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1.
Transplant Proc ; 42(9): 3729-34, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21094847

RESUMO

Late-onset hemorrhagic cystitis (HC) caused by adenovirus (AdV) infection is a common complication in hematopoietic stem cell transplantation (HSCT) recipients. However, limited information exists regarding adenovirus-associated HC. We report a retrospective study of 84 hematopoietic stem cell transplant recipients that evaluated the incidence and risk factors for AdV-induced HC. The development of HC was strongly related to adenoviral infection (P = .004). Among 13 patients who developed late-onset HC, AdVs were identified as a causative agent in 10 cases. AdV preferentially affected younger (P = .013) and male patients. Affected subjects had been transplanted for either malignant (7/10) or nonmalignant disorders (3/10). Most cases of AdV-hematuria were self-limited single or recurrent mild hemorrhagic episodes (P = .000), occurring at a median of 41 days after transplantation and lasting an average of 4 days. Viral load in patients with AdV-induced HC was similar to infected subjects who did not develop HC (2.5 × 10(3) vs 3.4 × 10(3) copies/mL). We HC occurring before 200 days was associated with a greater risk of a fatal outcome (P = .002) but occurrence of AdV infection did not affect a patient's survival. Our study confirmed the suggestion that non-AdV coinfections may worsen the course of AdV-HC.


Assuntos
Infecções por Adenoviridae/virologia , Adenoviridae/isolamento & purificação , Transplante de Medula Óssea/efeitos adversos , Cistite/virologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Hematúria/virologia , Hemorragia/virologia , Adenoviridae/genética , Infecções por Adenoviridae/diagnóstico , Infecções por Adenoviridae/mortalidade , Adolescente , Adulto , Transplante de Medula Óssea/mortalidade , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Cistite/mortalidade , DNA Viral/isolamento & purificação , Feminino , Transplante de Células-Tronco Hematopoéticas/mortalidade , Hematúria/mortalidade , Hemorragia/mortalidade , Humanos , Incidência , Lactente , Estimativa de Kaplan-Meier , Masculino , Polônia , Reação em Cadeia da Polimerase , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Carga Viral , Adulto Jovem
2.
Bone Marrow Transplant ; 33(2): 211-7, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14628077

RESUMO

Immunotherapy consisting of withdrawal of immunosuppression and/or donor lymphocyte infusions was initiated in 14 children (10 acute lymphoblastic leukemia, three acute myeloblastic leukemia and one myelodysplastic syndrome) with an increasing amount of autologous DNA (increasing mixed chimerism, inMC) detected after allogeneic hematopoietic cell transplantation (HCT). Two children were in relapse when inMC was detected, 12 remained in CR. Children with overt relapse at the time of cessation of cyclosporine A (CsA) received "debulking" chemotherapy. One of them developed acute grade III graft-versus-host disease, converted to complete donor chimerism (CC) and achieved remission. Another patient did not respond and died due to disease progression. Among 12 children treated in remission, 11 responded with conversion to CC, seven after CsA withdrawal and four after DLI. One patient did not respond, rejected the graft and died due to pulmonary aspergillosis. In one patient, the response was transient, inMC reappeared and frank relapse occurred. One patient developed isolated CNS relapse despite conversion to CC, but achieved CR after conventional treatment. One child died in CC due to infection. No graft-versus-host disease (GvHD)-related death occurred. A total of 10 patients are alive in remission with median follow-up of 338 days. Our results support the hypothesis that chimerism-guided immunotherapy after alloHCT may prevent progression to hematological relapse.


Assuntos
Ciclosporina/administração & dosagem , Transplante de Células-Tronco Hematopoéticas , Imunossupressores/administração & dosagem , Leucemia Mieloide/terapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Quimeras de Transplante/imunologia , Doença Aguda , Adolescente , Criança , Pré-Escolar , Ciclosporina/efeitos adversos , Feminino , Doença Enxerto-Hospedeiro/tratamento farmacológico , Doença Enxerto-Hospedeiro/imunologia , Humanos , Imunossupressores/efeitos adversos , Masculino , Transplante Autólogo , Resultado do Tratamento
3.
Transplant Proc ; 35(4): 1559-62, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12826220

