affiliated with the Department of Promotion for Blood and Marrow Transplantation at the Aichi Medical University School of Medicine, and the department is endowed by AIR WATER INC., Clinigen K.K., and JCR Pharmaceuticals Co., Ltd. CF reports support for attending meetings from Casa Bollar and support for attending meetings and travel from Diaz Gill Lab and Prosalud. LG reports consulting fees from Sanofi, Janssen Pharmaceutical, Bristol Myers Squibb, and GlaxoSmithKline Pharmaceuticals and support for attending meetings and travel from Pfizer and Sanofi. KK reports honoraria from Pierre Fabre, Medac, and Novartis. J Snowden reports consulting fees from Jazz Pharmaceuticals, Medac Pharma, Vertex Pharmaceuticals, and participation in a Data Safety Monitoring Board in Kiadis Pharma. NW reports consulting and speakers fees from BMS Celgene, Kite Gilead, Miltenyi BioTec, Novartis, Piere Fabre and Therakos Mallinckrodt. The other authors report no conflicts of interest to disclose., (Copyright © 2024. Published by Elsevier Ltd.)
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46. Hematopoietic cell transplantation and cellular therapies in Europe 2022. CAR-T activity continues to grow; transplant activity has slowed: a report from the EBMT.
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Passweg JR, Baldomero H, Ciceri F, de la Cámara R, Glass B, Greco R, Hazenberg MD, Kalwak K, McLornan DP, Neven B, Perić Z, Risitano AM, Ruggeri A, Snowden JA, and Sureda A
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- Humans, Europe, Male, Female, Hematopoietic Stem Cell Transplantation methods
- Abstract
In 2022, 46,143 HCT (19,011 (41.2%) allogeneic and 27,132 (58.8%) autologous) in 41,854 patients were reported by 689 European centers. 4329 patients received advanced cellular therapies, 3205 of which were CAR-T. An additional 2854 patients received DLI. Changes compared to the previous year were an increase in CAR-T treatments (+27%) and decrease in allogeneic (-4.0%) and autologous HCT (-1.7%). Main indications for allogeneic HCT were myeloid malignancies (10,433; 58.4%), lymphoid malignancies (4,674; 26.2%) and non-malignant disorders (2572; 14.4%). Main indications for autologous HCT were lymphomas (7897; 32.9%), PCD (13,694; 57.1%) and solid tumors (1593; 6.6%). In allogeneic HCT, use of sibling donors decreased by -7.7%, haploidentical donors by -6.3% and unrelated donors by -0.9%. Overall cord blood HCT decreased by -16.0%. Use of allogeneic, and to a lesser degree autologous HCT, decreased for lymphoid malignancies likely reflecting availability of new treatment modalities, including small molecules, bispecific antibodies, and CAR-T cells. Pediatric HCT activity remains stable (+0.3%) with differences between allogeneic and autologous HCT. Use of CAR-T continues to increase and reached a cumulative total of 9039 patients treated with wide differences across European countries. After many years of continuous growth, increase in application of HCT seems to have slowed down., (© 2024. The Author(s).)
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- 2024
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47. Patient-reported outcomes in HSCT for autoimmune diseases: Considerations on behalf of the EBMT ADWP, PAC, and Nurses Group.
