Comparison of clinical efficacy between first-generation and second-generation tyrosine kinase inhibitors based regimen in the treatment of patients with BCR-ABL positive acute lymphoblastic leukemia / 中华血液学杂志

Objective@#To explore the clinical efficacy and prognostic factors of first-generation and second-generation tyrosine kinase inhibitors (TKI) based regimen in the treatment of patients with BCR-ABL positive acute lymphoblastic leukemia (ALL) .@*Methods@#Retrospectively analyze the clinical characteristics and prognostic factors of 89 patients with BCR-ABL positive ALL from April 2012 to June 2018 in our hospital, the clinical efficacy of first-generation and second-generation TKI was compared.@*Results@#60 patients were classified into the first-generation TKI (imatinib) group, and 29 patients were in the second-generation TKI (dasatinib) group. There were no significant differences in gender, age, WBC, hemoglobin concentration, PLT, chromosomal karyotype, the types of fusion genes, allogeneic hematopoietic stem cell transplantation (allo-HSCT) and TKI initiation time between the two groups. The first-generation and second-generation TKI groups, for which the complete remission (CR) rate at the fourth week of induction therapy was 83.3% and 89.7% (P=0.637) , respectively, and the complete molecular remission (CMR) was 48.3%and 58.6% (P=0.363) , respectively, the difference was not statistically significant. The 2-year overall survival (OS) rate of first-generation and second-generation TKI group was 34.9% and 64.0% (χ2=4.743, P=0.029) , the 2-year relapse free survival (RFS) rate was 17.2% and 55.0% (χ2=8.801, P=0.003) , respectively. Multivariate analysis showed that complete molecular remission (HR=0.281, 95%CI 0.151-0.523, P<0.001) was independent favorable prognostic factor for overall survival (OS) , complete molecular remission (HR=0.209, 95%CI 0.112-0.390, P<0.001) and second-generation TKI (HR=0.318, 95%CI 0.158-0.641, P=0.001) were independent favorable prognostic factors for RFS.@*Conclusion@#For TKI-based regimen of BCR-ABL positive ALL, second-generation TKI is superior to first-generation TKI in OS and RFS time.

Clinical efficacy and safety of L-asparaginase combined with GDP regimen in treat-ment of patients with extranodal NK/T-cell lymphoma / 中国肿瘤临床

Objective:To evaluate the clinical efficacy and safety of L-asparaginase (L-ASP) combined with GDP regimen in initial treat-ment of patients with extranodal NK/T-cell lymphoma (ENKL). Methods:A total of 39 patients preliminarily diagnosed with nasal NK/T-cell lymphoma in Zhengzhou University Affiliated Cancer Hospital were retrospectively analyzed from January 2012 to January 2014. All patients received L-ASP combined with GDP chemotherapy. The efficacy of the treatment was observed (L-ASP 6000/m2, qod × 8;gemcitabine 1000 mg/m2, d1, 8;cisplatinum 90 mg/m2, d1;dexamethasone 10 mg, d1-4) every 21 days for one cycle. The efficacy and toxicity of the regimen were evaluated after therapy. Results:Of the 39 patients who received median six-cycle L-GDP regimen treat-ment, 24 achieved complete response, 7 had partial response, 6 had stable disease, and 2 had progressive disease. The rates of overall response (CR+PR), 2-year progression-free survival, and overall survival were 79.5%(31/39), 71.8%(28/39), and 87.2%(34/39), respec-tively. The primary side effects included gastrointestinal reaction, bone marrow suppression, and increased PT and APPT levels. All pa-tients tolerated and completed the therapy without termination of treatment and death. Conclusion:L-ASP combined with GDP regi-men is effective and safe and thus can be used for patients with ENKL.

