1.Clinical guidelines for indications, techniques, and complications of autogenous bone grafting.
Jianzheng ZHANG ; Shaoguang LI ; Hongying HE ; Li HAN ; Simeng ZHANG ; Lin YANG ; Wenxing HAN ; Xiaowei WANG ; Jie GAO ; Jianwen ZHAO ; Weidong SHI ; Zhuo WU ; Hao WANG ; Zhicheng ZHANG ; Licheng ZHANG ; Wei CHEN ; Qingtang ZHU ; Tiansheng SUN ; Peifu TANG ; Yingze ZHANG
Chinese Medical Journal 2024;137(1):5-7
3.Increased risk of cardio-cerebrovascular disease after hematopoietic cell transplantation in patients with previous history.
Bo PENG ; Li-Li WANG ; Li-Ping DOU ; Fei LI ; Xiang-Shu JIN ; Lu WANG ; Ming-Yu JIA ; Yan LI ; Jian BO ; Yu ZHAO ; Hai-Yan ZHU ; Wen-Rong HUANG ; Dai-Hong LIU
Chinese Medical Journal 2021;134(12):1431-1440
BACKGROUND:
The impacts of previous cardio-cerebrovascular disease (pre-CCVD) on the outcomes of hematopoietic cell transplantation (HCT) are not well described. Patients with pre-CCVD may often be poor candidates for HCT. This study aimed to investigate the impact of pre-CCVD on transplant outcomes.
METHODS:
A retrospective study was conducted between patients with and without pre-CCVD who consecutively received allogeneic or autologous HCT between November 2013 and January 2020 with a matching of age and disease status. The cardiovascular complications and HCT outcomes of the two groups were evaluated and compared. The primary endpoints were post-transplant cardio-cerebrovascular disease (post-CCVD) and non-relapse mortality (NRM). We used a multivariable Cox proportional hazard model and the Fine-Gray competing risk regressions for analyses to estimate the hazard ratios (HRs).
RESULTS:
The outcomes of 23 HCT recipients with pre-CCVD were compared with those of 107 patients in the control group. No significant differences were noted in terms of engraftment, overall survival (OS) (67.00% vs. 67.90%, P = 0.983), or relapse (29.78% vs. 28.26%, P = 0.561) between the pre-CCVD group and the control group. The cumulative incidences of 2-year NRM were similar between patients with pre-CCVD and the controls (14.68% vs. 17.08%, P = 0.670). However, pre-CCVD was associated with an increased incidence of post-CCVD (HR: 12.50, 95% confidence interval [CI]: 3.88-40.30, P < 0.001), which was an independent risk factor for increased NRM (HR: 10.29, 95% CI: 3.84-27.62, P < 0.001) and inferior OS (HR: 10.29, 95% CI: 3.84-27.62, P < 0.001).
CONCLUSIONS
These findings suggest that the existence of pre-CCVD before transplantation might not result in increased mortality directly but superpose the toxicity of the transplantation procedure, leading to a risk of post-CCVD. Post-CCVD was a powerful predictor for high NRM and inferior OS. Further risk stratification of pre-CCVD is needed to reduce NRM in various transplantation settings.
Cerebrovascular Disorders/etiology*
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Hematopoietic Stem Cell Transplantation/adverse effects*
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Humans
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Proportional Hazards Models
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Retrospective Studies
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Transplantation Conditioning
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Transplantation, Autologous
4.Efficacy and safety of tandem autologous stem cell transplantation in multiple myeloma: a retrospective single-center analysis.
Shunquan WU ; Zongjian QIU ; Ting LIN ; Zhijuan ZHU ; Xiaofan LI ; Xianling CHEN ; Ping CHEN ; Yiting WANG ; Rong ZHAN ; Nainong LI
Chinese Medical Journal 2023;136(15):1873-1875
5.Efficacy and Safety of Etoposide Combined with Cyclophosphamide for Autologous Peripheral Blood Stem Cell Mobilization in Patients with Multiple Myeloma.
