目的:探讨单倍体高剂量外周血干细胞移植术(haploidentical non T cell-depleted in vitro high dose peripheral blood hematopoietic stem cell transplantation,haplo-HDPSCT)后+21 d外周血淋巴细胞绝对值(absolute lymphocyte count...目的:探讨单倍体高剂量外周血干细胞移植术(haploidentical non T cell-depleted in vitro high dose peripheral blood hematopoietic stem cell transplantation,haplo-HDPSCT)后+21 d外周血淋巴细胞绝对值(absolute lymphocyte count,ALC)及血清白细胞介素-18(interleukin-18,IL-18)水平对移植后复发的预测价值。方法:选取从2017年1月—2023年8月接受haplo-HDPSCT治疗的141例患者,根据haplo-HDPSCT术后是否发生复发,分为复发组和未复发组。根据团队前期研究结果和文献检索,确定了8种细胞因子组合,使用酶联免疫吸附试验(ELISA)检测上述141例患者移植术后第1个月细胞因子水平。结果:141例患者都取得造血重建,平均随访31个月后,共有14例(9.92%)患者复发,127例(90.09%)未复发。单因素Cox回归分析结果表明,移植后+21 d ALC、IL-18水平及是否发生急性移植物抗宿主病(acute graft-versus-host disease,aGVHD)与移植后发生复发相关(P<0.05);进一步多因素Cox回归分析,结果显示移植后+21 d ALC、IL-18≥114 pg/mL及是否发生aGVHD是haplo-HDPSCT术后发生复发的独立影响因素(P<0.05)。根据多因素Cox回归分析建立列线图模型,列线图的ROC曲线下面积为0.839(95%CI:0.724~0.950),H-L检验提示列线图的预测概率与现况值之间具有较好的一致性(χ^(2)=13.495,P=0.096),提示该模型预测准确率较高。临床决策曲线分析还揭示了列线图具有较高的临床使用价值。基于列线图获得的截断值,发现高风险组的非复发生存期比低风险组差(P<0.001)。结论:移植后IL-18≥114 pg/mL及移植后+21 d ALC水平与haplo-HDPSCT术后发生复发存在相关性,对临床诊断的确立和预测预后提供帮助。展开更多
Stem cells are pluripotent cells that can divide and differentiate,forming many different types of cells.Stem cells can be obtained from various sources,with embryonic stem cells being the most advantageous as they po...Stem cells are pluripotent cells that can divide and differentiate,forming many different types of cells.Stem cells can be obtained from various sources,with embryonic stem cells being the most advantageous as they possess a broad dividing potential.When the standard treatment proves ineffective,stem cells are typically utilized as a final option.Infections and childhood malignancies are among the significant causes of mortality in the pediatric population.Stem cell therapy has shown a decrease in morbidity and mortality when used in patients with favorable conditions like young age and lack of comorbidities.This review discusses how stem cells are prepared and used in treating pediatric diseases like X-linked agammaglobulinemia,diabetes mellitus,aplastic anemia,infections,and leukemia.Technological advancement has played a significant role in producing more specific stem cells using genetic modification methods like clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9,which produce stem cells that target a particular cell type,e.g.,myocytes and hematopoietic cells,further increasing the effectiveness of the therapy.We address the obstacles faced when conducting research related to stem cells,including ethical and legal issues,which hinder the use of this therapy in some fields.We also indicate recommendations for increasing the efficacy of stem cell therapy in the pediatric population.展开更多
Regenerative medicine is a promising therapeutic avenue for previously incurable diseases.As the risk of chronic and degenerative diseases significantly increases with age,the elderly population represents a major coh...Regenerative medicine is a promising therapeutic avenue for previously incurable diseases.As the risk of chronic and degenerative diseases significantly increases with age,the elderly population represents a major cohort for stem cell-based therapies.However,the regenerative potential of stem cells significantly decreases with advanced age and deteriorating health status of the donor.Therefore,the efficacy of autologous stem cell therapy is significantly compromised in older patients.To overcome these limitations,alternative strategies have been used to restore the age-and disease-depleted function of stem cells.These methods aim to restore the therapeutic efficacy of aged stem cells for autologous use.This article explores the effect of donor age and health status on the regenerative potential of stem cells.It further highlights the limitations of stem cell-based therapy for autologous treatment in the elderly.A comprehensive insight into the potential strategies to address the“age”and“disease”compromised regenerative potential of autologous stem cells is also presented.The information provided here serves as a valuable resource for physicians and patients for optimization of stem cellbased autologous therapy for aged patients.展开更多
