Huan Chen

Peking University People's Hospital, Peping, Beijing, China

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Publications (129)192.65 Total impact

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    ABSTRACT: Allogeneic hematopoietic stem cell transplantation (HSCT) is the most effective post-consolidation therapy and curative option for adult patients with Philadelphia chromosome-negative (Ph-negative) acute lymphoblastic leukemia (ALL) in first complete remission (CR1). A human leukocyte antigen (HLA)-haploidentical related donor (haplo-RD) is one of the most important alternative sources for those without HLA-identical sibling donor (ISD). The present study aimed to evaluate the outcomes of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in adult Ph-negative ALL CR1 patients (n=183). We produced an unmanipulated haplo-HSCT protocol including granulocyte colony stimulating factor (G-CSF) for all donors, intensive immune suppression, anti-thymocyte globulin, and combination of G-CSF-primed bone marrow harvest and G-CSF-mobilized peripheral blood stem cells harvest as the source of stem cell grafts. The median age for high-risk versus low-risk groups were 29 versus 23 years. Three-year incidences of relapse mortality and nonrelapse mortality for high-risk versus low-risk groups were 7.1% versus 11.1% (P = 0.498) and 18.0% versus 16.2% (P = 0.717), respectively. Three-year probabilities of disease-free survival and overall survival for high-risk versus low-risk groups were 67.6% versus 68.2% (P = 0.896) and 74.9% versus 72.7% (P = 0.981), respectively. Multivariate analysis showed that limited cGVHD and a lower pre-HSCT comorbidity burden were associated with better outcomes. In summary, comparable outcomes were observed among high- and low-risk Ph-negative ALL CR1 patients after haplo-HSCT. Haplo-RD could be considered for adults with Ph-negative ALL in CR1 as an important alternative source of donors in cases when no ISD is available. © 2014 Wiley Periodicals, Inc.
    International Journal of Cancer 08/2014; · 6.20 Impact Factor
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    ABSTRACT: To improve the understanding of treatment for graft failure by analyzing the efficacy of second transplantation for graft failure after first allogeneic stem cell transplantation (allo-HSCT).
    08/2014; 35(8):673-7.
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    ABSTRACT: Minimal residual disease (MRD)-directedmodified donor lymphocyte infusion (mDLI) is used to treat relapse after hematopoietic stem cell transplantation (HSCT). For patients who experience an unsatisfactory response tomDLI, relapse is usually inevitable. Therefore, we sought to evaluate the efficacy ofinterferon α therapy in these patients.
    Chinese medical journal. 07/2014; 127(14):2583-7.
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    ABSTRACT: The best donor for a related donor for a HLA-haplotype-mismatched transplant for hematological neoplasms is controversial. We studied outcomes in 1210 consecutive transplant recipients treated on a uniform protocol. Younger donors and male donors were associated with less non-relapse-mortality (NRM; hazard ratio [(HR)=0.30; 95% confidence interval [CI] 0.01-0.39; P=0.008 and HR 0.65, 95% CI, 0.49-0.85; P=0.002) and better survival (HR=0.73; 95%CI, 0.54-0.97; P=0.033 and HR=0.73; 95%CI, 0.59-0.91; P=0.005). Father donors were associated with less NRM (HR=0.65; 95%CI, 0.45-0.95; P=0.02), acute graft-versus-host disease (GvHD) (HR=0.69; 95% CI, 0.55-0.86; P=0.001) and better survival (HR=0.66; 95%CI, 0.50-0.87; P=0.003) compared with mother donors. Children donors were associated with less acute GvHD than sibling donors (HR=0.57; 95% CI, 0.31-0.91; P=0.01). Older sister donors were inferior to father donors with regard to NRM (HR=1.87; 95%CI, 1.10-3.20; P=0.02) and survival (HR=1.59; 95%CI, 1.05-2.40; P=0.03). Non-inherited-maternal-antigen (NIMA)-mismatched sibling donors were associated with the lowest incidence of acute GvHD compared with parental donors and non-inherited-paternal-antigen (NIPA)-mismatched sibling donors. Specific HLA-disparities were not significantly correlated with transplant outcomes. Our data indicate which HLA-haplotype-mismatched related donors are associated with the best transplant outcomes in persons with hematological neoplasms.
