251
|
Shukla P, Dwivedi S, Bhargava M, Singh R, Singh S. Intraoperative autologous blood transfusion of peritoneal blood during laparotomy for ectopic pregnancy: prospective study. J Obstet Gynaecol India 2014; 64:358-61. [PMID: 25368461 DOI: 10.1007/s13224-014-0534-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 03/08/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the efficacy and safety of intraoperative autologous blood transfusion during laparotomy for hemoperitoneum in ectopic pregnancy and also safety of homologous blood transfusion along with autologous blood transfusion. METHOD Fresh blood, from peritoneal cavity, was collected for autotransfusion in sterile dish, filtered through eight layers of sterile gauze pieces, and collected in a sterile bowl. The collected blood was transferred into blood infusion bag containing citrate phosphate dextrose adenine solution in the proportion of five parts of blood to one part of citrate solution. RESULTS Mean volume of autologous blood transfused in patients without homologous transfusion was 573 ± 328. Mean preoperative hemoglobin was 4.95 ± 1.5, and postoperative hemoglobin was 6.85 ± 1.3. Hence, rise in hemoglobin was 1.9 g%. Autologous blood volume transfused in 29 patients (who required homologous blood transfusion) was 488 ± 216. Preoperative hemoglobin was 4.35 ± 1.94. The result was compared with other studies. CONCLUSION Intraoperative autologous blood transfusion enabled the performance of laparotomy in hemodynamically unstable ectopic pregnancy patients without availability of homologous blood transfusion. Homologous blood transfusion is compatible with autologous blood transfusion.
Collapse
|
252
|
Avelino-Silva VI, Ramos JF, Leal FE, Testagrossa L, Novis YS. Disseminated Fusarium infection in autologous stem cell transplant recipient. Braz J Infect Dis 2014; 19:90-3. [PMID: 25307678 PMCID: PMC9425235 DOI: 10.1016/j.bjid.2014.08.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 02/12/2014] [Accepted: 08/01/2014] [Indexed: 12/11/2022] Open
Abstract
Disseminated infection by Fusarium is a rare, frequently lethal condition in severely immunocompromised patients, including bone marrow transplant recipients. However, autologous bone marrow transplant recipients are not expected to be at high risk to develop fusariosis. We report a rare case of lethal disseminated Fusarium infection in an autologous bone marrow transplant recipient during pre-engraftment phase.
Collapse
Affiliation(s)
- Vivian Iida Avelino-Silva
- Department of Infectious and Parasitic Diseases, University of Sao Paulo Medical School, São Paulo, SP, Brazil; Hospital Sirio-Libanês, Sao Paulo, SP, Brazil.
| | - Jessica Fernandes Ramos
- Department of Infectious and Parasitic Diseases, University of Sao Paulo Medical School, São Paulo, SP, Brazil; Hospital Sirio-Libanês, Sao Paulo, SP, Brazil
| | - Fabio Eudes Leal
- Department of Infectious and Parasitic Diseases, University of Sao Paulo Medical School, São Paulo, SP, Brazil; Hospital Sirio-Libanês, Sao Paulo, SP, Brazil; Division of Clinic Immunology and Allergy, Medical School, University of São Paulo, São Paulo, SP, Brazil
| | | | | |
Collapse
|
253
|
Li F. The tale of autologous iPSCs: A monkey perspective. Genes Dis 2014; 1:129. [PMID: 30258860 PMCID: PMC6146141 DOI: 10.1016/j.gendis.2014.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 09/05/2014] [Indexed: 11/30/2022] Open
|
254
|
Bobrowitsch E, Lorenz A, Jörg J, Leichtle UG, Wülker N, Walter C. Changes in dissipated energy and contact pressure after osteochondral graft transplantation. Med Eng Phys 2014; 36:1156-61. [PMID: 25066582 DOI: 10.1016/j.medengphy.2014.06.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 06/10/2014] [Accepted: 06/28/2014] [Indexed: 11/27/2022]
Abstract
Osteochondral autologous transplantation is frequently used to repair small cartilage defects. Incongruence between the osteochondral graft surface and the adjacent cartilage leads to changed friction and contact pressure. The present study wanted to analyze the differences between intact and surgically treated cartilage surface in respect to contact pressure and frictional characteristic (dissipated energy). Six ovine carpometacarpal joints were used in the present study. Dissipated energy during instrumentally controlled joint movement as well as static contact pressure were measured in different cartilage states (intact, defect, deep-, flush-, high-implanted osteochondral graft and cartilage failure simulation on a high-implanted graft). The best contact area restoration was observed after the flush implantation. However, the dissipated energy measurements did not reveal an advantage of the flush implantation compared to the defect and deep-implanted graft states. The high-implanted graft was associated with a significant increase of the mean contact pressure and decrease of the contact area but the dissipated energy was on the level of intact cartilage in contrast to other treatments where the dissipated energy was significantly higher as in the intact state. However the cartilage failure simulation on the high-implanted graft showed the highest increase of the dissipated energy.
Collapse
Affiliation(s)
- Evgenij Bobrowitsch
- University Hospital Tübingen, Department of Orthopaedic Surgery, Biomechanics Laboratory, 72076 Tübingen, Germany.
| | - Andrea Lorenz
- University Hospital Tübingen, Department of Orthopaedic Surgery, Biomechanics Laboratory, 72076 Tübingen, Germany.
| | - Johanna Jörg
- University Hospital Tübingen, Department of Orthopaedic Surgery, Biomechanics Laboratory, 72076 Tübingen, Germany.
| | - Ulf G Leichtle
- University Hospital Tübingen, Department of Orthopaedic Surgery, Biomechanics Laboratory, 72076 Tübingen, Germany.
| | - Nikolaus Wülker
- University Hospital Tübingen, Department of Orthopaedic Surgery, Biomechanics Laboratory, 72076 Tübingen, Germany.
| | - Christian Walter
- University Hospital Tübingen, Department of Orthopaedic Surgery, Biomechanics Laboratory, 72076 Tübingen, Germany.
| |
Collapse
|
255
|
Bai YQ, Yang YX, Yang YG, Ding SZ, Jin FL, Cao MB, Zhang YR, Zhang BY. Outcomes of autologous bone marrow mononuclear cell transplantation in decompensated liver cirrhosis. World J Gastroenterol 2014; 20:8660-8666. [PMID: 25024623 PMCID: PMC4093718 DOI: 10.3748/wjg.v20.i26.8660] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/10/2014] [Accepted: 05/14/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine the long-term efficacy of autologous bone marrow mononuclear cells (BM-MNCs) transplantation in terms of improving liver function and reducing complications in patients with decompensated cirrhosis.
