ABSTRACT
Hepatosplenic T cell lymphoma (HSTCL) is a type of hematologic neoplasia with a poor prognosis and a high frequency of refractoriness to conventional chemotherapy. The results obtained by high dose chemotherapy followed by autologous stem cells transplantation seem to be a more effective option but still unsatisfactory. Also the role of allogeneic stem cell transplantation is still unclear, although the few cases reported on the literature would seem to show good results in overall survival rates. In this paper, we reported the patient׳s medical history affected by a αß variant of hepatosplenic T cell successfully rescued with a haploidentical transplant.
ABSTRACT
BACKGROUND: Recommendations on eligibility criteria for donation of haematopoietic stem cells, management of collection of the cells and follow-up mainly concern unrelated donors. The aim of this study was to analyse the screening of related donors and collection practices at different Italian apheresis centres. MATERIALS AND METHODS: A questionnaire regarding eligibility criteria for related haematopoietic stem cell donors, their peripheral blood collections and early follow-up was sent to several apheresis units. Data from the full charts of 500 candidates, screened between May 2005 and December 2009, were retrospectively evaluated. RESULTS: The donors' records, eligibility criteria, collections and follow-up are managed differently in each centre. Of the 500 evaluable candidates (51.2% male, 49.8% female; median age 47 years, range 13-77), 26.4% underwent thorough screening according to Italian Bone Marrow Donor Registry standards, while local protocols were applied to 73.6%; 91 candidates (18.2%) proved ineligible for donation. In the end, 352 donors (53.4% male, 46.6% female; median age 45 years, range 16-76) underwent 508 leukaphereses. Central venous catheters were used in 8.0% of donors, mainly in one centre. Unsuitable pre-apheresis peripheral blood parameters were reported in 38.7% of the aphereses. Leukapheresis-related adverse events were recorded in 23.0% of the procedures, with a drop-out rate of 0.2% for severe events. No donation-related fatalities occurred. The CD34+ cell yield was <2×10(6)/kg of recipient's body weight from 1.1% of donors ≥70 years old. DISCUSSION: More uniformity in donor screening procedures, management of peripheral blood collection and follow-up should be planned at a national level to maximise the safety of related donors.
Subject(s)
Blood Donors , Donor Selection , Leukapheresis , Safety , Stem Cells , Adolescent , Adult , Aged , Female , Follow-Up Studies , Humans , Italy , Male , Middle Aged , Retrospective StudiesABSTRACT
BACKGROUND AND OBJECTIVES: Recipients of peripheral blood progenitor cells (PBPC) are prone to opportunistic infections and their lives depend upon the availability of PBPC. Centres responsible for PBPC processing are committed to provide patients with products which are as safe as possible. These must be processed under quality assurance requirements. MATERIALS AND METHODS: A retrospective analysis of PBPC processed in a single centre according to quality assurance premises was carried out to define the rate and the cause of microbiologic contamination and bag ruptures. RESULTS: 940 microbiologic cultures were run on 725 cryopreserved bags. Five bacterial strains were identified in the positive cultures. The rate of bacterial contamination was 1.85% of the patients, 0.34% of the collected bags, and 0.79% of the reinfused bags. Bag ruptures occurred in 1.06% of the thawed bags. CONCLUSIONS: Permanent quality control of peripheral progenitor cell processing is mandatory. Preventive measures such as ex vivo cell manipulation in a clean room facility and the use of a double-bagged technique are highly recommended to prevent bacterial contamination and to rescue progenitor cells in the case of a bag rupture if those cells are necessary for the haematopoietic reconstitution of a patient.
