Bone marrow suppression and associated consequences in patients after heart transplantation: A 6-year retrospective review

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F15%3A00059547" target="_blank" >RIV/00023001:_____/15:00059547 - isvavai.cz</a>

Výsledek na webu

<a href="http://biomed.papers.upol.cz/pdfs/bio/2015/03/06.pdf" target="_blank" >http://biomed.papers.upol.cz/pdfs/bio/2015/03/06.pdf</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.5507/bp.2015.022" target="_blank" >10.5507/bp.2015.022</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Bone marrow suppression and associated consequences in patients after heart transplantation: A 6-year retrospective review

Popis výsledku v původním jazyce

Aims. To evaluate the incidence of bone marrow suppression and consequences of MMF dose adjustment in patients within the first year after heart transplantation. Methods. Group I (n=47) was treated with a regimen currently used in patients after heart transplantation (mycophenolatemofetil - MMF, valganciclovir - VGC and trimethoprim/sulfamethoxazole - TMP-SMX). Group II (n=47) received only MMF of potentially myelotoxic medications. The myelotoxic effect and need for dose modification were assessed. The incidence of rejections and infectious episodes associated with MMF adjustment were analyzed during the first 12 months in Group I. Results. There was a significantly greater proportion of patients with leukopenia (leukocyte count < 4 x 10<^>9/L) at 3 months after orthotopic heart transplantation in Group I compared with Group II (19.1% vs 2.1%; P=0.02). The difference in lymphopenia (lymphocyte count < 0.8 x 10<^>9/L) at 3 months follow-up was highly significant (38.3 % vs 6.4 %; P=0.0002). MMF was modified due to bone marrow suppression or severe infection in 63.8% patients in Group I and in only 8.5% of patients in Group II (P < 0.001). Reducing or stopping MMF was not associated with increased rejections. In Group I, at least 1 episode of higher degree cellular or humoral rejection occurred in 35% of patients with the standard MMF dosage compared with only 26% in patients with modified MMF (P=0.0534). Conclusions. Addition of VGC+TMP-SMX to current immunosuppressive medication regimen in patients after heart transplantation is associated with significant lymphocytopenia and leukopenia. Importantly, modification of immunosuppressive prophylaxis (reducing or stopping MMF) leads to normalization of blood count without increased incidence of rejections.

Název v anglickém jazyce

Bone marrow suppression and associated consequences in patients after heart transplantation: A 6-year retrospective review

Popis výsledku anglicky

Aims. To evaluate the incidence of bone marrow suppression and consequences of MMF dose adjustment in patients within the first year after heart transplantation. Methods. Group I (n=47) was treated with a regimen currently used in patients after heart transplantation (mycophenolatemofetil - MMF, valganciclovir - VGC and trimethoprim/sulfamethoxazole - TMP-SMX). Group II (n=47) received only MMF of potentially myelotoxic medications. The myelotoxic effect and need for dose modification were assessed. The incidence of rejections and infectious episodes associated with MMF adjustment were analyzed during the first 12 months in Group I. Results. There was a significantly greater proportion of patients with leukopenia (leukocyte count < 4 x 10<^>9/L) at 3 months after orthotopic heart transplantation in Group I compared with Group II (19.1% vs 2.1%; P=0.02). The difference in lymphopenia (lymphocyte count < 0.8 x 10<^>9/L) at 3 months follow-up was highly significant (38.3 % vs 6.4 %; P=0.0002). MMF was modified due to bone marrow suppression or severe infection in 63.8% patients in Group I and in only 8.5% of patients in Group II (P < 0.001). Reducing or stopping MMF was not associated with increased rejections. In Group I, at least 1 episode of higher degree cellular or humoral rejection occurred in 35% of patients with the standard MMF dosage compared with only 26% in patients with modified MMF (P=0.0534). Conclusions. Addition of VGC+TMP-SMX to current immunosuppressive medication regimen in patients after heart transplantation is associated with significant lymphocytopenia and leukopenia. Importantly, modification of immunosuppressive prophylaxis (reducing or stopping MMF) leads to normalization of blood count without increased incidence of rejections.

Druh

J_x - Nezařazeno - Článek v odborném periodiku (Jimp, Jsc a Jost)

CEP obor

FA - Kardiovaskulární nemoci včetně kardiochirurgie

OECD FORD obor

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Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2015

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Biomedical papers

ISSN

1213-8118

e-ISSN

—

Svazek periodika

159

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

CZ - Česká republika

Počet stran výsledku

6

Strana od-do

372-377

Kód UT WoS článku

000364948100006

EID výsledku v databázi Scopus

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