An Analysis of the Status of General Population with HCV Infection in Kunming Region from 2013 to 2015 / 昆明医科大学学报

Objective The aim of this study was to analyze the HCV seroprevalence in the general population visiting the Second Affiliated Hospital of Kunming Medical University. Methods Between January 2013 and December 2015, a total of 160, 239 subjects were screened for the presence of anti-HCV antibodies in blood serum. Anti-HCV antibodies in serum samples were detected by enzyme-linked immunosorbent assay (ELISA) . The results of anti-HCV were analyzed in the features of year, sex and age. Results The HCV seroprevalence in the general population from 2013 to 2015 was 1.11% , 1.04% and 0.91% , respectively, which was significantly higher in men than in women (1.30% vs. 0.91%,P＜0.05) . The highest HCV seroprevalence occurred in aged 31-65 years. Conclusions The analysis of the data suggests that the features of HCV-positive including year, sex and age could be beneficial for formulating scientific strategy and intervention measures of HCV infection and liver cirrhosis, liver failure and hepatocellular carcinoma caused by HCV in Kunming.

Changes of Alternative Splice Variant of the SRSF12 by Cisplatin in Multiple Cells / 昆明医科大学学报

Objective To detect the changes of mRNA isoforms in multiple cancer cell lines with dose of cisplatin. Methods Total RNA of the cells treated by cisplatin were abstracted 24 h after the treatment. mRNA isoforms of SRSF12 gene were detected by semiquantitative RT-PCR. The ratios of mRNA isoforms were analyzed by gel image software and statistical analysis. Results Under the cisplatin treatment, 2 mRNA isoforms of SRSF12 were detected in five cells except Caski cells,their ratios and relative mRNA levels were changed. With the increase of dose of cisplatin, the ratio of isoform-a was slightly increased; but the ratio of isoform-b was different, the changes were not obvious in the A549 and 293FT cells, the weaker expression was expressed in the H1299 and C33A cells, and the two isoforms were gradually weakening in the Siha cells. Conclution Under the cisplatin treatment in multiple cancer cells, the expression of SRSF12 shows tissue-specific and cell type-specific patterns .

Clinical significance of serum free light chain in patients with multiple myeloma / 中国实验血液学杂志

Multiple myeloma (MM) is a malignant disorder characterized by the proliferation of a single clone of plasma cells that can produce excessive amounts of serum free light chain (sFLC). sFLC plays an important role in MM diagnosis and disease monitoring. The quantitative immuno-nephelometric assay is sensitive and specific means for sFLC testing. The aim of this study was to investigate the levels of sFLC in multiple myeloma and the relationship between sFLC and serum total light chain (sTLC). sFLC in 45 newly diagnosed patients were detected by immuno-nephelometric assay, and then the ratio of free kappa to free lambda for every sample was calculated. Meanwhile, sTLC was also determined in these patients. The results showed that the difference of sFLC levels between MM patients and the normal controls was significant (tΚ = 8.86, P < 0.001; tλ = 15.48, P < 0.001;tΚ/λ = 5.54,P < 0.005). No correlation between sFLC and sTLC was found in MM patients. It is concluded that the level of sFLC in MM patients is significantly higher than that in normal controls. sFLC and its ratio may be served as a indicator for diagnosis of MM. sTLC can not replace the role of sFLC.

Detection and clinical features of MLL gene rearrangement in adult patients with acute leukemia / 中国实验血液学杂志

This study was purposed to investigate the incidence of mixed lineage leukemia (MLL) gene rearrangement and partner gene types as well as the clinical features and prognosis of acute leukemia (AL) with this rearrangement through detection in adult AL using combination of 3 techniques, and to evaluate the clinical value of this combination detection. The MLL gene rearrangement in 183 cases of adult AL was detected by combination of conventional cytogenetics, split signal FISH and multiplex nested PCR. The results showed that the incidence of MLL rearrangements in adult patients with AL was low (8.2%), and MLL-AF4 fusion gene was most common and predominant in acute lymphoblastic leukemia (ALL), while the MLL-AF6 and MLL-AF9 were most frequent in acute myeloid leukemia (AML). Extramedullary involvements were found in 40% of MLL-rearranged AL patients, and 33.3% of patients with MLL-rearranged AL reached to complete remission within 30 days during induction chemotherapy. In addition, in this cohort of MLL-rearranged adult AL patients, the 3-month relapse rate and 6-month overall survival rate were 50.0% and 50.0% respectively. It is concluded that the rate of missed diagnosis of CC technique for patients with MLL-rearranged AL reached to 60% in this study, while the combination of CC, FISH and multiplex nested PCR has been confirmed to have important significance for evaluating prognosis and conducting clinical therapy of patients with MLL-rearranged AL.

