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POEMS syndrome is a rare clinical disease associated with plasma cell diseases.Classic pentalogy includes: multiple peripheral neuropathy, organ enlargement, endocrine disorders, M-proteinemia and skin lesions.Due to its rarity, multiple system involvement and high clinical heterogeneity, the missed diagnosis rate and misdiagnosis rate are high.This paper reports a case of M protein negative POEMS syndrome with ascites as the prominent manifestation.
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Objective:To investigate the correlation of the expression of forkhead transcription factor O1 (FOXO1) with clinicopathological features and the prognosis in patients with diffuse large B-cell lymphoma (DLBCL).Methods:The data of 42 patients newly diagnosed with DLBCL in Hebei General Hospital admitted from June 2012 to January 2020 were collected. The expressions of FOXO1, phosphorylated FOXO1 (p-FOXO1) in DLBCL tissues were detected by using immunohistochemistry. The association of FOXO1 expression with clinicopathological features and the prognosis in DLBCL patients was retrospectively analyzed.Results:The positive rate of FOXO1 was 42.9% (18/42) and the positive rate of p-FOXO1 was 28.6% (12/42) in DLBCL tissues. There were no statistically significant differences in the positive rates of FOXO1 and p-FOXO1 among patients stratified by gender, age, Ann Arbor staging, immunophenotype, Eastern Cooperative Oncology Group score, lactate dehydrogenase, international prognostic index, β 2-microglobulin (β 2-MG) and primary sites (all P > 0.05). The positive rate of FOXO1 in patients with non-B symptoms was higher than that in those with B symptoms [53.6% (15/28) vs. 21.4% (3/14), χ2=3.938, P=0.047], and there was no statistically significant difference in the positive rate of p-FOXO1 among patients with or without B symptoms ( P > 0.05). The 2-year overall survival (OS) rate in FOXO1 positive group was higher than that in FOXO1 negative group (90.9% vs. 66.7%), the 2-year OS rate in p-FOXO1 positive group was lower than that in p-FOXO1 negative group (50.0% vs. 85.0%), and the differences were not statistically significant (all P > 0.05). Among patients without B symptoms, the 2-year OS rate in FOXO1 positive group was higher than that in FOXO1 negative group (100.0% vs. 50.0%, χ2=5.486, P=0.019). Among patients with primary lymph node, elevated β 2-MG and non-B symptoms, the 2-year OS rate in p-FOXO1 negative expression group was higher than that in p-FOXO1 positive group (100.0% vs. 50.0%, 100.0% vs. 25.0%, 91.7% vs. 33.3%), and the differences were statistically significant (all P < 0.05). Conclusions:FOXO1 may be involved in the development and progression of DLBCL, and FOXO1 positive expression may indicate the good prognosis of patients. These results suggest that p-FOXO1 positive expression may be related with poor prognosis.
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Clonal hematopoiesis is a special mode of hematopoiesis in which hematopoietic stem cells with specific genetic and molecular biological characteristics differentiate into mature blood cells. It is the basis of a variety of hematological diseases. In depth study of its etiology, mechanism and characteristics are conducive to our understanding of the value of clonal hematopoiesis in different populations or diseases. This article reviews the latest progress in clonal hematopoiesis and its related clonal diseases.
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Leukemia is a kind of cloning disease from malignant hematopoietic stem cells. Its patho-genesis may have relationship with proliferation out of control,dysdiffreentiation and inhibition of apoptosis about leukemia cells. The study confirms that CD44 is expressed in leukemia cells,promoting the occurrence and development of leukemia through participation in cell adhension,proliferation,migration and invasion behavior. In vitro experiment shows that CD44 targeted therapies can effectively kill leukemia cells,and reduce the toxicity to normal tissue cells. Therefore,aiming at the design of the anticancer drugs targeted for CD44 is expected to be used in clinical treatment of leukemia.
