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pediatric hematopoietic stem cell transplant

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https://www.readbyqxmd.com/read/29426831/cardiovascular-risk-factors-and-subclinical-organ-damage-after-hematopoietic-stem-cell-transplantation-in-pediatric-age
#1
Bianca Borchert-Mörlins, Nima Memaran, Martin Sauer, Britta Maecker-Kolhoff, Karl-Walter Sykora, Ricarda Blöte, Elena Bauer, Bernhard M W Schmidt, Anette Melk, Rita Beier
Advances in allogeneic hematopoietic stem cell transplantation (HSCT) in malignant and non-malignant diseases result in more long-term survivors, in whom cardiovascular (CV) disease is one leading non-cancer cause of death. This study aimed to evaluate risk factors and subclinical CV organ damage in survivors after HSCT in pediatric age. We enrolled 64 children in a cross-sectional approach 3.3 ± 3.1 years after HSCT. Anthropometric data, laboratory values, office and 24-h ambulatory blood pressure monitoring (ABPM) were evaluated, showing a high prevalence of obesity, hypertension and dyslipidemia...
February 9, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29423036/salvaged-allogeneic-hematopoietic-stem-cell-transplantation-for-pediatric-chemotherapy-refractory-acute-leukemia
#2
Jingbo Wang, Lei Yuan, Haoyu Cheng, Xinhong Fei, Yumin Yin, Jiangying Gu, Song Xue, Junbao He, Fan Yang, Xiaocan Wang, Yixin Yang, Weijie Zhang
There is an ongoing debate concerning the performance of salvaged allogeneic hematopoietic stem cell transplantation (allo-HSCT) in pediatric patients with acute refractory leukemia, in whom the prognosis is quite dismal. Few studies have ever been conducted on this subject. This may be partly due to missed opportunities by majority of the patients in such situations. To investigate the feasibility, evaluate the efficiency, and identify the prognostic factors of allo-HSCT in this sub-setting, the authors performed a single institution-based retrospective analysis...
January 9, 2018: Oncotarget
https://www.readbyqxmd.com/read/29417689/efficacy-of-high-dose-steroids-for-bronchiolitis-obliterans-syndrome-post-pediatric-hematopoietic-stem-cell-transplantation
#3
Ehud Even-Or, Hasan Ghandourah, Muhammad Ali, Joerg Krueger, Neil B Sweezey, Tal Schechter
BOS is the pulmonary manifestation of cGvHD post-allogeneic HSCT. Survival and treatment of this often fatal complication have not improved over the last 20 years and there is no clear standard of care. For the past 10 years, BOS was treated in our center with monthly cycles of HDPS. We reviewed the outcomes of patients with post-HSCT BOS who met the diagnostic criteria for BOS as per the NIH consensus and were treated with at least one cycle of methylprednisolone at a dose of 10-30 mg/kg/d×3 d. We collected demographic and clinical data, responses to treatment and results of pulmonary function tests at several time points...
February 7, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29410181/outcomes-of-children-with-hemophagocytic-lymphohistiocytosis-given-allogeneic-hematopoietic-stem-cell-transplantation-in-italy
#4
Chiara Messina, Marco Zecca, Franca Fagioli, Attilio Rovelli, Stefano Giardino, Pietro Merli, Fulvio Porta, Maurizio Aricò, Elena Sieni, Giuseppe Basso, Mimmo Ripaldi, Claudio Favre, Marta Pillon, Antonio Marzollo, Marco Rabusin, Simone Cesaro, Mattia Algeri, Maurizio Caniglia, Paolo Di Bartolomeo, Ottavio Ziino, Francesco Saglio, Arcangelo Prete, Franco Locatelli
We report on 109 patients with hemophagocytic lymphohistiocytosis (HLH) undergoing 126 procedures of allogeneic hematopoietic stem cell transplantation (HSCT) between 2000 and 2014 in centers associated with the Italian Pediatric Hematology Oncology Association. Genetic diagnosis was FHL2 (32%), FHL3 (33%) or other defined disorders known to cause HLH (15%); in the remaining patients, no genetic abnormality was found. Donor for first transplant was an HLA-matched sibling for 25 patients (23%), an unrelated donor for 73 (67%) and an HLA-partially matched family donor for 11 children (10%)...
February 1, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29404858/bayesian-networks-a-new-approach-to-predict-therapeutic-range-achievement-of-initial-cyclosporine-blood-concentration-after-pediatric-hematopoietic-stem-cell-transplantation
#5
Vincent Leclerc, Michel Ducher, Nathalie Bleyzac
BACKGROUND: Pediatric hematopoietic stem cell transplantation (HSCT) allows the treatment of numerous diseases, both malignant and non-malignant. Cyclosporine, a narrow therapeutic index drug, is the major immunosuppressant used to prevent graft-versus-host disease (GVHD), but may also cause severe adverse effects in case of overdosing. OBJECTIVE: The objective of this study is to predict the initial cyclosporine residual blood concentration value after pediatric HSCT, and consequently the dose necessary to reach the therapeutic range, using a mathematical individual predictive model...
