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Pre-engraftment

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https://www.readbyqxmd.com/read/29668124/a-reduced-dose-of-fluconazole-as-primary-antifungal-prophylaxis-is-not-associated-with-increased-risk-of-invasive-fungal-infections-after-allogeneic-stem-cell-transplantation-from-a-hla-identical-sibling
#1
B Sarina, J Mariotti, S Bramanti, L Morabito, R Crocchiolo, A Rimondo, F Tordato, D Pocaterra, E Casari, Chiara De Philippis, C Carlo-Stella, A Santoro, L Castagna
BACKGROUND: Invasive fungal infections (IFI) represent a common side effect of allogeneic hematopoietic stem cell transplant (allo-SCT), resulting in increased non relapse mortality (NRM) and reduced overall survival (OS) rates. 75-days of Fluconazole 400 mg/day represents the standard primary antifungal prophylaxis (PAP) after allo-SCT, especially for low-risk transplants. However, the ideal dosage of fluconazole has never been tested. METHODS: Here we report the experience of our institution on 113 consecutive patients receiving an allo-SCT from a HLA identical sibling between 1999 and 2015, where PAP consisted of fluconazole 100 mg/day only during the pre-engraftment phase...
April 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29578073/de-escalation-and-discontinuation-of-empirical-antibiotic-treatment-in-a-cohort-of-allogeneic-hematopoietic-stem-cell-transplantation-recipients-during-the-pre-engraftment-period
#2
Giulia Gustinetti, Annamaria Raiola, Riccardo Varaldo, Federica Galaverna, Francesca Gualandi, Valerio Del Bono, Andrea Bacigalupo, Emanuele Angelucci, Claudio Viscoli, Malgorzata Mikulska
OBJECTIVES: to investigate rates and outcomes of antibiotic de-escalation during pre-engraftment neutropenia in allogeneic hematopoietic stem cell transplantation (HSCT) recipients. METHODS: 110 consecutive HSCT performed between 01/2013-03/2014 were analysed. De-escalation was defined as narrowing the spectrum of antibiotic treatment either within (early) or after 96 hours (late) from starting antibiotics. Discontinuation, considered a form of de-escalation, was defined as stopping antibiotics before engraftment...
March 22, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29530743/epidemiology-risk-factors-and-outcomes-of-multi-drug-resistant-bloodstream-infections-in-hematopoietic-stem-cell-transplant-recipients-importance-of-previous-gut-colonisation
#3
Aliana Meneses Ferreira, Frederico Moreira, Thais Guimaraes, Fernanda Spadão, Jessica Fernandes Ramos, Marjorie Vieira Batista, Jayr Schmidt Filho, Silvia Figueiredo Costa, Vanderson Rocha
BACKGROUND: Bloodstream infections (BSI) are a major complication in the early phase of a hematopoietic stem cell transplant (HSCT). AIM: To describe the incidence and risk factors for BSI occurring in the pre-engraftment phase of HSCT and its impact on mortality. METHODS: We retrospectively analysed clinical variables of 232 HSCT patients between 2014 and 2015. Univariate Cox regression analyses were performed to test the association between each covariate and the outcome...
March 9, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29506345/infectious-complications-after-hematopoietic-stem-cell-transplantation-current-status-and-future-perspectives-in-korea
#4
REVIEW
Sung-Yeon Cho, Hyeon-Jeong Lee, Dong-Gun Lee
Hematopoietic stem cell transplantation (HSCT) is a treatment for hematologic malignancies, immune deficiencies, or genetic diseases, ect. Recently, the number of HSCTs performed in Korea has increased and the outcomes have improved. However, infectious complications account for most of the morbidity and mortality after HSCT. Post-HSCT infectious complications are usually classified according to the time after HSCT: pre-engraftment, immediate post-engraftment, and late post-engraftment period. In addition, the types and risk factors of infectious complications differ according to the stem cell source, donor type, conditioning intensity, region, prophylaxis strategy, and comorbidities, such as graft-versushost disease and invasive fungal infection...
March 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29464765/delay-of-alternative-antiviral-therapy-and-poor-outcomes-of-acyclovir-resistant-herpes-simplex-virus-infections-in-recipients-of-allogeneic-stem-cell-transplant
#5
Ella J Ariza-Heredia, Roy F Chemaly, Lokesh R Shahani, Ying Jang, Richard Champlin, Victor E Mulanovich
Acyclovir is commonly used to prevent and treat herpes simplex virus (HSV) reactivation after hematopoietic cell transplant (HCT), and only few reports have been published on acyclovir-resistant HSV in HCT recipients. We reviewed the medical records of patients with a microbiologic diagnosis of acyclovir-resistant HSV by plaque reduction test who received an HCT from 2002 through 2014. A total of 4028 HCTs were performed during the study period, and 18 of the recipients met the diagnostic criteria for acyclovir-resistant HSV...
