Ayh Leung

Effects of Azithromycin in bronchiolitis obliterans syndrome after hematopoietic SCT—a randomized double-blinded placebo-controlled study

Bronchiolitis obliterans syndrome (BOS) is an important complication after hematopoietic SCT (HSCT). Recent observations suggested that azithromycin might improve lung function in BOS after HSCT. We conducted a randomized double-blinded placebo-controlled study on azithromycin in patients with BOS after HSCT. The treatment group (n=10) received oral azithromycin 250 mg daily while the control group (n=12) received placebo daily for 12 weeks. Respiratory symptoms were assessed by the St George Respiratory Questionnaires and spirometry at baseline (drug commencement), 1, 2, 3 (drug cessation) and 4 months (1 month after drug cessation). There was no significant difference in the baseline demographic characteristics between the treatment and the control groups in age, gender, time from HSCT to BOS, time since diagnosis of BOS, chronic GVHD, baseline respiratory symptom scores and baseline forced expiratory volume in 1 s (FEV1). Throughout and after 3 months of treatment, there were no significant changes in respiratory symptom scores and FEV1 measurements between the treatment and the control groups. In conclusion, there was no significant benefit of 3 months of oral azithromycin on the respiratory symptoms and lung function in patients with relatively late BOS after HSCT in this randomized placebo-controlled study.

Liver graft-versus-host disease after donor lymphocyte infusion for relapses of hematologic malignancies post allogeneic hematopoietic stem cell transplantation

Summary:Graft-versus-host disease (GVHD) is the commonest complication after donor lymphocyte infusion (DLI). In 19 patients undergoing DLI for relapses of hematologic malignancies post hematopoietic stem cell transplantation (HSCT), 11 developed GVHD, of whom nine had isolated liver involvement, and two had liver and skin involvement. The clinical diagnosis of liver GVHD was hepatitic in six patients (55%) and classical in five patients (45%). Patients with GVHD post-DLI showed a different clinical pattern when compared to a cohort of 106 cases of GVHD post-HSCT, in having significantly more isolated liver involvement (9/11 vs 17/106, P<0.001), and less skin (2/11 vs 80/106, P<0.001) and gut (0/11 vs 28/106, P<0.001) involvement. However, liver GVHD post-DLI and post-HSCT had comparable patient characteristics, underlying diseases, clinical subtypes (classical and hepatitic) and response to treatment.

Proteomic identification of stress-response heat shock protein markers associated with tumor recurrence in patients with hepatocellular carcinoma

12.2%) largely present in the lobules. Although both of them were phenotypically mature, and strong T cell stimulators as shown by T cell cytokine (ELISA) and division (CFSE dilution), CD11c DCs induced potent T cell response while B220DC induced T cell hyporesponsiveness. Administration of CD11cDCs accelerated cardiac allograft rejection, while B220DCs significantly prolonged graft survival. This hyporesponsiveness is not due to inhibition of DC-T cell interaction, but rather through an active process of stimulating T cell apoptosis. Compared to B220 DCs that expressed mRNA of TLR 1, 2, 6, 7 and 9, CD11cDCs expressed all TLR 1 to 9, implicating that CD11c DCs may more extensively involve in innate immunity. CpG (TLR9 ligation) stimulated very high IL-12 in CD11c DCs, but high IL-10 (not IL-12) in B220 DCs. These data help to better understand the complex of liver immune regulation in chronic liver diseases and transplantation.

A comparison of non-TBI and TBI conditioning regimens in bone marrow recipients undergoing match-unrelated transplantation in Hong Kong

Combined annual meetings of CIBMTR and the American Society of Blood and Marrow Transplantation (ASBMT)