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Andrés Server, Nuria Bargalló, Yngvar Fløisand, Jon Sponheim, Francesc Graus, John K Hald
Neurologic complications are common after hematopoietic stem cell transplantation (HSCT) and solid organ transplantation (SOT) and affect 30-60% of transplant recipients. The aim of this article is to provide a practical imaging approach based on the timeline and etiology of CNS abnormalities, and neurologic complications related to transplantation of specific organs. The lesions will be classified based upon the interval from HSCT procedure: pre-engraftment period <30 days, early post-engraftment period 30-100 days, late post-engraftment period >100 days, and the interval from SOT procedure: postoperative phase 1-4 weeks, early posttransplant syndromes 1-6 months, late posttransplant syndromes >6 months...
March 2, 2017: Neuroradiology
Z B Radnay, M Udvardy, M Papp, J Hársfalvi, L Rejto, I Pál, Á Illés, A Kiss
Hematopoietic stem cell transplantation (HSCT) associated immunocompromised state carries high risk of infectious complications. Mannose-binding lectin (MBL) is an acute phase protein involved in innate immune response. Serum MBL level is genetically determined and quite stable. According to literature, significant association was shown between low MBL concentrations and serious infections. The association between serum MBL level and frequency and severity of infections was studied in 186 patients following autologous HSCT...
December 2016: Transplantation Proceedings
Ming Pei
Adult stem cells are a promising cell source for cartilage regeneration. Unfortunately, due to donor age and ex vivo expansion, stem cell senescence becomes a huge hurdle for these cells to be used clinically. Increasing evidence indicates that environmental preconditioning is a powerful approach in promoting stem cells' ability to resist a harsh environment post-engraftment, such as hypoxia and inflammation. However, few reports organize and evaluate the literature regarding the rejuvenation effect of environmental preconditioning on stem cell proliferation and chondrogenic differentiation capacity, which are important variables for stem cell based tissue regeneration...
February 2017: Biomaterials
Clyde D Ford, Michaela A Gazdik, Bert K Lopansri, Brandon Webb, Birgitta Mitchell, Jana Coombs, Daanish Hoda, Finn Bo Petersen
The association between pre-hematopoietic stem cell transplantation (HSCT) vancomycin-resistant Enterococcus (VRE) colonization, HSCT-associated VRE bacteremia, and HSCT mortality is disputed. We studied 161 consecutive patients with acute leukemia who underwent HSCT at our hospital between 2006 and 2014, of whom 109 also received leukemia induction/consolidation on our unit. All inpatients had weekly VRE stool surveillance. Pre-HSCT colonization was not associated with increases in HSCT mortality but did identify a subgroup of HSCT recipients with a higher risk for VRE bacteremia and possibly bacteremia from other organisms...
February 2017: Biology of Blood and Marrow Transplantation
Changcheng Zheng, Baolin Tang, Xiaoyu Zhu, Xuhan Zhang, Lei Zhang, Liangquan Geng, Huilan Liu, Zimin Sun
The aim of this study is to investigate the impact of pre-engraftment bloodstream infections (BSIs) on the outcomes in acute leukemia patients undergoing myeloablative cord blood transplantation (CBT). A total of 226 acute leukemia patients who received unrelated CBT were enrolled in this study, and all these patients received an intensified myeloablative conditioning without ATG. Pre-engraftment BSIs occurred in 72 patients (31.9 %), and the median time of onset was 4.5 days after cord blood infusion, BSIs of gram-negative bacilli, and gram-positive cocci comprised of 63...
January 2017: Annals of Hematology
Young-Ho Lee, Wee-Jin Rah
No abstract text is available yet for this article.
September 2016: Blood Research
Toshihiro Miyamoto, Shuichiro Takashima, Koji Kato, Ken Takase, Goichi Yoshimoto, Shuro Yoshida, Hideho Henzan, Koichi Osaki, Tomohiko Kamimura, Hiromi Iwasaki, Tetsuya Eto, Takanori Teshima, Koji Nagafuji, Koichi Akashi
Umbilical cord blood transplantation with a reduced-intensity conditioning regimen (RIC-UCBT) is used increasingly in patients who have comorbid organ functions and lack human leukocyte antigen-identical donors. We compared the outcomes in 35 patients who received mycophenolate mofetil plus cyclosporine (MMF/CSP, n = 17) or MMF plus tacrolimus (MMF/TAC, n = 18) for graft-versus-host disease (GVHD) prophylaxis after RIC-UCBT. Cumulative incidence of neutrophil engraftment was 94 and 89 % in MMF/CSP and MMF/TAC groups, respectively (p = 0...
