Innovative analysis of predictors for overall survival from systemic non-Hodgkin T cell lymphoma using quantile regression analysis / 中华医学杂志(英文版)

BACKGROUND@#Non-Hodgkin T/NK cell lymphoma is a rare and widely variable type of lymphoma with the most dismal prognosis. This study aimed to investigate varied impact of the clinical indicators to the overall survival (OS).@*METHODS@#We conducted a retrospective study to identify the non-invasive clinical features of T cell lymphoma that can predict prognosis with an innovative analysis method using quantile regression. A total of 183 patients who visited a top-tier hospital in Beijing, China, were enrolled from January 2006 to December 2015. Demographic information and main clinical indicators were collected including age, erythrocyte sedimentation rate (ESR), survival status, and international prognostic index (IPI) score.@*RESULTS@#The median age of the patients at diagnosis was 45 years. Approximately 80% of patients were at an advanced stage, and the median survival time after diagnosis was 5.1 months. Multivariable analysis of the prognostic factors for inferior OS associated with advanced clinical staging [HR=3.16, 95%CI (1.39-7.2)], lower platelet count [HR = 2.57, 95%CI (1.57-4.19), P < 0.001] and higher IPI score [HR = 1.29, 95%CI (1.01-1.66), P = 0.043]. Meanwhile, T cell lymphoblastic lymphoma [HR = 0.40, 95%CI (0.20-0.80), P = 0.010], higher white blood cell counts [HR = 0.57, 95%CI (0.34-0.96), P = 0.033], higher serum albumin level [HR = 0.6, 95%CI (0.37-0.97), P = 0.039], and higher ESR [HR = 0.53, 95%CI (0.33-0.87), P = 0.011] were protective factors for OS when stratified by hemophagocytic lymphohistiocytosis (HLH). Multivariable quantile regression between the OS rate and each predictor at quartiles 0.25, 0.5, 0.75, and 0.95 showed that the coefficients of serum β2-microglobulin level and serum ESR were statistically significant in the middle of the coefficient curve (quartile 0.25-0.75). The coefficient of IPI was negatively associated with OS. The coefficients of hematopoietic stem cell transplantation (HSCT) and no clinical symptoms were higher at the middle of the quartile level curve but were not statistically significant.@*CONCLUSIONS@#The IPI score is a comparatively robust indicator of prognosis at 3 quartiles, and serum ESR is stable at the middle 2 quartiles section when adjusted for HLH. Quantile regression can be used to observe detailed impacts of the predictors on OS.

Analysis of the Clinical Characteristics and Prognostic Factors of 31 Cases of Primary Central Nervous System Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics, therapeutic outcomes and prognostic factors of primary central nervous system lymphoma (PCNSL).</p><p><b>METHODS</b>Clinical records of 31 cases of PCNSL were collected, the clinical charactenstics were analyzed retrospectively. Survival curves were estimated using Kaplan-Meier survival methodology and statistical significance of continuous variables was assessed via the Cox proportional hazard model.</p><p><b>RESULTS</b>The median age was 52 years, with a ratio of male to female 1:1. Headache/dizzy/limb numbness were the most common presentation and the lesions of PCNSL were primarily located at the frontal, parietal, temporal lobes and corpus callosum. All the cases were pathologically diffuse large B cell lymphoma (DLBCL), 6 cases were the type of germinal center (GC) and 25 cases of non-GC type, after craniotomy operation and biopsy. Among 31 cases, 17 patients accepted the combined treatment, 3 patients underwent simple chemotherapy, 8 patients received simple radiotherapy, the other patients accepted support therapy. The median follow-up for surviving patients was 24 months. The 1-, 3-, and 5-year survival rates were 80.6%, 55.1%, and 36.4%, respectively. The median overall survival time in the combined treatment group was significantly longer than that in simply radiotherapy. There was no significant difference in OS between the groups with and without rituximab. ECOG PS≥2 and elevated serum LDH predicted inferior survival.</p><p><b>CONCLUSION</b>The clinical manifectation of PCNSL is various and complicated, and for the time being there is no optimal treatment scheme. The overall survival time of the combined treatment is longer than that in simply radiotherapy. ECOG PS≥2 and elevated serum LDH often are poor prognostic factors.</p>

