Publications by authors named "Agnieszka Tomaszewska"

62 Publications

Addition of Rituximab in Reduced Intensity Conditioning Regimens for B-Cell Malignancies Does Not Influence Transplant Outcomes: EBMT Registry Analyses Following Allogeneic Stem Cell Transplantation for B-Cell Malignancies.

Front Immunol 2020 2;11:613954. Epub 2021 Feb 2.

Department of Hematology, Transplantology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.

Rituximab (R) is increasingly incorporated in reduced intensity conditioning (RIC) regimens for allogeneic hematopoietic cell transplantation (alloHCT) in patients with B-cell malignancies, not only to improve disease control, but also to prevent graft-versus-host disease (GVHD). There are no randomized prospective data to validate this practice, although single center data and the CIBMTR analysis have shown promising results. We aimed at validation of these findings in a large registry study. We conducted a retrospective analysis using the EBMT registry of 3,803 adult patients with B-cell malignancies undergoing alloHCT (2001-2013) with either rituximab (R-RIC-9%) or non-rituximab (RIC-91%) reduced intensity regimens respectively. Median age and median follow up were 55 years (range 19.1-77.3) and 43.2 months (range 0.3-179.8), respectively. There was no difference in transplant outcomes (R-RIC vs RIC), including 1-year overall survival (69.9% vs 70.7%), 1-year disease-free survival (64.4% vs 62.2%), 1-year non-relapse mortality (21% vs 22%), and day-100 incidence of acute GVHD 2-4° (12% vs 12%). In summary, we found that addition of rituximab in RIC regimens for B-cell malignancies had no significant impact on major transplant outcome variables. Of note, data on chronic GVHD was not available, limiting the conclusions that can be drawn from the present study.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fimmu.2020.613954DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884746PMC
February 2021

Secondary immunodeficiencies with predominant antibody deficiency: multidisciplinary perspectives of Polish experts.

Cent Eur J Immunol 2020 1;45(3):334-341. Epub 2020 Nov 1.

Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.

At present, secondary immune deficiencies have become a clinical problem, recognized in different specialties. The aim of this paper was to increase awareness and support the need for screening at-risk populations. Secondary immune deficiencies result in variety of conditions, but not all of them require immunoglobulin replacement therapy, as specific antibody response might be preserved. Moreover, the management of secondary immune deficiencies vary between countries and different medical disciplines. This literature review presents the most common causes and clinical presentation of secondary immunodeficiencies with predominant impaired antibody production. We present diagnostic guidelines for patients at-risk, with an emphasis on the role of prophylactic vaccination as a treatment and diagnostic tool. This review considers the specificity and disparities of the Polish healthcare system and ultimately, suggests that management teams should include a clinical immunologist experienced in the treatment of humoral immunodeficiencies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5114/ceji.2020.101265DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790006PMC
November 2020

The affinity of the Harris lines to bone massiveness.

Anthropol Anz 2020 Dec 9. Epub 2020 Dec 9.

Department of Human Biology, Department of Biological Sciences, University of Wroclaw, Ul. Kuźnicza 35, 50-138 Wrocław, Poland.

The objective of the study was to investigate whether the occurrence of the Harris lines (HLs) affects the bone massiveness and intravital body height of the individuals. Depending on the nature of the Harris lines, catch up growth processes, bone remodelling or purely a nutritional stress response, may be the causing factor. The skeletal material of 404 individuals was investigated (male N = 141/ female N = 133). HLs were recorded on roentgenographs in two bone extremities. Although HLs appeared more frequently in male tibiae, the difference was not statistically significant. The distal ends of tibiae were characterized by significantly higher occurrence of HLs than the proximal ends. The percentage of HLs-containing tibiae decreased with an individual's age. Both frequency and intensity were independent of sex and they reached higher values in left tibiae. HLs frequency was higher in the distal ends of the tibiae. HLs-containing left and right female tibiae were significantly shorter. Moreover HLs-containing right female tibiae possessed significantly thinner distal ends. Intravital body height of female skeletons without HLs was significantly higher. When controlled, the massiveness ratios, despite its slightly higher values in tibiae with HLs, were not significant. Weak differences in massiveness ratios suggest, that the observed differences in the number of HLs were caused by factors other than different bone remodelling at the right and left side of a skeleton. The observations suggest also that the factors promoting HLs formation affected men and women in the dissimilar way or, at least, the effects of compensation of temporarily arrested bone growth were different in the two sexes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1127/anthranz/2020/1236DOI Listing
December 2020

Hematopoietic Stem Cell Transplantation Positively Affects the Natural History of Cancer in Nijmegen Breakage Syndrome.

Clin Cancer Res 2021 Jan 20;27(2):575-584. Epub 2020 Oct 20.

Department Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland.

Purpose: Nijmegen breakage syndrome (NBS) is a DNA repair disorder with a high predisposition to hematologic malignancies.

Experimental Design: We describe the natural history of NBS, including cancer incidence, risk of death, and the potential effectiveness of hematopoietic stem cell transplantation (HSCT) in preventing both pathologies: malignancy and immunodeficiency.