RESUMO

Thymidine ((3)H-TdR) incorporation remains the most commonly used method to quantifying T-cell proliferation. This method, however, does not provide information about specific lymphocyte subpopulations responding to different stimuli. In our study, we modified previously described nonradioactive flow-cytometric T-cell activation assay measuring the expression of a CD69+ antigen on T-cell subsets and applied it to analysis of lymphocyte subsets activation/proliferation in children after allogeneic hematopoietic cell transplantation (HCT). We compared the percentage of spontaneously activated lymphocyte subpopulations (background) and the percentage of PHA-P, PWM, and SEB-stimulated cell subsets from two groups of patients: group 1, children with Graft versus Host Disease (GvHD) and group 2, children without any signs of GvHD at the time of analysis. High rate of spontaneous T-cell subset activation was found in group 1 with CD3+CD8+Ts cells being the most affected cell population. High background activation of Th and B cells correlated with the occurrence of autoimmune phenomena posttransplant. Rapid quantification of CD69+ expression on unstimulated and stimulated T-cell subsets proved to be a valuable method for monitoring children after allogeneic HCT. High proportion of activated, unstimulated Ts cells observed in the GvHD group may underline the critical role of CD3+CD8+ cells in the pathogenesis of GvHD. Thus in future immunosuppressive therapy may be adjusted according to the proportion of activated Ts cells.


Assuntos
Doença Enxerto-Hospedeiro/imunologia , Ativação Linfocitária , Subpopulações de Linfócitos/imunologia , Transplante de Células-Tronco , Linfócitos T/imunologia , Transplante Homólogo/imunologia , Transplante de Medula Óssea/imunologia , Criança , Citometria de Fluxo/métodos , Seguimentos , Humanos , Leucemia/classificação , Leucemia/cirurgia , Leucemia/terapia , Depleção Linfocítica , Síndromes Mielodisplásicas/cirurgia , Síndromes Mielodisplásicas/terapia , Timidina/metabolismo , Fatores de Tempo , Trítio
6.
Wiad Lek ; 51 Suppl 4: 197-201, 1998.
Artigo em Polonês | MEDLINE | ID: mdl-10731968

RESUMO

The Langerhans cell histiocytosis (LCH) is an enigmatic disease, usually occurring in the young. Its etiology is unknown, its pathogenesis is not correctly understood and the clinical course is unpredictable. In the years from 1975 to 1998 in Department of Paediatric Haematology and Oncology (Wroclaw University School of Medicine) 32 children with diagnosis of the Langerhans Cell Histiocytosis (LCH) were treated. The study group included 19 boys and 13 girls, aged from 3 weeks to 14 years, median age 7.5 years. Investigations of immunological system were performed in the examined group. In all children lymphocytes' subsets were examined. We examined apoptosis with ELISA test in 3 patients, in 3--marked antigen CD44, in 12 marked sVCAM-1 by ELISA method. IL-1 in growing cell supernatants was determined in 17 children. In 15 children lower IL-1 production was observed before the beginning of therapy in comparison with control group. In all patients decreased concentrations of lymphocytes T were noted, but in 8 children lower CD4/CD8 rate was observed. In the study group higher expression of CD44 was noted. In 3 patients cell apoptosis was normal. In 12 patients lower expression of sVCAM-1 was observed. Abnormal expression of adhesion molecules may influence the pathogenesis of LCH. Disorders of immunological system were observed in the patients with LCH.


Assuntos
Histiocitose de Células de Langerhans/imunologia , Receptores de Hialuronatos/imunologia , Interleucina-1/imunologia , Molécula 1 de Adesão de Célula Vascular/imunologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos
7.
Wiad Lek ; 51 Suppl 4: 202-9, 1998.
Artigo em Polonês | MEDLINE | ID: mdl-10731969

RESUMO

Total number of 160 children with ALL, 98 boys and 62 girls, aged from 0.5 to 18 years was included in the study. Apoptotic cells death acc. to annexin V and ICAM-1 levels in serum and cell culture supernatants according to conventional antibody sandwich ELISA Genzyme assay were studied. Blood samples were drawn from children at different stages of their disease: at the time of diagnosis, during intensive therapy (induction, consolidation), during maintenance therapy and after completing the treatment. Thirty seven healthy children served as the control group. ICAM-1 before therapy was higher than that obtained in control group of healthy children (5.619 v 2.53 g/l). ICAM-1 decrease (3.228) after starting of chemotherapy of ALL was noticed. It was found that in children with ALL during the whole period of therapy the ICAM-1 serum levels were significantly lower than that observed in the control group of healthy children (p < 0.005). After cessation of the therapy ICAM-1 grew up (6.27 g/l). Therapeutics that modulate the regulation of apoptosis and/or expression of sICAM and cytokines production provide a new opportunity for the treatment of childhood ALL.


Assuntos
Apoptose , Molécula 1 de Adesão Intercelular/imunologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/imunologia , Adolescente , Apoptose/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Molécula 1 de Adesão Intercelular/sangue , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Indução de Remissão
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