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ABSTRACT Introduction and hypothesis: Umbilical cord blood (UCB) is an alternative source of hematopoietic stem cells for allogeneic hematopoietic stem cell transplantation in the absence of a compatible donor. The UCB transplantation has a lower incidence of chronic graft versus host disease (GvHD), but is associated with slower engraftment and slower immune reconstitution, compared to other sources. Dendritic cells (DCs) and Natural Killer cells (NKs) play a central role in the development of GvHD and the graft versus leukemia (GvL) effect, as well as in the control of infectious complications. Method: We quantified by multiparametric flow cytometry monocytes, lymphocytes, NK cells, and DCs, including their subsets, in UCB samples from 54 healthy newborns and peripheral blood (PB) from 25 healthy adult volunteers. Results: In the UCB samples, there were higher counts of NK cells 56bright16- (median 0.024 × 109/L), compared to the PB samples (0.012 × 109/L, p < 0.0001), NK 56dim16bright (median 0.446 × 109/L vs. 0.259 × 109/L for PB samples, p = 0.001) and plasmacytoid dendritic cells (pDCs, median 0.008 × 109/L for UCB samples vs. 0.006 × 109/L for PB samples, p = 0.03). Moreover, non-classic monocyte counts were lower in UCB than in PB (median 0.024 × 109/L vs. 0.051 × 109/L, respectively, p < 0.0001). Conclusion: In conclusion, there were higher counts of NK cells and pDCs and lower counts of non-classic monocytes in UCB than in PB from healthy individuals. These findings might explain the lower incidence and severity of chronic GvHD, although maintaining the GvL effect, in UCB transplant recipients, compared to other stem cell sources.
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COVID-19 patients commonly present with lower respiratory symptoms with other systemic involvement. Haematological manifestation such as low haemoglobin, thrombocytopenia, lymphocytopenia also common in COVID19 patients. In this study, we investigated prevalence, association with serum ferritin in post COVID-19 anaemic patients, after human umbilical cord blood transfusion in relation to control group. Among 155 COVID-19 RT-PCR positive patients 36 (23%) was anaemic. In our study 18 patients was transfused human umbilical cord blood, 12 patients were treated with haematinics and 6 patients denied taking any of the above. In most cases anaemia was moderate to severe that may be due to inflammation or due to pre-existing iron deficiency.Umbilical cord blood transfusion to post COVID -19 patients for the treatment of anaemia because of the unique composition of UCB. Haematological analysis and serum ferritin estimation reflecting the treatment out come in post COVID-19 anaemic patients. There was a difference between the dependent variable's serum ferritin (p <.001) in anaemic COVID-19 patients. In conclusion, our result highlight serum ferritin is widely used in diagnosis and monitoring of COVID-19 disease.
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Background: The hematological values of the new born is amenable to certain changes under the influence of fetal, maternal, and environmental factors. Aims and Objectives: The aims of this study was to study the effect of maternal factors on hemoglobin content and reticulocyte count in umbilical cord blood of newborns of Sikkim. Materials and Methods: A total of 150 cord blood samples from newborns delivered at CRH Hospital and STNM Govt. Hospital, Gangtok, Sikkim were analyzed. Two ml of cord blood was taken in an ethylene diamine tetra acetic acid tube under aseptic condition and within 6 h: Hemoglobin estimation and Reticulocyte count was done. Results: The mean reticulocyte count was 2.48 ± 0.87% in normal vaginal delivery (NVD) and in C/S was 3.06 ± 0.97%. The mean hemoglobin content was 13.9 ± 2.6 g/dL in NVD and in C/S was 16.1 ± 3.4 g/dL. P < 0.05 for cord hemoglobin and reticulocytes in relation to mode of delivery was found to be highly significant. The mean reticulocyte count was 2.85 ± 1.0% in normal pregnancy and in complication of pregnancy was 2.9 ± 0.70%. The mean hemoglobin content was 15.36 ± 3.31 g/dL in normal pregnancy and in complication of pregnancy was 16.1 ± 3.4 g/dL. The reticulocyte count was found to be statistically significant in relation to complication of pregnancy. The mean mother’s hemoglobin was 11.16 ± 1.27 when cord hemoglobin content was <14 g/dL and was 11.88 ± 1.24 g/dL when cord hemoglobin content was >14 g/dL. There was statistical significance between the cord hemoglobin content and the hemoglobin content of the mother. Conclusion: Maternal anemia leads to lower circulating hemoglobin in new born. Cord blood screening is a useful means for identification of anemia in neonatal period. High reticulocyte count in neonates denotes active erythropoiesis which might help to defer transfusion unless there were other special reasons for proceeding.
