%0 Journal Article %~ PubMed %A Brown, Ross %A Kabani, Karieshma %A Favaloro, James %A Yang, Shihong %A Ho, P Joy %A Gibson, John %A Fromm, Phillip %A Suen, Hayley %A Woodland, Narelle %A Nassif, Najah %A Hart, Derek %A Joshua, Douglas %T CD86+ or HLA-G+ myeloma cells are associated with poor prognosis and once acquired by trogocytosis create novel Tregacq cells. %B Blood %D 2012 %C United States %I American Society of Hematology %V 120 %N 10 %P 2055-2063 %@ 0006-4971 %X The transfer of membrane proteins between cells during contact, known as trogocytosis, can create novel cells with a unique phenotype and altered function. We demonstrate that trogocytosis is more common in multiple myeloma (MM) than chronic lymphocytic leukaemia (CLL) and Waldenstrom''s macroglobulinaemia (WM); that T cells are more likely to be recipients than B or NK cells; that trogocytosis occurs independently of either the TCR receptor or HLA compatibility and that following trogocytosis, T cells with acquired antigens can become novel regulators of T cell proliferation. We screened 168 patients with MM and found that CD86 and HLA-G were antigens commonly acquired by T cells from malignant plasma cells. CD3(+)CD86(acq+) and CD3(+) HLA-G(acq+) cells were more prevalent in bone marrow than peripheral blood samples. The presence of either CD86 or HLA-G on malignant plasma cells was associated with a poor prognosis. CD38(++)side population (SP) cells expressed HLA-G, suggesting that these putative myeloma stem cells could generate immune tolerance. HLA-G(+) T cells had a regulatory potency similar to natural Tregs, thus providing another novel mechanism for MM to avoid effective immune surveillance. %Z FOR Codes: 110709 111206 %0 Journal Article %~ PubMed %A Chohan, Gurjit %A Barnett, Yael %A Gibson, John %A Reddel, Stephen W R %A Barnett, Michael H %T Langerhans cell histiocytosis with refractory central nervous system involvement responsive to infliximab. %B Journal of Neurology, Neurosurgery, and Psychiatry %D 2012 %C United Kingdom %I B M J Group %V 83 %N 5 %P 573-575 %@ 1468-330X %X %Z FOR Codes: 110903 %0 Journal Article %~ PubMed %A Brown, C M S %A Larsen, S R %A Iland, H J %A Joshua, D E %A Gibson, J %T Leukaemias into the 21st century: part 1: the acute leukaemias. %B Internal Medicine Journal %D 2012 %C Australia %I Wiley-Blackwell Publishing Asia %V 42 %N 11 %P 1179-1186 %@ 1445-5994 %X %Z FOR Codes: 110202 111206 %0 Journal Article %~ PubMed %A Ho, P Joy %A Brown, Ross D %A Spencer, Andrew %A Jeffels, Melinda %A Daniher, Daniel %A Gibson, John %A Joshua, Douglas E %T Thalidomide consolidation improves progression-free survival in myeloma with normal but not up-regulated expression of fibroblast growth factor receptor 3: analysis from the Australasian Leukaemia and Lymphoma Group MM6 clinical trial. %B Leukemia & Lymphoma %D 2012 %C Switzerland %I Informa Healthcare %V 53 %N 9 %P 1728-1734 %@ 1029-2403 %X The translocation t(4;14) is associated with a poor prognosis in myeloma, but its effect in the setting of new drugs such as thalidomide, bortezomib and lenalidomide continues to be investigated, and the role of candidate genes such as FGFR3 (fibroblast growth factor receptor 3) is not yet clarified. In the Australasian Leukaemia and Lymphoma Group (ALLG) MM6 randomized study comparing consolidation thalidomide and prednisolone with prednisolone alone following autologous stem cell transplant, patients on consolidation thalidomide and prednisolone had superior progression-free (PFS) and overall survival (OS). We now show that thalidomide consolidation benefited both t(4;14)-positive (PFS 29 vs. 17 months, p =0.03) and -negative (52 vs. 24 months, p =0.04) disease. PFS for patients