Clinical study on high-dose etoposide with granulocyte colony-stimulating factor for mobilization of autologous peripheral blood stem cells in patients with hematologic malignancies / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the effectivity and safety of single high-dose (HD) etoposide (Vp16) with granulocyte colony-stimulating factor (G-CSF) for mobilization of autologous peripheral blood stem cells (PBSC) in patients with hematologic malignancies.</p><p><b>METHODS</b>80 patients of hematologic malignancies including 20 patients with acute leukemia (AL), 23 with multiple myeloma (MM), 35 with non-Hodgkin's lymphoma (NHL) and 2 with Hodgkin's lymphoma (HL) received Vp16 (1.6 g/m(2)) continuous intravenous infusion for 10 hrs on day 1. G-CSF at 10 µg/kg once daily subcutaneous injection began to use on day of ANC lower than 1×10(9)/L and continued until PBSC collection was completed. Autologous PBSC (APBSC) was collected on day of WBC greater than 5×10(9)/L and continuing until the collection goal was met (target value: MNC ≥ 6.0×10(8)/kg and CD34(+) ≥ 2.0×10(6)/kg). The patients received APBSC after conditioning regimen. The number of the cells collection, time of hematopoietic reconstruction, adverse effect and so on were observed during the course of stem cell mobilization and collection.</p><p><b>RESULTS</b>PBSC was collected on day 11 (range: 7 - 25 days) of after Vp16 administration with a median collection time of 2 (range 1 - 5). 3/80 patients with AML got stem cell mobilization failure. 5 of 6 patients who failed to mobilize before got successful stem cell mobilization, 1/6 patient with AML-M(5) got a second failure after the mobilization of VP16 whose first time's mobilization using Ara-C did not succeed. The median number of CD34(+) cells collected in 77 patients who got successful mobilization was 4×10(6)/kg \[range (1.59 - 24.68)×10(6)/kg\]. The collection of 20 patients with AL and 23 with MM were got detection for minimal residual disease, no pollution of tumor cells were happened. All patients could tolerate the whole course of stem cell mobilization. 29/80 (36.25%) patients got a 4 grade leucopenia, 19/80 (23.75%) patients got infection.</p><p><b>CONCLUSION</b>Single high-dose etoposide with G-CSF for mobilization of APBSC has a higher achievement ratio, a controllable adverse effect, a promising hematopoiesis recovery, which is an effective and safe mobilizing regimen for patients with hematologic malignancies.</p>

Investigation of 1q21 amplification in patients with multiple myeloma using I-FISH and cIg-FISH / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the prevlance of 1q21 amplification in patients with multiple myeloma (MM) and its correlation with the progression and prognosis of the disease.</p><p><b>METHODS</b>1q21 amplification was detected in 48 patients with MM using cytoplasmic light chain immunofluorescence with fluorescence in situ hybridization analysis (cIg-FISH) and interphase fluorescence in situ hybridization (I-FISH) analysis combined with CD138 immunomagnetic cell sorting (MACS).</p><p><b>RESULTS</b>1q21 amplification (≥ 3 red signals) was detected in 26/48(54.2%) cases by cIg-FISH and 31/48 (64.6%) cases by I-FISH combined with CD138 MACS. There was a good consistency between the two methods (P>0.05). The mortality of patients with 1q21 amplification was significantly higher than those without (P< 0.05). No significant difference was detected in terms of sex, age, Durie-Salmon stage, subgroup and international staging system (ISS) stage between patients with 1q21 amplification and those without (P>0.05).</p><p><b>CONCLUSION</b>The frequency of 1q21 amplification in MM is high. There was also an association between the amplification and poor prognosis. cIg-FISH is consistent with CD138 MACS combined with I-FISH.</p>

