Maintenance of efficacy and its predictors after discontinuation of eltrombopag in adults with primary immune thrombocytopenia / 中华血液学杂志

Objective: To determine the efficacy of eltrombopag for primary immune thrombocytopenia (ITP) in adults and the predictive factors for treatment-free response (TFR) . Methods: Clinical data of adults with ITP who received eltrombopag from June 14, 2013 to May 31, 2021 in the Hematology Department of Ruijin Hospital affiliated with Shanghai Jiao Tong University Medical College were retrospectively analyzed. The initial dose of eltrombopag was 25 mg/d, and the maximum dose was 75 mg/d; the dose was adjusted to maintain the platelet count to within 50-150×10(9)/L. Treatment was discontinued according either to the protocol, on the patient's wishes or doctor's judgment (prescription medication), or based on clinical trials. The efficacy of eltrombopag and factors for TFR among patients who achieved complete response and those who discontinued treatment were analyzed. Results: Overall, 106 patients with ITP (33 men and 73 women) were included in the study. The median age of patients was 50 (18-89) years. There were 2, 10, and 94 cases of newly diagnosed, persistent, and chronic ITP, respectively. The complete response rate was 44.3% (47/106), the response rate was 34.0% (36/106), and the overall response rate was 78.3% (83/106). Meanwhile, 83 patients who responded to treatment discontinued eltrombopag; of these, 81 patients were evaluated. Additionally, 17 patients (21.0%) achieved TFR. The median follow-up duration of patients who achieved TFR was 126 (30-170) weeks. The recurrence rate was 17.6% (3/17), and the relapse-free survival rate was 76.5%. The results of univariate analysis revealed that non-recurrence after discontinuation of other treatments for ITP (P=0.001), and platelet count and eltrombopag dose of ≥100×10(9)/L (P=0.007) and ≤25 mg/d (P=0.031), respectively, upon discontinuation of eltrombopag were predictors of TFR; these effects were attributed to prolonged effective duration of eltrombopag. Multivariate analysis showed that there was a correlation between non-recurrence and prolonged effective duration after discontinuation of other treatments for ITP (P=0.002) . Conclusion: Eltrombopag is effective for patients with ITP as it can result in TFR. Predictors for TFR include non-recurrence after discontinuation of concomitant ITP treatment, and platelet count and eltrombopag dose of ≥100 × 10(9)/L and ≤25 mg/d upon discontinuation of treatment, respectively.

Relationship Study on Serum Levels of Procalcitonin and Pulmonary Function in Patients with Chronic Obstructive Pulmonary Disease / 现代检验医学杂志

Objective To study the relationship between the serum levels of procalcitonin (PCT) and pulmonary function in patients with chronic obstructive pulmonary disease (COPD).Methods From January 2016 to May 2107,88 cases of patients with COPD and 100 cases of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were chosen as the object of study,pulmonary function was measured in all patients,grouped according to the standard of pulmonary function classification,and detected the serum levels of PCT by immunoturbidimetry.Results The serum levels of PCT were not statistically different among the COPD patients (F=1.401,P＞0.05).But among the AECOPD patients,the serum levels of PCT in the Ⅳ class of pulmonary function were significantly higher than that in the Ⅰ,Ⅱ class and Ⅲ class and this difference was statistically significant (F=9.128,P＜0.05).Conclusion The serum levels of PCT had significant reference value for the judgement of the severity of pulmonary function impairment in AECOPD patients.

Clinical Characteristics and Outcome of 66 Cases of Mantle Cell Lymphomas / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyze the clinical features and prognostic factors of patients with mantle cell lymphoma(MCL).</p><p><b>METHODS</b>The clinical data of 66 MCL patients were collected from the Department of Hematology of Shanghai Ruijin Hospital, Shanghai Jiaotong University Medical School from January 2000 to December 2014. The clinical characteristics, treatment efficiency and survival rate were analyzed retrospectively.</p><p><b>RESULTS</b>The sex ratio of male to female in these 66 MCL patients was 3.71:1, the nosopoietic median age was 59 years old, and most cases were diagnosed as MCL in Ann Arbor stage III-IV(90.9%). "R-HperCVAD" regimen had the highest CR-rate reached to 55.6%, and CR rate of "R-CHOP" reached to 44.4%. The total prospective 5-year overall survival and progress-free survival rates were 35.5%±11.5% and 8.8%±5.6%, respectively. Leukocyte count abnormality(>10×10/L or <4×10/L), B symptom, LDH level, bone marrow involvement, Ki-67 and high risk group of MIPI scores, and therapy combined with or without rituximab were the independent prognostic factors.</p><p><b>CONCLUSION</b>The prognosis of MCL patients is poor, and the incidence is higher in men. The extranodal sites of bone marrow and gastrointestinal tract are involved more easily. The treatment combined with rituximab can increase survival rate for these patients.</p>

