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1.
Rev. colomb. gastroenterol ; 37(2): 225-232, Jan.-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1394954

ABSTRACT

Abstract Graft-versus-host disease is a common complication after stem cell transplantation. The digestive tract is affected in many patients who suffer from it, with consequences that can be fatal. The proper approach, which includes endoscopic studies, allows ruling out differential diagnoses and managing the disease early.


Resumen La enfermedad de injerto contra huésped es una complicación frecuente después del trasplante de células madre. El tracto digestivo se afecta en una gran proporción de los pacientes que la sufren, con consecuencias que pueden llegar a ser fatales. El abordaje adecuado, que incluye el uso de estudios endoscópicos, permite descartar diagnósticos diferenciales y brindar un manejo temprano de la enfermedad.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Stem Cell Transplantation , Gastrointestinal Tract , Graft vs Host Disease , Patients , Disease , Diagnosis, Differential , Digestive System
2.
Acta sci., Health sci ; 44: e56546, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1367534

ABSTRACT

The aim of the study is to determine the psychological well-being of patients who underwent stem cell transplantation. This cross-sectional study was conducted with 100 patients. Data were collected face-to-face using an introductory information form and the Brief Symptom Inventory.When the results of the patients were examined, the interpersonal sensitivity of the sub-dimensions of the scale was found to be 5.0 ± 4.06, depression 7.60 ± 5.37, and anxiety disorder 7.90 ± 5.34. There was a significant difference between the diagnosistime of the patients and all sub-factors of the scale, except phobic anxiety. It was found that the psychological state of the patients was directly related to the time of first diagnosis. As a result, the importance of following the psychological processof the patients during the treatment process was revealed when planning nursing care.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Patients/psychology , Stem Cell Transplantation/nursing , Emotional Adjustment/ethics , Nursing Care/ethics , Anxiety Disorders/diagnosis , Anxiety Disorders/nursing , Anxiety Disorders/rehabilitation , Paranoid Disorders/diagnosis , Paranoid Disorders/nursing , Paranoid Disorders/therapy , Psychotic Disorders/diagnosis , Psychotic Disorders/nursing , Psychotic Disorders/therapy , Somatoform Disorders/diagnosis , Somatoform Disorders/nursing , Somatoform Disorders/therapy , Bone Marrow , Demography/statistics & numerical data , Cross-Sectional Studies , Depression/diagnosis , Depression/nursing , Hostility , Neoplasms/diagnosis , Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/nursing , Obsessive-Compulsive Disorder/therapy
3.
Chinese Journal of Burns ; (6): 281-286, 2022.
Article in Chinese | WPRIM | ID: wpr-936006

ABSTRACT

Diabetic foot wound repair is a challenging issue in clinical practice. Due to the influence of multiple factors including the damage and regeneration failure of local tissue, the impaired pathways of wound repairing through blood vessels and nerve nutrition, and disorders of a variety of cellular factors, traditional treatment methods are often difficult to achieve good therapeutic effects. Stem cells are a type of cells with potentials of multidirectional differentiation, which also possess functions such as regulating immunity and paracrine to facilitate the comprehensive wound repair, so they have promising application prospect at present for the treatment of diabetic foot wounds. Because the relevant parameters of stem cell treatment are in the exploratory phase, there were no standardized data. This paper reviews the application of stem cells in the research of diabetic foot wound treatment over the past 6 years, analyzing and summarizing the contents in focused aspects including the types and sources of stem cells, effects of donor age and gender on stem cells, mode of administration, transplantation survival rate and safety, which may provide a reference for further application of stem cells in the clinical treatment of diabetic foot wound.


Subject(s)
Cell Differentiation , Diabetes Mellitus , Diabetic Foot/therapy , Humans , Stem Cell Transplantation , Wound Healing/physiology
4.
Chinese Journal of Hematology ; (12): 215-220, 2022.
Article in Chinese | WPRIM | ID: wpr-929560

