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Yang QL, Chen Y, Wang XJ, Qiu HY, Chen MT, Zhou XH, Jian CY, Zhao SF. Correlation between lesion location and dysphagia characteristics in post-stroke patients. J Stroke Cerebrovasc Dis 2024; 33:107682. [PMID: 38522758 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107682] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/28/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE To assess the correlation between lesion location and swallowing function characteristics in post-stroke dysphagia (PSD) patients. MATERIALS AND METHODS We enrolled 133 PSD. The patients were divided into supratentorial and infratentorial stroke groups. We compared the measurements in the videofluoroscopic swallowing study (VFSS) with 3ml and 5 ml of diluted and thickened barium liquid data between supratentorial and brainstem stroke groups. We further compared the difference of VFSS measurements between patients with left hemispheric or right hemispheric lesions (further divided into unilateral hemispheric cortical and subcortical subgroups) and brianstem leison stroke group.To explore the lesion location's effect on different bolus volume, the VFSS measurements of 3ml and 5ml in each subgroups were compared respectively. The measurements of VFSS included the oral transit time, soft palate elevation duration, hyoid bone movement duration (HMD), UES opening duration, pharyngeal transit duration (PTD), stage of ansition duration, and laryngeal closure duration (LCD), the upper esophageal sphincter opening (UESO), hyoid bone superior horizontal displacement, and hyoid bone anterior horizontal displacement. General swallowing function was assessed using the Penetration Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS). We performed the paired t-test, Spearman's correlation, and Kruskal-Wallis test analysis to characterize the parameters among the groups. RESULTS Fifty-eight patients were assessed in the final analysis. The HMD (p = 0.019), PTD (p = 0.048) and LCD (p = 0.013) were significantly different between the supratentorial and brainstem lesion groups in 5ml volume. The HMD was significantly different (p = 0.045) between the left cortical and brainstem lesion groups. Significant differences in the HMD (p = 0.037) and LCD (p = 0.032) between the left subcortical and brainstem lesion groups were found in 5ml volume bolus. There was no group different when taking the 3ml volume bolus. Regarding the relationship between food bolus volume and swallowing functions, only the UESO demonstrated a significant difference in the subcortical lesion of the right hemisphere (p = 0.0032) compared the 3 ml and 5 ml volume bolus. The PTD demonstrated a moderate correlation with the PAS scores (r = 0.38, p = 0.0044). The HMD (r = 0.32, p = 0.018) and LCD (r = 0.29, p = 0.039) demonstrated weak correlations with the PAS scores. We did not identify any correlation between the VFSS parameters and FOIS scores in each subgroup level. CONCLUSION The PSD with brainstem lesion shows more sever dysfunction in the pharyngeal phases. The left hemisphere was engaged in both the oral and pharyngeal phases. Lesions in the bilateral cortical, subcortical, and brainstem regions may impair sensory input.
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Affiliation(s)
- Qing-Lu Yang
- Department of Rehabilitation Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Yang Chen
- Department of Radiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Xue-Jie Wang
- Department of Rehabilitation Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Hui-Ying Qiu
- Department of Rehabilitation Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Meng-Ting Chen
- Department of Radiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Xu-Hui Zhou
- Department of Radiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Chu-Yao Jian
- Department of Rehabilitation Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Shao-Feng Zhao
- Department of Rehabilitation Medicine, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
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Xia J, Zhao Y, Wu XJ, Qiu HY, Tang XW, Wang Y, Jin ZM, Miao M, Ma X, Wu DP, Chen SN, Chen F. [Clinical observation on 16 cases of DEK-NUP214 fusion gene positive acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:1041-1044. [PMID: 38503531 PMCID: PMC10834877 DOI: 10.3760/cma.j.issn.0253-2727.2023.12.014] [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] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Indexed: 03/21/2024]
Affiliation(s)
- J Xia
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China Department of Hematology, Soochow Hopes Hematology Hospital, Suzhou 215000, China
| | - Y Zhao
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China Department of Hematology, Soochow Hopes Hematology Hospital, Suzhou 215000, China
| | - X J Wu
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China Department of Hematology, Soochow Hopes Hematology Hospital, Suzhou 215000, China
| | - H Y Qiu
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - X W Tang
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - Y Wang
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - Z M Jin
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - M Miao
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - X Ma
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China Department of Hematology, Soochow Hopes Hematology Hospital, Suzhou 215000, China
| | - D P Wu
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - S N Chen
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - F Chen
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China Department of Hematology, Soochow Hopes Hematology Hospital, Suzhou 215000, China
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Zhang J, Song BQ, Kong X, Liu Y, Yang HL, Zong LH, Kong JY, Xu Y, Qiu HY, Wu DP. [Efficacy analysis of selinexor combined with hypomethylating agent in the treatment of refractory/relapsed acute myeloid leukemia exposed to venetoclax]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:936-939. [PMID: 38185524 PMCID: PMC10753257 DOI: 10.3760/cma.j.issn.0253-2727.2023.11.009] [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] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Indexed: 01/09/2024]
Affiliation(s)
- J Zhang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - B Q Song
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - X Kong
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y Liu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - H L Yang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - L H Zong
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - J Y Kong
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y Xu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - H Y Qiu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - D P Wu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
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Zhang XS, Liu BC, Du X, Zhang YL, Xu N, Liu XL, Li WM, Lin H, Liang R, Chen CY, Huang J, Yang YF, Zhu HL, Pan L, Wang XD, Li GH, Liu ZG, Zhang YQ, Liu ZF, Hu JD, Liu CS, Li F, Yang W, Meng L, Han YQ, Lin LE, Zhao ZY, Tu CQ, Zheng CF, Bai YL, Zhou ZP, Chen SN, Qiu HY, Yang LJ, Sun XL, Sun H, Zhou L, Liu ZL, Wang DY, Guo JX, Pang LP, Zeng QS, Suo XH, Zhang WH, Zheng YJ, Jiang Q. [To compare the efficacy and incidence of severe hematological adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:728-736. [PMID: 38049316 PMCID: PMC10630575 DOI: 10.3760/cma.j.issn.0253-2727.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Indexed: 12/06/2023]
Abstract
Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.
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Affiliation(s)
- X S Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
| | - B C Liu
- National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - X Du
- The Second People's Hospital of Shenzhen, Shenzhen 518035, China
| | - Y L Zhang
- Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - N Xu
- Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X L Liu
- Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - W M Li
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - H Lin
- First Hospital of Jilin University, Changchun 130021, China
| | - R Liang
- Xijing Hospital, Airforce Military Medical University, Xi'an 710032, China
| | - C Y Chen
- Qilu Hospital of Shandong University, Jinan 250012, China
| | - J Huang
- The Fourth Affiliated Hospital of Zhejiang University, Hangzhou 322000, China
| | - Y F Yang
- Institute of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - H L Zhu
- Institute of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - L Pan
- Institute of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - X D Wang
- Sichuan Academy of Medical Sciences Sichuan Provincial People's Hospital, Chengdu 610072, China
| | - G H Li
- Xi'an International Medical Center Hospital, Xi'an 710038, China
| | - Z G Liu
- Shengjing Hospital of China Medical University, Shenyang 110020, China
| | - Y Q Zhang
- The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Z F Liu
- The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - J D Hu
- Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C S Liu
- First Hospital of Jilin University, Changchun 130021, China
| | - F Li
- The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - W Yang
- Shengjing Hospital of China Medical University, Shenyang 110020, China
| | - L Meng
- Tongji Hospital of Tongji Medical College, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y Q Han
- The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China
| | - L E Lin
- Hainan General Hospital, Haikou 570311, China
| | - Z Y Zhao
- Hainan General Hospital, Haikou 570311, China
| | - C Q Tu
- Shenzhen Baoan Hospital, Shenzhen University Second Affiliated Hospital, Shenzhen 518101, China
| | - C F Zheng
- Shenzhen Baoan Hospital, Shenzhen University Second Affiliated Hospital, Shenzhen 518101, China
| | - Y L Bai
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou 450003, China
| | - Z P Zhou
- The Second Hospital Affiliated to Kunming Medical University, Kunming 650106, China
| | - S N Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation of Soochow University, Suzhou 215006, China
| | - H Y Qiu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation of Soochow University, Suzhou 215006, China
| | - L J Yang
- Xi'an International Medical Center Hospital, Xi'an 710117, China
| | - X L Sun
- The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - H Sun
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - L Zhou
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Z L Liu
- Huazhong University of Science and Technology Union Shenzhen Hospital, Nanshan Hospital, Shenzhen 518000, China
| | - D Y Wang
- Huazhong University of Science and Technology Union Shenzhen Hospital, Nanshan Hospital, Shenzhen 518000, China
| | - J X Guo
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China
| | - L P Pang
- Peking University Shenzhen Hospital, Shenzhen 516473, China
| | - Q S Zeng
- The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - X H Suo
- Handan Central Hospital, Handan 057150, China
| | - W H Zhang
- First Hospital of Shangxi Medical University, Taiyuan 300012, China
| | - Y J Zheng
- First Hospital of Shangxi Medical University, Taiyuan 300012, China
| | - Q Jiang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China
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Kong JY, Zong LH, Pu Y, Liu Y, Kong X, Li MY, Zhang J, Song BQ, Xue SL, Tang XW, Qiu HY, Wu DP. [Clinical efficacy and safety of venetoclax combined with multidrug chemotherapy in the treatment of 15 patients with relapsed or refractory early T-cell precursor acute lymphoblastic leukemia]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:649-653. [PMID: 37803838 PMCID: PMC10520236 DOI: 10.3760/cma.j.issn.0253-2727.2023.08.006] [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] [Grants] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Indexed: 10/08/2023]
Abstract
Objective: To explore the efficacy and safety of Venetoclax combined with multidrug chemotherapy in patients with relapsed or refractory early T-cell precursor acute lymphoblastic leukemia (R/R ETP-ALL) . Methods: This study retrospectively analyzed 15 patients with R/R ETP-ALL who received Venetoclax combined with multidrug chemotherapy from December 2018 to February 2022. Among them, eight cases were combined with demethylated drugs, four cases were combined with demethylated drugs and HAAG chemotherapy regimen, two cases were combined with demethylated drugs and CAG regimen, and one case was combined with Cladribine. Specific usage and dosage of Venetoclax: 100 mg on day 1, 200 mg on day 2, 400 mg on day 3-28, orally; when combined with azole antifungal drugs, dosage was reduced to 100 mg/d. Results: Fifteen patients (10 males and 5 females) with R/R ETP-ALL were treated with Venetoclax and multidrug chemotherapy with a median age of 35 (12-42) years old. Of 4 refractory and 11 relapsed patients, the efficacy was evaluated on the 21th day following combined chemotherapy: the overall response rate, the complete response (CR) rate, and the CR with incomplete hematological recovery (CRi) rate were 67.7% (10/15), 60.0% (9/15), and 6.7% (1/15), respectively. For the overall study population, the 12-month overall survival (OS) rate was 60.0%, and the median OS was 17.7 months. The disease-free survival (DFS) rate of all CR patients at 12 months was 60.0%, and the median DFS did not reach. About 14 patients had Ⅲ-Ⅳ hematological toxicity, but these adverse reactions were all controllable. No adverse reaction in the nervous system and tumor lysis syndrome occurred in this study, and no adverse reaction of organs above grade Ⅲ occurred. Conclusion: Venetoclax combined with multidrug chemotherapy may be a safe and promising treatment option for patients with R/R ETP-ALL.
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Affiliation(s)
- J Y Kong
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - L H Zong
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y Pu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y Liu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - X Kong
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - M Y Li
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - J Zhang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - B Q Song
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - S L Xue
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - X W Tang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - H Y Qiu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - D P Wu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
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Zhou M, Kang HZ, Gu CY, Liu YJ, Wang Y, Miao M, Fu JH, Tang XW, Qiu HY, Fu CC, Jin ZM, Li CX, Chen SN, Sun AN, Wu DP, Han Y. [Efficacy and safefy of Polymyxin B treatment for neutropenic patients suffering from refractory Gram-negative bacterial bloodstream infection]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:484-489. [PMID: 37550204 PMCID: PMC10450549 DOI: 10.3760/cma.j.issn.0253-2727.2023.06.007] [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] [Received: 10/08/2022] [Indexed: 08/09/2023]
Abstract
Objective: To assess the efficacy and safety of polymyxin B in neutropenic patients with hematologic disorders who had refractory gram-negative bacterial bloodstream infection. Methods: From August 2021 to July 2022, we retrospectively analyzed neutropenic patients with refractory gram-negative bacterial bloodstream infection who were treated with polymyxin B in the Department of Hematology of the First Affiliated Hospital of the Soochow University between August 2021 to July 2022. The cumulative response rate was then computed. Results: The study included 27 neutropenic patients with refractory gram-negative bacterial bloodstream infections. Polymyxin B therapy was effective in 22 of 27 patients. The median time between the onset of fever and the delivery of polymyxin B was 3 days [interquartile range (IQR) : 2-5]. The median duration of polymyxin B treatment was 7 days (IQR: 5-11). Polymyxin B therapy had a median antipyretic time of 37 h (IQR: 32-70). The incidence of acute renal dysfunction was 14.8% (four out of 27 cases), all classified as "injury" according to RIFLE criteria. The incidence of hyperpigmentation was 59.3%. Conclusion: Polymyxin B is a viable treatment option for granulocytopenia patients with refractory gram-negative bacterial bloodstream infections.
