scholarly journals Does High‐Dose Prophylactic Acyclovir Add Benefit in Allogeneic Marrow Transplant Recipients Receiving Prophylactic or Preemptive Ganciclovir?

1999 ◽  
Vol 180 (2) ◽  
pp. 571-572 ◽  
Author(s):  
R. de la Cámara ◽  
J. M. Fernández‐Rañada
Keyword(s):  
Marrow Transplant ◽  
High Dose ◽  
Transplant Recipients ◽  
Allogeneic Marrow

scholarly journals Foscarnet for prevention of cytomegalovirus infection in allogeneic marrow transplant recipients unable to receive ganciclovir

1997 ◽  
Vol 20 (6) ◽  
pp. 491-495 ◽  
Author(s):  
C Ippoliti ◽  
A Morgan ◽  
D Warkentin ◽  
K van Besien ◽  
R Mehra ◽  
...  
Keyword(s):  
Cytomegalovirus Infection ◽  
Marrow Transplant ◽  
Transplant Recipients ◽  
To Receive ◽  
Allogeneic Marrow

scholarly journals Transfusion support using filtered unscreened blood products for cytomegalovirus-negative allogeneic marrow transplant recipients

1998 ◽  
Vol 22 (6) ◽  
pp. 575-577 ◽  
Author(s):  
AB Narvios ◽  
D Przepiorka ◽  
J Tarrand ◽  
K-W Chan ◽  
R Champlin ◽  
...  
Keyword(s):  
Marrow Transplant ◽  
Transplant Recipients ◽  
Blood Products ◽  
Allogeneic Marrow

Second allogeneic marrow transplantation for patients with recurrent leukemia after initial transplant with total-body irradiation-containing regimens.

1993 ◽  
Vol 11 (2) ◽  
pp. 304-313 ◽  
Author(s):  
J P Radich ◽  
J E Sanders ◽  
C D Buckner ◽  
P J Martin ◽  
F B Petersen ◽  
...  
Keyword(s):  
Total Body Irradiation ◽  
Marrow Transplantation ◽  
Acute Gvhd ◽  
High Dose Chemotherapy ◽  
Marrow Transplant ◽  
Myelogenous Leukemia ◽  
High Dose ◽  
Allogeneic Marrow Transplantation ◽  
Total Body ◽  
Allogeneic Marrow

PURPOSE The impact of a second marrow transplant on long-term disease-free survival (DFS) was evaluated for 77 consecutive patients aged 2 to 51 years who relapsed subsequent to allogeneic marrow transplantation after high-dose chemotherapy and total-body irradiation (TBI). PATIENTS AND METHODS Patients received a second transplant for recurrent chronic myelogenous leukemia (CML) (n = 28), acute myelogenous leukemia (AML) (n = 32), and acute lymphoblastic leukemia (ALL) (n = 15) or lymphoma (n = 2) that used the same marrow donor as the initial transplant. High-dose chemotherapy of busulfan (BU) and cyclophosphamide (CY), or CY, carmustine (BCNU), and etoposide (VP-16), was used as a preparative regimen for the second transplant. Graft-versus-host disease (GVHD) prophylaxis consisted of the following: no prophylaxis (n = 8), T-cell depletion (n = 36), methotrexate (MTX) only (n = 21), cyclosporine (CSP) only (n = 1), MTX and CSP (n = 9), or anti-thymocyte globulin (ATG) and prednisone (n = 2). RESULTS Engraftment occurred in the 74 assessable patients. Severe veno-occlusive disease (VOD) was the most frequent cause of grades 3 and 4 regimen-related toxicity (RRT); it occurred in 20 patients. The probability of death before day 100 from nonleukemic causes was 36%. The probability of relapse after second transplant was 70%, and the DFS rate was 14% (median DFS, 36 months; range, 22 to 87). The DFS rates for ALL, AML, and CML were 8%, 10%, and 25%, respectively. Multivariate analysis showed that the risk of relapse was inversely associated with acute GVHD (relative risk [RR] of relapse = 0.2; P = .0009). No other factor was associated with relapse. DFS was associated with the presence of acute GVHD (RR of treatment failure = 0.5; P = .0085), and a reduction of DFS was associated with severe VOD (RR = 10.6; P = .0001) and those patients older than 10 years (RR = 2.5; P = .0337). CONCLUSION These data show that some patients may benefit from a second marrow transplant for recurrent leukemia after an initial marrow transplant. Younger patients and patients with CML especially should be considered as potential candidates for a second transplant.

scholarly journals Neutropenia in Allogeneic Marrow Transplant Recipients Receiving Ganciclovir for Prevention of Cytomegalovirus Disease: Risk Factors and Outcome

Blood ◽  
1997 ◽  
Vol 90 (6) ◽  
pp. 2502-2508 ◽  
Author(s):  
Bernd Salzberger ◽  
Raleigh A. Bowden ◽  
Robert C. Hackman ◽  
Chris Davis ◽  
Michael Boeckh
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Serum Creatinine ◽  
Elevated Serum ◽  
Significant Risk ◽  
Marrow Transplant ◽  
Transplant Recipients ◽  
Elevated Serum Creatinine ◽  
Marrow Cellularity ◽  
Allogeneic Marrow

Abstract To determine risk factors, frequency, time patterns, and outcome of ganciclovir-related neutropenia in allogeneic marrow transplant recipients, 278 consecutive patients receiving ganciclovir from engraftment until day 100 were studied. In this cohort, 159 patients (57%) had absolute neutrophil counts (ANC) less than 1,500/μL, 112 (41%) had an ANC less than 1,000/μL, 87 (31%) less than 750/μL, and 56 (21%) less than 500/μL for at least 2 consecutive days. Statistically significant risk factors for neutropenia in a Cox model were low marrow cellularity between day 21 and 28 (relative risk [RR] 2.4, P = .0002), hyperbilirubinemia ≥6 mg/dL during the first 20 days (RR 2.5, P = .0001), and elevation of serum creatinine ≥2 mg/dL after day 21 after transplant (RR 2.1, P = .001). Restriction to factors present at engraftment resulted in a similar model with low marrow cellularity, hyperbilirubinemia ≥6 mg/dL, and elevated serum creatinine as significant risk factors. Patients with no risk factor had an incidence of neutropenia of 21%, an incidence of 31% for one risk factor, and of 57% for two or more risk factors (RR 3.8, P = .001). Neutropenia was a negative predictor of overall (RR 2.0, P = .0001) and event-free survival (RR 2.1, P < .0001), and a predictor of relapse (RR 1.7, P = .03) and nonrelapse mortality (RR 2.1, P = .003). Thus, early liver dysfunction, elevated serum creatinine, and low marrow cellularity are risk factors for ganciclovir-related neutropenia. Neutropenia in ganciclovir recipients after marrow transplantation is an independent risk factor for mortality.

Early infectious complications in allogeneic marrow transplant recipients with acute leukemia: Effects of prophylactic measures

Infection ◽  
1983 ◽  
Vol 11 (5) ◽  
pp. 243-250 ◽  
Author(s):  
C. D. Buckner ◽  
R. A. Clift ◽  
E. D. Thomas ◽  
J. Hersman ◽  
J. E. Sanders ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Marrow Transplant ◽  
Infectious Complications ◽  
Transplant Recipients ◽  
Prophylactic Measures ◽  
Allogeneic Marrow
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