• Clinical and Experimental Pediatrics
• /
• v.50 no.7
• /
• pp.613-621
• /
• 2007

Hematopoietic stem cell transplantation (HSCT) has expanded and evolved substantially in the last decades to treat various malignant and nonmalignant diseases. However, the conditioning regimen can lead to transplantation related death by major organ dysfunction, severe infection and bleeding. In the allogeneic setting, graft versus host disease may also develop, making post-transplant management complex. To overcome these problems, new stem cell sources, stem cell mobilizing agents and new skills, nonmyeloablative stem cell transplantation including reduced intensity stem cell transplantation has been introduced in clinical practice, but problems remained so far. Recipients of stem cell transplant may be severely immunocompromised for many months after transplantation. Furthermore, long-term complications (endocrine, metabolic, relapse, second malignancies, etc) can develop. Pediatrician is open called on to participate in the evaluation and consideration of patients for possible transplant and long-term follow-up of HSCT patients. This review is intended as a basic overview of HSCT relevant to general pediatrician.

• Clinical and Experimental Pediatrics
• /
• v.57 no.12
• /
• pp.514-519
• /
• 2014

Hemorrhagic cystitis is a common stem cell transplantation-related complication. The incidence of early-onset hemorrhagic cystitis, which is related to the pretransplant conditioning regimen, has decreased with the concomitant use of mesna and hyperhydration. However, late-onset hemorrhagic cystitis, which is usually caused by the BK virus, continues to develop. Although the BK virus is the most common pathogenic microorganism of poststem cell transplantation late-onset hemorrhagic cystitis, pediatricians outside the hemato-oncology and nephrology specialties tend to be unfamiliar with hemorrhagic cystitis and the BK virus. Moreover, no standard guidelines for the early diagnosis and treatment of BK virus-associated hemorrhagic cystitis after stem cell transplantation have been established. Here, we briefly introduce poststem cell transplantation BK virus-associated hemorrhagic cystitis.

• Journal of the Korean Dietetic Association
• /
• v.15 no.2
• /
• pp.168-178
• /
• 2009

Hematopoietic stem cell tranntation is being widely used in an attempt to treat many hematological diseases such as leukemia, anemia, and lymphoma. To evaluate the success of hematopoietic stem cell transplantation, it is very important to determine how rapidly engraftment occurs. Therefore, this retrospective study was conducted to determine which factors affected the term of engraftment during hematopoietic stem cell transplantation, while focusing on the oral intake status. To accomplish this, 416 patients who underwent transplant operations at St. Mary's hospital from May 2006 to April 2008 were evaluated. The long-term engraftment group was characterized as having longer fasting days and more frequent vomiting, diarrhea, and oral mucositis incidences than the short-term engraftment group. In addition, the inhibitors of oral intake such as vomiting, diarrhea, and oral mucositis developed frequently between the pre-transplantation and 2 weeks after transplantation. A significantly negative correlation was observed between the oral intake volume and the duration of the oral intake inhibitors. A multiple regression analysis revealed that the frequency of vomiting and oral mucositis during hematopoietic stem cell transplantation, the length of hospitalization, and the hematocrit level in the 2 weeks after hematopoietic stem cell transplantation were significant predictors of engraftment. The results of this study could be used to establish a guideline for nutritional assessment, nutritional goals, and nutritional support for patients during hematopoietic stem cell transplantation.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.3
• /
• pp.1553-1564
• /
• 2016

Identification of novel therapeutics in glioblastoma remains crucial due to the devastating and infiltrative capacity of this malignancy. The current study was aimed to appraise effect of arsenic trioxide (ATO) in U87MG cells. The results demonstrated that ATO induced apoptosis and impeded proliferation of U87MG cells in a dose-dependent manner and also inhibited classical NF-${\kappa}B$ signaling pathway. ATO further upregulated expression of Bax as an important proapoptotic target of NF-${\kappa}B$ and also inhibited mRNA expression of survivin, c-Myc and hTERT and suppressed telomerase activity. Moreover, ATO significantly increased adhesion of U87MG cells and also diminished transcription of NF-${\kappa}B$ down-stream targets involved in cell migration and invasion, including cathepsin B, uPA, MMP-2, MMP-9 and MMP-14 and suppressed proteolytic activity of cathepsin B, MMP-2 and MMP-9, demonstrating a possible mechanism of ATO effect on a well-known signaling in glioblastoma dissemination. Taken together, here we suggest that ATO inhibits survival and invasion of U87MG cells possibly through NF-${\kappa}B$-mediated inhibition of survivin and telomerase activity and NF-${\kappa}B$-dependent suppression of cathepsin B, MMP-2 and MMP-9.

