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To explore the transcriptional gene expression profile up-regulated in human macrophages stimulated by interferon-γ (IFN-γ) and the underlying intracellular signaling mechanisms.RNA-seq was used to sequence and compare the differential gene expression profiles of human macrophage cell line U937 before and after IFN-γ stimulation, and the significantly up-regulated genes were screened out, which were verified by fluorescence-based real-time quantitative polymerase chain reaction (qPCR) in U937 and THP1 cell lines, respectively. JAK/STAT, MAPK/ERK and PI3K/AKT pathway inhibitors were added to simultaneously to the cultured U937 cells upon IFN-γ priming to detect their effects on the expressions of the up-regulated genes to explore the key regulatory mechanisms.RNA-seq and qPCR results showed that, the well-recognized chemokines CXCL9, CXCL10 and CXCL11, the APOL family including APOL1, APOL2, APOL3, APOL4, APOL6 and GBP family GBP1, GBP2, GBP3, GBP4 and GBP5 as well were significantly up-regulated in IFN-γ-stimulated U937 cells. JAK/STAT3 pathway inhibitor inhibited the upregulation of APOL1, APOL4, GBP1, GBP4 and GBP5 genes induced by IFN-γ, while MAPK/ERK pathway inhibitor inhibited the upregulation of CXCL10 gene. PI3K/AKT pathway inhibitor inhibited the upregulation of APOL1,APOL4, APOL6, GBP1 and GBP5 genes induced by IFN-γ, all three signal pathway inhibitors could inhibit the upregulation of CXCL9 gene, and none of them could inhibit the upregulation of APOL3 gene.Upon IFN-γ stimulation, some family molecules of APOL and GBP in macrophages are significantly up-regulated, and PI3K/AKT, JAK/STAT3 and MAPK/ERK pathways have positive regulation on their expressions, respectively.干扰素-γ刺激人巨噬细胞后的转录组变化与细胞内信号调控机制研究.探讨干扰素-γ（IFN-γ）刺激后人巨噬细胞内上调的转录组基因表达谱及其相应的细胞内信号调控机制.运用RNA-seq对IFN-γ刺激前后的人巨噬细胞系U937差异基因表达谱进行测序和比较，从中筛选出显著上调的基因，利用实时荧光定量PCR技术（qPCR）分别在U937和THP1两个巨噬细胞株内进行验证；在IFN-γ刺激U937细胞的同时，分别加入JAK/STAT3、MAPK/ERK和PI3K/AKT通路抑制剂，检测其对上调基因的影响，从中找出关键的调控机制.巨噬细胞经IFN-γ刺激后，RNA-seq筛选结合qPCR验证结果显示：趋化因子CXCL9、CXCL10、CXCL11，APOL家族包括APOL1、APOL2、APOL3、APOL4、APOL6以及GBP家族GBP1、GBP2、GBP3、GBP4、GBP5均显著上调。JAK/STAT3通路抑制剂抑制了IFN-γ诱导的APOL1、APOL4、GBP1、GBP4和GBP5基因上调表达，MAPK/ERK通路抑制剂抑制了IFN-γ诱导的CXCL10基因上调表达，PI3K/AKT通路抑制剂抑制了IFN-γ诱导的APOL1、APOL4、APOL6、GBP1和GBP5基因上调表达，三种信号通路抑制剂均能抑制IFN-γ诱导的CXCL9基因上调表达，三种通路抑制剂对IFN-γ诱导的APOL3基因上调均无抑制作用.IFN-γ刺激后巨噬细胞内APOL和GBP部分家族分子表现为显著上调，PI3K/AKT、JAK/STAT3和MAPK/ERK通路对其表达分别具有一定的正向调控作用.

In this study, we aimed to investigate treatment options and the prognosis of patients with mantle cell lymphoma in China. 805 patients diagnosed with MCL between April 1999 and December 2019 at 19 comprehensive hospitals in China were included in this retrospective analysis. The median age of the cohort was 60.0 years with a male-to-female ratio of 3.36:1. 5-year progression free survival (PFS) and overall survival (OS) rates were 30.9% and 65.0% respectively. High-intermediate/high risk group according to MIPI-c, without high-dose cytarabine, lack of Auto-SCT as consolidation and maintenance treatment and SD/PD in initial treatment remained statistically relevant to poor PFS on multivariate analysis (MVA), and ki67 ≥ 50%, B symtoms, high-intermediate/high risk group according to MIPI-c ,without high-dose cytarabine ,lack of maintenance treatment ,SD/PD in initial treatment and relapse/refractory state were independently associated with poorer OS on MVA. First-line high dose cytarabine exposure, auto-SCT as consolidation therapy obtained survival benefits in Chinese population. and our study further confirmed the value of maintenance treatment and explored the application of new drug treatment and bendamustine in R/R MCL patients.

To investigate the prognostic value of metabolic parameters ofThe clinical data of 58 patients with DLBCL who were examined byThe SUVMTV and TLG are independent risk factors for OS and PFS in patients with DLBCL, which may be valuable for prognosis of patients with DLBCL.探讨回顾性分析治疗前接受58例DLBCL患者的SUVMTV及TLG是影响DLBCL患者OS和PFS的独立危险因素，对DLBCL患者预后判断具有一定的参考价值。.

To explore the clinical pathological features of the patients with diffuse large B cell lymphoma (DLBCL) and their prognostic factors.The prognosis of the clinical pathological features and their influence on prognosis of 177 patients diagnosed as DLBCL at the first visit from January 2013 to May 2017 in our hospital were analyzed retrospectively.The univariate analysis showed that overall survival (OS) and progression-free survival (PFS) were associated with later Ann Arbor stage (Ⅲ-Ⅳ) ( P＜0.01, P＜0.05), high performance status (ECOG score 2-4) (P＜0.01, P＜0.05), extranodal involvement ＞1 (P＜0.01, P＜0.05), elevated LDH level (P＜0.01, P＜0.05). B symptom (P＜0.05) and elevated β2-MG level (P＜0.05) also influenced OS. COX multivariate analysis showed that the elevated β2-MG level (P＜0.05) and later stage (Ⅲ-Ⅳ) (P＜0.05) have an independent influence on OS, later stage (Ⅲ-Ⅳ) (P＜0.05) also independently influenced PFS. The patients with high aaIPI score (2-3) and bone marrow involvement before treatment had poor OS (P＜0.01, P＜0.01) and PFS (P＜0.05, P＜0.01).Elevated β2-MG level can independently influence OS, and later stage (Ⅲ-Ⅳ) can independently influence both OS and PFS. High aaIPI score (2-3) and bone marrow involvement before treatment have an inferior influence on OS and PFS.年轻弥漫大B细胞淋巴瘤患者的临床病理特征与预后分析.探讨弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma，DLBCL）患者的临床病理特征及其对预后评估作用.选取本院2013年1月至2017年5月177例确诊为弥漫大B细胞淋巴瘤的初治患者，回顾性分析其临床病理特征及其对预后的影响.单因素预后分析发现，分期Ⅲ-Ⅳ期（P=0.004，P=0.029）、ECOG评分2-4分（P=0.003，P=0.042）、结外受累＞1处（P=0.000，P=0.031）、异常升高的LDH值（P=0.000，P=0.046）为影响患者OS与PFS的危险因素；B症状（P=0.020）、异常升高的β2-MG值（P=0.020）仅影响患者OS。COX多因素分析显示，异常升高的β2-MG值（P=0.044）及分期（P=0.046）为影响患者OS的独立危险因素，分期（P=0.029）是影响患者PFS的独立因素。年龄调整的IPI（aaIPI）评分2-3分的患者与初治骨髓受累的患者OS（P=0.000，P=0.000）与PFS（P=0.013，P=0.000）更差.异常升高的β2-MG值是影响弥漫大B细胞淋巴瘤患者OS的独立因素，分期是影响患者OS与PFS的独立因素。aaIPI评分2-3分患者与初治骨髓受累的患者OS与PFS更差。.