ABSTRACT

Objective: This study aimed to determine the efficacy of dose-enhanced immunochemotherapy followed by autologous peripheral blood stem cell transplantation (ASCT) in young patients with newly diagnosed high-risk aggressive B-cell lymphoma. Methods: A retrospective study was conducted to examine the clinical and survival data of young patients with high-risk aggressive B-cell lymphoma who received dose-enhanced immunochemotherapy and ASCT as first-line treatment between January 2011 and December 2018 in Blood Diseases Hospital. Results: A total of 63 patients were included in the study. The median age range was 40 (14-63) years old. In terms of the induction therapy regimen, 52 cases received R-DA-EP (D) OCH, and the remaining 11 received R-HyperCVAD/R-MA. Sixteen (25.4% ) patients achieved partial response in the mid-term efficacy assessment, and ten of them were evaluated as complete response after transplantation. The median follow-up was 50 (8-112) months, and the 3-year progression-free survival (PFS) rate and overall survival (OS) rate were (83.9±4.7) % and (90.4±3.7) % , respectively. Univariate analysis demonstrated that age-adjusted international prognostic index ≥2 scores was a negative prognostic factor for OS (P=0.039) , and bone marrow involvement (BMI) was an adverse prognostic factor for OS (P<0.001) and PFS (P=0.001) . However, multivariate analysis confirmed that BMI was the only independent negative predictor of OS (P=0.016) and PFS (P=0.001) . Conclusions: The use of dose-enhanced immunochemotherapy in combination with ASCT as first-line therapy in the treatment of young, high-risk aggressive B-cell lymphoma results in good long-term outcomes, and BMI remains an adverse prognostic factor.


Subject(s)
Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Humans , Lymphoma, B-Cell , Peripheral Blood Stem Cell Transplantation , Prognosis , Retrospective Studies , Stem Cell Transplantation , Transplantation, Autologous
5.
Chinese Journal of Burns ; (6): 595-600, 2022.
Article in Chinese | WPRIM | ID: wpr-940967

ABSTRACT

Acne is a common chronic inflammatory disease of the skin that often occurs on the face, and acne scars are often secondary to the healing process of acne, which often leads to impaired appearance and psychological disorders of patients. The current treatment for acne scars is extremely difficult. With the development of regenerative medicine, stem cell transplantation has become a new treatment for acne scars. In recent years, it has been reported that stem cells and their derivatives can effectively antagonize the formation of acne scars. Therefore, this paper briefly reviews the basic and clinical researches on the treatment of acne scars with various mesenchymal stem cells and their derivatives, aiming to provide theoretical basis and reference for the stem cell therapy of acne scars.


Subject(s)
Acne Vulgaris/pathology , Cicatrix/pathology , Humans , Mesenchymal Stem Cells , Skin/pathology , Stem Cell Transplantation
6.
Frontiers of Medicine ; (4): 429-441, 2022.
Article in English | WPRIM | ID: wpr-939872

ABSTRACT

The local microenvironment is essential to stem cell-based therapy for ischemic stroke, and spatiotemporal changes of the microenvironment in the pathological process provide vital clues for understanding the therapeutic mechanisms. However, relevant studies on microenvironmental changes were mainly confined in the acute phase of stroke, and long-term changes remain unclear. This study aimed to investigate the microenvironmental changes in the subacute and chronic phases of ischemic stroke after stem cell transplantation. Herein, induced pluripotent stem cells (iPSCs) and neural stem cells (NSCs) were transplanted into the ischemic brain established by middle cerebral artery occlusion surgery. Positron emission tomography imaging and neurological tests were applied to evaluate the metabolic and neurofunctional alterations of rats transplanted with stem cells. Quantitative proteomics was employed to investigate the protein expression profiles in iPSCs-transplanted brain in the subacute and chronic phases of stroke. Compared with NSCs-transplanted rats, significantly increased glucose metabolism and neurofunctional scores were observed in iPSCs-transplanted rats. Subsequent proteomic data of iPSCs-transplanted rats identified a total of 39 differentially expressed proteins in the subacute and chronic phases, which are involved in various ischemic stroke-related biological processes, including neuronal survival, axonal remodeling, antioxidative stress, and mitochondrial function restoration. Taken together, our study indicated that iPSCs have a positive therapeutic effect in ischemic stroke and emphasized the wide-ranging microenvironmental changes in the subacute and chronic phases.


Subject(s)
Animals , Cell Differentiation , Disease Models, Animal , Ischemic Stroke , Proteomics , Rats , Stem Cell Transplantation/methods , Stroke/therapy
7.
Article in Chinese | WPRIM | ID: wpr-928686

