scholarly journals The Economic Costs to US Hospitals of Invasive Fungal Infections in Hematopoietic Stem Cell and Bone Marrow Transplant Patients

2009 ◽  
Vol 15 (2) ◽  
pp. 7
Author(s):  
J. Menzin ◽  
J.L. Jackel ◽  
M. Friedman ◽  
J.R. Korn ◽  
J. Perfect ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Bone Marrow Transplant ◽  
Hematopoietic Stem Cell ◽  
Fungal Infections ◽  
Marrow Transplant ◽  
Invasive Fungal Infections ◽  
Economic Costs ◽  
Hematopoietic Stem ◽  
Transplant Patients

scholarly journals Fungal infections in hematopoietic stem-cell transplant patients: a review of epidemiology, diagnosis, and management

2021 ◽  
Vol 8 ◽  
pp. 204993612110390
Author(s):  
Mandeep Singh Rahi ◽  
Vishal Jindal ◽  
Prachi Pednekar ◽  
Jay Parekh ◽  
Kulothungan Gunasekaran ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Fungal Infections ◽  
Marrow Transplant ◽  
Invasive Fungal Infections ◽  
Cell Transplant ◽  
Hematopoietic Stem

The advent of bone marrow transplant has opened doors to a different approach and offered a new treatment modality for various hematopoietic stem-cell-related disorders. Since the first bone marrow transplant in 1957, there has been significant progress in managing patients who undergo bone marrow transplants. Plasma-cell disorders, lymphoproliferative disorders, and myelodysplastic syndrome are the most common indications for hematopoietic stem-cell transplant. Despite the advances, invasive fungal infections remain a significant cause of morbidity and mortality in this high-risk population. The overall incidence of invasive fungal infection in patients with hematopoietic stem-cell transplant is around 4%, but the mortality in patients with allogeneic stem-cell transplant is as high as 13% in one study. Type of stem-cell transplant, conditioning regimen, and development of graft- versus-host disease are some of the risk factors that impact the risk and outcomes in patients with invasive fungal infections. Aspergillus and candida remain the two most common organisms causing invasive fungal infections. Molecular diagnostic methods have replaced some traditional methods due to their simplicity of use and rapid turnaround time. Primary prophylaxis has undoubtedly shown to improve outcomes even though breakthrough infection rates remain high. The directed treatment has seen a significant shift from amphotericin B to itraconazole, voriconazole, and echinocandins, which have shown better efficacy and fewer adverse effects. In this comprehensive review, we aim to detail epidemiology, risk factors, diagnosis, and management, including prophylaxis, empiric and directed management of invasive fungal infections in patients with hematopoietic stem-cell transplant.

Invasive fungal infections in pediatric hematopoietic stem cell transplant patients

2015 ◽  
Vol 47 (4) ◽  
pp. 218-224 ◽  
Author(s):  
Tiffany Simms-Waldrip ◽  
Galit Rosen ◽  
Karin Nielsen-Saines ◽  
Alan Ikeda ◽  
Berkley Brown ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Transplant Patients

scholarly journals Noninvasive Tracking of Hematopoietic Stem Cells in a Bone Marrow Transplant Model

Cells ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 939
Author(s):  
Fernando A. Oliveira ◽  
Mariana P. Nucci ◽  
Igor S. Filgueiras ◽  
João M. Ferreira ◽  
Leopoldo P. Nucci ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Bone Marrow Transplant ◽  
Hematopoietic Stem Cell ◽  
Marrow Transplant ◽  
Hematopoietic Progenitor Cell ◽  
Emission Computed Tomography ◽  
Cell Renewal ◽  
Hematopoietic Stem ◽  
Transplant Model