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Affiliation(s)
- M Zhou
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - H Z Kang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - C Y Gu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y J Liu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y Wang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - M Miao
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - J H Fu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - X W Tang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - H Y Qiu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - C C Fu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Z M Jin
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - C X Li
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - S N Chen
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - A N Sun
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - D P Wu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y Han
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
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Yang S, Zhang X, Gale RP, Du X, Chen CY, Weng JY, Huang J, Li F, Zeng Y, Xiao Z, Hu JD, Yang LJ, Liu ZG, Li GH, Sun XL, Yang W, Feng R, Han YQ, Jing Y, Xu N, Liu XL, Liu ZF, Wang XD, Wu SX, Liang R, Zhang YL, Yang YF, Zhu HL, Pan L, Meng L, Zhao YH, Yi H, Liu YL, Zhang WH, Zheng YJ, Zhou ZP, Chen SN, Qiu HY, Li WM, Jia ZL, Bai YL, Lin LE, Liu BC, Liu CS, Luo JM, Meng JX, Sun ZQ, Zhang YQ, Huang XJ, Jiang Q. Imatinib compared with second-generation tyrosine kinase-inhibitors in persons with chronic myeloid leukemia presenting in accelerated phase. Am J Hematol 2023. [PMID: 37128776 DOI: 10.1002/ajh.26943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 05/03/2023]
Affiliation(s)
- Sen Yang
- National Clinical Research Center for Haematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Haematology, Beijing, China
| | - Xiaoshuai Zhang
- National Clinical Research Center for Haematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Haematology, Beijing, China
| | - Robert Peter Gale
- Centre for Haematology, Department of Immunology and Inflammation, Imperial College of Science, Technology and Medicine, London, UK
| | - Xin Du
- Department of Hematology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Chun-Yan Chen
- Department of Haematology, Qilu Hospital, Shandong University, Jinan, China
| | - Jian-Yu Weng
- Department of Haematology, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Jian Huang
- Department of Haematology, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China
- Department of Haematology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Fei Li
- Center of Haematology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yun Zeng
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhen Xiao
- The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China
| | - Jian-da Hu
- Fujian Medical University Union Hospital, Fuzhou, China
| | - Li-Jie Yang
- Xi'an International Medical Center Hospital, Xi'an, China
| | - Zhuo-Gang Liu
- Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Guo-Hui Li
- Xi'an International Medical Center Hospital, Xi'an, China
| | - Xiu-Li Sun
- Department of Hematology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Wei Yang
- Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ru Feng
- Department of Hematology, Beijing Hospital, Beijing, China
| | - Yan-Qiu Han
- The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China
| | - Yu Jing
- Department of Hematology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Na Xu
- Department of Haematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao-Li Liu
- Department of Haematology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhen-Fang Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiao-Dong Wang
- Department of Haematology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Haematology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Shi-Xin Wu
- The Second Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Rong Liang
- Department of Haematology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yan-Li Zhang
- Department of Haematology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Yun-Fan Yang
- Department of Haematology, Institute of Haematology, West China Hospital, Sichuan University, Chengdu, China
| | - Huan-Ling Zhu
- Department of Haematology, Institute of Haematology, West China Hospital, Sichuan University, Chengdu, China
| | - Ling Pan
- Department of Haematology, Institute of Haematology, West China Hospital, Sichuan University, Chengdu, China
| | - Li Meng
- Department of Haematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Hong Zhao
- The First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Hai Yi
- Hematology Department, The General Hospital of Western Theater Command, PLA, Chengdu, China
| | - Yi-Lan Liu
- Hematology Department, The General Hospital of Western Theater Command, PLA, Chengdu, China
| | - Wei-Hua Zhang
- First Hospital of Shangxi Medical University, Shangxi, China
| | - Yuan-Jun Zheng
- First Hospital of Shangxi Medical University, Shangxi, China
| | - Ze-Ping Zhou
- Dept. of Hematology, The Second Hospital Affiliated to Kunming medical university, Kunming, China
| | - Su-Ning Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation of Soochow University, Suzhou, China
| | - Hui-Ying Qiu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation of Soochow University, Suzhou, China
| | - Wei-Ming Li
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi-Lin Jia
- Department of Hematology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yan-Liang Bai
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Li-E Lin
- Hainan General Hospital, Hainan, China
| | - Bing-Cheng Liu
- National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | | | - Jian-Min Luo
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | | | - Zhi-Qiang Sun
- Shenzhen Hospital of Southern Medical University, Shenzhen, China
| | - Yan-Qing Zhang
- Department of Hematology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiao-Jun Huang
- National Clinical Research Center for Haematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Haematology, Beijing, China
- Collaborative Innovation Center of Haematology, Soochow University, Suzhou, China
- Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
- Research Unit of Key Technique for Diagnosis and Treatments of Haematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, China
| | - Qian Jiang
- National Clinical Research Center for Haematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Haematology, Beijing, China
- Collaborative Innovation Center of Haematology, Soochow University, Suzhou, China
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8
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Xia J, Zhao Y, Chen F, Miao M, Qiu HY, Ma X, Tang XW, Wang Y, Wu XJ, Fu ZZ, Wu DP, Chen SN. [Allogeneic hematopoietic stem cell transplantation in acute leukemia patients with the SET-NUP214 fusion gene: Efficacy and survival analysis]. Zhonghua Nei Ke Za Zhi 2023; 62:410-415. [PMID: 37032136 DOI: 10.3760/cma.j.cn112138-20220411-00264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Objective: To investigate the clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with acute leukemia who are positive for the SET-NUP214 fusion gene (SET-NUP214+AL). Methods: This was a retrospective case series study. Clinical data of 18 patients with SET-NUP214+AL who received allo-HSCT in the First Affiliated Hospital of Soochow University and Soochow Hongci Hematology Hospital from December 2014 to October 2021 were retrospectively analyzed to investigate treatment efficacy and prognosis. The Kaplan-Meier method was used for survival analysis. Results: Of the 18 patients, 12 were male and 6 were female, and the median age was 29 years (range, 13-55 years). There were six cases of mixed phenotype acute leukemia (three cases of myeloid/T, two cases of B/T, one case of myeloid/B/T), nine cases of acute lymphoblastic leukemia (ALL) (one case of B-ALL and eight cases of T-ALL), and three cases of acute myeloid leukemia. All patients received induction chemotherapy after diagnosis, and 17 patients achieved complete remission (CR) after chemotherapy. All patients subsequently received allo-HSCT. Pre-transplantation status: 15 patients were in the first CR, 1 patient was in the second CR, 1 was in partial remission, and 1 patient did not reach CR. All patients were successfully implanted with stem cells. The median time of granulocyte and platelet reconstitution was +12 and +13 days, respectively. With a median follow-up of 23 (4-80) months, 15 patients survived, while 3 patients died. The cause of death was recurrence of SET-NUP214+AL after transplantation. After allo-HSCT, 5 patients relapsed. The estimated 3-year overall survival (OS) and relapse-free survival (RFS) rates were 83.3%±15.2% and 55.4%±20.7%, respectively. Among the 15 patients who achieved CR before transplantation, there was no significant difference in OS and RFS between haploidentical HSCT and matched sibling donor HSCT (all P>0.05). Conclusions: Allo-HSCT can improve the prognosis and long-term survival rate of patients with SET-NUP214+AL. Disease recurrence is the most important factor affecting long-term survival.
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Affiliation(s)
- J Xia
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China the First Affiliated Hospital of Soochow University, Soochow Hongci Hematology Hospital, Suzhou 215100, China
| | - Y Zhao
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China the First Affiliated Hospital of Soochow University, Soochow Hongci Hematology Hospital, Suzhou 215100, China
| | - F Chen
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China the First Affiliated Hospital of Soochow University, Soochow Hongci Hematology Hospital, Suzhou 215100, China
| | - M Miao
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - H Y Qiu
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - X Ma
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China the First Affiliated Hospital of Soochow University, Soochow Hongci Hematology Hospital, Suzhou 215100, China
| | - X W Tang
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - Y Wang
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - X J Wu
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China the First Affiliated Hospital of Soochow University, Soochow Hongci Hematology Hospital, Suzhou 215100, China
| | - Z Z Fu
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - D P Wu
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - S N Chen
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
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9
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Wang Y, Chen J, Xue SL, Han Y, Tang XW, Qiu HY, Wu DP, Wang Y. [Outcome of allogeneic hematopoietic stem cell transplantation in 14 patients with NPM1-mutated myelodysplastic syndromes]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:66-69. [PMID: 36987726 PMCID: PMC10067381 DOI: 10.3760/cma.j.issn.0253-2727.2023.01.012] [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] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Indexed: 03/30/2023]
Affiliation(s)
- Y Wang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - J Chen
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - S L Xue
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y Han
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - X W Tang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - H Y Qiu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - D P Wu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y Wang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
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10
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Wang Q, Cai WZ, Wang QR, Zhu MQ, Yan LZ, Yu Y, Bao XB, Shen HJ, Yao H, Xie JD, Zhang TT, Zhang L, Xu XY, Shan Z, Liu H, Cen JN, Liu DD, Pan JL, Lu DR, Chen J, Xu Y, Zhang R, Wang Y, Xue SL, Miao M, Han Y, Tang XW, Qiu HY, Sun AN, Huang JY, Dai HP, Wu DP, Chen SN. Integrative genomic and transcriptomic profiling reveals distinct molecular subsets in adult mixed phenotype acute leukemia. Am J Hematol 2023; 98:66-78. [PMID: 36219502 DOI: 10.1002/ajh.26758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 02/04/2023]
Abstract
Mixed phenotype acute leukemia (MPAL) is a subtype of leukemia in which lymphoid and myeloid markers are co-expressed. Knowledge regarding the genetic features of MPAL is lacking due to its rarity and heterogeneity. Here, we applied an integrated genomic and transcriptomic approach to explore the molecular characteristics of 176 adult patients with MPAL, including 86 patients with T-lymphoid/myeloid MPAL (T/My MPAL-NOS), 42 with Ph+ MPAL, 36 with B-lymphoid/myeloid MPAL (B/My MPAL-NOS), 4 with t(v;11q23), and 8 with MPAL, NOS, rare types. Genetically, T/My MPAL-NOS was similar to B/T MPAL-NOS but differed from Ph+ MPAL and B/My MPAL-NOS. T/My MPAL-NOS exhibited higher CEBPA, DNMT3A, and NOTCH1 mutations. Ph+ MPAL demonstrated higher RUNX1 mutations. B/T MPAL-NOS showed higher NOTCH1 mutations. By integrating next-generation sequencing and RNA sequencing data of 89 MPAL patients, we defined eight molecular subgroups (G1-G8) with distinct mutational and gene expression characteristics. G1 was associated with CEBPA mutations, G2 and G3 with NOTCH1 mutations, G4 with BCL11B rearrangement and FLT3 mutations, G5 and G8 with BCR::ABL1 fusion, G6 with KMT2A rearrangement/KMT2A rearrangement-like features, and G7 with ZNF384 rearrangement/ZNF384 rearrangement-like characteristics. Subsequently, we analyzed single-cell RNA sequencing data from five patients. Groups G1, G2, G3, and G4 exhibited overexpression of hematopoietic stem cell disease-like and common myeloid progenitor disease-like signatures, G5 and G6 had high expression of granulocyte-monocyte progenitor disease-like and monocyte disease-like signatures, and G7 and G8 had common lymphoid progenitor disease-like signatures. Collectively, our findings indicate that integrative genomic and transcriptomic profiling may facilitate more precise diagnosis and develop better treatment options for MPAL.
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Affiliation(s)
- Qian Wang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Wen-Zhi Cai
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Qin-Rong Wang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Ming-Qing Zhu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Ling-Zhi Yan
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Yan Yu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Xie-Bing Bao
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Hong-Jie Shen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Hong Yao
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Jun-Dan Xie
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Tong-Tong Zhang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Ling Zhang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Xiao-Yu Xu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Zhe Shan
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Hong Liu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Jian-Nong Cen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Dan-Dan Liu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Jin-Lan Pan
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Da-Ru Lu
- Key Laboratory of Birth Defects and Reproductive Health of National Health Commission, Chongqing Population and Family Planning, Science and Technology Research Institute, Chongqing, People's Republic of China.,State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, People's Republic of China
| | - Jia Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Yang Xu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Ri Zhang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Ying Wang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Sheng-Li Xue
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Miao Miao
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Yue Han
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Xiao-Wen Tang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Hui-Ying Qiu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Ai-Ning Sun
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Jin-Yan Huang
- Biomedical Big Data Center, Zhejiang Provincial Key Laboratory of Pancreatic Disease, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.,Zhejiang University Cancer Center, Zhejiang University, Hangzhou, People's Republic of China
| | - Hai-Ping Dai
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - De-Pei Wu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Su-Ning Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
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11
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Kong X, Zhang J, Li MY, Sun AN, Han Y, Tang XW, Qiu HY, Wu DP. [Treatment of infection by Ceftazidime Avibactam in hematopathy patients due to neutropenia]. Zhonghua Xue Ye Xue Za Zhi 2022; 43:1038-1042. [PMID: 36709111 PMCID: PMC9939339 DOI: 10.3760/cma.j.issn.0253-2727.2022.12.011] [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] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Indexed: 01/30/2023]
Affiliation(s)
- X Kong
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - J Zhang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - M Y Li
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - A N Sun
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Y Han
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - X W Tang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - H Y Qiu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - D P Wu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
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12
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Wei JF, Qiu HY, Chen Z, Miao L, Wang Y, Zhao LD, Cai ZM. [Clinical Significance of RAS Gene Mutations in Patients with Acute Myeloid Leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2022; 30:1391-1396. [PMID: 36208240] [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: 06/16/2023]
Abstract
OBJECTIVE To investigate the clinical characteristics of RAS gene mutations in patients with acute myeloid leukemia (AML). METHODS 43 myeloid gene mutations were detected using next-generation sequencing (NGS) in 180 patients with AML who were first diagnosed between May 2011 and February 2021. The molecular and clinical features of RAS gene mutations and their effects on efficacy and survival of patients were retrospectively analyzed. RESULTS Among 180 AML patients, the proportion of mutations in RAS pathway-related genes were NRAS (14.4%), KRAS (2.2%), FLT3-ITD (13.8%), PTPN11 (7.7%), KIT (5.0%), FLT3-TKD (3.8%) and CBL (2.7%). Seventy-three (40.6%) AML patients had gene mutations associated with the RAS pathway.The number of peripheral blood white blood cells and the proportion of bone marrow primitive juvenile cells in patients with NRAS/KRAS gene mutation were higher than those of patient with RAS wild-type, the difference was statistically significant (P<0.05). NRAS/KRAS gene mutations were significantly associated with the CBL gene mutation(r=0.287). In young AML patients (age <60 years), there were no significant differences in complete response rate (CR), progression-free survival (PFS), and overall survival (OS) between patients with RAS gene mutation and those with wild-type(P>0.05). In elderly AML patients (age≥60 years), PFS and OS in RAS mutants were significantly lower than those in wild-type patients(P<0.05). CONCLUSION In AML patients, RAS gene mutation is relatively common, and RAS gene mutation is associated with clinical characteristics and efficacy of patients, and may be a molecular marker of poor prognosis for elderly AML.