To study the clinical characteristics of patients with post-transplantation lymphoproliferative disease (PTLD) after allogeneic peripheral blood hematopoietic stem cell transplantation, and to improve the understanding and diagnosis of PTLD.The clinical data of 244 patients underwent allogeneic hematopoietic stem cell transplantation in the General Hospital of PLA from May 2014 to April 2017 were analyzed retrospectively. The follow-up time was up to November 30, 2017. The incidence, risk factors, treatment and survival of patients with PTLD were statistically analyzed.Among the 244 cases the PTLD occurred in 22 cases, the incidence rate was 9.02%, 5 of them were diagnosed by pathology, and 17 were diagnosed clinically. All of them had EB virus infection. They were all ATG user, either underwent related haploidentical hematopoietic stem cell transplantation or unrelated hematopoietic stem cell transplantation, 20 cases were treated with rituximab or rituximab combined with γ-globulin, glucocorticoid, ERV+CTL, chemotherapy and 17 showed the effective response, with a total effective rate of 85%. The median follow-up time was 122 days, the median survival time was 5 months (1-22 months) and the total survival rate was 50%.The incidence of PTLD after allogeneic peripheral blood hematopoietic stem cell transplantation closely relates with EB virus infection. The application of ATG in the preconditioning scheme is a high risk factor for the onset of PTLD. In the case of no pathological diagnosis, clinical and laboratory examinations should be actively combined so as to define clinical diagnosis. The riturimab should be used more and more for patients with PTLD.

To explore the factors which may have influences on hematopoietic reconstitution of the auto-peripheral blood stem cell transplantation(auto-PBHSCT).The successful rate, the time of hematopoietic reconstitution and implantation status at 28 days after transplantation of 177 patients received auto-PBSCT were retropectively analyzed, in order to explore the factors which may have influences on hematopoietic reconstitution.The median time of neutrophil recovery was 12 days (8-21 days), implantation rate was 98.9%, all patients' neutrophil were recovered in 28 days. The median time of platelet recovery was 17 days (7-420 days), implantation rate was 95.5%, the cumulative incidence of platelet recovery at day 28 was 80.8%. Univariate analysis showed that the CD34In auto-PBHSCT patients, disease kinds, conditioning regimen, the infused CD34

To analyze the therapeutic efficacy of different consolidation therapies after induction remission on Ph negative adolescent and young adults with acute B lymphoblastic leukemia, and to explore the effect of different risk factors on prognosis.The treatment and efficacy of 80 Ph negative B-ALL in patients of 16-39 years old in the Hematology Department of 301(65 cases) and 309(15 cases) hospital from 1999 to 2016 are retrospectively analyzed. The patients received combined induction chemotherapy of 4 or 5 chemotherapeutic drugs (VDCLP/ VDLP/ DOLP/ IOLP). After remission patients received consolidation protocols of 3-5 cycls, and then received allo-HSCT or haploidentical HSCT. The median follow-up time was 29 (6-153) months.HSCT was carried out after CR1. The 5-year OS and EFS of allo-HSCT group(n=29) was (73±16)% and (67±17)%, respectively, while those of haploidentical-HSCT group(n=20) were (53±22)% and (53±22)%, respectively, and those of pediatric-inspired protocols(n=31) was (63±17)% and (50±18)%, respectively. The difference between OS and EFS in 3 group was not statistically significant(P0.05). The re-remission rate of recurrent patients was (50±23)%. On the one side, the cumulative incidence of TRM of pediatric-inspired protocol was better than that of HSCT (P0.05). On the other side, the cummulative incidence of relapse (CIR) of pediatric-inspired protocol was poorer than that of HSCT, yet without significant difference (P0.05). The median remission time of CR2 in patients was 14(2-36) months. Univariate and multivariate analysis were performed in 65 patients, and showed an abnormal result of CD13 or CD33 positive, CD22 negative, indicating a poor prognosis(P0.05).In the adolescent and young adult patients with Ph

To investigate the therapeutic efficacy of allogeneic peripheral blood hematopoietic stem cell transpdantation (allo-HSCT) for T lymphoblastic lymphoma (T-LBL).The clinical data of 14 adult patients with T-LBL treated with allo-HSCT were collected, the hematopoietic reconstruction, survival and relapse, as well as overall survival (OS) rate, event-free survival (EFS) rate of 1, 3 and 5 years were analysed retrospectively.All the patients were engrafted with neutrophil successfully, the median time of absolute neutrophil count0.5 × 10(9)/L was 13 (10-19) d; 13 patients were engrafted with platelets successfully, the median time of Plt count20 × 10(9)/L was 17 (12-62) days. The acute GVHD occurred in 6 patients, but among them only 1 case with 3 grade of aGVHD; out of 14 patients, 5 developed chronic GVHD. The transplant-related mortality at 100 days was 7.1% (1/14), mainly from coronary heart disease and pulmonary infection. The median follow-up time was 26.5 months, the estimated 1, 3 and 5 year OS rate was 85.7%, 47.6% and 38.1%, respectively, and estimated 1, 3 year EFS rate was 85.7%, 34.4% and 34.1%, respectively. The relapse rate was 42.8% (6/14) and the median relapse time was 22.5% months after transplantation. Up to now, 7 patients still survive, 1 patient out of them have survived for 103 months.The allo-HSCT is a safe and effective method for treatment of T-LBL.

To analyze the cytogenetic abnormalities and prognostic outcomes of patients with multiple myeloma (MM) detected by fluorescence in situ hybridization (FISH).The clinical record of 117 newly-diagnosed patients with MM treated in department of hematology and geriatric hematology of our hospital for 7 years were collected, and their molecular cytogenetic abnormalities detected by FISH and the clinical outcome were analyzed retrospectively.The detected rate of cytogenetic abnormality was 76.9%(90/117), the most common abnormality deteted by FISH was 1q21+ (71.1%), followed by 13q- (56.6%). The cross comparison method showed that 13q- and 17p13-, t(11;14) and t(4;14) were related respectively. All the patients with cytogenetic abnormalities showed no significant difference in the overall survival from cytogenetic normal patients.The positive rate of molecular cytogenetic abnormalities detected by FISH in MM patients is high, but data from larger and longer studies are needed to evaluate the prognostic outcomes.

