[Daratumumab maintenance after autologous hematopoietic stem cell transplantation for newly diagnosed multiple myeloma]

Objective: This study aimed to evaluate the efficacy and safety of daratumumab as a maintenance treatment after autologous hematopoietic stem cell transplantation (auto-HSCT) in patients with newly diagnosed multiple myeloma (NDMM) . Methods: The clinical data, hematological and renal response, and safety of 15 post-transplant patients with NDMM who had received daratumumab maintenance between May 1, 2022 and June 30, 2023 were retrospectively analyzed. Results: Fifteen patients (11 males and 4 females) with a median age of 58 (41-72) years were included. Thirteen patients did not receive daratumumab during induction therapy and auto-HSCT, 6 patients had renal impairment, and nine patients had high-risk cytogenetics. The median infusion of daratumumab was 12 (6-17) times, and the median duration of maintenance was 6 (1.5-12) months. The treatment efficacy was evaluated in all 15 patients, and daratumumab maintenance therapy increased the rate of stringent complete response from 40% to 60%. The renal response rate and median estimated glomerular filtration rate of six patients with RI-NDMM were also improved. During daratumumab maintenance therapy, the most common hematological grade 3 adverse event (AE) was lymphopenia [4 of 15 patients (26.67%) ], whereas the most common nonhematologic AEs were infusion-related reactions [7 of 15 patients (46.67%) ] and grade 3 pneumonia [5 of 15 patients (33.33%) ]. The five patients with pneumonia were daratumumab naive [5 of 13 patients (38.46%) ], with a median of 8 (6-10) infusions. Among them, the chest computed tomography of three patients showed interstitial infiltrates, and treatment with methylprednisolone was effective. With a median follow-up of 12 months, the 1-year overall survival rate was 93.33%, and only one patient died (which was not related to daratumumab treatment) . Conclusions: Daratumumab was safe and effective as a maintenance agent for post-auto-HSCT patients with NDMM, and AEs were controllable. The most common nonhematologic AE was grade 3 pneumonia, and a less dose-intense maintenance regimen for the first 8 weeks could reduce the incidence of pneumonia.

[Epidemiological analysis of cytogenetic abnormalities in patients with newly-diagnosed multiple myeloma: a multi-center retrospective study]

目的

了解我国初诊多发性骨髓瘤（MM）患者细胞遗传学异常（CA）的构成和频率，基于2018年更新的危险分层标准（mSMART3.0）分析双打击MM（DHMM）及三打击MM（THMM）的发生率。

方法

纳入全国5个中心的初诊MM患者，磁珠分选CD138细胞或浆细胞比例≥50%的骨髓标本行初诊间期FISH（iFISH）检测CA的基线结果，分析原发CA（pCA）、继发CA（sCA）、高危（HR）CA和DHMM/THMM的发生率，并分析不同CA组合的情况。

结果

共纳入初诊MM患者1 015例，IgH重排、del（13q）/13q14、1q21扩增、del（17p）发生率分别为54.0%、46.4%、46.1%、9.9%。其中，1q21扩增拷贝数=3、≥4的发生率分别为35.8%、12.7%。454例患者具有完整CA基线结果，pCA中t（4；14）、t（11；14）和t（14；16）发生率分别为14.1%、11.2%和4.8%；44.3%患者携带≥2种CA，包括2种CA（28.0%）、3种CA（13.4%）和≥4种CA（2.9%）；83.3%的1q扩增患者伴其他CA，以del（13q）/13q14最常见（61.1%），IgH重排次之（31.5%）；95.0%的del（17p）患者伴其他CA，以del（13q）/13q14最常见（75.2%），1q21扩增次之（49.5%）；68.6%的IgH重排患者伴其他CA，以del（13q）/13q14和1q21扩增最常见（均为61.9%）；根据2016年国际骨髓瘤工作组的定义，57.7%患者携带HRCA；依据2018年mSMART 3.0的定义，DHMM（HRCA=2）和THMM（HRCA≥3）患者分别占14.3%和2.9%。

结论

更新了我国初诊MM患者的CA谱，发现基于CA的HR MM占初诊MM患者的比例近58%，并首次报道DHMM和THMM的发生率约为17%。

[Clinical outcomes of peripheral blood stem cell transplantation for aggressive peripheral T-cell lymphoma]

