Myelodysplastic syndromes combined with mature plasmacytoid dendritic cells proliferation: report of one case and review of literature / 白血病·淋巴瘤

Objective To investigate the clinical features, diagnosis, treatment and prognosis of myelodysplastic syndromes (MDS) with mature plasmacytoid dendritic cells (PDC) proliferation. Methods The clinical data of one case of MDS with excess blasts (EB)﹣1 with mature PDC proliferation in Air Force Medical Center was retrospectively analyzed, and the literature was reviewed. Results The patient′s physical examination revealed anemia and thrombocytopenia. Bone marrow smears showed 0.064 of myeloblasts and 0.152 of dendritic cells. Immunophenotyping showed two groups of abnormal proliferation cells, namely, myeloblasts and mature PDC. Decitabine treatment was given, and the red blood cells and platelets were infused intermittently. The condition of patient was basically stable. Conclusions MDS with mature PDC proliferation is extremely rare. No special clinical manifestations are found, and the diagnosis is based on bone marrow cytology and immunophenotyping. There is no standard regimen for treatment of MDS with mature PDC proliferation, and the prognosis depends on the progression of MDS.

Primary culture of murine spleen-derived mesenchymal stem cells by explant culture / 中国比较医学杂志

Objective This study aimed to establish a reliable primary culture protocol for preparing murine spleen-derived mesenchymal stem cells ( MSCs) by tissue explant culture.Methods Healthy mouse spleens were crushed by syringe handle to harvest spleen mesenchymal tissues.Then the tiny pieces of spleen tissue were digested by collagenase II before seeded into culture flasks.The morphological characteristics of spleen tissue-derived cells were observed under the inverted microscope.Further, the surface antigen profile of the cells was analyzed by flow cytometry (FACS).The cells were induced to differentiate into osteoblasts and adipocytes.Results The murine spleen-derived MSCs exhibited a spindle-shaped appearance.The FACS results showed that the spleen-derived MSCs highly expressed CD29, CD44, CD105 and Sca-1, but weakly expressed CD11b, CD34, CD45 and Ia. In addition, the spleen-derived MSCs steadily differentiated into osteoblasts and adipocytes in the induction medium.Conclusions A method of primary culture of murine spleen-derived MSCs by explant culture is successfully established.The harvested MSCs exhibit high purity and cell proliferation ability, and provide a reliable cell model for related researches.

Intrathecal injection of umbilical cord mesenchymal stem cells for spinocerebellar ataxia / 中国组织工程研究

BACKGROUND:Spinocerebel ar ataxia is a inherited neurodegenerative disease with progressive cerebel ar masonic movement disorders as the main clinical manifestation. So far, no drug is available to control the disease progression. OBJECTIVE:To observe the clinical effect of umbilical cord mesenchymal stem cells in treating spinocerebel ar ataxia by intrathecal injection. METHODS:Thirty-eight cases of spinocerebel ar ataxia were given umbilical cord mesenchymal stem cells by intrathecal injection, 1×106/kg once a week, four times as a course. These 38 cases received 52 courses. Among them, 27 cases received 1 course, 8 cases received 2 courses and 3 cases received 3 courses. International Cooperative Ataxia Rating Scale (ICARS) and Activity of Daily Living Scale (ADL) were used to evaluate patients’ neural functions (the greater scores, the more severe damage) and ability of daily living (the lower score, the stronger the ability of daily living). After treatment, al patients were subjected to fol ow-up visit. RESULTS AND CONCLUSION:The total effective rate of 52 courses of treatment was 84.62%. ICARS and ADL scores were significantly decreased at 1 month after treatment (P<0.01). In most of effective patients, unstable walking and standing, slow movement, upper limb fine motor disorder, writing difficulties, dysarthria, eye movement disorders were improved. After treatment, common adverse effects were dizziness (1 case), low back pain (2 cases), headache (1 case), and fever (2 cases). Al these symptoms disappeared within 1-3 days. No treatment-related adverse events happened in the median fol ow-up of 39 months (11-59 months). The il ness of effective patients had been stable for 1-19 months, average (5.95±4.84) months. Intrathecal injection of umbilical cord mesenchymal stem cells is safe to ameliorate clinical symptoms to some extent within a certain time. It may delay the progression of spinocerebel ar ataxia. Multiple courses of treatment can help to further improve neurological function in most patients.

