Infections After High-Dose Chemotherapy and Autologous Hematopoietic Stem Cell Transplantation

Nucci, Márcio; Anaissie, Elias

doi:10.1007/978-3-662-44000-1_4

Cited by 6 publications

(5 citation statements)

References 60 publications

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“…The most important factors influencing the speed of immune reconstitution are the immune status before HSCT and the need for additional immunosuppressive treatment. Likewise, additional chemotherapy after HSCT greatly increases the risk of infection [17]. When we correlated between septicemia and hepatic injury between autologous and allogeneic patients, we found that septicemia had no statistically significant effect on liver injury during transplant.…”

Section: Discussionmentioning

confidence: 84%

Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experience

Abdelbary

Magdy

Moussa

et al. 2020

J Egypt Natl Canc Inst

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Background: Hepatic complications are a well-known cause of both early and late mortality and morbidity in hematopoietic stem cell transplant (HSCT) recipients. Early diagnosis and management of hepatic complications is important in order to commence appropriate therapy. Conditioning regimens, acute and chronic graft versus host disease, sinusoidal obstruction syndrome, and infections among others represent major hepatic complications for the transplant recipient. We assessed liver function tests, viral markers, polymerase chain reaction, abdominal ultrasound, portal, and hepatic venous duplex in 88 patients underwent autologous and 102 patients underwent allogeneic transplant as well as liver biopsy in selected patients in this retrospective study and evaluated early and late hepatic complications and their impact on transplant outcome. Results: The major cause of hepatic injury in allogeneic patients is the conditioning regimen (38.8%) followed by acute GVHD (14.7%), after day +100 chronic hepatic GVHD is the primary cause of liver injury which occurred in about 40% of allogeneic patients. In autologous patients, the first cause of hepatotoxicity is also conditioning regimen involving 27.9% of patients followed by flare of viral hepatitis in 7.9% and sepsis in 6.3% of cases. The prevalence of HCV, HBV, and CMV is 19%, 16%, and 8%, respectively. Conclusion: In our study, conditioning regimens, acute and chronic hepatic GVHD are frequent causes of hepatic injury following allogeneic HSCT while conditioning regimens, flare of viral hepatitis, and sepsis represent the most common causes of hepatic injury following autologous HSCT.

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Section: Discussionmentioning

confidence: 84%

Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experience

Abdelbary

Magdy

Moussa

et al. 2020

J Egypt Natl Canc Inst

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“…Candida albicans is a prevalent fungal pathogen, causing superficial infection and life‐threatening systemic diseases (Horn et al ., ; Sardi et al ., ). With the increasing population suffering from AIDS and the broader practice of organ transplantation and chemotherapy, systemic infections relating to this pathogen have become a more pressing concern (Nucci and Anaissie, ; Pfaller and Diekema, ; Diekema and Pfaller, ). To survive the harsh environment, C .…”

Section: Introductionmentioning

confidence: 99%

Role of Aif1 in regulation of cell death under environmental stress in Candida albicans

Zhang

Wang

et al. 2016

Yeast

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Apoptosis-inducing factor (AIF) is a conserved flavoprotein localized in the mitochondria, inducing apoptosis after translocation into the nucleus. However, its role in the important fungal pathogen, Candida albicans, remains to be investigated. In this study, we find that the C. albicans AIF protein Aif1, similar to its homologues in other organisms, is localized at the mitochondria and translocated into the nucleus under apoptosis-inducing conditions. Moreover, deletion of AIF1 causes attenuated apoptosis in this pathogen under apoptosis-inducing conditions, such as the treatment of 2 mm H2 O2 , 10 mm acetic acid or 0.08 mg/l caspofungin, and its overexpression enhances this process. Interestingly, treatment with high levels of these agents leads to reversed sensitivity of aif1Δ/Δ and the overexpression strain AIF1ov. In addition, the virulence of C. albicans is not affected by deletion or overexpression of AIF1. Hence, C. albicans Aif1, as a mitochondria-localized protein, plays a dual role in the regulation of cell death under different concentrations of the stress-caused agents. Copyright © 2016 John Wiley & Sons, Ltd.