目的

研究外周血造血干细胞移植治疗外周T细胞淋巴瘤（PTCL）的疗效。

方法

回顾性分析解放军总医院血液科2007年6月至2017年6月接受外周血造血干细胞移植PTCL患者的临床资料。

结果

共有41例PTCL患者纳入研究，男30例，女11例，中位年龄38（13~57）岁。17例行自体外周血造血干细胞移植（auto-PBSCT），24例行异基因外周血造血干细胞移植（allo-PBSCT）。auto-PBSCT组ALK阳性间变大细胞淋巴瘤占47.1%（8/17），allo-PBSCT组NK/T细胞淋巴瘤和外周T细胞淋巴瘤-非特指型占66.7%（16/24）。auto-PBSCT组患者移植前疾病处于完全缓解（CR）状态者占58.8%（10/17），疾病进展（PD）状态者占11.8%（2/17）；allo-PBSCT组移植前疾病状态为CR者8.3%（2/24），PD者45.8%（11/24）。auto-PBSCT组和allo-PBSCT组移植后2年总生存率、无病生存率差异均无统计学意义[（64.0±10.8）%对（53.5±9.7）%，P=0.543；（57.1±12.4）%对（53.5±10.6）%，P=0.701]。auto-PBSCT组6例死亡，5例死于复发；allo-PBSCT组12例死亡，其中5例死于复发，7例为移植相关死亡。

结论

auto-PBSCT和allo-PBSCT均是PTCL的有效治疗方法。

[Impact of KIT D816 mutation on salvage therapy in relapsed acute myeloid leukemia with t(8;21) translocation]

Objective: To evaluate the impact of KIT D816 mutation on the salvage therapy in relapsed acute myeloid leukemia (AML) with t(8;21) translocation. Method: The characteristics of the first relapsed AML with t(8;21) translocation from 10 hospitals were retrospectively collected, complete remission (CR(2)) rate after one course salvage chemotherapy and the relationship between KIT mutation and CR(2) rate was analyzed. Results: 68 cases were enrolled in this study, and 30 cases (44.1%) achieved CR(2). All patients received KIT mutation detection, and KIT D816 mutation was identified in 26 cases. The KIT D816 positive group had significantly lower CR(2) compared with non-KIT D816 group (23.1% vs 57.1%, χ(2)=7.559, P=0.006), and patients with longer CR(1) duration achieved significantly higher CR(2) than those with CR(1) duration less than 12 months (74.1% vs 31.9%, χ(2)=9.192, P=0.002). KIT D816 mutation was tightly related to shorter CR(1) duration. No significant difference of 2 years post relapse survival was observed between KIT D816 mutation and non-KIT D816 mutation group. Conclusion: KIT D816 mutation at diagnosis was an adverse factor on the salvage therapy in relapsed AML with t(8;21) translocation, significantly related to shorter CR1 duration, and can be used for prediction of salvage therapy response. KIT D816 mutation could guide the decision-making of salvage therapy in relapsed AML with t(8;21) translocation.

DETECTION OF EXTRAORDINARY LARGE BIO-MAGNETIC FIELD STRENGTH FROM HUMAN HAND DURING EXTERNAL QI EMISSION

It is generally accepted that more than 10(-6) gauss order magnetism was not detected in normal human condition. However, we detected 10(-3) gauss (mGauss) order bio-magnetic field strength from the palm in special persons who emitted External Qi ("Chi" or "Ki"). This detection was possible by special arranged magnetic field detection system, consisted of a pair of 2 identical coils with 80,000 turns and a high sensitivity amplifier. Each of the coils were rolled 80,000 turns accurately, and were connected in series in opposite direction, actuating as a gradiometer. We measure bio-magnetic field strength in 37 subjects with this detection system. The only 3 subjects of them exhibited strong bio-magnetic field of 2 to 4 mGauss in frequency range of 4 to 10 Hz. This magnetic field strength was greater than that of normal human bio-magnetism by 1,000 times at least. A simultaneous measurement of bio-magnetic field strength and its corresponding bio-electric current was examined in one subject. During exhibiting such strong bio-magnetism, its corresponding electric current was not detectable. Therefore, the extra-ordinary large bio-magnetic field strength can not derive from internal body current alone, hence the origin of the large bio-magnetism is still unknown. We suppose that the extraordinary large bio-magnetic field strength might be originated from "Qi" energy in the oriental medicine or in the oriental traditional philosophy.