February 5, 2018: Drugs in R&D
https://www.readbyqxmd.com/read/29397331/fecal-calprotectin-and-serum-albumin-as-markers-of-gastrointestinal-graft-versus-host-disease
#6
Larisa Broglie, Alfred Rademaker, John Galvin, Ayita Ray, William T Tse, Reggie Duerst, Jennifer Schneiderman, Morris Kletzel, Sonali Chaudhury
BACKGROUND: Acute graft versus host disease (aGVHD) affects approximately 30-60% of patients after allogeneic hematopoietic stem cell transplantation (HCT) and our ability to predict who develops this complication and their response to treatment is limited. Fecal calprotectin has recently gained popularity as an effective marker of GI inflammation in patients with Inflammatory Bowel Disease (IBD). METHODS: Fecal calprotectin and albumin were evaluated as prognostic and predictive markers of aGVHD in 60 adult and pediatric HCT patients...
January 31, 2018: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/29396905/transplant-related-mortality-and-survival-in-children-with-malignancies-treated-with-allogeneic-hematopoietic-stem-cell-transplantation-a-multicenter-analysis
#7
Agnieszka Zaucha-Prazmo, Jolanta Gozdzik, Robert Debski, Katarzyna Drabko, Elzbieta Sadurska, Jerzy R Kowalczyk
The aim of the study was to assess the risk of TRM in pediatric patients treated for malignant disorders with allogeneic HSCT, according to different risk factors. The treatment outcome was analyzed in 299 pediatric patients treated in pediatric transplant departments from 2006 to 2015. To compare the outcome, patients were analyzed all together and in groups according to the diagnosis, age at transplant, donor type, disease status, stem cell source, and pediatric TRM score. At the end of the observation time, 82 patients were alive, 82 died, of which 40 due to transplant-related reasons...
February 3, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29395846/thymopoiesis-following-hsct-a-retrospective-review-comparing-interventions-for-agvhd-in-a-pediatric-cohort
#8
A M Flinn, C F Roberts, M A Slatter, R Skinner, H Robson, J Lawrence, J Guest, A R Gennery
Acute graft-versus-host disease (aGVHD) complicates allogeneic hematopoietic stem cell transplantation (HSCT), and is treated with topical and/or systemic corticosteroids. Systemic corticosteroids and aGVHD damage thymic tissue. We compared thymopoietic effect of topical steroid therapy, corticosteroids and extracorporeal photopheresis (ECP) in 102 pediatric allogeneic HSCT patients. We categorized patients into 4 groups: - no aGVHD, aGVHD treated with topical or systemic steroid, or ECP. Naïve CD4+CD45RA+CD27+ T-lymphocyte values at 3, 6, 9, 12months post-HSCT were recorded: for ECP patients, values were recorded at 3, 6, 9, 12months during ECP...
January 27, 2018: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/29388318/intravesicular-cidofovir-for-bk-hemorrhagic-cystitis-in-pediatric-patients-after-hematopoietic-stem-cell-transplant
#9
Jennifer H Foster, W Susan Cheng, Ngoc-Yen Nguyen, Robert Krance, Caridad Martinez
BK virus hemorrhagic cystitis is a complication of HCST. Response to IV cidofovir is unpredictable, and treatment carries risk of toxicity. We report the largest series of pediatric patients with BKHC after HSCT successfully treated with intravesicular cidofovir. There was no significant decrease in urine or plasma BK PCR. There was significant decrease in pain score on days 3 and 7, with associated decrease in morphine use. No patients experienced toxicities associated with IV cidofovir. Intravesicular cidofovir appears to be safe and effective for symptomatic treatment of BKHC in pediatric patients after HSCT...
