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Umbilical cord blood (UCB) transplants (UCBTs) are becoming increasingly common in the treatment of a variety of hematologic and nonhematologic conditions. The T cells from UCB are naïve T cells, which have not yet been exposed to antigens and therefore do not contain T cells with specific immune functions against viruses. Cytomegalovirus (CMV) infections occur in more than 80% of patients after UCBT compared to other types of transplantation. Anti-CMV medications are currently restricted, with ganciclovir, foscarnet, and valganciclovir being the most common in China; however, with limited efficacy and considerable side effects, all these drugs are susceptible to viral resistance. In recent years, cytomegalovirus-specific T cells (CMVST) have advanced the treatment of viral infections in immunodeficient patients. CMVST usually uses the same donor as hematopoietic stem cell transplantation. CMVST should be administered to UCBT patients because of the absence of donors after UCBT. In China, there is no report on the use of CMVST to treat CMV infection after UCBT, and foreign reports are also limited. This paper reported a 20-year-old male patient with acute myeloid leukemia who developed cytomegalovirus retinitis (CMVR) after umbilical cord blood transplantation. After ineffective viral treatment, he was treated with a third-party donor CMVST and was successfully transformed into CMV nucleic acid negative. [ABSTRACT FROM AUTHOR]

Long-term follow-up data for childhood acute lymphoblastic leukemia (ALL) are scarce in China because of lacking population-based and hospitalized registry system. This retrospective study, conducted at Shanghai's Children's Medical Center in China (SCMC), aimed to investigate the long-term results of childhood ALL and to identify prognostic factors. The Pediatric Oncology Network Database, designed by St. Jude Children's Research Hospital, USA, were used to collect data for the enrolled patients starting in 2005. From 2005 to 2014, 1085 evaluable patients with ALL aged 1 to 18 years old were enrolled and treated using SCMC-ALL-2005 risk-stratified protocol. Complete remission was achieved in 95.6% of patients. At 5 and 10 years, the event-free survival rate was 68.3 ± 1.4% and 64.6 ± 1.6%, and the overall survival rate was 80.0 ± 1.2% and 76.3 ± 1.6%, respectively. The 5-year event-free survival rates were 81.8 ± 2.0%, 67.0 ± 1.9%, and 14.3 ± 4.0% for patients in low-risk, intermediate-risk, and high-risk groups, respectively. The cumulative risk of relapse was 24.5% at 10 years. Induction failure conferred worse prognosis. Patients younger than 1 year of age at diagnosis, intermediate-risk/high-risk group, male gender, and positive minimal residual disease (MRD) results at day 55, both in the univariate and multivariate analysis, were associated with significantly worse prognosis (P < .05). Patients with positive MRD at both day 35 and day 55 were related to a significantly poor outcome (P < .0001), but not for patients with negitive MRD at day 35. The overall outcomes for ALL patients treated with protocol SCMC-ALL-2005 in SCMC are lower than in developed countries. Factors including age, gender, risk group and MRD results at day 55 were associated with treatment outcomes in childhood ALL. [ABSTRACT FROM AUTHOR]

Objectives: The current usage of hormone therapy (HT) among perimenopausal women is low in China, especial in women with premature ovarian insufficiency (POI) with malignant hematologic diseases. This study investigated the efficacy and safety of HT in POI patients with malignant hematologic diseases who have received myeloablative chemotherapy and hemopoietic stem cell transplantation (HSCT).Methods: Patients who had POI after myeloablative chemotherapy and HSCT for malignant hematologic diseases were enrolled. Questionnaires with information about characteristics, menstrual status, sex hormone levels and menopausal symptoms were used to evaluate the relief from menopausal symptoms and safety of HT.Results: Among 130 cases, 103 (79.2%) patients had perimenopausal symptoms. The mean total Kupperman menopausal index score changed significantly from 13.50 ± 7.128 to 6.13 ± 5.97 after HT for 24 months. Among the 118 patients who received estrogen/progestin cyclic sequential therapy, 89 (75.4%) had withdrawal bleeding.Conclusion: Myeloablative chemotherapy against leukemia may cause POI. HT may relieve perimenopausal symptoms after myeloablative chemotherapy and HSCT. HT was safe and no excessive recurrences or mortality were seen in the hormone-treated group for patients who survived from malignant hematologic diseases and who received HSCT. [ABSTRACT FROM AUTHOR]

Background: Invasive mold infection (IMI) is a major cause of infection-related mortality following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: We retrospectively analyzed 190 allo-HSCT recipients at Changhai Hospital between the y 2000 and 2007. The survival rate was evaluated with Kaplan-Meier curves. Logistic and Cox regression models were used for multivariate analyses. Results: The 1st y cumulative incidence rate of IMI was 12.8%, and invasive aspergillosis was the most commonly observed IMI (85%). Multivariate logistic regression analyses showed that significant predictors of IMI were corticosteroid therapy (odds ratio (OR) 1.656, 95% confidence interval (CI) 1.047-2.621, p == 0.031), positive cytomegalovirus antigenemia (OR 5.301, 95% CI 1.902-14.772, p == 0.001), and secondary neutropenia (OR 5.250, 95% CI 1.741-15.834, p == 0.003). The mortality rate of IMI at 12 weeks after diagnosis was 60%. In Cox regression models, IMI-related mortality was related to the dose of corticosteroid (2 mg/kg/day or more) administered at the time of IMI diagnosis (hazards ratio (HR) 20.841, 95% CI 2.151-201.944, p == 0.009) and neutropenia (HR 7.043, 95% CI 1.186-41.827, p == 0.032). Conclusions: These data confirm previous findings that the incidence and mortality of IMI are mostly associated with immunodeficiency caused by immunosuppressive therapy or virus infection. [ABSTRACT FROM AUTHOR]