ABSTRACT
Primary myelofibrosis (PMF) is easily confused with cirrhosis, due to its main clinical manifestations of splenomegaly and the blood cytopenia. This review focuses on clinical studies to identify primary myelofibrosis and cirrhosis related portal hypertension, to analyze the differences between the two diseases, in order to distinguish PMF and cirrhosis from the pathogenesis, clinical manifestations, laboratory examinations and treatment principles, and simultaneously improve clinicians' understanding of PMF, which is a reference for exploring the early screening or diagnostic indicators of PMF, also provides a clinical basis for the application of new targeted drugs such as ruxolitinib.
Subject(s)
Humans , Primary Myelofibrosis/drug therapy , Hypertension, Portal/complications , Liver Cirrhosis/pathology , Splenomegaly/pathology , AnemiaABSTRACT
OBJECTIVE@#To investigate the safety and clinical efficacy of autologous DC-CIK cells combined with other immune cells for patients with hematological malignancies and analyze patient prognosis.@*METHODS@#50 patients with hematological malignancies who received cellular immunotherapy from September 2014 to April 2016 were retrospectively studied in the First Affiliated Hospital of Xi'an Jiaotong University, 115 cases times of cellular immunotherapy were performed. According to the selected treatment, the patients were divided into the dual cell group (DC-CIK cell treatment) and the multi-cell group (DC-CIK cell combined with other immune cells); According to the treatment course, the patients were divided into the single course group (completed by ＜3 times) and the multiple course group. The changes of T lymphocyte subsets, blood routine indicators and KPS scores as well as the overall survival time before and after treatment were compared and analyzed.@*RESULTS@#[WTB1]The difference of general conditions before treatment including the number of patients, sex, age, T lymphocyte subsets, blood routine indicators, KPS scores and so on in 2 groups divided according to 2 kinds of treatment methods were not statistically significant, indicating that the 2 groups were comparable. Grouped by selected treatment, the CD4/CD8 ratio, Hb and Plt levels decreased in the dual cell group, compared with those before treatment(P＜0.05). The CD3CD4 ratio after treatment in multiple cell group decreased, compared with that before treatment (P＜0.05). The 3-year survival rate of patients in dual cell and multiple cell groups was 61.3% vs 69.8%, the overall survival time of patients in 2 groups was 32.4 months vs 39.6 months, there were no statisticall differences between 2 groups(P>0.05). Grouped by treatment course, the CD3 ratio after treatment increased, while the Hb level after treatment decreased in single course group, compared with level before treatment(P＜0.05). The CD3CD4 ratio, Plt level decreased, while the KPS scores increased after treatment in multiple course group, compared with those before treatment(P＜0.05). The 3-year survival rate in single course and multiple course groups was 52% vs 76.4%, the overall survival time was 28.7 months vs 40.9 months respectively, statistically significant with difference (P＜0.05).@*CONCLUSION@#Autologous DC-CIK cells combined with other immune cells in the treatment of hematological malignancies can change the immune function of the patients and improve the antitumor activity. The multi-course treatment can improve the quality of life, prolong the overall survival time, thus worthing clinical promotion.
Subject(s)
Humans , Cytokine-Induced Killer Cells , Dendritic Cells , Hematologic Neoplasms , Immunotherapy, Adoptive , Quality of Life , Retrospective Studies , Treatment OutcomeABSTRACT
In recent years, with the incidence of malignant tumors increasing year by year, its treatment has been made great progress on the basis of traditional treatments such as surgery, radiotherapy and chemotherapy, it mainly focuses on rapid development of cellular immunotherapy. The efficacy of dendritic cells combined with cytokine induced killer cell (DC-CIK) immunotherapy for cancer patients is positive, it shows good antitumor activities and the abilities to reconstruct and enhance the immune system of tumor patients in clinical application, it has potential application value. In the treatment of hematologic malignancies which are chemotherapy-based and high-grade malignant, what is the effect of DC-CIK cells immunotherapy for them? In this review, we searched Chinese and abroad literatures from 2012 to 2018 and further focused on 18 clinical research articles about hematologic malignancies in order to analyze the characteristics of DC-CIK cells immunotherapy. It was found that DC-CIK cells can be an effective and promising treatment for patients with hematologic malignancies, and thus, if the process and unified plan are further standardized and improved, the efficacy will be more obvious. For this purpose, this paper reviews the biological characteristic of DC cells, CIK cells and the clinical research progress of DC-CIK cell immunotherapy for hematological malignancies.
