Comparison of the efficacy and safety between decitabine combined with all-trans retinoic acid or half dose priming regimen in the treatment of elderly patients with myelodysplastic syndromes and acute myeloid leukemia / 医学研究生学报

Objective Decitabine (DAC) combined with the half dose priming regimen (HDPR) is a common treatment of myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) in the elderly. This study was to compare the clinical effect and safety of DAC combined with all-trans retinoic acid (ATRA) versus DAC plus HDPR in the treatment of MDS with excess of blasts (MDS-EB) or AML in elderly patients. Methods We retrospectively analyzed 48 elderly patients (≥60 years) with myeloid neoplasms (AML, MDS-EB-1 or MDS-EB-2) ineligible for standard chemotherapy treated in our hospital from January 2014 to October 2018, 22 by DAC+ATRA (group A) and the other 26 by DAC+HDPR (group B). We compared the overall response rate (ORR), overall survival (OS) and adverse events between the two groups of patients. Results No statistically significant difference was observed between groups A and B in ORR (86.4% vs 76.9%, P = 0.643) or median OS (26.2 vs 24.9 mo, P = 0.920). The median time to response was significantly longer in group A (2 courses) than in B (1 course) (P = 0.006). Compared with group A, group B showed remarkably lower incidence rates of grade-3 to -4 cytopenia (54.5% vs 84.6%, P = 0.029) and infection (45.5% vs 76.9%, P = 0.037), longer duration of neutropenia (P < 0.05), and higher volumes red blood cell infusion and platelet infusion (P < 0.05). There was no statistically significant difference in the incidence rate of bleeding between the two groups (P = 0.643). Conclusion DAC+ATRA and DAC+HDPR have comparable clinical effects on myeloid neoplasms in elderly patients, but the former is safer and better tolerated while the latter can achieve a more rapid response.

Decitabine combined with arsenious acid in the treatment of patients with higher-risk myelodysplastic syndromes and chronic myelomonocytic leukemia / 中国实用内科杂志

OBJECTIVE: To evaluate the clinical efficacy of decitabine combined with arsenious acid in the treatment of patients with higher-risk myelodysplastic syndromes(MDS) and chronic myelomonocytic leukemia(CMML). METHODS: Totally 39 patients with MDS and 8 patients with CMML received the treatment of decitabine and arsenious acid from April 2016 to December 2018. Decitabine [20 mg/(m~2·d)] and arsenious acid [0.15 mg/(m~2·d)] were administered intravenously for 5 consecutive days every 4-6 weeks. Patients who achieved complete or partial remission entered into the consolidation cycle. Efficacy and influencing factor were analyzed. RESULTS: Clinical response were observed in 31 patients after a median of 2 courses(ranging 1-12) of treatment. The overall response rate(ORR) was 66.0%. The median duration of response was 16 weeks(ranging 2-52 weeks). There were 8 cases(17.0%) of complete remission(CR), 10 cases(21.3%) of partial remission(PR),12 cases(25.5%) of hematological improvement(HI), 1 case(2.1%) of marrow complete remission(mCR), 8 cases(17.0%) of stable disease(SD), and 1 case(2.1%) of progressive disease(PD). By next generation sequencing, 25 genes mutated with 70 times in 33 cases. The mutation frequency of epigenetic regulators(57.6%) was higher than splicing factors(33.5%), transcription factors and kinase signaling(54.5%),and TP53(21.2%)(P<0.01). There was no significant difference in response rates among these patients(47.4%, 54.5%, 50.0% and85.7%, P=0.977). Gene mutation frequency(VAF) of patients who responded to the regimen declined significantly(16.67% vs. 10.26%,P=0.014). CONCLUSION: Decitabine combined with arsenious acid has significant effect in the treatment of patients with higher-risk MDS and CMML and is well-tolerated. Gene mutation test results by next generation sequencing might be related to clinical response.