with normal FGFR3 expression was significantly better than for those with up-regulated FGFR3 (31 vs. 21 months, p =0.02). Consolidation thalidomide conferred an improved PFS in patients with normal FGFR3 expression (41 vs. 19 months, p =0.02), but there was no improvement in patients with up-regulated FGFR3 (31 vs. 29 months, p =0.76). We conclude that consolidation thalidomide may mitigate the poor prognostic effect of t(4;14), and improves PFS in normal but not up-regulated FGFR3 expression. Thus the level of FGFR3 expression provides additional prognostic information to t(4;14) in myeloma induction and consolidation therapy. %Z FOR Codes: 110202 %0 Journal Article %~ PubMed %A Brown, Ross %A Suen, Hayley %A Favaloro, James %A Yang, Shihong %A Ho, P Joy %A Gibson, John %A Joshua, Douglas %T Trogocytosis generates acquired regulatory T cells adding further complexity to the dysfunctional immune response in multiple myeloma. %B Oncoimmunology %D 2012 %C United States %I Landes Bioscience %V 1 %N 9 %P 1658-1660 %@ 2162-4011 %X %Z FOR Codes: 1107 %0 Journal Article %~ PubMed %A Nivison-Smith, Ian %A Dodds, Anthony J %A Doocey, Richard %A Ganly, Peter %A Gibson, John %A Ma, David D F %A Simpson, Judy M %A Szer, Jeff %A Bradstock, Kenneth F %T Allogeneic hematopoietic cell transplant for multiple myeloma using reduced intensity conditioning therapy, 1998-2006: factors associated with improved survival outcome. %B Leukemia & Lymphoma %D 2011 %C Switzerland %I Informa Healthcare %V 52 %N 9 %P 1727-1735 %@ 1029-2403 %X Abstract This study reports on the outcome of 95 allogeneic hematopoietic cell transplants (HCTs) using reduced intensity conditioning (RIC) performed for patients with multiple myeloma (MM) in Australia and New Zealand between 1998 and 2006. The median age at HCT was 52 years. Of the 32 patients for whom the allograft was performed as a first transplant, 15 (47%) had their allograft less than 1 year from diagnosis, while for the 63 patients who had an allograft following an autograft, nine (14%) were allografted within 1 year post-diagnosis (p?95% donor chimerism, 145 patients were 5% to 95%, and 63 patients were <5%. The only donor characteristic associated with transplantation outcome was donor-recipient HLA matching. One- or 2-loci mismatched transplants led to higher grade 2-4 (relative risk [RR] = 1.27, P = .035) and grade 3-4 (RR = 1.85, P < .001) aGVHD and 2-loci mismatched transplants higher mortality (RR = 2.22, P < .001). Graft failure was higher after transplantation of bone marrow (RR = 2.33, P = .002). Donor age, parity, and donor sex match were not associated with transplantation outcome. Donor-recipient HLA matching is the only donor characteristic predictive for survival after RIC regimens for hematologic malignancies. %Z FOR Codes: 110202 %0 Journal Article %~ PubMed %A Vogl, Dan T %A Wang, Tao %A Pérez, Waleska S %A Stadtmauer, Edward A %A Heitjan, Daniel F %A Lazarus, Hillard M %A Kyle, Robert A %A Kamble, Ram %A Weisdorf, Daniel %A Roy, Vivek %A Gibson, John %A Ballen, Karen %A Holmberg, Leona %A Bashey, Asad %A McCarthy, Philip L %A Freytes, Cesar %A Maharaj, Dipnarine %A Maiolino, Angelo %A Vesole, David %A Hari, Parameswaran %T Effect of obesity on outcomes after autologous hematopoietic stem cell transplantation for multiple myeloma. %B Biology of Blood and Marrow Transplantation %D 2011 %C United States %I Elsevier Inc. %V 17 %N 12 %P 1765-1774 %@ 1523-6536 %X Obesity has implications for chemotherapy dosing and selection of patients for therapy. Autologous hematopoietic stem cell transplant (AutoHCT) improves outcomes for patients with multiple myeloma, but optimal chemotherapy dosing for obese patients is poorly defined. We