Subject(s)
Humans , Combined Modality Therapy , Cytokine-Induced Killer Cells , Dendritic Cells , Hematologic Neoplasms , Immunotherapy , Immunotherapy, AdoptiveABSTRACT
Objective To investigate the significance of serum HbA1c and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with acute coronary syndromes. Methods 120 patients with acute coronary syndromes were enrolled in Jinhua Wenrong hospital from June 2015 to December 2016. Among them, 68 patients with diabetes mellitus (group A) and 52 patients without diabetes (group B) were selected. 80 healthy cases in this hospital were selected as the control group. (HbA1c) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured and compared. Results The level of serum HbA1c in group A was (9.52±1.57)%, which was significantly higher than that in group B (5.92±0.36)%, control group (5.82±0.41)%, t=(16.19, 20.29), P=(0.00, 0.00); And group B compared with the control group, t=1.43, P=0.15. The level of NT-proBNP in group A was (442.78±79.14) μg/mL, which was significantly higher than that in group B (221.45±33.89) μg/mL, control group (87.14±14.82) μg/mL, t=(18.87, 39.41), P= (0.00, 0.00); and group B was significantly higher than those in the control group, t=31.19, P=0.00. Cardiac function in patients with acute coronary syndromes was positively correlated with serum HbA1c and NT-proBNP (r=0.624, 0.582). Conclusion The levels of HbA1c and NT-proBNP in patients with acute coronary syndromes were significantly higher than those in patients with acute coronary syndromes. The levels of HbA1c and NT-proBNP in patients with acute coronary syndromes were helpful to evaluate their cardiac function.
ABSTRACT
Objective To investigate the significance of serum HbA1c and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with acute coronary syndromes. Methods 120 patients with acute coronary syndromes were enrolled in Jinhua Wenrong hospital from June 2015 to December 2016. Among them, 68 patients with diabetes mellitus (group A) and 52 patients without diabetes (group B) were selected. 80 healthy cases in this hospital were selected as the control group. (HbA1c) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured and compared. Results The level of serum HbA1c in group A was (9.52±1.57)%, which was significantly higher than that in group B (5.92±0.36)%, control group (5.82±0.41)%, t=(16.19, 20.29), P=(0.00, 0.00); And group B compared with the control group, t=1.43, P=0.15. The level of NT-proBNP in group A was (442.78±79.14) μg/mL, which was significantly higher than that in group B (221.45±33.89) μg/mL, control group (87.14±14.82) μg/mL, t=(18.87, 39.41), P= (0.00, 0.00); and group B was significantly higher than those in the control group, t=31.19, P=0.00. Cardiac function in patients with acute coronary syndromes was positively correlated with serum HbA1c and NT-proBNP (r=0.624, 0.582). Conclusion The levels of HbA1c and NT-proBNP in patients with acute coronary syndromes were significantly higher than those in patients with acute coronary syndromes. The levels of HbA1c and NT-proBNP in patients with acute coronary syndromes were helpful to evaluate their cardiac function.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of hepatovirus B(HBV) infection on the hematopoietic stem cell collection and implantment in lymphoma patients received autologous peripheral hematopoietic blood stem cells transplantation.</p><p><b>METHODS</b>Clinical data of 40 lymphoma patients who received autologous peripheral hematopoietic blood stem cell transplantation between January 2006 and October 2014 was analyzed retrospectively. Among 40 patients with lymphoma 8 patients combined with HBV infection were prophylacticly given nucleoside analogues and 32 patients without HBV infection. The counts of mononuclear cells(MNC) and CD34 positive cells were collected and the hematopoietic reconstitution as well as overall survival rates and progress-free survival rates were detected and counted between patients with or without HBV infection.