Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma with highly heterogeneous clinical course. How to recognize patients with high risk is coming into the focus of the 57th American Society of Hematology (ASH) annual meeting. The International Prognostic Index (IPI) score as a classic prognostic system is challenged by variety of new prognosis systems. The tumor microenvironment plays an important role in progression of lymphoma, and its prognostic value draw much more attention. The value of PET-CT for prognosis of DLBCL has also been affirmed in this meeting.

TWO average expense control(TAEC) is the method that the hospital want to control the increasing breadth of medicine expense by limiting the total expense which include both clinic expense and hospitalize expense.TAEC will fake great help to improve the relationship of docfor and patient and to promote the hospital work.But the method of TAEC will also to be optimize further.

Bone marrow-derived mesenchymal stem cells (MSCs) are capable of migrating and homing to brain tumors in vivo and therefore is a promising targeted-delivery vehicle in cancer gene therapy. MSCs are transfected or transducted with the therapeutic genes and achieve stable expression in vitro, then are delivered to the host to exert their therapeutic effects. The Ex Vivo gene transfer of MSCs has been studied in several types of tumors including gliomas, and results were postive. The safety of MSC-based gene delivery remains to be controversial. The interactions between MSCs and host tumor cells need to be investigated.

Objective To evaluate the clinical effects of the interlocking intramedullary nails in treatment of the floating knee. Methods Internal fixation with the interlocking nail in unilateral femur and tibia was performed on 6 patients with the floating knee, and the treatments of complications were analyzed and summarized. Results After operation the 6 patients were followed up and their X ray films were reviewed after 3, 6, and 12 months respectively. Fractures in unilateral femur and tibia healed at once in 4 patients, the union of one femur fracture delayed in one case and the union of tibia fracture delayed in one case. The knee joint could flex to 80～90 degrees in 5 of the 6 patients, and the other one could flex to 60 degrees. No shortening of the limb occurred in all the patients who healed after 6～18 months. Conclusion As the “floating knee”is a kind of high energy injury, often complicated with injury of important organs, the complication should be treated while the internal fixation be conducted as soon as possible. The interlocking intramedullary nail is a good device with which the function of the limb can recover fast with the postoperative dysfunction of the knee and ankle joints greatly reduced.

The role of consolidating radiation therapy (RT) is very controversial in Hodgkin lymphoma (HL),especially in adolescents and young adults (AYA) HL.The key problem is how to achieve better therapeutic effect but bear less toxicities in chemotherapy and radiotherapy,which will be hopefully solved by clinical trials adopting interim positron emission tomography (iPET) scanning to guide therapy for HL.The new technologies including whole genome amplification (WGA),high-throughput gene sequencing (NGS) assay and genome-wide association study (GWAS) further illustrate abnormal signaling pathways in HL,such as NF-κB,JAK/STAT and PI3K pathway,which may provide new therapeutic targets for the disease.

Lenalidomide is an oral immunomodulator with multiple functions including immune regulation, anti-tumor, and regulation of tumor microenvironment. Since the United States Food and Drug Administration (FDA) approved lenalidomide for the treatment of mantle cell lymphoma, recent studies have indicated that lenalidomide monotherapy or lenalidomide combinations in other types of lymphoma also has broad prospects. The treatment progress of lenalidomide in lymphoma will be summarized in this paper based on the new reports in the 57th American Society of Hematology (ASH) annual meeting.

With the recent success of the Bruton's tyrosine kinase (BTK) inhibitor, ibrutinib, and the phosphoinositide-3-kinase (PI3K) inhibitor idelalisib in the treatment of patients with relapsed or refractory chronic lymphocytic leukemia (CLL), a number of new agents targeting the B cell receptor (BCR) pathway are in clinical development. In the 57th American Society of Hematology (ASH) annual meeting, great interests are still focused on these two drugs, either monotherapy or combination in the treatment of CLL. On the other hand, SYK inhibitors, new BTK and PI3K antagonists are also coming to the forefront, casting a new light on the treatment of ibrutinib/idelalisb-resistant patients. The progresses of BCR pathway inhibitors in CLL will be summarized in this paper based on the reports in the 57th ASH annual meeting.

Early stage Hodgkin' s lymphoma (HL) is highly curable with abbreviated chemotherapy plus involved-filed radiotherapy or chemotherapy alone,but the role of radiation remains the subject of debate and disagreement.The management of recurrent or refractory HL remains challenging with limited effective treatments except high dose therapy with autologous stem cell transplantation.Emerging new safe and effective drugs such as brentuximab vedotin might promisingly improve the outcome of these patients in the future.The interim positron emission tomography (PET-i) scan has important prognostic value in patients with early and advanced stage HL,especially PET scan after 2 cycles.However,the PET-i guided treatment decisions are not currently recommended outside clinical trials.

Follicular lymphoma (FL) is a kind of indolent Non-Hodgkin lymphoma (NHL),which stems from follicle germinal center.A lot of research reported the latest development about treatment of FL in the 56th American Society of Hematology (ASH) annual meeting.Effect of radiotherapy for patients at low stage was determined,while the outcomes of clinical trials in which monoclonal antibody (GA101) in combination with chemotherapy for the advanced stage FL were exciting.In rituximab era,relapsed/refractory FL patients who receive stem cell transplantation could acquire preferable remissions.Several novel drugs (inhibitor of BTK or PI3K) for relapsed/refractory FL played a role of guidepost with the progression of corresponding trials.

Diffuse large B cell lymphoma (DLBCL) is one of the most common non-Hodgkin lymphoma (NHL).Since the appearance of rituximab,the most common first-line therapy is rituximab in combination with chemotherapy.About 70 percent of patients could achieve complete remission (CR) and be cured finally.But one third of patients could not reach CR after frontline treatment or relapse early,especially the elder patients or high risk ones.In the 56th American Society of Hematology (ASH) annual meeting,a plenty of treatments focusing on these patients brought encouraging results,which makes it possible to further improve the CR rate.The progresses in relapse/refractory,high risk and special site DLBCL will be summarized in this paper based on the reports in the 56th ASH annual meeting.