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OBJECTIVE@#To explore the clinical characteristics and prognostic values of TP53 gene variant in patients with acute leukemia(AL).@*METHODS@#The clinical data of 44 newly diagnosed AL patients with TP53 variant detected by next generation sequencing (NGS) were analyzed retrospectively. Targeted sequencing technique containing 108 leukemia-related genes was used for variant analysis, and conventional R-banding technique was used for karyotype analysis. The clinical features, cytogenetics, gene variant, curative effect and survival of AL patients with TP53 gene variant were analyzed.@*RESULTS@#The median age of AML patients with TP53 gene variant (46 years) was higher than that of ALL patients (17.5 years), and the median number of bone marrow blasts (40.5%) was lower than the latter (89.2%), the differences were statistically significant (P< 0.01). A total of 28 cases of abnormal karyotype were detected, of which 25 cases were complex karyotype, 16 cases were monomeric karyotype, 14 cases had -17/17p-. The detection rates of TP53 in complex karyotype, monomeric karyotype and -17/17p- were 59.5%, 38.1% and 33.3%, respectively. Subgroup analysis showed that the detection rate of TP53 gene abnormalities in AML and ALL complex karyotypes was 73.1% and 40% respectively, the difference was statistically significant. A total of 41 TP53 gene variant types were found, and the median variant frequency was 43.58%. 75.6% variant was located in the DNA binding domain. The concomitant variant genes were mainly TET2 and IKZF1. Among 18 AML and 17 ALL patients who could be evaluated the curative effect, the CR rate of one course of treatment was 22.2% and 94.12% respectively, and the difference was statistically significant. The median RFS of 4 cases of AML with CR and 16 cases of ALL with CR were 174 and 246 days respectively, the difference was statistically insignificant. The median OS of AML and ALL was 20 and 375 days respectively, the difference was statistically significant.@*CONCLUSION@#The TP53 gene variant is associated with the complex karyotype of AML, but has no significant effect on ALL. The variant site of TP53 gene was mainly distributed in the DNA binding domain. The remission rate of AML with TP53 gene variant was lower than that of ALL. The prognosis of AL patients with TP53 gene variant is poor, so allogeneic hematopoietic stem cell transplantation should be performed as soon as possible to prolong the survival of the patients.
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Humans , Middle Aged , Acute Disease , Leukemia, Myeloid, Acute/genetics , Mutation , Retrospective Studies , Tumor Suppressor Protein p53/geneticsABSTRACT
Objective@#To explore the relationship between driver gene mutation (JAK2, MPL and CALR) and disease type in BCR-ABL negative myeloproliferative neoplasms (MPNs) including primary myeloid fibrosis (PMF), essential thrombocytosis (ET) and polycythemia vera (PV).@*Methods@#A total of 32 MPN related genes were detected by high-throughput sequencing in 156 MPN patients. The relationships between disease type and patients′ general performance, the characteristics of driver gene mutations, concomitant gene mutations were analyzed.@*Results@#In the population with JAK2 V617F positive mutation, the proportion of patients over 60 years old in PMF was higher than that with ET or PV. By high-throughput sequencing, 22 concomitant gene mutations were detected in 46 patients with JAK2, MPL or CALR mutations, including 4 (8.3%) in PV, 20 (29.4%) in ET, and 22 (55.0%) in PMF. DNMT3A mutation was detected only in patients with PV, while splicing factor related genes including SF3B1, SRSF2 and U2AF1 were only accompanied by PMF. According to the variation allele frequency (VAF) value of JAK2 V617F mutation, the VAF value associated with PV was the highest (68.15%), followed by PMF (37.7%) and ET (23%). However, there were significant differences in the incidence of JAK2 V617F homozygous among 3 different diseases. In patients with JAK2 mutation, the proportion of other gene mutations in PV and ET was significantly lower than that in PMF.@*Conclusions@#Under the condition of common driver gene mutations (JAK2, MPL and CALR), patients′ age, VAF value and homozygous state, concomitant gene mutations are closely related to different disease type. These correlations help to improve clinical understanding of disease characteristics and risk assessment.
