scholarly journals Cytomegalovirus Retinitis in an ALL Child during Maintenance Therapy Treated Successfully with Intravenous Ganciclovir

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Hande Celiker ◽  
Ayse Karaaslan ◽  
Eda Kepenekli Kadayifci ◽  
Serkan Atici ◽  
Ahmet Soysal ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Lymphoblastic Leukemia ◽  
Maintenance Phase ◽  
Cytomegalovirus Retinitis ◽  
Intravenous Ganciclovir ◽  
Hematopoietic Stem ◽  
Normal Limits ◽  
Retinal Examination ◽  
Oral Valganciclovir ◽  
The Right

Purpose.In here we described cytomegalovirus retinitis (CMVR) in 12-year-old male patient with acute lymphoblastic leukemia (ALL) who was on maintenance phase therapy.Methods.He was referred to our clinic for seeing of spots with the right eye for 3 days. At presentation, his best corrected visual acuity was 20/20 in the right eye and 20/20 in the left eye. Slit-lamp biomicroscopic examination of the anterior chamber of the left eye was within normal limits, whereas we observed 3+ anterior chamber cellular reaction in the right eye. On retinal examination, we found active retinitis lesions (cream-colored lesions associated with hemorrhages) and perivascular cuffing in the retinal periphery in the right eye. Left eye was normal.Results.On the basis of clinical picture, we made the diagnosis of CMVR in the right eye. Vitreous aspiration was performed and 23096 copies/mL of CMV DNA was detected by polymerase chain reaction (PCR) technique. The patient was successfully treated with intravenous ganciclovir for two weeks and discharged with oral valganciclovir prophylaxis.Conclusion.CMVR should be in mind in children with ALL on maintenance phase therapy even in those without hematopoietic stem cell transplantation. These patients can be treated successfully by intravenous ganciclovir alone.

scholarly journals Treating HIV-associated cytomegalovirus retinitis with oral valganciclovir and intra-ocular ganciclovir by primary HIV clinicians in southern Myanmar: a retrospective analysis of routinely collected data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jillian Murray ◽  
Adelene Hilbig ◽  
Theint Thida Soe ◽  
Win Le Shwe Sin Ei ◽  
Kyi Pyar Soe ◽  
...  
Keyword(s):  
Essential Medicine ◽  
Local Therapy ◽  
Cytomegalovirus Retinitis ◽  
Post Treatment ◽  
Hiv Care ◽  
Secondary Outcome ◽  
Intravenous Ganciclovir ◽  
Middle Income ◽  
Infected People ◽  
Oral Valganciclovir

Abstract Background Cytomegalovirus retinitis (CMVR) is an opportunistic infection in HIV-infected people. Intraocular or intravenous ganciclovir was gold standard for treatment; however, oral valganciclovir replaced this in high-income countries. Low- and middle-income countries (LMIC) frequently use intraocular injection of ganciclovir (IOG) alone because of cost. Methods Retrospective review of all HIV-positive patients with CMVR from February 2013 to April 2017 at a Médecins Sans Frontièrs HIV clinic in Myanmar. Treatment was classified as local (IOG) or systemic (valganciclovir, or valganciclovir and IOG). The primary outcome was change in visual acuity (VA) post-treatment. Mortality was a secondary outcome. Results Fifty-three patients were included. Baseline VA was available for 103 (97%) patient eyes. Active CMVR was present in 72 (68%) eyes. Post-treatment, seven (13%) patients had improvement in VA, 30 (57%) had no change, and three (6%) deteriorated. Among patients receiving systemic therapy, four (12.5%) died, compared with five (24%) receiving local therapy (p = 0.19). Conclusions Our results from the first introduction of valganciclovir for CMVR in LMIC show encouraging effectiveness and safety in patients with advanced HIV. We urge HIV programmes to include valganciclovir as an essential medicine, and to include CMVR screening and treatment in the package of advanced HIV care.

