Digital Commons Network^™

Definitions Of Arginine Availability: A Critical Metabolic Marker Of Physiological Processes, Mustafa Tosur, Farook Jahoor, Ashok Balasubramanyam

Faculty, Staff and Students Publications

No abstract provided.

Prevalence Of Clinically Relevant Nightmares And Their Differences By Sex And Diagnosis In Psychiatric Inpatients, Katrina A Rufino, Michelle A Patriquin, Courtney B Worley, Michael R Nadorff

Faculty, Staff and Students Publications

Nightmares have been shown to be associated with numerous forms of psychopathology, but the vast majority of this research has taken place in the general population and very little is known about their relation with psychopathology in those requiring inpatient hospitalization. In a sample of 1170 voluntarily admitted psychiatric inpatients, this study explores the frequency of reported nightmares in psychiatric inpatients with the aim of examining the prevalence of psychiatric diagnosis in those with and without clinically relevant nightmares. Participants completed the Disturbing Dream and Nightmare Severity Index (DDNSI) and the Structured Clinical Interview for DSM Disorders (SCID-5) at admission. …

Lessons Learned From An Epic Transformation Of A Radiation Oncology Department In Guatemala: Keys To Success, Edgar Ruiz, Hiram A Gay, Milton Ixquiac, Angel Velarde, Baozhou Sun, Jose García-Ramirez, Eric Laugeman, Benjamin Li, Jeff Michalski, Vicky De Falla, Geoff Hugo, Jacaranda Van Rheenen

Faculty, Staff and Students Publications

Purpose: We describe the radical modernization of a radiation oncology department in a developing country, Guatemala, from 2015 to the beginning of 2024. The Instituto de Cancerología y Hospital Dr. Bernardo del Valle S (INCAN) is the only public radiotherapy clinic serving patient referrals from the Ministry of Public Health and Social Assistance program.

Methods and materials: We describe the state of the radiation oncology department in 2015 versus 2024 while chronicling its gradual transformation. This multifaceted collaboration involved academic centers, government agencies, International Atomic Energy Agency (IAEA), industry, and nonprofits and continues to this day. We analyze the infrastructure, …

Gelatinous Zooplankton As Indicators In The Kunming Montreal Global Biodiversity Framework, John Terenzini, Laura J. Falkenberg, Sanae Chiba, Matthew Faith, Robert Puschendorf, Abigail Mcquatters-Gollop

School of Biological and Marine Sciences

Global biodiversity frameworks require robust, representative indicators to effectively track progress towards conservation targets. Spatial and temporal gaps in global marine biodiversity datasets, however, and a limited number of marine biodiversity indicators, limit our ability to effectively manage marine ecosystems. Despite the ecological and socio-economic significance of marine ecosystems, they remain underrepresented in current indicator suites, particularly in the recently adopted Kunming-Montreal Global Biodiversity Framework (KMGBF). Gelatinous zooplankton (GZ), a key yet often overlooked component of marine ecosystems, have the potential to strengthen biodiversity assessments through their responsiveness to environmental change and impacts on several contributions of the ocean to …

Testing The Transferability Of Ai Models For Cold-Water Coral Detection And Classification, Kyran P. Graves, Louise Allcock, David K.A. Barnes, Amelia E.H. Bridges, Kerry L. Howell

School of Biological and Marine Sciences

The proliferation of accessible deep-water imaging platforms has resulted in the acquisition of vast amounts of image data, resulting in an analysis bottleneck. Object detection is now being applied to assist the image annotation process, with the potential to reduce analysis time. However, for object detectors to effectively tackle the scale of the challenge, models need to be generalisable to allow the transfer between imaging platforms and in space. This study trains YOLOv5 object detection models to identify six coral morphology groups using annotated imagery collected by ROV ISIS in the UK (JC136). Model performance was tested with independent datasets …

Infant Sensory Gating And A Developmental Cascade To Autistic Traits And Anxiety, Rebecca F Schwarzlose

2020-Current year OA Pubs

Disruptions to the infant sensory environment can have lasting effects on neural response properties and behavior in both humans and animals. Recent work has begun to highlight an additional factor in infant sensory experience: differences in inhibitory signaling and sensory gating. Converging work from human and animal studies has begun to implicate a developmental cascade by which impaired sensory gating during a sensitive period of neonatal neurodevelopment promotes a phenotype of sensory over-responsivity, autistic traits, anxiety, and other psychiatric challenges. In this Review, I propose a model for this developmental cascade and highlight how differences in infant sensory responsivity represent …

