Imperial College London

Jiri Pavlu

Faculty of MedicineDepartment of Immunology and Inflammation

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 3313 8117j.pavlu Website

 
 
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Location

 

Leuka Building R2.20Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

164 results found

Battipaglia G, Mooyaart JE, Meyer R, Mohty M, Sadowska-Klasa A, Goloshchapov O, Locatelli F, Styczynski J, Pavlu J, Dybko J, Bronin G, Salmenniemi U, Jindra P, Hoogenboom JD, Kuball J, Ruggeri A, Malard Fet al., 2023, Current use of fecal microbiota transfer in patients with hematologic diseases: a survey on behalf of the Cellular Therapy and Immunobiology Working Party of the EBMT., Bone Marrow Transplant, Vol: 58, Pages: 1419-1421

Journal article

Battipaglia G, Mooyaart JE, Meyer R, Mohty M, Sadowska-Klasa A, Goloshchapov O, Locatelli F, Styczynski J, Pavlu J, Dybko J, Bronin G, Salmenniemi U, Jindra P, Hoogenboom JD, Kuball J, Ruggeri A, Malard Fet al., 2023, Current use of fecal microbiota transfer in patients with hematologic diseases: a survey on behalf of the Cellular Therapy and Immunobiology Working Party of the EBMT, BONE MARROW TRANSPLANTATION, ISSN: 0268-3369

Journal article

Saraceni F, Labopin M, Raiola AM, Blaise D, Remenyi P, Sora F, Pavlu J, Bramanti S, Busca A, Berceanu A, Battipaglia G, Visani G, Socie G, Bug G, Mico C, La Nasa G, Musso M, Olivieri A, Spyridonidis A, Savani B, Ciceri F, Nagler A, Mohty Met al., 2023, Thiotepa-busulfan-fludarabine compared to treosulfan-based conditioning for haploidentical transplant with posttransplant cyclophosphamide in patients with acute myeloid leukemia in remission: a study from the acute leukemia working party of the EBMT, HemaSphere, Vol: 7, ISSN: 2572-9241

We conducted a registry analysis including adult acute myeloid leukemia (AML) patients in remission who had received thiotepa, busulfan, and fludarabine (TBF) or treosulfan-based (Treo) conditioning for haplo-hematopoietic stem cell transplant (HSCT) with posttransplant cyclophosphamide (PTCy) between 2010 and 2020. A total of 1123 patients met the inclusion criteria (968 received TBF and 155 received Treo). A 1:1 matched-pair analysis was performed on 142 TBF and 142 Treo patients. In the Treo group, 68% of patients received treosulfan at a dose ≥36 g/m2 and 54% of patients received a second alkylator (thiotepa or melphalan). We observed a trend toward increased incidence of grade II–IV acute (a) graft-versus-host disease (GVHD) at 180 days in the TBF group compared with Treo (29% versus 20%; P = 0.08), while incidence of grade III–IV aGVHD was not statistically different. Similarly, the incidence of chronic (c) GVHD was not statistically different in the 2 groups. Incidence of nonrelapse mortality at 2 years was 19% in TBF and 14% in Treo (P = 0.4). Relapse incidence at 2 years was not statistically different in the 2 groups (16% and 18% in TBF and Treo, respectively; P = 0.9). Leukemia-free survival, overall survival, and GVHD-free, relapse-free survival was 65% versus 68% (P = 0.6), 73% versus 76% (P = 0.5), and 54% versus 53% (P = 0.8) in TBF versus Treo, respectively. In conclusion, we did not find a significant difference between the 2 conditioning in the present study; Treo and TBF represent 2 valid alternative regimens for haplo-HSCT with PTCy for AML in remission.