February 1, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29384898/diagnosis-and-treatment-of-neoplastic-post-transplant-lymphoproliferative-disorder-following-hematopoietic-stem-cell-transplant-in-%C3%AE-thalassemia-a-pediatric-case-report
#10
Xiaohong Zhang, Wenge Hao, Tao Xu, Sha Liu, Hua Jiang
INTRODUCTION: Post-transplant lymphoproliferative disorder (PTLD) is the most common form of lymphoproliferation in childhood and is associated with significant morbidity and mortality. In this report we reviewed the case of a pediatric patient who experienced PTLD after allogeneic hematopoietic stem cell transplantation (HSCT) from a human leukocyte antigen (HLA)-identical sibling. METHODS: The clinical characteristics, diagnosis, and treatment of PTLD after sibling HSCT in a 4-year-old boy with severe β-thalassemia was retrospectively reviewed...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29384263/possible-involvement-of-il-6-producing-tissue-resident-macrophages-in-early-onset-pericardial-effusion-pathogenesis-after-hematopoietic-stem-cell-transplantation
#11
Satoru Hamada, Jiro Miyamoto, Tokiko Oshiro, Takeshi Yagi, Shinobu Kiyuna, Taichi Uehara, Takehiro Matsuda, Takeshi Higa, Nobuyuki Hyakuna, Koichi Nakanishi
PURPOSE: Pericardial effusion (PE) is a potentially life-threatening complication following hematopoietic stem cell transplantation (HCT). A higher incidence of early-onset PE, unrelated to graft-versus-host disease, before day 100 after HCT has been reported in pediatric patients, but the pathogenic mechanism is poorly understood. Aiming to determine the pathogenesis of early-onset PE in pediatric patients, we analyzed the cytokine concentration and cell population in the pericardial fluid of four pediatric patients with PE...
January 31, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29376437/hematopoietic-stem-cell-transplant-in-adults-with-acute-lymphoblastic-leukemia-the-present-state
#12
Salwa S Saadeh, Mark R Litzow
Allogeneic hematopoietic stem cell transplant (allo-HSCT) has an important role in management of acute lymphoblastic leukemia (ALL). Proper patient selection is central to ensure optimal outcomes. Areas covered: This review covers various aspects of HSCT in ALL patients, including indications, donor selection, conditioning regimens, and post-transplant management. Expert commentary: Allo-HSCT is important in post-remission management of ALL but proper risk-stratification is a major challenge. Incorporation of minimal residual disease (MRD) and molecular testing will improve patient allocation...
January 29, 2018: Expert Review of Hematology
https://www.readbyqxmd.com/read/29350494/sleep-disruption-in-caregivers-of-pediatric-stem-cell-recipients
#13
Kristen Coleman, Laura Flesch, Lisa Petiniot, Abigail Pate, Li Lin, Lori Crosby, Dean W Beebe, Adam Nelson, Priscila Badia Alonso, Stella M Davies, Rachel B Baker, Christopher E Dandoy
Parents/caregivers of hospitalized patients are at risk of sleep disruption. We performed a cross-sectional quantitative and qualitative evaluation of sleep in parents/caregivers of children undergoing hematopoietic stem cell transplant (HSCT; n = 17). Additionally, we explored the frequency of room entries for hospitalized patients undergoing HSCT (n = 189 nights). Twelve caregivers (71%) demonstrated significant sleep disturbance, 12 (71%) described sleep quality as poor, 15 (88%) averaged < 6 hours of sleep per night, 14 (82%) awakened at least four times per night...
January 19, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29344584/early-and-late-outcomes-after-cord-blood-transplantation-for-pediatric-patients-with-inherited-leukodystrophies
#14
Brigitte T A van den Broek, Kristin Page, Annalisa Paviglianiti, Janna Hol, Heather Allewelt, Fernanda Volt, Gerard Michel, Miguel Angel Diaz, Victoria Bordon, Tracey O'Brien, Peter J Shaw, Chantal Kenzey, Amal Al-Seraihy, Peter M van Hasselt, Andrew R Gennery, Eliane Gluckman, Vanderson Rocha, Annalisa Ruggeri, Joanne Kurtzberg, Jaap Jan Boelens
Leukodystrophies (LD) are devastating inherited disorders leading to rapid neurological deterioration and premature death. Hematopoietic stem cell transplantation (HSCT) can halt disease progression for selected LD. Cord blood is a common donor source for transplantation of these patients because it is rapidly available and can be used without full HLA matching. However, precise recommendations allowing care providers to identify patients who benefit from HSCT are lacking. In this study, we define risk factors and describe the early and late outcomes of 169 patients with globoid cell leukodystrophy, X-linked adrenoleukodystrophy, and metachromatic leukodystrophy undergoing cord blood transplantation (CBT) at an European Society for Blood and Marrow Transplantation center or at Duke University Medical Center from 1996 to 2013...