Effect of BU and CY versus TBI and CY as conditioning regimens on the efficacy of haploidentical stem cell transplantation in patients with hematologic malignancy / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effects of the conditioning regimen with busulfan plus cyclophosphamide (BU+CY) or total body irradiation plus cyclophosphamide (TBI+CY) on haploidentical stem cell transplantation (HSCT) in hematologic malignancy.</p><p><b>METHODS</b>The clinical outcomes of 77 HSCT recipients with hematologic malignancy from January 2001 to December 2010, including 21 AML, 33 ALL, 19 CML and 4 MDS were retrospectively evaluated. Among them, 65 patients obtained complete remission (CR) and 12 non-remission (NR) before transplantation; 39 patients received conditioning regimen with BU+CY, and 38 with TBI+CY.</p><p><b>RESULTS</b>There were no statistically significant differences in hematopoietic reconstitution, disease free survival (DFS), and transplant- related mortality (TRM) between two groups. The estimated 3- years overall survival (OS) was 56.4% for BU+CY and 31.6% for TBI + CY (P=0.0283). The overall relapse rate was similar between two groups (15.4% vs 34.2%; P=0.1538). However, the accumulative probability of relapse at 1-year was significantly lower in BU+CY than that in TBI+CY group (2.56% vs 26.67%; P=0.0116). The incidence of grade II-IV graft-versus-host disease (GVHD) was similar between two regimens (20.5% in BU+CY group and 18.4% in TBI+CY group; P=0.8168). The incidence of chronic GVHD (cGVHD) was higher in the TBI+CY group than that of BU+CY group (84.6% vs 41.1%; P=0.0007). The extensive GVHD obtained the similar outcome (30.8% vs 10.5%; P=0.0416).</p><p><b>CONCLUSION</b>Patients using BU+CY as conditioning regimen before transplant could obtain a better 3 year OS and lower short-term relapse rate. The TBI+CY conditioning regimen could significantly increase the incidence of cGVHD without increasing the acute GVHD. BU+CY conditioning regimen could be used for HSCT, but the attention should be paid to prevent the related hemorrhagic cystitis.</p>

Efficacy of rituximab-containing regimens on post-transplantation lymphoproliferative disorder following haploidentical hematopoietic stem cell transplantation: a report of 3 cases / 中华器官移植杂志

Objective To evaluate the efficacy of rituximab-containing regimens on post-transplantation lymphoproliferative disorder (PTLD) following haploidentical hematopoietic stem cell transplantation (HSCT). Methods The clinical data of 3 cases of PTLD after haploidentical HSCT were analyzed retrospectively. Time to development of PTLD ranged from 57 to 164 days after HSCT.The main symptoms included fever, superficial lymph node enlargement. Epstein-Bart virus (EBV)-positive B-cell PTLD was diagnosed by biopsy of lymph node. Management of 3 patients consisted of withdraw of immunosuppressive treatment, anti-viral therapy, rituximab (375 rng/m2 , per week for four weeks) monotherapy or chemotherapy plus rituximab. Results All the patients had complete remission after treatment. Conclusion PTLD is a serious complication of HSCT especially haploidentical HSCT. Rituximab-containing regimens are potentially effective, well-tolerated with mild toxicity and improve the prognosis of PTLD following haploidentical HSCT.

Effect of anti-CD25 monoclonal antibody for prophylaxis and therapy of acute GVHD and immune reconstitution following HLA haplotype related T-cell undepleted allogeneic bone marrow transplantation / 中华器官移植杂志

(0.05)).It was noted that the number of CD4~(+) T cells was less significantly throughout the 18 months after BMT in two groups.The time to reach 200 CD4~(+)cells/ ?l was 6 months,and that to reach normal number of CD4~(+)was 18 months.Median time to reach normal CD3~(+) CD8~(+) and CD19~(+) was 9-12 months,and there was no significant difference between two groups.Conclusions The incidence of severe lethal aGVHD and GVHD-related deaths tended to be less in patients with Basiliximab group than un-treated group in haploidentical BMT.It is useful to use Basiliximab to treat sever GVHD.CD4~(+) reconstitution appeared significantly delayed in two groups.CD4~(+) reconstitution is crucial to control post-transplant opportunistic infections and leukemia relapse.Nevertheless,there was no significant difference in immune reconstitution and the incidence of infection and relapse between the two groups.

Antibiotic Combined Therapy as an Empirical Treatment for Febrile Patients with Neutropenia / 中华医院感染学杂志

OBJECTIVE To assess the clinical effectiveness of antibiotic combined therapy for febrile neutropenia as an empirical treatment.METHODS We analyzed bacterial epidemiology form Jan 2001 to Feb 2003 and performed a study in 202 neutropenic febrile patients after chemotherapy or(HSCT).Three groups were divided.In first group(84 cases) carbapenems and vancomycin were used.In second group(78 cases)and in third group(40(cases)) used cephalosporin or quinolone.RESULTS Carbapenems plus vancomycin were with response rate of 93%,and(without) vancomycin were only 66%.Cephalosporin or quinolone was with response rate only of 30%.(CONCLUSIONS) Strong antibiotic with vancomycin is effective for treating patients with neutropenia and fever(under) limited bacterial epidemiology.