G-CSF and Its Receptor in Hematonosis / 中国实验血液学杂志

The granulocyte colony-stimulating factor (G-CSF), now referred to as CSF3, is a very important cell growth factor that supports the proliferation, survival, and differentiation of neutrophilic progenitor cells, and also is a strong immune regulator of T cells and a promising therapeutic tool in acute graft versus host disease (GVHD). G-CSF acts by binding to its receptor G-CSFR (also called CSF3R), a member of the cytokine receptor type I superfamily, which after binding with G-CSF activates the canonical Janus kinase (Jak)/signal transducer, activator of transcription (STAT)and Ras/Raf/MAP kinase pathways. G-CSF has been applied to the clinic to treat congenital and acquired neutropenia before or during courses of intensive chemotherapy. It has also been applied to mobilize hematopoietic stem cells into the peripheral blood for Auto-or allogeneic transplantation, and the priming strategies designed to enhance the sensitivity of leukemia stem cells to cytotoxic agents in protocols aimed to induce their differentiation, accompanying growth arrest, and cell death. With the rapid development of molecular genetics and clinical research, CSF3R mutations have been implicated in the progression of severe congenital neutropenia (SCN) to leukemia. Recently, CSF3R mutations have been discovered frequently in chronic neutrophilic leukemia (CNL). Such findings might provide the theoretical basis for the targeted therapy. In this review, the clinical application of G-CSF receptor in hematonosis is briefhy summarized.

Prognostic significance of EBMT score system for hematological malignancies with allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the impact of EBMT score system in patients with hematological malignancies received allogeneic hematopoietic stem cell transplantation (allo-HSCT).</p><p><b>METHODS</b>A total of 144 consecutive patients were analyzed retrospectively. According to the EBMT score system, including age, disease status before transplantation, interval between diagnoses to transplantation, donor/recipient sex match and donor type, patients were divided into 3 risk groups: low risk (score 0-1), intermediate risk (score 2-3) and high risk (score 4-7).</p><p><b>RESULTS</b>The median follow-up duration were 413 (10-1827) days for all patients and 837 (166-1827) days for alive patients. The estimated 4-year overall survival (OS), transplant-related mortality (TRM) and relapse rate (RR) were (57.5±4.6)%, (21.6±3.7)% and (42.7±6.1)%, respectively. The 4-year OS, TRM and RR were (72.2±9.0)%, (8.1±4.5)% and (27.3±8.7)% in the low-risk group, significantly superior to both intermediate-risk group [(57.7±6.0)%, (23.1±5.1)% and (44.9±8.3)%] and high-risk group [(36.9±10.2)%, (33.5±9.2)% and (51.5±11.8)%] (P<0.01, 0.02 and 0.009 for OS, TRM and RR respectively).</p><p><b>CONCLUSION</b>The EBMT score system provides prognostic significance for OS, TRM and RR in patients with hematological malignancies received allo-HSCT.</p>

