Search PubMed⌕ Search

Biomedical subjects

Jianmin Wang

Publications and source records attributed to Jianmin Wang.

At least 37 records · Page 2Linked to original sources
PubMed2005

The identification and optimization of a N-hydroxy urea series of flap endonuclease 1 inhibitors.

Flap endonuclease-1 (FEN1) is a key enzyme involved in base excision repair (BER), a primary pathway utilized by mammalian cells to repair DNA damage. Sensitization to DNA damaging agents is a potential method for the improvement of the therapeutic window of traditional chemotherapeutics. In this paper, we describe the identification and SAR of a series of low nanomolar FEN1 inhibitors. Over 1000-fold specificity was achieved against a related endonuclease, xeroderma pigmentosum G (XPG). Two compounds from this series significantly potentiate the action of methyl methanesulfonate (MMS) and temozolamide in a bladder cancer cell line (T24). To our knowledge, these are the most potent endonuclease inhibitors reported to date.

Cell Line, Tumor↗
PubMed2005

Convergence behavior of iterative SENSE reconstruction with non-Cartesian trajectories.

In non-Cartesian SENSE reconstruction based on the conjugate gradient (CG) iteration method, the iteration very often exhibits a "semi-convergence" behavior, which can be characterized as initial convergence toward the exact solution and later divergence. This phenomenon causes difficulties in automatic implementation of this reconstruction strategy. In this study, the convergence behavior of the iterative SENSE reconstruction is analyzed based on the mathematical principle of the CG method. It is revealed that the semi-convergence behavior is caused by the ill-conditioning of the underlying generalized encoding matrix (GEM) and the intrinsic regularization effect of CG iteration. From the perspective of regularization, each iteration vector is a regularized solution and the number of iterations plays the role of the regularization parameter. Therefore, the iteration count controls the compromise between the SNR and the residual aliasing artifact. Based on this theory, suggestions with respect to the stopping rule for well-behaved reconstructions are provided. Simulated radial imaging and in vivo spiral imaging are performed to demonstrate the theoretical analysis on the semi-convergence phenomenon and the stopping criterion. The dependence of convergence behavior on the undersampling rate and the noise level in samples is also qualitatively investigated.

Algorithms↗
PubMed2005

Rethinking the use of radiation and chemotherapy after radical hysterectomy: a clinical-pathologic analysis of a Gynecologic Oncology Group/Southwest Oncology Group/Radiation Therapy Oncology Group trial.

OBJECTIVE: To retrospectively analyze data from a previously reported randomized trial of either pelvic radiation (RT) or RT + chemotherapy (CT) in patients undergoing radical hysterectomy and pelvic lymphadenectomy with positive pelvic lymph nodes, parametrial involvement, or surgical margins; to explore associations between RT + CT; and to investigate histopathologic and clinical factors which might be predictive of recurrence. METHODS: Histopathologic sections from biopsies and hysterectomies and clinical data were reviewed from patients with stage IA2, IB, or IIA cervical cancer treated with RT or RT + CT (cisplatin 70 mg/m2 plus fluorouracil 1000 mg/m2 every 3 weeks for four cycles). A univariate analysis was performed because the relatively small sample size limited the interpretation of a multivariate analysis. RESULTS: Of the 268 enrolled women, 243 (RT = 116; RT + CT = 127) were evaluable. The beneficial effect of adjuvant CT was not strongly associated with patient age, histological type, or tumor grade. The prognostic significance of histological type, tumor size, number of positive nodes, and parametrial extension in the RT group was less apparent when CT was added. The absolute improvement in 5-year survival for adjuvant CT in patients with tumors < or =2 cm was only 5% (77% versus 82%), while for those with tumors >2 cm it was 19% (58% versus 77%). Similarly, the absolute 5-year survival benefit was less evident among patients with one nodal metastasis (79% versus 83%) than when at least two nodes were positive (55% versus 75%). CONCLUSIONS: In this exploratory, hypothesis-generating analysis, adding CT to RT after radical hysterectomy, appears to provide a smaller absolute benefit when only one node is positive or when the tumor size is < 2 cm. Further study of the role of CT after radical hysterectomy in patients with a low risk of recurrence may be warranted.

