Objective:To investigate the efficacy and safety of BeEAM (bendamustine+cytarabine+etoposide+melphalan) regimen in pretreatment of autologous hematopoietic stem cell transplantation for patients with lymphoma.Methods:The clinical data of 15 patients with lymphoma who underwent autologous hematopoietic stem cell transplantation after pretreatment with BeEAM regimen from January 2020 to February 2021 in Gansu Provincial Hospital were retrospectively analyzed. The transplant-related adverse reactions and hematopoietic reconstitution were evaluated.Results:During the pretreatment process of 15 patients, 13 patients had gastrointestinal adverse reactions such as nausea, vomiting and diarrhea, 2 patients had hypokalemia, and 1 patient had abnormal liver function, but all of them were grade 1-2, and no grade 3-4 adverse reactions occurred. One patient had poor platelet implantation, and the remaining 14 patients all achieved hematopoietic reconstruction. After transplantation, the median time of peripheral blood neutrophils and platelets good implantation in patients was 10 d (9-14 d) and 11 d (9-17 d), respectively. Until March 2021, all patients were alive during follow-up.Conclusions:The efficacy of BeEAM regimen in pretreatment of autologous hematopoietic stem cell transplantation for patients with lymphoma is good, and the adverse reactions are tolerable.

Objective:To investigate the impact of malnutrition diagnosed with Global Leadership Initiative on Malnutrition (GLIM) criteria on the outcomes of patients with primary gastrointestinal lymphoma (PGIL).Methods:Patients with PGIL admitted into Gansu Provincial People's Hospital from January 2014 to July 2022 were retrospectively enrolled. Nutritional risk screening was conducted using Nutritional Risk Screening 2002 (NRS 2002) scale, and malnutrition was diagnosed as per GLIM criteria. Kaplan-Meier survival analysis and multivariate Cox regression analysis were performed to investigate the effect of malnutrition as per GLIM criteria on the outcomes of PGIL patients.Results:A total of 82 patients were included. The phenotypic parameters, including body mass index (BMI), arm circumference, leg circumference and grip strength, were at significantly lower levels in the 28 malnourished patients, compared with the other non-malnourished patients. The median overall survival of patients with malnutrition as per GLIM criteria was 10 months, while that of patients without malnutrition was 41 months, showing significant differences between groups. The univariate analysis revealed that age, loss of muscle mass, tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the impacting factors for survival in patients with PGIL. The multivariate analysis further demonstrated that tumor stage based on Lugano classification and malnutrition as per GLIM criteria were the independent impacting factors for survival in patients with PGIL.Conclusion:Malnutrition based on GLIM criteria is an independent risk factor for unfavorable outcomes in patients with PGIL and could be utilized as a prognostic indicator.

The relationship between pyroptosis and immune microenvironment and disease has received increasing attention. Pyroptosis plays a dual role in anti-tumor immunotherapy by promoting the release of inflammatory factors, forming the tumor microenvironment and suppressing tumour immunity on the one hand, and inducing the tumour inflammatory response to inhibit the proliferation of tumor cells on the other hand. The relationship between pyroptosis, immune microenvironment and tumors is different in different tissues and genetic backgrounds. This article reviews the molecular mechanisms of pyroptosis and the regulatory role of tumor immune microenvironment in hematologic malignancies, with a view to providing ideas for the anti-hematologic malignancies treatment and research based on the target of pyroptosis-regulated immune microenvironment.