Prognostic analysis of non-cytogenetic factors in elderly adults with acute myeloid leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To analyze the prognostic factors in elderly patients with acute myeloid leukemia (AML).</p><p><b>METHODS</b>The clinical data of 211 AML patients with age 55 years or over and treated in Shanghai Jiaotong University Medical School affiliated Ruijin Hospital from 2007 to 2011 were collected and analyzed. Multivariate and univariate analysis of clinical data were performed using a Cox regression model and log-rank test, including age, subtype, performance status, white blood cell count, serum LDH and albumin level, and treatment strategy.</p><p><b>RESULTS</b>Acute promyelocytic leukemia (APL) patients had longer survival than other subtypes. To rule out the impact of APL on the prognostic analysis, we conducted multivariate and univariate analysis excluding APL patients. The significant parameters of the univariate analysis were age (P = 0.003), achieving remission (P < 0.01), performance status (P < 0.01), organ dysfunction (P < 0.01), increased WBC counts (P = 0.022), increased LDH level (P = 0.006) and low albumin level (P < 0.01). Multivariate analysis showed that only failure of achieving remission (P < 0.01), poor performance status (ECOG 3-4) (P < 0.01) and increased WBC counts (P < 0.01) were independent prognostic factors. The patients aged 70 years or over had poor overall survival, and no significant difference of OS was observed among patients with age between 55 and 69 years. For patients aged 55 - 69 years received either DA/IA or CAG treatments had longer survival than those with palliative treatments. For those aged 70 years or over, only patients with CAG treatment had significantly longer survival than palliative treatment. For the patients with age less than 70 years and achieving complete remission after induction, intermediate-dose cytarabine consolidation might not improve survival.</p><p><b>CONCLUSION</b>Elderly AML patients should be treated individually. The intermediate-dose cytarabine consolidation might not improve survival of elderly AML patients.</p>

Mechanism and early evaluation of CNS infiltration in acute lymphocytic leukemia-review / 中国实验血液学杂志

Central nervous system (CNS) is one of places in which direct infiltration and involvement or relapse occur in adult lymphocytic leukemia. The main mechanism of CNS infiltration in leukemia is associated with blood brain barrier (BBB), however the ALL CNS infiltration is difficulty early predicted and evaluated.For this reason, the studies on accurately evaluating the ALL CNS infiltration have important significance for early diagnosis and adjustment of therapeutic regimen, performance of individualised treatment and improvement of ALL patient's prognosis. In this article, the pathway of ALL CNS infiltration and its molecular mechanism, the evaluation methods for BBB function are reviewed.

Research progress on B lymphocyte-induced maturation protein 1 and its relationship with the development of lymphoma / 中国实验血液学杂志

Many studies show that as a transcription factor, B lymphocyte-induced maturation protein 1 (Blimp 1) is the master regulator of plasma-cell differentiation. The abnormality of Blimp 1 plays an important part in the genesis and development of lymphoma. This review introduces and summarizes Blimp 1's protein structure and functions, its role in B cell differentiation, its main target genes and the mechanism of its transcriptional repressor activity. Besides, the relationship between Blimp 1 gene mutation or Blimp 1 protein expression reduction and the development of DLBCL is preliminary summaried.

The retrospective study of serum aspergillus galactomannan (GM) antigen assay in invasive aspergillosis on hematological diseases / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the relationship between the optical density index of serum aspergillus galactomannan (GM) assay and invasive aspergillosis (IA).</p><p><b>METHODS</b>From Jan 2008 to Dec 2011, 825 hematological diseases patients with neutrophil count <0.5×10⁹/L⁹ by continuous blood count tests were admitted into our hospital. The optical density index of GM assay was ≥0.5 at least once. Of 825 patients, 247 cases were manifested as fever during hospitalization. The optical density index of GM antigen was detected by enzyme-linked immunosorbent assay, and the sensitivity and specificity of optical density ranged in 0.5-1.5.</p><p><b>RESULTS</b>In this study, the sensitivity and specificity of GM assay with continuous twice samples (73% and 93%, respectively) were higher than single sample (66% and 80%, respectively) when optical density index ≥1.0. 69 cases were diagnosed as proven IA with the incidence rate of 8.36%.</p><p><b>CONCLUSION</b>The cut-off level for serum GM antigen assay should be decided as optical density index in two continuous samples of ≥1.0.</p>

