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1.
Curr Oncol ; 30(3): 3549-3556, 2023 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-36975483

RESUMO

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic profoundly influenced unrelated donor (UD) allogeneic peripheral blood stem cell (PBSC) collections. Changes included efforts to minimize COVID-19 exposure to donors and cryopreservation of products. The extent to which the efficacy and safety of PBSC donations were affected by the pandemic is unknown. METHODS: Prospective cohort analysis of PBSC collections comparing pre-pandemic (01 April 2019-14 March 2020) and pandemic (15 March 2020-31 March 2022) eras. RESULTS: Of a total of 291 PBSC collections, cryopreservation was undertaken in 71.4% of pandemic donations compared to 1.1% pre-pandemic. The mean requested CD34+ cell dose/kg increased from 4.9 ± 0.2 × 106 pre-pandemic to 5.4 ± 0.1 × 106 during the pandemic. Despite this increased demand, the proportion of collections that met or exceeded the requested cell dose did not change, and the mean CD34+ cell doses collected (8.9 ± 0.5 × 106 pre-pandemic vs. 9.7 ± 0.4 × 106 during the pandemic) remained above requested targets. Central-line placements were more frequent, and severe adverse events in donors increased during the pandemic. CONCLUSION: Cryopreservation of UD PBSC products increased during the pandemic. In association with this, requested cell doses for PBSC collections increased. Collection targets were met or exceeded at the same frequency, signaling high donor and collection center commitment. This was at the expense of increased donor or product-related severe adverse events. We highlight the need for heightened vigilance about donor safety as demands on donors have increased since the pandemic.


Assuntos
COVID-19 , Transplante de Células-Tronco Hematopoéticas , Humanos , Pandemias , Doadores não Relacionados , Estudos Prospectivos , Doadores de Sangue
2.
Oecologia ; 201(1): 107-118, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36414861

RESUMO

The healthy herds hypothesis (HHH) suggests that predators decrease parasitism in their prey. Repeated tests of this hypothesis across a range of taxa and ecosystems have revealed significant variation in the effect of predators on parasites in prey. Differences in the response to predators (1) between prey taxa, (2) between seasons, and (3) before and after catastrophic disturbance are common in natural systems, but typically ignored in empirical tests of the HHH. We used a predator exclusion experiment to measure the effect of these heterogeneities on the tri-trophic interaction among predators, parasites and prey. We experimentally excluded mammalian predators from the habitats of hispid cotton rats (Sigmodon hispidus) and cotton mice (Peromyscus gossypinus) and measured the effect of exclusion on gastrointestinal parasites in these rodents. Our experiment spanned multiple seasons and before and after a prescribed burn. We found that the exclusion of the same predators had opposite effects on the parasites of small mammal prey species. Additionally, we found that the effect of mammal exclusion on parasitism differed before versus after fire disturbance. Finally, we saw that the effect of predator exclusion was highly dependent on prey capture season. Significant effects of exclusion emerged primarily in the fall and winter months. The presence of so many different effects in one relatively simple system suggests that predator effects on parasites in prey are highly context dependent.


Assuntos
Ecossistema , Parasitos , Animais , Roedores , Estações do Ano , Cadeia Alimentar , Comportamento Predatório/fisiologia
3.
Vox Sang ; 117(9): 1121-1125, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35583125

RESUMO

BACKGROUND AND OBJECTIVES: Understanding changes in the demand and usage of unrelated allogeneic haematopoietic cell transplantation (HCT) donors during the COVID-19 pandemic is needed to optimize pandemic preparedness of registry and donor collection services. The aim of this study was to understand the extent to which the pandemic has impacted the demand and usage of unrelated donors and cord blood units (CBUs) at Canadian Blood Services (CBS). MATERIALS AND METHODS: Data regarding stem cell donor interest and product usage for unrelated allogeneic HCT were retrieved from the database at CBS using de-identified anonymous information. RESULTS: Unrelated donor searches for Canadian patients remained unchanged by the pandemic, reflecting stable demand. The number of unrelated allogeneic transplants performed within Canada also remained stable, while the number of cord blood transplants increased, chiefly for paediatric patients. Requests for donor verification typing, a first signal of potential interest, increased from domestic centres during the first 6 months of the pandemic and decreased from international centres, before returning to baseline levels. The proportion of transplants for Canadian patients who used stem cell products procured from Canadian donors increased between 3 and 6 months after the start of the pandemic before returning to baseline and appears to be increasing again more than 1 year after the start of the pandemic. Use of CBUs for Canadian paediatric patients increased and remains elevated. CONCLUSION: Demand for unrelated adult HCT donors has remained stable despite the evolving pandemic with a transient and recurring increased interest and usage of domestic adult donors. Use of CBUs for paediatric patients has increased and remains elevated. Registries and donor collection centres should maintain the capacity to expand services for domestic donor collection during pandemics to offset threats to international donor usage.


