scholarly journals Clinical and genetic spectrum of mitochondrial neurogastrointestinal encephalomyopathy

Brain ◽  
2011 ◽  
Vol 134 (11) ◽  
pp. 3326-3332 ◽  
Author(s):  
Caterina Garone ◽  
Saba Tadesse ◽  
Michio Hirano
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Age At Onset ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Progressive External Ophthalmoplegia ◽  
Metabolic Complications ◽  
Mitochondrial Neurogastrointestinal Encephalomyopathy ◽  
Number Of Patients

Abstract Mitochondrial neurogastrointestinal encephalomyopathy is a rare multisystemic autosomic recessive disorder characterized by: onset typically before the age of 30 years; ptosis; progressive external ophthalmoplegia; gastrointestinal dysmotility; cachexia; peripheral neuropathy; and leucoencephalopathy. The disease is caused by mutations in the TYMP gene encoding thymidine phosphorylasethymine phosphorylase. Anecdotal reports suggest that allogeneic haematopoetic stem cell transplantation may be beneficial for mitochondrial neurogastrointestinal encephalomyopathy, but is associated with a high mortality. After selecting patients who fulfilled the clinical criteria for mitochondrial neurogastrointestinal encephalomyopathy and had severe thymidine phosphorylase deficiency in the buffy coat (<10% of normal activity), we reviewed their medical records and laboratory studies. We identified 102 patients (50 females) with mitochondrial neurogastrointestinal encephalomyopathy and an average age of 32.4 years (range 11–59 years). We found 20 novel TYMP mutations. The average age-at-onset was 17.9 years (range 5 months to 35 years); however, the majority of patients reported the first symptoms before the age of 12 years. The patient distribution suggests a relatively high prevalence in Europeans, while the mutation distribution suggests founder effects for a few mutations, such as c.866A>G in Europe and c.518T>G in the Dominican Republic, that could guide genetic screening in each location. Although the sequence of clinical manifestations in the disease varied, half of the patients initially had gastrointestinal symptoms. We confirmed anecdotal reports of intra- and inter-familial clinical variability and absence of genotype–phenotype correlation in the disease, suggesting genetic modifiers, environmental factors or both contribute to disease manifestations. Acute medical events such as infections often provoked worsening of symptoms, suggesting that careful monitoring and early treatment of intercurrent illnesses may be beneficial. We observed endocrine/exocrine pancreatic insufficiency, which had not previously been reported. Kaplan–Meier analysis revealed significant mortality between the ages of 20 and 40 years due to infectious or metabolic complications. Despite increasing awareness of this illness, a high proportion of patients had been misdiagnosed. Early and accurate diagnosis of mitochondrial neurogastrointestinal encephalomyopathy, together with timely treatment of acute intercurrent illnesses, may retard disease progression and increase the number of patients eligible for allogeneic haematopoetic stem cell transplantation.

scholarly journals Epileptic Seizures After Allogeneic Hematopoietic Stem Cell Transplantation

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhuo Wang ◽  
Munan Zhao ◽  
Sujun Gao
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Clinical Manifestations ◽  
Epileptic Seizures ◽  
Hematopoietic Stem ◽  
Number Of Patients ◽  
Complex Procedure

Technique in allogeneic hematopoietic stem cell transplantation has greatly advanced over the past decades, which has led to an increase in the number of patients receiving transplantation, but the complex procedure places these transplant recipients at high risk of a large spectrum of complications including neurologic involvement. As a common manifestation of neurological disorders, epileptic seizures after transplantation have been of great concern to clinicians because it seriously affects the survival rate and living quality of those recipients. The aim of this review is to elucidate the incidence of seizures after allogeneic hematopoietic stem cell transplantation, and to further summarize in detail its etiologies, possible mechanisms, clinical manifestations, therapeutic schedule, and prognosis, hoping to improve doctors' understandings of concurrent seizures following transplantation, so they can prevent, process, and eventually improve the survival and outlook for patients in a timely manner and correctly.

scholarly journals Clinical and immunologic outcome of patients with cartilage hair hypoplasia after hematopoietic stem cell transplantation