Journal article

Nagler A, Labopin M, Blaise D, Raiola AM, Corral LL, Bramanti S, Sica S, Kwon M, Koc Y, Pavlu J, Kulagin A, Busca A, Rodriguez AB, Remenyi P, Schmid C, Brissot E, Sanz J, Bazarbachi A, Giebel S, Ciceri F, Mohty Met al., 2023, Non-T-depleted haploidentical transplantation with post-transplant cyclophosphamide in patients with secondary versus de novo AML in first complete remission: a study from the ALWP/EBMT (16, 58, 2023), JOURNAL OF HEMATOLOGY & ONCOLOGY, Vol: 16

Journal article

Baltas I, Kavallieros K, Konstantinou I, Gibani MM, Davies F, Pavlu Jet al., 2023, Urinary tract infections in HSCT: how big is the problem?, Publisher: OXFORD UNIV PRESS

Conference paper

Nagler A, Labopin M, Blaise D, Raiola AM, Corral LL, Bramanti S, Sica S, Kwon M, Koc Y, Pavlu J, Kulagin A, Busca A, Rodriguez AB, Remenyi P, Schmid C, Brissot E, Sanz J, Bazarbachi A, Giebel S, Ciceri F, Mohty Met al., 2023, Non-T-depleted haploidentical transplantation with post-transplant cyclophosphamide in patients with secondary versus de novo AML in first complete remission: a study from the ALWP/EBMT, Journal of Hematology and Oncology, Vol: 16, ISSN: 1756-8722

We compared outcomes of adult patients with secondary acute myeloid leukemia (sAML) versus de novo AML after non-T-depleted haploidentical stem cell transplant (HaploSCT) with post-transplant cyclophosphamide (PTCy). Seventeen hundred and eleven AML patients (sAML-231, de novo-1480) in first complete remission transplanted from 2010 to 2021, were included. Patients with de novo AML were younger, median age 55.8 versus 60.8 years, p < 0.0001, had better transplantation comorbidity index (HCT-CI) ≥ 3 21.3% versus 40.8%, p < 0.0001 and Karnofsky performance status (KPS) with KPS ≥ 90 in 78% versus 68.5%, respectively, p = 0.002. The two patient groups did not differ with respect to gender, cytomegalovirus serostatus, and cell source. Median time from diagnosis to HaploSCT was 5.2 versus 4.9 months, respectively, p = 0.005. Fewer sAML patients received myeloablative conditioning 35.1% versus 50.1%, p < 0.0001. Two hundred and eleven sAML and 410 de novo AML patients were included in the matched-pair analysis matching two de novo AML with each sAML. No significant difference was observed in any transplantation outcome parameter between the sAML versus de novo AML groups. Two-year non-relapse mortality and relapse incidence did not differ with HaploSCT for de novo versus sAML; 21.4% versus 21%, hazard ratio (HR) = 0.98, p = 0.9 and 23.4% versus 20.6%, HR = 0.92, p = 0.67, respectively. Two-year leukemia-free survival, overall survival, and graft-versus-host disease (GVHD)-free, relapse-free survival were also not different between the de novo AML and sAML groups 55.2% versus 58.4%, HR = 0.95, p = 0.67; 61.4% versus 66.4%, HR = 0.91, p = 0.51 and 46.3% versus 48.2%, HR = 0.92, p = 0.48, respectively. Similarly, the incidence

Journal article

Chakrabarty D, Wang K, Roy G, Bhojgaria A, Zhang C, Pavlu J, Chakrabartty Jet al., 2023, Constructing training set using distance between learnt graphical models of time series data on patient physiology, to predict disease scores., PLoS One, Vol: 18

Interventional endeavours in medicine include prediction of a score that parametrises a new subject's susceptibility to a given disease, at the pre-onset stage. Here, for the first time, we provide reliable learning of such a score in the context of the potentially-terminal disease VOD, that often arises after bone marrow transplants. Indeed, the probability of surviving VOD, is correlated with early intervention. In our work, the VOD-score of each patient in a retrospective cohort, is defined as the distance between the (posterior) probability of a random graph variable-given the inter-variable partial correlation matrix of the time series data on variables that represent different aspects of patient physiology-and that given such time series data of an arbitrarily-selected reference patient. Such time series data is recorded from a pre-transplant to a post-transplant time, for each patient in this cohort, though the data available for distinct patients bear differential temporal coverage, owing to differential patient longevities. Each graph is a Soft Random Geometric Graph drawn in a probabilistic metric space, and the computed inter-graph distance is oblivious to the length of the time series data. The VOD-score learnt in this way, and the corresponding pre-transplant parameter vector of each patient in this retrospective cohort, then results in the training data, using which we learn the function that takes VOD-score as its input, and outputs the vector of pre-transplant parameters. We model this function with a vector-variate Gaussian Process, the covariance structure of which is kernel parametrised. Such modelling is easier than if the score variable were the output. Then for any prospective patient, whose pre-transplant variables are known, we learn the VOD-score (and the hyperparameters of the covariance kernel), using Markov Chain Monte Carlo based inference.