Evaluation of the impact of R-CHOP chemotherapy on efficacy, safety and prognosis in newly diagnosed diffuse large B-cell lymphoma patients and its prognostic impact: a multicenter retrospective study with long term follow-up / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy, safety and prognostic impact of rituximab plus CHOP (R-CHOP) regimen on patients with diffuse large B-cell lymphoma (DLBCL), to access the impact of R-CHOP on patients' prognosis and to compare that with CHOP regimen.</p><p><b>METHODS</b>Five hundred and seven newly diagnosed DLBCL patients were enrolled from Jan. 1, 2000 to May 1, 2010. Patients were administered with 6 cycles of CHOP or at least 4 cycles of R-CHOP treatments. Rituximab was administered intravenously on day 1 at a dose of 375 mg/m(2). The typical CHOP regimen include cyclophosphamide (750 mg/m(2), IV), doxorubicin (50 mg/m(2), IV) and vincristine (1.4 mg/m(2), IV, maximum 2 mg) and prednisone (60 - 100 mg, oral, day 3 - 7). The complete response (CR) rates, overall response (OR) rates, and side events of these 2 groups were compared.</p><p><b>RESULTS</b>Of the 411 analyzable patients, 224 received CHOP regimen and 187 received R-CHOP regimen. CR rate for R-CHOP group and CHOP group was 77.01% and 71.43%, respectively. OR rate in R-CHOP group was higher than that in the CHOP group (95.19% vs 87.95%, P = 0.007). The median follow-up time of R-CHOP group was 28.1 months vs that of 35.2 months in CHOP group. There was significant difference in progression free survival (PFS) and overall survival (OS) between 2 groups (P = 0.018 and 0.034, respectively). At the end of follow-up, the estimated median PFS in R-CHOP group had not been reached, while that was 84.8 months in CHOP group. The median OS in both groups had not yet been reached. The adverse events in R-CHOP group were similar with that in CHOP group.</p><p><b>CONCLUSIONS</b>R-CHOP is a safe and effective regimen for management of newly diagnosed DLBCL, with a better remission rate, PFS and OS.</p>

Clinical features and prognostic analysis of mantle cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To study the clinical features, therapeutic effects, survival time and prognostic factors of patents with mantle cell lymphoma (MCL).</p><p><b>METHODS</b>Clinical data of 47 MCL patients admitted from January 2002 to December 2011 were retrospectively analyzed.</p><p><b>RESULTS</b>Of all patients, median age was 58 year-old and male to female ratio was 3.3:1. Forty-two cases (89.4%) were in Ann Arbor stage III-IV, 13 cases (27.7%) with bone marrow involvement, 6 cases (12.8%) with lymphocytosis, 18 cases (38.3%) with elevated LDH, and 28 cases (59.6%) with elevated β(2)-MG. Age, bone marrow involvement, increased LDH level and treatment without rituximab were poor prognostic factors. The efficiency and complete remission rate of rituximab combined with chemotherapy were 91.4% and 48.6%, which were superior to those of CHOP regimen (41.7% and 16.7%). As compared to CHOP regimen, rituximab combined with chemotherapy induced longer progression-free survival and overall survival.</p><p><b>CONCLUSION</b>Most patients with MCL were older adults with a male predominance and usually had bone marrow involvement and poor prognosis. Rituximab combined with chemotherapy could significantly improve patient outcome.</p>

Research progress of tumor microenvironment and non-Hodgkin's lymphomas / 中国实验血液学杂志

Non-Hodgkin's lymphoma cells including lymphoma stem cells reside in a specific microenvironment in which a series of nonmalignant bystander cells and cytokines play a crucial role in the genesis and development of non-Hodgkin's lymphomas. In addition, tumor microenvironment has important prognostic significance in Non-Hodgkin's lymphomas. Blocking the cross-talk between the tumor microenvironment and lymphoma cells may thus represent a promising new strategy for treating Non-Hodgkin's lymphomas. This review summarizes the current advance in studies of the tumor microenvironment and non-Hodgkin's lymphomas, including cells in tumor microenvironment, role of mesenchymal stem cells and stromal cells, auxiliary role of T cell subsets, macrcphage and dentritic cells, cytokines, immune surveillance and so on.