ABSTRACT

OBJECTIVE@#To compare the clinical efficacy, survival, and prognosis of autologous hematopoietic stem cell transplantation (ASCT) with new drug chemotherapy in the treatment of newly diagnosed multiple myeloma (NDMM) in the new drug era.@*METHODS@#The clinical data of 149 patients with NDMM treated with new drug induction regimen in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2012 to December 2019 were retrospectively analyzed. Twenty-four patients who received ASCT were in ASCT group, and 125 patients who did not receive ASCT were in non-ASCT group. The median follow-up time was 43 (1-90) months. The propensity score matching (PSM) method was used to balance confounding factors, then depth of response, overall survival (OS), and progression-free survival (PFS) between the two groups were compared and subgroup analysis was performed.@*RESULTS@#After matching, the covariates were balanced between the two groups. Fifty-one patients (15 cases in ASCT group and 36 cases in non-ASCT group) were included. ASCT patients had a better complete response (CR) rate than non-ASCT patients receiving maintenance therapy (93.3% vs 42.3%, P=0.004), while there were no statistical differences in deep response rate and overall response rate (ORR) between the two groups (93.3% vs 65.4%, P=0.103; 93.3% vs 96.2%, P=1.000). Before matching, the 3 and 5-year PFS rate and median PFS (mPFS) in ASCT group and non-ASCT group were [89.6% vs 66.5%, P=0.024; 69.8% vs 42.7%; non-response (NR) vs 51.0 months], and the 3 and 5-year OS rate and median OS (mOS) were (100% vs 70.6%, P=0.002; 92.3% vs 49.6%; NR vs 54.0 months). After matching, the 3 and 5-year PFS rate and mPFS in ASCT group and non-ASCT group were (83.6% vs 61.7%, P=0.182; 62.7% vs 45.7%; NR vs 51.0 months), the 3 and 5-year OS rate and mOS were (100% vs 65.6%, P=0.018; 88.9% vs 46.9%; NR vs 51.0 months). Subgroup analysis showed that patients with mSMART 3.0 high risk stratification, the 3-year PFS rate and mPFS in ASCT group and non-ASCT group were (83.3% vs 41.5%, P=0.091; NR vs 34.0 months), and the 3-year OS rate and mOS were (100% vs 41.5%, P=0.034; NR vs 34.0 months). Patients with mSMART 3.0 standard risk stratification, the 3-year PFS rate and OS rate in ASCT group and non-ASCT group were (83.3% vs 76.8%, P=0.672; 100% vs 87.2%, P=0.155). The 3-year PFS and OS rate in MM patients who achieved deep response within 3 months after transplantation compared with non-ASCT patients who achieved deep response after receiving maintenance therapy were (83.1% vs 56.7%, P=0.323; 100% vs 60.5%, P=0.042), and the 3-year PFS and OS rate in patients who achieved overall response in both groups were (83.1% vs 62.5%, P=0.433; 100% vs 68.1%, P=0.082). After matching, Cox multivariate regression analysis showed that mSMART 3.0 risk stratification and ASCT were independent prognostic factors for OS.@*CONCLUSION@#In the new drug era, ASCT can increase CR rate and prolong OS of NDMM patients. ASCT patients who are mSMART 3.0 high risk stratification or achieved deep response within 3 months after transplantation have better OS than non-ASCT patients receiving new drug chemotherapy. ASCT and mSMART 3.0 risk stratification are independent prognostic factors for OS in NDMM patients.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Humans , Multiple Myeloma/drug therapy , Pharmaceutical Preparations , Propensity Score , Retrospective Studies , Stem Cell Transplantation , Transplantation, Autologous , Treatment Outcome
8.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(4): 402-409, Oct.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350819

ABSTRACT

ABSTRACT Introduction: To study the efficacy and safety of single large volume leukapheresis by using generic G-CSF or G-CSF plus Plerixafor in achieving adequate stem cell yield and various factors influencing thereof in newly diagnosed multiple myeloma patients undergoing autologous stem cell transplant . Method: This prospective study was undertaken among 55 newly diagnosed multiple myeloma patients undergoing autologous stem cell transplant and aged between 18 and 75 years. Mobilization and harvesting of stem cells were performed by using GCSF or GCSF plus Plerixafor and large volume leukapheresis, respectively. A stem cell yield of ≥2 × 106 kg-1 and the number of apheresis procedures were primary efficacy endpoints, while the ideal stem cells yield >5 × 106 kg-1, the engraftment day and D100 response/graft sustainability were secondary endpoints. Result: The primary endpoint was achieved in all cases in both the groups by using a single LVL leukapheresis procedure. Fulfillment of all the secondary endpoints was satisfactory and comparable in both the groups. Age, pre-apheresis CD34+ count and number of interruptions during the LVL were significant factors influencing the stem cell yield (p < 0.05). Adverse drug reactions during the apheresis and post-ASCT period were manageable. Conclusion: The LVL is safe and cost-effective in attaining a minimum of CD34+ cells in a single procedure with manageable adverse reactions. Judicious intervention during the procedure may be helpful in ensuring the adequate yield.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Stem Cell Transplantation , Multiple Myeloma/diagnosis , Multiple Myeloma/drug therapy , Transplantation, Autologous , Leukapheresis , Receptors, CXCR4/antagonists & inhibitors
9.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(3): 295-302, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1346245

