Hematopoietic cell transplantation is frontline treatment of multiple myeloma (MM).Autologous hematopoietic stem cell transplantation (auto-HSCT) could improve remission rate,prolong survival time,the tandem auto-HSCT is able to make patients get further benefits for patients not achieving at least very good partial remission after the first auto-HSCT.Allologous hematopoietic stem cell transplantation (alloHSCT) is potentially able to cure multiple myeloma,but patients achieve less benefit because of high transplant-related mortality (TRM).The TRM is low after reduced-intensity conditioning allo-HSCT,but which exhibit no survival benefit.Moreover,patients achieve no survival benefit after tandem auto-HSCT and allologous reduced-intensity conditioning transplantation.This paper reviewes recent studies about HSCT in MM.

Many complex symptoms are observed in multiple myeloma and the most common symptom is bone damage, decreased renal function, increased infection susceptibility, anemia and peripheral neuropathy. Moreover some patients have other accompanying disease, such plasmacytoma and amyloidosis.Symptoms in multiple myeloma are the important basis for initiating anti-myeloma therapy. This paper is to review the pathophysiology of the complication of multiple myeloma and its treatment.

The 48th annual meeting of the American Society of Clinical Oncology (ASCO) was held in Chicago from June 1-5 2012 and the risk-adapted therapy of multiple myeloma (MM) was discussed.MM is a heterogeneous disease and all patients should be accepted risk-adapted therapy. According to cytogenetic abnormalities, MM patients are divided into three groups,standard risk, intermediate risk and high risk.Patients with standard risk may received 4 cycles Rd regimes (lenalidomide plus low dose dexamethasone) or VCD regimes (bortezomib,cyclophosphamide,dexamethasone) for induction therap.Patients with intermediate risk may received 4 cycles VCD regimes for induction therapy.Patients with high risk may received 4 cycles VRD regimes (bortezomib,lenalidomide,dexamethasone) for induction therapy.After induction treatment,patients can received autologous hematopoietic cell transplantation or consolidation/maintenance therapy. The determination of which patients are eligible for autologous hematopoietic cell transplantation according age,comorbidities and performance status.

Multiple myeloma is a malignancy of plasma cells and renal function impairment is one of common complications of multiple myeloma.Light-chain deposition in renal tubules which induces renal tubular disease is the major pathogenesis of renal impairment.The renal function impairment should be estimated based on glomerular filtration rate in multiple myeloma patients. Bortezomib with high-dose dexamethasone is effective to myeloma patients with renal impairment and improves renal function.Treatment experience of thalidomide is limited,but it can be used at the standard dosage to patients with renal failure.Lenalidomide is effective and can reverse renal impairment of several myeloma patients when this agent is used at reduced doses according to renal function.

Bruton tyrosine kinase (BTK) is a non-receptor tyrosine kinase which belongs to the Tec kinase family and plays an important role in B cell receptor signaling.Nowadays,BTK has been a nove] target for treating some B cell malignancies.Recently,some studies have confirmed that BTK inhibitor,PCI-32765 (ibrutinib),can effectively treat chronic lymphocytic leukemia,mantle cell lymphoma and so on.This review will discuss the preclinical and clinical development of this BTK inhibitor in B cell malignancies.

Objective To screen the optimum conditions carrying murine melanoma B16 cells in spaceflights without cares.MethodsMurine melanoma cells were cultured on micocarriers and grouped depending on cells concentration, serum concentration, microcarrier number and temperature.After 33 days, B16 cells were stained by Giemsa, observed with phase-contrast microscope and counted for surviving percentage.ResultsThe optimum conditions,in which the surviving percentages were 8% and 10%, were obtained in the experiments.B16 cells were carried in the 20th recoverable satellite orbiting 18 days under the optimum conditions. After recovering, 110 strain monocloned cells were survived and the surviving percentage was 1.1%.ConclusionThe optimum conditions carrying murine melanoma B16 cells in spaceflights without cares seems to be obtained,and it did improve the surviving time and percentage of cells in spaceflights without cares.

ObjectiveTo search for a new method of anti-tumor immunity,using mutated tumor cells by spaceflight.MethodsTumor cells were carried in the Shenzhou 4 and the recoverable satellite No.18.After 7 days and 18 days spaceflight respectively,the effects of spaceflight were investigated primarily.Results2382 and 1 strains of mutated tumor cells from the airship No.4 and the recoverable satellite No.18 had been obtained respectively. Comparing with the control group, the growth rate of mutated cells decreased, moreover, the secretion of cytokines also changed.ConclusionSpaceflight may affect physiological characteristics of tumor cells, and that, there was a negative correlation between the ratio of surviving cells and carrying time.