METHODS: A total of 47 inpatients with decompensated liver cirrhosis were enrolled in this trial, including 32 patients undergoing a single BM-MNCs transplantation plus routine medical treatment, and 15 patients receiving medical treatment only as controls. Forty-three of 47 patients were infected with hepatitis B virus. Bone marrow of 80-100 mL was obtained from each patient and the BM-MNCs suspension was transfused into the liver via the hepatic artery. The efficacy of BM-MNCs transplantation was monitored during a 24-mo follow-up period.
RESULTS: Liver function parameters in the two groups were observed at 1 mo after BM-MNCs transfusion. Prealbumin level was 118.3 ± 25.3 mg/L vs 101.4 ± 28.7 mg/L (P = 0.047); albumin level was 33.5 ± 3.6 g/L vs 30.3 ± 2.2 g/L (P = 0.002); total bilirubin 36.9 ± 9.7 mmol/L vs 45.6 ± 19.9 mmol/L (P = 0.048); prothrombin time 14.4 ± 2.3 s vs 15.9 ± 2.8 s (P = 0.046); prothrombin activity 84.3% ± 14.3% vs 74.4% ± 17.8% (P = 0.046); fibrinogen 2.28 ± 0.53 g/L vs 1.89 ± 0.44 g/L (P = 0.017); and platelet count 74.5 ± 15.7 × 109/L vs 63.3 ± 15.7 × 109/L (P = 0.027) in the treatment group and control group, respectively. Differences were statistically significant. The efficacy of BM-MNCs transplantation lasted 3-12 mo as compared with the control group. Serious complications such as hepatic encephalopathy and spontaneous bacterial peritonitis were also significantly reduced in BM-MNCs transfused patients compared with the controls. However, these improvements disappeared 24 mo after transplantation.
CONCLUSION: BM-MNCs transplantation is safe and effective in patients with decompensated cirrhosis. It also decreases the incidence of serious complications.
Collapse
|
256
|
Punnen S, Clint Cary K, Glass AS, Cowan JE, Carroll PR. Autologous retro-pubic urethral sling: a novel, quick, intra-operative technique to improve continence after robotic-assisted radical prostatectomy. J Robot Surg 2014; 8:99-104. [PMID: 27637518 DOI: 10.1007/s11701-013-0432-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 08/05/2013] [Indexed: 11/28/2022]
Abstract
After radical prostatectomy, many men may suffer from urinary incontinence, which can have detrimental effects on quality of life. We describe a novel technique using an autologous retro-pubic urethral sling placed at the time of robotic-assisted laparoscopic prostatectomy (RALP) and evaluate its impact on post-operative urinary continence. During 2011, 153 men who underwent sling placement at the time of RALP at a high-volume academic institution were compared to 78 men who did not undergo sling placement. The primary outcomes were time to one and no pads per day. The association between these outcomes and placement of a sling was assessed using Cox proportional hazards regression. Median follow-up was 26 weeks in those who had slings and 32.5 weeks in those who did not. Clinical and pathological characteristics were similar between the groups, with the exception that sling patients were older (p < 0.01) and underwent less nerve sparing (p < 0.01). Multivariate analysis showed that sling placement did not appear to have an effect on time to one (p = 0.24) or no pads per day (p = 0.20). Although the association between sling placement and early return of urinary continence did not reach statistical significance, there was a selection bias against the sling, since it was placed in men who were expected to have more difficulty regaining their continence. A randomized trial is needed to assess the true benefit of sling placement on urinary continence.
Collapse
Affiliation(s)
- Sanoj Punnen
- Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, 1600 Divisadero St, Box 1695, San Francisco, 94143-1695, CA, USA.
| | - K Clint Cary
- Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, 1600 Divisadero St, Box 1695, San Francisco, 94143-1695, CA, USA
| | - Allison S Glass
- Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, 1600 Divisadero St, Box 1695, San Francisco, 94143-1695, CA, USA
| | - Janet E Cowan
- Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, 1600 Divisadero St, Box 1695, San Francisco, 94143-1695, CA, USA
| | - Peter R Carroll
- Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, 1600 Divisadero St, Box 1695, San Francisco, 94143-1695, CA, USA
| |
Collapse
|
257
|
Buckland KF, Bobby Gaspar H. Gene and cell therapy for children--new medicines, new challenges? Adv Drug Deliv Rev 2014; 73:162-9. [PMID: 24583376 DOI: 10.1016/j.addr.2014.02.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 02/10/2014] [Accepted: 02/18/2014] [Indexed: 12/21/2022]
Abstract
The range of possible gene and cell therapy applications is expanding at an extremely rapid rate and advanced therapy medicinal products (ATMPs) are currently the hottest topic in novel medicines, particularly for inherited diseases. Paediatric patients stand to gain enormously from these novel therapies as it now seems plausible to develop a gene or cell therapy for a vast number of inherited diseases. There are a wide variety of potential gene and cell therapies in various stages of development. Patients who received first gene therapy treatments for primary immune deficiencies (PIDs) are reaching 10 and 15 years post-treatment, with robust and sustained immune recovery. Cell therapy clinical trials are underway for a variety of tissues including corneal, retinal and muscle repair and islet cell transplantation. Various cell therapy approaches are also being trialled to enhance the safety of bone marrow transplants, which should improve survival rates in childhood cancers and PIDs. Progress in genetic engineering of lymphocyte populations to target and kill cancerous cells is also described. If successful these ATMPs may enhance or replace the existing chemo-ablative therapy for several paediatric cancers. Emerging applications of gene therapy now include skin and neurological disorders such as epidermolysis bullosa, epilepsy and leukodystrophy. Gene therapy trials for haemophilia, muscular dystrophy and a range of metabolic disorders are underway. There is a vast array of potential advanced therapy medicinal products (ATMPs), and these are likely to be more cost effective than existing medicines. However, the first clinical trials have not been without setbacks and some of the key adverse events are discussed. Furthermore, the arrival of this novel class of therapies brings many new challenges for the healthcare industry. We present a summary of the key non-clinical factors required for successful delivery of these potential treatments. Technological advances are needed in vector design, raw material manufacture, cell culture and transduction methodology, and particularly in making all these technologies readily scalable.