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Objective:To explore the characteristics and clinical significance of clonal heterogeneity in patients with acute lymphoblastic leukemia(ALL).Methods:From January 2016 to June 2019, 170 newly diagnosed ALL patients were enrolled in the Department of Hematology, Henan Cancer Hospital, including 93 males and 77 females, with a median age of 17 (2-80) years. Fifty-two ALL-related genes were detected by high-throughput sequencing technique. The clonal heterogeneity of mutations was analyzed according to the variant allele frequency (VAF) and the results of flow cytometry. The prognostic value of mutations was also evaluated.Results:Gene mutations were detected in 121 (71.2%, 121/170) patients, of which 2 or more clones were detected in 18 (52.9%, 18/34) T-cell acute lymphoblastic leukemia patients, while only 23 (16.9%, 23/136) B-cell acute lymphoblastic leukemia patients were positive of multiple mutations ( P<0.01).Gene mutation-related clonal heterogeneity analysis showed that 2 or more clones were frequent in patients with NOTCH1 mutations (13/19 patients) ( P<0.01). Event free survival (EFS) in patients with 3 or more clones was significantly lower than other patients (χ 2=10.330, P=0.016). Child ALL patients had similar result, that multiple clones predicted lower overall survival (OS) and EFS (OS: χ 2=7.974, P=0.047; EFS: χ 2=10.860, P=0.013). Conclusion:Clonal heterogeneity in ALL patients is closely related to the different origin of lymphocyte lineages and the age of onset, which may reveal the nature of the disease and predict the clinical outcome.
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Objective:To explore the relationship between driver gene mutation (JAK2, MPL and CALR) and disease type in BCR-ABL negative myeloproliferative neoplasms (MPNs) including primary myeloid fibrosis (PMF), essential thrombocytosis (ET) and polycythemia vera (PV).Methods:A total of 32 MPN related genes were detected by high-throughput sequencing in 156 MPN patients. The relationships between disease type and patients′ general performance, the characteristics of driver gene mutations, concomitant gene mutations were analyzed.Results:In the population with JAK2 V617F positive mutation, the proportion of patients over 60 years old in PMF was higher than that with ET or PV. By high-throughput sequencing, 22 concomitant gene mutations were detected in 46 patients with JAK2, MPL or CALR mutations, including 4 (8.3%) in PV, 20 (29.4%) in ET, and 22 (55.0%) in PMF. DNMT3A mutation was detected only in patients with PV, while splicing factor related genes including SF3B1, SRSF2 and U2AF1 were only accompanied by PMF. According to the variation allele frequency (VAF) value of JAK2 V617F mutation, the VAF value associated with PV was the highest (68.15%), followed by PMF (37.7%) and ET (23%). However, there were significant differences in the incidence of JAK2 V617F homozygous among 3 different diseases. In patients with JAK2 mutation, the proportion of other gene mutations in PV and ET was significantly lower than that in PMF.Conclusions:Under the condition of common driver gene mutations (JAK2, MPL and CALR), patients′ age, VAF value and homozygous state, concomitant gene mutations are closely related to different disease type. These correlations help to improve clinical understanding of disease characteristics and risk assessment.
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Objective@#To establish a new method for chimerism analysis after allogeneic hematopoietic stem cell transplantation by using multiple nucleotide polymorphism sequencing (MNPseq) , and to explore its feasibility and superiority.@*Methods@#One hundred MNP fragments were screened and chimeric analysis was performed by high-throughput sequencing technology. The accuracy and sensitivity of the method were verified by simulating chimeric samples and post-transplant samples and comparing them with short tandem repeat (STR) analysis, fusion gene quantitative detection and flow cytometry for minimal residual disease.@*Results@#The accuracy and sensitivity of MNPseq were better than those of STR, in which the sensitivity could reach 0.01%, about 100 times more sensitive than STR. MNPseq could further distinguish 42 STR fully chimeric samples, and after corrected by cutoff value, it was correlated with the quantitative detection of fusion gene. MNPseq could correct false positive of STR caused by the shadow peak, and could be used to detect chimeric samples lacking pre-transplant information from donors and recipients.@*Conclusion@#MNPseq analysis based on high-throughput sequencing is a more accurate and sensitive chimerism detection method, and it solves the problem that chimerism cannot be detected due to the lack of pre-transplant information, which has extremely high clinical application value.