Adenocarcinoma↗
PubMed2005

Validation of referral guidelines for women with pelvic masses.

OBJECTIVE: Guidelines for referring women with pelvic masses suspicious for ovarian cancers to gynecologic oncologists have been published jointly by Society of Gynecologic Oncologists (SGO) and the American College of Obstetricians and Gynecologists (ACOG). They are based on patient age, CA 125 level, physical findings, imaging study results, and family history. Although the guidelines are evidence-based, their predictive value in distinguishing cancers from benign masses is unknown. METHODS: Chart review for factors included in the guidelines of surgically evaluated women with pelvic masses at 7 tertiary care centers during a 12-month interval was performed. This information was used to estimate the predictive values of the SGO and ACOG guidelines in identifying patients with malignant pelvic masses. RESULTS: A total of 1,035 patients were identified, including 318 (30.7%) with primary malignancies of the ovary, fallopian tube, or peritoneum. Seventy-seven were younger than 50 years old (premenopausal group), and 240 were 50 years old or older (postmenopausal group). Fifty additional patients (4.8%) had cancers metastatic to the ovaries, and the remaining 667 (64.4%) had benign masses. The referral guidelines captured 70% of the ovarian cancers in the premenopausal group and 94% of the ovarian cancers in the postmenopausal group. The positive predictive value was 33.8% for the premenopausal group and 59.5% for the postmenopausal group, whereas the negative predictive values were more than 90% for both groups. Elevated CA 125 level was the single best predictor of malignancy in both groups. CONCLUSION: The SGO and ACOG referral guidelines effectively separate women with pelvic masses into 2 risk categories for malignancy. This distinction permits a rational approach for referring high-risk patients to a gynecologic oncologist for management.

Adolescent↗
PubMed2005

Interleukin-6 polymorphism is associated with more aggressive prostate cancer.

PURPOSE: : Interleukin-6 (IL-6) has an important role during prostate cancer progression and IL-6 levels in the serum of patients with hormone refractory and metastatic prostate cancer are significantly increased compared with those in patients with hormone sensitive and localized prostate cancer. The G>C polymorphism at position -174 in the promoter of the IL-6 gene has been associated with differences in IL-6 transcription in vitro and IL-6 protein levels in vivo. We determined the association of IL-6 polymorphism with prostate cancer progression. MATERIALS AND METHODS: : We examined the association of IL-6 polymorphism with the risk of advanced disease in 95 patients with different stages of prostate cancer using the tetra-primer polymerase chain reaction genotyping method. RESULTS: : We found that the -174G>C genotype of IL-6 gene was associated with an overall increased risk of advanced prostate cancer. A strong association between this genotype and Gleason score was observed at the -174G>C locus of the IL-6 gene (p <0.001). The distribution of this genotype was also significantly different between stages T3-T4 and T1-T2 tumors (p <0.001). In addition, the IL-6 genotype was linked with vascular invasion (p = 0.024), seminal vesicle involvement (p = 0.006) and capsular invasion (p <0.001). Furthermore, the -174G>C genotype of the IL-6 gene was significantly associated with increased serum prostate specific antigen (p = 0.004) and with recurrent prostate cancer compared with GG homozygotes (p = 0.027). CONCLUSIONS: : These data demonstrate a strong association of the -174G>C polymorphism of the IL-6 gene with the aggressiveness and recurrence of prostate cancer, suggesting that genetic predisposition of genetic differences in the human IL-6 gene could be linked to the risk of recurrent prostate cancer.