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Affiliation(s)
- Ji-Feng Wei
- Department of Hematology, Lianyungang First People's Hospital; Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology. Lianyungang 222000, Jiangsu Province, China
| | - Hui-Ying Qiu
- Department of Hematology, Lianyungang First People's Hospital; Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology. Lianyungang 222000, Jiangsu Province, China
| | - Ze Chen
- Department of Hematology, Lianyungang First People's Hospital; Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology. Lianyungang 222000, Jiangsu Province, China
| | - Lei Miao
- Department of Hematology, Lianyungang First People's Hospital; Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology. Lianyungang 222000, Jiangsu Province, China
| | - Ying Wang
- Department of Hematology, Lianyungang First People's Hospital; Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology. Lianyungang 222000, Jiangsu Province, China
| | - Li-Dong Zhao
- Department of Hematology, Lianyungang First People's Hospital; Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology. Lianyungang 222000, Jiangsu Province, China
| | - Zhi-Mei Cai
- Department of Hematology, Lianyungang First People's Hospital; Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology. Lianyungang 222000, Jiangsu Province, China,E-mail:
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13
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Dai JJ, Wang L, Qiu HY, Huang XY, Tian YX, Peng Q, Liu Y, Guan H. [Clinical effects of autologous follicular unit extraction transplantation in the treatment of small area secondary cicatricial alopecia after burns]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2022; 38:532-537. [PMID: 35764578 DOI: 10.3760/cma.j.cn501120-20210224-00064] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the clinical effects of autologous follicular unit extraction (FUE) transplantation in the treatment of small area secondary cicatricial alopecia (hereinafter referred to as cicatricial alopecia) after burns. Methods: A retrospective observational study was carried out. According to the adopted treatment methods, 18 patients (12 males and 6 females, aged (29±6) years) who received autologous FUE transplantation for small area cicatricial alopecia after burns from March 2017 to November 2019 in the First Affiliated Hospital of Air Force Medical University were included in FUE transplantation group, and 18 patients (13 males and 5 females, aged (33±5) years) who were treated with expanded flap transplantation for small area cicatricial alopecia after burns by the same surgery team during the same period in the same hospital were included in expanded flap transplantation group. All the patients were followed up for more than 1 year. At the last follow-up, the follicular unit density in the transplanted area was measured by Folliscope hair detection system and the hair survival rate was calculated; the visual analogue scale (VAS) method was adopted to evaluate the treatment effect; patients were asked their satisfaction with the treatment effect and the occurrence of complications during follow-up; the hair growth and the scalp thickness, pain, pruritus, pigmentation, and surface roughness of the transplanted area were recorded. Data were statistically analyzed with Fisher's exact probability test and independent sample t test. Results: At the last follow-up, the follicular unit density in the transplanted area of patients in FUE transplantation group was (46.8±2.0)/cm2, which was significantly higher than (42.5±4.3)/cm2 in expanded flap transplantation group (t=3.84, P<0.01); the hair survival rates of patients were similar between the two groups (P>0.05). At the last follow-up, VAS scores evaluating the treatment effect of patients were similar between the two groups (P>0.05); the satisfaction score of patients toward the treatment effect in FUE transplantation group was 8.6±1.1, which was significantly higher than 7.6±0.8 in expanded flap transplantation group (t=2.89, P<0.01). During the follow-up, no inflammation or infection occurred in patients of the two groups, but only 2 patients in expanded flap transplantation group had postoperative pain. At the last follow-up, the transplanted area of patients in the two groups was covered with new hair, and the hair growth direction was basically consistent with the surrounding normal hair; scalp thickness, pain, pruritus, pigmentation, and surface roughness of the transplanted area of patients were similar between the two groups (P>0.05). Conclusions: Autologous FUE transplantation has better long-term follicular unit density and patients' satisfaction than expanded flap transplantation in the treatment of small area cicatricial alopecia after burns, showing better postoperative effect and a good prospect of clinical application.
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Affiliation(s)
- J J Dai
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - L Wang
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - H Y Qiu
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - X Y Huang
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - Y X Tian
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - Q Peng
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - Y Liu
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - H Guan
- Department of Burns and Cutaneous Surgery, Burn Center of PLA, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
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Yao XY, Xie L, Cai Y, Zhang Y, Deng Y, Gao MC, Wang YS, Xu HM, Ding J, Wu YF, Zhao N, Wang Z, Song YY, Wang LP, Xie C, Li ZZ, Wan WB, Lin Y, Jin HF, Wang K, Qiu HY, Zhuang L, Zhou Y, Jin YY, Ni LP, Yan JL, Guo Q, Xue JH, Qian BY, Guan YT. Human Umbilical Cord Mesenchymal Stem Cells to Treat Neuromyelitis Optica Spectrum Disorder (hUC-MSC-NMOSD): A Study Protocol for a Prospective, Multicenter, Randomized, Placebo-Controlled Clinical Trial. Front Neurol 2022; 13:860083. [PMID: 35547390 PMCID: PMC9082633 DOI: 10.3389/fneur.2022.860083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Received: 01/22/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Neuromyelitis Optica spectrum disorder (NMOSD) is severe relapsing and disabling autoimmune disease of the central nervous system. Its optimal first-line treatment to reduce relapse rate and ameliorate neurological disability remains unclear. We will conduct a prospective, multicenter, randomized, placebo-controlled clinical trial to study the safety and effectiveness of human umbilical cord mesenchymal stem cells (hUC-MSCs) in treating NMOSD. Methods The trial is planned to recruit 430 AQP4-IgG seropositive NMOSD patients. It consists of three consecutive stages. The first stage will be carried out in the leading center only and aims to evaluate the safety of hUC-MSCs. Patients will be treated with three different doses of hUC-MSCs: 1, 2, or 5 × 106 MSC/kg·weight for the low-, medium-, and high-dose group, respectively. The second and third stages will be carried out in six centers. The second stage aims to find the optimal dosage. Patients will be 1:1:1:1 randomized into the low-, medium-, high-dose group and the controlled group. The third stage aims to evaluate the effectiveness. Patients will be 1:1 randomized into the optimal dose and the controlled group. The primary endpoint is the first recurrent time and secondary endpoints are the recurrent times, EDSS scores, MRI lesion numbers, OSIS scores, Hauser walking index, and SF-36 scores. Endpoint events and side effects will be evaluated every 3 months for 2 years. Discussion Although hUC-MSC has shown promising treatment effects of NMOSD in preclinical studies, there is still a lack of well-designed clinical trials to evaluate the safety and effectiveness of hUC-MSC among NMOSD patients. As far as we know, this trial will be the first one to systematically demonstrate the clinical safety and efficacy of hUC-MSC in treating NMOSD and might be able to determine the optimal dose of hUC-MSC for NMOSD patients. Trial registration The study was registered with the Chinese Clinical Trial Registry (CHICTR.org.cn) on 2 March 2016 (registration No. ChiCTR-INR-16008037), and the revised trial protocol (Protocol version 1.2.1) was released on 16 March 2020.
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Affiliation(s)
- Xiao-Ying Yao
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li Xie
- Clinical Research Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Cai
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Zhang
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ye Deng
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mei-Chun Gao
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Shu Wang
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hui-Ming Xu
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med-X Clinical Stem Cell Research Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Ding
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi-Fan Wu
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Nan Zhao
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ze Wang
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ya-Ying Song
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li-Ping Wang
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chong Xie
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ze-Zhi Li
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wen-Bin Wan
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Lin
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hai-Feng Jin
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Kan Wang
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hui-Ying Qiu
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Zhuang
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Zhou
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yu-Yan Jin
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li-Ping Ni
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jia-Li Yan
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Quan Guo
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jia-Hui Xue
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bi-Yun Qian
- Clinical Research Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Clinical Research Promotion and Development Center, Shanghai Hospital Development Center, Shanghai, China
| | - Yang-Tai Guan
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Li Z, Wang J, Ge SS, Qiu QC, Du JH, Shan SS, Shen XD, Wan CL, Wang BR, Wu DP, Qiu HY, Xue SL. Combination of Venetoclax and Midostaurin Efficiently Suppressed Relapsed t(8;21)Acute Myeloid Leukemia With Mutant KIT After Failure of Venetoclax Plus Azacitidine Treatment. Front Oncol 2022; 12:841276. [PMID: 35211416 PMCID: PMC8861361 DOI: 10.3389/fonc.2022.841276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 12/22/2021] [Accepted: 01/24/2022] [Indexed: 11/16/2022] Open
Abstract
Acute myeloid leukemia (AML) with t(8;21) is categorized as favorable-risk AML, but KIT mutations show a significantly poor prognostic impact in such patients. Persistent vulnerability to relapse is a major challenge in the treatment of this subtype of patients. Venetoclax is a BCL-2 selective inhibitor. The venetoclax+HMA strategy is also a notable salvage regimen that achieves good clinical outcomes in the treatment of relapsed or refractory (R/R) AML. However, in our clinical practice, we found that disease progressed rapidly even after venetoclax+azacitidine (AZA) therapy in two relapsed t(8;21) AML patients with KIT mutations. We report for the first time the therapeutic potential of venetoclax+midostaurin as a new combination therapy for relapsed t(8;21) AMLs with KIT mutations showing resistance to venetoclax+AZA therapy. Our ex vivo study also showed that midostaurin alone could inhibit proliferation and induce apoptosis of Kasumi-1 cells (e.g. Midostaurin induced G2 phase cell arrest, down-regulated p-KIT and BCL-2, while Bax protein levels were up-regulated) and observed a synergistic anti effect when the two drugs were combined. Our study shows that the venetoclax+midostaurin regimen may be a promising treatment option for R/R t(8;21) AML with KIT mutations.
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Affiliation(s)
- Zheng Li
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Jun Wang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Shuai-Shuai Ge
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Qiao-Cheng Qiu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Jia-Hui Du
- Suzhou Key Laboratory of Medical Biotechnology, Suzhou Vocational Health College, Suzhou, China
| | - Shuang-Shuang Shan
- Suzhou Key Laboratory of Medical Biotechnology, Suzhou Vocational Health College, Suzhou, China
| | - Xiang-Dong Shen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Chao-Ling Wan
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Bin-Ru Wang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - De-Pei Wu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Hui-Ying Qiu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Sheng-Li Xue
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
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16
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Ma YJ, Dai HP, Cui QY, Cui W, Zhu WJ, Qu CJ, Kang LQ, Zhu MQ, Zhu XM, Liu DD, Feng YF, Shen HJ, Liu TH, Qiu HY, Yu L, Wu DP, Tang XW. Successful application of PD-1 knockdown CLL-1 CAR-T therapy in two AML patients with post-transplant relapse and failure of anti-CD38 CAR-T cell treatment. Am J Cancer Res 2022; 12:615-621. [PMID: 35261791 PMCID: PMC8899985] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/08/2022] [Indexed: 06/14/2023] Open
Abstract
Patients with relapsed/refractory acute myeloid leukemia (R/R AML) often show resistance to chemotherapy and have dismal outcomes. Therefore, it is urgent to develop new treatment strategies to address this problem. With tremendous achievement of chimeric antigen receptor T cells (CAR-T) therapy against B-cell malignancies, many efforts have been devoted to developing CAR-T therapy for R/R AML but with limited success, in part owing to a lack of specific targets. C-type lectin-like molecule-1 (CLL-1) is highly expressed on AML blasts with no expression on normal hematopoietic stem cells, which makes it an ideal target of immunotherapy for AML. Here, we report 2 R/R AML patients who relapsed after allogeneic stem cell transplantation and failed multiline salvage therapies including anti-CD38 CAR-T therapy, but were successfully treated with PD-1 silenced anti-CLL-1 CAR-T therapy. Both patients achieved molecular complete remission with incomplete hematologic recovery at 28 days of evaluation after CLL-1 CAR-T cell infusion. Cytokine release syndrome in cases 1 and 2 were grade 1 and 2, respectively. At the last follow-up, cases 1 and 2 had maintained continuous remission for 8 and 3 months, respectively. Our results demonstrated that CLL-1 CAR-T cells might be an effective and safe salvage therapy for AML patients with posttransplant relapse.
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Affiliation(s)
- Yun-Ju Ma
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Hai-Ping Dai
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Qing-Ya Cui
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Wei Cui
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Wen-Juan Zhu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Chang-Ju Qu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Li-Qing Kang
- Shanghai Unicar-Therapy Bio-medicine Technology Co, LtdShanghai, China
| | - Ming-Qing Zhu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Xia-Ming Zhu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Dan-Dan Liu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Yu-Feng Feng
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Hong-Jie Shen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Tian-Hui Liu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Hui-Ying Qiu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Lei Yu
- Shanghai Unicar-Therapy Bio-medicine Technology Co, LtdShanghai, China
| | - De-Pei Wu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
| | - Xiao-Wen Tang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow UniversitySuzhou, Jiangsu, China
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Li Z, Zhang J, Zhou M, Li JL, Qiu QC, Fu JH, Xue SL, Qiu HY. Epigenetic therapy with chidamide alone or combined with 5‑azacitidine exerts antitumour effects on acute myeloid leukaemia cells in vitro. Oncol Rep 2022; 47:66. [PMID: 35103292 PMCID: PMC8848469 DOI: 10.3892/or.2022.8277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 09/14/2021] [Accepted: 01/04/2022] [Indexed: 11/06/2022] Open
Abstract
Chidamide, a selective histone deacetylase inhibitor, has antitumour effects. 5‑azacitidine (5‑AZA), a hypomethylating agent, is effective in treating acute myeloid leukaemia (AML) and myelodysplastic syndrome. However, to the best of our knowledge, the effect of chidamide and 5‑AZA on AML cell lines has not been fully investigated. In the present study, the antileukaemia activity of chidamide, alone and in combination with 5‑AZA, was assessed on different subtypes of AML cell lines (M1‑M5) and primary samples from several patients with AML in vitro. The results indicated that the proliferation of leukaemia cells was significantly and dose‑dependently inhibited by chidamide and 5‑AZA alone or in combination. The combination also had marked synergistic effects to induce apoptosis of AML cells. The apoptosis of leukaemia cells was induced via downregulation of BCL‑2 and myeloid‑cell leukemia 1 (MCL‑1) levels. Of note, chidamide also degraded the MCL‑1 protein in venetoclax‑resistant U937 cells, in which the MCL‑1 protein is upregulated. In addition, chidamide was able to induce myeloid differentiation (with CD11b upregulation) of AML cell lines or monocytic/dendritic differentiation (with CD86 upregulation) of primary cultured cells from several patients with AML. Chidamide was also able to promote the differentiation of the venetoclax‑resistant U937 cell line by upregulating CD11b expression. In conclusion, chidamide alone or combined with 5‑AZA may be an effective therapy for AML.
