The impact of different doses of antithymocyte globulin conditioning on immune reconstitution upon hematopoietic stem cell transplantation.

INTRODUCTION: Anti-thymocyte globulin (ATG) is used prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) for graft-versus-host disease (GVHD) prophylaxis. Two different ATG doses (7.5 or 10 mg/kg) were evaluated in comparison with a group without ATG therapy. METHODS: We retrospectively analyzed 132 patients who were transplanted with HSCT without ATG (non-ATG), or who received 7.5 mg/kg ATG (ATG-7.5) or 10 mg/kg ATG (ATG-10) prior to transplantation. The immune cells (CD3+CD4+ T cells, CD3+CD8+ T cells, CD19+ B cells and CD16+CD56+ NK cells) were examined in peripheral blood every three months post-HSCT for 12 months. RESULTS: Compared with non-ATG group, combined ATG-7.5/ATG-10 groups had significantly lower CD3+CD4+ T cells and higher CD3+CD8+ T cells at 3, 6, 9, 12 months post-HSCT; thus, displaying a lower CD4/CD8 ratio in the ATG groups compared to non-ATG group. The ratio of CD19+ B cells was statistically lower (at 3rd month, p = .014; at 6th month, p = .025) in combined ATG-7.5/ATG-10 groups at 3 and 6 months post-HSCT, but not at 9 and 12 months after HSCT. The ratios of CD3+CD4+ T cells, CD3+CD8+ T cells, CD19+ B cells and CD16+CD56+ NK cells were similar between the ATG-7.5 and ATG-10 groups at all examined time points. The overall survival (OS), progression-free survival (PFS), relapse and acute GVHD (aGVHD) were comparable among recipients without ATG therapy and with ATG-7.5 or/and ATG-10 therapies. Multivariate analysis revealed that immune cells ratios were not independent factors affecting prognosis. CONCLUSION: The ATG therapy at higher and lower doses led to a delayed reconstitution of T cells and the inversion of CD4/CD8 ratio for at least one year after HSCT.

Traditional and emerging therapies for anaplastic large cell lymphoma (Review).

Anaplastic large cell lymphoma (ALCL) is a rare and highly invasive non­Hodgkin's lymphoma. In the past few decades, traditional chemotherapy regimens, such as as the cyclophosphamide, vincristine, doxorubicin and prednisone regimen, have been recommended for first­line treatment. In order to improve the survival of patients, dose­intensive chemotherapy and hematopoietic stem cell transplantation have been deeply studied and some progress has been made. Recently, with the accumulation of clinical cases and the development of clinical trials, as well improvements to our in­depth understanding of the biological behavior of ALCL, the signaling pathways and the immunotherapy involved, research on this topic is in full swing. The emergence of several targeted drugs and immunotherapies, including anaplastic lymphoma kinase inhibitors, brentuximab vedotin, mTOR inhibitors, programmed cell death protein 1/programmed death ligand 1 inhibitors and chimeric antigen receptor­T cell therapy, seems to provide new opportunities for certain patients with ALCL. The present review focuses on the current use of traditional therapy and the treatment prospects of these new drugs in ALCL.

Risk Stratification for Diffuse Large B-Cell Lymphoma by Integrating Interim Evaluation and International Prognostic Index: A Multicenter Retrospective Study.

The baseline International Prognostic Index (IPI) is not sufficient for the initial risk stratification of patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone). The aims of this study were to evaluate the prognostic relevance of early risk stratification in DLBCL and develop a new stratification system that combines an interim evaluation and IPI. This multicenter retrospective study enrolled 314 newly diagnosed DLBCL patients with baseline and interim evaluations. All patients were treated with R-CHOP or R-CHOP-like regimens as the first-line therapy. Survival differences were evaluated for different risk stratification systems including the IPI, interim evaluation, and the combined system. When stratified by IPI, the high-intermediate and high-risk groups presented overlapping survival curves with no significant differences, and the high-risk group still had >50% of 3-year overall survival (OS). The interim evaluation can also stratify patients into three groups, as 3-year OS and progression-free survival (PFS) rates in patients with stable disease (SD) and progressive disease (PD) were not significantly different. The SD and PD patients had significantly lower 3-year OS and PFS rates than complete remission and partial response patients, but the percentage of these patients was only ~10%. The IPI and interim evaluation combined risk stratification system separated the patients into low-, intermediate-, high-, and very high-risk groups. The 3-year OS rates were 96.4%, 86.7%, 46.4%, and 40%, while the 3-year PFS rates were 87.1%, 71.5%, 42.5%, and 7.2%. The OS comparison between the high-risk group and very high-risk group was marginally significant, and OS and PFS comparisons between any other two groups were significantly different. This combined risk stratification system could be a useful tool for the prognostic prediction of DLBCL patients.

Phenotypic and molecular characterization of multidrug resistant Klebsiella pneumoniae isolated from a university teaching hospital, China.

The multidrug-resistant rate of Klebsiella pneumoniae has risen rapidly worldwide. To better understand the multidrug resistance situation and molecular characterization of Klebsiella pneumoniae, a total of 153 Klebsiella pneumoniae isolates were collected, and drug susceptibility test was performed to detect its susceptibility patterns to 13 kinds of antibiotics. Phenotypic tests for carbapenemases ESBLs and AmpC enzyme-producing strains were performed to detect the resistance phenotype of the isolates. Then PCR amplification and sequencing analysis were performed for the drug resistance determinants. The results showed that 63 strains harbored bla CTX-M gene, and 14 strains harbored bla DHA gene. Moreover, there were 5 strains carrying bla KPC gene, among which 4 strains carried bla CTX-M, bla DHA and bla KPC genes, and these 4 strains were also resistant to imipenem. Our data indicated that drug-resistant Klebsiella pneumoniae were highly prevalent in the hospital. Thus it is warranted that surveillance of epidemiology of those resistant isolates should be a cause for concern, and appropriate drugs should be chosen.

[Development of a xMAP liquid chip assay for the rapid identification of 7 common foodborne pathogens and its application].

OBJECTIVE: To develop an assay for the simultaneous detection of 7 common foodborne pathogens with xMAP liquid chip in a single-tube reaction. METHODS: Seven specific primers and probes were designed and synthesized based on the target gene sequences from GenBank. Target bacterial sequences were amplified by asymmetric PCR. The biotinylated products were hybridized to seven probe beads in a multiplex reaction and analyzed by using streptavidin conjugated to a fluorescent reporter molecule. The developed liquid chip xMAP assay was used to test 140 strains of bacteria and then 56 food samples. RESULTS: No cross-reaction and false signals were observed. The detection limit was 1 - 100 pg and 10(5) - 10(6) cfu/ml. The results tested by xMAP were in accordance with the traditional culture method. CONCLUSION: The processing of xMAP liquid chip assay, including DNA preparation and sample detection, could be finished within 3.5 hours and could be applied to the classification and identification of foodborne pathogens in the food safety monitoring.