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  1 / 20262 MEDLINE  
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[PMID]:28461213
[Au] Autor:Vrooman LM; Millard HR; Brazauskas R; Majhail NS; Battiwalla M; Flowers ME; Savani BN; Akpek G; Aljurf M; Bajwa R; Baker KS; Beitinjaneh A; Bitan M; Buchbinder D; Chow E; Dandoy C; Dietz AC; Diller L; Gale RP; Hashmi SK; Hayashi RJ; Hematti P; Kamble RT; Kasow KA; Kletzel M; Lazarus HM; Malone AK; Marks DI; O'Brien TA; Olsson RF; Ringden O; Seo S; Steinberg A; Yu LC; Warwick A; Shaw B; Duncan C
[Ad] Endereço:Department of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts. Electronic address: lynda_vrooman@dfci.harvard.edu.
[Ti] Título:Survival and Late Effects after Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancy at Less than Three Years of Age.
[So] Source:Biol Blood Marrow Transplant;23(8):1327-1334, 2017 Aug.
[Is] ISSN:1523-6536
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Very young children undergoing hematopoietic cell transplantation (HCT) are a unique and vulnerable population. We analyzed outcomes of 717 patients from 117 centers who survived relapse free for ≥1 year after allogeneic myeloablative HCT for hematologic malignancy at <3 years of age, between 1987 and 2012. The median follow-up was 8.3 years (range, 1.0 to 26.4 years); median age at follow-up was 9 years (range, 2 to 29 years). Ten-year overall and relapse-free survival were 87% (95% confidence interval [CI], 85% to 90%) and 84% (95% CI, 81% to 87%). Ten-year cumulative incidence of relapse was 11% (95% CI, 9% to 13%). Of 84 deaths, relapse was the leading cause (43%). Chronic graft-versus-host-disease 1 year after HCT was associated with increased risk of mortality (hazard ratio [HR], 2.1; 95% CI, 1.3 to 3.3; P = .0018). Thirty percent of patients experienced ≥1 organ toxicity/late effect >1 year after HCT. The most frequent late effects included growth hormone deficiency/growth disturbance (10-year cumulative incidence, 23%; 95% CI, 19% to 28%), cataracts (18%; 95% CI, 15% to 22%), hypothyroidism (13%; 95% CI, 10% to 16%), gonadal dysfunction/infertility requiring hormone replacement (3%; 95% CI, 2% to 5%), and stroke/seizure (3%; 95% CI, 2% to 5%). Subsequent malignancy was reported in 3.6%. In multivariable analysis, total body irradiation (TBI) was predictive of increased risk of cataracts (HR, 17.2; 95% CI, 7.4 to 39.8; P < .001), growth deficiency (HR, 3.5; 95% CI, 2.2 to 5.5; P < .001), and hypothyroidism (HR, 5.3; 95% CI, 3.0 to 9.4; P < .001). In summary, those who survived relapse free ≥1 year after HCT for hematologic malignancy at <3 years of age had favorable overall survival. Chronic graft-versus-host-disease and TBI were associated with adverse outcomes. Future efforts should focus on reducing the risk of relapse and late effects after HCT at early age.
[Mh] Termos MeSH primário: Doença Enxerto-Hospedeiro/mortalidade
Doença Enxerto-Hospedeiro/terapia
Neoplasias Hematológicas/mortalidade
Neoplasias Hematológicas/terapia
Transplante de Células-Tronco Hematopoéticas
[Mh] Termos MeSH secundário: Fatores Etários
Aloenxertos
Pré-Escolar
Doença Crônica
Intervalo Livre de Doença
Feminino
Seguimentos
Seres Humanos
Lactente
Masculino
Taxa de Sobrevida
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  2 / 20262 MEDLINE  
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[PMID]:27777141
[Au] Autor:Politikos I; T Kim H; Karantanos T; Brown J; McDonough S; Li L; Cutler C; Antin JH; Ballen KK; Ritz J; Boussiotis VA
[Ad] Endereço:Hematology-Oncology and Cancer Biology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
[Ti] Título:Angiogenic Factors Correlate with T Cell Immune Reconstitution and Clinical Outcomes after Double-Unit Umbilical Cord Blood Transplantation in Adults.
[So] Source:Biol Blood Marrow Transplant;23(1):103-112, 2017 Jan.
[Is] ISSN:1523-6536
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Umbilical cord blood (UCB) is a valuable graft source for allogeneic hematopoietic stem cell transplantation (HSCT) in patients who lack adult donors. UCB transplantation (UCBT) in adults results in delayed immune reconstitution, leading to high infection-related morbidity and mortality. Angiogenic factors and markers of endothelial dysfunction have biologic and prognostic significance in conventional HSCT, but their role in UCBT has not been investigated. Furthermore, the interplay between angiogenesis and immune reconstitution has not been studied. Here we examined whether angiogenic cytokines, angiopoietin-1 (ANG-1) and vascular endothelial growth factor (VEGF), or markers of endothelial injury, thrombomodulin (TM) and angiopoietin-2 (ANG-2), associate with thymic regeneration as determined by T cell receptor excision circle (TREC) values and recovery of T cell subsets, as well as clinical outcomes in adult recipients of UCBT. We found that plasma levels of ANG-1 significantly correlated with the reconstitution of naive CD4 CD45RA and CD8 CD45RA T cell subsets, whereas plasma levels of VEGF displayed a positive correlation with CD4 CD45RO T cells and regulatory T cells and a weak correlation with TRECs. Assessment of TM and ANG-2 revealed a strong inverse correlation of both factors with naive T cells and TRECs. The angiogenic capacity of each patient's plasma, as determined by an in vitro angiogenesis assay, positively correlated with VEGF levels and with reconstitution of CD4 T cell subsets. Higher VEGF levels were associated with worse progression-free survival and higher risk of relapse, whereas higher levels of TM were associated with chronic graft-versus-host disease and nonrelapse mortality. Thus, angiogenic factors may serve as valuable markers associated with T cell reconstitution and clinical outcomes after UCBT.
[Mh] Termos MeSH primário: Indutores da Angiogênese/sangue
Transplante de Células-Tronco de Sangue do Cordão Umbilical/normas
Neoplasias Hematológicas/terapia
Reconstituição Imune/imunologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Angiopoietina-1/sangue
Angiopoietina-2/sangue
Biomarcadores/sangue
Transplante de Células-Tronco de Sangue do Cordão Umbilical/métodos
Intervalo Livre de Doença
Feminino
Doença Enxerto-Hospedeiro
Seres Humanos
Masculino
Meia-Idade
Receptores de Antígenos de Linfócitos T
Recidiva
Subpopulações de Linfócitos T/imunologia
Linfócitos T/imunologia
Trombomodulina/sangue
Resultado do Tratamento
Fator A de Crescimento do Endotélio Vascular/sangue
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiogenesis Inducing Agents); 0 (Angiopoietin-1); 0 (Angiopoietin-2); 0 (Biomarkers); 0 (Receptors, Antigen, T-Cell); 0 (Thrombomodulin); 0 (Vascular Endothelial Growth Factor A)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


  3 / 20262 MEDLINE  
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[PMID]:28460445
[Au] Autor:Lv W; Fan Z; Huang F; Xu N; Xuan L; GuopanYu; Jiang Q; Zhou H; Lin R; Zhang X; Sun J; Liu Q
[Ad] Endereço:Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515 China.
[Ti] Título:Autoimmune hematological diseases following haploidentical donor hematopoietic stem cell Transplant compared with matched sibling and unrelated donor.
[So] Source:Oncotarget;8(16):26505-26514, 2017 Apr 18.
[Is] ISSN:1949-2553
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Autoimmune hematological diseases (AHDs) occur more frequently than other autoimmune complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and are often refractory to treatment. This study was to analyze the incidence and risk factors of AHDs as well as their response to treatment . Four hundred and forty-five adult malignant hematopoietic disorders underwent allo-HSCT were enrolled in this retrospective study, including 124 haploidentical donor (HRD), 140 unrelated donor (MUD) and 181 HLA-matched sibling donor (MSD) transplants. Twelve patients developed AHDs, including 6 autoimmune hemolytic anemia and 6 Evans syndrome. Evans syndrome all occurred in HRD transplants. The 3-year cumulative incidence of AHDs was 4.0 ± 1.3%, and HRD had higher incidence than MUD (8.7 ± 3.0% vs 1.8 ± 1.2%, P = 0.012) and MSD (8.7 ± 3.0% vs 3.5 ± 2.6%, P = 0.004 ). The steroids combined with Cyclosporine A were acted as the first line treatment, and the response rate was 73%. No patients experienced recurrence at a median follow up of 313 days after stopping treatment. HRD transplants (vs MUD: HR, 5.87; CI, 1.24 to 27.73; p = 0.026 and vs MSD: HR, 7.70; CI, 1.63 to 36.44; P = 0.010) and concurrent chronic graft versus host disease (HR, 3.76; CI, 1.18 to 11.92; P = 0.025) were risk factors for AHDs.
[Mh] Termos MeSH primário: Doenças Autoimunes/terapia
Doenças Hematológicas/terapia
Transplante de Células-Tronco Hematopoéticas
Irmãos
Doadores não Relacionados
[Mh] Termos MeSH secundário: Adolescente
Adulto
Doenças Autoimunes/diagnóstico
Doenças Autoimunes/mortalidade
Feminino
Doença Enxerto-Hospedeiro/diagnóstico
Doença Enxerto-Hospedeiro/etiologia
Antígenos HLA/genética
Antígenos HLA/imunologia
Doenças Hematológicas/diagnóstico
Doenças Hematológicas/mortalidade
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Transplante de Células-Tronco Hematopoéticas/métodos
Teste de Histocompatibilidade
Seres Humanos
Incidência
Masculino
Meia-Idade
Transplante Homólogo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (HLA Antigens)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.18632/oncotarget.15710


  4 / 20262 MEDLINE  
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[PMID]:29335768
[Au] Autor:Hammrich J; Wittig S; Ernst T; Gruhn B
[Ad] Endereço:Department of Pediatrics, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
[Ti] Título:CTLA-4 polymorphisms: influence on transplant-related mortality and survival in children undergoing allogeneic hematopoietic stem cell transplantation.
[So] Source:J Cancer Res Clin Oncol;144(3):587-592, 2018 Mar.
[Is] ISSN:1432-1335
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative approach for a variety of hematological diseases; however, it is still associated with substantial morbidity and mortality. Transplant-related mortality (TRM) after HSCT depends mainly on the toxicity of the conditioning regimen, infections, and graft-versus-host disease. The purpose of this study was to identify the association between CTLA-4 single nucleotide polymorphisms and TRM in children undergoing allogeneic HSCT. METHODS: 153 donors and 153 children with acute lymphoblastic leukemia, acute myeloid leukemia or juvenile myelomonocytic leukemia who had undergone allogeneic HSCT were genotyped of CTLA-4 gene for rs3087243 (CT60G>A), rs231775 (+ 49 A>G) and rs4553808 using TaqMan real-time polymerase chain reaction. RESULTS: We observed a significant association between the donor's CLTA-4 genotype of rs3087243 and TRM in children undergoing allogeneic HSCT. Genotype AG was found in 78 donors (51%), GG in 44 donors (29%) and 31 donors (20%) were homozygous for AA. 30 patients died as a result of transplant-related causes. Interestingly, we observed a significantly reduced TRM in children who were transplanted from a donor with the CTLA-4 genotype GG in comparison to genotype AG or AA (9 versus 19 versus 36%, P = 0.013). In addition, we found significant differences of event-free survival (EFS) depending on the donor's genotype. The EFS was 64, 46 or 32% if the patient was transplanted from a donor with CTLA-4 genotype GG, AG or AA, respectively (P = 0.043). In multivariate analysis, CTLA-4 genotype of rs3087243 was an independent risk factor for TRM (P = 0.011) and EFS (P = 0.035). CONCLUSION: This study provides first evidence that the CTLA-4 polymorphisms are significant risk factors for TRM and survival in children undergoing allogeneic HSCT and should be evaluated in further trials.
[Mh] Termos MeSH primário: Antígeno CTLA-4/genética
Doença Enxerto-Hospedeiro/genética
Doença Enxerto-Hospedeiro/mortalidade
Transplante de Células-Tronco Hematopoéticas/mortalidade
Leucemia/mortalidade
Leucemia/terapia
Polimorfismo de Nucleotídeo Único
Doadores de Tecidos
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Intervalo Livre de Doença
Feminino
Genótipo
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Seres Humanos
Leucemia/genética
Masculino
Estudos Retrospectivos
Transplante Homólogo/efeitos adversos
Transplante Homólogo/mortalidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (CTLA-4 Antigen); 0 (CTLA4 protein, human)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180117
[St] Status:MEDLINE
[do] DOI:10.1007/s00432-018-2578-8


  5 / 20262 MEDLINE  
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[PMID]:29325312
[Au] Autor:Wang WJ; Sun YQ; Tang FF; Han TT; Mo XD; Wang JZ; Zhang XH; Huang XJ; Xu LP
[Ad] Endereço:Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China.
[Ti] Título:[Outcomes of alternative donor allogeneic hematopoietic stem cell transplantation for Fanconi anemia: a five cases report].
[So] Source:Zhonghua Nei Ke Za Zhi;57(1):54-56, 2018 Jan 01.
[Is] ISSN:0578-1426
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Five patients with Fanconi anemia who received hematopoietic cell transplantation were retrospectively analyzed. The conditioning regimens included fludarabine, cyclophosphamide and anti-thymocyte globulin. Two patients received both bone marrow and peripheral blood stem cells as the source of stem cell grafts from haploidentical matched related donors, while the others received peripheral blood stem cells from unrelated donors. All patients tolerated well and reached hematopoietic reconstitution. One patient died of intracranial infection. During follow-up, 4 patients survived independent of transfusion with full donor chimerism.
[Mh] Termos MeSH primário: Anemia de Fanconi/terapia
Doença Enxerto-Hospedeiro/prevenção & controle
Transplante de Células-Tronco Hematopoéticas
Condicionamento Pré-Transplante
[Mh] Termos MeSH secundário: Soro Antilinfocitário/administração & dosagem
Soro Antilinfocitário/uso terapêutico
Medula Óssea
Ciclofosfamida/administração & dosagem
Ciclofosfamida/uso terapêutico
Seres Humanos
Estudos Retrospectivos
Resultado do Tratamento
Doadores não Relacionados
Vidarabina/análogos & derivados
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antilymphocyte Serum); 8N3DW7272P (Cyclophosphamide); FA2DM6879K (Vidarabine); P2K93U8740 (fludarabine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1426.2018.01.010


  6 / 20262 MEDLINE  
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[PMID]:29270985
[Au] Autor:Liu J; Bian Z; Wang X; Xu LP; Fu Q; Wang C; Chang YJ; Wang Y; Zhang XH; Jiang Z; Huang XJ
[Ad] Endereço:Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
[Ti] Título:Inverse correlation of Vδ2 T-cell recovery with EBV reactivation after haematopoietic stem cell transplantation.
[So] Source:Br J Haematol;180(2):276-285, 2018 01.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Epstein-Barr virus (EBV) reactivation remains a life-threatening complication in recipients of a haploidentical haematopoietic stem cell transplantation (haploHSCT). Reconstitution of adaptive T lymphocytes is generally compromised at the early stages following transplant, suggesting an important role of other effector cells in preventing EBV infection. Our previous studies demonstrated that recovery of CD4 CD8 T cells negatively correlated with EBV reactivation after haploHSCT. In this prospective study on 132 adult patients with haematopoietic malignancy, recovery of T-cell subpopulations was characterized post-haploHSCT. We showed that the median counts of peripheral Vδ2 cells were continuously lower in recipients with EBV reactivation compared with controls at 30, 60 and 90 days after haploHSCT (P values: 0·006, <0·001 and 0·019, respectively). Landmark study further indicated that the cumulative incidence of EBV reactivation was significantly decreased in recipients with higher day-30 Vδ2 counts. Activation of Vδ2 cells upon EBV reactivation was accompanied by an induction of cell apoptosis. Cytotoxic effect of Vδ2 cells on EBV-infected cells was confirmed by in vitro experiments. Together, our findings uncovered a significant correlation of recovered Vδ2 with EBV reactivation following haploHSCT. These results will help to better understand the intrinsic anti-virus immunity and develop γδ T-based therapy strategies after haematopoietic transplantation.
[Mh] Termos MeSH primário: Infecções por Vírus Epstein-Barr/etiologia
Genes Codificadores da Cadeia delta de Receptores de Linfócitos T
Transplante de Células-Tronco Hematopoéticas
Herpesvirus Humano 4/fisiologia
Linfócitos T/metabolismo
Ativação Viral
[Mh] Termos MeSH secundário: Adolescente
Adulto
Apoptose/genética
Apoptose/imunologia
Citotoxicidade Imunológica
Infecções por Vírus Epstein-Barr/diagnóstico
Feminino
Doença Enxerto-Hospedeiro/etiologia
Doença Enxerto-Hospedeiro/prevenção & controle
Antígenos HLA/genética
Antígenos HLA/imunologia
Haplótipos
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Seres Humanos
Incidência
Ativação Linfocitária/imunologia
Masculino
Meia-Idade
Linfócitos T/imunologia
Transplante Homólogo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (HLA Antigens)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.15037


  7 / 20262 MEDLINE  
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[PMID]:29205259
[Au] Autor:Mainardi C; Ebinger M; Enkel S; Feuchtinger T; Teltschik HM; Eyrich M; Schumm M; Rabsteyn A; Schlegel P; Seitz C; Schwarze CP; Müller I; Greil J; Bader P; Schlegel PG; Martin D; Holzer U; Döring M; Handgretinger R; Lang P
[Ad] Endereço:Department of Paediatric Oncology, Children's University Hospital, University of Padova, Padova, Italy.
[Ti] Título:CD34 selected stem cell boosts can improve poor graft function after paediatric allogeneic stem cell transplantation.
[So] Source:Br J Haematol;180(1):90-99, 2018 01.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Poor graft function (PGF) is a severe complication of haematopoietic stem cell transplantation (HSCT) and administration of donor stem cell boosts (SCBs) represents a therapeutic option. We report 50 paediatric patients with PGF who received 61 boosts with CD34 selected peripheral blood stem cells (PBSC) after transplantation from matched unrelated (n = 25) or mismatched related (n = 25) donors. Within 8 weeks, a significant increase in median neutrophil counts (0·6 vs. 1·516 × 10 /l, P < 0·05) and a decrease in red blood cell and platelet transfusion requirement (median frequencies 1 and 7 vs. 0, P < 0·0001 and <0·001), were observed, and 78·8% of patients resolved one or two of their cytopenias. 36·5% had a complete haematological response. Median lymphocyte counts for CD3 , CD3 CD4 , CD19 and CD56 increased 8·3-, 14·2-, 22.- and 1·6-fold. The rate of de novo acute graft-versus-host disease (GvHD) grade I-III was only 6% and resolved completely. No GvHD grade IV or chronic GvHD occurred. Patients who responded to SCB displayed a trend toward better overall survival (OS) (P = 0·07). Thus, administration of CD34 selected SCBs from alternative donors is safe and effective. Further studies are warranted to clarify the impact on immune reconstitution and survival.
[Mh] Termos MeSH primário: Sobrevivência de Enxerto
Transplante de Células-Tronco Hematopoéticas
Células-Tronco Hematopoéticas
[Mh] Termos MeSH secundário: Adolescente
Adulto
Antígenos CD34/metabolismo
Linhagem da Célula
Criança
Pré-Escolar
Estudos de Coortes
Feminino
Doença Enxerto-Hospedeiro/etiologia
Hematopoese
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
Transplante de Células-Tronco Hematopoéticas/métodos
Células-Tronco Hematopoéticas/metabolismo
Seres Humanos
Lactente
Masculino
Prognóstico
Retratamento
Estudos Retrospectivos
Quimeras de Transplante
Condicionamento Pré-Transplante
Transplante Homólogo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antigens, CD34)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.15012


  8 / 20262 MEDLINE  
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[PMID]:29346409
[Au] Autor:Lee C; Haneuse S; Wang HL; Rose S; Spellman SR; Verneris M; Hsu KC; Fleischhauer K; Lee SJ; Abdi R
[Ad] Endereço:Kaiser Permanente Division of Research, Oakland, CA, United States of America.
[Ti] Título:Prediction of absolute risk of acute graft-versus-host disease following hematopoietic cell transplantation.
[So] Source:PLoS One;13(1):e0190610, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Allogeneic hematopoietic cell transplantation (HCT) is the treatment of choice for a variety of hematologic malignancies and disorders. Unfortunately, acute graft-versus-host disease (GVHD) is a frequent complication of HCT. While substantial research has identified clinical, genetic and proteomic risk factors for acute GVHD, few studies have sought to develop risk prediction tools that quantify absolute risk. Such tools would be useful for: optimizing donor selection; guiding GVHD prophylaxis, post-transplant treatment and monitoring strategies; and, recruitment of patients into clinical trials. Using data on 9,651 patients who underwent first allogeneic HLA-identical sibling or unrelated donor HCT between 01/1999-12/2011 for treatment of a hematologic malignancy, we developed and evaluated a suite of risk prediction tools for: (i) acute GVHD within 100 days post-transplant and (ii) a composite endpoint of acute GVHD or death within 100 days post-transplant. We considered two sets of inputs: (i) clinical factors that are typically readily-available, included as main effects; and, (ii) main effects combined with a selection of a priori specified two-way interactions. To build the prediction tools we used the super learner, a recently developed ensemble learning statistical framework that combines results from multiple other algorithms/methods to construct a single, optimal prediction tool. Across the final super learner prediction tools, the area-under-the curve (AUC) ranged from 0.613-0.640. Improving the performance of risk prediction tools will likely require extension beyond clinical factors to include biological variables such as genetic and proteomic biomarkers, although the measurement of these factors may currently not be practical in standard clinical settings.
[Mh] Termos MeSH primário: Doença Enxerto-Hospedeiro/etiologia
Neoplasias Hematológicas/terapia
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Feminino
Doença Enxerto-Hospedeiro/prevenção & controle
Seres Humanos
Meia-Idade
Curva ROC
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180119
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190610


  9 / 20262 MEDLINE  
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[PMID]:28746254
[Au] Autor:Powell MR; Davies BW
[Ad] Endereço:Department of Ophthalmology and Oculofacial Plastic and Reconstructive Surgery, Department of Ophthalmology, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, U.S.A.
[Ti] Título:Cicatricial Ectropion Secondary to Graft-Versus-Host Disease.
[So] Source:Ophthal Plast Reconstr Surg;34(1):e22-e23, 2018 Jan/Feb.
[Is] ISSN:1537-2677
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ocular complications of graft-versus-host disease are well documented. While skin changes due to graft-versus-host disease have been mentioned in the literature, cicatricial ectropion has not been previous reported. The authors present a case of a 31-year-old male with cicatricial ectropion secondary to graft-versus-host disease requiring treatment with a full thickness skin graft.
[Mh] Termos MeSH primário: Cicatriz/complicações
Ectrópio/etiologia
Pálpebras/cirurgia
Doença Enxerto-Hospedeiro/complicações
[Mh] Termos MeSH secundário: Adulto
Blefaroplastia
Cicatriz/diagnóstico
Cicatriz/cirurgia
Ectrópio/diagnóstico
Ectrópio/cirurgia
Pálpebras/patologia
Seres Humanos
Masculino
Transplante de Pele/métodos
Transplante de Células-Tronco/efeitos adversos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1097/IOP.0000000000000973


  10 / 20262 MEDLINE  
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[PMID]:29255911
[Au] Autor:Sadowska-Klasa A; Piekarska A; Prejzner W; Bieniaszewska M; Hellmann A
[Ad] Endereço:Department of Hematology and Transplantology, University Clinical Center, Medical University of Gdansk, Debinki 7, 80-952, Gdansk, Poland.
[Ti] Título:Colonization with multidrug-resistant bacteria increases the risk of complications and a fatal outcome after allogeneic hematopoietic cell transplantation.
[So] Source:Ann Hematol;97(3):509-517, 2018 Mar.
[Is] ISSN:1432-0584
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Composition of the gut microbiota seems to influence early complications of allogeneic hematopoietic cell transplantation (HCT) such as bacterial infections and acute graft-versus-host disease (GVHD). In this study, we assessed the impact of colonization with multidrug-resistant bacteria (MDRB) prior to HCT and the use of antibiotics against anaerobic bacteria on the outcomes of HCT. We retrospectively analyzed the data of 120 patients who underwent HCT for hematologic disorders between 2012 and 2014. Fifty-one (42.5%) patients were colonized with MDRB and 39 (32.5%) had infections caused by MDRB. Prior colonization was significantly correlated with MDRB infections (P < 0.001), especially bacteremia (P = 0.038). A higher incidence of MDRB infections was observed in patients with acute (P = 0.014) or chronic (P = 0.002) GVHD and in patients aged > 40 years (P = 0.002). Colonization had a negative impact on overall survival (OS) after HCT (64 vs. 47% at 24 months; P = 0.034) and infection-associated mortality (P < 0.001). Use of metronidazole was correlated with an increased incidence of acute GVHD (P < 0.001) and lower OS (P = 0.002). Patients colonized with MDRB are more susceptible to life-threatening infections. Colonization with virulent flora is the most probable source of neutropenic infection; therefore, information about prior positive colonization should be crucial for the selection of empiric antibiotic therapy. The use of metronidazole, affecting the biodiversity of the intestinal microbiome, seems to have a significant impact on OS and acute GVHD.
[Mh] Termos MeSH primário: Bacteriemia/mortalidade
Infecções Bacterianas/mortalidade
Farmacorresistência Bacteriana Múltipla
Doença Enxerto-Hospedeiro/mortalidade
Transplante de Células-Tronco Hematopoéticas/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Antibacterianos/uso terapêutico
Bacteriemia/etiologia
Infecções Bacterianas/complicações
Microbioma Gastrointestinal/fisiologia
Doença Enxerto-Hospedeiro/etiologia
Transplante de Células-Tronco Hematopoéticas/mortalidade
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Análise de Sobrevida
Condicionamento Pré-Transplante/métodos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.1007/s00277-017-3205-5



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