检索结果-南通市图书馆

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2008年第18期121卷 1766-1769页

作者： HUANG Xiao-jun liu dai-hong XU Lan-ping ZHANG hong-yu liu Kai-yan Institute of Hematology Peking University People's Hospital Beijing 100044 China

Background The pathophysiology of late-onset hemorrhagic cystitis （LOHC） is currently not well understood. The aim of this study was to analyze the alloimmune aetiology in the pathogenesis of LOHC post allogeneic hematopoietic stem cell transplantation （HSCT）. Methods A retrospective study was performed on the medical records of 11 patients with immune-related LOHC post allogeneic HSCT. The clinical characteristics, therapy, and outcomes of these patients were analyzed. Results The median time of onset was 42 days after HSCT （range 16-150 days） and the median duration of HC was 43 days （range 29-47 days）. All patients presented with prolonged HC for more than 35 days. Nine patients with evidence of cytomegalovirus （CMV） reactivation did not respond to anti-viral therapy even with CMV clearance in the urine post-therapy. Eleven patients with refractory HC received a low dose of corticosteroids and all patients went into complete remission. Conclusion Our data suggest that alloimmune injury is involved in the pathogenesis of HC in at least some patients and that specific therapy might improve the clinical outcome of hemorrhagic cystitis.

关键词： hemorrhagic cystitis hematopoietic stem cell transplantation alloimmune aetiology

Colonoscopy in the diagnosis of intestinal graft versus host disease and cytomegalovirus enteritis following allogeneic haematopoietic stem cell transplantation

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2008年第14期121卷 1285-1289页

作者： HE Jin-de liu Yu-lan WANG Zhi-feng liu dai-hong CHEN Huan CHEN Yu-hong Department of Gastroenterology People's Hospital Peking University Beijing 100044 China Department of Haematology People's Hospital Peking University Beijing 100044 China

Background Gastrointestinal graft versus host disease （GI-GVHD） and cytomegalovirus （CMV） enteritis are important complications following allogeneic haematopoietic stem cell transplantation （allo-HSCT）. We explored the role of colonoscopy in the diagnosis of GI-GVHD and CMV enteritis following alIo-HSCT to identify the endoscopic manifestations of GI-GVHD and CMV enteritis was made. Methods A retrospective analysis of the colonoscopic manifestations of GI-GVHD, CMV enteritis and GI-GVHD with concurrent CMV enteritis （GconC） and their related clinical issues. Results Forty-seven patients underwent 50 colonoscopies with diagnoses of 32 GI-GVHD, 7 CMV enteritis and 11 GconC. Both GI-GVHD and CMV enteritis had colonic mucosal lesions with various manifestations under colonoscopy. Tortoise shell like changes of the mucosa （12 of 32） and deep ulcers （2 of 7） were specific endoscopic manifestations for GI-GVHD and CMV enteritis, respectively, while mucosal oedema, erythema, congestion, erosion and shallow ulcers could not be used to differentiate GI-GVHD from CMV enteritis. GconC patients were prone to have oozing bleeding of the end ileal mucosa and typhlodicliditis. Of the biopsed specimens for GI-GVHD, CMV enteritis and GconC, 64%, 70% and 44% were taken from the rectum and sigmoid colon respectively. Conclusions Following allo-HSCT, tortoise shell like changes and deep ulcers of the colonic mucosa are characteristic changes for GI-GVHD and CMV enteritis, respectively, while the other lesions are not. Most of the GI-GVHDs and CMV enteritis cases can be diagnosed by left colon examination and tissue biopsy, but total colon examination to the terminal ileum is preferred.

关键词： graft versus host disease cytomegalovirus enteritis stem cell transplantation colonoscopy

Administration of imatinib in the first 90 days after allogeneic hematopoietic cell transplantation in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2011年第2期124卷 246-252页

作者： CHEN Huan liu Kai-yan XU Lan-ping liu dai-hong CHEN Yu-hong SHI hong-xia HAN Wei ZHAN Xiao-hui WANG Yu ZHAO Ting HUANG Xiao-jun Peking University Institute of Hematology Peking University People's Hospital Beijing 100044 China

