Download or read book Immune Cytopenias After Allogeneic Hematopoietic Stem Cell Transplantation in Children written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: ObjectivesTo have a better understanding of incidence, treatment, outcome and risk factors of immune cytopenia in children after allogeneic HSCT. MethodsBetween January 2010 and September 2018, 105 pediatric allogeneic HSCT have been performed in 99 patients at the Ghent University Hospital (Ghent, Belgium). Autoimmune hemolytic anemia was defined by a positive direct agglutinin test (DAT). DAT was performed at moment of engraftment and in case of hemolysis or unexplained anemia.Platelets antibodies were evaluated in case of no otherwise explained thrombocytopenia.ResultsThe cumulative incidence of post allo SCT autoimmune cytopenia is 9.5% (10/105). In 9 cases there were positive antibodies against red blood cells, and one patient against had antibodies against platelets. Of these 10 cases, only 4 (3.8%) were clinically relevant and needed treatment. The median observation period post SCT for the whole cohort was 36 months (3 -105). The clinically significant immune cytopenia started at a median time of day+158 and day +113 in the group without symptoms. The patient who presented the autoimmune thrombopenia developed antibodies against anti-gpIIb/IIIa, this was resolved after 130 days, the treatment consisted intravenous immunoglobulins (Ivig). Two of the 3 patients with autoimmune hemolytic anemia had IgG mediated antibodies, and 1 had complement-mediated DAT. These 3 patients were treated with Ivig, steroids, Rapamune and rituximab. One patient has still DAT positive after 36 months, but clinical stable. The other two are also DAT positive and have some hemolysis, but the follow up is much shorter (2 months). Treosulfan- contained conditioning regimens were more frequently used in patients with significant immune cytopenia.Conclusion Autoimmune cytopenia is an infrequent complication after allogeneic HSCT. However, its treatment can be challenging, and the hemolysis can persist for years. The association of Rapamune and rituximab was adequate to treat this problem in our patients. Treosulfan-containing regimes should be monitored for this complication.
Download or read book The European Blood and Marrow Transplantation Textbook for Nurses written by Michelle Kenyon and published by Springer. This book was released on 2018-03-14 with total page 318 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is open access under a CC BY 4.0 license. This textbook, endorsed by the European Society for Blood and Marrow Transplantation (EBMT), provides adult and paediatric nurses with a full and informative guide covering all aspects of transplant nursing, from basic principles to advanced concepts. It takes the reader on a journey through the history of transplant nursing, including essential and progressive elements to help nurses improve their knowledge and benefit the patient experience, as well as a comprehensive introduction to research and auditing methods. This new volume specifically intended for nurses, complements the ESH-EBMT reference title, a popular educational resource originally developed in 2003 for physicians to accompany an annual training course also serving as an educational tool in its own right. This title is designed to develop the knowledge of nurses in transplantation. It is the first book of its kind specifically targeted at nurses in this specialist field and acknowledges the valuable contribution that nursing makes in this area. This volume presents information that is essential for the education of nurses new to transplantation, while also offering a valuable resource for more experienced nurses who wish to update their knowledge.