PML-RARα and p21 are key factors for maintaining acute promyelocytic leukemia stem cells survival / 中国实验血液学杂志

Tumor stem/progenitor cells are the cells with the characteristics of self-renewal, differentiating to all the other cell populations within tumor, which are also regarded as the source of tumor relapse, drug-resistance and metastasis. As a subtype of acute myeloid leukemia, acute promyelocytic leukemia (APL) represents the target of therapy due to the good response of the oncogenic protein PML-RARα to all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). This review summarizes the latest research results of APL as follows: (1) there probably are two APL stem/progenitor cell populations within APL, and self-renewal and survival of APL stem/progenitor cells highly depend on PML-RARα expression, cell cycle inhibitor p21, self-renewal associated molecules and chemokines; and (2) ATRA and ATO eradicate APL stem/progenitor cells mainly by PML-RARα degradation, FOXO3A activation and the inhibition of self-renewal-associated signaling pathway of sonic hedgehog. These findings are helpful to improve other tumor therapy.

Treatment outcome analysis of CTOP or CHOP regimen in newly diagnosed aggressive non-Hodgkin's lymphoma patients-results of a prospective, open, randomized, multicenter clinical trial / 中华血液学杂志

<p><b>OBJECTIVE</b>To compare the efficacy and toxicity of CTOP and CHOP regimen for newly diagnosed aggressive non-Hodgkin's lymphoma (NHL) patients.</p><p><b>METHOD</b>From Oct 2006 to Jun 2009, 196 patients enrolled into this clinical trial from 72 centers in China were randomized into CTOP or CHOP group.</p><p><b>RESULTS</b>Of 154 patients evaluated, 105 assigned in CTOP group and 49 in CHOP. Complete remission (CR) rate was 73.3%, and response rate (RR) was 87.6% in CTOP group and CR rate 71.4%, RR 86.2% in CHOP group, respectively (both P > 0.05). For B cell lymphomas, there was no difference in outcome between the two groups, but for T cell lymphomas, CR was 71.1% in CHOP, being significantly higher than that of 58.8% in CHOP group. There was no difference in hematological toxicity, GI reaction, liver and kidney function abnormality, but the occurrence of grade 3-4 alopecia in CTOP group (12.4%) was significantly lower than that in CHOP group (40.8%). The progress-free survival and overall survival (PFS and OS) at 1-, 2-, 3-year in CTOP group were 79%, 64.8%, 51.4% and 82.9%, 70.5%, 58.1%respectively; while in CTOP group were 77.6%, 61.2%, 49% and 81.6%, 67.3%, 55.1% respectively.</p><p><b>CONCLUSION</b>CTOP regimen has similar effectiveness to CHOP regimen in newly diagnosed aggressive NHL, but with less side effects, and better efficacy for T cell lymphomas.</p>

Analysis of outocome of pirarubicin-based combination chemotherapy regimen in the treatment of newly diagnosed acute myeloid leukemia-a prospective, open, randomized and multicenter clinical trial / 中华血液学杂志

<p><b>OBJECTIVE</b>To compare the effectiveness and side effects of two chemotherapy regimens [pirarubicin + cytarabine (TA) and daunorubicin + cytarabine (DA)] in patients with acute myeloid leukemia (AML).</p><p><b>METHODS</b>From Oct 2006 to Jul 2009, there were 207 newly diagnosed AML patients randomized into DA or TA group from 72 centers all over the country. The aim of this clinical trial is to observe and evaluate complete remission rate (CR), total remission rate (TRR), and side effect after one or two circles of therapy.</p><p><b>RESULTS</b>In 198 evaluable patients, 126 cases in TA group and 72 in DA group were evalvable, with a ratio of 1.75:1. CR was 69.8% and TRR (CR + PR) was 81.8% in TA group and 63.9%, 80.9% in DA group, correspondingly (P > 0.05). For patients with subtype M(2), CR (77.1%) in TA group was higher than that in DA (60%). There was no difference in side effect between the two groups.</p><p><b>CONCLUSION</b>There is no difference of the effect between TA and DA chemotherapy for newly diagnosed AML patients. But for subtype M(2), TA is more efficacy. And there is no difference in side effect between the two regimens.</p>

Research progress on second-hit in malignant lymphomagenesis-- review / 中国实验血液学杂志

Stem/progenitor cells contribute to normal development of organs, but their mutation may lead to many human diseases including cancer. Stem/progenitor cells and some of the cancer cells have the same abilities of self-renewal and differentiation, suggesting that tumors were initiated from mutated stem/progenitor cells, the cancer stem/progenitor cells. The recent studies on the origin of the non-Hodgkin's lymphomas has proved that the second-hit aggravates gene mutation in lymphocytic progenitor cells, leading to the generation of lymphoma. This review summarizes the current advances in the studies of the second-hit at stem/progenitor cells in oncogenesis of B-cell non-Hodgkin's lymphoma.

