المؤلفون: Chorão, Pedro, Montoro, Juan, Balaguer-Roselló, Aitana, Guerreiro, Manuel, Villalba, Marta, Facal, Ana, Solves, Pilar, Gómez-Segui, Inés, Pasquini, Marcelo C., Granados, Pablo, Bataller, Ana, Louro, Alberto, de la Rubia, Javier, Sanz, Miguel A., Sanz, Jaime

المصدر: Transplantation and Cellular Therapy ; volume 29, issue 5, page 322.e1-322.e5 ; ISSN 2666-6367

مصطلحات موضوعية: Transplantation, Cell Biology, Hematology, Molecular Medicine, Immunology and Allergy

الإتاحة: https://doi.org/10.1016/j.jtct.2023.01.016Test
https://api.elsevier.com/content/article/PII:S2666636723000374?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2666636723000374?httpAccept=text/plainTest

المؤلفون: Cordón, Lourdes, Chorão, Pedro, Martín-Herreros, Beatriz, Montoro, Juan, Balaguer, Aitana, Guerreiro, Manuel, Villalba, Marta, Facal, Ana, Asensi, Pedro, Solves, Pilar, Gómez, Inés, Santiago, Marta, Lamas, Brais, Bataller, Ana, Granados, Pablo, Sempere, Amparo, Sanz, Guillermo F., Sanz, Miguel A., Sanz, Jaime

المصدر: Annals of Hematology; Jul2024, Vol. 103 Issue 7, p2475-2484, 10p

مستخلص: This study aimed to investigate the kinetics of immune recovery following umbilical cord blood transplantation (UCBT) in adults who received a myeloablative conditioning (MAC) regimen and antithymocyte globulin (ATG). While the immune recovery kinetics has been extensively studied in pediatric UCBT recipients, limited data exist for adults. We conducted a comprehensive analysis of 221 consecutive adult patients who underwent UCBT with MAC and ATG at a single institution. Our objective was to evaluate the influence of patient, disease, and transplant factors, along with acute graft-versus-host disease (aGVHD), on immune reconstitution and overall survival. Our findings confirm a delayed recovery of T cells, while B and NK cell reconstitution exhibited rapid progress, with NK cell counts reaching normal levels within 3 months post-transplantation and B cells within 6 months. Within CD3⁺ T cells, CD8⁺ T cells also experienced a delayed recovery (12 months), but to a lesser extent compared to CD4⁺ T cells (18 months). Delayed immune recovery of T-cell subsets was associated with the development of aGVHD grade II-IV, older age, CMV negativity, and a female donor. Patients with lymphoproliferative diseases showed slower NK cell recovery. Our study demonstrates that adult patients undergoing MAC with ATG and receiving a single unit UCBT for hematologic malignancies experienced rapid reconstitution of NK and B cells. However, T cell recovery, particularly CD4⁺ T cells, was significantly delayed. To enhance T cell recovery, it may be crucial to consider UCB units with higher cellularity and optimize ATG doses in conditioning. [ABSTRACT FROM AUTHOR]

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المؤلفون: Solves, Pilar^1,2 (AUTHOR) bataller_anaalf@gva.es, Bataller, Ana¹ (AUTHOR) galvez_anarui@gva.es, Gálvez, Ana Belén¹ (AUTHOR) asensi_ped@gva.es, Asensi Cantó, Pedro¹ (AUTHOR) santiago_marbal@gva.es, Santiago, Marta^1,2 (AUTHOR) gomez_ine@gva.es, Moreno, María José³ (AUTHOR) moreno_marjos@gva.es, Gómez-Seguí, Inés^1,2 (AUTHOR) delarubia_jav@gva.es, de la Rubia, Javier^1,2,4 (AUTHOR)

المصدر: Hemato. Jun2024, Vol. 5 Issue 2, p109-114. 6p.