Results: Among 241 patients with NBS enrolled in the study from 11 countries, 151 (63.0%) patients were diagnosed with cancer. Incidence rates for primary and secondary cancer, tumor characteristics, and risk factors affecting overall survival (OS) were estimated. The cumulative cancer incidence was 40.21% ± 3.5% and 77.78% ± 3.4% at 10 years and 20 years of follow-up, respectively. Most of the tumors = 95 (62.9%) were non-Hodgkin lymphomas. Overall, 20 (13.2%) secondary malignancies occurred at a median age of 18 (interquartile range, 13.7-21.5) years. The probability of 20-year overall survival (OS) for the whole cohort was 44.6% ± 4.5%. Patients who developed cancer had a shorter 20-year OS than those without malignancy (29.6% vs. 86.2%; < 10). A total of 49 patients with NBS underwent HSCT, including 14 patients transplanted before malignancy. Patients with NBS with diagnosed cancer who received HSCT had higher 20-year OS than those who did not (42.7% vs. 30.3%; = 0.038, respectively). In the group of patients who underwent preemptive transplantation, only 1 patient developed cancer, which is 6.7 times lower as compared with nontransplanted patients [incidence rate ratio 0.149 (95% confidence interval, 0.138-0.162); < 0.0001].

Conclusions: There is a beneficial effect of HSCT on the long-term survival of patients with NBS transplanted in their first complete remission of cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1158/1078-0432.CCR-20-2574DOI Listing
January 2021

Material Parameters Identification of Historic Lighthouse Based on Operational Modal Analysis.

Materials (Basel) 2020 Aug 28;13(17). Epub 2020 Aug 28.

Department of Rail Transportation and Bridges, Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Narutowicza 11/12, 80-233 Gdańsk, Poland.

In the present paper, the identification of the material parameters of a masonry lighthouse is discussed. A fully non-invasive method was selected, in which the material properties were determined via numerical model validation applied to the first pair of natural frequencies and their related mode shapes, determined experimentally. The exact structural model was built by means of the finite element method. To obtain experimental data for the inverse analysis, operational modal analysis was applied to the structure. Three methods were considered: peak picking (PP), eigensystem realization algorithm (ERA) and natural excitation technique with ERA (NExT-ERA). The acceleration's responses to environmental excitations, enhanced in some periods of time by sheet piling hammering or by sudden interruptions like wind stroke, were assumed within the analysis input. Different combinations of the input were considered in the PP and NExT-ERA analysis to find the most reasonable modal forms. A number of time periods of a free-decay character were considered in the ERA technique to finally calculate the averaged modal forms. Finally, the elastic modulus, Poisson's ratio and material density of brick, sandstone and granite masonry were determined. The obtained values supplement the state of the art database concerning historic building materials. In addition, the numerical model obtained in the analysis may be used in further cases of structural analysis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ma13173814DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503382PMC
August 2020

Oxidation Behavior of the Monolayered LaZrO, Composite LaZrO + 8YSZ, and Double-Ceramic Layered LaZrO/LaZrO + 8YSZ/8YSZ Thermal Barrier Coatings.

Materials (Basel) 2020 Jul 21;13(14). Epub 2020 Jul 21.

Department of Advanced Materials and Technologies, Silesian University of Technology, ul. Krasińskiego 8, 40-019 Katowice, Poland.

The degradation process of thermal barrier coatings (TBCs) such as monolayered LaZrO, composite 50% LaZrO + 50% 8YSZ, and double-ceramic layer (DCL) LaZrO/50% LaZrO + 50% 8YSZ/8YSZ was investigated. Coatings were deposited using the atmospheric plasma spraying (APS) process (ceramic layer and bond-coat) on the Ni-based superalloy substrate with Ni-22Cr-10Al-1Y bond-coat. The thickness of the ceramic top-coats in all cases were 300 µm. In the case of LaZrO/8YSZ, the internal sublayer was built from 8YSZ powder whereas the outer from LaZrO. Between both sublayers' "composite" a 50% LaZrO + 50% 8YSZ zone was present. The "composite" 50% LaZrO + 50% 8YSZ TBC system was sprayed from two different feedstock powders with equal weight ratios. In the first part of the investigation, the microstructural characterization of the TBCs was presented. The main goals were related to the characterization of the degradation processes in different TBC systems with special emphasis on the phenomenon in the thermally grown oxide (TGO) zone related to oxidation, and the phenomenon related to phase stability in ceramic top-coats as related to temperature influence. The oxidation test was carried out in air at 1100 °C for 500 h. In the second step of the investigation, the numerical simulation of the monolayered TBC 8YSZ and LaZrO systems was analyzed from the stress distribution point of view. Additionally, the two-layered TBC coating of the DCL type was also analyzed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ma13143242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7412262PMC
July 2020

Eosinophilic gastroenteritis and graft-versus-host disease induced by transmission of Norovirus with fecal microbiota transplant.

Transpl Infect Dis 2021 Feb 18;23(1):e13386. Epub 2021 Feb 18.

Department of Hematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.

Fecal microbiota transplantation (FMT) was performed to decolonize gastrointestinal tract from antibiotic-resistant bacteria before allogeneic hematopoietic cells transplantation (alloHCT). AlloHCT was complicated by norovirus gastroenteritis, acute graft-versus-host disease, and eosinophilic pancolitis. Norovirus was identified in samples from FMT material. Symptoms resolved after steroids course and second norovirus-free FMT from another donor.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/tid.13386DOI Listing
February 2021

In vivo performance of intraperitoneal onlay mesh after ventral hernia repair.

Clin Biomech (Bristol, Avon) 2020 Aug 6;78:105076. Epub 2020 Jun 6.

Medical University of Gdańsk, 2(nd) Department of Radiology, Hospital Swissmed S.A., Department of Surgery, Poland.

Background: Ventral hernia repair needs to be improved since recurrence, postoperative pain and other complications are still reported in many patients. The behavior of implants in vivo is not sufficiently understood to design a surgical mesh mechanically compatible with the human abdominal wall.

