ABSTRACT
Objective:To investigate the clinical features of IgD multiple myeloma (MM) and the effect and prognosis of daratumumab-based combination therapy.Methods:The clinicopathological data of a IgD MM patient with disease progression and extramedullary infiltration treated with daratumumab in the Affiliated Hospital of Qingdao University in December 2019 were retrospectively analyzed.Results:The 74-year-old woman was diagnosed as IgD MM by bone marrow aspiration and immunofixation electrophoresis. The patient was given VD (bortezomib, dexamethasone), RD (lenalidomide, dexamethasone) and ID (ixazomib, dexamethasone) regimens. In June 2020, the patient developed multiple subcutaneous nodules, and she was assessed as progressive disease with extensive extramedullary infiltration. After treated with daratumumab-PAD (liposomal doxorubicin, bortezomib, dexamethasone) regimen, the patient's subcutaneous nodules were significantly reduced and partially disappeared, and the general condition was significantly improved. But the patient was in a cachexia state and finally died of the irregular treatment and disease progression.Conclusions:IgD MM has a low incidence and a short survival period, and there is no uniform standard treatment. The early application of daratumumab combined with proteasome inhibitors, immunomodulators, cytotoxic drugs and hematopoietic stem cell transplantation may improve the overall survival of patients.
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Objective To investigate the expression and significance of breast cancer suscepterbility gene 1 (BRCA1) in leukemia.Methods Fluorescent quantitative reverse transcription-polymerase PCR was used to investigate the expression of BRCA1 in 18 patients with ALL-L2 (13 denovo ALL patients,5 relapsed ALL patients),20 patients with CML-CP and 15 normal controls.Results The mRNA expression of BRCA1 in denovo patients with ALL was lower than that in normal control,with statistical significance (P ＜ 0.05).The mRNA level of BRCA1 in ALL patients in CR was higher compared with before to cure, with statistical significance (P ＜ 0.05),but lower than that in normal control,without statistical significance(P ＞ 0.05).The mRNA expression of BRCA1 in patients with relapsed ALL was lower than that in normal control with statistical significance (P ＜ 0.05), and lower than that in denovo patients with ALL, without statistical significance (P ＞ 0.05).The mRNA level of BRCA1 showed no difference in CML-CP patients compared with normal control (P ＞ 0.05). Conclusion The different expression of BRCA1 in leukemia indicates that he has closely relationship with the prognosis of leukemia and guides the clinical diagnosis and treatment.
ABSTRACT
Breast cancer susceptibility gene 1 (BRCA1) is a tumor suppressor gene, whose encoded proteins play an important role in cell-cycle regulation, DNA damage repair, induction of apoptosis in damaged cells and the maintenance of genomic stability. Some foreign studies reported the down-regulation of BRCA1 expression in initial treatment leukaemia, and this result may have clinical implications for surveillance of therapy and prognosis .In this review, the construction features, biological characteristics of BRCA1 and the expression of BRCA1 in lenkaemia and lymphoma were covered.