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Affiliation(s)
- Zheng Li
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Jian Zhang
- Department of Blood Transfusion, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Min Zhou
- Department of Hematology, Changshu Affiliated Hospital of Soochow University, The First People's Hospital of Changshu, Changshu, Jiangsu 215500, P.R. China
| | - Jin-Li Li
- State Key Laboratory of Radiation Medicine and Protection, Oncology Radiotherapy Department, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Qiao-Cheng Qiu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Jian-Hong Fu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Sheng-Li Xue
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Hui-Ying Qiu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
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Yin J, Wan CL, Zhang L, Zhang H, Bai L, Zhou HX, Xu MZ, Chen LY, Qian CS, Qiu HY, Chen SN, Tang XW, Wu DP, Zhang YM, Sun AN, Xue SL. A Phase II Trial of the Double Epigenetic Priming Regimen Including Chidamide and Decitabine for Relapsed/Refractory Acute Myeloid Leukemia. Front Oncol 2021; 11:726926. [PMID: 34540696 PMCID: PMC8446637 DOI: 10.3389/fonc.2021.726926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Received: 06/17/2021] [Accepted: 08/20/2021] [Indexed: 12/19/2022] Open
Abstract
Objective To explore the role of chidamide, decitabine plus priming regimen in the salvage treatment of relapsed/refractory acute myeloid leukemia. Methods A clinical trial was conducted in relapsed/refractory acute myeloid leukemia patients using chidamide, decitabine, cytarabine, idarubicin, and granulocyte-colony stimulating factor, termed CDIAG, a double epigenetic priming regimen. Results Thirty-five patients were recruited. Three patients received 2 treatment cycles. In 32 evaluable patients and 35 treatment courses, the completed remission rate (CRR) was 42.9%. The median OS time was 11.7 months. The median OS times of responders were 18.4 months, while those of nonresponders were 7.4 months (P = 0.015). The presence of RUNX1 mutations was associated with a high CRR but a short 2-year OS (P = 0.023) and PFS (P = 0.018) due to relapse after treatment. The presence of IDH mutations had no effect on the remission rate (80.0% vs. 73.3%), but showed a better OS (2-year OS rate: 100.0% vs. 28.9%). Grade 3/4 nonhematological adverse events included pneumonia, hematosepsis, febrile neutropenia, skin and soft tissue infection and others. Conclusion The double epigenetic priming regimen (CDIAG regimen) showed considerably good antileukemia activity in these patients. Adverse events were acceptable according to previous experience. The study was registered as a clinical trial. Clinical Trial Registration https://clinicaltrials.gov/, identifier:NCT03985007
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Affiliation(s)
- Jia Yin
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Chao-Ling Wan
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Ling Zhang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Hao Zhang
- Department of Hematology, The Affiliated Hospital of Jining Medical College, Jining, China
| | - Lian Bai
- Department of Hematology, Canglang Hospital of Suzhou, Suzhou, China
| | - Hai-Xia Zhou
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Ming-Zhu Xu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Li-Yun Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Chong-Sheng Qian
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Hui-Ying Qiu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Su-Ning Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Xiao-Wen Tang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - De-Pei Wu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Yan-Ming Zhang
- Department of Hematology, The Affiliated Huai'an Hospital of Xuzhou Medical University and The Second People's Hospital of Huai'an, Huai'an, China
| | - Ai-Ning Sun
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Sheng-Li Xue
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
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19
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Huang F, Wang XD, Jiang L, Qiu HY. [Evaluation of the effectiveness of community health education for the prevention and control of retransmission of imported malaria in Zhangjiagang City]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2021; 33:308-310. [PMID: 34286536 DOI: 10.16250/j.32.1374.2020140] [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: 11/27/2022]
Abstract
OBJECTIVE To increase the awareness of malaria prevention and control among people going abroad and returners, so as to prevent the local retransmission of oversea imported malaria. METHODS Health education interventions for malaria control were given to people going abroad and returners in communities, and the changes of malaria prevention and control knowledge and medical-seeking behaviors were observed among the target populations. RESULTS There were 367 people going abroad and oversea returners from malaria-endemic areas in Zhangjiagang City from July 2018 to December 2019, and 18 imported malaria cases were found. Following the implementation of community health education, the awareness of malaria prevention and control knowledge increased significantly from 35.09% to 93.08% among the target populations (χ2 = 78.130, P < 0.01), and the proportions of carrying anti-malarial drugs and administration of anti-malarial drugs for emergency treatment increased from 12.14% and 11.46% to 26.79% and 26.79% (χ2 = 8.793 and 9.834, P < 0.05), respectively. In addition, the mean duration from malaria onset to the definitive diagnosis reduced from (5.86 ± 4.45) days to (3.11 ± 1.28) days (U = 64.000, P < 0.05). CONCLUSIONS Community health education based on the precision community administration is an effective approach for malaria control in current era.
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Affiliation(s)
- F Huang
- Zhangjiagang Center for Disease Control and Prevention, Jiangsu Province, ZhangJiagang 215600, China
| | - X D Wang
- Zhangjiagang Center for Disease Control and Prevention, Jiangsu Province, ZhangJiagang 215600, China
| | - L Jiang
- Zhangjiagang Center for Disease Control and Prevention, Jiangsu Province, ZhangJiagang 215600, China
| | - H Y Qiu
- Zhangjiagang Center for Disease Control and Prevention, Jiangsu Province, ZhangJiagang 215600, China
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20
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Wu YX, Wu DP, Chen SN, Qiu HY, Han Y, Li CX, Ma X, Sun AN, Tang XW, Hu XH. [Analysis of early death factors and prognosis of acute promyelocytic leukemia]. Zhonghua Xue Ye Xue Za Zhi 2021; 41:1025-1030. [PMID: 33445851 PMCID: PMC7840560 DOI: 10.3760/cma.j.issn.0253-2727.2020.12.010] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
目的 总结初诊急性早幼粒细胞白血病(APL)早期死亡患者的临床特征,分析早期死亡的危险因素和直接死亡原因,同时对患者进行生存分析。 方法 回顾性分析2011年1月至2017年12月苏州大学附属第一医院、苏州大学附属第一医院广慈分院、苏州弘慈血液病医院收治的368例初诊APL患者的临床特征,分析早期死亡的独立危险因素,比较出血性早期死亡与非出血性早期死亡患者的临床特征,并对所有APL患者进行生存分析。 结果 368例初诊APL患者中早期死亡31例,早期病死率为8.4%,从诊断至死亡的中位时间为7(0~29)d。比较早期死亡患者与非早期死亡患者的临床特征,应用Logistic回归模型进行多因素分析显示,年龄≥50岁和初诊时WBC≥10×109/L为初诊APL患者发生早期死亡的独立危险因素(P值均<0.01)。31例早期死亡患者中有27例(87.1%)的直接死亡原因为出血,出血是<50岁患者的唯一死亡原因,≥50岁患者的主要死亡原因。比较出血性早期死亡患者与非出血性早期死亡患者的临床特征,提示出血性早期死亡患者的中位年龄和间接胆红素水平较非出血性早期死亡患者低(P<0.05)。所有患者中位随访时间为41.0(0.3~101.4)个月。2年总生存(OS)率为(93.5±1.3)%,5年OS率为(91.0±1.5)%。2年无病生存(DFS)率为(98.8±0.6)%,5年DFS率为(97.1±0.9)%。≥50岁与<50岁患者的2年OS率分别为79.3%和94.2%(P=0.000);2年DFS率分别为92.3%和98.1%(P=0.023)。高危患者与非高危患者的2年OS率分别为77.3%和96.7%(P=0.000);2年DFS率分别为94.0%和98.4%(P=0.139)。 结论 年龄≥50岁和WBC≥10×109/L是APL患者早期死亡的独立危险因素;高危和低危APL的早期病死率有差异而DFS率差异无统计学意义。
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Affiliation(s)
- Y X Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematology Disease, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou 215006, China; Soochow Hopes Hematology Hospital, Suzhou 215006, China
| | - D P Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematology Disease, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - S N Chen
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematology Disease, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - H Y Qiu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematology Disease, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Y Han
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematology Disease, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - C X Li
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematology Disease, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - X Ma
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematology Disease, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - A N Sun
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematology Disease, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - X W Tang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematology Disease, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - X H Hu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematology Disease, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
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21
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Wang H, Li XQ, Chu TT, Han SY, Qi JQ, Tang YQ, Qiu HY, Fu CC, Tang XW, Ruan CG, Wu DP, Han Y. Clinical significance of FLT3-ITD/CEBPA mutations and minimal residual disease in cytogenetically normal acute myeloid leukemia after hematopoietic stem cell transplantation. J Cancer Res Clin Oncol 2021; 147:2659-2670. [PMID: 33550446 DOI: 10.1007/s00432-021-03530-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/10/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Genetic changes have prognostic significance in cytogenetically normal acute myeloid leukemia (CN-AML). We set out to evaluate the prognostic of 6 gene mutations in CN-AML. METHODS We performed a mutational analysis and evaluated prognostic findings of six genes (NPM1, CEBPA, DNMT3A, FLT3-ITD, FLT3-TKD, and C-KIT) in 428 CN-AML patients at our center over 10 years. RESULTS A total of 282 patients (65.9%) had at least one gene mutation, and the mutation frequencies were as follows: 29.7% (NPM1), 24.1% (CEBPA), 20.1% (FLT3-ITD), 4.0% (FLT3-TKD), 11.9% (DNMT3A), and 4.7% (C-KIT). Multivariate analysis indicated that FLT3-ITDmut and CEBPAwt were independent risk factors correlated with poor overall survival (OS) and disease-free survival (DFS) of CN-AML. Compared with patients who received chemotherapy as consolidation, hematopoietic stem cell transplantation (HSCT) significantly improved OS of CN-AML patients. For standard/high risk patients, HSCT improved both OS and DFS. Combined analysis showed that patients with CEBPAmut/FLT3-ITDwt had the best prognosis, and patients with CEBPAwt/FLT3-ITDmut had the worst OS, with 3-year OS of only 44%. In 212 patients who received HSCT, FLT3-ITD/CEBPA mutations and minimal residual disease (MRD) were correlated with OS and DFS in univariate analysis. CONCLUSIONS We found that HSCT significantly improves the prognosis of standard/high risk CN-AML patients with superior OS and DFS. Molecular marker analyses, especially combined analysis of the FLT3-ITD and CEBPA status revealed a correlation with the prognosis of CN-AML. For patients who have received HSCT, MRD before transplantation was a strong prognostic marker predicting patient outcome.
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Affiliation(s)
- Hong Wang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China.,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Xue-Qian Li
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China.,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China
| | - Tian-Tian Chu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China.,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China
| | - Shi-Yu Han
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China.,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China
| | - Jia-Qian Qi
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China.,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Ya-Qiong Tang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China.,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Hui-Ying Qiu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China.,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China.,State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
| | - Cheng-Cheng Fu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China.,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China.,State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
| | - Xiao-Wen Tang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China.,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China.,State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
| | - Chang-Geng Ruan
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China.,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China.,State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
| | - De-Pei Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China. .,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China. .,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China. .,State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China.
| | - Yue Han
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215000, China. .,Collaborative Innovation Center of Hematology, Institute of Blood and Marrow Transplantation, Suzhou, China. .,Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China. .,State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China.
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22
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Yan M, Wu YJ, Chen F, Tang XW, Han Y, Qiu HY, Sun AN, Xue SL, Jin ZM, Wang Y, Miao M, Wu DP. [CAR T-cell bridging to allo-HSCT for relapsed/refractory B-cell acute lymphoblastic leukemia: the follow-up outcomes]. Zhonghua Xue Ye Xue Za Zhi 2020; 41:710-715. [PMID: 33113601 PMCID: PMC7595870 DOI: 10.3760/cma.j.issn.0253-2727.2020.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Indexed: 12/12/2022]
Abstract
Objective: This study aims to investigate the efficacy and safety of chimeric antigen receptor (CAR) T-cell bridging allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of recurrent and refractory acute B-lymphocytic leukemia (R/R B-ALL) . Methods: A total of 50 R/R B-ALL patients who underwent CAR T-scell therapy to bridge allo-HSCT in the First Affiliated Hospital of Soochow University from January 2017 to May 2019 were retrospectively analyzed. The overall survival (OS) rate, event-free survival (EFS) rate, cumulative recurrence rate (CIR) , and transplant-related mortality (TRM) of patients with different bone marrow minimal residual disease (MRD) levels were analyzed before and after CAR T-cell infusion and before allo-HSCT. Results: The response rate of CAR T-cell therapy and the incidence rate of severe cytokine release syndrome were 92% and 28% , respectively. During 55 infusions, no treatment-related deaths occurred in any of the patients. The median time of CAR T-cell infusion to allo-HSCT was 54 (26-232) days, the median follow-up time after CAR T-cell infusion was 637 (117-1097) days, and the 1-year OS and EFS rates were (80.0±5.7) % and (60.0±6.9) % . The 1-year CIR and TRM after allo-HSCT were (28.0±0.4) % and (8.0±0.2) % . After CAR T-cell infusion and before allo-HSCT, patients with bone marrow MRD<0.01% had a significantly longer EFS [ (70.0±7.2) % vs (20.0±12.6) % , P<0.001; (66.7±7.5) % vs (36.4±14.5) % , P=0.008]and lower CIR [ (25.0±0.5) % vs (70.0±2.6) % , P<0.001; (23.08±0.47) % vs (45.45±2.60) % , P=0.038]. Conclusion: CAR T-cell therapy bridging allo-HSCT is safe and effective for recurrent and refractory B-ALL.
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Affiliation(s)
- M Yan
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - Y J Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - F Chen
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - X W Tang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - Y Han
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - H Y Qiu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - A N Sun
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - S L Xue
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - Z M Jin
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - Y Wang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - M Miao
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - D P Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
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Li MY, Lin ZH, Hu MM, Kang LQ, Wu XX, Chen QW, Kong X, Zhang J, Qiu HY, Wu DP. Secondary donor-derived humanized CD19-modified CAR-T cells induce remission in relapsed/refractory mixed phenotype acute leukemia after allogeneic hematopoietic stem cell transplantation: a case report. Biomark Res 2020; 8:36. [PMID: 32874588 PMCID: PMC7457525 DOI: 10.1186/s40364-020-00216-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Received: 04/22/2020] [Accepted: 08/13/2020] [Indexed: 01/04/2023] Open
Abstract
Background Mixed phenotype acute leukemia (MPAL) is a rare leukemia and is regarded as a high-risk entity with a poor prognosis. Induction therapy of an acute lymphoblastic leukemia type or hybrid regimen and hematopoietic stem cell transplantation has been recommended for MPAL. However, the optimal therapies for relapsed or refractory MPAL remain unclear, especially for relapse after stem cell transplantation. Donor-derived chimeric antigen receptor T (CAR-T) cell therapy may be a promising therapeutic option for patients with MPAL who express target antigens and have relapsed after stem cell transplantation. However, recurrence remains a challenge, and reinfusion of CAR-T cells is not always effective. An infusion of secondary donor-derived humanized CD19-modified CAR-T cells may be effective in inducing remission. Case presentation We report a case of MPAL with CD19 expression. The patient was treated with acute lymphoblastic leukemia-like induction and consolidation therapies but remained positive for SET-NUP214 fusion gene transcript. He subsequently underwent a haploidentical stem cell transplantation but relapsed within 6 months. He then underwent donor-derived CD19-targeted CAR-T cell therapy and achieved a sustained, complete molecular remission. Unfortunately, he developed a CD19-positive relapse after 2 years. Donor-derived humanized CD19-directed CAR-T cells induced a second complete molecular remission without severe cytokine release syndrome or acute graft-versus-host disease. Conclusion This case demonstrated the efficacy and safety of humanized donor-derived CD19-modified CAR-T cell infusion for treating the recurrence of MPAL previously exposed to murine-derived CD19-directed CAR-T cells.
