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1.
Br J Haematol ; 2024 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-38613241

RESUMO

CD7-targeted chimeric antigen receptor T-cell (CAR-T) therapy has shown promising initial complete remission (CR) rates in patients with refractory or relapsed (r/r) T-cell acute lymphoblastic leukaemia and lymphoblastic lymphoma (T-ALL/LBL). To enhance the remission duration, consolidation with allogeneic haematopoietic stem cell transplantation (allo-HSCT) is considered. Our study delved into the outcomes of 34 patients with r/r T-ALL/LBL who underwent allo-HSCT after achieving CR with autologous CD7 CAR-T therapy. These were compared with 124 consecutive T-ALL/LBL patients who received allo-HSCT in CR following chemotherapy. The study revealed that both the CAR-T and chemotherapy cohorts exhibited comparable 2-year overall survival (OS) (61.9% [95% CI, 44.1-78.1] vs. 67.6% [95% CI, 57.5-76.9], p = 0.210), leukaemia-free survival (LFS) (62.3% [95% CI, 44.6-78.4] vs. 62.0% [95% CI, 51.8-71.7], p = 0.548), non-relapse mortality (NRM) rates (32.0% [95% CI, 19.0-54.0] vs. 25.3% [95% CI, 17.9-35.8], p = 0.288) and relapse incidence rates (8.8% [95% CI, 3.0-26.0] vs. 15.8% [95% CI, 9.8-25.2], p = 0.557). Patients aged ≤14 in the CD7 CAR-T group achieved high 2-year OS and LFS rates of 87.5%. Our study indicates that CD7 CAR-T therapy followed by allo-HSCT is not only effective and safe for r/r T-ALL/LBL patients but also on par with the outcomes of those achieving CR through chemotherapy, without increasing NRM.

2.
Materials (Basel) ; 16(17)2023 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-37687583

RESUMO

Silicon has been proven to be one of the most promising anode materials for the next generation of lithium-ion batteries for application in batteries, the Si anode should have high capacity and must be industrially scalable. In this study, we designed and synthesised a hollow structure to meet these requirements. All the processes were carried out without special equipment. The Si nanoparticles that are commercially available were used as the core sealed inside a TiO2 shell, with rationally designed void space between the particles and shell. The Si@TiO2 were characterised using X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and scanning electron microscopy (SEM). The optimised hollow-structured silicon nanoparticles, when used as the anode in a lithium-ion battery, exhibited a high reversible specific capacity over 630 mAhg-1, much higher than the 370 mAhg-1 from the commercial graphite anodes. This excellent electrochemical property of the nanoparticles could be attributed to their optimised phase and unique hollow nanostructure.

3.
Leuk Lymphoma ; 64(13): 2133-2139, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37674391

RESUMO

T-acute lymphoblastic leukemia/lymphoma (T-ALL/LBL) patients with t(8;14)(q24;q11)/TCRA/D::MYC translocation represent a rare subgroup, with an aggressive course. In our retrospective analysis of 14 patients, all were identified during refractory or relapsed stages (5 primary tumor, 9 relapse). Notably, extramedullary invasion was detected in most patients. Four exhibited STIL::TAL1 translocation, and six demonstrated CDKN2A/B gene loss. The therapeutic outcomes were notably poor for all seven patients who received only chemotherapy or allogeneic hematopoietic stem cell transplantation (HSCT); all eventually succumbed to the disease with a median OS of 3 months. In the application of CD7 CAR-T therapy in six patients, five achieved CR. Of the four patients who underwent HSCT following CAR-T therapy, all have remained disease-free. The prognosis for T-ALL/LBL patients with t(8;14) translocation remains bleak, but interventions involving CD7 CAR-T may offer a potential pathway to CR. HSCT following CAR-T could be a viable strategy for long-term survival.


Assuntos
Leucemia-Linfoma Linfoblástico de Células Precursoras , Leucemia-Linfoma Linfoblástico de Células T Precursoras , Receptores de Antígenos Quiméricos , Humanos , Transplante de Células-Tronco Hematopoéticas , Imunoterapia Adotiva , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células T Precursoras/genética , Receptores de Antígenos Quiméricos/genética , Estudos Retrospectivos , Translocação Genética
4.
Front Immunol ; 14: 1191382, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37469510