Blood ◽  
2010 ◽  
Vol 116 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Victoria Bordon ◽  
Andrew R. Gennery ◽  
Mary A. Slatter ◽  
Els Vandecruys ◽  
Genevieve Laureys ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Clinical Manifestations ◽  
Hematopoietic Stem ◽  
Cartilage Hair Hypoplasia ◽  
Severe Immunodeficiency

Abstract Cartilage-hair hypoplasia (CHH) is a rare autosomal recessive disease caused by mutations in the RMRP gene. Beside dwarfism, CHH has a wide spectrum of clinical manifestations including variable grades of combined immunodeficiency, autoimmune complications, and malignancies. Previous reports in single CHH patients with significant immunodeficiencies have demonstrated that allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment for the severe immunodeficiency, while growth failure remains unaffected. Because long-term experience in larger cohorts of CHH patients after HSCT is currently unreported, we performed a European collaborative survey reporting on 16 patients with CHH and immunodeficiency who underwent HSCT. Immune dysregulation, lymphoid malignancy, and autoimmunity were important features in this cohort. Thirteen patients were transplanted in early childhood (∼ 2.5 years). The other 3 patients were transplanted at adolescent age. Of 16 patients, 10 (62.5%) were long-term survivors, with a median follow-up of 7 years. T-lymphocyte numbers and function have normalized, and autoimmunity has resolved in all survivors. HSCT should be considered in CHH patients with severe immunodeficiency/autoimmunity, before the development of severe infections, major organ damage, or malignancy might jeopardize the outcome of HSCT and the quality of life in these patients.

scholarly journals Pilot Study on Frailty and Functionality on Routine Clinical Assessment in Allogeneichematopoietic Cell Transplantation to Predict Outcomes

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 380-380 ◽  
Author(s):  
Maria Queralt Salas ◽  
Eshetu G Atenafu ◽  
Ora Bascom ◽  
Leeann Wilson ◽  
Arjun Law ◽  
...  
Keyword(s):  
Stem Cell ◽  
Pilot Study ◽  
Stem Cell Transplantation ◽  
Grip Strength ◽  
Cell Transplantation ◽  
Waiting Time ◽  
Acute Gvhd ◽  
Number Of Patients ◽  
And Function

