Hematopoietic stem cell transplantation complications

Allogeneic hematopoietic stem cell transplantation (HSCT) is the only potential cure for SCD. The best candidates are children with SCD who are younger than 16 years of age with severe complications who have an identical H LA-matched donor, usually a sibling. The transplant-related mortality rate is between 5% and 10%, and graft rejection is approximately 10%. Other risks include secondary malignancies, development of seizures or intracranial bleeding, and infection in the immediate posttransplant period.6,25,32,33... 

Allogeneic hematopoietic stem cell transplantation is the only therapy that is curative. The best candidates are younger than 16 years of age, have severe complications, and have human leukocyte antigen-matched donors. Risks must be carefully considered and include mortality, graft rejection, and secondary malignancies. 

Differential diagnosis of graft-versus-host disease currently depends on organ biopsy to distinguish it from other common complications associated with transplantation. As a means of avoiding repeated biopsies, one group analyzed the urine of patients after hematopoietic stem cell transplantation... 

In the support of hematopoietic stem cell transplantation there are programs developed to permit treatment with chemotherapy at home and treatment of complications. 

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Kim C-C. Infectious complications associated with alemtuzumab use for allogeneic hematopoietic stem cell transplantation comparison with anti-thymocyte globulin. Transplant Infect Dis 2009 11 413-23. 

Afessa B, Peters SG. Major Complications following Hematopoietic Stem Cell Transplantation. Semin Respir Crit Care Med 2006 27(3) 297-309. 

Afessa B, Litzow MR, Tefferi A. Bronchiolitis obliterans and other late onset non-infectious pulmonary complications in hematopoietic stem cell transplantation. Bone Marrow Transplant 2001 28(5) 425-434. 

Morales IJ, Anderson PM, Tazelaar HD, et al. Pulmonary cytolytic thrombi unusual complication of hematopoietic stem cell transplantation. J Pediatr Hematol Oncol 2003 25(l) 89-92. 

Franquet T, Muller NL, Lee KS, Gimenez A, Flint JD (2005a) High-resolution CT and pathologic findings of noninfectious pulmonary complications after hematopoietic stem cell transplantation. AJR Am J Roentgenol 184 629-637... 

Nichols WG, Guthrie KA, Corey L, Boeckh M (2004) Influenza infections after hematopoietic stem cell transplantation risk factors, mortality, and the effect of antiviral therapy. Clin Infect Dis 39 1300-1306 Nusair S, Breuer R, Shapira MY, Berkman N, Or R (2004) Low incidence of pulmonary complications following nonmyeloablative stem cell transplantation. Eur Respir J 23 440-445... 

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