Assuntos
COVID-19 , Transplante de Células-Tronco Hematopoéticas , Células-Tronco de Sangue Periférico , Adulto , COVID-19/epidemiologia , Canadá/epidemiologia , Criança , Humanos , Pandemias , Sistema de Registros , Doadores não Relacionados
4.
Transplant Cell Ther ; 28(7): 408.e1-408.e8, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35398578

RESUMO

Allogeneic hematopoietic cell transplantation (HCT) is used increasingly to treat blood and immune-based disorders. Post-transplantation testing of HCT recipients can lead to unexpected molecular, cytogenetic, and other information in donor-derived cells, raising questions regarding the potential impact on donor health. This study was conducted to identify the breadth of donor-derived abnormalities identified by testing HCT recipients and to determine the extent to which disclosure and donor follow-up are described. A systematic search and scoping review were conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping review guidelines in OVID MEDLINE and Embase (1947 to May 24, 2021). We identified 38 studies (63 donor-recipient pairs) addressing nonleukemic abnormalities to complement existing literature describing donor cell leukemia and donor-derived myelodysplasia. Donors were unrelated adults (n = 20), related family members (n = 28), cord blood donors (n = 6), or not reported (n = 9). Acquired cytogenetic, molecular, and morphologic abnormalities were reported. Donor origin was confirmed by cytogenetic analysis via karyotyping, fluorescence in situ hybridization, single tandem repeat PCR, and other techniques. A disease in donor-derived cells was described in 35 recipients (56.5%). Despite the relevance for testing and disclosure to donors, only 22 cases (32%) mentioned donor follow-up, and in 5 cases the donor developed a disease associated with the identified abnormality. Unrelated donor disclosure was mentioned in 3 of 26 cases (12%), with the findings reported back to the registry. Incidental abnormalities identified in transplanted donor cells may contribute to the post-transplantation risk of illness in the recipient and may be relevant to donor health. A framework for donor disclosure is proposed that incorporates consideration of analytic validity of the testing, potential significance of the finding, and the extent to which the abnormality is actionable. Adoption of effective processes to safeguard both donor and recipient health outcomes related to this issue is needed.


Assuntos
Revelação , Transplante de Células-Tronco Hematopoéticas , Adulto , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Hibridização in Situ Fluorescente , Transplante Homólogo/efeitos adversos , Doadores não Relacionados
5.
Transfusion ; 60(7): 1508-1518, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32319688

RESUMO

BACKGROUND: Patients undergoing hematopoietic cell transplantation (HCT) often require use of an unrelated donor or cord blood unit (CBU). An understanding of evolving practices in graft selection is needed for optimization of donor recruitment and cord blood collection. STUDY DESIGN AND METHODS: Each donor workup (WU) requested in 2018 involving a Canadian (CDN) patient and unique donor product or CBU was reviewed (n = 598). Degree of HLA match; product origin (domestic or international [INT]); and non-HLA factors including donor age, sex, cytomegalovirus (CMV), and ABO compatibility were analyzed for WUs that proceeded to transplant (n = 414). We also analyzed changes compared to a similar analysis performed in 2013. RESULTS: The majority of transplants used matched unrelated donors (MUDs; n = 323; 78%) and were most often young (≤35 years), male, INT donors (n = 136). The proportion of transplants involving MUDs, as opposed to mismatched unrelated donors or CBUs, increased by 12.4% compared with 2013. When young, male, CDN MUDs were identified in patient search reports but not selected, CMV mismatching and ABO incompatibility were most likely to have influenced the decision to use an INT MUD. Consistent with global trends, CBU transplants decreased compared to 2013; however, the degree of HLA matching improved significantly, and 27% of transplanted CBUs were procured from the Canadian Blood Services Cord Blood Bank. CONCLUSIONS: Access to MUDs and better HLA-matched CBUs by CDN patients has increased since 2013. Ongoing recruitment of young registrants and cord blood donors with diverse HLA haplotypes will support selection of donors with optimal non-HLA characteristics.