January 9, 2018: Blood Advances
https://www.readbyqxmd.com/read/29339271/early-increase-in-complement-terminal-pathway-activation-marker-sc5b-9-is-predictive-for-the-development-of-thrombotic-microangiopathy-after-stem-cell-transplantation
#15
Orsolya Horváth, Krisztián Kállay, Dorottya Csuka, Blanka Mező, György Sinkovits, Csaba Kassa, Anita Stréhn, Katalin Csordás, János Sinkó, Zoltán Prohászka, Gergely Kriván
Hematopoietic stem cell transplantation- (HSCT-) associated thrombotic microangiopathy (TA-TMA) is a multifactorial complication, and its prediction is largely unresolved.Our aim was to analyze changes of complement profile after HSCT in order to identify potential markers of TA-TMA development. Thirty- three consecutive pediatric patients (9.6 ± 4.4 years old) were included in this study who underwent allogeneic HSCT due to malignant (n=17) or non malignant (n=16) indications. Graft versus host disease (GVHD) was diagnosed using Glucksberg criteria, viral reactivation was monitored, five different TA-TMA diagnostic criteria were applied and all important clinical and laboratory parameters of TA-TMA activity were registered...
January 12, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29338379/factors-affecting-survival-in-children-with-pericardial-effusion-after-hematopoietic-stem-cell-transplantation
#16
Tang-Her Jaing, Shih-Hsiang Chen, Yu-Chuan Wen, Tsung-Yen Chang, Dai-Yun Tsai, Hung-Tao Chung, Pei-Kwei Tsay
The objective of this study was to determine the incidence, risk factors, outcome, and clinical significance of pericardial effusion (PE). We retrospectively analyzed outcomes of 272 pediatric patients undergoing their first hematopoietic stem cell transplantation (HSCT) from 1998 to 2016. In total, 15% (3/20) and 5.9% (15/252) of autologous and allogeneic HSCT recipients, respectively, were identified with PE. However, there was no statistically significant difference in the incidence of PE between the 2 groups...
November 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29335626/using-liver-elastography-to-diagnose-sinusoidal-obstruction-syndrome-in-pediatric-patients-undergoing-hematopoetic-stem-cell-transplant
#17
Naresh Reddivalla, Amie L Robinson, Kimberly J Reid, Mohamed A Radhi, Jignesh Dalal, Erin K Opfer, Sherwin S Chan
Sinusoidal obstruction syndrome (SOS) is a potentially fatal complication of hematopoietic stem cell transplantation (HSCT). Traditional ultrasound (US) has poor sensitivity and specificity. US shear wave elastography (SWE) is a newer technology that measures liver stiffness. This is a single-institution, prospective cohort study evaluating SWE in patients younger than 21 years who received HSCT from December 2015 through June 2017. SOS was defined using the modified Seattle criteria. Subjects had US with SWE at three scheduled time points...
January 15, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29334537/isolated-central-nervous-system-chloroma-as-a-presenting-sign-of-relapsed-pediatric-acute-lymphoblastic-leukemia
#18
Jessica L Heath, Waitman K Aumann, Charles M Maxfield, Daniel S Wechsler
Central nervous system (CNS) chloromas are an exceedingly rare presentation of CNS relapse in acute lymphoblastic leukemia (ALL). We report a relapsed ALL patient who presented with 2 separate chloromas and cerebrospinal fluid lymphoblastocytosis, and outline a treatment plan of systemic chemotherapy and CNS-directed radiation therapy. A review of the literature indicates that multiagent chemotherapy combined with CNS radiotherapy is effective, with hematopoietic stem cell transplantation used in half of reported cases...
January 12, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29315849/continuous-intravenous-vancomycin-in-children-with-normal-renal-function-hospitalized-in-hematology-oncology-prospective-validation-of-a-dosing-regimen-optimizing-steady-state-concentration
#19
Delphine Hoegy, Sylvain Goutelle, Nathalie Garnier, Cécile Rénard, Cécile Faure-Conter, Christophe Bergeron, Yves Bertrand, Nathalie Bleyzac
Continuous intravenous (IV) infusion has been shown to be the best option to administer vancomycin because of its time-dependent bactericidal activity. Available IV vancomycin dosing guidelines in pediatrics with normal renal function leads to less than 50% of patients achieving a vancomycin serum concentration (Css) in the target range (15 to 20 mg/l). The primary objective of this study was to prospectively validate an age-based dosing regimen in pediatric onco-hematology. The secondary objective was to investigate the influence on Css attainment of different variables...
January 6, 2018: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/29309375/use-of-intravenous-posaconazole-in-hematopoietic-stem-cell-transplant-patients
#20
Amanda Strommen, Amanda L Hurst, Donna Curtis, Mark J Abzug
BACKGROUND: Posaconazole is a broad-spectrum antifungal used for prophylaxis and treatment of invasive fungal infections. There is no published data to inform prescribers on dosing of the intravenous (IV) formulation in the pediatric population. We describe our experience including dosing, serum concentrations, and tolerability. OBSERVATIONS: Four patients (3 to 9 y) received IV posaconazole for treatment of documented/suspected invasive fungal infections. Patients achieved therapeutic concentrations on daily doses of 8...
January 5, 2018: Journal of Pediatric Hematology/oncology
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