الملخص
PURPOSE@#Mannitol is one of the first-line drugs for reducing cerebral edema through increasing the extracellular osmotic pressure. However, long-term administration of mannitol in the treatment of cerebral edema triggers damage to neurons and astrocytes. Given that neural stem cell (NSC) is a subpopulation of main regenerative cells in the central nervous system after injury, the effect of mannitol on NSC is still elusive. The present study aims to elucidate the role of mannitol in NSC proliferation.@*METHODS@#C57 mice were derived from the animal house of Zunyi Medical University. A total of 15 pregnant mice were employed for the purpose of isolating NSCs in this investigation. Initially, mouse primary NSCs were isolated from the embryonic cortex of mice and subsequently identified through immunofluorescence staining. In order to investigate the impact of mannitol on NSC proliferation, both cell counting kit-8 assays and neurospheres formation assays were conducted. The in vitro effects of mannitol were examined at various doses and time points. In order to elucidate the role of Aquaporin 4 (AQP4) in the suppressive effect of mannitol on NSC proliferation, various assays including reverse transcription polymerase chain reaction, western blotting, and immunocytochemistry were conducted on control and mannitol-treated groups. Additionally, the phosphorylated p38 (p-p38) was examined to explore the potential mechanism underlying the inhibitory effect of mannitol on NSC proliferation. Finally, to further confirm the involvement of the p38 mitogen-activated protein kinase-dependent (MAPK) signaling pathway in the observed inhibition of NSC proliferation by mannitol, SB203580 was employed. All data were analyzed using SPSS 20.0 software (SPSS, Inc., Chicago, IL). The statistical analysis among multiple comparisons was performed using one-way analysis of variance (ANOVA), followed by Turkey's post hoc test in case of the data following a normal distribution using a Shapiro-Wilk normality test. Comparisons between 2 groups were determined using Student's t-test, if the data exhibited a normal distribution using a Shapiro-Wilk normality test. Meanwhile, data were shown as median and interquartile range and analyzed using the Mann-Whitney U test, if the data failed the normality test. A p < 0.05 was considered as significant difference.@*RESULTS@#Primary NSC were isolated from the mice, and the characteristics were identified using immunostaining analysis. Thereafter, the results indicated that mannitol held the capability of inhibiting NSC proliferation in a dose-dependent and time-dependent manner using cell counting kit-8, neurospheres formation, and immunostaining of Nestin and Ki67 assays. During the process of mannitol suppressing NSC proliferation, the expression of AQP4 mRNA and protein was downregulated, while the gene expression of p-p38 was elevated by reverse transcription polymerase chain reaction, immunostaining, and western blotting assays. Subsequently, the administration of SB203580, one of the p38 MAPK signaling pathway inhibitors, partially abrogated this inhibitory effect resulting from mannitol, supporting the fact that the p38 MAPK signaling pathway participated in curbing NSC proliferation induced by mannitol.@*CONCLUSIONS@#Mannitol inhibits NSC proliferation through downregulating AQP4, while upregulating the expression of p-p38 MAPK.
الموضوعات
Humans , Animals , Mannitol/pharmacology , Brain Edema , Neural Stem Cells/metabolism , MAP Kinase Signaling System , p38 Mitogen-Activated Protein Kinases/pharmacology , Cell Proliferationالملخص
<p><b>OBJECTIVE</b>To study the clinical characteristics of patients with post-transplantation lymphoproliferative disease (PTLD) after allogeneic peripheral blood hematopoietic stem cell transplantation, and to improve the understanding and diagnosis of PTLD.</p><p><b>METHODS</b>The clinical data of 244 patients underwent allogeneic hematopoietic stem cell transplantation in the General Hospital of PLA from May 2014 to April 2017 were analyzed retrospectively. The follow-up time was up to November 30, 2017. The incidence, risk factors, treatment and survival of patients with PTLD were statistically analyzed.</p><p><b>RESULTS</b>Among the 244 cases the PTLD occurred in 22 cases, the incidence rate was 9.02%, 5 of them were diagnosed by pathology, and 17 were diagnosed clinically. All of them had EB virus infection. They were all ATG user, either underwent related haploidentical hematopoietic stem cell transplantation or unrelated hematopoietic stem cell transplantation, 20 cases were treated with rituximab or rituximab combined with γ-globulin, glucocorticoid, ERV+CTL, chemotherapy and 17 showed the effective response, with a total effective rate of 85%. The median follow-up time was 122 days, the median survival time was 5 months (1-22 months) and the total survival rate was 50%.</p><p><b>CONCLUSION</b>The incidence of PTLD after allogeneic peripheral blood hematopoietic stem cell transplantation closely relates with EB virus infection. The application of ATG in the preconditioning scheme is a high risk factor for the onset of PTLD. In the case of no pathological diagnosis, clinical and laboratory examinations should be actively combined so as to define clinical diagnosis. The riturimab should be used more and more for patients with PTLD.</p>