Song-Tao TU ; Yu-Lan ZHOU ; Fei LI
Journal of Experimental Hematology 2023;31(5):1410-1414
OBJECTIVE:
To evaluate the efficacy and safety of etoposide combined with cyclophosphamide (EC) regimen for mobilization of autologous peripheral blood stem cells (APBSCs) in patients with multiple myeloma (MM).
METHODS:
The clinical data of 48 MM patients who received APBSC transplantation (APBSCT) in Department of Hematology of the First Affiliated Hospital of Nanchang University from January 2015 to October 2021 were retrospectively analyzed. The mobilization success rate and mobilization optimal rate of EC regimen were counted, and its effect on transplant efficacy, adverse reactions, hematopoietic reconstitution after transplantation, and survival time of MM patients were analyzed.
RESULTS:
APBSCs were collected on day 14 (10-19) after EC administration. The median of collected CD34+ cells was 6.82 (1.27-22.57)×106/kg, and the median number of apheresis session was 2 (1-4). The mobilization success rate (collecting CD34+ cells≥2×106 cells/kg after completion of apheresis) was 98% (47/48), and mobilization optimal rate (collecting CD34+ cells≥5×106 cells/kg after completion of apheresis) was 71% (34/48). The depth of remission were improved after APBSCT, and the complete remission (CR) rate increased from 45.8% before transplantation to 87.5% after transplantation (P <0.01). There was no transplant-related death, no blood transfusion during mobilization, and no mucositis occurred in the patients. The most common complication was neutropenia, with an incidence of 75.0% (36/48). After transplantation, all the patients successfully achieved hematopoietic reconstitution. The median time to neutrophil engraftment was 10 (9-26) days, and median time to platelet engraftment was 10 (8-33) days. By the end of follow-up, both the median progression-free survival (PFS) and overall survival (OS) time were not reached. The 5-year estimated PFS rate and OS rate was 53.8% and 82.4%, respectively.
CONCLUSION
The EC regimen for mobilization of APBSC has a high acquisition success rate and controllable adverse reactions, which can be an effective and safe mobilization regimen in MM patients.
Humans
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Multiple Myeloma/therapy*
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Etoposide/therapeutic use*
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Peripheral Blood Stem Cells
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Hematopoietic Stem Cell Mobilization/adverse effects*
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Retrospective Studies
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Granulocyte Colony-Stimulating Factor
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Cyclophosphamide/therapeutic use*
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Hematopoietic Stem Cell Transplantation/adverse effects*
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Transplantation, Autologous/adverse effects*
6.Selected CD34+ cell autologous transplantation for advanced malignant tumors.
Lu-jia DONG ; Hu CHEN ; Min JIANG ; Liang-ding HU ; Mao-quan QIN ; Wei-jing ZHANG ; Zhi-yong YU ; Shi-kai WU ; Xi-lin CHEN ; Yun-hua BAO ; San-tai SONG ; Duan-qi LIU
Chinese Journal of Oncology 2003;25(2):183-185
OBJECTIVETo determine the clinical results of selected CD34(+) cell autologous transplantation in advanced malignant tumors.
METHODSAfter pretreatment, fifteen patients aged 12 - 70 (49.5) years with various Stage III or IV malignant tumors were given the sorted CD34(+) cells collected by magnetic-activated cell sorting (Clini MACS, Milteny Biotech, Germany).
RESULTSPeripheral blood progenitor cells (PBPC) from the patients were mobilized by chemotherapy and G-CSF 5 micro g/kg per day. CD34(+) cells gave 2.0 - 5 log depletion after cell sorting, with a median yield of CD34(+) selected cells of 2.4 (0.15 - 12.03) x 10(6)/kg. It gave a median recovery of 64 (52 - 81.4)% and median purity of 98.2 (83.2 - 99.7)%. The median time of neutrophil recovery > 1.0 x 10(9)/L and platelet recovery > 20 x 10(9)/L post-transplantation were 14 (8 - 26) days and 13 (11 - 35) days, respectively. On follow-up of 2 - 33 (11) months, the event-free survival rate was 53.3% (8/15) and the overall survival rate was 66.7% (10/15).