AIM:To explore the factors influencing the treatment duration and visual prognosis of cytomegalovirus(CMV)retinitis(CMVR)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).METHODS:All participants rec...AIM:To explore the factors influencing the treatment duration and visual prognosis of cytomegalovirus(CMV)retinitis(CMVR)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).METHODS:All participants received ganciclovir intravenous infusion or oral and intravitreal injection of ganciclovir(IVG)3 mg twice a week for 4 consecutive times(induction phase).The affected eyes were divided into stop treatment group(Group A),continue treatment group(Group B),and relapse after treatment group(Group C)according to whether local therapy could be terminated at the end of the induction phase and whether CMVR recurred within 3mo after the termination of local therapy.RESULTS:The study included 31 participants(48 eyes)diagnosed with CMVR including 11 males and 20 females.The mean age was(28±8.2)y.There were 17 cases of binocular disease(34 eyes)and 14 cases of monocular disease(14 eyes).Visual acuity improved in 26 eyes(54.1%),remained unchanged in 9 eyes(18.8%),and decreased in 13 eyes(27.1%).The peak value of blood CMV in Group B was significantly higher than that in Group A(P=0.013).The number of eyes with anterior chamber inflammation in Group C was significantly lower than that in Groups A and B(P=0.015,P=0.016).The average number of interval days was higher in Group A than in Group B.For Group A,there was a strong positive correlation between the number of eyes with CMV positive blood(r=0.712,P=0.031)and visual acuity changes.For Group B,there was a moderately strong positive correlation between the days of blood CMV after transplantation(r=0.371,P=0.043)and the times of injections.For Group C,there was a strong positive correlation between the peak value of blood CMV(r=0.719,P=0.029)and the times of injection.CONCLUSION:Systemic use of antivirals combined with intravitreal injection of antivirals is effective for patients with CMVR after allo-HSCT surgery.Patients with shorter interval days,higher peak or more days of blood CMV need more injections.Patients with positive blood CMV at initial diagnosis have worse visual prognosis.展开更多
文摘目的:探讨单倍体高剂量外周血干细胞移植术(haploidentical non T cell-depleted in vitro high dose peripheral blood hematopoietic stem cell transplantation,haplo-HDPSCT)后+21 d外周血淋巴细胞绝对值(absolute lymphocyte count,ALC)及血清白细胞介素-18(interleukin-18,IL-18)水平对移植后复发的预测价值。方法:选取从2017年1月—2023年8月接受haplo-HDPSCT治疗的141例患者,根据haplo-HDPSCT术后是否发生复发,分为复发组和未复发组。根据团队前期研究结果和文献检索,确定了8种细胞因子组合,使用酶联免疫吸附试验(ELISA)检测上述141例患者移植术后第1个月细胞因子水平。结果:141例患者都取得造血重建,平均随访31个月后,共有14例(9.92%)患者复发,127例(90.09%)未复发。单因素Cox回归分析结果表明,移植后+21 d ALC、IL-18水平及是否发生急性移植物抗宿主病(acute graft-versus-host disease,aGVHD)与移植后发生复发相关(P<0.05);进一步多因素Cox回归分析,结果显示移植后+21 d ALC、IL-18≥114 pg/mL及是否发生aGVHD是haplo-HDPSCT术后发生复发的独立影响因素(P<0.05)。根据多因素Cox回归分析建立列线图模型,列线图的ROC曲线下面积为0.839(95%CI:0.724~0.950),H-L检验提示列线图的预测概率与现况值之间具有较好的一致性(χ^(2)=13.495,P=0.096),提示该模型预测准确率较高。临床决策曲线分析还揭示了列线图具有较高的临床使用价值。基于列线图获得的截断值,发现高风险组的非复发生存期比低风险组差(P<0.001)。结论:移植后IL-18≥114 pg/mL及移植后+21 d ALC水平与haplo-HDPSCT术后发生复发存在相关性,对临床诊断的确立和预测预后提供帮助。
文摘Stem cells are pluripotent cells that can divide and differentiate,forming many different types of cells.Stem cells can be obtained from various sources,with embryonic stem cells being the most advantageous as they possess a broad dividing potential.When the standard treatment proves ineffective,stem cells are typically utilized as a final option.Infections and childhood malignancies are among the significant causes of mortality in the pediatric population.Stem cell therapy has shown a decrease in morbidity and mortality when used in patients with favorable conditions like young age and lack of comorbidities.This review discusses how stem cells are prepared and used in