Background Relapse happens frequently after allogeneic hematopoietic cell transplantation （alIo-HCT） in the patients with Philadelphia chromosome-positive acute lymphoblastic leukemia （Ph^＋ ALL）. Detection of the minimal residual disease （MRD） before and after alIo-HCT is associated with higher relapse rate. Early administration of imatinib after alIo-HCT may prevent recurrent Ph^＋ ALL. The aim of this study was to evaluate the safety and efficacy of imatinib in preventing hematological relapse when imatinib was administrated in the first 90 days after alIo-HCT. Methods Patients with Ph^＋ ALL that underwent alIo-HCT were enrolled in a prospective study. A TaqMan-based real-time quantitative polymerase chain reaction （RQ-PCR） technique was used to detect the MRD （bcr-abl transcript levels）. Imatinib therapy was initiated prior to 90 days after alIo-HCT if the patient＇s absolute neutrophil count （ANC） was above 1.0×10^9/L （without granulocyte colony-stimulating factor （G-CSF） administration） and the platelet count was greater than 50.0×10^9/L, or if the bcr-abl transcript levels were elevated in two consecutive tests, or if the bcr-abl transcript levels were 〉10.2 after the initial engraftment. The initial daily dose of imatinib was 400 mg/d for adults and 260 mg/m^2 for children （younger than 17 years）. Imatinib was administered for at least I month and the bcr-abl TaqMan results were negative for 3 consecutive tests, or complete molecular remission （CR^mol） was sustained for at least 3 months. Results From May 2005 to October 2008, 29 patients were enrolled in this study, of whom, 19 patients were male and 10 were female. The median age of the enrolled patients was 33 years （range 6-50 years）. Imatinib therapy was started at a median time of 60 days （range 20-122 days） post HCT （only one patient started Imatinib therapy at 122nd day after HCT）. Twenty-five adult patients could tolerate a dose of 300-400 mg/d of imatinib, and three children tolerated a dose of 260 mg

关键词： Philadelphia chromosome acute lymphoblastic leukemia allogeneic hematopoietic cell transplantation minimal residual disease

Hemorrhagic cystitis following hematopoietic stem cell transplantation:incidence,risk factors and association with CMV reactivation and graft-versus-host disease

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2007年第19期120卷 1666-1671页

作者： XU Lan-ping ZHANG hong-yu HUANG Xiao-jun liu Kai-yan liu dai-hong HAN Wei CHEN Huan CHEN Yu-hong GAO Zhi-yong ZHANG Yao-chen LU Dao-pei Peking University Institute of Hematology Peking University People＇s Hospital Beijing 100044 China

Background The definite pathogenesis of hemorrhagic cystitis （HC） after allogenic hematopoietic stem cell transplantation （allo-HSCT） has not been well elucidated. The role of cytomegalovirus （CMV） reactivation and graft-versus-host disease （GVHD） in the development of HC remains obscure. This study determined the incidence and risk factors for HC after alIo-HSCT and analyzed its association with CMV reactivation and GVHD. Methods We retrospectively studied 250 patients at high risk for CMV disease who underwent alIo-HSCT all based on busulfan/cyclophosphamide （BU/CY） myloablative regimens. The incidence, etiology, risk factors and clinical management of HC were investigated. Results HC developed within 180 days of transplant in 72 patients, with an overall incidence of 28.8% and an incidence of 12.6% in patients with HLA-matched related donors （MRD）, 34.38% in those with HLA-matched unrelated donors （MUD）, 49.45% in those with mismatched related donors （MMRD）. CMV-viremia significantly increased the incidence of later onset HC （LOHC）; however, only 9 out of 15 patients with CMV viruria actually developed LOHC. Multiple regression analysis identified grade II-IV acute GVHD （RR=2.75; 95% CI 1.63-4.66; P〈0.01） and grafts from MUD or MMRD （RR=2.60; 95% CI 1.52-5.20; P〈0.01） as independent risk factors for HC. Event sequence analysis indicated a majority of HC episodes began around GVHD initiation. Conclusions CMV-viremia is a high risk factor for LOHC. Our data also showed a correlation between acute GVHD and HC, which suggested that alloimmunity may be involved in the pathogenesis of HC.