    Blood 06/2014; · 9.78 Impact Factor
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    ABSTRACT: To compare the efficacy of haploidentical hematopoietic stem cell transplantation (HSCT) with chemotherapy alone in adult standard-risk acute lymphoblastic leukemia (ALL) in first complete remission (CR1). Consecutive 138 adult patients with standard-risk ALL in CR1 were retrospectively investigated. Out of these patients, 59 received chemotherapy alone (Group A), and 79 received unmanipulated haploidentical HSCT (Group B). Cumulative incidence of relapse at 5 years in Group A was significantly higher than Group B (66.3%vs.29.9%,P<0.0001). The OS and DFS in Group A were significantly inferior to Group B (P<0.0001). Moreover, multivariate analyses demonstrated that central nervous system leukemia (P=0.002), T-cell immunophenotype (P=0.044), expression of E2A-PBX1 (P=0.007) and minimal residual disease-positive after the 1(st) cycle of consolidation (P=0.004) were correlated with relapse. Patients with one of four risk factors were assigned to high-risk group. Otherwise, patients without risk factors were assigned to low-risk group. In high-risk group, HSCT had lower relapse rate and superior DFS compared with chemotherapy (P<0.05), but in low-risk group, there were no differences between HSCT and chemotherapy (P>0.05). This study is the first to demonstrate that, compared with chemotherapy alone, haploidentical HSCT is a better post-remission therapy in adult standard-risk ALL in CR1. Moreover, based on the four risk factors, the establishment of risk-stratification could identify the subgroup of patients with higher risk of relapse in adult standard-risk ALL in CR1. Furthermore, risk-stratification directed post-remission therapies using haploidentical HSCT or chemotherapy alone not only reduce relapse rate, but also avoid unnecessary treatment-related mortality and improve survival.
    Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation 04/2014; · 3.15 Impact Factor
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    ABSTRACT: We compared total body irradiation (TBI,700 cGy)/cyclophosphamide (Cy,3.6g/m(2))/simustine (250mg/m(2)) plus anti-thymocyte globulin (ATG) (TBI/Cy plus ATG) with cytarabine (8 g/m(2))/intravenous busulfan (Bu,9.6mg/kg)/Cy (3.6g/m(2)) /simustine (250mg/m(2)) plus ATG (modified Bu/Cy plus ATG) as preparative therapy in T-cell-replete haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for acute leukemia. From August 2009 to August 2013, 38 consecutive patients using TBI/Cy plus ATG regimen for T-cell-replete haplo-HSCT (TBI group) at our center were eligible, which contained 28 high-risk and 10 standard-risk patients. A nested case-control study was designed. Seventy-seven patients using modified Bu/Cy plus ATG regimen (Bu group) were randomly selected in a 1-3:1 ratio with matching for age, the disease and status, the year of HSCT (±2 years) and the length of follow-up. Only one graft failure occurred in TBI group. The incidence and time of neutrophil and platelet engraftment were comparable between the two groups. Severe grade III/IV GVHD was observed in 13.4% of Bu group and only 2.6% of TBI group (P=0.083). More toxicity of the liver (37.7% vs. 10.5%; P=0.002) and more hemorrhagic cystitis occured in Bu group (49.3% vs. 23.7% ,P=0.008). Diarrhea was more common in TBI group (44.7% vs. 22.1%; P= 0.031). There was no significant difference in the 2-year incidences of relapse (26.5 % for TBI group vs. 32.3 % for Bu group, P=0.742), the 1-year transplant-related mortality (12.6% vs. 16.2 %, P=0.862), the 2-year overall survial (60.2% vs. 57.0%, P=0.937) and the 2-year incidence of disease-free survial (57.9 % vs. 56.6 %, P=0.845) between the two groups.We conclude that the TBI/Cy plus ATG regimen seems to be feasible in T-cell-replete haplo-HSCT, with promotes stable engraftment,a lower incidence of liver toxicity and hemorrhagic cystitis.However, longer follow-up is necessary to determine the late relapse rate and late toxicity.
    Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation 04/2014; · 3.15 Impact Factor
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    ABSTRACT: To evaluate the molecular response and prognostic factors of patients with Philadelphia chromosome/BCR-ABL-positive acute lymphoblastic leukaemia (Ph⁺ ALL) treated by imatinib with chemotherapy. From May 2006 to July 2012, 82 adult Ph⁺ ALL patients were enrolled in the study. Forty-eight patients combined imatinib in, and 34 patients after induction therapy. Forty-nine patients underwent allogeneic hematopoietic stem cell transplant (allo-HSCT) after 3 to 5 cycles of consolidation therapy. The molecular response of BCR-ABL mRNA was evaluated by real-time quantitative PCR in every chemotherapy course ending. The complete remission (CR) rate after the first cycle of induction chemotherapy was 76.8% (63/82), with overall CR rate of 92.7% (76/82). The CR rate in the patients combined imatinib in was higher than of those combined imatinib after the first cycle of induction chemotherapy (93.8% vs 52.9%, P<0.001). 55.3% patients BCR-ABL decreased >1 log after induction therapy. Among 76 CR patients, cumulative incidence of relapse was 27.6%, the probabilities of disease-free survival (DFS) and overall survival (OS) at 3 years were 60.5% and 70.2%, respectively. allo-HSCT was an independent favorable factor for decrease of leukemia relapse (P<0.001). allo-HSCT, imatinib combined in the first cycle of induction therapy and female were independent favorable factors for DFS (P<0.01, 0.05 and 0.01, respectively), BCR-ABL mRNA reduction at least 1 log from baseline after the first induction therapy and allo-HSCT were independent favorable factors for OS (P=0.011 and 0.027, respectively). Imatinib combined in the first cycle of induction therapy, BCR-ABL mRNA reduction at least 1 log from baseline after the first induction therapy and allo-HSCT improved outcomes of Ph⁺ ALL patients.
    Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi 02/2014; 35(2):120-125.
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    ABSTRACT: Cancer-testis (CT) antigen genes might promote the progression of multiple myeloma (MM). CT antigens may act as diagnostic and prognostic markers in MM, but their expression levels and clinical implications in this disease are not fully understood. This study measured the expression levels of four CT antigen genes in Chinese patients with MM and explored their clinical implications. Real-time quantitative polymerase chain reaction (qPCR) was used to quantify the expression of MAGE-C1/CT7, MAGE-A3, MAGE-C2/CT10 and SSX-2 mRNA in 256 bone marrow samples from 144 MM patients. In the newly diagnosed patients, the positive expression rates were 88.5% for MAGE-C1/CT7, 82.1% for MAGE-C2/CT10, 76.9% for MAGE-A3 and 25.6% for SSX-2. The expression levels and the number of co-expressed CT antigens correlated significantly with several clinical indicators, including the percentage of plasma cells infiltrating the bone marrow, abnormal chromosome karyotypes and the clinical course. MAGE-C1/CT7, MAGE-A3, MAGE-C2/CT10 and SSX-2 expression levels provide potentially effective clinical indicators for the auxiliary diagnosis and monitoring of treatment efficacy in MM.
