OBJECTIVETo retrospectively analyze the curative effects and prognostic factors of HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic myelogenous leukemia patients (CML).

METHODSOf the 35 CML patients, 26 were males and 9 were females, with a median age of 32 (12 - 50) years. 30 patients were in chronic phase of CML, 5 patients were in accelerated phase. Allo-HSCT from HLA identical siblings was performed for 35 patients, of whom 11 received bone marrow transplantation (BMT) and 24 peripheral blood stem cell transplantation (PBSCT). Conditioning regimens was TBI (total-body irradiation) + CY (CTX) protocol in 8 patients and BU/CY protocol in 27 patients. The average follow-up was 48 months (range 7 - 108 months).

RESULTS34 (97.1%) patients were successfully engrafted. Among them, 21 patients (60.0%) had three years disease-free (DFS) survival. The overall 5-year survival (OS) was 57.1%. Two patients (5.7%) relapsed. Transplant-related mortality occurred in 12 patients. Hemorrhagic cystitis (HC) occurred in 5 patients and HVOD was observed in 1 patient. Acute graft-versus-host disease (aGVHD) occurred in 18 patients (51.4%), among them 7 patients (20.0%) were of grade III-IV. Chronic GVHD was in 17 patients (48.5%). There was no significant difference in 3-years DFS between BMT group and PBSCT group (54.5% vs. 62.5%, P > 0.05). The 3-year disease-free survival (DFS) was 42.9% in TBI/CY group and 55.6% in BU/CY group (P > 0.05). In univariate prognostic analysis model, the DFS at 3 years is 75% and 47.4% for < or =30 years patients and >30 years patients, respectively, P < 0.05. The 3-year DFS of patients with first chronic phase is higher than patients with advanced diseases (61.3% vs. 40%, P < 0. 05). The 3-year DFS in patients of grade I - II GVHD was higher than that in patients of grade III-IV GVHD (81.8% vs. 14.3%, P < 0.05).

CONCLUSIONThe patients who had transplantation done within 1 year after diagnosis during their first chronic phase of disease and who had low-grade GVHD have better prognosis. Those patients who had III-IV acute GVHD are prone to incorporate severe infection, which was a worse prognostic factor of allo-HSCT for chronic myelogenous leukemia.

Adolescent ; Adult ; Age Factors ; Child ; Cystitis ; etiology ; Disease-Free Survival ; Female ; Follow-Up Studies ; Graft vs Host Disease ; etiology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; methods ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; mortality ; therapy ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Siblings ; Survival Rate ; Transplantation Conditioning ; Transplantation, Homologous

The respiratory tract is primary contact site of the body and environment,and it is ventilated by 10-20 thousand liters of air per day.Inevitably,the respiratory system comes into contact with airborne microbes,which contain the disease-causing pathogens.Airway epithelial cells (AECs) are known to have innate sensor functions,which are similar to the "professional" immune cells,such as alveolar macrophage and sub-or intra-epithelial dendritic cells (DCs).Thus AECs are able to detect invading microbial danger including different types of respiratory viruses,and mount a potent host response,for example,activating type Ⅰ interferon signaling pathway genes.To avoid chronic inflammation and maintain the immunological homeostasis,the pulmonary system has developed intrinsic mechanisms to control local immune responses.Most recently,the role of AECs in control of local immunity has gained much attention,as 1) AECs express the pattern recognition receptors (PRRs),such as Toll-like receptors,retinoic acid inducible gene Ⅰ (RIG-Ⅰ)-like receptor,and so on,thus AECs are equipped to Participate in innate detection of microbial encounter;2) To keep immunological homeostasis in the respiratory tract,AECs behave not only as innate immune sensors but also as immune modulators in parallel,through modulating the sensitivity of innate immune sensing of both AECs per se and sub-or intra-epithelial immune cells;3) Loss of modularity capacity of AECs might be involved in the development of chronic airway diseases.In present review,how the AECs act will be intensively discussed in response to respiratory viruses and modulate the local immunity through cis-and trans-factors (direct and indirect factors),as well as the consequence of impairment of this control of local immunity,in the development and exacerbation of airway diseases,such as acute and chronic rhinosinusitis.