</p><p><b>RESULTS</b>The counts of MNC and CD34 positive cells in all patients were standard, and there was no significant difference between patients with or without HBV infection. HBV wasn't reactivated among the 8 patients with HBV infection. The 1, 3 and 5 years' overall survival rates and progress-free survival rates of patients with HBV infection were 100%, 85.7%, 57.1% and 100%, 80%, 53%, respectively and the 1,3 and 5 years' overall survival rates and progress-free survival rates of patients without HBV infection were 100%, 88.9%, 82.1% and 90%, 90%, 90%, respectively.</p><p><b>CONCLUSION</b>HBV infection may have no effect on the collection of stem cells and hematopoietic reconstitution. Prophylactic use of nucleoside analogues can effectively prevent the hepatitis B virus reactivation, moreover had no effect on the collection and hematopoietic reconstitution.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To observe the efficacy and adverse reactions of autologous PBSC collection when the autoPBSC procedure and MNC procedure of COBE Spectra cell separator and the MNC procedure of Spectra Optia cell separator were used.</p><p><b>METHODS</b>The autologous perepheral blood hematopoietic stem cells from 41 patients were collected by using autoPBSC procedure and MNC procedure of COBE Spectra blood cell separator and MNC procedure of Spectra Optia blood cell separator. The numbers of MNC and CD34cells collected by 3 collected procedure, the difference of hemoglobin (Hb) drop and platelet decrease, and the adverse reaction of patients were observed.</p><p><b>RESULTS</b>When the whole blood processing and the collection time were basically same among these 3 groups, the MNC counts collected by MNC procedure of COBE Spectra and Spectra Optia were higher than that of AutoPBSC procedure of COBE Spctra, but the CD34cell count was lower than that collected by AutoPBSC procedure (P< 0.05). The final product volume collected by MNC procedure of COBE Spectra and Spectra Optia was bigger than that collected by AutoPBSC procedure. In comprission with MNC procedure of COBE Spectra cell seperator, the CD34count collected by MNC procedure of Spectra Optia Seperator did not show significant difference, but the CD34cell count collected by MNC procedure of Spectra Optia was higher than that collected by MNC procedure of COBE Spectra cell separator (P<0.05). The platelet count and hemoglobin level collected by MNC procedure of Spectra Optia were lower than those before collection. The adverse reactions in the 3 procedures were similar, and the patients could tolerate them.</p><p><b>CONCLUSION</b>The AutoPBSC procedure of COBE Spectra and MNC procedure of Spectra Optia are better than MNC procedure of COBE Spectra for autologous peripheral blood hematopoietic stem cells collection. The loss of blood platelet and hemoglobin after collection is lowest in MNC procedure of Spectra Optia.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effects of DNMT3A gene mutation on prognosis of patients with acute myeloid leukemia (AML) by a meta-analysis.</p><p><b>METHODS</b>Methods of Cochrane systematic review was followed by 7 databases,including PubMed, Embase, Ovid, CNKI, CBM, WanFang Data and VIP, were searched for peer-reviewed articles related to DNMT3A gene mutations and prognosis of patients with AML.Then manual retrieval was applied into literature references. After the evaluation of quality and extract of clinical trialliterature data, Stata 11.0 was employed to perform meta-analysis.</p><p><b>RESULTS</b>Seven randomized controlled trials involving 1493 cases were included in the meta-analysis. The prognosis of patients with DNMT3A mutations and without DNMT3A mutations was compared. There was no statistically significant difference in complete remission(CR) rate (OR=1.034, 95%CI: 0.596~1.796, P=0.905 between two groups, but the overall survival (OS（HR=1.990, 95%CI: 1.463~2.510, P=0.000 and disease free survival (DFS) (HR= 2.840, 95%CI: 1.063~4.613, P=0.002) of patients without DNMT3A mutations were longer than those with DNMT3A mutation.</p><p><b>CONCLUSION</b>DNMT3A gene mutation is an independent risk factor of poor prognosis of patients with acute myeloid leukemia.</p>
Subject(s)
