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Bone marrow transplant complications

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https://www.readbyqxmd.com/read/28740621/direct-cost-analysis-of-the-second-year-post-allogeneic-hematopoietic-stem-cell-transplantation-in-the-bone-marrow-transplant-centre-of-tunisia
#1
Myriam Razgallah Khrouf, Leila Achour, Asma Thabti, Mohamed Ali Soussi, Nour Abdejelil, Olfa Lazreg, Chema Drira, Aida Zahaf, Saloua Ladab, Tarek Ben Othman
Background: Hematopoietic stem cell transplantation (HSCT) is a medically complicated therapy with a long recovery time. In Tunisia, the National Health Insurance Fund (CNAM) covers only the first year post-transplantation, after which the costs are borne by the hospital. Objective: Describe complications that can occur during the second year post-allogeneic HSCT and calculate direct costs in different groups of patients. Methods: In this pharmacoeconomic study, medical records of the second year post-allogeneic HSCT were collected...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28737949/effects-of-autogenous-bone-marrow-aspirate-concentrate-on-radiographic-integration-of-femoral-condylar-osteochondral-allografts
#2
Lasun O Oladeji, James P Stannard, Cristi R Cook, Mauricio Kfuri, Brett D Crist, Matthew J Smith, James L Cook
BACKGROUND: Transplantation of fresh osteochondral allografts (OCAs) is an attractive treatment option for symptomatic articular cartilage lesions in young, healthy patients. Because the lack of OCA bone integration can be a cause of treatment failure, methods for speeding and enhancing OCA bone integration to mitigate this potential complication are highly desirable. PURPOSE: To determine if autogenous bone marrow aspirate concentrate (BMC) treatment of large femoral condylar OCAs would be associated with superior radiographic OCA bone integration compared with nontreated allografts during the critical first 6 months after surgery...
July 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28731920/eye-movement-disorders-following-allogeneic-bone-marrow-transplantation-on-fk506-tacrolimus-and-ganciclovir
#3
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/28727801/proponent-or-collaborative-physician-perspectives-and-approaches-to-disease-modifying-therapies-in-sickle-cell-disease
#4
Nitya Bakshi, Cynthia B Sinha, Diana Ross, Kirshma Khemani, George Loewenstein, Lakshmanan Krishnamurti
Sickle cell disease (SCD) is an inherited blood disorder that primarily affects African-American and other ethnic minority populations. There are three available disease-modifying therapies for sickle cell disease: hydroxyurea (HU), bone marrow transplantation (BMT), and chronic blood transfusion (CBT). Since these treatments vary in their therapeutic intent, efficacy in preventing progression of the disease, short and long-term adverse effects, costs and patient burden, the decision-making process regarding these therapies is complicated for both the patient and healthcare provider...
2017: PloS One
https://www.readbyqxmd.com/read/28719147/human-immunology-studies-using-organ-donors-impact-of-clinical-variations-on-immune-parameters-in-tissues-and-circulation
#5
D J Carpenter, T Granot, N Matsuoka, T Senda, B V Kumar, J J C Thome, C L Gordon, M Miron, J Weiner, T Connors, H Lerner, A Friedman, T Kato, A D Griesemer, D L Farber
Organ donors are sources of physiologically healthy organs and tissues for life-saving transplantation, and have been recently used for human immunology studies which are typically confined to the sampling of peripheral blood. Donors comprise a diverse population with different causes of death and clinical outcomes during hospitalization, and the effects of such variations on immune parameters in blood and tissues are not known. We present here coordinate analyses of innate and adaptive immune components in blood, lymphoid (bone marrow, spleen, lymph nodes), and mucosal (lungs, intestines) sites from a population of brain-dead organ donors (3-months-93-years; n=291) across eight clinical parameters...
July 18, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28719093/bone-marrow-harvest-from-unrelated-donors-up-to-date-methodology
#6
Katarzyna Pruszczyk, Kamila Skwierawska, Małgorzata Król, Albert Moskowicz, Dariusz Jabłoński, Tigran Torosian, Iwona Piotrowska, Elżbieta Urbanowska, Wiesław Wiktor-Jędrzejczak, Emilian Snarski
OBJECTIVES: Bone marrow harvesting is one of the essential sources of stem cells for hematopoietic stem cell transplantation. We describe here the current "up to date" standard of the bone marrow harvest in unrelated stem cell donors. METHODS: We analyzed medical data of 187 unrelated hematopoietic stem cell donors who underwent bone marrow harvest without previous peripheral blood stem collection at the center between 2011 and 2015. The methodology of marrow collection includes multiple cells aimed at safety of the procedure e...