مستخلص: Background: Selective IgA deficiency (IgA-D) has been historically considered a high-risk entity for developing allergic/anaphylactic reactions after blood transfusion (AATRs). However, it has been suggested that the IgA-D-related anaphylactic transfusion reaction is not evidence-based. Methods: We conducted three different approaches to collect evidence about epidemiology, AATRs, and transfusion management of patients with IgA-D at La Fe University Hospital. Firstly, we analysed the prevalence of IgA-D in a population of patients diagnosed with acute leukaemia, The second approach consisted of collecting transfusion data from IgA-D patients. Finally, we reviewed the IgA levels of patients recorded in the hemovigilance system suffering an AATR. Results: IgA-D prevalence was 1 in 334 patients. At least one blood component was transfused to 23 patients diagnosed with IgA-D. Plasma was transfused to eight IgA-D patients, while six patients received red blood cells, platelets, and plasma. No adverse reactions were reported in any patient. AATRs occurred in 325 men and 264 women with a median age of 52 years. Severe reactions occurred in 56 patients (1/14,520 components). Mean IgA levels were 215 mg/dL (4–5570) for mild reactions and 214 mg/dL (14–824) for severe reactions (p = ns). Washed platelets were administered to two patients who developed severe and repeated AATRs. Both had normal IgA levels. Conclusions: Since the AATRs related to IgA-D are extremely low, as reported in current hemovigilance systems, IgA-D should not be considered a high-risk entity to develop AATRs. On the contrary, our findings support standard transfusion management of IgA-D patients. [ABSTRACT FROM AUTHOR]

المؤلفون: Chorão, Pedro, Henriques, Marta, Villalba, Marta, Montoro, Juan, Balaguer-Roselló, Aitana, González, Eva María, Gómez, María Dolores, Gómez, Inés, Solves, Pilar, Santiago, Marta, Asensi, Pedro, Lamas, Brais, Bataller, Ana, Granados, Pablo, Eiris, Juan, Martínez, David, Louro, Alberto, Rebollar, Paula, Perla, Aurora, Salavert, Miguel, de la Rubia, Javier, Sanz, Miguel Ángel, Sanz, Jaime

المصدر: Transplantation and Cellular Therapy; May 2024, Vol. 30 Issue: 5 p538.e1-538.e10, 48430p

مستخلص: • First CMV reactivations in HSCT with PTCy without letermovir prophylaxis occurred in 46% of patients.• The reactivation rate was 73% for CMV seropositive recipients and 49% for CMV-seropositive donors.• Risk factors for reactivation were CMV seropositivity, haploidentical HSCT, older patient, and grade II-IV acute GVHD.• Second and third CMV reactivations occurred in 13% and 4.4% of patients, independent of donor type.

المؤلفون: Sanz, Miguel Ángel, Montoro, Juan, Balaguer-Roselló, Aitana, Chorão, Pedro, Villalba, Marta, Gómez, Inés, Solves, Pilar, Santiago, Marta, Asensi, Pedro, Lamas, Brais, Bataller, Ana, Granados, Pablo, Eiris, Juan, Martinez, David, Lloret, Pilar, Louro, Alberto, Rebollar, Paula, Perla, Aurora, de la Rubia, Javier, Sanz, Jaime

المصدر: Bone Marrow Transplant ; ISSN:1476-5365

الوصف: This 45-year study (1978-2022) at a single institution evaluated HSCT outcomes and complications, emphasizing recent advances, with to provide insights into HSCT's evolving field and ongoing efforts to enhance patient outcomes. Involving 1707 patients, the study revealed an initial phase (1978-1987) with a limited activity that yielded modest outcomes, a nearly three-decade span (1988-2016) with a substantial increase in transplant activity, emphasizing umbilical cord blood transplantation (UCBT) for patients lacking a suitable matched sibling donor. In addition to a gradual increase in recipient age, significant improvement in outcomes emerged in the recent period (2017-2022), marked by UCBT replacement with haploidentical transplants, introduction of PTCY-based GVHD prophylaxis for all type of transplants, and increased use of conditioning regimens with thiotepa, busulfan, and fludarabine. In this period, reductions in GVHD, non-relapse mortality, and relapse rates significantly contributed to improved overall survival, event-free survival, and GVHD-free/relapse-free survival. The study identified specific factors, including GVHD prophylaxis and donor selection changes, associated with these positive trends. This four-decade study provides a unique perspective on allogeneic HSCT, showcasing the dynamic evolution of transplantation practices and their impact on outcomes, offering valuable insights for personalized treatment approaches and emphasizing continual innovation in this critical therapeutic modality.

