Development, Expansion, and <em>In vivo</em> Monitoring of Human NK Cells from Human Embryonic Stem Cells (hESCs) and Induced Pluripotent Stem Cells (iPSCs)

We present a method for deriving natural killer (NK) cells from undifferentiated hESCs and iPSCs using a feeder-free approach. This method gives rise to ...

University of Minnesota, Minneapolis

Bacterial infections continue to be a leading cause of mortality and morbidity in patients who undergo blood and marrow transplantations (BMTs). The relative importance of different clinical features (donor type, graft cell source, and conditioning regimen) on the incidence and timing of posttransplantation bacterial infections is uncertain, but a detailed analysis could better guide prevention and therapy. We retrospectively analyzed the incidence and risk factors for early bacterial infections, as well as patterns of antibiotic resistance. We observed 613 bacteremic events among 349 of 834 patients who underwent BMT treated at the University of Minnesota from 2005 to 2010 (cumulative incidence 42%; 95% confidence interval [CI], 38-45). Donor type (allogeneic vs autologous) had the greatest impact on the incidence of bacteremia within 100 days posttransplantation. Among allogeneic transplantations, myeloablative (MA), compared to reduced-intensity conditioning (RIC) was associated with a significantly greater risk of bacteremia, as was the development of acute graft-versus-host disease (aGVHD). Additionally, patients who underwent BMT, compared to the contemporaneous hospital population, developed infections with more frequent resistance to antibiotics used in the treatment against commonly isolated bacterial organisms. These findings have important clinical implications regarding the use and selection of both prophylactic and empiric antibiotic regimens.

Bacteremia in blood or marrow transplantation patients: clinical risk factors for infection and emerging antibiotic resistance.

Infections bact&eacute;riennes demeurent des principales causes de mortalit&eacute; et de morbidit&eacute; chez les patients qui subissent des greffes de sang et de moelle osseuse (OGEC). L&#39;importance relative des diff&eacute;rentes caract&eacute;ristiques cliniques (type de donneur, source de cellules de greffon et conditionnement sur l&#39;incidence) et le calendrier des infections bact&eacute;riennes posttransplantation sont incertaines, mais une analyse d&eacute;taill&eacute;e pourrait mieux guider pr&eacute;vention et th&eacute;rapie. Nous avons analys&eacute; r&eacute;trospectivement l&#39;incidence et les facteurs de risque des infections bact&eacute;riennes pr&eacute;coces, ainsi que les profils de r&eacute;sistance aux antibiotique. Nous avons observ&eacute; des &eacute;v&eacute;nements bact&eacute;ri&eacute;mique 613 entre 349 de 834 patients ayant subi une BMT trait&eacute;e &agrave; l&#39;Universit&eacute; du Minnesota de 2005 &agrave; 2010 (incidence cumul&eacute;e 42 %; intervalle de confiance de 95 % [IC], 38-45). Type de donneur (allogreffes vs autologues) avait le plus d&#39;impact sur l&#39;incidence des bact&eacute;ri&eacute;mies dans post-transplantation de 100 jours. Parmi les greffes allog&eacute;niques, my&eacute;loablatif (MA), par rapport au conditionnement d&#39;intensit&eacute; r&eacute;duite (RIC) &eacute;tait associ&eacute;e &agrave; un risque significativement plus &eacute;lev&eacute; de bact&eacute;ri&eacute;mie, tout comme le d&eacute;veloppement d&#39;aigu&euml; graft - versus - host disease (aGVHD). En outre, patients ayant subi une BMT, par rapport &agrave; la population de contemporains de l&#39;h&ocirc;pital, des infections d&eacute;velopp&eacute;es avec plus fr&eacute;quentes r&eacute;sistances aux antibiotiques utilis&eacute;s dans le traitement contre les organismes bact&eacute;riens souvent isol&eacute;s. Ces r&eacute;sultats ont des implications cliniques importantes concernant l&#39;utilisation et la s&eacute;lection des sch&eacute;mas d&#39;antibioth&eacute;rapie prophylactique tant empirique.

Bact&eacute;ri&eacute;mie chez les patients de transplantation de sang ou de moelle osseuse : des facteurs de risque cliniques d&#39;infection et d&#39;&eacute;mergence de r&eacute;sistance aux antibiotique.

Infezioni batteriche continuano ad essere delle principali cause di mortalit&agrave; e morbilit&agrave; in pazienti sottoposti a trapianto del midollo osseo e del sangue (BMTs). L&#39;importanza relativa delle diverse caratteristiche cliniche (tipo di donatore, innesto cella origine e regime di condizionamento sull&#39;incidenza) e la tempistica di miglioramenti infezioni batteriche &egrave; incerte, ma un&#39;analisi dettagliata potrebbe guida migliore prevenzione e terapia. Abbiamo analizzato retrospettivamente l&#39;incidenza e fattori di rischio per infezioni batteriche precoci, nonch&eacute; modelli di resistenza agli antibiotici. Abbiamo osservato 613 batteremica eventi tra 349 di 834 pazienti sottoposti a BMT trattati presso l&#39;Universit&agrave; del Minnesota dal 2005 al 2010 (incidenza cumulativa 42%; 95% intervallo di confidenza [CI], 38-45). Tipo di donatore (trapianto autologo allogenico vs) ha avuto il maggiore impatto sull&#39;incidenza di batteriemia all&#39;interno di posttransplantation 100 giorni. Fra i trapianti allogenici, myeloablative (MA), rispetto al condizionamento di intensit&agrave; ridotta (RIC) era associato con un rischio significativamente maggiore di batteriemia, come lo sviluppo di acuta graft - versus - host disease (aGVHD). Inoltre, pazienti sottoposti BMT, rispetto alla popolazione ospedale contemporaneo, sviluppate infezioni con pi&ugrave; frequente resistenza agli antibiotici usati nel trattamento contro gli organismi batterici comunemente isolati. Queste scoperte hanno importanti implicazioni cliniche per quanto riguarda l&#39;uso e la selezione dei regimi antibiotici profilattico sia empirici.

Allison M. Bock

Department of Medicine (Hematology,
Oncology,
and Transplant),
Stem Cell Institute,
Department of Medicine (Hematology, Oncology, and Transplant)

University of Minnesota, Minneapolis

Development, Expansion, and In vivo Monitoring of Human NK Cells from Human Embryonic Stem Cells (hESCs) and Induced Pluripotent Stem Cells (iPSCs)

Allison M. Bock

.css-o250i3{font-size:18px;font-family:Open Sans,sans-serif;line-height:21.6px;}Department of Medicine (Hematology,Oncology,and Transplant),Stem Cell Institute,Department of Medicine (Hematology, Oncology, and Transplant)

University of Minnesota, Minneapolis

Development, Expansion, and In vivo Monitoring of Human NK Cells from Human Embryonic Stem Cells (hESCs) and Induced Pluripotent Stem Cells (iPSCs)

Department of Medicine (Hematology,
Oncology,
and Transplant),
Stem Cell Institute,
Department of Medicine (Hematology, Oncology, and Transplant)