W03_07 immunodeficiency IV Flashcards
how many days in the preengraftment stage (phase I) of a hematopoeitic stem cell transplantation?
< 30
how many days in the postengraftment stage (phase II) of a hematopoeitic stem cell transplantation?
30-100
how many days in the late stage (phase III) of a hematopoeitic stem cell transplantation?
> 100
what effects would you see in phase I HSCT?
neutropenia, mucositis, acute GvHD
what effects would you see in phase II HSCT?
impaired cell immunity, latent infections, acute/chronic GvHD
what effects would you see in phase III HSCT?
impaired cellular and humoral immunity, chronic GvHD
what is mucositis?
leaky mouth, leaky gut
what’s the timeline of infections during HSCT?
neutropenic infections, herpes viruses (phase I and II), fungi (later half of phase II)
what’s a polyoma virus?
a latent virus that reactivates with severe cellular immunosuppression
what’s a papillomavirus?
a latent virus that reactivates with severe cellular immunosuppression
where is the BK virus usually?
urogenital tract - hemorrhagic cystitis in HSCT recipients; BK nephropathy in renal Tx recipients
where is the JC virus usually?
CNS; in transplant recipients, it can cause progressive multifocal leukoencephalopathy
how can we see if a patient has polyoma virus?
might see decoy cells in hemorrhagic cystitis, or virus at the epithelial cells of a kidney in BK nephropathy
what are the 3 components of prevention in HSCT recipients?
prophylaxis (prior), pre-emption (post-infection, pre-overt disease), minimizing exposure
what is CMV and why is it important in transplantation?
cytomegalovirus. 80-90% infected, but immune system fights it off. If CMV transplanted into someone deficient and negative for CMV, then could be devastating
