scholarly journals PIN30 Cost Analysis of Voriconazole Versus Itraconazole for Prophylaxis of Invasive Fungal Infection (IFI) in Allogeneic Hematopoietic Stem Cell Transplant (HSCT) in Canada, France, Germany, and the United States

2011 ◽  
Vol 14 (7) ◽  
pp. A270
Author(s):  
X. Gao ◽  
X. Ji ◽  
J.M. Stephens ◽  
H. Schlamm ◽  
M. Tarallo
Keyword(s):  
United States ◽  
Stem Cell ◽  
Cost Analysis ◽  
Fungal Infection ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
The United States ◽  
Cell Transplant ◽  
Hematopoietic Stem

scholarly journals Clostridium Difficile Infection in Hematopoietic Stem Cell Transplant Patients: A National Study

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 1988-1988
Author(s):  
Nivetha Vishnuvardhan ◽  
Ashutossh Naaraayan ◽  
Amrah Hasan ◽  
Stephen Jesmajian
Keyword(s):  
United States ◽  
Stem Cell ◽  
Clostridium Difficile ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
The United States ◽  
Cell Transplant ◽  
National Inpatient Sample ◽  
Hematopoietic Stem

Introduction Clostridium difficile infection (CDI) is the leading cause of infectious diarrhea among hospitalized patients. Patients undergoing hematopoietic stem-cell transplant (HSCT), either autologous stem cell transplant (Auto-SCT) or allogeneic stem cell transplant (Allo-SCT), are at high risk for CDI. We aim to describe the incidence and epidemiological trends for CDI in Auto-SCT and Allo-SCT in the United States, using the National Inpatient Sample (NIS) database provided by Healthcare Cost and Utilization Project (HCUP). Methods A descriptive, retrospective study was conducted on the National Inpatient Sample (NIS) Database for the years 2005-2014. Admissions with diagnosis of CDI were selected based on International Classification of Diseases-Ninth Revision (ICD-9), Clinical Modification diagnoses codes (00845). ICD-9 procedure codes were used to identify HSCT hospitalizations (autologous: 4101, 4104, 4107, and 4109; allogeneic: 4102, 4103, 4105, 4106, and 4108). Complex survey design, weights and clustering were accounted for during analysis. Results The mean age of patients undergoing HSCT was 45.69 + 20.35 years and 41.13% were female. There were total of 89,374 Auto-SCT patients and 66,044 Allo-SCT patients hospitalized between 2005-2014. Auto-SCTs constituted 55.5% of all the HSCTs. The incidence of Auto-SCT related hospitalizations increased from 205 per million admissions (pma) in 2005 to 291 pma in 2014 with an annual percentage change (APC) of 5.8, p<0.001. During the same period the incidence of Allo-SCT related hospitalizations increased from 151 pma to 224 pma with and APC of 6.3, p<0.001. Overall 6.67% of patients with Auto-SCT and 9.96% of Allo-SCT were diagnosed with CDI. There were statistically higher CDI rates in Allo-SCT when compared to Auto-SCT (p<0.001). The incidence of CDI in Auto-SCT patients showed a non-significant decrease from 2005-2009 and a significant increase from 2009-2014 (APC 7, p<0.001). The incidence of CDI in Allo-SCT patients increased significantly from 2005 to 2014 with an APC of 5.9, p<0.001. Conclusion The number of individuals being hospitalized for HSCTs in the United States is increasing and this increase is seen for both Auto-SCT and Allo-SCT procedures. One in fifteen patients undergoing Auto-SCT and one in ten patients undergoing Allo-SCT were diagnosed with CDI during hospitalization. There were significantly more CDIs in patients with Allo-SCT when compared to Auto-SCTs. The incidence of CDI in patients undergoing both Autologous and Allogeneic HSCT increased from 2005-2014 in the United States. Disclosures No relevant conflicts of interest to declare.

scholarly journals High on Cannabis and Calcineurin Inhibitors: A Word of Warning in an Era of Legalized Marijuana

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Naomi Hauser ◽  
Tanmay Sahai ◽  
Rocco Richards ◽  
Todd Roberts
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
T Cell Activation ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
The United States ◽  
Solid Organ ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Cytochrome P 450

Tacrolimus, a potent immunosuppressant medication, acts by inhibiting calcineurin, which eventually leads to inhibition of T-cell activation. The drug is commonly used to prevent graft rejection in solid organ transplant and graft-versus-host disease in hematopoietic stem cell transplant patients. Tacrolimus has a narrow therapeutic index with variable oral bioavailability and metabolism via cytochrome P-450 3A enzyme. Toxicity can occur from overdosing or from drug-drug interactions with the simultaneous administration of cytochrome P-450 3A inhibitors and possibly P-glycoprotein inhibitors. Tacrolimus toxicity can be severe and may include multiorgan damage. We present a case of suspected tacrolimus toxicity in a postallogeneic hematopoietic stem cell transplant patient who was concurrently using oral marijuana. This case represents an important and growing clinical scenario with the increasing legalization and use of marijuana throughout the United States.

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