简介：AbstractHematopoietic stem cell transplantation (HSCT) is a highly effective and unique medical procedure for the treatment of most hematological malignancies. The first allogeneic transplantation was performed by E. Donnall Thomas in 1957. Since then, the field has evolved and expanded worldwide. The first successful allogenic HSCT (allo-HSCT) in China was conducted in 1981. Although the development of allo-HSCT in China lagged, China has since made considerable contributions to the process of HSCT worldwide, with more than 10,000 HSCTs performed annually. In particular, haploid HSCT (haplo-HSCT) technology represented in the Beijing Protocol has demonstrated similar efficacy to human leukocyte antigen-matched HSCT and has gradually become the pre-dominant choice for allo-HSCT in China. Currently, the number of haplo-HSCT procedures exceeds 5000 per year, and the Beijing Protocol has been greatly improved by implementing updated individualized strategies for controlling complications, relapse, and infection management. In addition, innovative haplo-HSCT technologies developed by different medical transplantation centers, such as Soochow, Zhejiang, Fujian, Chongqing, and Anhui, have emerged, providing inspiration for the refinement of global practice. This review will focus on the current activity in this field and highlight important trends that are vital in China’s allo-HSCT process, examining the current viewpoint and future directions.

简介：Objective:Correctnutritionalassessmentisessentialforleukemiapatientsafterhematopoieticstemcelltransplantation(HSCT).ThisstudyaimedtoinvestigatethebestnutritionalassessmentmethodforleukemiapatientsafterHSCT,andfindthepossiblenutritionalriskofthepatientsduringthetransplantationprocessinordertointerveneinthepatientswithnutritionalrisksandundernourishedpatientstimely,sothattheentiretransplantationprocesscouldbesuccessfullycompleted.Methods:Aprospectivestudywasperformedin108leukemiapatientsafterHSCT,anddifferentnutritionalassessmentmethods,includingnutritionalriskscreening2002(NRS2002),mininutritionalassessment(MNA),subjectiveglobeassessment(SGA)andmalnutritionaluniversalscreeningtools(MUST),wereused.Theassociationsbetweennutritionalstatusofthesepatientsandnutritionalassessmentmethodswereanalyzed.Results:Atotalof108patientscompletedSGA,and99patientscompletedNRS2002,MNAandMUST.Duringthetreatmentprocess,85.2%ofthepatientslostweight,wherein,50%lostweightgreaterthan5%,and42.6%hadsignificantlyreducedfoodintake.Fornutritionalriskassessment,thepositiveratesofNRS2002,MNAandMUSTwere100%,74.7%and63.6%,respectively.Therewasasignificantdifference(P<0.05)amongthepositiveratesofNRS2002,MNAandMUST.Inundernutritionassessment,thepositiverateofSGA(83.3%)wassignificantlyhigherthanthatofMNA(17.2%)(P<0.05),andtheincidencerateofnutritionalriskamongleukemiapatients≤30yearsoldwasgreaterthanthatofpatients>30yearsold(P<0.05).Conclusions:PatientswithleukemiawereinpoornutritionalstatusduringandafterHSCT.Theleukemiapatients≤30yearsoldhadagreaterincidencerateofnutritionalrisk.Asnutritionalriskscreeningtool,thespecificityofNRS2002isnothigh,butitcanbeusedforevaluatingnutritionaldeficiencies.MNAisagoodnutritionalriskscreeningtool,butnotanadequatetoolfornutritionalassessment.Ifassessmentofundernutritionisneces

