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Infections in Recipients of Hematopoietic Stem Cell Transplants

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… Later in the post-transplantation period, GVHD and infection are contributing causes of cystitis. 29 The majority of infectious agents inducing cystitis are viral, usually either the polyomavirus BK virus or adenovirus. … virus may indicate a higher risk for hemorrhagic cystitis. 35 No standard antiviral treatment is currently available for viruria caused by BK virus or adenovirus, although intravesicular cidofovir or low-dose intravenous cidofovir has been administered when ongoing hemorrhage or large mucosal clots …

Clinical review: specific aspects of acute renal failure in cancer patients.

Acute renal failure (ARF) in cancer patients is a dreadful complication that causes substantial morbidity and mortality. Moreover, ARF may preclude optimal cancer treatment by requiring a decrease in chemotherapy dosage or by contraindicating potentially curative treatment. The pathways leading to ARF in cancer patients are common to the development of ARF in other conditions. However, ARF may also develop due to etiologies arising from cancer treatment, such as nephrotoxic chemotherapy agents or the disease itself, including post-renal obstruction, compression or infiltration, and metabolic o

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… Several studies confirm that ARF is associated with adenovirus, polyomavirus (BK virus or JC virus) and simian polyomavirus. … The well-documented association between the BK virus and haemorrhagic cystitis may explain not only the high incidence of haemorrhagic cystitis after BMT (20% to 25%), but also the occurrence of nephropathy [ 39 , 49 ]. …

Complication from Desensitization

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… Morath et al. [ 14 ] observed a higher incidence of BK virus replication and BK virus-associated nephropathy. A higher frequency of viral infections such as CMV, HSV, VZV, and BK virus, as well as P. jirovecii pneumonia, wound, and severe urinary tract infections have been described. … Table 6.1 List of infections between ABO compatible and ABO incompatible KT Variables | ABO compatible ( N = 1,019) | ABOi Era 2 ( N = 239) | ABOi Era 1 ( N = 64) | p -Value Number (%) | Number (%) | Number (%) BK virus PCR- positive | 243 (23.8) | 62 (25.9) | 23 (36.9) | 0.09 BK virus ≥4 logs | 86 ( …

Adverse Effects of Virus-Specific T-Cell Therapy: An Integrative Review.

Allogeneic hematopoietic stem cell transplant (HSCT) remains the mainstay in treating many hematologic malignancies. T-cell-depleted grafts designed to reduce graft-vs.-host disease (GVHD) may be complicated by severe viral infections that increase morbidity and mortality. Despite the use of antiviral pharmacologic therapy, challenges in controlling viral infections include drug resistance and/or side-effect intolerability. Virus-specific T-cell (VST) therapy is a promising targeted therapy for treating severe or drug-refractory viral infections after HSCT. An integrative review was conducted

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… The five most common viruses that present after HSCT include cytomegalovirus (CMV), Epstein-Barr virus (EBV), BK virus (BKV), adenovirus (AdV), and human herpesvirus 6 (HHV-6; Gratwohl et al., 2015 ). … The databases were searched on December 14, 2017, using the Medical Subject Heading (MeSH) terms "BK virus," "adenovirus," "adenoviridae infections," "herpesvirus," "herpesviridae," "cytomegalovirus," "Epstein-Barr," "viral infection*," "T-lymphocytes," "immunotherapy," "T cell*," "hematopoietic stem …

Post-Transplant Bendamustine as a Platform for Immune Modulation After Allogeneic Hematopoietic Cell Transplantation.

Post-transplant cyclophosphamide (PT-CY) remains the standard of care for graft-versus-host disease (GvHD) prophylaxis in haploidentical hematopoietic cell transplantation (HCT), yet relapse, delayed immune reconstitution, infections, and organ toxicity represent persistent and clinically meaningful limitations. Post-transplant bendamustine (PT-BEN) has been investigated as a biologically distinct alternative. In stringent haploidentical murine models, PT-BEN uncoupled GvHD from graft-versus-leukemia (GvL) effects through mechanisms centered on myeloid modulation and preservation of innate imm

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… CMV reactivation rates were comparable between platforms after adjustment for risk, while reduced BK virus–associated hemorrhagic cystitis was observed in PT‐CY/BEN recipients [ 58 , 59 , 64 ]. … Importantly, BK virus–associated hemorrhagic cystitis was effectively eliminated in the PT‐BEN cohort, a crucial advantage for resource‐limited settings. …

Adoptive JC Virus-Specific T Lymphocytes for the Treatment of Progressive Multifocal Leukoencephalopathy: Experience from Two Italian Centers.

