Comparison of the Curative Efficacy of Elderly Patients with High-Risk MDS and MDS-Transformed AML between Decitabine Combined with Low-Dose CEG Regimen and Decitabine Combined with Low-Dose CAG Regimen / 中国实验血液学杂志

OBJECTIVE@#To evaluate the efficacy of decitabine combined with low-dose CEG regimen (DCEG) and decitabine combined with low-dose CAG regimen (DCAG) in the treatment of elderly patients with MDS and MDS-transformed acute myeloid leukemia (AML).@*METHODS@#A prospective study was conducted in 7 medical centers, 45 patients with MDS (≥ 60 years old) and MDS-transformed AML from October 2016 to January 2019 were enrolled, with the median age of 68.5 years old. The risk stratification of patients was poor or very poor, according to IPSS-R score. The treament results of decitabine combined with CEG and decitabine combined with CAG were compared.@*RESULTS@#The comparison of the two regiem showed that the DCEG regimen had advantages on total effective rate (ORR, 86.4% vs 47.8%, respectively), overall survival time (OS) (10.0 months vs 6.0 months, respectively) and progression-free survival time (PFS) (9.0 months vs 3.0 months, respectively). About 50% of MDS patients treated by DCEG regimen achieved PR or CR, with a median OS of 31 months. Multivariate analysis showed that patients with PR or CR after induction therapy and DCEG regimen had longer survival time (31months). The incidence of bone marrow suppression, infection and treatment-related mortality rate were similar between the two groups.@*CONCLUSION@#Decitabine combined with CEG regimen could improve the survival of patients with high-risk MDS and MDS-transformed AML. The conclusion of the reaserch needs to be validated by a larger prospective randomized clinical trial.

Effect of Leukodepleted Blood Transfusions on the Balance of Th1/Th2 Cells in Peripheral Blood of Patients with Acute Lymphoblastic Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of leukodepleted blood transfusions on peripheral blood Th1/Th2 cell balance in patients with acute lymphoblastic leukemia (ALL).</p><p><b>METHODS</b>Fifty-seven ALL patients in our hospital from March 2016 to August 2017 were selected, 31 of them received routine blood transfusion were enrolled in group A, and 26 patients received depleted-blood leukotransfusion were enrolled in group B, 36 cases in normal physical examination at the same period were enrolled in control group. And the basic clinical characteristics of patients were recorded; the ratio of Th1/Th2 cells in peripheral blood of patients was analyzed by flow cytometry;the serum levels of IL-2, IFN-γ, IL-4, IL-10 were detected by ELISA method; the mRNA levels of T-bet and GATA-3 in lymphocytes were detected by RT-PCR;the protein levels of T-bet and GATA-3 in lymphocyte were detected by Western blot.</p><p><b>RESULTS</b>The Th1/Th2 ratio in peripheral blood of ALL patients significantly related with patient age and risk grade (P<0.05).After treatment,the change of Th1/Th2 ratio in group A showed no statistical difference from Th1/Th2 ratio before treatment (P>0.05), while the Th1/Th2 ratio in group B increased (P<0.05);the levels of IL-2, IFN-γ, IL-4 and IL-10 secreted from Th1 and Th2 cells of ALL patients in A group were not changed significantly(P>0.05), while the levels of IL-2 and IFN-γ secreted from Th1 cells of ALL patients in group B increased, the levels of IL-4 and IL-10 secreted from Th2 cells in group B decreased with statistical difference (P<0.05); the RT-PCR and Western blot showed that the expression levels of T-bet mRNA and T-bet protein in group A were lower than those in control group, while the expression levels of T-bet mRNA and T-bet protein in group B were higher than those in group A (P<0.05); the expression levels of mRNA and GATA-3 protein in group A were higher than those in control group, the expression levels of mRNA and GATA-3 protein in group B were lower than those in group A (P<0.05).</p><p><b>CONCLUSION</b>The leukoreduced blood transfusion helps to improve the balance of Th1/Th2 cells in peripheral blood and improve the immune function of patients, which may closely relate with the expression levels of T-bet and GATA-3.</p>

