Subject(s)
Bone Marrow Transplantation/adverse effects , Graft Rejection/immunology , Thalassemia/therapy , Adult , Child , Fathers , Female , Histocompatibility , Humans , Male , Mothers , Retrospective Studies , Tissue DonorsABSTRACT
DLIs are frequently used following haematopoietic SCT (HSCT) in patients with risk of relapse but data on GVHD following DLI are scarce. We report on 68 patients who received DLI following HSCT. Most patients developed GVHD following DLI (71%), which was acute in 22 patients (32%) almost half of whom had grade III-IV acute GVHD (aGVHD). Thirty patients (44%) developed cGVHD which followed aGVHD in four patients and was graded severe in nine patients. Corticosteroids were the most common first-line therapy for both acute and chronic GVHD. A wide range of second/third-line agents included cyclosporin, mycophenolate, tacrolimus, imatinib, infliximab and ECP. Relapse of initial malignancy occurred in 37%. Relapse was significantly less frequent in those receiving pre-emptive DLI. Relapse rates were also lower in those with GVHD (31%) than those without GVHD (50%), but this did not reach statistical significance. At 55 months post DLI, 34% of patients had died most commonly from relapse and 22% had on-going GVHD. Although GVHD was an important cause of morbidity post DLI (71%), only 6% died from GVHD. Although most patients develop GVHD post DLI and may require consecutive therapies, mortality from GVHD is infrequent. DLI remains an important option for relapse post transplant and manipulation of the GVT effect needs to be optimised to induce remission without morbidity from GVHD.
Subject(s)
Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Immunosuppressive Agents/administration & dosage , Lymphocyte Transfusion , Adult , Aged , Allografts , Disease-Free Survival , Female , Graft vs Host Disease/mortality , Graft vs Host Disease/prevention & control , Hematologic Neoplasms/mortality , Hematologic Neoplasms/therapy , Humans , Living Donors , Male , Middle Aged , Survival Rate , United Kingdom/epidemiologySubject(s)
Anaphylaxis/immunology , Anaphylaxis/therapy , Granulocyte Colony-Stimulating Factor/adverse effects , Granulocyte Colony-Stimulating Factor/immunology , Adult , Health , Humans , Lenograstim , Living Donors , Male , Recombinant Proteins/adverse effects , Recombinant Proteins/immunology , Reference ValuesABSTRACT
Thirteen cases of deep mycoses were found among 12,506 new patients attending two University clinics in Northern Nigeria. Patients with chromoblastomycosis due to Cladosporium carrionii, paracoccidioidomycosis, rhinophycomycosis, and sporotrichosis appear to be the first cases of these conditions recognized in the Savanna region of West Africa. The literature on systemic mycoses in Nigeria is reviewed and a need for a greater awareness of the problem is stressed.
Subject(s)
Mycoses/pathology , Adult , Africa, Western , Child , Chromoblastomycosis/epidemiology , Female , Histoplasmosis/pathology , Humans , Male , Middle Aged , Mycetoma/epidemiology , Mycoses/epidemiology , Nigeria , Paracoccidioidomycosis/pathology , Sporotrichosis/pathologyABSTRACT
An African patient with a hypopigmented plaque on the face, suggesting clinically tuberculoid leprosy or sarcoidosis, is described. Histology revealed palisading granulomas surrounding ova of Schistosoma mansoni.
