Objective To evaluate the feasibility and safety of peripheral CD34+ cell mobilization in patients with severe autoimmune disease. Methods Forty-two patients underwent a total of 46 mobilizations by the regimen of cyc...Objective To evaluate the feasibility and safety of peripheral CD34+ cell mobilization in patients with severe autoimmune disease. Methods Forty-two patients underwent a total of 46 mobilizations by the regimen of cyclophosphamide 2-3 g/m2 +recombinant human granulocyte colony stimulating factor (rhG-CSF) 5 μg·kg-1·d-1. The positive selection of CD34+ cell was performed through the CliniMACS. Results In 8.1±2.3 days after administration of cyclophosphamide, the peripheral white blood cell and mononuclear cell (MNC) decreased to the lowest level. In 3.7±1.6 days after injection of rhG-CSF, the peripheral absolute MNC and CD34+ cell counts were 0.95×109/L and 0.035×109/L, respectively. After 2.4±0.6 times of leukapheresis, there gained 4.46×108/kg of MNC and 5.26×106/kg of CD34+, respectively. After mobilization, the underlying diseases were ameliorated more or less. In systemic lupus erythematosus (SLE) patients, SLE Disease Activity Index (SLEDAI) decreased from a median of 17 to 3 (P<0.01). In rheumatic arthritis patients, an American College of Rheumatology criteria for 20%(ACR20) response was achieved in all five patients. Totally, 17.4% of patients whose absolute neutrophil count <0.5×109/L suffered infection, and 31.0% of patients had bone pain after the injection of rhG-CSF. Two patients suffered severe complications, one with acute renal failure and recovered by hemodialysis, the other died of thrombotic thrombocytopenic purpura. Failed mobilization occurred in three patients. Conclusions Sufficient CD34+ cells can be mobilized by low dose of cyclophosphamide and rhG-CSF. CD34+ cell mobilization for treatment of severe autoimmune disease not only is appropriate in both effectiveness and safety but ameliorates disease also.展开更多
To the Editor:Psoriatic arthritis(PsA)is a chronic musculoskeletal disease associated with psoriasis.A high proportion of patients with psoriasis have a missed diagnosis of PsA,which will lead to delay in treatment,wo...To the Editor:Psoriatic arthritis(PsA)is a chronic musculoskeletal disease associated with psoriasis.A high proportion of patients with psoriasis have a missed diagnosis of PsA,which will lead to delay in treatment,worse physical function,and severe radiographic progression.Skin symptoms precede joint symptoms in about 80%of patients with PsA,which places dermatologists in a unique position to identify PsA early.Therefore,a lot of screening questionnaires have been developed for early screening.The Early Arthritis for Psoriatic Patients(EARP)and Psoriasis Epidemiology Screening Tool(PEST)questionnaires are two of the commonly used.[1,2]To date,only the verified Chinese language version of the EARP questionnaire exists.展开更多
To the Editor:Psoriatic arthritis(PsA)is a chronic inflammatory musculoskeletal disease associated with psoriasis,mainly manifested as peripheral arthritis,enthesitis,finger or toe inflammation,and spinal arthritis.[1...To the Editor:Psoriatic arthritis(PsA)is a chronic inflammatory musculoskeletal disease associated with psoriasis,mainly manifested as peripheral arthritis,enthesitis,finger or toe inflammation,and spinal arthritis.[1]PsA may develop at any age,peaking at age of 30 to 50 years with no significant gender difference,but the spinal involvement is more frequent in men.The prevalence of PsA in China is about 1.23‰.About 75%of patients with PsA develop rash before arthritic onset whereas 10%after arthritis development.展开更多
文摘Objective To evaluate the feasibility and safety of peripheral CD34+ cell mobilization in patients with severe autoimmune disease. Methods Forty-two patients underwent a total of 46 mobilizations by the regimen of cyclophosphamide 2-3 g/m2 +recombinant human granulocyte colony stimulating factor (rhG-CSF) 5 μg·kg-1·d-1. The positive selection of CD34+ cell was performed through the CliniMACS. Results In 8.1±2.3 days after administration of cyclophosphamide, the peripheral white blood cell and mononuclear cell (MNC) decreased to the lowest level. In 3.7±1.6 days after injection of rhG-CSF, the peripheral absolute MNC and CD34+ cell counts were 0.95×109/L and 0.035×109/L, respectively. After 2.4±0.6 times of leukapheresis, there gained 4.46×108/kg of MNC and 5.26×106/kg of CD34+, respectively. After mobilization, the underlying diseases were ameliorated more or less. In systemic lupus erythematosus (SLE) patients, SLE Disease Activity Index (SLEDAI) decreased from a median of 17 to 3 (P<0.01). In rheumatic arthritis patients, an American College of Rheumatology criteria for 20%(ACR20) response was achieved in all five patients. Totally, 17.4% of patients whose absolute neutrophil count <0.5×109/L suffered infection, and 31.0% of patients had bone pain after the injection of rhG-CSF. Two patients suffered severe complications, one with acute renal failure and recovered by hemodialysis, the other died of thrombotic thrombocytopenic purpura. Failed mobilization occurred in three patients. Conclusions Sufficient CD34+ cells can be mobilized by low dose of cyclophosphamide and rhG-CSF. CD34+ cell mobilization for treatment of severe autoimmune disease not only is appropriate in both effectiveness and safety but ameliorates disease also.
基金by a grant from the National Program on Key Basic Research Project(973 Program)(No.2014CB541801).
文摘To the Editor:Psoriatic arthritis(PsA)is a chronic musculoskeletal disease associated with psoriasis.A high proportion of patients with psoriasis have a missed diagnosis of PsA,which will lead to delay in treatment,worse physical function,and severe radiographic progression.Skin symptoms precede joint symptoms in about 80%of patients with PsA,which places dermatologists in a unique position to identify PsA early.Therefore,a lot of screening questionnaires have been developed for early screening.The Early Arthritis for Psoriatic Patients(EARP)and Psoriasis Epidemiology Screening Tool(PEST)questionnaires are two of the commonly used.[1,2]To date,only the verified Chinese language version of the EARP questionnaire exists.
文摘To the Editor:Psoriatic arthritis(PsA)is a chronic inflammatory musculoskeletal disease associated with psoriasis,mainly manifested as peripheral arthritis,enthesitis,finger or toe inflammation,and spinal arthritis.[1]PsA may develop at any age,peaking at age of 30 to 50 years with no significant gender difference,but the spinal involvement is more frequent in men.The prevalence of PsA in China is about 1.23‰.About 75%of patients with PsA develop rash before arthritic onset whereas 10%after arthritis development.