العلاقة: https://doi.org/10.1038/s41409-024-02319-xTest; https://pubmed.ncbi.nlm.nih.gov/38918495Test

الإتاحة: https://doi.org/10.1038/s41409-024-02319-xTest
https://pubmed.ncbi.nlm.nih.gov/38918495Test

المؤلفون: Boluda, Blanca, Solana‐Altabella, Antonio, Cano, Isabel, Acuña‐Cruz, Evelyn, Rodríguez‐Veiga, Rebeca, Ballesta‐López, Octavio, Megías‐Vericat, Juan Eduardo, Martínez‐Cuadrón, David, Gómez, Ines, Solves, Pilar, Lorenzo, Ignacio, Piñana, Jose Luis, Sanz, Jaime, Guerreiro, Manuel, Montoro Gómez, Juan, Díaz‐González, Alvaro, Marco, Javier, Blanco, Albert, Sanz, Miguel Á., Montesinos, Pau

المساهمون: Therakos

المصدر: Journal of Clinical Apheresis ; volume 36, issue 4, page 612-620 ; ISSN 0733-2459 1098-1101

الوصف: Background This study assessed pharmacoeconomic costs associated with extracorporeal photopheresis (ECP) compared with other available second‐line therapies for chronic graft‐vs‐host disease (cGvHD) in a tertiary Spanish institution. Methods Patients (≥18 years) diagnosed with steroid‐refractory cGvHD were eligible. Data were collected retrospectively from index date until 1 year or relapse. Patients were distributed in two cohorts (ECP vs non‐ECP), matched by age (≤ or > 40), hematopoietic stem cell transplant (HLA‐identical sibling donor or other) and number of previous immunosuppressive lines (1, 2, or ≥ 3). Costs were assigned using the 2016 diagnosis‐related group (DRG) system: DRG 579 (€22 383) overnight stay due to major complication (ie, sepsis, pneumonia, parenteral nutrition, or respiratory failure), and DRG 875 (€5154) if no major complication. The primary endpoint was healthcare resource utilization per patient. Results Forty patients (n = 20 per cohort) were included. Median age was 49, and 37.5% were female. Mean total cost per patient was €25 319 (95% CI: €17 049–€33 590) across the two cohorts, with a slightly lower mean cost per ECP‐treated patient (€23 120) compared with the non‐ECP cohort (€27 519; P = .597). Twenty‐seven inpatient hospitalizations occurred among ECP‐treated patients, vs 33 in the non‐ECP cohort. Day hospital and external consultations were more frequent in the ECP cohort. However, fewer inpatient admissions included DRG 579 compared with the non‐ECP cohort (44% vs 58%). Inpatient length of stay was slightly shorter in the ECP cohort (30 vs 49 days; P = .298). Conclusions ECP treatment may yield economic savings in Spain through resource savings and moving costs toward outpatient care.

الإتاحة: https://doi.org/10.1002/jca.21901Test

المؤلفون: Guerreiro, Manuel, Aguilar‐Gallardo, Cristóbal, Montoro, Juan, Francés‐Gómez, Clara, Latorre, Víctor, Luna, Irene, Planelles, Dolores, Carrasco, María Paz, Gómez, María Dolores, González‐Barberá, Eva María, Aguado, Cristina, Sempere, Amparo, Solves, Pilar, Gómez‐Seguí, Inés, Balaguer‐Rosello, Aitana, Louro, Alberto, Perla, Aurora, Larrea, Luis, Sanz, Jaime, Arbona, Cristina, de la Rubia, Javier, Geller, Ron, Sanz, Miguel Ángel, Sanz, Guillermo, Luis Piñana, José

المساهمون: Fundación General CSIC

المصدر: Transplant Infectious Disease ; volume 23, issue 4 ; ISSN 1398-2273 1399-3062