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Affiliation(s)
- Meng-Yun Li
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Collaborative Innovation Center of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Soochow University, 188 Shizi Street, Suzhou, 215006 P.R. China
| | - Zhi-Hong Lin
- Suzhou Yongding Hospital, Suzhou, People's Republic of China
| | - Ming-Ming Hu
- Suzhou Yongding Hospital, Suzhou, People's Republic of China
| | - Li-Qing Kang
- Institute of Biomedical Engineering and Technology, Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, NO, 3663 North Zhongshan Road, Shanghai, 200065 China.,Shanghai Unicar-Therapy Bio-medicine Technology Co., Ltd, No 1525 Minqiang Road, Shanghai, 201612 China
| | - Xiao-Xia Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Collaborative Innovation Center of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Soochow University, 188 Shizi Street, Suzhou, 215006 P.R. China
| | - Qi-Wei Chen
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Collaborative Innovation Center of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Soochow University, 188 Shizi Street, Suzhou, 215006 P.R. China
| | - Xin Kong
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Collaborative Innovation Center of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Soochow University, 188 Shizi Street, Suzhou, 215006 P.R. China
| | - Jian Zhang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Collaborative Innovation Center of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Soochow University, 188 Shizi Street, Suzhou, 215006 P.R. China
| | - Hui-Ying Qiu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Collaborative Innovation Center of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Soochow University, 188 Shizi Street, Suzhou, 215006 P.R. China
| | - De-Pei Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Collaborative Innovation Center of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation, Soochow University, 188 Shizi Street, Suzhou, 215006 P.R. China
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Liu HF, Huang HW, Bai SX, Gong YL, Wu CX, Jin ZM, Wang YY, Yang Q, Zhang J, Qiu HY, Chen SN, Pan JL. [Chromosomal aberrations detection in chronic lymphocytic leukemia by conventional cytogenetics using DSP30 and IL-2]. Zhonghua Xue Ye Xue Za Zhi 2020; 41:143-148. [PMID: 32135632 PMCID: PMC7357944 DOI: 10.3760/cma.j.issn.0253-2727.2020.02.011] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: To study the value of unmethylated cytosine guanine dinucleotide oligodeoxynucleotide (DSP30) and IL-2 in the conventional cytogenetic (CA) detection of the chromosomal aberrations in chronic lymphocytic leukemia (CLL) . Methods: Bone marrow or peripheral blood cells of CLL patients were cultured with DSP30 plus IL-2 for 72 h, following which R-banding analysis was conducted. Fluorescence in situ hybridization (FISH) was performed in 85 patients. CA results were compared with data obtained by FISH. Results: Among 89 CLL patients, the success rate of chromosome analysis was 94.38% (84/89) . Clonal aberrations were detected in 51 patients (51/84, 60.71%) . Of them, 27 (27/51, 52.94%) were complex karyotype. Among 85 CLL patients tested by FISH, chromosomal abnormalities were detected in 74 (74/85, 87.06%) patients, of which 2 (2/74) patients were complex karyotypes, accounting for 2.70%. Of the 85 CLL patients examined by FISH, 50 had abnormal karyotype analysis, 30 had normal karyotype, 5 failed to have chromosome analysis. Among them, 25 cases showed clonal aberrations by FISH assay but normal by CA, and 4 cases were normal by FISH but displayed aberrations in chromosome analysis, and totally 78 (91.76%) cases with abnormality detected by the combination of the two methods. The frequency of 13q- abnormality detected by FISH was significantly higher than that by CA analysis (69.41%vs 16.67%, P<0.001) , while the frequency of 11q-,+12 and 17p- detected by two methods showed no significant difference (P>0.05) . The detection rate of complex abnormalities in conventional karyotype analysis was higher than that in FISH (50.98%vs 2.70%) . In addition, 11 low-risk and 9 intermediate-risk patients according to FISH results showed complex karyotype by cytogenetics, and were classified into high-risk cytogenetic subgroup. Conclusion: DSP30 and IL-2 are effective in improving the detection rate of CA in CLL patients (60.71%) and CA is more effective to detect complex karyotype. However, FISH had a higher overall abnormality detection rate (87.06%) than CA, especially for 13q-. The combination of CA and FISH not only enhanced the detection rate of clonal aberrations to 91.76%, but also provided more precise prognosis stratification for CLL patients, thus to provide more information for clinical implication.
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Affiliation(s)
- H F Liu
- Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
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Zhang YM, Zhang Y, Ni X, Gao L, Qiu HY, Zhang YS, Tang GS, Chen J, Zhang WP, Wang JM, Yang JM, Hu XX. [Effect of consolidation before allogeneic hematopoietic stem cell transplantation for non-favorable acute myeloid leukemia patients with first complete remisson and negative minimal residual disease]. Zhonghua Xue Ye Xue Za Zhi 2020; 41:16-22. [PMID: 32023749 PMCID: PMC7357906 DOI: 10.3760/cma.j.issn.0253-2727.2020.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
目的 探讨异基因造血干细胞移植(allo-HSCT)前巩固化疗对第1次形态学完全缓解且微小残留病阴性(CR1/MRD−)中/高危急性髓系白血病(AML)患者预后的影响。 方法 对2010年1月至2019年3月在CR1/MRD−状态下接受allo-HSCT的155例中/高危AML(不含急性早幼粒细胞白血病)患者进行回顾性分析。 结果 全部155例患者中,102例获得CR1/MRD−后接受移植前巩固化疗(巩固组),53例获得CR1/MRD−后直接行allo-HSCT(非巩固组),两组中位年龄分别为39(18~56)岁、38(19~67)岁。巩固组、非巩固组移植后5年总生存率分别为(59.3±7.5)%、(62.2±6.9)%(P=0.919),无复发生存率分别为(53.0±8.9)%、(61.6±7.0)%(P=0.936),累积复发率分别为(21.9±5.4)%、(18.3±6.0)%(P=0.942),非复发死亡率分别为(22.4±4.3)%、(28.4±6.5)%(P=0.464)。多因素分析显示,移植前是否接受巩固化疗及其疗程(<2个/≥2个)对预后无显著影响。 结论 中/高危AML患者可在获得CR1/MRD−后直接进行allo-HSCT。
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Affiliation(s)
- Y M Zhang
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
| | - Y Zhang
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
| | - X Ni
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
| | - L Gao
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
| | - H Y Qiu
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
| | - Y S Zhang
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
| | - G S Tang
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
| | - J Chen
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
| | - W P Zhang
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
| | - J M Wang
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
| | - J M Yang
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
| | - X X Hu
- Department of Hematology, Changhai Hospital, the Naval Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
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Fei Y, Hu XX, Chen Q, Huang AJ, Cheng H, Ni X, Qiu HY, Gao L, Tang GS, Chen J, Zhang WP, Yang JM, Wang JM. [Prognostic value of donor chimerism at +90 days after allogeneic hematopoietic stem cell transplantation in young patients with intermediate-risk acute myeloid leukemia]. Zhonghua Xue Ye Xue Za Zhi 2019; 40:990-995. [PMID: 32023728 PMCID: PMC7342688 DOI: 10.3760/cma.j.issn.0253-2727.2019.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the relationship between donor chimerism and relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: The clinical data of 105 patients with acute myeloid leukemia (AML) who underwent allo-HSCT and recurrence-free survival>90 days from January 2010 to January 2019 were retrospectively analyzed. The bone marrow samples were collected at 15, 30, 60, 90, 180, 270, 360 days after transplantation. Donor chimerism was detected by single nucleotide polymorphism (SNP) -PCR. Results: Of the 105 patients, 43 cases were male and 62 cases were female, with a median age of 38 (16-60) years. Till April 2019, the median follow-up was 843 (94-3 261) days. Ninety days after transplantation, 18 cases relapsed, 33 cases died, and 72 cases survived. The 3-year overall survival (OS) rate was (66.8±5.1) %, and the recurrence-free survival (RFS) rate was (65.1±5.0) %. Pre-transplant disease status, pre-transplant minimal residual disease (MRD) , and 90 day post-transplantation chimerism were independent risk factors related to RFS. The risk of recurrence was significantly increased in patients with a donor chimerism rate ≤97.24% at 90 days after transplantation[HR=6.921 (95%CI 2.669-17.950) , P<0.001], which was considered as a sign of early relapse. Conclusion: SNP-PCR is an applicable method for detecting donor chimerism in patients after allo-HSCT. Chimerism rate equal or less than 97.24% at 90 days after transplantation predicts a higher risk of relapse.
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Affiliation(s)
- Y Fei
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - X X Hu
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - Q Chen
- Department of Health Statistics, Second Military Medical University, Shanghai 200433, China
| | - A J Huang
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - H Cheng
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - X Ni
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - H Y Qiu
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - L Gao
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - G S Tang
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - J Chen
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - W P Zhang
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - J M Yang
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - J M Wang
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
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Huang AJ, Wang LB, Du J, Tang GS, Cheng H, Gong SL, Gao L, Qiu HY, Ni X, Chen J, Chen L, Zhang WP, Wang JM, Yang JM, Hu XX. [Efficacy of Hyper-CVAD/MA and CHALL-01 regimens in the treatment of Philadelphia chromosome-positive adult acute lymphoblastic leukemia patients under 60 years old]. Zhonghua Xue Ye Xue Za Zhi 2019; 40:625-632. [PMID: 31495127 PMCID: PMC7342869 DOI: 10.3760/cma.j.issn.0253-2727.2019.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: To compare the difference of efficacy between traditional Hyper-CVAD/MA regimen and the adolescents inspired chemotherapy regimen, CH ALL-01, in treatment of adult Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+) ALL) . Methods: In this study we retrospectively analyzed 158 Ph(+) ALL patients receiving Hyper-CVAD/MA regimen (n=63) or CHALL-01 regimen (n=95) in our center and Changzheng hospital from January 2007 to December 2017, excluding patients with chronic myeloid leukemia in blast crisis. Tyrosine kinase inhibitor (TKI) was administered during induction and consolidation chemotherapy. Patients who underwent hematopoietic stem cell transplantation received TKI as maintenance therapy. Results: Of them, 91.1% (144/158) patients achieved complete remission (CR) after 1-2 courses of induction. CR rate was 90.5% (57/63) for patients in Hyper-CVAD/MA group and 91.6% (87/95) for patients in CHALL-01 group. There was no difference in CR rates between the two groups (χ(2)=0.057, P=0.811) . The last follow-up was June 2018. A cohort of 134 CR patients could be used for further analysis, among them, 53 patients received Hyper-CVAD/MA regimen and other 81 patients received CHALL-01 regimen. The molecular remission rates were significantly higher in CHALL-01 group (complete molecular response: 44.4%vs 22.6%; major molecular response: 9.9% vs 18.9%) (χ(2)=7.216, P=0.027) . For the patients in Hyper-CVAD/MA group, the 4-year overall survival (OS) was 44.81% (95%CI: 30.80%-57.86%) and the 4-year disease free survival (DFS) was 37.95% (95%CI: 24.87%-50.93%) . For patients received CHALL-01 regimen, the 4-year OS was 55.63% (95%CI: 39.07%-69.36%) (P=0.037) and 4 year DFS was 49.06% (95%CI: 34.24%-62.29%) (P=0.015) , while there was no significant difference in 4 year cumulative incidence of relapse (CIR) (P=0.328) or cumulative incidence of nonrelapse mortality (CI-NRM) (P=0.138) . The rate of pulmonary infection was lower in patients received CHALL-01 regimen compared with patients received Hyper-CVAD regimen (43.4% vs 67.9%, χ(2)=7.908, P=0.005) . Conclusions: Outcome with CHALL-01 regimen appeared better than that with the Hyper-CVAD/MA regimen in Ph(+) ALL, which has lower incidence of pulmonary infection, higher molecular remission rate and better OS and DFS.
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Affiliation(s)
- A J Huang
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - L B Wang
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - J Du
- Department of Hematology, Changzheng Hospital, Second Military Medical University, Shanghai 200433, China
| | - G S Tang
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - H Cheng
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - S L Gong
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - L Gao
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - H Y Qiu
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - X Ni
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - J Chen
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - L Chen
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - W P Zhang
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - J M Wang
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - J M Yang
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| | - X X Hu
- Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
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Yang F, Cai WZ, Huang XW, Xue SL, Fu CC, Tang XW, Sun AN, Wu DP, Qiu HY. [Comparison of efficacy of first-line administration of generic dasatinib or imatinib in patients with Philadelphia chromosome positive acute lymphoblastic leukemia treated by hematopoietic stem cell transplantation]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:661-667. [PMID: 30180468 PMCID: PMC7342843 DOI: 10.3760/cma.j.issn.0253-2727.2018.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the efficacy of first-line administration of generic dasatinib or first-generation TKI (imatinib) in patients with Philadelphia chromosome positive acute lymphoblastic leukemia (Ph(+) ALL) treated by hematopoietic stem cell transplantation (HSCT). Methods: Clinical features and prognoses of 63 newly diagnosed Ph(+) ALL patients from Jan 2014 to June 2017 treated by HSCT combined with first-line administration of generic dasatinib or imatinib were retrospective analyzed. Results: Of 63 Ph(+) ALL patients, 31 cases were administered generic dasatinib, and the other 32 ones imatinib. Complete remission (CR) rates at the fourth week of induction therapy in generic dasatinib and imatinib groups were 96.8% and 93.8% (P=1.000) , respectively. Meanwhile major molecular response (MMR; BCR-ABL/ABL reduce 3log) rates were 41.9% and 43.8% (χ(2)=0.021, P=0.884), respectively. Relapse rates before transplantation were 6.5% and 12.5% (P=0.672), respectively. MMR rates before HSCT were 83.9% and 68.8% (χ(2)=1.985, P=0.159), respectively. The 20-monthes overall survival (OS) rates of generic dasatinib and imatinib groups were 95.5% and 76.5% (χ(2)=0.990, P=0.320) respectively; 20-monthes event-free survival (EFS) rates were 93.5% and 61.4% (χ(2)=5.926, P=0.015), respectively. Statistically significant differences of EFS were reached. Multiple factors analysis showed that generic dasatinib (HR=0.201, 95% CI 0.045-0.896, P=0.035) and MMR before transplantation (HR=0.344, 95% CI 0.124-0.956, CI=0.041) could improve EFS. Conclusions: First-line administration of generic dasatinib could improve EFS for Ph(+)ALL patients treated by HSCT when compered with imatinib.