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Background: Early-onset atherosclerosis is a marker of future cardiovascular diseases. However, indicators of early dyslipidemia for primary prevention are generally lacking in sub-Saharan Africa. This study aimed at describing the cord blood lipid profile among apparently healthy newborns in a tertiary hospital in Southeast Nigeria, and its relationship with gestational age and birth weight.Methods: Cross-sectional study of 167 consecutively recruited apparently well newborns in a tertiary hospital whose cord blood lipid profile parameters (total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL C), low-density lipoprotein cholesterol (LDL C) and very low-density lipoprotein cholesterol (VLDL C)) were assessed using an autoanalyzer (BiOLis 24i). Lipid variables were presented with descriptive statistics whereas their relationship with gestational age and birth weight was highlighted using Spearman's rank correlation analysis. Dunnett's T3 Post Hoc analysis was used for pairwise comparisons.Results: The 167 newborns recruited included 15 (9%) moderate preterm, 46 (27.5%) late preterm and 106 (63.5%) term babies of which 79 (47.3%) were males and 88 (52.7%) were females. The number of recruited SGA, AGA and LGA were respectively 13 (7.8%), 142 (85%), 12 (7.2%). Mode of delivery was majorly vaginal delivery (69.5%) while the rest (30.5%) was by caesarean section. The median values (in mg/dL) of TC, TG, HDL C, LDL C and VLDL C were 60.0, 30.5, 29.0, 25.8 and 6.1 respectively, all within the normal international ranges. Triglycerides and VLDL-C had a moderate positive correlation with gestational age (rs = 0.4;p < 0.001) and were significantly higher in small-for-gestational-age newborns. Total cholesterol, HDL C, and LDL-C had a weak negative correlation with gestational age and birth weight (spearman rsË-0.3). Birth weight, gestational age, and paternal age were the common predictors of lipid profile variability.Conclusion: The finding of a significant relationship between lipid variables with gestational age and birth weight underscores the need to clinically interpret these given the relationship. The relationship with paternal age is another interesting finding which needs to be replicated and the mechanism(s) elucidated.
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Birth Weight , Fetal Blood , Gestational Age , AtherosclerosisABSTRACT
@#Introduction: Vitamin D levels are known to be related to prevalence of allergy and infection in children. However, vitamin D levels in infants’ umbilical cord blood need to be investigated. Therefore, this study aimed to determine association between 25-hydroxyvitamin D [25(OH)D] levels and incidence of allergy and infection in children. Methods: A longitudinal study involving 38 full-term newborns was conducted. Serum 25(OH)D levels in infants’ umbilical cord and venous blood were measured at birth and six months, respectively. 25(OH)D levels were classified as insufficient (<20 ng/mL) and sufficient (>20 ng/mL). Parents filled out questionnaires about their children’s allergy and infection symptoms. Paired t-test was performed to compare the 25(OH)D levels at birth and at six months. Chisquared test was conducted to determine relationship between 25(OH)D levels and incidence of infection and allergy in children. Results: 25(OH)D levels in venous blood of 6-month-old infants were significantly higher than in umbilical cord blood (50.44±13.59 ng/mL vs. 20.70±6.60 ng/mL, p<0.001). In addition, 25(OH)D level insufficiency in umbilical cord blood was associated with infection (p<0.05). However, there was no incidence of allergy, and exclusive breastfeeding and sun exposure were not associated with vitamin D levels in 6-month-old infants. Conclusion: We conclude that 25(OH)D level insufficiency in umbilical cord blood was associated with incidence of infection in the first six months of life.
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【Objective】 To compare the difference in the detection rate of microorganisms in cord blood between BACTEC FX and BacT/ALERT 3D automated blood culture systems, and to compare the influence of incubation time and different types of culture sample on the detection rate of microorganisms in cord blood. 【Methods】 Cord blood samples prepared from April to August 2020 in Sichuan Cord Blood Bank(n=4 358) were selected, and 20 mL of plasma was used as culture samples for microbial detection. In addition, cord blood samples prepared in the same months of 2021(n=4 057) were selected, and 19 mL of plasma plus 1 mL of final product was used as culture samples for microbial detection. The total sample size was 8 415, of which 4 849 samples(2 458 in plasma group and 2 391 in plasma plus final product group) were assigned to the BACTEC FX system, and 3 566 samples(1 900 in the plasma group and 1 666 in the plasma plus final product group) to the BacT/ALERT 3D system. All samples were cultured for 7 days, and culture data were recorded on day 5 and day 7. Positive results were confirmed by Gram staining. 【Results】 The positive rate detected by the BACTEC FX system was higher than that of the BacT/ALERT 3D system(4.08% vs 2.69%), with statistically significant difference(P0.05) detected by the BacT/ALERT 3D system. With quality control strains, there were significant differences in TTP between these two systems for Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Clostridium sporogenes, and Bacillus subtilis(P0.05). 【Conclusion】 This study suggests that the selection of BACTEC FX blood culture system with incubation time of not less than 7 days and plasma plus final product as culture samples may improve the detection rate of microorganisms in cord blood.
