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Acute myeloid leukemia (AML) has highly heterogeneous clinical manifestations and poor prognosis, and traditional chemotherapy is the main treatment. In recent years, with the in-depth development of next-generation sequencing technology, the treatment of AML is gradually exploring the precise targeted therapy in the direction of molecular biology and immunophenotype. The advent of various small-molecule inhibitors and immune-targeted drugs has brought hope to patients who cannot tolerate intensive chemotherapy or with relapsed/refractory AML. Compared with traditional chemotherapy, targeted therapy has the advantages of significant curative effect and fewer adverse effects. This article reviews the latest research progress of targeted drug therapy for AML.
Assuntos
Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Imunoterapia , Imunoterapia Adotiva , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêuticoRESUMO
OBJECTIVE@#To investigate the expression of CSF3R mutation in acute myeloid leukemia (AML) and analyze its clinical characteristics and prognosis.@*METHODS@#A retrospective study was conducted in 212 patients with AML who were newly diagnosed in the Second Hospital of Shanxi Medical University from January 1th 2018 to June 30th 2021, including 22 patients with CSF3R mutations as mutation group and 190 patients with CSF3R wild type [66 cases of them were screened by propensity score matching (PSM), as control group]. The early efficacy and survival between the two groups were compared.@*RESULTS@#The median age of patients in the mutation group was 50(17-73) years old, and the ratio of male to female was 1.2:1 The main types were AML with maturation (11 cases) and acute myelomonocytic leukemia (9 cases). Prognostic stratification was carried out according to the risk stratification system of the European leukemia network in 2017, with 16 cases (72.73%) in the middle and high-risk group. At the initial diagnosis, the median count of white blood cell (WBC) was 44.75(1.30-368.71)×109/L, among which 15 cases (68.18%) were >10×109/L, and the median count of platelet (PLT) was 24(4-55)×109/L. CSF3R T618I (68.18%) was a common mutation site, which had concomitant gene mutations, in which CEBPA mutation was the most common (10 cases, 45.45%), but only existed in CSF3R T618I mutation. The CR/CRi rate was 68.18% and 71.21% in the mutant group and the control group (P >0.05), the median over all survival time was 15 months and 9 months (P >0.05), and the median disease-free survival time was 8 months and 4 months (P >0.05), respectively.@*CONCLUSION@#Most AML patients with CSF3R mutation are middle-aged patients, the main types are AML with maturation and acute myelomonocytic leukemia, and most of them have middle and high-risk prognosis. CSF3R mutation may not be an independent prognostic marker for newly diagnosed AML patients.
Assuntos
Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Idoso , Leucemia Mielomonocítica Aguda , Estudos Retrospectivos , Leucemia Mieloide Aguda/diagnóstico , Prognóstico , Mutação , Receptores de Fator Estimulador de Colônias/genéticaAssuntos
Antibacterianos , Imunoterapia , Tuberculose Pulmonar , Adolescente , Adulto , Idoso , Antibacterianos/economia , Antibacterianos/uso terapêutico , Terapia Combinada/economia , Análise Custo-Benefício , Feminino , Humanos , Imunoterapia/economia , Masculino , Pessoa de Meia-Idade , Mycobacterium/imunologia , Resultado do Tratamento , Tuberculose Pulmonar/economia , Tuberculose Pulmonar/terapia , Adulto JovemRESUMO
Objective To investigate the clinical value of multi-slice spiral CT(MSCT) in the diagnosis of mild digestive tract hemorrhage. Methods Thirty-five patients with mild gastrointestinal hemorrhage were examined by enhanced MSCT.CT signs were observed and compared with pathologic examination findings.Results Diseases in these 35 patients included gastric and duodenal ulcer and inflammation(n=4,11.4%),esophagogastric variceal rupture(n=7,20.0%),gastric carcinoma(n=3,8.6%),gastric stromal tumor(n=3,8.6%),gastric polyp(n=1,2.9%),colonic malignancy(n=5,14.2%),small intestinal stromal tumor(n=6,17.1%),rectal cancer(n=2,5.7%),intestinal Crohn disease(n=3,8.6%),and jejunum diverticulum combined with hemorrhage(n=1,2.9%).All of them were diagnosed by endoscopy of the digestive tract and confirmed by operation and pathology.The accuracy rate of CT was 100%.The coincidence rate of CT diagnosis was 97.1%.Conclusion MSCT is a promising technique in the localization,qualitative diagnosis,and clinical treatment of mild gastrointestinal hemorrhage.
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Objective To assess the income status of primary care providers and to explore the determinants of income in a county of Dali. Methods In August 2016, the questionnaire was employed to collect the data of income status of 191 rural health workers and 217 village doctors in the county. Results Through the study, we found that the income of rural health workers in the county was 34, 000 (26, 000, 46,000) yuan with a satisfaction rate of 62.3% (95% CI 55.4%~69.2%) and no change (74.7%) was seen in the income among majorities after implementing the Zero Mark-up Policy for essential medicines. For the village doctors, the income was 20,000 (15,000, 24,000) yuan with a satisfaction rate of 40.6% (95% CI 34.0%~47.1%) and a fall of the income was found in more than half of the doctors after the implement of the policy. Conclusion Health care workers in towns are quite satisfied with their income whereas those in health stations of villages are not content, compared with the average income at the national level. We should increase government's investments on grass-root healthcare team, improve the incentive pay plans and promote the integrated management of health facilities in towns and villages.
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Objective To study the bibenzyls and phenanthrenes from Arundina graminifolia.Methods The compounds were extracted by 95% alcohol and isolated by column chromatography on silica gel and Sephadex LH-20.Their structures were identified by spectroscopic analysis (1H NMR and13CNMR).Results Eleven compouds were obtained and identified as batatasin Ⅲ (1),arundinanin (2),2,8-dihydroxy-4,7-dimethoxy-9,10-dihydrophenanthrene (3),shancidin (4),arundinan (5),isoshancidin (6),erianthridin (7),lusianthridin (8),eulophiol (9),flavanthrin (10),orchinol (11).Conclusion Compounds 3,7,9 were isolated from this plant for the first time.