 The Bone Marrow Transplant Unit (BMT) of the Department of Internal Medicine I (Head of Department: Prof. Dr. Christoph Zielinski) of the Medical University of Vienna, Austria is the largest bone marrow and peripheral blood stem cell transplant center in Austria and has 55 employees. In 1978, the first allogeneic bone marrow transplant (BMT) with a HLA-identical sibling donor was performed in our center; the first autologous BMT, the first allogeneic BMT with an unrelated donor and the first allogeneic hemopoietic stem cell transplantation (SCT) with reduced-intensity conditioning were performed in 1983, 1994 and 1999, respectively. Since 1992 the number of transplants per year has increased markedly. Today, between 90 and 100 transplants per year are performed under the medical direction of Prof. Dr. Hildegard Greinix and Prof. Dr. Peter Kalhs. Transplantation from bone marrow (BM) as well as from peripheral blood derived hematopoietic progenitor cells (PBPC) has become an established form of treatment for many patients with hematological and oncological diseases and is able to achieve high cure rates. Significant advances in supportive care, HLA-typing technologies allowing improved donor selection and immunosuppressive treatment as well as use of PBPC instead of BM have led to improved survival rates and quality of life in transplanted patients. For many years the BMT Unit of the Medical University of Vienna has been accredited by the European Group for Blood and Marrow Transplantation (EBMT) for allogeneic related and unrelated and autologous SCT and BM harvests. In 2004 we achieved a certification according to ISO-9001:2000 and thus, successfully established a quality management program at our center. In January of next year the audit to obtain JACIE-accreditation of the EBMT will take place.  KMT
Knochenmarktransplantation
Medizinische Universitaet Wien
Universitaetsklinik fuer Innere Medizin I
Waehringer Guertel 18-20
A-1090 Vienna
Austria
Phone: 43-1-40 400 4457
FAX: 43-1-40 400 2511
E-mail: Hildegard.greinix@meduniwien.ac.at
Detailed information about the BMT Unit of the Medical University of Vienna is available under the internet address http://www.kmt-wien.at/ .
Professor Dr. Hildegard Greinix
 Prof. Dr. Hildegard Greinix graduated in Medicine from the Karl-Franzens-University in Graz in 1983. She worked as fellow in internal medicine, hematology and oncology at the University Hospital of Graz, Department of Internal Medicine III. During her postgraduate training she worked from 1989 until 1991 as research fellow in experimental and clinical marrow transplantation at the Fred Hutchinson Cancer Research Center in Seattle, USA within the program "Transplantation Biology" of Prof. Rainer Storb. Since 1992 Prof. Greinix has been attending physician at the Bone Marrow Transplant Unit (BMT) of the Department of Internal Medicine I of the Medical University of Vienna. She is head of the Outpatient Clinic of the BMT and leads the research programs of the BMT group. Prof. Greinix has established extracorporeal photochemotherapy (ECP) for the treatment of patients with acute and chronic graft-versus-host disease (GVHD) in Vienna and has published the, so far, largest series of patients given ECP successfully as second line therapy in steroid-refractory GVHD. Since 2000 Prof. Greinix chairs the Austrian Group for Blood and Marrow Transplantation within the Austrian Society of Hematology and Oncology. She is also the Austrian representative in the JACIE-Subcommittee of the EBMT and a member of the Chronic Leukemia Working Party of the EBMT. Since 2002 she chairs the Clinical Working Group of the World Marrow Donor Association. In October 2004 she was elected as chair of the Austrian Society of Transplantation, Transfusion and Genetics.
Research activities
 The research team of the BMT group of the Medical University of Vienna is focused on the exploration of alloreactivity with regards to potentiation of graft-versus-leukemia and graft-versus-tumor reactions and ways of influencing incidence and severity of graft-versus-host disease.
