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Browsing by Author "McCarthy, Philip L."
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Item Adoptive Immunotherapy by Allogeneic Stem Cell Transplantation for Metastatic Renal Cell Carcinoma: A CALGB Intergroup Phase II Study(Elsevier, 2006-07-01) Rini, Brian I.; Halabi, Susan; Barrier, Robert; Margolin, Kim A.; Avigan, David; Logan, Theodore; Stadler, Walter M.; McCarthy, Philip L.; Linker, Charles A.; Small, Eric J.; Medicine, School of MedicineA graft-versus-tumor effect through nonmyeloablative allogeneic stem cell transplantation (N-SCT) in metastatic renal cell carcinoma (RCC) has been reported. An Intergroup phase II trial was undertaken to define further the feasibility, toxicity and efficacy of this approach in a multi-institutional setting, Patients with cytokine-refractory, metastatic RCC were treated with N-SCT. The conditioning regimen was fludarabine 30 mg · m−2 · d−1 on day (d) −7 through d −3 and cyclophosphamide 60 mg · kg−1 · d−1 on d −4 and d −3. Patients received 2-8 × 106 CD34+ cells/kg of granulocyte colony-stimulating factor mobilized stem cells from a 6/6 HLA-matched sibling donor. Immunosuppression after transplantation included tacrolimus and methotrexate. Twenty-two patients were enrolled at 14 institutions. Greater than 90% donor T-cell chimerism was observed in 17 of 19 evaluable patients (89%) by d +120. No objective response was observed. Acute graft-versus-host disease (GVHD) was observed in 11 patients (50%). Chronic GVHD was reported in 5 patients (23%). There was 1 patient death from liver failure secondary to chronic GVHD. Regimen-related mortality was 2 of 22 (9%; liver failure, sepsis). Median survival time was 5.5 months (95% confidence interval, 3.9-12.0 months) and the median time to progression was 3.0 months (95% confidence interval, 2.3-4.2 months). N-SCT for metastatic RCC is feasible in a multi-institutional setting. Adequate donor T-cell engraftment was achieved in most patients before disease progression. A graft-versus-tumor effect was not observed in this study despite acute and chronic GVHD, thus highlighting the need for further understanding of this approach. Allogeneic SCT remains investigational in RCC.Item Multiple functional variants in the IL1RL1 region are pretransplant markers for risk of GVHD and infection deaths(American Society of Hematology, 2019-08-27) Karaesmen, Ezgi; Hahn, Theresa; Dile, Alexander James; Rizvi, Abbas A.; Wang, Junke; Wang, Tao; Haagenson, Michael D.; Preus, Leah; Zhu, Qianqian; Liu, Qian; Yan, Li; Liu, Song; Haiman, Christopher A.; Stram, Daniel; Pooler, Loreall; Sheng, Xin; Van Den Berg, David; Brock, Guy; Webb, Amy; McCarthy, Philip L.; Pasquini, Marcelo C.; Spellman, Stephen R.; Lee, Stephanie J.; Paczesny, Sophie; Sucheston-Campbell, Lara E.; Pediatrics, School of MedicineGraft-versus-host disease (GVHD) and infections are the 2 main causes of death without relapse after allogeneic hematopoietic cell transplantation (HCT). Elevated soluble serum simulation-2 (sST2), the product of IL1RL1 in plasma/serum post-HCT, is a validated GVHD biomarker. Hundreds of SNPs at 2q12.1 have been shown to be strongly associated with sST2 concentrations in healthy populations. We therefore hypothesized that the donor genetic variants in IL1RL1 correlate with sST2 protein levels associated with patient survival outcomes after HCT. We used DISCOVeRY-BMT (Determining the Influence of Susceptibility Conveying Variants Related to 1-Year Mortality after Blood and Marrow Transplantation), a genomic study of >3000 donor-recipient pairs, to inform our hypothesis. We first measured pre-HCT plasma/serum sST2 levels in a subset of DISCOVeRY-BMT donors (n = 757) and tested the association of donor sST2 levels with donor single nucleotide polymorphisms (SNPs) in the 2q12.1 region. Donor SNPs associated with sST2 levels were then tested for association with recipient death caused by acute GVHD (aGVHD)-, infection-, and transplant-related mortality in cohorts 1 and 2. Meta-analyses of cohorts 1 and 2 were performed using fixed-effects inverse variance weighting, and P values were corrected for multiple comparisons. Donor risk alleles in rs22441131 (P meta = .00026) and rs2310241 (P meta = .00033) increased the cumulative incidence of aGVHD death up to fourfold and were associated with high sST2 levels. Donor risk alleles at rs4851601 (P meta = 9.7 × 10-7), rs13019803 (P meta = 8.9 × 10-6), and rs13015714 (P meta = 5.3 × 10-4) increased cumulative incidence of infection death to almost sevenfold and were associated with low sST2 levels. These functional variants are biomarkers of infection or aGVHD death and could facilitate donor selection, prophylaxis, and a conditioning regimen to reduce post-HCT mortality.Item Summary of the 2019 Blood and Marrow Transplant Clinical Trials Network Myeloma Intergroup Workshop on Minimal Residual Disease and Immune Profiling(Elsevier, 2020-10) Holstein, Sarah A.; Howard, Alan; Avigan, David; Bhutani, Manisha; Cohen, Adam D.; Costa, Luciano J.; Dhodapkar, Madhav V.; Gay, Francesca; Gormley, Nicole; Green, Damian J.; Hillengass, Jens; Korde, Neha; Li, Zihai; Mailankody, Sham; Neri, Paola; Parekh, Samir; Pasquini, Marcelo C.; Puig, Noemi; Roodman, G. David; Samur, Mehmet Kemal; Shah, Nina; Shah, Urvi A.; Shi, Qian; Spencer, Andrew; Suman, Vera J.; Usmani, Saad Z.; McCarthy, Philip L.; Medicine, School of MedicineThe Blood and Marrow Transplant Clinical Trials Network (BMT CTN) Myeloma Intergroup has organized an annual workshop focused on minimal residual disease (MRD) testing and immune profiling (IP) in multiple myeloma since 2016. In 2019, the workshop took place as an American Society of Hematology (ASH) Friday Scientific Workshop entitled “Immune Profiling and Minimal Residual Disease Testing in Multiple Myeloma”. This workshop focused on four main topics: the molecular and immunological evolution of plasma cell disorders, the development of new laboratory- and imaging-based MRD assessment approaches, chimeric antigen receptor T-cell therapy research, and the statistical and regulatory issues associated with novel clinical endpoints. In this report, we provide a summary of the workshop and discuss future directions.Item Validation of genetic associations with acute GVHD and nonrelapse mortality in DISCOVeRY-BMT(American Society of Hematology, 2019-08-13) Tang, Hancong; Hahn, Theresa; Karaesmen, Ezgi; Rizvi, Abbas A.; Wang, Junke; Paczesny, Sophie; Wang, Tao; Preus, Leah; Zhu, Qianqian; Wang, Yiwen; Haiman, Christopher A.; Stram, Daniel; Pooler, Loreall; Sheng, Xin; Van Den Berg, David; Brock, Guy; Webb, Amy; Pasquini, Marcelo C.; McCarthy, Philip L.; Spellman, Stephen R.; Sucheston-Campbell, Lara E.; Pediatrics, School of Medicine