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Cao L, Jiang ZQ, Liu WJ, Sun Q, Zhu Y, Li JY, Qian SX, Hong M. [Efficacy and Safety of Decitabine Combined with Modified CAG Regimen in Patients Aged ≥ 70 Years with Newly Diagnosed Acute Myeloid Leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2023; 31:633-642. [PMID: 37356919 DOI: 10.19746/j.cnki.issn.1009-2137.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
OBJECTIVE To evaluate the clinical efficacy and safety of decitabine combined with modified CAG regimen (D-CAG regimen) in patients aged ≥70 years with newly diagnosed acute myeloid leukemia (AML). METHODS The clinical data of 59 AML patients (≥70 years old) who were newly diagnosed and treated in the Hematology Department of the First Affiliated Hospital of Nanjing Medical University from November 2010 to June 2021 were retrospectively analyzed. RESULTS Among the 59 AML patients, 28 were males and 31 were females, with a median age of 74 (70-86) years. The complete remission (CR) rate was 69.4% (34/49), and the median duration of CR was 10.7 (0.6-125.4) months after 2 courses of D-CAG treatment. According to the British Medical Research Council (MRC) classification, there was only one patient in the favorable-risk group, and the CR rate was 71.8% (28/39) in the intermediate-risk group, and 55.6% (5/9) in the adverse-risk group, respectively. There was no statistical difference in the CR rate between the intermediate-risk and adverse-risk group. Referring to ELN 2017 genetic risk classification, CR rate was 88.2% (15/17) in the favorable-risk group, 45.5% (5/11) in the intermediate-risk group, and 66.7% (14/21) in the adverse-risk group. There was no significant difference in CR rate between the favorable-risk and adverse-risk categories, but both were significantly higher than that in the intermediate-risk group (P <0.05). Next-generation sequencing (NGS) analysis showed that 11 gene mutations with a frequency of more than 10%, including TET2 mutation (35.6%), ASXL1 mutation (30.5%), NPM1 mutation (28.8%), FLT3-ITD mutation (27.1%), DNMT3A mutation (22.0%), IDH1 mutation (15.3%), CEBPA single mutation (13.6%), TP53 mutation (13.6%), IDH2 mutation (11.9%), RUNX1 mutation (11.9%), and NRAS mutation (10.2%). There were no statistical differences in mutation frequency of these 11 genes between CR group and non-CR group. Compared with normal karyotypes, patients with complex karyotypes were more likely to develop TP53 mutations (P <0.001), while FLT3-ITD and DNMT3A mutations were more likely to occur in patients with normal karyotypes (P =0.04, P =0.047). The median follow-up, overall survival (OS), and event-free survival (EFS) of all the patients was 11.7 (1.5-128.2) months, 12.3 (1.5-128.2) months, and 8.5 (1.5-128.2) months, respectively. The median OS and EFS of CR patients were 19.8 and 13.3 months, respectively, which were significantly longer than 6.4 and 5.7 months in patients experiencing treatment failure (P < 0.001, P =0.009). In regard to genes with mutation frequency >10%, there were no statistical differences in CR rate, median OS, and median EFS between mutated and wild-type patients by Chi-square test and survival analysis. Univariate analysis showed that age, hemoglobin, lactate dehydrogenase, cytogenetics and CR were factors affecting prognosis, while multivariate analysis showed that only CR failure was an independent adverse prognostic factor for OS. The major adverse reactions to D-CAG regimen were grade 3-4 myelosuppression, pulmonary infection, and fever (infection focus was not identified). CONCLUSION D-CAG regimen is safe and effective in the treatment of AML patients ≥70 years old, and can partially improve the prognosis of elderly and high-risk patients.
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Affiliation(s)
- Lan Cao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Zhao-Qing Jiang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Wen-Jie Liu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Qian Sun
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Yu Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Ming Hong
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China E-mail:
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Zhang XC, Fan L, Lu H, Qian SX, Chen LJ, Xu W, Li JY, Qu XY, Zhao XL. [The Risk and Survival Analysis of Multiple Malignancies in Hematologic Malignancy Patients: A Single Chinese Center Retrospective Study, 2009 through 2017]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2023; 31:389-395. [PMID: 37096510 DOI: 10.19746/j.cnki.issn.1009-2137.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
OBJECTIVE To explore the risk and location of multiple malignancies in patients with hematologic malignancies who were followed up for 9 years in Jiangsu Province Hospital and to evaluate the impact of the second primary malignancy on survival of patients. METHODS The incidence and survival of multiple malignancies in 7 921 patients with hematologic malignancies from 2009 to 2017 were analyzed retrospectively. RESULTS A total of 180 (2.3%, 180/7 921) patients developed second malignancy, of whom 58 patients were diagnosed with hematologic malignancies as the first primary malignancy, and 98 patients developed hematologic malignancies as second primary malignancy, and the other 24 cases were diagnosed with the second malignancy within 6 months after the first primary malignancy was diagnosed, which was difined as multiple malignancies occurring simultaneously. In 180 patients, 18 cases developed two hematologic malignancies successively, and 11 patients developed more than 3 primary cancers (among them, 2 female patients were diagnosed with 4 primary cancers). Patients with lymphoma and multiple myeloma (MM) as the second primary malignancy had poorer survival than patients with lymphoma and MM as the first primary malignancy. Patients with chronic myeloid leukemia as the second primary malignancy were also associated with inferior overall survival. CONCLUSION In this study, 2.3% of hematologic malignancy patients had multiple mali-gnancies, lymphoma and MM as the second primary malignancy had poor survival.
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Affiliation(s)
- Xu-Chang Zhang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China,Department of Geriatric, Guangdong Longgang District People's Hospital of Shenzhen, The Second Affiliated Hospital, School of Medicine, The Chinese University of Hong Kong, Shenzhen 518172, Guangdong Province, China
| | - Lei Fan
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Hua Lu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Li-Juan Chen
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Wei Xu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Xiao-Yan Qu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China,E-mail:
| | - Xiao-Li Zhao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China,E-mail:
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Li F, Liu YP, Zhu H, Hong M, Qian SX, Zhu Y, Shen WY, Chen LJ, He GS, Wu HX, Lu H, Li JY, Miao KR. [Clinical study of induction chemotherapy followed by allogeneic hematopoietic stem cell transplantation in the treatment of FLT3-ITD(+) acute myeloid leukemia with normal karyotype]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:230-235. [PMID: 37356985 DOI: 10.3760/cma.j.issn.0253-2727.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Objective: To assess the efficacy of induction chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of FLT3-ITD(+) acute myeloid leukemia (AML) with normal karyotype. Methods: The clinical data of FLT3-ITD(+) AML patients with normal karyotype in the First Affiliated Hospital of Nanjing Medical University from Jan 2018 to March 2021 were retrospectively analyzed. Results: The study included 49 patients with FLT3-ITD(+)AML, 31 males, and 18 females, with a median age of 46 (16-59) years old. All patients received induction chemotherapy, and 24 patients received sequential allo-HSCT (transplantation group) . The median follow-up time was 465 days, the one-year overall survival (OS) from diagnosis was (70.0 ± 7.4) %, and one-year disease-free survival (DFS) was (70.3±7.4) %. The one-year OS was significantly different between the transplantation group and the non-transplantation group [ (85.2 ± 7.9) % vs (52.6 ± 12.3) %, P=0.049]. but one-year DFS [ (84.7 ± 8.1) % vs (55.2 ± 11.9) %, P=0.061] was not. No significance was found in one-year OS between patients with low-frequency and high-frequency FLT3-ITD(+) (P>0.05) . There were 12 patients with high-frequency FLT3-ITD(+) in the transplantation and the non-transplantation groups, respectively. The one-year OS [ (68.8 ± 15.7) % in the transplantation group vs (26.2 ± 15.3) % in the non-transplantation group, P=0.027] and one-year DFS [ (45.5 ± 21.3) % in the transplantation group vs (27.8±15.8) % in the non-transplantation group, P=0.032] were significantly different between the two groups. Conclusion: Induction chemotherapy followed by allo-HSCT can enhance the prognosis of FLT3-ITD(+) patients, particularly those with FLT3-ITD high-frequency mutation.
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Affiliation(s)
- F Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Y P Liu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - M Hong
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - S X Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Y Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - W Y Shen
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - L J Chen
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - G S He
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H X Wu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H Lu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - J Y Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - K R Miao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Qin W, Cai XH, Han WM, Lu XZ, Chen MY, Jia ZX, Liu J, Xiao R, Qian SX. [The role and mechanism of lncRNA C9ORF139 targeting miR-24-3P/TAOK1 in regulating the proliferation of acute myeloid leukemia cells]. Zhonghua Yi Xue Za Zhi 2022; 102:576-583. [PMID: 35196780 DOI: 10.3760/cma.j.cn112137-20210703-01501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To investigate the role and mechanism of long non-coding RNA (lncRNA) C9ORF139 targeting micro RNA(miR)-24-3P/TAOK1 in regulating the proliferation of acute myeloid leukemia (AML) cells. Methods: AML cells HL-60 and THP-1 were purchased from the Chinese Academy of Sciences and divided into 4 groups:group A was negative control group (siNC group), group B was interference C9ORF139 group (siC9ORF139 group), group C was siC9ORF139+miR-24-3p inhibitor group, and group D was miR-24-3P+TAOK1 overexpression group (oe-TAOK1 group). Real-time fluorescence quantitative reverse transcription PCR was used to detect the expression levels of AML cell lines of HL-60 and THP-1 in four groups. Cell Counting Kit-8 assay was performed to measure cell proliferation. Flow cytometry was applied to analyze cell apoptosis. Transwell test was applied to detect cell migration and invasion ability. Western blot was used to detect p-serine/threonine kinase (p-raf) and p-mitogen activation proteinkinase (p-MEK), p-extracellular regulatory protein kinase (p-ERK) expression. The luciferase reporter gene plasmid was constructed to verify the binding ability of C9ORF139,miR-24-3P and TAOK1.Nude mice were inoculated with subcutaneous tumor cells of HL-60 (group A) and HL-60 (group B). Results: After the C9ORF139 gene was knocked down and cultured for 120 h, The cell proliferation ability (0.62±0.02, 0.82±0.02), migration ability (0.22±0.03, 0.05±0.01), invasion ability (0.20±0.02, 0.13±0.03) of group B were all lower than that of group A (1.30±0.02, 1.83±0.07; 0.99±0.02, 0.99±0.02; 1.00±0.01, 1.00±0.01) (all P<0.05). When co-transfected with miR-24-3 inhibitor, cell proliferation ability, migration ability and invasion ability were all higher in group B (all P<0.05). When co-transfected with miR-24-3P and oe-TAOK1 plasmid, cell proliferation ability, migration ability and invasion ability were all higher than group B (all P<0.05).When the C9ORF139 gene in the cells was knocked down, the apoptosis level of group B (28.56±8.07, 17.74±1.91) were higher than those of group A (0.31±0.27, 2.49±0.33)(all P<0.05); when co-transfected with miR-24-3P inhibitor, the apoptosis level (2.34±0.09, 3.06±0.06) were lower than those in group B (all P<0.05); when co-transfected with miR-24-3P and oe-TAOK1 in the plasmid group, the apoptosis level (2.16±1.29, 4.80±0.37) were also lower than those of group B (all P<0.05). In HL-60 and THP-1 cells, when C9ORF139 was not mutated, the luciferase activity of miR-24-3P group was lower than that of the miR-NC group (P<0.05). When the binding site with miR-24-3p in C9ORF139 sequence was mutated, the luciferase activity in miR-24-3p group was equivalent to that in miR-NC group (P>0.05).When TAOK1 was not mutated; the luciferase activity of miR-24-3P group was lower than that of group A (P<0.05). When the binding site with miR-24-3p in TAOK1 sequence was mutated, the luciferase activity in miR-24-3p group was equivalent to that in miR-NC group (P>0.05).When the C9ORF139 gene in HL-60 cells was knocked down and cultured for 72 h, the phosphorylation expression levels of Raf, MEK and ERK molecules in group B were significantly lower than those in group A (all P<0.05). By day 14, the tumor volume in the group A was greater than the tumor cell volume in the group B [(284.49±57.61) vs (125.70±18.64) mm3, P=0.017]. The tumor weight of HL-60 in group A was heavier than that of group B [(847.80±159.36) vs (408.40±113.16) mg, P=0.001]. Conclusions: LncRNA C9ORF139 regulates TAOK1 by sponging miR-24-3P to promote the proliferation, invasion and migration of acute myeloid leukemiacell.In vivo experiments have confirmed that the expression of C9ORF139 can promote the growth of subcutaneous tumors in AML nude mice.
