Glutamine parenteral supplementation in stem cell transplant

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Advanced algorithms for surgical gesture classification

to determine surgical ability. To this aim a sensory glove was employed to track surgical hand movements and sensors data were recorded to be processed by a specific algorithm. The classification task was able to discriminate a gesture made by an expert surgeon with respect to a novice one, thanks to a two steps classification strategy. The first one produced a binary tree of parameters associated to a sensor time function; they were elaborated in the second step by a neural network providing a real output whose magnitude was associated to the surgeon ability. Experimental tests correctly classify all operators in a group

Poliomavirus umano BK e cistite emorragica

pubblicato su: Bollettino SIM, anno 4-N.1, ottobre 2002, pag. 123

Correlation between paraproteinaemia and viral reactivation after allo-SCT

Medd et al.,1 retrospectively studied the occurrence of paraproteinaemia after allo-SCT in a cohort of 91 patients. They detected a paraproteinaemia incidence of 32%, multiple in the majority of cases, with a predominance of an IgG isotype and with equal kappa/lambda restriction. In this report, the most important risk factor for the development of post-transplant paraproteinaemia was CMV reactivation, which was more frequent when alemtuzumab was included in conditioning regimen. The authors also described a poorer OS in patients with paraproteinaemia, with relapse being the commonest cause of death in this group of patients. None of the patients with paraproteinaemia subsequently developed myeloma or a lymphoproliferative disorder and only one patient developed cryoglobulinemia

BKV infection and hemorragic cystitis after allogeneic bone marrow transplant.

Hemorrhagic cystitis (HC) is a well-known complication after allogeneic bone marrow transplant (BMT) and can be related to adenovirus or human polyomavirus BK (BKV) infections. In this study a group of 20 patients after allogeneic BMT has been examined. BMT urine samples were analysed for the presence of Adenovirus and BKV DNAby means of polymerase chain reaction (PCR). 5/20 BMT patients developed HC after BMT. The presence of BKV DNA in urine samples was evident in 3/15 patients without HC and in 5/5 patients with HC. In 2/5 HC-patients the BKV DNA was not found after therapy with Cidofovir and Ribavirin. The search for adenovirus DNA in all samples was negative. The analysis of BKV non-coding control region (NCCR) isolated from urine samples revealed a structure very similar to the archetype in all samples. The RFLP (Restriction Fragment Length Polymorphism assay) showed the presence of BKV subtypes I and IV, with the prevalence of subtype I (4/5). This study supports the hypothesis that HC is mainly related to BKV rather than to adenovirus infection in BMT patients. Moreover, since BKV subtype I was predominant, it is reasonable to hypothesize that a specific BKV subtype could be associated with the development of HC

Immune reconstitution after autologous peripheral blood progenitor cell transplantation

OBJECTIVE: The aim of this study was to evaluate the occurrence of T-cell spontaneous apoptosis (A(spont)) and its modulation in vitro by the interleukin-2 receptor (IL-2R) gamma-chain (gammac)-signaling cytokine IL-15 in patients transplanted with autologous peripheral blood progenitor cells (PBPC) for hematologic malignancies. MATERIALS AND METHODS: Patients were examined on days 30-60, 60-90, and 90-120 after PBPC infusion. Dissipation of mitochondrial transmembrane potential, a hallmark of T-cell apoptosis, has been detected using the fluorescent probe 3,3'-dihexyloxacarbocyanine iodide, after short-term T-cell culture in the absence or presence of exogenous cytokines. Expression of Bcl-2 family members has been studied by flow cytometry and reverse transcriptase polymerase chain reaction. T-cell proliferative responses to recall antigens have been estimated in autologous mixed leukocyte cultures. RESULTS: A(spont) was seen in 45% +/- 6% of CD4(+) and 55% +/- 6% of CD8(+) T cells cultured in the absence of cytokines. Of interest, IL-15 and, to a lesser extent, its structural cousin IL-2 counteracted T-cell A(spont) by inhibiting the processing of caspase-3 and up-regulating Bcl-2 mRNA and protein levels. Cell division tracking confirmed that IL-15 did not rescue T cells from A(spont) by promoting proliferation but rather acted as a genuine survival factor. Addition of a gammac-blocking antibody to cytokine-conditioned cultures abrogated both apoptosis inhibition and Bcl-2 induction by IL-15, suggesting involvement of the IL-2Rgammac signal transduction pathway. Whereas cytokine-unprimed posttransplant T cells mounted inadequate responses to recall antigens, T cells conditioned with IL-15 expanded vigorously, indicating restoration of antigen-specific proliferation. CONCLUSIONS: T cells recovering after autologous PBPC transplantation are highly susceptible to spontaneous apoptosis in vitro. This phenomenon can be counteracted by the gammac-signaling cytokine IL-15. These findings suggest that IL-15 might be a promising immunomodulating agent to improve postgrafting T-cell function