All-Trans Retinoic Acid and Decitabine Synergistically Induce Anti-Leukemia Effect on U937 Cell Line and Newly Diagnosed Elder AML Patients / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of all transretinoicacid(ATRA) combined with decitabine (5-Aza-2'-deoxycytidine;DAC) on DNA methylation and gene expression of p16INK4a (p16) and retinoic acid receptor β (RARβ), and to explore their combined anti neoplastic effect on U937 cells and newly diagnose delder acute myeloid leukemia(AML) patients.</p><p><b>METHODS</b>The expression levels of p16 and RARβ were determined by qRT-PCR and Western blot. Methylation-specific PCR was used to analyze their methylation status. WST-1 and flow cytometry were performed to detect growth inhibition, differentiation, apoptosis and cell cycle of U937 cells respectively.</p><p><b>RESULTS</b>The expression p16 and RARβ was down-regulated by promoter hypermethylation in newly diagnose delder AML patients and U937 cells. Combination treatment of ATRA and DAC induced DNA hypomethylation as well as gene expression of p16 and RARβ, which contributed to the growth inhibition, differentiation, apoptosis and cell cycle arrest of U937 cells. In addition for elder AML patients intolerable to standard chemotherapy, the combination regimen of ATRA and DAC showed antineoplastic activity accompamied by up-regulation of p16 and RARβ expression and decrease of bone marrow blast, moreover the parients showed good tolerence to the reginen.</p><p><b>CONCLUSION</b>The regimen of ATRA combined with DAC as the combination therapeutic strategy for inducing differentiation and demethylation possesses the anti-AML potency, and contributes to optimizing the therapeutic strategy for elder AML patients and promoting the clinical prognosis.</p>

Prognostic Significance of the Percentage of Blasts with CD34/CD38/CD123Phenotype in Acute Myeloid Leukemias / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the percentage of blasts with the CD34/CD38/CD123phenotype in de novo acute myeloid leukemia (AML) patients and analyse its correlation with prognosis.</p><p><b>METHODS</b>The percentage of CD34/CD38/CD123cells in the blast population of 148 newly diagnosed patients with AML was determined by using flow cytometry and its correlation with complete response, disease-free survival and overall survival were evaluated.</p><p><b>RESULTS</b>The median percentage of CD34/CD38/CD123cells in newly diagnosed patients was 2.8% (ranged from 0.01 to 67%). The high expression of CD34/CD38/CD123in AML patients positively correlated with the NPM1 wild-type (χ=5.194,P<0.05), but did not relate with the positive FLT3-ITD mutations (χ=0.418,P>0.05). Further multivariable analysis showed that the higher expression of the CD34/CD38/CD123was associated with lower complete remission (P<0.05), worse disease-free survival(P<0.01) and shorter overall survival(P<0.01) in AML patients.</p><p><b>CONCLUSION</b>The percentage of CD34/CD38/CD123cells at diagnosis significantly correlates with the response to treatment and survival. This prognostic marker may be used to rapidly identify the risk of treatment failure in clinical practice.</p>

Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation with IBu Precondition Regimen in Treatment for 11 Patients with Low to Intermediate Risk Acute Myeloid Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To evaluate safety and efficacy of autologous peripheral blood hematopoietic stem cell transplantation (auto-PBHSCT) with IBu precondition regimen consisting of high-dose idarubicin (IDA) and busulphan (Bu) for treatment of patients with low and intermediate risk acute myeloid leuekmia (AML).</p><p><b>METHODS</b>A total of 11 patients with AML (5 low and 6 intermediate risk patients) treated with auto-PBHSCT with IBu precondition regimen (IDA 20 mg/m, continuous i.v. from d-13 to d-11, Bu 0.8 mg/kg/q6h i.v. for 2h, from d-5 to d-2) from March 2011 to July 2014 were analyzed retrospectively. Adverse effects and transplantation-related mortality (TRM) were evaluated. Kaplan-Meier analysis was performed to calculate the overall survival (OS), disease-free survival (DFS) and cumulative relapse rate (RR). Cox regression was performed for univariate analysis for DFS.</p><p><b>RESULTS</b>Among the 11 patients, 10 patients obtained hematopoietic reconstitution, 1 patient died during transplantation, thus the TRM was 9.1%. The adverse effects were well tolerated. With median follow-up of 31.6 (8.7-52.5) months, 7 patients (63.3%) were alive, including 6 patients (54.5%) in continuous complete remission (CR). Median OS and DFS were not reached. The 3-year OS, DFS and RR were (57.7±16.3)%, (52.5±17.6)% and 47.5%, respectively. Univartiate analysis indicated that the age, sex, interval between diagnosis and transplantation, white blood cell count at diagnosis, risk-grouping (low or intermediate risk), disease status before transplantation (CR1 or CR2), and count of mononuclear cells for infusion all can not influence DFS(P>0.05, respectively).</p><p><b>CONCLUSION</b>The treatment of auto-PBHSCT with IBu precondition regimen for low to intermediate risk AML patients is safe and effective.</p>

