Day 1 :
- Kidney Transplantation
Session Introduction
Vivek Goel
Sir Ganga Ram Hospital, India
Title: Post-transplant lymphoproliferative disorder (PTLD) presenting as breast nodule and intestinal obstruction in a renal transplant recipient - A Case Report
Biography:
Abstract:
Post-transplant lymphoproliferative disease (PTLD) is a life-threatening complication among kidney transplant recipients. The clinical presentation of patients with PTLD is highly variable. The type of PTLD and the area of involvement determine its presentation, which includes constitutional symptoms such as fever, weight loss, fatigue, and other symptoms related to dysfunction of involved organs, or compression of surrounding structures. Most present with extranodal masses involving the gastrointestinal tract (stomach, intestine), lungs, skin, liver, central nervous system, and the allograft itself.
In our case, a 33-year-old woman developed EBV-negative PTLD - Plasmablastic lymphoma in her right breast and small intestine presenting as intestinal obstruction, 15 years after renal transplantation. She was managed with intestinal mass resection and chemotherapy. A follow-up PET scan showed near-complete resolution. Thus, PTLD should always be kept in mind in renal transplant recipients who present with features of the mass effect involving any organ.
- Bone Marrow Transplant
Session Introduction
Mousa Qatawneh
Queen Rania Children Hospital, Jordan
Title: Hematopoietic stem cell transplantation in thalassemia patients: A Jordanian Single centre experience
Biography:
Dr. Mousa Qatawneh MD, Department of Hematology and medical oncology, Queen Rania Children Hospital, Royal Medical services, Jordan.
Abstract:
Introduction: Beta thalassemia major is the commonest inherited hematological disorder worldwide which needs lifelong sufficient supportive management. Hematopoietic stem Cell transplantation (HSCT) is the only curative treatment available till now.
Aim: To evaluate the outcome of children who underwent allogenic hematopoietic stem Cell transplantation as a curative approach for Thalassemia Major.
Settings: Queen Rania AL- Abdullah children Hospital (QRCH).
Methods: A retrospective review of the medical files was conducted for all children ( < 15 years ) who had thalassemia major and received HSCT between January ,2010 and January ,2019.The following variables were studied for all patients: age , gender ,Pesaro classifications , the count of infused raw bone marrow stem cell (CD34) , engraftment time , outcome and complications .
Results: A total of 34 children were transplanted for thalassemia major, at an average of 4 cases per year .All underwent allogenic raw bone marrow transplantation from matched related donors. Thirteen patients (38.2%) were males and twenty one (61.2%) were females. The age ranged between 2 and 15 years, with a median age of 6.5 years. According to Pesaro classification, 31 patients were class 2 (91.2%) and 3 patients were class 3(8.8%) while no single case met the crieteria for class 1 Pesaro classification. The median CD34 count was 3.5 million /Kg of recipient weight (range, 1.5*106-7*106 /kg). The median time for neutrophil engraftment was 15.5 days. At a median follow up of 5 years (range 1- 9.5), 33 patients were alive. One patient died before 100 days post transplantation due to grade IV acute gastrointestinal Graft Versus Host Disease (GVHD). Three patients had secondary graft failure (8.8%). Six patients (17.5 %) developed mild grade 1-2 skin GVHD while another patient developed hemorrhagic cystitis due to BK virus and cytomegalovirus (CMV) which reactivated simultaneously, and was successfully managed .
Conclusion: The outlook for Thalassemia major has dramatically changed after HSCT, with a considerable success in Jordan and results comparable to international data.