UNLABELLED: Background: Progressive multifocal leukoencephalopathy (PML) is a rare but fatal disease caused by John Cunningham virus (JCV) in immunocompromised individuals, with no effective antiviral treatment currently available. This study aimed to evaluate the feasibility of adoptive JCV-specific T lymphocyte therapy in patients with PML. METHODS: Nineteen patients meeting the 2013 consensus criteria for "definite PML" were included, and JCV-specific T lymphocytes expanded from autologous or allogeneic peripheral blood mononuclear cells (PBMCs) using JCV antigen-derived peptides were admi

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… Moreover, in a recent study [ 8 ], 20 out of 28 patients treated with directly isolated allogenic BK virus-specific (DIAVIS) T cells survived at 12 months of follow-up after the PML diagnosis, with older age being a predictor of a poor treatment response. … BK Virus-Specific T Cells for Immunotherapy of Progressive Multifocal Leukoencephalopathy: An Open-Label, Single-Cohort Pilot Study. Lancet Neurol. 2021;20:639–652. doi: 10.1016/S1474-4422(21)00174-5. 8. …

Editorial: Autologous and Allogeneic Stem Cell Transplant in Cancer Therapy.

Over the last 10 to 20 years, there have been significant improvements in the fields of both autologous and allogenic transplantation [...].

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… Dybko et al. aimed to identify predictive and risk factors associated with the increased occurrence of the BK virus-related hemorrhagic cystitis (HC) following hematopoietic stem cell transplantation (HCT). … Furthermore, the level of BK virus DNA in serum at day +21 (>0.75 × 10 3 ) significantly impacted the patients’ survival time [ 5 ]. …

Recognition and management of early complications in CAR-T cell therapy and virus-specific T-lymphocyte therapy: a practical clinical reference.

BACKGROUND: Cellular immunotherapies-including chimeric antigen receptor T-cell (CAR-T) therapies and adoptive transfer of virus-specific T lymphocytes (VSTs) - have transformed the treatment of refractory hematological malignancies and post-transplant infectious complications. Eight products are currently authorized by the European Medicines Agency, encompassing seven autologous CAR-T products targeting CD19 or BCMA and tabelecleucel (Ebvallo), the first approved allogeneic off-the-shelf EBV-specific T-cell product for EBV-positive post-transplant lymphoproliferative disease. Despite their cl

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… In the post-HSCT context, the most clinically relevant products target EBV, CMV, adenovirus, BK virus, and HHV-6 ( 1 ). … Off-the-shelf virus-specific T cells to treat BK virus, human herpesvirus 6, cytomegalovirus, Epstein-Barr virus, and adenovirus infections after allogeneic hematopoietic stem-cell transplantation . …

References

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… Discovery and epidemiology of the human polyomaviruses BK virus (BKV) and JC virus (JCV) Adv Exp Med Biol. 2006;577:19–45. doi: 10.1007/0-387-32957-9_2. 349. Egli A, Infanti L, Stebler C, Bodaghi S, Gosert R, Hirsch HH. … Ciprofloxacin decreased polyoma BK virus load in patients who underwent allogeneic hematopoietic stem cell transplantation. Clin Infect Dis. 2005;40:528–537. doi: 10.1086/427291. 364. Hui CK, Lie A, Au WY, Leung YH, Ma SY, Cheung WW. …

A Phase II Trial of Melphalan Based Reduced-Intensity Conditioning for Transplantation of T-Replete HLA-Haploidentical Peripheral Blood Stem Cells with Posttransplant Cyclophosphamide in Patients with Hematologic Malignancies.