Journal article

Bhojgaria A, Chakrabarty D, Wang K, Roy G, Pavlu J, Padate B, Khattry N, Sengupta K, Gupta P, Panmei S, Das M, Ghazali D, Mundra P, Chakrabartty Jet al., 2022, Machine Learning Based Prediction of Veno Occlusive Disease Following Allogenic Stem Cell Transplantation, 64th Annual Meeting and Exposition of the American-Society-of-Hematology (ASH), Publisher: AMER SOC HEMATOLOGY, Pages: 12863-12863, ISSN: 0006-4971

Conference paper

Wood H, Bourlon C, Kulasekararaj A, Borg A, Pavlu J, Elder P, Taussig DC, Veitch S, Knapper S, Othman J, Dillon R, Aries J, Mitchell E, Basheer F, Leak S, Murthy V, Cross JW, Mehta P, Jain M, Khan A, Lam H, Leong S, O'Nions J, Craddock C, Potter V, Copland M, Krishnamurthy Pet al., 2022, Venetoclax-Based Non-Intensive Combinations Successfully Salvage Molecular Relapse of Acute Myeloid Leukemia and Are an Important Bridge to Cellular Therapy in Relapsed/Refractory Disease - Real-World Data from a UK-Wide Programme, 64th Annual Meeting and Exposition of the American-Society-of-Hematology (ASH), Publisher: AMER SOC HEMATOLOGY, Pages: 9016-9018, ISSN: 0006-4971

Conference paper

Hederih J, Charania A, Waldman A, Pavlu J, Szydlo R, Milojkovic D, Olavarria E, Palanicawandar R, Vladescu C, Soto JR, Innes AJ, Cooper Net al., 2022, Total Body Irradiation Is Associated with Higher Prevalence of Cerebral Microbleeds in Haematopoietic Stem Cell Transplant Survivors, 64th Annual Meeting and Exposition of the American-Society-of-Hematology (ASH), Publisher: AMER SOC HEMATOLOGY, Pages: 12910-12912, ISSN: 0006-4971

Conference paper

Anand A, Brown L, Smith R, Nouri B, Powell F, Mabrok M, Camille A, Cano-Flanagan J, Pavlu Jet al., 2022, Donor Derived Myelodysplastic Syndrome after Sex Matched Haploidentical Allograft for AML with Monosomy 7 in Both Diseases: Importance of Donor Chimerism Assessment By Two Independent Techniques, 64th Annual Meeting and Exposition of the American-Society-of-Hematology (ASH), Publisher: AMER SOC HEMATOLOGY, Pages: 13029-13030, ISSN: 0006-4971

Conference paper

Cook L, O'dell G, Vourvou E, Palanicawandar R, Marks S, Milojkovic D, Apperley J, Loaiza S, Claudiani S, Bua M, Hockings C, Macdonald D, Chaidos A, Pavlu J, Cooper N, Fidler S, Randell P, Innes Aet al., 2022, Third primary SARS-CoV-2 mRNA vaccines enhance antibody responses in most patients with haematological malignancies, Nature Communications, Vol: 13, Pages: 1-6, ISSN: 2041-1723

SARS-CoV-2 infection, and resulting disease, COVID-19, has a high mortality amongst patients with haematological malignancies. Global vaccine rollouts have reduced hospitalisations and deaths, but vaccine efficacy in patients with haematological malignancies is known to be reduced. The UK-strategyoffered a third, mRNA-based, vaccine as an extension to the primary course in these patients. The MARCH database is a retrospective observational study of serological responses in patients with blood disorders. Here we present data on 381 patients with haematological malignancies. By comparison with healthy controls, we report suboptimal responses following two primary vaccines, with significantly enhanced responses following the third primary dose. These responses however are heterogeneous and determined by haematological malignancy sub-type and therapy. We identify a group of patients with continued sub-optimal vaccine responses who may benefit from additional doses, prophylactic extended half-life neutralising monoclonal therapies (nMAB) or prompt nMAB treatment in the event of SARS-CoV-2 infection.

