Outbreak ofStenotrophomonas maltophiliaBacteremia Among Patients Undergoing Bone Marrow Transplantation: Association With Faulty Replacement of Handwashing Soap

1999 ◽  
Vol 20 (11) ◽  
pp. 756-758 ◽  
Author(s):  
Jeffrey D. Klausner ◽  
Carol Zukerman ◽  
Ajit P. Limaye ◽  
Lawrence Corey
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Healthcare Worker ◽  
Molecular Typing ◽  
Marrow Transplantation ◽  
Stenotrophomonas Maltophilia ◽  
Marrow Transplant ◽  
Hand Washing ◽  
Transplant Patients ◽  
Typing Methods

AbstractUsing molecular typing methods, we confirmed an outbreak ofStenotrophomonas maltophiliaamong bone marrow transplant patients. The likely source was a healthcare worker who may have washed with moisturizer instead of soap between patients. Hospital epidemiologists need to go beyond antibiograms when evaluating outbreaks and be vigilant about all aspects of hand washing.

scholarly journals Fatal Fulminant Hepatic Failure from Adenovirus in Allogeneic Bone Marrow Transplant Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Jatin M. Vyas ◽  
Wayne A. Marasco
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Fulminant Hepatic Failure ◽  
Hepatic Failure ◽  
Marrow Transplantation ◽  
Marrow Transplant ◽  
Allogeneic Bone ◽  
Transplant Patients ◽  
Liver Functions ◽  
Extensive Necrosis

We report two cases of fatal hepatic failure in patients who received matched unrelated bone marrow transplantation. Both patients presented with high fevers, abnormal liver functions tests, and hypodense lesions in the liver by CT scan. Histologic examination of postmortem liver samples demonstrated extensive necrosis, and immunohistochemistry was positive for adenovirus.

scholarly journals Bone marrow transplant nephropathy: a case report and review of the literature.

1997 ◽  
Vol 8 (1) ◽  
pp. 166-173
Author(s):  
D N Cruz ◽  
M A Perazella ◽  
R L Mahnensmith
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Bone Marrow Transplant ◽  
Renal Injury ◽  
Marrow Transplantation ◽  
Marrow Transplant ◽  
Subsequent Treatment ◽  
Pathologic Features ◽  
Uremic Syndrome ◽  
Effects Of Radiation

Bone marrow transplantation can be complicated by renal failure resulting from a variety of causes. Early renal injury most often results from infection and its subsequent treatment with nephrotoxic medications. Late renal injury after bone marrow transplantation is characterized by a syndrome similar to the hemolytic uremic syndrome. This renal syndrome, called "bone marrow transplant nephropathy," is thought to evolve from the late effects of radiation therapy and cytotoxic chemotherapy on the kidney. In this article, a case of bone marrow transplant nephropathy and a review of the clinical and pathologic features are presented.

Recipient immune-competent T lymphocytes can survive intensive conditioning for bone marrow transplantation

Blood ◽  
1986 ◽  
Vol 68 (4) ◽  
pp. 954-956 ◽  
Author(s):  
A Butturini ◽  
RC Seeger ◽  
RP Gale
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
T Lymphocytes ◽  
Graft Rejection ◽  
Marrow Transplantation ◽  
Interleukin 2 ◽  
Marrow Transplant ◽  
Effector Cells ◽  
And Function

Abstract Bone marrow transplantation is usually preceded by intensive chemotherapy and radiation therapy designed to completely eliminate recipient immune-competent cells that might reject the donor bone marrow. We show that seven of 14 bone marrow transplant recipients who received intensive conditioning retained circulating T lymphocytes that proliferate after incubation with interleukin 2 and phytohemagglutinin and function as effector cells in an in vitro model of graft rejection. These T cells may mediate graft rejection.

scholarly journals Donor leukocyte transfusions for treatment of recurrent chronic myelogenous leukemia in marrow transplant patients

Blood ◽  
1990 ◽  
Vol 76 (12) ◽  
pp. 2462-2465 ◽  
Author(s):  
HJ Kolb ◽  
J Mittermuller ◽  
C Clemm ◽  
E Holler ◽  
G Ledderose ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Chronic Myelogenous Leukemia ◽  
Adoptive Immunotherapy ◽  
Marrow Transplant ◽  
Buffy Coat ◽  
Myelogenous Leukemia ◽  
Graft Versus Host ◽  
Transplant Patients ◽  
Cytogenetic Remission

Abstract Three patients with hematologic relapse after bone marrow transplantation for chronic myelogenous leukemia were treated with interferon alpha and transfusion of viable donor buffy coat. All had complete hematologic and cytogenetic remission, which persisted 32 to 91 weeks after treatment. In two patients graft-versus-host disease developed and was treated by immunosuppression. These results are an example of adoptive immunotherapy without cytoreductive chemotherapy or radiotherapy in human chimeras.