T-replete haploidentical donor transplants using posttransplant cyclophosphamide (haplo) have greatly expanded donor availability and are increasingly utilized. Haplo were originally performed using truly nonmyeloablative conditioning and a bone marrow graft. We have also developed myeloablative conditioning and peripheral blood stem cell (PBSC) grafts for use with haplo. However, some patients may not tolerate myeloablative conditioning but may still benefit from a more dose-intensified preparative regimen to control malignancy and diminish graft rejection. To this end, we enrolled 25 patient

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… However, in this study, BK virus induced hemorrhagic cystitis was a significant cause of early posttransplant morbidity. … The second myeloablative study with TBI based conditioning showed much lower rates of BK virus hemorrhagic cystitis, full donor chimerism at day 30, a one-year NRM under 10%, and a 2-year DFS of 73% [ 4 ]. …

Запоздалая прогрессивная многофукальная лейкоэнцефалопатия после теклистамб в множественной миеломе: продление периода инфекционного риска.

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… Progressive multifocal leukoencephalopathy and BK virus-nephropathy with bispecific antibody therapy in multiple myeloma. Haematologica. 2026;111(1):431-435. 9. Hoeynck BW, Cohen AD, Stadtmauer EA, et al. Progressive multifocal leukoencephalopathy in multiple myeloma. … Progressive multifocal leukoencephalopathy and BK virus-nephropathy with bispecific antibody therapy in multiple myeloma. Haematologica. 2026;111(1):431-435. 13. Sun HY, Singh N. Immune reconstitution inflammatory syndrome in non-HIV immunocompromised patients. …

Экулизумаб для связанной с АТКР тромботической микроангиопатии в китайском реципиенте трансплантации почек с типом 2 диабет: отчет по делу.

ЦЕЛЬ: Данное исследование было направлено на изучение эффективности экулизумаба в лечении недавно разработанной тромботической микроангиопатии (TMA), связанной с острым отторжением с помощью Т-клеток (ATCR) у пациентов с типом 2 диабет после трансплантации почек. МЕТОДЫ: Новая тромботическая микроангиопатия после трансплантации почек является относительно редким, но серьезным осложнением, которое клинически трудно уладить и требует своевременного вмешательства для предотвращения пересадки или ранней потери трансплантатата. В настоящее время в клинической практике отсутствует консенсус в отноше

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… TA-TMA should be considered in cases of unexplained renal impairment after excluding more common etiologies, such as calcineurin inhibitor nephrotoxicity, ABMR, and BK virus-associated nephropathy. … BK virus testing was negative, as were tests for Shiga toxin-producing Escherichia coli and other bacterial infections, thus excluding infection-related TMA. …

Current trends of infectious complications following hematopoietic stem cell transplantation in a single center.

This study was to analyze the infectious complications after hematopoietic stem cell transplantation (HSCT) according to the recent changes of HSCT. Medical records of 379 adult patients who underwent HSCT consecutively at Catholic HSCT Center from January 2001 to December 2002 were reviewed retrospectively. Allogeneic HSCT accounted for 75.7% (287/379) and autologous HSCT for 24.3% (92/379). During pre-engraftment period, bacterial infection was predominant, and E. coli was still the most common organism. After engraftment, viral infection was predominant. The incidence of invasive fungal inf

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… During the early post-transplant period (pre-engraftment and mid-recovery periods), there were a total of 17 cases of virus-associated hemorrhagic cystitis including BK virus in 11 cases, adenovirus in 2, JC virus in 1, adenovirus plus BK virus in 1, and BK virus plus JC virus in 2 cases. …

The EHA Research Roadmap: Infections in Hematology.

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Stem Cell Transplantation

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… BK virus is a polyoma virus that infects many individuals early in life and persists lifelong in urogenital epithelial tissues. Reactivation may occur after allogeneic HCT, especially in patients with GVHD and is a cause of hemorrhagic cystitis [ 59 , 60 ]. … BK virus can also be detected in blood samples but its correlation with hemorrhagic cystitis has been less well documented. Nonneutropenic Fever At time of engraftment, fever occasionally occurs in the absence of infection (sometimes known as “engraftment syndrome”). …

Kidney Transplant Outcomes of Patients With Multiple Myeloma.