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Alexander T, Tassy N, Domenech A, Kramer E, Jessop H, Kenyon M, Sharrack B, Saccardi R, Bolanos N, Snowden JA, and Greco R
- Abstract
Background: Over the last 3 decades, hematopoietic stem cell transplantation (HSCT) has been successfully used to treat severe and refractory autoimmune diseases (AIDs). A multidisciplinary appraisal of potential benefits and risks by disease and transplant specialists is essential to determine individual suitability for HSCT., Objective: Our aim was to observe that patient-reported outcomes (PROs) and health-related quality of life instruments can capture the unique patient perspective on disease burden and impact of treatment., Methods: Herein, we describe the basis and complexity of end points measuring patient-reported perceptions of efficacy and tolerability used in clinical practice and trials for patients with AIDs undergoing autologous HSCT., Results: PRO measures and patient-reported experience measures are key tools to evaluate the impact and extent of disease burden for patients affected by AIDs. For formal scientific assessment, it is essential that validated general instruments are used, whereas adaptations have resulted in disease-specific instruments that may help guide tailored interventions. An additional approach relates to qualitative evaluations, from carefully structured qualitative research to informal narratives, as patient stories. The patients' subjectively reported responses to HSCT may be influenced by their preprocedure expectations and investment in the HSCT journey., Conclusions: The complexity of AIDs advocates for individualized and multidisciplinary approach to positively affect the patient journey. PROs and health-related quality of life need to be collected using validated instruments in clinical practice and trials to enable robustness of data and to ensure the impact of the intervention is comprehensively assessed, addressing the main questions and needs of the involved stakeholders., Competing Interests: This work was led and supported by the Autoimmune Diseases Working Party, Nurses Group, and Patient Advocacy Committee of the EBMT. The EBMT provided resources via the working party, data office, and registry. Other than EBMT support, there is no funding body supporting this work, commercial or otherwise. Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest., (© 2024 The Author(s).)
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- 2024
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48. Safety and efficacy of autologous haematopoietic stem-cell transplantation with low-dose cyclophosphamide mobilisation and reduced intensity conditioning versus standard of care in refractory Crohn's disease (ASTIClite): an open-label, multicentre, randomised controlled trial.
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Lindsay JO, Hind D, Swaby L, Berntsson H, Bradburn M, Bannur C U, Byrne J, Clarke C, Desoysa L, Dickins B, Din S, Emsley R, Foulds GA, Gribben J, Hawkey C, Irving PM, Kazmi M, Lee E, Loban A, Lobo A, Mahida Y, Moran GW, Papaioannou D, Parkes M, Peniket A, Pockley AG, Satsangi J, Subramanian S, Travis S, Turton E, Uttenthal B, Rutella S, and Snowden JA
- Subjects
- Adult, Humans, Standard of Care, State Medicine, Ulcer etiology, Treatment Outcome, Cyclophosphamide adverse effects, Granulocyte Colony-Stimulating Factor therapeutic use, Crohn Disease drug therapy, Hematopoietic Stem Cell Transplantation adverse effects, Renal Insufficiency
- Abstract
Background: A previous controlled trial of autologous haematopoietic stem-cell transplantation (HSCT) in patients with refractory Crohn's disease did not meet its primary endpoint and reported high toxicity. We aimed to assess the safety and efficacy of HSCT with an immune-ablative regimen of reduced intensity versus standard of care in this patient population., Methods: This open-label, multicentre, randomised controlled trial was conducted in nine National Health Service hospital trusts across the UK. Adults (aged 18-60 years) with active Crohn's disease on endoscopy (Simplified Endoscopic Score for Crohn's Disease [SES-CD] ulcer sub-score of ≥2) refractory to two or more classes of biological therapy, with no perianal or intra-abdominal sepsis or clinically significant comorbidity, were recruited. Participants were centrally randomly assigned (2:1) to either HSCT with a reduced dose of cyclophosphamide (intervention group) or standard care (control group). Randomisation was stratified by trial site by use of random permuted blocks of size 3 and 6. Patients in the intervention group underwent stem-cell mobilisation (cyclophosphamide 1 g/m