Characteristics And Outcomes Of Patients With Hematologic Malignancies Hospitalized With Respiratory Viral Infections, Zulfiqar A Lokhandwala, Brenna Park-Egan, Ravneet Waraich, Colleen A Mcevoy, Andrew P Michelson, Alice F Bewley, Lynne Strasfeld, Rachel Cook, Brandon Hayes-Lattin, Catherine L Hough, Patrick G Lyons

2020-Current year OA Pubs

BACKGROUND: Respiratory viral infections in patients with hematologic malignancies or hematopoietic stem cell transplants (HCTs) are associated with increased morbidity and mortality. However, the hospital presentations and courses of these infections remain under-described.

METHODS: We performed a multicenter retrospective cohort study of hospitalized patients with hematologic malignancy or HCT at 2 comprehensive cancer centers between January 2019 and June 2023. We included all patients with acute viral respiratory infection (identified based on a constellation of test results and objective physiology), comparing clinical presentations, care processes, and patient outcomes across pathogens; the primary outcome was the composite of hospital death or …

Steroid Hormone Metabolites And Mammographic Breast Density In Premenopausal Women, Ghazaleh Pourali, Kayode A Matthew, Myung Sik Jeon, Chongliang Luo, Gary J Patti, Jingqin Luo, Adetunji T Toriola

2020-Current year OA Pubs

BACKGROUND: Steroid hormones influence breast morphology and cellular proliferation and are associated with breast carcinogenesis. However, their associations with mammographic breast density (MBD) are less studied, particularly in premenopausal women. We, therefore, investigated the associations of steroid hormone metabolites with MBD in premenopausal women.

METHODS: Our study included 700 premenopausal women scheduled for screening mammograms. We analyzed 54 steroid hormone metabolites (Metabolon®) and assessed volumetric measures of MBD including volumetric percent density (VPD), dense volume (DV), and non-dense volume (NDV) using Volpara. We investigated associations using linear regression modeling to estimate the covariate-adjusted means of VPD, NDV, and DV, corresponding …

Maine Law Magazine - Issue No. 100, University Of Maine School Of Law

Maine Law Magazine

Features

• Maine Law’s Privacy Program Continues to Innovate
  How Maine Law’s privacy and innovation programs are preparing students for emerging legal challenges.

• New Business & Law Clinic
  Strengthening Maine’s economy one startup at a time.

• Global Experiential Learning
  From the Arctic Circle to U.N. climate negotiations, students engage with environmental law where it happens.

• Rural Access to Justice
  The Rural Practice Clinic’s impact on Maine’s growing justice gap.

• Law & Conservation Efforts
  How Maine Law alumni steward change and safeguard the future through environmental advocacy.

• Supporting Maine’s Vulnerable
  The Refugee & Human Rights Clinic expands access to justice across Maine. …

Frontline Aspiration Versus Stent Retriever Thrombectomy For M2 Occlusions: Insights From The Star Registry, Michael Gaub, Joshua Osbun, Et Al.

2020-Current year OA Pubs

BACKGROUND: Recent trials have furthered uncertainty regarding the endovascular benefit for medium vessel occlusions (MeVO). Stent retrievers (SR) were employed in the first attempt in most interventional arm participants. We sought to compare outcomes in acute MCA M2 occlusions between frontline aspiration and SR, and to delineate procedural and anatomical covariates associated with differential treatment effect.

METHODS: Retrospective analysis of a multicenter stroke thrombectomy cohort identified cases of MT for M2 occlusions. Unmatched and propensity score-matched (PSM) cohorts were generated comparing frontline aspiration to standalone and combined SR. The primary outcome was functional independence (mRS 0-2) at 90 days. Recanalization, …

Mapping Functional Connectivity In The Pigeon Brain With Wide-Field Optical Imaging, Kathryn C Chenard, Annie R Bice, Seana H Bice, Joseph P Culver, Paula Gerliz, Xavier Helluy, Onur Güntürkün, Jason W Trobaugh, Mehdi Behroozi, Carlos A Botero

2020-Current year OA Pubs

SIGNIFICANCE: Adapting optical imaging technology to avian models can overcome many limitations imposed by functional magnetic resonance imaging (fMRI), which currently restricts the number of species used to study functional connectivity. Developing advanced technology to expand the diversity of species that can be effectively imaged is crucial for addressing significant questions that are currently unreachable, such as understanding the evolution of cognition from a comparative perspective.