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“…Основной спектр токсичности у пациентов, получивших ВДХТ с аутоТГСК, представляют собой инфекционные осложнения, преимущественно бактериальной этиологии. Вероятность возникновения и степень тяжести инфекционного процесса во многом зависит от возраста пациента, его соматического статуса на момент проведения ВДХТ, сопутствующей патологии, объема предшествующей терапии, а также используемого режима кондиционирования [27]. В нашем исследовании также доминировали инфекционные осложнения бактериальной этиологии с преобладанием грамотрицательной микрофлоры (Enterobacter spp.…”

Section: рис 1 кривые 2-летней бессобытийной и общей выживаемости в з...unclassified

Intensive regimens of chemotherapy with hematopoetic stem cell rescue in paediatric patients with high-risk malignant tumors

Dinikina

Morgacheva

Smirnova

et al. 2022

jour

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Background. One of the possible options to intensify therapy in patients with high-risk malignant tumors is high-dose chemotherapy (HDCT) with autologous hematopoetic stem cell rescue. However, this method has a high risk of acute and delayed toxicity, and, sometimes doesn’t meet the expected effectiveness. This confirms the necessity of more considerate approach for choosing the category of patients for this therapeutic option with the determination of the most significant factors on the part of the patient and the type of malignant tumor.Objective. Analysis of the results of HDCT with autologous hematopoetic stem cell transplantation (HSCT) in children with high-risk solid malignancies, conducted in the Department of pediatric oncohematology and BMT of the Federal State Budgetary Institution “V.A. Almazov National Medical Research Center”.Design and methods. We perform a retrospective analysis of 55 cycles of HDCT with autologous hematopoetic stem cell rescue provided from 2017 to 2020 in 39 patients with high-risk malignant tumors. The toxicity and efficacy of the method were assessed taking into account the frequency of infectious complications, early post-transplant mortality, event-free (EFS) and overall survival (OS).Results. The predominant category of patients were children with CNS tumors (61.5 %). Mean age of the patients was 2 years 9 months. At the time of HDCT 35.9% of patients were in complete remission (CR), 64.1 % had signs of active disease (AD). In 59% of patients, one course of HDCT was performed, in 41 % — tandem transplantation was performed according to the recommendations of the protocol for the treatment of the disease. The most common conditioning regimen was carboplatin + etoposide (27.3 %). The predominant source of hematopoietic stem cells were peripheral stem cells (87.3 %). The frequency of infectious complications in the post-transplant period was 100 %, neutropenic enterocolitis (61.8 %) and febrile neutropenia (34.5 %) were predominant. A high frequency of reactivation of CMV infection (25.4 %) was noted, meanwhile CMV disease occurred in 35.7 % of cases. The most important prognostic factor was the disease status at the time of HDCT. 2-year OS incidence of 85.7 % vs 65.3% and EFS 85.7 % vs 39 % in patients with CR and AD respectively. After completing the course of HDCT with autologous HSCT 94.8 % of patients continued anticancer therapy.Conclusion. HDCT with autologous HSCT demonstrates a satisfactory toxicity profile and can improve OS and EFS in children with high-risk malignant tumors. A reliable prognostic factor that determines the effectiveness of the method is the disease status at the time of HDCT.

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Infections After High-Dose Chemotherapy and Autologous Hematopoietic Stem Cell Transplantation

Cited by 6 publications

References 60 publications

Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experience

Liver disease during and after hematopoietic stem cell transplantation in adults: a single-center Egyptian experience

Role of Aif1 in regulation of cell death under environmental stress in Candida albicans

Intensive regimens of chemotherapy with hematopoetic stem cell rescue in paediatric patients with high-risk malignant tumors

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