China
Africa
Explore chapters and articles related to this topic
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.
Clinical Studies In Acute and Chronic Inflammation
Published in Siegfried Matzku, Rolf A. Stahel, Antibodies in Diagnosis and Therapy, 2019
The IL-2 receptor (CD25) is expressed on activated T cells. IL-2 receptor bearing cells and soluble-IL-2 receptors are elevated in patients at risk for transplant rejection (Deng et al., 1995; Chang et al., 1996). Anti-IL-2 receptor therapy has been evaluated as prophylaxis in cardiac, hepatic and renal transplant patients and in the prophylaxis and treatment of GVHD. Results are encouraging, particularly with prophylaxis against transplant rejection, where anti-IL-2 therapy was found to be at least as effective as anti-thymocyte globulin (ATG) and anti-CD3 therapy.
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.
Monitoring and safety of CAR-T therapy in clinical practice
Published in Expert Opinion on Drug Safety, 2022
José M. Serra López-Matencio, Valle Gómez Garcia de Soria, Manuel Gómez, Estefanía Alañón-Plaza, Cecilia Muñoz-Calleja, Santos Castañeda
Siltuximab is an anti-IL-6 monoclonal antibody with a greater affinity for IL-6 than that of tocilizumab for the IL-6 receptor. These antibodies can be administered in refractory cases (without response to tocilizumab or corticosteroids). It is administered as a single IV dose of 11 mg/kg. However, the experience with this drug is very limited, and its preferential use to tocilizumab should be avoided [24–26]. Other options include anakinra (IL-1 receptor antagonist that crosses BBB) and T cell depleting treatments with cyclophosphamide or anti-thymocyte globulin. Regarding anakinra, this agent is administered subcutaneously, but an adequate dosing regimen is still being explored. No studies are comparing those treatments, and there is no firm recommendation on what the third-line drug of choice should be. Nevertheless, cyclophosphamide and anti-thymocyte globulin should be avoided if possible because they would eliminate CAR-T lymphocytes [24–26].