Collapse
|
258
|
Main H, Munsie M, O'Connor MD. Managing the potential and pitfalls during clinical translation of emerging stem cell therapies. Clin Transl Med 2014; 3:10. [PMID: 24949190 DOI: 10.1186/2001-1326-3-10] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 04/08/2014] [Indexed: 02/07/2023] Open
Abstract
We are moving into a new era of stem cell research where many possibilities for treatment of degenerative, chronic and/or fatal diseases and injuries are becoming primed for clinical trial. These reports have led millions of people worldwide to hope that regenerative medicine is about to revolutionise biomedicine: either through transplantation of cells grown in the laboratory, or by finding ways to stimulate a patient’s intrinsic stem cells to repair diseased and damaged organs. While major contributions of stem cells to drug discovery, safety and efficacy testing, as well as modelling ‘diseases in a dish’ are also expected, it is the in vivo use of stem cells that has captured the general public’s attention. However, public misconceptions of stem cell potential and applications can leave patients vulnerable to the influences of profit driven entities selling unproven treatments without solid scientific basis or appropriate clinical testing or follow up. This review provides a brief history of stem cell clinical translation together with an overview of the properties, potential, and current clinical application of various stem cell types. In doing so it presents a clearer picture of the inherent risks and opportunities associated with stem cell research translation, and thus offers a framework to help realise invested expectations more quickly, safely and effectively.
Collapse
|
259
|
Guinot A, Arnaud A, Azzis O, Habonimana E, Jasienski S, Frémond B. Preliminary experience with the use of an autologous platelet-rich fibrin membrane for urethroplasty coverage in distal hypospadias surgery. J Pediatr Urol 2014; 10:300-5. [PMID: 24325905 DOI: 10.1016/j.jpurol.2013.09.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 09/26/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Platelet-rich fibrin (PRF) has been shown to have structural and biological properties that promote tissue healing. This prospective study evaluated the feasibility, safety, and efficiency of using autologous PRF membrane for urethroplasty coverage in distal hypospadias. MATERIALS AND METHODS We prospectively included 33 patients with distal hypospadias operated on between June 2010 and September 2011. Urethroplasties were performed using the Duplay technique. During surgery, 5-10 ml of patient's blood was collected and immediately centrifuged. A PRF clot was transformed into a dense fibrin membrane with a particular cell content and architecture. This membrane was applied and sutured over the urethroplasty. The perioperative course and complications were recorded. Outcomes were compared with those in a control group of children undergoing the same procedure, but with another mean of coverage. RESULTS With a median follow-up of 8 months (range, 6-18 months), urethral fistula occurred in 2/33 patients. No other complication was noted. No complication related to the blood sampling was reported. There was no statistically significant difference with the control group (p = 0.65). CONCLUSION The PRF patch seems to be a safe and efficient covering technique. Thus, procedure is an additional approach to coverage for hypospadias surgery, and may help to reduce the incidence of postoperative complications when coverage healthy tissue is not available.
Collapse
Affiliation(s)
- A Guinot
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France.
| | - A Arnaud
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France
| | - O Azzis
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France
| | - E Habonimana
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France
| | - S Jasienski
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France
| | - B Frémond
- Department of Pediatric Surgery, University Hospital of Rennes, F-35000, France
| |
Collapse
|
260
|
Abstract
Macular detachment causes visual deterioration in 25-75% of patients with congenital optic disc pit. A number of treatment options have been reported to manage the macular detachment in optic pit. An optic disc pit represents a defect in the lamina cribrosa; theoretically, an ideal procedure to treat optic pit associated macular detachment would be one that prevents the flow of fluid across the pit by creating an additional barrier. We present a new surgical technique that employs an autologous internal limiting membrane (ILM) to create this barrier. The technique involves standard vitrectomy along-with ILM peeling. Subsequently, the peeled ILM was inverted and transplanted onto the optic disc pit to close the optic nerve pit. This technique showed satisfactory anatomic result with good functional improvement in visual acuity.
Collapse
Affiliation(s)
- Osman Abdelzaher Mohammed
- Department of Surgery, Ophthalmology Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | | |
Collapse
|
261
|
Gopal AK, Gooley TA, Rajendran JG, Pagel JM, Fisher DR, Maloney DG, Appelbaum FR, Cassaday RD, Shields A, Press OW. Myeloablative I-131-tositumomab with escalating doses of fludarabine and autologous hematopoietic transplantation for adults age ≥ 60 years with B cell lymphoma. Biol Blood Marrow Transplant 2014; 20:770-5. [PMID: 24530971 DOI: 10.1016/j.bbmt.2014.02.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 02/05/2014] [Indexed: 11/29/2022]
Abstract
Myeloablative therapy and autologous stem cell transplantation (ASCT) are underutilized in older patients with B cell non-Hodgkin (B-NHL) lymphoma. We hypothesized that myeloablative doses of (131)I-tositumomab could be augmented by concurrent fludarabine, based on preclinical data indicating synergy. Patients were ≥ 60 years of age and had high-risk, relapsed, or refractory B-NHL. Therapeutic infusions of (131)I-tositumomab were derived from individualized organ-specific absorbed dose estimates delivering ≤ 27 Gy to critical organs. Fludarabine was initiated 72 hours later followed by ASCT to define the maximally tolerated dose. Thirty-six patients with a median age of 65 years (range, 60 to 76), 2 (range, 1 to 9) prior regimens, and 33% with chemoresistant disease were treated on this trial. Dose-limiting organs included lung (30), kidney (4), and liver (2) with a median administered (131)I activity of 471 mCi (range, 260 to 1620). Fludarabine was safely escalated to 30 mg/m(2) × 7 days. Engraftment was prompt, there were no early treatment-related deaths, and 2 patients had ≥ grade 4 nonhematologic toxicities. The estimated 3-year overall survival, progression-free survival, and nonrelapse mortality were 54%, 53%, and 7%, respectively (median follow up of 3.9 years). Fludarabine up to 210 mg/m(2) can be safely delivered with myeloablative (131)I-tositumomab and ASCT in older adults with B-NHL.