Journal article

Ruggeri A, Galimard J-E, Labopin M, Rafii H, Blaise D, Ciceri F, Diez-Martin J-L, Cornelissen J, Chevallier P, Sanchez-Guijo F, Nicholson E, Castagna L, Forcade E, Kuball J, Rovira M, Koc Y, Pavlu J, Gulbas Z, Vydra J, Baron F, Sanz J, Spyridonidis A, Savani B, Gluckman E, Nagler A, Mohty Met al., 2022, Comparison of Outcomes after Unrelated Double-Unit Cord Blood and Haploidentical Peripheral Blood Stem Cell Transplantation in Adults with Acute Myelogenous Leukemia: A Study on Behalf of Eurocord and the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation, TRANSPLANTATION AND CELLULAR THERAPY, Vol: 28, ISSN: 2666-6375

Journal article

Devillier R, Galimard J-E, Labopin M, Blaise D, Raiola AM, Pavlu J, Castagna L, Socie G, Chalandon Y, Martino M, Stolzel F, Bug G, Bruno B, Vrhovac R, Charbonnier A, Olivieri A, Bay J-O, Arroyo H, Yakoub-Agha I, Avenoso D, Neubauer A, Nguyen S, Forcade E, Brissot E, Savani B, Nagler A, Mohty Met al., 2022, Reduced intensity versus non-myeloablative conditioning regimen for haploidentical transplantation and post-transplantation cyclophosphamide in complete remission acute myeloid leukemia: a study from the ALWP of the EBMT, BONE MARROW TRANSPLANTATION, Vol: 57, Pages: 1421-1427, ISSN: 0268-3369

Journal article

Battipaglia G, Galimard J-E, Labopin M, Raiola AM, Blaise D, Ruggeri A, Koc Y, Guelbas Z, Vitek A, Sica S, Diez-Martin JL, Castagna L, Bruno B, Rovira M, Moiseev I, Martino M, Grillo G, Araujo MC, Bulabois CE, Nguyen S, Socie G, Arat M, Pavlu J, Tischer J, Martin H, Corral LL, Choi G, Forcade E, McDonald A, Pane F, Bazarbachi A, Ciceri F, Nagler A, Mohty Met al., 2022, Post-transplant cyclophosphamide in one-antigen mismatched unrelated donor transplantation versus haploidentical transplantation in acute myeloid leukemia: a study from the Acute Leukemia Working Party of the EBMT, BONE MARROW TRANSPLANTATION, Vol: 57, Pages: 562-571, ISSN: 0268-3369

Journal article

Swoboda R, Labopin M, Giebel S, Angelucci E, Arat M, Aljurf M, Sica S, Pavlu J, Socie G, Bernasconi P, Rigacci L, Tischer J, Risitano A, Rovira M, Saccardi R, Pioltelli P, Van Gorkom G, Vitek A, Savani BN, Spyridonidis A, Peric Z, Nagler A, Mohty Met al., 2022, Total body irradiation plus fludarabine versus thiotepa, busulfan plus fludarabine as a myeloablative conditioning for adults with acute lymphoblastic leukemia treated with haploidentical hematopoietic cell transplantation. A study by the Acute Leukemia Working Party of the EBMT, BONE MARROW TRANSPLANTATION, Vol: 57, Pages: 399-406, ISSN: 0268-3369