CONCLUSIONTransplantation of autologous selected PBPC CD34(+) cells gives prompt and stable engraftment. Selected CD34(+) cell transplantation, being a safe approach, may improve the clinical outcome even in patients with advanced malignant tumors.
Adolescent ; Adult ; Aged ; Antigens, CD34 ; analysis ; Child ; Female ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Middle Aged ; Neoplasms ; mortality ; therapy ; Survival Rate ; Transplantation, Autologous
7.Transplantation of peripheral blood stem cells mobilized by intensified consolidation and granulocyte colony-stimulating factor in acute leukemia.
Yoo Hong MIN ; Seung Tae LEE ; Jin Seok KIM ; Joon Ho JANG ; Hyung Chan SUH ; Hyun Ok KIM ; Jae Sook HAHN ; Yun Woong KO
Yonsei Medical Journal 2001;42(1):65-73
The purpose of this study was to evaluate the feasibility and efficacy of autologous transplantation of peripheral blood stem cells (PBSC) mobilized with high-dose consolidation chemotherapy and granulocyte colony-stimulating factor in patients with acute myelogenous leukemia (AML). Twenty patients received myeloablative chemotherapy or chemo-radiotherapy including total body irradiation followed by the infusion of PBSC. PBSC were collected by large-volume leukaphereses. The mean number of mononuclear cells and CD34-positive cells infused were 7.2 x 10(8)/kg (range, 2.2-16.6), and 6.6 x 106/kg (range, 2.1-27.7), respectively. Engraftment failure was not seen in the enrolled patients. The median time to neutrophil (> or = 500/microL) and platelet recovery (> or = 50,000/microL) from the transplant was 12 days (range, 8-20) and 28 days (range, 10-600), respectively. The 2-year probability of disease-free survival (DFS) and relapse were 43% and 57% for patients with AML transplanted in first complete remission (CR1). The outcome of the patients transplanted in the advanced status was significantly worse than the patients transplanted in CR1 (P=0.04). Most relapses occurred within 1 year after transplantation. Fatal hepatic veno-occlusive disease was observed in one case. Other transplantation-related toxicities were mild. Our results demonstrated that autologous transplantation of high-dose consolidation chemotherapy-mobilized peripheral blood progenitor cells is feasible in the patients with AML in CR1. To further reduce the risk of leukemia relapse, much effort should be contributed to the field of ex vivo purging and post-transplant immunotherapy.
Adult
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Female
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Hematopoiesis
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Hematopoietic Stem Cell Mobilization*
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Hematopoietic Stem Cell Transplantation*/adverse effects
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Human
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Leukemia, Myelocytic, Acute/therapy*
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Leukemia, Myelocytic, Acute/mortality
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Male
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Middle Age
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Transplantation, Autologous
8.Ruptured Renal Artery Stump Aneurysm in a Renal Autotransplanted Behcet's Disease Patient.
Tae Won KWON ; Do Kyun KIM ; Sun Mo YANG ; Kyu Bo SUNG ; Geun Eun KIM
Yonsei Medical Journal 2003;44(5):943-945
A recurrent aneurysm at the anastomosis site or the remaining artery frequently occurs after the operative treatment of an aneurysm in Behcet's disease despite anti-inflammatory medication. Herein, a ruptured left renal artery stump aneurysm in a patient with Behcet's disease, who received a left nephrectomy, aorto-biiliac bypass and heterotopic autotransplantation of the right kidney for the treatment of an abdominal aortic aneurysm and renal hypertension one year prior to this admission, is reported. An aneurysm and rupture occurred despite the administration of anti-inflammatory medications while monitoring of the clinical findings, such as skin manifestations, erythrocyte segmentation rate (ESR) and C-reactive protein (CRP). Although there is no definite proven treatment modality to prevent recurrent aneurysms at the anastomosis site or a remote artery, close follow-up with anti-inflammatory medications, and surveillance with regular intervals are the only current methods for the prevention and/or to treatment of an arterial complication in patients with Behcet's disease.
