Hematopoietic Stem Cell Transplantation ; Humans ; Transplantation, Homologous ; Treatment Outcome

Acute Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia ; prevention & control ; therapy ; Postoperative Period ; Secondary Prevention

OBJECTIVETo report a case with cytomegalovirus retinitis (CMVR) after bone marrow transplantation (BMT). A review of the literature and possible mechanisms were presented.

METHODSCase report and literature review.

RESULTSThe patient received large dose of immunosuppressants after allo-BMT appeared CMV infection. There were bleeding and effusion around the ocular vessels. The patient improved after anti-CMV therapy.

CONCLUSIONPatients who undergone allo-BMT were in immunosuppressed condition, when continuous CMV antigenemia and antigenuremia were detected, associated with characteristic change in retinitis, CMVR could be diagnosed.

Adult ; Bone Marrow Transplantation ; adverse effects ; Cytomegalovirus Retinitis ; drug therapy ; etiology ; Humans ; Male ; Transplantation, Homologous

Natural killer (NK)/T-cell lymphomas represent a rare type of lymphoma derived from either activated NK cells or cytotoxic T cells. They are most commonly extranodal and tend to present as destructive lesions within the midline facial structures. Other than the nasal cavity and Para nasal sinuses, several other extra nodal sites of involvement have been reported, including the pharynx, gastrointestinal tract, and testis. Occasionally, pleural effusion has also been observed. Here, a case of lymphoma of NK/T-cell type presented as pleural effusion was reported. The patient was previously misdiagnosed as B cell non-Hodgkin's lymphoma by pathological and immunohistochemistry (IH) analysis for pleural membrane biopsy specimen. After the analysis of the pleural fluid cells by a combination of morphologic, immunophenotypic, cytogenetic and molecular (MICM) methods in Beijing Dao-Pei hospital, some lymphoblasts were found morphologically, which expressed cytoplasmic CD3 (cCD3) and CD56 by flow cytometry analysis and had a clonal T-cell receptor gamma (TCR-gamma) gene rearrangement by molecular analysis, so that the diagnosis was finally corrected as NK/T-cell lymphoma and an allogeneic stem cell transplantation was successfully performed. In conclusion, this unusual case highlights the significance of MICM combined techniques for the diagnosis of lymphoma, as well as an unusual presentation of a rare disease and the successful treatment.
Cytological Techniques ; Humans ; Lymphoma, Extranodal NK-T-Cell ; complications ; diagnosis ; Male ; Middle Aged ; Natural Killer T-Cells ; Pleural Effusion ; diagnosis ; etiology

The aim of this study was to establish a simple, convenient and efficient method of producing placental-eluted gamma globulin (PEGG) from human placenta, explore its inhibitory effect on the function of T lymphocyte in vitro and graft-versus-host disease (GVHD) in vivo. PEGG was prepared by elution at acid pH from human placental tissues that were extensively washed. Its effects on T lymphocyte proliferation induced by PHA and mixed lymphocyte reaction (MLR) were analysed by BrdU ELISA, its effect on the CD25 and CD69 expression on T cells was observed by flow cytometry, and the interferon gamma (IFN-gamma) and interleukin-4 (IL-4) quantification in MLR supernatant were assayed by ELISA. A murine GVHD model was established, the effect of PEGG on the manifestation and pathologic change of GVHD and 45-day survival rate were observed. The results showed that considerable level of immunoglobulin could be eluted from placenta at acid PH, of which the main components were IgG checked by SDS-PAGE analysis. In vitro study indicated that PEGG significantly inhibited both the proliferative response of T cells to PHA and the MLR, down-regulated the expression of CD25 and CD69 on T cells stimulated by PHA, and decreased the secretion of IFN-gamma but increased the production of IL-4 in MLR supernatant. In vivo, recipient mice treated with PEGG had a markedly increased survival rate with less histopathological evidence of GVHD. It is concluded that PEGG can inhibit the proliferation and activation of T cells, regulate the direction of T helper cells differentiating towards Th2 type, and effectively prevent GVHD in a murine model. In short, PEGG may be a potent therapeutic agent for GVHD.
Animals ; Bone Marrow Transplantation ; adverse effects ; Female ; Graft vs Host Disease ; drug therapy ; Humans ; Immunosuppressive Agents ; isolation & purification ; pharmacology ; therapeutic use ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Placenta ; chemistry ; T-Lymphocytes ; drug effects ; immunology ; gamma-Globulins ; isolation & purification ; pharmacology ; therapeutic use

