Dissertations / Theses on the topic 'Trapianto allogenico'
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Sessa, Mariarosaria <1989>. "Metilazione del DNA e Trapianto Allogenico di Cellule Staminali Emopoietiche." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2022. http://amsdottorato.unibo.it/10248/1/tesi%20dottorato%20FINALE%20caricata.pdf.
Full textAllogeneic hematopoietic stem cell transplantation (HSCT) is a well-established therapy for several life-threatening hematological disorders, mostly malignancies. However, non-relapse mortality (NRM) has limited its use in patients aged over 65 years. Nowadays age cannot be considered an absolute contraindication for this treatment and the use of transplantation, in patient groups once considered unsuitable, is increasing significantly. NRM is due to three types of complications: immunological (graft versus host disease), infectious and toxic. Organ toxicity is directly related to the intensity of conditioning which is therefore reduced in case of comorbidities and in elderly patients. However, reducing the intensity of chemotherapy also means increasing the risk of relapse of the underlying haematological disease and therefore this adjustment must consider aging and comorbidity indexes in order not to reduce the curative potential of the transplant. To evaluate comorbidities we have a highly predictive score (the Comorbidity Index Score by Sorror, HCT-CI), while to evaluate aging there is a great clinical need to apply innovative biological age markers. The present work aims to evaluate the state of DNA methylation, a biological age index, in the setting of patients undergoing allogeneic haematopoietic stem cell transplantation for all haematological indication. The aim is also to correlate the epigenome with the transplant risk of the single individual.
Gimondi, S. A. "IDENTIFICAZIONE DI NUOVE VIE DI SEGNALE E MARCATORI PREDITTIVI DELLA MALATTIA DEL TRAPIANTO CONTRO L'OSPITE DOPO TRAPIANTO ALLOGENICO DI CELLULE STAMINALI EMATOPOIETICHE." Doctoral thesis, Università degli Studi di Milano, 2014. http://hdl.handle.net/2434/232967.
Full textGUARONA, GIULIA. ""Valutazione della profilassi con Letermovir nei pazienti CMV positivi sottoposti a trapianto di midollo allogenico"." Doctoral thesis, Università degli studi di Genova, 2020. http://hdl.handle.net/11567/1004086.
Full textMariotti, J. "MODULAZIONE DEL SIGNALING DI STAT PER PREVENIRE IL RIGETTO DEL TRAPIANTO DI MIDOLLO OSSEO ALLOGENICO." Doctoral thesis, Università degli Studi di Milano, 2013. http://hdl.handle.net/2434/217168.
Full textVendramin, A. "RICOSTITUZIONE IMMUNITARIA IN PAZIENTI SOTTOPOSTI A TRAPIANTO ALLOGENICO DI CELLULE STAMINALI EMOPOIETICHE: VALUTAZIONI A LUNGO TERMINE." Doctoral thesis, Università degli Studi di Milano, 2012. http://hdl.handle.net/2434/214347.
Full textMARANI, CARLO. "IL TRAPIANTO DI MIDOLLO OSSEO ALLOGENICO DA DONATORE APLOIDENTICO NEI PAZIENTI CON LINFOMA DI HODGKIN RICADUTO/REFRATTARIO." Doctoral thesis, Università degli studi di Genova, 2019. http://hdl.handle.net/11567/945481.
Full textTENDAS, ANDREA. "Fotoaferesi extracorporea come terapia di prima linea nel trattamento della GVHD cronica dopo trapianto allogenico di cellule staminali." Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2008. http://hdl.handle.net/2108/649.
