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Objective To observe the clinical safety and efficacy of foscarnet prophylaxis and pre-emptive therapy for cytomegalovirus (CMV) infection in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods Ninety-six patients undergoing allo-HSCT from October 2014 to December 2016 were retrospectively analyzed. Plasma CMV-DNA was monitored with real-time quantitative polymerase chain reaction (RQ-PCR) from beginning to 180 days after transplantation. Foscarnet was used not only for prophylaxis but also for first-line pre-emptive therapy when plasma CMV-DNA turned to positive. Foscarnet was given 60 mg·kg-1·d-1 and 120 mg·kg-1·d-1 respectively in prevention and pre-emptive therapy. Incidences of CMV infection and CMV disease were observed, influencing factors on CMV in faction and the efficacy and safety of foscarnet prophylaxis were analyzed, and survival of patients treated by all-HSCT was evaluated. Results Of the total 96 patients, 42 cases (43.8%) had CMV infection with the median time of 42 days after allo-HSCT. CMV-DNA became negative in 36 patients (85.7%, 36/42) after pre-emptive therapy. Six patients (14.3 %, 6/42) developed CMV disease, including 5 patients with CMV negative and 1 patient died for CMV pneumonia. Haploidentical donor and grade Ⅱ-Ⅳacute graft versus host disease (GVHD) were the risk factors for CMV reactivation (χ2 = 3.834, P< 0.05; χ2 = 16.807, P< 0.001). The side effects of foscarnet prophylaxis were mild without hematologic toxicities. 12 patients (28.6 %) died in 42 patients with CMV infection, and 6 patients (11.1 %) died in 54 patients without CMV infection. The difference of survival rates between both groups was not statistically significant. Conclusion Foscarnet is an effective agent for prophylaxis and pre-emptive therapy in CMV infection after allo-HSCT with mild adverse reactions, especially for patients following with hematopoietic recovering.
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Berberine was an isoquinoline type alkaloid extracted from Chinese herbs such as Coptis chinensis.Recently, as a great many berberine derivatives had been synthesized with comprehensive physiological functions , the structural modification and ap-plication of berberine showed great promising significance .Recent literatures had been systematically analyzed and summarized in this review.With abundant pharmacological activities of berberine different sites ′derivatives had been presented , systematical information of berberine structural modification as a lead compound and new drug R&D were provided in this article .
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<p><b>OBJECTIVE</b>To study the role of interleukin (IL)-10 in acute-graft-versus-host disease (aGVHD) and graft rejection.</p><p><b>METHODS</b>Serum concentrations of IL-10 in 28 patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) were measured by enzymed-linked immunosorbent assay (ELISA). IL-10 gene expression in peripheral mononuclear cells was measured by reverse-transcriptase polymerase chain reaction (RT-PCR) after transplantation.</p><p><b>RESULTS</b>Seven patients developed grade I GVHD, 7 patients developed grade II-IV GVHD, 4 patients had graft rejection. Before transplantation, the concentrations of IL-10 were higher in patients who later did not developed aGVHD. After transplantation, IL-10 levels increased in patients without aGVHD, but decreased in patients with aGVHD or graft rejection. And IL-10mRNA was more frequent in patients without aGVHD compared to those with aGVHD.</p><p><b>CONCLUSIONS</b>IL-10 plays a negative role in the development of aGVHD and graft rejection.</p>
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Adult , Child , Humans , Middle Aged , Acute Disease , Graft Rejection , Graft vs Host Disease , Interleukin-10 , Blood , Genetics , Physiology , RNA, MessengerABSTRACT
Objective:To explore the influence of granulocyte-colony stimulating factor(G-CSF) combined with adrenocortical steroid and/or immunosuppressants on immune system of donor mice during hematopoietic stem cell mobilization.Methods: The donor C57BL/6 mice were divided into 4 groups according to the mobilization strategies,namely,the G-CSF group((250 ?g/kg) for 4 days),G-CSF(250 ?g/kg for 4 days) + methylprednisolone group(100 mg/kg on day 3),G-CSF((250 ?g/kg) for 4 days) + methylprednisolone group(100 mg/kg on day 3) + cyclosporine A(100 mg/kg on day 3),and PBS control group.The post-mobilization T lymphocytes of C57BL/6 mice and the splenocytes of BALB/c mice were subjected to mixed lymphocyte reactions(MLR).The levels of IFN-?,IL-4,and TGF-?_(1) were determined in the supernatants of donor mice splenocytes by ELISA method and the mRNA levels of IFN-? and IL-4 were determined by RT-PCR.Results: The results showed that the MLR-inhibitory activities in the 3(G-CSF) mobilized groups were 42%,21%, and 39%,respectively;all lower than that in PBS control group(68%).IFN-? levels in the 3 G-CSF mobilized groups were lower than that in PBS control group,but he levels of IL-4 and TGF-?_(1)were significantly higher than those in PBS group(P