RESUMO

Background: Chimeric antigen receptor (CAR) T-cell therapy has demonstrated high initial complete remission (CR) rates in B-cell acute lymphoblastic leukemia (B-ALL) patients, including those who relapsed after transplant. However, the duration of remission requires improvements. Whether bridging to a second allogeneic hematopoietic stem cell transplant (allo-HSCT) after CAR-T therapy can improve long-term survival remains controversial. We retrospectively analyzed long-term follow-up data of B-ALL patients who relapsed post-transplant and received CAR-T therapy followed by consolidation second allo-HSCT to investigate whether such a treatment sequence could improve long-term survival. Methods: A single-center, retrospective study was performed between October 2017 and March 2022, involving 95 patients who received a consolidation second transplant after achieving CR from CAR-T therapy. Results: The median age of patients was 22.8 years (range: 3.3-52.8) at the second transplant. After the first transplant, 71 patients (74.7%) experienced bone marrow relapse, 16 patients (16.8%) had extramedullary relapse, 5 patients (5.3%) had both bone marrow and extramedullary relapse and 3/95 patients (3.2%) had positive minimal residual disease (MRD) only. Patients received autologous (n=57, 60.0%) or allogeneic (n=28, 29.5%) CAR-T cells, while 10 patients (10.5%) were unknown. All patients achieved CR after CAR-T therapy. Before second HSCT, 86 patients (90.5%) were MRD-negative, and 9 (9.5%) were MRD-positive. All second transplant donors were different from the first transplant donors. The median follow-up time was 623 days (range: 33-1901) after the second HSCT. The 3-year overall survival (OS) and leukemia-free survival (LFS) were 55.3% (95%CI, 44.3-66.1%) and 49.8% (95%CI, 38.7-60.9%), respectively. The 3-year relapse incidence (RI) and non-relapse mortality (NRM) were 10.5% (95%CI, 5.6-19.6%) and 43.6% (95%CI, 33.9-56.2%), respectively. In multivariate analysis, the interval from CAR-T to second HSCT ≤90 days was associated with superior LFS(HR, 4.10, 95%CI,1.64-10.24; p=0.003) and OS(HR, 2.67, 95%CI, 1.24-5.74, p=0.012), as well as reduced NRM (HR, 2.45, 95%CI, 1.14-5.24, p=0.021). Conclusions: Our study indicated that CAR-T therapy followed by consolidation second transplant could significantly improve long-term survival in B-ALL patients who relapsed post-transplant. The second transplant should be considered in suitable patients and is recommended to be performed within 90 days after CAR-T treatment.


Assuntos
Linfoma de Burkitt , Transplante de Células-Tronco Hematopoéticas , Leucemia-Linfoma Linfoblástico de Células Precursoras B , Leucemia-Linfoma Linfoblástico de Células Precursoras , Receptores de Antígenos Quiméricos , Humanos , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Estudos Retrospectivos , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Imunoterapia Adotiva , Leucemia-Linfoma Linfoblástico de Células Precursoras B/terapia , Doença Aguda , Neoplasia Residual
5.
Adv Clin Exp Med ; 32(7): 791-802, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36881363

RESUMO

BACKGROUND: The role of ATPIF1 in ischemic brain injury is rarely reported. OBJECTIVES: This study explored the effect of ATPIF1 on astrocyte activity under oxygen glucose deprivation/reoxygenation (OGD/R). MATERIAL AND METHODS: The study sample was randomly allocated into: 1) control group (blank control); 2) OGD/R group (hypoxia for 6 h/reoxygenation for 1 h); 3) siRNA negative control (NC) group (OGD/R model+siRNA NC); and 4) siRNA-ATPIF1 group (OGD/R model+siRNA-ATPIF1). The OGD/R cell model was established from Sprague Dawley (SD) rats to simulate ischemia/reperfusion injury. Cells in the siRNA-ATPIF1 group were treated with siATPIF1. Ultrastructural changes in the mitochondria were observed using transmission electron microscopy (TEM). Apoptosis, cell cycle, reactive oxygen species (ROS), and mitochondrial membrane potential (MMP) were detected with flow cytometry. The protein expression levels of nuclear factor kappa B (NF-κB), B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X (Bax), and caspase-3 were detected with western blot. RESULTS: In the model group, the cell structure and the ridge structure were destroyed, and mitochondria edema, outer membrane damage and vacuole-like lesions were observed. Compared with the control group, the OGD/R group had considerably increased apoptosis, G0/G1 phase, ROS content, MMP, and Bax, caspase-3 and NF-κB protein expression, as well as markedly decreased S phase and Bcl-2 protein expression. Compared with the OGD/R group, the siRNA-ATPIF1 group had considerably decreased apoptosis, G0/G1 phase, ROS content, MMP, and Bax, caspase-3 and NF-κB protein expression, as well as remarkably increased S phase and Bcl-2 protein expression. CONCLUSIONS: The inhibition of ATPIF1 may alleviate OGD/R-induced astrocyte injury by regulating the NF-κB signaling pathway, inhibiting apoptosis, and reducing the ROS content and MMP in the rat brain ischemic model.


Assuntos
Lesões Encefálicas , Traumatismo por Reperfusão , Animais , Ratos , Apoptose , Astrócitos/metabolismo , Proteína X Associada a bcl-2/metabolismo , Caspase 3/metabolismo , Caspase 3/farmacologia , Glucose/metabolismo , NF-kappa B/metabolismo , Oxigênio/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo , Traumatismo por Reperfusão/metabolismo , RNA Interferente Pequeno
6.
Ibrain ; 9(4): 390-401, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38680510

RESUMO

This study aimed to examine the mediating role of anxiety and depression in the relationship between coping styles and life satisfaction among frontline medical workers during the COVID-19 pandemic. Five hundred and fourteen frontline medical workers from Zunyi were recruited to complete questionnaires, including the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Satisfaction with Life Scale (SWLS), and Simplified Coping Style Questionnaire (SCSQ). SPSS 24.0 was used to measure the characteristics of anxiety, depression, life satisfaction, and coping styles. We found that the prevalence rates of anxiety and depression among study participants were 22.57% and 18.29%, respectively. Besides, anxiety was positively correlated with depression; anxiety and depression were positively correlated with passive coping style but negatively correlated with life satisfaction and active coping style; life satisfaction was positively correlated with active coping style and negatively correlated with passive coping style (all p < 0.001). Moreover, anxiety and depression mediated the relationship between coping styles and life satisfaction. Anxiety accounted for 18.6% of the effect of active coping style and 35.48% of the effect of passive coping style on life satisfaction. Depression accounted for 48.84% of the effect of active coping style and 67.74% of the effect of passive coping style on life satisfaction. The present study provides novel insights into the effect of subclinical anxiety and depression on frontline medical workers in the pandemic area. Anxiety and depression yielded a mediating effect on the relationship between coping styles and life satisfaction.