Journal article

Loke J, Metzner M, Boucher R, Jackson A, Hopkins L, Pavlu J, Tholouli E, Drummond M, Peniket A, Bishop R, Fox S, Vyas P, Craddock Cet al., 2022, Combination romidepsin and azacitidine therapy is well tolerated and clinically active in adults with high-risk acute myeloid leukaemia ineligible for intensive chemotherapy, BRITISH JOURNAL OF HAEMATOLOGY, Vol: 196, Pages: 368-373, ISSN: 0007-1048

Journal article

Fernando F, Robertson HF, El-Zahab S, Pavlů Jet al., 2021, How I use measurable residual disease in the clinical management of adult acute lymphoblastic Leukemia, Clinical Hematology International, Vol: 3, Pages: 130-141, ISSN: 2590-0048

Over the last decade the use of measurable residual disease (MRD) diagnostics in adult acute lymphoblastic leukemia (ALL) has expanded from a limited number of study groups in Europe and the United States to a world-wide application. In this review, we summarize the advantages and drawbacks of the current available techniques used for MRD monitoring. Through the use of three representative case studies, we highlight the advances in the use of MRD in clinical decision-making in the management of ALL in adults. We acknowledge discrepancies in MRD monitoring and treatment between different countries, reflecting differing availability, accessibility and affordability.

Journal article

Geva M, Pryce A, Shouval R, Fein JA, Danylesko I, Shem-Tov N, Yerushalmi R, Shimoni A, Szydlo R, Pavlu J, Nagler Aet al., 2021, High lactate dehydrogenase at time of admission for allogeneic hematopoietic transplantation associates to poor survival in acute myeloid leukemia and non-Hodgkin lymphoma, BONE MARROW TRANSPLANTATION, Vol: 56, Pages: 2690-2696, ISSN: 0268-3369

Journal article

Innes AJ, Mullish BH, Ghani R, Szydlo RM, Apperley JF, Olavarria E, Palanicawandar R, Kanfer EJ, Milojkovic D, McDonald JAK, Brannigan ET, Thursz MR, Williams HRT, Davies FJ, Marchesi JR, Pavlu Jet al., 2021, Fecal microbiota transplant mitigates adverse outcomes in patients colonized with multidrug-resistant organisms undergoing allogeneic hematopoietic cell transplantation, Frontiers in Cellular and Infection Microbiology, Vol: 11, Pages: 1-8, ISSN: 2235-2988

The gut microbiome can be adversely affected by chemotherapy and antibiotics prior to hematopoietic cell transplantation (HCT).This affects graft success and increases susceptibility to multidrug-resistant organism (MDRO) colonization and infection. Weperformed an initial retrospective analysis of our use of fecal microbiota transplantation (FMT) from healthy donors as therapy forMDRO-colonized patients with hematological malignancy. FMT was performed on eight MDRO-colonized patients pre-HCT (FMT-MDROgroup), and outcomes compared with 11 MDRO colonized HCT patients from the same period. At 12 months, survival wassignificantly higher in the FMT-MDRO group (70% versus 36% p = 0.044). Post-HCT, fewer FMT-MDRO patients required intensivecare (0% versus 46%, P = 0.045) or experienced fever (0.29 versus 0.11 days, P = 0.027). Intestinal MDRO decolonization occurred in25% of FMT-MDRO patients versus 11% non-FMT MDRO patients. Despite the significant difference and statistically comparablepatient/transplant characteristics, as the sample size was small, a matched-pair analysis to non-MDRO colonized control cohorts(2:1 matching) was performed. At 12 months, the MDRO group who did not have an FMT had significantly lower survival (36.4%versus 61.9% respectively, p=0.012), and higher non relapse mortality (NRM; 60.2% versus 16.7% respectively, p=0.009) than theirpaired non-colonized cohort. There was no difference in survival (70% versus 43.4%, p=0.14) or NRM (12.5% versus 31.2%respectively, p=0.24) between the FMT-MDRO group and their paired cohort. Negative outcomes, including mortality associatedwith MDRO colonization, may be ameliorated by pre-HCT FMT, despite lack of intestinal decolonization. Further work is needed toexplore the observed benefit.