    Molecular Cancer 02/2014; 13(1):25. · 5.13 Impact Factor
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    ABSTRACT: To evaluate the efficacy and optimize the timing of allogeneic hematopoietic stem cell transplantation (allo-HSCT) from human leukocyte antigen (HLA)-identical siblings for myelodysplastic syndrome (MDS). From January 2003 to December 2012, 95 patients with MDS or secondary acute myeloid leukemia (AML) were treated with HLA-identical allo-HSCT in our hospital. The median age was 43 (21-59) years. Conditioning regimens including modified busulfan (Bu)/cyclophosphamide (Cy) or Bu/ fludarabine (Flu) were used. All patients received transfusion of donor stem cells mobilized by granulocyte colony-stimulating factor (G-CSF) from bone marrow and/or peripheral blood. Eleven patients had refractory anemia (RA) or RA with ringed sideroblasts, 53 of RA with excess blasts (RAEB), 15 of RAEB in transformation (RAEB-t), and 16 progressing to secondary AML. A total of 93 patients achieved sustained myeloid engraftment. The cumulative incidence of grade II-IV acute graft versus host disease (aGVHD) was 12.9% ± 3.5%. The 3-year cumulative incidence of chronic graft versus host disease (cGVHD) was 80.3% ± 4.9%. After a median follow-up of 28.7 months, 29 patients died. The 3-year estimated overall survival (OS) and disease-free survival (DFS) rates were 69.9% ± 5.0% and 58.0% ± 5.4% respectively. The cumulative relapse rate (RR) was 25.9% ± 4.7%, while non-relapse mortality (NRM) was 16.1% ± 4.0%. Multivariate analyses showed that non II-IV aGVHD and cGVHD were favorable factors associated with OS. Low DFS rate was correlated with high scores of international prognostic scoring system (IPSS). Patients with RAEB-t and AML (n = 31) were divided into 3 groups: no chemotherapy before HSCT (Group 1), chemotherapy but not achieving remission (Group 2) and chemotherapy and achieving remission (Group 3). The 3-year OS rate was 100.0% in Group 3, which was significantly higher than those of Groups 1 and 2 with 33.9%, 32.7% respectively (P < 0.05). The difference of DFS and RR in the three groups did not reach statistic difference. Allo-HSCT from HLA-identical siblings is effective for patients with MDS. IPSS is of prognostic value for post-transplantation outcome. For patients with progressive disease before transplantation, maximal control of blasts in bone marrow may improve the prognosis of advanced MDS.
    Zhonghua nei ke za zhi [Chinese journal of internal medicine] 02/2014; 53(2):89-93.
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    ABSTRACT: To compare the clinical characteristics and prognosis of acute graft-versus-host disease (aGVHD) between patients undergoing human leukocyte antigen (HLA)-identical and HLA-mismatched allogeneic hematopoietic stem cell transplantation (allo-HSCT). Cinical data of 544 patients receiving related allo-HSCT in Institute of Hematology of Peking University from January 2010 to December 2011 were retrospectively analyzed. The clinical features of aGVHD including manifestations and prognosis between HLA-identical and HLA-mismatched transplantation were compared. The cumulative incidence of aGVHD in related HLA-mismatched transplant was 50.2%, which was significantly higher than that of HLA-identical transplant (20.4%, P < 0.001). However, the cumulative incidence of grade III°-IV° aGVHD between the two groups was comparable (4.5% vs 6.8%, P = 0.066). Gut aGVHD accounted for 31.1% in HLA-identical transplant while cutaneous aGVHD was the dominant area in HLA-mismatched transplant (66.5%). The incidence of gut and liver aGVHD in HLA-mismatched patients was also lower than that in HLA-identical patients. The proportion of patients with aGVHD accompanied by fever was higher in HLA-mismatched patients than in HLA-identical patients (47.6% vs 28.9%, P = 0.028). The cure rate of aGVHD in identical transplant was lower than that in mismatched transplant, especially for grade III°-IV° aGVHD. The complete remission rate after second-line anti-GVHD therapies was lower than that of mismatched transplant (88.9% vs 98.8%, P = 0.006). More patients died of aGVHD in identical transplant compared with mismatched transplant (11.1% vs 2.4%, P = 0.024). More patients who received HLA-mismatched allo-HSCT develop into aGVHD compared with HLA-identical transplant. But the incidence of severe aGVHD between HLA-identical and -mismatched is comparable. The overall cure rate of HLA-mismatched transplant is significantly higher than that of HLA-identical transplant.
    Zhonghua nei ke za zhi [Chinese journal of internal medicine] 01/2014; 53(1):35-9.
