BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a well-established treatment modality for a variety of diseases. Immune reconstitution is an important event that determines outcomes. The immune recovery of T cells relies on peripheral expansion of mature graft cells, followed by differentiation of donor-derived hematopoietic stem cells. The formation of new T cells occurs in the thymus and as a byproduct, T cell receptor excision circles (TRECs) are released. Detection of TRECs by PCR is a reliable method for estimating the amount of newly formed T cells in the circulation and, indirectly, for estimating thymic function. The aim of this study was to determine the role of TREC quantitation in predicting outcomes of human leucocyte antigen (HLA) identical allogenic HSCT.METHODS: The study was conducted on 100 patients receiving allogenic HSCT from an HLA identical sibling. TREC quantification was done by real time PCR using a standard curve.RESULTS: TREC levels were inversely related to age (P=0.005) and were significantly lower in patients with malignant diseases than in those with benign diseases (P=0.038). TREC levels could predict relapse as an outcome but not graft versus host disease (GvHD) and infections.CONCLUSION: Age and nature of disease determine the TREC levels, which are related to relapse.
Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Methods ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Receptors, Antigen, T-Cell ; Recurrence ; Siblings ; T-Lymphocytes ; Thymus Gland ; Transplants

Transfusion-associated graft-versus-host disease (TA-GVHD) is known as one of common complications of blood transfusion. The blood irradiation is generally accepted as a proven method to prevent from this disease, for the reason that it makes lymphocytes inactivated in blood products. The blood irradiation indicator provides a guarantee of proper radiation dose, thus improving the transfusion safety. Though widely used in developed countries for decades, the blood irradiation indicator is still in the initial stage in our country. In this review, the action principle, applications and applied value of the blood irradiation indicator are summarized briefly.
Blood Transfusion ; Graft vs Host Disease ; Humans ; Lymphocytes ; Transfusion Reaction

Preterm infants are a special group, and related severe neurological, respiratory, and digestive disorders have high disability/fatality rates. Allogeneic cell transplantation may be an effective method for the prevention and treatment of these diseases. At present, animal studies have been conducted for allogeneic cell transplantation in the treatment of hypoxic-ischemic encephalopathy, bronchopulmonary dysplasia, and necrotizing enterocolitis. The main difficulty of this technique is graft-versus-host reaction (GVHR), and successful induction of immune tolerance needs to be achieved in order to solve this problem. This article reviews the research advances in immune tolerance of allogeneic cell transplantation in preterm infants.
Apoptosis ; Cell Transplantation ; adverse effects ; Cytokines ; physiology ; Graft vs Host Reaction ; Humans ; Immune Tolerance ; Infant, Newborn ; Infant, Premature ; immunology ; Transplantation, Homologous

In the field of orofacial surgery, a red blood cell transfusion (RBCT) is occasionally required during double jaw and oral cancer surgery. However, the question remains whether the effect of RBCT during the perioperative period is beneficial or harmful. The answer to this question remains challenging. In the field of orofacial surgery, transfusion is performed for the purpose of oxygen transfer to hypoxic tissues and plasma volume expansion when there is bleeding. However, there are various risks, such as infectious complications (viral and bacterial), transfusion-related acute lung injury, ABO and non-ABO associated hemolytic transfusion reactions, febrile non-hemolytic transfusion reactions, transfusion associated graft-versus-host disease, transfusion associated circulatory overload, and hypersensitivity transfusion reaction including anaphylaxis and transfusion-related immune-modulation. Many studies and guidelines have suggested RBCT is considered when hemoglobin levels recorded are 7 g/dL for general patients and 8-9 g/dL for patients with cardiovascular disease or hemodynamically unstable patients. However, RBCT is occasionally an essential treatment during surgeries and it is often required in emergency cases. We need to comprehensively consider postoperative bleeding, different clinical situations, the level of intra- and postoperative patient monitoring, and various problems that may arise from a transfusion, in the perspective of patient safety. Since orofacial surgery has an especially high risk of bleeding due to the complex structures involved and the extensive vascular distribution, measures to prevent bleeding should be taken and the conditions for a transfusion should be optimized and appropriate in order to promote patient safety.
Acute Lung Injury ; Anaphylaxis ; Cardiovascular Diseases ; Emergencies ; Erythrocyte Transfusion* ; Erythrocytes* ; Graft vs Host Disease ; Hemorrhage ; Humans ; Hypersensitivity ; Jaw ; Monitoring, Physiologic ; Mouth Neoplasms ; Oxygen ; Patient Safety ; Perioperative Period ; Plasma Volume ; Transfusion Reaction

OBJECTIVETo investigate the microRNA (miRNA) expression in plasma of patients with aGVHD and without aGVHD after allo-hematopoietic stem cell transplantation (allo-HSCT).