Objective To explore the application effects of continuous nursing based on multi-disciplinary cooperation in patients with multiple myeloma.MethodsA total of 108 patients with multiple myeloma hospitalized in Beijing Chao-Yang Hospital Affiliated to Capital Medical University from January 2015 to June 2016 were included and randomly divided into two groups, 54 cases respectively. In the control group, patients received the routine oral and written discharge guidance. The continuous nursing based onmulti-disciplinary cooperation was performed in the intervention group. Self-care ability, bone pain related health knowledge,pain relief and satisfaction of patients before and 6 months after the intervention were compared between two groups.ResultsBefore the intervention, there were no significant differences in self-care knowledge, self concept, self-care skills, self-care responsibility, the score of bone pain control health knowledge, patient numbers of bone pain relief and percentage of bone pain relief between two groups(t/χ2/Z=0.518,0.361,1.587,0.325,0.475,0.609,0.905;P>0.05). At 6 months after the intervention, the score of self-care knowledge(44.5±7.0), self concept(17.6±5.1), self-care skills(23.1±6.1), self-care responsibility (14.7±4.2), the score of bone pain control health knowledge(93.0±7.0), patient numbers of bone pain relief and percentage of bone pain relief(88.9%)in the intervention group were significantly better than those in the control group(t/χ2/Z=6.582,3.973,4.548,3.606,9.973,7.542,5.655;P<0.05). Nursing satisfaction in guidance, non-specialized service support, convenient service channels and available health service resources. Conclusions Extended nursing specially designed for empty nesters should be equipped with extended psychological nursing, daily nursing and other nursing services, and personalized services should be provided to empty nesters in effective forms of extended nursing. Meanwhile, community hospitals' functions as well as cooperation between hospitals and communities should be strengthened to improve extended nursing services.

Objective To explore the application effect of case method combined with role play in clinical nursing teaching on hematologic diseases.Methods Totals of 100 nursing students from School of Nursing in Capital Medical University were selected, with the 50 enrolled in 2015 as the experimental group, and the other 50 in 2014 as the control group. Traditional teaching method was conducted to the control group, while students in the experimental group were taught with case method combined with role play. After the class, nursing students in the two groups took a theoretical examination on completion of the course and an evaluation on their writing on nursing plans, and were also evaluated by Active learning state (ALS).Results Compared with the control group, scores of students in the experimental group were higher in terms of theoretical examination and evaluation on their writing on nursing plans (P<0.05); total scores of ALS evaluation and scores in its individual items in the experimental group were higher than that in the control group (P<0.05). Conclusions In clinical nursing teaching on hematologic diseases, by circulating the teaching through combining case method and role play, a standardized handbook was formed, which can quickly and effectively improve the students' clinical nursing practice skills.

Objective:To evaluate the prognostic value of CD56 expression in newly diagnosed MM (NDMM).Methods:A total of 332 NDMM patients were enrolled in Beijing Chaoyang Hospital, Capital Medical University from January 1, 2011 to January 1, 2021, with a median age of 60 years and a male to female ratio of 1.2∶1. CD56 expression on myeloma cells was detected by flow cytometry before induction therapy. Overall survival (OS) and progression-free survival (PFS) data were collected. In order to reduce the confounding factors, the propensity score matching technique was used to match CD56 positive versus negative patients at a ratio of 1∶1.Results:Among 332 patients, CD56 positivity rate was 65.1% (216/332). Patients with CD56 expression had significantly longer median OS (58.4 vs. 43.1 months, P=0.024) and PFS (28.7 vs. 24.1 months, P=0.013) than those with negative CD56. Univariate Cox proportional hazards regression analyses showed that CD56 expression was positively correlated with OS ( HR=0.644, 95 %CI 0.438-0.947, P=0.025) and a favorable prognostic factor for PFS ( HR=0.646, 95 %CI 0.457-0.913, P=0.013). The favorable effect of CD56 expression on PFS was confirmed in multivariate analysis ( HR=0.705, 95 %CI 0.497-0.998, P=0.049), but OS was not affected ( P>0.05).In the propensity score matching analysis, 194 patients with 97 in each group were identified. CD56 positivity consistently predicted longer PFS (34.2 vs.25.1 months, P=0.047), but not OS (63.4 vs.43.1 months, P=0.056). Conclusion:These results demonstrate that CD56 expression is a favorable prognostic factor for PFS of newly diagnosed MM patients.