Establishment of reference values based on influential characteristics of hematopoietic stem cells and immune cell subsets in the bone marrow.

Hematopoietic stem cell transplantation is still a curative treatment for many haematological cancers. Many factors, such as age, sex, ethnic background, smoking status, and body mass index, affect average reference values in different populations. This study aimed to establish a reference range for the absolute numbers and percentages of healthy individuals' hematopoietic stem cells and immune cells in the bone marrow. Seventy-one healthy donors (32 males and 39 females) were enrolled in the study. Following bone marrow harvesting, using flow cytometry, immunophenotyping was performed to determine the absolute number and percentage of CD34+ stem cells and various immune subsets. We found no statistically significant difference in the absolute count of HSCs or immune cell subsets in the bone marrow between males and females. Regarding age, the younger group had more significant CD34+ and immune cell subsets. Donors with healthier body weights tend to have richer bone marrow cellularity. Establishing a reference value for hematopoietic stem cells and immune cells in the bone marrow based on various influential factors is pivotal for defining bone marrow status and donor selection.

Allogeneic transplantation in multiple myeloma / Transplante alogênico no mieloma múltiplo

In this review the authors present a state of art tretment of multiple myeloma.High dose chemo-radiotherapy followed by autologous hematopoietic stem cell transplantation has been show to be superior a conventional chemotherapy and a double transplantation. The authors discuss too, the allogeneic transplantation with reduced intensity conditioning, allogeneic versus tandem autologous, results the patients long term outcome and a approach about the use of donor lymphocytes, anti thimocyte globulin and a overview of post transplant therapies.

Neste relato os autores apresentam uma revisão sobre o estado atual do tratamento mieloma múltiplo. São enfatizados aspectos sobre a vantagem do transplante autólogo em seguimento à quimioterapia convencional e o duplo transplante. São discutidos o transplante alogênico e o condicionamento com intensidade reduzida, além do uso de linfócitos do doador, da globulina antitimocítica e uma visão geral do futuro da terapia da moléstia.

Condicionamento reduzido no mieloma múltiplo / Reduced conditioning fo multiple myeloma

Os autores descrevem o estudo desenvolvido pelo Grupo Italiano de Transplante de Medula Óssea (GITMO), em 12 centros italianos, entre 2001 e 2005, com a utilização de transplante alogênico com condicionamento de intensidade reduzida (RIC) em mieloma múltiplo. Foram estudados 53 pacientes, a maioria com doença avançada. Os resultados mostraram que o RIC foi factível e com resultados que demonstram que o transplante alogênico pode ser melhorado em termos de toxicidade e evolução clínica utilizando novos regimes de condicionamento e novas drogas.

The authors report a study carried out about GITMO (Italian Group for Bone Marrow Transplantation) including 12 Italian Centers from 2001 to 2005 with allogeneic bone marrow transplantation using reduced intensity conditioning regimen (RIC) in patients with multiple myeloma. Fifty-three patients were enrolled, most of them presenting advanced disease. The study showed that RIC is feasible and suggested that RIC may improve outcome in this setting patients.