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【Objective】 To investigate the detection of pathogenic microorganisms in umbilical cord blood and maternal blood from 2012 to 2021, so as to improve the collection of umbilical cord blood and guarantee the safety of umbilical cord blood hematopoietic stem cells (HSC) . 【Methods】 Detection results of pathogenic microorganisms of umbilical cord blood and maternal blood among 64 077 cases from Tianjin Cord Blood Bank from 2012 to 2021 were retrospectively analyzed. 【Results】 A total of, 2 072 cases (3.23%) were detected positive, among which, 184 cases (0.29%) were positive for aerobic bacteria culture, 1 504 cases (2.34%) were positive for anaerobic bacteria culture, and 384 cases (0.60%) were positive for both aerobic and anaerobic bacteria culture. From 2012 to 2021,the overall positive rate showed a downward trend, with a difference in the positive rate between each year (P<0.05). The positive rate of anaerobic bacteria was higher than that of aerobic bacteria and that of anaerobic and aerobic bacteria (P<0.05). After Gram staining, the microscopic detection rate of bacterial positive samples was highest in G- bacilli, followed by G+ bacilli, G+ cocci, G- cocci and others. Among the 64 077 cases, 169 cases (0.26%) showed reactivity in cord blood tests and 1 231 cases (1.92%) showed reactivity in maternal blood tests. Umbilical cord blood and maternal blood HIV-Ag/Ab tests showed reactivity after initial screening. After confirmation by Western blotting, there was 1 case of uncertain maternal blood, while the rest were negative. The reactive rates of anti-TP (0.12%) and anti- HCV (0.11%) in umbilical cord blood were higher than those of HBsAg (0.03%) and CMV-IgM (1/64 077).There was a difference in the reactive rate of anti-TP detection in umbilical cord blood between different years (P<0.05),while there was no statistically significant difference in that of HBsAg, anti-HCV and CMV-IgM (P> 0.05).The reactive rate of HBsAg in maternal blood (1.38%) was higher than that of CMV-IgM(0.29%) , anti-TP(0.13%) and anti-HCV (0.12%) . There were differences in the reactive rates of HBsAg, anti-HCV ,and anti-TP in maternal blood among different years (P<0.05),and that of HBsAg showed a decreasing trend, while the reactive rate of CMV-IgM was not statistically significant (P>0.05). The reactive rates of HBsAg and CMV-IgM detected in maternal blood were significantly higher than those in umbilical cord blood (P<0.05) . The reactive rates of anti-HCV and anti-TP in maternal blood were consistent with those in umbilical cord blood (P>0.05). 【Conclusion】 The reactive rates of anti-HIV and CMV-IgM in cord blood, and that of anti-HIV in maternal blood are low, but those of anti-TP and anti-HCV in cord blood are relatively high. The reactive rate of HBsAg is high in maternal blood,but with a downward trend,but low in umbilical cord blood due to maternal-infantile transmission blocking. The detection of transfusion transmitted pathogens and bacteria plays a critical role on the safety of umbilical cord blood HSCs. Effective detection of transfusion transmitted pathogens and culture of bacteria are the key to ensure the quality of umbilical cord blood, which can improve the safety of umbilical cord blood HSCs transplantation.
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@#Introduction: Cord blood (CB) is rich in hematopoietic stem cells. There has been significant growth in cord blood banks (CBBs) throughout the world. In Malaysia, the CB units cryopreserved in public CBB is below its optimal level. Lack of knowledge about CB banking among mothers in other countries influenced their decision to donate CB, however, there is no local data to support this in Malaysia. Moreover, no validated and reliable tool is available for measuring local women’s knowledge about CB banking. In this study, a questionnaire to assess pregnant women’s knowledge about CB banking was developed and validated. Method: Several steps were taken to develop the knowledge items in the questionnaire which includes comprehensive literature review, content validity by a panel of experts, and face validity by a group of pregnant women. The questionnaire was developed in Malay language and contained 18 items. After modifications, the self-administered questionnaire was distributed to 121 pregnant women to assess its psychometric properties using two-parameter logistic item response theory analysis and internal consistency reliability analysis. Results: The majority of the knowledge items showed acceptable difficulty and discriminatory values. The Cronbach’s alpha and ICC values were 0.831 and 0.887, respectively, indicating good reliability. All 18 knowledge items were retained for the final version of the questionnaire. Conclusion: The newly developed questionnaire demonstrated acceptable psychometric properties and can be used as a reliable tool to assess knowledge about CB banking among pregnant women in the local population.
