[A multivariate model for predicting induction response and prognosis in core binding factor acute myeloid leukemia].

Objective: To evaluate the efficacy and prognostic factors in core binding factor (CBF) acute myeloid leukemia (AML) under current therapy modalities, therefore optimizing the treatment strategies. Methods: Standard cytological and immune methods including next generation sequencing (NGS) were used for risk stratification. Complete remission (CR) rate, disease-free survival (DFS) and overall survival (OS) were assessed by multivariate Logistic and Cox regression models in a total of 206 adults (aged 16-65 years) with CBF-AML, including 152 AML patients with t(8;21) and 54 with inv(16). Results: The CR rate of inv(16) patients after first course was 54/54(100%), significantly higher than that of t(8;21) patients [127/147(86.4%), P=0.005]. The fusion transcript level and KIT mutation were independent factors related to CR rate in t(8;21) patients (P=0.044 and 0.027; respectively). DFS and OS in inv(16) patients tended to be more superior than that in t(8;21) patients (P=0.066 for DFS; P=0.306 for OS; respectively). Multivariate Cox identified negative expression of CD(19) and female gender the independent predictors of inferior DFS in t(8;21) patients (P=0.000 for CD(19); P=0.006 for sex; respectively). Analysis of combining CD(19) with gender indicated that females/CD(1)(9-)subpopulation had significantly poor DFS than did males/CD(19)(+) ones (Bonferroni-P<0.000 01). The number of mutations in each patient, FLT3-ITD and additional karyotype abnormalities did not affect CR rate and DFS (all P>0.05). Conclusions: Patients with inv(16) have better induction response than those with t(8;21). High level of fusion transcripts and positive KIT mutation are associated with low CR rate in t(8;21) patients. Negative CD(19) expression and female gender are independent predictors of inferior DFS in t(8;21) patients.

Successful Treatment of Cytogenetically Normal Acute Myeloid Leukemia With Ten-Eleven Translocation 2-Isocitrate Dehydrogenase 2 and Additional Sex Comb-like 1-Nucleophosmin Co-mutations by HLA Haploidentical Stem Cell Transplantation: A Case Report and Literature Review.

The presence of recurrent gene mutations is increasingly important in acute myeloid leukemia (AML) and sheds new insights into the understanding of leukemogenesis, prognostic evaluation, and clinical therapeutic efficacy. Until now, ten-eleven translocation 2 (TET2) and isocitrate dehydrogenase 2 (IDH2) mutations were reported to be mutually exclusive in AML patients. Similarly, nucleophosmin (NPM1) and additional sex comb-like 1 (ASXL1) mutations were rarely coexisted in AML. A 47-year-old man diagnosed with high-risk AML presented simultaneous mutations of TET2-IDH2 and NPM1-ASXL1 revealed by next-generation sequencing. After successful treatment with chemotherapy followed by HLA haploidentical transplantation, he achieved a clinical complete remission without evidence of overt graft-versus-host disease. This case highlights that HLA haploidentical transplantation might be a safe and feasible therapy for AML patients who are characterized by TET2-IDH2 and NPM1-ASXL1 co-mutations.

Tuberculosis transmission and risk factors in a Chinese antimony mining community.

SETTING: An antimony mine in Jiangxi Province, China. OBJECTIVE: To investigate the incidence of tuberculosis (TB) transmission and associated risk factors in a Chinese antimony mining community. DESIGN: Retrospective cohort study METHODS: The 15-locus mycobacterial interspersed repetitive unit-variable number of tandem repeats (MIRU-VNTR(15-China)) method was used to determine clustering of patients. A region of difference (RD105) deletion-targeted multiplex polymerase chain reaction was adopted to identify Beijing strains. Risk factors for clustering were assessed. RESULTS: Of 263 TB patients, 175 were distributed into 35 clusters. Estimated recent transmission of TB was 53.2% within the community. Patients who failed treatment were more likely to be in clusters (adjusted odds ratio [aOR] 0.03, 95%CI 2.12-6.89). Patients with multiresistant isolates were more likely to have failed treatment and to be in a cluster than those carrying a susceptible strain (aOR 0.001, 95%CI 4.89-29.7). CONCLUSIONS: Individuals who fail treatment are an important source of infection in TB transmission, and multiresistant isolates are mostly responsible for this. TB control plans need to focus on treatment failure cases in the community.

[The development and application of oxypathor of standard atmosphere].

This paper introduces a newly-developed oxypathor under one absolute atmosphere. It provides both oxygen and mixed-oxygen therapies, featuring oxygen-supply and oxygen-inhalation of hyperbaric oxygen chamber, and broaden the clinical applications of oxygen-therapy, which gave shown satisfactory results.