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1.
Article in Chinese | WPRIM | ID: wpr-879874

ABSTRACT

OBJECTIVE@#To study the association of serum levels of trace elements with core symptoms in children with autism spectrum disorder (ASD).@*METHODS@#From September 2018 to September 2019, an investigation was performed for 1 020 children with ASD and 1 038 healthy children matched for age and sex in the outpatient service of grade A tertiary hospitals and special education institutions in 13 cities of China. Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and Childhood Autism Rating Scale (CARS) were used to assess the core symptoms of the children with ASD. The inductively coupled plasma mass spectrometry was used to measure serum levels of trace elements magnesium, iron, copper, and zinc.@*RESULTS@#The children with ASD had significantly lower serum levels of magnesium, copper, and zinc than the healthy children (@*CONCLUSIONS@#The serum levels of magnesium and zinc may be associated with core symptoms in children with ASD, which requires further studies. The nutritional status of trace elements should be monitored for children with ASD in clinical practice.


Subject(s)
Autism Spectrum Disorder , Child , China , Copper/analysis , Humans , Trace Elements/analysis , Zinc
2.
Chinese Medical Journal ; (24): 1299-1309, 2021.
Article in English | WPRIM | ID: wpr-878164

ABSTRACT

BACKGROUND@#Bendamustine was approved in China on May 26th, 2019 by the National Medical Product Administration for the treatment of indolent B-cell non-Hodgkin lymphoma (NHL). The current study was the registration trial and the first reported evaluation of the efficacy, safety, and pharmacokinetics of bendamustine in Chinese adult patients with indolent B-cell NHL following relapse after chemotherapy and rituximab treatment.@*METHODS@#This was a prospective, multicenter, open-label, single-arm, phase 3 study (NCT01596621; C18083/3076) with a 2-year follow-up period. Eligible patients received bendamustine hydrochloride 120 mg/m2 infused intravenously on days 1 and 2 of each 21-day treatment cycle for at least six planned cycles (and up to eight cycles). The primary endpoint was the overall response rate (ORR); and secondary endpoints were duration of response (DoR), progression-free survival (PFS), safety, and pharmacokinetics. Patients were classified according to their best overall response after initiation of therapy. Proportions of patients in each response category (complete response [CR], partial response [PR], stable disease, or progressive disease) were summarized along with a two-sided binomial exact 95% confidence intervals (CIs) for the ORR.@*RESULTS@#A total of 102 patients were enrolled from 20 centers between August 6th, 2012, and June 18th, 2015. At the time of the primary analysis, the ORR was 73% (95% CI: 63%-81%) per Independent Review Committee (IRC) including 19% CR and 54% PR. With the follow-up period, the median DoR was 16.2 months by IRC and 13.4 months by investigator assessment; the median PFS was 18.6 months and 15.3 months, respectively. The most common non-hematologic adverse events (AEs) were gastrointestinal toxicity, pyrexia, and rash. Grade 3/4 neutropenia was reported in 76% of patients. Serious AEs were reported in 29 patients and five patients died during the study. Pharmacokinetic analysis indicated that the characteristics of bendamustine and its metabolites M3 and M4 were generally consistent with those reported for other ethnicities.@*CONCLUSION@#Bendamustine is an active and effective therapy in Chinese patients with relapsed, indolent B-cell NHL, with a comparable risk/benefit relationship to that reported in North American patients.@*CLINICAL TRIAL REGISTRATION@#ClinicalTrials.gov, No. NCT01596621; https://clinicaltrials.gov/ct2/show/NCT01596621.


Subject(s)
Adult , Antineoplastic Combined Chemotherapy Protocols , Bendamustine Hydrochloride/therapeutic use , China , Humans , Lymphoma, Non-Hodgkin/drug therapy , Neoplasm Recurrence, Local/drug therapy , Prospective Studies , Rituximab/therapeutic use
3.
Journal of Experimental Hematology ; (6): 1498-1503, 2021.
Article in Chinese | WPRIM | ID: wpr-922285

ABSTRACT

OBJECTIVE@#To investigate the clinical characteristics and treatment outcome of patients with Burkitt lymphoma.@*METHODS@#The clinical data of 27 patients with Burkitt Lymphoma were collected and retrospectively analyzed, the clinical characteristics, laboratory data, survival and the factors affecting the prognosis were also analyzed.@*RESULTS@#Among the 27 patients (mainly for adults), the median age was 30 (15-83) years old, the ratio of male and female was 3.5∶1. There was no EB virus infection in all the patients, 92.6% of the patients showed extranodal organs involvement, 40.7% of them were leukemic stage, 85.2% patients belonged to Ⅲ and Ⅳ stage, 74.1% patients belonged to high/high-middle risk according to IPI index. In the terms of molecular biology, five patients were treated with next-generation sequencing test, and the MYC gene mutations were detected out in alt the patients, and the most common mutations were CCND3, ID3 and TP53. The overall response rate (ORR) for all the patients was 85.2%, the complete response (CR) rate was 63.0%, and the partial response rate was 22.2%, the 5-year progression-free survival rate and overall survival rate of the patients was 76.6% and 76.6%, respectively, which showed that the efficacy of the patients in high-dose methotrexate treatment group was higher than that in the non-high high-dose methotrexate treatment group. For the patients treated with LMB89 chemotherapy, the CR was 78.6%, ORR was 100%, the 5-year survival rate was 92.9%, which was superior to the patients treated with other regimens. Auto-hematopoietic stem cell transplantation as consolidation treatment could improve the prognosis for those patients who could not tolerate high-dose chemotherapy. Univariate analysis showed that ECOG score, the level of LDH>500 U/L, WBC level, CNS involvement, short-term effect and LMB89 regimen were the risk factors affecting the prognosis of the patients.@*CONCLUSION@#The adult Burkitt lymphoma are highly aggressive. For the patients in high-dose methotrexate treatment group, especially LMB89 regimen can improve the survival of the patients, and to choose HSCT as a consolidation treatment can be a choice for those patients who could not tolerate high-dose chemotherapy.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols , Burkitt Lymphoma/drug therapy , Female , Humans , Male , Middle Aged , Prognosis , Remission Induction , Retrospective Studies , Young Adult
4.
Article in Chinese | WPRIM | ID: wpr-880069

