Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.1.1.69 (BMT)
 2,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

T cells play an important role in protective immunity against tuberculosis. As patients are not reimmunized with BCG after BMT, the question arises as to whether PPD-specific memory T cells are transferred from the marrow donor to the recipient and persist in the long-term. We studied long-term survivors of non-T cell-depleted allogeneic bone marrow transplantation for in vitro PPD-induced proliferative responses (n = 14), and delayed-type hypersensitivity after intradermal injection of tuberculin (n = 20). We also studied 7 patients who received T cell-depleted bone marrow. Proliferative responses in the first group were low, but were increased by concentrating CD4+ T cells, the major responding cells in this system. In contrast, PBL from patients who received T cell-depleted marrow remained unresponsive to PPD, although they responded normally to CMV antigens. Of the 15 healthy patients in the first group who underwent tuberculin skin tests, 13 had positive reactions, while only two failed to react. (Five patients of the first group were suffering from chronic GVHD and 3 of them were negative.) All the patients in the second group had negative delayed-hypersensitivity responses. The difference between the two groups of patients was highly significant (P < 0.003). These results show that transferred PPD-specific T cells persist in long-term survivors of non-T cell-depleted BMT, even in the absence of reimmunization.
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PMID:Long-term persistence of transferred PPD-reactive T cells after allogeneic bone marrow transplantation. 838 May 10

Over a 6 year period we have seen two cases of tuberculosis among 118 allogeneic and 237 autologous bone marrow (BMT) or peripheral blood transplants. Both patients had received an HLA-identical related allogeneic BMT. The first case suffered from extensive chronic graft-versus-host disease (GVHD) and developed pulmonary tuberculosis 19 months after BMT. An open-lung biopsy was required to establish the diagnosis, and response to antituberculosis agents was complete, with no relapse at 49 months post-BMT. The second patient received a CD4+ T lymphocyte-depleted BMT, was receiving steroids for acute GVHD and developed rapid-onset meningeal tuberculosis on day +107 post-BMT. Despite initial severe neurologic deterioration, response to antituberculosis agents was good, and she remains alive and well 11 months from BMT. Review of the scant literature on this topic reveals that this is a relatively rare infection in BMT recipients despite their often severely immunosuppressed condition, occurring mainly in recipients of T cell-depleted allogeneic grafts or those who develop GVHD.
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PMID:Tuberculosis in bone marrow transplant recipients: report of two cases and review of the literature. 889 2

Mycobacterial infections are common in people with impaired cell-mediated immunity. Bone marrow transplant recipients have this defect and might be expected to have a high incidence of mycobacterial infections. We reviewed mycobacterial infections in 2241 BMT recipients at the University of Minnesota Hospital. Mycobacterial infections were diagnosed in 11 (0.49%), including nine of 1486 allograft recipients (0.6%) and two of 755 (0.26%) autograft recipients. Two patients had M. tuberculosis infection, two, M. avium-intracellulare infection and seven, infection with rapid growing atypical mycobacteria (M. fortuitum or M. chelonae). The manifestations included unexplained fever, pulmonary infiltrates, osteomyelitis or central venous catheter tunnel inflammation. Six of the seven infections with rapid growing atypical mycobacteria were related to central venous catheters. Appropriate local measures and therapy with antimycobacterial medications resulted in complete resolution of infection in the nine patients treated. The low incidence of mycobacterial infection observed in BMT recipients contrasts with that observed in people with impaired cell-mediated immunity.
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PMID:Mycobacterial infections following bone marrow transplantation: a 20 year retrospective review. 905 13

Mycobacterium tuberculosis is a serious, but rare infectious complication after allogeneic bone marrow transplantation. We describe a case of fatal sepsis due to Mycobacterium tuberculosis after allogeneic bone marrow transplantation for Philadelphia chromosome-positive ALL. The diagnosis was made after BAL. Although broad-spectrum antituberculous therapy was started immediately after diagnosis, blood cultures became positive for Mycobacterium tuberculosis. The patient developed severe pyrexias and finally died of multi-organ failure. Rapid progression of mycobacterial infection should be considered in patients post BMT with unexplained fever, particularly in patients from endemic areas.
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PMID:Fatal sepsis due to mycobacterium tuberculosis after allogeneic bone marrow transplantation. 1128 94

We studied the clinical profile of infections among 221 pediatric patients who underwent 230 allogeneic transplants between 1986 and June 2004. All patients developed febrile neutropenia. There were 283 documented infections, which included bacterial (36.9%), viral (45.7%), fungal (11.1%) and other infections (6.3%) including tuberculosis. Bacterial and fungal infections were more common in the first 30 days following BMT, while viral infections were more common >30 days after BMT. Bacterial pathogens were predominantly gram-negative organisms (72.7%), when compared with gram-positive organisms (27.3%). Common gram-negative organisms included NFGNB, Pseudomonas, Escherichia coli and Klebsiella while coagulase negative Staphylococci was the main gram-positive organism. Bacteremia (61.2%) was the main source positive cultures and was mainly because of gram-negative organisms (81%), predominantly NFGNB and Pseudomonas. Exactly 103/221(43.7%) transplants had 128 documented viral infections commonly because of Cytomegalovirus, Herpes group of viruses and transfusion related hepatitis. Thirty of 221 (13.5%) of transplants had 30 documented fungal infections with the majority being because of aspergillus (90%). Tuberculosis was seen in 1.7% of transplants while catheter infections were seen in 21 patients (9.1%). Infection related mortality was seen in 12% predominantly because of CMV or fungal infections. A sub group analysis (pre-1998 vs. post-1998) revealed higher incidences of gram-negative infections, bacteremia and bacterial infection related mortality in the pre-1998 era when compared with the recent times. The profile and mortality of infections in this series from India is not significantly different from reports from the West.
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PMID:Infections in children undergoing allogeneic bone marrow transplantation in India. 1649 87

Stem cell transplantation is curative in a number of otherwise fatal hematological diseases. In Pakistan, SCT was started in October 1995 at Dr Ziauddin Hospital by Dr Tahir Shamsi and his team. The first case was of a young man suffering from AML. In 1999, allogeneic BMT was started at Bismillah Taqee Institute of Health Sciences and Blood Diseases Centre, Karachi. In 2001, the Armed Forces Bone Marrow Transplant Centre, started functioning. Since then, over 350 allogeneic stem cell transplants have been carried out in these latter two centers. Another 50 autologous procedures were carried out in all centers. In 2004, a third center started transplants at the Aga Khan Hospital. The main indications for transplant are aplastic anemia, beta-thalassemia major and hematological malignancies. HLA-identical sibling donors provide stem cells for the recipient. In 70% of cases, a matched donor is identified. In sharp contrast to the rest of the world, the majority of transplants are allogeneic, donor-recipient pairs are CMV positive and fungal infection, tuberculosis and malaria are particular problems. The early results are promising, with transplant-related mortality reported to be 10-20%, whereas long-term survival is reported to be 78, 72 and 49% in aplastic anemia, beta-thalassemia major and leukemia, respectively. Financial constraints, poor socioeconomic status, poor transfusion services, trained human resources and difficulty in keeping pace with technological advances are major hurdles in the growth of transplant medicine. Government support is badly needed to strengthen existing facilities and to develop more centers.
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PMID:The stem cell transplant program in Pakistan--the first decade. 1872 82