Search

Your search keyword '"Geller, N."' showing total 320 results
Start Over Author "Geller, N."
320 results on '"Geller, N."'

2. Gilteritinib as Post-Transplant Maintenance for Acute Myeloid Leukemia With Internal Tandem Duplication Mutation of FLT3

Author

Levis, M, Hamadani, M, Logan, B, Jones, R, Singh, A, Litzow, M, Wingard, J, Papadopoulos, E, Perl, A, Soiffer, R, Ustun, C, Ueda Oshima, M, Uy, G, Waller, E, Vasu, S, Solh, M, Mishra, A, Muffly, L, Kim, H, Mikesch, J, Najima, Y, Onozawa, M, Thomson, K, Nagler, A, Wei, A, Marcucci, G, Geller, N, Hasabou, N, Delgado, D, Rosales, M, Hill, J, Gill, S, Nuthethi, R, King, D, Wittsack, H, Mendizabal, A, Devine, S, Horowitz, M, Chen, Y, Agura, E, Altman, J, Anagnostopoulos, A, Anand, S, Artz, A, Aulitzky, W, Balderman, S, Ballen, K, Becker, M, Beguin, Y, Berkahn, L, Berneman, Z, Bhatt, V, Bilmon, I, Bonifazi, F, Briggs, A, Bruno, B, Brunstein, C, Byrne, M, Byrne, J, Cabrero, M, Cairoli, R, Carrum, G, Cerny, J, Cheong, J, Ciceri, F, Colorado, M, Cook, R, Couriel, D, Craddock, C, Damon, L, Deol, A, Desbrosses, Y, Di Grazia, C, Di Stasi, A, Dias, A, Dorritie, K, Essell, J, Eto, T, Farag, S, Forcade, E, Frankfurt, O, Fujiwara, S, Fukuda, T, Fukushima, K, Furst, S, Goto, T, Hall, A, Hatta, S, Hicheri, Y, Horwitz, M, Hou, H, How, J, Howard, D, Hsu, W, Huynh, A, Irvine, D, Ishikawa, T, Jamieson, K, Jedrzejczak, W, Jethava, Y, Jimenez, A, Jung, C, Kanda, J, Karakasis, D, Kato, J, Kekre, N, Khera, N, Klein, A, Kobbe, G, Kornblit, B, Kota, V, Lachance, S, Leber, B, Lee, C, Lee, J, Lin, T, Liu, T, Martelli, M, Martinez, C, Matsuoka, K, Mccarty, J, Mendez, L, Michelis, F, Mineishi, S, Mohty, M, Moors, I, Motyckova, G, Mueller, L, Nakamae, H, Nakano, N, Nathan, S, Nicholson, E, Norkin, M, Ogawa, Y, Olesen, G, Oluwole, O, Pantin, J, Paulson, K, Pemberton, L, Perera, T, Piatkowska-Jakubas, B, Poire, X, Protheroe, R, Rambaldi, A, Ritchie, D, Ross, K, Rubio, M, Santarone, S, Sanz Caballer, J, Sawa, M, Schaar, D, Scheid, C, Schriber, J, Seropian, S, Shah, N, Shore, T, Gil, J, Sobecks, R, Socie, G, Sprague, K, Spyridonidis, A, Stelljes, M, Stiff, P, Stuart, R, Tanaka, M, Tandra, A, Tholouli, E, Thomas, X, Tiribelli, M, Tomlinson, B, Tsirigotis, P, Tzachanis, D, Uchida, N, Ueda, M, Valcarcel Ferreiras, D, Wagner, E, Watson, A, Weisdorf, D, Wolschke, C, Wrobel, T, Yakoub-Agha, I, Yamauchi, T, Yared, J, Yeh, S, Yoon, S, Yoshihara, S, Null, N, Levis, Mark J., Hamadani, Mehdi, Logan, Brent, Jones, Richard J., Singh, Anurag K., Litzow, Mark, Wingard, John R., Papadopoulos, Esperanza B., Perl, Alexander E., Soiffer, Robert J., Ustun, Celalettin, Ueda Oshima, Masumi, Uy, Geoffrey L., Waller, Edmund K., Vasu, Sumithra, Solh, Melhem, Mishra, Asmita, Muffly, Lori, Kim, Hee-Je, Mikesch, Jan-Henrik, Najima, Yuho, Onozawa, Masahiro, Thomson, Kirsty, Nagler, Arnon, Wei, Andrew H., Marcucci, Guido, Geller, Nancy L., Hasabou, Nahla, Delgado, David, Rosales, Matt, Hill, Jason, Gill, Stanley C., Nuthethi, Rishita, King, Denise, Wittsack, Heather, Mendizabal, Adam, Devine, Steven M., Horowitz, Mary M., Chen, Yi-Bin, Agura, Ed, Altman, Jessica, Anagnostopoulos, Achiles, Anand, Sarah, Artz, Andrew, Aulitzky, Walter, Balderman, Sophia, Ballen, Karen, Becker, Michael, Beguin, Yves, Berkahn, Leanne, Berneman, Zwi, Bhatt, Vijaya, Bilmon, Ian, Bonifazi, Francesca, Briggs, Adrienne, Bruno, Benedetto, Brunstein, Claudio, Byrne, Michael, Byrne, Jenny, Cabrero, Monica, Cairoli, Roberto, Carrum, George, Cerny, Jan, Cheong, June-Won, Ciceri, Fabio, Colorado, Mercedes, Cook, Rachel, Couriel, Daniel, Craddock, Charles, Damon, Lloyd, Deol, Abhinav, Desbrosses, Yohan, Devine, Steve, Di Grazia, Carmela, Di Stasi, Antonio, Dias, Ajoy, Dorritie, Kathy, Essell, James, Eto, Tetsuya, Farag, Sherif, Forcade, Edouard, Frankfurt, Olga, Fujiwara, Shinichiro, Fukuda, Takahiro, Fukushima, Kentaro, Furst, Sabine, Goto, Tatsunori, Hall, Aric, Hatta, Shunsuke, Hicheri, Yosr, Horwitz, Mitchell, Hou, Hsin-An, How, Jonathan, Howard, Dianna, Hsu, Wei-Hsun (Blake), Huynh, Anne, Irvine, David, Ishikawa, Takayuki, Jamieson, Katarzyna, Jedrzejczak, Wieslaw, Jethava, Yogesh, Jimenez, Antonio, Jung, Chul Won, Kanda, Junya, Karakasis, Dimitrios, Kato, Jun, Kekre, Natasha, Khera, Nandita, Klein, Andreas, Kobbe, Guido, Kornblit, Brian, Kota, Vamsi, Lachance, Silvy, Leber, Brian, Lee, Catherine, Lee, Je Hwan, Lin, Tung-Liang, Liu, Ta-Chih, Martelli, Maurizio, Martinez, Carmen, Matsuoka, Kenichi, McCarty, John, Mendez, Lourdes, Michelis, Fotios, Mineishi, Shin, Mohty, Mohamad, Moors, Ine, Motyckova, Gabriela, Mueller, Lutz, Nakamae, Hirohisa, Nakano, Nobuaki, Nathan, Sunita, Nicholson, Emma, Norkin, Maxim, Ogawa, Yoshiaki, Olesen, Gitte, Oluwole, Olalekan, Pantin, Jeremy, Paulson, Kristjan, Pemberton, Lucy, Perera, Travis, Piatkowska-Jakubas, Beata, Poire, Xavier, Protheroe, Rachel, Rambaldi, Alessandro, Ritchie, David, Ross, Kelly, Rubio, Marie-Therese, Santarone, Stella, Sanz Caballer, Jaime, Sawa, Masashi, Schaar, Dale, Scheid, Christoph, Schriber, Jeffrey, Seropian, Stuart, Shah, Nilay, Shah, Nirav, Shore, Tsiporah, Gil, Jorge Sierra, Singh, Anurag, Sobecks, Ronald, Socie, Gerard, Soiffer, Robert, Sprague, Kellie, Spyridonidis, Alexandros, Stelljes, Matthias, Stiff, Patrick, Stuart, Robert, Tanaka, Masatsugu, Tandra, Anand, Tholouli, Eleni, Thomas, Xavier, Tiribelli, Mario, Tomlinson, Benjamin, Tsirigotis, Panagiotis, Tzachanis, Dimitrios, Uchida, Naoyuki, Ueda, Masumi, Valcarcel