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Hematopoietic stem cell transplantation in children with inborn errors of immunity: a multi-center experience in Colombia / Luz Natalia Builes Restrepo  

Público ISBD Título : Hematopoietic stem cell transplantation in children with inborn errors of immunity: a multi-center experience in Colombia Tipo de documento : documento electrónico Autores : Luz Natalia Builes Restrepo, Fecha de publicación : 2020 Títulos uniformes : Journal of Clinical Immunology Idioma : Inglés (eng) Palabras clave : Hematopoietic stem cell transplantation  child  haploidentical transplantations  pediatrics  primary immunodeficiency diseases  transplant recipients Resumen : Purpose: To characterize the pediatric population with inborn errors of immunity (IEI) that was treated with hematopoietic stem cell transplantation (HSCT) in three reference centers in Colombia. What have been the characteristics and outcomes of hematopoietic stem cell transplantation in pediatric patients with inborn errors of immunity in three reference care centers in Colombia between 2007 and 2018. Methods: We conducted an observational, retrospective cohort study in children with a diagnosis of IEI who underwent HSCT between 2007 and 2018. Results: Forty-seven patients were identified, and 5 were re-transplanted. Sixty-eight percent were male. The median age at diagnosis was 0.6 years, and for HSCT was 1.4 years. The most common diseases were chronic granulomatous disease (38%) followed by severe combined immune deficiencies (19%) and hemophagocytic lymphohistiocytosis (15%). Cord blood donors were the most used source of HSCT (44%). T cell-replete grafts from haploidentical donors using post-transplantation cyclophosphamide represent 37% of the cohort. All patients received conditioning, 62% with a non-myeloablative regimen. Calcineurin inhibitors were the main graft-versus-host disease prophylaxis (63.8%). Acute graft-versus-host disease developed in 35% of the total patients. The most frequent post-transplant infections were viral and fungal infections. The 1-year overall survival rates for the patients who received HSCT from identical, haploidentical, and cord sources were 80%, 72%, and 63%, respectively. The 5-year overall survival was 63%. Conclusions: HSCT is a curative treatment option for some IEI and can be performed with any donor type. Early and timely treatment in referral centers can improve survival. Mención de responsabilidad : Manuela Olaya, Alexis Franco, Mauricio Chaparro, Marcela Estupiñan, David Aristizabal, Natalia Builes-Restrepo, José L Franco, Andrés F Zea-Vera, Mayra Estacio, Eliana Manzi, Estefania Beltran, Paola Perez, Jaime Patiño, Harry Pachajoa & Diego Medina-Valencia Referencia : J Clin Immunol. 2020 Nov;40(8):1116-1123. DOI (Digital Object Identifier) : 10.1007/s10875-020-00856-w PMID : 32880086 En línea : https://link.springer.com/article/10.1007/s10875-020-00856-w Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5135 Hematopoietic stem cell transplantation in children with inborn errors of immunity: a multi-center experience in Colombia [documento electrónico] / Luz Natalia Builes Restrepo,  . - 2020. Obra : Journal of Clinical Immunology Idioma : Inglés (eng) Palabras clave : Hematopoietic stem cell transplantation  child  haploidentical transplantations  pediatrics  primary immunodeficiency diseases  transplant recipients Resumen : Purpose: To characterize the pediatric population with inborn errors of immunity (IEI) that was treated with hematopoietic stem cell transplantation (HSCT) in three reference centers in Colombia. What have been the characteristics and outcomes of hematopoietic stem cell transplantation in pediatric patients with inborn errors of immunity in three reference care centers in Colombia between 2007 and 2018. Methods: We conducted an observational, retrospective cohort study in children with a diagnosis of IEI who underwent HSCT between 2007 and 2018. Results: Forty-seven patients were identified, and 5 were re-transplanted. Sixty-eight percent were male. The median age at diagnosis was 0.6 years, and for HSCT was 1.4 years. The most common diseases were chronic granulomatous disease (38%) followed by severe combined immune deficiencies (19%) and hemophagocytic lymphohistiocytosis (15%). Cord blood donors were the most used source of HSCT (44%). T cell-replete grafts from haploidentical donors using post-transplantation cyclophosphamide represent 37% of the cohort. All patients received conditioning, 62% with a non-myeloablative regimen. Calcineurin inhibitors were the main graft-versus-host disease prophylaxis (63.8%). Acute graft-versus-host disease developed in 35% of the total patients. The most frequent post-transplant infections were viral and fungal infections. The 1-year overall survival rates for the patients who received HSCT from identical, haploidentical, and cord sources were 80%, 72%, and 63%, respectively. The 5-year overall survival was 63%. Conclusions: HSCT is a curative treatment option for some IEI and can be performed with any donor type. Early and timely treatment in referral centers can improve survival. Mención de responsabilidad : Manuela Olaya, Alexis Franco, Mauricio Chaparro, Marcela Estupiñan, David Aristizabal, Natalia Builes-Restrepo, José L Franco, Andrés F Zea-Vera, Mayra Estacio, Eliana Manzi, Estefania Beltran, Paola Perez, Jaime Patiño, Harry Pachajoa & Diego Medina-Valencia Referencia : J Clin Immunol. 2020 Nov;40(8):1116-1123. DOI (Digital Object Identifier) : 10.1007/s10875-020-00856-w PMID : 32880086 En línea : https://link.springer.com/article/10.1007/s10875-020-00856-w Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5135

