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：AbstractAllogeneic hematopoietic stem cell transplantation (allo-HSCT) is currently the standard of care for adult acute lymphoblastic leukemia (ALL) patients. In recent years, with the continuous development of immunotherapy, such as chimeric antigen receptor T cells, blinatumomab, and inotuzumab ozogamicin, a series of vital clinical studies have confirmed its high response rate and favorable outcomes for ALL. Although the emergence of immunotherapy has expanded relapsed or refractory (r/r) ALL patients' opportunities to receive allo-HSCT, allo-HSCT is associated with potential challenges. In this review, the role of allo-HSCT in the treatment of adult ALL in the era of immunotherapy will be discussed.

简介：ObjectToinvestigatetheclinicalsignificanceofallogeneichematopoieticstemcelltransplantation(allo-HSCT)followingfludarabine(Flu)-basednomnyeloablativeconditioningregimen.Methods7patientswitholderageororgandysfunctionreceivedeitheroftwoFlu-basednonmyeloablativeconditioningprotocolsfollowedbyinfusionofgranulocytecolony-stimulatingfactor(G-CSF)mobilizedallogeneicperipheralblooclstemcells(PBSC).Cy-elosporincombiningmethotrexatewasusedasgraftvshostdisease(GVHD)prophylaxis.ResultsMinimalalloHSCTassociatedtoxicitywasfoundapartfrommucositis.Theallogeneicdonorengraftmentswereverifiedinallthepatients.Sixofseveneasessurvivedmorethan5months.AcuteGVHDoccurredinthreeofsevenpatientsincludingacaseofgrade1IGVHD.ConclusionTherapidengrafunentofallo-PBSCandgraftvsleukemia(GVL)effectscanbeobtainedbyFlu-basednomnyeloablativeconditioningregimen.Thismanagementissuitableforthepatientswhoaretoooldorhaveorgandysfunction.

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.

简介：Humanplacenta-derivedmononuclearcells(MNC)wereisolatedbyaPercolldensitygradientandculturedinmesenchymalstemcell(MSC)maintenancemedium.Thehomogenouslayerofadherentcellsexhibitedatypicalfibroblastlikemorphology,alargeexpansivepotential,andcellcyclecharacteristicsincludingasubsetofquiescentcells.Invitrodifferentiationassaysshowedthetripotentialdifferentiationcapacityofthesecellstowardadipogenic,osteogenicandchondrogeniclineages.FlowcytometryanalysesandimmunocytochemistrystainshowedthatplacentalMSCwasahomogeneouscellpopulationdevoidofhematopoieticcells,whichuniformlyexpressedCD29,CD44,CD73,CD105,CD166,laminin,fibronectinandvimentinwhilebeingnegativeforexpressionofCD31,CD34,CD45andα-smoothmuscleactin.Mostimportantly,immuno-phenotypicanalysesdemonstratedthatthesecellsexpressedclassImajorhistocompatibilitycomplex(MHC-Ⅰ),buttheydidnotexpressMHC-Ⅱmolecules.Additionallythesecellscouldsuppressumbilicalcordblood(UCB)lymphocytesproliferationinducedbycellularornonspecificmitogenicstimuli.Thisstronglyimpliesthattheymayhavepotentialapplicationinallografttransplantation.SinceplacentaandUCBarehomogeneous,theMSCderivedfromhumanplacentacanbetransplantedcombinedwithhematopoieticstemcells(HSC)fromUCBtoreducethepotentialgraft-versus-hostdisease(GVHD)inrecipients.

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简介：Myeloidsarcoma(MS)isararehematologicalneoplasmthatdevelopseitherdenovoorconcurrentlywithacutemyeloidleukemia(AML).ThisneoplasmcanalsobeaninitialmanifestationofrelapseinapreviouslytreatedAMLthatisinremission.A44-year-oldmalepatientwasdiagnosedwithtestisMSinalocalhospitalinAugust2010.Afteronemonth,bonemarrowbiopsyandaspirationconfirmedthediagnosisofAML.Allogeneicmobilizationperipheralbloodstemcelltransplantationwasperformed,withthesisterofthepatientasdonor,aftercompleteremission(CR)wasachievedbychemotherapy.Fivemonthsaftertreatment,anadrenalmasswasdetectedbypositronemissiontomography-computedtomography(PET-CT).Radiotherapywasperformedforthelocalizedmassafteramultidisciplinaryteam(MDT)discussion.ThepatientisstillaliveasofMay2013,withnoevidenceofrecurrentMSorleukemia.

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。

简介：AbstractBackground:Allogeneic natural killer (NK) cell immunotherapy is recognized as a promising anti-tumor strategy, but whether it plays a role in poor CD4 recovery among human immunodeficiency virus type 1 (HIV-1) infected patients is unknown. This study aimed to investigate the safety and effectiveness of allogeneic NK cells immunotherapy on HIV-1 immunological non-responders (INRs) receiving antiretroviral therapy (ART).Methods:From February to April 2018, a prospective, randomized, controlled, open-label clinical trial, which enrolled 20 HIV-1 INRs following specific inclusion criteria, was conducted at Nankai University Second People’s Hospital. Participants were randomly allocated (simple randomization 1:1) to either the combined treatment (NK + ART) group (n = 10) or the control (ART) group (n = 10). The allogenic highly activated NK cells from killer cell immunoglobulin-like receptor (KIR)/human leukocyte antigen (HLA)-Cw mismatched healthy donor were prepared (108 cells in each injection) and intravenously infused to each recruited patient of NK+ART group in three courses. Key immune parameters (CD4 count, CD8 count, CD4/CD8 ratio), laboratory tests (count of blood cells, biochemistry panel) and symptoms at baseline and at month 1, 3, 6, 9, 12, and 24 were measured/collected to analyze the safety and efficacy of the therapy. Comparisons were between the seven time-points of both groups using repeated measurement analysis of variance (ANOVA) test. Generalized estimating equations (GEE) model was performed to evaluate the overall effect of the NK+ART group vs. the ART group.Results:From baseline to 24 months, we noted a mean CD4 count augmentation (139 to 243 cells/μL) in the NK + ART group and (144 to 176 cells/μL) in the ART group (difference, 67; 95% CI, 10 to 124; P = 0.024). Our estimations revealed that NK+ART group could improve CD4 level (β = 54.59, P= 0.006) and CD8 level (β = 322.47, P= 0.010) on average among the six measurements compared with the ART group. Only two (2/10, 20%) participants in the NK+ART group developed a transient mild fever after the first course.Conclusions:This preliminary study informs that HIV-1 INRs, allogenic NK cells immunotherapy is safe and could significantly improve CD4 recovery but not CD4/CD8 ratio. The practical effects, however, need long-term follow-up observations. Further study on the potential underlying mechanism is warranted.Registration info:www.chictr.org.cn/showproj.aspx?proj=34912 (No. ChiCTR1900020634).

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：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.

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