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Affiliation(s)
- W Qin
- Department of Hematology, the Affiliated Changzhou 2nd People's Hospital of Nanjing Medical University, Changzhou 213000, China
| | - X H Cai
- Department of Hematology, the Affiliated Changzhou 2nd People's Hospital of Nanjing Medical University, Changzhou 213000, China
| | - W M Han
- Department of Hematology, the Affiliated Changzhou 2nd People's Hospital of Nanjing Medical University, Changzhou 213000, China
| | - X Z Lu
- Department of Hematology, the Affiliated Changzhou 2nd People's Hospital of Nanjing Medical University, Changzhou 213000, China
| | - M Y Chen
- Department of Hematology, the Affiliated Changzhou 2nd People's Hospital of Nanjing Medical University, Changzhou 213000, China
| | - Z X Jia
- Department of Hematology, the Affiliated Changzhou 2nd People's Hospital of Nanjing Medical University, Changzhou 213000, China
| | - J Liu
- Department of Hematology, the Affiliated Changzhou 2nd People's Hospital of Nanjing Medical University, Changzhou 213000, China
| | - R Xiao
- Department of Hematology, the Affiliated Changzhou 2nd People's Hospital of Nanjing Medical University, Changzhou 213000, China
| | - S X Qian
- Department of Hematology, Jiangsu Provincial People's Hospital, Nanjing 210029, China
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Liu L, Chen X, Jin HM, Zhao SS, Zhu Y, Qian SX, Wu YJ. [The Expression and Function of NK Cells in Patients with Acute Myeloid Leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2022; 30:49-55. [PMID: 35123603 DOI: 10.19746/j.cnki.issn.1009-2137.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the expression characteristics of antigens and functional markers of natural killer (NK) cells in patients with acute myeloid leukemia (AML). METHODS Multi-parameter flow cytometry was used to detect NK cell surface markers and their functional indicators in 56 newly diagnosed AML patients and 24 healthy controls, including activating receptors NKG2D, NKP46, DNAM-1, and killing indicators granzyme B, perforin. RESULTS Referring to the WHO hematopoiesis and lymph tissue tumor classification criteria, 56 cases were roughly divided into three types: AML M1, M2, and M4/M5. However, there was no differences about NK cells among the three types, so it was no longer subdivided. NK cells were divided into two groups: CD3-CD56hiCD16- (CD56hiNK) and CD3-CD56dimCD16+ (CD56dimNK). Compared with CD56dimNK cell population, except for NKP46, the positive expression levels of NKG2D and other receptors of CD56hiNK cells in AML patients decreased (P<0.001). Compared with healthy controls, the proportion of CD56hiNK cells in AML patients increased, while the number and proportion of NK cells and proportion of CD56dimNK cells significantly decreased (P<0.05). The proportion of perforin in CD56hiNK cells significantly increased (P<0.05). The expression of DNAM-1 in CD56hiNK cells, NKG2D, DNAM-1, and perforin in CD56dimNK cells decreased significantly (P<0.05). There was no statistically significant difference in expression of other functional indexes in AML patients compared with corresponding indexes of healthy controls. In addition, the proportion of CD56hiNK cells was positively correlated with the expression of CD34+ in AML (r=0.303). CONCLUSION Compared with CD56dimNK, the ratio of CD56hiNK and the expression of functional markers in AML patients are lower. Compared with healthy controls, the number and expression ratio of NK cells in AML patients decrease and the expression of functional markers is abnormal, indicating that its function is impaired.
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Affiliation(s)
- Lu Liu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Xiao Chen
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Hui-Min Jin
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Si-Shu Zhao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Yi Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
| | - Yu-Jie Wu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China,E-mail:
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Zhao XL, Hong M, Qiao C, Sun Q, Zhu H, Wang S, Li JY, Qian SX, Zhu Y. [A Retrospective Analysis of TKI Discontinuation in Patients with CML]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2021; 29:1746-1751. [PMID: 34893104 DOI: 10.19746/j.cnki.issn.1009-2137.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the clinical characteristics of the patients with chronic myeloid leukemia (CML) discontinued tyrosine kinase inhibitors (TKI) therapy and the outcome of the patients. METHODS 35 cases of CML patients experienced initiative discontinuation of TKI therapy in our hospital from June 1st 2015 to December 31th 2019 were retrospectively analyzed. The TFR of the patients and the factors affecting it were analyzed. RESULTS The median duration of TKI administration was 72 (range 35-173) months in the 35 patients. Among these patients, 8 had experienced TKI dose reduction or suspension. All the enrolled patients have achieved at least MMR. The median time for these patients achieving MMR was 15 (range 3-75) months after administration of TKI, and for MMR maintenance before TKI suspension was 55 (range 13-164) months. After TKI withdrawal the median follow up time was 20.3 (range 3-57.9) months, 22 out of 35 patients kept TFR, among them, 2 (5.71%) patients restarted TKI after 12 month suspension, and maintained MMR during suspension. 13 (37.1%)patients lost MMR, among them, 9 patients restarted TKI treatment, and 5 of them achieved MR4.0 after the median duration of 3(2-5) month. No patients were found to have disease progression. The estimated TFR rate was 57.8% and 51.8% at 12 and 24 months after discontinuation, respectively. Other clinical characteristic related to relapse were also analyzed, including the cumulative TKI administration duration, cumulative MMR duration, time to achieve MMR, median age at diagnosis, risk stratification by Sokal score, TKI dose reduction and discontinuation history, and second-generation TKI administration before stopping TKI, however, no statistical difference was found. CONCLUSION TKI discontinuation is practical for CML patients in our center.
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Affiliation(s)
- Xiao-Li Zhao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Ming Hong
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Chun Qiao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Qian Sun
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Han Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Shuai Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Yu Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China,E-mail:
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Qin W, Qian SX, Cai XH, Lu XZ, Chao HY. [Analysis of the Differential Expression of circRNA in Acute Myeloid Leukemia by GEO Database]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2021; 29:1719-1726. [PMID: 34893100 DOI: 10.19746/j.cnki.issn.1009-2137.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the difference expression of circular RNA (circRNA) in acute myeloid leukemia (AML) by using bioinformatics method. METHODS The microarray chip data of AML was searched and downloaded from the Gene Expression Omnibus (GEO) of the National Center for Bioinformatics (NCBI). The differences between AML samples and control samples were analyzed by R software. The interaction between deregulated circRNA, miRNA and mRNA were predicted by miranda software and miRTarBase software. The circRNA-miRNA-mRNA regulatory network was constructed by using the cytoHubba plugin based on the Cytoscape software. RESULTS A total of 203 differential expression of circRNAs were finally collected, including down-regulated 161 circRNAs and up-regulated 42 circRNAs. CircRNA/miRNA/mRNA interaction network was constructed through software prediction. hsa_circ_0001080, hsa_circ_0004511, hsa_circ_0054211, hsa_circ_0001944 may be positively regulated the gene expression in AML. CONCLUSION Abnormal expression of circRNA in AML may become a new target for AML treatment.
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Affiliation(s)
- Wei Qin
- Department of Hematology, The Affiliated Changzhou NO.2 People's Hospital Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Si-Xuan Qian
- Department of Hematology, Jiangsu Provincial People's Hospital (The First Affiliated Hospital of Nanjing Medical University), Nanjing 210029, Jiangsu Province, China,E-mail:
| | - Xiao-Hui Cai
- Department of Hematology, The Affiliated Changzhou NO.2 People's Hospital Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Xu-Zhang Lu
- Department of Hematology, The Affiliated Changzhou NO.2 People's Hospital Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Hong-Ying Chao
- Department of Hematology, The Affiliated Changzhou NO.2 People's Hospital Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
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Huang XL, Wu SH, Shi PF, Xu LH, Chen C, Xie YP, Gao DQ, Chen K, Tan JF, Liu LR, Xu Y, Yang F, Yu MX, Wang SY, Qian SX. [Active screening of intestinal carbapenem-resistant Enterobacteriaceae in high-risk patients admitted to the hematology wards and its effect evaluation]. Zhonghua Xue Ye Xue Za Zhi 2021; 41:932-936. [PMID: 33333697 PMCID: PMC7767815 DOI: 10.3760/cma.j.issn.0253-2727.2020.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
目的 观察血液科肠道碳青霉烯类耐药的肠杆菌科细菌(CRE)主动筛查患者CRE定植、感染的特征,并评价主动筛查结合加强干预在血液科患者CRE感染预防控制中的效果。 方法 以2017年3月至2019年12月血液内科接受化疗或免疫抑制治疗且预期会出现粒细胞缺乏(粒缺)的患者为研究对象,进行至少3个时间点(治疗前、治疗后粒缺期、粒缺伴发热期)的肠道CRE筛查,以2016年12月至2017年2月血液内科未开展肠道CRE主动筛查的、接受化疗或免疫抑制治疗的115例患者为历史对照组,两组患者均进行CRE感染实时监测,CRE筛查阳性者均采取接触隔离措施,CRE筛查阳性者出现发热或者感染症状时启动针对CRE联合抗生素治疗。 结果 主动筛查患者CRE定植率为16.46%(66/401);病种分布上,以急性白血病定植率最高,为23.03%(26/113)。66例筛查阳性患者中,其中第1次筛查阳性患者为27例,占40.9%(27/66),第2次筛查阳性患者为15例,占22.7%(15/66),第3次及以后筛查阳性患者为24例,占36.4%(24/66)。CRE定植病原菌中耐碳青霉烯类肺炎克雷伯菌(CRKP)最多,占54.55%(36/66)。主动筛查患者CRE感染率(2.49%)及死亡率(50.00%)低于历史对照组的11.30%及69.23%;干预期间10例CRE血流感染患者病原菌种类与前期主动筛查病原菌完全相同,符合率为100.0%。 结论 血液科病房急性白血病患者CRE定植率最高,CRKP是CRE定植、感染的主要病原菌,提高筛查频率可以显著提高筛查阳性率,采取主动筛查并及早干预能有效降低血液科患者CRE发生率及死亡率,CRE筛查阳性病原菌与后续CRE感染病原菌符合率高。恶性血液病患者肠道CRE筛查可以对后期CRE血流感染起到预警以及优化抗菌药物使用的作用。
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Affiliation(s)
- X L Huang
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - S H Wu
- Department of Microbiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - P F Shi
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - L H Xu
- Department of Microbiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - C Chen
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - Y P Xie
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - D Q Gao
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - K Chen
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - J F Tan
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - L R Liu
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - Y Xu
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - F Yang
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - M X Yu
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - S Y Wang
- Department of Hospital Infection Prevention and Control, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
| | - S X Qian
- Department of Hematology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang 310006, China
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Chen SS, Sun Q, Cao L, Wu WZ, Xie Y, Qiao C, Li JY, Qian SX, Hong M. Efficacy and safety of decitabine combined with low-dose cytarabine, aclarubicin, and granulocyte colony-stimulating factor compared with standard therapy in acute myeloid leukemia patients with TP53 mutation. Chin Med J (Engl) 2020; 134:1477-1479. [PMID: 33323826 PMCID: PMC8213253 DOI: 10.1097/cm9.0000000000001316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Si-Si Chen
- Department of Hematology,The Affiliated Yixing Hospital of Jiangsu University, Wuxi, Jiangsu 214200, China
| | - Qian Sun
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, Jiangsu 210029, China
- Pukou CLL Center, Pukou division of Jiangsu Province Hospital, Nanjing, Jiangsu 211899, China
| | - Lan Cao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, Jiangsu 210029, China
- Pukou CLL Center, Pukou division of Jiangsu Province Hospital, Nanjing, Jiangsu 211899, China
| | - Wen-Zhong Wu
- Department of Hematology,The Affiliated Yixing Hospital of Jiangsu University, Wuxi, Jiangsu 214200, China
| | - Yue Xie
- Department of Hematology,The Affiliated Yixing Hospital of Jiangsu University, Wuxi, Jiangsu 214200, China
| | - Chun Qiao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, Jiangsu 210029, China
- Pukou CLL Center, Pukou division of Jiangsu Province Hospital, Nanjing, Jiangsu 211899, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, Jiangsu 210029, China
- Pukou CLL Center, Pukou division of Jiangsu Province Hospital, Nanjing, Jiangsu 211899, China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, Jiangsu 210029, China
- Pukou CLL Center, Pukou division of Jiangsu Province Hospital, Nanjing, Jiangsu 211899, China
| | - Ming Hong
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing, Jiangsu 210029, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, Jiangsu 210029, China
- Pukou CLL Center, Pukou division of Jiangsu Province Hospital, Nanjing, Jiangsu 211899, China
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Hong M, Zhu H, Sun Q, Zhu Y, Miao Y, Yang H, Qiu HR, Li JY, Qian SX. Decitabine in combination with low-dose cytarabine, aclarubicin and G-CSF tends to improve prognosis in elderly patients with high-risk AML. Aging (Albany NY) 2020; 12:5792-5811. [PMID: 32238611 PMCID: PMC7185116 DOI: 10.18632/aging.102973] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 03/19/2020] [Indexed: 04/17/2023]
Abstract
We evaluated the risk status and survival outcomes of 125 elderly acute myeloid leukemia (AML) patients treated with decitabine in combination with low-dose cytarabine, aclarubicin, and G-CSF (D-CAG). The risk status was evaluated by determining the frequency of recurring gene mutations using next-generation sequencing (NGS) analysis of 23 selected genes and cytogenetic profiling of bone marrow samples at diagnosis. After a median follow-up of 12 months (range: 2-82 months), 86 patients (68.8%) had achieved complete remission after one cycle of induction, and 94 patients (75.2%) had achieved it after two cycles. The median overall survival (OS) and disease-free survival (DFS) were 16 and 12 months, respectively. In 21 AML patients aged above 75 years, the median OS and DFS were longer in the low- and intermediate-risk group than the high-risk group, but the differences were not statistically significant. The median OS and DFS were similar in patients with or without TET2, DNMT3A, IDH2, TP53 and FLT3 mutations. Multivariate analysis showed that patient age above 75 years, high-risk status, and genetic anomalies, like deletions in chromosomes 5 and/or 7, were significant variables in predicting OS. D-CAG regimen tends to improve the prognosis of a subgroup of elderly patients with high-risk AML.
