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Query: UMLS:C0018133 (graft-versus-host disease)
 18,032 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective review of 832 bone marrow transplant patients was performed to determine the clinical spectrum and risk factors for viridans streptococci infections. The incidence of viridans streptococci cultured from the blood and/or cerebrospinal fluid was 15% (123/832), occurring within 15 days of bone marrow transplant in 78% of patients, usually during profound neutropenia. Strep. mitis was the most frequent isolate (47%). Only 27% (33/123) of patients were symptomatic beyond fever, usually with neurologic, pulmonary, and/or cardiovascular manifestations. Ten (8%) of 123 culture positive patients developed a fulminant cardiorespiratory collapse, with a 60% mortality. One additional death occurred due to cerebritis. However, a time dependent covariate analysis found no significant difference in overall mortality (p = 0.30) or duration of hospitalization (p = 0.50) in patients with or without viridans streptococci infections. A multivariate analysis revealed that age less than 18 years (RR = 1.5, p = 0.04) and a primary diagnosis of acute lymphocytic leukemia (RR = 1.5, p = 0.07) were independent and significant risk factors for viridans streptococci infections. Sex, conditioning regimen, donor type, in vitro bone marrow treatment, and acute graft-versus-host disease were not significant. Viridans streptococci should be recognized as pathogens in bone marrow transplant patients which require appropriate antibiotics and aggressive supportive therapy.
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PMID:The clinical spectrum of infections with viridans streptococci in bone marrow transplant patients. 236 79

Congenital sideroblastic anemia (CSA) is a dyserythropoietic disorder that leads to transfusion dependency and subsequent iron overload. Nonmyeloablative allogeneic hematopoietic stem cell transplantation (NST) was performed for a patient with CSA, who had contraindications to conventional allografting. Conditioning was fludarabine, low-dose total body irradiation and antithymocyte globulin, followed by peripheral blood stem cell transplant. Cyclosporine and mycophenolate mofetil were used for graft-versus-host disease prophylaxis. Complete donor chimerism was observed day +131. Early after transplant, the patient became transfusion independent, allowing a regular phlebotomy program. On day +190, refractory lactic acidosis followed by fatal cardiovascular collapse developed, without evidence of infection. Data from this case demonstrates that NST may correct the erythropoietic defect of CSA.
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PMID:Nonmyeloablative allogeneic hematopoietic stem cell transplantation for congenital sideroblastic anemia. 1277 59

We herein report the case of a 31-year-old woman who presented with bilateral upper lobe volume loss and pleural irregularities with hilar retraction. She had undergone allogeneic bone marrow transplantation (BMT) for the treatment of acute lymphoblastic leukemia nine years earlier. A surgical lung biopsy showed pleural thickening and subpleural alveolar collapse and fibrosis, consistent with a diagnosis of pleuroparenchymal fibroelastosis (PPFE). Antecedent sicca syndrome and the absence of other causes of fibroelastosis suggested that these abnormalities were associated with chronic graft-versus-host disease (cGVHD). PPFE as a late, noninfectious complication is rare; however, the present case suggests a new class of BMT-related pulmonary complications associated with cGVHD.
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PMID:Pleuroparenchymal fibroelastosis as a series of airway complications associated with chronic graft-versus-host disease following allogeneic bone marrow transplantation. 2439 May 27