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  • 1
    Electronic Resource
    Electronic Resource
    Lung diseases after bone marrow transplantation (1986)
    Springer
    Journal of molecular medicine 64 (1986), S. 595-614 
    Details
    ISSN: 1432-1440
    Keywords: Lung diseases ; Bone marrow transplantation ; Clinic ; Radiology ; Histology ; Immunology ; Lung function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The case histories of 72 subsequently treated patients — 44 with acute leukemia, 10 with chronic myeloid leukemia, 16 with severe aplastic anemia and 2 with neuroblastoma — were analyzed after bone marrow transplantation (BMT) with respect to pulmonary diseases. Thirty-eight patients suffered from a total of 51 pulmonary complications, which led to death in 20. Of 13 patients, 3 died of bacterial pneumonia, all of them during granulocytopenia; 2 of 6 patients died of fungal pneumonia and 2 out of 3 of a mixed bacterialmycotic infection. Adult respiratory distress syndrome (ARDS) led to death in 2 patients. A granulocyte count under 500/µl correlated significantly (P〈0.002) with the fatal outcome of bacterial, fungal and ARDS pneumonia as well as with bronchitis. Viral pneumonia led to death in 8 of 9 patients; in each there was a significant correlation (P〈0.05) with graft-versus-host disease (GvHD). Patients with repeated episodes of pulmonary illness had significantly more chronic GvHD (P〈0.05); several of these patients displayed a reduction in helper T cells and an increase in suppressor T cells in the peripheral blood. The natural killer (NK) cells were reduced and the percentage of activated NK cell level lay between 6% and 69%. B-cells were absent or deficient. These findings explain in part the absence of specific antibody reactivity. Five of these patients also contracted GvHD-associated obstructive bronchiolitis, which did not respond to therapy. Pulmonary infiltrates of unknown origin (including idiopathic interstitial pneumonia) occurred in 8 of the patients (11.1%), with a fatal outcome in 3 patients. Significant changes (P〈0.05) in lung function after BMT appeared in the form of reduced vital capacity (VC) increased residual volume (RV) and an increase in RV expressed as the percentage of total lung capacity. Pulmonary diseases were the most common complication and cause of death in our patients after BMT.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01735262
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Acute folic acid deficiency after bone marrow transplantation (1986)
    Springer
    Journal of molecular medicine 64 (1986), S. 423-432 
    Details
    ISSN: 1432-1440
    Keywords: Bone marrow transplantation ; Folic acid deficiency ; Graft versus host disease ; Megaloblastic marrow ; Hematopoetic recovery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary After bone marrow transplantation (BMT), megaloblastic bone marrow changes are often observed that can only be partially explained by drug effects. Our goal was to find out whether folic acid deficiency represented an additional factor. The serum folic acid concentrations of 41 patients were determined regularly before and after BMT. A 2nd degree polynomial regression analysis revealed a clear and acute drop in folic acid concentrations within 7–9 days after BMT. In 19 patients the level fell below 3.0 ng/ml, the range of folic acid deficiency. The mean folic acid values without oral administration of folic acid after BMT lay significantly below the mean values with substitution (P〈0.001). If a case of acute graft versus host disease (GvHD) was more severe than grade I, the mean folic acid levels were significantly lower (P〈0.01). Patients with megaloblastic bone marrow changes after BMT had significantly lower folic acid values than those without such changes (P〈0.01). The 18 patients with folic acid deficiency had a significantly higher rate of megaloblasts, binucleate erythropoietic precursors, Howell-Jolly bodies, giant myelocytes, and giant metamyelocytes in bone marrow smears than the remaining 23 patients (P〈0.05). Folic acid deficiency did not slow down the increase in leukocytes, granulocytes, thrombocytes, or reticulocytes after BMT. There were 8.2%–9.7% hypersegmented neutrophils in the blood (normal 5%) after BMT both with and without folic acid deficiency. Folic acid deficiency after BMT was caused by insufficient intake combined with simultaneous decreased intestinal resorption and increased requirements for the regeneration of bone marrow and intestinal mucosa.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01727528
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Correlation between low CSA plasma concentration and severity of acute GvHD in bone marrow transplantation (1988)
    Springer
    Annals of hematology 57 (1988), S. 139-142 
    Details
    ISSN: 1432-0584
    Keywords: Ciclosporin ; Graft-versus-host-disease ; Bone marrow transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Between 1982 and 1986 51 patients were treated with ciclosporin a (CSA) to prevent graft versus host disease (GvHD) after bone marrow transplantation (BMT). Major side effects of the drug were tremor, hypertension, hepatotoxicity and nephrotoxicity. Acute GvHD 0° to II° occurred in 80% of our patients, and GvHD III° and IV° in 20% despite the use of CSA. Two to four days before the onset of GvHD, CSA serum levels were significantly lower on the average in patients who developed GvHD III° and IV° compared to the others. Our data indicate that plasma CSA concentrations higher than 250 ng/ml should be achieved to reduce the severity of GvHD after BMT.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00320154
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    Paper (German National Licenses)
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