AIM: We assessed the potential of optical imaging technology to measure functional connectivity in birds, utilizing pigeons as an avian model. We evaluated whether we could partition the dorsal surface of the pigeon brain …

The Impact Of Fixation Method And Surgical Approach On Outcomes Following Hip Hemiarthroplasty For Femoral Neck Fracture, Brian D Rust, Mitchel R Obey, Jenna-Leigh Wilson, Christopher M Mcandrew, Marschall B Berkes

2020-Current year OA Pubs

INTRODUCTION: Hip hemiarthroplasty is commonly performed for displaced femoral neck fractures in older adults, with implants placed either cemented or uncemented. While cemented fixation offers immediate stability, uncemented fixation reduces operative time and pulmonary complications. Large single-center analyses comparing these techniques remain limited, and this study aims to assess this.

METHODS: We conducted a retrospective case-control study of 634 adult patients undergoing hip hemiarthroplasty at a single Level 1 trauma center from 2019 to 2025. Patients were classified by cemented (n=403) or uncemented (n=231) fixation and further stratified by surgical approach (anterolateral vs posterior). Outcomes included length of stay, postoperative …

Sonobiopsy For Enrichment Of Circulating Micrornas In Glioma Patients, Jinyun Yuan, Yuanxiang Li, Chih-Yen Chien, Lu Xu, Andrew H Stark, Siaka Fadera, Zhaoning Gu, Yu Xuan Chin, Kevin Xu, Arash Nazeri, Umeshkumar Athiraman, Xiaowei Wang, Hong Chen, Eric C Leuthardt

2020-Current year OA Pubs

BACKGROUND: Sonobiopsy is a promising new technique that employs focused ultrasound (FUS) to noninvasively enrich brain tumor-derived biomarkers from spatially targeted brain location into the bloodstream. Building upon our recent first-in-human sonobiopsy trial demonstrating enrichment of circulating tumor DNA (ctDNA), here we investigated whether sonobiopsy can enhance the release and detection of tumor-derived microRNAs (miRNAs).

METHODS: Eleven patients with glioma underwent FUS sonication immediately prior to surgical resection. Peripheral blood samples were collected 5 min before and 5, 10, and 30 min after sonication. Plasma and brain tissue miRNA levels were quantified through small RNA sequencing and compared among different …

Psychological And Clinical Risk Factors For Substance Use In People With And Without Hiv, Joanna M Hobson, Shameka L Cody, Shannon R Gilstrap, Michael A Owens, Myles D Moody, Dyan M White-Gilliam, Stephen Justin Thomas, Emily J Bartley, Burel R Goodin

2020-Current year OA Pubs

BackgroundDespite growing concerns, limited research has demonstrated how psychological factors influence substance use in people with HIV (PWH). Therefore, we examined the association between heightened vigilance and substance use outcomes in people with (PWH) and without HIV (PWoH), while accounting for key risk factors.MethodsParticipants (n = 138) were recruited from an HIV clinic and the surrounding community, completing a urine drug screener (UDS) and questionnaires.ResultsPWH reported greater insomnia (

Nanoparticle Albumin-Bound Paclitaxel And Nivolumab For Pd-1 Inhibitor-Refractory Recurrent Or Metastatic Head And Neck Squamous-Cell Carcinoma, Douglas Adkins, Jessica C Ley, Christine Auberle, Brendan Knapp, Jesse Zaretsky, Jingxia Liu, Peter Oppelt

2020-Current year OA Pubs

INTRODUCTION: Standard therapy for PD-1 inhibitor-refractory recurrent or metastatic head and neck squamous-cell carcinoma (RM-HNSCC) has limited activity. Drugs bound to albumin selectively target cancer cells with upregulated macropinocytosis, a process driven by constitutively hyper-activated EGFR/RAS/PIK3CA signaling, which is common in HNSCC. Nanoparticle albumin-bound (nab)-paclitaxel is active in PD-1 inhibitor-naïve RM-HNSCC and alters immune cells to potentially prime tumor response and reverse resistance to PD-1 inhibitors.

METHODS: In a single-arm phase 2 trial, patients with PD-1 inhibitor-refractory RM-HNSCC received nab-paclitaxel and nivolumab given in 28-day cycles. The primary endpoint was objective response rate (ORR), using RECIST1.1. Key secondary endpoints were …

Intraoperative Neurophysiological Monitoring In Full-Endoscopic Cervical Endoscopic Ulbd, Miles Hudson, Sarah Esposito, Mark M Zaki, Simon M Glynn, Osama N Kashlan, John Ogunlade, Chandan Krishna, Joshua Bakhsheshian, Christoph P Hofstetter

2020-Current year OA Pubs

No abstract provided.

