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1.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 31(2): 327-332, 2023 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-37096501

RESUMO

OBJECTIVE: To investigate the efficacy and safety of venetoclax (VEN) combined with demethylating agents (HMA) in the treatment of relapsed/refractory acute myeloid leukemia (R/R AML). METHODS: The clinical data of 26 adult R/R AML patients who received the combination of VEN with azacitidine (AZA) or decitabine (DAC) in Huai'an Second People's Hospital from February 2019 to November 2021 were retrospectively analyzed. The treatment response, adverse events as well as survival were observed, and the factors of influencing the efficacy and survival were explored. RESULTS: The overall response rate (ORR) of 26 patients was 57.7% (15 cases), including 13 cases of complete response (CR) and CR with incomplete count recovery (CRi) and 2 cases of partial response (PR). Among the 13 patients who got CR/CRi, 7 cases achieved CRm (minimal residual disease negative CR) and 6 cases did not, with statistically significant differences in overall survival (OS) and event-free survival (EFS) between the two groups (P=0.044, 0.036). The median OS of all the patients was 6.6 (0.5-15.6) months, and median EFS was 3.4 (0.5-9.9) months. There were 13 patients in the relapse group and refractory group, respectively, with response rate of 84.6% and 30.8% (P=0.015). The survival analysis showed that the relapse group had a better OS than the refractory group (P=0.026), but there was no significant difference in EFS (P=0.069). Sixteen patients who treated for 1-2 cycles and 10 patients who treated for more than 3 cycles achieved response rates of 37.5% and 90.0%, respectively (P=0.014), and patients treated for more cycles had superior OS and EFS (both P<0.01). Adverse effects were mainly bone marrow suppression, complicated by various degrees of infection, bleeding, and gastrointestinal discomfort was common, but these could be all tolerated by patients. CONCLUSION: VEN combined with HMA is an effective salvage therapy for patients with R/R AML and is well tolerated by patients. Achieving minimal residual disease negativity is able to improve long-term survival of patients.


Assuntos
Compostos Bicíclicos Heterocíclicos com Pontes , Leucemia Mieloide Aguda , Adulto , Humanos , Estudos Retrospectivos , Neoplasia Residual/induzido quimicamente , Neoplasia Residual/tratamento farmacológico , Compostos Bicíclicos Heterocíclicos com Pontes/efeitos adversos , Recidiva , Leucemia Mieloide Aguda/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
2.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(5): 1610-1616, 2021 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-34627449

RESUMO

OBJECTIVE: To evaluate the incidence and clinical characteristics of metabolic syndrome (MS) within one year after hematopoietic stem cell transplantation (HSCT) in order to screen the risk factors for HSCT-MS, provide early intervention and improve the long-term quality of survival of patients. METHODS: The clinical follow-up data of 64 HSCT patients (survival time > 1 year) who received HSCT in our center from January 2007 to August 2018 were collected. Among them, 50 cases were allogeneic hematopoietic stem cell transplantation (allo-HSCT) and 14 cases were autologous hematopoietic stem cell transplantation (auto-HSCT). The changes of MS-related indexes and clinical characteristics before and 1, 3, 6 and 12 months after HSCT were analyzed retrospectively. RESULTS: In allo-HSCT group, 14 cases were diagnosed as MS before operation, including high-density lipoprotein cholesterol (hypo-HDL-C)> hyper triglycerides(hyper-TG)> hyper fasting glucose(hyper-FBG)> abdominal obesity (AO) > hypertension. The preoperative diagnosis of MS in the auto-HSCT group was 5 cases, in the order of hyper-FBG> hyper-TG> AO> hypo-HDL-C> hypertension. Incidence of MS at 1, 3, 6 and 12 months after transplantation: 19, 26, 24 and 20 cases in the allo-HSCT group, respectively; auto-HSCT group were 7, 7, 6 and 6 cases, respectively. Hyper-TG and hypo-HDL-C were prominent in both groups. CONCLUSION: The incidence of HSCT-MS is significantly higher within 1 year after HSCT. Regardless of allo-HSCT and auto-HSCT, the prevention and control of HSCT-MS is emphasized as an important guarantee to improve the long-term survival quality of HSCT patients.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Síndrome Metabólica , Células-Tronco Hematopoéticas , Humanos , Estudos Retrospectivos , Transplante Homólogo
3.
Zhonghua Yi Xue Za Zhi ; 93(20): 1537-40, 2013 May 28.
Artigo em Chinês | MEDLINE | ID: mdl-24028718

