Inpatient Management of Mucocutaneous GVHD

This article provides current clinical, diagnostic, and therapeutic considerations relevant to the hospitalist for both acute and chronic mucocutaneous GVHD. Optimal inpatient management of these diseases requires an interdisciplinary team.
Source: Current Dermatology Reports - Category: Dermatology Source Type: research

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Condition:   Graft Versus Host Disease (GVHD) Interventions:   Biological: Alpha-1 antitrypsin (AAT);   Drug: Placebo Sponsors:   CSL Behring;   Blood and Marrow Transplant Clinical Trials Network;   National Institutes of Health (NIH);   National Heart, Lung, and Blood Institute (NHLBI);   National Cancer Institute (NCI) Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is an established and potentially curative treatment for a variety of malignant and nonmalignant diseases [1 –6]. Acute graft-versus-host disease (aGVHD) is a major complication of haplo-HSCT and remains a leading cause of morbidity and nonrelapse mortality [7,8]. Although the standard initial therapy for aGVHD is corticosteroids [9,10], only approximately 50% of patients demonstrate responses. Steroid-r efractory aGVHD (SR-aGVHD) is associated with an increased long-term mortality rate of approximately 70% [11–13] and a dismal prognosis, with ...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is an established and potentially curative treatment for a variety of malignant and nonmalignant diseases [1-6]. Acute graft-versus-host disease (aGVHD) is a major complication of haplo-HSCT and remains a leading cause of morbidity and nonrelapse mortality (NRM) [7,8]. Although the standard initial therapy for aGVHD is corticosteroids [9,10], only approximately 50% of patients demonstrate responses. Steroid-refractory (SR) aGVHD is associated with an increased long-term mortality rate of approximately 70% [11-13] and a dismal prognosis, with only 25% of pa...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Semin Neurol 2019; 39: 596-607 DOI: 10.1055/s-0039-1693008Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a relatively common autoimmune disorder affecting the peripheral nerves and nerve roots, often causing progressive or recurrent weakness with diminished reflexes. Electrodiagnostic (EDx) studies, cerebral spinal fluid (CSF) analysis, and nerve biopsy may help provide supportive evidence for the diagnosis. Most cases have a favorable response to one of the three first-line treatments: corticosteroids, IV immunoglobulin (IVIG) and plasmapheresis. Responses to these treatments may vary among individual...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
AbstractHepatitis B virus (HBV) is a global disease with significant morbidity and mortality. Worldwide, an estimated 257 million people are chronically infected with HBV, defined as having a positive hepatitis B surface antigen, but millions more have prior HBV exposure indicated by positive hepatitis B core antibody. Reactivation of hepatitis B implies a sudden increase in viral replication in a patient with chronic HBV infection or prior HBV exposure. Hepatitis B reactivation (HBVr) can occur spontaneously, but it is more commonly triggered by immunosuppressive therapies for cancer, immunologic diseases, or transplantat...
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: Review Of Therapeutics Source Type: research
Unrelated cord blood (UCB) has been established as an alternative source of hematopoietic stem cells for adult and pediatric allogeneic hematopoietic cell transplant [1-15]. One of the advantages of UCB transplantation (UCBT) is the less stringent requirement for HLA matching compared with that in bone marrow or peripheral blood stem cell transplant under standard graft-versus-host disease (GVHD) prophylaxis, which makes it easier to find candidate UCB units. Another advantage of UCBT is lower incidences of acute and chronic GVHD despite multiple HLA mismatches and better responses to corticosteroid treatment for acute GVH...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Unrelated cord blood (UCB) has been established as an alternative source of hematopoietic stem cells for adult and pediatric allogeneic hematopoietic cell transplantation [1 –15]. One of the advantages of UCB transplantation (UCBT) is the less stringent requirement for HLA matching compared to that in bone marrow or peripheral blood stem cell transplantation (BMT/PBSCT) under standard GVHD prophylaxis, which makes it easier to find candidate UCB units. Another advanta ge of UCBT is lower incidences of acute and chronic GVHD despite multiple HLA mismatches and better responses to corticosteroid treatment for acute GVHD compared to PBSCT.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
AbstractHepatitis B virus (HBV) is a global disease with significant morbidity and mortality. Worldwide, an estimated 257 million people are chronically infected with HBV, defined as having a positive hepatitis B surface antigen, but millions more have prior HBV exposure indicated by positive hepatitis B core antibody. Reactivation of hepatitis B implies a sudden increase in viral replication in a patient with chronic HBV infection or prior HBV exposure. Hepatitis B reactivation (HBVr) can occur spontaneously, but it is more commonly triggered by immunosuppressive therapies for cancer, immunologic diseases, or transplantat...
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: Review Of Therapeutics Source Type: research
In conclusion, allo-HCT procedures for patients with aggressive ATL have considerably progressed and have helped improve the prognosis of these patients; however, many concerns still remain to be resolved. Further development of allo-HCT by using new molecular targeting agents is required for the improvement of cure rates in patients with ATL.
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
Autoimmune hemolytic anemia (AIHA) occurs more frequently than other autoimmune hematological diseases (AHDs) after allogeneic hematopoietic stem cell transplantation. Haploidentical donors and chronic graft vs host disease are risk factors for AIHA and corticosteroids combined with cyclosporine A are superior to corticosteroids as initial treatment for AIHA. AIHA does not contribute to increase treatment ‐related mortality and could reduce the malignant diseases relapse and increase disease‐free survival. AbstractTo investigate the incidence and risk factors as well as prognosis of autoimmune hemolytic anemia (AIHA) f...
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
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