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Search Results: 1 - 10 of 21362 matches for " Hematopietic Stem Cell Transplantation "
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HEPATITIS B AND C IN HEMATOPOIETIC STEM CELL TRANSPLANT
Anna Locasciulli,Barbara Montante,Emanuela Morelli,Virginia Gulino
Mediterranean Journal of Hematology and Infectious Diseases , 2009, DOI: 10.4084/mjhid.2011.
Abstract: Although the risk of acquisition of hepatitis B or hepatitis C virus through blood products has considerably reduced since the last decade, some infected patients are candidates to stem cell transplantation. Others may have no alternative than an infected donor. In all these cases, recipients of transplant are prone to short and long term liver complications. The evolution of liver tests under chemotherapy before transplant may give useful information to anticipate on the risk of hepatitis reactivation after transplant, both for HBv and HCv. More than sixty percent of the patients who are HBsAg-positive before transplant reactivate after transplant, and 3% develop acute severe liver failure. Because both viral replication and immune reconstitution are the key factors for reactivation, it is crucial to closely follow liver function tests and viral load during the first months of transplant, and to pay a special attention in slowly tapering the immunosuppression in these patients. Lamivudine reduces HBv viremia, but favors the emergence of HBv polymerase gene mutants and should be individually discussed. Both in case of HBv or HCv hepatitis reactivation with ALT > 10N concomitantly to an increase in viral load at time of immune reconstitution, steroids should be given. In case there is no alternative than a HBv or HCv positive geno-identical donor, the risk of viral hepatitis, including acute liver failure and late complications, should be balanced with the benefit of transplant in a given situation.
AUTOLOGOUS STEM CELL TRANSPLANTATION FOR AGGRESSIVE LYMPHOMAS
Giuseppe Visani,Paola Picardi,Patrizia Tosi,Alessandro Isidori
Mediterranean Journal of Hematology and Infectious Diseases , 2012, DOI: 10.4084/mjhid.2012.
Abstract: The role of high-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) in the treatment armamentarium of aggressive B- and T-cell non-Hodgkin lymphoma (NHL) is still a matter of debate. In the pre-Rituximab era, the PARMA study demonstrated the superiority of HDT/ASCT over conventional salvage chemotherapy in chemosensitive, relapsed patients. Subsequently, HDT/ASCT has become a standard approach for relapsed NHL. With the advent of Rituximab in the landscape of NHL, transplantation as part of first-line therapy has been challenged. However, no benefit in terms of disease-free or overall survival of HDT/ASCT over standard therapy was shown when Rituximab was added to both arms. Moreover, the superiority of HDT/ASCT over conventional salvage therapy in patients relapsing from first-line therapy including Rituximab was not confirmed. From these disappointing results, novel strategies, which can enhance the anti-lymphoma effect, at the same time reducing toxicity have been developed, with the aim of improving the outcome of HDT/ASCT in aggressive NHL. In T-cell lymphoma, few publications demonstrated that consolidation of complete remission with HDT/ASCT is safe and feasible. However, up to one-third of patients may never receive transplant, mostly due to progressive disease, and relapse still remains a major concern even after transplant.
New Frontiers in Transplantation and Stem Cell Technology: A Brief Synopsis  [PDF]
Saba Javadi, Joseph T. Brooks, Gian-Angelo Obi-Umahi, Obi Ekwenna
Open Journal of Organ Transplant Surgery (OJOTS) , 2018, DOI: 10.4236/ojots.2018.82002
Abstract: Since the first kidney transplant was performed in 1954 immense progress has been made in the world of transplantation. Modern immunosuppressive regimens have led to increasing graft and patient survival after solid organ transplantation. Furthermore, these advances have opened the door to new fields of transplantation such as composite tissue allotransplantation. These developments have made possible numerous types of transplantation including, but not limited to face, penile, and uterine transplantation. Moreover, innovations in genetic engineering and stem cell technology have contributed to rapid developments in the fields of xenotransplantation and the engineering of functional organs from induced pluripotent stem cells. As the prevalence of chronic diseases rises, so too will the necessity for organ transplantation. Thus, the transplant innovations of the modern era need to be expanded upon so as to continue to discover new ways to address organ shortages and the complications of transplantation.
