Management of Infectious Complications in the Hematopoietic Stem Cell Transplant Recipient

Nichols, W. Garrett

doi:10.1177/0885066603258009

Cited by 26 publications

(12 citation statements)

References 115 publications

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“…Plasma ADAMTS13 activity was determined by fluorescence resonance energy transfer (FRETS)-vWF73 according to the method described previously [28, 29]. …”

Section: Methodsmentioning

confidence: 99%

Plasma levels of complement activation fragments C3b and sC5b-9 significantly increased in patients with thrombotic microangiopathy after allogeneic stem cell transplantation

Wang

Chen

et al. 2017

Ann Hematol

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Transplantation-associated thrombotic microangiopathy (TA-TMA) is an uncommon but severe complication in patients undergoing allogeneic stem cell transplantation (allo-SCT). However, the mechanism is unclear. From 2011 to 2014, 20 patients with TA-TMA, 20 patients without, and 54 patients with various other complications, including veno occlusive disease (VOD), graft-versus-host disease (GVHD), and infection, were recruited in the study. Plasma vWF antigen (vWFAg), vWF activity (vWFAc), and ADAMTS13 activity were determined in these patients by ELISAs and FRETS-vWF73 assay, respectively. Plasma C3b, sC5b-9, and CH50 were also determined by ELISAs. Plasma levels of C3b were significantly increased in patients with either TA-TMA (p < 0.0001) or GVHD (p < 0.01). Plasma sC5b-9 and CH50 levels in patients with TA-TMA were also significantly increased (p < 0.001). Plasma ADAMTS13 activity was lower in patients with VOD, but normal with other complications. Both plasma vWFAg and vWFAc levels were not elevated in patients with TA-TMA or VOD compared with those of other groups. Complement activation likely via an alternative pathway (increased C3b, sC5b-9, and CH50) may play a role in the pathogenesis of TA-TMA. ADAMTS13 activity is reduced in VOD, but the ADAMTS13/vWF axis appears to be unaffected in patients with TA-TMA.

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“…Plasma ADAMTS13 activity was determined by fluorescence resonance energy transfer (FRETS)-vWF73 according to the method described previously [28, 29]. …”

Section: Methodsmentioning

confidence: 99%

Plasma levels of complement activation fragments C3b and sC5b-9 significantly increased in patients with thrombotic microangiopathy after allogeneic stem cell transplantation

Wang

Chen

et al. 2017

Ann Hematol

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“…In contrast, pulmonary aspergillosis may cause isolated nodular lesions, multiple lesions, or diffuse pulmonary infiltrates [10]. The time-distribution of the incidence of pulmonary mycoses following allogeneic HSCT is characterized by an early peak as a consequence of neutropenia, starting in the second week of neutropenia, and a later peak which is explained by the development of acute graft versus host disease (GVHD) and steroid treatment, resulting in a suppression of cell-mediated immunity and phagocytosis (Table I) [11].…”

Section: Pathogenesis and Risk Factors Of Pulmonary Mycoses Followingmentioning

confidence: 99%

Modern management of respiratory failure due to pulmonary mycoses following allogeneic hematopoietic stem‐cell transplantation

Koldehoff

Zakrzewski

2005

American J Hematol

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Pulmonary mycoses count among the most dangerous complications in allogeneic hematopoietic stem cell transplantation. Despite the establishment of antifungal chemoprophylaxis and empirical antifungal treatment, they frequently lead to respiratory failure and are still associated with an extraordinarily poor prognosis. However, the emergence of new antimycotics with alternative mechanisms of actions and decreased toxicity in combination with the development of new non culture-based diagnostic techniques may allow earlier, more aggressive and more effective antifungal treatment approaches. In addition, the optimized use of new technologies designed to augment spontaneous breathing efforts by patients, mechanical ventilation, as well as the advantages of early tracheostomy lead us to expect better outcomes in the treatment of respiratory failure due to pulmonary mycoses following allogeneic hematopoietic stem cell transplantation.

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“…Risk of CMV disease is only 1 -3% in seronegative donors to seronegative recipients [51]. In contrast, seropositive autologous SCT recipients have a lower risk of CMV reactivation and disease (40% and ~5% respectively) [49,52].…”

Section: Cytomegalovirus (Cmv)mentioning

confidence: 99%

Viral Diagnostics and Antiviral Therapy in Hematopoietic Stem Cell Transplantation

Anderson¹

2008

CPD

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Viral infections are important causes of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients. Some viruses, such as the respiratory and gastrointestinal viruses, are acquired from the healthcare or community in the midst of or after HSCT. Other viruses, such as the herpes-virus family, establish latency after resolution of primary infection but then may reactivate during the immunosuppression that occurs with HSCT. Due to the improved sensitivity and turn-around time with PCR-based molecular diagnostic methods, traditional viral diagnostic methods such as viral culture and rapid shell vial are rapidly being replaced or supplemented. Prophylactic and preemptive strategies are increasingly used to limit reactivation of viruses that have established latency. Improvements in diagnostics result in earlier viral detection and antiviral initiation which may improve outcomes. Newly identified viruses such as human metapneumovirus are being increasingly recognized as pathogens in HSCT recipients. Treatment strategies for viral pathogens continue to change as our understanding of these viral diseases improves.

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Management of Infectious Complications in the Hematopoietic Stem Cell Transplant Recipient

Cited by 26 publications

References 115 publications

Plasma levels of complement activation fragments C3b and sC5b-9 significantly increased in patients with thrombotic microangiopathy after allogeneic stem cell transplantation

Plasma levels of complement activation fragments C3b and sC5b-9 significantly increased in patients with thrombotic microangiopathy after allogeneic stem cell transplantation

Modern management of respiratory failure due to pulmonary mycoses following allogeneic hematopoietic stem‐cell transplantation

Viral Diagnostics and Antiviral Therapy in Hematopoietic Stem Cell Transplantation

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