• 제목/요약/키워드: Stem conditioning

검색결과 40건 처리시간 0.028초

동종말초조혈모세포이식 후 발생한 BK 바이러스 출혈성 방광염의 Cidofovir 방광 내 주입 치험 1례 (A Case of Intravesical Cidofovir Treatment of BK Virus-Associated Hemorrhagic Cystitis after Allogeneic Peripheral Blood Stem Cell Transplantation)

  • 강성훈;이화정;장예수;지준호;이선아;이원식;이정림;이경희
    • Journal of Yeungnam Medical Science
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    • 제26권2호
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    • pp.143-147
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    • 2009
  • Hemorrhagic cystitis (HC) is a common complication after allogeneic transplantation. Early posttransplant HC occurs in association with cyclophosphamide, while later on HC results from viral infections such as polyomavirus BK (BKV) and adenovirus. We report here the case of a 57-year-old woman who received an instillation of cidofovir into the bladder for the treatment of hemorrhagic cystitis after allogeneic peripheral stem cell transplantation for her acute myeloid leukemia. Cyclophosphamide and busulfan were used as conditioning treatments. Cyclosporin was administered daily. On the 71st day after transplantation, the patient developed acute severe hemorrhagic cystitis, and BK virus was demonstrated in the urine samples using polymerase chain reaction. Her urinary symptoms did not improve in spite of palliative treatment, but a response was evident after intravesical cidofovir treatment.

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Risk factors for short term thyroid dysfunction after hematopoietic stem cell transplantation in children

  • Jung, You Jin;Jeon, Yeon Jin;Cho, Won Kyoung;Lee, Jae Wook;Chung, Nack-Gyun;Jung, Min Ho;Cho, Bin;Suh, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • 제56권7호
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    • pp.298-303
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    • 2013
  • Purpose: The purpose of this study was to evaluate short-term thyroid dysfunction and related risk factors in pediatric patients who underwent hematopoietic stem cell transplantation (HSCT) during childhood. Methods: We studied 166 patients (100 boys and 66 girls) who underwent HSCT at the Catholic HSCT Center from January 2004 through December 2009. The mean age at HSCT was $10.0{\pm}4.8$ years. Thyroid function of the patients was tested before and during 3 months of HSCT. Results: Out of 166 patients, 165 (99.4%) underwent allotransplantation. Acute graft-versus-host disease (GVHD, grades II to IV) developed in 76 patients. Conditioning regimens before HSCT include total body irradiation (n=57), busulfan (n=80), and reduced intensity (n=29). Forty-five (27.1%) had thyroid dysfunction during 3 months after HSCT (29 euthyroid sick syndrome [ESS], 6 subclinical hyperthyroidism, 4 subclinical hypothyroidism, 3 hypothyroxinemia, 2 overt hyperthyroidism, and 1 high $T_4$ syndrome). In a univariate logistic regression analysis, age at HSCT (P=0.002) and acute GVHD (P=0.009) had statistically significant relationships with thyroid dysfunction during 3 months after HSCT. Also, in a univariate logistic regression analysis, ESS (P=0.014) showed a strong statistically significant association with mortality. Conclusion: In our study 27.1% patients experienced thyroid dysfunction during 3 months after HSCT. Increase in age and acute GVHD may be risk factors for thyroid dysfunction during 3 months after HSCT. There was a significant association between ESS and mortality.

