TAILIEUCHUNG - Chapter 126. Infections in Transplant Recipients (Part 15)

Virus-Associated Malignancies In addition to malignancy associated with gammaherpesvirus infection (EBV, KSHV) and simple warts (HPV), other tumors that are virus-associated or suspected of being virus-associated are more likely to develop in transplant recipients, particularly those who require long-term immunosuppression, than in the general population. The interval to tumor development is usually 1 year. Transplant recipients develop nonmelanoma skin or lip cancers that, in contrast to de novo skin cancers, have a high ratio of squamous cells to basal cells. HPV may play a major role in these lesions. Cervical and vulvar carcinomas, quite clearly associated with HPV, develop. | Chapter 126. Infections in Transplant Recipients Part 15 Virus-Associated Malignancies In addition to malignancy associated with gammaherpesvirus infection EBV KSHV and simple warts HPV other tumors that are virus-associated or suspected of being virus-associated are more likely to develop in transplant recipients particularly those who require long-term immunosuppression than in the general population. The interval to tumor development is usually 1 year. Transplant recipients develop nonmelanoma skin or lip cancers that in contrast to de novo skin cancers have a high ratio of squamous cells to basal cells. HPV may play a major role in these lesions. Cervical and vulvar carcinomas quite clearly associated with HPV develop with increased frequency in female transplant recipients. Among renal transplant recipients rates of melanoma are modestly increased and rates of cancers of the kidney and bladder are increased. Vaccination of Transplant Recipients In addition to receiving antibiotic prophylaxis transplant recipients should be vaccinated against likely pathogens Table 126-6 . In the case of HSCT recipients optimal responses cannot be achieved until after immune reconstitution despite previous immunization of both donor and recipient. Recipients of allogeneic HSCTs must be reimmunized if they are to be protected against pathogens. The situation is less clear-cut in the case of autologous transplantation. T and B cells in the peripheral blood may reconstitute the immune response if they are transferred in adequate numbers. However cancer patients particularly those with Hodgkin s disease in whom vaccination has been extensively studied who are undergoing chemotherapy do not respond normally to immunization and titers of antibodies to infectious agents fall more rapidly than in healthy individuals. Therefore even immunosuppressed patients who have not had HSCTs may need booster vaccine injections. If memory cells are specifically eliminated as part of a stem cell .

• Y học thường thức
• Infections in Transplant Recipients
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu y khoa
• Harrisons Internal Medicine
• Transplant infections
• Specific sites of infection
• Bacterial infections
• Immunosuppressive agents
• Transplant Infections in developing countries
• Infections in kidney transplant recipients
• medical books
• pharmacology
• epidemiologic
• Obstetrics
• anatomy
• Preventing Morbidity
• Multidisciplinary Care