RESUMO

OBJECTIVE: To explore the proportion of Th22 cells in peripheral blood of patients with aplastic anemia (AA) and evaluate its significance. METHODS: From January 2011 to June 2012, a total of 47 AA patients were recruited and divided into 4 groups: severe aplastic anemia (SAA) pre-therapy (group A, n = 11), non-severe aplastic anemia (NSAA) pre-therapy (group B, n = 12), SAA post-therapy (group C, n = 12), NSAA post-therapy (group D, n = 12) and healthy donor controls (n = 12). The proportion of Th22 cells in peripheral blood of each group was evaluated by flow cytometry. The cytokines interleukin-22 (IL-22), transforming growth factor-ß (TGF-ß), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were measured by ELISA. And the level of IL-22 mRNA was examined by reverse transcription-PCR (RT-PCR). RESULTS: The percentage of Th22 cells and the level of IL-22, TNF-α, IL-6 and IL-22 mRNA in group A (4.3% ± 1.4%, (57 ± 17) ng/L, (497 ± 123) ng/L, (323 ± 88) ng/L, 1.65 ± 0.51) and group C (2.6% ± 0.6%, (34 ± 10) ng/L, (314 ± 79) ng/L, (187 ± 45) ng/L, 0.92 ± 0.28) were significantly higher than that in control group (1.2% ± 0.3%, (19 ± 6) ng/L, (228 ± 50) ng/L, (134 ± 26) ng/L, 0.47 ± 0.09,all P < 0.05). The percentage of Th22 cells and the level of IL-22, TNF-α , IL-6 and IL-22 mRNA in group A were higher than those in group C (all P < 0.05). NSAA patients had similar results. The percentage of Th22 cells and the level of IL-22, TNF-α , IL-6 and IL-22 mRNA in group A were higher than those in group B (all P < 0.05). But the level of TGF-ß in groups A and C were significantly lower than that in control group ((3.4 ± 1.1) and (5.8 ± 1.7) vs (9.7 ± 2.8) ng/L, P < 0.05). And the level of TGF-ß in group A was lower than that of group B (P < 0.05). CONCLUSIONS: The number of Th22 cells is elevated in AA patients. Th22 cells may be positively correlated with the development of AA. And a higher level of TNF-α, IL-6 and a lower level of TGF-ß promote the differentiation of Th22 cells.


Assuntos
Anemia Aplástica/patologia , Interleucinas/sangue , Linfócitos T Auxiliares-Indutores/citologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Diferenciação Celular , Criança , Humanos , Interleucina-6/sangue , Pessoa de Meia-Idade , Fator de Crescimento Transformador beta1/sangue , Fator de Necrose Tumoral alfa/sangue , Adulto Jovem , Interleucina 22
4.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 28(12): 1314-6, 2012 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-23232525

RESUMO

AIM: To investigate the change of Th22 cells in the peripheral blood of the patients with primary immune thrombocytopenia (ITP) and evaluate the significance of Th22 cells in ITP. METHODS: The proportion of Th22 cells in the peripheral blood of ITP patients before therapy (group 1), ITP patients in complete response after therapy (ITP-CR, group 2) and healthy donors (group 3) was evaluated by flow cytometry. The cytokines IL-22, TGF-ß, TNF-α and IL-6 of each group were measured by ELISA. The level of IL-22 mRNA of each group was examined by RT-PCR. RESULTS: The proportion of Th22 cells and the levels of IL-22, TNF-α, IL-6 and IL-22 mRNA in group l and group 2 were significantly higher than those in group 3 (P<0.01). The proportion of Th22 cells and the levels of IL-22, TNF-α, IL-6 and IL-22 mRNA in group 2 were lower than those in group 1(P<0.05). But the level of TGF-ß in group l [(3.27±1.02) ng/L] and group 2 [(5.41±1.69) ng/L] was significantly lower than that in group 3 [(9.65±2.78) ng/L] (P<0.01), and the level of TGF-ß in group 1 was lower than that in group 2 (P<0.05). CONCLUSION: In ITP patients, the number of Th22 cells and the levels of TNF-α and IL-6 increase, and the level of TGF-ß decrease.


Assuntos
Subpopulações de Linfócitos T/citologia , Trombocitopenia/sangue , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Interleucina-10/sangue , Interleucina-6/sangue , Interleucina-6/genética , Interleucinas/sangue , Interleucinas/genética , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Subpopulações de Linfócitos T/imunologia , Trombocitopenia/genética , Trombocitopenia/imunologia , Fator de Crescimento Transformador beta/sangue , Fator de Crescimento Transformador beta/genética , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/genética , Adulto Jovem , Interleucina 22
6.
Zhonghua Xue Ye Xue Za Zhi ; 33(12): 985-8, 2012 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-23363787