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Affiliation(s)
- F Yang
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Clinical Medicine Center, Suzhou 215006, China
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Jiang SH, Hou C, Chen N, Chen SF, Qiu HY, Xu Y, Chen SN, Wu DP. [Prognostic analysis of allogeneic hematopoietic stem-cell transplantation in 47 patients with acute myeloid leukemia and MLL rearrangement]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:558-562. [PMID: 30122014 PMCID: PMC7342217 DOI: 10.3760/cma.j.issn.0253-2727.2018.07.006] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
目的 研究混合谱系白血病(MLL)基因重排阳性急性髓系白血病(AML)患者行异基因造血干细胞移植(allo-HSCT)的预后特点。 方法 回顾性分析2009年9月至2016年5月于苏州大学附属第一医院行allo-HSCT的47例MLL基因重排阳性AML患者的临床资料。 结果 全部47例MLL重排阳性AML患者中男24例,女23例,中位年龄30(15~58)岁,M4/M5共36例(76.6%)。移植后2年总生存(OS)率为(64.4±8.4)%,无病生存(DFS)率为(47.3±9.3)%,复发率为41.0%,移植相关死亡率为17.9%。45例患者检出11q23易位,2例染色体核型正常患者检出MLL部分串联重复。t(6;11)组(16例)、t(9;11)组(15例)、其他类型组(16例)的2年OS率差异无统计学意义(χ2=1.509,P=0.472)。多因素分析显示,移植时年龄>45岁是影响OS的独立危险因素[HR=4.454(95%CI 1.314~15.099),P=0.016],移植前MRD阳性是影响患者DFS[HR=4.236(95%CI 1.238~14.495),P=0.021]、复发[HR=5.491(95% CI 1.371~21.995),P=0.016]的独立不良预后因素,移植前疾病处于非CR状态患者移植相关死亡风险增高[HR=10.370(95%CI 1.043~103.110),P=0.046]。 结论 移植时年龄>45岁、移植前疾病处于非CR状态、移植前MRD阳性为影响allo-HSCT治疗MLL基因重排阳性AML患者预后的危险因素。
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Affiliation(s)
- S H Jiang
- First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Institute of Hematopoietic Stem Cell Transplantation, Soochow University, Suzhou 215006, China
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Liu LM, Zhang YM, Zhou HF, Wang QY, Qiu HY, Tang XW, Han Y, Fu CC, Jin ZM, Sun AN, Miao M, Wu DP. [Outcome of combination of HLA-haploidentical hematopoietic SCT with an unrelated cord blood unit for 127 patients with acquired severe aplastic anemia]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:624-628. [PMID: 30180460 PMCID: PMC7342829 DOI: 10.3760/cma.j.issn.0253-2727.2018.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
目的 评价单倍型造血干细胞移植(haplo-HSCT)联合第三方脐血干细胞移植治疗重型再生障碍性贫血(SAA)的疗效及安全性。 方法 对2011年9月至2017年4月间接受haplo-HSCT联合第三方脐血干细胞移植的127例SAA患者进行回顾性研究。 结果 全部127例SAA患者中,男74例,女53例,中位年龄23.5(3~54)岁,其中极重型再生障碍性贫血65例。诊断至移植中位时间2(0.5~180)个月。单倍型造血干细胞来源为骨髓+外周血。脐血均选用单份,HLA配型≥4/6相合。127例患者均接受改良Bu/Cy+ATG/ALG预处理方案(白消安+环磷酰胺+抗胸腺细胞球蛋白/抗淋巴细胞球蛋白)。以环孢素A、霉酚酸酯联合短程甲氨蝶呤预防GVHD。回输单倍型供者单个核细胞10.87(3.61~24.00)×108/kg,CD34+细胞3.49(1.02~8.89)×106/kg;回输脐血单个核细胞2.22(1.10~7.30)×107/kg,CD34+细胞0.56(0.16~2.27)×105/kg。127例患者中5例发生早期死亡。在可评估的122例患者中,1例发生原发植入失败,其余121例患者成功植入(均为单倍型造血干细胞植入)。中性粒细胞、血小板植入时间分别为11(9~28)d、15(9~330)d,5例患者发生血小板植入不良。移植过程中74例(58.27%)发生感染。存活患者中位随访20.5(4.0~60.0)个月,Ⅱ~Ⅳ度急性GVHD发生率为24.79%(30/121),中/重度慢性GVHD发生率为14.15%(15/106),预期4年总生存率为(78.5±4.3)%,无失败生存率为(77.4±4.3)%。 结论 haplo-HSCT联合第三方脐血干细胞移植治疗SAA疗效确切且安全性较好,在无全相合供者情况下可作为有价值的治疗选择。
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Affiliation(s)
- L M Liu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006, China
| | | | | | | | | | | | | | | | | | | | - M Miao
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006, China
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Chen GH, Huang HW, Wang Y, Liu HW, Xu LJ, Ma X, Xue SL, He XF, Wang Y, Gu B, Li CX, Qiu HY, Tang XW, Jin ZM, Miao M, Sun AN, Wu DP. [An experimental study of CD4 targeted chimeric antigen receptor modified T cell with anti-lymphoma activity]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:148-152. [PMID: 29562451 PMCID: PMC7342564 DOI: 10.3760/cma.j.issn.0253-2727.2018.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
目的 探讨针对CD4膜蛋白的CAR-T细胞对CD4+T细胞淋巴瘤细胞的靶向特异性杀伤作用。 方法 采用重组DNA技术构建含4-1BB共刺激分子的第二代针对CD4的CAR慢病毒载体,应用293T细胞包装慢病毒,采用流式细胞术检测T细胞的转染效率及T细胞亚群动态变化,采用流式细胞术微球法检测培养上清中IFN-γ浓度。 结果 ①构建的慢病毒载体转染激活的T细胞后CAR膜蛋白阳性率达到50.0%~70.0%。T细胞激活后部分CD8+T细胞弱表达(dim)CD4膜蛋白。T细胞转染针对CD4的CAR慢病毒后CD4+ T细胞、CD8+ CD4dim T细胞逐渐被清除。②CAR-T细胞、对照组T细胞(空载体转染的T细胞)以8∶1效靶比分别与CD4+人T细胞淋巴瘤细胞株KARPAS 299细胞共培养24 h,杀伤效率分别为(96.9±2.1)%和(11.2±3.1)%,前者明显高于后者(t=7.137,P=0.028)。③CAR-T细胞单独培养,与转染慢病毒载体表达人CD4的K562细胞(K562-CD4细胞)、K562细胞共培养后上清中IFN-γ浓度分别为(1 785±268)、(15 648±2 168)、(1 978±354)pg/ml,CAR-T细胞与K562-CD4细胞共培养上清IFN-γ浓度明显高于其他两组,差异有统计学意义(P<0.01)。 结论 CD4特异性CAR-T细胞效应细胞免疫表型为CD8+ CD4+ T细胞,在体外具有杀伤正常CD4+ T细胞和CD4+ T细胞淋巴瘤细胞的活性,对于CD4dim T细胞也有较好的清除活性。
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Affiliation(s)
- G H Chen
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Suzhou Institute of Blood and Marrow Transplantation, Suzhou 215006, China
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Yang F, Cai WZ, Yang XD, Chen SN, Tang XW, Sun AN, Wu DP, Qian WQ, Qiu HY. [Efficacy comparison of sequential treatment with first-line administration of second-generation and first-generation tyrosine kinase inhibitors in patients with Ph + acute lymphoblastic leukemia followed by allogeneic hematopoietic stem cell transplantation]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:110-115. [PMID: 29562444 PMCID: PMC7342571 DOI: 10.3760/cma.j.issn.0253-2727.2018.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the efficacy of sequential treatment with first-line administration of second-generation tyrosine kinase inhibitors (TKI) and first-generation TKI (imatinib) in patients with Ph+ acute lymphoblastic leukemia (Ph+ ALL) followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: Retrospective analysis of clinical features and prognosis of 76 newly diagnosed Ph +ALL patients from June 2011 to December 2015 treated by allo-HSCT combined with first-line administration of second-generation or first-generation TKI was performed and the efficacy compared. Results: Of 76 Ph+ ALL patients, first-generation TKI was administered in 57 cases, second-generation TKI in 19 cases, including 10 cases of nilotinib and 9 cases of dasatinib. There was no significant difference in age, WBC counts, additional chromosomal abnormalities, time form diagnosis to transplantation, transplantation type, conditioning regimen or TKI initiation time between the two groups. Complete remission (CR) rates at the fourth week of induction therapy in first-generation TKI group and second-generation TKI group was 93.0% and 94.7% (P=1.000), respectively. Major molecular response (MMR, BCR-ABL/ABL reduce 3 log) rates meanwhile were 46.0% and 40.0% (χ2=0.169, P=0.681). Relapse rates before transplantation were 14.0% and 10.5% (P=1.000). MMR rates before transplantation were 54.4% and 68.2% (χ2=1.152, P=0.283). The 2-year overall survival (OS) rates of first-generation and second-generation TKI group were 62.0% and 94.7% (χ2=5.765, P=0.016), 2-year event-free survival (EFS) rates were 46.3% and 84.2% (χ2=5.644, P=0.018), respectively. Univariate analysis showed that second-generation TKI could improve OS (HR=0.126, 95%CI 0.017-0.939, P=0.043). Multiple factors analysis showed that second-generation TKI (HR=0.267, 95%CI 0.081-0.873, P=0.029) and MMR before transplantation (HR=0.496, 95%CI 0.254-0.968, P=0.040) were good independent prognostic factors of EFS. Conclusions: There was significant difference in the efficacy of second-generation TKI and first-generation TKI for Ph+ ALL patients treated by allo-HSCT. First-line administration of second-generation TKI showed better efficacy than that of first-generation TKI for Ph+ ALL patients.
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Affiliation(s)
- F Yang
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Clinical Medicine Center, Suzhou 215006, China
| | | | | | | | | | | | | | | | - H Y Qiu
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Clinical Medicine Center, Suzhou 215006, China
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Li WY, Feng YF, Ma X, Qiu HY, Fu CC, Tang XW, Han Y, Wu DP, Sun AN. [Comparison of the efficacy of decitabine combined with micro-transplantation or priming regimen as consolidation treatment for older patients with acute myeloid leukemia]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:305-309. [PMID: 29779327 PMCID: PMC7342141 DOI: 10.3760/cma.j.issn.0253-2727.2018.04.010] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
目的 探索老年急性髓系白血病(AML)第1次完全缓解(CR1)后采用地西他滨联合微移植巩固治疗的疗效与安全性。 方法 回顾性分析2012年11月至2015年9月诊治的37例CR1老年(≥60岁)AML患者病例资料,比较分析地西他滨联合微移植(微移植组,19例)与地西他滨联合预激方案巩固治疗(化疗组,18例)的疗效和不良反应。 结果 两组患者起病时的年龄、WBC水平、疾病状态差异均无统计学意义(P值均>0.05)。两种巩固治疗方案的耐受性均良好,微移植组与化疗组的CTC 3~4级非血液学不良反应发生率差异无统计学意义[36.8%(7/19)对27.8%(5/18),χ2=0.347,P=0.728]。微移植组与化疗组中性粒细胞恢复的中位时间分别为12和13 d(z=1.599,P=0.110),血小板恢复的中位时间分别为14和12 d(z=−1.314,P=0.189)。微移植组患者均未发生移植物抗宿主病。微移植组与化疗组的2年无白血病生存率分别为50.7%和24.3%(P=0.047),2年总生存率分别为54.9%和30.0%(P=0.071)。 结论 对于老年AML患者,地西他滨联合微移植可能是一种安全有效的巩固方案。
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Affiliation(s)
- W Y Li
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Suzhou 215006, China
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Zhang Y, Zhang YM, Chen Q, Tang GS, Qiu HY, Gao L, Chen J, Ni X, Chen L, Zhang WP, Yang JM, Wang JM, Hu XX. [Minimal residual disease before post-remission therapy predicts outcomes in younger adult with intermediate-risk acute myeloid leukemia]. Zhonghua Xue Ye Xue Za Zhi 2019; 40:147-151. [PMID: 30831632 PMCID: PMC7342654 DOI: 10.3760/cma.j.issn.0253-2727.2019.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Indexed: 01/04/2023]
Affiliation(s)
- Y Zhang
- Department of Hematology, Changhai Hospital, the Second Military Medical University; Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
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Han QZ, Chen Y, Yang H, Zhang XF, Chen J, Wu DP, Chen SN, Qiu HY. [Incidence of blood stream infections of 1265 patients with hematopoietic stem cell transplantation and analysis of pathogenic bacteria]. Zhonghua Xue Ye Xue Za Zhi 2019; 38:930-933. [PMID: 29224313 PMCID: PMC7342786 DOI: 10.3760/cma.j.issn.0253-2727.2017.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
目的 分析造血干细胞移植(HSCT)患者血流感染的发生率、病原菌分布及药敏情况,为临床血流感染的经验性治疗提供依据。 方法 对2013–2015年在苏州大学附属第一医院行HSCT的1 265例患者进行血流感染发生率、血培养阳性率、病原菌种类和耐药情况分析。 结果 1 265例HSCT患者中,有784例(61.98%)共发生1 422例次血流感染,464例(59.2%)患者处于粒细胞缺乏期(ANC<0.5×109/L)。2013–2015年病原菌检出率逐年上升,总体为20.07%。检出的401株病原菌中,革兰阴性菌221株(55.1%),革兰阳性菌165株(41.2%),真菌15株(3.7%)。排名前三位为大肠埃希菌(16.0%)、表皮葡萄球菌(15.5%)和肺炎克雷伯菌(11.2%);细菌耐药情况严峻,多重耐药的鲍曼不动杆菌和嗜麦芽窄食单胞菌比例分别为64.70%与63.64%,耐甲氧西林金黄色葡萄球菌(MRSA)比例为57.14%,均超过50.0%。耐万古霉素肠球菌(VRE)与耐碳青霉烯类抗生素肠杆菌科细菌(CRE)比例分别为14.29%、6.78%。革兰阴性菌中肠杆菌科细菌对三、四代头孢类药物耐药率较高,对碳青霉烯类抗生素耐药率较低(6.4%)。非发酵菌对抗菌药物耐药情况差别较大,对碳青霉烯类抗生素耐药率较高(47.8%);葡萄球菌属菌株对万古霉素、替考拉宁和利奈唑胺的敏感率均为100.0%。 结论 HSCT患者血流感染发生率较高,病原菌仍以革兰阴性菌为主,非发酵菌的占比也较高,未检测到对万古霉素、替考拉宁和利奈唑胺耐药的葡萄球菌。
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Affiliation(s)
- Q Z Han
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Clinical Medicine Center, Suzhou 215006, China
| | | | | | | | | | | | | | - H Y Qiu
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Clinical Medicine Center, Suzhou 215006, China
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Wang H, Zhang TT, Qi JQ, Chu TT, Miao M, Qiu HY, Fu CC, Tang XW, Ruan CG, Wu DP, Han Y. Incidence, risk factors, and clinical significance of Epstein-Barr virus reactivation in myelodysplastic syndrome after allogeneic haematopoietic stem cell transplantation. Ann Hematol 2019; 98:987-996. [PMID: 30715567 DOI: 10.1007/s00277-019-03603-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 07/17/2018] [Accepted: 01/04/2019] [Indexed: 11/30/2022]
Abstract
Epstein-Barr virus (EBV) reactivation is a life-threatening complication after allogeneic haematopoietic stem cell transplantation (allo-HSCT). In this study, we investigated the characteristics of EBV reactivation in 186 consecutive myelodysplastic (MDS) patients who underwent allo-HSCT in our centre. In 35 patients (18.8%) who experienced EBV reactivation after allo-HSCT, the median onset was 53 days (range 4-381 days). The cumulative incidence of EBV reactivation at the first, sixth, and twelfth month after allo-HSCT was 10.7%, 15.1%, and 17.9%, respectively. Twenty-five patients (71.4%) received pre-emptive rituximab therapy, and no patients developed post-transplant lymphoproliferative disorders. Stem cell source was proven to be a risk factor correlated with EBV reactivation. The cumulative incidence of relapse in the EBV-positive group was 11.4%, 25.2%, and 31.0% at the first, second, and third year after transplantation, respectively, being significantly higher than the corresponding 6.8%, 10.2%, and 10.2%, in the EBV-negative group (P = 0.014). Prognostic analysis showed that EBV reactivation was an independent risk factor for relapse-free survival (RFS). Patients in the EBV-positive group showed obviously shorter RFS than those in the EBV-negative group, with 3-year RFS of 62% and 85%, respectively (P = 0.017).