Download or read book Immunological Challenges Following Pediatric Hematopoietic Transplantation written by Robert James Hayashi and published by Frontiers Media SA. This book was released on 2021-09-28 with total page 107 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Immune Reconstruction After Allogeneic Bone Marrow Transplantation In Pediatric Patients written by Popa Delia Codruta and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: CONTEXT: Allogeneic hematopoietic stem cell transplantation (HSCT) has become a well-defined therapeutic strategy for a wide variety of malignant and non-malignant diseases with curative potential. Immune reconstitution post-HSCT is a complex and dynamic process, achieved in stages, depending on the type of transplant, the characteristics of the donor and the recipient, and the occurrence and stage of the graft versus host disease (GvHD).OBJECTIVE: The objective of our study is to identify the correlations between regenerating cell lineage and the time required for complete reconstitution of the immune status depending on the type of allogeneic transplantation.DESIGN: We retrospectively evaluated 16 patients, who have been undergoing allogeneic transplantation between January 2015 and March 2018, and who survived at least 100 days after transplantation in the Pediatric Department, Fundeni Clinical Institute, Bucharest. We analyzed the immune status (B, T and NK cells) by immunophenotyping, using the following markers: Lambda, Kappa, CD56, CD5, CD19, TCRgd/CD16, CD3, CD38, CD20, CD8, CD4, CD45 at well-defined checkpoint intervals (3, 6, 9, 12, and 24 months after the transplant). Absolute values of each subgroup were calculated using the percentage of each subset and absolute count from the leukocytes. RESULTS: In this study, 16 patients have been undergoing allogeneic HSCT transplantation for malignant and non-malignant diseases. There were achieved 5 haploidentical HSCT, 8 HSTC from a matched unrelated donor (MUD), and 4 matched sibling donor (MSD). 5 patients experienced immune recovery during the first 6 months, the NK cells subset has reconstituted in the first 3 months, and the last one to recover was the T cells subset (CD4+). In our study group, the immune reconstitution rate was 20% for haploidentical transplantation, 37.5% for MUD and 25% for MSD. Moreover, delayed immune reconstitution has been associated with the occurrence/reactivation of viral infections (CMV, EBV, BKV, and JCV) with increased frequency in the post-grafting period.CONCLUSIONS: In our center, patients undergoing transplantation from MSD have the fastest immune reconstitution. The immune reconstitution of patients after allogeneic HSCT influences long-term survival by contributing to the management of infectious complications and of GvHD.
Download or read book Immune Reconstitution After Allogeneic Hematopoietic Stem Cell Transplantation in Children written by and published by . This book was released on 2019 with total page 259 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Chronic Graft Versus Host Disease written by Georgia B. Vogelsang and published by Cambridge University Press. This book was released on 2009-04-20 with total page 427 pages. Available in PDF, EPUB and Kindle. Book excerpt: Chronic graft versus host disease (GVHD) is the most common complication of allogenic bone marrow transplantation. Because of the protracted clinical course of chronic GVHD, transplant centers and hematology/oncology offices are inadequately equipped to manage these immuno-incompetent patients with a multi-system disorder. Practitioners need to be able to recognize and effectively manage chronic GVHD as a late effect of more than half of allogenic transplantations. The text is oriented for the clinician, with chapters covering staging, organ site and system-specific manifestations, treatment options, and supportive care. Drs Georgia B. Vogelsang and Steven Z. Pavletic have been pioneers in the recognition of the multi-organ complexity of this disease and have gathered the input of a variety of subspecialist physicians for this book. This book fills the gap in practical literature on chronic GVHD, providing a comprehensive, up-to-date, and clinically relevant resource for anyone who deals with cancer patients post-transplant.
Download or read book Congenital and Acquired Bone Marrow Failure written by Mahmoud Deeb Aljurf and published by Elsevier. This book was released on 2017-01-09 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Congenital and Acquired Bone Marrow Failure is a comprehensive guide to congenital and acquired bone marrow failure in adult and pediatric patients. Chapters are divided into two sections, acquired aplastic anemia and inherited bone marrow failure syndromes. Content ranges from the basic, to the translational, and from the epidemiology of acquired aplastic anemia and telomere biology, to the management, treatment, and supportive care of pediatric, adult, and geriatric patients. Contributors are world leading experts in the field of bone marrow failure. The book is required reading for residents, fellows, clinicians, and researchers across hematology, oncology, pathology, bone marrow transplantation, pediatrics, and internal medicine.
Download or read book Stem Cell Transplantation for Hematologic Malignancies written by Robert J. Soiffer and published by Springer Science & Business Media. This book was released on 2004 with total page 512 pages. Available in PDF, EPUB and Kindle. Book excerpt: A comprehensive survey of the current state-of-the-art in hematopoietic stem cell transplantation for malignant disease. The authors focus on the indications and results of transplantation for acute leukemia, chronic myelogenous leukemia, lymphoma, multiple myeloma, and breast cancer. Special attention is given to transplant-related complications, including the pathophysiology and clinical consequences of acute and chronic GVHD, delayed immune reconstitution leading to infectious complications, and organ damage to the lung and liver. Additional chapters address the sources of stem cells and the effects of graft manipulation used to eliminate residual contaminating tumor cells in autologous transplantation, or to reduce the number of T lymphocytes causing GVHD in allogenic transplantation.
