Trasplante alogénico de precursores hematopoyéticos de sangre de cordón umbilical de donante no emparentado: primera experiencia, en tres casos, con donantes del banco público chileno de células de cordón / Allogenic hematopoietic stem cell transplantation with unrelated cord blood: Report of three cases from the Chilean cord blood bank

Public cord blood banks are a source of hematopoietic stem cells for patients with hematological diseases who lack a family donor and need allogeneic transplantation. In June 2007 we started a cord blood bank with units donated in three maternity wards in Santiago, Chile. We report the first three transplants done with cord blood units form this bank. Cord blood units were obtained by intrauterine collection at delivery. They were depleted of plasma and red cells and frozen in liquid nitrogen. Tests for total nucleated cells, CD34 cell content, viral serology, bacterial cultures and HLA A, B and DRB1 were done. Six hundred cord blood units were stored by March 2012. Three patients received allogeneic transplant with cord blood from our bank, two with high risk lymphoblastic leukemia and one with severe congenital anemia. They received conditioning regimens according to their disease and usual supportive care for unrelated donor transplantation until full hematopoietic and immune reconstitution was achieved. The three patients had early engraftment of neutrophils and platelets. The child corrected his anemia and the leukemia patients remain in complete remission. The post-transplant course was complicated with Epstein Barr virus, cytomegalovirus and BK virus infection. Two patients are fully functional 24 and 33 months after transplant, the third is still receiving immunosuppression.

[Allogenic hematopoietic stem cell transplantation with unrelated cord blood: report of three cases from the Chilean cord blood bank]. / Trasplante alogénico de precursores hematopoyéticos de sangre de cordón umbilical de donante no emparentado: primera experiencia, en tres casos, con donantes del banco público chileno de células de cordón.

Public cord blood banks are a source of hematopoietic stem cells for patients with hematological diseases who lack a family donor and need allogeneic transplantation. In June 2007 we started a cord blood bank with units donated in three maternity wards in Santiago, Chile. We report the first three transplants done with cord blood units form this bank. Cord blood units were obtained by intrauterine collection at delivery. They were depleted of plasma and red cells and frozen in liquid nitrogen. Tests for total nucleated cells, CD34 cell content, viral serology, bacterial cultures and HLA A, B and DRB1 were done. Six hundred cord blood units were stored by March 2012. Three patients received allogeneic transplant with cord blood from our bank, two with high risk lymphoblastic leukemia and one with severe congenital anemia. They received conditioning regimens according to their disease and usual supportive care for unrelated donor transplantation until full hematopoietic and immune reconstitution was achieved. The three patients had early engraftment of neutrophils and platelets. The child corrected his anemia and the leukemia patients remain in complete remission. The post-transplant course was complicated with Epstein Barr virus, cytomegalovirus and BK virus infection. Two patients are fully functional 24 and 33 months after transplant, the third is still receiving immunosuppression.

Evaluación de la inmunidad específica celular en pacientes estadio III de cáncer de mama / Evaluation of the specific cellular inmunity in patients with breast cancer, stage III

Individuos que presentan procesos neoplásicos y sometidos a stress, cirugía y terapia inmunosupresora prolongada, presentan una marcada inmunodeficiencia en la función de los linfocitos T. En este trabajo se analizaron cuatro pacientes con Ca de mama en estadio III (UICC) sometidas a idéntico esquema terapéutico: biopsia, cobaltoterapia, quimioterapia y mastectomía. Se evaluó la inmunidad específica celular por análisis de rosetas E (RE), E activas (REa), EA (REA), linfocitos T4+, T8+ e índice T4/T8 en muestras tomadas durante 3 o 4 etapas de evolución. Los resultados mostraron en 3 pacientes (1, 2 y 4) que la muestra prebiopsia presentaba valores de RE, REa inferiores a lo normal, con un curso semejante; alza en la II muestra (prerradiación) y una marcada disminución en la III muestra (premastectomía). En sólo 1/3 de estas pacientes se analizó una IV muestra (postmastectomía), que mostró una recuperación en todos los parámetros analizados. Dos tercios presentaron también una disminución de rosetas EA. El índice T4/T8 en las pacientes 1, 2 y 4 estuvo dentro del rango normal; no obstante el paciente 3 mostró un aumento de la población T supresora, lo que disminuyo el índice T4/T8. L cuarta paciente (N-3) mostró resultados diferentes a las 3 anteriores, con valores disminuídos sólo en la II muestra

Análisis de subpoblaciones de linfocitos en pacientes hemofílicos con anticuerpos a-VIH / Analysis of lymphocyte subpopulations in hemophilic patients with HIV-a antibodies

En el trabajo se analizan las subpoblaciones de LT inductores (LTi), LT supresores (LTs) con anticuerpos monoclonales anti-CD4 y anti-CD8 y el índice CD4/CD8 en 8 niños hemofílicos menores de 12 años que presentaban anticuerpos contra el virus de la inmunodeficiencia humana (VIH), 8 niños hemofílicos anti-VIH negativos y 15 adultos sanos anti-VIH negativos. Los resultados de LT CD4 en ambos grupos de hemofílicos fueron semejantes y mostraron una disminución significativa comparados con el grupo normal (p<0,022). Los LT CD8 estaban significativamente aumentados en el grupo de hemofílicos anti-VIH (-) y normales p<0,0044 y p<0,0003, respectivamente), no hubo diferencias entre los dos últimos grupos. El índice CD/CD8 estuvo disminuído en ambos grupos de hemofílicos comparados con el normal (p<0,0003). Este índice en el grupo de hemofílicos anti-VHI(+) fue significativamente menor que en los hemofílicos anti-VIH (-) (p0,465). Se discute el significado de estos resultados