Assuntos
Transplante de Células-Tronco de Sangue do Cordão Umbilical , Antígenos HLA/sangue , Haplótipos , Transplante de Células-Tronco Hematopoéticas , Teste de Histocompatibilidade , Doadores não Relacionados , Aloenxertos , Canadá , Feminino , Sangue Fetal , Humanos , Masculino , Pessoa de Meia-Idade
6.
Sci Rep ; 9(1): 14615, 2019 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-31602009

RESUMO

Predator communities are changing worldwide: large carnivores are declining while mesocarnivores (medium-sized mammalian predators) are increasing in number and ecological influence. Predator choice of prey is not random and different predators select prey with different characteristics. Changes in predator communities can change predation patterns experienced by prey. Little is known about how mesocarnivore communities influence prey morphology. We used 14 years of mark-recapture data to investigate how mesocarnivore exclusion affected body mass of hispid cotton rats (Sigmodon hispidus). Finding adult male cotton rats were 9% heavier with mesocarnivore exclusion, we developed hypotheses to explain this observation. Greater adult male body mass in exclosures resulted from: (1) a non-significant trend of increased survival of large males, (2) faster juvenile male growth during the fall and a similar non-significant trend among adult males, and (3) spatial partitioning by size among males. Taxa-specific predation rates (i.e., rates of predation by snakes, raptors, or mesocarnivores) did not differ among male body mass classes. Mesocarnivores disproportionately preyed on large females while raptors targeted small females, but female body mass was not influenced by mesocarnivore exclusion. Changes in predator communities can result in multiple small effects that collectively result in large differences in prey morphology.


Assuntos
Peso Corporal , Carnívoros/fisiologia , Comportamento Predatório , Sigmodontinae/fisiologia , Animais , Tamanho Corporal , Comportamento Competitivo , Feminino , Cadeia Alimentar , Masculino , Dinâmica Populacional , Aves Predatórias , Estações do Ano , Serpentes , Especificidade da Espécie
7.
Biol Blood Marrow Transplant ; 24(12): 2466-2470, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30036572

RESUMO

Relapse after allogeneic hematopoietic cell transplantation (HCT) for acute leukemia can be reduced when pursued early after first complete remission. The impact of donor age and donor relatedness on the time from diagnosis to transplant in patients with acute leukemia was examined to clarify the design of future prospective studies that can address optimal donor choice. Files of 100 consecutive patients undergoing transplantation for leukemia were reviewed. Recipients of related donors (RDs) and unrelated donors (UDs) were not significantly different in terms of recipient gender, age, underlying diagnosis, disease risk index, graft source, or donor HLA match. UDs were significantly younger than RDs (median age, 29 versus 51, P < .001). Multivariate linear regression revealed that when controlling for age of donor and recipient, the time from diagnosis to transplant was 35% longer with UDs compared with RDs (P = .018). No significant correlation was observed between donor and recipient age on length of time to transplant (P = .134 and P = .850, respectively), when controlling for other variables. The steps in UD procurement that contribute most to the longer time to transplant relate to activating the donor workup and scheduling the donor workup before cell collection. Understanding sources of delay in the transplant process will help transplant centers and UD registries reduce the time to transplant for patients with acute leukemia and will provide necessary insight for the design of prospective controlled studies that can address optimal donor choice.


Assuntos
Transplante de Células-Tronco Hematopoéticas/métodos , Leucemia Mieloide Aguda/cirurgia , Adulto , Fatores Etários , Feminino , Humanos , Leucemia Mieloide Aguda/patologia , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Doadores de Tecidos
8.
Biol Blood Marrow Transplant ; 24(4): 861-865, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29253552

