简介:AbstractBackground:Compared with human leukocyte antigen (HLA)-matched sibling donor (MSD) transplantation, it remains unclear whether haploidentical donor (HID) transplantation has a superior graft-versus-leukemia (GVL) effect for Philadelphia-negative (Ph-) high-risk B-cell acute lymphoblastic leukemia (B-ALL). This study aimed to compare the GVL effect between HID and MSD transplantation for Ph- high-risk B-ALL.Methods:This study population came from two prospective multicenter trials (NCT01883180, NCT02673008). Immunosuppressant withdrawal and prophylactic or pre-emptive donor lymphocyte infusion (DLI) were administered in patients without active graft-versus-host disease (GVHD) to prevent relapse. All patients with measurable residual disease (MRD) positivity posttransplantation (post-MRD+) or non-remission (NR) pre-transplantation received prophylactic/pre-emptive interventions. The primary endpoint was the incidence of post-MRD+.Results:A total of 335 patients with Ph- high-risk B-ALL were enrolled, including 145 and 190, respectively, in the HID and MSD groups. The 3-year cumulative incidence of post-MRD+ was 27.2% (95% confidence interval [CI]: 20.2%-34.7%) and 42.6% (35.5%-49.6%) in the HID and MSD groups (P = 0.003), respectively. A total of 156 patients received DLI, including 60 (41.4%) and 96 (50.5%), respectively, in the HID and MSD groups (P= 0.096). The 3-year cumulative incidence of relapse was 18.6% (95% CI: 12.7%-25.4%) and 25.9% (19.9%-32.3%; P = 0.116) in the two groups, respectively. The 3-year overall survival (OS) was 67.4% (95% CI: 59.1%-74.4%) and 61.6% (54.2%-68.1%; P = 0.382), leukemia-free survival (LFS) was 63.4% (95% CI: 55.0%-70.7%) and 58.2% (50.8%-64.9%; P= 0.429), and GVHD-free/relapse-free survival (GRFS) was 51.7% (95% CI: 43.3%-59.5%) and 37.8% (30.9%-44.6%; P= 0.041), respectively, in the HID and MSD groups.Conclusion:HID transplantation has a lower incidence of post-MRD+ than MSD transplantation, suggesting that HID transplantation might have a superior GVL effect than MSD transplantation for Ph- high-risk B-ALL patients.Trial registration:ClinicalTrials.gov: NCT01883180, NCT02673008.
简介:摘要目的比较非小细胞肺癌(non-smallcelllungcancer,NSCLC)患者外周血CD3+T细胞、CD4+CD25high调节性T细胞(regulatoryTcell,Tregcell)健康人的差异,并分析其临床意义。方法选取NSCLC患者和健康对照组各20例。分别抽取患者和志愿者的外周血3ml,分离其外周血单个核细胞(peripheralbloodmononuclearcell,PBMC),采用流式细胞仪检测CD3+T细胞比例、CD4+CD25highTreg细胞比例(%)。结果健康组CD3+T细胞比例为61.52±13.46%,肺癌组CD3+T细胞比例为55.15±20.11%,两组比较无显著性差异。健康组CD4+CD25highTreg细胞的比例为2.14±0.85%;肺癌组CD4+CD25highTreg细胞的比例为2.76±0.53%,较健康人明显升高(p<0.05)。结论非小细胞肺癌患者存在免疫受损,可能对此开发有效的免疫治疗方法。
简介:Objective:Theaiminthisstudywastoidentifytheallelicfrequenciesofthechemokine(SDF1-3'A)andchemokinereceptor(CCR5△32,CCR5m303andCCR2-64I)genesresistanttoHIV-1infectionand/ordiseaseprogressioninindigenousChinesepopulations.Methods:ByusingQIAampDNABloodMiniKit,thegenomicDNAsampleswerepurifiedfromwholeperipheralbloodofhealthyindividuals(n=2067)fromHan,Uygur,MongolianandTibetanethnicgroups,aswellasHanpatientsincludingHIV-1carriers(n=330),patientswithothersexuallytransmitteddiseases(STDs,n=259)andintravenousdrugusers(IVDUs,n=125).TheallelicpolymorphismswereidentifiedbymeansofPCRorPCR-RFLPanalyses.ThesequencesofrandomlyselectedamplifiedPCRproductswerefurtherconfirmedbydirectDNAsequencing.Results:Themutantfrequencieswereidentifiedtobe0%-3.48%forCCR5△32,0%forCCR5m303,19.15%-28.79%forCCR2-64and19.10%-28.73%forSDF1-3'Aalleles,respectively,inChinesehealthyindividualsfromfourethnicgroups.Ourfindingsindicatedtheallelicfrequenciesvaryamongthedifferentethnicgroups.Furthermore,theHIV-1carriers,STDcasesandIVDUs(allofHanethnicity)werefoundtohavetheallelicfrequenciesof0%-0.19%(CCR5A32),0%(CCR5m303),19.31%-20.45%(CCR2-64)and25.61%-26.83%(SDF1-3'A)withminorvariationsintheirfrequenciesbetweenthepatientsandhealthyHangroups.TherewasnoCCR5-m303mutationfoundinanysubjectinthisstudy.Conclusion:TheexaminedsubjectsoffourChineseethnicoriginsshowedlowerfrequenciesofCCR5A32andCCR5m303alleles,buthigherfrequenciesofmutantCCR264IandSDF1-3'Aallelescomparedtothoseidentifiedinnorthern-EuropeanandAmericanCaucasians.ThesignificanceofthedifferentfrequenciesandpolymorphismsoftheaboveallelesinChinesepopulationsneedstobefurtherexaminedinHIV-1/AIDSdiseases.
简介:摘要:经导管主动脉瓣膜置换术具有创伤性小、术后并发症和致死率较低的优势,因此该手术具有极高的治疗安全性,成为了治疗复杂高危的主动脉瓣狭窄患者的主要治疗手段,根据相关学者的研究,为复杂高危主动脉瓣狭窄患者实施经导管主动脉瓣膜置换术治疗后的情况进行随访调查,证实了该手术用于治疗的安全性和与有效性。为患者实施手术治疗的时候,需要帮助患者完善各项检查,通过多学科协同评估患者的机体状态,制定合理的治疗方案,并且为患者实施个性化的护理方案,改善患者的心肾功能。护理人员需要充分了解经导管主动脉瓣膜置换术的流程、注意事项和潜在的危险,检测患者的病情,为患者术后实施呼吸支持,维持体循环等手段,降低并发症发病率。