ABSTRACT

ABSTRACT Background: Multiple myeloma is a disease of the elderly. However, 40% of patients are diagnosed before 65 years old. Outcomes regarding age as a prognostic factor in MM are heterogeneous. Method: We retrospectively analyzed clinical characteristics, response to treatment and survival of 282 patients with active newly-diagnosed multiple myeloma, comparing results between patients younger and older than 65 years. Main results: The frequency of multiple myeloma in those younger than 66 years was 53.2%. Younger patients presented with a more aggressive disease, more advanced Durie-Salmon stage (85.3% vs 73.5%; p = 0.013), extramedullary disease (12.7% vs 0%; p < 0.001), osteolytic lesions (78.7% vs 57.6%; p < 0.001) and bone plasmacytoma (25.3% vs 11.4%; p = 0.003). In spite of this, the overall response rate was similar between groups (80.6% vs 81.4%; p = 0.866). The overall survival was significantly longer in young patients (median, 65 months vs 41 months; p = 0.001) and higher in those who received autologous hematopoietic stem cell transplantation. The main cause of death was disease progression in both groups. Multivariable analysis revealed that creatinine ≥2 mg/dl, extramedullary disease, ≤very good partial remission and non-autologous hematopoietic stem cell transplantation are independent risk factors for shorter survival. Conclusion: Although multiple myeloma patients younger than 66 years of age have an aggressive presentation, this did not translate into an inferior overall survival, particularly in those undergoing autologous hematopoietic stem cell transplantation.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Stem Cell Transplantation , Multiple Myeloma/diagnosis , Multiple Myeloma/therapy , Transplantation, Autologous
10.
Rev. habanera cienc. méd ; 20(1): e3359, ene.-feb. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156681

ABSTRACT

Introducción: La polineuropatía desmielinizante inflamatoria crónica (CIDP) es una enfermedad desmielinizante e inflamatoria de mediación autoinmune. El tratamiento convencional es basado en la inmunomodulación e inmunosupresión. El uso de células madre es una terapia novedosa en los trastornos autoinmune, siendo incluida como terapia. Objetivo: Determinar la eficacia de la movilización de células madre mediante la aplicación del factor estimulador de colonias granulocíticas (F-ECG) en pacientes con CIDP que han recibido otras líneas de tratamiento. Material y Métodos: Se realizó un estudio aleatorizado, doble ciego sobre una cohorte de 45 pacientes con CIDP, donde se administró el (F-ECG) en 25 pacientes y 20 continuaron con el tratamiento habitual, tratados anteriormente con otras variantes terapéuticas por más de tres años, sin respuesta satisfactoria. Resultados: Predominio de los hombres para 64,4 por ciento, la Diabetes Mellitus tuvo mayor asociación y la medicación más usada fueron los esteroides. Los síntomas y signos clínicos mejoraron significativamente tras el tratamiento. Los valores de la puntuación del TCSS al mes y 3 meses después del tratamiento disminuyeron significativamente; pero este decremento no se mantuvo al final del estudio. La velocidad de conducción y el potencial de acción de los nervios sensoriales y motores mejoraron considerablemente después del tratamiento. Conclusiones: La efectividad de la aplicación del (F-ECG) para la mejoría de los síntomas clínicos y resultados de estudios neurofisiológicos evolutivamente son mayores que otras variantes terapéuticas en los primeros meses, con buena seguridad y tolerabilidad, por lo que se puede incluir en la terapéutica convencional para la CIDP(AU)


Introduction: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune demyelinating disease. Conventional treatment is based on immunomodulation and immunosuppression. The use of stem cells is a novel therapy in autoimmune disorders, so it is included as therapy. Objective: To determine the efficacy of mobilization of stem cells by applying granulocyte colony-stimulating factor (G-CSF) in patients with CIDP who have followed other lines of treatment. Material and Methods: A randomized, double-blind study was carried out on a cohort of 45 patients with CIDP. G-CSF was administered to 25 patients and 20 of them continued with the usual treatment. These patients were previously treated with other therapeutic variants for more than three years without satisfactory response. Results: There was a prevalence of men (64.4 percent), Diabetes Mellitus had a greater association, and the most used medications were steroids. Clinical symptoms and signs improved significantly after treatment. TCSS scores significantly decreased at one and three months after treatment, but this decrease was not maintained at the end of the study. The conduction velocity and action potential of sensory and motor nerves improved considerably after treatment. Conclusions: The effectiveness of the use of G-CSF shows an improvement of clinical symptoms. The results of neurophysiological studies have a better course than other therapeutic variants during the first months, with good safety and tolerability, so it can be included in the conventional therapy for the CIDP(AU)