Adult
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Anastomosis, Surgical/*adverse effects
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Aneurysm, Ruptured/*etiology
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Aortic Aneurysm, Abdominal/*surgery
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Behcet Syndrome/*complications/surgery
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Human
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Hypertension, Renal/surgery
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*Kidney Transplantation
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Male
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Recurrence
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*Renal Artery
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Transplantation, Autologous
9.Effect of orthodontic force on periodontal healing after autotransplantation: an experimental study.
Yun YANG ; Yu-xing BAI ; Song LI ; Wei-min GAO ; Nan RU ; Li-xuan LI
Chinese Journal of Stomatology 2012;47(10):618-621
OBJECTIVETo investigate the effect of the continuous light force to the donor teeth on the periodontal healing after transplantation.
METHODSThirty-two maxillary and mandibular incisors in four 10-month-old male Beagle dogs were autotransplanted. The pulps were removed in all teeth. The teeth were divided into four groups, one control and three experimental groups. In control group (group 1), the teeth were unloaded. In the other three experimental groups, continuous force (0.49 N) was applied in the 1st (group 2), 2nd (group 3) and 4th (group 4) week, respectively. The dogs were sacrificed in the 8th week. The tissue blocks were demineralized and sectioned perpendicular to the long axis of the teeth. The histological analysis was made.
RESULTSHistomophometric analysis revealed a significantly lower occurrence of replacement root resorption in the group 3 (2.1%) than in the control group (12.5%, P < 0.05). The significant lower incidence of replacement root resorption, and a higher surface and inflammatory root resorption were found in group 2 (6.3% and 68.8%) than in the control group (12.5% and 41.7%, P < 0.05). No significant difference was found between group 4 and control group (P > 0.05).
CONCLUSIONSThe orthodontic force promoted the regeneration of the periodontal ligament and prevented dentoalveolar ankylosis, whereas excessive initial force might cause root and bone resorption.
Animals ; Dogs ; Incisor ; transplantation ; Male ; Orthodontic Extrusion ; Periodontal Ligament ; physiology ; Root Resorption ; etiology ; Tooth Replantation ; adverse effects ; Transplantation, Autologous ; Wound Healing
10.Efficacy and safety of autologous hematopoietic stem cell transplantation in elderly multiple myeloma patients: a single center retrospective study.
Bei Hui HUANG ; Juan LI ; Wai Yi ZOU ; Jun Ru LIU ; Jing Li GU ; Xiao Zhe LI ; Mei Lan CHEN ; Li Fen KUANG
Chinese Journal of Hematology 2022;43(2):141-145
Objective: To evaluate the efficacy and safety of autologous hematopoietic stem cell transplantation (auto-HSCT) in elderly patients (≥65 years old) with multiple myeloma (MM) . Methods: From June 1, 2006 to July 31, 2020, 22 MM patients (≥65 years old) who were diagnosed in the First Affiliated Hospital, Sun Yat-sen University and received novel drug induction followed by auto-HSCT were analyzed retrospectively. These patients were evaluated for important organ functions before transplantation, and the International Myeloma Working Group frail score was used in 2016 to screen out transplant-eligible patients. Results: The median (interquartile range, IQR) age at the time of transplantation of the 22 patients was 66.75 (IQR 4.50) years. A total of 20 patients received stem cell mobilization. The median number of mononuclear cells collected was 4.53×10(8)/kg, that of CD34(+) cells was 3.37×10(6)/kg, and the median number of apheresis procedures performed was 2. After stem cell transfusion, the median time of neutrophil implantation was 11 days, that of platelet implantation was 13 days, and the treatment-related mortality was 0 at 100 days after transplantation. The median follow-up was 48.7 months. The median time to progression time was not reached, and the median overall survival time was 111.8 months. Conclusion: Auto-HSCT is a safe and effective treatment for selected elderly patients of 65 years or older with MM.
Aged
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Hematopoietic Stem Cell Mobilization/methods*
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Hematopoietic Stem Cell Transplantation/adverse effects*
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Humans
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Multiple Myeloma/drug therapy*
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Retrospective Studies
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Transplantation, Autologous/methods*
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Treatment Outcome