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Affiliation(s)
- Ming Hong
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- The Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu Province, China
| | - Han Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- The Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu Province, China
| | - Qian Sun
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- The Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu Province, China
| | - Yu Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- The Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu Province, China
| | - Yi Miao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- The Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu Province, China
| | - Hui Yang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- The Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu Province, China
| | - Hai-Rong Qiu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- The Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu Province, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- The Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu Province, China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu Province, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
- The Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu Province, China
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11
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Guo M, Chao NJ, Li JY, Rizzieri DA, Sun QY, Mohrbacher A, Krakow EF, Sun WJ, Shen XL, Zhan XR, Wu DP, Liu L, Wang J, Zhou M, Yang LH, Bao YY, Dong Z, Cai B, Hu KX, Yu CL, Qiao JH, Zuo HL, Huang YJ, Sung AD, Qiao JX, Liu ZQ, Liu TQ, Yao B, Zhao HX, Qian SX, Liu WW, Forés R, Duarte RF, Ai HS. HLA-Mismatched Microtransplant in Older Patients Newly Diagnosed With Acute Myeloid Leukemia: Results From the Microtransplantation Interest Group. JAMA Oncol 2019; 4:54-62. [PMID: 28910431 DOI: 10.1001/jamaoncol.2017.2656] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Importance The outcome of older patients with acute myeloid leukemia (AML) remains unsatisfactory. Recent studies have shown that HLA-mismatched microtransplant could improve outcomes in such patients. Objective To evaluate outcomes in different age groups among older patients with newly diagnosed AML who receive HLA-mismatched microtransplant. Design, Setting, and Participants This multicenter clinical study included 185 patients with de novo AML at 12 centers in China, the United States, and Spain in the Microtransplantation Interest Group. Patients were divided into the following 4 age groups: 60 to 64 years, 65 to 69 years, 70 to 74 years, and 75 to 85 years. The study period was May 1, 2006, to July 31, 2015. Exposures Induction chemotherapy and postremission therapy with cytarabine hydrochloride with or without anthracycline, followed by highly HLA-mismatched related or fully mismatched unrelated donor cell infusion. No graft-vs-host disease prophylaxis was used. Main Outcomes and Measures The primary end point of the study was to evaluate the complete remission rates, leukemia-free survival, and overall survival in different age groups. Additional end points of the study included hematopoietic recovery, graft-vs-host disease, relapse rate, nonrelapse mortality, and other treatment-related toxicities. Results Among 185 patients, the median age was 67 years (range, 60-85 years), and 75 (40.5%) were female. The denominators in adjusted percentages in overall survival, leukemia-free survival, relapse, and nonrelapse mortality are not the sample proportions of observations. The overall complete remission rate was not significantly different among the 4 age groups (75.4% [52 of 69], 70.2% [33 of 47], 79.1% [34 of 43], and 73.1% [19 of 26). The 1-year overall survival rates were 87.7%, 85.8%, and 77.8% in the first 3 age groups, which were much higher than the rate in the fourth age group (51.7%) (P = .004, P = .008, and P = .04, respectively). The 2-year overall survival rates were 63.7% and 66.8% in the first 2 age groups, which were higher than the rates in the last 2 age groups (34.2% and 14.8%) (P = .02, P = .03, P < .001, and P < .001, respectively). The 1-year cumulative incidences of nonrelapse mortality were 10.2%, 0%, 3.4%, and 26.0% in the 4 age groups and 8.1% in all patients. The median times to neutrophil and platelet recovery were 12 days and 14 days after induction chemotherapy, respectively. Five patients had full or mixed donor engraftment, and 30.8% (8 of 26) of patients demonstrated donor microchimerism. Two patients (1.1%) developed severe acute graft-vs-host disease. Conclusions and Relevance Microtransplant achieved a high complete remission rate in AML patients aged 60 to 85 years and higher 1-year overall survival in those aged 60 to 74 years.
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Affiliation(s)
- Mei Guo
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Nelson J Chao
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Duke Cancer Institute, Durham, North Carolina
| | - Jian-Yong Li
- Department of Hematology, Jiangsu Province People's Hospital, Nanjing, China
| | - David A Rizzieri
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Duke Cancer Institute, Durham, North Carolina
| | - Qi-Yun Sun
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Ann Mohrbacher
- Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases, Keck School of Medicine of University of Southern California, Los Angeles
| | - Elizabeth F Krakow
- Division of Medical Oncology, University of Washington, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle
| | - Wan-Jun Sun
- Department of Hematology, The Second Artillery General Hospital, Beijing, China
| | - Xu-Liang Shen
- Department of Hematology, He Ping Central Hospital of the Changzhi Medical College, Changzhi, China
| | - Xin-Rong Zhan
- Department of Hematology, Central Hospital of Xinxiang City, Xinxiang, China
| | - De-Pei Wu
- Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Li Liu
- Department of Hematology, The Fourth Military Medical University, Xi'an, China
| | - Juan Wang
- Department of Hematology, Central Hospital of Cangzhou City, Cangzhou, China
| | - Min Zhou
- Department of Hematology, The Second People's Hospital of Changzhou City, Changzhou, China
| | - Lin-Hua Yang
- Department of Hematology, The Second Affiliated Hospital of Shanxi University, Taiyuan, China
| | - Yang-Yi Bao
- Department of Hematology, Central Hospital of Hefei City, Hefei, China
| | - Zheng Dong
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Bo Cai
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Kai-Xun Hu
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Chang-Lin Yu
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Jian-Hui Qiao
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Hong-Li Zuo
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Ya-Jing Huang
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Anthony D Sung
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Duke Cancer Institute, Durham, North Carolina
| | - Jun-Xiao Qiao
- Department of Hematology, The Second Artillery General Hospital, Beijing, China
| | - Zhi-Qing Liu
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Tie-Qiang Liu
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Bo Yao
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
| | - Hong-Xia Zhao
- Department of Hematology, The Second Artillery General Hospital, Beijing, China
| | - Si-Xuan Qian
- Department of Hematology, Jiangsu Province People's Hospital, Nanjing, China
| | - Wei-Wei Liu
- Statistics Department, The Academy of Military Medical Sciences, Beijing, China
| | - Rafael Forés
- Department of Hematology, Hospital Universitario Puerta de Hierro, Majadahonda, Comunidad de Madrid, Spain
| | - Rafael F Duarte
- Department of Hematology, Hospital Universitario Puerta de Hierro, Majadahonda, Comunidad de Madrid, Spain
| | - Hui-Sheng Ai
- Department of Hematology and Transplantation, Affiliated Hospital of The Academy of Military Medical Sciences, Beijing, China
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Affiliation(s)
- R Yang
- Hangzhou Hospital Affiliated to Nanjing Medical University, Hangzhou 310006, China
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Qian SX, Gu JX, Guan QB, Zhang XL, Wang YP. Serum oxidative stress, inflammatory response and platelet activation in patients with vascular vertigo. J BIOL REG HOMEOS AG 2019; 33:499-504. [PMID: 30945512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of this study was to investigate the correlation and clinical significance of oxidative stress and inflammatory response in vascular vertigo (VV). The subjects were divided into three groups: vascular vertigo (group A), non-vascular vertigo (group B) and controls (group C). The serum levels of IL-6 (interleukins-6), SOD (superoxide dismutase), MDA (malondialdehyde) and TNF-α (tumor necrosis factor-α) and CD62P (also called P-Selectin) activation rates were determined and compared among the three groups. The levels of IL-6, TNF-α, MDA and CD62P in group A were significantly higher than those of group B and group C (P less than 0.05). The SOD level of group A was lower than that of group B and group C (P less than 0.05). There was no significant difference between groups B and C in IL-6, TNF- αMDA, SOD and CD62P (P>0.05). In patients with vascular vertigo, TNF-α levels had a weak linear correlation with those of low-density lipoprotein (P = 0.025, r = 0.312). There was no linear correlation between TNF-α and SOD in patients with VV and non-VV. The occurrence of inflammatory reaction and oxidative stress may cause abnormal lipid metabolism in the body and promote the occurrence of VV, and platelet activation may be involved in its formation.
