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Hematopoietic Stem Cell Transplantation
Stem Cell Transplantation Complications

Images

WIKIDATA, CC BY-SA 3.0
WIKIDATA, CC BY-SA 4.0

Presentation

The purpose of the present study was to determine HAdV types responsible for viremia in HSCT recipients at a large tertiary hospital in Poland. [ncbi.nlm.nih.gov]

Entire Body System

  • Lymphedema

    […] complications occurred in the post-transplantation phase, including acute graft versus host disease, posterior reversible encephalopathy, thrombotic thrombocytopenic purpura, bilateral keratoconjunctivitis with complete loss of vision, and chronic lower limb lymphedema [ncbi.nlm.nih.gov]

Jaw & Teeth

  • Tongue Ulcer

    Despite acyclovir prophylaxis (200 mg/day), she developed the right palatal ulcer that was positive for HSV-1 specific antigen by fluorescent antibody on day 20 and developed new hypoglossal and tongue ulcers on day 33. [ncbi.nlm.nih.gov]

Eyes

  • Dry Eyes

    Dry eye was diagnosed in 14 out 46 hematological patients (30.4%). [ncbi.nlm.nih.gov]

    Keratoconjunctivitis sicca, or dry eyes, is part of chronic GVHD syndrome. Other adverse effects include retinopathy, infectious retinitis, and hemorrhage. [emedicine.medscape.com]

    Other important symptoms that should be assessed include dry eyes and oral changes such as atrophy, ulcers, and lichen planus. [cancer.gov]

  • Blurred Vision

    Potential side effects: Nausea, vomiting and diarrhea Lowers blood counts Hair loss Irritation and sores in the mouth and intestinal tract Damage to the liver Drowsiness blurred vision May sensitize the skin to sunlight Tacrolimus (FK506) What it does [ucsfbenioffchildrens.org]

Neurologic

  • Bradykinesia

    Parkinsonism symptoms such as muscle rigidity, bradykinesia, tremor, and postural instability were initial manifestations. Magnetic resonance imaging showed diffuse symmetrical lesions of bilateral basal ganglia lacking ringed enhancement. [ncbi.nlm.nih.gov]

  • Postural Instability

    Parkinsonism symptoms such as muscle rigidity, bradykinesia, tremor, and postural instability were initial manifestations. Magnetic resonance imaging showed diffuse symmetrical lesions of bilateral basal ganglia lacking ringed enhancement. [ncbi.nlm.nih.gov]

Workup

The laboratory workup showed hemoglobin of 11.1 g/dL; white blood cells, 7500/mL; platelets, 172,000/mL; free thyroxine (FT4), 4.80 ng/dL (normal, 0.5-1.51); free triiodothyronine (FT3), 17.7 pg/mL (normal, 2.5-3.9); thyrotropin (TSH), 0.015 mIU/mL (normal [ncbi.nlm.nih.gov]

Several retrospective studies addressed that question, but an independent impact of age was often absent. 45, 48 ⇓ ⇓ - 51 Those studies suggested no definite age limit, but they noted that the assessment of comorbidities was an essential part of the workup [bloodjournal.org]

Table 2 Transplant features ( n =30) Pretransplant workup was as appropriate to ensure adequate organ function and to establish disease status. [doi.org]

Serum

  • Dyslipidemia

    Dyslipidemia was associated with a primary diagnosis of hematological malignancy, TBI, and a positive family history of dyslipidemia. Endocrine dysfunction was less frequent in patients who had received fludarabine. [ncbi.nlm.nih.gov]

    Survivors also had an increased cumulative incidence of related conditions that predispose towards more serious cardiovascular disease (i.e., hypertension, renal disease, dyslipidemia, and diabetes).[ 13 ] In addition, cardiac function and pre-HCT exposures [cancer.gov]

Microbiology

  • Toxoplasma Gondii

    KEYWORDS: Toxoplasma gondii ; hematopoietic stem cell transplantation; parkinsonism [ncbi.nlm.nih.gov]