analyzed the outcomes of 1087 recipients of AutoHCT for myeloma reported to the CIBMTR between 1995 and 2003 who received high-dose melphalan conditioning, with or without total body irradiation (TBI). We categorized patients by body mass index (BMI) as normal, overweight, obese, or severely obese. There was no overall effect of BMI on progression-free survival (PFS), overall survival (OS), progression, or nonrelapse mortality (NRM). In patients receiving melphalan and TBI conditioning, obese and severely obese patients had superior PFS and OS compared with normal and overweight patients, but the clinical significance of this finding is unclear. More obese patients were more likely to receive a reduced dose of melphalan, but there was no evidence that melphalan or TBI dosing variability affected PFS. Therefore, current common strategies of dosing melphalan do not impair outcomes for obese patients, and obesity should not exclude patients from consideration of autologous transplantation. Further research is necessary to optimize dosing of both chemotherapy and radiation in obese patients. %Z FOR Codes: 110202 %0 Journal Article %~ PubMed %A Khoo, Teh Liane %A Vangsted, Annette Juul %A Joshua, Douglas %A Gibson, John %T Interferon-alpha in the treatment of multiple myeloma. %B Current Drug Targets %D 2011 %C Netherlands %I Bentham Science Publishers Ltd. %V 12 %N 3 %P 437-446 %@ 1873-5592 %X Interferons are soluble proteins produced naturally by cells in response to viruses. It has both anti-proliferative and immunomodulating properties and is one of the first examples of a biological response modifier use to treat the haematological malignancy multiple myeloma. Interferon has been used in this clinical practice for over thirty years. However, despite considerable efforts, numerous clinical trials and two large meta-analysis, its exact role in the management of multiple myeloma still remains unclear. Its role in the treatment of multiple myeloma has been as a single induction agent, a co-induction agent with other chemotherapy regimens, and as maintenance therapy after conventional chemotherapy or complete remission after autologous or allogeneic transplantation. Interferon as a single induction agent or co-induction agent with other chemotherapy agents appears only to have minimal benefit in myeloma. Its role as maintenance therapy in the plateau phase of myeloma also remains uncertain. More recently, the use of interferon must now compete with the "new drugs"--thalidomide, lenalidomide and bortezomib in myeloma treatment. Will there be a future role of interferon in the treatment of multiple myeloma or will interferon be resigned to the history books remains to be seen. %Z FOR Codes: 60108 60108 %0 Journal Article %~ PubMed %A Brown, Ross D %A Langshaw, Mark R %A Uhr, Elaine J %A Gibson, John N %A Joshua, Douglas E %T The impact of mandatory fortification of flour with folic acid on the blood folate levels of an Australian population. %B Medical Journal of Australia %D 2011 %C Australia %I Australasian Medical Publishing Company Pty. Ltd. %V 194 %N 2 %P 65-67 %@ 0025-729X %X To determine the impact that mandatory fortification with folic acid of wheat flour used in breadmaking has had on the blood folate levels of an Australian population since it was introduced in September 2009. %Z FOR Codes: 1103 %0 Journal Article %~ PubMed %A Suryani, Santi %A Fulcher, David A %A Santner-Nanan, Brigitte %A Nanan, Ralph %A Wong, Melanie %A Shaw, Peter J %A Gibson, John %A Williams, Andrew %A Tangye, Stuart G %T Differential expression of CD21 identifies developmentally and functionally distinct subsets of human transitional B cells. %B Blood %D 2010 %C United States %I American