Pseudomonas aeruginosaSepsis in Stem Cell Transplantation Patients

2006 ◽  
Vol 27 (7) ◽  
pp. 767-770 ◽  
Author(s):  
Rosa Fanci ◽  
Patrizia Pecile ◽  
Enrico Casalone ◽  
Alessio Mengoni ◽  
Elena Tamburini ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Pseudomonas Aeruginosa ◽  
Stem Cell ◽  
Bone Marrow Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Molecular Analysis ◽  
Marrow Transplantation ◽  
Epidemiological Investigation ◽  
Source Of Infection

We report the epidemiological investigation of an outbreak ofPseudomonas aeruginosainfection in 6 patients who shared, during different periods, the same 2 rooms of a bone marrow transplantation unit. Phenotypic and molecular analysis of isolates from patients and from the environment strongly suggested a single, environmental source of infection.

Unexpected 5 Year Survival Benefit in Patients Given Oral Cryotherapy During Conditioning for Stem Cell Transplantation. A Prospective Randomized Study

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4559-4559
Author(s):  
Anncarin Svanberg ◽  
Kerstin Öhrn ◽  
Gunnar Birgegard
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Bone Marrow Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Marrow Transplantation ◽  
High Dose Chemotherapy ◽  
Control Group ◽  
High Dose ◽  
Oral Cryotherapy

Abstract Abstract 4559 Patients receiving high dose chemotherapy (HDC) in connection with bone marrow transplantation (BMT) often are afflicted with severe oral mucositis (OM). OM may affect 75–99% of patients. Oral cryotherapy has been shown to alleviate symptoms of mucositis alleviating oral pain and inability to maintain nutritional status. In a randomised controlled trial we have shown that patients receiving oral cryotherapy had less mucositis, less use of i.v. opioides and fewer doses of total parenteral nutrition (TPN) than a control group receiving routine oral care. Adult patients scheduled for bone marrow transplantation were randomly assigned to experimental (EXP) or control (CTR) group. A stratified randomisation was used with regard to type of transplantation (autologous vs allogeneic/unrelated donor (URD)). Randomisation was performed between January 2002 and August 2004. The final sample consisted of 78 patients, (31 autologous BMT and 8 allogeneic/URD BMT), and 39 constituted the CTR group and received standard treatment (31 autologous BMT and allogeneic/URD BMT). Concern has been raised for a possible protection of tumor cells by cryotherapy which could increase the risk of relapse and reduce survival. Thee aim of the present study was to investigate any difference in survival and relapse rates 5 years post-BMT for the two treatment groups from the randomised study. After 5 years, 25/39 (64%) of the cryotherapy patients were alive compare to 15/39 (38%) of the control group (odds ratio 0,35, 95 % CI 0,14–0,88, p = 0,025)(Figure 1). No significant difference could be found with regard to the relapse rate between the groups. Most of the deaths were due to relapse. The study offers no support for the speculation about tumor protection from cryotherapy during high dose chemotherapy conditioning for stem cell transplantation. These data indicate that oral cryotherapy is a safe prophylactic treatment for mucositis during chemotherapy. Unexpectedly, the cryotherapy group showed a significantly better 5-year survival. Further analyses are needed to explore the difference in survival rate. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Early and late invasive pneumococcal infection following stem cell transplantation: a European Bone Marrow Transplantation survey

2002 ◽  
Vol 117 (2) ◽  
pp. 444-450 ◽  
Author(s):  
Dan Engelhard ◽  
Catherine Cordonnier ◽  
Peter J. Shaw ◽  
Terttu Parkalli ◽  
Christine Guenther ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Bone Marrow Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Marrow Transplantation ◽  
Pneumococcal Infection ◽  
Invasive Pneumococcal Infection

scholarly journals Peripheral Blood Stem Cell Transplantation Versus Bone Marrow Transplantation in Severe Aplastic Anemia

2011 ◽  
Vol 17 (2) ◽  
pp. S291
Author(s):  
A. Ghavamzadeh ◽  
K. Alimoghaddam ◽  
A.A. Hamidieh ◽  
M. Jalili ◽  
B. Bahar ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Bone Marrow Transplantation ◽  
Stem Cell Transplantation ◽  
Aplastic Anemia ◽  
Cell Transplantation ◽  
Peripheral Blood ◽  
Marrow Transplantation ◽  
Peripheral Blood Stem Cell ◽  
Blood Stem Cell Transplantation

scholarly journals Detection of Cells with Low Side Scatter and Dimmer CD45 Expression after Allogeneic Hematopoietic Stem Cell Transplantation Predicts Good Survival

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3207-3207
Author(s):  
Yoshimitsu Shimomura ◽  
Hayato Maruoka ◽  
Yotaro Ochi ◽  
Yusuke Koba ◽  
Yuichiro Ono ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Bone Marrow Transplantation ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Cumulative Incidence ◽  
Marrow Transplantation ◽  
Hematopoietic Stem ◽  
Allogeneic Hsct

