After allogeneic peripheral blood stem cell transplantation (PBSCT),
children are at high risk of hepatitis B virus (HBV) infection because
of the potential loss of HBV immunity. The factors which can affect it
are not fully understand. This study aimed to assess the probability of
hepatitis B surface antibody (HBsAb) disappearance after PBSCT and to
evaluate the impact of donor and recipient immunity on HBsAb
disappearance. A total of 110 patients who underwent PBSCT between
January 2016 and December 2018 and their paired donors were
retrospectively enrolled in this study. Before transplantation, 87
(79.1%) patients were HBsAb seropositive, and 23 (20.9%) were HBsAb
seronegative. Fifty-five (63.2%) patients with protective HBsAb titers
before PBSCT lost their HBV immunity within one year after
transplantation. Univariate analysis showed that the low recipient
pretransplant HBsAb titer, antithymocyte globulin (ATG) administration,
corticosteroid administration and graft-versus-host disease (GVHD) were
significant risk factors for HBsAb disappearance (P<0.05).
Multivariate analysis showed that only recipient pretransplant HBsAb
titers lower than 207.5 IU/L (P=0.022, hazard ratio (HR): 1.925, 95%
confidence interval (CI): 1.101-3.367) and the presence of GVHD
(P=0.033, HR=1.921, 95% CI: 1.056-3.495) were risk factors for HBsAb
disappearance one year after HSCT. In conclusion, most recipients lost
previously acquired immunity to HBV after PBSCT. A high titer of HBsAb
in the recipient before transplantation had a protective effect against
posttransplant HBsAb disappearance, but the presence of donor immunity
did not significantly influence the maintenance of recipient immunity to
HBV.
Approximately 20-40% of pediatric patients with anaplastic large-cell lymphoma (ALCL) develop recurrent disease. Here, we report a pilot experience using single-drug weekly vinorelbine (25 mg/m2/wk) as a salvage re-induction regimen in 4 consecutive pediatric patients with relapsed ALCL. All 4 patients achieved complete remission after 2 cycles of weekly vinorelbine and were disease-free alive at last evaluation. The main toxicity was hematologic. Only one week of vinorelbine administration was withheld for a grade 4 neutropenia in one patient. The results suggest that weekly vinorelbine has good efficacy and safety in the treatment of relapsed pediatric ALCL.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.