- Email: [email protected]
Routine CMV Surveillance in Autologous Hematopoietic Cell Transplantation Setting: is It Time for Rethink?
Abstracts contains more than one putative binding sites for YY1. There was an inverse correlation between the expression of YY1 and Bax in the cell lines as examined by western blots. ChIP analysis demonstrated that YY1 was bound into the Bax promoter. Conclusion and Future Directions: The findings revealed that the overexpression of YY1 in B-NHL is responsible for proapoptotic Bax gene downregulation, hence, in the promoting of resistance. These results clarify our prior findings, which revealed that the inhibition of YY1 in B-NHL sensitized the resistant cells to apoptosis by chemoimmunotherapeutic drugs. Thus, YY1 inhibition may reverse resistance and inhibit relapses of patients with B-NHL. In addition, analysis of the expression levels of YY1 in B-NHL patients may select subgroups of responding and non-responding patients to design personalized therapies. Currently, (1) we are delineating the exact YY1-binding site on the Bax promoter (2) analyzing the correlation between YY1 and Bax expressions in B-NHL patient’s tissues and (3) developing specific YY1 chemical inhibitors for sensitization of resistant tumor cells to conventional therapies. Acknowledgment: This work was supported in part by the Lega Italiana per la Lotta contro i Tumori (LILT).
two (1.2%) patients (pneumonia and esophagitis). On patients (0.6%) died as a direct consequence of CMV pneumonia. Conclusions: Routine CMV surveillance in AHCT setting is not indicated in patients without traditionally defined risk factors. But this policy may result a higher than expected rate of CMV reactivation following AHCT in certain parts of the world, where CMV prevalence is higher compared to USA or Europe. Based on our results, it may be logical to state, that CMV surveillance may also be recommended during 60 days following AHCT in countries with a high CMV prevalence even in patients without high-risk features for reactivation.
RES-058 Attitudes Towards Hematopoietic Stem Cell Transplantation (HSCT) Differences Between Physicians and Nurses Oren Pasvolsky , Uri Rozovski, Pia Raanani, Moshe Yeshurun Institute of Hematology, Beilinson Hospital, Petah Tikva, Israel
RES-054 Routine CMV Surveillance in Autologous Hematopoietic Cell Transplantation Setting: is It Time for Rethink? Ali Kaya , Emre Tekgündüz, Seval Akpınar, Ömür Kayıkçı, Filiz Bekdemir, Bilge Ugur, Hikmetullah Batgi, Tugce Yigenoglu, Bahar UncuUlu, Mehmet Dal, Dicle _Iskender, Merih Kızıl, Fevzi Altuntas Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Hematology and BMT Clinic, Ankara, Turkey
Background: In autologous hematopoietic cell transplantation (AHCT) setting, routine CMV surveillance is not indicated except in high-risk situations like using T-cell depleted grafts or treatment with fludarabine, alemtuzumab and 2-chlorodeoxyadenosine. CMV prevalence in Turkey is almost 90%. We retrospectively analyzed CMV reactivation and infection rates in patients without any highrisk features, who were treated with AHCT. Patients and Methods: During January 2010-November 2015 all consecutive, CMV seropositive patients receiving AHCT were included. Quantitative CMV-DNA analysis was done using RT-PCR for 60 days following AHCT. CMV-DNA viral loads above the detection limit (> 43/ml) were used to define CMV reactivation. Patient who had certain serum CMV-DNA values (> 1000/ml on one occasion or > two consecutive values > 500/ml) received preemptive ganciclovir. Results: 106 (63%) men and 63 (37%) women were included in the study. The median age of study cohort was 51 (16-71). The indications for AHCT were Hodgkin lymphoma, non-Hodgkin lymphoma and multiple myeloma in 42 (25%), 44 (26%), 83 (49%) patients, respectively. 10 patients received double-AHCT. CMV reactivation occurred in 52 (31%) patients and 13 patients (7.8%) received preemptive treatment. CMV disease developed in
S120
-
Clinical Lymphoma, Myeloma & Leukemia September 2016
Context: Hematopoietic stem cell transplantation (HSCT) is a highly intensive medical procedure and the medical staff at a transplant unit experiences high levels of psychological distress. Since doctors and nurses differ in their clinical training, the level of professional indoctrination and in the duration and nature of exposure to the patients, we hypothesized that they hold different perspective towards the procedure. Objectives: To study the attitude of staff members of a transplant unit towards HSCT, and to determine whether the attitude of nurses and physicians towards HSCT differs. Design: Single center study. Nurses and physicians at our transplant unit were asked to fill out an electronic questionnaire. Five of the items were scenarios, each describing a clinical situation in which transplant is one of the therapeutic options. Following each scenario, participants had to rank on a 1 to 5 Likert Scale whether they would undergo transplant or recommend it to their close relatives or friends under these circumstances, if this were their doctors’ advice. Participants were also asked to rank their level of confidence in the transplant procedure. Demographic details and a work satisfaction questionnaire were also documented. Results: 51 staff members, 23 physicians and 28 nurses, filled out the questionnaire. Demographic data is described in Table1. When asked directly, a significant proportion of both physicians and nurses expressed a low/intermediate level of confidence in allogeneic and autologous HSCT (Figure1). 96% of doctors, but only 50% of nurses expressed a high degree of confidence in reduced intensity conditioning (RIC) HSCT (P¼0.002). When asked if they would undergo transplant or recommend it to their close relatives, in 3 of 5 scenarios presented, significantly more nurses were reluctant to undergo transplantation. Conclusions: In our experience there is a significant proportion of HSCT staff members, both physicians and nurses, whose confidence level in HSCT is not high. Nurses more often tend to consider palliative care and express more critical attitude towards HSCT. This study exposes fundamental differences in the professional views, and we call for open discussions around
two (1.2%) patients (pneumonia and esophagitis). On patients (0.6%) died as a direct consequence of CMV pneumonia. Conclusions: Routine CMV surveillance in AHCT setting is not indicated in patients without traditionally defined risk factors. But this policy may result a higher than expected rate of CMV reactivation following AHCT in certain parts of the world, where CMV prevalence is higher compared to USA or Europe. Based on our results, it may be logical to state, that CMV surveillance may also be recommended during 60 days following AHCT in countries with a high CMV prevalence even in patients without high-risk features for reactivation.