To explore the value of BCL-2 protein for evaluating the prognosis of patients with diffuse large B cell lymphama (DLBCL).The clinical data of 128 patients with DLBCL including clinical features, BCL-2 protein expression, therapeutic outcome and so on were analyzed retrospectively in departenent of hematology, Chinese PLA general hospital from January 2008 to December 2010, and the prognosis of DLBCL patients with different expression levels of BCL-2 protein was compared, including overall survival (OS) and progression-free survival (PFS) rates.The BCL-2 expression postive was found in 83 cases (64.8%), while BCL-2 expression negative was observed in 45 cases (35.2%). The OS rates in BCL-2 expression positive and negative groups were 76.6% vs 76.8% in 3 years (P0.05), and the PFS rates in BCL-2 expression positive and negative groups were 57.1% vs 70.5% (P0.05) in 3 years, suggesting that BCL-2 expression level had no significant impact on OS and PFS rates in all DLBCL patients. However, among the older patients aged ≥ 60 years, there was singnificant different of 3 year OS rates in BCL-2 expression positive and negative groups (66.7% vs 76.4%, P0.05), while 3-year PFS rate in BCL-2 expression positive group was obviosusly lower than that in BCL-2 expression negative group (35.8% vs 83.3%, P0.05).The positive expression of BCL-2 protein is a poor prognostic factor for older patients aged ≥ 60 years, thus this indicator possesses the prognostic value for these patients with DLBCL.

Invasive fungal disease (IFD) causes a high morbidity and mortality in patients with hematological malignancies. Reactivation of IFD after chemotherapy or hematopoietic stem cell transplantation (HSCT) is very common and associated with poor prognosis. Secondary antifungal prophylaxis (SAP) is effective in preventing IFD recurrence. With effective SAP, a history of IFD is not an absolute contraindication to allogeneic HSCT or continuation of high-dose chemotherapy. In recent years, a variety of antifungal drugs such as voriconazole, itraconazole, AmB and caspofungin have been found to be effective for SAP. However, its management during granulocytopenia and immunosuppression remains challenging. This review summarizes the current status of SAP in patients with hematological malignancies.

Adenoviral vectors (Ad) were widely used in gene therapy and study of gene function, but the commonly used serotype 5 adenovirus-based vectors (Ad5) could poorly transduce hematopoietic cells because of low expression of viral receptors on these cells. To overcome this limitation, we developed a retargeting adenovector with a chimeric fiber of Ad5 and Ad11p (Ad5F11p) and evaluated its gene transfer ability in hematopoietic cells.An Ad11p fiber pseudotyped Ad5 vector was generated by modifying the fiber gene of pAdEasy-1 backbone plasmid. Ad5F11p-GFP encoding enhanced green fluorescence protein (GFP) gene was transferred into human leukemic cell lines, primary leukemic cells, and CD34(+) hematopoietic cells. The gene transduction efficiency was determined by fluorescence-activated cell sorting assay.More than 90% of U937 or K562 cells could be infected by Ad5F11p-GFP at a moderate multiplicity of infection (MOI). Ad5F11p-GFP is also significantly more effective than control Ad5-GFP in infection of primary myeloid leukemic cells. At 200 MOI, GFP-positive percentages of Ad5F11p-GFP transduced myeloid leukemic cells range from 10.58% to 92.63% with a median of 28.65%. Ad5F11p-GFP could transduce about 50% human hematopoietic stem/progenitor (CD34(+)) cells, while Ad5-GFP could transduce15% at 200 MOI. CD46 was reported to be the receptor of Ad11p. Our data suggest that CD46 participates in the process of Ad5F11p-GFP infection but is not the unique molecule determining its gene transfer efficiency of host cells.We established a retargeting adenovector system, which could infect hematopoietic cells effectively and would benefit research work on Ad tropism.

Multiple myeloma (MM) remains incurable despite the use of high-dose chemotherapy and stem cell transplantation. However, immunotherapy is expected to offer long-term disease control, or even possibly a cure. We have previously demonstrated the suppressive effect of a recombinant adenovirus carrying human wild-type p53, granulocyte-macrophage colony-stimulating factor, and B7-1 genes (Ad-p53/GM-CSF/B7-1) on the growth of laryngeal cancer cells. In the present study, we evaluated the effects of an Ad-p53/GM-CSF/B7-1-modified myeloma cell vaccine strategy aimed to induce apoptosis and to augment the immunogenicity of MM cells. Both MM cell lines and purified primary myeloma cells were infected with Ad-p53/GM-CSF/B7-1. High expression levels of these three genes were confirmed separately by Western blot, enzyme-linked immunosorbent assay (ELISA), and flow cytometry. When wild-type p53, GM-CSF and B7-1 genes were introduced, the growth of MM cells was inhibited via enhanced apoptosis and the immunogenicity of tumor cells was augmented. The combinatorial effect of these three genes on inducing cytotoxic T lymphocytes (CTLs) was more evident than that of p53 individually or any combinations of two (p53 plus GM-CSF or p53 plus B7-1). Furthermore, significant proliferation of autologous peripheral blood lymphocytes (PBLs) and specific cytotoxicity against autologous primary MM cells were induced in vitro. These results suggest that myeloma cell vaccination co-transferred with p53, GM-CSF and B7-1 genes may be a promising immunotherapeutic approach against MM.

The study was to investigate the prognosis factors in acute myeloid leukemia (AML) patients treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT).The clinical information of 60 patients in our hospital was retrospectively analyzed and the prognosis factors of survival and relapse were explored by COX's proportional hazard model.The elderly (HR = 4.530, P = 0.012), cGVHD (HR = 0.023, P = 0.003) and infection fungal disease (IFD) (HR = 4.019, P = 0.017) were influence factors for 2 year cumulative overall survival (OS). Response status (high risk vs low risk: HR = 3.465, P = 0.028), preconditioning regimens (TBI/Cy vs Bu/Cy: HR = 0.071, P = 0.012; FB vs Bu/Cy: HR = 7.547, P = 0.025) and cGVHD (HR = 0.088, P = 0.004) were influence factors for 2 year cumulative relapse rate (RR). cGVHD (P = 0.017) and IFD (P = 0.000) had an effect on OS after 2 years since allo-HSCT.Age, response status, preconditioning regimens, cGVHD and IFD are closely associated with the prognosis of AML patients treated with allo-HSCT, and different patients need the individualized treatment.

Purpose of this study was to analyse the characteristics of clinical, iconographical, pathological and treatment methods of Langerhans cell histiocytosis (LCH), so as to improve the diagnosis and treatment level of this disease. The clinical data of 35 LCH patients were studied retrospectively. These patients were divided into 2 groups according to age14 years old and ≥ 14 years old. The clinical symptoms were analysed and the signs, imageology and pathology manifestation and treatment results were evaluated. The results showed that LCH clinical manifestations were diverse and complex. Surgical treatment for patients with single system involvement of LCH was better than that of multi-system involvement of LCH (MS-LCH). For the latter, combined chemotherapy effects was better. After 3-year follow-up, 1-year OS was 94% ± 4%, 2-years OS was 91% ± 5%, 3-year OS was 86% ± 7%. 3 years OS of group14 years old and ≥ 14 years old was 94% ± 6% and 81% ± 10% respectively. The OS of former was better than that of the later, but because a small number of cases, this difference was not statistically significant. It is concluded that LCH is easy to be misdiagnosed, the pathological biopsy is the gold standard of LCH diagnosis. The PET-CT can be of great help in identifying stages and finding lesion areas of the disease. Pulmonary Langerhans cell histiocytosis (PLCH) is more common in adult. Combined chemotherapy can improve the prognosis of the patients. The treatment methods should be choosed according to the stage and classification of disease.

