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Objective To investigate the clinical characteristics, curative effect and prognosis of myeloid sarcoma. Methods The clinical data of 12 patients with MS diagnosed at Xijing Hospital of Air Force Medical University from August 2008 to May 2018 were retrospectively analyzed. Their clinical manifestations, diagnosis, treatment and survival were analyzed. Results Twelve patients were 17 to 62 years old. The initial site included lymph node, external auditory canal, eye, buttock, lung, liver, pancreas, breast,skin, vertebra and its surroundings,and cervix. Among 11 patients with peripheral blood classification, bone marrow aspiration and bone marrow biopsy, 6 cases were isolated MS [one of which developed acute myeloid leukemia (AML)], 1 case was chronic myeloid leukemia in chronic phase, 2 cases were AML-M2, and 1 case was myelodysplastic syndrome (MDS), and 1 case was after aplastic anemia (AA) with no infiltration of bone marrow. Immunohistochemical results showed that LCA(+) (7/7), MPO(+) (12/12), CD43(+) (9/9), lysozyme(+) (5/7), CD3(-) (8/8), CD20(-) (9/9), CD34(+) (5/6), CD117(+) (7/7), and Ki-67(+) 30%-90%. Four patients were examined for bone marrow chromosomes, 2 patients with AML had t (8;21), 1 patient with MDS was 47, XX, +8, del(11)(q21), and 1 patient with CML was t(9;22). Two of the 12 patients were lost to follow-up. Among the 10 patients who were followed up, 6 died and 4 survived, and the median survival time was 21 months (2-27 months). Conclusions AA in stable phase with MS and CML in chronic phase with MS are rarely reported. The clinical manifestations of MS patients are varied, of which the common incidence sites are superficial lymph nodes, the infrequent sites are vertebra and its surrounding areas, and the rare sites are eye, pancreas, lung, liver, etc. The median survival time of MS patient is short and the curative effect is poor.
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Objective To investigate the expression of bone marrow γ-H2AX in the patients with multiple myeloma(MM) and its correlation with the prognosis.Methods The patients with newly diagnosed MM in this hospital were selected as the case group,and the patients with non-hemopoietic system tumor without obvious morphological abnormalities by bone marrow smear and biopsy served as the control group.The immunohistochemistry was adopted to detect the expression level of bone marrow γ-H2AX in the cases group and control group,the image-Pro Plus(IPP) semiquantitative analysis was performed.The expression differences were compared between the two groups,moreover the case group was re-divided into the strong expression group and weak expression group according to γ-H2AX expression level.Then the relation ship between γ-H2AX expression level and the prognosis in the patients with MM.Results The bone marrow γ-H2AX expression level in the case group was significantly higher than that in the control group (P＜0.05);the level of γ-H2AX expression in the strong expression group was significantly stronger than that in the weak expression group (P＜0.05).Conclusion The level of γ-H2AX expression was higher among MM patients,and the over expression of γ-H2AX predicts the shorter survival time.
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Objective To explore the value of applying multiple disciplinary team (MDT) in the clinical practice teaching of lymphoma. Methods 5-year program clinical medicine undergraduate students of 2012 were divided into experimental and control group randomly, with 30 cases in each group. The ex-perimental group received MDT in clinical teaching through MDT conference and cases analysis. The control group received conventional teaching mainly by smal class presentation and ward round . The effect of teaching was evaluated by examination and questionnaire. The data were analyzed through t-test and chi-square test by SPSS 20.0 software. Results The results showed the students' scores of the theory knowledge test of two groups were similar to each other, but the scores of discussional topic and clinical cases analysis were higher in experimental group than control group and statistically difference [(16.5 ±2.3)vs. (10.5 ±1.8);(37.5±2.5) vs.(27.5±1.8)], (P=0.000), and the final score of two groups showed statistically difference (93.5± 5.2 vs. 76.0 ±6.2) (P=0.000). Meanwhile, questionnaire survey of satisfaction showed that 27 students of experimental group (90.0%) were interested in this new teaching model, 29 students (96.7%) believed it im-proved understanding and memory to the process of lymphoma diagnosis and treatment, 25 students (83.3%) believed it could improved the ablility to diagnose and differential diagnose lymphoma and expanded their clinical view. 28 students (93.3%) had consolidated clinical thinking, and 26 students (86.7%) improved negotiation with patients. All issues were significantly better than control group (P<0.05). Conclusions The clinical teaching model innovation based on MDT could help medical students use the cross-discipinary interviewing and make optimal treatment plan for patients. It is conducive to the cultivation of their diagnosis, differential diagnosis and clinical thinking ability, which is worthy of promotion in hematological clinical teaching.
