Comparison of rabbit ATLG and ATG for GVHD prophylaxis in hematological malignancies with haploidentical hematopoietic stem cell transplantation

Rabbit anti-human T lymphocyte globulin (ATLG) and anti-thymocyte globulin (ATG) are commonly used for graft-versus-host disease (GVHD) prophylaxis in allogeneic hematopoietic stem cell transplantation (HSCT). Yet, their efficacy and safety have seldom been compared in hematological malignancies with haploidentical HSCT. A retrospective analysis with 28 ATLG (total dosage, 20-30 mg/kg) and 18 ATG (total dosage, 8-10 mg/kg) patients were performed. The cumulative incidences of chronic GVHD and relapse were comparable between both groups. ATLG showed a trend towards a lower acute GVHD incidence (28.6% vs. 44.4%, P = 0.242) and 3-year non-relapse mortality (10.7% vs. 27.8%, P = 0.160), and had a significantly higher 3-year overall survival (OS, 64.3% vs. 33.3%, P = 0.033) and GVHD-free and relapse-free survival (GRFS, 32.1% vs. 11.1%, P = 0.045) compared with ATG. Multivariate Cox regression analysis demonstrated ATLG was independently associated with a favorable OS (hazard ratio [HR] = 0.37, 95% confidence interval [CI]: 0.16-0.86, P = 0.020) and GRFS (HR = 0.51, 95%CI: 0.26-1.00, P = 0.051). Furthermore, ATLG had a lower risk of fever (25.0% vs. 61.1%, P = 0.014) and hemorrhage cystitis (7.1% vs. 38.9%, P = 0.008) than ATG-T. In conclusion, ATLG confers more survival benefit and a better safety profile than ATG and can be used in hematological malignancies with haploidentical HSCT. Prospective designed trials with a larger sample size are warranted to confirm the results in the future.

Association of serum lipids and abnormal lipid score with cancer risk: a population-based prospective study

BACKGROUND

Serum lipid levels are associated with cancer risk. However, there still have uncertainties about the single and combined effects of low lipid levels on cancer risk.

METHODS

A prospective cohort study of 33,773 adults in Shanghai between 2016 and 2017 was conducted. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were measured. Cox proportional hazard models were used to assess the association of single and combined lipids with overall, lung, colon, rectal, thyroid gland, stomach, and female breast cancers. The effect of the combination of abnormal lipid score and lifestyle on cancer was also estimated.

RESULTS

A total of 926 incident cancer cases were identified. In the RCS analysis, hazard ratios (HRs) of overall cancer for individuals with TC < 5.18 mmol/L or with LDL-C < 3.40 mmol/L were higher. Low TC was associated with higher colorectal cancer risk (HR [95% CI] = 1.76 [1.09-2.84]) and low HDL-C increased thyroid cancer risk by 90%. Abnormal lipid score was linearly and positively associated with cancer risk, and smokers with high abnormal lipid scores had a higher cancer risk, compared to non-smokers with low abnormal lipid scores (P < 0.05).

CONCLUSIONS

Low TC levels were associated with an increased risk of overall and colorectal cancer. More attention should be paid to participants with high abnormal lipid scores and unhealthy lifestyles who may have a higher risk of developing cancer. Determining the specific and comprehensive lipid combinations that affect tumorigenesis remains a valuable challenge.

Post-transplant cyclophosphamide for GVHD prophylaxis in pediatrics with chronic active Epstein-Barr virus infection after haplo-HSCT

BACKGROUND

Chronic active Epstein-Barr virus infection (CAEBV) is a rare but life-threatening progressive disease. Human leukocyte antigen (HLA)-haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is the best choice as sometimes HLA-matched donor is not accessible. However, graft-versus-host-disease (GVHD) following transplantation remains a major cause of treatment failure and elevated mortality. Post-transplant cyclophosphamide (PTCy) has recently emerged for effective GVHD prophylaxis in a haploidentical setting in many hematologic malignancies. Here, we report the performance of PTCy for GVHD prophylaxis in a series of CEABV patients treated with haplo-HSCT.

METHODS

Consecutive pediatric CAEBV patients who were treated with haplo-HSCT and give PTCy for GVHD prophylaxis were analyzed. 1-year GVHD and relapse-free survival (GRFS), overall survival (OS) and cumulative incidence of moderate-to-severe chronic GVHD (cGVHD) were estimated.