A case of myelodysplastic syndrome with aberrant evolution of chromosome 1 and 11 in 6 years of follow-up / 中国实验血液学杂志

This study was aimed to investigate the relationship between cytogenetic evolution and disease progression in patient with MDS-RAEB. By a long term (6 years) follow-up of a patient with MDS-RAEB, peripheral blood cell count, bone marrow cell morphology and conventional cytogenetics were monitored regularly. In addition, fluorescence in situ hybridization (FISH) was applied to confirm the aberrant karyotype. The results indicated that this patient was failed with conventional chemotherapy of AML, but had response to ATRA and 6-MP in the 72 months follow-up. At initial diagnosis, the cytogenetics analysis showed normal karyotype, whereas 46, XY, 2q+[1]/46, XY[19] was found at 48 months, 46, XY, dup(1q)[3]/46, XY[7] at 56 months, and dup (1) as well as der (11) with complex karyotype at 68 months, which was accompanied by progressive decrease of platelet count. It is concluded that karyotype evolution is perhaps associated with progression of MDS.

Investigation of chromosome 1 aberrations in patients with multiple myeloma using cIg-FISH method and its significance / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the incidence of 1q21 amplification and 1p12 deletion, and analyze the correlation between these aberrations with disease progression, prognosis and outcome in patients with multiple myeloma (MM).</p><p><b>METHODS</b>Cytoplasm light chain immunofluorescence with simultaneous interphase fluorescence in situ hybridization (cIg-FISH) was used to detecte the 1q21 amplification and 1p12 deletion in 48 patients with MM.</p><p><b>RESULTS</b>1q21 amplification (≥ 3 red signals) was determined in 26 of 48(54.2%) cases. The mortality of patients with 1q21 amplification was significantly higher than that of those lacking 1q21 amplification (P < 0.05). The sex, age, D-S stage, subgroup and ISS stage between patients with and without 1q21 amplification had no significant difference (P > 0.05). There was a significant difference in D-S stage and mortality between patients with 3 and with 4 copies of 1q21 (P < 0.05). No significant difference in sex, age, subgroup, ISS stage, and isotype was found between them (P > 0.05). 1p12 deletion (< 2 green signals) was found in 14 of 48 (29.2%) cases. There was no significant difference in sex, age, D-S stage, ISS stage, isotype, subgroup, and mortality between patients with and without 1p12 deletion.</p><p><b>CONCLUSION</b>The frequency of chromosome 1 aberrations in multiple myeloma is high and 1q21 amplification is a poor prognosis factor.</p>

Progressive transformation of lymph node germinal centers: a case report and literature review / 中华血液学杂志

<p><b>OBJECTIVE</b>To improve the understanding of progressive transformation of lymph node germinal centers (PTGC) and to explore its clinical, histopathologic and immunohistochemical features and the differential diagnosis between the related disease of germinal center hyperplasia.</p><p><b>METHODS</b>The clinical manifestation, laboratory bindings, treatment and outcome of a patient with PTGC were presented.</p><p><b>RESULTS</b>The main manifestation of the patient was painless peripheral lymphadenopathy. Histopathologic examination of an axillary lymph node showed reactive follicular hyperplasia and the progressive transformation changes germinal centers. The borderline between the germinal center and the mantle layer was obscured. The cells in the progressive transforming germinal centers were positive for CD20(+), CD5(+), CDw75(+).</p><p><b>CONCLUSION</b>PTGC is a rare lymphoid disorder. Histopathology and immunohistochemistry are important basis of the diagnosis.</p>

Therapeutic efficacy of bortezomib-based chemotherapy on 40 patients with multiple myeloma / 中国实验血液学杂志