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简介：讨论屏蔽2002的营养的风险(NRS2002)是否为营养的风险在造血的干细胞移植(HSCT)前后为白血病病人屏蔽是适当的，并且是否在其它有风险差别的目的调节，例如年龄，性和匹配的度；发现营养的风险在HSCT前后为这些病人屏蔽的方法和指示物，处理以便给及时干预保证全部移植的成功的结束。99个白血病病人的方法营养的风险在HSCT前后与NRS2002被屏蔽。，2测试被使用比较象年龄，性和匹配的度那样的组之间的风险差别另外的枚举数据的差别，例如最近(13个月)重量损失，在一个星期和BMI以内的减少的食物吸入，被连续性修正比较。99个白血病病人，结果22个盒子(22.2%)在HSCT前有营养的风险，当所有病人在HSCT以后有营养的风险时；有在在男性和女性之间的营养的风险的没有重要差别，和不到30岁的病人，不完整匹配，最近(13个月)重量损失，在一个星期或BMI以内的减少的食物吸入<18.5是更可能的有营养的风险；并且77个盒子(77.8%)有重量损失，49个病人(63.6%)在一个月以内在之中有超过5%重量损失。这研究显示出的结论白血病病人竟然收到在HSCT，和NRS2002前后通常屏蔽的营养的风险，这为营养的风险在HSCT前屏蔽仅仅是适当的。更多的注意应该对病人被给予不到30岁或不完整匹配。重量变化是为在HSCT以后的病人的重要营养的指示物之一。

简介：AbstractIntroduction:Toxoplasmosis is a life-threatening complication after hematopoietic stem cell transplantation (HSCT). However, for several reasons, clinicians know little about Toxoplasma infection.Case presentation:We report a case of toxoplasmosis that was diagnosed by bone marrow smear and metagenomic next-generation sequencing (mNGS) after HSCT in a boy. Additionally, we summarize the characteristics of toxoplasmosis after pediatric HSCT reported in the literature published in PubMed.Conclusion:Clinicians should increase their awareness of toxoplasmosis in children after HSCT and implement pre-transplant screening and post-transplant monitoring and prevention in future according to the national conditions of our country.

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简介：Graft-versus-host疾病(GVHD)是在造血的干细胞移植以后的最普通的复杂并发症。澄清像使用费的受体的角色4(TLR4)，它是为细菌的lipopolysaccharides(LPS)的主要受体在尖锐GVHD的发展，我们使用了一个TLR4大美人(TLR4−/−)老鼠GVHD模型并且分析了内在的免疫学的机制。当TLR4−/−老鼠被用作骨头髓和splenocyte房间接枝施主或接受者时，GVHD症状出现和死亡被推迟与相比野类型(TLR4+/+)老鼠。另外，组织病理学说的分析在TLR4−/−BALB/c怪物，肝和小肠织物损坏与最小的淋巴球的渗入被减少。与TLR4+/+,TLR4−/−老鼠相对照，树枝状的房间没在处于一个不成熟的状态感应、留下的LPS期间表示CD80，CD86，CD40，MHC-II或IL-12。而且，TLR4−/−鼠标怒气的能力支持allogeneicT房间增长的树枝状的房间和，特别地T助手房间1(Th1)开发显然与TLR4+/+鼠标相比被稀释interferon-γ的树枝状的房间，和层次；(IFN-γ；)并且IL-10，Th2房间特定的cytokines，在TLR4−/−BALB/c比在TLR4+/+BALB/c妄想的老鼠。总的来说，我们的数据表明TLR4可以在GVHD和基因治疗可能提供的那指向的TLR4的致病起一个作用减少GVHD的风险的一条新处理途径。