Collapse
Affiliation(s)
- Ajay K Gopal
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
| | - Ted A Gooley
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Joseph G Rajendran
- Division of Nuclear Medicine, Department of Radiology, University of Washington, Seattle, Washington
| | - John M Pagel
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - David G Maloney
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Frederick R Appelbaum
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Ryan D Cassaday
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Andrew Shields
- Division of Nuclear Medicine, Department of Radiology, University of Washington, Seattle, Washington
| | - Oliver W Press
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| |
Collapse
|
262
|
William BM, Allen MS, Loberiza FR, Bociek RG, Bierman PJ, Armitage JO, Vose JM. Phase I/II study of bortezomib-BEAM and autologous hematopoietic stem cell transplantation for relapsed indolent non-Hodgkin lymphoma, transformed, or mantle cell lymphoma. Biol Blood Marrow Transplant. 2014;20:536-542. [PMID: 24434781 DOI: 10.1016/j.bbmt.2014.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 01/08/2014] [Indexed: 11/22/2022]
Abstract
A phase I/II trial was designed to evaluate the safety and efficacy of adding bortezomib to standard BEAM (BCNU, etoposide, cytarabine, melphalan) and autologous hematopoietic stem cell transplantation (ASCT). Eligible patients had relapsed/refractory indolent or transformed non-Hodgkin lymphoma or mantle cell lymphoma (MCL) that was relapsed/refractory or in first partial (PR) or complete remission (CR). Patients received bortezomib on days -11, -8, -5, and -2 before ASCT. Phase I had 4 dose cohorts (.8, 1, 1.3, and 1.5 mg/m(2)) and 3 patients were accrued to each. Any nonhematological ASCT-related toxicity >2 on the Bearman scale occurring between day -11 and engraftment defined the maximum tolerated dose (MTD). After the MTD has been reached, another 20 patients were enrolled at this dose to determine a preliminary overall response rate (ORR). Patients who were in CR or PR at day +100 were considered responders. The study enrolled 42 patients through August 14, 2009. The median age was 58 (range, 34 to 73) years, with 33 males and 9 females. The most common diagnoses were MCL (23 patients) and follicular lymphoma (7 patients). The median number of prior therapies was 1 (range, 0 to 6). The median follow-up was 4.88 (range, 1.07 to 6.98) years. Thirteen patients were treated in phase I and 29 patients were treated in phase II. The MTD was initially determined to be 1.5 mg/m(2) but it was later decreased to 1 mg/m(2) because of excessive gastrointestinal toxicity and peripheral neuropathy. The ORR was 95% at 100 days and 87% at 1 year. For all 38 evaluable patients at 1 year, responses were CR 84%, PR 1%, and progressive disease 13%. Progression-free survival (PFS) was 83% (95% CI, 68% to 92%) at 1 year, and 32% (15% to 51%) at 5 years. Overall survival (OS) was 91% (95% CI, 79% to 96%) at 1 year and 67% (50% to 79%) at 5 years. The most common National Cancer Institute grade 3 toxicities were neutropenic fever (59%), anorexia (21%), peripheral neuropathy (19%), orthostatic hypotension/vasovagal syncope (16%), and 1 patient failed to engraft. Compared with 26 MCL in CR1 historic controls treated with BEAM and ASCT, PFS was 85% and 43% for the BEAM group versus 87% and 57% for those who received bortezomib in addition to standard BEAM (V-BEAM) at 1 and 5 years, respectively (log-rank P = .37). OS was 88% and 50% for the BEAM group versus 96% and 72% for V-BEAM at 1 and 5 years, respectively (log-rank P = .78). In conclusion, V-BEAM and ASCT is feasible. The toxicities were manageable and we did not observe any treatment-related mortalities; however, we did observe an excess of autonomic dysfunction and ileus, which is concerning for overlapping toxicity with BEAM conditioning. Determining relative efficacy of V-BEAM compared to BEAM would require a randomized trial.
Collapse
|
263
|
Abstract
OBJECTIVE Stem cell transplantation is usually performed in an effort to extend the patient's life span and to improve their quality of life. This study was conducted to determine the postoperative physiological effects experienced by patients who had undergone autologous and allogeneic stem cell transplantation. METHODS The research is a descriptive study conducted with a sample of 60 patients at Stem Cell Transplantation Units in Ankara. Percentile calculation and chi-square tests were used to evaluate the data. RESULTS When a comparison was made between patients who had undergone allogeneic Hematopoietic stem cell transplantation (HSCT) and those who had undergone autologous HSCT, results indicated that problems occurred more often for the allogeneic HSCT patients. The problems included: Digestion (94.3%), dermatological (76.7%), cardiac and respiratory (66.7%), neurological (66.7%), eye (56.7%), infections (26.7%) and Graft Versus Host Disease (5 patients). Furthermore, the problems with pain (50%), numbness and tingling (40%), and speech disorders (3 patients) were observed more often in autologous BMT patients. CONCLUSION Autologous and allogeneic patients experienced most of physical problems due to they receive high doses of chemotherapy. Therefore, it is recommended that an interdisciplinary support team approach should be usedtohelp reduce and manage the problems that may arise during patient care.
Collapse
Affiliation(s)
- Sevgisun Kapucu
- Department of Internal Diseases Nursing, Hacettepe University, Faculty of Nursing, Ankara, Turkey
| | - Yasemin Karacan
- Department of Hematology, MN Uludag University, Goruklu, Bursa, Turkey
| |
Collapse
|
264
|
Wayne AS, Giralt S, Kröger N, Bishop MR. Proceedings from the National Cancer Institute's Second International Workshop on the Biology, Prevention, and Treatment of Relapse after Hematopoietic Stem Cell Transplantation: introduction. Biol Blood Marrow Transplant 2013; 19:1534-6. [PMID: 24035783 DOI: 10.1016/j.bbmt.2013.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Accepted: 08/30/2013] [Indexed: 11/15/2022]
Abstract
Despite advances in hematopoietic stem cell transplantation (HSCT) for the treatment of hematologic malignancies, relapse remains the leading cause of death after transplant. Biologic and clinical investigations are needed to combat this primary cause of death after transplantation. The National Cancer Institute held international workshops in 2009 and 2012 to help address this problem. Three major initiatives for coordinated research were proposed: 1) To establish multicenter networks for basic, translational, epidemiologic and clinical research; 2) To establish a network of biorepositories for the collection of samples before and after HSCT to aid in laboratory and clinical studies; and 3) To refine, implement and study proposed definitions for disease-specific response and relapse and for monitoring of minimal residual disease. The workshop in 2012 also featured nine presentations, summaries of which follow in three manuscripts.