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    ABSTRACT: The aim of this study was to develop and investigate the significance of a new multi-factor risk score system to predict the outcome of patients with hematological malignancies received allogeneic hematopoietic stem cell transplantation (allo-HSCT). The impact of pre-, peri-, and post-transplant factors on the outcome including overall survival (OS), disease-free survival (DFS), relapse and transplant-related mortality (TRM) after allo-HSCT were retrospectively analyzed in 122 patients with hematological malignancies at our center. A new risk score system based on the independent risk factors was established and tested. The results showed that absolute monocyte count at day 30 after transplantation (AMC-30, ≥ 536 cells/µl) [hazard ratio (HR) = 0.313, 95% confidencial interval (CI):0.156-0.63], WT1( ≥ 1.0%) (HR = 3.268, 95% CI:1.644-6.499), pre-transplant risk grouping (HR = 1.999, 95% CI = 0.993-4.023) were independent prognostic factors of OS and DFS. Patients were divided into 3 groups based on the risk scoring system:group A (no risk factor; score 0), group B (1 risk factor; score 1) and group C (2-3 risk factors; score 2-3). OS at 5 years were 95.1% ± 3.4%, 62.9% ± 6.6% and 36.1% ± 9.6%, respectively (P < 0.0001). DFS at 5 years were 92.6% ± 4.9%, 60.4% ± 6.8% and 15.4% ± 7.1%, respectively (P < 0.0001). The akaike information criterion(AIC) value of the new score system for OS was 331, less than those of AMC-30, WT1, and pre-transplant risk group (346, 343, 346), AIC value for DFS and relapse were 378 and 231, both less than the three single elements(417, 397, 411 and 268, 238, 257). It is concluded that the risk scoring system based on AMC-30, WT1, pre-transplant risk grouping is more highly predictive for clinical outcomes of allo-HSCT than any one of the three single elements.
    Zhongguo shi yan xue ye xue za zhi / Zhongguo bing li sheng li xue hui = Journal of experimental hematology / Chinese Association of Pathophysiology 01/2014; 22(1):117-24.
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    ABSTRACT: We examined the incidence, risk factors, treatment, and clinical outcomes of extramedullary relapse (EMR) in 961 acute leukemia patients undergoing human leukocyte antigen-haploidentical hematopoietic stem cell transplantation (haplo-HSCT) between 2002 and 2013. Multiple controls were selected at random from the same cohort and matched to EMR cases for diagnosis, disease status at HSCT, age at the time of the HSCT, and year of the HSCT. Forty patients exhibited EMR with a median time to EMR of 207 days. The cumulative incidence of EMR was 4.0% at 3 years, and the incidence was higher in acute lymphoblastic leukemia patients compared to acute myeloid leukemia patients (5.6% vs. 2.4%). In the multivariate analysis, non-complete remission (CR) status at HSCT (hazard ratio [HR]=4.6; P=0.018) and non-chronic graft-versus-host disease after HSCT (HR=3.2; P<0.001) were the independent risk factors for EMR after haplo-HSCT. A total of 27 patients received combination treatments, and the proportion of patients who achieved CR was higher than those who received single treatment. Multifocal involvement at EMR (HR=2.7; P=0.024) and non-CR after EMR treatments (HR=4.6; P<0.001) were the independent risk factors for poor survival rates among EMR patients. We found that graft-versus-leukemia effect may help to prevent EMR after haplo-HSCT.
    Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 01/2014;
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    ABSTRACT: We investigated the clinical characteristics and therapeutic of elderly patients (≥55) with acute lymphoblastic leukemia (ALL). From Jenuary 2000 to July 2012, 45 elderly patients (≥55) were enrolled in the study. Patients assighed into CVDP VDP/VP induction chemotherapy based on organ function. Patients in complete remission (CR) undertake consolidation therapy, maintenance therapy or follow up. The patient who had appropriate donor received allogeneic hematopoietic stem cell transplantation (allo-HSCT). CR, Overall survival (OS), disease free survival (DFS), relapse rate and prognosis factors were analyzed. 45 elderly patients (≥55) about 9.6% in all 470 cases ALL simultaneity, and B-ALL about 88.9%. 27 patients (60%) obtained CR after 1 cycle of induction chemotherapy. 33 patients (73.3%) obtained overall CR. The CR rate significantly decreased in the elderly patients more than 60 years old vs. 55-60 years old patients (86.2% vs. 50%;P=0.009). All 45 patients 2 years OS rate was 33.7%, The median OS was 12 months (95%CI,6.68-17.32). 55-60 years (P=0.014), CR (P=0.002) and consolidation therapy (P=0.001) were independent favorite prognostic factors for OS. CVDP induction chemotherapy (P=0.013) and consolidation (P=0.049) were independent favorite prognostic factors for DFS. The outcomes of elderly patients with ALL were poor, 55-60 years, CVDP induction chemotherapy, CR and consolidation therapy were independent favorite prognostic factors.
    Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 12/2013; 45(6):938-44.
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    ABSTRACT: To evaluate the efficacy and safety of modified busulfan (Bu, 9.6 mg/kg)/fludarabine (Flu) conditioning regimen on malignant hematologic diseases in elderly and/or drug-intolerable patients. We utilized a new reduced intensity conditioning (RIC) containing of new dosage of intravenous Bu (9.6 mg/kg), Flu (150 mg/m(2)), cytarabine and semustine but without antithymocyte globulin (ATG) in 23 aged and/or intolerable patients with malignancies. All 23 patients, with a median age of 49 (8-66) years, received an allogenetic hematopoietic stem cell transplantation with human leukocyte antigen (HLA) identical sibling donors during January 2008 and January 2012. Stem cells were collected from granulocyte colony-stimulation factor (G-CSF) mobilized bone marrow plus G-CSF mobilized peripheral blood(G-PB) in 20 patients, G-PB alone in two, and non-mobilized BM in one. The graft had a median mononuclear cells (MNC) of 7.03 (4.04-9.9)×10(8)/kg and 1.76 (0.31-6.43)×10(6)/kg of CD(+)34 cells. Graft-versus-host disease (GVHD) prophylaxis included cyclosporin A, mycophenolate mofetil and methotrexate. All patients were well tolerated to the regimen without serious drug related toxicity. Transplant related mortality were 0 and 4.3% at day 100 and one year. All patients except one got full donor engraftment and achieved complete remission. Acute GVHD was observed in 6 patients (26.1%) including grade III-IV in 5 patients. Chronic GVHD was reported in 15 of 21 evaluable patients (71.4%). With a median follow-up of 1138 (55-1747) days, 16 of 23 patients were alive and disease-free. Three-year overall survival (OS) and event free survival (EFS) were 79.2% and 69.6%, respectively. Modified Bu/Flu as a new RIC regimen is well tolerated and safe for patients who need allogeneic hematopoietic stem cell transplantation, especially in older patients and/or patients with severe comorbidities.
    Zhonghua nei ke za zhi [Chinese journal of internal medicine] 12/2013; 52(12):1028-32.
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    ABSTRACT: In bone marrow transplant patients, the microenvironment in bone marrow is damaged after chemotherapy or radiotherapy. Subsequent to allogenic hematopoietic stem cell transplantation in patients with clinically successful engraftments, the source of mesenchymal stem cells (MSCs) remains controversial. To further verify the stimulatory effect of the simultaneous transplantation of cells from second donors on engraftment success for hematopoietic stem cell transplantation in support of donor MSCs engraftments, the aim of this study is to monitor the dynamics of the engraftment of bone marrow-derived MSCs in patients after transplantation with mismatched-sex hematopoietic stem and third-party cells. In this study, the hematopoietic stem cells from 32 clinical donors of different sexes that resulted in successful engraftments were selected for transplantation and were classified into three groups for research purposes: group A consisted of 14 cases of transplantation with bone marrow and recruited peripheral hematopoietic stem cell transplantation, group B contained 8 cases of simultaneous re-transfusion of MSCs from the second donor, and group C contained 10 cases of simultaneous re-transfusion of umbilical blood from the second donor. The bone marrow from 32 patients with successful engraftments of hematopoietic transplantation were selected and sub-cultured with MSCs. Flow cytometry (FCM) was used to measure the expression of surface antigens on MSCs. Denaturing high-performance liquid chromatography (DHPLC) in combination with polymerase chain reaction amplification of short tandem repeats (STRPCR) was used to measure the engraftment status of fifth-generation MSCs in patients. Fluorescence in situ hybridization (FISH) revealed the sex origin of the fifth-generation MSCs in 32 patients. Dynamic examinations were performed on patients receiving donor transplantations. The progenies of fifth-generation MSCs were successfully cultured in 32 cases. The results of FCM demonstrated that the expression levels of CD14+ and CD45+ cells were lower than 0.04% in the fifth-generation MSCs. The analysis using DHPLC and FISH showed similar results. One patient from group B also received a temporary transplantation of MSCs from the donor. The MSCs in the remaining 31 patients all originated from the patients themselves. After transplantation, the MSCs present in patients originated from the host. In patients transplanted with MSCs from a second donor, the phenomenon of temporary chimerization of MSCs was observed.