Haploidentical hematopoietic stem cell transplantation in children and adolescents with acquired severe aplastic anemia

  • Im, Ho Joon;Koh, Kyung-Nam;Seo, Jong Jin
    • Clinical and Experimental Pediatrics
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    • 제58권6호
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    • pp.199-205
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    • 2015
  • Severe aplastic anemia (SAA) is a life-threatening disorder for which allogeneic hematopoietic stem cell transplantation (HSCT) is the current available curative treatment. HSCT from matched sibling donors (MSDs) is the preferred therapy for children with acquired SAA. For patients who lack MSDs, immunosuppressive therapy (IST) is widely accepted as a first-line treatment before considering HCT from an unrelated donor (URD). Given the recent progress in HSCT using URDs for childhood SAA, well-matched URDs became a realistic alternative for pediatric patients who have no suitable related donors and who are refractory to IST. However, it is quite challenging to treat patients with refractory SAA who lack suitable related or URDs. Even though haploidentical HSCT from genetically mismatched family members seemed to be an attractive procedure with the amazing benefit of readily available donors for most patients, early attempts were disappointing because of refractory graft-versus-host disease (GVHD) and excessively high transplant-related mortality. Recent advances with effective ex vivo depletion of T cells or unmanipulated in vivo regulation of T cells, better supportive care, and optimal conditioning regimens have significantly improved the outcome of haploidentical transplant. Besides considerable progress in the treatment of malignant diseases, recent emerging evidences for haploidentical HSCT in SAA has provided additional therapeutic options for patients with refractory diseases. Further improvements to decrease the rates of graft failure, GVHD, and infectious complications will facilitate the emergence of haploidentical HSCT as a front-line therapy for treating acquired SAA in children and adolescents who have no suitably matched donors.

조혈모세포 이식 환자의 돌발성 구역·구토에 대한 항구토제 사용 현황 (Evaluation of Antiemetic Therapy for Breakthrough Nausea and Vomiting in Patients with Hematopoietic Stem Cell Transplantation)

  • 김지윤;홍소연;전수정;남궁형욱;이은숙;김은경;방수미
    • 한국임상약학회지
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    • 제28권3호
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    • pp.224-229
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    • 2018
  • Background: The patients receiving hematopoietic stem cell transplantation (HSCT) are known to have a high incidence of breakthrough nausea and vomiting due to the conditioning regimen. The purpose of this study was to evaluate the adequacy of antiemetic therapy for breakthrough nausea and vomiting in patients receiving HSCT and to propose an effective treatment regimen. Methods: We retrospectively reviewed the electronic medical records of 109 adult patients. The collected data were used to identify (1) antiemetic and dosing regimens prescribed for controlling breakthrough nausea and vomiting, (2) the rate of patients who developed breakthrough nausea and vomiting, and (3) the percent of antiemetics prescribed on the day of symptom onset. Based on the National Comprehensive Cancer Network guideline, we assessed the suitability of antiemetics for breakthrough nausea and vomiting, and prescription timing. Results: All patients were prescribed pro re nata antiemetics. About 40.0%, 41.4%, and 18.6% of patients were using one, two, and three or more additional drugs for breakthrough nausea and vomiting, respectively. The most frequently administered drugs were intravenous metoclopramide (43.8%) and granisetron patch (36.2%). Breakthrough nausea and vomiting occurred in 87 patients (79.1%) and they developed symptoms 320 cases. About 220 cases (68.8%) were treated with additional antiemetics on the day of symptom onset and the rate of symptom resolution was only 10.3% (9 patients). Conclusion: The breakthrough nausea and vomiting in patients receiving HSCT occurred very frequently and was hard to control, thus requiring more rapid and aggressive treatments.

지속적인 식이교육과 구내점막염 관리가 조혈모세포이식(HSCT) 환자의 영양상태에 미치는 효과 (The Effect of Continuous Nutritional Education and Oral Mucositis Management on Nutritional Status of Patients Undergoing Hematopoietic Stem Cell Transplantation)

