Dendritic Cells ; pathology ; Hematologic Neoplasms ; diagnosis ; therapy ; Humans

The treatment for chronic myeloid leukemia is still a challenge,at present.Tyrosine kinase inhibitors can partially control chronic myeloid leukemia in blast crisis (CML-BC),but the effect is not durable.Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only way that can cure CML-BC.This paper presents a review of the treatment before allo-HSCT for CML-BC,the selection of condition regimen,donor and hematopoietic stem cell,the monitoring of MRD post-transplant,the prophylaxis and intervention of relapse.

OBJECTIVE To evaluate the role of real-time fluorescent quantitative PCR assay in the early diagnosis of invasive aspergillosisi(IA) after allo-hematopoietic stem cell transplantation.METHODS All 123 serum samples from 18 IA patients and 38 no-invasive fungal infection(IFI) patients were detected by TaqMan-based real-time PCR to explore the cutoff of this array,while the primer and probe could amplificate five major Aspergillus species including A.fumigatus,A.flavus,A.niger,A.terreus and A.oryzae.RESULTS The optimal value could be acheived while the cutoff was set as two or more consecutive sample DNA≥15pg/?l in a week,and the sensitivity and specificity was 94.4% and 100.0%,respectively.CONCLUSIONS Real-time fluorescent quantitative PCR is helpful in early diagnosis of invasive aspergillosis.

Objective To study the value of c-reactive protein (CRP) level in the diagnosis and efficacy evaluation of clinical complications in patients after bone marrow transplantation.Methods Sixty-six patients with different complications after bone marrow transplantation were included and CRP levels were tested.The relationship between CRP levels and corresponding clinical complications were analyzed.Results The levels of CRP were significantly different in different complications after the bone marrow transplantation.CRP may marketly increase in the patients with bacterial infection,bacteria-associated mixed infection,ultra-acute GVHD,and ATG reaction;CRP may mildly increase in patients with bacterial infection,fungal infection,bacteria-associated mixed infection,acute/chronic GVHD;CRP did not increase in the patients with viral infection.CRP level reached the highest value in patients with most obvious clinical symptoms of bacterial infection,gradually decreased in patients after effective treatment,those restored to normal but then increased CRP always indicated new clinical complications.Conclusion CRP is a valuable mark for the early differential diagnosis and efficacy of therapy for complications in patients after bone marrow transplantation.

20.0?109/L was day 13(11~21).All the patients got engraftment successfully and attained CR.Acute Ⅰ~Ⅱ GVHD occurred in 5 patients,no acute Ⅲ~Ⅳ GVHD occurred and extensive chronic GVHD did in 2 patients.All the patients were alive and only one patient relapsed after 3~53 months follow-up.Conclusion TBI-based conditioning regimen appears to be safe and effective for non-T-depleted HLA mismatched hemotopoietic stem cell transplants,especially for high-risk and second transplant patients.

Objective To investigate the efficacy and safety of oral ganciclovir on cytomegalovirus viremia in patients receiving allogeneic stem cell transplantation.Methods Thirty patients who were treated with oral ganciclovir from Feb,2006 to May,2006 were studied.Intravenous ganciclovir was used 10 mg/(kg?d)for eight days before HSCT as prophylaxis of CMV infection.Cytomegalovirus was detected after HSCT once a week using polymerase chain reaction(PCR)method.If CMV was positive and CMV-DNA load was higher than 6.0?102 copies/mL and lower than 105 copies/mL,oral ganciclovir was used for the treatment(1 g,three times a day).Results CMV viremia was positive at a median time of 42 days after HSCT;median CMV-DNA load was 4.626?103 copies/mL.Good response on CMV DNA load(reduction below 6.0?102 copies/mL)was observed in 90% of oral ganciclovir and the response rate was 70.0% within 14 days.Median duration of therapy for good response was 10 days(range 2~30 days).Severe adverse effects were not observed and CMV-related disease did not occur.Conclusion Oral ganciclovir is an attractive and safe alternative for pre-emptive CMV viremia treatment in allo-HSCT recipients.

Objective To study the adsorption capability of chitosan(CTS)for Ni~(2+)in water.Methods The effects of different adsorption time(0-360 min),different temperature(25-60℃)and different initial pH value of the solution(4-8)on the adsorption were investigated.The adsorption kinetics and thermodynamics of CTS for Ni~(2+)in water were also studied and the IR of CTS and CTS-Ni~(2+)were determined.Results The maximal adsorption quantity could reach to 42.15 mg/g in the optimum condition that the temperature is 25℃,pH value was 7.0 and the adsorption time was 4 h.The adsorption kinetics showed that the pseudo-second-order equation was suitable for describing the adsorption of CTS for Ni~(2+)and the related correlation coefficients were more than 0.99.The calculated value of equilibrium adsorption quantity of Ni~(2+)was 45.05 mg/g.Study of adsorption thermodynamics showed that the linear regression equation of lnk and 1/T was lnk=-0.827 7/T+3.416 2,and the correlation coefficient was 0.998 9.The enthalpy change(△H~0)was 6.88 kJ/mol and the entropy change(△S~0)was 28.40 J/(mol?K).The IR showed that the coordination reaction occurred between-NH_2,-OH of CTS and Ni~(2+).Conclusion CTS can effectively remove Ni~(2+) in water.The adsorption of CTS for Ni~(2+)is spontaneous and endothermic.High temperature which is beneficial to the adsorption does not influence the adsorption quantity obviously.

