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【Objective】 To determine the therapeutic efficacy of cladribine combined with BuCy conditioning regimen for childhood acute leukemia, and compare it with fludarabine. 【Methods】 The clinical data of 70 children with acute leukemias who underwent all-HSCT from August 2018 to June 2020 were collected. The data of pretreatment-related toxicity, hematopoietic reconstitution, graft-versus-host disease, virus infection, relapsed and survival between CLAG and FLAG group were statistically analyzed. 【Results】 EBV infection in CLAG group was significantly more than that in FLAG group(P0.05). Multivariate analysis showed that there was no significant difference in the effect of conditioning regimen on relapsed and survival. Among other risk factors, types of diseases were significantly correlated with OS (P<0.05, HR: 0.088). Relapse was significantly correlated with bone marrow morphological remission before transplantation and the matching degree of donor and recipient HLA(P<0.05, HR: 34.678; P<0.05, HR: 0.024). 【Conclusion】 There was no significant difference in RRTs, hematopoietic reconstitution, GVHD occurrence, OS and relapsed between CLAG group and FLAG group. The overall efficacy of CLAG group was not inferior to FLAG group.
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Objective:To evaluate the effect of immune status on disease progression in patients with newly diagnosed multiple myeloma (NDMM) achieving deep response.Methods:Clinical data of 125 NDMM patients at Beijing Chaoyang Hospital from August 2015 to February 2020 were retrospectively analyzed who achieved very good partial response (VGPR) or better after front-line treatment. The immune status and its influence on progression-free survival (PFS) were analyzed.Results:(1) All patients received novel drug regimens, and 50.4% (63/125) patients followed by autologous stem cell transplantation (ASCT). The rate of complete response (CR) as best efficacy was 89.6%, in which 66.4% achieved CR and MRD negativity tested by second generation flow cytometry. (2) Cox multivariate analysis suggested that persistent severe immunoparesis 3 months and 6 months since the best response was an independent poor prognostic factor for PFS. (3) The 3-year PFS rate in the severe immunoparesis group was significantly lower than that in the control group (41.3% vs. 64.4%, P=0.021). (4) The 3-year PFS rates in patients with persistent severe immunoparesis at 3 months or 6 months were significantly lower (30.0% vs. 63.5%, P<0.001; 16.4% vs. 63.8%, P<0.001 respectively). (5) Even in those achieving CR and negative MRD, the 3-year PFS rate when severe immunoparesis lasted 6 months was significantly lower (22.2% vs. 83.2%, P=0.005). Conclusion:The immune status in NDMM patients achieving deep response is closely related to survival. Persistent severe immunoparesis indicates early progression of the disease.
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Objective To investigate the frailty status and related determinants among the elderly in China.Methods Frailty index (FI) was applied to evaluate the frailty status of the elderly.Data used in this study was from the China Health and Retirement Longitudinal Study (CHARLS) in 2011-2015.Binary logistic regression analysis was carried out to identify the determinants related to the status on frailty.Results The prevalence rates of frailty in the elderly were 18.7％,20.6％ and 28.4％ in 2011,2013 and 2015,respectively.Being female or elderly under advanced age,were both associated with the higher level of FI.Factors as hip fracture,falls,alcohol intake more than once a month,and less participation in social activities etc.,might serve as the risk factors for frailty.Conclusion Chinese elderly showed relatively high prevalence on frailty and with annual increasing trend.The status of frailty was related to factors as adverse events and unhealthy lifestyles.Comprehensive intervention strategies should be adopted in early life of the elderly to delay the development process of frailty.
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Objective To investigate the frailty status and related determinants among the elderly in China.Methods Frailty index (FI) was applied to evaluate the frailty status of the elderly.Data used in this study was from the China Health and Retirement Longitudinal Study (CHARLS) in 2011-2015.Binary logistic regression analysis was carried out to identify the determinants related to the status on frailty.Results The prevalence rates of frailty in the elderly were 18.7％,20.6％ and 28.4％ in 2011,2013 and 2015,respectively.Being female or elderly under advanced age,were both associated with the higher level of FI.Factors as hip fracture,falls,alcohol intake more than once a month,and less participation in social activities etc.,might serve as the risk factors for frailty.Conclusion Chinese elderly showed relatively high prevalence on frailty and with annual increasing trend.The status of frailty was related to factors as adverse events and unhealthy lifestyles.Comprehensive intervention strategies should be adopted in early life of the elderly to delay the development process of frailty.