2 with granulocyte colony-stimulating factor (G-CSF) 5 μg/kg) and stem-cell harvest (minimum 2·0 × 106 CD34+ cells per kg), before conditioning (fludarabine 125 mg/m2 , cyclophosphamide 120 mg/kg, and rabbit anti-thymocyte globulin [thymoglobulin] 7·5 mg/kg in total) and subsequent stem-cell reinfusion supported by G-CSF. Patients in the control group continued any available conventional, biological, or nutritional therapy. The primary outcome was absence of endoscopic ulceration (SES-CD ulcer sub-score of 0) without surgery or death at week 48, analysed in the intention-to-treat population by central reading. This trial is registered with the ISRCTN registry, 17160440., Findings: Between Oct 18, 2018, and Nov 8, 2019, 49 patients were screened for eligibility, of whom 23 (47%) were randomly assigned: 13 (57%) to the intervention group and ten (43%) to the control group. In the intervention group, ten (77%) participants underwent HSCT and nine (69%) reached 48-week follow-up; in the control group, nine (90%) reached 48-week follow-up. The trial was halted in response to nine reported suspected unexpected serious adverse reactions in six (46%) patients in the intervention group, including renal failure due to proven thrombotic microangiopathy in three participants and one death due to pulmonary veno-occlusive disease. At week 48, absence of endoscopic ulceration without surgery or death was reported in three (43%) of seven participants in the intervention group and in none of six participants in the control group with available data. Serious adverse events were more frequent in the intervention group (38 in 13 [100%] patients) than in the control group (16 in four [40%] patients). A second patient in the intervention group died after week 48 of respiratory and renal failure., Interpretation: Although HSCT with an immune-ablative regimen of reduced intensity decreased endoscopic disease activity, significant adverse events deem this regimen unsuitable for future clinical use in patients with refractory Crohn's disease., Funding: Efficacy and Mechanism Evaluation Programme, a Medical Research Council and National Institute for Health Research partnership., Competing Interests: Declaration of interests JOL reports grants for investigator-initiated research from the National Institute for Health and Care Research (NIHR) Efficacy and Mechanism Evaluation research grant for the current project, AbbVie, Gilead Sciences, Takeda UK, and Shire; honoraria for consulting or advisory boards from AbbVie, Allergan, Atlantic Healthcare, Bristol Meyers Squibb, Celgene, Celltrion, Lilly, Ferring Pharmaceuticals, Galapagos NV, Gilead Sciences, GlaxoSmithKline, Janssen, MSD, Napp Pharmaceuticals, Norgine BV, Pfizer, Shire, Takeda UK, and Vifor Pharma Management; honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie, Bristol Meyers Squibb, Ferring Pharmaceuticals, Galapagos NV, Janssen, Norgine BV, Pfizer, Shire, Takeda UK, and Cornerstone Healthcare Group; and support for attending meetings, travel, or both from AbbVie, Takeda UK, MSD, Ferring Pharmaceuticals, and Janssen, outside the submitted work. DH reports part funding for salary through the NIHR Efficacy and Mechanism Evaluation research grant for this project. RE reports participation in the NIHR Clinical Trials Unit Standing Advisory Committee (2020 to present), and the Health Technology Assessment Clinical Evaluation and Trials Committee (2017–21). LD reports various NIHR grants, none of which relate to Crohn's disease or investigate treatments similar to those in ASTIClite. SD reports salary funding from NHS Research Scotland via NHS Lothian to support clinical trial work; grants from the Edinburgh & Lothian Health Foundations Award, the Pathological Society of Great Britain & Northern Ireland, Helmsley Charitable Trust–Gut Cell Atlas Normal and Crohn's Disease, and Helmsley Charitable Trust CDTREAT and BIOPIC studies; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Jannsen, Ferring, Takeda, and AbbVie; and support for attending meetings, travel, or both from Janssen, Dr Falk Symposium, and AbbVie. SD also reports participation on a data safety monitoring board or advisory board for AbbVie and MHRA; and leadership or fiduciary role on other board, society, committee, or advocacy groups for the British Society of Gastroenterology, the Royal College of Physicians of Edinburgh, and the Scottish Government. JG reports consulting fees from AbbVie, AstraZeneca, Bristol Meyers Squibb, Gilead Sciences, Janssen, MorphoSys AG, and Novartis AG; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie, Bristol Meyers Squibb, Gilead Sciences, and Janssen; and participation on a data safety monitoring board or advisory board for AstraZeneca, outside the submitted work. PI reports grants or contracts from MSD, Takeda UK, Celltrion, and Pfizer; consulting fees from Bristol Meyers Squibb, AbbVie, Arena, Boehringer-Ingelheim, Celgene, Celltrion, Genentech, Gilead, Hospira, Janssen, Lilly, MSD, Pfizer, Pharmacosmos, Prometheus, Roche, Sandoz, Samsung Bioepis, Takeda, Topivert, VH2, Vifor Pharma, and