Society of Hematology %V 115 %N 3 %P 519-529 %@ 0006-4971 %X The transitional stage of B-cell development represents an important step where autoreactive cells are deleted, allowing the generation of a mature functional B-cell repertoire. In mice, 3 subsets of transitional B cells have been identified. In contrast, most studies of human transitional B cells have focused on a single subset defined as CD24(hi)CD38(hi) B cells. Here, we have identified 2 subsets of human transitional B cells based on the differential expression of CD21. CD21(hi) transitional cells displayed higher expression of CD23, CD44, and IgD, and exhibited greater proliferation and Ig secretion in vitro than CD21(lo) transitional B cells. In contrast, the CD21(lo) subset expressed elevated levels of LEF1, a transcription factor highly expressed by immature lymphocytes, and produced higher amounts of autoreactive Ab. These phenotypic, functional, and molecular features suggest that CD21(lo) transitional B cells are less mature than the CD21(hi) subset. This was confirmed by analyzing X-linked agammaglobulinemia patients and the kinetics of B-cell reconstitution after stem cell transplantation, which revealed that the development of CD21(lo) transitional B cells preceded that of CD21(hi) transitional cells. These findings provide important insights into the process of human B-cell development and have implications for understanding the processes underlying perturbed B-cell maturation in autoimmune and immunodeficient conditions. %Z FOR Codes: 110202 %0 Journal Article %~ Isi %A Reece, D. E. %A Vesole, D. H. %A Shrestha, S. %A Zhang, M. J. %A Perez, W. S. %A Dispenzieri, A. %A Milone, G. A. %A Abidi, M. %A Atkins, H. %A Bashey, A. %A Bredeson, C. N. %A Boza, W. B. %A Freytes, C. O. %A Gale, R. P. %A Gajewski, J. L. %A Gibson, J. %A Hale, G. A. %A Kumar, S. %A Kyle, R. A. %A Lazarus, H. M. %A McCarthy, P. L. %A Paylovsky, S. %A Roy, V. %A Weisdorf, D. J. %A Wiernik, P. H. %A Hari, P. N. %T Outcome of Patients With IgD and IgM Multiple Myeloma Undergoing Autologous Hematopoietic Stem Cell Transplantation: A Retrospective CIBMTR Study %B Clinical Lymphoma Myeloma & Leukemia %D 2010 %C United States %I CIG Media Group, LP %V 10 %N 6 %P 458-463 %@ 2152-2650 %X %Z FOR Codes: 30406 110202 %0 Journal Article %~ Isi %A Hari, P. N. %A Majhail, N. S. %A Zhang, M. J. %A Hassebroek, A. %A Siddiqui, F. %A Ballen, K. %A Bashey, A. %A Bird, J. %A Freytes, C. O. %A Gibson, J. %A Hale, G. %A Holmberg, L. %A Kamble, R. %A Kyle, R. A. %A Lazarus, H. M. %A LeMaistre, C. F. %A Loberiza, F. %A Maiolino, A. %A McCarthy, P. L. %A Milone, G. %A Omondi, N. %A Reece, D. E. %A Seftel, M. %A Trigg, M. %A Vesole, D. %A Weiss, B. %A Wiernik, P. %A Lee, S. J. %A Rizzo, J. D. %A Mehta, P. %T Race and Outcomes of Autologous Hematopoietic Cell Transplantation for Multiple Myeloma %B Biology of Blood and Marrow Transplantation %D 2010 %C United States %I Elsevier Inc. %V 16 %N 3 %P 395-402 %@ 1083-8791 %X %Z FOR Codes: 110202 60103 %0 Journal Article %~ PubMed %A Brown, Ross D %A Spencer, Andrew %A Ho, Phoebe Joy %A Kennedy, Nola %A Kabani, Karieshma %A Yang, Shihong %A Sze, Daniel M %A Aklilu, Esther %A Gibson, John %A Joshua, Douglas E %T Prognostically significant cytotoxic T cell clones are stimulated after thalidomide therapy in patients with multiple myeloma. %B Leukemia and Lymphoma %D 2009 %C United Kingdom %I Informa Healthcare %V 50 %N 11 %P 1860-1864 %@ 1029-2403 %X The expanded T cell clones are associated with a prolonged survival in patients with multiple myeloma. We sought to confirm this prognostic significance in a multicenter patient cohort and investigate the effect of thalidomide on clones and T regulatory cells (T(regs)). Blood was collected from 120 patients enrolled in a Phase III trial of maintenance therapy +/- thalidomide after autologous stem cell transplantation. TCR Vbeta repertoire analysis identified T cell expansions in 48% of patients pre-transplant and 68% after 8-month maintenance. T cell expansions, previously shown to be clonal, were predominantly CD8+ (93%) and all 24 TCR Vbeta families tested were represented. Thalidomide therapy was associated with a significant increase in the incidence of patients with multiple expansions (49% vs. 23%; chi2 = 6.8; p = 0.01). The presence of expansions regardless of therapy was associated with a significantly longer median progression free survival (PFS) (32.1 vs. 17.6 months; chi2 = 5.6; p = 0.02) and overall survival (OS) (chi2 = 3.9; p < 0.05). Median PFS in the thalidomide arm was 50.9 months for patients with expansions and 28.3 months for patients without expansions (chi2 = 19.4; p = 0.0002). Thalidomide did not appear to modulate T(reg) numbers. Expanded T cell clones are prognostically significant and have an impact on progression after thalidomide therapy in a proportion of patients. %Z FOR Codes: 60199 %0 Journal Article %~ Isi %A Devetten, M. P. %A Hari, P. N. %A Carreras, J. %A Logan, B. R. %A van Besien, K. %A Bredeson, C. N. %A Freytes, C. O. %A Gale, R. P. %A Gibson, J. %A Giralt, S. A. %A Goldstein, S. C. %A Gupta, V. %A Marks, D. I. %A Maziorz, R. T. %A Vase, J. M. %A Lazarus, H. M. %A Anderlini, P. %T Unrelated Donor Reduced-Intensity Allogeneic Hematopoietic Stem Cell Transplantation for Relapsed and Refractory Hodgkin Lymphoma %B Biology of Blood and Marrow Transplantation %D 2009 %C United States %I Elsevier Inc. %V 15 %N 1 %P 109-117 %@ 1083-8791 %X %Z FOR Codes: 110202 %0 Journal Article %~ PubMed %A Kumar, Shaji %A Pérez, Waleska S %A Zhang, Mei-Jie %A Ballen, Karen %A Bashey, Asad %A To, L Bik %A Bredeson, Christopher N %A Cairo, Mitchell S %A Elfenbein, Gerald J %A Freytes, César O %A Gale, Robert Peter %A Gibson, John %A Kyle, Robert A %A Lacy, Martha Q %A Lazarus, Hillard M %A McCarthy, Philip L %A Milone, Gustavo A %A Moreb, Jan S %A Pavlovsky, Santiago %A Reece, Donna E %A Vesole, David H %A Wiernik, Peter H %A Hari, Parameswaran %T Comparable outcomes in nonsecretory and secretory multiple myeloma after autologous stem cell transplantation. %B Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation %D 2008 %C United States %I Elsevier %V 14 %N 10 %P 1134-1140 %@ 1523-6536 %X Nonsecretory myeloma (NSM) accounts for <5% of cases of multiple myeloma (MM). The outcome of these patients following autologous stem cell transplantation (ASCT) has not been evaluated in clinical trials. We compared the outcomes after ASCT for patients with NSM reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) between 1989 and 2003, to a matched group of 438 patients (4 controls for each patient) with secretory myeloma (SM). The patients were matched using propensity scores calculated using age, Durie-Salmon stage, sensitivity to pretransplant therapy, time from diagnosis to transplant, and year of transplant. Disease characteristics were similar in both groups at diagnosis and at transplant except higher risk of anemia, hypoalbuminemia, and marrow plasmacytosis (in SM) and plasmacytoma (more in NSM). Cumulative incidence of treatment-related mortality (TRM), relapse, progression-free survival (PFS), and overall survival (OS) were similar between the groups. In multivariate analysis, based on a Cox model stratified on matched pairs and adjusted for covariates not considered in the propensity score, we found no difference in outcome between the NSM and SM groups. In this large cohort of patients undergoing