MORENA, M. Teresa de la, David LEONARD, Troy R. TORGERSON, Otavio CABRAL-MARQUES, Mary SLATTER, Asghar AGHAMOHAMMADI, Sharat CHANDRA, Luis MURGUIA-FAVELA, Francisco A. BONILLA, Maria KANARIOU, Rongras DAMRONGWATANASUK, Caroline Y. KUO, Chistopher C. DVORAK, Isabelle MEYTS, Karin CHEN, Lisa KOBRYNSKI, Neena KAPOOR, Darko RICHTER, Daniela DIGIOVANNI, Fatima DHALLA, Evangelia FARMAKI, Carsten SPECKMANN, Teresa ESPANOL, Anna SHCHERBINA, Imelda HANSON, Jiří LITZMAN, John M. ROUTES, Melanie WONG, Ramsay FULEIHAN, Suranjith SENEVIRATNE, Trudy N. SMALL, Ales JANDA, Liliana BEZRODNIK, Reinhard SEGER, Andrea Gomez RACCIO, J. David M. EDGAR, Janet CHOU, Jordan K. ABBOTT, Joris van MONTFRANS, Luis Ignacio GONZALEZ-GRANADO, Nancy BUNIN, Necil KUTUKCULER, Paul GRAY, Gisela SEMINARIO, Srdjan PASIC, Victor AQUINO, Christian WYSOCKI, Hassan ABOLHASSANI, Morna DORSEY, Charlotte CUNNINGHAM-RUNDLES, Alan KNUTSEN, John SLEASMAN, Beatriz Tavares Costa CARVALHO, Antonio CONDINO-NETO, Eyal GRUNEBAUM, Helen CHAPEL, Hans D. OCHS, Alexandra FILIPOVICH, Mort COWAN, Andrew GENNERY, Andrew CANT, Luigi D. NOTARANGELO and Chaim M. ROIFMAN. Long-term outcomes of 176 patients with X-linked hyper-IgM syndrome treated with or without hematopoietic cell transplantation. Journal of allergy and clinical immunology. New York: Mosby-Elsevier, vol. 139, No 4, p. 1282-1292. ISSN 0091-6749. doi:10.1016/j.jaci.2016.07.039. 2017.
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Basic information
Original name Long-term outcomes of 176 patients with X-linked hyper-IgM syndrome treated with or without hematopoietic cell transplantation
Authors MORENA, M. Teresa de la (840 United States of America), David LEONARD (840 United States of America), Troy R. TORGERSON (840 United States of America), Otavio CABRAL-MARQUES (276 Germany), Mary SLATTER (826 United Kingdom of Great Britain and Northern Ireland), Asghar AGHAMOHAMMADI (364 Islamic Republic of Iran), Sharat CHANDRA (840 United States of America), Luis MURGUIA-FAVELA (124 Canada), Francisco A. BONILLA (840 United States of America), Maria KANARIOU (840 United States of America), Rongras DAMRONGWATANASUK (840 United States of America), Caroline Y. KUO (840 United States of America), Chistopher C. DVORAK (840 United States of America), Isabelle MEYTS (276 Germany), Karin CHEN (840 United States of America), Lisa KOBRYNSKI (840 United States of America), Neena KAPOOR (840 United States of America), Darko RICHTER (191 Croatia), Daniela DIGIOVANNI (32 Argentina), Fatima DHALLA (826 United Kingdom of Great Britain and Northern Ireland), Evangelia FARMAKI (300 Greece), Carsten SPECKMANN (276 Germany), Teresa ESPANOL (724 Spain), Anna SHCHERBINA (643 Russian Federation), Imelda HANSON (840 United States of America), Jiří LITZMAN (203 Czech Republic, guarantor, belonging to the institution), John M. ROUTES (840 United States of America), Melanie WONG (36 Australia), Ramsay FULEIHAN (840 United States of America), Suranjith SENEVIRATNE (826 United Kingdom of Great Britain and Northern Ireland), Trudy N. SMALL (840 United States of America), Ales JANDA (203 Czech Republic), Liliana BEZRODNIK (372 Ireland), Reinhard SEGER (372 Ireland), Andrea Gomez RACCIO (372 Ireland), J. David M. EDGAR (372 Ireland), Janet CHOU (840 United States of America), Jordan K. ABBOTT (840 United States of America), Joris van MONTFRANS (528 Netherlands), Luis Ignacio GONZALEZ-GRANADO (724 Spain), Nancy BUNIN (840 United States of America), Necil KUTUKCULER (792 Turkey), Paul GRAY (36 Australia), Gisela SEMINARIO (688 Serbia), Srdjan PASIC (688 Serbia), Victor AQUINO (840 United States of America), Christian WYSOCKI (840 United States of America), Hassan ABOLHASSANI (840 United States of America), Morna DORSEY (840 United States of America), Charlotte CUNNINGHAM-RUNDLES (840 United States of America), Alan KNUTSEN (840 United States of America), John SLEASMAN (840 United States of America), Beatriz Tavares Costa CARVALHO (76 Brazil), Antonio CONDINO-NETO (76 Brazil), Eyal GRUNEBAUM (840 United States of America), Helen CHAPEL (840 United States of America), Hans D. OCHS (840 United States of America), Alexandra FILIPOVICH (840 United States of America), Mort COWAN (840 United States of America), Andrew GENNERY (840 United States of America), Andrew CANT (840 United States of America), Luigi D. NOTARANGELO (840 United States of America) and Chaim M. ROIFMAN (840 United States of America).
