Prognostic factors on graft-versus-host disease-free and relapse-free survival after allogeneic hematopoietic stem cell transplantation for adults with acute leukemia.

The cure of acute leukemia by allogeneic hematopoietic stem cell transplantation (allo-HSCT) is closely linked to major complications leading to adverse outcomes, including graft-versus-host disease (GVHD), disease relapse and death. This study retrospectively investigated a consecutive series of 312 adult patients with acute leukemia receiving allo-HSCT by using a novel concept of GVHD-free/relapse-free survival (GRFS), and further evaluated the impact of clinical factors on GRFS. Results indicated that the 1- and 2-year GRFS were 54.8% and 51.5%, respectively. In multivariable analysis, recipient age >35years (HR 1.676; p=0.006), diagnosis of acute lymphoblastic leukemia (HR 1.653; p=0.027) and acute biphenotypic leukemia (HR 2.175; p=0.010), advanced disease (HR 2.702; p<0.001), and donor age >35 years (HR 1.622; p=0.008) were significantly associated with inferior GRFS post-HSCT. GRFS of haploidentical-related donor transplant was comparable to that of matched sibling donor or matched unrelated donor transplant. Furthermore, prophylactic donor lymphocyte infusion (DLI) had an overall beneficial effect on GRFS (HR 0.645, p=0.044). Collectively, with a better understanding of these significant prognostic factors which impacted on GRFS, we can effectively evaluate the risk and probability of real recovery after allo-HSCT, further optimizing the therapeutic avenues for acute leukemia.

[Clinical significance of NF-kappaB continual activity and expression of WT1 and MDR1 in acute nonlymphocytic leukemia].

The study was aimed to explore the NF-kappaB continual activity and the expression of WT1 and MDR1 in acute non-lymphocytic leukemia (ANLL) patients, and to investigate if the three factors affect the curative effect of ANLL together as to provide some theoretical basis for finding new measures to improve the curative effect of refractory ANLL. The bone marrow samples of 45 ANLL patients was collected. 45 patients including 20 primary ANLL patients (A group) and 25 refractory ANLL patients. Refractory ANLL patients were divided into 2 sub-groups (B, C groups). The primary patients who was no effect after more than two courses of treatment were taken as group B, and the patients with more than two relapses were taken as group C. At the same time, 15 patients with simple iron deficiency anemia were collected as negative control. The NF-kappaB continual activity was measured by using electrophoretic mobility shift assay (EMSA) and the expressions of WT1, MDR1 were detected by reverse transcriptase polymerase chain reaction (RT-PCR). The results showed that the activity of NF-kappaB and the expressions of WT1, MDR1 were not detected in 15 samples of simply iron deficiency anemia subjects. The NF-kappaB continual activity, the expression levels of WT1 and MDR1 in the refractory group were significantly higher than that in primary group (P<0.001). But the NF-kappaB continual activity, the expression of WT1 gene and MDR1 gene were not significantly different between group B and group C (P>0.05). By assaying the relativity between the them the NF-kappaB continual activity and the expression of WT1 or MDR1 had positive correlation in ANLL patients. It is concluded that the NF-kappaB continual activity, the overexpression of WT1 and MDR1 may be one of the reasons causing poor curative effect in acute non-lymphocytic leukemia. The NF-kappaB continual activity and the expression of WT1, MDR1, all show positive correlation in ANLL patients.

[Renin angiotensin system in bone marrow of patients with aplastic anemia].

Renin-angiotensin system (RAS) has been shown to be involved in the growth, production, proliferation and differentiation of the bone marrow (BM) hematopoietic cells, while aplastic anemia (AA) is a disease in which proliferation ability of the BM hematopoietic cells is damaged with defective hematopoietic microenvironment. To investigated the pathogenesis of AA, the rennin activity, angiotensin I (Ang I) and angiotensin II (Ang II) concentration in peripheral blood and BM of 22 AA patients were detected by radioimmunoassay, 16 nonhematological disease patients with normal blood counts and BM picture were used as control, and the difference between two groups was compared. The results showed that BM Ang II concentration in the AA patients was significantly lower than that in the control (P < 0.01). In nonhematological disease patients, Ang II concentration in BM was significantly higher than that in peripheral blood, the renin activities and Ang I concentrations were not significantly different in the two groups (P > 0.05). In conclusion, the decreased BM Ang II concentration in AA patients may be involved to the pathogenesis of AA.

[Inhibitory effect of daunorubicin enhanced by PDTC on drug-resistant leukemic cells in vitro].

To investigate the chemosensitizing effect of pyrroledithiocarbomate (PDTC) on daunorubicin in drug-resistant leukemic cells in vitro, MTT method was used to observe the changes of the proliferation of intractable leukemia MNC treated with daunorubicin (30 microg/ml) combined with PDTC (25, 50 or 100 micromol/L). The results showed that inhibiting rate of daunorubicin combined with PDTC(25, 50 or 100 micromol/L) on drug-resistant leukemic cells was significantly higher than that of daunorubicin alone (P < 0.05). Among the three different doses of PDTC, the concentration of 50 micromol/L of PDTC inhibited the proliferation of drug-resistant leukemic cells significantly. In conclusion, PDTC can sensitize anti-tumor effect of daunorubicin in vitro. The concentration of 50 micromol/L of PDTC has stronger chemosensitizing effect on daunorubicin than that of the other concentrations of PDTC (25 micromol/L or 100 micromol/L) in vitro.