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Start Over Author "Adriana Vacca" Journal british journal of haematology
3 results on '"Adriana Vacca"'

1. Interactions between killer immunoglobulin-like receptors and their human leucocyte antigen Class I ligands influence the outcome of unrelated haematopoietic stem cell transplantation for thalassaemia: a novel predictive algorithm

Author

Giovanna Giorgiani, N Orru, Eugenia Piras, Adriana Vacca, Claudio Giardini, Marco Sanna, Maria Grazia Orofino, Giuseppe Visani, Alice Bertaina, M Mulargia, Giovanni Caocci, Roberto Littera, Giorgio La Nasa, Franco Locatelli, and Carlo Carcassi

Subjects
Male, Genotyping Techniques, medicine.medical_treatment, KIR Ligand, Graft vs Host Disease, Histocompatibility Testing, Hematopoietic stem cell transplantation, Activating killer immunoglobulin-like receptor genes, Ligands, Graft-versus-host disease, Gene Frequency, Receptors, KIR, immune system diseases, HLA-C KIR ligands, Child, Receptor, Haematopoietic stem cell transplantation, Hematopoietic Stem Cell Transplantation, Hematology, Middle Aged, Prognosis, Haematopoiesis, Child, Preschool, Thalassemia, Female, Antibody, Unrelated Donors, Algorithm, Algorithms, Protein Binding, Adult, Adolescent, chemical and pharmacologic phenomena, Donor selection algorithm, Biology, Young Adult, medicine, Humans, Retrospective Studies, Models, Statistical, Histocompatibility Antigens Class I, Infant, medicine.disease, Transplantation, Haplotypes, Immunology, biology.protein
Abstract

In a study conducted on 114 patients undergoing unrelated donor haematopoietic stem cell transplantation (HSCT) for thalassaemia, we observed that the lack of activating killer immunoglobulin-like receptors (KIRs) on donor natural killer (NK) cells significantly increased the risk of graft-versus-host disease (GvHD) [hazard risk (HR) 4.2, 95% confidence interval (CI) 1.7-10.1, P = 0.002] and transplantation-related mortality (HR 4.7, 95% CI 1.6-14.2, P = 0.01). The risk of GvHD furthermore increased when recipients heterozygous for HLA-C KIR ligand groups (C1/C2) were transplanted from donors completely lacking activating KIRs (HR 6.1, 95% CI 1.9-19.2, P = 0.002). We also found that the risk of rejection was highest when the recipient was homozygous for the C2 HLA-KIR ligand group and the donor carried two or more activating KIRs (HR 6.8, 95% CI 1.9-24.4, P = 0.005). By interpolating the number of donor activating KIRs with recipient HLA-C KIR ligands, we created an algorithm capable of stratifying patients according to the immunogenetic risk of complications following unrelated HSCT. In clinical practice, this predictive tool could serve as an important supplement to clinical judgement and decision-making.

Published
2011

2. Treosulfan-based conditioning regimen for allogeneic haematopoietic stem cell transplantation in patients with thalassaemia major

Author

Pietro Merli, Adriana Vacca, Angela Mastronuzzi, Marco Zecca, Maria Ester Bernardo, Giovanna Giorgiani, Giovanni Caocci, Patrizia Comoli, Eugenia Piras, Giorgio La Nasa, Chiara Cugno, Franco Locatelli, Bernardo, M. E., Zecca, M., Piras, E., Vacca, A., Giorgiani, G., Cugno, C., Caocci, G., Comoli, P., Mastronuzzi, A., Merli, P., La Nasa, G., and Locatelli, F.

