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Acute graft versus host disease

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https://www.readbyqxmd.com/read/28731920/eye-movement-disorders-following-allogeneic-bone-marrow-transplantation-on-fk506-tacrolimus-and-ganciclovir
#1
Barbaros S Karagun, Tugana Akbas, Taner Arpaci, Bulent Antmen
FK506 (tacrolimus) is an immunosuppressive drug and more potent than cyclosporine. FK506 is widely used for immunosuppression in the prevention and treatment of graft-versus-host disease after allogeneic bone marrow transplantation and solid organ transplantation. Neurotoxicity is a recognized complication of FK506 therapy, but ptosis and weakness of eye abduction unilaterally has not been reported in association with FK506 administration to date. We discuss a 13-year-old male patient who developed ptosis and weakness of eye abduction unilaterally 90 days after transplantation with bone marrow from an unrelated donor, for acute lymphoblastic leukemia in this case report...
July 20, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28728274/-a-retrospective-study-of-10-cases-of-post-transplant-bronchiolitis-obliterans
#2
J J Chai, T Liu, B Q Cai, H D Zhu
Objective: To analyze the clinical features of bronchiolitis obliterans syndrome (BOS) in patients with allogeneic hematopoietic stem cell transplantation (HSCT). Methods: This retrospective study included patients who underwent allogeneic HSCT from January 1998 to December 2016. The clinical features, radiological manifestations and treatment of clinically proven BOS were reviewed. Results: Of 681 patients who experienced HSCT, 10(1.47%) met the diagnostic criteria. The duration of BOS onset after transplantation was 5-48 months, averaging (18±15) months...
July 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28725544/successful-haploidentical-stem-cell-transplantation-with-prophylactic-administration-of-liposomal-amphotericin-b-after-invasive-pulmonary-zygomycosis
#3
Testuro Ochi, Yuta Katayama, Takeshi Okatani, Ryota Imanaka, Kohei Kyo, Mitsuhiro Itagaki, Shinya Katsutani, Koji Iwato, Hideki Asaoku
A 54-year-old woman with acute myeloid leukemia (AML) achieved complete remission by induction chemotherapy, but developed zygomycosis after consolidation therapy. As zygomycosis could not be cured by liposomal amphotericin B and micafungin, left lower lobectomy was performed. As AML relapsed 7 months after onset, she received haploidentical stem cell transplantation under administration of liposomal amphotericin B. Despite experiencing severe acute graft-versus-host disease, she remains alive with no relapse of either zygomycosis or AML...
December 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28721499/treg-protected-donor-lymphocyte-infusions-a-new-tool-to-address-the-graft-versus-leukemia-effect-in-the-absence-of-graft-versus-host-disease-in-patients-relapsed-after-hsct
#4
Mauro Di Ianni, Paola Olioso, Raffaella Giancola, Stella Santarone, Annalisa Natale, Gabriele Papalinetti, Ida Villanova, Stefano Baldoni, Ambra Di Tommaso, Tiziana Bonfini, Patrizia Accorsi, Paolo Di Bartolomeo
In high-risk acute leukemia patients undergoing haploidentical hematopoietic stem cell transplantation (HSCT), adoptive immunotherapy with T regulatory cells (Tregs) and T conventional cells (Tcons) prevented acute and chronic graft-versus-host disease (GvHD), favored post-transplant immunological reconstitution and was associated with a powerful graft-versus-leukemia (GvL) effect. With a particularly innovative approach, we developed a treatment with a Treg-protected donor lymphocyte infusion (DLI) for patients with early relapse after HSCT and we report here the results obtained in the first patient with APL (M3v) relapsed after a second matched allogeneic HSCT (15% blasts and 75% of donor cells in bone marrow)...
July 18, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28716402/the-role-of-low-dose-anti-thymocyte-globulin-as-standard-prophylaxis-in-mismatched-and-matched-unrelated-hematopoietic-peripheral-stem-cell-transplantation-for-hematologic-malignancies
#5
Ioanna Sakellari, Ioannis Batsis, Zoi Bousiou, Despina Mallouri, Varnavas Constantinou, Eleni Gavriilaki, Christos Smias, Evangelia Yannaki, Panayotis Kaloyannidis, Giorgos Papaioannou, Niki Stavroyianni, Antonia Syrigou, Damianos Sotiropoulos, Asimina Fylaktou, Aliki Tsompanakou, Riad Saloum, Achilles Anagnostopoulos
INTRODUCTION: Anti-thymocyte globulin (ATG)-based immunosuppressive therapy is often used in allogeneic hematopoietic cell transplantation to reduce incidence and severity of graft-versus-host disease (GVHD). PATIENTS AND METHODS: In our observational study, ATG (rabbit, Thymoglobulin; Sanofi, 5 mg/kg) was administered as a standardized part of the conditioning in 97 patients with a median age of 34 years (range, 14-58 years), allotransplanted for hematologic malignancies from matched (8/8; n = 52) and allele or antigen mismatched (7/8; n = 43 and 6/8; n = 2) unrelated donors...
