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  1. Article ; Online: Genital chronic graft-versus-host disease: an unmet need that requires trained gynecologists.

    Martínez-Maestre, M Á / Castelo-Branco, C / Calderón, A M / Espigado, I / Pérez-Simón, J A / González-Cejudo, C

    Climacteric : the journal of the International Menopause Society

    2024  Volume 27, Issue 3, Page(s) 275–281

    Abstract: Objective: Menopause and chronic graft-versus-host disease (cGvHD) are the leading causes of morbidity after allogeneic hematopoietic stem cell transplantation (alloHSCT). Genitalia are one of the target organs of cGvHD causing sexual dysfunction and ... ...

    Abstract Objective: Menopause and chronic graft-versus-host disease (cGvHD) are the leading causes of morbidity after allogeneic hematopoietic stem cell transplantation (alloHSCT). Genitalia are one of the target organs of cGvHD causing sexual dysfunction and local symptoms, which may impair women's quality of life. The aim of this study is to describe the prevalence and clinical characteristics of genital cGvHD.
    Methods: A retrospective cross-sectional observational study was performed including 85 women with alloHSCT. All women were diagnosed and counseled by a trained gynecologist. Health-related quality of life was assessed by the Cervantes Short-Form Scale and sexual function was evaluated by the Female Sexual Function Index.
    Results: Seventeen women (20%) included in the study were diagnosed with genital cGvHD. The main complaints were vulvovaginal dryness (42.2%) and dyspareunia (29.4%), the presence of erythema/erythematous plaques (52.9%) being the most frequent sign. Median time from transplant to diagnosis of genital cGvHD was 17 months among those with mild involvement, 25 months for moderate and 42 months for severe forms. Mortality was 29.4% in patients who developed cGvHD with genital involvement versus 8.8% among those without (
    Conclusion: Early gynecological evaluation might allow to identify patients with mild forms of genital cGvHD, potentially enabling better management and improved outcomes.
    MeSH term(s) Humans ; Female ; Graft vs Host Disease/diagnosis ; Cross-Sectional Studies ; Retrospective Studies ; Hematopoietic Stem Cell Transplantation/adverse effects ; Middle Aged ; Adult ; Quality of Life ; Genital Diseases, Female/etiology ; Chronic Disease ; Sexual Dysfunction, Physiological/etiology ; Sexual Dysfunction, Physiological/epidemiology ; Gynecology ; Dyspareunia/etiology ; Dyspareunia/epidemiology ; Prevalence ; Bronchiolitis Obliterans Syndrome ; Gynecologists
    Language English
    Publishing date 2024-02-28
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 1469153-x
    ISSN 1473-0804 ; 1369-7137
    ISSN (online) 1473-0804
    ISSN 1369-7137
    DOI 10.1080/13697137.2024.2314521
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    Zs.A 5245: Show issues Location:
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  2. Article: Coste-efectividad del tratamiento antifúngico empírico de pacientes hematológicos con alto riesgo de infección fúngica invasora.

    Espigado, I

    Farmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria

    2008  Volume 32, Issue 1, Page(s) 4–6

    Title translation Cost-effectiveness of empirical antifungal treatment of haematology patients with a high risk of invasive fungal infection.
    MeSH term(s) Antifungal Agents/economics ; Antifungal Agents/therapeutic use ; Cost-Benefit Analysis ; Empirical Research ; Hematologic Diseases/drug therapy ; Hematologic Diseases/economics ; Hematologic Diseases/microbiology ; Humans ; Mycoses/complications ; Mycoses/drug therapy ; Mycoses/economics ; Risk Factors ; Severity of Illness Index
    Chemical Substances Antifungal Agents
    Language Spanish
    Publishing date 2008-03-11
    Publishing country Spain
    Document type Editorial
    ZDB-ID 1122680-8
    ISSN 2171-8695 ; 1130-6343
    ISSN (online) 2171-8695
    ISSN 1130-6343
    DOI 10.1016/s1130-6343(08)72803-4
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    Zs.A 3450: Show issues Location:
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  3. Article ; Online: Ofatumumab as part of reduced intensity conditioning in high risk B-cell lymphoma patients: final long-term analysis from a prospective multicenter Phase-II Trial.

