scholarly journals PCN4 EFFECT OF PALIFERMIN ON ORAL MUCOSITIS AND ACUTE GVHD AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION IN PATIENTS WITH HEMATOLOGIC MALIGNANCY: A META-ANALYSIS

2019 ◽  
Vol 22 ◽  
pp. S56
Author(s):  
M. Adil ◽  
S. Sriram ◽  
M. Azharuddin ◽  
P. Ghosh ◽  
M. Sharma
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Oral Mucositis ◽  
Acute Gvhd ◽  
Hematologic Malignancy ◽  
Meta Analysis ◽  
Hematopoietic Stem

scholarly journals The Addition of Sirolimus to GVHD Prophylaxis After Allogeneic Hematopoietic Stem Cell Transplantation: A Meta-Analysis of Efficacy and Safety

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaoli Chen ◽  
Hengrui Sun ◽  
Kaniel Cassady ◽  
Shijie Yang ◽  
Ting Chen ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Acute Gvhd ◽  
Meta Analysis ◽  
Chronic Gvhd ◽  
Hematopoietic Stem ◽  
Safety And Efficacy

ObjectiveThe objective of this study was to evaluate the safety and efficacy of sirolimus (SRL) in the prevention of graft-versus-host disease (GVHD) in recipients following allogeneic hematopoietic stem cell transplantation (allo-HSCT).MethodsRandomized controlled trials (RCTs) evaluating the safety and efficacy of SRL-based prophylaxis regimens in patients receiving allo-HSCT were obtained from PubMed, Embase, and the Cochrane database. Following specific inclusion and exclusion criteria, studies were selected and screened by two independent reviewers who subsequently extracted the study data. The Cochrane risk bias evaluation tool was used for quality evaluation, and RevMan 5.3 software was used for statistical analysis comparing the effects of SRL-based and non–SRL-based regimens on acute GVHD, chronic GVHD, overall survival (OS), relapse rate, non-relapse mortality (NRM), thrombotic microangiopathy (TMA), and veno-occlusive disease (VOD).ResultsSeven studies were included in this meta-analysis, with a total sample size of 1,673 cases, including 778 cases of patients receiving SRL-based regimens and 895 cases in which patients received non-SRL-based regimens. Our data revealed that SRL containing prophylaxis can effectively reduce the incidence of grade II–IV acute GVHD (RR = 0.75, 95% CI: 0.68∼0.82, p < 0.0001). SRL-based prophylaxis was not associated with an improvement of grade III–IV acute GVHD (RR = 0.78, 95% CI: 0.59∼1.03, p = 0.08), chronic GVHD (p = 0.89), OS (p = 0.98), and relapse rate (p = 0.16). Despite its immunosuppressant effects, SRL-based regimens did not increase bacterial (p = 0.68), fungal (p = 0.70), or CMV (p = 0.10) infections. However, patients receiving SRL-based regimens had increased TMA (p < 0.00001) and VOD (p < 0.00001).ConclusionsThis meta-analysis indicates that addition of sirolimus is an effective alternative prophylaxis strategy for II–IV aGVHD but may cause endothelial cell injury and result in secondary TMA or VOD events.

scholarly journals Vitamin D Deficiency and Oral Mucositis in Hematopoietic Stem Cell Transplantation: A Cross-Sectional Observation

2019 ◽  
Author(s):  
Kosar Raoufinejad ◽  
Shahrzad Pezeshki ◽  
Bahram Chahardouli ◽  
Molouk Hadjibabaie ◽  
Zahra Jahangard-Rafsanjani ◽  
...  
Keyword(s):  
Vitamin D ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Hospital Stay ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Oral Mucositis ◽  
World Health ◽  
Hematopoietic Stem

Backgrounds: One of the most frequent complications of high-dose chemotherapy regimen before hematopoietic stem cell transplantation (HSCT) is oral mucositis (OM). Vitamin D (VD) has well-known immunoregulatory, anti-inflammatory, and antioxidant properties.This study aimed to evaluate the association of pre-HSCT VD levels with OM as well as neutrophil and platelet engraftments in patients with multiple myeloma, Hodgkin’s and non-Hodgkin’s lymphoma after autologous HSCT. Methods: A sample of 71 patients was enrolled after obtaining informed consent. Serum samples were collected in the morning prior to the administration of conditioning regimen to measure the 25-OH-D. OM was examined daily during hospital stay. The World Health Organization (WHO) scale was used for scoring the OM. Absolute neutrophil count and platelet count were determined daily from transplantation until engraftment. Results: Patients aged 18-65 years. Mean length of hospital stay was 15.8±5.7 days. OM was detected in 44/71 (62.0%) of patients. Mean time to the engraftment of neutrophils and platelets were 11.8±4.0 and 17.2±7.3 days, respectively. Mean level of 25-OH-D was 17.5±14.0 ng/ml. VD deficiency (<20 ng/ml) was diagnosed in 51/71 (71.8%) of patients. No association between the 25-OH-D levels and incidence of OM (P=0.69) or OM grade 3-4 (P=0.46) was found. No significant correlations were detected between the 25-OH-D and engraftment time of neutrophils (P=0.46) or platelets (P=0.17). Conclusions: The prevalence of VD deficiency was high among adult HSCT patients at the time of transplantation. No association was found between the pre-HSCT VD level and OM or engraftment time.

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