Follicular lymphoma (FL) is a subtype of B cell lymphoma,which derived from follicular germinal center.As the most common type of indolent lymphoma,the overall prognosis of FL is good.However,the prognosis of FL is heterogeneous.With the application of rituximab,the therapeutic effect and the prognosis of the disease is further improved.For the relapsed / refractory patients,especially who have received first-line chemotherapy with rituximab in the early,transplantation is an important choice.Compared with the previous conventional myeloablative conditioning regimen,reduced-intensity conditioning (RIC) effectively reduced the non-relapse mortality (NRM),extended the allogeneic transplantation recipients,but the high rate of relapse after transplantation is the main defect.The application of donor lymphocyte infusion after transplantation therapy not only can reduce the recurrence rate but also treat the disease relapse.In the future,the improvement of transplantation strategy and the application of new drugs may bring new ideas and opportunities for FL therapy.

Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by extreme immune activation, resulting in pathologic inflammation. The HLH-2004 diagnostic criteria is used widely based on the data from pediatric patients. However, there are differences between children and adults in the etiology, clinical and laboratory characteristics for HLH. Given these differences, diagnostic scoring systems unique to adult HLH have been proposed. HLH in adults is a much more heterogeneous syndrome requiring a more individualized approach depending on the underlying trigger, disease severity, as well as genetic background.

There is still no agreed standard of care for CD30+ T-cell lymphomas which are dominant in peripheral T-cell lymphoma.The combination of multidrug or dose-intensified chemotherapy regimen and consolidation of hematopoietic stem cell transplantation are widely used at present.In recent years,several clinical trails included certain new agents,such as etoposide,alemtuzumab,denileukin diftitox,bortezomib,romidepsin,lenalidomide,brentuximab vedotin,and so on,have demonstrated the promising outcome.Referring targeted therapies for relapsed/refractory CD30 + T-cell lymphomas,certain agents have been approved,such as pralatrexate,romidepsin,brentuximab vedotin (ALCL),belinostat,and the most encouraging agent is brentuximab vedotin.

Myelodysplastic syndrome(MDS) is a malignant clonal disease of hematopoietic system,characterized by dysplasia and ineffective hematopoiesis.Therefore,the morphology of bone marrow and peripheral blood cells are crucial in the diagnosis of MDS.The morphological features of marrow cells,the significance of morphological diagnosis,the progress in the study of morphological diagnosis and some major issues on morphological diagnosis of MDS are discussed in this article.

Objective To monitor the incidence of CMV infection in different stem cell transplantation.Methods From Mar.2001 to Jul.2003,using nested-PCR,we have detected the CMV-DNA in the 55 patients in the First Affiliated Hospital to Soochow University after different stem cell transplantation and compared the incidence of infection of CMV in different stem cell transplantation. Results In the 462 blood samples,there were 285 blood sample which we detected CMV-DNA.The infection rate in all the patients whom we have studied was 33/55(60.0%);in the group of nonmyeloablative allogeneic stem cell transplantation,it was 15/17(88.2%);in the group of peripheral stem cell transplantation,it was 3/7(42.9%);in the group of unrelated bone marrow transplantation,it was 7/11(63.6%);in the group of related bone marrow transplantation it was 8/20(40.0%).The infection rate of CMV in the group of nonmyeloablative allogeneic stem cell transplantation was significantly higher than those in related bone marrow and peripheral stem cell transplantation(?~2=5.44,P0.05).Conclusion The incidence of CMV infections may be varied in different stem cell transplantation schemes.

Chronic Disease ; Graft vs Host Disease ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans

Objective To investigate the clinical features, therapy and prognosis of elderly patients with newly diagnosed acute promyelocytic leukemia (APL). Methods The clinical features of 21 elderly patients and 89 patients aged ＜60 with newly diagnosed APL were retrospectively analyzed. Additionally,elderly patients were divided into different groups according to the count of white blood cell (WBC). Results There were no significant differences between elderly patients and patients aged ＜60 in the aspect of sex (male/female: 11/10 vs 47/42), WBC count (high initial WBC: 23.8 % vs 16.9 %), the percentage of bone marrow blasts plus promyelocytes (0.83±0.11 vs 0.83±0.12), complete remission (CR) rate (71.4 % vs 84.3 %),the time of CR occurrence (35.7±10.1 vs 39.1±13.5), the occurrence of retinoic acid syndrome(RAS) (14.3 % vs 22.5 %), disseminated intravascular coagulation (DIC) (52.4 % vs 34.8 %) as well as 2 years overall survival rate (72.7 % vs 80.0 %) (P ＞0.05). Of the 21 elderly patients who received inductive treatment, 5 with high initial WBC and 16 without high initial WBC. The incidences of DIC, early death in high initial WBC group were 80 %, 60 % respectively, which were higher than the group without high initial WBC (43.8 %,18.8 % respectively), whereas CR rate for the group with high initial WBC (40.0 %) was lower than that for the group without high initial WBC (81.3 %). Conclusion Elderly patients with APL could have fine prognosis as well as patients aged ＜60. The results of inductive treatment of elderly patients in high initial WBC group were poor as compared with the group without high initial WBC.

90 %) on months 1,2,3,6 and 12.An acute GVHD of grade Ⅱ and chronic limited GVHD developed,but improved with modification of immunosuppressive therapy.The patient has(regained) normal lives now.Conclusion NIMA-mismatched sibling with FMc may be a suitable donor for Non-TCD HLA haplo-identical HSCT.

Objective To explore the levels and the significance of IL-11 and sgp130 in the treatment of newly-diagnosed acute leukemia(AL)during the treatment of the induced remission,and to evaluate the curate effect of rhIL-11 on AL.Methods The levels of IL-11 and sgp130 in patients with AL were determined by ELISA respectively before treatment and after completing remission(CR).1.5 mg of rhIL-11 was injected subcutaneously,once a day,continuously for 14 days as one course,of treatment time 1～2 courses as total.Results Plasm IL-11 level in AL patients was significantly lower than normal(P

Objective To explore the possible immune pathophysiology of CD4+T regulatory(CD4+Treg)in acquired aplastic anemia(AA).Methods The levels of CD4+CD25+Treg、CD4+CTLA-4+Treg、CD4+PD-1+Treg、CD3+CD8-IL-10+Treg、CD3+CD8-TGF-?1+Treg、CD3+CD8-IL-4+ Treg in the bone marrow of 23 cases of AA at active phase,10 cases of AA at recovery phase and 15 normal controls were measured,and the relationship between CD4+Treg and priming immune factor-CD28 or effective immune factor-IFN-? was also evaluated respectively.Results Contrast to normal controls,while CD4+CTLA-4+Treg of AA at active phase decreased markedly,levels of other CD4+Treg:CD4+CD25+Treg,CD4+PD-1+Treg,CD3+CD8-IL-10+Treg,CD3+CD8-TGF-?1+Treg and CD3+CD8-IL-4+Treg did not change significantly.Contrast to normal controls,the ratio of membrane costimulatory of CD28/CTLA-4 and CD28/PD-1 were all increases significantly in AA at active phase;the ratio of cytokines in cell plasma of IFN-?/IL-4,IFN-?/TGF-?,and IFN-?/IL-10 were also increased significantly.Conclusion In AA,not only at priming stage but also at effective stage,the positive costimulatory increased while the negative regulatory costimulatory decreases or dose not change,which shifted the immune balance to intensification.That the CD4+Treg does not expand to control the intensified immune reaction might be one of immunopathgenesis of AA.