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Objective@#To explore the relative risk factors, clinical intervention and prognosis of hemorrhagic cystitis (HC) in patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) .@*Methods@#From January 1 2010 to May 31 2017, 425 patients with allo-HSCT received a retrospective analysis.@*Results@#①Among the 425 patients, 262 were male and 163 were female. The median age was 26 (2-56) years old. There were 138 cases of acute myeloid leukemia (AML) , 96 cases of acute lymphoblastic leukemia (ALL) , 29 cases of myelodysplastic syndrome (MDS) , 98 cases of severe aplastic anemia (SAA) and 64 cases of chronic myeloid leukemia (CML) . 221 cases of sibling match transplantation, 89 cases of unrelated donor transplantation and 115 cases of haplotype transplantation. ②108 patients (25.41%) developed HC, with the median time of onset of 32 (3-243) days and the median duration of 20 (3-93) days; 33 cases (30.56%) were grade Ⅰ, 49 cases of grade Ⅱ (45.36%) , 21 cases (19.44%) of grade Ⅲ, and 5 cases (4.63%) of grade Ⅳ. ③103 cases of HC were cured, 5 patients were ineffective, 12 patients died and died of transplantation related complications (infection, recurrence, severe acute GVHD, secondary implant failure) . ④Univariate analysis showed that age < 30, type of transplantation, CMV and acute GVHD were associated with the occurrence of HC after allo-HSCT. Multivariate analysis showed that acute GVHD was an independent risk factor for HC after allo-HSCT.@*Conclusion@#Prognosis of HC after allo-HSCT was better after timely treatment.
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Objective@#To investigate and analyze the impact on PLT recovery of recombinant human thrombopoietin (rhTPO) in severe aplastic anemia (SAA) patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT).@*Methods@#A retrospective analysis of Hematology Division of General Hospital of Jinan Military Command was conducted in the 85 SAA cases who treated with allo-HSCT from January 2010 to March 2017. According to the administration of medicines for platelets, 85 patients were divided into rhTPO group (n=29), rhIL-11 group (n=27) and blank group (n=29), respectively. The median time of PLT ≥20×109/L, PLT ≥50×109/L, and PLT ≥100×109/L, the numbers of megakaryocytes in marrow smear (25±5) days after transplantation and the quantities of platelet transfusion were analyzed retrospectively. The adverse events of rhTPO and rhIL-11 groups were observed.@*Results@#There were no significant differences in the recovery of granulocytes and PLT ≥20×109/L among the three groups (P>0.05). The time of PLT ≥50×109/L in rhTPO group was shorter than that in blank group [16.5 (11-39) d vs 22 (14-66) d, P<0.05], as well as the time of PLT ≥100×109/L [rhTPO: 23 (12-51) d; rhIL-11: 28 (12-80) d; blank group: 35 (18-86) d, P<0.05]. Platelet transfusions were also less in rhTPO group than in rhIL-11 and blank groups [20 (10-30) U, 30 (10-50) U, 35 (10-70) U, P<0.05]. The counts of megakaryocyte in rhTPO group, rhIL-11 group and blank group were 31.5 (0-200), 12 (0-142) and 11(0-187) (P<0.05), respectively. The difference between rhTPO group and rhIL-11 group was statistically significant (P<0.05), but no difference between rhIL-11 group and blank group (P>0.05). Multivariate analysis showed that rhTPO was an independent factor for platelet recovery [HR=4.01 (95%CI 1.81-9.97), P=0.010]. The rhTPO group had no obvious adverse events.@*Conclusion@#rhTPO can promote platelet recovery of SAA patients after allo-HSCT, reduce platelet transfusion with safety.
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Objective To evaluate the efficacy and safety of autologous hematopoietic stem cell transplantation (AHSCT) in patients with relapsed and refractory malignant lymphoma. Methods The clinical data of 10 patients (6 males and 4 females) with relapsed (4 cases) and refractory (6 cases) malignant lymphomas who received AHSCT in General Hospital of Jinan Military Command from August 2011 to June 2015 were analyzed retrospectively. The median age was 34 years (20 ˉ50 years); 5 cases of Hodgkin lymphoma, 5 cases of non-Hodgkin lymphoma. Before transplantation, all patients received several courses of radiotherapy or chemotherapy. High dose of cytoxan combined with G-CSF were used to mobilize peripheral hematopoietic stem cell, and preconditioning regimen included BEAM, CBV or TBI. Results The median mononuclear cell of 10 patients was 7.385 × 108/kg. Complete remission was achieved in 8 patients after transplantation, and 2 cases relapsed. Median follow-up time was 18 months (20ˉ50 months). The overall survival rate and disease-free survival rate both were 80%(8/10). All patients had nausea, vomiting, diarrhea, oral mucositis and other adverse reactions, which could be tolerated. Conclusion ASHCT is an effective and safe method for treatment of relapsed and refractory malignant lymphomas.
