1.Chidamide combined with linperlisib in treatment of recurrent angioimmunoblastic T-cell lymphoma: report of 1 case and review of literature
Yuanbin SONG ; Jingxia XU ; Yun WANG ; Yang LIANG ; Bingyi WU
Journal of Leukemia & Lymphoma 2024;33(10):622-625
Objective:To investigate the clinical effects of chidamide combined with linperlisib in treatment of recurrent angioimmunoblastic T-cell lymphoma (AITL) after autologous stem cell transplantation (ASCT).Methods:The clinical data of 1 patient with recurrent AITL receiving treatment of chidamide combined with linperlisib after ASCT in Sun Yat-Sen University Cancer Center in March, 2021 were retrospectively analyzed, and the related literatures were reviewed.Results:The 55- year-old male patient was presented with fatigue, night sweats and emaciation. According to the results of pathology, immunohistochemistry and imaging after admission, this patient was diagnosed as AITL. After treatment with venbutuximab + CDP (cyclophosphamide + doxorubicin + prednisone) regimen, the patient achieved complete remission, and then ASCT was performed. After the transplatation, programmed death receptor 1 inhibitor was maintained for 4 courses of treatment. It recurred 16 months after ASCT, and the patient achieved partial remission after 1 course of chidamide combined with linperlisib, and achieved complete remission after 2 courses of treatment. Later, recheck of hepatitis B virus showed a quantitative increase after the self withdrawal of anti hepatitis B drugs, and then the primary treatment was suspended. The last follow-up time was March, 2024, and recheck results of whole body enhanced magnetic resonance imaging indicated recurrence.Conclusions:The combination of chidamide and linperlisib is effective and safe in treatment of recurrent ATIL after ASCT.
2.Basic research and clinical application progress of CAR-NK cells
Lanyan WANG ; Xiangning LUO ; Yajie WANG
Journal of Leukemia & Lymphoma 2024;33(10):632-636
Natural killer (NK) cells are a part of the innate immune system, providing the first line of defense against pathogens and cancer cells. NK cells have multiple ways to kill tumor cells and have a stronger anti-tumor effect than T cells. NK cells-based adoptive cell immunotherapy has gradually shown its great advantages in the treatment of hematologic malignancies. This paper reviews the physiology of NK cells, the mechanism of chimeric antigen receptor (CAR)-NK cells, and the current clinical application of CAR-NK cells.
3.Progress of immune-targeted therapy drugs for advanced mycosis fungoides/Sézary syndrome
Journal of Leukemia & Lymphoma 2024;33(10):636-640
Primary cutaneous T-cell lymphoma (CTCL) is the most common malignant proliferative disease of mature memory T cells, and the most common subtype is mycosis fungoides/Sézary syndrome. The local treatment in the skin is mainly given in patients with early CTCL and good prognosis can be achieved generally, while for patients in advanced stage, there is no standard recommended treatment regimen due to the poor efficacy of traditional therapy. In recent years, with the development of immune-targeted drugs for T-cell lymphoma, a variety of new drugs have shown good efficacy in the clinical treatment of CTCL, including histone deacetylase inhibitors, monoclonal antibodies, chimeric antigen receptors T-cell therapy. This paper reviews the research progress of immune-targeted therapy drugs for advanced mycosis fungoides/Sézary syndrome.
4.Expert recommendations on venetoclax-based regimens for treatment of newly diagnosed unfit acute myeloid leukemia (2024 version)
Journal of Leukemia & Lymphoma 2024;33(11):641-648
Venetoclax is a novel bcl-2 targeted drug for the treatment of acute myeloid leukemia (AML). Clinical guidelines at home and abroad recommend the regimen of venetoclax combined with azacitidine as the standard of care for the newly diagnosed AML patients which are unfit for intensive chemotherapy. The drugs in this regimen are currently included in the China's national reimbursement drug list. A working group consisting of 25 Chinese leukemia experts reached a consensus using the Delphi method and developed guidance covering 9 clinical issues and 25 expert recommendations. These recommendations included the key clinical issues and provided practical guidance for Chinese doctors to standardize the usage of venetoclax-based regimens for treatment of newly diagnosed unfit AML.