    Cabrero, Mónica / López-Corral, Lucia / Jarque, Isidro / de la Cruz-Vicente, Fátima / Pérez-López, Estefanía / Valcárcel, David / Sanz, Jaime / Espigado, Ildefonso / Ortí, Guillermo / Martín-Calvo, Carmen / de la Serna, Javier / Caballero, Dolores

    Bone marrow transplantation

    2024  Volume 59, Issue 3, Page(s) 359–365

    Abstract: Curative potential of allogeneic transplantation (AlloSCT) in high-risk non-Hodgkin lymphoma (NHL) could be enhanced by the integration of Ofatumumab (OFA), a 2nd generation anti-CD20 moAb, due to an antitumor effect and a role over graft-versus-host ... ...

    Abstract Curative potential of allogeneic transplantation (AlloSCT) in high-risk non-Hodgkin lymphoma (NHL) could be enhanced by the integration of Ofatumumab (OFA), a 2nd generation anti-CD20 moAb, due to an antitumor effect and a role over graft-versus-host disease (GVHD). In this phase II trial (NCT01613300), we investigated safety and effectiveness of OFA-based reduced intensity conditioning (RIC). High-risk B-cell NHL patients with chemorrefractory disease or post-autologous SCT relapse were eligible. OFA was added to a standard RIC regimen. Primary endpoint was grade 3-4 aGVHD rate, while secondary endpoints included CR and survival rates. Thirty-three patients were included (median age 51; diffuse large B-cell:68%, HLA-identical donor: 74%). No grade >2 OFA toxicity was observed. Acute GVHD affected 77% of patients (16% grade 3-4). Remarkably, GVHD achieved CR in 75% of patients after first-line treatment. Chronic GVHD, primarily mild or moderate, occurred in 54% of patients. NHL CR rate at day +100 was 81%. Relapses occurred in 7 patients after a median of 3 months. Causes of death were lymphoma progression (5), infections (10), and GVHD (2). At 24 months, progression-free and overall survival rates were 50.1 and 51.6% respectively. OFA-RIC regimen is safe and effective, though acute GVHD remains a significant complication. However, data suggest that OFA could mitigate its severity.
    MeSH term(s) Humans ; Middle Aged ; Disease-Free Survival ; Prospective Studies ; Neoplasm Recurrence, Local ; Lymphoma, B-Cell/drug therapy ; Lymphoma, Non-Hodgkin/therapy ; Graft vs Host Disease/etiology ; Transplantation Conditioning/adverse effects ; Hematopoietic Stem Cell Transplantation ; Antibodies, Monoclonal, Humanized
    Chemical Substances ofatumumab (M95KG522R0) ; Antibodies, Monoclonal, Humanized
    Language English
    Publishing date 2024-01-02
    Publishing country England
    Document type Clinical Trial, Phase II ; Multicenter Study ; Journal Article
    ZDB-ID 632854-4
    ISSN 1476-5365 ; 0268-3369 ; 0951-3078
    ISSN (online) 1476-5365
    ISSN 0268-3369 ; 0951-3078
    DOI 10.1038/s41409-023-02171-5
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    Zs.A 2168: Show issues Location:
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  4. Article ; Online: Mortality of Oncohematological Patients Undergoing Hematopoietic Stem Cell Transplantation Admitted to the Intensive Care Unit.

    Corcía Palomo, Y / Knight Asorey, T / Espigado, I / Martín Villén, L / Garnacho Montero, J

    Transplantation proceedings

    2015  Volume 47, Issue 9, Page(s) 2665–2666

    Abstract: Background: Both autologous and allogenic hematopoietic stem cell transplantation (HSCT) are potentially curative treatments for hematological malignancies. Patients with related complications may need admission to the intensive care unit (ICU) for ... ...