Humans , DNA (Cytosine-5-)-Methyltransferases , Genetics , Leukemia, Myeloid, Acute , Diagnosis , Genetics , Mutation , Prognosis , Risk FactorsABSTRACT
This study was purposed to investigate the difference of morphology, immunophenotype, cytogenetic features and prognosis between myeloid blast crisis and lymphoid blast crisis of chronic myelogenous leukemia (CML). A total of 31 patients with CML in blastic crisis in Department of Hematology, the First Affiliated Hospital of Xi'an Jiaotong University school of Medicine from 2009 January to 2014 January were enrolled in this study. Out of 31 CML patients, 24 cases were patients with myeloid blast crisis and other 7 cases were patients with lymphoblastic crisis. The clinical data, blast cell percentage in peripheral blood and bone marrow, eosinophil and basophil percentage, immunophenotype, cytogenetic characteristics and prognosis were analyzed. The results indicated that there was no significant difference of blastic cell percentage in peripheral blood and bone marrow of CML with myeloid blast crisis, and the eosinophil and basophil cells could be easily detected. The ratio of blastic cells in BM was higher than that in PB in lymphoid blastic crisis of CML, eosinophil and basophil cells were rare. 7 cases of CML with lymphoid blastic crisis were B ALL with CD10, CD19, CD34, HLA-DR expression, and 2 cases with CD13 and CD33 expression. The lymphoid score was in all CML patients with lymphoid blastic crisis was greater than or equal to 1.5;and 2 patients with CD13 and CD33 expression, and with 1 myeloid score.24 cases of myeloid blastic crisis of CML patients mainly expressed CD33, CD13, CD38, CD34, CD11b and HLA-DR, and their myeloid score greater than or equal to 2, among them the lymphoid scores of 2 patients were 0.5 and 1 score, respectively. All the 31 patients showed 100% Ph(+) chromosome, among them 3 cases also showed other new chromosome aberrations. There was no significant difference of overall survival rate between lymphoid and myeloid blastic crisis of CML, but the overall survival rate of patients treated with tyrosine kinase inhibitor (TKI ) was higher than that in the patients without TKI treatment. It is concluded that eosinophil and basophil cells in peripheral blood of lymphoid blastic crisis were less than that of CML patients with myeloid blastic crisis. Lymphoid blastic crisis of CML patients occurred mostly in B ALL cases with expression of CD10 and CD19. Patients with myeloid blastic crisis of CML mainly expressed CD33, CD13, CD38, CD34, CD11b and HLA-DR, and could be accompanied by other lineage antigen expression, but the score was less than 2. New chromosome aberration is easily observed in myeloid blastic crisis of CML. There is no significant difference of overall survival rate of between CML patients with lymphoid and myeloid blastic crisis, but the overall survival rate of patients treated with TKI is higher than the patients without TKI treatment.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Blast Crisis , Bone Marrow Cells , Allergy and Immunology , Pathology , Cytogenetic Analysis , Immunophenotyping , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Drug Therapy , Pathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Drug Therapy , Pathology , Prognosis , Protein Kinase Inhibitors , Therapeutic Uses , Protein-Tyrosine Kinases , Retrospective Studies , Survival RateABSTRACT
Central nervous system leukemia (CNS-L) is a fatal complication with low remission, high relapse and high death rates in leukemia. Because the existence of blood brain barrier (BBB) hinders drug from going into CNS, therefore it is urgent that to develop a new drug delivery system by which drug can highly and effectively go through BBB. Searching home and abroad literatures from December 2012 to February 2014 found a scheme which may effectively treat the CNSL, that is, ultrasonic microbubbles loading Ara-C, which changes the cell membrane permeability and increases the intercellular space by cavitation effect so as to make the Ara-C through the BBB for therapy. This review focuses on the present status of CNSL treatment and the progress of treating CNSL with ultrasonic microbubbles loading drug.
