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Higher proportions of peripheral CD19+CD5+ B cells predict the effect of corticosteroid in patients with late-onset hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation / 中华医学杂志(英文版)
Chinese Medical Journal ; (24): 1517-1523, 2011.
Article in English | WPRIM | ID: wpr-353952
Responsible library: WPRO
ABSTRACT
<p><b>BACKGROUND</b>The cause of late-onset hemorrhagic cystitis (LOHC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains obscure. In clinical practice, some LOHC patients respond to immunosuppression. The aim of this study was to determine the immune pathogenesis of LOHC post allo-HSCT.</p><p><b>METHODS</b>With the diagnosis of LOHC, patients were given initial treatment consisting of fluid hydration, alkalization and forced diuresis, and empirical anti-viral therapy for 10 - 14 days or until a week after the virus became negative. The nonresponders were applied corticosteroid. Seven to ten days later, patients' response was evaluated. Along with treatment, CD19(+) B lymphocyte subsets were measured at various study points.</p><p><b>RESULTS</b>From October 2009 to March 2010, we found 28 cases of LOHC occurred in 25 patients who underwent allo-HSCT in our hospital. Except that three cases were not treated according to the protocol, the other 25 cases were divided into three groups anti-virus responders (Group A, n = 6), corticosteroid responders (Group B1, n = 16), corticosteroid and anti-virus nonresponders (Group C, n = 3) according to their clinical response. Percentages of CD19(+)CD5(+) B lymphocytes were not significantly different among three groups at onset of LOCH. However, in Group B1 after the first anti-virus phase, percentages of CD19(+)CD5(+) lymphocytes significantly increased comparing with those at onset (P = 0.022), and then significantly decreased at PR (P = 0.003) and CR (P = 0.002) with corticosteroid treatment. But significant change was not observed in Groups A and C.</p><p><b>CONCLUSION</b>The immune etiology seems to be involved in the development of LOHC and the proportion of CD19(+)CD5(+) lymphocytes may serve as a cellular biomarker to predict the response to corticosteroid in LOHC.</p>
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Therapeutics / Female / Humans / Male / B-Lymphocytes / Child / Child, Preschool / Adolescent / Adrenal Cortex Hormones / Hematopoietic Stem Cell Transplantation Language: English Journal: Chinese Medical Journal Year: 2011 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Therapeutics / Female / Humans / Male / B-Lymphocytes / Child / Child, Preschool / Adolescent / Adrenal Cortex Hormones / Hematopoietic Stem Cell Transplantation Language: English Journal: Chinese Medical Journal Year: 2011 Type: Article