Full chimerism in nonmyeloablative stem cell transplantation in a β-thalassemia major patient (class 3 Lucarelli)

Abstract Context.—Nonmyeloablative stem cell transplantation (NMSCT) is a mode of immunotherapy increasingly employed in treating hematologic, lymphoid, and solid tumors. Patients are monitored principally by molecular analysis of donor engraftment. Objective.—To determine the role of morphologic examination of bone marrow after NMSCT. Design.—Seventy-three patients undergoing NMSCT under the Campath 1H (humanized anti-CD52 antibody) protocol were studied. Pretransplant and sequential posttransplant bone marrow specimens were evaluated and the findings were correlated with corresponding engraftment data. Results.—Pretransplant bone marrow specimens from 43% of the patients were involved by disease, and these marrow specimens were significantly more cellular than those that were free of disease. Morphologically detectable disease was still present in day 14 posttransplant marrow specimens in more than one half of these patients, but there was no difference in engraftment in those with or without marrow disease. Early posttransplant marrow in nearly one half of the patients showed myeloid hyperplasia and atypical localization of immature myeloid precursors. Marrow cellularity for the first 2 months after NMSCT was significantly lower in those patients receiving stem cells mismatched at 1 to 3 loci as compared with those who received fully matched grafts (mean cellularity, 38.1% vs 54.1% at day 14). Marrow failure without recurrent disease at 3 to 6 months after transplant was detected by engraftment study in only approximately 15% of cases. Similarly, early recurrence of disease was detected first by morphologic examination in 4 of 13 cases before a decline in donor engraftment occurred. Conclusion.—Morphologic examination of bone marrow provides additional information that is complementary to donor engraftment analysis for optimal management after NMSCT.

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Quality of life in Patients with β-thalassemia Major: Short-term and Long-term Effects after Haematopoietic Stem Cell Transplantation

Current Stem Cell Research & Therapy ◽

10.2174/1574888x16666210203105340 ◽

2021 ◽

Vol 16 ◽

Author(s):

Lu Zhai ◽

Yuhua Liu ◽

Rongrui Huo ◽

Zhaofang Pan ◽

Juan Bin ◽

...

Keyword(s):

Quality Of Life ◽

Stem Cell ◽

Physical Therapy ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Haematopoietic Stem Cell Transplantation ◽

Psychological Intervention ◽

Thalassemia Major ◽

Haematopoietic Stem Cell

Background: Allogeneic haematopoietic stem cell transplantation (ALLO-HSCT) is a potentially curative approach to treat β-thalassemia major (β-TM). Objective and Methods: To assess the quality of life (QOL) of patients with β-TM after ALLO-HSCT, we searched PubMed, Embase, Web of Science, and Medline for articles on the quality of life (QOL) of patients with β-TM from 1 Feb 2020 to 31 Mar 2020. Results: Our review revealed that the QOL of patients with β-TM after ALLO-HSCT from a sibling donor is higher than that of patients that received blood infusion and iron-chelating therapy. Survivors of ALLO-HSCT have a QOL as good as that of a healthy population and the ability to return to normal life. However, studies thus far are limited to investigations with a few patients with β-TM who received ALLO-HSCT of the bone marrow (BM) from a sibling donor or related donor. Graft vs. host disease, patient age, gender, sexual desire, health condition, psychological state, financial and employment stress, and social support contributed to a worse QOL after ALLO-HSCT. Medicine usage, physical therapy, and psychological intervention may help improve the decline in QOL related to ALLO-HSCT in patients with β-TM. Conclusion: Doctors and nurses must focus on implementing medicine usage, physical therapy and psychological intervention to improve the decline in QOL related to ALLO-HSCT.

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Graft-versus-Host Disease, the Graft-versus-Leukemia Effect, and Mixed Chimerism following Nonmyeloablative Stem Cell Transplantation

International Journal of Hematology ◽

10.1007/bf02983795 ◽

2003 ◽

Vol 78 (3) ◽

pp. 195-207 ◽

Cited By ~ 11

Author(s):

Shimon Slavin

Keyword(s):

Stem Cell ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Graft Versus Host Disease ◽

Mixed Chimerism ◽

Host Disease ◽

Graft Versus Host ◽

Nonmyeloablative Stem Cell Transplantation ◽

Graft Versus Leukemia ◽

Graft Versus Leukemia Effect

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Total body irradiation in a case of thalassemia major with source to axis distance based planning: A case report

International Journal of Clinical and Biomedical Research ◽

10.31878/ijcbr.2020.64.06 ◽

2020 ◽

pp. 25-28

Author(s):

Mayuresh D. Virkar ◽

Rajkumar Chauhan ◽

Pranav Chadha ◽

Kaustav Talapatra ◽

Reuben Jake Rodrigues ◽

...

Keyword(s):

Stem Cell ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Total Body Irradiation ◽

Conditioning Regimen ◽

Thalassemia Major ◽

Entire Body ◽

Hematopoietic Stem ◽

Total Body

Background: The use of total body radiation (TBI) before hematopoietic stem cell transplantation (HSCT) would increase the engraftment without transplant-related morbidity or mortality among Thalassemia major (TM) cases. Case presentation: A 2-year-old female child, diagnosed with TM was scheduled for haploidentical allogenic transplant-based protocol, and after that, based on protocol she was scheduled to undergo a single session of TBI as a conditioning regimen before haploidentical allogenic hematopoietic stem cell tranplant. A total dose of 4 Gy was administered.. The incidence of graft failure was reduced as TBI was used before allogeneic stem cell transplantation. TBI provided a uniform dose of radiation to the entire body, penetrating areas such as the central nervous system (CNS) and testes. Conclusion: Total Body Irradiation with the SAD technique is the most effective way of treatment. As it is comfortable for the patient to undergo, easily reproducible, and it helps to achieve a uniform dose distribution.

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