Publications by authors named "Antonio Perez-Martinez"

Ruxolitinib has been approved for the treatment of adults and pediatric patients ≥12 years with steroid refractory graft-versus-host disease (GvHD). However, real-life studies are needed to confirm the results of clinical trials and further assess its efficacy in special populations. We performed a descriptive, retrospective, multi-center study of 352 adults and 42 pediatric patients treated with ruxolitinib for steroid-refractory acute or chronic GvHD.

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We analyzed here how formin-like 1 β (FMNL1β), an actin cytoskeleton-regulatory protein, regulates microtubule-organizing center (MTOC) and multivesicular bodies (MVB) polarization and exosome secretion at an immune synapse (IS) model in a phosphorylation-dependent manner. IS formation was associated with transient recruitment of FMNL1β to the IS, which was independent of protein kinase C δ (PKCδ). Simultaneous RNA interference of all FMNL1 isoforms prevented MTOC/MVB polarization and exosome secretion, which were restored by FMNL1βWT expression.

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Article Synopsis
  • Immune effector cell-associated hematotoxicity (ICAHT) is a common complication in CAR-T cell therapy, leading to significant thrombocytopenia in about one-third of patients, often necessitating platelet transfusions.
  • Eltrombopag, a thrombopoietin receptor agonist, was evaluated in a study involving 38 patients from 10 hospitals in Spain who developed platelet transfusion dependence after CAR-T treatment.
  • The results showed that 76.3% of patients achieved platelet transfusion independence after using eltrombopag, with additional improvements noted in neutrophil and red blood cell counts, and no serious side effects reported.
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Background: The aim of this study was to assess the contribution of the reflective multidisciplinary discussion in determining the value contribution of innovative drugs through the multi-criteria decision analysis (MCDA). This methodology considers all relevant criteria for healthcare decision-making in a global, transparent, and systematic manner and from the perspective of relevant stakeholders. The determination of value contribution of tabelecleucel for the treatment of Epstein-Barr virus-positive post-transplant lymphoproliferative disease (EBV PTLD) compared to salvage therapy was used as an example.

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Chimeric antigen receptor (CAR)-T cell therapy is approved for the treatment of relapsed/refractory (R/R) large B cell lymphoma (LBCL). However, elderly patients might not be candidates for this therapy due to its toxicity, and criteria for candidate selection are lacking. Our aim was to analyze efficacy and toxicity results of CAR-T cell therapy in the population of patients 70 years and older as compared to those obtained in younger patients in the real-world setting.

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Haploidentical stem cell transplantation (Haplo-SCT) and cord blood transplantation (CBT) are both effective alternative treatments in patients suffering from acute myeloid leukemia (AML) and lacking a matched HLA donor. In the last years, many centers have abandoned CBT procedures mostly due to concern about poorer immune recovery compared with Haplo-SCT. We conducted a retrospective multicenter study comparing the outcomes using both alternative approaches in AML.

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Memory T selected cells (CD45RA/RO) as donor lymphocyte infusion are less capable of producing alloreactivity and graft versus host disease (GvHD) compared with naïve T cells. The objective of this study was to evaluate the safety and efficacy of high-dose memory (CD45RA/RO) donor lymphocyte infusion (mDLI) after allogeneic hematopoietic cell transplantation (HCT). Indications for mDLI were "as needed" and "as prophylactic regimen.

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The short-lived nature and heterogeneity of Natural Killer (NK) cells limit the development of NK cell-based therapies, despite their proven safety and efficacy against cancer. Here, we describe the biological basis, detailed phenotype and function of long-lived anti-tumour human NK cells (CD56CD16), obtained without cell sorting or feeder cells, after priming of peripheral blood cells with Bacillus Calmette-Guérin (BCG). Further, we demonstrate that survival doses of a cytokine combination, excluding IL18, administered just weekly to BCG-primed NK cells avoids innate lymphocyte exhaustion and leads to specific long-term proliferation of innate cells that exert potent cytotoxic function against a broad range of solid tumours, mainly through NKG2D.

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Article Synopsis
  • Pediatric hematopoietic stem cell transplant recipients are at high risk for infections, particularly nontuberculous mycobacteria.
  • A study reports six cases of disseminated or pulmonary infections in five children, mostly caused by Mycobacterium avium complex.
  • Out of the five patients, four died, with two deaths directly linked to the mycobacterial infections.
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  • * It typically forms in the long bones and rarely spreads to distant sites, but when it does, it can lead to serious outcomes.
  • * In this report, two patients with periosteal ES were treated successfully, but one developed lung metastases and passed away 5 years later, while the other remained disease-free for 26 years despite having a late metastasis.
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This retrospective study evaluated 35 children (median age 5.2 years; range 0.4-18) with myelofibrosis (MF), including 33 with primary myelofibrosis and 2 with secondary myelofibrosis transplanted from matched sibling donor (MSD) (n = 17) or non-MSD (n = 18) between 2000 and 2022.

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Allogeneic haematopoietic cell transplantation (allo-HCT) remains an option for tyrosine kinase inhibitor-resistant chronic myeloid leukaemia (CML) in first chronic phase (CP1) and high-risk patients with advanced disease phases. In this European Society for Blood and Marrow Transplantation (EBMT) registry-based study of 1686 CML patients undergoing first allo-HCT between 2012 and 2019, outcomes were evaluated according to donor type, particularly focusing on mismatched related donors (MMRDs). Median age at allo-HCT was 46 years (IQR 36-55).