ABSTRACT

T lymphoid malignancy is a group of highly heterogeneous hematological tumors. Disease recurrence and resistance to therapy are the common causes of failed treatment. Traditional therapy is radiotherapy and chemotherapy, although it has achieved great success. However, many patients still failed to survive following the treatment. With the introduction of monoclonal antibodies, immunotherapy and cellular therapy into clinical practice, the outcome of hematologic malignancies has been significantly improved. In particular, chimeric antigen receptor T cells (CAR-T) showed high efficacy in treating B-cell lymphoma and acute B lymphocytic leukemia and surpassed any previous therapeutic strategies. However, this treatment seldom succeeded in treating T cell malignancies. In this review, the history of CAR-T cells treating T cell malignancies, and the clinical trials, adverse events of previously reported were summarized briefly.


Subject(s)
Humans , Immunotherapy , Immunotherapy, Adoptive , Receptors, Antigen, T-Cell , Receptors, Chimeric Antigen , T-Lymphocytes
5.
Article in Chinese | WPRIM | ID: wpr-880037

ABSTRACT

OBJECTIVE@#To explore the relationship between Treg cells level in peripheral blood and prognosis of patients with diffuse large B-cell lymphoma (DLBCL).@*METHODS@#The percentage and absolute value of Treg cells in peripheral blood of DLBCL patients were detected by flow lytometry, and their correlation to prognosis was analyzed by survival analysis. The absolute count of Treg cells was detected by using maximally selected Log-rank statistic, and it was used as cutoff point to distinguish difference survival. The new group of Treg based on cutoff point was combined with age, sex, pathological subtype, risk stratification, treatment plan, and other indicators to include in the single factor survival analysis of Kaplan-Meier. Finally, the COX proportional risk model was used to verify the effect of the above indicators on progression-free survival.@*RESULTS@#The absolute count of Treg cells in DLBCL patients was significantly lower in the disease progressed group than those in the remission group. The cutoff point of absolute value of the Treg cell was 19 cells /μl. The absolute count of Treg cells was an independent prognostic factor of the risk stratification.@*CONCLUSION@#At the beginning of diagnosis, the reduction of the absolute count of Treg cells in peripheral blood of DLBCL patients show a poor prognosis.


Subject(s)
Humans , Lymphoma, Large B-Cell, Diffuse , Monocytes , Prognosis , Proportional Hazards Models , Retrospective Studies , T-Lymphocytes, Regulatory
6.
Article in Chinese | WPRIM | ID: wpr-880036

ABSTRACT

OBJECTIVE@#To investigate the clinical features and prognostic factors of patients with extranodal NK/T cell lymphoma (ENKTL).@*METHODS@#The clinical data of patients with ENKTL from November 2009 to November 2019 was collected and retrospectively analyzed to clarify the clinical features of ENKTL, and evaluate the factors that affected survival and prognosis.@*RESULTS@#Forty-seven patients with ENKTL were collected, median age was 40 (12-82) years old, and more common in males than females, at the ratio of 1.47∶ 1. The median follow-up was 28 (1-112) months, and 5-year overall survival (OS) rate was 49.3%. The 5-year OS rates of the subjects with ECOG performance stage 0-1 and ≥2 were 51.6% and 0 (P=0.001), respectively. The 5-year OS rates of International Prognostic Index (IPI) score 0-1 and ≥2 were 60.0% and 40.6% (P=0.027), respectively. The 5-year OS rates of Ann Arbor staging Ⅰ/Ⅱ and stage Ⅲ/Ⅳ were 61.3% and 31.7% (P=0.005), respectively. The 5-year OS rates of the patients with presentation of B symptoms and without presentation of B symptoms were 79.0% and 30.1% (P=0.013), respectively. The 5-year OS rates of plasma EBV-DNA level < 5×10@*CONCLUSION@#ECOG score, B symptoms, the copy number of EBV-DNA, and treatment regimens are independent prognostic factors for OS of patients with ENKTL.


