Congenital and Acquired Bone Marrow Failure

Author: Aljurf   Mahmoud Deeb;Gluckman   Eliane;Dufour   Carlo  

Publisher: Elsevier Science‎

Publication year: 2016

E-ISBN: 9780128041758

P-ISBN(Paperback): 9780128041529

Subject: R551.3 Bone marrow disease

Keyword: 病理学,基础医学,肿瘤学,血液及淋巴系疾病,内科学

Language: ENG

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Description

Congenital and Acquired Bone Marrow Failure is a comprehensive guide to congenital and acquired bone marrow failure in adult and pediatric patients. Chapters are divided into two sections, acquired aplastic anemia and inherited bone marrow failure syndromes. Content ranges from the basic, to the translational, and from the epidemiology of acquired aplastic anemia and telomere biology, to the management, treatment, and supportive care of pediatric, adult, and geriatric patients.

Contributors are world leading experts in the field of bone marrow failure. The book is required reading for residents, fellows, clinicians, and researchers across hematology, oncology, pathology, bone marrow transplantation, pediatrics, and internal medicine.

  • Provides an overview of all congenital and acquired bone marrow failure syndromes
  • Focuses on the molecular pathogenesis, clinical manifestation and diagnosis, laboratory features, and treatment of each disease within the syndromes
  • Features the area of supportive care which is a topic of great interest to infectious disease physicians and those involved in transfusion services

Chapter

Posthepatitis AA and AA occurring after viral infections

AA and association with toxins/drugs

AA and association with HLA genes

AA and autoimmune disorders

AA during pregnancy

AA postvaccination

Problems with epidemiological studies in AA and future strategies

References

Chapter 2 - Pathophysiology of Acquired Bone Marrow Failure

Introduction: Evidence and Inferences from the Clinic

Pathophysiology

Hematopoiesis in AA

Immune Mechanisms in AA

Clinical Data

T Cells and Cytokines

HLA and Cytokine Gene Polymorphisms

Immune Escape Clones (PNH, 6pLOH)

STAT3 Mutant Clones

Innate Immunity

microRNAs

Autoantibodies

Immune-Mediated BM Failure Mouse Models

Mouse Models of Chemical and Drug Hematopoietic Toxicity

Genetic Risk Factors in AA

Clonal Evolution in AA

Treatments for AA

BMT With Matched Sibling Donors

BMT From Alternative Donors

Experimental HSCT

IST

Eltrombopag

Supportive Care

Conclusions

References

Chapter 3 - Diagnosis of Acquired Aplastic Anemiaa

Introduction

Approach to diagnosis of aplastic anemia

Diagnosis confirmation

Clinical Examination

Complete Blood Count

Bone Marrow Examination

Cytogenetic

Molecular Analysis

Telomere Length Measurement

HLA-Typing

Characterization of aplastic anemia

Exclusion of Congenital Bone Marrow Failures

Differential Diagnosis of AA From the Hypocellular Variant of MDS

AA and PNH

AA and Viral Infections

AA and Hepatitis

Drug-Induced AA

AA Associated With Chemicals

AA and Association With Autoimmune Diseases

AA and HLA-DR Typing

AA and LGL

Diagnostic of AA in the Elderly

Defining Severity of AA

Defining Response After Treatment

Future challenges in the diagnostics of AA

Acknowledgment

References

Chapter 4 - Acquired Overlap Bone Marrow Failure Disorders

Introduction

Hypoplastic MDS

Single lineage cytopenias (pure red cell aplasia or immune thrombocytopenia)

T cell large granular lymphocytes

Paroxysmal nocturnal hemoglobinuria

Congenital marrow failure undiagnosed

Conclusions

References

Chapter 5 - Supportive Care in Aplastic Anemia

Introduction

Prevention of infections by general medical management of aplastic anemia patients

Protective Environment

Protective Isolation

Special Low Bacterial Diet

Individual Hygiene Rules

Prevention of infections by antibiotic/antimycotic/antiviral prophylaxis

Antimycotic Prophylaxis

Antibiotic Prophylaxis

Antiviral Prophylaxis

Vaccination

Hematopoietic growth factors as prophylaxis of infections or in combination with immunosuppression to improve quality of re...