الموضوعات
Humans , Epstein-Barr Virus Infections , Hematopoietic Stem Cell Transplantation , Lymphoproliferative Disorders , Prognosis , Retrospective Studiesالملخص
Objective: To evaluate clinical outcomes of autologous and allogeneic peripheral blood stem cell transplantation (PBSCT) for aggressive peripheral T-cell lymphoma (PTCL). Methods: From June 2007 to June 2017, clinical data of PTCL patients who underwent PBSCT were assessed retrospectively. Results: Among 41 patients, 30 was male, 11 female, and median age was 38(13-57) years old. Seventeen patients with autologous PBSCT (auto-PBSCT) and 24 patients with allogeneic PBSCT (allo-PBSCT) were enrolled in this study. Eight patients (8/17, 47.1%) in auto-PBSCT group were ALK positive anaplastic large cell lymphoma (ALCL), 7 patients (7/24, 29.2%) with NK/T cell lymphoma and 9 patients (9/24, 37.5%) with PTCL-unspecified (PTCL-U) in allo-PBSCT group (P=0.035). There were 58.8% patients (10/17) in complete response (CR) status and 11.8% (2/17) in progression disease (PD) status before transplantation in auto-PBSCT group, and 8.3% (2/24) in CR status and 45.8% (11/24) in PD status before transplantation in allo-PBSCT group (P=0.026). The 2-years cumulative overall survival (OS) were (64.0±10.8)% and (53.5±9.7)% for auto-PBSCT and allo-PBSCT respectively (P=0.543). The 2-years cumulative disease-free survival (DFS) were (57.1±12.4)% and (53.5±10.6)% for auto-PBSCT and allo-PBSCT respectively (P=0.701). In patients with dead outcomes after PBSCT, 83.3% (5/6) of death cause was relapse in auto-PBSCT and 41.7% (5/12) of death cause was relapse in allo-PBSCT. Conclusion: Both auto-PBSCT and allo-PBSCT were effective for PTCL. Allo-PBSCT maybe was better than auto-PBSCT for high-risk PTCL with poor prognosis.
الموضوعات
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Hematopoietic Stem Cell Transplantation , Lymphoma, T-Cell, Peripheral/therapy , Neoplasm Recurrence, Local , Peripheral Blood Stem Cell Transplantation , Retrospective Studies , Transplantation, Autologous , Transplantation, Homologous , Treatment Outcomeالملخص
<p><b>OBJECTIVE</b>To analyze the clinical manifestations and laboratory features of patients with T large granular lymphocytic leukemia (T-LGLL), so as to improve the understanding of this disease.</p><p><b>METHODS</b>The clinical data of 10 patients with T-LGLL in General Hospital of Chinese PLA from October 2015 to March 2010 were analyzed retrospectively.</p><p><b>RESULTS</b>Their median age at diagnosis was 51 years old. 9/10 (90%) patients showed symptoms of anemia, with a median Hb level of 82.5 g/L, 5/10 (50%) patients combined with autoimmune disorders and with a median Hb level of 77 g/L. 7/10 (70%) patients had splenomegaly, 2/10 (20%) patients had complex karyotype, 2/10 (20%) patients had gene mutations, the median age of 4 patients with complex karyotype and gene mutation was 49 years old, all of them suffered from splenomegaly. The immunophenotype of 6/10 patients was CD3+ CD4- CD8+ and that of 2/10 patients (20%) was CD3+ CD4- CD8-, that of another 2/10 (20%) was CD3+ CD4+ CD8-, the clinical features between different types of immunization were not statistically different.</p><p><b>CONCLUSION</b>T-LGLL patients often are old men, combined with anemia and splenomegaly, often associated with autoimmune diseases; the patients with complex karyotype and gene mutation are younger and they are more with hepatosplenomegaly; the guide role of different immunotypes for clinical strategy is no significant.</p>
الموضوعات
Humans , Middle Aged , Anemia , Pathology , Autoimmune Diseases , Pathology , Chromosome Aberrations , Hemoglobins , Immunophenotyping , Leukemia, Large Granular Lymphocytic , Diagnosis , Pathology , Retrospective Studies , Spleen , Pathologyالملخص
<p><b>OBJECTIVE</b>To investigate the clinical value of Paroxetine combined with mid-frequency electrical pulse acupoint stimulation (EPAS) in the treatment of premature ejaculation (PE).</p><p><b>METHODS</b>Totally 69 PE patients were equally assigned to receive oral Paroxetine 20 mg/d, mid-frequency EPAS, or oral Paroxetine 10 mg/d combined with mid-frequency EPAS (P + EPAS) , all for 8 weeks. We obtained the intravaginal ejaculation latency time (IELT) and Chinese Index of Premature Ejaculation (CIPE-5) scores of the patients before and after treatment, and compared adverse reactions among the three groups of patients.</p><p><b>RESULTS</b>One patient of the Paroxetine group gave up treatment because of abdominal pain and nausea. Compared with the baseline, the patients in the Paroxetine, EPAS, and P + EPAS groups all showed markedly increased IELT ([0.92 ± 0.11] vs [4.07 ± 0.11] min, P < 0.01; [0.92 ± 0.12] VS [2.78 ± 0.17] min P < 0.05; [0.91 ± 0.09] vs [5.31 ± 0.13], P < 0.01) and decreased CIPE-5 scores (12.5 ± 3.0 vs 22.0 ± 2.1, P < 0.01; 12.8 ± 2.9 vs 19.5 ± 1.9, P > 0.05; 13.1 ± 2.8 vs 25.2 ± 2.1, P 0.01), with statistically significant differences between the P + EPAS group and the other two (P < 0.05). The total effectiveness rate was 95.7% in the P + EPAS group, remarkably higher than in the Paroxetine (72.7%, P < 0.05) and the EPAS group (47.8, P < 0.01).</p><p><b>CONCLUSION</b>Oral Paroxetine combined with mid-frequency EPAS has a higher safety and efficacy than either Paroxetine or EPAS alone in the treatment of PE.</p>
