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1.
Cancer Research and Clinic ; (6): 681-684, 2021.
Article in Chinese | WPRIM | ID: wpr-912947

ABSTRACT

Objective:To investigate the variation trend of peripheral blood CD34 + cells during the hematopoietic stem cell mobilization and its influence on the collection timing and results. Methods:The clinical data of 62 patients with hematologic diseases undergoing autologous peripheral blood hematopoietic stem cell mobilization from April 2012 to March 2017 in Shanxi Provincial Cancer Hospital were analyzed. Mobilization regimen used chemotherapy combined with granulocyte colony-stimulating factor (G-CSF) to monitor the number of white blood cells (WBC), mononuclear cells (MNC), CD34 + cells in peripheral blood and apheresis concentrates, and the correlation with CD34 + cells was analyzed. Furthermore, the receiver operating characteristic (ROC) curve was used to establish the threshold to start apheresis. Results:MNC (5.66±1.11)×10 8/kg and CD34 + cell count (2.15±1.20)×10 6/kg were obtained in 62 patients who received 136 times collection in total. The peak of peripheral blood CD34 + cells count appeared at day 4-5 after the treatment of G-CSF, and then it went down. CD34 + cell count in the product was correlated with the peripheral blood CD34 + cell count collected on the day ( r = 0.879, P < 0.01), and it was also correlated with the peripheral blood WBC and MNC collected on the day as well as MNC count in the product (all P < 0.05). Furthermore, the ROC curve analysis demonstrated that peripheral blood CD34 + cells count > 23/μl was the optimal threshold for stem cell collection on the day, 85.2% of patients reaching up to the threshold could be successfully collected at one time. Conclusions:The variation trend of peripheral blood CD34 + cell count can guide the best time of stem cell collection in clinic. Peripheral blood CD34 + cell count is the reliable index to predict CD34 + cells count in the products. Peripheral blood CD34 + cells count > 23/μl could be used as the collection threshold.

2.
Journal of Leukemia & Lymphoma ; (12): 165-169, 2020.
Article in Chinese | WPRIM | ID: wpr-862809

ABSTRACT

Objective:To investigate the effect of infused CD34 + cell count on hematopoietic recovery and prognosis of non-Hodgkin lymphoma (NHL) patients after autologous peripheral blood hematopoietic stem cell transplantation (APBSCT). Methods:The data of 60 NHL patients who underwent APBSCT from May 2010 to May 2016 in the Affiliated Cancer Hospital of Shanxi Medical University was retrospectively analyzed, including 32 B-NHL patients and 28 T-NHL patients. The patients were grouped according to the receiver operating characteristic curve (ROC) threshold, and the hematopoietic reconstruction after transplantation was analyzed. The relationship between the infused CD34 + cell count and prognosis was analyzed. The prognostic factors were analyzed using univariate and multivariate analyses. Results:The CD34 + cell count threshold was determined to be 4.35×10 6/kg based on ROC. In CD34 + cell count≥ 4.35×10 6/kg group (20 cases) and CD34 + cell count < 4.35×10 6/kg group (40 cases), the granulocyte recovery time was (9.9±1.2) d and (12.5±3.7) d ( P = 0.031), and the platelet recovery time was (9.4±1.7) d and (13.8±2.9) d ( P = 0.012). The 3-year overall survival(OS) rates in CD34 + cell count ≥ 4.35×10 6/kg group and CD34 + cell count < 4.35×10 6/kg group were 85.0% and 55.0% ( P = 0.024), and the 3-year PFS rates were 85.0% and 57.5% ( P = 0.016). In B-NHL patients, the 3-year PFS rates in CD34 + cell count ≥ 4.35×10 6/kg group (11 cases) and CD34 + cell count < 4.35×10 6/kg group (21 cases) were 81.8% and 42.9% ( P = 0.037), respectively. In T-NHL patients, the 3-year OS rates in CD34 + cell count ≥ 4.35×10 6/kg group (9 cases) and CD34 + cell count < 4.35×10 6/kg group (19 cases) were 77.8% and 36.8% ( P = 0.049), respectively. Univariate survival analysis showed that the predictive factors of both OS and PFS included age > 60 years old, Ann Arbor stage Ⅲ-Ⅳ, international prognostic index (IPI) score > 2 and infused CD34 + cell count < 4.35×10 6/kg (all P < 0.05). Multivariate analysis showed that IPI score and infused CD34 + cell count were both independent predictive factors of PFS ( RR = 0.333, 95% CI 0.112-0.994, P = 0.049; RR = 0.190, 95% CI 0.047-0.773, P = 0.020), and IPI score was an independent predictive factor of OS ( RR = 0.095, 95% CI 0.011-0.837, P = 0.034). Conclusion:The infused CD34 + cell count affects the hematopoietic reconstruction time and component blood transfusion after APBSCT, and has certain predictive value for the prognosis of NHL patients.