RESUMO

OBJECTIVE: To investigate the proportion of Th22 cells in peripheral blood of patients with acute lymphoblastic leukemia (ALL) and evaluate its significance. METHODS: The proportions of Th22 cells in peripheral blood of B-ALL and T-ALL patients before therapy (group 1), B-ALL and T-ALL patients in complete remission (ALL-CR, group 2) and healthy donors (group 3) were evaluated by flow cytometry. The cytokines IL-22, TGF-ß, TNF-α and IL-6 in peripheral blood of each group were measured by enzyme-linked immunosorbent assay (ELISA). The levels of IL-22 mRNA in peripheral blood mononuclear cells of each group were examined by reverse transcription-PCR (RT-PCR). RESULTS: The percentages of Th22 cells and the levels of IL-22, TNF-α, IL-6 and IL-22 mRNA in B-ALL and T-ALL patients before therapy were (0.44 ± 0.10)%, (10.9 ± 3.4) ng/L, (110.7 ± 26.5) ng/L, (60.2 ± 13.8) ng/L, 0.17 ± 0.04 and (0.46 ± 0.11)%, (11.2 ± 3.5) ng/L, (114.6 ± 27.0) ng/L, (58.7 ± 12.4) ng/L, 0.19 ± 0.04, respectively; Which in B-ALL and T-ALL patients in complete remission were(0.59 ± 0.15)%, (14.3 ± 4.1) ng/L, (142.5 ± 32.7) ng/L, (83.7 ± 18.9) ng/L, 0.25 ± 0.06 and(0.60 ± 0.15)%, (14.6 ± 4.3) ng/L, (140.4 ± 31.4) ng/L, (81.4 ± 18.2) ng/L, 0.26 ± 0.06, significantly lower than those in healthy donors \[(1.24 ± 0.31)%, (19.7 ± 6.6) ng/L, (238.3 ± 50.4) ng/L, (138.0 ± 27.1) ng/L, 0.49 ± 0.09\] (P < 0.01). The percentages of Th22 cells and the levels of IL-22, TNF-α, IL-6 and IL-22 mRNA in group l were lower than those in group 2 (P < 0.05), there was not significant difference between B-ALL and T-ALL (P > 0.05). But the levels of TGF-ß in B-ALL and T-ALL patients before therapy \[(30.6 ± 8.2) ng/L, (31.4 ± 8.8) ng/L\] and in complete remission \[(24.2 ± 5.8) ng/L, (25.1 ± 6.1) ng/L\] were significantly higher than those in group 3\[(9.6 ± 2.8) ng/L\] (P < 0.01). However, the level of TGF-ß in group 1 was higher than that of group 2 (P < 0.05), there was not significant difference between B-ALL and T-ALL (P > 0.05). CONCLUSION: Both the number and function of Th22 cells reduced in ALL patients. Th22 cells might be negatively correlated with ALL progression. The lower levels of TNF-α and IL-6, and overexpression of TGF-ß in ALL patients might suppress the differentiation of Th22 cells.


Assuntos
Interleucinas/metabolismo , Leucemia-Linfoma Linfoblástico de Células T Precursoras/sangue , Linfócitos T Auxiliares-Indutores/metabolismo , Adolescente , Adulto , Estudos de Casos e Controles , Humanos , Interferon gama/metabolismo , Interleucina-6/metabolismo , Leucócitos Mononucleares/metabolismo , Pessoa de Meia-Idade , RNA Mensageiro/genética , Fator de Crescimento Transformador beta/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Adulto Jovem , Interleucina 22
7.
Zhonghua Xue Ye Xue Za Zhi ; 33(9): 720-4, 2012 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-23336224

RESUMO

OBJECTIVE: To explore the mechanism of immunomodulatory activity of triptolide on primary immune thrombocytopenia (ITP)patients-derived plasmacytoid dendritic cells (pDCs). METHODS: pDCs in peripheral blood of ITP patients before therapy (group 1), ITP patients in complete response (ITP-CR, group 2) and healthy donors (group 3) were sorted by flow cytometry, then incubated with triptolide at 0, 5, 10 or 30 µg/L. After 24 hours, we collected the supernatants and then detected the concentrations of IFN-α, IL-6 and TNF-α using ELISA. After 5 days, the cultured cells were collected and CD11c, CD80 and CD86 expressions of myeloid dendritic cells (mDCs) were analyzed by flow cytometry, the morphology of mDC was observed by light microscope and electron microscope. RESULTS: After incubation with triptolide at 10 µg/L, the levels of IFN-α, IL-6 and TNF-α in group 1 \[(451.32 ± 85.77) ng/L, (105.68 ± 23.85) ng/L and (135.78 ± 30.62) ng/L\] and group 2 \[(391.71 ± 72.49) ng/L, (84.73 ± 17.77) ng/L and (108.16 ± 23.21) ng/L\] were significantly higher than those in group 3 \[(335.51 ± 67.54) ng/L, (73.62 ± 21.82) ng/L and (95.58 ± 32.85) ng/L\] (all P < 0.05); the levels of IFN-α, IL-6 and TNF-α in group 1 were significantly higher than those in group 2 (all P < 0.05) in a dose-dependent manner (P < 0.05). CD11c, CD80 and CD86 expressions of mDC in group1 and group 2 were significantly higher than those in group 3 (all P < 0.05); CD11c, CD80 and CD86 expressions of mDC in group 1 were significantly higher than those in group 2 (all P < 0.05) also in a dose-dependent manner (all P < 0.05). Triptolide could inhibit pDCs from differentiation into mDCs, the latter displayed more immature morphology than untreated-pDCs. CONCLUSION: Triptolide could decrease the immune function of pDCs from ITP, inhibit pDCs from differentiation and maturation.


Assuntos
Células Dendríticas/citologia , Células Dendríticas/efeitos dos fármacos , Diterpenos/farmacologia , Fenantrenos/farmacologia , Trombocitopenia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Diferenciação Celular/efeitos dos fármacos , Células Cultivadas , Compostos de Epóxi/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Trombocitopenia/etiologia , Trombocitopenia/imunologia , Adulto Jovem
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