scholarly journals The kinetics of immune reconstitution after human marrow transplantation

Blood ◽  
1987 ◽  
Vol 69 (2) ◽  
pp. 369-380 ◽  
Author(s):  
LG Lum
Keyword(s):  
Marrow Transplantation ◽  
Immune Reconstitution ◽  
General Pattern ◽  
Therapeutic Modality ◽  
First Year ◽  
Immune Reactivity ◽  
Immune Functions ◽  
Immune Systems ◽  
Specific Immunity ◽  
One Year

Human marrow transplantation for the treatment of malignant and nonmalignant disorders is becoming an established modality of therapy. As in any aggressive therapeutic modality, the benefits must be balanced with the risks of the therapy. The aggressive chemoradiotherapy used to prepare patients for marrow transplantation creates a transient immunodeficiency disorder postgrafting until the transferred donor marrow reestablishes a competent immune system. Immune reconstitution posttransplant follows a general pattern developing from immature to mature immune functions. Immune reactivity during the first month postgrafting is extremely low. Cytotoxic and phagocytic functions recover by day 100, while more specialized and cooperative functions of T and B cells remain impaired up to one year or more postgrafting. After the first year postgrafting, the various components of the immune systems of most healthy marrow recipients begin to work synchronously, whereas the immune systems of recipients with chronic graft-v-host disease (GVHD) remain crippled. Recent evidence shows that transfer of specific immunity from marrow donors to marrow recipients plays a role in reestablishing immunocompetence. Transferred antigen-specific immunity may explain why more recipients do not die from overwhelming infections.

scholarly journals The kinetics of immune reconstitution after human marrow transplantation

Blood ◽  
1987 ◽  
Vol 69 (2) ◽  
pp. 369-380 ◽  
Author(s):  
LG Lum
Keyword(s):  
Marrow Transplantation ◽  
Immune Reconstitution ◽  
General Pattern ◽  
Therapeutic Modality ◽  
First Year ◽  
Immune Reactivity ◽  
Immune Functions ◽  
Immune Systems ◽  
Specific Immunity ◽  
One Year

Abstract Human marrow transplantation for the treatment of malignant and nonmalignant disorders is becoming an established modality of therapy. As in any aggressive therapeutic modality, the benefits must be balanced with the risks of the therapy. The aggressive chemoradiotherapy used to prepare patients for marrow transplantation creates a transient immunodeficiency disorder postgrafting until the transferred donor marrow reestablishes a competent immune system. Immune reconstitution posttransplant follows a general pattern developing from immature to mature immune functions. Immune reactivity during the first month postgrafting is extremely low. Cytotoxic and phagocytic functions recover by day 100, while more specialized and cooperative functions of T and B cells remain impaired up to one year or more postgrafting. After the first year postgrafting, the various components of the immune systems of most healthy marrow recipients begin to work synchronously, whereas the immune systems of recipients with chronic graft-v-host disease (GVHD) remain crippled. Recent evidence shows that transfer of specific immunity from marrow donors to marrow recipients plays a role in reestablishing immunocompetence. Transferred antigen-specific immunity may explain why more recipients do not die from overwhelming infections.

Favorable Immune Reconstitution Profile after Allogeneic Hematopoietic Stem Cell Transplantation with Post-Transplant Cyclophosphamide

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2236-2236
Author(s):  
Omer Hassan Jamy ◽  
Ayman Saad ◽  
Rachael Orlandella ◽  
Samantha B Langford ◽  
Ravi K. Paluri ◽  
...  
Keyword(s):  
T Cells ◽  
Stem Cell ◽  
T Cell ◽  
Stem Cell Transplantation ◽  
Peripheral Blood ◽  
Research Funding ◽  
Immune Reconstitution ◽  
First Year ◽  
Gvhd Prophylaxis ◽  
One Year