Subject(s)
Humans , Central Nervous System Neoplasms , Drug Therapy , Drug Delivery Systems , Leukemia , Drug Therapy , MicrobubblesABSTRACT
This study was aimed to investigate the effects of myeloid antigen expression on hematopoietic reconstitution and disease prognosis in acute lymphocytic leukemia patients post-allogeneic stem cell transplantation (allo-HSCT). Clinical data of 20 patients with acute lymphocytic leukemia in Department of Hematology of the First Affiliated Hospital of Xi'an Jiaotong University from 2008 January to 2014 April were retrospectively analyzed, in which 5 cases were with myeloid antigen (My(+) ALL), while 15 patients were without myeloid antigen expression (My(-) ALL). Differences in prognosis and hematopoietic reconstitution post-allo-HSCT were observed in My(+) ALL and My(-) ALL patients. The results showed that the poor platelet engraftment in patients with My(+) ALL was found more than that in My(-)ALL patients. Three My(+) ALL patients experienced skin chronic graft versus host disease (cGVHD) including local in 2 cases and extensive in one case, and 3 My(-) ALL patients developed grade I-II acute GVHD, while five patients of My(-) ALL experienced cGVHD including local in 3 cases, extensive in 2 cases. One and two year overall survival rate of My(+) ALL and My(-) ALL patients was 80% and 85.7%, 53% and 69.8% respectively, one and two year progress-free survival rate was 53.3% and 54.7%, 26% and 27.4%, respectively. And there was no significant statistical difference between two groups (P > 0.05). It is concluded that the myeloid antigen expression may impact the platelet engraftment post-transplantation. There is no significant difference between one and two year overall survival rate and progress-free survival rate of My(+) ALL and My(-) ALL patients after allogeneic stem cell transplantation.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Antigens, Differentiation, Myelomonocytic , Allergy and Immunology , Hematopoietic Stem Cell Transplantation , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Allergy and Immunology , Therapeutics , Prognosis , Retrospective Studies , Transplantation, HomologousABSTRACT
This study was aimed to investigate the expression level of Wilms' tumor 1( WT1) gene in hematologic neoplasm (leukemia, multiple myeloma and lymphoma) patients and its clinical significance. Real-time quantitative polymerase chain reaction (RQ-PCR) was used to detect the copy number of WT1 gene and reference gene (ALB) in bone marrow cells of 228 patients with hematologic neoplasm in our hospital. The gene expression level was determined by using the ratio of the copy number of WT1 gene and reference gene. The results showed that the WT1 expression level between male and female patients was not statistically significantly different (P > 0.05). All the patients were divided into 3 groups: the group aged under 19, the group aged between 19-50, and the group aged over 50; the WT1 expression level among the three groups were not statistically significantly different (P > 0.05) . The above-mentioned patients were redivided into the groups aged under 45 and over 45, the difference between them was not statistically significant (P > 0.05). The difference of WT1 expression level between newly diagnosed patients and treated patients with hematologic neoplasm was statistically significant (P < 0.01), but no statistically significant difference of WT1 expression was found (P > 0.05) at each stage within 3 years after treatment, however, among them the difference between newly diagnosed leukemia patients and treated leukemia patients was very statistically significant (P < 0.01), while the difference between newly diagnosed and treated non-leukemia patients was not statistically significant (P > 0.05). The expression difference of WT1 between leukemia and non-leukemia patients was very statistically significant (P < 0.01), the difference between the newly diagnosed leukemia and non-leukemia patients also was very statistically significant (P < 0.01). The difference of WT1 expression between treated leukemia and non-leukemia patients was not statistically significant (P > 0.05). It is concluded that the WT1 expression level in leukemia patients can be a reliable marker to evaluate the prognosis of newly diagnosed leukemia and the curative effect for minimal residual disease. No WT1 expression difference has been found before and after treatment among the patients with non-leukemia, such as multiple myeloma and lymphoma, therefore, which should be furtherly explored.
