Autologous peripheral blood stem cell transplantation in the patients with hematologic malignancies and solid tumors

Objective To evaluate the long-term therapeutic effects of autologous peripheral blood st em cell transplantation (auto-PBSCT) on the treatment of hematological and soli d tumors. Methods Fifty-one patients were recruited in this auto-PBSCT study, in which several p otentially important parameters were studied including the optimal time for stem cell co llection, the dose of stem cell reinfusion, the time of hematopoietic reconsti tution, the disease free survival (DFS) and overall survival (OS), complication s related to transplantation, and maintenance chemotherapy after auto-PBSCT. Results After APBSCT, 3-year and 5-year survival rates of NHL were 83.3%; those of AM L were 74.7%; those of MM were 37.9% and 19%; those of ALL were 40% and 0% res pectively. Hematopoietic reconstitution was greatly promoted by granulocyte col ony stimulating factor (G-CSF). The mean time for patients’ neutrophil to reco ver up to >0.5×10(9) /L after APBSCT was 11.14 days in the group of the patien ts receiving G-CSF in contrast to 17.6 days in the group receiving no G-CSF. The most common complications of transplantation were fever, liver dysfunction and hypokalaemia, which were curable. No death was due to transplantation related complications.Conclusion Comparing with conventional chemotherapy, our study suggests that auto-PBSCT i s a very important therapeutic option that can significantly improve the prognos is in the patients with hematological and solid tumors, especially in the patien ts with AML and NHL.     

用国产自体-2000型血液回收机进行血液回收的动物实验研究

通过动物实验研究自体 2 0 0 0型血液回收机的应用价值。方法 :用杂种犬 5只制作外科出血模型 ,并用自体 2 0 0 0型血液回收机行自体血液回收。观察实验犬术后生存情况 ,术前、术后 1周行血常规及血液生化检测。其中 3只犬术后 1周取心、肝、肺、肾、脑、脾进行病理切片检查。结果 :5只犬术后均无输血反应 ,恢复顺利 ,存活良好。血液化验正常。 3只犬术后 1周病理切片检查正常。结论 :国产自体 2 0 0 0型血液回收机回收失血效果良好。血液回输后实验动物无输血反应。对重要器官无明显影响 ,应用该型血液回收机安全、有效。     

急性等容血液稀释在手术中的应用

目的 :探讨手术病人急性等容血液稀释自体输血对机体血流动力学、血液生化的影响。方法 :对 3 0例择期手术病人麻醉后放血 (8 0± 2 7)ml·kg-1,用等容量血定安 (gelofusine)进行血液稀释 ,观察急性等容血液稀释前后血流动力学、血液生化指标的变化。结果 :血液稀释后血红蛋白 (Hb)、血球压积 (Hct)和血小板计数 (Plc)下降幅度分别为 13 8% (P <0 .0 5 ) ,17 1% (P <0 .0 5 )和 7 1% (P >0 .0 5 ) ,但仍在临床正常范围内。血液稀释前后平均动脉压(MAP)、心率 (HR)、血氧饱和度 (SpO2 )、心电图 (ECG)均稳定 ,血Na+,K+,Cl-无明显变化。结论 :急性等容血液稀释是一种安全有效的自身输血方法 ,能有效减少或避免异体输血及由此所引起的输血相关疾病的发生 ,应积极推广应用。     

富集CD34~ 细胞作干细胞移植的临床初步探索

目的　观察富集CD34 的造血干 /祖细胞做肿瘤患者同种异基因造血干细胞移植 (Allo HSCT)和自体移植的临床疗效。观察输注纯化CD34 细胞患者的预后情况。方法　采用磁分选临床型细胞富集仪将表面包被有CD34单抗的磁性微球体系与细胞共同培养 ,特异性结合CD34 细胞。在磁场作用下分别收集CD34 和CD34-组分。完成 2 0例患者CD34 细胞体外纯化富集。其中HLA半相合移植 5例 ,自体移植 15例。结果　纯化后CD34 细胞纯度达 97%以上 ,移植CD34 细胞中位数 5 .72 (0 .15～ 12 .0 )× 10 6,CD34 细胞中位数 3.73(2 .6～ 6 .8)× 10 4 ;CD34-细胞 (CD3、CD4、CD8、CD19)对数去除率 (Log,下同 )为 1.99～ 5 .0。 19例患者移植后随访 11个月 (中位数 ,1～ 2 0 ) ,总体生存13/ 19(例 )。本院 11例中 ,总体生存为 8/ 11(例 ) ,其中HLA半相合 1/ 3(例 ) ,自体移植 7/ 8(例 )。移植后造血重建迅速 ,随访 18个月以上无病生存者 3例中 1例为同种异基因HLA半相合亲属移植 ,2例为肿瘤自体移植。 1例父子间HLA半相合移植 ,白细胞恢复 >1× 10 9/L ,血小板 >2 0× 10 9/L(均为移植后第 13天 )。仅有短暂的I度移植物抗宿主疾病。 2例自体移植病例白细胞恢复 >1× 10 9/L(8～ 2 6d) ,血小板恢复 >2 0× 10 9/L(2 2～ 35d)。结论     

Ultraviolet blood irradiation and oxygenation affects free radicals and antioxidase after rabbit spinal cord injury

