Current practice in nutrition after allogeneic hematopoietic stem cell transplantation – results from a survey among hematopoietic stem cell transplant centers

Author(s):  
R. Toenges ◽  
H. Greinix ◽  
A. Lawitschka ◽  
J. Halter ◽  
A. Baumgartner ◽  
...  
2020 ◽  
Vol 9 (3) ◽  
pp. 865 ◽  
Author(s):  
Carlos A. Q. Santos ◽  
Yoona Rhee ◽  
Michael T. Czapka ◽  
Aamir S. Kazi ◽  
Laurie A. Proia

Hematopoietic stem cell transplant recipients are at increased risk of infection and immune dysregulation due to reception of cytotoxic chemotherapy; development of graft versus host disease, which necessitates treatment with immunosuppressive medications; and placement of invasive catheters. The prevention and management of infections in these vulnerable hosts is of utmost importance and a key “safety net” in stem cell transplantation. In this review, we provide updates on the prevention and management of CMV infection; invasive fungal infections; bacterial infections; Clostridium difficile infection; and EBV, HHV-6, adenovirus and BK infections. We discuss novel drugs, such as letermovir, isavuconazole, meropenem-vaborbactam and bezlotoxumab; weigh the pros and cons of using fluoroquinolone prophylaxis during neutropenia after stem cell transplantation; and provide updates on important viral infections after hematopoietic stem cell transplant (HSCT). Optimizing the prevention and management of infectious diseases by using the best available evidence will contribute to better outcomes for stem cell transplant recipients, and provide the best possible “safety net” for these immunocompromised hosts.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4790-4790
Author(s):  
Moazzam Shahzad ◽  
Muhammad Arslan ◽  
Zehra Naseem ◽  
Sakina Abbas ◽  
Naira Fatima ◽  
...  

Abstract Background: Research performance is evaluated by bibliometric analysis of citations, and this can help to identify the most impactful articles in the field of hematopoietic stem cell transplantation (HSCT). We conducted a bibliometric analysis to identify scholarly impact and factors associated with the top 100 cited articles on HSCT. Methods: Thomas Reuters Web of Science core collection (WoS) was accessed in January 2021 and a title-specific search was conducted using the keywords "hematopoietic stem-cell transplantation ", "transplantation, hematopoietic stem cell," "stem cell transplantation, hematopoietic," "bone-marrow transplantation," "transplantation, bone marrow," "grafting, bone marrow," "transplantation bone marrow cell," "bone marrow cell transplantation," "stem cell transplant," "allogeneic hematopoietic stem cell transplant," "autologous hematopoietic stem cell transplant". Non-Human and non-HSCT studies were excluded. A total of 39,406 records were identified and a list of the top 100 articles was made. Articles included in our study were characterized by the number of citations, year of publication, topic, study design, authors, h-index, and institutions. Data were analyzed using SPSS in April 2021. Bivariate analyses, using chi-square and t-test, and linear regression analyses were performed. Results: The 100 most cited articles in the field were published over 52 years from 1968 to 2020, with a maximum number of articles (n=40) published in the 1990s decade. Top-100 articles were cited 62,002 times with a median citation count of 465 (range 336-2240). The top-cited articles originated from 12 countries and the United States (US) contributed 69 articles. The University of Washington Fred Hutchinson Cancer Center (n=15) was the leading institution. Blood (n=32) and New England Journal of Medicine (n=31) made the greatest contribution, and 41 manuscripts were clinical trials. In a multivariate regression model, the first author's h-index (regression coefficient 5.46, 95% confidence interval 2.99-7.93, p<0.001) correlated with the citation count while gender, journal impact factor, years since publication, and the number of authors did not have a significant association. Conclusion: Our study highlights the most influential articles on clinical HSCT, centralization of research to North American and European institutions, and provides valuable insight for future research needs of the specialty. Figure 1 Figure 1. Disclosures Abhyankar: Incyte/Therakos: Consultancy, Research Funding, Speakers Bureau. McGuirk: Novartis: Research Funding; Pluristem Therapeutics: Research Funding; Juno Therapeutics: Consultancy, Honoraria, Research Funding; Astelllas Pharma: Research Funding; Magenta Therapeutics: Consultancy, Honoraria, Research Funding; Allovir: Consultancy, Honoraria, Research Funding; Gamida Cell: Research Funding; EcoR1 Capital: Consultancy; Bellicum Pharmaceuticals: Research Funding; Novartis: Research Funding; Fresenius Biotech: Research Funding; Kite/ Gilead: Consultancy, Honoraria, Other: travel accommodations, expense, Kite a Gilead company, Research Funding, Speakers Bureau.


