1.Precision therapeutic strategies for Hodgkin lymphoma
Journal of Leukemia & Lymphoma 2017;26(6):372-375
Hodgkin lymphoma (HL) is a rare subtype of B-cell malignancies, and it often occurs in the youth. About 80 % patients can be cured with the advance of modern therapy. How to further improve the cure rate of HL and minimize adverse reactions are new tasks faced by the clinicians, meanwhile, short-term curative effect and long-term survival rate are worthy of attention. An accurate assessment of disease stage is crucial for the selection of the appropriate therapy. This review discusses the hot issues regarding HL treatments to further improve the precision therapeutics, and to provide more references for clinical treatment.
2.Survey of personality traits , anxiety and depression in patients with leukemia
Qingfeng RONG ; Lianrong XU ; Feng TIAN ; Hongmei WANG
Journal of Leukemia & Lymphoma 2017;26(6):349-352
Objective To investigate the personality traits, anxiety and depression in patients with leukemia. Methods A cross-sectional survey was performed in 120 patients with leukemia and 118 age and gender-matched controls. Personality was assessed using the Type A Behavior Pattern Questionnaire (TABPQ). Emotion was ascertained using the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). The relationship between personality type A and anxiety and depression was evaluated by Pearson correlation analysis. Results The prevalence of personality type A was significantly higher in patients with leukemia than healthy controls [71.67 % (86/120) vs. 30.51 % (36/118), P< 0.01]. Patients with leukemia also had higher prevalence of anxiety and depression compared with healthy controls [36.67%(44/120) vs. 9.32%(11/118), P< 0.01; 29.17 % (35/120) vs. 5.93 % (7/118), P< 0.01]. Pearson correlation analysis showed that time-hurry (TH) and competition-hostility (CH) of personality type A correlated positively with anxiety (r=0.292, r= 0.277, respectively; both P< 0.05). Conclusion TH and CH of personality type A are associated with anxiety in leukemia patients.
3.Effect of quality control cycle on reducing the false negative rate of minimal residual disease of flow cytometry in patients with acute myeloid leukemia
Jing DING ; Hui CHENG ; Min LIU ; Mengqiao GUO ; Shenglan GONG ; Chongmei HUANG ; Jianmin YANG ; Gusheng TANG
Journal of Leukemia & Lymphoma 2017;26(6):345-348,352
Objective To analyze the application of quality control cycle (QCC) in reducing the false negative rate of minimal residual disease (MRD) of flow cytometry in patients with acute myeloid leukemia (AML). Methods In AML patients with abnormal fusion gene detected in hematology laboratory of Changhai Hospital during the year of 2014, the prevalence of AML-MRD detected both by flow cytometry (FCM) and real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) were analyzed retrospectively. The possible causes of false negative rate of flow cytometric MRD referring to PCR were further deeply analyzed, and the improvement measures were adapted from January 2015 to December 2015 and further judged all according to the QCC methods. Results Pareto diagram showed that the dilution and coagulation of the specimen, the improper analysis strategy and the incomplete combination of the MRD index [composition ratio:83.3 % (60/72)] were the main factors leading to the leakage of FCM MRD in 2014. The QCC group devised measures to reduce the dilution probability of bone marrow and develop a standard operating procedures (SOP) for sampling and testing, strengthen the maintenance of the flow instrument and more importantly, focused on optimizing the antibody panels and gated strategies referring to the current two main kinds of MRD detection combination modes on the basis of the latest advances published in 2015. Finally, the undetected rate of AML-MRD was reduced by FCM from 14.8 % (72/486) in 2014 to 2.6 % (16/620) in 2015. Conclusions The QCC can effectively reduce the leakage rate of flow cytometric AML MRD, improve the ability of laboratory quality control and the ability to solve problems. Solving problems with QCC is thus worthy of being popularized.
4.Resistance mechanism of bortezomib in multiple myeloma
Journal of Leukemia & Lymphoma 2017;26(5):308-313
Bortezomib (BTZ), being the first proteasome inhibitor, has been applied widely in clinic. Through combining with targeting β5 subunit/chymotrypsin-like and inhibiting the activity of proteasome reversibly, BTZ manages to inhibit intracellular degradation of protein, thus inducing apoptosis of myeloma cells. Since 2000, when BTZ was approved by Food and Drug Administration (FDA) for treatment of multiple myeloma (MM), both response rates and long-term survival time of these patients have been improved significantly. However, most patients will inevitably end up with relapse or drug resistance due to its high heterogeneity. Thus, it is of great necessity to explore the mechanism as well as overcome BTZ resistance. This review aims to summarize the current researches available on mechanisms of BTZ resistance in MM.
5.Application of monoclonal antibodies in multiple myeloma
Journal of Leukemia & Lymphoma 2017;26(5):305-308
The survival time of multiple myeloma (MM) patients has been significantly prolonged due to improvements in therapy with the addition of novel agents, however, it's inevitable for some MM patients to have drug resistance. A certain number of MM patients can benefit from a new therapy, namely monoclonal antibodies (mAbs). This paper reviews the advances of mAbs in MM therapy.