Ｕｌｔｒａｖｉｏｌｅｔｂｌｏｏｄｉｒｒａｄｉａｔｉｏｎａｎｄｏｘｙｇｅｎａｔｉｏｎ (ＵＢＩＯ)ｉｓａｆｏｒｍｏｆｐｈｙｓｉｃａｌｔｈｅｒａｐｙ ,ｄｕｒｉｎｇｗｈｉｃｈａｃｅｒｔａｉｎｖｏｌｕｍｅｏｆｖｅｎｏｕｓｂｌｏｏｄｉｓｄｒａｗｎｆｒｏｍａｐａｔｉｅｎｔａｎｄｐｒｏｃｅｓｓｅｄｗｉｔｈａｓｐｅｃｉｆｉｃｄｏｓｅｏｆｕｌｔｒａｖｉｏｌｅｔｉｒｒａｄｉａｔｉｏｎａｎｄｏｘｙｇｅｎａｔｉｏｎｉｎａｂｌｏｏｄｔｈｅｒａｐｙｉｎｓｔｒｕｍｅｎｔ,ｉｔｉｓｔｈｅｎｉｎｆｕｓｅｄｂａｃｋｉｎｔｏｔｈｅｓａｍ…     

Single-agent high-dose melphalan salvage therapy for Hodgkin's disease: Cost, safety, and long-term efficacy

Background: Few data are available on the cost, safety, and long-termefficacy of single agent high-dose melphalan (HDM) followed by autologousbone marrow (ABMT) or blood stem cell (ABSCT) transplantation in the salvagetherapy of Hodgkins disease (HD).Patients and methods: From February 1981 to September 1996, 23 patientswith relapsed (n = 15) or refractory (n = 8) HD received salvage therapywith HDM 140–200 mg/m² followed by non-cryopreservedABMT (n = 18) or cryopreserved ABSCT (n = 5). The cost of HDM/ABSCT in 1996,from initial consultation until transfer back to referring physician, wasdetermined and compared to the estimated costs of two multi-agent regimenscommonly used for HD.Results: HDM was well tolerated with no early transplant-relatedmortality. The five-year overall and progression-free survival rates were52% and 50%, respectively. The average total cost in Canadianfunds of HDM/ABSCT in 1996 was $34,400/patient. This cost wasestimated to be $4,700–6,800 cheaper per patient than themulti-agent high-dose regimens.Conclusion: These data suggest that HDM is safe, feasible, active, andreasonably inexpensive salvage therapy for patients with relapsed/refractoryHD.     

Intensive therapy with peripheral stem cell transplantation in 16 patients with mantle cell lymphoma

Background: Despite improved detection of mantle cell lymphoma (MCL),results of its treatment with conventional therapies remain disappointing andthe survival rate poor. The role of high-dose chemotherapy has recently beeninvestigated but no potential benefit has been clearly established. We reporthere our experience with MCL patients treated with intensive chemotherapy andautologous stem cell transplantation (ASCT).Patients and methods: Of the 16 MCL patients who received high-dosechemotherapy and ASCT beginning in 1989, six were treated in first-line and10 in sensitive relapse. Twelve of 16 patients received regimens whichincluded total body irradiation. All patients received peripheral blood stemcells (PBSC) with the exception of one, who underwent bone marrowtransplantation.Results: Three patients died of toxic effects of treatment. Three monthsafter transplant, seven achieved complete responses (CR) and two partialresponses (PR), two were stable and two had progressed. With a medianfollow-up after transplant of 22 months, five of the six surviving patientswere without progression, and three were in CR. The median times forevent-free survival (EFS) and overall survival (OS) were, respectively, 249and 317 days. The expected three-year EFS and OS were 24%. The mediansurvival after diagnosis was only 29 months. None of the criteria appeared tobe significantly associated with a better outcome, but first-lineintensification and a short delay after initial diagnosis may be favorable.Conclusion: In this study we were not able to confirm the hypotheticalbenefit of high-dose chemotherapy and PBSC transplantation in mantle celllymphoma, even though this approach may be promising in a subgroup of patient.     

心内直视手术后回输心包引流血的研究

目的 探讨心内直视手术后回输心包引流血的安全性。方法 ４０例中,引流血回输组２０例（回输组）,未回输引流血组２０例（对照组）,两组病例分别检测血红蛋白浓度,红细胞计数,血小板计数,纤维蛋白降解酶产物（ＦＤＰ）等,用ｔ检验且均数进行比较。结果两组血红蛋白浓度,红细胞计数,红细胞压积及血小板计数无显著性差异,测定引流血和库血ＦＤＰ及Ⅷ因子,存在显著性差异,表明引流血纤溶活性明显低于库血,而Ⅷ因子含量高     

胃癌患者术后NDV-ATV治疗对机体免疫功能的影响

目的 探讨新城鸡瘟病毒修饰的自体肿瘤疫苗(NDV—ATV)治疗胃病术后患者机体免疫功能的影响。方法 采用流式细胞术分析36例胃病术后(术后2、3、4、5周)NDV—ATV治疗患者外周静脉血T淋巴细胞亚群及NK细胞的变化情况，并以15例术后未接受NDV—ATV治疗的胃癌患者作对照。结果 对照组术后CD3^ 、CD4^ 、NK细胞所占百分比和CD4^ /CD8^ 逐渐升高，以术后3周内升高最为明显。NDV—ATV治疗组，术后CD3^ 、CD4^ 、NK细胞所占百分比和CD4^ /CD8^ 上升速度更快，持续时间更长。治疗结束后与治疗前比较，有非常显著性差异(P＜0．01)；且明显高于未接受NDV—ATV治疗的对照组患者(P＜0．05)。第1次治疗后和治疗结束后相比较有显著性差异(P＜0．05)。结论 NDV—ATV可同时视为1种免疫调节剂，能明显改善胃癌患者术后机体的免疫功能，提高机体抗肿瘤能力。