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Induction of Alloantigen-specific Anergy in Human Peripheral Blood Mononuclear Cells by Alloantigen Stimulation with Co-stimulatory Signal Blockade
Published on: March 14, 2011
[Requirements for early discharge after allogeneic bone marrow transplantation]
M Yasumi1, T Karasuno, H Kanashima
1Fifth Department of Internal Medicine, Center for Cancer and Cardiovascular Diseases, Osaka.
[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|October 3, 2001
Summary
Early discharge after allogeneic bone marrow transplantation (BMT) is safe for patients without cytomegalovirus (CMV) antigenemia or acute graft-versus-host disease (GVHD) requiring prednisolone (PSL) therapy. These patients experienced fewer complications, enabling safe discharge by day 70.
Area of Science:
- Hematology
- Transplantation Immunology
- Infectious Diseases
Context:
- Allogeneic bone marrow transplantation (BMT) requires careful management of complications.
- Early discharge protocols aim to optimize patient recovery and resource utilization.
- Assessing safety criteria for early discharge is crucial for BMT recipients.
Purpose:
- To evaluate the feasibility and safety of early discharge (day 70) after allogeneic BMT.
- To identify key factors influencing infectious complications and transplantation-related toxicity (TRT).
- To determine criteria for safe early discharge in allogeneic BMT patients.
Summary:
- A study of 46 allogeneic BMT recipients found that patients without cytomegalovirus (CMV) antigenemia and without prednisolone (PSL) therapy for acute graft-versus-host disease (GVHD) had a low incidence of TRT and infections (3/15).
- These complications were manageable and non-fatal, supporting the safety of discharge by day 70 for this cohort.
- Conversely, patients with CMV antigenemia and/or requiring PSL for GVHD experienced higher rates of TRT and infections until day 180, with some fatal outcomes.
Impact:
- Establishes day 70 as a potentially safe discharge milestone for select allogeneic BMT patients.
- Highlights CMV antigenemia and acute GVHD requiring PSL therapy as critical factors for prolonged monitoring.
- Informs clinical decision-making regarding discharge timing and post-transplant care strategies.