Subject(s)
Adult , Aged , Aged, 80 and over , Disease-Free Survival , Female , Humans , Lymphoma, Extranodal NK-T-Cell/therapy , Male , Middle Aged , Prognosis , Retrospective Studies , Survival Rate , Transplantation, Autologous
7.
Journal of Experimental Hematology ; (6): 1115-1122, 2020.
Article in Chinese | WPRIM | ID: wpr-827153

ABSTRACT

OBJECTIVE@#To analyze the significance of various abnormal signal patterns appreared in CML and B-ALL patients by using BCR/ABL/ASS1 tricolor dual-fusion probe, and to explore its application value in detecting BCR/ABL fusion gene and ASS1 gene deletion.@*METHODS@#50 newly diagnosed CML patients and 50 newly diagnosed B-ALL patients were detected by fluorescence in situ hybridization (FISH) with BCR/ABL/ASS1 tricolor dual-fusion probe. Meanwhile, karyotype analysis was performed on all the patients using the 24 hours short-term culture and R-banding.@*RESULTS@#Among the 50 CML patients, Ph was found in 49 cases, 5 normal interphase karyotype was observed in 1 case. FISH detection showed that BCR/ABL fusion gene existed in all patients (100%), while the positive signal pathway showed that 1R1G2B2F was observed in 39 cases (78%), 2R1G2B1F in 2 cases (4%) and 1R1G2B1F in 6 cases (12%), simultaneous existence of 1R1G1B1F and 1R1G2B3F in 1 case (2%), 2R1G1B1F in 1 case (2%) 1R1G3B3F in 1 case (2%). FISH detection also showed that the karyotype of 6 case at ASS1 gene deletion (1R1G1B1F) all were simple t (9; 22) translocation, and other abnormalities not were observed. Among 50 cases of B-ALL, Ph was found in 13 cases, the numerical aberration and structural aberration of non t (9; 22) in 16 cases, normal karyotype in 20 cases, absence of mitotic phase in 1 case. FISH detection showed that 16 cases (32%) had BCR/ABL fusion gene including 13 cases (26%) of 1R1G2B2F, 1 case (2%) of stimultaneous exitance of 1R1G2B2F and 1R1G3B3F 1 case (2%) of 2R1G1B1F, 1 case (2%) of 1R1G3B2F. FISH detection also showed that 3 cases had BCR/ABL fusion gene, including 1 case with ASS1 gene deletion (2R1G1B1F), 1 case with classical t (9; 22) translocation (1R1G2B2F) and 1 case with BCR/ABL fusion gene and increase of ASS1 gene copy (1R1G3B3F).@*CONCLUSION@#Tricolor dual-fusion FISH probe for detecting BCR/ABL fusion gene and ASS1 gene deletion is simple, rapid, sensitive and stable. It can detect various forms of molecular fusion and avoid the false positive results due to coincidental overlap of signals generated by D-FISH probe and ES-FISH probe. In addition, this detection method not only can directly observe the presence or absence of ASS1 gene deletion, but also improve the reliability of the positive results of newly diagnosed BCR/ABL fusion gene and accuracy of monitoring results of minimal residual disease for the subsequent visit.


Subject(s)
Fusion Proteins, bcr-abl , Genetics , Gene Deletion , Humans , In Situ Hybridization, Fluorescence , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Genetics , Reproducibility of Results
8.
Journal of Experimental Hematology ; (6): 1183-1188, 2020.
Article in Chinese | WPRIM | ID: wpr-827142

ABSTRACT

OBJECTIVE@#To detect the expression levels of FAM19A5 in patients with mantle cell lymphoma (MCL), and to determine the relationship between FAM19A5 and the prognosis of MCL patients.@*METHODS@#Twenty-five MCL patients were choosen in the study, cytometric bead assay was used to detected the concentration of FAM19A5 in serum and immunohistochemical analysis were used to detect the expression levels of FAM19A5 in lymph nodes. The relationship of the FAM19A5 expression in serum and tissue were analyzed, the relationship of FAM19A5 and clinical characteristics of MCL patients, treatment and prognosis of MCL patients was analyzed.@*RESULTS@#The average serum concentration of FAM19A5 in MCL patients was 90.55±38.24 (ng/ml), which was significantly higher than that in control (P=0.0461). The proportion of high, medium, and low expression of FAM19A5 in lymph nodes was 32%, 36% and 32%, respectively, which showed significant difference from that in control group (P=0.001). The expression of FAM19A5 in serum and lymph nodes showed significant correlation (r=0.8683,P=0.001). The serum concentration of FAM19A5 showed positive correlation with the proportion of Ki67 (P=0.0222, r=0.4554). The mean survival time without relapse/death of MCL patients with high, middle and low expression of FAM19A5 was 17, 27 and 37.5 months, respectively,which showed significant statistical difference (P=0.0360). ROC curve analysis showed that serum concentration of FAM19A5 could predict the therapeutic effect in MCL patients, the cut-off value was 91.49 ng/ml. The proportion of recurrent/death in AML patients with FAM19A5 >91.49 ng/ml was significantly higher than that in patients with FAM19A5<91.49 ng/ml (P=0.0156).@*CONCLUSION@#The expression level of FAM19A5 is increased in MCL patient, and patients with high expression of FAM19A5 are more likely to relapse or die. FAM19A5 may be a new prognostic marker and potential therapeutic target for MCL.