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Cyclooxygenase-2 (COX-2) plays an important role in the development of leukemia.COX-2 inhibitor plays a certain anti-leukemia role in the process.Many studies show that COX-2 inhibitor plays antileukemia role by inhibiting the proliferation of leukemia cell,promoting apoptosis,affecting cell cycle,inhibiting cell metastasis and reversing cell drug resistance and so on.Therefore,the researches about the anti-leukemia mechanisms of COX-2 inhibitor will provide a new target in clinical prevention and treatment of leukemia.
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CD_(44) adhesion molecule is a cell surface transmembrane glycoprotein.It displays many varinat isoforms generated by alternative splicing of exons, including CD_(44s). and CD_(44v). It has been reported that CD_(44) adhesion molecule is strongly expressed on the surface of leukemic blasts in all acute myeloid leukemia subtypes.It has been found through in vitro study that CD_(44) monoclonal antibodies can inhibit proliferation of all acute myeloid leukemia cell lines and induce terminal differentiate or apoptosis of some cell lines to diverse extent. In this review the relationship between CD_(44v), and leukemia was analysed.
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Cyclooxygenase-2 (COX-2) is the rate-limiting enzyme in the production of arachidonic acid to PG, and was differently expressed in leukemia, which may be involved in the progression of leukemia. The specific COX-2 inhibitor might become a new target for the therapy of leukemia. In this article, the effect of COX-2 in pathogenesy of leukemia and application of COX-2 inhibitor in leukemia are reviewed.
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Objective To explore the expressions and correlation of COX-2, bcl-2 and Caspase-3 in diffuse large B-cell lymphoma(DLBCL). Methods The expression of COX-2, bcl-2 and Caspase-3 was studied in 29 cases of DLBCL and 10 cases of reactivited lymphoid tissue with immunohistochemistry of PowerVisionTM. Results The expression of COX-2 and bcl-2 are seperately 68.9 % and 72.4 %. The expression of COX-2 had correlation with Ann Arbor stage. The expression of COX-2 was positively correlated with that of bcl-2, the expression of bcl-2 was negatively correlated with that of Caspase-3, the expression of COX-2 was negatively correlated with that of Caspase-3. Conclusion COX-2, bcl-2 and Caspase-3 may be involved in the carcinogenesis of DLBCL, and their expression may be helpful in estimating the histology grade and prognosis of DLBCL.
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AIM: To investigate the role of mitochondrial ceramidase in mitochondrial functions, especially in the regulation of apoptosis. METHODS: pCDNA3.1/His-MtCDase plasmid, containing mitochondrial ceramidase cDNA sequence, was transfected into K562 cells by liposome, and G418 was used to screen the positive clones. A stable transfected K562 cell line was established and defined as ‘K562TC’. The differences between K562 and K562TC cells in serum withdrawal resistance and Bcl-2 protein expression were evaluated by annexin V/PI test, flow cytometry and Western blotting, respectively. RESULTS: K562TC cells with elevated Bcl-2 protein expression level identified by FCM or Western blotting showed stronger resistance to apoptosis induced by serum withdrawal than their parental cells. Inhibition of mitochondrial ceramidase expression in K562TC cells by its specific antisense oligodeoxynucleotide was correlated with a decrease in Bcl-2 protein level. N, N'-dimethylsphingosine (DMS), a sphingosine kinase inhibitor, depleted intracellular sphingosine-1-phosphate (SPP) production, also abrogated Bcl-2 protein expression in K562TC cells, while exogenous sphingosine-1-phosphate up-regulated Bcl-2 protein level in K562 cells. CONCLUSION: Mitochondrial ceramidase overexpression in K562 cells leads to markedly elevated level of Bcl-2 protein and results in more resistance to serum withdrawal. This effect is initiated not by sphingosine, the direct metabolite of mitochondrial ceramidase, but via sphingosine-1-phosphate, its phosphorylated form, indicating that mitochondrial ceramidase, through its sphingoid metabolite sphingosine-1-phosphate, up-regulates Bcl-2 protein expression in K562 cells.