Abstract Background: The administration of post-transplant high-dose cyclophosphamide (PTCy) has been shown to be an effective strategy for GvHD prophylaxis following allogeneic peripheral blood stem cell transplantation(PBSCT) from alternative donors. PTCy is toxic to allogeneic activated proliferating T lymphocytes, such as effector T cells. Conversely, it may not materially affect memory T cells. Methods: We evaluated immune reconstitution profile and transplant outcome in patients who received PBSCT with and without PTCy. PTCy was given on day +3 and +4 following haploidentical transplant (HAPLO), or only on day +3 following HLA-matched unrelated donor (MUD) transplant. No PTCy was given to patients with HLA-matched related donors (MRD). All patients received GvHD prophylaxis as tacrolimus (day +5 to +180) and MMF (day +5 to +35). Preparative regimens were myeloablative regimens (fludarabine/busulfan, fludarabine/TBI 12 Gy, or CY/TBI 12) in all patients except 4 patients (received fludarabine/melphalan). Immune reconstitution profile (IRP) was tested via serial flow cytometry analysis of peripheral blood lymphocytes after transplant were done on days +30, +100, and +180. Results: Data of 70 patients who underwent allogeneic PBSCT in our institution were analyzed in 3 groups; MRD (n=22), MUD (n=35), and HAPLO (n=13). The total cohort had 33 males (47%), and had median age of 52 years (range 20-70). All patients had hematological malignancy except one patient with HLH. The median duration of follow up was 6 months (range 1-17). The median day of neutrophil and platelet engraftment were 13, 12, 17 and 18, 15, 22 days for MRD, MUD and HAPLO groups respectively. The one-year overall survival of the whole group was 67% (95% confidence interval: 48-80) with no difference in OS among the 3 cohorts (log rank P value 0.4) (Figure 1). Lymphocyte and lymphocyte subset (T, B, NK) count recovery for MUD and HAPLO was significantly less (p<0.05) than MRD during the first month post-HSCT but these differences were statistically insignificant by day +60 and remained so through day +365. Recovery of both CD4+ and CD8+ naïve T cell (CD45RA+CD27+CD197+) population was generally slower for HAPLO patients during the first year and significantly less through day+ 180 for CD4+ T cells. As predicted, central memory (CD45RA-CD27+CD197+) CD4+ and CD8+ T cells remained proportionately equivalent at 40% and 28% respectively for all groups during the first year. The effector memory (CD45RA-CD27+CD197-) population was also proportionately consistent at 25% of total for both CD4+ and CD8+ subsets. Interestingly, the effector T cell population (CD45RA+CD27-CD197-) trended higher for all three recipient groups at each time point for both CD4+ and CD8+ populations increasing from 20% at one month to over 40% at one year. Conclusion: Post-PBSCT survival was not significantly different from alternative donor graft recipients and those that received MRD PBSCT. Lymphocyte recovery was impaired for the PTCy groups in the immediate post-PBSCT period but quickly recovered to that seen in MRD recipients. Figure 1 Figure 1. Disclosures Saad: Spectrum: Honoraria; American Porphyria foundation: Research Funding; Astellas: Research Funding; Alexion: Honoraria. Lamb:Incysus, Ltd: Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Research Funding.

scholarly journals Cardiovascular risk factors associated with acute myocardial infarction and stroke in the MADIABETES cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. A. Salinero-Fort ◽  
F. J. San Andrés-Rebollo ◽  
J. Cárdenas-Valladolid ◽  
M. Méndez-Bailón ◽  
R. M. Chico-Moraleja ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Hdl Cholesterol ◽  
First Year ◽  
Backward Elimination ◽  
One Year ◽  
Time Varying Covariates

AbstractWe aimed to develop two models to estimate first AMI and stroke/TIA, respectively, in type 2 diabetes mellitus patients, by applying backward elimination to the following variables: age, sex, duration of diabetes, smoking, BMI, and use of antihyperglycemic drugs, statins, and aspirin. As time-varying covariates, we analyzed blood pressure, albuminuria, lipid profile, HbA1c, retinopathy, neuropathy, and atrial fibrillation (only in stroke/TIA model). Both models were stratified by antihypertensive drugs. We evaluated 2980 patients (52.8% women; 67.3 ± 11.2 years) with 24,159 person-years of follow-up. We recorded 114 cases of AMI and 185 cases of stroke/TIA. The factors that were independently associated with first AMI were age (≥ 75 years vs. < 75 years) (p = 0.019), higher HbA1c (> 64 mmol/mol vs. < 53 mmol/mol) (p = 0.003), HDL-cholesterol (0.90–1.81 mmol/L vs. < 0.90 mmol/L) (p = 0.002), and diastolic blood pressure (65–85 mmHg vs. < 65 mmHg) (p < 0.001). The factors that were independently associated with first stroke/TIA were age (≥ 75 years vs. < 60 years) (p < 0.001), atrial fibrillation (first year after the diagnosis vs. more than one year) (p = 0.001), glomerular filtration rate (per each 15 mL/min/1.73 m2 decrease) (p < 0.001), total cholesterol (3.88–6.46 mmol/L vs. < 3.88 mmol/L) (p < 0.001), triglycerides (per each increment of 1.13 mmol/L) (p = 0.031), albuminuria (p < 0.001), neuropathy (p = 0.01), and retinopathy (p = 0.023).