3.
Cancer Research and Clinic ; (6): 633-636, 2020.
Article in Chinese | WPRIM | ID: wpr-872559

ABSTRACT

Objective:To investigate the clinical efficacy and safety of chidamide monotherapy or its combination of chemotherapy in the treatment of peripheral T-cell lymphoma (PTCL).Methods:The clinical data of 40 cases PTCL patients (26 cases newly diagnosed PTCL and 14 cases relapsed/refractory PTCL) treated with chidamide between December 2015 and April 2019 in Shanxi Provincial Cancer Hospital were retrospectively analyzed. The overall response rate (ORR), progression-free survival (PFS), overall survival (OS) of the patients were observed, and the adverse reactions were analyzed.Results:ORR of all patients was 70.0% (28/40), ORR of the newly diagnosed group was 80.8% (21/26), ORR of the relapsed/refractory group ORR was 50.0% (7/14). The short-term efficacy of the newly diagnosed group was better than that of the relapsed/refractory group ( P = 0.049). The ORR of prognostic index for PTCL (PIT) 0-1 score group was 83.3% (10/12), PIT 2-4 score group was 78.6% (11/14); the therapeutic efficacy of PIT 0-1 score group was better than that of PIT 2-4 score group, and the difference between the two groups was not statistically significant ( P = 0.578). ORR of angioimmunoblastic T-cell lymphoma (AITL) and PTCL not otherwise specified (PTCL-NOS) subtype in the newly diagnosed group was 90.0% (9/10). The median follow-up time was 14.5 months. The median PFS time was 12 months in the newly diagnosed group, 1-year PFS rate and OS rate was 49.6% and 84.2%, 2-year PFS rate and OS rate was 35.9% and 57.4%. The median PFS time was 7 months in the relapsed/refractory group, 1-year PFS rate was 28.6%, 1-year OS rate was 49.0%. There was no Ⅲ-Ⅳ neutropenia and Ⅲ-Ⅳ gastrointestinal reaction in the chidamide monotherapy group; the incidence of Ⅲ-Ⅳdegree neutropenia was 39.4% (13/33) in the chidamide combined with chemotherapy. The incidence of Ⅲ-Ⅳ degree gastrointestinal response rate was 27.3% (9/33), and there was no Ⅲ-Ⅳ degree of liver and kidney dysfunction. Conclusion:Chidamide has good short-term efficacy in newly treated or relapsed/refractory PTCL patients. All patients are well tolerated with chidamide monotherapy or its combination of chemotherapy.

4.
Article in Chinese | WPRIM | ID: wpr-742760

ABSTRACT

Objective To study the mitochondrial DNA mutation in patients with primary multiple myeloma. Methods The mitochondrial DNA of 5 patients with primary multiple myeloma in the First Hospital of Qinhuangdao from February to June 2017 were amplified by polymerase chain reaction (PCR) and sequenced directly, and the results were compared with revised Cambridge Reference Sequence (rCRS) and Human Mitochondrial Gene Database (mtDB) database. Results There were 42 mutation genes, with 52.38%(22/42) mutation genes in D-loop region, 9.52%(4/42) mutation genes in ND4L region, 2.38%(1/42) mutation genes in ND5 region, 26.19% (11/42) mutation genes in Cytb region, 7.14% (3/42) mutation genes in ND1 region, and 4.76% (2/42) mutation genes in COⅡ region. Conclusion There is a high mitochondrial DNA mutation rate in patients with primary multiple myeloma.

