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Clinical transplantation and tolerance: are we there yet?

Organ transplantation is not only considered as the last resort therapy but also as the treatment of choice for many patients with end-stage organ damage. Recipient-mediated acute or chronic immune response is the main challenge after transplant surgery. Nonspecific suppression of host immune system is currently the only method used to prevent organ rejection. Lifelong immunosuppression will cause significant side effects such as infections, malignancies, chronic kidney disease, hypertension and diabetes. This is more relevant in children who have a longer life expectancy so may receive longer

Kidney Disease and Hematopoietic Stem Cell Transplantation.

Hematopoietic stem cell transplantation (HSCT) is a potentially curative therapy for patients with hematologic malignancies and certain solid tumors and nonmalignant hematologic conditions. Both AKI and CKD occur commonly after HSCT and are associated with significant morbidity and mortality. AKI and CKD in this setting may result from direct effects of the transplant or be caused by pretransplant bone marrow conditioning regimens and/or nephrotoxic agents administered in the post-transplant period. In this article, we review the epidemiology, risk factors, etiologies, pathophysiology, diagnos

Respiratory Tract Infections: Sinusitis, Bronchitis, and Pneumonia

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… The virus itself is immunomodulatory in nature, and CMV has been associated with bacterial and fungal superinfections as well as lymphoproliferative disorders [ 105 , 106 ]. Fever and nonproductive cough are prominent but nonspecific features of viral respiratory tract infection. … Pretransplantation assessment of the risk of lymphoproliferative disorder. Clin Infect Dis. 1995;20:1346–1353. doi: 10.1093/clinids/20.5.1346. …

Summary of the Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation.

The 2020 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation is intended to assist health care professionals worldwide who evaluate and manage potential candidates for deceased or living donor kidney transplantation. This guideline addresses general candidacy issues such as access to transplantation, patient demographic and health status factors, immunological and psychosocial assessment. The roles of various risk factors and comorbid conditions governing an individual's suitability for transpla

Plasma Cell Disorders

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… A system that incorporates other lymphoproliferative disorders into MRD when they have protein-related functional disorders (e.g., lymphoma patients producing a monoclonal protein, or patients with IA or MIDD). Ultimately, this system is a combined diagnosis and risk stratification system. …

The clinical picture of Castleman disease: a systematic review and meta-analysis.

AbstractCastleman disease (CD) encompasses a spectrum of rare disorders, including unicentric CD (UCD), idiopathic multicentric CD (iMCD), and human herpesvirus 8-associated MCD (HHV8+ MCD). We performed a systematic review of publications reporting ≥5 cases of CD between 1995 and 2021, following preferred reporting items for systematic reviews and meta-analyses guidelines, to describe and compare subtypes. We extracted data on clinical symptoms and laboratory parameters as stated in international consensus diagnostic criteria for iMCD and estimated the frequency of each criterion using meta-a

Incidence and survival of lymphoid neoplasms in Spain, 2002-2013: A population-based study from the Spanish Network of Cancer Registries (REDECAN).

IntroductionThe aim of this study was to describe incidence, incidence trends and survival patterns of lymphoid neoplasms (LNs) and its subtypes in Spain in the period 2002-2013 using data from the Spanish Network of Cancer Registries (REDECAN).Materials and methodsData were extracted from 13 Spanish population-based cancer registries. LNs incident cases were codified using the International Classification of Diseases for Oncology, third edition (ICD-O-3) and grouped according to the WHO 2008 classification. Age-standardized incidence rates to the 2013 European standard population (ASIRe) were

Immunological and Clinical Impact of Manipulated and Unmanipulated DLI after Allogeneic Stem Cell Transplantation of AML Patients.

Allogeneic stem cell transplantation (allo-SCT) is the preferred curative treatment for several hematological malignancies. The efficacy of allo-SCT depends on the graft-versus-leukemia (GvL) effect. However, the prognosis of patients with relapsed acute myeloid leukemia (AML) following allo-SCT is poor. Donor lymphocyte infusion (DLI) is utilized after allo-SCT in this setting to prevent relapse, to prolong progression free survival, to establish full donor chimerism and to restore the GvL effect in patients with hematological malignancies. Thus, there are different options for the administra

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… Infusions of donor leukocytes to treat Epstein-Barr virus-associated lymphoproliferative disorders after allogeneic bone marrow transplantation. N. Engl. J. Med. 1994;330:1185–1191. doi: 10.1056/NEJM199404283301703. 94. … Outcome of treatment of Epstein-Barr virus-related post-transplant lymphoproliferative disorder in hematopoietic stem cell recipients: A comprehensive review of reported cases. Transpl. Infect. Dis. Off. J. Transplant. Soc. 2009;11:383–392. doi: 10.1111/j.1399-3062.2009.00411.x. 98. …

Влияние возраста на изменение или прекращение болезней, изменяющих терапию при множественном склерозе.

