Severe lung injury and lung biopsy in children post-hematopoietic stem cell transplantation: The differences between allogeneic and autologous transplantation

2013 ◽  
Vol 17 (3) ◽  
pp. 278-284 ◽  
Author(s):  
Adam Gassas ◽  
Hayley Craig-Barnes ◽  
Sharon D Dell ◽  
Peter Cox ◽  
Tal Schechter ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Lung Injury ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Lung Biopsy ◽  
Autologous Transplantation ◽  
Hematopoietic Stem ◽  
Severe Lung

scholarly journals Retrospective Analysis of 111 Cases of Multiple Myeloma Treated with Autologous Hematopoietic Stem Cell Transplantation

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5833-5833
Author(s):  
Chengcheng Fu ◽  
Yun Xu ◽  
Juan Wang ◽  
Jin Zhou ◽  
Ling Ma ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Maintenance Therapy ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Autologous Transplantation ◽  
Hematopoietic Stem ◽  
Free Treatment

Abstract Though a large number of studies have confirmed that large dose chemotherapy combined with autologous transplantation can improve the OS and PFS in patients with multiple myeloma, the suitable time for transplantation is not yet conclusive. The impact of treatment depth on survival and the essentiality of maintenance therapy after autologous transplantation because of the maintenance-related side effects is also inconclusive. To evaluate the efficacy of autologous hematopoietic stem cell transplantation (ASCT) in the treatment of multiple myeloma (MM), the effects of transplantation timing, depth of treatment and maintenance therapy on survival in patients with multiple myeloma (MM). The data of 111 patients with multiple myeloma who received autologous hematopoietic stem cell transplantation (ASCT) from April 30, 2004 to June 30, 2015 were retrospectively analyzed. The median follow-up period was 31 (6-139) months. 109 of the 111 patients successfully underwent hematopoietic reconstruction,2 patients died of transplantation-related mortality. The overall response rates(ORR)rate increased from 82.9%(92/111)at pre-ASCT to 91.9%(102/111)at post-ASCT. The median progress free survival(PFS)was 50 months. The median overall survival(OS)was not reached. The median PFS and median OS in the sequential transplantation group were significantly better than those in the non sequential transplantation group (86 months vs33 months, P=0.001,not reached vs 43 months, P=0.000).The median PFS of patients achieving a nCR at pre-ASCT was longer than those not achieving a nCR group (62 months vs 34 months, P=0.023).OS showed any significance(not reached vs 47 months, P=0.094).The median PFS of patients achieving a nCR at post-ASCT was longer than those not achieving a nCR group (54 months vs 26 months, P=0.004).OS showed any significance(not reached vs 53 months, P=0.128).Regarding maintenance therapy:the group of patients achieving post-ASCT nCR:The median PFS of patients with maintenance therapy was longer than those without maintenance treatment(86 months vs 33 months, P=0.009).The median OS in maintenance therapy group was not reached,the median OS in the maintenance free treatment group was 47 months (P=0.004).The group of patients achieving less than nCR at post-ASCT:In the maintenance group, the median PFS was 26 months,the median PFS for maintenance free treatment group was 9 months (P=0.518).The median OS of patients with maintenance therapy was longer than those without maintenance treatment(53 months vs 28 months, P=0.011). Autologous transplantation after induction chemotherapy, with maintenance therapy is the preferred treatment for patients with MM.The depth of treatment has a great influence on the survival time of patients,Patients with nCR at any time during the therapy (pre-ASCT,post-ASCT) had longer OS.Maintenance therapy is associated with an extended OS, no matter whether a nCR is reached or not at post-ASCT. Disclosures No relevant conflicts of interest to declare.

Late effects on haemostasis after haematopoietic stem cell transplantation

2012 ◽  
Vol 32 (01) ◽  
pp. 63-66 ◽  
Author(s):  
D. A. Tsakiris ◽  
G. Stussi
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Autologous Transplantation ◽  
Haematopoietic Stem Cell ◽  
First Year ◽  
Hematopoietic Stem ◽  
Considerable Morbidity

SummaryAllogeneic and autologous hematopoietic stem cell transplantations are important therapeutic options for patients with hematologic disorders. Hemostatic complications are frequent after hematopoietic stem cell transplantation with a considerable morbidity and mortality. The incidence of bleedings and thrombosis is highest in the first few weeks after transplantation, but may also occur later. However, beyond the first year of transplantation only limited data are available. In longterm survivors the risk for premature atherosclerosis increases over time after allogeneic hematopoietic stem cell transplantation and it is higher than in the age-adjusted general population and in recipients of autologous transplantation.

Bronchoalveolar Lavage and Lung Biopsy in Patients With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 33 (5) ◽  
pp. 501-509 ◽  
Author(s):  
DeepakBabu Chellapandian ◽  
Thomas Lehrnbecher ◽  
Bob Phillips ◽  
Brian T. Fisher ◽  
Theoklis E. Zaoutis ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Bronchoalveolar Lavage ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Lung Biopsy ◽  
Hematopoietic Stem ◽  
Pulmonary Lesions ◽  
Patients With Cancer

Purpose The objective of this study was to describe the diagnostic yield and complication rate of bronchoalveolar lavage (BAL) and lung biopsy in the evaluation of pulmonary lesions in patients with cancer and recipients of hematopoietic stem-cell transplantation (HSCT). Methods We conducted a systematic literature review and performed electronic searches of Ovid MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials. Studies were included if patients had cancer or were recipients of HSCT, and if they underwent BAL or lung biopsy for the evaluation of pulmonary lesions. Only English language publications were included. Results In all, 14,148 studies were screened; 72 studies of BAL and 31 of lung biopsy were included. The proportion of procedures leading to any diagnosis was similar by procedure type (0.53 v 0.54; P = .94) but an infectious diagnosis was more common with BAL compared with lung biopsy (0.49 v 0.34; P < .001). Lung biopsy more commonly led to a noninfectious diagnosis (0.43 v 0.07; P < .001) and was more likely to change how the patient was managed (0.48 v 0.31; P = .002) compared with BAL. However, complications were more common with lung biopsy (0.15 v 0.08; P = .006), and procedure-related mortality was four-fold higher for lung biopsy (0.0078) compared with BAL (0.0018). Conclusion BAL may be the preferred diagnostic modality for the evaluation of potentially infectious pulmonary lesions because of lower complication and mortality rates; thus, choice of procedure depends on clinical suspicion of infection. Guidelines to promote consistency in the approach to the evaluation of lung infiltrates may improve clinical care of patients.

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