Methods: This analysis was based on radiological pictures of patients who underwent laparoscopic ventral hernia repair. The pictures show the trunk of the patient at rest in a standing position and under side bending. The change in the distance between different tacks due to trunk movement was analyzed, which allowed us to determine the in vivo elongation of the mesh incorporated into the abdominal wall.

Findings: The relative elongations of the surgical mesh varied from a few percent to greater than 100% in two cases. The median of the median relative elongations obtained for all patients is 9.5%, and the median of the maximum relative elongations for all patients is 32.6%. The maximum elongation occurs between tacks that are next to each other. Trunk movement causes implant deformation, and this study provides quantitative information regarding changes in the distance between fasteners.

Interpretation: The physiological movement of the human abdomen must be regarded as a very important factor in mesh deformation and should be considered in surgical practice to reduce the hernia recurrence rate and postoperative pain.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clinbiomech.2020.105076DOI Listing
August 2020

Negative Impact of Borderline Creatinine Concentration and Glomerular Filtration Rate at Baseline on the Outcome of Patients With Multiple Myeloma Treated With Autologous Stem Cell Transplant.

Transplant Proc 2020 Sep 26;52(7):2186-2192. Epub 2020 Mar 26.

Department of Hematology, Oncology and Internal Diseases, Warsaw Medical University, Warsaw, Poland.

Background: Renal impairment (RI) is one of the multiple myeloma (MM)-defining events for initiating therapy. After induction therapy, high-dose chemotherapy followed by autologous peripheral blood stem cell transplant (ASCT) remains the standard of care for transplant-eligible patients with MM. According to the International Myeloma Working Group (IMWG), the organ criterion for kidney damage is defined by a serum creatinine concentration (CrC) > 2 mg/dL or estimated glomerular filtration rate (eGFR) < 40 mL/min. In this long-term study, we evaluated the impact of CrC and eGFR calculated by the Modification of Diet in Renal Disease equation on progression-free and overall survival using a lower threshold than the IMWG criteria.

Patients And Methods: We studied the longitudinal outcomes as measured by progression-free survival and overall survival in 59 transplant-eligible patients with MM: 38 patients with normal renal function and 21 patients with RI defined as a CrC higher than upper limit of normal (≥ 1.1 mg/dL), eGFR < 60 mL/min, treated with ASCT from 1998 to 2004.

Results: The risk of disease progression and death following ASCT increased by 16.5% (P = .005) and 19% (P < .0009) per 1 mg/dL of CrC, respectively. The thresholds for the association of renal insufficiency and negative outcomes were CrC > 1.4 mg/dL and eGFR < 55mL/min.

Conclusions: We observed a negative correlation between minimal renal insufficiency and long-term outcomes. Management of patients with even marginally increased CrC and/or decreased eGFR not fulfilling IMWG RI criteria requires more concentrated effort to reverse even minimal renal insufficiency.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.transproceed.2020.02.067DOI Listing
September 2020

Infectious Complications in Patients With Multiple Myeloma After High-Dose Chemotherapy Followed by Autologous Stem Cell Transplant: Nationwide Study of the Infectious Complications Study Group of the Polish Adult Leukemia Group.

Transplant Proc 2020 Sep 23;52(7):2178-2185. Epub 2020 Mar 23.

Poznan University of Medical Sciences, Poznan, Poland.

Background: Multiple myeloma (MM) has become a chronic disease in majority of patients, and remission consolidation with autologous hematopoietic stem cell transplant (ASCT) remains the backbone of treatment in transplant-eligible patients.

Objective: The aim of this multicenter cross-sectional nationwide retrospective study was to evaluate the epidemiology, etiology, and outcome of infections in patients with MM undergoing ASCT in 13 Polish transplant centers, carried out on behalf of the Infectious Complications Study Group of the Polish Adult Leukemia Group.

Methods: A total number of consecutive 1374 patients with MM treated in Polish adult transplant centers from 2012 to 2014 were followed for infectious complications up to day +100 after ASCT in nationwide study.

Results: Altogether 490 infection episodes in 336 patients (49% male, aged 21-72 years) were reported, including 145 episodes of neutropenic fever (103 patients) and 34 episodes of clinically documented infections (CDIs) (27 patients). Among microbiologically confirmed infections there were 251 episodes of bacterial infections (180 patients), 42 episodes of fungal infections (38 patients), and 18 episodes of viral infections (17 patients). The overall incidence of infections reached 13.1% for bacterial, 3.6% for fungal, and 1.3% for viral infections. There were 16 cases of infection-related deaths after ASCT (1.2%). The mortality risk factors included multidrug-resistant bacteria etiology (odds ratio [OR], 3.5; P = .033), coexistence of bacterial and fungal infection (OR, 6.3; P = .002), and CDI (OR, 5.5; P = .007).

Conclusion: ASCT in patients with MM was connected with low risk of life-threatening infections. However, multidrug-resistant bacteria bacterial etiology, mixed etiology, and CDI increased the risk of fatal outcome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.transproceed.2020.02.068DOI Listing
September 2020

Toxicity of parasites and their unconventional use in medicine.

Ann Agric Environ Med 2019 Dec 26;26(4):523-531. Epub 2019 Jun 26.

Department of Microbiology and Immunology, Institute of Medical Sciences, Faculty of Medicine and Health Sciences, Jan Kochanowski University in Kielce, Kielce, Poland.

Introduction: Over 300 species of parasites can possibly be passed on humans. Most of the parasitic infections are defined based on their pathogenicity; however, some positive effects of a parasite existence within the human body have recently been suggested. Beneficial outcomes of parasite infections might result from the production and release of metabolites, modification of host immune response or products uptake of the host.

Objective: The aim of the study was a comprehensive analysis of a wide range of effects of parasites on the human body, including an overview of the toxic and positive effects.

