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Seminars in Hematology Jul 2019Impaired immune reconstitution has been one of the perceived limitations of alternative donor transplantation. However, modern transplantation platforms such as... (Review)
Review
Impaired immune reconstitution has been one of the perceived limitations of alternative donor transplantation. However, modern transplantation platforms such as HLA-haploidentical transplantation with either post-transplantation cyclophosphamide or with anti-thymocyte globulin combined with intense immunosuppression may be associated with robust immune recovery as inferred by low rate of infectious mortality and post-transplantation lymphoproliferative disease. Here, we review the data on immune reconstitution including individual cell subsets, the effect of reconstitution on outcomes, and comparative studies using these commonly utilized T-cell replete HLA-haploidentical platforms. We find robust recovery of neutrophils, natural killer cells, CD8 T-cells, and B-cells, with delayed CD4 T-cell recovery comparable to that after HLA-matched transplantation. In addition, while viral reactivations and infections appear more common after HLA-haploidentical when compared with HLA-matched transplantation, infectious mortality remains low likely due to modern cytomegalovirus monitoring, preemptive treatment, as well as relative frequency of nonlethal viral infections like polyomavirus hominis 1 (BK virus). Higher graft cell doses also appear to be associated with faster recovery without concomitant increases in lethal graft-vs-host disease. Finally, despite rapid numerical return of natural killer cells post-transplant, phenotypically they retain immaturity markers till day 180 or more after transplantation, which suggests an avenue for future research to improve outcomes further.
Topics: Adult; Female; Hematopoietic Stem Cell Transplantation; Humans; Immune Reconstitution; Killer Cells, Natural; Male; Transplantation Conditioning; Transplantation, Haploidentical
PubMed: 31202434
DOI: 10.1053/j.seminhematol.2019.03.005 -
Transplantation Apr 2022Kidney transplantation is the best health option for patients with end-stage kidney disease. Ideally, a kidney transplant would last for the lifetime of each recipient....
Kidney transplantation is the best health option for patients with end-stage kidney disease. Ideally, a kidney transplant would last for the lifetime of each recipient. However, depending on the age of the recipient and details of the kidney transplant, there may be a need for a second, third, fourth, or even more kidney transplants. In this overview, the outcome of multiple kidney transplants for an individual is presented. Key issues include surgical approach and immunologic concerns. Included in the surgical approach is an analysis of transplant nephrectomy, with indications, timing, and immunologic impact. Allograft thrombosis, whether related to donor or recipient factors merits investigation to prevent it from happening again. Other posttransplant events such as rejection, viral illness (polyomavirus hominis type I), recurrent disease (focal segmental glomerulosclerosis), and posttransplant lymphoproliferative disease may lead to the need for retransplantation. The pediatric recipient is especially likely to need a subsequent kidney transplant. Finally, noncompliance/nonadherence can affect both adults and children. Innovative approaches may reduce the need for retransplantation in the future.
Topics: Adult; Child; Graft Rejection; Humans; Kidney; Kidney Transplantation; Reoperation; Tissue Donors
PubMed: 34310100
DOI: 10.1097/TP.0000000000003888 -
Annals of Agricultural and... 2015Head and neck cancers are the most common cancers worldwide. It is estimated that approximately 90% of all head and neck cancers are represented by squamous cell...
INTRODUCTION
Head and neck cancers are the most common cancers worldwide. It is estimated that approximately 90% of all head and neck cancers are represented by squamous cell carcinoma (SCC). There are many risk factors causing this type of cancer, including environmental factors and lifestyle choices, such as tobacco smoking or abusing alcohol. Other important risk factor include infectious factors.
OBJECTIVE
The aim of this study was to analyze the prevalence of BK and JC virus infections among patients with oral squamous cell carcinoma (OSCC).
MATERIALS AND METHOD
The correlation between BKV infection and OSCC, and correlation between BKV, OSCC, alcohol abuse, tobacco smoking, demographic data, pre-treatment staging, metastases of lymph node evidence, and grading, was analyzed. The study group consisted of 92 patients with squamous cell carcinoma (OSCC), 75 males, and 17 females, aged between 40 - 87 (average 56.8). All the patients underwent surgery and were not subjected to chemotherapy or radiotherapy prior to treatment. The analyzed samples were collected from paraffin sections.
RESULTS
BKV DNA was detected in 18.5% of patients with OSCC. In the control group, BKV DNA was detected in 3.3%. BKV DNA was statistically more frequently detected among patients with squamous carcinoma, compared to the control group (p<0.05).
CONCLUSIONS
The obtained results suggest that the BKV virus may play an important role in the development of oral squamous cell carcinoma.
Topics: Adult; Aged, 80 and over; BK Virus; Carcinoma, Squamous Cell; Female; Humans; JC Virus; Male; Middle Aged; Mouth Neoplasms; Poland; Polyomavirus Infections; Prevalence; Risk Factors; Tumor Virus Infections
PubMed: 25780838
DOI: 10.5604/12321966.1141378 -
Urology Journal Sep 2015Polyomavirus hominis 1, better known as BK virus (BKV) infection might be a predisposing factor for prostate cancer (PCa). The aim of this study was to compare the...
PURPOSE
Polyomavirus hominis 1, better known as BK virus (BKV) infection might be a predisposing factor for prostate cancer (PCa). The aim of this study was to compare the frequency of BK virus infection in pathological specimens of patients with PCa compared to patients with benign prostatic hyperplasia.
MATERIALS AND METHODS
From July 2011 to June 2012, paraffin-embedded tissue blocks of patients with PCa (60 specimens) and also with benign prostatic hyperplasia (60 specimens) were investigated. After DNA purification, existence of virus nucleic acid was assessed by polymerase chain reaction.
RESULTS
Viral DNA was identified in 9 patients (15%) with benign prostatic hyperplasia (BPH) and 17 patients (28%) with PCa (P = .076). In patients with PCa, viral DNA was observed more often in those with lower total Gleason scores (P = .045).
CONCLUSION
The frequency of BK virus infection in PCa patients was higher than BPH patients. BK virus was more often observed in patients with lower Gleason scores. Less detection of BK virus DNA in overt cancer may prove the activity of the virus which paves the way for tumorigenic transformation at early stages of PCa.
Topics: Aged; Aged, 80 and over; BK Virus; DNA, Viral; Follow-Up Studies; Humans; Incidence; Iran; Male; Middle Aged; Neoplasm Grading; Polymerase Chain Reaction; Polyomavirus Infections; Prostate; Prostatic Hyperplasia; Prostatic Neoplasms; Retrospective Studies; Risk Factors; Tumor Virus Infections
PubMed: 26341765
DOI: No ID Found