Treatment of infections

Granulocyte Transfusions

Transfusion therapy

Iron chelation therapy

Physical exercise

Gender-specific issues/sex life

Menstrual Cycle

Fertility

Pregnancy

Pregnancy Prevention

Psychological support

References

Chapter 6 - Immunosuppressive Therapy for Aplastic Anemia

The immune defect in aplastic anemia and the rationale for immunosuppressive therapy

Treatment options and indications for IST

ATG: possible mechanisms of action and administration

Historical development of the current standard ATG protocol (horse ATG combined with cyclosporine)

Alternative strategies used in an attempt to improve response to standard IST with ATG + CSA

ATG and CSA Combined With GCSF

ATG and CSA Combined With Additional Immunosuppressive Agents

Use of Rabbit ATG Instead of Horse ATG in First Line IST

Variations in CSA Dose and Duration

Addition of Eltrombopag to ATG and CSA

Conclusions

The use of alemtuzumab in AA

Treatment of NSAA

Predictive factors for response to ATG

Repeat courses of ATG for nonresponse and relapse

Clonal transformation to MDS/AML after IST

Future directions

References

Chapter 7 - Identical Sibling Donor Transplantation

Introduction

Indication for identical sibling donor transplantation

Conditioning regimen

Syngeneic stem cell transplantation in aplastic anemia

The source of the stem cells

Posttransplantation immunosuppression

Posttransplant Care

Chimerism

Survival

Fertility

Secondary Malignancy

References

Chapter 8 - Unrelated Donor Transplants for Acquired Aplastic Anemia

Eligibility in acquired SAA for UD transplantation

Upper age limit for UD transplants

Outcome of patients activating a UD search

HLA matched or mismatched donors

Graft rejection and stem cell source

Cyclophosphamide and the conditioning regimen for UD transplants

An update of EBMT data on UD transplants

Alemtuzumab instead of ATG

Graft versus host disease prophylaxis

Improvement of UD transplants with time and supportive care

Conclusions

References

Chapter 9 - Umbilical Cord Blood Transplantation for Patients With Acquired and Inherited Bone Marrow Failure Syndromes on Beha...

