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Objective To retrospectively evaluate the incidence and treatment of fungous infection compli-cations after hematopoietic stem cell transplantation. Methods The incidence, pathogenic microorganism, prophy-laxis,treatments of infectious complications in 150 patients, who accepted hematopoietic stem cell transplantation from September 1990 to Martch 2000 in our hospital were analyzed. Results The incidence of infectious complica-tions was 89.3% (134/150) in all 150 cases. Three patients (2%) died of the fungal infection. The incidence of the fungal infections was 32.5% (26/80) in patients who accepted treatment with impenem or/and ceftazidine, and 15.7% (11/70) in other patients without the above treatment (P<0.05). 12 fungal infection cases were treated with small-dosage of amphotericin B(10 mg/d) ,with the healing rate was 100%. Conclusion The strong antibac-terial prophylaxis can't reduce the incidence of infection ,but may increase the risk of fungal infection;small-dosage of amphotericin B is a new effective way to treat fungal infection.
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OBJECTIVE To evaluate retrospectively the incidence and treatment of infectious complications within the first 60 days after hematopoietic stem cell transplantation,and to find more efficient anti-infective regimens. METHODS To study the incidence,pathogenic microorganism,prophylaxis,treatments of infectious complications in 150 patients accepted hematopoietic stem cell transplantation from April 1984 to March 1998 in our hospital.The results were analyzed statistically.RESULTS Incidence of infectious complications was 89.3% in all 150 cases.Three patients(2%) died of the fungal infection.The incidence of the infections was 32.5% in patients accepted treatment with imipenem or／and ceftazidine,and 15.7% in other patients without the treatment with imipenem or／and ceftazidine(P＜0.02).CONCLUSIONS The strong antibacterial prophylaxis can′t reduce the incidence of infection,and may increase the chance of fungal infection.
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The objective of the study is to find out the synergistic effect on apoptosis resulting from the combination of chemotherapeutic drugs and some cytokines. Dexamethasone (DEX), etoposide (VP16), arsenic trioxide (As(2)O(3)) and alltrans-retinoic acid (ATRA) were added to the murine T lymphoma cell line RMA as well as to the cells preincubated with IL-2, IL-6 or GM-CSF, respectively. The effect on apoptosis was observed. All four chemotherapeutic drugs inhibited the cell proliferation. DEX, VP16 or As(2)O(3), except ATRA, singly induced apoptosis of RMA cells. The DEX concentration of inducing apoptosis was reduced when it was added together with ATRA. IL-2, IL-6 and GM-CSF did not induce apoptosis when the cytokines were added to RMA separately, however, apoptosis could be induced by combination of IL-2 and IL-6. The cytokines facilitated the apoptotic action of chemotherapeutic drugs, the drug concentration for inducing apoptosis decreased and the time period of starting apoptosis shortened. The results demonstrated that there was synergistic effect of chemotherapeutic drugs and some cytokines for induction of apoptosis. It raised an experimental basis for combination of chemotherapeutic drugs and some cytokines, especially IL-2, in the treatment of malignant lymphoma.
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We treated 50 acute leukemia patients with autologous hematopoietic stem cell transplantation. Among them, 10 patients were transplanted with unpurged autologous bone marrow (ABMT), 22 patients with purged autologous bone marrow(PABMT), 18 Patients with autologous blood hematopoietic stem cell (ABHSCT). The three years disease-free living incidences in the three groups were 75%,69.9% and 72.7%, respectively. The relapse rates were 36.6%, 27.2%, and 31.4%, respectively.A high three-year disease-free incidence and low relapse rate were found in the patients with less than two months between diagnosis and achieving complete remission (CR), transplantation after 6 months of achieving CR, conditioning treatment with chemotherapy and total body irradiation (TBI) and acute myeloid leukemia (AML). The results indicated that there are some correlations between the amount of infused mononuclear cells and the recovery of bone marrow hematopoiesis. No significant difference of therapeutic effiency was demonstrated among the three groups.
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61 cases of chronic granulocytic leukemia were reviewed in this paper. Based on the results, the following features are suggested as the diagnostic criteria for early acute transformation: (1) fever of unknown cause, (2) bone and joint pain, (3) a fall in hemoglobin, marked increase or decrease of the number of WBC's and platelets, (4) myeloblasts and promyelocytes exceed 5% in peripheral blood and 10% in bone marrow, and (5) poor or no response to previously effective drug therapy, It is also suggested that a rational therapeutic management in the chronic phase may help to prevent or delay acute transformation.