July 18, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28713380/targeting-the-human-t-cell-inducible-costimulator-molecule-with-a-monoclonal-antibody-prevents-graft-vs-host-disease-and-preserves-graft-vs-leukemia-in-a-xenograft-murine-model
#7
Aude Burlion, Simon Brunel, Nicolas Y Petit, Daniel Olive, Gilles Marodon
BACKGROUND: Graft-vs-host disease (GVHD) is a major complication of allogenic bone marrow transplantation (BMT). Targeting costimulatory molecules with antagonist antibodies could dampen the excessive immune response that occurs, while preserving the beneficial graft vs leukemia (GVL) of the allogeneic response. Previous studies using a mouse model of GVHD have shown that targeting the T-cell Inducible COStimulator (ICOS, CD278) molecule is beneficial, but it is unclear whether the same applies to human cells...
2017: Frontiers in Immunology
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
#8
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/28698986/novelties-in-the-pathophysiology-and-management-of-portal-hypertension-new-treatments-on-the-horizon
#9
REVIEW
Seong Hee Kang, Moon Young Kim, Soon Koo Baik
Portal hypertension (PH) is responsible for the most severe complications of cirrhosis and leading cause of death and liver transplantation. The standard pharmacological treatment available for PH currently consists of the use of a non-selective beta-blocker. However, a significant proportion of patients do not respond to pharmacological treatment. This has led to the development of identifiable targets for the discovery of new horizons in PH treatment. Recently, there has been significant progress in understanding the mechanism behind PH, which is a product of increased hepatic vascular resistance including structural changes and functional change due to endothelial dysfunction...
July 11, 2017: Hepatology International
https://www.readbyqxmd.com/read/28698779/bacterial-blood-stream-infections-negatively-impact-on-outcome-of-patients-treated-with-allogeneic-stem-cell-transplantation-6-years-single-centre-experience
#10
Michele Malagola, Bendetta Rambaldi, Giuseppe Ravizzola, Chiara Cattaneo, Erika Borlenghi, Nicola Polverelli, Alessandro Turra, Enrico Morello, Cristina Skert, Valeria Cancelli, Federica Cattina, Giorgio Giannetta, Simona Bernardi, Simone Perucca, Camillo Almici, Aldo Roccaro, Liana Signorini, Roberto Stellini, Francesco Castelli, Arnaldo Caruso, Domenico Russo
BACKGROUND: Blood stream infections (BSIs) represent a major complication of allo-SCT and are a major cause of morbidity and mortality during and after bone marrow aplasia. OBJECTIVES: The objective of this study was to describe the incidence and outcome of BSIs in a cohort of patients submitted to allo-SCT, in order to track changes of the epidemiology and bacteria resistance. METHODS: We retrospectively analyzed the microbiological data of 162 patients allotransplanted in Brescia University Hospital, over a period of 6 years...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28692026/association-between-single-nucleotide-polymorphisms-of-tumor-necrosis-factor-gene-and-grade-ii-iv-acute-gvhd-a-systematic-review-and-meta-analysis
#11
A Rashidi, D Weisdorf
Acute GvHD (aGvHD) complicates up to 50% of allogeneic hematopoietic cell transplants and pre-transplant estimation of its risk can guide prophylaxis, monitoring and early intervention strategies. Inspired by the role of tumor necrosis factor alpha (TNFα) in the pathogenesis of aGvHD and the inconsistency of the association studies exploring single nucleotide polymorphisms (SNPs) of the TNF gene, we conducted a systematic review and meta-analysis of the available reports using PubMed and EMBASE. Original human studies reporting on the association between recipient TNF SNPs and grade II-IV aGvHD in a format convertible to effect size and confidence interval were included...
July 10, 2017: Bone 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
#12
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/28688097/b-lymphocyte-chemoattractant-cxcl13-is-an-indicator-of-acute-gastrointestinal-gvhd-in-murine-model
#13
Yigeng Cao, Xiaoyi Qin, Na Wang, Erlie Jiang, Mingzhe Han, Yongyong Ma, Bin Liang, Kaiyan Yang, Kang Yu, Haige Ye
Gastrointestinal acute graft-vs.-host disease (GI aGVHD) remains a significant obstacle to the success of allogeneic hematopoietic cell transplantation and is a major cause of morbidity and mortality. In addition, GI aGVHD is often clinically indistinguishable from other causes of GI dysfunction such as conditioning regimen toxicity, infections, or medications, which complicates the diagnosis. Thus, specific biomarkers are needed to help improve diagnosis and obtain a deeper understanding of the cytokine changes in GI aGVHD...
July 7, 2017: Inflammation
https://www.readbyqxmd.com/read/28682672/sickle-cell-anemia-and-comorbid-leg-ulcer-treated-with-curative-peripheral-blood-stem-cell-transplantation
#14
Joseph L Connor, Caterina P Minniti, John F Tisdale, Matthew M Hsieh
Allogeneic bone marrow transplantation or peripheral blood stem cell transplantation (PBSCT) are the only curative therapies for patients with sickle cell disease (SCD). Once the patients have successfully undergone transplantation and engrafted, the hallmark of hemolytic anemia resolves, and normal hemoglobin levels are achieved. Some transplant protocols exclude patients with open wounds, including leg ulcers, because of infection risks associated with transplantation and long-term immunosuppression required to prevent graft-versus-host disease...