Collapse
Affiliation(s)
- Alan S Wayne
- Children's Center for Cancer and Blood Diseases, Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, The Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California; Organizing Committee, National Cancer Institute's Second International Workshop on the Biology, Prevention, and Treatment of Relapse after Hematopoietic Stem Cell Transplantation.
| | | | | | | |
Collapse
|
265
|
Avigan D, Hari P, Battiwalla M, Bishop MR, Giralt SA, Hardy NM, Kröger N, Wayne AS, Hsu KC. Proceedings from the National Cancer Institute's Second International Workshop on the Biology, Prevention, and Treatment of Relapse after Hematopoietic Stem Cell Transplantation: part II. Autologous Transplantation-novel agents and immunomodulatory strategies. Biol Blood Marrow Transplant 2013; 19:1661-9. [PMID: 24018393 DOI: 10.1016/j.bbmt.2013.08.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 08/30/2013] [Indexed: 12/11/2022]
Abstract
In the National Cancer Institute's Second International Workshop on the Biology, Prevention, and Treatment of Relapse after Hematopoietic Stem Cell Transplantation, the Scientific/Educational Session on Autologous Transplantation addressed the role of novel agents and immunomodulatory strategies in management of relapse after autologous hematopoietic stem cell transplantation (AHSCT). Concepts were illustrated through in-depth discussion of multiple myeloma, with broader discussion of areas relevant for relapse of other malignancies as well as in the setting of allogeneic transplantation. Dr. Hari provided an overview of the epidemiology of relapse after AHSCT in multiple myeloma, addressing clinical patterns, management implications, and treatment options at relapse, highlighting the implications of novel therapeutic agents in initial, maintenance, and relapse treatment. Dr. Avigan discussed current concepts in tumor vaccine design, including whole cell and antigen-specific strategies, use of an AHSCT platform to reverse tumor-associated immunosuppression and tolerance, and combining vaccines with immunomodulatory agents to promote establishment of durable antitumor immunity. Dr. Hsu reviewed the immunogenetics of natural killer (NK) cells and general NK biology, the clinical importance of autologous NK activity (eg, lymphoma and neuroblastoma), the impact of existing therapies on promotion of NK cell activity (eg, immunomodulatory drugs, monoclonal antibodies), and strategies for enhancing autologous and allogeneic NK cell effects through NK cell gene profiling.
Collapse
Affiliation(s)
- David Avigan
- Division of Hematology Oncology, Hematologic Malignancies/Bone Marrow Transplant Program, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | | | | | | | | | | | | | | |
Collapse
|
266
|
Abbasalizadeh S, Baharvand H. Technological progress and challenges towards cGMP manufacturing of human pluripotent stem cells based therapeutic products for allogeneic and autologous cell therapies. Biotechnol Adv 2013; 31:1600-23. [PMID: 23962714 DOI: 10.1016/j.biotechadv.2013.08.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 06/20/2013] [Accepted: 08/12/2013] [Indexed: 12/16/2022]
Abstract
Recent technological advances in the generation, characterization, and bioprocessing of human pluripotent stem cells (hPSCs) have created new hope for their use as a source for production of cell-based therapeutic products. To date, a few clinical trials that have used therapeutic cells derived from hESCs have been approved by the Food and Drug Administration (FDA), but numerous new hPSC-based cell therapy products are under various stages of development in cell therapy-specialized companies and their future market is estimated to be very promising. However, the multitude of critical challenges regarding different aspects of hPSC-based therapeutic product manufacturing and their therapies have made progress for the introduction of new products and clinical applications very slow. These challenges include scientific, technological, clinical, policy, and financial aspects. The technological aspects of manufacturing hPSC-based therapeutic products for allogeneic and autologous cell therapies according to good manufacturing practice (cGMP) quality requirements is one of the most important challenging and emerging topics in the development of new hPSCs for clinical use. In this review, we describe main critical challenges and highlight a series of technological advances in all aspects of hPSC-based therapeutic product manufacturing including clinical grade cell line development, large-scale banking, upstream processing, downstream processing, and quality assessment of final cell therapeutic products that have brought hPSCs closer to clinical application and commercial cGMP manufacturing.
Collapse
Affiliation(s)
- Saeed Abbasalizadeh
- Department of Stem Cells and Developmental Biology at Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | | |
Collapse
|
267
|
Majhail NS, Tao L, Bredeson C, Davies S, Dehn J, Gajewski JL, Hahn T, Jakubowski A, Joffe S, Lazarus HM, Parsons SK, Robien K, Lee SJ, Kuntz KM. Prevalence of hematopoietic cell transplant survivors in the United States. Biol Blood Marrow Transplant 2013; 19:1498-501. [PMID: 23906634 DOI: 10.1016/j.bbmt.2013.07.020] [Citation(s) in RCA: 171] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 07/21/2013] [Indexed: 11/21/2022]
Abstract
Advances in hematopoietic cell transplantation (HCT) have led to an increasing number of transplant survivors. To adequately support their healthcare needs, there is a need to know the prevalence of HCT survivors. We used data on 170,628 recipients of autologous and allogeneic HCT reported to the Center for International Blood and Marrow Transplant Research from 1968 to 2009 to estimate the current and future number of HCT survivors in the United States. Stacked cohort simulation models were used to estimate the number of HCT survivors in the United States in 2009 and to make projections for HCT survivors by the year 2030. There were 108,900 (range, 100,500 to 115,200) HCT survivors in the United States in 2009. This included 67,000 autologous HCT and 41,900 allogeneic HCT survivors. The number of HCT survivors is estimated to increase by 2.5 times by the year 2020 (242,000 survivors) and 5 times by the year 2030 (502,000 survivors). By 2030, the age at transplant will be < 18 years for 14% of all survivors (n = 64,000), 18 to 59 years for 61% survivors (n = 276,000), and 60 years and older for 25% of survivors (n = 113,000). In coming decades, a large number of individuals will be HCT survivors. Transplant center providers, hematologists, oncologists, primary care physicians, and other specialty providers will need to be familiar with the unique and complex health issues faced by this population.
