Prolonged chronic phase in chronic myelogenous leukemia after homoharringtonine therapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Homoharringtonine (HHT) is effective in treating late stage chronic myelogenous leukaemia (CML), but little is known about long term maintenance during complete cytogenetic response. Long term efficacy and toxicity profiles of low dose HHT were evaluated in this study.</p><p><b>METHODS</b>One hundred and six patients with CML received 1.5 mg/m(2) of HHT alone by continuous daily infusion for seven to nine days every four weeks. Of 79 patients in the control group, 31 were treated with interferon alpha (IFN-alpha) and 48 with hydroxycarbamide. For 17 patients who failed to achieve cytogenetic response within 12 months' treatment of IFN-alpha, HHT was administered. Quantitative RT-PCR was used to detect the BCR-ABL mRNA expression in 36 Philadelphia positive CML patients enrolled after 2007. Haematological and cytogenetic responses were evaluated in all patients at the 12th month of follow-up. Long term efficacy was assessed in a follow-up with a median time of 54 months (12 months-98 months).</p><p><b>RESULTS</b>After 12 months of therapy, cytogenetic response rate of the HHT, IFN-alpha and hydroxycarbamide groups were 39/106, 14/31 and 3/48, and corresponding molecular cytogenetic response rates 6/18, 3/8 and 0. Of the 17 patients who received HHT as salvage treatment, 6 achieved cytogenetic response (3 major). At the 48 months' follow-up, cytogenetic response was maintained in 32/39 patients treated with HHT. Patients who had cytogenetic response in HHT group or treated with IFN-alpha also showed longer median chronic durations, which were 45 months (12 months-98 months) and 49 months (12 months-92 months) respectively, indicating a longer survival time.</p><p><b>CONCLUSIONS</b>Low dose HHT alone showed considerable short term and long term efficacy in the treatment of late stage CML. It may also be a good choice for patients who have failed imatinib, IFN-alpha treatment or haematopoietic stem cell transplantation or cannot afford these treatments.</p>

Influence of methylprednisolone on cell component of donor graft and on H-2 haploidentical hematopoietic stem cell transplantation in mice / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the influence of methylprednisolone (MP) on cellular component in donor graft and on H-2 haploidentical hematopoietic stem cell transplantation (HSCT) in mice.</p><p><b>METHODS</b>A murine model of H-2 haploidentical HSCT was established by using of c57BL/6J male mouse as donor and (c57BL/6J x LB/C) F1 female mouse as recipient. The donor mouse received peripheral-blood (PB) progenitor cells mobilization regimens consisted of recombinant human granulocyte colony-stimulating factor (rhGCSF) alone (control group) or combined with MP in dose of 2 mg/kg daily [small-dose (SD) group], 10 mg/kg daily [middle-dose (MD) group], and 50 mg/kg daily [large-dose (LD) group] respectively. Percentage of T cell subsets, DC1 (HLA-DR+CD11c+) and CD34+ cell in the grafts were detected by flow cytometry. Transplant rejection,severity of GVHD and survival time were observed.</p><p><b>RESULTS</b>The percentages of CD3+ T cell in donor grafts in the three groups were significantly lower than that in control group (P < 0.05). The percentage of CD3+ CD4+ T cells decreased more significantly than that of CD3+ CD8+ T cells, and CD4/CD8 ratios decreased significantly. The percentage of CD4+ CD25+ T cells increased significantly, the percentage of DC1( HLA-DR+CD11c+) decreased and the percentage of CD34+ cells increased in all the three groups than in control group. There were significant differences in the percentage of CD3+ T cells, CD3+ CD4+ T cells and CD34+ cells in donor grafts among SD group, MD group and LD group (P < 0.05). The engraftment rates in control, SD, MD and LD groups were 90%, 100%, 100% and 80% respectively. Severity of aGVHD in each study group decreased significantly compared with that in control group (P < 0.05). There were statistical differences among different dosage groups (P < 0.05). Survival time after transplantation in all study groups were significantly longer than that in control group (P < 0.05), and in MD group was significantly longer than in SD group and LD groups (P < 0.05).</p><p><b>CONCLUSIONS</b>Addition of methylprednisolone to routine donor mice HSC mobilization regimen has a definite effect in alleviating aGVHD and prolonging survival time of mouse after H-2 haploidentical HSCT. With a suitable dosage addition of methylprednisolone to donor mice HSC mobilization regimen could avoid the increasing risk of graft rejection.</p>

Antisperm-antibodies induced by testicular torsion and its influence on testicular function / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the changes of antisperm antibodies (AsAb), sexual hormones, and inhibin B (INH B) in patients before and after testicular torsion, as well as the effects of these factors on testicular function and reproduction.</p><p><b>METHODS</b>Ten patients with single acute testicular torsion (left side 9 and right side 1), aged 16-45 years (19.6 on average), disease course of 3-6 days (averaging 4.7 days), underwent surgical removal of the damaged testis. Before and after the operation, serum AsAb (IgG, IgM, IgA) and INH B were measured by ELISA, and serum follicle-stimulating hormone (FSH), luteotropic hormone (LH), and testosterone (T) determined by chemoluminescence autoanalyzer.</p><p><b>RESULTS</b>After the operation, the AsAb levels rose significantly and remained high for at least 26 weeks. The level of INH B was the lowest in the 3rd week and restored to normal in the 12th week, with significant difference between preoperation and the 3rd or the 6th week after the operation. The levels of LH and INH B in the 26th week were elevated significantly compared with the 6th.</p><p><b>CONCLUSION</b>Testicular injury induced the elevation of AsAb, which would last a very long time. The change of INH B was closely related with the injury of the testis, which reflected the degree of testicular injury and functional restoration of the patients after the operation. Our study showed that AsAb and INH B can be used as useful tools for monitoring testicular function and reproduction.</p>