This study was purposed to evaluate the outcome of acute myeloid leukemia patients treated with related peripheral blood hematopoietic stem cell transplantation (PBHSCT) and analyse the potential prognostic factors. A total of 64 acute myeloid leukemia patients treated with related peripheral allo-HSCT from march 2008 to august 2012 in our hospital were enrolled in the analysis. All the patients received either HLA-matched related or mismatched related donor mobilized peripheral blood stem cells. All the patients were followed up and evaluated for overall survival (OS), leukemia-free survival (LFS) and relapse rate (RR) , and the potential prognostic factors well analyzed. The results showed that the 3 year OS , LFS and RR were 61.9%, 52% and 39.1% respectively. Univarite analysis demonstrated that the disease status before transplantation (P0.01) , donor type (P0.01), white blood cell count at initial diagnosis (P0.05) are related with outcome, and severe aGVHD has some influence on the outcome (P0.05) . Multivariate analysis indicated the status of disease before transplantation, donor type, severe aGVHD are the most important prognostic factors. It is concluded that the related PBHSCT is effective treatment method for AML patients, recurrence is the main reason for the failure after transplantation, disease status before transplantation, donor type, and severe aGVHD are independent prognostic factors.

This study was purposed to analyse the clinical efficacy of autologous peripheral blood stem cell transplantation (APBSCT) in 13 Patients with AML1/ETO (+) acute myeloid leukemia, and to evaluate the role of quantitative detecting the AML1/ETO gene in treatment of AML patients. A total of 13 patients with AML1/ETO (+) acute myeloid leukemia treated with APBSCT from August 2007 to November 2012 were retrospectively analyzed. The median follow-up time was 26 (7.8-75.8)months. Kaplan-Meier analysis was used to calculate the overall survival (OS), leukemia-free survival (LFS) and cumulative relapse rate (RR). Log rank method was used to perform univariate analysis. The results showed that the 3 year-OS, LFS, and RR were (70.5 ± 15.3)%, (51.3 ± 16.7)%, 48.7%, respectively. The AML1/ETO expression level in 4 cases out of 5 relapsed patients was quantified during and after therapy, and the result showed that AML1/ETO expression level significantly increased before morphological relapse. In univariate analysis, there was no statistic significance in terms of age, sex, count of white blood cells at diagnosis, interval from diagnosis to transplantation, count of MNC for infusion. It is concluded that APBSCT has good therapeutic effect on AML1/ETO (+) AML, and regular quantitative monitoring of AML1/ETO expression level can predict early recurrence. Allogeneic hematopoietic stem cell transplantation after relapse may contribute to obtain opportunity to achieve the long-term survival for intermediate and high risk patients.

This study was purposed to evaluate the efficacy and safety of linezolid, vancomycin and teicoplanin for the treatment of patients infected by Gram-positive bacteria in the Department of Hematology by retrospective analysis. The patients with fever in our department from January to December in 2011 were selected for blood culture with Gram-positive bacteria and treated with linezolid, vancomycin or teicoplanin alone.Various parameters were recorded before and after treatment, such as fever time, respiratory symptoms, physical signs, radiographic changes, blood and biochemical routine, and adverse reactions. The efficacy and safety of linezolid, vancomycin and teicoplanin were compared according to the fever abating time, bacterial clearance rate, clinical efficiencies and adverse events. The patients were divided into linezolid group (15 patients), vancomycin group (17 patients) and teicoplanin group (20 patients). The results showed that the mean time of fever abating in linezolid group was (4.43 ± 3.15)d, bacterial clearance rate and clinical efficiency in linezolid group were 55.56% and 86.67%, respectively. The above three data in vancomycin group were (6.83 ± 4.67)d, 54.54% and 76.47% respectively, and were (5.57 ± 4.16)d, 41.67% and 80.00% in teicoplanin group respectively. There was no statistically significant difference between three groups (P0.05). There were one case of diarrhea and two cases of thrombocytopenia in the linezolid group, and one case of nausea and two cases of creatinine increase in the vancomycin group. There were three cases of thrombocytopenia in the teicoplanin group. The thrombocytopenia in five cases and the hemogram drop in patients with leukemia after treatment were overlapped, their drug treatment did not stop, but their thrombocytopoiesis recovered to normal-level, thus the drug treatment were considered as no relation with thrombocytopenia. It is concluded that the treatment efficacy between linezolid, vancomycin and teicoplanin for Gram-positive bacterial infections is not statistically different, but linezolid maybe have advantage over vancomycin and teicoplanin in fever abating time, bacterial clearance rate and clinical efficiency.

This study was purposed to assess the effectiveness of haploidentical hematopoietic stem cell transplantation (HSCT) without in vitro T cell depletion for the treatment of severe aplastic anemia (SAA) in children. Two children with SAA/very SAA (VSAA) received T cell-depleted HSCT from their fathers with 2 loci mismatched in our center between October 2010 and March 2013. During 4 months after onset, both failed in treatment of cyclosporine (CsA)+ granulocyte colony stimulating factor (G-CSF), had active or serious infections, were transfusion dependent and lacked HLA-identical sibling donors and unrelated donors. The conditioning regimen before HSCT included fludarabine, cyclophosphamide and thymoglobulin. The source of grafts was a combination of G-CSF mobilized peripheral blood hematopoietic stem cells and BM. The recipients received CsA, mycophenolate mofetil (MMF) and short-term MTX for GVHD prophylaxis. Both children with SAA achieved 100% donor myeloid engraftment. Neutrophil engraftment occurred at day 12 and day 18 after transplant respectively. Platelet engraftment occurred at day 17 and day 26 after transplantation respectively. Two patients all developed grade I acute graft versus host disease (GVHD), one of which evolved into chronic limited GVHD well-controlled. Both have survived for two years after transplantation with 100% donor myeloid engraftment and effective lymphoid reconstitution. In conclusion, these limited cases suggest that haploidentical HSCT for children with SAA without a HLA-identical sibling donor and unrelated donor may be feasible. Further prospective clinical study is required to increase the overall survival (OS) by decreasing GVHD while maintaining stable engraftment.

To evaluate the efficacy and safety of unmanipulated haploidentical allogeneic peripheral blood stem cells transplantation (PBSCT) on hematologic diseases.Patients who underwent unmanipulated HLA-mismatched/haploidentical PBSCT from July 2007 to December 2011 were investigated retrospectively.Forty-nine patients with hematologic diseases underwent unmanipulated human leukocyte antigen (HLA)-mismatched/haploidentical PBSCT with myeloablative conditioning. All patients were mismatched at the allele level for HLA-A, HLA-B, HLA-Cw, HLA-DRB1 and HLA-DQ1. Fifteen patients were mismatched in 5 loci, 11 patients in 4 loci, 7 patients in 3 loci, 5 patients in 2 loci, and 11 patients in 1 locus. The median numbers of mononuclear cells and CD₃₄⁺ cells infused at transplantation were 10.01(7.05-25.34) × 10⁸/kg and 4.51 (2.01-11.47) × 10⁶/kg, respectively. Patients achieved myeloid and platelet engraftment at a median of 14 (10-25) days and 22 (10-135) days, respectively. The cumulative incidence of acute graft versus host disease (aGVHD) on day 100 was (61.6 ± 7.3)%, and the 2-year cumulative incidence of chronic graft versus host disease (cGVHD) was (42.6 ± 8.5)%. One hundred-day transplantation related mortality (TRM) rate and 2-year cumulative TRM rate were (14.7 ± 5.1)% and (30.9 ± 8.8)%, respectively. The 2-year cumulative incidence estimate of relapse was (25.4 ± 7.0)%. The 2-year cumulative overall survival rate was (58.1 ± 8.8)% and 2-year disease-free survival rate was (53.9 ± 8.4)% with an 11.5-months median follow-up.Unmanipulated PBSCT is a promising protocol for patients with hematologic diseases in HLA-mismatched/haploidentical transplant settings.