It has been well-known that intravenously infused hematopoietic stem and progenitor cells can home to the bone marrow and reconstitute hematopoiesis. However, little is understood about the homing efficiency or percentage of infused stem and progenitor cells. In order to examine distribution pattern of infused hematopoietic cells in the organs and tissues, a direct assay system to trace transplanted cells in vivo by employing PKH-26, a red fluorescent membrane dye, to label hematopoietic cells in inbred strain of mice transplanted cells (stem cell antigen-1 positive subpopulation cell, Sca-1(+) cells) was introduced. The numbers of labeled cells was measured by means of flow cytometry and fluorescence microscopy. The early fate of infused Sca-1(+) donor bone marrow cells after intravenous administration in a allogeneic mouse model was examined. The presence of infused donor cells with the fluorescent dye PKH-26 was evaluated within 60 hours in hematopoietic organ (bone marrow and spleen) and non-hematopoietic organ (lungs and liver) of recipients. The data showed that (1) Following intravenous infusion, Sca-1(+) donor bone marrow cells were detained in lungs shortly. (2) Sca-1(+) donor bone marrow cells localized to both hematopoietic organ (bone marrow and spleen) and non-hematopoietic organ (lungs and liver) for periods of up to 60 hours following infusion, however, the number of donor hematopoietic cells localized to bone marrow was more than that localized to non-hematopoietic organ (P < 0.05). These results indicated that there were also donor early hematopoietic cells in non-hematopoietic organ of recipients at the homing phase in allo-BMT mice.

In order to explore the improvement of seeding efficiencies of infused donor hematopoietic cells to bone marrow in bone marrow transplantation, two recipient groups of syngeneic rat model which received transplanted cells labeled with PKH-26, a red fluorescent membrane dye, by aortic or intravenous administration (2 x 10(7) nucleate cells per recipient rat) respectively, were assayed; at selected times following BMT, partial recipient rat were euthanized and then measured the numbers of PKH-26 labeled cells in recipient rat marrow samples by means of flow cytometry. The results showed that the homing indices of donor hematopoietic cells in aortic group and intravenous group were (14.52 +/- 1.07)% and (10.49 +/- 0.72)% at 30 hours after BMT, respectively (P < 0.05). The results indicated that the number of donor hematopoietic cells localized to recipient bone marrow infused by aortic route is more than that infused by intravenous route.

According to previous clinical experiences of the authors, plumbago zeylanica was effective against acute promyelocytic leukemia (APL). However, its effectiveness has never been proven experimentally or unequivocally clinically. This study was aimed to investigate the effects of plumbagin on the proliferation, cell cycle and apoptosis of APL cell line NB4 Cells. Cell inhibitory rates were detected by MTT colorimetric assay; morphologic changes were observed under light microscope and transmission electron microscope; apoptosis-inducing effects were determined by DNA gel electrophoresis, annexin V/PI double-stained and PI single-stained flow cytometry. The results demonstrated that 2-15 micromol/L plumbagin inhibited the proliferation of NB4 cells in a dose-dependent manner. The morphologic changes of cell apoptosis, such as chromsome condensation and apoptotic body formation, were observed by light microscope and transmission electron microscope. Cell cycle analysis showed that NB4 cells were blocked in G2/M phase of cell cycle. And plumbagin induced annexin V+/PI- cell increase and DNA fragmentation. There was a correlation between cell apoptosis rates and the concentrations of plumbagin in dose-dependent manner (P < 0.05). It is concluded that for the first time the present study shows that plumbagin can inhibit cell proliferation, block cell cycle and induce apoptosis of APL cell line NB4 cells.
Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Leukemia, Promyelocytic, Acute ; pathology ; Naphthoquinones ; pharmacology

