1.Acute myeloid leukemia with NPM-MLF1 fusion gene: report of one case and review of literature
Gangji ZHANG ; Wei LI ; Shaowei QIU ; Shuning WEI ; Kaiqi LIU ; Yuntao LIU ; Benfa GONG ; Runxia GU ; Xiaoyuan GONG ; Bingcheng LIU ; Chunlin ZHOU ; Hui WEI ; Ying WANG ; Dong LIN ; Yingchang MI ; Jianxiang WANG
Journal of Leukemia & Lymphoma 2017;26(5):283-286
Objective To investigate the characteristics of NPM-MLF1 fusion gene in acute myeloid leukemia (AML). Methods The data of one AML patient with NPM-MLF1 fusion gene was analyzed,and literatures were reviewed. Results A female patient was diagnosed as AML M6. In the course of the disease, 2 hematologic relapsed, and 2 recurrences were associated with NPM-MLF1 fusion gene positive. After inductive treatment, hematologic complete remission was achieved, and NPM-MLF1 fusion genes were all negative. Survival time surpassed 6 years when the chemotherapy was performed alone. Conclusion The incidence of NPM-MLF1 fusion gene in AML is low. It is necessary to collect more clinical data to judge whether an independent disease type or not.
2. Prognostic significance of flow cytometric minimal residual disease in acute myeloid leukemia during aplasia
Nan PENG ; Hui WEI ; Dong LIN ; Chunlin ZHOU ; Bingcheng LIU ; Ying WANG ; Kaiqi LIU ; Benfa GONG ; Shuning WEI ; Guangji ZHANG ; Yuntao LIU ; Xiaoyuan GONG ; Shaowei QIU ; Yingchang MI ; Jianxiang WANG
Chinese Journal of Hematology 2017;38(9):767-771
Objective:
To investigate the impact of minimal residual disease (MRD) by multiparameter flow cytometry (MPFC) during aplasia on efficacy and prognosis of de novo acute myeloid leukemia (AML) (non M3) patients.
Methods:
The MRD data by 8-color MPFC during aplasia (day 14-15 of induction therapy) in 85 de novo AML (non M3) patients and the MRD impact on efficacy and prognosis were retrospectively analyzed.
Results:
Data of 85 patients, including 42 males (49.4%) and 43 females (50.6%) , were collected, with a median age of 35 (15-54) years. The median MRD by MPFC during aplasia was 0.58% (0-81.11%) , and 70 (82.4%) patients achieved complete remission (CR) after first induction chemotherapy. The cutoff of MRD by receiver operating characteristic (ROC) analysis was 2.305% (Se= 0.867, Sp=0.800) . The CR rate after one course was significantly higher in patients with MRD<2.305% [96.6% (56/58) ]than in patients with MRD≥2.305%[51.9% (14/27) ] (
3. Impact of KIT D816 mutation on salvage therapy in relapsed acute myeloid leukemia with t(8;21) translocation
Benfa GONG ; Yehui TAN ; Aijun LIAO ; Jian LI ; Yueying MAO ; Ning LU ; Yi DING ; Erlie JIANG ; Tiejun GONG ; Zhilin JIA ; Yu SUN ; Bingzong LI ; Shuchuan LIU ; Juan DU ; Wenrong HUANG ; Hui WEI ; Jianxiang WANG
Chinese Journal of Hematology 2018;39(6):460-464
Objective:
To evaluate the impact of KIT D816 mutation on the salvage therapy in relapsed acute myeloid leukemia (AML) with t(8;21) translocation.
Method:
The characteristics of the first relapsed AML with t(8;21) translocation from 10 hospitals were retrospectively collected, complete remission (CR2) rate after one course salvage chemotherapy and the relationship between KIT mutation and CR2 rate was analyzed.
Results:
68 cases were enrolled in this study, and 30 cases (44.1%) achieved CR2. All patients received KIT mutation detection, and KIT D816 mutation was identified in 26 cases. The KIT D816 positive group had significantly lower CR2 compared with non-KIT D816 group (23.1%
4. Impact of duration of antibiotic therapy on the prognosis of patients with acute myeloid leukemia who had Gram-negative bloodstream infection in consolidation chemotherapy
Runxia GU ; Hui WEI ; Ying WANG ; Bingcheng LIU ; Chunlin ZHOU ; Dong LIN ; Kaiqi LIU ; Shuning WEI ; Benfa GONG ; Guangji ZHANG ; Yuntao LIU ; Xingli ZHAO ; Xiaoyuan GONG ; Yan LI ; Shaowei QIU ; Yingchang MI ; Jianxiang WANG
Chinese Journal of Hematology 2018;39(6):471-475
Objectives:
To investigate the influence of duration of antibiotic therapy on the prognosis of patients with AML who had Gram-negative bloodstream infection during consolidation chemotherapy.
Methods:
Data were collected retrospectively from 591 patients enrolled from the registered "A Phase III study on optimizing treatment based on risk stratification for acute myeloid leukemia, ChiCTR-TRC-10001202" treatment protocol between September 2010 and January 2016 in different treatment cycles.
