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Objective:To investigate the therapeutic effect and safety of low-dose dexitabine combined with DA/HA chemotherapy regimen in acute myeloid leukemia (AML) patients with moderate or poor prognosis.Methods:The clinical data of 25 initially diagnosed AML patients (non-acute promyelocytic leukemia) in Affiliated Hospital of Southwest Medical University from April 2013 to May 2020 were retrospectively analyzed. According to the National Comprehensive Cancer Network (NCCN) guideline, all patients were divided into moderate prognosis group (5 cases) and poor prognosis group (20 cases), and they were given low-dose decitabine combined with DA/HA regimen (decitabine 10 mg, day 1-10; daunorubicin 60 mg/m 2, day 1-3; homoharringtonine 2.5 mg/m 2, day 1-7; cytarabine 100-200 mg/m 2, day 1-7). The clinical efficacy and adverse reactions of both groups were observed. Results:Among 25 patients, 1 patient gave up during the treatment; 14 patients received 1 cycle of treatment and the complete response (CR) rate was 71.4% (10/14); 10 patients received ≥2 cycles of treatment and the CR rate was 70.0% (7/10); the difference of CR rate in patients with different treatment cycles was not statistically significant ( χ2 = 0.01, P > 0.05). In the moderate prognosis group, 4 cases achieved CR and 1 case had no response (NR), the CR rate was 80.0% (4/5), and the total effective rate was 80.0% (4/5). In poor prognosis group, 13 cases achieved CR, 4 cases achieved partial response (PR), 2 cases had NR, 1 case gave up the treatment, the CR rate was 68.4% (13/20), and the total effective rate was 89.5% (17/20). There were no statistical differences in the CR rate and the total effective rate between the two groups (both P > 0.05). The adverse reactions of all patients were mild and all patients could tolerate. Conclusions:Low-dose dexitabine combined with DA/HA regimen has a high remission rate in treatment of AML patients with moderate or poor prognosis, and the adverse reactions can be tolerated.
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Objective:To investigate the clinical therapeutic efficacy and safety of domestic imatinib mesylate in treatment of chronic myeloid leukemia (CML).Methods:The clinical data of 87 CML-chronic phase patients treated by domestic imatinib between December 2013 and March 2018 in the Affiliated Hospital of the Southwest Medical University were retrospectively analyzed. The clinical therapeutic efficacy and safety of imatinib was analyzed.Results:The completely hematologic reaction (CHR) rate was 95.4% (83/87), 97.7% (85/87) and 100.0% (87/87), respectively after treatment at 3, 6 and 12 months. The completely cytogenetic reaction (CCyR) rate was 31.0% (27/87), 42.5% (37/87) and 64.4% (56/87), respectively at 3, 6 and 12 months. At 3-month, BCR-ABL/ABL IS value was equal to or less than 10% in 44 patients (50.6%), BCR-ABL/ABL IS value was equal to or less than 0.1% in 4 patients (4.6%). At 6-month, BCR-ABL/ABL IS value was equal to or less than 1% in 39 patients (44.8%), BCR-ABL/ABL IS value was equal to or less than 0.1% in 13 patients (14.9%). The major molecular response rate at 12-month was 35.6% (31/87). The major hematologic adverse reaction was grade Ⅰ-Ⅱ hemacytopenia. The common non-hematology adverse reactions were edema, muscular and joints soreness, nausea and vomiting and diarrhea. Most patients didn't have severe adverse reactions. Conclusions:The clinical efficacy of CML patients treated with domestic imatinib is sure; CML patients are well-tolerated and the adverse reactions are mild. It is worthy of wide application in clinical treatment.
