Acute Myeloid Leukemia in a Geriatric Patient with a History of Minimal Change Disease

Background: The increase in the incidence of malignancies globally, and the increase in the usage frequency and types of new anti-cancer drugs, have made onconephrology more important in our clinical practice. Paraneoplastic glomerulonephritis constitutes an important part of this approach as well. Purpose: The association of AML-nephrotic syndrome is relatively less defined in the literature compared to other hematological malignancies. Case presentation: In this article, we present a case of acute myelocytic leukemia in a patient who was diagnosed with minimal change disease many years ago. Discussion and Conclusion: Hematological malignancies-MCD association, is one of the best described examples of paraneoplastic glomerulonephritis. We know that cancer can be clinically diagnosed years after the detection of renal disease in paraneoplastic glomerulonephritis. In this case; rationality of follow-up, not only during the diagnosis of glomerulonephritis but also periodically in the long term, especially in clinical situations such as MCD that occur in geriatric patients, should be discussed.

Introducción: El aumento en la incidencia de neoplasias malignas a nivel mundial, y el aumento en la frecuencia de uso y tipos de nuevos medicamentos contra el cáncer, han hecho que la onconefrología sea más importante en nuestra práctica clínica. Asimismo, la glomerulonefritis paraneoplásica también constituye una parte importante de este enfoque. Propósito: La asociación de LMA-síndrome nefrótico está relativamente menos definida en la literatura a comparación de otras neoplasias malignas hematológicas. Presentación del caso: En este artículo presentamos un caso de leucemia mielocítica aguda en un paciente al que se le diagnosticó enfermedad de cambios mínimos hace años. Discusión y Conclusión: La asociación de neoplasias hematológicas malignas-MCD, es uno de los ejemplos mejor descritos de glomerulonefritis paraneoplásica. Sabemos que el cáncer puede diagnosticarse clínicamente años después de la detección de la enfermedad renal en la glomerulonefritis paraneoplásica. En este caso, debe discutirse la racionalidad del seguimiento, no solo durante el diagnóstico de glomerulonefritis, sino también periódicamente a largo plazo especialmente en situaciones clínicas como la ECM que se presenta en pacientes geriátricos.

Effect of the PI3K/AKT signaling pathway regulated by HMGCS1 on drug sensitivity of HL-60 cells / 上海交通大学学报（医学版）

Objective: To explore the mechanism of 3-hydroxymethyl-3-methylglutaryl-CoA synthase 1 (HMGCS1) on drug sensitivity of acute myelocytic leukemia (AML) HL-60 cells. Methods: HL-60 cells were cultured. The negative control group and the HMGCS1 overexpressed group were constructed by infecting the negative control lentivirus and HMGCS1 lentivirus,and the untreated HL-60 cells were set as the blank control group. Real-time quantitative PCR (qPCR) was used to detect the expression of HMGCS1 mRNA in the 3 groups,and to verify whether the cell lines of the HMGCS1 overexpressed group were successfully constructed. The effect of HMGCS1 on the expression of AKT and phosphorylated AKT (p-AKT) in phosphatidylinositol 3 kinase (PI3K) / protein kinase B (PKB / AKT) signaling pathway was detected by Western blotting. CCK8 method was used to detect the effects of HMGCS1 and PI3K/AKT signaling pathway inhibitor LY29400 on the activity of HL-60 cells. The effect of LY29400 on HMGCS1 expression was detected by qPCR and Western blotting. Results: Compared with the negative control group,the HMGCS1 mRNA expression was increased significantly in the HMGCS1 overexpressed group (P=0.000). Compared with the blank control group and the negative control group,the p-AKT protein level in the HMGCS1 overexpression group was significantly increased,while the AKT expression of the 3 groups was not significantly different. CCK8 method showed that compared with the blank control group and the negative control group,HMGCS1 could reduce the effect of adriamycin on cell viability in the HMGCS1 overexpressed group (P=0.003,P=0.006),while LY294002 could inhibit the effect produced by HMGCS1 (P=0.000). The intervention of LY294002 could reduce the expression levels of HMGCS1 and p-AKT protein and HMGCS1 mRNA (both P=0.000) in the negative control group and the blank control group. Conclusion: HMGCS1 can reduce the sensitivity of HL-60 cells to chemotherapy drug adriamycin,while PI3K/AKT signaling pathway inhibitor LY294002 can restore its sensitivity.