June 29, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28716387/respiratory-virus-prior-to-hematopoietic-cell-transplantation-is-associated-with-allo-immune-mediated-lung-syndromes
#6
Birgitta Versluys, Marc Bierings, Jean Luc Murk, Tom Wolfs, Caroline Lindemans, Kors Vd Ent, Jaap Jan Boelens
BACKGROUND: Allo-immune mediated lung syndromes (allo-LS) are life-threatening complications after hematopoietic cell transplantation (HCT). Respiratory virus (RV) has been suggested to play a role in the pathogenesis. OBJECTIVE: We studied the relation between RV-DNA/RNA detection in upper/lower airway before HCT and the occurrence of allo-LS. METHODS: We retrospectively analyzed all HCT recipients between 2004 and 2014, in whom Real-Time PCR for RV was done from Nasal-Pharyngeal-Aspirates (NPA) and Broncho-Alveolar- Lavage (BAL) before HCT...
July 14, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28711728/allogeneic-blood-or-marrow-transplantation-with-post-transplantation-cyclophosphamide-as-graft-versus-host-disease-prophylaxis-in-multiple-myeloma
#7
Nilanjan Ghosh, Xiaobu Ye, Hua-Ling Tsai, Javier Bolaños-Meade, Ephraim J Fuchs, Leo Luznik, Lode J Swinnen, Douglas E Gladstone, Richard F Ambinder, Ravi Varadhan, Satish Shanbhag, Robert A Brodsky, Ivan M Borrello, Richard J Jones, William Matsui, Carol Ann Huff
Allogeneic blood or marrow transplantation (alloBMT) may lead to long-term disease control in patients with multiple myeloma (MM). However, historically, the use of alloBMT in MM has been limited by its high non-relapse mortality (NRM) rates primarily from graft versus host disease (GVHD). We previously demonstrated that post-transplantation cyclophosphamide (PTCy) decreases the toxicities of both acute and chronic GVHD rates following alloBMT. Here we examine the impact of PTCy in MM patients undergoing alloBMT at Johns Hopkins Hospital...
July 12, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28711168/surgical-treatment-of-intestinal-complications-of-graft-versus-host-disease-in-the-pediatric-population-case-series-and-review-of-literature
#8
REVIEW
Camille A Gutierrez, Mehul V Raval, Hannah R Vester, Sonali Chaudhury, Daniel von Allmen, David H Rothstein
BACKGROUND/PURPOSE: Intestinal complications of acute graft-versus-host disease (aGVHD) include hemorrhage and perforation in the short-term, and stricture with bowel obstruction in the long-term. As medical management of severe aGVHD has improved, more patients are surviving even advanced stages of intestinal aGVHD. This review summarizes the available pediatric literature on surgical treatment of complications of intestinal GVHD. METHODS: A systematic review was performed using PubMed, Cochrane, Embase, and Scopus databases...
June 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28709842/what-compatibility-in-2017-for-the-haematopoietic-stem-cell-transplantation
#9
X Lafarge
The diversification of potential donors to perform stem cell allografts now enables to propose a compatible graft cell source adapted to the different clinical situations. Transplants with a geno-identical sibling donor, otherwise with the most HLA-compatible unrelated donor, remain the first-line solutions. Alternative transplants allow to graft patients having no donors in international registries, owing to the rarity of their HLA typing. They are carried out with fairly incompatible grafts and are therefore limited by the existence in the recipient of preformed anti-HLA antibodies which predispose to their rejection...
July 11, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28708597/mri-based-evaluation-of-multiorgan-iron-overload-is-a-predictor-of-adverse-outcomes-in-pediatric-patients-undergoing-allogeneic-hematopoietic-stem-cell-transplantation
#10
Natalia Maximova, Massimo Gregori, Giulia Boz, Roberto Simeone, Davide Zanon, Giulia Schillani, Floriana Zennaro
The medical records of 44 pediatric patients who underwent allogeneic transplantation from 2011 to 2015 were retrospectively reviewed. Magnetic resonance imaging was used to measure iron concentrations in the liver, spleen, pancreas and bone. These patients were divided into two groups, 18 with non-elevated (< 100 μmol/g; Group 1) liver iron concentration before transplantation and 26 with elevated (> 100 μmol/g; Group 2) concentration . We compared transplant-related outcomes in the two groups. Iron overload was a negative prognostic risk factor for sinusoidal obstruction syndrome (OR = 17), osteoporosis (OR = 6...