Introduction: Frailty can adversely affect the outcomes of allogeneic hematopoietic stem cell transplantation (alloHSCT) but is difficult to measure in busy transplant clinics. The limited published studies have used dedicated trained persons and comprehensive geriatric assessment (GA) tools, which are time consuming (Muffly LS, Haematologica 2014; Holmes HM, J Geriatr Oncol 2014; Rodrigues M, J Geriatr Oncol 2019). The difficulty in application of GA tools by transplant clinicians, residents and nurses in their clinics has resulted in low adoption rates in routine practice. At our center we adopted selected tests for frailty and function which could be conducted during pre-transplant consultation in a busy clinic, without extra waiting time for patients, and using existing staff. The Timed up and Go test (TUGT) was adopted as it could be done in any closed clinic room, without need for a corridor. Thus it was considered safer than a gait speed test and was even applicable to patients in "isolation". We aim to share a preliminary analysis of the applicability and correlation between our selected frailty assessment with transplant outcomes and complications. Methods: Patients referred for transplant underwent the following assessments conducted by different providers. All ages were included. Relevant tests and source of data are as follows: Frailty and function by clinician evaluating (a) Clinical Frailty scale (CFS) with 9 points based on clinical judgement (Rockwood 2005) (b) Lawton's Instrumental activities of daily living (IADL). Objective physical performance by nursing BMT coordinator using (a) TUGT and (b) Grip strength using hydraulic "Jamar" hand dynamometer conducted in clinic room at time of documentation. Self assessment by patient completing (a) Self-rated health (SRH) question and (b) a question on falls. Blood tests (a) CRP (b) Albumin. The present study is a single center prospective observational study. Patients who did not proceed to transplant were excluded. Ninety-six consecutive adult allo-HSCT patients were eligible for the present analysis, updated on July 2019. The parameters were individually correlated with overall survival (OS), non-relapse mortality (NRM), cumulative incidence (cum.Inc) of acute GVHD, median time of transplant hospitalization and readmissions. Multivariate analysis was not performed in this pilot study due to limited number of patients and low frequency of adverse events. Results: Baseline characteristics and main post-transplant information are noted in Table 1. Median follow up of cohort was 5 months. Table 2 shows the main outcomes (with normal values). For the entire cohort the median OS at 6 months was 73.9% (range 61.7-82.8), NRM at day+100 was 8.7% (range 2.6-14.7), Cum.Inc of Acute GVHD 41.1% (range 30.1-52.1), Cum.Inc gr II-IV acute GVHD was 25.7% (range 15.6-35.9). Relapse occurred in 8 cases (8.3%) and deaths in 23 (23.9%). A TUGT of more than 10 seconds and raised CRP predicted poor OS (p<0.05). Abnormal TUGT, SRH question score of <A (excellent), lower albumin levels and raised CRP levels correlated with high NRM (p<0.05). A Clinical Frailty Score of more than 2, limitations of 1 or more IADLs, Grip strength below normal for age and sex, TUGT >10 seconds, SRH question <A, and lower albumin level were significant predictors for a longer median duration of transplant hospitalization. No frailty or functionality parameter correlated significantly with the Cum.Inc of any grade of acute GVHD, grade II-IV acute GVHD or the risk of rehospitalization after alloHSCT. Conclusions: Our pilot study shows that with selected brief tools, frailty and functionality can be assessed as part of routine clinical practice in allogeneic-stem cell transplantation in all age groups without extra waiting time for patients or additional human resources. TUGT is a useful prognostic tool which can be conducted in a clinic room and correlates with OS, NRM, and duration of hospitalization. Larger number of patients and longer follow-up will help to evaluate the different assessment modalities as prognostic tools in allo-HSCT and their wider applicability. Disclosures Michelis: CSL Behring: Other: Financial Support. Mattsson:Gilead: Honoraria; Celgene: Honoraria; Therakos: Honoraria.

Electronic Symptom Assessment in Children and Adolescents With Advanced Cancer Undergoing Hematopoietic Stem Cell Transplantation

2020 ◽  
Vol 37 (4) ◽  
pp. 255-264 ◽  
Author(s):  
Jessica A. Ward ◽  
Chelsea Balian ◽  
Elizabeth Gilger ◽  
Jennifer L. Raybin ◽  
Zhanhai Li ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Advanced Cancer ◽  
Gastrointestinal Symptoms ◽  
Symptom Assessment ◽  
Hematopoietic Stem ◽  
Patient Reported

Background/Purpose: Effective symptom assessment and management for children with advanced cancer undergoing hematopoietic stem cell transplantation (HSCT) is critical to minimize suffering. The purpose of this subanalysis was to compare feasibility of electronic data collection data and symptom prevalence, frequency, severity, and distress from children with advanced cancer undergoing HSCT with a non-HSCT cohort. Method: An abbreviated Pediatric Quality of Life and Evaluation of Symptoms Technology Memorial Symptom Assessment Scale was electronically administered every 2 weeks to children with advanced cancer. A subanalysis was conducted for the cohort of children who received autologous or allogeneic HSCT. Results: Forty-six participants completed 563 symptom assessments during the study. However, 11 of these 46 children received HSCT and completed 201 symptom assessments. The median age in the HSCT cohort was 12.7 years, 73% were female, and most children had a hematologic (45%) or solid tumor (45%) malignancy. Pain (35%), nausea (30%), sleeping difficulty (29%), and fatigue (22%) were the most commonly reported symptoms in children receiving HSCT. Children in the HSCT cohort had similar total, subscale, and individual symptom scores compared with children who did not receive HSCT. Certain domains of gastrointestinal symptoms (nausea, lack of appetite, and diarrhea) were higher for children receiving HSCT compared with children with advanced cancer not receiving HSCT ( p < .05). Conclusion: Elicitation of patient-reported symptom experiences using electronic methods improves nurses’ understanding of the symptom experience for children with advanced cancer undergoing HSCT and may promote timely assessment and treatment of distressing symptoms.