March 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28681086/effect-of-low-level-laser-treated-mesenchymal-stem-cells-on-myocardial-infarction
#15
Zaynab H El Gammal, Amr M Zaher, Nagwa El-Badri
Cardiovascular disease is the leading cause of death worldwide. Although cardiac transplantation is considered the most effective therapy for end-stage cardiac diseases, it is limited by the availability of matching donors and the complications of the immune suppressive regimen used to prevent graft rejection. Application of stem cell therapy in experimental animal models was shown to reverse cardiac remodeling, attenuate cardiac fibrosis, improve heart functions, and stimulate angiogenesis. The efficacy of stem cell therapy can be amplified by low-level laser radiation...
July 6, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28680278/current-practice-in-total-body-irradiation-results-of-a-canada-wide-survey
#16
R C N Studinski, D J Fraser, R S Samant, M S MacPherson
BACKGROUND: Total-body irradiation (tbi) is used to condition patients before bone marrow transplant. A variety of tbi treatment strategies have been described and implemented, but no consensus on best practice has been reached. We report on the results of a survey created to assess the current state of tbi delivery in Canada. RESULTS: A 19-question survey was distributed to 49 radiation oncology programs in Canada. Responses were received from 20 centres, including 12 centres that perform tbi...
June 2017: Current Oncology
https://www.readbyqxmd.com/read/28679992/chemotherapy-for-a-child-with-relapsed-acute-myeloid-leukemia-complicated-with-persistent-hepatitis-c-virus-infection
#17
Shunsuke Kimura, Shinsuke Hirabayashi, Daisuke Hasegawa, Wakako Sumiya, Megumi Seya, Toshihiro Matsui, Yuri Yoshimoto, Yosuke Hosoya, Nobuyoshi Mori, Akira Matsui, Atsushi Manabe
An 8-year-old Mongolian female was diagnosed with acute myeloid leukemia (AML) and treated at a hospital in Mongolia according to the BFM-AML2004 SR protocol. Although complete remission (CR) was achieved, chemotherapy was interrupted because of shortage of drugs. The patient moved to Japan 7 months after diagnosis. Screening for viral infection revealed the presence of hepatitis C virus (HCV) antibody and RNA. At 11 months after initial diagnosis, the patient experienced bone marrow relapse and a RUNX1-RUNX1T1 fusion transcript was detected...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28661312/mixed-donor-chimerism-following-simultaneous-pancreas-kidney-transplant
#18
Armin Rashidi, Daniel C Brennan, Ina E Amarillo, Jason R Wellen, Amanda Cashen
OBJECTIVES: Graft-versus-host disease after solid-organ transplant is exceedingly rare. Although the precise pathogenetic mechanisms are unknown, a progressive increase in donor chimerism is a requirement for its development. The incidence of mixed donor chimerism and its timeline after simultaneous pancreas-kidney transplant is unknown. MATERIALS AND METHODS: After encountering 2 cases of graft-versus-host disease after simultaneous pancreas-kidney transplant at our institution over a period of < 2 years, a collaborative pilot study was conducted by the bone marrow transplant, nephrology, and abdominal transplant surgery teams...
June 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28650448/transplant-associated-thrombotic-microangiopathy-is-an-endothelial-complication-associated-with-refractoriness-of-acute-gvhd
#19
M Zeisbrich, N Becker, A Benner, A Radujkovic, K Schmitt, J Beimler, A D Ho, M Zeier, P Dreger, T Luft
There is increasing evidence that endothelial dysfunction is involved in refractoriness of acute GvHD (aGvHD). Here we investigated the hypothesis that another endothelial complication, transplant-associated thrombotic microangiopathy (TMA), contributes to the pathogenesis of aGvHD refractoriness. TMA was retrospectively assessed in 771 patients after allogeneic stem cell transplantation (alloSCT). Incidences of TMA and refractory aGvHD were correlated with biomarkers of endothelial damage obtained before alloSCT for patients receiving or not receiving statin-based endothelial prophylaxis (SEP)...
June 26, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28646907/dimensions-of-social-capital-of-families-with-thalassemia-in-an-indigenous-population-in-tamil-nadu-india-a-qualitative-study
#20
Bharathi Palanisamy, Kalpana Kosalram, Vijayaprasad Gopichandran
BACKGROUND: Studies have shown that social capital is positively associated with health, and the association is context-based. Indigenous populations with poor access to health care largely depend on social capital for their health care needs. This study was conducted to explore the dimensions and types of social capital and its utilization by families with thalassemia for their health and well-being in an indigenous population in Tamil Nadu, India. METHODS: The participants in the study were parents who had children with thalassemia, belonged to an indigenous community in Tamil Nadu, were poor and marginalized, and had poor access to health care...
June 24, 2017: International Journal for Equity in Health
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