IntroductionData on kidney transplantation (KTx) outcomes of patients with multiple myeloma (MM) are very limited.MethodsWe investigated the outcomes of patients with MM who underwent KTx between 1994 and 2019.ResultsA total of 12 transplants from 11 patients were included. At the time of KTx, 6 were classified as having stringent complete response (CR), 2 as CR, 2 as very good partial response (VGPR), and 2 as partial response (PR). With a median follow-up of 40 (minimum-maximum, 5-92) months after KTx, hematologic progression occurred in 9 transplants (75%). There were 3 grafts (25%) that fa

Sirolimus versus cyclosporine in haploidentical stem cell transplantation with posttransplant cyclophosphamide and mycophenolate mofetil as graft-versus-host disease prophylaxis.

Sirolimus has emerged as an alternative to calcineurin inhibitors-based (CNI) graft-versus-host disease (GVHD) prophylaxis. This retrospective study compares the outcome of 133 consecutive adult patients with haematological malignancies undergoing haploidentical stem cell transplantation with posttransplant cyclophosphamide (PTCy) and mycophenolate mofetil (MMF), combined with cyclosporine A (PTCy-CsA-MMF, n = 67) or sirolimus (PTCy-Sir-MMF, n = 66) as GVHD prophylaxis strategy. The median follow-up was 48 (range 22-83) and 13 (range 3-33) months, respectively. PTCy-CsA-MMF was associated in m

Intestinal/Multivisceral Transplantation

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… The use of antiviral prophylactic strategies has made herpes virus infections uncommon, but the use of reverse transcriptase polymerase chain reaction (RT-PCR) assays for the detection and monitoring of viral DNA has identified other pathogens, including polyoma viruses such as BK virus and paramyxoviruses … Other common complications post-transplantation also contribute to an increased risk of renal dysfunction, e.g. hypoperfusion, dehydration, chronic hypertension, diabetes mellitus, infection with BK virus and dyslipidemia. …

Tailoring cells for clinical needs: Meeting report from the Advanced Therapy in Healthcare symposium (October 28-29 2017, Doha, Qatar).

New technologies and therapies designed to facilitate development of personalized treatments are rapidly emerging in the field of biomedicine. Strikingly, the goal of personalized medicine refined the concept of therapy by developing cell-based therapies, the so-called "living drugs". Breakthrough advancements were achieved in this regard in the fields of gene therapy, cell therapy, tissue-engineered products and advanced therapeutic techniques. The Advanced Therapies in Healthcare symposium, organized by the Clinical Research Center Department of Sidra Medicine, in Doha, Qatar (October 2017),

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… Dendritic cells pulsed with polyomavirus BK antigen induce ex vivo polyoma BK virus-specific cytotoxic T-cell lines in seropositive healthy individuals and renal transplant recipients. J Am Soc Nephrol. 2003;14:3197–3204. doi: 10.1097/01.ASN.0000096374.08473.E3. 73. …

Facing challenges with hope: universal immune cells for hematologic malignancies.

Many patients have achieved a favorable overall survival rate since allogenic hematopoietic stem cell transplantation (allo-HSCT) has been widely implemented to treat hematologic malignancies. However, graft-versus-host disease (GVHD) and complications of immunosuppressive drugs after allo-HSCT are the main causes of non-relapse mortality and a poor quality of life. In addition, GVHD and infusion-induced toxicity still occur with donor lymphocyte infusions (DLIs) and chimeric antigen receptor (CAR) T-cell therapy. Because of the special immune tolerance characteristics and anti-tumor ability o

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… Tzannou et al. 9 successfully constructed a VST cell bank recognizing five viral pathogens [EBV, AdV, CMV, BK virus (BKV) and human herpesvirus (HHV)-6]. The overall cumulative complete or partial response rate after a single infusion was 92% and 100% for BKV and EBV, respectively. … Tzannou I Papadopoulou A Naik S Leung K Martinez CA Ramos CA Off-the-shelf virus-specific T cells to treat BK virus, human herpesvirus 6, cytomegalovirus, Epstein-Barr virus, and adenovirus infections after allogeneic hematopoietic stem-cell transplantation J Clin Oncol 2017 35 3547 57 28783452 10.1200 …