[Clinical features and treatment of invasive fungal infection in 47 patients with hematological malignancies].

OBJECTIVE: To analyze the clinical features of invasive fungal infection in patients with hematological malignancies and to compare the the therapeutic effect of fluconazole and intraconazole. METHODS: The clinical manifestations, mycological features, and the therapeutic results of 47 patients were retrospectively analyzed. Fluconazole was given to 17 paitents, intraconazole was given to 21 patients, and intraconazole to the other 9 patients after they had no effect with fluconazole. RESULTS: All patients had fever. The lung and the mouth cavity were the main locations of infection (53.2% and 21.3%, respectively). Fungi were found in 23 (48.9%) patients, in which the majority were Candida albicans and Aspergillus (56.5% and 26.1%, respectively). Intraconazole was more effective than fluconazole (63.3% vs. 34.6%, P<0.05) with no serious side effect. CONCLUSION: The most common clinical features of IFI are fever, lung infection, and oral infection in patients with hematological malignancies. Candida albicans and Aspergillus infection are common. Intraconazole is safe and effective for invasive fungal infection.

[Therapeutic effect of priming induction regimen of CAG for newly diagnosed acute myeloid leukemia in elderly patients].

OBJECTIVE: To evaluate the clinical efficacy and toxicity of priming induction regimen of CAG for newly diagnosed acute myeloid leukemia (AML) in elderly patients. METHODS: Seventy-five patients with newly diagnosed AML were divided into 2 groups: 34 were treated with priming induction regimen CAG and the other 41 were treated with 2 classic routine chemotherapy regimens including pirarubicin+cytarabine (TA) and homoharringtonine+cytarabine (HA). All patients had a 14 day interval between the 2 courses of chemotherapy. RESULTS: The complete remission rate after 2 courses of induction therapy in patients with the priming induction regimen CAG and the total efficacy rate was significantly higher than that of the routine chemotherapy patients(67.6% vs. 39%; 82.4% vs. 56.1%). Patients with unfavorable karyotypes had poor chemotherapy efficacy. The 3-year disease-free-survival (DFS) time was longer in patients with AML treated with priming induction regimen CAG than in patients treated with 2 classic routine chemotherapy regimens. Except for the muscular soreness, the hematological and non-hematological side effects in the CAG priming induction group were significantly fewer than those in the routine chemotherapy group. CONCLUSION: The priming induction regimen of CAG has a significantly higher complete remission rate and an efficacy rate, fewer side effects, milder chemotherapy intensity and is more sensitive to chemotherapeutic drugs than those of the routine chemotherapy. It can shorten the duration of agranulocytosis and decrease infectious complications and increase the sensitivity of leukemia blast cells to chemotherapeutic drugs.

[BRAF V600E Mutation in Chinese Patients with Langerhans Cell Histiocytosis and Its Clinical Significance].

OBJECTIVE: To investigate the BRAF V600E mutation in Chinese patients with langerhans cell histiocytosis (LCH) and its clinical significance. METHODS: The clinical records of 50 pathology-diagnosed LCH cases were analyzed retrospectively and the Paraffin-embedded tissue blocks were retrieved to test the BRAF V600E mutation by immunohistochemical method with a specific BRAF V600E protein antibody. BRAF V600E mutation was also tested by High-resolution Melting Analysis (HRM) followed by Sanger sequence in 31 cases. RESULTS: BRAF V600E mutation was found in 58% (29/50) LCH cases by gene test or protein test. BRAF V600E expression was identified in 56% (28/50) LCH cases by immunohistochemical analysis alone while 54.8% (17/31) by HRM-Sanger alone. Two out of 14 cases, who were negative for BRAF V600E by HRM-Sanger analysis, were positive by immunohistochemical tests (14.3%). Otherwhile, only 1 out of 17 LCH cases with a positive BRAF V600E mutation by gene test were negative by immunohistochemical analysis. The status of BRAF V600E did not show significant relevance with age, sex, clinical stage or response. Also, BRAF V600E had no effect on the 3-year survival or event-free survival in this group. CONCLUSION: Immunohistochemical tests for BRAF V600E in Paraffin-embedded tissue is of ideal sensitivity, 58% Chinese LCH patients have BRAF V600E positive and so LCH is a clonal disease but the exact role of BRAF V600E in LCH needs further research.

[Hematopoietic stem cell transplantation for hematological malignancies].

OBJECTIVE: To evaluate the efficacy of hematopoietic stem cell transplantation (HSCT) in hematological malignancies. METHODS: Twenty-five patients with hematological malignancies were treated by autologous bone marrow transplantation (ABMT), autologous peripheral blood stem cell transplantation (APB-SCT) or Allo-PBSCT. Eight acute myeloid leuekmia (AML) patients who received autologous hematopoietic stem cell transplantation (AHSCT) were treated by chemotherapy again. RESULTS: All the patients engrafted gained hematopoietic reconstitution; they were followed up for 6 to 91 months; five patients died; twenty patients were alive in a disease-free situation. CONCLUSION: After the patients with acute leukemia receive AHSCT, the relapse incidences can be reduced obviously by regular chemotherapy. HSCT is one of the best methods for hematological malignancies.