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Objective:To explore the efficacy of tislelizumab combined with umbilical cord blood transplantation (UCBT) in relapsed/refractory acute myeloid leukemia (R/R AML) patients.Methods:The diagnosis and treatment of 1 patient with R/R AML who received tislelizumab bridging to UCBT after the failure of re-induction treatment in the First Affiliated Hospital of Soochow University in November 2021 was retrospectively analyzed.Results:The 59-year-old male patient with R/R AML achieved a complete remission after initial induction chemotherapy regimen of decitabine and venetoclax, and then additional consolidation therapy regimens of decitabine and middle-dose cytarabine, middle-dose cytarabine and idarubicin were performed. The patient relapsed 16 months later and failed to achieve a second remission after re-induction therapy regimens of cladribine, azacitidine, venetoclax combined with chemotherapy, and homoharringtonine, cytarabine combined with granulocyte colony-stimulating factor. Tislelizumab significantly reduced tumor burden and the patient achieved the complete remission after bridging to UCBT. After transplantation, the patient was given maintenance treatment with azacitidine and he had sustained remission without severe transplant-related complications during 9-month follow-up.Conclusions:The use of tislelizumab bridging UCBT can be a potential therapeutic strategy for R/R AML patients.
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【Objective】 To investigate the correlation between early immune reconstitution and clinical outcomes in patients with acute lymphoblastic leukemia (ALL) underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). 【Methods】 The basic information and treatment data of 99 patients with ALL undering allo-HSCT from December 2018 to February 2022 were collected. The proportions of CD3+ T, CD3+CD4+ T, CD3+CD8+ T and CD3-CD16+CD56+ NK cells were detected before and 30, 60 and 90 days after transplantation using flow cytometry. The correlation between early cellular immune reconstitution and neutrophil engraftment, platelet engraftment, infection, and acute and chronic graft-versus-host disease (GVHD) was analyzed. 【Results】 Among 99 ALL patients, the median time of neutrophil engraftment was day +11 (range, 8-28), and the median time of platelet engraftment was day +14 (range, 10-120). The cumulative incidence of blood stream infection (BSI) was 11.10% and the cumulative incidence of CMV within 100 days of transplantation was 40.40%. The cumulative incidence of EBV within 100 days was 7.10%. The cumulative incidence of acute graft-versus-host disease (aGVHD) was 22.30%. The cumulative incidence of chronic graft-versus-host disease (cGVHD) within 1 year of transplantation was 16.20%. 1 -year cumulative relapse rate was 13.84%. The 1 -year cumulative disease-free survival (DFS) for all patients was 80.60% and the 1-year overall survival (OS) was 90.30%. The CD4+/CD8+ ratio was positively associated with the development of aGVHD at 30 days post-transplant (OR 1.21, 95CI 1.01-1.45, P<0.05). The proportion of CD16+ CD56+ NK cell were higher in the group without BSI than that in the BSI group before and 30 days after transplantation (P < 0.05). The proportion of CD4+ T-cell were lower in the CMV infection group than that in the group without CMV infection at 60 and 90 days post-transplant(P<0.05). The higher level of CD4+ T-cells at 60 days post-transplant was a protective factor for CMV infection within 100 days (HR 0.91, 95CI 0.84-0.99, P<0.05). 【Conclusion】 Early immune reconstitution after allo-HSCT in patients with ALL is associated with aGVHD, CMV and BSI.
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【Objective】 To investigate the clinical characteristics and diagnosis and treatment of passenger lymphocyte syndrome (PLS) in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT). 【Methods】 A total of 489 patients who underwent allo-HSCT in Suzhou Hongci Hematology Hospital were retrospectively enrolled. The clinical process, diagnosis and treatment measures and prognosis of four patients complicated with PLS after transplantation were analyzed. 【Results】 Among the 489 patients, 4 were diagnosed with PLS. The blood types of donor/recipient ABO were all secondary incompatible (The blood type of donors were O and the recipients were A or B). The overall incidence of PLS in allo-HSCT was 0.82%(4/489)and 2.2%(4/179)in transplants with donor/recipient secondary incompatible ABO-blood types. PLS occured in 6-13 days after donor stem cell infusion. Clinical manifestations were dizziness and fatigue, low back pain, jaundice, deepening urine, rapid decrease in hemoglobin on laboratory tests, elevated indirect bilirubin and lactate dehydrogenase, positive urobilinogen, positive direct anti-human globulin test (DAT), and anti-A or anti-B antibodies against recipient red blood cells were detected in plasma. After the treatment of O-type washed red blood cells, methylprednisolone, gamma globulin, rituximab and other treatments, the hemolysis was improved. All patients achieved engraftment of neutrophil and platelet. Red blood cell transfusion was halted in 3 weeks. 【Conclusion】 PLS is a rare complication of allo-HSCT, which mainly occurs in allo-HSCT patients with secondary incompatibility of ABO blood group of donor/recipient. The clinical prognosis is good after properly treatment.
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Abstract@#Vaccination is the most effective prevenative measure against infectious diseases. As guardians of minor children, parental attitudes have a decisive influence on children s vaccination. Therefore, it is very important to understand parental attitudes and preference towards the vaccination of minor children in COVID-19 for the successful implementation of vaccination. In this study, the current situation and associated factors of parental COVID-19 vaccine hesitancy for children. It was found that parental vaccine hesitation was mainly influenced by factors related to parents, children, vaccination and information process. Parents should be guided to obtain information through authoritative channels and treat vaccination correctly. At the same time, medical staff should play an important role in health education, submit correct immunisation information, reduce vaccine hesitancy, and promote herd immunity.
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To investigate the effect of bilateral oophorectomy on bone mineral density, body composition and sex hormone of peri-menopause women. 33 cases of peri-menopause women patients performed bilateral oophorectomy were chosen from xxx gynaecology and obstetrics department of xxx hospital from January 1[st],2014 to Dec31[st], 2014. And the 33 cases were taken as ovariectomy group. 35 women who were the naturally postmenopausal after menopause collected in clinic and in the same period with the patients of ovariectomy group were taken in control group. American GE-Lunar-Prodigy dual energy X-ray absorptiometry and chemiluminescence method were employed to detect the bone mineral density, fat content, muscle content and sex hormone of the patients in both groups at the 6[th] and 12[th] month after menostasis. There was no statistical significance on the comparative difference of bone mineral density, fat content and muscle content at the 6[th] and 12[th] month after menostasis between both groups, P>0.05. At the 6[th] month after menostasis, the estradiol [E[2]] level in ovariectomy group was significantly lower than that of control group [[14.79+/- 22.17]U/L vs [32.74+/- 31.02U/L]], P<0.05; at the 12[th] month after menostasis, it had the statistical significance for the comparative difference between the level of E[2] and and follicle-stimulating hormone [FSH] in ovariectomy group and that in control group, E[2]: [8.09+/- 4.38]U/L vs [25.92+/- 3.53]U/L; FSH: [64.88+/- 18.39]U/L vs [40.69+/- 31.63]U/L], P<0.05. The change of E[2] and FSH were the main symptom of peri-menopausal women within 12 months after bilateral oophorectomy, the decrease of E[2] level had no effect on bone mineral density, fat content and muscle content