Pharmacokinetic characteristics of 14CCHMFL-FLT3-122 in rats / 药学学报

The study was conducted to characterize the pharmacokinetics, distribution, metabolism and excretion of CHMFL-FLT3-122 after a single oral dose of 50 mg·kg-1 [14C] labeled CHMFL-FLT3-122 in rats. Isotope tracing techniques were used to analyze drug concentration and identify the distribution of drugs in tissues and metabolites in biological samples. The experiments were approved by the Animal Ethics Committee of XenoBiotic Laboratories-China, Inc. The absolute bioavailability in male and female rats were 45.83% and 50.92% respectively. The parent drug and its metabolites were extensively distributed in the stomach, intestine, liver and lung, and were eliminated completely in 48 h. The majority of radioactivity was excreted through the feces at 92.34% of the dose with a small fraction through urine at 3.99% of the dose. The parent drug was the most significant circulating component, representing 49.23% and 70.65% over the 0-48 h collection time interval in the plasma of male and female. Two major metabolites, M553 (sulfate conjugate) and M457 (N-dealkyl product), were identified in plasma. Metabolites of CHMFL-FLT3-122, including ten phase I and four phase II metabolites, were identified. The metabolic pathways of CHMFL-FLT3-122 were proposed as N-dealkylation, oxidation, amide hydrolysis, sulfate conjugation, and glucuronic conjugation.

Midostaurin as a Novel Drug for the Therapy of FLT3 Mutation-positive Acute Myeloid Leukaemia / 中国药师

Midostaurin is an orally administered inhibitor of multiple tyrosine kinase receptors developed by Novartis Pharmaceuti-cals. In May 2017,it was approved in the USA for the treatment of adult patients with newly diagnosed FMS-like tyrosine kinase 3 (FLT3) mutation-positive acute myeloid leukaemia (AML). Its pharmacokinetics,pharmacodynamics,clinical trials,adverse effects and drug interactions were introduced in the paper.

Predictors of the Posttraumatic Growth in Parents of Children with Leukemia

PURPOSE: Parents caring for children with leukemia experience a tremendous challenge to get positive results in overcoming traumatic events with their children. The purpose of this study was to identify predictors of posttraumatic growth in parents of children with leukemia. METHODS: One hundred thirty seven parents (117 mothers and 20 fathers) of children with leukemia participated this study from May to August in 2016. Participants completed self-report measures of posttraumatic growth, core belief, deliberate rumination, resilience and social support. RESULTS: All the variables were positively correlated with posttraumatic growth. Core belief, resilience and social support were significant predictors related to posttraumatic growth in parents of children with leukemia and explained for 54% of the variance in posttraumatic growth. CONCLUSION: The results show that there are several factors affecting posttraumatic growth in parents of children with leukemia. Therefore, nursing intervention programs including strengthening resilience, revising core belief as well as utilizing social support systems should be provided for this population in order to enhance positive psychological change beyond parental traumatic events related to children with leukemia.

Relationship of the MTHFRC677T , MTHFRA1298C , and MTRRA66G Gene Polymorphisms with Acute Myelocytic Leukemia / 中国医科大学学报

Objective To investigate the relationship of the MTHFRC677T,MTHFRA1298C,and MTRRA66G gene polymorphisms with acute myelocytic leukemia (AML).Methods Mononuclear cells were collected from 63 patients diagnosed with AML,and 60 healthy,non-AML control-group patients.DNA extracted from each sample was screened for the MTHFRC677T,MTHFRA1298C,and MTRRA66G polymorphisms.Results No significant difference was observed in the distribution of the MTHFRC677T,MTHFRA1298C,and/or MTRRA66G polymorphisms between the two patient groups.In contrast,the MTRR G allele was observed to occur 1.935 times more frequently than the MTRR an allele (x2 =4.708,P ＜ 0.05,95％ CI:1.061-3.530).No significant difference was observed in the distribution of a combination of the three gene polymorphisms (MTHFRC677T,MTHFRA1298C,and MTRRA66G)between the AML and the control group.Conclusion The results of the present study suggest that the MTHFRC677T,MTHFRA1298C,and MTRRA66G polymorphisms are not associated with AML.