Subject(s)
Adult , Hematopoietic Stem Cell Transplantation , Humans , Leukemia, Myeloid, Acute , Neoplasm Recurrence, Local , Prognosis , Treatment Outcome , fms-Like Tyrosine Kinase 3
9.
Journal of Experimental Hematology ; (6): 1919-1922, 2020.
Article in Chinese | WPRIM | ID: wpr-879993

ABSTRACT

OBJECTIVE@#To summarize and analyze the clinical characteristics, treatment and prognosis of acute lung injury in patients with diffuse large B-cell lymphoma (DLBCL) after chemotherapy with rituximab chemotherapy, so as to improve the understanding of the disease and guide the clinical treatment.@*METHODS@#Twenty-Six patients with DLBCL were treated with rituximab chemotherapy and developed to acute lung injury in Third Hospital of Peking University from January 2013 to September 2018 were selected. The clinical features, imaging findings, chemotherapy course, therapeutic effect and prognosis were analyzed.@*RESULTS@#The main clinical symptoms of patients were fever, cough and chest tightness, among which 12 patients showed hypoxia and 3 patients showed respiratory failure type I. The mainly manifested chest CT was diffusive glass grinding in both lungs, and some patients were complicated with a small amount of pleural effusion. The onset chemotherapy time was mainly distributed in 2 to 4 courses, the time between the onset of symptoms and the infusion of rituximab was 8 to 49 days. 25 patients shows no obvious limitation in daily life after effective treatment, and 1 patient died of ineffective treatment.@*CONCLUSION@#There are no typical clinical symptoms in the early stage of acute lung injury after rituximab chemotherapy in DLBCL. Early detection and early hormone therapy are very important to achieve good therapeutic effect.


Subject(s)
Acute Lung Injury , Antineoplastic Combined Chemotherapy Protocols , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Humans , Lymphoma, Large B-Cell, Diffuse/drug therapy , Prognosis , Rituximab/therapeutic use , Treatment Outcome , Vincristine/therapeutic use
10.
Journal of Experimental Hematology ; (6): 1831-1837, 2019.
Article in Chinese | WPRIM | ID: wpr-781532

ABSTRACT

OBJECTIVE@#To investigate the expression and clinical significance of chemokine receptor CXCR3 in mantle cell lymphoma (MCL).@*METHODS@#Flow cytometry was used to detect CXCR3 in lymph nodes and extranodal tissues in 25 newly diagnosed MCL patients. The correlation of the expression of CXCR3 level with clinical features and prognostic factors was analyzed.@*RESULTS@#Twenty-five tumor submitted specimens all expressed CXCR3 at varied degrees. The expression levels of CXCR3 in lymph nodes (LN) and bone marrow (BM) were higher than those in peripheral blood (PB), and the expression intensity in BM positively correlated with the involved tumor numbers. The absolute values of lymphocytes and hemoglobins level in PB of CXCR3high group were significantly lower than those in CXCR3low group (all P0.05). The overall response rate (ORR) in CXCR3low group was significantly higher than that in CXCR3high group (P=0.001). The expression level of CXCR3 in MCL cells of the effective group was significantly lower than that before treatment (P=0.038), and the CXCR3 expression in the ineffective group was significantly higher than that before treatment (P=0.002). After following up, it was found that the 3-year overall survival (OS) time and progression-free survival (PFS) time in CXCR3high group were significantly shorter than those in CXCR3low group (all P<0.05).@*CONCLUSION@#The expression level of CXCR3 in MCL closely relates with early metastasis and prognosis. CXCR3 can be used as one of the indicators for clinical efficacy and prognosis evaluation.


Subject(s)
Bone Marrow , Humans , Lymphocytes , Lymphoma, Mantle-Cell , Prognosis , Receptors, CXCR3 , Metabolism , Treatment Outcome
11.
Chinese Medical Journal ; (24): 2199-2205, 2019.
Article in English | WPRIM | ID: wpr-774644

ABSTRACT

BACKGROUND@#Few studies have reported brain function differences in drug-naïve first-episode schizophrenia patients who had auditory verbal hallucinations (AVH) with insight vs. those without insight. This study aimed to investigate brain function differences between drug-naïve first-episode AVH-schizophrenia patients with and without insight.@*METHODS@#Forty first-episode drug-naïve AVH-schizophrenia patients with or without insight and 40 healthy controls between December 2016 and December 2018 were recruited in this study. The auditory hallucinations rating scale (AHRS) was used to assess AVH severity, while the insight and treatment attitudes questionnaire was used to distinguish insight. The global functional connectivity density (gFCD) between different groups was compared using a voxel-wise one-way analysis of covariance. The relationship between gFCD and AHRS total scores were analyzed using voxel-wise multiple regression.@*RESULTS@#Finally, 13 first-episode drug-naïve AVH-schizophrenia patients with insight, 15 AVH-schizophrenia patients without insight, and 20 healthy controls were included for analysis. Except for global assessment of functioning scores, there were no significant differences in sociodemographic information between the AVH-schizophrenia and healthy groups (P > 0.05). Compared to the healthy controls, AVH-schizophrenia patients with insight demonstrated a decreased gFCD in the supra-marginal gyrus within the primary auditory cortex, while those without insight demonstrated an increased gFCD in the inferior frontal gyrus and superior temporal gyrus and decreased gFCD in the supplemental motor area. Compared to the AVH-schizophrenia patients with insight, those without insight demonstrated an increased gFCD in the supra-marginal gyrus and posterior superior temporal lobule and a decreased gFCD in the frontal lobe. No significant correlation between gFCD and AVH severity (AHRS total score: r = 0.23, P = 0.590; and frequency: r = 0.42, P = 0.820) was found in both AVH-schizophrenia groups.@*CONCLUSIONS@#The gFCD-aberrant brain regions in the AVH-schizophrenia patients without insight were wider compared to those with insight, although the AHRS scores were not significantly different. The AVH-schizophrenia patients without insight had wide functional impairment in the frontal lobule, which may underlie the lack of insight and the abnormal hyperactivity in the inferior frontal gurus and temporal lobe related to the AVH symptoms.

