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Myocarditis
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Treatment of ICI-associated myocarditis is evolving. The use of the ICI should be discontinued, but perhaps not for low-grade inflammation, and use of high-dose corticosteroids for high grade inflammation cases. In unstable patients who do not respond to corticosteroids, antithymocyte globulin or intravenous immunoglobulin can be considered.
Autologous Stem Cell Transplantation for Refractory Juvenile Idiopathic Arthritis (JIA)
Published in Richard K. Burt, Alberto M. Marmont, Stem Cell Therapy for Autoimmune Disease, 2019
The conditioning regimen included 4 days of Anti-Thymocyte Globulin (ATG, IMTIX, France) in a dosage of 5 mg per Kg recipient weight from day -9 to -6, Cyclophosphamide in a dose of 50 mg/kg/day from day -5 to -2; and low dose Total Body Irradiation (TBI, 4 gray, single fraction) on day -1. Ten children did not receive TBI as a part of their conditioning. On day 0, the frozen stem cell suspension was thawed and infused. Anti TNF-r therapy, MTX and CsA were stopped before autologous HSCT, prednisone was tapered over 2 months.
Anemias of Bone Marrow Failure
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
Eighty percent of untreated aplastic anemia patients die within 1 year. Patients whose aplastic anemia fails to resolve in 4–6 weeks require aggressive therapy. Bone marrow transplantation should be considered for eligible patients, particularly those under 40 years of age. For all other patients, antithymocyte globulin should be administered. Patients who fail to respond to an initial course of antithymocyte globulin may respond to a second course using a product prepared in a different species of animal. The addition of cyclosporine appears to improve the response rate to antithymocyte globulins. Patients who respond to either antithymocyte globulin or bone marrow transplantation have prolonged survival.
Encouraging the outcomes of children with beta-thalassaemia major who underwent fresh cord blood transplantation from an HLA-matched sibling donor
Published in Hematology, 2022
Jianyun Wen, Xiaodong Wang, Libai Chen, Yuelin He, Xiaoqin Feng, Chunfu Li, Yongshen Ruan, Sixi Liu, Xuedong Wu
With respect to GVHD prophylaxis, none of the 68 patients received anti-thymocyte globulin (ATG). GVHD prophylaxis on the basis of cyclosporine A (CsA) was given to all 68 patients. Initial dose of CsA was 1.5 mg/kg/day i.v. from day –10 to –2, added up to 3 mg/kg/day i.v. from day –1 through about day 25, and subsequently i.v. CsA was switched to oral. The concentration of CsA was monitored once or twice per week, and the dosage was regulated to achieve a targeted concentration level of 200 ± 50 ng/mL. The duration of CsA depended on the occurrence of GVHD, and the dosage of CsA was gradually reduced from day 90 until discontinuation by the end of 1 year. Mycophenolate mofetil was given on day 1 at 30 mg/kg/day and was disabled on day 30 if the patient had no signs of grade ≥ II aGVHD. Methotrexate （MTX）was given to patients without skin and mucous membrane damage. Fifty-six patients in this study received MTX, and the MTX doses were 15, 10, and 10 mg/m2 on days 1, 3, and 6,respectively.
Thymic stromal lymphopoietin levels after allogeneic hematopoietic stem cell transplantation
Published in Immunopharmacology and Immunotoxicology, 2022
Dina Leth Møller, Katrine Kielsen, Claus Henrik Nielsen, Henrik Sengeløv, Anders Elm Pedersen, Lars Peter Ryder, Klaus Müller
We included 38 adult patients receiving their first allogeneic HSCT with either bone marrow (BM, n = 24) or G-CSF mobilized peripheral blood stem cells (PB, n = 14) from a matched related donor (MRD, n = 11) or a matched unrelated donor (MUD, n = 27) (Table 1). The majority of the patients were transplanted due to acute myeloid leukemia (n = 15), acute lymphoblastic leukemia (n = 11), or myelodysplastic syndrome (n = 6). The vast majority of the patients (n = 37) received myeloablative conditioning based on either total body irradiation (TBI) or busulphan, while a single patient received reduced-intensity conditioning with fludarabine and cyclophosphamide. Allografts were not T-cells depleted. Five patients received additional anti-thymocyte globulin (ATG) as part of the conditioning. GVHD prophylaxis consisted of cyclosporine A and methotrexate for all patients.
A prediction model of delayed graft function in deceased donor for renal transplant: a multi-center study from China
Published in Renal Failure, 2021
Wujun Xue, Changxi Wang, Jianghua Chen, Xuyong Sun, Xiaotong Wu, Longkai Peng, Zhishui Chen, Qingshan Qu, Xiaodong Zhang, Yaowen Fu, Zhen Dong, Zheng Chen, Guiwen Feng, Tao Lin, Tongyi Men, Lixin Yu, Qiquan Sun, Yongheng Zhao, Jiangqiao Zhou, Li Zeng, Ming Zhao, Jianming Tan, Qifa Ye, Bingyi Shi, Yingzi Ming, Tongyu Zhu, Weiguo Sui, Chibing Huang, Yingxin Fu
All recipients were administered 1.25–1.50 mg·kg−1·day−1 rabbit anti-thymocyte globulin (rATG; Genzyme Ireland, Waterford, Ireland) as intraoperative induction therapy and for 4–6 days postoperatively. A triple immunosuppressive regimen with enteric-coated mycophenolate sodium (EC-MPS; Myfortic, Novartis Pharma, Basel, Switzerland); prednisone; and calcineurin inhibitors (CNIs), including cyclosporine A (CsA; Sandimmun optoral, Novartis Pharma, Nuremberg, Germany) and tacrolimus (TAC; Prograf, Astellas Pharma, Deerfield, IL); was initiated postoperatively. The initial dosages of CsA, TAC, EC-MPS, and prednisone were 4.0–4.5 mg·kg−1·day−1, 0.06–0.08 mg·kg−1·day−1, 1080–1440 mg·day−1, and 10–20 mg·day−1, respectively.