RESUMO

Zika virus has emerged as a potential threat to the Canadian blood supply system. Stem cell donors within Canadian Blood Services' Cord Blood Bank (CBB) and OneMatch Stem Cell and Marrow Network (OM) now undergo screening measures designed to reduce the risk of Zika virus transmission. The impact these screening measures have on cord blood and unrelated adult stem cell donations is currently unknown. Among 146 donor workups initiated by OM between July 2016 and May 2017, 102 were completed and 44 workups were canceled. There were 17 potential donors (11.6%) with a risk of Zika virus exposure identified by the donor questionnaire (13 completed, 4 canceled workups). None of the workups involved a donor diagnosed with confirmed Zika virus within the past 6 months. Only 1 of the 44 canceled workups (and only 1 of 4 cases with a risk of Zika transmission) was canceled because of the risk of Zika transmission, and a backup donor was selected. Canadian Blood Services' CBB identified 25 of 875 cord blood units (2.9%) from women who donated their infants' cord blood and underwent screening that otherwise met the initial cell number thresholds for banking and had at least 1 risk factor for exposure to Zika virus. No women were diagnosed with Zika virus at any point of their pregnancy. All 25 units were discarded. Unrelated donors at OM have a higher incidence of a risk of exposure to Zika virus compared with cord blood donors. Only rarely did transplant centers cancel donor workups due to potential Zika virus exposure. The impact of screening for Zika virus exposure risk on cord blood banking was minor. Continued vigilance and surveillance is recommended.


Assuntos
Bancos de Sangue , Segurança do Sangue , Sangue Fetal , Inquéritos e Questionários , Doadores não Relacionados , Infecção por Zika virus/prevenção & controle , Zika virus , Adulto , Canadá , Feminino , Humanos , Masculino , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Fatores de Risco , Infecção por Zika virus/transmissão
9.
PLoS One ; 12(11): e0189020, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29190686

RESUMO

Global positioning system (GPS) technologies have improved the ability of researchers to monitor wildlife; however, use of these technologies is often limited by monetary costs. Some researchers have begun to use commercially available GPS loggers as a less expensive means of tracking wildlife, but data regarding performance of these devices are limited. We tested a commercially available GPS logger (i-gotU GT-120) by placing loggers at ground control points with locations known to < 30 cm. In a preliminary investigation, we collected locations every 15 minutes for several days to estimate location error (LE) and circular error probable (CEP). Using similar methods, we then investigated the influence of cover on LE, CEP, and fix success rate (FSR) by constructing cover over ground control points. We found mean LE was < 10 m and mean 50% CEP was < 7 m. FSR was not significantly influenced by cover and in all treatments remained near 100%. Cover had a minor but significant effect on LE. Denser cover was associated with higher mean LE, but the difference in LE between the no cover and highest cover treatments was only 2.2 m. Finally, the most commonly used commercially available devices provide a measure of estimated horizontal position error (EHPE) which potentially may be used to filter inaccurate locations. Using data combined from the preliminary and cover investigations, we modeled LE as a function of EHPE and number of satellites. We found support for use of both EHPE and number of satellites in predicting LE; however, use of EHPE to filter inaccurate locations resulted in the loss of many locations with low error in return for only modest improvements in LE. Even without filtering, the accuracy of the logger was likely sufficient for studies which can accept average location errors of approximately 10 m.


Assuntos
Sistemas de Informação Geográfica , Coleta de Dados
10.
Transfusion ; 57(11): 2782-2789, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28963719

RESUMO

BACKGROUND: The frequency of cryopreserving blood stem or progenitor products from unrelated donors is not known and the underlying reasons are poorly documented. Greater insight is needed to develop policies on cryopreservation that balance donor safety with patient needs. STUDY DESIGN AND METHODS: Cryopreservation requests between January 1, 2014, and May 31, 2016, at the OneMatch Stem Cell and Marrow Network at Canadian Blood Services were reviewed and a systematic review of the literature was performed. RESULTS: Thirty products of 719 (4.2%) unrelated donor collections facilitated by OneMatch were cryopreserved. Patient-related reasons were most common and included the need to delay transplant for continued antimicrobial treatment (six patients), patient too deconditioned to proceed with scheduled transplant (five patients), and/or need for more treatment for relapsed disease (three patients). Donor-related issues leading to cryopreservation requests were less common (five cases), mainly due to lack of donor availability after attempting to reschedule. Cryopreservation of a product that was never infused occurred infrequently (two cases, 7%). In our systematic review of the literature, 993 cases were identified in 32 published reports. Both patient-related and donor-related reasons were cited but not specifically reported, precluding quantitative insight regarding the relative frequency of causes. The impact of cryopreservation on hematopoietic engraftment appears negligible when compared to controls in a subset of studies; however, reporting of outcomes was inconsistent. CONCLUSION: Future studies with standard outcome measures are needed to clarify the impact of cryopreservation on engraftment and other transplant outcomes. International guidelines that consider the ethical framework surrounding requests for donor product cryopreservation are needed.


