TY - JOUR A1 - Salzmann-Manrique, Emilia A1 - Bremm, Melanie A1 - Huenecke, Sabine A1 - Stech, Milena A1 - Orth, Andreas A1 - Eyrich, Matthias A1 - Schulz, Ansgar A1 - Esser, Ruth A1 - Klingebiel, Thomas A1 - Bader, Peter A1 - Herrmann, Eva A1 - Koehl, Ulrike T1 - Joint Modeling of Immune Reconstitution Post Haploidentical Stem Cell Transplantation in Pediatric Patients With Acute Leukemia Comparing CD34(+)-Selected to CD3/CD19-Depleted Grafts in a Retrospective Multicenter Study JF - frontiers in Immunology N2 - Rapid immune reconstitution (IR) following stem cell transplantation (SCT) is essential for a favorable outcome. The optimization of graft composition should not only enable a sufficient IR but also improve graft vs. leukemia/tumor effects, overcome infectious complications and, finally, improve patient survival. Especially in haploidentical SCT, the optimization of graft composition is controversial. Therefore, we analyzed the influence of graft manipulation on IR in 40 patients with acute leukemia in remission. We examined the cell recovery post haploidentical SCT in patients receiving a CD34(+)-selected or CD3/CD19-depleted graft, considering the applied conditioning regimen. We used joint model analysis for overall survival (OS) and analyzed the dynamics of age-adjusted leukocytes; lymphocytes; monocytes; CD3(+), CD3(+) CD4(+), and CD3(+) CD8(+) T cells; natural killer (NK) cells; and B cells over the course of time after SCT. Lymphocytes, NK cells, and B cells expanded more rapidly after SCT with CD34(+)-selected grafts (P = 0.036, P = 0.002, and P < 0.001, respectively). Contrarily, CD3(+) CD4(+) helper T cells recovered delayer in the CD34 selected group (P = 0.026). Furthermore, reduced intensity conditioning facilitated faster immune recovery of lymphocytes and T cells and their subsets (P < 0.001). However, the immune recovery for NK cells and B cells was comparable for patients who received reduced-intensity or full preparative regimens. Dynamics of all cell types had a significant influence on OS, which did not differ between patients receiving CD34(+)-selected and those receiving CD3/CD19-depleted grafts. In conclusion, cell reconstitution dynamics showed complex diversity with regard to the graft manufacturing procedure and conditioning regimen. KW - immune reconstitution KW - allogeneic stem cell transplantation KW - CD34 selection KW - CD3/19 depletion KW - children Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227302 VL - 9 ER - TY - JOUR A1 - Lawitschka, Anita A1 - Brunmair, Matthias A1 - Bauer, Dorothea A1 - Zubarovskaya, Natalia A1 - Felder-Puig, Rosemarie A1 - Strahm, Brigitte A1 - Bader, Peter A1 - Strauss, Gabriele A1 - Albert, Michael A1 - Luettichau, Irene von A1 - Greinix, Hildegard A1 - Wolff, Daniel A1 - Peters, Christina T1 - Psychometric properties of the Activities Scale for Kids-performance after allogeneic hematopoietic stem cell transplantation in adolescents and children BT - Results of a prospective study on behalf of the German-Austrian-Swiss GVHD Consortium JF - Wiener klinische Wochenschrift N2 - Background The psychometric properties of an instrument, the Activity Scale for Kids-performance (ASKp), were assessed which was proposed to capture physical functioning after allogeneic hematopoietic stem cell transplantation (HSCT). Additionally, this multicenter observational prospective study investigated the influence of clinical correlates focusing on chronic graft-versus-host disease (cGVHD). Methods Patient-reported ASKp, clinician-reported Karnofsky/Lansky status (KPS/PSS), patient characteristics and cGVHD details were assessed of 55 patients with a median age of 12 years at baseline after day +100 post-HSCT and every 3 months during the next 18 months. The psychometric properties were evaluated and ASKp and KPS/PSS status was compared using ANOVAS and multiple regression models. Results The German version of the ASKp showed good psychometric properties except for ceiling effects. Discrimination ability of the ASKp was good regarding the need for devices but failed to predict cGVHD patients. Both the ASKp and the KPS/PSS