Warner Chilcott; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie, Bristol Meyers Squibb, Celgene, Celltrion, Dr Falk Pharma GmbH, Ferring Pharmaceuticals, Galapagos NV, Gilead Sciences, MSD, Janssen, Pfizer, Takeda UK, Tillotts Pharma AG, Sapphire Medical, Sandoz, Shire, and Warner Chilcott UK, outside the submitted work. EL reports various other NIHR grants, none of which relate to Crohn's disease or investigate treatments similar to those in ASTIClite; and participation in two data monitoring and ethics committees and two trial steering committees for NIHR trials outside the submitted work, none of which relate to Crohn's disease. MP reports grants or contracts from Pfizer, Gilead Sciences, and Crohn's & Colitis UK, outside the submitted work; and a leadership role as Director of Cambridge Biomedical Research Centre, outside the submitted work (2020 to present). AL reports consulting fees from Takeda UK, Vifor Pharma Management, Janssen, and PredictImmune; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Takeda UK, Janssen, and Celltrion; support for attending meetings, travel, or both from Janssen, Tillotts Pharma AG, Takeda UK, and Vifor Pharma Management; and is Director of the non-executive IBD Registry Board. AGP reports being the Chief Executive Officer of multimmune GmbH, Chief Scientific Officer of Alphageneron Pharmaceuticals, and a member of the scientific advisory board of Cytomos, none of which relate to Crohn's disease and all are outside the submitted work. SS reports grants or contracts from Crohn's & Colitis UK and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Takeda UK, Janssen, AbbVie, Celltrion, Boehringer Ingelheim International GmbH, and Bristol Meyers Squibb, outside the submitted work; and participation on a data safety monitoring board or advisory board for Takeda UK, Janssen, AbbVie, Celltrion, Boehringer Ingelheim International GmbH, Bristol Meyers Squibb, and Vifor Pharma Management, outside the submitted work. JS reports grant funding for IBD research from the European Crohn's & Colitis Organization (ECCO), The Leona M and Harry B Helmsley Charitable Trust, Crohn's & Colitis UK, Crohn's & Colitis Foundation, Action Medical Research, the NIHR Efficacy and Mechanism Evaluation, European Commission FP-7, and Horizon 2020 programmes, outside the submitted work; and payment or honoraria for a lecture for the Falk Foundation, and a leadership role on the UK IBD Registry Management Board. ST reports grants or contracts from ECCO, the Leona M and Harry B Helmsley Charitable Trust, Ferring Pharmaceuticals, Janssen, Lilly, Pfizer, Takeda UK, and the Norman Collisson Charitable Trust; and consulting fees from ai4gi Joint Venture, Allergan, Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim International GmbH, Bristol Meyers Squibb, Bühlmann Laboratories AG, Celgene, ChemoCentryx, Cosmo Pharmaceuticals NV, Enterome, Equillium, Ferring Pharmaceuticals, Genentech–Roche, Gilead Sciences, Glenmark Pharmaceuticals, Grünenthal, GlaxoSmithKline, Immunometabolism, Indigo Diabetes, Janssen, Lilly, Merck KGaA, Mestag Therapeutics, Novartis AG, Pfizer, PharmaVentures, Phesi, Satisfai Health, Sensyne Health, Sorriso, SynDermix, Synthon, Takeda UK, Topivert, UCB SA, Vertex Pharmaceuticals, VHsquared, and Vifor Pharma Management, outside the submitted work. ST also reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AbbVie, Amgen, Biogen, Dr Falk Pharma GmbH, Ferring Pharmaceuticals, Janssen, Pfizer, Shire, Takeda UK, and UCB SA; payment for expert testimony from Cosmo; support for attending meetings, travel, or both from AbbVie, Amgen, Biogen, Dr Falk Pharma GmbH, Ferring Pharmaceuticals, Janssen, Pfizer, Shire, Takeda UK, and UCB SA; and participation on a data safety monitoring board or advisory board for Amgen, outside the submitted work. SR reports research funding from MacroGenics and Kura Oncology, outside the submitted work. BU reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events for Gilead and Novartis; and support for attending meetings, travel, or both from Takeda and Gilead. JS reports support for the current work through a NIHR Efficacy and Mechanism Evaluation grant; consulting fees from Medac (not directly related to Crohn's disease); and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Jazz Pharmaceuticals, Mallinckrodt Pharmaceuticals, Janssen, Gilead Sciences, Vertex, and Actelion, none of which directly relate to Crohn's disease, outside the submitted work. JS also reports participation on the Kiadis Pharma trial Independent Data Monitoring Committee, which does not directly relate to Crohn's disease, outside the submitted work. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)- Published
- 2024
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49. Allogeneic hematopoietic cell transplantation for VEXAS syndrome: results of a multicenter study of the EBMT.