Results:
A total of 119 episodes of Gram-negative bloodstream infection occurred during consolidation chemotherapy. Excluding the 5 episodes in which fever lasted longer than 7 days, 114 episodes of infection were analyzed. The median neutrophil count was 0 (0-5.62)×109/L, median neutropenia duration was 9 (3-26) days, median interval of antibiotics administration was 7 (4-14) days. Logistic regression analysis showed that there is no significant difference on 3-day recurrent fever rate and reinfection by the same type bacteria between antibiotics administration ≤7 days or >7 days (1.2%
5. Characteristics and prognosis in adult patients with early T-cell precursor acute lymphoblastic leukemia
Xiaoyuan GONG ; Ying WANG ; Bingcheng LIU ; Hui WEI ; Chunlin ZHOU ; Dong LIN ; Kaiqi LIU ; Shuning WEI ; Benfa GONG ; Guangji ZHANG ; Yuntao LIU ; Xingli ZHAO ; Yan LI ; Runxia GU ; Shaowei QIU ; Yingchang MI ; Jianxiang WANG
Chinese Journal of Hematology 2018;39(12):977-982
Objective:
To analyze the clinical, laboratory characteristics and prognosis of adult early T-cell precursor acute lymphoblastic leukemia (ETP-ALL).
Methods:
The clinical data of 13 adult ETP-ALL patients from January 2009 to March 2017 were retrospectively analyzed and compared with non-ETP ALL patients.
Results:
13 ETP-ALL patients (17.3%) were identified in 75 adult T-ALL patients, the median age of the patients was 35 years old (15 to 49 years) and 10 patients were male (76.9%). ETP-ALL patients had lower WBC count, LDH level, blasts in peripheral blood, lower incidence of thymic mass and higher PLT count compared to non-ETP ALL patients. The CR rate after one course induction chemotherapy for ETP-ALL and non-ETP ALL patients was 33.3% and 90.1%, respectively (
6. Clinical features and prognosis in CD10- pre-B acute lymphoblastic leukemia
Xiaoyuan GONG ; Ying WANG ; Bingcheng LIU ; Hui WEI ; Chunlin ZHOU ; Dong LIN ; Kaiqi LIU ; Shuning WEI ; Benfa GONG ; Guangji ZHANG ; Yuntao LIU ; Xingli ZHAO ; Yan LI ; Runxia GU ; Shaowei QIU ; Yingchang MI ; Jianxiang WANG
Chinese Journal of Hematology 2017;38(1):17-21
Objective:
To analyze the clinical features and prognosis of acute lymphoblastic leukemia patients with immunophenotype of CD10-pre-B (CD10- pre B-ALL) .
Methods:
6 adult cases with CD10- pre B-ALL immunophenotypes were analyzed retrospectively, related literatures were reviewed to clarify these kind of patients’ clinical features and prognosis.
Results:
CD10- pre B-ALL occurred in 1.5% of ALL, 1.8% of B-ALL and 11.5% of pre B-ALL respectively. All the 6 patients were male with the median age as 33.5 years old, the median white blood cells was 101.78×109/L, MLL-AF4 fusion transcripts were evident in all cases. Complete remission (CR) was achieved in 5 patients after first induction chemotherapy, 1 patient failed to respond to induction therapy, and got CR after 3 courses of chemotherapy. 2 patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) in CR1, 1 patient relapsed in the short term and underwent allo-HSCT in CR2. 1 patient was still waiting for allo-HSCT. Of the 2 patients who didn’t receive transplantation, 1 died following a relapse, the other remained to be in CR.
Conclusions
CD10- pre B-ALL was a rare but distinct subtype in adult ALL characterized by male dominance, high onset white blood cells and MLL rearrangement rate. Conventional chemotherapy produced a high response rate but more likely relapse, allo-HSCT may have the potential to improve the prognosis of these patients.
7. Myeloid/lymphoid neoplasms with eosinophilia and FGFR1 rearrangement: 5 cases report and literatures review
Yuntao LIU ; Jiawei ZHAO ; Juan FENG ; Qinghua LI ; Yumei CHEN ; Lugui QIU ; Zhijian XIAO ; Yan LI ; Benfa GONG ; Xiaoyuan GONG ; Yingchang MI ; Jianxiang WANG
Chinese Journal of Hematology 2019;40(10):848-852
Objective:
To investigate the clinic-pathological features, diagnosis and treatment of 8p11 myeloproliferative syndrome (EMS) .
Methods:
Five patients diagnosed as EMS from Jan 2014 to May 2018 at Blood Disease Hospital, Chinese Academy of Medical Sciences were enrolled. The clinical manifestations, laboratory characteristics, treatment and outcome of these patients were summarized.
Results:
The peripheral blood leukocyte count of 5 patients with EMS increased significantly, accompanied with an elevated absolute eosinophils value (the average as 18.89×109/L) . The hypercellularity of myeloid cells was common in bone marrow, always with the elevated proportion of eosinophils (the average as 17.24%) , but less than 5% of blast cells. The chromosome karyotype of the 5 cases differed from each other, but presenting with the same rearrangement of FGFR1 gene by fluorescence in situ hybridization technology. The average interval between onset and diagnosis was 4.8 months with a median survival of only 14 months.