• Biotechnology and Bioprocess Engineering:BBE
• /
• v.7 no.5
• /
• pp.303-310
• /
• 2002

Cell therapy applied to wound healing or tissue regeneration presents a revolutionary realm to which principles of gene engineering and delivery may be applied. One promising application is the transplantation of cells into the wounded tissue to help the tissue repair. However, when cells are transplanted from in vitro to in vivo, immune rejection occurs due to the immune response triggered by the activation of T-cell, and the transplanted cells are destroyed by the attack of activated T-cell and lose their function. Immune suppressant such as FK506 is commonly used to suppress immune rejection during transplantation. However, such kind of immune suppressants not only suppresses immune rejection in the periphery of transplanted cells but also suppresses whole immune response system against pathogenic infection. In order to solve this problem, we developed a method to protect the desired cells from immune rejection without impairing whole immune system during cell transplantation. Previously, we reported the success of constructing glomerular epithelial cells for removal of immune complex, in which complement receptor of type 1 (CR1) was over-expressed on the membrane of renal glomerular epithelial cells and could bind immune complex of DNA/anti-DNA-antibody to remove immune complex through phagocy-tosis [1]. Attempting to apply the CR1-expressing cells to cell therapy and evade immune rejection during cell transplantation, we constructed three plasmids containing genes encoding a soluble fusion protein of cytolytic T lymphocyte associated antigen-4 (CTLA4Ig) and an enhanced green fluorescent protein (EGFP). The plasmids were transfected to the above-mentioned glomerular epithelial cells to express both genes simultaneously. Using the clone cells for cell transplantation showed that mice with autoimmune disease prolonged their life significantly as compared with the control mice, and two injections of the cells at the beginning of two weeks resulted in remarkable survivability, whereas it requires half a year and 50 administrations of proteins purified from the same amount of cells to achieve the same effect.

• Archives of Plastic Surgery
• /
• v.48 no.1
• /
• pp.133-143
• /
• 2021

Background Extensive research has been conducted on islet transplantation as a possible cure for diabetes. Islet transplantation in the liver via the portal vein has shown remarkable results, but numerous other recipient sites are currently being investigated. We aimed to show the effectiveness of using a muscle flap as a recipient site for islet transplantation. Methods Islet cells were harvested from 12 isogenic Lewis rats, and then diabetes was induced in another 12 isogenic Lewis rats by streptozotocin injection. In six rats, 3,000 islets were transplanted into gastrocnemius muscle flaps, and in the other six rats, the same number of islets were transplanted into the gastrocnemius muscle. The transplanted islet cell function between the two groups was compared by means of blood glucose tests, glucose tolerance tests, immunohistochemistry, and real-time reverse transcription polymerase chain reaction. Results In the muscle flap group, blood glucose levels significantly decreased after islet transplantation. Blood glucose levels were significantly different between the two groups at 3 weeks after transplantation. The muscle flap group showed nearly normoglycemic results upon the glucose tolerance test, whereas the muscle group was hyperglycemic. Immunohistochemical evaluation showed positive results against insulin and glucagon in biopsies of both groups, and the islet cell density was higher in the muscle flap group. There were no statistically significant differences between the two groups in real-time reverse transcription polymerase chain reaction results. Conclusions Our results suggest that muscle flaps are promising candidates for islet cell transplantation.

• The Korean Journal of Rehabilitation Nursing
• /
• v.7 no.2
• /
• pp.115-126
• /
• 2004

Purpose: This study was carried out to accumulate basic data for nursing intervention development by evaluating the stress and emotional status of patients and their families after receiving hematopoietic stem cell transplantation (HSCT), illucidating and analysing related factors in order to decrease the negative effects of HSCT on their emotion. Methods: Data were collected using a questionnaire to 53 HSCT patients and 50 families, who were older than 18 at tertiary-care institutions in Seoul, from January, 2000 to August, 2003. Results: There was a significant score difference in stress (t=-2.302, P<0.05). Correlation between stress and emotional status was statistically significant (r=0.486, P<0.01; r=0, P<0.05). Economical burden of cost had significant effects on stress of patients (F=4.194, P<0.05). The series of emotional status of patients without jobs were higher (T=-2.583, P<0.05). The emotional status of families were influenced by monthly income (F=4.036, P<0.05) and patients' diagnosis (F=3.088, P<0.05). Conclusion : These results suggest that the cares for families should be considered with great concern as well as the ones for patients. In addition, such factors as economical burden by medical cost, monthly income and job status should not be excluded in transplantation nursing plans.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.8
• /
• pp.3137-3140
• /
• 2015