were associated with patients after adoptive cell therapy being in need for devices, suffering from overlap cGVHD and from steroid side effects but not with patients’ age and gender. In contrast to the KPS/PSS the ASKp only showed significant differences after merging moderate and severe cGHVD patients when comparing them to No-cGVHD (F = 4.050; p = 0.049), being outperformed by the KPS/PSS (F = 20.082; p < 0.001). Conclusion The ASKp showed no clear advantages compared to KPS/PSS even though economical and patients’ effort was higher. Further application range may be limited through ceiling effects. Both should be taken into consideration. Therefore, the results may not support the usage of ASKp after HSCT and rather suggest KPS/PSS, both patient and clinician reported. KW - physical functioning KW - cancer patients KW - AYAs KW - GVHD Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-281100 VL - 133 IS - 1-2 ER - TY - JOUR A1 - Bonig, Halvard A1 - Kuçi, Zyrafete A1 - Kuçi, Selim A1 - Bakhtiar, Shahrzad A1 - Basu, Oliver A1 - Bug, Gesine A1 - Dennis, Mike A1 - Greil, Johann A1 - Barta, Aniko A1 - Kállay, Krisztián M. A1 - Lang, Peter A1 - Lucchini, Giovanna A1 - Pol, Raj A1 - Schulz, Ansgar A1 - Sykora, Karl-Walter A1 - Teichert von Luettichau, Irene A1 - Herter-Sprie, Grit A1 - Ashab Uddin, Mohammad A1 - Jenkin, Phil A1 - Alsultan, Abdulrahman A1 - Buechner, Jochen A1 - Stein, Jerry A1 - Kelemen, Agnes A1 - Jarisch, Andrea A1 - Soerensen, Jan A1 - Salzmann-Manrique, Emilia A1 - Hutter, Martin A1 - Schäfer, Richard A1 - Seifried, Erhard A1 - Paneesha, Shankara A1 - Novitzky-Basso, Igor A1 - Gefen, Aharon A1 - Nevo, Neta A1 - Beutel, Gernot A1 - Schlegel, Paul-Gerhardt A1 - Klingebiel, Thomas A1 - Bader, Peter T1 - Children and adults with Refractory acute Graft-versus-Host Disease respond to treatment with the Mesenchymal Stromal cell preparation “MSC-FFM”—Outcome report of 92 patients JF - Cells N2 - (1) Background: Refractory acute graft-versus-host disease (R-aGvHD) remains a leading cause of death after allogeneic stem cell transplantation. Survival rates of 15% after four years are currently achieved; deaths are only in part due to aGvHD itself, but mostly due to adverse effects of R-aGvHD treatment with immunosuppressive agents as these predispose patients to opportunistic infections and loss of graft-versus-leukemia surveillance resulting in relapse. Mesenchymal stromal cells (MSC) from different tissues and those generated by various protocols have been proposed as a remedy for R-aGvHD but the enthusiasm raised by initial reports has not been ubiquitously reproduced. (2) Methods: We previously reported on a unique MSC product, which was generated from pooled bone marrow mononuclear cells of multiple third-party donors. The products showed dose-to-dose equipotency and greater immunosuppressive capacity than individually expanded MSCs from the same donors. This product, MSC-FFM, has entered clinical routine in Germany where it is licensed with a national hospital exemption authorization. We previously reported satisfying initial clinical outcomes, which we are now updating. The data were collected in our post-approval pharmacovigilance program, i.e., this is not a clinical study and the data is high-level and non-monitored. (3) Results: Follow-up for 92 recipients of MSC-FFM was reported, 88 with GvHD ≥°III, one-third only steroid-refractory and two-thirds therapy resistant (refractory to steroids plus ≥2 additional lines of treatment). A median of three doses of MSC-FFM was administered without apparent toxicity. Overall response rates were 82% and 81% at the first and last evaluation, respectively. At six months, the estimated overall survival was 64%, while the cumulative incidence of death from underlying disease was 3%. (4) Conclusions: MSC-FFM promises to be a safe and efficient treatment for severe R-aGvHD. KW - graft-versus host KW - transplantation KW - mesenchymal stromal cell KW - cell therapy KW - hospital exemption KW - steroid-resistant aGvHD KW - refractory aGvHD Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-193878 SN - 2073-4409 VL - 8 IS - 12 ER -