Clinical Analysis of 24 Acute myeloid Leukemia Patients Aged -over 80 Years / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical features of acute myeloid leukemia patients aged over 80 years.@*METHODS@#The clinical data from 24 cases of acute myeloid leukemia (non-M3) aged over 80 years were analyzed retrospectively. Clinical characteristics, therapeutic efficacy and overall survival rate of the patients received low dose chemotherapy and/or decitabine were compared with that received only supportive care.@*RESULTS@#According to FAB classification, the 10 patients were M2 subtypes (41.7%), the 7 patients were M4 subtypes (29.2%), the 4 patiens were M5 (16.7%), the 3 patients were unclassifed (16.5%). 22 patients (91.0%) were complicated with underling diseases. Among 13 patients received low dose chemotherapy or decitabine, 8 cases (61.5%) achived partial remission or higher remission. The median survival time of patients who reseived chemotherapy was 30 weeks, and signicantly longer than that of patients received supportive care (median survival time was 9 weeks (P<0.05)). The univariated analysis showed that WBC≥50×10/L, ECOG≥2 and received supportive care were unfavonrable prognostic factors for overall survival.@*CONCLUSION@#More than half of patients aged over 80 years who received individudized treatment can achieve partial remission or higher remission, and can have more longer survival time..

Improvement of Method for Detecting Peripheral Blood Neutrophil CD64 Index in Patients with Hematologic Malignancies / 中国实验血液学杂志

OBJECTIVE@#To improve the method for detecting the neutrophil CD64 (nCD64) index and to enhance the detection rate and accuracy of nCD64 index in patients with hematologic malignancies.@*METHODS@#The nCD64 index in peripheral blood of patients with hematologic malignancies combined with suspicious bacterial infection (255 cases-time) was detected by using array method. When the detection of nCD64 index in samples was interfered with abnormal cells in detection process of enrolled patients, the antibodies CD45, CD15 and CD10 were added into samples on the basis of routine detection by using the primary detection kit, in order to more accurately distinguish the neutrphils and obtain the nCD64 index. The nCD64 index as well as the efficiency of nCD64 index, PCT and CRP for diagnosis of sepsis before and after the improvement of deteation method were compared.@*RESULTS@#The samples of 60 cases were interfered with abnormal cells in detection process, out of which the samples of 18 cases failed in detection, but these samples of 18 cases all got the effective results of detection after the detection method was improved. The detection showed that the nCD64 index before and after the improvement as well as the PCT and CRP levels in sepsis group were higher than those in non-sepsis group(P＜0.05). After improvement of method, the efficiency of nCD64 index for diagnosis of sepsis was suprior to the PCT and CRP, the nCD64 index obtained after the improvement of method possessed the diagnosis efficiency same as the efficiency obtained before improvement of method, moreover the detection results were more reliable.@*CONCLUSION@#For the samples of patients with hematologic malignancies interfered with abnormal cells in the process of detecting the nCD64 index, the corresponding antibodies are added into detected samples according to the kinds of hemotologic diseases of patients, in order to more accurately gate the neutrophils in paripheral blood of patients, there by the detection rate and accuracy for detecting the nCD64 index are enhanced by accurately distinguishing the neutrophils.

Reseach Progress of Ki-67 in Acute Myeloid Leukemia-Review / 中国实验血液学杂志

Ki-67 antigen expression is closely associated with the cell cycle. Its expression is in almost the entire mitosis in cell cycle. Detection of Ki-67 antigen can reflect the cell proliferation activity in hematological malignancies. Detection of Ki-67 has been widely applied in staging, therapy effect monitoring and prognosis judgment in lymphoma. There has been a lot of studies investigating the expression of Ki-67 in acute lymphocytic leukemia (ALL) and chronic lymphocytic leukemia (CLL), and investigating the relevance between Ki-67 expression and therapy effect and prognosis. However, there are a few studies about Ki-67 in acute myeloid leukemia (AML), and the results of studies are no consistant. In this review, the architecture, intracellular localization, expression regulation, physiological functions of Ki-67 and the application of Ki-67 in AML are summarized so as to understanding whether Ki-67 can play roles in diagnosis and prognostic evaluation of AML.