Full textBackground. Chronic graft versus host disease (cGVHD) is the major late complication after allogeneic stem cell transplantation. Standard therapy is steroid and Cyclosporine-A (CyA); however, immune suppression (ISS) related infections or unresponsiveness to ISS, are major mortality causes. Extracorporeal photopheresis (ECP) has shown activity in treatment of cGVHD, but its use has been limited to first-line-unresponsive cGVHD. Aim of the study. This is a single center pilot study testing feasibility of a programme of photopheresis in association with standard therapy as first line treatment in high risk cGVHD. High risk was defined as the presence of parameters predicting high cGVHD-related mortality. Secondary objectives were response and complications incidence. Patients. Among 10 pts fitting enrolling criteria, 2 refused due to logistic problem or low compliance with the procedure, 8 were enrolled. Median age was 40. Donor was HLA identical sibling in 7 cases and MUD in 1. All cases presented with extensive/moderate-severe cGVHD; Akpek score was > 0 in 3/8 pts. Treatment plan. Pts started with Prednison (PDN) 1 mg/kg and CyA at cGVHD diagnosis; ECP was started with a frequency of 4 application/month in the first 3 months and 2/month for the subsequent 9 months; PDN and CyA were slowly reduced until suspension, or otherwise modulated. Study duration was 1 year. Pts were ruled out the study in case of ECP suspension, requirement of other ISS drugs in case of GVHD progression unresponsive to standard therapy, or severe infections. Response was evaluated with standard criteria, as progression, partial response (PR), very good PR (vgPR) or complete response (CR). Results. Adherence to protocol was: 6/8 pts at 3 months, 4/8 at 6 and 9 months, 3/8 at 12 mm; exit from the study was due to infectious complications (2), ECP suspension due to venous access related thrombosis (1) and clear cGVHD progression (2). In evaluable pts, response (CR+very good PR / <=PR) per trimester was 4/6, 2/4 and 3/4 at I, II and III respectively; at the IV trimester, 1 very good PR, 2 PR and 1 progression were observed. Complications were observed in 4 pts with : 1 case of pneumonia, 1 case of urinary tract infection, 3 cases of CMV antigenemia activation, 1 case of condilomatosis, 1 case of catheter related infection, 1 case of catheter related thrombosis and 1 case of hemolitic uremic syndrome. At 1 year, 2/8 pts died (1 TRM, 1 relapse). Conclusion. ECP in association with standard therapy is feasible; complications incidence seems to be similar to those observed in patients not treated with ECP; a larger group of patients is needed to evaluate response in this setting.
Cattina, Federica <1983>. "Studio dei polimorfismi genici degli antigeni minori di istocompatibilità e GvHD/GvL nel trapianto allogenico di cellule staminali emopoietiche." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5672/1/Cattina_Federica_tesi.pdf.
Full textThe outcome of allogeneic stem cell transplantation (Allo-SCT) is closely related to graft versus host disease (GvHD) and graft versus leukemia (GvL) effects which, in part, are mediated by mHAgs. Twenty-six mHAgs have been identified and reported to be differently and variably correlated with GVHD or GVL, but a simultaneous method to genotype a so large panel of mHAgs has never been employed. The aim of this work has been to develop a feasible method to genotype all the 26 mHAgs described so far and to test them for their correlation with GVHD and GVL in a group of donor/recipient pairs submitted to allo-SCT. For a multi-genotyping of 23 mHAgs we used iPlex Gold Mass Array technology (3 multiplex). For the other three mHAgs we designed other three assays based on conventional molecular biology. By these methods, we tested the 26 mHAgs in 46 donor/recipient pairs full-matched that underwent allo-SCT (sibling or MUD) because of Philadelphia positive CML (n=46) or ALL-Ph+ (n=24). Maldi-Tof IPlex Gold technology proved a high degree of efficiency (98.6%). As expected, sibling pairs showed most identity of MUD pairs. Notably, donor/recipient mismatch on ACC-1, ACC-4, ACC-5, LB-MTHFD1-1Q, UGT2B17, DPH1, LRH1 can drive GvHD effect (p<0.01). Next we identified that LB-ADIR1 can enhance (p=ns, but there is a trend) GvL effect specially on ALL-Ph+ that is otherwise un-responsible to allo-immunotherapy. Our data generated by a multi-genotype technique confirm the role of mHAgs in addressing GvL (in some cases without GvHD) and suggest that a study of mHAgs could be perfomed before transplant in order to better investigate the role of the known and new mHAgs involved in GvHD and GvL effects.
Cattina, Federica <1983>. "Studio dei polimorfismi genici degli antigeni minori di istocompatibilità e GvHD/GvL nel trapianto allogenico di cellule staminali emopoietiche." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2013. http://amsdottorato.unibo.it/5672/.