Objective: To explore the immune reconstitution of $CD4^+T$ cells after allogeneic hematopoietic stem cell transplantation (Allo-HSCT) and its relationship with invasive fungal infection (IFI) in patients with hematological malignancies. Materials and Methods: Forty-seven patients with hematological malignancies undergoing Allo-HSCT in Binzhou Medical University Hospital from February, 2010 to October, 2014 were selected. At 1, 2 and 3 months after transplantation, the immune subpopulations and concentration of cytokines were assessed respectively using flow cytometry (FCM) and enzyme linked immunosorbent assay (ELISA). The incidence of IFI after transplantation and its correlation with immune reconstitution of $CD4^+T$ cells were investigated. Results: The number of $CD4^+T$ cells and immune subpopulations increased progressively after transplantation as time went on, but the subpopulation cell count 3 months after transplantation was still significantly lower than in the control group (p<0.01). In comparison to the control group, the levels of interleukin-6 (IL-6) and IL-10 after transplantation rose evidently (p<0.01), while that of transforming growth factor-${beta}$ (TGF-${beta}$) was decreased (p<0.01). There was no statistically significant difference level of interferon-${\gamma}$ (IFN-${\gamma}$) (p>0.05). The incidence of IFI was 19.2% (9/47), and multivariate logistic regression revealed that IFI might be related to Th17 cell count (p<0.05), instead of Th1, Th2 and Treg cell counts as well as IL-6, IL-10, TGF-${beta}$ and IFN-${\gamma}$ levels (p>0.05). Conclusions: After Allo-HSCT, the immune reconstitution of $CD4^+T$ cells is delayed and Th17 cell count decreases obviously, which may be related to occurrence of IFI.

• Journal of Korean Academy of Nursing
• /
• v.44 no.5
• /
• pp.542-551
• /
• 2014

Purpose: This study was done to examine the incidence of oral mucositis in hematopoietic stem cell transplantation patients and to identify factors influencing oral mucositis and patient outcomes according to severity. Methods: In this retrospective study, data were collected from electronic medical records of 222 patients who had received hematopoietic stem cell transplantation. Oral mucositis was evaluated using WHO's assessment scale. Data were analyzed using Chi-square test, Fisher exact test, Spearman's correlation, Ordinal logistic regression, ANOVA and Kruskal-Wallis test. Results: A total of 69.8% of the patients evaluated developed oral mucositis (grade II and over). As a results of ordinal regression, factors influencing oral mucositis severity were found to be diagnosis, type of transplantation, oxygen inhalation and the number of antiemetics administration before transplantation. The severity of oral mucositis was found to increase the days of hospitalization, days of TPN administration, days of using antibiotics and the number and dosage of analgesics. Conclusion: The results would help predict severity of oral mucositis in hematopoietic stem cell transplantation patients and suggest that provision of appropriate nursing assessment and oral care would improve patient outcomes.

• Korean Journal of Transplantation
• /
• v.28 no.3
• /
• pp.121-134
• /
• 2014

Current immunosuppressants have nonspecific immuosuppressive effects, and are not helpful for tolerance induction. Consequently, transplant patients cannot discontinue using them, and their nonspecific immunosuppressive effects result in many side effects, including infection and malignancy. However, most of cellular immunotherapy can have donor antigen-specific immunsuppressive effects. Therefore, cell therapy could be an alternative or adjunctive to nonspecific immunosuppressants. Polyclonal or antigen-specific Foxp3+ regulatory T cells have been actively tried for prevention of acute rejection, treatment of chronic rejection, or tolerance induction in clinical trials. Regulatory macrophages are also under clinical trials for kidney transplant patients. IL-10-secreting type 1 regulatory T cells and donor- or recipient-derived tolerogenic dendritic cells will also be used for immunoregulation in clinical trials of kidney transplantation. These cells have antigen-specific immunoregulatory effects. Mesenchymal stromal cells (MSCs) have good proliferative capacity and immunosuppressive actions independently of major histocompatibility complex; therefore, even third-party MSCs can be stored and used for many patients. Cell therapy using various immunoregulatory cells is now promising for not only reducing side effects of nonspecific immunosuppressants but also induction of immune tolerance, and is expected to contribute to better outcomes in transplant patients.