Survival Analysis of 148 Patients with Primary Diffuse Large B Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical outcome of the patients with primary diffuse large B-cell lymphoma（DLBCL）.@*METHODS@#Clinical data of 148 patients with DLBCL in our hospital and cancer hospital from March 2006 to April 2016 were retrospectively analyzed. Kaplan-Meier analysis was used to estimate progression-free survival（PFS）and overall survival（OS）.@*RESULTS@#5-year OS and PFS rates were 85% and 69%，respectively. The survival analysis showed that 5-year OS rate of R-CHOP group was significantly higher than that of CHOP alone group（89% vs. 70%，P60 years），poor ECOG score（≥2），advanced stage（Ⅲ-Ⅳ），higher IPI score（≥3），CHOP alone and absence of radiotherapy related with poor survival rate. Furthermore，multivariate analysis showed that age>60 year significantly related with the worse OS.@*CONCLUSION@#Age >60 year is an important independent prognostic factor to predict worse OS or PFS.

Clinical Analysis of Priming Regimen for Treatment of Acute Myeloid Leukemia (Non-APL) Patients Aged over 70 Years / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the therapeutic efficacy for patients aged over 70 years with acute myeloid leukemia(non-APL).</p><p><b>METHODS</b>Clinical data of 19 acute myeloid leukemia patients aged over 70 years admitted in our hospital from March 2006 to April 2016 years were analyzed retrospectively. Among them 15 patients received priming regimen and 4 patients received best supportive treatment. The overall survival time between patients with priming regimen and patients with best supportine treatment was compared by Kaplan-Meier analysis. The prognostic factors were evaluated by using multivariate analysis. Out of the 19 patients, 9 were males and 10 were females, with median age of 75 years (70-84).</p><p><b>RESULTS</b>After 2 cycles of induction chemotherapy, the complete response rate was (7/15)46.6% and overall response rate was (11/15) 73%. Significant longer median survival time was observed in priming regimen group, compared with that in best supportive treatment group (11 months vs 2 months)(χ=17.077, P<0.001). The patients were well tolerant to side-effect of chemotherapy. Multivariate analysis showed that only receiving induction chemotherapy or not was the independent prognostic factor of the survival time(P<0.05), while the sex, age, ECOG index, CD34, HLA-DR, WBC count and ratio of blast cells in bone marrow were factor affecting the prognosis.</p><p><b>CONCLUSION</b>The priming regimen may be practicable and effective for the treatment of patients with acute myeloid leukemia aged over 70 years (non-APL) and prolong the survival time of these patients.</p>

Long Term Curative Effects and Prognostic Analysis of Stem Cell Transplantation for Treating Patients with Peripheral T Cell Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the efficacy and prognostic factors of hematopoietic stem cell transplantation in the treatment of patients with peripheral T cell lymphoma (PTCL).</p><p><b>METHODS</b>The clinical records of 53 patients with PTCL were collected and analyzed retrospectively. The prognostic value of prognostic index PIT were evaluated.</p><p><b>RESULTS</b>Among 53 cases of PTCL, 31 patients underwent hematopoietic autologous stem cell transplantation (auto-HSCT), 22 patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT), their median follow-up time was 62 (1-174) months, from them 1 patients was not engrafted in each group, 4 patients underwent allo-HSCT died within 1 month after transplantation. The 3-year overall survival rates in auto- and allo-HSCT groups were 42.3% (95% CI 24.1-60.5%) and 42.9% (95% CI 21.7-64.1%) respectively, 11 and 3 patients died of relapse after auto-HSCT and allo-HSCT, respectively, the treatment-related mortality (TRM) was 22.6% (95% CI 6.1%-39.0%) and 48.7% (95% CI 26.8%-70.7%), respectively. Univariate analysis showed that bone marrow involvement at diagnosis was associated with poor prognosis. In allo-HSCT group, PIT showed statistically significant difference in both OS and PFS between the patients without or with one risk factor and the patients with 3-4 risk factors.</p><p><b>CONCLUSION</b>The relapse rate of relapse/refractory patients is high after auto-HSCT. The TRM is high after allo-HSCT, but long term survival is promising. The prognostic index for PTCL can reliably assess the prognosis of PTCL.</p>

Clinical observation of decitabine-treating patients with myelodysplastic syndrome and acute myeloid leukemia / 中国实验血液学杂志

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.

