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autologous transplant and fever

Noam Benyamini, Irit Avivi, Eldad J Dann, Tsila Zuckerman, Noa Lavi, Tami Katz
Bortezomib-based induction followed by autologous stem cell transplantation is a common treatment for multiple myeloma (MM). Stem cell (SC) mobilization with granulocyte-colony stimulating factor (G-CSF) alone has become an alternative to G-CSF combined with chemotherapeutic agents. This study aimed to compare the efficacy of the two mobilization modalities following induction with a uniform regimen containing bortezomib, cyclophosphamide and dexamethasone (VCD). We retrospectively evaluated results of SC mobilization using either G-CSF alone or combined with high-dose cyclophosphamide (HD-CY) in MM patients after VCD induction...
December 24, 2016: Annals of Hematology
Meera Mohan, Bradley Fogel, Thomas Eluvathingal, Carolina Schinke, Atul Kothari
A 59-year-old patient with multiple myeloma on maintenance chemotherapy presented with fever, weight loss, and night sweats. An F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT) showed intra-abdominal lymphadenopathy with a mesenteric mass that led to further workup and diagnosis of histoplamosis. The patient was treated with amphotericin B and subsequently switched to itraconazole. This exemplifies the usefulness of FDG PET CT in diagnosis of infectious complications...
December 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Nils Winkelmann, Max Desole, Inken Hilgendorf, Thomas Ernst, Herbert G Sayer, Christa Kunert, Lars-Olof Mügge, Andreas Hochhaus, Sebastian Scholl
INTRODUCTION: Even in the era of proteasome inhibitors and immunomodulatory drugs, the autologous stem cell transplantation after high-dose melphalan continues to represent a standard approach for myeloma patients in first-line therapy. Different mobilization chemotherapies before stem cell apheresis have been published while cyclophosphamide at a dose level of up to 4 g/m(2) has been evaluated and is commonly applied. In contrast, lower dose levels of cyclophosphamide (e.g., 1.5 g/m(2)) did not result in a sufficient collection of stem cells...
December 2016: Journal of Cancer Research and Clinical Oncology
Noa Biran, Scott D Rowley, David H Vesole, Shijia Zhang, Michele L Donato, Joshua Richter, Alan P Skarbnik, Andrew Pecora, David S Siegel
Escalating doses of bortezomib with high-dose melphalan was evaluated as as a conditioning regimen for autologous stem cell transplantation (ASCT) in patients with relapsed or refractory multiple myeloma (MM). MM patients with less than a partial remission (PR) (or 50% reduction) compared to their pretransplantation paraprotein parameters after a prior ASCT with melphalan conditioning, or who were in relapse after a prior autologous transplantation, were eligible for study. Bortezomib was dose escalated in steps of 1, 1...
August 31, 2016: Biology of Blood and Marrow Transplantation
Amanda F Cashen, Theresa Fletcher, Connie Ceriotti, Feng Gao, Armin Ghobadi, Ravi Vij, Keith Stockerl-Goldstein, John DiPersio, Camille Abboud
The lyophilized formulation of melphalan has several limitations based on its marginal solubility, limited stability after reconstitution, and the requirement to reconstitute it in propylene glycol (PG). PG-free melphalan (Evomela; Spectrum Pharmaceuticals, Irvine CA) overcomes these limitations by using the solubilizing agent Captisol (Ligand Pharmaceuticals, Inc., LaJolla CA) to improve the stability of the reconstituted melphalan and avoid the potential toxicities of PG. This phase II study investigated the safety and efficacy of high-dose PG-free melphalan when included in the carmustine, etoposide, and cytarabine (BEAM) regimen for adult patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL)...
August 26, 2016: Biology of Blood and Marrow Transplantation
Gerald Illerhaus, Benjamin Kasenda, Gabriele Ihorst, Gerlinde Egerer, Monika Lamprecht, Ulrich Keller, Hans-Heinrich Wolf, Carsten Hirt, Stephan Stilgenbauer, Mascha Binder, Peter Hau, Matthias Edinger, Norbert Frickhofen, Martin Bentz, Robert Möhle, Alexander Röth, Michael Pfreundschuh, Louisa von Baumgarten, Martina Deckert, Claudia Hader, Heidi Fricker, Elke Valk, Elisabeth Schorb, Kristina Fritsch, Jürgen Finke
BACKGROUND: High-dose methotrexate-based chemotherapy is standard for primary CNS lymphoma, but most patients relapse. High-dose chemotherapy with autologous stem cell transplantation (HCT-ASCT) is supposed to overcome the blood-brain barrier and eliminate residual disease in the CNS. We aimed to investigate the safety and efficacy of HCT-ASCT in patients with newly diagnosed primary CNS lymphoma. METHODS: In this prospective, single-arm, phase 2 trial, we recruited patients aged 18-65 years with newly diagnosed primary CNS lymphoma and immunocompetence, with no limitation on clinical performance status, from 15 hospitals in Germany...