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Affiliation(s)
- S X Qian
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, China
| | - J X Gu
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, China
| | - Q B Guan
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, China
| | - X L Zhang
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, China
| | - Y P Wang
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, China
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Wang Y, Qiao C, Guo R, Wang H, Yang H, Qiu HR, Wu YJ, Zhang JF, Wang R, Qian SX, Li JY. [Analysis of Clinical and Laboratory Features of Patients with Acute Myeloid Leukemia(AML)-M1/M2 with Cuplike Nuclei Morphology]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2018; 26:958-963. [PMID: 30111391 DOI: 10.7534/j.issn.1009-2137.2018.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze the clinical and laboratory features of acute myeloid leukemia (AML) with cuplike nuclei morphology. METHODS One hundred and seventy patients diagnosed with AML (M1andM2) between December 2009 and December 2016 were included in the study. Bone marrow smears were prepared for morphologic alanalysis, the immunophenotype was analyzed by flow cytometry and the RHG-banding was for conventional cytogenetic assay (CCA) ,gene mutation was detected by sequencing. RESULTS Among the 170 AMLpatients, 67 were diagnosed as M1 and 103 patients was diagnosed as M2, 43 patients(25.3%) defined as cuplike nuclei-positive, among them 38patients (88.4%) were M1 while only 5 patients (11.6%) were with M2(P<0.01). No significant value about sex(P> 0.05) between cuplike nuclei-positive and -negative group, while older patients were found in cuplike nuclei-positive group (P<0.05). Higher peroxydas (POX) ratio (P<0.05) and integration (P<0.05) were found in cuplike nuclei- positive group. Furthermore, the patients with cuplike nuclei-positive lack the expressions of CD34 (P<0.01) and HLA-DR(P<0.01) while no other immunophenotype markers were found. Among the 152 patients (89.4%) for genetic analysis ,83.8% karyotype of the cuplike nuclei-positive group were normal while only 54.8 of negative group was normal by CCA. Molecular biology analysis showed that the patients in cuplike nuclei-positive group have significantly highe rNMP1 (P<0.01) and FLT3(P<0.01) mutations as compared with the negative group. Furthermore, the relationship of the ratio o fcuplike nuclei and the type of gene mutations were investigated, and no significant associations were found. However, it was found that the patients with FLT3 mutation displayed more biological nuclear invagination than the patients with NPM1 mutations (P<0/01). CONCLUSION AML patients with positive cuplike nuclei have characteristic morphological changes, typical immunophenotype with HLA-DR- and CD34-, normal karyotype accompanied by NPM1 and FLT3 mutations.
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Affiliation(s)
- Yan Wang
- Department of Hematology,The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029,Jiangsu Province,China
| | - Chun Qiao
- Department of Hematology,The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029,Jiangsu Province,China
| | - Rui Guo
- Department of Hematology,The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029,Jiangsu Province,China
| | - Hui Wang
- Department of Hematology,The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029,Jiangsu Province,China
| | - Hui Yang
- Department of Hematology,The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029,Jiangsu Province,China
| | - Hai-Rong Qiu
- Department of Hematology,The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029,Jiangsu Province,China
| | - Yu-Jie Wu
- Department of Hematology,The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029,Jiangsu Province,China
| | - Jian-Fu Zhang
- Department of Hematology,The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029,Jiangsu Province,China
| | - Rong Wang
- Department of Hematology,The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029,Jiangsu Province,China SupervisingTechnician. E-mail:
| | - Si-Xuan Qian
- Department of Hematology,The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029,Jiangsu Province,China
| | - Jian-Yong Li
- Department of Hematology,The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029,Jiangsu Province,China.E-mail:
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Lu L, Qiao C, Hong M, Li YR, Pan LQ, Qian SX, Zhu Y, Li JY. [Mean Corpuscular Volume Can Be A Predictor for Therapeutic Response of Patients with Chronic Myeloid Leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2018; 26:382-388. [PMID: 29665902 DOI: 10.7534/j.issn.1009-2137.2018.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The past studies found that the treatment of chronic myeloid leukemia (CML) with imatinib can induce the macrocytic anemia, moreover the incidence of anemia increases along with enhancement of imatinib concentration. This study was aimed to evaluate the potential relation of erythrocyte mean corpuscular volume (MCV) increase after the treatment with tyrosine kinase inhibitors (TKI) with the therapeutic response in patients with CML-chronic phase (CML-CP). METHODS The clinical and hematologic data including MCV, molecular and cytogenetic response of 119 patients with CML-CP were collected after treatment with TKIs, and the relation of MCV changes after treatment with the clinical characteristics and therapeutic efficacy for patients with CML-CP was analyzed. RESULTS The MCV in patients treated with TKIs for 12 months significantly increased as compared with that at initial diagnosis (P<0.05). The proportion of patients with increased MCV in group of complete cytogenetic response (CCyR) was significantly higher than that in group of non-CCyR (P<0.05). As compared with decreased MCV group, the patients in increased MCV group much more easily achieved CCyR after treatment for 6, 12 months (P<0.05, P<0.05) respectively, furthermore, much more easily maintained MMR (P<0.05). CONCLUSION The MCV as a parameter which is easily acquired may be a new marker for prodecting the therapeutic response of patients treated with TKIs.
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Affiliation(s)
- Luo Lu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China
| | - Chun Qiao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China
| | - Ming Hong
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China
| | - Yan-Ru Li
- Department of Hematology, Qingdao Chengyang People's Hospital, Qingdao 266109, Shandong Province, China
| | - Liang-Qin Pan
- Department of Hematology and Oncology, Peking University Civil Aviation School of Clinical Medicine, Beijing 100025, China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China
| | - Yu Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China. E-mail:
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, China; Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, China. E-mail:
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Xu M, Zhao XL, Zhu Y, Shen WY, Hong M, He GS, Zhu H, Chen YY, Qian SX, Li JY, Qiao C. ND4 mutations are more prevalent in patients with acute myeloid leukemia of M2 morphology. Transl Cancer Res 2018. [DOI: 10.21037/tcr.2018.07.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Yang H, Qiu HR, Wang R, Guo R, Wang Y, Wang H, Wu YJ, Zhang JF, Fan L, Qian SX, Xu W, Li JY. [Distribution of Type 9 T Helper Cells and Expression of Transcriptional Factors in Acute Myeloid Leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2018; 25:1295-1299. [PMID: 29070098 DOI: 10.7534/j.issn.1009-2137.2017.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the distribution of T helper (Th9) cells and its relationship with clinical characteristics of patients with acute myeloid leukemia (AML), and to analyze the activating levels of different transcriptional factors in Th9 cells. METHODS The peripheral blood specimens of 102 AML patients and 83 healthy persons as controls were collected, then the T cells of peripheral blood in AML patients and controls were isolated by using CD3 magnetic beads, the mRNA expression of IL-9 was detected by real-time quantitative PCR, the Th9(CD4+IL-9+) cell levels in diffrent stages and activating level of Th9 coexpression with IL-9 were detected by flow cytometry. RESULTS The mRNA expression of IL-9 in peripheral blood of AML M2 and M3 patients was significantly higher than that in control groups (P<0.01), at same time the CD4+IL-9+ cell rate was significantly higher than that in control group also(P<0.01). The results of dynamically monitoring the distribution of Th9 cells in AML-M2 and M3 patients showed that the Th9 cell rate and the mRNA expression of IL-9 in newly diagnosed M2 and M3, and relapsed M2 groups were significantly higher than those of M2 and M3 in remission (P<0.01); the detection results of IL-9- co-expression with transcriptional factors (SMAD3+, IRF-1+ and IRF-4+) indicated that the percantage of Th9 pSMAD3+ cells in peripheral blood of newly diagnosed and relapsed M2 and M3 patients was significantly higher than that in M2 and M3 patients in remission (P<0.01); on the contrary, the percentage of Th9 IRF-1+ cells in peripheral blood of M2 and M3 patients in remission was significantly higher than that in newly diagnosed M2 and M3 patients (P<0.01). CONCLUSION The distribution of T helper cells in peripheral blood of AML-M2 and M3 patients significantly increases, moreover, correlates with disease status. The prediction of Th9 cell functions should be performed in combination with it transcriptional factors which have inmportant significance for microenvironment of tumors in AML patients.
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Affiliation(s)
- Hui Yang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Hai-Rong Qiu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Rong Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Rui Guo
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Yan Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Hui Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Yu-Jie Wu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Jian-Fu Zhang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Lei Fan
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China. E-mail:
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Wei Xu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing 210029, Jiangsu Province, China
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An N, Xie YP, Xu Y, Shi PF, Qian SX. [The prognostic significance of plasma Epstein-Barr virus DNA in patients with diffuse large B cell lymphoma]. Zhonghua Nei Ke Za Zhi 2017; 56:839-841. [PMID: 29136714 DOI: 10.3760/cma.j.issn.0578-1426.2017.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To retrospectively analyze the prognostic significance of plasma Epstein-Barr virus (EBV) DNA in 122 patients with diffuse large B cell lymphoma (DLBCL). Plasma EBV DNA positivity was related to advanced disease stage (P=0.030), B symptoms (P=0.004) and elevated serum lactic dehydrogenase (LDH) (P=0.001). Furthermore, univariate analysis indicated that plasma EBV DNA level was associated with worse overall survival (OS) (HR=0.223, 95%CI 0.096-0.518, P<0.001) and worse progression free survival (PFS) (HR=4.417, 95%CI 1.911-10.208, P<0.001), whereas multivariate analysis showed plasma EBV DNA as a probable independent prognostic factor of clinical outcome(HR=0.409, 95%CI 0.166-1.008, P=0.052).
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Affiliation(s)
- N An
- Department of Hematology, Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou 310006, China
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Qian SX, Li F, Zhuang JH, Chen Y, Yang HL, Zhou XW, Gu HH, Gao B. [Misdiagnosis and associated costs of benign paroxysmal positional vertigo]. Zhonghua Yi Xue Za Zhi 2017; 97:1057-1060. [PMID: 28395428 DOI: 10.3760/cma.j.issn.0376-2491.2017.14.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: The aims of this study were to investigate the misdiagnosis of benign paroxysmal positional vertigo (BPPV) and to estimate the associated costs. Methods: During October 2015 to December 2015, eighty patients were diagnosed with BPPV in the outpatient dizziness clinic of Shanghai Changzheng Hospital and the clinical data of all the 80 patients were collected including the demographic and clinical characteristics, the history of diagnosis, inappropriate diagnostic tests, costs of the medical tests, transportation and accommodation. All the data were investigated to estimate the misdiagnosis of benign paroxysmal positional vertigo and the associated costs in Shanghai, China. Results: This study showed that the misdiagnosis rate of BPPV was 60.0% (48/80) and the common inappropriate diagnostic tests for BPPV included Cranial CT and MRI test, cervical MRI, cervical and cerebrovascular investigations et al. There was no significant difference between the misdiagnosis patients (48) and patients without misdiagnosis (32) in gender, age, duration of symptom, involved canal and type of BPPV.Complications were significantly more frequent in the misdiagnosis group than for those without[81.3%(39 /48) vs 34.4%(11 /32)]. The estimated costs for each misdiagnosed individual were 8 502.98 China Yuan (CNY) and one-year economic burden associated with the misdiagnosis of BPPV in Shanghai was 13.184 7-78.862 1 million CNY. Conclusions: Our study suggests that the misdiagnosis rate of BPPV is high and the financial impact on patients and society with this disease is huge. The cost-effective Dix-Hallpike or supine roll test maneuver should be used before applying other expensive medical tests in order to minimize misdiagnosis and the waste of health care resources.