This study was aimed to investigate the therapeutic efficacy and adverse events of bortezomib-based chemotherapy for 40 patients with multiple myeloma. 16 newly diagnosed patients and 11 patients with refractory/relapse myeloma were treated with bortezomib, dexamethasone and thalidomide; 7 newly diagnosed patients and 4 patients with refractory/relapse myeloma were treated with bortezomib and dexamethasone; 2 newly diagnosed patients were treated with bortezomib, melphalan and thalidomide. Cycles were repeated every 28 or 35 days, all the patients were treated for 2 to 8 cycles. The therapeutic efficacy and adverse events were evaluated according to International Myeloma Working Group Uniform Response Criteria. The results indicated that the median follow-up duration was 13 months, the total response rate was 72.5%, among which 16 patients achieved complete response (CR), 13 achieved partial response (PR). The main side effects included gastrointestinal symptoms, peripheral neuropathy, thrombocytopenia, respiratory infection, herpes zoster and urinary retention and so on. The adverse events were ameliorated by treatment and decrease of the bortezomib dose. It is concluded that bortezomib-based chemotherapy is effective in the treatment of either newly diagnosed or refractory/relapse MM patients and the adverse events are tolerable and manageable for patients.

Clinical analysis of 10 cases of secondary hemophagocytic lymphohistiocytosis treated with HLH-2004 chemotherapy / 中国实验血液学杂志

This study was aimed to investigate the therapeutic efficacy of HLH-2004 chemotherapy in patients with secondary hemophagocytic lymphohistiocytosis (sHLH). 10 cases of sHLH treated with HLH-2004 regimen at our department were analyzed retrospectively. The results showed that 7 patients had clinical response to HLH-2004 regimen, while other 3 patients had no clinical response. 5 cases did not complete initial therapy of 8 weeks. Out of 5 cases, 4 died in the process of chemotherapy, 1 patient abandoned for serious side effects but finally acquired remission following 4 cycles of CHOP regimen. 5 cases underwent the whole courses of initial therapy. Out of 5 cases, 3 patients acquired remission, and other 2 were not well controlled. Out of the 3 patients who had achieved remission, one died of relapse, and other 2 patients kept remission. Out of the 2 patients who were not well controlled, one patient died, but another patient acquired remission after being discharged. It is concluded that patients with infection-associated hemophagocytic syndrome (IAHS) have high rates of remission after receiving HLH-2004 regimen combining with effective antibiotics. However, patients with HLH secondary to EBV (EBV-HLH) or lymphoma (LAHS) have low rates of remission or are easy to get relapse after remission.

Efficacy of IA regimen followed by FLAG regimen in the treatment of acute myeloid leukaemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and toxicity of standard-dose IA regimen (idarubicin and cytarabine) as induction therapy followed by FLAG regimen in patients with acute myeloid leukemia (AML), and its influence on peripheral stem cell mobilization.</p><p><b>METHODS</b>A total of 23 previously untreated de novo AML patients were enrolled. Thirteen patients were male, and 10 female, with ages ranging from 14 to 54 (median: 41) years. Cytogenetic analysis was performed for all patients. The IA regimen contained idarubicin (12 mg x m(-2) x d(-1), days 1 to 3) and cytarabine (100 mg x m(-2) x d(-1), days 1 to 7), and the FLAG regimen contained'fludarabine (50 mg/d, days 1 to 5), cytarabine (2 g x m(-2) x d(-1), days 1 to 5) and granulocyte colony-stimulating factor (G-CSF, 300 microg/d, days 0 to 5).</p><p><b>RESULTS</b>After one course of induction therapy, the CR rate was 91.3%. The CR rate for patients with favourable and intermediate prognostic karyotypes was 100% and 91.3%, respectively. Nineteen patients in CR were consolidated with FLAG regimen, of which 6/9 (66.7%) patients were able to mobilize a sufficient number of CD34+ cells and successfully performed autologous stem cell transplantation. Four patients relapsed. The median survival duration was 19.5 months and median disease-free survival was 14 months. Myelosuppression and infections due to neutropenia were the most frequent adverse effects, severe nonhematologic toxicity and the early death were not observed in all patients.</p><p><b>CONCLUSION</b>IA followed by FLAG regimen is effective and well tolerable in AML patients especially in those with favourable and intermediate prognostic karyotypes, and 1 to 2 courses of this therapy shows no influence on peripheral stem cell mobilization and subsequent autologous stem cell transplantation.</p>

Effect of FLAG consolidation therapy on mobilization of autologous peripheral blood stem cells in patients with acute myelogenous leukemia / 中国实验血液学杂志