7.
Materials (Basel) ; 15(17)2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36079288

RESUMO

A new photocatalyst, Er2FeSbO7, was prepared by solid phase sintering using the high-temperature synthesis method for the first time in this paper. Er2FeSbO7/BiTiSbO6 heterojunction (EBH) catalyst was prepared by the solvent thermal method for the first time. Er2FeSbO7 compound crystallized in the pyrochlore-type architecture and cubelike crystal system; the interspace group of Er2FeSbO7 was Fd3m and the crystal cellular parameter a of Er2FeSbO7 was 10.179902 Å. The band gap (BDG) width of Er2FeSbO7 was 1.88 eV. After visible light irradiation of 150 minutes (VLGI-150min) with EBH as a photocatalyst, the removal rate (RR) of enrofloxacin (ENR) concentration was 99.16%, and the total organic carbon (TOC) concentration RR was 94.96%. The power mechanics invariable k toward ENR consistency and visible light irradiation (VLGI) time with EBH as a photocatalyzer attained 0.02296 min−1. The power mechanics invariable k which was involved with TOC attained 0.01535 min−1. The experimental results showed that the photocatalytic degradation (PCD) of ENR within pharmaceutical waste water with EBH as a photocatalyzer under VLGI was in keeping with the single-order reactivity power mechanics. The RR of ENR with EBH as a photocatalyzer was 1.151 times, 1.269 times or 2.524 times that with Er2FeSbO7 as a photocatalyst, BiTiSbO6 as a photocatalyst, or N-doping TiO2 (N-TO) as a photocatalyst after VLGI-150min. The photocatalytic activity, which ranged from high to low among above four photocatalysts, was as follows: EBHP > Er2FeSbO7 > BiTiSbO6 > N-TO. After VLGI-150min toward three periods of the project with EBH as a photocatalyst, the RR of ENR attained 98.00%, 96.76% and 95.60%. The results showed that the stability of EBH was very high. With appending trapping agent, it could be proved that the oxidative capability for degrading ENR, which ranged from strong to weak among three oxidic radicals, was as follows: superoxide anion > hydroxyl radicals (HRS) > holes. This work provides a scientific basis for the research and oriented leader development of efficient heterojunction catalysts.

8.
Leuk Lymphoma ; 63(14): 3307-3316, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36067518

RESUMO

We retrospectively analyzed the outcomes of 240 pediatric SAA patients who underwent unmanipulated alternative HSCT between September 2012 and November 2020 at our center. The incidence of GF (PGF + SGF) was higher in the UCBD cohort compared to the MUD and HID cohorts [(13.5% ± 6.5%) vs (0%), and (1.6% ± 5.3%), respectively, p = .0001]. The incidence of platelet engraftment within 180 days post-HSCT was lower in the UCBD cohort (82.4% ± 2.3%) compared to the HID group (96.2% ± 1.3%) and the MUD group (97.4% ± 0.5%) (p = .020). the median duration time for platelet engraftment in the UCBD cohort was 29 days, longer than in HID cohort 14 days and the MUD cohort 13 days (p = .005). UCBD cohort had a lower 3-year failure-free survival (FFS) (70.5% ± 8.4%) compared to the HID cohort (81.1% ± 4.3%) and the MUD cohort (92.5% ± 3.1%) (p = .030) and lower 3-year GVHD/relapse free survival (GRFS) (63.3% ± 9.5.4%) compared to the HID cohort (75.5% ± 6.8%) and MUD cohort (87.9% ± 4.5%) (p = .002). UCBD-HSCT had inferior FFS and GRFS compared to an HSCT with an HID or MUD in pediatric patients with acquired SAA. A UCBD-HSCT had a higher GF and lower incidence of platelet engraftment and longer platelet engraftment time.


Assuntos
Anemia Aplástica , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Criança , Humanos , Doadores não Relacionados , Estudos Retrospectivos , Doadores de Sangue , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Recidiva , Condicionamento Pré-Transplante
9.
Materials (Basel) ; 15(11)2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35683292