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Introduction: Total body irradiation (TBI) is part of the myeloablative conditioning for hematopoietic stem cell transplantation (HSCT) in malignant hematologic disorders. This therapy has recently shown improved survival in acute lymphoblastic leukemia (ALL) compared to chemotherapy-based regimens. However, side effects are a significant limitation, especially in the pediatric population.

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Transplantation-associated thrombotic microangiopathy (TA-TMA) is associated with high morbidity and mortality. Although survival has improved significantly with the introduction of eculizumab, the need for improvement remains, especially in high-risk patients. This study aimed to describe the results obtained with eculizumab in a pediatric cohort with the attempt to define which risk factors could determine the response to treatment.

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The present article describes the protocol of a mixed-methods study (an observational cohort design and focus groups), aimed to examine neuropsychological functioning and other biopsychosocial outcomes, therapeutic adherence and unmet care needs in paediatric population undergoing solid organ or allogeneic hematopoietic transplant during the pre- and post-transplant phases. Following a multi-method/multi-source approach, neuropsychological domains will be comprehensively measured with objective tests (SDMT, K-CPT 2/CPT 3, TAVECI/TAVEC, WISC-V/WAIS-IV Vocabulary and Digit Span subtests, Verbal Fluency tests, Stroop, ROCF, and TONI-4); ecological executive functioning, affective and behavioral domains, pain intensity/interference, sleep quality and therapeutic adherence will be assessed through questionnaires (parent/legal guardians-reported: BRIEF-2 and BASC-3; and self-reported: BASC-3, BPI, PROMIS, AIQ and SMAQ); and blood levels of prescribed drugs will be taken from each patient's medical history. These outcomes will be measured at pre-transplant and at 4-weeks and 6-months post-transplant phases.

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Article Synopsis
  • Hematopoietic stem cell transplantation (HCT) is an effective treatment for chronic granulomatous disease (CGD) in children, but it carries risks of complications and varying benefits depending on donor type.
  • A study of 30 pediatric patients showed a graft failure rate of 28.26% and chronic graft-versus-host disease (GVHD) in 20.5%, with higher risks for those who received transplants from unrelated donors compared to sibling donors.
  • Overall, the 2-year overall survival rate was 77.3%, but careful consideration of donor type and post-transplant care is crucial due to the potential for significant morbidity and mortality.
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Background: Hematopoietic stem cell transplantation (HSCT) is a procedure with high morbidity and mortality. Identifying patients for maximum benefit and risk assessment is crucial in the decision-making process. This has led to the development of predictive risk models for HSCT in adults, which have limitations when applied to pediatric population.

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Chimeric antigen receptor (CAR) T-cell therapy is a breakthrough in hematologic malignancies, such as acute B lymphoblastic leukemia (B-ALL). Monitoring this treatment is recommended, although standardized protocols have not been developed yet. This work compares two flow cytometry monitoring strategies and correlates this technique with qPCR method.

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  • Loss of B-cell aplasia (BCA) is linked to the effectiveness of CD19 CAR-T therapy for B-cell acute lymphoblastic leukemia, with most relapses occurring in the first months post-infusion, particularly in patients with high tumor burden (HTB).
  • A study of 73 patients showed that those with HTB had significantly lower event-free survival (EFS) rates (19.3%) compared to those with low tumor burden (LTB) (67.2%), and relapses were more likely to be CD19-negative in the HTB group.
  • The findings suggest that BCA loss is associated with a higher risk of CD19-positive relapses and that patients with HTB might benefit from additional
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  • The Helios protein, part of the Ikaros transcription family, is being studied as a potential biomarker for the progression of systemic lupus erythematosus (SLE) in both mouse models and human patients.
  • Research is focusing on Helios's impact on T regulatory (Treg) cells, with changes in these cells linked to autoimmune issues.
  • The review also explores the role of Helios in immune interactions and the potential for new therapies, including immunosuppressive cell transfer and using nanotechnology for targeted treatments.
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Introduction: Refractory/relapsed pediatric acute leukemia are still clinically challenging and new therapeutic strategies are needed. Interactions between Natural Killer Group 2D (NKG2D) receptor, expressed in cytotoxic immune cells, and its ligands (NKG2DL), which are upregulated in leukemic blasts, are important for anti-leukemia immunosurveillance. Nevertheless, leukemia cells may develop immunoescape strategies as NKG2DL shedding and/or downregulation.

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  • Epithelioid sarcoma (EpS) is a rare and aggressive soft-tissue cancer mostly seen in adolescents and young adults, with a high mortality rate of about 50% despite aggressive treatment approaches.
  • EpS has two main subtypes: a less aggressive distal (classic) type and a more dangerous proximal type, both characterized by a typical loss of the INI1 protein due to genetic changes.
  • Recent advancements, like the approval of the EZH2 inhibitor tazemetostat and efforts in developing immunotherapy, have shown limited success, highlighting the urgent need for new targeted therapies and the establishment of a collaborative research community to drive progress.
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Background Aims: There are currently no effective anti-viral treatments for coronavirus disease 2019 (COVID-19)-hospitalized patients with hypoxemia. Lymphopenia is a biomarker of disease severity usually present in patients who are hospitalized. Approaches to increasing lymphocytes exerting an anti-viral effect must be considered to treat these patients.

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