ABSTRACT
Gran versus Host Disease (GVHD) is a common complication in allogenic bone marrow transplants and in some cases, it involves the oral mucosa. Therefore, the appropriate diagnosis and timely treatment is essential to prevent ¡ocal complications which interfere with normal oral functions and facilitate infection spread. We report a 17 years old woman with GVHD associated to ¡ichenoid and ulcerative ¡essions in the oral mucosa, which responded to the topical administration of a 0.1 percent tacrolimus ointment.
Subject(s)
Adolescent , Female , Humans , Bone Marrow Transplantation/adverse effects , Graft vs Host Disease/etiology , Mouth Diseases/etiology , Anemia, Aplastic/surgery , Graft vs Host Disease/drug therapy , Immunosuppressive Agents/therapeutic use , Mouth Diseases/drug therapy , Mouth Mucosa , Tacrolimus/therapeutic useABSTRACT
Gran versus Host Disease (GVHD) is a common complication in allogenic bone marrow transplants and in some cases, it involves the oral mucosa. Therefore, the appropriate diagnosis and timely treatment is essential to prevent local complications which interfere with normal oral functions and facilitate infection spread. We report a 17 years old woman with GVHD associated to lichenoid and ulcerative lesion in the oral mucosa, which responded to the topical administration of a 0.1% tacrolimus ointment.
Subject(s)
Bone Marrow Transplantation/adverse effects , Graft vs Host Disease/etiology , Mouth Diseases/etiology , Adolescent , Anemia, Aplastic/surgery , Female , Graft vs Host Disease/drug therapy , Humans , Immunosuppressive Agents/therapeutic use , Mouth Diseases/drug therapy , Mouth Mucosa , Tacrolimus/therapeutic useABSTRACT
The stem cell transplantation (SCT) has improved the disease free survival of a great number of diseases. It began as an experimental procedure, used as last resource in terminally ill patients. Nowadays it is a proved tool that allow the patient receive high dose of chemoradiotherapy, without the bone marrow toxicity being a conditioning step. The haematological recovery follows the same mechanisms that the organisms have designed for this purpose. First, cryopreservation of progenitors stem cells (PSCs) is required, then these cells are re-infused into the blood. The PSCs find their own homing in the bone marrow, proliferate, differentiate and re establish the haematopoietic balance. The present revision gives some information about the different phase or a SCT, physiology background, indications and principals adverse effects.
Subject(s)
Humans , Hematopoietic Stem Cell Transplantation , Donor Selection , LeukemiaABSTRACT
Background:Multiple myeloma is rarely curable. Advances in high dose chemotherapy and stem cell transplantation have improved overall survival and event-free disease periods, but relapses are inevitable. Aim: To report our experience with AT in multiple myeloma, between 1994 and 2003. Material and Methods: Retrospective analysis of 20 patients (12 women), with a mean age of 51.1 years. VAD (vincristine, doxorubicin and dexamethasone) was used as initial therapy in 19 patients. High dose cyclophosphamide (11 patients) and variations of VAD regimen (7) associated with granulocyte colony stimulating factor were used for peripheral-blood stem cell harvest. The conditioning regimen consisted of melphalan 200 mg/m2 followed by the reinfusion of peripheral-blood stem cells 24 hours later. The median number of CD34 cells infused was 3,3x106/kg. Three patients were subjected to a second auto graft and one to a non-myeloablative transplant. Mean follow up was 35.5 months. Results: Mucositis and febrile neutropenia were common complications. The median number of days for neutrophyl engraftment was 9 (range 8-11) and for platelets, 10 (range 7-13). No patient died. Complete remission was obtained in 60% (12/20), progession-free survival was 30 months and overall median survival, 47 months. Conclusions: The AT with high-dose melphalan is a safe procedure in our hospital, without mortality and engraftment in all the patients. Complete remission and progression free survival were similar to those reported abroad but the overall median survival was lower.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Multiple Myeloma/therapy , Peripheral Blood Stem Cell Transplantation , Transplantation Conditioning , Antineoplastic Agents/therapeutic use , Combined Modality Therapy , Disease-Free Survival , Granulocyte Colony-Stimulating Factor/therapeutic use , Retrospective Studies , Transplantation, Autologous , Treatment OutcomeABSTRACT
We report a 78 year old male with prostatism, that was subjected to a prostate biopsy. The pathological study showed a microvascular lymphocytic infiltration. Four months later, the patients presentd with reduced alertness, cough, dyspnea, fever and elevation of lactic dehydrogenase and erythrocyte sedimentation rate. Chest and abdominal CAT scans, bone marrow aspirate, protein electrophoresis and prostate specific antigen were normal. A re-evaluation of prostate biopsy showed an intravascular lymphoid infiltration, positive for CD45 and CD20, compatible with the diagnosis of intravascular lymphoma. Chemotherapy was started, but it was not tolerated by the patient and the response was partial. Therefore, treatment with monoclonal antibodies anti CD20 (Rituximab) was started. The tumor had a complete and prolonged (24 months) remission after the treatment.
