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Bone marrow transplant complications

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https://www.readbyqxmd.com/read/28627425/a-multicenter-retrospective-analysis-stressing-importance-of-long-term-follow-up-after-hematopoietic-cell-transplantation-for-%C3%AE-thalassemia
#1
S Chaudhury, M Ayas, C Rosen, M Ma, M Viqaruddin, S Parikh, S Kharbanda, K Y Chiang, A Haight, M Bhatia, Gmt Guilcher, A Thompson, S Shenoy
Allogeneic hematopoietic cell transplantation (HCT) is curative in patients with β-thalassemia major. However, the majority of reports on HCT outcomes lack long-term follow-up data with the exception of single center reports. An international multicenter retrospective data collection and analysis was conducted in 176 β-Thalassemia patients who were 1 year or beyond after first HCT to evaluate follow up methods and outcomes at 7 centers- Median age at HCT was 5.5 years (range, 0.6- 18.5) and median follow-up was 7 years (range, 1-20)...
June 13, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28596651/bacteremia-during-early-post-allogeneic-hematopoietic-stem-cell-transplantation-period-a-single-center-experience
#2
Amro Mohamed Sedky El-Ghammaz
Bacteremia is a significant complication of allogeneic hematopoietic stem cell transplantation (HSCT). We aimed to study bacteremia occurring during early post-transplant period at Bone Marrow Transplantation Unit of Ain Shams University regarding its risk factors and impact on survival. Patients performing allogeneic HSCT were followed up for occurrence of bacteremia. Survival status was assessed at 180 days post-transplant. Bacteremia occurred in 53.3 % of patients. On univariate analysis, CD34 +ve cell dose (P = 0...
June 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28585995/outcomes-of-primary-total-knee-arthroplasty-in-patients-with-hematopoietic-stem-cell-transplantation
#3
Brian P Chalmers, Cameron K Ledford, Kevin I Perry, Tad M Mabry, Arlen D Hanssen, Matthew P Abdel
Patients who have undergone hematopoietic stem cell transplantation to treat underlying bone marrow pathology represent a unique and potentially high-risk patient population for total knee arthroplasty (TKA). This study retrospectively reviewed 15 TKA procedures performed on 11 patients with a history of hematopoietic stem cell transplantation. The authors analyzed patient survivorship; clinical outcomes, including complications; and implant survivorship. Mean follow-up was 5 years (range, 2-10 years). Patient survivorship free from mortality was 91% (95% confidence interval, 76%-100%) and 55% (95% confidence interval, 25%-85%) at 2 and 5 years, respectively...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28584756/disseminated-cutaneous-trichosporonosis-in-an-adult-bone-marrow-transplant-patient
#4
A M Y Yong, S S Yang, K B Tan, S A Ho
The Trichosporon species are yeast-like opportunistic pathogens in immunocompromised patients. Trichosporon asahii infections have been reported in pediatric bone marrow transplant (BMT) patients. However, its incidence is low in the adult literature. A 52-year-old Chinese woman who was diagnosed with acute myeloid leukemia received induction chemotherapy and underwent allogenic bone marrow transplant, which was complicated by a relapse and required salvage chemotherapy. She developed persistent non-neutropenic fever secondary to presumed hepatosplenic candidiasis...
May 2017: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/28573314/reduced-toxicity-myeloablative-hla-haploidentical-hematopoietic-stem-cell-transplantation-with-post-transplantation-cyclophosphamide-for-sickle-cell-disease
#5
Volker Wiebking, Sebastian Hütker, Irene Schmid, Stefanie Immler, Tobias Feuchtinger, Michael H Albert
Allogeneic hematopoietic stem cell transplantation (HSCT) offers the possibility of cure for sickle cell disease (SCD) patients. Unfortunately, the probability of finding an HLA-matched donor for SCD patients is low. HSCT from HLA-haploidentical donors using reduced intensity conditioning, unmanipulated bone marrow and post-transplantation cyclophosphamide (ptCy) has resulted in negligible toxicity but high rates of graft rejection. We hypothesized that combining ptCy with a myeloablative reduced toxicity conditioning including serotherapy to increase immune ablation would allow for better engraftment...