الموضوعات
Aged , Humans , Male , Acupuncture Points , Combined Modality Therapy , Methods , Ejaculation , Electroacupuncture , Methods , Paroxetine , Therapeutic Uses , Premature Ejaculation , Therapeutics , Selective Serotonin Reuptake Inhibitors , Therapeutic Uses , Treatment Outcomeالملخص
<p><b>OBJECTIVE</b>To investigate the effect of Huangqi injection on the short-term prognosis in childhood with acute lymphoblastic leukemia (ALL).</p><p><b>METHODS</b>A retrospective analysis was performed on the clinical data of 105 children newly diagnosed with ALL between January 2009 and December 2012. These children were randomly divided into treatment group (18 low-risk cases, 7 medium-risk cases, and 24 high-risk cases) and control group (21 low-risk cases, 7 medium-risk cases, 28 high-risk cases). Both groups were given remission induction therapy based on the levels of risk. Throughout the remission induction therapy, the treatment group also received Huangqi injection (0.5-1.0 mL/kg per day) by intravenous infusion, while the control group was given 0.9% sodium chloride injection instead. The two groups were compared in terms of distribution of prognostic factors and complete remission (CR) rate after remission induction therapy, as well as the incidence of minimal residual disease (MDR) (≥ 10(-4) and < 10(-4)) among all patients in the two groups on day 19 of remission induction therapy and among B-ALL patients in the two groups when achieving a CR at the end of remission induction therapy.</p><p><b>RESULTS</b>Of the 105 children with ALL, 99 had B-ALL, and 6 had T-ALL. There were no significant differences in the distribution of prognostic factors between the two groups (P>0.05). The overall CR rate of 105 patients was 79%; there was no significant difference in CR rate between the treatment and control groups (82% vs 77%; P>0.05); also, no significant differences were found between the two groups in the CR rates among high-, medium-, and low-risk cases (P>0.05). On day 19 of remission induction therapy, the incidence of MRD≥10(-4) in the treatment group was significantly lower than that in the control group (69% vs 95%; P<0.05); among 80 children with B-ALL who achieved a CR (43 cases in the control group and 37 cases in the treatment group), the incidence of MRD≥10-4 was significantly lower in the treatment group than in the control group (27% vs 58%; P<0.05); in both circumstances above, the high- and low-risk cases in the treatment group had a significantly lower incidence of MRD≥10(-4) than the control group (P<0.05).</p><p><b>CONCLUSIONS</b>Huangqi injection combined with chemotherapy has an enhanced anti-tumor effect and can improve the short-term prognosis and clinical outcome in children with ALL.</p>
الموضوعات
Child , Child, Preschool , Female , Humans , Male , Astragalus Plant , Drugs, Chinese Herbal , Therapeutic Uses , Incidence , Induction Chemotherapy , Injections , Neoplasm, Residual , Epidemiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Drug Therapy , Mortality , Prognosisالملخص
Purpose of this study was to analyse the characteristics of clinical, iconographical, pathological and treatment methods of Langerhans cell histiocytosis (LCH), so as to improve the diagnosis and treatment level of this disease. The clinical data of 35 LCH patients were studied retrospectively. These patients were divided into 2 groups according to age <14 years old and ≥ 14 years old. The clinical symptoms were analysed and the signs, imageology and pathology manifestation and treatment results were evaluated. The results showed that LCH clinical manifestations were diverse and complex. Surgical treatment for patients with single system involvement of LCH was better than that of multi-system involvement of LCH (MS-LCH). For the latter, combined chemotherapy effects was better. After 3-year follow-up, 1-year OS was 94% ± 4%, 2-years OS was 91% ± 5%, 3-year OS was 86% ± 7%. 3 years OS of group <14 years old and ≥ 14 years old was 94% ± 6% and 81% ± 10% respectively. The OS of former was better than that of the later, but because a small number of cases, this difference was not statistically significant. It is concluded that LCH is easy to be misdiagnosed, the pathological biopsy is the gold standard of LCH diagnosis. The PET-CT can be of great help in identifying stages and finding lesion areas of the disease. Pulmonary Langerhans cell histiocytosis (PLCH) is more common in adult. Combined chemotherapy can improve the prognosis of the patients. The treatment methods should be choosed according to the stage and classification of disease.
