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Objective To analyze the clinical efficacy,safety and influencing factors of decitabine (DAC)-based regimens in patients with myelodysplastic syndrome-refractory anemia with excess blasts (MDS-RAEB).Methods We performed a retrospective analysis of 63 patients with MDS-RAEB treated with DAC,evaluated the clinical efficacy and adverse reactions,and analyzed the influencing factors affecting survival.Results Among 63 patients,23 were RAEB-1 and 40 were RAEB-2.The median treatment was 4 (2-13) courses.The total effective rate of DAC for MDS-RAEB was 58.7％ (37/63),and the complete response rate was 20.6％ (13/63).Among 37 patients who were effective,20 (54.1％) patients performed efficacy after 2 courses.The median course of treatment to achieve the best effect was 3.5 (3-4) courses.With a median follow-up of 14 (2-68) months,63 patients had a overall survival rate (OS) of 84.2％ and a 1-year progression-free survival rate (PFS) of 73％.In univariate analysis,the factors that prolonged OS were that the best effect after medication was stable disease (SD) (to achieve complete remission,partial remission,complete bone marrow remission,hematological improvement) (P =0.009) and no thrombocytopenia at first diagnosis (P =0.019),the factor that prolongs PFS is the best effect above SD (P =0.003).Multivariate analysis suggested that the factors affecting OS and PFS were the best curative effects above SD (P =0.015 vs P =0.008).The adverse effects of decitabine in the treatment of MDSRAEB were mainly bone marrow suppression and pulmonary infection.Conclusions Decitabine is an effective and well-tolerated drug in the treatment of MDS-RAEB.Response to decitabine treatment is one of the independent factors affecting the prognosis.
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Objective:To investigate the clinical efficacy and safety of domestic bortezomib in the treatment of patients with multiple myeloma (MM).Methods:The data of 60 MM patients treated with domestic bortezomib as the basic chemotherapy regimen in 5 medical centers of Qilu Hospital of Shandong University, Heze Municipal Hospital, Weifang People's Hospital, Binzhou Medical University Hospital, Zibo Central Hospital in Shandong Province from January 2018 to June 2019 were retrospectively analyzed, 52 of which were newly treated patients and 8 were relapsed and refractory patients. The patients received at least 2 courses of combined chemotherapy based on domestic bortezomib, and the efficacy was assessed and evaluated every 2 courses.Results:Follow-up until June 30, 2019 showed that some patients were unable to return to the hospital for regular treatment. All patients completed at least 2 courses of treatment, with an overall effective rate (ORR) of 76.7% (46/60); 42 patients completed 4 courses of treatment, with an ORR of 78.6% (33/42); 30 patients completed 6 courses of treatment, with an ORR of 86.7% (26/30); there was no significant difference in ORR of 2, 4 and 6 courses ( P > 0.05). The complete remission+very good partial remission rates of 2, 4 and 6 courses were 16.7% (10/60), 47.6% (20/42) and 66.7% (20/30), respectively, and the difference was statistically significant ( P < 0.01). During the treatment, the adverse events mainly included infection, peripheral neuropathy, herpes, digestive tract symptoms, hematologic toxicities and so on, which were light and moderate mostly, and most of them can be reversed. The total incidence of adverse events in patients who completed 2, 4 and 6 courses of treatment were 91.7% (55/60), 66.7% (28/42) and 36.7% (11/30), respectively. Conclusions:The domestic bortezomib-based chemotherapy regimens have good efficacy in the treatment of MM. The incidence of adverse events is similar to that of the original drug, and patients can tolerate the adverse events.
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Objective:To investigate the effect of c-maf gene on the MM cells' proliferation and invasion activity. Methods:Lipo-fectin Reagent was used to transfect c-maf siRNA into multiple myeloma cell of RPMI8226. The mRNA expression level of c-maf was detected by RT-PCR.Cell growth curve was measured by MTT assay. Transwell chamber test was used to measure MM cells' in vitro in-vasion activity. The cell cycle distribution were assessed by flow cytomentry. The protein expression levels of survivin,MMP-2, MMP-9, ARK5 and cyclin B1 were detected by Western blot. We also detected the activity of Caspase-3/7. Results:The c-maf siRNA was effectively transfected into cells and the mRNA expression of the c-maf gene was inhibited.MTT test and Transwell chamber test showed that the proliferation and in vitro invasion activity of transfected cells were significantly lower than those of other two groups (P<0.05). Cell cycle of c-maf siRNA transfected group cells was arrested in G2/M phase. The expression levels of survivin,MMP-2, MMP-9,ARK5,cyclin B1 and the activity of Caspase-3/7 between c-maf siRNA transfected group and the other two groups were sta-tistically different (P<0.05). Conclusion:c-maf gene by c-maf siRNA can remarkably inhibit proliferation and invasion of multiple my-eloma cell lines of RPMI8226. C-maf gene may be used as the target for multiple myeloma gene therapy.
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To detect the soluble Fas (sFas) receptor level in sera from patients with myelodysplastic syndrome (MDS) and acute leukemia (AL), and investigate its clinical significance, the levels of sFas receptor in sera from 18 patients with MDS and 42 patients with AL were detected by using ELISA methods. The results suggested that the sFas receptor levels in sera from patients with MDS-RA were significantly lower than that from normal control (2.89?1.72 ng/ml vs 6.29?1.07 ng/ml, P