Neutrophil CD64 Expression as A Biomarker in the Early Diagnosis of Sepsis in Malignant Hematologic Disease--Review / 中国实验血液学杂志

Malignant hematologic disease with sepsis has been characterized by high mortality and difficulty in diagnosis at early stage. A good biomarker may help to improve the accuracy of diagnosis and to reduce the mortality rate. In the early diagnosis of sepsis, neutrophil CD64 expression is a better candidate for biomarker rather than C-reactive proteins. Moreover, neutrophil CD64 expression is also helpful for assessing the severity of infection and prognosis of disease. Unfortunately, there are few studies of neutrophil CD64 expression on the early diagnosis of malignant hematologic diseases. This review focuses on the advantages, limitations, feasibilities and progresses of neutrophil CD64 expression in the early diagnosis of infection in malignant hematologic diseases in this paper.

Expression and clinical significance of PDCD5 in patients with acute myeloid leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>This study was aimed to investigate the roles of PDCD5 (programmed cell death 5) in pathogenesis of acute myeloid leukemia (AML) and the relevance of PDCD5 with the clinical characteristics and prognosis of patients by testing the PDCD5 expression in adult AML patients.</p><p><b>METHODS</b>The mRNA and intracellular protein levels of PDCD5 from 36 newly diagnosed AML patients were analyzed by real-time fluorescence quantitative polymerase chain reaction (RQ-PCR) and flow cytometry (FCM), respectively. The correlation of mRNA levels and intracellular protein levels of PDCD5 with the clinical characteristics and survival time of patients were analyzed.</p><p><b>RESULTS</b>The intracellular protein expression levels of PDCD5 in AML patients were significantly higher than those in normal controls (P < 0.05). The PDCD5 mRNA levels were not significantly different between patients and controls (P > 0.05). The mRNA and protein levels of PDCD5 did not significantly correlate with sex, age, WBC count, FAB subtype, extramedullary infiltration, WT1 gene, NPM1 gene mutation and the patients response to induction therapy. The patients with positive FLT3/ITD mutation displayed higher protein levels of PDCD5 as compared with negative FLT3/ITD mutation patients (P < 0.05).</p><p><b>CONCLUSION</b>The intracellular protein of PDCD5 significantly increased in AML patients. However, the increased PDCD5 does not exert the pro-apoptotic effects on AML cells. The patients with positive FLT3/ITD mutation show higher protein levels of PDCD5.</p>

Expression and clinical significance of B-cell lymphoma 2 (BCL-2) in hyperleukocytic acute myeloid leukemia / 中国实验血液学杂志

This study was aimed to investigate the role of B-cell lymphoma 2 (BCL-2) in pathogenesis of hyperleukocytic acute myeloid leukemia (AML). The levels of intracellular BCL-2 in 48 AML patients were detected by flow cytometry (FCM). Serum levels of BCL-2 in 40 AML patients were measured by enzyme-linked immunosorbent assay (ELISA). The results showed that the serum levels of BCL-2 in hyperleukocytic AML and non-hyperleukocytic AML patients were significantly higher than that in normal controls (P < 0.05), but intracellular BCL-2 levels were not significantly different, as compared with normal controls (P > 0.05). There were no difference of intracellular and serum BCL-2 levels between hyperleukocytic and non-hyperleukocytic AML patients (P > 0.05). The serum and intracellular levels of BCL-2 between hyperleukocytic AML, non-hyperleukocytic AML patients and normal controls were not statistically correlated. It is concluded that leukemic cells in AML patients produce and secrete too much BCL-2, which may be involved in the pathogenesis of leukemia disease. However, the anti-apoptosis effect of BCL-2 has no significant impact on the pathogenesis of hyperleukocytic AML.

The Importance of Properly Understanding SCI from the Perspective of Education for PhD Students in Medicine / 中华医学教育探索杂志

Doctor's degree is the highest degree for medical education.Nowadays,medical doctor candidates in more and more medical universities are requested to publish research papers in intemational journals embodied in Science Citation Index(SCI),or they can not graduate with doctor's degree.So,it is significant for medical doctor candidates to learn the related knowledge about SCI and Impact Factor(IF).