2020 ◽  
Vol 09 (04) ◽  
pp. 233-235
Author(s):  
Rahul Naithani ◽  
Nitin Dayal ◽  
Reeta Rai

Abstract Introduction Multiple myeloma (MM) in very young patients is uncommon, and no treatment guidelines exist for these patients. Patients and Methods We performed a retrospective analysis of five very young myeloma patients who underwent tandem autologous hematopoietic stem cell transplantation (HSCT). Results The median age was 37 years (range = 34–40 years). A median of two leukapheresis was performed (range = 1–4). The median number of hematopoietic stem cells collected was 5.4 × 106/kg (4.4–8.2 × 106/kg). During first transplant, four patients received melphalan of 200 mg/m2 and one patient received melphalan of 140 mg/m2 (due to renal failure) as conditioning regimen. Second transplant conditioning was melphalan of 200 mg/m2 for one patient and melphalan of 140 mg/m2 for remaining four patients. Two patients were in complete remission, and two were in very good partial remission and one patient progressed to active disease at the time of tandem autologous bone marrow transplant. All patients developed significant mucositis. Neutrophil and platelet recovery was longer in tandem autologous hematopoietic stem cell transplant. More viral infections were seen in tandem transplant. Day 30 and day 100 mortality was nil. Conclusion We present data on tandem autologous HSCTs in very young patients with MM in India. Responses continued to improve in this small series.


2021 ◽  
Vol 8 ◽  
pp. 204993612110132
Author(s):  
Kamal Kant Sahu ◽  
Ahmad Daniyal Siddiqui

For the last few months, various geographical regions and health sectors have been facing challenges posed by the current COVID-19 pandemic. COVID-19 has led to significant disruption in the normal functioning of potentially life-saving therapies of hematopoietic cell transplant and chimeric antigen receptor therapy. As transplant physicians are gaining more information and experience regarding the undertaking of these complex procedures during the ongoing COVID-19 pandemic, we believe it is important to discuss the challenges faced, prognostic risk factors, and outcomes of COVID-19 in post-hematopoietic stem cell transplantation patients based on the available real-world data.


2019 ◽  
Vol 15 (2) ◽  
pp. 289-297 ◽  
Author(s):  
Amanda DeMauro Renaghan ◽  
Edgar A. Jaimes ◽  
Jolanta Malyszko ◽  
Mark A. Perazella ◽  
Ben Sprangers ◽  
...  

Hematopoietic stem cell transplantation is a life-saving therapy for many patients with cancer, as well as patients with some nonmalignant hematologic disorders, such as aplastic anemia, sickle cell disease, and certain congenital immune deficiencies. Kidney injury directly associated with stem cell transplantation includes a wide range of structural and functional abnormalities, which may be vascular (hypertension, thrombotic microangiopathy), glomerular (albuminuria, nephrotic glomerulopathies), and/or tubulointerstitial. AKI occurs commonly after stem cell transplant, affecting 10%–73% of patients. The cause is often multifactorial and can include sepsis, nephrotoxic medications, marrow infusion syndrome, hepatic sinusoidal obstruction syndrome, thrombotic microangiopathy, infections, and graft versus host disease. The risk of post-transplant kidney injury varies depending on patient characteristics, type of transplant (allogeneic versus autologous), and choice of chemotherapeutic conditioning regimen (myeloablative versus nonmyeloablative). Importantly, AKI is associated with substantial morbidity, including the need for KRT in approximately 5% of patients and the development of CKD in up to 60% of transplant recipients. AKI has been associated universally with higher all-cause and nonrelapse mortality regardless of transplant type, and studies have consistently shown extremely high (>80%) mortality rates in those patients requiring acute dialysis. Accordingly, prevention, early recognition, and prompt treatment of kidney injury are essential to improving kidney and patient outcomes after hematopoietic stem cell transplantation, and for realizing the full potential of this therapy.


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