This study was aimed to investigate the effect of FLAG consolidatory therapy on peripheral blood stem cell (PBSC) mobilization in patients with acute myelogenous leukemia (AML) for autologous PBSC transplantation. A total of 15 AML patients were enrolled in this study. 10 patients were male, and 5 were female, with ages ranging from 14 to 51 (median 36) years. Out of 15 patients 13 were newly diagnosed, and 2 were refractory/relapsed AML. All patients were consolidated with FLAG regimen which including fludarabine 50 mg/d, days 1-5; Ara-C 2 g/(m2.d), days 1-5; G-CSF 300 microg/d, injection subcutaneously starting 24 hours before Ara-C and continuing until neutrophil count exceeding 1.0x10(9)/L. The harvest of the stem cells was performed after hematologic recovery from the second or third course of FLAG consolidation, or mobilized by high dose etoposide (1.6 g/m2). The results showed that among 15 patients scheduled for PBSC harvest, 11 (73.3%) harvested a median of 3.52x10(6)/kg CD34+ cells (range 2.2-4.6) and underwent autologous transplantation, while the minimal number of CD34+ cells could not be reached in the remaining 4 patients. It is concluded that the FLAG regimen is effective and well-tolerated treatment as consolidation regimen in AML, which does not influence PBSC mobilization and autologous transplantation after 2 courses of FLAG.

Cytogenetic analysis of 362 cases of chronic myeloid leukemia / 中国实验血液学杂志

In order to evaluate the cytogenetic features and clinical significance of chronic myeloid leukemia (CML), chromosome preparation of bone marrow cells was made by using 24-hour culture, and R-banding technique was employed for karyotyping in 362 patients with CML. The patients were divided into two groups of chronic phase (CP) and blast crisis (BC). The results showed that the incidence of additional chromosome, variant translocation and Philadelphia (Ph) negative, bcr/abl positive CML with abnormal chromosomes in CP group were 70 cases (26.1%), 19 cases (7.1%), 4 cases (1.5%), and were 50 cases (53.2%), 8 cases (8.5%), 4 cases (4.3%) in BC group. Among the 362 cases, 324 cases (89.5%) were Ph positive. Classic translocation was found in 297 cases (91.7%) and variant translocation in 27 cases (8.3%), including 13 cases of simple variant, 13 cases of complex variant and 1 case of marked Ph. Special karyotypes were found in 120 out of 362 cases. Analysis of these karyotypes demonstrated that the most common numerical abnormalities were +Ph (21.7%), +8 (10.0%), +21 (10.0%), +19 (7.5%) and structure abnormalities were i(17q) (13.3%). In conclusion, compared to chronic phase, the incidence of additional chromosome, variant translocation and so on are much higher at in blast crisis. It is feasible to evaluate the progress of the disease by karyotype analysis.

Immunophenotypic features in 143 cases of acute promyelocytic leukemia / 中国实验血液学杂志

This study was aimed to investigate the immunophenotypic characteristics of acute promyelocytic leukemia (APL). CD45/Side Scatter (SSC) gating strategy and multiparametric flow cytometry were used to determine immunophenotype of 143 patients with APL. The immunophenotypic features were compared between newly diagnosed APL patients and relapsed APL patients. 42 patients with HLA-DR(-) (non-APL AML, DR(-)AML) were randomly selected as controls. 31 out of 42 AML patients were CD34 negative, and their immunophenotypes were compared with those in newly diagnosed APL patients. The results showed that (1) CD34 and HLA-DR were both negative in 91.9% of newly diagnosed APL, while the positive rate of CD34 and HLA-DR elevated in relapsed cases (3.0% vs 37.5%, 3.9% vs 37.5%). The positive rate of CD34 in HLA-DR(-) AML group was higher than that in newly diagnosed APL group (23.4% vs 3.0%). The positive level of CD34 in newly diagnosed APL group was lower than that in HLA-DR(-) AML group; (2) the positive rate of CD33 in newly diagnosed APL group was higher than that in other groups (97.0% vs 75.0%, 83.3%, 83.9%), as well as the the positive level of CD33 (p < 0.05). (3) no lymphoid antigen other than CD2 was expressed in newly diagnosed APL group. The positive rate of CD7 was 9.5% in DR(-) AML group and 6.5% in CD34(-)/DR(-) AML group, both were higher than those of newly diagnosed APL group (p < 0.05). It is concluded that the immunophenotyping can provide proof to the rapid diagnosis of APL. For those patients with DR(-) AML, it may be helpful to identify APL depending on following features: low or negative CD34 expression, homogeneous and bright expression of CD33, no lymphoid antigens other than CD2, higher SSC.