Subject(s)
Aged , Female , Humans , Male , Gene Expression Regulation, Neoplastic , Genes, Wilms Tumor , Hematologic Neoplasms , Genetics , Leukemia , Genetics , Neoplasm, Residual , Polymerase Chain Reaction , PrognosisABSTRACT
This study was purpose to investigate the cytologic features of bone marrow (BM) and peripheral blood (PB) in hyperleukocytic acute leukemia (HAL) and their clinical significance in accordance with high leukocyte count as poor prognostic factor for acute leukemia. The smears of BM and PB were collected from 68 out-patients and inpatients including 28 cases of HLA and 40 cases of non HAL (NHAL) in our hospital since 2009. The proliferation degree, morphology and abnormal appearance in each cell lineage were observed with HE, POX, PAS, NSE+ NaF staining for BM mears and HE staining for PB smears by means of optical microscope. The final diagnosis was made by cellular chemical staining results, then the counting and classification were performed in 200 nucleated cells to calculate the percentage of each cell lineage, the myeloid/erythroid ratio and so on. The BP smears were observed with the same methods, the counting and classification of 100 nucleated cells were performed to calculate a variety of nucleated cell percentage. The resulted data were analyzed by the SPSS 12.0 statistical software, the difference of proliferation degree and ratio of each cell lineage in BM smears were compared, the relationship of morphological features of PB smears with BM smears was analyzed. The results showed that obvious or extreme active proliferation of nucleated cells was observed in HAL and NHAL groups, but the myeloproliferation in HAL group was more active than that in NHAL group (P < 0.05). The erythrocyte and megakaryocyte lineages were suppressed in both groups, while the HAL group showed a lower proportion of erythrocyte and megakaryocyte lineages in BM as compared with NHAL group (P < 0.05). The hemoglobin and platelet levels in PB of HAL group were obviously lower than those in PB of NHAL group (P < 0.05). The leukemia cells could be seen in PB smears of NHAL, but the proportion of leukemia cells in NHAL group was smaller than that in HAL group (P < 0.05). The leukocyte count in PB of HAL group strongly positively correlated with the proliferation degree of leukemia cells in BM of HAL group (r = 0.422). It is concluded that the significant difference of proliferation degree, cell levels and blast ratio in BM and PB exists in HAL and NHAL groups, moreover the leukemia cells ratio, leukocyte, hemoglobin and platelet levels in PB of HAL all show characteristic changes. Therefore the contrast analysis of characteristic changes from laboratorial detection contributes to grasp the regular pattern of HAL, meanwhile has an important value for guiding correct diagnosis of acute leukemia and choosing suitable treatment options.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Acute Disease , Bone Marrow , Pathology , Bone Marrow Examination , Leukemia , Blood , Pathology , Leukocyte CountABSTRACT
This study was aimed to investigate the relation of reinfused hematopoietic stem cell volume and recipient's leukocyte count at reinfusion with prognosis of disease in allo-hematopoietic stem cell transplantation (allo-HSCT). The clinical data of 37 patients received allo-HSCT in our hospital were analyzed retrospectively. The 37 patients were divided into agranulocytosis and non-agranulocytosis groups according to the recipient's leukocyte count at reinfusion, and were divided into the high dose and low dose groups according to the median number of reinfused mononuclear cells (MNC) and CD34(+) cells. Then, hematopoietic reconstructions,GVHD, relapse and death rates of patients were compared. The results showed that the hematopoietic reconstruction of patients in non-agranulocytosis group and high dose MNC group were earlier than that in agranulocytosis group and low dose MNC group. There was no significant difference of hematopoietic reconstruction between the groups of high dose CD34(+) cells and low dose CD34(+) cells. The GVHD incidence was higher in high dose MNC group and non-agranulocytosis group than that in low dose MNC group and agranulocytosis group (P < 0.05). There were no statistical differences of relapsed and death rates between different reinfused number of HSC and recipient's leukocyte count at reinfusion.It is concluded that the infused MNC number and the recipient's leukocyte count at reinfusion in allo-HSCT correlated with hematopoietic reconstruction, the GVHD incidence is high in high dose MNC and non-agranulocytosis groups, the reinfused HSC volume and the recipient's leukocyte count at reinfusion not significantly relate with relapse and death rates.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Methods , Hematopoietic Stem Cells , Cell Biology , Leukocyte Count , Prognosis , Recurrence , Retrospective StudiesABSTRACT