    Abstract Background: Both autologous and allogenic hematopoietic stem cell transplantation (HSCT) are potentially curative treatments for hematological malignancies. Patients with related complications may need admission to the intensive care unit (ICU) for specific therapy and organ support. A consensus on treatment between hematologists and intensive care specialists is essential.
    Methods: This observasional, retrospective study included all recipients of HSCT in a third-level hospital during 2013 and 2014. Certain parameters were taken into account for patients who needed to be admitted to the ICU, evolution, and ICU and hospital mortality.
    Results: A total of 228 HSCT were carried out: 127 autologous (55.7%) and 101 allogenic (44.3%). Twenty-four patients were admitted to the ICU; 22 had received allogenic HSCT and 2 autologous. The main underlying conditions were acute leukemias (41.6%) and myelodysplastic syndromes (20.8%). Of these patients, 45.8% were in complete remission and 33.3% were in relapse or progression. Causes of admission to the ICU were mainly respiratory failure (70.8%) followed by shock requiring vasoactive drugs. High values for severity scores were observed for APACHE II 25 (19-28) and SOFA 10 (8-14). During hospitalization, a high percentage of patients had hemodynamic (91.7%), renal (87.5%), hepatic (79.2%), and respiratory (87.5%) failure. Mortality in the ICU was 83.3% and hospitalary, 91.7%. All patients requiring invasive mechanical ventilation died in the ICU.
    Conclusions: Of recipient patients of allogenic HSCT, 21.8% were admitted to the ICU, presenting a mortality rate of >95%. The main reason for admission was respiratory failure with requirement of invasive mechanical ventilation. Patients with autologous HSCT presented very few complications needing organ support.
    MeSH term(s) Adult ; Female ; Hematologic Neoplasms/mortality ; Hematologic Neoplasms/surgery ; Hematopoietic Stem Cell Transplantation ; Hospital Mortality/trends ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Patient Admission ; Retrospective Studies ; Spain/epidemiology ; Survival Rate/trends
    Language English
    Publishing date 2015-11
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 82046-5
    ISSN 1873-2623 ; 0041-1345
    ISSN (online) 1873-2623
    ISSN 0041-1345
    DOI 10.1016/j.transproceed.2015.09.033
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  5. Article ; Online: SF3B1, RUNX1 and TP53 Mutations Significantly Impact the Outcome of Patients With Lower-Risk Myelodysplastic Syndrome.

    Falantes, Jose F / Márquez-Malaver, Francisco J / Carrillo, Estrella / Culebras, Marta García / Morales, Rosario / Prats, Concepción / Vargas, Maria T / Caballero, Teresa / Rodríguez-Arbolí, Eduardo / Espigado, Ildefonso / Pérez-Simón, Jose Antonio

    Clinical lymphoma, myeloma & leukemia

    2022  Volume 22, Issue 12, Page(s) e1059–e1066

    Abstract: Introduction: Prognosis of patients with myelodysplastic syndrome (MDS), particularly the group with lower-risk disease (LR-MDS) is very heterogeneous. Several studies have described the prognostic value of recurrent somatic mutations in MDS including ... ...

    Abstract Introduction: Prognosis of patients with myelodysplastic syndrome (MDS), particularly the group with lower-risk disease (LR-MDS) is very heterogeneous. Several studies have described the prognostic value of recurrent somatic mutations in MDS including all risk categories. Recently, the incorporation of genomic data to clinical parameters defined the new Molecular International Prognostic Scoring System (IPSS-M).
    Materials and methods: In this study, we evaluated the impact of molecular profile in a series of 181 patients with LR-MDS and non-proliferative chronic myelomonocytic leukemia.
    Results: Epigenetic regulators (TET2, ASXL1) and splicing (SF3B1) were the most recurrent mutated pathways. In univariate analysis, RUNX1 or TP53 mutations correlated with lower median overall survival (OS). In contrast, SF3B1 mutation was associated with prolonged median OS [95 months (95% IC, 32-157) vs. 33 months (95% CI, 19-46) in unmutated patients (P < 0.01)]. In a multivariate Cox regression model, RUNX1 mutations independently associated with shorter OS, while SF3B1 mutation retained its favorable impact on outcome (HR: 0.24, 95% CI, 0.1-0.5; P = 0.001). In addition, TP53 or RUNX1 mutations were identified as predictive covariates for the probability of leukemic progression (P < 0.001).
    Conclusion: Incorporation of molecular testing in LR-MDS identified a subset of patients with expected poorer outcome, either due to lower survival or probability of leukemic progression.
    MeSH term(s) Humans ; Core Binding Factor Alpha 2 Subunit/genetics ; Myelodysplastic Syndromes/genetics ; Mutation ; Prognosis ; Leukemia, Myelomonocytic, Chronic ; Tumor Suppressor Protein p53/genetics ; RNA Splicing Factors/genetics ; Phosphoproteins/genetics
    Chemical Substances Core Binding Factor Alpha 2 Subunit ; TP53 protein, human ; Tumor Suppressor Protein p53 ; RUNX1 protein, human ; SF3B1 protein, human ; RNA Splicing Factors ; Phosphoproteins
    Language English
    Publishing date 2022-08-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2540992-X
    ISSN 2152-2669 ; 2152-2650
    ISSN (online) 2152-2669
    ISSN 2152-2650
    DOI 10.1016/j.clml.2022.08.012
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    Zs.A 5903: Show issues Location:
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  6. Article ; Online: Differences in stem cell transplantation activity among regions in Spain: an economic explanation.

