TY - JOUR A1 - Zhou, Xiang A1 - Rasche, Leo A1 - Kortüm, K. Martin A1 - Danhof, Sophia A1 - Hudecek, Michael A1 - Einsele, Hermann T1 - Toxicities of Chimeric Antigen Receptor T Cell Therapy in Multiple Myeloma: An Overview of Experience From Clinical Trials, Pathophysiology, and Management Strategies JF - Frontiers in Immunology N2 - In the last few years, monoclonal antibodies (mAbs) such as elotuzumab and daratutumab have brought the treatment of multiple myeloma (MM) into the new era of immunotherapy. More recently, chimeric antigen receptor (CAR) modified T cell, a novel cellular immunotherapy, has been developed for treatment of relapsed/refractory (RR) MM, and early phase clinical trials have shown promising efficacy of CAR T cell therapy. Many patients with end stage RRMM regard CAR T cell therapy as their “last chance” and a “hope of cure”. However, severe adverse events (AEs) and even toxic death related to CAR T cell therapy have been observed. The management of AEs related to CAR T cell therapy represents a new challenge, as the pathophysiology is not fully understood and there is still no well-established standard of management. With regard to CAR T cell associated toxicities in MM, in this review, we will provide an overview of experience from clinical trials, pathophysiology, and management strategies. KW - CAR T cell KW - clinical trial KW - multiple myeloma KW - toxicity KW - pathophysiology KW - management Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-219911 SN - 1664-3224 VL - 11 ER - TY - JOUR A1 - Thorn, Simon A1 - Chao, Anne A1 - Georgiev, Konstadin B. A1 - Müller, Jörg A1 - Bässler, Claus A1 - Campbell, John L. A1 - Jorge, Castro A1 - Chen, Yan-Han A1 - Choi, Chang-Yong A1 - Cobb, Tyler P. A1 - Donato, Daniel C. A1 - Durska, Ewa A1 - Macdonald, Ellen A1 - Feldhaar, Heike A1 - Fontaine, Jospeh B. A1 - Fornwalt, Paula J. A1 - Hernández Hernández, Raquel María A1 - Hutto, Richard L. A1 - Koivula, Matti A1 - Lee, Eun-Jae A1 - Lindenmayer, David A1 - Mikusinski, Grzegorz A1 - Obrist, Martin K. A1 - Perlík, Michal A1 - Rost, Josep A1 - Waldron, Kaysandra A1 - Wermelinger, Beat A1 - Weiß, Ingmar A1 - Zmihorski, Michal A1 - Leverkus, Alexandro B. T1 - Estimating retention benchmarks for salvage logging to protect biodiversity JF - Nature Communications N2 - Forests are increasingly affected by natural disturbances. Subsequent salvage logging, a widespread management practice conducted predominantly to recover economic capital, produces further disturbance and impacts biodiversity worldwide. Hence, naturally disturbed forests are among the most threatened habitats in the world, with consequences for their associated biodiversity. However, there are no evidence-based benchmarks for the proportion of area of naturally disturbed forests to be excluded from salvage logging to conserve biodiversity. We apply a mixed rarefaction/extrapolation approach to a global multi-taxa dataset from disturbed forests, including birds, plants, insects and fungi, to close this gap. We find that 757% (mean +/- SD) of a naturally disturbed area of a forest needs to be left unlogged to maintain 90% richness of its unique species, whereas retaining 50% of a naturally disturbed forest unlogged maintains 73 +/- 12% of its unique species richness. These values do not change with the time elapsed since disturbance but vary considerably among taxonomic groups. Salvage logging has become a common practice to gain economic returns from naturally disturbed forests, but it could have considerable negative effects on biodiversity. Here the authors use a recently developed statistical method to estimate that ca. 75% of the naturally disturbed forest should be left unlogged to maintain 90% of the species unique to the area. KW - natural disturbance KW - bird communities KW - forest KW - management KW - beetle KW - conservation KW - windthrow KW - diversity KW - impact KW - fire Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-230512 VL - 11 ER - TY - JOUR A1 - Lock, J. F. A1 - Ungeheuer, L. A1 - Borst, P. A1 - Swol, J. A1 - Löb, S. A1 - Brede, E. M. A1 - Röder, D. A1 - Lengenfelder, B. A1 - Sauer, K. A1 - Gremer, C. - T. T1 - Markedly increased risk of postoperative bleeding complications during perioperative bridging anticoagulation in general and visceral surgery JF - Perioperative Medicine N2 - Background