Objective:To investigate the early efficacy and safety of pomalidomide-based regimen in relapsed/refractory multiple myeloma (MM) in the real world.Methods:The clinical data of 15 patients with relapsed/refractory MM treated with pomalidomide-based regimen who were admitted to Gansu Provincial Hospital from January 2021 to July 2021 were retrospectively analyzed, and the early efficacy and safety were also evaluated.Results:There were 8 males and 7 females, and the median age of onset of 15 patients was 60 years (43-83 years); the median time for the diagnosis of relapse and refractory was 15 months (4-84 months). All 15 patients previously received bortezomib-based treatment regimens, 9 patients previously received lenalidomide treatment, and 7 cases received autologous hematopoietic stem cell transplantation. All patients received pomalidomide-based regimen combined with two-drug or three-drug regimen (pomalidomide combined with bortezomib,daratumumab,bendamustine, dexamethasone, cyclophosphamide or lenalidomide). The median treatment cycle was 2 cycles (2-4 cycles). After 2 cycles of treatment, the therapeutic efficacy was evaluated; the overall response rate was 73% (11/15), including 3 cases of complete remission, 3 cases of very good partial remission, and 5 cases of partial remission. Hematological toxicity occurred in 9 patients, of which 5 cases had grade 3-4 hematological toxicity, 4 cases had grade 1-2 hematological toxicity, and other adverse reactions were mild and tolerable.Conclusion:Pomalidomide-based regimen is effective and safe for relapsed/refractory MM patients.

Objective To investigate the effects of Akkermansia muciniphila (AKK) on azomethane-oxide (AOM)/glucan sodium sulfate (DSS)-induced inflammatory colorectal cancer mouse model and intestinal stem cells. Methods AOM/DSS-induced mouse models of inflammatory-associated colorectal cancer were randomly divided into three groups, namely, model, AKK and aspirin groups, based on different administration of drugs by gavage. The tumor number, size, distribution, and burden were observed 10 weeks after intervention. Immunohistochemical method was used to analyze the expressions of Ki67 and Lgr5 proteins, which are utilized to characterize tumor malignancy and stem cells. The mRNA expressions of Lgr5, CD133, Nanog, and ALDH1 were detected by qRT-PCR. Results Compared with those of the model group, the tumor number, size, and burden of the AKK group were significantly reduced (P < 0.01). The expressions of Ki67 and Lgr5 in the AKK group of tumor tissues were significantly decreased (P < 0.05), and the mRNA expressions of CD133, Nanog and ALDH1 were significantly down-regulated. Conclusion AKK is effective against AOM/DSS-induced colitis-associated colorectal cancer in mice, and its mechanism of action may be closely related to colorectal stem cell activity.

OBJECTIVE To investigate the efficacy and safety of hetrombopag combined with low-dose prednison in the treatment of patients with refractory/recurrent primary immune thrombocytopenia(ITP). METHODS A total of 40 patients with ITP who failed to respond to previous treatment or relapsed in the Department of Hematology of Gansu Provincial People’s Hospital From July 2021 to August 2022 were selected. Used randomized controlled trial research methods, according to the treatment plan, they were divided into observation group and control group, with 20 cases in each group. The control group was treated with low-dose prednison alone. The observation group was combined with hetrombopag treatment on this basis. The efficacy and adverse reactions were compared between the two groups. RESULTS Treatment 6 weeks, patients who's proportion of platelet counts(PLT) reached≥50×109·L−1 and ≥30×109·L−1 in observation group were higher than control group with statistically significant differences in both groups[90%(18/20) vs 50%(10/20), P＝0.006; 90%(18/20) vs 65%(13/20), P＝0.130]; The study also indicated a statistically significant difference in favour of observation group compared with control group in the odds of achieving the outcome of a PLT≥50×109·L−1at least once during 6-week treatment[90%(18/20) vs 55%(11/20), P＝0.147], was more than placebo-treated one. The median time of PLT ≥ 50×109·L−1 for the first time within 6 weeks of treatment in the observation group was 3 weeks, which was the same as that in the control group. After 6 weeks of treatment, the median platelet count in the observation group was higher than that in the control group[97.50(58.25−166.75)×109·L−1 vs 45.50(13.25−82.50)×109·L−1 , P<0.05]. The median PLT count in the observation group was higher than that in the control group at week 1−6 after treatment, and the curative effect was significant. The two groups of patients tolerated the regimen well, and the degree of adverse reactions was mild, which improved quickly after symptomatic treatment. CONCLUSION Hetrombopag combined with low-dose prednison has a high effective rate in the treatment of refractory/recurrent ITP, which is better than that of single use, and the adverse reactions are tolerable, so it can be widely used in clinical practice.