Treatment and Prognosis of Adult T Cell Acute Lymphoblastic Leukemia / 中国医学科学院学报

To analyze the treatment and prognosis of T cell acute lymphoblastic leukemia(T-ALL)in adults. Method The clinicobiogical and survival data of 68 adult patients with newly diagnosis T-ALL were retrospectively analzyed. Results The median age of these 68 patients was 23 years(14-60 years).T-ALL was more common in men(81%).After the first cycle of treatment,complete remission was achieved in 50 patients(73%).The highest complete remission(CR) rate was in patients with cortex T-ALL(100%),followed by other T-ALL(73%)and early T-cell precursor lymphoblastic leukemia(54%),(=5.712,=0.058).The CR rate for adults aged >35 years was significantly lower than that of patients aged ≤ 35 years(40% 79%,=6.364,=0.012).The overall CR rate after the second treatment course was 93%.For patients treated with chemotherapy,autograft hematopoietic stem cell transplantation(auto-SCT),and allogeneic SCT,the median relapse free survival was 10 months,24 months,and not reached,respectively(=0.002).The 5-year overall survival rate was 25% for all patients;for patients treated with chemotherapy,auto-SCT and allogeneic SCT,the median overall survival was 24 months,34 months,and 30 months,respectively(=0.007),and the 5-year overall survival rate was 9%,33%,and 38%(=0.037).Multivariate analysis showed leukocyte count ≥100×10 /L was a risk factor for decreased relapse free survival(risk ratio 2.540,95%=1.058-6.099,=0.037). Conclusion Adult T-ALL patients have poor prognosis,which may be improved by SCT.

Expression and role of amyloid precrusor protein gene in acute myeloid leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the expression of amyloid precursor protein (APP) gene in acute myeloid leukemia (AML) and its biological behaviour in AML cells.</p><p><b>METHODS</b>The expressions of APP mRNA in 85 AML and 20 nonmalignant hematological diseases patients (as control) were measured by real-time PCR. The expression of APP in AML cell lines was also examined by real-time PCR and Western blot and the results were compared with those in their original subtypes. Small interfering RNAs (siRNAs) targeting APP gene were synthesized and transfected into HL-60 cell by lipofectamine 2000 for 24 h, 48h and 72 h. Cell growth was measured by trypan blue dye exclusion and MTT, differentiation by Wright-Giemsa staining, cell cycle by PI/RNase staining, apoptosis by Annexin V/PI and Hoechst33342 staining. Apoptosis-related protein NF-κB, bcl-2 and Caspase-3 were detected by Western blot after siRNAs transfection for 48 h. Sensitivity to adriamycin was measured by MTT.</p><p><b>RESULTS</b>The expression of APP mRNA among AML subtypes differed significantly (P = 0.019), the highest expression subtype was M(2) with t(8;21) (median 0.1080), followed in order by AML-undefined (0.0467), M(3) (0.0266), M(2a) (0.0221), M(4a) (0.0167), M(5b) (0.0151), and M(4b) (0.0025). APP expression had no significant effect on AML clinical characteristics excepting for subtypes. The expression of APP in Kasumi-1 cells was significantly higher than that of U937 cells (P < 0.05), which was in agreement with APP expression in their original AML subtypes. After siRNAs transfection for 24 h, 48 h, and 72 h, no significant difference in proliferation, differentiation, apoptosis, cell cycle and sensitivity to adriamycin was detected between interfering group and control groups (P > 0.05).</p><p><b>CONCLUSIONS</b>The APP mRNA expression was highest in M(2) with t(8;21) and lowest in M(5b). Down-regulation of APP expression has no significant effects on biological behaviour of HL-60 cells.</p>