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Severe aplastic anemia (SAA) is a severe bone marrow failure syndrome caused by multiple causes, which is clinically manifested with severe anemia, infection and bleeding. The complex pathogenesis of SAA has not been fully understood. SAA is characterized with acute onset, severe disease condition and rapid progression. At present, with the in-depth study of SAA and the improvement of diagnosis and treatment, the therapeutic strategy for SAA has been evolved from classical immunosuppressive therapy based on antithymocyte globulin and cyclosporine to the application of thrombopoietin receptor agonist and combined treatment based on allogeneic hematopoietic stem cell transplantation, which may promote the reconstruction of hematopoietic function of SAA patients to varying degree and significantly improve survival and clinical prognosis, becoming the research hotspot of SAA treatment. In this article, new advances in the treatment of SAA at home and abroad were reviewed.
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Objective:To explore the efficacy of tislelizumab combined with umbilical cord blood transplantation (UCBT) in relapsed/refractory acute myeloid leukemia (R/R AML) patients.Methods:The diagnosis and treatment of 1 patient with R/R AML who received tislelizumab bridging to UCBT after the failure of re-induction treatment in the First Affiliated Hospital of Soochow University in November 2021 was retrospectively analyzed.Results:The 59-year-old male patient with R/R AML achieved a complete remission after initial induction chemotherapy regimen of decitabine and venetoclax, and then additional consolidation therapy regimens of decitabine and middle-dose cytarabine, middle-dose cytarabine and idarubicin were performed. The patient relapsed 16 months later and failed to achieve a second remission after re-induction therapy regimens of cladribine, azacitidine, venetoclax combined with chemotherapy, and homoharringtonine, cytarabine combined with granulocyte colony-stimulating factor. Tislelizumab significantly reduced tumor burden and the patient achieved the complete remission after bridging to UCBT. After transplantation, the patient was given maintenance treatment with azacitidine and he had sustained remission without severe transplant-related complications during 9-month follow-up.Conclusions:The use of tislelizumab bridging UCBT can be a potential therapeutic strategy for R/R AML patients.
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OBJECTIVE@#To explore the effect of hypoxia-supported umbilical cord mesenchymal stem cell (UC-MSC) on the expansion of cord blood mononuclear cell （MNC） in vitro.@*METHODS@#The isolated cord blood mononuclear cells were inoculated on the preestablished umbilical cord mesenchymal stem cell layer and cultured under hypoxic conditions (3％ O2) and the experimental groups were normoxia (MNCs were cultured under normoxic conditions), hypoxia (MNCs were cultured under hypoxic conditions), UC-MSC (MNCs were cultured with UC-MSC under normoxic conditions), and UC-MSC+hypoxia (MNCs were cultured with UC-MSC under hypoxic conditions). To further investigate the combinational effect of 3 factors of SCF+FL+TPO (SFT) on expansion of cord blood MNCs in vitro in hypoxia-supported UC-MSC culture system, the experiments were further divided into group A (MNCs were cultured with UC-MSC and SFT under normoxic conditions), group B (MNCs were cultured with UC-MSC under hypoxic conditions), group C (MNCs were cultured with UC-MSC and SFT under hypoxic conditions). The number of nucleated cells (TNC), CD34+ cell, CFU and CD34+CXCR4+, CD34+CD49d+, CD34+CD62L+ cells of each groups were detected at 0, 7, 10 and 14 days, respectively.@*RESULTS@#Compared with group hypoxia and UC-MSC, group UC-MSC+hypoxia effectively promoted the expansion of TNC, CD34+ cell and CFU, and upregulated the expression level of adhesion molecule and CxCR4 of the cord blood CD34+ cell（P<0.05）. After culturing for 14 days, compared with group A and group B, group C effectively promoted the expansion of cord blood MNC at different time points（P<0.05）, and the effect of group A was better than that of group B at 7 and 10 days（P<0.05）.@*CONCLUSION@#Hypoxia-supported UC-MSC efficiently promoted the expansion and expression of adhesion molecule and CXCR4 of cord blood CD34+ cell, and the effect of expansion could be enhanced when SFT 3 factors were added.