Collapse
|
268
|
Esteban-Riesco L, Depaulis F, Moreau A, Bacq Y, Dubois F, Goudeau A, Gaudy-Graffin C. Rapid and sustained autologous neutralizing response leading to early spontaneous recovery after HCV infection. Virology 2013; 444:90-9. [PMID: 23890816 DOI: 10.1016/j.virol.2013.05.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 03/27/2013] [Accepted: 05/29/2013] [Indexed: 01/12/2023]
Abstract
After HCV infection, the association between the humoral response and viral sequence evolution remains unclear. We investigated the mechanisms leading to early HCV clearance and spontaneous recovery in two patients. The early evolution of the HCV envelope glycoproteins, and the infectivity spectrum of variants were explored using retroviral pseudoparticles bearing HCV envelopes. Ability of the autologous neutralizing response to control these variants was analyzed. For the first case, the maximum neutralizing activity was for serum collected between two and three months post ALT peak, this activity was still detectable after 30 months. For the second case, autologous neutralizing activity against the variant isolated at the ALT peak was detected in every serum collected between 4 days and 13 months after. The neutralizing response was sustained beyond the time at which the virus was cleared. This raise interesting questions about the role of such antibodies in case of re-exposure.
Collapse
|
269
|
Nimčenko T, Omerca G, Varinauskas V, Bramanti E, Signorino F, Cicciù M. Tooth auto-transplantation as an alternative treatment option: A literature review. Dent Res J (Isfahan) 2013; 10:1-6. [PMID: 23878556 PMCID: PMC3714809 DOI: 10.4103/1735-3327.111756] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Rapidly evolving implantation and alveolar ridge reconstruction techniques created a new area in modern dentistry where tooth loss is no longer a problem. Endless variations of implant's length, diameter, surface, and design along with autogenous, alogenous, aloplastic, or xenogenous bone substitutes made it possible to recreate physiological occlusion, esthetic and masticatory function. However, none of nowadays technologies in implant dentistry have the potential to adapt to a growth and development changes of a child's jaw. Therefore, patient's young age is a restriction for implantation and a particular challenge for a dentist willing to restore missing tooth. Thus, tooth auto-transplantation can be a good choice for treatment. The objective of this review is to underline the biologic principles required for successful auto-transplantation of teeth. Limits, indications, technique, and prognosis will be analyzed.
Collapse
Affiliation(s)
- Tatjana Nimčenko
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Lithuania
| | | | | | | | | | | |
Collapse
|
270
|
Nelson JA, Fischer JP, Radecki MA, Pasick C, McGrath J, Serletti JM, Wu LC. Delayed autologous breast reconstruction: factors which influence patient decision making. J Plast Reconstr Aesthet Surg 2013; 66:1513-20. [PMID: 23886556 DOI: 10.1016/j.bjps.2013.06.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 03/20/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Autologous breast reconstruction timing continues to be controversial. The purpose of this study was to examine delayed autologous breast reconstruction at a center favouring immediate reconstruction to better understand factors driving the decision to delay reconstruction. METHODS We performed a retrospective cohort study of all free autologous breast reconstruction patients between 2005 and 2009, focussing on ethnicity, cancer stage, unilateral or bilateral reconstructions, initial management, distance from the institution, and average income. Delayed reconstructions were compared to immediate reconstructions. All delayed reconstructions were surveyed to examine treatment and reconstruction decisions and satisfaction. RESULTS Of 709 patients, 169 (24%) underwent delayed treatment. Delayed reconstruction patients had higher cancer stages (p < 0.001), higher rates of pre-reconstruction radiation therapy (64% vs. 20%, p < 0.0001) and higher rates of unilateral reconstruction (64% vs. 48%, p < 0.001). Seventy delayed patients responded to the survey (41%), with 75% having had their initial mastectomy at an outside health system. Only 51% discussed immediate reconstruction prior to electing delayed treatment and 41% had no discussion regarding advantages or disadvantages to reconstructive options. Approximately 30% noted no choice in their reconstructive timing. Forty five percent would elect immediate reconstruction if given the option. CONCLUSIONS This study demonstrates that women may not be receiving all available information prior to undergoing mastectomy for initial breast cancer treatment. As a significant portion of women electing delayed reconstruction would elect immediate autologous reconstruction if given the option again, there is room for improvement in pre-operative patient education and in the education of our oncology colleagues.
Collapse
Affiliation(s)
- Jonas A Nelson
- Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
| | | | | | | | | | | | | |
Collapse
|
271
|
Hong SH, Shetty AA, Kim SJ, Kim YS, Choi NY, Kim NH. Treatment of osteonecrosis in the knee joint of a rabbit using autologous cultured osteoblasts. J Surg Res 2013; 185:861-8. [PMID: 23880651 DOI: 10.1016/j.jss.2013.06.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 06/17/2013] [Accepted: 06/20/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND [corrected] To develop a successful treatment modality for osteonecrosis, an appropriate animal model is essential. We have proposed a new osteonecrosis model that shows the total amount of necrosis and in which we observed new bone formation after transplanting autologous cultured osteoblasts. MATERIALS AND METHODS The femoral condyles of the right knees of New Zealand white rabbits were exposed after dissecting the ligaments surrounding the distal femur. After which, the metaphyseal-diaphyseal junction was cut using a saw, and the entire femoral condyle was isolated. After three liquid nitrogen treatments, the isolated femoral condyle was internally fixated to the femoral shaft using two or three Kirschner wires. Bone marrow isolated from the iliac crest was cultivated to differentiate it into osteoblasts, and the cultured cells were then injected into the necrotic bone. RESULTS Viable osteocytes with well-stained nuclei were not present in the necrotic areas at any stage of the development of the osteonecrosis model within 24 wk after osteonecrosis induction. However, new bone formation with osteocytes and blood vessels was observed in the necrotic bone 12 wk after transplanting the autologous cultured osteoblasts. CONCLUSIONS The distal femoral condyle of the rabbit is an appropriate model for demonstrating osteonecrosis and treatment evaluation owing to its easy reproducibility and treatment interpretation. Therefore, autologous cultured osteoblast treatment would seem to be a potentially successful treatment modality for osteonecrosis.