February 21, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29320771/perianal-infections-in-the-phase-before-engraftment-after-allogeneic-hematopoietic-stem-cell-transplantations-a-study-of-the-incidence-risk-factors-and-clinical-outcomes
#6
Xiao-Dong Mo, Xia Yan, Wei Hu, Xiao-Hui Zhang, Lan-Ping Xu, Yu Wang, Xiao-Dong Xu, Lin-Nan Wang, Xin-Xin He, Chen-Hua Yan, Huan Chen, Yu-Hong Chen, Kai-Yan Liu, Xiao-Jun Huang
In this study, we aimed to investigate the incidence, risk factors, and clinical outcomes of perianal infections during the pre-engraftment phase after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Consecutive patients who underwent non-T-cell-depleted allo-HSCT at the Peking University Institute of Hematology from January 1 to December 31, 2016 were enrolled (n = 646). Ninety-nine patients were found to have perianal infections during the pre-engraftment phase, and 80 were found to have neutropenia on perianal infection diagnosis...
2018: Acta Haematologica
https://www.readbyqxmd.com/read/29058698/foiling-fungal-disease-post-hematopoietic-cell-transplant-review-of-prophylactic-strategies
#7
REVIEW
S M Rubinstein, K A Culos, B Savani, G Satyanarayana
Hematopoietic cell transplantation (HCT) offers definitive management for a wide variety of malignant and nonmalignant diseases. Conditioning regimens and therapies used to prevent and treat GvHD are immune suppressive, often increasing the risk of developing fungal disease due to yeasts or molds. Antifungal prophylaxis may be useful in preventing morbidity and mortality during and after HCT. In this article, we review the epidemiology and current literature regarding strategies for prevention of invasive fungal disease (IFD) in the pre-engraftment and post-engraftment settings, and propose future direction for scientific discovery...
February 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29020286/incidence-risk-factors-and-outcome-of-pre-engraftment-gram-negative-bacteremia-after-allogeneic-and-autologous-hematopoietic-stem-cell-transplantation-an-italian-prospective-multicenter-survey
#8
Corrado Girmenia, Alice Bertaina, Alfonso Piciocchi, Katia Perruccio, Alessandra Algarotti, Alessandro Busca, Chiara Cattaneo, Anna Maria Raiola, Stefano Guidi, Anna Paola Iori, Anna Candoni, Giuseppe Irrera, Giuseppe Milone, Giampaolo Marcacci, Rosanna Scimè, Maurizio Musso, Laura Cudillo, Simona Sica, Luca Castagna, Paolo Corradini, Francesco Marchesi, Domenico Pastore, Emilio Paolo Alessandrino, Claudio Annaloro, Fabio Ciceri, Stella Santarone, Luca Nassi, Claudio Farina, Claudio Viscoli, Gian Maria Rossolini, Francesca Bonifazi, Alessandro Rambaldi
Background: Gram-negative bacteremia (GNB) is a major cause of illness and death after hematopoietic stem cell transplantation (HSCT), and updated epidemiological investigation is advisable. Methods: We prospectively evaluated the epidemiology of pre-engraftment GNB in 1118 allogeneic HSCTs (allo-HSCTs) and 1625 autologous HSCTs (auto-HSCTs) among 54 transplant centers during 2014 (SIGNB-GITMO-AMCLI study). Using logistic regression methods. we identified risk factors for GNB and evaluated the impact of GNB on the 4-month overall-survival after transplant...
November 13, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28860000/pre-engraftment-bloodstream-infections-after-allogeneic-hematopoietic-cell-transplantation-impact-of-t-cell-replete-transplantation-from-a-haploidentical-donor
#9
Malgorzata Mikulska, Anna Maria Raiola, Federica Galaverna, Elisa Balletto, Maria Lucia Borghesi, Riccardo Varaldo, Francesca Gualandi, Livia Giannoni, Giordana Pastori, Daniele Roberto Giacobbe, Alessio Signori, Valerio Del Bono, Claudio Viscoli, Andrea Bacigalupo, Emanuele Angelucci
Bloodstream infections (BSIs) are frequent and important infectious complications after hematopoietic cell transplantation (HCT). The aim of this study was to analyze the incidence, risk factors, and outcome of pre-engraftment BSIs after allogeneic HCT. We retrospectively analyzed data from 553 consecutive patients who underwent HCT between 2010 and 2016. Sixty percent of the patients received T cell-replete unmanipulated haploidentical bone marrow with high-dose post-transplantation cyclophosphamide. The BSI rate was 30%; among isolated 213 pathogens, 54% were Gram-positive, 43% were Gram-negative, and 3% were fungi...