A Single Center Survey of Distress Amongst Stem Cell Transplant Recipients

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 6006-6006
Author(s):  
Mark J. Fesler ◽  
Crystal Weaver ◽  
Kimberly McCormick ◽  
Andrew Dwiggins
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Trait Anxiety ◽  
State Anxiety ◽  
Marrow Transplantation ◽  
Marrow Transplant ◽  
Medical Visit ◽  
Medical Visits ◽  
Blood And Marrow Transplant ◽  
Preparative Regimen

Abstract Introduction: According to the Commission on Cancer's 2012 program standards, patients diagnosed with cancer may experience psychological issues that can interfere with patient treatment plans and adversely affect outcomes. To address these issues, the Commission developed the following guidelines to accurately determine patient distress levels: 1) patients with cancer are offered screening for distress at least 1 time during a pivotal medical visit, 2) the mode of administration for the distress screening is to be determined by the program, and 3) facilities select the tool to be administered to screen for distress with preference being given to standardized, validated instruments. To meet this standard and plan future work in distress reduction for stem cell transplant recipients, the St. Louis University Blood and Marrow Transplant Program began implementing The State Trait Anxiety Inventory (STAI) with patients during pivotal medical visits. The STAI is a psychological inventory based on a 4-point Likert scale and consists of 40 questions on a self-report basis. The STAI differentiates between the temporary condition of "state anxiety" and the long-standing quality of "trait anxiety." The essential qualities evaluated by the STAI scale are feelings of apprehension, tension, nervousness, stress, and worry. Scores on the STAI scale increase in response to physical danger and psychological stress and decrease as a result of relaxation training. Average scores for working, male adults are 35.72 (state) and 34.89 (trait). Average scores for working, female adults are 35.20 (state) and 34.79 (trait). After implementing the STAI, it was realized that these screenings could be de-identified and analyzed in groups to determine if patterns emerged regarding patients' perceived anxiety levels throughout the bone marrow transplantation process. Method: The study team received Institutional Review Board approval to perform a retrospective examination of STAIs completed by patients throughout the bone marrow transplantation process at the St. Louis University Blood and Marrow Transplant Program from 03/11/2104 through 06/24/2014. A total of 30 inventories were collected, de-identified, and categorized by the following medical visits: arrival visit (the patient's first visit to the Blood and Marrow Transplant clinic), data review visit (the visit to review transplant related testing and sign consents), start of preparative regimen visit, day 0 visit, day +30 bone marrow biopsy visit for allogenic transplantation, day +30 bone marrow biopsy result visit for allogenic transplantation, and day +100 visit for auto transplantation. Averages for each medical visit category were determined by finding the mean score. Category averages were then compared to determine if a particular pivotal medical visit caused patients to experience an overall increase in anxiety level. Results: Results from the study indicate that patients experience the highest levels of anxiety during the early medical visits of the bone marrow transplantation process. Average state anxiety scores were 46 during the arrival visits, 41 during the data review visits, and 44 during the start of preparative regimen visits. Average trait anxiety scores were 38 during the arrival visits, 45 during the data review visits, and 39 during the start of preparative regimen visits. During the day 0 visits, patients' state anxiety scores decreased to an average of 36 and trait anxiety scores decreased to an average of 35. Day +30 and day +100 visits demonstrated even further decreases in state and trait anxiety scores. Conclusion: The surprising finding of this study was that patients demonstrated a higher level of distress in the period leading up to the transplant which gradually decreased once the preparative regimen was administered. The sample size for this study was small and could possibly skew results. However, this study does provide a starting basis for future study in bone marrow transplant recipient distress, and larger, multi-site studies are being planned to ensure the accuracy of the patterns, which emerged from this study. If patterns could be accurately identified and predicted, the study team may also be able to develop future studies to primitively lower patients' anxiety levels early in the bone marrow transplantation process and thus improve outcomes. Abstract 6006 Figure 1 Abstract 6006 Figure 1. Disclosures No relevant conflicts of interest to declare.

Psychiatric Aspects of Renal Transplantation

1989 ◽  
Vol 23 (3) ◽  
pp. 407-417 ◽  
Author(s):  
Gregory L. Fricchione
Keyword(s):  
Bone Marrow ◽  
Renal Transplantation ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Organ Donors ◽  
Transplant Patients ◽  
Body Of Knowledge

Despite the growth of heart, liver and bone marrow transplantation, the kidney continues to be the organ most frequently transplanted. Over the years psychiatrists have been active in attempting to understand the adaptational tasks of organ donors and recipients and in evaluating and treating transplant patients. A body of knowledge with regard to renal transplantation has developed. What follows is an update of psychiatric aspects of renal transplantation.

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