Preparing For Long-Acting Technologies: A Multistate Analysis Of Prep Persistence And Hiv And Sti Lab Coverage Among Oral Prep Initiators In St. Louis, Missouri (2014-2021), Lindsey M Filiatreau, Rupa Patel, Kate Curoe, Ashley Underwood, Joseph Cherabie, Elvin H Geng, Aditi Ramakrishnan, Rachel Presti, Aaloke Mody

2020-Current year OA Pubs

BACKGROUND: Engagement in pre-exposure prophylaxis (PrEP) care and routine screening for HIV and sexually transmitted infections (STIs) is critical to realizing the full benefits of this HIV prevention strategy.

METHODS: We enrolled a cohort of individuals seeking PrEP services in two clinics in Missouri, an Ending the HIV Epidemic priority state, from June 2014 to November 2021. We used electronic health record and survey data to explore outcomes in the 2 years following linkage to care using multistate methods. We assessed transitions between eight mutually exclusive care states differentiated by receipt of a prescription, lab coverage status, and retention. We …

The Cognitive-Affective Social Processing And Emotion Regulation (Casper) Model, M Catalina Camacho, Elina Deshpande, Michael T Perino

2020-Current year OA Pubs

Humans are intensely social creatures. It is therefore not surprising that many psychiatric disorder criteria include social dysfunctions; however, overlapping presentations and diverse, complex etiologies make treating social dysfunctions difficult. Here, we introduce the Cognitive Affective Social Processing and Emotion Regulation (CASPER) model. CASPER integrates research from social psychology, cognitive neuroscience, and developmental science to describe how real-world social processing unfolds and is associated with differing psychiatric social cognitive neurophenotypes. Briefly, social processing can be broken down into the following cognitive steps: identifying relevant social cues, attending to related cues, interpreting cues, and adjusting behavior appropriately. Each of these steps …

Epithelial-Mesenchymal Transition And Stress Adaptations Underlie Yttrium-90 Resistance In Liver Cancer Cell Lines, Alexander Zheleznyak, Dhanusha Duraiyan, Prasanth Thunuguntla, Jessica Camacho, Shuang Wu, Jingxia Liu, Jason D Weber, Daniel L J Thorek, Benjamin S Strnad, Ryan C Fields, Matthew A Ciorba, Christine Yoon, Valerie Blanc, Nicholas Davidson, Jessica Silva-Fisher, Christopher D Malone

2020-Current year OA Pubs

UNLABELLED: Molecular signatures predict prognosis in hepatocellular carcinoma, but their relevance to transarterial radioembolization (TARE) with yttrium-90 (90Y) is unknown. We aimed to identify baseline and treatment-induced pathways associated with response and nominate biomarkers. Ten transcriptomically diverse human liver cancer cell lines were exposed to escalating activities of glass 90Y microspheres for 10 days. Normalized AUC values quantified sensitivity. Whole-transcriptome RNA sequencing at baseline and after treatment was analyzed with elastic net regression and gene set enrichment. Findings were corroborated by qRT-qPCR and exploratory analysis of pretreatment tumor samples from patients undergoing TARE. Liver cancer cell line responses to 90Y …

Focused Ultrasound-Enhanced Nose-To-Brain Delivery Of A Therapeutic Antibody In A Large-Animal Model, Siaka Fadera, Cristian Antonio Wieczorek Villas Boas, Yimei Yue, Zhaoning Gu, Jinyun Yuan, Debolina De, Buck E Rogers, Arash Nazeri, Hong Chen

2020-Current year OA Pubs

No abstract provided.

Cutibacterium Adaptation To Life On Humans Provides A Potential C Acnes Infection Biomarker, Md Shafiuddin, Wen-Chi Huang, Gabriel William Prather, Jeffrey Ryan Anton, Andrew Lawrence Martin, Sydney Brianna Sillart, Jonathan Z Tang, Michael R Vittori, Michael J Prinsen, Jessica Jane Ninneman, Chandrashekhara Manithody, Jeffrey P Henderson, Alexander W Aleem, Ma Xenia Garcia Ilagan, William H Mccoy 4th