Journal article

Ruggeri A, Galimard JE, Labopin M, Blaise D, Diez-Martin J-L, Ciceri F, Koc Y, Chevallier P, Cornelissen JJ, Nicholson E, Rovira M, Gulbas Z, Pavlu J, Forcade E, Vydra J, Kuball J, Castagna L, Guijo FS, Baron F, Sanz J, Gluckman E, Spyridonidis A, Savani B, Nagler A, Mohty Met al., 2021, Comparison of Haploidentical Peripheral Blood Cell Transplantation Using Post-Transplant Cyclophosphamide With Double Cord Blood Transplantation in Adults With Acute Leukemia, Publisher: SPRINGERNATURE, Pages: 24-25, ISSN: 0268-3369

Conference paper

Mullish BH, Innes AJ, Ghani R, Szydlo R, Williams HR, Thursz MR, Marchesi J, Davies F, Pavlu Jet al., 2021, FECAL MICROBIOTA TRANSPLANT PRIOR TO ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT IN PATIENTS COLONIZED WITH MULTI-DRUG RESISTANT ORGANISMS IS ASSOCIATED WITH IMPROVED SURVIVAL, Society-for-Surgery-of-the-Alimentary-Tract Annual Meeting at Digestive Disease Week (DDW), Publisher: W B SAUNDERS CO-ELSEVIER INC, Pages: S168-S169, ISSN: 0016-5085

Conference paper

Ghani R, Mullish BH, McDonald JAK, Ghazy A, Williams HRT, Brannigan ET, Mookerjee S, Satta G, Gilchrist M, Duncan N, Corbett R, Innes AJ, Pavlu J, Thursz MR, Davies F, Marchesi JRet al., 2021, Disease prevention not decolonization – a model for fecal microbiota transplantation in patients colonized with multidrug-resistant organisms, Clinical Infectious Diseases, Vol: 72, Pages: 1444-1447, ISSN: 1058-4838

Fecal microbiota transplantation (FMT) yields variable intestinal decolonization results for multidrug-resistant organisms (MDROs). This study showed significant reductions in antibiotic duration, bacteremia and length of stay in 20 patients colonized/ infected with MDRO receiving FMT (compared to pre-FMT history, and a matched group not receiving FMT), despite modest decolonization rates.

Journal article

Craddock C, Jackson A, Loke J, Siddique S, Hodgkinson A, Mason J, Andrew G, Nagra S, Malladi R, Peniket A, Gilleece M, Salim R, Tholouli E, Potter V, Crawley C, Wheatley K, Protheroe R, Vyas P, Hunter A, Parker A, Wilson K, Pavlu J, Byrne J, Dillon R, Khan N, McCarthy N, Freeman SDet al., 2021, Augmented Reduced-Intensity Regimen Does Not Improve Postallogeneic Transplant Outcomes in Acute Myeloid Leukemia, JOURNAL OF CLINICAL ONCOLOGY, Vol: 39, Pages: 768-+, ISSN: 0732-183X

Journal article

Ghani R, Mullish B, Innes A, Szydlo RM, Apperley JF, Olavarria E, Palanicawandar R, Kanfer E, Milojkovic D, McDonald JAK, Brannigan E, Thursz MR, Williams HRT, Davies FJ, Pavlu J, Marchesi Jet al., 2021, Faecal microbiota transplant (FMT) prior to allogeneic haematopoietic cell transplantation (HCT) in patients colonised with multidrug-resistant organisms (MDRO) results in improved survival, ECCMID

Conference paper

Dholaria B, Labopin M, Angelucci E, Tischer J, Arat M, Ciceri F, Guelbas Z, Ozdogu H, Sica S, Diez-Martin JL, Koc Y, Pavlu J, Socie G, Giebel S, Savani BN, Nagler A, Mohty Met al., 2021, Improved Outcomes of Haploidentical Hematopoietic Cell Transplantation with Total Body Irradiation-Based Myeloablative Conditioning in Acute Lymphoblastic Leukemia, TRANSPLANTATION AND CELLULAR THERAPY, Vol: 27, ISSN: 2666-6375