Ocular Graft versus Host Disease: A Review of Clinical Manifestations, Diagnostic Approaches and Treatment  [PDF]
Sridevi Nair, Murugesan Vanathi, Anita Ganger, Radhika Tandon
Open Journal of Ophthalmology (OJOph) , 2016, DOI: 10.4236/ojoph.2016.61004
Abstract: Allogenic haematological stem cell transplantation (allo-SCT) from a human leukocyte antigen (HLA) matched related or unrelated donor is used as a curative therapy for a large number of malignant and non-malignant haematological diseases. The curative effect of allo-SCT is achieved by graft versus leukaemia effect while the downside of the graft versus patient activity is the graft-versus-host-disease (GVHD), a major reason for mortality and morbidity. The search of articles for this review had been accomplished using Ovid, Medline, Embase, Pubmed and was supplemented by retrieving cross references also. Electronic literature search for English language articles with full text access was performed using graft versus host disease, ocular, management, dry eyes as key words. This review has been intended to explicate the classification, pathogenesis, risk factors and management of ocular graft versus host disease.
Low Dose Total Body Irradiation (600 cGy) as a Conditioning Regimen in Allogenic Hematopoietic Stem Cell Transplant in Children with Acute Lymphoblastic Leukemia  [PDF]
Alberto Olaya-Vargas, Martín Pérez-García, Nideshda Ramírez-Uribe, M. Angeles Del Campo-Martinez, Gerardo Lopez-Hernández, Montserrat Hernández-García, Jorge Amador-Zarco, Guadalupe Garcia-Vega, Yadira Melchor-Vidal, Marta Zapata-Tarres, Rocío Cárdenas-Cardos, Roberto Rivera-Luna
Journal of Cancer Therapy (JCT) , 2016, DOI: 10.4236/jct.2016.78061
Abstract: Total body irradiation (TBI) is conditioning regimen in children with acute lymphoblastic leukemia (ALL) with a very high risk of relapse or in those who have not achieved remission and have relapsed and subsequently received allogenic hematopoietic stem cell transplantation (HSCT). A retrospective evaluation of 33 ALL patients in full remission with an indication of HSCT was performed to evaluate overall survival (OS) and event-free survival (EFS). The inclusion criteria included a myeloablative conditioning regimen of TBI at a dose of 600 cGy. The observed OS at 5 years was 50%, and the EFS of 32% we observed difference in the EFS stem cell origin; the peripheral blood (PB) 60%, and the umbilical cord blood (UC) accounted for 40%. Overall, 45% had a documented chimerism. The OS at 5 years from patients with chimeras was 75%, while those without chimeras had an OS at 5 years of 25%. The mortality in the first 100 days was 24%. A total of 24.2% of children presented with acute graft versus-host disease (GVHD), while 33% had chronic GVHD. Currently, there is no general agreement among all international centers regarding the optimum TBI dose. Our study reports an acceptable range of adverse events with a relatively low dose of 600 cGy.
Stem cells and cell therapy: From basic sciences to clinical perspectives  [PDF]
Luciana Machado, Arnaldo Rodrigues Santos Jr.
Journal of Biomedical Science and Engineering (JBiSE) , 2013, DOI: 10.4236/jbise.2013.66083
Abstract:

Stem cells are seen as a possible solution for organ and tissue regeneration and for the treatment or even cure of various diseases. There are basically two types of stem cells: embryonic and adult stem cells. Embryonic stem cells are derived from embryos and exhibit an extensive multiplication and differentiation potential. On the other hand, adult stem cells, which are found in bone marrow and other tissues, have a lower multiplication and differentiation capacity but are more easily isolated and applied. In adult stem cell therapies using bone marrow or umbilical cord blood transplantation, the differentiation of a certain cell type is induced and its multiplication is stimulated, followed by the implantation of these cells into damaged tissues. Examples of the application of stem cells include the treatment of autoimmune diseases such as type 1 diabetes mellitus and heart diseases. Stem cells open up new prospects for the treatment of a series of diseases. In this respect, basic knowledge of the mechanisms of growth and differentiation of these cells is of the utmost importance to optimize therapeutic results. In this review, we discuss the mechanisms of stem cell differentiation and describe the clinical results reported in the literature, mainly by Brazilian research groups.