Collapse
|
272
|
Shaughnessy P, Chao N, Shapiro J, Walters K, McCarty J, Abhyankar S, Shayani S, Helmons P, Leather H, Pazzalia A, Pickard S. Pharmacoeconomics of hematopoietic stem cell mobilization: an overview of current evidence and gaps in the literature. Biol Blood Marrow Transplant 2013; 19:1301-9. [PMID: 23685251 DOI: 10.1016/j.bbmt.2013.05.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 05/08/2013] [Indexed: 12/22/2022]
Abstract
Adequate hematopoietic stem cell (HSC) mobilization and collection is required prior to proceeding with high dose chemotherapy and autologous hematopoietic stem cell transplant. Cytokines such as G-CSF, GM-CSF, and peg-filgrastim, alone or in combination with plerixafor, and after chemotherapy have been used to mobilize HSCs. Studies have shown that the efficiency of HSC mobilization and collection may vary when different methods of mobilization are used. No studies have shown that survival is significantly affected by the method of mobilization, but some studies have suggested that cost and resource utilization may be different between different mobilization techniques. After the FDA approval of plerixafor with G-CSF to mobilize HSCs many transplant centers became concerned about the cost of HSC mobilization. A panel of experts was convened ant this paper reviews the current literature on the pharmacoeconomics of HSC mobilization.
Collapse
|
273
|
Kharfan-Dabaja MA, Nishihori T, Otrock ZK, Haidar N, Mohty M, Hamadani M. Monoclonal antibodies in conditioning regimens for hematopoietic cell transplantation. Biol Blood Marrow Transplant 2013; 19:1288-300. [PMID: 23618718 DOI: 10.1016/j.bbmt.2013.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 04/16/2013] [Indexed: 10/26/2022]
Abstract
Monoclonal antibodies are increasingly being incorporated in conditioning regimens for autologous or allogeneic hematopoietic cell transplantation (HCT). The benefit of adding rituximab to autologous HCT regimens is purportedly related to in vivo purging of clonal B cells. Randomized trials comparing the addition (or not) of rituximab to high-dose therapy regimens are lacking. No benefit of standard-dose radioimmunotherapy-based regimens for autografting in aggressive lymphomas was seen in a randomized controlled study. The incorporation of rituximab into allogeneic HCT regimens aims to improve responses while reducing nonrelapse mortality resulting from acute graft-versus-host disease. The optimal dose and administration schedule of rituximab in this setting are unknown, and potentially serious complications from increased infections owing to prolonged (and profound) cytopenias or persistent hypogammaglobulinemia are of concern. Radioimmunotherapy-based conditioning for allografting holds promise as a modality to optimize tumor control and synergize adoptive immunotherapy effects, but it remains experimental at this time. The addition of alemtuzumab to allogeneic HCT regimens is associated with prolonged lymphopenia and impaired immune reconstitution, high relapse rates, and serious infections. The optimal dose and schedule of alemtuzumab to avoid prolonged immune paresis remain elusive. It is anticipated that additional monoclonal antibodies will soon become available that can be incorporated into HCT regimens after safety and clinical efficacy are demonstrated.
Collapse
Affiliation(s)
- Mohamed A Kharfan-Dabaja
- Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, Tampa, Florida 33612,
| | | | | | | | | | | |
Collapse
|
274
|
Majhail NS, Rizzo JD, Lee SJ, Aljurf M, Atsuta Y, Bonfim C, Burns LJ, Chaudhri N, Davies S, Okamoto S, Seber A, Socie G, Szer J, Lint MTV, Wingard JR, Tichelli A. Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation. Rev Bras Hematol Hemoter 2012; 34:109-33. [PMID: 23049402 PMCID: PMC3459383 DOI: 10.5581/1516-8484.20120032] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 01/27/2012] [Indexed: 02/06/2023] Open
Abstract
Advances in hematopoietic cell transplantation (HCT) technology and supportive care techniques have led to improvements in long-term survival after HCT. Emerging indications for transplantation, introduction of newer graft sources (e.g. umbilical cord blood) and transplantation of older patients using less intense conditioning regimens have also contributed to an increase in the number of HCT survivors. These survivors are at risk for developing late complications secondary to pre-, periand post-transplant exposures and risk-factors. Guidelines for screening and preventive practices for HCT survivors were published in 2006. An international group of transplant experts was convened in 2011 to review contemporary literature and update the recommendations while considering the changing practice of transplantation and international applicability of these guidelines. This review provides the updated recommendations for screening and preventive practices for pediatric and adult survivors of autologous and allogeneic HCT.
Collapse
Affiliation(s)
- Navneet Singh Majhail
- National Marrow Donor Program, Minneapolis, MN, USA ; Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
275
|
Kaul RP, Godhi SS, Singh A. Autologous platelet rich plasma after third molar surgery: a comparative study. J Maxillofac Oral Surg 2012; 11:200-5. [PMID: 23730070 PMCID: PMC3386415 DOI: 10.1007/s12663-011-0311-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Accepted: 10/05/2011] [Indexed: 10/14/2022] Open
Abstract
PURPOSE This study is an attempt to evaluate the use of autologous platelet rich plasma (PRP) to promote wound healing and osseous regeneration in human third molar extraction sockets. MATERIALS AND METHOD PRP was prepared after two centrifugation and the gelling agent used was freshly prepared 10% calcium chloride.PRP gel was placed in one of the extracted sockets of bilateral impacted mandibular third molars. IOPA Xrays were used to evaluate the wound dehiscence, probing depth, bone density & alveolar bone level after 1st, 2nd and 7th day and 3rd & 6th month respectively. RESULTS On evaluation, it was found that PRP grafted sockets showed dehiscence in 8% cases. The decrease in alveolar bone level was highly significant in PRP grafted sockets in 3rd and 6th month post operatively. There was significant difference between pre-operative density of adjacent bone and bone formed in extraction sockets at 3rd and 6th month in PRP grafted sockets. There was significant reduction in probing depth from initial period to 3 and 6 months in both the groups, but PRP grafted sockets showed greater decrease in probing depth. CONCLUSION PRP is an inexpensive and widely available modality to minimize postoperative complication and enhance both hard and soft tissue healing potentials. This autologous product eliminates concern about immunogenic reaction and disease transmission. Its beneficial outcomes in dental clinic, including decrease in bleeding and rapid wound healing hold promise for further procedures.PRP is thus a new application in tissue engineering and developing area for clinician and researchers.