ASCT, we found no difference in outcomes of patients with NSM compared to those with SM. %Z FOR Codes: 110202 111299 %0 Journal Article %~ PubMed %A Bashey, Asad %A Pérez, Waleska S %A Zhang, Mei-Jie %A Anderson, Kenneth C %A Ballen, Karen %A Berenson, James R %A To, L Bik %A Fonseca, Rafael %A Freytes, César O %A Gale, Robert Peter %A Gibson, John %A Giralt, Sergio A %A Kyle, Robert A %A Lazarus, Hillard M %A Maharaj, Dipnarine %A McCarthy, Philip L %A Milone, Gustavo A %A Nimer, Stephen %A Pavlovsky, Santiago %A Reece, Donna E %A Schiller, Gary %A Vesole, David H %A Hari, Parameswaran %A , Plasma Cell Disorders Working Committee %T Comparison of twin and autologous transplants for multiple myeloma. %B Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation %D 2008 %C United States %I Elsevier %V 14 %N 10 %P 1118-1124 %@ 1523-6536 %X Relapse is the overwhelming cause of treatment failure after autologous transplantation for multiple myeloma (MM). For patients with a syngeneic donor, twin transplants provide a healthy graft that is free of myeloma. The relative impact of the graft on posttransplant relapse can be estimated by comparing risk of relapse after hematopoietic cell transplantation from genetically identical twins versus autotransplants because confounding differences in minor or major histocompatibility antigens are absent in the syngeneic transplant setting. Outcomes of 43 subjects who received twin transplants for MM were compared to 170 matched autotransplant recipients reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). Multivariate analysis was performed by fitting a Cox model stratified on matched pairs. The matched transplant patients studied were similar with respect to subject-, disease-, and transplant-related characteristics. Cumulative incidence of relapse/progression was significantly lower, and progression-free survival (PFS) was significantly higher following twin transplants. In multivariate analysis, the probability of relapse/progression was lower in twins (relative risk [RR] = 0.49, 95% confidence interval [CI] 0.28-0.86, P = .011). Twin transplants have a significantly lower relapse risk than autotransplants in MM, suggesting that graft composition may impact outcomes following high-dose chemotherapy. %Z FOR Codes: 111299 110202 %0 Journal Article %~ PubMed %A Joshua, Douglas E %A Brown, Ross D %A Ho, P Joy %A Gibson, John %T Regulatory T cells and Multiple Myeloma. %B Clinical Lymphoma & Myeloma %D 2008 %C United States %I Cancer Information Group %V 8 %N 5 %P 283-286 %@ 1557-9190 %X Many clinical observations point to active immunologic phenomena in patients with myeloma. These consist of active suppression of the host''s immune system and partially successful attempts by the host''s immune system to suppress the malignant B-cell population. Clinical conditions such as asymptomatic myeloma, which represents clinical presentation in the plateau phase of the disease, plateau establishment after conventional induction therapy without the ongoing need for therapy, and the positive prognostic importance of the presence of clones of cytotoxic T cells in the peripheral blood of some patients, suggest that host-tumor interaction is an active dynamic state. Regulatory T (Treg) cells comprise 5%-10% of peripheral CD4 T cells and are responsible for the control of autoimmune phenomena. Deficiency of the FoxP3 transcription factor, which normally characterizes Treg cells, leads to multiorgan autoimmune disorders in humans and mice. The role of Treg cells in the protection from malignancy is unclear, but their depletion can lead to the induction of tumor rejection in murine models, and their demonstration as tumorinfiltrating lymphocytes