In this paper, a model of three allogeneic mixed bone marrow transplantation of mice (BALB/c, H-2(d); C57BL/6, H-2(b); and CBA/N, H-2(k)) was established and whether or not prolongation of the survival time in recipient mice was observed. Lethally irradiated mice were transplanted with a mixture of a syngeneic plus two allogeneic bone marrow (A + B + C-->A, in a ratio of 1:4:4). At same time, mixed lymphocyte culture (MLC) with three allogeneic lymphocytes in vitro and two allogeneic antigens stimulated delayed type hypersensitivity (DTH) in vivo were performed. The results showed that the mice receiving mixed bone marrow transplant survived 56.6 +/- 27 days and the longest 103 days, however, only 15 +/- 5 days in the single allogeneic transplantation group. Whether two reacting cells to one stimulating cells or one reacting cells to two stimulating cells, all showed lower activity of MLC than that in one to one control group. In DTH assay, the mice sensitized with two allogeneic antigens showed lower reactivity than that in one antigen stimulated mice. It was concluded that the survival time of recipient mice was significantly prolonged after transplantation with three mixed allogeneic bone marrow.
Animals ; Bone Marrow Transplantation ; immunology ; mortality ; Graft vs Host Disease ; etiology ; Hypersensitivity, Delayed ; etiology ; Lymphocyte Culture Test, Mixed ; Mice ; Mice, Inbred Strains ; Models, Animal ; Survival Rate ; Transplantation, Homologous

OBJECTIVETo investigate the safety and effectiveness of HLA-mismatched allogeneic hematopoietic stem cell transplantation (allo-HSCT) combined with related haploidentical bone marrow infusion for treatment of hematologic malignancies and to explore the mathod for reduction of aGVHD incidence and clinical significance.

METHODSA total of 30 patients with hematologic malignancies (8 cases of AML, 17 AML, 2 MDS and 3 Mix-AL) received related haploidentical and unrelated HLA-mismatched allo-HSCT combined with related haploidentical bone marrow infusion. Among them 20 cases received related haploidentical transplantation of the first donor, 10 cases received unrelated HLA-mismatched treaplantation. The new conditioning regimen for the patients underwent allo-HSCT consisted of fludarabine, busulfan, Me-CCNU and cyclophosphamide. The drugs for GVHD prophylaxis included cyclosporine A and methotrexate, while mycophenolate mofetil and rabbit anti-T-lymphocyte globulin (ATG) were used.

RESULTSAll the patients achieved full engraftment. The median time for neutrophils to reach over 0.5 × 10(9)/L was 14 days (8-26 days), while the median time for platelets to reach over 20 × 10(9)/L was 11.5days (10-24 days). The incidence of I-II grade of aGVHD at 100 d was 22.28% (95% CI 9.9%-34.7%), the incidences of II-IV and III-IV grade of aGVHD were 22.7% (95% CI, 10%-35.4%) and 12.7% (95% CI 6.9%-15.5%) respectively. The incidences of I-II and III-IV cGVHD were 13.3% (95% CI, 1.4%- 26.8%) and 3.3 % (95% CI, 0%-12.2%), one case (3.3%) was in extensive cGVHD. DFS and OS of 2 years were 81.1% (95% CI, 66.0%-96.2%) and 68.2% (95% CI 51.0%-85.4%).

CONCLUSIONThese data suggest that the incidence of grade II-IV grade of aGVHD in recipients of 2 partially HLA-matched units was lower, co-infusion of haplo-BM and partially matched units in allogeneic transplantation is safe and effective for reducing the incidence of aGVHD and improving the survival in DFS.

Antilymphocyte Serum ; therapeutic use ; Busulfan ; therapeutic use ; Cyclosporine ; therapeutic use ; Graft vs Host Disease ; prevention & control ; HLA Antigens ; genetics ; Hematologic Neoplasms ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Incidence ; Leukemia ; therapy ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; Stem Cell Transplantation ; Tissue Donors ; Transplantation Conditioning ; Transplantation, Homologous ; Vidarabine ; analogs & derivatives ; therapeutic use