ABSTRACT
【Objective】 To explore the clinical efficacy of traditional Chinese medicine(TCM) therapy in patients with transfusion related iron overload diagnosed with chronic aplastic anemia (CAA). 【Methods】 A total of 115 patients with CAA and iron overload who had been admitted to Zhejiang Provincal Hospital of TCM from February 2015 to December 2016 were studied. They were assigned to treatment group(n=69), positive control group(n=16), and negative control group(n=30) according to different treatment plan designed in advance. Patients in the treatment group were treated with TCM of "Bushen Huoxue" recipe once a day, with the formula mixed with astragalus 40 g, rehmannia 12 g, cornus 12 g, deerhorn glue melting by heat 12 g, atractylodes 20 g, radix paeoniae alba 20 g, curculigo orchioides 10 g, herba epimedii 10 g, cistanche 12 g, cassia stem 10 g, dried orange peel 8 g, poria 10, gingembre 6 g, angelica sinensis 20 g, salvia miltiorrhiza 20 g, zedoary 9 g, leonurus 30 g, gromwell 15 g, and prepared liquorice root 6 g. Patients in positive control group were treated with desferrioxamine for more than 8 h per day, 5 to 7 days per week. Patients in negative control group were treated with basic treatment.The serum ferritin (SF) and cytokines of patients of the three groups before and 3 months after therapy were detected according to the blood-stasis of TCM symptom rating scale, and the correlation between the decrease of ferritin after treatment and the improvement of blood stasis syndrome score was analyzed. 【Results】 The level of SF of the treatment group, positive and negative control group before treatment were 1 881.63±1 386.81 vs 6 581.36±5 180.96 vs1 974.25±1 753.06, and were 2 040.14±1 484.27 vs 4 169.18±3 631.64(P<0.05)vs 2 699.80±2 352.34(P<0.05) 3 months after treatment. The treatment was effctive in 16 patients in treatment group, accounted for 23.19%(16/69). The score of blood stasis syndrome of the three groups before and after treatment were 4.26±1.45vs 6.88±1.31 vs 4.17±1.18 and 4.42±1.43 vs 5.00±0.89 vs 4.67±1.51(P<0.01), respectively. The effective rate of improving blood stasis syndrome score in the treatment group was up to 26.09%. The decrease of serum ferritin was positively correlated with the improvement of blood stasis score (P < 0.01). The levels of IL-6 and IL-10 in treatment group were 20.79±14.14 and 56.27±25.54 before treatment, 13.00±6.48 and 41.02±9.93(P<0.05)3 months after treatment, respectively. 【Conclusion】 "Bushen Huoxue" therapy can stabilize the the level of SF and improve the blood stasis syndrome in CAA patients with iron overload.
ABSTRACT
Objective@#To investigate the biological characteristics of high hyperdiploid and triploid/tetraploid acute myeloid leukemia (HH/TT-AML) and its relationship with prognosis. @*Methods@#The clinical data of 28 patients with newly diagnosed HH/TT-AML during March 2006 and June 2017 were retrospectively analyzed, and the factors influencing prognosis were analyzed by the Kaplan-Meier method. @*Results@#The karyotypes of HH/TT-AML patients were mainly 49 chromosomes, accounting for 39.3% (11/28), followed by 50-55 chromosomes, accounting for 32.1% (9/28). The karyotypes of high hyperdiploid acute myeloid leukemia (HH-AML) patients were more likely to be +8 (77.3%, 17/22) or +21 (54.5%, 12/22). The survival analysis showed that the overall survival rate of HH/TT-AML patients with -5/5q-, -7/7q-, -17/der(17p) or der(3q) was significantly lower than that without these abnormalities (4.1 months vs 10.1 months,P＜0.05). There was no significant difference in the overall survival rate between triploid/tetraploid acute myeloid leukemia (TT-AML) patients and HH-AML patients (8.4 months vs 7.2 months,P＞0.05). The overall survival rate of the patients with allogeneic hematopoietic stem cell transplantation was significantly longer than that with chemotherapy alone (25.4 months vs 4.1 months,P＜0.01). @*Conclusion@#HH/TT AML patients are highly heterogeneous. The identification of poor prognosis-related chromosome abnormalities is helpful for the stratification of prognosis. The overall survival time of these patients is short. Early allogeneic hematopoietic stem cell transplantation after remission by combination chemotherapy can significantly improve the prognosis of these patients.