Effects of simvastatin on PI3K/AKT signaling pathway in human acute monocytic leukemia cell line SHI-1 / 中国实验血液学杂志

To investigate the effects of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor simvastatin (SV) on proliferation, apoptosis and the PI3K/AKT signaling pathway in human acute monocytic leukemia cell line SHI-1. SHI-1 cells were incubated with different concentrations of SV (5, 10, 15 µmol/L). Otherwise, SHI-1 cells without any treatment were used as control. Cells in different groups were collected at 24, 48 and 72 h after incubation for further detection. MTT method was used to assay the growth inhibition rate and flow cytometry was used to detect the early stage apoptosis ratio. The human PI3K-AKT Signaling Pathway RT(2) Profiler(TM) PCR Array was used to detect the expression of 84 genes involved in PI3K-AKT signaling. The results indicated that the SV inhibited the proliferation and inducted the apoptosis of SHI-1 cells in time- and dose-dependent manners significantly. The growth inhibition rates of SHI-1 cells treated with 15 µmol/L SV for 24, 48 and 72 h were 26.82, 47.09 and 63.92, respectively; and their early stage apoptosis ratios were 5.75, 13.25 and 15.59, respectively. Compared with the control group, expression levels of 39 genes were changed in the group of 15 µmol/L SV at 48 h, among them 26 genes were down-regulated and 13 genes were up-regulated. It is concluded that the SV can inhibit proliferation and induce apoptosis of SHI-1 cells, and the mechanism may be associated with the changes of gene expression level in PI3K-AKT signaling pathway regulated by SV.

Induction of dendritic cells with multidrug resistance from K562/MDR1 cells / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To induce the differentiation of K562/MDR1 cells into dendritic cells (DC) with multidrug resistance property.</p><p><b>METHODS</b>K562/MDR1 cells and K562 cells were cultured in the presence of GM-CSF and IL-4 to generate DC and matured by TNF-α. On d14 K562/MDR1-DC and K562-DC cells were harvested and the expressions of CD1a, CD83, CD80, CD86, HLA-ABC and HLA-DR were assessed by flow cytometry (FCM). The antigen presentation function of K562/MDR1-DC and K562-DC was determined by allogenic mixed lymphocyte reaction (Allo-MLR). The expression of P-glycoprotein and the intracellular accumulation of daunorubicin (DNR) were detected by FCM. The sensitivity of K562/MDR1-DC and K562-DC cell to vincristine, adriamycin was measured using MTT assay.</p><p><b>RESULTS</b>Both K562/MDR1 and K562 cells were differentiated into dendritic cells in the presence of cytokine cocktails, showing the morphologic and immunophenotypic characteristics of DC. K562/MDR1-DC more markedly enhanced proliferation of allogeneic lymphocytes in MLR than K562-DC. High level expression of P-glycoprotein and efflux of DNR were demonstrated in K562/MDR1-DC. K562/MDR1-DC showed multidrug resistance property, with higher IC(50) to VCR and ADM than that of K562-DCs.</p><p><b>CONCLUSION</b>K562/MDR1 cells can be differentiated into DC with the presence of cytokines, the induced K562/MDR1-DC cells express high level of P-glycoprotein and acquire the multidrug resistance property.</p>

