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Objective To investigate the outcome of high-risk acute non-lymphocytic leukemia treated with sequential low-dose cytarabine and harringtonine(LD-HA) and standard induction. Methods 50 high-risk ANLL. patients (LD-HA group) who were regarded as unfit for intensive chemotherapy were chosen to receive LD-HA. Reinductive treatments with standard regimens would be given for those who did not achieve complete remission. 23 patients DA/HA group given two cycles of standard inductive regimens were taken as the control. Results In LD-HA group 80.0 %. (40/50) reached CR, 2 patients died shortly after inductive therapy. The median leukemia-free survival(LFS) was 19.6 months, and the median overall survival (OS) was 12.2 months. Overall survival was 57.0 % at 1 year, 24.1% at 3 years, and 18.8 % at 5 years. While the CR rate was 73.9 % for DA/HA group, and none died during the inductive therapy. LFS and OS was 19.8 months and 12.1 months, respectively. OS rate was 56.58 % at 1 year, 27.1% at 3 years, and 27.1% at 5 years.There were no difference on OS rates between 2 groups (x2 were 0.009, 0.237 and 1.807, respectively,P ＞0.05). Conclusion In patients who were unfit for intensive chemotherapy, sequential therapy with LD-HA and standard induction improved the rate of complete remission and the duration of survival.
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Objective To study the expression and clinical significance of TNF related apoptosis-inducing ligand(TRAIL) and Caspase-3 in the bone marrow mononuclear cell(BMMNC) of aplastic anemia(AA) ,and to approach their effect on the apoptosis of haemopoietic stem cell in AA patients.Methods The TRAIL and Caspase-3 expression in 15 cases with newly diagnosed AA patients and remission patients,and 15 cases with normal bone marrow patients were detected by flow cytometry and microplate reader. Results The TRAIL expression of newly diagnosed AA patient, emission AA patients and control group was ( 5.94 ± 2. 57 ) ％, ( 2. 87 ± 1. 72 ) ％ and ( 3.01 ±2. 06)％ respectively,the Caspase-3 expression of newly diagnosed AA patient, emission AA patients and control group was ( 1. 3840 ± 0. 0236), (0. 8018 ± 0. 0126) and ( 0. 7441 ± 0. 0112 ) respectively. The TRAIL and Caspase-3 expression of newly diagnosed AA patient were significantly higher than the remission AA patients and control group,the difference was significant( all P ＜0. 05) ;The TRAIL and Caspase-3 expression of control group were higher than the remission AA patients, but the difference was not significant ( all P ＞ 0. 05 ). Conclusion The TRAIL and Caspase-3 had high expression in the BMMNC of AA patients, and the apoptosis induced by TRAIL and Caspase-3 should play an important role in the pathogenesis of AA.
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ObjectiveTo investigate the methods and effects on the mobilization and collection of peripheral hematopoietic stem cells.MethodsPeripheral hematopoietic stem cells of 198 cases of healthy donors were selected and mobilized by subcutaneous recombinant human granulocyte colony stimulating factor (rhG-CSF) by (5-10) μg·kg-1 ·d-1 and collected on the 5th day. The effects of gender, height, age and WBC count of donors on mobilization and collection were analyzed. ResultsAll the peripheral hematopoietic stem cells of donors were successfully mobilized.The average counts of mononuclear cells(MNC)and CD34+ cells were (4.19±1.96)×108/kg and (2.98±1.40)×106/kg, respectively, which had no correlation with gender, height and age.The counts of MNC and CD34+ cells collected were positively correlated with the WBC count of peripheral blood (r =0.9201, P =0.0035; r =0.8420, P =0.0149). The donors with WBC ≥20.0×109/L had moresignificant effect than thoseWBC＜20.0×109/L (F =4.688, P =0.0013; F =4.622, P =0.0006). Conclusion The WBC count of peripheral blood from healthy donors is a simple and feasible indicator to predict the quantity of CD34+ cells.
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Objective To increase the recognition and diagnostic rate of multiple myeloma.Methods 43 patients with multiple myeloma confirmed by medula needle biopsy and/or pathology were reviewed.Results Misdiagnosis rate reached 65%.Bone abnormality was not found on X-ray and CT films in 8 cases,the remained 35 cases showed bone destructions in varied degrees and types.Conclusion It's main way for improving diagnostic rate of multiple myeloma that deepen recognition of multiple myeloma.Clinical diagnosis must be combined with imageology,laboratory and pathology.