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Objective@#To detect the expression of CRLF2 in adult Ph negative acute B lymphocytic leukemia (B-ALL) in newly diagnosed cases, and to investigate the relationship between CRLF2 and the general clinical characteristics, efficacy and prognosis.@*Methods@#103 cases of newly diagnosed adult B-ALL patients were investigated from Apr 2016 to Dec 2017 in the Department of Hematology, Henan Cancer Hospital. Bone marrow samples was used to detect the expression of CRLF2 in leukemic cells. The expression of CRLF2 ≥20% was defined as CRLF2-high group and <20% was defined as CRLF2-low group. The clinical characteristics and prognosis of the two groups were compared.@*Results@#The Median overall survival (OS) and disease free survial (DFS) in CRLF2-high group were 9.0 months and 4.25 months, respectively. CRLF2-low group were 15.5 months and 10.25 months, respectively. There was a statistically significant difference in median OS and DFS between the two groups (P=0.007, P=0.000) . The 18-month OS and DFS in CRLF2-high group were 38.6% and 25.1%, respectively. CRLF2-low group were 57.8% and 42.3%, respectively. Multivariate analysis showed high expression of CRLF2 was an independent risk factor for OS (HR=2.991, 95% CI 1.429-6.261, P=0.004) and DFS (HR=2.374, 95%CI 1.146-4.960, P=0.041) in patients.@*Conclusion@#Patients with high expression of CRLF2 had poor prognosis.
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Objective To investigate the efficacy and toxicity of low dose of docetaxel and cisplatin (TP) combined with radiotherapy in the treatment of elderly patients with esophageal cancer.Methods The data of 65 elderly patients with esophageal cancer were studied retrospectively, including 33 patients treated by TP combined with radiotherapy (chemoradiotherapy group) and 32 patients by radiotherapy only (radiotherapy group).Patients in both groups received 3D conventional radiotherapy (3D-CRT).In chemoradiotherapy group, 40 mg/1f docetaxel and 40 mg/1f cisplatin were administered once a week on the 1st, 8th, 15th, 22th, 36th day of five successive weeks.Results In chemoradiotherapy group and radiotherapy group, the response (CR+RR) rates were 87.8 ％ (29/33) and 65.6 ％ (21/32), respectively (P ＜ 0.05), the median TTPs were 5.5 months and 4.3 months, and the difference had statistically significant (P ＜ 0.05).The 1-year survival rate was 69.6 ％ and 59.3 ％ in chemoradiotherapy group and radiotherapy group, respectively, and there was no statistically significant difference between both groups (P ＞ 0.05).The incidences of esophagitis and gastrointestinal tract were slightly higher in chemoradiotherapy group than those in radiotherapy group (P ＜ 0.05).Conclusion Concurrent radiotherapy and chemotherapy with low dose TP can treat effectively esophageal cancer in elderly patients with the tolerable toxic reactions.
