Subject(s)
Cord Blood Stem Cell Transplantation/methods , Fetal Stem Cells/transplantation , Hematologic Diseases/surgery , Transplantation, Haploidentical/methods , Adolescent , Adult , Aged , Child , Child, Preschool , Cross-Sectional Studies , Disease-Free Survival , Female , Graft vs Host Disease/epidemiology , Hematologic Diseases/mortality , Hematopoietic Stem Cell Transplantation , Humans , Infant , Infant, Newborn , Kaplan-Meier Estimate , Latin America , Length of Stay , Male , Middle Aged , Postoperative Complications/epidemiology , Pregnancy , Young AdultABSTRACT
Acute GvHD (aGvHD) is a life-threatening complication of hematopoietic stem cell transplantation. Frontline therapy for aGvHD consists of corticosteroid administration. However, â¼25% of the patients have a steroid-refractory disease, a sign of poor prognosis. An alternative therapy for steroid-refractory aGvHD is infusion of mesenchymal stromal cells (MSCs). Herein, we report the results of 46 patients treated with MSC infusion as salvage therapy for steroid-refractory aGvHD III/IV (78% grade IV). Patients received a median cumulative dose of MSCs of 6.81 × 106/kg (range, 0.98-29.78 × 106/kg) in a median of 3 infusions (range, 1-7). Median time between the onset of aGvHD and the first MSC infusion was 25.5 days (range, 6-153). Of the patients, 50% (23/46) presented clinical improvement. Of these, 3 patients (13%) had complete response, 14 (61%) had partial response and 6 (26%) had transient partial response. The estimated probability of survival at 2s year was 17.4%. Only 2 patients (4.3%) presented acute transient side effects (nausea/vomiting and blurred vision) during cell infusion. No patient had late or severe side effects because of MSC infusion. These results suggest that this therapeutic modality is safe and should be considered for steroid-refractory aGvHD, especially in countries where other second-line agents are less available.
Subject(s)
Graft vs Host Disease , Hematologic Neoplasms , Hematopoietic Stem Cell Transplantation , Mesenchymal Stem Cell Transplantation , Acute Disease , Adolescent , Adult , Aged , Allografts , Child , Child, Preschool , Disease-Free Survival , Female , Graft vs Host Disease/mortality , Graft vs Host Disease/therapy , Hematologic Neoplasms/mortality , Hematologic Neoplasms/therapy , Humans , Infant , Male , Middle Aged , Steroids/administration & dosage , Survival RateABSTRACT
Pulmonary amoebiasis without liver involvement occurs sporadically as a result of haematogenous spread from a primary site, the colon. The case history is presented of a patient who developed superior vena cava syndrome due to a pulmonary amoebic abscess without liver involvement. He was initially suspected of having a neoplasm but a combination of tests including histological examination of the H&E stained excised tissue, immunofluorescence using anti-Entamoeba histolytica antibodies, and serology confirmed the diagnosis of amoebiasis. To our knowledge this is the first description of pulmonary amoebiasis presenting as superior vena cava syndrome.