Syngeneic Hematopoietic Stem Cell Transplantation in Acute Leukaemia. A Report of the Acute Leukaemia Working Party of the EBMT.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2303-2303
Author(s):  
Loic Fouillard ◽  
Myriam Labopin ◽  
Eliane Gluckman ◽  
Alois Gratwohl ◽  
Francesco Frassoni ◽  
...  
Keyword(s):  
Stem Cell ◽  
Complete Remission ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Graft Versus Host Disease ◽  
Acute Leukaemia ◽  
Adult Patients ◽  
Host Disease ◽  
Graft Versus Host ◽  
Number Of Patients

Abstract Syngeneic haematopoietic stem cell transplantation (HSCT) is a rare situation and is usually characterised by a high relapse rate because of the absence of graft versus leukaemia effect. We report results of syngeneic HSCT reported to the EBMT registry from 1975 to 2003. One hundred and 24 acute myeloid leukaemia (AML) and 104 acute lymphoblastic leukaemia (ALL) were reported comprising 150 adults and 78 children, 133 males and 95 females. The number of patients in first complete remission (CR1) was 137, comprising 93 AML (72 adults and 21 children) and 44 ALL (33 adults and 11 children). The number of patients in second complete remission (CR2) was 52 comprising 12 AML (9 adults and 3 children) and 40 ALL (11 adults and 29 children). The number of patients in more advanced disease (AD) was 39 comprising 19 AML (16 adults and 3 children) and 20 ALL (9 adults and 11 children). Total body irradiation was given to 36% of patients. Prophylaxis of graft versus host disease was given to 10% of patients. Source of stem cells was bone marrow for 81% of patients, peripheral blood for 18% and both for 1%. Outcome at 5 years showed for adult patients with AML in CR1 (n=72) a leukaemia free survival (LFS) of 56+/−7%, a relapse incidence (RI) of 37+/−7% and a non relapse mortality (NMR) of 11+/−5%. For adult patients with ALL in CR1 (n=33), LFS was 60+/−10%, RI 38+/−10% and NRM 3+/−3%. Outcome at 5 years showed for children with AML in CR1 (n=21) a LFS of 61+/−11%, a RI of 39+/−11% and a NMR of 0%. For children with ALL in CR2 (n=29), LFS was 46+/−10%, RI 52+/−10% and NRM 5+/−5%. Acute graft versus host disease (GVHD) was diagnosed in 12% of patients, 7% grade 1 and 5% grade ≥ 2. Chronic GVHD was observed in 2% of patients. These retrospective study indicates that syngeneic HSCT can lead to a high LFS in patients with acute leukaemia in CR1 and that GVHD is not a rare event. A graft versus leukemia effect is highly probable in syngeneic HSCT.

Cidofovir Is Safe and Effective in the Treatment of Adenoviral Infection in Pediatric Hematopoietic Stem Cell Transplantation.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2232-2232
Author(s):  
Usman Yusuf ◽  
Gregory Hale ◽  
Paul Woodard ◽  
Ely Benaim ◽  
Kimberly Kasow ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Hemorrhagic Cystitis ◽  
Clinical Manifestations ◽  
Hematopoietic Stem ◽  
Adenoviral Infection ◽  
Viral Culture