The purpose of this study was to investigate the efficacy of autologous hematopoietic stem cell transplantation (auto-HSCT) for patients with diffuse large B-cell lymphoma (DLBCL), and analyse the factors influencing prognosis. The clinical data of 67 patients with DLBCL received auto-HSCT from 1996 to 2011 and cumulative overall survival (OS), progression-free survival (PFS), transplant-related mortality (TRM), and relapse rate were retrospectively analyzed. The results showed that the median follow-up time was 40 months after transplantation. Three-year cumulative OS and PFS were 70.6% and 66.4% respectively, 5-year cumulative OS and PFS were 70.6% and 63.8% respectively, and TRM was 7.2%. One-year and three-year cumulative relapse rate were 16.5% and 23.7% respectively. Univariate analysis revealed that the age and pre-transplant disease status were significantly associated with poor prognosis (P0.05). It is concluded that auto-HSCT is a safe and effective therapeutic option for patients with DLBCL, especially for the young patients or patients with better remission.

To further understand the clinical features of non-gastric mucosa-associated lymphoid tissue (MALT) lymphoma and investigate its suitable treatment.A retrospective survey of 57 non-gastric MATL lymphoma patients pathologically confirmed in our hospital from 1999 to 2011.The median age was 58 years (range 14-86 years). Common presenting sites of non-gastric MALT lymphoma included lungs and upper respiratory tract (17 patients, 29.8%), intestinal tracts (16 patients,28.1%), orbital and ocular adnexal (7 patients, 12.3%), and salivary glands (8 patients, 14.0%). Stage Ⅰ-Ⅱdisease presented in 35 patients (61.4%), stage Ⅲ-Ⅳ disease in 22 patients (38.6%). A total of 26 patients had nodal involvement and 7 patients multiple organ involvement. Regimens included surgery alone, chemotherapy alone, surgery followed by chemotherapy or chemoradiotherapy. The complete response (CR) rate was 66.0% and the overall response rate 85.7%. At a median follow-up of 52 months, the 5-year overall survival (OS) and the 5-year progression free survival (PFS) were 91.6% and 77.7%, respectively. The 5-year survival rate of surgery, chemotherapy, surgery+chemotherapy, surgery + chemotherapy + radiotherapy groups were 87.5%, 100.0%, 90.2% and 100.0%, respectively, without significant differences. The 5-year PFS of the four groups were 62.3%, 80.0%, 90.2% and 75.0% respectively.Non-gastric MALT lymphoma is characterized by disseminated onset, favorable response to treatments and good outcomes. There is no statistically significant difference in the overall survival of the various treatments. But the recurrence rate of surgery alone is relatively high (22.3%).目的 进一步了解非胃黏膜相关淋巴组织（MALT）淋巴瘤患者的临床特点并探讨合理的治疗方法。方法 回顾性分析57例经病理确诊的非胃MALT淋巴瘤患者资料,对其临床特点和治疗疗效进行分析。结果 57例患者中,男32例、女25例,中位年龄58（14～86）岁,常见发病部位为肺及支气管（17例,29.8%）、肠道(16例,28.1%)、涎腺（8例,14.0%）、眼及附属器（7例,12.3%）等。临床分期为Ⅰ～Ⅱ期者35例（61.4%）,Ⅲ～Ⅳ期者22例（38.6%）,淋巴结受累者26例（45.6%）,多个结外器官受累者7例（12.5%）。56例接受治疗的患者完全缓解率为66.0%,总反应率85.7%。中位随访时间52个月,患者5年总生存（OS）率和5年无疾病进展生存（PFS）率分别为91.6%和77.7%。单纯手术组、单纯化疗组、手术+化疗、手术+化疗+放疗组5年OS率分别为87.5%、100.0%、90.2%和100.0%,5年PFS率分别为62.3%、80.0%、90.2%和75.0%,差异无统计学意义。单纯手术者复发率高(22.3%)。结论 非胃MALT淋巴瘤起病呈播散性,患者治疗反应率高,预后好,各种治疗方法的OS率差异无统计学意义,但单纯手术者复发率高。

This study was purposed to investigate the clinical efficiencies and adverse reactions of treating the myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) by using decitabine. The clinical data of 12 MDS and AML patients treated with decitabine were analyzed retrospectively. Among 12 patients there were 1 case of MDS-RA, 2 cases of MDS-RAEB-I, 3 cases of MDS-RAEB-II, 2 cases of AML-M4, 2 cases of AML-M5, 1 case of AML-M6 and 1 case of AML-M0. In decitabine chemotherapy program for 5 days (n = 8), decitabine 20 mg/(m(2)·d) × 5 days was applied, 4 weeks for 1 cycle; in program for 3 days (n = 2), decitabine 15 mg/m(2), once 8 h for 3 days, 6 weeks for 1 cycle; another program (n = 2), decitabine 20 mg/(m(2)·d) every other day for 5 times. For 1 patient achieved complete remission (CR) after treatment with decitabine, ID4 gene methylated level was detected by MS-PCR and ML-PCR before and after treatment. The results showed that 2 cases achieved CR, 1 case partial remission, 5 cases stable disease, 1 case progress of disease and 3 cases died. Disease control rate was 66.67% (8/12), the effective rate 25% (3/12). The average survival time was (11.5 ± 2.1) months. 1-year OS rate was 40%, 2-year OS rate was 16.7%. MS-PCR detection showed that the decitabine could significantly reduce the ID4 gene methylation level. It is concluded that decitabine can stabilize disease status of MDS patients, reduce blood transfusion dependence and improve the life quality of patients, and even some patients who transformed from MDS to leukemia achieved CR after treatment with decitabine. Decitabine can reduce the ID4 gene methylation level. The main adverse reaction of decitabine was myelosuppression, infection and so on. So the blood transfusions, antibiotics and other supportive treatments for these patients are needed. Most of patients well tolerate the adverse effects of decitabine after active symptomatic and supportive treatment. The efficacy and survival rate of patients in this study were similar to that of application of decitabine to treat MDS in other domestic studies.

This study was aimed to investigate the factors influencing mobilization efficiency of peripheral hematopoietic stem cells with granulocyte colony stimulating factor (G-CSF) and their impact on healthy donors. 181 donors were mobilized subcutaneously with G-CSF at 5 - 10 µg/(kg·d), and 10 donors were mobilized with G-CSF at 3.3 - 4.9 µg/(kg·d), once 12 h, for 4 - 5 d. Peripheral blood mononuclear cell (MNC) and CD34(+) cell counts were analyzed by flow cytometry. Mobilization-related side effects were also monitored. The results showed that white blood cell counts increased by 6 times averaged after mobilization (P0.01). The platelet count obviously decreased (P0.01), while the hemoglobin level did not show significant difference. No significant differences were observed in MNC and CD34(+) cell counts between those subjects harvested on the 4th and 5th day after mobilization. Male donors were superior to female ones in cell harvest (P0.01). Donor body weight played positive role in cell yield, while impact of age on harvest was not remarkable. Neither MNC nor CD34(+) cell count showed a linear relationship with G-CSF dose. Only slight side effects were observed on the donors in this study. It is concluded that mobilization with G-CSF is sufficient in healthy donors without remarkable side effects.