July 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28708253/cytomegalovirus-appendicitis-after-hematopoietic-stem-cell-transplantation
#11
Atul Kothari, Kari D Caradine, Juan Carlos Crescencio Rico, Appalanaidu Sasapu, Muthu K Veeraputhiran, Yogesh Jethava, Mary J Burgess
We present the case of a young man with acute lymphoblastic leukemia who developed cytomegalovirus (CMV) appendicitis after receiving alemtuzumab for acute refractory graft-versus-host disease after allogeneic hematopoietic stem cell transplantation (HSCT). CMV appendicitis is a rare complication; and we are reporting the first case to our knowledge of CMV appendicitis following HSCT. Our case highlights the importance of recognition of CMV viral reactivation following the use of alemtuzumab. Using a preemptive strategy of checking CMV PCR, with initiation of early effective treatment on detection of CMV replication, may be appropriate following use of alemtuzumab in hematologic malignancies in patients after HSCT...
July 14, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28706856/disseminated-nocardia-cyriacigeorgia-causing-pancreatitis-in-a-haploidentical-stem-cell-transplant-recipient
#12
Jason Chen, Jonathan Pan, Joanne Filicko-O'Hara, Margaret Kasner, Phyllis Flomenberg
We report the first published case of acute pancreatitis secondary to disseminated nocardiosis in a hematopoietic stem cell transplant (HSCT) recipient on chronic immunosuppression for graft-versus-host disease (GVHD). Nocardiosis in the HSCT population is relatively rare, and has not yet been described in haploidentical HSCT recipients. Our patient is a 28-year-old male with a history of haploidentical HSCT and GVHD of the skin and lung who was admitted to the hospital with acute pancreatitis. The workup for the etiology of his pancreatitis was initially unrevealing...
2017: IDCases
https://www.readbyqxmd.com/read/28705454/efficacy-of-two-different-doses-of-rabbit-anti-t-lymphocyte-globulin-to-prevent-graft-versus-host-disease-in-children-with-haematological-malignancies-transplanted-from-an-unrelated-donor-a-multicentre-randomised-open-label-phase-3-trial
#13
Franco Locatelli, Maria Ester Bernardo, Alice Bertaina, Carla Rognoni, Patrizia Comoli, Attilio Rovelli, Andrea Pession, Franca Fagioli, Claudio Favre, Edoardo Lanino, Giovanna Giorgiani, Pietro Merli, Daria Pagliara, Arcangelo Prete, Marco Zecca
BACKGROUND: Although rabbit anti-T-lymphocyte globulin (ATLG) is largely used for the prevention of immune-mediated complications in patients given allogeneic haemopoietic stem-cell transplantation (HSCT) from an unrelated donor, the optimum dose of this drug in children is still undefined. We aimed to test whether a higher dose of ATLG was superior to a lower dose for prevention of grade II-IV acute graft-versus-host disease (GVHD). METHODS: We conducted a multicentre, randomised, open-label, phase 3 trial in seven Italian centres comparing two different doses of ATLG (30 mg/kg vs 15 mg/kg, given intravenously over 3 days, from day -4 to -2) in children (aged 0-18 years) with haematological malignancies transplanted from an unrelated donor, selected using high-resolution typing for HLA-class I/II loci...
July 10, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28702856/dynamics-of-torque-teno-virus-viremia-could-predict-risk-of-complications-after-allogeneic-hematopoietic-stem-cell-transplantation
#14
Ramona Gilles, Marco Herling, Udo Holtick, Eva Heger, Sabine Awerkiew, Irina Fish, Konstantin Höller, Saleta Sierra, Elena Knops, Rolf Kaiser, Christof Scheid, Veronica Di Cristanziano
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an established treatment option for several hematological diseases. However, the first year post-transplantation is often complicated by infections and graft-versus-host disease (GVHD). Improvements in immunological monitoring could reduce such post-transplant complications. Torque Teno virus (TTV), a chronically persisting DNA virus, is reported to be a marker for immune function in immunocompromised patients. In the present study, the TTV kinetics were analyzed to investigate the potential role of TTV viremia as immune-competence read-out after allo-HSCT...
July 12, 2017: Medical Microbiology and Immunology
https://www.readbyqxmd.com/read/28702160/bk-virus-associated-hemorrhagic-cystitis-in-patients-with-allogeneic-hematopoietic-cell-transplantation-report-of-three-cases
#15
Duygu Mert, Hikmetullah Batgi, Alparslan Merdin, Sabahat Çeken, Mehmet Sinan Dal, Emre Tekgündüz, Fevzi Altuntaş, Mustafa Ertek
BK viras is a human polyoma viras. It is acquired in early childhood and remains life-long latent in the genitourinary system. BK virus replication is more common in receiving immunosuppressive therapy receiving patients and transplant patients. BK virus could cause hemorrhagic cystitis in patients with allogeneic stem cell transplantation. Hemorrhagic cystitis is a serious complication of hematopoietic stem cell transplantation. Hemorrhagic cystitis could cause morbidity and long stay in the hospital. Diagnosis is more frequently determined by the presence of BK virus DNA detected with quantitative or real-time PCR testing in serum or plasma and less often in urine...