State Of Knowledge: In the light of the latest research presenting the unconventional use of parasites in medicine, the widely understood of their impact on the human body can also be considered in a positive context. Clinical cases from diseases caused by the toxic effects of parasites, as described in recent years, indicate that the problem of parasitic infections still persists. Despite a great deal of knowledge about the toxic effects of parasites on the human organism and, above all, despite the improvement in sanitary conditions, there is a resurgence of parasitic infections, as evidenced, e.g. by the examples presented in this review.

Conclusions: The examples of positive effects of parasites presented so far give hope for the future in terms of fighting many diseases for which pharmacological treatment has not yet brought a positive effect. A better understanding of those processes might lead to the development of new methods of unconventional medical treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.26444/aaem/109665DOI Listing
December 2019

Asterion localization - variability of the location for surgical and anthropological relevance.

Homo 2020 02;70(4):325-333

Department of Anthropology, Wroclaw University of Environmental and Life Sciences, Kożuchowska Street 5, 51-631Wrocław, Poland.

This work aimed to study the variability in location of the in a Polish population, which may be important for both surgical and anthropological procedures. In surgical approaches to the posterior cranial fossa, the is of great importance as a reference landmark. Its accurate localization may be impeded by the presence of additional, irregular sutural bones. Dry adult human skulls (n = 113, 60.2% male and 39.8% female) were analyzed for location in relation to the reference points (). The exhibits wide variation in location. The range of ± 2 SD of measured distances demonstrated broad variation intra and interindividually (15.9-27.8 mm for male skulls and 13.1-24.6 mm for female skulls). Distances from the to the reference landmarks were longer for males compared to females ( < 0.05), and some distances were longer for people of lower socioeconomic status. Because of its lesser variation, measurements to three reference landmarks ( and ) may be particularly important for surgical purposes. Defining accurately the safe area for is important but problematic. Because of the complex relations between bony landmarks, preoperative imaging assistance is required, and the should only be used as auxiliary, not as a key superficial cranial landmark in surgical interventions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1127/homo/2019/1124DOI Listing
February 2020

Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study.

Ann Hematol 2019 Sep 18;98(9):2197-2211. Epub 2019 Jul 18.

Department of Hematology, Poznan University of Medical Sciences, Poznan, Poland.

Incidence and outcome of microbiologically documented bacterial/viral infections and invasive fungal disease (IFD) in children and adults after hematopoietic cell transplantation (HCT) were compared in 650 children and 3200 adults in multicenter cross-sectional nationwide study. Infections were diagnosed in 60.8% children and 35.0% adults, including respectively 69.1% and 63.5% allo-HCT, and 33.1% and 20.8% auto-HCT patients. The incidence of bacterial infections was higher in children (36.0% vs 27.6%; p < 0.0001). Infections with Gram-negative bacteria were more frequent than Gram-positives in adults (64.6% vs 44.8%; p < 0.0001). Outcome of bacterial infections was better in children (95.5% vs 91.4%; p = 0.0011). The IFD incidence (25.3% vs 6.3%; p < 0.0001) and outcome (88.0% vs 74.9%; p < 0.0001) were higher in children. The incidence of viral infections was higher in children after allo-HCT (56.3% vs 29.3%; p < 0.0001), and auto-HCT (6.6% vs 0.8%; p < 0.0001). Outcome of viral infections was better in children (98.6% vs 92.3%; p = 0.0096). Infection-related mortality was 7.8% in children and 18.4% in adults (p < 0.0001). No child after auto-HCT died of infection. Adult age, mismatched transplants, acute leukemia, chronic GVHD, CMV reactivation, infection with Gram-negatives, and duration of infection > 21 days were risk factors for death from infection. In conclusion, pediatric patients have 2.9-fold higher incidence and 2.5-fold better outcome of infections than adults after HCT.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00277-019-03755-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700048PMC
September 2019

Mechanics of mesh implanted into abdominal wall under repetitive load. Experimental and numerical study.

J Biomed Mater Res B Appl Biomater 2019 07 28;107(5):1400-1409. Epub 2018 Sep 28.

Gdańsk University of Technology, Faculty of Ocean Engineering and Ship Technology, Department of Structural Mechanics, Narutowicza 11/12, 80-233, Gdańsk, Poland.

There are a number of papers discussing medical and mechanical aspects of ventral hernia management. Despite intensive work on the problem understanding, recurrences of the sickness still happen too often. For that reason, new aspects of the problem must be considered. In this article, a change in the abdominal implant's stiffness is discussed, which is caused by cyclic loading. Such loading influence abdominal implant, for example, while patient is coughing or exercising. For the first time, this stiffness change is quantitatively described for a selected knitted mesh. The influence of mesh stiffness changes on repaired hernia persistence is studied. Then, ex vivo experiments on a repaired hernia model under cyclic pressure loading are performed. Finally, numerical simulations of the experiments are made in which stresses and forces in the system are calculated. The two following cases are considered. In the first case, the mesh has its baseline stiffness, and in the second case, the mesh is preconditioned by former loading; thus, it is stiffened. Reaction forces at the mesh fixation points appear to be approximately twofold higher in the second case than in the first case. That may be a reason for a fixation damage in operated hernia system. The results presented shed new light on the necessary strength of mesh fixation in the abdominal wall. They enlarge the state of the art on laparoscopic hernia management with the use of a synthetic implant. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1400-1409, 2019.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jbm.b.34232DOI Listing
July 2019

Role of donor HLA class I mismatch, KIR-ligand mismatch and HLA:KIR pairings in hematological malignancy relapse after unrelated hematopoietic stem cell transplantation.