Subject(s)
Humans , Granulocyte Colony-Stimulating Factor , Demyelinating Diseases/diagnosis , Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/therapy , Double-Blind Method , Immunosuppression Therapy , Stem Cell Transplantation/methods
11.
Braz. arch. biol. technol ; 64: e21180392, 2021. graf
Article in English | LILACS | ID: biblio-1249216

ABSTRACT

ABSTRACT The therapeutic effect of adipose tissue-derived stem cells (ADSCs) or RE on hippocampal neurogenesis and memory in Parkinsonian rats were investigated. Male rats were lesioned by bilateral intra-nigral injections of 6-OHDA and divided into six groups: 1. Lesion 2 and 3: RE and water groups were lesioned rats pretreated with RE or water, from 2weeks before neurotoxin injection and treated once a day for 8weeks post lesion. 4&5: Cell and α-MEM (α-minimal essential médium) received intravenous injection of BrdU-labeled ADSCs or medium, respectively from 10days post lesion until 8weeks later. 6: Sham was injected by saline instead of neurotoxin. Memory was assessed using Morris water Maze (MWM), one week before and at 1, 4 and 8weeks post 6-OHDA lesion. After the last probe, the animals were sacrificed and brain tissue obtained. Paraffin sections were stained using cresyl violet, anti-BrdU (Bromodeoxyuridine / 5-bromo-2'-deoxyuridine), anti-GFAP (Glial fibrillary acidic protein) and anti-TH antibodies. There was a significant difference of time spent in the target quadrant between groups during probe trial at 4 and 8 weeks' post- lesion. Cell and RE groups spent a significantly longer period in the target quadrant and had lower latency as compared with lesion. Treated groups have a significantly higher neuronal density in hippocampus compared to water, α-MEM and lesion groups. BrdU positive cells were presented in lesioned sites. The GFAP (Glial fibrillary acidic protein) positive cells were reduced in treated and sham groups compared to the water, α-MEM and lesion groups. Oral administration of RE (Rosemary extract) or ADSCs injection could improve memory deficit in the Parkinsonian rat by neuroprotection.


Subject(s)
Parkinson Disease/physiopathology , Rosmarinus , Stem Cell Transplantation , Memory Disorders/therapy , Morris Water Maze Test , Hippocampus
12.
National Journal of Andrology ; (12): 840-844, 2021.
Article in Chinese | WPRIM | ID: wpr-922167

ABSTRACT

Peyronie's disease (PD) is a connective tissue disorder characterized as fibrotic plaque localized in the tunica albuginea (TA), and its pathomechanism remains obscure. Endeavors are being made to explore effective and minimally invasive therapeutic strategies for PD, and some experimental studies have verified the preventative and therapeutic effects of stem cells (SC), especially adipose tissue-derived SCs (ADSC), on this disease and excavated some of their action mechanisms. Some scholars attempted the integration of SCs with graft tissues, aiming at the improvement of TA grafting and reconstruction. The only publicly available clinical trial of SC therapy for PD was encouraging, and further on-coming relevant researches are expected with simultaneous optimization of the scheme. In a word, the application of SCs in the prevention and treatment of PD is a promising topic for clinical research, and there remain quite a lot of unknowns to be explored. This article summarizes the existing researches in this field.


Subject(s)
Humans , Male , Penile Induration/surgery , Stem Cell Transplantation
13.
Chinese Medical Journal ; (24): 1199-1208, 2021.
Article in English | WPRIM | ID: wpr-878101

ABSTRACT

BACKGROUND@#For patients with B cell acute lymphocytic leukemia (B-ALL) who underwent allogeneic stem cell transplantation (allo-SCT), many variables have been demonstrated to be associated with leukemia relapse. In this study, we attempted to establish a risk score system to predict transplant outcomes more precisely in patients with B-ALL after allo-SCT.@*METHODS@#A total of 477 patients with B-ALL who underwent allo-SCT at Peking University People's Hospital from December 2010 to December 2015 were enrolled in this retrospective study. We aimed to evaluate the factors associated with transplant outcomes after allo-SCT, and establish a risk score to identify patients with different probabilities of relapse. The univariate and multivariate analyses were performed with the Cox proportional hazards model with time-dependent variables.@*RESULTS@#All patients achieved neutrophil engraftment, and 95.4% of patients achieved platelet engraftment. The 5-year cumulative incidence of relapse (CIR), overall survival (OS), leukemia-free survival (LFS), and non-relapse mortality were 20.7%, 70.4%, 65.6%, and 13.9%, respectively. Multivariate analysis showed that patients with positive post-transplantation minimal residual disease (MRD), transplanted beyond the first complete remission (≥CR2), and without chronic graft-versus-host disease (cGVHD) had higher CIR (P  < 0.001, P = 0.004, and P  < 0.001, respectively) and worse LFS (P  < 0.001, P = 0.017, and P  < 0.001, respectively), and OS (P  < 0.001, P = 0.009, and P  < 0.001, respectively) than patients without MRD after transplantation, transplanted in CR1, and with cGVHD. A risk score for predicting relapse was formulated with the three above variables. The 5-year relapse rates were 6.3%, 16.6%, 55.9%, and 81.8% for patients with scores of 0, 1, 2, and 3 (P  < 0.001), respectively, while the 5-year LFS and OS values decreased with increasing risk score.@*CONCLUSION@#This new risk score system might stratify patients with different risks of relapse, which could guide treatment.


