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Objective@#To explore the relative risk factors, clinical intervention and prognosis of hemorrhagic cystitis (HC) in patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) .@*Methods@#From January 1 2010 to May 31 2017, 425 patients with allo-HSCT received a retrospective analysis.@*Results@#①Among the 425 patients, 262 were male and 163 were female. The median age was 26 (2-56) years old. There were 138 cases of acute myeloid leukemia (AML) , 96 cases of acute lymphoblastic leukemia (ALL) , 29 cases of myelodysplastic syndrome (MDS) , 98 cases of severe aplastic anemia (SAA) and 64 cases of chronic myeloid leukemia (CML) . 221 cases of sibling match transplantation, 89 cases of unrelated donor transplantation and 115 cases of haplotype transplantation. ②108 patients (25.41%) developed HC, with the median time of onset of 32 (3-243) days and the median duration of 20 (3-93) days; 33 cases (30.56%) were grade Ⅰ, 49 cases of grade Ⅱ (45.36%) , 21 cases (19.44%) of grade Ⅲ, and 5 cases (4.63%) of grade Ⅳ. ③103 cases of HC were cured, 5 patients were ineffective, 12 patients died and died of transplantation related complications (infection, recurrence, severe acute GVHD, secondary implant failure) . ④Univariate analysis showed that age < 30, type of transplantation, CMV and acute GVHD were associated with the occurrence of HC after allo-HSCT. Multivariate analysis showed that acute GVHD was an independent risk factor for HC after allo-HSCT.@*Conclusion@#Prognosis of HC after allo-HSCT was better after timely treatment.
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Objective@#To investigate and analyze the impact on PLT recovery of recombinant human thrombopoietin (rhTPO) in severe aplastic anemia (SAA) patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT).@*Methods@#A retrospective analysis of Hematology Division of General Hospital of Jinan Military Command was conducted in the 85 SAA cases who treated with allo-HSCT from January 2010 to March 2017. According to the administration of medicines for platelets, 85 patients were divided into rhTPO group (n=29), rhIL-11 group (n=27) and blank group (n=29), respectively. The median time of PLT ≥20×109/L, PLT ≥50×109/L, and PLT ≥100×109/L, the numbers of megakaryocytes in marrow smear (25±5) days after transplantation and the quantities of platelet transfusion were analyzed retrospectively. The adverse events of rhTPO and rhIL-11 groups were observed.@*Results@#There were no significant differences in the recovery of granulocytes and PLT ≥20×109/L among the three groups (P>0.05). The time of PLT ≥50×109/L in rhTPO group was shorter than that in blank group [16.5 (11-39) d vs 22 (14-66) d, P<0.05], as well as the time of PLT ≥100×109/L [rhTPO: 23 (12-51) d; rhIL-11: 28 (12-80) d; blank group: 35 (18-86) d, P<0.05]. Platelet transfusions were also less in rhTPO group than in rhIL-11 and blank groups [20 (10-30) U, 30 (10-50) U, 35 (10-70) U, P<0.05]. The counts of megakaryocyte in rhTPO group, rhIL-11 group and blank group were 31.5 (0-200), 12 (0-142) and 11(0-187) (P<0.05), respectively. The difference between rhTPO group and rhIL-11 group was statistically significant (P<0.05), but no difference between rhIL-11 group and blank group (P>0.05). Multivariate analysis showed that rhTPO was an independent factor for platelet recovery [HR=4.01 (95%CI 1.81-9.97), P=0.010]. The rhTPO group had no obvious adverse events.@*Conclusion@#rhTPO can promote platelet recovery of SAA patients after allo-HSCT, reduce platelet transfusion with safety.
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Objective To evaluate the efficacy and safety of autologous hematopoietic stem cell transplantation (AHSCT) in patients with relapsed and refractory malignant lymphoma. Methods The clinical data of 10 patients (6 males and 4 females) with relapsed (4 cases) and refractory (6 cases) malignant lymphomas who received AHSCT in General Hospital of Jinan Military Command from August 2011 to June 2015 were analyzed retrospectively. The median age was 34 years (20 ˉ50 years); 5 cases of Hodgkin lymphoma, 5 cases of non-Hodgkin lymphoma. Before transplantation, all patients received several courses of radiotherapy or chemotherapy. High dose of cytoxan combined with G-CSF were used to mobilize peripheral hematopoietic stem cell, and preconditioning regimen included BEAM, CBV or TBI. Results The median mononuclear cell of 10 patients was 7.385 × 108/kg. Complete remission was achieved in 8 patients after transplantation, and 2 cases relapsed. Median follow-up time was 18 months (20ˉ50 months). The overall survival rate and disease-free survival rate both were 80%(8/10). All patients had nausea, vomiting, diarrhea, oral mucositis and other adverse reactions, which could be tolerated. Conclusion ASHCT is an effective and safe method for treatment of relapsed and refractory malignant lymphomas.
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Objective To detect the change of CD47 on T-lymphocyte subsets marked by CD3 + CD4+ and CD3+ CD8+ in the acute graft versus host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and to explore its clinical significance.Methods The peripheral blood of 30 patients was collected before and every two weeks from hematopoietic reconstitution after allo-HSCT.The expression of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ was detected by flow cytometry,and the relationship between their expression and the occurrence of aGVHD was analyzed.Results The percentage of CD3+ CD4+-and CD3+ CD8+-marked T-lymphocyte subsets showed no statistically significant difference between aGVHD group and non-aGVHDgroup [(38.95 ± 6.18)％ vs.(37.38 ± 4.6)％,and (22.35 ± 3.32)％ vs.(20.34 ±4.56) ％,respectively] (P＞0.05).The expression levels of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ was obviously increased in aGVHD group when compared to before transplantation and non-aGVHD group after transplantation,and that had no changes in non-aGVHD group when compared to before conditioning regimen after transplantation.Mean fluorescence intensity of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ [(93.70 ± 14.88) and (70.09 ± 12.51)] in aGVHD group significantly increased as compared with non-aGVHD group [(71.27-± 11.32) and (53.93 ± 8.35)] (P＜0.05).There was no significant difference in the expression of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ and CD3+ CD8+ before and after transplantation in non-aGVHD group (P＞0.05).Moreover the expression of CD47 on T-lymphocyte subsets marked by CD3 + CD4 + and CD3 + CD8 + changed correspondingly with the outcome of aGVHD in aGVHD group.Conclusion The change of CD47 on T-lymphocyte subsets marked by CD3+ CD4+ andCD3+ CD8+ is valuable to monitor the aGVHD after allo-HSCT,which may provide a new means for the early detection of aGVHD.