RESUMO

Originally, the new catalyst Bi2SmSbO7 was synthesized by the hydrothermal synthesis method or by the solid-phase sintering method at a lofty temperature. A solvothermal method was utilized to prepare a Bi2SmSbO7/ZnBiYO4 heterojunction photocatalyst (BZHP). The crystal structure of Bi2SmSbO7 belonged to the pyrochlore structure and face-centered cubic crystal system by the space group of Fd3m. The cell parameter a was equivalent to 10.835(1) Å (Bi2SmSbO7). With Bi2SmSbO7/ZnBiYO4 heterojunction (BZH) as the photocatalyst, the removal rate (RR) of direct orange (DO) and the total organic carbon were 99.10% and 96.21% after visible light irradiation of 160 min (VLI-160M). The kinetic constant k toward DO concentration and visible light irradiation time (VLI) with BZH as photocatalyst reached 2.167 min−1. The kinetic constant k, which was concerned with total organic carbon, reached 0.047 min−1. The kinetic curve that came from DO degradation with BZH as a catalyst under VLI conformed to the second-order reaction kinetics. After VLI-160M, the photocatalytic degradation (PD) removal percentage of DO with BZH as the photocatalyst was 1.200 times, 1.268 times or 3.019 times that with Bi2SmSbO7 as the photocatalyst, ZnBiYO4 as the photocatalyst or with nitrogen-doped titanium dioxide as the photocatalyst. The photocatalytic activity (PA) was as following: BZH > Bi2SmSbO7 > ZnBiYO4 > nitrogen-doped titanium dioxide. After VLI-160M for three cycles of experiments with BZH as the photocatalyst, the RR of DO reached 98.03%, 96.73% and 95.43%, respectively, which meant that BZHP possessed high stability. By using the experiment of adding a trapping agent, the oxidative purifying capability for degradation of direct orange, which was in gradual depressed order, was as following: hydroxyl radical > superoxide anion > holes. Finally, the possible degradation pathway and degradation mechanism of DO were discussed systematically. A new high active heterojunction catalyst BZHP, which could efficiently remove toxic organic pollutants such as DO from dye wastewater after VLI, was obtained. Our research was meant to improve the photocatalytic property of the single photocatalyst.

10.
Leuk Lymphoma ; 63(5): 1211-1219, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34913818

RESUMO

We analyzed the outcomes of 32 patients with paroxysmal nocturnal hemoglobinuria (PNH) who underwent either a haploidentical donor (HID) or a matched unrelated donor (MUD) hematopoietic stem cell transplantation (HSCT). Seventeen patients received an HSCT from an HID and 15 patients received an HSCT from an MUD. The median follow-up time of the surviving patients was 36 months (range: 12-96 months). No significant differences were observed in the 3-year overall survival (OS) between the HID and MUD cohorts (74.1%±11.4% vs. 93.3%±6.4%, respectively, p=.222) or in the 3-year failure-free survival (68.8%±11.8% vs. 86.7%±8.8%, respectively, p=.307). Treatment-related mortality occurred in five patients. A univariate analysis of risk factors revealed platelet engraftment failure negatively impacted OS and FFS. We conclude that HID and MUD-HSCT are feasible and can be effective options for those PNH patients with concomitant bone marrow failure, recurrent life-threatening thrombosis, and uncontrollable hemolysis.


Assuntos
Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Hemoglobinúria Paroxística , Pancitopenia , Transtornos da Insuficiência da Medula Óssea , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Hemoglobinúria Paroxística/diagnóstico , Hemoglobinúria Paroxística/terapia , Humanos , Pancitopenia/etiologia , Estudos Retrospectivos , Condicionamento Pré-Transplante , Doadores não Relacionados
11.
Front Immunol ; 13: 1066748, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36685540

RESUMO

Introduction: We aimed to evaluate prognostic factors of a second allogeneic stem cell transplantation (allo-HSCT2) among hematological malignancy patients who have relapsed after the first allo-HSCT(allo-HSCT1). Methods: We retrospectively analyzed 199 hematological malignancy patients who received allo-HSCT2 as a salvage treatment post allo-HSCT1 relapse between November 2012 and October 2021. Results: The median age at allo-HSCT2 was 23 (range: 3-60) years. The median time to relapse after HSCT1 was 9 (range: 1-72) months. Prior to allo-HSCT2, patients had the following hematopoietic cell transplantation-comorbidity indexes (HCT-CI): 127 with a score of 0, 52 with a score of 1, and 20 with a score of 2 or greater. Fifty percent of patients received chimeric antigen receptor (CAR) T-cell therapy following HSCT1 relapse. Disease status was minimal residual disease (MRD)-negative complete remission (CR) among 119 patients, MRD-positive CR among 37 patients and non-remission (NR) for 43 patients prior to allo-HSCT2. Allo-HSCT2 was performed from a new donor in 194 patients (97.4%) and 134 patients (67.3%) received a graft with a new mismatched haplotype. The median follow-up time was 24 months (range: 6-98 months), and the 2-year OS and LFS were 43.8% ± 4.0% and 42.1% ± 4.1%, respectively. The 2-year cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) was 30.0%±4.8% and 38.5%±3.8%, respectively. Cox regression multivariate analysis showed that disease statusof MRD-negative CR, HCT-CI score of 0 prior to allo-HSCT2, and new mismatched haplotype donor were predictive factors of improved OS and LFS compared to patients without these characteristics. Based on these three favorable factors, we developed a predictive scoring system for patients who received allo-HSCT2. Patients with a prognostic score of 3 who had the three factors showed a superior 2-year OS of 63.3% ± 6.7% and LFS of 63.3% ± 6.7% and a lower CIR of 5.5% ± 3.1% than patients with a prognostic score of 0. Allo-HSCT2 is feasible and patients with good prognostic features prior to allo-HSCT2 -disease status of CR/MRD- and HCT-CI score of 0 as well as a second donor with a new mismatched haplotype could have the maximal benefit from the second allo-HSCT. Conclusions: Allo-HSCT2 is feasible and patients with good prognostic features prior to allo-HSCT2 -disease status of CR/MRD- and HCT-CI score of 0 as well as a second donor with a new mismatched haplotype could have the maximal benefit from the second allo-HSCT.