Subject(s)
B-Lymphocytes , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Humans , Leukemia, Myeloid, Acute , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Recurrence , Retrospective Studies , Risk Factors , Stem Cell Transplantation
14.
Chinese Medical Journal ; (24): 1535-1545, 2021.
Article in English | WPRIM | ID: wpr-887611

ABSTRACT

Chronic obstructive pulmonary disease (COPD), characterized by persistent and not fully reversible airflow restrictions, is currently one of the most widespread chronic lung diseases in the world. The most common symptoms of COPD are cough, expectoration, and exertional dyspnea. Although various strategies have been developed during the last few decades, current medical treatment for COPD only focuses on the relief of symptoms, and the reversal of lung function deterioration and improvement in patient's quality of life are very limited. Consequently, development of novel effective therapeutic strategies for COPD is urgently needed. Stem cells were known to differentiate into a variety of cell types and used to regenerate lung parenchyma and airway structures. Stem cell therapy is a promising therapeutic strategy that has the potential to restore the lung function and improve the quality of life in patients with COPD. This review summarizes the current state of knowledge regarding the clinical research on the treatment of COPD with mesenchymal stem cells (MSCs) and aims to update the understanding of the role of MSCs in COPD treatment, which may be helpful for developing effective therapeutic strategies in clinical settings.


Subject(s)
Humans , Lung , Mesenchymal Stem Cells , Pulmonary Disease, Chronic Obstructive/therapy , Quality of Life , Stem Cell Transplantation
15.
Rev. Nutr. (Online) ; 34: e200266, 2021. tab
Article in English | LILACS | ID: biblio-1351567

ABSTRACT

ABSTRACT Objective Describe the dietary intake of children and adolescents submitted to allogeneic hematopoietic stem cell transplantation. Methods Data from 0 to 19-year-old patients' medical records who were submitted to the procedure from January 2012 to September 2017 were used. These medical records provided anthropometric, food intake control and symptoms data for three moments: three days before infusion (M1), the infusion day (M2), and 25 days after the cell infusion (M3). This study was approved by the Ethics in Research Committee (17-0267). Results The patients presented weight loss (p>0.001) and a decrease in body mass index (p>0.001) in M1 versus M2 and M3. The means of calorie intake (p=0.031), protein (p=0.006), lipid (p=0.017), dietary fiber (p=0.035), calcium (p=0.005), iron (p=0.012), and sodium (p=0.022) had a reduction from M1 to M2 and an increase from M2 to M3. There was a decrease in mean intake of carbohydrates and calories per kilo from M1 to M2 and an increase from M2 to M3. The nutritional status was related to temperature above 37ºC (p<0.001) and to mucositis (p=0.001), in M1 and M2. There was a correlation of dietary intake with the presence of temperature above 37ºC (p=0.019) in M2 and M3. Conclusion Reduced intake and worsening of the patients' previous nutritional status appear to interfere with allogeneic hematopoietic stem cell transplantation and its complications, such as the presence of temperature above 37ºC and mucositis.