Available Evidence of Association between Zika Virus and Microcephaly / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To clarify the possible association between the Zika virus (ZIKV) and microcephaly and understand where we are in terms of research and the debate on the causation between mild maternal clinical features and severe fetal microcephaly.</p><p><b>DATA SOURCES</b>We did a comprehensive literature review with the keywords "zika" and/or "microcephaly" from inception to May 27, 2016, with PubMed.</p><p><b>STUDY SELECTION</b>Studies were included and analyzed if they met all of the following criteria: "probable or confirmed infant microcephaly" and "probable or confirmed ZIKV infection among mothers or infants".</p><p><b>RESULTS</b>We emphasize the diagnosis of ZIKV infection, including maternal clinical manifestations, maternal and fetal laboratory confirmation, and possible autopsy if need. Other confounders that may lead to microcephaly should be excluded from the study. We presented the results from clinical manifestations of ZIKV infection, testing methods evolving but the mechanism of microcephaly uncertain, flexible definition challenging the diagnosis of microcephaly, and limited causal reference on pregnant women. We made analog comparison of severe acute respiratory syndrome and chikungunya virus in terms of DNA mutation and global movement to provide further research recommendation. The chance of catch-up growth may decrease the number of pervious "diagnosed" microcephaly.</p><p><b>CONCLUSIONS</b>There are some evidence available through mice models and direct isolation of ZIKV in affected pregnancies on kindly causal relationship but not convincible enough. We analyzed and presented the weakness or limitation of published reports with the desire to shed light to further study directions.</p>

Inhibitory effect of genistein on the proliferation of Raji cells and its related mechanism / 中国实验血液学杂志

This study was aimed to investigate the anti-proliferative effect of genistein (Gen) on BCL-6 positive Raji cells and its related mechanism. Trypan blue staining and MTT method were used to analyze the anti-proliferative effect of Gen on Raji cells. Cell apoptosis, protein expression and the interaction of BCL-6 and NCoR were detected by PI/AV dual staining, Western blot and Co-IP method, respectively. The results showed that Gen had time- and dose-dependent inhibitory effect on Raji cell proliferation and induced apoptosis. Different dose of Gen had no significant effect on the expression of BCL-6 and NCoR, but could inhibit the binding of BCL-6 and NCoR. It is concluded that Gen shows inhibitory effect on BCL-6 positive lymphoma cells, which can be as a adjuvant therapy for combined rituximab with chemotherapy.

Clinical analysis of non-Hodgkin lymphoma after renal transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and therapeutic outcomes of non-Hodgkin lymphoma (NHL) occurring after renal transplantation.</p><p><b>METHODS</b>We reviewed a total population of 2045 adult kidney recipients between January 1998 and October 2012, 12 of which developed NHL. Their clinical features and outcomes were analyzed.</p><p><b>RESULTS</b>12 patients with a median age of 52.5 (range: 30-68) years old, including 5 males and 7 females, were diagnosed as diffuse large B-cell lymphoma (DLBCL) at a median interval of 84 (range: 12-253) months after transplantation. The incidences of developing NHL at 2-year, 5-year and 10-year were 0.10%, 0.15% and 0.44%, respectively. The locations of lymphoma were diverse, including central nervous system, stomach, liver, kidney, pancreas, uterus, ribs, sKin, soft palate and Waldeyer ring. After reduction of immunosuppression intensity, 3 cases received surgical therapy, 6 cases with chemotherapy, 1 case with surgery combined with chemotherapy, 1 case with chemotherapy combined with irradiation and 1 case without treatment. The overall response rate was 81.8%, including 8 cases with CR, 1 with PR and 2 with progression. During a median of 11.5 (range: 1 to 130) months follow-up, 3 patients died.</p><p><b>CONCLUSION</b>NHL was a rare but serious complication after renal transplantation occurred with bimodal distribution, which was symptomatic diversity and non- specificity. The most histopathological type was DLBCL. Reduction of immunosuppression intensity was not enough to get efficacy, and CHOP with or without rituximab was effective in the treatment of NHL after renal transplantation.</p>

The role of Th17 cells in immune thrombocytopenia mice models / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the role of Th17 cells in immune thrombocytopenia (ITP) mice model.</p><p><b>METHOD</b>ITP was induced by daily intraperitoneal injection of anti-platelet membrane CD41 antibody (MWReg30) into BALB/c mice, the mRNA expressions of Th17 cell associated transcription factors and cytokines in peripheral blood and spleen mononuclear cells were measured by real-time PCR, and the proportion of Th17 cells by FCM analysis.</p><p><b>RESULTS</b>The percentage of Th17 cell was significantly elevated in ITP mice both in splenocyte and peripheral blood as compared with that in normal controls (P<0.01). ITP mice had elevated mRNA expressions of IL-17F, IL-17A and IL-6 in splenocyte (P<0.05), and of IL-21 in peripheral blood (P<0.05). There was a positive correlation between IL-17A and IL-17F (r = 0.934, P = 0.000), and between IL-17A/IL-17F and IL-6 (r = 0.598, P = 0.001; r = 0. 619, P = 0.000).</p><p><b>CONCLUSIONS</b>Th17 cell might play an important role in the pathogenesis of ITP, at least involving in the clearance of platelets.</p>