  • 박경;이병화;박호란
    • 종양간호연구
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    • 제10권2호
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    • pp.119-128
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    • 2010
  • Purpose: This study aimed to evaluate the effectiveness of continuous nutritional education and oral mucositis management on the nutritive status of patients who received hematopoietic stem cell transplantation (HSCT). Methods: After randomly allotting 72 patients who received HSCT to either an experimental group or a control group, intensive and continuous care for preventing malnutrition was conducted in the experimental group while usual routine care was conducted in the control group. The changes of the body scale, blood chemistry profile, oral intake calories, nausea and vomitus, and oral stomatitis scores were measured at three points during their hospitalization using a oral assessment guide and nutrition analysis program: admission, HSCT, and discharge day. The differences between the scores of two groups were analyzed by repeated measures analysis of covariance. Results: The number of total lymphocytes was significantly improved in the experimental group after transplantation (p<.001). Nausea and vomiting score was significantly decreased in the experimental group during the conditioning regimen (p<.001). Conclusion: It was found that continuous nutritional education and oral mucositis control is an effective intervention by improving immune condition. Further investigations concerning direct examination of oral intake with controlling the effect of the chemotherapy are needed to ultimately discern the impact of varying oral nutrition patterns during HSCT.

Effects of Pre-conditioning dose on the Immune Kinetics and Cytokine Production in the Leukocytes Infiltrating GVHD Tissues after MHC-matched Transplantation

  • Choi, Jung-Hwa;Yoon, Hye-Won;Min, Chang-Ki;Choi, Eun-Young
    • IMMUNE NETWORK
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    • 제11권1호
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    • pp.68-78
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    • 2011
  • Background: Graft-versus-host disease (GVHD) is a huddle for success of hematopoietic stem cell transplantation. In this study, effects of irradiation dose on immune kinetics of GVHD were investigated using B6 ${\rightarrow}$ BALB.B system, a mouse model for GVHD after MHC-matched allogeneic transplantation. Methods: BALB.B mice were transplanted with bone marrow and spleen cells from C57BL/6 mice after irradiation with different doses. Leukocytes residing in the peripheral blood and target organs were collected periodically from the GVHD hosts for analysis of chimerism formation and immune kinetics along the GVHD development via flow cytometry. Myeloid cells were tested for production of IL-17 via flow cytometry. Results: Pre-conditioning of BALB.B hosts with 900 cGy and 400 cGy resulted in different chimerism of leukocytes from the blood and affected survival of GVHD hosts. Profiles of leukocytes infiltrating GVHD target organs, rather than profiles of peripheral blood leukocytes (PBLs), were significantly influenced by irradiation dose. Proportions of IL-17 producing cells in the infiltrating $Gr-1^+$ or $Mac-1^+$ cells were higher in the GVHD hosts with high does irradiation than those with low dose irradiation. Conclusion: Pre-conditioning dose affected tissue infiltration of leukocytes and cytokine production by myeloid cells in the target organs.

Analysis of a Cryogenic System for Cord Blood Banking

  • Zhang, Bin;Kim, Eun-Pil
    • Journal of Advanced Marine Engineering and Technology
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    • 제33권7호
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    • pp.981-986
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    • 2009
  • The application of a cryogenic storage system is growing fast in different kinds of fields including to keep umbilical cord blood. Umbilical cord blood stem plays an important role in the treatment of a blood and immune system related genetic diseases, cancers and blood disorders. This study gives the optimal cryogenic system for cord blood banking. Three-dimensional models are employed and finite element method is used to do structure analyses of all designed models. The results shows model 3 have a good structure properties, and model 4 shows the best structure property as its maximum is 92.9 MPa. The other is too dangerous or infeasible to support load condition that allowed by STS 304. The results can be used in the design of these kinds of systems to obtain good predictions of trends over a wide range of design alternatives and operating conditions.

