RESUMO
<p><b>BACKGROUND AND OBJECTIVE</b>Precursor T lymphoblastic lymphoma (T-LBL) is a highly aggressive lymphoma. Myeloid antigen expression was found in some of the patients, and its clinical significance is worth studying. This study was to compare the clinical features, short-term efficacy and survival of T-LBL patients with or without myeloid antigen expression so as to evaluate its prognostic significance.</p><p><b>METHODS</b>Forty-five T-LBL patients, with a median age of 14 years, were treated at Sun Yet-sen University Cancer Center between January 2000 and July 2008. These patients were divided into myeloid antigen-positive group (My(+) group) and myeloid antigen-negative group (My(-) group) based on the flow cytometric (FCM) analysis in bone marrow or pleural fluid. Myeloid antigen expression and its correlation with the short-term efficacy and overall survival were assessed in the two groups.</p><p><b>RESULTS</b>There were 18 patients (40.0%) in the My(+) group and 27 (60.0%) in the My(-) group. The myeloid antigen expression was negatively correlated with the initial level of lactate dehydrogenase (LDH), but not with other clinical features. The remission rate was lower in the My(+) group than in the My(-) group (38.8% vs. 70.3%, P = 0.028). The 2-year overall survival rate was lower in the My(+) group than in the My(-) group (51.9% vs. 78.7%, P = 0.036). By age subgroup analysis, there were no differences in response and survival rate among children and adolescents with or without myeloid antigen expression. But the remission rate and the 2-year overall survival rate were significantly lower in adult patients with myeloid antigen expression than in patients without it. Univariate and multivariate analysis demonstrated that age and myeloid antigen expression were adverse prognostic factors.</p><p><b>CONCLUSION</b>Myeloid antigen expression is a predictor of a poor response to chemotherapy, and adverse prognostic factor in adult T-LBL, but not in children with T-LBL.</p>
Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Fatores Etários , Antígenos CD7 , Metabolismo , Antígenos de Diferenciação Mielomonocítica , Metabolismo , Protocolos de Quimioterapia Combinada Antineoplásica , Usos Terapêuticos , Asparaginase , Usos Terapêuticos , Ciclina D3 , Metabolismo , Ciclofosfamida , Usos Terapêuticos , Citarabina , Usos Terapêuticos , Daunorrubicina , Usos Terapêuticos , Doxorrubicina , Usos Terapêuticos , Etoposídeo , Usos Terapêuticos , Seguimentos , Mercaptopurina , Usos Terapêuticos , Metotrexato , Usos Terapêuticos , Leucemia-Linfoma Linfoblástico de Células T Precursoras , Tratamento Farmacológico , Alergia e Imunologia , Prednisona , Usos Terapêuticos , Modelos de Riscos Proporcionais , Indução de Remissão , Taxa de Sobrevida , Fatores de Transcrição , Metabolismo , Vincristina , Usos TerapêuticosRESUMO
OBJECTIVE: To observe the characteristics of changes in hemorheology at the early stage of irreversible hemorrhagic shock in a rodent model. METHODS: Rodent model of irreversible hemorrhagic shock was reproduced. Animals were randomized into 4 groups. In the first group, survival rate and mean arterial pressure (MAP) in 180 minutes were observed after hemorrhagic shock (S group). In the second group, animals were sacrificed soon after hemorrhagic shock (S0 group). In the third group, animals were sacrificed 60 minutes after hemorrhagic shock (S1 group). In the fourth group, animals were sacrificed 120 minutes after hemorrhagic shock (S2 group). Blood samples of animals of S0, S1 and S2 were all obtained before hemorrhagic shock. Blood lactate, hemorheological parameters, red blood cell (RBC) deformability and RBC aggregation index were determined. RESULTS: Mean blood loss of S group was (22.9+/-3.8) ml/kg, constituting about (38.1+/-6.3)% of total blood volume. At 60, 120 and 180 minutes after hemorrhagic shock, survival rates were 100%, 72% and 64%, respectively. Compared with baseline, 0, 60 and 120 minutes after hemorrhagic shock, blood lactate increased significantly (all P<0.01), but 120 minutes after hemorrhagic shock, it decreased significantly compared with 0 minute after hemorrhagic shock (P<0.05). Compared with baseline, 0 minute and 60 minutes after hemorrhagic shock, blood viscosity was found to be decreased at shear rate of 10 s(-1), 60 s(-1) and 100 s(-1) (all P<0.01); 120 minutes after hemorrhagic shock, at shear rate of 10 s-1 and 60 s(-1), blood viscosity decreased significantly (both P<0.01); 0, 60 and 120 minutes after hemorrhagic shock, plasma viscosity, RBC deformability and RBC aggregation index at shear rates of 600 s(-1), 800 s(-1) and 1 000 s(-1) decreased significantly (all P<0.01). CONCLUSION: At the early stage of irreversible hemorrhagic shock, blood lactate increased significantly, and decreased afterwards. These indicate reversal of deterioration of metabolism. At different time after the early stage of irreversible hemorrhagic shock, blood and plasma viscosity, RBC deformability and aggregation index lowered significantly and did not improve. Changes in viscosity and RBC aggregation are different from the changes in late stage, and this indicates that hemorheological disorders should be corrected in the treatment at the early stage after hemorrhagic shock.