الموضوعات
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Histiocytosis, Langerhans-Cell , Diagnosis , Drug Therapy , Pathology , Prognosis , Retrospective Studiesالملخص
This study was purposed to evaluate the efficacy and safety of linezolid, vancomycin and teicoplanin for the treatment of patients infected by Gram-positive bacteria in the Department of Hematology by retrospective analysis. The patients with fever in our department from January to December in 2011 were selected for blood culture with Gram-positive bacteria and treated with linezolid, vancomycin or teicoplanin alone.Various parameters were recorded before and after treatment, such as fever time, respiratory symptoms, physical signs, radiographic changes, blood and biochemical routine, and adverse reactions. The efficacy and safety of linezolid, vancomycin and teicoplanin were compared according to the fever abating time, bacterial clearance rate, clinical efficiencies and adverse events. The patients were divided into linezolid group (15 patients), vancomycin group (17 patients) and teicoplanin group (20 patients). The results showed that the mean time of fever abating in linezolid group was (4.43 ± 3.15)d, bacterial clearance rate and clinical efficiency in linezolid group were 55.56% and 86.67%, respectively. The above three data in vancomycin group were (6.83 ± 4.67)d, 54.54% and 76.47% respectively, and were (5.57 ± 4.16)d, 41.67% and 80.00% in teicoplanin group respectively. There was no statistically significant difference between three groups (P > 0.05). There were one case of diarrhea and two cases of thrombocytopenia in the linezolid group, and one case of nausea and two cases of creatinine increase in the vancomycin group. There were three cases of thrombocytopenia in the teicoplanin group. The thrombocytopenia in five cases and the hemogram drop in patients with leukemia after treatment were overlapped, their drug treatment did not stop, but their thrombocytopoiesis recovered to normal-level, thus the drug treatment were considered as no relation with thrombocytopenia. It is concluded that the treatment efficacy between linezolid, vancomycin and teicoplanin for Gram-positive bacterial infections is not statistically different, but linezolid maybe have advantage over vancomycin and teicoplanin in fever abating time, bacterial clearance rate and clinical efficiency.
الموضوعات
Adult , Aged , Female , Humans , Male , Middle Aged , Acetamides , Therapeutic Uses , Gram-Positive Bacterial Infections , Diagnosis , Drug Therapy , Linezolid , Oxazolidinones , Therapeutic Uses , Retrospective Studies , Teicoplanin , Therapeutic Uses , Vancomycin , Therapeutic Usesالملخص
This study was purposed to evaluate the clinical and pathological features, prognosis of patients with subcutaneous panniculitis-time T cell lymphoma (SPTCL). The clinicopathologic features, immunophenotypes and treatment of 10 SPTCL patients which confirmed by pathology were analyzed retrospectively. The results showed that the main clinical manifestations of SPTCL were the single or multiple subcutaneous nodules. Of them 8 cases were found with recurrent high fever, weight loss, injury of liver function, bone marrow involvement and pancytopenia. This disease rapidly advanced. Pathologically, atypical large, medium-size and small-lymphocytes rounded the lipocytes look like rosettes. The reactive proliferation of histiocytes accompanied by phagothrocytic phenomena, polynuclear giant cells and granulomatous reaction. The tumor cells infiltrated into the lipolubuls. This lymphoma expressed the cytotoxic T-cell immunophenotype. CHOP regimen was the most common chemotherapy regimen used. 60% patients achieved a good initial response to chemotherapy. 3-year survival was 10%, with median survival time of 10 months. It is concluded that SPTCL is a specific type of lymphoma involving primarily in subcutaneous fatty tissues, most cases of SPTCL display an aggressive course, the disease may progress rapidly and accompanies with unfavorable prognosis. And the prognosis is poor in SPTCL patients with hemophagocytic syndrome. but the allo-HSCT can improve the outcome of this disease.