June 1, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28554856/beneficial-role-of-low-dose-atg-in-unrelated-stem-cell-transplantation-for-adult-patients-with-acquired-severe-aplastic-anemia-reduction-of-graft-versus-host-disease-gvhd-and-improvement-of-gvhd-free-failure-free-survival-rate
#6
Sung-Soo Park, Dae Hun Kwak, Young-Woo Jeon, Jae-Ho Yoon, Sung-Eun Lee, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Hee-Je Kim, Seok Lee, Chang-Ki Min, Seok-Goo Cho, Dong-Wook Kim, Woo-Sung Min, Jong Wook Lee
Stem cell transplantation from an unrelated donor (URD SCT) is often considered in patients with severe aplastic anemia (SAA) whom immunosuppressive therapy failed and matched sibling donor is not available. To reduce the incidence of graft-versus-host disease (GVHD) in URD SCT, introduction of antithymocyte globulin (ATG) to the conditioning regimen has been proposed. Although ATG was shown to play a role in reducing GVHD in a cohort with diverse hematologic diseases, its role in SAA remains uncertain. The aim of this study was to determine the efficacy and toxicity of ATG in URD SCT for adult patients with SAA...
May 26, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28538506/allogeneic-hematopoietic-cell-transplantation-for-dyskeratosis-congenita-a-report-of-3-cases
#7
Shinichi Tamura, Toshihiko Imamura, Takayo Urata, Miki Kobayashi, Mari Gen, Toshihiro Tomii, Junko Do, Shinya Osone, Hiroyuki Ishida, Hajime Hosoi, Hiroshi Kuroda
Although bone marrow failure in patients with dyskeratosis congenita (DKC) can be successfully treated with allogeneic hematopoietic cell transplantation (allo-HCT) using a reduced intensity conditioning (RIC) regimen, the outcome of nonhematological disorders in patients with DKC treated with allo-HCT using RIC has not been fully elucidated. Here, we describe the clinical course of nonhematological disorders after allo-HCT with RIC in 3 consecutive patients with DKC. Allo-HCT with RIC was feasible in all cases; however, patient 1 developed lethal pulmonary disease and patient 2 experienced progression of hepatic fibrosis...
May 22, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28530163/gastrointestinal-histoplasmosis-a-case-series
#8
Rashi Sharma, Lipika Lipi, Smeeta Gajendra, Ishani Mohapatra, Ruchika K Goel, Rajan Duggal, Smruti Ranjan Mishra, Dheeraj Gautam
Histoplasmosis is an invasive mycosis caused by inhalation of the spores of dimorphic fungi Histoplasma capsulatum. The disease manifests in the lung as acute or chronic pulmonary histoplasmosis and in severe cases gets disseminated in multiple organs like skin, adrenal gland, central nervous system, lymph node, liver, spleen, bone marrow, and gastrointestinal tract. It occurs most commonly in immunodeficient patients like HIV-positive patients and transplant recipients, while immunocompetent hosts are affected rarely...