Assuntos
Neoplasias Hematológicas , Transplante de Células-Tronco Hematopoéticas , Humanos , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Transplante Homólogo , Recidiva Local de Neoplasia/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Neoplasias Hematológicas/terapia , Doença Crônica
12.
Front Immunol ; 12: 605766, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34025637

RESUMO

Patients often undergo consolidation allogeneic hematopoietic stem cell transplantation (allo-HSCT) to maintain long-term remission following chimeric antigen receptor (CAR) T-cell therapy. Comparisons of safety and efficacy of allo-HSCT following complete remission (CR) achieved by CAR-T therapy versus by chemotherapy for B-cell acute lymphoblastic leukemia (B-ALL) has not been reported. We performed a parallel comparison of transplant outcomes in 105 consecutive B-ALL patients who received allo-HSCT after achieving CR with CAR-T therapy (n=27) or with chemotherapy (n=78). The CAR-T-allo-HSCT group had more patients in second CR compared to the chemotherapy-allo-HSCT group (78% vs. 37%; p<0.01) and more with complex cytogenetics (44% vs. 6%; p<0.001) but the proportion of patients with pre-transplant minimal residual disease (MRD) was similar. The median follow-up time was 49 months (range: 25-54 months). The CAR-T cohort had a higher incidence of Grade II-IV acute graft-versus-host disease (aGVHD 48.1% [95% CI: 46.1-50.1%] vs. 25.6% [95%CI: 25.2-26.0%]; p=0.016). The incidence of Grade III-IV aGVHD was similar in both groups (11.1% vs.11.5%, p=0.945). The overall incidence of chronic GVHD in the CAR-T group was higher compared to the chemotherapy group (73.3% [95%CI: 71.3-75.3%] vs. 55.0% [95%CI: 54.2-55.8%], p=0.107), but the rate of extensive chronic GVHD was similar (11.1% vs.11.9%, p=0.964). Efficacy measures 4 years following transplant were all similar in the CAR-T vs. the chemotherapy groups: cumulative incidences of relapse (CIR; 11.1% vs.12.8%; p=0.84), cumulative incidences of non-relapse mortality (NRM; 18.7% vs. 23.1%; p=0.641) leukemia-free survival (LFS; 70.2% vs. 64.1%; p=0.63) and overall survival (OS; 70.2% vs. 65.4%; p=0.681). We found that pre-transplant MRD-negative CR predicted a lower CIR and a higher LFS compared with MRD-positive CR. In conclusion, our data indicate that, in B-ALL patients, similar clinical safety outcomes could be achieved with either CD19 CAR T-cell therapy followed by allo-HSCT or chemotherapy followed by allo-HSCT. Despite the inclusion of more patients with advanced diseases in the CAR-T group, the 4-year LFS and OS achieved with CAR T-cells followed by allo-HSCT were as remarkable as those achieved with chemotherapy followed by allo-HSCT. Further confirmation of these results requires larger, randomized clinical trials.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Imunoterapia Adotiva , Leucemia-Linfoma Linfoblástico de Células Precursoras B/terapia , Adolescente , Antígenos CD19 , Antígenos de Neoplasias , Criança , Terapia Combinada , Resistencia a Medicamentos Antineoplásicos , Feminino , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Imunoterapia Adotiva/efeitos adversos , Imunoterapia Adotiva/métodos , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras B/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras B/mortalidade , Prognóstico , Receptores de Antígenos de Linfócitos T , Receptores de Antígenos Quiméricos , Recidiva , Retratamento , Transplante Homólogo , Resultado do Tratamento , Adulto Jovem
13.
Am J Transl Res ; 13(4): 3330-3336, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34017506

RESUMO

OBJECTIVE: To study the influence of color Doppler ultrasound on hemodynamic changes and pregnancy outcome of pregnant women with gestational diabetes mellitus (GDM). METHODS: From October 2018 to October 2019, a total of 76 pregnant women with GDM treated in the obstetric outpatient department of our hospital were selected as the experimental group, and 76 healthy pregnant women were selected as the control group. The uterine artery (UA) hemodynamic parameters, fetal middle cerebral artery (MCA) hemodynamic parameters and umbilical artery (Ut-A) hemodynamic parameters of the two groups of pregnant women were examined by color Doppler ultrasound. The arterial blood flow of the two groups of pregnant women was evaluated, and the incidence of early diastolic notches and pregnancy outcome were counted. The correlation between blood flow index changes during pregnancy [peak systolic velocity/end-systolic blood flow velocity (S/D), resistance index (RI), pulsation index (PI)] and GDM was analyzed. RESULTS: The arterial hemodynamic parameters and arterial blood flow scores of pregnant women in the experimental group were better than those in the control group (P < 0.05); the incidence of early diastolic notch in the experimental group was significantly higher than that in the control group (P < 0.05); the number of neonates with the Apgar score ≥ 7 points in the experimental group was significantly smaller than that in the control group (P < 0.05). PI, RI and S/D of arterial blood flow during pregnancy were positively correlated with the occurrence of GDM (P < 0.05). CONCLUSION: Clinically, color Doppler ultrasound may be used to understand the abnormal blood glucose of GDM pregnant women, identify the cause of the abnormality through symptoms, and detect the maternal arterial blood flow indicators to achieve timely understanding of the abnormal condition of the fetus, and provide a basis for preventing adverse pregnancy outcomes.