In order to study the epidemiological characteristics of cytomegalovirus (CMV) infection in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients by means of plasma real time quantitative polymerase chain reaction (RQ-PCR), 141 adult patients undergoing allo-HSCT between January 2008 and June 2010 were serially monitored by RQ-PCR for detecting CMV and guiding the preemptive therapy followed up to 180 days post-HSCT. The results showed that the incidence of CMV infection and CMV pneumonia was 81.5% and 2.9% respectively, which mainly occurred within 2 months post-HSCT. Single-therapy with ganciclovir (GCV) for 63 patients or foscarnet 6 patients was performed for preemptive therapy. The total efficacy was 87.8%, and the response patterns were different. CMV infection was more frequent in female patients (P = 0.044), and those with aGVHD (P = 0.043), using ATG or basiliximab in conditioning regimens (P = 0.049), as well as earlier in patients using ATG or basiliximab or those with aGVHD (P = 0.007; P = 0.000). The aGVHD, maximum load, positive times of CMV-DNA detection and therapy duration all correlated with the efficacy (P0.05). It is concluded that the incidence of CMV infection is still high after HSCT. Plasma RQ-PCR assay for CMV-DNA shows a strong correlation with the clinical outcome of CMV infection, which is useful and suitable for management of CMV infection in HSCT.

To evaluate the value of spectral karyotyping (SKY) in cytogenetic analysis of acute myeloid leukemias (AML).Nine AML patients were analyzed by R-banding and SKY. MLL, PML-RARalpha, AML1-ETO fusion genes were detected by dual fusion- fluorescence in situ hybridization (D-FISH).All 9 samples were successfully hybridized. SKY identified structural aberrations including 9q -, t(15;17) and ins(10;17) (q22;p11p12) ; and some numeral abnormalities. The results of SKY confirmed those of R-band karyotyping and D-FISH; with more accurate localization.SKY appears to be fairly stable, accurate and sensitive, for AML cytogenetic study.

This study was purposed to investigate the changes of serum immunoglobulin (Ig) level during treatment of diffuse large B cell lymphoma by using rituximab (RTX) combined with CHOP. Total of 122 newly diagnosed patients with CD20(+) diffuse large B cell lymphoma from January 2004 to December 2009 were analyzed retrospectively. According to different treatment regimens, 122 patients were divided into 2 group: group treated with CHOP (n = 24) and group treated with R-CHOP (n = 98, out of which 16 patients with abnormal Ig levels before treatment). Ig levels of patients in 2 groups at different stages were recorded and analyzed after abandoning those patients with abnormal Ig levels before treatment. The results showed that after 6 cycles of treatment, among the total 82 patients with normal levels of serum immunoglobulin, the decreased levels of IgG, IgA and IgM by 20% of baseline value were found in 85.4% (70/82), 85.4% (70/82) and 87.8% (72/82) patients respectively, while levels of IgG, IgA and IgMlow limit of normal value were observed in 47.6% (39/82), 48.8% (40/82) and 52.4% (43/82) patients respectively. No obvious changes of IgG, IgA and IgM levels were found in 24 patients of CHOP group before and after treatment.It is concluded that hypogammaglobulinemia is a common complication in chemotherapy using RTX combined with CHOP, the decreased level of Ig is recovered to normal level about 1 year after stop of treatment, the decrease of Ig in some cases can last even for over 2 years.

Multiple myeloma (MM) is a malignant plasma cell neoplasm that can not be cured with the conventional chemotherapy. Although new drugs, such as bortezomib, are highly effective in controlling the disease, the hematopoietic stem cell transplantation (HSCT) still should be performed, so as to increase the patients response and survival time. For over a decade, autologous HSCT has been a critical component in the treatment plan for newly diagnosed myeloma. The survival outcome with auto-HSCT seems to be highly dependent on the ability of this approach to enhance the depth of response. Maintenance therapy prolongs the responses after auto-HSCT by continuous administration of drug, such as thalidomide. However, patients invariably relapse after single auto-HSCT or double auto-HSCT. Allogeneic HSCT for myeloma has a potential for curing MM with the presence of a graft versus myeloma effect. Currently, allogeneic approaches should be considered in MM transplant procedure. Clinical data suggest that the mortality after allo-HSCT is definitely lower with the reduced-intensity regimens, but the relapse rate was higher than myeloablative regimens. Individual-adapted treatment strategy is benefited for MM transplant candidates. This article reviews the whole process of MM transplant candidates, including regimens for initial therapy, time of transplantation, choice of transplantation procedure and maintenance therapy.

This study was purposed to explore the clinical characteristics, therapy and prognosis of patients with extranodal NK/T cell lymphoma (ENKL). 47 patients with ENKL from October 1995 to December 2008 in our hospital were analyzed retrospectively. The survival of patients was analyzed by using Kaplan-Meier methods, the prognosis of patients was evaluated by multivariate analysis using COX regression model. The clinical parameters used included CD56, Ann Arbor stage, international prognostic index (IPI) and B symptom. The results showed that the 2-year and 5-year overall survival (OS) rates were 91%, 71% respectively. Multivariant analysis by COX regression showed the CD56 and Ann Arbor stage were independent prognostic factors. Single factor analysis with staging in CHOP chemotherapy group indicated that more than stage IIIE (including IIIE) was a prognostic factor. Single factor analysis with B symptom showed that B symptom also was a prognostic factor. The cumulative survival rate of patients received radiotherapy alone was higher than that of patients got chemotherapy alone, its difference had a statistical significance, but there was no statistical significance between radiotherapy group and chemoradiotherapy group. It is concluded that CD56, Ann Arbor stage and B symptoms are prognostic factors. Radiotherapy alone is better than chemotherapy alone in therapy of ENKL. Chemotherapy combined with radiotherapy can not improve the survival. Improving the status of patients can make prognosis better.

To compare the efficacy and adverse effects of bortezomib + adriamycin + dexamethasone (PAD) and vincristine + adriamycin + dexamethasone (VAD) regimens in untreated multiple myeloma (MM).There were 26 and 28 new diagnosed MM patients in PAD and VAD groups. Both clinical effects and adverse effects were observed. Patients accepted VAD or PAD regimens for 2 - 4 cycles and followed up for 7 - 27 months.There were 10, 5 and 11 patients accepted 2, 3 and 4 cycles in PAD group, and 6, 11 and 11 in VAD group. In PAD group, there were 2, 14, 9, 1 and 0 patients achieved complete remission (CR), very good partial remission (VGPR), partial remission (PR), stable disease (SD) and progressive disease (PD); in VAD group, the number were 0, 4, 12, 10 and 2. The rate of patients who achieved good efficacy (CR + VGPR) in PAD group was 61.5%, which was higher than that in VAD group (14.3%). The incidences of infection and gastrointestinal symptoms were similar in the two groups, while the incidences of peripheral neuropathy, thrombosis and Herpes Zoster infection in PAD group were higher than those in VAD group.Compared with the conventional VAD chemotherapy, PAD may improve CR and VGPR rates in new diagnosed MM, while it may bring more and severer toxicities in peripheral neuropathy, thrombosis and Herpes Zoster infection. Preventive medical care is necessary in PAD protocol.