RESUMO Objetivo Descrever a ingestão de alimentos de crianças e adolescentes submetidos ao transplante alogênico de células-tronco hematopoiéticas. Métodos Foram utilizados dados de prontuários de pacientes de 0 a 19 anos submetidos ao procedimento no período de janeiro de 2012 a setembro de 2017. Esses prontuários forneceram dados antropométricos, de ingestão alimentar e de sintomas durante três momentos: três dias antes da infusão (M1), no dia da infusão (M2) e 25 dias após a infusão celular (M3). Este estudo foi aprovado pelo Comitê de Ética em Pesquisa (17-0267). Resultados Os pacientes apresentaram perda de peso (p>0,001) e diminuição do índice de massa corporal (p>0,001) no M1 versus M2 e M3. As médias de ingestão calórica (p=0,031), de proteínas (p=0,006), de lipídios (p=0,017), de fibra alimentar (p=0,035), de cálcio (p=0,005), de ferro (p=0,012) e de sódio (p=0,022) tiveram redução de M1 para M2 e aumento de M2 para M3. Houve diminuição na ingestão média de carboidratos e calorias por quilo de M1 para M2 e um aumento de M2 para M3. O estado nutricional foi relacionado à temperatura acima de 37ºC (p<0,001) e à mucosite (p=0,001), em M1 e M2. Houve correlação da ingestão alimentar com a presença de temperatura acima de 37ºC (p=0,019) em M2 e M3. Conclusão A redução na ingestão e a piora do quadro nutricional prévio dos pacientes parece interferir no transplante alogênico de células tronco hematopoiéticas e em suas complicações, como temperatura corporal acima de 37°C e mucosite.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Hematopoietic Stem Cells , Child , Nutritional Status , Adolescent , Stem Cell Transplantation , Eating
17.
Hematol., Transfus. Cell Ther. (Impr.) ; 42(4): 293-299, Oct.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142962

ABSTRACT

ABSTRACT During the COVID-19 pandemic, special attention has been addressed in cancer care to mitigate the impact on the patient's prognosis. We addressed our preparation to face COVID-19 pandemic in a Hematological and Stem Cell Transplant Unit in Brazil during the first two months of COVID-19 pandemic and described COVID-19 cases in patients and health care workers (HCW). Modifications in daily routines included a separation of area and professionals, SARS-CoV-2 screening protocols, and others. A total of 47 patients and 54 HCW were tested for COVID-19, by PCR-SARS-CoV-2. We report 11 cases of COVID-19 in hematological patients (including 2 post stem cell transplant) and 28 cases in HCW. Hematological cases were most severe or moderate and presented with several poor risk factors. Among HCW, COVID-19 were mostly mild, and all recovered without hospitalization. A cluster was observed among HCW. Despite a decrease in the number of procedures, the Transplant Program performed 8 autologous and 4 allogeneic SCT during the period, and 49 onco-hematological patients were admitted to continuing their treatments. Although we observed a high frequency of COVID-19 among patients and HCW, showing that SARS-CoV-2 is disseminated in Brazil, hematological patients were safely treated during pandemic times.


Subject(s)
Humans , Infectious Disease Transmission, Professional-to-Patient , Medical Care , Stem Cell Transplantation , Pandemics , Patient Care Bundles , SARS-CoV-2 , COVID-19 , Neoplasms , Delivery of Health Care , Hematology
18.
Hematol., Transfus. Cell Ther. (Impr.) ; 42(3): 200-205, July-Sept. 2020.
Article in English | LILACS | ID: biblio-1134043

ABSTRACT

ABSTRACT Since the World has been facing the COVID-19 pandemic, special attention has been taken concerning cancer patients; related to their immunosuppression status, adding risk for more aggressive COVID-19 and mortality, but also concerns about the access and the quality of care in cancer therapy. The COVID-19 pandemic impacts the number of infected, its related mortality, as well as the care of cancer patients. Multiple myeloma patients are a particular group with several important aspects to be considered during pandemic times. In essence, they are immunosuppressed in different intensities during their treatment. Most of them are elderly and all of them require long-term therapy, with prolonged contact with the health care system, possibly including a stem cell transplant during the treatment. A panel of experts in multiple myeloma and infectious diseases discusses pieces of evidence and the lack of the same in the scenario of COVID-19 in myeloma patients, while also exposing what is expected for the next phases of the COVID-19 pandemic.


Subject(s)
Paraproteinemias , Stem Cell Transplantation , SARS-CoV-2 , COVID-19 , Multiple Myeloma/diagnosis , Multiple Myeloma/therapy
19.
Estud. Interdiscip. Psicol ; 11(2): 167-197, maio-ago.2020. Tab
Article in Portuguese | LILACS | ID: biblio-1342145

ABSTRACT

Este estudo teve por objetivo conhecer as percepções e vivências do acompanhante familiar diante do adoecer e do transplante de células-tronco hematopoéticas (TCTH) à luz da teoria do luto antecipatório. Trata-se de um estudo exploratório com abordagem qualitativa, do qual participaram 11 familiares. As entrevistas individuais foram organizadas pela análise temática e interpretados em três níveis contextuais, envolvendo mudanças intrapsíquicas, interacionais com o paciente e no âmbito familiar/social. Constatou-se que o familiar experimenta sentimentos e reações emocionais consistentes com o processo de enlutamento. As mudanças na interação com o paciente acontecem desde os primeiros sintomas e intensificam-se com a necessidade de fornecer cuidado integral na enfermaria durante o transplante. Transformações na dinâmica familiar acontecem em resposta às perdas de papéis sociais, ocupacionais e seus impactos financeiros. Ademais, o sofrimento experimentado pelo cuidador durante esse processo não é legitimado, tanto pela família quanto pela equipe de saúde, já que do acompanhante se exige que seja uma fonte de apoio inabalável (AU).


