0000000000319454

AUTHOR

Rafael F. Duarte

showing 6 related works from this author

Prophylaxis and management of graft versus host disease after stem-cell transplantation for haematological malignancies: updated consensus recommenda…

2020

Graft-versus-host disease (GVHD) is a major factor contributing to mortality and morbidity after allogeneic stem-cell transplantation. Because of the small number of results from well designed, large- scale, clinical studies there is considerable variability in the prevention and treatment of GVHD worldwide. In 2014, to standardise treatment approaches the European Society of Blood and Marrow Transplantation published recommendations on the management of GVHD in the setting of HLA-identical sibling or unrelated donor transplantation in adult patients with haematological malignancies. Here we update these recommendations including the results of study published after 2014. Evidence was searc…

medicine.medical_specialtyTransplantation ConditioningDrug ResistanceMEDLINEGraft vs Host DiseaseBronchiolitis obliteransDisease03 medical and health sciences0302 clinical medicinegraft versus host diseasemedicineHumansDisease management (health)Intensive care medicineImmunosuppression Therapybusiness.industryDisease ManagementHematologymedicine.disease3. Good healthAnti-thymocyte globulinTransplantationSystematic reviewGraft-versus-host diseasesurgical procedures operativeHematologic Neoplasms030220 oncology & carcinogenesisDrug MonitoringbusinessImmunosuppressive AgentsStem Cell Transplantation030215 immunology
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Thrombopoietin Receptor Agonists for Severe Thrombocytopenia after Allogeneic Stem Cell Transplantation: Experience of a Multicenter Study from the G…

2018

Abstract Introduction Thrombocytopenia is a common complication after allogeneic hematopoietic stem cell transplantation (allo-SCT). Underlying mechanisms are poorly known and usually multifactorial. Its treatment is not well defined, mostly based in platelet transfusion. Thus, is important to identify new strategies to manage this important post-SCT complication. Romiplostim and Eltrombopag are currently available thrombopoietin receptor agonists (TPO-RAs) that stimulate platelet production. Some studies with very small number of cases have reported their potential efficacy in the allo-SCT setting. For this reason, the aim of our study is to analyze the efficacy and safety of TPO-RAs for s…

medicine.medical_specialtymedicine.medical_treatmentImmunologyEltrombopagHematopoietic stem cell transplantationNeutropeniaBiochemistryGastroenterology03 medical and health scienceschemistry.chemical_compound0302 clinical medicineInternal medicinemedicinePlateletRomiplostimbusiness.industryCell BiologyHematologymedicine.diseaseTransplantationPlatelet transfusionGraft-versus-host diseasechemistry030220 oncology & carcinogenesisbusiness030215 immunologymedicine.drugBlood
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A Single-Arm, Open-Label Phase 1 Study of Itacitinib (ITA) with Calcineurin Inhibitor (CNI)-Based Interventions for Prophylaxis of Graft-Versus-Host …

2020

Background Despite prophylaxis, GVHD remains a significant cause of morbidity and nonrelapse mortality after allogeneic hematopoietic cell transplantation (HCT). ITA is a potent, selective Janus kinase (JAK) 1 inhibitor that has been combined safely with steroids in patients (pts) with acute GVHD. We describe results from a proof-of-concept study evaluating ITA + CNI-based regimens for GVHD prophylaxis. Study Design and Methods GRAVITAS-119 (NCT03320642) was a single-arm, open-label study enrolling pts aged ≥18 y undergoing allogeneic HCT using peripheral blood stem cells from 8/8 or 7/8 matched related or unrelated donors for a hematologic malignancy. Eligible pts were candidates for reduc…

medicine.medical_specialtybusiness.industryImmunologyUrologyItacitinibCell BiologyHematologymedicine.diseaseBiochemistryCalcineurinGraft-versus-host diseaseMedicineOpen labelbusinessBlood
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Assessment of the association between cytomegalovirus DNAemia and subsequent acute graft-versus-host disease in allogeneic peripheral blood stem cell…

2021

The potential role of active CMV infection in promoting acute Graft-versus-Host Disease (aGvHD) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a matter of debate. We further addressed this issue conducting a retrospective, observational, multicenter study of 632 patients subjected to allogeneic peripheral blood HSCT at 20 Spanish centers. Monitoring of CMV DNA load in plasma or whole blood was performed by real-time PCR assays. Cumulative incidence of CMV DNAemia was 48.9% (95% CI, 45%-52.9%), of any grade aGvHD, 45.6; 95% (CI, 41.3%-50.1%), and of grade II-IV aGvHD, 30.7 (95% CI, 24.9%-36.4%). Overall, development of CMV DNAemia at any level resulted in an increa…

medicine.medical_specialtyversus&#8208medicine.medical_treatmentCongenital cytomegalovirus infectionCytomegalovirusGraft vs Host DiseaseDiseaseHematopoietic stem cell transplantationCMV DNAemia030230 surgeryGastroenterologyCMV DNAemia acute graft-versus-host disease allogeneic hematopoietic stem cell transplantation cytomegalovirus (CMV)Cell therapy03 medical and health sciences0302 clinical medicineInternal medicinehemic and lymphatic diseasesMedicineHumansCumulative incidenceallogeneic hematopoietic stem cell transplantationWhole bloodRetrospective StudiesTransplantationhost diseasePeripheral Blood Stem Cell Transplantationbusiness.industryHematopoietic Stem Cell Transplantationvirus diseasesmedicine.diseaseacute graft&#8208TransplantationHaematopoiesisInfectious Diseasessurgical procedures operativecytomegalovirus (CMV)030211 gastroenterology & hepatologybusinessTransplant infectious disease : an official journal of the Transplantation SocietyREFERENCES
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Single umbilical cord blood with or without CD34+ cells from a third-party donor in adults with leukemia