Collapse
Affiliation(s)
- Ruchi Pathak Kaul
- Department of Oral& Maxillofacial Surgery, ITS-CDSR, Muradnagar, Ghaziabad, India
| | - Suhas S. Godhi
- Department of Oral& Maxillofacial Surgery, ITS-CDSR, Muradnagar, Ghaziabad, India
| | - Anurag Singh
- Department of Oral& Maxillofacial Surgery, ITS-CDSR, Muradnagar, Ghaziabad, India
| |
Collapse
|
276
|
Sohn HM, Park YH, Byon HJ, Kim JT, Kim HS, Kim CS. Application of the continuous autotransfusion system (CATS) to prevent transfusion-related hyperkalemia following hyperkalemic cardiac arrest in an infant -A case report-. Korean J Anesthesiol 2012; 62:281-4. [PMID: 22474558 PMCID: PMC3315661 DOI: 10.4097/kjae.2012.62.3.281] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 09/24/2011] [Accepted: 10/05/2011] [Indexed: 11/10/2022] Open
Abstract
Transfusion-induced hyperkalemia can lead to cardiac arrest, especially when the patient rapidly receives a large amount of red blood cells (RBCs), previously stored for a long period of time, irradiated or both. We report on a case of application of the Continuous AutoTransfusion System (CATS) to wash RBCs, in order to lower the high potassium (K(+)) level in the packed RBCs unit, during massive transfusion following transfusion-induced hyperkalemic cardiac arrest. After the washing process using CATS, there was no more electrocardiographic abnormality or cardiac arrest due to hyperkalemia. This case emphasizes the potential risk to develop transfusion-related hyperkalemic cardiac arrest, during massive transfusion of irradiated, pre-stored RBCs. CATS can be effectively used to lower the K(+) concentration in the packed RBCs unit, especially when the risk of transfusion-induced hyperkalemia is high.
Collapse
Affiliation(s)
- Hye-Min Sohn
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
277
|
Hashemi H, Salehnia M, Kamali M, Beigi Boroujeni M. The histological characteristics of cultured oral epithelium in different culture conditions. Iran Biomed J 2009; 13:109-115. [PMID: 19471551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND This study was undertaken to establish the characterization of cultured oral mucosal epithelium and introducing them as an alternative source for reconstruction of ocular surface disease. METHODS Human oral epithelial cells were cultured on simple media (DMEM/HF12) as control and co-cultured on mitomycin C-treated 3T3 feeder layer, on the amniotic membrane (AM) without nitrocellulose and the mitotically inactivated 3T3 fibroblast, and on the sandwich layer of AM fastened on the nitrocellulose as insert and 3T3 fibroblast. After 3 weeks, the characteristics of the cells were assessed morphologically and also ultrastructurally using scanning electron microscopy and transmission electron microscopy and immuno-cytochemically. RESULTS The epithelial cells were cultured on AM spread on nitrocellulose insert and 3T3 feeder layer showed better growth than other groups and all groups of study were shown similar characteristics. The cultured oral epithelial shared the characteristics with corneal epithelium. CONCLUSION Thus the oral epithelial could be an alternative source for transplantation.
Collapse
Affiliation(s)
- Hassan Hashemi
- Dept. of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Noor Ophtalmology Research Cente ,Noor Eye Haspital, Tehran. Iran
| | - Mojdeh Salehnia
- Dept. of Anatomy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran. Iran
| | - Morvarid Kamali
- Dept. of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mandana Beigi Boroujeni
- Dept. of Anatomy, Faculty of Medical Sciences, Lorestan University of Medical Sciences, Khoramabad, Iran
| |
Collapse
|
278
|
Jawan B, Cheng YF, Tseng CC, Chen YS, Wang CC, Huang TL, Eng HL, Liu PP, Chiu KW, Wang SH, Lin CC, Lin TS, Liu YW, Chen CL. Effect of autologous blood donation on the central venous pressure, blood loss and blood transfusion during living donor left hepatectomy. World J Gastroenterol 2005; 11:4233-6. [PMID: 16015696 PMCID: PMC4615449 DOI: 10.3748/wjg.v11.i27.4233] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: Autologous blood donation (ABD) is mainly used to reduce the use of banked blood. In fact, ABD can be regarded as acute blood loss. Would ABD 2-3 d before operation affect the CVP level and subsequently result in less blood loss during liver resection was to be determined.
METHODS: Eighty-four patients undergoing living donor left hepatectomy were retrospectively divided as group I (GI) and group II (GII) according to have donated 250-300 mL blood 2-3 d before living donor hepatectomy or not. The changes of the intraoperative CVP, surgical blood loss, blood products used and the changes of perioperative hemoglobin (Hb) between groups were analyzed and compared by using Mann-Whitney U test.
RESULTS: The results show that the intraoperative CVP changes between GI (n = 35) and GII (n = 49) up to graft procurement were the same, subsequently the blood loss, but ABD resulted in significantly lower perioperative Hb levels in GI.
CONCLUSION: Since none of the patients required any blood products perioperatively, all the predonated bloods were discarded after the patients were discharged from the hospital. It indicates that ABD in current series had no any beneficial effects, in term of cost, lowering the CVP, blood loss and reduce the use of banked blood products, but resulted in significant lower Hb in perioperative period.
Collapse
Affiliation(s)
- Bruno Jawan
- Department of Anesthesiology, Chang Gung Memorial Hospital, Kaoshiung Medical Center, Taiwan, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|