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Objective:To investigate the efficacy and safety of zanubrutinib combined regimens for treatment of elderly patients with central nervous system lymphoma (CNSL).Methods:The clinical data of 3 elderly patients with CNSL who received zanubrutinib combined regimens from July 2020 to March 2022 in the Affiliated Suzhou Hospital of Nanjing Medical University were retrospectively analyzed. Two of them were primary central nervous system lymphoma (PCNSL) and one was secondary central nervous system lymphoma (SCNSL). Relevant literature was reviewed at the same time.Results:The two patients with PCNSL were treated with zanubrutinib in combination with rituximab and lenalidomide (Z-R 2) regimen. One of them achieved complete remission (CR) after 6 cycles, and the other patient achieved partial remission (PR) after 1 cycle of Z-R 2 regimen. The patient with SCNSL was diagnosed with diffuse large B-cell lymphoma (DLBCL) previously and suffered from central nervous system relapse after achieving CR. The patient achieved PR after 2 cycles of Z-R 2 regimen, and then achieved CR followed by 4 cycles of zanubrutinib in combination with rituximab and high-dose methotrexate (Z-R-HD-MTX) regimen. Two of the three patients were still in CR until April 2022, and the longest disease-free survival time was 15 months. There were no severe adverse reactions during the treatment. Conclusions:Zanubrutinib combined regimens for 3 elderly patients with CNSL have shown promising effect and well tolerance, which may be considered as novel treatment for CNSL patients who are unable to tolerate severe chemotherapies or autologous hematopoietic stem cell transplantations.
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Objective To study the correlation between ABO blood groups and leukemia and lymphoma, and the regional difference. Methods A case-control study had been conducted. The distribution of ABO blood groups was investigated in leukemia patients, lymphoma patients and controls, respectively. Also ABO blood group distribution of leukemia and lymphoma were compared in different areas. Results The distribution of ABO blood groups between patients with acute non-lymphocytic leukemia, acute lymphocytic leukemia, non-Hodgkin lymphoma and health person was significantly different (χ2 = 21.23, χ2 =8.36, χ2 = 9.39,P <0.05). There were regional differences in the ABO blood groups distribution of leukemia and lymphoma,especially ABO blood groups were significantly different in leukemia patients (χ2 = 50.65, P <0.05).Conclusion ABO blood groups might be a genetic susceptible factor of leukemia and lymphoma, but the geography might be a major influential factor.
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Objective To investigate the expression level of lipoprotein lipase (LPL) mRNA in chronic lymphocytic leukemia (CLL) patients and evaluate the prognostic value of LPL in CLL Methods Quantitative real-time RT-PCR (qRT-PCR) was performed in 62 CLL patients, 10 normal controls using Taqman probe system. Association between LPL and other known prognostic factors, such as IgVH mutation status, ZAP-70 and CD38 expression, was determined using the Spearman correlation analysis. ROC curve was used to determine the cut-off value of LPL expression level, the positive and negative predictive value of IgVH mutation status. Results The correlation coefficients of the standard curves in qRT-PCR were not less than 0.990. The coefficients of variation (CV) of interrun assay and intramn assay were < 5%, and the sensitivity can reached 102 copies/μg RNA. The median LPL mRNA expression level was 0.006 0 (0-0.737 0) in 62 CLL patients, whereas in 10 normal controls LPL mRNA expression level was extremely low with the median level of 0 (0-0.000 4). The expression levels of LPL in three CLL samples after miniMACS-sorted CD19 positive B cells were 0.036 0, 0.075 0 and 0.197 0, which were similar to the levels before miniMACS-sorted (0.024 0, 0.074 0 and 0.225 0). LFL expression was significantly associated with IgVH mutation status (r=0.45, P<0.05) . LPL expression level in IgVH unmutated patients [0.006 0 (0.000 7-0.110 0)] was significantly higher than the level in IgVH mutated patients [0.002 0(0.000 2-0.027 0)] (U=96.5, P<0.05). LPL expression was also significantly associated with ZAP-70 (r=0.38, P<0.05), CD38 expressions (r=0.43, P<0.05). According to ROC curve, the cut-off of LPL mRNA expression level was 0.036, with a 66.7% specificity, a 72.4% sensitivity, a 51.8% positive predictive value (IgVH unmutated), and a 83.3% negative predictive value (IgVH mutated) for IgVH mutation status. Conclusions The qRT-PCR assay is reliable and sensitive. LPL mRNA expression significantly correlates with IgVH mutation status, ZAP-70 and CD38 expression, and could be a predictive marker of IgVH mutation status. Our data confirms a role for LPL as a novel prognostic indicator in CLL.
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Objective To investigate the serum levels of soluble CD23 ( sCD23 ) and thrombopeietin (TPO) in chronic lymphocytic leukemia (CLL) and their correlation with other prognostic factors. Methods The serum levels of sCD23 and TPO of 25 CLL patients were detected with enzyme linked immunosorbent assay. Flow cytometry was employed to determine the expression of CD38 and ZAP-70 protein. Results TPO level in CLL patients was significantly higher than that in normal controls 67.22 - 1881.77 ng/L and 70. 29 - 147. 98 ng/L respectively, P =0. 003. sCD23 level in CLL patients was significantly higher than that in normal controls 129. 80-405. 31 U/ml and 0. 65 -32. 99 U/ml respectively, P =0. 000. TPO level was significantly correlated with Binet stage and CD38 expression. Patients in stage B and C had higher level of TPO than those in stage A 140. 57 -457.48 ng/L and 121.92 - 163.83 ng/L respectively, P =0.014,while TPO level was higher in patients with higher CD38 expression than in patients lower CD38 expression 113.23- 199. 10 ng/L and 141.34 -454. 92 ng/L respectively, P = 0. 033. No significant correlation of sCD23 and TPO levels with ZAP-70 protein, sex, age, peripheral lymphocyte count and lactate dehydrogenase were observed. Conclusion Serum TPO level might be a prognostic factor in CLL.