scholarly journals Coping strategies modify risk of depression associated with hematopoietic cell transplant symptomatology

2016 ◽  
Vol 23 (8) ◽  
pp. 1028-1037 ◽  
Author(s):  
Anna Barata ◽  
Brian D Gonzalez ◽  
Steven K Sutton ◽  
Brent J Small ◽  
Paul B Jacobsen ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Problem Solving ◽  
Coping Strategies ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Adaptive Coping ◽  
Maladaptive Coping ◽  
Hematopoietic Cell Transplant ◽  
Post Transplant ◽  
Patients At Risk

To determine whether coping strategies modify the risk of depression among allogeneic recipients experiencing post-transplant-related symptomatology, 105 participants (mean age = 52 years, 42% female) completed questionnaires 90 days post-transplant. A total of 28 percent reported depressive symptoms. Univariate correlations indicated that depression was associated with greater transplant-related symptomatology and avoidance, acceptance/resignation, and emotional discharge coping. Depression was negatively associated with problem-solving coping. Moderator analyses indicated that transplant-related symptomatology was significantly associated with depression among patients who frequently used maladaptive coping and rarely used adaptive coping. These data suggest that transplant-related symptomatology, combined with maladaptive coping, place patients at risk of depression.

scholarly journals Inferior Outcomes for Patients Developing New-Onset Post-Transplant Diabetes Mellitus after Haploidentical Hematopoietic Cell Transplant

2020 ◽  
Vol 26 (3) ◽  
pp. S354-S355
Author(s):  
Brendan L. Mangan ◽  
Dilan A. Patel ◽  
Heidi Chen ◽  
Katie S. Gatwood ◽  
Michael T. Byrne ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Post Transplant ◽  
New Onset

scholarly journals Cytomegalovirus (CMV) Cell-Mediated Immunity and CMV Infection After Allogeneic Hematopoietic Cell Transplantation: The REACT Study

2020 ◽  
Author(s):  
Roy F Chemaly ◽  
Lynn El Haddad ◽  
Drew J Winston ◽  
Scott D Rowley ◽  
Kathleen M Mulane ◽  
...  
Keyword(s):  
At Risk ◽  
Hematopoietic Cell Transplantation ◽  
Multivariable Analysis ◽  
Hematopoietic Cell ◽  
Cell Mediated Immunity ◽  
Cell Transplant ◽  
Cmv Infection ◽  
Hematopoietic Cell Transplant ◽  
Allogeneic Hematopoietic Cell Transplant ◽  
Patients At Risk

Abstract Background Cytomegalovirus (CMV) infection remains an important cause of morbidity and mortality in allogeneic hematopoietic cell transplant (allo-HCT) recipients. CMV cell-mediated immunity (CMV-CMI) as determined by a peptide-based enzyme-linked immunospot (ELISPOT) CMV assay may identify patients at risk for clinically significant CMV infection (CS-CMVi). Methods The CS-CMVi was defined as CMV viremia and/or disease necessitating antiviral therapy. CMV-CMI was characterized as high when the intermediate-early 1 (IE-1) antigen spot counts (SPCs) were >100 (cutoff 1) or when the IE-1 and phosphoprotein 65 antigen SPCs were both >100 SPCs per 250 000 cells (cutoff 2), and a low CMV-CMI when SPCs were below these thresholds. In this prospective multicenter study, we evaluated CMV-CMI every 2 weeks from the pretransplant period until 6 months posttransplantation in 241 allo-HCT recipients with positive CMV serostatus. The primary endpoint was CS-CMVi occurring within 2 weeks of the last measurement of CMV-CMI. Results CS-CMVi occurred in 70 allo-HCT recipients (29%). CMV-CMI was low in patients who experienced CS-CMVi (94%), whereas those who had a high CMV-CMI were less likely to have CS-CMVi (P < .0001). Patients with CS-CMVi had higher all-cause mortality (P = .007), especially those with low CMV-CMI (P = .035). On multivariable analysis, CMV-CMI, sex, race, antithymocyte globulin, and steroid use were independent predictors of CS-CMVi, and the time from transplant to engraftment was the only predictor of mortality. Conclusions Measurement of CMV-CMI using a novel ELISPOT assay would be useful clinically to monitor allo-HCT recipients and distinguish between those at risk of developing CS-CMVi and requiring antiviral prophylaxis or therapy and those who are protected.

Cutaneous complications in hematopoietic cell transplant recipients: Impact of biopsy on patient management.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7036-7036
Author(s):  
Oana Valeria Paun ◽  
Tycel Jovelle Phillips ◽  
PingFu Fu ◽  
Robert Novoa ◽  
Kord Honda ◽  
...  
Keyword(s):  
Classification Tree ◽  
Regression Tree ◽  
Hematopoietic Cell ◽  
Classification And Regression Tree ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Data Set ◽  
Post Transplant ◽  
Skin Biopsies ◽  
The Impact

7036 Background: Although skin biopsies are recommended for diagnostic purposes in hematopoietic cell transplant (HCT) recipients, their utility in directing management of post transplant cutaneous eruptions remains uncertain. Little evidence was found in support of this procedure either from a diagnostic or prognostic perspective. Methods: We retrospectively evaluated 351 consecutive HCT recipients transplanted at our institution between January 2005 and December 2011; 156 patients underwent 388 cutaneous biopsies. Results: The group that underwent cutaneous biopsy after transplantation and the group that was spared the procedure were homogenous with regards to age and gender. The pre-biopsy diagnosis and final diagnosis differed in 213 episodes (55%) as determined by histologic evaluation. Biopsy results led to a change in therapy in 61 of 388 (16%) biopsied rashes. With regards to therapy changes, 24 of 61 (39%) occurred in response to a clinical diagnosis of GVHD. In this situation the most frequently noted change was augmentation or addition of systemic immuno-suppression (19 of 24). Changes in systemic therapy occurred with similar frequencies with respect to concordance or discordance between clinical and histopathologic diagnosis (p = 0.12). We used classification and regression tree analysis to develop an algorithm to predict the biopsy yield as expressed by change of management. This is a non-parametric decision tree learning technique that produces a classification tree based on a categorical dependent variable, formed by a collection of rules based on variables in the modeling data set. Conclusions: Cutaneous biopsy findings often changed the clinical dermatologic diagnoses of HCT recipients; however, the impact of biopsy results on treatment decisions was less profound; altered diagnoses in patients who underwent biopsy often did not lead to therapy changes. Skin biopsies of post-transplant patients may not be mandatory for either diagnostic or therapeutic reasons, but in carefully chosen circumstances can yield extremely important data. A prospective study should be undertaken in order to evaluate current practice data and to validate our decision making analysis tree.

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