Standard-dose of idarubicin in combination with continuous infusion of cytarabine as induction therapy in patients with acute myeloid leukaemia / 中国实验血液学杂志

The objective of this study was to investigate the efficacy and toxicity of standard-dose idarubicin in combination with continuous infusion of cytarabine as induction therapy in patients with acute myeloid leukemia (AML). A total of 38 AML patients were enrolled, including 30 new diagnosed patients, 8 relapsed and refractory patients. Cytogenetic analysis was performed in all patients, 15 patients had cytogenetic aberrations including 4 complex abnormalities. All patients were treated with standard-dose idarubicin [12 mg/(m(2).d), days 1 to 3] and continuous infusion of cytarabine [100 mg/(m(2).d), days 1 to 7]. The results showed that after one course of induction therapy, the overall response rate was 89.5% (34/38), and 32 out of 38 (84.2%) patients achieved complete remission (CR), including 27 of 30 (90.0%) new diagnosed AML patients, 5 (62.5%) refractory and relapsed AML patients, all 4 patients with complex cytogenetic aberrations achieved cytogenetic CR. Out of 6 relapsed patients 2 showed as extramedullary relapse, 4 showed as bone marrow relapse. The median survival duration was > 22 months and median disease-free survival time was > 16 months. Myelosuppression and infections due to neutropenia were the most frequent adverse effects, severe nonhematologic toxicity and the early death were not observed in the patients. It is concluded that standard-dose of idarubicin combined with continuous infusions of cytarabine as the induction therapy is highly effective and well tolerated approach in patients with AML, this regimen provides an opportune moment for hematopoietic stem cell transplantation.

FLAG regimen as consolidation therapy for patients with acute myeloid leukemia / 中国实验血液学杂志

The objective of study was to primarily explore the efficacy of combination of high doses cytarabine, fludarabine and G-CSF (FLAG) as the consolidation therapy for patients with acute myeloid leukemia (AML), and to analyze the influence of FLAG on peripheral stem cell mobilization. 31 patients with AML in complete remission were divided into two groups based on induction regimens, e.g. IA group (idarubicin and cytarabine) and non-IA group. All patients were consolidated with FLAG regimen which including fludarabine 50 mg/d, days 1-5; Ara-C 2 g/(m(2).d), days 1-5; G-CSF 300 microg/d. Time of its use sustained from day 0 until absolute neutrophil count > 1.0 x 10(9)/L. 17 patients received 2 or 3 courses of FLAG regimen, and 14 patients took 1 course. 9 patients received 2 courses of FLAG regimen as consolidation therapy, and then peripheral stem cells were collected from them. The results showed that sufficient peripheral stem cells were obtained in 7 out of 9 patients (77.8%) after 2 courses of FLAG regimen, however one patient failed to obtain sufficient CD34(+) cells after 3 courses. 6 patients received autologous stem cell transplantation, 3 patients received allogeneic stem cell transplantation, and 7 cases received 2 courses of Ara-c after treating with mitoxantrone or daunorubicin. One patient died within 4 weeks. 9 patients relapsed. The median survival duration was 14 (1 - 46) months and median disease-free survival time was 12 (2 - 45) months. There was no significant difference for OS and DFS between IA and non-IA groups. Myelosuppression and infections due to neutropenia were the most frequent adverse effects, severe nonhematologic toxicities were not observed in all patients. It is concluded that as consolidation regimen, the FLAG is an effective and well-tolerated treatment in AML with acceptable toxicity, and may not influence the peripheral stem cell mobilization for autologous stem cell transplantation after 2 courses of FLAG.