Correlation between human herpesvirus 6 activation and acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

<p><b>OBJECTIVE</b>To study the potential relationship between HHV-6 activation and acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic cell transplantation (HSCT).</p><p><b>METHODS</b>Peripheral blood samples were collected before and weekly after HSCT from 72 consecutive recipients. HHV-6 DNAemia was monitored by nested polymerase chain reaction (PCR). The genotypes of HHV-6 were identified by Hind III restriction assay.</p><p><b>RESULTS</b>Of the 72 patients, HHV-6 DNAemia were detected in 45 (62.5%) on a median of day 14 (range, 7 - 63 days) after HSCT. Grade I - IV aGHVD occurred in 40 (55.6%) on a median of day 26 (range, 9 -73 days). The median onset time of HHV-6 DNAemia was significantly earlier than that of aGHVD (P = 0.018). Compared with that in HHV-6 DNAemia negative [HHV-6(-)] patients, the cumulative incidence of grade I - IV aGHVD was higher (68.9% vs. 33.3% , P = 0.003) in HHV-6 (+) patients. Cumulative incidence of grade II - IV aGVHD in HHV-6 (+) cohort was also higher than that in HHV-6 (-) cohort (35.6% vs 14.8% , P = 0.027). Cumulative incidence of grade I - IV aGVHD was higher in patients with both HHV-6 and CMV positive (CMV+/HHV-6+) than in those with either CMV (CMV+/HHV-6-) or HHV-6 positive (CMV+/HHV-6+) and neither of them positive (CMV-/HHV-6-) [78.9% (30/38), 55. 6% (5/9) , 14. 3% (1/7) and 22. 2% (4/18), respectively, P = 0. 0001]. Cumulative incidence of grade II - IV aGVHD in CMV+/HHV-6+ group was also higher than that in CMV+/HHV-6-, CMV-/HHV-6+ and CMV-/HHV-6- groups [42.1% (16/38), 22.2% (2/9), 0% (0/7) and 11.1% (2/18), P = 0. 008].</p><p><b>CONCLUSIONS</b>Patients with HHV-6 activation or HHV-6/CMV co-infection maybe involved in the occurrence of aGVHD after HSCT.</p>

Prevalence of human herpesvirus-6 in allogeneic hematopoietic stem cell transplant recipients in correlation with cytomegalovirus infection / 中国实验血液学杂志

In order to study the prevalence of human herpesvirus 6 (HHV-6) in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients in China and to analyze the relationship between HHV-6 and cytomegalovirus (CMV) infection in post-HSCT patients, nested polymerase chain reaction (PCR) was used to monitor HHV-6 DNAemia in 72 consecutive allo-HSCT recipients. 680 EDTA anticoagulated peripheral blood specimens were gathered before HSCT or weekly until 12 weeks after allo-HSCT. The variants of HHV-6 were identified by Hind III restriction analysis. CMV-pp65 antigenemia was detected by immunofluorescence stain. The results showed that HHV-6 DNAemia was detected at least once in 62.5% (45/72) of the patients on the median day 14 (range, 7 - 63 days) after allo-HSCT, and HHV-6B was the predominant variant. CMV antigenemia was detected at least once in 65.3% (47/72) of the patients on the median day 43 (range, 14 - 105 days) after allo-HSCT. Co-infection of HHV-6 and CMV (HHV-6+/CMV+) occurred in 52.8% (38/72) recipients. The onset of HHV-6 DNAemia was earlier than that of CMV antigenemia (P < 0.0001). Patients with HHV-6 DNAemia positive were more likely to have concurrent CMV antigenemia than HHV-6 DNAemia negative patients (84.4% vs 33.3%, P = 0.0001) after allo-HSCT. Among the herpesvirus related disease, the relatively high incidence of hemorrhage cystitis (HC) occurred in 23.6% (17/72) of post-HSCT patients. 88.2% (15/17) of HC developed in HHV-6 positive patients, and 82.3% (14/17) occurred in CMV+/HHV-6+ patients. It is concluded that infection of HHV-6, co-infection of HHV-6 and CMV, commonly occurred in post-HSCT patients in China, HHV-6 infection closely related to CMV antigenemia.

Dendritic cells cultured with human umbilical cord serum instead of fetal calf serum / 中国实验血液学杂志

To investigate whether the dendritic cells (DC) could grow up in cultural system with umbilical cord serum (UCS), the UCS was used in the culture instead of fetal calf serum. The phenotype of dendritic cells was detected by flow cytometry and the antigen presenting ability of DC in allo-MLR was measured by MTT assay. The results showed that DC grown in UCS (UCS-DC) had higher expression rate of CD86, CD83 and HLA-DR than that in grown in FCS (FCS-DC). (P < 0.05), and their expression of CD1a was lower than that of FCS-DC. The ability to induce T cell proliferation had no difference between UCS-DC and FCS-DC. It is suggested that dendritic cells with more mature phenotype had been produced in the medium containing UCS than those in the medium containing FCS, and UCS-DC possessed potent ability to stimulate proliferation of allogeneic T cells.