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Humans , Cells, Cultured , Fetal Blood , Cell Proliferation , Umbilical Cord/metabolism , Mesenchymal Stem Cells , Antigens, CD34/metabolism , Hypoxia/metabolismABSTRACT
Introduction: Background: Cardiovascular diseases are common cause of moertality in developed countries and also are rising trend in developing countries. It has its roots in adverse fetal environment; which lead to adult diseases like Coronary artery diseases in later life. The objective of this study was to compare & contrast the lipid profiles inAim: term and preterm neonates. a case-control study was conducted in departments of PediatricsMaterials and Methods: & Obstetrics of Karwar Institute of Medical Sciences, Karwar, Karnataka of India over a period of 10 months. 500 deliveries were recruited randomly which met the inclusion criteria after informed written consent; babies were divided into Comparison group 1 (Preterm gestation of <37weeks gestational age)& comparison group 2 (term gestation of >37 weeks gestational age). Cord blood lipd-profiles of these babies were compared & studied. Out of 500 babiesResults: studied, there were 197 preterm (<37weeks gestational age) & 409 term babies (>37 weeks gestational age) babies. The Mean gestational age was 39.55±1.11 weeks for term babies & 34.50 ± 2.77 weeks for preterm babies. The mean TC level (73.76±27.98 mg/dL) was higher in comparison group 1(preterms) compared to comparison group 2(term)babies(62.60 ± 34.20mg/dL) and this difference was statistically very significant(P=0.003). The mean low density lipoprotein(LDL) level (35.54 ± 20.96mg/dL) was more higher in comparison group 1(preterms) compared to comparison group 2(term)babies (27.89 ± 15.62 mg/dL) and this difference was statistically very significant(P=0.001). The mean very low density lipoprotein(VLDL) level (11.12 ± 5.13mg/dL) was more higher in comparison group 1(preterms) compared to comparison group 2(term)babies (8.68 ± 7.55 mg/dL) and this difference was statistically very significant(P=0.003).The mean Triglycerides(TGs) levels of comparison group 1(preterms) & comparison group 2(term)babies were comparable with no statistical significance(42.63 ± 25.80mg/dL of preterm babies ; 42.43 ± 28.10mg/dL of term babies; P=0.948). The mean High density lipoprotein(HDL) levels of comparison group 1(preterms comparison) & comparison group 2(term)babies were comparable with low statistical significance(26.37 ± 13.65mg/dLof reterm babies ; 24.78 ± 10.76mg/dL of term babies;P=0.218). Levels of most lipidConclusion: components were observed to be higher in preterm babies compared to term babies
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Introduction: Birth asphyxia is a leading cause of neonatal deaths across the globe. Clinical examination, Apgar score, pH, EEG/aEEG, Lactate are being used as markers for prediction of outcome. Serum Lactate is a better reflector of metabolic mechanism. We intend to study cord blood lactate and serial lactate levels in term birth asphyxia babies. Aim: To determine correlation between cord blood lactate, serial lactate levels and short term outcome in term new-born babies with perinatal asphyxia. Materials and Methods: It was a prospective, observational study. Thirty term babies with birth asphyxia were selected. Their Cord blood lactate, serum lactate at 6, 12, 24 hours of life were correlated to short term outcomes (NICU stay, shock, Acute kidney injury, mortality). Results: Eighteen babies with moderate asphyxia and 12 with severe asphyxia had mean cord blood lactate of 10.4mmol/L and 13.47mmol/L respectively. There was difference in mean lactate levels at 6, 12, 24 hours of life between the babies who survived and expired; also survivors had significant reduction in mean lactate levels at various time points. Babies with moderate asphyxia had no shock and AKI. Babies with severe asphyxia and shock had mean lactate levels of 12mmol/L in survivors and 13.8mmol/L in who expired. Babies with severe asphyxia and AKI had mean lactate of 14mmol/L in survivors and 14.6mmol/L in who expired. Babies with moderate asphyxia had no mortality. In babies with severe asphyxia, survivors had mean lactate of 12.74mmol/L and 14mmol/L in babies who expired. There was no correlation between the lactate levels and the length of the NICU stay. Conclusion: Serial lactate levels can be used to predictor the short term prognosis in term babies with perinatal asphyxia. There was significant difference in mean lactate levels between the babies who survived and expired. Serial lactate levels showed significant reduction in babies who survived.
