scholarly journals Phase Angle and Dry Weight Benefit Nutritional Management of a Patient with Primary Myelofibrosis Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

2019 ◽  
Vol 2 (1-3) ◽  
pp. 16-20
Author(s):  
Isabelle Novelli ◽  
Giancarlo Fatobene ◽  
Ana Carolina Silva ◽  
Ana Lucia Rodrigues ◽  
Ariane Severine ◽  
...  
Keyword(s):  
Body Weight ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Fluid Balance ◽  
Nutritional Assessment ◽  
Dry Weight ◽  
Primary Myelofibrosis ◽  
Nutritional Intervention ◽  
Hematopoietic Stem

Background: Progressive, involuntary weight loss (WL) is common in patients with primary myelofibrosis (PMF), and the etiology of this manifestation is multifactorial. A triad of ascites, edema, and splenomegaly is common; therefore, the body weight may be overestimated due to fluid overload. A comprehensive nutritional assessment, including measurement of dry weight, is necessary for monitoring disease progression and to allow the effective planning of nutritional interventions. Also, the phase angle (PA) has been suggested as an important prognostic and muscle mass marker in patients with cancer. To date, there have been no reports of bioimpedance analysis (BIA) of patients with PMF. Case Presentation: A 56-year-old man with PMF underwent allogeneic hematopoietic stem cell transplantation (HSCT) with fatigue and postprandial abdominal fullness, exhibiting splenomegaly (> 10 cm) and bilateral lower-extremity edema. On day –13, a BIA was performed. The patient had a body weight of 73.5 kg, with a fluid balance of +9.2 L and a PA at 50 kHz of 3.15°. A nutritional intervention was administered for 26 days, and on day +13 of HSCT, a repeat BIA revealed an estimated body weight of 69.7 kg with a fluid balance of +5.8 L and a PA at 50 kHz of 3.17°, as well as nonsignificant WL (3.1% in 1 month). Conclusions: This case report is an important addition to the nutritional assessment of PFM patients, since we could provide a better nutritional intervention due to our understanding of the estimated dry weight and assess the PA to investigate a new element of prognosis. Additional studies are needed to demonstrate the effectiveness of BIA in these patients.

Population Pharmacokinetic of Oral Busulfan in Japanese Undergoing Hematopoietic Stem Cell Transplantation.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5317-5317
Author(s):  
Noriaki Sasaki ◽  
Kentaro Ogata ◽  
Keita Yamauchi ◽  
Yasushi Takamatsu ◽  
Junji Suzumiya ◽  
...  
Keyword(s):  
Body Weight ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Total Bilirubin ◽  
Total Body Weight ◽  
Serum Levels ◽  
Japanese Adult ◽  
Hematopoietic Stem ◽  
Total Body

Abstract We previous evaluated busulfan (BU) pharmacokinetics (PK) in seven Japanese adult patients who underwent allogenic hematopoietic stem cell transplantation (HSCT) at Fukuoka University Hospital. We showed that the average plasma BU concentrations at steady state (Css) ranged from 745 to 2422 ng/mL. BU population PK (PPK) parameters for Caucasian have already been reported. However, few data are available for Asian people. We therefore investigated the PPK parameters of BU in 82 Japanese adult patients (51 males and 31 females) who underwent HSCT following a BU-containing conditioning regimen. Their average age was 43.4 years, ranging from 16 to 68 years. Blood samples were collected in heparinized tubes at 0.5,1,2,4 and 6 hours after the oral administration of BU, and the plasma BU concentrations were measured by high performance liquid chromatography (HPLC). A one compartment open model with first-order absorption was used. We estimated individual BU doses by using Bayesian, and PK parameters by using nonlinear mixed effects modeling (NONMEM) computer program. Since Oral clearance (L/h/kg) (CL/F) and distribution volumes (L/kg) (Vd/F) were proportional to total body weight, so we set the following formulas. The final PPK parameters were CL/F = 0.139•TBW•1.14GEN •1.09VPA •1.52TBIL≥1.2, Vd/F = 0.76•TBW•0.902GEN, absorption rate constant (h−1) (ka) = 2.58. TBW is total body weight (kg), VPA = 1 for concomitant administration of valproic acid and 0 for another anticonvulsant, GEN = 1 for patients gender female and 0 for male, TBIL≥1.2 = 1 for total bilirubin above 1.2 mg/dL and 0 for below. CL/F in Japanese and Caucasian were 0.139 and 0.149, respectively, Vd/F were 0.76 and 0.64, respectively, and ka were 2.58 and 1.68, respectively. These data showed that CL/F and Vd/F were almost same between Japanese and Caucasian, but ka was larger. We also found that high serum levels of total bilirubin and administration of VPA induced the increase of CL/F at 52 % and 9 %, respectively. The interindividual variabilities in CL/F, Vd/F and ka were 21.9%, 20.9% and 82.3%, respectively, and the residual variability was 18.4% as coefficient of variation. This study represented that oral BU PPK parameters in Japanese were different from that in Caucasian. BU PPK parameters were influenced by gender, serum levels of total bilirubin and administration of VPA. Our study showed that BU PPK differed between Japanese and Caucasian.

