Cord blood transplantation in Ho Chi Minh Center for hematology and blood transfusion

On January and June, 2002 four Cord Blood Transplantations were implemented at HCMC Blood Transfusion Hematology Center with ALL, AML, CML and (Thalassemia, where a relation and three unrelation, Results: ANC>0.5x109 L/L: 21 days (relation) and 45 days (unrelation). Platelet count of >50x109 L/L: 27 days (relation) and 60 days (unrelation).

Autologous peripheral blood stem cell transplantation without cryopreservation in the acute myeloid leukemia

From 11/1997 to 8/2000, 11 patients with acute myeloid leukemia (AML) were performed autologous peripheral blood stem cell (PBSC) transplantation without cryopreservation. PBSC were mobilized by high-dose cyclophosphamide plus granulocyte colony-stimulating factor.When WBC count reached>5x109/l, leukapheresis was started and continued for 3 consecutive days. As soon as the third collection was finished, mephalan was given as a conditioning regimen. 24-42 hours after giving melphalan, the collected PBSC which were preserved at +40C were reinfused. Granulocyte macrophage colony-stimulating factor was given during the nardir period until the an ANC> 1x 109/l for 3 consecutive days. All the patients were engrafted with the mean no time to recover ANC> 0.5x109/l and platelet count > 20x109/l was 14 days and 33.8 days. Overall survival and disease free survival at 2 years were 77.7% and 76.1% respectively. In conclusion, autologous PBSC transplantation without cryopreservation in AML is simple and economic method which may be applied in developing countries.

The treatment of the acute myeloid leukemia by guideline of 7-3-5 (CDE: cytarabine, daurorubicin, etoposide)

Induction chemotherapy of 7-3-5 protocol (cytarabine, daunorubicin, etoposide) in acute myeloid leukemia. Between October 1998 and October 1999, 10 patients with AML (4M, 6F, median age 31) were treated with induction chemotherapy of 7-3-5 protocol at the blood transfusion and hematology center, HCM city. A complete remission was achieved in 9 of 10 patients. 1 patient died from transfusion- associated graft- versus- host disease. The median time to recover ANC> 05x 109/1 and platelets> 20x109/1 were 16 days. Oral mucositis was mild in 2 patients. 7-3-5 protocol may be more effective than 7-3 protocol in response rate and prolonged remission but toxicity was similar.

The situation of the treatment of the hematologic diseases in Ho Chi Minh city Blood Transfussion Hematology Center

Ho Chi Minh city Blood Transfusion Hematology Center in ten years (1990-1999) admitted 6,896 cases of blood disease. The percentages are as follows: the highest acute leukemia: 34.16% (AML: 18.43%; ALL: 15.57%); aplastic anemia: 8.98%. Anemia mainly hypochromic 8.48%. Myeloproliferative syndrome 7.98% of which CMV comprises 7.42%.

The graft- versus host disease due to blood transfussion: report of a case received blood transfussion in the Ho Chi Minh center for hematogy and blood transfusion

A 33 years old female with acute myeloid leukemia was treated with induction chemotherapy of 7-3-5 protocol (Cytarabine, Daunorubicine, Etoposide). On day 15 of chemotherapy; 15 days from the first blood transfusion and 1 day from the last, she developed high-grade fever, general erythroderma, diarrhea, hyperbilirubinemia and evaluation of liver enzymes. A diagnosis of TA- GVHD was suspected. The patients had no response to any therapy and expired 5 days later. TA-GVHD is uncommon complication; there is no effective therapy and high mortality. Since TA- GVHD can be prevented by irradiating blood products with 2,500- 3,500 rads, patients at high risk should receive irradiated blood products only.

Quality control of the total blood, erythroprecipitin and condensed thrombocyte according to the ISO 9002 in the Ho Chi Minh Center for hematology and blood transfusion

203 products of total blood and 203 products of the erythroprecipitin undergone the quality control during 1/200-27/9/2000. The results have shown that the blood volume of 4.92% products was lower than 250 ml and level of hemoglobin of 1% products was lower than 22g among 203 controlled products of the total blood; volume of 2.11% products was less than 125ml and of 12.67% products was more than 125 ml; the level of hemoglobin of 100% products was higher than 22 g and of 80% products was higher than 25g, the hematocrite of 4.22% products was higher than 0.75 l/l among 142 controlled products of the erythroprecipitin. The conclusion: products, in generally obtained the ISO 9002.