Clinical features and survival analysis of patients with CD56 expression in de- novo acute myeloid leukemia with t（8;21） / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the clinical features and survival of patients with CD56 expression in de- novo acute myeloid leukemia（AML）with t（8;21). .</p><p><b>METHODS</b>Clinical data of 82 de novo AML with t（8;21）who were newly diagnosed from Jan 2008 to Apr 2014 were analyzed retrospectively, 50 expressed CD56 and 32 not. Clinical characteristics and prognoses were compared between patients expressing and nonexpressing CD56.</p><p><b>RESULTS</b>There were no statistically significant differences in terms of age, gender, white blood cell count（WBC）, percentage of bone marrow blasts, extramedullary infiltration rate, the early mortality or the presence of additional cytogenetic abnormalities between CD56 + and CD56- groups（P＞0.05). The expressions of lymphatic antigens CD19 between CD56 + and CD56- groups showed significant difference （30.0% vs 53.1% , P=0.036). The complete remission and 3-year overall survival（OS）showed no significant differences between CD56+ and CD56-groups, while 3- year disease- free survival（DFS）showed significant differences（25.8% vs 46.9%, P=0.014). Multivariable analysis for DFS identified CD56 positivity as an independent predictor. DFS of who received allogeneic hematopoietic stem cell transplantation（HSCT）was better than those treated with intermediate- dose cytarabine/high dose cytarabine（IDAC）as postremission therapy.</p><p><b>CONCLUSION</b>The expression of CD56 in de-novo AML with t（8;21) appeared to be associated with poorer prognosis.</p>

Clinical features and survival analysis of patients with CD20 positive adult B-lineage acute lymphoblastic leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the clinical and survival significance of CD20 positive adult patients with B-lineage acute lymphoblastic leukemia (B-ALL).</p><p><b>METHODS</b>The clinical features and survival of 168 adult patients with B-ALL diagnosed and treated in our department from May 2007 to July 2011 were analyzed retrospectively, 58 expressed CD20 and 110 not.</p><p><b>RESULTS</b>The sex, distribution of age, anemia, thrombocytopenia, infiltration of liver, spleen and lymph nodes, the expression of myeloid lineage marker, incidence of Ph chromosome, complete remission within 4 weeks showed no significant differences in CD20 positive and negative groups (P>0.05); median white blood cell count at diagnosis and the rate of patients with high white blood cell count in CD20 positive group were 19.2×10⁹/L and 37.9% respectively, which were significantly higher than those of 6.93 × 10⁹/L and 20.9% in CD20 negative group (P<0.05); cumulative incidence of relapse between two groups showed significant difference (P<0.05); multivariable analysis for overall survival and progress-free survival identified CD20 positivity as independent predictor.</p><p><b>CONCLUSION</b>The expression of CD20 in adult patients with B-ALL appeared to be associated with high white blood cell count and poor prognosis.</p>

Clinical study of BACOD regimen of relapsed and refractory non-Hodgkin lymphoma / 白血病·淋巴瘤

Objective To investigate the efficacy and adverse events of BACOD regimen for relapsed and refractory non-Hodgkin lymphoma (NHL). Methods Sixty patients with relapsed and refractory NHL received chemotherapy of BACOD regimen: bleomycin 10 mg/m2, intravenous drip on the 2nd and 9th day;cyclophosphamide 750 mg/m2, intravenous drip on 1st day; vindesine 3 mg/m2, intravenous drip on 1st and 8th day; cytarabine 150 mg/m2, intravenous drip on 2nd-5th days; dexamethasone 10 mg/m2, intravenous drip on 2nd-5th days; every 3 weeks was one cycle. Results Eighteen cases (27.7 %) received the complete remission (CR), 30 the partial remission (PR), 13 stable disease (SD) and 4 progressive disease (PD). The overall response (CR+PR) rate was 70.8 %. The median remission time of patients with response was 11 months(2-38 months). The 1-year survival rate was 32.3 % and the 2-year survival rate was 24.6 %. The main adverse events were myelosuppression. Conclusion BACOD regimen can be used as the relief regimen of relapsed and refractory NHL.

A report of two cases with Richter's syndrome and literature review / 白血病·淋巴瘤

Objective To explore the epidemiology, clinical and pathological characteristics,treatment and prognosis of Richter's syndrome (RS). Methods The clinical and laboratory feature,treatment, prognosis of two cases were reported, and the related literature was reviewed. Results The major symptom of two cases suffered with enlarged lymph nodes, and pathological examination indicated a diffuse large B cell lymphoma. A large number of mature small lymphocytes were found in peripheral blood and bone marrow, and the immune phenotype was consistent with chronic lymphocytic leukemia. CHOP regiment was used on two cases. One obtained complete remission, and the other cases partial remission. Conclusion RS may occur at early stage after CLL diagnosis. In some cases, the diagnosis of RS and CLL are concomitant.Prognosis of some patients of RS is unfavourable. It was important to take biopsy at early stage.