5.
Cancer Research and Clinic ; (6): 452-455, 2019.
Article in Chinese | WPRIM | ID: wpr-756776

ABSTRACT

Objective To investigate the mutation of mitochondrial genome in lymphoma. Methods The peripheral blood or borrow fluid 2 ml from 14 lymphoma patients in the First Hospital of Qinhuangdao between May 2016 and July 2017 were collected. Polymerase chain reaction (PCR) was used to amplify and sequence mitochondrial DNA, and the results were compared with the revised Cambridge reference sequence (rCRS) and human mitochondrial genome database (mtDB), and then the mutation was also analyzed. Results There were 118 mutation genes, including 57.63% (68/118) in D-loop region, 18.64% (22/118) in NADH dehydrogenase 5 (ND5) region, 13.56%(16/118) in cytochrome b oxidase (CbO) region, 5.08%(6/118) in ND1 region, 3.39% (4/118) in cytochrome oxidase (COⅡ) region, 1.69% (2/118) in ND4 region. Conclusion Mitochondrial DNA mutation in lymphoma has a high mutation rate.

6.
Journal of Leukemia & Lymphoma ; (12): 533-537, 2019.
Article in Chinese | WPRIM | ID: wpr-751438

ABSTRACT

Objective To explore the factors influencing the mobilization and collection of autologous peripheral blood stem cells. Methods The clinical data of 62 patients who received autologous peripheral blood hematopoietic stem cell mobilization in Shanxi Provincial Cancer Hospital from April 2012 to March 2017 were collected. The effects of age, gender, disease type, chemotherapy cycle, disease status, different schemes and the number of CD34+cells in peripheral blood of patients 1 d before collection on the number of CD34+cells and the success rate of CD34+cells collection were analyzed. Measurement data were compared by one-way ANOVA and t test; count data were compared by χ2 test; multivariate analysis was performed by multiple linear regression analysis. Results There were statistically significant differences in the number of CD34+cells between patients with chemotherapy>6 cycles and≤6 cycles [(2.6±1.3)×106/kg vs. (5.8±2.2)×106/kg;t=5.221, P<0.01], and the difference in the success rate of CD34+cell collection between the two groups was statistically significant [68.8% (11/16) vs. 97.8% (45/46); χ 2= 8.396, P = 0.004]. The difference in the CD34+cells yield was not statistical significance between male and female patients [(5.4±2.2)×106/kg vs. (4.5± 2.8)×106/kg; t = 1.302, P= 0.198)], but the collection success rate in males was higher than that in females [97.6% (40/41) vs. 76.2% (16/21)], and the difference was statistically significant (χ2=5.017, P =0.025). The success rate of CD34 + cell collection in patients with ≥10/μl CD34 + cell in the peripheral blood was significantly higher than that in patients with < 10/μl CD34+cells 1 d before the collection[97.9% (47/48) vs. 64.3% (9/14)], and the difference was statistically significant (χ 2 = 10.668, P= 0.001). The differences in CD34+cells yield and collection success rate between patients with different age, disease type, disease status and mobilization regimen were not statistically significant (all P> 0.05). Multi-factor analysis showed that >6 cycles chemotherapy before mobilization was the adverse factor affecting stem cell collection (b = -3.435, P< 0.01). Conclusions The effective mobilization and collection of autologous peripheral blood stem cells are related to the number of chemotherapy cycles before mobilization. The stem cell mobilization and collection should be conducted as soon as possible when the chemotherapy is ≤ 6 cycles and the patient reaches partial remission or above. In addition, peripheral blood CD34+cell count should be monitored during mobilization. When the peripheral blood CD34+cell count is >10/μl, the collection could be started on the next day to obtain a better collection effect, so as to improve the success rate of collection.

7.
Chinese Journal of Oncology ; (12): 389-392, 2019.
Article in Chinese | WPRIM | ID: wpr-805239

ABSTRACT

Objective@#To investigate the clinical manifestations, pathological features, diagnosis and treatment of myeloid sarcoma, and to improve the understanding of myeloid sarcoma.@*Methods@#The clinical data, diagnosis and treatment of 7 patients with myeloid sarcoma were retrospectively analyzed.@*Results@#Of the 7 patients with myeloid sarcoma, 1 was male and 6 were female. In most patients, the local compression symptoms caused by painless local masses or masses were the first manifestations. One patient had lesions involving the cervix and vaginal bleeding was the first symptom. The lesions were extensive with 19 sites involved. The positive proportion of immunohistochemical staining was 6/6 for CD43, 6/7 for MPO, 4/5 for CD117, 4/4 for LCA, 3/5 for CD34 and 2/2 for CD99. Lymphocyte markers CD3 and CD20 were negative in all 7 patients.@*Conclusions@#Myeloid sarcoma is a rare hematological malignancy. Early diagnosis and active treatment are the key to improve prognosis. Current treatments include systemic chemotherapy, surgical resection, radiation therapy, and hematopoietic stem cell transplantation.