in malignancy point to a significant immunomodulator role. In myeloma, host-tumor immune interactions are complex. However, patients can clearly exhibit control of their B-cell malignancy for many years with stability of paraprotein levels, demonstrating a homeostasis between tumor and host. Whether Treg cells are playing a role in this homeostasis is unclear. At present, there is considerable debate in the literature regarding observations such as whether Treg cells are increased or decreased, functional or dysfunctional. In this review, we will discuss the potential importance of Treg cells and their role in myeloma, a disease characterized by a unique set of host-tumor interactions. %Z FOR Codes: 1107 %0 Journal Article %~ PubMed %A Burgess, P %A Robin, H %A Langshaw, M %A Kershaw, G %A Pathiraja, R %A Yuen, S %A Coad, C %A Xiros, N %A Mansy, G %A Coleman, R %A Brown, R %A Gibson, J %A Holman, R %A Hubbard, J %A Wick, V %A Lammers, M %A Johnson, R %A Huffman, K %A Bell, J %A Ibrahim, A %A Estepa, F %A Lovegrove, J %A Joshua, D %T Rule based processing of the CD4000, CD3200 and CD Sapphire analyser output using the Cerner Discern Expert Module. %B International journal of laboratory hematology %D 2008 %C United Kingdom %I Wiley-Blackwell %V 31 %N 0 %P 603-14 %@ 1751-5521 %X The latest version of our Laboratory Information System haematology laboratory expert system that handles the output of Abbott Cell-Dyn Sapphires, CD4000s and a CD3200 full blood count analyser in three high-volume haematology laboratories is described. The three hospital laboratories use Cerner Millennium Version 2007.02 software and the expert system uses Cerner Millennium Discern Expert rules and some small Cerner Command Language in-house programs. The entire expert system is totally integrated with the area-wide database and has been built and maintained by haematology staff members, as has the haematology database. Using patient demographic data, analyser numeric results, analyser error and morphology flags and previous results for the patient, this expert system decides whether to validate the main full blood count indices and white cell differential, or if the analyser results warrant further operator intervention/investigation before verifying, whether a blood film is required for microscopic review and if abnormal results require phoning to the staff treating the patient. The principles of this expert system can be generalized to different haematology analysers and haematology laboratories that have different workflows and different software. %Z FOR Codes: 110202 %0 Journal Article %~ PubMed %A Grigg, A P %A Gibson, J %A Bardy, P G %A Reynolds, J %A Shuttleworth, P %A Koelmeyer, R L %A Szer, J %A Roberts, A W %A To, L B %A Kennedy, G %A Bradstock, K F %T A prospective multicenter trial of peripheral blood stem cell sibling allografts for acute myeloid leukemia in first complete remission using fludarabine-cyclophosphamide reduced intensity conditioning. %B Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation %D 2007 %C United States %I Elsevier Inc. %V 13 %N 5 %P 560-567 %@ 1083-8791 %X The role of allogeneic transplantation in patients with de novo acute myeloid leukemia in first complete remission (AML-CR1) is controversial. Aiming to preserve a graft-versus-leukemia effect, but minimize morbidity and mortality from conditioning-related toxicity and graft-versus-host disease (GVHD), we conducted a prospective multicenter study of reduced-intensity conditioning (RIC) as preparation for peripheral blood stem cell sibling allografts in patients with intermediate or poor risk AML-CR1. Conditioning consisted of fludarabine 125 mg/m(2) and cyclophosphamide 120 mg/kg. Thirty-four