12.
Chinese Medical Journal ; (24): 2199-2205, 2019.
Article in English | WPRIM | ID: wpr-802928

ABSTRACT

Background@#Few studies have reported brain function differences in drug-naïve first-episode schizophrenia patients who had auditory verbal hallucinations (AVH) with insight vs. those without insight. This study aimed to investigate brain function differences between drug-naïve first-episode AVH-schizophrenia patients with and without insight.@*Methods@#Forty first-episode drug-naïve AVH-schizophrenia patients with or without insight and 40 healthy controls between December 2016 and December 2018 were recruited in this study. The auditory hallucinations rating scale (AHRS) was used to assess AVH severity, while the insight and treatment attitudes questionnaire was used to distinguish insight. The global functional connectivity density (gFCD) between different groups was compared using a voxel-wise one-way analysis of covariance. The relationship between gFCD and AHRS total scores were analyzed using voxel-wise multiple regression.@*Results@#Finally, 13 first-episode drug-naïve AVH-schizophrenia patients with insight, 15 AVH-schizophrenia patients without insight, and 20 healthy controls were included for analysis. Except for global assessment of functioning scores, there were no significant differences in sociodemographic information between the AVH-schizophrenia and healthy groups (P > 0.05). Compared to the healthy controls, AVH-schizophrenia patients with insight demonstrated a decreased gFCD in the supramarginal gyrus within the primary auditory cortex, while those without insight demonstrated an increased gFCD in the inferior frontal gyrus and superior temporal gyrus and decreased gFCD in the supplemental motor area. Compared to the AVH-schizophrenia patients with insight, those without insight demonstrated an increased gFCD in the supra-marginal gyrus and posterior superior temporal lobule and a decreased gFCD in the frontal lobe. No significant correlation between gFCD and AVH severity (AHRS total score: r = 0.23, P = 0.590; and frequency: r = 0.42, P = 0.820) was found in both AVH-schizophrenia groups.@*Conclusions@#The gFCD-aberrant brain regions in the AVH-schizophrenia patients without insight were wider compared to those with insight, although the AHRS scores were not significantly different. The AVH-schizophrenia patients without insight had wide functional impairment in the frontal lobule, which may underlie the lack of insight and the abnormal hyperactivity in the inferior frontal gurus and temporal lobe related to the AVH symptoms.

13.
Article in Chinese | WPRIM | ID: wpr-690984

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinical characteristics of acute myeloid leukemia(AML) patients with FLT3-ITD(Fms-like tyrosine kinase3, intenal tandem duplication) mutation and their response to treatment.</p><p><b>METHODS</b>Retrospective analysis of 128 newly diagnosed AML (except type M3) patients was performed between January 2014 and July 2017. Patients were divided into FLT3-ITD mutated group and non-mutated group. Mutation detection was carried out by using polymerase chain reaction(PCR) and gene sequencing analysis. Standard 3 + 7 or CAG regimen were taken as the first induction chemotherapy, 4 cases received sorafenib, overall survival (OS) was calculated by Kaplan-Meier.</p><p><b>RESULTS</b>Ninety-seven patients can be evaluable for clinical data available; 4 patients were FLT3-TKD mutated, which accounted for 4.1%; 19 patients were FLT3-ITD mutated, which accounted for 19.59%(19/97). Median white blood cell count (WBC), percentage of peripheral blasts and LDH value were significantly higher in FLT3-ITD group than those in non-mutated group [64.65(1.07-587.92)×10/L vs 39.68 (0.45-203.81) ×10/L](P<0.01), [69.62(16-99)% vs 36.35(0-92) %](P<0.01 ) and [LDH 526(124-2 729)U/L vs 265(20-1977)U/L](P<0.05), respectively. The frequency of coexisting NPM1 mutation was higher in FLT3-ITD group than that in non-mutated group [36.8(7/19)% vs 6.8 (5/74) %](P<0.01). The CR+PR was lower in FLT3-ITD group than that in non-mutated group [31.6(6/19)% vs 64.9 (48/74)%](P<0.05). OS in FLT3-ITD group was significantly shorter than that in non-mutated group (5 vs 18 months)(P<0.05). There is no significant difference in OS between FLT3-ITD concomitant with and without NPM1 mutation groups(5 vs 5 months)(P>0.05). The median OS was 13 months for the FLT3-ITD patients taking sorafenib.</p><p><b>CONCLUSION</b>The FLT3-ITD is a common mutation in AML, FLT3-ITD mutated AML is more likely concomitant with NPM1 mutation with higher number of WBC, percentage of peripheral blasts and LDH value, thus CR is low after the 1st treatment and survival is poor.</p>