Adipose Tissue↗
PubMed2005

Progression of mild cognitive impairment to Alzheimer's or vascular dementia versus normative aging among elderly Chinese.

To compare differences in evolutionary progressions from Mild Cognitive Impairment (MCI) to dementia of Alzheimer's type (DAT) or to vascular dementia (VaD) versus normal aging, subjects identified as MCI or as cognitively normal (CN) during standard cognitive evaluations among a large epidemiological study designed to determine prevalence and incidence of dementia and its major subtypes in Beijing, China were re-examined after an interval of approximately 3 years, repeating the same investigation protocol as at baseline. MCI subjects meeting criteria for dementia and the two major subtypes, DAT and VaD were identified at follow-up evaluation. Annual conversion rates for combined dementias and for major subtypes of DAT and VaD, from MCI, were compared with conversion rates among CN subjects. Relative risks for conversion from MCI to major subtypes of dementia were also compared with CN subjects by Cox regression models. 175 MCI and 400 CN subjects were identified at baseline. Among 121 MCI subjects available at follow-up, 51 were diagnosed with dementia (29 with DAT, 18 with VaD and 4 with other dementias), compared with 14(10 DAT, 3 VaD and 1 other type dementia) diagnosed as dementia among 281 CN subjects available at follow-up. Annual conversion rates calculated from MCI to all dementias, compared with conversion rates from CNs, were 14.1% versus 1.6%. Specifically for DAT, annual conversion rates were 8.0% versus 1.1% and for VaD were 5.0% versus 0.3%. Relative risks for developing all dementias, DAT and VaD among MCI subjects were 9, 6 and 5 times greater than among CN subjects. Conversion rates among MCI subjects to dementia, and major subtypes, for elderly Chinese residents of Beijing were comparable with results reported among similar studies worldwide. Risks of developing dementia, and major subtypes, among MCI subjects in Beijing were significantly higher than among normal subjects. Identification of MCI among elderly populations provides the possibilities for dementia prevention and treatment within prodromal stages.

Age Distribution↗
PubMed2004

Characterizing the metal adsorption capability of a class F coal fly ash.

The surface physical-chemical characteristics of a class F coal fly ash were studied in an effort to establish a quantitative understanding of metal adsorption. The ash surface acidity (acid site density and acidity constant), surface electrical characteristics, and adsorption constants for selected heavy metal ions were determined using a batch titration method, an electrophoretic method, and a batch equilibrium metal adsorption method, respectively. Results showed that the fly ash has a pHzpc value of 6.2. Its surface contains three types of acid sites. The densities of these acid sites are 2.1 x 10(-4), 1.8 x 10(-5), and 5.3 x 10(-5) mol/g, with acidity constants (pK(H)) of 2.7, 7.8, and 11.0, respectively. Metal adsorption results indicated that, of the three types of acid sites on surface, only the acid site with 7.8 pK(H) is responsible for metal adsorption. The adsorption constants (log K(S)) of Cd(II), Cr(III), Cu(II), Ni(II), and Pb(II) are 4.8, 7.0, 6.4, 4.9, and 8.6, respectively. Adsorption results indicated that the metal adsorption is in the linear range of the Langmuir isotherm if the total metal in the system is less than 10% of the total metal binding site. Results also showed that the presence of anionic metal ions does not affect the adsorption of cationic metal ions by the fly ash.

Adsorption↗
PubMed2004

SAR and factor IXa crystal structure of a dual inhibitor of factors IXa and Xa.

Modifications to the P4 moiety and pyrazole C3 substituent of factor Xa inhibitor SN-429 provided several new compounds, which are 5-10nM inhibitors of factor IXa. An X-ray crystal structure of one example complexed to factor IXa shows that these compounds adopt a similar binding mode to that previously observed with pyrazole inhibitors in the factor Xa active site both with regard to how the inhibitor binds and the position of Tyr99.