    Espigado, I / Ortega-Ortega, M / Montero-Granados, R / Rodriguez-Torres, N / Márquez-Malaver, F J

    Bone marrow transplantation

    2016  Volume 51, Issue 11, Page(s) 1537–1539

    Language English
    Publishing date 2016-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 632854-4
    ISSN 1476-5365 ; 0268-3369 ; 0951-3078
    ISSN (online) 1476-5365
    ISSN 0268-3369 ; 0951-3078
    DOI 10.1038/bmt.2016.177
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  7. Article ; Online: Allogeneic hematopoietic stem cell transplant recipients in Spain: Human leukocyte antigen characteristics and diversity by high-resolution analysis.

    Guerreiro, Manuel / Planelles, Dolores / Aguilar-Gallardo, Cristóbal / Lorenzo, José Ignacio / Montoro, Juan / Sanz, Jaime / Balaguer, Aitana / Gómez, Inés / Solves, Pilar / Pérez, Ariadna / Blanquer, Miguel / Espigado, Ildefonso / Solano, Carlos / Piñana, José Luis

    HLA

    2021  Volume 97, Issue 3, Page(s) 198–213

    Abstract: There are many studies on the polymorphism of the HLA system in healthy donor populations, such as registries of unrelated bone marrow donors. Investigations on the characterization of the HLA complex in hematopoietic stem cell transplant (HSCT) patients, ...

    Abstract There are many studies on the polymorphism of the HLA system in healthy donor populations, such as registries of unrelated bone marrow donors. Investigations on the characterization of the HLA complex in hematopoietic stem cell transplant (HSCT) patients, however, are scarce, at least in the Spanish population. This study presents a large-scale analysis of allelic diversity and HLA distribution at a high-resolution level in 2886 patients undergoing HSCT in Spanish centres of the "Grupo Español de Trasplante Hematopoyético y Terapia Celular" during a period of 11 years. Allelic diversity analysis identified 67 HLA-A, 133 HLA-B, 60 HLA-C, 63 HLA-DRB1, 24 HLA-DQB1 and 27 HLA-DPB1 different alleles. Rare alleles were detected among which 33 alleles had not been reported in the European catalog of common and well-documented HLA alleles. Regarding the distribution of five genes-haplotypes, it was observed that the five most frequent extended haplotypes found in our population were between the most common in other Spanish populations, both in patients and in healthy subjects. However, some particular haplotypes were also detected. Bilocus associations HLA-C ~ B and -DRB1 ~ DQB1 were analyzed in order to predict the probability of finding 10/10 matched donors in registries. We found HLA-B alleles showing a great diversity of combinations with HLA-C alleles and unusual associations involving a negative predicting factor. In the field of adoptive therapies, our work supports the necessity to expand further research of TCR-engineered cells, adoptive transfer of virus-specific T-cells and vaccines to target HLA alleles other than A*02:01. HLA alleles such as A*01:01, A*03:01, A*24:02, B*44:03, B*07:02 or B*51:01, might be considered new targets due to its high frequency in our population.
    MeSH term(s) Alleles ; Gene Frequency ; HLA-A Antigens/genetics ; HLA-B Antigens/genetics ; HLA-DRB1 Chains ; Haplotypes ; Hematopoietic Stem Cell Transplantation ; Humans ; Spain
    Chemical Substances HLA-A Antigens ; HLA-B Antigens ; HLA-DRB1 Chains
    Language English
    Publishing date 2021-01-17
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2845111-9
    ISSN 2059-2310 ; 2059-2302
    ISSN (online) 2059-2310
    ISSN 2059-2302
    DOI 10.1111/tan.14179
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    Zs.A 661: Show issues Location:
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  8. Article ; Online: Posicionamiento y actitudes de manejo sobre la profilaxis antifúngica en el paciente hematológico (proyecto PROMIC).

    Vázquez López, L / Villaescusa de la Rosa, T / de la Cámara, R / Espigado, I / Grau Cerrato, S / Jurado, M / Rovira, M / Salavert, M / Serrano Simonneau, D / Solano Vercet, C / Ruiz Camps, I

    Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia

    2017  Volume 30, Issue 3, Page(s) 213–223

    Abstract: Objective: Invasive fungal disease (IFD) is an important cause of morbidity and mortality in haematological patients. Antifungal prophylaxis (AFP) is indicated for a number of clinical scenarios in this group of patients. The aim of this study was to ... ...

