scholarly journals Lung transplantation for late-onset non-infectious chronic pulmonary complications of allogenic hematopoietic stem cell transplant

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Peter Riddell ◽  
Ram Vasudevan-Nampoothiri ◽  
Jin Ma ◽  
Lianne G. Singer ◽  
Jeff H. Lipton ◽  
...  
Keyword(s):  
Stem Cell ◽  
Lung Transplantation ◽  
Hematopoietic Stem Cell ◽  
Late Onset ◽  
Pulmonary Complications ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Impact

Abstract Background Late onset non-infectious pulmonary complications (LONIPCs) following allogenic hematopoietic stem cell transplantation (allo-HSCT) confer a significant mortality risk. Lung transplantation (LTx) has the potential to provide survival benefit but the impact of prior allo-HSCT on post-LTx outcomes is not well studied. Methods This retrospective, single-centre cohort study assessed the post-LTx outcomes of adults with LONIPCs of allo-HSCT. Outcomes of LTx for LONIPCs were compared to propensity-score matched LTx controls (n = 38, non-HSCT) and recipients of re-LTx (n = 70) for chronic lung allograft dysfunction (CLAD). Results Nineteen patients underwent DLTx for LONIPCs of allo-HSCT between 2003 and 2019. Post-LTx survival was 50% at 5-years. Survival to 1-year post-LTx was similar to matched controls (p = 0.473). Survival, conditional on 1-year survival, was lower in the allo-HSCT cohort (p = 0.034). An increased risk of death due to infection was identified in the allo-HSCT cohort compared to matched controls (p = 0.003). Compared to re-LTx recipients, the allo-HSCT cohort had superior survival to 1-year post-LTx (p = 0.034) but conditional 1-year survival was similar (p = 0.145). Conclusion This study identifies an increased risk of post-LTx mortality in recipients with previous allo-HSCT, associated with infection. It supports the hypothesis that allo-HSCT LTx recipients are relatively more immunosuppressed than patients undergoing LTx for other indications. Optimisation of post-LTx immunosuppressive and antimicrobial strategies to account for this finding should be considered.

scholarly journals Bone and Joint Infections among Hematopoietic Stem Cell Transplant Recipients

2019 ◽  
Vol 4 (5) ◽  
pp. 209-215
Author(s):  
Cybele Lara Abad ◽  
Vania Phuoc ◽  
Prashant Kapoor ◽  
Pritish K. Tosh ◽  
Irene G. Sia ◽  
...  
Keyword(s):  
Stem Cell ◽  
Septic Arthritis ◽  
Hematopoietic Stem Cell ◽  
Joint Infection ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Joint Infections ◽  
Bone And Joint Infections ◽  
Prosthetic Joint ◽  
Increased Risk

Abstract. Background: Hematopoietic stem cell transplantation (HSCT) recipients are at increased risk for infection. This study describes bone and joint infections (BJI) among HSCT recipients.Methods: We reviewed 5861 patients who underwent HSCT at Mayo Clinic, Rochester, MN from January 1, 2005 through January 1, 2015 for study inclusion. BJI was defined as native septic arthritis, prosthetic joint infection, osteomyelitis, and orthopedic implant infection. All adults with BJI after HSCT were included in the analysis.Results: Of 5861 patients, 33 (0.6%) developed BJI. Native joint septic arthritis was the most common BJI occurring in 15/33 (45.4%) patients. Patients were predominantly male (24/33, 72.7%), with median age of 58 (range 20-72) years. BJI was diagnosed a median of 39 (range 1-114) months after allogeneic (14/33, 42.4%) or autologous (19/33, 57.6%) HSCT. Organisms were recovered via tissue (24/27, 88.9%), synovial fluid (13/17, 76.5%), and/or blood cultures (16/25, 64%). Most underwent surgical debridement (23/33, 69.7%). Patients were followed a median of 78.3 months (range 74-119). Therapy was unsuccessful in 4/33 (12.1%), with death related to the underlying BJI in two (50%). Failure occurred a median of 3.4 (0.1-48.5) months from diagnosis. At last follow up, 7/33 (21.2%) patients were alive. Median overall survival was 13 months (0.07-70.6).Conclusion: BJI among HSCT recipients is infrequent. The most common infection is native joint septic arthritis. Pathogens appear similar to patients without HSCT. Treatment involving surgical-medical modalities is successful, with most patients surviving >1 year after BJI.

scholarly journals Pre–Hematopoietic Stem Cell Transplant Lung Function and Pulmonary Complications in Children

2014 ◽  
Vol 11 (10) ◽  
pp. 1576-1585 ◽  
Author(s):  
Ashok Srinivasan ◽  
Saumini Srinivasan ◽  
Sudeep Sunthankar ◽  
Anusha Sunkara ◽  
Guolian Kang ◽  
...  
Keyword(s):  
Stem Cell ◽  
Lung Function ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Pulmonary Complications ◽  
Cell Transplant ◽  
Hematopoietic Stem

scholarly journals RhizomucorandScedosporiumInfection Post Hematopoietic Stem-Cell Transplant

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Dânia Sofia Marques ◽  
Carlos Pinho Vaz ◽  
Rosa Branca ◽  
Fernando Campilho ◽  
Catarina Lamelas ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Unrelated Donor ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Increased Risk

Hematopoietic stem-cell transplant recipients are at increased risk of developing invasive fungal infections. This is a major cause of morbidity and mortality. We report a case of a 17-year-old male patient diagnosed with severe idiopathic acquired aplastic anemia who developed fungal pneumonitis due toRhizomucor sp.and rhinoencephalitis due toScedosporium apiospermum6 and 8 months after undergoing allogeneic hematopoietic stem-cell transplant from an HLA-matched unrelated donor. Discussion highlights risk factors for invasive fungal infections (i.e., mucormycosis and scedosporiosis), its clinical features, and the factors that must be taken into account to successfully treat them (early diagnosis, correction of predisposing factors, aggressive surgical debridement, and antifungal and adjunctive therapies).

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