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<p><b>OBJECTIVE</b>To explore the clinical features and survival of patients with CD56 expression in de- novo acute myeloid leukemia（AML）with t（8;21). .</p><p><b>METHODS</b>Clinical data of 82 de novo AML with t（8;21）who were newly diagnosed from Jan 2008 to Apr 2014 were analyzed retrospectively, 50 expressed CD56 and 32 not. Clinical characteristics and prognoses were compared between patients expressing and nonexpressing CD56.</p><p><b>RESULTS</b>There were no statistically significant differences in terms of age, gender, white blood cell count（WBC）, percentage of bone marrow blasts, extramedullary infiltration rate, the early mortality or the presence of additional cytogenetic abnormalities between CD56 + and CD56- groups（P＞0.05). The expressions of lymphatic antigens CD19 between CD56 + and CD56- groups showed significant difference （30.0% vs 53.1% , P=0.036). The complete remission and 3-year overall survival（OS）showed no significant differences between CD56+ and CD56-groups, while 3- year disease- free survival（DFS）showed significant differences（25.8% vs 46.9%, P=0.014). Multivariable analysis for DFS identified CD56 positivity as an independent predictor. DFS of who received allogeneic hematopoietic stem cell transplantation（HSCT）was better than those treated with intermediate- dose cytarabine/high dose cytarabine（IDAC）as postremission therapy.</p><p><b>CONCLUSION</b>The expression of CD56 in de-novo AML with t（8;21) appeared to be associated with poorer prognosis.</p>
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Humans , Bone Marrow , CD56 Antigen , Chromosome Aberrations , Chromosomes, Human, Pair 21 , Chromosomes, Human, Pair 8 , Cytarabine , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Leukemia, Myeloid, Acute , Prognosis , Remission Induction , Retrospective Studies , Survival AnalysisABSTRACT
<p><b>OBJECTIVE</b>To explore the inhibitory effect of thalidomide combined with interferon (IFN) on the human acute myeloid leukemia cell line Kasumi- 1 and its mechanism.</p><p><b>METHODS</b>The inhibitiory effect of Kasumi- 1 cells by thalidomide, interferon or combination was detected by CCK- 8 method, the apoptosis by flow cytometry, the expression of apoptosis related proteins by Western blot, vascular endothelial growth factor (VEGF) concentration in culture supernatant by ELISA.</p><p><b>RESULTS</b>Thalidomide inhibited the proliferation of Kasumi- 1 in a dose- dependent manner from 50 μg/ml to 500 μg/ml with an IC₅₀ of (451.13 ± 6.92）μg/ml at 24 h and (362.50 ± 14.52）μg/ml at 48 h. IFN also demonstrated the inhibitory capacity in a dose-dependent manner from 500 U/ml to 5 000 U/ml, with an IC₅₀ of (2 209 ± 127) U/ml at 24 h and (1 393±63) U/ml at 48 h. The apoptosis rates of Kasumi-1 cells treated with thalidomide 350 μg/ml or IFN 1 400 U/ml for 48 h were (14.68 ± 2.61) % and (21.71 ± 0.71)%, respectively, significantly higher than control group (P<0.01). In combination group the inhibition and the apoptosis rate were (88.50 ± 2.40) % and (41.95 ± 3.41)%, significantly higher than control and each single agent group (P<0.01). The VEGF concentrations of combination group [(94.61 ± 5.46) ng/L decreased significantly, as compared to thalidomide group [(141.11 ± 3.70) ng/L and IFN group [(119.90 ± 2.00) ng/L (P < 0.05). Western blot analysis showed Bcl-2 expression of Kasumi-1 cells decreased, while p-P38, Bax, cytochrome C, cleaved-Caspase-3, 8, 9 increased after treated with thalidomide 350 μg/ml or IFN 1 400 U/ml for 48 h. When treated with the combination agents, the expression of Bcl-2 further decreased and p-P38, Bax, cytochrome C, cleaved-Caspase-3, 8, 9 further increased as compared with each single agent (P < 0.05).</p><p><b>CONCLUSION</b>Thalidomide and IFN could synergistically inhibit the proliferation of Kasumi-1 cells probably through inducing apoptosis via the mitochondrial pathway, death receptor pathway and P38 MAPK pathway, as well as inhibiting VEGF secretion.</p>