الموضوعات
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Lymphoma, T-Cell , Drug Therapy , Pathology , Panniculitis , Drug Therapy , Pathology , Retrospective Studiesالملخص
This study was aimed to investigate the factors influencing mobilization efficiency of peripheral hematopoietic stem cells with granulocyte colony stimulating factor (G-CSF) and their impact on healthy donors. 181 donors were mobilized subcutaneously with G-CSF at 5 - 10 µg/(kg·d), and 10 donors were mobilized with G-CSF at 3.3 - 4.9 µg/(kg·d), once 12 h, for 4 - 5 d. Peripheral blood mononuclear cell (MNC) and CD34(+) cell counts were analyzed by flow cytometry. Mobilization-related side effects were also monitored. The results showed that white blood cell counts increased by 6 times averaged after mobilization (P < 0.01). The platelet count obviously decreased (P < 0.01), while the hemoglobin level did not show significant difference. No significant differences were observed in MNC and CD34(+) cell counts between those subjects harvested on the 4th and 5th day after mobilization. Male donors were superior to female ones in cell harvest (P < 0.01). Donor body weight played positive role in cell yield, while impact of age on harvest was not remarkable. Neither MNC nor CD34(+) cell count showed a linear relationship with G-CSF dose. Only slight side effects were observed on the donors in this study. It is concluded that mobilization with G-CSF is sufficient in healthy donors without remarkable side effects.
الموضوعات
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Factor Analysis, Statistical , Granulocyte Colony-Stimulating Factor , Pharmacology , Hematopoietic Stem Cell Mobilization , Methods , Peripheral Blood Stem Cell Transplantation , Methods , Tissue Donorsالملخص
This study was purposed to investigate the clinical efficiencies and adverse reactions of treating the myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) by using decitabine. The clinical data of 12 MDS and AML patients treated with decitabine were analyzed retrospectively. Among 12 patients there were 1 case of MDS-RA, 2 cases of MDS-RAEB-I, 3 cases of MDS-RAEB-II, 2 cases of AML-M4, 2 cases of AML-M5, 1 case of AML-M6 and 1 case of AML-M0. In decitabine chemotherapy program for 5 days (n = 8), decitabine 20 mg/(m(2)·d) × 5 days was applied, 4 weeks for 1 cycle; in program for 3 days (n = 2), decitabine 15 mg/m(2), once 8 h for 3 days, 6 weeks for 1 cycle; another program (n = 2), decitabine 20 mg/(m(2)·d) every other day for 5 times. For 1 patient achieved complete remission (CR) after treatment with decitabine, ID4 gene methylated level was detected by MS-PCR and ML-PCR before and after treatment. The results showed that 2 cases achieved CR, 1 case partial remission, 5 cases stable disease, 1 case progress of disease and 3 cases died. Disease control rate was 66.67% (8/12), the effective rate 25% (3/12). The average survival time was (11.5 ± 2.1) months. 1-year OS rate was 40%, 2-year OS rate was 16.7%. MS-PCR detection showed that the decitabine could significantly reduce the ID4 gene methylation level. It is concluded that decitabine can stabilize disease status of MDS patients, reduce blood transfusion dependence and improve the life quality of patients, and even some patients who transformed from MDS to leukemia achieved CR after treatment with decitabine. Decitabine can reduce the ID4 gene methylation level. The main adverse reaction of decitabine was myelosuppression, infection and so on. So the blood transfusions, antibiotics and other supportive treatments for these patients are needed. Most of patients well tolerate the adverse effects of decitabine after active symptomatic and supportive treatment. The efficacy and survival rate of patients in this study were similar to that of application of decitabine to treat MDS in other domestic studies.