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Objective To study the clinical features and prognostic factors of patients with acute paraquat poisoning.Methods The clinical data of 108 patients with acute paraquat poisoning in Affiliated Hospital of Southwest Medical University from June 2013 to June 2015 were collected and followed up for half a year.The clinical features and prognostic factors were analyzed.Results Of 108 patients,about 90.00％ cases were from the rural areas,the married population accounted for 81.48％.Among them,53 people were living,55 cases were dead,and the death rate was 51.00％.The average amount of poison,average hospitalization time,poison to gastric lavage time interval in the survival group were (22.08 ±5.32) mL,(16.5 ± 3.72) d,(2.00 ±0.49) h,respectively,which in the death group were (88.12 ± 14.96) mL,(5.50 ± 1.20) d,(8.56 ± 1.65) h,respectively.The average amount of poison in the death group was far greater than that of the survival group,about 3.6 times,and the average hospitalization time was significantly reduced,only 1/3 of the survival group.The gastric lavage time interval was also lengthened 1.7 times than that of the survival group,the differences were statistically significant (all P ＜ 0.05).The proportions of fever,increased serum creatinine,liver function damage and pulmonary fibrosis in the death group were significantly higher than those in the survival group,the differences were statistically significant (x2 =12.20,8.35,8.84,50.68,all P ＜ 0.05).Conclusion Mortality rates are still high in patients with acute paraquat poisoning.The amount of poison is still the key factor of death in patients.Early gastric lavage and blood purification,as soon as possible to clear the poison,as far as possible to reduce the absorption of the toxic chemical and aggressive treatment can significantly improve the prognosis of patients.Early fever,liver and kidney function damage and pulmonary fibrosis may predict the poor prognosis of patients.
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Objective To investigate the association between non-Hodgkin lymphoma (NHL) and hepatitis B virus (HBV). Methods The serum HBV markers in 305 NHL patients who were diagnosed in the Affiliated Hospital of Southwest Medical University from January 2014 to December 2016 was detected by automatic chemiluminescence immunoassay. The infection rate of HBV in NHL patients was compared with that in 312 colorectal cancer patients and the national general population (81775 peoples). Results The positive rates of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb) and hepatitis B core antibody (HBcAb) in 305 patients of NHL were compared with the general population [19.0 ％ (58/305) vs. 7.2 ％ (5888/81775), 44.3 ％ (135/305) vs. 50.1 ％ (40969/81775), 45.9 ％ (140/305) vs. 34.1 ％(27885/81775)], and the differences were statistically significant (χ2 values were 63.1, 4.1, 18.8, all P<0.05). The positive rate of HBsAg in NHL patients was compared with colorectal cancer patients and the general population, and the differences were statistically significant (χ2= 65.7, P< 0.01). The positive rate of HBsAg in B-cell NHL was statistically different from T-cell NHL [21.3％(51/239) vs. 10.6％(7/66),χ2=3.869, P<0.05]. But the positive rate of HBcAb and HBsAb in B-cell NHL were compared with T-cell NHL, and there was no statistically significant difference (both P> 0.05). Among 133 NHL patients, the HBV DNA positive rate was 33.1 ％ (44/133), and 74.1 ％ (43/58) in 58 cases of HBsAg-positive NHL, while 4.2 ％ (1/24) in 24 cases of HBsAg-negative but HBcAb-positive NHL. Conclusions The infection rate of HBV in NHL patients is higher than that in colorectal cancer patients and the general population, in which the occult HBV infection is worthy of much attention. The positive rate of HBsAg in T-cell NHL patients is lower than that in B-cell NHL patients. For NHL patients with HBV infection, anti-HBV treatment to prevent reactivation of the virus should be given before the anti-tumor treatment.
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Objective To deepen the understanding of curative effect and adverse drug reaction of brentuximab vedotin in the treatment of Hodgkin's lymphoma.Methods One case of newly diagnosed Hodgkin's lymphoma who treated with brentuximab vedotin was collected.The clinical features,laboratory examination,treatment procedure,prognosis were analyzed,and the relevant literature was reviewed.Results The patient was twenty years old,female,found the right neck masses for five days,diagnosed with Hodgkin's lymphoma,mixed cell type,stage Ⅳ group B.Chose the chemotherapy regimen BV + GABVD for 4 courses,the PET-CT indicated CR,then used GABVD 4 courses,now in the stage of clinical observation and followed up.Conclusion BV is a kind of antibody-drug conjugate which targeted on CD30 protein.The FDA approved for the treatment of Hodgkin's lymphoma and systemic anaplastic large cell lymphoma.The common adverse reactions are granulocyte,peripheral neuropathy,fatigue,nausea and vomiting.BV can significantly improve the prognosis of CD30 positive Hodgkin's lymphoma,but need to pay attention to the prevention of adverse reactions.