Subject(s)
Humans , Leukemia, Myeloid, Acute , Mutation , Prognosis , Retrospective Studies , Tandem Repeat Sequences , fms-Like Tyrosine Kinase 3
14.
Journal of Experimental Hematology ; (6): 1336-1342, 2018.
Article in Chinese | WPRIM | ID: wpr-689934

ABSTRACT

<p><b>OBJECTIVE</b>To analyse the clinical characteristics and therapeutic efticacy of patients with mantle cell lymphoma(MCL).</p><p><b>METHODS</b>The clinical data including cliniced parameters and laboratorial test results of 54 patients with MCL were collected and restrospectively analyzed to clarity the clinical characteristics of MCL and to evaluate the survival and factors affecting prgnosis of patients.</p><p><b>RESULTS</b>The incidence of MCL accounted for 4.0% of NHL in our center. The median age of MCL patients was 63 years old, the male and female ratio was 1.4∶1. The MCL patients inⅢ-Ⅳ stage accounted for 96.3%; the extranodal organ involvement existed in 98.1% patients, the most common extranodal involvement sites were bone marrow(72.2%), spleen(51.9%), gastrointestinal tract(25.9%). The overall response rate(ORR) was 66.7%, among which the complete remisson (CR) rate was 37.1%, 3 year and 5 year-progression free survival rate was 52.7% and 34.7% respectively, 3 year and 5 year overall survival rate was 60.4% and 49.6% respectively. The therapeutic efficacy in chemotherapy combined with cytarabine group was suprior to that in chemotherapy group without cyteratine, the chemotherapy comtined with auto-HSCT could further improve the prognosis of patients. The unvariatc analysis showed that the KI67 level, B sgmptom, liver function, LDH and C-RP levels, initial therapeutic efficacy, high dose cytarabine regimen, auto-HSCT and relapse-refractroy status were prognosis-related factors; the multi-variate analysis showed that the initial therapeutic efficacy and relapse rcfractory stasus were independent prognostic risk factors. Analysis showed that the surival of patients stratified according to MIPI and MIPI-c indexes was significantly different from that stratified by IPI index.</p><p><b>CONCLUSION</b>The MCL patients commonly complicated by extranodal involvement and have poor prognoss. Using the chenotherapy regimen combined with high doge of cytarabine as induction therapy and auto-HSCT as consotidatory therapy shows the significont efficacy for survival of young patients with MCL. The MIPI and MIPIc indexe are more much suitable for prognosis evaluation of MCL patients.The initial therapeuntic efficacy and relapse-refractrong status are the independant prognosis-related factors.</p>

15.
Journal of Experimental Hematology ; (6): 1389-1395, 2018.
Article in Chinese | WPRIM | ID: wpr-689925

ABSTRACT

<p><b>OBJECTIVE</b>To detect the molecular cytogenetic abnormalities of multiple myeloma (MM) by using microrray-based comparative genomic hybridization (array-CGH) technology and to investigate its value of application in MM.</p><p><b>METHODS</b>The whole-genoine copy number variants (CNV) of bone marrow samples acquired from 20 cases of newly diagnosed MM patients were detected by genome-wide hybridization and scanning by CytoScan 750K Array (Affymetrix). At the same time, the chromosome abnormalities of bone marrow cells were detected by karyotype analysis and FISH using 9 specific probes: D13S319, RB1, p53, 1q21, IgH, IgH/CCND1, IgH/FGFR3, IgH/MAF, IgH/MAFB.</p><p><b>RESULTS</b>Among the 20 MM patients, the incidence of chromosome abnormalities detected by karyotype analysis, FISH and array-CGH were 15%, 65% and 90%, respectively. The types of CNV detected by array-CGH included the gain (106), loss (156) or UPD (23). There were many different CNVs in every chromosomes except chromosome 5, 9, 18, 21 and Y. Comparison of chromosome abnormalities detected by FISH and array-CGH showed that, the positive ratio of del (13q) was 35% and 40% respectively; the positive ratio of amp (1q) was 40% and 50% respectively; the positive ratio of del (17p) was both 15%. FISH detection showed 8 cases with IgH rearrangement, meansahile the array-CGH detection showed that 4 cases had amp (11q13) (CCND1 gene), 3 cases had amp (16q23) (MAF gene), 1 case had amp (4p16) (FGFR3 gene) and 2 cases had amp (20q12) (MAFB gene). Besides, many other new chromosome abnormalities were found.</p><p><b>CONCLUSION</b>More than half of MM patients have cytogenetic changes, and most of them are complex chromosomal abnormalities. By using array-CGH, more chromosome abnormalities can be detected and more cytogenetic information can be provided for clinician.</p>