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Affiliation(s)
- Hong Wang
- Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
| | - Tong-Tong Zhang
- Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
| | - Jia-Qian Qi
- Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China
| | - Tian-Tian Chu
- Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Miao Miao
- Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China.,Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
| | - Hui-Ying Qiu
- Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China.,Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
| | - Cheng-Cheng Fu
- Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China.,Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
| | - Xiao-Wen Tang
- Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China.,Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
| | - Chang-Geng Ruan
- Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Blood and Marrow Transplantation, Suzhou, China.,Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China.,Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China
| | - De-Pei Wu
- Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China. .,Institute of Blood and Marrow Transplantation, Suzhou, China. .,Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China. .,Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China.
| | - Yue Han
- Jiangsu Institute of Haematology, The First Affiliated Hospital of Soochow University, Suzhou, China. .,Institute of Blood and Marrow Transplantation, Suzhou, China. .,Key Laboratory of Thrombosis and Haemostasis of Ministry of Health, Suzhou, China. .,Collaborative Innovation Centre of Haematology, Soochow University, Suzhou, China.
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Zhang J, Yang F, Qiu HY, Wu Q, Kong DQ, Zhou J, Han Y, Wu DP. Anti-CD19 chimeric antigen receptors T cells for the treatment of relapsed or refractory E2A-PBX1 positive acute lymphoblastic leukemia: report of three cases. Leuk Lymphoma 2019; 60:1454-1461. [PMID: 30714847 DOI: 10.1080/10428194.2018.1533127] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Jian Zhang
- Department of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Fei Yang
- Department of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hui-Ying Qiu
- Department of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qian Wu
- Department of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Dan-Qing Kong
- Department of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jin Zhou
- Department of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yue Han
- Department of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - De-Pei Wu
- Department of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Wang QL, Huang HW, Jin ZM, Tang XW, Qiu HY, Fu CC, Han Y, Miao M, Chang HR, Sun AN, Wu DP. [Comparison of allogeneic or autologous hematopoietic stem cell transplant for high-risk peripheral T cell lymphomas]. Zhonghua Xue Ye Xue Za Zhi 2018; 37:952-956. [PMID: 27995879 PMCID: PMC7348511 DOI: 10.3760/cma.j.issn.0253-2727.2016.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
目的 比较自体造血干细胞移植(auto-HSCT)和异基因造血干细胞移植(allo-HSCT)治疗高危外周T细胞淋巴瘤(PTCL)疗效的差异。 方法 回顾性分析苏州大学附属第一医院60例接受HSCT治疗的高危PTCL患者临床资料。 结果 60例PTCL患者均为高危组患者(IPI评分≥3分),接受移植时中位年龄31 (12~58)岁。包括PTCL非特指型22例、ALK阴性的间变大细胞淋巴瘤22例、血管免疫母细胞淋巴瘤16例。其中接受auto-HSCT的有39例(63.5%),接受allo-HSCT的有21例(36.5%)。移植前40例完全缓解(CR),2例部分缓解(PR),18例未缓解(NR)。40例CR患者中10例接受allo-HSCT, 30例接受auto-HSCT。20例PR+NR患者中11例接受allo-HSCT, 9例接受auto-HSCT。移植后中位随访时间为39 (1~96)个月,auto-HSCT和allo-HSCT组的5年无进展生存率分别为61%和60%(P=0.724)。auto-HSCT和allo-HSCT组的5年总生存率分别为62%和61%(P=0.724)。auto-HSCT和allo-HSCT组的5年移植相关死亡率分别为22.7%和41.8%(P=0.250)。截至末次随访时间,auto-HSCT中7例患者复发,allo-HSCT组中2例复发,auto-HSCT和allo-HSCT组的5年累计复发率分别为37.2%和10.1%(P=0.298)。 结论 高危PTCL患者选择auto-HSCT或allo-HSCT治疗长期生存无明显差异,但allo-HSCT组患者移植前多为NR状态,表明对于NR患者,allo-HSCT效果可能较好。
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Affiliation(s)
- Q L Wang
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemstasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006, China
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Liu D, Ke P, Huo L, Hu XH, Fu CC, Li CX, Huang HW, Xue SL, Qiu HY, Wu DP, Ma X. [Safety and efficacy of chimeric antigen receptor T cell in the treatment of elderly patients with hematological malignancies]. Zhonghua Xue Ye Xue Za Zhi 2018; 39:952-955. [PMID: 30486596 PMCID: PMC7342352 DOI: 10.3760/cma.j.issn.0253-2727.2018.11.017] [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] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Indexed: 11/12/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - X Ma
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006, China
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Yan LZ, Chen SN, He XF, Zhao Y, Zhang XY, Wu LL, Ping NN, Xu XY, Sun AN, Qiu HY, Tang XW, Han Y, Fu CC, Jin ZM, Miao M, Wu DP. [Expression level and clinical significance of MEF2C gene in adult acute myeloid leukemia]. Zhonghua Xue Ye Xue Za Zhi 2018; 39:682-685. [PMID: 30180473 PMCID: PMC7342833 DOI: 10.3760/cma.j.issn.0253-2727.2018.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Indexed: 11/05/2022]
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Bao XB, Cai WZ, He XF, Chen SN, Qiu HY, Sun AN, Wu DP. [Risk Factors of Leukemia-free Survival in Ph + ALL Patients with Allogeneic Hematopoietic Stem Cell Transplantation]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2018; 25:1787-1792. [PMID: 29262917 DOI: 10.7534/j.issn.1009-2137.2017.06.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore the effect of BCR-ABL gene transcripts on Leukemia-free survival (LFS) and prognosis of patients with Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS The clinical data of 107 cases of Ph+ B-ALL patients received allo-HSCT from July 2006 to November 2014 in the First Affiliated Hospital of Soochow University were collected and the relationship between the clinical characteristics and LFS after transplantation was analyzed. RESULTS Out of 107 Ph+ ALL patients (64 males and 43 females) with a median age of 30(7 to 54)years old, 35.5% (38/107) cases relapsed after transplantation within a median time of 6.9 (1.5 to 40.7) months. A total of 39 (36.4%) cases died within a median time of 19.8 (3.6 to 83.7) months after HSCT, of which 51.3% (20/39) due to disease relapse and 25.6% (10/39) due to infection. BCR-ABL gene transcripts of 49 cases turn into negative before transplantation, of which the expected 5-year cumulative incidence of relapse (CIR), non-relapse mortality (NRM) and overall survival (OS) were 26.5%, 29.5% and 41.6%, respectively. Another 49 cases still had a positive BCR-ABL gene transcripts before transplantation, of which the life expectancy of 5 year CIR, NRM and OS were 64.4%,8.9% and 48.9%, respectively. Compared with BCR-ABL positive patients, BCR-ABL negative patients showed a lower CIR (P<0.001), a higher NRM (P=0.030) and a similar OS (41.6% versus 48.9%, P=0.497). Multivariate analysis showed that BCR-ABL positive (P=0.016) and a disease statusphase ≥CR2 (P<0.001) before HSCT were independent risk factors for LFS, while the age underwent HSCT was the principal element affecting prognosis (P<0.001). CONCLUSION Both the relapse and infection are the main causes of death in the patients after transplantation. A disease status ≥CR2 and the BCR-ABL positive before transplantation are 2 independent risk factors of LFS in the patients with Ph+ ALL after allo-HSCT.
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Affiliation(s)
- Xie-Bing Bao
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Collaborate Innovation Center of Hematology, Suzhou 215006, Jiangsu Province, China
| | - Wen-Zhi Cai
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Collaborate Innovation Center of Hematology, Suzhou 215006, Jiangsu Province, China
| | - Xue-Feng He
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Collaborate Innovation Center of Hematology, Suzhou 215006, Jiangsu Province, China. E-mail:
| | - Su-Ning Chen
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Collaborate Innovation Center of Hematology, Suzhou 215006, Jiangsu Province, China
| | - Hui-Ying Qiu
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Collaborate Innovation Center of Hematology, Suzhou 215006, Jiangsu Province, China
| | - Ai-Ning Sun
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Collaborate Innovation Center of Hematology, Suzhou 215006, Jiangsu Province, China
| | - De-Pei Wu
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Collaborate Innovation Center of Hematology, Suzhou 215006, Jiangsu Province, China
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Li WY, Wang Y, Chen SN, Qiu HY, Fu ZZ, Wu DP, Sun AN. Consolidation therapy with decitabine and intermediate-dose cytarabine followed by HLA-mismatched peripheral blood stem cells infusion for older patients with acute myeloid leukemia in first remission. Leuk Lymphoma 2017; 59:1652-1658. [PMID: 29043875 DOI: 10.1080/10428194.2017.1390235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Wei-Yang Li
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China
- Suzhou Institute of Blood and Marrow Transplantation, Suzhou, PR China
| | - Ying Wang
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China
- Suzhou Institute of Blood and Marrow Transplantation, Suzhou, PR China
| | - Su-Ning Chen
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China
- Suzhou Institute of Blood and Marrow Transplantation, Suzhou, PR China
| | - Hui-Ying Qiu
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China
- Suzhou Institute of Blood and Marrow Transplantation, Suzhou, PR China
| | - Zheng-Zheng Fu
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China
- Suzhou Institute of Blood and Marrow Transplantation, Suzhou, PR China
| | - De-Pei Wu
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China
- Suzhou Institute of Blood and Marrow Transplantation, Suzhou, PR China
| | - Ai-Ning Sun
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
- Collaborative Innovation Center of Hematology, Soochow University, Suzhou, PR China
- Suzhou Institute of Blood and Marrow Transplantation, Suzhou, PR China
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Han W, Han Y, Chen J, Ma X, Chen F, Wu XJ, Qi JQ, Qiu HY, Sun AN, Wu DP. [Allogeneic hematopoietic stem cell transplantation associated thrombotic microangiopathy: 16 cases report and literature review]. Zhonghua Xue Ye Xue Za Zhi 2017; 37:666-70. [PMID: 27587247 PMCID: PMC7348544 DOI: 10.3760/cma.j.issn.0253-2727.2016.08.007] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
目的 分析异基因造血干细胞移植(allo-HSCT)相关血栓性微血管病(TA-TMA)患者临床特征、疗效及转归。 方法 回顾性分析2013年1月至2015年6月于苏州大学附属第一医院接受allo-HSCT后发生TA-TMA的16例患者临床资料。 结果 纳入研究的852例allo-HSCT患者,16例(1.9%)发生TA-TMA,中位随访时间14个月,1年累计发生率为(2.3±0.6)%。16例患者中,男7例,女9例,中位年龄41(12~54)岁,中位发病时间为移植后72(21~525) d, PLT中位数为20(11~36)×109/L,HGB中位数为74(56~99)g/L,LDH中位水平为762(309~1 049) U/L,外周血破碎红细胞比例中位数为3%(2%~13%),所有患者ADAMTS13活性均>60%。10例出现精神症状,7例肌酐水平升高。TA-TMA确诊后的主要治疗措施为钙调磷酸酶体抑制剂的减停、激素及血浆置换疗法,8例经治疗后病情得以控制,治疗有效;8例患者治疗无效死亡。治疗无效组8例患者中5例合并急性肠道移植物抗宿主病(GVHD),治疗有效组患者无一例合并肠道GVHD;8例治疗无效患者中5例外周血破碎红细胞比例>5%,而治疗有效组破碎红比例最高为4%;治疗无效患者LDH及肌酐中位水平均高于治疗有效组,分别为826(674~1 310) U/L对636(309~941)U/L及127(70~215)µmol/L对56(22~101)µmol/L。 结论 TA-TMA是allo-HSCT后的一类严重并发症,可导致全身多器官功能损伤,即使采取治疗早期病死率仍较高,疗效与病情轻重及有无并发症有关。
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Affiliation(s)
- W Han
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Soochow University, Suzhou 215006, China
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Dai HP, Zhu GH, Wu LL, Wang Q, Yao H, Wang QR, Wen LJ, Qiu HY, Shen Q, Chen SN, Wu DP. [Effect of LPXN Overexpression on the Proliferation, Adhesion and Invasion of THP-1 Cells and Its Mechamisms]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2017. [PMID: 28641616 DOI: 10.7534/j.issn.1009-2137.2017.03.007] [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 explore the effect of LPXN overexpression on the proliferation, adhesion and invasion of THP-1 cells and its possible mechanism. METHODS A THP-1 cell line with stable overexpression of LPXN was constucted by using a lentivirus method, CCK-8 was used to detect the proliferation of cells, adhesion test was used to evaluate adhesion ablity of cells to Fn. Transwell assay was used to detect the change of invasion capability. Western blot was used to detect expression of LPXN, ERK, pERK and integrin α4, α5, β1, the Gelatin zymography was applied to detect activity of MMP2/MMP9 secreted by the THP-1 cells. RESULTS Successful establishment of THP-1 cells with LPXN overexpression (THP-1 LPXN) was confirmed with Western blot. THP-1 LPXN cells were shown to proliferate faster than the control THP-1 vector cells. Adhesion to Fn and expression of ERK, integrin α4, α5 and β1 in the THP-1 LPXN cells were higher than that in the control cells. Invasion across matrigel and enhanced activity of MMP2 could be detected both in the THP-1 LPXN cells as compared with the control cells. CONCLUSION Ectopically ovexpression of LPXN may promote proliferation of THP-1 cells through up-regulation of ERK; promote adhesion of THP-1 cells through up-regulating the integrin α4/β1 as well as integrin α5/β1 complex; promote invasion of THP-1 cells through activating MMP2.