الوصف: Cellular and humoral response to acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infections is on focus of research. We evaluate herein the feasibility of expanding virus‐specific T cells (VST) against SARS‐CoV‐2 ex vivo through a standard protocol proven effective for other viruses. The experiment was performed in three different donors' scenarios: (a) SARS‐CoV‐2 asymptomatic infection/negative serology, (b) SARS‐CoV‐2 symptomatic infection/positive serology, and (c) no history of SARS‐CoV‐2 infection/negative serology. We were able to obtain an expanded VST product from donors 1 and 2 (1.6x and 1.8x increase of baseline VST count, respectively) consisting in CD3 + cells (80.3% and 62.7%, respectively) with CD4 + dominance (60% in both donors). Higher numbers of VST were obtained from the donor 2 as compared to donor 1. T‐cell clonality test showed oligoclonal reproducible peaks on a polyclonal background for both donors. In contrast, VST could be neither expanded nor primed in a donor without evidence of prior infection. This proof‐of‐concept study supports the feasibility of expanding ex vivo SARS‐CoV‐2‐specific VST from blood of convalescent donors. The results raise the question of whether the selection of seropositive donors may be a strategy to obtain cell lines enriched in their SARS‐CoV‐2‐specificity for future adoptive transfer to immunosuppressed patients.

الإتاحة: https://doi.org/10.1111/tid.13602Test

المؤلفون: Balaguer-Rosello, Aitana, Piñana, José Luis, Bataller, Luis, Montoro, Juan, Romero, Samuel, Navarro, Irene, Lorenzo, Ignacio, Andreu, Rafael, Guerreiro, Manuel, Aguilar, Cristobal, Gorriz, David, Dominguez, Lara, de la Puerta, Rosalia, Gómez, Inés, Solves, Pilar, Jarque, Isidro, Sanz, Miguel Ángel, Sanz, Guillermo, Sanz, Jaime

المصدر: Transplantation and Cellular Therapy ; volume 27, issue 3, page 261.e1-261.e7 ; ISSN 2666-6367

مصطلحات موضوعية: Transplantation, Cell Biology, Hematology, Molecular Medicine, Immunology and Allergy

الإتاحة: https://doi.org/10.1016/j.jtct.2020.12.019Test
https://api.elsevier.com/content/article/PII:S2666636720300932?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2666636720300932?httpAccept=text/plainTest

المؤلفون: Sanz, Jaime, Moscardó, Federico, Montoro, Juan, Cano, Isabel, Guerreiro, Manuel, Dasí, María A., Solves, Pilar, Lorenzo, Ignacio, Gómez-Segui, Inés, Montesinos, Pau, Mora, Elvira, Arnao, Mario, Sempere, Amparo, Jarque, Isidro, Carretero, Carlos, Senent, Leonor, Vicente, Ana, Andreu, Rafael, Luna, Irene, Balaguer-Roselló, Aitana, Carpio, Nelly, Sanz, Guillermo F., Sanz, Miguel A., Piñana, José L.

المصدر: Biology of Blood and Marrow Transplantation ; volume 26, issue 1, page 83-87 ; ISSN 1083-8791

مصطلحات موضوعية: Transplantation, Hematology

الإتاحة: https://doi.org/10.1016/j.bbmt.2019.08.020Test
https://api.elsevier.com/content/article/PII:S1083879119305609?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1083879119305609?httpAccept=text/plainTest

المؤلفون: Balaguer-Roselló, Aitana, Gil-Perotín, Sara, Montoro, Juan, Bataller, Luis, Lamas, Brais, Villalba, Marta, Facal, Ana, Guerreiro, Manuel, Chorão, Pedro, Bataller, Ana, Granados, Pablo, Gómez, Inés, Solves, Pilar, Louro, Alberto, de la Rubia, Javier, Sanz, Miguel Ángel, Sanz, Jaime

المصدر: Transplantation and Cellular Therapy ; volume 29, issue 10, page 610.e1-610.e12 ; ISSN 2666-6367

مصطلحات موضوعية: Transplantation, Cell Biology, Hematology, Molecular Medicine, Immunology and Allergy

الإتاحة: https://doi.org/10.1016/j.jtct.2023.07.008Test
https://api.elsevier.com/content/article/PII:S2666636723014161?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2666636723014161?httpAccept=text/plainTest