Portal vein thrombosis after hematopoietic cell transplantation: frequency, treatment and outcome

Kikuchi, Kokichi; Rudolph, R. H.; Murakami, Carol S.; Kowdley, Kris V.; McDonald, George B.

doi:10.1038/sj.bmt.1703368

Cited by 18 publications

(4 citation statements)

References 25 publications

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“…Serious adverse events due to procedural complications in combination with underlying disease conditions (e.g. veno-oclusive disease) have been reported during clinical experience with HSC transplantation [99,100]. …”

Section: Risk Factorsmentioning

confidence: 99%

Risk factors in the development of stem cell therapy

2011

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Stem cell therapy holds the promise to treat degenerative diseases, cancer and repair of damaged tissues for which there are currently no or limited therapeutic options. The potential of stem cell therapies has long been recognised and the creation of induced pluripotent stem cells (iPSC) has boosted the stem cell field leading to increasing development and scientific knowledge. Despite the clinical potential of stem cell based medicinal products there are also potential and unanticipated risks. These risks deserve a thorough discussion within the perspective of current scientific knowledge and experience. Evaluation of potential risks should be a prerequisite step before clinical use of stem cell based medicinal products.The risk profile of stem cell based medicinal products depends on many risk factors, which include the type of stem cells, their differentiation status and proliferation capacity, the route of administration, the intended location, in vitro culture and/or other manipulation steps, irreversibility of treatment, need/possibility for concurrent tissue regeneration in case of irreversible tissue loss, and long-term survival of engrafted cells. Together these factors determine the risk profile associated with a stem cell based medicinal product. The identified risks (i.e. risks identified in clinical experience) or potential/theoretical risks (i.e. risks observed in animal studies) include tumour formation, unwanted immune responses and the transmission of adventitious agents.Currently, there is no clinical experience with pluripotent stem cells (i.e. embryonal stem cells and iPSC). Based on their characteristics of unlimited self-renewal and high proliferation rate the risks associated with a product containing these cells (e.g. risk on tumour formation) are considered high, if not perceived to be unacceptable. In contrast, the vast majority of small-sized clinical trials conducted with mesenchymal stem/stromal cells (MSC) in regenerative medicine applications has not reported major health concerns, suggesting that MSC therapies could be relatively safe. However, in some clinical trials serious adverse events have been reported, which emphasizes the need for additional knowledge, particularly with regard to biological mechanisms and long term safety.

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Section: Risk Factorsmentioning

confidence: 99%

Risk factors in the development of stem cell therapy

2011

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“…Therefore, high dose of cells may be needed for therapy, increasing the risk of unwanted effects. Finally, concentrated cells may form aggregates and lead to pulmonary emboli or infarctions following administration , especially when intravenously infused, as demonstrated in hematopoietic stem cell (HSC) transplants . A recent study showed no serious side effects, systemic infection or cancer was associated with SVF cell therapy in a total of 1114 patients who received SVF for the treatment of osteoarthritis , indicating a safe profile of SVF, at least following intra‐articular injections for the treatment of joints.…”

Section: The Svf: Rise and Riskmentioning

confidence: 99%

Concise Review: Fat and Furious: Harnessing the Full Potential of Adipose-Derived Stromal Vascular Fraction

Dykstra

Facile

Patrick

et al. 2017

Stem Cells Translational Medicine

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Due to their capacity to self‐renew, proliferate and generate multi‐lineage cells, adult‐derived stem cells offer great potential for use in regenerative therapies to stop and/or reverse degenerative diseases such as diabetes, heart failure, Alzheimer's disease and others. However, these subsets of cells can be isolated from different niches, each with differing potential for therapeutic applications. The stromal vascular fraction (SVF), a stem cell enriched and adipose‐derived cell population, has garnered interest as a therapeutic in regenerative medicine due to its ability to secrete paracrine factors that accelerate endogenous repair, ease of accessibility and lack of identified major adverse effects. Thus, one can easily understand the rush to employ adipose‐derived SVF to treat human disease. Perhaps faster than any other cell preparation, SVF is making its way to clinics worldwide, while critical preclinical research needed to establish SVF safety, efficacy and optimal, standardized clinical procedures are underway. Here, we will provide an overview of the current knowledge driving this phenomenon, its regulatory issues and existing studies, and propose potential unmapped applications. Stem Cells Translational Medicine 2017;6:1096–1108

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“…When compared head to head, however postmenopausal women with hormone receptor positive breast cancer receiving anastrozole displayed significantly fewer incidence of steatosis compared to the tamoxifen arm 14.6% vs 41% at 3 year follow-up P <0.001. 9 …”

Section: Introductionmentioning

confidence: 99%

Chemotherapy induced liver abnormalities: an imaging perspective

et al. 2014

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Treating patients undergoing chemotherapy who display findings of liver toxicity, requires a solid understanding of these medications. It is important for any clinician to have an index of suspicion for liver toxicity and be able to recognize it, even on imaging. Cancer chemotherapy has evolved, and newer medications that target cell biology have a different pattern of liver toxicity and may differ from the more traditional cytotoxic agents. There are several hepatic conditions that can result and keen clinical as well as radiographic recognition are paramount. Conditions such as sinusoidal obstructive syndrome, steatosis, and pseudocirrhosis are more commonly associated with chemotherapy. These conditions can display clinical signs of acute hepatitis, liver cirrhosis, and even liver failure. It is important to anticipate and recognize these adverse reactions and thus appropriate clinical action can be taken. Often times, patients with these liver manifestations can be managed with supportive therapies, and liver toxicity may resolve after discontinuation of chemotherapy.

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Portal vein thrombosis after hematopoietic cell transplantation: frequency, treatment and outcome

Cited by 18 publications

References 25 publications

Risk factors in the development of stem cell therapy

Risk factors in the development of stem cell therapy

Concise Review: Fat and Furious: Harnessing the Full Potential of Adipose-Derived Stromal Vascular Fraction

Chemotherapy induced liver abnormalities: an imaging perspective

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