scholarly journals HUMAN HERPES VIRUS TYPE 6 INFECTION IN CHILDREN AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION IN THE REPUBLIC OF BELARUS

2020 ◽  
pp. 409-418
Author(s):  
E.P. KISHKURNO ◽  
◽  
T.V. AMVROSIEVA ◽  
YU.E. MAREYKO ◽  
E.V. DIVAKOVA ◽  
...  
Keyword(s):  
Stem Cell ◽  
Viral Load ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Blood Serum ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Clinical Manifestations ◽  
Hematopoietic Stem ◽  
The Republic

Objective: To evaluate the frequency of reactivation of HHV-6 infection in patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT); determine viral load in serum/plasma and associated clinical manifestations; to determine the criteria for initiating anti-viral prophylaxis and etiotropic therapy in patients with this infection in the Republic of Belarus. Methods: Monitoring of polymerase chain reaction (PCR) of blood serum in 42 patients after allo-HSCT. Results: In 31% of patients, HHV-6 DNA was detected in serum/plasma on 14-28 days after allo-HSCT. The concentration of HHV-6 DNA in blood serum was up to 2.3-6.5×103 copies/ml, in 3 patients (18.8%) with the concentration of DNA≥2.3×103 copies/ml, developed clinical manifestations in the form of hepatitis. Regular monitoring of HHV-6 infection revealed reactivation of the infection and, with a viral load of≥100 copies/ml, initiate timely preventive treatment with ganciclovir. Conclusions: HHV-6 DNA is detected in one-third of patients after allo-HSCT and in the form of hepatitis. Timely prevention and therapy with ganciclovir reduce the risk of severe complications and fatal outcomes. Keywords: Children, HHV-6, hematology, stem cells transplantation, hepatitis.

scholarly journals Clinical and immunologic outcome of patients with cartilage hair hypoplasia after hematopoietic stem cell transplantation

Blood ◽  
2010 ◽  
Vol 116 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Victoria Bordon ◽  
Andrew R. Gennery ◽  
Mary A. Slatter ◽  
Els Vandecruys ◽  
Genevieve Laureys ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Clinical Manifestations ◽  
Hematopoietic Stem ◽  
Cartilage Hair Hypoplasia ◽  
Severe Immunodeficiency

Abstract Cartilage-hair hypoplasia (CHH) is a rare autosomal recessive disease caused by mutations in the RMRP gene. Beside dwarfism, CHH has a wide spectrum of clinical manifestations including variable grades of combined immunodeficiency, autoimmune complications, and malignancies. Previous reports in single CHH patients with significant immunodeficiencies have demonstrated that allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment for the severe immunodeficiency, while growth failure remains unaffected. Because long-term experience in larger cohorts of CHH patients after HSCT is currently unreported, we performed a European collaborative survey reporting on 16 patients with CHH and immunodeficiency who underwent HSCT. Immune dysregulation, lymphoid malignancy, and autoimmunity were important features in this cohort. Thirteen patients were transplanted in early childhood (∼ 2.5 years). The other 3 patients were transplanted at adolescent age. Of 16 patients, 10 (62.5%) were long-term survivors, with a median follow-up of 7 years. T-lymphocyte numbers and function have normalized, and autoimmunity has resolved in all survivors. HSCT should be considered in CHH patients with severe immunodeficiency/autoimmunity, before the development of severe infections, major organ damage, or malignancy might jeopardize the outcome of HSCT and the quality of life in these patients.

Cidofovir Is Safe and Effective in the Treatment of Adenoviral Infection in Pediatric Hematopoietic Stem Cell Transplantation.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2232-2232
Author(s):  
Usman Yusuf ◽  
Gregory Hale ◽  
Paul Woodard ◽  
Ely Benaim ◽  
Kimberly Kasow ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Hemorrhagic Cystitis ◽  
Clinical Manifestations ◽  
Hematopoietic Stem ◽  
Adenoviral Infection ◽  
Viral Culture

Abstract Adenovirus (ADV) infections are increasingly recognized as significant cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). Early diagnosis and prompt initiation of effective treatment are important in preventing often fatal disseminated ADV disease. We report our experience with using cidofovir (CDV) for the treatment of adenovirus infection in 57 HSCT patients, median age 8 years (range 0.5–26). Fifty-four patients received allogeneic HSCT, 35 of whom were T-cell depleted with 3 patients receiving autologous marrow. Blood was tested weekly for ADV by quantitative real-time PCR, with viral culture performed on urine, stool and throat swabs. Antiviral therapy was initiated immediately upon detection of ADV by PCR, culture or tissue histopathology. Cidofovir was given at 5mg/kg once weekly for 2 weeks, then every 2 weeks untill 3 negative PCR or cultures were documented. ADV was first detected at a median of 53 days (range 6–319 days) after HSCT. The most common clinical manifestations were diarrhea (53%), fever (21%), hemorrhagic cystitis (12%), and pneumonitis (11%). Fourteen (25%) patients were asymptomatic and four (7%) patients had exacerbation of an ongoing GVHD. The virus was isolated from stool 53%, blood 50%, urine 16%, respiratory specimens 16% and the cerebrospinal fluid in 1 patient. Twenty (35%) patients had the virus isolated from more than 2 sites. Of the 30 patients who initially had ADV only in stool, 77% of them became PCR-positive in the blood while on CDV therapy, at a median of 10 days after ADV was first detected from the stool. The median duration of therapy was 60 days (range 1–270), with a median of 5 doses given (range 1–22). CDV treatment was associated with resolution of diarrhea, hemorrhagic cystitis, fever and pneumonitis in 56 patients in whom the virus became undetectable by both cultures and quantitative PCR. There was one adenovirus-related death due to pneumonitis and ARDS. No cases of dose-limiting nephrotoxicity were observed. Cidofovir was demonstrated to be safe and effective for the treatment of ADV infection in this predominantly pediatric HSCT patient population. Vigilant surveillance for ADV and early treatment with CDV can prevent the poor outcomes associated with ADV disease. A larger prospective study will be needed to further determine the role of CDV in the treatment of ADV in patients after HSCT.