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Humans , Apoptosis , Caspases , Metabolism , Cell Line, Tumor , Cell Proliferation , Interferons , Pharmacology , Leukemia, Myeloid, Acute , Pathology , MAP Kinase Signaling System , Thalidomide , Pharmacology , Vascular Endothelial Growth Factor A , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To investigate the inhibitory effect of arsenic trioxide (As₂O₃) combined with tetradecanoylphorbol acetate (TPA) on the proliferation of Kasumi-1 cell line and its mechanism.</p><p><b>METHODS</b>Kasumi-1 cells were treated with 200 nmol/L TPA, different concentrations of As₂O₃ alone and combined with 200 nmol/L TPA. The proliferative inhibition rates were determined with CCK-8. Annexin V was adopted to detect apoptosis. Colony formation assay was used to determine the cloning efficiency. Flow cytometry was used to detect the cell differentiation and cell cycle changes. Western blot was employed to detect the expression of P38 and p-P38.</p><p><b>RESULTS</b>The proliferation inhibition rates of Kasumi-1 cells by TPA combined with different concentrations of As₂O₃ (0.2, 2.0 and 20.0 mmol/L)for 48 h were (25.56 ± 7.29)%, (60.63 ± 6.64)%, and (73.37 ± 2.15)%, the apoptosis rates were (61.65 ± 2.62)%, (75.39 ± 1.04)%, and (89.95 ± 1.46)%, and the colony formation rates were (76.17 ± 2.06)%, (38.50 ± 1.87)%, and (18.53 ± 2.20)%, respectively, compared with the different concentrations of As₂O₃ alone groups, the difference was statistically significant (P<0.05). Cells treated with both TPA and As₂O₃ expressed more CD11b antigens compared with the cells exposed to As₂O₃ alone. TPA treated Kasumi-1 cells were arrested at G1 phase compared with the control group, while As₂O₃ increased the percentage of Kasumi-1 cells in the G2 phase. Combination treatment increased the expression of p-P38 of Kasumi-1 cells compared with the cells exposed to As₂O₃ alone.</p><p><b>CONCLUSION</b>TPA can enhance the effect of As₂O₃ on inducing apoptosis and regulating cell cycle, thereby enhancing its anti-leukemia effect.</p>
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Humans , Apoptosis , Arsenicals , Pharmacology , Cell Differentiation , Cell Line, Tumor , Cell Proliferation , Oxides , Pharmacology , Phorbol Esters , PharmacologyABSTRACT
BACKGROUND:To study the phenotypes of side population cells in leukemia is important for understanding the heterogeneity and origin of tumor cells, molecular markers and targeted therapy. OBJECTIVE:To identify whether the human chronic myeloid leukemia cellline-K562 contains side population cells or not, and to further observe the differences in expressions of leukocyte differentiation antigens from side population cellsubset and non-side population cells subset. METHODS:Flow cytometry was used to detect whether there were side population cells in the K562 celllines. Then, the expression of CD34+, CD34+CD38-, CD34+CD38+, HLA-DR+cells in the side population subsets and non-side population subsets. RESULTS AND CONCLUSION:Flow cytometry results showed that the K562 cellline contained side population cells, and the proportion of side population cells was much lower. The side population cells accounted for (2.7±0.5)%of viable cells in K562. The expressions of CD34+cells and CD34+CD38-cells in the side population subset were significantly higher than those in the non-side population subsets. The expressions of CD34+CD38+cells and HLA-DR+cells in the side population subset and non-side population subset did not have a significant difference. Heterogeneity was found in the differentiation antigen expression between the side population subset and non-side population subset.
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Objective To evaluate significance of the quantification of bcr-abl mRNA in diagnosis and therapy of chronic myeloid leukemia (CML),essentiality significance for monitoring minimal residual disease. Methods Bcr-abl mRNA of 518 CML patients were detected using real-time PCR. Results Expression of bcr-abl mRNA was gradually increased among blastic phase (BP) (12.6 %),accelerated phase (AP) (25.4 %) and chronic phase (CP) (57.2 %) (P<0.05). Quantification of bcr-abl mRNA was cut down gradually after allotransplantation in the patients and becomes normal after treatment for 6 months. But quantification of bcr-abl mRNA inpatients treated with imatinib mesylate became normal after 12 months. Conclusion Real-time PCR was reliable and can be used for diagnosis,monitoring the treatment outcome,detecting the minimal residual disease,and predicting blast crisis.
