Background: Parathyroid hormone (PTH) is a calcium homeostasis regulator and can affect bone marrow niche. PTH leads to the bone marrow stem cell niche expansion as well as the induction of stem cell mobilization from the bone marrow into peripheral blood. In this study, we evaluated the association between pre-transplantation serum PTH levels and the number of circulating CD34+ cells along with the platelets/white blood cells (Plt/WBC) engraftment in patients who underwent autologous Hematopoietic Stem Cell Transplantation . Methods: Subjects for the study were 100 patients who received autologous hematopoietic stem cell transplantation (auto-HSCT), retrospectively. Serum levels of PTH, calcium, phosphorus, and alkaline phosphatase were measured before mobilization. Their impacts were measured on the number of mobilized CD34+ hematopoietic stem cells, and Plt/WBC engraftment. Results: High levels of serum PTH (> 63.10 pg/mL) was significantly associated with higher number of CD34+ cells in peripheral blood after granulocyte-colony stimulating factor (G-CSF)-induced mobilization (p= 0.079*). Serum calcium at low levels were associated with higher number of circulating CD34+ cells post mobilization. Pre-transplantation serum levels of phosphorus and alkaline phosphatase on CD34+ numbers were not statistically significant. Serum Plt/WBC engraftment was not improved in presence of high levels of serum PTH. Conclusions: We suggested that serum PTH levels before transplantation could be influential in raising the number of circulating CD34+ hematopoietic stem cell after mobilization.
Background: Patients undergoing bone marrow transplantation (BMT) are high-risk during the Coronavirus disease 2019 (COVID-19) outbreak. Viral infections are a common complication in transplanted patients. Since BMT is a definitive line treatment for many hematological malignancies, the BMT unit should provide therapy services during the COVID-19 outbreak. According to studies over the past two years, following the COVID-19 prevention guidelines recommended by the World Health Organization (WHO) and European Group for Blood and Marrow Transplantation (EBMT) has made it possible to carry out this high-risk treatment. This review article presents the experiences and challenges of BMT centers during the outbreak of COVID-19.
Methods: The present study is a review article based on searching in medical-scientific databases, including PubMed, Scopus, MEDLINE, and Google Scholar, from 2020 to 2021. All articles were evaluated, and 30 articles were selected as the primary sources of study.
Conclusion: Regarding the stability and new strains emergence of coronavirus over the last two years, as well as the importance of BMT as the last-line treatment in some hematological malignancies, COVID-19 prevention is the first pivotal step for immunity of BMT donor and recipient. Training medical service personnel and patients will effectively prevent virus contagiousness and spread. Moreover, regular screening of medical staff can inhibit viral transmission to admitted patients. Stick to home quarantine in patients pre-and post-BMT restricts the risk of COVID-19 contamination.
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