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Pulmonary nodules in a man with a history of bone marrow transplantation

Our patient was diagnosed as having Philadelphia chromosome positive pre-B acute lymphoblastic leukaemia with lymphoid blast crisis (blast crisis of chronic myeloid leukaemia) in 2011. Treatment with two cycles of hyper-CVAD (alternating cyclophosphamide+vincristine+doxorubicin+dexamethasone with methotrexate+cytarabine) plus dasatinib resulted in a negative bone marrow biopsy (remission). He had an allogeneic peripheral blood stem cell transplant from a 10/10 HLA matched unrelated donor in 2013. Conditioning was with cyclophosphamide and 1200 cGy total body irradiation. Graft versus host disease prophylaxis was with tacrolimus and methotrexate. Dasatinib was continued after his transplant. In late 2013 he developed relapsed acute lymphoblastic leukaemia. He was treated with fludarabine, cytarabine, and granulocyte colony stimulating factor. Bone marrow biopsy after chemotherapy showed persistent acute lymphoblastic leukaemia, even after he was switched to ponatinib and dexamethasone. Daunorubicin and vincristine were added for one cycle but were discontinued when he was admitted to hospital for cellulitis. Bone marrow biopsy was negative but one three months later showed recurrent acute B lymphoblastic leukaemia. Remission occurred after re-induction with clofarabine in the autumn of 2014; this was followed by 6-mercaptopurine, methotrexate, vincristine, and prednisone maintenance therapy.  
feeds.bmj.com
over 4 years ago
Preview
0
8

Pulmonary nodules in a man with a history of bone marrow transplantation

Our patient was diagnosed as having Philadelphia chromosome positive pre-B acute lymphoblastic leukaemia with lymphoid blast crisis (blast crisis of chronic myeloid leukaemia) in 2011. Treatment with two cycles of hyper-CVAD (alternating cyclophosphamide+vincristine+doxorubicin+dexamethasone with methotrexate+cytarabine) plus dasatinib resulted in a negative bone marrow biopsy (remission). He had an allogeneic peripheral blood stem cell transplant from a 10/10 HLA matched unrelated donor in 2013. Conditioning was with cyclophosphamide and 1200 cGy total body irradiation. Graft versus host disease prophylaxis was with tacrolimus and methotrexate. Dasatinib was continued after his transplant. In late 2013 he developed relapsed acute lymphoblastic leukaemia. He was treated with fludarabine, cytarabine, and granulocyte colony stimulating factor. Bone marrow biopsy after chemotherapy showed persistent acute lymphoblastic leukaemia, even after he was switched to ponatinib and dexamethasone. Daunorubicin and vincristine were added for one cycle but were discontinued when he was admitted to hospital for cellulitis. Bone marrow biopsy was negative but one three months later showed recurrent acute B lymphoblastic leukaemia. Remission occurred after re-induction with clofarabine in the autumn of 2014; this was followed by 6-mercaptopurine, methotrexate, vincristine, and prednisone maintenance therapy.  
feeds.bmj.com
over 4 years ago
Preview
0
8

Pulmonary nodules in a man with a history of bone marrow transplantation

Our patient was diagnosed as having Philadelphia chromosome positive pre-B acute lymphoblastic leukaemia with lymphoid blast crisis (blast crisis of chronic myeloid leukaemia) in 2011. Treatment with two cycles of hyper-CVAD (alternating cyclophosphamide+vincristine+doxorubicin+dexamethasone with methotrexate+cytarabine) plus dasatinib resulted in a negative bone marrow biopsy (remission). He had an allogeneic peripheral blood stem cell transplant from a 10/10 HLA matched unrelated donor in 2013. Conditioning was with cyclophosphamide and 1200 cGy total body irradiation. Graft versus host disease prophylaxis was with tacrolimus and methotrexate. Dasatinib was continued after his transplant. In late 2013 he developed relapsed acute lymphoblastic leukaemia. He was treated with fludarabine, cytarabine, and granulocyte colony stimulating factor. Bone marrow biopsy after chemotherapy showed persistent acute lymphoblastic leukaemia, even after he was switched to ponatinib and dexamethasone. Daunorubicin and vincristine were added for one cycle but were discontinued when he was admitted to hospital for cellulitis. Bone marrow biopsy was negative but one three months later showed recurrent acute B lymphoblastic leukaemia. Remission occurred after re-induction with clofarabine in the autumn of 2014; this was followed by 6-mercaptopurine, methotrexate, vincristine, and prednisone maintenance therapy.  
feeds.bmj.com
over 4 years ago
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0
9

Should Patients in Their 70s Get Lung Transplants?