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Affiliation(s)
- S X Qian
- Department of Neurology, the Second Affiliated Hospital of Jiaxing College, Jiaxing 314000, China
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Shi PF, Xie YP, Xu Y, Qian SX, Chen K, Gao DQ, Huang XL. [Clinical analysis of 13 patients with EB virus-positive T-cell lymphoproliferative disorders in adults]. Zhonghua Xue Ye Xue Za Zhi 2017; 38:243-246. [PMID: 28395451 PMCID: PMC7348377 DOI: 10.3760/cma.j.issn.0253-2727.2017.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- P F Shi
- Department of Hematology, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou 310006, China
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Hong M, Xia Y, Zhu Y, Zhao HH, Zhu H, Xie Y, Fan L, Wang L, Miao KR, Yu H, Miao YQ, Wu W, Zhu HY, Chen YY, Xu W, Qian SX, Li JY. TP53-induced glycolysis and apoptosis regulator protects from spontaneous apoptosis and predicts poor prognosis in chronic lymphocytic leukemia. Leuk Res 2016; 50:72-77. [PMID: 27693855 DOI: 10.1016/j.leukres.2016.09.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 09/14/2016] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Circulating chronic lymphocytic leukemia (CLL) cells appear not to be overly utilizing aerobic glycolysis. However, recurrent contact with CLL cells in a stromal microenvironment leads to increased aerobic glycolysis and the cells' overall glycolytic capacity, which promotes cell survival and proliferation. TP53-induced glycolysis and apoptosis regulator (TIGAR) has been directly implicated in cellular metabolism in the control of glycolysis. TIGAR inhibits glycolysis and protects cells from intracellular reactive oxygen species (ROS)-associated apoptosis. METHODS TIGAR mRNA expression was investigated by quantitative PCR in 102 newly diagnosed CLL patients. Furthermore, the relationship between the expression of TIGAR and its clinical characteristics and prognosis were investigated. Moreover, we also investigated the correlation between TIGAR expression and apoptosis in primary CLL cells. RESULTS Our data revealed that TIGAR overexpression was correlated with the protection from spontaneous apoptosis in CLL cells, and is strongly associated with advanced Binet stage, unmutated immunoglobulin heavy-chain variable region (IGHV) status, CD38 positivity, β2-microglobulin and p53 aberrations. Higher expression of TIGAR was associated with shorter treatment-free survival (median: three months vs. 51 months, P=0.0108), worse overall survival (median: 74 months vs. not reached, P=0.0242), and the diverse responses to fludarabine-based chemotherapy. TIGAR expression in patients resistant to chemotherapy was significantly higher than in patients sensitive to chemotherapy (mean: 0.3859±0.1710 vs. 0.0974±0.0291, P=0.0290). CONCLUSION Taken together, our findings revealed that high TIGAR expression is closely correlated with worse clinical outcome in CLL patients, and depicted how bioenergetic characteristics could be therapeutically exploited in CLL.
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Affiliation(s)
- Ming Hong
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Yi Xia
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Yu Zhu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Hui-Hui Zhao
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Han Zhu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Yue Xie
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Lei Fan
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Li Wang
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Kou-Rong Miao
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Hui Yu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Yu-Qing Miao
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Wei Wu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Hua-Yuan Zhu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Yao-Yu Chen
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Wei Xu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Si-Xuan Qian
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China.
| | - Jian-Yong Li
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China; Collaborative Innovation Center For Cancer Personalized Medicine, Nanjing Medical University, Nanjing, 210029, China
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Pan LQ, Liu WX, Zhu Y, Hong M, Qiao S, Li JY, Qian SX. [Nilotinib treatment for patients with imatinib-resistant or intolerant chronic myeloid leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2014; 22:1545-1549. [PMID: 25543472 DOI: 10.7534/j.issn.1009-2137.2014.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study was purposed to evaluate the efficacy and safety of nilotinib for treating patients with imatinib-resistant or intolerant chronic myeloid leukemia (CML). A total of 23 patients with imatinib-resistant or intolerant CML were enrolled in this study. These patients received nilotinib orally 600-800 mg every day, their curative efficacy, tolerance and overal survival were evaluated. The results showed that all the patients treated with nilotinib obtained complete hematologic remission (CHR), out of them 82.6% patients achieved complete cytogenetic remission (CCyR) and 56.5% patients achieved complete molecular remission (CMR), their adverse events mostly were mild to moderate, generally were transient and easily cured; the median treatment time with nilotinib was 13.5 (1-44) months, and the median follow-up time was 40 (12-102) months. It is concluded that nilotinib has been confirmed to be effective for patients with imatinib-resistant or intolerant CML, and may be selected as a second generation of tyrosine kinase inhibitor (TKI).
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Affiliation(s)
- Liang-Qin Pan
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Wei-Xin Liu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Yu Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Ming Hong
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Shun Qiao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province People's Hospital, Nanjing 210029, Jiangsu Province, China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province People's Hospital, Nanjing 210029, Jiangsu Province, China. E-mail:
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Qiao C, Sun C, Ouyang Y, Wang JJ, Qian SX, Li JY, Zhang SJ. Clinical importance of different calreticulin gene mutation types in wild-type JAK2 essential thrombocythemia and myelofibrosis patients. Haematologica 2014; 99:e182-4. [PMID: 25015940 DOI: 10.3324/haematol.2014.109199] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Chun Qiao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Chao Sun
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Yuan Ouyang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Ju-Juan Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Su-Jiang Zhang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
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Lu RN, Miao KR, Zhang R, Hong M, Xu J, Zhu Y, Zhu HY, Qu XY, Wang S, Wang L, Fan L, Shen WY, Lu H, Qiu HX, Zhang XY, Chen LJ, Xu W, Li JY, Wu HX, Qian SX. Haploidentical hematopoietic stem cell transplantation following myeloablative conditioning regimens in hematologic diseases with G-CSF-mobilized peripheral blood stem cells grafts without T cell depletion: a single center report of 38 cases. Med Oncol 2014; 31:81. [PMID: 25001087 DOI: 10.1007/s12032-014-0081-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 06/13/2014] [Indexed: 12/11/2022]
Abstract
Many Chinese patients with hematologic diseases, who need allogeneic hematopoietic stem cell transplantation (HSCT), lack a human leukocyte antigen-matched donor. To save these patients and to avoid collecting donor bone marrow graft, we adopted haploidentical peripheral blood HSCT with granulocyte colony stimulating factor (G-CSF) mobilized peripheral blood stem cells as the grafts without ex vivo T cell depletion. Thirty-eight patients were enrolled, and they received myeloablative preconditioning. Thirty-five patients attained a successful neutrophil and platelet recovery. The median time for the neutrophil recovery was 16 days (range of 10-23 days), and the median time for the platelet recovery was 19 days (range of 10-66 days). During the follow-up at a median time of 33.1 weeks (range of 1.1-412.6 weeks), eleven (28.9 %) patients developed aGVHD grade I-II and seven (18.4 %) patients developed aGVHD grade III-IV. The incidence of cGVHD was 27.6 %, and nine (23.7 %) patients died within the first 100 days after transplantation. The cumulative survival proportions at 1 and 2 years were 52.51 ± 8.57 % and 43.76 ± 9.11 %, respectively. These results suggested that the G-CSF-primed peripheral blood stem cell grafts, without in vitro T cell depletion, could be an appropriate stem cell source for Haplo-HSCT.
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Affiliation(s)
- Rui-Nan Lu
- Department of Hematology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
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Hong M, Miao KR, Zhang R, Lu H, Liu P, Xu W, Chen LJ, Zhang SJ, Wu HX, Qiu HX, Li JY, Qian SX. High-dose idarubicin plus busulfan as conditioning regimen to autologous stem cell transplantation: promising post-remission therapy for acute myeloid leukemia in first complete remission? Med Oncol 2014; 31:980. [PMID: 24802329 DOI: 10.1007/s12032-014-0980-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 04/21/2014] [Indexed: 12/01/2022]
Abstract
The optimal post-remission therapy (PRT) for acute myeloid leukemia (AML) remains uncertain. We reported 32 AML patients in first complete remission (CR1) undergoing autologous hematopoietic stem cell transplantation (ASCT) with a characteristic conditioning regimen, termed I-Bu, based on high-dose idarubicin plus busulfan, which considerably strengthened antileukemic activity. Most patients were in better or intermediate-risk group except that cytogenetic or molecular risk information was missing for 18.7 % of the patients. Unpurged peripheral blood stem cells were used in all the cases. The adverse effects were mild and reversible. Only one case of transplant-related mortality was observed. All the patients in this study acquired hematopoietic reconstitution after ASCT. After a median follow-up of 30 (6-119) months, 24 patients (75.0 %) were alive in which 20 (62.5 %) patients were in continuous CR. There were 11 (34.4 %) patients who relapsed after HSCT. Cumulative relapse probability was about 40 % after 24 months. Median OS and DFS have not been reached. Patients in the better and intermediate-risk group had different clinical outcomes, but the differences were not statistically significant. ASCT with I-Bu regimen is possibly promising PRT for better and intermediate-risk AML patients in CR1.
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Affiliation(s)
- Ming Hong
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
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Zhu Y, Qian SX. Clinical efficacy and safety of imatinib in the management of Ph(+) chronic myeloid or acute lymphoblastic leukemia in Chinese patients. Onco Targets Ther 2014; 7:395-404. [PMID: 24623982 PMCID: PMC3949731 DOI: 10.2147/ott.s38846] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Imatinib mesylate is considered the standard first-line systemic treatment for patients with chronic myeloid leukemia (CML) and functions by targeting BCR-ABL tyrosine kinases. Imatinib has substantially changed the clinical management and improved the prognosis of CML and Philadelphia chromosome-positive acute lymphocytic leukemia (Ph+ ALL). Here, we review the pharmacology, mode of action, and pharmacokinetics of imatinib; Chinese efficacy studies in CML and Ph+ ALL; safety and tolerability; patient-focused perspectives, such as quality of life, patient satisfaction, acceptability, and adherence; and uptake of imatinib.
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Affiliation(s)
- Yu Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu Province, People's Republic of China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu Province, People's Republic of China
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Ma LD, Lu XZ, Zhu ZC, Jiang LJ, Zhou M, Qian SX, Li JY. [Effects of matrine on the expression of NKG2D ligands in leukemia cells]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2013; 21:1429-34. [PMID: 24370024 DOI: 10.7534/j.issn.1009-2137.2013.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study was aimed to analyze the expression of NKG2D ligands in human leukemic cells and to investigate the effects of matrine on NKG2D ligand expression. The expressions of NKG2D ligand MICA/B, ULBP1-3 in several human leukemia cell lines (K562, OUN-1, U937 and K562/AO2), as well as primary leukemic cells isolated from malignant leukemia patients were analyzed by flow cytometry. After treatment with different doses of matrine, the expression level of NKG2D ligands in these leukemic cells was detected by FCM. The results indicated that NKG2D ligand expression was detected in both the leukemia cell lines and primary malignant leukemic cells. Generally, the expression of ULBP was high or obviously higher than that of MICA/B in leukemia cell lines and primary leukemic cells. The expression pattern of NKG2D ligands was different among these cells, possibly due to the different types of leukemia. Not all the expression of NKG2D ligands was upregulated after matrine treatment. Much higher expressions of ULBP2 and ULBP3 were found in K562 cells, compared to the other cell lines, which partly contributes to the higher sensitivity of K562 cells to NK cytotoxicity as target cells. It is concluded that there is universal expression of NKG2D ligand in leukemia cells. The high ULBP expression is prevalent in human leukemia cells. Matrine has the potential to induce the expression of NKG2D ligands in leukemia cells.
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Affiliation(s)
- Ling-Di Ma
- Lab Center, Changzhou No.2 People's Hospital, The Affiliated Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China. E-mail:
| | - Xu-Zhang Lu
- Department of Hematology, Changzhou No.2 People's Hospital, The Affiliated Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Zhi-Chao Zhu
- Lab Center, Changzhou No.2 People's Hospital, The Affiliated Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Li-Jia Jiang
- Lab Center, Changzhou No.2 People's Hospital, The Affiliated Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Min Zhou
- Department of Hematology, Changzhou No.2 People's Hospital, The Affiliated Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China. E-mail:
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Zhu Y, Pan LQ, Qian SX, Song P, Yu H, Zhang SJ, Ge Z, Hong M, Tian T, Li JY. [Efficacy of dasatinib in treatment of imatinib-resistant BCR/ABL positive leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2013; 21:581-6. [PMID: 23815902 DOI: 10.7534/j.issn.1009-2137.2013.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study was aimed to evaluate the efficacy and safety of dasatinib in BCR/ABL positive leukemia patients with primary or secondary resistance to imatinib. 27 patients with primary or secondary imatinib-resistant chronic myelogenous leukemia (CML) or Philadelphia chromosome positive acute lymphocytic leukemia (Ph(+) ALL) received 100 - 140 mg/d dasatinib orally. Their overall survival and tolerance were evaluated. The results showed that the median duration of dasatinib therapy was 8 (1-66) months in the 27 imatinib-resistant BCR/ABL positive leukemia cases, with a median follow-up of 54 (3-75) months. After the dasatinib treatment, 88.8% of all the 27 cases achieved complete hematologic response (CHR), 29.6% of them achieved major cytogenetic response (mCyR), 37% of all achieved complete cytogenetic response (CCyR) and 18.5% cases achieved major molecular response (MMR). Patients who received dasatinib in progress of disease (CML-AP, CML-BC and bone marrow relapse Ph(+) ALL) had a lower CCyR rate than those in stable disease (CML-CP and bone marrow remission Ph(+) ALL) (P = 0.0377), and 3 - 4 grade adverse events occurred more frequently in progress of disease than that in stable disease. Overall survival of the patients who achieved CCyR after dasatinib therapy was statistically longer than those who did not achieve CCyR (63 m vs 9 m, P = 0.0126). The most common grade 3 - 4 adverse events during dasatinib therapy including hematology events such as thrombocytopenia (51.8%), neutropenia (48.1%), anemia (33.3%), and non-hematologic events such as pleural effusion (18.5%), pulmonary infection (18.5%), pericardial effusion (11.1%). The 3-4 grade adverse events occurred within 12 months from dasatinib therapy, and were mainly observed in patients with progress of disease. It is concluded that dasatinib is an effective drug in imatinib-resistant BCR/ABL positive leukemia patients, the better curative effect and better tolerance has been observed in patients who received dasatinib in stable disease.