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Objective To investigate the effects of human bone marrow fibroblastoid stromal cell lines HFCL on the proliferation .migrating and homing of multiple myeloma cell lines RPM18226. Methods The co-culture system of RPMI8226 and HFCL was established through cell culture in vitro, growth curves were determined by trypan blue exclusion, cell cycle and expression of adhension molecule CD49d were detected by flow cytometry, and expression of CXCR4 gene was examined by RT-PCR. Results The proliferation of RPMI8226 cells in direct contact with HFCL cells group was inhibited strongerly than that in transwell group. The percentage of G1 phase cells of RPMI8226 cells in direct contact with HFCL group was higher than that of RPM 18226 in transwell group, while the percentage of S phase cells was lower. The expressions of CD49d and CXCR4 in RPMI8226 cells were down-regulated by HFCL cells, and that in transwell group was higher than that in direct contact with HFCL cells group. Conclusion Human bone marrow fibroblastoidss tromal cell HFCL can inhibit the proliferation and the expressions of CD49d and CXCR4 of multiple myeloma cell line RPMI8226, and can prevent multiple myeloma cells from migrating and homing.
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Objective To investigate the effect of arsenic trioxide(As2O3) on the biology characteristics of multiple myeloma RPMI8226 cells in vitro and the molecular mechanism.Methods Multiple myeloma RPMI8226 cells were used for experiments target,cell cycle,apoptotic peak,and adhesion molecular VLA4(CD49d) were determinded by flow cytometry.Expression of CXCR4gene was examined by RT-PCR.Expression of death receptor DR4 and DR5 were measured by immunofluorescence microscopy and flow cytometry.Results Five ?mol/L As2O3 upregulated DR4 and DR5 expression on RPMI8226 cells markedly(P
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Objective To observe the efficacy and main complications of allogeneic hematopoietic stem cell transplantation(allo-HSCT)for 76 patients with hematopoietic malignancies.Methods From September 2001 to March 2007,76 patients received allo-HSCT in Department of Hematology,Xijing Hospital,Fourth Military Medical University.All cases included 24 acute myeloid leukemia(AML),15 acute lymphocytic leukemia(ALL)and 34 chronic myelogenous leukemia(CML)and 3 T cell lymphoma/leukemia.Donors were HLA-identical sibling(n=57),1 locus mismatched sibling(n=3),HLA-matched unrelated volunteer(n=9)and haplo-identical sibling(n=7).Conditioning regimen consisted of busulphan-cyclophosphamide or cyclophosphamide and total body irradiation plus Ara-c/VP-16.Graft versus-host disease prophylaxis was the standard methotrexate and cyclosporine combination.Anti-human thymocyte immunoglobulin(ATG)and CD25 monoclonal antibody was given in unrelated donor and haplo-identical HSCT.Results Totally 73 patients got sustained engraftment.Acute GVHD and chronic GVHD were found in 18/73(24.7%)and 24/73(32.9%)patients,respectively.Severe veno-occlusive disease occurred in 2 cases.Pure red cell aplasia was found in 5 patients with major ABO mismatched HSCT.With a follow-up of 3 to 76 months,43/76(56.6%))patients were still alive and 33/76(43.4%)died from leukemia relapse or transplantation-related complications.Conclusion Allogeneic heamatopoietic stem cell transplantation is an effective therapy for leukemia,especially in CML-chronic period and acute leukemia in complete remission,but there is high rate of relapse in patients with high-risk and refractory status before transplantation.