16.
Article in Chinese | WPRIM | ID: wpr-689580

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinical manifestation, therapeutic efficacy and related prognostic factors of patients with follicular lymphoma.</p><p><b>METHODS</b>A retroretrospective study was conducted on 94 patients with follicular lymphoma who were admitted to our hospital from March 1999 to June 2016. The total of 94 newly diagnosed FL patients were analyzed in terms of clinical manifestation, laboratory data, pathological examination, clinical stage and so on, so as to find out the related prognostic factors.</p><p><b>RESULTS</b>Ninety-four patients were included in this study. The median age at onset was 50.60 years old, more common in women, and ratio of male to female was 1:1.35. The superficial lymphadenopathy was found to be the first symptom in 72.3% patients, 25.5% patients had B symptoms when diagnosed, 57.4% cases had extranodal organ invasion when diagnosed, of which bone marrow invasion is the most common, accounting for 36.2%, followed by the digestive tract, bone, spleen and so on. The detected rate of BCL-2 / IGH gene rearrangement was 33.9%. Patients with grade 3 of FL accounted for 24.5%. Cases of clinical stage III-IV accounted for 71.2% in these FL patients. The overall response rate (ORR) was 92.0%, and the complete remission (CR) rate was 79.3% and the recurrence rate was 35.2%. The cumulative overall survival rates of 3, 5 and 10 years were 92.1% , 84.6% and 77.4% respectively, and the cumulative progression-free survival(PFS) rate in 3,5 and 10 years was 68.5%, 61.4% and 41.9%, respectively. The results showed that the CR rate was 85.2% in patients treated with rituximab and 69.7% in patients treated without rituximab. The OS and PFS in patients treated with rituximab were better than those in patients treated without rituximab, but there was no significant difference between them(P>0.05). Univariate analysis showed that FL stage, ECOG score, Hb and LDH levels, digestive tract involvement or not, CR or not after initial treatment had a significant impact on OS(P<0.05), while BCL-2, CD10, ECOG score, albumin, Hb and LDH levels, percentage of lymphocytes, erythrocyte sedimentation rate, digestive tract involvement had a significant impact on PFS (P<0.05). Multivariate analysis showed that digestive tract involvement or not, CR or not after initial treatment were independent risk factors for OS(P<0.05), while CR or not after initial treatment, digestive tract invdvement or not, LDH level and ECOG score were independent risk factors for PFS(P<0.05).</p><p><b>CONCLUSION</b>The FL is more common in middle-aged women, the FL was in late stage at confirmed diagnosis, bone marrow involvement is more common. The CD10 negative is poor prognostic factor for FL. The digestive tract involvement or not, CR or not after initial treatment are independent risk factors for OS, while CR or not after initial treatment, digestive tract involvement or not, LDH level and ECOG score are independent risk factors for PFS.</p>


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Disease-Free Survival , Female , Humans , Lymphoma, Follicular , Male , Middle Aged , Neoplasm Recurrence, Local , Prognosis , Retrospective Studies , Rituximab , Treatment Outcome
17.
Article in Chinese | WPRIM | ID: wpr-689552

ABSTRACT

In tumor patients, programmed cell death-1 (PD-1) can inhibit T-cell activation and proliferation by binding to its ligand, thereby promote tumor immune escape. A large number of experiments showed that PD-L1 molecule highly expressed on lymphoma cells, while PD-1 expression was up-regulated in tumor-infiltrating lymphocytes, suggesting its role in the development of lymphoma, which may be an important therapeutic target for lymphoma. PD-1 and PD-L1 monoclonal antibodies can block the PD-1 / PD-Ls signaling pathway, restore T cell function, thus inhibit the tumor growth. At present, a number of early clinical trials have demonstrated the significant efficacy and less side effects in various subtypes of recurrent lymphoma, which will be promising therapeutic agents. In this review, the mechanism of PD-1/PD-L1 signal pathway, the expression of PD-1 / PD-L1 in lymphoma and the anti-tumor effect of its antibody in lymphoma are summarized.


Subject(s)
B7-H1 Antigen , Humans , Lymphocytes, Tumor-Infiltrating , Lymphoma , Programmed Cell Death 1 Receptor , Signal Transduction , T-Lymphocytes
18.
Journal of Experimental Hematology ; (6): 1275-1282, 2017.
Article in Chinese | WPRIM | ID: wpr-301736

ABSTRACT

<p><b>OBJECTIVE</b>To establish a new inducing system for differentiation of human embryonic stem (ES) cells to dendritic cells (DC), and further explore how microRNA-223 (miR-223) regulates DC differentiation from ES cells.</p><p><b>METHODS</b>Human ES cells were cultured on plates coated by IV type collagen and differentiated into hematopoietic stem/progenitor cells, common myeloid progenitor cells and DC step by step via adding different hematopoietic growth factors. The differentiated cells were identified by morphology, flow cytometry and hematopoietic colony forming unit (CFU) assays. Human ES cells were transfected with lentiviral vectors to overexpress miR-223 or inhibit miR-223 expression, then initiated the differentiation to DC. The differentiated cells at the different miR-223 levels were compared by the numbers of hematopoietic CFU and the expressions of specific surface markers. Dual-luciferase reporter assay was performed to test whether miR-223 directly targets TGFBR3.</p><p><b>RESULTS</b>Human ES cells were successfully induced into DC as the percentage of CD83 was approximately 82%, and the expression of miR-223 was up-regulated during the whole process. Supplementing miR-223 level using synthetic miR-223 mimics improved the proportions of CD34CD45, CD34CD45and CD83in differentiated cells, which were significantly higher than those in synthetic miR-223 inhibitor group and negative control (P<0.05). The expressions of cell makers at each differentiated phase in miR-223 inhibitor group were significantly lower than those in negative control (P<0.05). The differentiated cells in miR-223 mimics group showed approximately 759 CFUs per 10cells, which was significantly higher than that in others (P<0.05). Compared with negative control, miR-223 substantially inhibited the luciferase activity of Tgfbr3 3'UTR construct (by 37%) (P<0.05). In addition, the luciferase activity of the mutant construct was significantly higher than that of the WT construct in the presence of miR-223 mimics (P<0.05). With DC mature, the protein level of TGFBR3 gradually decreased using miR-223 mimics, and increased in miR-223 inhibitor group due to the suppression of the endogenous miR-223.</p><p><b>CONCLUSION</b>MiR-223 promotes the differentiation of human ES cells to DC, probably through direet target to TGFBR3.</p>