Download or read book Daratumumab Therapy for Post HSCT Immune mediated Cytopenia Experiences from Two Pediatric Cases and Review of Literature written by Lina Driouk and published by . This book was released on 2021 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Background Immune-mediated cytopenias (AIC) are challenging complications following allogeneic hematopoietic stem cell transplantation (HSCT). While broad-acting immunosuppressive agents like corticosteroids are often standard of care, several novel therapies which target specific immunological pathways have recently been developed and provide hope for patients with steroid-refractory courses and may limit long-term toxicity. The successful off-label use of the plasma cell depleting anti-CD38 antibody daratumumab was published in several case reports, suggesting efficacy, i.e., in patients with antibody-mediated AIC refractory to previous B cell depletion. We want to share our experience with two children, whom we treated with daratumumab, including one fatal course with uncontrolled disease. Given the absence of substantial data from HSCT registries or prospective trials, we furthermore provide a critical review of the literature on daratumumab treatment of AIC. Case presentations Patient 1 (P1), an 11-year-old girl with lipopolysaccharide-responsive and beige-like anchor protein (LRBA) deficiency who developed immune-mediated thrombocytopenia (AIT) from day +58 after HSCT, showed a complete response to daratumumab after the fourth of six total daratumumab doses. She remains transfusion independent for over a year of follow-up. Previously, her thrombocytopenia was refractory to corticosteroids, rituximab, intravenous immunoglobulins (IVIG), eltrombopag, cyclosporine A, and sirolimus. Patient 2 (P2), a 6-year-old boy with CD40 ligand (CD40L) deficiency, developed both AIT and hemolytic anemia (AIHA) after HSCT on days +58 and +83, respectively, and was also treated with daratumumab after being previously refractory to prednisolone, rituximab, and IVIG. Yet, he did neither respond to daratumumab nor the concomitantly administered methyprednisolone pulse, plasmapheresis, and eculizumab and succumbed due to refractory disease. Conclusion Reviewing the literature on the use of daratumumab for refractory AIC post-HSCT, we consider daratumumab a promising agent for this life-threatening disorder: ten of the twelve patients reached transfusion independency in the literature. However, treatment failures are likely to be underreported. Thus, controlled trials are needed to explore the safety and efficacy of daratumumab in this rare post-HSCT complication
Download or read book Blood and Marrow Transplant Handbook written by Richard T. Maziarz and published by Springer. This book was released on 2015-04-20 with total page 437 pages. Available in PDF, EPUB and Kindle. Book excerpt: This updated and expanded edition developed by the Blood and Marrow Stem Cell Transplant team at Oregon Health & Science University Knight Cancer Institute features the latest medical management guidelines and standards of care for hematopoietic stem cell transplant patients. Spanning the timeline from the initial consultation throughout the transplant process, this handbook includes indications for transplantation and donor selection, treatment guidelines for addressing complications during and after transplant, and recommendations for long-term follow up care. Concise, comprehensive, and easy-to-use, Blood and Marrow Transplant Handbook, 2nd Edition presents a multidisciplinary approach to information for physicians and advanced practice medical providers who care for transplant patients, and also residents, fellows, and other trainees.
Download or read book Contemporary Bone Marrow Transplantation written by Mammen Chandy and published by Springer. This book was released on 2021-03-25 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Bone Marrow transplantation or Hematopoietic stem cell transplantation is a life saving procedure in a number of diseases,hematological and non hematological, which fail alternative medical management or have no other treatment options. It has transformed the lives of thousands of patients and their families around the world battling with fatal or debilitating diseases.There are many unique aspects of bone marrow transplantation which makes it very different from solid organ transplants. There is an enormous amount of research going on in this field both at clinical and basic science levels.With the rapidly changing world and field of transplantation, there is a need for an authoritative and up to date resource for transplant professionals. This book titled Contemporary Bone Marrow Transplantation aims to be a reference text comprehensively covering various facets of hematopoietic stem cell transplants with latest insights about the technique and basic science behind it . The book is the product of collective effort of transplant professionals round the world, and will reflect their experience as well as the current standard of care practices in Stem cell transplantation.The book will be divided into different sections focusing on the basic science of bone marrow transplant, the technical aspects of the procedure itself and the supportive care of transplant patients.There will also be a section each on epidemiology, upcoming trends and also case studies , which will discuss real case scenarios from the experience of the authors, to illustrate the practical challenges in managing bone marrow transplant recipients.