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Affiliation(s)
- Yu Zhu
- Department of Hematology, Jiangsu Province People's Hospital, Nanjing, Jiangsu Province, China
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Liu P, Zhang R, Ge Z, Lin ZK, Liu J, Qian SX, Zhang SJ, Lu H, Wu HX, Qiu HX, Liu P, Xu W, Chen LJ, Lu C, Lu BB, Qiao C, Qiu HR, Zhu GR, Zhang JF, Wu YJ, Li JY. [Detection and clinical features of MLL gene rearrangement in adult patients with acute leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2012; 20:1110-1116. [PMID: 23114129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study was purposed to investigate the incidence of mixed lineage leukemia (MLL) gene rearrangement and partner gene types as well as the clinical features and prognosis of acute leukemia (AL) with this rearrangement through detection in adult AL using combination of 3 techniques, and to evaluate the clinical value of this combination detection. The MLL gene rearrangement in 183 cases of adult AL was detected by combination of conventional cytogenetics, split signal FISH and multiplex nested PCR. The results showed that the incidence of MLL rearrangements in adult patients with AL was low (8.2%), and MLL-AF4 fusion gene was most common and predominant in acute lymphoblastic leukemia (ALL), while the MLL-AF6 and MLL-AF9 were most frequent in acute myeloid leukemia (AML). Extramedullary involvements were found in 40% of MLL-rearranged AL patients, and 33.3% of patients with MLL-rearranged AL reached to complete remission within 30 days during induction chemotherapy. In addition, in this cohort of MLL-rearranged adult AL patients, the 3-month relapse rate and 6-month overall survival rate were 50.0% and 50.0% respectively. It is concluded that the rate of missed diagnosis of CC technique for patients with MLL-rearranged AL reached to 60% in this study, while the combination of CC, FISH and multiplex nested PCR has been confirmed to have important significance for evaluating prognosis and conducting clinical therapy of patients with MLL-rearranged AL.
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Affiliation(s)
- Ping Liu
- Department of Hematology, Nanjing Medical University, Nanjing, Jiangsu Province, China
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Liu P, Ge Z, Lin ZK, Qian SX, Qiao C, Zhang JF, Wu YJ, Qiu HR, Zhu GR, Li JY. [Expression characteristics of isoforms of Ikaros and Helios in patients with leukemia and their mechanism]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2012; 20:812-817. [PMID: 22931634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study was aimed to investigate the expression characteristics of two transcriptional factors in Ikaros family, Ikaros and Helios isoforms and their mechanism, as well as their correlation with clinical parameters, which play important roles in transcriptional regulation of hematopoiesis. Expression of Ikaros and Helios isoforms in a total of 163 patients with leukemia and correlations between Ikaros and Helios isoforms were analyzed by PCR. The results showed that different expression patters of Ikaros and Helios isoforms existed in leukemia patients, that is, Ikaros isoform (Ik-6) was predominantly expressed in acute lymphoblastic leukemia (ALL) with BCR/ABL fusion gene, while Helios isoform (He-i) was overexpressed in T-cell ALL patients. The results of cloning and sequencing demonstrated that the isoforms of Ikaros and Helios had different genetic alterations. The statistical correlation between these two isoforms not was found in this study, although interaction between Ikaros and Helios has been reported. It is concluded that although Ikaros and Helios belong to the same family with similar structure of zinc fingers, their isoforms have different expression profile, specific genetic alterations, and different clinical relevance in patients with leukemia. The connection and interaction between Ik-6 and He-i needs further research.
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Affiliation(s)
- Ping Liu
- Department of Hematology, Nanjing Medical University, Nanjing, Jiangsu Province, China
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Qiao C, Zhang R, Hong M, Wang L, Zhang JF, Wu YJ, Qiu HR, Qiu HX, Qian SX, Lu H, Zhang SJ, Li JY. Heterogeneous leukemic clones identified by NPM1 mutation analysis in patient with acute monocytic leukemia. Leuk Lymphoma 2011; 53:886-90. [PMID: 22035378 DOI: 10.3109/10428194.2011.635860] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
NPM1 mutation is the most common molecular abnormality in patients with acute myeloid leukemia (AML), especially normal karyotype AML (NK-AML), and is associated with a favorable prognosis in the absence of concomitant FLT3-ITD. Like other molecular abnormalities such as FLT3-ITD, C/EBPα and c-Kit mutation, NPM1 mutation normally presents as a recurrent molecular abnormality. The NPM1 mutation is generally used as a molecular marker in the prognosis evaluation of a patient with AML. Here, we report a different case. He was first diagnosed with NPM1 mutation-positive acute monocytic leukemia. However, he achieved no remission, but the NPM1 mutation dramatically became negative after induction chemotherapy. Finally, he achieved complete remission after salvage chemotherapy and the NPM1 mutation was still negative. To our knowledge, this is a rare case according to the worldwide published literature.
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Affiliation(s)
- Chun Qiao
- Department of Hematology, Nanjing Medical University, Nanjing , China
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Wang R, Miao KR, Qiu HR, Qian SX, Hong M, Qiao C, Zhag JF, Fan L, Wu HX, Lu H, Qiu HX, Chen LJ, Zhag SJ, Xu W, Liu P, Li JY. [Comparison of conventional cytogenetics and interphase fluorescence in situ hybridization in diagnosis of acute promyelocytic leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2011; 19:983-986. [PMID: 21867629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The aim of this study was to explore cytogenetic characteristics of acute promyelocytic leukemia (APL) and compare the interphase fluorescence in situ hybridization (I-FISH) with conventional cytogenetic (CC) analysis. A total number of 157 APL patients were recruited in this study, and the I-FISH and CC were applied to analyze cytogenetic features. Chromosome samples of bone marrow cells were prepared by short-term culture. Out of all 157 cases, 136 were observed with CC assay, 66 with I-FISH, of which 45 samples were analyzed with both methods. The results showed that among all 136 CC samples, t(15;17)(q22;q21) was found in 120 cases, of which 107 cases was isolated t(15;17)(q22;q21) abnormality, 13 cases was complex abnormalities and 12 case without mitotic figure. Among all 66 cases of I-FISH group, PMI/RARα fusion gene was found in 64 cases (97.0%), suggesting that I-FISH group was more sensitive than CC group (p = 0.041). It is concluded that combination of I-FISH and CC techniques plays a pivotal role for diagnosis and detection of minimal residual disease in APL.
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Affiliation(s)
- Rong Wang
- Department of Hematology, Nanjing Medical University, Jiangsu Provincial Hospital, Nanjing, Jiangsu Province, China
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33
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Qiao C, Sun C, Zhang SJ, Qian SX, Qian XF, Miao KR, Zhu HY, Hong M, Li JY. [Analysis of DNMT3a gene mutations in acute myelogenous leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2011; 19:303-307. [PMID: 21518476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study was purposed to investigate the mutational status of DNA methyltransferase (DNMT3a) gene and the clinical features of AML patients with DNMT3a mutations. Using PCR combined with directly sequencing, the somatic mutations of DNMT3a involving residue of amino acid 882 were detected in 77 AML patients. Furthermore, the clinical features of these patients were also studied. The results showed that the DNMT3a mutation were detected in 7 out of 59 patients with de novo AML (11.9%), which included 4 patients with DNMT3a R882C, 2 patients with DNMT3a R882H and 1 patient with DNMT3a Y874C. Morphology examination indicated that 2 patients were M(2), 1 patient was M(4) and 4 patients were M(5). Cytogenetic analysis revealed that karyotype in 5 out of 7 patients with DNMT3a mutation were normal. In total of 27 patients with normal karyotype 5 patients (22.7%) were found harboring DNMT3a mutation, while no DNMT3a mutation was found in 21 patients with abnormal karyotype. The mutation rate in patients with positive CEBPA was obviously higher than that in patients with negative CEBPA (p = 0.002). Immunophenotype analysis showed that 4 patients (4/7, 57.1%) with DNMT3a mutation expressed lymphoid antigens including CD4 or/and CD7. There were no statistical significance in age, gender, blast cells of bone marrow, white blood cell and platelet counts, hemoglobin level, ratio of CR, mutations of FLT3-ITD, NPM1 and c-kit between patients with DNMT3a mutation and patients with wild DNMT3a (p > 0.05). It is concluded that the DNMT3a mutations are more prevalent in AML patients with normal karyotype accompanying with positive NPM1 and/or CEBPA mutation, the role of DNMT3a mutation in AML prognosis needs to be further studied.
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Affiliation(s)
- Chun Qiao
- Department of Hematology, Jiangsu Provincial People Hospital, Nanjing, Jiangsu Province, China
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Zhang LJ, Qiu HX, Li JY, Xu J, Wang LL, Hu YX, Fan L, Zhang SJ, Xu W, Wu HX, Qian SX, Lu H. [Clinical analysis of 10 cases of secondary hemophagocytic lymphohistiocytosis treated with HLH-2004 chemotherapy]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2010; 18:1525-1530. [PMID: 21176364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study was aimed to investigate the therapeutic efficacy of HLH-2004 chemotherapy in patients with secondary hemophagocytic lymphohistiocytosis (sHLH). 10 cases of sHLH treated with HLH-2004 regimen at our department were analyzed retrospectively. The results showed that 7 patients had clinical response to HLH-2004 regimen, while other 3 patients had no clinical response. 5 cases did not complete initial therapy of 8 weeks. Out of 5 cases, 4 died in the process of chemotherapy, 1 patient abandoned for serious side effects but finally acquired remission following 4 cycles of CHOP regimen. 5 cases underwent the whole courses of initial therapy. Out of 5 cases, 3 patients acquired remission, and other 2 were not well controlled. Out of the 3 patients who had achieved remission, one died of relapse, and other 2 patients kept remission. Out of the 2 patients who were not well controlled, one patient died, but another patient acquired remission after being discharged. It is concluded that patients with infection-associated hemophagocytic syndrome (IAHS) have high rates of remission after receiving HLH-2004 regimen combining with effective antibiotics. However, patients with HLH secondary to EBV (EBV-HLH) or lymphoma (LAHS) have low rates of remission or are easy to get relapse after remission.