2020-Current year OA Pubs

Propionibacteriaceae appear to have adapted to life on humans during the domestication of cattle. These microbial immigrants formed the genus Cutibacterium, and a descendent of those microbial trailblazers (C acnes) now dominates 25% of human skin. C acnes colonization of human skin requires the protein RoxP. Although all Cutibacteria encode this adaptation to life on humans, nothing like RoxP has been found in any other organism. In this study, we report an extensive assessment of 21 RoxP orthologs, which identified conserved molecular surfaces linked to heme-dependent oligomerization and low pH stability. Our investigation suggests how RoxP helps C acnes dominate …

Coordinated Regulation Of Capping Protein By Carmil And V-1/Myotrophin, John A Hammer, John A Cooper

2020-Current year OA Pubs

Capping Protein (CP) plays a central role in controlling actin filament dynamics in almost all eukaryotic cell types by virtue of its ability to block monomer addition and loss at the barbed end of the actin filament. Like other proteins that control actin assembly, CP is subject to regulation. Here we focus on two direct regulators of CP-CARMIL and V-1/Myotrophin. Specifically, we review recent biochemical, structural, imaging, and cell biological data that argue these two proteins cooperate to create a regulatory cycle for CP that controls its availability, activity, and site of action in the cell. Finally, we discuss unresolved …

Mutations In Hsp40 Co-Chaperone Change The Canonical Interdomain Interactions Stimulating Lgmdd1 Myopathy, Ankan K Bhadra, Geetika Aggarwal, Anshuman Jaysingh, Daniel Chen, Jil Daw, Conrad C Weihl, Heather L True

2020-Current year OA Pubs

Limb-girdle muscular dystrophy D1 (LGMDD1) is a rare, dominantly inherited neuromuscular protein-misfolding chaperonopathy caused by mutations in the Hsp40 co-chaperone DNAJB6, primarily in the glycine-phenylalanine (GF) or J-domains. Currently, no treatments are available, and a challenge in understanding the disease is identifying a specific client protein for DNAJB6 in skeletal muscle. DNAJB6 has homology to the yeast DNAJ family member, Sis1. Our previous research indicated that LGMDD1 GF domain mutants in Sis1 exhibit substrate-specific effects, influenced by Hsp70 activity. Herein, we employed functional assays along with advanced molecular simulation studies to understand the regulatory interdomain interactions in disease-causing mutants of …

A Deep Learning Model To Guide Personalized Mechanical Circulatory Support Use In Cardiogenic Shock Patients Undergoing Pci, Amit P Amin, Richard G Bach, Darren C Tsang, Weili S Zheng, Raed A Qarajeh, Emmanouil S Brilakis, Hemant Kulkarni

2020-Current year OA Pubs

BACKGROUND: Cardiogenic shock (CS) in patients undergoing percutaneous coronary intervention (PCI) involves rapidly changing clinical, hemodynamic, and metabolic factors that current models cannot effectively integrate.

OBJECTIVES: The purpose of this study was to develop and validate a deep learning (DL) model to guide personalized use of mechanical circulatory support (MCS) devices in CS patients undergoing PCI.

METHODS: The authors analyzed data from 1,408 CS patients treated with intra-aortic balloon pump (IABP) or microaxial flow-pump (mAFP) at multiple hospitals (2004-2019). Clinical, hemodynamic, and metabolic variables from admission to MCS placement were compiled into longitudinal vectors. Using Python 3.7 and TabNet in …

Genome-Wide Gene-Sleep Interaction Study Identifies Novel Lipid Loci In 732,564 Participants, Raymond Noordam, Karen Schwander, Lisa De Las Fuentes, Mary F Feitosa, Anh Do, C Charles Gu, Changwei Li, Michael A Province, Dabeeru C Rao, Et Al.

2020-Current year OA Pubs

BACKGROUND AND AIMS: Deviations from the population mean in sleep duration have been associated with increased risk for developing dyslipidemia and atherosclerotic cardiovascular disease, but the mechanism of effect is poorly characterized. We performed large-scale genome-wide gene-sleep interaction analyses of lipid levels to identify genetic variants underpinning the biomolecular pathways of sleep-associated lipid disturbances and to suggest possible druggable targets.

METHODS: We collected data from 55 cohorts with a combined sample size of 732,564 participants (87 % European ancestry) with data on lipid traits (high-density lipoprotein [HDL-c] and low-density lipoprotein [LDL-c] cholesterol and triglycerides [TG]). Short (STST) and long (LTST) …

Oculomics And Ai: The Eye As A Biomarker For Health Span, Joy Le Yi Wong, Rajendra S Apte, Et Al.