METHODSThe miRNAs (miR-423, mirR199a-3p, miR93*, miR377) expression levels in peripheral blood plasma of 25 patients before and after allo-HSCT were detected by real-time PCR.

RESULTSmiR-423, miR199a-3p and miR-93* in aGVHD group were significantly upregulated (P<0.05); miR-377 expression was not significantly different between aGVHD and non-aGVHD (P>0.05).

CONCLUSIONThe expression of miR-423, miR-199a-3p, miR-93* are upregulated in aGVHD group, which can be used as biomarkes to monitor and to diagnose aGVHD.

Biomarkers ; blood ; Graft vs Host Disease ; blood ; pathology ; Hematopoietic Stem Cell Transplantation ; Humans ; MicroRNAs ; blood ; Real-Time Polymerase Chain Reaction ; Up-Regulation

No abstract available.
Adult ; Bone Marrow/*pathology ; Fatal Outcome ; Graft vs Host Disease/etiology ; High-Throughput Nucleotide Sequencing ; Humans ; Liver Cirrhosis/pathology/*therapy ; *Liver Transplantation/adverse effects ; Microsatellite Repeats ; Middle Aged ; Polymerase Chain Reaction ; *Polymorphism, Single Nucleotide ; Transplantation Chimera/*genetics

OBJECTIVETo investigate the clinical difference of cytomegalovirus (CMV) infection between HLA-matched allogeneic hematopoietic stem cell transplantation (allo-HSCT) and haploidentical hematopoietic stem cell transplantation (hi-HSCT).

METHODSThe clinical data of 83 patients who had undergone allo-HSCT were retrospectively analyzed. Out of them 50 patients underwent hi-HSCT and 33 patients received grafts from HLA-matched donors. The sera of all recipients and donors were CMV-negative before transplantation. All patients accepted myeloablative regimen without total body irradiation. PCR was performed to detect CMV in the peripheral blood twice a week after neutrophil recovery. CMV-DNA>500 copies/ml was defined as CMV viremia.

RESULTS68 patients (81.9%) were diagnosed as CMV viremia before 100 days after transplantation. The incidence of CMV infection in hi-HSCT group was 90% and significantly higher than that in HLA-matched HSCT group (69.7%) (P < 0.05). All the patients responded well to anti-CMV therapy; however, 63 cases experienced CMV reactivation. The occurrence rate of CMV reactivation in hi-HSCT group (95.6%) was comparable to that in HLA-matched HSCT group (87.0%) (P > 0.05). Univariate analysis showed that the transplantation pattern, the recovery time of peripheral neutrophils and the occurrence of acute graft-versus-host disease (aGVHD) significantly related to the episode of CMV viremia, while the sex and age of the recipients, and the recovery time of platelets did not associate with the incidence. Further analysis found that the recovery time of neutropils and platelets in HLA-matched HSCT group were greatly shorter than those in hi-HSCT group (P < 0.05). The incidence of aGVHD was comparable between two groups however, incidence of severe aGVHD was significantly higher in hi-HSCT (P < 0.05).

CONCLUSIONThe hi-HSCT is more susceptible to CMV infection, which may be related to the higher incidence of severe aGVHD and the relative delay of hematopoietic reconstruction as compared with HLA-matched HSCT.

