tailieunhanh - Báo cáo khoa học: " Tailored total lymphoid irradiation in heart transplant patients: 10-years experience of one center"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Radiation Oncology cung cấp cho các bạn kiến thức về ngành y đề tài:" Tailored total lymphoid irradiation in heart transplant patients: 10-years experience of one center. | Ghadjar et al. Radiation Oncology 2010 5 3 http content 5 1 3 RADIATION ONCOLOGY RESEARCH Open Access Tailored total lymphoid irradiation in heart transplant patients 10-years experience of one center 11 2 2 3 12 Pirus Ghadjar Daniela Joos Michele Martinelli Roger Hullin Marcel Zwahlen Kristina Lossl Thierry Carrel Daniel M Aebersold1 Paul Mohacsi2 Abstract Background To assess safety and efficacy of tailored total lymphoid irradiation tTLI in cardiac transplant patients. Methods A total of seven patients of which five had recalcitrant cellular cardiac allograft rejection RCCAR confirmed by endomyocardial biopsies and two had side effects of immunosuppressive drug therapy were all treated with tTLI. tTLI was defined by the adjustment of both the fraction interval and the final irradiation dosage both being dependent on the patients general condition irradiation-dependent response and the white blood and platelet counts. A mean dose of Gy range - Gy was given. Median follow-up was 7 years range - years . Results tTLI was well tolerated. Two patients experienced a severe infection during tTLI pneumocystis jirovecii pneumonia urosepsis and generalized herpes zoster and one patient developed a lymphoproliferative disorder after tTLI. The rate of rejection episodes before tTLI was episodes patient month and decreased to episodes patient month after tTLI P .001 . At the end of the observation time all patients except one were alive. Conclusions tTLI is a useful treatment strategy for the management of RCCAR and in patients with significant side effects of immunosuppressive drug therapy. In this series tTLI demonstrated significantly decreased rejection rates without causing relevant treatment-related toxicity. Background Recalcitrant cellular cardiac allograft rejection RCCAR is one of the remaining unsolved problems after heart transplantation HTx . In case of RCCAR aggressive up-regulation or adaptation of .