The usage of comprehensive geriatric assessment in elderly patients with acute myeloid leukemia: a multicenter, prospective study / 中华血液学杂志

Objective@#To evaluate the feasibility and potential value of comprehensive geriatric assessment (CGA) in elderly (≥60 years) patients with newly diagnosed acute myeloid leukemia (AML) in China.@*Methods@#The CGA results of 83 newly diagnosed AML (non-APL) patients from 16 hospitals in Beijing and Tianjin between March 2016 and December 2017 were prospectively collected and analyzed. The clinical data, treatment and follow-up information were also collected.@*Results@#Of 83 newly diagnosed elderly AML patients, 81 patients (97.6%) completed all designated CGA assessment. The median number of impaired scales of the CGA assessment in the studied population was 2(0-6). Sixteen patients (19.3%) showed no impairments according to the geriatric assessment scales implem ented by this study. The distributions of impaired scales were as follows: impairment in ADL, 55.4%; IADL impairment, 42.2%; MNA-SF impairment, 48.2%; cognitive impairment, 15.7%; GDS impairment, 31.7%; HCT-CI impairment, 19.5%, respectively. In patients with "good" ECOG (n=46), the proportion of impairment for each CGA scale ranged from 6.5% to 37.0% and 32 patients (68.9%) had at least one impaired CGA scale. Survival analysis showed that the number of impaired scales of the CGA was significantly correlated with median overall survival (P=0.050).@*Conclusions@#CGA was a tool with feasibility for the comprehensive evaluation in elderly AML patients in China. Combined with age and ECOG, CGA may be more comprehensive in assessing patients’ physical condition.

Detection of NPM1 gene mutation in acute myeloid leukemia / 中华检验医学杂志

Objective To analyze the frequency of NPM1 mutation in de novo acute myeloid leukemia (AML) patients and the relationship between NPM1 mutation and chromosome alterations,as well as FAB subgroups,and to analyze the mutation type.MethodsA total of 99 de novo AML patients from 2004 to 2010 in China-Japan Friendship Hospital were studied.Genomic DNA was amplified by polymerase chain reaction (PCR),denaturing polyacrylamide gel electrophoresis (PAGE) and capillary electrophoresis were used to detect the mutation of NPM1 gene in 99 AML patients,and karyotyping was performed in 72 AML patients by G banding techniques.DNA sequences analysis of NPM1 mutation was performed on 10 patients.Chi-square test was used to compare the frequencies of NPM1 mutation among the different subgroups,and McNemar's test was used to compare the different rates between denaturing PAGE and capillary electrophoresis.ResultsThe frequencies of NPM1 mutations were detected in 15％ (15/99) of AML patients with capillary electrophoresis and 11％ (11/99 ) with denaturing PAGE(x2 =2.25,P ＞0.05 ).The NPM1 was at different rates in M2(27％,8/30),M5(32％,6/19),M6( 13％,1/8),respectively (x2 =1.06,P ＞ 0.05 ),and not detected in the other subgroups.NPM1 mutation in patients with normal karyotype(26％ ) was more prevalent than patients with abnormal karyotype (4％) (x2 =5.61,P ＜ 0.05)All of the 10 patients were of A type ( c.860_863dupTCTG).The C-terminal portion of the NPM protein by replacing the last seven amino acids(WQWRKSL) with 11 residues (CLAVEEVSLRK).Two intronic deletions were novel,one case was IVS10-18_-15delCTTT,the other was IVS10-17_-15delTTT.Conclusions NPM1 mutations represents a common genetic abnormality in AML patients,and NPM1 mutation in patients with normal karyotype is higher than patients with abnormal karyotype.Two new intronic deletion mutations are identified.

Screening of serum biomarkers in acute leukemia by protein chip / 基础医学与临床

Objective To screen serum biomarkers in patients with acute leukemia.Methods Proteomic spectra were generated by mass spectrometry in 158,including 44 acute lymphocyte leukemia patients and 36 acute myeloid leukemia,78 healthy control.158 spectra obtained were used to train and to develop a decision tree classification algorithm.Results A total of 7 distinguished proteomic peaks were detected in acute lymphocyte leukemia and were used to build a proteomic pattern.The results yielded a sensitivity of 88.6%(39/44)、specificity of 82.9%(29/35);A total of 8 distinguished proteomic peaks were detected in acute myeloid leukemia,7 peaks were used to build a proteomic pattern.The results yielded a sensitivity of 86.1%(31/36)、specificity of 95.3%(41/43).Conclusion SELDI-TOF-MS offers a unique platform for the proteomic detection of acute leukemia.It also offers a noninvasive method to further study the proteomic changs in the development and progression of leukemia.

Distinction Between Adult T-cell Leukemia/Lymphoma and Cutaneous Lymphoma / 中华皮肤科杂志

Adult T-cell leukemia/lymphoma (ATLL) and cutaneous T-cell lymphoma (CTCL) have similar clinieopathology and immunophenotype, in order to differentiate the two diseases, 4 eases of ATLL associated cutaneous lesions and 18 eases of CL were studied for elinieopathology, immunophenotype and HTLV-I provirus DNA. Two eases of actinic reticuloid and two eases of lymphocytic infiltration of the skin were selected as negative control. The results showed that four patients of ATLL manifested cutaneous lesions, at same time, they had additional systemic diseases, such as generalized lymphadenopathy, increased levels of LDH and IL-2R, rosette-like cells in their peripheral blood and abnormal bone marrow. The HTLV-I provirus DNA was detected in the peripheral blood, bone marrow, cutaneous lesions and lymph node biopsy specimens of the four patients by PCR amplification of specific HTLV-I DNA fragment. 18 cases of CL were negative for HTLV-I. The study indicates that ATLL may be diagnosed if the patients are associated with CTCL-Iike cutaneous lesions, characteristic histopathological pattern and immunophenotype, rosette-like cells in the peripheral blood and positive HTLV-I provirus DNA.