STUDY ON HIGH-DENSITY CULTURE OF AMMONIUM-RESISTANT N_2-FIXING BACTERIUM KLEBSIELLA OXYTOCA / 微生物学通报

Based on the physiological properties of ammonium-resistant N2-fixingbacterium ( Klebsiella oxytoca NG13/pMC73A), the fermentation technology of it was studied. The basic medium of high-density culture was established, with glucose as carbon source coupled with appropriate nitrogen source and inorganic salts. At the middle and late phase of culture, glucose and ammonia were added to supply carbon source and nitrogen source, stabilizing the pHat 6.5 ~ 6.8. Optimal level of dissolved oxygen was kept by controlling aeration and stirring rate. Bacterium number of Klebsiella oxytoca NG13/pMC73A reached 600 ~ 700 x 10s cfu/mL at the end of culture. Compared with previous technology, bacterium number was increased by more than ten-fold with a comparable culture period.

The Developments of Microbial Resistance to Industrial Antiseptics and Disinfectants / 微生物学通报

These years with industrial antiseptics and disinfectants widely used, especially unscientifically used, the resistance of microorganisms is more and more serious, which brought much more difficulties to industrial producing. The developments on the resistance of microorganisms to industrial antiseptics and disinfectants, their resistant mechanisms and the control strategies are reviewed, which aids us to reasonably use industrial organic antiseptics and disinfectants in existence and provides academic and scientific basis.

The Microorganism Constitutes Analysis of Soy Sauce Liquor from High-Salt-Level Watery State Fermentation / 微生物学通报

A system analysis about the microbial flora of normal and abnormal soybean sauce liquor from the high-salt-level watery state fermentation was made and the dominant bacteria and yeasts were identified.On the other hand,a discussion of effect of temperature on microbial flora was made.The results indicated that there were no obvious differences about the count of aerobe,spore-producing bacteria,enterobacteriaceae,lactic acid bacteria and anaerobe between the normal and abnormal soybean sauce liquor and there were marked differences about the count of yeasts and salt-tolerant bacteria.The predominant yeasts in normal soybean sauce were Torulopsis and Saccharomyces,accounting for 55.9% and 35.3% of the total yeasts separately,and in abnormal soybean sauce were Pichia,candida and Saccharomyces,accounting for 62.8%,17.9% and 9.0% respectively.

The Concentration and Variation of Airborne Microbe in Guangzhou City / 微生物学通报

One year survey on the concentrations and monthly or seasonal variations of airborne microbe in Guangzhou city were analysed and studied with JWL-IIB airborne microbial sampler. The results showed that the yearly average airborne microbe content of outdoor was 2, 298 cfu/m3, and that of indoor was 1,792 cfu/m3 in Guangzhou city. The monthly variation range of outdoor airborne microbe was from 1,073 to 4,096 cfu/m3, the highest content was 4,096 cfu/m3 in March, and the lowest content was 1,073 cfu/m3 in October. The outdoor airborne bacteria and fungi counts were the highest in spring, next in summer, lower in winter and the lowest in autumn in the four seasons . The yearly average concentrations of outdoor airborne microbe at the Garbage compression station, the business walk street, the key traffic route, the residential area, the industrial district and the garden were 4, 573, 3, 835, 1, 580, 1,413, 1, 197 and 1, 187 cfu/m3respectively; and Ones of indoor at the key traffic route, the tourist three star-route hotel and the subway station were 2,511, 1,699and 1,167 cfu/m3 respectively . The study on airborne microbe can be used for the research of health prevention and environment control measures in Guangzhou .

Isolation and Identification of Osmotolerant Yeast from "Swollen Can" Soy Sauce / 微生物学通报

Three osmotolerant yeasts were isolated from three batches of "swollen can" soy sauce produced by a Guangdong condiment plant. These strains grew faster in the media containing 50%～60% glucose or 15% NaCl than in common yeast media. The three yeasts were identified as Pichia etchellsii by using morphological characteristics, physiological and biochemical tests.