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ABSTRACT Background: Hematopoietic stem/progenitor cell transplantation is the main treatment option for hematological malignancies and disorders. One strategy to solve the problem of low stem cell doses used in transplantation is pre-transplant expansion. We hypothesized that using fibronectin-coated microfluidic channels would expand HSPCs and keep self-renewal potential in a three-dimensional environment, compared to the conventional method. We also compared stem cell homing factors expression in microfluidic to conventional cultures. Materials and methods: A microfluidic device was created and characterized by scanning electron microscopy. The CD133+ cells were collected from cord blood and purified. They were subsequently cultured in 24-well plates and microfluidic bioreactor systems using the StemSpan serum-free medium. Eventually, we analyzed cell surface expression levels of the CXCR4 molecule and CXCR4 mRNA expression in CD133+ cells cultured in different systems. Results: The expansion results showed significant improvement in CD133+ cell expansion in the microfluidic system than the conventional method. The median expression of the CXCR4 in the expanded cell was lower in the conventional system than in the microfluidic system. The CXCR4 gene expression up-regulated in the microfluidic system. Conclusion: Utilizing microfluidic systems to expand desired cells effectively is the next step in cell culture. Comparative gene expression profiling provides a glimpse of the effects of culture microenvironments on the genetic program of HSCs grown in different systems.
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Fibronectins , Hematologic Diseases , Neoplastic Stem Cells , Hematopoietic Stem Cells , Hematologic Neoplasms , Bioreactors , Receptors, CXCR4 , Fetal BloodABSTRACT
Abstract Objective To describe the relationship of oxidative stress and antioxidant biomarkers in cord blood of premature newborns and the prognosis of diseases in the neonatal period. Sources This study consists of an integrative review. Searches were conducted in electronic databases Scopus, PubMed, Web of Science, and Medline/Lilacs through the Virtual Library on Health Issues, using the descriptors: "premature infants", "preterm infants", "preterm birth", "preterm", "oxidative stress", "antioxidants", "infant, premature, diseases" and "cord blood". Original articles published between 2016 and 2021 in Portuguese, English, or Spanish, which analyzed oxidative stress and/or antioxidant levels through cord blood of premature newborns and evaluated clinical outcomes, were included. Summary of the findings Of the 1,003 studies reviewed, after exclusion of duplicate articles, analysis of titles, abstracts, and full texts, 18 articles were included. 72.2% (n = 13) of analyzed studies reported a positive association between oxidative stress and the development of prematurity-related diseases; 27.7% (n = 5) showed no significant relation. Outcomes that showed a positive association were: intrauterine growth restriction, necrotizing enterocolitis, bronchopulmonary dysplasia, intraventricular hemorrhage, fetal inflammatory response syndrome, early-onset neonatal sepsis, retinopathy of prematurity, morbidity, and mortality. Conclusion The analysis of oxidative stress and antioxidants in cord blood of premature newborns may be useful in the prognosis of some pathologies. The consequences of oxidative damage are known to be associated with increased morbidity in the short and long term. Further investigation is needed in this population in order to define normality parameters of biomarkers, clinical manifestations, diagnosis and treatment of these conditions.
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【Objective】 To optimize the bottom and top(B&T) method for nucleated cell separation in cord blood in order to reduce the disturbance and improve the nucleated cell yield. 【Methods】 A new device comprised of two plastic plates and connection units was developed. B&T Cord blood bag was put between the plates, which were then centrifuged and put into the serum expresser together to go through serum and red blood cells separation simultaneously. After centrifugation parameter adjustment, the new Plates-B&T method was compared with traditional method in parallel. 【Results】 New Plates-B&T method could avoid buffy coat movement and disturbance. Compared to conventional PRP method, Plates-B&T method reduced centrifugation and separation time from(29.12±2.79)min to(14.91±2.12)min(P<0.05). Using new method, the recovery rate of total nucleated cell(TNC) was (89.04±5.19)%, the removal rate of red blood cell(RBC) was(55.56±22.57) %, and hematocrit(HCT) in buffy coat was(0.48±0.09)L/L. RBC removal was enhanced significantly, especially for cord blood samples with medium-low volume. 【Conclusion】 Based on B&T method, we established a new device and method, which increased the efficiency and quality of cord blood nucleated cell separation.
