Rapports de transplantation : accès libre

Abstrait

The Importance of Presymptomatic State and the Rapid Transition from Consultation to Transplantation are Highlighted in This Study for Both Early and Late Difficulties

Jaap Jan Boelens

Leukodystrophies (LD) are ruinous inherited diseases leading to rapid-fire neurological deterioration and unseasonable death. Hematopoietic stem cell transplantation (HSCT) can halt complaint progression for named LD. Cord blood is a common patron source for transplantation of these cases because it's fleetly available and can be used without full HLA matching. Still, precise recommendations allowing care providers to identify cases that profit from HSCT are lacking. In this study, we define threat factors and describe the early and late issues of 169 cases with globoid cell leukodystrophy-linked adrenoleukodystrophy, and metachromatic leukodystrophy witnessing cord blood transplantation (CBT) at a European Society for Blood and Gist Transplantation center or at Duke University Medical Center from 1996 to 2013. Factors associated with advanced overall survival( zilches) included presymptomatic status( 77 vs 49; P = .006), well- matched( ≤ 1 HLA mismatch) CB units( 71 vs 54; P = .009), and performance status( PS) of> 80 vs< 60 or 60 to 80( 69 vs 32 and 55, independently; P = .003). For cases with PS ≤ 60(n = 20) or 60 to 80(n = 24) pre-CBT, only 4(9) showed enhancement. Overall, encouraging zilches was set up for LD cases after CBT, especially for those who are presymptomatic before CBT and entered adequately cured grafts. Beforehand identification and fast referral to a technical center may lead to earlier treatment and, latterly, to bettered outgrowth