treating pediatric diseases like X-linked agammaglobulinemia,diabetes mellitus,aplastic anemia,infections,and leukemia.Technological advancement has played a significant role in producing more specific stem cells using genetic modification methods like clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9,which produce stem cells that target a particular cell type,e.g.,myocytes and hematopoietic cells,further increasing the effectiveness of the therapy.We address the obstacles faced when conducting research related to stem cells,including ethical and legal issues,which hinder the use of this therapy in some fields.We also indicate recommendations for increasing the efficacy of stem cell therapy in the pediatric population.
文摘Regenerative medicine is a promising therapeutic avenue for previously incurable diseases.As the risk of chronic and degenerative diseases significantly increases with age,the elderly population represents a major cohort for stem cell-based therapies.However,the regenerative potential of stem cells significantly decreases with advanced age and deteriorating health status of the donor.Therefore,the efficacy of autologous stem cell therapy is significantly compromised in older patients.To overcome these limitations,alternative strategies have been used to restore the age-and disease-depleted function of stem cells.These methods aim to restore the therapeutic efficacy of aged stem cells for autologous use.This article explores the effect of donor age and health status on the regenerative potential of stem cells.It further highlights the limitations of stem cell-based therapy for autologous treatment in the elderly.A comprehensive insight into the potential strategies to address the“age”and“disease”compromised regenerative potential of autologous stem cells is also presented.The information provided here serves as a valuable resource for physicians and patients for optimization of stem cellbased autologous therapy for aged patients.
文摘AIM:To explore the factors influencing the treatment duration and visual prognosis of cytomegalovirus(CMV)retinitis(CMVR)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).METHODS:All participants received ganciclovir intravenous infusion or oral and intravitreal injection of ganciclovir(IVG)3 mg twice a week for 4 consecutive times(induction phase).The affected eyes were divided into stop treatment group(Group A),continue treatment group(Group B),and relapse after treatment group(Group C)according to whether local therapy could be terminated at the end of the induction phase and whether CMVR recurred within 3mo after the termination of local therapy.RESULTS:The study included 31 participants(48 eyes)diagnosed with CMVR including 11 males and 20 females.The mean age was(28±8.2)y.There were 17 cases of binocular disease(34 eyes)and 14 cases of monocular disease(14 eyes).Visual acuity improved in 26 eyes(54.1%),remained unchanged in 9 eyes(18.8%),and decreased in 13 eyes(27.1%).The peak value of blood CMV in Group B was significantly higher than that in Group A(P=0.013).The number of eyes with anterior chamber inflammation in Group C was significantly lower than that in Groups A and B(P=0.015,P=0.016).The average number of interval days was higher in Group A than in Group B.For Group A,there was a strong positive correlation between the number of eyes with CMV positive blood(r=0.712,P=0.031)and visual acuity changes.For Group B,there was a moderately strong positive correlation between the days of blood CMV after transplantation(r=0.371,P=0.043)and the times of injections.For Group C,there was a strong positive correlation between the peak value of blood CMV(r=0.719,P=0.029)and the times of injection.CONCLUSION:Systemic use of antivirals combined with intravitreal injection of antivirals is effective for patients with CMVR after allo-HSCT surgery.Patients with shorter interval days,higher peak or more days of blood CMV need more injections.Patients with positive blood CMV at initial diagnosis have worse visual prognosis.
