ABSTRACT
Objective:To investigate the efficacy and safety of ixazomib-based therapy for multiple myeloma.Methods:The data of 32 patients with multiple myeloma treated with isazomib-based regimen in the Affiliated Hospital of Jining Medical University from December 2020 to December 2021 were retrospectively analyzed. Among 32 patients, 17 cases were relapsed/refractory, and the remaining 15 cases had initial treatment. The treatment regimens included ID (isazomib + dexamethasone), IRD (isazomib + lenalidomide + dexamethasone) and ICD (isazomib + cyclophosphamide + dexamethasone). The short-term curative effect and adverse reactions of relapsed/refractory patients and patients at initial onset were analyzed.Results:The overall response rate (ORR) of relapsed/refractory patients was 52.9% (9/17), of which 6 cases achieved complete remission (CR), 2 cases achieved very good partial remission (VGPR) and 1 case achieved partial remission (PR). The ORR of refractory patients receiving bortezomib therapy was 40.0% (4/10). The ORR of patients at initial onset who could be evaluated the curative effect was 100.0% (14/14), including 9 cases of CR, 2 cases of VGPR and 3 cases of PR. After treatment, 2 patients (6.2%) had grade Ⅲ-Ⅳ adverse events (1 case of herpes zoster and 1 case of thrombocytopenia), and none of the patients had grade Ⅲ-Ⅳ peripheral neuropathy.Conclusion:Isazomib is effective and safe in the treatment of initially treated and relapsed/refractory multiple myeloma.
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Objective:To investigate the clinical efficacy of autologous peripheral blood hematopoietic stem cell transplantation (HSCT) in treatment of lymphoma.Methods:The clinical data of 41 lymphoma patients undergoing autologous peripheral blood HSCT at the Affiliated Hospital of Jining Medical University between January 2014 to December 2020 were retrospectively analyzed. There were 6 cases of Hodgkin lymphoma and 35 cases of non-Hodgkin lymphoma. The mobilization regimens included chemotherapy drugs + granulocyte colony-stimulating factor (G-CSF) + thrombopoietin (TPO) or chemotherapy drugs + G-CSF. The pre-conditioning schemes before transplantation were listed as follows: BEAM (mustine + cytarabine + etoposide + melphalan) regimen + decitabine in 26 patients, BEAM regimen in 12 patients, BEAM regimen + chidamide in 3 patients. The progression-free survival (PFS), overall survival (OS), related complications, prognoses after transplantation were observed. The effects of clinical staging, B symptom,International Prognostic Score Index (IPI), extranodal involved sites, hemoglobin (Hb), lactic dehydrogenase (LDH), β 2-microglobulin (β 2-MG), transplantation regimen and the status before transplantation on PFS and OS after transplantation were evaluated. Results:Among 41 patients, 37 patients (90.24%) achieved complete remission (CR), 2 patients (4.88%) achieved partial remission (PR) and 2 patients loss assessment data (4.88%) before autologous peripheral blood HSCT. The median karyocyte count was 12.74×10 8 /kg [(3.91-22.68)×10 8/kg] in 24 patients with the complete data of stem cell collection, the median CD34 positive cell count was 6.74×10 6/kg [(0.91-50.47)×10 6/kg]. All 41 patients had hematologic reconstruction. The median time of platelet implantation was 11 d (7-32 d) and the median time of granulocyte implantation was 9 d (8-16 d). All patients achieved CR after transplantation and no one case had transplantation-related death. By the end of follow-up, 33 cases (80.49%) had no progression of disease, 8 cases (19.51%) died. The OS rates of 12-month, 24-month and 72-month were 93.4%, 85.3% and 60.9%, respectively after transplantation. The PFS rates of 12-month, 24-month and 72 month were 93.3%, 84.0% and 84.0%, respectively. Median PFS and OS had not been reached. There were no statistically significant differences in the PFS and OS of patients with different gender, clinical staging, B symptom, IPI score, extranodal involved sites, Hb, LDH, β 2-MG and the status before transplantation(all P > 0.05) . The PFS and OS of patients receiving BEAM regimen + decitabine were better than those of patients receiving BEAM regimen alone (all P < 0.05). Conclusions:Autologous peripheral blood HSCT is effective in treatment of lymphoma. Moreover, BEAM regimen + dicitabine preconditioning regimen can achieve longer survival time compared with BEAM regimen alone.
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Objective To explore a new approach to isolate the umbilical cord-mesenchymal stem cells (UC-MSCs) from a whole umbilical cord. Methods Single enzyme was used to digest the whole umbilical cord,and passaged and cultured,draw the growth curve,cell cycle and cell wall antigen on the surface by flow cytometry. In particular inducing system, the adherent cells were induced into adipocytes and osteoblast. Results The mesenchymal stem cells (MSCs) were derived from the whole umbilical cord. The growth curve showed that the cell doubling time was (24.15 ± 0.49) h and the percentage of G1phase cells was 82.66%.The adherent cells expressed the CD93,CD105,CD44,CD29and CD73, and did not express the CD34, CD45, CD31and human leukocyte antigen DR (HLA-DR). UC-MSCs could differentiate into adipocytes and osteoblast. Conclusions Single enzyme approach is a good method to obtain UC-MSCs from whole human umbilical cord,and it provides a theoretical basis for the establishment of MSCs bank and clinical application.
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Objective To observe the curative effect of erythrocyte separation in the treatment of patients with polycythemia vera (PV). Methods Sixty- five patients with P- were selected, and the patients were divided into control group (20 cases) and observation group (45 cases) according to the treatment method. All patients of 2 groups were treated with oral hydroxyurea and intramuscular interferon, but the patients of observation group combined with erythrocyte separation. The hemoglobin and hematocrit (HCT) before and after treatment and untoward reaction were compared between 2 groups. Results There were no statistical differences in hemoglobin and HCT before treatment between 2 groups:(196 ± 17) g/L vs. (182 ± 23) g/L and 0.606 ± 0.049 vs. 0.578 ± 0.066, P>0.05. The hemoglobin and HCT levels after treatment in observation group were significantly lower than those in control group:(153 ± 27) g/L vs. (168 ± 14) g/L and 0.490 ± 0.050 vs. 0.539 ± 0.054, and there were statistical differences (P<0.05). There was no obvious untoward reaction in 2 groups. Conclusions Erythrocyte separation is one of first choices for PV. It is safe and effective, and has less obvious untoward reaction.