Clinical analysis of 23 patients in hematologic neoplasms with fungemia / 白血病·淋巴瘤

Objective To investigate the epidemiology of patients in malignant hematologic neoplasms with fungemia and provide evidence for clinical therapy. Methods 23 cases of patients of malignant hematologic neoplasms with fungemia concurrent clinical material, the dangerous factor, the fungus colony classification as well as the treatment and the prognosis were carried on the review analysis. Results Each patient with fungemia was seriously ill with two or more predisposing factors;Candida ablicans accounted for 47%;the rate of candida parapsilosi, candida tropicalis were 17%, 12%. In the 23 cases of patients,13 cases of patients cure (56.5%), 8 cases of patients died (34.7%);2 cases of patients give up (8.6%). Conclusion Fungemia in the patients of malignant hematologic neoplasms usually occurred with predisposing factors. Important measures to reduce mortality include curing the underlying diseases, emphasis on mornitoring fungal pathogen and susceptibility tests, early diagnosis and compliance medication principles.

Primary Hodgkin disease of the supermaxilla: a case report and review of the literatures / 白血病·淋巴瘤

Objective To intensify the diagnosis and treatment of primary osseous Hodgkin disease (HD) and reinforce the impression of its features of pathology and imaging. Methods The clinical manifestation, laboratory examination, treatment and outcome of a patient with primary Hodgkin disease of the supermaxilla were first reported and the pertinent literatures were reviewed. Results Pain of the right supermaxilla was the first clinicM symptom. Plain X-rays showed mixed osteolytic and partially osteosclerotie lesions in the right supermaxiUa. The tumor was removed and the pathohistology was HD lymphocyte-depletion. The clinical diagnosis was primary HD of the supermaxilla (Stage Ⅰ ). The case was treated with ABVD regimen and no obviously adverse reaction appeared. Conclusion Primary osseous HD rarely presents as a malignant bone lymphoma and is easily misdiagnoed. Pathological and immunohistologic studies can be useful to confirm the diagnosis of primary osseous HD. Early diagnosis and the differentiation from other disease should be performed and the prognosis of the present-day chemotherapy regimen appears good.

ABVD chemotherapy scheme at day 1 and 8 for treatment of primary Hodgkin's lymphomas / 中华内科杂志

Objective To explore the effect of adriamycin, bleomyein, vincristine and dacarbazinum (ABVD) chemotherapy scheme executed at day I and day 8 for primary Hodgkin's lymphomas (HL). Methods 62 patients with primary HL in stages Ⅱ-Ⅳ treated in our department from October 2005 to October 2006 were divided into group A and B at random with 31 patients in each group. The patients in group A received ABVD chemotherapy scheme executed at day 1 and day 8 for 6-8 cycles. The patients in group B received ABVD chemotherapy scheme executed at day 1 and day 15 for 6-8 cycles. The patients of the groups received radiotherapy by the same doctor after chemotherapy according to the patients condition and the radiotherapy regimens were not affected by the grouping. Results The complete remission rate (CR)in group A after chemotherapy was 90. 3% (28/31);the one-year and two-year disease free survival (DFS) rates were 87. 1% (27/31) and 80.0% (20/25)respectively. The CR rate in group B after chemotherapy was 83.9% (26/31);the one-year and two-year DFS rates were 80. 6% (25/31)and 72. 0% (18/25) respectively. The discrepancy of CR rates and the one-year and two-year DFS rates between the two groups was not significant (P>0.05). The incidences of therapeutic side effecte such as myocardial iscnemia grade Ⅲ-Ⅳ liver function impair-ment,pulmonary fibrosis and serious marrow inhibition between the two groups were not significant too (P > 0.05). Average chemotherapy period for the patients in group A was 159 days; it was 69 days shorter than that in group B. Conclusion The CR rate,1-year DFS rate and 2-year DFS rate of ABVD chemotherapy scheme executed at day 1 and 8 are similar to those of ABVD chemotherapy scheme executed at day Ⅰ and 15 for primary HL in stages Ⅱ-Ⅳ. The side-effects of chemoterapy between group A and B are similar too. The chemotherapy period in group A is shortened significantly.