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简介：AbstractBackground:There were few studies on real-world data about autologous hematopoietic stem cell transplantation (auto-HSCT) or allogeneic HSCT (allo-HSCT) in peripheral T-cell lymphoma (PTCL). This study aimed to investigate the clinical outcomes of patients who received auto-HSCT or allo-HSCT in China.Methods:From July 2007 to June 2017, a total of 128 patients who received auto-HSCT (n = 72) or allo-HSCT (n = 56) at eight medical centers across China were included in this study. We retrospectively collected their demographic and clinical data and compared the clinical outcomes between groups.Results:Patients receiving allo-HSCT were more likely to be diagnosed with stage III or IV disease (95% vs. 82%, P = 0.027), bone marrow involvement (42% vs. 15%, P= 0.001), chemotherapy-resistant disease (41% vs. 8%, P= 0.001), and progression disease (32% vs. 4%, P < 0.001) at transplantation than those receiving auto-HSCT. With a median follow-up of 30 (2-143) months, 3-year overall survival (OS) and progression-free survival (PFS) in the auto-HSCT group were 70%(48/63) and 59%(42/63), respectively. Three-year OS and PFS for allo-HSCT recipients were 46%(27/54) and 44%(29/54), respectively. There was no difference in relapse rate (34%[17/63] in auto-HSCT vs. 29%[15/54] in allo-HSCT, P = 0.840). Three-year non-relapse mortality rate in auto-HSCT recipients was 6%(4/63) compared with 27%(14/54) for allo-HSCT recipients (P = 0.004). Subanalyses showed that patients with lower prognostic index scores for PTCL (PIT) who received auto-HSCT in an upfront setting had a better outcome than patients with higher PIT scores (3-year OS: 85% vs. 40%, P = 0.003). Patients with complete remission (CR) undergoing auto-HSCT had better survival (3-year OS: 88% vs. 48% in allo-HSCT, P = 0.008). For patients beyond CR, the outcome of patients who received allo-HSCT was similar to that in the atuo-HSCT group (3-year OS: 51% vs. 46%, P = 0.300).Conclusions:Our study provided real-world data about auto-HSCT and allo-HSCT in China. Auto-HSCT seemed to be associated with better survival for patients in good condition (lower PIT score and/or better disease control). For patients possessing unfavorable characteristics, the survival of patients receiving allo-HSCT group was similar to that in the auto-HSCT group.

简介：Objective:Toanalyzelong-termoutcomeinsixtyleukemiapatientsreceivedallogeneichematopoieticstemcelltransplantation(allo-HSCT)followingbusulfanandcyclophosphamide(BU-CY2)between1994and2000.Methods:BU-CY2wasusedastheconditioningregimenandallo-HSCTwasperformedforallpatients.Allthepatientswerefollowed-upuntilAugust2001ordeath.Theleukemia-freesurvival,relapseandtransplant-relatedmortalitywerediscussed.Results:All60patientshadsustainedengraftment.AcuteGVHDoccurredin22outof60patients(36.7%),andtheincidenceofacuteGVHDwas48%inthepatientswithCML,30%inAMLand26.7%inALL.38patientsarestillaliveincontinuousremissionwithamedianfollow-upof30months(range12-84)and22patientshavedied.ThemaincausesofdeathwereacuteGVHDin3patients,CMV-IPin7patientsandrelapsein11patients,theremainingonediedofpulmonaryinfection.Among11patientswhodiedofrelapse,8patientswithALLrelapsedintheearlystageposttransplant(8/15,53.3%),relapsewasobservedintheremaining3patientswithAML,andhowever,norelapsewasobservedinCML.Theprobabilityofdisease-freesurvivalat3yearsforCML.AMLandALLpatientswas80%,70%and26.7%,respectively.Conclusion:ThisresultssuggeststhatBU-CY2isaneffectiveconditioningregimeninpatientswithAMLandCML,resultinginalowrelapserateandhighlong-termsurvivalrate,butnotaseffectiveinpatientswithALL,withahigherincidenceofrelapseandtherefore,notrecommendedforALLpatients.

简介：AbstractImportance:131I-metaiodobenzylguanidine (131I-mIBG) has a significant targeted antitumor effect for neuroblastoma. However, currently there is a paucity of data for the use of 131I-mIBG as a "front-line" therapeutic agent in those patients with newly diagnosed high-risk neuroblastoma as part of the conditioning regimen for myeloablative chemotherapy (MAC).Objective:To evaluate the feasibility of upfront consolidation treatment with 131I-mIBG plus MAC and hematopoietic stem cell transplantation (HSCT) in high-risk neuroblastoma patients.Methods:A retrospective, single-center study was conducted from 2003-2019 on newly diagnosed high-risk neuroblastoma patients without progressive disease (PD) after the completion of induction therapy. They received 131I-mIBG infusion and MAC followed by HSCT.Results:A total of 24 high-risk neuroblastoma patients were enrolled with a median age of 3.0 years at diagnosis. After receiving this sequential consolidation treatment, 3 of 13 patients who were in partial response (PR) before 131I-mIBG treatment achieved either complete response (CR) (n = 1) or very good partial response (VGPR) (n = 2) after HSCT. With a median follow-up duration of 13.0 months after 131I-mIBG therapy, the 5-year event-free survival and overall survival rates estimated were 29% and 38% for the entire cohort, and 53% and 67% for the patients who were in CR/VGPR at the time of 131I-mIBG treatment.Interpretation:Upfront consolidation treatment with 131I-mIBG plus MAC and HSCT is feasible and tolerable in high-risk neuroblastoma patients, however the survival benefit of this 131I-mIBG regimen is only observed in the patients who were in CR/VGPR at the time of 131I-mIBG treatment.