patients were transplanted with a median age of 45 years; 85% had intermediate risk cytogenetics. Early toxicity was minimal. The overall incidence of grade II-IV acute GVHD was low (21%), but the 3 patients (9%) who developed grade IV GVHD died. Donor T cell chimerism was rapid and generally complete, but complete myeloid chimerism was delayed. Thirteen patients (38%) relapsed, 12 within a year of transplant. The estimated disease-free survival (DFS) and overall survival at 2 years was 56% (95% confidence interval [CI] 39%-71%) and 68% (95% CI 50%-81%), respectively. The incidence of extensive chronic GVHD (cGVHD) was low (24% of surviving patients at 12 months) and most survivors had an excellent performance status. These observations justify a prospective comparison of RIC versus myeloablative conditioning allografts for AML-CR1. %Z FOR Codes: %0 Journal Article %~ PubMed %A Sanders, J %A Crawford, B %A Gibson, J %A Joy Ho, P %A Iland, H %A Joshua, D %T Is there a case for the early use of bisphosphonates in smouldering myeloma and MGUS? (Bisphosphonates in SMM & MGUS). %B International journal of laboratory hematology %D 2007 %C United Kingdom %I Blackwell Publishing Ltd. %V 29 %N 5 %P 395-397 %@ 1751-5521 %X %Z FOR Codes: %0 Book Section %A Ling, Silvia %A Campbell, Lynda J %A Ho, Joy %A Gibson, John %A Joshua, Douglas %T Molecular Biology, Pathology, and Cytogenetics %B Clinical Malignant Haematology %D 2007 %C United States %I McGraw Hill %V %N %P 847-857 %@ 9780071436502 %E Sekeres, Mikkael A. %E Kalaycio, Matt E. %E Bolwell, Brian J. %X %Z FOR Codes: 110202 111201 %0 Journal Article %~ Isi %A Gibson, J %A Ho, PJ %A Brown, R %A Joshua, D %A Sze, D %T The role of T-cells in myeloma %B HAEMATOLOGICA-THE HEMATOLOGY JOURNAL %D 2007 %C Italy %I FERRATA STORTI FOUNDATION, %V 92 %N %P 11-12 %@ 0390-6078 %X %Z FOR Codes: 110202 %0 Journal Article %~ PubMed %A Feyler, S %A Prince, H M %A Pearce, R %A Towlson, K %A Nivison-Smith, I %A Schey, S %A Gibson, J %A Patton, N %A Bradstock, K %A Marks, D I %A Cook, G %T The role of high-dose therapy and stem cell rescue in the management of T-cell malignant lymphomas: a BSBMT and ABMTRR study. %B Bone marrow transplantation %D 2007 %C UK %I Nature Publishing Group %V 40 %N 5 %P 443-450 %@ 0268-3369 %X Peripheral T-cell lymphomas (PTCL) are a rare and heterogeneous subset of lymphomas with a poorer prognosis compared with B-cell lymphomas. We conducted a retrospective study of 82 patients who received high-dose therapy for PTCL (autologous SCT (ASCT) N=64; allogeneic SCT (Allo-SCT) N=18). With a median follow-up from ASCT of 37 months from transplant, 33 patients were alive; 20 died of progressive disease, 10 died from non-relapse mortality (NRM) with 1 unknown cause. Three-year overall survival (OS) and progression-free survival (PFS) were 53% (95% confidence interval (CI) 42, 67) and 50% (95% CI 39, 64), respectively. Factors significantly affecting OS and PFS on univariate analysis were histological subtype and chemotherapy sensitivity. In a multivariate analysis, the only factor with significant impact was chemotherapy sensitivity. After a median follow-up from Allo-SCT of 57 months, five patients were alive; five died of progressive disease and eight died from NRM. The 3-year OS and PFS were 39% (95% CI 22, 69) and 33% (95% CI 17, 64), respectively, and the 3-year relapse rate was 28% (95% CI 6, 50). These results demonstrate that high-dose chemotherapy with autologous stem cell rescue has a substantial role in the management of T-cell lymphoma. The use of full-intensity allogeneic transplantation is limited by high transplant-related mortality, and exploration of reduced intensity regimens is warranted. %Z FOR Codes: