Effects of glutathione- S -transferase polymorphisms on intravenous busulfan in hematopoietic stem cell transplant patients: a meta-analysis.
This study examined the impact of glutathione- S -transferase polymorphisms (GSTA1, GSTM1, GSTP1, and GSTT1) on the area under the curve (AUC), clearance, veno-occlusive disease (VOD), and graft-versus-host disease (GvHD) in hematopoietic stem cell transplant (HSCT) patients treated with intravenous busulfan. A systematic review was performed on three electronic databases to identify relevant studies. The relative risk and the 95% confidence interval (CI) of the association of different GST polymorphisms with pharmacokinetic and clinical outcomes were reported using the random and fixed effect models. Quality of the studies was assessed using the Newcastle-Ottawa Scale for cohort studies. Heterogeneity between studies and publication bias were also carried out using R software. Eighteen studies were included in the meta-analysis. GSTA1*A/*B was significantly associated with lower clearance (95% CI: 0.008-1.223, P = 0.048) and higher AUC (95% CI: -374.960 to -56.661, P = 0.008) than the GSTA1*A/*A genotype. GSTA1*B/*B had a higher busulfan AUC than GSTA1*A/*A (95% CI: -403.531 to -89.454, P = 0.002). None of the other genotypes was significantly associated with busulfan pharmacokinetic parameters or the risk of VOD or GvHD. GSTA1 should be considered as a guide for intravenous busulfan dosing in allogeneic HSCT patients, where patients with the GSTA1*A/*A genotype require a higher dose than GSTA1*B carriers.
- # Higher Area Under The Curve
- # Transferase Polymorphisms
- # Area Under The Curve
- # Allogeneic Hematopoietic Stem Cell Transplant Patients
- # Risk Of Veno-occlusive Disease
- # Hematopoietic Stem Cell Transplant Patients
- # Graft-versus-host Disease
- # Confidence Interval
- # GST Polymorphisms
- # Hematopoietic Stem Cell Transplant
- Abstract
1
- 10.1182/blood-2019-123657
- Nov 13, 2019
- Blood
Comparison of Fixed Dose, Reduced-Intensity Conditioning with Busulfan and Fludarabine to Reduced PK-Guided Busulfan AUC Conditioning in Patients Undergoing Hematopoietic Stem Cell Transplant for AML/MDS
- Abstract
- 10.1182/blood.v110.11.4962.4962
- Nov 16, 2007
- Blood
Immunoglobulin Prophylaxis in Patients Undergoing Hematopoietic Stem Cell Transplantation - Systematic Review and Meta-Analysis.
- Abstract
1
- 10.1182/blood.v122.21.2052.2052
- Nov 15, 2013
- Blood
Influence Of GST Gene Polymorphisms On Busulfan Pharmacokinetics and Outcome Of Hematopoietic Stem Cell Transplantation In Thalassemia Pediatric Patients
- Abstract
2
- 10.1182/blood.v126.23.3280.3280
- Dec 3, 2015
- Blood
Incidence of Hepatic Veno-Occlusive Disease (VOD) in Premier Healthcare Database
- Research Article
192
- 10.1016/j.bbmt.2011.06.006
- Jun 25, 2011
- Biology of Blood and Marrow Transplantation
The Incidence of Veno-Occlusive Disease Following Allogeneic Hematopoietic Stem Cell Transplantation Has Diminished and the Outcome Improved over the Last Decade
- Research Article
- 10.1182/blood-2025-271
- Nov 3, 2025
- Blood
GMP-manufactured allogeneic human t lymphoid progenitors (HTLP) promote early and sustained T-cell recovery after CD34+-selected haploidentical HSCT in SCID patients : Final results of the htlp-SCID study
- Abstract
- 10.1182/blood.v114.22.1184.1184
- Nov 20, 2009
- Blood
Unpredictable Pharmacokinetics of Once-Daily Intravenous Busulfan When Combined with Fludarabine in Pediatric Patients: Phase I Clinical Study for Determination of Optimal Once-Daily Busulfan Dose Using Pharmacokinetic Modeling.
- Research Article
- 10.1016/j.ijt.2015.10.012
- Jul 1, 2015
- Indian Journal of Transplantation
Experience of hematopoietic stem cell transplantation (HSCT) in the patients infected with either hepatitis B or hepatitis C virus
- Research Article
4
- 10.1111/petr.13425
- Apr 23, 2019
- Pediatric Transplantation
Sirolimus, a mammalian target of rapamycin (mTOR) inhibitor, is a potent immunosuppressant that is increasingly used in prevention and treatment of graft-vs-host disease (GVHD) in allogeneic hematopoietic stem cell transplant (HSCT) patients. However, data regarding its adverse effects in HSCT patients remain limited. We describe an 18-year-old HSCT patient with a history of invasive fungal infection, who developed pericardial effusion with cardiac tamponade and interstitial pneumonitis while receiving sirolimus for GVHD prophylaxis. Our case illustrates potentially life-threatening complications of sirolimus use in allogeneic HSCT patients.
