OBJECTIVETo study the relationship between pretransplantation host thymic recent output function and prognosis in HLA-matched sibling bone marrow transplantation (MSD-BMT) and determine whether pretransplantation host thymic recent output function can act as a marker for predication of prognosis after HSCT.

METHODST-cell receptor excision circle (TREC) in DNA of pretransplantation peripheral blood mononuclear cells from 64 patients underwent MSD-BMT was detected by real-time quantitative PCR. The content of TREC in 70 normal donors was detected as well. All clinical data of patients after HSCT were collected and studied. Survival rates of patients after HSCT were estimated with Log-rank test. Univariate and multivariate analysis of prognostic factors were carried out by COX's proportional hazard regression model.

RESULTSThe mean value of TREC in normal donors was (3351 +/- 3711) copies/10(5) cells. There was an inverse correlation between TREC and age in the donor groups. Before transplantation, all patients were detected TREC, with a mean TREC number of (180 +/-332) copies/10(5) cells being significantly lower than that of normal donors. The results of univariate analysis showed that the counts of pre-HSCT TREC were closely, correlated with long term survival and chronic graft versus host disease (cGVHD) (P < 0.05) and with CMV infection (P = 0.084) but not with acute graft versus host disease (aGVHD). The results of multivariate analysis showed the same thing as that of univariate analysis.

CONCLUSIONPretransplantation host thymic recent output function is closely correlated with prognosis in MSD-BMT and can be a factor for predicting the outcome of HSCT.

Adolescent ; Adult ; Child ; Female ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Male ; Middle Aged ; Prognosis ; Receptors, Antigen, T-Cell ; genetics ; Retrospective Studies ; Siblings ; Thymus Gland ; immunology ; Transplantation, Homologous ; immunology ; methods

Objective To evaluate the clinical efficacy of drospirenone and ethinylestradiol tablets combined with gonadotropin-releasing hormone agonistin(GnRH-a) in treatment of patients with uterine muscular glands and its effect on serum ovarian cancer antigen (CA125) and human epididymis protein (HE4).Methods A total of 96 patients with adenomyosis were randomly divided into control group and treatment group,each group 48 cases.Control group was given levonorgestrel intrauterine birth control system,placed levonorgestrel intrauterine system,given drospirenone ethinyl estradiol tablets (ethinyl estradiol 0.03 mg and drospirenone 3 mg),once a day,orally given for 21 d,and stopped for 7 d,then continue for 3 months after discontinuation of oral,according to this method for 3 consecutive months medication.Treatment group was given GnRH-a 3.75 mg every 4 weeks a time before treatment,subcutaneous injection for 3 times.The clinical effect,cancer antigen-125 (CA125),human epididymis protein 4 (HE4),B lymphocyte tumor-2 (Bcl-2),Bcl-2 relative X protein (Bax),caspase-3 and adverse drug reactions in two groups were observed.Results After treatment,the clinical efficacy in control group was 81.25％ (39/48 cases),had significant difference with that in treatment group,which was 95.83％ (46/48 cases,P ＜0.05).The levels of serum CA125,HE4 and Bcl-2 and uterine volume in treatment group were (27.22 ±0.35) U · L-1,(20.67 ±0.52) pmol · L-1,(3.62 ±0.43) μg · mL-1,(95.11 ± 10.29)cm2,had significant difference with those in control group,which were (41.42 ± 0.43) U · L-1,(36.67 ± 0.38) pmol · L-1,(4.76 ± 0.52) μg · mL-1,(120.02 ± 13.92) cm2 (P ＜0.05).The levels of Bax and caspase-3 in treatment group had significant difference with control group (P ＜ 0.05).The adverse drug reactions in treatment group were agitation,nausea,intermenstrual bleeding,total incidence rate of adverse drug reactions was 6.25％ (3/48 cases).The adverse drug reactions in control group were nausea,intermenstrual bleeding,skin rash,total incidence rate of adverse drug reactions was 14.58％ (7/48 cases,P ＞ 0.05).Conclusion Drospirenone and ethinylestradiol tablets in the treatment of adenomyosis was effective with high safety.