This study aimed to know the perceptions and experiences of family companions facing illness and transplantation of hematopoietic stem cells (HSCT) in light of the theory of anticipatory grief. This is an exploratory study with a qualitative approach, in which 11 relatives participated. The individual interviews were organized by thematic analysis and interpreted at three contextual levels, involving intra-psychic, interactional with the patient and family / social changes. It was found that the family member experiences feelings and emotional reactions consistent with the bereavement process. Changes in patient interaction occur from the earliest symptoms and intensify with the need to provide comprehensive nursing care during transplantation. Transformations in family dynamics occur in response to the loss of social, occupational roles and their financial impacts. Moreover, the suffering experienced by the caregiver during this process is not validated, either by the family or by the healthcare providers, as the companion is required to be an unshakable source of support (AU).


Este estudio tuvo como objetivo conocer las percepciones y experiencias del compañero familiar cuando se enfrenta a una enfermedad y el trasplante de células madre hematopoyéticas (TCMH) a la luz de la teoría del duelo anticipatorio. Este es un estudio exploratorio con un enfoque cualitativo, en el que participaron 11 familiares. Las entrevistas individuales fueron organizadas por análisis temático e interpretadas en tres niveles contextuales, involucrando intrapsíquica, interacción con el paciente y cambios familiares / sociales. Se descubrió que el miembro de la familia experimenta sentimientos y reacciones emocionales consistentes con el proceso de duelo. Los cambios en la interacción con el paciente ocurren desde los primeros síntomas y se intensifican con la necesidad de proporcionar atención integral de enfermería durante el trasplante. Las transformaciones en la dinámica familiar ocurren en respuesta a la pérdida de roles sociales, ocupacionales y sus impactos financieros. Además, el sufrimiento experimentado por el cuidador durante este proceso no está legitimado, ni por la familia ni por el equipo de salud, ya que el acompañante debe ser una fuente de apoyo inquebrantable (AU).


Subject(s)
Humans , Male , Female , Hematopoietic Stem Cells , Bereavement , Family , Caregivers , Stem Cell Transplantation , Emotions , Grief
20.
Autops. Case Rep ; 10(2): e2020147, Apr.-June 2020. graf
Article in English | LILACS | ID: biblio-1131811

ABSTRACT

In adults, B-lymphocytes comprise approximately 10% of circulating lymphocytes. The majority of peripheral B cells are B2 cells ("Mature" B-cells), which function as part of the humoral adaptive immune system. B1 cells ("Innate-like" B cells) are another sub-class of B lymphocytes, considered as innate immune cells with a characteristic phenotype (CD20+, CD27+, CD43+, CD70-, CD11b+, sIgM++, sIgD+) which can be divided into two subtypes; B1a (CD5+): spontaneously produce broadly reactive natural IgM, and B1b (CD5-): can generate T-cell independent, long-lasting IgM. There is very limited data available, indicating a correlation between allogeneic bone marrow transplantation and an increase in B1a cells. Here we present a case of a 17-year-old female with homozygous sickle cell disease (HbSS disease) who underwent hematopoietic stem cell transplant (HSCT). Approximately seven months post-transplant, she was found to have 16% immature mononuclear cells on complete blood count (CBC)-differential report. A follow-up peripheral blood flow cytometry showed that these cells were polyclonal CD5+/CD20+ B-cells, and comprised 66% of lymphocytes. Further workup and follow up failed to reveal any lymphoproliferative disorders. It is important not to misdiagnose these cells as an atypical CD5+ lymphoproliferative disorder. The presence of B1a cells has not been widely reported in non-neoplastic post-stem cell transplanted patients. This case also adds to and expands our knowledge regarding the presence of increased circulating B1a cells after stem cell transplant in a patient with no history of hematological malignancy.


Subject(s)
Humans , Female , Adolescent , Stem Cell Transplantation/adverse effects , Blood Cell Count , Hematopoietic Stem Cells , B-Lymphocytes/cytology , B-Lymphocyte Subsets/pathology , Flow Cytometry , Anemia, Sickle Cell , Lymphoproliferative Disorders/diagnosis
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