In our lab (Ferry Elahi, PhD; Karin Moser; Axel Schulenburg, MD; Roman Weigl; Stefan Wöhrer, MD) we are assessing the following questions using experimental models as well as translational research on clinical samples:
. In-vitro monitoring for graft-versus-host disease and graft-versus-leukemia by the help of in-vitro predictive tests (skin explant assay, cytokine secretion assay, cytokine gene polymorphisms, minor histocompatibility antigen typing)
. Studies on tolerance induction by regulatory T-cells and anergizing dendritic cells
. Monitoring of organ-specific alloreactions in the skin
. Assessment of donor-derived chimerism in various cell subsets by fluorescence in situ hybridization
. Analysis of immune reconstitution post SCT
. Studies on effects of UVA irradiation including extracorporeal photochemotherapy (induction of apoptosis, Th1/Th2 cytokine production, induction of regulatory T-cells, influence on antigen presenting cells) and correlation with clinical response to ECP
. Assessment of organ-specific alloreactions in the gut (immunohistochemistry, apoptosis) and endothelial regeneration
Ferry Elahi, PhD, was trained in technical chemistry and became an expert in culturing of marrow and blood stem cells including long-term marrow cultures. He is currently working on skin explant assays and in-vitro UVA irradiation.
Karin Moser is our excellent lab technician and involved in cell cultures, flow cytometric analyses, cell sorting and fluorescence in situ hybridization.
Axel Schulenburg is an MD trained in hematology, oncology and stem cell transplantation. His main research interests involve immune reconstitution after SCT, alloreactions in the gastrointestinal tract and endothelial regeneration including endothelial stem cells.
Roman Weigl is a PhD student in technical chemistry and achieved excellent knowledge on immunological staining techniques and flow cytometric analyses including intracellular cytokine staining and assessment of apoptosis.
Stefan Wöhrer is an MD fellow in hematology and oncology and is an expert in fluorescence in situ hybridization techniques and culturing of hematopoietic cells.
Transeurope Research Team/ Collaborators
The clinical transplant team includes Professor Peter Kalhs, Professor Margit Mitterbauer, Professor Werner Rabitsch and Dr. Axel Schulenburg who are experienced clinicians in the field of Hematology, Oncology and Hematopoietic Stem Cell Transplantation.
Collaboration with Department of Dermatology of the Medical University of Vienna:
Professor Robert Knobler is Director of the Extracorporeal Photopheresis Unit of the Division of Special Dermatology. His main research interest lies in the areas of clinical and experimental aspects of photomedicine, T-cell mediated diseases including. cutaneous T-cell lymphoma, organ transplantation and autoimmune diseases.
Professor Franz Trautinger is Head of the inpatient ward of the Division of Special and Environmental Dermatology, Head of the ward for cutaneous lymphomas and Head of the experimental research laboratory of the division. His main research interests are clinically diagnosis and treatment of cutaneous lymphomas and photomedicine. Experimentally, his research involves photobiology of the skin, and investigation of the expression and function of heat shock proteins in the skin.
Professor Franz Karlhofer is Head of the laboratory of immunopathology and Head of the inpatients' ward at the Division of Immunology, Allergy and Infectious Diseases (DIAID). Together with Professor Achim Schneeberger he is in charge of the outpatient clinic for GVHD patients of the DIAID. His main research interests are diagnosis and treatment of cutaneous autoimmune dermatoses and the characterization of disease specific parameters. Professor Schneeberger has been instrumental in establishing serological melanoma markers and immunization strategies for the treatment of melanoma patients. His further interests are focused on the care of patients with GVHD.
Collaboration with the Department of Blood Group Serology and Transfusion Medicine: Professor Gottfried Fischer is Head of the tissue culture laboratory of the Department of Blood Group Serology and member of the Board of the European Federation of Immunogenetics (EFI). His main research interests are minor histocompatibility antigen typing, cytokine gene polymorphism analyses and the genetic interaction of Killer Cell Immunoglobulin like Receptor with HLA.
Professor Paul Höcker is the Head of the Division of Transfusion Medicine and in charge of the extracorporal photochemotherapy at his center.
