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Monocyte-predominant engraftment, cytokine levels and early transplant-related complications in pediatric hematopoietic stem cell recipients.

Authors
  • Maximova, Natalia1, 2
  • Granzotto, Marilena3, 4
  • Barbieri, Francesca5
  • Marcuzzi, Annalisa5
  • Tommasini, Alberto1, 2
  • Monasta, Lorenzo1, 2
  • Simeone, Roberto3, 4
  • Zanon, Davide1, 2
  • Sala, Roberto6
  • 1 Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy. , (Italy)
  • 2 Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy. , (Italy)
  • 3 Department of Laboratory Medicine, ASUITS, Trieste, Italy. , (Italy)
  • 4 Department of Transfusion Medicine, ASUITS, Trieste, Italy. , (Italy)
  • 5 Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy. , (Italy)
  • 6 Department of Medicine and Surgery, University of Parma, Parma, Italy. , (Italy)
Type
Published Article
Journal
Cancer Medicine
Publisher
Wiley
Publication Date
Mar 01, 2019
Volume
8
Issue
3
Pages
890–901
Identifiers
DOI: 10.1002/cam4.1912
PMID: 30690926
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Myeloablative conditioning is a well-established procedure that precedes hematopoietic stem cell transplantation (HSCT), particularly in pediatric patients. In the period directly following transplantation, several factors may contribute to complications that lead to the activation or damage of endothelial cells, involved in the pathogenesis of vascular endothelial syndromes (VES). However, to date, sufficiently specific and sensitive diagnostic markers for the various forms of VES have not been identified. This was a retrospective single-center study of patients who underwent allogeneic HSCT. For this cohort of patients, parameters including type of engraftment, donor characteristics, and cytokine production were measured and correlated with a high prevalence of short-term complications after HSCT. The aim of this study was to identify specific parameters useful for improving diagnostics and predicting adverse effects in VES. We confirmed that monocyte-predominant engraftment was related to a higher risk for an early transplant-related complication termed sinusoidal obstruction syndrome (SOS). The increased production of specific cytokines, in particular RANTES, represents a marker associated with prevalent engraftment. In addition, patients undergoing prophylaxis with defibrotide had "classical" engraftment, a common cytokine profile and a lower incidence of life-threatening transplant-related complications. The beneficial effect of defibrotide might be a starting point for developing selective prophylaxis for patients with monocyte engraftment to prevent severe early transplant-related complications. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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