Application of multiplex nested RT-PCR to detecting 10 fusion genes related with MLL gene in myelodysplastic syndrome / 中国实验血液学杂志

This study was aimed to investigate the clinical value of multiplex nested reverse transcription PCR (RT-PCR) in detecting MLL-related fusion genes in myelodysplastic syndrome (MDS). Ten MLL-related genes (dupMLL, MLL-ELL, MLL-ENL, MLL-AF6, MLL-AF9, MLL-AF10, MLL-AF17, MLL-CBP, MLL-AF1P, MLL-AF1Q) in 221 MDS cases were detected by multiplex nested RT-PCR. The results indicated that 20 patients were detected with positive result among 221 patients and the positive rate was 9.05%. The number of the positive cases and positive rates of the above mentioned 10 fusion genes were in order: 7 (3.16%), 2 (0.9%), 1 (0.45%), 1 (0.45%), 2 (0.9%), 2 (0.9%), 1 (0.45%), 2 (0.9%), 1 (0.45%), 1 (10.45%). It is concluded that the multiplex nested RT-PCR has been confirmed to be able to detect 10 fusion genes in MDS patients, which can provide important evidences for assessing diagnosis and treatment, and give related necessary information about minimal residual disease and its prognosis.

Therapy and prognosis analysis of 47 patients with extranodal NK/T-cell lymphoma / 中国实验血液学杂志

This study was purposed to explore the clinical characteristics, therapy and prognosis of patients with extranodal NK/T cell lymphoma (ENKL). 47 patients with ENKL from October 1995 to December 2008 in our hospital were analyzed retrospectively. The survival of patients was analyzed by using Kaplan-Meier methods, the prognosis of patients was evaluated by multivariate analysis using COX regression model. The clinical parameters used included CD56, Ann Arbor stage, international prognostic index (IPI) and B symptom. The results showed that the 2-year and 5-year overall survival (OS) rates were 91%, 71% respectively. Multivariant analysis by COX regression showed the CD56 and Ann Arbor stage were independent prognostic factors. Single factor analysis with staging in CHOP chemotherapy group indicated that more than stage IIIE (including IIIE) was a prognostic factor. Single factor analysis with B symptom showed that B symptom also was a prognostic factor. The cumulative survival rate of patients received radiotherapy alone was higher than that of patients got chemotherapy alone, its difference had a statistical significance, but there was no statistical significance between radiotherapy group and chemoradiotherapy group. It is concluded that CD56, Ann Arbor stage and B symptoms are prognostic factors. Radiotherapy alone is better than chemotherapy alone in therapy of ENKL. Chemotherapy combined with radiotherapy can not improve the survival. Improving the status of patients can make prognosis better.

Advances of treatment for extranodal NK/T-cell lymphoma --- review / 中国实验血液学杂志

Extranodal NK/T-cell lymphoma is a rare pathological type, incidence of which is 2% - 10% of the primary NHL cases, showing a broad morphologic spectrum with frequent necrosis. Extranodal NK/T-cell lymphoma occurs more frequently in Asian population, especially in Southern China and Southeast Asian population. It is reported that the incidence of ENKL among lymphomas (1314 cases) in Asian countries was 4 times as much as the Western countries (22% vs. 5%) by the International Peripheral T-cell Lymphoma Project. Nasal NK/T-cell lymphoma most commonly occurred in the nasal cavity or other parts of the upper aerodigestive tract, and is highly associated with EBV (Epstein-Barr virus) infection, which is highly aggressive and its prognosis generally is poor. The mean survival time is about 12-38 months. It is important to accurately assess the patients prognosis for an optimal treatment. Localized disease (stage I and II) often has a relatively good prognosis through local radiation or combined therapy. There is a paucity of data to guide therapy in advanced disease. Generally, combining therapy is the most commonly selected approach for advanced disease. The conditions of the patients with advanced, relapsed or refractory diseases have been improved by high-intensity chemotherapy combined with radiation, and a regimen containing L-asparaginase L-Asp. Recently some studies have demonstrated promising outcomes in the selected cases by high-dose chemotherapy supplemented with auto-or allo-HSCT. Targeting therapy is also developing quickly. This current review mainly focuses on the advance of treatment for extranodal NK/T-cell lymphoma.