Subcutaneous infection caused by Blastoschizomyces capitatus post allogeneic hematopoietic transplant and its successful treatment with voriconazole.

We describe a 33-year-old man with relapsed acute myelogenous leukemia who developed subcutaneous nodules >6 months after allogeneic hematopoietic stem cell transplant. These nodules were caused by Blastoschizomyces capitatus. The lesions progressed after treatment with a posaconazole suspension. The lesions resolved after switching to voriconazole, which was given for 21 weeks. B. capitatus is a rare infection affecting immunocompromised patients, which responds to azoles.

Severe weight loss in 3 months after allogeneic hematopoietic SCT was associated with an increased risk of subsequent non-relapse mortality.

Patients after allogeneic hematopoietic SCT (HSCT) are at risk of malnutrition. To assess the impact of malnutrition after allogeneic HSCT on transplant outcomes, we conducted a retrospective study. Adult patients who received allogeneic HSCT from 2000 to 2009 for standard-risk leukemia and achieved disease-free survival up to 3 months after allogeneic HSCT were included. From participating centers, 145 patients were enrolled. Median age was 46 years (19-68). Patients were classified based on weight loss during 3 months after allogeneic HSCT as follows: normal group (weight loss <5%, n=53), mild malnutrition group (5%⩽weight loss<10%, n=47), severe malnutrition group (10% ⩽weight loss, n=45). The cumulative incidences of 2-year nonrelapse mortality (NRM) were 3.8% in the normal group, 8.5% in the mild malnutrition group and 27.3% in the severe malnutrition group. The probabilities of a 2-year OS were 73.2% in the normal group, 74.5% in the mild malnutrition group and 55.3% in the severe malnutrition group. In multivariate analysis, severe malnutrition was associated with an increased risk of NRM and a worse OS. In conclusion, weight loss ⩾10% was associated with a worse clinical outcome. Prospective studies that identify patients at risk of malnutrition and intervention by a nutritional support team are warranted.

CD26 expression in donor stem cell harvest and its correlation with engraftment in human haematopoietic stem cell transplantation: potential predictor of early engraftment.

BACKGROUND: The efficiency of haematopoietic stem and progenitor cells (HSPCs) is important when donor cell numbers are limiting. Stable white blood cell (WBC) and platelet engraftment is crucial for the outcome of haematopoietic stem cell transplantation (HSCT). DESIGN: This article evaluates CD26/dipeptidyl peptidase-IV expression on mobilised peripheral blood stem cell (PBSC) harvest of donors and its correlation with engraftment in HSCT. We have analysed CD26 expression on cells in various gates, that is, lymphocytes, monocytes, neutrophils and all populations using flow cytometry tool. RESULTS: Ours is the first study on human mobilised PBSC harvest from cancer patients or allogeneic related donors (n = 28) to demonstrate that increased CD26 expression leads to early engraftment in transplanted cancer patients. Correlation of CD26 expression with WBC engraftment was statistically significant (lymphocyte gate: P < 0.00001; monocyte gate: P < 0.00001; neutrophil gate: P < 0.00001; all populations: P < 0.00001). CD34 expression is a known predictor of engraftment. Nevertheless, there was no correlation between CD34 and CD26 expression in these cases. CONCLUSIONS: This study has given important leads indicating that CD26 expression may be an independent predictor of engraftment. Further study with large number of patients as well as study on circulatory CD26 may add valuable information towards improving current knowledge on CD26.