Benzimidazoles↗
PubMed2004

Association between serum levels of soluble tumor necrosis factor receptors/CA 125 and disease progression in patients with epithelial ovarian malignancy: a gynecologic oncology group study.

BACKGROUND: A prospective study was undertaken within the Gynecologic Oncology Group to determine whether serum levels of soluble tumor necrosis factor receptors I (sTNFR-I) and II (sTNFR-II), alone or in combination with CA 125, were associated with clinicopathologic characteristics or outcome in patients with epithelial ovarian malignancies. METHODS: Quantitative immunoassays were performed on valid pretreatment serum specimens obtained from patients with epithelial ovarian malignancies to assess levels of sTNFR-I, sTNFR-II, and CA 125. The authors then analyzed the results of these immunoassays for potential correlations with clinicopathologic characteristics and outcome. RESULTS: The median age of the 139 women evaluated was 59 years. Seventy-eight percent had Stage III or IV disease, and 58% had serous carcinomas. sTNFR-II was associated with age (P = 0.013), and CA 125 was associated with histologic subtype (P = 0.0009). In addition, sTNFR-I (P = 0.037) and CA 125 (P < 0.0001) were associated with extent of disease. After adjusting for patient age, histologic subtype, and extent of disease, all three biomarkers were predictive of progression-free survival, but not overall survival, when the combination was included in the model. The authors observed a 51% reduction (hazard ratio [HR], 0.49; 95% confidence interval [CI], 0.24-0.99), a 2.9-fold increase (HR, 2.87; 95% CI, 1.15-7.20), and a 22% increase (HR, 1.22; 95% CI, 0.99-1.51) in the risk of progression for each unit increase in the log-transformed levels of sTNFR-I, sTNFR-II, and CA 125, respectively. CONCLUSIONS: The observations made in the current study-that among patients with low or high CA 125 levels, those with high sTNFR-I levels and low sTNFR-II levels had the lowest risk, that patients with low-low or high-high sTNFR-I and sTNFR-II levels, respectively, had an intermediate risk, and that patients with low sTNFR-I levels and high sTNFR-II levels had the highest risk of progression-suggested the potential value of simultaneous assessment of all three biomarkers in patients with epithelial ovarian malignancies.

Aged↗
PubMed2004

Field-of-view limitations in parallel imaging.

Parallel imaging is one of the most promising developments in recent years for the acceleration of MR acquisitions. One area of practical importance where different parallel imaging methods perform differently is the manner in which they deal with aliasing in the full-FOV reconstructed image. It has been reported that sensitivity encoding (SENSE) reconstruction fails whenever the reconstructed FOV is smaller than the object being imaged. On the other hand, generalized autocalibrating partially parallel acquisition (GRAPPA) has been used successfully to reconstruct images with aliasing in the reconstructed FOV, as in conventional imaging. The disparate behavior of these methods can be easily demonstrated by a few simple illustrative examples. Additional in vivo examples using GRAPPA and modified SENSE (mSENSE) make this distinction clear. These experiments demonstrate that SENSE fails to reconstruct correct images when coil sensitivity maps are used that do not automatically account for the object size and therefore the aliasing in the reconstructed images. However, with the use of aliased high-resolution coil sensitivity maps, accurate SENSE reconstructions can be generated. On the other hand, GRAPPA produces images with an aliasing appearance that is exactly as would be expected from normal nonaccelerated acquisitions. An understanding of these effects could potentially lead to fewer operator-dependent errors, as well as a better understanding of the differences between the underlying reconstruction processes.

Computer Simulation↗
PubMed2004

Altered E-cadherin and epidermal growth factor receptor expressions are associated with patient survival in lung cancer: a study utilizing high-density tissue microarray and immunohistochemistry.