Ferreiras, David, Wagner, Eva, Watson, Anne-Marie, Weisdorf, Daniel, Wolschke, Christine, Wrobel, Tomasz, Yakoub-Agha, Ibrahim, Yamauchi, Takuji, Yared, Jean, Yeh, Su-Peng, Yoon, Sung-Soo, Yoshihara, Satoshi, null, null, Levis, M, Hamadani, M, Logan, B, Jones, R, Singh, A, Litzow, M, Wingard, J, Papadopoulos, E, Perl, A, Soiffer, R, Ustun, C, Ueda Oshima, M, Uy, G, Waller, E, Vasu, S, Solh, M, Mishra, A, Muffly, L, Kim, H, Mikesch, J, Najima, Y, Onozawa, M, Thomson, K, Nagler, A, Wei, A, Marcucci, G, Geller, N, Hasabou, N, Delgado, D, Rosales, M, Hill, J, Gill, S, Nuthethi, R, King, D, Wittsack, H, Mendizabal, A, Devine, S, Horowitz, M, Chen, Y, Agura, E, Altman, J, Anagnostopoulos, A, Anand, S, Artz, A, Aulitzky, W, Balderman, S, Ballen, K, Becker, M, Beguin, Y, Berkahn, L, Berneman, Z, Bhatt, V, Bilmon, I, Bonifazi, F, Briggs, A, Bruno, B, Brunstein, C, Byrne, M, Byrne, J, Cabrero, M, Cairoli, R, Carrum, G, Cerny, J, Cheong, J, Ciceri, F, Colorado, M, Cook, R, Couriel, D, Craddock, C, Damon, L, Deol, A, Desbrosses, Y, Di Grazia, C, Di Stasi, A, Dias, A, Dorritie, K, Essell, J, Eto, T, Farag, S, Forcade, E, Frankfurt, O, Fujiwara, S, Fukuda, T, Fukushima, K, Furst, S, Goto, T, Hall, A, Hatta, S, Hicheri, Y, Horwitz, M, Hou, H, How, J, Howard, D, Hsu, W, Huynh, A, Irvine, D, Ishikawa, T, Jamieson, K, Jedrzejczak, W, Jethava, Y, Jimenez, A, Jung, C, Kanda, J, Karakasis, D, Kato, J, Kekre, N, Khera, N, Klein, A, Kobbe, G, Kornblit, B, Kota, V, Lachance, S, Leber, B, Lee, C, Lee, J, Lin, T, Liu, T, Martelli, M, Martinez, C, Matsuoka, K, Mccarty, J, Mendez, L, Michelis, F, Mineishi, S, Mohty, M, Moors, I, Motyckova, G, Mueller, L, Nakamae, H, Nakano, N, Nathan, S, Nicholson, E, Norkin, M, Ogawa, Y, Olesen, G, Oluwole, O, Pantin, J, Paulson, K, Pemberton, L, Perera, T, Piatkowska-Jakubas, B, Poire, X, Protheroe, R, Rambaldi, A, Ritchie, D, Ross, K, Rubio, M, Santarone, S, Sanz Caballer, J, Sawa, M, Schaar, D, Scheid, C, Schriber, J, Seropian, S, Shah, N, Shore, T, Gil, J, Sobecks, R, Socie, G, Sprague, K, Spyridonidis, A, Stelljes, M, Stiff, P, Stuart, R, Tanaka, M, Tandra, A, Tholouli, E, Thomas, X, Tiribelli, M, Tomlinson, B, Tsirigotis, P, Tzachanis, D, Uchida, N, Ueda, M, Valcarcel Ferreiras, D, Wagner, E, Watson, A, Weisdorf, D, Wolschke, C, Wrobel, T, Yakoub-Agha, I, Yamauchi, T, Yared, J, Yeh, S, Yoon, S, Yoshihara, S, Null, N, Levis, Mark J., Hamadani, Mehdi, Logan, Brent, Jones, Richard J., Singh, Anurag K., Litzow, Mark, Wingard, John R., Papadopoulos, Esperanza B., Perl, Alexander E., Soiffer, Robert J., Ustun, Celalettin, Ueda Oshima, Masumi, Uy, Geoffrey L., Waller, Edmund K., Vasu, Sumithra, Solh, Melhem, Mishra, Asmita, Muffly, Lori, Kim, Hee-Je, Mikesch, Jan-Henrik, Najima, Yuho, Onozawa, Masahiro, Thomson, Kirsty, Nagler, Arnon, Wei, Andrew H., Marcucci, Guido, Geller, Nancy L., Hasabou, Nahla, Delgado, David, Rosales, Matt, Hill, Jason, Gill, Stanley C., Nuthethi, Rishita, King, Denise, Wittsack, Heather, Mendizabal, Adam, Devine, Steven M., Horowitz, Mary M., Chen, Yi-Bin, Agura, Ed, Altman, Jessica, Anagnostopoulos, Achiles, Anand, Sarah, Artz, Andrew, Aulitzky, Walter, Balderman, Sophia, Ballen, Karen, Becker, Michael, Beguin, Yves, Berkahn, Leanne, Berneman, Zwi, Bhatt, Vijaya, Bilmon, Ian, Bonifazi, Francesca, Briggs, Adrienne, Bruno, Benedetto, Brunstein, Claudio, Byrne, Michael, Byrne, Jenny, Cabrero, Monica, Cairoli, Roberto, Carrum, George, Cerny, Jan, Cheong, June-Won, Ciceri, Fabio, Colorado, Mercedes, Cook, Rachel, Couriel, Daniel, Craddock, Charles, Damon, Lloyd, Deol, Abhinav, Desbrosses, Yohan, Devine, Steve, Di Grazia, Carmela, Di Stasi, Antonio, Dias, Ajoy, Dorritie, Kathy, Essell, James, Eto, Tetsuya, Farag, Sherif, Forcade, Edouard, Frankfurt, Olga, Fujiwara, Shinichiro, Fukuda, Takahiro, Fukushima, Kentaro, Furst, Sabine, Goto, Tatsunori, Hall, Aric, Hatta, Shunsuke, Hicheri, Yosr, Horwitz, Mitchell, Hou, Hsin-An, How, Jonathan, Howard, Dianna, Hsu, Wei-Hsun (Blake), Huynh, Anne, Irvine, David, Ishikawa, Takayuki, Jamieson, Katarzyna, Jedrzejczak, Wieslaw, Jethava, Yogesh, Jimenez, Antonio, Jung, Chul Won, Kanda, Junya, Karakasis, Dimitrios, Kato, Jun, Kekre, Natasha, Khera, Nandita, Klein, Andreas, Kobbe, Guido, Kornblit, Brian, Kota, Vamsi, Lachance, Silvy, Leber, Brian, Lee, Catherine, Lee, Je Hwan, Lin, Tung-Liang, Liu, Ta-Chih, Martelli, Maurizio, Martinez, Carmen, Matsuoka, Kenichi, McCarty, John, Mendez, Lourdes, Michelis, Fotios, Mineishi, Shin, Mohty, Mohamad, Moors, Ine, Motyckova, Gabriela, Mueller, Lutz, Nakamae, Hirohisa, Nakano, Nobuaki, Nathan, Sunita, Nicholson, Emma, Norkin, Maxim, Ogawa, Yoshiaki, Olesen, Gitte, Oluwole, Olalekan, Pantin, Jeremy, Paulson, Kristjan, Pemberton, Lucy, Perera, Travis, Piatkowska-Jakubas, Beata, Poire, Xavier, Protheroe, Rachel, Rambaldi, Alessandro, Ritchie, David, Ross, Kelly, Rubio, Marie-Therese, Santarone, Stella, Sanz Caballer, Jaime, Sawa, Masashi, Schaar, Dale, Scheid, Christoph, Schriber, Jeffrey, Seropian, Stuart, Shah, Nilay, Shah, Nirav, Shore, Tsiporah, Gil, Jorge Sierra, Singh, Anurag, Sobecks, Ronald, Socie, Gerard, Soiffer, Robert, Sprague, Kellie, Spyridonidis, Alexandros, Stelljes, Matthias, Stiff, Patrick, Stuart, Robert, Tanaka, Masatsugu, Tandra, Anand, Tholouli, Eleni, Thomas, Xavier, Tiribelli, Mario, Tomlinson, Benjamin, Tsirigotis, Panagiotis, Tzachanis, Dimitrios, Uchida, Naoyuki, Ueda, Masumi, Valcarcel Ferreiras, David, Wagner, Eva, Watson, Anne-Marie, Weisdorf, Daniel, Wolschke, Christine, Wrobel, Tomasz, Yakoub-Agha, Ibrahim, Yamauchi, Takuji, Yared, Jean, Yeh, Su-Peng, Yoon, Sung-Soo, Yoshihara, Satoshi, and null, null

