Our results though hampered by the limited number of patients and the lack of a control group suggest AHSCT to be efficacious in therapy-refractory CIDP, with a manageable complication profile. Confirmation of these results is necessary through randomised controlled trials.

Summary:solid tumours. 1 Haematological toxicity is no longer doselimiting. Instead, toxic effects to other organs, especially the gastro-intestinal tract (mucositis), prevent further dose The intensive cytotoxic treatment given in connection with bone marrow transplantations induces severe escalation. Clinically, mucositis can be categorised into oral toxicity which is characterized by mouth soreness and injury to the gut consistent with an increase in intestinal permeability. Currently, extent of the gut injury is which may lead to inability to eat and drink, and non-oral (gastro-intestinal) toxicity, manifesting with diarrhoea and assessed by inspecting the mouth and recording symptoms deriving from the gastro-intestinal tract. The aims abdominal pain, and which reflects diffuse intestinal injury. Gastro-intestinal permeability increases 2 may permit the of this study were to evaluate whether changes in permeability correlate with clinical assessment of gut passage of viable bacteria through the intestinal wall (bacterial translocation). 3 Various attempts have been made toxicity, according to the WHO criteria, and also to examine the duration of intestinal permeability after to circumvent mucositis, without convincing success. [4][5][6][7][8][9][10][11][12][13] In these trials, mostly focused on oral toxicity, the extent of high-dose chemotherapy. In 18 consecutive patients undergoing bone marrow transplantation, gastrogut damage has been evaluated clinically according to the WHO criteria. 14 Currently, no objective method is routinely intestinal permeability was assessed by a 51 Cr-EDTA absorption test before the start of cytotoxic treatment, used in clinical trials, as a complement to clinical evaluation, for the assessment of gastro-intestinal toxicity due and 4, 7, 10 and 14 days after stem-cell infusion. In another seven patients, permeability was assessed 2 days to chemotherapy and radiation. However, there are several reliable methods for non-invasive assessment of gastroafter the start of cytotoxic treatment, and 1, 7 and 14 days after stem cell infusion. During the same period, intestinal permeability in vivo, an accepted parameter for gut damage, 15 and the need for such a method has been oral-and non-oral clinical toxicity according to the WHO criteria were recorded. Permeability increased emphasized by others previously. 2The aims of this work were to evaluate whether changes significantly 2 days after the start of cytotoxic treatment (P Ͻ 0.05), on day 1 (P Ͻ 0.05), on day 4 (P Ͻ 0.0005), in permeability correlate with the clinical assessment of gut toxicity, according to the WHO criteria and to assess the on day 7 (P Ͻ 0.0005) and on day 10 (P Ͻ 0.005) after stem cell infusion, compared with pre-treatment perduration of the changes in intestinal permeability in the early post-transplant period. meability. Despite significant barrier dysfunction, clinical toxicity was very moderate in the early transplantation course. Gastro-intestinal, but not oral clinical Materials and methods toxicity requir...

The efficacy of allogeneic, haemopoietic stem cell transplantation (HSCT) is limited by concomitant toxicity. This has led to the development of less toxic, reduced intensity conditioning (RIC) protocols, whose therapeutic benefit is largely related to an associated, immunity-mediated graft-versus-malignancy effect rather than by the cytotoxic treatment itself. Murine HSCT models suggests that acute graft-versus-host disease (GVHD) increases with the intensification of the conditioning regimen mediated by loss of integrity of the gut mucosa barrier. The present study was undertaken to investigate gastro-intestinal (GI) permeability during allogeneic HSCT with RIC. In 17 patients (myeloablative conditioning in nine, RIC in eight), intestinal permeability was assessed by a (51)Cr-EDTA absorption test before the start of cytotoxic treatment the day before stem cell infusion (day -1) and 4, 7 and 14 days after stem cell infusion. Patients receiving RIC did not develop any significant increase in intestinal permeability during the transplantation course but in myeloablatively conditioned patients there was a significant increase in intestinal permeability the day before the stem cell infusion (P < 0.005), on day 4 (P < 0.005), on day 7 (P < 0.01) and on day 14 (P < 0.005) after stem cell infusion, compared with the baseline. Myeloablative conditioning also revealed increased intestinal permeability on day 7 compared with the RIC (P < 0.05). The finding of preserved intestinal-barrier function during allogeneic HSCT with RIC is discussed, with reference to the hypothesis that GI tract damage may be an important initiating event of GVHD.

Adenoviruses (AdV) have emerged as important causes of morbidity and mortality in patients after hematopoietic SCT (HSCT). Early diagnosis of the infection by detection of viral DNA may improve the prognosis. A surveillance strategy was evaluated for detection of AdV DNA by PCR in a prospective study of unselected allogeneic HSCT recipients. In parallel with a routine CMV surveillance program, plasma from 20 children and 77 adults was analyzed by quantitative PCR for detection of AdV DNA. In addition, in 12 unselected patients, the presence of AdV-specific T cells were analyzed by enzyme-linked immunosorbent spot (ELISPOT) at 1 to 3 months after transplantation. A total of 5 of 97 (5%) patients had detectable AdV DNA in peripheral blood. Only one patient had high titers and none developed AdV disease. BM as a source of stem cells and myelodysplastic syndrome as the indication for transplantation were independently associated with higher risk of acquiring AdV infection. AdV-specific T cells were detected in 7 (58%) of 12 patients. Although AdV DNA was found in peripheral blood by quantitative PCR in 5% of patients undergoing allogeneic HSCT, the present surveillance program did not have a significant effect on the clinical outcome.

In five out of 80 patients, orchiectomized in the course of treatment for prostatic carcinoma, metastatic growth in testicles, epididymis and/or spermatic cord was found. Two patients had bilateral metastases. Metastatic spread to scrotal organs seems to be more common than earlier thought. The most common way of dissemination is probably by lymphatic extension. Scrotal spread is a sign of advanced disease.