3.Unrelated allogeneic umbilical cord blood transplantation: present status, problems and countermeasures.
Shao-Liang HUANG ; Dun-Hua ZHOU
Journal of Experimental Hematology 2009;17(1):1-7
As unrelated allogeneic umbilical cord blood transplantation (UCBT) has been developed for 20 years already since 1988, more than ten thousands cases have cumulatively undergone UCBT over the world. A huge number of clinical data confirmed that UCBT had unique characters with low rate of severe GVHD. The efficacy and data on TRM, relapse and EFS of allogeneic UCBT with HLA 0-1 mismatched are similar to those in HLA matched BMT. UCBT has become the optimal choice for source of hematopoietic stem cells for allogeneic stem cell transplant especially when HLA-matched or haploidentical donors are not available in time. In most developed countries, unrelated allogeneic UCBT developed successively, and in recent years HLA mismatched UCBT with double units performed in adults increased even more rapidly than in children. Another recent trend of UCBT has been extending to treat some non-malignant but refractory diseases in pediatrics, such as severe combined immunodeficiency, thalassemia major, bone marrow failure syndrome and metabolic disorders. The clinical successful practice of double units for cord blood transplantation inspires to ponder over questions remaining mystery. What is the conflict like between two mismatched donor cells in vivo, which does not spoil the whole transplantation but enable the patient to be engrafted successfully without any increment of the dosage by the sum of two doses together? How can they both be taken at the same time firstly by the recipient, but why does only one predominate later? What are the factors enable the donor cells of the winner to sustain? With the references of the international experiences, how to solve the clinical encountered problems, perspective of unrelated allogeneic UCBT and proper strategies to be enacted are reviewed.
Cord Blood Stem Cell Transplantation
;
adverse effects
;
methods
;
Humans
;
Tissue Donors
;
Transplantation, Homologous
5.Cytomegalovirus retinitis after allogeneic bone marrow transplantation: a case report and literature review.
Jin LU ; Xiao-jun HUANG ; Dao-pei LU
Chinese Journal of Hematology 2003;24(6):312-315
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
6.Discussion on the key aspects of risk control and problems of quality management systems for allogeneic bone products.
Chinese Journal of Medical Instrumentation 2012;36(5):365-369
From the view of the potential risks of allogeneic bone products in clinical use. the key aspects of risk control and quality management for these products are discussed, as well as the general problems existing in the quality management system of their production enterprises in China are briefly introduced.
Bone Transplantation
;
instrumentation
;
methods
;
Humans
;
Quality Control
;
Risk Assessment
;
Transplantation, Homologous
;
adverse effects
;
instrumentation
;
methods
8.Influential factors and therapeutic options for erectile dysfunction in allograft renal transplantation recipients.
Zheng-guo JI ; Ye TIAN ; Li-sheng CHEN
National Journal of Andrology 2007;13(4):360-363
The quality of sexual life is important for renal transplantation recipients. With the increase of survival rate of renal transplantation, the quality of the male recipients' sexual life, especially their erectile function, has been generally remarked. The prevalence of ED is 35.8%-78.3% in male allograft renal transplantation recipients. And it can be caused by various factors, such as age, dialysis time, modus operandi, hemoglobin level, deprementia, immunosuppressant, and diabetes. We give an overview of the therapeutic options for ED in this special population. Sildenafil is effective and safe. If the oral drug fails, we can choose intracavernosal injection and penile prosthesis implantation. Nevertheless, three-piece prostheses should be avoided.
Erectile Dysfunction
;
epidemiology
;
therapy
;
Humans
;
Kidney Transplantation
;
adverse effects
;
Male
;
Prevalence
;
Quality of Life
;
Transplantation, Homologous
;
adverse effects
9.Novel strategy and latest research progress on treatment of acute graft versus host disease.
Bo TANG ; Heng ZHU ; Fan ZHOU ; Yi ZHANG
Journal of Experimental Hematology 2014;22(2):543-548
Acute graft-versus-host disease (aGVHD) is the major complication associated with allogeneic hematopoietic stem cell transplantation (allo-HSCT) and the major cause of morbidity and mortality following allo-HSCT. Diagnosis of aGVHD is typically based on clinical symptoms and confirmed by biopsy. Once aGVHD has occurrence, the steroids should be the first choice of treatment. However, if the treatment with steroids failed, the prognosis would be poor. In recent years, the novel strategies for the treatment of aGVHD have been developed. In this article, the clinical features, pathogenesis and novel strategies, including mAb treatment, physical and cell therapies are briefly summarized.
Acute Disease
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Graft vs Host Disease
;
therapy
;
Hematopoietic Stem Cell Transplantation
;
adverse effects
;
Humans
;
Transplantation, Homologous
;
adverse effects
10.Expression and Prognostic Impact of HK2 in Bone Marrow of Patients with Newly Diagnosed Acute Myeloid Leukemia.
Ping MA ; Li-Huan SHI ; Liang TIAN ; Ya-Feng WANG ; Jian-Wen ZHOU ; Yan-Na MAO ; Wei LIU ; Yu-Wei HOU ; Hui SUN
Journal of Experimental Hematology 2023;31(5):1309-1314
OBJECTIVE:
To detect the expression level of HK2 gene in the bone marrow of newly diagnosed patients with acute myeloid leukemia (AML) and investigate its influence on the clinical characteristics and prognosis.
METHODS:
The expression level of HK2 gene in the bone marrow of 90 newly diagnosed patients with AML that accompanying clinical characteristics and survival status were detected by RT-qPCR, and compared with 18 allogeneic hematopoietic stem cell transplantation (allo-HSCT) donors. The Chi-square test, Kaplan-Meier survival analysis, and Cox proportional hazards regression model were used to analyze the correlation of HK2 expression level with clinical characteristics and prognosis.
RESULTS:
Compared with allo-HSCT donors, the HK2 expression was significantly increased in newly diagnosed AML patients (P <0.01). Compared with patients with total response (OR, complete response + complete response with incomplete hematologic recovery) after 2 courses of induction chemotherapy, the expression of HK2 in patients without OR was significantly increased (P <0.05). There was a significant difference in the relative expression of HK2 between patients with and without OR after 2 courses of induction therapy (P <0.001). The median survival time of patients with high expression of HK2 was significantly shorter than that of patients with low expression of HK2 (P <0.05). The multivariate Cox proportional hazards regression analysis showed that prognostic stratification, the expression level of HK2, and whether two courses of induction therapy achieved OR were independent factors affecting the prognosis of AML patients (P <0.05).
CONCLUSIONS
Compared with allo-HSCT donors, the expression level of HK2 gene is increased in the bone marrow of newly diagnosed AML patients. The prognosis of patients with high expression of HK2 is poor. The expression level of HK2 is an independent factor affecting the prognosis of AML patients.
Humans
;
Bone Marrow
;
Hematopoietic Stem Cell Transplantation/adverse effects*
;
Leukemia, Myeloid, Acute/therapy*
;
Prognosis
;
Retrospective Studies
;
Transplantation, Homologous/adverse effects*