August 2016: Lancet Haematology
Rita Gomes, Eva Padrão, Hans Dabó, Filipa Soares Pires, Patrícia Mota, Natália Melo, José Miguel Jesus, Rui Cunha, Susana Guimarães, Conceição Souto Moura, António Morais
INTRODUCTION: Acute fibrinous and organizing pneumonia (AFOP) is a rare diffuse pulmonary disease, but it is not yet known whether it is a distinct form of interstitial pneumonia or simply a reflection of a tissue sampling issue. METHODS: Cross-sectional evaluation of clinical and radiological findings, treatments, and outcomes for patients with histologically confirmed AFOP at a tertiary university hospital between 2002 and 2015. RESULTS: Thirteen patients (7 women, 53...
July 2016: Medicine (Baltimore)
Lidiane Miotto Barretta, Lúcia Marinilza Beccaria, Cláudia Bernardi Cesarino, Maria Helena Pinto
OBJECTIVE: to identify the model, average length of stay on site and complications of central venous catheter in patients undergoing transplant of hematopoietic stem cells and verify the corresponding relationship between the variables: age, gender, medical diagnosis, type of transplant, implanted catheter and insertion site. METHOD: a retrospective and quantitative study with a sample of 188 patients transplanted records between 2007 and 2011. RESULTS: the majority of patients used Hickman catheter with an average length of stay on site of 47...
June 7, 2016: Revista Latino-americana de Enfermagem
D J Green, W I Bensinger, L A Holmberg, T Gooley, B G Till, L E Budde, J M Pagel, S L Frayo, J E Roden, L Hedin, O W Press, A K Gopal
Chemotherapeutic agents without cross-resistance to prior therapies may enhance PBSC collection and improve patient outcomes by exacting a more potent direct antitumor effect before autologous stem cell transplant. Bendamustine has broad clinical activity in transplantable lymphoid malignancies, but concern remains over the potential adverse impact of this combined alkylator-nucleoside analog on stem cell mobilization. We performed a prospective, nonrandomized phase II study including 34 patients with multiple myeloma (MM) (n=34; International Staging System (ISS) stages I (35%), II (29%) and III (24%); not scored (13%)) to evaluate bendamustine's efficacy and safety as a stem cell mobilizing agent...
October 2016: Bone Marrow Transplantation
Mehmet Sinan Dal, Emre Tekgündüz, Merih Kızıl Çakar, Ali Hakan Kaya, Sinem Namdaroğu, Hikmetullah Batgi, Filiz Bekdemir, Bahar Uncu Ulu, Tuğçe Nur Yiğenoğlu, Ali Kılınç, Dicle İskender, Bilge Uğur, Şerife Koçubaba, Gülşen İskender, Fevzi Altuntaş
INTRODUCTION: Microbial contamination can be a marker for faulty process and is assumed to play an important role in the collection of hematopoietic progenitor cell (HPC) and infusion procedure. We aimed to determine the microbial contamination rates and evaluate the success of hematopoietic cell transplantation (HCT) in patients who received contaminated products. PATIENTS-METHODS: We analyzed microbial contamination records of HPC grafts between 2012 and 2015, retrospectively...
August 2016: Transfusion and Apheresis Science
Juan Jose Toro, Francisca Cecilia Gushiken, Deanna Schneider, Shuko Lee, David Johannes Haile, Cesar Ovidio Freytes
PURPOSE: Patients undergoing autologous hematopoietic stem cell transplantation (HSCT) are at risk for oral complications which may cause significant morbidity. The aim of this study was to compare the incidence of toxicities and complications in edentulous and dentate patients undergoing autologous HSCT for multiple myeloma. METHODS: We conducted a retrospective case-control study to analyze the incidence of bacteremia, fever, and oral mucositis, between edentulous and dentate patients...
August 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
S Schlaweck, J Brägelmann, P Brossart, K Mayer
We present the case of a 62-year-old man treated with high-dose chemotherapy and consecutive autologous stem cell transplantation for mantle cell lymphoma, who developed high fever and a rash of the trunk and both axillae 10 days after stem cell transplantation.
April 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Sławomira Kyrcz-Krzemień, Grzegorz Helbig, Karolina Torba, Anna Koclęga, Małgorzata Krawczyk-Kuliś
Introduction Multiple sclerosis (MS) is a T-cell-mediated chronic inflammatory disorder of the central nervous system. Several agents have been approved for treatment of MS, however their efficacy is limited and short term. Autologous hematopoietic stem cell (HSC) transplantation may remain an encouraging option for some MS patients who failed prior conventional treatment. Objective To assess the safety and effectiveness of HSCs mobilization in patients with MS. Material and methods Thirty-nine patients (20 females, 19 males) with relapsing-remitting MS at median age of 40 years (range 25-63) were included in this study...
February 22, 2016: Hematology (Amsterdam, Netherlands)
Tetsuya Ishikawa, Hiroaki Shimizu, Toshifumi Takei, Hiroko Koya, Hirono Iriuchishima, Takumi Hosiho, Junko Hirato, Masaru Kojima, Hiroshi Handa, Yoshihisa Nojima, Hirokazu Murakami
We report a rare case of T cell type monomorphic post-transplant lymphoproliferative disorders (PTLD) after autologous stem cell transplantation. A 53-year-old man with multiple myeloma received autologous stem cell transplantation and achieved a very good partial response. Nine months later, he developed a high fever and consciousness disturbance, and had multiple swollen lymph nodes and a high titer of Epstein-Barr (EB) virus DNA in his peripheral blood. Neither CT nor MRI of the brain revealed any abnormalities...