Abstract

PURPOSEAllogeneic hematopoietic cell transplantation (HCT) improves outcomes for patients with AML harboring an internal tandem duplication mutation of FLT3 (FLT3-ITD) AML. These patients are routinely treated with a FLT3 inhibitor after HCT, but there is limited evidence to support this. Accordingly, we conducted a randomized trial of post-HCT maintenance with the FLT3 inhibitor gilteritinib (ClinicalTrials.gov identifier: NCT02997202) to determine if all such patients benefit or if detection of measurable residual disease (MRD) could identify those who might benefit.METHODSAdults with FLT3-ITD AML in first remission underwent HCT and were randomly assigned to placebo or 120 mg once daily gilteritinib for 24 months after HCT. The primary end point was relapse-free survival (RFS). Secondary end points included overall survival (OS) and the effect of MRD pre- and post-HCT on RFS and OS.RESULTSThree hundred fifty-six participants were randomly assigned post-HCT to receive gilteritinib or placebo. Although RFS was higher in the gilteritinib arm, the difference was not statistically significant (hazard ratio [HR], 0.679 [95% CI, 0.459 to 1.005]; two-sided P =.0518). However, 50.5% of participants had MRD detectable pre- or post-HCT, and, in a prespecified subgroup analysis, gilteritinib was beneficial in this population (HR, 0.515 [95% CI, 0.316 to 0.838]; P =.0065). Those without detectable MRD showed no benefit (HR, 1.213 [95% CI, 0.616 to 2.387]; P =.575).CONCLUSIONAlthough the overall improvement in RFS was not statistically significant, RFS was higher for participants with detectable FLT3-ITD MRD pre- or post-HCT who received gilteritinib treatment. To our knowledge, these data are among the first to support the effectiveness of MRD-based post-HCT therapy.