Targeted busulfan and fludarabine-based conditioning for bone marrow transplantation in chronic granulomatous disease

  • Ju, Hee Young;Kang, Hyoung Jin;Hong, Che Ry;Lee, Ji Won;Kim, Hyery;Song, Sang Hoon;Yu, Kyung-Sang;Jang, In-Jin;Park, June Dong;Park, Kyung Duk;Shin, Hee Young;Kim, Joong-Gon;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • 제59권sup1호
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    • pp.57-59
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    • 2016
  • Chronic granulomatous disease (CGD) is a primary immunodeficiency disease caused by impaired phagocytic function. Hematopoietic stem cell transplantation (HSCT) is a definitive cure for CGD; however, the use of HSCT is limited because of associated problems, including transplantation-related mortality and engraftment failure. We report a case of a patient with CGD who underwent successful HSCT following a targeted busulfan and fludarabine reduced-toxicity myeloablative conditioning. Intravenous busulfan was administered once daily for 4 consecutive days (days -8 to -5), and the target area under the curve was $75,000{\mu}g{\cdot}hr/L$. Fludarabine ($40mg/m^2$) was administered once daily for 6 consecutive days from days -8 to -3. Antithymocyte globulin (2.5 mg/kg/day) was administered from days -4 to -2. The patient underwent successful engraftment and did not have any severe toxicity related to the transplantation. Conditioning with a targeted busulfan and fludarabine regimen could provide a better outcome for HSCT in CGD, with close regulation of the busulfan dose.

폐쇄형 하우스를 이용한 인삼 재배에서 상토의 조성이 2년 근 인삼의 생육 및 수량에 미치는 영향 (Effects of Various Bed Soil Substrates on the Growth and Yield of 2-Year-Old Ginseng Grown in the Closed Plastic House)

  • 최재을;이누리;조서리;김정선;최영규
    • 한국약용작물학회지
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    • 제20권4호
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    • pp.217-221
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    • 2012
  • This research was conducted to investigate the influence of various organic substrates on growth and yield of ginseng seedling grown organically in the closed plastic house. The pH and EC of substrates used for organically ginseng cultivation ranged 5.93~6.78 and 0.03~0.15 dS/m respectively. The concentrations $NH_4$-N and $NO_3$-N respectively was 14.01~68.63 mg/L, 5.60~58.83 mg/L. The average quantum of the closed plastic house was range from 10 to 16% of natural light. In July and August, the maximum temperature of the closed plastic house did not exceed 30 and the average temperature was maintained within 25 lower than the field because air conditioning ran. The PPV-1 and PPV-2 bed soil substrates produced higher stem length, stem diameter, shoot fresh weight and leaf area than those of conventional culture. In PPV-2 bed soil substrates, root fresh weight and root diameter was the highest. The root fresh weight of PPV-2 bed soil substrates in closed plastic house was maximum 25% heavier than the conventional cultivation. The results of this experiment will be utilized for making new substrate application for organic ginseng culture in the plastic house.

Assessment of the effects of virus-mediated limited Oct4 overexpression on the structure of the hippocampus and behavior in mice

  • Sim, Su-Eon;Park, Soo-Won;Choi, Sun-Lim;Yu, Nam-Kyung;Ko, Hyoung-Gon;Jang, Deok-Jin;Lee, Kyung-Min;Kaang, Bong-Kiun
    • BMB Reports
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    • 제44권12호
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    • pp.793-798
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    • 2011
  • Recently, pluripotency induction or cellular reprogramming by introducing critical transcription factors has been extensively studied, but has been demonstrated only in vitro. Based on reports that Oct4 is critically involved in transforming neural stem cells into pluripotent cells, we used the lentiviral vector to introduce the Oct4 gene into the hippocampal dentate gyrus (DG) of adult mice. We examined whether this manipulation led to cellular or behavioral changes, possibly through processes involving the transformation of NS cells into pluripotent cells. The Oct4 lentivirus-infused group and the green fluorescent protein lentivirus-infused group showed a similar thickness of the DG and a comparable level of synaptophysin expression in the DG. Furthermore, our behavioral analyses did not show any differences between the groups concerning exploratory activity, anxiety, or memory abilities. This first trial for pluripotency induction in vivo, despite negative results, provides implications and information for future studies on in vivo cellular reprogramming.