Clinical analysis of low-dose decitabine combined with CAG regimen in treatment of elderly patients with acute myeloid leukemia and myelodysplastic syndromes patients with intermediate- or high-risk / 白血病·淋巴瘤

Objective To investigate the clinical value of low-dose decitabine (DAC) in elderly patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) patients with intermediate-or high-risk. Methods Low-dose DAC (10 mg/d, 7 days) combined with CAG regimen were given to 19 elderly patients with AML and intermediate- or high-risk MDS patients. The efficacy and adverse reactions were evaluated after a course of treatment, and the patients were followed up for survival. Results After a course of treatment, 8 patients achieved complete remission (CR), 7 patients achieved partial remission (PR). After 4 courses of treatment, 68.4 % (13/19) of patients achieved CR, the overall response rate reached 78.9% (15/19). Fewer side effects were seen associated with chemotherapy. After 42 months of follow-up, there were 12 survival cases, the median survival time was 13.5 months (3-42 months). Conclusion Low-dose DAC combined with CAG regimen have a better efficacy, higher safety, and lower economic burden for elderly AML patients and intermediate- or high-risk MDS patients, which is beneficial to greatly improve patients' compliance.

Anti-apoptosis of hepatocyte growth factor on CML K562 cells / 中国药学杂志

OBJECTIVE: To investigate the protection of hepatocyte growth factor (HGF) on CML cell line K562 from apoptosis induced by etoposide (VP-16) and its molecular mechanism. METHODS: Quantitative and qualitative analyses on cell morphological change of apoptosis were performed through acridine orange (AO) staining and HE staining, and fluorescent flow cytometry.The test analyzes membrane on the surface of the PS evagination and integrity of cell membrane surface and mitochondrial membrane potential changes were performed through Annexin V-FITC/PI double dyeing and JC-1 cell dyeing tests, and apoptotic factors such as Bcl-2, Bax, Caspase-3 and Caspase-9 were measured by SYBR Green (Takara) qRT-PCR. RESULTS: The HE and AO staining revealed that apoptotic rates in HGF+VP-16 groups were significantly lower than those in VP-16 groups (P<0.05, P<0.05), HGF can inhibit the apoptosis of cells induced by VP-16; FCM (Annexin V-FITC/ PI and JC-1) tests showed that cells apoptotic rates in HGF+VP-16 groups were significantly lower than those in VP-16 groups (P<0.05, P<0.001), indicating that HGF has the anti-apoptosis function. Apoptosis related gene mRNA expression tests found that the Bcl-2 mRNA expression in HGF+VP group was obviously higher than that in the VP-16 group (P<0.001), while Bax mRNA, Caspase-3 mRNA, and Caspase-9 mRNA expressions were significantly lower than those in the VP-16 group (P<0.05, P<0.001, P<0.001), suggesting that HGF possesses antiapoptotic effect through inhibiting apoptosis gene expression and promoting the antiapoptotic gene expression simultaneously. CONCLUSION: HGF can significantly protect K562 cells from apoptosis induced by VP-16 through the HGF/c-Met way to regulate PI3K/AKT pathway.

Immunophenotyping and bone marrow hematology analysis in acute myelocytic leukemia / 国际检验医学杂志

Objective To investigate the clinical significance in diagnosis and prognostic judgments of acute myelocytic leukemia with combined detection of morphology ,peripheral blood and immune typing of bone marrow cells .Methods Microscopic examina‐tion of bone marrow cell morphology ,automatic blood cell analyzer detection of peripheral blood parameter and flow cytometry anal‐ysis of immune markers of leukemia cells ,all these datas were analyzed statistically .Results Peripheral blood cell analysis showed that instruments may indicate the presence of abnormal or naive cells in about 85% patients ,different kinds of leukemia had signifi‐cant difference in total leukocyte count (majority higher in M1 - 2 ,M5 ;majority lower in M3) ;while anemia and thrombocytopenia were observed in most patients ,but the degree was different ;M1 - 2 and M5 can not be identified by classification of leukocyte by automatic blood cell analyzer ,CD7 ,CD10 and CD2 can cross express in myeloid leukemia ,which have a prompt effect with treatment and prognosis .Conclusion Detection of peripheral blood parameters has an important role in early screening ,differential diagnosis and prognosis judgment of leukemia ,immunological markers detection is the powerful supplement and support for leukemia diagno‐sis and typing ,sensitive markers have close contact with prognosis ,which significantly improves the effect of the diagnosis and treatment of leukemia .