Analysis of Prognostic Factors for 96 Patients with Acute Lymphoblastic Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and clinical prognostic factors of patients with acute lymphoblastic leukemia (ALL).</p><p><b>METHODS</b>Ninety-six ALL patients in our hospital from June 2012 to August 2014 were selected and their clinical data were collected. The related clinical data of patients were recorded, and the relation between clinical characteristics and therapeutic efficacy was analyzed. The COX analysis was used to reveal the risk factors affecting the patient's OS and DFS time.</p><p><b>RESULTS</b>Among 96 ALL patients, 65 patients achieved complete remission (CR) after treatment. The age, immunophenotype, central nervous system leukemia (CNSL) and peripheral blood WBC count correlated with complete remission (P<0.05). The age, WBC count, platelet level, immune typing and consolidation therapy were the prognostic factors (P<0.05), the 2 year OS rate was influenced by age, WBC count, CD34 and consolidation therapy (P<0.05), the 2 year DFS rate was influenced by age, CD34 and consolidation therapy (P<0.05).</p><p><b>CONCLUSION</b>Age, WBC counts, CD34 and consolidated treatment after remission are prognostic factors for ALL patients, which has guiding significance for clinical treatment of ALL.</p>

Correlation of Th17 Cells and IL-17 Level in Multiple Myeloma Patients with Pathogenesis of Multiple Myeloma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the correlation of Th17 cell rate and IL-17 level with pathogenetis of multiple myeloma(MM).</p><p><b>METHODS</b>Forty-five cases of MM were enrolled in MM group, while 45 healthy volunteers were selected in control group. The rate of Th17 cells, levels of IL-17 and β2-microglobulin(β2-MG) in patients subgrouping according to ISS staging and treatment were detected by using flow cytometer and IL-17 assay kit. The correlation of Th17 cell rate and IL-17 level with MM was analyzed.</p><p><b>RESULTS</b>The rate of Th17 cells and level of IL-17 in MM group were higher than those in control group(P<0.05), the rate of Th17 cells and level of IL-17 in ISS III stage patients were higher than those in ISS I and II stage patients(P<0.05); the rate of Th17 cells and level of IL-17 in ISS I and ISS II stage patients were not significant difference (P>0.05); the rate of Th17 cells and level of IL-17 in firstly treated, retreated/refractory patients were significantly higher than those in patients with effective treatment(P<0.05), while the rate of Th17 cells and level of IL-17 between firstly treated patients and retreated/refractory patients were not significant difference (P>0.05). The Th17 rate and IL-17 level in MM patients positively correlated with β2-MG level (r=0.422, r=0.416, P<0.05).</p><p><b>CONCLUSION</b>The obvious increase of Th17 rate, IL-17 and β2-MG levels closely relates with pathogenesis of MM. The Th17 rate and IL-17 level may be used as important evidence for evaluation of ISS stage and therapeutic efficacy of MM.</p>

Clinicopathological Features of Primary Central Nervous System Lymphoma and Their Influence on Prognosis of Desease / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the clinical features of of patients with primary central nervous system lymphoma(PCNSL) and their influence on prognosis.</p><p><b>METHODS</b>Forty-two cases of PCNSL hospitallized in our hospital from January 2012 to December 2015 were selected, and the laboratory analysis, imaging examination, bone marrow analysis and pathological examination all were performed, 26 cases were treated by lumbar puncture combined with intrathecal injection of drugs (Ara C, dexamethason and methotrexate), 8 cases were treated by methotrexate combined with rituximab, 8 cases voluntanly abandon treatment after being diagnosed as PCNSL.</p><p><b>RESULTS</b>Headache accrued in 12 cases, diplopia in 2 cases, dizziness in 6 cases, limb weakness in 10 cases, amnesia in 2 cases, inhibited speech in 4 cases.Out of 42 patients 4 cases of peripheral T cell lymphoma, 38 cases of B cell lymphoma; 30 cases of multiple lesions, 12 cases of solitary lesions, 8 cases of corpus callosum, 8 cases of thalamus, 8 cases of frontal lobe, parietal lobe, temporal lobe, thalamus and other lesions, 2 cases of hydrocephalus, 2 cases of cerebral hemorrhage; and the patients HIV were negative. 8 cases erythrocyte sedimentation rate were faster, IgG, IgE and IgM levels increased to varying degrees in 42 cases, and the blood routine, liver function and blood coagulation examinations showed normal; There was no significant difference in the influence of the lumbar injection, methotrexate dose, radiation therapy, and hematopoietic stem cell transplantation on survival time(P>0.05); but there was significant difference in the influence of rituximab and number of lesions on survival time (P<0.05); there were significant differences in the effects of age and protein content in cerebrospinal fluid on therapeutic effecacy(P<0.05).</p><p><b>CONCLUSION</b>There is no significant difference in the imaging examination and clinical manifestation between PCNSL and other intracranial tumors. The lumbar puncture is an effective way to identify, the age, cerebrospinal fluid protein and the number of lesions are the adverse factors influencing the prognosis.</p>