Assuntos
Criopreservação , Transplante de Células-Tronco Hematopoéticas , Doadores não Relacionados , Humanos , Canadá , Criopreservação/normas , Criopreservação/estatística & dados numéricos , Criopreservação/tendências , Sobrevivência de Enxerto , Transplante de Células-Tronco Hematopoéticas/métodos , Transplante de Células-Tronco Hematopoéticas/normas , Guias de Prática Clínica como Assunto
11.
PLoS One ; 10(9): e0137169, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26361211

RESUMO

Declining large carnivore populations, increased habitat fragmentation, declining interests in fur trapping, and other anthropogenic factors can all lead to increased mesopredator populations and these may negatively impact biodiversity. Lethal mesopredator control potentially mitigates some of these effects but can be controversial, largely because impacts on mesopredator populations have not been evaluated. Estimating these impacts may reduce controversies while increasing our understanding of when lethal control may be beneficial. Therefore, we analyzed published mesopredator removal data to determine if mesopredator removal rates changed over time. Removals of medium,(e.g., raccoons (Procyon lotor) or red foxes (Vulpes vulpes), and large, i.e., bobcats (Lynx rufus) or coyotes (Canis latrans), mesopredators were consistent from year to year and over the duration of study (i.e., number removed during the first and last years of studies were similar). In contrast, removals of small mesopredators, e.g., weasels (Mustela spp.) or spotted skunks (Spilogale putorius), declined over the duration of study. Study area size, number of species targeted for removal, and duration of removal effort were poor predictors of removal rates. Our analyses suggest that: (1) control, as typically implemented, is unlikely to cause negative long-term impacts on populations of medium and large mesopredators but may negatively impact small mesopredators, (2) if mesopredator control benefits prey, recurring removals will generally be needed to maintain benefits, and (3) timing of removals will be important to achieve management goals. We suggest that mesopredator control efforts are frequently spatially structured harvests from continuously distributed populations. This may explain (1) why removal of small mesopredators declined over time; whereas, medium and large mesopredator removals remained consistent, and (2) why some prey failed to respond to mesopredator control efforts.


Assuntos
Ecossistema , Cadeia Alimentar , Comportamento Predatório , Animais , Biodiversidade , Bases de Dados Factuais
12.
Oecologia ; 167(4): 1005-16, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21706331

RESUMO

Predation and food resources can strongly affect small mammal population dynamics directly by altering vital rates or indirectly by influencing behaviors. Fire may also strongly influence population dynamics of species inhabiting fire-adapted habitats because fire can alter food and cover availability. We used capture-mark-recapture and radio-telemetry studies to experimentally examine how supplemental feeding, mammalian predator exclusion, and prescribed fire affected survival, abundance, and reproduction of hispid cotton rats (Sigmodon hispidus) in southwestern Georgia, USA. Prescribed fire reduced survival, abundance, and rates of transitions to reproductive states. Food supplementation increased survival, transitions to reproductive states, and abundance, but was not sufficient to prevent post-fire declines in any of these parameters. Mammalian predator exclusion did not strongly affect any of the considered parameters. Our results show that fire strongly influenced cotton rat populations in our study site, primarily by reducing cover and increasing predation risk from non-mammalian predators.


Assuntos
Incêndios , Cadeia Alimentar , Reprodução , Sigmodontinae/fisiologia , Animais , Meio Ambiente , Feminino , Georgia , Masculino , Dinâmica Populacional , Estações do Ano , Telemetria/veterinária
13.
Environ Manage ; 47(6): 1033-46, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21573910

RESUMO

National Pollution Discharge Elimination Permit (NPDES)-driven effluent toxicity tests using Ceriodaphnia dubia and fathead minnows were conducted for more than 20 years to assess and monitor the effects of wastewaters at the United States (U.S.) Department of Energy Y-12 National Security Complex (Y-12 Complex) in Oak Ridge, Tennessee. Toxicity testing was also conducted on water samples from East Fork Poplar Creek (EFPC), the wastewater receiving stream, as part of a comprehensive biological monitoring and assessment program. In this paper, we evaluate the roles of this long-term toxicity assessment and monitoring program in the management and ecological recovery of EFPC. Effluent toxicity testing, associated toxicant evaluation studies, and ambient toxicity monitoring were instrumental in identifying toxicant sources at the Y-12 Complex, guiding modifications to wastewater treatment procedures, and assessing the success of various pollution-abatement actions. The elimination of untreated wastewater discharges, the dechlorination of remaining wastewater streams, and the implementation of flow management at the stream headwaters were the primary actions associated with significant reductions in the toxicity of stream water in the upper reaches of EFPC from the late 1980s through mid 1990s. Through time, as regulatory requirements changed and water quality improved, emphasis shifted from comprehensive toxicity assessments to more focused toxicity monitoring efforts. Ambient toxicity testing with C. dubia and fathead minnows was supplemented with less-standardized but more sensitive alternative laboratory toxicity tests and in situ bioassays. The Y-12 Complex biological monitoring experience demonstrates the value of toxicity studies to the management of a wastewater receiving stream.