14.
Saudi J Biol Sci ; 28(4): 2128-2138, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33911929

RESUMO

Mutations in Valosin-containing protein (VCP) have been implicated in the pathology linked to inclusion body myopathy, paget disease of bone and frontotemporal dementia (IBMPFD). VCP is an essential component of AAA-ATPase superfamily involved in various cellular functions. Advanced In-silico analysis was performed using prediction based servers to determine the most deleterious mutation. Molecular dynamics simulation was used to study the protein dynamics at atomic level. Molecular docking was used to study the effect of mutation on ATP/ADP transition in the kinase domain. This ATPase of 806 amino acids has four domains: N-terminal domain, C-terminal domain and two ATPase domains D1 and D2 and each of these domains have a distinct role in its functioning. The mutations in VCP protein are distributed among regions known as hotspots, one such hotspot is codon 155. Three missense mutations reported in this hotspot are R155C, R155H and R155P. Potentiality of the deleteriousness calculated using server based prediction models reveal R155C mutation to be the most deleterious. The atomic insight into the effect of mutation by molecular dynamics simulation revealed major conformational changes in R155C variants ATP binding site in D1 domain. The nucleotide-binding mode at the catalytic pocket of VCP and its three variants at codon 155 showed change in the structure, which affects the ATP-ADP transition kinetics in all the three variants.

15.
Hematology ; 26(1): 134-143, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33491597

RESUMO

Objective: The outcomes of alternative donor hematopoietic stem cell transplantation (HSCT) with unmanipulated grafts for Inherited bone marrow failure syndromes (IBMFS) are discouraging. Our study is to demonstrate that IBMFS with disease-specific characteristics requires a tailored conditioning regimens to enhance engraftment and reduce regimen related toxicities. Methods: We retrospectively analyzed 42 patients diagnosed with IBMFS and transplanted with an alternative donor graft at our center from November 2012 to August 2018. Twenty-seven patients had Fanconi anemia (FA), 7 had dyskeratosis congenita (DC), and 8 had severe congenital neutropenia (SCN). Patients received ex-vivo unmanipulated alternative donor grafts from a matched unrelated donor (MUD) (n = 22), haploidentical donor (HID) (n = 17) and unrelated cord blood donor (UCBD) (n = 3). FA and DC patient subgroups received reduce intensified conditioning (RIC), while SCN patients received a myeloablative conditioning (MAC) regimen. Results: The median follow-up time for the surviving patients was 38 months (range: 9-63 months). The failure-free survival (FFS) for entire cohort was 76.1%, and was 72.4%, 100% and 56.2% for patients with FA, DC and SCN, respectively. There were no primary graft failures. The cumulative incidence of aGVHD at day 100 was 48.1%. The cumulative incidence of cGVHD at 1 and 3 years was 35.0% and 69.3%, respectively. Conclusion: HSCT using alternative donors with unmanipulated grafts and disease-specific conditioning regimens for IBMFS patients shows promising survival.


Assuntos
Síndrome Congênita de Insuficiência da Medula Óssea/terapia , Transplante de Células-Tronco Hematopoéticas/métodos , Condicionamento Pré-Transplante/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Seguimentos , Sobrevivência de Enxerto , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Masculino , Análise de Sobrevida , Condicionamento Pré-Transplante/efeitos adversos , Doadores não Relacionados , Adulto Jovem
16.
Ann Hematol ; 100(6): 1579-1591, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33236196

RESUMO

There are a limited number of studies comparing outcomes of busulfan (BU)-based myeloablative hematopoietic stem cell transplantation using unmanipulated haploidentical donors (HIDs), HLA-matched unrelated donors (MUDs), and HLA-matched sibling related donors (MSDs) in acute myeloid leukemia (AML) patients with complete remission (CR) status. With this background, we compared outcomes among 377 cases of CR following consecutive HID-HSCT for AML (CR) to 86 MUD and 92 MSD-HSCT cases. All patients received BU-based myeloablative conditioning and an unmanipulated graft within the same period. The median patient age was 23 years (range 1.1 to 65 years), and 230 patients (41.4%) were under age18. Among the 555 patients, 432 (77.8%) were of intermediate cytogenetic risk and 123 (22.2%) were of adverse risk. A total of 113 patients (20.5%) had FLT3-ITD+ AML, 425 patients (76.6%) were in first complete remission (CR1) post-transplant, and 130 (23.4%) patients were in second CR (CR2). GVHD prophylaxis included mycophenolate mofetil (MMF), cyclosporine-A (CSA) with short-term methotrexate (MTX) for HID, and MUD-HSCT. MMF is not used for MSD-HSCT. The median survival follow-up time was 42 months (range 18-91 months). The 3-year leukemia-free survival (LFS) among the HID, MUD, and MSD cohorts was 73.8% ± 4.8%, 66.4% ± 8.5%, 74.5% ± 2.4%, respectively (P = 0.637). Three-year overall survival (OS) was 74.9% ± 2.4%, 81.8% ± 4.3%, and 77.5% ± 4.5% among the HID, MUD, and MSD cohorts, respectively (P = 0.322). There were no difference among the relapse rate among the HID, MUD, and MSD donor cohorts (14.3% ± 4.0% vs 20.3% ± 6.4% vs 14.5% ± 2.2, respectively; P = 0.851) or the non-relapse mortality (NRM) (12.3% ± 3.5% vs 9.5% ± 3.2% vs 14.0% ± 1.8%, respectively; P = 0.441). Multivariate analyses showed that MRD-positive pre-HSCT was the only risk factor associated with a lower OS and LFS and higher risk of relapse among all 555 patients. Compared with the use of a MUD or MSD, an HID for HSCT had similar outcomes among AML patients with CR states who underwent an allo-HSCT with BU-based myeloablative conditioning. MFC-MRD-positive pre-HSCT was an independent negative factor impact on outcomes for AML patients in CR. We conclude that for AML patients who do not have a MSD or if an urgent transplant is required, HSCT from an HID is a valid option.


