Early and Late Complications in Patients with Allogeneic Transplantation of Hematopoietic Stem Cell – Case Report

Ivana Trajkovska, Borce Georgievski, Lidija Cevreska, Andrijana Gacovski, Taner Hasan, Natasha Nedeska-Minova

Abstract


BACKGROUND: Allogeneic hematopoietic stem cells transplantation (HSCT) is a curative intervention in patients with haematological malignant and non-malignant diseases, immunodeficiency, autoimmune, and other genetic diseases. Early complications are complications that are occurring in the first 100 days, while complications arising after the 100th day of transplantation belong to late complications.

CASE REPORT: Forty-nine years old patient with AML treated with allogeneic HSCT from HLA-identical (sister) donor. Ascertained and display of early (acute Graft versus host disease (GvHD) and late complications (chronic GVHD, infections, cataract, secondary malignancy with MS deposits) are made, that emerged after the patient transplantation.

CONCLUSION: Rapidly growing population of patients that undergo allogeneic HSCT creates an obligation to educate patients and physicians about observed late complications that occur after this therapy.


Keywords


allogeneic transplantation; early and late complications; case report

Full Text:

PDF OnlineFirst

References


Peccatori J, Ciceri F. Allogeneic stem cell transplantation for acute myeloid leukemia. Haematologica. 2010;95:857–859. https://doi.org/10.3324/haematol.2010.023184 PMid:20513804 PMCid:PMC2878779

Servais S, et al. Pre-transplant prognostic factors of long-term survival after allogeneic peripheral blood stem cell transplantation with matched related/unrelated donors. Haematologica. 2014;99: 519–526. https://doi.org/10.3324/haematol.2013.089979 PMid:24241489 PMCid:PMC3943316

Giebel S, et al. Improving results of allogeneic hematopoietic cell transplantation for adults with acute lymphoblastic leukemia in first complete remission: an analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Haematologica. 2017;102:139–149. https://doi.org/10.3324/haematol.2016.145631 PMid:27686376 PMCid:PMC5210244

Ribera J-M. Allogeneic stem cell transplantation for adult acute lymphoblastic leukemia: when and how. Haematologica. 2011;96:1083–6. https://doi.org/10.3324/haematol.2011.048348 PMid:21810970 PMCid:PMC3148898

Kim HT, et al. Donor and recipient sex in allogeneic stem cell transplantation: what really matters. Haematologica Haematol. 2016;216:147645. https://doi.org/10.3324/haematol.2016.147645

Nakasone H et al. Risks and benefits of sex-mismatched hematopoietic cell transplantation differ according to conditioning strategy. Haematologica. 2015;100:1477–1485. https://doi.org/10.3324/haematol.2015.125294 PMid:26250581 PMCid:PMC4825314

Eapen M. Hematopoietic cell transplantation for acute leukemia: selecting donors. Haematologica. 2015;100(4):414-5. https://doi.org/10.3324/haematol.2015.124974 PMid:25828086 PMCid:PMC4380712

Gratwohl A, et al. Allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia in Europe 2006: transplant activity, long-term data and current results. An analysis by the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplan. Haematologica. 2006;91:513–21. PMid:16533723

Terwey TH, et al. A modified EBMT risk score and the hematopoietic cell transplantation-specific comorbidity index for pre-transplant risk assessment in adult acute lymphoblastic leukemia. Haematologica. 2010;95:810–818. https://doi.org/10.3324/haematol.2009.011809 PMid:20007143 PMCid:PMC2864388

Ditschkowski M, et al. Dynamic international prognostic scoring system scores, pre-transplant therapy and chronic graft-versus-host disease determine outcome after allogeneic hematopoietic stem cell transplantation for myelofibrosis. Haematologica. 2012;97:1574–1581. https://doi.org/10.3324/haematol.2011.061168 PMid:22491742 PMCid:PMC3487559

Baron F, et al. Anti-thymocyte globulin as graft-versus-host disease prevention in the setting of allogeneic peripheral blood stem cell transplantation: a review from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Haematologica. 2016;101.

Bacigalupo A, Sormani M. Reducing transplant-related mortality after allogeneic hematopoietic stem cell transplantation. Haematologica. 2004; 89:1238–1247. PMid:15477210

Hospital N, ta Fo. Trial. 2004;89:1–5.