الموضوعات
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Azacitidine , Therapeutic Uses , Leukemia, Myeloid, Acute , Drug Therapy , Myelodysplastic Syndromes , Drug Therapy , Retrospective Studies , Survival Rate , Treatment Outcomeالملخص
This study was purposed to investigate the changes of serum immunoglobulin (Ig) level during treatment of diffuse large B cell lymphoma by using rituximab (RTX) combined with CHOP. Total of 122 newly diagnosed patients with CD20(+) diffuse large B cell lymphoma from January 2004 to December 2009 were analyzed retrospectively. According to different treatment regimens, 122 patients were divided into 2 group: group treated with CHOP (n = 24) and group treated with R-CHOP (n = 98, out of which 16 patients with abnormal Ig levels before treatment). Ig levels of patients in 2 groups at different stages were recorded and analyzed after abandoning those patients with abnormal Ig levels before treatment. The results showed that after 6 cycles of treatment, among the total 82 patients with normal levels of serum immunoglobulin, the decreased levels of IgG, IgA and IgM by 20% of baseline value were found in 85.4% (70/82), 85.4% (70/82) and 87.8% (72/82) patients respectively, while levels of IgG, IgA and IgM < low limit of normal value were observed in 47.6% (39/82), 48.8% (40/82) and 52.4% (43/82) patients respectively. No obvious changes of IgG, IgA and IgM levels were found in 24 patients of CHOP group before and after treatment.It is concluded that hypogammaglobulinemia is a common complication in chemotherapy using RTX combined with CHOP, the decreased level of Ig is recovered to normal level about 1 year after stop of treatment, the decrease of Ig in some cases can last even for over 2 years.
الموضوعات
Humans , Antibodies, Monoclonal, Murine-Derived , Therapeutic Uses , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cyclophosphamide , Therapeutic Uses , Doxorubicin , Therapeutic Uses , Immunoglobulins , Blood , Lymphoma, Large B-Cell, Diffuse , Blood , Drug Therapy , Allergy and Immunology , Prednisone , Therapeutic Uses , Prognosis , Retrospective Studies , Rituximab , Treatment Outcome , Vincristine , Therapeutic Usesالملخص
This study was aimed to compare the efficacy and adverse effects of PD (bortezomib + dexamethasone) and VAD (vincristine + adriamycin + dexamethasone) as regimens for treatment of multiple myeloma patients. 21 and 31 multiple myeloma patients were enrolled in the PD and VAD groups respectively which received 2 to 5 courses of treatments, and both clinical effects and adverse reactions were observed. In the all 52 patients, 48 were newly diagnosed and the other 4 patients had accepted 1 to 2 courses of M2 or MP treatment, but didn't get PR. In 52 patients, 4, 4, 8 and 5 patients accepted 2, 3, 4 and 5 courses of PD regimen respectively, while 6, 11, 12 and 2 patients accepted 2, 3, 4 and 5 courses of VAD regimen respectively. The results indicated that the rate of good efficacy (both CR and VGPR) in PD group was 57.1%, while the rate of good efficacy in VAD group was 16.1%, there was significant difference (p = 0.0052). The percentage of patients who got CR, VGPR and PR in PD and VAD groups were 95.2% and 74.2% respectively, there was no significant difference (p = 0.1108). The incidences of adverse effects in 2 groups were similar, which included hematological toxicity, liver and kidney functional lesion, peripheral neuropathy, infection, interstitial pneumonia. It is concluded that compared with conventional VAD chemotherapy, PD may improve CR and VGPR rate in newly diagnosed patients with multiple myeloma, meanwhile it does not bring about more and worse toxicity.
الموضوعات
Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Bleomycin , Therapeutic Uses , Dexamethasone , Therapeutic Uses , Doxorubicin , Therapeutic Uses , Multiple Myeloma , Drug Therapy , Treatment Outcome , Vincristine , Therapeutic Usesالملخص
The study was aimed to evaluate the adverse effects of PAD (bortezomib + adriamycin + dexamethasone) and VAD (vincristine + adriamycin + dexamethasone) as chemotherapy regimens in multiple myeloma patients. 27 and 30 patients with multiple myeloma (MM) were enrolled in PAD and VAD groups respectively. MM patients accepted 3 - 5 cycles of VAD or PAD regimens. The type, degree and occurrence time of adverse reactions during the treatment were observed. The results showed that the rash was found in two patients only in PAD group, leucocytopenia, thrombocytopenia, peripheral neuropathy, infection, fatigue, nausea, constipation, and adverse effects of cortex hormone (hypertension, glycemia, hypokalemia, hyponatremia and acne) were found in the both two groups. The thrombosis was not observed in both two groups during treatment. Although statistical analysis indicated that only the incidence of thrombocytopenia was higher in PAD group than in VAD group with statistical difference but the incidence of leucocytopenia, peripheral neuropathy and infection in PAD group were higher than those in VAD group. Rash, constipation, peripheral neuropathy could be found in the first course of chemotherapy, while the others mostly emerged after 3 courses of treatment. The main reasons for the patients who's treatment was stopped include infection and intolerable peripheral neuropathy. Although peripheral neuropathy could be found in the two groups, but the chemotherapy was stopped only in 2 patients of PAD group after 3 cycles of treatment. It is concluded that compared with conventional VAD chemotherapy, PAD may improve therapeutic effect, but it may bring more severe toxicities to the patients with multiple myeloma.
