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  • Liang, Xinquan  (2)
  • Medizin  (2)
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  • Medizin  (2)
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  • 1
    In: Blood, American Society of Hematology, Vol. 138, No. Supplement 1 ( 2021-11-05), p. 1793-1793
    Kurzfassung: Background: Intestinal herpesvirus disease remains one of the major causes of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). There is lack of useful methods for etiological diagnosis of intestinal herpesvirus diseases. Here, we evaluated the efficiency of detecting herpesvirus in feces samples via real-time quantitative PCR (RQ-PCR) for diagnosis of intestinal herpesvirus diseases after allo-HSCT. Methods: This was a multicenter, prospective study. Patients with refractory diarrhea after intestinal graft-versus-host diseases (GVHD) were enrolled in this study. Laboratory tests which consisted of morphologic examination, immunohistochemistry, in situ hybridization, and RQ-PCR of tissue homogenate were used to detect viral pathogens including cytomegalovirus (CMV), epstein-Barr virus (EBV), herpes simplex virus (HSV)-I, HSV-II, varicella zoster virus (VZV), adenovirus (ADV) and human herpes virus (HHV)-6, HHV-7. These viruses aforementioned were also detected in feces and blood samples. Results: One hundred and seven patients with refractory diarrhea after intestinal GVHD were enrolled between January 2016 and December 2020. Based on the detection of viruses in biopsy specimens, 75 patients were diagnosed as intestinal infectious diseases including 64 accompanying with intestinal GVHD. CMV was the most frequent pathogen of intestinal infectious diseases (53.8%), followed by EBV (36.5%), bacteria (3.4%) and others (6.3%). For diagnosis of intestinal CMV diseases, the sensitivity and specificity of RQ-PCR in feces samples were better than those of blood (sensitivity: 96.9% v.s. 72.5%, p=0.004; specificity: 93.6% v.s. 75.8%, p=0.035). Similarly, the sensitivity of RQ-PCR in feces and blood samples were 88.2% and 21.9% (p & lt;0.001) and the specificity were 98.5% and 86.3% (p=0.032) for diagnosis of intestinal EBV diseases. Conclusion: Intestinal infectious diseases were one of the main causes of refractory diarrhea after intestinal GVHD. Herpesviruses, especially CMV and EBV, were the most common pathogens. Herpesvirus-DNA detection by RQ-PCR in feces samples was a useful diagnostic method for intestinal herpesviruses diseases. Disclosures No relevant conflicts of interest to declare.
    Materialart: Online-Ressource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: American Society of Hematology
    Publikationsdatum: 2021
    ZDB Id: 1468538-3
    ZDB Id: 80069-7
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 2 ( 2023-01-10), p. 343-353
    Kurzfassung: It remains controversial whether busulfan-based versus total body irradiation (TBI)–based regimens have comparable outcomes in patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem-cell transplantation (allo-HSCT). We investigated the efficacy and toxicity of busulfan plus cyclophosphamide (BuCy) and TBI plus cyclophosphamide (TBI-Cy) conditioning in allo-HSCT for adult standard-risk B-cell-ALL in first complete remission (CR1). PATIENTS AND METHODS We performed an open-label, randomized phase III trial at 13 hospitals in China. Eligible patients (age 14-65 years) had standard-risk ALL in CR1. Patients were randomly assigned (1:1) to BuCy (0.8 mg/kg four times per day on days –7 to –4 and cyclophosphamide 60 mg/kg once daily on days –3 to –2) or TBI-Cy (4.5 Gy TBI on days –5 to –4 and cyclophosphamide 60 mg/kg once daily on days –3 to –2). The primary end point was 2-year overall survival. Analysis was per protocol. This trial is registered with ClinicalTrials.gov (identifier: NCT02670252 ) and is complete. RESULTS Between January 2016 and February 2020, 275 patients were assigned to receive BuCy (273 assessed) and 275 to TBI-Cy (272 assessed). The 2-year overall survival was 76.6% (95% CI, 71.7 to 81.8) and 79.4% (74.7 to 84.4; P = .457; difference 2.9%; 95% CI, –4.1 to 9.8; P = .022), indicating noninferiority of BuCy. The 2-year relapse was 20.2% (95% CI, 15.6 to 25.1) and 18.4% (14.0 to 23.2; P = .616), and the nonrelapse mortality was 11.0% (95% CI, 7.6 to 15.0) and 11.0% (7.7 to 15.1; P = .988) in the BuCy and TBI-Cy groups, respectively. There were no differences in regimen-related toxicity, graft-versus-host disease, or late effects between the two groups. CONCLUSION The BuCy regimen has noninferior efficiency and safety as TBI-Cy (4.5 Gy × 2) for patients with adult standard-risk B cell-ALL in CR1 undergoing HLA-matched allo-HSCT.
    Materialart: Online-Ressource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Sprache: Englisch
    Verlag: American Society of Clinical Oncology (ASCO)
    Publikationsdatum: 2023
    ZDB Id: 2005181-5
    Standort Signatur Einschränkungen Verfügbarkeit
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