关键词： hemorrhagic cystitis allogeneic hematopoietic stem cell transplantation cytomegalovirus graft-versus-host disease

Modified conditioning regimen busulfan-cyclophosphamide followed by allogeneic stem cell transplantation in patients with multiple myeloma

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2007年第6期120卷 463-468页

作者： ZHANG Xiao-hui HUANG Xiao-jun liu Kai-yan XU Lan-ping liu dai-hong CHEN Huan CHEN Yu-hong WANG Jing-zhi HAN Wei LU Dao-pei Institute of Hematology Peking University People＇s Hospital Beijing 100044 China

Background Allogeneic stem cell transplantation is a potential curative approach in patients with multiple myeloma. The very high transplant related mortality associated with standard allogeneic stem cell transplantation is currently the major limitation to wider use of this potentially curative treatment modality. The challenge for clinical investigators is to reduce the incidence of post-transplant complications for patients receiving autologous hematopoietic stem cell transplantion for multiple myeloma. In this study the toxicity and efficacy of modified myeloablative conditioning regimen followed by allogeneic stem cell transplantation was investigated in patients with multiple myeloma. Methods The conditioning regimen consisted of hydroxyurea, cytarabine, busulfan, cyclophosphamide, and semustine. Ten patients underwent allogeneic transplantation among them hydroxyurea （40 mg/kg） was administered twice on day -10 and cytarabine （2 g/ms） was given on day -9, busulfan was administered orally in four divided doses daily for 3 days （days -8 to -6）. The dose of busulfan was 12 mg/kg in the protocol followed by cyclophosphamide intravenously over 1 hour on days -5 and -4 （1.8 g/m^2）, and with semustine （Me-CCNU） 250 mg/m^2 on day -3. Results Chimerism data were available on all patients and all patients achieved full donor chimerism without graft failure. Six patients had not acute graft-versus-host disease （GVHD, 36.4%; 95% CI： 13.9%-38.6%）. Two patients （18.2%） developed grade Ⅰ acute GVHD （95% CI： 10.9%-35.9%） and grade Ⅱ acute GVHD occurred in one patient （9.1%; 95% Cl. 8.4%-32.3%）. Severe grade IVa GVHD was seen in one patient, who died from acute GVHD. The incidence of chronic GVHD was 22.2% （95% Cl： 11.7%-36.7%）, among them one died of severe grade IV GVHD and one developed multiorgan failure on day ＋170; the treatment-related mortality was 22.0% （95% Cl： 10.3%-34.1%）. The overall 4-year survival rate was 67.8% （95% Cl： 16.3%-46.7%）. The estimated 4-year progr

关键词： multiple myeloma stem cell transplantation modified conditioning regimen

Monitoring the source of mesenchymal stem cells in patients after transplantation of mismatched-sex hematopoietic stem cells plus thirdparty cells

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2013年第22期126卷 4254-4259页

作者： WANG Jing HUANG Xiao-jun XU Lan-ping liu dai-hong CHEN Huan CHEN Yu-hong LAI Yue-yun HOU Rui-qin QIN Xiao-ying liu Kai-yan Peking University Institute of Hematology Peking University People's Hospital Beijing 100044 China

Background In bone marrow transplant patients, the microenvironment in bone marrow is damaged after chemotherapy or radiotherapy. Subsequent to allogenic hematopoietic stem cell transplantation in patients with clinically successful engraftments, the source of mesenchymal stem cells （MSCs） remains controversial. To further verify the stimulatory effect of the simultaneous transplantation of cells from second donors on engraftment success for hematopoietic stem cell transplantation in support of donor MSCs engraftments, the aim of this study is to monitor the dynamics of the engraftment of bone marrow-derived MSCs in patients after transplantation with mismatched-sex hematopoietic stem and third-party cells. Methods In this study, the hematopoietic stem cells from 32 clinical donors of different sexes that resulted in successful engraftments were selected for transplantation and were classified into three groups for research purposes： group A consisted of 14 cases of transplantation with bone marrow and recruited peripheral hematopoietic stem cell transplantation, group B contained 8 cases of simultaneous re-transfusion of MSCs from the second donor, and group C contained 10 cases of simultaneous re-transfusion of umbilical blood from the second donor. The bone marrow from 32 patients with successful engraftments of hematopoietic transplantation were selected and sub-cultured with MSCs. Flow cytometry （FCM） was used to measure the expression of surface antigens on MSCs. Denaturing high-performance liquid chromatography （DHPLC） in combination with polymerase chain reaction amplification of short tandem repeats （STR- PCR） was used to measure the engraftment status of fifth-generation MSCs in patients. Fluorescence in situ hybridization （FISH） revealed the sex origin of the fifth-generation MSCs in 32 patients. Dynamic examinations were performed on patients receiving donor transplantations. Results The progenies of fifth-generation MSCs were successfully cultured in 32