June 1, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28698754/early-and-late-complications-in-patients-with-allogeneic-transplantation-of-hematopoietic-stem-cell-case-report
#16
Ivana Trajkovska, Borce Georgievski, Lidija Cevreska, Andrijana Gacovski, Taner Hasan, Natasha Nedeska-Minova
BACKGROUND: Allogeneic hematopoietic stem cells transplantation (HSCT) is a curative intervention in patients with haematological malignant and non-malignant diseases, immunodeficiency, autoimmune, and other genetic diseases. Early complications are complications that are occurring in the first 100 days, while complications arising after the 100th day of transplantation belong to late complications. CASE REPORT: Forty-nine years old patient with AML treated with allogeneic HSCT from HLA-identical (sister) donor...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28694183/stat3-expression-in-host-myeloid-cells-controls-gvhd-severity
#17
Evelyn C Nieves, Tomomi Toubai, Daniel C Peltier, Katherine Oravecz-Wilson, Chen Liu, Hiroya Tamaki, Yaping Sun, Pavan Reddy
Professional antigen presenting cell (APCs) are important modulators of acute graft-versus-host disease (GVHD). Although dendritic cells (DCs) are most potent APC subset, other myeloid cells, especially macrophages (MFs) and neutrophils have recently been shown to play a role in the severity of GVHD. However, the critical molecular mechanisms that determine the functions of myeloid cells in GVHD are unclear. Signal transducer and activator of transcription 3 (STAT3) is a master transcription factor that plays a crucial role in regulating immunity...
July 7, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28691152/reduced-bucy-2-and-g-csf-primed-bone-marrow-associates-with-low-graft-versus-host-disease-and-transplant-related-mortality-in-allogeneic-hsct
#18
Eucario Leon Rodriguez, Monica M Rivera Franco, Sandra I Perez Alvarez
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the ideal treatment for several diseases. However, the morbidity and mortality associated with the procedure might limit its widespread use; therefore, we implemented reduced BUCY2 as conditioning method along with the use of G-CSF-primed bone marrow (G-BM) in order to reduce complications, including graft-versus-host-disease (GVHD), and to improve survival in these patients. An analysis of transplant characteristics, complications, and survival of patients undergoing an allo-HSCT using this conditioning regimen (busulfan 12 mg/kg and cyclophosphamide 80 mg/kg) plus G-BM was performed...
July 9, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28690612/protection-of-mice-from-acute-graft-versus-host-disease-requires-cd28-co-stimulation-on-donor-cd4-foxp3-regulatory-t-cells
#19
Anna Uri, Sandra Werner, Fred Lühder, Thomas Hünig, Thomas Kerkau, Niklas Beyersdorf
Acute graft-versus-host disease (aGvHD) is a major cause of morbidity and mortality after allogeneic hematopoietic stem cell plus T cell transplantation (allo-HSCT). In this study, we investigated the requirement for CD28 co-stimulation of donor CD4(+) conventional (CD4(+)CD25(-)Foxp3(-), Tconv) and regulatory (CD4(+)CD25(+)Foxp3(+), Treg) T cells in aGvHD using tamoxifen-inducible CD28 knockout (iCD28KO) or wild-type (wt) littermates as donors of CD4(+) Tconv and Treg. In the highly inflammatory C57BL/6 into BALB/c allo-HSCT transplantation model, CD28 depletion on donor CD4(+) Tconv reduced clinical signs of aGvHD, but did not significantly prolong survival of the recipient mice...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28689016/long-term-follow-up-of-invasive-aspergillosis-in-allogeneic-stem-cell-transplantation-recipients-and-leukemia-patients-differences-in-risk-factors-and-outcomes
#20
S Bonnet, R Duléry, K Regany, M Bouketouche, L Magro, V Coiteux, S Alfandari, C Berthon, B Quesnel, I Yakoub-Agha
Antifungal prophylaxis (AP) has dramatically changed the epidemiology of invasive aspergillosis (IA). To better understand the differences in terms of clinical significance of IA between allogeneic stem cell transplantation (allo-SCT) recipients and patients treated for leukemia, we report a single-center study of 735 unselected consecutive patients treated between 2000 and 2004, before the era of systematic AP. Probable or confirmed IA were observed in 29 patients (2008 EORTC/MSG criteria), including 7/235 undergoing allo-SCT (5...
July 5, 2017: Current Research in Translational Medicine
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