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Gurnari C, Koster L, Baaij L, Heiblig M, Yakoub-Agha I, Collin M, Passweg J, Bulabois CE, Khan A, Loschi M, Carnevale-Schianca F, Crisà E, Caravelli D, Kuball J, Saraceni F, Olivieri A, Rambaldi A, Kulasekararaj AG, Hayden PJ, Badoglio M, Onida F, Scheid C, Franceschini F, Mekinian A, Savic S, Voso MT, Drozd-Sokolowska J, Snowden JA, Raj K, Alexander T, Robin M, Greco R, and McLornan DP
- Subjects
- Transplantation, Homologous, Humans, Hematopoietic Stem Cell Transplantation methods, Myelodysplastic Syndromes, Skin Diseases, Genetic
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- 2024
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50. Current use of androgens in bone marrow failure disorders: a report from the Severe Aplastic Anemia Working Party of the European Society for Blood and Marrow Transplantation.
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Pagliuca S, Kulasekararaj AG, Eikema DJ, Piepenbroek B, Iftikhar R, Satti TM, Griffin M, Laurino M, Kupesiz A, Bertrand Y, Fattizzo B, Yakoub-Agha I, Aljurf M, Corti P, Massaccesi E, Lioure B, Calabuig M, Klammer M, Unal E, Wu D, Chevallier P, Forcade E, Snowden JA, Ozdogu H, Risitano A, and De Latour RP
- Subjects
- Humans, Adult, Child, Androgens, Bone Marrow, Prospective Studies, Retrospective Studies, Bone Marrow Failure Disorders, Anemia, Aplastic therapy
- Abstract
Androgens represent the historical therapeutic backbone of bone marrow failure (BMF) syndromes. However, their role has rarely been analyzed in a prospective setting, and systematic and long-term data regarding their usage, effectiveness and toxicity in both acquired and inherited BMF are currently unavailable. Here, taking advantage of a unique disease-specific international dataset, we retrospectively analyzed the largest cohort so far of BMF patients who received androgens before or in the absence of an allogeneic hematopoietic cell transplantation (HCT), re-evaluating their current use in these disorders. We identified 274 patients across 82 European Society for Blood and Marrow Transplantation (EBMT) affiliated centers: 193 with acquired (median age 32 years) and 81 with inherited (median age 8 years) BMF. With a median duration of androgen treatment of 5.6 and 20 months, respectively, complete and partial remission rates at 3 months were 6% and 29% in acquired and 8% and 29% in inherited disorders. Five-year overall survival and failure-free survival (FFS) were respectively 63% and 23% in acquired and 78% and 14% in inherited BMF. Androgen initiation after second-line treatments for acquired BMF, and after >12 months post diagnosis for inherited BMF were identified as factors associated with improved FFS in multivariable analysis. Androgen use was associated with a manageable incidence of organ-specific toxicity, and low rates of solid and hematologic malignancies. Sub-analysis of transplant-related outcomes after exposure to these compounds showed probabilities of survival and complications similar to other transplanted BMF cohorts. This study delivers a unique opportunity to track androgen use in BMF syndromes and represents the basis for general recommendations on this category of therapeutics on behalf of the Severe Aplastic Anemia Working Party of the EBMT.
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- 2024
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