Cytology in patients with hematopoietic stem cell transplantation (CROSBI ID 603970)
Prilog sa skupa u časopisu | sažetak izlaganja sa skupa | međunarodna recenzija
Podaci o odgovornosti
Sučić, Mirna ; Ries, Sunčica ; Gjadrov Kuveždić, Koraljka ; Ljubić, Nives ; Perković, Leila ; Ivanović, Dunja ; Labar, Boris ; Nemet, Damir
engleski
Cytology in patients with hematopoietic stem cell transplantation
Indications for hematopoiteic stem cell (HSC) transplantation (HSCT) are hematological malignancies, solid tumors and nonmalignant conditions (i.e. aplastic anemia, immunodeficiency syndromes, congenital disorder of metabolism). For some of these diseases HSCT is now standard therapy and for others it is used as a rescue when standard therapy is unsuccessful. HSCs may be taken from donor (allogeneic) and from patient itself (autologous). HSCs sources can be bone marrow (BM), umbilical cord and peripheral blood (PB). In pretransplantation period BM cytology and/or histology is required for definition of type and status of diseases (i.e. in cases of hematological malignancies remission of disease). In preengraftment period (0-30 days post HSCT) cytological analysis is required for follow-up of engraftment of hematopoiteic cells. Thus, on days 10-15 post HSCT BM is very hypocellular with clusters of stromal cells, some histiocytes, phagocytes, lymphocytes and plasmocytes. Myeloid and erythroid cells are scanty with moderate shift to the left. Scanty megakaryocytic cell are also found in majority of patients. Such cytological finding is objective evidence of BM engraftment. On a day 25 after HSCT BM is less hypocellular, present are cells of granulopoiesis, erythropoiesis and megakaryopoiesis and shift to the left is less pronounced. In postengraftment period (30-100 days after HSCT) BM is normocellular, present are all HSCs cell lines without shift to the left. Ratio of white and red cells is often near 1:1 and part of erythroid cells could be slightly megaloblastoid. Cytology analyses are part of follow-up of patients with HSCT and used if relapse of disease is suspected or if second malignant tumor occurs and also for the diagnosis of post-transplantat lymphoproliferative disorders. Atypical epithelial cells and higher number of lymphocytes in bronchoalveolar lavage in HSCT patients could be associated with pulmonary graft versus host disease (GVHD). In other cytological mucosa specimens also could be found cell atypia, squamous metaplasia and inflammatory background in patients with chronic GVHD. Severe cell atypia could be also found due to cytostatic therapy in urine of HSCT patients and such cytological changes should be not misdiagnosed as cancer cells. Presence of tubular cells with round inclusions in HSCT patients could be associated to cyclosporine administration and point to cyclosporine nephrotoxicity. Urine cytology is also useful for evaluating etiology of hemorrhagic cystitis in HSCT patients. HC predisposing factors are possible graft versus host disease (GVHD), thrombocytopenia, coagulopathy and viral infections (polyoma BK virus, cytomegalovirusvirus and adenovirus). Cytomorphology of polyoma BK virus and cytomegalovirus virus is specific but further virological tests, like PCR, should be done for final confirmation. Reported is also increase risk for human papillomavirus cervical abnormalities in HSCT patients. In patients after HSCT because of impaired immunity human herpes (gingivostomatis, pneumonia) and varicella zoster virus reactivation infections could be found. Microbiological diagnostics revealed various microorganisms if other opportunistic infections occur. Thus, beside bacterial, detected are fungal microorganisms (Candida, Aspergillus, Cryptococcus, etc.), parasitic microorganisms - pneumocystis jiroveci and less frequently toxoplasmosis. In such cases cytological analyses of various specimens is also useful in diagnostics.
stem cell transplantation ; cytology
pozvano predavanje
nije evidentirano
nije evidentirano
nije evidentirano
nije evidentirano
nije evidentirano
Podaci o prilogu
26-27.
2012.
nije evidentirano
objavljeno
Podaci o matičnoj publikaciji
Cytopathology
Herbert , Amanda
Oxford: Wiley-Blackwell
0956-5507
Podaci o skupu
37th European Congress of Cytology
pozvano predavanje
30.09.2012-03.10.2012
Cavtat, Hrvatska; Dubrovnik, Hrvatska
Povezanost rada
Kliničke medicinske znanosti, Farmacija