Published
2024

3. Ranolazine in High-Risk Patients With Implanted Cardioverter-Defibrillators: The RAID Trial

Author

Zareba, W., Pyykkonen, K., Buttaccio, A., Perkins, E., DeGrey, D., Robertson, S., Moss, A.J., Brown, M., Lansing, R., Oberer, A., Polonsky, B., Ross, V., Papernov, A., Schleede, S., Beck, C., Oakes, D., Feng, C., McNitt S, S., Hall, W.J., Moss, A., Daubert, J., Huang, D., Winters, S., Schuger, C., Haigney, M., Piccini, J., Alexis, J., Chen, L., Miller, A., Richeson, J.F., Rosero, S., Kutyifa, V., Shah, A., Lamas, G., Cohn, F., Harrell, F., Jr., Piña, I., Poole, J., Sullivan, M., Lathrop, D., Geller, N., Boineau, R., Trondell, J., Cooper, L., Itturiaga, E., Gottlieb, C., Greer, S., Perzanowski, C., McPherson, C., Hedgepeth, C., Assal, C., Salam, T., Woollett, I., Tomassoni, G., Ayala-Paredes, F., Russo, A., Punnam, S., Sangrigoli, R., Sloan, S., Kutalek, S., Sun, A., Lustgarten, D., Monir, G., Haithcock, D., Sorrentino, R., Cannom, D., Kluger, J., Varanasi, S., Rashtian, M., Philippon, F., Berger, R., Mazzella, M., Lessmeier, T., Silver, J., Worley, S., Bernabei, M., Esberg, D., Dixon, M., LeLorier, P., Greenberg, Y., Essebag, V., Venkataraman, G., Shinn, T., Dubuc, M., Turitto, G., Henrikson, C., Mirro, M., Raitt, M., Baranchuk, A., O'Neill, G., Lockwood, E., Vloka, M., Hurwitz, J., Mead, R.H., Somasundarum, P., Aziz, E., Rashba, E., Budzikowski, A., Cox, M., Natale, A., Chung, E., Ziv, O., McGrew, F., III, Tamirisa, K., Greenspon, A., Estes, M., Taylor, S., Janardhanan, R., Mitchell, L.B., Burke, M., Attari, M., Mikaelian, B., Hsu, S., Conti, J., Mazur, A., Shorofsky, S., Rosenthal, L., Sakaguchi, S., Wolfe, D., Flaker, G., Saba, S., Aktas, M., Mason, P., Shalaby, A., Musat, D., Abraham, R., Ellenbogen, K., Fellows, C., Kavesh, N., Thomas, G., Hemsworth, D., Williamson, B., Zareba, Wojciech, Daubert, James P., Beck, Christopher A., Huang, David T., Alexis, Jeffrey D., Brown, Mary W., Pyykkonen, Kathryn, McNitt, Scott, Oakes, David, Feng, Changyong, Aktas, Mehmet K., Ayala-Parades, Felix, Baranchuk, Adrian, Dubuc, Marc, Haigney, Mark, Mazur, Alexander, McPherson, Craig A., Mitchell, L. Brent, Natale, Andrea, Piccini, Jonathan P., Raitt, Merritt, Rashtian, Mayer Y., Schuger, Claudio, Winters, Stephen, Worley, Seth J., Ziv, Ohad, and Moss, Arthur J.

Published
2018
Full Text
View/download PDF

6. The effect of frequent hemodialysis on self-reported sleep quality: Frequent Hemodialysis Network Trials

Author

Unruh, Mark L., Larive, Brett, Eggers, Paul W., Garg, Amit X., Gassman, Jennifer J., Finkelstein, Fredric O., Kimmel, Paul L., Chertow, Glenn M., Achinger, S., Anderson, S., Appel, L., Apruzzes, R., Atwal, J., Augustine, B., Ayus, J., Bardsley, J., Bay, W., Beach, S., Beck, G., Bharti, B., Briggs, J., Bullas, R., Burkart, J., Burrowes, J., Cabezon, E., Callegari, J., Carter, M., Champagne, J., Chan, C., Chan, W., Chang, J., Chertow, G., Cheung, A., Copland, M., Coplon, N., Coppley, A., Daugirdas, J., Dellagrottaglie, S., Depner, T., Derse, A., Dominguez, A., Doss, S., Eggers, P., Eknoyan, G., Escalada, R., Fensterer, A., Finkelstein, F., Fofie, Y., Franzwa, B., Frome, R., Fu, Z., Garg, A., Gassman, J., Gayda, P., Geller, N., Geronemus, R., Goodman, W., Gorodetskaya, I., Gotch, F., Greene, T., Greenwood, R., Grimm, R., Gutierrez, M., Hall, Y., Handelman, G., Henderson, L., Hernandez, A., Higgins, H., Hilkin, A., Hostetter, T., Hoy, C., Humphreys, M., Hunsicker, L., James, S., Kariisa, M., Kaufman, A., Kaufman, T., Kaysen, G., Ke, S., Keene, R., Kimmel, P., Kliger, A., Kotanko, P., Kramer, C., Kuhlmann, M., Kwan, S., Kwok, S., Lacson, E., Larive, B., Leavell, E., Lemus, D., Levin, A., Levin, N., Li, M., Lilli, K., Lindsay, R., Lockridge, R., Luan, J., MacKrell, J., Manaster, R., Mandaci, O., Mathew, R., Mauck, V., Mazzorato, A., McCulloch, C., McGrath-Chong, M., McLeroy, S., Mehta, R., Meisels, I., Miller, B., Mohr, P., Moossavi, S., Nabali, A., Narva, A., Nissenson, A., Ornt, D., Painter, P., Pepas, J., Peterson, C., Pierratos, A., Pipkin, M., Prichard, S., Rajagopalan, S., Ramos, R., Rashid, M., Rastogi, A., Regozo, K., Riley, J., Rivas, M., Rocco, M., Rodriquez, R., Roecker, E., Roger, D., Rogers, J., Salusky, I., Sanz, G., Sanz, J., Schiller-Moran, B., Schlarb, J., Schuessler, R., Schulman, G., Schweitzer, S., Sergeyeva, O., Shah, S., Sherer, S., Sika, M., Sioson, L., Skelton, R., Smith, M., Snell, C., Somers, D., Sonico, J., Spanner, E., Star, R., Steigerwald, D., Stokes, J., Suri, R., Suter, M., Tamura, M., Tarallo, M., Tichy, M., Ting, G., Tran, T., Ulloa, D., Unruh, M., Vassalotti, J., Wallace, W., Waterman, E., Wei, J., Weiss, B., West, J., Wiggins, K., and Winchester, J.