HHV-6 Reactivation after Hematopoietic Stem Cell Transplantation in Chinese Patients Is Associated with aGVHD.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4995-4995
Author(s):  
Xiu Jing Ye ◽  
Wei Wei Liao ◽  
Jing Song He ◽  
He Huang
Keyword(s):  
Stem Cell ◽  
Viral Load ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Cumulative Incidence ◽  
Significant Risk ◽  
Chinese Patients ◽  
Hematopoietic Stem

Abstract Recent reports indicate that human herpesvirus (HHV)-6 reactivation occurs in 40–65% of patients undergoing hematopoietic stem cell transplantation (HSCT).But the complication after HSCT that predispose to HHV-6 viremia are not well characterized. The aim of our research is to study the potential relationship between HHV-6 activation and acute graft-versus-host disease (aGVHD) after hematopoietic cell transplantation (HSCT) in chinese patients. Peripheral blood samples were collected before and weekly after HSCT from 40 consecutive recipients who underwent HSCT between March 2005 and Joungry 2007 (2 autologous and 38 allogeneic transplants) .HHV-6 DNAemia was monitored by real-time PCR. The genotypes of HHV-6 were identified by Hind III restriction assay. Of the 40 patients, HHV-6 DNAemia were detected in only 1 patient (2.5%) before HSCT, and the viral load was 420 copies/ml.After HSCT there were 18(45%) patients detected HHV-6 DNA on a median of day 14.5 (range, 0– 23 days), and the median HHV-6 viral load of 4884.4±374.4 copies/ml (range, 282 – 43400 copies/ml). Respectively, HHV-6B was identified as the predominant variant.Grade I – IV aGHVD occurred in 18 (45%) on a median of day 20 (range, 8–40 days). The median onset time of HHV-6 DNAemia was significantly earlier than that of aGHVD (P <0.05). Compared with that in HHV-6 DNAemia positive [HHV-6(+)] patients, the cumulative incidence of grade I – IV aGHVD was higher (72.2% vs. 27.7%, P <0.05) than in negative [HHV-6(−)] patients. Cumulative incidence of grade I – IV aGVHD was higher in patients with both HHV-6 and CMV positive (CMV+/HHV-6+) than in those with either CMV (CMV+/HHV-6−) or HHV-6 positive (CMV−/HHV-6+) and neither of them positive (CMV−/HHV-6−) [66.7% (10/15),26.7% (4/15) ,66.7% (2/3) and 28.6% (2/7), respectively, P<0.05]. Our data suggest that patients who undergo HSCT are at significant risk for HHV-6 reactivation. HHV-6 viremia occurs early during the post-transplant course, most often within the first 2 weeks. Patients with HHV-6 activation or HHV-6/CMV co-infection maybe involved in the occurrence of aGVHD after HSCT.

scholarly journals Thrombotic microangiopathy associated with hematopoietic stem cell transplantation: general characteristics and an example from clinical practice

2020 ◽  
Vol 7 (3) ◽  
pp. 86-93
Author(s):  
E. B. Machneva ◽  
M. A. Bolokhonova ◽  
T. Z. Aliev ◽  
D. V. Shevtsov ◽  
A. M. Suleymanova ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Thrombotic Microangiopathy ◽  
Conditioning Regimen ◽  
Clinical Manifestations ◽  
Chemotherapeutic Agents ◽  
Hematopoietic Stem

Associated hematopoietic stem cell transplantation (HSCT) or transplant-associated thrombotic microangiopathy (TA-TMA) is currently a generally recognized and severe complication of HSCT with a high risk of mortality. TMA is characterized by microangiopathic hemolytic anemia and thrombocytopenia, resulting in the accumulation of platelets in the microvasculature, which leads to dysfunction of the ischemic organ. The pathogenesis of TА-TMA is based on endothelial damage by various trigger factors (in particular, chemotherapeutic agents in the conditioning regimen, the use of calcineurin inhibitors, alloreactivity, infectious agents). The article presents the peculiarities of terminology, pathogenesis and clinical manifestations of TA-TMA, methods of therapy for this pathology. Examples of management of patients with TA-TMA are demonstrated using a clinical example.

scholarly journals Chronic “graft versus host” disease after allogeneic hematopoietic stem cell transplantation: basic characteristics, pathogenetic mechanisms, treatment strategies and problems of clinical practice

2020 ◽  
Vol 7 (2) ◽  
pp. 94-111
Author(s):  
E. B. Machneva ◽  
V. Yu. Panarina ◽  
T. Z. Aliev ◽  
D. V. Shevtsov ◽  
A. M. Suleymanova ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Graft Versus Host Disease ◽  
Clinical Manifestations ◽  
Hematopoietic Stem ◽  
Host Disease ◽  
Graft Versus Host

Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for different spectrum of diseases. This type of treatment is constantly improving, but HSCT remains a risky procedure with various possible complications, the main is – chronic “graft versus host” disease (cGVHD). сGVHD is immune disregulation, and characterized by a variety of clinical manifestations that reflect the multiple underlying pathophysiology mechanisms. The study of cGVHD has now made great progress, but there’s still a lot of questions. General characteristics, risk-factors of development, clinical manifestations, pathogenesis of cGVHD will be discussed in this article. Clinical case presented in this article explains usage of basic and novel agents for cGVHD treatment, prevention criterions for treatment of cGVHD in children.

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