RES-058 Attitudes Towards Hematopoietic Stem Cell Transplantation (HSCT) Differences Between Physicians and Nurses Oren Pasvolsky , Uri Rozovski, Pia Raanani, Moshe Yeshurun Institute of Hematology, Beilinson Hospital, Petah Tikva, Israel
RES-054 Routine CMV Surveillance in Autologous Hematopoietic Cell Transplantation Setting: is It Time for Rethink? Ali Kaya , Emre Tekgündüz, Seval Akpınar, Ömür Kayıkçı, Filiz Bekdemir, Bilge Ugur, Hikmetullah Batgi, Tugce Yigenoglu, Bahar UncuUlu, Mehmet Dal, Dicle _Iskender, Merih Kızıl, Fevzi Altuntas Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Hematology and BMT Clinic, Ankara, Turkey
Background: In autologous hematopoietic cell transplantation (AHCT) setting, routine CMV surveillance is not indicated except in high-risk situations like using T-cell depleted grafts or treatment with fludarabine, alemtuzumab and 2-chlorodeoxyadenosine. CMV prevalence in Turkey is almost 90%. We retrospectively analyzed CMV reactivation and infection rates in patients without any highrisk features, who were treated with AHCT. Patients and Methods: During January 2010-November 2015 all consecutive, CMV seropositive patients receiving AHCT were included. Quantitative CMV-DNA analysis was done using RT-PCR for 60 days following AHCT. CMV-DNA viral loads above the detection limit (> 43/ml) were used to define CMV reactivation. Patient who had certain serum CMV-DNA values (> 1000/ml on one occasion or > two consecutive values > 500/ml) received preemptive ganciclovir. Results: 106 (63%) men and 63 (37%) women were included in the study. The median age of study cohort was 51 (16-71). The indications for AHCT were Hodgkin lymphoma, non-Hodgkin lymphoma and multiple myeloma in 42 (25%), 44 (26%), 83 (49%) patients, respectively. 10 patients received double-AHCT. CMV reactivation occurred in 52 (31%) patients and 13 patients (7.8%) received preemptive treatment. CMV disease developed in
S120
-
Clinical Lymphoma, Myeloma & Leukemia September 2016
Context: Hematopoietic stem cell transplantation (HSCT) is a highly intensive medical procedure and the medical staff at a transplant unit experiences high levels of psychological distress. Since doctors and nurses differ in their clinical training, the level of professional indoctrination and in the duration and nature of exposure to the patients, we hypothesized that they hold different perspective towards the procedure. Objectives: To study the attitude of staff members of a transplant unit towards HSCT, and to determine whether the attitude of nurses and physicians towards HSCT differs. Design: Single center study. Nurses and physicians at our transplant unit were asked to fill out an electronic questionnaire. Five of the items were scenarios, each describing a clinical situation in which transplant is one of the therapeutic options. Following each scenario, participants had to rank on a 1 to 5 Likert Scale whether they would undergo transplant or recommend it to their close relatives or friends under these circumstances, if this were their doctors’ advice. Participants were also asked to rank their level of confidence in the transplant procedure. Demographic details and a work satisfaction questionnaire were also documented. Results: 51 staff members, 23 physicians and 28 nurses, filled out the questionnaire. Demographic data is described in Table1. When asked directly, a significant proportion of both physicians and nurses expressed a low/intermediate level of confidence in allogeneic and autologous HSCT (Figure1). 96% of doctors, but only 50% of nurses expressed a high degree of confidence in reduced intensity conditioning (RIC) HSCT (P¼0.002). When asked if they would undergo transplant or recommend it to their close relatives, in 3 of 5 scenarios presented, significantly more nurses were reluctant to undergo transplantation. Conclusions: In our experience there is a significant proportion of HSCT staff members, both physicians and nurses, whose confidence level in HSCT is not high. Nurses more often tend to consider palliative care and express more critical attitude towards HSCT. This study exposes fundamental differences in the professional views, and we call for open discussions around