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Project leader Pavletic Steven Zivko
Project co-leader: Prof. Dr. Damir Nemet, MD, PhD
Administering organization: University of Zagreb School of Medicine Address: Šalata 3, 10 000 Zagreb, Croatia Web address: www.mef.unizg.hr OIB: 45001686598 Contact person: Ivana Dazgić, Phone: ++385-(0)1-4590-242, E-mail: ivana.dazgic@mef.hr
Partner Institution/Company: Experimental Transplantation and Immunology Branch (ETIB), Center for Cancer Research (CCR), National Cancer Institute (NCI), National Institutes of Health (NIH)
Grant type: 1B
Project title: Clinical and biological factors determining severity and activity of chronic graft- versus-host disease after allogeneic hematopoietic stem cell transplantation
Project summary: Chronic graft-versus-host disease (cGVHD) is a multi-organ alloimmune and autoimmune disorder occurring after allogeneic hematopoietic stem cell transplantation (alloHSCT). It occurs in about 50% of alloHSCT recipients and can last for many years. Chronic GVHD is the major cause of non-relapse morbidity and mortality after alloHSCT. Due to increasing safety of transplants number of survivors is increasing and more patients are at risk of developing cGVHD. Division of Hematology, University Department of Internal Medicine, Clinical Hospital Center Zagreb and University of Zagreb School of Medicine, Zagreb, Croatia, has 30-years long experience with alloHSCT. Until today, more than 700 patients received alloHSCT in this leading hematology center in Croatia, and in recent years about 50 patients annually. In whole European region more than 12,000 alloHSCT are performed each year nowadays with increasing number of transplants (Bone Marrow Transplant. 2012;47(7):906-23.). International transplant community recognized an urgent need for progress in understanding and effective treatments for cGVHD as it is one of the most serious complications of cancer therapy and alloHSCT. Since cGVHD is disorder that simultaneously affects many organ systems in highly variable fashion, it requires complex and coordinated multidisciplinary medical management by different medical specialties. Primary goal of this proposed project is to establish a multidisciplinary clinic infrastructure in Croatia to study clinical and biological factors that determine severity and activity of cGVHD, using established and clinically relevant cGVHD-related grading scales and measurements in collaboration with the most prominent cGVHD clinic in the world at the National Cancer Institute, National Institutes of Health (NIH), USA. Secondary goal of this proposed project is to create a comprehensive database with cGVHD-associated data as well as the information on non-cGVHD survivors. At the end of the 2-year project implementation a measurement of the effect will be conducted using the outcome parameters such as completeness of documentation, compliance with long term follow-up guidelines, health and cGVHD-related outcomes as well as the overall scientific impact and productivity. Such consistent and detailed approach to cGVHD patients would be beneficial for further improvement of treatment of those complex patients and improvements of their health related quality of life. Establishment of this clinical research infrastructure would allow further collaboration with other European cGVHD centers and organizations which are using similar NIH cGVHD-related evaluations with the goal to establish Croatian hematology and medicine as one of the regional and international leaders in such important biomedical field.
Hrvatski sažetak: Kronična reakcija davatelja protiv primatelja (engleski Chronic Graft versus Host Disease, cGVHD) je multiorganski aloimuni i autoimuni poremećaj koji nastaje nakon alogene transplantacije krvotvornih matičnih stanica (aloTKMS) u oko 50% bolesnika i može trajati mnogo godina. Kronični GVHD je glavni uzrok ne-relapsnog morbiditeta i mortaliteta nakon aloTKMS. S obzirom na porast sigurnosti transplantacije i sve većeg broja preživjelih nakon aloTKMS, sve je više osoba pod rizikom za nastanak cGVHD. Zavod za hematologiju Klinike za unutarnje bolesti Kliničkog bolničkog centra Zagreb i Medicinskog fakulteta Sveučilišta u Zagrebu, Zagreb, Hrvatska, ima 30-godišnju tradiciju liječenja aloTKMS. Do danas je više od 700 bolesnika liječeno aloTKMS u ovom vodećem hematološkom centru u Hrvatskoj, a posljednjih godina oko 50 bolesnika na godinu. U cijeloj Europi danas se godišnje transplantira više od 12000 aloTKMS s porastom broja transplantacija (Bone Marrow Transplant. 2012;47(7):906-23.). Međunarodna transplantacijska zajednica je prepoznala žurnu potrebu za napretkom u razumijevanju i učinkovitom liječenju cGVHD kao jedne od najozbiljnijih komplikacija liječenja raka i aloTKMS. Budući da je cGVHD poremećaj koji istovremeno zahvaća mnoge organske sustave na vrlo različite načine, zahtijeva složeni i kooridinirani liječnički pristup s različitim specijalistima. Primarni cilj ovog predloženog projekta je formiranje multidisciplinarne kliničke infrastrukture u Hrvatskoj koja bi istraživala kliničke i biološke čimbenike koji određuju težinu i aktivnost cGVHD, koristeći postojeće i klinički relevantne skale i mjerenja cGVHD u suradnji s najuglednijom svjetskom cGVHD klinikom u National Cancer Institutes, National Institutes of Health (NIH) iz Sjedinjenih Američkih Država. Sekundarni cilj ovog predloženog projekta je formiranje detaljne baze podataka o cGVHD kao i o podacima o preživjelim osobama nakon aloTKMS bez cGVHD. Na kraju dvogodišnjeg razdoblja projekta, analizirat će se ispunjavanje dokumentacije, pridržavanje smjernica dugotrajnog praćenja bolesnika, analizirat će se pokazatelji zdravlja i cGVHD-a, kao i sveukupni znanstveni utjecaj i produktivnost. Takav konzistentan i detaljni pristup bolesnicima sa cGVHD bit će koristan u daljnjem napretku liječenja i kvalitete života tih složenih bolesnika. Uspostavljanje ove kliničke istraživačke infrastrukture omogučit će daljnju suradnju s drugim europskim cGVHD centrima i organizacijama koje koriste slične NIH evaluacije cGVHD-a, sa ciljem uspostavljanja hrvatske hematologije i medicine kao jedne od regionalnih i internacionalnih lidera u ovom važnom biomedicinskom polju.
Amount requested from UKF: 1.500.000,00 HRK
Amount of matching funding: 300.000,00 HRK
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