The study was aimed to evaluate the adverse effects of PAD (bortezomib + adriamycin + dexamethasone) and VAD (vincristine + adriamycin + dexamethasone) as chemotherapy regimens in multiple myeloma patients. 27 and 30 patients with multiple myeloma (MM) were enrolled in PAD and VAD groups respectively. MM patients accepted 3 - 5 cycles of VAD or PAD regimens. The type, degree and occurrence time of adverse reactions during the treatment were observed. The results showed that the rash was found in two patients only in PAD group, leucocytopenia, thrombocytopenia, peripheral neuropathy, infection, fatigue, nausea, constipation, and adverse effects of cortex hormone (hypertension, glycemia, hypokalemia, hyponatremia and acne) were found in the both two groups. The thrombosis was not observed in both two groups during treatment. Although statistical analysis indicated that only the incidence of thrombocytopenia was higher in PAD group than in VAD group with statistical difference but the incidence of leucocytopenia, peripheral neuropathy and infection in PAD group were higher than those in VAD group. Rash, constipation, peripheral neuropathy could be found in the first course of chemotherapy, while the others mostly emerged after 3 courses of treatment. The main reasons for the patients who's treatment was stopped include infection and intolerable peripheral neuropathy. Although peripheral neuropathy could be found in the two groups, but the chemotherapy was stopped only in 2 patients of PAD group after 3 cycles of treatment. It is concluded that compared with conventional VAD chemotherapy, PAD may improve therapeutic effect, but it may bring more severe toxicities to the patients with multiple myeloma.

The aim of this study was to explore the feasibility and efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for treatment of patients with myelodysplastic syndrome (MDS). 14 patients with MDS were treated with allo-HSCT, out of them 9 patients received hematopoietic stem cell transplantation from related donors, while 5 donors were unrelated. 1 patient received bone marrow transplantation and other 13 patients received peripheral blood hematopoietic stem cell transplantation. The modified BU/CY conditioning regimen was used in 11 patients, TBI+CY in 2 patients and reduced intensity FB conditioning regimen in 1 patient. CsA + MTX + MMF were used for graft-versus-host disease (GVHD) prophylaxis. Patients with allo-HSCT from unrelated donors or HLA-mismatched donors received rabbit anti-T-lymphocyte globulin (ATG). The results showed that 12 ALL patients successfully reconstructed their haematopoietic system. The time from transplantation to ANC1.0 x 10(9)/L and Plt50 x 10(9)/L were 12 (11 - 16) days and 13 (11 - 19) day after transplantation respectively. 11 patients survival free disease and their longest survival time had been up to 125 months. 1 case died early because of cerebral hemorrhage. 1 case died at 66 day because of aGVHD IV, alimentary tract hemorrhage and multiple organ failure.1 case relapsed at 8 months and died of marrow failure at 17 months. Over survival (OS) rate was 78.6% and disease free survival (DFS) was 84.6%. The main complications were aGVHD of I-II grade in 6 cases. It is concluded that allo-HSCT is a safe and effective option for the patients with MDS.

This study was aimed to compare the efficacy and adverse effects of PD (bortezomib + dexamethasone) and VAD (vincristine + adriamycin + dexamethasone) as regimens for treatment of multiple myeloma patients. 21 and 31 multiple myeloma patients were enrolled in the PD and VAD groups respectively which received 2 to 5 courses of treatments, and both clinical effects and adverse reactions were observed. In the all 52 patients, 48 were newly diagnosed and the other 4 patients had accepted 1 to 2 courses of M2 or MP treatment, but didn't get PR. In 52 patients, 4, 4, 8 and 5 patients accepted 2, 3, 4 and 5 courses of PD regimen respectively, while 6, 11, 12 and 2 patients accepted 2, 3, 4 and 5 courses of VAD regimen respectively. The results indicated that the rate of good efficacy (both CR and VGPR) in PD group was 57.1%, while the rate of good efficacy in VAD group was 16.1%, there was significant difference (p = 0.0052). The percentage of patients who got CR, VGPR and PR in PD and VAD groups were 95.2% and 74.2% respectively, there was no significant difference (p = 0.1108). The incidences of adverse effects in 2 groups were similar, which included hematological toxicity, liver and kidney functional lesion, peripheral neuropathy, infection, interstitial pneumonia. It is concluded that compared with conventional VAD chemotherapy, PD may improve CR and VGPR rate in newly diagnosed patients with multiple myeloma, meanwhile it does not bring about more and worse toxicity.

CD4+ T cells mainly interact with Sphingosine 1-phosphate (S1P) to regulate immune function through Sphingosine 1-phosphate receptor 1 (S1P1). This study was aimed to investigate the effects of recombinant human granulocyte-colony-stimulating factor (rhG-CSF) mobilization on S1P1 expression in CD4+ T cells of donor's peripheral blood. The CD4+T cells of peripheral blood were isolated by magnetic beads from 17 allo-hematopoietic stem cell transplantation (allo-HSCT) donors before and at fourth day of mobilization with rhG-CSF. The S1P1 expression was detected by real time quantitative PCR in the RNA extracted from CD4+ T cells collected before and after rhG-CSF mobilization. The results showed that the expression of S1P1 was found in CD4+ cells before and after rhG-CSF mobilization, but the expression level of SIP1 in CD4+ cells after rhG-CSF mobilization was significantly lower than that before rhG-CSF mobilization (p0.01). It is concluded that the mobilization with rhG-CSF obviously down-regulates the expression of S1P1 in CD4+ T cells of donor's peripheral blood.

The aim of study was to clarify the repertoire of killer immunoglobulin-like receptor (KIR) at the level of DNA and RNA in healthy persons and to compare KIR on genotypes and expression patterns. KIR genotypes including KIR2DL1, 2DL2, 2DL3, 2DL4, 2DL5, 2DS1, 2DS2, 2DS3, 2DS4, 2DS5, 3DL1, 3DL2, 3DL3, 3DS1, 2DP1 and 3DP1 were analyzed by PCR. The phenotypes including KIR2DL1, KIR2DL2, KIR2DL3, KIR3DL1, KIR2DS1, KIR2DS3, KIR2DS2/4 gene were determined by RT-PCR. The results showed that the genes of KIR2DL1, KIR2DL3, KIR2DL4, KIR3DL2, KIR3DL3 and KIR3DP1 could be detected in all healthy persons, NK-92MI cells and Molt4 cells, but all corresponding receptors were not expressed by Molt4 T cells. Only partial transcripts of KIR2DL1, KIR2DL3 and KIR2DS2/4 were detectable in NK-92MI cells. If genotypes of KIR2DL1, 2DL2, 2DL3, 2DS1, 2DS2, 2DS3 and 2DS4 were detected in healthy persons, almost all transcripts of corresponding receptors were expressed in peripheral blood NK cells. The expression levels of KIR were different. In conclusion, the repertoires of KIR are individually specific. The expression pattern of KIR is also specific, the expression levels of different KIRs are different in one individual, and the expression levels of the same KIR are also different in different individuals.

The study was purposed to explore the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) combined with Imatinib for treatment of Philadelphia chromosome positive acute lymphoblastic leukemia (Ph(+)ALL) patients. From 2007 to 2008, 3 patients with Ph(+)ALL were treated with allogeneic hematopoietic stem cell transplantation and Imatinib, and the follow-up ended at Oct 21(st) 2009. 1 patient received HSCT from matched sibling donor and 2 patients from haploidentical related donors. All 3 patients achieved complete remission before transplantation and were treated with Imatinib for distinct time at different periods before and/or after transplantation. The level of bcr/abl mRNA was monitored using real-time PCR. The results showed that all 3 patients achieved stable engraftments without severe transplantation related complications. The level of bcr/abl mRNA declined and achieved zero level finally. In conclusion, the allo-HSCT combined with Imatinib is an effective therapy regimen for Ph(+)ALL patients.