May 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28508984/successful-treatment-of-myeloma-cast-nephropathy-using-bortezomib-based-chemotherapy-plus-selective-plasma-exchange
#9
Mayuko Kawabe, Izumi Yamamoto, Ai Katsuma, Naomi Hayashi, Yo Komatsuzaki, Yasuyuki Nakada, Akihiro Shimizu, Yudo Tanno, Ichiro Ohkido, Nobuo Tsuboi, Kazuhito Suzuki, Takaki Shimada, Yoji Ogasawara, Katsuki Sugiyama, Keisuke Aiba, Takashi Yokoo
Myeloma cast nephropathy is a major complication of multiple myeloma. Recent evidence has demonstrated that the earlier induction of bortezomib-based chemotherapy with plasma exchange (PE) provides better results for kidney function and patient survival. Due to its non-selectivity, PE with albumin replacement carries the risk of fibrinogen loss, leading to bleeding. We herein report a case of successful treatment of myeloma cast nephropathy using bortezomib-based chemotherapy and selective PE. A 61-year-old woman who had a 20-year history of type II diabetes mellitus was admitted to our hospital for the evaluation of hypercalcemia, severe kidney dysfunction, and anemia...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28495641/safety-and-efficacy-of-infliximab-therapy-in-the-setting-of-steroid-refractory-acute-graft-versus-host-disease
#10
Fevzi F Yalniz, Mehrdad Hefazi, Kristen McCullough, Mark R Litzow, William J Hogan, Robert Wolf, Hassan Alkhateeb, Ankit Kansagra, Moussab Damlaj, Mrinal M Patnaik
Acute graft-versus-host disease (aGVHD) is the leading cause of morbidity and mortality after allogenic hematopoietic cell transplantation (HCT). Corticosteroids are the first-line treatment; however, less than one-half of patients achieve durable remission. Studies suggest that TNF-α, a cytokine released from the bone marrow during conditioning, is involved in the pathogenesis of aGVHD. We retrospectively evaluated the outcome of anti-TNF-α therapy with infliximab in 35 patients with steroid refractory (SR) aGVHD...
May 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28488966/haemolysis-pure-red-cell-aplasia-and-red-cell-antibody-formation-associated-with-major-and-bidirectional-abo-incompatible-haematopoietic-stem-cell-transplantation
#11
Gordana Tomac, Ines Bojanić, Sanja Mazić, Ivana Vidović, Mirela Raos, Branka Golubić Ćepulić, Ranka Serventi Seiwerth, Jadranka Kelečić, Boris Labar
BACKGROUND: Acute and delayed haemolysis, alloimmunisation and pure red cell aplasia (PRCA) are potential complications after ABO incompatible haematopoietic stem cell transplantation (HSCT). The aims of this study were to investigate acute and delayed red blood cell (RBC) antibody-associated complications, including haemolysis, PRCA and alloimmunisation in major and bidirectional ABO incompatible HSCT. MATERIALS AND METHODS: We retrospectively examined the transplant courses of 36 recipients of bone marrow or peripheral blood stem cells from ABO incompatible donors and evaluated the current practice of performing plasmapheresis in patients with higher isoagglutinin titres...
April 19, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28473623/tbet-is-a-critical-modulator-of-foxp3-expression-in-autoimmune-graft-versus-host-disease
#12
Shoba Amarnath, Arian Laurence, Nathaniel Zhu, Renato Cunha, Michael A Eckhaus, Samuel Taylor, Jason E Foley, Monalisa Ghosh, Tania C Felizardo, Daniel H Fowler
CD4+ T-helper subsets drive autoimmune chronic graft-versus-host disease, a major complication post allogeneic bone marrow transplantation. However, it remains unclear how specific T-helper subsets contribute to chronic graft versus host disease. Th1 cells are one of the major disease mediating T cell subsets and require IFNγ signaling and Tbet expression for their function. Regulatory T cells on the other hand can inhibit Th1 cell mediated responses. Using an established murine model that isolates the autoimmune component of graft-versus-host disease, we hypothesized that Th1 cells would restrict FoxP3-driven regulatory T cells...
May 4, 2017: Haematologica
https://www.readbyqxmd.com/read/28469041/hepatosplenic-candidiasis-without-prior-documented-candidemia-an-underrecognized-diagnosis
#13
Joffrey van Prehn, C Willemien Menke-van der Houven van Oordt, Madelon L de Rooij, Ellen Meijer, Marije K Bomers, Karin van Dijk
INTRODUCTION: Patients with a history of chemotherapy or stem cell transplantation (SCT) and prolonged neutropenia are at risk for hepatic and/or splenic seeding of Candida. In our experience, hepatosplenic candidiasis (HSC) without documented candidemia often remains unrecognized. CASE PRESENTATIONS: We describe three cases of HSC without documented candidemia and the challenges in establishing the diagnosis and adequately treating this condition. The first patient had a history of SCT for treatment of breast cancer and was scheduled for hemihepatectomy for suspected liver metastasis...