简介：AbstractBackground:The role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with high-risk (HR) T-cell acute lymphoblastic leukemia (T-ALL) in first complete remission (CR1) is still under evaluation. Moreover, relapse is the main factor affecting survival. This study aimed to explore the effect of allo-HSCT (especially haploidentical HSCT [haplo-HSCT]) on improving survival and reducing relapse for HR childhood T-ALL in CR1 and the prognostic factors of childhood T-ALL in order to identify who could benefit from HSCT.Methods:A total of 74 newly diagnosed pediatric T-ALL patients between January 1, 2012 and June 30, 2018 were enrolled in this retrospective study. Patients were stratified into the low-risk chemotherapy cohort (n = 16), HR chemotherapy cohort (n = 31), and HR transplant cohort (n = 27). Characteristics, survival outcomes, and prognostic factors of all patients were then analyzed.Results:Patient prognosis in the HR chemotherapy cohort was significantly worse than that in the low-risk chemotherapy cohort (5-year overall survival [OS]: 58.5% vs. 100%, P = 0.003; 5-year event-free survival [EFS]: 54.1% vs. 83.4%, P = 0.010; 5-year cumulative incidence of relapse [CIR]: 45.2% vs. 6.3%, P = 0.011). In HR patients, allo-HSCT improved the 5-year EFS and CIR compared to that of chemotherapy (5-year EFS: 80.1% vs. 54.1%, P = 0.041; 5-year CIR: 11.6% vs. 45.2%, P = 0.006). The 5-year OS was higher in the HR transplant cohort than that in the HR chemotherapy cohort (81.0% vs. 58.5%, P = 0.084). Minimal residual disease re-emergence was an independent risk factor for 5-year OS, EFS, and CIR; age ≥10 years was an independent risk factor for OS and EFS; and high white blood cell count was an independent risk factor for EFS and CIR.Conclusion:Allo-HSCT, especially haplo-HSCT, could effectively reduce relapse of children with HR T-ALL in CR1.

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简介：AbstractBackground: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.

简介：Allogeneicstemcelltransplantation(allo-SCT)isapotentialcureforpatientswithmalignantlymphomathatisbasedonthegraft-versus-lymphoma(GVL)effect.Myeloablativeconditioningallo-SCTisassociatedwithhighmortalityandmorbidity,particularlyinpatientsolderthan45years,heavilypretreatedpatients(priorhematopoieticstemcelltransplantationormorethantwolinesofconventionalchemotherapy)orpatientsaffectedbyothercomorbidities.Therefore,conventionalallo-SCTisrestrictedtoyoungerpatients(<50to55years)ingoodphysicalcondition.Overthelastdecade,allo-SCTwithreduced-intensityconditioning(RIC-allo-SCT)hasbeenincreasinglyusedtotreatpatientswithlymphoma.Thistreatmentisassociatedwithlowertoxicityandsubstantialdecreaseintheincidenceoftransplant-relatedmortality,andhasthepotentialtoleadtolong-termremissions.Therefore,patientswhoarenotsuitabletoundergoconventionalallo-SCTcanbenefitfromthepotentiallycurativeGVLeffectsofallo-SCT.AlthoughRIC-allo-SCThasimprovedthesurvivaloflymphomapatients,highpost-transplantrelapseratesordiseaseprogressionmainlyresultsintreatmentfailure.Thus,furtherimprovementisclearlyneeded.TheroleandtimingofRIC-allo-SCTinthetreatmentoflymphomaremainsunclear.Therefore,moreprospectivestudiesshouldclarifytheeffectivenessofthismethod.Inthisarticle,wereviewtherecentliteratureonRIC-allo-SCTasatreatmentformajorlymphomasubtypes.Areasthatrequirefurtherinvestigationinthecontextofclinicaltrialsarealsohighlighted.