E-cadherin (E-cad) and epidermal growth factor receptor (EGFR) are important cell adhesion and signaling pathway mediators. This study aimed to assess their expression in lung adenocarcinoma (AdC) and squamous cell carcinoma (SCC) and their association with clinicopathologic variables. In all, 130 resectable lung cancers (stages I-IIIA) were studied using a high-density tissue microarray. Two to three cores from each case were arrayed into three blocks using a Beecher system. Immunohistochemistry was performed using an avidin-biotin complex method and monoclonal antibodies against E-cad and EGFR. Unequivocal membrane staining in >10% of tumor cells was considered as a positive expression of E-cad and EGFR. Markers expression and coexpression were analyzed against clinicopathologic variables (age, gender, smoking status, performance status, weight loss, histology, grade, stage, and lymph node involvement) and patient survival. There were 118, 126, and 115 cases that were fully assessable for E-cad, EGFR, and both markers, respectively. For E-cad, 65 cases (55%) were positive (+), 53 (45%) were negative (-); 23 cases of the negative group had only cytoplasmic staining. For EGRF, 43 cases (34%) were (+), and 83 (66%) were (-). There was no significant association between E-cad or EGFR, and any of the clinicopathologic variables except for an association between EGFR(+) and SCC histologic type. Both negative and cytoplasmic staining of E-cad correlated with shorter patient survival with P=0.008 and 0.002, respectively. EGFR expression did not correlate with patient survival; however, patients with E-cad(-)/EGFR(+) phenotype had poorer survival than those with E-cad(+)/EGFR(-) (P=0.026). Our study suggests that lung AdC and SCC may be stratified based on expression of E-cad and EGFR with the E-cad(-)/EGFR(+) expression having a worse disease outcome. Moreover, the cytoplasmic expression of E-cad may represent an altered localization of this protein in association with tumorigenicity.

Adenocarcinoma↗
PubMed2003

Modeling heavy metal uptake by sludge particulates in the presence of dissolved organic matter.

The uptake of the seven heavy metal ions Cd(II), Co(II), Cr(III), Cu(II), Ni(II), Pb(II), and Zn(II) by sludge particulates in single-metal systems was investigated. Results showed that under acidic and neutral pH conditions, the uptake of all heavy metals by sludge particulates increases with the increase of pH. However, in the alkaline pH region, the uptake of Cu(II), Ni(II), and Co(II) decreases with the increase of pH, primarily due to the high dissolved organic matter (DOM) concentration in high pH conditions. Based on chemical reactions among heavy metal, sludge solids, and DOM, a mathematical model describing metal uptake as functions of DOM and pH was developed. The stability constants of metal-sludge and metal-DOM complexes can be determined using this model in conjunction with experimental metal uptake data. Results showed that, for the secondary sludge sample collected from Baltimore Back River Wastewater Treatment plant on March 1997, the stability constants of Cu(II)-sludge complex (log K(S)) and Cu(II)-DOM complex (log K(L)) are 5.3+/-0.2 and 4.7+/-0.3, respectively; for Ni(II), they are 4.0+/-0.2 and 3.9+/-0.2, respectively. Results also showed that under neutral and low pH conditions (pH<8), the DOM effects on metal uptake for all heavy metals are insignificant. Therefore, the DOM term in the model can be ignored. Results showed that, for the secondary sludge sample collected from Baltimore Back River Wastewater Treatment plant on December 1996, the estimated log K(S) values of metal-sludge complexes for Cd(II), Co(II), Cr(III), Cu(II), Ni(II), Pb(II), and Zn(II) are, respectively, 3.6+/-0.2, 3.0+/-0.1, 5.5+/-0.1, 4.8+/-0.1, 3.1+/-0.1, 5.1+/-0.1, and 4.4+/-0.3.

Hydrogen-Ion Concentration↗
PubMed2003

Interactions of silver with wastewater constituents.