5.Clinical pathway for diagnosis and treatment of multiple myeloma in Henan (2024 version)
Journal of Leukemia & Lymphoma 2024;33(11):649-656
The multiple myeloma (MM) accounts for about 10% of hematologic malignancies, making it the second most common hematologic malignancy, primarily affecting middle-aged and elderly individuals. With continuous advancements in understanding the etiology and pathogenesis of MM, the advent of new drugs and improvements in detection methods, MM has evolved from a tumor with a low treatment response rate to a disease capable of achieving deep remission. However, it remains incurable. Standardized diagnosis and treatment are crucial for prolonging survival and improving the quality of life for MM patients. To enhance the standardized diagnosis and treatment of MM in Henan, and by referring to both domestic and international MM diagnosis and treatment guidelines while considering the specific circumstances of Henan, the expert group members discussed and formulated a clinical pathway for MM diagnosis and treatment. This pathway aims to further improve the level of MM diagnosis and treatment in Henan.
6.Effects of silencing of muscle blind-like protein 1 gene on cell proliferation, apoptosis and migration abilities of leukemia cell line K562
Jun WANG ; Shenhua TANG ; Cuicui WANG ; Cong ZHU ; Xiuhong JIA
Journal of Leukemia & Lymphoma 2024;33(11):657-663
Objective:To investigate the effects of targeted silencing of muscle blind-like protein 1 (MBNL1) gene on the proliferation, apoptosis and migration abilities of leukemia cell line K562 and their possible mechanisms.Methods:Single gene analysis was used to search for differences in MBNL1 gene expression between leukemia samples (173 cases) and healthy control samples (70 cases) in The Cancer Genome Atlas (TCGA) database. The data were updated in 2018. The logarithmic growth phase leukemia cell line K562 was taken and divided into sh-MBNL1 group (transfected with shRNA sequence with targeted silencing of MBNL1 gene), sh-NC group (transfected with corresponding negative control shRNA sequence) and blank control group (not transfected with shRNA sequence). Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression levels of MBNL1, transforming growth factor β 1 (TGF-β 1) and Smad7 mRNA in each group of cells; Western blotting was used to detect the relative expression levels of cell migration-related proteins, apoptosis-related proteins, TGF-β 1, and Smad7 proteins; CCK-8 method was used to detect cell proliferation ability; Transwell method was used to detect cell migration ability. Results:In TCGA database, the relative expression level of MBNL1 gene in leukemia samples was higher than that in healthy control samples ( P < 0.05). The relative expression levels of MBNL1 protein in the sh-MBNL1 group, sh-NC group and blank control group were 0.71±0.11, 1.00±0.11 and 1.03±0.10, respectively, and the difference was statistically significant ( F = 7.78, P < 0.05); the relative expression level of MBNL1 protein in the sh-MBNL1 group was lower than that in the sh-NC group and blank control group (both P < 0.05). The results of CCK-8 assay showed that the cell proliferation ability of sh-MBNL1 group at 72 and 96 hours after transfection was higher than that of sh-NC group and blank control group (both P < 0.05). The Transwell method detection results showed that the number of cell membrane penetration in the sh-MBNL1 group, sh-NC group and blank control group were 666±135, 1 072±157 and 1 006±51, respectively, and the difference was statistically significant ( F = 9.40, P = 0.014); the number of cell membrane penetration in the sh-MBNL1 group was less than that in the sh-NC group and blank control group (both P < 0.05). The relative expression level of E-cadherin protein in the sh-MBNL1 group was higher than that in the sh-NC group and blank control group (both P < 0.01); the relative expression levels of Vimentin, Bax, caspase-3, TGF-β 1, and Smad7 proteins in the sh-MBNL1 group were lower than those in the sh-NC group and blank control group (all P < 0.01). The qRT-PCR detection results showed that the relative expression levels of TGF-β 1 mRNA and Smad7 mRNA in the sh-MBNL1 group were lower than those in the sh-NC group and blank control group (both P < 0.05). Conclusions:Silencing of MBNL1 gene can promote the proliferation of leukemia cell line K562, weaken its migration ability, and affect cell apoptosis. The mechanism may be related to the regulatory effect of TGF-β-Smad signaling pathway.