scholarly journals T-Lymphoblastic Leukemia/Lymphoma and Thymoma: A Case Report and Review of the Literature of a Rare Association

2021 ◽  
pp. 1-5
Author(s):  
Nadav Mizrahi ◽  
Eitan Kugler ◽  
Lucille Hayman ◽  
Moshe Yeshurun ◽  
Alon Grossman ◽  
...  
Keyword(s):  
Past History ◽  
Lymphoblastic Leukemia ◽  
Malignant Neoplasms ◽  
Tissue Mass ◽  
Hematopoietic Stem ◽  
History Of ◽  
Complicated Course ◽  
Related Donor ◽  
The Right ◽  
T Lymphoblastic Lymphoma

The co-occurrence of thymoma and T-lymphoblastic lymphoma/leukemia is an extremely rare but previously reported association that poses a diagnostic and therapeutic challenge. We describe a 67-year-old patient with long-standing untreated B1 thymoma that presented with constitutional symptoms and a painless soft tissue mass on the right chest wall. Pathological analysis of the biopsy from the mass demonstrated T-lymphoblastic leukemia/lymphoma. The patient went through a complicated course, was refractory to several lines of therapy, and eventually underwent allogeneic hematopoietic stem cell transplantation in complete remission from a matched related donor. The association between thymoma and malignant neoplasms has been described in the literature, most notably with colorectal adenocarcinoma and thyroid cancer. Thymoma-associated leukemia is, however, extremely unusual, with limited reports in the literature. Distinguishing between thymoma and leukemia can be challenging and often requires meticulous diagnostic efforts. For patients with a past history of thymoma, awareness of this particular association should be bared in mind to allow earlier diagnosis and therapy.

Anatomical and Morphological study of the Heart's Chambers and valves in Iraqi ducks Anser platyrhuncha

2019 ◽  
Vol 43 (1) ◽  
pp. 21-25
Author(s):  
Mohammed Senna Hassan
Keyword(s):  
Blood Pressure ◽  
Anterior Chamber ◽  
High Blood Pressure ◽  
Pulse Rate ◽  
Morphological Study ◽  
Heart Valves ◽  
Simple Manner ◽  
High Pulse ◽  
The Right ◽  
High Pulse Rate

   Twenty Iraqi ducks hearts ( 10 male and 10 female ) have been  used for   demonstration  and illustration of heart's valves  and chambers  as well as  anatomical   and morphological site of view to explain what modifications had been take place for ducks heart  to perform  his normal life at the  circumstances  of  high  blood  pressure  and  pulse  rate. The heart  which has distinctly pointed  apex  was  built   in simple  manner located  in a transparent  taught  heart  pericardial  sac. It   was pyramidal in shape  externally  and  has a longitudinal  salcus  passing  to the  right  side, the  anterior of  the   heart  is  divided  into two  unequal  anterior  chamber  similar  to  those of mammalian  hear  .The heart valves are modified  in  order to  minimize  the  fraction  that occur as a result of  high  blood  pressure  and  pulse  rate  of  the  duck  heart , also  the  muscular  trabeculae   replace  the  chordate  tendineae  , which  were  present in the  mammalian    heart  in order to  minimize  the  fraction  resulting  from high  pulse  rate..    

scholarly journals Targeting Interleukin-2-Inducible T-Cell Kinase (ITK) Differentiates GVL and GVHD in Allo-HSCT

2020 ◽  
Vol 11 ◽  
Author(s):  
Mahinbanu Mammadli ◽  
Weishan Huang ◽  
Rebecca Harris ◽  
Aisha Sultana ◽  
Ying Cheng ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
Lymphoblastic Leukemia ◽  
Interleukin 2 ◽  
Treatment Strategies ◽  
Receptor Expression ◽  
Hematopoietic Stem ◽  
Target Organs ◽  
Donor T Cells ◽  
Inducible T Cell Kinase