Introduction

Candidates for cord blood transplantation for aplastic anemia

HLA-identical sibling cord blood transplant: Eurocord results

Unrelated cord blood transplantation for BMFS

Results of Unrelated Cord Blood Transplants for Idiopathic Aplastic Anemia

Results of Unrelated Cord Blood Transplants for Fanconi Anemia

Results of Cord Blood Transplant for Hereditary BMF Other than Fanconi Anemia

Recommendations for cord blood transplantation in BMF

Future directions

References

Chapter 10 - Haploidentical Transplantation

Ex vivo T-cell depletion

Unmanipulated graft haplo-SCT

Conclusions

References

Chapter 11 - Management of Acquired Aplastic Anemia in Children

Diagnosis and clinical characteristics

Supportive treatment

General concepts for specific treatment

Options for first-line treatment

HSCT from MSD

Immunosuppressive Therapy

HSCT from MUD

Options for second line treatments

Options for third line treatments

Haploidentical HSCT

Cord Blood Transplant

Other Nontransplant Treatments

References

Chapter 12 - Treatment of Elderly Patients With Aplastic Anemia

Aging and Its Consequences on the Approach to Treatment

Comprehensive Geriatric Assessment

Treatment of Aplastic Anemia in the Elderly

Immunosuppression in the Elderly

Algorithm for First-Line Treatment of Elderly Aplastic Anemia Patients

Transplantation in the Elderly

Open Questions in the Treatment of Elderly Patients With Aplastic Anemia

Conclusions

Acknowledgments

References

Chapter 13 - Emerging New Therapies for Acquired Bone Marrow Failure Disorders

Introduction

Alternative Strategies of Immunosuppression

Adding a Third Immunosuppressive Agent

Mycophenolate Mofetil

Rapamycin/Sirolimus

Replacing h-ATG With Other Lymphocyte-Depleting Agents

Rabbit ATG

Cyclophosphamide

Alemtuzumab

The Lesson From Alternative Lymphocyte-Depleting Agents

Novel Strategies Without Conventional Lymphocyte Depletion

Nonimmunosuppressive Strategies

Androgens

Eltrombopag

Combination Strategies

Conclusions

References

Chapter 14 - Bone Marrow Failure in Paroxysmal Nocturnal Hemoglobinuria

Introduction

Pathophysiology of BMF in PNH

Derangement of the Immune System

The Dual Pathophysiology Theory

The Role of Somatic Mutations

PNH clone in patients with BMF

PNH Disease Subcategories

The Clinical Relevance of a PNH Clone in the Context of BMF

Pathophysiology

Risk of Thrombosis

Evolution to Classic PNH

Treatment

Immunosuppressive Therapy

Hematopoietic Stem Cell Transplantation

Eculizumab Treatment

Conclusions

References

Chapter 15 - Telomere Biology and Disease

Introduction

Molecular biology of telomeres and telomerase

Genotype and phenotype in telomere disease

Telomerase Complex Mutations

Shelterin Complex Mutations

Additional Mutations

Bone marrow, organ failure, and malignancy in telomeropathies

Bone Marrow Failure

Pulmonary Disease

Liver Disease

Telomeres and Malignancy Risk

Diagnosis of telomere disease

Conclusions

References

Chapter 16 - Fanconi Anemia

Introduction

Diagnosis and staging

Clinical Presentation

Evaluating New Onset Cytopenia in Children

Diagnosis and Staging

Hematopoietic stem cell transplantation (HSCT)

HLA Identical Sibling Transplants

Alternative Donor Transplants

Matched Unrelated Donors

Cord Blood Transplantation

FA Patients With MDS and AML

Post-HCT monitoring in FA

Conclusions

References

Chapter 17 - Ribosomopathies and the Quality Control of Ribosome Assembly

Introduction

Diamond–Blackfan anemia

Clinical Features

Diagnostic Criteria

Genetics

Molecular Pathophysiology

Management

Shwachman–Diamond syndrome

Clinical Features

Hematology

Solid Tumors

Gastrointestinal Tract

Skeletal

Neurocognitive

Cardiac

Miscellaneous

Diagnosis

Clinical Management

Genetics

SBDS Protein Structure

Function of SBDS in Large Ribosomal Subunit Maturation

Alternative Models for eIF6 Release

Putative Extraribosomal Functions of the SBDS Protein

Visualizing SBDS and EFL1 Bound to the Ribosome

Interpreting Pathologic SBDS Missense Variants

Interpreting uL16 (RPL10) Mutations in Pediatric T-ALL

Proposed Mechanism of eIF6 Release by SBDS and the GTPase EFL1

SBDS and the Quality Control of Ribosome Assembly

How Do We Explain the SDS Phenotype?

Additional ribosomopathies

Conclusions

Acknowledgments

References

Chapter 18 - Dyskeratosis Congenita

Background

Pathobiology

Clinical features

Diagnosis

Management

Androgens

Immune Suppressive Therapy

Growth Factors

Hematopoietic Cell Transplantation

Choice of a Suitable Conditioning Regimen

Choice of a Suitable Donor

Matched related donors

Matched unrelated donors

Unrelated cord blood transplantation

Haploidentical transplantation

Does Transplantation Accelerate Pulmonary Complications?

Conditioning and Cancer Risk

Conclusions

References

Chapter 19 - Amegakaryocytic Thrombocytopenia

Introduction

Molecular Pathogenesis

Clinical Manifestation and Diagnosis

Laboratory Features

Treatment and Supportive Care

HSCT

Source of Stem Cells

Cell Dose

Graft Versus Host Disease Prophylaxis

References

Chapter 20 - Severe Congenital Neutropenias and Other Rare Inherited Disorders With Marrow Failure

Severe congenital neutropenia

Definition, Epidemiology, and Genetics

Physiopathologic Mechanism

Diagnosis and Clinical Phenotype

Natural History

Treatment

Other rare diseases

Osteopetrosis

Definition, Epidemiology, Genetics, and Physiopathologic Mechanism

Clinical Picture, Diagnosis, and Differential Diagnosis

Treatment

Pearson Syndrome

Definition, Epidemiology, and Pathogenic Mechanism

Clinical Phenotype

Laboratory

Treatment

Survival

Congenital Dyserythropoietic Anemia

References

Chapter 21 - Bone Marrow Failure Syndromes in Children

Introduction

Next generation sequencing for inherited BMFs

Childhood aplastic anemia and refractory cytopenia of childhood

The treatment algorithm for severe AA in children

References

Index

Back cover

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