Пожилые пациенты в возрасте ≥55 лет составляют почти половину от общей численности населения страны. Несмотря на то, что в результате возникновения заболеваний происходят такие точечные и подстрекательские процессы демиелионации и такие прогрессивные процессы, как разрозненное воспаление CNS, нейродегенерация и отказ компенсационных механизмов, наблюдается сдвиг в преобладающих болезнях с заметным клиническим прогрессом в течение пятого десятилетия жизни. Клинически это проявляется в уменьшении числа рецидивов в клинической области и активности МРТ в качестве лиц в возрасте MS, что приводит к

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… There was an age-related increase in serious infections, malignancies (malignancies including thyroid cancer, melanoma and lymphoproliferative disorders) and death, particularly in individuals over 45 years of age. Occurrence of immune thrombocytopenia did not demonstrate age-related significance. …

Teclistamab в случае множественных легочных повреждений в внематочной миломе: первый успешный случай и обзор литературы.

Внешняя болезнь (ЭМД) в миеломе (ММ) связана с агрессивным клиническим поведением и плохим прогнозом, особенно когда речь идет о легочной паренхиме, которая является крайне редким проявлением. Биогенные антитела, направленные против антигена B-клеток (BCMA), такие, как теклистамб, недавно продемонстрировали многообещающую эффективность при сильно обработанном реактивном/охлаждении множественной миеломы (RRMM). Однако данные об их активности у пациентов с внематочным участием лёгких остаются ограниченными. Мы сообщаем о случае 76-year-old Человек с Ига-Ирма, у которого возникли множественные вн

Surrogate endpoints in mature B-cell neoplasms - meaningful or misleading?

Indolent mature B-cell neoplasms are a group of diseases in which recent therapeutic advances have led to an improved overall survival (OS) extending beyond several years. While cause of celebration for patients and caregivers, the increasingly long observation periods necessary to capture treatment effects are complicating trial design and possibly hindering swift access to more effective therapies. Surrogate endpoints are a tool with the potential of earlier study readouts, however, their validity needs to be proven in each individual disease and therapeutic setting. The validation of surrog

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… In this perspective response parameters such as MRD, but also complete response and overall response as well as PFS as surrogate endpoints in indolent lymphoproliferative disorders are discussed with respect to their validation, potential use and limitations. …

Самые горячие темы трансплантации стволовых клеток: резюме 8th Международный курс трансплантации и клеточной терапии.

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Secukinumab in the Treatment of Plaque Psoriasis in Patients with Malignancy.

Although available data are conflicting, psoriasis seems to be associated with an increased baseline risk of malignancy. In addition, some antipsoriatic systemic treatments have been associated with risk of malignancy. There is not enough data on the association of interleukin (IL)-17 and IL-23 inhibitors with malignancy rate, but there have been no cases reported so far. Secukinumab is a recombinant human monoclonal immunoglobulin G1/κ antibody that selectively targets IL-17A; it was demonstrated to be effective and safe for the treatment of moderate to severe psoriasis that may be appropriat

Comparable safety profile of BeEAM (bendamustine, etoposide, cytarabine, melphalan) and BEAM (carmustine, etoposide, cytarabine, melphalan) as conditioning before autologous haematopoietic cell transplantation.

IntroductionBEAM (carmustine, etoposide, cytarabine, melphalan) is the most frequently used high-dose chemotherapy regimen for patients with lymphoma referred for autologous haematopoietic cell transplantation (autoHCT). Recently, a novel conditioning protocol containing bendamustine instead of carmustine (BeEAM) has been proposed to potentially increase the efficacy.Aim of the studyThe aim of this study was to retrospectively compare the safety profile of BEAM and BeEAM based on single-centre experience.Material and methodsA total of 237 consecutive patients with lymphoma treated with either

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… The drug has a proven clinical activity in RR lymphoproliferative disorders like chronic lymphocytic leukaemia, multiple myeloma, or indolent lymphomas [ 13 – 16 ]. …

Risks and burden of viral respiratory tract infections in patients with multiple myeloma in the era of immunomodulatory drugs and bortezomib: experience at an Australian Cancer Hospital.