- Research Article
22
- 10.1038/s41598-023-31272-w
- Mar 13, 2023
- Scientific Reports
Gastric cancer (GC), with a 5-year survival rate of less than 40%, is known as the fourth principal reason of cancer-related mortality over the world. This study aims to develop predictive models using different machine learning (ML) classifiers based on both demographic and clinical variables to predict metastasis status of patients with GC. The data applied in this study including 733 of GC patients, divided into a train and test groups at a ratio of 8:2, diagnosed at Taleghani tertiary hospital. In order to predict metastasis in GC, ML-based algorithms, including Naive Bayes (NB), Random Forest (RF), Support Vector Machine (SVM), Neural Network (NN), Decision Tree (RT) and Logistic Regression (LR), with 5-fold cross validation were performed. To assess the model performance, F1 score, precision, sensitivity, specificity, area under the curve (AUC) of receiver operating characteristic (ROC) curve and precision-recall AUC (PR-AUC) were obtained. 262 (36%) experienced metastasis among 733 patients with GC. Although all models have optimal performance, the indices of SVM model seems to be more appropiate (training set: AUC: 0.94, Sensitivity: 0.94; testing set: AUC: 0.85, Sensitivity: 0.92). Then, NN has the higher AUC among ML approaches (training set: AUC: 0.98; testing set: AUC: 0.86). The RF of ML-based models, which determine size of tumor and age as two essential variables, is considered as the third efficient model, because of higher specificity and AUC (84% and 87%). Based on the demographic and clinical characteristics, ML approaches can predict the metastasis status in GC patients. According to AUC, sensitivity and specificity in both SVM and NN can be regarded as better algorithms among 6 applied ML-based methods.
- Abstract
- 10.1182/blood-2022-165079
- Nov 15, 2022
- Blood
Real World Favourable Experience of Haematopoietic Stem Cell Transplantation during Acute Coronavirus Disease 2019 in a Highly-Vaccinated Asian Population
- Front Matter
17
- 10.1053/j.gastro.2005.01.015
- Mar 1, 2005
- Gastroenterology
Resetting the immune system in refractory Crohn’s disease: Is autologous hematopoietic stem cell transplantation the way forward?
- Research Article
22
- 10.5664/jcsm.8166
- Jan 13, 2020
- Journal of Clinical Sleep Medicine
The accuracy of obstructive sleep apnea (OSA) screening instruments in seniors may change as the predictive role of sex, age, and body mass index (BMI) changes with aging. We investigated the diagnostic performance of the STOP-BANG questionnaire in older individuals with aging-adapted scores and thresholds. Independent community-dwelling adults aged 65 years or older were screened for OSA. The STOP-BANG questionnaire was tested with different configurations and compared to the apnea-hypopnea index (AHI) obtained from home sleep apnea testing (HSAT). Epworth Sleepiness Scale (ESS) and Athens Insomnia Scale (AIS) were tested as possible supplementary screening criteria. We recruited 458 individuals with a mean age of 71 ± 5 years, 41% men, BMI of 28.5 ± 4.6 kg/m². Mild, moderate, and severe OSA were present in, respectively, 34%, 30%, and 19% of the sample. The STOP questions had an area under the curve (AUC) of the receiver operating characteristic curve significantly lower than the STOP-BANG and the STOP+BMI > 28 kg/m² (STOP-B28). Both STOP-BANG and STOP-B28 had high sensitivity and low specificity in all OSA levels with similar AUC to predict AHI ≥ 5 events/h, 0.64. ESS and AIS were nonsignificant as adjunctive instruments. Novel modifications of a standard instrument created the STOP-B28, a simpler-to-obtain and similarly performing variation of the STOP-BANG using fewer inputs, and useful to exclude OSA. Screening seniors via questionnaires to detect OSA is problematic. Considering the 83% OSA prevalence in this age group, it may be a sensible option to indicate objective tests, oximetry, HSAT, or even polysomnography, as a first step in OSA investigation.
- Research Article
18
- 10.3390/vaccines10111830
- Oct 29, 2022
- Vaccines
We previously reported that a second dose of BNT162b2 was safe and effective for allogeneic hematopoietic stem cell transplantation (HSCT) patients. Here, we investigated the safety and efficacy of a third dose of COVID-19 mRNA vaccine in allogeneic HSCT patients. Antibody titers against the S1 spike protein were measured using the QuaResearch COVID-19 Human IgM IgG ELISA kit. The previous study included 25 allogeneic HSCT patients who received two doses of BNT162b2. Following the exclusion of three patients because of the development of COVID-19 (n = 2) and loss to follow-up (n = 1), the study evaluated 22 allogeneic HSCT patients who received a third dose of COVID-19 mRNA vaccine (BNT162b2 [n = 15] and mRNA-1273 [n = 7]). Median age at the time of the first vaccination was 56 (range, 23–71) years. Five patients were receiving immunosuppressants at the third vaccination, namely calcineurin inhibitors (CI) alone (n = 1), steroids alone (n = 2), or CI combined with steroids (n = 2). Twenty-one patients (95%) seroconverted after the third dose. None of our patients had serious adverse events, new-onset graft-versus-host disease (GVHD), or GVHD exacerbation after vaccination. A third dose of the BNT162b2 and mRNA-1273 COVID-19 vaccines was safe and effective for allogeneic HSCT patients.
- Abstract
- 10.1182/blood.v114.22.1136.1136
- Nov 20, 2009
- Blood
High Incidence of Invasive Fungal Infections in Adult Patients Undergoing Hematopoietic Stem Cell Transplantation.
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