As the age of lung transplant patients increases, the age of recipients and the stewardship of organs have become controversial. Experts debated these issues at a heart and lung transplant meeting.  
medscape.com
over 4 years ago
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0

Islet-Cell Transplants May Benefit Type 1 Diabetes Patients

This investigational procedure, which has evolved since the landmark "Edmonton Protocol" results from over a decade ago, may offer a promising option for patients with severe hypoglycemia.  
medscape.com
over 4 years ago
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2

Amniotic Membrane Allograft for Chronic Diabetic Foot Ulcers

Is dehydrated amniotic membrane allograft safe and effective in the management of chronic diabetic foot ulcers?  
medscape.com
over 4 years ago
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8

Older Lung Donors Raise Mortality Risk Only Slightly

Pushing the maximum recommended donor age for lung transplants from 55 to 64 years greatly expands the donor pool, with only a slight increase in recipient mortality. However, more research is needed.  
medscape.com
over 4 years ago
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7

Success With Stem Cell Transplant in Myasthenia Gravis

Seven patients with severe myasthenia gravis who received autologous hematopoietic stem cell transplants have experienced long-term remission.  
medscape.com
over 4 years ago
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1

HIV-infected organs transplant success - BBC News

HIV-infected organs have been successfully transplanted into four HIV-positive NHS patients in the UK, for the first time.  
bbc.co.uk
over 4 years ago
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7

Liver Transplant Allograft Dysfunction and Kidney Function

Early allograft dysfunction after liver transplantation may lead to renal dysfunction in the form of acute kidney injury or end-stage renal disease.  
medscape.com
over 4 years ago
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2

Parkinson's Cell Transplant Shows Good Reinnervation at 24 Years

A postmortem report showing transplanted dopaminergic cells survived for almost a quarter of a century provides hope for future stem cell therapy, researchers say.  
medscape.com
over 4 years ago
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7

Antibody-Mediated Rejection in Lung Transplantation

Antibody-mediated rejection may negatively impact lung transplant prognosis, according to a new study.  
medscape.com
over 4 years ago
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2

European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) 53rd Congress

European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) 53rd Congress: Read clinically focused news coverage of key developments from ERA-EDTA 2016.  
medscape.com
over 4 years ago
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1

Man receives penis transplant in US - BBC News

A hospital in Boston becomes the first in the US to perform a successful penis transplant, say doctors, calling the operation "a surgical milestone".  
bbc.co.uk
over 4 years ago
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9

A Simultaneous Liver-Kidney Transplant? Not So Fast

Do you really need that kidney first? Drs Berns and Reese discuss UNOS' new rules for kidney transplantation in liver transplant recipients.  
medscape.com
over 4 years ago
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1

Transplant Still Best Up-front Option in Myeloma

Treatment options for myeloma have dramatically increased, but at least for right now, transplant should remain the preferred treatment for younger patients.  
medscape.com
over 4 years ago
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10

Right Lateral Sector Graft in Living Donor Liver Transplant

Right lateral sector graft may be a feasible option for living donor liver transplantation, but certain anatomical aspects should be considered.  
medscape.com
over 4 years ago
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1

Massachusetts Man Has First Successful U.S. Penis Transplant

A 64-year-old man became the first in the United States to undergo a successful penis transplant in a procedure at Massachusetts General Hospital earlier this month, his doctors said on Monday.  
medscape.com
over 4 years ago
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7

Pentoxifylline Is Ineffective for Severe Alcoholic Hepatitis

Should patients with severe alcoholic hepatitis receive pentoxifylline? New research answers whether this drug reduces mortality and need for liver transplant.  
medscape.com
over 4 years ago