Incidence and Characterization of Taste Disturbances After Allogeneic or Autologous Hematopoietic Stem Cell Transplantation Using Myeloablative or Reduced-Intensity-Conditioning.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3319-3319
Author(s):  
Birgit Federmann ◽  
Jens Weidmann ◽  
Gunnar Blumenstock ◽  
Silke Schwarz ◽  
Lothar Kanz ◽  
...  
Keyword(s):  
Body Weight ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Taste Perception ◽  
Hematopoietic Stem ◽  
Allogeneic Hct ◽  
Loss Of Weight ◽  
Autologous Hct ◽  
Taste And Smell

Abstract Abstract 3319 Poster Board III-207 After hematopoietic stem cell transplantation (HCT) a high incidence of taste and smell alterations is observed which might be associated with delayed physical recovery, general wasting and decreased quality of life. Insufficient nutritional intake can even impair host defense and increase susceptibility to infections. So far, only few systematic evaluations of taste disturbances after HCT have been conducted. We therefore retrospectively analyzed this question using a new standardized questionnaire covering aspects of the dietary pattern and changes in the perception of taste and smell. Clinical data were gathered from patient's charts, and the study was approved by our institutional review board. 181 patients (71 female, 110 male) treated in our institution with a median age of 52 years (range 20-79) were included in the study. The patients completed the questionnaire after a median of 25 months from HCT (range, 1-292). Indications for HCT included acute leukemia =72, myeloproliferative disease =32, lymphoma =29, MDS =10 and other =38. 148 patients received an allogeneic graft after myeloablative conditioning (MAC) (n=87) or reduced-intensitiy-conditioning (RIC) (n=61) and 33 patients were treated with an autologous HCT. 71% of the patients reported moderate to severe changes in taste perception on a semiquantitative visual analogue scale during the acute phase of HCT with no significant differences between the three groups (MAC 74%, RIC 66%, autologous SCT 73%). Changes in smell perception were documented in 54% of patients with a median of 33.5 days (range, 2-365) to improvement. 30% of these patients reported a reduction in smell perception, while 21% described intensification with persistence of these changes in 62% of the patients. In univariate analysis using chi square-tests we examined the difference between autologous and allogeneic transplantation as well as the influence of GvHD or immunosuppression on taste disturbances and loss of weight. Changes in taste perception were significantly associated with loss of body weight > 5kg (69.2% vs. 45.6%, p= 0.002). Alterations in body weight and changes in taste perception tended to be more prevalent after allogeneic SCT compared to after autologous HCT with 45.9% vs. 30.3% and 58.1% vs. 45.5%, respectively. A complete recovery at the time of the survey was reported by 29% of the patients, whereas 26% still suffered from ongoing moderate to severe taste alterations. We observed a significant difference in time to recovery with a subjective improvement of symptoms after a median of 60 days (range, 3-365) after autologous HCT vs. 120 days after allogeneic HCT (range, 30-600) (p= 0.03). The incidence of chronic GVHD was 79/148 (53%) in the patients receiving allogeneic HCT. In patients with cGVHD significantly more patients reported changes in taste perception (64.6% vs. 49.0%, p= 0.04) and loss of body weight > 5kg (55.7% vs 33.3%, p= 0.004). There was a significant association between the use of immunosuppression and taste alterations using tacrolimus (67.2% vs. 50.0%, p= 0.04) or steroids (72.7% vs. 48.4%, p= 0.03) as well as a loss of weight > 5kg using mycophenolatmofetil (53.8% vs. 34.7%, p= 0.01). In conclusion taste and smell disturbances are common events in the early course after HCT. The symptoms persist in one quarter of the patients receiving allogeneic grafts. Interestingly, after allogeneic HCT, no differences between MAC and RIC conditioning but a major impact of GVHD and immunosuppression are observed. Disclosures No relevant conflicts of interest to declare.

scholarly journals The prognostic value of ASXL1 mutation in primary myelofibrosis. Literature review and clinical case description

2020 ◽  
Vol 92 (7) ◽  
pp. 95-99
Author(s):  
A. L. Melikyan ◽  
I. N. Subortseva ◽  
E. A. Gilyazitdinova ◽  
T. I. Koloshejnova ◽  
E. K. Egorova ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Prognostic Value ◽  
Clinical Case ◽  
Myeloproliferative Neoplasm ◽  
Primary Myelofibrosis ◽  
Hematopoietic Stem