Conclusion
EMS was a rare hematologic malignancy with poor prognosis and short survival. It was commonly to be misdiagnosed. Analysis of cytogenetics and molecular biology were helpful for early diagnosis.
8. A single-center, randomized controlled trial of PEG-rhG-CSF and common rhG-CSF to promote neutrophil recovery after induction chemotherapy in newly diagnosed acute myeloid leukemia
Kaiqi LIU ; Ying WANG ; Zi ZHAO ; Dong LIN ; Chunlin ZHOU ; Bingcheng LIU ; Xiaoyuan GONG ; Xingli ZHAO ; Shuning WEI ; Guangji ZHANG ; Benfa GONG ; Yan LI ; Yuntao LIU ; Yingchang MI ; Jianxiang WANG ; Hui WEI
Chinese Journal of Hematology 2019;40(6):497-501
Objective:
To compare the time of the recovery of neutrophils or leukocytes by pegylated recombinant human granulocyte stimulating factor (PEG-rhG-CSF) or common recombinant human granulocyte stimulating factor (rhG-CSF) in the myelosuppressive phase after induction chemotherapy in newly diagnosed acute myeloid leukemia (AML) patients. At the same time, the incidences of infection and hospitalization were compared.
Methods:
A prospective randomized controlled trial was conducted in patients with newly diagnosed AML who met the enrollment criteria from August 2014 to December 2017. The patients were randomly divided into two groups according to a 1:1 ratio: PEG-rhG-CSF group and rhG-CSF group. The time of neutrophil or leukocyte recovery, infection rate and hospitalization interval were compared between the two groups.
Results:
60 patients with newly diagnosed AML were enrolled: 30 patients in the PEG-rhG-CSF group and 30 patients in the rhG-CSF group. There were no significant differences in age, chemotherapy regimen, pre-chemotherapy ANC, WBC, and induction efficacy between the two groups (
9. Prediction of outcome in acute myeloid leukemia by measurement of WT1 expression as a basic marker of minimal residual disease
Na ZHAO ; Hui WEI ; Ying WANG ; Dong LIN ; Chunlin ZHOU ; Bingcheng LIU ; Kaiqi LIU ; Guangji ZHANG ; Shuning WEI ; Benfa GONG ; Xiaoyuan GONG ; Wei LI ; Yan LI ; Yuntao LIU ; Shaowei QIU ; Runxia GU ; Yingchang MI ; Jianxiang WANG
Chinese Journal of Hematology 2017;38(8):695-699
Objective:
To probe the potential utility of Wilms tumor 1 (WT1) as a marker of minimal residual disease (MRD) in acute myeloid leukemia (AML) to estimate the relapse-predicting cut-off value.
Methods:
Quantitative assessment of bone marrow WT1 mRNA level was preformed using real-time quantitative reverse transcription polymerase chain reaction (RQ-RT-PCR) assay. The expression levels of WT1 dynamically measured with RQ-RT-PCR were retrospectively analyzed in 121 AML cases (not including acute promyelocytic leukemia) achieving complete remission (CR) after induction therapy followed by consolidation therapy. By comparing WT1 levels of patients with different post-therapy outcomes, the investigators used the receiver operating characteristic (ROC) curve to determine WT1 threshold so as to predict their clinical relapses. Then prognoses and the significance of intervention were analyzed between WT1 positive and negative patients according to the cut-off value of WT1.
Results:
According to ROC curve, WT1 level higher than 2.98% predicted the possibility of relapse. For simplicity and clinical application, 3.00% was used as the cut-off value of WT1 level for relapse. WT1 levels in 41 patients at diagnosis were detected, meanwhile 3 patients whose WT1 levels at diagnosis below 3.00% were excluded, then the median WT1 level of the rest 38 patients at diagnosis was 44.09% (range 7.19%-188.06%) . The median WT1 level in remission was 0.48% (352 samples, range 0-8.41%) . The median WT1 level at diagnosis was higher than that in remission. Excluding the 3 patients with WT1 level at diagnosis under 3.00%, the relapse rate of WT1 positive group (>3.00% during consolidation phase and follow-up) and WT1 negative group (≤3.00%) was 70.0% (14/20) and 12.2% (12/98) respectively (
10. Clinical significance of minimal residual disease in patients with Ph-negative precursor B-acute lymphoblastic leukemia
Kaiqi LIU ; Hui WEI ; Dong LIN ; Ying WANG ; Chunlin ZHOU ; Bingcheng LIU ; Wei LI ; Xingli ZHAO ; Yan LI ; Huijun WANG ; Chengwen LI ; Qinghua LI ; Benfa GONG ; Yuntao LIU ; Xiaoyuan GONG ; Yingchang MI ; Jianxiang WANG
Chinese Journal of Hematology 2018;39(9):724-728
Objective:
To explore the predictive value of minimal residual disease (MRD) level in Ph-negative precursor B-acute lymphoblastic leukemia (ALL) patients.
Methods: