scholarly journals Peri-transplant clostridium difficile infections in patients undergoing allogeneic hematopoietic progenitor cell transplant

2016 ◽  
Vol 91 (3) ◽  
pp. 291-294 ◽  
Author(s):  
Aya Agha ◽  
Alison Sehgal ◽  
Matthew J. Lim ◽  
David Weber ◽  
Jing-Zhou Hou ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Progenitor Cell ◽  
Hematopoietic Progenitor Cell ◽  
Cell Transplant ◽  
Hematopoietic Progenitor

scholarly journals Mobilization of hematopoietic progenitor cells for autologous transportation: consensus recommendations

2016 ◽  
Vol 62 (suppl 1) ◽  
pp. 10-15 ◽  
Author(s):  
Fernando Barroso Duarte ◽  
Benedito de Pina Almeida Prado ◽  
Garles Miller Matias Vieira ◽  
Luciano J. Costa
Keyword(s):  
Bone Marrow ◽  
Progenitor Cells ◽  
Blood Circulation ◽  
Progenitor Cell ◽  
National Health System ◽  
Hematopoietic Progenitor Cell ◽  
Cell Transplant ◽  
Hematopoietic Progenitor ◽  
Term Survival

SUMMARY Selected patients with certain hematological malignancies and solid tumors have the potential to achieve long-term survival with autologous hematopoietic progenitor cell transplant. The collection of these cells in peripheral blood avoids multiple bone marrow aspirations, results in faster engraftment and allows treatment of patients with infection, fibrosis, or bone marrow hypocellularity. However, for the procedure to be successful, it is essential to mobilize a sufficient number of progenitor cells from the bone marrow into the blood circulation. Therefore, a group of Brazilian experts met in order to develop recommendations for mobilization strategies adapted to the reality of the Brazilian national health system, which could help minimize the risk of failure, reduce toxicity and improve the allocation of financial resources.

Factors that predict successful remobilization after autologous hematopoietic progenitor cell transplant (aHCT) for multiple myeloma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8610-8610
Author(s):  
Xenofon Dimitrios Papanikolaou ◽  
Eric Rosenbaum ◽  
Lisa Tyler ◽  
Bart Barlogie ◽  
Michele Cottler-Fox
Keyword(s):  
Multiple Myeloma ◽  
Progenitor Cell ◽  
Median Number ◽  
Therapeutic Modality ◽  
Hematopoietic Progenitor Cell ◽  
Cell Transplant ◽  
Hematopoietic Progenitor ◽  
Storage Methods ◽  
Treatment Related Mortality ◽  
Related Mortality

8610 Background: aHCT is a proven therapeutic modality in treating relapsed multiple myeloma (MM). However, previously transplanted patients may have no hematopoietic progenitor cells (HPC) left in storage. Methods: Collection of HPC after aHCT was studied in 221 MM patients who underwent 333 mobilization attempts between 10/2000 and 06/2012. Results: The median number of CD34+ collected was 4.7 ×106/kg, with 74% of collections yielding at least 2.5×106/kg. Mobilization with chemotherapy and G-CSF was most efficient, yielding a median of 6.84×106/kg (p<0.001). Growth factor-only mobilization was least effective, with a median of 3.01×106/kg (p<0.001). The addition of plerixafor yielded a significant increase if there was a previous “poor” (<2.5×106/kg) collection (1.83 vs. 3.43×106/kg, p<0.001). In univariate statistical analysis female sex (p=0.048), platelets (PLT) ≤100×106/L (p<0.001), hemoglobin ≤11g/dL (p=0.032), and albumin ≤3.5 g/dL (p=0.003) prior to mobilization correlated with a “poor” collection. In multivariate analysis only PLT ≤100×106/L was significant (p<0.001). Of the 221 patients collected, 154 underwent subsequent aHCT. Infusion of HPC procured after previous aHCT did not yield a difference in treatment-related mortality (p=0.766). Use of only cells collected after aHCT was related to a delayed platelet engraftment ≥50×106/L (p<0.001). Conclusions: Remobilization and collection of an adequate number of HPC after previous aHCT is feasible. PLT ≤100×106/L suggest the need for plerixafor for a successful collection. Infusion of the graft procured is safe and effective, but use of only cells collected after aHCT is associated with delayed platelet engraftment >50×106/L.