Published
2016
Full Text
View/download PDF

7. Analysis of Chromosome 12 Abnormalities in Male Germ Cell Cancers

Author

Dmitrovsky, E., Rodriguez, E., Samaniego, F., Reuter, V. E., Miller, W. H., Jr., Geller, N. L., Bosl, G. J., Chaganti, R. S. K., Herfarth, Ch., editor, Senn, H.-J., editor, Baum, M., editor, Diehl, V., editor, Gutzwiller, F., editor, Rajewsky, M. F., editor, Wannenmacher, M., editor, Oosterhuis, J. Wolter, editor, Walt, Heinrich, editor, and Damjanov, Ivan, editor

Published
1991
Full Text
View/download PDF

8. Common genetic variants and modifiable risk factors underpin hypertrophic cardiomyopathy susceptibility and expressivity

Author

Harper, A. R., Goel, A., Grace, C., Thomson, K. L., Petersen, S. E., Xu, X., Waring, A., Ormondroyd, E., Kramer, C. M., C. Y., Ho, Neubauer, S., Kolm, P., Kwong, R., Dolman, S. F., Desvigne-Nickens, P., Dimarco, J. P., Geller, N., Kim, D. -Y., Zhang, C., Weintraub, W., Abraham, T., Anderson, L., Appelbaum, E., Autore, C., Berry, C., Biagini, E., Bradlow, W., Bucciarelli-Ducci, C., Chiribiri, A., Choudhury, L., Crean, A., Dawson, D., Desai, M. Y., Elstein, E., Flett, A., Friedrich, M., Heitner, S., Helms, A., Jacoby, D. L., Kim, H., Kim, B., Larose, E., Mahmod, M., Mahrholdt, H., Maron, M., Mccann, G., Michels, M., Mohiddin, S., Nagueh, S., Newby, D., Olivotto, I., Owens, A., Pierre-Mongeon, F., Prasad, S., Rimoldi, O., Salerno, M., Schulz-Menger, J., Sherrid, M., Swoboda, P., van Rossum, A., Weinsaft, J., White, J., Williamson, E., Tadros, R., Ware, J. S., Bezzina, C. R., Farrall, M., Watkins, H., Cardiology, and ACS - Heart failure & arrhythmias

Subjects
LOCI, Genome-wide association study, Blood Pressure, Bioinformatics, DISEASE, SYSTOLIC HYPERTENSION, 0302 clinical medicine, Adolescent, Adult, Aged, Cardiac Myosins, Cardiomyopathy, Hypertrophic, Carrier Proteins, Case-Control Studies, Formins, Genetic Predisposition to Disease, Genome-Wide Association Study, Heterozygote, Humans, Middle Aged, Myosin Heavy Chains, Risk Factors, Sarcomeres, Young Adult, Polymorphism, Single Nucleotide, 11 Medical and Health Sciences, Genetics & Heredity, 0303 health sciences, Hypertrophic cardiomyopathy, Single Nucleotide, 3. Good health, GENOTYPE, cardiovascular system, Life Sciences & Biomedicine, Cardiomyopathy, macromolecular substances, Biology, AMERICAN-COLLEGE, 03 medical and health sciences, Heart disorder, Mendelian randomization, Genetics, medicine, Expressivity (genetics), cardiovascular diseases, Risk factor, GENOME-WIDE ASSOCIATION, Polymorphism, 030304 developmental biology, HCMR Investigators, Science & Technology, Genetic heterogeneity, Case-control study, 06 Biological Sciences, medicine.disease, Hypertrophic, DISCOVERY, 030217 neurology & neurosurgery, Developmental Biology
Abstract

Hypertrophic cardiomyopathy (HCM) is a common, serious, genetic heart disorder. Rare pathogenic variants in sarcomere genes cause HCM, but with unexplained phenotypic heterogeneity. Moreover, most patients do not carry such variants. We report a genome-wide association study of 2,780 cases and 47,486 controls that identified 12 genome-wide-significant susceptibility loci for HCM. Single-nucleotide polymorphism heritability indicated a strong polygenic influence, especially for sarcomere-negative HCM (64% of cases; h2g = 0.34 ± 0.02). A genetic risk score showed substantial influence on the odds of HCM in a validation study, halving the odds in the lowest quintile and doubling them in the highest quintile, and also influenced phenotypic severity in sarcomere variant carriers. Mendelian randomization identified diastolic blood pressure (DBP) as a key modifiable risk factor for sarcomere-negative HCM, with a one standard deviation increase in DBP increasing the HCM risk fourfold. Common variants and modifiable risk factors have important roles in HCM that we suggest will be clinically actionable.

Published
2021

15. Correlates of myocardial fibrosis in hypertrophic cardiomyopathy

Author

Kramer, CM, Appelbaum, E, Desai, MY, Desvigne-Nickens, P, DiMarco, JP, Dolman, S, Friedrich, MF, Geller, N, Ho, CY, Jerosch-Herold, M, Kim, D-Y, Kolm, P, Kwong, RY, Maron, MS, Schulz-Menger, J, Piechnik, S, Watkins, H, Weintraub, WS, and Neubauer, S

Published
2020

19. Transitioning a randomized controlled trial to a digital registry – experience from the TAILOR-PCI digital follow-up study on onboarding, engagement and geofencing consent rate

Author

Avram, R, primary, So, D, additional, Iturriaga, E, additional, Byrne, J, additional, Lennon, R.J, additional, Murthy, V, additional, Geller, N, additional, Goodman, S.G, additional, Rihal, C.S, additional, Bailey, K.R, additional, Farkouh, M, additional, Olgin, J, additional, and Pereira, N.L, additional

Published
2020
Full Text
View/download PDF

20. Distinct Subgroups in Hypertrophic Cardiomyopathy in the NHLBI HCM Registry

Author

Neubauer, S, Kolm, P, Ho, CY, Kwong, RY, Desai, MY, Dolman, SF, Appelbaum, E, Desvigne-Nickens, P, DiMarco, JP, Friedrich, MG, Geller, N, Harper, AR, Jarolim, P, Jerosch-Herold, M, Kim, D-Y, Maron, MS, Schulz-Menger, J, Piechnik, SK, Thomson, K, Zhang, C, Watkins, H, Weintraub, WS, Kramer, CM, and HCMR Investigators

Subjects
cardiovascular diseases
Abstract

BACKGROUND: The HCMR (Hypertrophic Cardiomyopathy Registry) is a National Heart, Lung, and Blood Institute-funded, prospective registry of 2,755 patients with hypertrophic cardiomyopathy (HCM) recruited from 44 sites in 6 countries. OBJECTIVES: The authors sought to improve risk prediction in HCM by incorporating cardiac magnetic resonance (CMR), genetic, and biomarker data. METHODS: Demographic and echocardiographic data were collected. Patients underwent CMR including cine imaging, late gadolinium enhancement imaging (LGE) (replacement fibrosis), and T1 mapping for measurement of extracellular volume as a measure of interstitial fibrosis. Blood was drawn for the biomarkers N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (cTnT), and genetic analysis. RESULTS: A total of 2,755 patients were studied. Mean age was 49 ± 11 years, 71% were male, and 17% non-white. Mean ESC (European Society of Cardiology) risk score was 2.48 ± 0.56. Eighteen percent had a resting left ventricular outflow tract (LVOT) gradient ≥30 mm Hg. Thirty-six percent had a sarcomere mutation identified, and 50% had any LGE. Sarcomere mutation-positive patients were more likely to have reverse septal curvature morphology, LGE, and no significant resting LVOT obstruction. Those that were sarcomere mutation negative were more likely to have isolated basal septal hypertrophy, less LGE, and more LVOT obstruction. Interstitial fibrosis was present in segments both with and without LGE. Serum NT-proBNP and cTnT levels correlated with increasing LGE and extracellular volume in a graded fashion. CONCLUSIONS: The HCMR population has characteristics of low-risk HCM. Ninety-three percent had no or only mild functional limitation. Baseline data separated patients broadly into 2 categories. One group was sarcomere mutation positive and more likely had reverse septal curvature morphology, more fibrosis, but less resting obstruction, whereas the other was sarcomere mutation negative and more likely had isolated basal septal hypertrophy with obstruction, but less fibrosis. Further follow-up will allow better understanding of these subgroups and development of an improved risk prediction model incorporating all these markers.