简介：OBJECTIVE:Theaimofthisstudywastoevaluatetheeffectivenessandsafetyofstemcelltransplantationforspinalcordinjury(SCI).DATASOURCES:PubMed,EMBASE,Cochrane,ChinaNationalKnowledgeInfrastructure,ChinaScienceandTechnologyJournal,Wanfang,andSinoMeddatabasesweresystematicallysearchedbycomputertoselectclinicalrandomizedcontrolledtrialsusingstemcelltransplantationtotreatSCI,publishedbetweeneachdatabaseinitiationandJuly2016.DATASELECTION:RandomizedcontrolledtrialscomparingstemcelltransplantationwithrehabilitationtreatmentforpatientswithSCI.Inclusioncriteria:(1)PatientswithSCIdiagnosedaccordingtotheAmericanSpinalInjuryAssociation(ASIA)InternationalstandardsforneurologicalclassificationofSCI;(2)patientswithSCIwhoreceivedonlystemcelltransplantationtherapyorstemcelltransplantationcombinedwithrehabilitationtherapy;(3)oneormoreofthefollowingoutcomesreported:outcomesconcerningneurologicalfunctionincludingsensoryfunctionandlocomotorfunction,activitiesofdailyliving,urinationfunctions,andseverityofSCIoradverseeffects.Studiescomprisingpatientswithcomplications,withoutfull-text,andpreclinicalanimalmodelswereexcluded.QualityoftheincludedstudieswasevaluatedusingtheCochraneriskofbiasassessmenttoolandRevManV5.3software,providedbytheCochraneCollaboration,wasusedtoperformstatisticalanalysis.OUTCOMEMEASURES:ASIAmotorscore,ASIAlighttouchscore,ASIApinprickscore,ASIAimpairmentscalegradingimprovementrate,activitiesofdailylivingscore,residualurinevolume,andadverseevents.RESULTS:Tenstudiescomprising377patientswereincludedintheanalysisandtheoverallriskofbiaswasrelativelylowlevel.Fourstudiesdidnotdetailhowrandomsequencesweregenerated,twostudiesdidnotclearlystatetheblindingoutcomeassessment,twostudieslackedblindingoutcomeassessment,onestudylackedfollow-upinformation,andfourstudiesc

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简介：AbstractBackground:For patients with B cell acute lymphocytic leukemia (B-ALL) who underwent allogeneic stem cell transplantation (allo-SCT), many variables have been demonstrated to be associated with leukemia relapse. In this study, we attempted to establish a risk score system to predict transplant outcomes more precisely in patients with B-ALL after allo-SCT.Methods:A total of 477 patients with B-ALL who underwent allo-SCT at Peking University People’s Hospital from December 2010 to December 2015 were enrolled in this retrospective study. We aimed to evaluate the factors associated with transplant outcomes after allo-SCT, and establish a risk score to identify patients with different probabilities of relapse. The univariate and multivariate analyses were performed with the Cox proportional hazards model with time-dependent variables.Results:All patients achieved neutrophil engraftment, and 95.4% of patients achieved platelet engraftment. The 5-year cumulative incidence of relapse (CIR), overall survival (OS), leukemia-free survival (LFS), and non-relapse mortality were 20.7%, 70.4%, 65.6%, and 13.9%, respectively. Multivariate analysis showed that patients with positive post-transplantation minimal residual disease (MRD), transplanted beyond the first complete remission (≥CR2), and without chronic graft-versus-host disease (cGVHD) had higher CIR (P < 0.001, P= 0.004, and P < 0.001, respectively) and worse LFS (P < 0.001, P= 0.017, and P < 0.001, respectively), and OS (P < 0.001, P = 0.009, and P < 0.001, respectively) than patients without MRD after transplantation, transplanted in CR1, and with cGVHD. A risk score for predicting relapse was formulated with the three above variables. The 5-year relapse rates were 6.3%, 16.6%, 55.9%, and 81.8% for patients with scores of 0, 1, 2, and 3 (P < 0.001), respectively, while the 5-year LFS and OS values decreased with increasing risk score.Conclusion:This new risk score system might stratify patients with different risks of relapse, which could guide treatment.