The hematopoietic stem cell engraftment depends on adequate cell numbers, their homing, and the subsequent short and long-term engraftment of these cells in the niche. We performed a systematic review of the methods employed to track hematopoietic reconstitution using molecular imaging. We searched articles indexed, published prior to January 2020, in PubMed, Cochrane, and Scopus with the following keyword sequences: (Hematopoietic Stem Cell OR Hematopoietic Progenitor Cell) AND (Tracking OR Homing) AND (Transplantation). Of 2191 articles identified, only 21 articles were included in this review, after screening and eligibility assessment. The cell source was in the majority of bone marrow from mice (43%), followed by the umbilical cord from humans (33%). The labeling agent had the follow distribution between the selected studies: 14% nanoparticle, 29% radioisotope, 19% fluorophore, 19% luciferase, and 19% animal transgenic. The type of graft used in the studies was 57% allogeneic, 38% xenogeneic, and 5% autologous, being the HSC receptor: 57% mice, 9% rat, 19% fish, 5% for dog, porcine and salamander. The imaging technique used in the HSC tracking had the following distribution between studies: Positron emission tomography/single-photon emission computed tomography 29%, bioluminescence 33%, fluorescence 19%, magnetic resonance imaging 14%, and near-infrared fluorescence imaging 5%. The efficiency of the graft was evaluated in 61% of the selected studies, and before one month of implantation, the cell renewal was very low (less than 20%), but after three months, the efficiency was more than 50%, mainly in the allogeneic graft. In conclusion, our review showed an increase in using noninvasive imaging techniques in HSC tracking using the bone marrow transplant model. However, successful transplantation depends on the formation of engraftment, and the functionality of cells after the graft, aspects that are poorly explored and that have high relevance for clinical analysis.

scholarly journals Voriconazole Monitoring in Children with Invasive Fungal Infections

2015 ◽  
Vol 20 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Lyn Tucker ◽  
Tara Higgins ◽  
Eric F. Egelund ◽  
Baiming Zou ◽  
Vini Vijayan ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Pediatric Oncology ◽  
Trough Concentration ◽  
Fungal Infections ◽  
Dose Range ◽  
Marrow Transplant ◽  
Invasive Fungal Infections ◽  
Transplant Patients ◽  
Trough Concentrations

OBJECTIVES: The primary objective of this study was to determine the optimal daily dose of voriconazole required to achieve therapeutic trough concentrations in children 1 month to 18 years of age. The secondary objective was to analyze the association between voriconazole trough concentrations and clinical and microbiological outcomes, toxicity, and mortality. METHODS: This study was a retrospective chart review (October 2009 to August 2012) of pediatric oncology/bone marrow transplant patients with proven or probable invasive fungal infections treated with intravenous or oral voriconazole. Patients were excluded if they were older than 18 years of age, had no voriconazole concentrations drawn during the study period, or received voriconazole prior to the study period. RESULTS: Thirty-four patients were reviewed; 11 patients met all criteria for inclusion. There were 6 males and 5 females, with a median age of 8 years (range: 0.8–14.8) and a median weight of 27 kg (range: 9–74). Doses were adjusted to a median 6 mg/kg/dose (range: 3–8.7 mg/kg/dose) given every 8 (n = 5) to 12 (n = 6) hours; dose regimens varied greatly. All but 1 child achieved a voriconazole trough concentration above 1 mg/L; 7 children had a trough concentration above 2 mg/L. The median time to achieve a therapeutic trough concentration was 11 days (range: 6–37 days). Therapy failed for 4 of 11 patients, including 3 of the 4 youngest patients (p=0.022). Three of the 4 for whom therapy failed also had voriconazole trough concentrations less than 2 mg/L; this did not reach statistical significance. Voriconazole therapy was discontinued in 2 patients due to toxicity. CONCLUSIONS: This study confirmed that voriconazole pharmacokinetics vary greatly in pediatric oncology/bone marrow transplant patients. “Optimal” doses varied over nearly a 3-fold range. Younger patients may be at greater risk of poor outcomes and may require additional monitoring and dose adjustment.

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