May 3, 2017: Oncologist
https://www.readbyqxmd.com/read/28453180/a-novel-homozygous-vps45-p-p468l-mutation-leading-to-severe-congenital-neutropenia-with-myelofibrosis
#14
Rikin K Shah, Mary Munson, Klaas J Wierenga, Hanumantha R Pokala, Peter E Newburger, David Crawford
VPS45-associated severe congenital neutropenia (SCN) is a rare disorder characterized by life-threating infections, neutropenia, neutrophil and platelet dysfunction, poor response to filgrastim, and myelofibrosis with extramedullary hematopoiesis. We present a patient with SCN due to a homozygous c.1403C>T (p.P468L) mutation in VPS45, critical regulator of SNARE-dependent membrane fusion. Structural modeling indicates that P468, like the T224 and E238 residues affected by previously reported mutations, cluster in a VPS45 "hinge" region, indicating its critical role in membrane fusion and VPS45-associated SCN...
April 28, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28436977/provision-of-long-term-monitoring-and-late-effects-services-following-adult-allogeneic-haematopoietic-stem-cell-transplant-a-survey-of-uk-nhs-based-programmes
#15
A Hamblin, D M Greenfield, M Gilleece, N Salooja, M Kenyon, E Morris, N Glover, P Miller, H Braund, A Peniket, B E Shaw, J A Snowden
Despite international guidelines, optimal delivery models of late effects (LE) services for HSCT patients are unclear from the clinical, organizational and economic viewpoints. To scope current LE service delivery models within the UK NHS (National Health Service), in 2014, we surveyed the 27 adult allogeneic HSCT centres using a 30-question online tool, achieving a 100% response rate. Most LE services were led and delivered by senior physicians (>80% centres). Follow-up was usually provided in a dedicated allograft or LE clinic for the first year (>90% centres), but thereafter attrition meant that only ~50% of patients were followed after 5 years...
June 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28411358/early-diagnostic-markers-for-detection-of-acute-kidney-injury-in-allogeneic-hematopoietic-stem-cell-transplant-recipients
#16
Serpil Muge Deger, Yasemin Erten, Elif Suyani, Sahika Zeynep Aki, Gulay Ulusal Okyay, Ozge T Pasaoglu, Hatice Pasaoglu, Turgay Arinsoy, Gulsan Turkoz Sucak
OBJECTIVES: Acute kidney injury is a relatively frequent complication of allogenic hematopoietic stem cell transplant, resulting in increased risk of morbidity and mortality. Early diagnosis and management of acute kidney injury is of great importance for prevention of poor outcomes in these transplant recipients. MATERIALS AND METHODS: Fifty consecutive patients, hospitalized for allogenic hematopoietic stem cell transplant at the Bone Marrow Transplantation Unit of Gazi University Faculty of Medicine, were included in this prospective study...