Nilotinib treatment for imatinib resistant or intolerant chronic myelogenous leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of nilotinib in chronic myelogenous leukemia (CML) patients with resistance or intolerance to imatinib.</p><p><b>METHODS</b>Thirty-five CML patients after imatinib failure or intolerance received oral administration of 400 mg nilotinib twice daily. The overall survival, hematologic and cytogenetic responses, as well as adverse events were evaluated.</p><p><b>RESULTS</b>The median duration of nilotinib therapy was 11 (1 - 23) months, with a median follow-up of 19 months. Nonhematologic adverse events were mostly of grade 1-2. The most common ones possibly related to nilotinib were increase of bilirubin (76%) and rash (46%). Grade 3-4 hematologic adverse events includes thrombocytopenia (37%), neutropenia (26%) and anemia (26%). Nilotinib was proved to be well-tolerated in this study. Grade 3-4 hematologic adverse events happened more frequently in advanced phase CML. The rate of major cytogenetic response in chronic phase (CP) CML was much higher than those in advanced CML (38.5% vs 22.2%). The median time to major cytogenetic response was 3 months. The estimated overall survival at 18 months was (93.5 +/- 1.0)%.</p><p><b>CONCLUSION</b>Nilotinib is a more effective and safe treatment option for imatinib-resistant or -intolerant CML-CP patients.</p>

Contents of secondary metabolites and anti-bacterial activity of compound Caulis Sargentodoxae decoction / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To compare the contents of secondary metabolites and the anti-bacterial activity of seven different compound Caulis Sargentodoxae decoctions.</p><p><b>METHODS</b>Kirby-Bauer disk agar diffusion method was used for measuring anti-bacterial activity. The contents of secondary metabolites were determined by spectrometry. The correlation and path analysis were used to identify the goal compound.</p><p><b>RESULT</b>The secondary metabolites contents and anti-bacterial activity of seven different compound Caulis Sargentodoxae decoctions varied significantly. The total contents of six secondary metabolites of Shushao Caulis Sargentodoxae decoction was the highest, while that of Caihu Caulis Sargentodoxae decoction was the second highest and that of Yiyi Caulis Sargentodoxae decoction was the lowest. The anti-bacterial activity of Shushao Caulis Sargentodoxae decoction was the highest and that of Cangbai Caulis Sargentodoxae decoction was the lowest. The correlation and path analysis showed that the total tannin and total chlorogenic acid might be the major factors related to the anti-bacterial activity of compound Caulis Sargentodoxae decoctions.</p><p><b>CONCLUSION</b>The total contents of six secondary metabolites and the anti-bacterial activity of Shushao Caulis Sargentodoxae decoction are the highest among seven different decoctions and there is a significant correlation of the anti-bacterial activity with the contents of total tannin and total chlorogenic acid.</p>