2017

We retrospectively compared the clinical outcomes of adults with acute leukemia who received single-unit umbilical cord blood (UCB) transplantation (sUCBT) (n = 135) or stem cell transplant using coinfusion of a UCB graft with CD34+ cells from a third-party donor (Haplo-Cord) (n = 72) at different institutions within the Grupo Espanol de Trasplante Hematopoyetico. In multivariable analysis, patients in the Haplo-Cord group showed more rapid neutrophil (hazard ratio [HR], 2.3; 95% confidence interval [CI], 1.5-3.3; P < .001) and platelet recovery (HR, 1.6; 95% CI, 1.2-2.3; P = .015) and lower incidence of chronic graft-versus-host disease (GVHD) (relative risk, 0.5; 95% CI, 0.3-0.8; P = .01)…

Acute leukemiamedicine.medical_specialtyendocrine systemTransplantationbusiness.industryHazard ratioMyeloid leukemiaContext (language use)Hematologymedicine.diseaseUmbilical cordGastroenterologyTransplantation03 medical and health sciencesLeukemia0302 clinical medicinemedicine.anatomical_structureGraft-versus-host disease030220 oncology & carcinogenesisInternal medicineImmunologyMedicinebusiness030215 immunology
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Antilymphocyte Globulin for Prevention of Chronic Graft-versus-Host Disease.

2016

Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; BACKGROUND Chronic graft-versus-host disease (GVHD) is the leading cause of later illness and death after allogeneic hematopoietic stem-cell transplantation. We hypothesized that the inclusion of antihuman T-lymphocyte immune globulin (ATG) in a myeloablative conditioning regimen for patients with acute leukemia would result in a significant reduction in chronic GVHD 2 years after allogeneic peripheral-blood stem-cell transplantation from an HLA-identical sibling. METHODS We conducted a prospective, multicenter, open-label, randomized phase 3 study of ATG as part of …

Male:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models Statistical::Proportional Hazards Models [Medical Subject Headings]T-LymphocytesPhases of clinical researchGraft vs Host Disease:Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings]Linfocitos t:Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings]Immunosuppressive Agent0302 clinical medicineTrasplante homólogoEstudios prospectivosMedicineCumulative incidenceProspective StudiesProspective cohort studyChildTransplantation Homologou:Chemicals and Drugs::Amino Acids Peptides and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Immune Sera::Antilymphocyte Serum [Medical Subject Headings]Acute leukemia:Anatomy::Cells::Blood Cells::Leukocytes::Leukocytes Mononuclear::Lymphocytes::T-Lymphocytes [Medical Subject Headings]:Diseases::Pathological Conditions Signs and Symptoms::Pathologic Processes::Disease Attributes::Chronic Disease [Medical Subject Headings]:Named Groups::Persons::Age Groups::Child::Child Preschool [Medical Subject Headings]Medicine (all)IncidenceSuero antilinfocíticoGeneral MedicineMiddle AgedModelos de riesgos proporcionales3. Good healthHumanosSurvival Rate030220 oncology & carcinogenesis:Named Groups::Persons::Age Groups::Adolescent [Medical Subject Headings]Child PreschoolFemale:Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Immunologic Factors::Immunosuppressive Agents [Medical Subject Headings]Immunosuppressive AgentsHumanHomologousAdultmedicine.medical_specialty:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings]:Named Groups::Persons::Age Groups::Adult::Young Adult [Medical Subject Headings]AdolescentEnfermedad injerto contra huéspedDisease-Free Survival03 medical and health sciencesYoung AdultInternal medicine:Named Groups::Persons::Age Groups::Adult [Medical Subject Headings]HumansTransplantation HomologousSupervivencia sin enfermedadPreschoolSurvival rate:Analytical Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Disease-Free Survival [Medical Subject Headings]:Named Groups::Persons::Age Groups::Child [Medical Subject Headings]Antilymphocyte SerumProportional Hazards ModelsTransplantationbusiness.industryEnfermedad crónicamedicine.diseaseInmunosupresoresAnti-thymocyte globulinSurgeryTransplantation:Diseases::Immune System Diseases::Graft vs Host Disease [Medical Subject Headings]Prospective Studie:Analytical Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures Operative::Transplantation::Transplantation Homologous [Medical Subject Headings]Graft-versus-host diseaseT-Lymphocyte:Check Tags::Female [Medical Subject Headings]Chronic DiseaseProportional Hazards ModelAdolescent; Adult; Antilymphocyte Serum; Child; Child Preschool; Chronic Disease; Disease-Free Survival; Female; Graft vs Host Disease; Humans; Immunosuppressive Agents; Incidence; Male; Middle Aged; Proportional Hazards Models; Prospective Studies; Survival Rate; T-Lymphocytes; Transplantation Homologous; Young Adult; Medicine (all)business030215 immunology
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