HLA 2018 12;92 Suppl 2:42-46

Department of Immunogenetics, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.

HLA are functional in cancer immunosurveillance in adaptive and innate immunity pathways. In unrelated hematopoietic stem cell transplantation (HSCT) in 688 patients with hematological malignancies we compared antitumor efficacy of transplant in three models including the level of: (a) donor-recipient HLA class I mismatch, (b) KIR-ligand mismatch, (c) post-transplant cognate HLA:KIR pairing. The effects were directly compared in multivariate models with backward elimination including all three effects in initial model. In final multivariate model HLA mismatch and KIR-ligand mismatch levels were eliminated and HLA:KIR-dependent NK cell licensing effect remained independent prognostic factor for DFS, relapse/progression incidence, and overall survival (OS). These results suggested that NK cell licensing via cognate HLA:KIR pairs is primarily functional in cancer immunosurveillance in HSCT.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/tan.13386DOI Listing
December 2018

HLA-inferred extended haplotype disparity level is more relevant than the level of HLA mismatch alone for the patients survival and GvHD in T cell-replate hematopoietic stem cell transplantation from unrelated donor.

Hum Immunol 2018 Jun 29;79(6):403-412. Epub 2018 Mar 29.

Department of Clinical Immunology, L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland; Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry, Wrocław, Poland.

Serious risks in unrelated hematopoietic stem cell transplantation (HSCT) including graft versus host disease (GvHD) and mortality are associated with HLA disparity between donor and recipient. The increased risks might be dependent on disparity in not-routinely-tested multiple polymorphisms in genetically dense MHC region, being organized in combinations of two extended MHC haplotypes (Ehp). We assessed the clinical role of donor-recipient Ehp disparity levels in N = 889 patients by the population-based detection of HLA allele phase mismatch. We found increased GvHD incidences and mortality rates with increasing Ehp mismatch level even with the same HLA mismatch level. In multivariate analysis HLA mismatch levels were excluded from models and Ehp disparity level remained independent prognostic factor for high grade acute GvHD (p = 0.000037, HR = 10.68, 95%CI 5.50-32.5) and extended chronic GvHD (p < 0.000001, HR = 15.51, CI95% 5.36-44.8). In group with single HLA mismatch, patients with double Ehp disparity had worse 5-year overall survival (45% vs. 56%, p = 0.00065, HR = 4.05, CI95% 1.69-9.71) and non-relapse mortality (40% vs. 31%, p = 0.00037, HR = 5.63, CI95% 2.04-15.5) than patients with single Ehp disparity. We conclude that Ehp-linked factors contribute to the high morbidity and mortality in recipients given HLA-mismatched unrelated transplant and Ehp matching should be considered in clinical HSCT.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.humimm.2018.03.011DOI Listing
June 2018

Two-criteria optimisation problem for ventral hernia repair.

Comput Methods Biomech Biomed Engin 2017 May 6;20(7):760-769. Epub 2017 Mar 6.

b Department of Structural Mechanics, Faculty of Civil and Environmental Engineering , Gdańsk University of Technology , Gdańsk , Poland.

Two-criteria optimisation problem related to laparoscopic ventral hernia repair is formulated in this paper. An optimal implant from a given set and its orientation is sought. The implant is subjected to kinematic extortions due to a patient's body movement and intra-abdominal pressure. The first criterion of the optimisation problem deals with the reaction force in the implant fastener, while the deflection of the implant constitutes the second criterion. A two-stage optimization procedure is proposed and the optimal solution is determined with the aid of minimization of an additional objective function. Numerical examples for typical locations of hernia are provided.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/10255842.2017.1300658DOI Listing
May 2017

Infections due to alphaherpesviruses in early post-transplant period after allogeneic haematopoietic stem cell transplantation: Results of a 5-year survey.

J Clin Virol 2017 02 21;87:67-72. Epub 2016 Dec 21.

Department of Haematopoietic Stem Cell Transplantation, Institute of Haematology and Transfusion Medicine, 14 Gandhi Str., 02-776 Warsaw, Poland.

Background: Infections caused by human α-herpesviruses usually have a benign course with recurrencies. However, they may become dangerous in immunocompromised hosts. In this case, molecular methods constitute a reliable diagnostic tool enabling rapid assessment of the efficacy of antiviral treatment strategies.

Objectives: We estimated the frequency of alphaherpesviral DNAemia and the viral load during early post-transplantation period after alloHSCT; we also analyzed association of the DNAemia and chosen parameters of the patients.

Study Design: A cohort of 190 alloHSCT recipients from two hospitals in Warsaw, Poland, was examined weekly during 100-day early post-transplantation period using quantitative real time PCR assays. A total of 2475 sera samples were evaluated for the presence of α-herpesviral DNA in patients, of whom 117 (62%) received unrelated grafts, while the remaining 73 (38%) received grafts from sibling donors. All patients received standard antiviral prophylaxis with acyclovir. In the examined group, anti-HSV-1, anti-HSV-2 and anti-VZV IgGs were examined prior to transplantation, RESULTS: Within the study period, DNA of α-herpesviruses was detected in 44 patients (23.2%). Most patients tested positive for HSV-1 DNA (43 patients, 22.6%), single patient for HSV-2, and no patient positive for VZV. Clinical symptoms such as pneumonia, skin changes, elevated levels of aminotransferases were observed in five patients, four of these patients presented symptoms of GvHD at the same time. (2,6%). Statistics shows that GvHD (P<0.001) and matched unrelated donor as a source of HSCT (P=0.048) are associated with the development of HSV-1 DNAemia.

