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

• Radiation Oncology Journal
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• v.30 no.4
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• pp.165-172
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• 2012

Purpose: To retrospectively evaluate the outcome and toxicity of total lymphoid irradiation (TLI) based conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT) in severe aplastic anemia (SAA) patients who experienced an engraftment failure from prior HSCT or were heavily transfused. Materials and Methods: Between 1995 and 2006, 20 SAA patients received TLI for conditioning of HSCT. All patients were multi-transfused or had long duration of disease. Fifteen (75%) patients had graft failure from prior HSCT. In 18 (90%) patients, the donors were human leukocyte antigen identical siblings. The stem cell source was the peripheral blood stem cell in 15 (75%) patients. The conditioning regimen was composed of antithymocyte globulin plus TLI with a median dose of 750 cGy in 1 fraction. The graft-versus-host disease (GVHD) prophylaxis used cyclosporine with methotrexate. Results: With a median follow-up of 10.8 years, graft failures developed in 6 patients. Among them, 3 patients received their third HSCT to be engrafted finally. The Kaplan-Meier overall survival rate was 85.0% and 83.1% at 5 and 10 years, respectively. The incidence of acute and chronic GVHD was 20% and 20%, respectively. None of the patients have developed a malignancy after HSCT. Conclusion: In our study, TLI based conditioning in allogeneic HSCT was feasible with acceptable rates of GVHD in SAA patients who experienced graft failure from prior HSCT or was at a high risk of graft rejection. We achieved relatively better results of engraftment and survival with a long term follow-up.

• IMMUNE NETWORK
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• v.23 no.6
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• pp.44.1-44.16
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• 2023

Mesenchymal stem cells (MSCs) are effective in treating autoimmune diseases and managing various conditions, such as engraftment of allogeneic islets. Additionally, autologous and HLA-matched allogeneic MSCs can aid in the engraftment of human allogeneic kidneys with or without low doses of tacrolimus, respectively. However, HLA alloantigens are problematic because cell therapy uses more HLA-mismatched allogeneic cells than autologous for convenience and standardization. In particular, HLA-mismatched MSCs showed increased Ag-specific T/B cells and reduced viability faster than HLA-matched MSCs. In CRISPR/Cas9-based cell therapy, Cas9 induce T cell activation in the recipient's immune system. Interestingly, despite their immunogenicity being limited to the cells with foreign Ags, the accumulation of HLA alloantigen-sensitized T/B cells may lead to allograft rejection, suggesting that alloantigens may have a greater scope of adverse effects than foreign Ags. To avoid alloantigen recognition, the β2-microglobulin knockout (B2MKO) system, eliminating class-I MHC, was able to avoid rejection by alloreactive CD8 T cells compared to controls. Moreover, universal donor cells in which both B2M and Class II MHC transactivator (CIITA) were knocked out was more effective in avoiding immune rejection than single KO. However, B2MKO and CIITA KO system remain to be controlled and validated for adverse effects such as the development of tumorigenicity due to deficient Ag recognition by CD8 T and CD4 T cells, respectively. Overall, better HLA-matching or depletion of HLA alloantigens prior to cell therapy can reduce repetitive transplantation through the long-term survival of allogeneic cell therapy, which may be especially important for patients seeking allogeneic transplantation.

• Journal of Chest Surgery
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• v.29 no.7
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• pp.713-722
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• 1996

Poor long term patient survival (60% at 2 years) in lung allograft recipients are mainly due to rejection and complications associated with the use of nonspecific immunosuppressants. Better means to achieve waft acceptance is desperately needed. 1 have investigated whether mixed allogeneic chimerism in the form of bone marrow stem cell engraftment would induce donor-specific tolerance for lung allografts. Fisher (F344) and Wistar Forth (WF)rats were lethally irradiated (1100c0y) and reconstituted with a mixture of T-cell depleted syngeneic and allogeneic bone marrow (F344+WFIWF, ACI +F344- F344). After Mixed chimerism was documented by peripheral blood Ipnphocyte typing at 28 days, orthotopic left single lung transplantation was performed, using donor-s ecific or third party allografts. No immunosuppressants were administered. Graft rejection was monitored by chest rentgenography, and con- firmed by histology Mixed chimeric rats accepted lung allografts permanently, and it was not strain specific effect. Tolerance was all or none phenomenon which had nothing to do with the percentage of chimerlsm. Mixed chimeras rejected third party allografts in less than 10 days, a time course similar to that of unmanipulated controls. No acute or chronic rejection was observed in donor specific grafts more than 150 days posttransplant. These data suggest that mixed chimerism in the form of bone marrow stem cell engraftment results in stable, systemic donor-specific transplantation tolerance for lung allografts.

• Journal of Life Science
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• v.31 no.9
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• pp.856-861
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• 2021

CD82/KAI1, identified as a metastasis suppressor, was initially known only as a molecular facilitator, but its various functions have recently been revealed. CD82 plays an important role in the stem-progenitor cell, angiogenesis, and muscle. We would like to introduce the recently reported functions and roles of CD82 in this review. CD82 is a member of the tetraspanin family, which consists of four transmembrane domains. The interaction between CD82 and cell adhesion molecules suppresses the metastasis of cancer. CD82 regulates the cell cycle of stem-progenitor cells in the stem cell niche. In the bone marrow, CD82 is expressed on long-term repopulating hematopoietic stem cells (LT-HSCs), which show multipotent differentiation potential. The interaction between CD82 and Duffy antigen receptor for chemokines (DARC) induces quiescence in LT-HSCs. CD82 also regulates Rac1 activity, resulting in the homing and engraftment of HSCs into the bone marrow niche. Besides, CD82 maintains the differentiation potential of muscle stem cells and prevents angiogenesis by inhibiting the expression of cytokines, such as IL-6 and VEGF and adhesion molecules in endothelial cells. CD82 is a key membrane protein that distinguishes the hierarchy of stem-progenitor cells, and is also important for amplification and verification of cellular resources. Further studies on the function of CD82 in various organs and cells are expected to advance cell biology and cell therapy.

• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.370-375
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• 2002

Purpose : In most cases, myelodysplastic syndrome(MDS) transforms into a more aggressive state or acute myelogenous leukemia; it's prognosis is very poor. It is believed that hematopoietic stem cell transplantation(HSCT) is the only curative treatment of MDS, but available data in children are very sparse. In this report, the short term outcome of HSCT in childhood MDS was analyzed. Methods : Ten children with MDS(CMMoL 5, RAEB 3, RAEBt 2) underwent HSCT(HLA-matched sibling transplantation 4, HLA-matched unrelated transplantation 4, cord blood transplantation 1, HLA-mismatched familial transplantation 1) between November 1995 and January 2001 at St. Mary's Hospital. Median follow-up duration was 11 months. Results : Engraftment was successful in all cases and 8 patients are alive without disease. Three cases of VOD were observed and improved without complication. Four cases of grade II and 1 case of grade III acute GVHD were observed and well controlled with treatment. Three patients relapsed after transplantation. One patient is alive without disease after cytoreduction with allogenic stem cell rescue and 2 patients died of relapse. Conclusion : HSCT is a curative strategy of MDS and the survival rate is relatively higher than that of adults. But there is an obvious need for more studies because of the small number of patients and the short duration of the follow-up.