Primary myelofibrosis is a myeloproliferative neoplasm that occurs de novo, characterized by clonal proliferation of stem cells, abnormal expression of cytokines, bone marrow fibrosis, hepatosplenomegaly as a result of extramedullary hematopoiesis, symptoms of tumor intoxication, cachexemia, peripheral blood leukoerythroblastosis, leukemic progression and low survival. Primary myelofibrosis is a chronic incurable disease. The aims of therapy: preventing progression, increasing overall survival, improving quality of life. The choice of therapeutic tactics is limited. Allogenic hematopoietic stem cell transplantation is the only method that gives a chance for a cure. The role of mutations in a number of genes in the early identification of candidates for allogeneic hematopoietic stem cell transplantation is being actively studied. The article describes the clinical case of the detection ofASXL1gene mutations in a patient with prefibrous primary myelofibrosis. The diagnosis was established on the basis of WHO criteria 2016. The examination revealed a mutation ofASXL1. Interferon alfa therapy is carried out, against the background of which clinico-hematological remission has been achieved. Despite the identified mutation, the patient is not a candidate for allogeneic hematopoietic stem cell transplantation. Given the unfavorable prognostic value of theASXL1mutation, the patient is subject to active dynamic observation and aggressive therapeutic tactics when signs of disease progression appear.

scholarly journals A Case Series and Literature Review of Isavuconazole Use in Pediatric Patients with Hemato-oncologic Diseases and Hematopoietic Stem Cell Transplantation

2019 ◽  
Vol 64 (3) ◽  
Author(s):  
N. Decembrino ◽  
K. Perruccio ◽  
M. Zecca ◽  
A. Colombini ◽  
E. Calore ◽  
...  
Keyword(s):  
Body Weight ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Case Series ◽  
European Organization ◽  
Hematopoietic Stem ◽  
Oncologic Diseases

ABSTRACT We analyzed the use of isavuconazole (ISA) as treatment or prophylaxis for invasive fungal disease (IFD) in children with hemato-oncologic diseases. A multicentric retrospective analysis was performed among centers belonging to the Italian Association for Pediatric Hematology and Oncology (AIEOP). Pharmacokinetic (PK) monitoring was applied by a high-performance liquid chromatography-tandem mass spectrometry (HLPC-MS/MS) assay. Twenty-nine patients were studied: 10 during chemotherapy and 19 after allogeneic hematopoietic stem cell transplantation (HSCT). The patients consisted of 20 males and 9 females with a median age of 14.5 years (age range, 3 to 18 years) and a median body weight of 47 kg (body weight range, 15 to 80 kg). ISA was used as prophylaxis in 5 patients and as treatment in 24 cases (20 after therapeutic failure, 4 as first-line therapy). According to European Organization for Research and Treatment of Cancer (EORTC) criteria, we registered 5 patients with proven IFD, 9 patients with probable IFD, and 10 patients with possible IFD. Patients with a body weight of <30 kg received half the ISA dose; the others received ISA on the adult schedule (a 200-mg loading dose every 8 h on days 1 and 2 and a 200-mg/day maintenance dose); for all but 10 patients, the route of administration switched from the intravenous route to the oral route during treatment. ISA was administered for a median of 75.5 days (range, 6 to 523 days). The overall response rate was 70.8%; 12 patients with IFD achieved complete remission, 5 achieved partial remission, 5 achieved progression, and 3 achieved stable IFD. No breakthrough infections were registered. PK monitoring of 17 patients revealed a median ISA steady-state trough concentration of 4.91 mg/liter (range, 2.15 to 8.54 mg/liter) and a concentration/dose (in kilograms) ratio of 1.13 (range, 0.47 to 3.42). Determination of the 12-h PK profile was performed in 6 cases. The median area under the concentration-time curve from 0 to 12 h was 153.16 mg·h/liter (range, 86.31 to 169.45 mg·h/liter). Common Terminology Criteria for Adverse Events grade 1 to 3 toxicity (increased transaminase and/or creatinine levels) was observed in 6 patients, with no drug-drug interactions being seen in patients receiving immunosuppressants. Isavuconazole may be useful and safe in children with hemato-oncologic diseases, even in the HSCT setting. Prospective studies are warranted.

scholarly journals Repeated haploidentical allogeneic hematopoietic stem cell transplantation with TCR αβ/CD19 depletion in patient with primary myelofibrosis. Case report

2021 ◽  
Vol 93 (7) ◽  
pp. 805-810
Author(s):  
Elmira I. Kolgaeva ◽  
Vera A. Vasilyeva ◽  
Larisa A. Kuzmina ◽  
Mikhail Yu. Drokov ◽  
Mariya V. Dovydenko ◽  
...  
Keyword(s):  
Stem Cell ◽  
T Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Primary Myelofibrosis ◽  
High Risk Group ◽  
International Prognostic Scoring System ◽  
Hematopoietic Stem

Indications of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with primary myelofibrosis are intermediate-2 and high-risk group of DIPSS (Dynamic International Prognostic Scoring System), beginning of the disease in childhood. The other adverse factors affect engraftment and survival after allo-HSCT, example partialy matched donor. But the result of allo-HSCT from matched related donors and result of allo-HSCT from haploidentical donors are comparable. The method for haploidentical hematopoietic stem cell transplantation is T-cell-depletion. This is clinical case of T-cell-depleted haploidentical hematopoietic stem cell transplantation in patient with primary myelofibrosis, the diagnosis was established in childhood.

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