8.
Journal of Leukemia & Lymphoma ; (12): 533-537, 2019.
Article in Chinese | WPRIM | ID: wpr-798244

ABSTRACT

Objective@#To explore the factors influencing the mobilization and collection of autologous peripheral blood stem cells.@*Methods@#The clinical data of 62 patients who received autologous peripheral blood hematopoietic stem cell mobilization in Shanxi Provincial Cancer Hospital from April 2012 to March 2017 were collected. The effects of age, gender, disease type, chemotherapy cycle, disease status, different schemes and the number of CD34+ cells in peripheral blood of patients 1 d before collection on the number of CD34+ cells and the success rate of CD34+ cells collection were analyzed. Measurement data were compared by one-way ANOVA and t test; count data were compared by χ 2 test; multivariate analysis was performed by multiple linear regression analysis.@*Results@#There were statistically significant differences in the number of CD34+ cells between patients with chemotherapy >6 cycles and ≤6 cycles [(2.6±1.3)×106/kg vs. (5.8±2.2)×106/kg; t = 5.221, P < 0.01], and the difference in the success rate of CD34+ cell collection between the two groups was statistically significant [68.8% (11/16) vs. 97.8% (45/46); χ2 = 8.396, P = 0.004]. The difference in the CD34+ cells yield was not statistical significance between male and female patients [(5.4±2.2)×106/kg vs. (4.5±2.8)×106/kg; t = 1.302, P = 0.198)], but the collection success rate in males was higher than that in females [97.6% (40/41) vs. 76.2% (16/21)], and the difference was statistically significant (χ 2 = 5.017, P = 0.025). The success rate of CD34+ cell collection in patients with ≥10/μl CD34+ cell in the peripheral blood was significantly higher than that in patients with < 10/μl CD34+ cells 1 d before the collection[97.9% (47/48) vs. 64.3% (9/14)], and the difference was statistically significant (χ 2 = 10.668, P = 0.001). The differences in CD34+ cells yield and collection success rate between patients with different age, disease type, disease status and mobilization regimen were not statistically significant (all P > 0.05). Multi-factor analysis showed that > 6 cycles chemotherapy before mobilization was the adverse factor affecting stem cell collection (b = -3.435, P < 0.01).@*Conclusions@#The effective mobilization and collection of autologous peripheral blood stem cells are related to the number of chemotherapy cycles before mobilization. The stem cell mobilization and collection should be conducted as soon as possible when the chemotherapy is ≤ 6 cycles and the patient reaches partial remission or above. In addition, peripheral blood CD34+ cell count should be monitored during mobilization. When the peripheral blood CD34+ cell count is > 10/μl, the collection could be started on the next day to obtain a better collection effect, so as to improve the success rate of collection.

9.
Cancer Research and Clinic ; (6): 473-476, 2018.
Article in Chinese | WPRIM | ID: wpr-712854

ABSTRACT

Objective To study the mitochondrial DNA mutation in leukemia.Methods Mitochondrial DNA of 16 leukemia patients in First Hospital of Qinhuangdao from February to June 2017 were amplified and sequenced by using polymerase chain reaction (PCR).The result was compared with revised Cambridge reference sequence (rCRS) and human mitochondrial genome database (mtDB),and the mutation was also analyzed.Results There were 106 mutation genes in total,including 47.17 % (50/106) in D-loop region,2.83 % (3/106) in ND4 region,17.92 % (19/106) in ND5 region,22.64 % (24/106) in Cytb region,7.55 % (8/106) in ND1 region,1.89 % (2/106) in Co Ⅱ region.Conclusion There is a high mitochondrial DNA mutation rate in leukemia patients.

