scholarly journals RhodococcusInfection in Solid Organ and Hematopoietic Stem Cell Transplant Recipients1

2017 ◽  
Vol 23 (3) ◽  
pp. 510-512 ◽  
Author(s):  
Pascalis Vergidis ◽  
Ella J. Ariza-Heredia ◽  
Anoma Nellore ◽  
Camille N. Kotton ◽  
Daniel R. Kaul ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Solid Organ ◽  
Cell Transplant ◽  
Hematopoietic Stem

scholarly journals High on Cannabis and Calcineurin Inhibitors: A Word of Warning in an Era of Legalized Marijuana

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Naomi Hauser ◽  
Tanmay Sahai ◽  
Rocco Richards ◽  
Todd Roberts
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
T Cell Activation ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
The United States ◽  
Solid Organ ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Cytochrome P 450

Tacrolimus, a potent immunosuppressant medication, acts by inhibiting calcineurin, which eventually leads to inhibition of T-cell activation. The drug is commonly used to prevent graft rejection in solid organ transplant and graft-versus-host disease in hematopoietic stem cell transplant patients. Tacrolimus has a narrow therapeutic index with variable oral bioavailability and metabolism via cytochrome P-450 3A enzyme. Toxicity can occur from overdosing or from drug-drug interactions with the simultaneous administration of cytochrome P-450 3A inhibitors and possibly P-glycoprotein inhibitors. Tacrolimus toxicity can be severe and may include multiorgan damage. We present a case of suspected tacrolimus toxicity in a postallogeneic hematopoietic stem cell transplant patient who was concurrently using oral marijuana. This case represents an important and growing clinical scenario with the increasing legalization and use of marijuana throughout the United States.

Pharmacokinetics of Ganciclovir Following Oral Valganciclovir Versus Intravenous Ganciclovir in Allogeneic Hematopoietic Stem-Cell Transplant Patients with Stable Graft-Versus-Host Disease of the Gastrointestinal Tract.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2223-2223 ◽  
Author(s):  
Drew J. Winston ◽  
Voravit Ratanatharathorn ◽  
Lindsey Baden ◽  
Christos Emmanouilides ◽  
Don Gabriel ◽  
...  
Keyword(s):  
Stem Cell ◽  
Creatinine Clearance ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Study Drug ◽  
Preemptive Therapy ◽  
Solid Organ ◽  
Cell Transplant ◽  
Hematopoietic Stem

Abstract Cytomegalovirus (CMV) disease can be effectively prevented in allogeneic hematopoietic stem cell transplant (HSCT) patients by ganciclovir (GCV) given as prophylaxis or preemptive therapy. Due to the low bioavailability of oral GCV capsules, GCV is usually administered intravenously (IV) to HSCT patients. Valganciclovir (VGCV) is the valine ester prodrug of ganciclovir. In healthy subjects, HIV-infected patients, and solid-organ transplants, the oral bioavailability of VGCV is about 60%, or 10-fold higher than oral GCV capsules. The bioavailability and total GCV exposure provided by oral VGCV relative to IV GCV in HSCT patients with gastrointestinal (GI) GHVD has not been established. METHODS: HSCT patients were eligible for the study if the following criteria were satisfied: 1) ≥16 years of age; 2) biopsy-proven GHVD of GI tract with nausea and/or diarrhea (300–1500 ml/day) or proven GVHD of skin or liver plus diarrhea with no other explanation; 3) no active CMV infection or disease; 4) neutrophil count ≥1000/μL; 5)creatinine clearance >60 ml/min. Following a standardized breakfast, eligible patients were randomized to receive a single dose of open-label study drug (900 mg of oral VGCV or 5 mg/kg of IV GCV). After a minimum 48 hr. washout period, patients were crossovered to alternate study drug. Blood for levels of GCV and VGCV were obtained predose and then over the 24 hours after dosing. Pharmacokinetic (PK) parameters were derived by noncompartmental methods. RESULTS: Data from 16 patients are currently available. Patient demographics include mean age 45 yrs (range 23 to 58 yrs); males 13, females 3; mean weight 80kg (range 52 to 107 kg); mean creatinine clearance 96 ml/min (range 62 to 184 ml/min). Median time after transplant for study was 303 days (range 102 to 988 days). Mean GCV PK parameters are summarized in the following table. Mean GCV Value (Coefficient of variation in %) Oral VGCV-900 mg IV GCV-5mg/kg Parameter N = 16 N = 16 AUC o -τ (μg•hr/mL) 43.58 (37) 46.74 (40) AUC o-∞ (μg•hr/mL) 46.03 (41) 48.89 (43) C(max) μg/mL) ( 6.45 (30) 12.53 (30) T max (hr) 3.13 (22) 0.97 (8) T½ (hr) 4.97 (31) 5.09 (29) GCV AUC values were similar, although maximum GCV concentrations were higher and acheived earlier with IV GCV. Terminal elimination half-life of GCV with oral VGCV and IV GCV were similar. After 900 mg of oral VGCV, mean plasma Cmax for VGCV was low (0.22 μg/mL), which is consistent with rapid and almost complete metabolism of VGCV to GCV. CONCLUSION: These preliminary results suggest that systemic exposure to GCV after 900 mg of oral VGCV is comparable to that achieved with IV GCV in HSCT patients with stable GI GVHD. Oral VGCV could be a useful alternative to IV GCV in certain HSCT patients requiring prophylaxis or preemptive therapy for CMV.

Tuberculosis in Pediatric Solid Organ and Hematopoietic Stem Cell Transplant Recipients

2012 ◽  
Vol 31 (7) ◽  
pp. 774-777 ◽  
Author(s):  
Raquel Vecino ◽  
Begoña Santiago ◽  
Fernando Baquero-Artigao ◽  
Goosen Luis López ◽  
Carmen García ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell ◽  
Hematopoietic Stem Cell Transplant ◽  
Stem Cell Transplant ◽  
Solid Organ ◽  
Cell Transplant ◽  
Transplant Recipients ◽  
Hematopoietic Stem
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