This study was aimed to investigate the effects of different mobilization methods on mobilization and collection of peripheral blood stem cells in healthy donors and the adverse effect of collection, as well as hematopoietic construction in recipients. A total of 43 donors between January 2008 and May 2013 were divided into the simple mobilization group and the combined mobilization group. The simple group was subcutaneously injected with 5.0-10.0 µg/(kg·d) recombinant human granulocyte colony-stimulating factor (rhG-CSF), and the combined mobilization group was treated with rhG-CSF and intravenously dripped with 10 mg dexamethasone for 2-4 hours before collection. The acquisition and count of MNC and CD34(+) cells in different groups, the relationship between the stem cells and MNC count in blood before collection, and the adverse reactions were analyzed; the hematopoietic reconstruction of recipients was investigated. The results showed that the hematopoietic stem cell number of the two groups meet the demands. The count of MNC and CD34(+) cells in the simple mobilization group was more than that in the combined mobilization group. The MNC count in two groups positively correlated with peripheral blood MNC count before collection. The decline of hemoglobin and platelet levels was more obvious in the simple mobilization group than that in combined mobilization group. The adverse reactions of collection in the simple mobilization group could be well tolerated and reversed. There was no adverse reaction in the combined mobilization group. The differences of conditioning regimens between two groups were not statistically significant and the hematopoietic reconstruction time of combined group was shorter than that in the simple mobilization group.It is concluded that the adverse reactions in process of collection can be reduced, and enough hematopoietic stem cells can be collected by G-CSF plus dexamethasone in mobilization of peripheral blood stem cells. The count of MNC in peripheral blood before collection can be still used as a reference index to evaluate the acquisition of MNC. Especially the combination with dexamethasone for stem cell mobilization can promote the hematopoietic reconstruction of the recipients.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Dexamethasone , Pharmacology , Granulocyte Colony-Stimulating Factor , Pharmacology , Hematopoietic Stem Cell Mobilization , Methods , Hematopoietic Stem Cells , Peripheral Blood Stem Cell Transplantation , Methods , Recovery of FunctionABSTRACT
<p><b>OBJECTIVES</b>To study the quantitative relationship between the levels of serum liver fibrosis markers and fibrosis stages of liver tissues in patients with chronic hepatic diseases.</p><p><b>METHODS</b>In 118 patients with chronic hepatitis, fatty liver or cirrhosis, their Serum levels of LN, HA, PCIII and CIV were investigated by EIA and their liver histological changes were studied. The relationship between the levels of serum LN, HA, PCIII and CIV and the degrees of liver tissue fibrosis was analyzed quantitatively by using the SPSS11.0.</p><p><b>RESULTS</b>A correlation between the levels of serum LN, HA, PCIII and CIV and the histologically assessed grades of inflammatory activity was found (r = 0.394, 0.449, 0.443, 0.351, respectively, P <0.01). The correlation between the levels of serum LN, HA, PCIII and CIV and the histological assessed stages of liver fibrosis was strong (r = 0.456, 0.564, 0.476, 0.421 respectively, P <0.01). The levels of serum LN, HA, PCIII and CIV of the patients with a stage 2 liver fibrosis were 110 ng/ml, 110 ng/ml, 100 ng/ml and 70 ng/ml respectively, with sensibilities of diagnosing stage 2 liver fibrosis at 70%, 79%, 79% and 74% respectively. Their specificities in diagnosing stage 2 liver fibrosis were 68%, 72%, 64% and 73% respectively. The levels of LN, HA, PCIII and CIV in serum of these patients diagnosing cut-off value in stage 4 liver fibrosis (early cirrhosis) were 130 ng/ml, 140 ng/ml, 120 ng/ml and 70 ng/ml respectively. Their sensibility of diagnosing liver cirrhosis was 79%, 93%, 79% and 86% respectively. Their specificity of diagnosing liver cirrhosis was 66%, 82%, 72% and 61% respectively. As shown by the ROC curves in these patients, differentiating patients with cirrhosis or without cirrhosis, serum HA level was more valuable than LN, PCIII, CIV (the areas under the curves = 0.938 vs 0.775, 0.787, 0.791 ) When serum HA was higher than 190 ng/ml, the veracity of diagnosing liver cirrhosis was 93%.</p><p><b>CONCLUSIONS</b>There is a certain quantitative relationship between the levels of LN, HA, PCIII and CIV in serum and the degrees of liver tissue fibrosis. The level of HA in serum is an important reference datum for early diagnosing liver cirrhosis.</p>