10.
Article in Chinese | WPRIM | ID: wpr-708917

ABSTRACT

Objective To evaluate the prognostic value of the maximum standardized uptake value decrease proportion (△SUVmax%) on 18F-fluorodeoxyglucose (FDG) PET/CT imaging and C-MYC gene in diffuse large B cell lymphoma (DLBCL),and to find the optimal time of PET/CT imaging.Methods From September 2010 to February 2016,171 patients (87 males,84 females,average age:(50.66±2.56) years)with pathologically confirmed DLBCL were analyzed.18F-FDG PET/CT were performed before and after different courses of chemotherapy (60 patients in early phase which means 1 and 2 courses;55 patients in medium phase,3 and 4 courses;56 patients in late phase,5 and 6 courses).The region of interest (ROI) was drawn and the △SUVmax% was calculated.Patients were evaluated with Deauville 5-point scale.Fluorescence in situ hybridization (FISH) was employed to detect C-MYC gene.Patients were followed up for 6-71 months,and progression-free survival (PFS) was calculated.x2 test,one-way analysis of variance,Kaplan-Meier analysis and Spearman correlation analysis were used to analyze the data.Results There were 42 C-MYC gene rearrangement of 171 DLBCL patients.Age,Ann Arbor stage,international prognostic index (IPI) score,serum lactate dehydrogenase (LDH) level and therapeutic response were different between patients with C-MYC gene rearrangement and those without rearrangement (x2:6.139-98.339,all P<0.05).The optimum cutoff values of the △SUVmax% were 62.5%,87.0% and 92.0% respectively in the early,medium and late phases of chemotherapy.Patients with △SUVmax% ≥≥ 62.5%,≥ 87.0% or ≥ 92.0% and normal C-MYC gene showed longer PFS (x2 values:21.983-61.899,all P<0.001).The △SUVmax% was negatively correlated with C-MYC gene rearrangement (rs =-0.801,P < 0.001).Significant differences were found in △SUVmax% (F=6.509,P<0.01) and Deauville 5-point scale (F=19.897,P<0.001) among patients in early,medium and late phases.No Significant differences were shown between medium and late phases (P>0.05).Conclusion △SUVmax% in the different phases of chemotherapy and C-MYC gene rearrangemeut have better values for predicting the prognosis of DLBCL,and 18F-FDG PET/CT imaging should be performed between 1 course and 4 courses of chemotherapy.

11.
Article in Chinese | WPRIM | ID: wpr-693443

ABSTRACT

Minimal residual disease (MRD) is a very important prognostic factor in multiple myeloma (MM).The major types of MRD tests include cell-based test (multi-parameter flow cytometry) and molecular tests (including PCR and gene sequencing),and the various techniques have inherent advantages and limitations.In clinical application,MRD negative can significantly prolong progression-free survival and overall survival of patients who receive hematopoietic stem cell transplantation and conventional che-motherapy.Moreover,the MRD status is of great significance to the selection of treatment options.

12.
Journal of Leukemia & Lymphoma ; (12): 111-113,128, 2017.
Article in Chinese | WPRIM | ID: wpr-605853

ABSTRACT

Primary hepatic lymphoma (PHL) is an extremely rare disease without any unified diagnostic criterion.The symptoms are usually nonspecific.Liver biopsy remains the most valuable tool for diagnosis of PHL.The predominant histology of PHL is diffuse large B-cell lymphoma.The therapeutic modalities are variable,including surgery,chemotherapy,radiotherapy,or combination of the various processes.This article described a 33-year-old man with diffuse large B-cell PHL who was treated at the Affiliated Cancer Hospital of Shanxi Medical Univeitity Blood Disease Diagnosis and Treatment Center in February 2014.The patient benefited from eight-cycle chemotherapy.At present,the patient is disease-free and undergoes regular follow-up.