Assuntos
Monitoramento Ambiental/métodos , Rios/química , Poluentes Químicos da Água/análise , Poluição Química da Água/estatística & dados numéricos , Animais , Cyprinidae , Daphnia , Tennessee , Testes de Toxicidade , Estados Unidos , United States Government Agencies , Poluentes Químicos da Água/toxicidade
14.
Leuk Lymphoma ; 51(1): 73-8, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20017599

RESUMO

Cytarabine resistance characterizes relapsed and refractory acute myelogenous leukemia (AML). Restoration of cytarabine sensitivity can potentially improve treatment outcome in this setting. Acquired hypermethylation of gene promoters and associated silencing of gene expression has been implicated in chemo resistance, and drug-induced hypomethylation can improve sensitivity to cytarabine in vitro. We conducted an adaptively randomized study of a combination of azacitidine, a hypomethylating agent, and cytarabine in 34 patients with AML. The combination administered in a concomitant fashion is safe at full doses of azacitidine and cytarabine, without unexpected toxicities. However, in this advanced AML population, it was difficult to deliver more than one cycle of therapy, and minimal anti-leukemia activity was seen in patients with relapsed/refractory disease. Complete remission was achieved in 2 of 6 minimally pre-treated patients. We conclude that the combination of azacitidine and cytarabine is feasible but has limited activity in relapsed/refractory AML.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Azacitidina/administração & dosagem , Citarabina/administração & dosagem , Leucemia Mieloide Aguda/tratamento farmacológico , Síndromes Mielodisplásicas/tratamento farmacológico , Adulto , Idoso , Resistencia a Medicamentos Antineoplásicos , Epigênese Genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Resultado do Tratamento
15.
Blood ; 111(3): 1060-6, 2008 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-17962510

RESUMO

Vorinostat (suberoylanilide hydroxamic acid, SAHA) is a histone deacetylase inhibitor active clinically in cutaneous T-cell lymphoma and preclinically in leukemia. A phase 1 study was conducted to evaluate the safety and activity of oral vorinostat 100 to 300 mg twice or thrice daily for 14 days followed by 1-week rest. Patients with relapsed or refractory leukemias or myelodysplastic syndromes (MDS) and untreated patients who were not candidates for chemotherapy were eligible. Of 41 patients, 31 had acute myeloid leukemia (AML), 4 chronic lymphocytic leukemia, 3 MDS, 2 acute lymphoblastic leukemia, and 1 chronic myelocytic leukemia. The maximum tolerated dose (MTD) was 200 mg twice daily or 250 mg thrice daily. Dose-limiting toxicities were fatigue, nausea, vomiting, and diarrhea. Common drug-related adverse experiences were diarrhea, nausea, fatigue, and anorexia and were mild/moderate in severity. Grade 3/4 drug-related adverse experiences included fatigue (27%), thrombocytopenia (12%), and diarrhea (10%). There were no drug-related deaths; 7 patients had hematologic improvement response, including 2 complete responses and 2 complete responses with incomplete blood count recovery (all with AML treated at/below MTD). Increased histone acetylation was observed at all doses. Antioxidant gene expression may confer vorinostat resistance. Further evaluation of vorinostat in AML/MDS is warranted.