Assuntos
Bussulfano/uso terapêutico , Transplante de Células-Tronco Hematopoéticas/métodos , Leucemia Mieloide Aguda/terapia , Agonistas Mieloablativos/uso terapêutico , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Estudos Retrospectivos , Irmãos , Doadores de Tecidos , Condicionamento Pré-Transplante/métodos , Resultado do Tratamento , Doadores não Relacionados , Adulto Jovem
17.
Ann Hematol ; 99(12): 2911-2925, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33000361

RESUMO

Prior studies have suggested that for leukemia patients with high-risk features, haplo-identical-hematopoietic stem cell transplantation (HID-HSCT) has a stronger anti-leukemia effect compared with HSCT using an identical sibling donor (ISD-HSCT). However, it is unclear whether an HID-HSC transplant also augments the graft-versus-leukemia (GVL) effect among refractory/relapsed (R/R) acute myeloid leukemia (AML) patients who are not in remission (NR). We conducted a retrospective analysis of 124 R/R AML patients with NR status who underwent HID-HSCT between April 2012 and December 2016 and compared these to 27 R/R AML patients who underwent an ISD-HSCT within the same timeframe. Among all of the patients, 68 (45.0%) had primary induction failure (PIF) and 83 (54.9%) were relapsed and had failed to respond to at least one cycle of salvage combination chemotherapy. Myeloablative conditioning regimens were administered to all patients. Here, we present a retrospective multivariate analysis of pre-transplantation risk factors and characteristics of all 151 patients and developed a predictive scoring system to predict patient survival. The median period of follow-up was 46 months for all patients. The HID cohort had a higher 5-year overall survival (OS) compared with the ISD cohort (48.6% ± 4.6% vs 25.9% ± 8.4, respectively; P = 0.017) and higher LFS (leukemia-free survival) (41.6% ± 7.5% vs 25.9% ± 8.4%, respectively; P = 0.019). There was no difference in the 5-year cumulative incidence of non-relapse mortality (NRM) (18.0% ± 3.8% and 34.9% ± 12.6%, respectively; P = 0.212) between the two group. However, the 5-year cumulative incidence of relapse (CIRs) was lower in the HID group compared with the ISD group (55.4% ± 8.9% vs 67.3% ± 9.9%, respectively; P = 0.021). Multivariate analysis showed three risk factors associated with OS and LFS: (1) ISD-HSCT, (2) use of a standardized conditioning regimen, and (3) less than 50% proportional reduction of blast cells in the bone marrow (BM). Based on these three risk factors, we developed a predictive scoring system for R/R AML patients undergoing HSCT. Patients who had a predictive score of 0 and 1 had a 66.6% ± 4.5% and 44.1% ± 3.6% OS rate at 5 years, respectively. Patients with a score ≥ 2 had only a 4.4 ± 0.2% OS rate at 5 years. An HID-HSCT had a better anti-leukemia effect among R/R AML patients with an NR status compared with an ISD-HSCT. We also identified pre-transplantation risk factors to delineate subgroups that could derive maximal benefit from HSCT.


Assuntos
Transplante de Células-Tronco Hematopoéticas/métodos , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/terapia , Doadores Vivos , Irmãos , Transplante Haploidêntico/métodos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Seguimentos , Transplante de Células-Tronco Hematopoéticas/tendências , Teste de Histocompatibilidade/métodos , Teste de Histocompatibilidade/tendências , Humanos , Leucemia Mieloide Aguda/diagnóstico , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Condicionamento Pré-Transplante/métodos , Condicionamento Pré-Transplante/tendências , Transplante Haploidêntico/tendências , Resultado do Tratamento , Adulto Jovem
18.
Peptides ; 131: 170353, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32599080

RESUMO

A large body of evidence suggests a relationship between depression and coronary heart disease (CHD). Angiotensin-Ⅱ (Ang-Ⅱ) and angiotensin-(1-7) [Ang-(1-7)] are considered to exert biological effects in both conditions. Here, we aimed to determine the role of Ang-Ⅱ and Ang-(1-7) in the occurrence of comorbid depression in patients with CHD. Our study included 214 CHD patients and 100 matched healthy controls. Serum Ang-Ⅱ and Ang-(1-7) levels were assessed by ELISA, and the depression symptoms were evaluated by the nine-item Patient Health Questionnaire (PHQ-9). Linear regression and correlation analyses were used to estimate the associations between PHQ-9 scores and Ang-Ⅱ and Ang-(1-7) serum levels. Six single-nucleotide polymorphisms (SNPs) spanning the angiotensin converting enzyme 2 (ACE2) and MAS1 genes were genotyped. The associations between SNPs and depression risk in CHD patients were examined using logistic regression analysis with adjustment for age and gender. Decreased Ang-(1-7) (P < 0.05) and an elevated Ang-Ⅱ/Ang-(1-7) ratio (P < 0.01) were observed in CHD patients with depression compared to CHD patients without depression. PHQ-9 scores were negatively correlated with Ang-(1-7) level (r=-0.44, P < 0.01) and positively correlated with the Ang-Ⅱ/Ang-(1-7) ratio (r = 0.33, P < 0.05). Furthermore, carriers of risk allele T for CHD with depression had significantly higher PHQ-9 scores (P < 0.05), lower Ang-(1-7) level (P < 0.01), and higher Ang-Ⅱ/Ang-(1-7) ratio (P < 0.05) than those CC carriers. Collectively, our results firstly showed that Ang-(1-7) serum level in CHD patients may protect against comorbid depression. Moreover, the imbalance between Ang-Ⅱ and Ang-(1-7) may contribute to depression in CHD patients.