Journal article

Innes AJ, Ghani R, Mullish BH, Szydlo R, Palanicawandar R, Olavarria E, Apperley JF, Thursz MR, Williams HR, Marchesi JR, Davies F, Pavlu Jet al., 2020, O105. Faecal microbiota transplant (FMT) can reduce the high NRM associated with multi-drug resistant organism (MDRO) colonisation prior to allogeneic HCT., The 46th Annual Meeting of the European Society for Blood and Marrow Transplantation, Publisher: Springer Nature [academic journals on nature.com], Pages: 122-122, ISSN: 0268-3369

Conference paper

Giebel S, Labopin M, Angelucci E, Arat M, Aljurf M, Sica S, Pavlu J, Socie G, Bernasconi P, Rigacci L, Tischer J, Risitano A, Rovira M, Saccardi R, Pioltelli P, Van Gorkom G, Vitek A, Peric Z, Nagler A, Mohty Met al., 2020, Total Body Irradiation/Fludarabine Versus Thiotepa/ busulfan/fludarabine for Adults with Acute Lymphoblastic Leukemia Treated with Haploidentical HCT. A Study by Acute Leukemia Working Party of the EBMT, Publisher: SPRINGERNATURE, Pages: 65-65, ISSN: 0268-3369

Conference paper

Ellington MJ, Davies F, Jauneikaite E, Hopkins KL, Turton JF, Adams G, Pavlu J, Innes AJ, Eades C, Brannigan ET, Findlay J, White L, Bolt F, Kadhani T, Chow Y, Patel B, Mookerjee S, Otter JA, Sriskandan S, Woodford N, Holmes Aet al., 2020, A multi-species cluster of GES-5 carbapenemase producing Enterobacterales linked by a geographically disseminated plasmid, Clinical Infectious Diseases, Vol: 71, Pages: 2553-2560, ISSN: 1058-4838

BACKGROUND: Early and accurate treatment of infections due to carbapenem-resistant organisms is facilitated by rapid diagnostics but rare resistance mechanisms can compromise detection. One year after a GES-5 carbapenemase-positive Klebsiella oxytoca infection was identified by whole genome sequencing (WGS) (later found to be part of a cluster of three cases), a cluster of 11 patients with GES-5-positive K. oxytoca was identified over 18 weeks in the same hospital.METHODS: Bacteria were identified by MALDI-TOF, antimicrobial susceptibility testing followed EUCAST guidelines. Ertapenem-resistant isolates were referred to Public Health England for characterization using PCR detection of GES, pulse-field gel electrophoresis (PFGE) and WGS for the second cluster.RESULTS: The identification of the first GES-5 K. oxytoca isolate was delayed, being identified on WGS. A GES-gene PCR informed the occurrence of the second cluster in real-time. In contrast to PFGE, WGS phylogenetic analysis refuted an epidemiological link between the two clusters; it also suggested a cascade of patient-to-patient transmission in the later cluster. A novel GES-5-encoding plasmid was present in K. oxytoca,E. coli and E. cloacae isolates from unlinked patients within the same hospital group and in human and wastewater isolates from three hospitals elsewhere in the UK.CONCLUSIONS: Genomic sequencing revolutionized the epidemiological understanding of the clusters, it also underlined the risk of covert plasmid propagation in healthcare settings and revealed the national distribution of the resistance-encoding plasmid. Sequencing results also informed and led to the ongoing use of enhanced diagnostic tests for detecting carbapenemases locally and nationally.

Journal article

Devillier R, Galimard J-E, Labopin M, Blaise D, Angelucci E, Castagna L, Pavlu J, Socie G, Martino M, Stoelzel F, Bug G, Chalandon Y, Bruno B, Potter V, Brissot E, Savani BN, Nagler A, Mohty Met al., 2020, Reduced Intensity Vs. Non-Myeloablative Conditioning Regimens for Haploidentical Transplantation in Complete Remission Acute Myeloid Leukemia: A Study from the ALWP of the EBMT, Publisher: AMER SOC HEMATOLOGY, ISSN: 0006-4971

Conference paper

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