The interactions of silver ion with wastewater constituents including chloride, sludge particulates, and dissolved organic matter (DOM) were investigated using fresh and processed sludge samples from various municipal wastewater treatment plants. Fresh sludge samples were used to examine the silver removal characteristics in the presence of chloride. Processed sludge samples that were subjected to a deionized-water washing procedure to remove the chloride ion were used to examine the interactions among Ag(I), sludge solids, and DOM. Results showed that, under field conditions, most of the silver can be removed through precipitation with chloride and adsorption by sludge particulates. Results obtained using washed sludge samples showed that Ag(I) adsorption by sludge particulates increases with the increase of pH in the acidic pH range, but decreases with the increase of pH in the alkaline pH range. Since the DOM concentration increases significantly with the increase of pH in the alkaline pH region, it can be concluded that the formation of Ag(I)-DOM complexes reduces the Ag(I) adsorption by sludge. Fitting of the Langmuir isotherm to the adsorption data indicated that adsorption constants have a slight increase with the increase of pH in the acidic pH range, but decrease significantly with the increase of pH in the alkaline pH range. The decrease of the Ag(I) adsorption constants in the alkaline pH range can be attributed to the formation of Ag(I)-DOM complexes which weaken the Ag(I) binding strength by sludge surface sites. The fitted isotherms also showed that the Ag(I) adsorption capacity increases with the increase of pH in the entire pH range.

Adsorption↗
PubMed2003

HER-2/neu protein expression and gene alteration in stage I-IIIA non-small-cell lung cancer: a study of 140 cases using a combination of high throughput tissue microarray, immunohistochemistry, and fluorescent in situ hybridization.

Regarding HER-2/neu expression (gene or protein level) in lung cancer, several studies with inconsistent results have been recently reported, partially due to variable techniques used and/or heterogeneous populations examined. The objective of this study was to examine HER-2/neu expression in a well-defined cohort of non-small-cell lung cancers (NSCLC) and in nonneoplastic lung tissue utilizing a combination of high-density tissue microarray, immunohistochemistry (IHC), and fluorescent in situ hybridization (FISH) under uniform test conditions. One hundred forty stage I-IIIA primary NSCLCs and 38 non-neoplastic lung samples were examined. IHC, using an FDA-approved Hercept monoclonal antibody kit, was performed and HER-2/neu gene alteration was assessed by FISH. The association of expression of HER-2/neu with clinicopathologic parameters was analyzed. Ninety-four percent of tumor samples (131/140) were fully interpretable after tissue processing. Twenty-five of them (19%) overexpressed (2+, 3+) HER-2/neu, while 106 (81%) had no or weak expression. All thirty-four interpretable non-neoplastic lung samples were negative for HER-2/neu alteration at protein and gene level. HER-2/neu protein overexpression correlated well with HER-2/neu gene amplification (r =.83, P < 0.001). HER-2/neu overexpression was significantly associated with histologic subtype: 19 adenocarcinomas (19/82, 23%) versus 4 squamous cell carcinomas (4/44, 9%) overexpressed Her-2/neu (P = 0.04). Statistical significance was observed between HER-2/neu expression and tumor differentiation, with strong positive (3+) expression observed more frequently in poorly differentiated tumors (P = 0.01). Patients with HER-2/neu abnormalities, particularly HER-2/neu gene amplification, exhibited a shorter survival (P = 0.043). The statistically significant difference (P < 0.005) between HER-2/neu alteration in tumor samples(25/131, 19%) and in the nonneoplastic tissue (0/34, 0%) implies that HER-2/neu may have a role in the carcinogenesis of NSCLC. The findings provide evidence supporting the hypothesis that the HER-2/neu receptor may represent a useful molecular target in the treatment of NSCLC. The significant association of HER-2/neu expression and gene amplification with poorly differentiated carcinoma compared with well differentiated carcinoma suggests that HER-2/neu may be involved in NSCLC tumor evolution. Patients with HER-2/neu gene amplification and strong positive expression of HER-2/neu protein showed a strong tendency toward shorter survival.

Adult↗
PubMed2003

PCAP: a whole-genome assembly program.