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New insights into risk factors for transplant-associated thrombotic microangiopathy in pediatric HSCT / Luz Natalia Builes Restrepo  

Público ISBD Título : New insights into risk factors for transplant-associated thrombotic microangiopathy in pediatric HSCT Tipo de documento : documento electrónico Autores : Luz Natalia Builes Restrepo, Fecha de publicación : 2020 Títulos uniformes : Blood Advances Idioma : Inglés (eng) Palabras clave : tissue microarray  transplantation  trimethylamine  hematopoietic stem cell transplantation Resumen : This study aimed to identify a risk profile for development of transplant-associated thrombotic microangiopathy (TA-TMA) in children undergoing hematopoietic stem cell transplantation (HSCT). Between 2013 and 2016, 439 children underwent 474 HSCTs at 2 supraregional United Kingdom centers. At a median of 153 days post-HSCT, TA-TMA occurred among 25 of 441 evaluable cases (5.6%) with no evidence of center variation. Sex, underlying disease, intensity of the conditioning, total body irradiation–based conditioning, the use of calcineurin inhibitors, venoocclusive disease, and viral reactivation did not influence the development of TA-TMA. Donor type: matched sibling donor/matched family donor vs matched unrelated donor vs mismatched unrelated donor/haplo-HSCT, showed a trend toward the development of TA-TMA in 1.8% vs 6.1% vs 8.3%, respectively. Presence of active comorbidity was associated with an increased risk for TA-TMA; 13% vs 3.7% in the absence of comorbidity. The risk of TA-TMA was threefold higher among patients who received >1 transplant. TA-TMA rates were significantly higher among patients with acute graft-versus-host disease (aGVHD) grades III to IV vs aGVHD grade 0 to II. On multivariate analysis, the presence of active comorbidity, >1 transplant, aGVHD grade III to IV were risk factors for TA-TMA (odds ratio [OR]: 5.1, 5.2, and 26.9; respectively), whereas the use of cyclosporine A/tacrolimus-based GVHD prophylaxis was not a risk factor for TA-TMA (OR: 0.3). Active comorbidity, subsequent transplant, and aGVHD grades III to IV were significant risk factors for TA-TMA. TA-TMA might represent a form of a vascular GVHD, and therefore, continuing control of aGVHD is important to prevent worsening of TA-TMA associated with GVHD. Mención de responsabilidad : Reem Elfeky, Giovanna Lucchini, Su-Han Lum, Giorgio Ottaviano, Natalia Builes, Zohreh Nademi, Alexandra Battersby, Terence Flood, Stephen Owens, Andrew J Cant, Helen Young, Sinéad Greener, Patrick Walsh, David Kavanagh, Srinivas Annavarapu, Kanchan Rao, Persis Amrolia, Robert Chiesa, Austen Worth, Claire Booth, Roderick Skinner, Bilyana Doncheva, Joseph Standing, Andrew R Gennery, Waseem Qasim, Mary Slatter, Paul Veys Referencia : Blood Adv. 2020 Jun 9;4(11):2418-2429. DOI (Digital Object Identifier) : 10.1182/bloodadvances.2019001315 PMID : 32492158 En línea : https://ashpublications.org/bloodadvances/article/4/11/2418/460608/New-insights- [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5105 New insights into risk factors for transplant-associated thrombotic microangiopathy in pediatric HSCT [documento electrónico] / Luz Natalia Builes Restrepo,  . - 2020. Obra : Blood Advances Idioma : Inglés (eng) Palabras clave : tissue microarray  transplantation  trimethylamine  hematopoietic stem cell transplantation Resumen : This study aimed to identify a risk profile for development of transplant-associated thrombotic microangiopathy (TA-TMA) in children undergoing hematopoietic stem cell transplantation (HSCT). Between 2013 and 2016, 439 children underwent 474 HSCTs at 2 supraregional United Kingdom centers. At a median of 153 days post-HSCT, TA-TMA occurred among 25 of 441 evaluable cases (5.6%) with no evidence of center variation. Sex, underlying disease, intensity of the conditioning, total body irradiation–based conditioning, the use of calcineurin inhibitors, venoocclusive disease, and viral reactivation did not influence the development of TA-TMA. Donor type: matched sibling donor/matched family donor vs matched unrelated donor vs mismatched unrelated donor/haplo-HSCT, showed a trend toward the development of TA-TMA in 1.8% vs 6.1% vs 8.3%, respectively. Presence of active comorbidity was associated with an increased risk for TA-TMA; 13% vs 3.7% in the absence of comorbidity. The risk of TA-TMA was threefold higher among patients who received >1 transplant. TA-TMA rates were significantly higher among patients with acute graft-versus-host disease (aGVHD) grades III to IV vs aGVHD grade 0 to II. On multivariate analysis, the presence of active comorbidity, >1 transplant, aGVHD grade III to IV were risk factors for TA-TMA (odds ratio [OR]: 5.1, 5.2, and 26.9; respectively), whereas the use of cyclosporine A/tacrolimus-based GVHD prophylaxis was not a risk factor for TA-TMA (OR: 0.3). Active comorbidity, subsequent transplant, and aGVHD grades III to IV were significant risk factors for TA-TMA. TA-TMA might represent a form of a vascular GVHD, and therefore, continuing control of aGVHD is important to prevent worsening of TA-TMA associated with GVHD. Mención de responsabilidad : Reem Elfeky, Giovanna Lucchini, Su-Han Lum, Giorgio Ottaviano, Natalia Builes, Zohreh Nademi, Alexandra Battersby, Terence Flood, Stephen Owens, Andrew J Cant, Helen Young, Sinéad Greener, Patrick Walsh, David Kavanagh, Srinivas Annavarapu, Kanchan Rao, Persis Amrolia, Robert Chiesa, Austen Worth, Claire Booth, Roderick Skinner, Bilyana Doncheva, Joseph Standing, Andrew R Gennery, Waseem Qasim, Mary Slatter, Paul Veys Referencia : Blood Adv. 2020 Jun 9;4(11):2418-2429. DOI (Digital Object Identifier) : 10.1182/bloodadvances.2019001315 PMID : 32492158 En línea : https://ashpublications.org/bloodadvances/article/4/11/2418/460608/New-insights- [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5105