Effects of hydroxyl morpholine resistance on K562 cells of chronic myelocytic leukemia / 中国药学杂志

OBJECTIVE: To investigate the inhibitory activity, induced differentiation-inducing activity and apoptosis-inducingactivity of hydroxyl morpholine (QDML-01) on chronic myelocytic leukemia cells line K562. METHODS: The cell growth curve was drawn based on cell counting method. The IC50 value of QDML-01 and positive control medicine to K562 cells were evaluated by methyl thiazolyl tetrazolium (MTT) assay method. Double soft agar assay method was carried out to study the ability of cell proliferation to determine efficacy of phamacognosy. The pathomorphism was analyed by the Wright-Giemsa staining method. The mechanism of cell apoptosis from morphology and gene level were investigated, by AO-EB double-staining method and DNA breakage test. The effect of QDML-01 on K562 cells from the protein level was determined by Western-blot. RESULTS: The growth curves showed the K562 cells had strong cell vitality. They came into logarithmic phase on the third generation. The MTT assay results showed that the IC50 values of QDML-01 and imatinib to K562 cells were 5. 81 and 596.88 nmol ·L-1. Double soft agar colony formation test showed that clone formed at 21 d and the inhibitory rate of QDML-01 was 81.7%. It indicated that K562 cells were sensitive to QDML-01. Morphology test result showed that QDML-01 induced K562 cells to normal cells. The results of AO-EB double-staining method showed that QDML-01 induced the apoptosis of K562 cells. The study of DNA breakage test indicated that QDML-01 can induce the apoptosis of K562 cells to produce DNA banding with step-like. Western-blot analysis result suggested that QDML-01 can downregulated the expression of P210bcr/abl protein. CONCLUSION: QDML-01 has the inhibitory activity on chronic myelocytic leukemia cells line K562 by promoting the apoptosis of K562 cells and inducing differentiation to normal cells.

Chromosome’s Influence and Curative Effect on First and Second Generation Tyrosine Kinase Inhibitor Therapy to CML / 现代检验医学杂志

Objective Research of chromosome’s influence and curative effect on first and second generation tyrosine kinase inhibitor therapy to CML patients.Methods Giving conventional genetic analysis to 80 Ph+ CML patients,and contrast CML patients’chromosome changing situation with first and second generation tyrosine kinase inhibitor therapy.Results There were 1 1 cases with other abnormalities of chromosome number and structure in 80 cases of Ph+ CML patients,and 10 cases were resistant or intolerant to imatinib.35 patients (87.5%)achieve sustained complete cytogenetic remission (CCyR)who treated with imatinib (TKI-Ⅰ)in the total 40 cases,in these 35 patients,7 cases (17.5%)got CCyR in 3 months;10 cases (25%)got CCyR in 6 months,13 cases (32.5%)got CCyR in 12 months,and 5 cases (12.5%)got CCyR in 18 months.33 patients (82.5%)achieve sustained completecytogenetic remission (CCyR)who treated with dasatinib/nilotinib (TKI-Ⅱ)in the total 40 cases,in these 33 cases,16 cases (40%)got CCyR in 3 months;9 cases (22.5%)got CCyR in 6 months,5 cases (1 2.5%)got CCyR in 1 2 months,and 3 cases (7.5%)got CCyR in 1 8 months.Conclusion Ph+ CML patients combined with other chromosome abnormity were more easily to be resistant or intolerant to imatinib,espe-cially in acceleratd phase and blastic phase.First and second generation tyrosine kinase inhibitor have little difference to treat with CML patients in long time efficacy,but the second generation effect is better than first generation in short time effica-cy.