6.Clinical observation of intermedium-dose cytarabine for consolidation therapy of elderly patients with acute myelogenous leukemia
Menghuan CHEN ; Silin GAN ; Hui SUN ; Yanfang LIU ; Zhongxing JIANG ; Dingming WAN ; Xinsheng XIE ; Jie MA
Journal of Leukemia & Lymphoma 2017;26(5):276-279
Objective To investigate the effect of postremission consolidation therapy with intermedium-dose cytarabine (MDAC) in elderly patients with acute myelogenous leukemia (AML). Methods Clinical data of 61 elderly AML patients (except M3) in postremission who achieved complete remission (CR) in two period of remission induction program were retrospectively analyzed. Results There were 26 cases in MDAC group and 35 cases in standard-dose cytarabine (SDAC) group. In MDAC group and SDAC group, the relapse free survival (RFS) time were 42.7 months and 16.0 months respectively (P= 0.002), the overall survival (OS) time were 44.6 months and 18.2 months respectively (P= 0.004), and the cumulative relapse frequencies rates were 26.9 % (7/26) and 54.3 % (19/35) respectively (x 2= 4.567, P= 0.033). However, 3 years OS rate of the two groups were 23.1%(6/26) and 8.6%(3/35) (x 2=2.496, P=0.114) , and there was no significant difference in the incidence of adverse reactions between the two groups (all P > 0.05). Conclusion MDAC could improve RFS and OS for the elderly AML patients in postremission who received CR in the early stage, and the incidence of adverse reactions is similar to that of SDAC.
7.Prognostic value of FLT3-ITD detection on acute myelogenous leukemia by DNA extracted from stored bone marrow slides by chemical method
Yunying HUANG ; Hui SHANGGUAN ; Baozhen WANG
Journal of Leukemia & Lymphoma 2017;26(5):272-275
Objective To investigate the prognostic value of Fms-like tyrosine kinase3, intenal tandem duplication (FLT3-ITD) detection by DNA extracted from stored bone marrow slides in chemical method. Methods Trace DNA was extracted from 58 bone marrow slides which were stored for 1-5 years below 20 ℃, including 48 patients with de novo acute myeloid leukemia (AML) and 10 controls without hematologic malignancies. Polymerase chain reaction (PCR) was used to detect the FLT3-ITD of these bone marrow slides samples. Results There were 6 patients of FLT3-ITD+ detected in these 48 AML patients (12.5 %, 6/48). No FLT3-ITD was found in 10 healthy controls. AML patients with FLT3-ITD+ had low complete time compared with FLT3-ITD-patients (x2= 7.274, P= 0.007). Splenohepatomegalia and FLT3 mutation were the risk factors affecting AML patients with CR after the first chemotherapy (OR= 7.2, P=0.12; OR=36.3, P=0.10). FLT3-ITD was a risk factor of poor prognosis in patients with newly diagnosed AML (RR=9.088, P= 0.029). Conclusion Extraction of AML bone marrow slides trace DNA by using chemical method can be widely applied in clinic and is a key experimental way to study the molecular biology retrospectively. Furthermore, the detection of FLT3-ITD by trace DNA extracted from stored bone marrow slides can be used to predict the prognosis of AML.
8.Expression of programmed death 1/programmed death ligand 1 signaling pathway in lymphoma
Journal of Leukemia & Lymphoma 2017;26(5):317-320
The latest study shows that the expression abnormalities of programmed death 1/programmed death ligand 1 (PD-1/PD-L1) signaling pathway in a variety of solid tumor tissues and cells are related to disease progression and poor prognosis, and directly involve in tumor immune escape, becoming the recent focus. With the further research, PD-1/PD-L1 signaling pathway in blood diseases, for example, in the development of lymphoma, is catching more attention gradually. The signaling pathway not only is associated significantly with malignancy, progression, recurrence of lymphoma and prognosis of patients, but probably becomes a new target for cancer immunotherapy. This paper summarizes the expression and research status of the biological characteristics and mechanism of PD-1/PD-L1 signaling pathway in lymphoma, in order to provide a new way for lymphoma treatment.
9.Progress in preconditioning regimen of autologous hematopoietic stem cell transplantation for treatment of multiple myeloma
Journal of Leukemia & Lymphoma 2017;26(5):313-317
High-dose melphalan (Mel) is considered as a current standard preparative regimen in autologous stem cell transplantation (ASCT) for multiple myeloma (MM). Irradiation in total body (TBI) combined with Mel is not superior to Mel alone, and the adverse reactions are increased at the same time. The efficacy of 200 mg/m2 Mel is much better than that of 100-140 mg/m2 Mel in young patients. Several regimens including MelBU, TBC, BCV, MET, MTC, MelBCNU, VMel, MTC as well as bendamustine have similar treatment outcomes compared with 200 mg/m2 Mel. Other strategies need to be evaluated in different trials.
10.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.