Conclusions: Although our data demonstrate frequent reactivation of HSV-1 in the early post-transplant period, the rate of symptomatic infections was low. We did not find association between HSV-1 viremia and mortality, but significant association with GvHD and donor source was observed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcv.2016.12.008DOI Listing
February 2017

Mechanical behaviour of knit synthetic mesh used in hernia surgery.

Acta Bioeng Biomech 2016 ;18(1):77-86

Gdańsk University of Technology, Faculty of Civil and Environmental Engineering.

Purpose: There is a discussion in literature concerning mechanical properties and modelling of surgical meshes. An important feature of elastic modulus dependency on load history is taken into account in this paper, as implants are subjected to variable loading during human activity. The example of DynaMesh®-IPOM surgical implant is studied.

Methods: The analysis is based on failure tension tests and cyclic loading and unloading tests performed for the material samples. Stiffness changes of the material samples within successive load cycles are noted. The values the elastic modulus of the material tend to during successive cycles determine the material stiffness in the preconditioned state. The analysis is performed for two axes of the mesh, as the material reveals orthotropic properties.

Results: For the initial displacements state of the material bilinear stiffness functions are determined for the two considered material axes. The functions for the preconditioned state are specified basing in the observed stiffness changes in subsequent loading cycles in experiments with different load (and strain) ranges. The identified elastic modulus values for different strain levels in the preconditioned state are then a basis for the nonlinear stiffness function formulation.

Conclusions: The author concludes that two states of the considered mesh should be considered in calculations, initial and preconditioned ones. As the material stiffness in its preconditioned state is higher than in the initial one, omitting of the preconditioned state in calculation, e.g., considering fixation of the mesh, may lead to underestimation of necessary fixation strength.
View Article and Find Full Text PDF

Download full-text PDF

Source
January 2017

Safety and efficacy of a Ventralight ST echo ps implant for a laparoscopic ventral hernia repair - a prospective cohort study with a one-year follow-up.

Pol Przegl Chir 2016 Jan;88(1):7-14

Unlabelled: Laparoscopic ventral hernia repair has become popular technique. Every year, companies are introducing new products Thus, every mesh prior to introduction in clinical settings should be tested with a dedicated tacker to discover the proper fixation algorithm. The aim of the study was to assess the safety and efficacy of the Ventralight ST implant with an ECHO positioning system and a dedicated fixation device, the SorbaFix stapler, in a prospective cohort of patients.

Material And Methods: The study was a prospective single centre cohort study with a one-year followup period. Fifty-two patients received operations for a ventral hernia using a laparoscopic IPOM mesh - Ventralight ST ECHO PS. The size of the mesh and the fixation method were based on mathematical considerations. A recurrence of the hernia and pain after 1, 2 and 12 months were assessed as the primary endpoints.

Results: Two recurrences were noted, one in parastomal and one in a large incisional hernia. Pain was observed in 22 patients (41%) and mostly disappeared after 3 months (7%). The intensity of pain was low (VAS <2). However, 2 patients still experienced severe pain (VAS>6) until the end of the study.

Conclusion: The Ventralight ST Echo PS implant fixed with a Sorbafix stapler is a valuable and safe option for a laparoscopic ventral hernia repair. In our opinion, the implant could be used in all patients due to the hernia ring diameter. According to the mathematical models and clinical practice, we do not recommend this implant in orifices with a width larger than 10 cm.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1515/pjs-2016-0020DOI Listing
January 2016

Analysis of the shedding of three β-herpesviruses DNA in Polish patients subjected to allogeneic hematopoietic stem cell transplantation: Six-year follow up.

J Clin Virol 2016 Mar 12;76:30-5. Epub 2016 Jan 12.

Department of Haematopoietic Stem Cell Transplantation, Institute of Haematology and Transfusion Medicine, 14 Gandhi Str., 02-776 Warsaw, Poland.

Background: Infections with human β-herpesviruses are common worldwide and are still frequent in patients after hematopoietic stem cell transplantation. Some data suggest that HHV-6 and HHV-7 could take part in CMV reactivation from latency and/or progression of CMV disease in immunosupressed patients.

Objectives: The aims of this study were: (1) to summarise retrospectively the results of β-herpesviruses DNA detection in a large group of adult allogeneic haematopoietic stem cell transplant recipients; and (2) to find a potential correlation between viruses belonging to this subfamily.

Study Design: AlloHSCT recipients (N=142) were examined in the early post-transplant period (median=89 days). The presence of CMV, HHV-6 and HHV-7 was confirmed through detection and quantification of viral DNA, isolated from 1679 sera samples.

Results: CMV DNA alone was detected in 23.9% of patients, while single HHV-6 and HHV-7 were detected in 14.8% and 9.9% of individuals, respectively. The reactivation of more than one virus was identified in 31% of analysed patients. In cases of concurrent infection, HHV-7 was detected at the same time as HHV-6, and both of them were usually reactivated before CMV. The kinetics of virus reactivation and measured viral load may suggest a potential role of HHV-6 and HHV-7 as co-factors in CMV reactivation.

Conclusions: The observed kinetics of virus reactivation may strongly suggest a potential role of HHV-6 and/or HHV-7 as co-factors of CMV reactivation. The co-infection with these β-herpesviruses could predispose patients after hematopoietic stem cell transplantation to a longer and more severe CMV infection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcv.2016.01.005DOI Listing
March 2016

The first de novo non-mosaic 14q11.2q13.1 tetrasomy of paternal origin.

Am J Med Genet A 2016 May 20;170A(5):1283-7. Epub 2016 Jan 20.

Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands.