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BACKGROUND:Side population(SP)cells,with varied contents,are widely distributed in adult tissues,embryos,and certain tumor cells.Haematological tumor is one of the main pathological conditions,which endangers human life.Thus,it is important to recognize SP cells in haematological tumor cell lines.OBJECTIVE:To identify whether hematologic tumor cell lines contain SP cells,and to explore a stable detection and separation methods.METHODS:Cells with the characteristics of stem cells being capable of fluorescent dye Hoechst33342 were isolated by flow cytometry;whether there were SP cells in logarithmic growth period of NB4,Raji,K562/ADM and K562 or not were detected.After sorting K562 subpopulations,the purity of sorted cells was detected.RESULTS AND CONCLUSION:After Hoechst33342 staining,flow cytometry results showed that the SP cells appeared in the haematological tumor NB4,Raji,K562/ADM and K562 cell lines,which accounted for 0.8%,2.7%,1.3% and 2.7%,respectively.These cells could be blocked by Verapamil.The purity was greater after a second detection of SP and Non SP cells in K562 cells.
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Objective To investigate the novel V617F point mutation of JAK2 gene by real-time PGR in the patients with chronic myeloproliferative disease (CMPD) and evaluate its clinical significance. Methods Genomic DNA from bone marrow or peripheral blood mononuclear cells was extracted from 56 patients with CMPD, including 26 cases of polycythemia vera (PV), 24 cases of essential thrombocythemia (ET), 5 cases of chronic idiopathicmyelofibrosis (CIMF) and 1 case of high eosinophilic syndrome (HES). The exon 14 of JAK2 gene which harbourd V617F mutation were screened by real-time PGR. Results JAK2 V617F mutation was measured in 29 of the 56 patients with CMPD. The prevalence of mutation was 65.38 %(17/26) in PV,37.50 % in ET and 60.00 %(3/5) in CIMF. The proportion of mutation in PV, ET and CIMF are respectively 53.85 %(14/26), 29.17 %(7/24), 40.0 %(2/5) in heterozygotes and 11.54 %(3/26), 8.33 %(2/24), 20.00 %(1/5)in homozygotes. JAK2 mutation was negative in one patient with HES. JAK2 V617F allele burden in PV, ET and CIMF are respectively 2.14×102-1.5×107, 9.80×102-4.4×107 and 4.10×103-3.70×106 copies. Conclusion Real-time PCR is a useful tool for pre cisely assess the grade of mutant allele burden as well as to screen JAK2V617F mutation simultaneously, which is simple and convenient to carry out in clinical laboratories for diagnosis and further evaluations of minimal residual disease in CMPD patients.
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Objective To investigate the value of panel fluorescence in situ hybridization (panel FISH)for detection of genomic aberrations in chronic lymphocytic leukemia(CLL). Methods Five types of fluorescein-labelled DNA probes including five sequence specific probes D13S25 for 13q14. 3, RB1, p53, ATM (11 q23)and centromeric probe for chromosome (CSP12) were used to perform fluorescence in situ hybridization assays in 17 patients with CLL. Its results were compared with that obtain by conventional cytogenetic (CC)examination. Results In 17 patients with CLL, CC examination showed that only one case (1/17) was found to have chromosomal abnormality that was simultaneous trisomies 3,8 and 18, whereas panel FISH assay showed that 10 cases (10/17) were found to have genomic aberrations including deletion of D13S25 in 4 cases,deletion of ATM in 2 cases,deletion of p53 in 1 case,deletion of D13S25 combined RB1 in 1 case and 1 case with a variety of abnormalities. Conclusions Panel FISH is a useful method for detection of genomic aberration in CLL If it is combined with CC,it can obviously enhance the detection rate of chromosomal abnormalities in CLL.