January 2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Dorothy R McKenna, Matthew R Sullivan, John M Hill, Christopher H Lowrey, Jeremiah R Brown, Joshua Hickman, Kenneth R Meehan
BACKGROUND: About 1 in 7 of all hospitalized patients is readmitted within 30 days of discharge. The cost of readmissions is significant, with Medicare readmissions alone costing the health care system an estimated $28 billion a year. OBJECTIVE: To identify the rates of and causes for readmission within 100 days of patients receiving a hematopoietic stem cell transplant. METHODS: We performed a retrospective review of 235 consecutive transplant recipients (autologous, n = 144; allogeneic, n = 91) to determine rates and causes for readmission within 100 days of patients receiving a transplant...
September 2015: Journal of Community and Supportive Oncology
Chen Tian, Yong Yu, Hongliang Yang, Lei Zhu, Yafei Wang, Yizhuo Zhang
INTRODUCTION: Anaplastic lymphoma kinase-positive (ALK+) anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin lymphoma, which has strong expression of cluster of differentiation (CD)-30 and ALK. ALCL sometimes can involve the bone marrow, and in advanced stages, it can produce destructive bone lesions. But ALK+ ALCL with prominent bone involvement is very rare, especially in children. CASE REPORT: A 13-year-old boy presented with waist pain and low-grade fever for 8 months...
2016: OncoTargets and Therapy
Chenue Abongwa, Rolla Abu-Arja, Stephen Rumelhart, Hillard M Lazarus, Ghada Abusin
UNLABELLED: ES remains an important cause of morbidity and mortality in children undergoing auto-HCT. Glucocorticoid use in ES is an area of debate. We retrospectively analyzed single-institution experience from September 2000 through December 2012 to evaluate the use of glucocorticoids in auto-HCT patients. ES was defined by the occurrence of new onset of non-infectious fever plus diarrhea, rash, or pulmonary infiltrates 24-h before or within five days after neutrophil engraftment. Sixty-five pediatric patients (<21 yr) with different solid tumors underwent auto-HCTs in the study period...
March 2016: Pediatric Transplantation
Heather Landau, Kevin Wood, David J Chung, Guenther Koehne, Nikoletta Lendvai, Hani Hassoun, Alexander Lesokhin, Elizabeth Hoover, Junting Zheng, Sean M Devlin, Sergio Giralt
We conducted a phase II trial investigating the impact of fractionated hematopoietic cell infusions on engraftment kinetics and symptom burden in patients with plasma cell myeloma (PCM) undergoing autologous hematopoietic cell transplant (AHCT). We hypothesized that multiple hematopoietic cell infusions would reduce duration of neutropenia and enhance immune recovery resulting in a better tolerated procedure. Twenty-six patients received high-dose melphalan followed by multiple cell infusions (Days 0, +2, +4, +6) and were compared to PCM patients (N = 77) who received high-dose melphalan and a single infusion (Day 0) (concurrent control group)...
August 2016: Leukemia & Lymphoma
Kui Song, Weichao Li, Min Li
Acute myeloid leukemia (AML) is an extremely rare complication that can be observed following mesenchymal stem cells (MSC) transplantation for traumatic brain injury (TBI). Few cases have been reported thus far. The present study reports a case of acute promyelocytic leukemia (APL) following MSC transplantation in a 36-year-old female. The patient presented with a fever and dermatorrhagia with an associative abnormal coagulation test almost 2 months after the MSC transplantation for TBI. The routine blood test, bone marrow (BM) test, and examination of the promyelocytic leukemia/retinoic acid receptor-α and mixed lineage leukemia chimeric genes confirmed the diagnosis of APL and disseminated intravascular coagulation (DIC)...
November 2015: Oncology Letters
So Eun Kim, Jong Ho Won, Hyun Soo Kim, Joon Sung Park, Chan Kyu Kim, Kyu Taeg Lee, Sung Kyu Park, Seung Ho Baick, Dae Sik Hong, Hee Sook Park, Hugh Chul Kim
PURPOSE: High dose chemotherapy (HDC) is increasingly being used for ovarian cancer. Although early studies of autotransplantation for advanced ovarian cancer have been encouraging, most reported series were small, and no randomized trials have been reported. HDC and autologous hematopoietic stem cell transplantation were rarely performed in patients with ovarian cancer in Korea, and no results have been reported with the exception of one case report. MATERIALS AND METHODS: We retrospectively analyzed 10 patients with refractory or relapsed ovarian cancer having received HDC and autologous peripheral blood stem cell transplantation (APBSCT), between January 1996 and September 1998, at the Soon Chun Hyang and Ajou University Hospitals...
December 2002: Cancer Research and Treatment: Official Journal of Korean Cancer Association
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