ABSTRACT
Objective:To investigate the clinical efficacy of chidamide combined with BEAC (camustine+etoposide+ cytarabine+cyclophosphamide) preconditioning regimen in high-risk or refractory diffuse large B-cell lymphoma (DLBCL) receiving autologous stem cell transplantation.Methods:The clinical data of 10 high-risk or refractory DLBCL patients with autologous stem cell transplantation after receiving chidamide combined with BEAC preconditioning regimen who were admitted to Xuzhou Central Hospital from March 2022 to May 2023 were retrospectively analyzed. The related complications during preconditioning and hematopoietic reconstruction process, the time of hematopoietic stem cell reconstruction after transplantation, and the short-term efficacy were summarized.Results:Of the 10 patients, 6 were women and 4 were men; the median age was 58 years old (27-68 years old). Hematopoietic reconstruction was achieved in all 10 patients after transplantation. The median time of neutrophil engraftment was 11 d (range 7-12 d), and the median time of platelet engraftment was 12 d (range 9-16 d) after transplantation. Hematological adverse reactions were described as follows: 2 cases had grade 3 febrile neutropenia, 1 case had grade 4 febrile neutropenia, 3 cases had grade 2 anemia, and 1 case had grade 3 anemia. Non-hematological adverse reactions were described as follows: 1 case had grade 2 nausea with vomiting, and 1 case had diarrhea. Eight patients were followed-up for >3 months after transplantation, 6 patients achieved complete remission, 1 patient achieved partial remission, and 1 patient with TP53 deletion developed disease progression 1 month after transplantation.Conclusions:Autologous hematopoietic stem cell transplantation with chidamide combined with BEAC preconditioning regimen is effective for patients with high-risk or refractory DLBCL, and the adverse reactions are tolerable.
ABSTRACT
Objective To investigate the efficacy of domestic porcine antihuman lymphocyte immunoglobulin (p-ALG) in the treatment of severe aplastic anemia (SAA) with allogeneic hemopoietic stem cell transplantation (HSCT). Methods The clinical data of 5 SAA patients who received allogeneic HSCT from January 2015 to May 2018 were retrospectively analyzed. The conditioning regimen included p-ALG + cyclophosphamide + fludarabine. The method of peripheral stem cell and bone marrow blood was used in allogeneic HSCT (the total amount of bone marrow blood was less than 400 ml and the puncture point was not replaced). The p-ALG related complications, post-transplantation hemopoietic stem cell reconstitution time and efficacy were recorded. Results Allergic reaction occurred in 1 patient when using p-ALG, and there was no serum reaction. Hemopoietic reconstitution was achieved in all the 5 patients. The time for neutrophilic granulocyte > 0.5 × 109/L was 11 to 17 d, and the time for platelet count > 20 × 109/L was 11 to 15 d after transplantation. The results of short-strand repeat polymerase chain reaction assays showed all complete donor chimera. Graft versus host disease occurred in 3 cases, and was successfully controlled by methylprednisolone and tacrolimus. The time for stopping red blood cell transfusion was 9 to 87 d. The patients were followed up for 1 to 37 months, and the patients all survived well. Conclusions The efficacy of p-ALG in SAA patients of allogeneic HSCT is affirmative, and the cost is obviously reduced. It is worthy of clinical use.
ABSTRACT
Objective To investigate the efficacy, safety and prevention of complications of haploidentical allogeneic hematopoietic stem cell transplantation (Haplo-HSCT) in patients with severe aplastic anemia (SAA). Methods The clinical data of 8 SAA patients treated with Haplo-HSCT were retrospectively analyzed, with male in 5 cases, female in 3 cases, and an average age of 14 years. The donors of hematopoietic stem cells were patient′ s parents. The preparative regimen was cyclophosphamide + fludarabine + anti-human lymphocyte immune globulin, and 2 patients combined with total body irradiation. The recipients received cyclosporine, short- term methotrexate and mycophenolate mofetil (MMF) for preventing graft versus host disease (GVHD). The hematopoietic reconstitution, the chimerism rate of donor cells, and the incidence of postoperative complications such as infection, GVHD, liver veno- occlusive disease (VOD), hemorrhagic cystitis (HC), and cytomegalovirus (CMV) were observed. Results Hematopoietic reconstitution was achieved in all the 8 patients, the neutrophil engraftment time was (14.80 ± 3.24) d, and the platelet engraftment time was (15.00 ± 3.42) d. One month after transplantation, all the patients had complete DNA chimerism. Seven patients occurred acute GVHD, includingⅠ-Ⅱgrade in 5 cases, Ⅲgrade in 1 case, andⅣgrade in 1 case. Two patients occurred chronic GVHD, including 1 case with localized GVHD in the oral cavity and 1 case with extensive type chronic GVHD in the whole body skin. No liver VOD or HC occurred. No transplantation-related death occurred at average follow-up time of 8.5 (2 - 18) months. Conclusions Haplo-HSCT is safe and effective in patients with SAA.