A Multi-Center International Survey Related to the Nutritional Support after Hematopoietic Stem Cell Transplantation Endorsed by the ASIA Pacific Blood and Marrow Transplantation (APBMT)  [PDF]
Shigeo Fuji, Takehiko Mori, Vincent Lee, Jessica Cheng, Natalie Linton, Albert Lie, Navin Khattry, Akio Shigematsu, Naoyuki Uchida, Tetsuya Eto, Nguyen Duy Thang, Yi-Chang Liu, Deok-Hwan Yang, Jin Seok Kim, Joon Ho Moon, Dae-Young Kim, Minako Iida, Ritsuro Suzuki, Yoshihisa Kodera, Sung-Won Kim
Food and Nutrition Sciences (FNS) , 2012, DOI: 10.4236/fns.2012.33060
Abstract: Background: The nutritional support after hematopoietic stem cell transplantation (HSCT) has not been well established due to the scarcity of clinical trials. To conduct international clinical trials in Asia, we performed the questionnaire survey to investigate the current standard of nutritional support after HSCT. Method: We sent the questionnaire to the physicians nominated by the Asia Pacific Blood and Marrow Transplantation (APBMT) members of each country/ region. Result: We received 15 responses from 7 different countries/regions. The target calorie amount is 1.0 - 1.3 × basal energy expenditure (BEE) in 11 institutes when partial parenteral nutrition is used. When total parenteral nutrition (TPN) is used, the target calorie amount is 1.0 - 1.3 × BEE in 9 institutes and 1.3 - 1.5 × BEE in 4 institutes. Lipid emulsion is routinely used in 12 institutes. Multivitamins and trace elements are routinely added to TPN used in most institutes. It is still uncommon to use the immunonutrition. Blood glucose levels are routinely monitored in all institutes, but the target range varies (<110 in 2 institutes, <150 in 4 institutes, and <200 in 8 institutes). Conclusions: Basic nutritional support is similar in participating institutes. However, the target glucose level varies and the use of immunonutrition is rather rare. These points can be the theme of future clinical trials.
The curative effect of the associated cell transplantation on the rabbit myocardial infarction  [PDF]
Zhicheng Fang, Chang’e Zhou, Xiang Zheng, Boyi Liu, Li Chen, Chunfeng Shen, Pei Liu, Yunfei Huang
Stem Cell Discovery (SCD) , 2013, DOI: 10.4236/scd.2013.34025
Abstract:

Inducing Mesenchymal stem cells to differentiate into cardiomyocycte-like cells and endothelial progenitor cells orientedly and evaluating the curative effect of the associated cell transplantation on the rabbit myocardial infarction (MI). Methods: Mesenchymal stem cells (MSCs) were isolated from the bone marrow of 24 rabbits and cultured in special cell culture medium containing 5-azacytidine (5-AZA), endothelial cell growth supplements (ECGS), vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (BFGF) respectively. The cell transplantation was performed 2 weeks after MI. Rabbits were divided into control group, cardiomyocytes-like cell group, endothelial progenitor cell group and combination group. We used the echocardiography to measure the heart function 2 to 4 weeks after MI, TTC to measure the area of the infarction, flow cytometry to estimate the cell apoptosis. Results: After induced, MSCs were differentiated orientedly into cardiomyocycte-like cells (CLCs) and endothelial progenitor cells (EPCs). CLCs became greater and had a “stick” or “ball” shape. Transmisson electron microscopy showed that the cells had oval nuclei positioned in the central part and well organized myofilaments, atrial granules and mitochomdrion. RT-PCR showed the expression of the atrial natriuretic polypeptide, phospholamban and myosin heavy chain in CLCs. EPCs formed confluent one-celled layer which showed a cobblestone shape by phase-contrast microscope. The expression of CD133 in EPCs was much at first and then descended gradually. Compared with the control group, cell transplantation could improve the heart function, reduce the size of MI, decrease the left ventricular end systole diameter and end diastolic diameter, suppressed cell apoptosis. The curative effect of cell transplantation was better in the associated-cell group than in the single-cell transplantation group (LVEF: 32.49% ± 1.29% vs 53.22% ± 2.13% vs 56.91% ±

Successful Treatment of Low-Dose Lenalidomide Maintenance Therapy Followed by Second Autologous Peripheral Blood Stem Cell Transplantation in Heavily Treated Multiple Myeloma  [PDF]
Naohiro Sekiguchi, Naoki Takezako, Takashi Ishii, Akihisa Nagata, Satoshi Noto, Akiyoshi Miwa
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.32022
Abstract: Recently, the prognosis of multiple myeloma has been improved by using high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (ASCT), bortezomib, and immunomodulatory drugs including thalidomide and lenalidomide. On the other hand, treatment strategy remains difficult for refractory and relapse cases. Here, we report the successful treatment of low-dose lenalidomide maintenance therapy followed by salvage ASCT in a heavily treated patient with multiple myeloma. This 58-year-old woman with IgG-λ multiple myeloma had a 5th recurrence in June, 2011. It was 7 years post-diagnosis, and she had received conventional therapies such as VAD, MP therapy. Furthermore, the patient had already been treated with ASCT, bortezomib, and thalidomide therapy. At the 5th recurrence, she had extramedullary plasmacytoma in the left orbit. She initially received bortezomib and dexamethasone therapy as induction therapy. After peripheral blood stem cell collection, radiation therapy was performed. The patient then received a second ASCT. Three months later, the response was very good partial response. Finally, the patient was treated with 5 mg/day lenalidomide orally as a maintenance therapy, and she achieved stringent complete response after 2 months according to International Myeloma Working Group response criteria. Low-dose lenalidomide maintenance therapy might be also useful for ASCT as salvage therapy, although further studies are warranted.
Allogeneic and autologous stem cell transplantation with busulfan, cyclophosphamide, and etoposide conditioning therapy for relapsed/refractory non-Hodgkin lymphoma  [PDF]
Neelima Vidula, Andrew M. Evens, Irene B. Helenowski, Borko Jovanovic, Jane N. Winter, Jayesh Mehta, Seema Singhal, Stephanie F. Williams, Olga Frankfurt, Jessica K. Altman, Joanne Monreal, Leo I. Gordon
Modern Chemotherapy (MC) , 2013, DOI: 10.4236/mc.2013.24007
Abstract: The optimal stem cell transplantation (SCT) conditioning therapy for relapsed/refractory non-Hodgkin lymphoma (NHL) is not clearly defined. In a retrospective analysis, we examined 25 patients with “high risk” relapsed/refractory NHL who received busulfan, cyclophosphamide, and etoposide (Bu/Cy/VP16) conditioning with autologous or allogeneic SCT. The majority of patients had aggressive histology and 52% had primary refractory NHL. Furthermore, 48% of patients had chemotherapy-resistant disease at the time of SCT. Fifty-six percent of patients underwent allogeneic SCT, while 44% had autologous SCT. The median engraftment time for neutrophils and platelets was 13.5 and 14 days, respectively. The 100-day treatment-related mortality (TRM) was 16%, while the 2-year non-relapse mortality (NRM) rate was also 16%. At a median follow-up of 15 months, the estimated 2-year disease-free survival (DFS) rate was 64% (95% confidence interval (CI): 36%-82%) and the estimated 2-year overall survival (OS) was 69% (95% CI: 40%-86%). Furthermore, the 2-year disease-specific survival (DSS) rate was 73% (95% CI: 40%-90%). Using Cox proportional hazard modeling, the International Prognostic Index at time of relapse predicted DFS and OS. Altogether, Bu/Cy/VP16 was associated with early TRM; however, late toxicities (including NRM) were uncommon resulting in relatively good survival rates in a high-risk relapsed/refractory NHL population.
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