Published
2019

26. Rationale, design, implementation, and baseline characteristics of patients in the dig trial: A large, simple, long-term trial to evaluate the effect of digitalis on mortality in heart failure

Author

Abernathy, GT, Abrams, J, Akhtar, S, Albitar, I, Amidi, M, Anand, IS, Arnold, JMO, Ashton, T, Aubrey, B, Auger, P, Babb, J, Baigrie, R, Baird, MG, Baitz, T, Barber, NC, Barbour, DJ, Barr, DM, Basu, AK, Baughman, KL, Beckham, V, BekheitSaad, S, Berkson, DM, Bertoglio, M, Bessoudo, R, Beaudoin, J, Bhaskar, G, Binder, A, Bloomfield, D, Bodine, K, Boehmer, JP, Borgersen, K, Borts, D, Bouchard, G, Bourassa, MG, Boutros, G, Bozek, B, Brisbin, D, Brophy, J, Brossoit, R, Brown, E, Brown, J, Bruinsma, N, Burton, G, Cameron, A, Campbell, R, Campeau, J, Campos, EE, Cardello, FP, Carter, RP, Chan, YK, Charles, FR, Chaudhry, MA, Chiaramida, A, Chiaramida, S, Chohan, A, Christie, LG, Clemson, BS, Collin, R, Cook, TH, Copen, DL, Cossett, J, Costantino, T, Crawford, MH, Croke, RP, Crowell, R, DAmours, G, Dagenais, GR, Danisa, K, Davidson, S, Davies, ML, Davies, R, Davies, RA, DeLarochelliere, R, DeLeon, AC, Delage, F, Denes, P, Dennish, GW, Denny, DM, DeVilla, MA, DeYoung, JP, Dhurandhar, RW, DibnerDunlap, M, Dodek, A, Doherty, JE, Dominguez, J, Dubbin, J, Dufton, J, Effron, MB, ElSherif, N, Eladasari, B, Fly, D, Ericson, K, Fahrenholtz, D, Fast, A, Fell, DA, Fishman, S, Fitchett, D, Fleg, JL, Flint, E, Folger, JS, Folkins, D, Forker, AD, Fowles, RE, Fraker, TD, Francis, G, Frerking, TR, Friesinger, GC, Fulop, JC, Gagnon, J, Gamble, L, Ganjavi, F, Garrou, BW, Gervais, PB, Gheorghiade, M, Gilbert, L, Gillie, E, Glatter, TR, Godley, ML, Goeres, M, Goldberger, MH, Gollapudi, A, Goode, JE, Goodman, LS, Gordon, R, Gossard, D, Gosselin, G, Goulet, C, Grant, C, Graettinger, WF, Greene, JG, Greenwood, PV, Gregoratos, G, Gregory, JJ, Groden, DL, Grover, J, Gudapati, R, Guess, MA, Gupta, SC, Habib, N, Hack, I, Hamilton, WP, Hankey, TL, Hanna, M, Harper, D, Harris, DE, Hassapoyannes, CA, Hatheway, RJ, Heinsimer, J, Pequignot, MH, Heiselman, DE, Hess, AR, Hickner, J, Hickey, JE, Higgins, T, Higginson, L, Hill, L, Hobbs, RE, Honos, G, Horner, BA, Horwitz, L, Hsieh, A, Hsueh, JT, Hubbard, J, Hughes, DF, Hui, W, Imrie, JR, Jacobs, MH, Jarmukli, N, Johnson, TH, Johnstone, D, Jutila, CK, Kadri, N, Kahl, FR, Kaimal, PK, Karnegis, J, Kay, R, Kelly, KJ, Kenefick, G, Kennelly, BM, Kent, E, Khan, AH, Khanijo, V, Khouri, M, Kinloch, D, Kirlin, PC, Kiwan, GS, Kline, MD, Kohn, RM, Koilpillai, C, Kornder, JM, Kouz, S, Kumar, VA, Kumar, U, Kuntz, A, Kuritzky, RA, Kuruvilla, G, Kwok, KK, Lader, E, Laforest, M, LaForge, D, Lalonde, G, Lalonde, L, Lang, RM, Latour, Y, Lawal, O, LeBlanc, MH, Lee, AB, Lee, RW, Legault, C, Lemay, M, Lenis, JHF, Lepage, S, Letarte, P, Levesque, C, LevinoffRoth, SN, Lewis, BK, Lipshutz, H, Loungani, RR, Lowery, ML, Lubell, DL, Lucariello, R, LugoRodriguez, JE, Lui, C, Lutterodt, AT, Lutz, L, Machel, T, Macina, G, MacLellan, K, Magnan, O, Mansuri, M, Manyari, DE, Mallis, GI, Marr, D, Mast, DJ, Mathew, J, McBarron, FD, McIntyre, KM, McLean, RW, McMahon, DP, Mercier, M, Methe, M, Miller, AB, Minkowitz, J, Milton, JR, Mizgala, HF, Mohanty, PK, Mohiuddin, S, Montero, A, Mookherjee, S, Morris, A, Morris, L, Morrison, J, Moten, M, Nafziger, A, Nair, PH, Nawaz, S, Neiman, JC, Nutting, P, NguyenPho, HT, OBrien, TK, OKelly, RL, OReilly, MV, Okerson, D, Patel, G, Pande, PN, Papa, LA, Patrick, L, Payne, RM, Perry, G, Philbin, EF, Pierpont, G, Pitt, WA, Poirier, C, Pollak, EM, Popio, K, Poulin, JF, Probst, PA, Pruneau, G, Pu, C, Puram, BS, Putatunda, B, Quinn, B, Rabkin, SW, Racine, N, Raco, DL, Radant, L, Radford, MJ, Radwany, S, Rajachar, M, Ramanathan, KB, Rashkow, A, Rausch, DC, Read, L, Reddy, KR, Reid, R, Rich, MW, Ricci, AJ, Richman, HG, Riley, A, Rim, DA, Rinne, C, Roberge, G, Roberts, DK, Robinson, V, Rodeheffer, RT, Rosenstein, R, Roth, DL, Rothbart, R, Rouleau, JL, Ruble, P, Sacco, J, Safford, RE, Salmon, D, Sahay, BM, Sarma, RJ, Sayeed, MAR, Schick, EC, Schroeder, GS, Seifert, M, Senaratne, MPJ, Sestier, F, Shah, A, Shanes, JG, Sheesley, K, Silverman, A, Shiva, T, Shrestha, DD, Silver, MA, Silverberg, L, Simard, L, Singh, BN, Small, RS, Smith, MR, Smith, S, Sochowski, RA, Southern, RF, Sridharan, MR, StHilaire, R, Stein, M, Stewart, JW, Stillabower, ME, Sullivan, BHM, Sturrock, WA, Sussex, BA, Swan, J, Swenson, L, Talbot, P, Talibi, T, Tamilia, M, Tan, A, Tanser, PH, Tarry, L, Teo, KK, Thadani, U, Thagirisa, S, Thompson, B, Thornton, R, Timmis, GC, Tobin, M, Tommaso, C, Toren, M, Tsuyuki, R, Turek, M, Utley, K, Vanderbush, EJ, VanVoorhees, L, Ventura, H, Vertes, G, Vizel, S, Wagner, KR, Wagner, S, Weeks, A, Weingert, ME, Weinstein, C, Weiss, MM, Weiss, R, Wickemeyer, W, Wielgoz, A, Willens, HJ, Williams, WL, Wong, D, Yarows, SA, Yao, L, Shalev, Y, Young, JB, Yousefian, M, Zajac, EJ, Zatuchni, J, Ziperman, DB, Zoble, RG, Zoneraich, S, Gorlin, R, Sleight, P, Cohn, JN, Collins, R, Deykin, D, Hennekens, C, Kjekshus, J, Smith, TW, Tognoni, G, Collins, JF, Williford, WO, Fye, C, Sather, R, Jolly, MK, Held, CP, Verter, J, Yusuf, S, Egan, D, Garg, R, Johnstone, DE, Montague, T, Bristow, D, Engelhardt, HT, Gent, M, Hood, WB, Jones, S, Meier, P, Pitt, B, Waters, D, Baker, A, Barnhill, S, Carew, B, Hagar, S, Liuni, C, Martin, S, Miles, R, Arthur, MM, Feldbush, MW, Highfield, DA, Hobbins, TE, Kurz, R, Leviton, SP, Libonati, JP, Moore, M, Perez, E, Mills, P, Geller, N, Hunsberger, S, Gold, J, Huang, PC, Burns, A, Caleb, H, Cline, DR, Harris, S, Hockenbrock, R, Horney, RA, Jadwin, LM, King, J, Sexton, P, Spence, ME, Chacon, F, Gagne, W, Maple, S, and Martinez, G

