ABSTRACT
Objective To evaluate the efficiency of amifostine in protecting against oral and gastrointestinal mucositis in hematologic malignancies patients with high-dose total body irradiation following the hematopoietic stem cell transplantation,and assess the hematologic recovery as well as the potential side effect of amifostine.Methods Thirty-two hematologic malignancies patients underwent hematopoietic stem cell transplantation in our institution from 2012 to 2016 were retrospectively analyzed.All of them were treated with total body irradiation (700-1 200 cGy) and high-dose chemotherapy,in which 14 patients received 400 mg amifostine before radiotherapy.Prior institutional experience in 18 patients treated without amifostine was used as a historical comparison (no-amifostine group).Results Severe oral mucositis occurred in 14.3％ of patients in the amifostine group while 77.2％ in the no-amifostine group (x2 =10.62,P ＜0.05).Total parenteral nutrition was used in 21.4％ of amifostine group and 38.8％ in noamifostine group (P ＞ 0.05).The rates of grade 2 and 3 gastrointestinal mucositis were 35.7％ and 61.5％ in amifostine group,while in no-amifostine group the rates were 33.3％ and 66.7％,respectively (P ＞ 0.05).No significant difference was found in engraftnent times of granulocyte and platelet.No amifostine related side effects were observed.Conclusions The combination of amifostine and total body irradiation conditioning therapy during hematologic stem cell transplantation might reduce the severity of oral mucositis.The utilize of amifostine has no obvious effect on hematopoietic recovery and can be well tolerated.
ABSTRACT
BACKGROUND/AIMS: This study examined the effects of hepatitis B virus (HBV) infection state and immunologic capability in both the recipients and donors of allogenic hematopoietic stem-cell transplantation (allo-HSCT) on changes in HBV serologic markers in recipients. METHODS: A total of 537 patients underwent allo-HSCT for the treatment of leukemia, malignant lymphoma, and solid tumor. HBV serologic markers were examined in both recipients and donors prior to and following the transplantation. The mean follow-up period was 36.6 months (range 3-80 months). RESULTS: Of the 537 patients who underwent allo-HSCT, 45 recipients were positive for HBsAg prior to transplantation. Of these 45 patients, 21 were transplanted from anti-HBs-positive donors and the remaining 24 were transplanted from anti-HBs-negative donors. In the former cases, seroconversion was noted in 4 of the 21 patients (19%). In the latter cases, however, no seroconversion was noted following the transplantation. Thirty patients who were negative for both HBsAg and anti-HBs were transplanted from anti-HBs-positive donors, and 15 out of 30 patients (50%) acquired anti-HBs. Four hundred and seven patients who were positive for anti-HBs were transplanted from anti-HBs-positive or HbsAg-negative donors; 8 of these proved HBsAg-positive following the transplantation. There were no changes in HBV serological markers following transplantation in 41 patients who were transplanted from HbsAg-positive donors. CONCLUSIONS: Due to the adoptive immunity that was transferred from anti-HBs-positive donors, a seroconversion of HBsAg could occur in some HBsAg-positive recipients. HBsAg-positive donors had a lesser effect on the HBV serologic markers of recipients. However, a reactivation of HBV can occur following hematopoietic stem-cell transplantation in the cases of recipients or donors with a history of HBV, infection by an accompanying immune suppression. Therefore, prevention should be instigated.