Assuntos
Inibidores Enzimáticos/uso terapêutico , Inibidores de Histona Desacetilases , Ácidos Hidroxâmicos/uso terapêutico , Leucemia/tratamento farmacológico , Leucemia/patologia , Síndromes Mielodisplásicas/tratamento farmacológico , Síndromes Mielodisplásicas/patologia , Acetilação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ensaios Clínicos Fase I como Assunto , Relação Dose-Resposta a Droga , Tolerância a Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Feminino , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Histona Desacetilases/metabolismo , Histonas/metabolismo , Humanos , Ácidos Hidroxâmicos/administração & dosagem , Ácidos Hidroxâmicos/efeitos adversos , Leucemia/enzimologia , Leucemia/genética , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/enzimologia , Estadiamento de Neoplasias , Vorinostat
16.
Cancer ; 109(5): 899-906, 2007 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-17236224

RESUMO

BACKGROUND: Resistance to imatinib is a frequent clinical problem in advanced phase chronic myelogenous leukemia (CML). A Phase II study was performed on low-dose decitabine, a DNA methyltransferase inhibitor, in combination with imatinib in patients with CML in accelerated phase (AP) and myeloid blastic phase (BP). METHODS: Patients received decitabine 15 mg/m(2) intravenously daily, 5 days a week for 2 weeks, and imatinib 600 mg orally daily. Global DNA methylation was measured by long interspersed nucleotide element (LINE) bisulfite/pyrosequencing. RESULTS: Twenty-eight patients were enrolled (25 with imatinib resistance; 18 in AP, 10 in BP). A total of 91 cycles (median, 2.5 cycles per patient) was administered. Complete hematologic responses, partial hematologic responses, and hematologic improvement were observed in 9 (32%), 1 (4%), and 2 (7%) patients. Major and minor cytogenetic responses were observed in 5 (18%) and 3 (11%) patients. The hematologic response rate was higher in patients without BCR-ABL kinase mutations (10 of 19, 53%) than in those with mutations (1 of 7, 14%). Median duration of hematologic response was 18 (range, 4 to 107+) weeks. Myelosuppression was the major adverse effect, with neutropenic fever in 9 patients (32%). LINE methylation decreased from 71.6% +/- 0.9% (mean +/- standard error of the mean) to 60.4% +/- 2.0% on Day 5, 60.5% +/- 1.8% on Day 12, and returned to 68.8% +/- 1.4% at peripheral blood recovery. A decrease in LINE methylation tended to be greater in nonresponders than in responders on Days 5 and 12. CONCLUSIONS: Combination therapy with decitabine and imatinib is well tolerated and active in advanced phase CML without BCR-ABL kinase mutations.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Crise Blástica/tratamento farmacológico , Adulto , Idoso , Azacitidina/administração & dosagem , Azacitidina/análogos & derivados , Benzamidas , Crise Blástica/genética , Crise Blástica/metabolismo , Metilação de DNA , Decitabina , Feminino , Genes abl , Humanos , Mesilato de Imatinib , Masculino , Pessoa de Meia-Idade , Piperazinas/administração & dosagem , Reação em Cadeia da Polimerase , Pirimidinas/administração & dosagem , Análise de Sobrevida , Resultado do Tratamento
17.
J Clin Oncol ; 23(17): 3948-56, 2005 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-15883410

RESUMO

PURPOSE: To determine the activity of decitabine, a DNA methylation inhibitor, in imatinib-refractory or intolerant chronic myelogenous leukemia. MATERIALS AND METHODS: Thirty-five patients were enrolled in this phase II study (12 in chronic phase, 17 in accelerated phase, and six in blastic phase). Decitabine was administered at 15 mg/m2 intravenously over 1 hour daily, 5 days a week for 2 weeks. DNA methylation was measured using a LINE1 bisulfite/pyrosequencing assay. RESULTS: Complete hematologic responses were seen in 12 patients (34%) and partial hematologic responses in seven patients (20%), for an overall hematologic response rate of 54% (83% in chronic phase, 41% in accelerated phase, and 34% in blastic phase). Major cytogenetic responses were observed in six patients (17%), and minor cytogenetic responses were seen in 10 patients (29%) for an overall cytogenetic response rate of 46%. Median response duration was 3.5 months (range, 2 to 13+ months). Myelosuppression was the major adverse effect, with neutropenic fever in 28 (23%) of 124 courses of therapy. LINE1 methylation decreased from 71.3% +/- 1.4% (mean +/- standard error of the mean) to 60.7% +/- 1.4% after 1 week, 50.9% +/- 2.4% after 2 weeks, and returned to 66.5% +/- 2.7% at recovery of counts (median, 46 days). LINE1 methylation at the end of week 1 did not correlate with subsequent responses. However, at day 12, the absolute decrease in methylation was 14.5% +/- 3.0% versus 26.8% +/- 2.7% in responders versus nonresponders (P = .007). CONCLUSION: Decitabine induces hypomethylation and has clinical activity in imatinib refractory chronic myelogenous leukemia. We hypothesize that the inverse correlation between hypomethylation 2 weeks after therapy and response is due to a cell death mechanism of response, whereby resistant cells can withstand more hypomethylation.