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Capnocytophaga sputigena bacteremia in a neutropenic host / Isabel Cristina Ramírez Sánchez    

Público ISBD Título : Capnocytophaga sputigena bacteremia in a neutropenic host Tipo de documento : documento electrónico Autores : Isabel Cristina Ramírez Sánchez, Fecha de publicación : 2019 Títulos uniformes : IDCases Idioma : Inglés (eng) Palabras clave : Capnocytophaga  hematopoietic stem cell transplantation  microbiota  febrile neutropenia Resumen : Capnocytophaga species belong to the oral microbiota but are not a common cause of infection in febrile neutropenia. Nevertheless, neutropenia can cause bacteremia associated with mucositis, with lower rates of mortality. While empirical therapy with beta-lactams is generally effective, there is concern about the emergence of bacterial resistance. We present a case of a febrile neutropenic patient with mucositis presenting with C. sputigena bacteremia. Mención de responsabilidad : Ramírez Isabel Referencia : IDCases. 2019 Apr 12;17:e00536. DOI (Digital Object Identifier) : 10.1016/j.idcr.2019.e00536 PMID : 31384554 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2214250919300496 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4238 Capnocytophaga sputigena bacteremia in a neutropenic host [documento electrónico] / Isabel Cristina Ramírez Sánchez,  . - 2019. Obra : IDCases Idioma : Inglés (eng) Palabras clave : Capnocytophaga  hematopoietic stem cell transplantation  microbiota  febrile neutropenia Resumen : Capnocytophaga species belong to the oral microbiota but are not a common cause of infection in febrile neutropenia. Nevertheless, neutropenia can cause bacteremia associated with mucositis, with lower rates of mortality. While empirical therapy with beta-lactams is generally effective, there is concern about the emergence of bacterial resistance. We present a case of a febrile neutropenic patient with mucositis presenting with C. sputigena bacteremia. Mención de responsabilidad : Ramírez Isabel Referencia : IDCases. 2019 Apr 12;17:e00536. DOI (Digital Object Identifier) : 10.1016/j.idcr.2019.e00536 PMID : 31384554 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2214250919300496 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4238

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