April 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28407835/-recurrent-pulmonary-infection-and-oral-mucosal-ulcer
#17
Fei-Mei Kuang, Lan-Lan Tang, Hui Zhang, Min Xie, Ming-Hua Yang, Liang-Chun Yang, Yan Yu, Li-Zhi Cao
An 8-year-old girl who had experienced intermittent cough and fever over a 3 year period, was admitted after experiencing a recurrence for one month. One year ago the patient experienced a recurrent oral mucosal ulcer. Physical examination showed vitiligo in the skin of the upper right back. Routine blood tests and immune function tests performed in other hospitals had shown normal results. Multiple lung CT scans showed pulmonary infection. The patient had recurrent fever and cough and persistent presence of some lesions after anti-infective therapy...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28407355/extracellular-vesicles-from-bone-marrow-derived-mesenchymal-stem-cells-protect-against-murine-hepatic-ischemia-reperfusion-injury
#18
Hiroaki Haga, Irene K Yan, David Borelli, Akiko Matsuda, Mansi Parasramka, Neha Shukla, David D Lee, Tushar Patel
Hepatic ischemia-reperfusion injury (IRI) and associated inflammation contributes to liver dysfunction and complications after liver surgery and transplantation. Mesenchymal stem cells (MSC) have been reported to reduce hepatic IRI because of their reparative immunomodulatory effects in injured tissues. Recent studies have highlighted beneficial effects of extracellular vesicles from MSCs (MSC-EV) on tissue injury. The effects of systemically administered mouse bone marrow derived MSC-EV were evaluated in an experimental murine model of hepatic IRI induced by cross clamping the hepatic artery and portal vein for 90 minutes followed by reperfusion for periods of upto 6 hours...
April 13, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28403842/outcomes-of-autologous-bone-marrow-mononuclear-cells-for-cerebral-palsy-an-open-label-uncontrolled-clinical-trial
#19
Liem Thanh Nguyen, Anh Tuan Nguyen, Chinh Duy Vu, Doan V Ngo, Anh V Bui
BACKGROUND: Stem cell therapy has emerged as a promising method for improving motor function of patients with cerebral palsy. The aim of this study is to assess the safety and effectiveness of autologous bone marrow mononuclear stem cell transplantation in patients with cerebral palsy related to oxygen deprivation. METHODS: An open label uncontrolled clinical trial was carried out at Vinmec International Hospital. The intervention consisted of two administrations of stem cells, the first at baseline and the second 3 months later...
April 12, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28392333/outcome-of-hematopoietic-cell-transplantation-for-dna-double-strand-breakage-repair-disorders
#20
James Slack, Michael H Albert, Dmitry Balashov, Bernd H Belohradsky, Alice Bertaina, Jack Bleesing, Claire Booth, Jochen Büchner, Rebecca H Buckley, Marie Ouachée-Chardin, Elena Deripapa, Katarzyna Drabko, Mary Eapen, Tobias Feuchtinger, Andrea Finocchi, H Bobby Gaspar, Sujal Ghosh, Alfred Gillio, Luis I Gonzalez-Granado, Eyal Grunebaum, Tayfun Güngör, Carsten Heilmann, Merja Helminen, Kohei Higuchi, Kohsuke Imai, Krzysztof Kalwak, Nubuo Kanazawa, Gülsün Karasu, Zeynep Y Kucuk, Alexandra Laberko, Andrzej Lange, Nizar Mahlaoui, Roland Meisel, D Moshous, Hideki Muramatsu, Suhag Parikh, Srdjan Pasic, Irene Schmid, Catharina Schuetz, Ansgar Schulz, Kirk R Schultz, Peter J Shaw, Mary A Slatter, Karl-Walter Sykora, Shinobu Tamura, Mervi Taskinen, Angela Wawer, Beata Wolska-Kus Nierz, Morton J Cowan, Alain Fischer, Andrew R Gennery
BACKGROUND: Rare DNA breakage-repair disorders predispose to infection and lympho-reticular malignancies. Hematopoietic cell transplantation (HCT) is curative but co-administered chemo- or radio-therapy is damaging due to systemic radio-sensitivity. We collected HCT outcome data for Nijmegen Breakage syndrome (NBS), DNA ligase IV deficiency (LIG4), Cernunnos-XLF deficiency and ataxia-telangiectasia. METHODS: Data from 38 centres worldwide, including indication, donor, conditioning regimen, graft-versus-host disease (GvHD) and outcome were analyzed...
April 6, 2017: Journal of Allergy and Clinical Immunology
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