ORCID Profile
0000-0002-3031-5447
Current Organisation
Peter MacCallum Cancer Centre
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Publisher: Public Library of Science (PLoS)
Date: 18-02-2015
Publisher: Informa UK Limited
Date: 24-11-2022
DOI: 10.1080/10428194.2022.2148376
Abstract: Lymphoma in pregnancy is a rare and challenging diagnosis that complicates ∼1:6000 pregnancies posing a series of unique therapeutic, social, and ethical challenges to the patient, her family, and the medical professionals involved. These difficulties are compounded by the paucity of real-world data on the management of LIP, and a lack of relevant support systems for women in this setting. We conducted a retrospective multicenter qualitative study, interviewing women aged ≥18 years of age diagnosed with Hodgkin (HL) or non-Hodgkin lymphoma (NHL) during pregnancy or within 12 months postpartum, between 1 January 2009 and 31 December 2020 from 13 Australasian sites. Semi-structured telephone interviews were conducted, recorded, and analyzed using QSR Int NVivo 12 Pro (March 2020, USA) to quantify salient themes. Of the 32 women interviewed, 20 (63%) were diagnosed during pregnancy (16, 34, and 13% in the 1st, 2nd, and 3rd trimesters, respectively), while 12 (37%) were diagnosed post-partum. Women recalled that their chief concerns at diagnosis were the welfare of their child (
Publisher: Springer Science and Business Media LLC
Date: 03-09-2019
Publisher: Springer Science and Business Media LLC
Date: 09-2020
DOI: 10.1007/S11695-020-04943-0
Abstract: Bariatric surgery is associated with deficiencies of vitamins and minerals, and patients are routinely advised supplements postoperatively. We studied prevalence of vitamin B 12 , folate and iron deficiencies and anaemia before and after bariatric surgery over 4 years of follow-up. We performed a retrospective cohort analysis of 353 people with obesity, including 257 (72.8%) women, who underwent gastric bypass (252, 71.4%) or sleeve gastrectomy (101, 28.6%) at our National Health Service bariatric centre in Northwest England. At baseline, mean (standard error) age was 46.0 (0.6) years, body mass index 53.1 (0.4) kg/m 2 , serum vitamin B 12 400.2 (16.4) pg/L, folate 7.7 (0.2) μg/L, iron 12.0 (0.3) μmol/L, ferritin 118.3 (8.4) μg/L and haemoglobin 137.9 (0.8) g/L. Frequency of low vitamin B 12 levels reduced from 7.5% preoperatively to 2.3% at 48 months ( P 0.038). Mean folate levels increased from baseline to 48 months by 5.3 μg/L ( P 0.001) but frequency of low folate levels increased from 4.7% preoperatively to 10.3% ( P 0.048). Ferritin levels increased from baseline to 48 months by 51.3 μg/L ( P 0.009). Frequency of low ferritin levels was greater in women (39.1%) than in men (8.9%) at baseline ( P 0.001) and throughout the study period. Haemoglobin was low in 4.6% of all patients at baseline with no significant change over the study period. There were notable rates of haematinic insufficiencies in bariatric surgical candidates preoperatively. Our study lends further support to regular supplementation with vitamin B 12 , folic acid, and iron in people undergoing bariatric surgery.
Publisher: American Society of Hematology
Date: 21-07-2011
DOI: 10.1182/BLOOD-2011-01-328864
Abstract: Induction of antibody-mediated immunity against hematologic malignancies requires CD4+ T-cell help, but weak tumor antigens generally fail to induce adequate T-cell responses, or to overcome tolerance. Conjugate vaccines can harness alternative help to activate responses, but memory B cells may then be exposed to leaking tumor-derived antigen without CD4+ T-cell support. We showed previously using lymphoma-derived idiotypic antigen that exposure to “helpless” antigen silences the majority of memory IgG+ B cells. Transfer experiments now indicate that silencing is permanent. In marked contrast to IgG, most coexisting IgM+ memory B cells exposed to “helpless” antigen survive. Confirmation in a hapten (NP) model allowed measurement of affinity, revealing this, rather than isotype, as the determinant of survival. IgM+ B cells had Ig variable region gene usage similar to IgG but with fewer somatic mutations. Survival of memory B cells appears variably controlled by affinity for antigen, allowing a minority of low affinity IgG+, but most IgM+, memory B cells to escape deletion in the absence of T-cell help. The latter remain, but the majority fail to undergo isotype switch. These findings could apply to other tumor antigens and are relevant for vaccination strategies aimed to induce long-term antibody.
Publisher: Royal College of Physicians
Date: 30-03-2015
Publisher: Springer Science and Business Media LLC
Date: 11-04-2022
Publisher: Springer Science and Business Media LLC
Date: 14-06-2021
DOI: 10.1007/S11695-021-05515-6
Abstract: A Correction to this paper has been published: 10.1007/s11695-020-04943-0
Publisher: Wiley
Date: 07-03-2023
DOI: 10.1111/BJH.18727
Abstract: Lymphoma in pregnancy (LIP) presents unique clinical, social and ethical challenges however, the evidence regarding this clinical scenario is limited. We conducted a multicentre retrospective observational study reporting on the features, management, and outcomes of LIP in patients diagnosed between January 2009 and December 2020 at 16 sites in Australia and New Zealand for the first time. We included diagnoses occurring either during pregnancy or within the first 12 months following delivery. A total of 73 patients were included, 41 diagnosed antenatally (AN cohort) and 32 postnatally (PN cohort). The most common diagnoses were Hodgkin lymphoma (HL 40 patients), diffuse large B‐cell lymphoma (DLBCL 11) and primary mediastinal B‐cell lymphoma (PMBCL six). At a median follow up of 2.37 years, the 2‐ and 5‐year overall survival (OS) for patients with HL were 91% and 82%. For the combined DLBCL and PMBCL group, the 2‐year OS was 92%. Standard curative chemotherapy regimens were successfully delivered to 64% of women in the AN cohort however, counselling regarding future fertility and termination of pregnancy were suboptimal, and a standardised approach to staging lacking. Neonatal outcomes were generally favourable. We present a large multicentre cohort of LIP reflecting contemporary practice and identify areas in need of ongoing research.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Michael Shipton.