    Title translation Consensus opinion on antifungal prophylaxis in haematologic patients: Results of the PROMIC project.
    Abstract Objective: Invasive fungal disease (IFD) is an important cause of morbidity and mortality in haematological patients. Antifungal prophylaxis (AFP) is indicated for a number of clinical scenarios in this group of patients. The aim of this study was to reach a consensus on IFD prophylaxis in haematological patients in order to optimize their management.
    Methods: A committee of experts in haematology and infectious diseases compiled a survey of 79 items with controversial aspects about antifungal prophylaxis in haematological patients. The survey was evaluated in two rounds by a panel of experts following a modified Delphi methodology.
    Results: Forty-four experts in haematology and infectious diseases answered the survey. After two evaluation rounds, consensus was reached in 67 of the 79 items (84.8%), specifically 48 items were consensually agreed on (60.7%) and 19 were disagreed on (24.0%). Consensus was reached on prophylaxis candidates profiles and questions related to indications, mechanisms of action, spectrum of activity, toxicity and interactions of antifungal were elucidated. The usefulness of micafungin in IFD prophylaxis was particularly analysed. The consensus reached was that micafungin is an antifungal to be considered in this context as its safety profile and lower interaction potential may be advantageous.
    Conclusions: A broad consensus was found in the management of IFD prophylaxis in the haematological patient. This consensus provides practical indications about its optimal management and can help determine the profile of patients eligible for this type of intervention.
    Language Spanish
    Publishing date 2017-06
    Publishing country Spain
    Document type English Abstract ; Journal Article
    ZDB-ID 1018135-0
    ISSN 1988-9518 ; 0214-3429
    ISSN (online) 1988-9518
    ISSN 0214-3429
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  9. Article ; Online: Role of second hematopoietic stem cell transplantation in relapsed or refractory hematologic malignancies.

    Falantes, J F / Carrillo, E / Márquez, F / Carmona, M / Espigado, I

    Transplantation proceedings

    2010  Volume 42, Issue 8, Page(s) 3225–3227

    Abstract: Prognosis of patients relapsing after stem cell transplantation (SCT) is poor if no further treatment is given. A second SCT is a limited option in these high-risk patients. We retrospectively analyzed the outcomes of second SCT in acute myeloid leukemia, ...

    Abstract Prognosis of patients relapsing after stem cell transplantation (SCT) is poor if no further treatment is given. A second SCT is a limited option in these high-risk patients. We retrospectively analyzed the outcomes of second SCT in acute myeloid leukemia, myelodysplastic syndrome, and acute lymphoblastic leukemia after a first SCT. Twenty-five of 30 patients received second allogeneic SCT. Variables related to survival were disease status before second allogeneic SCT and time interval between transplants more than 1 year (P<.01 and P<.02 in multivariate analysis). Treatment-related mortality was 33% with no impact of the conditioning regimen on overall survival. Second allogeneic SCT in selected patients may be an option in this group with a poor outcome.
    MeSH term(s) Cohort Studies ; Hematologic Neoplasms/surgery ; Hematopoietic Stem Cell Transplantation ; Humans ; Prognosis ; Recurrence ; Survival Rate
    Language English
    Publishing date 2010-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 82046-5
    ISSN 1873-2623 ; 0041-1345
    ISSN (online) 1873-2623
    ISSN 0041-1345
    DOI 10.1016/j.transproceed.2010.05.045
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  10. Article ; Online: T-cells immune response controls the high incidence of adenovirus infection in adult allogenic hematopoietic transplantation recipients.

    Sánchez-Céspedes, Javier / Marrugal-Lorenzo, José Antonio / Martín-Gandul, Cecilia / Rodríguez-Torres, Nancy / Montero-Mateos, Enrique / Serna-Gallego, Ana / Escamilla-Gómez, Virginia / Merino, Laura / Espigado, Ildefonso / Pachón, Jerónimo / Pérez-Simón, José Antonio / Aguilar-Guisado, Manuela

    Haematologica

    2021  Volume 106, Issue 1, Page(s) 275–278

    MeSH term(s) Adenoviridae Infections/epidemiology ; Adult ; Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Immunity ; Incidence ; T-Lymphocytes
    Language English
    Publishing date 2021-01-01
    Publishing country Italy
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 2333-4
    ISSN 1592-8721 ; 0017-6567 ; 0390-6078
    ISSN (online) 1592-8721
    ISSN 0017-6567 ; 0390-6078
    DOI 10.3324/haematol.2019.240101
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