scholarly journals Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jacques P. Brown ◽  
Jonathan D. Adachi ◽  
Emil Schemitsch ◽  
Jean-Eric Tarride ◽  
Vivien Brown ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Fragility Fracture ◽  
Mortality Risk ◽  
Real World ◽  
First Year ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Fracture Cohort ◽  
One Year

Abstract Background Recent studies are lacking reports on mortality after non-hip fractures in adults aged > 65. Methods This retrospective, matched-cohort study used de-identified health services data from the publicly funded healthcare system in Ontario, Canada, contained in the ICES Data Repository. Patients aged 66 years and older with an index fragility fracture occurring at any osteoporotic site between 2011 and 2015 were identified from acute hospital admissions, emergency and ambulatory care using International Classification of Diseases (ICD)-10 codes and data were analyzed until 2017. Thus, follow-up ranged from 2 years to 6 years. Patients were excluded if they presented with an index fracture occurring at a non-osteoporotic fracture site, their index fracture was associated with a trauma code, or they experienced a previous fracture within 5 years prior to their index fracture. This fracture cohort was matched 1:1 to controls within a non-fracture cohort by date, sex, age, geography and comorbidities. All-cause mortality risk was assessed. Results The survival probability for up to 6 years post-fracture was significantly reduced for the fracture cohort vs matched non-fracture controls (p < 0.0001; n = 101,773 per cohort), with the sharpest decline occurring within the first-year post-fracture. Crude relative risk of mortality (95% confidence interval) within 1-year post-fracture was 2.47 (2.38–2.56) in women and 3.22 (3.06–3.40) in men. In the fracture vs non-fracture cohort, the absolute mortality risk within one year after a fragility fracture occurring at any site was 12.5% vs 5.1% in women and 19.5% vs 6.0% in men. The absolute mortality risk within one year after a fragility fracture occurring at a non-hip vs hip site was 9.4% vs 21.5% in women and 14.4% vs 32.3% in men. Conclusions In this real-world cohort aged > 65 years, a fragility fracture occurring at any site was associated with reduced survival for up to 6 years post-fracture. The greatest reduction in survival occurred within the first-year post-fracture, where mortality risk more than doubled and deaths were observed in 1 in 11 women and 1 in 7 men following a non-hip fracture and in 1 in 5 women and 1 in 3 men following a hip fracture.

scholarly journals Across the COVID-19 Waves; Assessing Temporal Fluctuations in Perceived Stress, Post-Traumatic Symptoms, Worry, Anxiety and Civic Moral Disengagement over One Year of Pandemic

2021 ◽  
Vol 18 (11) ◽  
pp. 5651
Author(s):  
Alessio Gori ◽  
Eleonora Topino
Keyword(s):  
Perceived Stress ◽  
State Anxiety ◽  
Moral Disengagement ◽  
Online Survey ◽  
Well Being ◽  
First Year ◽  
Effective Interventions ◽  
Post Traumatic ◽  
One Year ◽  
Traumatic Symptoms

This study aimed at investigating the psychological effect of the COVID-19 pandemic in Italy by analysing the trends of perceived stress, post-traumatic symptoms, state anxiety, worry, and civic moral disengagement in four different moments from March 2020 to March 2021. The study involved a total of 1827 Italian participants (30% men and 70% women; Mage = 34.72; SD = 12.40) divided into four groups to which an online survey was administered. The first group completed the survey in March 2020, the second one in August 2020, the third one in November 2020, and the fourth one in March 2021. Results highlighted significant decreases in post-traumatic symptoms and a significant increase in civic moral disengagement over the first year of the COVID-19 pandemic. The levels of perceived stress, worry, and state anxiety remained constant. The correlations between the variables at different times were also explored, as well as gender differences over the year. The COVID-19 emergency has had significant effects on the mental state of the population, with important repercussions for individual and collective well-being during but probably also after the pandemic. This study offers a clear snapshot of the psychological outcomes over one COVID-19 pandemic year, providing important information that may contribute to tailor more effective interventions for mental health.

scholarly journals Recruitment, Dispersal, and Demographic Rescue in Spatially-Structured White-Tailed Ptarmigan Populations

The Condor ◽  
2000 ◽  
Vol 102 (3) ◽  
pp. 503-516 ◽  
Author(s):  
Kathy Martin ◽  
Peter B. Stacey ◽  
Clait E. Braun
Keyword(s):  
General Pattern ◽  
Population Connectivity ◽  
Site Location ◽  
Breeding Sites ◽  
Stochastic Conditions ◽  
Local Survival ◽  
Regular Event ◽  
Study Sites ◽  
One Year ◽  
Almost All

