scholarly journals EXPRESS: Pulmonary Arterial Hypertension in Pediatric Patients Undergoing High Dose Carboplatin/Thiotepa and Stem Cell Transplant

2021 ◽  
pp. 204589402110504
Author(s):  
Gretchen Louise Hackett ◽  
Farrah Munir ◽  
Teresa Shapiro ◽  
Robert Greiner ◽  
Daniel J. McKeone ◽  
...  
Keyword(s):  
Stem Cell ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Pediatric Patients ◽  
Stem Cell Transplant ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Pulmonary Arterial

Pulmonary arterial hypertension (PAH) in pediatric patients is associated with significant morbidity and mortality. Few studies exist to evaluate the incidence of PAH in pediatric oncology patients treated with carboplatin and thiotepa followed by hematopoietic stem cell transplant (HSCT). We describe two pediatric patients who developed PAH following high dose chemotherapy with carboplatin and thiotepa followed by autologous HSCT. These cases highlight the need for a surveillance protocol and reinforce the need for cardiologist-oncologists or close collaboration between providers in these sub-specialties who provide care to patients undergoing this type of chemotherapy regimen.

Pulmonary Arterial Hypertension After Hematopoeitic Stem Cell Transplant

CHEST Journal ◽  
2012 ◽  
Vol 142 (4) ◽  
pp. 118A
Author(s):  
Hala Moukhachen ◽  
Prabalini Rajendram ◽  
Sanjay Chawla ◽  
Nina Raoof ◽  
Kaye Hale ◽  
...  
Keyword(s):  
Stem Cell ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Pulmonary Arterial

#714 High dose chemotherapy (HDC) and hematopoietic stem cell transplant (HSCT) in advanced pediatric soft tissue tumors (STT)

1999 ◽  
Vol 21 (4) ◽  
pp. 340 ◽  
Author(s):  
L. Mascarenhas ◽  
A. Butturini ◽  
A. EpsteinEderich ◽  
R. Seeger ◽  
J. Villablanca ◽  
...  
Keyword(s):  
Stem Cell ◽  
Soft Tissue ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
High Dose Chemotherapy ◽  
Soft Tissue Tumors ◽  
High Dose ◽  
Cell Transplant ◽  
Hematopoietic Stem

scholarly journals Treatment of Acquired von Willebrand Syndrome and Prevention of Bleeding Postautologous Stem Cell Transplant during Severe Pancytopenia with IVIG

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Behyar Zoghi ◽  
Paul Shaughnessy ◽  
Roger M. Lyons ◽  
Richard Helmer ◽  
Carlos Bachier ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplant ◽  
Significant Risk ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Acquired Von Willebrand Syndrome ◽  
Von Willebrand

The use of high dose chemotherapy followed by autologous hematopoietic stem cell transplantation for remission consolidation after initial induction represents standard of care for patients with multiple myeloma. Patients with myeloma and Acquired von Willebrand Syndrome (AVWS) undergoing autologous stem cell transplant (ASCT) are at significant risk of bleeding due to the profound thrombocytopenia, low Factor VIII levels, fever, and toxicities associated with the preparative regimen. We report a patient with AVWS associated with multiple myeloma who underwent autologous stem cell transplants as consolidation after initial induction and again at relapse. He was successfully treated with high dose intravenous immunoglobulin (IVIG) prior to each transplant with rapid resolution of AVWS.

Association between adenovirus infection and mortality outcome among pediatric patients after hematopoietic stem cell transplant

2021 ◽  
Author(s):  
Thakoon Wiriyachai ◽  
Weerapong Chaya ◽  
Usanarat Anurathapan ◽  
Sasivimol Rattanasiri ◽  
Sophida Boonsathorn ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Pediatric Patients ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Adenovirus Infection ◽  
Hematopoietic Stem ◽  
Mortality Outcome

scholarly journals Morbidity, Mortality, and Healthcare Utilization in a National Cohort of Pediatric Patients with Hemophagocytic Lymphohistiocytosis Who Received Hematopoietic Stem Cell Transplant

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2183-2183
Author(s):  
Archana Ramgopal ◽  
Meghan McCormick ◽  
Ram Kalpatthi ◽  
Louis Rapkin ◽  
James Zullo ◽  
...  
Keyword(s):  
Stem Cell ◽  
Resource Utilization ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Hematopoietic Stem Cell Transplant ◽  
Pediatric Patients ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Elapsed Time ◽  
Over Time

Background Hemophagocytic lymphohistiocytosis (HLH) is a severe life threatening hyper-inflammatory syndrome of abnormal immune activation and dysregulation if untreated. The 5-year probability of survival (pSu) obtained from HLH registries and treatment protocols HLH-94 and HLH-2004 ranges from 21%-64%, with improved 5-year pSu of up to 70% following hematopoietic stem cell transplant (HSCT) (Arico et al., Trottestam et al., Bergsten et al.). Despite significant advances in the management of HLH over time, survival remains low and the extent of disease morbidity and healthcare utilization is poorly characterized. In this study, we sought to investigate morbidity, mortality, and the healthcare burden in children and adolescents with HLH who underwent HSCT. Methods Using the Pediatric Health Information System (PHIS) database, we identified patients under the age of 21 years admitted between 01/01/2004 and 09/30/2018 with a primary or secondary ICD-9 or ICD-10 diagnosis codes for HLH, as well as concurrent medication charges for both dexamethasone and etoposide in the same encounter. We then identified the patients who underwent HSCT to further analyze them. We abstracted data on demographics, hospitalizations, HSCT related complications, mortality, resource utilization and costs. Results were summarized using descriptive statistics. Time to HSCT was calculated as elapsed time from the admission date of the initial encounter to the date of the encounter in which there was a procedure code for HSCT. Time to mortality event was calculated as elapsed time from the admission date of the initial encounter to the discharge date of the encounter in which mortality occurred. The PHIS database provides an encrypted patient medical record number; thus, we were able to follow patients over time. This allowed for a better visualization of the patient's hospitalizations trend over 14 years. Results A total of 493 patients met inclusion criteria for HLH during the study period from 52 children's hospitals. The majority of patients (n = 284, 58%) were less than 5 years of age. Of these, 136 patients (28%) underwent HSCT with 155 hospital encounters, including readmissions. The median age at the time HSCT was 2 years (IQR; 0-9 years) and there were 82 males (60%). The median time to HSCT was 126 days (IQR: 75-193 days) and the average length of stay for the initial HSCT hospitalization was 61.1 days. Median initial HSCT hospitalization cost was $463,630 (IQR; 230,795 - 558,533). ICU care was required for 71 (46%) of patients. Overall, 91 (67%) patients developed transplant-related complications, which included infections, sinusoidal obstruction syndrome or graft versus host disease (Table 1). Mortality after HSCT was 22% (n=30) with an increased mortality observed with advanced age at the time of HSCT (Figure 1). The median time to death after the initial HSCT admission was 65 days (IQR; 56-94 days). Conclusion This is a large in-patient cohort of pediatric patients with HLH who underwent HSCT in the US. We observed an improved overall mortality after HSCT in this population compared to previous studies. However, morbidity (particularly from infections) and heath care resource utilization remain high. This stresses the importance of novel therapeutic approaches to improve not only patient survival but also long-term quality of life. Planned future analysis of this database will be aimed at assessing treatment variability; morbidity and mortality by treatment regimen, time to HSCT, and HSCT preparative regimen; and risk factors associated with mortality in pediatric patients with HLH who do and do not undergo HSCT. Disclosures No relevant conflicts of interest to declare.

Sign in / Sign up

Export Citation Format

Share Document