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Objective:To explore the efficacy and clinical significance of Eltrombopag combined with immunosuppression therapy(IST) in the treatment of severe aplastic anemia (SAA) in children.Methods:Clinical data of 63 children with initially diagnosed SAA in the Department of Hematology of Xinxiang Central Hospital from May 2017 to June 2019 were retrospectively analyzed.All of them were all donors without siblings and they were classified into observation group (31 cases) and control group (32 cases). Patients in the observation group received IST combined with Eltrombopag treatment, and those in the control group received IST treatment.The Chi- square test was used to compare the overall remission (OR) rate and complete remission (CR) rate at 3 months, 6 months and 12 months, and incidence of infection and significant bleeding between groups.The t-test was used to compare the application of gra-nulocyte colony stimulating factor, the mean red blood cell transfusion, and the mean platelet infusion volume between groups.Kaplan-Meier method was adopted to analyze the 2-year overall survival (OS) rate and failure-free survival (FFS) rate, followed by the Log- rank test. Results:The 3-month and 6-month OR rate of the observation group were 61.29%(19/31 cases) and 80.64% (25/31 cases), respectively, which was significantly higher than that of the control group [37.50%(12/32 cases) and 59.38%(19/32 cases), χ2=45.27, 43.81, respectively, all P<0.05]. The 3-month and 6-month CR rate of the observation group were 32.26%(10/31 cases) and 45.16%(14 /31 cases), respectively, which was significantly higher than that of the control group [15.62%(5/32 cases) and 28.13%(9/32 cases), χ2=47.02, 48.35, respectively, all P<0.05]. The 12-month OR rate and CR rate in the observation group were 83.87%(26/31 cases), and 64.52%(20/31 cases), respectively, which were 81.25%(26/32 cases), and 59.38%(19/32 cases), respectively in the control group, and no significant differences in them were detected between the two groups (all P>0.05). The total amount of granulocyte colony stimulating factors [(13.58±4.28) doses vs.(23.24±6.68) doses, t=2.591], and the mean infusion volume of red blood cells [(5.48±1.67) U vs.(10.58±3.67) U, t=2.040] and platelets (4.15±2.47) bags vs.(9.15±3.87) bags, t=2.744) used in observation group within 6 months of treatment were significantly lower than those of the control group (all P<0.05). The rate of infection (16.13% vs.43.75%, χ2=47.12) and significant bleeding (16.13% vs.37.50%, χ2=44.52) in the observation group were significantly lower than those of the control group (all P<0.05). The 2-year OS rate of the observation group and control group were 93.55% (29/31 cases), and 87.50% (28/32 cases), respectively.No significant difference in the OS rate was found between groups ( P=0.407 3), nor as the 2-year FFS rate(87.10% vs.78.13%, P=0.326 6). Conclusions:IST combined with Eltrombopag can significantly improve the early treatment response rate of SAA children without a sibling identical donor, which can reduce red blood cell and platelet transfusion, and the incidence of infection and bleeding.
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Objective To observe the effects of different dosages of granulocyte-macrophage colony-stimulating factor (GM-CSF) on generating the routine bone marrow dendritic cells, and supply suitable dosage of GM-CSF on preparation of dendritic cell vaccines used for different purpose. Methods Using low (5 ng/ml) and conventional (20 ng/ml) and high dosage( 50 ng/ml ) of GM-CSF combined interleukin-4 ( IL-4 ) to induce murine bone marrow dendritic cells were performed, The phenotypes (CD_(11c), CD_(80), CD_(86)) and functional properties of the DC were compared by FACS analysis and MLR. Results The DC induced by low dosage of GM-CSF were immature DC, expressing low CD_(11c), CD_(80), and CD_(86). DC induced by conventional dosage were functional mature, expressing higher CD_(11c), CD_(80), CD_(86), which could induce allogeneic T lymphocyte responses. DC induced by the high dosage GM-CSF were the most phetotypicaUy and functional mature cells, expressing the highest CD_(11c), CD_(80) CD_(86), which could induce the strongest allogeneic T lymphocyte responses. Conclusion The dosages of GM-CSF affect the maturation stage of dendritic cells. Low dosage of GM-CSF generated immature dendritic cells, but conventional dosage and high dosage generated mature dendritic cells. DC generated through high dosage of GM-CSF were the most mature in phenotype and function.
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@# ObjectiveTo evaluate the efficacy and safety of electrical acupuncture therapy through adhesive surface electrodes and concomitant auricular acupuncture therapy on acute spinal cord injury.MethodsA total of 56 acute spinal cord injury patients with American Spinal Injury Association(ASIA) impairment grading of A and B were recruited into this study.They were randomly divided into the acupuncture and control groups.In the acupuncture group,electrical acupuncture therapy via the adhesive surface electrodes and auricular acupuncture were applied.Rehabilitation therapy was also provided to the patients during acupuncture therapy.In the control group,only rehabilitation therapy was provided to the patients.The ASIA neurologic and functional scores and the Functional Independence Measure(FIM) scores were assessed during the time of admission,hospital discharge,and 1-year postinjury follow-up.There were no adverse events.ResultsThere were significant improvements in neurologic(sensory and motor),functional,and FIM scores in the acupuncture group compared with the control either when hospital discharged or 1-year postinjury follow-up.There was no adverse events.ConclusionThe early use of concomitant auricular and electrical acupuncture therapies are effective and safe in treating acute spinal cord injury.