Evaluation of neutrophilic CD64 index as a diagnostic marker of bacterial infection in blood diseases / 中国实验血液学杂志

This study was aimed to investigate the value of neutrophilic CD64 index (nCD64 index) as a diagnostic marker of bacterial infection in hematologic diseases. Experimental data of 232 patients with hematologic diseases were analyzed retrospectively. The nCD64 index was detected by flow cytometry and was compared with the levels of erythrocyte sedimentation rate (ESR), C reaction protein (CRP) and fibrinogen respectively. The results showed that the nCD64 index in clinical infection group were significantly higher than that in non-infection group and autoimmune disease group (P < 0.0001 respectively). The nCD64 index in blood culture positive group was also significantly higher than that in blood culture-negative group (P < 0.01). The result of ROC curve analysis showed that the optimal critical values of nCD64 index, ESR, CRP and Fib were 4.96, 21.5 mm/h, 8.56 mg/dl and 4.42 mg/dl, respectively. The sensitivity and specificity of nCD64 index were 0.928 and 0.933, while the sensitivities of ESR, CRP and Fib were 0.725, 0.754 and 0.594, and the specificities of CRP, ESR and Fib were 0.625,0.837 and 0.77, respectively. It is concluded that nCD64 index is possessed of much higher in sensitivity and specificity, compared with ESR, CRP and Fib in diagnosis of bacterial infection of hematologic diseases. nCD64 index can be used as an effective diagnostic marker for bacterial infection of hematologic diseases.

Ex vivo expansion of regulatory T cells for clinical applications against graft-versus-host disease in allogeneic hematopoietic stem cell transplantation / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the characteristics of regulatory T cells (Tregs) and ex vivo expansion of Tregs for treatment of graft-versus-host disease (GVHD).</p><p><b>DATA SOURCES</b>The data used in this review were retrieved from PubMed (1970-2013). The terms "ex vivo expansion", "regulatory T cell", and "graft-versus-host disease" were used for literature search.</p><p><b>STUDY SELECTION</b>The publications about the characteristics of Tregs, ex vivo expansion of Tregs and clinical applications of Tregs against GVHD were identified, retrieved and reviewed.</p><p><b>RESULTS</b>Tregs can be classified as natural Tregs (nTregs) and induced Tregs (iTregs). Both subsets share most Treg features. Given their immunosuppressive property, Tregs have been tested for their capability of preventing GVHD. The bottleneck of Treg therapy is the limited numbers of naturally existing Tregs. To solve this problem, ex vivo expansion of nTregs or iTregs has been executed. The initial data indicate Treg therapy is effective in reducing GVHD without compromising graft-versus-leukemia (GVL).</p><p><b>CONCLUSION</b>Ex vivo expansion of Tregs is a reliable way to prepare sufficient number of Tregs for management of GVHD.</p>

Incipient Coombs' test negative autoimmune hemolytic anemia precedes non-Hodgkin's lymphoma / 中国实验血液学杂志

The cases of lymphoma accompanied or preceded by Coombs' test positive autoimmune hemolytic anemia (AIHA) have been reported. However, Coombs' test negative AIHA prior to the diagnosis of lymphoma was rarely described. Herein, this article reports a case of non-Hodgkin's lymphoma (NHL) preceded about 1.5 years by Coombs test negative AIHA. A woman aged 69 was diagnosed with HA based on the history and laboratory tests. Further studies revealed that this patient was negative with Coombs' test for IgG, IgM, IgA and C3. After all possible causes of HA, especially malignancies were ruled out, the patient was diagnosed with Coombs' test negative AIHA and treated with prednisolone. The patient responded well initially to steroid treatment. Two recurrences of acute HA were presented at time of 10 months post steroid cessation, and immediately after an attempt to withdraw steroid, respectively, but the hemolysis was effectively controlled by reinstitution of prednisolone. At third recurrence, however, the patient was no longer responding to steroid, and was found with cervical lymphadenopathy. Coombs' test for IgG, IgM, IgA and C3 remained negative. B cell NHL was diagnosed by pathology. After receiving 6 cycles of CHOP chemotherapy, the patient was lymphoma free, but the hemolysis was not improved, however, which was effectively controlled by the following low dose-rituximab (RTX) therapy. The patient was still kept in a remission of lymphoma free of anemia. In conclusion, this report presented a very rare case of NHL with Coombs' test negative AIHA as initial major clinical manifestation.