IntroductionInfections are a leading cause of morbidity and mortality in patients with multiple myeloma. The epidemiology, risk factors and outcomes of viral respiratory tract infections (vRTI) are not well described in patients with multiple myeloma managed with novel agents, the current standard of care.MethodsPatients with myeloma from 2009 to 2012 who tested positive on respiratory virus multiplex polymerase chain reaction had clinical, radiological and microbiological records reviewed. The Fourth European Conference on Infections in Leukaemia (ECIL-4) definitions of RTI were applied. Univ

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… Influenza vaccine in chronic lymphoproliferative disorders and multiple myeloma. Eur J Haematol. 2003;70:225–230. doi: 10.1034/j.1600-0609.2003.00028.x. 11. Chemaly RF, Ghosh S, Bodey GP, et al. …

Efficacy of deferred dosing of granulocyte colony-stimulating factor in autologous hematopoietic transplantation for multiple myeloma.

Routine administration of G-CSF following autologous hematopoietic SCT (ASCT) expedites ANC recovery and reduces hospitalization by 1-2 days; it has no impact on febrile neutropenia, infections, morbidity, mortality, event-free survival or OS. To determine whether delayed G-CSF dosage could result in equivalent ANC recovery and thereby improve cost effectiveness, we deferred the administration of G-CSF until WBC recovery had begun. A total of 117 patients with multiple myeloma received ASCT from January 2005 to September 2012. Of these, 52 were in the conventional dosing group (CGD) and receiv

The Crystalline Nephropathies.

Crystalline nephropathies are a unique form of kidney disease characterized by the histologic finding of intrarenal crystal deposition. The intrinsic nature of some molecules and ions combined with a favorable tubular fluid physiology leads to crystal precipitation and deposition within the tubular lumens. Crystal deposition promotes kidney injury through tubular obstruction and both direct and indirect cytotoxicities. Further kidney injury develops from inflammation triggered by these crystals. From a clinical standpoint, the crystalline nephropathies are associated with abnormal urinalysis a

A Rare Presentation of Multiple Myeloma as a Second Primary Cancer Sequential to Non-Hodgkin Lymphoma: Case Report.

INTRODUCTION: The sequential occurrence of diffuse large B-cell lymphoma (DLBCL) a common type of non-Hodgkin's lymphoma (NHL) and multiple myeloma (MM) is exceedingly rare, presenting a significant challenge in both diagnosis and treatment. CASE PRESENTATION: The case report discusses a 60-year-old male patient with a history of DLBCL which was diagnosed following symptoms of fever, weight loss and night sweats. He was treated with RVP (rituximab 375 mg/m2, vincristine 1.4 mg/m2, prednisolone 60 mg/m2) and R-CHOP regimen (rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2,

Clinical practice guidelines and consensus statements in oncology--an assessment of their methodological quality.

BackgroundConsensus statements and clinical practice guidelines are widely available for enhancing the care of cancer patients. Despite subtle differences in their definition and purpose, these terms are often used interchangeably. We systematically assessed the methodological quality of consensus statements and clinical practice guidelines published in three commonly read, geographically diverse, cancer-specific journals. Methods Consensus statements and clinical practice guidelines published between January 2005 and September 2013 in Current Oncology, European Journal of Cancer and Journal o

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… disorders and solid tumours [68] | 2011 | ✓ | 63 | 50 | ✓ The development of evidence-based Europeanguidelines on the management of depression inpalliative cancer care [69] | 2011 | | 41 | 71 | Clinical Practice Guidelines pre IOM 2011 (n = 11) Mean (95% Confidence Interval) | 47 (32, 62) | 58 (51 … Aapro MS, Bohlius J, Cameron DA, Dal Lago L, Donnelly JP, et al. (2011) 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours. …

Infectious Complications of Cancer Therapy

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… Nonmyeloablative transplantation with or without alemtuzumab: comparison between 2 prospective studies in patients with lymphoproliferative disorders. Blood. 2002;100:3121–3127. doi: 10.1182/blood-2002-03-0701. 123. Reusser P. Opportunistic viral infections. In: Powderly W.G., editor. … Post-transplant lymphoproliferative disorder: a review. Bone Marrow Transplant. 2003;31:145–155. doi: 10.1038/sj.bmt.1703806. 150. Cohen J.I. Epstein-Barr virus infection. N Engl J Med. 2000;343:481–492. doi: 10.1056/NEJM200008173430707. 151. Singh N., Paterson D.L. …