A Propensity Score Matching Study of Autologous Hematopoietic Stem Cell Transplantation and New Drug Chemotherapy for Newly Diagnosed Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To compare the clinical efficacy, survival, and prognosis of autologous hematopoietic stem cell transplantation (ASCT) with new drug chemotherapy in the treatment of newly diagnosed multiple myeloma (NDMM) in the new drug era.@*METHODS@#The clinical data of 149 patients with NDMM treated with new drug induction regimen in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2012 to December 2019 were retrospectively analyzed. Twenty-four patients who received ASCT were in ASCT group, and 125 patients who did not receive ASCT were in non-ASCT group. The median follow-up time was 43 (1-90) months. The propensity score matching (PSM) method was used to balance confounding factors, then depth of response, overall survival (OS), and progression-free survival (PFS) between the two groups were compared and subgroup analysis was performed.@*RESULTS@#After matching, the covariates were balanced between the two groups. Fifty-one patients (15 cases in ASCT group and 36 cases in non-ASCT group) were included. ASCT patients had a better complete response (CR) rate than non-ASCT patients receiving maintenance therapy (93.3% vs 42.3%, P=0.004), while there were no statistical differences in deep response rate and overall response rate (ORR) between the two groups (93.3% vs 65.4%, P=0.103; 93.3% vs 96.2%, P=1.000). Before matching, the 3 and 5-year PFS rate and median PFS (mPFS) in ASCT group and non-ASCT group were [89.6% vs 66.5%, P=0.024; 69.8% vs 42.7%; non-response (NR) vs 51.0 months], and the 3 and 5-year OS rate and median OS (mOS) were (100% vs 70.6%, P=0.002; 92.3% vs 49.6%; NR vs 54.0 months). After matching, the 3 and 5-year PFS rate and mPFS in ASCT group and non-ASCT group were (83.6% vs 61.7%, P=0.182; 62.7% vs 45.7%; NR vs 51.0 months), the 3 and 5-year OS rate and mOS were (100% vs 65.6%, P=0.018; 88.9% vs 46.9%; NR vs 51.0 months). Subgroup analysis showed that patients with mSMART 3.0 high risk stratification, the 3-year PFS rate and mPFS in ASCT group and non-ASCT group were (83.3% vs 41.5%, P=0.091; NR vs 34.0 months), and the 3-year OS rate and mOS were (100% vs 41.5%, P=0.034; NR vs 34.0 months). Patients with mSMART 3.0 standard risk stratification, the 3-year PFS rate and OS rate in ASCT group and non-ASCT group were (83.3% vs 76.8%, P=0.672; 100% vs 87.2%, P=0.155). The 3-year PFS and OS rate in MM patients who achieved deep response within 3 months after transplantation compared with non-ASCT patients who achieved deep response after receiving maintenance therapy were (83.1% vs 56.7%, P=0.323; 100% vs 60.5%, P=0.042), and the 3-year PFS and OS rate in patients who achieved overall response in both groups were (83.1% vs 62.5%, P=0.433; 100% vs 68.1%, P=0.082). After matching, Cox multivariate regression analysis showed that mSMART 3.0 risk stratification and ASCT were independent prognostic factors for OS.@*CONCLUSION@#In the new drug era, ASCT can increase CR rate and prolong OS of NDMM patients. ASCT patients who are mSMART 3.0 high risk stratification or achieved deep response within 3 months after transplantation have better OS than non-ASCT patients receiving new drug chemotherapy. ASCT and mSMART 3.0 risk stratification are independent prognostic factors for OS in NDMM patients.

Effect of small ubiquitin-like modifier 1 pseudogene 3 on the proliferation and apoptosis of non-small cell lung cancer cell line H1299 through protein kinase B signaling pathway / 解剖学报

Objective To investigate the effect of long noncoding RNA (IncRNA) small ubiquitin-like modifier 1 pseudogene 3(SUM01P3) on the proliferation and apoptosis of non-small cell lung cancer cell line 1299. Methods Determination of SUM01P3 expression in non-small cell lung cancer cells by Real-time PCR. SUM01P3 small interfering RNA(siRNA) was transfected into H1299 cells, the down regulation effect was determined by Real-time PCR. Cell proliferation was measured by MTT, 5-ethynyl-2′-deoxyuridine(EdU) method, the cell cycle was determined by PI single staining, apoptosis was detected by annexin V -FITC/PI, detection of apoptosis by TUNEL, Western blotting was used to detect the expression of cleaved Caspase-3 (c-Caspase-3), cyclin Dl, P27, phosphorylated phospoinositide 3-kinase (p-PI3K) and phosphorylated protein kinase B (p-Akt). Akt signal activator treated H1299 cells transfected with SUM01P3 siRNA, cell proliferation, apoptosis and cycle change were also measured by the above methods. The number of samples was 9. Results SUM01P3 was up-regulated in non-small cell lung cancer cells. The expression of SUM01P3 in H1299 cells decreased after transfection with SUM01P3 siRNA, cell proliferation decreased, the ratio of G0/Gj phase increased, apoptosis rate increased, c-Caspase-3 and P27 protein in the cells increased, the protein levels of cyclin D1, p-PI3K and p-Akt decreased. Akt signal activator could reverse the inhibition of proliferation, cycle arrest and apoptosis of H1299 cells by SUM01P3 siRNA. Conclusion Down-regulation of SUM01P3 inhibits the proliferation of non-small cell lung cancer H1299 cells and induces apoptosis, the mechanism of action is related to the reduction of the activation level of the Akt signaling pathway.

Difference of dilation resistance to coronary stenting between fibrous plaques and lipid-rich plaques / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Dilation resistance to stenting in non-calcified coronary plaques was compared in patients with percutaneous coronary intervention (PCI) in order to confirm the clinical usefulness of multislice computed tomography in examining coronary plaque type and to provide information pertaining to the effects of plaque type on dilatation resistance.</p><p><b>METHODS</b>A retrospective analysis of 64-slice computed tomography coronary imaging data collected in the month prior to coronary stenting in 93 patients (65 male and 28 female, mean age of (57.22±7.22) years) was conducted. Non-calcified coronary plaques were divided into lipid-rich (lipid content >25% of plaque volume) and fibrous plaques according to the Hammer-Hansen S method: where lipids, fiber, and intraluminal components were indicated by contrast using Hu values of -100-49, 50-129, and >130, respectively. Clinical features, pre-dilatation balloon specifications and filling pressure, and stent size and release pressure were compared.</p><p><b>RESULTS</b>High-sensitivity C-reactive protein levels were higher in the lipid-rich plaque group. In patients with typical symptoms, unstable angina was more commonly observed in the lipid-rich plaque group. No significant differences in low density lipoprotein, pre-dilatation balloon specifications, pre-dilatation pressure, or stent specifications were observed. Stent release pressure in the lipid-rich plaque group ((1130.16±202.04) kPa), was significantly lower than that observed in the fibrous plaque group ((1240.61±193.29) kPa, P = 0.009).</p><p><b>CONCLUSION</b>Softer, lipid-rich plaques exhibit lower dilation resistance during stenting in PCI patients.</p>