Increasing numbers of patients receiving oral anticoagulants are undergoing elective surgery. Low molecular weight heparin (LMWH) is frequently applied as bridging therapy during perioperative interruption of anticoagulation. The aim of this study was to explore the postoperative bleeding risk of patients receiving surgery under bridging anticoagulation. Methods We performed a monocentric retrospective two-arm matched cohort study. Patients that received perioperative bridging anticoagulation were compared to a matched control group with identical surgical procedure, age, and sex. Emergency and vascular operations were excluded. The primary endpoint was the incidence of major postoperative bleeding. Secondary endpoints were minor postoperative bleeding, thromboembolic events, length of stay, and in-hospital mortality. Multivariate analysis explored risk factors of major postoperative bleeding. Results A total of 263 patients in each study arm were analyzed. The patient cohort included the entire field of general and visceral surgery including a large proportion of major oncological resections. Bridging anticoagulation increased the postoperative incidence of major bleeding events (8% vs. 1%; p < 0.001) as well as minor bleeding events (14% vs. 5%; p < 0.001). Thromboembolic events were equally rare in both groups (1% vs. 2%; p = 0.45). No effect on mortality was observed (1.5% vs. 1.9%). Independent risk factors of major postoperative bleeding were full-therapeutic dose of LMWH, renal insufficiency, and the procedure-specific bleeding risk. Conclusion Perioperative bridging anticoagulation, especially full-therapeutic dose LMWH, markedly increases the risk of postoperative bleeding complications in general and visceral surgery. Surgeons should carefully consider the practice of routine bridging. KW - low molecular heparin KW - atrial fibrillation KW - postoperative bleeding KW - thromboembolism KW - anticoagulation KW - bridging KW - antithrombotic therapy KW - warfarin interruption KW - oral anticoagulants KW - management Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-230690 VL - 9 ER - TY - JOUR A1 - Lobbezoo, Frank A1 - Aarab, Ghizlane A1 - Ahlers, M. Oliver A1 - Baad-Hansen, Lene A1 - Bernhardt, Olaf A1 - Castrillon, Eduardo E. A1 - Giannakopoulos, Nikolaos Nikitas A1 - Grønbeck, Anders A1 - Hauschild, Justus A1 - Holst-Knudsen, Marianne A1 - Skovlund, Naja A1 - Thymi, Magdalini A1 - Svensson, Peter T1 - Consensus-based clinical guidelines for ambulatory electromyography and contingent electrical stimulation in sleep bruxism JF - Journal of Oral Rehabilitation N2 - As yet, there are still no evidence-based clinical diagnostic and management guidelines for ambulatory single-channel EMG devices, like the BUTLER® GrindCare® (GrindCare), that are used in patients with sleep bruxism. Therefore, a consensus meeting was organised with GrindCare developers, researchers, and academic and non-academic clinicians experienced with the use of ambulatory EMG devices. The aim of the meeting was to discuss and develop recommendations for clinical guidelines for GrindCare usage, based on the existing clinical and research experience of the consensus meeting's participants. As an important outcome of the consensus meeting, clinical guidelines were proposed in which an initial 2-week baseline phase with the device in its inactive (non-stimulus) mode for habituation and assessment of the number of jaw-muscle activities is followed by a 4-week active phase with contingent electrical stimuli suppressing the jaw-muscle activities. As to avoid the commonly reported reduction in sensitivity to the stimuli, a 2-week inactive phase is subsequently installed, followed by a repetition of active and inactive phases until a lasting reduction in the number of jaw-muscle activities and/or associated complaints has been achieved. This proposal has the characteristics of a single-patient clinical trial. From a research point of view, adoption of this approach by large numbers of GrindCare users creates a great opportunity to recruit relatively large numbers of study participants that follow the same protocol. KW - assessment KW - clinical guideline KW - contingent electrical stimulation KW - electromyography KW - management KW - sleep bruxism Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-237032 VL - 47 ER -