January 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28756243/cytokine-profiles-of-pre-engraftment-syndrome-after-single-unit-cord-blood-transplantation-for-adult-patients
#10
Takaaki Konuma, Chisato Kohara, Eri Watanabe, Motoko Mizukami, Etsuko Nagai, Maki Oiwa-Monna, Susumu Tanoue, Masamichi Isobe, Seiko Kato, Arinobu Tojo, Satoshi Takahashi
Clinical manifestation of high-grade fever and skin rash before neutrophil engraftment, termed pre-engraftment syndrome (PES) or pre-engraftment immune reaction, has been frequently observed after cord blood transplantation (CBT). The pathophysiology of PES is poorly understood, but cytokine storm during the early phase of CBT is thought to be 1 of the main cause of PES. However, the cytokine profiles of PES after CBT are unclear. Therefore, we examined the relationship between serum cytokine profiles and PES in 44 adult patients who received CBT in our institution between February 2013 and June 2016...
July 26, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28736021/infectious-complications-and-multidrug-resistant-bacteria-in-patients-with-hematopoietic-stem-cell-transplantation-in-the-first-12-months-after-transplant
#11
A César-Arce, P Volkow-Fernández, L M Valero-Saldaña, B Acosta-Maldonado, D Vilar-Compte, P Cornejo-Juárez
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) has been used as treatment in different hematologic and solid malignancies. The aim of this study was to describe the frequency of infectious complications, microbiology, and outcome in patients undergoing HSCT in Mexico during the pre-engraftment period and the impact on mortality rates at 12 months. METHODS: We conducted a retrospective study of all hematologic malignancies that received HSCT from January 2009 and December 2014, at an oncology reference center...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28692817/complications-of-hematopoietic-stem-cell-transplantation-bacterial-infections
#12
REVIEW
Ali S Omrani, Reem S Almaghrabi
Bacterial infections remain a common complication of hematopoietic stem cell transplantation (HSCT), especially in the pre-engraftment phase. The risk of bacterial infections is mainly related to neutropenia, mucositis, and the presence of vascular lines. Most parts of the world have witnessed a shift in epidemiology toward Gram-negative bacteria; a large proportion of which are resistant to fluoroquinolones, extended-spectrum beta-lactams, carbapenems, and in some units even colistin. Meticulous infection control practices are essential for prevention of bacterial infections in HSCT...
December 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28255902/imaging-spectrum-of-central-nervous-system-complications-of-hematopoietic-stem-cell-and-solid-organ-transplantation
#13
REVIEW
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...
February 2017: Neuroradiology
https://www.readbyqxmd.com/read/27931588/evaluation-of-mannose-binding-lectin-is-a-useful-approach-to-predict-the-risk-of-infectious-complications-following-autologous-hematopoietic-stem-cell-transplantation
#14
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
https://www.readbyqxmd.com/read/27923196/environmental-preconditioning-rejuvenates-adult-stem-cells-proliferation-and-chondrogenic-potential
#15
REVIEW
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
https://www.readbyqxmd.com/read/27890428/vancomycin-resistant-enterococcus-colonization-and-bacteremia-and-hematopoietic-stem-cell-transplantation-outcomes
#16
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
https://www.readbyqxmd.com/read/27771742/pre-engraftment-bloodstream-infections-in-acute-leukemia-patients-undergoing-unrelated-cord-blood-transplantation-following-intensified-myeloablative-conditioning-without-atg
#17
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
https://www.readbyqxmd.com/read/27722122/pre-engraftment-syndrome-clinical-significance-and-pathophysiology
#18
REVIEW
Young-Ho Lee, Wee-Jin Rah
No abstract text is available yet for this article.
September 2016: Blood Research
https://www.readbyqxmd.com/read/27686673/comparison-of-cyclosporine-and-tacrolimus-combined-with-mycophenolate-mofetil-in-prophylaxis-for-graft-versus-host-disease-after-reduced-intensity-umbilical-cord-blood-transplantation
#19
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/27599417/successful-cord-blood-transplantation-in-an-adult-acute-lymphoblastic-leukemia-patient-with-congenital-heart-disease
#20
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
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