7.Clinicopathological features of pulmonary mucosa-associated lymphoid tissue lymphoma: analysis of 41 cases
Hui YANG ; Haijian HUANG ; Baicheng LI ; Meiling ZHENG ; Zaifeng LI ; Zhi YANG ; Xin CHEN ; Zhaohui LU
Journal of Leukemia & Lymphoma 2024;33(11):664-670
Objective:To investigate the clinicopathological features of pulmonary mucosa-associated lymphoid tissue lymphoma (MALToma).Methods:A retrospective case series study was conducted. A total of 41 cases of pulmonary MALToma who were admitted to multiple centers from April 2002 to August 2023 were collected, including 33 cases from Fujian Provincial Hospital, 5 cases from Binzhou People's Hospital, 1 case from the Second Hospital of Zhangzhou, 1 case from the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, and 1 case from Jinjiang Hospital. The results of pathological morphological examination, immunohistochemical examination and genetic testing of patients were summarized, their clinicopathological characteristics were analyzed, and the relevant literature was reviewed.Results:Among the 41 patients, there were 24 males and 17 females, aged (58±13) years (range: 36-81 years). The longest diameter of the tumor under the gross macroscopic examination was (2.8±2.0) cm, with a range of 0.8-9.7 cm. Under the microscope, diffuse, flakelike and nodular patterns of lymphoid tissue were seen in the lung tissue with small- to medium-sized lymphoid cells including small lymphocytes, centrocyte-like cells, mononuclear cells and plasma cells. A small number of activated cells were noted, and the lymphoid cells grew along the alveoli. In some areas, the lymphoid cells invaded the bronchi, and lymphatic follicular implantation was rare; 1 case was accompanied by large cell transformation. Tumor cells expressed CD20, Pax-5, bcl-2, and CD43, with Ki-67 proliferation index of 2%-20%, and 50% in some areas of 1 case. The positive rate of clonal B-cell receptor gene rearrangement was 100.00% (29/29); the positive rate of MALT1 gene was 18.75% (3/16), and the positive rate of API2-MALT1 fusion was 66.67% (2/3). The treatment methods included surgery, anti-inflammatory therapy, radiotherapy, and chemotherapy. Follow-up for 4-143 months showed that 43.90% (18/41) had disease-free survival, 21.95% (9/41) had tumor bearing survival, 9.76% (4/41) died, and 24.39%, (10/41) were lost to follow-up. The progression-free survival of patients aged ≥ 60 years was worse than that of patients aged < 60 years ( χ2 = 5.39, P = 0.020). Conclusions:Pulmonary MALToma belongs to indolent B-cell lymphoma, and its diagnosis requires a combination of clinical imaging, pathology and immunophenotyping. If necessary, genetic testing can be used to assist in the diagnosis. The differential diagnosis should be made from pneumonia, low-grade B-cell lymphoma, and extrapulmonary MALToma with lung involvement. The treatment methods include anti-inflammatory therapy, surgical resection and chemotherapy, and the prognosis is good.
