Comparison of the efficacy of decitabine combined with micro-transplantation or priming regimen as consolidation treatment for older patients with acute myeloid leukemia / 中华血液学杂志

Objective: To probe the feasibility of decitabine (DAC) combined with micro-transplantation as consolidation treatment for older patients with acute myeloid leukemia (AML). Methods: Between November 2012 and September 2015, 37 consecutive patients with AML ≥60 years of age were analyzed. Of them, 19 patients received consolidation therapy with DAC followed by micro-transplantation (microtransplant group). Another 18 ones (chemo group) were treated with DAC plus priming regimen as consolidation chemotherapy in the same period. Results: There were no significant differences in terms of age, WBC count, and disease status of onset between the microtransplant and chemo groups (P>0.05). The two regimens were well tolerated. There was no difference of CTC grade 3-4 nonhematologic toxicities between the microtransplant and chemo groups (36.8% vs 27.8%, χ(2)=0.347, P=0.728). The median recovery durations for neutrophil and platelet in the microtransplant group were similar to those in the chemo group (12 vs 13 days, z=1.599, P=0.110; 14 vs 12 days, z=-1.314, P=0.189, respectively). No graft-versus-host disease was observed in the microtransplant group. The 2-year leukemia-free survival and overall survival were better in microtransplant group (50.7% and 54.9%, respectively) than in chemo group (24.3% and 30.0%, respectively) (P=0.047 and P=0.071, respectively). Conclusion: DAC combined with micro-transplantation as a consolidation regimen may be a safe and promising option for older patients with AML.

Comparison of the efficacy of decitabine combined with micro-transplantation or priming regimen as consolidation treatment for older patients with acute myeloid leukemia / 中华血液学杂志

Objective@#To probe the feasibility of decitabine (DAC) combined with micro-transplantation as consolidation treatment for older patients with acute myeloid leukemia (AML).@*Methods@#Between November 2012 and September 2015, 37 consecutive patients with AML ≥60 years of age were analyzed. Of them, 19 patients received consolidation therapy with DAC followed by micro-transplantation (microtransplant group). Another 18 ones (chemo group) were treated with DAC plus priming regimen as consolidation chemotherapy in the same period.@*Results@#There were no significant differences in terms of age, WBC count, and disease status of onset between the microtransplant and chemo groups (P>0.05). The two regimens were well tolerated. There was no difference of CTC grade 3-4 nonhematologic toxicities between the microtransplant and chemo groups (36.8% vs 27.8%, χ2=0.347, P=0.728). The median recovery durations for neutrophil and platelet in the microtransplant group were similar to those in the chemo group (12 vs 13 days, z=1.599, P=0.110; 14 vs 12 days, z=-1.314, P=0.189, respectively). No graft-versus-host disease was observed in the microtransplant group. The 2-year leukemia-free survival and overall survival were better in microtransplant group (50.7% and 54.9%, respectively) than in chemo group (24.3% and 30.0%, respectively) (P=0.047 and P=0.071, respectively).@*Conclusion@#DAC combined with micro-transplantation as a consolidation regimen may be a safe and promising option for older patients with AML.

A retrospective analysis of prognosis in favorable-risk acute myeloid leukemia patients with different consolidation regimens / 中华血液学杂志

Objective@#To explore the impact on prognosis in favorable-risk acute myeloid leukemia (AML) patients with different consolidation regimens after first complete remission (CR1).@*Methods@#A total of 107 cases of non-refractory adult AML from January 2010 to June 2015 in single center were enrolled in the study. HD-Ara-C group (38 cases) as the control group, we explore the prognosis in three consolidation regimens, including micro-transplantation (16 cases) , autologous transplantation (auto-PBSCT, 14 cases) , allogeneic transplantation (allo-HSCT, 39 cases).@*Results@#Of 107 patients (59 males and 48 females) , with a median age of 33 (16-59) years old and a median follow-up of 36.5 (5.3-79.1) months, the overall relapse rate was 20.6% (22/107) , and overall mortality rate was 18.7% (20/107). The 5 years cumulative relapse rate (CIR) of HD-Ara-C, micro-transplantation, auto-PBSCT and allo-HSCT group were 39.7%, 6.2%, 14.3% and 5.6%, respectively (P<0.001). The CIR of the observed group was lower than the HD-Ara-C group. The 5 years progression-free survival (PFS) rate of HD-Ara-C, micro-transplantation, auto-PBSCT and allo-HSCT group were 44.7%, 93.8%, 85.7% and 78.1%, respectively (P=0.011). The PFS of observed groups were similar, but superior to that in HD-Ara-C group. The 5-year overall survival (OS) in four groups was 54.9%, 100%, 92.9% and 77.4%, respectively (P>0.05). Multiple factors analysis showed that compared to HD-Ara-C regimen, allo-HSCT could improve PFS (HR=0.376, P=0.031) , but not OS (P>0.05) ; micro-transplantation and auto-PBSCT could not improve the PFS or OS (P>0.05).@*Conclusion@#As compared with HD-Ara-C regimen, allo-HSCT could obviously decrease CIR, improve PFS, but treatment-related mortality is high. These results show that auto-PBSCT and micro-transplantation have similar outcomes, compared to HD-Ara-C regimen, so both can be used as a option of consolidation treatment for favorable-risk AML.

Application of neural micro-transplantation technique on therapy of excitotoxic striatal lesion of rat model / 中国综合临床

Objective To compare the number of DARPP-32 positive cells yield in the grafts based on the application of single cell suspension by neural micro-transplantation technique and by traditional cell delivery technique and to explore effects and mechanisms of different approaches.Methods Cells derived from the whole ganglionic eminence of E15 rat embryos,ubiquitously expressing Green Fluorescent Protein(GFP) were implanted into unilaterally QA-lesioned rat striatum in a single-tract with an ultra-thin glass capillary with an outer diameter of 50 μm or using traditional cannula tip with a diameter of 500 μm.Results Histological assessment at 4 months after transplantation showed that there was about two-fold DARRP-32 positive striatal-like neurons in the micro-transplantation group(TT group) than that in the traditional group(MT group).Total graft volume was similar in both groups[(2.8±0.2) mm3 vs(2.5±0.4)mm3,F =0.25,P ＞ 0.05].And DARRP-32positive plaque volume[(0.6±0.1) mm3 vs(0.6±0.2) mm3,F =0.90,P ＞ 0.05]and TH staining plaque volume[(1.0±0.1) mm3 vs(0.7±0.1)mm3,F =1.44,P ＞ 0.05]also had the same performance in both groups.Number of DARRP-32 positive cells was calculated by Abercrombie correction formula,and the result showed that the number of DARRP-32 positive cells in MT group was two-fold of that in TT group[(20.1 ×103±1.2 × 103) vs(9.8 × 103±3.2 × 103),F =8.62,P ＜ 0.05].Higher DARRP-32 positive cells in MT group indicated that grafts had a better condition of growth and development.Conclusion Micro-transplantation approach can increase the number of new born striatal-like neurons,potentially due to the enlargement of the graft-host border area intensifying the graft's exposure to host derived factors and the minimized mechanical injury.