Abstract Adenovirus (ADV) infections are increasingly recognized as significant cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). Early diagnosis and prompt initiation of effective treatment are important in preventing often fatal disseminated ADV disease. We report our experience with using cidofovir (CDV) for the treatment of adenovirus infection in 57 HSCT patients, median age 8 years (range 0.5–26). Fifty-four patients received allogeneic HSCT, 35 of whom were T-cell depleted with 3 patients receiving autologous marrow. Blood was tested weekly for ADV by quantitative real-time PCR, with viral culture performed on urine, stool and throat swabs. Antiviral therapy was initiated immediately upon detection of ADV by PCR, culture or tissue histopathology. Cidofovir was given at 5mg/kg once weekly for 2 weeks, then every 2 weeks untill 3 negative PCR or cultures were documented. ADV was first detected at a median of 53 days (range 6–319 days) after HSCT. The most common clinical manifestations were diarrhea (53%), fever (21%), hemorrhagic cystitis (12%), and pneumonitis (11%). Fourteen (25%) patients were asymptomatic and four (7%) patients had exacerbation of an ongoing GVHD. The virus was isolated from stool 53%, blood 50%, urine 16%, respiratory specimens 16% and the cerebrospinal fluid in 1 patient. Twenty (35%) patients had the virus isolated from more than 2 sites. Of the 30 patients who initially had ADV only in stool, 77% of them became PCR-positive in the blood while on CDV therapy, at a median of 10 days after ADV was first detected from the stool. The median duration of therapy was 60 days (range 1–270), with a median of 5 doses given (range 1–22). CDV treatment was associated with resolution of diarrhea, hemorrhagic cystitis, fever and pneumonitis in 56 patients in whom the virus became undetectable by both cultures and quantitative PCR. There was one adenovirus-related death due to pneumonitis and ARDS. No cases of dose-limiting nephrotoxicity were observed. Cidofovir was demonstrated to be safe and effective for the treatment of ADV infection in this predominantly pediatric HSCT patient population. Vigilant surveillance for ADV and early treatment with CDV can prevent the poor outcomes associated with ADV disease. A larger prospective study will be needed to further determine the role of CDV in the treatment of ADV in patients after HSCT.

Association between Polyoma BK Virus Infection and Hemorraghic Cystitis in Allogenic Hematopoietic Stem Cell Transplantation Recipients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5291-5291
Author(s):  
Kamal Bouabdallah ◽  
Aurélie Gomez ◽  
Marie-Edith Lafon ◽  
Reza Tabrizi ◽  
Noel-Jean Milpied
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Conditioning Regimen ◽  
Bk Virus ◽  
Hematopoietic Stem ◽  
Allogenic Stem Cell Transplantation ◽  
Number Of Patients

Abstract BK Virus (BKV) infection is a common and benign infection occuring in childhood and resulting in viral latency. Because of immunosuppression, acute graft-versus-host disease (a-GVHD), and co infection with other viruses BKV infection often occurs after allogenic hematopoietic stem cell transplantation (HSCT) resulting, in some cases, in hemorraghic cystitis (HC). We reviewed 258 patients who underwent allogenic HSCT in our institution between january 2001 and december 2005. One hundred and seven patients had a myeloablative conditioning regimen based on cyclophosphomide in combination with either total-body-irradiation (TBI/Cy) or Busulfan (Bus/Cy) with prophylaxis by MESNA. One hundred and fifty-one patients had a Fludarabine based reduced intensity conditioning regimen. BKV was detected by real-time PCR on urinary samples in most cases. Macroscopic HC occured in 17 patients and BKV was detected in 15 patients out of 17. Among patients with HC and BKV viruria 11 (out of 107) received a conventional regimen compared with only 4 patients out of 151) positive for BKV in the non-myeloablative regimen group. Although the number of patients is small, these data suggest strongly the role of the myeloablative regimen in the occurence of BKV induced HC. The high immunosuppression level induced by the conditioning regimen and the bladder injuries could explain this high frequency compared with the relative low frequency in patients with the less intensive regimen. A prospective work is ongoing to better characterize the incidence, risk factors, clinical outcome and management of BKV induced HC after allogenic stem cell transplantation.

Comparison Of Flow Cytometric and Clinical Findings In Patients With Paroxysmal Nocturnal Hemoglobinuria

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4877-4877
Author(s):  
Taner Demirer ◽  
Suphi Baslar ◽  
Vasif akin Uysal ◽  
Meral Beksac ◽  
Mehmet Ozen ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Conditioning Regimen ◽  
Classical Type ◽  
Clone Size ◽  
Number Of Patients