The significance of Treg and T lymphocyte subsets in acute myelocytic leukemia / 安徽医科大学学报

Objective To explore the alterations, relationship and clinical significance of CD4 +CD25 +CD127 low/ - regulatory T cells ( Treg ) and lymphocyte subsets in peripheral blood of patients with acute myelocytic leukemia ( AML) . Methods The level of peripheral blood lymphocyte subsets and Treg of untreated AML patients and com-plete remission( CR) patients were tested by flow cytometry,and were compared with that of 30 normal controls. Re-sults The proportions of Treg were much higher in untreated AML patients and CR patients than in normal con-trols, while the mean proportion of Treg in untreated AML patients was higher than that in CR patients(P<0. 05). The proportions of NK( CD3 -CD16 +CD56 +) cells in untreated AML patients and CR patients were both decreased compared with normal controls,and the mean proportion of NK cells in untreated AML patients was lower than that in CR patients(P<0. 05). Compared with the normal controls,the proportions of CD3 +T cell, CD4 +T cell,and the ratio of CD4 +/CD8 + decreased in untreated AML patients ( P <0. 05 ) , but the proportions of CD8 +T cell was higher than in normal controls;the proportions of CD3 +T cell, CD4 + T cell, CD8 +T cell and the ratio of CD4 +/CD8 + in CR patients were close to the proportions in normal controls, but there was significant difference between CR patients and untreated AML patients(P<0. 05). Conclusion The increase of Treg, CD8 +T cell and decrease of NK cells, CD3 +T cell, CD4 +T cell, and the ratio of CD4 +/CD8 + in peripheral blood of patients with AML in-dicate that the immune function of patients with AML is depressed. Treg control the immune response of CD8 +T cells,at the same time inhibit the natural immune response of NK cells, playing a major role in the disorders of CD4 +T cells and CD8 +T cell balance,and closely relate with the development of AML. The immune treatment of patients with AML will be optimised by reducing the amount of Treg or removing the suppression function.

Astragalus polysaccharide induces apoptosis of human KG-1a cells through inhibiting PTEN-PI3K-Akt signaling pathway / 白血病·淋巴瘤

Objective To investigate the effect of astragalus polysaccharide (AP) on proliferation and apoptosis of human acute myelocytic leukemia cell line KG-1a and the underlying mechanisms.Methods Human acute myelocytic leukemia cell line KG-la was cultured under 37 ℃ and 5 ％ C02,when appropriate cell passage and cryopreservation were performed.After treatment for 48 h with different concentrations of AP,the proliferative activity and apoptosis rate of KG-1a cells were examined by CCK-8 assay and flow cytometry,respectively.The expressions of p-Akt and bcl-2 protein in AP-treated KG-1a cells were evaluated by Western blot.The expression of PTEN mRNA by quantified real-time PCR.Results The proliferative activity of KG-la cell was obviously suppressed by AP treatment,and the inhibition rate increased in a dosedependent manner.The flow cytometry showed that,compared with the control group,the apoptosis rates of KG-1a cells were significantly increased after treatment with AP for 48 h.The early apoptosis rates were (1.98±0.16) ％,(12.60±0.48) ％,(16.31±0.73) ％,the late apoptotic rates were (3.11±0.19) ％,(17.17±1.40) ％,(21.17 ± 0.81)％,the differences were statistically significant (P ＜ 0.05).Western blot showed that the expressions of p-Akt and bcl-2 protein in KG-1a cells decreased significantly after treatment with AP (P ＜ 0.05).In contrast,the mRNA level of PTEN increased (P ＜0.05),which was shown by real-time PCR.Conclusion AP could repress cellular proliferation activity of KG-1a cells,which could be attributed to inhibition of PTEN-PI3K-Akt signaling pathway.