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Affiliation(s)
- Li-Juan Zhang
- Department of Hematology, Jiangsu Provincial Hospital, Nanjing 210029, Jiangsu Province, China
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Li CM, Lu H, Wu HX, Qiu HX, Qian SX, Xu W, Li JY, Chen LJ. [Therapeutic efficacy of bortezomib-based chemotherapy on 40 patients with multiple myeloma]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2010; 18:1511-1514. [PMID: 21176361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study was aimed to investigate the therapeutic efficacy and adverse events of bortezomib-based chemotherapy for 40 patients with multiple myeloma. 16 newly diagnosed patients and 11 patients with refractory/relapse myeloma were treated with bortezomib, dexamethasone and thalidomide; 7 newly diagnosed patients and 4 patients with refractory/relapse myeloma were treated with bortezomib and dexamethasone; 2 newly diagnosed patients were treated with bortezomib, melphalan and thalidomide. Cycles were repeated every 28 or 35 days, all the patients were treated for 2 to 8 cycles. The therapeutic efficacy and adverse events were evaluated according to International Myeloma Working Group Uniform Response Criteria. The results indicated that the median follow-up duration was 13 months, the total response rate was 72.5%, among which 16 patients achieved complete response (CR), 13 achieved partial response (PR). The main side effects included gastrointestinal symptoms, peripheral neuropathy, thrombocytopenia, respiratory infection, herpes zoster and urinary retention and so on. The adverse events were ameliorated by treatment and decrease of the bortezomib dose. It is concluded that bortezomib-based chemotherapy is effective in the treatment of either newly diagnosed or refractory/relapse MM patients and the adverse events are tolerable and manageable for patients.
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Affiliation(s)
- Chun-Ming Li
- Department of Hematology, Jiangsu Provincial People Hospital, Nanjing, 210029, Jiangsu Province, China
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Ni LN, Li JY, Miao KR, Qiao C, Zhang SJ, Qiu HR, Qian SX. Multidrug resistance gene (MDR1) polymorphisms correlate with imatinib response in chronic myeloid leukemia. Med Oncol 2010; 28:265-9. [PMID: 20204543 DOI: 10.1007/s12032-010-9456-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 02/15/2010] [Indexed: 12/30/2022]
Abstract
The human multidrug resistance gene (MDR1, ABCB1) codes for P-glycoprotein (P-gp) that affects the pharmacokinetics of many drugs. MDR1 single nucleotide polymorphisms (SNPs) are associated with drug clearance. Imatinib is a substrate of P-gp-mediated efflux. We investigated the MDR1 T1236C, G 2677T/A, and C3435T polymorphism in 52 patients with chronic myeloid leukemia treated with imatinib. The distribution of MDR1 1236, 2677, or 3435 genotypes was significantly different between the resistance patients and sensitivity patients. The resistance incidence correlated with the number of T alleles at locus 1236 and 3435. Resistance was higher for patients homozygous for the 1236T allele when compared to patients with CT/CC genotype groups (75% vs. 31.3%, P = 0.004). For the G2677T/A polymorphism, a better complete cytogenetic remission was observed for patients with genotype AG/AT/AA, when compared to other genotype groups (TT/GT/GG, P = 0.02). Patients with 3435 TT/CT genotypes showed a higher resistance when compared with patients with CC genotype (59.4% vs. 25%, P = 0.023). In conclusion, determination of 1236T, C3435T, and G2677T MDR1 polymorphisms might be useful in response prediction to therapy with imatinib in patients with CML.
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Affiliation(s)
- Ling-Na Ni
- Department of Hematology, Jiangsu Province Hospital, The First Affiliated Nanjing Medical University Hospital, Nanjing Medical University, 300 Guangzhou Rd, 210029 Nanjing, China
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Qian SX, Wu HX, Hong M, Lu H, Xu W, Li JY. [FLAG regimen as consolidation therapy for patients with acute myeloid leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:1577-1581. [PMID: 20030951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The objective of study was to primarily explore the efficacy of combination of high doses cytarabine, fludarabine and G-CSF (FLAG) as the consolidation therapy for patients with acute myeloid leukemia (AML), and to analyze the influence of FLAG on peripheral stem cell mobilization. 31 patients with AML in complete remission were divided into two groups based on induction regimens, e.g. IA group (idarubicin and cytarabine) and non-IA group. All patients were consolidated with FLAG regimen which including fludarabine 50 mg/d, days 1-5; Ara-C 2 g/(m(2).d), days 1-5; G-CSF 300 microg/d. Time of its use sustained from day 0 until absolute neutrophil count > 1.0 x 10(9)/L. 17 patients received 2 or 3 courses of FLAG regimen, and 14 patients took 1 course. 9 patients received 2 courses of FLAG regimen as consolidation therapy, and then peripheral stem cells were collected from them. The results showed that sufficient peripheral stem cells were obtained in 7 out of 9 patients (77.8%) after 2 courses of FLAG regimen, however one patient failed to obtain sufficient CD34(+) cells after 3 courses. 6 patients received autologous stem cell transplantation, 3 patients received allogeneic stem cell transplantation, and 7 cases received 2 courses of Ara-c after treating with mitoxantrone or daunorubicin. One patient died within 4 weeks. 9 patients relapsed. The median survival duration was 14 (1 - 46) months and median disease-free survival time was 12 (2 - 45) months. There was no significant difference for OS and DFS between IA and non-IA groups. Myelosuppression and infections due to neutropenia were the most frequent adverse effects, severe nonhematologic toxicities were not observed in all patients. It is concluded that as consolidation regimen, the FLAG is an effective and well-tolerated treatment in AML with acceptable toxicity, and may not influence the peripheral stem cell mobilization for autologous stem cell transplantation after 2 courses of FLAG.
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Affiliation(s)
- Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital, Nanjing Medical University, Jiangsu Province People Hospital, Nanjing 210029, Jiansu Province, China
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Han YL, Zhang SJ, Qiao C, Dai D, Sun XM, Xu YL, Qian SX, Xu W, Wang JS, Li JY. [FMS-like tyrosine kinase 3 gene mutations in acute myeloid leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:1135-1139. [PMID: 19840437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study was aimed to investigate the frequency of FMS-like tyrosine kinase 3 (FLT3) mutations including internal tandem duplication (ITD) mutation of juxtamembrane region and point mutation of the second tyrosine kinase domain (TKD) in acute myeloid leukemia (AML) patients and its clinical significance. The ITD mutation in FLT3 exon 14, 15 of bone marrow mononuclear cells was detected by genomic DNA-PCR, the TKD point mutation in FLT3 exon 20 was detected by genomic DNA-PCR combined with restriction endonuclease digest. The results indicated that among 131 newly diagnosed AML patients, 21 patients (16.0%) showed FLT3-ITD positive, 3 patients (2.3%) showed FLT3-TKD positive. None was found harboring both mutations. The WBC and bone marrow blast counts in FLT3-ITD positive patients seemed both higher than those in patients with wild-type FLT3 (FLT3-wt), but there was significant difference only in WBC count (p<0.05). The complete remission (CR) rate in FLT3-ITD positive patients was 47.6%, which was significantly lower than that in FLT3-wt patients (88.1%, p<0.05). There was no statistical difference in CR rate between FLT3-ITD positive and negative patients in 20 cases of M3; the CR rate in FLT3-ITD positive patients with non M(3) was 37.5 (6/16) which was obviously lower than that in FLT3-wt patients with non M3 (90.6%, 48/53) (p<0.05). 3 FLT3-ITD positive patients with CR relapsed after CR for 14 (2-20) months with relapse rate 50% (3/6) which was higher than that in FLT3-wt patients (29.2%, 14/48). It is concluded that FLT3 mutation is common in AML patients, while FLT3-ITD mutation is more frequent than FLT3-TKD mutation. The AML patients with FLT3-ITD mutation have a poor prognosis, while FLT3-TKD point mutation does not significantly influences prognosis of the patients. Therefore early detection of FLT3 mutation may be important for targeting therapy and evaluating clinical prognosis of AML patients.
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Affiliation(s)
- Yang-Li Han
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
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Wang XW, Li JY, Chen LJ, Qian SX, Hong M, Qiao C, Zhang JF, Xu W, Lu H, Xu JR. [Fluorescence in situ hybridization on bone marrow smear in the detection of cytogenetic aberrations of multiple myeloma]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:1230-1233. [PMID: 19840456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study was aimed to establish the technique of interphase fluorescence in situ hybridization (I-FISH) used on smear of bone marrow directly, and to develop a new method for detection of the molecular cytogenetics in multiple myeloma (MM). After a series of treatment, fixation and digestion of the bone marrow smear as the carrier, the chromosome 8 centromere probe were used in I-FISH for molecular cytogenetics detection. At the same time, differences were compared in the results between the new method and the conventional I-FISH. The results showed that there was no statistically significant difference of proportion of various signals in non-hematologic malignancies when detected with the two methods (p>0.05). In bone marrow smear I-FISH, 8 out of 19 cases (42.1%) had abnormality of chromosome 8, including 5 cases with -8 (26.3%) and 3 cases with +8 (15.8%). It is concluded that the I-FISH on smear of bone marrow is characterized by convenience, economy and accuracy. Therefore, it can be used for research of molecular cytogenetics in MM.
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Affiliation(s)
- Xiao-Wei Wang
- Department of Hematology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
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40
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Li Q, Hong M, Qian SX, Zhang R, Sheng WY, Wu HX, Lu H, Qiu HX, Xu W, Li JY. [Effect of FLAG consolidation therapy on mobilization of autologous peripheral blood stem cells in patients with acute myelogenous leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:1335-1338. [PMID: 19840478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study was aimed to investigate the effect of FLAG consolidatory therapy on peripheral blood stem cell (PBSC) mobilization in patients with acute myelogenous leukemia (AML) for autologous PBSC transplantation. A total of 15 AML patients were enrolled in this study. 10 patients were male, and 5 were female, with ages ranging from 14 to 51 (median 36) years. Out of 15 patients 13 were newly diagnosed, and 2 were refractory/relapsed AML. All patients were consolidated with FLAG regimen which including fludarabine 50 mg/d, days 1-5; Ara-C 2 g/(m2.d), days 1-5; G-CSF 300 microg/d, injection subcutaneously starting 24 hours before Ara-C and continuing until neutrophil count exceeding 1.0x10(9)/L. The harvest of the stem cells was performed after hematologic recovery from the second or third course of FLAG consolidation, or mobilized by high dose etoposide (1.6 g/m2). The results showed that among 15 patients scheduled for PBSC harvest, 11 (73.3%) harvested a median of 3.52x10(6)/kg CD34+ cells (range 2.2-4.6) and underwent autologous transplantation, while the minimal number of CD34+ cells could not be reached in the remaining 4 patients. It is concluded that the FLAG regimen is effective and well-tolerated treatment as consolidation regimen in AML, which does not influence PBSC mobilization and autologous transplantation after 2 courses of FLAG.
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Affiliation(s)
- Qin Li
- Department of Hematology, The First Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
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41
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Hong M, Xu W, Qian SX, Miao KR, Fan L, Li JY. [High-dose methylprednisolone for the treatment of refractory chronic lymphocytic leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:1052-1055. [PMID: 19698258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
To investigate the curative effects of high-dose methylprednisolone (HDMP) in the treatment of refractory chronic lymphocytic leukemia (CLL), 5 patients with CLL who poorly reacted to several cycles of fludarabine based protocols with or without rituximab were treated with 1 to 6 cycles of HDMP with 1 g/(m(2)xd) for d1-5. All the patients were at Binet stage C. 3 patients were at Rai stage IV and 2 were at Rai stage III. 2 patients were diagnosed as Richter syndrome. CD38 and ZAP-70 were expressed in 5 and 3 patients respectively. All the patients developed with B group symptoms including fever, night sweat and/or weight loss and so on. Clinical manifestations and complete blood cell count, peripheral blood smear, bone marrow aspirate, hepatic and renal function, blood serum electrolytes, blood glucose were examined, CD5(+)CD19(+) lymphocytes of peripheral blood and bone marrow were determined by flow cytometry. The results showed that B group symptoms disappeared in 4 patients at 2 - 4 weeks after therapy. The size of enlarged lymph nodes was reduced in all the 5 patients. In 1 patient spleen was not palpable from 10 cm below costal margin at 2 weeks after therapy, and his hemafecia was alleviated. The renal function in another patient with renal failure recovered to normal after two cycles of therapy. Pancytopenia improved in 3 patients after therapy. CD5(+)CD19(+) lymphocytes decreased in all the patients. 4 patients acquired partial remission and 1 patient acquired stable status of disease. The side effects became mild. In conclusion, the therapeutic results preliminarily show that HDMP is an effective and safe protocol for the treatment of refractory CLL.