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Objective:To investigate the effects of hypertensive disorders during pregnancy (HDP) on preterm newborns in terms of umbilical cord blood serum ferritin (SF), hemoglobin (Hb) at birth and outcome.Methods:Among inpatients of the First Maternity and Infant Health Hospital Affiliated to Tongji University from October 1, 2015 to December 31, 2016, totally 1 419 cases of preterm newborns were prospectively collected.Preterm infants whose mothers with diagnosis of HDP were recruited as the HDP group.Meanwhile, premature newborns whose mothers without HDP were recruited as the control group.Umbilical cord blood SF levels, Hb levels at birth, outcome of preterm newborns and the basic information for maternity were compared between the two groups.The data of normal distribution between the two groups were compared by independent sample t test.The count data was tested by χ2, and the count data with frequency <5 was tested by Fisher′ s exact test. Results:SF levels of HDP group were significantly lower than the control group [(85.6±67.2) μg/L vs. (103.9±95.5) μg/L]. But Hb levels of HDP group were much higher than the control group [(206.2±33.8) g/L vs. (193.2±31.9) g/L]. The difference between two groups was statistically significant ( t=2.791, 4.825 all P<0.05). Umbilical cord blood SF levels were negatively correlated with Hb levels at birth ( r=-0.120, P<0.001). Moreover, compared to the control group, statistically significant lower incidence of neonatal respiratory distress syndrome (NRDS), pneumonia and bronchopulmonary dysplasia (BPD) in HDP group was observed (all P<0.05). Conclusions:HDP was correlated with umbilical cord blood SF levels and Hb levels at birth in premature newborns.Higher Hb levels and relatively lower incidences of NRDS, pneumonia and BPD were observed in these newborns delivered by mothers with diagnosis of HDP.
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Objective:To evaluate the efficacy of allogeneic hematopoietic cell transplantation(allo-HSCT) using unrelated cord blood or haploidentical donors in the treatment of children with primary immunodeficiency diseases (PID).Methods:The clinical data of 60 children with PID admitted to Chinese People′s Liberation Army General Hospital-Sixth Medical Center from April 2014 to October 2019 were retrospectively analyzed, including 56 cases of chronic granulomatous disease, 2 cases of severe combined immunodeficiency disease, 1 case of high-IgM syndrome and 1 case of severe congenital neutropenia.All patients underwent allo-HSCT, including 12 cases receiving the transplantation from unrelated cord blood (UCB group) and 48 cases from haploidentical donors combined with a third party unrelated cord blood (haploid group). Among these patients, there were 59 males and 1 female, with a median age of 3.4 years.All patients received a myeloablative conditioning regimen based on Busulfan.The prophylaxis of acute graft versus host disease (aGVHD) was performed based on Cyclosporine.In the UCB group, the median dose of mononuclear cells and CD 34+ cells was 0.67×10 8/kg and 0.51×10 6/kg recipient body weight, respectively; In the haploid group, bone marrow and peripheral stem cells from haploid donors were infused on day 01 and day 02, respectively.The third party cord blood was infused 4 hours before bone marrow infusion.The median dose of mononuclear cells and CD 34+ cells of bone marrow and peripheral stem cells from haploid donors was 9.97×10 8/kg and 5.12×10 6/kg recipient body weight, respectively.Kaplan-Meier method was used to analyze the overall survival rate. Results:The median day to neutrophil and platelet engraftment was 13.0 days and 23.5 days, respectively.The rate of complete donor chime-rism was shown 30.0 days after transplantation.There was no case with primary engraftment failure, and 1 case with secondary engraftment failure.The incidence of grade Ⅰ-Ⅱ and grade Ⅲ-Ⅳ aGVHD was 43.3% and 15.5%, respectively.The incidence of chronic graft versus host disease with limited skin type was 6.7%, while that with extensive type was 1.1%.The median follow-up period was 818 days.There were 6 death cases, among which, 5 cases died from infection and 1 case died from heart failure.The total mortality related to transplantation was 11.9%.A total of 53 cases survived without diseases.The estimated 5-year failure free survival and overall survival rate was 83.9% and 88.1%, respectively.Conclusion:The efficacy of allo-HSCT in the treatment of children with PID using unrelated cord blood and haploidentical donors is favorable.