Study on the application of the preparation and storage of cord blood cells in the Ho Chi Minh Center for Hematology and Blood Transfusion

We study characteristic of 306 cord blood samples collected at Hung Vuong hospital from 1997 year to 2000 year. The results were the following: as compared with foreign authors’ results we revealed that the median volume of Vietnamese newborn’s cord blood was smaller, there were not significantly different on the median number of nucleated cells, the median number of CD34+ stem cells, the percentage of CD34+ cells as compared with mononuclear cells and the value of the use of cord blood for transplantation; the average percentage of immunologic makers on cord blood cells and peripheral blood cells and in our study was comparable with other author’s results but the percentage of CD2+ and CD19+; hematologic indexes of cord blood in our study were not significantly different as compared with other but the number of granulocytes, red blood cells and hematocrite were smaller; the incidence of infectious diseases was the following: bacterial infection 5.9%; viral infection: HbsAg(+) : 1.79%; anti HCV(+): 1.34%; anti HIV(+): 0.44%; VDRL(+): 0%; anti HTLV-1.2: 0; anti CMV IgM: 0.90%. Anti HBc IgM: 5.3%. Conclusion as compared with foreign authour results we revealed that the median volume of Vietnamses newborn’s cord blood was smaller and there were not significantly different on the median number of nucleated cells, the median number of CD34+ stem cells, the percentage of CD34+ cells as compared with mononuclear cells and the average percentage of immunologic makers. So it is useful in transplantation to treat malignant and congenital diseases in Vietnam.

Bone marrow transplantation during 1995-2000

The bone marrow transplantation is a most modern technique and applied in Vietnam to treat the malignant hematological diseases. This paper introduced the bone marrow heterotransplantation and the autologous peripheral blood stem cell transplantation. 3 patients (1 male; 2 female) received transplantation (bone marrow fluid was extracted from patient’s brothers) for the treatment of the chronic myeloid leukemia and severe thalassemia and 17 patients received the autologous peripheral blood stem cell transplantation for treatment of acute myeloid leukemia, chronic myeloid leukemia, acute lyphoid leukemia and lymphoma. The results have shown that the longest survival duration was 42 months after the autologous peripheral blood stem cell transplantation. The patients had a normal life such as learning, working and social activities. After 2 months of transplantation, the average disease free duration of 10 patients with AML and 6 patients with ALL were 27 months, and 30-40 months, respectively. This was an great encouragement.

Phenotype blood transfusion

The study was carried out on 98 patients who needed to be transfused regularly. Phenotyped red blood cells of groups were used for this purpose. Only immunogenic antigens of the common blood groups were included in this study, such as Rh, MNSs, Duffy and Kidd systems. The highest quantity of units transfused depassed the number 44. After a period of thirteen months, there was no antibody detected. But in the other hand, we found 4 cases of immune antibodies in patients who previously received multiply transfusions of non phenotyped blood. These antibodies belong to Rh, Duffy and Kidd systems which are highly immunogenic. These results showed the need and importance of performing adequate compatibility testing for multiply transfused patients and the benefit of using phenotyped blood for those who need regular transfusions.

Autologus peripheral blood stem transplantation without the cryopreseration in the treatment of the malignant hematologic pathology

We performed 10 cases of autologous peripheral blood stem cell transplantation without cryoprevervation in 11/1996 and 12/1997 12. Patients were diagnosed of AML, ALL, CML and non Hodgkin’s lymphoma. The median age of the patients was 34 years (range 18-43). Peripheral blood stem cell mobilizing regiments consisted of Daunorubicine (50 mg/ m2/d, d1-d5) cytarabine and etoposide in 3 CML patients and high dose cyclophosphamide in the seven other patients, followed by G-CSF starting when an ANC 1x109/l for 3 consecutive days. The median number of mononucleated cells and CD34+ cell were 5x108/kg respectively. All platelet count > 20 x 109/l was 13 days and 20 days following transplantation, all patients are still in CR and alive with the median follow-up of 8 months.

Survey on HBsAg, anti HCV, anti HIV. In voluntary blood donors from 12/1994 to 11/1997

Blood screening voluntary donor in HCMC. We investigated 47,621 samples of blood. Results: HbsAg (+): 7.15%, antiHCV: 3.11%, anti HIV: 0.29; VDRL (+) 1.08%, Malaria (+): 0.27%; abnormal antibodies: 0.20%.

The blood transfusion in the bone marrow transplantation

The blood transfusion is necessary while the donor’s marrow has not been growed yet. The transfused blood products must assure completely the safety principles for disease transmission, the blood products is not infected the MCV and removed the leucocyte usually transfused after 4- 12 weeks of transplantation with the suitable dosage for individuals. Condensed platalet is transfused after 6-12 weeks of transplantation. It should maintain the amount of thrombocyte in the peripheral blood within 50-100x109/lit, the dose is different from one patient to another.