We describe a whole-genome assembly program named PCAP for processing tens of millions of reads. The PCAP program has several features to address efficiency and accuracy issues in assembly. Multiple processors are used to perform most time-consuming computations in assembly. A more sensitive method is used to avoid missing overlaps caused by sequencing errors. Repetitive regions of reads are detected on the basis of many overlaps with other reads, instead of many shorter word matches with other reads. Contaminated end regions of reads are identified and removed. Generation of a consensus sequence for a contig is based on an alignment of reads in the contig, in which both base quality values and coverage information are used to determine every consensus base. The PCAP program was tested on a mouse whole-genome data set of 30 million reads and a human Chromosome 20 data set of 1.7 million reads. The program is freely available for academic use.

Algorithms↗
PubMed2003

Roles of interleukin-10 in acute graft-versus-host disease and graft rejection.

OBJECTIVE: To study the role of interleukin (IL)-10 in acute-graft-versus-host disease (aGVHD) and graft rejection. METHODS: Serum concentrations of IL-10 in 28 patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) were measured by enzymed-linked immunosorbent assay (ELISA). IL-10 gene expression in peripheral mononuclear cells was measured by reverse-transcriptase polymerase chain reaction (RT-PCR) after transplantation. RESULTS: Seven patients developed grade I GVHD, 7 patients developed grade II-IV GVHD, 4 patients had graft rejection. Before transplantation, the concentrations of IL-10 were higher in patients who later did not developed aGVHD. After transplantation, IL-10 levels increased in patients without aGVHD, but decreased in patients with aGVHD or graft rejection. And IL-10mRNA was more frequent in patients without aGVHD compared to those with aGVHD. CONCLUSIONS: IL-10 plays a negative role in the development of aGVHD and graft rejection.

Acute Disease↗
PubMed2002

[Combination of mycophenolate mofetil with cyclosporine A and methotrexate for the prophylaxes of acute graft versus host disease in allogeneic peripheral stem cell transplantation].

OBJECTIVE: To evaluate the efficacy of combination of mycophenolate mofetil (MMF) with cyclosporine (CsA) and methotrexate (MTX) on prophylaxes of acute graft-versus-host disease (GVHD) in HLA-matched allogeneic peripheral blood stem cell transplantation (allo-PBSCT). METHODS: Thirty-nine patients with acute leukemia (n = 21) and chronic myeloid leukemia (n = 17) and severe aplastic anemia (n = 1) were treated with allo-PBSCT from HLA matched siblings (n = 36) or unrelated donors (n = 3). Twenty-six patients were in CsA + MTX group. CsA was given at a dosage of 2 mg.kg(-1).d(-1) by continuous intravenous injection for 24 h, since on day(-1) and injection of CsA was changed to oral administration of CsA around day 18. CsA was tapered by 10% per week after day + 90. MTX was given at the dosage of 15 mg at day + 1, and 10 mg at day + 3, + 6 and + 11, respectively. Thirteen patients were included in MMF + CsA + MTX group with the same dosage of CsA and MTX as above but omitted at day + 11. MMF of 2 g/day was added orally from day + 1 to day + 28 post transplantation. RESULTS: All patients in both groups were successfully engrafted. The days of recovery of neutrophils and platelets were not significantly different between two groups (P > 0.05). The incidence of acute GVHD in MMF + CsA + MTX group (7.6%) was significantly lower than that in CsA/MTX group (46.2%, P < 0.05). Incidence of grade II approximately IV GVHD in MMF group was 0 while that in control group was 23.0%. The incidence of severe mucositis was lower in MMF group (15.4%) than in the control group (30.8%) (P < 0.05). CONCLUSION: The regimen of MMF + CsA + MTX for prevention of acute GVHD in allo-PBSCT is more efficient than that of CsA + MTX, without adversely affecting the engraftment and relapse rate.

Acute Disease↗