Naslov
Cytology in patients with hematopoietic stem cell transplantation

Autori
Sučić, Mirna ; Ries, Sunčica ; Gjadrov Kuveždić, Koraljka ; Ljubić, Nives ; Perković, Leila ; Ivanović, Dunja ; Labar, Boris ; Nemet, Damir

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Cytopathology 23 (Supplement 1) - Abstracts of the 37th European Congress of Cytology / Herbert , Amanda - Oxford : Wiley-Blackwell, 2012, 26-27

Skup
37th European Congress of Cytology

Mjesto i datum
Cavtat, Hrvatska; Dubrovnik, Hrvatska, 30.09.2012. - 03.10.2012

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
stem cell transplantation ; cytology

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Farmacija

Napomena
Pozvano predavanje

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