الموضوعات
Adult , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Boronic Acids , Bortezomib , Dexamethasone , Therapeutic Uses , Doxorubicin , Therapeutic Uses , Multiple Myeloma , Drug Therapy , Pyrazines , Vincristine , Therapeutic Usesالملخص
To evaluate the clinical, pathological characters and prognosis of patients with angioimmunoblastic T cell lymphoma (AITL), the clinicopathologic features, immunophenotypes, therapy and survival rate of 12 AITL patients which were confirmed by pathologic examination were retrospectively studied. The results indicated that main symptom was observed as general lymphadenopathy, however, 9 patients had fever. The diagnosis of AITL was based on lymph-node biopsy. The histopathologic characteristics of AITL showed the damage of normal lymphnode structure, the proliferation of immunoblastic cells and arborescent super vascularization. All immunophenotypes were mature peripheral T-cellular. CVP regimen was the most common chemotherapy regimen used for patients. 58% patients have a good initial response to chemotherapy. 3-year survival was 25%, with median survival time of 25 months. In conclusion, most cases of AITL display an aggressive course, therefore, the disease progresses rapidly and has unfavorable prognosis, further studies are required to improve its therapy regimen.
الموضوعات
Aged , Female , Humans , Male , Middle Aged , Immunoblastic Lymphadenopathy , Diagnosis , Pathology , Therapeutics , Lymph Nodes , Pathology , Lymphoma, T-Cell, Peripheral , Diagnosis , Pathology , Therapeutics , Survival Rateالملخص
The aim of this study was to investigate the difference of Id4 gene promoter methylation in patients with different subtypes of myelodysplastic syndromes (MDS). By using MS-PCR method, the methylation status of Id4 gene was detected in 50 patients with different subtypes of MDS. Id4 methylation was also detected in bone marrow samples from patients with iron deficiency anemia which served as control. The results showed that Id4 gene was unmethylated in all of bone marrow samples from controls. In various subtypes of MDS patients, the rate of Id4 gene methylation was different. No Id4 methylation was found in 6 cases of RA, 2 cases of RARS and 4 cases of MDS-U. Id4 methylations was found in 2 out of 18 patients with RCMD. Id4 methylation in 3 out of 12 patients with RAEBI and other 3 out 8 patients with RAEBII were found. In groups with blast ratio lower or higher than 5%, the incidence of Id4 gene methylation were 6.7% and 30% respectively, so that there was significant difference. In tentative conclusion, Id4 gene methylation possibly is found in MDS patients with higher ratio of blast cells.
الموضوعات
Adult , Aged , Female , Humans , Male , Middle Aged , DNA Methylation , Inhibitor of Differentiation Proteins , Genetics , Myelodysplastic Syndromes , Classification , Genetics , Promoter Regions, Geneticالملخص
The aim of this study was to investigate the feasibility of monitoring minimal residual disease (MRD) of leukemia with methylation specified-polymerase chain reaction (MS-PCR). The HL-60 cells with Id4 gene complete methylation and Hek937 cells with Id4 gene complete unmethylation were mixed in accordance with different ratios of cells and were divided into 3 groups: group A (10% HL-60 + 90% Hek937), group B (1% HL-60 + 99% Hek937) and group C (0.1% HL-60 + 99.9% Hek937). The MS-PCR technique was used to detect the methylation status of Id4 gene in different ratios of leukemia cells. The results indicated that the methylation specific amplification of Id4 gene with 155 bp was observed in HL-60 cells showing complete methylation of Id4 gene; while the unmethylation specific amplication of Id4 gene with 156 bp was found in Hek937 cells, showing complete unmethylation. The methylation specific amplification of Id4 gene with 155 bp and unmethylation specific amplification of Id4 gene with 156 bp were simultaneously detected in A, B and C groups, which showed the expression of Id4 gene methylation. In conclusion, the MS-PCR technique can detect the Id4 gene methylation in leukemia cell sample containing 0.1% of HL-60 cells, moreover the Id4 gene methylation in various leukemia cells shows no significant difference, thereby use of MS-PCR to detect the Id4 methylation level may be a potential approach for monitoring of MRD. Id4 gene promoter methylation is a candidate of biomarker for MRD detection in acute leukemias.