RESULTS

A total of 8 patients ranging from 2 to 15 years old were included. Among them, 4 patients had early complications after haplo-HSCT. Counts of T-cell subsets increased within 6 months post transplantation, indicating an immune reconstitution. Only 1 patient developed grade II acute GVHD, and 2 patients had moderate cGVHD. One patient died from diffuse alveolar hemorrhage within the first year after transplantation. The 1-year GRFS rate, OS rate and cumulative incidence of moderate-to-severe cGVHD were 62.5%, 87.5% and 25.0%, respectively.

CONCLUSION

Our findings suggest that, among CAEBV patients treated with haplo-HSCT, PTCy may be an alternative choice for the prevention of GVHD.

[Mechanism of silk hydrates on modulating the blood glucose metabolism in rats with experimental diabetes]

Thirty eight adult male Wistar rats injected with streptozotocin(STZ) 30 mg/kg BW via tail vein and fed on a diet of high fat, high sucrose and high calorie for 3 weeks and then for another 8 weeks were successfully established as the diabetes model(type II diabetes mellitus). The effects of feeding silk hydrates(SH) for 12 weeks on the activities of insulin receptors and postreceptors were observed. The results showed that: 1) SH greatly improved the glucose tolerance of diabetic rats, but no effect on the secretion of insulin in rats with or without diabetes; 2) Only the low-affinity constant of insulin binding rates(K2) in skeletal muscle cell membranes of diabetic rats fed with SH were obviously increased, the high-affinity binding constant and the number of receptors were not changed; 3) the uptake of glucose in skeletal muscle of diabetic rats fed on SH was significantly increased. 4) SH partly improved the metabolism of serum lipids. The results indicated that SH could modulate the metabolism of blood glucose mainly through the mechanism on the activity of insulin postreceptor.

[Effects of silk hydrates on the blood glucose metabolism in rats with experimental diabetes]

Male Wistar rats were divided into two groups by random. One group was injected with streptozotocin(STZ) 30 mg/kg BW via tail vein. Three weeks later, the rats were fed on diet of high fat, high sucrose and high calorie for another 8 weeks. There were 38 rats with impaired glucose tolerance and insulin level higher or equal to the control group selected as the diabetic model group. Another 36 rats not injected with STZ and fed on normal diet were selected as controls. The two groups were divided into two subgroups and fed with normal diet for another 4 weeks. The four subgroups were normal control group, normal +SH group, diabetes control group and diabetes +SH group. The rats in normal +SH group and diabetes +SH group were tube feeding every day with silk hydrate (SH) 1.0 g/kg BW for 4 weeks. The results showed that in the diabetes +SH group, the glucose tolerance, blood lipid and the predictive index of coronary heart disease were significantly improved, but no effect on their blood insulin level. There was no change in the normal +SH group. The results suggested that SH could modulate the metabolism of blood glucose and partly improve the disorder of the serum lipid of diabetic rats.

[The cytologic ultrastructure and cytochemical features of human dendritic cells from peripheral blood]

OBJECTIVE

To observe the cytomorphological, cellular ultrastructure and cytochemical features of the dendritic cell (DC) enriched populations in vitro.

METHODS

Fresh peripheral blood from healthy volunteers was collected and mononuclear cells (PBMC) were isolated on lymphocyte separating solution. The PBMC were cultured in mediums containing rhGM-CSF, rhIL-4 and rhTNF-alpha 9-12 days to generate DC-enriched populations, the morphological features and numbers of DC were identified and counted respectively by light microscope (LM) and confirmed by immunofluorescence assay (IFA), the ultrastructure characteristics of the DC populations were observed by transmission electron microscope, and the cytochemical features of them were also examined.

RESULTS

The percentage of DCs was 70%-80% in the DC-enriched populations as confirmed by IFA using mABXII. Transmission electron microscopy revealed that the DC populations contained two subsets of DC, one was considered as precursor cell derived DC(PC-DC), the cell surface of which had many irregular dendrites with a irregular nucleus, small nucleoli, numerous mitochondria, but scanty lysosomes, ribosome, rough endoplasmic reticulum and free polysomes. Cytochemical staining showed the DCs were both peroxidase (POX) and non-specific esterase (NSE) negative. The other was indentified as monocyte-derived DC(MO-DC), the features of which included: irregular shape, many ruffles and some rough lames on cell surfaces, nephritic or horseshoe nuclei with a thick rim of heterochromatin, numerous mitochondria, much more lysosomes, ribosomes, rough endoplasmic reticulum and Golgiosome. The cytochemical reactions indicated that most of them had POX-positive granules, and were NSE slightly positive.

CONCLUSION

Cytokines in vitro induced DCs from human peripheral blood are heterogeneous.