1.Long-term survival and clinical implications of allogeneic stem cell transplantation in relapse/refractory lymphoma: A 20-year Singapore experience.
Wei Sheng Joshua LOKE ; Jean Rachel CATAPIA ; Chay Lee LOW ; Francesca LIM ; Jeffrey QUEK ; Hein THAN ; Yeow Tee GOH ; Yeh Ching LINN ; Colin Phipps DIONG ; Aloysius HO ; William HWANG ; Chung Cheng Jordan HWANG ; Aditi GHOSH ; Liang Pui KOH ; Lip Koon TAN ; Joanne LEE ; Li Mei Michelle POON ; Cheng Kiat Lawrence NG
Annals of the Academy of Medicine, Singapore 2024;54(1):5-16
INTRODUCTION:
Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a curative option for relapse/refractory (R/R) lymphomas that have failed autologous transplantation or for high-risk lymphomas in the upfront setting. We conducted a retrospective analysis on consecutive lymphoma patients who underwent allo-HSCT over a 20-year period (2003- 2022) at Singapore General Hospital and National University Hospital Singapore.
METHOD:
A total of 121 patients were included in the study. Median age was 41 years. Diagnoses include Hodgkin lymphoma (HL, 15%), B-cell non- Hodgkin lymphoma (B-NHL, 34%), T-cell non-Hodgkin lymphoma (T-NHL, 31%) and natural killer T-cell lymphoma (NKTL, 20%). Moreover, 27% of patients had prior auto-haematopoietic stem cell transplanta-tion (auto-HSCT), and 84% received reduced intensity conditioning (RIC). Donor types were matched sibling donor (45%), matched unrelated donor (29%), haploidentical donor (19%) and cord blood (CB, 7%).
RESULTS:
After median follow-up of 56 months, estimated 4-year progression-free survival (PFS) and overall survival (OS) for all patients were 38% and 45%, respectively. Non-relapse mortality (NRM) was 15% at day 100 and 24% at 1 year. On univariate analysis, complete remission status at transplant and RIC confers superior OS. On multivariate analysis, HL was associated with superior OS compared to NHL, whereas matched unrelated donor transplant was associated with significantly inferior OS compared to matched sibling donor.
CONCLUSION
Long-term curative durability was observed with allo-HSCT for patients with relapsed/ refractory lymphomas. This real-world data serves as a valuable historical benchmark for future studies on lymphomas in Singapore and the Asia Pacific region.
Humans
;
Singapore/epidemiology*
;
Adult
;
Male
;
Retrospective Studies
;
Female
;
Hematopoietic Stem Cell Transplantation/methods*
;
Middle Aged
;
Transplantation, Homologous
;
Young Adult
;
Transplantation Conditioning/methods*
;
Lymphoma/mortality*
;
Adolescent
;
Hodgkin Disease/mortality*
;
Aged
;
Lymphoma, B-Cell/mortality*
2.Cathelicidin LL-37 level in presence and absence of vitamin D in cultured macrophages isolated from elderly women
Joyeta Ghosh ; Aditi Nag Chaudhuri ; Indranil Saha ; Debnath Chaudhuri
Malaysian Journal of Nutrition 2022;28(No.3):327-334
Introduction: Vitamin D deficiency and frequent infections are the two common
worldwide phenomenon among elderly. Recent studies have demonstrated that
vitamin D regulates the expression of specific endogenous antimicrobial peptides
like cathelicidin LL-37 of macrophages and neutrophils, which is active against a
broad spectrum of infectious agents. Therefore, the objective of the present study
was to determine the level of cathelicidin LL-37 in macrophages of elderly women
(classified according to serum 25(OH)D level) after exposure to Vibrio cholera
infection and to find out the effect of 1,25(OH)2D added in vitro. Methods: This study
was conducted among 40 randomly selected rural elderly women aged between
60 to 70 years of age. Their vitamin D status was assessed by the estimation
of serum 25(OH)D and classified into three groups viz. sufficient (14 members),
insufficient (13 members), and deficient (13 members). Later, their peripheral blood
mononuclear cells (PBMC) were isolated and cultured from fresh blood. 1,25(OH)2D
supplementation was given selectively at a dose of 10 ×10-8 M for 72 hours in the
culture media; then exposed to infection and screened according to the objectives of
this study. Results: Macrophages in all groups, except vitamin D deficient group,
responded significantly in terms of LL-37 release during exposure to Vibrio cholera
infection. Considering in vitro 1,25(OH)2D, supplementation responded significantly
(p<0.05) in all three groups. Conclusion: Vitamin D can be used as a prophylaxis
to enhance cathelicidin LL-37 release for all three groups as in the present study.


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