Autologous Hematopoietic Progenitor Cell Transplant in Patients with Multiple Myeloma in Hospital Central Sur De Alta Especialidad in Petróleos Mexicanos

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5912-5912
Author(s):  
Patricio Azaola
Keyword(s):  
Multiple Myeloma ◽  
Partial Response ◽  
Progenitor Cell ◽  
Conflicts Of Interest ◽  
Autologous Transplantation ◽  
Complete Response ◽  
Hematopoietic Progenitor Cell ◽  
Cell Transplant ◽  
Hematopoietic Progenitor ◽  
Petroleos Mexicanos

INTRODUCTION Multiple Myeloma (MM) is a clonal B cells disorder producing an accumulation of plasmatic abnormal cells and abnormal light or heavy immunoglobulines. The onset of multiple myeloma is usually insidious, and the subclinical phase may vary in duration from 1 to 3 years. Bone pain is the most frequent initial feature and 60% of patients present with this symptom. Other clinical features may result from anaemia, uraemia, hypercalcaemia, infections, paraplegia, hyperviscosity syndrome and sensorimotor peripheral neuropathies. It accounts for approximately 1% of all neoplastic diseases and 10% of haematological malignancies. The sex incidence of myeloma is approximately equal until the age of 65 years, after which it is somewhat more common in men than in women. The incidence is approximately 3.8 per 100,000 population, it is lower in the white than the black population. In the last decades different treatments have been described with 60 to 80% of complete response, nevertheless disease free survival rate goes from 22 to 50% in the best treatment international centers. That is why autologous transplantation has been used in patients below 65 years old with very good response. OBJECTIVE Describe the experience of patients treated with autologous hematopoietic progenitor cell transplant with diagnosis of Multiple Myeloma in Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos (PEMEX). MATERIAL AND METHODS We analyzed clinical data of patients with diagnosis of Multiple Myeloma that were transplanted from april 2008 to may 2014. RESULTS Ten patients were studied, three of them were over 65 years. Only 7 patients were considered for autologous hematopoietic progenitor cell transplantation, there ages were from 40 to 55 years with a median of 46 years. Transplants were performed from april 2008 to may 2014, 66% were men and 34% women. 66% were IgG and 18% IgA. Presence of Bence-Jones protein without monoclonal peak was found in 16% of the patients. In regard to prognosis index 66% were ISS-I and 34% were ISS-I. Cytogenetic studies were not performed because we did not have molecular cytogenetics so we could not perform the usual FISH translocations described in this disease. One hundred percent of the patients received the first line treatment with dexamethasone, cyclophosphamide, thalidomide and bortezomib. Only one patient received radiotherapy because he had a tumor in the leg, before the transplant was done 68% had complete response and 16 % partial response. Six autologous transplants were doned with conditioning by giving melphalan 200 mg/m2 orally because we did not have IV presentation. The 7 transplanted patients are alive and 71% had complete response and 29% had partial response. Patients that were transplanted responded 11 or 12 days after the transplant. CONCLUSIONS Patients with multiple myeloma that were transplanted were below 46 years, there were below the age reported in the literature, the predominant gender was masculine (2:1). The majority was IgG. The overall survival after the transplant was 40 months (72-6), the most common complication associated to transplant was fever and neutropenia and only in 16% of the patients we could isolate the germ. The patients are currently alive and in complete remission until june 2014. We think that this is the most adequate actual treatment for patients with Multiple Myeloma. We found in the literature that lenalidomide, carfilzomib and dexamethasone may achieve the same response that autologous hematopoietic cell transplant but the results are still in intense investigation. Disclosures No relevant conflicts of interest to declare.

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