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Affiliation(s)
- Ming Hong
- Department of Hematology, The First Hospital, Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029, Jiangsu Province, China
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Han YL, Zhang SJ, Qiao C, Dai D, Sun XM, Xu YL, Qian SX, Xu W, Wang JS, Li JY. [Tyrosine kinase mutation and acute myeloid leukemia with T (8; 21)]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:866-869. [PMID: 19698218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This study was aimed to investigate the status of c-KIT, Fms-like tyrosine kinase 3 (FLT3) and Janus kinase 2 (JAK2) mutations in acute myeloid leukemia (AML) patients with t (8; 21) and to analyze their relation to clinical feature and prognosis. PCR, AS-PCR, restriction and sequencing methods were used respectively to detect the FLT3, JAK 2 and c-KIT mutations in 8 cases of de novo AML with t (8; 21) and 6 cases of relapsed AML with t (8; 21). The results showed that the c-KIT mutation was found in 2 cases out of 14 AML patients with t (8; 21) (14.3%), among them 1 case had c-KIT D816V mutation, the other had c-KIT D816Y mutation. The FLT3-ITD mutation was detect in 1 out of 14 patients (7.1%), but JAK2 mutation could not be detected in all 14 cases. In conclusion, tyrosine kinase mutation relates to AML with t (8; 21), patients with tyrosine kinase mutation may have higher relapse, extramedullary infiltration and poor prognosis. The screening c-KIT, FLT3 mutations may play an important role in evaluating prognosis and guiding treatment of t (8; 21) AML.
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Affiliation(s)
- Yang-Li Han
- Department of Hematology, The First Hospital, Nanjing Medical University, Jiangsu Provincial People Hospital, Nanjing 210029, Jiangsu Province, China
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Zhang SJ, Li JY, Zhang JF, Finn J, Lu H, Xu W, Qian SX, Wu HX. The decrease of JAK2 V617F allele burden in leukemia transformation of an elderly patient with myelofibrosis. Leuk Res 2009; 33:e116-8. [DOI: 10.1016/j.leukres.2009.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Revised: 02/03/2009] [Accepted: 02/05/2009] [Indexed: 11/29/2022]
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Zhu BG, Qian SX, Hong M, Lu H, Wu HX, Zhang SJ, Qiu HX, Xu W, Li JY. [Low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor priming in 50 patients with relapsed acute myeloid leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:760-764. [PMID: 19549403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
To evaluate the efficacy and toxicity of low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor (G-CSF) protocol for patients with relapsed acute myeloid leukemia (AML). A total of fifty relapsed patients have been enrolled, including 13 early relapsed and 37 late relapsed. 24 patients were male and 26 were female, with age ranging from 15 to 69 (median 47) years. Out of them, 7 patients relapsed after allogeneic peripheral blood stem cell transplantation (allo-PBSCT), 3 patients relapsed after autologous peripheral blood stem cell transplantation (auto-PBSCT), 25 patients relapsed after received regimens including high dose cytarabine and 15 patients relapsed after CR or stopping chemical therapy themself in course of consolidatory therapy. 30 relapsed patients received CAG regimen, and 20 patients (control group) received an anthracycline in combination with cytarabine. The results indicated that after one course, the complete remission (CR) rate was 46.7% (14/30), the CR rate after allo-PBSCT was 50% (3/6), the early death rate was 3.3% in CAG group; and CR rate was 30% (6/20) and the early death rate was 15% in control group. Myelosuppression was mild to moderate, and no severe nonhematologic toxicity was observed in two groups. The overall median times in CAG group and control group were 22 and 19 months respectively. In conclusion, CAG regimen as the induction therapy is effective and well tolerable with low side effects for relapsed patients who had received high dose cytarabine, auto-PBSCT or allo-PBSCT.
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Affiliation(s)
- Bo-Gui Zhu
- Deparrtment of Hematology, Jiangsu Provincial Armed Police General Corps Hospital, Yangzhou, Jiangsu Province, China
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Sun HM, Qian SX, Li JY. [Advance of study on MN1 gene in acute myeloid leukemia - review]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:504-508. [PMID: 19379599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The transcriptional coactivator MN1 has been identified as a gene overexpressed in certain types of human acute myeloid leukemia. Overexpression of this gene is associated with all inv (16) AML, retinoic acid-resistance, a worse prognosis as well as a shorter survival in AML patients with a normal karyotype. This article reviews the role of MN1 in acute myeloid leukemia including MN1 gene structure and action mechanism, MN1-TEL and AML with normal karyotype, MN1 and inv (16) AML, MN1 and retinoic ocid-resistance, and so on.
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Affiliation(s)
- Hai-Ming Sun
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
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Dai D, Zhang SJ, Qiao C, Sun XM, Qian SX, Xu W, Xu YL, Li JY. [Analysis of NPM1 gene mutations in acute myeloid leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:294-297. [PMID: 19379554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The aim of this study was to evaluate the nucleophosmin (NPM1) gene exon 12 mutation in patients with acute myelogenous leukemia (AML) and its clinical characteristics. Genomic DNAs from 33 AML patients were amplified by PCR and sequencing for NPM1 mutations. The results showed that the NPM1 exon 12 mutations were found is 8 patients from 33 AML patients (24.2%) including 1 of M(1), 3 of M(2), 1 of M(4) and 3 of M(5). The NPM1 gene mutations were found in 7 out of 19 patients with normal karyotype and their incidence was significantly higher than that in patients with karyotype abnormalities (1/14, 7.1%, p < 0.005). The proportion of bone marrow blast cells and the count of peripheral white blood cells in patients with NPMI exon 12 mutation were higher than that in patients with wild type NPMI gene. It is concluded that the occurrence of NPM1 exon 12 mutations is observed more in AML patients with normal karyotype. NPM1 mutant cases are associated with more high amount of boon marrow blast cells and peripheral white blood cell count.
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Affiliation(s)
- Dan Dai
- Department of Hematology, Nanjing Medical University, Nanjing 210006, China
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Wang L, Qian SX, Qiu HR, Wang R, Zhang SJ, Miao KR, Fan L, Xu W, Li JY. [Deletions of derivative chromosome 9 in 138 patients with chronic myeloid leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:281-284. [PMID: 19379551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
To investigate the frequency of derivative chromosome 9 [der (9)] deletions in patients with chronic myelogenous leukemia (CML), karyotype analysis in 138 patients with CML was performed with R-banding technique, and dual fusion fluorescence in situ hybridization (FISH) was used to detect der (9) deletion. The results showed that among 138 cases, 126 cases were Ph positive (91.3%) from which 122 cases were typical Ph translocation, 12 cases were Ph negative (8.7%). FISH detection revealed 23 with der (9) deletions out of 138 cases (16.7%), 20 out of 122 cases with typical Ph translocation showed typical Ph translocation (16.4%) and 3 out of 4 cases with variant Ph translocation had variant Ph translocation (75%). 20 cases were in chronic phase (CP) (17.2%), 3 cases were in blast crisis (BC) (17.6%), there was no significant difference in the frequency of the der (9) deletions between the cases in CP and in BC (p < 0.05). It is concluded that incidence of der (9) partial deletions in CML patients is 16.7%, FISH can effectively detect the der (9) deletions, and there is no correlation of der (9) deletion frequency between cases in different phases of CML.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Chromosome Deletion
- Chromosomes, Human, Pair 9
- Female
- Humans
- In Situ Hybridization, Fluorescence/methods
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Middle Aged
- Sequence Deletion
- Young Adult
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Affiliation(s)
- Li Wang
- Department of Hematology, Nanjing Medical University, Jiangsu Provincial Hospital, Nanjing 210029, Jiangsu Province, China
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Qian SX, Li JY, Wu HX, Zhang R, Hong M, Xu W, Qiu HX. [IDA-FLAG regimen in treatment of patients with refractory or relapsed acute leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:464-467. [PMID: 19379589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The objective of this study was to evaluate the efficacy and toxicity of the fludarabine combination with high-dose cytarabine (Ara C), idarubicin and granulocyte colony-stimulating factor (G-CSF) (IDA-FLAG regimen) in treatment of refractory/relapsed acute leukemia (AL) patients. 4 patients were male aged from 32 to 44 years, consisted of 3 cases of acute myeloid leukaemia (AML) and 1 cases of acute lymphocytic leukaemia (ALL). All the patients were treated with idarubicin (10 - 12 mg/m(2)/d, days 1 to 3), fludarabine (50 mg/d, days 1 to 5), cytarabine (2 g/m(2)/d, days 1 to 5) and granulocyte colony-stimulating factor (G-CSF, 300 microg/d, days 0 to 5). The results showed that after one course of induction therapy, 4 patients all achieved complete remission (CR), in which 2 patients were in continuous CR after a follow-up of 3 and 4 months; 1 patient relapsed after 10 months and another one patient died of thrombotic thrombocytopenic purpura at 4 months after allogeneic peripheral blood stem cell transplantation. Myelosuppression and infections due to neutropenia were the most frequent adverse effects, severe nonhematologic toxicity and the early death were not observed in these patients. In conclusion, the IDA-FLAG regimen is effective in treatment of patients with refractory and relapsed AL, the adverse effects from this regimen were well tolerated by patients, which gains time for further treatment.
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Affiliation(s)
- Si-Xuan Qian
- Department of Hematology, Nanjing Medical University, Nanjing 210029, China
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Qian SX, Li JY, Hong M, Xu W, Qiu HX. Nonhematological autoimmunity (glomerulosclerosis, paraneoplastic pemphigus and paraneoplastic neurological syndrome) in a patient with chronic lymphocytic leukemia: Diagnosis, prognosis and management. Leuk Res 2009; 33:500-5. [DOI: 10.1016/j.leukres.2008.07.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 07/30/2008] [Accepted: 07/31/2008] [Indexed: 10/21/2022]
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Qian SX, Li JY, Wu HX, Lu H, Qiu HX, Chen LJ, Lu RN, Xu W, Sheng RL. [Standard-dose of idarubicin in combination with continuous infusion of cytarabine as induction therapy in patients with acute myeloid leukaemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2009; 17:209-213. [PMID: 19236781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The objective of this study was to investigate the efficacy and toxicity of standard-dose idarubicin in combination with continuous infusion of cytarabine as induction therapy in patients with acute myeloid leukemia (AML). A total of 38 AML patients were enrolled, including 30 new diagnosed patients, 8 relapsed and refractory patients. Cytogenetic analysis was performed in all patients, 15 patients had cytogenetic aberrations including 4 complex abnormalities. All patients were treated with standard-dose idarubicin [12 mg/(m(2).d), days 1 to 3] and continuous infusion of cytarabine [100 mg/(m(2).d), days 1 to 7]. The results showed that after one course of induction therapy, the overall response rate was 89.5% (34/38), and 32 out of 38 (84.2%) patients achieved complete remission (CR), including 27 of 30 (90.0%) new diagnosed AML patients, 5 (62.5%) refractory and relapsed AML patients, all 4 patients with complex cytogenetic aberrations achieved cytogenetic CR. Out of 6 relapsed patients 2 showed as extramedullary relapse, 4 showed as bone marrow relapse. The median survival duration was > 22 months and median disease-free survival time was > 16 months. Myelosuppression and infections due to neutropenia were the most frequent adverse effects, severe nonhematologic toxicity and the early death were not observed in the patients. It is concluded that standard-dose of idarubicin combined with continuous infusions of cytarabine as the induction therapy is highly effective and well tolerated approach in patients with AML, this regimen provides an opportune moment for hematopoietic stem cell transplantation.
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Affiliation(s)
- Si-Xuan Qian
- Department of Hematology, Nanjing Medical University, Jiangsu Province People Hospital, Nanjing 210029, China
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