Abstract Paroxysmal Nocturnal Hemoglobinuria (PNH) is a rare disorder of blood cells associated with mutations of X-linked gene called phosphatidylinositol glycan class A, and presenting as hemoglobinuria, signs of cytopenias (fatigue, easy bleeding) or thrombosis. In this study, 39 patients with PNH were retrospectively evaluated with regard to disease findings, laboratory investigations, complications and relationship between those and clone size. Median follow-up time was 26 months. Patients were divided into two groups. There were 24 classical PNH and 15 Aplastic Anemia (AA) or Myelodisplastic Syndrome (MDS) associated PNH patients. Evident signs of hemolysis at the time of diagnosis and thrombosis were seen in classical PNH patients. Sign of hemolysis developed in two AA patients. Hemoglobinuria, hemolysis test (increased reticulocyte and lactate dehydrogenase) were determined to be correlated with clone size. There was association between clone size and thrombosis. No patients with clone size smaller than 50% developed thrombosis and all patients with thrombosis were in classical PNH subtype which has greater clone size. PNH is a rare disease; therefore the effect of small number of patients on the statistical parameters must be taken into consideration. Over the entire course of follow-up time 8 patients died, 6 due to complications of allogeneic stem cell transplantation and 2 due to conditioning regimen before transplantation. Numbers of deaths are equal in each subtype. In summary, in this study there was a linear correlation between hemoglobinuria and LDH levels with clone size, which was statistically significant (p=0,031 and p=0,001 respectively). Other clinical signs did not correlate with clone size. Thrombotic complications were seen only in classical type PNH patients. No patients with clone size smaller than 50% developed thrombosis, MPV levels were significantly higher than others (p=0,04). There was also statistically significant correlation between reticulocyte and LDH levels with thrombotic events (p=0,009 and 0,003 respectively). In addition, after allogeneic stem cell transplantation 9 patients were evaluated for PNH clone and in 7 the clone was disappeared. Disclosures: No relevant conflicts of interest to declare.

Interventions to combat Vitamin D Deficiency in patients undergoing Hematopoietic Stem Cell Transplantation

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5996-5996
Author(s):  
Andrea Z Pereira ◽  
Silvia MF Piovacari ◽  
Fabiana Lucio ◽  
Marcia Tanaka ◽  
Ana Paula N Barrere ◽  
...  
Keyword(s):  
Vitamin D ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Normal Body Mass Index ◽  
Research Protocol ◽  
Hematopoietic Stem ◽  
Number Of Patients

Abstract Introduction: Patients undergoing Hematopoietic Stem Cell Transplantation(HSCT) may have low vitamin D (VD) level because of decreased exposure to sunlight, the major cause of VD Deficiency (VDD), from prolonged hospital stays, limited outdoor activity, and sunscreen use, and decreased oral intake caused by gastrointestinal treatment toxicity. Besides that gastrointestinal graft-versus-host disease (GVHD) limit absorption of VD. Some medications received during the HSCT can increased the VD catabolism, and alterate renal and kidney function. Objectives: To evaluate the reduction of number of patients with VD Deficiency in patients undergoing HSCT after educational classes for the multi-professional team (physicians, dietitians and nurses). Methods: We analyzed 72 patients undergoing HSCT May 2012 to January 2014 in the Hematology-Oncology and Bone Marrow Transplantation Center at Albert Einstein Hospital in São Paulo, Brazil. The serum levels of vitamin were measured in the first day of hospitalization of the patients adults (>= 18 years) who would be undergoing HSCT. All types of HSCT patients were included.We used in our study the VDD was defined and recommended by the Institute of Medicine as a 25(OH)D <=20 ng/ml, VD insufficiency of 21-29 ng/ml, and VD normal >=30 ng/ml.In the 2012 the multi-professional HSCT Team had 3 classes about VD and, everyone were informes about the VD research protocol. Results: 72 adult patients were observed in this study, aged between 18 and 74 years, with the majority (77.8%) with less than 65 years. Of the total, 59.7% were men and 41.7% had normal body mass index. 100% of the lymphoma patients had VDD. In 2012(n:33), 60% patients had VDD and in 2013 (n:39), 40% (p<0,05). Conclusions: When all of members of HSCT team were informed about the benefits of high VD levels in patients undergoing HSCT by classes and research protocol, we can reduce VDD. Disclosures No relevant conflicts of interest to declare.

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