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<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>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Busulfan , Cyclophosphamide , Hematologic Neoplasms , Therapeutics , Hematopoietic Stem Cell Transplantation , Retrospective Studies , Transplantation Conditioning , Methods , Whole-Body IrradiationABSTRACT
<p><b>OBJECTIVE</b>To investigate the apoptosis of NK cells induced by the erythroleukemia cell line K562 in vitro.</p><p><b>METHODS</b>Primary NK cells isolated from the peripheral blood of healthy donors by magnetic-activated cell sorting were cultured with stem cell medium containing recombinant human interleukin-2 (rhIL-2). The NK cells and K562 cells were mixed and co-cultured at different E:T ratios for different time lengths. The apoptosis of NK cells and K562 cells were detected using PE-AnnexinV/7-AAD labeling and flow cytometry.</p><p><b>RESULTS</b>The purity of isolated NK cells reached (93.99∓4.22)%. At the same E: T ratio, the apoptotic rate of NK cells induced by K562 cells increased significantly with time. As the E:T ratio reduced, the apoptotic rate of the NK cells increased and their cytotoxic activity against K562 cells was attenuated.</p><p><b>CONCLUSION</b>K562 cells can induce the apoptosis of activated NK cells, which is one of the probable mechanisms of immune escape of tumors.</p>
Subject(s)
Humans , Apoptosis , Cytotoxicity, Immunologic , K562 Cells , Killer Cells, Natural , Cell Biology , Allergy and Immunology , Tumor EscapeABSTRACT
Only in recent years, attentions have been drawn to the significance of expressing killer cell inhibitory receptors (KIR) in T cells KIRs specifically bind to the corresponding region of the MHC class I molecules and transmit negative signals to prevent cytotoxity of T cells. When the ligands of KIRs are missing, the lysis of the target cells can't be avoided. Perhaps the existence of KIRs is the main mechanism for preventing T cells from attacking autologous tissues. The recognition mechanism of the interaction between the KIR + donor T cells and the recipient's MHC class I molecule expressing tissue cells might shed light on the establishment of the immunotolerance for the prevention of allo-graft rejection and graft-versus-host disease.
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This study was undertaken to explore whether the graft-versus-host-disease could be decreased and graft-versus-leukemia effect be retained by transplantation of allogeneic T helper-2 (Th2) cells. T cells from C57BL/6(H-2b) mice were incubated and polarized with rmIL-4, Con A and ionomycin in vitro, and then, the T cells were mixed with marrow cells and transplanted into recipient BALB/c(H-2d) mice bearing erythroleukemia cells. The occurence of GVHD and GVL effect was observed. The results showed that the mean survival time in the groups of untreated control, cyclophosphamide treatment, marrow and spleen T cell transplantation and marrow and Th2 cell transplantation was 10.6 +/- 1.3, 18.7 +/- 4.2, 22.7 +/- 7.4 and 36.9 +/- 10.8 days, respectively. In untreated control and cycophosphamide treatment groups, all of ten mice died from leukemia. Nine of ten mice died from GVHD in marrow and spleen T cells transplantation group. In marrow and spleen Th2 cell transplantation group, three of ten mice died from GVHD, and GVHD was not occurred in the other seven mice, and there was no any evidence of leukemia in two mice on 50 days after transplantation. It was concluded that tranplantation with polarized Th2 cells could relieve GVHD, and at the same time retain the GVL effect.
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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.
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AIM: To study the effects of cotransplantation of donor-derived bone marrow mesenchymal stem cells on graft versus host disease in a rat allogeneic bone marrow transplantation model. METHODS: Fisher 344 rat bone marrow MSCs were isolated and cultured to the fifth passage (P5) in vitro . The recipient Wistar rats were conditioned with lethal total body irradiation and transplanted with F344 rat bone marrow cells and spleen cells in the presence or absence of (P5) MSCs. The onset time of graft versus host disease (GVHD), incidence of GVHD and survival time were monitored. RESULTS: Cotransplantation of MSCs deferred the onset time of GVHD[(19.1?1.7) d vs (15.6?1.5) d, P
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AIM: To investigate the sequence expression o f CD158 molecule after tacrolimus (FK506), mycophenolate mofetil (MMF) combined with methylprednisone (MP) treatment for refractory chronic graft-versus-host di seases (cGVHD). METHODS: The efficacy and the side effect were observed in 6 chi ld patients with extensive cGVHD after allogeneic hematopoietic stem cell transp lantation treated with the combination of FK506, MMF and MP, meanwhile the chang es of the CD158 expressions on T lymphocytes and NK cells in peripheral blood be fore and after treatment were observed. RESULTS: The expression of CD4+CD158a+ and CD4+CD158b+ were very low before and after transplantation and treatment, there was no stati stical significance. The expression of CD3+CD158b+ and CD3+CD8+CD158b + were 4.97%?2.36% and 4.58%?2.90% respectively in five patients with acut e GVHD, and there was statistical significance compared with that of before-tran splantation (P
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AIM: To investigate the differentiation potential of human bone marrow mesenchymal stem cells (hBMMSCs) into hematopoietic cells in vivo. METHODS: hBMMSCs prepared from the bone marrow-aspirate sample obtained from healthy human donors were culture-expanded in vitro with 5-8 passages. hBMMSCs(P5-8, 4.8?10 5 cells/mouse) were injected into the severe combined immuodeficiency (SCID) mice treated by cyclophosphamide(CPA) and various tissues were analyzed at 35 days post-transplant for the presence of differentiated human cells. RESULTS: hBMMSCs(P5-8) viability, which was determined by typan blue staining at the end of the harvest and before infusion, was greater than 95% in every infusate at both time points. Cells characterized by flow cytometry using human MSC-specific monoclonal antibodies were uniformly positive for CD29, CD44, CD90, CD105, CD106, CD166 and negative for CD11a, CD14, CD34, CD38, CD45, CD80, CD86 which are common on cells of the hematopoietic lineages. Analysis of PB demonstrated that 5 of 6 hBMMSCs transplanted SCID mice had low level of circulating human CD45 +/ H-2D d- cells(range from 0.17% to 0.36%)and CD34 +/ H-2D d- cells(range from 0.10% to 0.50%). Analysis of BM for the presence of hematopoietic chimerism demonstrated human CD45 +/ H-2D d- cells and CD34 +/ H-2D d- cells in the marrow of 4 out of 6 hBMMSCs transplanted SCID mice (0.10%-0.19% and 0.03%-0.52%, respectively). Human hematopoietic cells with these same phenotype were also detected in the spleen 4 of the hBMMSCs transplanted SCID mice (range from 0.19% to 1.65% ,from 0.20% to 0.26%, respectively). No human hematopoietic cell was seen either in the PB, BM or spleen of all control animals. CONCLUSION: hBMMSCs have the ability to differentiate into blood cells of multiple lineages, including CD34 + hematopoietic stem cells/progenitor cells (HSC/HPC).