Acquired haemophilia associated with pulmonary tuberculosis — a case report

Nabyta hemofilia (NH) to rzadki rodzaj skazy osoczowej. Najczęściej rozpoznawaną jej postacią jest hemofilia A, która może mieć charakter pierwotny lub wtórny do innych chorób. Rozpoznanie wtórnej postaci zaburzeń krzepnięcia znacząco wpływa na możliwości terapeutyczne, gdyż leczenie współistniejącej choroby może doprowadzić do ustąpienia NH.Acquired hemophilia is rare type of coagulation disorder. The most common variety is acquired hemophilia A, which may be primary or secondary to other diseases. Recognition of the secondary type of coagulation disorder is very important and affects the therapeutic potential, because proper treatment of the primary disease may be essential also for regression of hemophilia symptoms

Treatment of Graft-versus-Host Disease with Naturally Occurring T Regulatory Cells

A significant body of evidence suggests that treatment with naturally occurring CD4(+)CD25(+) T regulatory cells (Tregs) is an appropriate therapy for graft-versus-host disease (GvHD). GvHD is a major complication of bone marrow transplantation in which the transplanted immune system recognizes recipient tissues as a non-self and destroys them. In many cases, this condition significantly deteriorates the quality of life of the affected patients. It is also one of the most important causes of death after bone marrow transplantation. Tregs constitute a population responsible for dominant tolerance to self-tissues in the immune system. These cells prevent autoimmune and allergic reactions and decrease the risk of rejection of allotransplants. For these reasons, Tregs are considered as a cellular drug in GvHD. The results of the first clinical trials with these cells are already available. In this review we present important experimental facts which led to the clinical use of Tregs. We then critically evaluate specific requirements for Treg therapy in GvHD and therapies with Tregs currently under clinical investigation, including our experience and future perspectives on this kind of cellular treatment

Opieka ginekologiczna po transplantacji komórek krwiotwórczych – zalecenia na podstawie piśmiennictwa i własnych doświadczeń

Transplantacja komórek krwiotwórczych ( – HCT ) jest ugruntowaną metodą leczenia zarówno nienowotworowych, jak i rozrostowych chorób układu krwiotwórczego. U kobiet wiąże się jednak z występowaniem powikłań wczesnych i późnych dotyczących układu moczowo-płciowego. Konsekwencją gonadotoksycznego postępowania przygotowawczego (chemioterapii i radioterapii) jest przedwczesne wygaśnięcie funkcji jajników. U biorczyń allogenicznych przeszczepów ( HCT, allo-HCT) dodatkowo występują powikłania związane z występowaniem przewlekłej choroby przeczep przeciw gospodarzowi ( cGvHD) w istotny sposób upośledzające jakość życia kobiet w przypadku zajęcia strefy anogenitalnej (GvHDgyn). Dodatkowo przewlekła immunosupresja sprzyja występowaniu wtórnych nowotworów układu moczowo-płciowego. Pacjentki po HCT, szczególnie obciążone cGvHD, wymagają długoletniej interdyscyplinarnej opieki, włączając opiekę ginekologiczną. W pracy przedstawiono problemy ginekologiczne pacjentek po HCT oraz zaproponowano schemat standardu opieki ginekologicznej po transplantacji na podstawie piśmiennictwa i własnych doświadczeń

Long-term allogeneic hematopoietic cells transplantation survivors proinflammatory cytokine profile compared to their respective donors and immunophenotype differences depending on GvHD history and infection status

Background In the course of allogeneic hematopoietic cell transplantation (allo-HCT) the donor’s hematopoietic progenitor cells are exposed to immense proliferative stress to reconstitute in the recipient the functional hematopoiesis. Moreover, recipients who develop infections or chronic GvHD are subjected to further proliferative stress, especially in the lymphocyte subset. We hypothesized that allo-HCT may induce changes in proinflammatory cytokines profile and immunophenotype in the allo-HCT recipients, especially in patients with cGVHD history. We compared the cytokine profile (Il-6, Il-10, and TNF-) between long-term allo-HCT recipients and their respective donors and we analyzed cytokines profile and the immunophenotype of lymphocytes in long-term recipients grouped according to the infection and GvHD history. Results We have found no differences in the proinflammatory cytokines between allo-HCT recipients and their respective donors, as well as between recipients grouped according to infectious risk status. Immunophenotyping of recipients grouped according to GvHD status revealed an increased percentage of B-cell presenting PD-1 in recipients without a history of GvHD. Conclusions Lack of differences in proinflammatory cytokines concentrations between recipients and donors of allo-HCT would suggest that allo-HCT does not induce acceleration of the inflammageing-resembling phenomenon. No differences in the cytokine profile and immunophenotype between recipients grouped according to infectious risk status suggest that infectious risk is not reflected by the immunophenotype and cytokine profile. Furthermore, the lack of significant differences in immunophenotype of the recipients grouped according to the history of GvHD may suggest that in long-term survivors the immune system tends to stabilize with time

BKV Related Hemorrhagic Cystitis—An Insight into Risk Factors and Later Complications—An Analysis on Behalf of Polish Adult Leukemia Group

BK virus reactivation increases the likelihood of hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplant (HCT). In this study, we aimed to identify predictive and risk factors associated with the increased occurrence of this condition following HCT. On a group of 124 patients aged ≤71 years old (median 40 years) who underwent HCT, we analyzed sex, age, time from diagnosis to transplantation, type of conditioning, donor’s relationship, age, and sex, the impact of immunosuppression with different drugs, and acute and chronic GVHD, BK viremia and viruria as potential factors increasing the risk of BK-related HC after HCT. HC occurred among 24 patients (24/124; 29.2%). A significant correlation was observed between HC incidences after HCT, BK viremia and viruria, and acute GVHD occurrence. Furthermore, the level of BKV DNA in serum at day +21 (>0.75 × 103) significantly impacted the patients’ survival time. According to our results, the likelihood ratio of BKV-DNA on day +21 in serum is 6.25, indicating that this diagnostic test has the potential to be utilized in a clinical setting. These findings may be used as a voice in the discussion on implementing an optimal preemptive treatment in BKV reactivation after allogeneic HCT