Rovó A, et al. Late altered organ function in very long-term survivors after allogeneic hematopoietic stem cell transplantation: A paired comparison with their HLA-identical sibling donor. Haematologica. 2011;96:150–155. https://doi.org/10.3324/haematol.2010.030874 PMid:20851864 PMCid:PMC3012779

Porta F, Locatelli F, Burgio GR. Hematopoietic stem cell transplantation: 40 Years of continuous progress and evolution. Haematologica. 2008;93:1607–1610. https://doi.org/10.3324/haematol.13706 PMid:18978297

Mohty B, Mohty M. Long-term complications and side effects after allogeneic hematopoietic stem cell transplantation: an update. Blood Cancer J. 2011;1: e16. https://doi.org/10.1038/bcj.2011.14 PMid:22829137 PMCid:PMC3255242

Silva LP, et al. Hemorrhagic cystitis after allogeneic hematopoietic stem cell transplants is the complex result of BK virus infection, preparative regimen intensity and donor type. Haematologica. 2010;95:1183–1190. https://doi.org/10.3324/haematol.2009.016758 PMid:20410183 PMCid:PMC2895044

Labrador J, et al. Analysis of incidence, risk factors and clinical outcome of thromboembolic and bleeding events in 431 allogeneic hematopoietic stem cell transplantation recipients. Haematologica. 2013;98:437–443. https://doi.org/10.3324/haematol.2012.069559 PMid:22899581 PMCid:PMC3659939

Ljungman P, et al. Risk factors for the development of cytomegalovirus disease after allogeneic stem cell transplantation. Haematologica. 2006;91:78–83. PMid:16434374

Itzykson R, et al. Cytomegalovirus shapes long-term immune reconstitution after Allogeneic stem cell transplantation. Haematologica. 2015;100:114–123. https://doi.org/10.3324/haematol.2014.113415 PMid:25261095 PMCid:PMC4281324

Saudemont A, Madrigal JA. Allogeneic T cells: Maestro in the co-ordination of the immune response after hematopoietic stem cell transplantation. Haematologica. 2014;99:203–205. https://doi.org/10.3324/haematol.2013.101295 PMid:24497556 PMCid:PMC3912948

Corre E, et al. Long-term immune deficiency after allogeneic stem cell transplantation: B-cell deficiency is associated with late infections. Haematologica. 2010;95:1025–1029. https://doi.org/10.3324/haematol.2009.018853 PMid:20133894 PMCid:PMC2878804

Torlen J, et al. A prospective randomized trial comparing cyclosporine/methotrexate and tacrolimus/sirolimus as graft-versus-host disease prophylaxis after allogeneic hematopoietic stem cell transplantation. Haematologica. 2016;101:1417–1425. https://doi.org/10.3324/haematol.2016.149294 PMid:27662016

Pidala J, et al. Prolonged sirolimus administration after allogeneic hematopoietic cell transplantation is associated with decreased risk for moderate-severe chronic graft-versus-host disease. Haematologica. 2015;100: 970–977. https://doi.org/10.3324/haematol.2015.123588 PMid:25840599 PMCid:PMC4486232

DeFilipp Z, et al. Metabolic Syndrome and Cardiovascular Disease after Hematopoietic Cell Transplantation: Screening and Preventive Practice Recommendations from the CIBMTR and EBMT. Biol. Blood Marrow Transplant.2016;22: 1493–1503. https://doi.org/10.1016/j.bbmt.2016.05.007 PMid:27184625 PMCid:PMC4949101

Armenian SH, Bhatia S. Cardiovascular disease after hematopoietic cell transplantation--lessons learned. Haematologica. 2008;93:1132–1136. https://doi.org/10.3324/haematol.13514 PMid:18669977

Tichelli A, et al. Late cardiovascular events after allogeneic hematopoietic stem cell transplantation: A retrospective multicenter study of the Late Effects Working Party of the European Group for Blood and Marrow Transplantation. Haematologica. 2008;93:1203–1210. https://doi.org/10.3324/haematol.12949 PMid:18556401

Rovo A, et al. Ongoing graft-versus-host disease is a risk factor for azoospermia after allogeneic hematopoietic stem cell transplantation: a survey of the Late Effects Working Party of the European Group for Blood and Marrow Transplantation. Haematologica. 2012;98:339–345. https://doi.org/10.3324/haematol.2012.071944 PMid:22929982 PMCid:PMC3659920

Ossenkoppele GJ, Janssen JJWM, van de Loosdrecht AA. Risk factors for relapse after allogeneic transplantation in acute myeloid leukemia. Haematologica. 2016;101: 20–25. https://doi.org/10.3324/haematol.2015.139105 PMid:26721801 PMCid:PMC4697888




DOI: http://dx.doi.org/10.3889/oamjms.2017.038

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM

Refbacks

  • There are currently no refbacks.




Copyright (c) 2017 Ivana Trajkovska, Borce Georgievski, Lidija Cevreska, Andrijana Gacovski, Taner Hasan, Natasha Nedeska-Minova

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 



Published by: Id Design 2012/DOOEL Skopje, Republic of Macedonia