Abstract We studied recruitment and dispersal of White-tailed Ptarmigan (Lagopus leucurus) breeding in naturally fragmented alpine habitats at four study sites in Colorado from 1987–1998. Almost all recruitment for both sexes, particularly females, was of birds produced outside local populations and also external to nearby studied populations. Populations were more dependent on female recruitment than on male recruitment to sustain them, and patterns of recruitment were not correlated with local survival of adults or production of young the previous year, except at one site for females. Over 95% of recruits were yearlings. Breeding dispersal of adults, an infrequent but regular event, was also important to inter-population connectivity. Our data for multiple populations allowed us to describe movement patterns among populations to assess consistency with conditions required for a rescue system. After widespread reproductive failure in one year, we expected all populations the next year would have low recruitment due to a reduced supply of recruits produced in the region. Recruitment was low, but impact varied among populations. We conducted an over-winter study of radio-marked offspring to determine possible influences of winter site location and relatives on recruitment patterns. Contrary to expectation, offspring remained on or near breeding sites in winter, but were not located near their mothers or siblings. Recruitment location was related to winter site location. White-tailed Ptarmigan exhibit a well developed capacity for external recruitment that allows them to persist in small populations with stochastic conditions for breeding and survival. Extensive external recruitment may be a general pattern for birds.

Teething Symptoms in the First Year of Life and Associated Factors: A Cohort Study

2010 ◽  
Vol 34 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Carlos Alberto Feldens ◽  
Italo Medeiros Faraco Junior ◽  
Andréia Bertani Ottoni ◽  
Eliane Gerson Feldens ◽  
Márcia Regina Vítolo
Keyword(s):  
Associated Factors ◽  
Primary Outcome ◽  
First Year ◽  
Structured Interviews ◽  
Self Medication ◽  
Nuclear Families ◽  
Dental Examination ◽  
Pediatric Dentists ◽  
One Year ◽  
First Year Of Life

Objective: To investigate the occurrence and management of teething symptoms during the first year of life and associated factors. Study design: 500 children were recruited at birth. Research assessments including structured interviews, anthropometric measurements and dental examination were carried out after birth, at 6 months and at one-year of age. The primary outcome of this study was defined as the occurrence of one or more teething symptoms within the first year of life, as reported by the mother. Results: Teething symptoms were reported in 73% of the children analyzed (273/375). The symptoms most frequently reported were irritability (40.5%), fever (38.9%), diarrhoea (36.0%) and itching (33.6%). Dentists had little influence on the management of symptoms and self-medication to relieve them was a common practice. The risk of reporting teething symptoms was higher for children from nuclear families (p=0.040) and for children from families with higher income (p=0.040). Conclusions: Teething symptoms were highly reported in this population. Pediatric dentists should be accessible and provide adequate orientation when symptoms can be managed at home or immediate referral to health services when more serious diseases are suspected.

Long-term immune reconstitution after marrow transplantation

Blood ◽  
2001 ◽  
Vol 98 (13) ◽  
pp. 3503-3503
Author(s):  
Gérard Socié
Keyword(s):  
Marrow Transplantation ◽  
Immune Reconstitution

Partnership in Post-Adoption Services Evaluating the First Year of a Complementary Contract

1997 ◽  
Vol 21 (3) ◽  
pp. 50-56 ◽  
Author(s):  
Alan Burnell ◽  
Adrian Briggs
Keyword(s):  
Social Services ◽  
Comprehensive Assessment ◽  
First Year ◽  
Service Users ◽  
Adoptive Families ◽  
Treatment Services ◽  
Assessment And Treatment ◽  
One Year ◽  
Families With Children ◽  
Consultation Services

In the autumn 1995 edition of Adoption & Fostering, Alan Burnell and Adrian Briggs described the origins and objectives of a novel complementary contract between East Sussex Social Services and the Post-Adoption Centre (PAC), aimed at providing post-adoption counselling and consultation services to all those involved in adoption in the county. The same authors now evaluate the operation of the contract, one year on. After filling in some background they assess its achievements so far, with particular regard to the extra support to service users and staff, and reducing the risk of disruption. The article concludes that the first year of the contract has demonstrated the need for comprehensive assessment and treatment services for adoptive families with children experiencing attachment difficulties.

Sign in / Sign up

Export Citation Format

Share Document