Assuntos
Azacitidina/análogos & derivados , Azacitidina/administração & dosagem , Resistencia a Medicamentos Antineoplásicos , Inibidores Enzimáticos/administração & dosagem , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Piperazinas/uso terapêutico , Inibidores de Proteínas Quinases/uso terapêutico , Pirimidinas/uso terapêutico , Adulto , Idoso , Antimetabólitos Antineoplásicos/uso terapêutico , Benzamidas , Metilação de DNA , Metilases de Modificação do DNA/antagonistas & inibidores , Decitabina , Relação Dose-Resposta a Droga , Feminino , Humanos , Mesilato de Imatinib , Masculino , Pessoa de Meia-Idade , Proteínas Tirosina Quinases/antagonistas & inibidores
18.
Environ Toxicol Chem ; 23(1): 12-6, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14768861

RESUMO

A Department of Energy site in Paducah, Kentucky (USA), stores thousands of cylinders of depleted uranium hexafluoride. Breaches of the cylinders could result in the release of uranium and hydrogen fluoride. Beginning in 1996, a program was begun to paint the cylinders in order to prevent corrosion of the cylinders and the surfaces of the storage yards were converted to concrete. In 1998, storm water from the cylinder storage yards was found to be toxic to Ceriodaphnia, at concentrations exceeding limits in the site's discharge permit. A six-month study was conducted to identify the source of the toxicity in the storm water. Ceriodaphnia toxicity tests with the storm water resulted in 48-h median lethal concentrations (LC50) ranging from 12 to 94%; zinc concentrations in the storm water ranged from 0.08 to 0.54 mg/L. Acute toxicity tests with zinc and linear regression identified that zinc concentrations in the storm water were sufficient to account for the toxicity observed. By tracking the sources to the discharge point, newly painted cylinders were identified as the source of the zinc in the storm water. Rainwater collected directly from the painted cylinders contained up to 13 mg Zn/L. Laboratory and field tests showed that topcoating the cylinders would reduce the amount of zinc in the runoff from the cylinders.


Assuntos
Pintura , Chuva , Poluentes da Água/toxicidade , Zinco/toxicidade , Animais , Cladocera , Fluoretos , Resíduos Perigosos , Dose Letal Mediana , Eliminação de Resíduos , Compostos de Urânio
19.
Genetics ; 162(4): 1631-9, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12524338

RESUMO

The signaling pathway initiated by the TGF-beta family member DBL-1 in Caenorhabditis elegans controls body shape in a dose-dependent manner. Loss-of-function (lf) mutations in the dbl-1 gene cause a short, small body (Sma phenotype), whereas overexpression of dbl-1 causes a long body (Lon phenotype). To understand the cellular mechanisms underlying these phenotypes, we have isolated suppressors of the Sma phenotype resulting from a dbl-1(lf) mutation. Two of these suppressors are mutations in the lon-3 gene, of which four additional alleles are known. We show that lon-3 encodes a collagen that is a component of the C. elegans cuticle. Genetic and reporter-gene expression analyses suggest that lon-3 is involved in determination of body shape and is post-transcriptionally regulated by the dbl-1 pathway. These results support the possibility that TGF-beta signaling controls C. elegans body shape by regulating cuticle composition.


Assuntos
Proteínas de Caenorhabditis elegans/genética , Proteínas de Caenorhabditis elegans/fisiologia , Caenorhabditis elegans/anatomia & histologia , Caenorhabditis elegans/genética , Colágeno/genética , Colágeno/fisiologia , Genes de Helmintos , Fator de Crescimento Transformador beta/fisiologia , Animais , Sequência de Bases , Caenorhabditis elegans/fisiologia , DNA de Helmintos/genética , Genes Reporter , Proteínas de Fluorescência Verde , Proteínas Luminescentes/genética , Proteínas Luminescentes/metabolismo , Modelos Biológicos , Dados de Sequência Molecular , Mutação , Fenótipo , Processamento de Proteína Pós-Traducional , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/metabolismo , Transdução de Sinais , Supressão Genética
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