Full textThe outcome of allogeneic stem cell transplantation (Allo-SCT) is closely related to graft versus host disease (GvHD) and graft versus leukemia (GvL) effects which, in part, are mediated by mHAgs. Twenty-six mHAgs have been identified and reported to be differently and variably correlated with GVHD or GVL, but a simultaneous method to genotype a so large panel of mHAgs has never been employed. The aim of this work has been to develop a feasible method to genotype all the 26 mHAgs described so far and to test them for their correlation with GVHD and GVL in a group of donor/recipient pairs submitted to allo-SCT. For a multi-genotyping of 23 mHAgs we used iPlex Gold Mass Array technology (3 multiplex). For the other three mHAgs we designed other three assays based on conventional molecular biology. By these methods, we tested the 26 mHAgs in 46 donor/recipient pairs full-matched that underwent allo-SCT (sibling or MUD) because of Philadelphia positive CML (n=46) or ALL-Ph+ (n=24). Maldi-Tof IPlex Gold technology proved a high degree of efficiency (98.6%). As expected, sibling pairs showed most identity of MUD pairs. Notably, donor/recipient mismatch on ACC-1, ACC-4, ACC-5, LB-MTHFD1-1Q, UGT2B17, DPH1, LRH1 can drive GvHD effect (p<0.01). Next we identified that LB-ADIR1 can enhance (p=ns, but there is a trend) GvL effect specially on ALL-Ph+ that is otherwise un-responsible to allo-immunotherapy. Our data generated by a multi-genotype technique confirm the role of mHAgs in addressing GvL (in some cases without GvHD) and suggest that a study of mHAgs could be perfomed before transplant in order to better investigate the role of the known and new mHAgs involved in GvHD and GvL effects.
Zama, Daniele <1981>. "La relazione tra il microbiota intestinale e la Graft versus Host Disease nel paziente pediatrico sottoposto a trapianto allogenico di cellule staminali emopoietiche." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7407/1/ZAMA_DANIELE_TESI.pdf.
Full textThe impact of the gut microbiota(MI) on allogeneic hematopoietic stem cell transplantation(HSCT) has been recently demonstrated. This observation supported the idea of a significant role of MI in the immunological reconstruction after HSCT and in the genesis of acute Graft-versus-Host-Disease(GvHD). We therefore conducted the first longitudinal study on the role of MI in the onset of GvHD in pediatric patients undergoing HSCT. 10 patients were enrolled, including 5 with GvHD. For each patient were collected seriated fecal samples every 10-15 days up to 100 days after HSCT. The phylogenetic profile of MI was characterized by pyrosequencing 454 of the hypervariable V4 region of the 16S rRNA subunit. The functional profile was evaluated by analysis of fatty acid-fat-to-short-chain using the gas chromatography-mass spectroscopy. After HSCT a profound structural and functional destruction of the normal position mutualistic gut ecosystem was observed. The reconstruction of the trajectory of the MI after HSCT was significantly different between patients with and without GVHD. In particular, in patients without GVHD, a precise of the MI signature before the HSCT was highlighted, characterized by a high concentration of Bacteroidetes and Parabacteoidetes(p <0.05, Fig. 1). In parallel in patients without GVHD it was observed a significant increase of the fatty-acid-to-short-chain and in particular propionate(p <0.05). This characteristic signature was projected after HSCT, persisting to the intestinal ecosystem destruction and demonstrating the high adaptability of these germs. Our data indicate that the intestinal microbial ecosystem dynamics can be a factor influencing the onset of GvHD. In particular, the presence of a mutualistic profile pre-HSCT of the MI, characterized by the presence of germs producers of acid-fat-to-short-chain recognized with immunomodulatory, seems to mitigate the risk of developing GVHD. These results therefore open new perspectives on the possibility of manipulating the MI pre-HSCT to modulate the reconstruction of the immune system.
Zama, Daniele <1981>. "La relazione tra il microbiota intestinale e la Graft versus Host Disease nel paziente pediatrico sottoposto a trapianto allogenico di cellule staminali emopoietiche." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2016. http://amsdottorato.unibo.it/7407/.
Full textThe impact of the gut microbiota(MI) on allogeneic hematopoietic stem cell transplantation(HSCT) has been recently demonstrated. This observation supported the idea of a significant role of MI in the immunological reconstruction after HSCT and in the genesis of acute Graft-versus-Host-Disease(GvHD). We therefore conducted the first longitudinal study on the role of MI in the onset of GvHD in pediatric patients undergoing HSCT. 10 patients were enrolled, including 5 with GvHD. For each patient were collected seriated fecal samples every 10-15 days up to 100 days after HSCT. The phylogenetic profile of MI was characterized by pyrosequencing 454 of the hypervariable V4 region of the 16S rRNA subunit. The functional profile was evaluated by analysis of fatty acid-fat-to-short-chain using the gas chromatography-mass spectroscopy. After HSCT a profound structural and functional destruction of the normal position mutualistic gut ecosystem was observed. The reconstruction of the trajectory of the MI after HSCT was significantly different between patients with and without GVHD. In particular, in patients without GVHD, a precise of the MI signature before the HSCT was highlighted, characterized by a high concentration of Bacteroidetes and Parabacteoidetes(p <0.05, Fig. 1). In parallel in patients without GVHD it was observed a significant increase of the fatty-acid-to-short-chain and in particular propionate(p <0.05). This characteristic signature was projected after HSCT, persisting to the intestinal ecosystem destruction and demonstrating the high adaptability of these germs. Our data indicate that the intestinal microbial ecosystem dynamics can be a factor influencing the onset of GvHD. In particular, the presence of a mutualistic profile pre-HSCT of the MI, characterized by the presence of germs producers of acid-fat-to-short-chain recognized with immunomodulatory, seems to mitigate the risk of developing GVHD. These results therefore open new perspectives on the possibility of manipulating the MI pre-HSCT to modulate the reconstruction of the immune system.