IDA-FLAG regimen in treatment of patients with refractory or relapsed acute leukemia / 中国实验血液学杂志

The objective of this study was to evaluate the efficacy and toxicity of the fludarabine combination with high-dose cytarabine (Ara C), idarubicin and granulocyte colony-stimulating factor (G-CSF) (IDA-FLAG regimen) in treatment of refractory/relapsed acute leukemia (AL) patients. 4 patients were male aged from 32 to 44 years, consisted of 3 cases of acute myeloid leukaemia (AML) and 1 cases of acute lymphocytic leukaemia (ALL). All the patients were treated with idarubicin (10 - 12 mg/m(2)/d, days 1 to 3), fludarabine (50 mg/d, days 1 to 5), cytarabine (2 g/m(2)/d, days 1 to 5) and granulocyte colony-stimulating factor (G-CSF, 300 microg/d, days 0 to 5). The results showed that after one course of induction therapy, 4 patients all achieved complete remission (CR), in which 2 patients were in continuous CR after a follow-up of 3 and 4 months; 1 patient relapsed after 10 months and another one patient died of thrombotic thrombocytopenic purpura at 4 months after allogeneic peripheral blood stem cell transplantation. Myelosuppression and infections due to neutropenia were the most frequent adverse effects, severe nonhematologic toxicity and the early death were not observed in these patients. In conclusion, the IDA-FLAG regimen is effective in treatment of patients with refractory and relapsed AL, the adverse effects from this regimen were well tolerated by patients, which gains time for further treatment.

Secondary acute myeloid leukemia complicated after treatment of non-Hodgkin's lymphoma / 中国实验血液学杂志

The aim of this study was to investigate the mechanism, susceptibility, (18)F-FDG positron emission computerized tomography ((18)F-FDG PET/CT) features and the treatment of therapy-related acute myeloid leukemia. One patient with NHL was affected with t-MDS after treatment and then progressed to t-AML. The clinical data including bone marrow cell morphology, flow cytometry, karyotype and PET/CT features were analyzed. The results showed that the primary treatment for NHL refers to varieties of cytotoxic drug such as cyclophosphamide-hydroxydaunomycin-oncovin-prednisone (CHOP) chemotherapy. The interval time from the chemotherapy of NHL to the occurrence of t-MDS was 105 months and t-MDS progressed to AML-M(2) in 2 months. Karyotype analysis results of t-MDS and t-AML were normal. (18)F-FDG PET indicated that the FDG uptake in the bone raised diffusely. The patient showed complete response after second-line therapy (CAG regiments). In conclusion, the occurrence of t-AML/MDS may be associated with the application of the cytotoxic chemotherapeutics. (18)F-FDG PET may be an indicator predicting the transformation of t-MDS to t-AML.

Low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor priming in 50 patients with relapsed acute myeloid leukemia / 中国实验血液学杂志

To evaluate the efficacy and toxicity of low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor (G-CSF) protocol for patients with relapsed acute myeloid leukemia (AML). A total of fifty relapsed patients have been enrolled, including 13 early relapsed and 37 late relapsed. 24 patients were male and 26 were female, with age ranging from 15 to 69 (median 47) years. Out of them, 7 patients relapsed after allogeneic peripheral blood stem cell transplantation (allo-PBSCT), 3 patients relapsed after autologous peripheral blood stem cell transplantation (auto-PBSCT), 25 patients relapsed after received regimens including high dose cytarabine and 15 patients relapsed after CR or stopping chemical therapy themself in course of consolidatory therapy. 30 relapsed patients received CAG regimen, and 20 patients (control group) received an anthracycline in combination with cytarabine. The results indicated that after one course, the complete remission (CR) rate was 46.7% (14/30), the CR rate after allo-PBSCT was 50% (3/6), the early death rate was 3.3% in CAG group; and CR rate was 30% (6/20) and the early death rate was 15% in control group. Myelosuppression was mild to moderate, and no severe nonhematologic toxicity was observed in two groups. The overall median times in CAG group and control group were 22 and 19 months respectively. In conclusion, CAG regimen as the induction therapy is effective and well tolerable with low side effects for relapsed patients who had received high dose cytarabine, auto-PBSCT or allo-PBSCT.