    Chinese medical journal 11/2013; 126(22):4254-9. · 0.90 Impact Factor
  • Leukemia & lymphoma 10/2013; · 2.61 Impact Factor
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    ABSTRACT: This retrospective study compared the transplantation outcomes of 98 consecutive patients with acute leukemia. Allogeneic hematopoietic stem cell transplantation was performed using G-CSF-mobilized bone marrow and blood (G-BM&PB) or G-CSF-mobilized peripheral blood (G-PB) from HLA-identical sibling donors. The G-BM&PB and G-PB groups displayed significantly different neutrophil recovery rates (medians of 15 vs. 14 d, respectively; p = 0.009) but similar platelet recovery rates. The cumulative incidences of grades II-IV acute graft-versus-host disease (aGVHD) in the G-BM&PB and G-PB cohorts were similar (16.2 ± 4.7% vs. 21.8 ± 7.4%, respectively; p = 0.676), but the incidences of grades III-IV aGVHD were significantly different (5.5 ± 3.1% vs. 18.9 ± 7.1%, respectively; p = 0.042). The G-BM&PB and G-PB cohorts displayed similar cumulative incidences of chronic GVHD (cGVHD, 49.1 ± 5.7% vs. 42.7 ± 6.8%, respectively; p = 0.465), one-yr cumulative incidences of treatment-related mortality (16.5 ± 3.5% vs. 24.4 ± 4.1%, respectively; p = 0.220), and five-yr cumulative incidences of relapse (13.9 ± 4.8% vs. 26.8 ± 7.2%, respectively; p = 0.113). The five-yr probability of leukemia-free survival (LFS) was significantly higher in the G-BM&PB group than in the G-PB group (77.8 ± 5.2% vs. 57.6 ± 8.6%, respectively; p = 0.023). Multivariate analysis identified G-PB as an independent risk factor for grades III-IV aGVHD and LFS. Our results suggest that HLA-identical transplantation with G-BM&PB results in superior clinical outcomes compared with G-PB for patients with acute leukemia.
    Clinical Transplantation 09/2013; · 1.63 Impact Factor
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    ABSTRACT: To analyze the prevalence of Epstein Barr Virus (EBV) in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT). We retrospectively analyzed the clinical characteristics of 720 patients received allo-HSCT from January 2010 through December 2011 in the Stem Cell Transplant Center of People's Hospital. Of 720 patients (469 male presented and 251 females), with a median age of 30 years (range, 2 to 67 years) old, 66 patients were presented with EBV reactivation. The cumulative incidence of EBV reactivation was (9.3±1.1)%, with a median days of 54.5 (range, 18 to 253 days). During one- year post-transplantation, the cumulative incidences of EBV reactivation in sibling allo-HSCT, haploidentical HSCT and unrelated donor HSCT were (1.3±0.7)%, (13.7±1.7)%, and (9.1±4.4)%, respectively. In patients with haplo-identical HSCT, the cumulative incidences of EBV viremia, probable EBV disease, and post-transplant lymphoproliferative disease (PTLD) were (5.8±1.1)%, (5.7±1.1)%, and (2.3±0.7)%. The mortality was (33.9±5.9)% in all patients with EBV infection: (63.6±15.8)% in PTLD, (42.3±9.9)% in probable EBV disease, (13.8±6.5)% in EBV viremia. By univariate and multivariate analysis, the use of ATG was an independent risk factor for EBV infection. EBV reactivation is a common complication in patients with allo- HSCT, especially high mortality in PTLD and probable EBV disease. The use of ATG was an independent risk factor for EBV infection.
    Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi 08/2013; 34(8):651-4.
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    ABSTRACT: Chronic graft-versus-host disease (GVHD), the commonest long-term complication after allogeneic hematopoietic stem cell transplantation (HSCT), has a negative impact on patients' health related quality of life (HRQoL). This study was designed to investigate the HRQoL in patients with chronic GVHD in China. Two hundred and sixty-four patients with chronic GVHD who were ≥ 24 months post-HSCT and had been in continuous complete remission since HSCT were enrolled in this retrospective study. HRQoL was evaluated using an SF-36 questionnaire. Multivariate analysis was used to identify the factors that affect HRQoL in patients with chronic GVHD. HRQoL in patients categorized as having mild and moderate chronic GVHD was significantly better than in those in the severe category. In the moderate chronic GVHD category, markedly poorer HRQoL was observed in patients with both multiple organ involvement and more severe organ impairment than in those without these factors. According to multivariate analysis, chronic GVHD severity had the greatest significant negative impact on patients' HRQoL; whereas being female was associated with a negative impact on psychological health. Chronic GVHD severity strongly correlates with negative impacts on patients' HRQoL.
    Chinese medical journal 08/2013; 126(16):3048-52. · 0.90 Impact Factor
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    ABSTRACT: We retrospectively compared the anti-leukemic effects of chemotherapy alone and chemotherapy followed by modified donor lymphocyte infusion (DLI) in 82 patients with relapsed acute leukemia after haploidentical hematopoietic stem cell transplantation (HSCT) without in vitro T-cell depletion. We also investigated prognostic factors in patients receiving chemotherapy followed by modified DLI. Thirty-two patients received chemotherapy alone, and the remaining 50 patients received chemotherapy followed by modified DLI. In patients receiving chemotherapy followed by modified DLI, complete remission rate was significantly higher (64.0% vs. 12.5%, P=0.000), the incidence of relapse was significantly lower (50.0% vs. 100.0%, P=0.000), and disease-free survival was significantly improved (36.0% vs. 0.0%, P=0.000) compared with patients receiving chemotherapy alone. Multivariate analysis demonstrated that patients with chronic graft-versus-host disease (GVHD) after intervention (P=0.000) and patients receiving chemotherapy followed by modified DLI (P=0.037) were associated with a lower relapse rate. Furthermore, in patients receiving chemotherapy followed by modified DLI, multivariate analysis demonstrated that chronic GVHD after modified DLI (P=0.039) and duration of minimal residual disease (MRD) (-) ≥ 4 months after modified DLI (P=0.001) were associated with a lower relapse rate. Our study is the first to suggest that chemotherapy followed by modified DLI is associated with stronger anti-leukemic effects and better survival in relapsed acute leukemia after haploidentical HSCT without in vitro T-cell depletion. Furthermore, our study suggests that lack of chronic GVHD and duration of MRD (-) < 4 months after modified DLI are associated with higher relapse rates in patients receiving chemotherapy followed by modified DLI. This article is protected by copyright. All rights reserved.
    European Journal Of Haematology 07/2013; · 2.55 Impact Factor

Publication Stats

607 Citations
192.65 Total Impact Points

Institutions

  • 2004–2014
    • Peking University People's Hospital
      Peping, Beijing, China
  • 2003–2014
    • Peking University
      • Institute of Hematology
      Peping, Beijing, China
  • 2010–2012
    • Beijing University of Technology
      Peping, Beijing, China
  • 2008
    • Linyi People's Hospital
      Yichow, Shandong Sheng, China