Edition Journal of allergy and clinical immunology, New York, Mosby-Elsevier, 2017, 0091-6749.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30102 Immunology
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 13.258
RIV identification code RIV/00216224:14110/17:00096613
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1016/j.jaci.2016.07.039
UT WoS 000398771800023
Keywords in English X-linked hyper-IgM syndrome; CD40 ligand; hematopoietic cell transplantation; defects in class-switch recombination; long-term outcomes; primary immunodeficiency; Karnofsky/Lansky scores
Tags EL OK
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 21/3/2018 16:47.
Abstract
Background: X-linked hyper-IgM syndrome (XHIGM) is a primary immunodeficiency with high morbidity and mortality compared with those seen in healthy subjects. Hematopoietic cell transplantation (HCT) has been considered a curative therapy, but the procedure has inherent complications and might not be available for all patients. Objectives: We sought to collect data on the clinical presentation, treatment, and follow-up of a large sample of patients with XHIGM to (1) compare long-term overall survival and general well-being of patients treated with or without HCT along with clinical factors associated with mortality and (2) summarize clinical practice and risk factors in the subgroup of patients treated with HCT. Methods: Physicians caring for patients with primary immunodeficiency diseases were identified through the Jeffrey Modell Foundation, United States Immunodeficiency Network, Latin American Society for Immunodeficiency, and Primary Immune Deficiency Treatment Consortium. Data were collected with a Research Electronic Data Capture Web application. Survival from time of diagnosis or transplantation was estimated by using the Kaplan-Meier method compared with log-rank tests and modeled by using proportional hazards regression. Results: Twenty-eight clinical sites provided data on 189 patients given a diagnosis of XHIGM between 1964 and 2013; 176 had valid follow-up and vital status information. Sixty-seven (38%) patients received HCT. The average follow-up time was 8.5 +/- 7.2 years (range, 0.1-36.2 years). No difference in overall survival was observed between patients treated with or without HCT (P = .671). However, risk associated with HCT decreased for diagnosis years 1987-1995; the hazard ratio was significantly less than 1 for diagnosis years 1995-1999. Liver disease was a significant predictor of overall survival (hazard ratio, 4.9; 95% confidence limits, 2.2-10.8; P < .001). Among survivors, those treated with HCT had higher median Karnofsky/Lansky scores than those treated without HCT (P < .001). Among patients receiving HCT, 27 (40%) had graft-versus-host disease, and most deaths occurred within 1 year of transplantation. Conclusion: No difference in survival was observed between patients treated with or without HCT across all diagnosis years (1964-2013). However, survivors treated with HCT experienced somewhat greater well-being, and hazards associated with HCT decreased, reaching levels of significantly less risk in the late 1990s. Among patients treated with HCT, treatment at an early age is associated with improved survival. Optimism remains guarded as additional evidence accumulates.
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