MIRABILE, MILENA. "La potenziale applicazione del trapianto allogenico secondo una politica allargata della ricerca del donatore: analisi di intenzione al trattamento effettuata presso il Rome Transplant Network." Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2009. http://hdl.handle.net/2108/209070.
Full textRome Transplant Network (RTN), founded in April 2006, represents a Metropolitan Transplant Program involving seven transplant centers. The policy of RTN for patients (pts) lacking of a HLA identical sibling and candidate to an allogeneic hematopoietic stem cell transplant (HSCT) is the contemporary search for an alternative HSC source such as Matched Unreleted Donor (MUD), Cord Blood (CB) or Haploidentical Related Donor (HRD). The aim of the study is the identification of a suitable donor in order to perform transplant procedure in adequate timing. Data were obtained from RTN database. The selection criteria for MUD consist of a 8/10 HLA loci matching tested at low resolution for class I HLA and at high resolution (HR) for class II. Selection criteria for single CB unit are based on cell doses TNC > 3x107 / kg and CD34+ > 1x 105 / kg and on a > 4/6 HLA antigen compatibility. From April 2006, the haploidentical option was also simultaneously considered, so all closer family members have been tested for the HLA. Mother was considered as 1st choice. Here, we report the results of the intention to treat (ITT) analysis on the potential therapeutic impact of our transplant policy. From April 2006 to December 2010, 428 out of 462 candidate pts have been considered eligible to receive an allogeneic HSCT for hematological desease. HLA identical sibling donor was available in 146 out of 428 (34%) cases, while a search process for an alternative donor was activated for 282 (66%) pts. 13 pts are too early to be evaluated and we were not able to identify any alternative donor for 25 (9%) of the 269 (95%) remaining pts because of 40%, affected by Haemoglobinopathies, requiring more restricted HLA matching criteria. An alternative donor was identified for 244 (91%) of these 269 pts. Despite the identification of an alternative donor, 51 (20%) pts lost the eligibility during the search process because of several causes. To date, 193 (80%) of 244 pts have been definitively transplanted (50 CB; 73 MUD; 54 HRD) or are willing to proceed towards the transplant (n = 16), while 146 pts have been grafted from a HLA identical siblings. In summary, a suitable donor was identified for 390 (91%) of 428 pts eligible for an allogeneic transplant which could be performed in 339 (80%) of them. From this ITT analysis, we can conclude that, by adopting the RTN policy of widespread donor search and multiple transplant options, the allogeneic transplant can be offered as a potential therapeutic procedure to a large majority of pts.
PILUDU, MARIA BONARIA. "Associazione tra i polimorfismi dei geni NOD2/CARD15, TLR-4, IL23R e GVHD, infezioni e mortalità precoce nel trapianto allogenico di cellule staminali ematopoietiche nella popolazione pediatrica sarda talassemica, ampliamento del progetto con lo studio molecolare di altri geni candidati." Doctoral thesis, Università degli Studi di Cagliari, 2016. http://hdl.handle.net/11584/266633.
Full textCastellini, Claudia <1973>. "Protocollo per l'impiego di cellule staminali mesenchimali (MSC) nella profilassi e terapia della GvHD acuta insorta in bambini affetti da tumore solido sottoposti a trapianto allogenico di cellule staminali emopoietiche." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2011. http://amsdottorato.unibo.it/3330/1/Castellini_Claudia_Tesi.pdf.
Full textCastellini, Claudia <1973>. "Protocollo per l'impiego di cellule staminali mesenchimali (MSC) nella profilassi e terapia della GvHD acuta insorta in bambini affetti da tumore solido sottoposti a trapianto allogenico di cellule staminali emopoietiche." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2011. http://amsdottorato.unibo.it/3330/.
Full textTumino, Manuela Rossella. "Espressione genica e Profilo Fosfoproteomico nella Malattia del Trapianto contro l Ospite in bambini sottoposti a trapianto di cellule staminali ematopoietiche: confronto tra forma acuta e forma cronica." Doctoral thesis, Università di Catania, 2013. http://hdl.handle.net/10761/1375.
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