Objective To investigate the photodynamic effect induced by laser and use it as a method for purging of minimal residual tumor cells from autologous peripheral blood stem cell grafts. Methods We studied the effect of various concentrations of hematoporphyrin derivative (HPD) combined with of different time of laser irradiation on human leukemia cell line K562, breast tumor cell line MCF-7 and human umbilical cord blood-derived hematopoietic stem/progenitor cells by using MTT assay to compare the photodynamic effect between cell lines of each group. Results HPD or laser irradiation alone had no apparent cytotoxicity while the application of HPD plus laser exposure caused photosensitization. HPD plus laser irradiation was more efficient for killing K562 cells and MCF-7 cells than doing the normal human umbilical cord blood-derived hematopoietic stem/progenitor cells. The photodynamic effect on K562 cells and MCF-7 cells was positively correlated with the increase of treatment duration and HPD concentration. Conclusion These results indicated that the laser photodynamic effect mediated by HPD might be used for purging autologous peripheral blood stem cell grafts in vitro.

Objective To evaluate the prognostic value of the expression of epidermal growth factor receptor (EGFR) and nm23 in patients with nasopharyngeal carcinoma (NPC). Methods From 2003 to 2006, 127 NPC patients who had undergone biopsy before radiotherapy were reviewed retrospectively. All patients received intensity-modulated radiotherapy using 6 MV X-rays combined with platinum-based chemotherapy. Immunohistochemistry SP method was adopted to detect the expression of EGFR and nm23 in NPC biopsy specimens . The relationship between the expression of EGFR and nm23 and survival was analyzed. Results The positive rate of EGFR and nm23 were 80.3% and 47. 2% respectively. The nm23expression was correlated with distant metastasis (χ2=7.03, P = 0. 008 ). The 5-year estimated local control, over-all survival (OS) and disease-free survival (DFS) were 58.3% ,53.5% and 46. 5%. Patients with negative expression of EGFR had a significantly better 5-year OS, DFS (χ2=8.23, P=0.004;χ2=5.25,P=0.022) than those with positive expression. Patients with positive expression of nm23 had a significantly higher 5-year OS (χ2=15.68, P = 0. 000) and DFS (χ2=14. 85, P = 0. 000) than those with negative expression. The clinical stage, EGFR and nm23 expression were independent prognostic factors shown by Cox proportional hazard model (χ2=23.03, 18.33, 39.92, P= 0.000, 0.000, 0.000).Conclusions The EFGR and nm23 expression were correlated with the prognosis in NPC patients.

Objective To compare the clinical features of cytomegalovirus (CMV) infection and CMV disease after allogeneic hematopoietic stem-cell transplantation (HSCT) from HLA haploidentical related doors vs.HLA-matched sibling donors.Methods A total of 327 patients who received allogeneic HSCT from Jan.2011 to Dec.2011 were enrolled.There were 312 patients who had complete serological data before HSCT including 216 cases of HLA haploidentical related HSCT and 96 cases of HLA-matched sibling HSCT.Monitoring of CMV antigenemia was performed by using real-time quantitative (RQ) PCR after transplantation.Risk factors were compared by univariate and multivariate analysis.Results The cumulative incidence of CMV infection and CMV disease was (80.1 ± 2.7) ％ and (8.7 ± 2.0) ％ in HLA haploiddentical HSCT group,and (21.1 ± 4.9) ％ and 0 in HLA-matched sibling HSCT group respectively,and the difference was statistically significant between the two groups (P＜0.01).Univariate analysis revealed that HLA haploidentical related HSCT,less than 20 years of age,high risk disease,CMV-IgG serum positivity in patients or donors,acute graft-versus-host disease (aGVHD),EB viremia,and hemorrhagic cystitis were the risk factors of CMV infection.HLA haploidentical related SCT and hemorrhagic cystitis were the risk factors for CMV disease.Multivariate analysis showed that patients less than 20 years of age had a significantly high incidence of CMV infection.Patients from HLA-matched sibling HSCT,low risk disease,aGVHD,hemorrhagic cystitis had a significantly low incidence of CMV infection.Conclusion Compared with patients receiving HLA-matched sibling HSCT,those who received HLA haploidentical related HSCT had significantly high incidence of CMV infection and CMV disease,which were correlated with incidence of hemorrhagic cystitis.