关键词： hematopoietic stem cell transplantation mesenchymal stem cells source of engraftment

亚太地区中性粒细胞减少伴不明原因发热治疗指南解读

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

中国实用内科杂志 2007年第20期27卷 1573-1575页

作者：刘代红北京大学人民医院北京大学血液病研究所北京100044

全球范围内由于恶性肿瘤而接受放化疗的患者中中性粒细胞减少(粒减)极其常见,不明原因的发热常常是这些患者感染时的惟一征象.在未获得病原学证据之前必须争分夺秒地开始经验性抗感染治疗,以控制病情,降低重症感染的病死率.

关键词：中性粒细胞减少发热指南

异基因造血干细胞移植治疗骨髓增生异常综合征：适应证及移植前是否需化疗

在线全文

学校读者我要写书评

暂无评论

白血病．淋巴瘤 2013年第6期22卷 341-343页

作者：刘代红北京大学血液病研究所北京大学人民医院血液科 100044

异基因造血干细胞移植（***）治疗骨髓增生异常综合征（MDS）的适应证以FAB分型、国际预后评分系统（IPSS）、世界卫生组织预后评分系统（WPSS）为基础，IPSS中危-2及高危的患者应尽可能在诊断早期接受移植；中危-1及以下者将从延迟移... 详细信息

异基因造血干细胞移植（***）治疗骨髓增生异常综合征（MDS）的适应证以FAB分型、国际预后评分系统（IPSS）、世界卫生组织预后评分系统（WPSS）为基础，IPSS中危-2及高危的患者应尽可能在诊断早期接受移植；中危-1及以下者将从延迟移植中受益。临床决策中应动态随诊病情变化、及时把握疾病状态及进展速度适时移植。中低危患者血小板极低、中性粒细胞缺乏或输血依赖重者应尽早移植。MDS中高危患者移植前是否该应用去甲基化药物或化疗尚存争议，迄今临床研究数据表明移植前化疗对移植预后无益。

关键词：骨髓增生异常综合征造血干细胞移植异基因化疗

Risk factors for bronchiolitis obliterans syndrome in allogeneic hematopoietic stem cell transplantation

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2013年第13期126卷 2489-2494页

作者： MO Xiao-dong XU Lan-ping liu dai-hong ZHANG Xiao-hui CHEN Huan CHEN Yu-hong HAN Wei WANG Yu WANG Feng-rong WANG Jing-zhi liu Kai-yan HUANG Xiao-jun Peking University People's Hospital & Institute of Hematology Beijing Key laboratory of Hematopoitic Stem Cell Transplantation Beijing 100044 China

Background The occurrence of bronchiolitis obliterans syndrome （BOS） after allogeneic hematopoietic stem cell transplantation （alIo-HSCT） is rare but severe. We examine the role of pre-HSCT chemotherapeutic exposure, pre-HSCT comorbidities, and transplant-related complications in the development of BOS after alIo-HSCT. Methods A nested case-control study was designed. Cases with BOS and controls matched for the year of alIo-HSCT and length of the follow-up were identified from a cohort of 1646 patients who underwent alIo-HSCT for treatment of hematologic malignancies between 2006 and 2011. Antithymocyte globulin was used in the partial matched related and unrelated matched donor HSCT, or patients with severe aplastic anemia. Results Thirty-six patients suffered from BOS; the mean age at the time of presentation was （32.7±2.4） years, and the mean time to presentation was （474±350） days post-HSCT. A pre-HSCT cyclophosphamide dose of 〉3.2 g/m2 （OR=8.74, P=0.025）, chronic graft-versus-host disease （moderate to severe）（OR=12.02, P=0.000）, and conditioning regimens without antithymocyte globulin （OR=2.79, P=0.031） were independently associated with BOS. Conclusions We found that higher pre-HSCT cyclophosphamide exposure, a conditioning regimen without antithymocyte globulin, and moderate to severe chronic graft-versus-host disease are significantly and independently associated with BOS. Based on these results, we can identify patients who are at a higher risk of developing BOS after alIo-HSCT, select a more appropriate therapeutic strategy, and improve the outcome of HSCT recipients.

关键词： bronchiolitis obliterans syndrome allogeneic hematopoietic stem cell transplantation graft-versus-host disease,"antithymoeyte globulin