13.
Clinical Medicine of China ; (12): 828-833, 2017.
Article in Chinese | WPRIM | ID: wpr-607734

ABSTRACT

Objective To assess the effect of neutrophil?to?lymphocyte ratio ( NLR) on the recurrence rate of patients with alpha?fetoprotein (AFP) ?negative hepatocellular carcinoma (HCC) and the value of NLR in predicting prognosis. Methods The clinical data of seventy?seven patients diagnosed with AFP?negative HCC and treated with hepatocellular carcinoma surgery in the First Hospital in Weinan from June 2015 to March 2017 were analyzed. According to the recurrence at the end of the follow?up, the patients were divided into the recurrence group and the non?recurrence group. Cox single factor analysis was used to analyze the relationship between the clinicopathological features and postoperative recurrence, and the clinical risk factors with statistically significance in the univariate analysis were placed in the Cox multivariate regression analysis to determine whether it is independent risk factor. Results The differences between the two groups in the number of tumors (31/15,28/3),tumor size (>5 cm) (5. 53±1. 83,4. 65±1. 73),portal vein tumor thrombus (18/28,2/29),microvascular invasion (14/32,2/29) were all statistically significant (P5 cm ) ( RR=0. 550, 95%CI 0. 316-0. 956, P=0. 038),portal vein tumor thrombus (RR=1. 294,95%CI 1. 208-1. 386,P=0. 022),microvascular invasion (RR=1. 575,95%CI1. 209-2. 052,P=0. 028) were the risk factors of postoperative recurrence. Cox regression model showed that tumor number (RR=1. 830,95%CI 1. 184-2. 828,P=0. 026),portal vein tumor thrombus ( RR=2. 860,95%CI 2. 062-3. 968,P=0. 001) ,microvascular invasion ( RR=1. 760,95%CI 1. 019-3. 041,P=0. 037) and preoperative NLR level ( RR=1. 890,95%CI 1. 056-3. 383,P=0. 028) were independent risk factors of the recurrence in AFP negative HCC patients after surgery. Among the 77 patients,46 cases were in the recurrent group, the average value of NLR was 3. 49 ± 0. 30, and the average preoperative NLR of the non?recurrence group ( 31 patients ) were 3. 01 ± 0. 30, the difference between the two groups in NLR value was statistically significant (t=-6. 885,P=0. 000). According to the ROC curve,the NLR=3. 17 corresponded to the maximum Youden index,the sensitivity of NLR was 82. 6%,the specificity was 67. 7%. Conclusion The preoperative NLR level is inversely proportional to the recurrence?free survival time of patients with AFP?negative HCC,which is one of the independent risk factors for recurrence. The optimal critical value of NLR is 3. 17.

14.
Article in Chinese | WPRIM | ID: wpr-659116

ABSTRACT

At present,immunotherapies for lymphoma are becoming gradually important.Chimeric antigen receptor-modified T cells therapy,bispecific antibody and immune-checkpoint inhibitor are considered as breakthrough treatments,each has its own unique mechanism,and more advanced treatments will be developed based on them.

15.
Article in Chinese | WPRIM | ID: wpr-657252

ABSTRACT

At present,immunotherapies for lymphoma are becoming gradually important.Chimeric antigen receptor-modified T cells therapy,bispecific antibody and immune-checkpoint inhibitor are considered as breakthrough treatments,each has its own unique mechanism,and more advanced treatments will be developed based on them.

16.
Journal of Leukemia & Lymphoma ; (12): 413-416, 2017.
Article in Chinese | WPRIM | ID: wpr-616256

ABSTRACT

Objective To study the clinical characteristics and treatment of primary nasal B-cell lymphoma (PNBCL). Methods A retrospective analysis was performed based on the clinical records of 18 PNBCL cases who were treated from January 2009 to June 2015. The clinical manifestations, imaging features, diagnosis approaches and treatment of them were analyzed. Results The main symptoms were nasal obstruction and rhinorrhea. Of all patients, 15 cases were in Ann Arbor stageⅠE-ⅡE, and 3 cases were in Ann Arbor stageⅢE-Ⅳ. The median age was 51 years (12-76 years). The ratio of men to women was 11:7. Only 1 patient had B symptoms. Elevated LDH levels were observed in 4 patients. 13 patients were diffuse large B-cell lymphoma(DLBCL), 3 patients were mantle cell lymphoma, and 2 patients were Burkitt lymphoma. CT examination showed the abnormal nasal soft tissue shadow, with unilateral location and light to moderate enhancement. 14 patients received combination chemotherapy only, and 3 patients received chemotherapy and radiotherapy. Total effective rate was 82.3 % (14/17). At the time of last follow-up, 5 patients died, and the 3-year OS rate was 54.5%(6/11). Conclusions Most PNBCL patients are in Ann Arbor stageⅠE-ⅡE and B symptoms are rare, and the most common pathological types is DLBCL. The treatment for PNBCL is chemotherapy, radiotherapy can assist, but the prognosis is poor, and innovative chemotherapy regimens are necessary.