Subjects
Adult, Graft Rejection, Male, medicine.medical_specialty, Transplantation Conditioning, Treosulfan, Adolescent, medicine.medical_treatment, Graft vs Host Disease, Hematopoietic stem cell transplantation, ThioTEPA, Young Adult, Conditioning regimen, Internal medicine, medicine, Humans, Cumulative incidence, Child, Busulfan, Toxicity, business.industry, beta-Thalassemia, Haematopoietic stem cell transplantation, Hematopoietic Stem Cell Transplantation, Infant, Thalassaemia major, Hematology, Myeloablative Agonists, medicine.disease, Surgery, Fludarabine, Transplantation, Regimen, Hemoglobinopathy, Treatment Outcome, Child, Preschool, Adolescent, Adult, Busulfan, adverse effects/analogs /&/ derivatives/therapeutic use, Child, Child, Preschool, Drug Therapy, Combination, Female, Graft Rejection, Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Humans, Infant, Male, Myeloablative Agonists, adverse effects/therapeutic use, Thiotepa, adverse effects/therapeutic use, Transplantation Conditioning, adverse effects/methods, Treatment Outcome, Vidarabine, adverse effects/analogs /&/ derivatives/therapeutic use, Young Adult, beta-Thalassemia, drug therapy/therapy, Drug Therapy, Combination, Female, business, Thiotepa, Vidarabine, medicine.drug
Abstract

The safety and efficacy of a preparation with treosulfan/thiotepa/ fludarabine were explored in 20 thalassaemia patients given allogeneic marrow transplantation. Seventeen patients were transplanted from unrelated donors after receiving anti-thymocyte globulin. The regimen was well tolerated. Two patients experienced secondary graft failure; one died of acute graft-versus-host disease. Cumulative incidence (95% confidence interval, CI) of transplantation-related mortality and graft failure was 5% (95% CI, 0-34%) and 11% (95% CI, 3-43%), respectively. Two-year probability of survival and thalassaemia-free survival was 95% (95% CI, 85-100%) and 85% (95% CI, 66-100%), respectively. This regimen might find elective application in patients at high risk of developing life-threatening complications. © 2008 The Authors.

Published
2008

3. The human leucocyte antigen-G 14-basepair polymorphism correlates with graft-versus-host disease in unrelated bone marrow transplantation for thalassaemia

Author

F Alba, Eugenia Piras, Carlo Carcassi, Daniela Lisini, Adriana Vacca, Nesci S, Alessandra Di Cesare-Merlone, Sandro Orru, Franco Locatelli, Maria Ester Bernardo, Sara Lai, Giorgio La Nasa, Giovanni Caocci, Roberto Littera, La Nasa, G, Littera, R, Locatelli, F, Lai, S, Alba, F, Caocci, G, Lisini, D, Nesci, S, Vacca, A, Piras, E, Bernardo, M, Di Cesare-Merlone, A, Orrù, S, and Carcassi, C

Subjects
Hemolytic anemia, Adult, Male, medicine.medical_specialty, Bone marrow transplantation, Adolescent, Genes, MHC Class I, Graft vs Host Disease, Human leukocyte antigen, Biology, Risk Assessment, Immune tolerance, Immunopathology, Internal medicine, Genotype, medicine, Humans, Genetic Testing, Child, 14-basepair polymorphism, Bone Marrow Transplantation, Acute graft-versus-host disease, Hematology, Polymorphism, Genetic, Human leucocyte antigen-G, Thalassaemia, medicine.disease, medicine.anatomical_structure, Graft-versus-host disease, Treatment Outcome, Child, Preschool, Immunology, Thalassemia, Female, Bone marrow, Gene Deletion
Abstract

The presence of the 14-bp insertion polymorphism of the human leucocyte antigen (HLA)-G gene (HLA-G) promotes immune tolerance through increased synthesis of HLA-G molecules. We investigated this polymorphism in a large cohort of 53 thalassaemia patients transplanted from an unrelated donor. Sixteen patients (30.2%) homozygous for the 14-bp deletion had a higher risk of developing acute graft-versus-host disease (aGvHD) than patients homozygous for the 14-bp insertion (-14-bp/-14-bp vs +14-bp/+14-bp: Relative Risk = 15.0; 95% confidence interval 1.59-141.24; P = 0.008). Therefore, the 14-bp polymorphism could be an important predictive factor for aGvHD following bone marrow transplantation. © 2007 The Authors.

Published
2007

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