Subjects
Heart Failure, Male, Pharmacology, Digoxin, Treatment Outcome, Patient Selection, Digitalis Glycosides, Humans, Multicenter Studies as Topic, Female, Middle Aged, Aged, Randomized Controlled Trials as Topic
Abstract

This article provides a detailed overview of the rationale for key aspects of the protocol of the Digitalis Investigation Group (DIG) trial. It also highlights unusual aspects of the study implementation and the baseline characteristics. The DIG trial is a large, simple, international placebo-controlled trial whose primary objective is to determine the effect of digoxin on all cause mortality in patients with clinical heart failure who are in sinus rhythm and whose ejection fraction isor = 0.45. An ancillary study examines the effect in those with an ejection fraction0.45. Key aspects of the trial include the simplicity of the design, broad eligibility criteria, essential data collection, and inclusion of various types of centers. A total of 302 centers in the United States and Canada enrolled 7788 patients between February 1991 and September 1993. Follow-up continued until December 1995 with the results available in Spring 1996.

Published
1996
Full Text
View/download PDF

28. Statin use and risk of haemorrhagic stroke in a community-based cohort of postmenopausal women: an observational study from the Women's Health Initiative

Author

Salmoirago-Blotcher, E., primary, Hovey, K. M., additional, Andrews, C. A., additional, Robinson, J. G., additional, Johnson, K. C., additional, Wassertheil-Smoller, S., additional, Crawford, S., additional, Qi, L., additional, Martin, L. W., additional, Ockene, J., additional, Manson, J. E., additional, Nabel, E., additional, Rossouw, J., additional, Ludlam, S., additional, McGowan, J., additional, Ford, L., additional, Geller, N., additional, Prentice, R., additional, Anderson, G., additional, LaCroix, A., additional, Kooperberg, C. L., additional, Patterson, R. E., additional, McTiernan, A., additional, Stein, E., additional, Cummings, S., additional, Rajkovic, A., additional, Eaton, C. B., additional, Phillips, L., additional, Beresford, S., additional, Chlebowski, R., additional, Michael, Y., additional, Caan, B., additional, Kotchen, J. M., additional, Howard, B. V., additional, Van Horn, L., additional, Black, H., additional, Stefanick, M. L., additional, Lane, D., additional, Jackson, R., additional, Lewis, C. E., additional, Thomson, C. A., additional, Wactawski-Wende, J., additional, Robbins, J., additional, Hubbell, F. A., additional, Nathan, L., additional, Langer, R. D., additional, Gass, M., additional, Limacher, M., additional, Curb, J. D., additional, Wallace, R., additional, Lasser, N., additional, O'Sullivan, M. J., additional, Margolis, K., additional, Brunner, R., additional, Heiss, G., additional, Kuller, L., additional, Brzyski, R., additional, Sarto, G. E., additional, Vitolins, M., additional, Simon, M., additional, and Shumaker, S., additional

Published
2015
Full Text
View/download PDF

31. Pre-Transplant T-Cell Lymphopenia Accelerates Early Donor T-Cell and Myeloid Chimerism but Is Not Required for Full Donor Lymphohematopoietic Engraftment or To Prevent Graft Rejection Following Nonmyeloablative Hematopoietic Cell Transplantation (NST).

