ABSTRACT
Objective: To assess the feasibility of using donors with novel coronavirus disease 2019 (COVID-19) for allogeneic hematopoietic stem cell transplantation (allo-HSCT) when there are no other available donors and allo-HSCT cannot be delayed or discontinued. Methods: Seventy-one patients with malignant hematological diseases undergoing allo-HSCT between December 8, 2022, and January 10, 2023, were included. Of these, 16 received grafts from donors with mild COVID-19 (D-COVID(+) group) and 55 received grafts from donors without COVID-19 (D-COVID(-) group). The graft compositions were compared between the two groups. Engraftment, acute graft-versus-host disease (aGVHD), overall survival (OS), and relapse were also evaluated. Results: There were no serious side effects or adverse events in the D-COVID(+) group. The mononuclear cell dose and CD34(+) cell dose were comparable between the two groups, and no additional apheresis was required. There were no significant differences in the lymphocyte, monocyte, and T-cell subset doses between the two groups. The median natural killer cell dose in the D-COVID(+) group was significantly higher than that in the D-COVID(-) group (0.69×10(8)/kg vs. 0.53×10(8)/kg, P=0.031). The median follow-up time was 72 (33-104) days. All patients achieved primary engraftment. The 60-day platelet engraftment rates in the D-COVID(+) and D-COVID(-) groups were 100% and (96.4±0.2) %, respectively (P=0.568). There were no significant differences in neutrophil (P=0.309) and platelet (P=0.544) engraftment times. The cumulative incidence of grade 2-4 aGVHD was (37.5±1.6) % vs. (16.4±0.3) % (P=0.062), and of grade 3-4 aGVHD was 25.0% ±1.3% vs. 9.1% ±0.2% (P=0.095) in the D-COVID(+) and D-COVID(-) groups, respectively. The probabilities of 60-day OS were 100% and 98.1% ±1.8% (P=0.522) in the D-COVID(+) and D-COVID(-) groups, respectively. There was no relapse of primary disease during the study period. Conclusion: When allo-HSCT cannot be delayed or discontinued and no other donor is available, a donor with mild COVID-19 should be considered if tolerable. Larger sample sizes and longer follow-up periods are required to validate these results.
Subject(s)
Humans , COVID-19 , SARS-CoV-2 , Hematopoietic Stem Cell Transplantation , Tissue Donors , Graft vs Host DiseaseABSTRACT
<p><b>OBJECTIVE</b>To compare differences of effects between new moxibustion-massage apparatus and suspended moxibustion for infantile asthma.</p><p><b>METHODS</b>Sixty patients were divided into 2 groups randomly, observation group and control group, 30 cases in each. Tiaoyuan Yuping Decoction, a decoction made by the hospital, was applied for both groups. New moxibustion-massage apparatus was applied for the observation group, and suspended moxibustion was adopted for the control group. Moxibustion was applied on acupoints of Fengmen (BL 12), Feishu (BL 13), Geshu (BL 17), Pishu (BL 20), Juque (CV 14) and Zhongwan (CV 12) for 3 months, and therapeutic effect was observed.</p><p><b>RESULTS</b>The remarkably effective rate of the observe group is 66.7% (20/30) and the total effective rate is 90.0% (27/30), which are better than 40.0% (12/30) and 83.3% (25/30) of the control group. The asthma of attack of both groups after the treatment obviously decreased (both P < 0.05). The asthma of attack of the observation group is obviously lower than that of the control group (P < 0.05). And the effect is approved without side-effects such as dermal infection.</p><p><b>CONCLUSION</b>It is held that the combination of new moxibustion-massage apparatus and Chinese medicine for infantile asthma in remission stage has obvious therapeutic effect, which can reduce the attack of asthma and alleviate symptoms. The result is better than suspended moxibustion.</p>