RESUMO
Although acute promyelocytic leukaemia (APL) is a highly curable disease, challenges of early death (ED) and relapse still exist, and real-world data are scarce in the ATRA plus ATO era. A total of 1105 APL patients from 1990 to 2020 were enrolled and categorized into three treatment periods, namely ATRA, ATRA plus ATO, and risk-adapted therapy. The early death (ED) rate was 20.2%, 10.1%, and 7.0%, respectively, in three periods, while there was no significant decline in the 7-day death rate. Consistently, the overall survival (OS) and disease-free survival (DFS) of APL patients markedly improved over time. Despite the last two periods exhibiting similar DFS, the chemotherapy load was substantially lower in Period 3. Notably, leveraging older age and higher WBC count (especially > 50 × 109/L), we could identify a small group of extremely high-risk patients who had a very high ED rate and poor prognosis, while those with NRAS mutations and higher WBC tended to relapse, both representing obstacles to curing all patients. In conclusion, the evolvement of treatment paradigms can reduce the ED rate, improve clinical outcomes, and spare patients the toxicity of chemotherapy. Special care and innovative agents are warranted for the particularly high-risk APL.
RESUMO
The joint segregation analysis of a mixed genetic model of major gene plus poly-gene was conducted to study the inheritance of oil content in Brassica napus L.. Five populations, i.e the populations of 2 parents (P1 and P2), F1, F2 and F2:3 (derived from F2) family, from each of the two crosses (1141B x Ken C-1, 32B x Ken C1-2) were investigated.The frequency distributions of oil content in F2 and F2:3 family populations show characteristics of a mixed normal distribution, which indicated that the inheritance of oil content followed a major gene plus poly-gene model. Twenty-one genetic models were established, which could be classified into five types: one and two major genes, polygenes, one and two major genes plus polygenes. The most suitable genetic model could be selected using Akaike's Information Criterion and the fitness of the selected one could be examined by a set of tests. Results show that genetic model D-2 is the most fitting genetic model for the trait. In other words, oil content in oilseed rape is controlled by one additive major gene plus additive and dominance polygenes. For cross 1 (1141B x Ken C1-1) the heritabilities of major gene and poly-genes in F2 are 68.21% and 27.17%, respectively, and in F2:3 are 81.70% and 16.80%, respectively. The additive effect of major gene is -1.74, which indicates that the locus of the allele in parent 1141B may decrease the oil content, but that in parent Ken C1-1 may increase it. The additive and dominance effects of the polygenes are 1.20 and -1.93, respectively. For cross 2 (32B x Ken C1-2) the heritabilities of major gene and polygenes in F2 are 66.20% and 28.10%, respectively, and in F2:3 were 81.00% and 14.90%, respectively. The additive effect of major gene was -3.74, which also indicates that the locus of the allele in parent 32B may decrease the oil content, but that in parent Ken C1-2 may increase it. The additive and dominance effects are -1.99 and 0.93, respectively. The heritability of the major gene in F2:3 is higher than that in F2 in both crosses, so it would be more efficent to conduct selection in F2:3 families for high oil content in breeding.