Download or read book Thomas Hematopoietic Cell Transplantation written by Stephen J. Forman and published by John Wiley & Sons. This book was released on 2015-12-14 with total page 1416 pages. Available in PDF, EPUB and Kindle. Book excerpt: Fully revised for the fifth edition, this outstanding reference on bone marrow transplantation is an essential, field-leading resource. Extensive coverage of the field, from the scientific basis for stem-cell transplantation to the future direction of research Combines the knowledge and expertise of over 170 international specialists across 106 chapters Includes new chapters addressing basic science experiments in stem-cell biology, immunology, and tolerance Contains expanded content on the benefits and challenges of transplantation, and analysis of the impact of new therapies to help clinical decision-making Includes a fully searchable Wiley Digital Edition with downloadable figures, linked references, and more References for this new edition are online only, accessible via the Wiley Digital Edition code printed inside the front cover or at www.wiley.com/go/forman/hematopoietic.
Download or read book Aplastic Anemia written by Hubert Schrezenmeier and published by Cambridge University Press. This book was released on 2000 with total page 410 pages. Available in PDF, EPUB and Kindle. Book excerpt: Comprehensive and up-to-date clinical reference, with an emphasis on treatment.
Download or read book Allogeneic Stem Cell Transplantation written by Hillard M. Lazarus and published by Springer Science & Business Media. This book was released on 2010-03-02 with total page 885 pages. Available in PDF, EPUB and Kindle. Book excerpt: Since the original publication of Allogeneic Stem Cell Transplantation: Clinical Research and Practice, Allogeneic hematopoietic stem cell transplantation (HSC) has undergone several fast-paced changes. In this second edition, the editors have focused on topics relevant to evolving knowledge in the field in order to better guide clinicians in decision-making and management of their patients, as well as help lead laboratory investigators in new directions emanating from clinical observations. Some of the most respected clinicians and scientists in this discipline have responded to the recent advances in the field by providing state-of-the-art discussions addressing these topics in the second edition. The text covers the scope of human genomic variation, the methods of HLA typing and interpretation of high-resolution HLA results. Comprehensive and up-to-date, Allogeneic Stem Cell Transplantation: Clinical Research and Practice, Second Edition offers concise advice on today's best clinical practice and will be of significant benefit to all clinicians and researchers in allogeneic HSC transplantation.
Download or read book The EBMT EHA CAR T Cell Handbook written by Nicolaus Kröger and published by Springer Nature. This book was released on 2022-02-07 with total page 221 pages. Available in PDF, EPUB and Kindle. Book excerpt: This first open access European CAR-T Handbook, co-promoted by the European Society for Blood and Marrow Transplantation (EBMT) and the European Hematology Association (EHA), covers several aspects of CAR-T cell treatments, including the underlying biology, indications, management of side-effects, access and manufacturing issues. This book, written by leading experts in the field to enhance readers’ knowledge and practice skills, provides an unparalleled overview of the CAR-T cell technology and its application in clinical care, to enhance readers’ knowledge and practice skills.
Download or read book Manual of Stem Cell and Bone Marrow Transplantation written by Joseph H. Antin and published by Cambridge University Press. This book was released on 2013-10-17 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fully revised second edition is a practical manual for all members of the stem cell and bone marrow transplant team.
Download or read book Haploidentical Transplantation written by Stefan O. Ciurea and published by Springer. This book was released on 2018-05-03 with total page 330 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this book, world-renowned experts in the field express well-reasoned opinions on a range of issues and controversies relating to haploidentical transplantation with the aim of providing practicing hematologists with clinically relevant and readily applicable information. Among the areas covered are graft manipulation and methods to control T-cell alloreactivity, the nature of the ideal graft and donor, haploidentical transplantation in pediatric and adult patients with malignant and nonmalignant diseases, immunologic reconstitution following transplantation, complications, and the prevention and treatment of relapse post transplantation. Attention is drawn to the implications of high-impact clinical trials whenever such trials are available. The readily intelligible text is complemented by numerous helpful tables, algorithms, and figures. The book will provide practical support for hematologists and transplant physicians as they attempt to provide optimal care in this exciting but increasingly complex medical specialty.