Efficacy and safety of imatinib in treatment of 151 chronic myeloid leukemia patients / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of imatinib in treatment of chronic myeloid leukemia (CML) patients.</p><p><b>METHODS</b>From December 2003 to March 2007, 151 patients entered Glivec International Patient Assistance Program (GIPAP) in our center and received imatinib therapy. The overall and progression free survival, hematologic, cytogenetic and molecular response, and adverse events were evaluated. The factors associated with outcome of imatinib therapy were also analysed.</p><p><b>RESULTS</b>One hundred and forty-two patients were evaluable with a median follow-up duration of 21.5 (6 -78) months. (1) The rate of cumulative complete hematologic response (CHR), major cytogenetic response (MCyR), complete cytogenetic response (CCyR) and complete molecular response (CMoR) in chronic phase (CP) CML patients were 96.9%, 82.6%, 76.1% and 29.4%, respectively. These rates were significantly higher in patients with CP than in those with accelerated phase (AP) and blast crisis (BC) (P < 0.0001). (2) The overall survival (OS) rates at 1, 2 and 3 year were 100%, (97.3 +/- 1.9)% and (95.8 +/- 2.4)% for CP patients, they were (84.7 +/- 8.2)%, (77.0 +/- 10.4)% and (69.3 +/- 11.9)% for AP patients, and (62.9 +/- 8.9)%, (41.9 +/- 9.2)% and (28.5 +/- 9.1)% for BC patients, respectively (P < 0.0001). The progression-free survival (PFS) rates at 1, 2 and 3 year were (98.9 +/- 1.1)%, (93.9 +/- 2.7)%, (93.9 +/- 2.7)% for CP patients, (68.9 +/- 10.6)%, (61.3 +/- 11.9)%, (61.3 +/- 11.9)% for AP patients, (36.4 +/- 8.8)%, (25.4 +/- 8.1)%, (10.1 +/- 8.2)% (P < 0.0001) for BC patients respectively. (3) Among 92 CP patients, the rates of MCyR and CCyR in newly diagnosed patients were significantly higher than those in interferon therapy failure patients (P = 0.015, P = 0.010). Patients obtained CCyR at 12 months after the initiation of imatinib treatment were associated with longer PFS (P = 0.0099). According to the Sokal scoring system, the rates of MCyR and CCyR in low-risk patients were significantly higher than those in intermediate-risk and high-risk patients (P = 0.0013, P = 0.0024). Sokal score was also significantly associated with disease progression (P = 0.0467). (4) The adverse events of imatinib were moderate and tolerable.</p><p><b>CONCLUSIONS</b>Treatment of CML patients in CP with imatinib can induce high hematologic, cytogenetic and molecular response and overall survival, but can not do satisfactorily for patients in AP and BC.</p>

Prognostic factors analysis for R-CHOP regimen therapy in diffuse large B cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To reassess the prognostic factors of diffuse large B cell lymphoma (DLBCL) treated with R-CHOP therapy.</p><p><b>METHODS</b>One hundred and twenty five patients were enrolled in this study from Feb. 2000 to Sep. 2006. They received 6 courses of R-CHOP regimen consisting of rituximab 375 mg/ m2, intravenously, d 1; cyclophosphamide 750 mg/m2, bolus intravenously, d 2; doxorubicin 50 mg/m2, bolus intravenously, d 2; vincristine 1.4 mg/m2, bolus intravenously, d 2 and prednisone 60 mg, orally, d 2 - 6. All the patients were evaluated and followed up after the treatment.</p><p><b>RESULTS</b>Eighty six patients (68.8%) achieved complete response (CR), 16 (12.8%) partial response (PR), 11 (12.8%) stable disease (SD) and 12 (9.6%) progressive disease (PD). In univariate analysis, performance status (PS), clinical stage, LDH level, extranodal disease, international prognostic index (IPI) and bulky disease were statistically significantly correlated with the induction of CR; however, only PS, clinical stage and bulky disease remained significant in multi-variate analysis (P = 0.0098, 0.000 and 0.004, respectively). Twenty four month for time to treatment failure (TTF) rate, overall survival (OS) rate, and disease free survival (DFS) rate was (59.7 +/- 5. 3)%, (67.1 +/- 5.6)% and (77.6 +/- 5.8)%, respectively. In univariate analysis, LDH, clinical stage and PS exerted significant effect on TTF and OS rate, but not on DFS rate; age and extranodal disease was not related with TTF, OS and DFS rate. In multi-variate analysis, achieved CR was the only prognostic factor for TTF (P =0.001) and bulky disease had influence on DFS rate. LDH level, PS, and achieved CR was correlated with the OS rate in multi-variate setting (P = 0.002, 0.009 and 0.001 respectively).</p><p><b>CONCLUSION</b>IPI score has its limitation in predicting the prognosis in the R-CHOP era in DLBCL. Other two relevant prognostic factors are bulky disease and achieved CR after 6 courses of treatment.</p>