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Veno-occlusive disease of the liver (VOD) is one of the most common complications in patients after hematopoietic stem cell transplantation (HSCT). So far, the mortality of severe VOD is almost 100%. How to deal with the disease remains to be an unresolved problem. This study was to explore more efficient methods of prevention and treatment of VOD.Clinical data of 18 patients undergoing allogeneic HSCT were analyzed. All the patients were pretreated with busulfan and cyclophosphamide, and treated with prostaglandin E1, glutathione and ornithine aspartate before HSCT to prevent VOD. Prostagland E1, low molecular weight heparin and tissue plasminogen activator (tPA) were used to treat the patient with VOD.The serum level of glutamate-pyruvate transaminase was elevated in 11 patients after HSCT, and all the patients were cured. Only 1 patient suffered VOD which was severe. Prostaglandin E1 and low molecular weight heparin were not effective in this case, while tPA was. The side effect of tPA was bleeding of the skin and mucosa.The combination of prostaglandin E1, glutathione and ornithine aspartate is probably effective and safe in preventing VOD for it aims at many aspects of pathogenesis of VOD. tPA can be used carefully as a choice of treating severe VOD.

Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT), and also is an important factor affecting the outcome of transplantation. Some researches showed that either acute or chronic GVHD is often accompanied by graft-versus-leukemia (GVL) effect, and this positive effect is associated with the decrease of leukemia relapse and the prolongation of disease-free survival of recipients. This study was to assess the influence of GVHD on the outcome of allo-HSCT.Twenty-six patients with hematologic malignancies received allo-HSCT from Mar. 1995 to Oct. 2005. The occurrence of GVHD, relapse of leukemia, and survival of recipients were analyzed retrospectively, and the correlations of GVHD to leukemia relapse and patients' survival were evaluated.With a median follow-up of 20 months (range 2-127 months) after transplantation, 20 (76.9%) patients developed GVHD, 1 of which had tumor relapsed; 3 of the 6 patients without GVHD had tumor relapsed. The relapse rate was significantly lower in the recipients with GVHD than in the recipients without GVHD (P0.05). After transplantation, 16 patients survived disease-freely, and 10 died. Kaplan-Meier survival curves showed that the 3-year disease-freely survival rate was 60%. The disease-freely survival rate was significantly higher in the recipients with GVHD than in the recipients without GVHD (15/20 vs. 1/6, log-rank=7.30, P0.05). Cox regression models showed a significantly decreased risk of death in the recipients with GVHD (risk ratio=0.2, P0.05). Of the 20 recipients with GVHD, 17 achieved complete response (CR), 15 of whom survived disease-freely; no survived in the 3 patients who did not achieve CR. The disease-freely survival rate was significantly higher in the recipients achieved CR than in the recipients did not (P0.05).GVHD is an important factor that may influence the outcome of allo-HSCT. Treatment efficacy of GVHD is significantly associated with the disease-free survival of recipients. Early recognition and treatment of acute GVHD is the key factor of successful treatment.

Epstein-Barr virus (EBV) is associated with genesis of many human tumors, including non-Hodgkin's lymphoma (NHL). Latent membrane protein 1 (LMP1) gene is considered as an oncogene of EBV. Recent researches have suggested that LMP1 polymorphisms, especially C-terminal 30bp-deletion (del-LMP1), might be associated with carcinogenicity of EBV, and play important roles in tumorigenesis. This study was to detect expression of del-LMP1 gene in NHL patients and healthy people, and explore relationship of del-LMP1 gene to tumorigenesis and prognosis of NHL.LMPl gene segments (including the 30 bp deletion) in 48 NHL patients and 60 healthy people were amplified by polymerase chain reaction (PCR) with sequence-specific primers. PCR products were randomly chosen,and sequenced to confirm their specificities and to detect other mutations of LMP1 gene. The distributions of del-LMPl in NHL patients and healthy people were compared. Relationship of del-LMP1 gene to prognosis of NHL was analyzed.(1) LMP1 gene was detected in 23 of 48 NHL patients, 18 of 23 (78%) harbored del-LMPl; LMP1 gene was detected in 32 of 60 healthy people, 13 of 32 (41%) harbored del-LMPl. Positive rate of del-LMPl gene in NHL patients was significantly higher than that in healthy people (P0.05). (2) Among 23 EBV-related NHL patients, 15 belonged to high risk group (IPI/=3), and del-LMPl was detected in 14 of them (93%); 8 belonged to low risk group (IPI3), and del-LMPl was detected in 4 of them (50%). Positive rate of del-LMP1 in IPI/=3 group was significantly higher than that in IPI3 group (P0.05). (3)Sequencing confirmed that the 30 bp-deletion located at 168 285-168 256 nt (355-346 aa), and most C-terminal mutations located at 168 357-168 225 nt.Del-LMPl gene exists commonly in EBV-related NHL, and might correlate with prognosis of NHL.