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Objective:To examine the clinical experience and efficacy of unrelated cord blood transplantation (UCBT) in the treatment of recurrent refractory Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in children.Methods:The clinical data of a patient with recurrent refractory EBV-HLH and intestinal perforation who was treated by UCBT in Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University in September 2015 and finally cured were retrospectively analyzed.Meanwhile, literature was reviewed.Results:The patient, male, 1 year and 6 months, was admitted to the hospital with " fever for 15 days, rash for 9 days" as the main complaint, mainly manifested as high fever, large liver, spleen, lymph nodes, rapidly progressing pancytopenia, liver function damage, phagocytic blood cells on bone marrow smear, diagnosed as EBV-HLH in September 2015.The patient received chemotherapy according to the HLH-2004 protocol developed by the International Association of Cell Societies.During the treatment, he suffered two recurrence during the maintenance period, and a second-line rescue treatment was adopted, namely, " Pegaspargase, Doxorubicin liposome, Etoposide and Methylprednisolone" (L-DEP regimen) chemotherapy.The complete relief of diagnostic indexes for hemophagocytic lymphohistiocytosis was evaluated after chemotherapy.The patient developed sudden intestinal perforation and underwent emergency surgical surgery, enteroenterostomy.After the condition was stabilized, the patient was pretreated with the " Fludarabine+ Busulfan+ Cyclophosphamide" (Flu+ BU+ CY) therapy and then treated with UCBT, with intravenous nutritional support provided during the entire process.Neutrophil and platelet implantation was implemented on day 13 and day 35 after transplantation, respectively.The chimeric rate was 100%, and the implantation was a success.Hepatic veno-occlusive disease, fungal pneumonia and skin graft-versus-host disease (GVHD) Ⅱ occurred on the 15 th day, 22 nd day and 26 th day after transplantation, respectively.The corresponding symptoms improved after treatment.On day 49 after transplantation, phase Ⅱ " enterostomy fistula" was performed.The patient was followed up to 70 months after transplantation, and generally in good condition.His symptoms relieved, and no chronic GVHD and other comorbidities occurred. Conclusions:Allogeneic hematopoietic stem cell transplantation is the only possible effective means of treating relapsed refractory EBV-HLH in children.In the absence of a suitable sibling or unrelated donor, unrelated cord blood stem cells can be used as a graft source.Enterostomy after intestinal perforation is not contraindicated for transplantation.
ABSTRACT
Background Essential and non-essential elements have an important impact on the development of the central nervous system during fetal development. Due to their less developed brain, preterm infants are more sensitive to element exposure, and are high-risk groups of neurodevelopmental abnormalities. However, it is not clear whether the effects of element exposure in utero on postpartum neurodevelopment are different between full-term infants and preterm infants. Objective To evaluate the effects of element exposure levels during pregnancy on neurodevelopment of children aged 6-24 months (of corrected age), and compare the effects between preterm and full-term children. Methods A prospective study design was adopted and this study was conducted based on the Maoming Birth Cohort Study (MBCS) in Maoming City, Guangdong Province. Twenty elements in cord blood of 197 preterm infants and 297 full-term infants were measured, including 11 essential trace elements [vanadium (V), chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), selenium (Se), strontium (Sr), tin (Sn), and iron (Fe)], and 9 non-essential trace elements [aluminum (Al), arsenic (As), thallium (Tl), lead (Pb), uranium (U), cerium (Ce), antimony (Sb), cadmium (Cd), and yttrium (Y)]. The neurodevelopment of the children at 6, 12, and 24 months were evaluated by the Ages and Stages Questionnaires-the Third Edition (ASQ-3). A generalized estimating equation (GEE) model was adopted to evaluate the associations between elements and neurodevelopment in full-term and preterm children separately. Results The positive rates of 10 elements (Mn, Cu, Zn, Se, Sr, Fe, Sb, Tl, Pb, and As) in cord blood were greater than 80%. Among the preterm birth children, the results of GEE analysis showed that after adjusting for the covariates, for each increase of interquartile range (IQR) in ln-transformed concentration, As was associated with problems/delay in the communication and problem-solving sub-scales, with the adjusted odds ratios (OR) and 95% confidence intervals (CI) of 1.36 (1.03-1.80) and 1.55 (1.10-2.20), respectively; the adjusted OR (95%CI) of problems/delay in the fine motor and problem-solving sub-scales were 1.44 (1.00-2.07) and 1.76 (1.09-2.84) for Sb, respectively; the adjusted OR (95%CI) of problems/delay in the communication sub-scale was 1.37 (1.09-1.74) for Se. No statistically significant associations between umbilical cord blood element concentrations and neurodevelopment indicators were observed among full-term children. The results of stratified analysis by sex showed that the associations between umbilical cord blood element concentrations and neurodevelopment problems/delay were only significant among female preterm children. Conclusion Exposures to As, Se, and Sb during pregnancy may increase the risk of neurodevelopment problems/delay in preterm children aged 6-24 months, and female seem to be more vulnerable.