Chronic myelogenous leukemia (CML) is a clonal myeloproliferative disease of transformed hematopoietic progenitor cells. In order to investigate the role of sphingosine kinase-1 (SphK-1)/sphingosine 1-phosphate (S1P) signal pathway in the expression of CML cells, and to explore whether P210(bcr/abl) involved is activating SphK-1/S1P signal pathwey, the expressions of SphK-1 and S1P receptor mRNA in bcr/abl positive K562 cells and bcr/abl positive primary CML cells were detected by RT-PCR, the imatinib mesylate, the specific inhibitor of P210(bcr/abl) was employed to inhibit the P210(bcr/abl) tyrosine kinases of K562 cells and CML primary cells, and then the intracellular SphK-1 activity was assayed. The results indicated that after being cultured with 2.5 micromol/L imatinib mesylate for 0.5, 2, 6, 24 and 48 hours, the intensions of inhibiting SphK-1 activity were 0.007%, 38.9%, 34.6%, 28.1% and 76.1% resepectively. SphK-1 activity in CML cells also was reduced by 2.5 micromol/L imatinib mesylate (16.8% - 41.9% decrease). It is concluded that the CML cells express SphK-1 and different S1P receptor, and P210(bcr/abl) fusion protein in CML cells can activate SphK-1.

This study was aimed to evaluate the effects of recombinant human interleukin 11 (rhIL-11) and recombinant human granulocyte colony stimulating factor (rhG-CSF) in mobilization for autologous peripheral blood stem cell transplantation (APBSCT). 16 patients with non-Hodgkin's lymphoma or acute myeloblastic leukemia were given myelosuppressive chemotherapy, then were mobilized by using rhG-CSF 5 microg/(kg.d) for median 5.5 days and rhIL-11 50 microg/(kg.d) for median 4 days (experimental group) or rhG-CSF 5 microg/(kg.d) alone for median 5.5 days (control group). After mobilizing, the peripheral blood leucocyte and platelet counts, total mononuclear cells, CD34+ cells and CFU-GM counts in PBSC collection, and amount of apheresed platelet transfusion were assayed. The results showed that the peripheral blood leucocyte and platelet counts, total mononuclear cell, CD34+ cell and CFU-GM counts in PBSC collection were no significant difference between two groups (p0.05). After APBSCT, the median time for neutrophil countor=0.5x10(9)/L and the median time for platelet countor=20x10(9)/L were 10.5 and 11.5 days in experimental group, while were 13 and 13 days in control group, respectively. The median amount of apheresed platelet transfusion was 3.5 unit in experimental group and 5 unit in control group. Data were significantly different between two groups (p0.05). The adverse reactions of mobilization were mild fever, fatigue, symptoms like as common cold, poor appetite, dizziness, muscular soreness in experimental group, but only mild fever in control. These symptoms were well tolerated and overcome with drug withdrawal. It is concluded that the regimen of rhIL-11 in combination with rhG-CSF after myelosuppressive chemotherapy to mobilize PBSC is efficient and safe with rapid hematologic reconstitution and less platelet transfusions after APBSCT were used.

The aim of study was to explore the incidence, risk factors, outcome and efficacious treatment of late-onset noninfectious pulmonary complications (LNIPC) after allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Seventy patients received allo-PBSCT were analyzed retrospectively. The results showed that 9 out of 63 patients surviving more than 3 months occurred late-onset noninfectious pulmonary complications (14.3%). Five out of the 9 patients developed secondary pulmonary infections. In 4 patients, LNIPC caused death directly. Advanced stage of disease at transplantation and extensive chronic graft-versus-host disease (GVHD) happened in association with LNIPC. However, other transplantation-related factors including age at transplantation, gender of patient, conditioning regimen, HLA matching and GVHD prophylaxis were not significantly correlated with the incidence of LNIPC. It is concluded that performing pulmonary function test (PFT) and thoracic computer tomography should be taken routinely after transplantation. Most patients who get correct and early diagnosis for LNIPC will show a positive response to prednisone with or without CsA.

This study was aimed to evaluate whether mesenchymal stem cells (MSCs) obtained from patients with myelodysplastic syndrome possess immunosuppressive effect. MSCs from bone marrow samples of MDS patients were isolated, cultured and expanded. MSCs were morphologically analyzed and their immunophenotype were determined by flow cytometry. Various amounts of MSCs were added into one-way mixed lymphocyte reaction. MSCs from MDS patients were tested for their ability to suppress in vitro proliferation of autologous and allogeneic peripheral blood lymphocytes (PBLs). The results showed that 3 x 10(3 - 1) x 10(5) MSCs from MDS patients could inhibit autologuous PBLs proliferation to (66.9 +/- 20.1)% - (30.2 +/- 5.9)% of maximal response, as well as inhibit allogeneic PBLs proliferation to (56.6 +/- 14.7)% - (20.5% +/- 9.7)% of maximal response, as compared with inhibitory ability of MSCs from healthy donors, there was no significant difference (P0.05). It is concluded MSCs from patients with myelodysplastic syndrome also possess immunosuppressive activity.

Chronic myelogenous leukemia (CML) is a clonal myeloproliferative disease of transformed hematopoietic progenitor cells. It is now clear that the chimeric bcr/abl P210(bcr/abl) fusion protein, which is generated by the reciprocal translocation t (9; 22), inhibits apoptosis and increase proliferation. P210(bcr/abl) plays a central role in the pathophysiology of CML. The purpose of this study was to construct a cell line model that bcr/abl expression can be regulated by Tet-off inducing-expression-system. The full-length b3a2 bcr/abl cDNA was subcloned into the pTRE2hyg expression vector to construct the pT2-P210 plasmid. 293 cells were firstly transfected with Tet-off plasmid and the clone that the Tet-off system can work effectively after transfected with pTRE2hyg-LUC was selected by luciferase activity assay. The pT2-P210 plasmid was then transfected into the selected clone and cells were then selected for hygromycin B and G418 resistance. The results showed that individual subclones expressing bcr/abl after withdrawing doxycycline were 293pT2-P210 cell line. In conclusion, selected 293pT2-P210 cells are cells that bcr/abl expression can be regulated by Tet-off inducing-expression-system. They are suitable thoroughly to study the function of bcr/abl fusion gene and its signal regulation mechanism.

The aim of this research was to understand the influence of rhG-CSF on the sphingosine kinase (SphK) activity of monocytes. The peripheral blood monocytes were collected from 6 peripheral blood progenitor cell donors on the fifth day of mobilization with rhG-CSF and from 5 blood donors' buffy coats. The mRNA expressions of monocyte G-CSF receptor and SphK were tested with RT-PCR. The changes of SphK activity of monocytes were assayed after being treated with rhG-CSF. The results showed that the two kinds monocytes collected from both blood donors and peripheral blood progenitor cell donors mobilized with rhG-CSF expressed mRNA of G-CSF receptor and SphK. The SphK activity of monocytes collected from blood donors was not changed significantly after being treated with rhG-CSF (P0.05). The SphK activity of monocytes collected from peripheral blood progenitor cell donors transiently increased by (39.6 - 87.2)% after being treated by means of rhG-CSF (P0.05) without obviously dose-dependent effect. It is concluded that the SphK activity of monocytes collected from peripheral blood progenitor cell donors can be activated by rhG-CSF.