Research progress of microRNA in acute leukemia with molecular and cytogenetic abnormalities / 白血病·淋巴瘤

microRNA (miRNA) refers to small (19-25 nt) single-stranded noncoding RNA molecules that work as post-transcriptional regulator for gene expression by binding to 3' untranslated regions of target mRNA,thus inducing its digestion,degradation and translational repression.Many studies have confirmed that dysregulation of miRNA expression can cause disruption of the hematopoietic system and contribute to leukemogenesis by regulating the expression of some oncogenes and anti-oncogenes.The unique miRNA expression profiles associated with cytogenetic aberrations and mutational status of protein-coding genes may reveal insight into the biology of these leukemia types.This review discussed the latest studies on miRNA expression in different cytogenetic and molecular subtypes of acute myelocytic leukemia and acute lymphoblastic leukemia.

Treatment of an elderly patient with acute myelocytic leukemia transformed from myelodysplastic syndrome with decitabine in ultra-low dosage combining with transfusion of autologous cytokineinduced killer cells: A case report and review of literature / 解放军医学杂志

Objective To investigate the efficacy and safety of decitabine in ultra-low dose combining with autologous cytokine-induced killer (CIK) cells for treatment of elderly patients with acute myelocytic leukemia (AML) transformed from myelodysplastic syndrome (MDS). Methods An 83-year-old patient with initial diagnosis of MDS-RA was treated with amifostine combined with erythropoietin (EPO), and hemogram was improved nearly to normal lasting about three and a half years. Then the patient's morbidity transformed to chronic myelomonocytic leukemia (AML-M4) two months later. Then the patient was treated with an ultra-low dose of decitabine combining with autologous CIK cells. The detailed treatment included decitabine 10mg, d1-5, and CIK cells transfusion (2×109-8×109 each time) d14; rhIL-2 2mU d15-19. 28-day treatment was accounted as one treatment course. Side effects, changes in hemogram, signs of recuperation and duration of survival were systematically observed. Further, the literature concerning decitabine for the treatment of elderly patients with MDS/AML was reviewed. Results In total, 8 cycles of decitabine combining with autologous CIK cells were given in addition to the best supportive treatments available. During treatment, side reactions including I/II grade bone marrow inhibition and grade I gastrointestinal reaction were observed. No obvious signs of dysfunction were found in liver and kidney. Leukocytosis appeared during 2nd, 3rd and 8th cycles of treatment, with the highest white blood cells count of 141.95×109/L, and it could be controlled by giving etoposide (50mg, d1-3). Hemoglobin content varied between 77 and 138g/L in the context of intermittent blood transfusion. During 3rd treatment, platelets started to increase in number, but reaching normal level during 6th treatment cycle. It was evaluated as partial remission. Finally, the patient died due to deterioration in leukemia and pneumonia. The overall survival duration was 22 months from diagnosis of AML to death, and it was significantly longer than that reported before. Conclusion The treatment consisting of ultra-low dose of decitabine combining with autologous CIK cells, is safe and effective in treatment of elderly patients with AML transformed from MDS. Further investigation with more patients is warranted in the future.

Observation and nursing of adverse reactions in chronic myelocytic leukemia patients receiving imatinib therapy / 中国实用护理杂志

Objective To discuss the observation and nursing of adverse reactions in chronic myelocytic leukemia patients receiving imatinib therapy.Methods Adverse reactions were observed and recorded in 193 chronic phase myelocytic leukemia patients who received imatinib therapy,and corresponding treatment and nursing were given to them.Results Among 193 patients,more than 60％ of patients had adverse reactions,of which,54％ of patients showed gastrointestinal adverse reactions including nausea,vomiting,anepithymia and diarrhea; 22％ of them had muscle and bone pain; 7％ had rash; 65％ got edema.After proper treatment and nursing,all adverse effects obtained satisfactory remission.Condusions During the treatment course of chronic myelocytic leukemia patients using imatinib,careful observation of any possible adverse reactions,and giving corresponding treatment and nursing can facilitate good compliance and longterm remission of patients.

2011 American Society of Hematology annual meeting and exposition on clinical advance of acute myeloid leukemia / 白血病·淋巴瘤

Acute myeloid leukemia (AML) is the major topic in American Society Hematology (ASH)Annual Meeting and Exposition. There were 887 scientific articles on AML in the 53rd ASH Annual Meeting and Exposition in 2011,in which many studies focused on clinics.Here is introduction of o.ptimized regimens for AML and elderly AML,as well as targeted therapy for AML presented in the meeting.