January 2017: International Journal of Hematology
Shugo Kowata, Yukiteru Fujishima, Yuzo Suzuki, Yasuhiko Tsukushi, Tatsuo Oyake, Ryou Togawa, Kotaro Oyama, Akio Ikai, Shigeki Ito, Yoji Ishida
Recent advances in surgical corrections and supportive care for congenital heart disease have resulted in increasing numbers of adult survivors who may develop hematological malignancies. Treatments including chemotherapy for such patients may cause serious hemodynamic or cardiac complications, especially in those receiving stem cell transplantation. We present a 29-year-old woman with acute lymphoblastic leukemia and congenital heart disease. She had been diagnosed with pulmonary atresia with an intact ventricular septum at birth, and the anomaly was surgically corrected according to the Fontan technique at age 9 years...
August 2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Jared W Glenn, Mark J Cody, Meghann P McManus, Michael A Pulsipher, Joshua D Schiffman, Christian Con Yost
Overwhelming infection causes significant morbidity and mortality among patients treated with bone marrow transplantation (BMT) for primary immune deficiencies, syndromes of bone marrow failure, or cancer. The polymorphonuclear leukocyte (PMN; neutrophil) is the first responder to microbial invasion and acts within the innate immune system to contain and clear infections. PMNs contain, and possibly clear, infections in part by forming neutrophil extracellular traps (NETs). NETs are extensive lattices of extracellular DNA and decondensed chromatin decorated with antimicrobial proteins and degradative enzymes, such as histones, myeloperoxidase, and neutrophil elastase...
2016: Frontiers in Immunology
S Y Thien, S J Chung, A L Tan, W Y K Hwang, B H Tan, T T Tan
Trichosporon is an ubiquitous yeast that has emerged as an opportunistic pathogen in the immunocompromised host. We describe a case of invasive trichosporonosis in an allogeneic hematopoietic stem cell transplant (allo-HSCT) recipient while on caspofungin antifungal prophylaxis. She developed disseminated trichosporonosis in the pre-engraftment period and was successfully treated with voriconazole. She later developed 2 further episodes of invasive trichosporonosis involving the central nervous system. This case highlights the challenges of managing trichosporonosis in allo-HSCT recipients and suggests the need for lifelong therapy in some patients...
October 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Igor Stoma, Igor Karpov, Natalia Milanovich, Anatoly Uss, Igor Iskrov
BACKGROUND: Bloodstream infections (BSI) remain a frequent complication during the pre-engraftment period after hematopoietic stem cell transplantation (HSCT), resulting in high mortality rates. This study evaluated risk factors for mortality in hematopoietic stem cell transplant recipients with BSI in the pre-engraftment period. METHODS: This prospective case control study was performed at the Center of Hematology and Bone Marrow Transplantation in Minsk, Republic of Belarus...
June 2016: Blood Research
Bungo Saito, Norimichi Hattori, Kohei Yamamoto, Nana Arai, Yukiko Kawaguchi, Shun Fujiwara, Nobuyuki Kabasawa, Hiroyuki Tsukamoto, Yui Uto, Hirotsugu Ariizumi, Kouji Yanagisawa, Tsuyoshi Nakamaki
Cord blood transplantation (CBT) is an alternative approach to allogeneic stem cell transplantation. However, CBT is associated with issues including pre-engraftment immune reaction (PIR), engraftment syndrome (ES), and graft failure (GF). Tacrolimus (TAC) and short-term methotrexate (sMTX: days 1, 3, 6, and/or 11) are used for graft-versus-host disease (GVHD) prophylaxis during CBT; however, sMTX does not accelerate neutrophil engraftment. Therefore, we hypothesized that lower doses of sMTX [very-short-term MTX (vsMTX): 10 and 7mg/m(2) on days 1 and 3, respectively] with TAC reduce the risk of GF without increasing post-transplantation immune reactions during CBT...
August 2016: Leukemia Research
Ugur Sahin, Selami Kocak Toprak, Pinar Ataca Atilla, Erden Atilla, Taner Demirer
Infections are the most common and significant cause of mortality and morbidity after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The presence of neutropenia and mucosal damage are the leading risk factors in the early pre-engraftment phase. In the early post-engraftment phase, graft versus host disease (GvHD) induced infection risk is increased in addition to catheter related infections. In the late phase, in which reconstitution of cellular and humoral immunity continues, as well as the pathogens seen during the early post-engraftment phase, varicella-zoster virus and encapsulated bacterial infections due to impaired opsonization are observed...