Tetrasomy 14q11q13 is a very rare chromosome aberration. So far, only five patients with such an imbalance were described. All these patients had a de novo marker chromosome idic(14)(q13) leading to a partial tetrasomy of chromosome 14. We report on the first case of a de novo non-mosaic partial tetrasomy 14q resulted not from a marker chromosome, but from an inverted triplication on paternal chromosome 14, characterized by using FISH and SNP array. Our patient showed some anomalies described in tetrasomy 14q11q13 with striking presence of paternal UPD(14) features (blepharophimosis, small thorax, and joint contractures, developmental delay). This unique patient supports the hypothesis that 14q11q13 may contain imprinted gene(s) that contribute to the paternal UPD(14) features of joint contractures and/or blepharophimosis. This patient demonstrates the utility of parent of origin testing in patients with de novo chromosome 14 aberrations. Overdosage of 14q11.1q13.1 may cause some features related to UPD(14) phenotype.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ajmg.a.37565DOI Listing
May 2016

[Prevalence of CI-HHV-6 in patients with hematological diseases and healthy donors in Poland - preliminary study].

Med Dosw Mikrobiol 2016 ;68(2):113-117

of specific anti-HHV-6 antibodies in IgM and IgG classes and viral DNA. Quantitative real-time PCR assay was also used to determine viral load in alloHSCT recipients in plasma samples. Results: All individuals from studied group have not IgM antibodies against-HHV-6 prior transplantation. Specific IgG-class anti-HHV-6 antibodies were detected in 38 of 54 (70%) donors and in 47 of 54 recipients before HSCT (870/o), respectively. High load of HHV-6 DNA (>1x10A6 copies/ml) was detected in plasma samples taken only from one person (1,9%) of the 54 recipients. Conclusions: There is a high frequency specific anti-HHV-6 antibody in studied Polish patients; otherwise CI-HHV-6 was rare detected. Nonetheless, we urge careful observation of individuals with hematological malignances supposed to have CI-HHV-6. Further research on larger study group is needed to determine the clear role of CI-HHV-6 in alloHSCT recipients.
View Article and Find Full Text PDF

Download full-text PDF

Source
November 2018

Real-Time PCR Analysis of Chimerism in T Cell Subsets as an Early Predictor of Graft-Versus-Host Disease Following Allogeneic Stem Cell Transplantation.

Ann Transplant 2015 Dec 3;20:720-8. Epub 2015 Dec 3.

Department of of Immunohematology and Transfusion Medicine, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.

Background: Graft-versus-host-disease (GvHD) is the major cause of morbidity and mortality after stem cell transplantation. The development of early prediction methods is therefore of importance. Our aim was to analyze the usefulness of early donor chimerism monitoring after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in T cells and in CD4+ and CD8+ (lineage chimerism) for GvHD prediction.

Material And Methods: Chimerism was analyzed in 76 consecutive adult patients using RQ-PCR TaqMan technology on DNA extracted from Pan T, CD4+, and CD8+ cell subsets on Day 5, 10, 15 and 30 after allo-HSCT.

Results: The threshold of chimerism predictive for GvHD was the same for all tested cell subsets. In acute myeloid leukemia (AML) patients treated with myeloablative conditioning (MAC), the threshold predictive for acute graft versus host disease was 95% and 99% for Day 10 and Day 15, respectively. In patients treated with reduced intensity conditioning (RIC), the threshold predictive for chronic graft versus host disease was 98% on Day 10. The differences were statistically significant.

Conclusions: Chimerism analysis in T cell subsets by RQ-PCR on Day 10 and Day 15 after transplantation is useful for prediction of aGvHD (AML patients after MAC) and cGvHD (patients after RIC). However, there was no difference in the results between chimerism in the T cell subsets. Our RQ-PCR protocol was highly sensitive and proved effective for analysis of lineage chimerism.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.12659/aot.894621DOI Listing
December 2015

11p15 duplication and 13q34 deletion with Beckwith-Wiedemann syndrome and factor VII deficiency.

Pediatr Int 2015 Jun 27;57(3):486-91. Epub 2015 May 27.

Department of Medical Genetics, Children's Memorial Health Institute, Warsaw, Poland.

Here we report a patient with 11p15.4p15.5 duplication and 13q34 deletion presenting with Beckwith-Wiedemann syndrome (BWS) and moderate deficiency of factor VII (FVII). The duplication was initially diagnosed on methylation-sensitive multiplex ligation-dependent probe amplification. Array comparative genome hybridization confirmed its presence and indicated a 13q34 distal deletion. The patient's clinical symptoms, including developmental delay and facial dysmorphism, were typical of BWS with paternal 11p15 trisomy. Partial 13q monosomy in this patient is associated with moderate deficiency of FVII and may also overlap with a few symptoms of paternal 11p15 trisomy such as developmental delay and some facial features. To our knowledge this is the first report of 11p15.4p15.5 duplication associated with deletion of 13q34 and FVII deficiency. Moreover, this report emphasizes the importance of detailed clinical as well as molecular examinations in patients with BWS features and developmental delay.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ped.12611DOI Listing
June 2015

Beneficial effect of the CXCL12-3'A variant for patients undergoing hematopoietic stem cell transplantation from unrelated donors.

Cytokine 2015 Dec 14;76(2):182-186. Epub 2015 May 14.

L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland; Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry, Wroclaw, Poland.