8.Clinical application of ear point embedding beans combined with acupoint pressing in prevention and treatment of chemotherapy-induced nausea and vomiting in patients with hematologic malignancies
Jinying KE ; Chunrong CHEN ; Ling CHEN ; Yanfang LIN
Journal of Leukemia & Lymphoma 2024;33(11):671-676
Objective:To explore the effect of ear point embedding beans combined with acupoint pressing in the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) in patients with hematologic malignancies.Methods:A prospective case series study was conducted. Two hundred patients with hematological tumors who underwent chemotherapy at Fujian Medical University Affiliated Union Hospital from October 2022 to August 2023 were divided into experimental group and control group using the random number table method, with 100 patients in each group. Both groups of patients received chemotherapy with high emetic risk drugs and received routine antiemetic treatment and nursing care with tropisetron hydrochloride. The experimental group added ear point embedding beans and acupoint pressing. The Multinational Association of Supportive Care in Cancer (MASCC) antiemesis tool (MAT) scale was used to evaluate the acute (within 24 hours after the start of chemotherapy, for 3 d) and delayed (24 hours after the end of chemotherapy, for 4 d) CINV status of patients, and the two groups were compared.Results:The final experimental group included 99 cases, while the control group included 90 cases. The age of 189 patients was (38±12) years old; there were 116 males (61.38%) and 73 females (38.62%). There were no statistically significant differences in sociodemographic characteristics (age, gender, etc.), disease type, and gastrointestinal disease history distributions between the two groups (all P>0.05). The incidence of acute nausea [81.81% (81/99) vs. 94.44% (85/90)] and delayed nausea [45.45% (45/99) vs. 78.89% (71/90)] in the experimental group were lower than those in the control group, the delayed MASCC-MAT scale nausea score [ M ( Q1, Q3)] was lower than that in the control group [0 point (0 point, 4 points) vs. 3 points (1 point, 4 points)], and the differences were statistically significant (all P<0.01); there was no statistically significant difference in the acute nausea score between the experimental group and the control group [5 points (2 points, 5 points) vs. 5 points (3 points, 5 points)] ( P = 0.080). The incidence of delayed vomiting in the experimental group [25.25% (25/99) vs. 45.56% (41/90)] and the frequency of vomiting [0 time (0 time, 1 time) vs. 0 time (0 time, 2 times)] were lower than those in the control group, and the differences were statistically significant (both P<0.01); there was no statistically significant difference in the incidence of acute vomiting between the experimental group and the control group [48.48% (48/99) vs. 61.11% (55/90)] and the frequency of vomiting [0 time (0 time, 3 times) vs. 1 time (0 time, 3 times)] (both P>0.05). Conclusions:Ear point embedding beans combined with acupoint pressing can effectively alleviate delayed CINV in patients with hematologic malignancies, and to some extent reduce the incidence of acute nausea.
9.Progress of small-molecule compounds combined with chimeric antigen receptor T-cell therapy for treatment of B lymphocyte malignancies
Jingwen RUI ; Biqi ZHOU ; Yang XU
Journal of Leukemia & Lymphoma 2024;33(11):692-695
Chimeric antigen receptor T-cell (CAR-T) therapy has been widely used in patients with hematologic malignancies. However, there are still problems like high relapse rate and limited persistence. Challenges remain in enhancing the efficacy of CAR-T therapy while minimizing the adverse reactions. In recent years, small-molecule compounds, such as Bruton tyrosine kinase inhibitors, tyrosine kinase inhibitors and demethylating drugs, have been shown to have potential synergistic interactions when combined with CAR-T therapy. This review summarizes the latest progress of small-molecular compounds combined with CAR-T therapy in treatment of B lymphocyte malignancies.
10.Progress of pathology and genetics of histologic transformation in follicular lymphoma
Junhong ZHUO ; Wenyi LU ; Zunmin ZHU
Journal of Leukemia & Lymphoma 2024;33(11):696-700
Follicular lymphoma (FL) is an indolent lymphoma derived from B cells, and most patients have a good prognosis, high remission rate and long overall survival. However, approximately 2%-3% of FL patients develop aggressive lymphoma during treatment or surveillance each year. Transformed FL has high heterogeneity and poor prognosis, and may be involved in clonal evolution by a variety of molecular mechanisms such as bcl-2 mutation, myc mutation, histone modification genes mutation, CDKN2A/B deletion and disruptions in the tumor microenvironment. At present, there are no standard biomarkers available to predict the transformation and prognosis. In this paper, the pathological characteristics, gene mutation and tumor microenvironment of FL histologic transformation are reviewed.

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