الموضوعات
Humans , HL-60 Cells , Inhibitor of Differentiation Proteins , Genetics , Leukemia , Diagnosis , Methylation , Neoplasm, Residual , Diagnosis , Polymerase Chain Reaction , Methodsالملخص
<p><b>OBJECTIVE</b>To construct a eukaryotic fluorescent expression vector of truncated lymphoid enhancer-binding factor 1 (LEF-1) gene and investigate its effect on the proliferation and apoptosis of human colonic carcinoma cell line SW480.</p><p><b>METHODS</b>Truncated LEF-1 gene was obtained by PCR and DNA recombination from human lymphoid node cDNA library. The PCR product of LEF-1 gene was inserted into the plasmid pMD-18T and sequenced. The truncated LEF-1 gene was inserted into the eukaryotic expression plasmid pcDNA3.1 and fused with mRFP for tracing. Using Lipofectamine 2000, the plasmid pcDNA3.1-LEF-1-mRFP was transfected into Hela cells and detected by Western blotting and fluorescence activated cell sorting (FACS). The changes in the growth, proliferation and apoptosis of the SW480 cells were observed after transfection with the plasmids.</p><p><b>RESULTS</b>The truncated LEF-1 gene was successfully cloned. After transfection with the plasmid pcDNA3.1-LEF-1-mRFP, the Hela cells expressed the product of LEF-1 as detected by Western blotting and FACS. The growth and proliferation of SW480 cells was inhibited and the cell apoptosis increased after transfection with the plasmid pcDNA3.1-LEF-1-mRFP, which also caused cell cycle arrest in G0/1 phase.</p><p><b>CONCLUSION</b>The eukaryotic expression fluorescent vector pcDNA3.1-LEF-1-mRFP has been constructed and expressed in eukaryotic cell line successfully. The truncated LEF-1 protein expressed in the transfected SW480 cells results in inhibition of the cell growth and proliferation with increased cell apoptosis and cell cycle arrest in G0/1 phase.</p>
الموضوعات
Humans , Cell Line, Tumor , Colonic Neoplasms , Metabolism , Pathology , Fluorescence , Genetic Vectors , Genetics , Lymphoid Enhancer-Binding Factor 1 , Genetics , Recombinant Proteins , Geneticsالملخص
This study was aimed to explore the efficacy and associated complications of haploidentical peripheral blood stem cell transplantation (hi-PBSCT) without ex vivo T-cell depletion in treatment of hematological malignancies. 15 high-risk patients received HLA 1-3 loci (A, B, or DRB1) mismatched hi-PBSCT. The modified Bu/Cy or TBI/Cy regimen was used for preconditioning of patients. The anti-thymocyte globulin, cyclosporin A, methotrexate and mycophenolate mofetil were used for GVHD prophylaxis. 4 cases were administrated with anti-CD25 monoclonal antibody. G-CSF-mobilized peripheral blood stem cells were infused, with the median number of infused nucleated cells was 8.16 (3.92-10.86)x10(8)/kg and that of CD34+ cells was 4.51 (1.27-5.95)x10(6)/kg. The results showed that the rapid engraftment was observed in all cases. The median times of neutrophil recovery>or=0.5x10(9)/L and platelet recovery>or=20x10(9)/L were 14 (11-19) and 22 (11-52) days after transplantation respectively. 6 cases developed acute GVHD of grade I-II, and 2 cases experienced chronic extensive GVHD. Infection within 100 days after hi-PBSCT was documented in all cases. 8 cases were subjected to bacterial infection, and six got cytomegalovirus infection. Relapse occurred in five cases. Overall survival of patients was 46.7% (7/15), with a median follow-up of 213 (42-589) days. In conclusion, hi-PBSCT provides an effective alternative treatment for high-risk patients in lack of matched donors, and to reduce the high transplantation-related mortality.
الموضوعات
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Graft Survival , Graft vs Host Disease , Haploidy , Hematologic Neoplasms , General Surgery , Peripheral Blood Stem Cell Transplantation , Methods , Transplantation Conditioning , Methodsالملخص
This study was purposed to investigate the status of Id4 gene promoter methylation in malignant hematologic cell lines. MS-PCR methods were used to detect the status of Id4 gene methylation in K562, HL-60, Ramous and CA46. Meanwhile bone marrow cells in healthy individuals and Hek937, a benign renal cell line, were involved as control. The results showed that Id4 gene kept unmethylated in bone marrow cells from healthy individuals and Hek937 cells, while Id4 gene was methylated in all of K562, HL-60, Ramous and CA46 cell lines. It is concluded that different from healthy bone marrow cells and non-malignant cell line Hek937, Id4 gene was methylated in leukemia and lymphoma cell lines including K562, HL-60, Ramous and CA46. The change of Id4 gene methylation is thought to be associated with occurrence of hematologic malignancies.