Assuntos
Angiotensina II/genética , Angiotensina I/genética , Enzima de Conversão de Angiotensina 2/genética , Doença das Coronárias/epidemiologia , Depressão/epidemiologia , Fragmentos de Peptídeos/genética , Proteínas Proto-Oncogênicas/genética , Receptores Acoplados a Proteínas G/genética , Adulto , Angiotensina I/sangue , Angiotensina II/sangue , Enzima de Conversão de Angiotensina 2/sangue , Estudos de Casos e Controles , China/epidemiologia , Comorbidade , Doença das Coronárias/sangue , Doença das Coronárias/genética , Doença das Coronárias/fisiopatologia , Depressão/sangue , Depressão/genética , Depressão/fisiopatologia , Feminino , Regulação da Expressão Gênica , Genótipo , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/sangue , Polimorfismo de Nucleotídeo Único , Proto-Oncogene Mas , Proteínas Proto-Oncogênicas/sangue , Curva ROC , Receptores Acoplados a Proteínas G/sangue , Transdução de Sinais , Inquéritos e Questionários
19.
Front Chem ; 8: 188, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32318538

RESUMO

Oil-immersed power transformers are considered to be one of the most crucial and expensive devices used in power systems. Hence, high-performance gas sensors have been extensively explored and are widely used for detecting fault characteristic gases dissolved in transformer oil which can be used to evaluate the working state of transformers and thus ensure the reliable operation of power grids. Hitherto, as a typical n-type metal-oxide semiconductor, tungsten trioxide (WO3) has received considerable attention due to its unique structure. Also, the requirements for high quality gas detectors were given. Based on this, considerable efforts have been made to design and fabricate more prominent WO3 based sensors with higher responses and more outstanding properties. Lots of research has focused on the synthesis of WO3 nanomaterials with different effective and controllable strategies. Meanwhile, the various morphologies of currently synthesized nanostructures from 0-D to 3-D are discussed, along with their respective beneficial characteristics. Additionally, this paper focused on the gas sensing properties and mechanisms of the WO3 based sensors, especially for the detection of fault characteristic gases. In all, the detailed analysis has contributed some beneficial guidance to the exploration on the surface morphology and special hierarchical structure of WO3 for highly sensitive detection of fault characteristic gases in oil-immersed transformers.

20.
J Inflamm Res ; 13: 71-79, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32104044

RESUMO

PURPOSE: Inflammation is a key contributor to coronary heart disease (CHD). Sortilin is a sorting receptor and has been identified as a critical regulator of inflammatory response. Therefore, our study aimed to determine the link between circulating sortilin levels, proinflammatory cytokine levels, and the occurrence of CHD. PATIENTS AND METHODS: Our study included 227 CHD patients and 101 matched healthy individuals. Circulating serum levels of sortilin and proinflammatory cytokines, including IL-1ß, IL-6 and TNF-α, were assessed by a double-antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA). Linear regression and correlation analyses were used to estimate the associations between sortilin and proinflammatory cytokines. Moreover, six single-nucleotide polymorphisms (SNPs) spanning the sortilin and SORL1 genes were genotyped. RESULTS: Elevated levels of sortilin (P=0.027) and proinflammatory cytokines IL-1ß (P=0.013), IL-6 (P=0.000) and TNF-α (P=0.010) were observed in CHD patients compared to those in healthy controls. Furthermore, sortilin levels were significantly positively correlated with IL-1ß (r=0.252, P=0.0001), IL-6 (r=0.250, P=0.0001) and TNF-α (r=0.180, P=0.0064) levels. Notably, sortilin polymorphisms were revealed to be associated with the occurrence of CHD and varying sortilin levels. Subjects with the rs599839 AA risk genotype for CHD had significantly higher sortilin levels than those with the GG and GA genotypes (P=0.000); the same tendency was also observed in the levels of the proinflammatory cytokines IL-1ß (P=0.003) and TNF-α (P=0.000). Similarly, GG carriers of rs464218 with increased sortilin levels were found to be at increased risk for CHD (P=0.014). The levels of IL-1ß (P=0.025) and IL-6 (P=0.015) were also increased in these patients. CONCLUSION: Our findings reveal that high sortilin levels may interact with inflammatory response to contribute to the occurrence of CHD. Considering that our clinical evidence suggests for the first time that sortilin involves in inflammatory response in CHD, the mechanistic role of sortilin in the progression of CHD deserves detailed investigation.

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