Treatment

In case the patient's own stem cells are increasing in number post-treatment, this might be a sign the treatment did not work as intended. [en.wikipedia.org]

Interest has developed in combining these treatments for high-risk hematologic diseases. [ncbi.nlm.nih.gov]

Donor lymphocyte infusion Donor lymphocyte infusion (DLI) was a treatment option in the event of relapse or disease progression in patients without GVHD who had discontinued immunosuppressive treatment. [dx.doi.org]

Prognosis

Nutritional status recovery and prognosis were significantly worse in patients who developed OM. [ncbi.nlm.nih.gov]

Etiology

Pneumatosis intestinalis (PI), defined as intestinal intra- and extramural gas accumulation, is a rare radiographic finding in conditions of intestinal wall damage of varied etiology. [ncbi.nlm.nih.gov]

Coplin et al, evaluated the incidence, etiology and prognosis of strokes in patients after HSCT. [scielo.br]

[…] as preparative regimen elements, prior use of gemtuzumab ozogamicin (Mylotarg, which is used to treat acute myelogenous leukemia by targeting CD33 expressing cells and thus may be toxic to liver sinusoids) and pre-HSCT liver disease irrespective of etiology [clinicaladvisor.com]

Idiopathic pneumonia syndrome after hematopoietic cell transplantation: evidence of occult infectious etiologies. Blood 2015;125:3789–97. 74. Nakane T, Nakamae H, Kamoi H, et al. [mdedge.com]

[…] chronic complications of type 1 diabetes mellitus (DM)—the higher the C-peptide levels (an indirect measure of viable beta-cell function), the lower the incidence of microvascular complications of type 1 DM. 1 Since the establishment of the autoimmune etiology [dx.doi.org]

Epidemiology

Epidemiology of Aspergillus infections in a large cohort of patients undergoing bone marrow transplantation. J Infect Dis 1997;175:1459–66. 45. Ascioglu S, Rex JH, de Pauw B, et al. [mdedge.com]

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007; 147 :573–7. [ PubMed ] [ Google Scholar ] 19. [ncbi.nlm.nih.gov]

Knowles WA (2006) Discovery and epidemiology of the human polyomaviruses BK virus (BKV) and JC virus (JCV). Adv Exp Med Biol 577: 19-45. [omicsonline.org]

Calculated incidence rates were compared with age-specific (crude) incidence rates in the general white population of leukemia, non-Hodgkin’s lymphoma, Hodgkin’s lymphoma and myeloma, obtained from the US Surveillance, Epidemiology, and End Results (SEER [doi.org]

Pathophysiology

In this paper, we focused on the definitions of graft failure / poor graft function and also we reviewed the current understanding of the pathophysiology, risk factors and treatment approaches for these entities. Copyright © 2018. [ncbi.nlm.nih.gov]

Review the pathophysiology of graft-versus-host disease, its presentation, and its prevention and management. [pedsinreview.aappublications.org]

Abstract Multiple sclerosis (MS) is a demyelinating disease of the central nervous system in which immune mechanisms appear to be an important component of the pathophysiology. [doi.org]

Pathophysiology of acute lung injury and the adult respiratory distress syndrome. Semin Respir Crit Care Med 2006;27:337-349. Cagle PT, Allen TC, Barrios R, Bedrossian C, Dishop MK. Color atlas and text of pulmonary pathology. 2nd ed. [thoracic.org]

Prevention

The role of the newly approved drug, letermovir, for CMV prevention is highlighted in the context of current prevention strategies after allogeneic hematopoietic stem cell transplantation. [ncbi.nlm.nih.gov]

Larmouth. 5 Prevention of infection during hematopoietic stem cell transplantation. W. Larmouth and A.Galloway. 6 Bacterial, fungal, and parasitic infections in the transplant patient. G. Jones, J. Clark and A. [wiley.com]

These can often be prevented by simple measures as frequent hand washing, vaccinations and appropriate donor screening. [omicsonline.org]

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