August 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Fevzi Altuntaş, Orhan Yıldız, Bülent Eser, Emine Alp, İsmail Sarı, Mustafa Çetin, Bülent Sümerkan, Ali Ünal
This study was performed to assess the incidence of infectious complications in patients undergoing autologous and allogeneic hematopoietic stem cell transplantation (HSCT). The characteristics of microbiologically documented infections in 114 consecutive patients undergoing HSCT (84 autologous, 30 allogeneic) were analyzed. Conditioning and the pre-engraftment period until one month was defined as the early period; the post-engraftment period until one year was defined as the late period. All patients received antibiotic prophylaxis and hematopoietic growth factors during neutropenia...
September 5, 2005: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
Bianca Harris, Sejal M Morjaria, Eric R Littmann, Alexander I Geyer, Diane E Stover, Juliet N Barker, Sergio A Giralt, Ying Taur, Eric G Pamer
RATIONALE: Pulmonary complications (PCs) cause significant morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HCT). Shifts in gut microbiota have been linked to HCT outcomes; however, their effect on PCs is unknown. OBJECTIVES: To investigate whether changes in gut microbiota are associated with PCs after HCT. METHODS: A single-center observational study was performed on 94 patients who underwent HCT from 2009 to 2011 and who were previously enrolled in a protocol for 16S ribosomal RNA sequencing of fecal microbiota...
August 15, 2016: American Journal of Respiratory and Critical Care Medicine
Elizabeth O Stenger, Lakshmanan Krishnamurti, Jacques Galipeau
Mesenchymal stromal cells (MSCs) are multipotent progenitor cells known to modulate the immune system and to promote hematopoiesis. These dual effects make MSCs attractive for use as cellular therapy in hematopoietic cell transplantation (HCT). MSCs can be used peri-HCT or pre-engraftment to modulate immune reconstitution, promoting hematopoietic stem cell (HSC) engraftment and/or preventing graft-versus-host disease (GVHD). Pre-clinical studies have demonstrated that MSCs can potentiate HSC engraftment and prevent GVHD in a variety of animal models...
December 16, 2015: BMC Immunology
Akihiro Iguchi, Yukayo Terashita, Minako Sugiyama, Junjiro Ohshima, Tomonobu Z Sato, Yuko Cho, Ryoji Kobayashi, Tadashi Ariga
GVHD and graft failure are serious problems in CBT. PES after CBT also occurs frequently and is associated with transplantation-related complications such as acute GVHD. We reviewed medical records for 70 consecutive child CBT recipients between December 1997 and April 2015. Forty-nine patients received prophylaxis against GVHD with CsA or Tac in combination with mPSL from day +7 (mPSL group), and 21 patients received CsA or Tac with MTX on day +1 and day +3 (MTX group). Neutrophil engraftment was detected in 59 patients (84...
February 2016: Pediatric Transplantation
Masao Ogata
Reactivation of human herpesvirus (HHV)-6B is a relatively common occurrence after allogeneic stem cell transplantation (SCT), and it is associated with the development of various post-transplant complications. HHV-6 encephalitis appears to be a significant, life-threatening complication caused by HHV-6B reactivation. HHV-6 encephalitis typically develops 2-6 weeks after SCT, and the symptoms are characterized by memory loss, seizures, and consciousness loss. Magnetic resonance imaging typically shows limbic encephalitis...
October 2015: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
W Yao, C C Zheng, H L Liu, L Q Geng, B L Tang, J Tong, X Y Zhu, K D Song, P Qiang, Z M Sun
Treatments for patients with hematologic malignancies not in remission are limited, but a few clinical studies have investigated the effects of salvaged unrelated cord blood transplantation (CBT). We retrospectively studied 19 patients with acute leukemia, 5 with myelodysplastic syndrome (MDS with refractory anemia with excess blasts [RAEB]), and 2 with non-Hodgkin's lymphoma who received 1 CBT unit ≤ 2 loci human leukocyte antigen (HLA)-mismatched after undergoing myeloablative conditioning regimens between July 2005 and July 2014...
October 2015: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
P Montesinos, R Rodríguez-Veiga, B Boluda, D Martínez-Cuadrón, I Cano, A Lancharro, J Sanz, M J Arilla, F López-Chuliá, I Navarro, I Lorenzo, M Salavert, J Pemán, P Calvillo, J Martínez, N Carpio, I Jarque, G F Sanz, M A Sanz
Studies that analyze the epidemiology and risk factors for invasive fungal disease (IFD) after engraftment in alloSCT are few in number. This single-center retrospective study included 404 alloSCT adult recipients surviving >40 days who engrafted and were discharged without prior IFD. All patients who received ⩾20 mg/day of prednisone were assigned to primary oral prophylaxis (itraconazole or low-dose voriconazole). The primary end point was the cumulative incidence (CI) of probable/proven IFD using the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) criteria...
November 2015: Bone Marrow Transplantation
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