The present study aimed to assess the impact of the CXCL12 gene polymorphism (rs1801157) on clinical outcome of hematopoietic stem cell transplantation from unrelated donors. Toxic complications were less frequent among patients transplanted from donors carrying the CXCL12-3'-A allele (42/79 vs. 105/151, p=0.014 and 24/79 vs. 73/151, p=0.009, for grade II-IV and III-IV, respectively). Logistic regression analyses confirmed a role of donor A allele (OR=0.509, p=0.022 and OR=0.473, p=0.013 for grade II-IV and III-IV toxicity). In addition, age of recipients (OR=0.980, p=0.036 and OR=0.981, p=0.040, respectively) was independently protective while female to male transplantation and HLA compatibility were not significant. The incidence of aGvHD (grades I-IV) was lower in patients having A allele (52/119 vs. 113/204, p=0.043) and AA homozygous genotype (6/25 vs. 159/298, p=0.005). Independent associations of both genetic markers with a decreased risk of aGvHD were also seen in multivariate analyses (A allele: OR=0.591, p=0.030; AA homozygosity: OR=0.257, p=0.006) in which HLA compatibility seemed to play less protective role (p<0.1) while recipient age and donor-recipient gender relation were not significant. Moreover, CXCL12-3'-A-positive patients were less prone to early HHV-6 reactivation (2/34 vs. 19/69, p=0.026). The presence of the CXCL12-3'-A variant was found to facilitate outcome of unrelated HSCT.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cyto.2015.05.001DOI Listing
December 2015

Is the area of the orbital opening in humans related to climate?

Am J Hum Biol 2015 Nov-Dec;27(6):845-50. Epub 2015 May 7.

Department of Anatomy, Histology, and Anthropology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Objectives: The aim of this study was to evaluate whether climatic conditions impact the size of the anterior orbital opening in humans. The previous research has shown that morphology of the human orbit, a trait strongly related to the shape of the cranium, varies significantly among populations. However, the mechanisms of this variation are still debatable. Besides such evolutionary forces as genetic drift, climatic conditions may be involved. Thermoregulatory processes affect skull shape, and thus may also influence orbital morphology.

Methods: A total of 846 dry skulls of male and female adults from three climatic areas (i.e., warm, temperate, and cold) of Europe were evaluated. The areas of the left and right orbital openings were measured using the three-dimensional contact scanner MicroScribe G2L, and analyzed with regard to climate.

Results: The results reveal a statistically significant association with climatic conditions on the area of orbital opening in accordance with Bergmann's rule. The anterior orbital opening area was smaller in male individuals from the cold climate, and larger in individuals from the warm climate areas.

Conclusions: These data may support the hypothesized association between size of the orbital opening and adaptation to different climatic conditions, but only in males.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ajhb.22735DOI Listing
April 2016

Role of Donor Activating KIR-HLA Ligand-Mediated NK Cell Education Status in Control of Malignancy in Hematopoietic Cell Transplant Recipients.

Biol Blood Marrow Transplant 2015 May 21;21(5):829-39. Epub 2015 Jan 21.

Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry, Wroclaw, Poland; Department of Clinical Immunology, L. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland.

Some cancers treated with allogeneic hematopoietic stem cell transplantation (HSCT) are sensitive to natural killer cell (NK) reactivity. NK function depends on activating and inhibitory receptors and is modified by NK education/licensing effect and mediated by coexpression of inhibitory killer-cell immunoglobulin-like receptor (KIR) and its corresponding HLA I ligand. We assessed activating KIR (aKIR)-based HLA I-dependent education capacity in donor NKs in 285 patients with hematological malignancies after HSCT from unrelated donors. We found significantly adverse progression-free survival (PFS) and time to progression (TTP) in patients who received transplant from donors with NKs educated by C1:KIR2DS2/3, C2:KIR2DS1, or Bw4:KIR3DS1 pairs (for PFS: hazard ratio [HR], 1.70; P = .0020, Pcorr = .0039; HR, 1.54; P = .020, Pcorr = .039; HR, 1.51; P = .020, Pcorr = .040; and for TTP: HR, 1.82; P = .049, Pcorr = .096; HR, 1.72; P = .096, Pcorr = .18; and HR, 1.65; P = .11, Pcorr = .20, respectively). Reduced PFS and TTP were significantly dependent on the number of aKIR-based education systems in donors (HR, 1.36; P = .00031, Pcorr = .00062; and HR, 1.43; P = .019, Pcorr = .038). Furthermore, the PFS and TTP were strongly adverse in patients with missing HLA ligand cognate with educating aKIR-HLA pair in donor (HR, 3.25; P = .00022, Pcorr = .00045; and HR, 3.82; P = .027, Pcorr = .054). Together, these data suggest important qualitative and quantitative role of donor NK education via aKIR-cognate HLA ligand pairs in the outcome of HSCT. Avoiding the selection of transplant donors with high numbers of aKIR-HLA-based education systems, especially for recipients with missing cognate ligand, is advisable.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bbmt.2015.01.018DOI Listing
May 2015

Unexpected loss of stereoselectivity in ring-opening reaction of 2-alkoxy-2-thio-1,3,2-oxathiaphospholanes with a pyrophosphate anion.

Chirality 2015 Feb 18;27(2):115-22. Epub 2014 Nov 18.

Centre of Molecular and Macromolecular Studies, Polish Academy of Sciences, Department of Bioorganic Chemistry, Łodź, Poland.

A reaction of DBU promoted ring opening in nucleoside-3'-O- and nucleoside-5'-O-(2-thio-4,4-pentamethylene-1,3,2-oxathiaphospholane) monomers with a pyrophosphate or a methylenediphosphonate anion proceeds with substantial loss of stereoselectivity. Depending on the absolute configuration of the phosphorus atom, so far widely accepted the stereoretentive mechanism of condensation is accompanied by a stereoinvertive one, most likely employing an intramolecular ligand-ligand exchange in an uncharged intermediate.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/chir.22398DOI Listing
February 2015