Clinical Value of Arsenous Acid for Treating Patients with Acute Promyelocytic Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the clinical value of arsenious acid (H3AsO3) for treating patients with acute promyelocytic leukemia (APL).</p><p><b>METHODS</b>A total of 86 patients with APL were randomly divided into experimental group (43 cases) and control group (43 cases). The control group was treated by all trans retinoic acid combined with chemotherapy, the experimental group were treated by arsenous acid on the basis of the control group.</p><p><b>RESULTS</b>The overall response rate (ORR) in experimental group (100.00%) was significantly higher than that in control group (88.37%) (P < 0.05). The time of returm to complete remission in experimental group (30.86 ± 4.34) was better than that in control group (42.42 ± 7.10) d (P < 0.05). The time of return to normal levels of peripheral WBC count (20.86 ± 9.28) × 10⁹/L, hemoglobin count (68.62 ± 14.97) g/L and thrombocyte count in experimental group obviously less than that in control group (P < 0.05). The rates of high white blood syndrome (HWBS), disseminated intravascular coagulation (DIC) in experimental group were lower than that in control group (P < 0.05). The survival rates of 2 and 3 years in experimental group were higher than that in control group (P < 0.05). The recurrence rate after treatment in experimental group was lower than that in control group (P < 0.05). The application of arsenious acid was main factor for patients survival (P < 0.05).</p><p><b>CONCLUSION</b>Arsenious acid can improve the clinical efficacy for the patients with acute promyelocytic leukemia, and reduce the complication, therefore it is worthy of application in clinic.</p>

Values of Detecting the Levels of β2-MG, TNF-α, CRP, IL-6 in the Patients with Multiple Myeloma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the values of detecting the serum levels of β2-MG, TNF-α, CRP, IL-6 in the patients with multiple myeloma.</p><p><b>METHODS</b>A total of 40 patents with multiple myeloma were included in the experiment group, and 40 healthy volunteers were selected as the control group. The levels of β2-MG, TNF-α, CRP and IL-6 were detected and compared in 2 groups, the different durie-salmon (DS) stages of β2-MG, TNF-α, CRP and IL-6 in the experiment group were analyzed.</p><p><b>RESULTS</b>The levels of β2-MG, CRP, IL-6 in the experiment group were higher than those in control group (P < 0.05); the level of TNF-α in the experiment group was lower than that in control group (P < 0.05); the levels of β2-MG, CRP, IL-6 at stage I, II, III in the experiment group was higher than those in control group (P < 0.05); the level of TNF-α at stage I, II, III in the experiment group was lower than that in the control group (P < 0.05); the levels of β2-MG, CRP, IL-6 at stage I, II, III in the experiment group displayed an increasing tendency, the levels of TNF-α at stage I, II, III in the experiment group displayed a declining trend (P < 0.05); the levels of β2-MG, CRP, IL-6 in the experiment group after treatment for 8, 16 weeks were higher than those in control group (P < 0.05); the level of TNF-α in the experiment group after treatment for 8, 16 weeks was lower than that in control group (P < 0.05); the levels of β2-MG, CRP and IL-6 in the experiment group after treatment for 16 weeks were lower than those for 8 weeks (P < 0.05); the levels of TNF-α in the experiment group after treatment for 16 weeks were higher than those for 8 weeks (P < 0.05). The levels of APE1 after treatment in the experiment group were lower than that before treatment.</p><p><b>CONCLUSION</b>The serum levels of β2-MG, TNF-α, CRP and IL-6 can be as index for diagnosis of multiple myeloma, can effectively evaluate the disease severity; their combination with APE1 expression level can evaluate the therapeutic efficacy; thus the detection of above-mentioned indexes is possessed of higher value for clinical applications.</p>