19.
Journal of Experimental Hematology ; (6): 1334-1341, 2017.
Article in Chinese | WPRIM | ID: wpr-301727

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the synergistic antiproliferative and inducing-apoptotic effect of EPZ-5676 combined with chemotherapeutic drugs on acute lymploblastic leukemia(ALL).</p><p><b>METHODS</b>The MLL rearragement positive (MLL-r) ALL cell line RS4;11 was treated with EPZ-5676 alone and its combination with 5 kinds of chemotherapeutic drugs of ALL, the CCK-8 method was used to assay the inhibitory rate of leukemia cells treated with EPZ-5676 and chemotherapeutic drugs alone and their combination; the compusyn software was used to evaluate the relationthip between inhibitory rate (Fa) of combined drugs for leukemia cells and combination index (CI), and to determine the interaction of drugs; the flow cytometry with Annexin V-FITC/PI double staining was used to detect the apoptotic rate of RS4;11 treated EPZ-5676, GC, VCR, CTX, epirubicin and VP16 alone and combination of EPZ-5676 with them and to compare the inducing apoptotic effect of combined drugs.</p><p><b>RESULTS</b>The combination of EPZ-5672 with GC or VCR or VP16 showed synergistic antiproliferative effect; the combination of EPZ-5676 with TX or epirubicin displayed antogonistic effect. As compared with blank control group, 5, 10 and 25 µmol/L EPZ-5676 did not affected on apoptosis of RS4;11 cells, but 5 µmol/L EPZ-5676 combined with VCR of GC possessed synergistically inducing apoptotic effect (56.87% vs 12.93%)(P<0.01), (8.86% vs 5.28%)(P<0.05).</p><p><b>CONCLUSION</b>The EPZ-5676 combined with GC or VCR or VP16 possesses synergistic antiproliferative effect on RS4;11 cells, the effect of EPZ-5676 alone on apoptosis of RS4;11 cells is no significant, but the combination of low concentration EPZ-5676 with VCR or GC displays synergistically inducing apoptotic effect.</p>

20.
Article in Chinese | WPRIM | ID: wpr-271915

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinical features and response to therapies in multiple myeloma (MM) patients with del (17p).</p><p><b>METHODS</b>A total of 122 newly diagnosed MM patients hospitalized in the Department of Hematology of Peking University Third Hospital between October 2012 and September 2016 were analyzed retrospectively. The fluorescent in situ hybridization(FISH) and G-binding staining were used for detection of cytogenetic abnormalities. These MM patients with del (17p) were divided into non-bortezomib chemotherapy (VAD or CHOP) group and bortezomib chemotherapy (PAD or PCD) group. Response criteria was according to IMWG criteria, including complete remission (CR), very good partial remission (VGPR), partial remission (PR), stable disease (SD), overall response rate (ORR) was defined as CR+VGPR+PR. The Kaplan-Meier method was used to evaluate overall survival (OS) and progressive free survival (PFS).</p><p><b>RESULTS</b>Cytogenetic abnormalities were detected in 60 patients, and the frequency of del(17p) was 10.7% (13 of the 122 patients). For the 13 MM patients with del(17p), median age was 59 years old, male vs female ratio was 8:5, 7 patients were found to have soft tissue plasmacytoma at the time of diagnosis, and IgG accounted for 61.5% (8/13). The frequency of coexisting other cytogenetic abnormalities was 53.8% (7/13); del(13q14) (D13S319 and/or RB1) accounted for 30.8%(4/13), and gain (1q21) 23.1%(3/13), 13 patients were able to be evaluated for the response, ORR were 33.3%(2/6) vs 100.0%(7/7), VGPR 0% vs 57.1%, PR 33.3% vs 42.9%, PD 50.0% vs 0% in non-bortezomib chemotherapy and bortezomib groups, respectively (P=0.042). 4 patients received 50 Gy radiotherapy for soft tissue plasmacytoma, no responses were observed. With a median follow up of 14(2.0-40)months, median PFS and OS time were 6(95% CI0.9-11.1) months and 21(95% CI9.0-33.0) months, respectively. Median OS in bortezomib groups was significant longer than that in the non-bortezomib groups, not reachable vs 10.8(95%CI3.4-16.6) months (P=0.017).</p><p><b>CONCLUSION</b>MM with del(17p) shows high frequency of soft tissue plasmacytoma, and high prevalence of coexisting gain(1q21) and del(13q14). These patients are not sensitive to non-bortezomib chemotherapy or radiotherapy, and has a poor survival. Bortezomib are able to improve the outcome of these MM patients.</p>

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