Author

Srivastava, Shivani, primary, Savani, Bipin N., additional, Geller, N., additional, Carvallo, C., additional, Srinivasan, Ramaprasad, additional, Takahashi, Y., additional, Lundqvist, A., additional, Kurlander, R., additional, Goodwin, R., additional, Barrett, A. John, additional, Fleisher, T., additional, and Childs, Richard W., additional

Published
2006
Full Text
View/download PDF

32. Letter to the Editor

Author

Geller, N L, primary, Sorlie, P, additional, Coady, S, additional, Fleg, J, additional, Manolio, T, additional, and Friedman, L, additional

Published
2005
Full Text
View/download PDF

33. Effects of aggressive cholesterol lowering and low-dose anticoagulation on clinical and angiographic outcomes in patients with diabetes: the Post Coronary Artery Bypass Graft Trial.

Author

Hoogwerf BJ, Waness A, Cressman M, Canner J, Campeau L, Domanski M, Geller N, Herd A, Hickey A, Hunninghake DB, Knatterud GL, White C, Hoogwerf, B J, Waness, A, Cressman, M, Canner, J, Campeau, L, Domanski, M, Geller, N, and Herd, A

Abstract

Diabetic patients have greater risk for coronary heart disease (CHD) events after coronary artery bypass graft (CABG) surgery than nondiabetic patients. The Post CABG trial studied the effects of aggressive cholesterol lowering and low-dose anticoagulation in diabetic patients compared with nondiabetic patients. A double-blind, randomized clinical trial in 1,351 patients (1-11 years after CABG), the Post CABG trial consisted of two interventions (aggressive cholesterol-lowering versus moderate lowering and low-dose warfarin versus placebo) on angiographic end points. Angiographic changes in saphenous vein graft conduits 4.3 years after entry were compared in 116 diabetic and 1,235 nondiabetic patients. Seven clinical centers participated in the trial, as well as the National Institutes of Health project office (National Heart, Lung, and Blood Institute), the coordinating center (Maryland Medical Research Institute), and the Angiogram Reading Center (University of Minnesota). Baseline characteristics of the diabetic patients differed from the nondiabetic patients in the following ways: percentage of women participants, 15 vs. 7%, P = 0.002; mean baseline weight, 87.4 vs. 82.8 kg, P = 0.006; mean BMI, 29.5 vs. 27.6 kg/m2, P = 0.0002; mean systolic blood pressure, 141.7 vs. 133.6, P < 0.0001; mean triglyceride concentrations, 2.09 vs. 1.77 mmol/l, P < 0.0001; and mean HDL cholesterol concentrations, 0.93 vs. 1.02 mmol, P = 0.0001. The percentage of clinical events was higher in diabetic than nondiabetic patients (20.6 vs. 13.4, P = 0.033) and angiographic outcomes were not different. The benefits of aggressive cholesterol lowering were comparable in diabetic and nondiabetic patients for the angiographic end points. Warfarin use was not associated with clinical or angiographic benefit. Diabetic patients in the Post CABG trial had more CHD risk factors at study entry and higher clinical event rates during the study than nondiabetic patients. The benefits of aggressive cholesterol lowering in diabetic patients were comparable to those in nondiabetic patients for both angiographic and clinical end points. The small number of diabetic patients provided limited power to detect significant differences between diabetic and nondiabetic patients or between diabetic patients in the aggressive versus moderate cholesterol treatment strategies. [ABSTRACT FROM AUTHOR]

Published
1999
Full Text
View/download PDF

34. Improved survival in steroid-refractory acute graftversushost disease after non-myeloablative allogeneic transplantation using a daclizumab-based strategy with comprehensive infection prophylaxis

Author

Srinivasan, R., primary, Chakrabarti, S., additional, Walsh, T., additional, Igarashi, T., additional, Takahashi, Y., additional, Kleiner, D., additional, Donohue, T., additional, Shalabi, R., additional, Carvallo, C., additional, Barrett, A. J., additional, Geller, N., additional, and Childs, R., additional

Published
2004
Full Text
View/download PDF

37. Delayed progression of atherosclerosis in coronary bypass grafts is similar in women compared to men following aggressive cholesterol lowering despite more frequent risk factors: post CABG trial

Author

Campeau, L., primary, Knatterud, G., additional, Domanski, M., additional, Forrester, J.S., additional, Geller, N., additional, Gobel, F., additional, Herd, J.A., additional, Hoogwerf, B., additional, Hunninghake, D.B., additional, White, C., additional, and Rosenberg, Y., additional

Published
1998
Full Text
View/download PDF

43. research paper Improved survival in steroid-refractory acute graft versus host disease after non-myeloablative allogeneic transplantation using a daclizumab-based strategy with comprehensive infection prophylaxis.

Author

Srinivasan, R., Chakrabarti, S., Walsh, T., Igarashi, I., Takahashi, Y., Kleiner, D., Donohue, T., Shalabi, R., Carvallo, C., Barrett, A. J., Geller, N., and Childs, R.

Subjects
CELL transplantation, GRAFT versus host disease, LEUCOCYTES, STEROIDS, ANTI-infective agents, MONOCLONAL antibodies, INFLIXIMAB
Abstract

Approximately 15% of patients undergoing non-myeloablative allogeneic haematopoietical cell transplantation (NMHCT) develop steroid-refractory acute-graft versus host disease (aGVHD), a usually fatal complication. We encountered 18 cases of steroid-refractory aGVHD in 146 patients, undergoing NMHCT from a related human leucocyte antigen-compatible donor following cyclophosphamide/fludarabine-based conditioning. Our initial cohort of steroid-refractory aGVHD patients treated with antithymocyte globulin (ATG) and mycophenolate mofetil (regimen-1: n = 6) had high GVHD-related mortality. Therefore, we investigated an alternative strategy for subsequent patients developing this complication (regimen-2: n = 12), consisting of daclizumab (alone or combined with infliximab/ATG) and targeted broad spectrum antibacterial and aspergillus prophylaxis in conjunction with rapid tapering of steroids to minimize opportunistic infections. In a retrospective analysis, patients receiving regimen-2 were significantly more likely to have complete resolution of GVHD compared with those receiving regimen-1 [12/12 (100%) vs. 1/6 (17%); P < 0·001]. When compared with those receiving regimen-1, regimen-2 patients also had a higher probability of survival at day 100 (100% vs. 50%) and day 200 (73% vs. 17%) post-transplant, and improved overall survival (median 453 d vs. 42 d from aGVHD onset; P < 0·0001). GVHD-related mortality was 89% for regimen-1 patients vs. 17% for regimen-2 patients ( P < 0·0001). These data suggest that a co-ordinated approach using immunoregulatory monoclonal antibodies, pre-emptive antimicrobial therapy and judicious steroid withdrawal can dramatically improve outcome in steroid-refractory aGVHD. [ABSTRACT FROM AUTHOR]

Published
2004
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results