The cytogenetic characteristics of 178 acute myeloid leukemia patients / 中华内科杂志

Objective To explore the cytogenetic characteristics of acute myeloid leukemia(AML) patients.Methods The karyotype analysis was performed in 178 AML using the short-term culture of bone marrow cell and G-banding technique.Results Among the 178 patients,171 had enough metaphases for analysis and 128(74.9%)had clonal karyotypic abnormalities.Twenty-seven patients were secondary to myelodysplastic syndrome (MDS-AML),with 25 (92.6%) patients carrying clonal karyotypic abnormalities.Among the remaining 144 patients of de novo AML,103(71.5%)had clonal karyotypic abnormalities.The rate of abnormal clonal karyotype was higher in MDS-AML than that of de novo AML (P=0.021).Among the 171 patients,41(24.0%)were in favorable risk group,80(46.8%)in intermediate risk group and 50(29.2%)in adverse risk group.t(15;17)was the most common chromosomal aberration.The maiority intermediate risk chromosomal aberration was;normal karyotype.The most common cytogenetic abnormality among adverse group was a complex karyotype.Adverse cytogenetic aberrations,such as -5/5q-,-7/7q-,frequently occurred in conjunction with one another as part of a complex karyotype.Totally 75 patients were 60 years or older,among them,16.0%were in favorable risk group,48.0%in intermediate risk group and 36.0%in adverse risk group.Among 96 younger patients,30.2%were in favorable risk group.45.8%in intermediate risk group and 24.0%in adverse risk group.The rate of favorable risk chromosomal aberration was lower in elder patients than in younger(P=0.03 1).The rate of adverse risk chromosomal aberration and the rate of monosomal karyotype were higher in MDSAML than in de novo AML patients(P<0.001).Conclusions The most common favorable,intermediate and adverse chromosomal aberrations were t(15;17),normal karyotype and complex karyotype respectively.The karyotype was poor in MDS-AML and elder AML patients.

Retrospective analysis of t (8;21) acute myeloid leukemia patients with MICM classification / 白血病·淋巴瘤

Objective To study the significance of morphologic, immunophenotype, cytogenetic features, molecular biology (MICM) and prognosis of t (8;21) acute myeloid leukemia (AML) patients.Methods Morphological, FAB subtypes, flow cytometric immunophenotyping, G-binding technique and RTPCR were performed in 70 AML patients with t (8;21) and AML1-ETO fusion transcripts as compared with normal karyotype 70 AML patients. Results In 70 AML patients with t(8;21), 1 case of M1, 64 cases of M2, 3cases of M4 and 2 cases of ambiguity AL according to FAB classification. The CD13, CD33, CD34 and CD117expression were higher, meanwhile CD19 was positive in 40 %, CD15 was 11%, CD11b was 10 % and CD7 was 7 %. Cytogenetically, 50 % cases had additional chromosomal abnormalities, and main associated recurrent additional abnormalities were loss of a sex chromosome, 9q- and hyperdiploid. AML1/ETO fusion gene transcripts were detected in all 70 AML patients with t(8;21) by RT-PCR. CR rate of t(8;21) AML with CD19were 72 %, t(8;21) AML with CD19 and CD7 were 0; in normal karyotype AML were 31%. Conclusion The t(8;21) is the characteristic chromosome abnormality of M2. In the t(8;21), CD19, CD34 and CD117 expression are high, while CD7 are low. These antigen expression in t(8;21) AML closely correlated with karyotype. CD19 is a marker of good prognosis, but CD7 is a marker of low CR.

Genetic prognostic markers for acute myeloid leukemia with normal cytogenetics / 白血病·淋巴瘤

Acute myeloid leukemia (AML) is a heterogenous disorder disease, about 40 %-49 % of the adult AML and 25 % of children had normal karyotype AML, and usually categorized as an intermediaterisk group, but for acquired genetic change, such as mutations of FLT3, NPM1, CEBPα, MLL, and KIT as well as alterations in expression levels of BAALC, MN1, ERG, and EVI1, leading to significant heterogeneity for the prognosis of this group. In this report, prognostic genetic findings in normal karyotypical AML and discuss their clinical implications was reviewed.