[Comparisons of occurrence and curative effect of interstitial pneumonia after the related HLA-haploidentical and HLA-matched sibling peripheral blood hematopoietic stem cell transplantation]

OBJECTIVE

To compare occurrence and curative effect of interstitial pneumonia (IP) of patients with malignant hematologic disease after related HLA-haploidentical peripheral blood stem cell transplantation without T-cell depletion (RHNT-PBSCT) and non T cell-depleted HLA-matched sibling peripheral blood stem cell transplantation (MSNT-PBSCT).

METHODS

109 patients with malignant hematologic disease as the research cases received RHNT-PBSCT from January 2006 to December 2014, which were compared with 125 patients treated with MSNT-PBSCT during the same period to determine the occurrence of IP and curative effect produced by ganciclovir and joint adrenal glucocorticoids.

RESULTS

The incidences of IP in RHNT-PBSCT and MSNT-PBSCT groups were 15.60%(17/109) and 13.60%(17/125) (P=0.150), respectively; both the effective rates were 76.47%(13/17) (P=0.536), the difference was not statistically significant. Single factor analysis showed that acute graft versus host disease was a risk factor for the occurrence of IP after RHNT-PBSCT (P=0.001).

CONCLUSION

The incidence of IP in patients with malignant hematologic disease after RHNT-PBSCT didn' t increase when compared with patients after MSNT-PBSCT. The curative effects of the two groups were equivalent after priority to ganciclovir and joint adrenal glucocorticoids.

Immunotherapy of malignant disease with tumor antigen-specific monoclonal antibodies

A few tumor antigen (TA)-specific monoclonal antibodies (mAb) have been approved by the Food and Drug Administration for the treatment of several major malignant diseases and are commercially available. Once in the clinic, mAbs have an average success rate of approximately 30% and are well tolerated. These results have changed the face of cancer therapy, bringing us closer to more specific and more effective biological therapy of cancer. The challenge facing tumor immunologists at present is represented by the identification of the mechanism(s) underlying the patients' differential clinical response to mAb-based immunotherapy. This information is expected to lead to the development of criteria to select patients to be treated with mAb-based immunotherapy. In the past, in vitro and in vivo evidence has shown that TA-specific mAbs can mediate their therapeutic effect by inducing tumor cell apoptosis, inhibiting the targeted antigen function, blocking tumor cell signaling, and/or mediating complement- or cell-dependent lysis of tumor cells. More recent evidence suggests that TA-specific mAb can induce TA-specific cytotoxic T-cell responses by enhancing TA uptake by dendritic cells and cross-priming of T cells. In this review, we briefly summarize the TA-specific mAbs that have received Food and Drug Administration approval. Next, we review the potential mechanisms underlying the therapeutic efficacy of TA-specific mAbs with emphasis on the induction of TA-specific cellular immune responses and their potential to contribute to the clinical efficacy of TA-specific mAb-based immunotherapy. Lastly, we discuss the potential negative effect of immune escape mechanisms on the clinical efficacy of TA-specific mAb-based immunotherapy.

Lack of association between HLA antigen DR3 and alpha 1-antitrypsin deficiency in liver transplant recipients

The relationship between alpha 1-antitrypsin deficiency (alpha 1-ATD) and the HLA antigen system was studied in 32 liver transplant recipients. Despite previous reports of an association of HLA antigen DR3 with homozygosity for alpha 1-AT ZZ, no such association was seen in this population of alpha 1-ATD homozygous ZZ patients with advanced hepatic disease. Thus, the reported association of HLA class II antigens and homozygosity for the Z allele for alpha 1-AT may be an artifact of either a small study population or geographic inbreeding and a coincidental association of certain HLA antigens with the presence of homozygosity for the Z allele of alpha 1-AT.