Early T-cell precursor acute lymphoblastic leukemia: report of 1 case and review of literature / 白血病·淋巴瘤

Objective:To improve the understanding of the diagnosis and treatment of early T-cell precursor acute lymphoblastic leukemia (ETP-ALL).Methods:The clinical data of a patient with ETP-ALL who was misdiagnosed as peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS) admitted to the Second Hospital of Lanzhou University in October 2020 were retrospectively analyzed, and the relevant literature was reviewed.Results:The patient who presented "inguinal lymphadenopathy" as the first symptom underwent lymph node biopsy and pathological examination at local hospital, and he was diagnosed as PTCL-NOS according to the consultation of another 2 hospitals. After 2 courses of chemotherapy (CHOPE regimen, GLD regimen, unknown specific medication and dosage), the therapeutic efficacy was poor. For further diagnosis and treatment, this patient came to Lanzhou University Second Hospital. Flow cytometry found blast cells in the bone marrow, and then other related examinations were completed, he was finally diagnosed as ETP-ALL. The chemotherapy regimens of Hyper-CVAD and EA were alternatively used, progressive disease (PD) occurred after 3 courses of treatment, and chidamide was added in the 4th and 5th courses of treatment, the disease still progressed, and the patient died after follow-up. The disease course of the patient was about 12 months.Conclusions:ETP-ALL has unique immunophenotypic characteristics. ETP-ALL patients have a low remission rate after conventional induction therapy, high recurrence rate and poor prognosis. Currently, there is no effective standard treatment regimen, and allogeneic hematopoietic stem cell transplantation or timely addition of new drugs may improve the prognosis.

Immuno-effect of plasmacytoid dendritic cells on bacteria infection induced spontaneous remission of leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the immuno-effect of plasmacytoid dendritic cells (pDC) on bacteria infection induced spontaneous remission (SR) of leukemia.</p><p><b>METHODS</b>Both pDC and myeloid dendritic cells (mDC) were isolated and purified from leukemic patient with SR and healthy donor by combination of immunomagnetic beads and flow cytometry. pDC were cultured in RPMI1640 medium and stimulated with different bacteria. The T cells proliferation was detected by MTT, and cytokine production by ELISA kits.</p><p><b>RESULTS</b>The human bacterial pathogen Staphylococcus aureus and Pseudomonas aeruginosa stimulation for 48 h resulted in the maturation of pDC with production of high quantity of IFN-α at (15.34 ± 2.91) ng/ml and (10.38 ± 1.41) ng/ml, respectively, comparing with that of negative group at (1.36 ± 0.13) ng/ml (P<0.01). Activated pDC could promote the differentiation of naive CD4⁺ T cells to Th1 cells with secretion of IFN-γ at (2.16 ± 0.37) ng/ml and (2.73 ± 1.11) ng/ml, respectively, comparing with that of positive control at (2.55 ± 0.23) ng/ml (P > 0.05). Activated pDC showed higher T cell stimulatory capacities [proliferation index (PI) was 4.36 and 4.05, respectively] than that of non-activated pDC (PI was 1.23 and 0.13, respectively) (P < 0.01).</p><p><b>CONCLUSION</b>Staphylococcus aureus and Pseudomonas aeruginosa activated pDC may play a key role in SR of leukemia following severe infections.</p>

Effect of dendritic cells pulsed with tumor lysate antigens co-cultured with cytokine induced killer cells on cytotoxicity against multidrug resistant cells / 中国实用内科杂志

Objective To investigate the effect of dendritic cells(DC)pulsed with tumor lysate antigens of K562/A02 co-cultured with cytokine induced killer(CIK)cells on cytotoxicity against multidrug resistant(MDR)leukemia K562/A02 cells with high expression of p-glycoprotein(P-gp).Methods Bone marrow mononuclear cells isolated from healthy adult donors were induced to obtain CIK cells and DC respectively and then CIK were co-cultured with DCs which were pulsed with tumor lysate.The morphologic features were observed with optical microscopy and expressions of markers typical were measured using flow cytometry.The cytotoxicity of three effect cells was measured with MTT assay respectively.Results After pulsing DCs with tumor lysate antigens co-cultured CIK or DC-CIK led to a significant increase of lymphocyte proliferation of both populations.The cytotoxicity of CIK co-culturing with DCs pulsed with tumor lysate antigens to K562/A02 and K562 cells was(42.90?0.67)%、(49.85?0.28)%(63.36?0.46)% and(23.56 ?0.43)%、(26.11?0.34)%、(34.46?0.35)% respectively at an effector-to-target ratio of(5∶1、 10∶1 、20∶1).Conclusion This study indicates that DC pulsed with tumor lysate antigens co-cultured with CIK can improve lymphocyte proliferation and enhance the cytotoxic activity.Especially,it can induce a P-gp specific anti-leukemic immune.