Relevant references
Greinix HT, Volc-Platzer B, Rabitsch W, Gmeinhart B, Guevara-Pineda C, Kalhs P, Krutmann J, Hönigsmann H, Ciovica M, Knobler R: Successful use of extracorporeal photochemotherapy in the treatment of severe acute and chronic graft-versus-host disease. Blood 92: 3098 - 3104, 1998
Greinix HT, Volc-Platzer B, Kalhs P, Fischer G, Rosenmayr A, Keil F, Hönigsmann H, Knobler RM: Extracorporeal photochemotherapy in the treatment of severe steroid- refractory acute graft-versus-host disease: a pilot study. Blood 96: 2426 – 2431, 2000
Greinix HT, Volc-Platzer B, Knobler R: Criteria for assessing chronic GVHD. Bone Marrow Transplantation 25: 575, 2000
Greinix HT, Nachbaur D, Krieger O, Eibl M, Knöbl P, Kalhs P, Lutz D, Linkesch W, Niederwieser D, Hinterberger W, Lechner K, Rosenmayr A, Gritsch B: Factors affecting long-term outcome after allogeneic hematopoietic stem cell transplantation for acute myelogenous leukemia: a retrospective study of 172 patients reported to the Austrian Stem Cell Transplantation Registry. British Journal of Haematology 117: 914- 923, 2002
Worel N, Biener D, Kalhs P, Mitterbauer M, Keil F, Schulenburg A, Höcker P, Dieckmann K, Fischer G, Rosenmayr A, Linkesch W, Hinterberger W, Lechner K, Greinix HT: Long-term outcome and quality of life of patients who are alive and in complete remission more than two years after allogeneic and syngeneic stem cell transplantation. Bone Marrow Transplantation 30: 619-626, 2002
Worel N, Greinix HT, Keil F, Mitterbauer M, Lechner K, Fischer G, Mayr W, Hoecker P, Kalhs P: Severe immune hemolysis after minor ABO-mismatched allogeneic peripheral blood progenitor cell transplantation occurs more frequently after nonmyeloablative than myeloablative conditioning. Transfusion 42: 1293-1301, 2003
Peniket AJ, Ruiz-De-Elvira MC, Taghipour G, Cordonnier C, Gluckman E, De Witte T, Santini G, Blaise D, Greinix H, Ferrant A, Cornelissen J, Schmitz N, Goldstone AH: An EBMT registry matched study of allogeneic stem cell transplants for lymphoma: allogeneic transplantation is associated with a lower relapse rate but a higher procedure-related mortality rate than autologous transplantation. Bone Marrow Transplant 31: 667-678, 2003
Keil F, Prinz E, Moser K, Mannhalter C, Kalhs P, Worel N, Rabitsch W, Schulenburg A, Mitterbauer M, Greinix H: Rapid establishment of long-term culture-initiating cells of donor origin after nonmyeloablative allogeneic hematopoietic stem-cell transplantation, and significant prognostic impact of donor T-cell chimerism on stable engraftment and progression-free survival. Transplantation 76: 230-236, 2003
Rabitsch W, Knöbl P, Prinz E, Keil F, Greinix H, Kalhs P, Worel N, Jansen M, Hörl WH, Derfler K: Prolonged red cell aplasia after major ABO-incompatible allogeneic hematopoietic stem cell transplantation: removal of persisting isohemagglutinins with Ig-Therasorb immunoadsorption. Bone Marrow Transplantation 32: 1015-1019, 2003
Rabitsch W, Prinz E, Ackermann J, Wöhrer S, Kaufmann H, Seidl S, Keil F, Kalhs P, Greinix H, Gisslinger H, Leitner G, Drach J: Long-term follow up of patients with multiple myeloma after high-dose chemotherapy and allogeneic stem cell transplantation. European Journal of Haematology 72: 26-31, 2004
Schulenburg A, Turetschek K, Wrba F, Vogelsang H, Greinix HT, Keil F, Mitterbauer M, Kalhs P: Early and late gastrointestinal complications after myeloablative and nonmyeloablative allogeneic stem cell transplantation. Annals of Hematology 83: 101-106, 2004
Greinix HT, Fae I, Schneider B, Rosenmayr A, Mitterschiffthaler A, Pelzmann B, Kalhs P, Lechner K, Mayr WR, Fischer GF: Impact of HLA class I high resolution mismatches on chronic graft-versus-host disease and survival of patients given hematopoietic stem cell grafts from unrelated donors. Bone Marrow Transplantation accepted for publication Sept 20, 2004
Hainz U, Obexer P, Winkler C, Sedlmayr P, Takikawa O, Greinix H; Lawitschka A, Pötschger U, Fuchs D, Ladisch S, Heitger A: Monocyte-mediated T cell suppression and augmented monocyte tryptophan catabolism after human hematopoietic stem cell transplantation. Blood accepted for publication Nov 15, 2004
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