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Objective To summarize the experience of improved nonmyeloablative hematopoietic stem cell transplantation(NSCT) in the treatment of severe aplastie anemia. Methods Seventeen patients with Severe Aplastic Anemia received NSCT after a nonmyeloablative conditioning.The patients were conditioned with decreased dosage of immunosuppressive agents of CTX and anti-lymphoid cell globulin or anti-thymus gland cell globulins;CsA and MMF were used to prevent the graft-versus-host disease (GVHD) after transplantation. Results 75 % of severe aplastic anemia in patients with type Ⅰ and 60 % of severe aplastic anemia in patients with type Ⅱ achieved rapid hematopoietic reconstitution, with good prognosis and implantation rate with fewer complieations and light symptoms were observed. Conclusion NSCT is an effective treatment of severe aplastic anemia.
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Objective To study the therapeutic efficacy of HSV-TK/GCV in acute graft versus host disease (GVHD) produced by infusion of H-2 haplotype matched CD34 + cells in combination with TK +T lymphocytes transplantation. Methods CD34 + cells were separated from bone marrow of male donor mice, and T lymphocytes were acquired from the spleen and transfected with retroviral vectors carrying tk gene. Forty-eight female F1 recipient mice were divided into six groups. Group 1 received 1?10 5 CD34 + cells, groups 2 and 3 received 1?10 5 CD34 + cells and 1?10 7 T lymphocytes, groups 4～6 received 1?10 5 CD34 + cells and 1?10 7 TK +T lymphocytes. GCV was administered to group 5 and group 6 in the dosage of 50mg/(kg?d) for 7 days by intraperitoneal injection on day 0 and 7 posttransplant, respectively. Results All the recipient mice in group 1 survived more than 30 days and no acute GVHD symptoms emerged. Acute GVHD symptoms appeared in the recipient mice in groups 2～6 showing typical pathological manifestations. The recipient mice in groups 2～4 died of acute GVHD 3 weeks posttransplant. The survival time of recipient mice in groups 5 and 6 was 26.6?4.8 days and 40.5?8.4 days, respectively, which was significantly longer than that of groups 2～4 (P
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Objective To improve the diagnosis and treatment effect of closing duodenal injury. Methods By reviewing the documents, the development in the diagnosis and treatment of duodenal injury were summarized. Results (1) Every patient with closing belly injury should be considered the possibility of duodenal injury; (2) According to the extent of duodenal injury, five common different operetion treatments wuld be adopted respectively; (3) Non-operation treatment should be given to those unable to be operated on, such methods as nutrition support, application of sandostatine etc. Conclusions Combine the operation treatment with the non-operation treatment can greatly improve the cure rate of the duodenal injury.
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Objective To study the therapeutic effect of TK/GCV in the treatment of acute graft-versus-host disease in H-2 haploidentical mice induced by CD34 + cells mixed with TK + T lymphocytes transplantation.Methods CD34 + cells were separated from male parental donors,bone marrows,meanwhile T lymphocytes were gained from their spleens and transduced by retroviral vectors comprising TK gene. Both were mixed and transfused into female F1 recipient mice,CD34 + cells and TK + T lymphocytes each F1 recipient mouse received were 1?10 5 and 1?10 7,respectively. GCV was administered at the dosage of 50 mg ?kg -1 ?day -1 for 7 by intraperitoneal injections on the day 0 or 7 after transplantation.Results Acute GVHDs appeared in all mice. Survival time of the mice treated with GCV on the day 0 or 7 after transplantation was ( 26.6 ? 4.8 ) days and ( 40.5 ? 8.4 ) days,respectively. Therapeutic effect of GCV on the day 7 posttransplantation was better than that on the day 0 posttransplantation ( P
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Levels of lipids, lipoproteins and apolipoproteins in 59 patients with cerebral infarction were compared before and after therapy. Evening—Primrose—oil group (EPOG 32cases) was treated with EPO and routine drugs (low molecular dextran, piracetam, vitamine E), the routine—drug group (RDG 27cases) was treated only with above- mentioned routine drugs. After treating for one month the lab data demonstrated that the(HDL—c, HDL2—c and apo A—I levels in EPOG were significantly higher than)before treating (P0.05). All parameters above- mentioned in RDG had no significant change after treating.