Allogeneic hematopoietic stem cell transplantation is a potentially curative procedure for many malignant diseases. Donor T cells prevent disease recurrence via graft-versus-leukemia (GVL) effect. Donor T cells also contribute to graft-versus-host disease (GVHD), a debilitating and potentially fatal complication. Novel treatment strategies are needed which allow preservation of GVL effects without causing GVHD. Using murine models, we show that targeting IL-2-inducible T cell kinase (ITK) in donor T cells reduces GVHD while preserving GVL effects. Both CD8+ and CD4+ donor T cells from Itk-/- mice produce less inflammatory cytokines and show decrease migration to GVHD target organs such as the liver and small intestine, while maintaining GVL efficacy against primary B-cell acute lymphoblastic leukemia (B-ALL). Itk-/- T cells exhibit reduced expression of IRF4 and decreased JAK/STAT signaling activity but upregulating expression of Eomesodermin (Eomes) and preserve cytotoxicity, necessary for GVL effect. Transcriptome analysis indicates that ITK signaling controls chemokine receptor expression during alloactivation, which in turn affects the ability of donor T cells to migrate to GVHD target organs. Our data suggest that inhibiting ITK could be a therapeutic strategy to reduce GVHD while preserving the beneficial GVL effects following allo-HSCT treatment.

scholarly journals Post-transplant cyclophosphamide containing regimens after matched sibling, matched unrelated and haploidentical donor transplants in patients with acute lymphoblastic leukemia in first complete remission, a comparative study of the ALWP of the EBMT

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Jaime Sanz ◽  
Jacques-Emmanuel Galimard ◽  
Myriam Labopin ◽  
Boris Afanasyev ◽  
Moiseev Ivan Sergeevich ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Cumulative Incidence ◽  
Lymphoblastic Leukemia ◽  
Hematopoietic Stem ◽  
Free Survival ◽  
Post Transplant ◽  
Gvhd Prophylaxis ◽  
Donor Type ◽  
Matched Sibling ◽  
The Impact

Abstract Background There is no information on the impact of donor type in allogeneic hematopoietic stem cell transplantation (HCT) using homogeneous graft-versus-host (GVHD) prophylaxis with post-transplant cyclophosphamide (PTCy) in acute lymphoblastic leukemia (ALL). Methods We retrospectively analyzed outcomes of adult patients with ALL in CR1 that had received HCT with PTCy as GVHD prophylaxis from HLA-matched sibling (MSD) (n = 78), matched unrelated (MUD) (n = 94) and haploidentical family (Haplo) (n = 297) donors registered in the EBMT database between 2010 and 2018. The median follow-up period of the entire cohort was 2.2 years. Results Median age of patients was 38 years (range 18–76). Compared to MSD and MUD, Haplo patients received peripheral blood less frequently. For Haplo, MUD, and MSD, the cumulative incidence of 100-day acute GVHD grade II–IV and III–IV, and 2-year chronic and extensive chronic GVHD were 32%, 41%, and 34% (p = 0.4); 13%, 15%, and 15% (p = 0.8); 35%, 50%, and 42% (p = 0.01); and 11%, 17%, and 21% (p = 0.2), respectively. At 2 years, the cumulative incidence of relapse and non-relapse mortality was 20%, 20%, and 28% (p = 0.8); and 21%, 18%, and 21% (p = 0.8) for Haplo, MUD, and MSD, respectively. The leukemia-free survival, overall survival and GVHD-free, relapse-free survival for Haplo, MUD, and MSD was 59%, 62%, and 51% (p = 0.8); 66%, 69%, and 62% (p = 0.8); and 46%, 44%, and 35% (p = 0.9), respectively. On multivariable analysis, transplant outcomes did not differ significantly between donor types. TBI-based conditioning was associated with better LFS. Conclusions Donor type did not significantly affect transplant outcome in patient with ALL receiving SCT with PTCy.

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