17.
Chinese Journal of Hematology ; (12): 1017-1023, 2017.
Article in Chinese | WPRIM | ID: wpr-809710

ABSTRACT

Objective@#To investigate the efficacy and safety of IA regimen which contains idarubicin (IDA) 8 mg/m2, 10 mg/m2 or 12 mg/m2 as induction chemotherapy for adult patients with de-novo acute myeloid leukemia (AML) .@*Methods@#A total of 1 215 newly diagnosed adult AML patients, ranging from May 2011 to March 2015 in the First Affiliated Hospital of Soochow University and other 36 clinical blood centers in China were enrolled in the multicenter, single-blind, non-randomized, clinical controlled study. To compare the response rate of complete remission (CR) , adverse events between different dose idarubicin combined with cytarabine (100 mg/m2) as induction chemotherapy in newly diagnosed patients of adult AML.@*Results@#Of 1 207 evaluable AML patients were assigned to this analysis of CR rate. The CR rates of IDA 8 mg/m2 group, IDA 10 mg/m2 group and IDA 12 mg/m2 group were 73.6% (215/292) , 84.1% (662/787) and 86.7% (111/128) , respectively (P<0.001) . After adjusted for age, blast ratio of bone marrow, FAB classification and risk stratification, the odds ratios (95% CI) of IDA 10 mg/m2 group and IDA 12 mg/m2 group were 0.49 (0.34-0.70) and 0.36 (0.18-0.71) , as compared with the IDA 8 mg/m2 group (P<0.001, P=0.003) . In the intermediate and favorable groups, CR rates was 76.5% (163/213) , 86.9% (506/582) and 86.1% (68/79) in different doses of IDA (P=0.007) . Interestingly, IA regimen with IDA 10 mg/m2 was the only beneficial factor affecting CR in this group after adjusted for age, blast ratio of bone marrow and FAB classification[OR=0.47 (95% CI 0.31-0.71) , P<0.001]. CR rates in adverse group was 50.0% (18/36) , 60.6% (43/71) and 81.8% (18/22) respectively (P=0.089) . However, the odds ratios (95% CI) of IDA 12 mg/m2 when compared with the IDA 8 mg/m2 was 0.22 (0.06-0.80) , after adjusted for age, blast ratio of bone marrow and FAB classification. The median time (days) of neutrophil count less than 0.5×109/L in IDA 8 mg/m2 group, IDA 10 mg/m2 group and IDA 12 mg/m2 group were 14 (11-18) , 15 (11-20) and 18 (14-22) , respectively (P=0.012) and of platelet count lower than 20×109/L were 14 (7-17) , 15 (11-20) and 17 (15-21) , respectively (P=0.001) . The incidences of lung infection in the three groups were 9.8%, 13.5% and 25.2%, respectively (P<0.001) .@*Conclusions@#For young adult patients (aged 18-60 years) with AML in China, intensifying induction therapy with idarubicin 10 mg/m2 is clinically superior to IDA 8 mg/m2 and IDA 12 mg/m2 in favorable intermediate AML subgroup. However, idarubicin 12 mg/m2 is more suitable to adverse AML subgroup.

18.
Article in Chinese | WPRIM | ID: wpr-489648

ABSTRACT

18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) and bone marrow biopsy (BMB) have high consistency in the detection of lymphoma bone marrow infiltration (BMI).18F-FDG PET/CT has a high sensitivity to Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphoma (NHL) BMI,while the sensitivity of indolent NHL is low.Since 18F-FDG PET/CT may appears false positive or false negative,so it can not replace the conventional BMB.We can carry out a BMB under the guidance of 18F-FDG PET/CT,which can greatly improve the detection rate of BMI.

19.
Article in Chinese | WPRIM | ID: wpr-497587

ABSTRACT

Bone marrow infiltration in lymphoma is crucial to the disease diagnosis,staging,treatment options and prognostic evaluation.Although bone marrow biopsy is the main detecting method,it has high false negative rate.At present,18F-fluorodeoxyglucose positron emission tomography-computed tomography (18 F-FDG PET-CT) technology which is integrating morphological characteristics with metabolic function provides a new way for the diagnosis,staging and prognostic evaluation of bone marrow infiltration in lymphoma due to its advantages of high sensitivity,high specificity and functional image.

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