2020-Current year OA Pubs

As the world's population ages, the focus of healthcare is shifting from extending life span to promoting health span. There is an unmet need to identify sensitive and reliable markers of health span through more cost-effective and non-invasive methods, to enable early and effective intervention on modifiable aging factors. The eye offers a unique window into systemic health, providing direct visualization of the body's vascular and neural health. This review presents an overview of how various ocular structures can serve as biomarkers of health span-drawing on insights from ocular imaging, metabolomics, and proteomics, with evidence from basic science, animal models, …

Airway Management In Emergency Department Thoracotomy: A Narrative Review, Aaron J Lacy, Adam Liebendorfer, Sarah M Guess, Rami S Al-Aref, Anthony P Kronfli, Rachel E Armstrong, Amelia W Maiga, Alexander Bracey, Ryan N Barnicle

2020-Current year OA Pubs

INTRODUCTION: Emergency department thoracotomy (EDT) is a high-risk, life-saving intervention for patients in traumatic cardiac arrest. A critical component of EDT is airway management, typically performed by emergency physicians, yet formal guidance regarding optimal strategies remains limited. Airway management in this setting is uniquely complex due to concurrent anatomic injury, physiologic instability, and the procedural demands of thoracotomy.

DISCUSSION: Endotracheal intubation (ETI) during EDT presents multiple challenges. Anatomic difficulties may arise from facial or cervical trauma, restricted positioning, and the presence of cervical collars. Cognitive load is heightened by the chaotic, multidisciplinary environment, requiring strategies such as pre-briefing, checklists, and …

Foot-Specific Exercise Intervention For Forefoot Deformity In Individuals With Type 2 Diabetes And Peripheral Neuropathy: A Randomized Controlled Clinical Trial With 3-Year Follow-Up, J A Zellers, K Steger-May, P K Commean, H-J Jeong, E M Bullard, M J Mueller, M K Hastings

2020-Current year OA Pubs

BACKGROUND: Diabetes with peripheral neuropathy can lead to metatarsophalangeal joint (MTPJ) deformity. The purpose of this study was to estimate the effect of a foot-specific intervention on MTPJ deformity. Secondary aims were determining MTPJ deformity progression over 3 years and predictors of MTPJ deformity progression.

METHODS: Sixty people with type 2 diabetes and peripheral neuropathy were recruited for this randomized controlled clinical trial. Participants were assessed at baseline, 6 months (post-intervention), 1.5 years, and 3 years. A 6-month, foot-specific intervention in the experimental group was compared to a shoulder intervention in the control group. The primary outcome was change in …

Identification Of Distinct Subtypes In Immune Tolerance After Hematopoietic Cell Transplantation Using The Prospective Able1.0 Pediatric Study Cohort, Bernard Ng, Shalini Shenoy, Et Al.

2020-Current year OA Pubs

The lack of immune tolerance after hematopoietic cell transplantation (HCT) can result in chronic graft-versus-host disease (cGvHD), which is the primary nonrelapse limitation of successful HCT. To date, immune tolerance has been considered a single biological entity, but we hypothesized that post-HCT immune tolerance could develop through multiple pathways. Using the ABLE network database, which comprises measurements of 75 cell populations, 10 cytokines and chemokines, lymphocyte population telomere length, KRECs and TRECs, and 132 metabolites from the largest pediatric cGvHD cohort (n = 241), we applied clustering analysis to patients with primary immune tolerance (PIT; no acute GvHD [aGvHD] or …

Excellent Outcomes In Feasibility Study Of Radiation-Free Conditioning And Transplant In Pediatric Severe Aplastic Anemia, Mithra Lakshmi Narasimhan, Irem Eldem, Jeffrey J Bednarski, Ginny L Schulz, Robert J Hayashi, Shalini Shenoy

2020-Current year OA Pubs

Severe aplastic anemia (SAA) is treated with a hematopoietic cell transplant (HCT) in the presence of an HLA-matched sibling donor (MSD) with disease-free survival (DFS) of >90%. In the absence of an MSD, immunosuppressive therapy (IST) can induce remission but concerns for relapsed/refractory disease and clonal hematopoiesis persist. IST failure is an indication for HCT. Modern HCT approaches target barriers such as graft rejection (GR), graft-versus-host disease (GVHD), and transplant-related toxicities. Traditionally, total body irradiation (TBI) inclusive HCT conditioning helps decrease GR, but the use of TBI in children increases concerns for late effects such as malignancies. To describe outcomes …