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Affiliation(s)
- Hai-Ping Dai
- The First Affilliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Minestry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006,Jiangsu Province,China. E-mail:
| | - Guo-Hua Zhu
- The First Clinical College of Nanjing University of Traditional Chinese Medicine, Nanjing 210046,Jiangsu Province,China
| | - Li-Li Wu
- The First Affilliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Minestry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006,Jiangsu Province,China
| | - Qian Wang
- The First Affilliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Minestry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006,Jiangsu Province,China
| | - Hong Yao
- The First Affilliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Minestry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006,Jiangsu Province,China
| | - Qin-Rong Wang
- The First Affilliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Minestry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006,Jiangsu Province,China
| | - Li-Jun Wen
- The First Affilliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Minestry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006,Jiangsu Province,China
| | - Hui-Ying Qiu
- The First Affilliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Minestry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006,Jiangsu Province,China
| | - Qun Shen
- The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210029,Jiangsu Province,China
| | - Su-Ning Chen
- The First Affilliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Minestry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006,Jiangsu Province,China
| | - De-Pei Wu
- The First Affilliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Minestry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006,Jiangsu Province,China
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Wang H, Huang M, Zhao Y, Qi JQ, Chen C, Tang YQ, Qiu HY, Fu CC, Tang XW, Wu DP, Ruan CG, Han Y. Recombinant Human Thrombopoietin Promotes Platelet Engraftment and Improves Prognosis of Patients with Myelodysplastic Syndromes and Aplastic Anemia after Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2017. [PMID: 28642072 DOI: 10.1016/j.bbmt.2017.06.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Poor platelet graft function (PPGF) is a significant complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, no optimal treatment has been recommended. This study investigated aspects of platelet recovery after allo-HSCT, including prognostic value and the effect of recombinant human thrombopoietin (rhTPO). We retrospectively analyzed 275 patients who received allo-HSCT in our center. Of them, 135 (49.1%) patients had good platelet graft function (GPGF) and 140 (50.9%) had PPGF. The latter included 59 (21.5%) patients with primary PPGF and 81 (29.4%) with secondary PPGF. Multivariate analysis showed that male gender (P = .024), lower CD34+ cell count (P = .04), and no use of rhTPO (P <.001) were associated with PPGF. The 3-year overall survival rate of patients with PPGF (58%) was significantly less than that of patients with GPGF (82%; P <.001). We further analyzed the effect of rhTPO on prognosis of patients after allo-HSCT. Although no advantage was apparent when analyzing the entire cohort, for patients with myelodysplastic syndromes and aplastic anemia, rhTPO was associated with a significant survival advantage (P = .014).
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Affiliation(s)
- Hong Wang
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Man Huang
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ying Zhao
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jia-Qian Qi
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chun Chen
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ya-Qiong Tang
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hui-Ying Qiu
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China; Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Cheng-Cheng Fu
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China; Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Xiao-Wen Tang
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China; Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - De-Pei Wu
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China; Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Chang-Geng Ruan
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China; Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
| | - Yue Han
- Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China; Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
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Wang HY, Bao XB, Tang XW, Sun AN, Wu DP, Zhou HX, Qiu HY. [A retrospective analysis of prognosis in favorable-risk acute myeloid leukemia patients with different consolidation regimens]. Zhonghua Xue Ye Xue Za Zhi 2017; 38:517-522. [PMID: 28655096 PMCID: PMC7342968 DOI: 10.3760/cma.j.issn.0253-2727.2017.06.010] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Indexed: 11/06/2022]
Abstract
Objective: To explore the impact on prognosis in favorable-risk acute myeloid leukemia (AML) patients with different consolidation regimens after first complete remission (CR(1)). Methods: A total of 107 cases of non-refractory adult AML from January 2010 to June 2015 in single center were enrolled in the study. HD-Ara-C group (38 cases) as the control group, we explore the prognosis in three consolidation regimens, including micro-transplantation (16 cases) , autologous transplantation (auto-PBSCT, 14 cases) , allogeneic transplantation (allo-HSCT, 39 cases). Results: Of 107 patients (59 males and 48 females) , with a median age of 33 (16-59) years old and a median follow-up of 36.5 (5.3-79.1) months, the overall relapse rate was 20.6% (22/107) , and overall mortality rate was 18.7% (20/107). The 5 years cumulative relapse rate (CIR) of HD-Ara-C, micro-transplantation, auto-PBSCT and allo-HSCT group were 39.7%, 6.2%, 14.3% and 5.6%, respectively (P<0.001). The CIR of the observed group was lower than the HD-Ara-C group. The 5 years progression-free survival (PFS) rate of HD-Ara-C, micro-transplantation, auto-PBSCT and allo-HSCT group were 44.7%, 93.8%, 85.7% and 78.1%, respectively (P=0.011). The PFS of observed groups were similar, but superior to that in HD-Ara-C group. The 5-year overall survival (OS) in four groups was 54.9%, 100%, 92.9% and 77.4%, respectively (P>0.05). Multiple factors analysis showed that compared to HD-Ara-C regimen, allo-HSCT could improve PFS (HR=0.376, P=0.031) , but not OS (P>0.05) ; micro-transplantation and auto-PBSCT could not improve the PFS or OS (P>0.05). Conclusion: As compared with HD-Ara-C regimen, allo-HSCT could obviously decrease CIR, improve PFS, but treatment-related mortality is high. These results show that auto-PBSCT and micro-transplantation have similar outcomes, compared to HD-Ara-C regimen, so both can be used as a option of consolidation treatment for favorable-risk AML.
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Affiliation(s)
- H Y Wang
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Clinical Medicine Center, Suzhou 215006, China
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Qiu HY, Ren P, Li R, Zhang QL, Lu XT, Niu Q. [Association between H3K4me3/BDNF and the cognitive function of workers occupationally exposed to aluminum]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2016; 34:900-904. [PMID: 28241677 DOI: 10.3760/cma.j.issn.1001-9391.2016.12.005] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Objective: To investigate the influence of occupational aluminum exposure on cognitive function and its relationship with tri-methyl histone H3 lysine residues 4 points (H3K4me3) and brain-derived neurotrophic factor (BDNF) levels. Methods: By cluster random sampling method, a total of 235 cases of male workers selected from a Shanxi aluminum factory were recruited in the study in September 2015. Used the occupational epidemiological investigation questionnaire, which included Mini-Mental State Examination (MMSE) , Clock Drawing Test (CDT) , Digit Span Test (DST, including forward test DSFT and backward test DSBT) , Fuild Object Memory Evaluation (FOME) and Verbal Fluency Test (VFT) , to collect workers' basic information and assess their cognitive function score. Detected the concentration of aluminum in plasma by graphite furnace atomic absorption spectrometry. Workers were divided into three groups by the 25 percentile and 75 percentile of the aluminum content, such as low, middle and high aluminum concentration groups. The concentrations of H3K4me3 in lymphocyte and BDNF in plasma were determined by enzyme-linked immunosorbent assay. Results: The levels of aluminum in plasma was 134.36 (100.14, 178.96) μg/L. The scores of MMSE, DSFT, DSBT, DST of high aluminum concentration group were lower than low aluminum group (27.98±1.25 vs 28.83±1.54, 9.19±2.00 vs 10.64±2.87, 6.08±1.63 vs 7.19±3.07, 15.27±3.11 vs 17.81±4.72, all P<0.05) , the scores of CDT, FOME, VFT among three groups had no statistical significance (all P>0.05) . The expression levels of H3K4me3 and BDNF of high aluminum concentration group were lower than the low group [ (18.45±9.81) ng/μg Pro vs (23.76±9.89) ng/μg Pro, (26.07±10.18) ng/ml vs (31.66±9.24) ng/ml, all P<0.05]. Multiple correlation analysis showed that aluminum concentration were negatively correlated toH3K4me3, BDNF, MMSE, DSFT, DST, respectively (r(s)=-0.307、-0.214、-0.252、-0.197, -0.181, all P<0.01) . Conclusion: Exposure to occupational aluminum for a long time may change cognitive function, which go along with the decreasing of H3K4me3 level in lymphocyte and BDNF protein expression in plasma.
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Affiliation(s)
- H Y Qiu
- Department of Occupational and Environmental Health, Shanxi Medical University, Taiyuan 030001, China
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He XF, Wang QR, Cen JN, Qiu HY, Sun AN, Chen SN, Wu DP. [EVI1 expression, clinical and cytogenetical characteristics in 447 patients with acute myeloid leukemia]. Zhonghua Xue Ye Xue Za Zhi 2016; 37:936-941. [PMID: 27995876 PMCID: PMC7348514 DOI: 10.3760/cma.j.issn.0253-2727.2016.11.002] [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] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Indexed: 02/05/2023]
Abstract
Objective: To investigate EVI1 expression and its associated clinical and cytogenetic characteristics in 447 acute myeloid leukemia (AML) patients. Methods: EVI1 expressions were measured in 447 AML cases from Jan. 2007 to Apr. 2015 to couple with clinical, cytogenetic and mutations' characteristics to summarize the features of AMLs with high EVI1 expression. Results: 17.9% of AML were high EVI1 expression (EVI1 +), and the remainder low EVI1 expression (EVI1-). No significant differences between the two groups in terms of age, sex, hemoglobin level, white blood cell count and platelet count were observed. More M0, M5 and M6 subtypes were observed in EVI1+ group (P= 0.027, 0.004 and 0.011, respectively). Cytogenetic abnormalities of 11q15, 11q23/MLL, 3q26, -7/7q- and t (9;11) were observed more frequently in EVI1 + group (P<0.001, <0.001, <0.001, <0.001, =0.014, respectively). Normal karyotype, inv (16), t (8;21) were observed more frequent in EVI1- group (P=0.001, 0.009, 0.002, respectively). EVI1 + was more observed in high risk cytogenetics. Mutation of NPM1 was more observed in EVI1- group (P <0.001). Remission rate in EVI1 + group was significantly lower than EVI1- group (P<0.001). Leukemia-free survival was improved in EVI1 + AML patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Conclusions: High EVI1 expression was more observed in FAB subgroup M5, harbored more cytogenetic abnormalities of 11p15, 11q23/MLL, 3q26 rearrangement, -7/7q- and t (9;11). Remission rate of high EVI1 expression AML was lower, which could be improved by allo-HSCT.
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Affiliation(s)
- X F He
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou 215006, China
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Bao XB, Hu XH, Tian CY, Ji YH, Chen SN, Qiu HY, Sun AN, Wu DP. [Establishment and assessment of a nomogram for predicting the differentiation syndrome of acute promyelocytic leukemia]. Zhonghua Xue Ye Xue Za Zhi 2016; 37:961-965. [PMID: 27995881 PMCID: PMC7348516 DOI: 10.3760/cma.j.issn.0253-2727.2016.11.007] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Indexed: 11/25/2022]
Abstract
Objective: By analyzing the risk factors for occurrence of differentiation syndrome (DS) during induction therapy in newly-diagnosed acute promyelocytic leukemia (APL) patients, a prediction nomogram for DS was established and the accuracy of this nomogram was validated. Methods: The modeling group was made up of 130 classical APL patients during the period of 1st January 2011 to 31st December 2013. After single factor screening of clinical variables, the logistic regression model was used to identify the final model variables. A nomogram subsequently established by R software was validated by Bootstrap resampling as internal validation. Concordance index (C-index) was used for the accuracy evaluation of the nomogram, and calibration curves were painted to test the actual observation and the nomogram-prediction of occurrence rate of DS. Results: Occurrence rate of DS in 130 APL patients was 30.0%; In multivariate analysis, body mass index (BMI) ≥24 kg/m2 and without using steroids for prevention of DS were identified as independent risk factors. The C-index of the nomogram for predicting DS was 0.818 (95% CI 0.741-0.895). The calibration curves showed good concordance of occurrence rate of DS between nomogram-prediction and actual observation. Conclusion: The nomogram was successfully established as a more accurate and visible tool for predicting the occurrence rate of DS in APL patients.
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Affiliation(s)
- X B Bao
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Clinical Medicine Center, Suzhou 215006, China
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Gao S, Li Z, Fu JH, Hu XH, Xu Y, Jin ZM, Tang XW, Han Y, Chen SN, Sun AN, Wu DP, Qiu HY. Decitabine in the Treatment of Acute Myeloid Leukemia and Myelodysplastic Syndromes, Which Combined with Complex Karyotype Respectively. Asian Pac J Cancer Prev 2016; 16:6627-32. [PMID: 26434886 DOI: 10.7314/apjcp.2015.16.15.6627] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We conducted a study exploring the clinical safety and efficacy of decitabine in patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), combined with a complex karyotype. MATERIALS AND METHODS From April 2009 to September 2013, a total of 35 patients with AML/MDS combined with a complex karyotype diagnosed in the First Affiliated Hospital of Soochow University were included for retrospective analysis. All patients were treated with decitabine alone (20 mg/m2 daily for 5 days) or combination AAG chemotherapy (Acla 20 mg qod*4d, Ara-C 10 mg/m2 q12h*7d, G-CSF 300 μg qd, the dose of G-CSF adjusted to the amount in blood routinely). RESULTS In 35 patients, 15 exhibited a complete response (CR), and 6 a partial response (PR), the overall response rate (CR+PR) being 60% (21 of 35). Median disease-free survival was 18 months and overall survival was 14 months. In the 15 MDS patients with a complex karyotype, the CR rate was 53.3% (8 of 15); in 20 AML patients with complex karyotype, the overall response rate was 65% (13 of 20). The response rate of decitabine alone (22 cases) was 56.5% (13 of 22), while in the combination chemotherapy group (13 cases), the effective rate was 61.5% (8 of 13)(P>0.05). There are 15 patients with chromosome 7 aberration, after treatment with decitabine, 7 CR, 3 PR, overall response rate was 66.7% (10 of 15). Of 18 patients with 3 to 5 kinds of chromosomal abnormalities, 66.7% demonstrated a response; of 17 with more than 5 chromosomal abnormalities, 52.9% had a response. In the total of 35 patients, with one course (23 patients) and ≥two courses (12 patients), the overall response rate was 40.9% and 92.3% (P<0.05). Grade III to IV hematological toxicity was observed in 27 cases (75%). Grade III to IV infections were clinically documented in 7 (20%). Grades I to II non-hematological toxicity were infections (18 patients), haematuria (2 patients), and bleeding (3 patients). With follow-up until September 2013, 7 patients were surviving, 18 had died and 10 were lost to follow-up. In the 6 cases who underwent allogeneic hematopoietic stem cell transplantation (HSCT) all were still relapse-free survivors. CONCLUSIONS Decitabine alone or combination with AAG can improve outcome of AML/MDS with a complex karyotype, there being no significant difference decitabine in inducing remission rates in patients with different karyotype. Increasing the number of courses can improve efficiency. This approach with fewer treatment side effects in patients with a better tolerance should be employed in order to create an improved subsequent chance for HSCT.
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Affiliation(s)
- Su Gao
- Leukemia Research Division, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of the Ministry of Health, First Affiliated Hospital of Soochow University, Suzhou, China E-mail :
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