Dissertation/ Thesis
Complement system and vascular complications in pediatric allogeneic hematopoietic stem cell transplantation ; Komplementtijärjestelmä ja verisuoniperäiset komplikaatiot lasten allogeenisissa kantasolusiirroissa
| العنوان: | Complement system and vascular complications in pediatric allogeneic hematopoietic stem cell transplantation ; Komplementtijärjestelmä ja verisuoniperäiset komplikaatiot lasten allogeenisissa kantasolusiirroissa |
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| المؤلفون: | Leimi, Lilli |
| المساهمون: | Helsingin yliopisto, lääketieteellinen tiedekunta, Helsingfors universitet, medicinska fakulteten, University of Helsinki, Faculty of Medicine, Salmenniemi, Urpu, Vettenranta, Kim, Meri, Seppo |
| بيانات النشر: | Helsingin yliopisto Helsingfors universitet University of Helsinki |
| سنة النشر: | 2024 |
| المجموعة: | Helsingfors Universitet: HELDA – Helsingin yliopiston digitaalinen arkisto |
| مصطلحات موضوعية: | 3122 Syöpätaudit, 3123 Naisten- ja lastentaudit, 3122 Cancersjukdomar, 3123 Kvinno- och barnsjukdomar, 3122 Cancers, 3123 Gynaecology and paediatrics, lääketiede, Doctoral Program in Clinical Research, Kliininen tohtoriohjelma, Doktorandprogrammet i klinisk forskning |
| الوصف: | Hematopoietic stem cell transplantation (HSCT) is a well-established therapy for hematologic and lymphoid malignancies as well as inborn or acquired disorders of the immune or hematopoietic systems and metabolism. The overall survival has improved over time, yet, treatment-related morbidity and mortality remain a challenge. Endothelial cell activation and dysfunction have recently been considered to be involved in many severe complications of allo-HSCT. Thrombotic microangiopathy (TMA) is one of the most well established endotheliopathy syndromes and now recognized as a severe complication in HSCT. TMA has been linked to complement activation. In this study we examined adverse events post-HSCT and the complement system, its activation and factors contributing to it, among 164 pediatric patients who underwent an allogeneic HSCT at the Helsinki University Children´s Hospital between 2001-2020. This thesis tests the hypothesis that HSCT as a process and possible genetic predisposition of the patient may cause excessive complement activation leading to treatment-related complications. In this study we were especially interested in the clinical findings explainable through inadequate complement regulation. We describe the incidence, clinical phenotype, and timing of the vascular complications. This study also addresses the question of the effect of stem cell infusion on the activation of the complement cascade in the recipient peri-transplant, and the activation of the complement system during the entire process of hematopoietic stem cell transplantation. We also determined the relevant genotype of the patient for the key components of the complement system and related the genotype to the level of complement activation and acute toxic events encountered. Our study shows that acute toxic events remain a significant problem in pediatric allogeneic HSCT. We report 75-93% of the patients having at least one, grade 2-4 toxic event prior to day 100 post-transplant. Up to one half of the observed adverse events are severe. ... |
| نوع الوثيقة: | doctoral or postdoctoral thesis |
| وصف الملف: | application/pdf; fulltext |
| اللغة: | English |
| ردمك: | 978-952-84-0275-6 952-84-0275-5 |
| تدمد: | 2954-2898 2954-2952 |
| Relation: | Dissertationes Universitatis Helsingiensis; 208/2024; http://hdl.handle.net/10138/585156 |
| الاتاحة: | http://hdl.handle.net/10138/585156 |
| Rights: | Julkaisu on tekijänoikeussäännösten alainen. Teosta voi lukea ja tulostaa henkilökohtaista käyttöä varten. Käyttö kaupallisiin tarkoituksiin on kielletty. ; This publication is copyrighted. You may download, display and print it for Your own personal use. Commercial use is prohibited. ; Publikationen är skyddad av upphovsrätten. Den får läsas och skrivas ut för personligt bruk. Användning i kommersiellt syfte är förbjuden. |
| رقم الانضمام: | edsbas.A85DBCAA |
| قاعدة البيانات: | BASE |
| ردمك: | 9789528402756 9528402755 |
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| تدمد: | 29542898 29542952 |