Cytomegalovirus Infections ; blood ; diagnosis ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Incidence ; Polymerase Chain Reaction ; Retrospective Studies ; Risk Factors ; Tissue Donors

Respiratory viral infection has been reported as a risk factor for invasive pulmonary aspergillosis (IPA) in hematopoietic cell transplantation (HCT) recipients, and IPA following influenza has been reported. We report a 13-year-old boy diagnosed with IPA following influenza. He received allogeneic HCT and then received glucocorticoids for chronic graft-versus-host disease. On admission, he complained of non-neutropenic fever and dyspnea. He was diagnosed with influenza A via a polymerase chain reaction (PCR) test from nasopharyngeal swab, and oseltamivir was administered. Fever re-emerged nine days later and repeat PCR was positive for influenza A. His fever did not resolve despite triple antiviral and empirical antibiotic therapy. On hospital day 22, IPA was diagnosed based on chest computed tomography and positive serum galactomannan results, and his symptoms improved with voriconazole therapy. However, he died of uncontrolled bronchiolitis obliterans on hospital day 128. IPA should be considered a complication of influenza in immunocompromised children.
Adolescent ; Bronchiolitis Obliterans ; Cell Transplantation ; Child ; Dyspnea ; Fever ; Glucocorticoids ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Influenza, Human ; Invasive Pulmonary Aspergillosis ; Leukemia, Myeloid, Acute ; Male ; Oseltamivir ; Polymerase Chain Reaction ; Risk Factors ; Thorax ; Transplants

Based on the representative articles in recent years, the different mechanisms of decitabine on immune regulation in patients with acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (HSCT) are summarized. Decitabine improves the expression of WT1 gene to stimulate specific cytotoxic T cells which can enhance graft versus leukemia effect (GVL) and improve the expression of FOXP3 gene to stimulate regulatory T cells so as to inhibit the acute graft versus host disease (GVHD). Through the above-mentimed mechanisms, decitabine can improve both therapeutic effect and quality of life in the patients with AML after allogeneic HSCT.
Antimetabolites, Antineoplastic ; pharmacology ; Azacitidine ; analogs & derivatives ; pharmacology ; Graft vs Leukemia Effect ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute ; immunology ; therapy ; Quality of Life ; T-Lymphocytes, Cytotoxic ; T-Lymphocytes, Regulatory ; Transplantation, Homologous

BACKGROUND: Suppressor of cytokine signaling genes (SOCS) are regarded as pivotal negative feedback regulators of cytokine signals, including the interferon-gamma (IFN-gamma), granulocyte-colony stimulating factor, and interleukin families, released by T cells. A detailed understanding of the involvement of SOCS genes in graft-versus-host disease (GVHD) is critical to effectively manage GVHD, yet their expression patterns among recipients remain largely unexplored. METHODS: Expression levels of SOCS1 and SOCS3 were determined by real-time quantitative reverse transcription PCR (qRT-PCR) in patients with acute GVHD (aGVHD) and chronic GVHD (cGVHD), in a severity-dependent manner, after allogeneic hematopoietic stem cell transplantation (HSCT). A total of 71 recipients with AML (N=40), ALL (N=12), myelodysplastic syndromes (MDS; N=10), chronic myelogenous leukemia (CML; N=2), severe aplastic anemia (SAA; N=5), or others (N=2), who received allogeneic HSCT from human leukocyte antigen-identical siblings or unrelated donors between 2009 and 2011, were included in the present study. RESULTS: Overall, the expression levels of SOCS1 decreased in recipients with grade II to IV aGVHD and cGVHD when compared to normal donors and non-GVHD recipients. Interestingly, the expressions of SOCS1 decreased significantly more in cGVHD than in aGVHD recipients (P=0.0091). In contrast, SOCS3 expressions were similarly reduced in all the recipients. CONCLUSION: This is the first study to show that SOCS1 and SOCS3 are differentially expressed in recipients following allogeneic HSCT, suggesting a prognostic correlation between SOCS genes and the development of GVHD. This result provides a new platform to study GVHD immunobiology and potential diagnostic and therapeutic targets for GVHD.
Anemia, Aplastic ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Interferon-gamma ; Interleukins ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukocytes ; Myelodysplastic Syndromes ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Reverse Transcription ; Siblings ; Suppressor of Cytokine Signaling Proteins ; T-Lymphocytes ; Tissue Donors ; Transplantation, Homologous ; Unrelated Donors