RESUMO
Patterns of hepatitis B virus reactivation (HBV-R) in HBsAg (-)/HBcAb (+) patients with B-cell non-Hodgkin lymphoma (NHL) receiving rituximab based immunochemotherapy have not been well described. The retrospective study included 222 HBsAg (-)/HBcAb (+) NHL patients as training cohort and 127 cases as validation cohort. The incidence of HBV-R in HBsAg (-)/HBcAb (+) B-cell NHL patients was 6.3% (14/222), of which that in HBsAg (-)/HBsAb (-)/HBeAg (-)/HBeAb (+)/HBcAb (+) population was 23.7% (9/38). Multivariate analysis showed that HBsAg (-)/HBsAb (-)/HBeAg (-)/HBeAb (+)/HBcAb (+) correlated with a high risk of HBV-R in B-cell lymphoma patients (training phase hazard ratio [HR], 10.123; 95% confidence interval [CI], 3.389-30.239; p < 0.001; validation phase HR, 18.619; 95% CI, 1.684-205.906; p = 0.017; combined HR, 12.264; 95% CI, 4.529-33.207; p < 0.001). In the training cohort, the mortality rate of HBsAg (-)/HBcAb (+) B-cell NHL caused by HBV-R was 14.3% (2/14) while that for HBV reactivated HBsAg (-)/HBsAb (-)/HBeAg (-)/HBeAb (+)/HBcAb (+) population was up to 44.4% (4/9). As a high incidence of HBV-R and high mortality after HBV-R was found in HBsAg (-)/HBsAb (-)/HBcAb (+)/HBeAg (-)/HBeAb (+) patients with B-cell NHL receiving rituximab based immunochemotherapy, prophylactic antiviral therapy is recommended for these patients.
Assuntos
Hepatite B , Linfoma de Células B , Humanos , Rituximab/uso terapêutico , Antígenos de Superfície da Hepatite B , Antígenos E da Hepatite B , Estudos Retrospectivos , Ativação Viral , Hepatite B/epidemiologia , Vírus da Hepatite B , Anticorpos Anti-Hepatite B , Linfoma de Células B/induzido quimicamente , Linfoma de Células B/tratamento farmacológicoRESUMO
Preeclampsia gravely threatens the health of mothers and infants. At present, treatment based on the relevant mechanisms of pathogenesis is still not available, and there is no independent reliable clinical index for early prediction of preeclampsia. According to recent studies, analysis of the cell-free RNA in the peripheral blood of pregnant women has shown that testing certain cell-free RNA levels can help predict in advance the occurrence of preeclampsia before clinical symptoms appear. In this paper, we described the status of research and progress in using maternal cell-free RNA analysis in predicting preeclampsia. In addition, we stated that cell-free RNA in peripheral blood may become a promising, real-time and non-invasive monitoring method that can be used to explore the mechanisms of pathogenesis and pathophysiology of preeclampsia and to identify different subtypes of preeclampsia.
Assuntos
Ácidos Nucleicos Livres , Pré-Eclâmpsia , Gravidez , Lactente , Feminino , Humanos , Gestantes , Pré-Eclâmpsia/diagnóstico , FamíliaRESUMO
2019 coronavirus disease (COVID-19) presents as a newly recognized pneumonia that has brought about a global pandemic and is increasingly considered as a systemic illness. We investigated the clinical and laboratory features of recovered COVID-19 patients without pre-existing hematologic diseases at Wuhan No. 1 Hospital. Fifty-nine male and 68 female Chinese patients were included with the median age at 64 years in the present study. Eosinopenia (37.80%), monocytosis (51.97%), lymphocytopenia (25.20%), and anemia (51.97%) were the most common hematologic findings in our cohort, particularly in severe or critically ill COVID-19. The levels of changes in leukocytes, neutrophils, lymphocytes, monocytes, eosinophils, basophils, platelets, hemoglobin levels, mean corpuscular volume (MCV), and mean cell hemoglobin concentration (MCHC) are overall associated with lung involvement, oxygen demand, and disease activity. However, changes of eosinophils (end hospitalization-baseline) (coefficients = 10.32; 95% CI = 1.03-19.60, P = 0.03) and basophils (Max - Min) (coefficients = 71.43; 95% CI = 8.55-134.31, P = 0.03) were independent predictors of delayed recovery in the hospital by the multivariate analysis in this recovered population. A variety of hematologic changes are associated with the severity and clinical outcome of recovered COVID-19 patients, which warrants further exploration of their underlying mechanisms.
Assuntos
Contagem de Células Sanguíneas , COVID-19/sangue , Convalescença , SARS-CoV-2 , Adulto , Idoso , Basófilos , Proteína C-Reativa/análise , COVID-19/epidemiologia , COVID-19/fisiopatologia , COVID-19/terapia , China , Terapia Combinada , Comorbidade , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Eosinófilos , Feminino , Hemoglobinas/análise , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Interleucina-6/sangue , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Oxigenoterapia , Prognóstico , Resultado do Tratamento , Tratamento Farmacológico da COVID-19Assuntos
Cesárea/efeitos adversos , Corpo Lúteo , Complicações Pós-Operatórias , Hemorragia Pós-Parto , alfa 1-Antitripsina , Adulto , Corpo Lúteo/metabolismo , Corpo Lúteo/patologia , Feminino , Humanos , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/genética , Complicações Pós-Operatórias/patologia , Hemorragia Pós-Parto/sangue , Hemorragia Pós-Parto/etiologia , Hemorragia Pós-Parto/genética , Hemorragia Pós-Parto/patologia , Gravidez , Ruptura Espontânea , alfa 1-Antitripsina/sangue , alfa 1-Antitripsina/genéticaRESUMO
Haploidentical stem cell transplantation (haploSCT) has advanced to a common procedure for treating patients with hematological malignancies and immunodeficiency diseases. However, cure is seriously hampered by cytomegalovirus (CMV) infections and delayed immune reconstitution for the majority of haploidentical transplant recipients compared to HLA-matched stem cell transplantation. Three major approaches, including in vivo T-cell depletion (TCD) using antithymocyte globulin for haploSCT (in vivo TCD-haploSCT), ex vivo TCD using CD34 + positive selection for haploSCT (ex vivo TCD-haploSCT), and T-cell replete haploSCT using posttransplant cyclophosphamide (PTCy-haploSCT), are currently used worldwide. We provide an update on CMV infection and CMV-specific immune recovery in this fast-evolving field. The progress made in cellular immunotherapy of CMV infection after haploSCT is also addressed. Groundwork has been prepared for the creation of personalized avenues to enhance immune reconstitution and decrease the incidence of CMV infection after haploSCT.