Abstract <Introduction> Hematogones are lymphoblast-like cells that increase transiently in the bone marrow and have a characteristic profile of normal B cell precursors co-expressing CD10 and CD19. A cluster of hematogones is often found in the region of low side scatter and dimmer CD45 expression (SSC low CD45 dim), which also includes lymphoid and myeloid precursors, basophils, and partial components of natural killer cells. However, in steady state healthy adult bone marrow, SSC low CD45 dim populations are hardly detectable. In the bone marrow of patients recovering from chemotherapy or bone marrow transplantation, SSC low CD45 dim populations occasionally appear, with the majority of the population consisting of hematogones, especially in patients in complete remission (CR). Studies have shown that increased hematogones in patients with high-risk hematological malignancies after allogeneic hematopoietic stem cell transplantation (HSCT) improved survival. The specific detection of hematogones is difficult because multicolor flow cytometry is necessary to exclude myeloid/lymphoid blasts in active leukemia patients. However, after allogeneic HSCT in patients with leukemia and confirmed CR or malignant lymphoma without bone marrow invasion, hematogones can be easily detected as cells with SSC low CD45 dim populations. <Patients and methods> This retrospective case analysis included 88 patients treated with allogeneic HSCT at our hospitals from October 2010 to November 2014. The cases included acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) in CR at the time of allogeneic HSCT, chemo-naïve or azacitidine-treated myelodysplastic syndrome (MDS) and malignant lymphoma (ML) or adult T cell leukemia/lymphoma (ATL) with marrow CR or without bone marrow invasion. We excluded 8 patients without engraftment. The remaining 80 patients underwent bone marrow aspiration around 28 days after HSCT and were confirmed to be in CR. Bone marrow cells were stained with APC-Cy7-conjugated CD45 and analyzed using FACSCanto. Patients were defined as being simply detected hematogones (SHG)-positive if 0.6%, which is the median proportion of SSC low CD45 dim cells in this study, or more of total nuclear cells were SSC low CD45 dim; the others were defined as SHG-negative. <Results> The median follow-up of survivors of our cohort was 773 (81-1593) days. Primary diagnoses were AML (n=36), ALL (n=21), MDS (n=8), and ML or ATL (n=15). They were treated with bone marrow transplantation (n=51), peripheral blood stem cell transplantation (n=6), and cord blood transplantation (n=23). Among them, 40 were SHG-positive and 40 were SHG-negative. Overall survivals (OS) at 2 years was 94.8% and 58.2% (p<0.001), event free survival (EFS) at 2 years was 94.9% and 46.5% (p<0.001). Cumulative incidence of relapse at 2 years was 5.1% and 34.0% (p<0.001), and cumulative incidence of treatment related mortality (TRM) at 2 years was 0% and 20.6% (p=0.0059) in SHG-positive and SHG-negative groups, respectively. Cumulative incidence of acute graft-versus-host disease (aGVHD) at day 100 was 68.3% and 65.5% (p=0.31) and for severe aGVHD (grade II-IV) was 31.8% and 36.3% (p=0.87) in SHG-positive and SHG-negative groups, respectively. Age ≥50 years, sex, hematopoietic cell transplant-comorbidity index over 2, disease risk index (DRI), myeloablative conditioning regimen and donor source were entered into multivariate analysis, which identified SHG-positive and a low or intermediate DRI as independently associated with a good prognosis. <Conclusion> Thus, the presence of SHG at day 28 predicts improved OS and EFS, and a lower incidence of relapse and TRM. This population of cells is easily detectable, providing useful information for outcome predictions. Patients without SSC low CD45 dim populations should be carefully observed after allogeneic HSCT. Disclosures No relevant conflicts of interest to declare.

scholarly journals Nonmyeloablative stem cell transplantation for congenital immunodeficiencies

Blood ◽  
2000 ◽  
Vol 96 (4) ◽  
pp. 1239-1246 ◽  
Author(s):  
Persis Amrolia ◽  
Hubert B. Gaspar ◽  
Amel Hassan ◽  
David Webb ◽  
Alison Jones ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Bone Marrow Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Marrow Transplantation ◽  
Immune Reconstitution ◽  
Nonmyeloablative Stem Cell Transplantation ◽  
Short And Long Term

The optimal approach for stem cell transplantation in children with immunodeficiency has yet to be determined. Conditioning therapy is necessary for reliable engraftment and full immune reconstitution; however, the beneficial effect of cytoreductive conditioning is counterbalanced by increased short- and long-term treatment-related toxicity. Whether bone marrow transplantation with a nonmyeloablative preparative regimen was sufficient for the establishment of donor immune reconstitution, with the resultant correction of disease phenotype, was investigated. Eight patients with severe immunodeficiency states underwent T-cell replete bone marrow transplantation from a human leukocyte antigen-matched unrelated (n = 6) or sibling (n = 2) donor with nonmyeloablative conditioning using a fludarabine–melphalan–anti-lymphocyte globulin-based regimen. All patients had severe organ dysfunction that precluded transplantation with conventional conditioning. All patients were engrafted with predominantly donor hematopoiesis, and the duration of neutropenia was brief. Significant acute graft-versus-host disease (GVHD) did not develop, but one patient had limited chronic GVHD. One patient died of disease recurrence, and 3 have stable, mixed chimerism. At a median follow-up of 1 year, all patients have had good recovery of CD3+ T-cell numbers, and 6 of 7 evaluable patients have normal phytohemagglutinin stimulation indices. The rate of immune reconstitution is comparable with that of historical controls undergoing standard myeloablative protocols. Two patients with CD40 ligand deficiency now show significant expression, and a patient with adenosine deaminase deficiency has improved deoxy adenosine triphosphate metabolites. In summary, it has been demonstrated that nonmyeloablative stem cell transplantation permits rapid engraftment from both sibling and unrelated donors with minimal toxicity even in the presence of severe organ dysfunction. If long-term immune reconstitution of patients treated with this protocol is demonstrated, it is believed this approach might offer significant advantages compared with standard protocols by combining adequate immune reconstitution with reduced short- and long-term toxicity.

Sign in / Sign up

Export Citation Format

Share Document