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Objective To investgate the pathogenesis of PTEN/PI3K/AKT/mTOR signaling pathways in nasal type extranodal NK/T cell lymphoma(ENKTCL-N).Methods The expression of PTEN,p-AKT,p-4EBP1 and p-mTOR in 51 patients with ENKTCL-N and 20 patients with reactive proliferative lymph nodes was detected by immunohistochemistry EnVision.The clinical data were collected and the clinical features,curative effect and prognosis were analyzed retrospectively.Survival analysis was performed by Kaplan-Meier method.Results The positive rate of PTEN in ENKTCL-N patients was lower than that in patients with reactive hyperplastic lymph nodes,and the positive rates of p-AKT and p-4EBP1 were higher than those in patients with reactive hyperplastic lymph nodes,and the difference was statistically significant(P＜0.05);The positive rate of p-mTOR in ENKTCL-N patients was higher than that in patients with reactive hyperplastic lymph nodes,but the difference was not statistically significant (P＞0.05).The survival rate of PTEN-positive patients was higher than that of PTEN-negative patients,and the difference was statistically significant(P＜0.05).Conclusion PTEN/PI3K/AKT/mTOR signaling pathway is abnormally active in ENKTCL-N,which may be related to its pathogenesis;PTEN-positive patients may have better prognosis.
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Objective To investigate the pathogenesis,clinical feature,laboratory examination characteristics and the prognosis of the bone marrow necrosis.Methods To analyze the clinical data of one case of diagnostic bone marrow necrosis and review the relevant literature.Results The peripheral blood examinations were as follows:the hemoglobin(HGB)level was 36g/L,platelet count was 17 ×109 /L.The biochemistry tests showed that lactate dehydro genase (LDH)was 1 454.9U /L and alkaline phosphatase(ALP)was 1 319.4U /L.Bone marrow necrosis was detected by bone marrow smear.Bone marrow biopsy was considered as a bone marrow metastatic carcinoma,which was prone to adenocarcinoma.Conclusion The bone marrow necrosis is mainly caused by the cancer,the serious infection and the drug.Its main performances were bone pain,fever,progressive decline in bloods cells,the LDH and ALP increasing and poor prognosis.In order to extend the lifetime of this kind of patients,the key lies in the early detection,the early diagnosis,and the early treatment of its primary diseases.
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Objective To explore the role of Fas and FasL system in the pathogenesis of adult primary immune thrombocyto‐penic purpura (ITP) .Methods The peripheral anticoagulant venous blood samples were collected from the patients with newly di‐agnosed ITP and healthy adults .The expression rates of Fas and FasL in Th/Tc ,Th1/Th2 ,Tc1/Tc2 cells and their expression rates at platelet surface were detected by flow cytometry .Results The Fas and FasL expression rates on the surface of Th ,Th1 ,Th2 , Tc ,Tc1 and Tc2 in the ITP group were increased compared with the healthy control group(P0 .05) .Conclusion The Fas and FasL expression on T cell subsets and platelet surface in ITP patients is abnormal , which may be related with the pathogenesis of ITP .
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Objective To analyze the clinical characteristics of 1126 cases of malignant lymphoma in our hospital from 2005 to 2009. Methods Age, sex, pathological classification, onset locus and clinical staging of the malignant lymphoma were analyzed and summed up, based on the data of the malignant lymphoma patient information in hospital case database from 2005 to 2009 and excluded the cases as pathology was not sure and the repeated cases. Results A male:female ratio of malignant lymphoma in inpatient was 1.94:1. The majority of Hodgkin lymphoma (HL) manifested in 20-40 years old, mixed cellularity (64.16 %) and nodular sclerosis (29.48%) was most common. The majority of non-Hodgkin lymphoma (NHL) manifested in 50-70 years old, the most common pathological classifications were diffuse large B-cell lymphoma (53.31 %), extranode nasal-type NK/T cell lymphoma (7.35 %), mantle cell lymphoma (6.40 %), B chronic lymphocytic leukemia/small B-cell lymphoma (4.30 %), anaplastic large cell lymphoma (4.09 %), precursor T cell lymphoblastic leukemia/lymphoma (3.88 %), peripheral T cell lymphoma but not otherwise specified (3.46 %), angioimmunoblastic lymphoma(3.04 %), follicular lymphoma(2.94 %), Burkitt lymphoma (2.52 %). The onset locus of both HL and NHL most often involved lymph nodes of the cervical region. Conclusion The gender, age, pathological classification, onset locus and clinical staging of malignant lymphoma were different between HL and NHL.